Read the Transcript Below the Questions and Highlights
Stressed out and not losing weight? Then this podcast is for you! Dr. Grasser is one of the world’s top experts in Ayurvedic practice and integration of Functional Medicine. In addition, he is a primary care physician and is trained in functional medicine. With his wide knowledge, we chat about his insights regarding issues that lead to gut issues, and how it adds to anxiety and stress.
Dr. Grasser is one of the world’s foremost experts in the integration of Functional Medicine and Ayurveda. Dr. Grasser supports his patients through his extensive experience in Western Medical practice as well as his deep knowledge of the alternative healing systems of Ayurveda, Yoga and Functional Medicine.
Dr. Grasser is a graduate of Stanford University and Dartmouth Medical School. He is a Clinical Assistant Professor at the University of New Mexico, Department of Family and Community Medicine. Dr. Grasser is also an Active Teacher In Family Medicine as recognized by the American Academy of Family Physicians. He has been Board Certified by the American Board of Family Medicine since 2003, and through his extensive and continuing practice in obstetrics at St. Vincent, he has been blessed to attend the birth of hundreds of babies. He is currently working towards becoming Board Certified in Integrative Medicine.
Dr. Grasser is certified to practice Ayurveda Medicine by Albuquerque’s Ayurvedic Institute, where he studied under the tutelage of world-renowned Ayurveda physician Dr. Vasant Lad. In addition to his full 2-year course of study at the Institute, Dr. Grasser completed advanced clinical studies under Dr Lad’s Gurukula Studies Program in Pune, India, and additional clinical hours at AVP Ayurveda Hospital in Coimbatore, India. He has served on the Board of Directors of the National Ayurvedic Medical Association since 2013. Dr. Grasser has studied yoga extensively since 2001 in the tradition of BKS Iyengar. He incorporates the principles and teachings of the sister sciences of Ayurveda and Yoga into his daily life and practice of medicine. Dr. Grasser has also completed courses of study in Functional Medicine through the Institute for Functional Medicine. He is currently enrolled in a two year course of study with the Academy of Functional Medicine and Genomics, for which he serves on the Board of Advisors. He believes that Functional Medicine is a modern approach to healing which embodies many of the principles of Ayurveda and other ancient healing traditions.
Dr. Grasser is an active staff member in the Department of Family Medicine at Christus St. Vincent Regional Medical Center in Santa Fe, New Mexico, where he has also practiced obstetrics since 2001. He works with patients of all ages and health conditions as their primary care physician.
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Key Questions answered and highlights:
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1. What made you want to go get more knowledge, especially Ayurveda and integrative function medicine? (01:56)
– ‘I had to find a way to integrate ancient wisdom with modern science, and along the way I discovered functional medicine’
– Functional medicine is a greate ‘marriage’ of Ayurveda and western medicine
2. What do you believe is the biggest difference between the conventional primary care medicines practice today? (04:05)
– There is a Practical and Spiritual Difference
Your typical physician is constrained by:
1. Structure of western medicine, as structured in the primary care medicine
2. Practical Health Care Setting — medicine and delivery
– Ayurveda is a consciousness based system
– It takes into account more than just the consciousness of an individual, but also the entire universe
– It opens up the concept of spirituality, love, holistic understanding, community, etc.
3. What are the top illnesses that you deal with, and what are you most successful in holistically? (06:54)
– Most often we see are lifestyle related conditions
Top diseases are:
– gut/gastrointestinal issues
– anxiety and depression
– fatigue
– autoimmune disease
– brain function such as dementia and other neurological diseases
4. Why do you think we are seeing an increasing growth of gut issues especially in teens? (07:55)
– Just like in a factory, you will have issues with inputs, machinery, and outputs.
– We have to excrete what isn’t beneficial to us and is toxic
– This is same for our thoughts
– We have to be able to process them for them not to build up toxicity
– If we’re overwhelmed in our nervous system due to stress and anxiety, then it will translate down to the gut. There will be changes in the gut microbiome.
5. When you have gut issues, what’s the first thing you prioritize — input, output, or detox? (12:07)
– You can fix everything through a program addressing input, output, and detox.
– But, you have to remember the ideal treatment protocol and the reality of what people can achieve.
– If we’re not being sensitive to what’s doable to the patient then we’re not helping them
– Reducing the toxic inputs is the easiest place to start
– It may cost a little bit more money since choosing healthier food is a little bit more expensive
6. What are your top do’s/don’ts to heal the gut? (13:19)
– It’s more of the when, where, how and why of eating
– Eat fewer meals; You can eat once a day
– If you keep eating frequent small meals, you ask your body to shift
Do’s:
1. Pay attention to hunger
2. Eat a lighter, earlier dinner
3. Eat a heavy midday meal
4. Eat a carb-heavy breakfast including refined carb
Don’ts:
1. Anything artificial – colorings, additives
2. Preservatives
3. Seed oils – sunflower, canola, etc.
4. Liquid sugars/Added sugars – soda, iced tea, etc.
5. Flour
7. What’s the latest time to finish dinner? (20:07)
– If they have a disease to work with, eat and finish an hour to 2 before sunset
– Eat a light dinner
– You want to go to bed hungry
8. “Everyone should be a vegetarian/vegan”, juice cleanse, and detox practice, what are your thoughts on that? (23:44)
– Just thinking about nutrition/health for an individual, being a vegan is not natural
– The closest to vegetarianism is Hinduism
– A natural diet includes animal products
9. Let’s talk Detox (26:59)
– Elimination Diet is a good exercise to clean up their system for a period of time, at least 3 weeks
– It’s good to eliminate food that have too much caffeine, chocolate, alcohol
– Support the detox mechanisms of the body
– We can obtain amino acids from vegetables for detoxification
– Do not do prolonged depletion type cleanses such as master cleanse, water cleanse, juice fasting
– They reduce macro and micro nutrients when doing these cleanses
In an elimination diet, take out:
– gluten
– dairy
– soy
– corn
– nightshades
– shellfish
– citrus
– caffeine
– alcohol
– seed oils
– added sugars
Herbs to help:
– Triphala
– Aloe to move bowels and help hydration, stress reduction
– Rhubarb
– Don’t drink too much water with a meal as it violates an ayurvedic principle
– Stay hydrated in between meals
– We exhale toxicity in our breathing, like in Prayanama
SIBO
– overdiagnosed
– Bacteria from large intestine going to the small intestine
– It tends to reccur
– Stress reduction is important in bowel disease
10. How do you treat anxiety and depression? (41:52)
– Treat gut function
– Treat inflammation
– Neurotoxicity is a trigger in anxiety and depression
– Support bile flow can help reduce neurotoxicity
– It is important to have meditative practice
Basic Components of Meditation
1. You need to be in a quiet space to avoid distraction
2. You need to be in a comfortable position
– Yoga posturing is designed to prepare the body to sit for meditation/breathwork
3. You need to have a repetitive focuse, a phrase or breath
– You can try “All is good”, “I am beautiful”
4. Don’t judge yourself
TRANSCRIPT:
This is auto-generated and may have mistakes. Please listen to the interview for accuracy.
[00:25] Reena Jadhav: Hi everyone. I am excited to have with us today Dr Eric Brasseur, who was the world’s foremost expert on the integration of Ayurveda and functional medicine. He founded his integrative medicine and now you’re ready. The practice in Santa Fe, New Mexico. Nice. He attended Stanford University, Dartmouth Medical School, and the University of New Mexico family practice residency as well as the Irb, the institute, which is actually by Dr. Lot for those of you listening to this podcast and is a clinical assistant professor at the University of New Mexico. He is board certified in family medicine, trained in functional medicine through the Institute for Functional Medicine, certified by the Academy of Functional Medicine and genomics for which he serves on the advisory board. He hosted the Irb, the summit in Twenty 15, which is the largest ever online irb that he serves on the board of directors of the national irb. The institution also offers online programs and consultations throughout the world. You can learn more about him at Dr Grasser, Dr. Grasser, welcome.
[01:32] Dr Grasser: Thank you, Reena for having me. It’s my pleasure.
[01:34] Reena Jadhav: Oh, it’s our honor. I’m so excited to meet a primary care physician that is also trained in functional medicine and Integrative Medicine and has knowledge of ancient healing traditions like Ayurveda. So first of all, I want to thank you for expanding your horizons and becoming truly holistic, but I have to ask you, you have amazing pedigree, Stanford, Dartmouth. What made you want to go get more knowledge, especially Irv, that integrative and functional medicine?
[02:06] Dr Grasser: Well, that’s a great question. I mean, I would have to say that my introduction to a holistic healing systems and eastern philosophical knowledge and vedic wisdom was through yoga, like for so many people now in North America, we get introduced to yoga, you know, Yoga classes that are primarily focused on yoga posturing, what we call Asana. But then after we’ve gotten in the door, we start to realize what a vast system yoga really is in terms of its philosophy and its teachings and spirituality. And then being already in the medical profession. Uh, I discovered Iyer Veda, a sister science of yoga, and serendipitously found out that one of the greatest schools of our bid in North America was a 60 miles from where I was living here in Santa Fe. That being the arbiter institute in Albuquerque. So I went down and met Dr Lott and really was impressed with him, of course in the institute and decided I needed to study western medicine and work in western medicine for some years longer just to solidify that skillset.
[03:13] Dr Grasser: But once I felt ready, I went ahead and quit my job and went down to Albuquerque, uh, and to India and study with him. And then after that I realized, well, now what do I do? I, the light’s gone on and I cannot just go back to practicing a reductionist form of medicine, which unfortunately is the way western medicine is in this country. And I had to figure out a way to integrate the ancient wisdom with the modern science and along the way kind of discovered functional medicine took my first course in that and basically kept hearing our vedic wisdom being restated in a modern scientific way and thought this is a great marriage of the two. And that’s when I ended up opening up my practice here in Santa Fe, uh, as an integrative practice.
[04:05] Reena Jadhav: What a journey. What do you believe is the biggest difference between the way conventional primary care medicine is practiced today and for a patient coming to see you instead? The practices more of an integrated holistic approach?
[04:21] Dr Grasser: Well, I mean the, so there’s practical differences and then there’s maybe more a spiritual differences, if you will. Obviously the practical differences are that your typical primary care physician is constrained both by the structure of Western medicine as it’s practiced in the primary care setting and constrained by the structure of the practice setting. Uh, so both the medicine and the delivery setting are both constructive and that that physician or nurse practitioner, physician’s assistant has to follow sort of an algorithmic, a evidence based ideally, although we can talk about how not evidenced based a lot of what is done is, but they, they’re trying to follow algorithmic standard of care medicine and they’re doing this under the constraints of, of the business model basically. Uh, and that, that’s true whether they work in a federally Qualified Health Center, uh, uh, a large, uh, managed care clinic or private practice.
[05:30] Dr Grasser: Uh, there are, there is financial constraints and we all have to follow coding and billing rules and coding and billing rules. Actually a, probably more than most patients realize guide the way the care goes. And it’s a reductionist system because you’re basically trying to make somebody look like a set of potentially unrelated symptoms and diagnoses to justify the medical complexity that allows you to get paid. So right there, the system actually feeds back to the fact that Western medicine is reductionist science in and of itself. And the main difference between that and a system such as Ira Beta is that our bed is a consciousness based system and it takes into account the consciousness of more than just the individual, but the entire universe and how, uh, this consciousness, this, this universal consciousness, a was distilled into the individual, a person a and it therefore sort of opens the playing field to be able to introduce concepts of spirituality, love, holistic healing, understanding, community, all these things that, uh, unfortunately there’s just not time nor money structure for in the traditional Western approach.
[06:54] Reena Jadhav: So what are some of the illnesses that you deal with that and what have you been most successful at treating holistically?
[07:05] Dr Grasser: Yeah. Well, I think this could be said of pretty much any primary care doctor working in our culture that most of the things we see the most often are, are lifestyle related conditions that are manifesting as physical symptomatology or disease patterns. Uh, the top being, you know, got gastrointestinal health issues, anxiety and depression as well as, um, fatigue issues of autoimmunity, which is on the rise. And then brain function issues of, of brain higher cognitive function, including a, ultimately a lot of, uh, dementia and neurologic diseases. Let’s start with gut because I think yeah,
[07:53] Reena Jadhav: universally is a problem. It’s exploded. Why do you think we are seeing such an explosive growth in gut issues by the way? Especially in teens?
[08:04] Dr Grasser: Yeah, I mean, I think that, uh, there’s a few things here. So one, uh, and I think have a lot in terms of detoxification because I teach classes on detoxification. You have issues with inputs, you have issues with the, uh, the, the machinery, and then you have issues with outputs. So just like in any factory, if the factory is going to keep up and producing the product, they need adequate input of raw materials but, and an, a minimal input of a, of toxicity and then well functioning machinery and then adequate outputs to create the finished product. And we do the same thing in, in our gut where we take in food and beverage and we have to process it within our machinery and we have to excrete what is not beneficial to us. And what is toxic. And this is true to some extent as well with our emotions and our thoughts that we have our sense organs that take in sights and sounds and smells and experiences, and we have to be able to process them and we have to be able to sort of move them through so that they don’t build up and create toxicity.
[09:15] Dr Grasser: And so why are we having so many gut problems? Well, one is, of course the inputs are toxic. Our food is not real anymore. Not only the, what of what of eating, but I talk a lot about the, where, when, how, and why of eating Iyer Veda has massive amounts of wisdom on what to eat, but also how to eat, when to eat it, to eat it. And then also, you know, trying to clean up our detoxification systems, which are also overburdened by toxicity from environmental chemicals, from a allergens, and then helping our outputs in that we need to Poop and pee and sweat and breathe. Uh, the way we release toxins. So that’s a huge issue in terms of just the, the, the in the end, the out and the machinery, that processes, but also because of the incredible connection between the gut and the brain, uh, which we’re discovering more and more about all the time, uh, the enteric nervous system found in the gut the presence of the immune system which is concentrated in the gut and even more interesting things that are just coming out about the lymphatic system that goes all the way up into the brain and even the Vegas nerve which connects the brain and the nervous system down to the gut and how things may actually be moving straight from the gut to the brain through the vegas nerve.
[10:41] Dr Grasser: Uh, there is a, you know, that means it goes both ways. So if we’re overwhelmed in our nervous system due to stress and anxiety and depression, uh, and uh, an, uh, you know, uh, demands that are placed on us, uh, that are, that are impossible to achieve, then it’s going to go translate down to the gut and we’re going to have changes in our gut ecosystem and microbiome that then go and implicate in, are implicated in all kinds of other organ dysfunction. And as you know, Reno, fascinatingly Iyer Veda has been speaking about the central role of the gut and it’s, you know, for it’s 5,000 or more year tradition. And when we do detoxification treatments, uh, the classic ones, uh, known as a punch of Karma detox vacations, they all involve moving disease, uh, uh, first into the gut from the peripheral tissues and then out of the gut through techniques such as purgation and induced vomiting and a enemas. Uh, so, uh, you know, uh, when I hear all these new things being learned about gut and how it’s so such a hot topic and so central to health, I just sort of chuckle and think that our Beta was way ahead in its knowledge of, of, of using the gut as a healing a portal.
[12:06] Reena Jadhav: So true. So the question always is, well, when the whole, that’s a mess. What’s the first thing to prioritize? So how do you do first fix the input, the output or the detox?
[12:17] Dr Grasser: Um, well, no, I mean you can fix everything through a program that addresses all three of those elements, but also we have to remember there is an ideal treatment protocol. Um, and then there’s the reality of what people can achieve, uh, and, and if we’re not being sensitive to what’s doable by the client or the patient, then we’re not necessarily helping them. Um, and so, you know, I think that that reducing the toxic inputs is probably the easiest place to start because it generally doesn’t take up much time in the patient’s life. Uh, it may cost a little bit more money because a healthier food and avoiding toxic foodstuffs is sometimes a little bit more expensive. It doesn’t have to be extremely more expensive, but removing toxic inputs, so not, it’s not what, you know, instead of do this, do that, just don’t do this and don’t do that.
[13:23] Dr Grasser: Well, interestingly, they wouldn’t all be, don’t eat this. Uh, some of them would actually be more of the when, where, how, and why of eating. Um, and so I try to get people to eat fewer meals. Okay. I tried to get. Well, it depends. Well, okay. So if you had to just say one. Okay. Two to three would be the broad answer to that. A Vata types will want to eat more, possibly three and even a snack cuff, a types, uh, it can get away with two meals, one meal, even the Ayurvedic Wisdom says the cuff is going eat once a day and practice somewhere in between. So fewer meals so that the meals are spaced out so that the hunger is actually building prior to eating. Because you remember that when you eat, you move your body into the parasympathetic nervous system, the rest and digest.
[14:17] Dr Grasser: Whereas when you’re trying to do your regular day to day life, whether it’s a mental focus because you have a desk job or whether it’s physical activity because you have a more active job, active lifestyle, uh, you still need, that’s more moving in the direction of sympathetic which is the fight, flight or freeze. And so if you keep eating throughout the day, frequent small meals, you keep asking your body to shift over into digest, absorb and assimilate mode, uh, and then it detracts from, you know, sending blood flow to the muscles so that you can do your physical labor or you’re or you’re gardening or your sports or whatnot. And also it takes away from higher cognitive functioning because you don’t really need to be doing complex math when you’re trying to digest a meal. So fewer meals. I’m paying attention to hunger so that you don’t eat when you’re not hungry.
[15:13] Dr Grasser: And also generally for people it’s eating. I’m a lighter earlier dinner, which ideally is matched with a bigger midday meal if possible based on their lifestyle. Um, so that’s, uh, a, a schedule thing that’s not, I take this out of your diet, it’s to do this. And then I also try to get people to move. A lot of folks eat a fairly carb heavy breakfast, uh, and including refined carbs. So, you know, the standard American breakfast may include everything from toast and jam, a coffee and milk, cereal and milk, orange juice, a muffin or a Bagel. Okay. All these things that are high in refined carbohydrates and they require your body, therefore to release insulin, uh, to move the blood sugar from the blood into the cell. Whereas when you wake up in the morning, your cortisol actually is at its peak because cortisol helps you get going and get on with your day.
[16:17] Dr Grasser: And Insulin. Cortisol are like a seesaw and you want to support one and sort of repressed the other. Whereas if you eat a big carb heavy breakfast, you’re actually asking for insulin release at the time when cortisol is up. And so the two can kind of compete with each other and the body can get confused, a rather move to a heavier protein and healthy fat breakfast. And if you’re going to do more refined carbs like pastas and breads, move them to later in the day when it’s okay that your insulin goes up somewhat and then you get, you get into rest and digest, you get sleeping, you go to bed, which is what our ancestors used to do. They didn’t stay up til midnight because they didn’t have light and computers and all that. So, um, there’s a shift in the macronutrient ratios to match the circadian rhythms of the day.
[17:05] Dr Grasser: And then there’s also, like I said, I’m a reduction in the number of meals, uh, so that we can properly digest in between, uh, now if I had to say take out these top foods, I mean clearly anything, artificial, artificial colorings, artificial additives, preservatives, things that are frankenfoods and many of us have heard. If you don’t know what the ingredient is on the label, you probably don’t want to be buying that food product. So there’s that. And then I also think that, you know, removing a seed oils, uh, is, is important. Um, most of the seed oils, like sunflower, safflower, corn, canola, they are rancid, potentially rancid by the time we even get them off the shelf and they were not traditionally eaten as new nutrition, uh, and so, uh, clearly, um, not just removing hydrogenated oils and, uh, and trans fats which are kind of man men made a types of fat fats which are given, you know, put in food stuffs to preserve them so that they don’t spoil, but also kind of minimizing the seed oils that you eat.
[18:16] Dr Grasser: Um, because these were not traditionally used for nutrition unless you’re sourcing them extremely clean so that you’re not worried about rancidity. And I got to look at what people are eating. I mean, if they’re eating liquid sugars, I get rid of those right away. I mean, so does, uh, uh, Arizona ice tea. Uh, you know, all of these beverages that may sound healthy if you don’t actually look at the fact that they’ve added sugar to them. Um, fruit juices can be too much sugar for people, uh, that, that then is a burden on the, uh, on the endocrine system that you have to actually figure out what to do with that sugar load when it gets into your bloodstream. Uh, so refund, you know, that’s I, I called them added sugars to some extent. Um, so if it’s not naturally occurring in the, in the food product, in the, in the food, then it’s an added sugar in.
[19:10] Dr Grasser: It hides under some 50 names that you have to kind of learn because it’s not just going to say sugar on the label. It might say Brooke toast or high fructose corn syrup or maltose or corn syrup solids or you know, and, and you got, you got to kind of be a detective in figuring out what’s, what, what’s in there. And it hides. I mean they add sugar to all kinds of things. Catch up, salad dressings, sauces. If you go out to eat and you’re getting a, you know, some sort of food that has a sauce on it, it tastes good. I’ll say it probably has sugar in it, probably has added sugar and so those are two of the big ones in terms of what I try to get people to eliminate or are added sugars and then, and then flower is the next level, a refined carbs that have been stripped of their nutrition. Uh, and, and then seed oils.
[20:06] Reena Jadhav: Quick follow up questions. First one you mentioned, donate too late. What’s the latest that you recommend? Typically someone finished their dinner by.
[20:14] Dr Grasser: Yeah, I mean it gets to, it depends on whether, you know, is there this, are they healthy and trying to get more healthy, what I call the well getting weller, uh, or are they, are they imbalanced and have disease process going on. If they’re, if they’re dizzy, if they have disease they’re trying to work with or they’re overweight or they have heartburn or acid reflux or indigestion, bloating, gas, abdominal pain, then I basically try to get them to eat and finish, uh, even a potentially an hour to two before sunset. Um, which in the winter is challenging because at least where we live, it gets dark in the winter at five, 5:30. Um, and so that doesn’t always work well with people’s work schedule. Um, you know, you can do get away with a little later in the, in the summer months because again, the circadian rhythms of your body are dictated by the light and dark cycles.
[21:13] Dr Grasser: But certainly I would say in comparison to the bedtime, you have issues. You probably want to be done eating at least two and a half hours before bed. Um, that makes sense. And even if you can’t move the dinnertime up too much, just eat a lighter dinner. You want to go to bed hungry. Oh, interesting. Okay. If you’re not hungry when you’re getting ready for bed, then you ate too much, too late. But we all kind of get in this hat. Well not all of us, but a lot of us get in this habit of, uh, well there’s dinner and then there’s. And then there’s desert, a bedtime snack. I mean, sure, there are unique circumstances where I will have somebody eat a protein snack closer to bed and that’s often with, there’s diabetic issues where they’re making too much. They’re kicking out blood sugar from the liver in the middle of the night because he didn’t have enough in the bloodstream to fuel them through the night.
[22:06] Dr Grasser: Or if somebody has insomnia and they’re waking up at three in the morning, occasionally that’s from a relative dip in blood sugar that could be mitigated by a small protein snack closer to bed. But for the most part you want to go to bed hungry. And um, I personally know that I suffer from this challenge being, having busy work day and I’m also an intermittent faster so I don’t eat breakfast. I intermittently fast between about eight PM and, and noon or one the next day. But I get, if I don’t get a good lunch and I’m sort of behind the caloric curve and then I’m trying to catch up. And so I do this thing where I get home and I snack. Well, you know, I’m helping my wife with dinner and then I, you know, I don’t get enough dinner because I was behind the curve and then I’m like continually eating and wanting to eat until 9:00 PM and then I’m not hungry when I go to bed. So I need to sort of reflect and shift the behavior, what we call in yoga pose and repose a, so you assess and then you say tomorrow, uh, I pro, I need to eat less for dinner because I wasn’t hungry last night when I went to bed.
[23:18] Reena Jadhav: Clearly, very smart to think about living according to the circadian rhythm and really managing your diet based on when the sunsets, which is very hard to do in real life, but it’s a great philosophy to follow. Let’s talk about that. That’s input. Let’s talk about vegetarian as I mean the input before we move to detox and output. So there’s, there’s been some controversy around should everyone be a vegetarian veganism versus eating some protein? Where do you come out on that?
[23:52] Dr Grasser: Okay. Um, well I come out on,
[23:57] Dr Grasser: so obviously, uh, putting the ethical and moral considerations aside for a moment and just thinking about nutrition and health or shall I say, health of the individual. So things like veganism are not natural. Uh, they, they are not, they’ve never been tested over long periods of time. I mean, granted, sure, we have people that have been Vegan for 40 years, uh, but we don’t have large base large population based studies on the longterm population based outcomes with the something like veganism, nor do we have it for something like a Paleo, what’s called a modern paleo style diet, a much higher in fat, uh, and, and potentially protein but not always in the low carb diet. We don’t have long term data in populations that have done this because we can’t find people that are 80 years old that had been eating this way for 60 years of their life.
[24:52] Dr Grasser: Furthermore, veganism and vegetarianism never evolved naturally in any culture. The closest thing to vegetarianism culturally as Hinduism and the reason that they don’t need animal products, uh, with the exception of, you know, like cows products is for spiritual, unethical reasons. Um, so we evolved into humans because of eating animal products that allowed us to survive on, um, with a shorter gut and it allowed us to fuel in ever growing frontal brain, which is the part of the brain that allows us to do higher functioning like language and math and do the way we were driven from our pre homosapien ancestors towards our current human physiology was through introducing animal products. So I think that it is, if you want to argue what’s a natural diet and natural diet does include animal products. Uh, but there are, there also have been, you know, cultures cultural. If you look at diets according to geography and according to cultures and ancestry, we certainly have certain diets that are super high in animal products and fat take say the inuits in northern North America. Uh, and then you have cultures that have much lower fat diets like people living on the plains in Africa. Um, and so there is obviously different diets with different macronutrient proportions in different proportions of animal versus plant products can all be healthy
[26:28] Dr Grasser: and, and I would say we don’t have a lot of data, for example, that says that veganism from a micronutrient perspective is dangerous. I mean really if you look at the literature closely on Veganism, you’re not really risking macronutrient deficiencies with the exception of possibly vitamin D and vitamin B, b 12, uh, but we just don’t have the longterm data to say like, is this, is this a healthy, what’s this gonna do to, to, to, to bone health later in life? What’s this gonna do to dental health later in life? Okay, let’s talk detox. Well, I think it’s always a, a worthwhile a treatment to go on a, some sort of elimination diet. Um, you know, we have classical elimination diets in the functional medicine world. The tend to take out a set of foods that are, that are, if you look at a population that are, that are the top foods to which people have sensitivity or true food allergies, as well as taking out foods that are not nutritive foods, that have qualities that may be, um, unhealthy, such as too much stimulants like caffeine or chocolate, uh, as well as uh, alcohol.
[27:41] Dr Grasser: Uh, and so, uh, uh, an elimination diet is a, is a good exercise for people to sort of clean up the Diet for a period of time. I like people to do it for at least three weeks. Uh, I think you need that amount of time to really, to really let the system kind of a relax from, from potentially toxic inputs. And then you want to support the detoxification mechanisms in the body, which interestingly, if you actually look at the biochemistry of how we detoxify, do rely on a fair number of compounds, most of which can be obtained from Fido nutrients from vegetables, uh, as well as a amino acids that are necessary for detoxification. So, you know, adequate levels of healthy protein are, are important for, for proper detoxification. This means not doing a prolonged, a depletion type type cleanses, like a water fasting or juice cleansing or the master cleanse.
[28:44] Dr Grasser: I mean, these things, they just don’t make sense from a biochemical detox vacation standpoint. Um, and so yeah, I mean they don’t because they’re depleting. Um, and uh, and, and so when you look at, well, they’re depleting in the sense that they, they reduced the, the nutrients that are taken in a, of both macro and micro macro be like if you take a juice cleanse, you’re going to get a fair amount of micronutrients if you do variety of plants and vegetables, fruits and vegetables, but you’re actually going to be probably, um, to deplete in, in amino acids. So, which are the building blocks of proteins that are required, especially for phase two detoxification in the liver, which is where most of our detox occurs, although it occurs in every cell in the body. Um, and so if you really look at the science to support a detox, you’re going to want to, um,
[29:45] Reena Jadhav: you’re going to want to take in
[29:47] Dr Grasser: you adequate amounts of protein. Now people say, well, what about an hour Beta when I go for Punch Karma? And they basically give me a bunch of Medicaid again and then I can’t eat anything for days. And then they build my backup starting with Rice water. And I know when I did Punch Karma in India for 21 days, I lost, I lost 12 pounds. That’s a ton of a different theory. Uh, and also you have to remember that there are people that are not candidates for punch Karma there two week, uh, there are two depleted already and they would not be fit to go through conch Karma. So there is a depletion aspect to Poncha Karma, uh, but, uh, outside of using punch Karma, which is also often a traditionally only done for people that had, you know, a significant disease state or a significant imbalance of their constitution. Whereas regular people who are relatively healthy, uh, would just follow seasonal eating patterns and they would, you know, do what are called lightning therapies and building therapies, London in Broome, Hannah, uh, and, and these would not necessarily involve the intense detoxification protocols like in Punch Karma, so we have to remember that, um, although we may feel like, you know, taking a bunch of things out and going on some sort of fairly extreme diet for a period of time may make us feel like we’re cleansing.
[31:17] Dr Grasser: It actually could be damaging to your system because you’re depleting too much just at the time when you’re actually trying to detoxify better.
[31:26] Reena Jadhav: That makes a lot of sense. You said, so one thing is as a nation, I’m assuming that means sort of looking.
[31:38] Dr Grasser: Exactly. So the big ones are the ones that um, you know, end. So it’s, it’s, it’s things that tend to get a lot of people have sensitivities to or true allergies and that often keep bad company. Um, and so, you know, when I run people through an elimination diet, I take out, like you mentioned, gluten, dairy, soy, corn, nightshades, shellfish, citrus, caffeine, alcohol, and then I also try to get them to really watch out for seed oils and take in very minimal added sugars. I don’t 100 percent eliminate added sugars, but very small amounts of things like honey and maple syrup, a, just because, again, Iyer Veda, remember, speaks about six tastes of which suite is one and that it’s not completely evil, it’s just has to be taken in, in, in context and in balance. So much patient or A. Yeah, absolutely more constipation and diarrhea. Um, well, okay. So I think it’s important,
[32:40] Dr Grasser: um, ideally prior to the detoxification, but prior to doing a to doing the concentrated detoxification. Uh, and I will say, you know, just to, to, to back up just one bit here, um, I do think there’s a value to doing these types of detoxes, but there isn’t western science to back me up on this. Okay. So I’m not going to stand here and say that there’s all this evidence that people, if they do a spring, a detox or cleanse, uh, that, that you know, that there’s all this evidence that they’re going to live longer, but, um, so just as an aside, but output. So I try to get them to poop at least once a day prior to initiating the program. And there’s a variety of ways that that can be done in classically in our beta. We used a lot of old creation or oiling of the gut to help, uh, not only, um, with bowel movements, but also the pole, the Dosha is, which you might call a, you know, excess.
[33:39] Dr Grasser: And the Alma, the concept of Alma, that’s ama to pull it into the GI tract, but you know, there’s all kinds of mild laxatives and, and things that people can use. So triphala is a classic ayervetic remedy has three herbs in one, uh, one of which is a purgative. That’s the Tucky aloe can help move the bowels, a certainly adequate hydration, adequate fiber exercise, um, and um, and also stress reduction because a lot of constipation is due to anxiety, uh, as, as can be loose stools as well. Um, what western medicine just throws in this category of irritable Bowel Syndrome, um, and then, you know, rhubarb can work as well, including in the elderly population where you don’t want to, you got to be a little bit careful about some of the harsher laxatives. Um, and then, so once you get pooping, uh, you then also want to do, um, you know, you want to be urinating properly and supporting the kidney function, so hydrating adequately, not drinking too much fluids with the meal because that violates an ayurvedic principle, but between the meals, making sure you’re adequately hydrated, especially a, and then some, like I said, sweating therapies like the detox baths, uh, as well as breath.
[34:58] Dr Grasser: Remember, we exhale toxins through not just carbon dioxide, but we also exhale toxicity in our breathing. And so teaching people to do basic breath techniques, a Pranayama, uh, from the yoga can ayervetic traditions are important as well, and have many other benefits. Okay. So starting with, um, okay, we can start with CBO, CBO. This is a one of a two gut conditions that I think is a over diagnosed and over popularized the other being leaky gut, which of course we have no hard evidence that it really even exists, but I think it explains a variety of conditions under one name, a cbo we learned about in really in the surgical literature, uh, especially after somebody has had a, a portion of their gut removed or altered, uh, and there was therefore a change in the anatomy and in the, in the mechanics of the gut.
[36:02] Dr Grasser: And you allowed a sort of a reflux or a movement upward of bacteria that generally live in the, uh, upper large intestine refluxing into the lower small intestine. It stands for small intestinal bacteria, bacterial overgrowth. A. So likewise, just like you don’t want the bacteria in your colon to, to be predominant in your mouth or in your urinary tract. You don’t want them pushing up into the small intestine because they will create, um, needed. Their properties are different, they’ll create a gases that you don’t want to have to deal with in the small intestine and, and, uh, and then these can be detected through breath tests. Uh, so CBO is a tough thing to treat. Uh, I think that, um, you know, the, the standard approach is, will kill off some of those bacteria. I’m just like, if you had a, you know, a dirty bathroom, you would just pour bleach on everything, uh, but the problem is when you take away the, a antibiotic, if you will, they, it tends to recur.
[37:09] Dr Grasser: And so you’ve got to also help keep things moving into, in the right direction. Uh, so the peristyle cysts in the gut that occurs, that Ayer Bedo beautifully described as upon a value. The downward moving wind, uh, needs to be supported through a, I generally will use a pro pro motility herbs that help move things along. Ginger being one of the best for that. Uh, and then also, um, mechanical treatments such as visceral massage from a good body worker. A in case there’s valves that are getting stuck, uh, and also if you know, the, the intestines can move around quite a lot in our abdomen and if they get kinked or shifted, that can also be helped by a visceral massage therapist. So Cbos a tough one to treat. I have to, I have to say, and um, um, and I think that, uh, it’s, but I also think it’s kind of overdiagnosed, um, crones, uh, diseases a, uh, you know, one of the two main, uh, inflammatory bowel diseases along with ulcerative colitis.
[38:16] Dr Grasser: These are, uh, these are somewhat serious conditions because they can have both symptomatic effects where, you know, there’s a lot of pain and bloody bowel movements and diarrhea, but also, uh, they can be a risk factor for cancers of the, of the gut as well. And so it’s important for anyone with colitis to be under the care of a qualified medical professional. Uh, but, uh, because inflammation is a big component of it, I tend to use a very strict anti-inflammatory style diets, much of which we’ve already talked about under a different name. So avoiding seed oils, refined carbohydrates. And a lot of the foods that may create an inflammation, um, and, and using, you know, fair amounts of phytonutrients in the forms of vegetables and fruits and then I’ll use certain gut healing compounds and anti inflammatory gut herbs from Boswellia to turmeric to glutamine and other like medical foods that are combinations of gut healing compounds and herbs just kind of combined into one powder that people can use.
[39:37] Dr Grasser: A fish oils also have some evidence for helping colitis. So they’ll make it three fats which are quite anti-inflammatory. Um, and then, uh, I will usually try to put people on high dose probiotics mostly because I have anecdotal evidence that they help, not because I’ve seen too much in terms of the larger studies on them for, for these conditions, but there is even prescription strength. The probiotics that are super high colony counts that I’ll try to get people on. Stress Reduction is also really important in, in inflammatory bowel disease. Um, because people will certainly tell me that they flare up when they’re under higher levels of stress.
[40:23] Dr Grasser: And so that’s a great disease for a lifestyle management. I mean, a great evidence there, of course the gut microbiome is a huge topic now just to remind listeners that our guts are really only 10 percent human cells. They’re 90 percent nonhuman organisms, the majority of which are bacteria, but also viruses and parasites and yeast, uh, live in the gut. And so they, uh, that ecosystem has a kind of a brain of its own that actually will communicate with other organs in our body and other systems in our body and in and dictate. I mean, we. And now I’ve evidenced that the gut microbiome tells our brain things. Um, and so a lot of it could be just a shifts in the gut microbiome, uh, that are, that are creative, that are sort of allowing inflammation to be upregulated. But then you, it’s a question that chicken and the egg, like, is it the gut microbiome that’s driving it or did we do it to the gut microbiome based on what we put into our bodies or the fact that a good microbiome was not established in childhood to a number of things which gmos could be part of that and antibiotics and births.
[41:46] Dr Grasser: And a whole host of things, lack of breastfeeding cetera.
[41:55] Dr Grasser: Yeah. Um, so certainly it, it, it never hurts, uh, with, with, with anxiety and depression to improve the, uh, other organ function. So treating gut dysfunction, treating inflammation, uh, and then also neurotoxicity is something that I’m interested in as a, uh, as a trigger or, or a confounding variable in, in anxiety and depression. So, uh, there are a lot of things that are toxic to the brain, uh, both, uh, external toxins that we’ve already talked about and also even just bacterial endotoxins that a certain types of bacterial bacteria make that then can go up into the brain. And so part of how we detoxify, um, things that can end up crossing the blood brain barrier is through normal detoxification pathways in the liver. And then the creation of good healthy file that flows from the liver into the small intestine and then binds toxins and carries them out through the stool, through, through bowel movements.
[43:08] Dr Grasser: Um, and so supporting bile flow, uh, with certain compounds and herbs can also actually help, uh, reduce neuro toxicity and then help anxiety and depression. But also while we’re doing that functional medicine type approach, it’s so, so, so important for people, I think to have some sort of meditative practice, you know, you probably interviewing a lot of people for the podcast, for videos on your site, et Cetera. Um, you talked to a lot of practitioners and I talked a lot of practitioners on my podcasts and when I did the iron status summit, and just time and time again, practitioners are talking about the benefits of meditative practices, uh, as, and, and it doesn’t have to be hard. It doesn’t have to mean that you’re identifying with some other culture or religion or spirituality. Meditation can come in many forms. Uh, and it’s very simple. Uh, and if, if we still have time, I can talk real briefly about just basic components of meditation.
[44:18] Dr Grasser: So a lot of people are familiar with the worker. Herbert Benson, who was a Harvard md who wrote a book called the relaxation response that I believe came out in the early seventies, maybe even the late sixties. And they went ahead and studied a bunch of cultures who engage in meditative practices. Whether it was a Asians that sat for formal meditation or whether it was a people all over the world who were Christians that prayed, or Muslims who prayed, they wanted to look at what we’re a parallel concepts among the different cultures, meditative practices or prayer practices. And they kind of distilled it down into really that you only need four things to start meditating. You need a quiet space, uh, because that minimizes distraction. You need to be in a comfortable position. Uh, and if you look at the yoga teachings of a, just to remember that yoga, Asana, yoga posturing is really designed only to prepare the body to sit for meditation and then meditation to sit for, or shall I say, to sit for breathwork, Pranayama, and meditation.
[45:28] Dr Grasser: So you’ve got to make sure that when you’re meditating, you’re comfortable. And if that means laying down with your head on a pillow, that’s okay. You don’t have to be seated in some, you know, Lotus pose, uh, to be able to meditate. So a quiet environment, comfortable position. You can do this walking meditation while you’re hiking in the woods a while you’re walking to work while you’re driving, even as long as you pay enough attention to the road. Um, number three is you need to have some focus, some repetitive focus. So it’s either the breath focusing on the slow, steady inhalation and a slow steady escalation, or it can be some phrase that’s being repeated over and over in your head. Either a mantra of prayer or if people don’t have anything they can identify with there. I just say try all is good. Just repeat that.
[46:20] Dr Grasser: All is good. All is good, all is good. Or it may be you’re saying like if you have self esteem issues, I am beautiful, or something like that. So you repeat that. And then the fourth thing is you don’t judge yourself. So you don’t judge the outcome. You don’t judge the process. So I tell people, you know, when I sit to medicate tate because I’m a pit to guy, I’ve got a busy brain that’s always going. I start thinking about my grocery list. So what I tell people is that’s okay. Yes. Think about the grocery list, just don’t plan the grocery shopping it, you know, another words, pretend that you’re outside of yourself watching your thought process and just sort of with a, with a quizzical, a nature. Just say, well, okay, so the grocery list came into my head. Let me let it wash over me like a wave of ocean wave, and then I’ll wait for the next wave going back to the breath, going back to the mantra, going back to the prayer, and then you think about, uh, that, uh, you know, that you left, you’re a computer, you’re on, you want to shut it down, that’s fine.
[47:29] Dr Grasser: Just let that Passover. You don’t think, okay, I’m going to do that immediately after I get up. Or, or tomorrow morning, I’m going to do that this time. Just observe the thoughts waving, washing over you and that. And that’s all you need to do. If you have those four ingredients, they found that, that, that actually was created, the relaxation response. It lowered blood pressure, it improved heart rate variability, and it’s just anybody who’s not trying to do a meditative practice who has an anxiety disorder, depressive disorder, or for that matter, just about any ailment is missing out on something that’s a free easy and uh, and powerful. I have a membership based medical practice, which means people pay me a small monthly fee to be my patient and I do member member lectures and q and a’s a every two months. Uh, I get my invite all my members and I do a talk and I just did one on brain health last earlier this month.
[48:31] Dr Grasser: Um, and it’s, it’s a, it’s a really short answer, but, um, there’s a variety of things that I, that I put into place for people that’s like a brain healing protocol. Um, in some of the. Probably the, the most powerful things are again, meditative practices. Number two, learning new things. Okay. So people have heard about, oh, well, if I just do crossword puzzles, you know, I’ll exercise my brain and I see a lot of older patients in the hospital. I go in and, oh, t hey’re doing the crossword puzzle. Yeah. I’m trying to prevent dementia. Well, doing a crossword puzzles, actually recalling, trying to recall things thatyou already know that’s not as potent as learning something new. So new language, getting into an know, making a new friend and, and figuring out that person and how to get along with them. I’m taking on a new task, learning a new hobby.
[49:27] Dr Grasser: If you’re not somebody, if you’re somebody like me who’s kind of a white collar guy, like go learn how to do woodworking. Know because you’re using new, you’re creating new neuronal connections in your brain, new skills and new techniques, um, that you didn’t have refined before and that actually is going to be quite protective. Uh, I do like fish oils for brain health. Uh, they’re highly anti-inflammatory. Medium chain triglycerides like coconut oil, cross the blood brain barrier easily. There’s some nervine tonics that we use in our Beta, like Ashwagandha Bacopa, um, that are, you know, have some evidence for, for brain function. The detox is, again, important to prevent neurotoxins from building up in the brain. Uh, and then one test that if you want the information, uh, is called the Apo e gene, uh, because the people with a apo e type four are at much greater risk of Alzheimer’s disease and some people want to know this information because some people don’t.
[50:29] Dr Grasser: So consider what you’re going to do with the information if you ask your doctor to order that test, but it greatly increases your chance of Alzheimer’s and, and it might motivate you to actually do some of these things that have been proven to, uh, to prevent and slow the progression of dementia. How has your practice, what do you mean by monthly subscription? How does it work? Insurance. Yeah. So, okay. So basically, um, people, uh, my patients pay me a small monthly fee, uh, which is they’re paid, they’re paying for an enhanced experience, uh, in that, uh, I have a small practice, I have longer visits with my patients than, than is typical in primary care will much longer. Um, and then also I provide a membership meetings about six times a year with a lecture, like I mentioned. Uh, I provide them access to me 24 hours a day with my cell phone number as well as a secure patient portal so that we can do like email messaging back and forth, um, and uh, and, and that, and that is what’s covered by the monthly fee.
[51:44] Dr Grasser: Also will do things like teach them meditation and, and review their diet and supplements. The regular medical care is still covered by the patient’s insurance. Um, and I still billed the insurance for the visits, whether it be Medicare or commercial insurance. And then I also have patients on it. Uh, I have a subset of patients on, uh, that are part of what’s called a medical cost sharing community, which is an alternative to health insurance where again, you pay a monthly fee to the medical cost sharing community. The money’s all pooled and then it’s used when the, when somebody in that community needs services, but they work with me on, again, on a membership base. But that medical cost sharing community will actually subsidize their membership with me because I am in partnership with them as the premier practice. Um, and so they’re basically getting what I call slow medicine or a term that I like to use called meaningful medicine.
[52:40] Dr Grasser: And so many of my patients after I did this, a change in my practice model said this feels like the way it used to feel when I was younger. I was a kid and my family doctor used to, you know, know me, know my family and then I have, you know, I have a comprehensive level memberships, a little more expensive, but I also will do home visits with that too. So I have a set of people that are fairly confined to their home that I will see at home as well. They also take care of my patients when they are hospitalized because I still do hospital medicine as well.
[53:12] Reena Jadhav: And Are you available for telemedicine? So if you’ve got folks out in California that are interested in you, is that something you.
[53:19] Dr Grasser: Yeah, so I can do iyer Veda over telemedicine. Um, due to telemedicine
[53:26] Dr Grasser: laws. I cannot practice western medicine via telemedicine. Um, they would have to come see me at least once a year in person, but I can do an integrative Ira Beta consults over skype and phone, and I do. I do do that on a routine basis and then often with that, I can educate them on how to navigate getting tests and whatnot through their local physician.
[53:50] Reena Jadhav: Got It, got it. That makes a lot of sense. This has been incredible. Dr Grasser you, you are doing something amazing in terms of bringing the holistic practices, the ancient traditions, functional medicine into your practice. I really do believe that you’re pioneering and one of the doctors at the forefront of what I hope will become the future of primary care medicine in, in our country, at least.
[54:15] Dr Grasser: Thank you so much for your time. Thank you, Reena.
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