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Hosted by Dr. Val Civelli, White Coat Black Sheep explores physiology, functional medicine, and the medical questions most people are told not to ask.
This is where evidence meets curiosity, where dogma gets uncomfortable, and where real world medicine takes priority over headlines.
From understanding your lab work to debunking hormone myths, medication misconceptions, and optimization strategies, this podcast helps you understand what is actually happening inside your body.
If you care about health and think there might be a better way to practice medicine, you’re in the right place.
Welcome to White Coat, Black Sheep, where science gets curious and dogma gets
uncomfortable. I am Dr. Civelli, and today, we're talking
physiology, evidence, and real-world medicine, plus the
questions you probably should ask but are not
asking. If you care about health and think there's a better way, welcome to our
show.
So today, we have Jean All from Adventist Health, nurse practitioner.
Yes. How are you? I'm so good. I'm so excited because- I'm- I'm
excited about the things we're going to talk about ... I am too. Yeah.
There's just so much that I know off-camera we've
just chatted about, and I've loved it. Yeah.
Not liked it, I loved it. Right. I feel like I can really go to
a higher level and just such a depth of- Mm-hmm ...
functional medicine. And so you know what it is.
You practice it, you offer- Right ...
primary care and, which I love. Right. And it's- I like the plus ...
the new age of medicine, right? Yes.
The conference that we recently went to, Functional Medicine, it was talking about
how 20 years ago, medicine was completely different than medicine is
now. Yeah. It is. And instead of just treating illnesses,
we want to be a step ahead and prevent them too. Yeah.
Which is like we thought we were already doing that.
Right, with the screenings and everything, right?
I'm going to bring you just slightly closer. Oh, sure.
So you guys can hear everything she's saying.
It's my first time doing a podcast. So you're kind of like almost kissing the mic.
All right. Which is weird. Yeah. That's perfect. Oh, yeah. Yeah.
Now you sound really good. Okay, good.
Yeah. So the conference was in Vegas. Mm-hmm.
And I started going to those probably,
oh my gosh, it's 2026. So since
2022. Okay. Wow. Yeah. And this was my
first one. Oh my gosh. Yeah. And I- You're already at expert
level ... but I learned so much. And I already-
I love it ... feel like, okay, if one conference gives me this much
information, imagine- Exactly ... like in five years, how much I'll know.
That's how I feel. Yeah. I feel obsessed. I feel inspired. Mm.
Every single time. I've done their peptides and their-
Mm-hmm ... certification, which is a journey in itself. Right. It's a whole thing.
Because no one teaches you about peptides in school.
Like med school, nursing school. No. No. Yeah.
This is where you get to really
become the expert by teaching- Mm-hmm ... yourself. Right.
And that's okay because we're taught how to teach ourselves- Yeah ...
at a certain point. And that's what medicine is, right? Yeah.
You're in the profession because you know it's evolving, growing every day. Mm-hmm.
So. Exactly. Yeah. So you're coming today from the clinic.
You're at Adventist Health- Yeah ...
which are future sponsors of White Coat, Black Sheep. Oh, cool. Yeah. Yeah.
So I'm at the Chester location. I'm
a family nurse practitioner, but I practice in an internal medicine clinic. Okay.
So I get to see patients with many chronic
illnesses, multiple comorbidities,
cancers and stuff like that. So we're trying to manage their
health where we're kind of, okay, when
the patient comes in, we're like, "Okay. You went to go see this specialist.
What did they talk about?" Mm-hmm.
"What did this specialist talk about?" And we're trying to interwine- Mm-hmm ...
all of that together.
Mm-hmm. So it's very--
I've learnt so much in the past. I've been with Adventist for almost two years
now. Mm-hmm. Oh my gosh. And I love working there. It's mainly the people.
Mm-hmm. The people are so supportive and so nice. Huge.
And it's like- Huge. Right. It makes a difference because I've worked
in a toxic environment- Same ... and now I work in a non-toxic environment.
Like the non-tox
world, right? Yeah. Everyone's obsessed with non-toxic stuff right now. I love it.
But it's amazing. It's culture. Okay, so- Right ... work culture.
Work culture, yeah. You come into work- It's a thing ...
you're-- Good job, guys. Aw. Good job.
We're proud of you for preserving a good culture. Yeah.
And you come to work happy, happy to treat patients, happy to
be around your coworkers. And when you're happy, you're
going to do your job 10 times better. I love that. Yeah.
And that is what patients are dying and crying for. Right.
I mean, they are just so dissatisfied most- Yeah ...
places most of the time- Right ... because the business model- It- ...
is volume-based ... it is. All these private practices, well, not all, but I want
to say most of them, they work you like a dog.
Mm-hmm. You're in and out of the room.
You're seeing maybe 30, 40 patients a day. Mm-hmm.
So you have maybe, what, five minutes in the room, and then that care- And then-
... the patient's not getting the care- Yeah ... they deserve, right?
And the stories that you have in between. I was just talking to- Right ...
Tim about that. And then when am I going to do my notes, right?
Like- Or order any of the things. Order, right.
Or talk to all the specialists that I just- Right ...
told you I'm going to talk to for you.
Or educate them on lifestyle and diet.
Like when will I have time to do that? But now I get to. Yeah. I love it. Really.
I have the time. I have the patient population that is
eager to know about that. Mm-hmm. And yes, I'm treating their
chronic illnesses. Mm-hmm.
Some of them are so ill. They're
sick. At this point, they've passed the stage where its diseases
are curable, and now we just want to preserve the life that they do have.
Oh, that's an interesting point. Yeah.
So what you're describing, there is a point of no return.
Right. The point of no return, and it's
sad. It's sad. It's a reality. Yeah.
And there's different, unique
things out there for some people that can intervene at
some areas- Mm-hmm ... like, say, in Europe or other countries.
They're doing things a little bit- Right ... uniquely. Uniquely, yeah.
But even with all of what the world can offer, there is a
point of no return. Right. And you're born with your
genetics. Mm-hmm. Some people have genetic conditions.
That, yes, will not be irreversible, right? Mm-hmm.
But things like hypertension, diabetes, high
cholesterol-A lot of these things are irreversible.
Yeah.
Or sorry, reversible.
Yeah.
And-
To a degree
... but to a degree.
Yeah.
But then when you end up to the point where you're in your 60s, 70s, have had
multiple heart attacks, stents put in, this put in then
there comes a time when you're just trying to
preserve their life-
Yeah
... and their longevity because they don't wanna just live
and add years to their life. They wanna live a happy, fruitful
life, right?
So that's vitality.
Vitality, yeah.
Yeah. I'm obsessed with vitality.
Yeah.
And that word is not commonplace.
No.
I wish it were.
Yeah.
But just like you're describing, we're really good at like keeping a
carcass alive.
Mm-hmm.
We can keep you alive longer, but you're miserable.
Right, and that's not...
My patients tell me like, "No, I wanna live a- What's the point of living a
life that you're not going to enjoy, that you're not going to flourish
in," right?
Yeah.
But hey, sometimes we can preserve their
lifespan.
Yeah.
And to a degree, it's better than they would have gone anywhere
else.
Yeah. That's true.
Yeah.
Do you feel like maybe the culture that was
preserved or created-
Mm-hmm
... where you currently work, do you think it comes from the top or do you think
it was just like choosing the right people in that one space, or
it's just the
system structure?
I think it's the system structure for Adventist.
Providers have their own say in the types of things
they wanna do.
So you feel like-
You have more-
... support
... autonomy.
Okay.
Right. You're not listening to just one boss telling you what to do.
Mm-hmm.
And if you don't do it their way, they're going to not like you or torture
you to the point where you mentally break and want to quit.
That's a thing, for sure.
And hey-
... we've all been there.
Yeah.
And I'm so happy we're not there anymore.
Nope.
So-
Nope
... love that for us.
Yeah, I love that for us too.
And you know, right now I get to set my own schedule.
I get to set my time blocks of, hey, I wanna see these kinds of patients
at this time, and what makes my day flow better.
Wow.
Right? And sometimes I have patients, I'm spending 40
minutes in a room with them.
Wow. That's unheard of.
Right. And-
And they're supportive
... and they're supportive of that because that's
when you know that we're addressing all aspects of their
life, right?
Mm-hmm.
Not just the medicine aspect, because when you address the
medicine aspect, that's one thing.
They go home, and maybe their work life or their personal
life, there's some things going on that no matter what you
did for them for the treatment-
Mm-hmm
... it's not going to work in a holistic manner.
Geez, you guys-
So-
... you can't get this experience that you're describing, you can't get this-
Right
... in regular medicine at a primary or in any-
No, and then obviously there's patients where-
Right
... you know, they want simple things.
They need a medication refill, or they just need an annual or blood
work. And the, so it's like a give and take, right?
And the patients know that-
Yeah
... when they come in for the appointment that, "Hey, I'm here for this." And
sometimes I have to tell the patients that, "Hey, we've discussed
all these things, but I want to do further for you."
Yeah.
"So please schedule a follow-up appointment."
Okay.
And they're more than willing to do that.
So just communicating.
Yeah, communicating.
Imagine it.
And you know your, the staff you work with-
Yeah
... like I love the staff I work with.
Aw.
It's like a-
I love this.
Yeah. And like-
That's hard to say
... we're always laughing and joking, and they're there.
Everybody makes mistakes here and there-
I love that
... but no one is... Like little mistakes here and there,
that's life.
Have you-
Right
... you've worked other places.
Mm-hmm.
And you did not feel this-
Right
... this joy.
You felt like, oh, you made one mistake, oh my gosh, someone's gonna, behind
closed doors, yell at you.
Like you're getting weird talks.
Right. Right.
Called into the office.
Called into the office. "Come to my office."
Oh my gosh
... close the door and start yelling at you when you're crying in that seat,
and there's just five people bashing at you, that's not a work environment- ...
that anyone wants to be in.
No, and my favorite is like you would think that like, okay, we're grown adults,
we're professionals.
Right. I know.
Like why would this even bother me?
Right.
Like why... I'm a strong person, why would this even get to me? I've also cried.
Right.
And let me tell you, I won't cry again at work.
No, 100%, I'm not gonna put myself- ... If I ever...
So, there's in every profession, right, you have a first
job.
Yes.
And that you're like scared to leave because you're like, "Oh my-"
You're scared.
You're scared.
You're under contract.
Yeah, and all that. But-
Feels very serious.
Right.
Yeah.
But at the end of the day, the only person hurting is you, right?
Yeah.
Because you're gonna get anxiety, you're gonna start getting high blood pressure.
Uh-huh.
You're gonna not sleep well.
Yeah.
And we're trying to treat others, but in turn, we're
not treating ourself.
Dying.
Yeah.
Yeah.
So-
I never wanna go back to that
... and that's what Adventist, I think, really promotes.
Mm-hmm.
They promote that work life culture-
Yeah
... where they want you to be happy in your personal life-
Right
... and they will help you through that too.
Like, when there's time off, or, "Hey, I have a doctor's
appointment," or, "I have a nail appointment.
Hey, I need to block one hour from my schedule."
You know? Hey.
That's like, that's them investing into you being well.
Right. Right.
I totally love that.
And the doctors I work with, the nurse practitioners, the PAs, and
the staff, like, it, not one person's job is
less than another.
Wow.
Right?
Do you think the spirituality has anything to do with it?
Because it is a-
Mm-hmm
... spiritual based-
Faith based
... yeah, faith based.
And I think what they promote is
there's
a higher being, right?
Mm-hmm.
That when everything else is going wrong,
it's the faith that carries you through.
It's true, because it gives you choice.
And whether you believe in a specific
religion-
Yeah
... or another religion, at the end of the day, we're all in this world, we're
all equals-
Yeah
... no matter our culture, no matter our religion
Yeah, and it's with purpose.
Mm-hmm.
It's faith-based, but it's not about, "Oh, you have to
be a Christian worshipping Jesus and all that." No,
it's any faith.
Yeah.
They're faith-based in that way.
Yeah.
Yeah.
A belief in something bigger than you.
Something higher power.
That is healing.
That is wholesome.
Yeah.
That is...
Whether it be the people around you-
Yeah
... your environment.
Mm-hmm.
There is a higher being that
miracles happen, right?
Mm-hmm.
We see it day and night.
Yeah.
And it's because of the community we have.
I absolutely love that.
Yeah.
Well, okay, so that's definitely a huge part of healing and
wholesomeness and
being a human. Which-
Yeah
... I used to think I was a machine. I'm not.
No.
I wanted to be, but I have to sleep. I have
to drink water-
Right
... and eat food. And the right food.
Sometimes we're having like 100 things going on in our minds at once,
but you know what?
So annoying.
Yeah, and then you need to take that time for yourself-
Yeah
... and just relax your mind. Because that's what recovery is.
Yeah.
Even when we work out, right?
Yeah.
You're not going to be working out every single day of the week.
You need recovery days-
Yes
... to grow. And in life-
Yeah
... it's like that, too.
Yeah.
Yeah.
Well, at the recent conference, I know you had a few
favorite sections and-
Yeah
... favorite speakers.
Right.
Where do you want to start with that? Because there's just so many.
So-
I loved it
... there's so many. And we could talk about it for
many hours.
Yeah.
Right?
There was one that really stood out to me,
and that was cycle syncing.
Oh, interesting.
There was a presentation. So,
one of the female presenters, she's done her own
research and gone through
cycle syncing with menstrual cycle syncing.
Oh.
Right? So women, as soon as you start your menstrual
cycle to when you're even done
your menstrual cycle, perimenopause, menopause, post-menopause.
Mm-hmm.
It's in your luteal phase, in your ovulatory phase,
your follicular phase-
Mm-hmm
... and all that. The types of day-to-day
that you do, so intermittent fasting, the types of
workouts.
No one tells us that because all these previous studies have been done
on men's health-
Yes
... where they're not going through ups and downs, right?
And they've done studies on the women's Olympic teams,
where more injuries occurred when the women
were in their luteal phase, which is the two weeks right before
menstruation.
Mm-hmm.
More ligament, tendon injuries, and all that.
That-
You would think it'd be opposite to that-
Right
... because your estrogen surge.
Right.
It's like a slow climb, and then it surges.
Mm-hmm.
So maybe...
So in luteal, right before, it's when you want to take it more
easy. Maybe don't do the 16-hour intermittent fasting.
Mm-hmm.
Your body needs the fuel, right?
Yeah, the protein.
You need the rest.
Yeah.
So yes, work out, but maybe something like yoga, Pilates, a
walk, a jog.
Mm-hmm.
Not like high-intensity HIIT workouts at that time.
Yes.
Eating the right things. More magnesium, more omega-3s.
Yes.
That help-
Exactly right.
Right. So it was a presentation where-
Just track your-
Yeah
... cycle so that you see the right rise, the fall, the-
Right. And many women don't know that.
Yeah.
I didn't know that before, right?
Yeah.
We treat every day as the same, but our bodies are definitely not telling us that.
Yeah.
Every day is different-
Yeah
... for us.
So that was just one.
Do you use a wearable device?
I use an Oura Ring.
Okay.
I have one.
Yeah.
I just got one, actually. It's two months ago.
Okay.
So I've been tracking my sleep, and-
Yeah
... my body temperature and the HR-
Yeah, the temperature is what I was going to do
... heart rate variability and all that.
How's your HRV?
Well, it's supposed to be below 10 usually, right? When you sleep.
The lower, the better.
I think the higher, the better.
Okay.
But not the heart rate, but the HRV.
The heart rate variability-
Mm-hmm
... it's my understanding if it's a low score-
Uh-huh
... then you're not handling your stress.
Got it.
Yeah.
So, I think the highest you can make is around a
88-
Okay
... I want to say. So
the higher the score, the better.
Uh-huh.
So it's like your ability to handle stress.
Right.
It's the time, I believe, between heartbeats.
Mm.
And if it's shorter, you're more stressed, your heart rate-
Right
... is more active.
And it tells me the times I'm stressed throughout the day.
And it's right.
And it's very up and down right now.
And I'm like, I need to-
Regular
... you're
stimulating your vagus nerve.
Yeah.
That's part one.
Yeah.
You can do it without any devices or anything like that, by just
humming, listening to music.
Interesting.
So you know what I've started doing?
What?
On my drive to work in the morning.
Let's hear it.
Because I get really... I guess I'm always
trying to get somewhere on time, so I'm stressed,
right? Without knowing that I'm stressed.
And I've realized that-
Yeah
... that when I'm driving,
the stress that my ring shows is higher.
So I started just humming.
Is there a certain pitch or place in your voice?
In yoga practice, they do-
Right. There is. There's Om, right?
Yeah.
Yeah. So I-
The Om.
The Om, right. And that takes me back to
my Indian roots, right? Where I learned to do this.
How? What do you mean?
So Om is a very...
It comes from within. It's known to, that
sound is to come from your soul.
Wow.
So just like we can do it right now, like
ohmmm.
The vibrations
stimulate your vagus nerve.
Wow.
And helps reduce cortisol spikes and just stress
levels.
Oh my gosh. So I've been to a lot of different trainings over the
years, including-
Mm-hmm
... A for M, and-
Yeah
... and also-
Yeah
Different regenerative treatment courses.
Mm-hmm.
And they do speak a lot about sound therapy.
Right. Yeah.
I want to learn more about it because the hertz,
the pitch-
The frequency
... and tone and-
Yeah
... the hertz that-
Mm-hmm
... the Om-
Mm-hmm
... specifically resonates with your body, which is made of
water.
Yeah. Right.
So you're making your water molecules oscillate at a certain-
Mm-hmm
... frequency.
Like those sound baths.
Yes.
The lingering on-
Yes
... of sound, right?
So that hertz, and on the different pitches that you
hear, as you probably already know, some are healing-
Right
... some are calming.
Okay. I didn't know that. Yeah.
Some, they're meant to do different things-
Mm-hmm
... according to what we know to be true.
Mm-hmm.
But it's ancient practice. I mean-
Yeah, it's ancient. It's been there for centuries.
Yeah.
Right? And now that's why Western medicine and Eastern
medicine, it's an integration of both.
They need to get married-
Yeah
... and have offspring.
Basically. Another thing from-
Yeah
... medicine from that side of the world is turmeric. Right?
Like-
Okay, so tell me what you know about-
Tell me
... turmeric, because I've learned just so much-
Mm-hmm
... that I feel like I don't take it-
Mm-hmm
... because number one, it's on my list from my microbiome not to take.
Okay.
But I think I would be a good candidate for it if I
fix a few other things.
Right, and that's what the new
medicine is, learning what is right for you and what
isn't. Because everyone's different.
Powerful.
Everyone's DNA is different.
We are.
One supplement might work for somebody, and for another it's not going to work.
Right.
Just like that, for turmeric. We know it has antibacterial,
anti-inflammatory properties.
Yeah.
It was a thing growing up. I was born in
India,
and then I grew up in Canada-
Mm-hmm
... from age of six onwards. So my parents, when I
got sick as a child, I would get milk
with some turmeric, and
it would-
Wow
... just help with feeling better and-
Yeah
... that recovery process, it would speed it up.
Let me see what my...
So I did this Gut Health test.
The Gut Health, yeah.
And it said something about turmeric for me, not for all people-
Mm-hmm
... but for me.
Yeah,
and that's the thing with many ingredients-
It's weird
... not just turmeric.
You need to know what's
right for you, what's going to be-
Yes
... most beneficial for your own body and your genetics.
And it seems-
Yeah
... so far out there, or almost hippie-esque, but this is-
Mm-hmm
... where we are different. Our genetic
makeup-
Is different, yeah
... it's different.
Yeah.
And our environments, we're going to react differently, even -
Mm-hmm
... side by side, or siblings side by side.
Right. And imagine 50 years ago, the
amount of the air, the water, the
foods our parents ate-
Yes
... versus what we're eating. It's a complete 180.
Dramatically different.
Things are getting injected with chlorine and sodium, and
there's this pesticide and arsenic and this-
Yes
... and we don't even know most of the time what's in our
food.
And you know what else is crazy?
Yeah.
I think about,
okay,
everyone has... Okay, I say everybody, but most- ...
people, they go through different phases.
Yeah.
Through your kid stage.
Yeah.
Your awkward stage, where your teeth or-
Yeah
... maybe your braces phase.
Yeah. Puberty, all that.
Puberty stage. And then you shoot up-
Yeah
... you get skinnier.
Yeah.
But some people,
they're more robust-
Yeah
... the majority of their-
Right
... earlier years-
Right
... and then they're thinner.
Yeah.
There's just-
It's genetic makeup. It's their DNA.
Okay, well, which is better?
Mm-hmm.
To be
large most of your life-
Mm-hmm
... and then skinny in the last few years-
Mm-hmm
... because we hear about, "Oh, they're so thin, they have no reserve."
Right.
Or is it more efficient that you are not eating much because your
body is channeling all of the energy-
Mm-hmm
... not into digesting food, but into fighting disease?
That's a very good point.
When your body is fighting off disease, which you may know of or which you
may not know of-
Right
...
when a patient comes in and they've lost 20 pounds in the last
two months, we get concerned. We're trying to rule out for cancers-
Right
... autoimmune-
Yeah
... a lot of things, right?
Yeah.
Because they might not realize, they might not have loss of appetite.
Right.
But they're losing weight, and there's a cause for that.
Yeah.
So I don't believe there's a right and wrong to that,
whether you're in your earlier stages of your life or skinnier-
Like you're tall or you're not
... or that.
Like it's that linear.
Right.
But what I can tell, because a lot of patients I see are above the age of
60.
Mm-hmm.
So I treat a lot of osteoporosis.
And when, for some reason,
as they're getting skinnier, like old ladies.
I don't want to say old, but above 60.
Right? I'm like, "Hey, Doc-"
We don't use that language.
There's no sense of old, because your heart's going to be young forever if you want
it to be, right?
Yeah.
But
when they're getting to that age where we want to do screenings with a DEXA scan
and see-
Mm-hmm
... it really comes down to their muscle mass, their bone mass, right?
Yes.
And if they're not eating the amounts of calories they need to
be eating to maintain that muscle mass,
that bone mass-
Right
... because we know as we age, we're losing muscle, bone. We're losing it all.
Well, I'm working so hard-
Right
... to not lose it.
Right, and you cannot lose it.
Right.
But what we've been taught in the last five,
10 years is completely different from what our parents or grandparents were
taught 50 years ago.
Yes.
So we have a step ahead that we're already doing this in our 20s,
30s, 40s-
Yes
... versusMaybe for them, yes, it's great that they start
doing this in their 60s or their 70s. Yeah.
And it will help because at the end of the day, loss of bone,
loss of muscle- Yeah ... is going to be linked to fractures,
osteoporosis- Or alive ... cognitive decline. Yes. Right.
And we know that a hip fracture is one of the leading
causes of physical decline- Yeah ...
in older women especially. Yes. So- And it's almost like
estrogen would be- Right, and hormones have a big part in that too.
That's a whole thing. Ugh. I love it- Don't you wish? ... so much. I know.
I'm like, "Can't we just have the same-" "...
genes as men do and not go through hormonal
decline and all that?" Hey, they go through their own things too. They do, they do.
They still have myriads.
They go through their testosterone decline, for sure. Mm-hmm.
But that also can be preserved. It can.
It can, with the proper diet- Mm-hmm ... gut biosis.
Yes. Right? Yes. Vitamin D. I couldn't find the turmeric
situation, but- Uh-huh ... I know we were
talking about... Oh wait, maybe I just found it.
Nope, I'm going to quit. Yeah.
It was under one of these categories on biome.
Maybe, okay, I'll try one more category. Oh, biome, yeah. Yeah. I really like it.
Oh, here it is actually. Mm-hmm. This is under the category of your
inflammation igniter. Okay. And it says,
"These blockers," and then it gives me the different foods that are on this
list for me. Yes. Yes. These blockers may contribute to gut
irritation and inflammation- Mm-hmm ...
by promoting activities that disrupt gut balance.
Limiting these foods can help reduce discomfort and support a calmer,
healthier digestive system. So this is true for me. Right.
But for the majority, turmeric is a very well documented-
It is ... option. But I'm sure for you, you can find some other supplement that's
going to be working the way turmeric does- Oh, yeah ...
where it's anti-inflammatory, right? It gives me a ton of great options.
So it's really getting those DNA
tests done. It makes a- Those gut microbiome tests done ... difference. Yeah.
And the one thing I think I've just started to realize this
is insurance companies, right? Mm-hmm.
Big pharma, all that.
When a patient ends up in the hospital,
how much are they paying?
Thousands, millions, right? Yeah.
Versus, hey, if we had prevented that illness
five, 10 years ago by doing a simple DNA
gut dysbiosis test, spending $500,
$1,000 on it. It's more than that. I actually run them. Right? Yeah.
And I'll tell you, but it's still worth it. But it's still worth it, right?
It's under 5,000. Okay, yeah. But still- It's like 3 to 5,000 ...
so
hopefully,
we can all dream this, in 5, 10 years,
maybe these tests will be covered by insurance.
I think there should at least be some- At least some of them. Right.
There should be some sort of coverage, right?
Yeah, like the MTHFR, the mother gene. Mm-hmm.
Right. That is critical for every single- Right ...
reaction of your body. Not just like, oh, okay, I think we've moved
to genetic cancer screening- Mm-hmm ...
very- A little bit ... well. We've dipped a toe in it. Right.
We chuck for like- Right ... a few. Right.
And why can't we now dip our feet into the gut
microbiome testing as well? Because it's expensive.
I know, but hey, in 5, 10 years maybe,
what we're realizing, maybe they will realize. Yeah.
It's a long stretch, but- Well, the reality
is like-
Right ... the insurance is built to cover the majority for
common things. Right. But the rest of it, if you want to optimize, if you want to
live longer than what they're statistically expecting you- Mm ...
to live, then you just need to work- Right ...
to pay out of pocket for that. And- Right ...
I don't love that. I think the more that people are demanding it, the more that's
going to drive- Mm-hmm ... price down because there's going to be more options.
That's so true. Right? More companies. More options. But- More options.
But I feel like that's so much going into preventable.
Fixing- Yes ... the diseases at their root
cause. Yes. And- That needs to happen ...
making some of these diseases reversible.
That would be incredible. Right. And okay, so when it comes to
reversible, so let's talk metabolic. Right. So when it comes to- Mm-hmm ...
our glucose and insulin- Right. Insulin ... I talk about it all the time. Yeah.
It's just so not even talked about enough. It's not.
I want to get a GCM- Yeah ... a glucose control monitor. Right.
I want to see how does my body react- Mm ...
to different foods, because that's all that matters. Right.
On average, we know how
their glucose will react- Mm-hmm ... but how does it specifically for you?
Specifically. So I've actually done it for two weeks. Ooh, which is fine.
I tried it.
And what I found was-
Were you surprised? I was- Why? ...
because I didn't know my glucose spike after a meal
would be as high as I thought it would be. How high was it? I don't have diabetes.
I don't have, at least I don't think yet. Not yet. Not yet, right?
So baseline, obviously 80s, 90s.
Yeah. And then after a meal,
it was maybe not the highest protein meal, but also not the highest
carb meal. Like a salad.
It still has carbs, but black beans.
So most
of the time I'm a vegetarian.
Here and there I'll have eggs, dairy, and stuff.
But vegetarian, vegan is primarily my diet.
And I'm trying to get in protein more, but from plant- Like lentils? Yeah, lentils.
Yeah. Uh-huh. Black beans, chickpeas, all that, right? Yeah.
But at the end of the day, that's protein, but it's also carb, right? Mm-hmm.
So the glucose spike goes to maybe 160.
Okay.
After a heavy meal. Mm-hmm.
Not like junk food or takeout- Mm-hmm ... but still, I was like, okay, surprised.
I was like, if my spike is 160 after an
average... meal,
what would it be if I'm eating out? Like pizza and-
Açaí
Yeah.
I love açaí.
I know. I'm like, "Okay, well, things to consider." But
there is this
person that I've been following for a year to two years
now. Her name is Glucose Goddess.
That's not her name, obviously. Her name's probably an
actual name, but she goes by Glucose Goddess.
Yeah.
And she talks about, hey, when you're eating a
snack, right? If, let's say you're eating some bananas or some blueberries for a
snack. Pair them up with a healthy fat or a protein so your
glucose spike won't be as much.
Hmm.
When you're eating at a restaurant, right?
So that would slow your gut, your gastric emptying-
Mm-hmm
... in a sense, just like a GLP would.
It's like a blanket to cover the carb.
Interesting.
Cover the sugar-
Okay
... with a healthy fat or a healthy protein.
Mm-hmm.
So maybe have some blueberries with some Greek yogurt,
right?
Mm-hmm.
Have the banana with some peanut butter.
Mm-hmm.
Also, when you're going out for restaurants, maybe avoid...
I think the one thing that we're doing wrong, I mean,
we're doing a lot of things wrong. With the American food industry, there's a lot
of things that are wrong, right? But I actually tell this to my
patients. When you go out, have the chips and salsa, breadsticks and
butter, at the end of the meal-
Oh, my gosh
... not in the beginning of the meal.
Chips, it's like-
Right
... it's become my new-
So-
... problem.
It's always been a problem for me.
I've never had a chip problem, ever.
I've always had a chip problem.
This is newer. Honestly, I blame California-
Yeah
... because it's just so delicious.
Right.
Their salsa's too fresh.
So I tell them, "When you see me back in a month, I want you
to change one thing." Have the same meals you're having, because obviously when you
tell them to make so many changes, they're more likely not to, right?
So I tell them one thing at a time. Like, "Okay, let's make a change for this
month. No matter what meal you have-
Right
... have your veggies first,
then have your healthy fats and proteins, and then end with a
carb or a starch." So potatoes and fruits.
That's a good-
Or pasta or pizza.
That's a good one.
Or whatever, right?
Yeah.
So we see this a lot of in Asian cuisine.
You're eating the seaweed salad, the edamame first.
That's what's offered to you.
Yeah.
There's a reason for that.
Is seaweed not good for you?
I haven't heard that, but hey, there's studies been...
I think it's what type of seaweed, right?
Because-
Okay, that makes sense
... there's-
Just like beans.
Right. If it's sprayed with glyphosates, and
pesticides, and stuff like that.
Yeah.
You want to know-
Which it probably is
... the source it's coming from.
Yeah.
Yeah, so if you buy organic.
Yeah. Treated in some form, it's no longer just seaweed.
Right.
It's now like a chip.
So Asian cultures, when you go to an Asian
restaurant, they're giving you the veggies, the seaweed salad, the edamame
first, and that helps-
Is the soup good?
... decrease.
The soup is good for you.
Right, but it decreases your glucose spike, right?
Right.
Instead of having, at an Italian restaurant or at a
Mexican restaurant, the chips and salsa first.
So good.
So have it, just have it last.
Yes.
If you change that, you'll see your A1C come down.
Mm-hmm.
It's a little change like that.
So I feel reward when I have those foods.
Right.
So I get dopamine from them.
Mm-hmm.
I feel drawn to them.
Yeah.
So to me, that is already a gut issue-
Mm-hmm
... that I am actively working on.
So the type of bacteria that are thriving-
Mm-hmm
... are giving me that signal.
Yeah.
And then-
Different types of bacteria-
Yes
... are giving different types of signal.
It's really awful, so-
Yeah
... but because I know the issue, I know how to fix it.
Right.
So that's the good news.
It's knowing the issue. How are you going to-
Yeah
... fix the issue in the first place if you never even know about it?
And-
You have to know
... 99% of the population does not know about it.
Exactly.
Right. So that's the new age medicine that we're talking about.
It's way beyond just prescriptions and lab orders and imaging orders.
I just don't believe it. It's just not enough. That has fallen short to me.
Yeah.
And this should be a part of the curriculum
in all medical professional schools.
There's just so much they throw at you, would it even
stick?
Right.
I don't know what's-
And like you're scrolling on social media, and this person tells you, "Take this
supplement, and then take this supplement, and do this, and do this red light, and
do that." And you're just bombarded with all these
stimuluses.
Yeah.
And so actually knowing your DNA-
Yeah
... you will know what works for you and what doesn't, so that-
Yeah
... you could weed out
all this extra noise.
So I really value the opportunity to check the
DNA-
Yeah
... when patients do allow me to.
Right.
So if they have the financial means to
do it-
Right
... it just makes their treatment so much more-
Yeah
... focused and successful.
They learn so much from it, too.
Yes.
And they know, okay, I
have autonomy. I will do this, and I will-
Mm-hmm
... learn from it, and I will make the changes.
Yes.
Because it's then not somebody else telling them what to do, a physician or a
provider.
Right.
It's their DNA that's telling them that.
This is you.
And I'm like, hey. So, I definitely need that DNA test.
I'm definitely, hopefully, going to get one soon.
I'll send it to you.
Yeah, I know.
I have the one that I love, DNA Collect.
Right, and the gut microbiome test.
Yes.
Right?
Yeah, Viome.
Both of those.
And I do that every few months.
Viome. Yeah.
And they give you a-
That's great
... treatment for your actual profile-
Mm-hmm
... of issues. But anyway, so I know you mentioned-
Mm-hmm
... beta-glucuronidase. What were you
hoping to mention?
So-
Go over that
... I've learnt that recently in one of the
longevity presentations that I was attendingAnd
everyone talks about, okay, how
especially with the new rules that have come out with hormonal
replacement therapy, right?
Mm-hmm.
Where-
Like the reversal of the statement that it causes cancer?
Right.
Yeah.
No, it does not.
That little thing?
Like, okay.
And we knew this. We knew this way before it did come out too, right?
Yeah.
But we just want people to believe it, and they're not going to believe it until
it's-
The medical board-
If the med-
... is going to endorse it, so it's not like Valerie's opinion or Gina's
opinion.
Right. And now it-
I
think-
... the medical board is saying this, FDA regulations have changed.
Yeah.
And it's great for some people.
Yeah.
But not for everybody.
Which ones is it not good for?
So-
What are you thinking?
... when you have this marker, beta-glucuronidase, right?
Mm-hmm.
Like the gene.
The gene, and you have
plentiful of it.
Mm-hmm.
So it's
the enzyme. The gene creates an enzyme, basically.
Mm-hmm.
And some people have a normal amount of that enzyme.
Mm-hmm.
But some people have a high amount of that enzyme.
Mm-hmm.
That creates dysbiosis in your gut.
Okay.
And you cannot excrete out, your liver is not able to detoxify and
excrete out the toxins as much as when you have
a level that's normal. So things like estrogen, right?
Mm-hmm.
When you're
giving your body estrogen,
it is good up to the point until there's an excess amount.
Mm-hmm.
Because we know an excess amount causes many other issues,
including cancers.
Yes.
So if you have this gene that's creating this high
enzyme level-
Mm-hmm
... then you need something like a binder-
Mm-hmm
... to detoxify that or decrease-
I love it
... the amount of the enzyme in your body.
Yes.
Then sure, you can do. But if someone's, let's say a person comes in,
has symptoms, post-menopausal symptoms, we start them on hormonal replacement
therapy, right?
Yeah.
And we're thinking, "Okay, we're doing the right thing."
Mm-hmm.
But what if they have this gene that is causing their
beta-glucuronidase enzyme level to be high,
and now we're putting estrogen in their body, and they're not able to excrete it
out properly.
You know, my response to that is this is the reason why
we check levels.
Right.
If I'm giving somebody-
Mm-hmm
... something, some like estrogen-
You need to check it that it's low, right?
Right. If it's 80/20, 50/50-
Mm-hmm
... if it-
And their level. Yeah, and that's perfect.
Yeah.
And most providers-
You see a spike
... should do that. But we do know that not everybody does.
Now, things like even peptides like GLP-1s.
Yeah.
You can get them without a medical prescriber.
Yeah.
You can get them online.
Yeah.
There's many websites that do that.
Yeah.
Are they checking their levels of things? Are they...
No, they're not.
So, I think for that respect-
Mm-hmm
...
the safety profile is pretty good.
Right.
But for estrogens, I like what you said about binders.
Right.
I like-
Fiber is a binder. Soluble-
Yes
... there's specific inulin-
Yes
... is one of the-
Or eat apples. That's my new favorite.
Yeah. Hey, you keep the doctor away, eat an apple.
We're going back to what our parents used to say. You know how crazy is that?
It's like a cycle.
They actually had it figured out.
Had it figured out. But you know what?
They didn't need all these peptides and all these supplements because they were
breathing clean air, drinking fresh water,
having fresh organic produce.
Don't you think there's a little bit of suffering that they just also did in
silence?
Right. Yeah, mental health is one of them too, right?
Yeah. My dad is, he's 90. I can't even believe it.
Wow.
He was in Nam. He's a veteran of war.
Oh my God.
He had Agent Orange exposure.
Wow, and he's living to be in his 90s.
That-
Yeah
... hey.
His bones are very soft.
Right. And that's what you are doing to prevent you from getting
to that-
Yeah
... stage where
we don't want these things that-
Right
... make us feel older.
Right.
Right.
Okay, so binders, you said fiber. I love that.
Yeah.
I typically will also do N-acetylcysteine, NAC.
Right. Right, NAD.
Glutathione.
Mm-hmm, glutathione. All these things-
Yeah
... that work great.
Thistle.
But we need to be educated ourselves-
Yes
... so we can guide our patients-
And look for it
... to do it and look for it, right?
Yes.
And
I'm just stepping into this world right now. I don't even know everything.
You're like diving in. You're doing it mainstream.
Right, but I don't even know everything, right?
Like some of the things-
Nobody does
... no, because we're not taught that.
And I think that's what's so exciting about it is I
know that in my career, I'm not
just going to be doing internal medicine,
focusing on a disease-
It's your launchpad
... and treating it. I want to do that, but I also want to
incorporate the integ-
Integrated
... integrated medicine.
Totally.
Functional medicine.
Me too.
Yeah.
Me too.
Because that's what-
Feels inadequate to not
... I know. That's what I would do for myself-
Yeah
... my parents-
Yeah, same
... my patients, right?
Yeah.
So why not?
Yeah.
Yeah.
And even if you think about, okay, people get cancer. Why do people get cancer?
Right.
Well, we all have cancer cells circulating in our blood.
Right.
Why is there-
It's the gene activation-
Yes
... of mutations and all that.
So, and it's your poor immune system-
Immune system
... not able to fight against it.
Your gut microbiome.
Everything.
EMF.
Yeah. There's nothing regulating-
Water that's not reverse osmosed.
Yeah.
There's so many things.
There's so much.
Pollution in the air.
Yeah.
So what was life 50,
70, 60 years ago is totally different from what life is now.
Yeah.
So, I think we're doing a pretty good job as keeping up with what's going
on.
Right.
But at the same time,
the food industry, the health industry,
maybe are lacking in so many aspects.
Totally. I want to go take it back to the farm-
Right
... to the table.
Right.
And like
grow your own food.
Right.
We have to just-
And you know blue zones-
Start over
... right? You know blue zones groups.
Yes.
Where the specific population in Japan was it, or Chi-
Japan.
Yeah.
Where they're living to be hundreds.
I definitely know Malta where my family's from.
Right.
Right.
And why? Not because just the food was fresh.
Yes-
Yeah
... the food is fresh,
but the connections.
That's true.
The people.
That's true.
The environment.
Yes.
Right? Getting good sleep.
Sense of community.
Community.
Yeah.
That's also there. It's not just food and exercise.
There you go.
It's community.
You know how people say laughter is the best medicine? Well, it is.
It is so the best medicine.
Hugging somebody-
Yeah
... that you love creates those happy hormones-
Yeah
... that fights all these toxins away.
Or calling your best friend.
Right. People are known to live longer-
Yeah
... when they have good social connections.
Yeah.
And I think we're fortunate to be living in a community like
Bakersfield
and to work with staff that we can live longer with
at the end of the day.
I love that.
Yeah.
So really quick, I just want to just mention a few things, since you did
bring it up-
Mm-hmm
... for the gut bacteria with that genetic expression.
Mm-hmm.
That makes you not
unable to get the treatment for estrogen, but-
Mm-hmm
... it's just something to look for and to-
Right, to look for.
Be aware of.
Because you may benefit from it.
Yes.
But if your DNA sequencing and gut microbiome is telling you otherwise-
Yes
... that's why that is the first step, right?
I agree.
Before we treat.
So if you have that gene, then you're going to carry
higher levels of E. coli, Clostridium, and Bacteroides.
Right.
It does create the dysbiosis, microbiome imbalance.
Mm-hmm.
Hormone issues are predominant, especially for-
Right
... PMS, fibroids-
Fibroids
... endometriosis, hormonal acne.
You are estrogen dominant.
Mm-hmm.
You have an increased cancer risk. This, oh, we'll see.
I'm going to read into-
Right
... what type of estrogen is higher.
Because there's so many different types.
There's different types of estrogen.
And that's what it is. It's like, okay, we know this-
Yeah
... but let's dive deeper and get to the root, like the bottom of it.
Yes.
You know?
It has to be checked.
Right. It has to be-
And we can do that
... evidence-based practice.
Yes.
Yeah.
And then symptoms would be bloating, hormonal swings, breast tenderness,
heavy cycles, acne around the jawline, which could also be just from
touching. If you're like me, like, hmm.
Huh. All this bacteria on our hands. Let's just put them here.
I put it right on my face.
And then we're like, "Why am I having a breakout?" Like, no duh.
Oh my gosh. And fatigue.
Yeah.
And then you're at-
Yeah
... commonly causes of elevated levels would be low-fiber diet,
constipation, gut dysbiosis-
Mm-hmm
... high alcohol intake, which also increases your estrogen.
You can't have your hormones titrated with high alcohol.
Mm-hmm.
And then antibiotic history, low diversity of microbiome.
Right.
So very, very good. I'm glad that you brought that up.
Yeah.
I would not think to check it, but I do check labs after I
treat.
Right, which is great. Yeah.
So it would've shown a spike in one-
Of course
... of the estrogens.
Of course. And that's what we're trying to focus on is
doing it the right way.
Yeah.
Because
with the field getting more and more saturated-
Yeah
... and us not having the proper education through schooling-
Right
... we have to find the good sources to actually...
Because right now, AI and everything, how do you know what to believe, right?
You know what? It's just not there yet.
No.
The prompts matter.
They do.
So intelligent prompts, intelligent answers.
Right.
Poor, low level prompts-
Yeah.
... low quality answer. I'm sorry, I said it.
And-
There's a space for us-
Yeah
... still to exist, and-
For sure
... we need more people like us.
Yeah. And maybe we can end on this is,
no matter how many supplements you take, no matter how many peptides you
take, because there's great ones out there.
Yep.
There's great medication out there.
Mm-hmm.
There's great things, but if you don't have the basics-
Mm-hmm
... if you don't have a good diet-
Yeah
... if you don't have a good
physical activity routine-
Yeah
... if you don't have good community around you, if you don't have-
Right
... good sleep-
Yes
... if you're not controlling your cortisol spikes, then at the end of the
day, all this other stuff is not going to fix you.
You need the basics.
So good.
And then let's focus on all these things to make it even better.
It's like the sprinkle-
Yes
... on top, right?
Yeah.
You got to have a cake, you got to have the foundation.
Not just the whipped cream.
Not just whipped cream. Or the champagne.
That just reminds me of champagne cake, and now I want champagne cake.
Well, that sounds-
The reason it's so good is because-
Like an actual fire
... it has sprinkles, it has whipped cream. Oh, we're just talking about cake.
But yeah.
Well, thank you so much again-
Of course
... for joining. It won't be the last.
No.
Always a pleasure.
This just felt like it went by so fast because we're just talking.
We're in the fort.
We would talk like this at a dinner table together too.
This is what-
Which we did.
This is what we actually look like.
Yeah.
This is our normal. We actually-
Yeah
... go probably another level deep.
Yeah. And hey.
We're on good behavior slightly, right?
Yeah.
But all right.
All right.
Thank you so much.
Too much more learning with you, for sure.
Absolutely.
Yeah.
Until next time, guys.
Bye.
Take care.