On this Q&A plant-based doctors Dr. Chris Miller and Dr. Laurie Marbas welcome Dr. Kim Scheuer and answer questions about fibromyalgia, Impossible burgers, and Iodine tests.
Questions Answered
- (00:03) – Introducing Dr. Kim Scheuer
- (02:34) – Do children who eat plant-based three to four days a week still need a B12 supplement?
- (05:07) – How do I conquer fibromyalgia?
- (09:48) – In what states is Dr. Kim Scheuer licensed?
- (11:42) – What are your thoughts on saturated fats in Beyond burgers and Impossible burgers?
- (19:27) – How much is the daily minimum milligram dose of B12 for adults? Are there any side effects if you have too much B12?
- (24:35) – What is the best method to test iodine levels?
- (26:33) – My doctor told me not to eat soy, cruciferous veggies, millet, et cetera. Could you explain how people can enjoy these healthy foods when taking thyroid medications?
- (36:49) – I get a lot of gas after eating beans. Any suggestions?
Complete Transcript
Dr. Laurie Marbas
(00:03)
Welcome everybody, and today we really want to highlight our very special new addition, Dr. Kim Scheuer. How are you?
Dr. Kim Scheuer
(00:11)
Hi, I'm happy. How are you? It's so great to be joining you guys. You guys are wonderful. I'm so excited.
Dr. Laurie Marbas
(00:17)
This is fantastic. So Chris, you want to start the questions? Let's just bombard her. No, I'm just kidding.
Dr. Chris Miller
(00:24)
Well, welcome Kim. It's awesome to have you here, or Dr. Kim-
Dr. Kim Scheuer
(00:28)
Thank you so much.
Dr. Chris Miller
(00:28)
… Scheuer I should say. But I will just say that I've known Kim for a long time, because we both come from the same area, Aspen, Colorado. So I've had the pleasure of working with her for many years. But do you want to start off by telling us who you are? And what you do? And why you are so happy to be here?
Dr. Kim Scheuer
(00:46)
I am thrilled to be here. So my name is Kim Scheuer. I'm double boarded in family practice and lifestyle medicine. I have lived in Colorado for over 20 years, love my mountains. And I started in traditional family practice, but then when I was 47, decided that I didn't want to get the breast cancer my mom had at 48, so I started to look at how I could prevent that. And found out about lifestyle medicine, eating healthier, stressing less, moving more. And I already lived place where we move a lot, but moving more appropriately and having some fun. And it changed my life.
Dr. Kim Scheuer
(01:27)
Eating plant-based just… I was a Milky Way vegetarian for most of my adult life, which was a junk food vegetarian. I liked lots of sweets. I liked lots of cheese. I liked lots of junk. And I had struggled with my weight all my life, too, until I started this, to try and prevent myself from getting breast cancer.
Dr. Kim Scheuer
(01:50)
And the research was unequivocal. The effect on my body, I mean, immediately I lost weight. I had more energy. I felt great. My cholesterol plummeted. I now have so much less concern about getting chronic diseases. And it worked so well on me, then I started using it on my patients, and reading more reading, watching [inaudible 00:02:15], and reading the China study, and Dr. Fuhrman's books, and Dr. Greger I got involved with, and it was mind-blowing. And it's changed my life, my practice, my style, and my family's lives, my patient's lives. So, yes, I'm thrilled to be here, to work with people who do the same thing.
Dr. Laurie Marbas
(02:34)
Fantastic. And so just a reminder, if everyone has questions, if you're in the webinars section, you can actually just type them in the Q&A box, please. And then on the Plant Based TeleHealth Facebook page, and if you'll just comment there and I'll be watching that as we go along. And please share this, we're live right now, if you can share it to your Facebook feed or to any groups that you feel would be appropriate, that people might benefit from asking us some questions. We're super excited. So Kim we have the first one? So if you have children… You're like, “Yes.” All right, “If you have children who eat plant-based three to four days a week, do they still need a B12 supplement?”
Dr. Kim Scheuer
(03:18)
Are they asking me or somebody who has children in this group?
Dr. Laurie Marbas
(03:19)
Yep, we're going to… Well, you're a family doc, what would you recommend?
Dr. Chris Miller
(03:24)
Yeah. We're giving you a chance to get to be known. And then we'll also chime in here and there, but this is your chance today.
Dr. Kim Scheuer
(03:30)
Yay. So for adults, I definitely think that you might, depending on the age, too, because as we get older, we lose our ability to get the B12, but I think B12 is very important for folks. I like to get it naturally in foods. Now that means supplemented in foods, so there are some foods that are supplemented with B12, like there is nutritional yeast that can be, and some other things that have it in it.
Dr. Kim Scheuer
(03:58)
In adults, I tend to usually suggest check a level, and if you're low, yes, absolutely. And most of the time, most adults, whether they're plant-based or not will need some B12. And so, yeah, I think that it might… I would actually defer to Laurie, because you have children, what do you say?
Dr. Laurie Marbas
(04:19)
Oh yeah. Yeah. Yeah. Kids are really interesting, so depending on the age of the child, and what are they eating the other three days? Are they still plant predominant those other days? Why are you only feeding them three or four days? Are you moving towards strictly plant-based? And I think even a lot of my omnivores in the past have also been low in B12. So I think, honestly, it's a smart idea, that children should be on a vitamin D and B12. It's not going to be harmful. And like, Chris, or I'm sorry, Kim was saying, I'm so used to saying Chris, Kim was saying, that this is really, test don't guess. If you really concerned about it, go ahead and test them.
Dr. Laurie Marbas
(04:57)
But some of your non-dairy milks will also have B12 and some of the cereals and things. But Dr. Miller, any other thoughts?
Dr. Chris Miller
(05:05)
I agree with you guys. I love it.
Dr. Laurie Marbas
(05:07)
Awesome. Okay, next question. Sharon asked, “How do I conquer fibromyalgia? I'm plant-based already, do you any suggestions or thoughts on investigations or [crosstalk 00:05:18]?”
Dr. Kim Scheuer
(05:18)
Absolutely. So fibromyalgia is huge, and I love it that you're plant-based. That makes a huge difference, because you want to flood your body with nutrients. Just flood it with nutrients and keep out toxic things, but, also, it's so important to move for fibromyalgia. You don't want to move too much so you can't move the next day, but you do need to start building up some movement and that would be just walking or a natural movement. If you have a garden, that's a great way to do it.
Dr. Kim Scheuer
(05:53)
That's what I like with fibromyalgia. Plus, make sure you're getting your B12, your vitamin D. You may want some DHA and EPA, a vegan DHA, EPA, and things like that. But those are some of the things. And stress, stress is so important with fibromyalgia. We all have stress, it's how do you deal with the stress? So limit as you can, but also how you deal with the stress, and learn ways to breathe. There's breathing techniques, there's meditation techniques, so all of those are extremely important with fibromyalgia. And then I suggest talking to somebody like Dr. Miller, who's like the queen of-
Dr. Laurie Marbas
(06:39)
Inflammatory conditions.
Dr. Kim Scheuer
(06:40)
Yeah, absolutely.
Dr. Chris Miller
(06:45)
So great question and great answer, Kim. So for fibromyalgia, like other immune responsive diseases, I guess, where people are under inflammation, where they're feeling aches and pains and discomfort and fatigue. Fatigue is such a hallmark of it, that can be debilitating as you probably are well aware of. And so we treat that kind of similarly by the lifestyle and diet factors. So getting the microbiome under control with the right foods, healing a leaky gut is huge. So taking care of your gut health is really, really going to be important, and flooding with those nutrients. So especially raw dark leafy greens, really important to get those in. And if you have food sensitivities, we have to deal with those, so that your gut is functioning well.
Dr. Chris Miller
(07:38)
So we give be the right foods. We remove anything that's a trigger for you. And that includes food, so that's an important thing. People have a lot of food triggers, so we got to remove those. And then we remove other triggers. So your emotional triggers. Those thoughts that are holding you back, those worries, those fears, those doubts, those concerns, and this has been the worst year of all for it, with us all in lockdown with COVID and under stress that we never had before.
Dr. Chris Miller
(08:04)
So this is tough for me to say this right now, but it's something that we have to work on, and there's all sorts of things. Kim has given you some of her favorite mind/body tricks, and it's all about changing how we perceive our stress. And so there's so many different mind/body things that we can and work on from meditation to yoga, to being outdoors, to deep breathing, to laughter, to reading a good book, to taking a hot bath, to all of these things are going to help calm down your overactive sympathetic nervous system.
Dr. Chris Miller
(08:33)
So that's a part of the plan and then of course, exercise, movement. So if you're really sore, you can't do a lot, just gentle stretching, just light movement. Yoga's really beneficial for people with joint pains, with fibromyalgia, even gentle mild, if you can only do a pose, that's going to be helpful for you. So things like that, and finding what works for you.
Dr. Chris Miller
(08:52)
And sleep, it needs to be addressed. So if you're not-
Dr. Kim Scheuer
(08:57)
Yes.
Dr. Chris Miller
(08:57)
… sleeping, and it's often because you're in pain, you have all these other things going on. So we have to kind of address it all together, so that we can help your pain, and then you're able to get some sleep. We can help you relax. We can help reduce some of the tension. So it's kind of a comprehensive plan with all of that. And from there, and some people have certain things, so they'll need more of a gut health program or more of a stress reduction program, or it's kind of tailored for each person. But hopefully that's an introduction, it's a general five minute between the two of us introduction to it. And if you need more individualized help, you could see one of us for that. We'd be happy to develop a plan for you, that fits what's going on with you.
Dr. Laurie Marbas
(09:36)
Speaking of, Kim, would you be able to share with us all the states that you're currently located in?
Dr. Kim Scheuer
(09:43)
Oh, okay. So-
Dr. Chris Miller
(09:47)
I hope you know them all.
Dr. Laurie Marbas
(09:48)
Well, I'll let you look up, and then we'll go ahead and get a next question, but we would like to let the audience know where you are. And then Chris is like, it's over 20. So at this point you just have to go look at Plant Based TeleHealth and see where she's at. Let's see-
Dr. Kim Scheuer
(10:01)
So my licenses are at-
Dr. Laurie Marbas
(10:02)
Got them.
Dr. Kim Scheuer
(10:04)
… in Arizona, California, Colorado, Illinois, Maine, Nevada, Utah, Vermont, Washington, and Wyoming.
Dr. Laurie Marbas
(10:18)
Perfect. All right guys, so if you're there, that's who you need to be seeing. That's all fantastic.
Dr. Chris Miller
(10:23)
And on that same note real quick, Kim, is there a certain type of patient that you like to see or certain thing that you do see more or specialize in? Or tell us what it is, if there is, anything like that.
Dr. Kim Scheuer
(10:37)
So I love a little bit of everybody. I'm very much of a generalist. And so I've taken care of quite a few people who've had weight issues, who've had cholesterol, diabetes, more Type 2s than Type 1s that I've taken care of in the past, hypertension, let's see, cardiac diseases. I love to keep people from getting on medicines, and I love to take people off of medicines, as they can, as they become healthier. I also have worked with a very athletic group of people before, because being athletic, doesn't necessarily mean you're healthy.
Dr. Kim Scheuer
(11:19)
And so what I'm more interested is in health. There's lots of ways to lose weight, but that doesn't mean it's healthy for you. And my goal is for you to be as healthy as you can be. And I love to get families to change their whole families to a healthier lifestyle.
Dr. Chris Miller
(11:39)
That's perfect. That's-
Dr. Laurie Marbas
(11:39)
Perfect.
Dr. Chris Miller
(11:40)
… fabulous. Yep, thank you.
Dr. Laurie Marbas
(11:42)
Yes. That's excellent. And we're so excited to have you, Kim. And plus, Kim is quite the athlete. So I think she would be very good for anybody who have athletic endeavors and things like that, so just keep that in mind. Next question, I think there's a couple here that kind of go together. Someone's asking use of oil, some plant-based people differ on this. And then another question, by the same person, was, “Saturated fats in Beyond burgers, Impossible burgers, thoughts?” So just kind of in that realm, either of you want to take that on?
Dr. Kim Scheuer
(12:15)
Sure. So first of all, we definitely support and promote whole food plant-based, which is getting off the animal products and getting off of the toxins and the things like cheeses that have elements in it that are unhealthy, but we also don't want to take away healthy things. So the more natural, the more whole foods you are, the better. Now, as you're transitioning over, the plant-based burgers, like the Beyond burger that is healthier than a regular burger, but it's not as healthy. It's a good transition, if you want to transition that way. And so saturated fat is not healthy for you, just it's not. You're getting rid of some of the other things that are in there, but you want to move on a spectrum to being as healthy as you can, so that's that.
Dr. Kim Scheuer
(13:21)
Oils, oil is so think about olive oil or versus olives or avocado oil versus avocado. You're taking out micronutrients, you're taking out fiber, you're taking out some of the basic components of what makes something healthy. So I don't have oil in my house. There's no reason for me to cook with oil. There's no reason for me to use oil, and the natural oils in like a nut or a seed or an avocado has all the good component, too. So you don't want to take away the good components and you don't want to add bad components. So that's my suggestion for most folks.
Dr. Kim Scheuer
(14:05)
And it depends on where you are on the spectrum too. If you're end stage heart disease, no oils. If you are just trying to get healthier and you use a lot of oil, cut it down and start transitioning over. That's my thought, but wonder what everybody else has to say.
Dr. Chris Miller
(14:22)
I just have a thing or two to add to that. And one is that, when people are reversing chronic illness, sometimes they get stuck at a certain point. And often at that point, when we dive into what they're actually eating and look at their food diary, it's oil that often impairs the healing. It delays it, it stops it, it holds people back. And so the people who are truly healing the fastest and getting results the quickest, are removing oil and eating completely whole food plant-based, where it's not processed. So for that reason, because I am working with people reversing their illnesses, for the most part, and trying to get them off medications to age, better, to be at their optimal health, as best as they can be. So we're pushing for no oils at that point.
Dr. Chris Miller
(15:10)
And we often will see, when people are eating a clean, whole food plant-based diet without oils, and they travel and they eat at a vegan restaurant for a couple days, and choosing as healthy as they can, but maybe getting some oils in. And then they come back home and we end up doing like a cholesterol panel. We check some labs, there's a huge difference already in just those few days that they ate the oil. We see the numbers go up. So our bodies are really sensitive to it. And it's impressive the dramatic differences we see.
Dr. Chris Miller
(15:40)
And even with autoimmune diseases, when we take the oil out, we get much more, much faster response. And a lot of oils are high in Omega-6 to Omega-3, or high in saturated fat, depending on the type of oil. And so that is going to impair, when we're trying to flood the body with Omega-3s to reverse their chronic inflammation, and so, again, it delays the process. So I've learned from experience as well as reading different things that removing it is definitely optimal for optimal healing.
Dr. Laurie Marbas
(16:14)
Absolutely. Fantastic. And since most of my patients are diabetics, you guys got to stay away from the fats.
Dr. Kim Scheuer
(16:21)
Absolutely.
Dr. Laurie Marbas
(16:22)
So that will include oils, it'll include the processed foods, it includes even the nuts and the avocados, in excess. You can have some in a more minimal way of thinking about it, like a quarter cup a day of nuts, at max, those type of things. And, honestly, it really depends on how insulin insensitive, how insulin resistant you are, but someone who eats a high fat meal, you're going to see these blood sugars, instead of going, Ooh, like this, like they're supposed to, you'll go, ooh, and it takes a little while. And sometimes, especially, like Chris mentioned, going out to eat at a restaurant, you'll see people's blood sugars higher 20, 30 points for a few days. And if you're trying to lose weight, liquid fat is not going to help you, so stop it.
Dr. Laurie Marbas
(17:06)
There's no reason to be consuming oil. So you can eat the food, the whole food and still get all those amazing nutrients with liquid fat, which is literally 120 calories per tablespoon. I have to run over a mile to burn 120 calories. Not that it's a direct correlation, but just for you to think about it, that's some intense, that's a lot of energy in that one tablespoon of oil. So remember it's liquid fat, do you need liquid fat? No, it's not a whole food, simple as that. So everything there.
Dr. Kim Scheuer
(17:37)
For somebody who, myself, I'm a food addict. I love to eat. I love, love, love, love, love to eat. For years, I struggled with that. And if you think of calorie density, oil is the highest calorie density, and it's not nutrient dense. You want the highest nutrient density food that you can eat with the lowest calories. And then you can eat more. It's delicious. And you don't have to worry about your weight or your blood sugar or your cholesterol or your inflammation, and there's no question oil affects all of those.
Dr. Laurie Marbas
(18:11)
Absolutely. And I do want to mention as well, guys, the next webinar that we have, which is on March 25th, we are going to have Nelson Campbell from PlantPure. He's going to be our guest. And we're going to be talking about an exciting program that we're doing together. And then April 22nd, mark your calendars, Dr. Michael Greger is going to be hanging out with us, but we moved up the time. So it'll be at 10:15 Mountain Time, which is 12:15 Eastern. And I'll let y'all figure out wherever you guys are. But that is something to keep an eye on. Like I said, on the webinar side, you go to Plant Based TeleHealth, it tells you how to register for the webinar, if you want to just do the webinar or just come back and hang out with us on April 22nd or March 25th with our special guest. And with some additional questions-
Dr. Chris Miller
(19:01)
That's awesome.
Dr. Laurie Marbas
(19:02)
Yes. We're very excited.
Dr. Chris Miller
(19:03)
Yeah. I hope you guys can join us, and that's also Earth Day-
Dr. Kim Scheuer
(19:05)
Oh, my gosh, that's huge.
Dr. Chris Miller
(19:05)
… on that day.
Dr. Laurie Marbas
(19:08)
Appropriately, Earth Day, fantastic.
Dr. Chris Miller
(19:11)
It's also another special day, it's my birthday that day.
Dr. Laurie Marbas
(19:14)
Oh, happy birthday.
Dr. Kim Scheuer
(19:15)
Happy birthday.
Dr. Chris Miller
(19:16)
Well, not today, but April 22nd.
Dr. Laurie Marbas
(19:18)
Yes.
Dr. Kim Scheuer
(19:18)
What a great birthday present.
Dr. Chris Miller
(19:20)
We'll have Dr. Greger sing a birthday song for me.
Dr. Laurie Marbas
(19:22)
On your birthday. Oh-
Dr. Kim Scheuer
(19:24)
That's awesome.
Dr. Laurie Marbas
(19:25)
… that'll be awesome. Okay, guys. So here we go-
Dr. Chris Miller
(19:26)
Super fun.
Dr. Laurie Marbas
(19:27)
… how much… And we have another question, a few different ones, how much is the minimum milligram dose per day for adults? And is there any side effects if you have too much B12? Well, the RDA is two point four micrograms, not milligrams, micrograms of B12 for adults. But I found that typically patients have to take much more to actually absorb enough. So what I would suggest is, again, tests don't guess. There are three tests that I typically do to make sure someone's B12 is sufficient. Number one, is I test their just regular blood tests, it says, vitamin B12, then there's homocysteine and methylmalonic acid, which require B12 or B12 is required… Well, there's other ones with B12 and homocysteine, but methylmalonic acid is, literally, coupled to needing B12 to do its thing later on in its chain of events.
Dr. Laurie Marbas
(20:19)
So if those are off, we know you're not getting quite enough B12, even if your B12 level is normal, if that makes sense. So what I have found, a majority of people are needing 250 micrograms daily up to a 1,000 micrograms per day. It really depends on the person, how well they're absorbing, their age, inflammation and a variety of different things. And your levels, I found I feel pretty good if someone's levels are around 600. Most of the time, I don't see the methylmalonic acid elevated, I don't see the homocysteine elevated, and they aren't symptomatic.
Dr. Laurie Marbas
(20:53)
A little bit below that you may see some markers off a little bit on some of the others. And that's just my own anecdotal experience with patients over two decades of treating patients. So that would be my thoughts or suggestions. But there is some studies showing there may be some ill effects with B12. I don't think those are actually confirmed and shown, it was just more correlation. But you can actually, again, you test and if you're too high, you just cut back. It's very simple. It's a water soluble vitamin, and it's going to be quickly released into your urine. So you also want to take too much, because it's expensive urine. So that's where I thought on that, but any of you guys have any thoughts on the B12?
Dr. Chris Miller
(21:34)
Yeah, I agree with you. I like the level between 600 and 900 for similar purposes. And there was a study that showed that, and again, it was just a correlation, but it came out in the past year or two years, now, maybe, but that showed that people with really high levels of vitamin B12 had higher all-cause mortality.
Dr. Chris Miller
(21:57)
So what does that mean? We don't know what that means, but still there was a link where we used to say, “Oh, it's safe. You just pee it out. It's no big deal.” And now we've kind of backed down, if the level's high when we test it, then we do cut people down.
Dr. Laurie Marbas
(22:09)
Yeah, exactly.
Dr. Chris Miller
(22:09)
And I have patients coming in who've had huge amounts of B12, so I definitely check it like Laurie checks it, Dr. Marbas, and make sure that everything is okay and not too high. And if it is, we cut it back to a safe amount. But you definitely want to take it. Everyone, you definitely want to take it, because you can get anemic and you can get nerve damage, peripheral neuropathy, numbness, tingling, weakness, things like that, that's permanent, so it's a big deal. You can get people with what we call ataxia, where you're not able to walk straight, all sorts of things that's very serious. And low energy because of the anemia. So it actually is really important.
Dr. Chris Miller
(22:48)
And especially people with gut health issues. So anything GI related, if you have IBS, if you're not digesting your food, if you have celiac disease, many autoimmune people, your gut is not absorbing nutrients appropriately. And it's hard to absorb the B12. It happens in the stomach. It requires another protein to bind to it and pull it in. And so a lot of people are not digesting it, especially as they get older. And so it is important that you do take it and you take a good amount. So 250 to 1,000 is a great place to start for everybody. I usually start 500 to a 1,000 just to be safe, but anything like that, you'll be fine.
Dr. Laurie Marbas
(23:25)
Yeah. I'd say majority of people end up being over 500 daily that they require, to get the levels where we need them. But Kim, any other thoughts on any of that?
Dr. Kim Scheuer
(23:34)
Yeah, I was thinking there's a lot of over-the-counter medications that can affect the absorption of it. So I mean, I agree with Chris and Laurie, but you want to make sure, check the levels and that helps to really do it. And I have had a lot of people on way too much, and they have had some side effects, again, anecdotal, but I try and cut them down. You want to be in the right range, but taking it.
Dr. Laurie Marbas
(23:59)
Absolutely. And so then we have a couple of iodine questions, so I'm just going to get… And iodine, just for everyone understands, it's very important for your thyroid health. So this is something to consider, because we have a lot of salt-free patients now. So it's really interesting to see this different, not everybody, but we do have a subset of patients who are coming to us and they're very strict about their diet. And these are things that really should be actually looked at, because they made table salt iodized, because they want to treat the iodine deficiency that can cause goiters and some other things with the thyroid.
Dr. Laurie Marbas
(24:35)
So anyway, there was a question here from Kip, “What is the best method to test iodine levels? A 24 hour urine test?” Yes, that is correct. And any suggestions getting iodine your diet? Was kind of the other question.
Dr. Kim Scheuer
(24:48)
So for getting iodine in the diet, one is you can do some supplements, like Complement has a supplement that has it. Seaweeds or sea vegetables have a lot of iodine. You have to be careful not to get too much and not too little. So you don't want to get… There's nori, you can have a square a day or a sheet a day, but some kelp you have to be careful on how much you put in. So those are a couple of ways that I think of getting iodine. And you have to be of salt, because there's certain salts that are not… First of all, you don't want extra salt, but if you're at the restaurant, the salts that they tend to use, don't have iodine in it, so don't assume you're getting it that way. Other people, Chris?
Dr. Chris Miller
(25:46)
I don't have much to add to that. I agree with you. If you're getting it from sea vegetables, just be careful how much you're getting, because I have seen… Actually, I've had two patients just in the past two weeks, who've come in with thyroid… one was hyperthyroid and one is hypothyroid from iodine excess. So it's interesting, they started adding sea vegetables into their diet, and they're not supplementing with anything else, but they're adding the sea vegetables in their diet, and their iodine levels went high, and they started having thyroid issues. So rapidly we jumped on that and started working on that. And one of them has fully improved and the other is starting to make slow changes back. So thankfully we are catching those, but you do want to monitor that very closely.
Dr. Laurie Marbas
(26:33)
Absolutely. And speaking of thyroid, here's the next question. Denise says, “When I teach people with hypothyroidism, they always ask, ‘My doctor told me not to eat soy, cruciferous veggies, millet, et cetera.' Could you explain how people can enjoy these healthy foods when taking thyroid medications? Thank you.” Well, I for one have been hypothyroid for 25 years, and when I switched to a plant-based diet, I have flooded my body with these things on a daily basis. And my thyroid got better, not a 100%, I still take a lower dose of medication.
Dr. Laurie Marbas
(27:02)
So that's, again, anecdotal, but also when you're eating these foods, they're not going to just make the thyroid worse or block… I mean, it's just crazy to me when people say avoid these very healthy foods, when the effect is not going to be detrimental, unless you're eating a whole bunch of these foods, like I'm talking way more than most people can consume. But any of you guys have thoughts or question or suggestions on that?
Dr. Kim Scheuer
(27:27)
One thing I have is to make sure you don't have the foods with the iodine that you're supplementing. So separate the time of when you eat anything, and you take your thyroid medicine, because that can affect the absorption, so that's my thought on that one.
Dr. Laurie Marbas
(27:43)
Definitely take your iodine, your thyroid medication-
Dr. Kim Scheuer
(27:47)
Thyroid.
Dr. Laurie Marbas
(27:48)
… on an empty stomach, so that's the first thing I take in the morning. You don't even want to take it with tea. You just want to take it with water or something like that. And so you just take it first thing in the morning, an hour later, it's okay to eat. If you take it in the evening, you want to be at least three or four hours on an empty stomach. So it's just easier to do it when you first way it up. So you're exactly right, you want to take it without these other foods that may inhibit the absorption. So, again, these are things that should be tested. Have them eat these [inaudible 00:28:14] and foods and then say, “Why don't you go get tested and see if that made a difference?” And so if anything, I would hope that they would get somewhat better. Chris, any other thoughts?
Dr. Chris Miller
(28:22)
Yeah. And so the people who have had had problems with soy or with cruciferous vegetables, which also can inhibit iodine absorption into the thyroid, so you get that, you can have thyroid problems with high amounts of these vegetables, is when their iodine is low. And so that's one thing. If plant-based eaters aren't paying attention to their iodine level, and then they start consuming a large amount of soy products and cruciferous vegetables, they can actually run into some sort of problem. There's not a lot of studies supporting that. A lot of it's still theory, but there are a few case reports of this out there. So it's something we're cautious about.
Dr. Chris Miller
(29:00)
And so you just want to make sure you're getting the proper amount of iodine and then it is safe. I have patients who are consuming large amounts of both of those, and actually improving their thyroid. We have several people improving their thyroid numbers, improving their thyroid antibodies for Hashimoto's, and they're eating large amounts of these values. As long as we make sure their labs are okay, and we keep an eye on things. And, yeah, enjoy these foods, you need to eat them. There's super for healthy. They're going to heal you.
Dr. Laurie Marbas
(29:28)
Yeah, absolutely. Recently had a patient whose hypothyroid, Hashimoto's, her TPO or the thyroid peroxidase antibody was over 800, went on a plant-based diet, six months later, her thyroid antibody is zero. So-
Dr. Kim Scheuer
(29:42)
Nice.
Dr. Laurie Marbas
(29:43)
Yeah. And the only thing she changed was what was entering her mouth, and there's lots of soy and cruciferous vegetables. So, again, reassure them, and if they have any questions, send them our way, we'll be happy to answer those questions for them. So there's so many good questions here, I'm trying to piece them together. One that I really would like to reference here is, she says, “Postmenopausal and weight will not come off,” she's whole food plant-based and oil free. “Anything else I can try to tweak?” So go ahead guys, what would you like to say to that? I have my own thoughts, but go ahead.
Dr. Kim Scheuer
(30:24)
Well, I'd love to know exactly what you mean by whole food plant-based and no oil. That's great, keep it up. But what exactly are you eating? Are you eating a lot of nuts and seeds or a lot of dried fruits or what are you drinking? Things like that. Those are some things, have you checked your thyroid level? Are you exercising and moving? How's your stress level? There's a lot of things that I would look at. There's a lot of oils hidden in things, so we got to make sure, a 100%, you're not having that. And then watch the high calorie foods, the high calorie density foods. So I tend to love to… I'd have to see a three day food diary, and even just writing the diary sometimes helps to get you aware of what might be in there that you don't know about. But those are some initial thoughts I have. How about you guys?
Dr. Chris Miller
(31:23)
So, yeah, I would say whoever asked that question that is very common, and it changes, your hormones are changing, and things are different and it is tough. Postmenopausal weight gain is real, and it is tough actually for people. So you're not alone in this, and it's not all your fault. Your body is changing without you even knowing what's going on. But that being said, so cleaning up the diet, as Dr. Scheuer was explaining, is definitely one thing that you can look at. And so maybe adjusting the amount of fat intake, maybe adjusting amount of certain foods and adding more leafy greens to it, or there's little things that we can tweak about it to help you. Depending, you might already be doing that, and it's still not working. And that can be true too, so that's usually not always enough.
Dr. Chris Miller
(32:12)
And so changing the timing of eating. So-
Dr. Kim Scheuer
(32:17)
Yes, huge.
Dr. Chris Miller
(32:17)
… practicing a little intermittent fasting, where you are stopping eating a little bit earlier in the evening can make a big difference. And a couple other things is that I really help people address their stress level. Stress, and especially in that age and things are happening and maybe you're not sleeping as well, and now you're not feeling as great, and there's all sorts of things happening. So sleep and stress are going to be really important also for weight loss.
Dr. Chris Miller
(32:46)
And finally, with exercise, what I start to tweak is studies have shown that high intensity exercise are actually more beneficial for postmenopausal weight loss. So adding a high intensity type workout, even just a few minutes, a couple days a week can start to make more of a difference. Of course, you want to do your cardio and you want to do your strength, the resistance training, all that's for health benefits. But for postmenopausal weight loss, I definitely add the high intensity to their plan, and see how they do with that. And then from there it could be individualized. It can take other tweaks. So see what Dr. Marbas has to add to it. And hopefully this will help you.
Dr. Laurie Marbas
(33:29)
Yeah. So I just turned 50 last year, so I'm entering into this weird things are just different. When I was 40, it's different than when now I'm 50. I cannot eat as much or same as I did then. It's just the way it is. My thyroids have still been regulated well. So it's just something to keep in mind that exercise is important, your sleep and stress, like everything was saying, but there's two things I found to, be very effective. One start tracking actually what you're eating, because you can overeat on a plant-based diet guys. I don't care why people say-
Dr. Kim Scheuer
(34:03)
Absolutely.
Dr. Laurie Marbas
(34:03)
… you can eat all you want. That is not true. A calorie is still a calorie. But sometimes people focus on eating nuts and peanut butter and all those are still plant foods. People may think, oh, I'm going to be eating a whole avocado or half an avocado every day, no big deal. And before you know it, you've eaten an extra 500, 600 calories. One pecan half is like 10 calories. And I love pecans, can't have pecans in the house. But those are just some things to keep in mind that you may be over consuming things that you're not really aware of. Are you snacking between meals? So make it definite meals, hold the snacking. The intermittent fasting is huge. And then-
Dr. Kim Scheuer
(34:44)
Huge.
Dr. Laurie Marbas
(34:44)
Absolutely huge, because what happens is you find that you're, one, yes, you're having this fast, which does help, but you're also eating less calories. Because when your window is shorter, you just naturally eat less. And I'm not saying you go to bed hungry, but what I am saying is that you just want to be cautious of the timing of eating, because as you eat later, there is some studies indicating that those who eat, if they have third shift or if they eat later in the evening, they have a harder time losing weight, higher risk of diabetes, heart disease, those type of things. So just some things to keep in mind.
Dr. Laurie Marbas
(35:17)
So move up your… like I eat breakfast every morning, eat your lunch or earlier dinner. Some people can't do that, but it's just some ideas and thoughts. But like Chris was saying, HIT training is great, but also slow, the slow, I run not very fast, but I run longer distances. That really helps too, because that will start putting you in that aerobic, and there's this anaerobic/aerobic phase that you want to do.
Dr. Laurie Marbas
(35:41)
And anyway, we get into exercise physiology later, but that can also be very helpful. But just moving your body, it's really important. And it's good for you, stretching all that good stuff. But yeah, intermittent fasting. And then last thing that might be helpful is a little bit play on Dr. McDougall's, I call it a 50/50 plates, and I think he names it a similar type of name. But basically 50% of your plates that non-starchy veggies, the broccoli, the cauliflower, all that great stuff. And then the other 50% is your starchy vegetables, your beans, your legumes, your grains.
Dr. Laurie Marbas
(36:13)
Because people tend to be, like me, I'm a homing pigeon towards potatoes and rice and beans, I'm less of a homing pigeon to the non-starchy. I like them, but I just like, it's like comfort food. It's cold. It's delicious. So balancing your plate, and then if you are still hungry, go ahead and get seconds. But, again, make that volume ratio about the same on your plate and eat on a smaller plate as well. That's also helpful.
Dr. Laurie Marbas
(36:36)
So just some visual things to keep in mind that are easy to do, track your foods, intermittent fasting, and HIT training is very helpful. But, yeah, that's a great question. Do you guys have time for one more question or do we need-
Dr. Chris Miller
(36:49)
Sure.
Dr. Kim Scheuer
(36:49)
Sure.
Dr. Laurie Marbas
(36:49)
Okay. All right, because I know we try to keep this pretty tight. Oh, goodness. There's so many questions. All right, this one is the one we get a lot, so I think it's kind of helpful. “If you have trouble digesting beans, meaning you get a lot of gas after eating of them, even after doing it for a long time. Any suggestions? Do you recommend Beano?” Any thoughts there?
Dr. Kim Scheuer
(37:13)
Well, interesting about the Beano. So for the beans, obviously, for some people it's really tough. So cooking them really well, mashing them up really well, starting very small and then adding more as you can. I have people who say they can't eat beans, but they can eat hummus, which is good, but make sure it's oil free. I have actually personally used Beano in the past, but not since I've gotten whole food plant-based, because I haven't needed it. So I'd be curious to see what everybody else says about that. But I like lentils tend to be easier for some people than whole beans. Peas are a good way to get some of that bean-ish kind of food into you, but anybody else?
Dr. Laurie Marbas
(38:07)
Chris?
Dr. Chris Miller
(38:08)
Beans are tough. They're tough for a lot of people when they go plant-based, we're all excited, and we add all this fiber into our plates and into our diet and our guts are not used to it. And our microbiome isn't used to it. And it's like, ah, what is happening to me? And so people have this terrible gas, which is fermenting. We're fermenting, the beans. Beans are tremendous prebiotic fiber for our guts. And so when it gets in us, we ferment it. But if we don't have the proper microbiome from not eating high fiber foods, we are not able to ferment these beans in this fiber, and we see the off gassing, which we notice and we're very uncomfortable with. And so we slow it way down for people. So we can't jump-
Dr. Kim Scheuer
(38:53)
Slow and [crosstalk 00:38:54]-
Dr. Chris Miller
(38:53)
… into all of fiber all at once. We have to do a little bit at a time and ease our way into it. I have people starting with as little as a teaspoon of beans, basically, two beans chewing it really well, and then making sure… You might get a little gas from that, but it's whatever. It's such a small amount and then doing it twice a day. And then we go to a tablespoon twice a day, and we gradually work our way up. So that is a more typical thing, and if people are still having problems, some people are, because their gut's just way out of balance, then we actually have a gut healing protocol type thing that we can use with you, and help you get it back in balance. And there's different stages depending on how you are doing.
Dr. Chris Miller
(39:40)
But first off, I would slow it way down and I would also make sure you're chewing it really well, and it's fully digested. That helps tremendously. When we eat fast and we gulp it down, we have undigested food in us, and that is fermented even more too, and can cause more gas and bloating. So couple easy tips, and then you can, if you're still having problems, we can work with you.
Dr. Laurie Marbas
(40:02)
Yeah, absolutely. And Kip also mentioned, too, making sure you're soaking your beans. If you're going from a dry bean, you want to make sure you soak it well and then rinse that well. And, honestly, if you're really struggling, Beano's fine, but I also look at the fiber. So if you have to soak something for a really long time, those are the beans we want to add last. So I would start with lentils, like Chris said, in small amounts and just gently growing and go up, up, up from there. I was lucky, I guess, I grew up in a home without much money, so we ate a lot of beans. So I never had a trouble with the beans component.
Dr. Laurie Marbas
(40:35)
The other thing that might be an issue here, I do know that sometimes when we eat more processed foods or high sugary foods that can set off the gas as well. So it may not be as much the beans as what's coming along with the beans. So just some thoughts there to think about, what other foods am I eating that might be at play here besides the beans, especially, if you've been eating the beans long time. So, but simethicone, Beano those type of things are… When you look up the side effects of simethicone, they say, there are no adverse reactions have been actually ever reported. So it's a pretty safe medication. So if you need it-
Dr. Chris Miller
(41:11)
My thought on that actually is, the goal is to not need it, because it blocks the effects of the prebiotic fiber that you're trying to get the benefits of the beans. So it may block the gas and bloating, but you're not getting these benefits, and you're not going to build the tolerance that you want in your gut. So if you need it here and there, you're going out or something's going on, I don't think it's a big deal. But it's not something you want to do all the time, because then you're not getting all the benefits that you really want from these beans. And you're not training your gut microbiome. So I usually discourage the use of Beano, unless it's an emergency and someone needs it, which I understand, it happens. But try to instead train your gut.
Dr. Chris Miller
(41:50)
The other thing, which I have never tested this, I don't know, but is that a little piece of seaweed as you're cooking your beans is actually supposed to help-
Dr. Kim Scheuer
(41:59)
Right.
Dr. Chris Miller
(41:59)
… decrease the amount of gas and bloating. And so feel free to add just a little bit of seaweed when you're cooking your beans with all the other tips that everybody shared, and see if that helps it as well. And then if it does help, will you please report back to me, because I read about this everywhere, but I would like to hear it actually helping someone, so I know that it actually has helped someone, and I would appreciate that. So good luck with your beans.
Dr. Kim Scheuer
(42:23)
[crosstalk 00:42:23] your iodine.
Dr. Laurie Marbas
(42:25)
All right. Any final words you'd like to share with our audience before we go?
Dr. Chris Miller
(42:31)
Kim, do you want to-
Dr. Kim Scheuer
(42:32)
I think it's amazing that you guys are on this webinar and recording, so that you guys are already taking the first steps to improve your health. It's wonderful. And so congratulations to everyone there. I'm really so pleased to see everybody on this. It makes me happy. [crosstalk 00:42:53]-
Dr. Laurie Marbas
(42:53)
And Chris? Yes.
Dr. Chris Miller
(42:54)
Yeah. Thank you, Dr. Kim Scheuer for taking the brunt of all of the questions today, and we put you on the spot so that you got a chance to shine. So thank you. Welcome, again.
Dr. Kim Scheuer
(43:04)
Thank you.
Dr. Chris Miller
(43:04)
And to everyone, thanks you guys for being here. It's awesome to see you. We really, really love having you as part of the community, and we wouldn't do this without you. So it's all of us in it together. So stay well and take care of yourselves.
Dr. Laurie Marbas
(43:16)
Yes. And thanks everyone for joining. Again, these are every second and fourth Thursday of the month. We are having Nelson Campbell on our next one on March 25th. And again, Dr. Michael Greger, April 22nd, but it's going to be two hours earlier at 10:15 AM Mountain Standard Time. Don't say I didn't warn you.
Dr. Chris Miller
(43:37)
We'll send out reminders though, so you guys will get-
Dr. Laurie Marbas
(43:39)
Yes, there is reminder.
Dr. Chris Miller
(43:40)
… reminders. Yeah, yeah. Yeah.
Dr. Laurie Marbas
(43:41)
Absolutely. But write it down. So anyway, we're very excited, and it's going to be Dr. Miller's birthday, so all the more to come celebrate with us. And we're super excited to have you here. Again, you can make appointments with Dr. Miller, Dr. Scheuer, Dr. Klaper, and Dr. Pierce and myself at plantbasedtelehealth.com. Go there, and we have two new docs coming to join us very quickly, and some others in the wing. So we're growing, please share the word. The best thing we ever have is someone share this, word of mouth is so huge for us. So if you could do that, share this video, let people know there are plant-based doctors across the nation, and I should get my Massachusetts license today, it's what I've been told. We will be in all [crosstalk 00:44:31]-
Dr. Chris Miller
(44:30)
Good luck.
Dr. Laurie Marbas
(44:30)
So we'll see how that rolls out. But, anyway, so thanks everyone for watching. And we're really appreciative of you being here, and we're honored to help you in your journey and you have a great day. Bye.
*Recorded on 3.11.21