Just released April, 2015, Natural Cures for Dummies is a superb survey of all things Natural Medicine. In this podcast, Dr. Banks and I cover a ton of content: The book, appropriate diets, including the elimination diet and the perils of gluten, we cover his approach to detox, appropriate supplements, genomics and systems medicine, Functional Medicine and so much more. Dr. Banks is a long time functional medicine chiropractor. He’s an IFM certified practitioner (and has been to more IFM Annual conferences than almost anyone I know). Scott is funny, warm and brilliant. A treasure to our FxMed community. This is a great podcast for clinicians transitioning into FxMed and everyone else interested in hearing an expert functional medicine doctor talk about what he does best: care for patients.
Pearls from Dr. Scott J. Banks, DC, IFMCP
Find Dr. Bank’s new book Natural Cures for Dummies at Amazon.
Dr. Kara Fitzgerald: Hi, everybody! It’s great to be with you again. I’m Dr. Kara Fitzgerald. And with me today, I have Dr. Scott Banks. Dr. Banks has been in the functional medicine community for years and I count him among my functional medicine, actually, inspirations and friends.
So, Dr. Banks graduated from Fairleigh Dickinson. He’s a doctor of chiropractic and he received his degree from New York Chiropractic College. He’s also a clinical nutritionist. He’s a professor actually teaching anatomy and physiology at Nassau Community College and he’s been in private clinical practice for over 30 years. He’s an IFM-certified practitioner. Congratulations on moving through that rather large exam, Dr. Banks!
Dr. Scott Banks: Thank you! Thank you!
Dr. Kara: So, he really takes his systems approach to treating complex chronic disease. We’re going to talk about that and we’ll talk about what he’s seeing in practice and so forth. He was also voted one of America’s healers by the Naval Expo in 2009. He’s been on Dr. Phil.
He’s lectured naturally for years. In fact, he does webinars for the Institute for Functional Medicine as well. And finally, just in this year, April, he published Natural Cures for Dummies.
I have a copy of the book on my desk and I’ve been reading it now for the last week or so. I just want to tell you, Scott, it’s really an amazing accomplishment, this book. I look forward to talking about it today.
You’ve really put together an extremely user-friendly, easy to understand, yet comprehensive manual on all things functional, integrative. You touched on a variety of healing methodologies which I appreciate. So, you get into Ayurveda, you get into botanical medicine, osteopathy, chiropractic, functional medicine, of course. And it’s written for the lay person, so it’s understandable. There are pearls in this book for all of us. So, thank you! Thank you for this, I have enjoyed reading it.
Dr. Scott: I really appreciate that! I know that you have written books yourself for functional medicine and you know what it takes to get something like this done. The Natural Cures for Dummies is a Wiley brand. They have 1500 different titles. Now, there’s 1501. There’s about 10 books that sell a minute in the United States which blew me away. And their website gets about 22 million hits a month. So, this is a great way to get our message of functional medicine and diet and lifestyle to a very large population around the world.
Dr. Kara: Yes, absolutely! I was with Scott at the Austin Institute for Functional Medicine Annual Conference a few weeks ago and he gave me that factoid of – how many books in a minute did you say?
Dr. Scott: Ten books a minute.
Dr. Kara: Yeah, it’s amazing! I came back to my office and I was looking for the various volumes of dummies that I have on my shelf. I know I’ve got biostatistics. I’ve got a number of them. I’ve got a Business Plan for Dummies, but it’s true!
Dr. Scott: You did have quite a bit. I mean, a lot of my book I did through Dragon Dictate and I had no idea how to use it. So, I ordered a book on Dragon Dictate and people like the dummies brand because they know what they are going to get.
Dr. Kara: Yeah.
Dr. Scott: There are more tips in there, you have the website content and it’s an easy to read format. So, I think it’s real good for doctors to use. As an IFM doctor (and I always go to functional medicine conferences), a lot of my colleagues had bought the book and they said they’ve been using it as rapid guide to…
Dr. Kara: Absolutely!
Dr. Scott: …help them with their patients when they have things that maybe they need another set of eyes looking at.
Dr. Kara: There’s no doubt about it! So, it’s patient-friendly, it’s consumer-friendly, but you covered such a breadth of information.
I know that at the core, this is a functional medicine book and I appreciate you pushing the functional medicine model forward. It’s incredibly important. But you cover so many different modalities.
You also cover an enormous variety of conditions. And again, it’s user-friendly stuff people can do at home.
For instance, you have a section in chapter six on mending methicillin resistant staphylococcus aureus and then, you also cover herpes zoster, you cover how to appropriately prepare herbs, you cover the safety behind using herbs and then, you give an overview on chiropractic, massage. So, the breadth and the depth of it, Scott, is pretty amazing.
Dr. Scott: Again, I really appreciate that. When we worked on the table of contents, we tried to encompass so many different modalities in healing. I’m a chiropractor and I’m an Institute of Functional Medicine certified practitioner, but a lot of these other things, I’m kind of a novice at, so I had to do a lot of research around the book to be able to bring that to the publisher.
And their fact-finding was pretty intense. They have gone through the process of editing and make sure that everything was the way it’s supposed to be. Every t was crossed and every i is dotted. It was really a tremendous amount of editing that went into the book to make sure that everything that was in here is true and reference based.
Dr. Kara: Mm-hmm. Yeah, yeah. It is an enormous undertaking having been in that pond.
So listen, let’s jump in to what you do know and talk about detox protocols. You want to give me a little bit of overview on your perception of detoxification or need to do it and maybe some of the protocols that you are using in finding effective in practice?
Dr. Scott: Sure! Just like you, as an Institute of Functional Medicine practitioner (and you teach one of the advance practice modules), people come in through so many different doors into our practice. Where do you start?
So, I’ll have the patient fill out the adult medical questionnaire and the medical systems questionnaire. And when the people score relatively high and their diet is poor for such a long time and you just look at them and they just look toxic, I will decide to put them into a detox program.
Dr. Kara: Wait! Let me ask you. Let me just interrupt you before you jump into the program. What are your flags? I know the adult medical questionnaire you’re using because I have some variation of that in my practice as well. And again it’s really functional medicine centric. But what’s flagging you? What kind of information is flagging you towards detox?
Dr. Scott: I think when it’s so many different things that are going on.
Dr. Kara: Right.
Dr. Scott: Gut issues, fatigue and inability to lose weight, skin issues, gas, bloating, you know name it, just about everything. They have so many different stuff. I don’t want to give them different nutrients for this problem and different nutrients for this problem.
Dr. Kara: Yes.
Dr. Scott: So, the first thing I’ll do is I‘ll put them into a modified elimination diet and pull out all those things that are really bad including gluten and dairy and processed foods and bad fats and sugar. And then, I’ll put them into medical food. We all know that all the top nutritional companies have good detox formulas and you have to pick the ones you want. I have a couple of my favorites.
Dr. Kara: What kind of protein? What kind of protein do you like in your medical foods?
Dr. Scott: A combination of rice and pea protein I think works pretty well for most patients. Some people don’t do well with rice, so you put them into a pea protein. Some people don’t do well with pea, you need to put them into a rice protein, but a hypoallergenic protein, of course. No soy, absolutely that’s off the list.
Dr. Kara: Right.
Dr. Scott: And whey is made from dairy so that can give people a lot of problems also if they have any kind of lactose intolerance or sensitivity or food allergy to dairy. So, then I would use a rice and pea protein as the concentration for the base of the protein.
Dr. Kara: Yup.
Dr. Scott: But then, it’s loaded with accessory nutrients that really fit in the detoxification process, things like N-acetyl cysteine, glutathione, ellagic acid from water grass and pomegranate and different nutrients that are going to support phase 1 and phase 2 detoxification.
Dr. Kara: So, you’ve got them in a modified elimination which, by the way, you cover in Natural Cures and then you start a medical food. Are you giving them anything else or having them do any lifestyle stuff?
Dr. Scott: Well, I’m usually doing a probiotic with that. I have my own private label. There’s a formula that I use called Crisis Care Probiotic that I find to be very effective. It’s in a sachet. It’s a beefy powder, a couple of different really good strains and some saccharomyces boulardii in there as well. I just try to keep it really simple when I start them on a detox. If you do too much too fast, they rebel.
Dr. Kara: Yeah, got it! Yeah.
Dr. Scott: Their body might rebel or it might be just too much for them. And it’s a lot for them just even with the diet to make those changes because food is addicting and sometimes they can’t control themselves.
And so, before I start getting into a lot of testing, I’m just really trying to clean up their diet. I find that to be the most important thing.
Last year symposium was Functional Perspectives on Food: the Ultimate Upstream Medicine. That’s really very, very true. I don’t know if Hippocrates said, “Let food be your medicine, let medicine be your food,” but we know in the functional medicine arena, that there are not a lot of doctors that are in the know that you’re not going to get better no matter how much nutrients you take if you’re still using your ho-hos and dingdongs and things.
Dr. Kara: Yeah, got it! Got it! So, most folks that come in to see you, you’re going to have them do what sounds like a relatively gentle detox protocol?
Dr. Scott: Not everybody. There are some patients that I would start with detox and other patients, I’ll go into gastrointestinal restoration program. I would say, most people, that’s where we’re going to start. I know like you, if you had 50 functional medicine doctors in the room and you presented different cases to them, most of us will start in the gastrointestinal tract.
Dr. Kara: Yup, I agree with you. Do you do any lifestyle stuff with folks? Would you recommend that they exercise or get sweating or dry skin brushing? Do you do any additional things at this early stage to support detox activities or you’re keeping it simple?
Dr. Scott: Well, at least move their body, to exercise lightly, to walk. If they have access to a sauna, I would highly recommend that, infrared sauna, about 15 to 20 minutes three times a week. When I practice in Long island, there is a place right up the street that has a far infrared sauna in it that people could go pay and use it for a short period of time.
Dr. Kara: Oh, that’s convenient!
Dr. Scott: It’s a great service to have.
Dr. Kara: Yeah, very convenient.
Dr. Scott: There is, of course, the skin brushing. But really, the most important thing is to really follow the diet and get them on a good medical food and good detox nutrients that remove solvents and will remove metals and support the gastrointestinal tract at the same time.
Dr. Kara: Got it! On that note, you do have, again, a nice section in the book on cleaning up the home. So, obviously, you’re just talking to them about exposure sources, be it through pesticides on food or some basic changes one can make in the home. You cover it nicely in Natural Cures for Dummies.
Dr. Scott: Thank you! I appreciate that. And there’s a really good test. Actually, Cyrex Labs has array, I believe it’s 11. It tests the chemical sensitivity. It looks at things in the household environment such as formaldehyde, aflatoxin, heavy metals, flame retardants that are sprayed on people’s clothing, on mattresses, on couches to see if that’s a contributory factor as well.
But sometimes, to get the testing right from the get-go, it’s kind of impossible to have all your ducks in a row before you even walk in a program, so we just start on a program.
Dr. Kara: Yeah, I got it! That makes sense. It totally…
Dr. Scott: And then, we could do the testing later on.
Dr. Kara: Yeah.
Dr. Scott: The testing could be expensive, but patients do like doing that. And I do practice in New York state where doing some of the functional testing is restrictive.
Dr. Kara: Yeah, that’s right. I know.
Dr. Scott: My patients have to go to New Jersey which is about an hour and a half from where I practice, but they’ll go to get some of those Cyrex Testing performed legally.
Dr. Kara: Yes, I understand. New York has an interesting board of health, but that’s a whole another conversation.
Dr. Scott: Don’t get me going on that.
Dr. Kara: I won’t!
Dr. Scott: It’s only gotten worse over the last couple of years, it hadn’t gotten better. It’s crazy!
Just a perfect example, we just came back from the conference and it was on genomix. 23andMe, Dr. [inaudible 00:14:12] gave a great talk on 23andMe, so I ordered the kit as soon as I came back. As soon as I put in New York, they said, “Oops, you’re in New York. Now, we’ll send you the kit but you’re going to have to sign an affidavit that the test has to be performed. You have to collect your saliva in another state and ship it from another state, anywhere other than New York.”
Dr. Kara: Yes, I know! I know because I’m Connecticut and shouting distance from the board. So, I have a lot of New York patients. And I worked in the lab for a long time, as you know, and we spend a good deal of time providing scientific rationale for some of the tests that we wanted approved in New York. I mean, we sent them stacks of evidence. But let’s not digress too far down this. It’s frustrating!
Dr. Scott: No, let’s not! I’d just like to say money, stupidity, egos and politics.
Dr. Kara: Yeah, I think that’s true. It was interesting.
So, talk to me about genomics. I know that’s another area you’re segueing in your attempt to get your 23andMe. Talk to me about genomics and what you’re thinking about it, big picture and then – well, of course, this is our topic at the IFM Annual Symposium. So, big picturing it for me, but then, also, how you’re thinking about it with regards to patient care?
Dr. Scott: Well, I’ve been using genomics as much as I have been able to in New York and I find it interesting. Now, we know that the genes load the gun, but the environment pull the trigger.
We know that, but the patients don’t know that. Patients don’t think that their diseases are determinative by their genes. There are some. But for the most part, we’ve learned that your genes don’t necessarily cause the disease. It’s how you treat them. It’s the epigenetics, the things that happen above the genes which is your diet and your lifestyle.
Dr. Kara: Yes. Right!
Dr. Scott: So, I’ve looked at it for patients like, “Well, you have this genetic failure.” I don’t even like to call it a genetic mutation because MTHFR now has got its own national stardom out there and people that have that they think it’s the end of the world. I have to explain to them that it’s not. We’d like to think that homocysteine, of course.
But then, we can nutritionally modulate that genetic expression and that’s what I’m really trying to explain to patients. So, I will take out some of the charts and some of the better slides that I’ve accumulated over decades of doing this and explain these different variants to the patients where it be around glutathione-s transferase or around cytochrome p450 pathways or around methylations.
So, if you’re APOE 4 genotype, we know that’s sort of like 54% of patients that have Alzheimer’s disease have those genes. But just because you have the gene doesn’t necessarily mean that you’re going to get Alzheimer’s disease.
So, in Dr. Pearl Butlers, The Better Brain book, which was in 2004, he has a quote in the beginning of the book and he said, “The time to repair the roof is when the sun is shining” by J. F. Kennedy and I find that to be very appropriate. You want to take care of yourself before you come down with a disease with diet and lifestyle. We now know that there are certain things that should be pulled out of people’s diet like gluten and insecticides and pesticides and other toxic foods.
Dr. Kara: Yeah, amen to that. It was interesting when we were covering some of the common genetic variations, as you say, or single nucleotide polymorphisms at IFM in the immune module, looking at n-acetyltransferases and glutathione-s transferase and COMT and the cytochromes, et cetera, et cetera – and the MTFHR of course. Really, ultimately, as you say, the environment is the big love area of leverage and I would find that my ultimate take home for my lecturing from my slides, but also my patients is it’s really lifestyle management. And we’re doing very similar things.
Now, sometimes, we might see a biomarker like an elevated homocysteine along with MTHFR and we may go towards B12 or folate, methylated folate or some sort of a natural folate. But really, we’re looking at lifestyle. Reducing toxic exposure, as you’ve just said, eating right, moving our body, just fundamental stuff that we’re recommending to all our patients anyway regardless of their collection of genetic single nucleotide polymorphisms. I mean, really, a lot of these SNPs are going to guide us back to this same lifestyle changes.
Dr. Scott: Right.
Dr. Kara: In some cases, we’re going to get in there and be a little bit more specific. But big picturing it, it’s really healthy lifestyle, I think, at the end of the day.
Dr. Scott: Absolutely! I couldn’t agree more! So, it’s just a part of the puzzle, your genetic uniqueness. And then, if you know what genetic variants are, then you can modify your unique expression through the proper lifestyle intervention which is clean living and the right type of nutrients. But you get those right type of nutrients through clean living.
Dr. Kara: Yes, that’s exactly right! And I’ve got a number of patients coming to us far more educated. Really, every year, they’re coming more and more savvy around us. And many folks come to me with a 23andMe already done and they’ve already diagnosed themselves as having significant methylation defects, et cetera.
And just like you, a lot of I’m talking them off the ledge, saying, “That’s a slice of the pie and it may be a very thin slice. I mean, we’ll look at biomarkers to see whether there’s evidence for it being more significant. But really, there’s a rationality around it that I think we need to bring into the dialogue.
Dr. Scott: Right and that was the big takeaway also from the conference, I think. Your genes load the gun, but your environment pulls the trigger. That has to be address to the patients, the science of genetics. The jet landed for well over a decade already.
Dr. Kara: Yes, that’s right! Yup, absolutely! Okay, let’s go back to this pretty cool book of yours.
Dr. Scott: I’d like that!
Dr. Kara: So, you say, “Check it out for whatever ails you.” As I’ve said, it’s content dense. Do you want to give me any more of a snapshot or is there a particular area in here that is near and dear to your heart or eye-openers for you?
Dr. Scott: I love Neurological Support! I’ve was always been a big fan of Dr. Perlmutter. I’ve been listening to him for 20 years and I try to incorporate what I’ve learned from him in the book really around preventing and reversing neurodegenerative disorders using what we do in functional medicine as lifestyle motivation.
But the way that it is, I’ll give certain ailment, I’ll talk about what that ailment is, a traditional medical approach for that and then more of a functional medicine approach and then the top nutrients and herbs that I would use for that particular condition.
So, in the book, there are 170 different conditions in there that I do exactly that. And again, like you said, there are a lot of things in there. But the neurological section, the cardiovascular sections (that I’ve learned so much through IFM and the teachers in Mark Houston) and dealing with cholesterol issues and hypertension, how to do that more from an upstream medicine approach using nutrition as the first form of approach.
Dr. Kara: Right. Absolutely!
Dr. Scott: Then, of course, there’s the section on diabetes and metabolic syndrome and weight management. That’s one of my favorite areas as well. And then, as a chiropractor, musculoskeletal things to deal with instead of just taking pharmaceutical drugs. I use spinal decompression in my practice and that’s been a Godsend for dealing with patients with these problems, people from preventive surgeries.
Dr. Kara: Tell me what it is. Give us an overview on it.
Dr. Scott: Well, there are several high-end decompression tables in the market. I have a table called Intelligent Tracking. The reason why I went with tables is that I can do cervical decompression, lumbar decompression that articulate. So, I could put patients in different postures.
And so a posture that is painful actually becomes therapeutic on the table because I will decompress at that point.
So, the table, we could set it up. You’re sort of in a sitting position and then the table goes back, your head is above the parallel. But I can put you into different ranges of motion. So, I can do left and right rotation, left and right level flexion, flexion and extension and a combination of those. And so, I can hit the disk right at the spot.
Actually, what you do is you create vacuum effect inside the disk and you’re able to pull the disk material back in and also help to rehydrate the disk.
Dr. Kara: I’m going to come over. I really want to try it. It sounds like it feels great!
Dr. Scott: Yes, you’re welcome! You can take a boat. If I look out my window, I can see Connecticut.
Dr. Kara: I’ll take a boat over. It sounds like it feels really good too.
Dr. Scott: It feels really good – most of the time. Patients that come on the table are usually surgical candidates and some people are going to need surgery. But 8 out 10 that get on the table do really well if they do it correctly. You want to get some momentum with the table, you’d start slow. You don’t want to do too much too fast. You want to kind of build up.
But you need to do it often. It’s like working out. If you do it once a week, you’re not going to get great results. But if you do it three times a week, you’ll get much better results.
Dr. Kara: Well, it’s certainly a good option to give a very earnest and dedicated trial to before going for surgery. That’s for sure.
Dr. Scott: Absolutely! And like you, we’re usually the patients’ doctors of last resort. Patients, they come to me, but they’ve been to different doctors already. Often, they’re pretty well-educated. They come in with the notebooks and stuff and 23andMe and different types of testing that they’ve done. But nobody’s able to really fill in the spaces or connect the dots. That’s what I really try do with the patients.
And it takes some time. Most of the time, we’re pretty successful.
Sometimes, we’re not. But for the most part, I think that patients really follow through with the recommendations. They change their diet, they take a couple of the key nutrients from the better manufacturers (because somebody will go to CVS and buy something. That’s not the same even though the label might look the same). So you want to be in charge of that and make sure they’re taking the top quality nutrients and they’ll get great results.
Dr. Kara: Yeah. Very good points, Scott! Thank you.
Listen, I want to go back to the section on neuroconditions from your book. You brought that up as a section that’s very near and dear to you and you brought up APOE 4 and Alzheimer’s and so forth. What are some of your basic recommendations and interventions going to be for somebody at risk for dementia?
Dr. Scott: Right. So, again, the time to fix this one is when the sun is shining.
Dr. Kara: Yup.
Dr. Scott: And I would tell patients (that I’ve learned from Dr. Perlmutter) that Alzheimer’s disease is a preventable disease of which there is no cure. So, we want to control a couple of things.
The first thing is we want to control inflammation, you want to control glycation, you want to control detoxification and how your body really handles sugar. Of course, we need information. So we look at C-reactive protein or ESR or other inflammatory markers and we get patients into an anti-flammatory diet. That’s really one of the most important things.
Dr. Kara: Is your antiflammatory diet – I’m sorry to interrupt. But is it relatively going to be a modified elimination?
Dr. Scott: Yes.
Dr. Kara: Okay. Keep going.
Dr. Scott: The antiflammatory diet is a modified elimination diet because all those foods that we pull out can be inflammatory.
Dr. Kara: Okay, okay. Good.
Dr. Scott: Then it’s food testing that I’ve done with either Genova or Metametrix or Cyrex testing or Alcat that really look at foods that can trigger that inflammatory immune response.
Dr. Kara: Yup. So, clean inflammatory.
Dr. Scott: We know that glycation is a risk factor and Alzheimer’s disease is a type III diabetes. Maybe some people have not heard that. Maybe a lot of doctors have, but some of the lay people have not known that. So, hemoglobin A1C becomes really important.
There is an archive in neurology from 2006. There’s a picture that I use that shows that the higher your hemoglobin A1c, let’s say 5.9 to 9.0, your percentage of annual brain shrinkage is pretty high as compared to somebody that’s 4.8 to 5.2.
Dr. Kara: Wow! Okay. Is that your range then for folks, 4.8 to 5.2?
Dr. Scott: 4.8 to 5.2 is really the ideal level to get somebody’s hemoglobin A1c at. Do I see that often? No.
Dr. Kara: No.
Dr. Scott: Most people are 5.7, 5.8 6.0. 6.2. So, that becomes really the most important thing. So, they’re eating a bagel for breakfast in the morning or they’re having a cereal or a muffin or something like that, they’re staring their day of with dessert.
Just to take them and put them into a medical food that’s high protein, good quality protein that’s got really good fats in it and very low in sugar, of course is the better way to go.
And then, all the great nutrients especially things like coconut oil and then DHA from cod liver oil and phosphatidylserine and the NRS 2 activators, things that increase nuclear regulatory factor 2, that controls inflammation and the intoxication in the brain. It’s very important to have a green tea and resveratrol.
But one of the most important things is caloric restriction. So, how much caloric restriction would somebody really need? What the research really shows is probably about 400 calories a day. It’s very interesting. When you eat wheat, you end up consuming another 400 calories a day.
So, just by pulling patients off of gluten, whether they positive for it or not – that’s a message that I really try to get across to people, that consuming gluten, whether they test positive or negative, is really just not a very good food for them to be consuming.
Dr. Kara: So, in other words, you can have two identical calorically matched diet and they will behave differently in the body.
So, the anti-flammatory modified elimination is going to speak differently to the physiology than will a high-grain, high-sugar diet.
So, they are not ultimately calorically identical.
So, what you’re saying to me, scoot, is that your brand of caloric restriction is again getting people on to a good anti-inflammatory diet rather formally reducing calorie intake. Is that true?
Dr. Scott: Well, what I did want to say (maybe I didn’t come across) is that when you pull gluten out of a diet, you end up consuming about 400 less calories a day.
Dr. Kara: Oh, interesting.
Dr. Scott: When you eat wheat, when you eat gluten, your blood sugar spikes up very high in the glycemic index, your blood sugar spikes up and then it crashes. And then, you consume more food.
Now, food scientists about 25 years ago discovered that. Was there a conspiracy somewhere, “Hey, let’s put wheat in all the food. This way, people will eat more and we’ll make more money!” But I don’t know if that’s necessarily what happened, but if you look at it, wheat flour is in everything. So, when you eat wheat, you end up eating more food.
And we know that one of the best things to turn on NRF2 pathways, the nuclear regulatory factor 2 pathway is preventing Alzheimer’s disease by turning off the genes that control inflammation and turning on the genes that help you detoxify, if the caloric restriction is up there and turning on that NRF2.
Dr. Kara: Yes, big time, actually very much so. And there was a really interesting piece of research that came out not too long ago at Yale, actually, earlier this year, showing that the ketone body beta-hydroxybutyrate is an anti-inflammatory and similarly, turning off the inflammasome. Remarkable! So if you can achieve a little bit of ketosis which would be a – you could certainly use a modest calorie restriction or you could lower carbohydrates, which you’re going to do if you pull out grains, it’s potently anti-inflammatory.
Dr. Scott: Right. The ketogenic diet is the diet that I would really give to patients with any type of neurological disorder whether it be Parkinson’s or MS or early on, dementia. By eating coconut oil regularly actually has that effect because it releases those MCTs, those medium chain triglycerides without fattening.
The human brain is designed utilized fat, but we don’t generally because we’re consuming too much carbohydrate. So, by keeping your carbohydrate level down to a minimum, maybe 25-30 grams a day will put you in trace ketogenic-like diet. It’s like consuming coconut oil on a regular basis.
Dr. Kara: Yeah, yeah. It’s powerful in a variety of mechanisms. Thank you for that. Now, you’ve covered quite a bit one can do toward dementia prevention. Anything else you want to add?
Dr. Scott: Well, we definitely want to control inflammation. Curcumin is a very powerful anti-inflammatory and that would be part of somebody’s diet. I think that that’s very important.
Also, we look at viruses. So, when I do initial bloodwork for patients,
I will always do a viral low panel. And so we’d look at beta-amyloid is known as an AMP or antimicrobial peptide and is actually your body’s innate response to a foreign invader that has entered the brain.
So, it’s important to keep viruses at bay whether you need a pharmaceutical antiviral or homeopathics. [Inaudible 00:33:35] makes great homeopathic remedies that I like to use in my practice. I don’t write prescriptions as a chiropractor. But really, we try to keep the viruses at bay. We use choline rich polypeptide, some colostrum. I find that to be a very powerful immune modulator.
And the same mechanisms that create leaky gut create the leaky blood brain barrier. So, we look at things that release zonulin. So, we know again that wheat releases an enzyme called zonulin, which causes leaky gut. That also causes the leaky blood brain barrier.
And so Cyrex Array 2 would look at that. It would look at zonulin, the enzyme that causes leaky gut; [inaudible 00:34:17], which is the glue that holds those tight junctions in the cells together. And then, we’d look at LPS or lipopolysaccharides from the gram-negative bacterial cell walls, bacteria that translocate into the system of circulation as a sign of leaky gut or leaky blood brain barrier.
Dr. Kara: Yeah. So, listen, just going back to anti-microbial peptide that beta-amyloid, it’s actually the body’s attempt to restore homeostasis. You talk a lot about viruses, but then you shot back over to the gut, speaking about intestinal permeability and leaky blood brain barrier too and you talked about lipopolysaccharides too.
So, obviously, you think disruption to the microbiome is linked to dementia as well.
Dr. Scott: Right, exactly!
Dr. Kara: Go ahead.
Dr. Scott: This whole gut-brain connection has really blasted into the literature in the last couple of years with the work of Dr. Alessio Fasano and Dr. [Inaudible 00:35:21] and other scientists. I know that
Dr. Perlmutter has an Integrative Healthcare Symposium in October in Florida all dealing with the microbiome that I will be at. And I did the Derrick MacFabe, the resource speech years back at IFM around changes in the gut flora, increases in propionic acid and then causing autistic type behavior, which is wild!
But this is where the research is really going now, gut-brain. That’s why as a functional medicine doctor, people come from all different avenues because we can handle so many different things by taking systems biology.
In the regular medical community, everybody is in their own individual silos. The neurologist will deal with brain, the pulmonologist is just going to deal with the bellows, the gastroenterologist is just going to deal with the plumbing. But they’re all connected. So, what goes on in the gut affects the brain and you have to think that way and you have to be able to connect the dots.
So, if a patient is coming in and the biggest issue is – or somebody’s bringing their parents and they’re showing signs of dementia and Alzheimer’s disease, I need to address their whole body. I need to look at their diet and I need to look at their gut, maybe some target nutrients, poor neurological health.
But it would all include removing gluten found in wheat as the most inflammatory and very damaging food out there. Whether it’s organic or it’s stone ground, whether it’s whole wheat, it’s all wheat and it’s all causing destruction in all multiple metabolic pathways in everybody’s body whether you perceive them or not.
Dr. Kara: Yeah. Okay, I got it. Give me some of the top foods that you’re going to recommend an individual consume who’s either presenting with dementia or at risk of developing early stages. What is their plate going to look like?
Dr. Scott: Well, I’m a fan of good fat!
Dr. Kara: Yeah, I hear.
Dr. Scott: So, avocados are great and nuts, organic nuts, good quality fish. Good quality Alaskan sockeye salmon is a great fish. People have to be able to know that. If they go get farm fish, it’s not the same creature.
So, part of my plan, believe it or not, is there’s a buying club on Long Island where we get all our food from this small farm in Lancaster, Pennsylvania that’s hooked up with wild Alaskan fish farmers.
Dr. Kara: Oh, nice!
Dr. Scott: So, great quality food, a lot of colors of the rainbow, a lot of vegetables, botanicals.
Dr. Kara: Any particular stand out veggies?
Dr. Scott: Ah, kales is a super one, just all different colors. Eggplant, zucchini, squash and broccoli sprouts is probably the best vegetable. It’s very high in sulforaphane glucosinolate, SGS, which is beknown to turn on NRF2 pathways. That’s a great food to put on people’s plates, those broccoli sprouts that you can get in Stop & Shop or in a local supermarket. That becomes a great food.
But I get people to go for the colors of the rainbows. We want mushrooms and the purples, tans and the yellows and the greens and the red and the orange and all different colors, but with a real emphasis on purchasing organic. You want to keep them off the chemicals especially – well, we want to keep everybody off the chemicals. Who wakes up in the morning and says, “I want to eat RoundUp.”
Dr. Kara: I know! The data are just horrendous coming out around that.
Dr. Scott: Right! I was just in the market the other day and you have the choice of conventionally grown and organic. Why would you choose?
Dr. Kara: It’s a no-brainer, yup.
Dr. Scott: Just go with the organic.
Dr. Kara: Yup, it’s very straightforward. Listen, I just want to go back to wheat and gluten because you’re presenting it as a toxin, plain and simple and you mentioned specifically enriched wheat flour, so that’s going to have synthetic folic acid in it. So, I just wanted to get your thoughts on folic acid versus natural?
Dr. Scott: This is my feeling, your body has to be able to convert folic acid into folate. If you have the MTHFR genome type, whether it be [inaudible 00:40:13], the 677 or 129AT, you might not do that well.
So, you’re better off with folic acid in better utilizable form as by 5-methyltetrahydrofolate. That’s the more utilizable form. If you have the MTHFR variant, then you will not necessarily do that well. Folic acid can actually probably do more harm than good or it’s not really going to work the way you wanted it to work.
Dr. Kara: Yeah, that’s right.
Dr. Scott: I know there’s a little bit of controversy around that. If you give somebody a lot folic acid then, you’ll drive that pathway.
But keep an eye on homocysteine. All the better nutritional companies will give folate now in the form of 5-methyltetrahydrofolic acid or 5-methyltetrahydrofolate.
And the same thing with methylcobalamin, you’ll see pyridoxine as pyridoxal-5-phosphate.
And then, if you can’t really push that, I like to use SAMe. And then, you can check COMT as well on the 23andMe test, the COMT.
And then, there’s another lab called Genomind, which I have been able to do in New York and I do use around neurological and brain health. Genomind.
Dr. Kara: Yeah, that’s good. Genomind is a good lab.
Dr. Scott: And that’s been a real good product that I’ve been able to use in my practice with great results.
Dr. Kara: I think they’re actually a New York lab if I’m not mistaken. Aren’t they?
Dr. Scott: I think that’s one of the issues. Ith if the lab is set up in New York, they actually have a plant, a facility, then, I think it bypasses a lot of the problems.
Dr. Kara: That’s really interesting.
Dr. Scott: I think. Don’t quote me on that. But as far as the wheat goes…
Dr. Kara: Let me throw this out to you and then fold this to your answer. We didn’t have certainly the same degree of wheat-associated complications 30, 40, 50 years ago.
Dr. Scott: That’s true!
Dr. Kara: I want to get your take on that and say whatever else you want. Go for it!
Dr. Scott: Well, I think what’s happened, when I was a kid (which was a long time ago), wheat was not genetically modified. Wheat was hybridized. And so, they mate plants together. Every time they do that, they create new proteins that are new to nature molecules. And so wheat has been hybridized with about 50,000 plants.
You take the combination of wheat now – according to Dr. Fasano, every human being, when you eat wheat, you release zonulin. Zonulin causes leaky gut. Leaky gut causes the tight junctures to break open.
Now, a lot of people will have that. Your body will treat it like a bacterial infection. You’ll heal it and you won’t even know you had it. One percent of the population will manifest itself as Celiac disease. For every one patient that has celiac disease that manifests itself in the gut, eight of those persons will have symptoms that are extraintestinal.
So, the misconception that Celiac disease is a disorder of the intestines is really is misconception that’s still thought in mainstream medicine these days. In most of the medical community, Celiac disease, you’re going to have inflammatory bowel, you’re going to have diarrhea, you’re going to have bloody stools. But you can have none of that and you could still have Celiac disease.
And then, anywhere between 18 to 40 percent of the population I’ve seen is non-Celiac gluten sensitive. Now, the regular testing for Celiac disease where you look at anti-gliadin antibodies, anti-endomysial antibodies, transglutaminase, deaminated gliadin will only really take out people that have full-blown atrophy or Celiac Disease. It misses a lot of people.
Now, I do that test anyway because I figure while there’s a needle in my patient arm, I might as well see it because if it comes back positive, then it’s really positive.
So, the Cyrex Array 3 looks at 19 different wheat peptides. It’s a much better test. But not everybody is going to do that. Now, some people need to see it in color. So, if they get the test results, they come back, then they know that “Hey, I shouldn’t be eating this” or the foods that cross-react with wheat or mimic wheat in the body, the array 4.
But I still put the patients off of wheat whether the test comes back positive or negative. It’s very high on the glycemic index. It’s very high in sugar, so it’s going to feed pathogenic bacteria in the gut. It’s inflammatory. And gluten is very hard to break down.
And so, I look at the combination of gluten and then the combination of genetically modified foods really changing the microbiome in the gut leading to intestinal permeability and the rise of autoimmune disorders. So, it’s kind of all connected. It’s not just one thing. It could be the perfect storm of gluten and GMOs.
Dr. Kara: Right, or gluten and pesticides, the glyphospates. Yes, absolutely!
Well, let’s say you’ve ruled out Celiac using Celiac serology, but you’re still putting them on a gluten-free diet, are you going to have them at any time challenged with gluten to determine how their body reacts to it or are you wanting them off for life?
Dr. Scott: You know what? If I can keep them off of it for life and they stay off of it for life, then, good for them. But like most people, it will sneak back in periodically because they went to somebody’s birthday and there was a piece of cake or they were out and the only thing to eat was pizza, so they had a pizza. [Inaudible 00:46:01] comes around once a year and the bagels look really good with the cream cheese, somebody will end up eating that. They will be able to notice how they feel as a result of eating that, hopefully.
The symptoms might ont manifest themselves immediately, but most patients, I’d get them to journal their food. Not all of them do it, but some of them do do it and then they should be able to put two and two together. A light should go off in their head going, “Hey, maybe I shouldn’t eat this thing.”
Dr. Kara: I agree with you. Well, in my practice I actually do it very structured. We have them pay attention. We give them a tracking matrix for symptoms. But you’re right. Many, many people do manifest a variety of extraintestinal symptoms.
Dr. Scott: Sure and that could be skin issues, joint, issues, brain fog, headache.
Dr. Kara: Yes, common, common.
Dr. Scott: Absolutely.
Dr. Kara: Listen, talk to me about the kinds of cases you’re seeing in practice. What kind of patients do you get?
Dr. Scott: I have a very varied practice. I see a lot of people with a lot of different things. I call myself a ‘holistic doctor’ because people come in with a ‘whole list of problems’.
Dr. Kara: That’s funny.
Dr. Scott: Now, for people who haven’t heard that before, I always get a laugh. But if they’ve heard it before…
Dr. Kara: They groan.
Dr. Scott: But it’s really true! A lot of gastrointestinal issues, ulcerative colitis, Crohn’s, irritable bowel syndrome and then people with just like gas, bloating, but then a lot of people, fatigue, chronic fatigue and then, autoimmune diseases, especially a lot of autoimmune thyroid, some neurological issues like Parkinson’s, MS, a lot of kids with some behavioral issues, what else, a lot of diabetics, insulin resistance, metabolic syndrome type patients, pretty much that, people that are overweight, fatigue, gas and bloating, hormone type issues as well too, guys with low testosterone or women with low estrogen and progesterone. Pretty much just about anything!
I know they tell you, “Get a niche for yourself!” and I’ve thought about doing that, but come in with a whole host of issues. And a functional medicine trained doctor, we start taking upstream, start taking systems biology, we can handle a lot of different things as long as it’s not an acute are thing that requires medical intervention where they should be in a hospital setting or something like that.
Dr. Kara: Yes, that’s interesting. Yeah, I know. I hear you. I mean, I describe myself as a functional medicine generalist. I get a lot of allergy because I teach on that quite a bit and I enjoy working with folks suffering with allergic disease. But yeah, you’re right, I’m a generalist as well.
Dr. Scott: We’re both super-generalists!
Dr. Kara: Yeah. Well, when we go way upstream, we’ve got amazing leverage points in working with diet, making sure nutrients are adequate, obviously, treating gut, et cetera. The effects are far reaching on the web.
Dr. Scott: Absolutely! And I find that just by changing people’s breakfast and just getting them to do a medical food in the morning for breakfast, you can kind of load up.
I’ll take a shake and we’ll throw some colostrum with it and some greens and some fibers and some probiotics. They might mix five things together, but they just made themselves a super cocktail that was a world different from the breakfast that they were eating, not consuming at all or that was all carbohydrates. We remove gluten out of the diet and give them a couple of key nutrients, you see great things happen.
Yesterday, I had a guy came in. He’s been doing some work with me for a long time. He was a decompression client that also became a nutritional client and still, the decompression. We did our body composition analysis yesterday. He lost of seven pounds of fat and he put on five pounds of muscle. That’s a dramatic change.
Dr. Kara: That’s impressive, very.
Dr. Scott: The weight didn’t change much, but the body composition. You look at him, you could just see that he’s just glowing.
And this is what I see with patients that come in that are following the recommendations, they’re glowing. They just look a lot healthier.
It’s a combination of things. Some people might say, “Well, you gave me so much stuff. How do you know what’s working?” What’s the bottom line? The patient is doing better. It’s Cindy Baker’s the four-tack rule. You got to hit it from multiple angles. You got to remove all the tacks, not just one tack.
Dr. Kara: Right, right, from the painful chair. Listen, you’ve mentioned weight loss a number of times and how you enjoy working with folks who need to lose weight. What are you thinking about with regards to weight loss resistance? What’s the approach that you’re going to take? Give me some pearls for that.
Dr. Scott: Well, that traces back to toxicity that we started the podcast off. Patients are often doing that. They are loaded with toxins and they are insulin resistant, their diet is poor. So again, we really want to change the diet up. A couple of key nutrients would really work the best, get them to start moving their bodies and exercise.
I’ve been pretty successful getting people lose the weight if they’re going to do the work. They’ve got to do the work. That means they have to journal and they have to keep a list of foods and what they’re every single day.
Some people start off with that and then they stop doing it. We all know that patients that journal do much better. They might be thinking they’re eating well, but they’re really not eating that well.
Dr. Kara: So, you have people track their food daily?
Dr. Scott: Yes, they write it down. And through the IFM tool chest, the tool kit, they have that beautiful page now. They just came out with a new toolkit that gets them to eat what they want for breakfast, lunch, dinner and see if they’re getting all the different colors of the rainbow in.
Dr. Kara: Yes.
Dr. Scott: And then, their exercise, their hydration, their stress levels and their sleep, all those things play a role. It might not be necessarily just be calories, you’ve got to look at people’s stress levels and if they’re sleeping enough. If they’re not sleeping, then your cortisol’s awake. If your cortisol’s awake, you block insulin and you’re not using sugar really for fuel and you get fatter.
Dr. Kara: That’s right. That’s right. What about your macronutrients ratio? I know you love fat, so people are going on more fats. Are you increasing protein, lowering carbs or changing the carb quality to veggies and certain fruits? What are you doing?
Dr. Scott: That’s such a great question! What I have playing in my reception room right now is last year, the Functional Medicine Conference, Loren Cordain (who wrote all the Paleo book) and then Mimi Guarneri (who wrote about the Mediterranean diet) and then, Jill Fuhrman (about the plant-based diet) and then Chris Gardner, who’s a Stanford epidemiologist where they’re having a panel discussion.
Dr. Kara: I know! I remember it well.
Dr. Scott: And it was great! I play it on my reception room. I put them on the flash drive and then just put them on the computer. The patients will sit here and they’ll watch these things. The bottom line is here you’ve got Loren Cordain talking about the Paleo, you’re eating good meat and you’re loaded with vegetables, you’re pulling out the legumes, there are no grains. And then, Jill Fuhrman on the other side is like there’s no meat, it’s all plant-based, there are grains included. So, what’s the bottom line? What should we eat?
The bottom line is as human beings, we’ve adapted to many different types of diet, just not the Western diet. You want to get patients off the Western diet as Michael Pollan said in his book In Defense of Food. As long as the quality of food id really good…
Dr. Kara: You have some flexibility there. What about lectins? What’s your position? Do you think it’s appropriate for some people?
Dr. Scott: I think for patients that have a lot of gastrointestinal issues, we want to put them into a FODMAP and we seek and entertain the FODMAP, then we can pull those out for a period of time.
Dr. Kara: Yeah, I got it!
Dr. Scott: Definitely, soy is out. Soy is like a food that we don’t have patients consume unless they are really good and they can guarantee that the soy is organic. But 90% of all soy in the Unites States is genetically modified soy, which is a different creature. So, we really want to stay away from genetically modified foods.
Dr. Kara: So, I want to ask you just one more question here.
Dr. Scott: Only one more?
Dr. Kara: Well, it may segue, you never know. That’s basically how conversation has gone today. It’s been very enjoyable. You’ve given a lot of pearls, I appreciate that! I’ve taken quite a bit.
Anyway, I know you’re private labeling some products and you’re actually doing a nice job with it. You’ve mentioned some compounds you’re using like the [inaudible 00:55:30] polypeptides and colostrum and so forth. I just want to hear about going private label and how you like it.
Dr. Scott: I’m sorry that I didn’t do it sooner. I always said, “Why would I go private label when patients are really looking for these top quality nutrients?” But the bottom line is that your patients are coming to you, they believe in you, they trust you. They like that you have your own private label. It’s been a really great, great thing that I did.
Now, I probably have about 25 products at my own private label. And with another, probably another 20 things that I really would like to add as well too. I think it’s a really great, great move if you’re a healthcare provider to create your brand.
And we all know these days of the internet, your patients come in one time or two times, but maybe then you don’t have something in stock and they’ll go Amazon or they’ll go look online. It’s very tough for the nutritional companies to police everything on the internet.
So, if you’re providing all these information to your patients, you would appreciate if they do purchase their nutrients from you. I mean, this is how you are making a living and it is your business.
So, I think it serves a very good purpose. It’s unique formulas that you’d like to use in your private label. It keeps your customers loyalty.
We did create a loyalty programs. The patients, we use a program called Shop Keep and the patients are able to download an app to the phone called AppCard and they can keep a log of their reward points so that they stay true to you.
Dr. Kara: Jeez! That’s pretty neat! So, with this podcast, we’ll put your website up there obviously. We’ll give people info on obtaining – well, it’s easy. It’s at Amazon, Natural Cures for Dummies. In fact, it’s one of the best sellers I think in the naturopathy category. You said it’s number one.
Dr. Scott: It’s unbelievable! When I saw bestseller on there, I fell out of my chair!
Dr. Kara: That’s really cool, Scott! I’m so happy for you. But some of this information regarding the app and maybe even checking your private label stuff out, is that on your website?
Dr. Scott: The private label products are on the websites. We just actually just switched over our website to another company from Yahoo, so we have a lot more flexibility. We did add all the private label products there with a nice description for each one.
Dr. Kara: Oh, good!
Dr. Scott: It’s nice to see patients from all around the country that I’m dealing with ordering my private label product.
Dr. Kara: Okay, that information will be available when we release this podcast. Again, Dr. Banks, a pleasure to talk to you! It was very fun to spend time with you out in Austin. His book is Natural Cures for Dummies published by Wiley just out this year.
I think that most clinicians will absolutely love it. It’s a treasure. You cover so many things. Plus, we can also comfortably recommend it to our patients. There’s a very hardline functional approach to this book and it will resonate with you. So, thanks, again, doctor for joining us!
Dr. Scott: Dr. Fitzgerald, thank you again for having me on your podcast. I really appreciate it!
Dr. Kara: You’re welcome!
Dr. Scott J. Banks, DC, IFMCP, ()holds a Bachelor of Science Degree from Farleigh Dickinson University, a Doctor of Chiropractic from New York Chiropractic College and is a Clinical Nutritionist. As an Adjunct Professor at Nassau Community College, in Garden City, New York he teaches Anatomy and Physiology. He has been in clinical practice for more than 30 years with offices on Long Island, New York.
In 2013, Dr. Banks joined an elite group of Institute for Functional Medicine Certified Practitioners. He is uniquely trained in the functional medicine model to identify and treat the root causes of illness, disease and chronic disorders.He addresses the underlying origins of disease, using a systems-oriented approach and engages with his patients in a therapeutic partnership. By shifting the traditional disease-centered focus of medical practice to a more patient-centered methodology, Dr. Banks concentrates on the whole person, not just an isolated set of symptoms. As a Functional Medicine practitioner, he spends time with his patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease.
Always striving to further his medicinal knowledge and offer additional health-oriented solutions for his patients, Dr. Banks is also a Certified Gluten Practitioner. He has the expertise to identify and treat gluten-related disorders, such as non-celiac gluten sensitivity (NCGS) and celiac disease.
Recognized among thousands of wellness practitioners, Dr. Banks was awarded the distinguished honor of America’s Greatest Healer by the Navel Expo 2009. He has appeared on Dr. Phil as a clinical nutrition expert and is an ‘in-demand’ speaker lecturing nationally to students, doctors and the public on the ‘natural’ approach to health and wellbeing. And finally, Dr. Banks was nominated Best of Long Island in the Alternative Medicine category.
Dr. Banks’ first book, Natural Cures for Dummies (Wiley), released in April 2015 and hit #1on the Amazon Bestseller list in the Naturopathy Medicine category. He also created his own private label of Functional Medicine Solutions in April 2015. He can be reached at Spine Life