 everyone. Sorry for the pause there I was waiting because last time I got this crazy echo and I was trying to prevent that from happening again. Welcome to another episode of Dr. Jill live you can find all of my episodes on YouTube or stitch your iTunes or wherever you watch. And today we have another amazing guest and I always love I just have the most fun ways of meeting people and connecting and Dr. Asia Mohammed which I'll introduce who I'll introduce in just a moment and I met in Las Vegas this last time and we probably met in other circles like I'm sure we've kind of been around. And we're just talking you are in St. Louis, Missouri and I grew up just a few hours north of their impure yes so very yeah. So welcome today. We're going to talk about the gut liver access. Her specialty is gut health which I love. I'm going to introduce her formally and then we'll die right in. Dr. Asia Mohammed values the power of lifestyle modifications to achieve optimal health she uses evidence based science based medicine to prove to provide individualized attention to those in her practice. As a naturopathic doctor she's like uses nutrition exercise supplementation with nutraceuticals botanical medicine mind body therapies, such as hypnosis and a special interest in GI health mind body medicine and stress management. Increasing research shows there's such a connection to health. She received additional training in mind body therapies, hypnosis guided imagery biofeedback auto genetic training which I want to know more about what that is. So welcome Dr. Asia Mohammed it's so nice to see you again. Thanks for having me it's so nice to be here and I'm so excited to chat with you today to and looks like we wore the right color today. Yeah. So remember meaning you had lovely energy gorgeous smile and we were just like, you know, shaking and dancing a little bit. We were so fun. I really remember that so great to see you again and welcome. I always like to start with kind of your story like how'd you get into this world of healing. So tell us just a little about your journey. I grew up. I was born in Ohio and I moved to Tennessee so I went to undergrad in Tennessee and I was always into science and health and at the time in Tennessee. There weren't any naturopathic doctors and so I was part of like all the you know student medical clubs, and they always have doctors come in of course to talk and they were always conditional doctors. And I always knew I wanted to do more with like foods and herbs and supplements and I didn't know what that was called. And my mom, like we never had medication in the house so this is just kind of how I was I guess primed in a way as a young child I was always just into teas and herbal medicine and you know I didn't have my first ibuprofen so I was like 22. And I thought it was the best thing ever. And I was like, my mom was withholding all of this is child abuse, you know, but I'm glad that she did not kind of instill this peeled mentality into us and we were always like problem solvers with our health so when I was in undergrad. I kind of wanted a profession that was similar to that and so I would shadow all these doctors and in Tennessee everybody's either an MD or a DO or you have you have chiropractors. But the chiropractors they were doing more manipulations at the time which I wasn't really familiar with. Then and so I was like okay this is not exactly what I want to do so I found this what we have this book in our home of this woman who's an nd or it said nd on her title and I'm like what is that. Yeah, this is really cool flip chart book where you just like decide you know I want to find some tea or some like reflect reflexology points today for asthma for period cramps it's like literally a to Z flip chart. And I thought this was the coolest book ever and we had it in the house and I was a little girl. And anytime I was sick I look in the book so I was really sick one semester in school and I was looking at things for I think respiratory issues. And I said it said nd and I'm like what is this person do I would love to just do this so I googled nd and I literally have to see 50 I was like oh this is what I'm doing I don't care what they required this is where I'm going. And that's pretty much how the came in after having doctors so yeah. Well good for you especially in that realm because obviously like maybe Colorado California they're more common, you know a lot of different not always. Yeah, I have a practice and I have a natural path who comes in the office and like that you know so yeah. So it's and it's interesting. I am a medical doctor but I actually remember looking same thing and I'm, I would say about the heart of a natural path. And really the only reason I went the conventional system was like because of you as you know well know reimbursement in the system. Yeah, yeah. And I gosh if I do that if I want to travel or do mission work or do, you know, even infiltrate and change the system. Yeah, exactly. You know, in Tennessee, naturopathic medicine is actually illegal. Right, so that's why there weren't any naturopathic doctors there. At the time, they're like four states where it's illegal, which I didn't know at the time but you know Arizona is where I went to school which is like kind of them, the widest scope of practice for indies. It is very wide because I've had friends who've done it and they go to different states and they can prescribe versus not. Well, I'm so glad you did because again it brings such a wealth of I told you before we jumped on I always learned something new from my natural friends. Talk the gut today which is both of us love this key and it's so key like you said with the gut and liver. So let's start with just like what is non alcohol fatty liver and some of these first of all, Nash is the old name but now. Yeah, so hepatitis right about how you would treat someone or look at someone who has some issues with their liver and why is it connected to the gut. So when I was doing my residency with two conventional GI doctors a lot of GI doctors see also liver cases. And so we had all these patients that would come in from their primary care who just incidentally found fatty liver on an ultrasound that they got for like right sided pain. And they're like oh go see the GI so they will come and see us and the GI is I was working with and still to this day there's not like an FDA approved drug or it was just like okay well, you know eat better and you know lose some weight. The patients are like all right. Meanwhile, like we're having like Snickers and coax from the, from the reps could bring bringing lunch to our office right so we didn't know what to tell these patients and then I started digging, digging deeper into the literature around non alcoholic fatty liver disease and it's pretty fine it's pretty much like the liver manifestation of metabolic disease metabolic syndrome which is kind of one of these like drivers of inflammation cardiovascular disease and so forth. And so I just kind of got into this like rabbit hole of fatty liver research non alcoholic fatty liver research, and I remember seeing this woman who was like in her 30s with like cirrhosis of the liver. And in cirrhosis is pretty much that in stage of liver disease right where the liver is kind of like a shriveled up raisin, and pretty much you have like 10 years of life left they will estimate after that point. And I just thought like how could you not really know this and there that's the crazy thing about non alcoholic fatty liver disease, there really aren't any signs and symptoms beyond like maybe some fatigue but everybody's like tire fatigue so how would you know. And so that's how I got into fatty liver disease and then you look at the research like liver doctors hepatologists are now saying that in the next 10 to 15 years fatty liver will be the number one reason for liver transplants displacing have see in alcoholism so I think it's an important conversation that we need to have. I do to that's I loved your topic love that we're talking about it because I don't know if I've ever had an interview on the liver but I think when I went to Switzerland we did live or go there detoxes I went two different years for like I love that. Yeah, for a retreat, and they would the German doctors there were so respectful like they would call the liver the queen we need to respect the. I love it because honestly, almost like Rodney Rodney Dangerfield it doesn't get much respect right like you don't. We just take it for granted and we yeah home we do taught you know. And our liver is so precious like it is. It's our detox organ so we have this like phase one phase two and any type of that we come in contact with again, as you well know we have to take through there and eliminate it and it's it's our, it's our car filters like the filter in our car. Exactly. Right. So what is going through the body and next to the gut and getting all the nutrients and all the time than everything and then it goes directly to the liver exactly filters the blood. So it's it's just this really really important thing that most people never think about like who thinks about their liver. It's interesting you know when you talk about the gut liver connection right because then you look at some of the literature some reports will say oh 60% some will say. Of course of 75% of the blood going into the liver is coming from the guy which is just like why you know if you have liver issues you have good issues as well and if you have good issues you need to also think about liver stress right so I just think that you know so much in our modern world we just isolate organ systems and they're all so intimately connected. So could I agree more yes we just get this and then you get that liver gut connection is really critical because often want to heal the liver, we need to start with the gut. So, where would you start with someone who comes in and they've been told by their doctor and they maybe feel okay because except they're a little tired. Right. What would you start with would you start with their diet or supplements or things what would you do for their liver. Yeah, so when I see folks who have fatty liver disease or liver issues, typically if it's non alcoholic fatty liver disease the best studied interventions at this point are pretty much like weight loss. Managing blood sugar insulin resistance and then dietary modification so you know typically I'll go through the list and just like go through diet diaries and see kind of what they're eating day to day and kind of start just teasing and it's a lot of education and as you know a lot of what we do is just education. And so that's where I typically start and I try to focus on a weight loss goal of like seven to 10% of your body weight because when you look at the literature when you lose approximately that amount of weight. The fat and the liver also starts to go away so you're improving your liver and you don't need to have like repetitive liver scans are like, you know liver biopsies we know there's enough literature to say just 7% of your body is an it's enough to kind of start stimulating those positive changes in the liver. Tremendous, and you typically have them cut like refined carbs and sugars or anything in particular obviously we know leafy greens and plant based as ideal. You're like try to and obviously we know alcohol could be a big right. What kinds of things are you asking them to decrease or increase. I typically will always ask them about like their sugar intake. It's interesting because a lot of people have different ideas around like sugar juices versus sugar sodas, which is why we're seeing high amount of fatty liver and pediatric populations to. But I'm not a fan of high fructose corn syrup at all I think it is the devil and I talk about this often and you know you look at high fructose corn syrup and how just it's fractionated compared to say fruit me sugar in an apple or sugar in fruit. You know it's just too much fructose and you have a high amount of receptors on the liver that will uptake that fructose which is why it's particularly problematic for the liver. So I typically will go through and say okay, like what's your soda intake what's your juice intake because most of these things are sweet and with high fructose corn syrup and it's interesting because I had a case. A couple months ago, the woman who was diagnosed with fatty liver disease with maybe like stage two fibrosis the liver starting to scar up. And I go through the diet diary, and then I go I say do you drink any soda they're like no. They're like towards and we were talking about something and I'm like yeah I love ginger ale I drink like a couple of can today, but in their mind ginger ale wasn't so it was just interesting. Across different cultures you know I mean how different things are not looked at as sodas or juices per se so I think just collecting a really good history is where where I typically will start. Oh right because I find people like oh I almost universally I have a pretty healthy diet like that's fine right like. Yeah, about it and you're like well I greens for you know it's a lettuce at dinner but then I put it in muffins and ice cream in this and you know whatever it is I don't know. Right the refined carbohydrates so the processed corn and soy and wheat and then the refined sugars and the sources of fructose really do we know that fructose drives this process. Absolutely. And then gut microbiome I think has something to do with it. Do you do any testing like stool organic acids or do you just talk through like what do you do for looking at their gut. Yeah, so I do use stool testing to see what their microbiome looks like in a sense to see kind of if there is anything that we're missing maybe any like yeast any parasites just kind of doing more a deeper dive. And when you look at like the liver gut connection. It can actually correlate. So how dysbiotic somebody's gut is with their kind of risk for fatty liver disease or liver injury. And that's based on this, the LPS molecule right when you have a certain type of bacteria in your gut releases this compound LPS it's going to go to the liver, and it up regulates his liver immune cells he's come for cells and the liver, and it just kind of changes the liver from like immune balance to like now this heightened immune space, which just contributes to more So, you know, I will say this I've not done a single stool test and I've seen thousands and thousands of patients. I've not done a single stool test on someone and not found dysbiosis. Obviously people that are coming to see me or like have health issues or not just like oh yeah I'm like, I'm exercising I'm eating the best my, my lifestyle is this way like they're coming to a doctor because they need help. They're going to see dysbiosis but I'm just saying that it's so prevalent. But at this point for some people I don't even need to run it it's like let's just get you on a gut protocol. Let's just save the money and we can just put that somewhere else if you need that but I've not seen a single person without some dysbiotic characterization of their gut. Okay, I love that you say that because I couldn't agree more years ago I would test for leaky gut which is in test for permeability and it's at the core so you just mentioned something so key that LPS is the bacterial coding certain type of gram negative organisms in the gut they're not all bad, like we get more bacteria, but what happens is when they crossover from that gut lumen, which is that from mouth to anus and then into the bloodstream was just one cell layer less than the LPS coding is that is probably one of the most potent inflammatory immune system as you begin you mentioned, and we know now that it's a it's literally probably the biggest risk factor for heart disease. LPS is not only for diabetes, but also mood disorders like sleep, insomnia and depression and anxiety and even low testosterone and men when I look at the data on LPS I was like wow this covers so much of the problems, especially in our country. So that's a big deal and part of that is that permeability but back to testing. I always said, now I just assume everybody you work in the office is leaky gut right and leaky gut is really the reason why. Yeah, bacterial translocation into the bloodstream and then dumping in the liver and then the fatty liver like that's the pathway. Exactly, exactly. Yeah. So I love that you're kind of the same way and some I mean I definitely test you but there are times when I'm like we can just assume there's some yeah it's like listen let's just move beyond that we know what's happening. Yeah. Yeah, and then what you can do do you use herbs like say berberine or other. I love berberine. Oh yeah I do so I will do like a antimicrobial approach, I will add prebiotics support what they have, and then I'll add in different types of probiotics and just kind of go from there. Is there any particular kinds of probiotics that you like for the fatty liver is there but I don't know all the literature on that but there any particular. So I like to use so I love using sport based probiotics for biotics so I use some of those. I also use there's like a company that makes a gut liver probiotic now. It's a powder I'm not sure if his ads potent as like to this biome DSL powders, because those can be really intense but it's a basically like different lack of basillus strains and Bifido strains. If you look at the literature you see a lot of like positive findings for using lacto in the liver and kind of changing the picture around. Oh, excellent yeah and like you said I love the spores to I felt like that then the game changes and less. Yes, that yes, because I had Crohn's about 20 years ago, and I knew nothing about strains of probiotics. Remember when I was really sick. I didn't know what this basillus coagulants was it's a sport, but I didn't have an education back then and it was the one that worked the best for me. No wonder right the spores really right I know about the research the spores have not only increase ability to increase diversity in the gut, but with this LPS thing this crossover this they're one of the best to kind of pretend. So yeah I totally agree with you there. So we talked about diet talk about interventions. Has there been any studies on like activity or loss what other things could they do with lifestyle. Yeah, so when you look at activity the type of activity matters right so simple like walks are impactful but kind of sometimes like breaking that up with like higher intensity exercise can also prevent the risk to fight fibrosis. So when you have fatty liver, it's estimated that around 20 or 30% of people who have fatty liver will progress to Nash, which is the inflammatory space. And then, of that amount it's like only a small percent actually ever progressed to like liver cancer, but when you get to the space of inflammation you're concerned about kind of continual inflammation scarring inflammation scarring. And they find that when you have like intervals of high intensity exercise, maybe like really intense protocols, you have a reduced risk of like the liver progressing to fibrosis so the type of exercise also matters. When it comes to fighting liver disease it's interesting because they did some studies and they found that they have people doing like cycling like higher moderate to the high intensity bike cycling. Even though these participants did not lose any weight there, the fat in their liver still reduced and they actually reverse their Nash. So they reverse the inflammatory component of the liver and went back to just like the basic fatty liver just by doing exercise, even though they did not actually lose any weight they didn't shed any pounds on the scale which I thought was wonderful because sometimes we kind of, you know our discouraged when we're trying to lose weight and you're not losing weight but it actually does still matter. Fantastic. Yeah that's encouraging because some people are kind of feeling stuck and maybe not in the way they would like but still that that would make such a difference is really. Yeah. And you said the high intensity, the interval. So it's like moderate to high intensity exercise. Yeah. Excellent. Any other nutrients or I've read some on toco triangles which is a formula. I love vitamin E for fatty liver. There is a study, they compare vitamin E with pia glutathione which is a medication that's commonly used for diabetes. And they found that the vitamin in the vitamin E group the people who took vitamin E I think it was around like 800 I use daily, they found that they had a slower progression of the inflammatory changes in their liver compared to the group that did the pia glutathione. Neither one of the groups actually, like neither one of the therapies actually reduced like the risk of fibrosis, but it actually did reduce inflammation in the liver the vitamin E did more than the pia glutathione. So, I love vitamin E I love telling people to just kind of increase their nuts and seeds and then kind of add in vitamin E. I love toco triangles to cough for all I love all that. Fantastic. Is there any other nutrients that we haven't talked about that you feel like are real crucial to liver health. I think is really important for the liver, the liver loves vitamin C. So I usually will kind of sometimes I'll do this test, looking at people's intracellular extracellular levels of vitamins minerals nutrients to kind of see where they're at. And a lot of times you see people are really low and like their their serum vitamin C it's okay but their white blood cell vitamin C would be really low just really it's not it's not shocking but it's really interesting to see that. And it just kind of plays on you know conventional blood work and if it's actually getting to the whole picture of the person. So when I do that and I'll see like low zinc levels and I'm like going to say increase the school meant. So I'll do zinc vitamin E vitamin C I'll do glutathione you pretty much find glutathione low across all chronic diseases right and you see that in the liver glutathione is most concentrated in the liver so it makes sense that when somebody has fatty liver disease if their liver is in the state of inflammation oxidation you're going to be burning through that glutathione. So I'll have people do glutathione as well or like the precursors in AC or like different amino acids to support that. And then, let's see, as far as nutrients mean that's pretty much where I start. Yeah, perfect. It's amazing, by the way, Alpha Lepoic. Yes. Yeah, it's great for the liver. Yes, you mentioned like my favorites with the glutathione, NAC, Alpha Lepoic acid and then milk thistle I'm sure you use yep yep yep. Do you prefer a supplement or a tea or how do you like to use the milk thistle. I prefer a supplement I find that the, like the component you're looking for in milk thistle that's been studied for liver disease you can't really extract it that well with tea unless it's like really really hot and you know. So I will typically do like just capsule formulations for that. And then I love like one of my favorite herbs to use for all things liver metabolic diseases kind of stem up into phylum. It's a Vietnamese herb, but it's interesting because you have animal models and human models and this one human model they took these like treatment naive like diabetics and they gave one group green tea and they gave another group. They had a plant they had him drink like six grams a day for like 12 weeks and they measure their A1C scores. After 12 weeks of drinking the gynaestema versus the green tea the group that drank the gynaestema had a two point reduction in their A1C score. The gynaestema also reduces fat in the liver this is an animal model they found the liver weight of the animals after the study was significantly reduced and they knew it was fat that was going away so I love that was really really safe botanical. They can have them drink that they can eat it, they can get it in capsules but in the studies, it was just study as like a water extract so a tea so. Oh, fantastic. That's great great information to super. So die. And then let's before we before we let you go, you talked about your expertise in mind body and all these. Any area, that's right, definitely the liver but all areas. What, how do you implement those kinds of mind body things maybe you do hypnosis in the office as well or what else do you. Yeah, I love my body because when you think about chronic disease in America it all in my opinion it starts in the mind and there's so many subtle suggestions around us and you know you see these big billboards for like. natural fries at Taco Bell and then the next week you're eating natural fries you know where that came from you know it was a suggestion from a week ago from a billboard that you saw so I'm really big on kind of mind body just because it all starts as a thought. And so I will do hypnotherapy in office I'll record hypnosis hypnosis scripts customized for people and just have them like play them over every night or like 15 10 minutes long. You know, like muscle relaxation just kind of going through and verbalizing essentially just giving some more suggestions to the body for how to relax itself so yeah. Tremendous and so powerful because we know this talk about the whole new conversation but sympathetic person that they're going to fight or flight person that it gets rest relaxed adjust and so this especially got liver we need that person that is very sympathetic but most of us are going around with 90% of our time in the sympathetic go go go go go. So we really this is great. Do you have any practical so say they couldn't get your recordings or any that do you have any practical ways that someone could implement those things themselves like the four bed or what could. Yeah. I just want to tell folks all you need to do is just like take out the recording app on your phone and just record affirmations to yourself, and kind of make it into a longer script and you can just anything that's positive anything you want to accomplish like say that to yourself and just play it in the morning play before you go to bed make it be as simple as, you know, I'm going to make healthier choices and this looks like X Y and Z. I'm going to go to the park and when I you know my ideal goal is to be to look this way or to, you know, be able to walk with my kids or so forth so just kind of saying those things it's interesting how we can rewire our brain with just suggestions, like verbal suggestions so yeah. Oh, I love that. So I remember I don't know five six years ago I was like I wanted to start to change this and I started going on a walk and I would every day be like every day and everywhere I'm stronger and healthier well I love that every day and everywhere I'm getting better and I would literally say this every single day and this little thing and and it everything started to really does work I mean it does and you can begin it just repetition. And what happens is your subconscious doesn't have the filter that our analytical mind does right. So, yeah, subconscious it'll just take it'll be like, I believe this so let's go. Yes, I love that the mind works that way it's so simple we honestly I think humans think we're so deep and complex and we're really not Again, you know this well the subconscious is like it'll just play it out exactly script so. Well, Dr. Asia Mohammed it is a pleasure like before when I love your joy and vibrancy love what you're doing there in St. Louis near my hometown and where can people find you if they want to know more about what you do or if they're near St. Louis. Yeah, totally so pretty much my website is the best way to find me it's just Asia Mohammed calm you can reach out there and contact me. I'll be in a brick and mortar space this this month actually so kind of post pandemic getting back to seeing people in person so I'm excited about that. And then yeah I just offer like online like educational type webinars and events but yeah. Perfect we will link up wherever you're watching this you'll be able to find her website and links and thank you again for taking the time to talk about the liver with me. Thank you so much for having me this is great. You're welcome.