On this Q&A plant-based doctors answer questions about recommended supplements, ways to improve your health post Covid, and constipation.
Questions Answered
- (01:59) – Is one tablespoon of flax, half a tablespoon of walnut butter, one tablespoon of walnuts, one tablespoon of avocado daily okay for fat intake?
- (05:24) – How can I get rid of hemorrhoids
- (08:46) – Any suggestions for treating NTM lung disease, besides antibiotics?
- (12:21)740- How do I stop leg cramps at night?
- (14:33) – My internist said I have a diastolic dysfunction. Can you tell me more about it?
- (20:21) – Since being infected with COVID last November, I've been having a hard time lowering my glucose and with feeling fatigued. Any advice?
- (23:38) – How do I eat starchy foods without retriggering constipation?
- (34:32) – Are nuts okay for someone without a gallbladder?
- (35:47) – I'm sensitive to beans, How do I build that into a diet?
- (37:15) – What types of supplements should I take for very dry brittle hair?
- (41:57) – What does too much lisinopril do to you?
Complete Transcript
Dr. Laurie Marbas
(00:03)
Welcome everyone to the Plant Based TeleHealth. Second and fourth Thursdays, we do these live webinars and try to answer your questions. Sometimes we have topics, sometimes we have special guests, but today we thought we'd just keep it general and answer any questions that you might have. And we do want to encourage you, if you haven't already, if you're considering seeing one of our most amazing doctors, you can go to plantbasedtelehealth.com and go to the Meet the Docs section and go scroll through all of those docs. There's some incredible docs across our country, please check them out, they're amazing. I would be comfortable going to anyone of these guys for any sorts of issues. So actually, Dr. Chris Miller is my personal doctor, sorry for her, but other than that… But I do say some incredible folks here and welcome everyone, so let's get started. If you have any questions, please put them in the Q&A box. And if you're on Facebook, if you'll please put them on the Plant Based TeleHealth page and under there, that's where I'll be looking for those questions. And please share this, if you're on Facebook, please share this. And Dr. Davis is with us, Dr. Elisabeth Fontaine and Dr. Chris Miller today, so welcome. And like we said, we just really would love to see, let these questions start rolling. So how are you guys today, Niki?
Dr. Niki Davis
(01:28)
Doing really good. Thanks.
Dr. Laurie Marbas
(01:30)
Awesome.
Dr. Niki Davis
(01:31)
Just running around, you know?
Dr. Laurie Marbas
(01:33)
Absolutely. Dr. Fontaine, how are you?
Dr. Elisabeth Fontaine
(01:35)
Oh, amazing. The weather's starting to get a little bit warmer, it's about time here. I'm in Maine for people and so it's been in the fifties, now we're going to have a couple of days in the high sixties. Amazing.
Dr. Laurie Marbas
(01:51)
Ah, that's fantastic. And so, Chris, how are you doing?
Dr. Chris Miller
(01:55)
I'm doing awesome. Thank you. Love being here on Thursdays with everybody.
Dr. Laurie Marbas
(01:59)
Excellent. So we do have some questions. Let's see here. Okay, here we go. Let's talk about, let's start with this one and we'll start with an easy one and I'm going to work on some of our docs, there's trouble being logged in. I'm going to work on them, and you guys answer this question for me. It says, “I am not overweight. Actually, underweight. Is one tablespoon of flax, half a tablespoon of walnut butter, one tablespoon of walnuts, one tablespoon of avocado daily okay for fat intake?” So maybe you guys would address that, and then also for those who are struggling to actually maintain weight on this diet, that would be awesome.
Dr. Niki Davis
(02:38)
Yeah. So I can talk to that. So we've got whole plant foods and some of the whole plant foods that we eat can be higher in fat. So for a lot of people they're concerned with taking in too much fat because they want to lose weight. But if you are someone who is underweight and trying to either gain weight or maintain, then definitely adding in some of those higher fat whole plant foods makes a lot of sense. And the ones that you're describing, avocados, nuts, seeds are perfect for that. So that's absolutely fine to add in some of those higher fat whole plant foods.
Dr. Elisabeth Fontaine
(03:21)
Yeah. I think you're the specialist on the nutrition here, Niki. So it's good to hear that, but I will say as a personal experience of somebody who's attempting to gain weight constantly, which is totally the opposite everybody in the planet. When you think about the plant-based diet, you do have to have a lot more in your plate. And we have this idea of a plate that we should be not doing more than a certain amount and in the plant-based you really have to be a little bit more generous. Now I'm not saying you should be eating a whole bucket of peanuts, but certainly telling, especially in the weight discussion here, it's very important that you make sure that you put a little bit more in your plate. And sometime that looks a lot, but when it's plant food based, it's almost like there is no limit.
Dr. Laurie Marbas
(04:22)
Absolutely. Chris, any other thoughts on that?
Dr. Chris Miller
(04:24)
Yeah, I agree with what they said. The other thing is just everyone is individual, so looking at what you are eating, how much exercise you're getting, how you're metabolizing it, what time of day you're eating, and you can also make sure you're getting plenty of carbohydrate rich foods, as in complex carbohydrate rich foods, so that you can plenty of whole grains, plenty of legumes. And in addition to nut butters and sometimes we do extra snacks or more satisfying meals, so just taking a good look at what you're eating and make sure it's reaching your goals. And when you say, is it enough? Well, if you're continuing to lose weight, then we have to keep tweaking it. And if you're at a place where you're happy or putting on muscle mass, then you're good. And also remember weight gain, muscle mass, it happens in the gym. So, so many of us are worried about muscle and it's not just from food, but we have to actually put muscle mass on. And I don't know what your concerns are, but hopefully that will help.
Dr. Laurie Marbas
(05:24)
Excellent. Okay, so that's very good, and I would agree with everything everyone said. Let's see here. Let me… I'm actually going to ask this question here. This one seems okay. Ruth asked, “Hi, I just had a colonoscopy. Everything looks great for a former ulcerative colitis patient, except for a couple small inactive internal hemorrhoids, just inside the rectum. Surprised by that since I've been whole food plant based for six and a half years and never need to strain with bowel movements, any idea how to get rid of them? I'm also salt, oil, sugar, alcohol net free, and gluten free.” That's a lot of frees, but go ahead. Any thoughts on hemorrhoid care?
Dr. Chris Miller
(06:08)
I would just take a look at your fiber intake. It sounds like you're doing great. You're eating a good diet, having regular bowel movements, so that is always first, that they're nice and soft, that you're not pushing, that you're still not having any issue there. And then, well, your past history is important. So I don't know who you are, if you've had babies before, or if you've had history of constipation before. There's Kim.
Dr. Kim Scheuer
(06:32)
Yay.
Dr. Chris Miller
(06:34)
And three babies, okay, thank you. And so that can, sometimes it can make them actually protrude out. So even on a high fiber diet, they still are an issue. So sometimes they do need to be explored and see if they're able to come back, actually improve with just diet alone and soft bowel moments, or if they need something more. But having soft bowel movements is always important, to make sure that they're regular, that you're not straining, that you're not making them worse. And then it matters where they are and exactly where the hemorrhoids are and how severe they are. So taking a look at them is what I would recommend.
Dr. Laurie Marbas
(07:13)
Yeah, absolutely. Any other thoughts on hemorrhoids? And you may have had them a long time, but they just saw them now, so again, having them babies, they'll do lots of interesting things to things down there. So before we go into TMI. But how about our gynecologist? She's delivered lots of babies and I'm sure there's recurring issues, so what do you recommend?
Dr. Elisabeth Fontaine
(07:36)
Here we go again, the gynecologist is on the plate. So certainly agree with Chris, especially for the external hemorrhage when you get pushed, but it's a little bit the same as some women will experience what we call prolapse and have one baby and some other would have six baby and then have prolapse. So I think that the external hemorrhoids and that's something that a French Canadian has difficulty to say, hemorrhoids, there is more risk of usually when the pushing and all that, the internal, usually it's something that we have had personally, I wouldn't say genetic, but maybe the diet was little bit different and they don't tend to necessarily disappear. And who knows, when they describe it, it's just a description. It's not anything excessively dangerous. So I think that at this age that, up your age roots. So I think they probably just going to stabilize and being part of who you are.
Dr. Laurie Marbas
(08:46)
Yeah, absolutely. I agree with all that. So we also have another question from DD, “Any suggestions for treating NTM lung disease, besides antibiotics?” Not that I'm aware of. I mean, that's a bacterial infection that can be a pretty serious bacterial infection. Any other thoughts on maybe helping with immunity? What foods we should be looking at to make sure her immune system's up to par while she's fighting some type of infection? Maybe that's kind of a general direction we should be going, but you should definitely be taking the care that your doctors are locally telling you you should be doing, but any other thoughts there?
Dr. Chris Miller
(09:21)
What kind of lung disease? I missed that.
Dr. Laurie Marbas
(09:23)
NTM. It's the, I think it's the nontuberculous mycobacterial infection. If I recall, I believe so, but that is definitely, you want to treat with antibiotics. So any other thoughts on, as far as improving your immunity for fighting infection, especially with COVID? We talked about this before too.
Dr. Kim Scheuer
(09:42)
Lots and lots of colorful vegetables and fruits, and you want as many phytochemicals in there as possible to try and help out.
Dr. Niki Davis
(09:48)
And the other thing, sorry, yeah. The other thing I would add to that is just being really aware of the extra oils that you have in your diet, because oil, I mean, once you eat something like really high end fat, such as oil, it goes into your bloodstream pretty quickly, and it slows down the blood flow to all the important organs and tissues. And so if you're trying to help those, the fighters in your body, your immune system, to be able to get to these areas in your lungs, having really clean blood where the flow isn't hindered by fat that's in the blood can make a difference too.
Dr. Laurie Marbas
(10:34)
Very good. Chris, you're like the immune queen.
Dr. Chris Miller
(10:37)
Yeah, I don't know if that's a good thing or bad thing. But I always think like total body health for immune system. So making sure you're getting sleep, whatever you do for some movement every day, really try to help your immune system, drinking plenty of water, and then all the foods like everybody has been mentioning is so helpful. And I always think of Dr. Fuhrman, for so many of you who follow Dr. Fuhrman and his G-BOMBS. So every single day, aim to eat your greens, both raw and cooked and your beans, your legumes, your onions, and your garlic, your mushrooms, always lightly cooked, your G-BOMBS, where are we? Your seeds and your berries, so make sure you're eating your G-BOMBS every day. And that really is helpful, and avoiding sugar and the processed foods that are going to hinder, and the oils like Dr. Davis talked about, that are going to hinder your immune system. And then lots of fruits and vegetables like Dr. Scheuer said, and so that is [crosstalk 00:11:38].
Dr. Kim Scheuer
(11:38)
Some of the spices might help, like cardamom, which will improve your some of your ability to fight infection, things like that would help.
Dr. Laurie Marbas
(11:51)
Yeah, absolutely. And I actually also have on Healthy Human Revolution, I have a free course on how to build your immune system. It talks about all the foods, the different things, it's free, just put in your email and it can deliver it to you. So I even built a super immunity burger so has all the things in it. Vitamin D, all those things, very, very important. So move on to the… We got a lot of questions. So pulling up my hands, catching, here we go. So how about, I'm going to bounce around here, Carrie asked, “I need to know how to stop the leg cramps at night. They seem to be circulation related. Magnesium doesn't seem to be helping nor does more water. The cramps are in the front, inside of the lower leg, the various feet and toe muscles, and thank goodness, not the calf.” Sounds painful. “Thoughts? I'm following Dr. Fuhrman's Nutritarian diet pretty strictly, not 100%. I'm also having 16 ounces of coffee or green tea in the morning. The not 100% is my sugar monster winning battles, now and then.” Fair enough. Any thoughts on leg cramps at night?
Dr. Niki Davis
(12:56)
I would say that one of the first things that you want to check for is to make sure that you're not having issues with anemia. Sometimes if you're anemic due to either iron deficiency or even B12 deficiency, which can happen when you're eating a plant-based diet, you want to, sometimes having that anemia can cause you to have some leg cramps. So you definitely want to talk to your doctor about checking for that as one of the first things that I would do.
Dr. Laurie Marbas
(13:25)
That's good. And stretching is an important thing, too. Make sure you're, if it's in the front, that anterior tibia region, it may be a matter of, did you increase your walking recently? Was there any type of new movement and stuff like that? So stretching might be very important and very helpful as well, but any other thoughts on interior calf…?
Dr. Chris Miller
(13:47)
Yeah, I've seen a couple patients who have had a lot of calf pain and we've tried to correct everything with diet, so drinking plenty of water and make sure electrolytes are okay and all these things. And it turns out to be mechanical, so it can be the types of shoes you're wearing, or like Dr. Marbas said, the stretching. So look into that as well as a possible cause of your leg cramps.
Dr. Laurie Marbas
(14:09)
Absolutely. It doesn't always surround, but of course diet is foundational, but then we go from there, so that's where we start peeling back the onion layers. Okay. So here's a good question from Facebook, from Krishna. “I had a stroke in January this year. I'm fine, not very significant repercussions.” Thank goodness, thankful for that. “But they also did a heart echo. My internist said I have a diastolic dysfunction. Can you tell me more about it? I'm seeing a cardiologist on the 25th of this month. I'm on blood pressure, cholesterol meds and a baby aspirin. Blood pressure is controlled now. It was not when I had the stroke.” So any thoughts? You want to, would you like to describe the diastolic, systolic type of dysfunctions that we'll see in the heart? All right.
Dr. Niki Davis
(14:54)
I can.
Dr. Laurie Marbas
(14:56)
Go, Niki.
Dr. Niki Davis
(14:57)
So diastolic versus systolic. So really kind of the basic way to think about it is systolic is your heart pumping blood to your body, diastolic is your heart taking blood from your body, getting ready to pump it to your body. So the diastolic is really filling up the heart with blood. So when you have some diastolic dysfunction, it just means that your heart just isn't functioning as well as it should be in that phase. And so for whatever reason, we do see that in a lot of people, especially people who are eating the standard American diet. A lot of dysfunction in the heart that can cause things like heart failure are due to many, many years of having high blood pressure and having your heart having to push against that pressure in your body. But we have found that when you change your diet and you start giving your body really healthy, good, whole plant foods, that some of that is able to be improved. So definitely it's not too late to try to improve your diet and see how you feel.
Dr. Laurie Marbas
(16:10)
Yeah, absolutely. Any other thoughts? Yeah, just remember the diastolic's the bottom number, the systolic's the top number and the diastolic's just a stiffer heart, but that could be a lot to do with that high blood pressure. So now that it's better controlled, hopefully we'll see some improvement there. But another question about the stroke, hold on, sorry guys. There is a lot of questions, which is fantastic. Let's see here, Jila, I think, I hope I said your name correct, or I'm not sure. “Is there a relationship between arthritis and a stroke? A doctor told me the inflammation that causes arthritis can also cause a stroke too. So does the arthritis and the pain get better with whole food plant based?” So maybe discuss arthritis and then inflammation, stroke, arterial health, any thoughts, questions, suggestions there?
Dr. Chris Miller
(17:01)
I can take that one. So, yes, that's a great point though, and it was awesome of your doctor actually to bring that up. Most doctors think of them as totally separate and unrelated, but if there is any inflammation in your body, even if you stub your toe or you have a dental infection, any inflammation in your body, our bodies are systemic. Our blood is circulating. So if we can check a blood test and measure inflammation, that means your whole body is feeling it. And we've learned over recent years that inflammation really is the cause of so many underlying disorders that we see in America. So from things like heart disease, strokes, those and endovascular disease, so cardiovascular disease in your endothelium, your blood vessels, that's all related to inflammation, joint pains, all of our little joints related inflammation and even both osteoarthritis and all the systemic arthritis, like rheumatoid arthritis and lupus and psoriasis, psoriatic arthritis, all of those, they're all inflammation.
Dr. Chris Miller
(18:03)
Cancer has an inflammatory route where the more inflammation feeds cancer, so it worsens that. So it's all related. And so lowering inflammation is paramount. It's paramount to all of these. And it helps with all of these medical problems. And that's sort of the hallmark of the whole food plant based diet and the lifestyle medicine is to lower inflammation. And so taking people off pro-inflammatory foods, pro-inflammatory foods being processed foods, vegetable oils, animal products, dairy products, all of that, very, very pro-inflammatory. So that's number one, you take that out. Number two is you're feeding your body with good stuff, so all of the fiber rich foods that we're talking about, the colorful fruits and vegetables, the spices, the herbs, these are all anti-inflammatory. So you feed your body with the anti-inflammatory, including the omega threes, which you'll get from your flax seeds, chia seeds, hemp seeds, walnuts, green leafy vegetables.
Dr. Chris Miller
(18:58)
So flooding your body with the good stuff and you lower your inflammation, so you lower your risk of all of that. As far as arthritis, a whole food plant-based diet is enough for a lot of people. Their pain gets significantly getting better with that alone. And for some people there's other certain things, so there's certain foods that kind of contribute to joint pains, foods like, in a few people, 10% or less, it can be the night shade vegetables can bother them, which are tomatoes, bell peppers, eggplant, white potatoes. So if you're having joint pains and you're already whole food plant based, you can look into those types of foods. And then it can be, it depends if it's a systemic arthritis, then there's other things, if it's autoimmune, then you want to go more of an autoimmune route. But for general arthritis pain, definitely a good whole food plant-based diet. And also watch out for sugar and processed foods because sugar really, really affects joint pain, so be real careful with that. As is dehydration, so being real hydrated really helps clear those poor little joints, because there's such little blood vessels going to each joint. And so if you're dehydrated those blood vessels dry up and then toxins build in the joints and you get the stiff, painful fingers. So just being hydrated alone can really help with that too. So that's a general overview on all of that, all in one.
Dr. Laurie Marbas
(20:21)
That's excellent. I love that. Any other who'd like to add to that? Okay. Here's a good one actually, that we're going to be seeing more of I think. “Since being infected with COVID last November, I've been having a hard time to lower my glucose and being fatigued. I was placed back on high blood pressure medications, which has brought them back down. And then also back down to five milligrams, [inaudible 00:20:44]. Any experience working with post COVID folks, if so, what is recommended?” Any thoughts or suggestions on post COVID? I certainly have seen a few, but anybody else would like to take that on?
Dr. Elisabeth Fontaine
(20:57)
Well, I think we're starting just to have more research on the involvement of the COVID long term. So it hasn't been that long when you think about it, it's only been a year that we've been exposed to this new virus and then we realize that it's not just having the infection, but the people that have infection that could have gone through it very, well, some of them continue having huge impact. One thing we know though, is that the COVID tend to, the incidence, tend to be much higher in people that would have some chronic disease or would be overweight and goes to what Chris just mentioned, is the inflammation. So I think that for the people, and that might come with the research, the people that has this post COVID chronic inflammation could definitely be helped by adopting a plant food based diet. But again, I think that it's going to take a little bit of time before we have research that will back up what I'm talking about.
Dr. Laurie Marbas
(22:08)
Yeah, absolutely. I would say, what I'm seeing with my diabetics, that they'll have blood sugars raised, even with the vaccine, it'll be up for a few days, even up to a week or so, but it comes turning back down. But the important thing is just supporting your health, like you said, make these recommendations that we would be making outside of even a pandemic is just really getting your body in the best shape possible, starting with the foundation and nutrition, but exercise, stress, relationships, all those things take important, take into account your immune system and your recovery just from any stressors, even outside of COVID, which is special, because it's unique and new to us. But the daily stressors of just living life as a human being, the better you are internally to accept those stressors, the less repercussions you'll have in your long term health, but-
Dr. Kim Scheuer
(22:59)
It's good to remember also that our bodies tend to heal themselves if you let them. So if you keep doing all the good stuff and not do the bad stuff and not keep attacking your body, so as Laurie and everybody else said, just bathe your body with nutrient rich foods, and then do everything else. Keep your stress down, connect again with people, sleep well, et cetera, give your body the time it will need, and it will work until it's healing itself. So keep the hope up.
Dr. Laurie Marbas
(23:35)
Basically just get out of our own ways, is that what you're saying?
Dr. Kim Scheuer
(23:38)
Right.
Dr. Laurie Marbas
(23:38)
All right. Fair enough. Here's some other questions. Susanna asked, “I have an autonomic nervous system disorder for the past 14 years with serious chronic constipation. Plant-based eating has helped a lot, capital letters, but it is up and down. Do you have any opinions about candida diets to address overgrowth?” Maybe even further to discuss here, it says here, Susanna continues the question. “The candida diet seems to help my digestion quite a bit, but I'm unsure of how long to do it since it eliminates a lot of healthy foods like starchy vegetables, sweet potatoes, is there a good length of time to do a candida diet? How do I phase back and eat starchy foods without retriggering constipations? Beans seem to be difficult for me, edamame is okay though.” So do you want to first start with just the discussion of candida in general that it's here, it's around us, it's in us, it's normal, unless… Those type of things and maybe the chronic constipation things, especially as someone who's had some type of anatomical issue. Any ideas, thoughts? No?
Dr. Chris Miller
(24:43)
I can take that. So candida is a, what is it? It's a, help me out here.
Dr. Kim Scheuer
(24:52)
Yeast.
Dr. Chris Miller
(24:53)
Yeah, it's a yeast, is what I was getting at and it's normal in our flora. So it's a part of it. If you checked, most people are going to have some candida. And remember the microbiome is a balance of bacteria, there's viruses in there, there's yeast in there, there's protozoa, there's that archaea, or whatever, that ancient micro viruses. So it's all in there in balance and that's totally fine, that's how it's supposed to be. But what can happen is for certain reasons, certain bacteria can be overgrown or the yeast can be overgrown. And what happens is when it is overgrown, then you start, you can start to see some problems. So people might get more yeast infections, vaginal yeast infections, or foot, toe with yeast infections, or start having some skin reactions or peeling skin, things like that.
Dr. Chris Miller
(25:42)
So we can see some of that sometimes in people and it can even become systemic and where it gets into the blood system, and then it can be a terrible life-threatening disease at that point. And we have to treat it with IV antifungal, antibiotic or antimicrobial medication. This can happen in very sick ICU type patients. But so what to do about it, I think there's a little hype personally about all the candida diet, but that being said, I have seen where it's been a little bit of a problem for some people, one common reason where it can be an overgrowth. One, it can happen after antibiotics. Two, it can happen for people in high sugar diets because you're feeding them and eating a high sugar diet feeds certain type of microorganisms, certain bacteria and the fungus, and so they can flourish a little bit more and you see, you have more sugar cravings, more sweet cravings at that time, or it can happen after antibiotics as well.
Dr. Chris Miller
(26:37)
But so what we want to do is kind of rebalance it. And number one is a high fiber whole food plant-based diet. So make sure it's built well that it can be more vegetable related if certain high carbohydrate foods like sweet potatoes bother you or something, but so a good, maybe lower glycemic high fiber whole food plant-based diet would be the route that I like to go. Candida diets, what they do for people who don't know, is they take out all sorts of sugar. Which makes sense a little bit, because like I said, it feeds it. So removing processed sugar, honey, maple syrup, all that type of stuff, which that all makes sense, but they also remove all fruit, they remove mushrooms because mushroom itself is a fungus and they, I don't understand that link myself, but they take mushrooms out and they take out starchy vegetables.
Dr. Chris Miller
(27:30)
And so it's a very limiting type diet. And so people are on that and I think they feel better because they get less of that. And so this person's asking how, if she does something like that, how does she add them back in? I tend to, when I work with my patients, I tend to put them on a low glycemic, high fiber diet, but not quite the candida diet. So maybe lower glycemic fruits, legumes and avoiding the higher glycemic fruits and vegetables for a short time and watch how that does, really flooding their body with fiber. And I've seen my patients do really well with that. Of course everybody's different. So I haven't taken them off the mushrooms and I find they do just fine with them. So that is my, I guess, I'm not sure you're saying it helps with constipation, how to add food back in.
Dr. Chris Miller
(28:20)
I guess I would just go one at a time and start bringing the high fiber foods back in, bring the mushrooms back in, bring the lower glycemic high fiber foods, bring in berries, bring in all your vegetables, start bringing those back in. And maybe if there's a few that bother you, like a few of the starchier vegetables, you can hold off on those a little bit, see how your gut is doing, how you feel, what works for you. But make sure you're getting diverse nutrients, you don't want to be on a limited diet for too long. That's never good for anybody. So really work on diversifying. And if you need to work with one of us, we have all of us here waiting eagerly to take patients, so feel free to make an appointment with us and we can help you with that too.
Dr. Kim Scheuer
(29:00)
Another suggestion is going low and slow. I mean you want to add, as Dr. Miller said, Chris Miller said, add one at a time to make sure that you're not having issues with it, but make sure you're getting plenty of hydration too, because if you're not hydrating, you're going to not be pooping.
Dr. Laurie Marbas
(29:15)
Yeah, absolutely. Yeah. That's exactly right. So first of all, we are, exactly low and slow. I like that, low and slow, take it easy, hydration, exercise will also help with that. But sometimes people who have some, think about it, the guts a muscle, right? So there's motility occurring, think of a snake doing its dance through your gut. Sometimes you need medications that are prokinetic, that'll make things move, and some of those will have side effects. That's a discussion with your doc, for sure. But that's some really excellent, good advice. I see the majority of these people who are promoting these, “I have overgrowth of candida. I have this…” There's no scientific evidence to prove someone has, unless you have thrush, you have some immune compromise, you're on, you have way out of control diabetes, you might see something there, or you've had some antibiotics, you can get some.
Dr. Laurie Marbas
(30:09)
So again, I think these are typically fad diets. There may be some changes in the food composition that's helped with your constipation, that's definitely something to clue into. And then like they were saying, just bring it in slow and bring it in easy and just take your time. And then of course working with the plant-based GI doc or one of us, we'd be happy to help you, walk you along. Do you guys have time for a few more questions? I know it's already at half the hour, but you guys cool? Doctors?
Dr. Niki Davis
(30:36)
I'm okay. Can I add one more thing to that last question?
Dr. Laurie Marbas
(30:39)
Yeah, please go ahead.
Dr. Niki Davis
(30:40)
So the only other thing I would mention, because she said that the whole food plant-based diet has definitely helped, but that it still, she has her ups and downs, good days and bad days, is just consider keeping a journal. So a food journal and you can even have it be a constipation journal too. So you're writing down what you're eating, but you're also writing how was your bowel movements of that day. And then you can start to look back and see if there's any connections there. What kinds of foods are helping, helping out and what sorts of foods seem to be making it worse?
Dr. Laurie Marbas
(31:13)
Excellent. Because honestly we all forget what we had yesterday to eat, much less how did our stool look, so I think that's an excellent, I'm not going to say as far as taking pictures, but you could draw something maybe, I don't know. But anyway.
Dr. Kim Scheuer
(31:25)
There's a good [inaudible 00:31:27].
Dr. Laurie Marbas
(31:28)
I will say, one of my patients I work with, her little one is a type one diabetic and their seven year old has, and she's granted me permission to share her story publicly, I've asked because they're so cute. They actually have the poop chart. There's a poop chart you can get, she even has a mug, I actually was inspired to get the mug with a poop chart on it. Basically, and it talks to you about different types of poop and the kids are already recognizing, so the mom will ask, “How was your poop?”
Dr. Laurie Marbas
(31:56)
She goes, “I was a number four today.” She's like, “Oh, that's excellent.” Okay, I'll just leave it at that. There's a future GI doc in your midst. Oh my goodness. We had another question. Well, we have some questions about international patients, I do just want to recommend that we can, we are more than happy to see anyone outside of the US. We cannot be your quote unquote physician, but we can give you some coaching guidelines as to things that maybe speak to your physician about, test to ask for, medication management and just give you some ideas of where to be going and what to be looking for. So for international patients like in Canada, Mexico, Egypt, Switzerland, I've seen them all over, I know Dr. Klaper and Chris, a lot of you guys will see these international folks come to us, but again, we can't practice medicine there, but we can give you some advice as to how to, because every country has some unique qualities, which I'm learning quite a bit of how to engage with your physician and what to ask and just how to bring that conversation.
Dr. Laurie Marbas
(32:58)
So that alone can be valuable. It can be, just even one visit may give you enough information to help get you started down the right path. But I do want to mention that, and there's a link on, if you go to plantbasedtelehealth.com, it'll say, I think it's under the information tab and there's an international questions. We answer everything there that you need to know how to set that up. [crosstalk 00:33:20].
Dr. Elisabeth Fontaine
(33:20)
You do have some of us that speak another language.
Dr. Laurie Marbas
(33:25)
Oh yes, my bad.
Dr. Elisabeth Fontaine
(33:27)
And maybe some others do other language.
Dr. Laurie Marbas
(33:30)
Absolutely. We have Dr. Elisabeth Fontaine, who is just speaking, speaks French. We have Dr. Kim Scheuer, who is multi talented and not only English and Spanish, but also American Sign Language. Is that right? I got that right. And Dr. Jeff Pierce, he's not with us today, he's, I know delivering babies or something, that's what he does in his day job. And he also speaks Spanish. And so all these amazing docs are licensed at different states, check them out. But definitely if you have those international patients who speak in a foreign language, we have some talented people here. I'm happy just to speak English because I struggle with that enough, but let's leave that there. And here is, I know people are laughing because they know this is the truth. And so we have another question that's a good one, “Are nuts okay for someone without a gallbladder?” I think that's a pretty basic good question. Anybody like to take that on? Come on ladies.
Dr. Elisabeth Fontaine
(34:27)
I didn't even hear the question, sorry. You were too fast.
Dr. Laurie Marbas
(34:32)
“Are nuts okay with someone without a gallbladder?” Just because they're higher fat.
Dr. Kim Scheuer
(34:35)
That's the issue, it's the higher fat content.
Dr. Laurie Marbas
(34:39)
Yeah, so I mean, if you think about the gallbladder, what does a gallbladder do, right? It produces bile, bile emulsifies the fat, makes it easier to absorb basically. Honestly it just really depends on you. So I would try it out, if you find that you eat more nuts and you're getting looser stools and it's kind of fatty and greasy and stuff, you know that's probably a problem. Probably the whole nut would be a little bit easier than the nut butters because you're breaking it down so it's a little bit easier to separate the oil out, but I would just test it out, honestly. It should be okay, for the most part I haven't seen patients who are post removal of the gallbladder having too much of an issue, but you guys have other experiences with that?
Dr. Niki Davis
(35:20)
I would just say that in eating the nuts, just have it mixed maybe with something else that's lower in fat. So if you're going to have some walnuts, have it over a big green salad so that you have those mixed together, so it's not a cup of walnuts that you're eating and it's that big load of fat going through your system. But that if you're mixing it up with things that are lower in fat, that your body can handle that a little bit easier.
Dr. Laurie Marbas
(35:47)
Perfect. And here's a good question we get fairly often, “I'm sensitive to beans,” not necessarily, but she says it causes constipation, but some people get more gassy. “How do you build that into a diet?” You guys want to just go to the basics of how to up the fiber game?
Dr. Kim Scheuer
(36:03)
Low and slow, go low and slow. But when you get your beans, even in the can you want to rinse them off really well. You want to, if you are cooking them yourself, soak them overnight, cook them and then rinse them again. The more you rinse them, that kind of helps that. But again, low and slow and a little bit at a time, add a tablespoon a day and see what happens and then add another tablespoon. But it's very helpful.
Dr. Elisabeth Fontaine
(36:29)
And I think that some people will be more sensitive to certain types of beans. I will say that chickpea, even if I've been, eating them for quite some times, seems to be the one that caused more issue for me. So I'm just trying to be careful with that. It's not all them, so just need to know your body.
Dr. Laurie Marbas
(36:52)
Absolutely. Great. And we have a few supplement questions, I'm going to just merge these two together. Fred asked, “I understand that on a plant-based diet, we need to supplement with B12.” That's good. “In fact, other plant-based doctors have suggested only B12. What about CoQ10 and a multivitamin?” So hold that, this other question. “What types of supplement should I take for very dry brittle hair? Already have vitamin D, thyroid and iron. I take a vegan supplement that has biotin, DHA and EPA. I'm hopeful that I may stay SOS free.” So again, the brittle hair can be a variety of different things going on, but what about these supplements? Any thoughts, questions, your suggestions, ladies?
Dr. Kim Scheuer
(37:34)
Definitely the B12 in the wintertime, or if you cover up a lot and don't get outside, vitamin D very important. There is some controversy about whether you should or not take the algae based omega 3s, those are the ones I know about. And if you have, I would suggest if you're over the age of 50 and that you have family history of Alzheimer's, you might want to consider that, the algae based omega 3s. Some other people, you might want to do some testing if you have specific problems and then see what your levels are on certain ones, but any other people?
Dr. Laurie Marbas
(38:15)
Absolutely.
Dr. Chris Miller
(38:16)
I also do testing in people. So I agree with Dr. Scheuer there. And I think it's important because we're all very individual, people absorb differently, that's the bottom line. If you have gut issues, people don't absorb many nutrients, so vitamin D, B12, magnesium even, people can be low in these nutrients. Whereas if you have a healthy gut that may not be a problem for you at all. So the vitamin D is so important even in states like Colorado. When I test my patients in the summer in Aspen, Colorado, they are low and they're outside playing. So depending on where you live, make sure you keep a close eye on that. And your question about the CoQ10, if you are on Astatin for any reason, I do find it to be helpful to decrease some of the symptoms of comorbidity of the Astatin, such as the leg cramping.
Dr. Chris Miller
(39:05)
So if you're on something like that, or if you have a proven deficiency in it, otherwise, I don't know that it's helpful if you don't and if you're eating a good, healthy diet, but it can be helpful for people with that. Also people, if you have some other disorder, neuromuscular disorders, CoQ10s can be helpful for that sometimes too. So there are certain people like with Parkinson's and things that we might put them on a CoQ10. So there are reasons for it. So depending on your individual self, I am not one of those people who say no to all supplements. I find that we're very individual and when people see me, when my patients see me, usually they're seeing me for a reason that means they're sick, something's going on. And so supplements can be a helpful tool as we're trying to get them nourished and make sure they're not deficient in anything. Big ones that we think about are vitamin B12, vitamin D3, zinc can be low in plant-based eaters, because it's hard to absorb.
Dr. Chris Miller
(40:00)
Iodine, if you're not eating iodized salts. So you want to make sure you have a good source of iodine and you can check the level to make sure it's okay, but that's important as well. The EPA and DHA, I do recommend a low dose of that. So whether people are getting it from their flax, chia seeds, walnuts, and we can check the level, make sure that's working, or if they need a little something else to make sure that they're getting enough omega 3s, that they're going to age healthfully. And then if people have bone health issues, we might talk about something like K2 or look into other things. So there are some supplements for certain people, certain reasons that we'll talk about, maybe not everyone, maybe just the basic ones, if you're super healthy and everything looks good, just make sure your D is okay and you're on B12. So it kind of depends.
Dr. Laurie Marbas
(40:46)
Yeah. I would agree. I personally take the B12, a vitamin D3 and the algae omega 3s. And we discuss and we test, so tests don't guess, that was a Dr. Joel Kahn phrase I saw. And just like Chris saying there's other supplements that in certain individuals might be beneficial either long term or short term. So again, these are individual recommendations, but as a plant-based eater, definitely need your B12 and you really should have these things tested also with homocystine methylmalonic acid, because as we get older we don't absorb well, some people are on medications that decrease absorption. And again, that needs to be taken into account and we really can make a big difference there. But your gut health is a big one as far as absorption. So hopefully that's helpful. I do just want to address one more question, just because I'm a little bit worried about… Oh, and someone asked about a brand of algae omegas. I like Nordic Naturals. Do you guys have another brand that you prefer? The Nordic Natural algae omegas is a good one. But any others that you like?
Dr. Kim Scheuer
(41:55)
I use Nordic Natural also.
Dr. Laurie Marbas
(41:57)
Cool. And someone's asking, “What does too much lisinopril do to you? I've reduced 20 milligrams to 10 milligrams after losing 70 pounds on a whole food plant-based diet.” Congratulations, by the way. “And I get numbers like 108 over 60.” Shall we talk about high blood pressure, eating a healthy diet and what's happening and what's going on? Anybody like to take that on?
Dr. Kim Scheuer
(42:20)
So you definitely do not want too much lisinopril. I mean, because what can it do to you? It can drop your blood pressure too much and you can get in trouble that way. Your numbers are pretty low at 108 over 60, and that's great. If you're starting to get dizzy on that, I would cut it even more. So when you're eating a plant-based diet, you're doing so many things to improve your blood pressure. You're improving your endothelial function, which helps vasodilate your vessels, which helps with your blood pressure, you're decreasing the amount of saturated fats that sludge up your blood. There's so many reasons, and so you definitely, definitely, definitely, definitely, if you're getting dizzy at all, if you're having weakness, you're probably on too much right now. And so great job on losing the weight, great job on changing your diet and start to, and really be careful with, talk to one of us or talk to your regular physician and get down as soon as you can, if there's no other reason for you to be on it.
Dr. Laurie Marbas
(43:19)
A hundred percent. So there are two reasons I tell my patients, “Message me in the portal immediately.” Blood sugar's going too low or too high, but blood sugar's typically too low or blood pressures are dropping, and I give them very specific parameters to look at. Dizziness upon standing, you had energy and now you're just like, “Oh, I'm just suddenly tired.” Those are indications that blood pressure is too low. And you're on medications that are causing the blood pressure, because the blood pressure medicines don't care what your blood pressure is. The blood pressure medicines are going to do what the blood pressure medicine does. It lowers blood pressure, even in a normotensive or normal blood pressure person. Those blood pressures will drop. So call your doctor, please, today. Tell them what you told us and, or make an appointment to see one of us. There are many of us here that have appointments available very quickly and we can advise you and we'd be happy to do so. Anything else anyone would like to say before we go? I know I've kept you guys 15 minutes past, thank you for answering all those questions. Anything else you'd like to say before I wrap up?
Dr. Kim Scheuer
(44:23)
Be healthy, be happy.
Dr. Laurie Marbas
(44:26)
Be healthy. I love it. Eat more plants. Okay.
Dr. Niki Davis
(44:29)
Low and slow.
Dr. Laurie Marbas
(44:29)
So we got Dr. Niki Davis, can you tell us where you're licensed please?
Dr. Niki Davis
(44:35)
Yes. So licensed in Utah, California, and Florida.
Dr. Laurie Marbas
(44:40)
Great. And more to come. And Dr. Scheuer?
Dr. Kim Scheuer
(44:43)
Oh my God. I got to look it up.
Dr. Laurie Marbas
(44:45)
There's a long list.
Dr. Kim Scheuer
(44:47)
It's a long list. Alabama now, Arizona, California, Colorado, Florida now, Georgia, Illinois, Kentucky, Maine, Michigan, Nevada, Utah, Vermont, Washington and Wyoming.
Dr. Laurie Marbas
(44:57)
Oh my goodness. There, excellent. And Dr. Elisabeth?
Dr. Elisabeth Fontaine
(45:01)
For me, it's pretty simple. Vermont, Michigan and Florida and New York.
Dr. Laurie Marbas
(45:06)
There you go. And Dr. Chris Miller? She's well over, she's got a lot. So go ahead.
Dr. Chris Miller
(45:11)
I don't know them all off hand. There's 20 of them on the website, but please check me out if you're interested in me.
Dr. Laurie Marbas
(45:16)
Yes. Go down to Meet the Doctors, scroll down to these amazing doctors. Look at where they're licensed, book an appointment, plantbasedtelehealth.com. Guys, we are here to help. We're so excited. We're having phenomenal success with patients. The feedback's been excellent and we have more doctors available, Dr. Michael Klaper, Dr. Jeff Pierce. So please check us out, and we're super excited to be a part of your health journey. And thanks everyone for joining us. This will be live on our YouTube channel, and it's also on the Plant Based TeleHealth website. If you want to actually register to be on the webinar side of things, that's also listed there. All the information is on the website. So again, thanks for joining us and we'll see you in two weeks, I have to think about that for a moment. All right. Thanks guys.
Dr. Chris Miller
(46:04)
Bye everyone.
Dr. Elisabeth Fontaine
(46:04)
Thank you.
Recorded on 5.13.21