 Well, hello everybody. Welcome to another episode of Dr. Jill live. I have a colleague and friend that I have known for a long time here today and so excited about our show. Dr. Tom, who I will formally introduce in just a moment is full of knowledge and resources and references and you will all want to get his latest book as well. We're going to dive into gluten related disorders and auto immunity and everything related to immune system and the gut. Just a note if you want to hear previous episodes you can find me on Stitcher iTunes YouTube wherever you listen to podcast, and we've got tons and loads of great guests there. But without further ado, let me introduce today's guest. When it comes to getting healthy Dr. Tom O'Brien's goal for you is making it easy to do the right thing. Great, great line as an internationally recognized and admired and compassionate speaker focuses focusing on food sensitivities environmental toxins and the development of auto immune diseases. Dr. Tom's audiences discover that is through clear understanding of how you got to where you are that you and your doctor can figure out what it will take to get you well. Dr. Tom O'Brien is considered the Sherlock Holmes for chronic diseases and teaches that recognizing and addressing the underlying mechanisms that activate an immune response is the map to the highway towards better health. I can't wait to dive into that today Tom he teach he holds teaching and faculty positions with the Institute of functional medicine and the National University of Health Sciences, and I'm sure there's a lot more we could put in that bio but without further ado, welcome and thanks for joining me today. Oh, thank you Dr. Joe is really a pleasure it's always fun when we can interact you know it's like to kindred spirits dancing in the ethers. Absolutely, absolutely I'm so fun to you know I'm we've known each other for years but we got to spend a little bit of dedicated time when we both took a group to Switzerland about three or four years ago and it was really special and got to know you at another level. So today we're going to talk about immune system gluten related disorders, but I always like to start with story and kind of the why behind you got where you got in medicine you're well respected teacher speaker author. How did you get here what got you into medicine and this trajectory to functional health. When I was an intern 4044 years ago. My ex and I could not get pregnant. And I called the seven most famous holistic doctors I'd ever heard of if I were doing that today I'd call you and ask your office manager, could I talk to Dr Jill please. So I did that with the leaders at the time and I asked them all, what do you do for infertility they all told me what they do I wrote it all down. Do you know what a category one is. No, well learn. Okay, category one. Right, and I put a program together and we were pregnant in six weeks. Wow. My neighbors and married housing we lived on campus and they had been through artificial insemination and nothing at work you know they'd spent 10s of dollars you know that that rabbit hole that unfortunately so many couples have to go down and they asked if I'd work with them and I said well you know I don't think anything here is going to harm you sure they were pregnant in three months. So now we are four months pregnant just hot to trot and ready to tell the world so we tell our friends, and our friend sister in Wisconsin, you know, we were in Chicago's in school in Chicago, our friend sister Wisconsin drives down and I'm treating people out of my dorm room. You're not supposed to do that. And, you know, there's not much in medicine that's all or every but this was an every every couple having reproductive concerns of any type, whether it was infertility or recurrent miscarriages or premature ejaculations every single couple as a component of what was contributing to their problem was that they were eating foods that they didn't know their immune system was responding to producing inflammation. Yeah, and you know we know 14 of the top 15 causes of death according to CDC or chronic inflammatory diseases. So, irrespective of whatever you're dealing with, it's chronic, and you need to deal with the inflammation. And when I wrote a chapter in our friend Mark Houston's integrative cardiovascular textbook. I pointed out that it was 1986. When science identified that atherosclerosis is a chronic inflammatory disease it's an immune system disease. So the cardiologist is stuck now with two lines of thinking they have to do. They have to treat the acute condition that's presenting before them and that's what they're trying to do in cardiology. But then they have to have a different line of thought. Where is the inflammation coming from. Because if you just put a stent in you know the average lifespan of a stence about five years and you need a new one, because the mechanism is still going on, creating the, the atherosclerosis so our cardiologists have to think about how do I reduce the inflammation for this patient. And that's true with our neurologists and our pediatricians and our gastroenterologist 14 of the top 15 causes of death are chronic inflammatory diseases. So you don't want to just treat the symptoms, you have to treat. Where is the inflammation coming from you have to investigate, and then becomes really clear. I have to deal with mold. Well I don't feel bad when I'm in my house well doesn't matter how you feel, if that's the mechanism causing inflammation in your body. So that's how I got into all of this amazing and you know it's funny because I remember back when I was first in practice practicing functional medicine I had a 42 year old woman. She had been infertile and never even thought about it but I treated her not thinking about the fertility. And all several months later she was actually angry she's Dr Jill I'm pregnant with twins. Now later, it ended up being the best thing that ever happened to her you know she's so yes, my praises that the moment she was not expecting. Right, and I learned my lesson I'm like okay I have to console patients as you get well and you do these things and you clean up your diet, you might get pregnant. Be prepared. Right. I had the same experience I've had you know I was a chiropractor and so I also dealt with mechanical care. And I've had the experience with people with women with amenorrhea. And as I treated their mechanics their pelvic their sacroiliac joints I said now just be aware that this care might start your blog again because I had a couple of people that were really angry they walked out in their cycle came. Okay. The whole body works. But I love your story because it often is these problems that we face that conventional system maybe hasn't given us the solutions to that we want to go deeper and you're a seeker you're curious. Recently read and studied and wrote in my book about curiosity curiosity is the number one factor to genius and discovery and no surprise because you're curious. I'm curious but these things lead us to discover there's more. So let's dive into. First let's talk about the gut immune connection like why would the foods that we eat trigger immune inflammation auto immunity and all of these things that lead to many many of the chronic conditions that we see. Yeah, sure. It's ancestral. You have the same body as your ancestor thousands and thousands of years ago you know our kidneys work the same. Their hair follicles grow the same. Your gall bladder works the same the immune system works the same. And the number one threat for our ancestors. First, their number one goal was to find food foraging this is before agriculture was to find food so number two was shelter number three was safety number for reproduction that's arguably the priority order of our ancestors so they find something to eat. First thing they do is a sniff it. Then they nibble. So we've got smell and we've got taste. Then they eat it. And if there was pathogens in that food that they were eating bad bacteria that they couldn't identify. It's the job of acid in the stomach to kill anything. But if it can't kill it if it can't kill it and this bad guy gets out of the stomach into the small intestine where food can now get into the whole body. Then we have centuries standing guard and I like to think of the British soldiers at Buckingham Palace you know those big hats on that are so stiff they just stand there. But don't mess with those guys. We have centuries in our immune system in the gut called toll like receptors. And they're watching everything that comes out of the stomach. And if there's anything that shouldn't be there, they immediately within five minutes do two things. One they increase the protein zonulin, which means leaky gut. Why because when you get a leaky gut water comes into the intestines. And it's like you got mud stuck on your driveway you turn on the garden hose and it doesn't wash off so you put your thumb over the opening of the hose and you get a spray. Now you wash the mud off the driveway. So, zonulin increase brings water into the gut to wash out the threat. That's the first thing that the centuries do the second thing is they activate NF Kappa B the major amplifier of inflammation in the gut. So you get this washing out, and you get this inflammation in your gut, because the the most common threat for our ancestors and that's the body we've inherited today, the most common threat was what they ate and what they drank. So that protective mechanism is, we still have it. And those those that didn't have well functioning toll like receptors, they died, and they did not reproduce. So those that had good defense mechanism, a good century standing guard, activating that immune response, they survive they thrive they reproduce. And that's what's passed down to us today. And the reason why I'm doing all that is because there is one food, and only one food that does that every single time you eat it. And that's gluten from wheat, wheat does that. But at Harvard, they're, they're teaching this and they say that wheat is misinterpreted as a harmful component of a bug that toll like receptor standing guard inside your gut, watching everything. When it sees wheat, it fires it activates that whole response mechanism leaky gut and increased inflammation. And it happens. Maureen Leonard a gastroenterologist at Harvard very famous cow. She did a literature review of over 60 studies on this topic. And she published in the Journal of the American Medical Association in 2017. That's six years ago. And she said, this occurs in all humans who consume gluten. Every person, every time they eat it, whether they feel it or not, they get leaky gut, and they get increased inflammation in their gut. That's why wheat's a problem, whether you feel bad when you eat it or not. So such a great analogy of really what's happening inside our gut, because many people are like, Oh, I feel fine. It's no big deal. So what kinds of conditions, I think I know we're going to say where you're going to go here. But what kinds of conditions, what kind of people that would see you or talk to you about this, would you recommend go off gluten or how. Right, right, right. And I never say everyone should go off gluten ever because I sound like a nutcase like a fanatic, but I say everyone that has a health concern should be comprehensively tested to see is your immune system fighting wheat. And that test is called the wheat zoomer because you zoom in on the problem. Like you, I traveled the world teaching I'm on stage all over. And at the breaks, I go down to the vendors and I look at the laboratories through their manuals of their tech, no one has a test that compares in the western world I've not been to China. I don't know there, but no one has a test that compares with the wheat zoomer. So everyone should be tested comprehensively to see is your immune system fighting wheat. And if it is, you're done. You're done. By the way, wheat is the only food where I can find the science that when you've crossed that line of tolerance and your immune system says no more with this no more. You crossed that line of tolerance. You produce memory B cells, which just like a childhood vaccine for the MMR vaccines or DPT vaccine that you have memory cells. So if you're ever exposed to tetanus later in life, you've got a memory cells way that's a problem let's fight that right now. You produce memory B cells to wheat. Yes, we don't produce memory B cells to egg or to dairy, but we do to wheat because it looks like the structure of it looks like a pathogen a micro organism. So the the entire immune system of humans is designed to protect you from bad bugs and wheat is considered a harmful component of a micro organism. And one more time. This is what they're teaching at Harvard Medical School right now. It's so cool. Yeah, this is science. I mean, that's the best thing is this is very science. This is not on the edges is like solid now finally after all the years we've been working towards getting the data out there and you're one of the leaders there. Let's talk just a little bit because we do have partitions that listen to obviously we know like on a lab core quest or hospital lab we can get TTG IGA and IGG and kind of the basic tell us like the weed zoomer love that test. What is that different from your classical celiac test. And then let's also talk about the difference between true celiac and non celiac gluten sensitivity those two things. Really good quite very important that we all cut our teeth, learning about the potential potential dangers of wheat with celiac disease. Right. And so the, the historical misconception is that if you don't have evidence of celiac disease you don't have a problem with wheat. That's a misconception, because it was celiac disease by which we learn wheat can be a real problem life threatening problem. And so you have to test for celiac disease that's TTG. And that TTG chest by itself is not very good either, because it's only highly sensitive and specific meaning very accurate. When you are at the end stage of celiac disease with total villus atrophy. If you're at the earlier stage of celiac disease the accuracy of the test, the sensitivity and specificity is about 32%. Meaning it's wrong seven out of 10 times. So no, you don't have celiac disease. Well, you may. It's just an earlier stage that TTG is very accurate when you're at the end stage of celiac. But once again, celiac is how we all learned about the problems with wheat. But our friend professor and teacher yahoo to Sean felt the godfather of auto immunity and to give the listeners a sense of who is this guy. And I see the sun shining in right through my eyes here. So I'll just leave it be. I'm not going to go over there to change it. But Sean, actually, maybe I will I'm just going to go from it all. Hey everybody, I just stopped by to let you know that my new book, unexpected finding resilience through functional medicine science and faith is now available for order wherever you purchase books. In this book I share my own journey of overcoming life threatening illness and the tools and tips and tricks and hope and resilience I found along the way. This book includes practical advice for things like cancer and Crohn's disease and other auto immune conditions, infections like lime or Epstein bar and mold and biotoxin related illness. What I really hope is that as you read this book, you find transformational wisdom for health and healing. If you want to get your own copy stop by read unexpected.com. There you can also collect your free bonuses. So grab your copy today and begin your own transformational journey through functional medicine in finding resilience. No more. Here is Dr Tom back to talk to us. I just get a little interlude about if you're dealing with auto immunity or you're dealing with some of these inflammatory conditions stay tuned because this is really important. Yes. So Professor Sean Feld and get a sense of who this guy is when I interviewed him for our betrayal docu series on auto immunity. At that time that was 2016 and so a few years ago, 28 of the medical doctors who went back and got their PhD in immunology from Tel Aviv University in Israel, or many more, many more but 28 chair departments of immunology and med schools and hospitals around the world. They're his students. This is the Godfather. Wow. And he just published a paper in March of last year of the effects of gluten free diet on non celiac auto immune diseases. And he did this is from Sean Feld. Right. They did a they did a literature review. And they said that 79% of the patients get better. And this was confirmed in 64% of the studies on a gluten free diet. And the most common auto immune diseases that benefited were the most common one was Hashimoto's thyroid disease with over 80% got better psoriasis it was in the 60% tiles inflammatory bowel disease in the 60% tiles. But they listed all of the auto immune disease, pancreatic auto immune pancreatitis, cardiac cardiomyopathies, the list went on and on and on of all of the auto immune diseases that may get better on a gluten free diet and actually the accurate word is probably get better because 79% of the patients got better on a gluten free diet, irrespective of what auto immune disease they had. So if you have any auto immune disease, you just need to do the wheat zoomer, you just need to check is my immune system fighting wheat, because that likely is a contributor to the inflammation. I'm currently having that is manifesting as alopecia or psoriasis or whatever the auto immune disease is you just have to check. So, I love this Dr Tom because it's so straightforward and I love that you bring the daddy bring the science we're talking about leaders and research we're not talking about esoteric things here. I just want to tell you a short little story you know some of my history but I had Crohn's disease at 26 a year later I completely went off all gluten and literally over the several years of healing my gut completely cured that Crohn's disease and I eventually the auto mean I always say I collect auto mean diseases but all of them are in remission because I'm off gluten and have dealt with the gut dysbiosis so it's real I'm like standing here as a testimony to confirm that. What about I'm going to go in a little tangent because I think it's important I've heard you talk about this liver, liver is your like filter the blood from the gut right and the liver is affected. And I'm wondering how many people out there maybe have some auto immune hepatitis or just a fatty liver, how can that be related to this topic of gluten and the gut. Anything you eat if you drop an apple on the ground you pick it up and you wipe it off and you eat it. And there's some dirt on the apple. Anything you eat when it comes out of the stomach into the intestines there's only one place it can go. It gets absorbed into the bloodstream it goes right to the liver. Your liver is an oil filter. It's got over 500 functions that have been identified now but the primary one it's an oil filter. I think it's like a honeycomb, and each of the honeycombs is lined with cheese cloth, so that when the blood comes from the gut, straight to the liver with whatever you've been eating. It goes through these honeycomb these cheese cloths honeycombs to filter any garbage out that shouldn't get into the body, and then the blood goes out the other side to the rest of the body. So, every time you eat wheat, you activate this this NF Kappa B inflammatory mechanism in your gut, those inflammatory molecules go into the blood to the liver, and those inflammatory molecules are like gasoline on the fire. They start to get inflammation in the liver. And was that look like increased liver enzymes. That's why male clinic writes the papers that talk about this are great papers. There was one from November of 2007. There's a journal, Hepatology, which means liver diseases, and it was called the liver and celiac disease. And in there they talk about increased liver enzymes may be the only presentation to celiac disease everything else can be fine. People think they're fine but you get a blood test with increased liver enzymes you must just rule out that is not a reaction to wheat. It's that very common that that could be the trigger. So just to clarify for those listening I think you've made it really really nice and crystal clear but pretty much any of you out there suffering from auto immunity, rheumatoid arthritis, any itases lupus Crohn's colitis multiple sclerosis Hashimoto's thyroiditis and I could name a dozen others. Your first recommendation is going to be get rid of gluten from your diet and do the wheat zoomer. My, my first recommendation is do the wheat zoomer. Yeah. And, and if you can't afford to get the test done for some reason, then do what I do and I believe you do also gluten free dairy free added sugar free. And that's what you start with for any auto immune disease but always we recommend do the test, don't guess so that, because it's also a baseline, because it's looking at 26 different markers of a sensitivity to wheat in that test. And let's make it up let's say you've got 12 markers that are elevated, but, and then you're doing the protocol and six months later you check again, and you have three markers elevated. And it's easy to say wow I'm really doing great. This is 75% healed I just need to keep on in the right direction but if you don't do that first test, where you had 12, but in six months you're feeling better but not quite rice as all right I'll do that zoomer test now. And it comes back with three markers elevated. The tendencies to say wow everything I've done for the last six months it's not working. Well I better do something complete. No, it's working really well. You just didn't have the baseline to start with to compare to right that's why you want to test. Don't guess to begin with, because it's going to take you a year to two years to turn your body turn the entire metabolism around. And I've heard you describe again you do so well with board pitchers to make things easy to understand and I love that about the pearl necklaces like this chain of gluten is long and I'll let you describe it but I think that's helpful. Tell us about that because what we're looking at with the sweet zoomers like the pieces of the chain right like we're looking at with the TTG really got one little piece. So describe that for the listeners a little bit more about how that might relate because we're looking at a lot more than just one part of the gluten molecule. You bet you bet Mrs patient, your intestines are a tube. The digestive tract is a tube it starts at the mouth that goes to the other end, about 25 feet long winds around in the center there you know the inside the tube is lined with cheese clot. When you eat food, think of proteins like a pearl necklace, and the acid in your stomach undoes the class for the pearl necklace now you have a string of pearls. And the job of our enzymes is to act like scissors to cut the pearl necklace into smaller pieces flip snip snip snip, and those pieces are called peptides smaller snip snip snip snip until you're down to each pearl of the pearl necklace. Now is that foods moving down from the stomach into the intestines, each pearl can go through the cheese cloth into the bloodstream, and your bloodstream is just a highway, you know everything's going in the same direction. There's no lanes of traffic everything's bouncing into each other but it's just a highway. Right. But now you've got these pearls that are building blocks on the highway. So your brain cells can make you can make new brain cells you've got all the raw material you make new bone cells. That's what the amino acids the pearls of the pearl necklace or for. But when you and the problem with wheat is that nobody can break it down into the pearls of the pearl necklace. No human. The best we can do is snip it into clumps called peptides. And that's why it looks like the outer surface of above. When it comes out of the stomach into the first part of the small intestine, because it looks the same amino acid structure as the outside shell of a bacteria. So total like receptor the guards standing there say that's a bacteria, and they activate this whole immune response to it. And that happens when wheat comes out because it activates its immune response. You also get this inflammation in the gut and have Kappa B and all the cytokines that are formed there, and that inflammation of the gut tears the cheese claw. When you tear the cheese cloth. Now these larger clumps, these peptides of weed or any other clump gets through the tears of the cheese cloth. They're it's supposed to be able to get through and they're called macro molecules, big molecules. Now they're in the bloodstream, and your immune system says what the heck is that I better fight that. Now you make antibodies to chicken or to tomatoes or to raspberries or to any other good food, because the tears of the cheese cloth, allow the macro molecules to get through into the bloodstream and your immune system trying to protect you creates this systemic inflammation in your bloodstream because these macro molecules are in there from the leaky gut. Yes, that's why they're teaching at Harvard right now. All disease begins in the leaky gut that is the macro molecules getting through into the bloodstream that activate this immune response, systemically through your whole body. Depending on your genetic vulnerabilities and how you live your life there that's called antecedent sorry for the geek words but. And what what that means is, you eat tuna fish to two to three times a week, you got mercury toxicity, because all the tuna fish almost all the tuna fish has mercury in it. So depending on your genetics and your antecedents determines where that inflammation is going to manifest. Is it rheumatoid, is it psoriasis, is it alopecia, is it Hashimoto's thyroid, it doesn't matter. The mechanism is the same. Disease begins in the gut. So you have to focus, at least some of your attention on stop throwing gasoline on the fire, stop creating the inflammation irrespective of what disease you've got. Gosh, love this as always Tom, Dr. Tom and one of the things that's so interesting is, you know, I talk about mold all the time mold is one of the biggest inducers of leaky gut as well so if you are out there listening, my audience who has been exposed to mold knows someone with mold this is very relevant to you as well, even if you don't yet have an autoimmune disease. Now I want to talk specifically about gluten in the US versus gluten overseas because I get a lot of questions about, what if I go to Italy, I mean you lived in Italy for a while and it is different. But let's talk about that, because obviously we do have more contaminants we have more pesticides we have more glyphosate sprayed here we have more bread. We that has higher gluten, but still it's wheat is wheat right tell us more about how that works as far as Europe, if you're not silly I can eat gluten. No, no, not not if you cross the line of tolerance. But and here's the reason why science tells us you just read the science it's really clear that when you have immune system responses to wheat. It activates an inflammatory mechanism somewhere in your body wherever the weak link in the chain is you pull it a chain it always breaks at the weakest link your heart your lungs your liver wherever your weak link is, that's where your symptoms are going to happen. So that comes from the proteins in wheat, but the, the GI complaints the bloating, the gas, the, the constipation, the diarrhea, the GI complaints, mainly not exclusively, but mainly come from the fog maps in wheat is the fermented carbohydrates in wheat. And so, when you eat wheat if you get that a bloating that's probably the pod maps, but when you eat wheat and you feel fine but the next day you got to migraine, that's the proteins that triggering that inflammatory response. And in Italy and Europe, the wheat in Europe is lower in pod maps. And so you don't get that bloating response that gaseous response. Oh, I can eat the wheat in Italy and I feel fine. You can't, because the immune system is still reacting. And your MS, if that's weak link in your chain is still being fueled or your Crohn's or your rheumatoid, wherever your weak link is, you're still consuming the proteins that activate the immune response systemically, not just in the gut. Yes. So you're saying there's this immediate response. We can literally at sitting at the table like bloating you and button your pants. Yeah, button your pants and all that, right. And because it's associated with your meal, people think, oh, if I don't feel bad, I'm okay, but you're saying no. No, it could be the next day or the next day or even I've had that a lot of patients go they consume whatever they want. They come back and like inflammation markers are off the chart. They felt okay as far as gas and bloating and bowels. But what they didn't notice until they got back was their immune system went. Exactly. You know, I've had so many patients say, Doc, my tests are better. I'm normal now and I'm staying away from weed. I really got the system down how to do this, but we're going to Italy. And I eat the weed over there because I'm told that you don't feel so bad. And I'll say no, here's why. And they go, oh, well, I said, but if you're going to do it anyway, and they smile a little bit say, let's do the test right now just to confirm everything is great. And your, your, your myelin antibodies for MS or your Hashimoto's for thyroid, the antibodies are down in normal ranges, everything is calm. Then go to Italy do what you want and come back and we'll do the test again. Never has a patient had a normal test when they come back, not once. I would agree. And I want to go one step further with the leaky gut because people like do I have leaky gut 20 years ago when you and I first started. And I would do some of the lecture list manatelle there were tests out there there still are the test for leaky gut. I'll tell you, Dr. Tom now I assume every single person walking in my office has some sort of leaky gut because our toxic load, the types of food, the dirty air dirty water I say clean air clean water clean food will all those things are contaminating our systems. Would you say it's do you test for leaky gut or do you assume people have leaky gut or where are you at in that argument, and where's the beauty behind that question is that when this laboratory vibrant wellness came out in 2015 they opened up with this new technology. Mayo Clinic called it a new era in laboratory medicine, a new era and I'm looking for my phone here, and I see it so I'm going to grab it here. I had told you in 1995 that you know, in 20 years or so 25 years I'm going to hold this little black thing in my hand about the size of my wallet maybe a little bit bigger. I'm going to push a couple of buttons here. I can tell you within five to 10 seconds that the air particulate matter in spiazzo Italy is 70 today do not exercise outside that in Chicago it's 41 that's good San Diego's 44 that's okay, but San Antonio's at 72 do not exercise in San Antonio today, I can tell you that in five seconds. In other words, I've got the encyclopedia of the world in my hand here. If I told you that in 1995, you would have thought that I was watching too much Star Trek. Yeah, right. The same has happened in laboratory medicine the technology has improved dramatically. And it is called silicone chip technology, and this laboratory has the patent on this technology. So I read the paper in January of 2016 from Mayo Clinic that said, and this is their language, a new era in laboratory medicine, where the patent for wheat sensitivity has 97 to 99% sensitivity 98 to 100% specificity. And I went, Whoa, like this, like my two year old son. Whoa. I went to visit the lab and it's you have to wear a space suit literally a space suit when you go in there because it's dust free. They're dealing with silicone chips. And they look at 26 markers of a sensitivity to wheat with that kind of accuracy not one marker, not to 26. And on top of that, because they were really smart, business wise to be competitive in the world out there. They included in the wheat zoomer the most accurate test for intestinal permeability. It's on the same test. And so you get both the best of both worlds you identify the number one potential gasoline on the fire in our diet today you identify it if it's a problem for you or not. And you can identify do you have leaky gut right now. And I fully agree with your assumption that all auto immune patients until proven ever otherwise have a leaky gut, because that's the gateway in the development of auto immune diseases. Wow, this is just jam packed with pearls. Literally, I love it. Um, no super good information. So let's kind of end with a couple little things. First of all, an auto immune patient walks in your office or you're you were talking to them. Obviously we're going to test them for the wheat zoomer check for gluten sensitivity and take them off. What would be a couple of the things like what other steps would you think about with auto immunity and the gut that you might want to look at or, or That's really good question the there's two answers to this the first answer and most important if there's only one thing you're going to do, Mrs patient only one thing, it's build a healthy diverse microbiome that that is the best protection you can have in the world against any auto immune disease. Of course stop throwing gasoline on the fire, whether it's mold or foods or whatever it should be. You have to identify and get that gasoline out of there, but then how do I rebuild how do I get a stronger system, build a healthy That's critically important as the first thing. And the second thing on the gluten free diet. The primary talk I'm doing this year around the world is, I've titled it the enigma. Yes, of a gluten free diet reduced symptomatology and increased mortality. Now, the word enigma means that doesn't make sense. And what I just said in the follow up sentence reduced symptomatology everybody, not everybody, almost everybody feels better on a gluten free diet you know a couple of weeks your belts going a notch tighter, because you're losing weight you're not subloaded your energies up you sleep better your child's seizures have reduced you know whatever the symptoms are reduced symptomatology, but increased mortality. And when you read the science on this it's jaw dropping and no one's reading that science in the journal the American Medical Association they looked at 350,000 endoscopy biopsies. That's when you put a tube down into the stomach passes stomach into the intestines snip out a little piece of intestine and look at it under a microscope. And so this is from Sweden where they've got socialized medicine you know they got records on everybody. And so they patient went to a doctor, the doctor referred them to a gastroenterologist the gastroenterologist did an endoscopy biopsy. They found 39,000 celiacs in that group of 350,000. Okay. And then the rest of them had colitis or Crohn's or cancer, or nothing that they could identify but there were 39,000 celiacs. They followed these patients for 25 to 30 years. How did they do. How many people die. When did they die and all of that. And they found that if you were diagnosed with celiac disease. You were twice as likely to die early compared to any other disease, twice as likely. And that was that was like what. Yeah, but that's the only autoimmune disease we know what to do stop eating wheat right but still they died early. Then, more important in my opinion, they showed that if you were diagnosed with celiac you had an 86% increased risk of death in the first year from a cardiovascular incident. Compared to the other 300,000 people 86% compared to the colitis patients compared to the Crohn's patients, compared to the cancer patients 86% more likely to die of a cardiovascular incident and 3.87 fold increased risk of dying from a cancer in the first year after diagnosis compared to any other disease. And that's like, what. What. I mean, that's just jaw dropping and there are now eight studies that I have in my all day course for healthcare professionals on mortality and celiac disease. So they really understand this now why does that happen. Well, what do they do after being diagnosed with celiac disease what's what's the recommendation. What else. Absolutely nothing. The way the gluten free diet is being done, kills people, kills more people that you can't substitute these gluten free crap products, excuse me, for the wheat products that you were eating. You have to learn how to do it correctly that's why we just launched a 30 day hands on over 40 videos of how to do gluten free diet correctly. And you know it's on our website because you if you learn how to do it correctly, you thrive, and all of those at risk numbers just go away. They all go away. You've got to do it correctly and you go to Starbucks you say oh they've got gluten free muffins, I can have when it's healthy for me as a matter of fact, I can have to their healthy for me. No they're not. They're just not poison for you. But what happens when you don't do a gluten free diet correctly. 80% depending on the study 78 to 81% of the prebiotics in the Western diet come from wheat from the Arabino zylands and wheat, not everything in weeks bad for you. So when you go wheat free, and you substitute the gluten free products that are just white paste, they are not prebiotics, then all of the good guys in your gut, who have for years and decades lived on the wheat food for prebiotics. Now they're gone. They start to starve and die off and the pathogens, the bad bacteria that love the white paste sugary stuff. They thrive on that so what happens in eight months to a year. You've completely changed your microbiome. And every study shows that when you look at the microbiome of healthy people put them on a gluten free diet in 30 days. Their microbiome is much, much worse than it was before the good guys have gone down the bad guys have gone up the diversity has gone down, because they don't know how to do a gluten free diet correctly. So gluten free diet is the best thing you can do. If you do it correctly, and you have to know how to do it correctly. I love this data so, so important and especially because what's so common is you want your, you're wanting your brownies and your pizza crust and your cookies and your crackers and then you go gluten free like well I still want all those things. You go by the gluten free process version we're back to process so, and I couldn't agree more diversity is king with the guy and we have to feed that microbiome. This is why even like a low pot med diet which can be a game changer with Sebo is not a long term because they are eliminating all the food for your good bacteria and increasing diversity so I love love this. I went on your time today so I want to ask where people can find you but before we go there. Give us one last synopsis Pearl what would you leave people with that are, and let's assume you're out there struggling with autoimmune disease and these things we're talking about. What's the, what's the last bit of wisdom from Dr. Tom. Dr. Joe would agree with me on this that it's really wonderful when people know they have a diagnosis of an autoimmune disease. That's wonderful and if you read my book the autoimmune fix you understand the mechanism is the same so what we need to do is show you the map. So that you can then get on the highway to get back to health and get back to higher levels of health. The, the diagnosis of an autoimmune disease is not a sentence for the rest of your life. You can improve your body function in any condition that you have the body wants to be healthy. You just have to stop throwing gasoline on the fire and release the emergency, you don't, you back out of a driveway and you say what's wrong with this car is moving but not the emergency break and you let go of the emergency break right. You just have to stop throwing gasoline on the fire and release the emergency breaks because your body wants to be healthy it wants to thrive. You just have to find the map, your map or your body from your history from your lifestyle from your environment. And when you find that map, and your doctor lays out for you usually a functional medicine doctor but others can have this overview also. You can find this map, and you're not just dealing with well this will help you feel better right now, which is important that you can function better, but you're also going down that other pathway to reduce the inflammation. You build healthier cells that your blueprint, your genetics is for a healthier vibrant you. And there's just emergency breaks holding you back from building healthier, vibrant cells. You just stop throwing gasoline on the fire and release the emergency breaks holding back your rejuvenation. Really only said and what you're describing, which you also describe in your book the autoimmune fix is the fact that we are told what's incurable is really not we actually have reversible auto immunity and that's what we're talking about today. So where can people give your book where can people take the course on gluten where can people find you Dr Tom. Oh thank you it's the dr.com the doctor.com just don't spell the word Dr out the dr.com and everything's there. You'll find the gluten course and it works really great and by the way, anything you get from us if you if practitioners do the gluten free certification anything you're not happy. Send us an email no questions asked we'll give you a refund, you know on anything it doesn't mean we're not here to like sell to make a you know we're here to help you, but I have to pay staff and everything else right so we have to make some income but you'll see that it's all very reasonably structured for you but if you're ever not happy at all, we always take care of you. Brilliant and you are a great resource if you're listening I do highly encourage you to go check out the doctor.com. Check out Dr Tom stuff he is just a, just a pillar in our community Dr Tom and it is such a treat to have you here today. Thank you, my friend for coming on. Thank you Joe Dr Joe it's a pleasure to be with you always and like I said you know we dance in the ethers together so easily. It's really fun. Thank you. It is fun.