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Speaker 1: 00:00 Welcome to The Dr. Gundry Podcast, the weekly podcast where Dr. G. gives you the tools you need to boost your health and live your healthiest life.

Dr. Gundry: 00:14 Welcome to The Dr. Gundry Podcast. I’m willing to bet that just about everyone has woken up stiff, sore or achy from time to time. In fact, according to the National Institutes of Health, 80% of adults experience lower back pain at some point in their lifetimes, 80%, and a quarter of adults have experienced lower back pain in just the last three months.
Today’s guest has spent his entire career helping thousands of patients reclaim their lives from chronic back pain. He’s Dr. Vijay Vad. On today’s episode, he and I will discuss why everything you’ve been told about back pain is wrong, how he treats his patients, and what you can do about back pain today without dangerous drugs.
Dr. Vad, welcome to the podcast.

Dr. Vijay Vad: 01:11 Thank you, Dr. Gundry. Nice to be here.

Dr. Gundry: 01:15 Your book, Back RX, was just reissued this year. It was originally out in 2004. Is that right?

Dr. Vijay Vad: 01:25 Yes. Correct. That was my first attempt at writing the book.

Dr. Gundry: 01:31 What’s changed since you first wrote this book? This is totally revised and reedited. What’s happened in 15 years since that book?

Dr. Vijay Vad: 01:41 I think, in 15 years, there are a lot of simple things that we know now. Call it combining ancient wisdom of the east with scientific discipline of the west, and it’s been my mission really to have simple, effective solutions for big issues like back pain, so now we know, for example, simple things like vitamin D, for example, taken in adequate amounts, keep your levels 50-plus if you have chronic back pain because it has a big impact on not just reducing back pain, but potential depression that may sometimes present with back pain.

Dr. Gundry: 02:22 One of the things that I’m impressed about you is that you’re willing to say that a lot has changed in the last 15 years since I wrote my first book and I’ve learned things in the last 15 years and I’m not afraid to say here’s the new things, and I want to tell you what I’ve learned in 15 years.

Dr. Vijay Vad: 02:50 First of all, in those 15 years, I’ve probably been blessed to gain knowledge from at least 10,000 extra patients suffering with back pain, so that’s always… Patients teach, as you know, every single day about little tidbits there, and hopefully that makes us better clinicians and better armed with knowledge. Also, I’ve learned a lot from my colleagues here at Cornell Medical Center in different disciplines, from cardiology to internal medicine arms, and, being here, there’s a constant bombardment of knowledge from people that come and speak to us from all over the world, so we saw that cumulative distillation effect of secrets, if you will, that I’ve been able to put together over the last 15 years because I’m a “seasoned clinician” now, whereas, when I started in 2004, I was only in practice a few years.

Dr. Gundry: 03:42 One of the nice things, and I dedicated one of my books to my patients because, if it really wasn’t for my patients, I wouldn’t know most of what I know. Among other things, they’ve taught me tips, and they’ve asked me questions that, quite frankly, I didn’t have the answer to or I needed a better answer than what I had been taught, so I congratulate you that you learn from your patients, and that’s a-

Dr. Vijay Vad: 04:13 I think, despite our degrees, we have to be open-minded because patients can really… I mean, for example, about 2009, right after the stock market crashed, one of my patients was suffering with a lot of back pain. He had arthritis in his facet joints, and we tried everything, and I said, “Look, you’re really a back surgical candidate,” and then he comes to me three months later and, “I bought this $25 inverter table, and my pain is 80% better,” and I hadn’t even thought about inversion table till that point, so it’s that cumulative experience. Now, it may not work for everybody, but it worked for him, and a $25 table saved him from expensive procedures and maybe lumbar fusion.

Dr. Gundry: 04:57 Yeah, I think, I’d probably rather spend $25 on an inversion table than a lumbar fusion, and maybe we can get into that, and just to continue on that note, you and I were taught that this is the practice of medicine, and I think the beauty of what you do and what I hope I do is our patients allow us to practice medicine and, “Okay, I want you to try this and let’s see whether it works,” or a patient tells you, “Hey, I spent 25 bucks and, guess what, my back pain is 80% better,” so good for you. I congratulate you on that, and that’s why, one of the reasons I wanted to have you on the podcast.

Dr. Vijay Vad: 05:45 Thank you.

Dr. Gundry: 05:45 You were one of the early voices about sounding the alarm about opioid painkiller addiction back then. What were you seeing in the early 2000s that alarmed you, and what’s changed since that time?

Dr. Vijay Vad: 06:03 Boy, a lot has changed, so, right around 2000, with the National Institutes of Health and the National Academy of Medicine basically saying we’re way under-treating pain, that pain is a real symptom, so, what happened, doctors took their prescription pads out and just started writing opiates left, right and center, and so we are partially responsible for creating the opiate epidemic, but that epidemic really started at the federal government level. It was messaged from there, and then the federal government realized that there were too many deaths, too many complications, and now we’ve done a 180 turnaround where I think we are… There’s a huge backlash against any opiate use whatsoever, and there are circumstances where small amounts of opiates aren’t necessarily that bad for somebody who’s had a failed fusion and is in severe pain, but we’ve gone the other direction, that any opiates are bad now, so there’s a huge shift from 2000 to 2019 with opiates.

Dr. Gundry: 07:10 In your practice, how do you make the decision of when you’re going to use these or you’re trying to get somebody off of these? I’m sure you’re faced with this almost every day.

Dr. Vijay Vad: 07:24 My battle in the last 20 years has been trying to get patients of opiates. I mean, I really don’t have this come in, get an opioid prescription, have a nice life. I go for what I call the protocol. If you have a chronic disk issue with back pain, walk every single day for 30 minutes. Take the vitamin D.
One thing you and I share is food as medicine, the most overlooked potent weapon we have. Good food is good medicine, and, sometimes, if you just say to somebody with chronic disk issues or any back pain, “Don’t sit too much. Take your vitamin D, good ergonomics, vitamin D and good food,” and that can sometimes have a dramatic impact in lowering their back pain where they don’t need opiates long term, and we have other things that I use, and turmeric, things like highly absorbable curcumin that has a positive impact on managing back pain, so my goal has been to get patients off of opiates as much as I can. Now, for acute severe back pain, five days of opiates are probably appropriate, but, long term, I think the harm is more than the good.

Dr. Gundry: 08:34 In a similar vein, and I really want to dive deep into your thoughts of food and the gut and the gut wall and back pain. I know a lot of, particularly, sports medicine and orthopedic physicians that I deal with give out NSAIDs like ibuprofen or naproxen like candy for back injuries. Any thoughts on the danger of just using these simple over-the-counter painkillers?

Dr. Vijay Vad: 09:08 I talk a lot about that in Back RX, the book, the old book and the new book. I’ve been on this, if you want to call it a crusade of not overly prescribing anti-inflammatories because there are 40,000 deaths a year just from going to your local CVS and buying Advil and Aleve and taking them recklessly, so my philosophy has been, if you want to take anti-inflammatories, take them in spurts, and to my physician colleagues, I say to them, “First do no harm.” I mean, try not to cause the patient a bleeding ulcer that could potentially lead to death or kidney damage or high blood pressure or heart disease, which are all dangers of anti-inflammatories if used long term, so I think we as physicians have to really be cognizant of that and stick to the first-do-no-harm oath that we took.

Dr. Gundry: 10:00 Yeah, I’ve looked at the pharmaceutical literature about the dangers of simple NSAIDs, and it’s shocking that they knew how dangerous ibuprofen or naproxen was to damaging the gut wall, even a few of them, and, we, we’re old enough to remember that, actually, ibuprofen, Motrin was a prescription drug, and it was really, the FDA, the original warnings were you should only take it for two weeks because it was so dangerous, and, now, we have children’s Advil and we… Again, it’s the most widely available painkiller in your drugstore, and I think-

Dr. Vijay Vad: 10:52 That’s 40,000 deaths a year.

Dr. Gundry: 10:53 Yeah. Say that one more time, 40,000 deaths a year.

Dr. Vijay Vad: 10:58 40,000 people die every single year by taking Advil, Aleve and those kind of over-the-counter drugs.

Dr. Gundry: 11:04 Yeah. Yeah, you and I, you’re right, we’re on a crusade to really severely limit this, and my experience in treating autoimmune disease, and I’ve written about this, a number of people with autoimmune diseases that started with a sports injury or an injury that they were told to take ibuprofen or naproxen for a few weeks and it, literally, perforated their gut wall and it released all these problems, and you could… Now, you could set the date when this happened, and it’s scary, and the really scary thing is pharmaceutical companies researched this. They knew it was going to happen, and we physicians, unfortunately, weren’t told about this, but it’s there, so… Okay, so let’s go back to the gut now, and you talked about food as medicine as I do, so let’s talk about pain and the gut microbiome and the gut wall. What’s your thoughts about the relationship of pain, the microbiome, and the gut wall? Is there a relationship?

Dr. Vijay Vad: 12:25 There’s a big relationship. I mean, I’ve seen it in multiple examples of patients, and, again, to me, good food is good medicine, not necessarily food is medicine, but good food is good medicine, and if you get the microbiome altered in a positive way, then it can actually have an impact on decreasing pain sensitization, so, if you have good gut microbiome, it will actually decrease your pain sensitivity. If you have a bad gut microbiome, then it will increase your pain sensitivity, so the same injury in your disc, let’s say, with good microbiome, if your pain level is three, the same disk injury in somebody with a bad microbiome, your pain level will be set, so it definitely plays a pretty significant role in back pain and can be an effective weapon in managing chronic back pain.

Dr. Gundry: 13:21 Yeah, I think that many of our listeners, hopefully not many of my listeners, know of this influence, but the casual person on the street is going to go, “Oh, come on now, a bunch of bacteria in your gut are going to control the pain you feel? Please, Dr. Vad, get out of this pseudoscience world,” but there’s, literally, plenty of research that proves this.

Dr. Vijay Vad: 13:51 Yeah, I mean, there’s plenty of research, and the research is going to come out in a big, big, big way now that the medical community has all of a sudden woken up and realized that the trillions of bugs in your stomach can have a profound impact on your health. I mean, finally, [inaudible 00:14:08] and our colleagues and said, “Hey, we need to look at what we’re putting in our mouth,” but, look, I’ve met patients, I’ll give you a prime example of a guy who had peripheral neuropathy and significant radicular pain as well, so sciatica combined with peripheral neuropathy, and he was on high doses of Lyrica. He couldn’t tolerate high doses of neurontin. He couldn’t tolerate it, severe pain when he walked.
He was recommended a fusion for his back and, not to mention the peripheral neuropathy. They were doing this IVIG infusions possibly, gamma globulin infusions, and I sent him to a nutritionist, and she recommends… She said, “You are gluten allergic, so why don’t you try a gluten-free diet?” 80% of his radicular symptoms and 80% of his peripheral neuropathic symptoms went away like that in eight weeks, and he was flabbergasted that simply using good food as good medicine, as a tool can have that big of an impact on his quality of life, and, by the way, I have numerous examples in my practice like that, so I wish it was pseudoscience. I mean, it is potent real science.

Dr. Gundry: 15:24 Yeah, and, fortunately, you’re right, I think we’re… The general medical community is beginning to wake up to this, but, just yesterday in my practice, I saw a 63-year-old woman who, literally, arrived in a wheelchair brought in by her husband, and she had a really profound muscle wasting in her thenar eminence in those, and she had a [inaudible 00:15:53] contraction and she literally wasn’t able to walk, and she had been diagnosed with Parkinson’s and that this was a typical presentation for Parkinson’s, and I say, “I see a lot of Parkinson’s patient in my practice, and I can tell you that thenar eminence, muscle wasting and [inaudible 00:16:18] contractor is not a presentation of Parkinson’s,” and she had no tremor, which is possible, and she really didn’t have the flat affect of Parkinson’s, and I said, “Did you even have just simplistically an MRI of your brain or your neck and spine?” and she said, no, they told me that… She was an HMO, a very good HMO, and they said, “No, that’s not indicated in the diagnosis of what you have. It’s classic Parkinson’s,” and she, it turns out, her initial testing shows she carriers the gluten intolerance gene. She has autoimmune markers of Lupus, and no one had bothered to even consider that… You have Parkinson’s and try this drug, and, you’re right, it’s just astounding in almost 2020 that this still goes on.
The point I think I want to make and you want to make is you got to find a healthcare provider that’s going to take your issues seriously, whether it’s your back, whether it’s peripheral neuropathy, and don’t keep looking for proper answers until you find someone who will listen to you. What do your colleagues there in orthopedics say, the spine surgeons, tell you about what you’re doing? Are they in favor of this?

Dr. Vijay Vad: 18:06 I mean, this is a hospital that’s built on procedures and surgeries, a big [inaudible 00:18:11] generating hospital. I’m a big believer that you got to do what’s in the best interest of patients and like with a horse with [inaudible 00:18:19], so, when I initially invented in Back RX simple 15 exercises for reducing back pain, clinical trial results are clinical trial results, we went through the whole IRV and enrolling the patients, and the results were amazing. Simple 15 mind-body exercises done minimum three times a week had a profound impact on decreasing back pain, recurrence of back pain, use of opiates and medical procedures, so the proof is in the data. You know what I mean?
They can throw mud at me as much as they want. Look, in this, doctors especially in a procedure-driven place, they’re not necessarily happy if you say to them that we have tools in our arsenals to keep you… simple solutions to keep you active that does not involve medical procedures or surgeries. They feel threatened by that, because medical economics is a sad part of medical practice, but I think if you’re true to the principle of a being a physician where you put the patient’s interest first, there are a lot of simple solutions for staying active, and I think we have to arm patients with those tools to be able to take better care of themselves and rely less on the healthcare system.

Dr. Gundry: 19:32 Yeah, that’s a great segue into Back RX, so what are the most common issues that you see in the patient who comes to you, and what causes them, and we’ll go from them?

Dr. Vijay Vad: 19:46 Sitting is the [inaudible 00:19:47], so excessive flying, driving, sitting at work and, coming home, sitting on a sofa, that… Sitting is the number reason for a huge explosion in back pain, and what that does is it puts a lot of stress on the disk and it predisposes the risk to get… It predisposes the disk to get injured because it’s not getting enough nutrition during the 24-hour cycle because… so walking actually is very good for the disk because it does this kind of thing in bringing nutrition to the inside of the disc, so I see a lot of disk issues big time and especially nowadays in younger and younger population in their early 20’s because people are just sitting more, and then, at the other end of the spectrum, I see a lot of… Spinal stenosis is the general term, but I just call it the wear and tear in your back from just living life where the disk wears out, the joints become arthritic and you get back pain or sciatic pain, so those are the two most common categories of people that I see.

Dr. Gundry: 20:54 What kind of lifestyle changes can our listeners make to reduce their risk of these chronic forms or acute forms of back pain?

Dr. Vijay Vad: 21:08 I mean, to me, the most important weapon during the workday is something… You and I have sitting for maybe 30 minutes now. You just get up and do a single extend with your arms bent backwards. Let the disk breathe a bit. If you could do that every 30 minutes to an hour, you’re on your way to really reducing your risk of herniating a disc. I can’t think of anything more simple than that. Get up every 30 minutes to an hour at work.

Dr. Gundry: 21:39 I think that’s a great recommendation. I actually haven’t heard it expressed that way, and I love that. You’re not stretching your back, you’re exercising your disk and you’re giving your discs a massage. I like that. I like that a lot, and I think-

Dr. Vijay Vad: 21:56 You’re giving it nutrition actually. When you stand up in that position, you’re bring some nutrition into the disc.

Dr. Gundry: 22:02 Fantastic. Okay, so computers aren’t going away. Desk jobs aren’t going to go away. You and I are seated usually when we’re seeing our patients. Other than just standing up every 30 minutes, what do you think about everybody using standing desks?

Dr. Vijay Vad: 22:27 That’s a big thing of mine in the last two or three years. As data mounts that those who stand more during their work than they sit, they tend to have less chronic health issues. They enjoy better quality of life and, potentially, better longevity, so I’m a big believer. If you can get a standing workstation, then go for it. Especially if you’re 20, 25 years old and you got 30, 40 years of work life ahead of you, get used to having a standing work desk. Great investment.

Dr. Gundry: 22:58 Any tricks on a plane in an economy seat across country?

Dr. Vijay Vad: 23:05 Whether it’s economy, business or first class, still, the pressurized cabin is the big deal, pressurized cabin with low oxygen content. Now, that’s changing as aviation changes with better ergonomics, better oxygenation and better humidity, so, if you look at the new Dreamliners, they have better ergonomics, better humidity and better oxygen content, but not all of us have the luxury of always flying in a Dreamliner, so I think you’ve got to figure out a way to try to recline the seat back a bit. That alone helps whenever you’re allowed to do that, and then, if possible, every hour and a half, two hour, just get up and just try to walk in the back and come back. If you’re going to introduce something as simple as that, it could really help save a lot of air travel-related back issues.

Dr. Gundry: 24:01 If I’m on the window seat and I bring a prescription from Dr. Vad, says, excuse me, I have to get-

Dr. Vijay Vad: 24:09 Wake up the two people seating next to you.

Dr. Gundry: 24:11 Yeah. Hey, I have to get up and walk for the sake of my back.

Dr. Vijay Vad: 24:15 Sorry, my disk needs oxygenation. You can just stand up in place. I mean, honestly, you could do the single extend that I showed you a little a while ago. You’re just sitting in your seat. You just get up and just do these single extends that are… that we’ve shown in the book as well, just 10 counts each leg and sit back down.

Dr. Gundry: 24:33 Perfect, and maybe carry a note from you saying I’m not crazy, this is what I’m supposed to do?

Dr. Vijay Vad: 24:42 They could carry the book and show it to the staff and say, “Look, it’s right in the book.”

Dr. Gundry: 24:48 Yeah, even better. Okay, everybody, so I’m holding up a copy of his book, Back RX, so, yeah, you have to carry this on the plane and just hold it up and say, “Excuse me, I’m protecting my back on this long flight.” Great. I’m going to do that the next time somebody gives me an ugly look. Okay. I like that.
What if somebody… I mean, people are told, if you stand a long time, you’re going to get varicose veins, you’re going to get swollen ankles, and standing isn’t such a good idea because you’re not walking. There are certain people who obviously are not going to be able to stand for an extended period of time. Any tricks for the seated individual?

Dr. Vijay Vad: 25:36 There are desks that you can go up and down, so you could sit for 20, 30 minutes, and you can stand for 20, 30 minutes, and I think, for them, this, they’re called the variable desk that go up and down, would be a great solution, 30 minutes standing, 30 minutes sitting.

Dr. Gundry: 25:52 Perfect, and I like hearing the way these desks came about. They were actually two cardboard boxes on top of each other, and so, if worse comes to worst, get yourself two cardboard boxes and you’ve got a standing desk. I don’t want to take anything from the designers, but they’ve actually-

Dr. Vijay Vad: 26:12 That’s the Dr. Gundry $100-standing desk.

Dr. Gundry: 26:15 That’s right, the $100-standing desk. Okay. Okay, so we’re going to take a quick short break, and we’re going to come right back, so stay tuned.
If you’re listening to this podcast through your favorite podcast app, I’ve got some great news. You can also watch every episode of this podcast, plus hundreds more special videos, on my YouTube page. Just go to youtube.com/drgundry, and be sure to click the subscribe button.
Okay. Welcome back to The Dr. Gundry Podcast. We’ve got Dr. Vijay Vad, the author of Back RX, the new and expanded, revised edition, and welcome back, sir. We’re talking about back pain, and I want to go to a new subject. Tell me about the relationship of weight gain and back pain. Is there any?

Dr. Vijay Vad: 27:14 There’s a huge relationship between weight gain and back pain, so, whether it comes to putting a tear and bulging a disk or the disk wearing out sooner and you get… You’re getting arthritis through your spine in your 40’s and 50’s because of increased weight. It has a lot to do with it, so, I think, besides maintaining a good core, maintaining a good body weight is crucial for trying to minimize back pain.

Dr. Gundry: 27:46 I’ve heard, and I know any pregnant woman knows this, that particularly weight gain particularly in your gut really changes your posture and how your back… The lordosis of the spine is changed. Do you see that as a factor? Is it more than that?

Dr. Vijay Vad: 28:10 I think that’s a factor, definitely, but the sheer loads that you’re pressing down the disk are just… so, if you’re seated, if your normal weight and you’re seated and slightly bent forward, let’s say, the disk pressures are X, but if you’re 25 pounds overweight, then, the seated bent-forward, the pressures are almost doubled even just by 25 pounds overweight, so… but the good part about that is it’s a four to one ratio. If you lose one pound, you take about four pounds per square inch of pressure off the discs and the joints, so it’s a 400% return, so not a bad deal.

Dr. Gundry: 28:49 That’s a very good deal. I used to long ago, when I was doing some early TV shows, when I first changed my career, I had lost 70 pounds, and I would bring a 50-pound bag of dog food into the TV studio and I would ask my host to take and hold the 50-pound bag of dog food in front of him or her and start walking around the studio and see how they did, and it’s… What creeps up on you slowly, you don’t notice it, but when you suddenly have 50 pounds or 40 pounds or 30 pounds, it’s dramatic what you can feel in your back.

Dr. Vijay Vad: 29:39 Exactly. All of a sudden, you realize, oh, my God, I’ve been carrying around those 70 extra pounds for all those years. Imagine the tension on the back, the hips, the knees, the ankles.

Dr. Gundry: 29:51 Yeah, and, certainly, in my practice, we’ve seen people who, literally, were scheduled for back works and spinal fusion, hip replacement and even knee replacement. When we got weight off of them, they actually canceled their operations, and it was the weight that was exacerbating these conditions, and, certainly, the weight, as you and I both know, contributes, particularly abdominal fat, contributes to inflammation to the entire inflammatory condition.

Dr. Vijay Vad: 30:28 Absolutely, you already increased the chronic inflammation that is associated with increased back pain, arthritis, heart disease, cancer and on and on and on, neurodegenerative issues, so it pays to keep the weight down and keep the inflammation down.

Dr. Gundry: 30:44 Yeah, and getting back to what we talked about earlier, I mean, there is a very strong correlation to NSAID use and coronary artery disease and vascular disease in general. In fact, many of us forget that several of the prescription NSAIDs were removed from the market because of this association with increased heart attack and stroke, and so all of these actually share a common factor, and there’s really none of these that are safe for long-term use.

Dr. Vijay Vad: 31:23 There are absolutely none, and that’s one of the reasons I invented a medical food called Vonacor. It’s a highly absorbable curcumin that we just finished clinical trial showing that its pain-reducing efficacy is similar to that of naproxen without having the side affects of the [inaudible 00:31:42]. As a matter of fact, this particular curcumin, the micro-active formulation we have, the serendipity was that it reduced high-sensitivity CRP, so the Cornell cardiologists are salivating over this serendipitous discovery.

Dr. Gundry: 31:58 That’s great. Yeah, I’m a big fan of curcumin, and, people who are listening to us, that’s the active ingredient, if you will, in turmeric, but, unfortunately, you and I both know that turmeric is very poorly absorbed and-

Dr. Vijay Vad: 32:15 That’s why we have my team in Boston put together a technology to increase not just the absorption, but is… We call it bio-activity…

Dr. Gundry: 32:24 Activity, yeah.

Dr. Vijay Vad: 32:24 … so that the curcumin could get into the inflamed tissues.

Dr. Gundry: 32:27 Yep. Exactly. Okay, shifting gears, every good old… Dr. Sarno was famous for his claim that all back pains started in the mind. What say you about that?

Dr. Vijay Vad: 32:43 I used to invite John Sarno to come and give grand rounds at our hospital, and he was a positive influence on my journey that I think his contribution was that the mind plays a big role in back pain. After 9/11, I saw a big number of people with herniated, real herniated disk from the stress of 9/11, so there’s a real relationship, the mind-body relationship.
I think where he went a little bit overboard is that all back pain is tension myositis. Back pain, there are multiple diagnoses that can cause back pain, and whereas 10% of back pain could be the tension myositis that Dr. Sarno says, where there’s nothing structurally wrong with you, the other 90% have structural issues. Maybe that the mind and the stress contributed to either the disk blowing out or the pain spiking up, but there was a real underlying structural issue, so… but I do believe his overall contribution is a good one despite over… going on one diagnosis as an end-all-be-all for back pain.

Dr. Gundry: 33:52 Are there any mental exercises that people with back pain can benefit from?

Dr. Vijay Vad: 33:58 Absolutely. I mean, I tell patients with chronic back pain to do five minutes of meditation at night before going to sleep or… That’s why Back RX is truly a mind-body exercise regimen. I mean, the book title is actually an exercise program where you do deep breathing combined with 15 postures, but, to this date, I get letters from 2004 to ’19, 15 years, from patients saying, “Just the breathing aspect of that exercise program had a profound impact on my pain,” so I think controlled deep breathing, meditation, mind-body therapy, these all have a huge positive impact on back pain, and, remember, often, back pain can present with depression, so it can have a positive impact on both.

Dr. Gundry: 34:45 Yeah. Okay, so we’ve got the mind. We’ve got posture. We’ve got your great exercises. Your and my food recommendations look very similar, and I think a lot of us working in this area for so long have very similar views. Give our listeners your thoughts on what foods in particular are really going to benefit them with back pain for instance.

Dr. Vijay Vad: 35:19 I mean, the anti-inflammatory foods really, so, instead of corn oil, try to use olive oil. Minimize intake of processed sugar, and if you have ice cream one day a week, it probably is not going to have any huge negative impact, but, in general, minimize processed sugar as much as you can, but I’m a big believer in plant-based diet, so I think that has an impact, but plant-based diet doesn’t mean eating popcorn and chips, but it means eating complex carbohydrates, so the bulgur, the quinoas, those kind of complex greens, obviously greens. Fish, to me, that’s a rare exception. For me, that truly has very high anti-inflammatory properties with Omega-3, but you’ve got to be careful about lead poisoning and things like that with fish also. It’s not a gimmick, but… so I think the general recommendations are less processed sugar, less fatty meats, more greens, more complex greens, more things like olive oils, more berries, those kinds of things.

Dr. Gundry: 36:35 Great. Getting back to supplements. You started our conversation with mentioning how important vitamin D is, and I second that. Number one, it’s a hormone. It’s not a vitamin, and I think it’s probably essential. I’m glad to see there are a lot of labs in this country that are raising the normal vitamin D level up to about 120, and I, in my practice, try to get my patients somewhere between 80, 100. I’ll take 120. I’ve run my vitamin D level greater than 120 for the last 17 years now to prove I’m not dead, and so far, so good.
Any other supplements that, just as a general rule, besides vitamin D3 that we should be thinking about?

Dr. Vijay Vad: 37:29 I mean, practice what you preach. For me, I take daily vitamin D3 and I take curcumin. I mean, for me, curcumin has benefits of potentially reducing risk for Alzheimer’s, potentially, heart disease, colon cancer. I mean, outside of those two, of course, I’m not a huge believer in taking 18, 20 supplements every single day, but I think it’s balanced diet. Take things like vitamin D and curcumin. Try to exercise every day to keep your back pain in check, pragmatic, sensible things.

Dr. Gundry: 38:06 Okay. Dr. Vad, it’s a pleasure to talk to you, and thanks so much for coming on the podcast. Where can listeners find out more about you and your work, and where can they pick up the new edition of Back RX?

Dr. Vijay Vad: 38:21 Back RX new edition is available at Amazon, Barnes & Noble, all that kind of places, and then more information about me is vijayvad.com or hss.edu. That’s Hospital for Special Surgery in New York, and, hopefully, I’ll continue my work for finding simple, effective solutions for staying active.

Dr. Gundry: 38:45 Please never retire and please keep seeing patients because that’s where people like you and me get all of our knowledge, and I congratulate you again on that.

Dr. Vijay Vad: 38:56 Yep, patients keep me young and active, and I appreciate the tip about the vitamin D, whereas it was 50… was my personal bar for chronic back pain, maybe actually consider raising that to 70 or 80, so I learn something new every day, so I learn something new.

Dr. Gundry: 39:10 Yeah, and vitamin D actually is very essential for activating stem cells that line our gut that I referenced in my latest book, The Longevity Paradox. It’s very shocking to me to see how important high vitamin D levels are for sealing the wall of our gut and making stem cells grow, so I love that. I love that hormone.

Dr. Vijay Vad: 39:34 That’s great.

Dr. Gundry: 39:35 All right, thanks again, and I hope we’ll have you back again sometime soon for some more tips.

Dr. Vijay Vad: 39:42 Absolutely.

Dr. Gundry: 39:43 All right. Thank you very much.

Dr. Vijay Vad: 39:44 Thank you, Dr. Gundry. Nice chatting with you.

Dr. Gundry: 39:47 Okay, it’s time for one of my favorite parts of the podcast, the audience question, and ryansmith394 on Instagram asked, “Dr. G., does coffee or tea disrupt the autophagy taking place while in a fasted state?”
Absolutely not. First of all, for those of you who are wondering what the heck is autophagy, autophagy is actually the cellular process when a cell is nearing the end of its lifespan. We actually have two things that can take place. We can actually recycle the cellular components and build a new cell, and that’s called autophagy and, quite frankly, autophagy is incredibly good for your longevity. The other is the cell, literally, exploding like a death star as I tell my patients, and that’s called apoptosis, and there won’t be a test, so it’s okay, so coffee and tea actually does not influence autophagy. In fact, there is some evidence that compounds in coffee and tea, as long as you drink them black, may actually stimulate autophagy, so, yeah, have your coffee and tea.
When I’m fasting during the day, I start with two cups of coffee in the morning, and then I have about five cups of green and Pu-Erh tea during the day along with mint tea mixed in with that, so… and you can, I guess, see the effect on me which is so far, so good, so… but that’s a great question, so thanks very much.
Another question I get all the time from my patients is, “Can I still take my supplements if I’m fasting?” and, absolutely, there’s going to be no effect on taking supplements while you’re fasting. In fact, I happen to think that there are certain supplements that will really benefit you during fasting, but now is not the time to talk about that.
Okay, and here’s our review for the week from Maria Mamina, who gave her review on Apple Podcast. I believe that we have the wisdom to cure all diseases and Mother Earth help is with that. This podcast shows we don’t need medicine in order to be healthy. We need to be aware. Thank you Maria. That’s a great comments, and thanks again.
All right, that’s all for this week’s episode of The Dr. Gundry Podcast. We’ll see you next week. Bye for now.
Thanks for joining me on this episode of The Dr. Gundry Podcast. Before you go, I just wanted to remind you that you can find the show on iTunes, Google Play, Stitcher or wherever you get your podcasts, and, if you want to watch each episode of The Dr. Gundry Podcast, you can always find me on YouTube at youtube.com/drgundry, because I’m Dr. Gundry and I’m always looking out for you.