In this week's webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas answer a series of questions asked by the live audience on all topics related to medical conditions, plant based nutrition, and lifestyle medicine.
Questions Answered
- (01:34) – Do you have any advice for dealing with salt cravings?
- (05:59) – Can plant-based foods help with thyroid issues?
- (09:50) – What causes protein in your urine?
- (21:04) – Any suggestion on what foods will help lower inflammation?
- (26:58) – My husband's Cardiologist wants to increase his cholesterol medications to 40 milligrams, since his calcium score has doubled to over 500. Any thoughts or suggestions?
- (31:27) – GP has recommended a multivitamin with iron for my seven-year-old. She has not identified any deficiencies. Just said she will likely become anemic due to plant-based diet. What are your thoughts?
- (33:59) – My son is 11 with celiac on a whole food plant-based diet. His doctor wants to put him on a multivitamin and B complex just based on diet. Can you talk about celiac disease and nutritional needs?
- (39:07) – Is there such a thing as eating too many beans? I eat beans with most meals. Is it too much protein for my kidneys?
- (41:11) – What do you use for protein? Hemp hearts, tempeh, or nuts?
- (42:27) – Just been diagnosed with arthritis. I also have myasthenia gravis. I have changed my diet, but I'm very confused with foods I should eat. Could you suggest a book to start with or a site?
- (45:04) – My five-year-old is slightly anemic after we have been vegan for six months. What can I do to help him?
- (47:30) – Is CoQ10 a good supplement?
- (48:29) – I'm a type 1 diabetic and have hypothyroid, and on 88 micrograms of levothyroxine. I'm going to the doctor next Tuesday. What blood test should I ask to get?
- (50:25) – Should tahini be avoided?
- (50:58) – Should I be worried about the amount of chemicals in rice?
- (52:34) – If my vitamin D levels are low, do vitamin D pills really help?
- (54:05) – My daughter is four and is a plant-based baby. She has her yearly pediatric appointment coming up. Should I ask for blood work to make sure she's okay in iron and calcium?
- (55:09) – I'm resistant to thyroid hormone and have elevated both TSH and T4. Can diet help these levels?
- (56:45) – Is having a gallstone always equal to having your gallbladder removed, or can there be alternative routes to get rid of the stone?
Complete Transcript
Dr. Laurie Marbas
(00:04)
Yeah, I think we're going to just let the answers or the questions go freely and we will answer those today. We don't really have a topic. We've done such an extensive answers and questions session before that I feel like we should do a good… let's everyone answer the questions that they want us to answer.
Dr. Chris Miller
(00:24)
Yeah, exactly. So anyone, if you're thinking of any questions or anything you would like help with or want a tune-up or just kind of want to know, put it out there and we'll give you our best shot. If we don't know it, we always go and look things up, too. So it'll be fun to discuss things.
Dr. Laurie Marbas
(00:40)
Absolutely. Penny, if you want to put in the question Q&A box, please, the question that you sent us, that would be awesome. So it looks like we are live on Facebook. Here we go. When Dr. Klaper and Julieanna, if they can make it, that'd be great. I know there were some… they had some other things going on, so we will-
Dr. Chris Miller
(00:58)
Here's Dr. Klaper. He's there.
Dr. Laurie Marbas
(01:00)
Dr. Klaper, excellent. We'll move Dr. Klaper up here. Most excellent. Okay. So like I said, if you have any questions, please feel free to put those in the Q&A box or the chat box. But it's easier on the Q&A box. If you're on Facebook, if you'll go to the Plant Based TeleHealth page and comment under the live stream, that would be super helpful. That's the only place that I'm going to be monitoring for questions and then we'll go from there. But welcome Dr. K, how are you?
Dr. Michael Klaper
(01:30)
Good. Good to see everybody. Hi everyone. Good to be with you.
Dr. Laurie Marbas
(01:34)
Always good to see you and Dr. Miller as well. So Dr. K, we're just going to go ahead and get started with, excuse me, with just a Q&A today. We did get one question sent to us via email. Penny sent it in. Let me pull it up real quick. She says she's been plant-based for a couple months now. I'm curious that I have been strongly craving salt, and adding salt in salty foods. Before going plant-based, I used very little salt or processed foods. The craving is really noticeable. On the other hand my strong sweet tooth has almost completely disappeared. No problem with this one. So any suggestions on a craving for salt that started after going plant-based?
Dr. Michael Klaper
(02:21)
Well, it may be a real message from his body that he may need some more sodium in his diet. Everybody… it's a bella shaped curve. Some folks need very, very little and some folks keep their blood pressure up and just function. Sodium's involved in many reactions in the body. Some folks may need a bit more of it. Whole plant food are naturally low in sodium, at least compared to how much we usually put into our processed foods. So his body may be ready for some.
Dr. Michael Klaper
(02:55)
There are several things to do about that. One is to first of all determine if it's a true salt need. One thing to do is his tongue might be looking for a little bit more entertainment. One thing to do is to entertain your tongue with non-salty flavorings like lemon juice or lime juice or some of these… a lovely balsamic vinegars that are available now. If that's all you need, great, you're ahead of the game.
Dr. Michael Klaper
(03:20)
But if you really want the salt, I don't have any objections to taking a good quality salt and adding literally a pinch, less than an eighth of a teaspoon on the veggies at the table. People say, oh, I don't have a salt shaker anymore. Actually, that's the one place you've got control over. At the Italian restaurants salt's already in the spaghetti sauce. You can't do anything about it. But if just a tiny pinch of salt on your food helps, it well might. When the granules of salt are on the surface of the food and it hits your tongue, you get this big salty taste explosion for very little actual sodium. But, again, if it's already in the spaghetti sauce, you don't need to chase it.
Dr. Michael Klaper
(04:07)
So try the lemon juice and the vinegar. But if you're just absolutely craving salt, then just add a little pinch of it at the table and see if that's all you really need. You can use a little bit of tamari sauce, a little bit of Bragg's liquid amino so you have some sodium. I like to take tamari and put it in a spray bottle, half water/half tamari, just dilute it out and a couple of spritzes there give you a nice salty flavor for very little actual sodium. So find ways to tie a little bit salt in and probably your body will be pretty happy with it.
Dr. Laurie Marbas
(04:43)
Excellent. Yeah, I think also, too, if it continues or it becomes worse or you're noticing other symptoms, fatigue, darkening of the skin, you worry about Addison's Disease or some odd thing like that. But just either check it out with your regular doctor or you can always come see us, too. It's a simple blood test, but just monitor those symptoms. If it's strictly just a craving, it should improve with adding a little salt, but it shouldn't get worse, so for sure.
Dr. Chris Miller
(05:09)
Yeah. I have seen patients along that line come back hyponatremic, so low sodium on a plant-based diet and drinking a lot of water. So that could be a concern, too. So depending on how much water you're drinking. Then it also takes the kidneys some time to adjust to a lower salt diet because they're used to excreting more salt. When you first make a change, it takes it some time for it to realize, oh, I'm not getting in as much salt and it stops excreting quite as much. If you've been doing four months it seems like it should have realized it by that point. If you are so really strongly craving salt, I would probably recommend just a basic electrolyte blood test that anyone can do and just gauge where you are and make sure that you're on track. Then all the tips that Dr. Klaper said kick them into high gear because they help a lot of us with salt cravings, so.
Dr. Laurie Marbas
(05:59)
Yeah. I love adding miso. Miso is kind of my new thing. So we have another question here. They recently found a six millimeter nodule on my thyroid gland. Can plant-based foods help with thyroid issues? Any recommendations?
Dr. Laurie Marbas
(06:14)
So, Chris, I know maybe not specifically to a nodule, but do you want to speak to the thyroid in general?
Dr. Chris Miller
(06:20)
Mm-hmm (affirmative). I would be happy to. So the thyroid is an organ and it secrets hormones which are related to… go to our body and do different things. So when we eat more plant-based anti-inflammatory foods, we can put out inflammation. Yes, our bodies start to recover and repair and regenerate and heal, all sorts of things. So we do see improvement in thyroid conditions. So we have people lowering thyroid medicines. All different types of nodes and masses can improve depending on what they are.
Dr. Chris Miller
(06:56)
So I always recommend getting it checked out, getting it… find out what it is and whatever you treatment you need. But in general anywhere in our bodies a lot of this can start to improve with nutrition. So that's definitely really important for you at that point.
Dr. Chris Miller
(07:13)
The thyroid's interesting, though, because if the organ actually gets burnt out and it's no longer able to produce thyroid hormone over time for whatever reason has caused it, it won't regenerate fully. So it's not one of those where people can go whole food plant-based and taper off and completely stop their medications. Often people still need that little bit of thyroid medicine. That's okay. That's giving you the physiological map that you need. So you still do your healthy whole food plant-based diet and get your anti-inflammatory nutrients, lots of fiber, all the good stuff that your body needs, and you take that little bit of thyroid hormone. But we often see people need less and less and less over time. So that's real important.
Dr. Chris Miller
(07:53)
You want to make sure you have the right nutrients for your thyroid, that you're getting a little bit extra iodine that you need, especially if you're not eating the salt. Maybe a little selenium which you can get through your food. Just pay attention and be aware of these things. A little extra zinc by eating more nuts and seeds and legumes. Or making taking a small amount of supplement. But those are all really important to enhance your thyroid function. So hopefully that's a quick overview.
Dr. Laurie Marbas
(08:22)
Yeah, absolutely. I just have a personal testament to that. I was hypothyroid, Hashimoto's for 15 years. When I went to a plant-based diet, that was almost nine years ago, and it did get better, not to the point where I could stop medications, but I'm using a lot less medication now. Yes, there are definitely things that can improve even years into having a particular disease. Dr. K, any final words on thyroid health?
Dr. Michael Klaper
(08:45)
I hate to sound like a western doctor here, but you do have a lump on your thyroid. Do work with your doctor during diagnosis. Make sure it is not a malignant tumor and they do happen. So get the necessary biopsies or scans or whatever you need done. But if it's truly benign, then that nodule was a message from your thyroid that Dr. Miller translated very nicely for you as probably looking for some iodine, zinc, and other nutrients that you find in a plant-based diet. But do be responsible and check it out and find out the true nature of that lump.
Dr. Laurie Marbas
(09:21)
Absolutely, and I think it's always worth reiterating that a plant-based diet is not a panacea for everything. It does a lot, it's very powerful. In many cases more powerful than drugs, but that's where the beauty of having a doctor who's versed in both can marry both the powerful, the western medicine and the diet, and really give you the best outcome overall. Just like I can't say that enough, don't ignore it. But I'm sure they're talking to you about a biopsy or whatever needs to be done.
Dr. Laurie Marbas
(09:50)
Larry asked what causes protein in your urine? My doctor keeps me on a blood pressure medication to decrease that, and I always fail that test. So who would like to take on the kidney question?
Dr. Chris Miller
(10:03)
So I can start with that and then you guys can add in what else. I'll just give a little tiny overview. But, yeah, protein is something that we monitor. So the way the kidney is set up and has its glomeruli and then it has this nephron and it's not supposed to let out big molecules like proteins. It's supposed to let out small things. The kidney is really important for filtering. It's a filter basically. So it filters out toxins and waste products, urea, but it also modulates your electrolytes like we were talking about the sodium.
Dr. Chris Miller
(10:38)
So it's got channel to regulate that potassium, calcium, things like that. But what the kidney also does… or it's not supposed to do is leak out protein or albumin, things like that. Those are supposed to be too big for it. But if the kidney starts to get damaged or inflamed, so any inflammatory condition to the kidney, then it starts to leak out that albumin and so you'll see it as protein in your urine. So that's a sign right away that's something's going on in your kidneys and that's why they're monitoring.
Dr. Chris Miller
(11:04)
There are certain blood pressure medicines like the ACE inhibitors which have shown to help decrease that and can help preserve kidney function. So if your doctor thinks that you need something like that, that could be very helpful. A whole food plant-based diet is actually coming out with evidence now that's it's very helpful for many different types of kidney disease.
Dr. Chris Miller
(11:22)
So one of the mechanisms it's working at is it's reducing the inflammation tremendously, reducing the inflammation. Your kidney can even start to repair itself. So that's a really, really helpful tool. Getting off the animal products is really important because the nitrate group from the amino acids, it takes work from the kidney to actually get rid of that and excrete it. That's a lot of work for it. So just getting off of the animal products is a huge thing for preservation of kidneys.
Dr. Chris Miller
(11:59)
It's interesting, even in regular medicine we're taught to when people have severe kidney disease to put them on a low-protein diet, low-animal protein diet. But in the real world nobody thinks about that until they're in severe kidney disease, right, except for us in the plant-based world. We know that high protein, that's so dangerous for our kidneys. It damaged mine with my own lupus nephritis before I was plant-based eating that animal protein.
Dr. Chris Miller
(12:26)
So just going whole food plant-based and adding the anti-inflammatory nutrients in can really start to help reduce that inflammation and start to… we see a reduction of protein in the urine. So but do monitor that with your doctor because it can go out of control fast and lead to all sorts of permanent problems, so I'm glad you're watching that.
Dr. Laurie Marbas
(12:48)
Dr. K?
Dr. Michael Klaper
(12:51)
Well, I'll say about buy a used [inaudible 00:12:54] and I asked a guy who owns one. You just heard Dr. Miller give you a very authoritative answer. She owns one. She has personal experience with that and that was a beautifully answered question. In the answer she did all the major points there. People don't appreciate, like Dr. Marbas said, how hard the standard western diet is on our kidneys. It's a multi-pronged assault when you think about it. Who thinks about their kidneys? But the reality is that there's a number of things in the western diet that really make it hard on the kidneys.
Dr. Michael Klaper
(13:31)
One is as Dr. Miller said the high-protein diet. When all those amino acids hit the glomeruli, the filtration mechanisms in the kidney, they're not thrilled with that. We're meant to be plant-eating creatures that slowly absorb protein coming off the fruits and vegetables and grains that we eat. These big bolts of protein that are absorbed very quickly from meat slam into the filtering membranes and put them in a gear called hyperfiltration. It's a biochemically strenuous state for the kidneys' filters to stay in week after week, meal after meal, month after month. So that contributes to the loss of filtering mechanisms.
Dr. Michael Klaper
(14:18)
High blood pressure just from the high-salt diet that people eat and all the fat that makes the blood more viscous, makes the heart pump at a higher pressure and bangs that blood into the glomeruli, and the higher pressure damages these delicate, delicate glomeruli. They're gossamer thin, one-cell-thin filtration membranes. They don't take a high pressure of 140 millimeters of mercury beat after beat after beat. So high pressure can damage them.
Dr. Michael Klaper
(14:52)
Just atherosclerosis, it's the clogging of the arteries, one of the major arteries clogged up is the renal arteries going into the kidneys. You develop the old plaque there and you choke off the kidneys' blood flow. It thinks you're in shock so it puts out chemicals to raise your blood pressure because its own blood supply is being choked off. So it's false slow blood pressure as far as the kidney goes, but you really have high blood pressure. So clogging up the arteries in the kidney is another kind of assault.
Dr. Michael Klaper
(15:24)
So no wonder so many people, especially when they get to their 40s, 50s, 60s and there's protein leaking out in their urine and their creatinine level's going up and they've got borderline kidney issues there, can borderline early kidney disease onto kidney failure. As Dr. Miller appropriately said, we are learning how amazingly… Most nephrologists, the kidney specialists, when they see your creatinine going up, they think that as a one-way slope, man. It never gets better. You're heading for the dialysis machine.
Dr. Michael Klaper
(15:57)
But those of us in the plant-based medicine world, we see what Dr. Miller just said that get them on a plant-based diet. It's so much gentler on your kidneys that the kidney function gets better. Their blood flow is better to the kidney, filtration happens better, and then creatinine level starts coming down. The first time I saw it I couldn't believe it, but now I look for that. I expect it.
Dr. Michael Klaper
(16:20)
So only around the western diet, your kidneys are giving you another message. Stop the meat and the dairy and oils and sugars and all that toxic stuff. Run whole plant foods through your system, your GI tract, your kidneys… everything, and it's going to work much better and last a long lifetime. So, yes, I agree with Dr. Miller completely.
Dr. Laurie Marbas
(16:43)
Excellent, well said. You know, the glomeruli, I always tell my patients, if you think about they're like a delicate daisy and then the high blood pressure is like putting on a fire hydrant and you just like… you obliterate. So now instead of keeping those proteins in the blood, it's constantly being filtered, you're just allowing them to filter out. So maybe that will help make a little sense where you're finding protein.
Dr. Laurie Marbas
(17:05)
But diabetes also is a big contributor. It's the number one cause of renal failure in the United States. Diabetes gets much better on a plant-based diet, you can guarantee it. So that's the other issue. There's a type of autoimmune type of diseases that can occur. I'd have to do more research on the autoimmune disease in a plant-based diet, but there's so many things that can be causing that. But I would just also just if you don't have high blood pressure eating a plant-based diet, I would maybe seek out why you are actually spilling protein. Did you have high blood pressure before and that damage is stuck there? Do you have diabetes? So I would be curious to see why you're spilling the protein, not just accepting a diagnosis.
Dr. Laurie Marbas
(17:48)
That's really interesting when people have that they just accept the diagnosis and they never ask why. Well, people, why is that occurring? What's the root issue? I just want to put out a nice little thank you to Dr. Michael Greger who highlighted our journal, it's the IJDRP, the International Journal of Disease Reversal and Prevention, that I helped found three years ago and we got it out in nine months. He's been doing some really cool videos.
Dr. Laurie Marbas
(18:18)
He did a video yesterday and I was getting all these emails. I was like, “What is going on? Suddenly with all the email traffic.” So I just wanted to say thank you. But he also spoke to Dr. [inaudible 00:18:29] had written an article of a case series about a lupus nephritis patient and it was a really interesting one. I know Dr. Klaper and Dr. Miller have also reviewed some of our articles, so thank you for that.
Dr. Laurie Marbas
(18:43)
So check it out, it's IJDRP. It's free to authors, it's free to the community. I think we're the only journal that doesn't charge anyone anything for anything because we want to make sure everyone has it. You just have to register. But check it out, IJDRP.org and it's pretty cool. Dr. Kim Williams is our editor in chief, so you can't get a more higher caliber than that at least in my eyes. So I appreciate all that and everybody's work.
Dr. Michael Klaper
(19:10)
I'd be glad to just emphasize. This is really landmark in the history of medicine. The International Journal of Disease Reversal, it's a journal devoted to diseases going away largely from diet and lifestyle. How wonderful, how hopeful that is. Most journals are so dreary with one case of catastrophe after another. This is a journal of hope and so great. Dr. Marbas in the captain on that ship. She's doing a great job. This is really hopeful. So check out the International Journal of Disease Reversal and Prevention and it's a good read to say the least.
Dr. Laurie Marbas
(19:48)
Yeah, thank you. Yeah, it was three people on a conversation in December 2017 and like, “Here we go.” I'm like, “Well, have any of us ever started a journal?” They're like, “No.” I'm like, “Well, okay then.” So lots of research and staying up and it waking me up in the middle of the night and I had post-it notes on how it should flow and calling people and asking their opinion and it finally came to fruition. We just hit the two-year mark and we can apply to be on PubMed and all the articles that we've had will also automatically get-
Dr. Chris Miller
(20:19)
Wow.
Dr. Laurie Marbas
(20:19)
… over there once we get accepted. So we-
Dr. Michael Klaper
(20:21)
Great.
Dr. Laurie Marbas
(20:21)
… had to pass a certain mark, but we're super excited about that. We're also bringing on some extra help and we'll be announcing that soon, too, so I'm super excited about all of the things. Anyway, just great to plug that and appreciate your guys. Also, I also have a podcast called the Healthy Human Revolution Podcast. You guys should check it out. I've actually interviewed several people whose kidneys have gotten better. I have over 200 interviews. I've checked out… Dr. Miller was my very first interview in her living room and I've interviewed also Dr. Klaper. We were talking about his movie, Medicine Forward, and so some good stuff there if you want to search through those. You might find a case that might inspire you.
Dr. Laurie Marbas
(21:04)
Let's move on the next one. This is actually very interesting. I think it just speaks well-rounding about the plant-based diet. Currently I eat a plant-based diet. Any suggestion on what foods will help lower inflammation? So there might be some specifics that you guys want to speak to?
Dr. Michael Klaper
(21:23)
Well, I'll take the low-hanging fruit here. I'll let Dr. Miller really lace it up. Again, a whole food plant-based, quinoa and greens and yellow vegetables should not incite inflammation, they really should be anti-inflammatory on a lot of levels, largely from what they don't have. You don't fry them and you don't add a lot of sugars and additives, things that are oxidizing agents. So just whole plant foods, raw or lightly steamed, really should ask very little in the way of oxidation or inflammation.
Dr. Michael Klaper
(22:01)
But then there's the classic anti-inflammatory seasonings and spices clearly it seems that the curcumin that's found in turmeric, that lovely yellow spice from India, is a potent anti-inflammatory. Ginger seems to be an anti-inflammatory. There's a number of anti-inflammatory spices I'm sure Dr. Miller will fill us in on. Again, it's the whole food plant-based diet prepared lovingly and gently is really the most powerful anti-inflammatory medicine I know. Dr. Miller, what would you add to that?
Dr. Chris Miller
(22:42)
Yeah, so I agree 100% with all of that exactly. So it depends on what's going on with you and what stage you are. So just going whole food plant-based like Dr. Klaper just said is extremely anti-inflammatory. So it's real important that you're not eating processed foods, you're not eating gluten-free crackers or things like that, but the actual whole food plant based and not over-eating, too. That's an important thing to contribute to lowering inflammation.
Dr. Chris Miller
(23:06)
So if you're doing nice good three meals a day or whatever you're doing with those foods, that is the first step. If you continue to have inflammation, then I always have people add in more raw vegetables, especially leafy greens. All those living enzymes in them and the phytonutrients in them, they really ramp up the detox process and put out oxidative stress even more powerfully than just being on a mostly cooked whole food plant-based. So really ramping that up is extremely helpful and trying to get a little bit of raw in with each meal. So that's the next step.
Dr. Chris Miller
(23:42)
Things like onions and garlic are extremely anti-inflammatory, so including those, mushrooms, extremely anti-inflammatory. Like Dr. Klaper said so adding some of the herbs such as turmeric. I actually like turmeric root, having a little bit of that with each meal is very powerful to reduce inflammation, so that one. Then ginger is another powerful one, saffron, cloves, cinnamon, basil, oregano, cilantro. So you see all of these herbs and spices really spice up your food and that's very helpful.
Dr. Chris Miller
(24:19)
Then the last care I would have if your diet is a mess, though, if you are having all sorts of inflammatory conditions and you were having disruption of your bowels in any way, then you may need to simplify it for a little bit and then we kind of work with you with an initial elimination diet and then we keep on flooding in these anti-inflammatory nutrients with the ultimate goal to being building a whole diverse plant-based diet. You want the diversity, you want the fiber, but some people at the beginning with the all inflammation, if you have inflammation regrets, they don't tolerate that. So we have to start simply and working our way towards that and fixing the gut issues if that's going on.
Dr. Chris Miller
(25:01)
So it's a process, but I would definitely start with what Dr. Klaper said, that's exactly the right thing. Then add in a little bit more raw and spices. If you're still struggling, then we can step it up for you and get you or someone, or you can look into how to step it up and get you even more anti-inflammatory.
Dr. Michael Klaper
(25:18)
So one last PS. When I worked at a fasting center at TrueNorth Health Center that we would people on water fasts and just were stunned how quickly the inflammation leaves our joints and their kidneys and their whole body. So fasting is certainly a potent anti-inflammatory, so that then doubles back to well how about intermittent fasting? How about extending your overnight fast through the morning hours and don't starting eating until noon or so and get an extra four hours of anti-inflammatory fasting state on a daily basis. That might help you with your inflammation as well.
Dr. Chris Miller
(25:52)
It totally helps with inflammation, Dr. Klaper. That is a huge tool that I've been using myself and in my patients. If any of my patients that are hear listening today know that I've been talking to you about it, that stopping eating early is tremendous. It's really so interesting to me. Again, food is medicine. Food causes my inflammation, no question. When I'm flaring, all I have to do is stop eating or eat less and I feel better. It's unfortunate, I like to eat, I like my plant-based foods. I don't like to be hungry. It's hard for me to focus and get my work done, but I feel so much better. I feel it literally melts away immediately and I'm stunned at the power of food to cause my inflammation or just not eating to feel good. So that's a huge draw. I strongly recommend that, too.
Dr. Laurie Marbas
(26:38)
Excellent. So fasting and a plant-based diet, some particular spices, some other things, too. Excellent. I think looking at rest is also important so make sure people are sleeping. It's been really interesting. I've been really focused on some sleep patterns of patients and a lot of them have really bad sleep habits. So that might be the other issue, too.
Dr. Laurie Marbas
(26:58)
So there's an interesting question here. Cardiologist wants to increase her husband's cholesterol medications to 40 milligrams. I'm assuming it's a statin, since his calcium score has doubled to over 500. He's healthy, active, and thin. His cholesterol is stable at 180 on five milligrams. He is plant-based. Any thoughts or suggestions? Would either of you like to speak to that on medication and [crosstalk 00:27:22]?
Dr. Chris Miller
(27:22)
I'll start that one off real quick, and then I know Dr. Klaper has a lot of good stuff about this so I'll let him take the good stuff after I just do the low-hanging fruit as he said. A couple things on that. One is really hard to give advice without knowing anyone, so I definitely am not giving any advice here. I'm just giving general information myself because without knowing your husband's past history of cardiac history, I don't want to say anything about any of that. Your doctor certainly knows something that we don't, so we can't say that.
Dr. Chris Miller
(27:51)
But that being said, usually I was taught not to repeat the calcium CT scans because one you have it done once, okay, we know he has calcium now. So as you go plant-based, as you start to stabilize that plaque going from an unstable plaque that can rupture and cause problems to a stable plaque, it actually shows up as higher calcium. So that can be a sign that actually that you're doing better. So you really cannot use it as a gauge anymore. Once you've had it done once, that's rally it. Now you know your husband has calcium and I would not recommend repeating it. So I wouldn't worry about that number. I wouldn't use it.
Dr. Chris Miller
(28:29)
That being said, what I recommend to my patients is I do advanced cardiac lab testing to see if they have inflammation to blood vessels, to see if they have anything that I would be worried about. I also recommend a CIMT, the carotid intima-media thickness test. It's an ultrasound done of your carotids. It usually costs about $200, insurance may or may not cover it. You can get them all over the place. My hospitals do them here. So you get the CIMT and that shows you if you have plaque. What we do with that is we monitor that and we can see recession of plaque. People on a plant-based diet we see a regression where it gets better. We'd repeat it usually in six months or year and follow with that, because that one you can follow. Whereas you can't follow that calcium CT scan. So that's just general information about that.
Dr. Laurie Marbas
(29:19)
Cool.
Dr. Michael Klaper
(29:20)
Well said. The only thing I would add is when I hear he's plant-based but he's got this, this, and this, well, then I need to know what this man is really eating. I would want a four-day food diary. What is really going into his mouth here because there's something inflaming his artery walls there. Atherosclerosis is an active inflammatory process. Those artery walls are being injured. So the question is what's really injuring those artery walls? Start with a food diary, but talk about… If he's really, truly eating a whole food plant-based diet, the only thing that's going through his arteries are rice and beans and greens, then his inflammatory markers should go down and the process should stop. Again, just tons of green vegetables, yellow vegetables, the antioxidants are really important found in food and not in pills. So that's the first and foremost thing.
Dr. Michael Klaper
(30:17)
I totally agree with Dr. Miller, get these inflammatory markers, get his [inaudible 00:30:21] CRP, myeloperoxidase, phospholipase, prostaglandin 2. Find out if those artery walls are inflamed. If they are, he's doing something to inflame them and that's where the attention should be directed.
Dr. Michael Klaper
(30:38)
It's 3:00. I'm giving a Zoom lecture to the medical students at Nova Southeastern University College Of Osteopathic Medicine right now about the importance of plant-based diets, so to further medical education of these young students and I'll wake them up a little bit. I'm going to be off to South Florida here, so thank you everybody. I'll see you next time around.
Dr. Laurie Marbas
(30:58)
All right. Bye Dr. K. Thanks for you joining us.
Dr. Michael Klaper
(31:03)
You bet. Bye-bye.
Dr. Laurie Marbas
(31:03)
All right, so you're stuck with me and Dr. Miller for the next half hour.
Dr. Chris Miller
(31:09)
We'll try to be as interesting how we are answer our questions as Dr. Klaper is. He's the best.
Dr. Laurie Marbas
(31:15)
I have to use some of Dr. Klaper-isms, the [fooz-naval 00:31:18]. All right.
Dr. Chris Miller
(31:18)
It's the food.
Dr. Laurie Marbas
(31:22)
It's the food, yeah, absolutely.
Dr. Laurie Marbas
(31:25)
All right. Donna asks my daughter's GP is concerned with our whole food plant-based diet. Has recommended a multivitamin with iron for my seven-year-old. She has not identified deficiencies. Just said she will likely become anemic due to diet. I'm hesitant to do this. What are your thoughts?
Dr. Laurie Marbas
(31:44)
Well, I think you're right to be hesitant, not that I want to step on the toes of your doctor and concerns, but is this doctor plant-based? Have they looked at what a plant-based diet does in iron? Now you may have lower variant scores in some other things going on there. What I would suggest is treat to a test. You want to test, don't guess type thing. She's not anemic. She's eating a wide variety of foods. She's not a picky kiddo. You're able to get those foods in her. Say, I don't feel comfortable, let's check iron levels in three months, six months, nine months, whatever, something that you feel comfortable with and your doctor.
Dr. Laurie Marbas
(32:25)
You would then give accordingly to what she actually needs. So just to throw something at someone because they think they heard something, it's like people saying soy was bad and it caused cancer when they didn't actually read the research. So I would certainly not just… because iron can have some side effects and it's not healthy to take too much iron. It can cause constipation and all sorts of issues. But, Chris, any thoughts on there or anything?
Dr. Chris Miller
(32:53)
You answered that beautifully so I don't have too much to add. I just find it interesting that the number one cause of anemia in little kids is from drinking dairy from milk.
Dr. Laurie Marbas
(33:03)
Yes, exactly.
Dr. Chris Miller
(33:04)
So now you've gone off the dairy into a healthy whole food plant-based diet and the doctors are worried about anemia or iron deficiency. So that just always interests me how off we are our training in medicine these days. So I think you're on the right track unless there's a deficiency or something going on. Keep going with your healthy diet. It's helpful hopefully you're working with someone to make sure you have a well-rounded diet and she is getting what she needs because some people still can be deficient in things.
Dr. Laurie Marbas
(33:37)
Yeah. Absolutely, and just make sure she is taking her B12 and maybe a vitamin D3, but other than that, I don't think there's any need. There might be some supplementation recommendations for omega-3s. There's just a few different things. Honestly, I would just speak to someone who's well-versed in a plant-based died. We'd be happy to see her as well. But hopefully that's helpful.
Dr. Laurie Marbas
(33:59)
Here's another one, Chris. My son is 11 with celiac on a whole food plant-based diet. His doctor wants to put him on a multivitamin and B complex just based on diet. I think that's a lot. Both his vitamin and B complex are the same amounts. So I'm not sure what they mean, but you want to speak to maybe the celiac disease and nutritional needs?
Dr. Chris Miller
(34:20)
Yeah. So hopefully he's doing better now on a gluten-free whole food plant-based diet. So that's a great, great, great first step to it. But the thing with celiac is that you can be deficient in nutrients. So what happens is the little cilia of the intestinal lining get inflamed and so they don't absorb nutrients as well anymore. So we see people deficient in B vitamins actually and magnesium. It's very common for iron. Vitamin D, some of the fat solubles don't absorb across quite as well. We can see calcium and magnesium… I think I said that already. So we do see that. That's actually very true. Even iron, people who are iron deficient, it's one of the common ones, too.
Dr. Chris Miller
(35:07)
So I definitely recommend some sort of multivitamin for him, at least right now, since you're just getting started. I think that's a very good idea. But if he needs both of them, I'm not sure. That seems a little redundant to me, but I don't know your son's numbers or what's going on with him. So I'm not sure about that. But definitely getting in some nutrients and some supplements is very important for celiac people.
Dr. Chris Miller
(35:31)
Then when things improve and stabilize and if his numbers are looking good, and once those cilia regenerate and heal, then you shouldn't have to worry about those vitamin deficiencies anymore. Then it's just normal whole food plant-based diet where we look at B12, vitamin D, and maybe a few other things that some people need a little extra of here and there. But at the beginning it is very important and very helpful.
Dr. Laurie Marbas
(35:54)
Yeah, absolutely. So Kim, one of your patients, she said just a comment on some doctors and nutrition. As Dr. Miller knows, my husband is facing a big surgery. Yesterday his surgeon recommended weight gain high-protein powder from GNC. I told him that my doctor will be advising on the nutrition piece. He said, “Oh, good. That is not my area of expertise. Just know that nutrition is important.” That's great. Let's just give information that we don't know.
Dr. Chris Miller
(36:27)
Kim, that's just a standard thing that doctors are taught in medical school. He said it's not his area of expertise, he doesn't really know, but that's what we're all taught. When someone has cancer they need to gain weight, put them on high-protein diets. Then if you actually start delving into the science of it, which is what we do here, you start to see, wait, all that high protein actually promotes cancer, increases IJ1 and it doesn't facilitate healing and what he needs [inaudible 00:36:53] and a good healthy well-balanced diet and good fiber and microbiome. So we know so much more now than that advice. I learned that 20 years ago in med school, I heard the same thing. But there's no evidence to support that and it's actually the opposite it seems like. So I'm glad that he said to trust in us because I would be happy to work with you and help you with that.
Dr. Laurie Marbas
(37:14)
Yeah, absolutely. It says here Dolly's asking can you take iodine while you're taking the low levothyroxine? My other question is how low are the doses of levothyroxine medication? I take 50 micrograms. Thank you. Well, right up my alley.
Dr. Laurie Marbas
(37:33)
So the lowest dose of levothyroxine is 25 micrograms. Most people require more than that, unless you have some subclinical hypothyroidism that you're attempting to treat and that's a whole another conversation. Yes, you can take the iodine. I take a very small amount of iodine because I try to avoid iodized salt, so I only take 150 micrograms daily of that. So it's a very, very small amount and that's all you need is just a little bit.
Dr. Laurie Marbas
(38:02)
Yes, and I would monitor if you're just recently switched over to a whole food plant-based diet. You're on a very small amount, so that actually might get better. So I would definitely keep an eye on that. So maybe check it every couple of months because there can be some consequences to taking too much levothyroxine as I suffered myself. So please keep an eye on that.
Dr. Laurie Marbas
(38:25)
So, yes, you can take the iodine and that will help support your thyroid functions. It may be why you actually have hypothyroidism actually, too, is that if you've been a very strict salt/oil/sugar-free plant-based diet eater, you actually may be too low in your iodine and may have caused it or worsened it. So there are some really interesting things to dive into. Again, those are some things you can test and so we'd be happy to do that for you as well, or your doctor. It's a 24-hour urine test for iodine is the most accurate, so something to think about there.
Dr. Laurie Marbas
(39:07)
There is something… Here we go. Is there such a thing as eating too many beans? I eat beans with most meals. Is it too much protein for my kidneys? Go ahead.
Dr. Chris Miller
(39:19)
That's a great question. So it's hard to answer that, well, it's not hard but that's interesting how I'm going to answer it. So in general, no. But then it can cause a couple things. So let's talk about beans. They're filled with fiber and that can affect your microbiome. So in one sense you can get really gassy, bloaty, or if your microbiome is not liking all of that that's coming at it, so that's one.
Dr. Chris Miller
(39:45)
But if you're not, if that stuff's not bothering you, so that's not a problem. The only people that I start to think a little bit about are people with kidney disease or some of that autoimmune. Then even with the whole food plant-based diet, I don't want them having tons and tons of even plant-based protein until their inflammation is down and their new numbers are improved. So if you have some sort of kidney issue and even if that's from diabetes or if that's from whatever reason you may have some kidney disease, or if you have a really bad autoimmune disease that's kind of out of control, then I would recommend a lower, I don't mean no beans, but just be a little mindful. Maybe not quite as much, keep it to maybe a cup to a cup-and-a-half a day, something like that, more reasonable amount.
Dr. Chris Miller
(40:33)
But if you're totally healthy and you're doing great, then I don't really think it's a problem. So I don't know that I've seen that people have had problems with too many beans as long as you're taking all your other micronutrients. I think you can enjoy them.
Dr. Laurie Marbas
(40:50)
Yeah, absolutely. I eat a lot of beans everyday. So remember it's the one food associated with longevity around the world, guys. So eat your beans.
Dr. Chris Miller
(41:00)
I think you could eat just beans, different bean, though. Mix them up. Yeah, no that-
Dr. Laurie Marbas
(41:05)
Definitely different beans, yeah, lentils, cannellini beans, black beans, kidney beans, all these great beans.
Dr. Laurie Marbas
(41:11)
So someone asked what do you use for protein? Hemp hearts, tempeh, or nuts? So you're going to get enough protein just eating a wide variety of plant foods, so your whole grains, your beans, even your fruits and veggies have a little protein in them. So just eating the wide variety of a whole food plant-based diet you're going to get enough protein, unless there's some very specific categories of patients. Like athletes who are going to be burning through fuel a little bit faster, that might be something that we might alter a little bit or use some alternatives. But for the most of us just eating the plant-based diet. But, Chris, any specifics?
Dr. Chris Miller
(41:49)
I agree completely, eating a nice whole food plant-based diet like that is the best source of all your amino acids that you need, so making sure you have a well-balanced plant-based meal. Like Dr. Marbas said, if you're an athlete or if your aging… Some people as people get older, older than 70 or so, they don't absorb the amino acids quite as well. So then we do want to make sure you have a little extra. I like all of the sources that you just said. I love tempeh, I love tofu, love nuts and seeds, love hemp hearts, that's far from the only sources. So eat your beans, your whole grains, all your nuts, all your seeds, all your veggies and they're very good.
Dr. Laurie Marbas
(42:27)
Absolutely. Susan asked, just diagnosed with arthritis. I have… excuse me. I also have myasthenia gravis. I have changed my diet, but I'm very confused with foods I should eat. Just a book to start with or a site. Thanks.
Dr. Laurie Marbas
(42:40)
Oh, there's so much. So I'll just throw this out there. One, it depends on what arthritis you have. Everything is going to improve with the whole food plant-based diet, but there might be some specifics so I'll let Dr. Miller speak to you on the rheumatoid. She's our autoimmune expert. But that typically responds very well to a plant-based diet.
Dr. Laurie Marbas
(43:00)
But on HealthyHumanRevolution.com, so it's Healthy Human Revolution.com, We do have a seven-day get started on a plant-based diet. We talk about everything, going shopping, what's in your cupboards, doing it on a budget, dealing with social pressures. So that might be something worth looking into.
Dr. Laurie Marbas
(43:21)
But one of my favorite books I think is definitely is How Not to Die or How Not to Diet by Dr. Greger. That's a good one. But, Chris, do you have any specifics?
Dr. Chris Miller
(43:32)
Yeah, so starting with the Human Healthy Revolution, you do have a lot of a good stuff for getting you started there, so you just make sure that you're getting a diverse whole food plant-based diet and you know what the nutrients are and what you're looking at here and how to do it and make it easier for you.
Dr. Chris Miller
(43:48)
So, yeah, what we talked about earlier today already with the anti-inflammatory that's real important. So really stepping that up. Some of the herbs like the turmeric is really helpful for joint pains. It's been shown for knee osteoarthritis that 1,000 milligrams of turmeric twice a day in a head-to-head study with ibuprofen was equivalent. So it caused the same amount of anti-inflammatory effect. So that can be very helpful in addition to your diet.
Dr. Chris Miller
(44:14)
Then the fasting we talked about earlier, just the intermittent fasting stuff and eating a little earlier at night, powerful for reducing inflammation. So those are some extra tools that I would add on in addition to just a diet plan.
Dr. Chris Miller
(44:29)
Then the last thing a resource. So for me I started with the Eat to Live books by Dr. Joel Fuhrman. He's got a lot of tips for anti-inflammatory and joint pains and just got me started. But there's so many good books out there right now. Julieanna Hever, who is often here and helps us with dietician stuff, she has written a really good book about… what is it called? Plant Based for Dummies or something like that. She has a couple really good books like that that are simple and easy to get started and go through the nutrients and what you need. So I find that also to be a really good resource.
Dr. Laurie Marbas
(45:04)
Absolutely. So next question is my five-year-old is slightly anemic after we have been vegan for six months. What can I do to help him? I give him a multivitamin and iron supplement.
Dr. Laurie Marbas
(45:14)
So was he anemic before? Also, is he a picky little five-year-old? Most five-year-olds wax and wane in their appetite. That's just the attitude of a five-year-old and many small children. So I would try to put in front of him foods that he enjoys that are full of iron. So you want your dark green leafies, beans, things like that. Combine that with some high vitamin C foods, peppers, citrus, that type of thing. So you want to encourage him to eat those foods first. Try to maybe do a smoothie might be a good way. But entice him, but make it flavorful so he'll eat those things or she will eat those things first. So that would be my first suggestion.
Dr. Laurie Marbas
(45:59)
So kids can be a little tricky at that age. It's not like you can reason with them like, “You're a little anemic, you need to be eating this.” They're five, they're like, “I don't want to.” So, Chris, any thoughts on the kiddo with anemia?
Dr. Chris Miller
(46:12)
Yeah. I agree with that, stepping up how you absorb your iron. So if you're eating things like spinach, which is very high in iron, that's great. Then put some citrus on it. That's really powerful to combine the two. If he will eat for you some nuts and seeds and some whole wheat, whole grains, legumes, those are all really high in iron, too, as well as your green leafy vegetables.
Dr. Chris Miller
(46:33)
So if he's eating that for you, he's not drinking dairy, so that's good so that can increase his iron deficiency. If he's really iron-deficient, hopefully, his pediatrician has done some blood work just to see if it's iron deficiency or it's a different type of anemia. Maybe you can get anemia from being B12 deficient, folate deficient. Some people's enzymes they don't process. So those are all much rarer. So it's most likely he's just not taking in enough or something, a simple diet thing.
Dr. Chris Miller
(47:02)
But I would just make sure some simple blood work was done just to make sure we didn't miss anything like that. Then do all the tips that Dr. Marbas said to help him diversify and actually eat the foods that have iron in it.
Dr. Laurie Marbas
(47:15)
Yeah. I would just make the highlight of every meal first and see what happens. Make sure he's not consuming it with tea or something. There are some foods that will decrease absorption of certain elements, so just some thought there.
Dr. Laurie Marbas
(47:30)
Let's see here. Is CoQ10 a good supplement? I think if you're on a statin it's not a bad idea because it's depleted when you're taking certain medications. So that might be something. Chris, anything in particular about CoQ10 and statin use?
Dr. Chris Miller
(47:44)
Yeah. No, I agree. If you're on a statin I do always recommend a CoQ10 to my patients because it depletes that enzyme and then you're more higher risk to have muscle aches and fatigue and liver injury. So I do agree with that that's helpful. Some people who have neurodegenerative diseases, sometimes it can be a little helpful too for them. People with heart disease, so heart failure, there's some good studies now that CoQ10 can be helpful for that as well. Yeah, I do recommend that. It's shown to be safe at pretty high doses, so I don't know how much he's taking, but usually we don't have to worry about that too much.
Dr. Laurie Marbas
(48:29)
Yeah, cool. Vera asked, I'm a type 1 diabetic and have thyroid… I'm assuming hypothyroid. She's 88 micrograms of levothyroxine. I'm going to the doctor next Tuesday. What blood test should I ask to get. Chris, do you want to speak to that?
Dr. Chris Miller
(48:44)
Sure. We just gave a talk on this, Dr. [Morris 00:48:50] and I did. So there are general labs that we check. The common, the TSH, the Thyroid Stimulating Hormone that everybody checks with the T4. T4 is the type of thyroid that's actually released from your thyroid gland. Then what happens at the level of each cell peripherally the T4's converted into T3. That's the active form. But T3 is very unstable. It doesn't circulate. So you do want to check the T4 as well as the T3. Then we check thyroid antibodies in our patients, too. The reason I kind of like it is we can follow your thyroid antibodies. So if they're high right now, then we can work on you with diet and lifestyle and anti-inflammatory and other medications and your lifestyle and figure out what's going on and get those antibodies lower. We can see that over time.
Dr. Chris Miller
(49:40)
So if you have high antibodies it tells us it's very active right now and it puts you at higher risk for other diseases. So those are my most common ones that I'll check. Then if there's any deficiencies, if you're worried about any nutrient deficiencies or anything like that, but that's where we start.
Dr. Laurie Marbas
(49:58)
Absolutely. Getting back to the little person with the low iron, our good friend Karen [inaudible 00:50:03] who is a nurse and cooks with her granddaughter often, she's an amazing cook, she says that she adds iron-fortified organic baby cereal to pancakes and serve with berries. You can also add to smoothies or smoothie frozen pops, so that's an excellent idea. So thank you, Karen.
Dr. Chris Miller
(50:23)
That is an excellent idea. Yeah, I love that.
Dr. Laurie Marbas
(50:25)
Absolutely. Then someone asked also should tahini be avoided? I mean, honestly I don't think so unless you're concerned about the fat content. It's a sesame seed, it's often used in humus and some other things. But Chris, do you have any specifics? I know my daughter is actually allergic to sesame seeds, which seems very odd. But any thoughts or suggestions there?
Dr. Chris Miller
(50:48)
I agree. As long as you can eat different nuts and seeds, it's just another seed that's blended up. I think it's okay.
Dr. Laurie Marbas
(50:58)
Yeah, absolutely. Someone's asking we're eating a lot of rice and got worried about the amount of chemicals in the rice.
Dr. Laurie Marbas
(51:06)
Yeah, so there's a lot of interesting recent research regarding rice. Do I avoid rice completely? No. I was never a huge rice eater myself. I still have rice available, but I try to be aware of those things, so I try to do alternatives like quinoa or bulgur or something like that. Chris, any specifics on the rice and the contents of arsenic? I'm sure that depends on the soil and where it comes from.
Dr. Chris Miller
(51:35)
Right. That's what's been shown that the soil is so contaminated of arsenic now the rice is now contaminated. I've definitely recommended less rice these days because of that, especially the brown rice. We definitely want to get it organic and look where it's been sourced. You can do research and see if there's a lot of arsenic in that area. I think it's maybe a good idea not eat too much rice and switch out with quinoa or with millet or some of the other wonderful whole grains. It's good to diversify our diets anyway, right? I've definitely done that myself. I've started switching up and not having the same rice anymore because of this. Until we figure out-
Dr. Laurie Marbas
(52:19)
That's true.
Dr. Chris Miller
(52:19)
… how to clean the soil a little bit.
Dr. Laurie Marbas
(52:22)
Yeah, that's going to be interesting. But I actually found that groat oats are an interesting replacement for rice because they're just so hearty. So it's another thought there.
Dr. Laurie Marbas
(52:34)
Someone asked also if their vitamin D levels are low, do vitamin D pills really help? Yes, they do. I have been really fascinated with vitamin D recently, been diving into research. I have the majority of my patients on D3 supplements. We try to push our levels closer to 70 to 75 and they do feel better. Some really interesting research on diabetes, especially your immune system. There's some interesting research on COVID-19 and having low vitamin D. So I would certainly, if you are low, it is worth your time and effort to get those levels up to a normal level. But, Chris, any other additional thoughts?
Dr. Chris Miller
(53:13)
Yeah, I agree with you. So interestingly with COVID-19 a recent article just came out that said the number one cause of increased mortality with COVID-19 was low vitamin D levels. They were finding that tentatively the people who ended up in ICU and then died had low vitamin D, versus people who had good vitamin Ds did not. It is major for the immune system. It actually put those receptors on our cells that bind to it that really get it working properly, and if it's deficient it's not a good thing. So for anything immune, which is basically everything essentially, all autoimmune stuff, cancer stuff, preventing cancer, treating cancer, and even just energy levels it's really important. So I definitely recommend that to you and follow the levels.
Dr. Laurie Marbas
(53:58)
Yeah, absolutely. So it's really fascinating the whole vitamin D thing.
Dr. Laurie Marbas
(54:05)
So this is another question. Alba asked my daughter is four and is a plant-based baby. We're starting to get a lot more of those plant-based babies. She has her yearly pediatric appointment coming up. Should I ask for blood work to make sure she's okay in iron and calcium?
Dr. Laurie Marbas
(54:19)
Yeah, absolutely. So I think just a basic CBC, which is a complete blood count, to make sure she's not anemic. If those come abnormally, if you do iron studies, I think that would be a great start. That's not anything out of the ordinary just for kids who aren't eating a plant-based diet. Chris, any other specifics you would think about?
Dr. Chris Miller
(54:42)
I don't know if you're supplementing B12, so I would make sure of that. You can even check that and vitamin D level, too, as well. Even in babies, right, so make sure we don't want anyone to be deficient like we just talked about. Other than that, just a good physical and make sure your baby is growing and reaching other landmarks appropriately and everything's going well. Awesome, that would be about it.
Dr. Laurie Marbas
(55:09)
Lillian asked my endo says I'm resistant to thyroid hormone. I have elevated both TSH and T4. He says medication will not help. If we lower the T4, the TSH increases. I also have Hashimoto's. Can diet… I'm not sure of that other word… help these levels?
Dr. Laurie Marbas
(55:29)
Lillian, that's a really interesting scenario. I would definitely need to look at all the records and what tests have been done, including your hypothalamus, your pituitary, some other hormone-type of testing before I would even begin to… There's some interesting things going on here. So I would definitely want to see all the medical records and their reasoning. But any thoughts on that specifically, Chris?
Dr. Chris Miller
(55:58)
I agree. So if you have both the high TSH and a high T4, then it doesn't sound like it's coming primarily from the thyroid, that it's above the level of the thyroid.
Dr. Laurie Marbas
(56:06)
Yeah, so there is something that's going on.
Dr. Chris Miller
(56:08)
So I would want to know if you're having symptoms of anything, like headaches, or just a whole slew of symptoms. I would want to know all that blood work and do some more maybe some imaging even. I don't think treating with medicine would be the perfect thing for what it sounds like. But again, like Dr. Marbas said, without knowing all your blood values and all your workup and your history, it's hard for us to say right now.
Dr. Laurie Marbas
(56:34)
Yeah, that would definitely be a dive into the medical records and see what's done. It's not a typical thyroid case.
Dr. Laurie Marbas
(56:45)
Let's see here. Let me get here… I'm not sure about that one. Okay. Is having a gallstone always equal to having your gallbladder removed, or can there be alternative routes to get rid of the stone?
Dr. Laurie Marbas
(57:00)
There are medications that might dissolve it in people who are unable to get surgery. But if you're not symptomatic, I certainly wouldn't just have someone have surgery if they're not symptomatic. Chris, any specifics or questions?
Dr. Chris Miller
(57:14)
Yeah, so if you see gallstone, having a gallstone is not an indication for removing the gallbladder in anybody. So it's only when it's inflamed. So what can happen is the gallstone gets caught in the duct that as it's leaving the gallbladder, and that duct gets inflamed. It gets blocked and gets inflamed and that's where that inflammation can lead to problems. So that's where the gallbladder is removed for that reason. A lot of people are walking around with gallstones that are just sitting there and not bothering them. They're not getting inflamed, they're not getting caught.
Dr. Chris Miller
(57:47)
So that's where the benefit again of a whole food plant-based diet, even a lower fat whole food plant-based diet can be very helpful and some of those gallstones can start to dissolve and break down, break themselves down, and then they pass without a problem. So they never become a problem even though you may have them. So if you are having gallbladder problems, if you're having pain in your right upper side here [inaudible 00:58:11] after eating things like that, then you would want to get an image [inaudible 00:58:18] blood work and see if it's inflamed. It's only the inflamed that we care about. So, hopefully, yours aren't. If you're eating well and taking good care of yourself, hopefully, they won't become that way either.
Dr. Laurie Marbas
(58:30)
Perfect. Yeah, so we're running at the end of our hour here. Someone did ask if they could send us their information. Lillian, if you can see myself, Dr. Miller, or Dr. Klaper depending on what state you're in, we are in 41 states right now. We're working on getting in those last ones.
Dr. Laurie Marbas
(58:50)
If you'll just go to PlantBasedTeleHealth.com and you can request a portal invitation and then set up an appointment with the doctor who's licensed in your state. We're going to be adding additional doctors in the near future, so we'll be increasing our capacity because we're getting very busy. So it's all very exciting, but yes, absolutely. We'd love to help you out and at least give you at least one visit to make sure if there's anything we can do to serve you.
Dr. Laurie Marbas
(59:21)
So thanks everybody for watching, and Chris, any final words?
Dr. Chris Miller
(59:25)
Thank you for your questions, those were awesome. So I can tell you guys are doing so well and totally into this. So thank you. That was fun and keep up the great work.
Dr. Laurie Marbas
(59:36)
Yeah, absolutely. So thanks everyone again for your time. We know your time can be valuable at other places and we appreciate that you feel that we're worth it, that hour. So please share the PlantBasedTeleHealth.com with anyone you feel might find it beneficial. If there's anything else we can do for you, just let us know and we'll be back. We'll see if we're back next Thursday. We may be moving to every other week just as schedules get busy, especially in the fall and the holidays. So we'll be letting you guys know that, but we do appreciate you so much and have a great day.
Dr. Chris Miller
(01:00:09)
Thanks everybody. Bye.
Dr. Laurie Marbas
(01:00:11)
Bye.
*Recorded on 9.24.20