Podcasts about immunosuppressive

In this episode, we are joined by Drs. John Kempen and Sapna Gangaputra to review the many ways the SITE cohort study has shaped the way we approach uveitis.Drs. Kempen and Gangaputra have received grant support from the NIH for their work on the SITE cohort study.

Safety alert issued for serious reactions to certain seizure drugs; Drug approved to treat a rare form of tumor; T-cell malignancies reported with cell immunotherapies; organ transplant rejection treatment recalled; CPAP machine associated with reports of burns and fires.

A new research paper was published in Oncotarget's Volume 14 on July 1, 2023, entitled, “Transformation of immunosuppressive mtKRAS tumors into immunostimulatory tumors by Nerofe and Doxorubicin.” Members of the rat sarcoma viral oncogene (RAS) subfamily KRAS are frequently mutated oncogenes in human cancers and have been identified in pancreatic ductal, colorectal, and lung adenocarcinomas. Recently, two drugs that specifically target KRAS G12C, sotorasib (Lumakras™) and adagrasib (Krazati™), have received accelerated approval by the FDA for the treatment of adult patients with KRAS G12C-mutated locally advanced or metastatic NSCLC, who have received at least one prior systemic therapy. These drugs are the first RAS GTPase family inhibitors to be approved for clinical use, representing a major breakthrough in the field of precision oncology. In this new study, researchers Joel Ohana, Uziel Sandler, Orly Devary, and Yoram Devary from Immune System Key (ISK) and Jerusalem College of Technology show that a derivative of the hormone peptide Tumor Cell Apoptosis Factor (TCApF), Nerofe™ (dTCApFs), in combination with Doxorubicin (DOX) substantially reduces viability of tumor cells. “The objective of the present study was to investigate the synergistic effect of the combination of Nerofe and DOX in colorectal cancer and its underlying mechanism.” It was observed that the combination of Nerofe and DOX downregulated KRAS signaling via miR217 upregulation, resulting in enhanced apoptosis of tumor cells. In addition, the combination of Nerofe and DOX also resulted in activation of the immune system against tumor cells, manifested by an increase in the immunostimulatory cytokines IL-2 and IFN-γ as well as the recruitment of NK cells and M1 macrophages to the tumor site. “In conclusion, we demonstrated that the combination of Nerofe and DOX exerts a synergistic effect during mCRC treatment, which could stem from several independent and complementary mechanisms of action.” DOI - https://doi.org/10.18632/oncotarget.28467 Correspondence to - Yoram Devary - ydevary@immunesk.com Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28467 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - Colorectal cancer, KRAS, apoptosis, hormone peptide, endoplasmic reticulum stress About Oncotarget Oncotarget is a primarily oncology-focused, peer-reviewed, open access journal. Papers are published continuously within yearly volumes in their final and complete form, and then quickly released to Pubmed. On September 15, 2022, Oncotarget was accepted again for indexing by MEDLINE. Oncotarget is now indexed by Medline/PubMed and PMC/PubMed. To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: SoundCloud - https://soundcloud.com/oncotarget Facebook - https://www.facebook.com/Oncotarget/ Twitter - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957

Guest: Gates B. Colbert, MD, FASN Although immunosuppressive therapy has been the backbone of IgA nephropathy (IgAN) treatment, this type of approach comes with several challenges. Here to share how non-immunosuppressive treatments could help revolutionize the IgAN treatment landscape is Dr. Gates B. Colbert, Assistant Clinical Professor at Texas A&M College of Medicine.

Join Drs Sunanda Kane and Uma Mahadevan as they set out to separate fact from fiction when treating patients with ulcerative colitis before, during, and after pregnancy. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/984004). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources PIANO (Pregnancy Inflammatory bowel disease And Neonatal Outcomes) https://gastroenterology.ucsf.edu/research/piano Ileal Pouch–Anal Anastomosis https://emedicine.medscape.com/article/1892231-overview Does Laparoscopic IIeal Pouch–Anal Anastomosis Reduce Infertility Compared With Open Approach? https://pubmed.ncbi.nlm.nih.gov/31420214/ The Impact of Medical Therapies and Factors Related to Treatment Procedures in Women With Rheumatoid Arthritis and Inflammatory Bowel Disease Receiving Assisted Reproduction: A Nationwide Cohort Study https://www.fertstert.org/article/S0015-0282(21)01797-0/fulltext Effects of 6-Mercaptopurine Treatment on Sperm Production and Reproductive Performance: A Study in Male Mice https://pubmed.ncbi.nlm.nih.gov/16028439/ Paternal Exposure to Immunosuppressive and/or Biologic Agents and Birth Outcomes in Patients With Immune-Mediated Inflammatory Diseases https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8238837/ Child-Mother Index: A New Risk Factor for Selected Adverse Maternal Birth Outcomes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758341/ Association of a Mediterranean Diet Pattern With Adverse Pregnancy Outcomes Among US Women https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799855 Fecal Calprotectin During Pregnancy in Women With Moderate-Severe Inflammatory Bowel Disease https://academic.oup.com/ibdjournal/article/24/4/839/4913664 Fecal Calprotectin as a Predictor of Abnormal Colonic Histology https://pubmed.ncbi.nlm.nih.gov/17963005/ Safety of Flexible Sigmoidoscopy in Pregnant Patients With Known or Suspected Inflammatory Bowel Disease https://link.springer.com/article/10.1007/s10620-020-06122-8

Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 2 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 8th Season starts up and Episode 9 features her Newsworthy Grab Bag session. Trusty Tip features Sonal's compliance recommendations for the second CBR of of 2023 - the CBR report issued on Immunosuppressive Drugs. Spark inspires us all to reflect on creativity based on the inspirational words of Dorothy Parker. Thanks to Advanced Coding Services, LLC: Website: https://advancedcodingservices.com/ MS Awareness Month Resource: https://www.nationalmssociety.org/What-is-MS Paint The Medical Picture Podcast now on: Anchor: https://anchor.fm/sonal-patel5 Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3X Apple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177 Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy8zMGYyMmZiYy9wb2RjYXN0L3Jzcw== Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcast Breaker: https://www.breaker.audio/paint-the-medical-picture-podcast Pocket Casts: https://pca.st/tcwfkshx Radio Public: https://radiopublic.com/paint-the-medical-picture-podcast-WRZvAw Find Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7A Find Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/ And checkout the website: https://paintthemedicalpicturepodcast.com/ If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/sonal-patel5/message Support this podcast: https://anchor.fm/sonal-patel5/support

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.08.23.504918v1?rss=1 Authors: Pons-Espinal, M., Blasco-Agell, L., Fernandez-Carasa, I., di Domenico, A., Richaud, Y., Mosquera, J. L., Marruecos, L., Espinosa, L., Garrido, A., Tolosa, E., Edel, M. J., Juan Otero, M., Ferrer, I., Raya, A., Consiglio, A. Abstract: Parkinson's disease (PD) is associated with premature death of dopamine-producing neurons in the brain. Previous studies have shown that astrocytes of PD patients may contribute to neuronal degeneration by mechanisms involving both direct cell-to-cell contact and transfer of soluble molecules. Since it has been proposed that PD patients exhibit an overall pro-inflammatory state, and since astrocytes are key mediators of the inflammation response in the brain, here we sought to address whether astrocyte-mediated inflammatory signaling could contribute to PD neuropathology. For this purpose, we generated astrocytes from induced pluripotent stem cells (iPSCs) representing PD patients and healthy controls. Transcriptomic analyses identified a unique inflammatory gene expression signature in PD astrocytes compared to controls. In particular, the pro-inflammatory cytokine IL-6 was found to be highly expressed and released by PD astrocytes, and to induce toxicity in dopamine neurons. Mechanistically, neuronal cell death was mediated by IL-6 signaling via IL-6 receptor (IL-6R) expressed in human PD neurons, leading to downstream activation of STAT3. Importantly, astrocyte-induced cell death in PD disease midbrain neurons could be prevented by blocking IL6R-mediated signaling using clinically available antibodies. Moreover, examination of postmortem tissue brain of early-stage PD patients uncovered increased numbers of dopamine neurons overexpressing IL-6R and of reactive astrocytes overexpressing IL-6, compared to healthy brains. Our findings highlight the potential role of astrocyte-mediated inflammatory signaling in neuronal loss in PD, and open the way for new therapies based on IL-6 immunomodulation for preventing PD pathogenesis. Copy rights belong to original authors. Visit the link for more info Podcast created by PaperPlayer

This episode is sponsored by the Osteosarcoma Institute (OSI), a nonprofit organization led by osteosarcoma experts from top U.S. cancer centers who, together, are concentrating on the cure ® for osteosarcoma. The mission of the OSI is to dramatically increase treatment options and survival rates in osteosarcoma patients through identifying and funding the most promising and breakthrough osteosarcoma clinical trials and science. In addition to advancing research, OSI also provides a free resource called OSI Connect for osteosarcoma patients. Our osteosarcoma experts can discuss available treatments, possible side effects, and provide helpful advice for getting the most out of your visits with your treating physician. This resource is available in English and Spanish and aims to help patients and families find answers to their questions. -- John A. Ligon, MD, is an assistant professor in the department of pediatrics at the University of Florida College of Medicine. Dr. Ligon earned his medical degree from the Baylor College of Medicine in Houston. After he completed his residency in pediatrics at the University of Texas Southwestern Medical Center in Dallas, he pursued a fellowship in pediatric hematology and oncology at Johns Hopkins University and the National Cancer Institute in Maryland. In the following years, he completed a senior fellowship in pediatric immunotherapy at the National Cancer Institute and another in pediatric sarcoma at Johns Hopkins University. Dr. Ligon is board-certified in both general pediatrics and pediatric hematology and oncology by the American Board of Pediatrics. In addition to his numerous original research publications and editorial review appointments, he is a member of various professional societies, such as the Children's Oncology Group and the American Association for Cancer Research. Dr. Ligon has been honored with a variety of awards for his research skills and academic excellence. His research interests include immunotherapy, tumors and bloodstream infections.

If you're a woman in your 40s, 50s, or beyond, you know that hormone health is key. But did you know that gut health is essential for hormone balance?   In this episode of The Hormone Prescription Podcast, Lindsey Parsons, a Certified Health Coach specializing in helping clients locally and nationally heal gut health issues and reverse autoimmune disease naturally as well as lose weight without cutting calories and hosts the podcast "The Perfect Stool: Understanding and Healing the Gut Microbiome", joins us to discuss the gut-hormone connection.     Lindsey shares with us:     How the gut and hormones are interconnected     How to heal your gut for better hormone health     The link between gut health and autoimmune disease     Type of tests to diagnose gut issues     How to create a healthy gut environment     Why some people suffer from SIBO as a chronic long term illness     The latest treatments for GI problems like  fecal microbiota transplant, breathwork, and colostrum   And more!   If you're interested in learning more about the gut-hormone connection and how to heal your gut for better hormone health, tune in now!   [00:00:00] "I'd rather pay for healthy food now than healthcare later." Would you? So the big question is how do women over 40, like us keep weight off, have great energy balance. Our hormones in our moods feel sexy and confident and master midlife. If you're like most of us, you are not getting the answers you need and remain confused and pretty hopeless to ever feel like yourself again.   [00:00:23] As an OB GYN, I had. Discover for myself, the truth about what creates a rock, solid metabolism, lasting weight loss, and supercharged energy. After 40 in order to lose a hundred pounds and fix my fatigue. Now I'm on a mission. This podcast is designed to share the natural tools you need for impactful results.   [00:00:41] And to give you clarity on the answers to your midlife metabolism challenge. Join me for tangible natural strategies to crush the hormone imbalances you are facing and help you get unstuck from the sidelines of life. My name is Dr. Kyrin Dunston. Welcome to The Hormone Prescription Podcast. Hey everybody.   [00:01:00] And welcome back to another episode of The Hormone Prescription Podcast with Dr. Kyrin. Thank you so much for joining me. My guest today is Lindsey Parsons. She has an amazing podcast called The Perfect Stool, Understanding And Healing, The Gut Microbiome. When I discovered her recently, I saw her podcast and I saw all the amazing guests she had and just really the depth and breadth of her knowledge in gut health and healing.   [00:01:26] And I know how central this is to hormone health and overall health. I had to have her on the podcast. And I reached out and she kind of said, well, I don't really do that kind of thing. I said, no, please, you gotta come talk to my ladies. So I bring her here to you today and I hope you enjoy her as much as I do.   [00:01:45] In addition to hosting the podcast, the perfect stool. She's a certified health coach and she works in Tucson. She specializes in helping clients nationally heal gut health issues and reverse autoimmune disease, as well as lose weight without cutting calories who doesn't want that. She also has this wonderful quote about a calorie not being a calorie.   [00:02:06] And she tells a little bit of a story about that, but you don't want to miss. She talks about fecal transplants, which if you don't know about that, you're gonna wanna hear about that. She talks about colostrum use for healing gut issues. We talk about SIBO testing. What tests to do.    [00:02:28] We talk about everything.   [00:02:29] So you'll see this episode is a little all over the place because I was super excited to talk to her. I knew I only had her for max an hour, so I was trying to jump around and hit all the things that I really wanted to chat with her about. You like it, and I hope you take it as an invitation to listen to her podcast and go more in depth into a lot of these issues that are of interest to you.   [00:02:54] There are way more than we could even cover. And I think we talked for 35, 40 minutes, so she has even way more available. So without further ado, please welcome Lindsey Parsons.   [00:03:06] Thank you.   [00:03:08] So glad to have you here. I don't remember where I found your podcast, but I was super excited when I did the perfect stool, understanding and healing, the gut microbiome, and then all the amazing guests and topics that you've had and how in depth you go.   [00:03:27] I was like, I have to talk to you.    [00:03:31] and I have to have you on the podcast. So thank you so much. Yeah, well, I appreciate you for inviting me. So I think that a lot of people in the general public who are looking for answers to their health, tend to only look for physicians. I'm glad to see that that's changing because I think there are some amazing health coaches, for instance, like you out there who really go so much deeper into a lot of these issues and really are better experts than a lot of physicians on things like you are for gut health.   [00:04:06] So talk to us about how you became so passion. About gut health and really what led you down that.    [00:04:15] So it was really my own health struggles that led me into this path. So years ago, unbeknownst to me, my, an episode of food poisoning led to something called Post infectious IBS, which I only actually found out within the last year or so is an autoimmune diagnosis that I have because I didn't have a typical presentation of IBS, which you might think of as, you know, may having diarrhea six times a day or severe constipation.   [00:04:47] I didn't have either of those, but. I did have gut symptoms that, you know, including bloating and reflux and things like that, that went on for years. And when I did see traditional doctors didn't really get a lot of help other than suggesting I take proton pump inhibitors, which I did for something like 10 or 15 years.   [00:05:08] And now they super strict about not taking more than two weeks at a time. So, you know, the long term damage from that, you can only imagine. . And when I did eventually find my way to a functional medicine provider and was put on a course of herbal treatment for something called SIBO or small intestine, bacterial overgrowth, which is what happens when you have this post infectious IBS.   [00:05:29] What happens is you have an autoimmune situation where the Migrating motor complex or the process by which food is cleared through your intestines after eating is impacted negatively and is attacked by your own body. Therefore, you don't have that clearing of the intestines and clearing of the bacteria and the intestines.   [00:05:50] So you get these overgrowths and stagnation, and then you end up with bloating every time you eat, because it's coming, the food's coming in, and immediately the bacteria are going crazy and producing gases. So I had that going on for years and you know, you meet a lot of people that have a lot of bloating after they eat and they just sort of rack it up to, I ate too much or, you know, a whole number of things.   [00:06:12] So. I did finally see somebody and they cleared the placebo for me. Eventually it took herbals and then followed by Rifaximin, which is a prescription, very expensive prescription drug that, that takes care of it. And then over time started changing my diet, getting rid of gluten, getting rid of dairy.   [00:06:29] Really, you know, reducing sugar significantly. And all of those things contributed to me getting much better. And then I also had several autoimmune diagnoses that, you know, cuz when you have these kind of gut issues, you can have followed on autoimmune issues. And so I had Hashimoto thyroiditis, which really, you know, when I found out about that, that really kicked me into gear about trying to turn things around because the doctor had said to me, oh, you can just wait until your thyroid's gone.   [00:06:55] Then we'll put you on. You know, thyroid hormones. And I thought, oh, I'm just gonna sit around and wait until my entire thyroid's destroyed by this. No, that's not what I'm gonna do.    [00:07:05] right. But that's such a typical mainstream medical approach. Um, nothing to do. You have raging thyroid peroxidase antibodies, you have Hashimotos and they do nothing.   [00:07:16] And then they literally say, we're not gonna do anything, you know, until you're you burn out your thyroid, which is just kind of insane. So then what happened at that point? I think I, all of this is a bit perhaps out of order, but I did eventually get off gluten, get off dairy and for a while off of Soy.   [00:07:34] Yeah, mm-hmm and, and, and I just kept retesting my hormones as I, my, I mean, my antibodies, rather my thyroid antibodies as I retested those foods. So it took a couple years. I, you know, I stayed off gluten for a year before I think I even retested, but then I, you know, you try it again and you see what happens and, and each of those foods.   [00:07:52] So anyway, I ultimately decided gluten and dairy are the two things that I'm most sensitive to. And then of course, everyone should stay off added sugar. So I try and avoid that in any case. And. Ultimately, I never had to take any thyroid hormones. My antibodies are now at zero. They're all completely normal and I never, now they can still see the damage from Hashimotos when they all use an ultrasound on my thyroid, but I still have normal TSH levels.   [00:08:17] I mean, not even just normal, optimal TSH levels. That's awesome.    [00:08:21] I want everyone listening to hear that clearly. She just told you that she healed herself from Hashimoto has no antibodies and has optimized thyroid function. This is what's possible with a root cause approach. And I think that when I talk about this on the podcast or on social media, people don't believe me because it's such an anomaly in mainstream medicine.   [00:08:44] And of course, regular doctors will look at you. Like you're crazy and say, that's not true, but it happens every day. We see it's an everyday miracle. So I love that you came down this path and you became so passionate about gut health. And I think to me, it makes sense why you focus on having the autoimmune disease or diseases focused on gut health, but I don't know  that's gonna make sense to everyone.   [00:09:11] Can you help them make that link betweeut health and autoimmune disease.   [00:09:15] Absolutely. So. There are three things that are necessary for an autoimmune condition to happen. And one is a genetic predisposition for that particular autoimmune disease. So some people's bodies will attack one, some one organ, some people's bodies will attack a different organ.   [00:09:32] Then you need to have a leaky gut or intestinal permeability, which means that the tight junctions in your intestines are not holding together or there are holes through actual cells in the intestines that are letting. Both toxins, undigested, food, bacteria, body parts, all sorts of things that your immune system is going to then start attacking.   [00:09:54] And then you activate the immune system like this. And that's what inflammation is in essence. And when you have undigested gluten proteins in particular or gliadin, it's called is the protein in gluten. It resembles the cells in your thyroid gland and your body will attack this protein and then also create antibodies that attack your thyroid.   [00:10:19] So in essence, it's a, what they call molecular mimicry or some sort of confusion in your body where it starts attacking itself. So that's always at the root of all autoimmune diseases. Yes.    [00:10:30] So if you have an autoimmune immune disease, I always tell people by definition you have a gut problem and people will say to me, well, My gut works just fine.   [00:10:39] I eat, I poop. I don't have loose stool. I'm not constipated. I don't get indigestion gas, bloating. And they say, I don't have a gut problem. I say, yes, you do. If you have a autoimmune disease, you've got a gut problem. So where is the disconnect? Why do people seemingly have no gut symptoms? But they have a gut problem, help us understand that.   [00:10:58] Well, sometimes I think what happens is there's a balance of bacteria in the gut, such that your stool looks okay, right? Like maybe, you have some constipating bacteria and you have some loosening bacteria and together they've canceled each other out. But that doesn't mean that you don't have a leaky gut.   [00:11:16] Typically there is some sort of gut infection causing leaky gut, but it doesn't necessarily. I mean, you could have toxins that are also in play or mold or things like that, but in general, something is causing your gut to be leaky. So, you know, it's interesting because sometimes I will see people's gut tests for potential stool donors for fecal transplants.   [00:11:39] And. And I'll say, oh no, you can't take this person's stool. They may have good stool, and they may seem healthy and have good digestion, but it's just full of problems. Like, I mean, they have, you know, major pathogens that you'd never wanna take on. So just because you don't have any obvious gut problems doesn't mean something's not gonna show up on a test, right?   [00:11:58] Yeah. I mean, you may not overtly have symptoms, but that doesn't mean that on a microscope or on the micro level, you're not having problems you are. If you have an autoimmune. Yeah. So you mentioned testing, let's start with that. Cause a lot of people, you know, they're used to going to their regular doctor and what happens at their regular doctor.   [00:12:19] Oh doc, I have indigestion after I eat. No tests are done and they're given a proton pump inhibitor or Hey doc, I can't poop. No tests are done. And then they're given some pro motility agent for their gut. Hey doc, I alternate diarrhea, constipation. oh, diagnosis of exclusion. You have irritable bowel syndrome.   [00:12:39] Mm-hmm and they're put on anti-spam. So they're not used to doing gut stool tests. And I remember when I first started doing this work and I started with my gynecologic patients and I told them they needed to do a stool test and they would look at me like I was crazy. What are you talking about? Well, you need to poop in this pie plate and send it off to scoop it into these little tubes and send it to the lab.   [00:13:01] And they're like, what? I'm not doing that cuz no doctor ever asked them to do that. mm-hmm so talk about, you know, the testing, maybe what are some of your favorite tests to do and what it shows you and how people can get comfortable with this idea of pooping in the pie plate?    [00:13:21] Well, I have to say the people who come to me have no problem giving up their stool for a test because they are coming typically with gut issues.   [00:13:28] However, yeah, my favorite is the GI map. I like that one because it includes H pylori and I have found it now over the course  of. Three or four years now of helping people with gut issues that people who are severely constipated often have an overgrowth of H pylori or just a high level of it that's given their symptomatic is also problematic.   [00:13:51] So that's a bacteria that causes ulcers or stomach cancer, but not always only when it has certain virulence factors. Nevertheless, people will typically present with stomach pain with reflux, but sometimes just constipation. Sometimes they don't have those upper GI symptoms with H pylori. So I like that it includes also the GI map.   [00:14:14] You know, a number of different levels of bacteria in the gut. So you can see if certain classes or certain Gena or certain species are elevated or too low, both of the commences, the normal good ones, and then the potentially pathogenic and then the actual toxic pathogenic ones. It also includes all the parasites.   [00:14:33] So you can catch up somebody as a para and then it includes markers of gut health and just digestion. So, like, do you have enough pancreatic enzymes? Do you have elevated levels of beta lyase, which ties into hormones? Do you have sufficient secretory, IGA, or is that super elevated? Indicating your gut immune system is on high alert and trying to fight something.   [00:14:55] So I just like that it's a good overall test of various markers. And then of course it has marker for Calprotectin, which is a marker of inflammatory bowel disease and the inflammation in the colon.    [00:15:07] Yes. That's actually my favorite too. So great minds think alike. I think it really gives you the most comprehensive view.   [00:15:14] And sometimes people will come to me and say, well, I had a volume test. Can't you use that? and I go, yeah, that's not useful at all. Can you share with your people your thoughts on the bio, that one or any other one of these direct to consumer tests are not as far as I'm concerned, clinically useful. They might be good for the consumer, but they typically, you know, they will make all sorts of commentary about what diet changes are necessary, for example, based on your microbiome and no harm in trying those things.   [00:15:49] But when you're dealing with parasites or digestive dysfunction, Dysbiosis, et cetera. I think you need a clinical level test for that kind of stuff. There's just not a lot of actionable for a practitioner. There's not a lot of actionable information on a volume test. I agree.    [00:16:11] I, I think the same is true for a lot of the DNA direct to consumer test.   [00:16:15] Like, is it 23? And me, it's just not all the actionable information that you would want. Like the Alzheimer's gene mm-hmm , that's something I think everyone should have. And, uh, they don't include. Oh, really? I feel like they've included in well, so, oh, maybe they have, well, you can take, you can pull the raw data.   [00:16:34] I'll sometimes ask my clients for their raw data and I put it in genetic genie and I run that. And then I see, cause I, because I know that I'm, I'm APO four, three Aprile four. Homozygous. So I have my high Alzheimer's risk, which I, the only reason I know that is from the 23 and me. So I know it came through may, either on genetic gen genie or directly on 23 and me.   [00:16:55] Great.    [00:16:56] And so how has that empowered you? Do you feel like it's empowered you or disempowered you to have that information?   [00:17:03] I don't know that I would be doing anything different because I'm already somebody who seeks to optimize my health and have been my entire life. So I don't know, but I think as I get older, I'm definitely going to be more attentive to any kind of lapses in memory.   [00:17:21] And then at some point I'm probably going to get hooked up with that. Program the Dale BNS program related to Alzheimer's just to make sure that I'm doing absolutely everything preventative and everything testing wise, to make sure I don't lose my memory any sooner than necessary. Yes, absolutely. The Recode protocol.   [00:17:38] And I think there are 28 parameters, 28 things you need to be doing that are totally worthwhile. My mom. It has advanced Alzheimer's. So it's something I'm very keenly aware of and, you know, it's too late for her. Like I shared in a recent TEDx talk that I did talk about her only risk factor was that she had been menopausal for three decades without hormone therapy.   [00:18:01] And that is, of course, one of the main tens of the Recode protocol is using. Hormones therapy, natural hormone therapy. Speaking of which the podcast is called the hormone prescription. So I tie everything into hormones because to me, everything in the body is related to hormones. So how does let's go back to autoimmune disease with gut dysfunction, leaky gut.   [00:18:25] Intestine intestinal hyperpermeability as a key factor.    [00:18:30] How does this interact with the hormonal meal, you and the body?   [00:18:32] In my particular case, I'm not sure if there's a huge interaction, but in general, I mentioned on the GI map, there's a hormone, uh, I mean an enzyme called beta Gluar days and that. Is an enzyme that breaks the tight bond between glucuronic acid and toxins, including circulating estrogens in the intestines.   [00:18:55] And so when that gets elevated in certain bacteria in the gut, produce it so certain bacteria from the, the, uh, class ties also certain clostridia E coli. And there's a lot of healthy E coli, not just the ones that are known to be pathogenic and stalac rheumatic. So there's a number of different bacteria that produce it.   [00:19:18] And when those tend to get overgrown, then you can have access. Beta glucoronide and then this is breaking apart, this bond and recirculating estrogens in the body, which can lead to estrogen-related breast cancer, potentially colon cancer. So there's some correlations between those and. When that happens, what you can do to reverse it is to move to a lower fat, lower meat diet, to more of a plant-based diet because higher fiber will help undo that process.   [00:19:50] Yes, it's so    [00:19:51] true. The beta glucuronidase. So anyone who is suffering, which is very common sometimes in thirties and forties year old women, before they go through menopause with excess estrogen. And symptoms of that. It could be fibroid, endometriosis, heavy, painful periods, which is often associated with weight gain bloating.   [00:20:13] These are estrogen dominant conditions. You gotta look at your beta Glu UASE in your stool because it could be elevated. So that could be one of the key causes of one of your hormonal imbalances And then the other thing I always like to say for anyone with an autoimmune disease is you've got a foot on the accelerator of inflammation and that's this leaky gut, but you have no break on your car.   [00:20:39] And that would be cortisol, which is your body's natural steroid. So what do they do when you have a flare up of any type of inflammation or autoimmune disease? Steroids is the treatment and that's your body. Cortisol inside naturally. So you have a brake failure and you have a foot on the accelerator.   [00:20:57] So it's kind of a two-prong problem. So you've got to address both, but by healing your gut, you can work on your cortisol as well.   [00:21:03] So let me interrupt you for a second, because when you said all those things, as I think of this stuff now more in terms of my client than myself, but I did actually have estrogen dominance.   [00:21:15] No, no doubt. I had always low progesterone and I went through years of infertility. So I, I assumed that all of my gut stuff was at the root of that as well as the autoimmune stuff and probably, uh, you know, some thyroid issues.    [00:21:28] Yeah. You know, I think it's, isn't it Louis pastor who said death begins in the colon and I think  it's absolutely true.   [00:21:37] The gut is the center of your body physically. And it's the center of your health. Literally. It has branches to everything. And, you know, I always like to say. I ask people, what's your biggest interface with the external environment? And they say, oh my skin. And I say, no, think again. And it takes them a minute and most people don't get it.   [00:21:58] It's your gastrointestinal tract, cuz you're taking the external environment and you're putting it inside of you into this tube. That seems like it's in you, but it really just passes through and interacts. So it's like an inner skin and it's as big as two doubles tennis courts, the surface area. And so.   [00:22:17] Really that's your biggest ability for the environment to program you? You mentioned genetics, right? That's part of probably five, 10, maybe 20% of our health, but then what turns on those genes? In terms of our epigenetic code and, and food is the biggest programmer of that, that we're putting into our body and think of all the food you eat in the day.   [00:22:41] So I, I wanted to, to touch on something else. You said, well, we were talking about testing and I think you mentioned earlier about that you had SIBO small intestine bacteria overgrowth.    [00:22:53] Yes. What are your favorite tests to diagnose that? And it's such a Gnarly topic for the people who have it. How do you get rid of it?   [00:23:02] You mentioned the migrating motor complex, which a lot of people really don't have that working. So there's no motility going. So can you talk about SIBO?   [00:23:14] I don't tend to use breath tests. I'll start by saying mm-hmm . I tend to use the GI map and organic acids in general. When I see somebody with some type of presentation of bloating and what look like SIBO symptoms.   [00:23:31] Mm-hmm that being said, if. After looking at those and after taking herbal supplements to get rid of bacterial overgrowth, there still seems to be no resolution. I may recommend either the trio smart, especially if I suspect there could be hydrogen sulfide overgrowth, or I might recommend the IBS smart test to see if they have post.   [00:23:57] Infectious IBS to see if they have that autoimmune component and are always gonna be dealing with SIBO. So some people just get this overgrowth, they clean it up once, and they're all good. And then other people like me are going to constantly have to be fighting it. So I have to take something each night.   [00:24:12] A prokinetic. In order to keep things moving in my migrating motor complex and just be conscientious of not eating tons. No, not snacking all day long, letting my intestines empty out completely and periodically have to kind of Rell the bacteria. I have to take antimicrobials, you know, every year, roughly.   [00:24:31] In some quantity when I start to see things getting bloated again. Okay.    [00:24:35] So now the average person listening and probably a lot of the clients that you see and that I see they've been to their regular doctor and they've got this bloating problem. That seems pretty consistent. They're probably not gonna get any of these tests.   [00:24:50] Are they, there are some doctors at this point who will order SIBO, breath tests. That's not unheard of now at this point for GI doctors and some will have heard of, and may be using some, the trio smarter, the IBS smart, because they are, they were developed by an MD who is the expert at, Mark Pimentel.   [00:25:10] Who's the expert in SIBO and who does try and reach that traditional audience or conventional, I should say audience, but typically you'll have to ask for and seek out these more. Specialized tests with somebody who's either practicing functional medicine, a natural path, a health coach, somebody who is mm-hmm, more of a non-conventional expert in gut health.   [00:25:34] Yes.    [00:25:35] And so it sounds like you're describing, which has kind of been my experience too, with people who have SIBO. Some people do recover, and they don't have a problem any longer, but there is a subset of people who this is a very chronic problem. Can you talk a little bit about why someone might suffer with that as a chronic long term condition?   [00:25:57] Sure. So I did talk about. The primary, I guess I think about it as the primary, but I'm not actually sure. In terms of percentages, but I did mention the primary, which is the post infectious IBS, there, incidents of food poisoning, where you have an autoimmune problem, you can also have of course thyroid issues that can contribute to it.   [00:26:17] Hypothyroid, you can have traumatic brain injuries that are causing issues with the vagus nerve and with. Movement in the intestines from that of course infections, diabetes can be a root cause. Mold toxicity. You can have problems with your production of stomach acid, so you can have low stomach acid or hypochlorhydria.   [00:26:41] And that can cause. Overgrowth of bacteria or poor bio flow, uh, lack of pancreatic enzymes or brush border enzymes. There can be deficiencies in your secretory, IGA. If you've been under periods of extreme stress that can reduce secretory IGA, which is your gut immune defense, which is what is killing off these bacteria that are coming in.   [00:27:00] Mm-hmm , you can have medications that you're taking that could be causing problems and slowing your motility, obviously proton pump inhibitors, but also antidepressants. Anti SMOs opiates, narcotics. Then you can also have issues that are physical in nature. So you've had a past abdominal surgery and you could have adhesions for example, that are keeping your intestines from flowing properly endometriosis, which I also had, can be a root cause.   [00:27:28] Alors Danlos syndrome can also cause problems with motility. And then you can have dysfunction of your I valve.    [00:27:35] Yeah. There's such a long list of problems that you can have that can contribute to this. And I think, you know, people listening, I kind of want, because you have such breadth and depth of knowledge.   [00:27:48] For them to really get a good idea of what you, what you know, and what you offer. You have so much information on your podcast. We're definitely gonna give everyone, um, we'll put the link in the show notes to the podcast. And I was just looking at all the episodes you have. I was like, oh my gosh, I wanna talk to her about this.   [00:28:11] I wanna talk to her about that. I want her to share this. I want her to share. And so I think even if you're listening and you're like, oh my gosh, you guys are going way too fast and covering way too much ground. That is information for you to spur your interest, to go watch. Or listen to Lindsey's podcast, cuz she has so much valuable information.   [00:28:32] And then you can select the topics that interest you and you can listen to those. She talks about the FMT, the fecal microbiota transplant as a treatment. And I'm wondering if you could share a little bit about what that is and what it's used for? Cause I don't think a lot of people know that. An up and coming treatment for our GI problems.   [00:28:54] Okay. So FMT in the US is legal only in non-experimental contexts for recurrent C difficile infections, which is very potent bacteria that causes, you know, explosive diarrhea that can kill you and kills. I don't know something like 40,000 people a year. So if you have recurrent C diff, that's not treatable by antibiotics a couple times, then you could, in theory, if you can access it, get a fecal transplant done in a hospital.   [00:29:23] And it's basically taking the stool from a healthy donor and either putting it in capsule format or in ENMA format. And then you get a retention en ENMA of it. And for C diff it's usually just one treatment for other. So in other countries it's legal for other conditions like. IBS or inflammatory bowel disease with different levels of success, given the condition, even for autoimmune conditions, for any number of things, even, even conditions you might think aren't connected to.   [00:29:58] The gut is like ALS or multiple sclerosis. Well, that's autoimmune. So you may think that, but in any case, there are definitely some testimonies on a number of different conditions. So in, in particular, I think I know of clinics that do this in Australia, in the UK, in The Bahamas in Canada. Now I think there's one in Mexico focusing on, on children with autism in particular.   [00:30:23] Oh, and I think there used to be one in Argentina. I'm not sure if that's still there. So around the world, you can do treatments. And typically those will last for two five-day courses, essentially over the course of two weeks during the work week. And, you know, there are just some amazing testimonials of, of, oh, and of course mental health.   [00:30:41] I hadn't even discussed that cuz I have a lot of stories of people with serious mental health issues from bipolar to depression, to anxiety and pan and pan pans and pan, does that have been resolved after fecal transplants? And then of course it's also being used and in a particular, very purified form, that's an experimental form being used for autism.   [00:31:03] So it has the potential to be quite life changing, which is not to say it is for everyone. Uh, there's a Facebook group full of people who have tried it and it didn't help them. So I think the donor quality and just sort of the good match between the donor and the recipient are also important. So it's not always a foolproof thing.   [00:31:22] I. but, but there are for those, for whom it makes a difference, boy, it sure can make a big difference. Yeah. And I think probably some people listening are thinking, wow, that's really radical. Cuz I know when I talk about coffee, ENMA some people just really freak out. they're like what? I'm not doing.   [00:31:39] Putting what in my butt. No. And so when we talk about a fecal transplant via enema, I know some people get freaked out, but you know, if anybody listening has heard any of the recent data or information or knowledge that we have about the microbiome and how key it is for our overall health, you really, for some people could call it almost like getting a brain transplant, cuz your gut is your second brain.   [00:32:04] And. See the podcast episode that you had with the woman who I think she healed herself from bipolar using fecal transplant. Can you talk a little bit about her story?   [00:32:15] So she was in Australia and had bipolar for many years. I think she had probably, I think if I recall correctly, I think there had been suicide attempts.   [00:32:27] She had been in the hospitalized maybe five times with, you know, major depressive episodes. So. It was a serious and ongoing problem for her, from which she would emerge, you know, for periods of time when she could function normally, but mostly couldn't hold down a job. She did get married though, to a wonderful man who also had a wonderful stool.   [00:32:49] And at some point heard about yeah.    [00:32:52] New criteria for finding a partner.    [00:32:55] Absolutely.    [00:32:56] So did I get a stool sample before we seriously? Well, she didn't test it or anything. She just tried it and sure enough. It really worked for her. I think she, I think she did it more intensely at first and then more periodically afterwards, but it absolutely pulled her out of her depressions.   [00:33:15] And, you know, in large part resolved her bipolar. I wouldn't say she said it wa I think she emphasized it. Wasn't like a hundred percent cure, but from what I could hear, it really turned her life around. So she just DIYed it. She DIYed it. Yeah. So there's a lot of people doing that in the US, by the way, they're just finding donors.   [00:33:35] They may or may not be testing 'em I always recommend, of course, if you're gonna consider a donor that you do the full protocol of testing, which involves both blood tests for infectious diseases and sexually transmitted transmitted infections, as well as a stool test to, to make sure they don't have any of the major stool pathogens that you could potentially get.   [00:33:52] Because especially if you're doing it. Reasons related to gut issues. And you're, if you're in fragile health, like, especially if you have any kind of inflammatory bowel disease, you can really mess yourself up. If you bring in a pathogen and your gut is not prepared to fight it.    [00:34:07] Yes. Yeah. I would say, you know, it'd be similar to having sex.   [00:34:11] It's pretty intimate. You might wanna even more so.   [00:34:15] Right. Even more so. Yeah. Wow. So much. And then I was wondering, I saw you had another, a few episodes. I. On colostrum. Yeah. The one with ni not Nike, is that how you say his name and how and breathwork and colostrum that he used to restore his gut. And I was wondering if you could talk about some of that.   [00:34:39] So colostrum is the first milk that comes out of the breast and, or the cow in this case, because if you buy it, you're buying cow colostrum and. It is full of antibodies and transfer factors and immunoglobulin. And in particular, now they're also selling these serum bovine immunoglobulin, which are extracted from colostrums. [00:35:05] So I often recommend those to clients who have serious gut issues, because it just kind of enhances your. Immune system in the gut, without specifically, it's not like an antibiotic, which kind of indiscriminately kills. It's more like bringing in an extra immune system. Mm-hmm . So I often do recommend those powders to people who have something that you don't quite want to hit with an antimicrobial right off the bat.   [00:35:29] So anyway, so in his case though, he used a colostrum to heal his gut. And so it's just, I think it's just a way of bringing in a new immune system to the gut slowly but surely and helping it turn itself around. Yeah, I love them as like, you it's like a supportive, I don't know that it fixes necessarily.   [00:35:47] It's a bandaid and it gives support in the short term and can help promote healing. So I love them. And then I was just interested. For you to also talk about breathwork, which is something that I use in my programs all the time with people. Um, I teach them about the nature of HR V heart rate variability and parasympathetic sympathetic, autonomic nervous system balance.   [00:36:09] And how that really programs your gut, your guts motility. Is that something that you recommend for people?   [00:36:16] I have recommended it to certain people since that podcast in particular. And then since I read the word, the book breath by while I'm in the middle of it by James Nester Yes. So I definitely have gotten more interested in the breath and how it relates to good health in particular.   [00:36:32] Now, if I have a client who snores, I'll suggest mouth taping, mm-hmm . If I have a client for whom. Everything has been tried in terms of diet changes in terms of supplements and antimicrobials. And there's still kind of the root cause of their stress or of their dysfunction has not been identified. I'll really think about breath work and or some other type of practice like meditation or yoga, etcetera, to start reducing stress and just bringing some focus.   [00:37:05] But  I probably have not exploited it to the extent that it could be, because there's always so many different things you can bring in with a client and you don't want to overload them.    [00:37:15] That is so true. And along those lines, I'm wondering if, because we've jumped all over the place, cuz I'm just so excited to talk to you.   [00:37:23] And there's so many things I wanna ask you about and chat with you about, but for everybody listening, can you kind of bring it full circle, maybe using a who comes to mind that maybe had really been suffering for a long time. And who came to you and kind of, what is the process you usually take people through. And what does, what does a gut journey look like?   [00:37:46] for people? So I have such a variety of clients, from people who think they've been suffering a long time because they've had something for a year versus people who've had something for 15 years. And, but I would say, uh, a typical journey might be somebody who comes in with a little more complexity.   [00:38:02] Maybe they have both gut issues and autoimmune issues. Typically, we would just have a first appointment to talk over a complete medical history in the way that no doctor has ever sat and listened to you where I'm gonna totally try and understand all the potential root causes of what has come to pass and how they've ended up where they are.   [00:38:20] And then together we'll decide on what tests fit in based on. What their symptoms are and then what their budget is because obviously not everybody can afford a thousand dollars worth of testing right off the bat. It would be lovely if everybody could, but not everyone can. So we have to be thoughtful about that.   [00:38:37] And then typically we'll get the results back, and then we'll go over those results and all the potential things that could help given what, what was found on the test. And I'll educate them about the protocols that practitioners use to deal with those that's come up, be it some type of dysbiosis or SIBO or overgrowth of candida.   [00:38:57] Or something like the ion profile, we may be looking at deficiencies in amino acids or in fatty acids or vitamins and minerals that can come up on organic acids or on the ion profile. So we'll look at that. And then typically I'm recommending things to them over a period of time because you can't again, throw.   [00:39:15] A hundred supplements at a person at the same time, people can only take so much. I mean, there are, people are just like, give it all to me. I want it all right now but other people are gonna be like, yeah, that's too much both financially and too much in terms of taking pills. So, you know, I'll, I'll explain to them what, what the different supplements the benefits are and what I think in a good order would probably be for doing it.   [00:39:37] And then diet changes, of course, will be recommended based on. What they've already tried, but I find that by the time people get to me, they're usually already eating some version of a paleo diet, or I do occasionally get people who are plant based and I often have to push them towards getting more protein.   [00:39:54] Somehow mm-hmm, potentially moving towards eating some animal protein or some seafood, just because I can see frequent deficiencies, amino acids when that happens. And, it's also very common to see mental health issues in my clients. So if that's the case, then I'm often. You know, educating them about the amino acids that can bring up serotonin and dopamine.   [00:40:16] And you can see the deficiencies of that  on an organic acid test, or you can see actual levels of the amino acids on the ion profile. And then with autoimmune stuff, then we're also looking at supplements that can help reduce inflammation if we've already addressed gut stuff. So typically we'd go through addressing any kind of gut.   [00:40:36] But then after that, if they're still flaring, then we might look at anti-inflammatory supplements, like, you know, fish oil or SPMS, or I get the name of right off the bat. Oh, alpha glyco, ISO Quatrine Soin BAIC or Cuban. Yeah. Curcumin. Right. Those kind of anti-inflammatory things. So over time, you know, I'll educate them about each kind of supplement and how it might play a role in helping them heal. [00:41:04] and yeah, so I'll ultimately see people over the course of five appointments that might take most of a year and slowly but surely help them restore their health and get them at least to a point of stability. There's no magic cure in terms of autoimmune disease. Not everybody's gonna have the results I did because I caught it early enough and there was not so much damage to my thyroid.   [00:41:25] So. You know, you have a certain amount of damage, and it's not gonna be, you're not gonna reverse it, but you may reduce your medication dosages and you may at least get to a point of stability or potentially if, if the client is interested, get off any kind of, you know, steroid medications or. Other autoimmune prescription medications.   [00:41:46] Yeah. Immunosuppressive drugs. Right. I'm curious to know.    [00:41:49] I mean, we're, we're getting short on time. I'm gonna have to let you go, but I wanna know your thoughts on alcohol, cuz my thoughts are not necessarily popular. So I just want to see where you stand on that with gut health. Well, it is toxic. There's no question about that.   [00:42:05] And it does. Kind of go in and cause some damage to gut bacteria. And if you're having guest right and upper GI issues, for sure. It's definitely not helpful. That being said, I can't say I'm a non-drinker, so I'm not, but generally my clients who are really sick are just not drinking in the first place.   [00:42:26] So I'm not having to tell most of them to stay away from alcohol there, but they've already done it themselves. So obviously you want to stay at the lowest levels. You want to be considered a low level drinker, not a moderate level, which unfortunately for a woman is no more than a drink a day. And for men no more than two, up until 65 than one after 65, if I recall correctly.   [00:42:47] And then the other things is that people wanna say, do we all have to stop eating gluten and cow smoke dairy Lindsey?    [00:42:55] We'll typically recommend cutting out gluten and dairy to everybody for some period of time. Now, if I have a very simple case of SIBO that resolves quickly and easily, and the person says, I don't seem to have any problem with gluten, I cut it out, and I put it back in, and I had no difference.   [00:43:12] Then I won't necessarily say you have to cut out gluten. If you have an autoimmune issue, I'm gonna say gluten's gone for life.   [00:43:20] Yeah. I, I generally would agree with that for sure Lindsey, so much great information that you shared today. I know everybody listening has been like, it's a whirlwind Kyrin, you took her all over the place.   [00:43:31] I know, I know guys, but I wanted you to get a sampling of everything that she has to offer. There's so much more, even on her podcast, the perfect stool, which is an amazing name. And great content. You've had some of the same. Yes. I've had Steve Wright and Dr. Gray SL and they're probably more if I continue to look at it, I did wanna ask you about this before we wrap up, you shared, uh, some quotes that you like before we started with me and I just wanna share this one.   [00:44:01] A calorie is not a calorie. And can you tell everyone what that means to you?   [00:44:04] Absolutely. So, number one, I, before I did this, I was. A, an advocate for healthier school food. And one of the things that we fought the most in that particular battle in Montgomery County, Maryland, was to try and reduce the sugar in school food.   [00:44:22] And I remember sitting at a hearing with the state Senate, trying to get a bill passed, to reduce sugar in school food, and having. Former home EC teacher who was a state Senator said, well, a calorie's just a calorie. And I said, no, it is not. In fact, that is a soda marketing campaign to try and convince you.   [00:44:41] You can just go calories and calories out, just exercise more, and you can drink your Coke every day, which I definitely do not believe. So part of the issue with calories is that they're not metabolized the same. So for example, when you eat protein, 25 to 30% of it is. Of the calories of protein is used up just in digesting the protein.   [00:45:01] Whereas it's, it's a much lower number for carbohydrates and fat. So, you know, something like six to 8% of the carbs are used to digest carbs and two to 3% of the fat. So therefore you're getting a lot more calories from your fat and your carbs. And then. You also have different foods and have that have different impact on the body.   [00:45:20] So for example, fructose versus glucose, glucose can be used by almost all your cells. Fructose is going to your liver and ultimately, mostly being stored as fat. So, you know, that's why the whole thing against high fructose corn syrup, not to say glucose is good, but just to say that, that they impact your body differently.   [00:45:37] And then of course you have fiber. So, you know, if you eat a hundred calories of almonds versus a hundred calories of soda, That impacts your body in a completely different way because the almonds have healthy fats, and they have fiber, and that is gonna slow down the absorption of the calories of any sugars, et cetera, that are in the food when you're eating fiber.   [00:45:59] So it just makes a complete difference in which kinds of foods you're eating. A calorie is not a calorie. It's so true.    [00:46:04] And I, I really love to help people understand that a lot of people believe the food that they eat is only about calories. And it's speaking to your system on so many levels. Right.   [00:46:17] Mm-hmm, in so many languages at one time. It's like they're having this international language conference. It's speaking because of its bio force. It's life force, it's PR it's Chi, whatever you want to call it, it's speaking nutrition, right? Certain vitamins, which are not present in soda and in the almonds are of course speaking the fiber language, right.   [00:46:39] Or it's not speaking fiber language. And so about so much more than macronutrients, which are calories. It's about micronutrients, energetic nutrients. And I think that goes to the other quote that you shared with me that I love. I'd rather pay for healthy food now than healthcare later. So one of people's biggest objections to doing this type of work is eating, trying to eat healthy and particularly organic.   [00:47:07] And so talk a little bit about that and then we'll go ahead and wrap up.   [00:47:09] Oh, I just have, I've been of the philosophy since I have tried to turn around my health, that that indeed it is worth it to pay for more expensive organic foods and in particular, and this is a lot of people, they, they think, well, I, I mostly buy organic vegetables and I say, do you eat Pasteur raised meats?   [00:47:29] How about your dairy products? Are they pasture raised? So I don't, I, the only dairy I. Is butter and GE. And so I make sure that those products and, and I know it cost $4 more, a pound for pasture raise butter, but I get it because that's where all the toxins from the body settle into your fat.    [00:47:54] So if you want to maximize your, you know, or minimize your consumption of toxins, then you definitely wanna look for high quality meat and wild cut seafood and that kind of thing not. And then of course, low mercury seafood at that. When you're looking for your animal products, cuz the animals, you know, you think about everything else. It's the build up the entire environment and the plants that builds into the  animal and the protein and the fat.   [00:48:10] So true.    [00:48:14] Thank you so much, Lindsey for joining us today, Lindsey Parsons, we are gonna have links in the show notes. You've got a free E booklet available on your website, finding your root cause through stool and organic acids testing. So I'll have a link over to that.   [00:48:29] We'll have a link to the 30 minute breakthrough session that people can do by phone or video chat. We'll have a link to the podcast also that you definitely wanna check out if you're interested in your health and healing from a root cause. Gut is a huge part of that. So you want to go there and check out the perfect stool so you can have the perfect stool and thanks so much for joining me today.   [00:48:53] Any last words you'd like to leave everybody?    [00:48:54] No, I just wanna thank you so much for bringing me on and for checking out my podcast and recommending it. I really appreciate it.    [00:49:02] It is absolutely my pleasure to have you here, and thank you all for listening today. Thanks for spending a little bit of your day with us.   [00:49:10] Hopefully you have learned something today that you can put into action. This is all about taking action to move your. To the brilliance that it can be. I thank you for joining me, and I'll see you next week until then peace, love and hormones. Y'all thank you so much for listening. I know that incredible vitality occurs for women over 40.   [00:49:32] When we learn to speak hormone and balance these vital regulators to create the health and life that we. If you're enjoying this podcast, I'd love it. If you give me a review and subscribe, it really does help this podcast out so much. You can visit the hormone prescription.com, where we have some free gifts for you, and you can sign up to have a hormone evaluation with me on the podcast to gain clarity into your personal situation until next time.   [00:50:02] Remember, small steps each day to balance your hormones and watch the wonderful changes in your health that begin to unfold for you. Talk to you soon.   Get Lindsey Parsons's free e-booklet: “Finding Your Root Cause Through Stool and Organic Acids Testing.” https://highdeserthealthcoaching.com/newsletter/   30 Minute Breakthrough Session with Lindsey Parsons - by phone or video chat https://calendly.com/highdeserthealth/30-minute-breakthrough-session-by-phone-or-vi-clone   Feeling tired? Can't seem to lose weight, no matter how hard you try? It might be time to check your hormones.   Most people don't even know that their hormones could be the culprit behind their problems. But at Her Hormone Club, we specialize in hormone testing and treatment. We can help you figure out what's going on with your hormones and get you back on track.   We offer advanced hormone testing and treatment from Board Certified Practitioners, so you can feel confident that you're getting the best possible care. Plus, our convenient online consultation process makes it easy to get started.   Try Her Hormone Club for 30 days and see how it can help you feel better than before. CLICK HERE to sign up: https://www.herhormoneclub.com/  

Video for this podcast: https://mehlmanmedical.com/audio-qbank-hy-usmle-q-494-immunosuppressive-agents Main website: https://mehlmanmedical.com/ Instagram: https://www.instagram.com/mehlman_medical/ Telegram private group: https://mehlmanmedical.com/subscribe/ Telegram public channel: https://t.me/mehlmanmedical Facebook: https://www.facebook.com/mehlmanmedical Podcast: https://anchor.fm/mehlmanmedical Patreon: https://www.patreon.com/mehlmanmedical

CMS has proposed that non-disable, under age 65 year old kidney transplants have lifetime coverage under Part B for immunosuppressives instead of the 36-month limit currently.

Join us for a conversation about types of vaccines and what's appropriate for use with immunosuppressive therapy. Dr. Sandy Chat from Indiana University School of Medicine and Dr. Christoph Ellebrecht, Clinical Instructor, Dept. of Dermatology at University of Pennsylvania, discuss the flu, shingles and mRNA vaccines. Psound Bytes is supported by unrestricted educational grants from Amgen, Bristol Myers Squibb, Janssen, Novartis, Pfizer and UCB.

In this episode, we review the high-yield topic of Immunosuppressive Drugs from the Immunology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

Exposing Mold - Episode 8 - Getting to Know Erik Johnson,  U.S. Military Nuclear Missile Launch SpecialistIn this episode, listeners learn more about Erik's background in the military as a U.S. Nuclear Missile Launch Specialist,  the use of biological warfare agents, and where nanoparticles come from.   If you've been affected by mold and want to contribute to our efforts, visit our Patreon or GoFundMe page to donate today.Patreon - patreon.com/exposingmoldGoFundMe - gofund.me/daf1233eWe understand the huge financial loss mold causes. You can do your part by Liking, Sharing, Commenting, and Rating our content. We need your support to raise awareness of this devastating illness so that people can get the help they deserve.Transcript:English - https://bit.ly/3wlKlih Spanish - https://bit.ly/3osI95x Resources:[1] Photo of Erik in the military, Nijmegen March - https://bit.ly/3hOkPhF [2] Hitler's Bunker - https://bit.ly/3bBRTWd [3] Immunosuppressive evidence of toxic mold/sick buildings - https://bit.ly/3tYyRPW [4] Video of US Military Biological Warfare training exercises - https://bit.ly/2T2YFh9 [5] Nazi's utilizing DDT - https://bit.ly/3flSyfa [6] How nanoparticles are created and their applications- https://bit.ly/2QuW92l, https://bit.ly/3tXOIhP, https://bit.ly/3u0yIvg, https://bit.ly/3hxqGYp  [7] Nanomedicine - https://go.nature.com/3ouDobC [8] Nanoparticles bypassing BBB - https://bit.ly/33RKsWx, https://bit.ly/3v1VGU6,  https://bit.ly/3eYBooZ  [9] Nanoparticles and mold - https://bit.ly/3v0eEL3, https://go.nature.com/33SzjEQ [10] Aspergillus creates nanoparticles- https://bit.ly/3wjPze2[11] Black mold found in Chernobyl - https://bit.ly/3wmAUiB [12] Nanoparticles in volcanic ash - https://bit.ly/2SVFXYB [13] Nerve agents - https://bit.ly/3whbsLf, https://bit.ly/3bx9RJl [14] Bryan Rosner, successful family mold avoidance - https://bit.ly/2S3LIDp Support the show (https://www.gofund.me/daf1233e)

Go online to PeerView.com/SDN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, an expert in nephrology discusses evidence-based strategies to individualize immunosuppressive therapy and optimize long-term outcomes after renal transplantation. Upon completion of this activity, participants should be better able to: Identify risk factors for graft loss and mortality after renal transplantation, Recognize the benefits and limitations of current immunosuppressive strategies used to prevent acute rejection and promote long-term graft survival after renal transplantation, Apply evidence-based approaches to optimize maintenance immunosuppressive therapy in individual kidney transplant recipients, recognizing how and when to initiate CNI-sparing strategies, Describe emerging strategies to prolong the durability of transplanted kidneys as well as potentially improve long-term outcomes for kidney transplant patients.

Go online to PeerView.com/SDN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, an expert in nephrology discusses evidence-based strategies to individualize immunosuppressive therapy and optimize long-term outcomes after renal transplantation. Upon completion of this activity, participants should be better able to: Identify risk factors for graft loss and mortality after renal transplantation, Recognize the benefits and limitations of current immunosuppressive strategies used to prevent acute rejection and promote long-term graft survival after renal transplantation, Apply evidence-based approaches to optimize maintenance immunosuppressive therapy in individual kidney transplant recipients, recognizing how and when to initiate CNI-sparing strategies, Describe emerging strategies to prolong the durability of transplanted kidneys as well as potentially improve long-term outcomes for kidney transplant patients.

Go online to PeerView.com/SDN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, an expert in nephrology discusses evidence-based strategies to individualize immunosuppressive therapy and optimize long-term outcomes after renal transplantation. Upon completion of this activity, participants should be better able to: Identify risk factors for graft loss and mortality after renal transplantation, Recognize the benefits and limitations of current immunosuppressive strategies used to prevent acute rejection and promote long-term graft survival after renal transplantation, Apply evidence-based approaches to optimize maintenance immunosuppressive therapy in individual kidney transplant recipients, recognizing how and when to initiate CNI-sparing strategies, Describe emerging strategies to prolong the durability of transplanted kidneys as well as potentially improve long-term outcomes for kidney transplant patients.

Go online to PeerView.com/SDN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, an expert in nephrology discusses evidence-based strategies to individualize immunosuppressive therapy and optimize long-term outcomes after renal transplantation. Upon completion of this activity, participants should be better able to: Identify risk factors for graft loss and mortality after renal transplantation, Recognize the benefits and limitations of current immunosuppressive strategies used to prevent acute rejection and promote long-term graft survival after renal transplantation, Apply evidence-based approaches to optimize maintenance immunosuppressive therapy in individual kidney transplant recipients, recognizing how and when to initiate CNI-sparing strategies, Describe emerging strategies to prolong the durability of transplanted kidneys as well as potentially improve long-term outcomes for kidney transplant patients.

Go online to PeerView.com/SDN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, an expert in nephrology discusses evidence-based strategies to individualize immunosuppressive therapy and optimize long-term outcomes after renal transplantation. Upon completion of this activity, participants should be better able to: Identify risk factors for graft loss and mortality after renal transplantation, Recognize the benefits and limitations of current immunosuppressive strategies used to prevent acute rejection and promote long-term graft survival after renal transplantation, Apply evidence-based approaches to optimize maintenance immunosuppressive therapy in individual kidney transplant recipients, recognizing how and when to initiate CNI-sparing strategies, Describe emerging strategies to prolong the durability of transplanted kidneys as well as potentially improve long-term outcomes for kidney transplant patients.

Go online to PeerView.com/SDN860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, an expert in nephrology discusses evidence-based strategies to individualize immunosuppressive therapy and optimize long-term outcomes after renal transplantation. Upon completion of this activity, participants should be better able to: Identify risk factors for graft loss and mortality after renal transplantation, Recognize the benefits and limitations of current immunosuppressive strategies used to prevent acute rejection and promote long-term graft survival after renal transplantation, Apply evidence-based approaches to optimize maintenance immunosuppressive therapy in individual kidney transplant recipients, recognizing how and when to initiate CNI-sparing strategies, Describe emerging strategies to prolong the durability of transplanted kidneys as well as potentially improve long-term outcomes for kidney transplant patients.

The Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act that passed in congress in 2020 extends Medicare coverage for anti-rejection drugs from 36 months to the life of the transplant. Troy Zimmerman, Special Projects Director, National Kidney Foundation worked closely with congress to bring this bill to fruition. He explains the details of the bill, when it goes into effect and who will benefit by the new law.

It would be hard to find any health practitioner - traditional, functional, or otherwise - who doesn’t acknowledge the importance of consuming omega-3 fatty acids. Supplements in the form of fish oil or krill oil are widely recommended and consumed, and come with claims of cardiovascular disease prevention, cognitive benefits, and anti-inflammatory properties. But is it really a good idea to get your omega-3s in a gel cap rather than from food? And do they really do everything the media would have you believe? On this podcast, NBT Scientific Director Megan Hall and I discuss omega-3 fatty acids: what they are, what they’re good for, and the best ways to get them. Megan outlines the different types of omega-3 and explains why some are better than others. She also explains why some health claims are overblown, and why buying fish oil supplements may not be the best health strategy. Be sure to follow along with Megan’s outline for this podcast.  Here’s the outline of this interview with Megan Hall: [00:04:30] Blood flow restriction (BFR) training; Podcast: Blood Flow Restriction Training for Improved Strength, Performance, and Healthspan with Dr Jim Stray-Gundersen MD. [00:04:51] Podcast: Wired to Run: Why Your Brain Needs Exercise, David Raichlen. [00:05:41] What are omega-3 fatty acids? [00:06:31] Picture of omega-3 fatty acids. [00:08:40] Finding omega-3s in the diet; Review: Saini, Ramesh Kumar, and Young-Soo Keum. "Omega-3 and omega-6 polyunsaturated fatty acids: Dietary sources, metabolism, and significance—A review." Life sciences 203 (2018): 255-267. [00:09:16] Poor conversion from ALA to EPA/DHA: Gerster, Helga. "Can adults adequately convert a-linolenic acid (18: 3n-3) to eicosapentaenoic acid (20: 5n-3) and docosahexaenoic acid (22: 6n-3)?." International journal for vitamin and nutrition research 68.3 (1998): 159-173. [00:10:56] Why EPA and DHA are important. [00:11:38] Conditions associated with inadequate omega-3 intake. [00:12:02] Whole foods vs. supplements; other micronutrients. [00:12:42] Krill oil vs. fish oil; Studies: 1. Ulven, Stine M., et al. "Metabolic effects of krill oil are essentially similar to those of fish oil but at lower dose of EPA and DHA, in healthy volunteers." Lipids 46.1 (2011): 37-46. 2. Schuchardt, Jan Philipp, et al. "Incorporation of EPA and DHA into plasma phospholipids in response to different omega-3 fatty acid formulations-a comparative bioavailability study of fish oil vs. krill oil." Lipids in health and disease 10.1 (2011): 1-7. 3. Maki, Kevin C., et al. "Krill oil supplementation increases plasma concentrations of eicosapentaenoic and docosahexaenoic acids in overweight and obese men and women." Nutrition research 29.9 (2009): 609-615. 4. Mödinger, Yvonne, et al. "Plasma kinetics of choline and choline metabolites after a single dose of SuperbaBoostTM krill oil or choline bitartrate in healthy volunteers." Nutrients 11.10 (2019): 2548. [00:16:59] Megan's outline for this podcast. [00:18:21] Algae-based omega-3 supplements. [00:19:40] Omega 6:3 ratio; Paper: Simopoulos, Artemis P. "The importance of the ratio of omega-6/omega-3 essential fatty acids." Biomedicine & pharmacotherapy 56.8 (2002): 365-379. [00:25:54] Should we be supplementing with grams of fish oil? Studies: 1. De Magalhães, João Pedro, et al. "Fish oil supplements, longevity and aging." Aging (Albany NY) 8.8 (2016): 1578. 2. Strong, Randy, et al. "Longer lifespan in male mice treated with a weakly estrogenic agonist, an antioxidant, an α‐glucosidase inhibitor or a Nrf2‐inducer." Aging cell 15.5 (2016): 872-884. 3. López-Domínguez, José A., et al. "The influence of dietary fat source on life span in calorie restricted mice." Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences 70.10 (2015): 1181-1188. [00:27:42] No support for omega-3 (fish oil) in the prevention of cardiovascular disease; Meta-analysis: Aung, Theingi, et al. "Associations of omega-3 fatty acid supplement use with cardiovascular disease risks: meta-analysis of 10 trials involving 77 917 individuals." JAMA cardiology 3.3 (2018): 225-233. [00:29:12] Signs you're supplementing too much fish oil. [00:30:26] Podcast: How Oxidative Stress Impacts Performance and Healthspan [00:30:43] Elevated blood glucose omega-3 supplementation; Study: Friday, Karen E., et al. "Elevated plasma glucose and lowered triglyceride levels from omega-3 fatty acid supplementation in type II diabetes." Diabetes care 12.4 (1989): 276-281. [00:31:01] Immunosuppressive effects of supplementing omega-3s: Fenton, Jenifer I., et al. "Immunomodulation by dietary long chain omega-3 fatty acids and the potential for adverse health outcomes." Prostaglandins, Leukotrienes and Essential Fatty Acids 89.6 (2013): 379-390. [00:34:17] Stages of life when omega-3s are especially important. [00:34:48] Specialized pro-resolving mediators; STEM Talk podcast episode: David LeMay Talks About Countering Inflammation with SPMS. [00:35:31] DHA to mitigate traumatic brain injury; Study: Bailes, Julian E., and Vimal Patel. "The potential for DHA to mitigate mild traumatic brain injury." Military medicine 179.suppl_11 (2014): 112-116. [00:35:45] DHA for cognitive function and aging; Study: Weiser, Michael J., Christopher M. Butt, and M. Hasan Mohajeri. "Docosahexaenoic acid and cognition throughout the lifespan." Nutrients 8.2 (2016): 99. [00:37:20] omega-3s for athletic performance; Review: Gammone, Maria Alessandra, et al. "Omega-3 polyunsaturated fatty acids: benefits and endpoints in sport." Nutrients 11.1 (2019): 46. [00:38:54] omega-3s during pregnancy; Studies: Greenberg, James A., Stacey J. Bell, and Wendy Van Ausdal. "Omega-3 fatty acid supplementation during pregnancy." Reviews in obstetrics and Gynecology 1.4 (2008): 162; 2. Braarud, Hanne Cecilie, et al. "Maternal DHA status during pregnancy has a positive impact on infant problem solving: a Norwegian prospective observation study." Nutrients 10.5 (2018): 529. [00:39:44] Excess omega-3 consumption during pregnancy could be detrimental to offspring; Study: Church, M. W., et al. "Excess omega-3 fatty acid consumption by mothers during pregnancy and lactation caused shorter life span and abnormal ABRs in old adult offspring." Neurotoxicology and teratology 32.2 (2010): 171-181. [00:40:12] Testing: The Omega Index test; Framingham Heart Study: Harris, William S., et al. "Erythrocyte long-chain omega-3 fatty acid levels are inversely associated with mortality and with incident cardiovascular disease: The Framingham Heart Study." Journal of clinical lipidology 12.3 (2018): 718-727. [00:42:34] Bottom line: More may not be better. [00:43:09] SMASH fish - sardines, mackerel, anchovies, salmon, herring (also black cod), 3-4x/week. [00:49:30] Schedule a free 15 min call with Megan.

COVID-19 Task Force Co-Chairs dermatologist Dr. Joel Gelfand, Psoriasis & Phototherapy Treatment Center at PENN, and rheumatologist Dr. Christopher Ritchlin, Psoriasis Center, University of Rochester Medical Center, return to discuss the new vaccines and their use with psoriatic disease treatments. Disclosures/credit: https://www.eeds.com/em/1920. This program is supported by educational grants from Lilly, Bristol Myers Squibb and Novartis. 

COVID-19 Task Force Co-Chairs dermatologist Dr. Joel Gelfand, Psoriasis & Phototherapy Treatment Center at PENN, and rheumatologist Dr. Christopher Ritchlin, Psoriasis Center, University of Rochester Medical Center, return to discuss the new vaccines and their use with psoriatic disease treatments. Disclosures/credit: https://www.eeds.com/em/1920. This program is supported by educational grants from Lilly, Bristol Myers Squibb and Novartis. 

Tod Ibrahim and David White talk about the end-of-year stimulus package from Congress and the recent approval of full immunosuppressive drug coverage for kidney transplant recipients.

Tod Ibrahim and David White talk about the end-of-year stimulus package from Congress and the recent approval of full immunosuppressive drug coverage for kidney transplant recipients.

Tod Ibrahim and David White talk about the end-of-year stimulus package from Congress and the recent approval of full immunosuppressive drug coverage for kidney transplant recipients.

Tod Ibrahim and David White talk about the end-of-year stimulus package from Congress and the recent approval of full immunosuppressive drug coverage for kidney transplant recipients.

Welcome back! In today’s episode, Kent records a podcast while on his morning walk. He reflects on the monumental news of the U.S. Senate approval of immunosuppressive drug coverage for Kidney Transplant Patients.  If you have questions regarding items discussed during this episode, contact Kent at kent.bressler@kidneysolutions.org For more information on Kidney Solutions, visit them at www.kidneysolutions.org Host: Kent BresslerProducer: Jason Nunez

There’s a common misconception that you need to run expensive advanced biomedical tests to fix your health. Over the years we’ve found just the opposite, that you can learn much of what you need to know from basic blood chemistry. Perhaps the best example is the information gained from a Complete Blood Count (CBC) with Differential. As the most common blood test, it is widely used to assess general health status, screen for disorders, and to evaluate nutritional status. On this podcast, NBT Scientific Director Megan Hall and I are talking about leukocytes, also known as white blood cells (WBCs), as critical elements of the CBC blood test. Megan discusses the various types of leukocytes and what it means when your count is outside the reference range. We talk about what leukocytes tell you about your nutritional status, why some people “never get sick” as well as signs you’ve got chronic inflammation or physiological stress. Megan also discusses how to use this information to determine the next steps in your health journey. Here’s the outline of this interview with Megan Hall: [00:01:04] Forum post: Chronically Low White Blood Cell Count. Get access when you support us on Patreon. [00:01:45] Leukocytes = White Blood Cells (WBCs) found on CBC with differential blood test. [00:02:58] Different types of white blood cells. [00:04:18] Phagocytosis video. [00:06:10] Absolute vs relative counts of WBCs. [00:09:15] Optimal range of WBCs in relation to all-cause mortality. [00:11:25] Baltimore Longitudinal Study on Aging: Ruggiero, Carmelinda, et al. "White blood cell count and mortality in the Baltimore Longitudinal Study of Aging." Journal of the American College of Cardiology 49.18 (2007): 1841-1850.  [00:12:57] Study: Shah, Anoop Dinesh, et al. "White cell count in the normal range and short-term and long-term mortality: international comparisons of electronic health record cohorts in England and New Zealand." BMJ open 7.2 (2017): e013100.  [00:15:30] bloodsmart.ai. [00:18:00] Why WBCs might be high: Leukocytosis. [00:18:45] Paper: WBCs are predictive of all cause mortality: Crowell, Richard J., and Jonathan M. Samet. "Invited commentary: why does the white blood cell count predict mortality?." American Journal of Epidemiology 142.5 (1995): 499-501.  [00:20:00] Podcast: Air Pollution Is a Cause of Endothelial Injury, Systemic Inflammation and Cardiovascular Disease, with Arden Pope, PhD. [00:21:57] Association of leukocytosis with metabolic syndrome; Study: Babio, Nancy, et al. "White blood cell counts as risk markers of developing metabolic syndrome and its components in the PREDIMED study." PloS one 8.3 (2013): e58354. [00:22:15] Megan's outline for this podcast. [00:22:41] What to do if you have elevated WBC counts. [00:22:54] Impact of stress; Studies: 1. Nishitani, Naoko, and Hisataka Sakakibara. "Association of psychological stress response of fatigue with white blood cell count in male daytime workers." Industrial health 52.6 (2014): 531-534. and 2. Jasinska, Anna J., et al. "Immunosuppressive effect and global dysregulation of blood transcriptome in response to psychosocial stress in vervet monkeys (Chlorocebus sabaeus)." Scientific reports 10.1 (2020): 1-12.  [00:23:32] Dr. Simon Marshall and Lesley Paterson; Podcast: How to Manage Stress, with Simon Marshall, PhD. [00:24:08] Reasons WBC counts might be low; Leukopenia. [00:27:57] "I never get sick". [00:30:40] What to do if your WBCs are low. [00:30:56] Effects of low energy availability: Studies: 1. Johannsen, Neil M., et al. "Effect of different doses of aerobic exercise on total white blood cell (WBC) and WBC subfraction number in postmenopausal women: results from DREW." PloS one 7.2 (2012): e31319. and 2. Sarin, Heikki V., et al. "Molecular pathways mediating immunosuppression in response to prolonged intensive physical training, low-energy availability, and intensive weight loss." Frontiers in immunology 10 (2019): 907.  [00:31:44] Articles by Megan on energy availability and underfueling: 1. Why Your Ketogenic Diet Isn’t Working Part One: Underfueling and Overtraining; 2. How to Prevent Weight Loss (or Gain Muscle) on a Therapeutic Ketogenic Diet; 3. What We Eat and How We Train Part 1: Coach and Ketogenic Diet Researcher, Megan Roberts; 4. How to Carbo Load the Right Way [00:31:52] Podcast: How to Identify and Treat Relative Energy Deficiency in Sport (RED-S), with Nicky Keay. [00:33:03] Ranges may slightly differ by ethnicity; 1. Haddy, Theresa B., Sohail R. Rana, and Oswaldo Castro. "Benign ethnic neutropenia: what is a normal absolute neutrophil count?." Journal of Laboratory and Clinical Medicine 133.1 (1999): 15-22; 2. Palmblad, Jan, and Petter Höglund. "Ethnic benign neutropenia: a phenomenon finds an explanation." Pediatric blood & cancer 65.12 (2018): e27361; 3. Grann, Victor R., et al. "Neutropenia in 6 ethnic groups from the Caribbean and the US." Cancer: Interdisciplinary International Journal of the American Cancer Society 113.4 (2008): 854-860.  [00:34:39] Absolute Neutrophil to absolute Lymphocyte Ratio (NLR) as indicator of systemic inflammation; Studies: 1. Gürağaç, Ali, and Zafer Demirer. "The neutrophil-to-lymphocyte ratio in clinical practice." Canadian Urological Association Journal 10.3-4 (2016): 141-2; 2. Fest, Jesse, et al. "The neutrophil-to-lymphocyte ratio is associated with mortality in the general population: The Rotterdam Study." European journal of epidemiology 34.5 (2019): 463-470.  [00:36:19] Elevated NLR associated with poor outcomes in COVID-19 patients. Studies: 1. Yang, Ai-Ping, et al. "The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients." International immunopharmacology (2020): 106504; 2. Ciccullo, Arturo, et al. "Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line." International Journal of Antimicrobial Agents (2020); 3. Liu, Jingyuan, et al. "Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage." Journal of Translational Medicine 18 (2020): 1-12.  [00:37:41] NLR predicts mortality in medical inpatients: Isaac, Vivian, et al. "Elevated neutrophil to lymphocyte ratio predicts mortality in medical inpatients with multiple chronic conditions." Medicine 95.23 (2016).  [00:38:21] What to do if NLR is out of range. [00:39:23] NLR on bloodsmart.ai (found on the Marker Detail View page). [00:40:01] NLR as a marker of physiological stress: 1. Onsrud, M., and E. Thorsby. "Influence of in vivo hydrocortisone on some human blood lymphocyte subpopulations: I. Effect on natural killer cell activity." Scandinavian journal of immunology 13.6 (1981): 573-579; 2. PulmCrit: Neutrophil-Lymphocyte Ratio (NLR): Free upgrade to your WBC. [00:41:59] Schedule a 15-minute Starter Session.

Dr. Justin Willer interviews Dr. Constantine Farmakidis on his article, Immunomodulatory and Immunosuppressive Therapy for Neuromuscular Disorders Part I.

Dr. Justin Willer interviews Dr. Constantine Farmakidis on his article, Immunomodulatory and Immunosuppressive Therapy for Neuromuscular Disorders Part II.

Volume 11 Issue 25 of @Oncotarget reported that Indoximod has shaped the understanding of the biology of IDO1 in the control of immune responses, though its mechanism of action has been poorly understood. Indoximod can have a direct effect on T cells, increasing their proliferation as a result of mTOR reactivation. Further, indoximod modulates the differentiation of CD4+ T cells via the aryl hydrocarbon receptor, which controls transcription of several genes in response to different ligands including kynurenine. Indoximod increases the transcription of RORC while inhibiting transcription of FOXP3, thus favoring differentiation to IL-17-producing helper T cells and inhibiting the differentiation of regulatory T cells. Indoximod can also downregulate expression of IDO protein in vivo in murine lymph node dendritic cells and in vitro in human monocyte-derived dendritic cells via a mechanism that involves signaling through the Ah R. Together, these data improve the understanding of how indoximod influences the effects of IDO, beyond and distinct from direct enzymatic inhibition of the enzyme. Dr. Erik L. Brincks from NewLink Genetics Corporation as well as Lumos Pharma, Inc. said "Indoleamine 2,3-dioxygenase (IDO1) plays an important role in the regulation of acquired local and peripheral immune tolerance in normal and pathological scenarios." In cancer, IDO1 can be expressed either directly by the tumor cells or induced indirectly in host antigen presenting cells by the tumor. IDO1 expression by tumor cells has been associated with significantly worse clinical prognosis and reduced survival in malignant melanoma, pancreatic cancer, ovarian cancer, both pediatric and adult acute myelogenous leukemia, colorectal cancer, prostate cancer, endometrial cancer, and others. The cellular pharmacodynamic effects of IDO1 activity include the inhibition of antigen-specific CD8+ T cell proliferation, stimulation of differentiation of na�ve CD4+ T cells to Fox P3+ regulatory T cells, the activation of Tregs, and the recruitment of MDSC to the tumor. Both isomers are capable of restoring T-cell proliferation in an MLR assay with IDO+ dendritic cells as the stimulator cells, or in syngeneic antigen-dependent T-cell proliferation assays using IDO+ dendritic cells isolated from tumor-draining lymph nodes. L1m T is a competitive inhibitor and substrate of IDO1 enzymatic activity in cell-free assays using purified recombinant IDO1 enzyme, and in tumor cells treated with INFγ or in tumor cell lines transfected with expression vectors that encode IDO1 under the control of an heterologous promoter. The Brincks Research Team concluded in their Oncotarget Research Paper that these effects are independent on the Trp metabolizing activity of IDO and/or TDO but happen to oppose the effects of the enzymatic activity of IDO and TDO by multiple mechanisms that act on cell types commonly affected by the IDO and TDO pathways. Indoximod creates a Trp-sufficiency signal which leads to reactivation of MAP4K3 which leads to activation of mTORC1 activity, thus opposing and bypassing the effects of Trp deprivation that lead to GCN2 activation and MAP4K3 and mTOR inactivation. This effect requires a relatively high concentration of indoximod, is observed in both CD4+ and CD8+ T cells and leads to an increase in the proliferative capacity of activated effector and helper T cells. This effect takes place at clinically relevant concentrations of indoximod and is independent of IDO/TDO activity or exogenous Kyn, though it happens to oppose the Kyn/Ah R effects on T cell differentiation. Full text - https://www.oncotarget.com/article/27646/text/

We welcome back our friend, Payal Shah. Aside from being a Kidney Transplant recipient, she is a Doctor of Pharmacy (PharmD). Payal provides great insight regarding Belatacept. What is it? How is it given? What are the Side Effects? What resources are available for Belatacept? Kent and Payal discuss all this and more! Have questions for Kent? Contact him at kent.bressler@kidneysolutions.org For more information on Kidney Solutions, visit them at www.kidneysolutions.org Host: Kent Bressler Producer: Jason Nunez

"I will always ask myself, what can I do with my knowledge in science to be able to bridge that to patients?" - Michel Detheux, co-founder and CEO of iTeos Therapeutics

Welcome back! In this week’s episode, Kent talks about HR5534 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2019. www.congress.gov --> Use this to find out who your representative so you can email them. Have questions for Kent? You can contact him at kent.bressler@kidneysolutions.org For more information on Kidney Solutions, visit them at http://kidneysolutions.org/ Host: Kent Bressler Producer: Jason Nunez

Welcome back! Kent speaks about immunosuppressive medications. Why are they important Post-Transplant? What are these medications used for?  What are the risks if these medications are NOT taken, Post-Transplant?  Kent also gives some great advice for those who are in need of a Kidney Transplant, in regards to interacting with others.  Have questions for Kent? You can contact him at kent.bressler@kidneysolutions.org For more information on Kidney Solutions, visit them at http://kidneysolutions.org/

Systemic lupus erythematosus, or SLE, is an autoimmune disease that can affect any part of the body. About half the people with it develop lupus nephritis. In the June 2018 update of their Cochrane Review, David Tunnicliffe from the Centre for Kidney Research in the Children’s Hospital at Westmead and the University of Sydney’s School of Public Health in Australia and colleagues brought together the studies that have tested a range of treatments.

Systemic lupus erythematosus, or SLE, is an autoimmune disease that can affect any part of the body. About half the people with it develop lupus nephritis. In the June 2018 update of their Cochrane Review, David Tunnicliffe from the Centre for Kidney Research in the Children’s Hospital at Westmead and the University of Sydney’s School of Public Health in Australia and colleagues brought together the studies that have tested a range of treatments.

Systemic lupus erythematosus, or SLE, is an autoimmune disease that can affect any part of the body. About half the people with it develop lupus nephritis. In the June 2018 update of their Cochrane Review, David Tunnicliffe from the Centre for Kidney Research in the Children’s Hospital at Westmead and the University of Sydney’s School of Public Health in Australia and colleagues brought together the studies that have tested a range of treatments.

One of the leading authorities on psoriasis in the world, Dr Kim Papp speaks with JCMS Editor-in-Chief Dr Kirk Barber about his outstanding report on vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies. Dr Papp was the lead author on this multi-disciplinary effort. According to Dr Barber, the paper provides clinicians with a clear path to develop their own guidelines for use when assessing individual patients.Theme by Lee Rosevere

One of the leading authorities on psoriasis in the world, Dr Kim Papp speaks with JCMS Editor-in-Chief Dr Kirk Barber about his outstanding report on vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.

One of the leading authorities on psoriasis in the world, Dr Kim Papp speaks with JCMS Editor-in-Chief Dr Kirk Barber about his outstanding report on vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies. Dr Papp was the lead author on this multi-disciplinary effort. According to Dr Barber, the paper provides clinicians with a clear path to develop their own guidelines for use when assessing individual patients. Theme by Lee Rosevere

Today I’ll discuss two more factors that can debilitate the human immune system (allowing the microbiome to better cause disease). They are antibiotics (when used too frequently) and immunosuppressive drugs: two of the most common medical interventions of our time.

Gastroprotectants are commonly prescribed in patients receiving immunosuppressive therapy with glucocorticoids. Presently, there is limited evidence to support such use of gastroprotectants. The objective of this study was to establish if the prophylactic use of gastroprotectants was associated with a reduced incidence of gastrointestinal signs in dogs receiving immunosuppressive doses of glucocorticoids, compared to not receiving prophylactic gastroprotectants. Read more and listen to the Q&As here. Veterinary Evidence TodayEdinburgh, 1-3 November 2016

Dr Townsley talks to ecancertv at ASH 2015 about adding eltrombopag to standard immunosuppressive therapy for aplastic anaemia in previously untreated patients. Eltrombopag was originally developed to increase platelet counts in patients with chronic immune thrombocytopenia (ITP) but it was found to also increase white and red cell counts. This was logical in hindsight, Dr Townsley observes in the interview. Although it is licensed for the treatment of refractory aplastic anaemia in Europe, eltrombopag is only approved for use in ITP in the USA and further study data were needed. The study presented by Dr Townsley aimed to provide evidence that eltrombopag could be used in aplastic anaemia setting and included 92 patients with the rare disease. Results showed a clear benefit of adding eltrombopag to standard immunosuppressive therapy of horse antithymocyte globulin (hATG) and cyclosporine versus the immunosuppressive therapy alone. Haematological overall response rates were 80% and 85% at 3 and 6 months, respectively, and highest if eltrombopag was given on the first day of immunosuppressive therapy as opposed to 2 weeks after and continued for either 3 or 6 months. Overall survival is 99%, Dr Townsley highlights, as only one patient has died while in the study to date but follow up is short.

Prof Pili talks to ecancertv at ASCO GU 2016, about the results from the phase II study CTEP#7870: treating renal cell carcinoma patients with entinostat and high-dose interleukin 2 (IL-2). Immunosuppressive factors such as regulatory T cells and myeloid-derived suppressive cells limit the efficacy of immunotherapies. Histone deacetylase (HDAC) inhibitors have been shown to have immunomodulatory effects which can be harnessed to improve treatment efficacy. The results from this phase I/II suggest that entinostat may increase the therapeutic effect of high dose IL-2 by modulating immunosuppressive cells.

Dr. Amy Myers, author of The Autoimmune Solution and host of The Autoimmune Summit, returned to the podcast to discuss how toxins and untreated infections contribute to autoimmune conditions.   Here's what we talked about:    3:55 – The confusion and frustration of a second-year medical student (Dr. Myers) suffering from the symptoms of an autoimmune thyroid condition.   8:30 – How having your thyroid removed can cause mood swings and panic attacks!   11:00 – The “healthy diet” that may have contributed to Dr. Myers’s condition … and the dramatic “meaty” changes she had to make.   13:20 – It’s not all about gluten and leaky gut! The multifactorial complexity of autoimmune disease.   19:43 – What is autoimmune disease anyway?    20:41 – How a flawed medical system contributes to underreported cases of autoimmunity.   23:19 – The autoimmune spectrum. Where do you fall?   25:15 – The”elevator pitch” version for why you should heal your gut and drop gluten.   27:26 – Dr. Myer’s two non-negotiable foods for healing your gut.   31:00 – Immunosuppressive drugs: how leaving yourself wide open for an infection can be a major problem with autoimmunity.   35:40 – Three theories for how common, everyday toxins may be affecting (or triggering) autoimmune conditions.    41:00 – MAJOR problems with how chemicals and toxins are approved for personal and commercial usage.   44:22 – Dr. Myers’s 3 simple strategies for clearing toxins from your air, water, and food.   48:52 – How to detox WITHOUT triggering autoimmunity.   50:47 – How bacterial infections and viruses trigger autoimmunity. And how to test for them.   1:00:39 – Pre-order The Autoimmune Solution and get these free goodies!   Want the written version? Join The Transcribe Tribe for FREE transcripts at www.undergroundwellnessradio.com!   Hosted by Sean Croxton of Underground Wellness. 

Pancreatic ductal adenocarcinoma (PDAC) is a very aggressive tumor that is characterized by abundant tumor stroma and a potent immunosuppressive microenvironment. Further studies to clarify why T cells infiltrate the tumor but are not able to perform effector functions as well as to find new effective therapies to overcome immunosuppression are urgently needed. The aims of the present study were (1) to characterize different murine PDAC tumor models in regard to their utility for studying novel immunotherapeutic approaches, (2) to assess the therapeutic efficacy of a novel bifunctional ppp-siRNA that combines silencing of the immunosuppressive molecule galectin-1 and RIG-I-mediated immune activation in murine PDAC and (3) to characterize the immunosuppressive mechanisms leading to T cell inhibition in the tumor microenvironment. (1) This study revealed that the pancreatic cancer cell line T110299, which was developed from a primary tumor of the KPC mouse model, is a new valuable tool for studying novel treatment strategies for PDAC. The histological appearance of T110299 tumors reflects in many aspects the primary tumors in KPC mice, which harbor mutations in the Kras oncogene and p53, and the human disease with regard to tumor differentiation, extensive tumor stroma development, poor vascularization and expression of immunosuppressive molecules, like indoleamine 2,3-dioxygenase (IDO) and galectin-1 (Gal-1). In contrast, Panc02 tumors were found to have a sarcomatoid architecture with very little tumor stroma. In Panc02 cells, galectin-1 was strongly expressed by the tumor cells, which differs from the situation found in humans, KPC mice and T110299 tumors, where galectin-1 is preferentially expressed in tumor-associated pancreatic stellate cells (PSC). However, expression of the cytosolic helicase RIG-I was functional in Panc02 cells, but defective in T110299 cells. As RIG-I is expressed in all human PDAC cell lines tested, the Panc02 model appears to be better suited to study RIG-I-based immunotherapies (Ellermeier et al., 2013). Thus, the histological and functional characterization of the tumor models in this thesis will allow selecting the best-suited tumor model for addressing specific aspects of immunotherapy. (2) Treatment studies of PDAC were performed with the 5’ppp-modified siRNA molecule ppp-Gal-1 in the orthotopic Panc02 tumor model. The dual activities of this molecule were confirmed in vitro, leading to (i) reduced galectin-1 expression via RNAi; and (ii) production of CXCL10 and IFN-, MHC-I up-regulation and apoptosis of tumor cells via RIG-I activation. Treatment of mice with orthotopic pancreatic tumors with ppp-Gal-1 significantly prolonged survival, as compared to unmodified OH-Gal-1 or control RNA. In addition, 20% of the mice completely rejected their tumors leading to long-term tumor control. Thus, bifunctional 5’ppp-modified siRNA is a promising treatment strategy for PDAC deserving further pre-clinical evaluation. (3) Pancreatic tumor cells employ multiple mechanisms for suppression of T cell responses. This study identified TGF-β and IDO as two potent mechanisms leading to inhibition of T cell proliferation. Minute amounts of PDAC supernatants effectively blocked T cell proliferation induced by CD3 and CD28 triggering. This could be partially prevented by SD-208, a small molecule inhibitor of TGF-β receptor signaling, or by blocking IDO activity with D-1-MT. Interestingly, tumor supernatants induced up-regulation of IDO mRNA expression in T cells. Furthermore, blocking IDO activity in T cells appeared to be more effective than blocking IDO in tumor cells. This leads to a new hypothesis that factors secreted by the tumor cells induce IDO expression in T cells, which in turn leads to auto-intoxication of the T cells via kynurenine production and eventually T cell apoptosis. Further studies confirming this hypothesis are warranted.

Background: Knowledge on immunosuppressive factors in the pathogenesis of endometrial cancer is scarce. The aim of this study was to assess Glycodelin (Gd) and its immunosuppressive isoform Glycodelin A (GdA) in endometrial cancer tissue and to analyze its impact on clinical and pathological features and patient outcome. Methods: 292 patients diagnosed and treated for endometrial cancer were included. Patient characteristics, histology and follow-up data were available. Gd and GdA was determined by immunohistochemistry and in situ hybridization was performed for Gd mRNA. Results: Endometrial cancer shows intermediate (52.2%) or high (20.6%) expression for Gd in 72.8%, and GdA in 71.6% (intermediate 62.6%, high 9.%) of all cases. The glycosylation dependent staining of GdA is tumour specific and correlates with the peptide-specific Gd staining though neither of the two is associated with estrogen receptor, progesterone receptor or clinic-pathological features. Also Gd protein positively correlates with Gd mRNA as quantified by in situ hybridization. Gd positive cases have a favourable prognosis (p = 0.039), while GdA positive patients have a poor outcome (p = 0.003). Cox-regression analysis proofed GdA to be an independent prognostic marker for patient survival (p = 0.002), besides tumour stage, grade and the concomitant diagnosis of hypertension. Conclusion: Gd and GdA are commonly expressed in endometrial cancer tissue and seem to be of relevance in tumourigenesis. They differ not only in glycosylation but also in their biological activity, since only GdA holds prognostic significance for a poor overall survival in endometrial cancer patients. This finding might be explained by GdAs immunosuppressive capacity.

ASN and AST discuss legislation to cover drug therapy.

ASN and AST discuss legislation to cover drug therapy.

ASN and AST discuss legislation to cover drug therapy.

ASN and AST discuss legislation to cover drug therapy.

Transplant nephrologists David Cohen, MD, and Bryan Becker, MD, discuss immunosuppressive legislative debate and next steps.

Transplant nephrologists David Cohen, MD, and Bryan Becker, MD, discuss immunosuppressive legislative debate and next steps.

Transplant nephrologists David Cohen, MD, and Bryan Becker, MD, discuss immunosuppressive legislative debate and next steps.

Transplant nephrologists David Cohen, MD, and Bryan Becker, MD, discuss immunosuppressive legislative debate and next steps.

Fri, 1 Jan 2010 12:00:00 +0100 https://epub.ub.uni-muenchen.de/17997/1/oa_17997.pdf Gerbes, Alexander L.; Beaugerie, Laurent

Background Herpes simplex virus type-1 (HSV-1) has been described to cause respiratory tract infections in critically ill patients or in individuals that are immunocompromised. It is a continuing matter of debate under which circumstances HSV-1 is a relevant pathogen for pneumonitis. While its role during critical illness has been investigated by prospective interventional studies, comparatively little systematic data is available on the role of HSV-1 for pneumonitis in outpatients with autoimmune disease under a maintenance regimen of immunosuppression. Methods We retrospectively reviewed the charts of ~1400 patients with rheumatoid arthritis, vasculitis, and systemic lupus erythematosus (SLE) that were followed at the outpatient clinic of a German University hospital during the years 2000–2007. Episodes of admission to a ward resulting in the diagnosis of pneumonia/pneumonitis were identified, and the type of pneumonia and clinical features retrospectively studied. Results 63 patients with rheumatoid arthritis, vasculitis, or SLE were admitted to a ward and diagnosed to have pneumonia/pneumonitis. Using bronchoscopy a total of 6 cases of pulmonary infection associated with HSV-1 in the lower respiratory tract were identified. Among those, 2 cases suggested a causative role of HSV-1 as the sole agent causing pneumonitis that proved clinically responsive to antiviral treatment. In the remaining 4 cases HSV-1 appeared as a bystander of bacterial infection. Maintenance therapy with leflunomide, which inhibits HSV-1 assembly in vitro, was associated with a milder course of pneumonitis in one patient. Detection of HSV-1 was associated with stronger immunosuppressive regimens and vasculitic disease. Conclusion The present study analyzed the frequency and hallmarks of cases of HSV-1 associated pneumonitis that occurred in a comparatively large cohort of patients with rheumatologic autoimmune diseases. In an area of controversy, this study provides further evidence that HSV-1 causes isolated pneumonitis in the immunocompromised. The study may provide an estimate on the frequency of relevant HSV-1 infection and bacterial agents in outpatients with autoimmune disease.

Sun, 1 Jan 2006 12:00:00 +0100 http://jnnp.bmj.com/content/77/10/1199.full.pdf https://epub.ub.uni-muenchen.de/15871/1/successful_immunosuppressive.pdf Lewerenz, J.; Münchau, A.; Saager, C.; Eichhorn, Peter; Leypoldt, F.

Thu, 1 Jan 1981 12:00:00 +0100 https://epub.ub.uni-muenchen.de/5380/1/Zimmermann_Wolfgang_5380.pdf Hartmann, G. R.; Zimmermann, Wolfgang ddc:610, Medizi

Sun, 1 Jan 1978 12:00:00 +0100 https://epub.ub.uni-muenchen.de/5370/1/5370.pdf Zimmermann, Wolfgang; Weiner, E. M.; Richter, H.; Hartmann, G. R.