During this Q&A, the PBTH doctors discuss: B12 supplement recommendations, tips for losing weight, which plants reduce inflammation, and salt cravings.
Questions Answered
- (00:04) – I have an autoimmune disease. Can you tell me the difference between Twinlab B12 and PlantFusion B12?
- (04:31) – I'm eating whole food plant base, no oil. Can't get my weight coming down. How do you learn a calorie range?
- (09:35) – plant-based for almost 10 years, pretty strict, no cheating. Lab work suggests inflammation. Could any plant-based foods be causing this?
- (11:55) – Is there a doc here that specializes in RA?
- (12:49) – Could there be a physical reason that causes me to crave salty snacks?
- (15:48) – Is there any update on the DHA EPA test to see how accurate these tests are?
- (19:32) – What CGM do you recommend?
- (20:10) – I have an A1C of 5.8 and glucose over a hundred. My PCP wants to diagnose me as type II. I am eating whole food plant-based, no processed foods. Should I be concerned?
- (22:42) – Is there a doctor in Oklahoma City who could help me refine what I'm eating?
- (23:22) – What could cause low ferritin when hemoglobin levels are in normal range?
- (29:33) – Do I need to be concerned about too much plant protein, for example, too many beans in a day?
- (31:37) – Would you recommend changing from an SSRI to whole plant-based diet to treat generalized anxiety disorder?
Complete Transcript
Dr. Laurie Marbas
(00:04)
Let's get started with our questions. We have the first one for Dr. Miller. “I have an autoimmune disease.” Excuse me, “I want to know the difference between Twinlab B12 and PlantFusion B12. And do we need other,” I don't know, I'm sure that means BS, but-
Dr. Kim Scheuer
(00:20)
B's, other vitamin B's.
Dr. Laurie Marbas
(00:22)
Oh, vitamin B's. Got you. A little slow.
Dr. Niki Davis
(00:25)
Not BS.
Dr. Chris Miller
(00:28)
I'm not familiar actually with PlantFusion B12. So I can't really say to that. I do know Twinlab B12. I've looked that up before, but basically what you're looking for in a B12 is you're looking for something that's easily absorbed. We usually start people with cyanocobalamin, unless there's a reason certain people need to start with different B's. So that may be something that I would talk to you about to see whether you need a different type of B, but I don't know, PlantFusion. So I can't really give an answer on that at all, but you just want to look that it's easily absorbable, so often a liquid droplet or something that dissolves in your mouth. That's been shown to be a little bit more helpful for absorbing it.
Dr. Chris Miller
(01:09)
And then I always look at products to make sure that it's clean. I don't like the supplements that have a whole bunch of chemicals or additives that you can't pronounce. So I tend to shy away from those, especially as an autoimmune person. So you just want to make sure that it's a clean product and some people do need other B's, but basically you wouldn't know that without checking labs, I would think. And so if you are deficient or having a hard time, then maybe, but otherwise I would just start with a good B12 that you absorb well.
Dr. Laurie Marbas
(01:38)
That's excellent. Anybody else like to add to… I have used PlantFusion with some patients, that seems like a good one. So just a side note there.
Dr. Chris Miller
(01:47)
Oh, it's on our list. I didn't know that. So-
Dr. Laurie Marbas
(01:50)
It's on my list.
Dr. Chris Miller
(01:52)
[inaudible 00:01:52] That one. So I'm not familiar with it. So
Dr. Laurie Marbas
(01:54)
What she's talking about is I made a list of vitamin supplements, been third party tested that we've all used. We've all kind of put inputs and it's just easier than trying to tell each patient, okay, write this down. Oh, I'll send this you. It's just, go straight to B12. Here's some options.
Dr. Michael Klaper
(02:11)
True. I just like to point out that the [inaudible 00:02:14] are nice, but the proof of the pudding is in the homocysteine and whatever you're on, in about a year, have a CBC done, complete blood count. Make sure your red blood cells are all the right sized and check this stuff called homocysteine that goes up if you don't have add B12 and it can injure the walls of your arteries and open the door to unpleasant changes there. So just make sure that whatever B12 you're on that is keeping your homocysteine down, your red cells healthy. And then it's the right one for you. But if your red cells are getting big and funny looking, where your home cystine is going up, then you might want to move on to methylcobalamin or some other form, but talk to your doctor about that.
Dr. Laurie Marbas
(02:58)
Absolutely. That's excellent. Thank you, Dr. K. Okay. Someone says, “Speaking of B12, my sublingual is 80% methylcobalamin and 20% adenosylcobalamin, which would be fine. Is that a good mix or should I look for something different?” Yeah. If you're doing the mix, that would be fine too. So, but the cyano's are usually a little cheaper and easier to find. So anybody else on the thoughts, but those are the two that are the combo. Okay.
Dr. Chris Miller
(03:21)
That should be fine. And again, like Dr. K said the best way is to check and then you would know.
Dr. Laurie Marbas
(03:25)
Yeah, hopefully. Is that publicly available? No, you have to come see one of these amazing physicians to do that. And I do want to announce that I am no longer accepting new patients outside of the States that I am the only one licensing and my established patients, I am transferring care to these other amazing doctors, as I pull away from patient care to grow this practice. We've added Dr. Alaniz, who's our temp doc, and we'll be adding a few others in those critical states. Just want to share with us. So how at these guys they're amazing. So just [inaudible 00:03:59].
Dr. Kim Scheuer
(03:59)
I want to say something about that too, though. That doesn't mean that Dr. Laurie Marbas is leaving.
Dr. Laurie Marbas
(04:04)
No.
Dr. Kim Scheuer
(04:05)
That we can talk to her with questions if we have questions about certain people and we can grab her intelligence to help everybody else too. So don't worry she's with us. We won't let her go.
Dr. Laurie Marbas
(04:17)
I'm actually going to be more present because of that. So if anything, you will also get even more sick of me. So I am definitely fully invested here. Not going anywhere, just more involved actually.
Dr. Michael Klaper
(04:32)
[inaudible 00:04:32].
Dr. Laurie Marbas
(04:32)
Yeah. There's even more fibers of my being infused in this place. So, all right. Here's a great question from PM, “62 and post menopause. I'm eating whole food plant base, no oil. Can't get my weight coming down. How do you learn a calorie range? And should I be shooting for something to make sure that's not the issue? I get 30 to 40 minutes of cardio daily.” Docs?
Dr. Kim Scheuer
(04:54)
I've got a couple of quick, quick things. One is adding some resistance training might help. Two is making sure you don't have something else going on that's keeping you from losing weight. So coming to see one of us and getting some testing done and things like that. And then, three, we would really like to look at what you're eating specifically, because those are the things that we can tweak and try and get you to lose some more weight if needed. Also when you're eating, there's a lot of things that go into this, but that's my original opinion. Anybody else?
Dr. Chris Miller
(05:30)
Yeah, I would just add to that. That was great. And that's exactly the right thing to approach. And I would also say to make sure you're really focusing on whole foods and minimally processed plants. And so instead of eating crackers or other plant-based foods, eating the actual rice or eating the actual whole food, that's filled with water, water based. And to make sure that you can even eat lower glycemic. As we get older, we just don't metabolize. We don't need the calories anymore, unfortunately, for those of us who like to eat, but so eating more things like salads and vegetables and lowered glycemic foods. And so that's where working with someone or taking a look at your diet and picking those foods might be helpful.
Dr. Michael Klaper
(06:15)
Can you hear all the pearls rattling around here on the floor? There's some really wonderful piece of wisdom that just gone by and they're absolutely right. Keep your belly full of soups and salads and steam veggies and stews and things that are mostly fiber and water. And don't stick to, your fruits are fine. And do walk every day and the way it's going to come down, it's the really dense starches and the processed food, the flower products, the hidden oils that keep you stuck there. So stick with those whole foods, the high water content ones, take walk every day to keep the bowels moving. And the laws of thermodynamics should work for you as well, too. So, it's a tincture of time, powerful medicine, but it'll get you there.
Dr. Laurie Marbas
(07:01)
I love that. Yes. Thermodynamics does work for us too. I love Dr. Klaper. I'm writing a book about you, is Dr. Klaper. I'm not even kidding. I keep saying I'm going to do it, but my favorite was the, what was it? The Nat's belly button or something like that.
Dr. Michael Klaper
(07:17)
The risk could fit at a fleet' naval.
Dr. Laurie Marbas
(07:19)
Naval. Okay again bake to me up.
Dr. Niki Davis
(07:24)
Maybe we could get a copy too.
“Dr. Alon Sitzer
(07:25)
Yeah, one comment. I've seen quite a few people who want to lose more weight. And when we look objectively at their numbers, they're really, weight wise, at a place that I was not concerned about. So I don't know what the numbers are, but there's also that place what really is your weight, what are your goals? And I think that's just important, that part of acceptance and loving our bodies and all that good stuff. Again, I don't know what the numbers are. I don't know all the facts, but just another, I guess, [inaudible 00:08:02] wisdom in this process of trying to be good to our bodies and et cetera.
Dr. Laurie Marbas
(08:10)
I would echo that so much. Alon, I don't even tell you how much, especially as we have women entering into this middle age group, our body shift weights, metabolism changes, hormones are changing. They're going through a lot of different changes. Body composition is more important than the scale. And if we really look at a lot of gurus are like you have to be under this BMI of this and this, and women are just so focused in man, I'm sure on that particular number, even though, like you said, they're healthy weights and they're energized and they're out doing their life. So let's not focus so much on what the gurus are saying for the BMI, but let's look at you as an individual. And if you really want to improve the metabolism that you are going, lift some heavy weights, get out there. If it's safe, get your doctor's approval, but go out there and change that body composition by building more muscle.
Dr. Laurie Marbas
(09:01)
And I will tell you, I've engaged with Danny Taylor, who's our vegan body builder that we had on here before. And she's helping me and she's put me on a regimen. Holy moly. So I'm feeling stronger. I'm moving heavier weights than I did before. So check it out, veganproteins.com. But yeah. Anyway, I just have to throw out the muscle building stuff is really key too. So anyway, here is another question. This is probably a good one. Plant-based for almost 10 years, pretty strict, no cheating. Lab work suggests inflammation. Could any plant-based foods be causing this? I have no illness that I'm aware of. Any thoughts on inflammation?
Dr. Niki Davis
(09:43)
I would say, sometimes we find that people can have some inflammation if they're low on omega fats. That would be something that you could consider having. One of the doctors take a look at to see if increasing your omegas, whether that's dietary or maybe of supplement, if you can't get enough in your diet, but sometimes that can help with inflammation. I've had some patients with some joint pain improve just by making sure they get enough omegas.
Dr. Laurie Marbas
(10:17)
Yes, 100%. Anyone else?
Dr. Kim Scheuer
(10:18)
I also find that some people don't realize they have tooth issues that can cause generalized inflammation, things like that. But I agree 100% check your omegas, and.
Dr. Laurie Marbas
(10:29)
I will tell you just a quick story on that one. That's a really good point, Kim, because I had a patient who had, had a root canal and it became infected unaware because he couldn't feel anything. He was having hypertension. This guy was athlete, right? Hypertension, heart rate was going up, was having fevers, not feeling well, but no pain, nothing could figure out. And he went to the dentist. I can't remember exactly what was the prompt for that. And they literally removed that tooth and it all cleared. So that is a really, really good point. Chris, were you going to say something to that as well?
Dr. Chris Miller
(11:04)
Well, I was just going to say there's a lot of reasons for inflammation. So like, even if you have some arthritis going on or if you have a plantar fasciitis or anything like that, and then I would also want to know about your gut health, because if your microbiome is out of balance, if you have a little bit of leaky gut, you can get inflammation from any food basically. So that's what we do with a lot. And so that's something to think about what your gut health is doing. And then if you are concerned, I would keep a food symptom journal and try to see when, if you're noticing any symptoms, first of all, if you're just finding your CRP elevated or if you're noticing symptoms, and if you are noticing symptoms when and what you're eating and just take a look at it and maybe have one of us take a look at it with you, because I look at those all day long, looking for possible food triggers or things like that, so that can be helpful.
Dr. Laurie Marbas
(11:55)
Excellent. And there's another good question here. “Is there a doc here that specializes in RA? Would like to make an appointment with one of you in New York.” Chris?
Dr. Chris Miller
(12:04)
I definitely specialize in autoimmune in general, given I have a lot of personal experience. So if you're in one of my states, I would be happy to see you.
Dr. Laurie Marbas
(12:12)
She's in New York. You're in New York, right?
Dr. Chris Miller
(12:13)
I'm in New York. Yeah. I'm happy to see you, if you want to.
Dr. Laurie Marbas
(12:17)
Yeah. No, I would say go see Dr. Miller in New York. I'm just going to point you in that direction. She's incredible. I try to get all my autoimmune patients to at least be aware of her. And honestly, I actually had one that I started this week. This happened, had an appointment. She had the host of autoimmune issues and the more she kept talking to me, I was like, “I really think I'm going to not charge you for this appointment. I really need you to see Dr. Miller because I feel like you will connect.” And she goes, “Really? I've been aware Dr. Miller, but I wasn't sure if I should change.” I was like, “Oh yes, we're going to do that.”
Dr. Laurie Marbas
(12:49)
I got her right in. And I was like, this is really, she's amazing. So please do that. All of our doctors have some incredible experience. So this is a good one. We get a lot of, “I'm 61 and have been, hopefully plant based for three years. I struggle with avoiding salty snacks. I eat air popped” Excuse me, “air popped popcorn, mix it with water and salt nearly every night. Could there be a physical reason that causes me to crave these type of foods?” What do you guys think?
Dr. Chris Miller
(13:22)
I guess I'll start with that one. So it's always possible. Yeah. I would check your labs, your electrolytes, make sure something's not off in general. It's a taste bud thing. And your taste buds will adapt and change. If you're used to high salt, you're going to crave high salt and you're going to want high salt. So what we teach with our plant-based diet is to go low salt and your taste bud will follow and adjust to that. But we do see people low in sodium or people with adrenal issues or thyroid issues or some other hormonal thing. And so it is possible that it could be something metabolic going on with inside of you. So it's not unreasonable to check your electrolytes to check some of that basic stuff. But my first thought and the most common thing is that you're probably just used to salt. And so if you started to make a change, then over time, you would no longer crave that anymore. So yeah.
Dr. Niki Davis
(14:16)
And there are some really good salt substitutes out there, now. One that I like is ground sumac berries. It's kind of like a brownish colored little berry that they grind up and it's got this kind of lemon tangy flavor to it that you can put over the top of food. And it gives you the feeling like you're having some salt. Another one that I recently tried was with a company called Well Your World. He has one called Stardust, and it tastes like salt and it's completely salt-free. And you can even just use something simple as even just garlic powder to give you a little bit of extra flavor over the top of your food.
Dr. Laurie Marbas
(14:59)
I like that tip. Go ahead, Dr. K. I was just going to say Table Tasty is a good one too. Just kind of-
Dr. Michael Klaper
(15:07)
That's just one I was going to recommend, Benson's Table Tasty. Really it's lovely. And nutritionally uses some dried herbs. It tastes salty, but it isn't. And, but she may have a low grade salt losing situation in her kidneys or, maybe she check her adrenals out, it's a really powerful drive for that 24 hour urine for electrolytes might be very revealing there just make sure she's not losing excess salt there, but I totally agree with Dr. Miller. Common things are common and it's probably just I'm a recovering saltoholic myself and I know how powerful that is. So time will probably help her as well.
Dr. Laurie Marbas
(15:48)
Excellent. Dr. K one for you also, is there any update on the DHA EPA test to see how accurate these tests are? I'd love to participate if you're looking for volunteers.
Dr. Michael Klaper
(16:01)
I'm really on the knife edge about this. Nobody really knows whether you can make a solid case for taking supplemental DHA. You can make a solid case or you're trusting your body and easily sueable either way these days. DHA and the omega 3's are involved in so many reactions. I had no idea. The powerful anti-cancer effects they have that cancer cells thrive on inflammation, and the DHA, there're molecules that specifically call in cells that wipe up the debris after cancer cells die. So the inflammation doesn't continue on, who knew, but you need DHA for that. And do I want to short change that in any way? I'm leaning back more towards taking DHA. But again, a couple hundred milligrams, couple times a week, not every day. I'm going to be putting out a video on this soon, but I've just been researching this.
Dr. Michael Klaper
(17:08)
I had my own numbers done. They were low. They were funny. I sent it to four different labs. I got one as low as 1.2, another one as high as 3.7. None of them were terribly high. So I don't know, I'm leaning back towards putting it back in my diet here, but it still doesn't stop me from a couple of tablespoons of ground flaxseeds and chia seeds on my oatmeal and a handful of walnuts on my salad and lots of green vegetables. And you still want to give your body as much of the raw material to make DHA as you can. But someone said, no other society's been pure vegan all throughout history, usually a slow lizard wound up in the pot on most nights. Most people had a little bit of meats every once in a while.
Dr. Michael Klaper
(18:03)
And here we are straight arrows going without preformed DHA. And I'm assuming my liver and my brain will make everything, but how can you really know that you can't really, you can't really measure it in your brain there. But the low quote, omega indexes, whatever that really reflects your risk of heart disease, if it's below four. Well, if you're eating rice and beans and greens and fruits and veggies, that doesn't really apply to us folks that are really eating a whole food plant based diet. So that carries less weight with me. But again, it's the dementia, and mental clarity, as we age, I'm turning 75 this month.
Dr. Laurie Marbas
(18:51)
Oh, happy birthday.
Dr. Michael Klaper
(18:52)
Well, thank you. Not until July, but yeah, two months ago I was 52. And then last month I was 60 and couldn't believe his little man looking back at the mirror this morning, but so what's happening with the DHA in my brain, with all this, you hope it's okay, but I don't know. I may get back on. I'll make a video, but it's going to have basically this flavor that it's a kind of a toss ups, which side you want to err on here. And I think it's pretty safe to take a low dose of that stuff. So stay tuned. But that's where I am with the, wherever this question really wanted me to go.
Dr. Laurie Marbas
(19:32)
Cautiously approached. I love it. Okay. Here's another question we're kind of bump over into the diabetes realm, higher blood sugars. Someone is asking about what CGM they recommend. I would recommend, especially if you're not an insulin independent diabetic, the FreeStyle Libre will be the cheapest version. It is a prescription. Any of our doctors can prescribe it for you. They can actually follow with you on the Libre. And it's pretty cool. Otherwise, most of my insulin-dependent diabetics are going to be using the Dexcom because they're making insulin decisions. It tends to be a tad bit more accurate for most people, but the Libre can be very accurate for others as well. But this kind of goes into this question. “For years, I've had an A1C of 5.8 and glucose over a hundred. It seems to be my baseline, but my PCP wants to diagnose me as type II. This has been tracked since 2007. I am eating whole food plant-based, no processed foods. And the only sugars I eat comes from fruit. I exercise at least 30 minutes a day, four days a week. Should I be concerned?” Go ahead guys.
Dr. Michael Klaper
(20:32)
No, in my opinion. Go live your life. The tyranny of the numbers here, my God, this woman, assuming she's lean and active and plant based. She's never going to develop type two diabetes with again, rice and beans and green and fruits and veggies. Don't ask that much insulin and she should be fine. Her artery should be open and she should be okay. And numbers, numbers. We give them the way more power than they deserve. But look at the patient doctor, is this woman really at risk for getting type II diabetes? I would dare say not. Measure her C-peptide and all that stuff, but I think she'll be fine. And don't worry her with a disease. She's probably never going to develop in my humble opinion.
Dr. Laurie Marbas
(21:20)
I agree Dr. K, because when you look at this a 5.8, first of all, that is so close to bringing nondiabetic range. Okay. First, you don't need additional medications. You don't need to have that diagnosis on you because you don't truly meet type II diabetes criteria, number one. But the C-peptide if you're really curious about what's going on, would be a very interesting test to get, and then maybe a month or so on a CGM and seeing where things are going. Maybe you're eating some foods that are causing the blood sugar to run up a little bit higher and you can make those adjustments if you'd like to. And it would get your A1C down very easily and very quickly, but you just may not be making the quite enough insulin for a variety of reasons. I don't know your whole history, but that's probably, and in my opinion, that's probably what's going on just because I've seen so many of those cases, but anybody else, any thoughts on that?
Dr. Niki Davis
(22:08)
Well, I was going to say as a former engineer, I love the numbers. I love looking at the numbers, but they're just a tool, right. And I have this conversation with people about labs. We were talking earlier about BMI. BMI is a tool, it's not perfect. These lab tests are also not perfect. And you really do have to look at the entire person taking that lab tested to account, of course, but you don't want to focus so much on those numbers that you get out of the way of what's most important, which is living a healthy lifestyle.
Dr. Laurie Marbas
(22:42)
Exactly. Excellent. Excellent. Okay. And here's another good one too. “I'm coming up on five years since my diagnosis of prostate cancer, a whole food plant-based diet for four and a half years, still no treatment. Is there a doctor in Oklahoma city who could help me refine what I'm eating?” Yes. Any of our doctors licensed in Oklahoma, or who are you guys, or I know Chris is.
Dr. Chris Miller
(23:04)
I know. Have to look.
Dr. Laurie Marbas
(23:06)
Okay. Definitely, Chris. Yeah. So we definitely have other doctors who are licensed in Oklahoma who can help you 100%.
Dr. Chris Miller
(23:13)
Yeah. Definitely. I'm very familiar with prostate cancer. So I would be happy to see you.
Dr. Laurie Marbas
(23:19)
And Debbie says, she's very excited to see you, Dr. Miller.
Dr. Chris Miller
(23:21)
Okay.
Dr. Laurie Marbas
(23:22)
She's on upcoming appointment. Here's a good question, too. “What could cause low ferritin when hemoglobin levels are in normal range?” That's interesting. I've been diving into the ferritin rabbit hole recently, but go ahead, guys. What do you think?
Dr. Chris Miller
(23:36)
Well, ferritin is your iron store. And so when you're on a whole food plant based diet, your body absorbs the iron. It's the non-heme iron that's in plants versus the heme iron that's in animal meat and animal food. And so with the non-heme iron, your body regulates and absorb what it needs. So if you get sufficient iron, you may not be getting all the stores of iron. So you may have lower ferritin levels, but you should have enough iron to at least make your hemoglobin, make your red blood cells, not be anemic and have energy to do everything you need, but you may not have the store in iron is one thing, one possibility, given that you're on a whole food plant based diet, and it's not as absorbable.
Dr. Chris Miller
(24:20)
And for some people that doesn't bother them at all, they have good energy and they're doing great. And so we don't care, but there are other people who have fatigue and their ferritin is low. And sometimes they actually do benefit from just a little bit of iron with their energy. But if you don't need the extra iron, I don't recommend taking a supplement because you really don't want to take extra iron unless you actually need it. So that would be something I would only say to work with your doctor and not to do by yourself, but I'd be curious to see what everyone else thinks about that.
Dr. Niki Davis
(24:50)
Yeah. And Addition to the-
“Dr. Alon Sitzer
(24:52)
Is this a male or a female?
Dr. Laurie Marbas
(24:55)
I think it was a female.
“Dr. Alon Sitzer
(24:56)
Okay.
Dr. Niki Davis
(24:58)
In addition to the ferritin, if you're treating low ferritin in a person who's not anemic, does not have low iron, definitely can sometimes help with energy and there's research that shows that. But also I've noticed that it also has been helpful in mood disorders as well. Sometimes people who have depression, if their ferritin is low and they are taking an iron supplement, that they have had some people with some mood improvement.
Dr. Laurie Marbas
(25:28)
That is really cool. Yeah. That's a really interesting study on the ferritin store. So non-anemic females, excuse me, and their ferritin was less than 50, fatigue was a large complaint. They did an intervention with low-dose iron supplementation, ferritin bumped over 50 and half of them have actually improved in their energy levels. So that is something definitely to consider and talk about. There's lots of reasons, but you also want to understand looking for the cause of loss of iron. Is it an absorption issue? Are you not getting it in via enough food or are you losing it or something else going, are you not making the red blood cells? So there's lots of things that could be occurring here. There could be some genetic issues, thalassemia, lots of different things going on here. Gut health, all that. So really, really, really, like Dr. Miller said, do not do this on your own. It should be another guidance of an incredible physician, like one of ours. Alon, did you have a suggestion or thought.
“Dr. Alon Sitzer
(26:20)
Well, I just wanted to add women are more prone to losing, having low iron or even low ferritin because you bleed once a month and I've seen cases like that. So just again, just medical history, just something to, I don't know who it is out there, but yes.
Dr. Laurie Marbas
(26:41)
That's where we kind of, and remember this is not medical advice. This is just generalized some information, and then we're always encouraging to follow up with your doctor or one of us. Yes. Dr. K.
Dr. Michael Klaper
(26:51)
Yes. Just to put the cherry on it. That appropriate analogy, I guess, but food is important. Again, make sure there's no iron loss or that you're not eating stuff that's really interfering with iron absorption, but one way to increase iron absorption, because it's a tough mineral to absorb. Well, I think the absorption fractions like 1% on it, but you can increase the absorption fraction one by obviously chewing your food to a cream and breaking up those cell walls of the kale and the chard, all green foods have iron, but also you can increase the iron absorption across the intestinal membranes by the additional vitamin C that does not mean taking a vitamin C tablet. It means if you've got a heap of kale or broccoli in front of you, squeeze some lemon juice over it. If you are making spinach salad, throw some mandarin orange slices in there, get that citrus and greens combination going and dried fruits, some raisins on your oatmeal and some prunes at night, et cetera, also give you a little bit of iron boost as well.
Dr. Michael Klaper
(27:56)
And finally, if the doctor does recommend an iron supplement, if they just want to boost it up quickly, now the one I've had good luck with is a liquid that you get at the health food store or online called Floradix. I have no connection with the company, but it's a sweet, dark liquid made of raisins and apricots and prunes and fruits that have a lot of iron in them. And a couple of teaspoons give you 10 milligrams of iron a day. So rather than the ferrous fumarate tablets or whatever, I like the couple teaspoons of Floradix in the morning with breakfast. So that's my wrap on iron there, but make sure that all is well, as far as your iron absorption and you're not losing any points, you were very valid.
Dr. Laurie Marbas
(28:45)
Yeah. And any medications too. Yeah. Go ahead doctor.
Dr. Niki Davis
(28:47)
Have you noticed that Floradix is that what you said?
Dr. Michael Klaper
(28:52)
Floradix, F-L-O-R-A-D-I-X.
Dr. Niki Davis
(28:53)
Okay.
Dr. Michael Klaper
(28:53)
Yeah.
Dr. Niki Davis
(28:55)
Do people have less constipation?
Dr. Michael Klaper
(28:57)
Yes, they do. It's a mild little… Dried fruits are a little bit of a lax group there and yes, iron is notoriously constipating and this Floradix-
Dr. Niki Davis
(29:05)
Right.
Dr. Michael Klaper
(29:08)
Actually is not.
Dr. Laurie Marbas
(29:10)
Good. I like Solgar as well. It's a different form of iron. And that seems to work well too with some of the patients. But I had one patient when we were doing, she was a non anemic with ferritin. She thought her whole life was super charged when we got her on the right. Because she was having heavy periods, but I'm telling you, she was like, holy moly. I can't believe it. So-
Dr. Chris Miller
(29:30)
No, it definitely makes a difference. I've noticed with given patients.
Dr. Laurie Marbas
(29:33)
Absolutely. Okay. So we're a few more questions guys. You guys cool with maybe two more questions? I think there's some good ones here. “Do I need to be too concerned about too much plant protein, for example, too many beans in a day.” So this is the opposite of what we normally get questions. What do you guys think?
Dr. Michael Klaper
(29:53)
No. As long as it's in the form of whole food, that it's beans and lentils. No. How many beans can you eat there? Most of it would just pass out as fiber, but the protein powders, throwing a hundred grams of P-protein into your smoothie, not a great idea. You may form some nasty microbes in your gut and all those amino acid slam into your kidneys and shifts them into hyperfiltration. It's not a gentle thing to do to your body. No gorilla does that. No [inaudible 00:30:20] does that and shouldn't either of that. That's one of this whole plant food, no, I don't think you can get into trouble there.
Dr. Michael Klaper
(30:29)
I'm looking to bringing those two in the chart here. There is a lady facing a trouble with hip replacement. Her albumin level came in at 3.2. Doctor said he'd like me to be up at 3.5 for surgery, eating plant-based greens and beans, et cetera. But here's a woman who really needs an extra scoop or two of lentil stew on a daily basis there. If she might benefit from a tablespoon of the protein powder for just a month or so mixed into her soup or a smoothie or whatever, don't go overboard with it. But yeah, high protein, whole grains and legumes are this woman's friend. Assuming she's got a healthy liver but this is not a sign of that she's having problems synthesizing albumin. So have your doc check that out. But yeah. Put the pedal to the metal with the legumes in preparation to surgery there and take a good walk every day. Back to you.
Dr. Laurie Marbas
(31:24)
Absolutely. Anybody else.
“Dr. Alon Sitzer
(31:26)
I guess, as long as it doesn't give you too much gas, you're good to go.
Dr. Michael Klaper
(31:32)
Yeah. It may for a while, this too shall pass and you know, it decreases after a while.
Dr. Laurie Marbas
(31:37)
Oh my goodness. Puns are among us today. All right. So last question. “Would you recommend changing from an SSRI to whole plant-based diet to treat generalized anxiety disorder?” So I'd really like to talk about the mental health things. And I think that is often not expressed or discussed often. What do you guys think?
Dr. Kim Scheuer
(31:58)
No matter what you should be on a whole food plant based diet.
Dr. Laurie Marbas
(32:01)
Absolutely.
Dr. Michael Klaper
(32:02)
If somebody didn't hit that ball, I'd be disappointed. [inaudible 00:32:06] soft ball there I could.
Dr. Laurie Marbas
(32:09)
Okay. Yeah. So there's some interesting research showing. There's a book called Psychobiotics. You guys might want to check it out. It's not strictly plant based, but it's really interesting in their research about a third case is a depression and anxiety related to the foods reading. So there's a new type of practice called clinical psychiatry where they're looking at food and nutrition to treat these type of disorders. So now this doesn't mean that you don't still maybe require medication, but this may lessen your need for it, or may be able to come off it completely. It's definitely not something you want to do on your own. You should be under the guidance of a physician who can help walk you through that process, engage you in your journey, because this is not an overnight fix, and it would definitely take some time, but it goes back to gut health in that brain gut access, for sure. But, any other thoughts on that? Dr. Alon.
Dr. Niki Davis
(33:04)
Go ahead Kim.
“Dr. Alon Sitzer
(33:05)
Oh, I was just going to say, it's not one or the other. There's a lot of factors that go into general mental health and definitely Pearl would be, you don't want to just stop that SSRI, kind of cold turkey that could definitely give you a form of a withdrawal symptom syndrome. That's kind of very uncomfortable, made me take you a few, two steps back that you wanted. So it's working hand in hand and do whatever you can to basically love your body, love yourself. And also help all those reasons that are causing anxiety, whatever the fears are underlying and et cetera, but definitely healthy nutrition is key to coping with anxiety, for sure, and exercise, of course, and strength training, making our body strong and our mind stronger cetera, et cetera.
Dr. Laurie Marbas
(34:04)
Excellent. And a good reference is Dr. Jud Brewer's website. Go to Dr. Jud, jud.com. And he's got a wonderful app called unwinding anxiety and also a book called unwinding anxiety. So we are collaborating with him and I would definitely encourage you to check that out as well. Kim.
Dr. Kim Scheuer
(34:22)
Yeah, this is not a one thing. It's not just food. It's not just exercise. It's not just some help with possibly cognitive behavioral therapy or other therapies or your environment, the stresses around you and how you deal it. It's everything. Do it together. And if you need some meds, we're lucky we have some of that, but we want to take the least that works.
Dr. Laurie Marbas
(34:47)
Absolutely.
Dr. Niki Davis
(34:47)
Yeah. And I was going to say, I recently had a patient with pretty severe depression and anxiety who was not wanting to start a medication right away, but she had been eating more of a standard American diet and switched over to a whole food plant based diet. And her depression and anxiety became so much less severe that it felt like, I mean, she said she felt like she had been taking some sort of a miracle medication because she felt so much better. So she's probably one of those that may not end up meeting any sort of medication, but she's also getting therapy as well, doing CBT. But just to know that there is a lot of benefit to be had from just the way your lifestyle and that includes your diet.
Dr. Laurie Marbas
(35:38)
Absolutely.
Dr. Chris Miller
(35:39)
And your studies that support exactly what you just said, Niki, in that I think it was Dr. Gregor who reports that there were, in one study that if people who ate more than nine servings of fruits and vegetables per day reported significantly less depression or mental health concerns. And also we know that if your omega 3's are deficient, so inflammation leads to mental health and there's the brain gut access there too.
Dr. Chris Miller
(36:07)
So looking at your omega 3's, so just on a really good plant-based whole food diet, removing pro-inflammatory foods, eating these anti-inflammatory foods and then moving your body. So exercise has been shown to be as effective as antidepressant for mild to moderate depression in people. If you're not exercising regularly, you're missing on and that antidepressant that's right there. And that's two of them with your food as well. Yeah, like all the other doctors said hit it from all angles and you should be able to at least get better control. Then if you still need a medication, maybe not as much, or you could work towards tapering down over time.
Dr. Laurie Marbas
(36:50)
Okay. I think we're good. That was an excellent round of questions, guys. There's a ton we didn't reach, but oh my God, we'd be here for three hours. So, but thanks everyone for tuning in again, you can see any of these doctors here and many of our others that are not here today on plantbasedtelehealth.com and we're across all 50 states, and internationally, we can see you as well. So check us out and we are hope to see you next Friday at 11:30 AM Mountain Time. Y'all figure it out from there and have a good one. Take care. Bye.
Dr. Kim Scheuer
(37:24)
Will be happy.
*Recorded on 3.10.22