#035 Alex Manos - Why You're Always Tired: CFS Root Causes Exposed
Alex Manos has over 15 years experience supporting people regain and optimise their health. He started as a personal trainer and massage therapist before studying at the renowned Institute Of Optimum Nutrition where he certified as a Nutritional Therapist. He went on to gain his MSc in Personalised Nutrition while also studying with The Institute Of Functional Medicine. In 2016 he became one og 18 certified Functional Medicine Practitioners in the U.K. Most recently, he has certified as a breathwork facilitator, as well as a Psychedelic Practitioner.
Away from coaching clients 1-2-1, Alex is a co-founder of Healthpath. a company that offers advanced gut microbiome testing, and the CWO of Exhale Coffee.
It is Alex's dream to own a plot of land, where he and his family grow some of their own produce, have a close connection to the local farms, and offer a truly holistic, comprehensive and transformative approach to health and wellness to those that come and stay.
> During our discussion, you’ll discover:
(00:04:23) What is Healthpath and how is Alex involved
(00:07:16) What is Chronic Fatigue Syndrome (CFS)
(00:11:39) Potential triggers of CFS
(00:21:13) Can environmental toxins be a trigger
(00:27:48) How to start finding the causes of your CFS
(00:33:15) Can tracking your HRV provide good information
(00:39:26) How stress can contribute to CFS
(00:53:01) How the body falls into a CFS state
(00:55:33) The downstream effects of CFS
(01:05:28) Mitochondrial dysfunction and CDR
(01:10:33) The vagus nerve
(01:18:06) Lifestyle and diet interventions for CFS
(01:28:44) Sleep
(01:34:41) Gut health
(01:43:50) Detox
(01:47:14) Hormones
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Transcript
Welcome to the VP Life Podcast, the show
Speaker:where we bring you actionable health
Speaker:advice from leading minds.
Speaker:I'm your host, Rob.
Speaker:My guest today is Alex Manos, a
Speaker:functional medicine provider who
Speaker:specializes in working with individuals
Speaker:with chronic fatigue syndrome.
Speaker:Expect to learn the history of chronic
Speaker:fatigue syndrome, also known as malleGic
Speaker:and cephalomyelitis we can say that three
Speaker:times for OST the triggers and root
Speaker:causes of chronic fatigue syndrome and
Speaker:actionable steps you can start taking
Speaker:today to reclaim your life.
Speaker:Now, on to the
Speaker:conversation with Alex Manos.
Speaker:Good morning, Alex.
Speaker:It's great to have you join us today.
Speaker:It's going to be quite the episode, I
Speaker:think, and the timing for our discussion
Speaker:today is actually pretty ideal.
Speaker:As it wraps up the last few podcasts I've
Speaker:done on mitochondrial dysfunction,
Speaker:cellular metabolism, NCAS,
Speaker:environmental toxins, etc.
Speaker:Anyway, you're at the start of our
Speaker:conversation today, but before we sort of
Speaker:dive into CFS and how individuals should
Speaker:start thinking about the condition and
Speaker:how they can manage it themselves, would
Speaker:you mind just introducing yourself and
Speaker:how you ended up in this sort of
Speaker:functional nutrition space?
Speaker:Yeah, well, thank you
Speaker:for having me on, Robert.
Speaker:It's been taking us a
Speaker:while, but we're here.
Speaker:So yeah, I guess my story, keeping it
Speaker:short, is I had a long history of IBS,
Speaker:ultimately, as a child and teenage.
Speaker:I eventually got diagnosed
Speaker:when I was 18 from the GP.
Speaker:And as anyone who's been diagnosed knows,
Speaker:I got given some peppermint oil capsules
Speaker:and was told that I'm just going to have
Speaker:to figure out a way to
Speaker:manage it ultimately.
Speaker:And it really did peak when I was 18.
Speaker:So in regards to the severity,
Speaker:there were times when I was in a fetal
Speaker:position holding my stomach just with
Speaker:crippling abdominal pain.
Speaker:And I had some of the common symptoms
Speaker:that will come with it.
Speaker:I was napping for up to
Speaker:two hours in the afternoon.
Speaker:I was at boarding school, so everyone
Speaker:else was out playing sports.
Speaker:And I was kind of just in my beds,
Speaker:hunking down, trying to
Speaker:get through to dinner.
Speaker:Brain fog, I had
Speaker:terrible skin growing up.
Speaker:So there was a lot of
Speaker:other things kind of at play.
Speaker:But I think the root of many of those
Speaker:were the fact that I had quite
Speaker:significant digestive
Speaker:imbalances, ultimately.
Speaker:So the gut issues and the inflammation
Speaker:from that also meant that I had a lot of
Speaker:musculoskeletal issues as a teenager.
Speaker:So from 15, 16 onwards, I was just
Speaker:getting injury after injury.
Speaker:So I see a lot of physiotherapists,
Speaker:osteopaths, massage therapists.
Speaker:And I think that a mixture of just my gut
Speaker:issues and seeing these professionals
Speaker:meant that I just started to get a real
Speaker:interest in the human body.
Speaker:And then fast forward to after
Speaker:university, I read a
Speaker:book by Patrick Holford.
Speaker:Well, most of his books, but I read his
Speaker:gut's book, did it to the letter, did it
Speaker:alongside some gut focused hypnotherapy.
Speaker:And within two weeks, every single
Speaker:symptom that I was suffering with
Speaker:completely disappeared.
Speaker:And it just blew my mind.
Speaker:And not just sort of digestive symptoms.
Speaker:I would put my head down on the pillow,
Speaker:fall asleep, and I would
Speaker:wake up eight hours later.
Speaker:I'm not sure I'd ever done
Speaker:that in my life before then.
Speaker:Backaches from a rugby
Speaker:tackle completely disappeared.
Speaker:So there was like a total reset.
Speaker:And from then on, I guess I haven't
Speaker:really looked back in
Speaker:trying to learn more about it.
Speaker:So I went and studied at the
Speaker:Institute of Optimum Nutrition.
Speaker:I went then and got my master's in
Speaker:personalized nutrition.
Speaker:I studied with the Institute for
Speaker:Functional Medicine.
Speaker:And I've kind of branched
Speaker:out a little bit since then.
Speaker:So I've done a diploma in
Speaker:transformational life coaching.
Speaker:I've trained in transformational breath.
Speaker:And I was in the first cohort of the
Speaker:Synthesis Institute Psychedelic
Speaker:Practitioner Training Program as well.
Speaker:So I've kind of tried to add a few more
Speaker:strings to my bow to help people because
Speaker:especially with these sorts of
Speaker:conditions, they're
Speaker:complex, they're multifactorial.
Speaker:And I think the more therapies, for want
Speaker:of a better word, that you can apply, the
Speaker:better our chances of
Speaker:success are ultimately.
Speaker:Yeah, no, that's quite the story.
Speaker:And I know you also are involved in a
Speaker:company called HealthPath, I believe.
Speaker:Yes.
Speaker:Can you tell us a little more about that?
Speaker:Excuse me.
Speaker:Yeah.
Speaker:One of the co-founders of HealthPath and
Speaker:HealthPath Pro, and HealthPath is
Speaker:ultimately a platform whereby the public
Speaker:can get access to some of these sort of
Speaker:functional advanced tests.
Speaker:So we have a gut microbiome test.
Speaker:We have a SIBO breath test.
Speaker:We did have a slide record still test.
Speaker:The lab just stopped running that one.
Speaker:And we have some food
Speaker:sensitivity testing as well.
Speaker:And then essentially, our customers will
Speaker:complete a couple of symptom surveys.
Speaker:One of them sort of more closed-ended
Speaker:questions, one of them sort of more
Speaker:open-ended questions.
Speaker:So we get the context of what's going on
Speaker:with their health, why
Speaker:they've done the test.
Speaker:And I've got a team of nutritional
Speaker:therapists that are looking at those
Speaker:symptom profiles, looking at the test
Speaker:results, and then creating some health
Speaker:plans on the back of kind of that
Speaker:subjective and objective data.
Speaker:So we get a lot of people with IBS, IBD,
Speaker:autoimmune conditions, fibromyalgia,
Speaker:chronic fatigue syndrome, and also just
Speaker:people interested in sort of their
Speaker:microbiome, ultimately, doing the testing
Speaker:to see how much is the gut and the gut
Speaker:microbiome potentially contributing to
Speaker:what's going on for them.
Speaker:So yeah, that's kind of the high level.
Speaker:Now, the CEO is
Speaker:actually an old client of mine.
Speaker:So it's a little bit
Speaker:like Al from XL Coffee.
Speaker:He was an old client of mine.
Speaker:He's the people that got really
Speaker:passionate about health, ultimately, and
Speaker:helping others achieve health.
Speaker:And so Richard Naimi is sort of the true
Speaker:founder of HealthPath, ultimately, who
Speaker:had a lot of health issues and functional
Speaker:medicine really helped him and get his
Speaker:life back on track, ultimately, and
Speaker:wanted to kind of pass that forward.
Speaker:Yeah, no, I think it's an amazing
Speaker:platform you've built.
Speaker:And something that's definitely going to
Speaker:be useful for anyone listening today is
Speaker:they sort of, as we talk about this
Speaker:concept of CFS and how people can start
Speaker:working through it to an extent
Speaker:themselves, but then having something
Speaker:like that platform like that on the back
Speaker:end of that way, they maybe don't
Speaker:necessarily want to or can afford to see
Speaker:a GP or a functional therapist who
Speaker:charges four to 600 pounds an hour.
Speaker:I think that's an incredible service.
Speaker:And just is, yeah, it really does fill a
Speaker:much needed gap in the market.
Speaker:Yeah, I know, Al's an interesting one.
Speaker:I'm still trying to
Speaker:get him onto the podcast.
Speaker:And I was quite distraught to see the
Speaker:other day that they're
Speaker:about to run out of coffee.
Speaker:So I've got to, I made a very quick order
Speaker:while there was still some there.
Speaker:But anyway,
Speaker:all right, CFS, I suppose we
Speaker:might as well jump into it.
Speaker:This isn't a question, ironically, not
Speaker:that I've actually
Speaker:asked in the podcast before.
Speaker:But how would you define CFS, sort of
Speaker:this this concept of milder,
Speaker:conservative, milder as it's also known?
Speaker:Yes, from a clinician's perspective,
Speaker:obviously, there's some interesting
Speaker:history there, if
Speaker:you're familiar with that.
Speaker:But yeah, yeah, it's interesting, I think
Speaker:that there are different definitions by
Speaker:different organizations, which doesn't
Speaker:help the process in some ways.
Speaker:But I guess, you know, the textbook
Speaker:features are going to be someone that is
Speaker:experiencing debilitating fatigue for a
Speaker:period of six months or more, that isn't
Speaker:improved by sleep, and that is
Speaker:exacerbated by physical exertion.
Speaker:And some of those organizations will
Speaker:incorporate additional symptoms.
Speaker:I think there's an American organization
Speaker:that talks about either brain fog,
Speaker:or, oh, I forget now, but one other
Speaker:symptom, one of those has to be included
Speaker:within the criteria to receive the
Speaker:diagnosis, which seems a
Speaker:little bit odd, ultimately.
Speaker:But yes, I think, you know, six months or
Speaker:longer of debilitating fatigue that's
Speaker:impacting day to day quality of life,
Speaker:that isn't improved by rest or sleep, and
Speaker:that is exacerbated by physical exertion,
Speaker:a kind of, I guess, the markers in there
Speaker:in the consensus amongst all of these
Speaker:different organizations.
Speaker:Yeah, that's a fairly sort
Speaker:of simple way of advocating.
Speaker:And I think we're
Speaker:definitely aligned there.
Speaker:I think I mentioned this to Gillian
Speaker:Crowther last week, when we were talking
Speaker:about the cell danger response, which I
Speaker:know we'll touch on a little later.
Speaker:But I think the one silver lining, maybe
Speaker:you could call it, of the pandemic and
Speaker:long COVID is that I brought this idea of
Speaker:sort of recalcitrant, recalcitrant, or
Speaker:persistent viral fatigue into the
Speaker:spotlight, which I think is a good thing
Speaker:as, yeah, well, it is.
Speaker:And while sadly, I don't think we're much
Speaker:closer to really a sort of a one pill
Speaker:solution, I do think at least from a
Speaker:social standpoint that it's broken down
Speaker:some of the stigma around
Speaker:the condition maybe because,
Speaker:well, and I think that's a win for a lot
Speaker:of people because they don't, you know,
Speaker:when you sort of are going
Speaker:through these conditions,
Speaker:well, as you know, you often get sort of
Speaker:told that it's just in your head and it's
Speaker:just, it's not real.
Speaker:I think there's definitely some roots
Speaker:there going back to Gulf War Syndrome,
Speaker:which I think just looking into the
Speaker:history of the condition is quite
Speaker:interesting because everything you've
Speaker:just mentioned is what soldiers from that
Speaker:era came back with, with these mystery
Speaker:illnesses of extreme
Speaker:fatigue, aching joints.
Speaker:And yeah, I think it's just sort of
Speaker:building on that and it's providing just
Speaker:more awareness of the fact that this is a
Speaker:real condition and it's not just this
Speaker:sort of psychosomatic
Speaker:state that people just happen to fall
Speaker:into and then never get out of.
Speaker:But yeah, that's my
Speaker:tangent for the day done.
Speaker:I'll try and keep it at least somewhat on
Speaker:track going forwards.
Speaker:No, no, I agree.
Speaker:And I think, you know, some of the
Speaker:comments that people can receive with
Speaker:chronic fatigue syndrome just perpetuate
Speaker:the whole situation.
Speaker:You know, oh, you look fine, you look
Speaker:healthy, what's wrong
Speaker:with you kind of thing.
Speaker:Like it's it's sort of a silent disease
Speaker:in that way that people can look
Speaker:perfectly well and yet be bed bound
Speaker:because of the severity of their fatigue
Speaker:and other symptoms they're experiencing.
Speaker:So it is incredibly challenging.
Speaker:And I think, you know, it's it's made
Speaker:worse with those sorts of belief systems
Speaker:or comments that we can receive.
Speaker:So, yes, I would agree with
Speaker:you on all of that, Robert.
Speaker:Yeah, no, I think it just at the end of
Speaker:the day, having someone who's just
Speaker:willing to acknowledge that you have an
Speaker:actual issue will move the
Speaker:needle as much as anything else.
Speaker:Yeah.
Speaker:Yeah.
Speaker:Anyway, so sort of to dig into it.
Speaker:I have a few ideas and of course, I
Speaker:suppose this speaks to my framework and
Speaker:understanding of the condition.
Speaker:But I reckon if we start talking about
Speaker:the potential triggers of CFS and then
Speaker:start to look downstream at the sort of
Speaker:more immunological cellular and then sort
Speaker:of the hormonal endocrine systems that
Speaker:are affected, that that
Speaker:should cover most of it.
Speaker:Of course, we'll cover the gut in there,
Speaker:too, which at least from a functional
Speaker:medicine standpoint is really the
Speaker:starting point for a lot of this.
Speaker:From there, I think it would be pretty
Speaker:cool if we put together a basic framework
Speaker:of sorts that the listener can then
Speaker:utilize at least as a starting point if
Speaker:they're trying to troubleshoot these
Speaker:issues themselves and at which point if
Speaker:they do struggle, obviously reaching out
Speaker:to HealthPath or a company like that, I
Speaker:think is a great option.
Speaker:Yeah, does that sound fair enough?
Speaker:Have I missed anything there?
Speaker:Would you sort of agree with that?
Speaker:Yeah, I think exploring all of that is
Speaker:going to be really helpful and there are
Speaker:different lenses that we can
Speaker:take to look at that as well.
Speaker:So I think there's some really
Speaker:interesting concepts that we
Speaker:can kind of cover within that.
Speaker:Yeah, awesome.
Speaker:OK, let's dive into the triggers.
Speaker:Now, of course, before I get into my list
Speaker:of which I have a few and I'd like to
Speaker:discuss those with you, I'd like to sort
Speaker:of get your perspective.
Speaker:As the audience knows, my background is
Speaker:in Biochem and working through some of
Speaker:these issues myself and have helped a few
Speaker:customers through work.
Speaker:But most of what I do is
Speaker:definitely theory-based.
Speaker:I don't have that level of clinical or
Speaker:practical experience that you necessarily
Speaker:do or that you do have.
Speaker:So what do you generally see as being the
Speaker:most sort of obvious triggers, mold, etc?
Speaker:Yeah, so I'm going to potentially
Speaker:contradict myself here, but I'm going to
Speaker:try and explain why I'm
Speaker:going to contradict myself.
Speaker:So if we think about potential triggers
Speaker:of CFSME, you know, we're going to be
Speaker:thinking about microbial.
Speaker:So this could be bacterial, viral,
Speaker:parasitic or fungal.
Speaker:We could be thinking
Speaker:about things like trauma.
Speaker:That will certainly be
Speaker:a contributory factor.
Speaker:We can be thinking
Speaker:about environmental toxins.
Speaker:So mold and mycotoxins, I do think is
Speaker:quite a common contributory factor.
Speaker:And I try and use that term contributory
Speaker:factor because I think
Speaker:that it's rarely one thing.
Speaker:And I'm going to expand on
Speaker:that in a second as well.
Speaker:But we've also got, you know, potentially
Speaker:heavy metals like mercury, toxicity,
Speaker:lead, cadmium that can be
Speaker:contributing here as well.
Speaker:We have obviously there is the gut
Speaker:component, whether that could be related
Speaker:to the microbial part or whether that's
Speaker:related to just intestinal permeability
Speaker:for whatever reason, that intestinal
Speaker:permeability is there.
Speaker:Intestinal permeability
Speaker:being this idea of leaky gut.
Speaker:AKA leaky gut.
Speaker:Yes, thank you.
Speaker:And then also we can think and again,
Speaker:this could blend with the
Speaker:microbial, but oral health.
Speaker:This is kind of one of the
Speaker:new frontiers in the research.
Speaker:Ultimately, what we're understanding
Speaker:about the oral microbiome and our oral
Speaker:health and how this impacts
Speaker:on systemic health as well.
Speaker:And then there can be again, as a
Speaker:contributory factor, I don't think it
Speaker:would ever probably really be
Speaker:considered a trigger as such.
Speaker:But food, you know, food allergies, food
Speaker:sensitivities, food intolerances could
Speaker:potentially be contributing to a reduced
Speaker:ability of the cell to produce energy,
Speaker:which is fundamentally
Speaker:what we're talking about here.
Speaker:Now, there are two things I want to add
Speaker:to this, which is if the cell has reduced
Speaker:capacity to produce energy, then none of
Speaker:these things really work anyway.
Speaker:So you've got suddenly this
Speaker:bi-directional relationship whereby we
Speaker:understand the importance of
Speaker:mitochondrial health and energy
Speaker:production in maintaining an intact gut
Speaker:lining and in
Speaker:maintaining a healthy microbiome.
Speaker:And therefore,
Speaker:actually, which even came first?
Speaker:Was it a reduction in capacity to produce
Speaker:energy that led to dysbiosis or
Speaker:imbalances within the gut
Speaker:microbiome and leaky guts?
Speaker:Or was it the imbalances in the gut
Speaker:microbiome and leaky gut for whatever
Speaker:reason that may be that then led to
Speaker:reduced capacity of the
Speaker:cell to produce energy?
Speaker:So it's really important, I think, to
Speaker:take that sort of functional medicine
Speaker:systems biology approach where
Speaker:understanding that most of these things
Speaker:we're talking about are all
Speaker:bi-directional relationships.
Speaker:And while that can sounds a little bit
Speaker:daunting and confusing and like, oh,
Speaker:great, what do I do with that then?
Speaker:I think it can also be quite empowering
Speaker:because it means that we can take this
Speaker:sort of multi-pronged approach to
Speaker:supporting the bodily systems, knowing
Speaker:that we're having actually multiple
Speaker:benefits and impacts at the same time.
Speaker:And just the other thing, because I said
Speaker:there were two things I wanted to touch
Speaker:on, was the concept of allostatic load,
Speaker:you know, the accumulative wear and tear
Speaker:on the cell from just life, you know, and
Speaker:our exposome, which is basically our
Speaker:entire life experience and exposures,
Speaker:everything we've breathed, everything
Speaker:we've thought,
Speaker:everything we've eaten, etc.
Speaker:So what we know in the research and what
Speaker:gets discussed a lot is, you know, we
Speaker:basically are going to be experiencing a
Speaker:cumulative wear and
Speaker:tear at a cellular level.
Speaker:And we may hit a threshold whereby we
Speaker:don't have the psycho-emotional
Speaker:physiological resources to maintain
Speaker:homeostasis, to maintain
Speaker:equilibrium, to maintain health.
Speaker:And there is going to be a collapse in
Speaker:our health, in our physiology, in those
Speaker:interconnected bodily systems that is
Speaker:going to manifest for some maybe as CFS
Speaker:ME, but for others maybe
Speaker:as an autoimmune condition.
Speaker:And obviously there's been a discussion
Speaker:anyway around the
Speaker:interconnection there as well.
Speaker:So it is very complex, I think.
Speaker:And I'm really, as I think a lot of
Speaker:people are moving away from this idea of
Speaker:trying to find the root cause, because
Speaker:what I think might look like the root
Speaker:cause when you map out someone's timeline
Speaker:is really just the final
Speaker:straw that broke the camel's back.
Speaker:You've got everything that happened
Speaker:before that, which is why that trigger
Speaker:was the trigger in the first place.
Speaker:So I think this is where sometimes we've
Speaker:got it wrong, whereby someone, let's just
Speaker:say, gets glandular fever.
Speaker:So we think about the Epstein-Barr virus
Speaker:and we go, "Oh, EBV was your trigger, and
Speaker:therefore we just need like an antiviral
Speaker:protocol or a viral protocol,
Speaker:and you'll be back on track."
Speaker:When actually the only reason why the
Speaker:virus became problematic was because
Speaker:often, in my experience, working with a
Speaker:teenager in school, they're often the
Speaker:academic and the athlete, and they've got
Speaker:pressure to get into the
Speaker:university, et cetera, et cetera.
Speaker:There's just an accumulative strain on
Speaker:the systems and it's meant that they've
Speaker:hit their threshold.
Speaker:So I think it's really important when
Speaker:we're thinking about someone's timeline,
Speaker:basically their life story, we're trying
Speaker:to understand where are these stresses
Speaker:and strains, where have they come from?
Speaker:Has it been through courses of
Speaker:antibiotics or has it been through family
Speaker:dynamics or were they bullied or what was
Speaker:their diet like or did they live in a
Speaker:water-damaged property?
Speaker:What infections, what
Speaker:diagnoses have they received?
Speaker:And then you can start to get a little
Speaker:bit more of, I think, a helpful model in
Speaker:regards to this individual, "This is
Speaker:their story, this is their experience,"
Speaker:and then we get a sense of where we might
Speaker:want to go to support them.
Speaker:Yeah, no, I think that just points to the
Speaker:need for a personalised approach.
Speaker:It really does.
Speaker:I think there's just so much chicken and
Speaker:egg when dealing with a condition like
Speaker:this, as you sort of alluded to earlier.
Speaker:I do like the fact that you brought up
Speaker:the concept of an elastatic load.
Speaker:I don't know if you're familiar with Dr. Eric Balc Harvage? Yeah, I think that's a very important point, too, that is to keep the sense of
Speaker:the mischievousness of energy production.
Speaker:And that's consequently, it starts to
Speaker:downregulate itself to the point where it
Speaker:is able to find its own equilibrium again
Speaker:in a reduced state of energy production.
Speaker:So it's trying to find that lowest common
Speaker:denominator where it's essentially still
Speaker:functional, although at a
Speaker:point, I think that's, I like that lens,
Speaker:looking through it as the fact that
Speaker:there's not something wrong, it's just
Speaker:the fact that the cell and the body oil
Speaker:in the specific sense, the area in which
Speaker:is an issue has become downregulated.
Speaker:And yeah, I like that lens, I like
Speaker:looking through that standpoint.
Speaker:Alex, you mentioned heavy metals earlier,
Speaker:and I'd like to ask a
Speaker:quick follow up question there.
Speaker:I think everyone and their aunt generally
Speaker:test positive for heavy metals.
Speaker:I don't know if you see that in clinical
Speaker:practice a lot, but from some of the
Speaker:research I've done, I've noted that when
Speaker:there is a lot of inflammation in the
Speaker:body, for whatever reason, that you're
Speaker:going to then have an inability for the
Speaker:body to properly detox, you're going to
Speaker:have impaired lymph activity, you're
Speaker:going to have compromised maybe bowel
Speaker:flow or hepatic liver function.
Speaker:And then subsequently, you're then going
Speaker:to end up with an accumulation of these
Speaker:environmental toxins.
Speaker:Now I know that there's a lot of
Speaker:bioenvironmental toxins,
Speaker:heavy metals, molds, etc.
Speaker:Now I know there's a lot of talk about
Speaker:this, this at the moment, it's quite
Speaker:invoke, I think, talking about the fact
Speaker:that if you drink water out of any
Speaker:plastic bottle, you're going to be dead
Speaker:and five seconds flat.
Speaker:But do you think that these are necessary
Speaker:and just plain devil's advocate, by the
Speaker:way, because I fully subscribe to the
Speaker:model that these
Speaker:environmental toxins are an issue.
Speaker:But do you think that there
Speaker:are a trigger in their own right?
Speaker:Or are they just a downstream consequence
Speaker:of the body not necessarily being in a
Speaker:position to effectively
Speaker:get rid of these chemicals?
Speaker:I would say both, dependent on the
Speaker:individual, ultimately.
Speaker:So my thinking around this, certainly
Speaker:with heavy metals, if we think of heavy
Speaker:metals, because it's slightly different,
Speaker:you could say in some ways from a micro
Speaker:toxins, for example, but heavy metals,
Speaker:the two primary mechanisms by which they
Speaker:cause havoc on our cells is
Speaker:inflammation, oxidative stress.
Speaker:And therefore, the question becomes, you
Speaker:know, why can some of us be walking down
Speaker:the high street feeling relatively well,
Speaker:asymptomatic, and have positive heavy
Speaker:metal tests or micro toxin tests.
Speaker:And you know, I think you've always got
Speaker:to put the environmental toxin within the
Speaker:context of someone's
Speaker:capacity to deal with it, basically.
Speaker:So what is someone's
Speaker:antioxidant status like?
Speaker:What is someone's immune resilience like,
Speaker:meaning what kind of anti inflammatory
Speaker:sort of approach or
Speaker:benefit can they take?
Speaker:So I don't think again, it's ever just
Speaker:the micro toxin or just the heavy metal.
Speaker:It is a why is this accumulated as you
Speaker:were sort of alluding to?
Speaker:And secondly, have you lost capacity to
Speaker:manage that's going back to the
Speaker:allostatic load and this idea that the
Speaker:body's maintaining
Speaker:equilibrium as long as it can do.
Speaker:And therefore, there's going to be a
Speaker:certain amount of heavy metal or micro
Speaker:toxin mold, it can accumulate and
Speaker:maintain homeostasis.
Speaker:And that level that it can accumulate is
Speaker:going to be based on your anesthetic
Speaker:load, your nutrient status, your bio
Speaker:flow, everything, your overall health and
Speaker:your overall physiological function.
Speaker:So again, it's got to just be put within
Speaker:the context of the body and the person
Speaker:and how they're able to handle that
Speaker:ultimately, what's their overall
Speaker:resilience like within this?
Speaker:Because it's true, you know, inflammation
Speaker:will absolutely down regulate various
Speaker:liver enzymes that detoxify some of these
Speaker:things, but also chronic stress will down
Speaker:regulate detoxification because you're
Speaker:distributing your resources according to
Speaker:the state of that nervous system.
Speaker:So if you've got someone who is in some
Speaker:state of fight or flight, let's just say
Speaker:they have an aura ring and you know,
Speaker:their HRV is down in
Speaker:the 20s all the time.
Speaker:That is someone who isn't in a state to
Speaker:heal, you know, they are in a mobilized
Speaker:state whereby at a cellular level, they
Speaker:are in a state of stress, they are
Speaker:unsafe, there's danger
Speaker:somewhere that is being detected.
Speaker:And therefore, resources are being
Speaker:distributed to fight or flight or freeze.
Speaker:And again, you are going to get an
Speaker:accumulation of environmental toxins, you
Speaker:are going to get compromised digestive
Speaker:health, you're going to get compromised
Speaker:gut lining health, because those things
Speaker:just aren't important
Speaker:to that point in time.
Speaker:So I think there are some real
Speaker:foundational pieces that have to be
Speaker:considered before even sort of thinking
Speaker:about what's the appropriate protocol for
Speaker:this person, based on any of that kind of
Speaker:functional testing that you might have
Speaker:done, because, you know, they might have
Speaker:SIBO, a good chunk of
Speaker:people with CFS do have SIBO.
Speaker:But is that because of the
Speaker:state of their nervous system?
Speaker:And actually, if you support them in that
Speaker:side of things, then
Speaker:the SIBO just disappears.
Speaker:So yeah, it's just another key
Speaker:consideration,
Speaker:ultimately, within all of this.
Speaker:So yes, you like going back to your
Speaker:question a little bit there, Robert, if
Speaker:someone's got a positive
Speaker:environmental toxin test,
Speaker:and I don't have I don't know if there's
Speaker:like an obvious answer here or black and
Speaker:white answer, there never really is.
Speaker:But if you were able to improve their
Speaker:nutrient status, if you were able to
Speaker:reduce the oxidative stress, if you were
Speaker:able to reduce the inflammation in kind
Speaker:of independent of that toxic burden, to
Speaker:some degree, you
Speaker:would be able to do that.
Speaker:Would that person get noticeable
Speaker:improvement in symptoms, but still have a
Speaker:chunk of that trigger or
Speaker:environmental toxin left?
Speaker:And I believe, yes, you
Speaker:know, that's quite possible.
Speaker:So do we need to get do we need to detox
Speaker:totally and get like a
Speaker:negative test result?
Speaker:Or actually, do we just need
Speaker:to get them feeling better?
Speaker:You know, and that's where you know, you
Speaker:never really want to be treating the test
Speaker:results or the page.
Speaker:Yeah, no, I couldn't
Speaker:have said a bit of myself.
Speaker:And yeah, I think it really does speak to
Speaker:the importance of looking at a client's
Speaker:symptoms, or what patient's symptoms or
Speaker:an individual symptoms and sort of
Speaker:acknowledging those as maybe the
Speaker:benchmark of health.
Speaker:I think a lot of practitioners, at least
Speaker:in my experience, maybe not a lot, but
Speaker:maybe neuro practitioners tend to sort of
Speaker:get caught up with the
Speaker:number that's on the page.
Speaker:And I think that can sometimes be to the
Speaker:detriment of the individual in question.
Speaker:Definitely.
Speaker:Yeah, just sort of,
Speaker:I sort of I'd like to
Speaker:move on in a second.
Speaker:But for the listener,
Speaker:we've discussed a lot of triggers,
Speaker:everything from some sort of the some
Speaker:from, yeah, viral infections, to
Speaker:bacterial infections, things like tick
Speaker:bites, to potential molds and mycotoxins.
Speaker:For those listening who maybe are just
Speaker:sort of trying to figure this out
Speaker:themselves to start with, how do you how
Speaker:would you advise them to start when there
Speaker:isn't necessarily an obvious
Speaker:sign of or beginning or trigger?
Speaker:Obviously, if you have something
Speaker:potentially like Lyme disease, there's
Speaker:going to be a bullseye rash in all
Speaker:likelihood, that's a pretty good
Speaker:indicator of where the issue sort of
Speaker:starts has started off.
Speaker:But for individuals who just sort of
Speaker:slowly enter this sort of malaise of
Speaker:dysfunction, how do you normally sort of
Speaker:work through that process when there
Speaker:obviously is a lot going on, but there's
Speaker:sort of, yeah, like, as I said, and sorry
Speaker:for being verbose, no sort of clear
Speaker:signal, as it were, as to what's maybe
Speaker:initiated the problem?
Speaker:Yeah, it's a good question, especially
Speaker:when there isn't sort of
Speaker:an obvious trigger as such.
Speaker:I think you know, you always want to be,
Speaker:you always want to be
Speaker:thinking about that timeline.
Speaker:So one of the analogies I use is, you
Speaker:know, we're trying to get to the first or
Speaker:first few dominoes that fell over and
Speaker:pick those back up to have any chance of
Speaker:obviously dealing with the rest.
Speaker:So when we think of like cellular energy
Speaker:production, there are some real
Speaker:foundational things that
Speaker:would need to be ruled out.
Speaker:And again, I think one of the challenges
Speaker:we have with kind of CFS me is, is the
Speaker:breadth of debilitation, if that's the
Speaker:right word, like some people are still
Speaker:working, but are struggling with their
Speaker:chronic fatigue syndrome, some people are
Speaker:totally bed bound and can
Speaker:barely hold a conversation.
Speaker:And they're all put under the same
Speaker:umbrella
Speaker:fundamentally, which is just crazy.
Speaker:And I think that's why there's, there's a
Speaker:lot of friction and a lot of heat in some
Speaker:of these kind of conversations, because
Speaker:actually, who are we talking about?
Speaker:These are two very
Speaker:different types of people.
Speaker:But you know, if we think of, if we try
Speaker:and maybe go through the entire spectrum,
Speaker:we're thinking, okay,
Speaker:what's your nutrient status?
Speaker:Because for some people, it could be, you
Speaker:know, like an iron deficiency anemia, or
Speaker:a B12 deficiency that's actually
Speaker:contributing to that fatigue.
Speaker:So at the early stages, there are some
Speaker:really basic things that obviously have
Speaker:to be really ruled out.
Speaker:We will do want to be
Speaker:thinking around gut health.
Speaker:So then we start thinking about how many
Speaker:courses of antibiotics have you had?
Speaker:And what's your diet been like over
Speaker:different stages of life?
Speaker:Ultimately, what's your
Speaker:alcohol intake been like?
Speaker:What's your sort of drug sort
Speaker:of intake or usage been like?
Speaker:I think adverse childhood events is a
Speaker:really big one as well.
Speaker:So that has to be considered.
Speaker:And, you know, understandably, the public
Speaker:often don't understand there can be a
Speaker:connection between those first few years
Speaker:of life and why you ended up with a
Speaker:disease when you were 40, for example,
Speaker:but we see in the research partly related
Speaker:to this idea of allostatic lows, that
Speaker:there's a real connection there.
Speaker:So I do think going back to day one, if
Speaker:not earlier, is actually a really
Speaker:important way to sort of move forward to
Speaker:ensure we're not missing
Speaker:any pieces of the puzzle.
Speaker:You know, questions around have you lived
Speaker:in a property that's had any visible
Speaker:mold, or just a historical water leak?
Speaker:Or do you feel better when you're out of
Speaker:your property on
Speaker:holiday or visiting a friend?
Speaker:Or have you noticed sort of symptoms
Speaker:coming on when
Speaker:entering certain properties?
Speaker:Just to get a sense of if there is
Speaker:anything there from a sort of mold
Speaker:mycotoxin sort of perspective, what's
Speaker:their oral health like?
Speaker:Do they have any amalgam fillings that we
Speaker:just need to be a
Speaker:little bit mindful about?
Speaker:And these sorts of things.
Speaker:So I think it's just it's a mixture of
Speaker:understanding someone's actual just
Speaker:journey, and the key events within it,
Speaker:and then asking specific questions that
Speaker:are the best we can do to get a sense of
Speaker:do we need to go further with this
Speaker:inquiry, which might be then a mycotoxin
Speaker:test or whatever it may be.
Speaker:You know, have you been
Speaker:knowingly bitten by a tick?
Speaker:Or, you know, did you have a dog?
Speaker:Have you lived in the countryside?
Speaker:These sorts of things can
Speaker:all be considered as well.
Speaker:I've had a couple of clients just spring
Speaker:to mind who, you know, moved into a
Speaker:property that was rural, and it was
Speaker:surrounded by fields, and they were just
Speaker:aware of the tractors spraying stuff all
Speaker:over the crops that
Speaker:they were surrounded by.
Speaker:And you just start thinking, okay, there
Speaker:could very much be an environmental
Speaker:exposure there, that has been
Speaker:contributing to why they're
Speaker:now feeling the way they do.
Speaker:So even little things like that, that if
Speaker:you don't ask the question, you might
Speaker:never know that they live surrounded by
Speaker:fields that are sprayed with all sorts of
Speaker:different pesticides, herbicides,
Speaker:fungicides throughout the year.
Speaker:So yes, I think a mixture of questioning
Speaker:and just plotting someone's timeline.
Speaker:You know, what was
Speaker:the first 10 years like?
Speaker:What were your teenage years like?
Speaker:What happened in your 20s?
Speaker:And then, you know, asking the specific
Speaker:questions just to try and
Speaker:rule in or rule out any of that.
Speaker:Did you have glandular fever,
Speaker:etc.
Speaker:So I think, you know, that's the that's
Speaker:the only way to go about it really.
Speaker:And then I do find the HRV monitoring in
Speaker:some people can be really helpful in
Speaker:others is feels really unhelpful and can
Speaker:be just frustrating sometimes.
Speaker:Yeah, that was actually going to be my
Speaker:next question was about HRV.
Speaker:I've always sort of looked at it as more
Speaker:of a performance metric because when you
Speaker:have somebody who is definitely in a
Speaker:state of disease or unwellness, was a
Speaker:better word, their HRV is going to be
Speaker:tanged almost regardless.
Speaker:At least that's been my experience.
Speaker:Again, not a clinician.
Speaker:So I don't necessarily have that hands on
Speaker:understanding of the technology.
Speaker:But do you think it is, I mean, evidently
Speaker:to do, but how do you utilize it from
Speaker:that standpoint, if you
Speaker:sort of get what I mean?
Speaker:Is it a tool that you find is able to
Speaker:provide sort of that longitudinal data
Speaker:that is consistently objectively useful?
Speaker:Or does it just become a bit sort of
Speaker:almost background or shifts?
Speaker:It's a bit like some of these new tests
Speaker:that are looking at DNA methylation that
Speaker:show that you have a high level of
Speaker:information there before you're going to
Speaker:either die tomorrow or
Speaker:in a thousand years' time.
Speaker:They don't necessarily provide a
Speaker:quantitative standpoint
Speaker:of actually what's wrong.
Speaker:Maybe some of the new
Speaker:true age diagnostic tests do.
Speaker:And I'm sorry, I'm just being a verbose
Speaker:again, but they just provide this sort of
Speaker:this blanket statement, i.e. you are
Speaker:inflamed, you have a terrible score.
Speaker:Do you find that to be
Speaker:this similar with HRV?
Speaker:I think I honestly have found it helpful
Speaker:in certain individuals and that's not
Speaker:based on the individual, but more just
Speaker:like the context, what I mean there.
Speaker:So just to give examples,
Speaker:I find one of two things.
Speaker:Either it's really low, you know, it can
Speaker:be in the tens, twenties, low thirties,
Speaker:or it's really high and symptomatically
Speaker:lifestyle that person looks, feels like
Speaker:actually they're in more of like a
Speaker:freeze, functional freeze type states.
Speaker:And in both those situations, I think it
Speaker:can be helpful in the sense that if
Speaker:you've got someone with really low HRV,
Speaker:then you know, we're being informed that
Speaker:that person is in, people
Speaker:call it different things.
Speaker:I've heard it as being
Speaker:called sort of a mobilized state.
Speaker:They're in that kind of fight or flight,
Speaker:they're putting resources to sort of
Speaker:fight or flight and survival ultimately.
Speaker:So they're not detoxing, they're not
Speaker:digesting as well as
Speaker:they could be, etc, etc.
Speaker:That is someone who most likely will not
Speaker:respond to antimicrobials as well as
Speaker:someone who's got better HRV.
Speaker:They're more likely to have a Herxheimer
Speaker:type reaction and therefore you might not
Speaker:even go there to begin
Speaker:with, with that person.
Speaker:You might work on some of the metabolic
Speaker:aspects of things and look to get that
Speaker:heart rate variability up a little bit
Speaker:before going in with antimicrobials to
Speaker:avoid just a Herxheimer
Speaker:die-off type situation.
Speaker:So it can be helpful because it can to
Speaker:some degree inform when is the right time
Speaker:to do the intervention that
Speaker:you are thinking of doing.
Speaker:And at the under end of the spectrum, if
Speaker:you've got someone the way you're
Speaker:thinking that actually it looks like
Speaker:they're in more of a freeze state, then
Speaker:that is someone who is almost guaranteed
Speaker:to have, they're going to have to feel
Speaker:worse before they feel better because
Speaker:they're going to have
Speaker:to move out of a freeze.
Speaker:And with that comes immobilization that
Speaker:might manifest as you
Speaker:know, anxiety, for example.
Speaker:And you know, I just heard I have a
Speaker:friend slash colleague who I really
Speaker:admire, Marek Doyle, who, who would, who
Speaker:shared a kind of a anecdotal story
Speaker:whereby he was warning someone, this was
Speaker:sort of the situation they're in, the
Speaker:plan they put into place led to some
Speaker:anxiety come up and the client thought
Speaker:they were having a
Speaker:negative reaction to the protocol.
Speaker:But Marek monitoring HRV as he does with
Speaker:all of his clients saw that
Speaker:actually HRV was improving.
Speaker:This was someone coming out
Speaker:of kind of a freeze state.
Speaker:And therefore, the reaction they were
Speaker:having, it was something that they were
Speaker:going to have to navigate through.
Speaker:Ultimately, it was like it was a good
Speaker:thing, ultimately, because they were
Speaker:coming out of this state.
Speaker:And that's the only
Speaker:way it's going to work.
Speaker:And you wouldn't have known that if you
Speaker:weren't tracking heart rate variability
Speaker:at that point in time, you might have
Speaker:just agreed with them always
Speaker:sounds like a die off reaction.
Speaker:Yeah, let's back off
Speaker:some of these supplements.
Speaker:So it can help inform you in
Speaker:regards to the interventions.
Speaker:Is it working?
Speaker:Is it not?
Speaker:Is it the right time?
Speaker:Is it not?
Speaker:So I think it can have real
Speaker:value from that perspective.
Speaker:And then if you are able to obviously get
Speaker:improvement month on month, it's just
Speaker:obviously incredibly motivating and
Speaker:inspiring for the clients because they've
Speaker:got this objective biomarker that things
Speaker:are starting to move underneath the hood.
Speaker:And I've certainly had clients whereby it
Speaker:looks like HRV starting to track in the
Speaker:right way, but symptomatically, they
Speaker:haven't yet noticed improvements.
Speaker:So again, it gives them a positive
Speaker:reinforcement that this stuff is working
Speaker:under the hood, things are
Speaker:going in the right direction.
Speaker:You just haven't been able to experience
Speaker:that on a symptom level yet.
Speaker:But we know that what we're doing is
Speaker:having a positive impact on physiology
Speaker:because HRV is starting to trend upwards.
Speaker:So sometimes it can be helpful.
Speaker:And then the reasons I think when
Speaker:sometimes it doesn't work is primarily
Speaker:when it just, you know, it's stuck and
Speaker:it's not trending upwards.
Speaker:And then it just
Speaker:becomes really frustrating.
Speaker:And every morning you're looking at your
Speaker:data going, "Oh, I'm still just where I
Speaker:am and nothing's working."
Speaker:And then you start to get that negative
Speaker:reinforcement that something's broken or
Speaker:I'm not able to get well and actually it
Speaker:becomes a real negative
Speaker:thing.
Speaker:Yeah, I mean, that can be a helpful
Speaker:metric in and of itself.
Speaker:Exactly.
Speaker:Yeah, if you can put it within the right
Speaker:context, if you have the right
Speaker:relationship with the data, it's still a
Speaker:positive thing, ultimately.
Speaker:Yeah, I'd agree with that.
Speaker:Yeah, no, I think you just got to look at
Speaker:as data at the end of the
Speaker:day, a bit like SleepScore.
Speaker:Just, "Okay, this is my SleepScore.
Speaker:And then don't let that sort of influence
Speaker:you because it's going to have that sort
Speaker:of placebo-no-cebo effect if you sort of
Speaker:then sort of feed into it."
Speaker:Just, yeah, I suppose that's actually a
Speaker:good time to maybe talk about the
Speaker:trigger that maybe, and for those
Speaker:listening, I've put that into air quotes,
Speaker:that most people don't think about and
Speaker:something you've already talked more
Speaker:alluded to a few times.
Speaker:And that's this thing about autonomic
Speaker:nervous system dysregulation.
Speaker:Yeah, call it what you will, maybe
Speaker:adverse childhood events, a sort of a
Speaker:heightened limbic system response, a
Speaker:hypothalamic response.
Speaker:But yeah, I think a lot of people don't
Speaker:necessarily think that stress is
Speaker:potentially a major trigger or a trigger
Speaker:in itself for CFS or
Speaker:ME or any fatigue state.
Speaker:This is something sort of I get quite
Speaker:passionate about because I just love the
Speaker:neurobiology behind it, how high levels
Speaker:of stress can sort of influence, yeah,
Speaker:the release of your transcription factors
Speaker:in the cytokines, which then feed down
Speaker:into this vicious circle of driving
Speaker:central nervous system fatigue,
Speaker:upregulating stress hormones and around
Speaker:and around you going.
Speaker:Could you sort of carry that statement
Speaker:forward and discuss why, yeah, it's
Speaker:potentially such an issue?
Speaker:I can try, yeah.
Speaker:So I guess, you know, I kind of do see it
Speaker:as foundational ultimately.
Speaker:And I think the easiest way to think
Speaker:about it is if that autonomic nervous
Speaker:system is dysregulated, you know, that is
Speaker:kind of the conductor.
Speaker:It's dictating to some degree where your
Speaker:resources are being distributed.
Speaker:And if you're not
Speaker:distributing your resources to,
Speaker:you know, as we've already sort of
Speaker:discussed to certain bodily systems or
Speaker:pathways, whether that's the guts,
Speaker:whether it's digestion, whether it's
Speaker:detoxification, whether it's distributing
Speaker:blood flow to the gut lining to maintain
Speaker:an intact gut lining, then you're going
Speaker:to ultimately end up with these
Speaker:downstream consequences that sometimes
Speaker:people confuse with the
Speaker:trigger, like leaky guts.
Speaker:You know, if you're not getting enough
Speaker:blood flow to the cells that line the
Speaker:guts, then you're not able to repair the
Speaker:guts and you will
Speaker:have chronic leaky guts.
Speaker:So a lot of the things that I think we
Speaker:sort of diagnose, so to speak, are often
Speaker:downstream of the initial imbalance, if
Speaker:we just call it that,
Speaker:I guess, ultimately.
Speaker:So I do think sort of autonomic nervous
Speaker:system, dysregulation, limbic sort of
Speaker:dysfunction are common, you know, and
Speaker:again, thinking about this just from our
Speaker:modern way of living and the environment
Speaker:that so many of us are in, you can take
Speaker:that in so many different ways, noise
Speaker:pollution, air pollution,
Speaker:sort of EMFs and going
Speaker:down that sort of rabbit hole.
Speaker:All of this is having some kind of impact
Speaker:on our physiology at an unconscious or
Speaker:sometimes conscious level.
Speaker:So, you know, living by a really busy,
Speaker:noisy road, that is a
Speaker:stressor on your physiology.
Speaker:You know, there's research around that.
Speaker:So my master's dissertation was on
Speaker:cortisol resistance and
Speaker:chronic fatigue syndrome.
Speaker:So again, like you already alluded to a
Speaker:little bit, Robert, this idea of if you
Speaker:are constantly producing excessive levels
Speaker:of cortisol for whatever reason, some
Speaker:kind of stressor, let's just say, the
Speaker:receptors on your cells to cortisol can
Speaker:desensitize, can become resistant, like
Speaker:we think of insulin
Speaker:resistance and type 2 diabetes.
Speaker:And although everyone will know of
Speaker:cortisol as the stress hormone, as many
Speaker:of us also know, it is a potent
Speaker:anti-inflammatory
Speaker:immune modulating hormone.
Speaker:And therefore, if you end up with
Speaker:cortisol resistance, you are not getting
Speaker:that anti-inflammatory immune modulating
Speaker:property that we need
Speaker:and want from cortisol.
Speaker:And this can sometimes manifest in low
Speaker:cortisol in salivary testing, where
Speaker:people go, "Oh, I've got adrenal fatigue.
Speaker:I need to kind of support my adrenals."
Speaker:Actually, that is again, often thought to
Speaker:be an adaptive response.
Speaker:Your bodily has deliberately lowered your
Speaker:free cortisol to free up immune resources
Speaker:to deal with something that you're
Speaker:struggling to deal with,
Speaker:an infection, for example.
Speaker:So I really do, in my heart, believe that
Speaker:the body very rarely,
Speaker:if ever, makes a mistake
Speaker:and that everything we're seeing in test
Speaker:results, or nearly everything, is a
Speaker:deliberate act by the body, by the cell,
Speaker:because it has far more wisdom and
Speaker:intelligence than we do.
Speaker:And then we're trying to figure out
Speaker:what's going on ultimately.
Speaker:So the question is, why
Speaker:would the body do that?
Speaker:Why would the body deliberately do what
Speaker:we're seeing with free cortisol that we
Speaker:just went through, for example?
Speaker:And it's the same with this idea that CFS
Speaker:is a sort of hibernation reduced
Speaker:metabolic state as a way to
Speaker:preserve life, ultimately.
Speaker:It just comes at a huge
Speaker:cost in many other ways.
Speaker:So the body has deliberately done that.
Speaker:And what we need to try and do is
Speaker:obviously understand the accumulative
Speaker:wear and tear and the
Speaker:biggest fish in the pond that's Dr.
Speaker:Neil Nathan sometimes calls it.
Speaker:What are those that if we can act upon
Speaker:and if we can sort of deal with, so to
Speaker:speak, then the body has enough resources
Speaker:to deal with the other stuff that might
Speaker:be accumulating the
Speaker:wear and the tear as well.
Speaker:So there's going to be a tipping point
Speaker:whereby healing spontaneously happens
Speaker:once we've dealt with the excess that we
Speaker:referred to earlier, when we've hit that
Speaker:threshold, where the body no longer has
Speaker:the resources to cope with the strain
Speaker:that is being placed on the system.
Speaker:And this is where we also have to be
Speaker:thinking about our emotional well-being.
Speaker:You know, there's a condition called
Speaker:alexithymia, which is kind of this
Speaker:reduced ability to identify, label,
Speaker:experience our emotions.
Speaker:And one of the theories is that if you
Speaker:have a reduced ability to kind of
Speaker:recognize and identify and label how you
Speaker:are emotionally feeling, there's kind of
Speaker:like, there's another stressor
Speaker:ultimately, because you're not going to
Speaker:be able to act accordingly.
Speaker:You're not going to be able to respond to
Speaker:what is actually happening
Speaker:in your internal landscape.
Speaker:And that's been associated with some of
Speaker:these conditions,
Speaker:certainly IBS and fibromyalgia.
Speaker:I'm pretty sure chronic
Speaker:fatigue syndrome as well.
Speaker:It would totally make
Speaker:sense that it would be.
Speaker:So, you know, I also think that actually
Speaker:some of the most powerful therapies can
Speaker:sometimes be journaling, for example, but
Speaker:not just necessarily journaling without
Speaker:any prompts, but, you know, again,
Speaker:looking at the research and looking at
Speaker:the sort of questions or statements that
Speaker:are being used to prompt people to go
Speaker:deep with their journaling practice.
Speaker:You know, being in the breathwork space a
Speaker:little bit, there are, you know, these
Speaker:stories of people going into a conscious
Speaker:connected breathwork ceremony where
Speaker:they're lying down, eyes closed, music
Speaker:playing, breathing through the mouth for
Speaker:60 minutes, often having some sort of
Speaker:quite profound experience.
Speaker:That could be an emotional release or
Speaker:that could be something psychological.
Speaker:But I know of people who have had chronic
Speaker:fatigue syndrome, who have had
Speaker:significant improvement in symptoms after
Speaker:going through something like a conscious
Speaker:connected breath experience.
Speaker:So, you know, there is that mind body
Speaker:element to this as well, which I think is
Speaker:a really valid route to explore.
Speaker:Yeah, it's definitely,
Speaker:I keep on going forward
Speaker:and backward on that one.
Speaker:I must admit having sort of worked
Speaker:through programs like the Gupta program
Speaker:myself, and maybe not necessarily having
Speaker:seen the results I was after.
Speaker:I do wonder if I do think it works.
Speaker:I just, I'm not, I don't necessarily
Speaker:believe that it's maybe a
Speaker:modality that works off the bat.
Speaker:I still think you have to get that
Speaker:supportive, the supportive basis in first
Speaker:before you can sort of maybe start before
Speaker:you start to deal with the sort of the
Speaker:mind body aspect of it.
Speaker:I'm not denouncing it at all.
Speaker:I just think that you have to have that
Speaker:baseline support and to allow the body to
Speaker:then slowly start at
Speaker:least at a cellular level.
Speaker:And I suppose this gets more into the
Speaker:cell dangerous response stuff that we'll
Speaker:talk about in a bit.
Speaker:After that sort of CDR1, CDR2 state and
Speaker:then back into a position where maybe,
Speaker:yeah, you can then leverage these more
Speaker:broadly speaking, yeah,
Speaker:psychosomatic approaches.
Speaker:Would you agree with that?
Speaker:Yeah, I think it's all of these things
Speaker:are quite frankly a bit hit and miss.
Speaker:And we don't necessarily have a logical
Speaker:explanation as to why it worked for this
Speaker:person and didn't for this person.
Speaker:And it could be all sorts of different
Speaker:little components at the end of the day.
Speaker:But I do like what you say, Robert,
Speaker:because, partly because, you know, we're
Speaker:at a space, I think, where people are
Speaker:really pushing their
Speaker:bias, you know, their thing.
Speaker:And we're at a point where I'm seeing
Speaker:more like somatic practitioners, like
Speaker:dissing functional medicine, because, oh,
Speaker:I had a client come to me and they spend
Speaker:thousands on tests and supplements and
Speaker:they didn't get better and
Speaker:they did my program and did.
Speaker:But it's like, that's
Speaker:true the other way as well.
Speaker:Like it's not, one isn't better.
Speaker:And like a multi pronged approach is
Speaker:always going to give you the most
Speaker:likelihood of success.
Speaker:But I think, you know, there's got to be
Speaker:those foundations in place, as you say.
Speaker:And again, keeping it really basic, this
Speaker:won't be relevant to a lot of people.
Speaker:But if there are some nutrient
Speaker:deficiencies where the cell actually just
Speaker:doesn't have the raw ingredients it needs
Speaker:to create energy, no amount of journaling
Speaker:or breath work or anything is going to
Speaker:touch it, because that's just a pure
Speaker:physiological, biochemistry, biological,
Speaker:whatever root cause that
Speaker:needs to be addressed as that.
Speaker:Now, there are those cases, and I imagine
Speaker:the more we go down the spectrum of
Speaker:severity of kind of chronic fatigue
Speaker:syndrome and the more multi prongs it
Speaker:comes, I think the more likely is that
Speaker:there are some ACEs, that there are
Speaker:environmental toxins at play that are,
Speaker:that is disposed of intestinal
Speaker:permeability, because there's been a
Speaker:greater collapse in physiology and
Speaker:homeostasis, ultimately.
Speaker:So yeah, I think again, it comes back to
Speaker:where is that person
Speaker:within their journey?
Speaker:What have they explored, but also just
Speaker:how severe is their condition?
Speaker:Yeah, no, I really like the way you put
Speaker:that because oftentimes you're, you're
Speaker:going to onto social media, and you'll be
Speaker:struggling with one of
Speaker:these sorts of issues.
Speaker:And again, just to reuse the same analogy
Speaker:from earlier, everybody in the pen there
Speaker:on will have the solution.
Speaker:And it's oftentimes just a
Speaker:fairly narrow viewpoint on this.
Speaker:Okay, so I'm just going to go through
Speaker:this detox program, which may be great.
Speaker:I'm not saying it isn't, but and there's
Speaker:there often a lot of claims that it's
Speaker:that will solve your problem, or you've
Speaker:just got mast cell activation syndrome,
Speaker:and all you've got to do is take
Speaker:quesitin, crumblin, low histamine diet,
Speaker:and Bob's your your be heal.
Speaker:And I think, I think these clinicians or
Speaker:sometimes just people who've worked
Speaker:through themselves, and who are then
Speaker:selling a solution, they really mean
Speaker:well, they really want help.
Speaker:But I think, and I'm not necessarily
Speaker:pointing to them and saying that they're
Speaker:doing anything wrong.
Speaker:But I think people have just got to be
Speaker:aware that that that that as you've
Speaker:highlighted, excuse me, a multi pronged
Speaker:approach is is definitely,
Speaker:well, it just makes sense, you're sort of
Speaker:the more approaches you have, the more
Speaker:likely you are to hit the target.
Speaker:And I think if you sort of go in with the
Speaker:mentality that this one thing is going
Speaker:to, to be your answer, that you're going
Speaker:to be disappointed and ultimately, well,
Speaker:not ultimately, but potentially end up
Speaker:sort of back on the back foot in a sort
Speaker:of state of, well, where is me, life's
Speaker:I'm just been destined to be miserable
Speaker:forever sort of thing.
Speaker:Cool.
Speaker:I'd love to carry on
Speaker:this discussion all day.
Speaker:There is a receptor sensitivity part sort
Speaker:of really sort of litify
Speaker:under me and what I wanted.
Speaker:And we think, yeah, I think if we were to
Speaker:sort of then discuss things like cytokine
Speaker:insensitivity, that would be something
Speaker:else to, well, another
Speaker:rabbit hole to go down.
Speaker:I think if one could figure out how to
Speaker:stop various receptors from becoming
Speaker:insensitive to any
Speaker:input, be it a hormone drug,
Speaker:whatever, you'd probably
Speaker:be a billionaire overnight.
Speaker:But anyway,
Speaker:I reckon it's probably a good time to
Speaker:move on and maybe talk about some of
Speaker:these downstream issues that arise from
Speaker:these triggers that
Speaker:we've really been discussing.
Speaker:But first, I'd just like to the audience
Speaker:to understand that there is almost orders
Speaker:of operations to how the body enters into
Speaker:the sort of aloe static
Speaker:state, the state of dysfunction.
Speaker:Now, I want to keep this very high level
Speaker:and I'd love your feedbacks.
Speaker:And if I miss anything,
Speaker:please feel free to correct me.
Speaker:But the way I see this is that there will
Speaker:be a trigger and I want to find another
Speaker:word now because that
Speaker:one's driving me nuts.
Speaker:But that will ultimately drive some level
Speaker:of inflammation within the body and
Speaker:that's going to be mediated most of the
Speaker:time by the immune system.
Speaker:A good example of this would be, say you
Speaker:have mold as your primary trigger,
Speaker:obviously speaking to the audience here,
Speaker:and that could then be driving high
Speaker:levels of incast of the sort of histamine
Speaker:controlled
Speaker:immunological response in the body.
Speaker:And then consequently downstream of that
Speaker:inflammation, you then end up at least
Speaker:according to Naviocerri, a rubber doctor,
Speaker:rubber Naviocerri, this sort of, this, as
Speaker:we alluded to earlier, this
Speaker:state where the mitochondria become
Speaker:dysfunctional, the cell
Speaker:danger response, as it were.
Speaker:And then downstream of that, again,
Speaker:you're going to end up
Speaker:with hormonal dysregulation,
Speaker:which is where I think some people tend
Speaker:to sort of miss the mark a bit and they
Speaker:end up going straight to HRT because on
Speaker:paper they have a low testosterone or
Speaker:estrogen or whatever when all the results
Speaker:are, all the issues are upstream of that
Speaker:and that the hormones are just a
Speaker:consequence of this sort
Speaker:of dysfunctional physiology.
Speaker:I know that again was very high level and
Speaker:that I miss out a lot of nuance there.
Speaker:But again, just from the sort of order
Speaker:operation standpoint, do you think that
Speaker:sort of sums up how the body sort of
Speaker:enters into this state of dysfunction or
Speaker:anything or did I get it wrong entirely?
Speaker:No, I think that sums up nicely
Speaker:ultimately and easy to understand.
Speaker:Like, I think, as you said, it's really
Speaker:important to stress like the biggest
Speaker:trigger or the final trigger.
Speaker:So if you just think of an individual
Speaker:cell, you know, you've got all of these
Speaker:different stimuli ultimately, and the
Speaker:cell can maintain its
Speaker:health for only so long.
Speaker:So going back to this threshold, then you
Speaker:get exposed to mold or whatever it may
Speaker:be, and yeah, then
Speaker:there's just this collapse.
Speaker:So I think you summarize that sort of
Speaker:dominant sequence nicely.
Speaker:Cool.
Speaker:I'm glad I got something right today.
Speaker:I might actually put in for pay rise.
Speaker:All right.
Speaker:So I reckon the next logical step would
Speaker:be to maybe discuss some of these
Speaker:downstream issues of the
Speaker:trigger in a little more detail.
Speaker:And now I know we could go, there are
Speaker:obviously there are
Speaker:dozens, hundreds of them.
Speaker:But if we were to just touch on the main
Speaker:ones, I think that would be helpful.
Speaker:And talk about things like mast cell
Speaker:activation syndrome, and then maybe dive
Speaker:in a little deeper into the CDR side of
Speaker:things, the mitochondrial dysfunction,
Speaker:would just be helpful to people.
Speaker:As I think that these are generally
Speaker:issues that affect more people than not
Speaker:when it comes to these states.
Speaker:And then again, maybe to talk about the
Speaker:vagus nerve in a little more detail, just
Speaker:to carry on that conversation we had
Speaker:earlier from a, from an autonomic
Speaker:dysregulation standpoint.
Speaker:Are there any more there that you would
Speaker:like to maybe hide for
Speaker:people listening in or?
Speaker:I think the histamine
Speaker:piece is, is really big.
Speaker:I think it's been really big for a long
Speaker:time, but we're only now just starting to
Speaker:really appreciate how big it is.
Speaker:And COVID has definitely sort
Speaker:of been a player within that.
Speaker:But you know, histamine and its
Speaker:contribution from an IBS, CFS, and
Speaker:obviously going through sort of MCAS type
Speaker:stuff, like it's,
Speaker:it's really significant.
Speaker:And I think it is definitely
Speaker:underdiagnosed, misdiagnosed, missed by a
Speaker:lot of practitioners, including myself
Speaker:over the years, obviously.
Speaker:Because partly it can manifest in so many
Speaker:different ways for different people.
Speaker:So in mast cells,
Speaker:we have an abundance of mast cells that
Speaker:infiltrate the gut lining.
Speaker:So in people with IBS, they often have an
Speaker:accumulation of mast cells along the
Speaker:lining of the gut, which is then
Speaker:obviously contributing to some of the
Speaker:symptoms they might be experiencing.
Speaker:And mast cells can be triggered to
Speaker:release their content, which includes
Speaker:histamine, but hundreds of other
Speaker:mediators, obviously, as well.
Speaker:Many are pro-inflammatory.
Speaker:Mycotoxins, heavy metals have been shown
Speaker:to sort of trigger mast cells.
Speaker:Now that's not mast cell.
Speaker:I think I'm right in saying from the
Speaker:paper, it wasn't mast cell degranulation,
Speaker:which we often hear about.
Speaker:It was just literally the mast cell being
Speaker:triggered to release
Speaker:contents from the cell.
Speaker:And this can contribute to, you know,
Speaker:your classic symptoms, sneezing,
Speaker:reactivity, hay fever type stuff.
Speaker:But it could be purely digestive related.
Speaker:It could be cognitive.
Speaker:A brain fog will be a
Speaker:really common scenario there.
Speaker:It can be related to the
Speaker:monthly cycle in females.
Speaker:It can be related to
Speaker:blood pressure regulation.
Speaker:It can be migraines and headaches.
Speaker:Blood pressure?
Speaker:There is a mechanism around certainly the
Speaker:cardiovascular system
Speaker:being influenced as well.
Speaker:Would that have to do with
Speaker:nitric oxide potentially?
Speaker:Yes, that would make sense.
Speaker:Yeah, at least if nothing else, then I
Speaker:imagine nitric oxide at play.
Speaker:I'm not sure what the mechanisms are
Speaker:there off the top of my head.
Speaker:But yeah, I mean, almost most bodily
Speaker:systems can be
Speaker:influenced at the end of the day.
Speaker:Now with IBS, you know, there are studies
Speaker:where they've given an over-the-counter
Speaker:antihistamine and a subset of people get
Speaker:total improvement in their
Speaker:gastrointestinal symptoms.
Speaker:So that kind of shows you the role that
Speaker:it can play within IBS.
Speaker:And with histamine, obviously you've got
Speaker:exogenous consumption
Speaker:from high histamine foods.
Speaker:You've got potential production from gut
Speaker:bacteria that can produce histamine.
Speaker:And then you've got mast cell and
Speaker:basophils that can produce histamine and
Speaker:they both kind of store
Speaker:it within the cytoplasm.
Speaker:So you've got endogenous and exogenous
Speaker:exposures ultimately.
Speaker:And then various environmental toxins,
Speaker:like we've mentioned, can trigger the
Speaker:mast cell to release that
Speaker:histamine that it contains.
Speaker:And we've all got,
Speaker:remotely familiar with histamines,
Speaker:probably heard about the
Speaker:whole histamine buckets.
Speaker:You know, again, we've got a
Speaker:threshold that we can handle.
Speaker:And then when that threshold has
Speaker:exceeded, we're going to be
Speaker:symptomatic fundamentally.
Speaker:And there are two primary ways that we
Speaker:deal with histamine.
Speaker:Sort of the dietary
Speaker:source, we have the DAO enzyme.
Speaker:So you can supplement DAO to help you
Speaker:tolerate dietary histamine ultimately.
Speaker:And for some people, it works wonders and
Speaker:it diversifies the diet
Speaker:again and they're happy as Larry.
Speaker:For others, it doesn't work.
Speaker:And that's just because their issue
Speaker:wasn't a DAO issue, most likely.
Speaker:So again, it's just one of the things
Speaker:that can be at play there.
Speaker:Diamine oxidase being the enzyme that
Speaker:brings down histamine.
Speaker:Yes, correct.
Speaker:Yeah.
Speaker:And that's primarily
Speaker:dietary or exogenous histamine.
Speaker:Now you could have a bacterial overgrowth
Speaker:that is driving histamine if those
Speaker:bacteria are histamine producers.
Speaker:And then we have to go down more of a,
Speaker:let's just call it a microbiome
Speaker:modulating sort of protocol to deal with
Speaker:the overgrowth or at least understand the
Speaker:cause of the overgrowth.
Speaker:And then you've got the environmental
Speaker:triggers of actual mast cells triggering
Speaker:histamine release and
Speaker:releasing it from that perspective.
Speaker:And then there's also the HNMT.
Speaker:I was just going to ask.
Speaker:And I never, I can't
Speaker:remember what it stands for.
Speaker:HNMT.
Speaker:But that's dealing with kind of more
Speaker:endogenous histamine.
Speaker:Now both of those enzymes, DAO and HNMT,
Speaker:as they all require,
Speaker:they have co-factors.
Speaker:So there is copper and
Speaker:B6 among others for DAO.
Speaker:And I think there's zinc
Speaker:and B6 for HNMT among others.
Speaker:So nutrient deficiencies will contribute
Speaker:to kind of your histamine bucket, your
Speaker:histamine threshold and how much you're
Speaker:dealing with there as well.
Speaker:Now DAO can be deteriorated with any
Speaker:damage to the gut lining because that's
Speaker:its primary place of origin, so to speak.
Speaker:So when you do have intestinal
Speaker:permeability, AKA leaky guts or gut
Speaker:information, it's very likely that DAO
Speaker:has been compromised as well.
Speaker:And then MCAS is kind of further down the
Speaker:spectrum again of severity ultimately.
Speaker:So you have histamine intolerance, which
Speaker:is often more of a DAO dietary thing,
Speaker:moving down to MCAS, where now you've got
Speaker:a multi-system, multi-factorial condition
Speaker:that can be
Speaker:incredibly complex ultimately.
Speaker:But we still want to be thinking about
Speaker:what is the trigger.
Speaker:And that could be the things that we have
Speaker:been talking about, infections, toxins,
Speaker:trauma, and these sorts of things.
Speaker:Yeah, no, that was beautifully put.
Speaker:Thank you.
Speaker:And it just it really sort of highlights
Speaker:the fact that these mast cell issues,
Speaker:these histamine issues are a symptom of a
Speaker:bigger issue than not the issue in
Speaker:themselves, which again, I think is what
Speaker:where a lot of people sort of scrolling
Speaker:through social media sort of tend to sort
Speaker:of maybe make a mistake, they sort of see
Speaker:their issue as a histamine issue.
Speaker:The histamine is a symptom of something
Speaker:else that's going on.
Speaker:And just by maybe just taking your
Speaker:chromoly and quercetin or whatever, you
Speaker:aren't actually, maybe you're controlling
Speaker:some of the symptoms, but you're not
Speaker:actually dealing with the picture.
Speaker:It's definitely a very sort of, I don't
Speaker:want to say reductionist because that has
Speaker:a lot of negative connotations.
Speaker:But I think, yeah, it's just sort of
Speaker:cherry picking one specific
Speaker:pathway or one specific issue.
Speaker:And then sort of saying, okay, right,
Speaker:that's my issue and then
Speaker:sort of ignoring the rest.
Speaker:The enzyme that you were thinking about,
Speaker:by the way, was histamine
Speaker:N-methyltransferase, I believe.
Speaker:Thank you.
Speaker:I could be wrong.
Speaker:I've been going through my genetics a
Speaker:little bit, trying to sort of remember
Speaker:some of what I learnt in
Speaker:uni, which was a long time ago.
Speaker:But anyway, but yeah, I think histamine,
Speaker:it definitely is an issue for a lot of
Speaker:people, especially as you alluded to, it
Speaker:can be triggered by so many things.
Speaker:And people who are trying to maybe do the
Speaker:right thing by detoxing are oftentimes
Speaker:going to sort of run into this issue of
Speaker:excess histamine release.
Speaker:People getting into a sauna for too long,
Speaker:because that's great maybe for helping to
Speaker:liberate some heavy metals, that's great.
Speaker:But heat is going to drive up histamine
Speaker:release or a woman who sort of maybe jump
Speaker:onto HRT because they think that this is
Speaker:their solution and then all of a sudden
Speaker:they're taking more estrogen and that's
Speaker:going to sort of drive
Speaker:up histamine release.
Speaker:So yeah, it really is an
Speaker:issue for so many people.
Speaker:And the fact that yeah, it's, and I think
Speaker:that's again where COVID is a bit of a
Speaker:silver lining, because it's just brought
Speaker:this to the forefront, especially when
Speaker:you start looking through the lens,
Speaker:through the lens of long COVID.
Speaker:Now I'm sure we could
Speaker:discuss that all day.
Speaker:And
Speaker:yeah, I had a lovely podcast with Dr.
Speaker:Tina Moore, I'm sure
Speaker:you're familiar with.
Speaker:Yes.
Speaker:For anyone who is listening who wants to
Speaker:dive down the histamine rabbit hole, I
Speaker:highly encourage you to listen to that
Speaker:podcast that we did or
Speaker:any podcast that she's done.
Speaker:She's done a number of
Speaker:podcasts recently, including Dr.
Speaker:John something.
Speaker:Yeah, that escaped me out.
Speaker:We'll link it in the show notes, but
Speaker:she's an excellent source thereof.
Speaker:Let's discuss the mitochondrial piece.
Speaker:CDO, again, we've done a deep dive into
Speaker:this, but from a high level, I think it's
Speaker:important to know why mitochondria sort
Speaker:of break and then maybe we'll discuss
Speaker:what we can do about it a little later on
Speaker:in the episode when we start to put
Speaker:together this
Speaker:framework for folks to follow.
Speaker:But from your vantage point anyway, how
Speaker:do you see
Speaker:mitochondrial dysfunction occurring?
Speaker:And then where do you see this idea of
Speaker:the cell danger response fitting in?
Speaker:So on mitochondria, I read recently, the
Speaker:canaries in the coal mine
Speaker:from a cellular perspective.
Speaker:So as many of us as your listeners would
Speaker:have probably heard, they're an ancient
Speaker:bacteria that sort of co-evolved with an
Speaker:archaea, I think it was, wasn't it?
Speaker:Millions and millions of years ago.
Speaker:So this is why there's the antibiotic
Speaker:piece with mitochondria.
Speaker:But mitochondria are not just the
Speaker:powerhouses of the cell
Speaker:that often we hear them being.
Speaker:They are that, but they are so much more.
Speaker:I mean, they regulate calcium sort of
Speaker:regulation and they have many other roles
Speaker:in including relation to the production
Speaker:of steroid hormones,
Speaker:cholesterol, among other things as well.
Speaker:But mitochondrial dysfunction, you know,
Speaker:the textbook thing is the manifestation
Speaker:is most likely going to be among other
Speaker:things, fatigue because of their role,
Speaker:obviously, in energy production.
Speaker:But mitochondria can be damaged.
Speaker:We can develop mitochondrial dysfunction
Speaker:because of nutrient deficiencies, because
Speaker:of dysbiosis and leaky gut, you know,
Speaker:these lipopolysaccharides or endotoxins
Speaker:can have an impact on mitochondrial
Speaker:function, apparently.
Speaker:Butrate, you know, a metabolite, healthy,
Speaker:good, important metabolite from some of
Speaker:our gut bacteria
Speaker:supports mitochondrial function.
Speaker:We've got xenobiotics and various
Speaker:environmental chemicals that can inhibit
Speaker:mitochondrial function.
Speaker:What else have we got that impacts
Speaker:mitochondrial function?
Speaker:I mean, all of the typical things,
Speaker:inflammation, mycotoxins, they're all
Speaker:going to be impacting it ultimately.
Speaker:So again, mitochondrial dysfunction,
Speaker:there's this kind of camp that think
Speaker:mitochondrial dysfunction is, you know,
Speaker:the cure, you know, the cause of
Speaker:everything and therefore the cure.
Speaker:Because if you can get healthy
Speaker:mitochondria, you can get a healthy cell.
Speaker:And if you have a healthy
Speaker:cell, you have a healthy organ.
Speaker:If you have a healthy
Speaker:organ, you have a healthy system.
Speaker:If you have a healthy system,
Speaker:you have a healthy organism.
Speaker:But as you kind of said, Robert, you
Speaker:know, mitochondrial dysfunction is
Speaker:downstream of these sorts of things.
Speaker:And therefore, we still have to
Speaker:constantly ask the why until we feel
Speaker:we've actually got to the answer,
Speaker:ultimately, like what is the most
Speaker:upstream thing we can get to?
Speaker:And that is the thing that
Speaker:we probably need to focus on.
Speaker:So is it nutrients?
Speaker:It could be the guts from a
Speaker:mitochondrial perspective.
Speaker:Is it some kind of
Speaker:environmental chemical or toxin?
Speaker:Is it trauma?
Speaker:There's a study that was looking at
Speaker:adverse childhood events.
Speaker:And, you know, it's been a long time
Speaker:since I read it, but the takeaway was
Speaker:ultimately that it can contribute to
Speaker:reduced ATP
Speaker:production within mitochondria.
Speaker:So one of the sort of almost mechanisms
Speaker:between early childhood trauma and
Speaker:diseases later in life could be related
Speaker:to mitochondria dysfunction.
Speaker:And essentially, that person just being
Speaker:less resilient as a result on
Speaker:a physical level, so to speak.
Speaker:And then obviously, mitochondria
Speaker:dysfunction, you would have thought, will
Speaker:manifest in certain organs first the most
Speaker:energy dependent organs.
Speaker:So hearts, liver, kidneys, gut lining.
Speaker:And we've already mentioned how
Speaker:mitochondria have a big role to play
Speaker:within maintaining a healthy gut
Speaker:microbiome and a healthy gut lining.
Speaker:So again, are you is the glutamine and
Speaker:zinc carnosine really going to fix the
Speaker:leaky gut if there's some mitochondrial
Speaker:dysfunction, which is
Speaker:actually upstream of that?
Speaker:So yeah, I think mitochondria are really
Speaker:important piece of the puzzle, but it's
Speaker:just important that we don't do what you
Speaker:were saying, Robert, which is, you know,
Speaker:along the lines of take your quercetin
Speaker:and think that you've kind
Speaker:of dealt with it ultimately.
Speaker:So don't take your CoQ10 or whatever it
Speaker:may be and think that
Speaker:you've dealt with it.
Speaker:And within the cell danger response, you
Speaker:know, one of the many changes that
Speaker:happens is the cell membrane
Speaker:obviously becomes more rigid.
Speaker:So the cell membrane, I always remember
Speaker:one of my lecturers and the masters kind
Speaker:of really emphasizing the cell membrane.
Speaker:It is the brain of the cell.
Speaker:The cell membrane is so important for
Speaker:cellular function,
Speaker:and this becomes rigid.
Speaker:So less good stuff gets in, less bad
Speaker:stuff gets out, and it's going into that
Speaker:sort of hibernation or
Speaker:locked down state to survive.
Speaker:And that's where I guess, you know,
Speaker:things like your phospholipid replacement
Speaker:therapy type protocols have some value
Speaker:and some people respond well to.
Speaker:So yeah, I'll pause there.
Speaker:No, again, that was that was perfect.
Speaker:Thank you very much.
Speaker:And again, it just sort of points to the
Speaker:fact that just dealing with the basics,
Speaker:which I know we'll touch on a bit getting
Speaker:in your essential nutrients, it is so
Speaker:important and almost taking this sort of
Speaker:orthomolecular approach, maybe as a first
Speaker:stop is probably for the most part the
Speaker:best place to start for a lot of people.
Speaker:However, we'll get to that in a bit.
Speaker:I'd love it if we could also just quickly
Speaker:sort of backtrack slightly and then talk
Speaker:a little more about the nervous system
Speaker:again, but this time from the standpoint
Speaker:of the vagus nerve, because I think, I
Speaker:mean, this is quite a trigger, but it's
Speaker:also oftentimes a downstream result of a
Speaker:lot of this dysfunction.
Speaker:And there's a lot of chicken and egg
Speaker:going on with the vagus nerve, and the
Speaker:more the vagus nerve gets more
Speaker:dysregulation that happens
Speaker:with regards to the vagus nerve,
Speaker:the more oftentimes an individual is
Speaker:going to end up in a sort of
Speaker:sympathetically dominant state, which
Speaker:actually is going to sort of then trigger
Speaker:that some of at least,
Speaker:yeah, some of the CDR type stuff, some of
Speaker:this mitochondrial dysfunction as well,
Speaker:just by way of increasing the release of
Speaker:catecholamines, all
Speaker:these stress hormones.
Speaker:Now, there's a lot to be said about the
Speaker:vagus nerve, especially around polyvagal
Speaker:theory, which I believe I'm right in
Speaker:saying it, you're fairly well-read and
Speaker:definitely more so than I am.
Speaker:Can we have a quick discussion about that
Speaker:and where that fits into the picture?
Speaker:Yeah, it's been a while since I've talked
Speaker:about this, so feel free
Speaker:to jump in and help me here.
Speaker:But, you know, the vagus nerve obviously,
Speaker:in Latin, I think it's wandering, so most
Speaker:people can picture like the roots of a
Speaker:tree, you've got branches of this nerve
Speaker:innovating all the
Speaker:different organs in the body.
Speaker:And the polyvagal theory put really
Speaker:simply is this idea that there is a
Speaker:hierarchy to the vagus nerve.
Speaker:And we have, let's think about this, we
Speaker:have the ventral vagal and the dorsal
Speaker:vagal, which are parts of this kind of
Speaker:hierarchy, ultimately.
Speaker:And I think the ventral vagal, correct me
Speaker:if I'm wrong here, Robert, but the
Speaker:ventral vagal is kind of the social
Speaker:safety component of this, and the dorsal
Speaker:vagal is kind of the shutdown ultimately.
Speaker:And we can definitely see people who have
Speaker:gone down into this kind of shutdown
Speaker:vagus nerve response.
Speaker:You know, you could almost think about it
Speaker:as the freeze or this
Speaker:hibernation type state, ultimately.
Speaker:And the key theme with the pole polyvagal
Speaker:theory from my perspective, again,
Speaker:keeping this quite high level is the
Speaker:theme around safety.
Speaker:If we don't feel safe, we can see a shift
Speaker:in vagus nerve, and that's obviously
Speaker:going to manifest from a behavioral
Speaker:perspective, but also
Speaker:from a cellular perspective.
Speaker:And there's this really, I think,
Speaker:sensitive sort of topic around, you know,
Speaker:a lot of people struggling with chronic
Speaker:complex illnesses retreat for various
Speaker:reasons, both just because of the
Speaker:debilitating nature of the symptoms, but
Speaker:also because sometimes the comments they
Speaker:receive from friends or family, you look
Speaker:fine, these sorts of things.
Speaker:And, you know, they feel, you know, gut
Speaker:stuff bloated, who wants to go out and
Speaker:have fun and socialize when you feel
Speaker:really bloated, for example.
Speaker:So there's lots of
Speaker:different things that come into it.
Speaker:The problem is, we all know now know the
Speaker:importance of our social
Speaker:lives in regards to healing.
Speaker:So there's this kind of really sensitive
Speaker:conversation sometimes that has to be had
Speaker:around balancing the retreat, which
Speaker:totally makes sense and is understandable
Speaker:with actually engaging in life as a way
Speaker:to support the healing process as well.
Speaker:And that's where I think, you know, the
Speaker:polyvagal theory can be really helpful
Speaker:with this theme around safety and
Speaker:understanding where
Speaker:someone is at within it.
Speaker:I know people that specialize in this
Speaker:will even talk about, dependent on where
Speaker:you are within that hierarchy, that will
Speaker:very much influence the most appropriate
Speaker:form of exercise for you, for example.
Speaker:So it can be very helpful
Speaker:on a clinical level as well.
Speaker:So, yes, that's kind of
Speaker:what comes to mind immediately.
Speaker:That's perfect.
Speaker:Thank you.
Speaker:And again, it just sort of really works
Speaker:to complete that picture of everything
Speaker:that we've discussed up until now.
Speaker:And again, just to sort of hop on about
Speaker:this again, I really encourage the
Speaker:audience to sort of look at their
Speaker:emotional health when it comes to sort of
Speaker:starting to try and work your way through
Speaker:these sorts of issues
Speaker:because it really cannot be,
Speaker:and what's the word, it can't be sort of
Speaker:downplayed as to its importance, how
Speaker:important the nervous system is in
Speaker:regulating the wrist, the body, in
Speaker:regulating how cells communicate.
Speaker:Yeah, and just to touch on that, you
Speaker:know, maybe branched with that is the
Speaker:whole concept of psychoneuroimmunology,
Speaker:you know, the mind, the nervous system
Speaker:and the immune system.
Speaker:These are deeply interconnected systems.
Speaker:So we absolutely have to be thinking
Speaker:about our psyche when we're thinking
Speaker:about the states of our nervous system
Speaker:and our immune system.
Speaker:And we all know the immune system is so
Speaker:interconnected with everything that we're
Speaker:kind of talking about here.
Speaker:So if you wanted like the science,
Speaker:polyvagal theory, yes, but also this
Speaker:psycho neuroimmunology is
Speaker:a really fascinating area.
Speaker:So, you know, it's little practices,
Speaker:giving yourself 10 minutes a day, find
Speaker:yourself a little grounding exercise that
Speaker:could just be coming to the breath and
Speaker:doing some diaphragmatic breathing, feel
Speaker:your feet on the floor, feel your
Speaker:buttocks on the chair, kind of get
Speaker:grounded, get censored as much as you
Speaker:can, and do a little bit of journaling,
Speaker:find some prompts, even if it's using
Speaker:chat GPT, to ask for
Speaker:some journaling prompts.
Speaker:Like there's lots of ways that we could
Speaker:go about that now, but I think it's so
Speaker:helpful because, you know, it's going to
Speaker:be arguably, I think for a lot of us, you
Speaker:know, the safest environment.
Speaker:We're on our own, we're journaling, no
Speaker:one's going to read it, hear
Speaker:it, we can burn it afterwards.
Speaker:And that can be quite a therapeutic sort
Speaker:of ritual to do as well, where you're
Speaker:literally kind of releasing that back
Speaker:into sort of the atmosphere ultimately.
Speaker:But I think those little habits where
Speaker:there's a bit of self-inquiry can be
Speaker:incredibly helpful to help us understand
Speaker:ourselves, which is part of I think the
Speaker:healing process ultimately.
Speaker:Yeah, no, it definitely is.
Speaker:And I love the fact that you touched on
Speaker:the psychoneuroimmunology.
Speaker:Dr.
Speaker:Leo Primrook is an absolute wizard.
Speaker:And I've got a friend who's going through
Speaker:his course at the moment, and she's
Speaker:shared her notes with me.
Speaker:I won't mention her in case she gets,
Speaker:somebody's listening.
Speaker:But yeah, no, I've been going through
Speaker:some of the coursework.
Speaker:And it's, yeah, no, it's everything that
Speaker:you've just described.
Speaker:He really sort of gets
Speaker:this properly nailed down.
Speaker:And anyone who really, really wants to
Speaker:deep dive into this side of it, you
Speaker:definitely have a look at
Speaker:his, what he posts online.
Speaker:Alex, I reckon we've got
Speaker:the basics covered there.
Speaker:I mean, we've only just scratched the tip
Speaker:of the iceberg when it
Speaker:comes to all the potential
Speaker:immunological side of things, not to
Speaker:mention the cut side of things, etc.
Speaker:But for the sake of time and your sanity,
Speaker:I'd love to sort of maybe pivot towards
Speaker:talking about how people can really start
Speaker:to deal with these sorts of issues, at
Speaker:least at a high level.
Speaker:And I'd love it if we could sort of
Speaker:create just again, broadly speaking, a
Speaker:framework that people
Speaker:can start to follow.
Speaker:Again, I know we could go in many
Speaker:directions with this.
Speaker:And we can't get that granular because,
Speaker:as you've alluded to, I mean, there's
Speaker:something like the gut, for example, I
Speaker:mean, you can have, there's three
Speaker:different types of SIBO, for example,
Speaker:each of which could have
Speaker:10 different inventions.
Speaker:So, yeah, I know we can't help anyone,
Speaker:everyone with this sort of framework, but
Speaker:just a way to sort of view it, which I
Speaker:think would be helpful.
Speaker:And then maybe if time allows, we can
Speaker:start talking about some more esoteric
Speaker:ideas like H-Bot and LDN, etc.
Speaker:I think obviously the best place to start
Speaker:off with here would be with obviously the
Speaker:boring, the lifestyle, the diet piece.
Speaker:And then maybe we can sort of pivot into
Speaker:helping people maybe
Speaker:identify their trigger.
Speaker:I think we've already done that to some
Speaker:extent, but maybe we can
Speaker:touch on that again too.
Speaker:And then different strategies to help
Speaker:maybe start to reduce that toxic load to
Speaker:support the adrenals.
Speaker:I know that's a bit hidden-ness.
Speaker:And then, yeah, to support the nervous
Speaker:system, we've discussed that a lot.
Speaker:And I think some
Speaker:strategies there would be useful.
Speaker:And then finally, things like just basic
Speaker:hormonal and mitochondrial support.
Speaker:Again, I think we've, yeah, and this will
Speaker:come through obviously in our
Speaker:conversation, but I just want to point
Speaker:out to the audience that really you do
Speaker:want to sort of follow a framework in
Speaker:this respect, because just going back to
Speaker:our conversation earlier about
Speaker:mitochondrial dysfunction,
Speaker:chances are if you have any sort of
Speaker:lingering fatigue, there's going to be an
Speaker:element of
Speaker:mitochondrial dysfunction to it.
Speaker:However, if you suddenly start taking
Speaker:mitochondrial support, supplements,
Speaker:nutrients, co-cutin, carnitine, all these
Speaker:sorts of particular, these electron
Speaker:donors for the most part, you can
Speaker:sometimes make things worse.
Speaker:One of the byproducts of, as you know,
Speaker:Alex, energy production, oxidative
Speaker:phosphorylation is the production of
Speaker:reaction of oxygen species, ROS, at the
Speaker:end of that particular cycle.
Speaker:And if you're going to feed the body
Speaker:large amounts of these electron donors
Speaker:and antioxidants, well, they are
Speaker:secondary antioxidants, some of them, you
Speaker:can actually make matters worse.
Speaker:So yeah, there really, again, is an order
Speaker:of operations to this where, so I think
Speaker:having this system in place would be, for
Speaker:those listening, quite beneficial.
Speaker:So again, unless I missed anything, and
Speaker:please feel free to correct me on
Speaker:anything that I've said that's wrong,
Speaker:which is probably quite high,
Speaker:I think we should jump into the lifestyle
Speaker:and the diet piece, which
Speaker:is a good place to start.
Speaker:Broadly speaking, where would you have
Speaker:someone start with regards to this?
Speaker:Yeah, so I guess from a dietary
Speaker:perspective, like if I had to, if I had
Speaker:to give like a generic comment around it,
Speaker:it would essentially be moving people
Speaker:towards a paleo style framework, I think,
Speaker:you know, moderate, moderate high
Speaker:protein, moderate high
Speaker:fat, low carb framework.
Speaker:And I think a lot of
Speaker:people will benefit from that.
Speaker:I wouldn't go all the way to keto,
Speaker:obviously, because that can be, again,
Speaker:that can go wrong, especially when
Speaker:there's mitochondrial
Speaker:dysfunction at play.
Speaker:So we'd want carbs in there, but
Speaker:certainly a paleo style framework is
Speaker:probably the easiest, quickest way of
Speaker:describing what is going to be
Speaker:beneficial, I think, for
Speaker:more, the majority of people.
Speaker:Now, ideally, you know, in season, whole
Speaker:food, I actually don't think it without
Speaker:the context of an individual, it needs to
Speaker:be over complicated.
Speaker:So whole food diets, nutrient dense, lots
Speaker:of polyphenols, lots of color, this idea
Speaker:of eat the rainbow a day if you can.
Speaker:Now, oftentimes, people are going to have
Speaker:personal reactions to foods.
Speaker:And the caveat here is I do think, you
Speaker:know, there's a moderate percentage of
Speaker:people that could have a
Speaker:bit of a histamine issue.
Speaker:So, you know, FYI, you might need to go
Speaker:more to a low histamine diet
Speaker:within that framework as well.
Speaker:So it can start to sound much more
Speaker:complicated and have more nuance to it.
Speaker:Once we know about the individual and
Speaker:their unique sensitivities.
Speaker:But yes, I do think, you know, a high
Speaker:protein, high fat sort of breakfast for
Speaker:many people works well.
Speaker:And then really thinking about in season
Speaker:and whole food, and I'm not sure it needs
Speaker:to be more complicated without specific
Speaker:knowledge of the individual, ultimately.
Speaker:Certainly in fibromyalgia, there are
Speaker:studies and I think a meta analysis that
Speaker:basically concluded every single diet
Speaker:that has been trialed has
Speaker:been beneficial for some.
Speaker:So whether that's paleo Mediterranean,
Speaker:low FODMAP, low histamine, vegan, you
Speaker:know, there are people that benefit it.
Speaker:So that I find quite interesting as well.
Speaker:Now, fibromyalgia, obviously a different
Speaker:entity, but there is an overlap there.
Speaker:So it's something that I think, although
Speaker:I sit here as, you know, a nutritional
Speaker:therapist, primarily nutrition for me is
Speaker:actually one of the smaller pieces that
Speaker:we probably need to like
Speaker:investigate and acquire around.
Speaker:And if it's whole food in season,
Speaker:nutrient dense, you're kind of ticking
Speaker:the big boxes without then personalizing
Speaker:it to the individual needs.
Speaker:Yeah, that was perfect.
Speaker:Just a quick question regarding the
Speaker:elimination side of things.
Speaker:And I know that might be getting slightly
Speaker:into the weeds, but I think for a lot of
Speaker:people that is quite doable, if you are
Speaker:indeed still getting a lot of flare ups
Speaker:when you're just following this very sort
Speaker:of, yeah, this elemental paleo approach.
Speaker:I often sort of suggest that for a short
Speaker:period of time, that people really do
Speaker:have sort of a lot of food restrictions
Speaker:or a lot of flare ups that they take the
Speaker:easiest approach and if they're open to
Speaker:it, maybe follow something like a
Speaker:carnivore diet for a short period of
Speaker:time, and then sort of reverse engineer
Speaker:it and then slowly reintroduce foods that
Speaker:they can handle that aren't necessarily
Speaker:triggering the
Speaker:reactions that they're having.
Speaker:And I suppose I really recommend that
Speaker:because a carnivore diet is basically the
Speaker:ultimate elimination diet and it takes
Speaker:care of FOBMAPs, takes care of histamine
Speaker:as long as obviously your meat's not
Speaker:sitting in the fridge for three weeks.
Speaker:And it takes care of a lot.
Speaker:So you can then start to reintroduce
Speaker:things like dairy and see if this
Speaker:actually is an issue for you or not.
Speaker:I mean, obviously there are multiple
Speaker:things in dairy that could be triggering.
Speaker:Do you think utilizing something like
Speaker:that, if following a whole foods approach
Speaker:doesn't work as an option?
Speaker:The way that I've said it for a while is
Speaker:I think the sort of the extremity is the
Speaker:word I'm looking for, if that is a word,
Speaker:extremity of the diet needs to correlate.
Speaker:Well, one way to look at this is the
Speaker:extremity of the diet needs to correlate
Speaker:with the extremity of the symptoms.
Speaker:So if someone is really struggling and
Speaker:they're saying, "Alex, I'm just reacting
Speaker:to everything ultimately,"
Speaker:then that would be the only time to start
Speaker:considering it, I think.
Speaker:And again, it's a tricky one because
Speaker:there are some people that can have
Speaker:life-changing
Speaker:experiences going on carnivore.
Speaker:And there are people that have never been
Speaker:right since going on carnivore or have
Speaker:been worse since going on carnivore.
Speaker:So I think it's really important to
Speaker:appreciate whenever you're doing an
Speaker:extreme intervention, you have higher
Speaker:risks attached to it.
Speaker:And if you're already fragile on a
Speaker:physiological level, I sometimes wonder
Speaker:whether actually you are more susceptible
Speaker:to having a negative reaction to an
Speaker:extreme intervention.
Speaker:So it's something that I'm open to.
Speaker:And obviously all of these things, the
Speaker:client is the one deciding
Speaker:how they want to proceed.
Speaker:So if symptoms are severe enough, then it
Speaker:could be something that you trial.
Speaker:And maybe it's a trial for a week before
Speaker:you start reintroducing things.
Speaker:It doesn't have to be a long time when
Speaker:you're doing something that extreme.
Speaker:And in the research, although they don't
Speaker:go as far as talking about carnivore,
Speaker:what they do talk about with elimination
Speaker:diets is the two
Speaker:different ways of going about it.
Speaker:And your personality can dictate which
Speaker:one's most appropriate for you.
Speaker:And this is common sense.
Speaker:You can take one food out
Speaker:at a time and do it that way.
Speaker:Or you can go and do...
Speaker:They have different names for these, but
Speaker:a 12 food elimination diet or a six food
Speaker:elimination diet or a
Speaker:three food elimination diet.
Speaker:And so you can go all the way and that
Speaker:you say with
Speaker:carnivore, come back from there.
Speaker:And that's just a personal preference
Speaker:type thing that's going to be based
Speaker:probably on how much someone is suffering
Speaker:at the end of the day.
Speaker:Yeah, those are great words.
Speaker:And I think another great resource while
Speaker:you're talking, I just sprung to mind and
Speaker:I should have mentioned earlier was the
Speaker:autoimmune paleo diet, I
Speaker:believe by Mickey Trescott.
Speaker:I think that's a bit of an
Speaker:original text in this space.
Speaker:And that's probably also a good starting
Speaker:point for a lot of people to follow if
Speaker:they find that they are reacting to the
Speaker:sort of traditional paleo,
Speaker:maybe lower carb approach.
Speaker:And yeah, as you said, I think that's a
Speaker:great place to start and that it
Speaker:shouldn't really be over
Speaker:complicated unnecessarily.
Speaker:That's perfect.
Speaker:Okay, so beyond dietary interventions,
Speaker:we've got the basic movement, sunlight,
Speaker:sleep.
Speaker:Now, obviously, I think anyone who is in
Speaker:the space and is listening to these sorts
Speaker:of podcasts trying to find resolution is,
Speaker:it is likely familiar with the importance
Speaker:of grounding, of getting outdoors, of
Speaker:getting natural sunlight to help restore
Speaker:the circadian rhythm.
Speaker:Sleep, I think is something that people,
Speaker:that sounds intuitive and people would,
Speaker:they understand that
Speaker:they need to get more of it.
Speaker:But I think there are a few nuances there
Speaker:that people really need
Speaker:to dig into a little more.
Speaker:And maybe that sounds a bit prescriptive,
Speaker:it wasn't meant to be.
Speaker:But I think that when you think about
Speaker:sleep, you've got to also think about
Speaker:what makes sleep
Speaker:healthy, what makes sleep good.
Speaker:And in that respect, things like healthy
Speaker:airways, being able to breathe nasally
Speaker:properly at night is important, as well
Speaker:as making sure that your sleep
Speaker:environment is on point.
Speaker:I think those are two things that people,
Speaker:yeah, folks listening should be aware of.
Speaker:And in that regard, I think that the use
Speaker:of nasal strips can help from a
Speaker:congestion standpoint.
Speaker:Definitely just open up those airways and
Speaker:allow some more sympathetic,
Speaker:parasympathetic
Speaker:activity to occur during sleep.
Speaker:I think that's an easy, sort of easily
Speaker:accessible tool for
Speaker:most people to utilize.
Speaker:And then also making sure that your sleep
Speaker:environment is on point.
Speaker:So maybe turning off the Wi-Fi router,
Speaker:making sure that it is as little out in
Speaker:the room as possible.
Speaker:I think those are both easy strategies
Speaker:that people can utilize to ensure that
Speaker:they're getting the best possible sleep.
Speaker:Would you add anything into that?
Speaker:And what do you think of the
Speaker:Wi-Fi piece, the EMF piece?
Speaker:Nothing that I'd really add, apart from
Speaker:just acknowledging that inflammation or
Speaker:microbiome, histamine, these things
Speaker:impact sleep quality.
Speaker:So I think a lot of the time with these
Speaker:sorts of individuals dealing with MCAS,
Speaker:CFS, et cetera, their poor sleep is
Speaker:often, again, a symptom downstream.
Speaker:And there's things that are interrupting
Speaker:that sleep quality and that sleep cycle.
Speaker:And histamine can be so neurostimulatory.
Speaker:I mean, I've had terrible
Speaker:histamine issues in the past.
Speaker:And one of the primary symptoms was
Speaker:insomnia, basically.
Speaker:And it was this weird state of the mind
Speaker:being so switched on, but
Speaker:physically feeling very tired.
Speaker:So it can be really problematic.
Speaker:But yes, the foundations
Speaker:still have to be in place.
Speaker:You still need the sleep hygiene.
Speaker:You still want to be thinking about your
Speaker:breathing patterns and
Speaker:these sorts of things.
Speaker:But if you're still struggling, it's not
Speaker:because you need to do more around the
Speaker:sleep hygiene in your environment.
Speaker:It's that there's
Speaker:something else, obviously, at play.
Speaker:And then your other parts of this was?
Speaker:Yeah, we talked about sunlight exposure
Speaker:and the movement ground
Speaker:movements.
Speaker:So yeah, movement is
Speaker:going to be very personal.
Speaker:And I know this is a bit of a heated
Speaker:topic within the
Speaker:space for obvious reasons.
Speaker:But I think it's a
Speaker:matter of doing what you can.
Speaker:And I do think it's about understanding
Speaker:to the best of your
Speaker:ability what your capacity is.
Speaker:And sometimes you might overheat that.
Speaker:And then there's going to be a little bit
Speaker:of a flare or relapse.
Speaker:But I really like the idea of there's got
Speaker:to be something no matter what, almost no
Speaker:matter what, there's got to be something
Speaker:even if that's getting yourself a can of
Speaker:baked beans and doing a bicep curl in
Speaker:bed, because there's
Speaker:the intention behind it.
Speaker:And there's the mindset behind it, which
Speaker:I think is actually really important and
Speaker:powerful in its own right.
Speaker:So I have an old client who
Speaker:always comes to mind to you.
Speaker:She just started with one repetition of
Speaker:five different exercises.
Speaker:And it was either with a dumb, small,
Speaker:tiny dumbbells that she bought, it was a
Speaker:bodyweight squat, for example, one
Speaker:bodyweight squat a day.
Speaker:And that went to two,
Speaker:and then it went to three.
Speaker:And she just very slowly built it up.
Speaker:Because there's this fine balance, I
Speaker:think, between like, when you do nothing,
Speaker:and you're getting more and more D
Speaker:conditions, then it starts to obviously
Speaker:compound your overall
Speaker:health state ultimately.
Speaker:So we want to try and maintain whatever
Speaker:we can, if not improve upon it.
Speaker:And I think that's such
Speaker:an important piece of this.
Speaker:But again, without knowing where someone
Speaker:is within the spectrum, you know, it's
Speaker:hard to be able to give any specificity.
Speaker:Yeah, just with regard to that, and thank
Speaker:you for bringing it
Speaker:up, I do glean over it.
Speaker:What do you think about,
Speaker:I don't want to use the term exercise
Speaker:mimetics, but technologies like PEMF, to
Speaker:maybe support that process to maybe help
Speaker:from an oxygenation
Speaker:standpoint within the body?
Speaker:Yeah, it's not something I've looked into
Speaker:a huge amount, I must
Speaker:say, but I do know that Dr.
Speaker:Terry Walls did some of this stuff with
Speaker:her kind of journey
Speaker:with multiple sclerosis.
Speaker:So yeah, that came to mind.
Speaker:And obviously, she has some incredible
Speaker:results with everything that
Speaker:she did, and there was a lot.
Speaker:But yeah, I think there is value for
Speaker:people that are really struggling to, you
Speaker:know, to move into exercise because of
Speaker:the nature of their health.
Speaker:Yeah, no, it's, it's definitely a big
Speaker:one, especially where there is that sort
Speaker:of post-exertional malaise that happens
Speaker:that sort of post those issues with
Speaker:recovering from exercise when people
Speaker:really are struggling.
Speaker:But yeah, it is important just from a
Speaker:sort of an ability to keep those
Speaker:mitochondria taking over to help with
Speaker:lymphatic flow, lymphatic flow, etc.
Speaker:Okay, so I think the next sort of logical
Speaker:sort of step in this would be to sort of
Speaker:talk about the gut, and we could probably
Speaker:tie in detoxification that in that, in
Speaker:that as well, just
Speaker:from a time perspective.
Speaker:But how do you generally approach that?
Speaker:So yeah, it's a good question.
Speaker:It's an important point, because
Speaker:obviously another foundational piece
Speaker:that, you know, is one of the first
Speaker:things that we need to be considering is
Speaker:a daily bowel movement.
Speaker:You know, people need to be pooping at
Speaker:least once a day, it should be easy to
Speaker:pass, well-formed, sausage-like,
Speaker:shouldn't be any pain.
Speaker:And that's, you know,
Speaker:becoming rarer and rarer, ultimately.
Speaker:But from a detox perspective, but also as
Speaker:the best biomarker of your gut health, an
Speaker:easy to pass, well-formed stool is, you
Speaker:know, that's the goal, that's what we're
Speaker:all looking for for
Speaker:gut health, ultimately.
Speaker:So I would worry less about those one,
Speaker:two, three bacteria in your stool test
Speaker:that are out of the reference range and
Speaker:focus much more on, do
Speaker:you have any bloating?
Speaker:Do you have much flatulence?
Speaker:And how is your bowel movement?
Speaker:If those are all good, then,
Speaker:you know, that's good enough.
Speaker:And then you can move on to the next
Speaker:piece of the puzzle, ultimately.
Speaker:But yeah, with chronic fatigue syndrome,
Speaker:ME, we definitely do need to sometimes be
Speaker:thinking about SIBO.
Speaker:We do need to be thinking about
Speaker:overgrowth infections within
Speaker:the large intestine as well.
Speaker:And an interesting one with SIBO or EMO,
Speaker:as it's now called intestinal methanogen
Speaker:overgrowth, rather
Speaker:than kind of methane SIBO,
Speaker:is there is a little bit of research that
Speaker:discusses this being an
Speaker:adaptive response again.
Speaker:So exogenous methane, given by IV, has
Speaker:been shown to have anti-inflammatory
Speaker:antioxidant properties.
Speaker:So there's this kind of working theory,
Speaker:which is actually, if you're, if you're
Speaker:methanobrevibacter or methanogens are
Speaker:producing more methane, could that be an
Speaker:adaptive response because methane has
Speaker:anti-inflammatory antioxidant properties,
Speaker:and actually your redox is really poor
Speaker:and you need those things.
Speaker:There's also some research that is now
Speaker:showing us that our own cells have the
Speaker:capacity to produce methane, and all
Speaker:cells have the
Speaker:capacity to produce methane.
Speaker:And therefore, what we're seeing on a
Speaker:breath test for SIBO, when methane is
Speaker:elevated, the research at the moment says
Speaker:the majority is probably from methanogens
Speaker:in your gut, but a subset, it could
Speaker:absolutely be coming from mitochondria,
Speaker:cellular production.
Speaker:And therefore, is there this kind of
Speaker:adaptive response and the collateral
Speaker:damage for some people is constipation,
Speaker:but not everyone with positive methane
Speaker:tests is constipated either, which kind
Speaker:of again shows you just the
Speaker:gray nature of the human body.
Speaker:So yes, you know, you've got these things
Speaker:that have to be considered.
Speaker:Now, you're going to
Speaker:suspect SIBO if there is bloating.
Speaker:If you don't have any bloating, you just
Speaker:don't have SIBO in my opinion, and
Speaker:there's no point doing the test.
Speaker:And if you did the test for some reason,
Speaker:and you didn't have any bloating, and the
Speaker:test was positive, I would argue that's a
Speaker:false positive test, because the whole
Speaker:premise of SIBO is excess gas production.
Speaker:And therefore, you kind of have to have
Speaker:bloating and excessive flatulence or
Speaker:belching, because that's the main route
Speaker:that that gas is going to
Speaker:come out of you ultimately.
Speaker:So that's kind of an easy one to
Speaker:consider, you know, do I need to go down
Speaker:the SIBO rabbit hole at all?
Speaker:If you don't have bloating, probably not.
Speaker:If you do have bloating, do you need to
Speaker:go down the SIBO rabbit hole?
Speaker:Maybe to some degree, but and I say that
Speaker:because there are people that go down the
Speaker:SIBO rabbit hole and stay down the rabbit
Speaker:hole for two years trying to kill, kill,
Speaker:kill, kill, kill the sober growth, when
Speaker:actually it could be nervous system
Speaker:dysregulation as an actual root cause to
Speaker:why they've got SIBO.
Speaker:Or actually they need to do much more
Speaker:around motility and transit through the
Speaker:stomach and small intestine.
Speaker:And they just have an
Speaker:undiagnosed upper GI condition maybe.
Speaker:So yeah, the guts are really, really
Speaker:complex one, but there's definitely a
Speaker:strong connection between
Speaker:the guts and energy production.
Speaker:Partly obviously common sense, we digest
Speaker:and absorb our nutrients there.
Speaker:And therefore, if you're not doing that
Speaker:very well, you're not getting those
Speaker:nutrients to the
Speaker:mitochondria to produce your energy.
Speaker:So it is kind of the bread and butter
Speaker:from a nutrient status perspective.
Speaker:And then you've got 70 ish percent of
Speaker:your immune system in the gut.
Speaker:And therefore, when we think of immune
Speaker:modulation and inflammation, we were
Speaker:thinking partly about gut health and the
Speaker:role that that's playing in
Speaker:managing your inflammatory loads.
Speaker:You've got neurotransmitters that
Speaker:influencing things, you've got the gut
Speaker:brain access that is going to be
Speaker:massively involved in
Speaker:some of these things.
Speaker:So it's definitely a foundational piece.
Speaker:The million dollar question is how much
Speaker:is the gut driving other stuff?
Speaker:And how much is that other
Speaker:stuff driving the gut stuff?
Speaker:Yeah, I was going to ask what your
Speaker:thoughts are on the idea that everybody
Speaker:who is ill has some
Speaker:sort of GI dysfunction.
Speaker:I think there's real truth to that.
Speaker:And that's why a
Speaker:multi-pronged approach is needed.
Speaker:And again, it's not going into the whole
Speaker:black and white either or debate.
Speaker:It's like, well, we want to support the
Speaker:gut, but we don't want to throw the
Speaker:kitchen sink in the guts.
Speaker:And we want to support the other stuff,
Speaker:potentially simultaneously in some shape
Speaker:or form, because that's how we're going
Speaker:to be able to shift that physiological
Speaker:state back into a
Speaker:healthier equilibrium, as it were.
Speaker:So it's kind of, again, multiple inputs
Speaker:to nudge physiology back
Speaker:to where it needs to be.
Speaker:And there are two ways of doing that.
Speaker:I guess one would be doing something more
Speaker:gut focused and doing that, but doing it
Speaker:for let's just say six, eight weeks, and
Speaker:then moving on to the next phase of your
Speaker:plan or taking more of a multi-pronged
Speaker:approach where you're doing a bit of gut
Speaker:and a bit of whatever else it might be
Speaker:liver or mitochondria,
Speaker:et cetera, et cetera.
Speaker:So I don't think
Speaker:there's a right or a wrong.
Speaker:It's just, it's building the most logical
Speaker:rationale for the protocol.
Speaker:Yeah, that was very well put.
Speaker:Just a quick question.
Speaker:What are your thoughts on single dose,
Speaker:the use of high single, excuse me, the
Speaker:use of single nutrients and high doses,
Speaker:things like thiamine.
Speaker:Have you found those to be effective,
Speaker:especially from a gut perspective?
Speaker:Yeah, it's actually something I've only
Speaker:just started sort of doing clinically.
Speaker:I had Elliot Oberton on the podcast, so
Speaker:I've become more and more aware of he's
Speaker:doing amazing stuff, kind of getting that
Speaker:information out there.
Speaker:So yeah, and you look at some of the,
Speaker:just the comments on his YouTube page and
Speaker:all these sorts of things.
Speaker:And there are lots of people that have
Speaker:had wonderful improvements and healings
Speaker:through doing this for gut health or
Speaker:fibro and other conditions as well.
Speaker:So it's definitely a legitimate option.
Speaker:I think the thing that's, if I mean,
Speaker:totally honest, that's kind of held me
Speaker:back with it is there's no
Speaker:way of knowing when to do it.
Speaker:So it feels a bit like we're just going
Speaker:to try this thing because we don't really
Speaker:know what else to do.
Speaker:It isn't like we can go and do a test.
Speaker:It's like, oh, you are a
Speaker:really good candidate for this.
Speaker:It's almost like, well, we've tried these
Speaker:things, they haven't worked.
Speaker:Should we give this a go?
Speaker:And there's not
Speaker:necessarily anything wrong with that.
Speaker:But obviously, it doesn't, it just feels
Speaker:a bit like, as a practitioner trying to
Speaker:be a bit more precise about things,
Speaker:you know, you can just go and get some B1
Speaker:and try it out and see kind of thing.
Speaker:But that's the only way that we can
Speaker:really do it at the end of the day.
Speaker:Yeah, again, that was a great answer.
Speaker:And Tony, you mentioned your podcast,
Speaker:because I interviewed Elliot on the back
Speaker:end of that one actually.
Speaker:So it was, yeah, I like to think that if
Speaker:somebody's going to trials Hido Simon for
Speaker:a GI issue, it's probably the other point
Speaker:that they should take into consideration
Speaker:is the nervous system standpoint, the
Speaker:nervous system piece.
Speaker:I think if there is some level of
Speaker:autonomic nervous system dysregulation, I
Speaker:think Simon can be a needle mover.
Speaker:I know we've found that with regards to
Speaker:recommending Benfertiamine to customers
Speaker:who have a lot of, I don't want to use
Speaker:the word trauma, but emotional
Speaker:dysregulation, when they sort of hit that
Speaker:sort of north of a gram of Benfertiamine,
Speaker:it doesn't happen all the time.
Speaker:But just now and again, I will find that
Speaker:someone sort of writes back and they'll
Speaker:say, you know what, I've taken
Speaker:Benfertiamine at the suggested doses and
Speaker:all of a sudden, the anxiety sort of
Speaker:dropped off the map and the
Speaker:bowel issues have improved.
Speaker:But yeah, as you've alluded to, well, not
Speaker:alluded to, said, it's really hard to
Speaker:sort of from a diagnostic standpoint,
Speaker:sort of, okay, well, we're going to try
Speaker:this intervention because data, it's
Speaker:still sort of yet to be elucidated, I
Speaker:think, when that intervention is maybe
Speaker:best placed in a protocol.
Speaker:I think, yeah, it's looking to start to
Speaker:wrap up, but I think it would be great if
Speaker:we could sort of also talk about the
Speaker:detoxification side of things.
Speaker:Are you one who feels that active
Speaker:detoxification strategies are a good
Speaker:idea, or do you sort of work off the
Speaker:premise that if someone is struggling
Speaker:with some sort of, yeah, fibro, ME, CFS,
Speaker:that they should get the basics in place
Speaker:and then work off the assumption that the
Speaker:detox processes in the body,
Speaker:glucuronidation, sulfation, etc., will
Speaker:then start to naturally and come back
Speaker:online and improve and the body will then
Speaker:start to detox
Speaker:whatever's in the badder fault.
Speaker:Yeah, I think more the latter,
Speaker:ultimately, like it's not that we
Speaker:wouldn't do any sort of direct detox
Speaker:support, but I certainly wouldn't be
Speaker:putting any kind of
Speaker:extensive detox protocol together.
Speaker:You know, we start with elimination, so
Speaker:hydration, pooing daily, we think about
Speaker:the microbiome, we think about adequate
Speaker:fiber intake, and we think
Speaker:about it from that perspective.
Speaker:And you know, there are studies showing
Speaker:that as you increase fiber intake, there
Speaker:is an increase in excretion of certain
Speaker:heavy metals, for example.
Speaker:So there is that kind of
Speaker:binding capacity there.
Speaker:And detox, you know, there's even a
Speaker:paper, I can't remember who wrote it now,
Speaker:but I mean, they basically said detox is
Speaker:lifestyle, you know, it's not a protocol,
Speaker:so it's a lifestyle.
Speaker:So your movements, your breathing, your
Speaker:hydration, your diet, if you can get
Speaker:access to a sauna, wonderful.
Speaker:Can you do some sort of lymphatic work,
Speaker:whether that's dry
Speaker:brushing or seeing a therapist?
Speaker:You know, yes, there are key nutrients.
Speaker:So most of them, ultimately, are really
Speaker:important at some phase within
Speaker:detoxification, your B vitamins, all of
Speaker:the antioxidants, amino
Speaker:acids are all important.
Speaker:And then that takes us back to gut
Speaker:health, just from a
Speaker:digestive capacity perspective.
Speaker:We've got to think
Speaker:about the biliary system.
Speaker:So I do use bitters a lot
Speaker:with kind of the exceptions.
Speaker:What I said at the beginning, by the way,
Speaker:it's kind of, if I'm working with like a
Speaker:mold client, like glutathione, it's the
Speaker:bread and butter of kind of
Speaker:detoxing some of this stuff.
Speaker:So I use liposomal
Speaker:glutathione a lot with clients.
Speaker:I need to send you some of Dr.
Speaker:Andrew Campbell's research
Speaker:on glutathione and gliotoxin.
Speaker:He's on the impression
Speaker:that if you increase,
Speaker:that if you provide glutathione, when
Speaker:there's a high gliotoxin alone, you can
Speaker:actually sort of impair that
Speaker:immunological mismatch, so sort of from
Speaker:M1 to M2 macrophage movement within the
Speaker:brain and actually
Speaker:increase neural inflammation.
Speaker:Just his research.
Speaker:I'll send you some research there.
Speaker:But yeah, just an aside.
Speaker:Yeah.
Speaker:So yeah, we'd be supporting that.
Speaker:And I think the biliary system is a
Speaker:really, I think it's a really common area
Speaker:that people need some support around.
Speaker:So, you know, thinking of bitters, for
Speaker:example, as ways to support that,
Speaker:phosphatidylcholine is kind of trending
Speaker:at the moment, I
Speaker:think, ultimately as well.
Speaker:But yeah, I do think really kind of
Speaker:working on those foundations, getting the
Speaker:nervous system in a more regulated state,
Speaker:all of those things are
Speaker:going to improve detox capacity.
Speaker:And then it's a matter of, you know,
Speaker:patients, ultimately.
Speaker:So that's kind of definitely more the
Speaker:approach that I would
Speaker:take, I think, from it.
Speaker:Okay, perfect.
Speaker:And then last question for the day.
Speaker:The hormonal thyroid
Speaker:adrenal side of things.
Speaker:Where do you stand on that?
Speaker:Do you think that those sorts of
Speaker:interventions are useful off the bat?
Speaker:And by adrenal, I'm talking specifically
Speaker:about things like adaptogenic herbs, etc.
Speaker:Or do you just get the basic sort of
Speaker:nutrients into place, your
Speaker:B6s, B5s, magnesium, etc.
Speaker:I think the basics always
Speaker:need to be the priority.
Speaker:I do use adaptogens with some clients.
Speaker:And I think that sometimes
Speaker:people just really want them.
Speaker:So it's kind of like, it's providing that
Speaker:support as well, ultimately.
Speaker:I want a client at the moment who is just
Speaker:benefiting from ashil gandha so much.
Speaker:So she's just like the biggest
Speaker:cheerleader for ashil
Speaker:gandha, for example.
Speaker:So I think they do
Speaker:absolutely have a place.
Speaker:You know, there's some interesting
Speaker:research, ashil gandha
Speaker:and sleep, for example.
Speaker:So they can be helpful, I think, right
Speaker:time, right place, and
Speaker:something I definitely use.
Speaker:But again, I think, oftentimes, I really
Speaker:like the idea that the human body is a
Speaker:self-organising, self-healing organism
Speaker:given the right environment.
Speaker:If we can improve that environment, then
Speaker:there is that kind of positive snowball
Speaker:effect that takes place.
Speaker:So it's really focusing on that
Speaker:environment, which is kind of, you know,
Speaker:a lot of what we've
Speaker:been talking about today.
Speaker:Obviously, everything from the diets, the
Speaker:air you breathe, thinking about the
Speaker:quality of your home in the building, and
Speaker:whether there's any damp issues, etc.
Speaker:So yes, you know, and then the
Speaker:supplements from those sort of
Speaker:perspectives are of kind
Speaker:of the cherry on the top.
Speaker:Yeah, definitely.
Speaker:And obviously, being a nutritional
Speaker:therapist, you are not going to sort of
Speaker:get involved in the
Speaker:hormonal side directly.
Speaker:But do you ever find that sort of maybe
Speaker:suggesting or somebody sees a medical
Speaker:doctor for hormonal support?
Speaker:Is that ever effective, as you find?
Speaker:Yeah, I think sometimes it really can be,
Speaker:you know, I think it's, it's, I'm not
Speaker:sure I could tell you when I feel it's
Speaker:going to be most
Speaker:valuable or an important step.
Speaker:But I definitely have had clients over
Speaker:the years whereby they
Speaker:found it incredibly helpful.
Speaker:So yeah, context is always going to
Speaker:matter there from that perspective.
Speaker:And again, you know, I think thyroid
Speaker:adrenal stuff is
Speaker:downstream of, of other stuff.
Speaker:And therefore, how good a job have we
Speaker:done of exploring that and intervening
Speaker:appropriately on those things.
Speaker:But that's it, you know, they are
Speaker:absolutely downstream of other things.
Speaker:And therefore, that comprehensive
Speaker:evaluation becomes just so important.
Speaker:So yeah, you know, it takes us back to
Speaker:really that functional medicine matrix
Speaker:and systems biology and understanding how
Speaker:all of these things are interconnected,
Speaker:and how all of these things are
Speaker:bi-directionally interconnected.
Speaker:Definitely.
Speaker:I couldn't have thought
Speaker:of a better place to end.
Speaker:And with, yeah, thank you
Speaker:so much to your patients.
Speaker:Thank you so much to your time.
Speaker:You've had to put up with
Speaker:me for the last two hours.
Speaker:So that's, that's no
Speaker:mean feat in and of itself.
Speaker:So thank you.
Speaker:Alex, where can people find you should
Speaker:they wish to work with you if they are
Speaker:struggling with these sorts of issues and
Speaker:have sort of on the ground?
Speaker:Yeah, my website is just alexmanos.co.uk.
Speaker:My Instagram handle that I'm not
Speaker:massively active on these
Speaker:days, but is alexandamanos.
Speaker:And yeah, either of those two are really
Speaker:the best places to find me.
Speaker:Yeah.
Speaker:And for those listening, Alex has a great
Speaker:podcast slash YouTube channel.
Speaker:That's definitely worth visiting.
Speaker:If you are, yeah, if you're interested in
Speaker:more of what he does, as I mentioned
Speaker:earlier, I found his podcast with Elliot
Speaker:there too, and it was
Speaker:definitely insightful.
Speaker:So again, thank you for the time, Alex.
Speaker:And yeah, it was great to chat to you.
Speaker:Likewise. Thank you,
