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Sept. 11, 2018 - Dr. Oz Podcast
42:24
An Integrative Doctor’s Approach to Fighting Disease

Dr. Woodson Merrell is the one of the nation's leading experts in integrative medicine and healthcare. His expertise spans from managing chronic illness through Western botanical and nutraceutical approaches to implementing the most cutting edge mind-body techniques to ensure optimal health. In this episode, Dr. Oz sits down with Dr. Merrell to understand the great connections between conventional Western bio-scientific medical practice with indigenous traditions - such as Chinese Medicine, acupuncture, and Ayurveda. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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How do you know when they start with the gut?
Do you always check the gut?
And what do you do to check the gut?
What a fantastic question.
Because the gut is so important, you know, they've even been shown now that perhaps Parkinson's disease and multiple sclerosis may be primarily caused by literally bacteria in the gut traveling up the vagus nerve into the brain, bypassing the blood-brain barrier and causing neurologic diseases.
I never heard that.
Yeah, it's unbelievable.
Yeah, isn't that mind-blowing?
Completely.
Hey, everyone. everyone.
I'm Dr. Oz, and this is the Dr. Oz Podcast. podcast.
Welcome to this podcast.
I am back with someone who I truly adore, someone who you will love as well.
And I partly appreciate him because he's been a mentor to me throughout my life.
Taught me a lot about integrative medicine, which is how people around the world learn to take care of themselves and not abdicate that responsibility to somebody else, including doctors.
And I want to ask Dr. Merrill the common reasons people visit their doctor.
It's all the biggies.
You in?
Mm-hmm.
Absolutely.
All right.
Now I've got you excited.
Let's walk through these one by one.
I want lots of answers.
Only the answers today.
Got it.
Doing my best.
So I love talking to people who have been a part of my life for so many years.
Folks who I've learned to trust because when I go to them with medical problems and oftentimes to ask for support from my family or friends, they're always there.
So, Hudson Merrill, God bless you for being here.
Oh, thanks for having me on.
It's great.
Let me brag on you for a little bit.
So Woody has been a fixture in New York City, actually nationally, but especially in the New York area, taking care of folks who have ailments that were befuddling to the average clinician, complicated problems that often seem like they were multiplying, and they often seem not to have any common root cause.
And Woody was one of the first people who taught me that there actually was some deeper functional reason why things were breaking down, that you're Painful joint, your headache, and your intestinal issues were maybe related.
You just didn't know how to connect the dots.
And once you figured it out, you were good to go.
That's interesting, and I say this about Woody, because he didn't come from an untraditional background.
He actually came from where most of the rest of us came from.
Studied hard, went to school, did well.
And then somewhere in the middle of all this, as he was doing his primary care internal medicine rotation, Again, he had trained at Columbia University for med school, so he was part of the culture that I was introduced to when I joined the faculty at Columbia.
He decided that he was interested in going beyond where the traditional barriers of medicine were creating walls.
What was the epiphany that led to your looking beyond?
I got lucky.
I was raised really healthy.
We had whole food, fresh food.
My grandfather was in Sierra Club.
Interestingly, we were actually given homeopathy when we were kids, so it's a little bit unusual background in San Francisco.
And I was in college, actually, I was teaching, actually learned and then began to teach yoga and meditation.
I was so enamored of Asian kind of metaphysical practices.
That's really what led me into medical school, to kind of see if there were Western, as a real science jock, to see if Western science could actually explain these kind of alternative and metaphysical practices that didn't seem to have A clear evidence base.
And back in the 70s, there wasn't Western science.
Now there is a lot.
It took about 20 years to catch up.
And so I pretty much just put myself through medical school just learning Western science because there wasn't any East meets West at the time.
And it wasn't until I got out of my training that they began to look around to see if I could find places to train in some of these complementary disciplines.
So just to get the vocabulary straight for everyone who's listening in, I grew up using the word alternative medicine because it seemed outside the norm of medicine.
Then we began using integrative medicine, complementary at first, meaning you'd use it together.
And then the concept of integrative medicine, which seems corporate, but it really isn't.
It means you're bringing the two together.
But I'm reminded of a story of a patient of mine, an older woman, a spry woman.
She was a schoolteacher.
And this lady was pretty meticulous.
She taught English.
And after her surgery, although initially reluctant, she began to embrace some of these alternative approaches we were offering in the hospital.
This is at New York Presbyterian in Columbia where I first met Woody.
And she took the acupressure and the massages and the audio tapes and the reflexology and they would play music for her.
She really was a pretty big participant.
And of course there was a small amount of money you gotta pay for each of the practitioners who's doing this.
It's not a ton, but it does add up over time.
So at the end of her five, six days stay after open heart surgery, the practitioner coordinator went in there and said, well, Mrs. Rosenthal, you have a small debt here.
And I made that name up.
And she said, well, I don't understand.
Dr. Oz said it was complimentary.
So I had to make sure we actually spelled it incorrectly on the brochure.
So it wasn't that it was free, it was that it added to.
And you mentioned that Western medicine really wasn't very enticed to think about integrative approaches.
But even this week, there was yet another example of how Western medicine is beginning to catch up.
The idea there's a new organ.
I could cue organ music now if I wanted.
But there's a new organ called the interstitium, which just, again, for everybody that's listening, it's this sort of air or water spaces, really, in between the different layers of tissue that all organs have.
And maybe acupressure works through that.
Maybe lymphatic massage milks that fluid back into our lymph.
So have you been...
I've been impressed that Western medicine is beginning to catch up to some of the things that our mothers and ancient healers were telling us.
Yeah, finding the mechanisms is so exciting for acupuncturists.
Again, if I'm in acupuncturist, I've been doing it for 30 years.
Actually, it was the first libel that went off when I finished my residency and I went to a lecture on acupuncture.
I figured it was all going to be Yin-Yang Five Elements Theory.
J.S. Han, who at the time was the chairman of physiology at Beijing University Medical School, which is the only institute in China that during the Cultural Revolution was allowed to do Western science.
Everybody else was sent away.
And they actually taught internal medicine using an English version of Harrison's textbook of internal medicine in Beijing.
Oh, my goodness.
Yeah, it was really wild.
So he had this tradition of Western medicine because Chiu and Lai wanted to export Chinese medicine, and he knew they needed to speak the Western language.
So J.S. Han came to give a lecture, and I figured he'd be talking about the traditional Chinese approach to the meridians.
He talked about all his research showing how every neurotransmitter, serotonin, dopamine, acetylcholine in the brain changed with acupuncture in the brain.
And this was research back in the late 70s and early 80s he'd done during the Cultural Revolution.
So there was the light bulb.
My God, there's actually incredible science that actually exists now that's been around for a while.
Nobody knows about it in the West.
So how does the average American get exposed to this?
There aren't enough physicians like you who are conversant in integrative medicine.
They end up searching on Google, finding some ideas.
Some of them are well-vested, others completely made up.
It's difficult to tell the difference.
Yeah, there wasn't much when I started doing it back in the late 70s and early 80s.
But actually, there's now a lot of CME courses, doctors can learn.
It's a very interesting thing, though.
You know, back in the early 2000s, this organization formed the Consortium of Academic Health Centers for Integrative Medicine.
It's a long name, but basically it was the medical schools that were interested in integrative medicine and would support it.
And the organization formed to join it.
The dean of the medical school had to pledge that they would transform undergraduate education and training to include integrative medicine.
And so there were five, eight medical schools at the beginning.
Now 60% of the medical schools actually are in this organization.
So the medical schools get it.
The problem is there aren't enough teachers to teach it.
And so doctors aren't really learning this, even though they kind of pay lip service to it.
And there are integrative centers at the majority of U.S. medical schools, so actually patients can find access to it.
There are very few practitioners doing it.
The training is increased, though.
In terms of the last 15 years, it's almost exponentially more courses where doctors can train.
But it's all self-taught.
You have to make the effort after medical school.
Medical school still doesn't teach nutrition, for goodness sakes.
No.
Almost no more than when I was a student and basically learned how vitamins were made in biochemistry.
That was about our nutritional education.
So doctors get out and people are talking about nutritional therapies and if their esteemed professors didn't think it was important enough to teach it, why should they pay attention to it?
That mentality is still...
The majority is very pervasive.
It's hard to overcome that.
So oftentimes we end up learning from individuals like you.
So what I want to do, if I can, is tackle some of the bigger challenges that the average person can act on.
Folks who are open to integrative approaches generally are more action-oriented anyway.
And activists.
So they'll spread the wisdom.
So that's your tax out there if you'll hear in Woody Merrill's Pearls of Wisdom.
So the Detox Prescriptions book you wrote, that started off talking about a lot of environmental factors that many of us took for granted that could offend our health.
And in particular, there are a couple of toxic substances that you focused on that I hadn't paid much attention to.
So if you don't mind, a tiny dissertation about toxins in the environment, and then let's talk about how we can avoid them or even know if they're bothering us.
Well, it's pervasive.
And what's interesting is that, for example, autoimmunity has just skyrocketed.
It's gone up exponentially on the planet.
When I was in medical school, most inflammatory bowel disease was Eastern Europeans.
And at this point, And about, you know, 30 years later, that's 5% of it.
95% of it's Asians, Africans, all over the world.
And this has spread not because our genetics have changed, but it's clearly environmental.
So there's so many environmental influences on health and illness that have changed in the last few decades.
And the biggest driver of this are toxins in the environment.
The CDC did a study 10 years ago.
Each of us has an average of 180 toxins in our body.
And they're all below the limit of what's technically adverse for most people.
But the question is about the cumulative nature of them.
And each of us is very individual.
Some of us can get rid of them quickly.
Others take a long time.
Some people can metabolize off coffee in an hour.
Some take six hours.
So the individual variability of how we get rid of toxins is enormous.
So the idea of assaying what toxins are there would be great, except it's expensive.
So the idea is, first of all, remove your exposure to them, household cleaning products, personal care products, food, which is loaded, most food with pesticides.
To eliminate that from our bodies, to clean it, but then there are also ways you can actually help to remove it, and it really goes back to lifestyle.
So much in health and what we do...
Integrative medicine, most of it is lifestyle, self-healing through improving your lifestyle and your environment.
What's the biggest toxin that you find when you examine your patients?
Well, mercury is the most common by far.
Arsenic is there because there's arsenic in chicken, there's arsenic in rice, but the biggest one, most common one, mostly comes from fish, is mercury.
Of the household toxins that you don't measure, which is the one that you fear the most?
Well, if your PCBs and these endocrine-disrupting chemicals, PCBs, flame retardants, which are pervasive, PFOAs, PVCs, BPA, they got rid of most BPA, but they replaced it with BPS. How much better is that?
We don't know.
So I think this accumulation of all the...
Most of them, particularly the pesticides that are out there, Are hormone disruptors.
So they actually transform the ability of the body to utilize hormones and activate hormone receptors, which can be a big problem in illness, particularly people who have hormone-sensitive tumors.
Part that scares me is realizing that much of the fish doesn't declare it's sex until after it's born.
So they are all female now.
In part because they're being stimulated by estrogen-containing or stimulating hormones, or chemicals, rather, that are in the food that we're throwing into our water supply.
And if you have, like, for example, salmon, it usually doesn't have mercury anyway, but farm salmon, most farm fish has a lot of PCBs, and they use antibiotics and pesticides in the water.
So actually, it can be very difficult, very toxic from other things, and it can be measured easily in animals that are raised.
All right, we're just scratching the surface here, but we've got a lot more to discuss, so stay with us right after the break.
All right, so with all these toxins in there, there are detoxes that have become extremely popular.
You search online, they're all over the place.
My beautiful wife is always trying one detox after another once in a while.
She suckers me in as well.
What should a detox do?
Which are the ones that make the most sense to you?
First of all, you have to remove everything from your environment that's putting into yourself.
There's no point in detoxing, but then you're going to reintroduce everything.
You have to...
The Environmental Working Group's got a website, great website, ewg.org.
You can go there and you can learn all the safe household chemical products, all the personal care products, and all the food that is safe for you to eat.
And that's a great place to begin.
And then after that, in terms of what you do to remove what's there...
It's exercising.
It's sleeping enough so you're in platics to drain out things.
It's actually using whole fresh food.
Juicing is great, but food itself will do it.
I think that juicing is great because it actually provides you with super nutrient-dense food that people often don't eat a lot of fruits and vegetables.
So I think that the phytochemicals that are in food provide the nutrients that your body needs to detoxify, because we have two pathways, phase one and two, and phase two is one where you actually need all the nutrients, phase one also, but you need the nutrients to pull the chemicals out of the body, and particularly people who don't eat many fruits and vegetables, which is the majority of Americans, by the way, don't provide themselves with the nutrients they need to adequately detoxify.
The liver, your major detoxifying organ, is particularly helped by cruciferous vegetables.
Yes.
What other foods do you give, especially these whiners out there who say, I don't like broccoli, listen to this carefully, because if the sieve of the body, the filter is the liver, you have to suscitate those cells, allow them the nourishment to let them do the work for you.
Juicing is nice because it rests the gut also and allows it a chance to heal.
We talk about The body just is constantly consuming energy that we're constantly almost fighting against ourselves with all the toxic influences, whether it's our thoughts or the food we eat or smoke that we're around or the air pollution in the cities.
So really, the idea of resting the gut with the juicing is nice, but you don't have to do it.
You can do it with food.
But particularly foods that are great, honestly, it's a rainbow diet.
Greens are probably the powerhouse, and it doesn't have to be broccoli, though broccoli has so many incredible nutrients from For metabolizing off estrogen, for anti-cancer, for detoxification, it really is a powerhouse nutrient.
But all the green vegetables are great.
But the rainbow dye is what you need.
You need the reds and the purples and the browns and the greens.
For example, the sulfurous vegetables, the brown ones, garlic and And onions have sulfation, which is a big detoxification pathway.
So you need a bit of everything.
If you overload on one, for example, people do too many greens, there's a lot of something called oxalic acid, and they can actually precipitate a kidney stone.
Or too much kale, theoretically, can depress the thyroid production.
So you want a rainbow diet.
That's the key, whether it's food or juicing.
Don't give the kale haters any ammo.
They come after me, those kale...
I remember when we first started the show, we were talking about foods that most people didn't know much about.
Kale was one of them.
Quinoa was the hardest because they couldn't spell it.
Now, of course, they become more common.
But then we always get the pendulum swings back, the kale haters with their thyroid.
Yeah.
I mean, there's a big thing with food right now.
What should you be eating?
That's another big topic.
Should I be doing keto or paleo or vegan?
I think that...
The closer you are to a plant-based diet, the better off you are because plants are really the powerhouse.
And there's no way you can get in a pill all the phytochemicals that are in the food.
So food is your best medicine by far.
But you can take judicious supplements when you have a particular health problem.
And whether you go...
Some people do well with a keto diet, but it's very difficult to do.
It's just like a vegan diet has been proven by Dean Ornans to reverse heart disease to stop the growth of prostate cancer cells.
But really, it's very hard to do.
The difference is when you go off a vegan diet, your body will kind of just naturally equilibrate.
But when you go off a keto diet, all the stats you've been eating will probably turn back into bad fat, essentially in terms of weight.
Well, when your patients want to lose weight, what diet do you recommend for them?
First of all, it's very difficult to lose weight.
It depends on your age.
It's very difficult once your metabolism begins to slow in the 40s and 50s to lose weight with that exercise.
You know, all of us, if we eat the same thing at 50 that we do at 40, we'll probably put on 5 to 10 pounds.
It has nothing to do with our hormones.
Our metabolism is literally dropping.
For 30,000 years of life expectancy was 40. So if you're skinny and you're 40 and there's a famine, you died.
So there's a survival advantage to holding on to fat.
And we do.
Tenaciously, in every decade, the metabolism slows.
So if you literally don't eat less and exercise more, you will put on weight guaranteed, 95% plus of people.
So most people do the opposite.
We eat more and we exercise less.
So without movement, it's very difficult to lose weight, especially the older you get.
So you really, you can focus on calorie loss, but the body's not stupid.
If you eat very few calories, the metabolism's going to slow.
It's going to counter that.
And then when you eat more food, then the metabolism's still slow and you're counterproductive.
So exercise keeps your metabolism up, makes it so much easier to lose weight.
Back to the detox, one quick question.
How often should someone detox?
Why should they do it whenever the weather changes, once a month, once a year?
You know, something has taken the nutrition world by storm right now.
I just have to mention that topic.
It's called the Fasting Mimicking Diet by Walter Longo, who is the director of the USC Longevity Institute.
This is no mean person.
This is like a serious scientist.
For 15 years, he's been doing research.
And he now has gotten the FDA approved to approve.
You actually have a doctor's prescription to to do his five-day diet, the fasting-mimicking diet, and it's five days where you actually eat 850 calories a day of specific prescribed foods.
It tricks the body into thinking you're fasting, and it completely turns over your entire body.
Your entire immune system turns over.
All your white blood cells are made into it.
It doubles your stem cells.
It's extraordinary.
So there are many different ways of doing a detox, but this one is incredible.
It mimics a fast, which is why it's called Fasting Mimicking Diet.
What's the actual food you eat?
Well, that's the problem.
So my preference is to have people eat real food.
And to focus on plants because they give you the most nutrients and you can't just do plants because you'll be starving.
You need some protein and a few carbohydrates and just bring down the calories in a balanced way.
Theirs is a box of kind of made-up food.
It's powders for juices and soups and smoothies and bars and things like that.
But it's just for five days, but they've proven in all animals, if you do that three months out of the year, you increase life expectancy by 30%.
So there are a lot of ways to skin a cat that can make a dramatic transformation in your health.
What about the 12-hour on, 12-hour off program, which a lot of bodybuilders are doing.
Hugh Jackman, who I've had on the show, said that that's the way that he was able to gain weight and then lose weight when he was being Wolverine.
So, you know, he would eat meticulously but a lot in order to gain the weight, but he wanted to get it off again.
And this is something he learned from other actors and weightlifters, and it seems to have worked.
It definitely worked.
That's a really good point.
That's also, again, about fasting.
And if you do it 16 hours, it even works better.
But you have to run the risk of not eating enough during the day.
And if you don't eat early on during the day, the body gets the message you're kind of starving.
If you only have dinner, your metabolism, again, is going to slow, and unless you're exercising, which he wasn't...
He was.
I know.
But they're definitely the 12 hours fasting, which is basically finish dinner at 8 p.m.
and then don't eat until 8 a.m.
in the morning.
And that works.
That works very well to facilitate weight loss.
Personally, that's what I do when I try to lose weight.
I don't have to lose weight too often, but once in a while I go off with Lisa somewhere crazy and put on a ton of calories.
My weight hasn't changed much in my adult life, but if I gain two, three pounds, I just don't like the way I feel.
It's not so much the vanity Of, you know, people noticing it, although, you know, at some point it become noticeable.
But at that weight, I can feel my pants a little tighter.
I feel sluggish.
I feel like there's a gook in my blood vessels.
I know it's not literally happening, but you sense that it's occurring.
And I know that within a couple days of switching your diet, your hormones begin to tell the difference.
Again, if you're like, you know, 40, 50 years old, you can spend all week losing two pounds and two, three pounds and put it back in one meal.
So there's really not much room for error.
So the easiest, fasting for 12 hours is a, It's a little known secret that works really well.
The other thing most people know about not eating starches, bread, pasta, rice, rolls, potato, but they don't realize about oil.
So oil can be incredibly healthy, olive oil, but it's also highly caloric.
Just the oil in one tablespoon of oil a day is a pound a month or 12 pounds a year worth of fat.
So I think that there are things you can do that don't actually have to make your life miserable when you're trying to take up weight.
The The interesting things you learn about the web are something that I love sharing with audiences.
So when you go online, everyone at home can do this right now, and just type in, why am I? Which seems like an existential question, right?
Thinking about God or some spiritual pursuit.
But you'll notice as you type in, why am I, that the Google browser will auto-complete it as, so tired.
So, the average person is much more focused on the fact that they don't have the pep they used to have than anything else.
You've talked about this, you know, Power Up the Source, which is a nice book you put out a few years ago, gets into the deeper realities of why patients come to you saying, I've lost my get up and go.
Mm-hmm.
And I'd love if you could share with our audience, for free, something that most people have to bail out of cash to get access to, the wisdom of integrative medicine on this issue.
You know, it all goes back to lifestyle.
And the thing is, the majority of people come in to me and they're tired.
And of course, we're in New York, so there's a lot more stress.
But it's multifactorial.
They don't eat well.
They don't sleep enough.
They don't exercise.
And it really goes back to lifestyle.
You know, what's interesting is that the $3 trillion we spend in healthcare, 70% of that's for chronic disease and 50% of that's preventable, reversible, just for the lifestyle.
So the more and more we're doing this, it really goes back to lifestyle.
It's sleeping enough.
It's eating properly.
It's not putting toxins in your environment.
It's not being stressed, it's exercising, and it's being connected.
It's having social connectivity, whether the connection is religious or personal, whatever.
You have to really have your life in balance.
So people say to me, what's the most important thing that I should do?
Of those, I say, well, it's probably the thing you're not doing, because you have to have them all in balance.
If you're eating great and you're exercising, but you're sleeping four hours a night, you're just not going to make it.
You can't possibly replenish yourself and get your energy.
If you're not exercising, you're not moving, you're sedentary.
So you really need to focus on those six fundamentals to really have a life that's healthy and to begin to prevent health.
And also one of my favorite categories of seeing patients is people who are beginning to slip into disease, where they're beginning to get hypertension or high cholesterol.
Or diabetes or arthritis.
And have them do things that can pull them back from that.
And yes, there's supplements, but for the most part, it's really lifestyle.
And we're seeing that more and more, how the power of lifestyle to change should radically transform people's health.
It's helpful for people to have jump starts.
Ways to sort of getting back in the saddle again.
Because when you have no energy, you don't want to do the things that will give you more energy.
So I understand physical activity.
I got that.
That's something that I always tell the audience is, Do first thing in the morning, just do five minutes.
That way, you can always brag all day long into my five minutes of yoga, but at least put some numbers on the board.
You control that.
But with regard to food, sleep, and the like, it becomes a bit more complicated.
So caffeine, good example.
Often used tool to get people energized in the mornings.
Are you in favor of coffee or other sources of caffeine to give people energy?
It's very individual, and that's the thing about personalized medicine.
You have to figure out what's best for the person.
So if somebody has a slow metabolism, their half-life for metabolizing coffee is six hours, so they have a double latte at 8 a.m.
It's like drinking half a cup of coffee at 8 p.m.
and wondering why you can't sleep.
So one of the things that triggers sleep is these things called the adenosine receptors, and coffee blocks the adenosine receptors.
So if you have coffee late, I don't think there's anything the matter with having a cup of coffee or two.
It's the people who live on coffee where there's the problem.
They use that.
It's a drug to keep them going.
It's almost like kind of a cheap Adderall.
And I think that I prefer green tea because it actually has caffeine in it, but also has something called theanine, which is an amino acid that calms the nervous system, so you get a gentle lift in the day rather than the kind of rush and crash you get from caffeine.
With regard to the food you use to energize yourself, the choice is I'll share mine.
You judge me.
You can judge once in a while.
Although you're generally a non-judgmental person.
Chocolate.
70% cocoa or better chocolate is my usual pickup in the afternoon.
It's fantastic.
I love chocolate.
I'm a huge fan of dark cocoa.
It's very, very powerful.
Actually, it's one of nature's, if not nature's most powerful antioxidant.
And there's actually anandamide in chocolate and phenylethanolamine, which actually help improve and actually helps the brain function.
So if you're doing a dark chocolate, which is more than 70%, there's not that much sugar in it.
Honestly, if I have two squares of an 85% sugar, Dark chocolate.
I feel like I've had a cup of espresso.
I love chocolate.
It feels like that.
Yes.
Teas, which ones do you like?
And how do you use them?
Which one?
Teas.
I know you have a bunch that's used for your patients as well.
I'd love to get a little primer in that.
Well, green tea is activating, obviously, because it has caffeine.
Herbamate can help some people with energy.
It doesn't have much caffeine.
A lot of people's problem is stress during the day.
And actually, Tulsi tea, which is holy basil, which is a very powerful drink.
It's a very powerful herb in Ayurvedic medicine.
It's a wonderful one.
There's a longevity tea called Gymnostema that actually you don't feel that as much, but once you can actually feel, the Tulsi tea is common, kind of like chamomile does.
What do you spell T-U-L-S-I? T-U-L-S-I. Yeah, you could get it in all health food stores.
They make capsules of holy basil.
It's kind of like an herbal valium, like an herbal relaxant.
That's for when you want to relax and be calmer, which is a lot of people's problem is their nervous system is so jacked up they feel tired, but actually they're just too jagged.
And they need to relax.
You really need to meditate and do breath work.
But a green tea for activating, and perhaps herbamate, and then Tulsi tea for calming.
Which fruits do you find acceptable?
Do you worry about sugar at all in the fruit?
Well, the fructose and sugar, you know, the thing is if you eat a whole piece of fruit, there's so much fiber that the sugar is absorbed fairly slowly.
If you drink an 8-ounce glass of orange juice, there's a lot of sugar in there.
There are 100 calories, and it's mostly sugar.
I mean, it does have vitamin C, but I kind of refer to it as flavored sugar water.
Although it's healthy, but it's very caloric.
Whereas if you eat an orange or an apple, you're not getting all just the fructose.
You're getting a lot of the nutrients in there.
And so much more slowly.
It's all about the glycemic index with these foods with sugar, how quickly they break down into sugar.
And obviously, sugar is sugar, although fructose is not glucose.
And the glycemic index is still as utilized in the body, obviously, as a sugar.
So I think if you're taking...
The whole food, once again, that it's much better and it's no problem.
We have a lot more to talk about, but first, let's take a quick break.
All right, now, quick hitters on the common problems you see in your office.
A healthy person comes in high cholesterol, that quote-unquote high cholesterol.
I get asked this question all the time.
How do you break it down?
How do you advise them?
Well, you first need to look at good and bad.
So if they have a good cholesterol, then it's not that bad.
A lot of people have high cholesterol because they have a lot of the good.
If they have the bad one, the LDL cholesterol, actually I break it down into, you can actually look at whether they're large or small particles because if they're mostly large particles, they're less sticky.
But if overall the cholesterol is high from too much of the quote-unquote bad cholesterol, a lot of it is diet.
So first of all, 80% of it is genetic in terms of what the liver makes every day because you need cholesterol for hormones and for your cell walls.
But in most people, the issue is the diet.
So they really have to think about getting off cholesterol in their diet, which all land animals have cholesterol.
Even chicken has Under the skin has quite a bit of cholesterol.
So they have to really focus on being what I would say more like a pesca-vegetarian diet where they remove themselves from most land animals and lower the cholesterol.
There are some nutrients that could be helpful.
But I think that one of the things that I love to do is for people who are perplexed about whether they should be taking medication or not, and way too many people are taking statins, they should be in the drinking water from It's a cardiologist perspective.
And unfortunately, it's not reimbursed yet, but there's a test called the coronary CT angiogram or CT scan that I love doing because what it does is you get an eight-second injection of iodine, so you can't do it if you're allergic to iodine, but that's rare.
And then you get a 30-second CAT scan, an open machine, and it visualizes the inside of the coronary arteries almost as accurately as an arteriogram.
And if you have zero plaque, Then cholesterol really is not an issue.
Because the bad thing about cholesterol, is it sticking or not?
Is it causing blockage?
And if your cholesterol is high, close to 50% of people with high cholesterol don't have blockage and they probably don't need to be medicated.
It's more lifestyle.
50% of people with normal cholesterol, they do have blockage and they probably need medication.
So cholesterol is not necessarily...
The only judge, C-reactive protein, lipoprotein A. There are other things that we look at in the whole picture.
And also sometimes red yeast rice has been shown to work when people can't take the statins or they're kind of in an in-between state.
So just give us a high-level number.
Of the people who see you, what percentage should be and therefore are on a medication for cholesterol?
And what percentage can either manage you with diet or probably don't need to be on?
This is of the group of people who come to you saying they've got high cholesterol.
I'd say I've never kept stats, but I'm guessing it's 50-50.
I'd say I would probably take off maybe 30% of the people who are on cholesterol.
When they do the coronary CT scan, we can work with diet, and they show no plaque.
They really don't need to be on cholesterol at all.
Some people are surprised to find out with the family history their cholesterol is okay.
But they got the bad gene that allows it to stick, and so they actually probably need to be on some medication.
But the studies have shown that a good form of red G's rise has 80% of the effectiveness of a statin for people who are kind of in the in-between state where they don't have to necessarily take a statin.
All right.
How about folks come to you who say they've got a problem with blood pressure?
Basics on how you manage that.
Number one killer of all Americans, it's like a fire hydrant blasting through the delicate Teflon lining of your arteries.
People aren't fearful of it.
They should.
We have very simple ways at home now of measuring it, measuring at different times of the day.
I know that it all varies a lot, but let's say they actually are suffering from high blood pressure.
They're worried about it.
They come to see you.
How do you treat them?
Stress, stress, stress.
So reducing it.
So I think that one of the biggest ways of doing that is meditation or any kind of mind-body exercise that relaxes the nervous system.
So Most of us are on sympathetic overdrive.
There's way too much adrenaline in our body, and the parasympathetic or calming part of the nervous system, the vagus nerve, is underactive.
So there's some really interesting books people can look at.
One is called HeartMath.
It actually shows you if you increase your heart rate variability, it shows that you're bringing up the calming part of your nervous system and lowering the sympathetic part of your nervous system.
There are biofeedback devices.
There's one called RESP-E-Rate.
It's actually FDA-approved for blood pressure lowering and shown to lower the blood pressure 5 to 10 points.
I think that the exercise has also been shown to lower blood pressure.
Sleep apnea is a big one.
You have to make sure you're sleeping properly and getting enough sleep, but also if you have sleep apnea, that's a risk factor that perhaps is even worse than cholesterol blood pressure for heart disease and early death.
I love if you would explain the holistic approach to gut flora.
Everyone is out there thinking about probiotics there, connecting every element to the gut.
Some of them are connected, some of them are not.
Someone like you has the unique ability to sort of discern which problems are more likely related to the gut and which ones don't matter.
And this ranges from hormone complaints like thyroid issues to asthma.
How do you know when to start with the gut?
Do you always check the gut?
And what do you do to check the gut?
What a fantastic question.
Because the gut is so important, you know, we now know, I think most people realize this, but those who don't, you know, we're born 100% human, we die 90% bacterial.
90% of our DNA is primarily bacterial.
So actually the microbiome is huge.
It's even been shown now that perhaps Parkinson's disease and multiple sclerosis is maybe primarily caused by literally bacteria in the gut traveling up the vagus nerve into the I never heard that.
Yeah, it's unbelievable.
Yeah, isn't that mind-blowing?
Completely.
Where'd you hear that?
It's in published studies that just came out over the last, it's only the last six months, there have been two or three published studies, and they're looking, actually, the blood-brain barrier, which we all saw is fairly sacrosanct, very few things could bypass it, Oh, my goodness.
Oh, my goodness.
It was produced by the gut bacteria.
So it has a lot to do with depression.
It has to do with weight gain and weight loss for a particular species that if you have it, you're much more prone to weight gain or to weight loss.
So you can actually measure your microbiome and see which species you have through a number of companies.
Two or three years ago, it wasn't really ready for prime time.
And the problem is you can find out the...
800 or 1,000 odd species you have, but what do you do with that information?
What do you do with that information?
Well, the data is not there yet to fully guide us, but there are some general guidelines that are, for some of the species, that they're more likely to produce weight gain or weight loss or mood changes or kidney stones even than others.
So there's tests that are done.
I wouldn't say that they're holy grail, but when it comes to treatment, they at least provide some guidance.
Without the testing, what we've been doing for the last decades has been using probiotics.
And probiotics are very important because the majority of us, of our bacteria, of the thousand-odd species, 70% is pathological.
It's amazing we don't get sicker.
And the more beneficial species don't last.
They don't colonize in the gut.
So you need to keep taking them in.
You can get it with foods, yogurt, sauerkraut, but also you can get it from supplements.
There's a bacteria called athermansia.
I don't know if you've heard of this, but a friend of mine who was actually in the business community knew all about it.
And he was of the belief that it could influence how much weight you would gain or lose.
And I looked into it, there's actually some data.
It's not just a matter of taking big vials of athermancy or killing them all off.
It's not that simple.
But I've learned a lot recently about how complicated the process really is.
And medications that I thought I knew pretty well, like Leucofage, which is one metformin many of you may know about, which is used for diabetics early in the course of their illness.
It might actually work by influencing the gut bacteria and sensitizing the liver to insulin so that all of a sudden your insulin works better so you're no longer a diabetic or at least your blood sugar corrects.
And these are the kinds of breakthrough ideas that are fabulous.
But in a clinical practice, you've got to take someone In the next day or two, who's seeing you in the office and decide whether you give them probiotics or not, which ones to give them, or do you tell them to eat more kefir and sauerkraut?
So what's the actual practical advice today?
I'd say the majority of my people who come in, let's say, with irritable bowel syndrome, a very perplexing problem where you can't find any actual illness, but it's a more functional disorder, they actually feel dramatically better when they take a medical-grade yogurt, or like kefir, which is fantastic, 16 strains of bacteria, or medical-grade yogurt like Bio-K more than taking the capsules.
And the capsules are helpful, but the food actually often works better.
The other thing about probiotics is you need prebiotics.
So actually microbiologists kind of laugh that you're going to take 10 billion bacteria and say, what's the big deal?
You've got millions of trillions in your gut, and these aren't going to even colonize.
They're not going to last for two or three days, and they'll be killed off.
So why are you bothering?
We don't even know which species are the best ones to take anyway, but we do know that prebiotics are very important.
So prebiotics are the food that the bacteria live on.
So if you provide the right starches and the right fibers, the healthy bacteria will survive it.
And not only survive, but they'll produce a substance called butyrate that actually heals the lining of the digestive system.
So butyrate is really important.
The pathological bacteria do not produce it.
The healthy ones do.
The healthy ones won't produce it unless they get the food to make it.
So you need to do the prebiotics.
And their oats has it, the Jerusalem artichokes.
You can get combinations of pre and probiotics.
So if you're going to do a probiotic, you really need to do one.
With a prebiotic.
The average person who comes to your office where you think that there's a unifying process in the gut, you give them all the food advice that you've given us.
How long does it take for them to get better?
What other testing do you do?
It's such a black box for me right now, and yet I know when someone comes to me and says their thyroid's off, or they've got headaches, or they can't sleep at night, there's often going to be a deeper unifying process.
What does the testing look like?
Well, it depends.
So, for example, if someone comes in with a headache, I mean, the problem may be structural.
Maybe the cervical spine is out of alignment.
Maybe it's stress.
Maybe their magnesium is low.
Maybe their celiac.
There's so many factors.
So, one of the things about integrated medicine is we really look much deeper into the root cause of things.
And this is part of the problem in conventional medicine right now is doctors can't spend the time to get to the root causes.
So, they're just used to seeing a symptom and giving a Band-Aid treatment.
For an illness and putting them in a disease category where really it's a lifestyle-based root cause you need to look at it.
So nutrient deficiencies, lifestyle practices.
So this is the biggest thing that I do when patients come in with an issue.
But particularly for gut issues, it's so complicated that the first thing to do is...
One of the things to do is eliminate food...
So you eliminate the things that are causing problems in the first place.
So one of the things that I do, I would say easily 50% of people in my practice by the age of 40 are relatively intolerant to wheat.
And this thing about celiac...
50%?
Yeah, 50% are relatively...
So I take them off wheat.
It doesn't show up in blood tests.
There's no good allergy tests.
They're not allergic to wheat.
Even the IgG, delayed allergy tests, maybe show, maybe not.
But the most accurate way of figuring out if you have a food sensitivity is going off the food for three or four weeks completely...
And then having it for two or three days and seeing if you're better off it or worse back on it.
And they think it's the gluten, but it's not necessarily the gluten because American wheat was genetically transformed 100 years ago to withstand the conditions in America and where they were growing the wheat and making different kinds of bread, particularly like softer breads.
They weren't natural to bread making necessarily.
Wheat Belly talks a lot about this by William Davis.
But the other thing is that there's, you know, there are pesticides on wheat like there are on fruits and vegetables.
And I think that a lot of people who have a problem with wheat sensitivity, it may be the pesticide, it may be these other proteins and carbohydrates in the wheat, but it's usually not celiac, although I test them for it.
And I take them off wheat and they feel dramatically better.
I see that's the number one food It's sensitizing, and they can go to other grains.
Oat is a very good grain to go to, for example, oatmeal or pure oat bread.
They can do that.
I have nothing against wheat.
I think wheat is a great grain, but I think that it's particularly American wheat.
People go to Italy, and they eat all the bread and pasta they want.
Like, what's the big deal?
And they come back to America, and American wheat is very problematic.
It's the number one most problematic food, more than lactose, more than soy, more than anything that The first thing I do when they come in, if they're eating a lot of wheat, is go off wheat.
The other thing is there's a pretty pervasive prevalence of low-grade chronic dysbiosis in the gut.
So if you can measure the gut, something called SIBO, S-I-B-O, which is a test you could do.
It's a simple breath test to see if you have An overgrowth of bad bacteria.
And also, low-grade amoebas are not uncommon at all in our food chain.
You know, the old adage, if you ever worked in a restaurant, you never eaten one.
Oh, they don't wash the salad.
The guy doesn't wash his hands.
If food falls on the floor, he's not going to notice.
So I think that the idea that the dysbiosis in the gut is a tremendous problem, but also the food reactivity is close behind it.
Explain dysbiosis real quick for the audience.
Too many bad, too few good organisms in the gut.
Woody Merrill, encyclopedic.
I'm getting rid of Google.
Thank you for all the wisdom you've shared with me throughout our lives, and congratulations on all you've been able to accomplish.
Woody Merrill runs the Integrative Medicine Center in downtown New York City, and he's been an iconic figure in the community for many years.
That's one of the reasons I wanted him to come on, because if you want to go see a top-notch doctor, this is the kind of guy you want to see, but this is practical advice that gives you the most wisdom.
Woody Merrill, take care.
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