On this Q&A our plant-based doctors answer questions and discuss how to get through the sometimes difficult process of healing, cravings, and high cholesterol.
Questions Answered
- (00:47) – What to do if your cholesterol remains high or you can't lose weight
- (09:10) – Should we limit our intake of mushrooms due to potential arsenic content?
- (12:38) – When do cravings fully go away?
- (17:37) – What to expect when making an appointment
- (21:27) – Do auto-immunity disorders have any correlation with gallbladder issues?
Complete Transcript
Dr. Laurie Marbas
(00:00)
All right. Thanks everyone for joining the plant-based telehealth Q and A. It's every second and fourth Thursday of every month. And we do appreciate you joining us. Next week is going to be extra special. We're actually going to be intro … not next week, but the next webinar in two weeks, our new doc that's joining us and I'm super excited for you to meet him. And if you have any questions, if you're on the webinar, please put them in the Q and A chat box and if you have any questions on Facebook, please put those on the plant-based telehealth actual page in the comments, and that's where I'll be monitoring.
Dr. Laurie Marbas
(00:38)
Please share this with your groups, with your feed so we can share this information and get it in front of many people as possible. And we do appreciate it.
Dr. Laurie Marbas
(00:47)
Today we just wanted to share a topic with you that we're seeing recurring with our patients who are joining us on plant based telehealth. A lot of information can be a little bit confusing, especially when you're just starting out on a plant based diet. Even if you're on a plant-based diet. What to do, if your cholesterol remains high, what if your blood pressure's not coming down? What if you can't lose weight? This guru says that, that guru says that and so we just wanted to share our thoughts and what we're seeing that patients are coming in with and how we can help solve those problems. So, Chris, do you want to start and just give us in your own background, just your story that we talked about last night?
Dr. Chris Miller
(01:24)
Yeah. The reason this came up is just like Laurie with Dr. Marbas was describing and so many of our patients are following different plant-based people online and there's so many amazing people. There's awesome information out there. There're different textbooks, but they're all written a little bit different and people are getting confused. The other thing that comes up with that is that we expect to get the same results as we see from those people and so it's very disappointing if we're not getting it right away. There's been several people that are coming through that are not getting the results and are finding it frustrating.
Dr. Chris Miller
(02:02)
I'm going to tackle that second part and leave the first part to someone else to talk about. As far as the getting the success stories and the results that we're striving for, that other people have had, I'll say this, to remind people that it's a journey for one. Everybody is different and we start at one point and we're working towards the end point. How we get there is not always straight up, there's bumps, there's turns, there's tweaks and we're individual people as well.
Dr. Chris Miller
(02:35)
So no matter what is happening with someone else, it's going to be a little bit different with you and your story will be different, your journey will be different, and the tweaks that have to be made will also be different. Just because one person reversed an autoimmune disease in three months, if you follow that exact plan does not mean you're going to get that exact result, or if they lower their cholesterol reverse their plaque or whatever it was that was doing, it's going to be a little bit different. And that's okay. As long as we get to the same end point, we're working in the right direction.
Dr. Chris Miller
(03:02)
I'll tell you my own story, personal story, is that I was healing my lupus, and I saw all these other people healing and reversing in three months and completely gone, antibodies negative, and so I did the raw food diet for five months exactly the way I was taught. I did the water fasting for 14 days, and I did all these exact plans that other people had done, but my results were not the same and I had to make tweaks and it was a journey for me and it was me figuring out my body and what was causing my autoimmune symptoms and my inflammation. Which were different from these other people and their case stories. While I felt like I was a failure and it wasn't working and I was doing something wrong and it was so disappointing for me, I realize now that it wasn't those things at all, it was just that my body was very different.
Dr. Chris Miller
(03:55)
One, it takes time. It takes more time for certain people. It took a lifetime to build these diseases and it doesn't necessarily disappear within three months like I really wanted it to, and two, it's not in my schedule. It happens when my body is healing and repairing. And three, there were still other triggers for me. There are other things that I had to figure out and work with my doctors and get to the bottom of and just keep at it. So the persistence and the really continuing with it, because ultimately I got to a point where I was able to heal, but it took a lot longer and a bigger journey.
Dr. Chris Miller
(04:30)
So I learned that personally, and I see it now in my patients, some of them who are struggling or feeling frustrated, and I always let them know, no it's not you. One, we have to be persistent. Two, we have to make tweaks and three, we have to remember you're an individual and you're on your own journey. So I would say to all of you, wherever you are in your journey, it's your journey. You get your own it and be proud of it and honor it and it's your life story and it's amazing and you'll get the results, but it might not look exactly the way you want it to.
Dr. Laurie Marbas
(05:00)
Excellent. Dr. K, Anything you'd like to add to that?
Dr. Michael Klaper
(05:03)
Oh, that was beautiful. That was very profound. A lot of truth just went by I hope everybody opened themselves to that. Dr. Miller hit on some very important things. The fact is that we are biological creatures. We are not mechanical devices. It's not a matter of pushing this button and getting this result. And sometimes it takes months for membranes to heal and antibodies to fade and inflammation to resolve. When I was on the plastic surgery service and on the burn service and to watch the burns heal over months, it takes and you know that two years now, five years from now, they're going to be pain-free and functional, but man, it's a journey to get there. The same thing with these complex diseases.
Dr. Michael Klaper
(05:51)
So patience is important, but also implied in that is make sure you're doing anything that's perpetuating the problem along the way and your body is never not looking. You got to answer to it. If you're not healing at the rate just reassess, is there anything I need to change here? But again the patience, it's just really important and having faith that the body wants to heal. The body doesn't wasn't to stay inflamed. It's an expensive thing for the body to do. To run all these white blood cells and make these antibodies. The body doesn't want to do that. If we stop prodding it and keeping the inflammation alive and it generally settles down. I think that was some very profound advice to allow the biology to heal itself.
Dr. Michael Klaper
(06:45)
There's so much to say on this topic and my viewing of the body and healing has changed so much, especially in recent years. When I was learning about the circulatory system, about the heart and the blood vessels, and seemed … it's an amazing system of pumps and plumbing and all of that and if it got disease, the pipes were kind of grotty and caking up and all that. But the thought that you could heal it as an organ, that you can heal it as a sprained ankle or as a burn or whatever, that it's responsive to the food going through it. Nobody ever told me that, but that it's a live response [inaudible 00:07:26] that you can heal it. The same with our immune system and our joints.
Dr. Michael Klaper
(07:31)
Lifestyle medicine and plant-based medicine, it was such a hopeful approach to these fearsome chronic diseases because you can get into the watch works of the disease and smooth out the rough running's of it that's keeping the inflammation alive. So the fact that these systems are responsive and that food is our most effective tool to accomplish healing. That's something to rejoice over and keep in mind as you're working with plant-based physicians, which you happen to have three of them here.
Dr. Laurie Marbas
(08:06)
This is great. I think that's exactly right and then the interesting thing is recently in the last few weeks, seeing more and more of these patients come in and saying, “I'm trying to do everything that everybody says.” They're listening to some amazing physicians who have a very large platform and share their thoughts on eating healthy, but it may not be just right for you at this point. So that's really where it's important to consider speaking to your own physician or seeking out maybe one of us who can actually help you tweak that to actually get some improvements where maybe you had seen some stalling. Because not all diabetics should be eating a lot of fatty foods. So there's a lot of other things, maybe the blood pressure, there's some other things you need to look at, or your GI.
Dr. Laurie Marbas
(08:51)
The guts is very special. So we get all sorts of interesting things coming there. Just some things there, maybe you have kids there're different stages and ages that we need to think about certain things. Certainly, I'm family practice, we see kids here as well so just consider seeking us out if you're really struggling.
Dr. Laurie Marbas
(09:10)
In addition to that, if you guys have any questions, please put them in the Q and A box or put them on the plant-based telehealth comment section. One of the questions we do have is from Kip. Thank you, Kip. He's asking on behalf of a friend, who's a breast cancer survivor. Should we limit our intake of mushrooms due to potential arsenic content? That's a new one, I know about the rice, but I'm not so much about the mushroom. I'm not sure about that. Any others, any of you guys?
Dr. Chris Miller
(09:38)
I don't know about that either.
Dr. Michael Klaper
(09:40)
No, I haven't heard of that.
Dr. Chris Miller
(09:41)
Kip, that's a good point. We'll have to do some research and get back to you.
Dr. Laurie Marbas
(09:46)
Yeah.
Dr. Michael Klaper
(09:48)
If I could just continue, what Laurie said just set off a few other things, that as far as problems that people in the plant-based community run into, there's a bit of a one size fits all approach from some doctors and that is often echoed with the wealth. A little is good, more must be better response in the patients and I'm running into people on so-called starch based diet. In general, we are carbohydrate burning organisms and yes, we can handle starches quite well. But again, if a little is good, more must be better and I've got patients who are eating just a huge amount. So potatoes and rice and fruit and their triglycerides are going up through the roof and they put on some weights and they don't feel so good.
Dr. Michael Klaper
(10:40)
I thought that was a clean burning fuel, what's up doc? I always wanted to use that phrase, I finally got to do that, but not that context. Again, and we have to beware, if something isn't working for you, then your body has the final say here. Back off and say, is there another way to look … maybe I do need another opinion, hopefully not from a very extreme practitioner from the far fringes there, but having a level headed plant-based diet, what are you really eating? Send me a food diary. Let me see what you're really eating and let's see what we need to change here.
Dr. Michael Klaper
(11:26)
We all know that the balanced whole food plant based diet, where there's fruits and vegetables and whole grains and legumes and mushrooms and greens, et cetera. That is a clean burning fuel that really should settle down inflammation and lipids and all of that. If something is way up, inflammations up or triglycerides up, whatever, then there's something out of balance in the diet. It starts with, what are you really eating? So food diaries are really helpful. We'll ask for those on a semi frequent basis there, but I just wanted to point out that can be a pitfall of folks along the plant-based trail there.
Dr. Laurie Marbas
(12:07)
Yeah absolutely, and then that's a really good point, people go, I thought I couldn't gain weight on a plant-based diet? I'm like, “Yeah, you can.” You eat too much even healthy foods, from eating too much nuts and avocados, or even if you're just eating too much for your activity level or your stature, you can certainly … you're eating to a caloric excess are going to gain weight. It doesn't matter where that food comes from. Now, you can do it faster on processed foods and other things, but again, that's a really good point Dr. K.
Dr. Laurie Marbas
(12:38)
We do have a question. Someone asks ,with abstinence when do cravings fully go away? Chris, I know you love to talk about that. Do you want to take that?
Dr. Chris Miller
(12:46)
I have strong food cravings myself so I'm going to speak both personally and working professionally with many people along the way, but it depends. That's the best answer I can give you, it totally depends. It depends on you. It depends on your craving. It depends on what's going on. Some people will say they'll be fully gone in two months, they'll be fully gone in six months, they'll be fully gone in two weeks and that is not been my own personal experience, but they get better. They go away. You'll lose that crazy … for sure that goes away. It gets better probably after one to two months, depending how severe it is. So you got to really go for that month in about two weeks in, it's going to get a little worse where you're really going to crave it, but it's got to be cold turkey.
Dr. Chris Miller
(13:30)
It really works well to have substitutes. So maybe at the time you get a snack, you're going for a quick walk or something to distract yourself or having some carrots or something, whatever it is you're craving was, switch it out. If it was a chocolate dessert, now it's an Apple, switch it out, have that substitute. After a month, maybe it starts getting better. Definitely by two months, it's getting a little better. By six months, I would say, you're going to be feeling better.
Dr. Chris Miller
(13:53)
It does get to the point where you don't think of it, but if you go back to it ,for many things it might come back if it's a bad craving. So you have to be pretty vigilant and not give into it and stay away from it. Once you do, the cravings will definitely get better and subside as long as you stay vigilant.
Dr. Laurie Marbas
(14:13)
Yeah, and I would say too, as well, a lot of these food cravings are around circumstances like emotional stress or boredom or something. If that habit … if you haven't dealt with the really true reason, I think the root cause of why you're eating these foods to begin with, it's going to be easier to go back to.
Dr. Laurie Marbas
(14:32)
Maybe you're eating better and you're feeling well and life's going okay, but then something happens and anxiety and stress. And if you haven't learned or had come up with more constructive ways, like Chris was mentioning exercise or something like that, mindfulness, meditation, whatever that might be that works for you, it's going to be easy to go back into it. Or maybe over the holidays. I got a lot of notes from people saying I crashed and burned over the holidays.
Dr. Laurie Marbas
(14:56)
Well, we didn't set up a plan to, how am I going to handle all these foods in front of me, because maybe you were with family or maybe you always had a tradition and you just didn't know the emotional components of that. How was I going to deal with not doing that particular food on this particular holiday? So just some things there to think about as preparation will more likely get you down the path further without kind of falling off the wagon so to speak. Dr. K any thoughts there?
Dr. Michael Klaper
(15:23)
Yes, absolutely. That's very valid and the whole issue of social situations is a whole program in itself. But you know you're making progress with the food cravings themselves when, after a couple of months and you're sneaking a little of the forbidden food and it starts to taste like what it really is. You're thinking about that chocolate brownie for weeks and then finally, you're alone with it and you finally put it in your mouth and you eat it. You realize it's a bunch of fat and sugar I've got in my mouth now and you taste if for what it is, a bunch of fat and sugar. Or the vegetables come out at the restaurant sauteed and they're sauteed in a oil and they are dripping with oil. You put it in mouth and this is dripping with … this is disgusting. I can't even eat it anymore. When you used to really enjoy it.
Dr. Michael Klaper
(16:17)
And then if you eat a piece of meat, I'm chewing on a piece of chicken muscle that's been fried in hot oil and you taste it for what it really is and you know you're done with it at that point. I'm done with this and with the brownie and the chicken and all that stuff.
Dr. Michael Klaper
(16:33)
So when you start tasting things for what they really are, I mean carrots are carrots, and yay. [crosstalk 00:16:39] you can feel good about it, but the other stuff, when you're faced with what they really are, then you start getting mastery over them.
Dr. Laurie Marbas
(16:49)
Yes, 100%. I would say salt and cheese were definitely mine. Salt now, if you go out to eat and you're like, “I'm sorry I can't eat this, there's a little too much salt.” And everyone's like, “What's wrong?” But that the cheese too, like even the smell of the regular cheese, it grosses me out and I used to eat blocks of cheese as a kid. Like, this is good.
Dr. Laurie Marbas
(17:10)
But that happens, you're exactly right. That is a great way to measure your progress with the food cravings. Honestly, it doesn't taste so good. Even little kids will have this experience. Even with my kids in the families that I'm working with, the little kids are making better choices. Like, “I don't feel that when I eat that. I don't want that birthday cake.” Little five and seven year olds. It's a phenomenal thing that happens, wow. Fantastic.
Dr. Laurie Marbas
(17:37)
Another question is, when someone makes an appointment to see one of you, how does that work? What should one expect? And then how far, as far as the process goes?
Dr. Laurie Marbas
(17:46)
I'll talk about the mechanics and then maybe Dr. Miller and Dr. Klaper, you can discuss what they can expect with each of you. How the process works, you go to plantbasedtelehealth.com, you request a patient portal invitation, and just to give heads up, we are switching EHR's over the next two to four weeks so that process might change just a little bit, but it'll pretty much be generally the same. You will get an invitation to join our HIPAA compliant patient portal. In that portal is where you can upload documents, you have private conversations with your provider once you've seen them. All those things can be there. Your results will be there after labs, whatever.
Dr. Laurie Marbas
(18:28)
In that patient portal is where you can request appointments. You will see open appointments with the physician that's licensed in your state at the time of the … you need to be in a state physically at the time of the appointment where that physician is licensed. So for example, Dr. K is in Florida, New York, Hawaii, and California, Chris just got New York and she's got a plethora of other states. And so these are the things that you're looking at is where they're located and where you'll be located. Not where thyre located but where they're licensed and where you'll be located. It costs $150 per half hour visit. In the near future with our changing of the EHR, we will have different opportunities for different time periods and different costs there.
Dr. Laurie Marbas
(19:10)
I'm hoping this will open the door for us to bring on specialists that have shown some interest in joining us. That's where it starts, and then each of us practice lifestyle plant based medicine, however, we may approach things a tad bit differently, but overall, the general gist is the same, but Chris, do you have any preference or a specifics that you'd like to share?
Dr. Chris Miller
(19:32)
That's a great overview of how to make appointments and I love taking care of different patients and I'm in 20 States now. So, so excited to get to work with people.
Dr. Laurie Marbas
(19:42)
Awesome.
Dr. Michael Klaper
(19:44)
I just asked and we're changing over to a new electronic health record system here and which I'm not familiar with yet, but I'm sure there's going to be an area for the patient, for the new client to plug in important information to them. I really want to know what's the main problem that you're coming in and you're talking to me about. I want to know the first one, two or three issues that we're going to be covering in the half hour. I want to know what medications you're on. I want to know if you're carrying any official medical diagnoses from a doctor. If you've got lupus, if you've got a chron's disease, I wat to know about that and your questions.
Dr. Michael Klaper
(20:23)
At the end of our session, you don't hang up and say oh I forgot to ask. I want to know what you really want so at the end you know you got your 50 cents worth out of the session there. So please fill out the information, because it's frustrating when I get on the record and then nobody's written anything in. I got to to start from scratch. What can I help you with today? And a lot of time goes by that we could be using for counseling. So please fill out the records as well as you can.
Dr. Laurie Marbas
(20:54)
That's a really good point, Dr. K, because sometimes there is an extensive, what we call an intake form for the first visit only, that we do ask those very important questions. We may ask what you're eating throughout the day, any current symptoms that are worrisome, all of those things, and you have some freedom to write in more specific things that maybe we don't ask, but it's really important that, that get done ahead of the visit. So like he said, we can actually make utilization of your time and money to the best of our ability. That's just something to keep in mind.
Dr. Laurie Marbas
(21:27)
I will now go into the next question, unless you guys have anything else to say about that specifically. That was a great question. Thanks by the way, Carol. Linda asks, does auto-immunity, she has Hashimoto's, which is a thyroid dysfunction, have any correlation with gallbladder issues and how would one know if they should take bile salts?
Dr. Laurie Marbas
(21:45)
I am not familiar with gallbladder issues with Hashimoto's but are either of you in with that? Any suggestions on bile salts? I don't have any suggestions [crosstalk 00:21:56] .
Dr. Chris Miller
(21:56)
I don't really use them either-
Dr. Michael Klaper
(21:57)
I don't use them.
Dr. Chris Miller
(21:58)
Bile salts help you absorb fat so they're more for people eating high fat diets. It's some functional medicine people seem to be using that. I haven't really had to use that, I don't use them.
Dr. Laurie Marbas
(22:08)
Yeah, I don't either. Dr. K?
Dr. Michael Klaper
(22:09)
Right, nope. No, I think they're referring to ursodeoxycholic acid to dissolve gallstones, but I don't use it myself either. You're right.
Dr. Laurie Marbas
(22:22)
Now, I have had … like you mentioned, there's some medication to help dissolve medically gallstones for those who can't do surgery and some other things, but those are few and far in between cases. So again, if you guys have any specific questions, please let us know, and please share this with anyone that you feel might ask questions or looking for any plant-based doctor. Again, we're at plantbasedtelehealth.com and we have a few minutes left. I think that one question echoing back to where we were earlier in the conversation, what would you say, Dr. K, would be what you consider at least the tenants of a healthy whole food plant based diet? Just for maybe someone who's listening is just getting started and just get some basic guidelines to help them get started to get rid of all the confusion and just like here's some very simple, basic tenants.
Dr. Michael Klaper
(23:13)
Okay. Well, recognition to Dr. Fermin, the salad is the main dish. Boy, you got to have that fresh stuff once a day, at least. So plan a big salad, at least part of one meal, if not lunch and dinner. So the fresh produce is really important. Eat enough healthy starches. It's okay to have another scoop of quinoa, another baked potato, eat enough so you're feeling full and find a way to get legumes into your diet pretty much every day. Beans, peas, chickpeas, lentils, anything in a pot that's where that protein boost comes from and enjoy fruit for the sweetness. So just do those things, eat enough healthy starches, get some legumes in, eat those salads and steam veggies and enjoy mangoes and cherries and grapes and all these wonderful fruits we have available, and your body will know what to do with that fuel.
Dr. Laurie Marbas
(24:07)
Excellent, I love it. Chris, any suggestions there as well?
Dr. Chris Miller
(24:11)
Yeah. I agree completely with what you both have said on that. So that's a great place to start. And then what I always remind my patients who are working with me is that we're working on healing diets. We really want to make sure it's all completely whole foods and that they're healing foods, meaning plenty of raw, like Dr. Klaper said, include a salad every day so we can make sure we include some sort of raw every day, because I think we sometimes forget that when we cook vegetables, we lose some of the B vitamins, we lose some vitamin C, those are heat labile. So we have to be eating the raw vegetables for many of those raw micronutrients and it should be well balanced. Make sure we are getting like … the joke is where do you get your protein? How do we get enough protein? But, the truth is if we're not eating well balanced meal, we could be in, especially in certain phases of our life, as people get older, they aren't absorbing protein as well potentially and they might need a little bit more.
Dr. Chris Miller
(25:07)
W have to make sure that it's well-balanced, that we're getting protein throughout the day, that we're getting plenty of micronutrients, that we're eating color, variety. And then I would say for healing diets, that it is a little bit individualized. So we start with the general whole food plant based diet, which is fabulous for anyone who's healthy that's a perfect place to start, but for healing diet, we may want to tweak it a little bit more. Maybe someone needs a little more raw because they're really inflamed or reversing a serious thing like cardiovascular disease, or maybe they need a little less of the tough fibers to digest, because their gut is irritated right now. So we got to tone it down a little bit at the beginning and then diversify it down the road. So there's little individual things we can do for it, but my tenants would be, make sure we include raw every day and to make sure it's well balanced, that we're getting everything in and then number three is make sure you enjoy it. It should be fun. Whatever that looks like for you might be slightly different for me, but it should be fun and not work and not a chore. We're lucky to get to eat this way. And so hopefully that's my third tenant.
Dr. Laurie Marbas
(26:17)
I think that's excellent. I would just add two things. Don't be afraid of spices. Spices will add to, make those same beans and quinoa dish go from Indian, to Mexican, to Ethiopian. So who knows, don't be afraid of those spices. You can't fail in the kitchen. It's an experiment. Sure some things may not taste good, but guess what? It's data and you're going to learn well, maybe I put a little too much of something in there. So that's how I learned when you're a kid. That's how you learn as an adult. Doing something new. And the final thing is please take a B12 supplement and then have your levels checked because there may be some issue with absorption and you might want to consider having a methylmalonic acid homocysteine checked just to make sure that you're getting enough.
Dr. Laurie Marbas
(27:00)
Now that we've been doing this … in March it will be a year for us that we'd launched live and I am seeing more and more cases where people, even who were on an omnivorous diet, coming in and even if they are supplementing B12, but they're still low and having some symptoms and we bump them up a bit and they feel better. So just keep an eye on your B12 levels and tests don't guess like Dr. Khan always says. I did want to mention the B12 is an absolute must for everyone who's eating a strictly whole food plant based.
Dr. Chris Miller
(27:28)
Well, it's true that we're all individualized. So people absorb different, people have different enzymes, were just made differently and so we may all be on one diet, but we're not going to all get the same results again. So that's why it's really important if you get to work with one of us or one of your own doctors, but to check levels, to make sure that you're above … this is the right thing for your body and we don't need to tweak it and these are the tweaks that we're always talking about. We're tweaking it for people to individualize it for that person to maximize their plan so they get the healing results that they're looking for.
Dr. Laurie Marbas
(27:58)
Absolutely. And Dr. K any final words before we sign off?
Dr. Michael Klaper
(28:05)
Like Dr. Miller says, enjoy this food, it's a gift and it's a guilt-free eating. And like Dr. Marbas says, make it taste wonderful and count yourself lucky to be able to have this knowledge and access to this wonderful food and enjoy the good things it does in your body. Health is your greatest wealth, without question.
Dr. Laurie Marbas
(28:25)
Absolutely and I think that's an excellent way to end this. Thanks everyone.
Dr. Laurie Marbas
(28:30)
Like I said, we will be back in two weeks with Dr. Jeff Pierce. You guys don't want to miss this. He has got some amazing experience. What a phenomenal human, we're blessed to have him join our team and I can't wait for you to meet him. So thanks everyone again for joining us and we'll see you next time.
Dr. Michael Klaper
(28:49)
Bye-bye.
*Recorded on 1.14.21