In this Q&A episode our team of plant-based doctors discuss self-love, fortified yeast, iodine, and more!
Questions Answered
- (00:03) – The concept of self-love
- (11:48) – Do you recommend fortified nutritional yeast or non-fortified?
- (16:58) – Could you please talk a little bit about total low cholesterol number, but high triglycerides, high glucose A1C?
- (20:13) – Any thoughts on low HDL?
- (23:09) – Has anyone brought down a patient's rising TSH, thyroid simulating hormone, by adding an iodine supplement?
- (24:45) – Does anyone have struggles in one health area, but have success in others? Any tips for pulling the whole package together?
- (27:31) – Quest For Sleep
Complete Transcript
Dr. Alon Sitzer
(00:03)
My name is Dr. Alon Sitzer. I live in West Newberry, Massachusetts, and I've been asked to share a few words on the concept of self-love and what that means. Obviously, all of you who are here are trying to better yourselves in one way or another, especially focusing on our nutrition. And I acknowledge all of you for being here for that matter.
Dr. Alon Sitzer
(00:31)
Yeah, love. I think all the doctors here had an agreement. We were talking about it earlier. It's not a word that's commonly used in medical school or medical residency. And I personally think that it is a core word that means so much more than just… Even if it's just plant based food, you can define it for yourself. For me, love means being kind to myself, trying to empower myself, asking myself on a day-to-day basis, sometimes even moment to the moment, what do I need right now? Being in the present moment.
Dr. Alon Sitzer
(01:23)
And then there's the practical elements of it. And one of them, I think, is what we're all doing here is, how do we eat better? I mean, that is an expression of how to treat our bodies with more respect, how to support our bodies in healing, in feeling good. I like the idea that we too easily forget the fact that once upon a time there was a little sperm and a little egg and they came together, and they decided to start developing. Somehow the body knows how to do it, and then it turns into something that looks like a fetus, and then it turns into a fetus and eventually it comes out of the belly of the mother, and all along the body knows how to do these things. We never give it a second thought that the body… How does it know to do that?
Dr. Alon Sitzer
(02:24)
Sometimes in medicine, we use the term maybe genetics, but that's too cut and dry. That's too black and white. There's so much more to that. And then the body, the brain develops, the liver, our bowels get longer and longer and longer, our vision develops. And these are things that I think in today's world, in terms of how we take care of ourselves, too easily we neglect, or we forget, or we just take it for granted. I mean, there's enough things on the outside that are challenging and difficult, especially in today's world, where we are right now.
Dr. Alon Sitzer
(03:03)
And that's, in my mind, a purpose of whole food plant based nutrition, of exercising, of getting enough rest and sleep, of praying or meditating, cutting out the alcohol or cigarettes or the recreational drug use, forming healthy relationship, and the list goes on, is to basically aid the body, that natural inherent intelligence that created you from that little relationship between the sperm and the egg back in the day, to support it in to make it easier for it to exist. So if you get a wound, for example, the body heals that wound. The body knows how to do it, but if you don't take care of the wound and you keep it dirty, it's going to be really difficult for that wound to heal. But if you nurture it, if you care for it, if you love it, then it's going to be a lot easier for that wound to heal.
Dr. Alon Sitzer
(04:08)
And I think that goes into whatever it is you're trying to heal from. If your blood pressure is high, or if your cholesterol is high, or you have a new diagnosis of an autoimmune or some chronic disease, or even just a simple cold, for example, it's, how do we support the body? How do we make it easier for the body to heal? And the medical term now is called lifestyle medicine. It brings all of those ideas of not just focusing on here's a pill to fix it. Although sometimes, that may be part of the program perhaps, but we lack too much, even in the world of medicine, all these other concepts, the nutrition and et cetera.
Dr. Alon Sitzer
(04:59)
Whatever your goal is, think, let it come from a place of, I care about myself and I want to feel good and I want to love myself. And I think it's a great exercise to ask yourself even, what would it look like if I loved myself, if I took care of myself? And yeah. In a nutshell. In a nutshell.
Dr. Laurie Marbas
(05:32)
I think that is fabulous. We really is, it's a matter of loving yourself enough to take care of yourself with your sleep, your nutrition, all of these things. And then the whole reason this got started was just the self sabotage that we see patients. They'll do well and then they, bam, struggle, but anybody else have thoughts on that?
Dr. Kim Scheuer
(05:52)
I think it's excellent what you said and I think it also takes practice. Sometimes we aren't used to loving ourselves. We haven't done it for so long that it does take practice, so continuing to work on it makes a huge difference and loving is healing and healing is loving. And so I think there's tons of studies out there that talk about if you… That show that if you are angry or unhappy, your wounds don't heal as fast. So it is a mind body connection. And so, it's the whole lifestyle, including loving yourself.
Dr. Chris Miller
(06:27)
And for a lot of people, it's new. It's not something that's talked about. It's not something that's thought about, and it's not something you may even know how to do. And so that's where it takes work. It took a lot of work for me to do work on that, to look in a mirror and just say things to yourself, kind things to yourself. And so, yeah. For anyone out there struggling with it, it definitely takes work and practice, but it's worth it in the long run. So that was a great talk, Alon. Thank you for sharing that.
Dr. Alon Sitzer
(06:55)
You know, I find many times people treat other people nicer than they treat themselves. And I see that a lot with people who cope, who deal with anxiety or depression. And they say these really non not nice things to themselves, but if a friend were to come over, they would be more nurturing. They would be supportive. I empower and I encourage you all to treat yourself like you would treat others, be kind to yourselves. You're allowed to do that. And ultimately, who else is going to take care of yourself? It starts with our thoughts, with our choices, with our decisions and goes from there.
Dr. Alon Sitzer
(07:39)
All of us here in Plant-Based, we're human beings, just like all of you. Know we're all coping with the same kind of, this is a human existence thing. This is, it's for all of us. It's part of this wonderful experience and gift we all have, even just being alive. And I guess my last, my other idea would be, you know they always say, you want to focus on a cup that's half full and not half empty. Well, at one point I thought to myself, why don't we just appreciate the fact we even have a cup? Whether it's full, whether it's empty. I mean, we have a cup so we can choose what we're going to do with this cup as well. And it's all a matter of perspective. Our minds are… And we have a choice to perceive things from whatever angle we want to. And if you can create such a perspective that will nurture and support and help you, you are allowed to do that and you can do that. It's free, too.
Dr. Elisabeth Fontaine
(08:45)
Yeah. Thank you. It makes me think also about the positive psychology of [Martin Sellingman 00:08:51]. That's one of those things is happiness factor, makes it that we can start loving ourself. I agree with Chris, so hard to look at yourself in the mirror every morning and say, okay, I start my day. I love myself and that seems stupid. And when you think about it, but it does have an impact. [inaudible 00:09:11] You start your day by looking at yourself, smiling to yourself and say, I'm going to have a good day and I love myself. Totally change things. Really interesting.
Dr. Elisabeth Fontaine
(09:19)
I was talking to the group before and I said, self sabotage, there's perception that we have for quite some time in ourself, thinking about why. Why are we thinking that way about ourself? So there's a lot of discussion sometime that we need to have with the person in order to allow them to move into something a little bit more positive and understanding what makes it so difficult. Oh, now today, there's a lot more than just eating a proper diet. That's good discussion. Love it.
Dr. Laurie Marbas
(09:54)
Yeah. I love… Go ahead, Alon. I'm sorry.
Dr. Alon Sitzer
(09:56)
No, your turn.
Dr. Laurie Marbas
(10:00)
No, I was just going to say, we're getting people loving the idea that you said, just having a cup. And I like to draw, so one of my drawings a couple months ago was a woman who was crying, but her head was taped into a teacup and it was a faucet. Really, she had control of it. Her hand was turning up, but on the side of it was all these little other faucets, people just turning. It's stress, family, finance, stresses, all these things. So we have to be continually filling that cup. Regardless if it's half empty or half full at that moment, we really need to be taking the time to fill the cup. And that really is exactly what you're saying, because it could be half full or half empty at any point, but we just need to continually fill it. And I think what you're saying is it starts with love for sure, for the person in the mirror.
Dr. Laurie Marbas
(10:51)
And I mean, it really, it's a touchy subject. And I really think too, there's some of it that stems back to childhood. There's a lot of childhood trauma that we don't quite understand how significant impact that has on individuals and their reactions to things, the habits they have developed, the relationships they may or may not engage in. And so some really important things that, just to be grace, give grace to those that you run into because we don't know, like you said. We don't walk in their shoes. We don't know what they're going through. And so just like your doctor may have a bad day guys, and we understand you guys, so sometimes I think doctors need grace, especially, too. So I want to lay that out there for everyone. But any other thoughts there? I can move on to some other questions.
Dr. Alon Sitzer
(11:43)
By the way, that's what I was exactly going to say. And you said it.
Dr. Laurie Marbas
(11:45)
Word. All right.
Dr. Alon Sitzer
(11:47)
We're all connected. We're all connected.
Dr. Laurie Marbas
(11:48)
You're obviously in the right place, Plant-Based TeleHealth, my friend. So one of the questions from Barbara, she asked, do you recommend fortified nutritional yeast or non fortified? I've heard pros and cons for both. So anyone would like to take that on? I'm assuming fortified would B12, is most of the time. I don't see any problems with it. Honestly, it's one more source of B12, especially if you're not really regular at taking your supplement, because B12 is a non-negotiable, guys, when it comes to supplementation on a strict plant-based diet. Any other thoughts why we shouldn't?
Dr. Kim Scheuer
(12:26)
I go with what I can get. Sometimes [inaudible 00:12:30] long time getting things.
Dr. Laurie Marbas
(12:32)
Especially in rural Colorado, I can imagine.
Dr. Alon Sitzer
(12:37)
I think it has this idea of nutritional support and then there's, I think, the practical aspect of, if it's going to help you enjoy food, if you love, they enjoy the taste of it. Sometimes it gives them that cheesy flavor that people sometimes miss, I think it's also worth it. I've heard at one point that… And I think it was Dr. [Jeff Novak 00:13:12] who made a comment about its effect on IGF, on et cetera. And he doesn't like it as much, but I think when we sometimes get too lost in the tiny details and rather, it's not about where they used a little bit of nutritional yeast or… It's the bigger things to I think keep all of this and all that, this change involves keeping it sane and keeping it enjoyable.
Dr. Alon Sitzer
(13:49)
I've said this in the past, but you can be an A plus student or you can be an A minus or a B plus, and guess what? Being a B plus, you're still going to get a lot of great effects from all the changes you're making and you'll still do great in life. And I think that sometimes falls into the category of health and taking good care of yourself. If you're an A plus personality or if you're an A plus and you enjoy that, all for you, but we all know that sometimes be a bit challenging.
Dr. Elisabeth Fontaine
(14:27)
I think you're going to such an important point of what we see. There's so much information and nutrition supplement. I mean, we are bombarded. Any individual, doctor, whoever we are, and that makes it very difficult. And the idea, especially when it comes to plant-base, and I repeat it very often to the people that I see, that it's a whole. You got to be able to, not specifically go to that little thing, but everything that you're going to, as much as colorful that you can put in your mouth and the rest and everything else, what we've discussed before. That's what's important. That's a good point.
Dr. Laurie Marbas
(15:09)
Yeah. There were some comments about showing the folic acid was the fortified nutrition yeast. I don't think we need folic acid added to anything. You're going to get plenty of folate in your food. So yeah, I wouldn't necessarily go out of my way to find it, but if that's all that's available, I think it's fine. And to your point, Alon, this is, I call guru syndrome. Literally, people are so stressed out because they hear all these different people saying, you have to do this, you have to do that. And they get into the weeds. It's that one, 2% that freaks people out. I mean, but it's like, it's the other 90%, the fruits, the veggies, the beans, the whole grains, all that's going to make the difference, not the 2%. It's that, the [inaudible 00:15:48] 20/80, that's the big part here. So anyway, but absolutely.
Dr. Elisabeth Fontaine
(15:53)
I have one little thing on folic acid. Don't forget for prevention in pregnancy, early pregnancy. That's probably the only time that I definitely say, okay, got to have folic acid to prevent for a neural to defect, so just to be careful.
Dr. Laurie Marbas
(16:09)
Yeah, absolutely. Or if you're on methotrexate, that might be a really important spot there too. Well, I have some other question. I did want to go back to this real quick, because [Kathy 00:16:18] shared something I think was kind of cool. She said, for years I was hiding the fact that I've had childhood trauma. Since we have been through this virus crisis for the last two years… I like that. Virus crisis. I feel there is a great dialogue in the mental health issues. We still need more emphasis on mental health. I agree 100%, Kathy. I have been in therapy for several years now and I realize that I have to let go of toxic relationships, including family members. And I still feel the guilt, guilty about letting those people go, and I think it's part of the childhood trauma. I'm still working on these negative self dialogue and I feel this will be a lifelong struggle. Thank you for all you do. I think that's fabulous that she's even aware of it. That's amazing.
Dr. Chris Miller
(16:55)
Yeah. Thank you for sharing that.
Dr. Laurie Marbas
(16:58)
So now we have a few other questions. I think we're going to focus in on cholesterol. There's a few on cholesterol. Could you please talk a little bit about total low cholesterol number, but high triglycerides, high glucose A1C? Should we be concerned about that? Does it usually level out over time? And this person's been plant-based for about six months. Any thoughts on the cholesterol levels?
Dr. Chris Miller
(17:21)
I guess I can start with that. So first of all, congratulations on going plant-based for six months. That's the first important step. And next, I would say that, yes. Give it more time. Really tweak the diet and the lifestyle factors. You do want to get that hemoglobin A1C down and the triglycerides down. And usually, those are very diet and lifestyle sensitive, so there's a lot that you can do. And six months is a great start, but it can take longer than that. I would just stick with a program that hopefully is working for you and you should see those two improve. So yeah, because you're looking at the big picture and that's part of metabolic syndrome. There's five factors that contribute, but it's your blood sugar is one and your triglycerides is another one. Blood pressure, waste circumference, and help me out guys. What's the fifth one that I'm forgetting? There's one more [inaudible 00:18:19].
Dr. Laurie Marbas
(18:18)
That's a good question. What is the fifth one guys? I just consider this-
Dr. Elisabeth Fontaine
(18:24)
[inaudible 00:18:24] Is there a fifth one? Hmm.
Dr. Kim Scheuer
(18:26)
Sugar… I forgot what you [inaudible 00:18:29].
Dr. Laurie Marbas
(18:29)
Well, the thing about the metabolic syndrome guys, all it means is that you need to be eating healthier.
Dr. Chris Miller
(18:34)
Yeah. It's [inaudible 00:18:35].
Dr. Laurie Marbas
(18:35)
It's a diagnosis by medical convention, but it is a cluster of a few things. Puts you at increased risk, [inaudible 00:18:44] blood pressure, cholesterol. I mean, sorry. Cholesterol, triglycerides, excess body fat around the waist and high blood sugar. Yeah.
Dr. Chris Miller
(18:50)
It was the cholesterols one I forgot. But yeah, so what my point of that was is that it's a big picture of all these different factors in your body that start getting elevated and they show that your blood sugar's elevated, that your body's working too hard and it's under stress and these are diet and lifestyle related, very much related to what you're eating and how you're living. Should you be concerned? Well, concerned enough to continue on your program and to keep at it and you should be able to get results. So yeah.
Dr. Kim Scheuer
(19:17)
One of the things I've found with my patients is once they hit their ideal weight, then it starts to normalize even more. So keep going at it if you have, if that's part of your issue, but… And then if you have specific questions, come see one of us because we will absolutely get to the root cause of what's going on and help you out.
Dr. Laurie Marbas
(19:38)
I think that's a really important point [inaudible 00:19:39] Chris is pointing out, there's other things that are going to be involved here. And sometimes what you'll see with someone is their weight drops and become more of a ideal body weight, which may vary according… That's another hot topic with me, is that people think they have to reach a certain BMI. No, there is more to your body than a number. So anyway, but as you do lose weight and become a healthier weight for your body habitus or your stuff, that number will tend to decline as well. But not always. There's definitely some struggles. What about cholesterol? That's total cholesterol is 117, someone asked, and they have a low HDL. Any thoughts on those?
Dr. Kim Scheuer
(20:19)
Again, there's lots of reasons why it could be low. Your HDL, if you eat a healthier diet, can go lower because you don't need it as much, but we want to make sure that there's nothing else going on that you have, that your vessels are clear that you're healthy. And there's a lot of reasons that we would look at and help you to decide if your inflammation's down, all those things are very important. So it's not just one number, it's figuring out what's going on with your whole body.
Dr. Elisabeth Fontaine
(20:49)
Yeah. We always go back to this and say, it's not just one number, but one more element often, is this relationship with HDL and exercise, so it seems that if somebody is totally inactive, it's possible that the HDL won't be as high. And if you compare it to somebody who's extremely active, you often will see HDI being a little bit, quite a bit higher, sometimes.
Dr. Laurie Marbas
(21:16)
Absolutely.
Dr. Chris Miller
(21:18)
[inaudible 00:21:18] the risk stratify a little bit further so that it doesn't mean a lot to me anymore to just see a number, but I have to look at the whole picture. What are your other risk factors and what's your LDL level, and do you actually have plaque depositing? Is it oxidized LDL? Is it sticking or is it not? Just looking at those two numbers in isolation, I'm not really sure what to make of that, but I would look at a big picture and then we can know exactly what that means. That may be perfect for you or it may be, well, we still need to make some tweaks for you. I would say you got to look at more than just those two numbers, as everyone else has said, basically.
Dr. Laurie Marbas
(21:59)
Yeah, absolutely, because it is in a great segue into George's question. He said, I lower my cholesterol with the plant-based diet. My primary care physician said I no longer needed a statin, but offered to continue my prescription as a prophylactic due to strong family history of heart disease, which is serious business. Would there be any harm in continuing this statin? And that's where the risk stratification that Dr. Miller was mentioning is really, really key. What was your life before going plant-based? What are your risk factors outside of even just family, your family history, but that is a very big one. And for example, my biological father had his first heart attack at 38. I mean, I'm genetically not in a good place. So it's really everything we can do to make sure that we've made the right decisions for the long haul.
Dr. Laurie Marbas
(22:42)
And the benefit that you'll see is long term lower cholesterol. It's not going to be, oh, guess what? I've been 60 years, high cholesterol, eating poorly. Now I go plant-based over night, my cholesterol is dropping and I'm fine. Not necessarily. That's where we have to look at the context of your whole life, your numbers, what's going on. Lots of different things to consider. George, I would say that's a conversation to have with your doctor or maybe one of our doctors who'd like to go, can go further in depth with you. Go ahead. Has anyone brought down a patient's rising TSH, thyroid simulating hormone, by adding an iodine supplement? Anyone like to take that one on?
Dr. Chris Miller
(23:19)
Yes. If someone is hypo iodine, it has low iodine levels, then adding iodine can definitely improve that. That would be someone who has hypothyroid related to iodine deficiency. And we are seeing that in plant-based eaters. It's funny, if you read the literature, iodine deficiency is very common around the world, but not in the United States because the United States is iodized salt, but as people go plant-based and they take out the salt, then we are actually seeing iodine deficiency in our population if they're not thinking of an iodine source. So it's definitely worth if someone is hypothyroid or having any thyroid issues to check your iodine, and if that is their cause of that hypothyroid, treat that iodine and absolutely, you may see results.
Dr. Laurie Marbas
(24:05)
Make sure it's a 24 hour urine iodine collection, not a blood serum. That's just not as helpful, because what's happening in over 24 hours, you're going to be spilling iodine at different rates and different things. That's why it's that 24 hour collection is important. It's because your things happen differently over the course of a 24 hour period.
Dr. Chris Miller
(24:21)
And that's what we all do at Plant-Based Telehealth, so if anyone [inaudible 00:24:25]
Dr. Kim Scheuer
(24:25)
Don't just take iodine without checking your levels.
Dr. Laurie Marbas
(24:27)
Please don't do that. Good work. Good point. Let's see here. Let's do one more question because I know some of us have to get going. Someone mentioned they… Okay, let's just put this here. I have made progress with improving my eating habits and exercise routine, but I have had a hard time maintaining a healthy sleep routine. Does anyone have struggles in one health area, but have success in others? Any tips for pulling the whole package together? I think that's a great way to end this.
Dr. Chris Miller
(24:59)
I'm going to say everyone does, including myself. Are you kidding me? But I'll let someone else answer that first.
Dr. Laurie Marbas
(25:06)
Who would like to take that one on, because it is absolutely true. Dr. Scheuer.
Dr. Kim Scheuer
(25:12)
Yes. It is all connected. We are all connected and yes, you can make great progress in improving your habits and your exercise and things like that. But if you're not sleeping, you still can have problems. That's when we repair. That's when we do lots of good things for our body. So there are lots of techniques to help with sleep routines. If you come see one of us, we will absolutely help you with that. There's a lot of free things online, but yes, every single one of us has. We're all have our issues. Whether it's in the exercise department or in the self-love department or in the eating department, we all… You want to try and maximize every single one of those pieces and we'd love to help you. And there's lots of ways that could happen.
Dr. Chris Miller
(26:03)
And as far as pulling it all together, and I made that comment at the beginning because of course, I have my own things that I'm struggling with still and working on, but what I would recommend or what I've been doing myself too, is working on one thing at a time. And so I worked on my diet, got that good. Okay, got my exercise down. I have a routine that's working for me. Okay. I'm working on stress reduction. I do my meditation and my mindfulness and my yoga classes. All right. I'm working on my sleep now myself, so I'm right there with ya, Ellen, and working on improving my own sleep pattern and habits and reading books and listening to podcasts and trying different techniques out, getting sunlight in the morning and the evening. I'm doing different things, getting away from my computer screen and doing different techniques myself.
Dr. Chris Miller
(26:53)
I have found it helpful to just… I can't do everything at once, it's too overwhelming, so I've been tackling different lifestyle pillars and reassessing it all. And if there's something I find that I'm weak on, I'm working on that. And I might find someone who's more expert than me or someone who can help me with that and work on that at that time. So yeah. Anyway, I would say, keep up with working on your sleep and there is a whole lot about sleep actually, and we've talked about it and we should, we'll keep on talking about sleep because it's a big deal and it's something that a lot of people are struggling in. So yeah.
Dr. Laurie Marbas
(27:31)
I did want to mention, [John Min 00:27:33] shared with us a documentary, Quest For Sleep. Quote, was released two days ago, narrated by Octavia Spencer. It is very revealing and has a lot of new information on the subject. It's on Netflix and also free to watch on YouTube. So thank you, John. That's fantastic. I may be watching that later at the airport.
Dr. Chris Miller
(27:51)
One more thing for me to tackle or try to improve my own sleep, so thank you.
Dr. Laurie Marbas
(27:55)
Yeah, absolutely. Quest For Sleep, everyone. Quest For Sleep.
Dr. Elisabeth Fontaine
(28:02)
Quest For Sleep. That's what I was going to ask.
Dr. Laurie Marbas
(28:03)
Quest For Sleep, so thank you. We learn so much from you guys and our patients. Honestly, I feel like I am way better physician for having been around these other amazing doctors, but our patients too, because they ask these tough questions, like that's a good question. I got to go look that up. I'm always on my toes. Thank you. Thank you. Again, we want to thank these amazing doctors for sharing their expertise with us here. We are at plantbasedtelehealth.com. If you would like to see one of our amazing doctors, just head on over there and feel free to book an appointment and we'll be happy to take care of you. You guys have a blessed weekend and if there's anything else we can do for you, we'll see you next week on Thursday. All right.
Dr. Kim Scheuer
(28:47)
Lots of love.
Dr. Laurie Marbas
(28:47)
Okay.
Dr. Chris Miller
(28:47)
Bye everyone. Thanks.
Dr. Laurie Marbas
(28:47)
Bye.
Dr. Chris Miller
(28:47)
Thanks for coming.
*Recorded on 3.18.22