Speaker 1 (00:00:00):
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 (00:00:14):
My wife Penny and I love a movie night. We just saw Studio 54 and thought it was marvelous and wrenching. Whenever we sit down to enjoy a movie we always crave a bowl of popcorn, and I’m sure most of you can relate, but popcorn is a lectin bomb. As a corn based product, it wreaks havoc on our gut. Eat enough corn based products like tortilla chips and popcorn, eventually these toxic lectins or sticky proteins found in corn make tiny holes in your gut lining that can lead to inflammation.
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To name a few of their delicious flavors, Nature Nate’s has ghee butter flavored, avocado and sea salt, masala, pink Himalayan salt, my wife’s favorite, and so many more to choose from. And as a listener of this podcast, when you visit naturenatesllc.com you get a 15% discount off your first purchase when you use the code Gundrypodcast, all one word. That’s Nature Nate’s LLC, N-A-T-U-R-E-N-A-T-E-S-L-L-C.com and use the code Gundrypodcast for 15% off your order.
Being a surgeon for more than 40 years, it’s fair to say I’ve earned my nickname Mr. Knife Guy, but as the saying goes, you can’t teach an old dog new tricks. I’m talking about a Masterclass. You see, I love cooking, and anything that improves my game in the kitchen, I’m game. So, when I watched award-winning chef Thomas Keller’s class on knives and how to keep them in tip-top shape, then his lesson about which tools I needed for creating a five-star restaurant experience at home, I have to say, I learned a few things. As you probably know by now, that’s the theme of my life. Keeping an open mind and never, never, ever stop learning. That’s why I’m a big fan of Masterclass. Where else do you have access to the greatest minds in art, business, entertainment, tech, design, entrepreneurship and so much more at your fingertips?
My wife Penny loves it too. You see, she has a great eye for style and loves all things design, so one of her favorite Masterclass series by interior designer Kelly Wearstler about choosing room colors, working with textures, and sourcing inspiration. But really, there is something for everyone with literally hundreds of topic to choose from. The best part is they’re bite sized classes, usually around 10 minutes or less, and accessible any time on your phone, web, or smart TV. So, even if you’re crazy busy like me, you can fit in an enlightening session here or there throughout your week. I highly recommend you check it out. Giving the gift of knowledge is also a great idea. Get unlimited access to every Masterclass, and as a Dr. Gundry Podcast listener, you get 15% off an annual membership. Go to masterclass.com/gundry. That’s masterclass.com/gundry for 15% off Masterclass.
Welcome to the Dr. Gundry Podcast. So, here’s probably a shocking statistic that doesn’t shock me, but I hope it shocks you. One in five children has a mental health disorder, one in five, and if you’re a parent or a grandparent then you want to listen up, because today I’m going to be diving deep into what’s driving this alarming rise in childhood mental health issues. To do that, I’m joined by Dr. Kenneth Bock.
Kenneth has over 35 years of experience diagnosing the root cause of chronic illnesses and restoring balance to his patients’ immune systems. He’s got a brand-new book out called Brain Inflamed: Uncovering the Hidden Causes of Anxiety, Depression, and Other Mood Disorders in Teens and Adolescents. So, in today’s episode Kenneth and I are going to discuss why these mental health problems appear to be increasing, not only appear to be increasing, they are increasing. What it has to do with your children’s gut health, one of my favorite subjects, and what you can do if you suspect your child is suffering from a mental health issue.
Kenneth, it’s great to have you on the show today.
Kenneth Bock (00:05:22):
Dr. Gundry, it’s great to be with you, really great to be with you.
Dr. Gundry (00:05:25):
Welcome. This is just for people who are listening, I have actually raved about this book and my comment of the book is on the back cover. So listen up folks, because this is important. All right. So, I want to dive into a bunch of questions, and the first question is, there are theories about the root of mental health problems in children, and maybe we could divide that into two almost conflicting theories. One is diet and then nature theories, nurture or nature in a way. So, you contrast a Mediterranean diet, high in fish, olive oil and vegetables, with a high saturated fat, high sugar diet common in the US and elsewhere in Western countries. Is there literally a connection between the food that we eat and what goes on in our brain? Let’s start there.
Kenneth Bock (00:06:32):
That’s actually getting down to basics, right? Food.
Dr. Gundry (00:06:35):
Yeah.
Kenneth Bock (00:06:35):
And there clearly is, and it kind of always blows my mind that people seem to almost gloss over it and not really pay it any heat, because you think of what the typical American, especially the typical American teenager shovels into their mouth that goes through the gut, and I know how important you know the gut is, and on an everyday basis. I see it because when you see all these kids, you hear about their diets, and you realize by just sometimes changing, and obviously we’d love people to be on more like the Mediterranean type diets as much as possible, and there are studies, obviously many studies to show how this can help with depression and anxiety, but it’s just sometimes you have to do the simple things. You have to cut out the refined sugars, first step, and also the artificial additives, the preservatives, the flavorings, the colorings, because I can remember, I’ve been saying this in our field of integrative medicine, I’ve been in practice since ’83, but I remember a study, I think it was in 2008 in The Lancet from Wales, and they actually did a double-blind controlled study of food additives, preservatives, colorings and food additives in two cohorts of kids, three-year-olds and eight and nine-year-olds, and they clearly showed that it contributed to ADHD.
I think from then on, all the naysayers really, it was in The Lancet, they could no longer be naysayers. So, what we’ve been saying for all these years, as you know, so many things you probably say, years later it gets more accepted, it’s not “controversial.” Well, I think so the very initial things are stop the food additives, the processed foods, and the refined carbs. If we can do that, we can really help a lot of kids. Then of course if you can move more into the Mediterranean type diet and get off all those grains, and get more into the healthy proteins, and fats and veggies, veggies, veggies, we’re in even better shape.
Dr. Gundry (00:08:40):
So, I may have mentioned this on one of my other podcasts, but you’re probably aware, and if not, I know you’re aware of it. Do you remember the Appleton school, Appleton, Wisconsin middle school study of changing the food in the school cafeteria and behavior?
Kenneth Bock (00:09:03):
Yeah, I can’t quote it, but yeah.
Dr. Gundry (00:09:06):
Yeah. Again, I think because we’re talking about this, I’ve been to Appleton, Wisconsin. It’s a cute little Midwest college town. They were having a lot of behavior issues in their middle school, their junior high, and they had an organic café in the town. The school district says, “We’re going to contract with this organic café to serve breakfast and lunch at the school and then we’re going to have all the families come in, all the parents come in, and we’re going to teach them what we’d really like you to feed your kids at night, try to keep this going.” And lo and behold, their truancy dropped, the trips to the vice principal’s office plummeted, and their test scores went up. Everybody says, “Wow, look at that.” And they were so impressed that they decided, the café said, “Well, this has been great, but we can’t keep doing this, it’s not our business.”
So they said, “Okay, we’re going to institutionalize this. We’re going to get a big corporation to come in and keep this going.” I won’t mention the name of the corporation, you can find it out. Once the corporation took over, everything went back to normal. The truancy increased, the behavior, the test scores went down. Of course, the big corporation didn’t do the … They just went back to giant food suppliers and it changed behavior. You’re right, it’s hard to believe, but in fact that’s what happens.
Kenneth Bock (00:10:56):
Yeah, or the problem I think also is it takes effort, and unfortunately to eat more organic, it costs more. So, I think that’s one of the barriers to more widespread implementation unfortunately. It takes effort, I mean, to cook healthier foods rather than eat all the fast foods. I mean, imagine a kid starting with a cold cereal. I don’t want to give a name, I don’t, maybe you can, but you know these colored flavored charms or whatever. I mean, what a way to start. I mean, it’s just empty calories and all kinds of processed additives, and it’s no wonder that the raw materials for the function of the brain, which is responsible for not only cognition but mood, is altered. I’m sure you feel this way, it doesn’t take a rocket scientist to figure some of these things out.
Dr. Gundry (00:11:53):
These are very modern foods. I have to remind my patients that nobody had a bowl of cold cereal for breakfast until 1906, when Kellogg’s invented it. I did some of my training in England, and no one in England ever had a bowl of cold cereal until 1940 when the Yanks brought it over during World War II. These are modern foods, and you’re right, they’re just a bowl of sugar, with coloring now that … So, I see a lot of kids and teenagers in my practice primarily with autoimmune diseases. I have a big Crohn’s practice, a lot of juvenile rheumatoid arthritis. Certainly these kids and teenagers have some really good motivation to, once we show them that food is the culprit, to change their diet, and they can feel it, they can see it. But in the mental health area, in your practice, how the heck do you motivate a teenager who is living on Lucky Charms and McDonald’s and can see absolutely no reason that that food that all of his friends or her friends eat who are “normal”, how do you convince somebody to make a change?
Kenneth Bock (00:13:37):
It’s a great question, and that’s something I’ve really worked hard at and I feel like I’ve gotten good at it over the years, and part of it is to learn how to bond with the kids. You can’t at any way be arrogant, or condescending, obviously. I mean, the kids I take care of with autism, that’s another part of the population I deal with, I get down on the floor and look them right in the eyes, even though they don’t want to look in my eyes.
With the teenagers, I’ll get to them. I’ll try to figure out what it is that they can relate to. If it’s a kid that’s a boy or a girl who’s interested in athletics and they play basketball, I may be able to make an image because I coached my kids when they were younger. Hey, can you dribble with your left hand? Can you go to the hole to the left, not just the right? Some things that they may perk up, wow, this guy is not too bad. Also, it’s a matter of the pain that they have, and not just physical pain, it’s a matter of … So, try to get to them. How are you doing with your friends? How is this affecting you? Even maybe pimples or gas.
We talk about in the book, we make a funny image of the gas, but if you’re a teenager and you’re making smelly, we use the word farts, I mean, if you’re passing malodorous gas, as I’ll say in my most scientific way, but it’s like that’s kind of embarrassing. So hey, what happens if we can help you with that or your pimples? And then get to the thing about maybe make you feel better, be better with your friends, that kind of stuff.
Dr. Gundry (00:15:10):
Gotcha. We certainly see that behavior changes from food choices. Do people, obviously you’re successful at this, people actually notice a change in their behavior or things are doing better when they’re eating certain foods?
Kenneth Bock (00:15:35):
No question, but the interesting thing is sometimes you ask the question, how are you doing? No [inaudible 00:15:42].
Dr. Gundry (00:15:42):
Yeah.
Kenneth Bock (00:15:42):
Teenagers, their head’s down. But then you start asking the specific. Well, okay, how are you doing in school? Well, actually my grades are better. I’m able to attend better and concentrate. How are you doing with your friends? Well, maybe I’m not as irritable, maybe hey, I’m getting along better, I’m a little bit more affable. So, you have to be able to point it out to them sometimes, but when you can make the changes in their life, you definitely see it. There’s no question. I see it, obviously that’s why people come from all over the world for these kind of treatments. You see it, but the key is to relate to the kids. I really feel like that’s something that … And I think it’s something that doctors really have to learn, how to interact and relate to.
There’s one thing I learned in University of Rochester. I had this mentor, George Engel, I don’t know if you have, but he was the father of biomedical psychosocial medicine. Right from the first day when we did our cadavers, we did them in the morning and then we met in the afternoon and talked about how we felt, which was pretty profound. So, I learned that whole open-ended interview and how to relate, and I think that’s really helped me with the kids.
Dr. Gundry (00:16:57):
So, actually take us through that. So, how would, number one, okay, somebody’s found you, maybe from not the Hudson River Valley, and we’ve got a “problem” teenager. Let’s use that as an example. Do they come to your center? Do they spend time at your center or is this all remote now? How does it work?
Kenneth Bock (00:17:26):
Well, it can be either way. I mean, I love when they’re local because we have people come from so far that now a lot of it’s always been telemedicine, video, et cetera, but they always had to come first. So, you’d have to travel from Thailand, or you have to do an exam, as you know, but now it actually freed up. We don’t have to do that, so I can treat through a video first. But either they’ll come in, I like when they come in because I can actually really interact. I have a couch, I have chairs and a couch, and the kid usually sits on the couch. So, I’ll talk to them. If they’re an older kid I usually let them do the talking. If they’re certainly over 18 they got to give permission for their parents to be there, which is very interesting, and they have to sign.
So, I guess the word I would say, Dr. Gundry, is I like to try to empower the kids. So, if you can empower the kids and get them onboard with you and not just jump “on the side” of their parents and really get them to be able to somehow acknowledge what’s bothering them. Because at first they’re going to say, “Eh.” So, if I can somehow get to them, and I’ve had a sense of who they are, and I can get to what’s really there and say, “Hey, listen, if I could help you with this, would that interest you?” And I say, “Because I don’t want to waste your parents’ time and money and my time because I’m not going to be over you with a stick.” I tell them. So, you’d be surprised how you can enlist them with this kind of a thing. I think for practitioners who hear about this, they just need to somehow try to be able to relate to the kid. I think it’s really key.
Dr. Gundry (00:19:06):
So, let’s shift gears. You and I probably even will talk some more about food, but the other side of the coin is the nature theory that well, children right now and teenagers have far less unstructured time for play, and time to be in nature. Poverty certainly has a big piece to play on this. Show me or tell me what your thought is. Okay, how much of this change is a part of what’s going on with kids today?
Kenneth Bock (00:19:47):
I think that’s huge, and it’s going to manifest. In a second I’ll get to how it manifests physiologically, but psychologically this whole thing with … I’m two hours north of New York in the Hudson Valley, but I get a lot of patients probably from New York City. In New York City, even before you have a kid you’re thinking about their preschool. Then once you have a kid they’re getting tutored to interview for preschool. This is true. I don’t know if you’ve heard of this. They’re actually getting tutored, and I’m not putting the parents down, this is not a put-down, but it’s so competitive, it’s so crazy, that kids are not being allowed to be kids, and I’m a big proponent of letting kids be kids.
We grew up, we screwed around, we played. I didn’t have much money. We played with any kind of ball and a stick, that was a bat. We wrapped tape around it, a broomstick. Skiing and tennis were beyond me at that time, but the point is we had fun and it was unstructured, and we were outside. Nowadays, as you know, the pressure, any sport now it’s a competitive club sport, you got to really be the best, you’re going to get tutoring or coaching for that, you’re going to get tutored in your school, you have to have the best grades, and obviously we all did very well in school, but the point is I think that’s a big thing. I want kids to be able to be kids, that’s number one.
Number two, the social media pressure. This need to be aware and know everything, and be on display every minute. So, if you’re picking your nose and somebody gets it on a camera, it’s terrible. So, that coupled with FOMO, fear of missing out, I think these kids have so much pressure on them, and I feel bad about it. Then you couple that with the whole pandemic and the loneliness and isolation, and that’s what I say look, we end up having this cauldron, and they’re just boiling, bubbling over the cauldron with so much stress, and the thing is stress causes systemic inflammation, and that systemic inflammation affects the blood brain barrier and then leads to brain inflammation, and brain inflammation can manifest not only as cognitive issues but as neuropsychiatric symptoms, and that’s the whole premise of the book.
The interesting thing, Dr. Gundry, is when we see all that stress we attribute everything to stress, but we forget all the other layers in the cauldron that bring people up so that the stress throws them over. If you really lay low in this cauldron, or I call it immune kettle, you can tolerate more stress, because stress is the thing that is the most obvious, and you say, “Oh, this is all stress.” Well, truthfully, it’s not. It’s coupled with all the other things, which we can talk about, but it’s also that that stress causes inflammation, and that’s the thing I want people to be aware of.
Dr. Gundry (00:22:52):
So, what’s the difference between this seeming rise in mental health issues and normal teenager behavior? Help us all understand that because all of us were teenagers. [crosstalk 00:23:11].
Kenneth Bock (00:23:10):
And we know what we did, right? We know.
Dr. Gundry (00:23:13):
Exactly.
Kenneth Bock (00:23:14):
So, it’s a good point, and what I’ve done in the book is I put together something that I term the mood dysregulation spectrum, which puts together kind of like the autism spectrum, but it’s for neurotypical kids and their moods. It goes from left to right in terms of lower intensity symptoms to much more intense. So, like irritability and moodiness, I have this normal curve that allows for some of that, that we all can have a little bit of that sometimes, and certainly teens can have that. Then you go to anxiety, and depression, OCD, panic, aggression, bad mood swings and psychosis, those are really intense. So, there is an amount of that’s “normal”, and then there’s a little higher in the irritability and moodiness that I call teenageitis. How you differentiate normal from really kind of the more pathological or problematic?
You got a teen in your home, he or she is a bear. I mean, unbelievable. They go have a sleepover, right? That mother or father tells you, “You kid is the most wonderful kid. So polite, so sweet.” And you are going, “You’re talking about my kid? You’re talking about my kid?” That’s what we call teenageitis. That’s a behavioral thing. That’s not going to be all this inflammation and all the other stuff. That’s more a behavioral thing. They’re good in school maybe and on the outside with friends and at a friends house, at home, that’s unfortunately where it’s going to happen. You want it to be there, obviously you don’t want it to be there, but if it’s going to be anywhere, as parents, we got to deal with that. They aren’t stressed at home, they feel comfortable, they take it out on us. So, that’s a teenage thing, when it seeps over with friends, and schools, and certainly at a sleepover where you hear back, oh my god, your kid’s really a problem, that’s much more of a problem.
Dr. Gundry (00:25:12):
Gotcha. So, you break the immune system and inflammation, and brain inflammation, into lots of different layers. So, let’s start at the bottom. The bottom I think you and I would probably both agree is genetic predisposition. Start there. How much does genetics factor into this?
Kenneth Bock (00:25:41):
I mean, I think obviously genetics plays a role because we all get this predisposition, the genes from both our mother and father. So, some of those genes, as we know, genes code for proteins. Proteins are either structural or functional, like enzymes. So, if you have these mutations in a gene, even these tiny, tiny mutations that can affect one nucleotide, one or two of them can affect the function of a gene, like the MTHFR that metabolizes folate to methylfolate, which is the active folate that crosses the blood brain barrier into the brain. Then you’re going to have let’s say if you have one mutation you may be 70% efficient. If you have two mutations, you may be 30% efficient. So, how do we remedy that’s interesting, and that’s just one gene. There are many genes that we get from our parents, in addition to how we look, the phenotype, that obviously we get from our parents, is also these predispositions.
You hear, boy, my father was anxious and my uncle had bipolar or OCD. There is that genetic predisposition. What we do in integrative medicine, and I imagine in certainly what you do as well, I call it nutritional modulation of genetic expression. It’s not a fait accompli, so that’s the good news. I mean, the bad news is we do get our genes, and for better or worse, some people have great genes. I just saw somebody yesterday. One parent died at 98, the other is still living, 95 or something. I mean, that’s amazing, those are good genes. We don’t all get that, but we can modulate the genetic expression of genes, which is really comforting in some way, and it should be comforting.
It takes effort in terms of diet, it takes maybe taking some supplements, right? With the mutation in the MTHFR gene, if you’re going to get less methylfolate because you have two mutations, so let’s say you’re only 30% efficient, you can supplement with methylfolate, and in fact, we’ve been doing that for a long time in our kids. We use a lot of methyl B12 and methylfolate because it can affect cognition, it can affect attention, it can be calming, but the point is you have to take it. Now even that’s known as an adjunctive antidepressant. So, in addition to the SSRIs, we know now that there are … We use the natural forms of methylfolate, but there are prescription forms also that you can take at higher doses, 15 milligrams even, and it can have a significant difference because the methylfolate is involved in the production of neurotransmitters, for instance. So, it’s all about affecting the neurotransmitters.
So, I think this is the genetics predisposition, but also one of the other levels is metabolic disruptions, metabolic dysfunction, and we can impact on that greatly, so.
Dr. Gundry (00:28:33):
Yeah, let me just stay with the MTHFR mutations. We call them the mother effer genes in my practice, and I tell everyone, because if you kind of say this out loud we will bleep you from network television, and the kids really like that. Now, some-
Kenneth Bock (00:28:54):
Do you mind if I use that?
Dr. Gundry (00:28:58):
Oh no, please.
Kenneth Bock (00:29:00):
[crosstalk 00:29:00].
Dr. Gundry (00:29:00):
I’m telling you, they’ll really like it. One of the reasons that I like to call it that is because there’s a lot of awareness of the mother effer genes, and a lot of people, and you and I know both know that these do correlate to increased risk of anxiety and depression, and ADHD, and drug abuse, alcohol abuse, suicide tendencies, and they do track in families, and I take a complete family history, and lo and behold, you can spot this. But a lot of people, even tons of people carry either a half mutation or a full mutation in one of the two, and a lot of people want to blame everything that has ever gone wrong in their lives with well, I carry this gene, and that’s the cause of all my problems. I bet you’ve seen this as well.
Kenneth Bock (00:30:02):
Totally. They put too much … Well, I think it’s not just that gene, but it’s people put too much attention. Even the whole thing with the genetics, it’s very important, it’s a predisposition. I call this a roadmap, it’s a roadmap, but it’s not a fait accompli. So people come in with their whole genetics and they think that’s them, and I say, “No, no, no, that’s not you. It is a predisposition.” We look at it, and we can affect it [inaudible 00:30:30]. But I think there’s too much weight, and some practitioners put way too much weight on that, and they treat every single thing, and it’s you have to do the clinical. The genetics is a good to know, and the MTHFR is very helpful because if you see a, we call it a homozygous, or a double mutation, they’re going to need higher doses of methylfolate. But we also have to remember that with the good, and it’s very helpful with many patients, there’s also in the kids methylfolate can cause hyperactivity, irritability. I say in about 10%, rarely aggression, rarely. So, you have to be aware of that. So, sometimes you have to go very slowly. I wouldn’t just jump and-
Dr. Gundry (00:30:02):
Correct.
Kenneth Bock (00:31:09):
… give somebody 15 milligrams. You got to go very slowly and you have to be able to see how they do clinically, definitely.
Dr. Gundry (00:31:16):
Yeah. We found, and you’re right, there are more than a handful of people that will have the exact opposite effect to giving methyl groups as replacement. I use low dose niacinamide as a way of damping down this effect. Actually, it usually works really well.
Kenneth Bock (00:31:38):
Yeah, I use niacin, but true, you can use niacinamide, also hydroxy B12, because hydroxy B12 can suck up the methyl group. So, if you’re having that, exactly. I’m with you there. Niacin, niacinamide and hydroxy B12.
Dr. Gundry (00:31:51):
All right, so let’s go to the next level, which you like to talk about, and that’s nutritional deficiencies. You and I know perhaps more than most people, the nutritional deficiencies because of the way our soils are depleted and the food we eat is striking. So, what say you about nutritional deficiency?
Kenneth Bock (00:32:17):
I think it’s all of the above. That’s one of these multiple choice questions, all of the above. It is definitely the soils are depleted. Certainly with selenium we know that, and other things, but I think it’s the diets. I mean, I think when you talked about the cold cereals, somebody just told me yesterday about how these foods have all these nutrients. I say yeah, what they do is they strip out all the nutrients and they add back small doses of a few, and they say they’re “enriched.”
Dr. Gundry (00:32:47):
Yeah.
Kenneth Bock (00:32:48):
All these sugar laden foods, they’re nutrient empty, they’re calorie dense, nutrient empty. The one thing about sugar is it puts additional demand for nutrients that metabolize carbohydrates and sugar. So, it’s a double whammy. You’re getting an increased load of junk that you have to metabolize and you’re not getting the nutrients to metabolize it.
So, the interesting thing is when we talk about nutrients and a pediatrician, and again, I’m not downing pediatricians, they do the best they can, they help so many kids, but if you talk about these nutrients, say, “Oh, they eat well. They eat it, they’re fine, the parents give them a good diet, they’re fine.” Well, the good diet is not always so good, but if you don’t look. I said this in my book, The Road to Immunity in 1997, it was my first book, if you don’t look, you won’t see, and if you don’t listen, you won’t hear. So, if you don’t look at nutrients, sure, you’re going to say they’re fine, but I check vitamin D in every patient, I check multiple nutrients like zinc, and lo and behold, a lot of them. I mean, vitamin D is deficient in so many, you know that, I’m sure. So many.
Dr. Gundry (00:33:59):
Yeah.
Kenneth Bock (00:34:02):
The B vitamins I generally check with the urine organic acids, so I can look at metabolites that are consistent with function of B vitamin insufficiencies. I like the word insufficiency because sometimes they’re not below the quote deficient level, same thing with vitamin D, but I think insufficiency is a much better word because it’s insufficient for their adequate function as opposed to you get a vitamin D of 30 and they say, “Oh, they’re fine.” Well, they’re not really fine, or even some of them will say 23, that’s in the zone, that’s maybe. It’s not maybe. So, even a lot of the B vitamins I think it’s a matter of insufficiency rather than frank deficiency.
Dr. Gundry (00:34:47):
So, next area. Allergies and sensitivities.
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Where does that fit in all of this?
Kenneth Bock (00:39:27):
Well, and as I mentioned before about the whole area of inflammation and inflammation affecting the brain and causing symptoms, psychological kinds of symptoms, allergies and sensitivities create inflammation. So, this inflammation can come in so many different forms. I mean, infections create inflammation. You’re dealing with chronic autoimmunity, autoimmunity creates inflammation. Allergies and sensitivities create inflammation. Frank food allergies like … Sometimes you can see it, if let’s say you take a strawberry allergy, you get hives. That’s the skin is inflamed. That’s very simple. You can see it, it’s obvious, it’s very quick, but there’s a lot of allergies that are not as obvious that create inflammation. So, there’s the classic IgE allergies, which like a strawberry causing a hive or urticarias, but then there’s the sensitivities, the gluten sensitivities, which are not allergies but either they’re immunologically based like in celiac, or non-celiac gluten sensitivity, which causes a lot of inflammation. Dairy can cause a lot of inflammation, as can any single food. I know you talk about a lot of foods, the lectins and things, there’s a lot of type of foods that can contribute to inflammation. I think we have to not be rigid about it. We have to realize that it can differ in various people.
Dr. Gundry (00:40:52):
Sure.
Kenneth Bock (00:40:53):
So, that’s part of my job, is to figure out what foods. Although I would say that I put many people on gluten-free, dairy-free diets, got to make sure they obviously take calcium, magnesium in the dairy-free and things, because I find that they are inflammatory in many people, not everybody. They’re specific foods. If you’re allergic to a food, that’s going to be inflammatory. So, you have to either you have to avoid it for a while, we have to heal the gut, because those things lead to inflammation in the gut, which is the start of things, and then we can desensitize people to it. We have some sublingual immunotherapy, you can put it on your tongue. There are various things to do, but I think avoidance of the foods that cause inflammation is the first thing. I think the awareness of that is key.
Dr. Gundry (00:41:41):
So, let me ask you in your practice, I always say it’s what I tell people not to eat that’s far more important than telling them what to eat. Where in your practice does an elimination diet come into play?
Kenneth Bock (00:41:57):
Well, I mean, there are various ways to do it. Sometimes clinically I just say I think, and I just had somebody with Hashimoto’s, we’ll talk about thyroid in a second, and there were studies to show that there’s a certain percentage of Hashimoto’s that definitely need to be gluten-free. So, I would say a lot of times they won’t come up celiac, so I say you can clinically go on a gluten-free diet, which I think makes sense, and do it for three months, let’s say give it a trail. Or in other people if I diagnose certain foods I might say, if they’re very low-grade, I might say, “Listen, I can see a low-grade reaction in the blood, or even in the skin, we do some skin testing with foods, but that may not be clinically causing this or that.” So then we do an elimination challenge, where we take those foods, take them off those foods for around 10 days and then add, so that they get … They’ll actually get more reactive after the 10 days, and every other day we add one back, add it back every meal for that one day. You watch how they do. The next day you take it out, it’s like kind of a washout day, and the next day you add another one, and you watch how they do. Certainly over the 10 days did anything get better? And then as you reintroduce each food.
So, that’s always been the classic, the elimination challenge, but a lot of people don’t want to do that. So, sometimes clinically we’ll just take them off certain foods that they’ve reacted to, and I think the proof is in the pudding. Dr. Gundry, when patients see they get better they come back in a month and they say, “My god, my headaches are gone, my bowels are much better.” The proof is in the pudding really, I would say there. Most of the time when they’re feeling that much better they don’t want to add it back, but if after a while, after you heal the gut, I would say that it’s only a certain percentage of foods, like the IgE foods are more fixed, maybe 85% of them are fixed, and maybe 15% are variable, but any IgG foods or other kinds of non-IgE sensitivities, most of them are much more variable. If you heal the gut and keep them away long enough you can readd them, even let’s say maybe every fourth day and you can get by with them.
Dr. Gundry (00:44:04):
Yeah. I agree. We used to look at IgE for food sensitivities, and I wasn’t very impressed, quite frankly. We’ve now gone to IgA and IgG.
Kenneth Bock (00:44:18):
Yeah.
Dr. Gundry (00:44:19):
You’re right. I gave a paper at the American Heart Association, lifestyle and epidemiology meeting last year, looking at people with really bad leaky gut, that we can measure with blood tests, and after a year, and lots of food sensitivities, including gluten. After a year, nine out of 10 of the people in this study, they not only their food sensitivities went away but they lost IgG and IgA sensitivity to gluten, which they were profoundly sensitive to. Now, I’m not … Don’t want everybody listening saying, “Oh good, if you heal the gut you can have gluten again.” I’m not saying that, but I actually think that, I think we’ll agree on, the immune system can be retrained, and not react to these things, and it’s all because of leaky gut that started all this, and that your book makes a beautiful point about that.
Kenneth Bock (00:45:19):
And certainly in the IgG when you see a really, really positive IgG of like every food, they’re not allergic to every food, it’s a leaky gut.
Dr. Gundry (00:45:19):
Correct.
Kenneth Bock (00:45:28):
I mean, we don’t need any other test to show you that that’s a leaky gut, allowing these larger proteins to get in and the immune systems is reacting. Definitely, no question.
Dr. Gundry (00:45:38):
All right. So you mentioned hormones and you brought up thyroid, so that’s the next, hormone imbalances.
Kenneth Bock (00:45:46):
These are big.
Dr. Gundry (00:45:47):
Go for it.
Kenneth Bock (00:45:48):
Well, these are big. I think that they’re underrecognized. Again, I think one point I would love to make to the people that are listening is that to recognize that blood tests have “normal values,” a lower value, an upper value, but they’re not concrete. So, let’s say thyroid. Thyroid is a gland that’s in your neck around the Adam apple, lower part of your neck. I feel free to palpate it in every patient, and sometimes it’s a little large, which is indicative of probably it’s trying to produce more.
Dr. Gundry (00:46:22):
Trying to hard, yeah.
Kenneth Bock (00:46:23):
Yeah. Sometimes there are nodules which you have to get an ultrasound and check out, but the point being the thyroid hormone is involved with the metabolism of every cell, and that’s why symptoms of low thyroid could look like so many things, because it’s involved with your whole body. So, the classic symptoms are fatigue, maybe a little mental sluggishness, constipation, dry skin, coarse hair, or your hair is falling out, you feel cold, you have cold hands or feet, or you’re wearing sweatshirts while other people are wearing T-shirts, and yet you get a blood test and your thyroid is in the lower range but it’s normal. So, your doctor says, “No, your thyroid is fine.” No, your thyroid is not fine. You have what I would call, and there’s a whole thing they call subclinical hypothyroidism, which I don’t agree with because it’s not subclinical. I call it sub laboratory because they have the clinical symptoms but they don’t have the laboratory symptoms. Sometimes they have an elevated TSH but normal T3 and T4, and they need thyroid. You give them, I like to give them a natural desiccated thyroid and sometimes some of the supplements like iodine and selenium, they help produce the T3. You’d be amazed at how many of these symptoms can help, and in terms of psychological symptoms you’re looking at depression.
So, if you look at, I have these MDS snapshots, these graphs in the book, and there’s actually if they go to braininflamed.com there’s a template that they can actually download. It’s totally free and they can actually chart their child on this template, compare it to some of the templates I’ve put together, none is exactly one thing, but it gives them the idea. The thyroid, the low thyroid template, the big spike is in depression. That’s what you see a lot with low thyroid. It’s a sluggishness, it’s a physical and a mental sluggishness, depression. And you give thyroid, you’ll be amazed. There are a lot of papers to support this, especially with T3, of course, as you know, because you may not be producing the active T3 from the T [crosstalk 00:48:27].
Dr. Gundry (00:48:27):
Right.
Kenneth Bock (00:48:28):
So, thyroid is something I … And I have so many patients say, “God, I feel so much better, it’s amazing.” And yet their thyroid blood tests never went into the “totally abnormal” range.
Dr. Gundry (00:48:43):
Yeah, I see the same thing and I write about it in my new book, The Energy Paradox. One of the things I’ve found, just as a simple first step, is the vast majority of people I see now are using either sea salt or pink salt, Himalayan salt, and they don’t have any iodine in it.
Kenneth Bock (00:48:43):
Don’t have iodine.
Dr. Gundry (00:49:03):
And the first thing I do is I go, “Look, just go to the grocery store, buy iodized sea salt.” It’s everywhere now. Even Morton’s makes iodized sea salt. It’s amazing, just that simple step. The government used to mandate iodine in salt for a really good reason, and just that simple step can make a huge difference, and it’s easy. It’s basically free. So yeah, I agree with you. The thyroid “sub laboratory” hypothyroidism is a very real thing.
Kenneth Bock (00:49:45):
Yeah, totally.
Dr. Gundry (00:49:45):
Well, listen. We have talked about a lot of things. Since it’s Brain Inflamed, is leaky gut and our crazy awful microbiome a huge piece of this problem?
Kenneth Bock (00:50:04):
Totally, yes. In fact, what I talk about in the book and I talk about with patients all the time is you have examples of patients whose only symptoms may be not even in the gut, their brain. So, they may be fatigued, brain fog, very common.
Dr. Gundry (00:50:23):
Yep.
Kenneth Bock (00:50:23):
They’re depressed, or anxious, or what have you, and you treat the gut. You determine if there’s dysbiosis, which is an altered abnormal intestinal flora, you treat the microbiome, whether you have to use antimicrobials like antifungals if there’s an abnormal fungal overgrowth. If there is dysbiotic bacteria, and I’ll use herbs for that usually. If they have a history of lots of antibiotics, which certainly predisposes to either a candidal or “yeast” overgrow, or anaerobic bacteria too. In a lot of the kids, especially the kids with autism, there are studies showing vancomycin orally and metronidazole, that get the anaerobes, especially when kids are aggression. I just had one yesterday, this kid responds so well to a course of metronidazole or vanco because he’s had this recurrent dysbiosis.
You give that, and even if there’s not a lot or any gut symptoms, you can take a kid’s brain fog, cognitive dysfunction, depression, and lack of motivation and reverse it with an antifungal or with prebiotics and probiotics, and because you are affecting the microbiome and all the messengers that come from the microbiome, the metabolites and the effect on inflammatory cytokines, immune messenger molecules, all that stuff that affects the gut lining and contributes to leaky gut. I mean, the microbiome is so important in leaky gut. So, I mean, and interestingly enough from my work, the microbiome is involved with both the development and maintenance of the microglia, which are the immune cells in the brain. So, there is a direct connection there between, and it’s again, because of some of the products like butyrate and some of the short-chain fatty acids.
Dr. Gundry (00:52:25):
Yeah.
Kenneth Bock (00:52:26):
And it’s very [inaudible 00:52:27] the microglia are so key. In many of these kids the microglia are upregulated, they are pouring out these inflammatory what I call they’re cytokines, but in lay terms they’re immune messenger molecules, just like neurotransmitters in the nervous system. In the immune system, their immune messenger molecules, and they are just so inflammatory, and a lot of our job is to downregulate them. That’s how we quiet inflammation in the brain, part of it for sure, and part of it is really improving the microbiome. So yes, and then of course the whole leaky gut thing.
When I lecture, I always say leaky gut, leaky brain, right? And what I would generally do, we are lecturing a lot more, and obviously not in the pandemic, we’re doing webinars now, but not … So, I would always have the audience, if I was in the audience of 500, 1,000 parent, I might say, “Okay, now I want you to say this, leaky gut, leaky brain.” And the audience, once or twice I’d have them say that. I want it to get in their brains. Leaky gut, leaky brain. You know what? There used to be that whole thing controversial and people would say, “No way.” Now I think the literature is really supporting it. I’m lecturing a lot now in the blood-brain barrier because I’m fascinated by it, I think it’s very, very important. So, I’ve done a lot of research on it, and there’s no question that these inflammatory mediators, and I have a lot of beautiful schematics and illustrations of it when I lecture of how these inflammatory mediators get out through a leaky gut.
The tight junctions open up, it allows these molecules, inflammatory mediators, the cytokines, to get up to the blood-brain barrier and just like that one layer of epithelium in the gut, you have one layer of these endothelial cells. I have a slide that shows them side by side, they look so much alike. You open up those tight junctions and then you allow these inflammatory immune cells, like the Th17 cells, and also the immune globulins, which are very large molecules. They usually can’t get in. So, some of these cases of brain inflammation are really dependent on a leaky blood-brain barrier, which frequently is incited by a leaky gut. It’s fascinating.
Dr. Gundry (00:54:39):
Yeah, no, absolutely. We now can do blood tests for blood brain barrier disruption, and you can just see it as the gut seals, the blood-brain barrier seals. It’s exciting stuff, and it used to be pseudoscience, as you and I both know. It’s not pseudoscience, folks.
Kenneth Bock (00:55:02):
[crosstalk 00:55:02]. They call it pseudoscience. I don’t actually think it was. I think what happens is, and you probably, but I’ve been in this field since I got out of residency, and I got out of residency in ’82. So, we’re talking 38 years now, and I really have found this, and my kids will say this and my … That pretty much everything that we’ve done usually enters the mainstream five, 10, 15 years later. My patients can’t wait for that, and I’m not doing stuff pulling it out of my head, it’s all based in sciences like translating that science into the clinical. It may not have had a robust 5,000 patient double-blind placebo controlled study, which may never get done for a nutrient, but it’s clearly the science makes sense to me. The risk benefit is so much in favor of benefit versus risk, and like the microbiome, right? I mean, how long have you and I’ve been talking about the microbiome, right? And now it’s like you can’t get away from any scientific publication without hearing about it.
Dr. Gundry (00:56:03):
Yeah. No, you’re right. All right, so the book is Brain Inflamed by Dr. Kenneth Bock. Where do they find you? Where do they find your book? Where do they learn more about you?
Kenneth Bock (00:56:14):
So, our website is Bock Integrative B-O-C-K Integrative, I-N-T-E-G-R-A-T-I-V-E, bockintegrative.com. They can find all that information. We’re in Red Hook, New York. I can give a phone number if anybody wants to call, if they have to call and speak to my new patient person, her name is [Tee 00:56:38]. She’s been with me 35 years, 35 years.
Dr. Gundry (00:56:40):
Wow, wow.
Kenneth Bock (00:56:42):
Yeah, it’s great. Then the book’s website is called Brain Inflamed. Braininflamed.com. There’s information on it, and I really think what can really be helpful to track their child’s, teenager, adolescent progress is the MDS, mood dysregulation spectrum snapshot where you can actually kind of graph. It’ll show you how various … You can graph your child, and as you do the various treatments you can hopefully watch that graph change, move to the left, get further down in terms of the Y axis. So, I think it’s a very helpful tool, and I’m happy. If there are any questions, I’m happy. I have a wonderful nurse practitioner, Jennifer, who she’s a doll, she’s terrific. So, my staff is funny, and you probably have the same thing. They’re worried about me retiring, right? And I say, “Why would I want to retire? I love [crosstalk 00:57:35].”
Dr. Gundry (00:57:35):
Exactly right.
Kenneth Bock (00:57:35):
I get to be a medical detective and we get to help so many kids. The one thing I would say about this whole thing with Brain Inflamed, I want to leave people this, is that not every kid has a medical or biological underpinning. Sometimes it’s just stress. A girl breaks up with a boy, they’re devastated and they’re suicidal. It’s horrible, there’s inflammation from that, but that’s a real psychosocial stressor and there’s maybe some, and parental divorce and heavy. But if you miss, if you have a kid who has all these problems, psychological and is on psychotropic meds, and getting therapy, and they’re not getting better, if you miss the medical biological underpinnings, you miss the chance to change the trajectory of their life, and not only their life, but the family’s life, because one of the most gratifying things for me when I heal these kids or help heal these kids, you hear the parents, the siblings, the grandparents, the aunts and uncles, the close friends, because we all know, I always say to my patients, and my friends and family, you are only as good as your worst kid. You are only as good as your worst kid, and if you have a really severely ill kid with a lot, a lot of psychological symptoms, then you know how it affects the family.
So, that to me is the most gratifying thing, to be able to help them, but I really want to make sure they understand that when this is there, it needs. If you have Lyme disease, all the psychotropics and all the therapy in the world is not going to help you if the Lyme disease or coinfection is causing these symptoms.
Dr. Gundry (00:59:08):
Yeah. No, you’re right. All right, we’ll let you go with that. Yeah. Look at this book, folks. Incredibly useful information. So, thanks so much.
Kenneth Bock (00:59:20):
Thank you, doctor.
Dr. Gundry (00:59:20):
Talk to you again.
Kenneth Bock (00:59:20):
It’s been a pleasure to be with you.
Dr. Gundry (00:59:22):
All right. It’s time for our audience question.
Speaker 4 (00:59:26):
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Kimberly Snyder (00:59:55):
Welcome to the Feel Good Podcast with Kimberly Snyder. My goal is to help you develop a holistic lifestyle based on our four cornerstone philosophy, food, body emotional wellbeing, and spiritual growth. This holistic approach will help you feel good, which I define as being connected to your most authentic highest self, and this is the place from which your energy, confidence, creativity, true power and true beauty will start to explode.
Every week we provide you with interviews from top experts in their field or a solocast from yours truly, to support you in living your most beautiful, healthy, and joyful life. I’m your host, Kimberly Snyder, founder of Solluna, New York Times bestselling author, and holistic wellness, nutrition, and meditation teacher. Let’s get started.
Dr. Gundry (01:00:48):
This week’s question comes from Christine, who left us a five-star review on iTunes. Thank you, Christine. She asked, “I only have one quarter of my thyroid left and take Synthroid on a daily basis. In your experience, will I ever be able to get off this synthetic hormone if I completely follow your Plant Paradox plan? Thank you again and I look forward to hearing your thoughts.” Well, first of all, the great news is that Synthroid, even though it’s synthetic levothyroxine, is actually the actual hormone that your thyroid gland would produce. One of the huge benefits of both levothyroxine and liothyronine, which is T3, is that we can manufacture these compounds, and if they are used by a practitioner who hopefully knows what they’re doing, you have nothing to fear about being on those compounds.
Now, I will say this. About 30% of women do not convert Synthroid, T4, into the active form of thyroid, which is T3, free T3. So, make sure no matter what that when your thyroid hormone levels are being looked at, you not only get TSH, thyroid stimulating hormone, but you also get free T4 and free T3. As I talk about in The Energy Paradox, for many of my patients we also get reverse T3, which simplistically is throwing some of T3 into a trashcan where you can’t get to it. But I see so many people who are told, just like in this podcast, that you have well, your TSH is okay, and your T4 is okay, and your T3 is okay, but you know something is wrong, but when we look at TSH, free T4, and free T3 at the very minimum, that’s when we begin to start to uncover mischief, and we’re having an epidemic of Hashimoto’s thyroiditis, which is the autoimmune cause of low thyroid, and that I can guarantee you is from leaky gut. We’ve had tremendous success in reversing Hashimoto’s by repairing leaky gut.
So, don’t be afraid that you’re going to be on that medication the rest of your life. It’s one of the medications that is the actual hormone that you make anyhow. So, good question.
Review of the week. This week’s review comes from Cynthia Peterson on iTunes, who gave us a five-star review and wrote, “I listen to Dr. Gundry on a weekly basis. I’ve changed my diet to keto. I’ve lost weight. I have good heart health. My skin looks great. I feel energized. He and I are the same age, so I am thankful for his wisdom as I age. I also purchased one of his books. Thank you Dr. G for everything you do for the health of our generation.” Well, that’s wonderful to hear, Cynthia. I’m happy to hear you’re in such great health, and I’m also grateful for your review, because reviews like yours help us reach a bigger audience with our what I think is a powerful health message, just like you’ve mentioned.
So, if you haven’t already, please go to iTunes and leave us a rating and a review, and if you’d like to ask me a question, leave your question in the review. I’ll be sure to answer your question on a future episode of this podcast, because as you know, I’m Dr. Gundry, and I’m always looking out for you. See you next week.
Disclaimer. On the Dr. Gundry Podcast we provide a venue for discussion, and the views expressed by my guests do not necessarily reflect my own.
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 could always find me on YouTube at YouTube.com/drgundry, because I’m Dr. Gundry and I’m always looking out for you.
