Within the realm of functional medicine, we are quite successful at restoring some order to this cacophonous symphony of chronic illness, and getting our patients better to a large extent. However, there is a final piece – a missing piece, if you will – and my guest today, Ashok Gupta, shares how neuroplasticity affected his own healing journey of chronic fatigue syndrome and why this final piece is integral to restoring optimal health. Ashok is a speaker, filmmaker, and health practitioner who created a program for retraining the brain using interventions to facilitate neuroplasticity. In this episode of New Frontiers, we discuss neuroplasticity dysfunction, how to rewire the brain’s survival response, and so much more. Folks, this conversation goes well beyond the patient-physician encounter and explores the depths of our homes, our communities, and how we experience the world around us. Stay tuned, leave us a comment, and subscribe to stay up to date on our latest content! ~DrKF
The Role of Neuroplasticity in Chronic Illness & Healing with Ashok Gupta, Clinical Director of the Gupta Program
An overly fired-up brain can undermine the best healing efforts. It turns out, our neurology, and how “primed” our brain is to reach for its fight-or-flight response, can over time drive widespread dysfunction in our immune system, stoking the fires of inflammation, and lead to symptoms such as chronic fatigue, chronic pain syndromes, autoimmunity, mast cell activation, POTS, IBS, SIBO, lasting effects from chronic infections (such as Lyme disease and Covid-19), and more. How do we help patients recognize and address the neuroplasticity dysfunction driving many chronic diseases? In this episode of New Frontiers, our guest Ashok Gupta, a speaker, filmmaker, and health practitioner who has dedicated his life to supporting people through chronic illness, shares why and how to retrain the brain’s survival response through neuroplasticity. Join us to dive into this fascinating conversation about using interventions to promote neuroplasticity to treat all kinds of chronic illness.
In this episode of New Frontiers, learn about:
- The connection between chronic health conditions and the brain
- Neuroplasticity dysfunction
- Retraining the brain’s survival response
- How to downregulate the sympathetic nervous system
- The three Rs of the Gupta Program
- Recognizing unconscious signals
- Treatment for chronic fatigue syndrome, fibromyalgia, chronic pain, Lyme, mast cell activation, postural orthostatic tachycardia syndrome (POTS), and long-haul-COVID
- Neuroimmune conditioned syndromes
Dr. Fitzgerald: Hi, everybody. Welcome to New Frontiers in Functional Medicine, where we are interviewing the best minds in functional medicine. And of course, today is no exception. I am here with Ashok Gupta, and we are going to talk about his limbic retraining program. I know more and more of us working in the functional medicine/integrative medicine space are moving towards using these tools with our complex patients that we, despite our best efforts, don’t seem to be able to budge. So I’m really excited to drill down into what Ashok has discovered in his work.
Background on him. He is a speaker, filmmaker, he’s a health practitioner who’s dedicated his life to supporting people through chronic illness and to achieve their potential. He suffered himself from chronic fatigue syndrome 25 years ago when he was studying at Cambridge, and then through really his own research he studied, he published an interesting hypothesis we’ll talk about, he got better and set up a clinic using his method.
He’s published on this method. I know that there was a 2020 trial that we’ll chat about using his method in fibromyalgia, and he continues to research. He’ll talk to us about that. He, in 2017, he published an app called The Meaning of Life Experiment, a 30 day program of videos and meditations to discover more happiness, meaning, and to uncover your purpose in life. It actually, Ashok, that sounds like a great app, a useful app, particularly right now. Welcome to New Frontiers.
Ashok Gupta: Thank you for inviting me. Great to be here.
Dr. Fitzgerald: So listen, I want to hear your story. Your story is incredibly interesting. So you were studying in Cambridge 25 years ago. What were you studying there?
Ashok Gupta: So I was actually studying economics, believe it or not. So, and that’s seen as a discipline which is very different to, I suppose, medicine or psychology. But in fact, I learned a lot from my methods and understanding of economics in terms of how cycles work, and how they might work between the brain and the body as well. So yeah, that was my undergrad degree.
Dr. Fitzgerald: Oh, isn’t that fascinating? And during that journey, actually, I can see the connection with economic. I mean, economics, especially as we move towards these systems models of medicine. So, I mean, I could see your skillset being useful in what you’re doing, and putting together this program. But you were in school, you were an undergrad, and you got sick?
Ashok Gupta: That’s right. So like many of us who’ve got involved in this particular profession or this particular area, we’ve often done it from our own experiences. And so I went to India. I was somebody who was burning the candle at both ends at university, so I was partying hard, I was studying hard. I was pretty stressed out. I knew that I wasn’t taking care of myself, or retrospectively at least. And I went to India and caught some kind of stomach bug.
And then I came back to university for my third year, but I got worse and worse and worse. I had symptoms of extreme fatigue and exhaustion. I couldn’t exercise. The slightest type of activity would put me in bed for a couple of days, and the post exertional malaise, and the sore throats, and a whole host of different symptoms. Lots of gastro symptoms as well. And essentially, I was housebound often, not really feeling like doing anything. I tried so many different things and went to see so many specialists, but no one really helped me at the time.
Dr. Fitzgerald: Well, can you tell me… God, I know. I know that story. I really know that story myself, it’s incredibly fascinating. It’s really the story that brought me here as well. But what were some of the diagnoses that you encountered or were you just referred to… not just, but referred to psychiatry? I mean, just I’m curious what you might’ve gone through before you ended up piecing together what you needed to do.
Ashok Gupta: Yeah. So I was formally diagnosed with chronic fatigue syndrome, I mean, eventually, but that was after going through the system of saying, “Oh, right, you’ve got depression, so you need to take these antidepressants.” And I took those and they made me feel worse. Obviously I looked at diet, made some dietary changes, which did improve things a little, but I didn’t really get to the root of it. So I went through the system, the mainstream medical system, and eventually did get a formal diagnosis. And at that point it was pretty much, “Well, we don’t know what causes it. We don’t know how people get better, or if anyone gets better. So you may have this for the rest of your life.”
Dr. Fitzgerald: And how did they diagnose you? Did they actually use any laboratory or did they just, was it a clinical diagnosis?
Ashok Gupta: It was a diagnosis of exclusion. So obviously they did all the tests, and found that all the tests were pretty normal. And at that time, there weren’t specific tests for this kind of thing in terms of-
Dr. Fitzgerald: Right.
Ashok Gupta: Markers or anything like that. So yeah, that was really their default diagnosis for me.
Dr. Fitzgerald: Okay. So there you are, you’ve been diagnosed officially. You still feel terrible, I’m assuming, you’re still forcing yourself through school. What then?
Ashok Gupta: Well, then I actually had to take a year out because it was pretty severe and I went back the following year. But as you say, it was a struggle to really study and try and get through whilst also on the side, trying to just understand my condition. And that’s where I was introduced to some work by Professor Joseph LeDoux on the brain neurology of emotion, and the brain neurology specifically of pain syndromes and fatigue syndromes.
So I studied medical papers, I studied various books, a lot of stuff in the literature, and especially brain neurology, and came up with a hypothesis in 1999, which got published, as you know, in Medical Hypotheses in 2002. And this hypothesis was based on my own internal experiences of the condition, as well as, I suppose, extending or expanding on some of the brain neurology systems around PTSD and around emotion, but applying it to physical conditions, essentially. And I was able to, once I’d done that, and done that research, I was able to rapidly, anecdotally and ad hoc, reprogram my brain, retrain my brain, and get myself back to full health. And I’ve been fully healthy since then.
Dr. Fitzgerald: And so talk about what you found, what your hypothesis was, and what you started to do in your first, N of one experiment.
Ashok Gupta: Sure. So if I can just give a background to what this hypothesis actually is.
Dr. Fitzgerald: Yes.
Ashok Gupta: So I start with the biggest question of all. Why are we here? And I love that question, because it can be answered in so many ways. So we won’t answer it in a philosophical way, but let’s answer it in a scientific way. We’re here because over millions of years of evolution, this nervous system and this immune system that we’ve inherited has developed itself and adapted to its environment to ensure survival. So we are survival machines because of all the previous animals and plants, and everything that they’ve been through to adapt to the environment, to get us to where we are right now. So the priority of our brains and our bodies is to ensure survival, to pass on genes to the next generation. So from the purest kind of scientific perspective, we can answer that question of why are we here.
And that then helps us understand what may cause any chronic fatigue syndrome and then fibromyalgia, even long haul COVID and the whole range of these types of chronic conditions. So I believe that what happens is when we… Let’s take the example of flu. When we have flu, it is actually life-threatening. And obviously because of the experiences of long-haul COVID oh, sorry, of COVID-19, more people are aware that actually many people do die every year from things like flu, things like COVID-19. And if we are in a stressed state or a weakened state, then our immune system is weakened. And we know that from obviously psychoneuroimmunology, and therefore it can take us longer to fight off a virus, like COVID-19, like the flu. And in that process, in that system, I believe that a malfunction occurs in the brain, right?
Now, it’s a malfunction from our perspective, but from our brain’s perspective, it’s the right thing to do. And what I believe happens is the brain says, “We are only just managing to overcome this virus. What happens if this virus surges again within us, overtakes us, and threatens survival? This is the ultimate danger.” Therefore, the logical thing to do is to overstimulate immune responses and nervous system responses, in order to protect the body and ensure survival. Because the body cares more about your survival than your wellbeing and your happiness. Survival is the number one priority. And we know that this is happening in COVID-19. So unfortunately, the people who’ve passed away from COVID-19, the majority have been through things like cytokine storms, where our own body’s immune system has over inflamed the lungs, and then threatens survival. So we know that the body can get into this state of wanting to over respond.
And once that happens, I believe that because the brain is in this heightened state of trigger-happy responses, it starts learning new defensive responses to otherwise neutral stimuli. Now, what I mean by that is, the very symptoms in the body, such as fatigue, exhaustion, the sore throats, those become conditioned triggers as evidence that we are still in danger, as evidence that the body is still under attack from that virus, or that bacterial infection. So the brain takes in incoming stimuli from the body. The symptoms. Interprets those as dangerous and representative of us still being in an infected state, then triggers the nervous system and immune system. So all those inflammatory markers go up, it’s the cytokines, the tightness in the muscles. The body is going into this hyper-defense state, which then causes inflammation throughout the body and the brain and the gut, and all the downstream symptoms from that perspective.
So there can be gastric symptoms that occur as a result of that. There can be effects on the mitochondria, people talking about the cell danger response. All of those downstream effects, more allergies and sensitivities, as well as mental effects like cognitive difficulties, memory problems, sleep issues, autonomic dysfunction. And those downstream symptoms then loop back to a hypersensitive, hypervigilant brain, which magnifies those signals, interprets them as dangerous, and re-triggers that chronic sympathetic arousal and the immune dysfunction, the oxidative stress, all of these different mediums. Once again, causing the downstream symptoms, there may also be mast cell activation as well.
So the body and the brain get caught in a vicious cycle, like a very powerful game of tennis, where the brain says, “I’m in danger. I must trigger defensive responses.” And the body says, “I’m experiencing all of these symptoms. What is going on? This is dangerous.” And then throws the ball back to the brain to say, “Do something about this.” The brain says, “Well, this is evidence we’re still in danger,” and then creates ongoing chronic symptoms that then can last for months, if not years.
Dr. Fitzgerald: And it’s really a side conversation from the original insult, which I think in some cases, not all, but certainly some cases, was probably relatively mild.
Ashok Gupta: I agree. The original insult, the original thing that triggered off this vicious cycle, may have completely disappeared by now, right? But it’s left a legacy in the brain, which is this hyper defensive response.
Dr. Fitzgerald: Right, right.
Ashok Gupta: And as I discovered this cycle, it’s not that these conditions are psychological. I want to be very, very clear about this. They’re happening in the unconscious brain. And these conditioning effects can occur without any conscious awareness at all. Now, but once they happen, there is usually no way of accessing this unconscious response, because it’s a survival response, a protective response. The same as if you’re putting your hand on a hot plate and your hand immediately moves off, it’s a survival instinct, as it were. But what we’ve been able to do, or at the time that I was understanding this in my own brain, on the periphery of consciousness, it was the ability to recognize some of those unconscious danger signals that normally wouldn’t be processed, or we wouldn’t do anything with. To recognize those subtle signals of danger and to be able to retrain them using neuroplasticity techniques.
Dr. Fitzgerald: Can you give me an example? Like how did you do that? Like what would be an example of the danger that you might be able to just tune into? Yeah, go ahead.
Ashok Gupta: Well, as an example, because the brain is in this heightened state, it will prioritize emotions and thinking patterns which represent danger. So many people with these conditions will also have an overlap of anxiety or certainly a background worry or concern. So it’s recognizing that type of signaling. Or another type of signaling is the brain will become hypervigilant to the symptoms. So you’ll be trying to think about something else or distract your mind, but your brain will keep going back to, “Well, how am I feeling now?” There’ll be a constant monitoring of the body because we are in danger.
So that would be another example of signaling. We may recognize a feeling of dread, a feeling of, what happens if I have this forever? So the ultimate fear of the unconscious brain, especially the amygdala and the insula, which I’m sure we’ll talk about, the ultimate fear is that we will remain in this experience forever. And there’s no way out of it, essentially. That’s the ultimate fear that we all face in many different aspects of our lives.
Dr. Fitzgerald: Right. So you began to pull the thread around these almost unconscious thoughts, bring them up to consciousness?
Ashok Gupta: Become more aware of them at a conscious level and practice that process, yes. And once again, what we’re saying is that these aren’t psychological processes per se. And it’s not that these are thoughts per se, but they’re unconscious signals that then we begin to become more aware of and form patterns that we can then retrain. And an example of this would be phantom limb pain, which I’m sure you’ve come across, where war veterans have come back from war zones and they’ve had their legs amputated or an arm amputated, but their brain is still receiving signals as if that part of the body still exists.
And they use very interesting and novel, what we would call brain retraining or neuro-plasticity techniques, to repeatedly train the brain that look, there is no limb there, there is no longer a need to magnify signaling from that part of the body, because it no longer exists. Now I wouldn’t call that a psychological process. I would call that a brain rewiring process or a neuroplasticity process.
Dr. Fitzgerald: Sure.
Ashok Gupta: And so it is in the same way here that we’re training the brain out of these unconscious defense responses that it’s got stuck into.
Dr. Fitzgerald: Right, right. It’s extraordinary. So just going back to you, you’re completely stressed out. So when you were in school, you’re existing in this fight or flight place, just as a response to the stressors of pushing yourself in school and partying, et cetera. And so it’s like you’re vulnerable to this neuroplasticity dysfunction. And then you go to India, you get what should be, a relatively acute, brief illness, it sounds like. And instead it just throws you into this loop tape of difficulty, really for years. Would you say that’s correct.
Ashok Gupta: Yes. That’s exactly a good reading of it. It’s when we are in weakened states, we are more prone, or the brain is more prone, to learning new conditioning events. And an example of this is we know that what primes people for these conditions are actually potentially when they’ve had more adverse childhood experiences.
Dr. Fitzgerald: Right.
Ashok Gupta: And as a result of that, we know that the amygdala, which is our fear center, is more primed to defensive responses. Now the amygdala always used to be associated with psychological responses. But in the last 20 years or so, we’ve started linking the amygdala to pain responses, to immune responses. So what’s really interesting is in traditional medicine, we split these areas of medicine into different departments, but as far as the brain is concerned, it doesn’t care whether you have a biological threat or an emotional threat, it’s the same brain structures creating defensive responses.
Dr. Fitzgerald: And I just want to say, you’re talking about one being in a weakened state, but paradoxically, simultaneously there’s incredible hypervigilance occurring. So it’s both of those together, it seems, that this sympathetic dominant hypervigilant/perhaps immunologically, really, and neurologically weakened, it’s into this seeming paradox that allows the full disruption to occur in this. Would you agree with that?
Ashok Gupta: I would. And what’s really interesting is that we may think of the immune system as being on or off, but actually the more that the immune system is on unnecessarily, the weaker we become, and the less likely we are to be able to deal with real threats.
Dr. Fitzgerald: Right. That’s right. That’s right.
Ashok Gupta: And the example that I give, the analogy people love is, I don’t know if you’re a fan of Game of Thrones.
Dr. Fitzgerald: I’m actually, I mean, I’m sure I would be, but I have to honestly admit I haven’t seen even a single episode. But yeah, go ahead. Everybody else has.
Ashok Gupta: I’m sure many people have. So essentially you’ve got the idea of kingdoms and a castle, let’s say, so imagine you are the king or the queen of the castle, and you have to defend the castle to make sure everyone’s safe. And all the population is safe within the castle and you have an army and a navy. So the army is the nervous system. And the navy is the immune system.
Now, when there is a threat coming over the hill, and let’s say the whole kingdom is weakened because there’s been a famine or a drought or something that’s weakened the army, the navy, the castle. Suddenly there’s an army invading. Now the army and the navy have to really be on high alert and fight off the invading army. So they go off and do that. But now they’re exhausted. And they’re so traumatized by the experience of nearly being overwhelmed, that the army and navy decided to be on high alert every moment of every day, using up all the resources of the castle and the kingdom.
So then what happens is just a little girl or a little boy walking over that hill suddenly gets the army ready to respond and they start throwing arrows and using up once again, all the resources of the kingdom. But they’re missing the army that’s coming over from another angle. So then some people are sent over to the other hill to go and defend against the other army that’s coming in. But you can see by being over responsive, the immune system, it becomes less effective. And then opportunistic viruses and infections start flourishing within the body, causing a secondary amount of symptoms.
Dr. Fitzgerald: Yeah. It’s extraordinary, it’s just wildly complex. And it’s so interesting, like it just makes me think about… and then I want to talk, I want to get into a drill down on your program… but I mean, of course into this environment, we’ve got the immune system is turned up, which is a massive protein wasting process. So in order to generate, in order for these army and navy guys to exist, right, they’re going to break down muscle to have some nutrients. So they’re destroying the body to fight the little girl who’s coming over the hill, this sort of benign quote invader. And so their nutrients and their amino acids are being spent, and any drop of glucocorticoids, endogenous glucocorticoids are going to be released, but only for a period.
So they’re going to attempt to inhibit this over aggressive immune system, but it’s only going to be effective in the short term. And then of course, it’s going to be involved in breaking down tissue, and then there’s going to be some level of fatigue or inability for glucocorticoid response to be effective. And then we of course concurrently into this, see the gut damage and microbiome damage, and intestinal permeability. And are they eating? What are they eating? Are they eating cleanly? Or is there some background toxin exposure, or are they living in a healthy environment, et cetera, et cetera. So just almost an exquisite cascade of multifactorial confounders, I think, can come into this to further create really a cacophonous symphony of imbalance. Would you say that’s true?
Ashok Gupta: I couldn’t have put it more poetically myself. Yes, absolutely. This is what you just… What you’ve described there is… Yeah, sorry. Go ahead.
Dr. Fitzgerald: Well I just want to say one other piece. So because I practice functional medicine, as do a lot of us listening, and we are good at doing rebuilding. So we can analyze the micronutrients. We can repair a gut exquisitely effectively. We can do a lot. We know that the immune system is going to be inducing a sarcopenic type of response, and dysglycemia and insulin resistance, et cetera. So we know that, we’re actually really good at turning those things around. So really, restoring some order to this cacophonous symphony, and getting our people better to an extent. Really, to a profound extent, considering they often don’t get better in the greater medical model.
However, what you’re doing and your own experience, what you walked yourself through, and then figured out, is something that I’m going to admit, I certainly have struggled with this final piece. And I think that that’s why a lot of clinicians have come to using your tools, and actually why I wanted to talk to you. I was referred to you by a group who interviewed you out in Australia. So would you say that that’s true? And then I want to just know everything about your program, as I’m sure everybody listening does. But go ahead. Respond to that.
Ashok Gupta: So, yeah, we’re getting a lot of functional medicine, doctors, integrative doctors who are prescribing our program now because they’re seeing the profound effects, and it also supports their model as well. So if you have the two things going on in parallel, because we’re not dogmatic, we say find as many things that support your healing. So it can be a great parallel and support the recovery and accelerated recovery of patients. So I will say that definitely when we are treating patients with supplements and the nutrients, the enzymes, balancing the biome, these are all powerful things to do. And what they’re doing is they sometimes actually cause some brain retraining to occur. Because as the body gets better from treating the downstream symptoms, the brain gets the message that actually what we thought was a chronic condition and therefore we are in supreme danger, is beginning to ease. Therefore, perhaps we’re not in the danger situation that we thought we were. Do you see?
So actually treating the symptoms can create an unconscious state of brain retraining as well. And what we’re doing is we’re saying we’re standing on the bridge and we’re seeing people drowning in the river. So we jump in and we pull them out of the river and we think, great. We pulled them out of the river, but then there’s more people in the river. So we jump in the river again. But no one’s asking the question, who’s throwing them in the river upstream in the first place. Why are these people’s, or these patients’ bodies, going into these altered states in the first place? Why is the system getting disrupted? And so I think that’s the fascinating piece, is rather than look at the localized level, the localized inflammation, or what’s going on in the gut, let’s go to the centerpiece, the brain, where the action I believe is really happening.
Where, why is the brain going into this altered state? Actually, there’s a perfectly rational, evolutionary reason why the brain is doing this. And I think, just to take a step back, why are more of these conditions occurring now in the modern population? Because over the last couple of hundred years, we’re not living according to our evolutionary inheritance. So we’re surrounded by toxins. We’re eating toxins, we’re in polluted environments, and we’re leading more stressful lives.
So therefore, that background inflammation is always occurring. And so when we have that background inflammation, background stimulation of mast cells, it means our system is primed to have a big response to something new that’s come along. And that’s why I believe that 70 to 80% of the conditions that now present themselves in a doctor’s office are functional conditions where traditional medicine is just going to treat the symptoms, but not really get to the root cause. Because it’s in the electrical system, not the physical hardware, as it were. So these are software problems, not hardware problems.
Dr. Fitzgerald: So walk us through your program and talk to us about some of the… Well, talk to us about some of the research that you’re doing. So what is your program?
Ashok Gupta: Okay. So our program is something we’ve spent 20 years developing. So I first started treating patients in 2001, a long time ago in my clinic, using the techniques that I had used. And obviously that worked for some people, but not all the people. So we refined and refined and refined. And then in 2007, we published an interactive DVD program. So this was the first neuroplasticity brain retraining program, and we were able to reach a lot more patients than we could at our clinic. And then we revamped it in 2019. And essentially it’s now an online program, which people can join. And there’s 15 interactive videos, about 20 audio exercises, and a support group and weekly webinars. So we like to give patients a whole ecosystem of support as they recover. And the program is split into three aspects, the three R’s of the Gupta program as we call them.
The first one, and the core part, is retraining the brain. That is the core unique aspect of the program. The second R is relaxing the nervous system. So we know from a neuroplasticity basis that the calmer the nervous system is, and the brain, the more neuroplastic it can become, or certainly the rewiring becomes easier, than if you’re stuck in a hypervigilant state.
So relaxing the nervous system is a very important part of that, and stimulating the parasympathetic nervous system. And the third R, which is often negated or overlooked in modern medicine is reengaging with joy. The power of actually a positive mindset, of being able to engage the brain in uplifting positive experiences. Think of the work of Patch Adams and whatever, and actually quite a lot of literature on this. That actually laughter, happiness, all of those things can really support neuroplasticity and getting us out of stuck responses.
So we look at that aspect as well, but the core of it is the brain retraining. And what we do is we teach a patient to recognize his unconscious signals. And then there’s a specialized and unique seven step process that they go through each time they recognize that signaling. And through repetition, just like we talked about the phantom limb pain, through repetition and commitment, eventually the brain gets the message that we are no longer in danger. The symptoms in the body do not represent evidence of ongoing infection, or in the case of mold illness and chemical sensitivities, that that mold or chemical does not represent a threat to our survival. So we gradually retrain the brain, and then a person comes back to, often they come back to 70, 80% health, and then guess what happens? They then go and throw themselves back into a busy, stressful lifestyle again, because that’s often one of the reasons they were prone to these conditions in the first place.
So we teach somebody to not just get well, but stay well. So then we look at some of the aspects of their personality, which may be impacting on their health and stopping them from engaging in self-care, being aware of when they’re pushing themselves too hard, then we get them up to 90, 95%. And then that final 5 to 10% is getting back gradually into normal life and doing the things that they were able to do before, but without increasing their stress levels. And then we get people back to health. So that’s the kind of overview of the program. And in terms of our research that you asked me about, so we are very much research focused. So as you’ve mentioned, I published the hypothesis in Medical Hypotheses in 2002, then we published a clinical audit in 2010, that was without a control group.
And that found that in patients with MECFS, after one year, two thirds of patients reached an 80 to 100% recovery, and 92% of patients made some kind of improvement. But there was no control. Then we were very lucky to get a randomized controlled trial published in the Journal of Clinical Medicine late last year, 2020. And that found that our treatment was far more effective than a relaxation control. So both groups of patients, these are fibromyalgia patients in Spain, they had an equal amount of practitioner time. And the control group, as I said, was relaxation techniques. And after just a few-
Dr. Fitzgerald: They did have their baseline protocols continued in each group, and then they layered onto it your protocol or a relaxation technique, correct?
Ashok Gupta: That’s correct. Yeah. So it was treatment as usual plus either intervention. Yes, you’re absolutely right. And so after an eight week intervention, now normally our program is a six month intervention, but after just an eight week intervention, there was a zero impact on fibromyalgia scores in the control group, but there was close to a 40% reduction in fibromyalgia scores in the active Gupta program group. And also in terms of other areas, there was close to 50% reduction in pain, but only 9% in the control group, there was close to a halving of anxiety and depression in the active group, very low in the control group. And close to 50%, a 47% increase in perceived health in the active group, but only 16% in the control group. So this was a groundbreaking results in the first randomized controlled trial ever published on a neuro-plasticity program, which was very exciting.
Dr. Fitzgerald: It’s really exciting.
Ashok Gupta: Yeah. And you know, obviously we would encourage those patients to continue for six months, because we say a minimum of six months to really, really get fully well. So any future interventions, we’d hope to do a six month or a one year study to really see the longer term effects. And yeah, so we are now looking for phase three trials in fibromyalgia, in any chronic fatigue syndrome and many other conditions we know that seem to have good outcomes. And really, that’s the future for this. And for us, we don’t want to hold onto the IP. We’re not saying this can only be the Gupta program. We want to prove this, and then train everyone and anyone who’s interested to deliver this at a primary or secondary care level as well.
Dr. Fitzgerald: Okay. So I was going to ask you about time. Yeah. It’s amazing that they saw the turnaround in eight weeks, because that really is just a drop. And you say at least six months, so that’s fascinating. It would be interesting actually to follow up. Do you have any plans, or does the group who conducted this 2020 study have any plans to see how the cohort is doing?
Ashok Gupta: So this was a study where it actually took a couple of years, two to three years to actually get it published. So I think it was actually conducted in 2016 with our old program, funny enough. But I certainly have offered to that team to say, let’s do a larger study now, now that we’ve had this published and hopefully get the funding for something like that. But we’re very open to collaborations across the world to do a larger study with hundreds of patients, because we think this is a really good option for patients. And actually the intervention is relatively cheap compared to many things that people spend money on.
Dr. Fitzgerald: Right. Labs, supplements, medications, et cetera, physician time and so forth. Yeah, that’s right. Okay. So in our show notes, folks, we will put all the links that you need to be able to access the Gupta program and Ashok specifically. And so if some of the clinicians listening, I know that there are folks in university listening who might be interested in jumping in to conducting some research here, just make sure that you give us contact, and you’re open to collaborating.
Ashok Gupta: Yes, absolutely.
Dr. Fitzgerald: Okay. Okay. Fabulous.
Ashok Gupta: That would be great.
Dr. Fitzgerald: And then-
Ashok Gupta: There’s something that-
Dr. Fitzgerald: Go ahead.
Ashok Gupta: There’s something that we’d like to offer to your audience and your listeners who are clinicians. So if they are working with cohorts of patients, we actually provide free access to the Gupta program for clinicians to take a look, see which patients may be the most appropriate for this type of intervention. And so we can also include that in the show notes as well.
Dr. Fitzgerald: Perfect. Yep. That would be fabulous. Again, I just want to underscore that we do see a need in clinical practice, and something that’s increased, I would say, over my career. I’ve been practicing medicine going on 20 years. And when I first started, I would say our interventions were a little bit more straightforward, and we got a little bit more bang for our buck. And things are becoming more challenging, we’re seeing, quote, tougher guts and maybe heightened intolerances and allergies. And I think it feeds into this piece being so essential. And so, in addition to chronic fatigue, just conditions that are responsive in your experience?
Ashok Gupta: Yes. So I think that for instance, POTS. We are getting good results with POTS (postural orthostatic tachycardia syndrome), which often has crossovers with these types of conditions. Then things like, obviously long-haul COVID, which is very big in the news right now. We’re actually starting initiating a study on that as well, a randomized controlled trial. And then any kind of sensitivity to food, chemical sensitivities, electrical sensitivities, and another big area is pain. So once someone has had their particular pain, chronic unexplained pain, investigated, and there’s no obvious organic cause we find that our program is highly effective for those kinds of things as well.
And then obviously the gut related things like SIBO, irritable bowel syndrome, and those kind of burnout related conditions. We’re also finding good results with those because so many of these conditions crossover. And we call all of these conditions collectively neuroimmune conditioned syndromes, or NICS, that’s our name for these types of conditions. And that’s why there’s so many crossovers of symptoms. Does someone have chronic fatigue syndrome with IBS or do they have IBS with chronic fatigue syndrome? Actually underlying it, the underlying neurology is very similar, but the complexity comes from the range of downstream symptoms that then occur in each patient. And that will be down to the genetic and physiological vulnerability of each patient.
Dr. Fitzgerald: Right. Yeah, that makes total sense. So POTS, mast cell activation?
Ashok Gupta: Yes.
Dr. Fitzgerald: And what about Lyme, and other… Chronic Lyme, I should say, and sometimes really difficult stealth infections. What have you seen?
Ashok Gupta: Yeah, definitely. We’ve had good results with Lyme, and many of the stories on our site you’ll see from previous Lyme experiences. And once again, we see Lyme as a triggering infection, but once this cycle starts occurring, the Lyme ironically becomes an opportunistic infection that that then may persist in the body. But once we go through the retraining, rebalance the entire system, our own immune system is the best fighter of these opportunistic infections and is able to deal with them very easily. And the same from a detoxification perspective. That we know that detoxification is compromised, but once we bring back the parasympathetic response, we bring back balance, then the body once again is its own best detoxifier.
Dr. Fitzgerald: It’s absolutely true. So a friend of mine, Dr. Tom Salt talks about, for many of us, Lyme disease is a mild summer flu. You’re sick for a couple of days. For many of us. And then there’s those of us who are vulnerable to chronic Lyme and those numbers seem to be, or other stealth infections, and those numbers seem to be exponentially growing. And his first intervention is also looking at autonomic nervous response. And I think, again, I just think more and more of us are coming to needing these tools.
Dr. Fitzgerald: My question to you is, so for me as a functional medicine clinician, somebody who’s dealing with biochemistry and so forth, it’s a no brainer that I would concurrently be using the set of interventions that I find effective. However, in your experience, and in your 2020 study, they did treatment as usual and then layered on your program or the relaxation technique in the control group. In your experience, is that always required? Or could you say, get somebody who’s got a chronic stealth infection, or mast cell activation, or chronic fatigue? Well, you got better, interestingly, in your story, with your tools only, I’m assuming. But I mean, is there a place for your program as a standalone intervention in these cases? I mean, have you, have you gotten SIBO patients better or IBS patients? Anyway, speak to that?
Ashok Gupta: This is a really good question. And I think that it’s too early to say. Certainly with our patients, they’ve been around the houses in terms of looking for solutions before they come to us, often. And they find that actually they use our program, they get better, and then all the supplements and things that they had been prescribed, they come off them without any change, without any effect. So it’s really difficult to say, but we are open to understanding if those downstream interventions can support the upstream interventions. Generally, we find yes, if a patient can successfully deal with the upstream issues, and is able to rebalance the system, the body itself gets back into a normal, healthy balance. But not always. No intervention is 100% effective, of course. And so, once they use our program, if there are some downstream issues afterwards that they want to investigate, then they also go on that route as well. So some patients don’t need anything else. Some patients may require some extra investigation.
Dr. Fitzgerald: I want to throw… I just, I want to talk about adverse childhood experience, and I actually want to throw in a curve ball on this conversation, and question from my own area of interest. I recently published a study looking at changes in DNA methylation. Specifically, we were looking at biological aging, but if you get into the literature on epigenetics, then you can see pretty profound influence in early childhood trauma, in utero exposures. And one of my very favorite studies in the field of heritable epigenetics comes out of Emory University. I think it was published in 2017, and it was a mouse study where in the first generation they exposed the mice to a bad odor plus pain, plus a tail clamp, so a smell plus tail clamp. And then they isolated these animals and did IVF in subsequent generations, and found that through the duration of the study, so two more generations, the bad odor elicited the fear of the subsequent pain.
So they had the behavioral response. And then when they actually looked at the brain, the olfactory, so that particular receptor was hypomethylated in the subsequent generations, which means it was turned on, and anatomically it was actually larger. So that region of the brain became hyperplastic from previous generations, which is mind blowing to me, to see this going through. And we know, more studies are coming out in humans to show this heritability pattern, led by epigenetic changes. Because clearly these aren’t genetic mutations, these are epigenetic changes, which actually change physiology, anatomy and physiology. And it’s just so extraordinary. And so this newer research coming down the pike does suggest this is happening in humans.
And there’s a heritable portion, but there’s also a portion where it’s heritable within the being. So after subsequent cell division, so adverse childhood experience does influence us on down the line into adulthood. We know that, there’s an increased risk of illnesses, and so on and so forth. What are your thoughts? There’s no doubt you’re encountering probably some of what I’m talking about, whether you’re thinking about it or articulating it or not. And I’m just, I’m wondering if you’ve thought in this direction at all, and just any kind of observations.
Ashok Gupta: Yes. I mean, I love this area of medicine. And I think we’re just on really the beginning of us really understanding this area. And absolutely, I think this idea of nature and nurture impacting on our vulnerability to illness is really interesting. So I think that there is that idea of generational trauma as well, where actually what may have happened to our parents, and our grandparents, and our great-grandparents, may have an impact on who we are now, right? So obviously there is that inheritance, that genetic inheritance. But then how it expresses itself, or how much inflammation we get in the body, or how much anxiety we experience, will then be, I suppose, changed, by our childhood experiences. So we have the inheritance, and we have then how much it expresses. And I think that that similar pattern may occur with some of our physiology, as well as the emotional side as well.
So if we have more of those adverse childhood experiences, which actually can start in the womb itself, secondary impact can be on the factory setting of the amygdala itself. And there’s some support there. So the mental and emotional state of the mother maybe impacting not only at the genetic level, but also in the structure of the amygdala and its development, and then the experience of childbirth can impact on the amygdala. And then the adverse childhood experiences can impact on its reactivity, as well as the other effects. So piecing this all together, it is really like a big jigsaw puzzle. But what we do know is that people who’ve had adverse childhood experiences are three to four times more likely, sometimes more, to experience chronic illness later in life. And that’s really a public health emergency, for the research to go into that area and understand why.
And I believe that more and more people are experiencing generational anxiety and trauma, more people are experiencing anxiety in general, because of the modern way that we’re living. We’re not living according to things that would… We’re almost programming people to grow up anxious and depressed. And especially with Gen Zed right now. I mean, I feel for them. The levels of anxiety they experience are 60 to 70% of Gen Z’s and teenagers are experiencing regular anxiety. I mean, how has society comes to that? And unfortunately, we as practitioners will see this 10, 20, 30 years down the line when they end up with these types of chronic conditions. Because their system has become primed to become defensive versus healthily operational, is the way I see it.
Dr. Fitzgerald: Yes, yes, yes. The threshold for response is dropped. Actually Moshe Szyf who was an author on paper, did the seminal research in this area, looking at animals who were exposed to either in utero stress or early life stress, having their glucocorticoid system, just hypervigilant, basically, because of that stress later on. And I think that really is what you’re describing. So we need to take this retraining very seriously. And as far as where it is in our interventions, it needs to just be front and center, I think. As well as granting it the respect that it needs, we can throw, you know you just throw out a handful of really profound, disturbing statistics with Gen Zed and the extent of anxiety. But we need to really train our vision on it, and prioritize that and give people the room to do the work. Yeah, go ahead.
Ashok Gupta: Yes. And the important part of this is a shift in the zeitgeist. We shift in how we are approaching healthcare in general, and that is beginning to happen. And it’s slow because it’s like moving a big tanker. But as the functional medicine doctors are in the right place and doing the right thing, I believe here. Which is we’re treating the whole person, we’re treating them holistically, and we are treating them at a mental, physical, emotional, and spiritual level, which is something that in Eastern medicine was very common.
Dr. Fitzgerald: Yes.
Ashok Gupta: My caution always is that sometimes in modern alternative medicine or complimentary medicine, we can become just as reductionist as mainstream medicine by saying, “Right, we’ve done this test, which shows this, therefore you have this.” And just focusing purely on, once again, certain levels of hormones, neurotransmitters, enzymes, and just treating at that level. And it’s important at the same time to treat at the holistic level, because otherwise, they may get better temporarily, but some other stress will come in their lives and they’ll go right back to where they were before. And I’m sure many of us see that, where we’ll get recurring patients who feel better for a while, but then something’s happened in their life a year later or two years later and they’ll come back. Because the overall skills of being able to balance our nervous system and keep it at that state is an important factor in long-term health.
Dr. Fitzgerald: I want to just say, just in my closing comments, A, this has been a fabulous, such an important conversation. But I want to say this extends beyond medicine into how we’re living, just to bring us full circle. This is well beyond the patient-physician encounter, and into our homes, and our connections, and our communities, and how we’re choosing to actually interpret life.
Ashok Gupta: And this comes down to society’s values. I mean, we can get very deep and profound here, but ultimately our modern societies are based on unconscious values, which have been based on the human ego, and dare I say it, the male ego. And those values have become unconsciously ingrained, which is survival of the fittest. The strongest will do well and survive, or our aim and mission is to increase GDP of the economy, and for each of us to earn as much money as possible, which is obviously plundering the planet and causing so much environmental chaos.
And so those values don’t fit well with our evolutionary inheritance, which actually, it means that we’re pushing our bodies mentally, physically, emotionally, far harder than they are used to, which is then what we’re seeing in the consulting room. And so that whole model of driving people towards more and more and more, whether that’s more physical items in their lives, or more money, or all of this, is that societal set of values, which ultimately is causing the health issues we’re seeing, the burnout, the physical illness.
And so at the moment, it’s the responsibility of each individual to recognize that, and jump out of that game and prioritize their own health. But ultimately society itself, governments themselves, have to… how can we put it? Refocus the priorities of society towards wellbeing, and happiness, and community cohesion, and all of those good things that ultimately come from a space of love, versus a space of fear and ego.
Dr. Fitzgerald: Yeah, a recalibration. I would argue too, that it needs to really begin with us individually and perhaps at home with our families. Thank you so much for joining me. This was a great conversation.
Ashok Gupta: Thank you so much. It’s been wonderful, thank you.
Dr. Kara Fitzgerald: And that wraps up another amazing conversation with a great mind in functional medicine. I am so glad that you could join me. None of this would be possible, through the years, without our generous, wonderful sponsors, including Integrative Therapeutics, Metagenics, and Biotics. These are companies that I trust, and I use with my patients, every single day. Visit them at IntegativePro.com, BioticsResearch.com, and Metagenics.com. Please tell them that I sent you and thank them for making New Frontiers in Functional Medicine possible.
And one more thing? Leave a review and a thumbs-up on iTunes or Soundcloud or wherever you’re hearing my voice. These kinds of comments will promote New Frontiers in Functional Medicine getting the word on functional medicine out there to greater community. And for that, I thank you.
Ashok is an internationally renowned Speaker, Filmmaker & Health Practitioner who has dedicated his life to supporting people through chronic illness, and achieving their potential. Ashok suffered from ME, or Chronic Fatigue Syndrome, around 25 years ago when he was studying at Cambridge University. Through neurological research that he conducted, he managed to get himself 100% better. He then set up a clinic to treat others, and then published the well-known recovery program known as the Gupta Program in 2007. He has published several medical papers and is continually researching these conditions, you can find out more information at www.guptaprogram.com. In 2017 Ashok published a popular 4.7 star rated app called the Meaning of Life Experiment, a 30-Day program of videos and meditations to discover more happiness, meaning, and to uncover your Life Purpose. www.themeaningoflife.tv
Dr. Kara Fitzgerald FxMed Resources
Clinician Professional Development: DrKF FxMed Clinic Immersion