 Welcome to the Dr. Gundry podcast. So here's probably a shocking statistic that doesn't shock me, but I hope it shocks you. One in five children has a mental health disorder. One in five. And if you're a parent or a grandparent, then you'll want to listen up because today I'm going to be diving deep into what's driving this alarming rise in childhood mental health issues. To do that, I'm joined by Dr. Kenneth Bach. Kenneth has over 35 years of experience diagnosing the root cause of chronic illnesses and restoring balance to his patient's immune systems. And he's got a brand new book out called Brain Inflamed, uncovering the hidden causes of anxiety, depression, and other mood disorders in teens and adolescents. So in today's episode Kenneth and I are going to discuss why these mental health problems appear to be increasing. Not only appear to be increasing, they are increasing. What it has to do with your children's God health, one of my favorite subjects, and what you can do if you suspect your child is suffering from a mental health issue. Kenneth, it's great to have you on the show today. Well, Dr. Gundry, it's great to be with you. Really great to be with you. Welcome. This is just for people who are listening. I have actually raved about this book and my comment or the book is on the back cover. So listen up, folks, because this is important. All right. So I want to dive into a bunch of questions. And the first question is, there are theories about the root of mental health problems in children. And maybe we could divide that into two almost conflicting theories. One is diet and then nature theories, nurture or nature in a way. So you contrast a Mediterranean diet, high in fish, olive oil, and vegetables with a high saturated fat, high sugar diet common in the US and elsewhere in Western countries. Is there literally a connection between the food that we eat and what goes on in our brain? Let's start there. That's actually getting down to basics, right? Food. Yeah. And there clearly is. And it always kind of always blows my mind that people seem to almost gloss over it and not really pay it any heat. Because you think of what we, you know, what the typical American, especially the typical American teenager, shovels into their mouth that goes through the gut. And I know how important you know the gut is. And on an everyday basis. And I see it because when you see all these kids, you hear about their diets and you realize by just sometimes changing. And, you know, obviously we love people to be on more like the Mediterranean type diets as much as possible. And there are studies, obviously many studies to show how this can help with depression and anxiety. But it's just sometimes you have to do the simple things. You have to cut out the refined sugars for a step. And also the artificial additives, the preservatives, the flavorings, the colorings. Because I can remember I've been saying this in our field of intuitive medicine. I've been in practice since 83. But I remember a study, I think it was in 90, I think it was in 2008 in the Lancet from Wales. And they actually did a double blind controlled study of food editors, preservatives, colorings and food editors in two cohorts of kids, three year old and eight, nine year olds. And they clearly showed that it contributed to ADHD. And I think from then on, all the naysayers really was in the Lancet, they could no longer be naysayers. And so what we've been saying for all these years, as you know, so many things you probably say, years later, it gets more accepted. It's not called controversial. Well, I think so the very initial things are stop the food additives, the processed foods and the refined carbs. If we can do that, we can really help a lot of kids. And then of course, if you can move more into the Mediterranean type diet and get off all those grains and get more into the healthy proteins and fats and veggies, veggies, veggies, we're even better shape. So, you know, I may have mentioned this on one of my other podcasts, but you're probably aware. And if not, I know you're aware of it. Do you remember the Appleton School, the Appleton, Wisconsin middle school study of changing the food in the school cafeteria and behavior? I can't quote it, but I yeah. Yeah. Well, again, I think because we're talking about this, I've been to Appleton, Wisconsin, it's a cute little Midwest college town. And they were having a lot of behavior issues in their middle school, their junior high. And they had an organic cafe in the town. And the school district says, we're going to contract with this organic cafe to serve breakfast and lunch at the school. And then we're going to, we're going to have all the families come in, all the parents come in, and we're going to teach them what we'd really like you to feed your kids at night, try to keep this going. And lo and behold, their truancy dropped the trips to the vice principal's office plummeted, and their test scores went up. And everybody says, wow, you know, look at that. And they were so impressed that they decided the cafe said, well, this has been great, you know, but you know, we can't keep doing this. It's not our business. And so they said, okay, we're going to institutionalize this, we're going to get a big corporation to come in and keep this going. And I won't mention the name of the corporation. You can find it out. Once the corporation took over, they everything went back to normal. The truancy increased the behavior, the test scores went down. And of course, the big corporation didn't do the, you know, they just went back to, you know, giant food suppliers and it changed behavior. And you're right. It's, it's hard to believe. But in fact, that's what happens. Yeah, well, the problem I think also is it takes effort. And unfortunately, to eat more organic takes a course more. And so I think that's one of the the barriers to more widespread implementation, unfortunately. But and it takes effort to I mean, to cook healthier foods rather than eat all the fast foods. I mean, you imagine a kid starting with a cold cereal, I don't want to give a name, I don't maybe give a bit, you know, but you know, these colored flavored, you know, charms or whatever. I mean, what a way to start. I mean, it's just, you know, empty calories and all kinds of processed additives. And it's, it's no wonder that the, the raw materials for the function of the brain, which is responsible for not only cognition, but mood is altered. You know, it doesn't take a right, I'm sure you feel this way. It doesn't take a rocket scientist to, to figure some of these things out. And the, you know, and these are, you know, these are very modern foods. I have to remind my patients that nobody had a bowl of cold cereal for breakfast until 1906, when you know, Kellogg's invented it. And I did some of my training in England. And no one in England ever had a bowl of cold cereal until 1940, when the Yanks brought it over during World War II. And, you know, these are, these are modern foods. Not, not, and you're right, they're just a bowl of sugar with, you know, with coloring now that. So how do you, so I see a lot of kids and teenagers in my practice primarily with autoimmune diseases. I have a big Crohn's practice, a lot of juvenile rheumatoid arthritis, and certainly these, these kids and teenagers have some really good motivation to, once we show them that food is the culprit to change their diet, and they can feel it, they can see it. But in the, in the mental health area, how in your practice, how the heck do you motivate a teenager who's, you know, living on Lucky Charms and McDonald's, and can see absolutely no reason that that food that all of his friends or her friends eat, who are, quote, normal, how do you convince somebody to make a change? That's a great question. And that's something I really worked hard at. And I feel like I've gotten good at it over the years. And part of it is to learn how to bond with the kids, you can't in any way be arrogant or condescending, obviously, I mean, you know, and the kids I take care of with autism, that's another part of the population to deal with. I get down on the floor and look them right in the eyes, even though they don't want to look in my eyes. With the teenagers, I'll get to them, I'll try to figure out what it is that they can relate to if it's a kid, let's say a boy or a girl who's interested in athletics and they play basketball, I may be able to make an image because I coach my kids when they were, you know, younger. Hey, can you dribble with your left hand? Can you go to the hole to the left, not just the right, you know, some things that they may be able to make perk up, wow, this guy's not too bad. And also, it's a matter of the pain that they have, and not just physical pain, it's a matter of it. So try to get to them. How are you doing with your friends? How is this affecting you? Even maybe pimples or gas. You know, we say, we talked about in the book, we make a funny image of the gas, but you're a teenager and you're making smelly, use the word farts, I mean, if you're passing malodorous gas, as I'll say in my more scientific way, but you know, it's like, that's kind of embarrassing. So hey, you know, what happens if we can help you with that, or your pimples, and or may and then get to the thing about maybe make you feel better and be better with your friends, that kind of stuff. Gotcha. And do they, we certainly see that behavior changes from food choices. And do do people, obviously, you're successful at this, people actually notice a change in their behavior, or things are doing better when they're eating certain foods? No question. But the interesting thing is, sometimes you ask the question, how you're doing? No, no, no, no, no, no. But then you start asking the specific, well, okay, how you doing in school? Actually, my grades are better. I'm able to attend better and concentrate. How you doing your friends? You know, well, maybe I'm not as irritable. I may be, hey, I'm getting along better. I'm a little bit more affable, or you know, so you you you have to be able to point it out to them sometimes. But but when you can make the changes in their life, you definitely see it. There's no question. I see it. Obviously, that's why people come from all over the world to for these kind of treatments. But you see it. But the key is to relate to the kids. I really feel like that's something that and I think it's something that doctors really have learned how to interact and relate to this one thing I learned in University of Rochester, I had this mentor, George Engel, I don't know if you have he was the he was the father of bio so bio medical psychosocial medicine right from the first day we went when we did our cadavers, we did him in the morning and then we met in the afternoon and talked about how we felt, which is pretty profound. So I learned that whole open ended into interview and how to relate. And I think that's really helped me with the kids. So actually take us through that. So how how would number one? Okay, somebody's found you, maybe from not the Hudson River Valley. And we've got a quote problem teenager. Let's let's use that as an example. Do they do they come to your center? Do they spend time at your center? Or is this all remote now? How's it work? Well, it can either be either way. I mean, I love when they're local, because we don't we have a really, we have people come from so far that now a lot of a lot of it's always been, you know, telemedicine video, etc. But they always had to come first. So you have to travel from Thailand, or you know, you have to do an exam, as you know, but now actually freed up, we don't have to do that. So I can treat for a video first. But either they'll come in I like when they come in, because I can actually really interact to have a couch have chairs and a couch and the kid usually sits on the couch. And so I'll talk to them if they're an older kid, I usually let them do the talking if they're certainly over 18, they got to give permission for their parents to be there, which is very interesting. And they have to sign. So I like to try I guess the word I would say that's going to be like to try to empower the kids. So if you can empower the kids and get them on board with you, and not just jump on the quote on the side of their parents, and really get them to be able to somehow acknowledge what's bothering them. Because at first, you know, they're going to say, you know, you know. And so if I can somehow get to and I've had a sense of who they are, and I can get to what's really there and say, Hey, listen, if I could help you in this, would that interest you? And I said, because I don't want to waste your parents time and money and my time, because I'm not going to be over you with a stick, I tell them I'm going to. And so you be surprised how you can enlist them with this kind of a thing. And I think for practitioners who hear about this, they they just need to somehow try to be able to relate to the to the kid. I think it's I think it's really key. So let's shift gears. You and I probably and we'll talk some more about food. But the other side of the coin is the the nature theory that, well, children right now and teenagers have far less unstructured time for play and time to be in nature. poverty certainly has a has a big piece to play in this. Show me or tell me what your thought is. Okay, how much of this change is a part of what's going on with kids today? I think that's huge. And it's going to manifest in a second. I'll get to how it manifests physiologically, but psychologically, this whole thing with I'm two hours north of New York in the Hudson Valley, but I got a lot of patients out of New York City. In New York City, even before you have a kid, you're thinking about their preschool. Then once you have a kid, you're getting tutored to interview for preschool. This is true. I don't know if you've heard of this. They're actually getting tutored to and I'm not putting the parents down. This is not a put down, but it's so competitive. It's so crazy that, you know, kids are not being allowed to be kids. And I'm a big proponent of letting kids be kids. We grew up. We screwed around. We played. I didn't have much money. We played with a any kind of ball and a stick that was a bat. You know, we wrapped tape around that a broomstick. I, you know, skiing and tennis were above, you know, were beyond me at that time. But the point is we had fun and it was unstructured and we were outside. And nowadays, as you know, the pressure any sport is now it's a competitive club sport. You've got to really be the best. You're going to get tutoring quote, you know, or coaching for that. You're going to get tutored in your school. You have to have the best grades and obviously we all did very well in school. But the point is I think that's a big thing. I want kids to be able to be kids. That's number one. And number two, the social media pressure. This need to be aware of it and know everything and be on display every minute. So if you're picking your nose and somebody gets it on a camera, or, you know, it's it's terrible. And so that couple with FOMO, fear of missing out, the I think these kids have so much pressure on them. And I feel I feel I feel bad about it. I feel and then you couple that with the whole pandemic and the loneliness and isolation. And that's what I say. Look, we end up having this cauldron and they're just boiling bubbling over the cauldron with so much stress. And the thing is stress causes systemic inflammation. And that's systemic inflammation affects the blood brain barrier, and then leads to brain inflammation. And brain inflammation can manifest not only as cognitive issues, but as neuropsychiatric symptoms. And that's the whole premise of the book. And the interesting thing, Dr. Gundry is when we see all the stress, we we attribute everything to stress. But we forget all the other layers in the cauldron that bring people up in the so that the stress throws them over. If you really lay low on this cauldron or I call it immune kettle, you can tolerate more stress, because stress is the thing that is the most obvious. And you say, oh, this is all stress. Well, truthfully, it's not. It's coupled with all the other things which we can talk about. But it's also that stress causes inflammation. And that's the thing I want people to be aware of. So what's what's the difference between this seeming rise in mental health issues and normal teenage behavior? Help us all understand that because all of us were teenagers. And we know what we did, right? We know exactly. So it's a good point. And what I've done in the book is I put together something that I term the mood dysregulation spectrum, which puts together kind of like the autism spectrum. But it's for neuro typical kids and their moods. And it goes it's it goes from left to right in terms of lower intensity symptoms to much more intense. So like irritability and moodiness, that I have this normal curve that allows for some of that that we all can have a little bit of that sometimes and certainly teens can have that. So and then you go to anxiety and depression, OCD, panic, aggression, bad mood swings and psychosis. Those are really intense. So there is an amount of that's quote normal. And then there's a little higher in the irritability and moodiness that I call teenageitis. And how you differentiate normal from really kind of the more pathological or problematic. You got a teen in your in your home, he or she is a bear. I mean, unbelievable. They go have a sleepover, right? That mother or father tells you your kid is the most wonderful kid so polite, so sweet. And you are going, you're talking about my kid? You're talking about my kid? That's what we call teenageitis. That's a behavioral thing. That's not going to be all this inflammation and all the other stuff. That's more behavioral thing. They they're good in school, maybe on the outside with friends and at a friend's house at home. That's unfortunately where it's going to happen. You want it to be there. Obviously, you don't want it to be there. But if it's going to be anywhere, as parents we got to deal with that, you know, they unstress at home, they feel comfortable, they take it out on set. And so that's a teenage thing. When it when it seeps over with friends at school and certainly had a sleepover where you hear back, oh my god, your kid's really a problem. That's much more of a problem. Gotcha. So you you you break, you know, the immune system and inflammation and brain inflammation into lots of different layers. So let's let's start at the bottom. And the bottom, I think you and I would probably both agree is genetic predisposition. Start there. How how much does genetics factor into this? I mean, I think obviously genetics plays a role because we all get this predisposition the genes from both our mother and father. And so, you know, some of those genes, as we know, genes code for proteins, proteins are either structural or functional like enzymes. So if you have these mutations in a gene, even these tiny, tiny mutations that can affect one nucleotide, one or two of them can affect the function of a gene like the MTHFR that metabolizes folate to methyl folate, which is the active folate that crosses the blood brain barrier into the brain. Then you're going to have, let's say, if you have one mutation, you may be 70% efficient. If you have two mutations, you may be 30% efficient. So how do we remedy that's interesting. And that's just one gene. There are many genes that we get from our parents. And in addition to how we look, the phenotype, obviously we get from our parents. There's also these predispositions. You'll hear, boy, you know, my father was anxious and my uncle had bipolar or OCD. You know, there is that genetic predisposition. What we do in integrative medicine, and I imagine certainly what you do as well, I call it nutritional modulation of genetic expression. It's not a fader complete. So that's the good news. I mean, the bad news is we do get our genes and for better or worse, some people have great gene. I just saw somebody yesterday, you know, one parent died at 98, the other still living, you know, 95 or something. I mean, that's amazing. Those are good genes. We don't all get that. But we can modulate the genetic expression of genes, and which is really comforting in some way. And it should be comforting. It takes effort in terms of diet. It may be taking some supplements, like with the method with a mutation in the MTH. If our gene, you if you're going to get less methylfolate because you have two mutations. So let's say you're, you're, you're only 30% efficient. You can supplement with methylfolate. And in fact, we've been doing that for a long time in our kids, we use a lot of methyl B12 and methyl folate because it can affect cognition, it can affect attention, it can be calming. But, but the point is you have to take it, you know, and now even that that's known as an adjunct of anti depression. So in addition to the SSRIs, we know now that they are, you know, we use the natural forms of methylfolate, but their prescription forms also that you can take at higher doses, 15 milligrams even. And it can and it can have a significant difference because the methylfolate's involved in the production of transmitters, for instance. So you sure it's all about affecting the neurotransmitters. So I think this whole thing, this is this is the genetics, predisposition, but also one of the other levels is metabolic disruptions, metabolic dysfunction, and we can impact on that greatly. So yeah, let me let me just stay with the MTHFR mutations. We we call them the mother effort genes in my practice. And I tell everyone, because if you kind of say this out loud, we will bleep you, you know, from network television. And the kids really like that. Oh, and now. So you mind if I use that? Oh, no, please. I'm telling you, they'll they'll really like it. And one of the one of the reasons that I like to call it that is because there's a lot of awareness of the mother effort genes and a lot of people and you and I both know that these do correlate to increased risk of anxiety and depression and ADHD and and drug abuse, alcohol abuse, suicide tendencies, and they do track in families. And I take a complete, you know, family history and, lo and behold, you can spot this. But a lot of people even and tons of people carry either a half mutation or a full mutation and one of the two. And a lot of people want to blame everything that has ever gone wrong in their lives with. Well, I carry this gene and you know, it's and that's the cause of all my problems. And I bet you've seen this as well. And they put too much. Well, I think it's not just that gene, but it's people put too much attention, even the whole thing with the genetics. It's very important. It's a predisposition. I call it's a roadmap. You know, it's a roadmap, but it's not a fate to complete. So people come in with the whole, you know, their whole genetics, and they think that's them. And I say, no, no, no, that's not you. That it is a predisposition. We look at it, we can we can affect it. But but I think there's too much weight in some practitioners put way too much weight on that. And they and they and they treat every single thing. And it's you have to do the clinical. The genetics is good to know. And the mth of ours is very helpful. Because if you see a home, we call it homozygous or double mutation, they're going to need higher doses of methylfoli. But we also have to remember that with the good, and it's very helpful many patients, there's also in the kids, a methylfoli can cause hyperactivity, irritability, I said about 10%, rarely aggression, rarely. So you have to be aware of that. So sometimes you have to go very slowly, I wouldn't just jump and get 15 milligrams, you got to go very slowly and you have to be able to see how they do clinically, definitely. Yeah, and we found and you're right, there are there are not there are more than a handful of people that will have the exact opposite effect to giving methyl groups as replacements. And I use low dose niacinamide as a way of damping down this effect. And actually usually works really well. I use niacin, but true, you can use niacinamide also hydroxy B12, because hydroxy B12 can suck up the methyl group. So if you're having that, exactly, I'm with you there. Nice and nice and hydroxy B12. All right, so let's go to the next level, which you like to talk about. And that's nutritional deficiencies. And if you and I know perhaps more than most people are the nutritional deficiencies because of the way our soils are depleted, are and the food we eat is striking. So what say you about nutritional deficiencies? I think it's I think it's all of the above. That's one of the multiple choice questions all of the above. It is definitely the soils are depleted. You know, certainly with selenium, we know that and other things. But I think it's the diets. I mean, I think when you talked about the cold cereals, you know, some of you just told me yesterday about how these foods are, you know, have all these nutrients, you know, I say, yeah, what they do is they strip out all the nutrients and they add back small doses of a few, you know, and they say they're quote enriched, you know, all these sugar laden foods, they're, they're, they're nutrient empty, they're calorie dense, nutrient empty. And the one thing about sugar is it puts an additional demand for nutrients that metabolize carbohydrates and sugar, you know, and so it's a double whammy, you're getting an increased load of junk that you have to metabolize and you and you're not getting the nutrients to metabolize it. And so so many kids, you know, the interesting thing is when we talk about nutrients and, and, and a pediatrician, and again, I'm not downing pediatricians, they do the best they can, they help so many kids. But if you talk about this, the nutrients, how they eat it, well, they eat it, they're fine. The parents give them a good diet, they're fine. Well, the good diet is not always so good. But if you, if you don't look, I said this in my book, The Road to Mutiny in 1997 is my first book. If you don't look, you won't see. And if you don't listen, you won't hear. So if you don't look at nutrients, sure, you're going to say they're fine. But I check vitamin D in every patient. I check multiple nutrients like zinc. And lo and behold, a lot of I mean, vitamin D is deficient in so many, you know that, I'm sure so many. We know we should, but even and the B vitamins, I generally check with the urine organic acid, so I can look at metabolites that are consistent with, you know, functional B vitamin insufficiencies. I like the word insufficiency because sometimes they're not below the quote deficient level. Same thing with vitamin D. But I think insufficiency is a much better word because it's insufficient for their adequate function, as opposed to, you know, you get a vitamin D of 30 and they say, oh, they're fine. Well, they're not really fine. Or even some of them will say 23. That's that's in his own. That's maybe it's not maybe. And so I even even a lot of the B vitamins. I think it's a matter of insufficiency rather than frank deficiency. So next area allergies and sensitivities. Where does that fit in all of this? Well, as I mentioned before about the whole area of inflammation and inflammation affecting the brain and causing symptoms, psych, you know, psychological kinds of symptoms, allergies and sensitivities create inflammation. So this inflammation can come in so many different forms. I mean, infections create inflammation. You deal with the kind of autoimmunity autoimmunity creates inflammation. Allergies and sensitivities create inflammation. Frank food allergies, like, you know, we that you know, sometimes you can see it. If you let's say you take a strawberry allergy, get hives. That's the skin is inflamed. That's very simple. You can see it. It's obvious it's very quick. But there's a lot of allergies that are not as obvious that create inflammation. So there's the classic IGE allergies, which like a strawberry causing a hive or urticaria is, but then there's the sensitivities, the gluten sensitivities, which are not allergies, but are either they're immunologically based like in celiac or non celiac gluten sensitivity, which causes a lot of inflammation, you know, and dairy can cause a lot of inflammation as can any single food, you know, and I know you talk about a lot of foods, the lectins and things. There's a lot of type of foods that can contribute to inflammation. And I think we have to not be rigid about it. We have to be realized that it can differ in various people. And so that that's part of my job is to figure out what foods are. I would say that I put many people on gluten free, dairy free diet. It's going to make sure they obviously take calcium magnesium, the dairy free and things. But and because I find that they are inflammatory in many people, not everybody. And the specific foods, if you're allergic to food, that's going to be inflammatory. So you have to either you have to avoid it for a while, we have to heal the gut, because those things lead to inflammation in the gut, which is the start of things. And then we can desensitize people to it. We have some sublegal immunotherapy you can put on your tongue. There are various things to do. But I think avoidance of the foods that cause inflammation is the first thing. And I think the awareness of that is key. So let me ask you in your practice, you know, I always say it's what I tell people not to eat that's far more important than telling them what to eat. Where in your practice does an elimination diet come in to play? Well, you can. I mean there are various ways to do it. Sometimes clinically, I just say I think in your I just had somebody with Hashimoto's will talk about God in a second. And there are studies to show that there's a certain percentage of Hashimoto's definitely need to be gluten free. So I would say, you know, a lot of times they won't come up silly acts. I'll say you can clinically go on a gluten free diet, which I think makes sense. Or, you know, and do it for three months, let's say give it a trial. Or, you know, in other people, if I diagnose certain foods, I might say like, if they're very low grade, I mentioned, listen, I can see a low grade reaction in the blood. But that, you know, or even in the skin, we do some skin testing of foods. But that they that may not be clinically causing this or that. So then we do an elimination challenge where we take those foods, take them off those foods for around 10 days, and then add so that they get they'll actually get more reactive after the 10 days. And every other day we add one back, add it back every meal. For that one day, you watch how they do the next day you take it out. It's like a kind of a washout day in the next day you have another one. And you watch how they do certainly over the 10 days that anything get better. And then as you reintroduce each food. So that's always been the classic the elimination challenge. But a lot of people don't want to do that. So sometimes clinically, we'll just take them off certain foods that they've reacted to. And I think the proof is in the pudding. Dr. Gundry, if they when when patients see they get bad, they come back in a month and they say, you know, my my my headaches are gone. You know, I bowels are much better. The proof is in the pudding really, I would say there. And, you know, most of the time when they're feeling that much better, they don't want to add it back. But if after a while after you heal the gut, you know, I would say that there's only a certain percentage of foods, like the IGF foods are more fixed, maybe 85% of them are fixed and maybe 15% of variable. But any IGG foods or other kinds of non IgE sensitivities, most of them are much more variable. If you heal the gut and keep them away long enough, you can read them, even let's say maybe every fourth day, and you can get by with it. Yeah, I agree. We, we, you know, we used to look at IgE for food sensitivities. And I wasn't very impressed, quite frankly. We've now gone to IgA and IgG. And you're right, I gave a paper in the American Heart Association, Lifestyle and Epidemiology meeting last year, looking at people with really bad leaky gut that, you know, we can measure with blood tests. And after a year and lots of food sensitivities, including gluten, and after a year, nine out of 10 of the people in this study, they not only their food sensitivities went away, but they lost IgG and IgA sensitivity to gluten, which they were profoundly sensitive to. Now I'm not, don't everybody listening saying, Oh, good, if you heal the gut, you can have gluten again. I'm not saying that. But I actually think that I think, well, agree with me, the immune system can be retrained and not react to these things. And it's all because of leaky gut that started all this. And that your book makes a beautiful point about that. Well, and the, and certainly the IgG, when you see a really, really positive IgG of like every food, they're not allergic to every food, they're saying it's a leaky gut. I mean, that correct, you don't need any other tests to show you that that's a leaky gut, allowing these larger proteins to get in and the immune system is reacting. Definitely. No question. All right. So you mentioned hormones and you brought up thyroid. So that's, that's the next hormone imbalances. These are big. Go for it. Well, these are big, you know, I think that they're under recognized. Again, I think one point I would love to make to the people that are listening is that to recognize that blood tests have normal values quote, a lower value and upper value, but they're not concrete. And there's, you know, so let's say thyroid, thyroid is a gland that's in your neck around the atom apple, you know, lower part of your neck. I feel for it. I palpate it in every patient. And sometimes it's a little large, which is indicative of it probably trying, you know, it's trying to produce more trying too hard. Yeah. Sometimes there are nodules, which you have to get an ultrasound and check out. But the point being the third hormone is involved with the metabolism of every cell. And that's why symptoms of low thyroid could look like so many things because it's involved with your whole body. So the classic symptoms are fatigue, maybe a little mental sluggishness, constipation, dry skin, coarse hair or your hair's falling out. You feel cold, you know, your cold hands or feet or you're wearing sweatshirts or other people who wear T shirts, you know, and yet you get a blood test and your thyroid is in the lower range, but it's normal. So your doctor says, no, your thyroid's fine. No, your thyroid's not fine. You have what I would call them. There's a whole thing of cold subclinical. They call subclinical hypothyroid. I don't agree with because it's not subclinical. I call it sublaboratory because they have the clinical symptoms, but they don't have the laboratory symptoms. Sometimes they have an elevated TSH but normal T3 and T4, you know, and they need thyroid. You give them. I like to give them a natural desiccated thyroid and sometimes some of the supplements like iodine and selenium to help produce the T3 and you'll be amazed at how many of these symptoms can help. And in terms of psychological symptoms, you're looking at depression. So that's if you look at, I have these MDS snapshots, these graphs in the book and there's actually if they go to braininflame.com there's a template that they can actually download is totally free and they they can actually chart their their child on this template, compare it to some of the templates I put together. None is exactly one thing, but it gives an idea. And the thyroid, the low thyroid template, the big spike is in depression. That's what you see alive with low thyroid. This is a sluggishness. It's a physical and a mental sluggishness depression. And you give thyroid, you'll be amazed a lot of papers to support this, especially with T3, of course, as you know, because you may not be producing the active T3 from the teeth. Right. And so thyroid is something I and I have so many patients say, God, I feel so much better. It's amazing. And and and yet their thyroid blood tests never went into the quote, totally abnormal range. Yeah, I see this same thing. And I write about it in my new book, The Energy Paradox. One of the things I've found just as a simple first step is the vast majority of people I see now are using either sea salt or pink salt, Himalayan salt, and they don't have any iodine. They don't have iodine. And the first thing I do is I go, look, just go to the grocery store by iodide sea salt. It's everywhere now, you know, even Morton's makes iodide sea salt. And it's amazing. Just that simple step. You know, the government used to mandate iodine and salt for a really good reason. And just that simple step can make a huge difference. And it's it's easy. And it's basically free. So yeah, I agree with you that the thyroid sub quote, sub sub laboratory hypothyroidism is a very real thing. Well, listen, I we have talked about a lot of things. Since it's brain inflamed is is leaky gut and our crazy awful microbiome, a huge piece of this problem. Totally. Yes. In fact, you know, what I what I talk about in the book and I talk about with patients all the time is you have examples of patients whose only symptoms, maybe not even in the gut, their their their brain. So they may be fatigued, brain fog, very common. Yeah, they're they're depressed or anxious or what have you. And you you treat the gut. You you you you determine if there's dysbiosis, which is an altered, you know, abnormal intestinal flora, you treat the microbiome, whether you have to use antimicrobials like antifungals, if there's an abnormal fungal overgrowth. If there is dysbiotic bacteria, I use herbs for that. Usually if they have the history of lots of antibiotics, which certainly predisposes to either a candidle or quote, yeast overgrowth or anaerobic bacteria, too. And a lot of the kids, especially the kids with autism, there are studies showing vancomycin orally and metronidazole that get the anaerobes, especially when kids are aggression. I just I just had one yesterday. His kid responds so well to a course of metronidazole or vanco because he's had this recurrent dysbiosis. And you give that and even if there's not a lot or any gut symptoms, you can you can take a kid's brain fog, cognitive dysfunction, depression, and lack of motivation and reverse it with an antifungal or with prebiotics and probiotics. And because you're affecting the microbiome and all the messengers that come from the microbiome, the metabolites and the and the effect on inflammatory cytokines immune messenger molecules, all that stuff that that affects the gut lining and contributes to leaky gut. I mean, the microbiome is so important in leaky gut. And so I mean, and interestingly enough, from my work, the microbiome is involved with both the development and maintenance of the microglia, which are the immune cells in the brain. So there's a direct connection there between and it's again because of some of the products like butyrate and some of the short chain acids. And it's very but the microglia are so key and many of these kids, the microglia are up regulated, they are pouring out these inflammatory, what I call their cytokines, but in late terms, they're immune messenger molecules just like neurotransmitters in the in the nervous system, in the immune system, their immune messenger molecules. And they're just so inflammatory, a lot of our job is to down regulate them. That's how we quiet inflammation in the brain, part of it for sure. And part of it is really improving the microbiome. So yes. And then of course, the whole leaky gut thing, you know, when I lecture, I always, I always say leaky gut, leaky brain, right. And what I would generally do, you know, we're lecturing a lot more in the not obviously not in the pandemic, we're not doing webinars now, but not. So I would always have the audience, you know, if I was in an audience of 500, 1000 parents, I say, okay, I want you to say this, leaky gut, leaky brain and the audience that once or twice, I'd have them say that I wanted to get in their brains, leaky gut, leaky brain. And you know what, they used to be the whole thing controversial, and people would say out no way. Now I think the literature is really supporting it. And, you know, I'm lecturing a lot now in the blood brain barrier because I'm fascinated by it. I think it's very, very important. And so I've done a lot of research on it. And there's no question that these inflammatory mediators, and I have a lot of beautiful schematics and illustrations of it, when I lecture, of how these inflammatory mediators get out through a leaky gut, you know, the tight junctions open up, it allows these molecules, inflammatory mediators, the cytokines to get up to the blood brain barrier. And just like that one layer of epithelium in the gut, you have one layer of these endothelial cells there. You put, I have slideshows inside by side, they look so much alike. You open up those tight junctions, and then you allow these inflammatory immune cells like the TH-17 cells, and also the immune globulins, which are very large molecules. They usually can't get in. So some of these cases of brain inflammation are really dependent on a leaky blood brain barrier, which frequently is incited by a leaky gut. It's fascinating. Yeah, no, absolutely. And we now can, you know, do blood tests for blood brain barrier disruption. And you can you can just see it as the gut seals, the brain blood brain barrier seals. It's exciting stuff. And it used to be pseudoscience, as you and I both know. It's not pseudoscience, folks. They call it pseudoscience. I don't actually think it was. I think what happens is, and you're probably, I've been in this field since I got out of residency. So I got a residency in 82. So it's talking 38 years now 30. And I really have found this and my kids will say this in my pet, that pretty much everything that we've done, usually enters the mainstream five, 10, 15 years later, my patients can't wait for that. And I'm not doing stuff pulling out of my head. It's all based in science. It's like translating that science into the clinical. And it may not have had a robust 5000 patient double blind placebo controlled study, which may never get done for a nutrient. But it's clearly the science makes sense to me. The risk benefit is so much in favor of benefit versus risk that that and like the microbiome, right? I mean, how how long have you and I've been talking about the microbiome, right? And now and now it's like you can't get away from any scientific publication without hearing about it. Yeah. No, you're right. All right. So the book is brain inflamed by Dr. Kenneth Bach. Where do they find you? Where do they find your book? Where do they learn more about you? So our website is Bach integrative B O C K integrative I N T E G R A T I V E Bach integrative.com. And they can find all that information. We're in red up New York. I can give a phone number if anybody wants to call if they have to call and speak to my new patient person. Her name is T. She's one she's only 35 years 35 years. Wow. Yeah, it's great. And then the the the the books website is called brain inflamed brain inflamed.com. There's information on it. And I really think what can really be helpful to track their child's teenage adolescent progress is the MDS mood dysregulation spectrum snapshot where you can actually kind of graph it'll show you how various you can graph your child and as you do the various treatments, you can hopefully watch that graph change, move to the left, get further down in terms of the y axis. So I think it's a very helpful tool. And I'm and I'm happy. Are there any questions? I'm happy if you know where I have a wonderful nurse practitioner Jennifer Jennifer who's just she's a doll. She's terrific. And so you know we my my staff is funny and you probably have the same thing. They're very they're worried about me retiring, right? And I say, Why would I want to retire? I love exactly right. I get to be a medical detective. And we get to help so many kids. And the one thing I would say about this whole thing with brain inflamed one, I want to leave people this is that not every kid has a medical or biological underpinning. Sometimes it's just stress a kid, a girl breaks up with a boy and they're devastated and they're suicidal. That's it's horrible. There's inflammation from that. But that you know, that's a real psychosocial stress on there's maybe some and, you know, parental divorce and heavy. But if you miss, if you have a kid who has all these problems, psychological and is on psychotropic meds and getting therapy, they're not getting better. If you miss the medical biological underpinnings, you miss the chance to change the trajectory of their life. And not only their life, but the family's life, because one of the most gratifying things for me, when I heal these kids or help heal these kids, you heal the parents, the siblings, the grandparents, the aunts and uncles, the close friends, because we all know, I always say to my, my patients and my friends and family, you're only as good as your worst kid. You're only as good as your worst kid. If you have a really severely ill kid with a lot, a lot of psychological symptoms, then you know how it affects the family. And so that that to me is the most gratifying thing to be able to help them. But I really want to make sure they understand that this when this is there, it needs, if you have Lyme disease, all the psychotrophics and all the therapy in the world is not going to help you if the Lyme disease or infection is causing these symptoms. Yeah, no, you're right. All right, we'll let you go at that. And yeah, look at look at this book, folks, incredibly useful information. So thanks so much to talk to you again. It's a pleasure to be with you. All right, time for our audience question. This week's question comes from Christine, who left us a five star review on iTunes. One. Thank you, Christine. She asked, I only have one quarter of my thyroid left and take centroid on a daily basis in your experience. Will I ever be able to get off this synthetic hormone? If I completely follow your plant paradox plan. Thank you again. And I look forward to hearing your thoughts. Well, first of all, the great news is that centroid, even though it's synthetic levothyroxin, is actually the actual hormone that your thyroid gland would produce. And one of the huge benefits of both levothyroxin and liothyronin, which is T three, is that we can manufacture these compounds. And if they are used by a practitioner who hopefully knows what they're doing, you have nothing to fear about being on those compounds. Now, I will say this, about 30% of women do not convert centroid T four into the active form of thyroid, which is T three, free T three. So make sure, no matter what, that when your thyroid hormone levels are being looked at, you not only get T S H thyroid stimulating hormone, but you also get free T four and free T three. And as I talk about in the energy paradox, for many of my patients, we also get reverse T three, which simplistically is throwing some of T three into a trash can where you can't get to it. But I see so many people who are told just like in this podcast, that you have, well, your T S H is okay, and your T four is okay, and your T three is okay. But you know something is wrong. But when we look at T S H free T four and free T three at the very minimum, that's when we begin to start on cover mischief. And we're having epidemic of Hashimoto's thyroiditis, which is the autoimmune cause of low thyroid. And that I can guarantee you is from leaky gut. And we've had tremendous success in reversing Hashimoto's by repairing leaky gut. So don't be afraid that you're going to be on that medication the rest of your life. It's one of the medications that is the actual hormone that you make anyhow. So good question. Review of the week, this week's review comes from Cynthia Peterson on iTunes, who gave us a five star review and wrote I listened to Dr. Gundry on a weekly basis. I've changed my diet to keto. I've lost weight. I have good heart health. My skin looks great. I feel energized. He and I are the same age. So I am thankful for his wisdom as I age. I also purchased one of his books. Thank you, Dr. G for everything you do for the health of our generation. Well, that's wonderful to hear, Cynthia. You know, I'm happy to hear you're in such great health. And I'm also grateful for your review because reviews like yours help us reach a bigger audience with our what I think is a powerful health message just like you've mentioned. So if you haven't already, please go to iTunes and leave us a rating and a review. And if you'd like to ask me a question, leave your question in the review. I'll be sure to answer your question on a future episode of this podcast, because as you know, I'm Dr. Gundry and I'm always looking out for you. See you next week. Before you go, I just wanted to remind you that you can find the show on iTunes, Google Play, Stitcher or wherever you get your podcasts because I'm Dr. Gundry and I'm always looking out for you.