Written by Christopher Kelly
May 5, 2018
[0:00:00]
Christopher: Steve, thank you so much for joining me this afternoon.
Steve: Absolute pleasure, Chris. Thanks for having me.
Christopher: Our absolute pleasure. We're huge fans of your work and your Holistic Practitioner podcast. I was just listening to it this weekend where there was a fantastic story of recovery through functional medicine. You're clearly doing amazing work. Your interview on insulin resistance with Dr. Tommy Wood is one of my favorite podcast to date. You did an amazing job of not only understanding what Tommy was saying but also asking really good probing questions. That was a really phenomenal interview that I will link to in the show notes for this episode. Thank you so much for producing that content.
Steve: That interview with Tommy was, I think, my favorite by a long shot. It really did remind me when I first started studying acupuncture I had a biochemistry teacher by the name of Heidi, and she was a phenomenal teacher and I used to sit up the front and anything I couldn't understand I just put my hand up and say, "Heidi, I don't understand. Can you explain it in a different way?"
I was a pest to her but she really enjoyed it and it really felt like that when I was chatting with Tommy because I genuinely didn't know a lot of the things he was talking about and he was speaking light bulbs were going off for me. That was the most fun interview I've done to date, I think.
Christopher: Excellent. Tell me about how you became interested in acupuncture. Back in the day, ten years ago, if you'd ask me about acupuncture, I'd just say, "Well, it's all quackery, isn't?" How can there be anything in medicine apart from evidence-based medicine like the medicine that the medical doctors do? There is nothing else.
I wouldn't have been interested in how you became interested in acupuncture. And now I've learned a little bit more about health, I feel like I don't know anything at all. And now I'm very curious about acupuncture. So, can you tell me about the time that you became interested in acupuncture?
Steve: Yeah. It all started back in the early 90s. I think it was around about '92 and a friend of mine suggested that we do tai chi. I sort of had been chatting with him and said, "Let's do something different." He recommended tai chi and I went to a tai chi class and absolutely loved it from the very first moment I walked into that class.
From that point, I started to read a lot of books around the topic of tai chi. In the back of those books there would be related reading and then I would go to the library -- back then people would go to libraries -- and I would get another book on Chinese philosophy and I continued to read and continued to read.
And then at some point, I thought, "I wonder if I could study this," and got out the phone book and looked up where you could study it. This was on the Gold Coast in Australia back in '94, I first started studying acupuncture. It was really tai chi and that whole Chinese approach to philosophy in life that got me interested in acupuncture.
Christopher: You better tell us a little bit more about tai chi. I know what it is just because I've seen it. It was that class that ended just as my kung fu class started when I was about 17 or 18 years old. At that time I couldn't really see the point of it. It looked a bit like kung fu but didn't have any of the interesting stuff. Can you tell us a little bit about tai chi?
Steve: Yes. Tai chi is what's known as an internal martial arts. It really is a martial art. Where I was learning was at a place called the Chinese Kung Fu Academy and there was a grandmaster, Henry Sue, who taught kung fu and had been a master at that time for around 35 years. He taught kung fu and tai chi. They're really, if you like, the yin and the yang of martial arts.
Tai chi is the soft form of the martial art. They're very, very connected, the kung fu and the tai chi. Interestingly, you'll probably find this interesting. One of the great tai chi masters, his name was Chen Man Ching, and he had this beautiful softness about him, very, very relaxed.
Whenever someone would push him or attack him he was able to yield completely so that there was no way for the force to land on him and he was able to redirect that force back to them. The one thing that he always said was that you needed to become fearless. That was the biggest thing for him.
When you think about the HPA axis and the fear response, he was deeply training people to not have that stress response, to be completely relaxed in the face of whatever was coming. That could be physically or mentally. Tai chi is a way of true bodily training, training your mind to be relaxed and be able to yield to whatever comes to you in life as well as physically.
Christopher: That's amazing. So, he's not removing the stressor or, in this case, the attack be it a flying fist or a flying foot, but rather he's changing his response to it, right, which is all you can really do with stress.
[0:05:06]
Steve: Yes. That's right. The response is to be completely relaxed and just allow that to come towards you and just yield as it comes. So, yeah, that's a metaphor for life for me. I'd been practicing tai chi for over 25 years now and, yeah, it's an incredible art. It's a moving meditation really.
Christopher: Tell me about your time studying in Japan.
Steve: Yeah. So, I studied in Australia acupuncture and I really didn't feel like I was ready to go into clinic after I'd finished studying. And I'd met a teacher who had come to Australia to do a seminar. He also did tai chi and he said to me, "If you ever feel like coming to Japan and studying, you're welcome in my clinic." I said okay.
Once I finished my studies, I sold everything that I had like car, everything, and I called him up and said, "I'm ready to come to Japan now." He said okay. I went to Japan. That was the first time I'd ever traveled abroad. I was 26. I hadn't traveled abroad at that point. So, went to Japan and thought I would go for six months but ended up there for five years working in three different clinics.
Christopher: What year was this?
Steve: That was in '96 through to 2001.
Christopher: And what was that like? You arrived in Tokyo and you can't speak the language and presumably the signs are not in English. How was that?
Steve: Very, very intimidating. I'm a country boy and so turning out to Tokyo, I remember getting to Narita airport and then taking a taxi from Narita all the way into Tokyo and it was $300 or $400 back in the '90s just for a taxi ride. The whole way was just a mass of buildings. There was just city all the way into Tokyo and I just couldn't believe it. It was very intimidating but also I love change so once I settled in I ended up getting a mountain bike and I would ride everywhere in Tokyo that I needed to go.
Christopher: What a fantastic way to learn a city.
Steve: People after work they'd say, "Let's go up to this part of Tokyo and we'll have a few beers and diner." And I'd say, "Yeah, okay. I'll meet you up there." They would catch a train to wherever they're going and invariably there'd be two or three connections. And I'd be sitting there at the train station waiting for them on my bike. I was there 15 minutes before them.
Christopher: I had that same experience in London. I felt like I didn't really get to know London until I started riding my bicycle around. You start to appreciate how close together some of the underground stations are. Why do they even put these two stations in so close?
Steve: Yeah. Tokyo was brilliant, really, really great experience and it was probably there where my love and passion for accelerated learning really took off as well. Prior to going to Japan, someone had lent me Harry Lorayne's Superpower Memory book so I took that with me and was able to use what he calls his major system which is called the peg memory system. If you look at Harry Lorayne you'll be able to find that.
Christopher: Yeah. You're not the first person to mention him, actually. I interviewed Jonathan Levi that has a SuperLearner course and I'm fairly sure that he mentioned that name too.
Steve: Yeah. So, in the end, I was able to learn the written language in about a year using Harry Lorayne's method. And I could literally write the 2,042 Japanese characters from number one all the way to 2,042 from my head. I could give people the book and just say, "Pick a number," and they'd pick a number and I'd write it out. To me, that was a huge challenge and very, very fun.
Christopher: Was it practically useful though?
Steve: Well, one of my teachers is a prolific writer and has published about 25 text books in Japan. So, I was able to learn to read his text books, which was really phenomenal. And apart from that, just getting around Tokyo and getting around Japan in general, I was able to read all the signs and so I could travel deep into the countryside and communicate with people very, very easily. When you do that, people are just so welcoming and warm towards you because you've learned to speak their language. They love it. It opens up a whole new world once you learn the language.
Christopher: What else did you learn about health and fitness in Japan?
Steve: Well, I didn't learn much about fitness really. I continued my tai chi studies and then just really dove very deeply into the acupuncture world. It's a very different approach, obviously, acupuncture, to what I'm doing now but it still is holistic. So, yes, being in Tokyo, what did I learn about health?
Christopher: Tell me about what acupuncture is really useful for? What did you see it work well for?
Steve: Yeah. It has a very broad scope, definitely, and over the last 20 years of seeing that, but very, very good for, obviously, pain. That's what it's possibly most well known for. But also over the years I've helped a lot of couples with fertility which is really, really rewarding work.
[0:10:04]
In fact, it's possibly the most rewarding work that I do in the world of acupuncture. It's just so thrilling to help couples on their way to building a family. So, yes, fertility, very, very good. Digestive issues also, very, very good. Sleep, stress, anxiety, there's a quite a wide scope for acupuncture.
Christopher: Can you walk me through a typical fertility case? That seems very interesting to me.
Steve: Yeah, it is interesting. Although a lot of fertility often stems back to the male, it's usually the females that come in and see me. So, typically, there's some sort of menstrual irregularity and most commonly I see things such as PCOS or polycystic ovarian syndrome. There's this issue with the menstrual cycle.
So, generally, correcting that through acupuncture. You'd be interested there's acupuncture points that have an impact on diabetes and insulin regulation and working on those areas and balancing out the hormones and then giving people guidance as to what kinds of foods they should eat and then the acupuncture, of course, works very well on the stress response.
Tying all these things in over a period of time works really well. And what happens is the female starts to get into that healthy zone so they tend to do the cooking. It's sort of overflows into the other side of the partnership where the men just get healthy as a result of their partners coming in, yeah. So, yeah. That's where acupuncture works really well for fertility. In fact, it was a fertility patient that got me started on the whole functional medicine journey interestingly enough.
Christopher: Tell us about that story. How did that go down?
Steve: Yeah. Well, there was a girl that came into me for fertility. She had irregular menstrual cycles. She was needle-phobic actually. She was totally scared of needles and was able to conceive and have a baby and she was coming back to me for just follow-up treatment actually a couple of years later. A friend of hers from Queensland came into the clinic because she was wanting to get pregnant so she wanted to just come in and ask me a few questions.
She said to me, "What do you think of Dr. Fox's diet for fertility?" I said I've got no idea who Dr. Fox is. She said his name is Michael Fox and he recommends this particular diet. I said, "Okay, I'll look into that for you." At the end of that session I jumped on YouTube, Dr. Michael Fox. I don't know, have you heard of Dr. Michael Fox?
Christopher: No. I absolutely have no idea.
Steve: He's in the low carb community. He's a fertility specialist that recommends a ketogenic diet. Most of his patients are overweight have a BMI above 40. He recommends a ketogenic diet and quite often before the BMI even changes that much they're pregnant because of the hormonal shift in changing their diet seems to work very well.
This girl, I emailed her. I said, "Yeah, I looked into Dr. Fox's diet. I think it looks like it could be good. Give it a try." She had a baby a few months later. And a few months later I was on a ketogenic diet and absolutely totally involved in that world looking into low carb. That really did change my health dramatically at that time. It just all started there.
Christopher: So, you were one of those people that didn't really know you had any problems and yet you changed your diet and you realize that actually you did have some problems and you could only see the resolution of the problems once they were resolved.
Steve: Pretty much, yeah. That's about right. Probably just getting into lifestyle habits that weren't exactly ideal, even though I'm in the health industry it's funny how you can just sort of let these little habits sneak in and they're accumulating. I was in my 40s and there's a strong history of diabetes in my family. I was collecting a little bit of abdominal fat. I just wasn't quite feeling as good as what I could have been. A ketogenic diet really, really changed my health amazingly so. I was in danger of becoming a low carb zealot and, thankfully, Tommy Wood and Chris Kresser and the other people like yourself cured me of that.
Christopher: It's not that we have something against the diet. We just think that it's a tool in a box and there's lots of tools in the box that you can use to help someone be a better person. I don't like just focusing on a single tool. I have to admit that I was probably one of those people too until Tommy came along. Maybe we both have Tommy to thank for having a zoom out a little bit and see the whole picture of health.
Steve: Yeah. Tommy has this amazing way of approaching a problem which I really appreciate. He always looks for the other side of the story. I think that's important. There always is more than just one side to anything.
[0:15:00]
Christopher: Tell us a bit more about your transition into functional medicine. So, obviously, you must have had some feelings both for and against the idea of leaving the acupuncture world and entering into this brave new world. Tell us about what was going on in your mind when you made that decision.
Steve: Yeah. It's interesting. So, being in acupuncture practice now for nearly 20 years, I suppose. It's a long time. I really do enjoy my work but I have a lot of clients or patients who come to me for pain. That's the main issue that they're coming for.
For example, I'll see someone with sciatica coming to me and I'll look at them and think, "My gosh, you're two steps away from type II diabetes and probably risk of cardiovascular disease." I can just see that they're not in a good place health-wise but the only thing that they want treated is their sciatica and they're not really interested in making any other deep changes in their health.
For me, I'm definitely more interested in helping people make a complete change and become very healthy. So, I was getting a little bit frustrated with that side of my practice. Once I came into the functional medicine world, it's just such a great holistic approach as is Chinese medicine but it's just slightly different.
So, moving into functional medicine -- There's people in my clinic that are very interested in working that way but it's a small subset of people. So, I've decided now to attract people who are at that point where they want to make those deeper changes in their health just through word of mouth, through my podcasts, through the internet and some sort of transitioning into working with people that are really interested in making those deep changes and are committed to becoming the best version of themselves. That's kind of where I'm at now. I'm sort of moving more towards that way.
Christopher: Can you talk about some of those terms that you use? So, I said it too, functional medicine, and then you use this word, holistic. Can you talk about what those words mean to you and which of them you prefer?
Steve: Yeah. I know we've chatted about this before. So, functional medicine in Australia particularly is a term that most people have no clue what it means. I think it's very popular in the States at the moment.
Christopher: I'm not sure I'd say very popular. It's well known amongst the circles that we live in but I'm not sure if you would walk into a local primary care doctor's office in Santa Cruz where I live and ask them what functional medicine is, they probably just look at you funny.
Steve: It's really difficult because somehow people need to put you in a box before they know what you do. So, that's really how I think of what I do. When I think of holistic, it's not just one aspect of health. There's all the different things that impact people's health and functional medicine as we know I think it does a really good job at looking at all those different elements of people's lives from their exercise routine to their eating to their stress management to their relationships, and then what's going on within their body.
We know that they all overlap. Part of what I do is look at that big picture and try and work out what areas that person needs help with. I really don't know what to call it. Functional medicine is what people are starting to relate to. Holistic healthcare is probably a little bit too broad and people wouldn't necessarily know exactly what I'd do. If you come up with a good term other than functional medicine let me know.
Christopher: I have to say that we've struggled with this as well. I like the word holistic. I mean, it says to me that you're coming at the problem for every conceivable angle. And the world holistic has made it easy for me to embrace the services of Dr. Simon Marshall. So, everybody that signs up for our program now talks to Simon and then there is follow-up too but that first initial consultation is a check up from the neck up. It's a way for you to help with your behavior change. The world holistic very much encompasses that in a way that I'm not sure any other word does.
Steve: Yeah. It's a really tricky one. I don't know. I like holistic healthcare because that's really what it is that I do but it is a pretty nebulous term in one respect. So many people could say that they do holistic healthcare and it doesn't really give people a clear image of what you're doing. So, yeah, I don't know. I'm not sure.
Christopher: I don't like the way it doesn't encompass the idea that you're doing a root cause analysis. In that interview that you did with Tommy, you talked about his systems analysis and you're trying to identify all the moving parts and how they're contributing to the causes. I very much emphasize the plural use of that word to the reason you're in my office right now. So, we're not going to just manage the symptoms with some kind of pain management thing. We're actually going to look really deeply the causes of this problem.
[0:20:01]
I'm not sure any of those terms that we've discussed so far really encapsulate that but maybe somebody listening is going to come up with a better idea and send it to me and I'll gladly use it.
Steve: Yeah, the root cause medicine, just that pretty much. I don't know if you could say that but, yeah, addressing the root cause is definitely where we are at and trying to identify the root causes.
Christopher: Talk about your experience in Chris Kresser's Institute for Functional Medicine, his ADAPT level one training that I heard so much about. You were probably one of the original people to go through that training, right?
Steve: Yes, correct. In 20016, Chris had his first enrolment for what he calls the ADAPT level one. That's just what he called it. So, I'm assuming over time he's going to release some more training that's perhaps a little bit more advanced. I know this year he's doing health coaching course so he's going to be training health coaches.
I haven't spoken to Chris at all about this but I'm just guessing that we always create things because we have problems and I think perhaps one of the problems he was facing is that he's very, very good at identifying and working out at what people need but then providing the support so that people can go through that process was a challenge.
And so now he's training a whole army of health coaches that he can work with so that they can get through that process. That's interesting. But, yeah, back to the ADAPT course, it was a really intensive course and for me it put all the pieces together very clearly. Chris has this amazing way of categorizing information.
It was a very dense course. If I hadn't gone through that, I probably would have done something else, I suppose, but it really gave me such a good framework for approaching functional medicine. If I haven't had done that I wouldn't have had all the pieces together on how to approach and layer a treatment. I just wouldn't have been able to do it, I'm sure, which testing to do.
Christopher: What was going through your mind when you pulled the trigger on that? I imagine, can you cast your mind back to the moment you're on that shopping cart page and there's a product there and I'm not sure whether you paid all in one lump sum, probably not, but it was thousands of dollars, wasn't it? What was going through your mind at the moment you pressed the submit button with your credit card details there?
Steve: Yeah. Very excited. I was very excited. The sales page for that course sort of outlined everything that was going to be taught so when I was looking at what was involved in that course I was thinking, yeah, this is exactly what I need to be able to take this really strong interest in this functional medicine world and consolidate it into a package that's going to allow me to help people in this way. I was really excited.
I think it was around about $15,000 or $16,000 Australian. It was a pretty bit commitment really. But I had this sense that Chris knew his stuff. I had this sense that he was very trustworthy and that he would deliver a really great course that was equal to the value that I was paying and I think he exceeded the value actually. Just an amazing guy.
And what he put together and the team of people that -- He had Dr. Amy Nett, one of the doctors in his California Center for Functional Medicine, she was brilliant. And he also had a couple of nutritionists that were working with us as well. It was just really, really good value.
Christopher: So, did you already have some familiarity with some of the lab tests that Chris was teaching? That's a good question to begin with. Did he start with a lab test? Did he start with some of the more underlying things like biochemistry and physiology? Did he just dive straight into labs?
Steve: Yeah. The presumption was that people who were doing the course were licensed practitioners. So, the presumption was that they are already familiar with all--
Christopher: The prerequisites.
Steve: All of that prerequisite information. So, we really did start with the testing although Chris sort of has this, right at the beginning of the ADAPT framework course, Chris sort of outlined what he called the hierarchy of treatment. It basically looks like a pyramid. The way he breaks it down is there's this pyramid of--
Right on the bottom, he says that perhaps 40% or 50% of people that he sees for functional medicine, their issues can be resolved with diet and lifestyle and environmental medicine, the exposome, the influences on people's health that come from the outside.
The next layer up in that triangle was probably where the most basic level of functional medicine, if we're going to use that term, is more the nutrient imbalance, gut pathologies and HPA axis dysregulation. He felt that that would probably cover another 20% to 40% of people. So, you're looking at 50% or 0% of people, if they get that right, probably not going to need anything else.
[0:25:01]
Christopher: Which is great.
Steve: Yeah. Yeah, absolutely. That's where the ADAPT level one framework course had all of its focus. And then there were what he called complex cases where you're looking at mitochondrial dysfunction, toxic overload, hormonal imbalance, which he didn't teach in that course. And then right at the top of that pyramid where Chris tends to see most of his patients are in the chronic infection and immune dysregulation and things that are very, very sneaky and difficult sometimes to treat. So, we started off with gut pathology as the first place. We spent the first probably 12 weeks looking at gut pathology and how to test, identify and then treat those gut pathologies. And then we went into blood chemistry quite deeply as well.
Christopher: So, that would be, the gut pathology, that would be people like Ann Bolch that I just heard on your podcast, right?
Steve: Exactly, yeah. Ann Bolch is a classic example of someone who fits. So, she had tried diet, lifestyle and a whole manner of different things and it didn't really get her the result she was looking for and so she really did need someone to go to that next level and take a deeper look and see if there was something going on there and indeed there was a parasitic infection overgrowth of commensal bacteria and also a diagnosis of SIBO.
For Ann Bolch, she really did need that something extra to clear up her issues. So, without going any deeper, we were able to really help her amazingly in a period of about eight months. She recovered her health phenomenally well. That's just so exciting to be able to do that work. That's really my wheelhouse at the moment. I wouldn't say I'm an expert in hormone or imbalances or the more complex issues. But, I guess, one day I will be. I'm very, very interested in it.
Christopher: Maybe I would argue that if you keep taking care of people's gut then the hormones will take care of themselves.
Steve: Yeah, absolutely. That's my feeling, actually.
Christopher: Well, tell me about how you've been using blood chemistry in your practice?
Steve: Yeah. So, with Chris Kresser's training, blood chemistry was a really big component of the course. So, Chris's blood chemistry work up has about 80 markers. It's quite an extensive blood chemistry panel. To get that done here in Australia, you're looking at around about $800 to run that blood chemistry panel. As we'll discuss a little bit later today, getting doctors to run a panel like that, good luck. They're just not going to do it.
Christopher: And is that your only option in Australia? In the US you can order your own labs, no problem. Is that true in Australia?
Steve: You can't really order your own labs but I'm able to order those labs for people and they need to pay for those labs out of their own pocket. Whereas if a doctor requests those labs, mostly they'll be covered by Medicare so there's no out of pocket expense. But for a doctor, they need to be able to justify why they're doing those tests and that could mean doing fairly extensive reporting on their part.
I understand their conundrum because they're in that disease management system rather than a healthcare management system. So, there's a bit of a mismatch often and they're really under the pressure of maybe 15 minutes per appointment and someone comes to them with this whole long list of things that they would like tested, it's really not fair for the doctor. They just haven't got time to go into it. That's not how they're practicing. It's an unfair expectation sometimes unless you can find a doctor that is working that way but they're pretty rare and hard to find in Australia.
Christopher: Yeah. I mean, it's exactly the same in the US. It's just not fair to walk into a doctor's office and say, "I want this list of fancy blood markers," they've never heard of. When you see the Quest catalogue you'll understand why. You're expecting that doctor to sit and look through that catalogue and find all these markers and then for every marker that you've asked for there's probably six different variants of that particular marker and he or she has to try and understand which of the ones -- I mean, it's just not fair.
I think I mentioned this on the podcast before but I actually have the doctor throw the catalogue at me and say, "Here, you order the blood test. I don't care. I haven't got time for this." It's just not fair.
Steve: Yeah, that's right. So, doing that extensive blood chemistry is really valuable but when you release the blood chemistry calculator software I was just so excited because it made my life so much easier in regards to doing blood testing, phenomenally easier. As I said, when I had you on my podcast, I knew that you and Tommy were going to do something brilliant and then you brought Bryan Walsh in who I absolutely love his approach.
And then you have Megan Roberts also and you put together this blood chemistry calculator software that uses sort of machine learning to analyze simple blood chemistry. It's really allowed me to do a simple blood test with just 38 markers which is so much less expensive and gives a lot of that information that the extensive blood chemistry panel would have done anyway.
[0:30:10]
And so it's really nice that I'm able to do this now and I'm finding it just so valuable. So, even for people in my acupuncture practice who maybe aren't ready to make a big commitment into a full on functional medicine approach, they are more than interested in just doing a blood chemistry report and seeing what's going on there. People are really interested in that. So, I'm using your software in that way to just start the conversation with people who are not necessarily in the place where they're ready to make a huge change and I'm finding that to be just really, really valuable.
Christopher: Have we reached the point where you can just run the software without asking for additional data? So, that really, for me, is the holy grail and that was the draw for us with subjective questioning. As you probably know, Steve, but maybe for the listeners they don't know, we have a seven-minute analysis on our website at nbt.ai.
And the reason we wanted to use subjective questions to try and predict the results of some of these expensive testing we do is because anybody can click on a radio button. You can produce that data any time at any point. Obviously, that's very valuable. With the blood chemistry, you may also be able to do that.
So, the markers that we've chosen as input are very commonly run but you don't necessarily have them on hand like you do the answers to these questions. How are you finding it in Australia? Are clients or patients coming to you already having this data or are you always having to run an additional blood test?
Steve: Yeah. I'm needing to run an additional blood test for the most part. Some people have blood test results which I can access but for the most part, the general blood chemistry workup that they get done by the doctors is just not adequate for the blood chemistry calculator software. It's just missing too many of the markers and so it's not going to give an accurate prediction.
It's interesting. Since I've been using the blood chemistry calculator, I created a pretty basic letter that I could give people to take to their doctors and ask them to run those 38 markers and then I can get the results back. In that way, they didn't have to pay for the blood test. But I found that to be the doctors are not particularly interested, the ones that I've come across at this point.
They're not seeing -- For me, when I saw what the blood chemistry software could do, I was blown out. I was like, "Oh my god, this is freaking phenomenal. Look at this." But the doctors don't have that response. They kind of just raise their eyebrows and say, "Well, ferritin is in range anyway. I don't think an iron overload is an issue." And it's like, okay.
As an example, when I have someone go directly to the lab to get their blood drawn, they pay $132 including GST, and they can get their blood drawn, the next day I get the results showing up in my portal, and I can then just run the report. If they go to the doctor -- I had a patient just recently go to a doctor so the doctor had her run the 38 markers but she didn't want to run them all so the patient had to pay for some of the markers on that 38 marker panel and the cost to that patient was $145.
I was looking through the results thinking is there extra test? Why is it more expensive than the one when I sent them directly to the lab? I couldn't work it out. In any case, sometimes it's just better off for me just to send people straight to the lab, get it done. They don't have to have the conversation with the doctor, "This is why I'm doing it."
And I appreciate the doctor's perspective as well. I'm certainly not down on the doctors for not wanting to do it. They've got their own agenda when someone comes to see them and so they don't want to be told by someone else, "Can you do this?" I appreciate that.
Christopher: Right. That's just precious time. Something's going to fall off the table, what is it? It's definitely going to be this. I'm not going to look at this. And then, of course, we have the same experience in the US. You think that you're doing the right thing by asking your insurance company to cover it and then six months down the road the insurance ninja comes for you in the middle of the night and sometimes you don't even know. Like what was this? I can't even remember was this doctor even present when this procedure? So, you end up paying more money than had you just paid cash up front.
Steve: That's right. So, I'm really, really interested in behavioral change. So, just being in clinic for so many years you can just ask a couple of questions and you know where someone is on the chain spectrum as I call it. Are they wanting to make a change or not? So, one of the things that I think having lab test does is it really helps people make a connection between what it is that you would like them to do as far as change and it kind of motivates them because they know that there's some sort of hard evidence with the lab test that they can track to see if the change that they're making is really having an effect.
[0:35:14]
So, just doing this blood chemistry calculator report is enough for people to really want to make lifestyle changes and then retest. So, the people that are sort of dipping their toe into change, just having this one report I'm finding is enough for people to really want to make those changes quite seriously and follow through on them.
So, what I find is people make changes but they're not sure if the changes they're making are really having the desired impact on their health. Deep down there's this question mark, is this really right? And often they just fall off the change wagon at some point. So, having some sort of validated simple test like this allows people to track whether or not this change is having a desired effect on their health so then that can sort of reinforce that habit that they're starting to move towards.
I think that's really, really valuable. A classic example are people who maybe change their diet and they feel pretty good but then when you have a look at their blood chemistry there's maybe things that aren't so good and so just bringing that to their awareness is really important.
Christopher: Yeah, I agree. Closing the loop. Unless you close the loop, how can you know it's working? We've implemented several scores with the blood chemistry calculator. Perhaps the most important of which is the five-year wellness score a.k.a. the intermountain risk score which is designed by another group, Benjamin D. Horne, et al., exceptional mortality prediction from common laboratory test.
So, this is an algorithm that anybody can implement using even an Excel spreadsheet. So, we do it for you in the blood chemistry calculator but it can be done without our software. Is that the score that you're looking at with your patients or clients? Or is it one of the other scores? Or does it depend on a particular person?
Steve: Yeah. It depends on the particular person. So, there's one lady that we'll discuss and I spoke with her and she's happy for us to talk about her case. So, definitely that predicted age score, the wellness score, all of those looking at as far as how effective is the treatment that we're doing. This lady came to me. She's been seeing me for a number of years. A few years ago, when I was getting into low carb, I said, "I think this would be a good approach for you."
She took that on board and went to a low carb approach and lost a lot of weight, a lot of her health markers improved incredibly so actually. So, she was feeling much, much better. But her cholesterol was creeping up and creeping up. In fact, one of her doctors wanted to put on a statin and her way of convincing her was, "Well, if you don't take a statin, how is your family going to feel when you have a stroke in a few year's time?" That's pretty heavy duty thing to say to someone who is 65.
Christopher: To a woman that's never had an event.
Steve: To a woman.
Christopher: She has no history of cardiovascular disease or anything like that.
Steve: No, no history. She was very, very worried about that. So, I said to her, "All right. Let's run your blood chemistry panel and we'll just see what the blood calculator shows up." So, we did that for her and, lo and behold, she had 100% probability of iron overload. Now, this lady had a hysterectomy at 34. It could just be that she hasn't had a period for now, what is it, 20, 30 years. They could just be an accumulation of iron because of that, we don't know.
Part of the treatment, because of that prediction, is that she's now starting to donate blood which is really great and we'll see how that impacts things. But the other thing that came up was she had a very strong probability of elevated LDL particle.
Going through Chris Kresser's course, so he interviewed Thomas Dayspring who's probably one of the world's leading lipidologist at the moment. He also had Peter Attia on. Both those guys are very strong in their opinion of LDL-P as a very good marker for cardiovascular risk. And if it's elevated that's something that they want to lower to reduce people's risk.
There's still debate whether just that alone is a good marker because there's probably cases where people have everything else in line and that high LDL-P may not necessarily be a risk but looking at a Adele's overall picture, she had that elevated LDL-P, she had the iron overload, her homocysteine also was predicted as being high. I think it was 88% probability of that being high. And her inflammation score was also high.
[0:40:01]
A lot of things in her picture that were red flag for me but three years prior she had been on a statin and this was before I had seen her. And when she was on a statin she didn't realize the side effects of statin but her memory declined so bad that she couldn't even do basic arithmetic. She couldn't add up. She couldn't spend a day or an afternoon in the garden and then go to yoga because of the muscular fatigue that she was experiencing.
Also, even at yoga, she was unable to just connect her mind and her body. So, thing that she used to be able to do with ease she would look at the instructor and try to do these poses and just couldn't get it together. So, the statins had a terrible impact on her. She really had all of the whole max of the side effects of statin. So she's really not very keen to try a statin.
And also she's not at the point where she wants to do a full functional medicine work up. It's just not quite where she's at and so I'm not going to say to her, "Look, we really need to do a full gut workup to see if there's some gut infection there that's causing the issue." It could be the case.
Christopher: Right. Hypothyroidism, secondary to something going on in the gut and then the cholesterol is just the symptom of all of that.
Steve: Yeah, that's right. As I went through Chris' course, the main risk factors for elevated HDL particle number was, number one, insulin resistance, not really showing up on her panel. Then the next thing was infections. Peter Attia mentioned how he had dental infection and his LDL-P doubled because of that infection that he wasn't able to get to straight away. Infection can absolutely affect that.
Gut pathology is another thing, environmental toxicity, which the blood chemistry calculator can pinpoint quite well. And then hypothalamus pituitary adrenal axis dysregulation is another risk factor which she has had a lot of stress over her life. That is potentially something. But then there's the non-modifiable risk factors such as hereditary familial hypercholesterolemia.
It was really interesting when I was talking to Adele about this. There's this Simon Broome criteria for familial hypercholesterolemia. She fits that pattern for a genetic variation. That could mean that she just can't clear low density lipoproteins from blood as well as other people. The total cholesterol needs to be over 290. Adele's was in the 300s. The LDL was over 200. I think hers was 228 or something like that.
And then there was the tendon xanthomas which are these like fatty deposits that people have around their joints. She doesn't have that but she did have a surgery a number of years ago and afterwards the surgeon said, "Oh my gosh, I've not noticed anything like it." She was full of these fatty cysts on the inside. She kind of does fit that criteria for familial hypercholesterolemia.
Both her grandmothers died of heart attack so there is a risk factor there for her absolutely. If she had just followed a low carbohydrate higher fat diet and just ignored what we found, I don't know what would happen. I can't say. But I would rather identify these things and see if we can change them ASAP.
Christopher: That was going to be my next question. One of the things I promise with this software was Tommy and Bryan in a box and I've delivered no such thing as far as we can tell. It still requires someone like you to do the interpretation and to figure out what to do which is, of course, what everybody really cares about. So, what can be done for this woman at this time?
Steve: Yeah. So, when I looked at Adele's picture, there's a couple of different things. Looking at, just if we're looking at the LDL-P number then there's a couple of different treatment approaches. If there is elevated LDL-P with inflammation and looking at Adele's score, her inflammation score was pretty high on the blood chemistry calculator.
I'm treating this as inflammation. So, there's a couple of things that I've suggested. First thing is more of a Mediterranean style diet for her, so not adding in the saturated fats to a diet. She's still going to be a on a lower carb way of eating, just cutting out the saturated fats and going more towards the monounsaturated fats is one thing.
So then we've put her on some B vitamins for the elevated homocysteine which is definitely a risk factor for cardiovascular disease. That's one of the markers. And I've also put her on a Thorne product which is Choleast-900. It's from the, is it the red rice extract? Yeast? Yes. So, it's got monacolin K in it which is kind of where statins -- That was the molecule they took out to make statins. It's virtually like a low dose statin therapy really without the side effects.
[0:45:01]
They did a study where people who responded poorly to statins were then put on this product and only 7% of those people who responded poorly to the statins had side effects from this product. It's a pretty good chance that she'll take that and not feel the negative effects. Vitamin B5 is another thing that I've suggested for her and then Ubiquinol for the inflammation and glutathione, whether she takes that in the form of creating fish broth and making sure she gets some of that tendons and cartilage in the diet. They're the levers that we're able to pull so that we'll do that, she's going to exercise more, commit a little bit more to her meditation and those sorts of practices. And after 60 days then we'll test and see, okay, where are we at with all of these markers? Are they going in the right direction?
And so her doctor is happy for her not to take statins and do this for a period of time to see if we can bring all of those numbers into some sort of reasonable range. That's really exciting and it's just a perfect example of how useful $138 blood chemistry panel can be when you've got this incredible machine learning ability to identify these different patterns.
Christopher: Yeah, that is incredible. So the total cost of testing is just what, two blood chemistries.
Steve: Yeah, that's right.
Christopher: That's amazing.
Steve: Yeah, really.
Christopher: That's amazing. And how is the -- I mean, clearly, your strategy relies heavily on behavior change there. Have you got any favorite techniques that you use to help people with behavior change?
Steve: Yeah, small steps is a good way to approach it for sure. I find that having this information through testing and then explaining to the person what the test results mean and then connecting those results to a behavior change that could then affect these results is probably the most powerful thing. That's where I'm at with that at the moment.
Christopher: So, this particular woman did want to see -- This is something I'd been wondering about. Should I be showing our clients this rather complicated looking dashboard, all of these knobs and dials on? And some of them, in fact, most of them absolutely love it and others rather intimidated by it. This is not a problem that's exclusive to the blood chemistry calculator. You could say exactly the same thing is the Precision Analytical DUTCH report. It's looking at hormones and all the different metabolites.
The first time you look at it, it's like, what is this? It looks really, really complicated and intimidating. But you found it better then to show people the report and have them understand it and then that way you get better behavior change?
Steve: Yeah, absolutely. There's no doubt that having that connection to the lab really helps people follow through with any suggested protocols. So, yeah, it really makes a difference. One of the things that I consistently hear when I do a thorough work up of someone and then I get the lab results back and then I sit down and I look at all of their symptoms and what's going on for them and then I tie them back to the labs.
There's a sense of, wow. Many times people have said, "Wow, I feel so relieved that there is something going on there." Because they've been through this process so many times of going to the doctor, getting the standard blood chemistry panel, the doctor is saying, "Yeah, everything is in rage. You're fine." But they still feel like crap. So, which is it? So, when they're able to see something that validates how they feel, they really feel the sense of relief.
So, yeah, I think that's the biggest thing. I'm still wondering about what are the best ways to help people through change? But I find that this really works quite well, just having the results and tying them to the health picture and then supporting them through that change.
Christopher: Yeah, absolutely. I'm looking at this woman's predicted age and it's higher than her chronological age and if she jumps through some fiery hoops like donating blood as I did quite recently and then you redo the blood chemistry and the algorithm thinks that your blood now looks, and I use looks in inverted commas, younger, then you're going to be stoked about that, right? What I'm doing is working. That's a really good thing. I don't think there's really anything else out there on the market, at least not of this price, that can give you that type of feedback.
Steve: Absolutely. And when the test result comes back and her LDL-P number, the probability of that being high is reduced, that's probably going to be the biggest thing for her because when the doctors told you you're going to have a stroke you're very worried. That is the one thing that will make the biggest impact on her, saying those markers for inflammation and cardiovascular disease trend in the right direction. That's really what -- I don't think she'll care so much about her age score much as her cardiovascular risk going in the right direction and she just doesn't want to take a statin if at all possible.
Christopher: Have you talked to her about getting a coronary artery calcium scan? I mean, that was my takeaway from listening to Ivor Cummins and Jeff Gerber and other experts too actually.
[0:50:03]
I mean, if you really care about your cardiovascular disease risk, you should stop messing around with cholesterol and get yourself into a CT-scanner and look at the disease directly. Have you talked to her about that? Is that even possible in Australia?
Steve: Yeah. I have spoken to her about that and her doctor also is on board with that. The first step will be to make this lifestyle dietary changes with a little bit of, as you would say, bespoke supplementation and see how that impacts her and then if we can't make too many inroads in that area then, by all means, she'll go and have calcium artery score done and she can truly asses her cardiovascular risk and then she can make her own mind up whether or not she feels like she needs to go on statin therapy or not.
I feel there's a lot of work that can be done well before going on a statin therapy. So, to me, gosh, if there's other work that can be done why not do the other work, get to the root causes.
Christopher: I take it she's getting plenty of sunshine? Is that always a given for everybody in Australia?
Steve: Yeah, yeah, lots of sunshine here. She loves to walk. She's got lots of animals so she's walking the animals out in the sun. She gets plenty of sun.
Christopher: That's good. Let me put you on the spot and ask you how can I make the software better?
Steve: Yeah. I think what we should do is just have Tommy hooked up to the internet 24 hours a day, Tommy Wood and Bryan Walsh, and then whenever blood chemistry report comes through and there's predictions then we can just go straight to Tommy or Bryan and say, "Okay, what are the protocols that we need to implement here? Tommy, what do you think? And also what other test should we follow up with?" That would be brilliant.
So, if you could have a machine learning algorithm that based on the predictions could then predict what would be the most useful follow-up test and what would be the most useful approach to treatment then we wouldn't have to think. We could just be drones. Actually, I probably wouldn't enjoy my job so much if you had a machine that took care of that side of things for me, so maybe not. That's kind of where the interest is.
Christopher: Exactly. It's like Ken Ford said on the podcast recently. Is this something that's going to improve the human condition or not? And Ken talked about the wife kissing robot. I mean, theoretically, we could do it but that's my job, right? I thought that was a really beautiful metaphor. Maybe there will be a what to do about something but I worry that we're going to then import our bias.
So, if we have certain things that we like to do at Nourish Balance Thrive, well, that's not necessarily what you, Steve Anderson, like to do as a practitioner. Maybe your way works better or maybe it works better for your particular type of person that you work with. And so I'm not sure about importing our bias just yet. But we'll see what happens in the future.
Steve: Yeah, that's right.
Christopher: So, if I'm listening to this and I'm in Australia, am I right in thinking that I can come to you and order a blood chemistry and then potentially you could talk to me about the report?
Steve: Yeah. I thought about this before coming on the show and what I did is I set up a web page for people who are listening to this podcast. They could just go to my web page, which is stephenanderson.com.au/nbt. What I've done is I've set it up where they can purchase a blood chemistry report. From there, they would just need to fill out a very brief health intake form and then I will send them a requisition form where they can just take that to the lab and they pay the lab directly $132 and then within a day or two I get the results back in my portal and can then run the results through the blood chemistry calculator.
So, your listeners are pretty switched on listeners I know. Some of those people may just want to get the blood chemistry calculator report for their own information. This is where I think the value of what you're doing is just so phenomenal. There may be people out there that are on, when we talk about that pyramid that Chris talks about, they may be on that bottom tier where they're starting to tinker with their diet and lifestyle and those environmental factors.
And they may just want to get this report so that they can look at their predicted age and their health score and make changes and then follow up and do another test and see that those changes are having the desired effect. That's someone who really just wants to track their own health. So, I'm more than happy for people to just get that report go, go away and do whatever it is that they want to do or consult with their allied health professional, doctor, maybe, maybe not.
There's that option. I put that option there for people. If they get the report and I think, "Oh, jeez, I don't even know what to do with this," then there is an option for them just to contact me and we can arrange a consultation where we just spend an hour going through the report. And if I was to do that I would have people fill out a fairly comprehensive health history and metabolic assessment form so that I could get a clear picture ahead of time as to where they are health wise so that I could actually tie that back to the report.
[0:55:12]
Rather than just looking at the report in isolation, I'd rather some context. That's a little bit more involved, that process. So, wherever people are on that spectrum, I'm more than happy to accommodate them.
Christopher: That's awesome. We can't do that at the moment. I'm too expensive. I have all these expensive people. And I think they do a wonderful job but it means that we have to run a $10,000 program and I realize that the $10,000 program is not for all of the people all of the time. So, having people like you that are just willing to do an hour for a discovery session I think is absolutely amazing. I will definitely be sending people your way.
Steve: When there's an hour discovery session, there's usually about probably two and a half hours involved to be clear. So, I'll send people the forms then I'll look through the forms and start to think about what's going on and then I'll meet with the person and work through those forms and clarify any of those answers and then look at the blood chemistry result and tie that back to that.
And then, of course, I'm not just going to like leave it there. I need to put together some sort of action plan. Okay, well, these are the one, two, three, four steps that you most likely could benefit from. So, you put all of that into a document and send it to them. It's not just one hour. Just people are mindful that it's a little bit more involved than just getting together and chatting about the results. That's fine but I'm more in the camp of having a thorough look at things so that's where I'd like to focus if people do want that.
Christopher: I'd been thinking about that a lot lately. Would it be better to do our consultations as quite often as a teaching component and then there's question and answer component? Do you really need the client to be present at that time listening at 1x for the teaching component? Could you just record a video and then send that to the client and then the client looks at it and then they come up with a bunch of questions?
Maybe they pause the video and they write down some questions and then they organize their questions and then when you meet for the one on one consultation via video conference, the client is then armed with their list of questions and the whole consultation process becomes more efficient that way. I've not really tested it out to the fullest extent so I'm not really sure at this time.
Steve: That's an interesting idea. That would be using screen catcher software looking at the results.
Christopher: Exactly.
Steve: Okay, yeah. That could be a good way to do it, actually.
Christopher: It's something to think about in the future.
Steve: That could be.
Christopher: Well, I will, of course, link to everything that you mentioned in the show notes. That URL again is stephenanderson.com.au/nbt. Is there anything else that you'd want people to know about?
Steve: Not really. I do have a podcast called the Holistic Practitioner podcast.
Christopher: The Holistic Practitioner podcast is fantastic.
Steve: I started off wanting to do one podcast a week but it hasn't worked out that way. One of the things that I've decided is that I want to have people on the podcast that I'm really interested in speaking with. If that happens, that happens. And if it doesn't happen, I'm okay with that as well. So, I'm not going to try and force the episodes just so I have an episode. I think when the urge comes and I really want to speak with someone about a topic then I just have them on. That's how it turned out so far. Maybe that's an excuse for me being slack, I'm not sure.
Christopher: No. I know exactly what you're talking about. It's just like dating. It doesn't work as well when your mom tries to set it up. I get all these people reach out to me saying, "Oh, you should really interview this doctor to your podcast." I think you're probably right but until I discover that person for myself it's not happening.
Steve: Yeah. That's about it, really. So, yeah, I'm just working away in my practice, got a very busy acupuncture practice and then help people with functional medicine via Skype or whatever software we use at times. So, I've sort of been helping people, different ends of Australia doing that functional medicine work.
Christopher: Well, Steve, this has been awesome. Thank you so much for your time. I really appreciate you. Thank you.
Steve: Oh, no. Yeah, it's my pleasure. It's great to be on your podcast. I've been a fan of it right from the start. Yeah, it's quite a thrill being on your show. Thank you very much.
Christopher: Thank you, Steve.
[0:59:11] End of Audio
© 2013-2024 nourishbalancethrive