Written by Christopher Kelly
April 12, 2024
Chris:
Hello and welcome to the Nourish Balance Thrive podcast. My name is Christopher Kelly. This week I'm delighted to present to you Deborah Gordon. She is the founder and medical director of North West Wellness Center. She has a lifelong interest in health and wellness which is incorporated into an integrative medical practice in Southern Oregon for over 30 years.
She is dedicated to finding lifestyle choices that can prevent and reverse health problems, avoiding medications where possible, and using them wisely where necessary. For the last decade she has worked with a particular focus on cognitive health. On today's podcast Deborah talks about mold and mycotoxin illness, bone health and hormone balance. She elaborates on the precise tests and approaches to diagnose and manage mycotoxin illness, assess bone health, and explore hormone replacement options beyond estrogen and testosterone. She also highlights the potential risks of assessment of vitamin k 2 intake, supplements that aid in mold detoxification and bone density enhancement and the best way to monitor kidney function while supplementing creatine.
Deborah, thank you so much for joining me this evening. It is in Lisbon, Portugal. Whereabouts are you?
Deborah:
I'm in Southern Oregon, and it's morning, midmorning.
Chris:
Well, thank you so much for taking the time. I was just trying to think when I first met you. I think it might have been at the Ancestral Health Symposium in Berkeley in 2014. Does that sound like it might be right?
Deborah:
No. I actually think I met you first at Physicians For Ancestral Health in Scottsdale, Arizona.
Chris:
Yeah. You see, I've been stalking you before that. I'm pretty sure I saw you at HS before that. But that you're right. I think that might be the first time I plucked up the courage to say hello.
Deborah:
Yeah. Because I'm so scary.
Chris:
No. You're not, like, probably the least scary person I know. I really enjoyed that Physicians For Ancestral Health then, and I felt like I was very lucky to be there because, obviously, I'm not a physician and you let me in anyway. I do like these technical talks, and I remember you gave a talk there that was it was a very provocative title. Do you remember what it was?
Inhaled Alzheimer's. Remember that talk?
Deborah:
Oh, so that would have been my an earlier talk than the mole talk. But I did do a talk. I don't remember the title of it, but it was going through doctor Bredesen's initial release of his suggested protocol for treating Alzheimer's.
Chris:
Okay. Well, I mean, let's talk about I'm really, like, very curious to know how all this has panned out for you. So the talk you gave at the Physicians For Ancestral Health Symposium, I'll link to that on YouTube so people can watch it, was given in 2019. And it seemed like then that mold, mycotoxins, water damaged buildings was like a huge deal for health in general and in particular for neurodegenerative disease. I'd love to know how all this has panned out for you 5 years later in your practice.
But before you tell us any about that, can you explain to me and the listeners what is the problem? What is mold? What is a mycotoxin?
Deborah:
Great. And, good question because those are 2 separate items, and it's important to keep those clear when you're talking to patients. So mold, we, you know, we've all seen mold. In fact, I did a science project on bread mold, like, when I was in the 3rd grade. I mean, we've all seen mold and figured we should throw it out.
And some of us have probably even seen black crumbly stuff on the bottom of showers or bathrooms or kitchen plumbing fixtures. And someone will say, oh, that's mold. And mold in and of itself you like mold on your food, you cut it out. It's not a problem. We eat mold when we eat blue cheese.
That's not really a problem. But there are some molds that become essentially airborne in their efforts to reproduce. So when a mold reproduces, it sends out a spore, and the spore is looking for a welcome home, but it's prepared for pushback. And the way that mold spore prepares for pushback is by coating its surface with a toxic molecule called a mycotoxin. And if you just inhaled a mold and it didn't have a mycotoxin on it, your immune system would probably handle it and say, get out of here.
This is Chris's home. We're not gonna let you set up housekeeping here. And the thought is that even with that mycotoxin coating, about 3 quarters of us do pretty well if we inhale or ingest mold and more specifically mold spores that wanna set up residence in our house. So the mold is living somewhere. The spores go out.
They're coated with mycotoxins. And we refer to mold illness primarily as mycotoxin illness because those coatings on the mold spores are what serves to be inflammatory in the host location where it lands.
Chris:
Okay. So just
Deborah:
Mycotoxin illness more than mold illness.
Chris:
I see. That makes sense. And so just because I see visible mold doesn't necessarily mean there's a health problem. So for example, today, I was in the gym in Lisbon for the first time in a long time in the gym, and I'm doing bench press. And I look up at the ceiling, and then there's a pipe, a water pipe, and I can hear water running through the pipe.
It was raining pretty hard today in Lisbon. And then the black mold and sort of bubbling of paint around that pipe was completely terrifying. But just because I'm seeing that doesn't necessarily mean there's a health problem. Is that correct?
Deborah:
That's correct. And I like to put it you know, I like to tell corny jokes when I'm seeing my patients. So I say, you know, 4 people walk into a moldy bar. You know, that joke about what happens when you know? So 4 people walk into a moldy bar, and one of them says, oh my god.
I've had mold before. I can smell the mold in here. This is terrible. I have to leave. I'm sneezing.
My nose is congested. But 3 people say we don't notice anything. And of those 3 remaining, probably only one of them is gonna have trouble fending off whatever mold they're inhaling at the bar. So it's somewhere between 1 third and one quarter of us that are actually should get out of that gym if they're doing a bench press and see the mold over their head.
Chris:
He was also I've been doing Brazilian jiu jitsu, and downstairs, they have a mat. And that reeked of mold as well.
Deborah:
So I would guess that if you have the ability to smell it and then carry on with your routines, you're probably one of the lucky ones. You know, you've traveled a lot. I'm sure you've stayed in a moldy bedroom.
Chris:
Yeah. And it it seems okay. I mean, this is kind of maybe getting ahead of ourselves now a little bit, but I know there's a test for visual contrast sensitivity that you can do. And I did that recently and failed pretty abysmally. And then I looked up some results from 2015 when I first did that test, and I passed it with flying colors.
So it did make me wonder.
Deborah:
Yeah. So there's two ways to fail it. You know, there's failing it on the left hand. So this is the visual contrast sensitivity test, and anyone can take it. Vcstest.org.
And if you don't wanna keep your results, I think it's still free to take the test. But it's nominal fee if you wanna keep your results as you did for your earlier test, which is a great idea for comparison. But, you know, you fail on the left hand side of the test, and it's nutritional. And you fail on the right hand side of the test, and it's thought to be more complicated, but not necessarily mold.
Chris:
Interesting. So you're not talking about the difference between the left eye and the right eye. There's something No.
Deborah:
You know, each test gives you a kind of mountain shaped
Chris:
Yeah. I know.
Deborah:
Diagram. And if it's on the left hand side of the diagram, it's thought to be nutritional. You're low in vitamin a, or maybe you have I see. You know, something. But if it's on the right hand side, something's affecting your visual contrast sensitivity, which could be mold, but could be you've got something going on in your retina that is showing up over there.
Chris:
I see. Yeah. So Laura Paling was on the podcast recently. Her PhD is on the gut microbiome, and, we suspected that she's been exposed to some water damaged buildings, and she did the test also and also failed, as did her partner, who's only 28. He failed it.
And then we thought, okay. There's, like, something up with this test. Maybe they changed it or something since 2015. So I've got my wife, Julie, to do it, and she passed it with flying colors. We're like, oh, Karen.
Deborah:
It probably was legitimate for your state at the time, but what caused it is not clear. And whether that's going to be a transient or a permanent state is not clear. So you you should do it again in 2 weeks.
Chris:
You know, you might say,
Deborah:
oh, that was a blip.
Chris:
Okay. Alright. Okay. So And
Deborah:
if not, I'll expect an email or a call from you in 3 weeks. It's meant
Chris:
it's meant to get on your 2 year waiting list at your at your practice. I mentioned briefly that inhaled Alzheimer's. But what health problems do mycotoxins cause in humans?
Deborah:
Mycotoxins really can cause anything. So the talk that I gave at the Physicians for Ancestral Health Talk Conference was mycotoxin illness, the great oh, em no. What was that TV program where somebody could always masquerade as somebody else?
Chris:
The great imposter.
Deborah:
The great imposter. So I say mycotoxin illness is the great imposter. And by the way, to those of you listening who occasionally have word finding difficulty like I just did right then, knowing that I would come up with it myself in the next 5 or 10 minutes, but you helped me out sooner, does not mean I have Alzheimer's disease. It means I have a very full file cabinet, and I didn't shuffle through it quite quickly enough.
Chris:
Do you
Deborah:
know what?
Chris:
I get that all the time. Like, I can't like, I feel like I'm never gonna remember the name of that. It's like, I know that I used to know that name, and I'm never gonna find it. And then talking around the topic, and then 10 minutes later, it comes to me. You think that means you've just got a very full filing cabinet?
Deborah:
Yes. You have a very full or what's it called on a computer? And this is not like, I don't have the words. Like, I don't have the computer expertise. There's what you can do and what you can work with right now, and then there's what you can store on your hard drive.
So whatever that RAM, is that what it is? Yeah.
Chris:
That's right. Read only memory versus, like, more persistent storage on disk that could be Yeah. A number of technologies. Yeah. More persistent is Right.
Ephemeral versus persistent perhaps.
Deborah:
Yeah. The more full life you lead and the older you are, and I've got a few years on you, the more likely what you're working with on a day to day basis is limited. It is probably a little bit less than, you know, decades ago, but it doesn't mean we're getting Alzheimer's disease.
Chris:
Okay. Well, that's good.
Deborah:
Okay. So but alright. So mold illness. Yeah. Mold illness is really it's a great imposter, and I see it much more frequently, you know, since cognitive impairment is a big part of my practice.
But I try it also, and I've seen it aggravate people who had chronic fatigue, fibromyalgia, who have had long COVID, who you know, if I had a autoimmune disease or internal medicine practice, I would have to start nudging myself to test for it in more people because it can show up in anything, you know, sleep disturbances, shooting pains, chronic pains, inflammation, digestive disturbances. You talked about You keep calling her Laura Mailing. How come I think of her as Lucy Mailing?
Chris:
It's 2 different people. That's why. So there's Laura it is confusing, isn't it? I was in Costa Rica. I lived in separate buildings, but, you know, together, seeing them on a daily basis.
Lucy Mailing, who's been on the podcast a couple of times, she has a PhD in the gut microbiome. And Laura Paling
Deborah:
Oh, Paling.
Chris:
She also has a PhD in the gut microbiome. I'd love them both there sat next to me. So if you, like, had any gut questions, between the 2 of them, they definitely had it covered.
Deborah:
Okay. Yeah. I definitely refer to Lucy a lot and think of her when I have my sauerkraut for breakfast every morning.
Chris:
That they were both women were huge fans of fermented vegetables, I have to say.
Deborah:
Yeah. Okay. So it can cause gut problems too. But I will say the first time I ventured into it was for cognitive impairment, and then it was a big part of the clinical trial I did with doctor Bredesen that I talked with you about earlier, and it continues to be a big part of my clinical practice with people with cognitive impairment. And like so many other things, there's a primary care level of confronting a problem.
And I am a big advocate that primary care doctors should learn the basics of mold, should learn the basics of treating osteoporosis, should learn the basics of managing hormone therapy, and not just say, oh, you need to go see your gynecologist or I don't do that. I've never heard of mold. I'm not sure it's real. There's a lot you can do in the first steps. And if you turned out, Chris, to really actually have a mold issue that showed up in your visual contrast test recently, you'd be easy to treat.
If somebody has had it for years and continues to have an exposure, you know, you move around a lot. There's clearly not one exposure that you live in all the time that's done this to you. And it's probably not your house since your wife does it as perfect. Although, as I said, some people withstand it really well. So I haven't been able to apply it in as many noncognitive settings as I think it deserves just because I don't see that many patients with that illness.
I do have a patient who has a chronic pain syndrome around his jaw with a resulting chronic fatigue kind of fibromyalgia picture. And he's been my patient for about 20 or 25 years. And so I recently did test him for mold, and he had a little bit of mold. And that's a judgment call. Does somebody have a little bit of a hazardous mold, a little bit of a pretty transient mold, or something that's more meriting intervention?
Chris:
Well, I was gonna ask if you could tell us any stories of patients or case reports, I guess, you might say, of, you know, people that have come in with, like, problems that looked like they might be some sort of neurodegenerative disease like Alzheimer's and and you figuring out that, actually, they were exposed to mycotoxins and what happened about it. You did talk about one case in your Physicians for Ancestral Health talk. I don't know if you can remember this.
Deborah:
I do.
Chris:
You just had the initials, SM, 51 years old, Not self, unable to work, organized, weak. Numbers, there's a lot of abbreviations, medical abbreviations here. Sleep disrupted. Do you remember all that?
Deborah:
I do remember her. And mostly, I remember her being walked in by her husband because this business owner, entrepreneur, and I don't even remember what she did, but she works in the bigger town in our valley. It's almost a city. And she couldn't answer the phone. She couldn't keep up with anything.
And so they thought she had Alzheimer's because she has the APOE 4 gene, which puts people at about double the risk of having Alzheimer's. And they came in, and we talked. And I believe we did some testing. I'm not sure how I got the thought. Maybe he actually mentioned that they had some mold exposure.
And I started out with them by saying, oh, you know that? I've just recently learned about mold. It can be a huge complicated topic. I'm not sure we're gonna go there, but I'll just test you for it. And tested her for mold.
And so what the test is not actually testing for mold. It's testing for the mycotoxins, the coating in the spores that presumed resident mold in your body is throwing off. And we test by looking at the urine. And, there's 2 highly reputable, respected urine tests. There might be more now, but I'm pretty happy with Great Plains Labs and real time mycotoxins and the latter being covered by Medicare and that being my patient demographic.
That's what I usually do.
Chris:
That's interesting. I also found out the Great Plains is renamed to Mosaic as well.
Deborah:
Oh, that's right. And, yes, and we should call it by its proper name. Yeah. It is for Okay.
Chris:
And I I've got a colleague, Elaine. He makes phenomenal show notes for the podcast episodes. So if you, like, wanna find any of the things that Deborah's talking about here, you can find those in the podcast show notes. We link to everything.
Deborah:
And Elaine should reach out to me if I say something obscure that needs my detective work rather than hers. But, yeah, it does do really good show notes. So we tested this woman, and, yes, she did have mold. And we started treating her, and her husband took on the job of looking for the mold in their house. And they had evident mold in their house, but they also had hidden mold in their house.
And if you remember, we talked about at the Physicians for Ancestral Health at that talk, mold became more of a problem in the last 40 or 50 years when we developed the building intervention known as Sheetrock, because that beautiful looking wall in my dining room could be tracking water between the outside wall and the inner wall and mold could be growing in there, and I would never know it or see it.
Chris:
Yeah. That's terrifying. Yeah.
Deborah:
Yeah. It is terrifying. So there's diagnosing mold in the person, and then there's diagnosing mold in the house. This woman's husband took it upon himself to have a high index of suspicion and began tearing out walls in the garage and found out their exercise room, garage room, shared wall was riddled with mold inside. So he treated the house, and I, you know, told him to wear a respirator, but I would never have suggested a mold patient themselves do that.
He was not affected. He was fine. He was completely cognitively intact. They lived in the same house. And this might have something to do with her APOE4 gene, which I'll get back to that.
But we did pretty much the basic level of mold treatment, which means how are we going to get the mold's attention, and how are we going to cut it off where it hurts? And we want the mold toxins, which are the reproductive forces of the mold, in circulation. And we do that with having people take saunas and people take higher dose of fish oils because the mycotoxins are fat soluble. And then we want the people to actually pay attention and get those mycotoxins out of the body. And we do it by turning up the detoxability of the liver with extra glutathione.
We actually have them take oral charcoal clay combinations that work as binders and even some prescription versions that will bind the mycotoxins. And if somebody has it pretty recently, you can do this combination of binders, supportive supplements, sauna. Far infrared sauna works a little bit better to get everything going. And you get rid of all the mycotoxins and you starve the mold of its ability to reproduce. And some molds in some people, that's all you have to do.
And for her, that was all you needed to do. So her husband came in to give me a follow-up and said, you know, she's doing much better, and this is where I found the mold. I thought you'd wanna be interested. And I said, well, I'd like her to come back for a follow-up. You know, I wanna sort of see how her brain works.
He says, good luck getting her away from her work. You know? She missed months of work, and she's catching up and working full time. So I've had a couple more phone calls with her, but I've never seen her in person again. And she knows where I am.
Chris:
So Sounds like a good problem to have.
Deborah:
Yeah. It was a great problem to have. She was so busy. She didn't have the time to come in and have just a doctor's appointment for something she knew she didn't need anymore.
Chris:
Wow. That's amazing. Congratulations on that. Good for you for thinking to look. I'm sure a lot of primary care doctors would have not thought to look
Deborah:
as Right. Well, there's an organization called ISEAI, ICI, International Society For Environmentally Acquired Illness, and they're an incredible group of serious experts to whom I would refer and have referred. And I'm a member of that, and I've heard their presentations. And I know here's my level of what I can handle because I'm also handling all this other stuff for them. But if their mold persists and we can't easily eradicate it with mycotoxins and a few prescriptions that might actually address the mold itself, Antifungals.
We use antifungals to get rid of the mold that we only presume lives in the body. See, this is what gets really complicated. You fail that visual contrast sensitivity test you took. We can presume maybe you have mold, but we have to do a urine test. And the urine test, you have to prepare yourself and take it right correctly.
You have to exercise the day before and not take anything like charcoal or clay that could, you know, be binding it up somewhere. So the process of figuring out whether or not you have it and how much you have oh, you just have one mold. So most of these tests test for about 5 molds, and 2 of them are pretty common in foods. So if somebody comes back and they just have a super high level of ochratoxin, ochratoxin. Just be transient and not to worry about.
So we have to figure out if it's really bothering them, And we can figure it out with your visual contrast sensitivity test, but that's not reliable for everybody, as I suspect it's not reliable for you, for mold. There are blood tests that have to do with brain inflammation. Sometimes we're just really stymied. Gee, you you look a little bit affected by the mold. We're not sure.
I know. Go to a mold free place for 2 weeks and see how you feel. And that's the best diagnostic criteria. If the patient really says, no. When I'm in my house, I can't be in my house.
You know, that I can tell it's not good for the way my brain is working. And then, you know, if you've gotten it early enough, it's amenable to what a primary care doctor should be able to do. Treat the binders, get the body capable of eradicating its own mold problem, and going on from there. And if you can't do that, you need people who are willing to dive more deeply into the weeds, look for other molds, help the people with detailed evaluation of their home. There's a great group, Environmental Analytics, that will actually go on a cell phone video tour with you of your home.
Say you decide you really do have something and somebody puts a bug in and they think it's in your house. You could walk around your house with a cell phone and show it to these engineers, environmental engineers. And they would say, if there's any bad place in your house, it's under that kitchen sink. This is what literally happened to a patient of mine. She had her kitchen rebuilt.
I treated her for mold. It just kept persisting. But she did not use these analytical engineers on a video consult. And they said, well, I know you fixed it, but we're pretty sure it's still under your sink. And this is how you can do a do it yourself at home test to see.
And sure enough, even though she'd had her house fixed by the local mold experts who are not really at the same caliber as some of the health oriented mold experts, she had mold back and had to re remediate it.
Chris:
Interesting. And how much do you worry about this causing a tremendous amount of stress, especially financial stress for the patient. It seems like kind of hard to reconcile that. You know, like, when people are so worried about the building they're living is poisoning them.
Deborah:
I worry about it a lot, Chris, because there's some remediations that have cost people 25, $30,000. So I think it's worth really making sure that it is coming from the house and not one of these just food transient exposures. Or I've had people that I'm positive their exposure is not current. That happened they know when they lived in a moldy home. They know they've not been well since then.
But they left that apartment in San Francisco. And they've been up in Southern Oregon for 5 years, and they're just not getting fully well. So I do my best to mitigate the worry about their homes. But if it is their home, the saving point is that real estate remediation is a lot cheaper than health remediation.
Chris:
Yeah. That makes a lot of sense. And is there anything out are there any particular types of home or areas that are of greater concern to you? You mentioned San Francisco there that's famous for its summer fog. And, obviously, I well, not obviously, but I live in the Santa Cruz Mountains, which is a rainforest.
It's, like, super foggy up there. It's, like, obviously damp. But it's also kind of arid and dry during the day. So maybe it has a chance to dry out. And then, of course, there are other parts of the US like southern Texas that relies heavily on heating and air conditioning all year round.
And you do have to wonder about how well these systems are maintained and what would happen if, you know, mold were to get into those and then it's constantly recirculate. But I'm just wondering. I'm sort of putting words in your mouth. Is there anything in particular that you worry about when it comes to either the location or the type of building?
Deborah:
I don't think you can presume. 1 of the ICI experts practices in Arizona, and she says, oh, great. A dry climate. Wonderful. But that means builders don't take this kind of mold moisture sealing precautions that a modern builder would take in the Santa Cruz mountains.
So the ideal place that you live is somewhere where it gets enough rain that they're building homes to try and seal out the rain, but not enough that your area gets flooded. I mean, the whole southeast of the United States, I have to worry that they're affected by mold.
Chris:
Yeah. Honestly, Costa Rica was pretty terrible as well. I think about it in the jungle. You know, we opened the kitchen cabinets is when we first moved into the place. We're like, oh, god.
Like, it's like the smell of Walter's hits here. And you're like, oh, no. But how could it be anything else? You know, it's like the jungle. The wet season is insane there.
Deborah:
Right. So somebody was saying that, they stayed in a palapa in Mexico and they were worried because the bamboo roof over their patio seemed infested with mold. And they just switched to it. They switched to another one where they just changed the roof because it'd been disturbed enough. And that's the best way to remediate is if all your building structures are annually replaceable.
Those don't live that way.
Chris:
Yeah. That's right. That's a good point. Yeah. I did see that in Costa Rica too.
The Rancho and the Ogechala and whatnot have, like, basically disposable roofs that they replace quite regularly.
Deborah:
Yeah. And it really is sheetrock that's a problem. So
Chris:
Yeah.
Deborah:
It sets
Chris:
her forever.
Deborah:
In the clinical trial we did with doctor Bredesen, I did have one patient, and they lived in a place here that they thought had mold damage. His wife had absolutely no problem. He had other issues that we fixed, but we thought he had a continued mold issue. But they also wanted to move to Portland. So, you know, they had a real estate inspection that cleared the house for mold, which I would have advised him not to stay in that house.
And he didn't, and he moved to Portland. And probably most people, 3 quarters of people moving into his home are going to be fine. But if anybody's moving to his home because they've had mold illness elsewhere, anybody who's had mold illness needs to carefully check out the next place they live.
Chris:
And tell us about the supplements you've been using. So I talked to a client recently. They've been working with my colleague, Megan, and he gotten great results. He was failing the VCS test before, then did some nutritional supplements, including binders like you mentioned. Got much better.
Did the VCS test again. He was also doing urinary mycotoxin testing. I'm hoping to get him on the podcast to talk about all this, but he got better using just the nutritional supplements. But I know the physicians are possibly more commonly using prescription meds like cholestyramine?
Deborah:
No. Not necessarily. In fact, cholestyramine is not as effective for the water damage mold. How I pronounce the category of water damage molds that show up frequently in the real time mycotoxin test, the one that's covered by Medicare, is tricosacines. I'm not really sure how you pronounce it.
And the standard advanced mold protocol has included prescription cholestyramine or Wellcol, But chlorella works better for tricofacines. This ICI group that I keep referring to. And if you'd like, I can introduce you to somebody if you're interested in having somebody on your podcast who's you know, I'm the primary care doc. They are the expert. They're actually, I know somebody great who you could speak with.
They continually are testing and reporting their experience. So while I use cholecyramine early in my mold career with all the molds, now I know that there's some molds for which that works really well. And the water damaged building mold, I'm better off giving them chlorella. We always start out with fish oil, glutathione, saunas, and then move on to some form of charcoal and clay. And some people can't tolerate that, so you do other kinds of fibers.
You can pick almost any type of fiber supplement. And if it's changing your digestive health and changing what your bowel movements look like, it's probably working for binding your mycotoxins and carrying them out. So people who get digestive upset with clay or charcoal, we move on to UltraFibre Lean. I can't remember the name of it. I'll look it up for Elaine for the show notes.
That's recommended as a pretty gentle one you just get on Amazon and is more gentle on the digestive system for very sensitive people. And this is an important point. This requires a lot of people's digestive system. So if somebody comes in and we suspect they have mold, but they also have some irritable bowel, I'm gonna do my best to sort that out before I start putting charcoal and clay and high dose fish oil in their intestines.
Chris:
Well, cholestyramine is famous for being constipating. Is it not?
Deborah:
Yes. So,
Chris:
you know, we've got
Deborah:
a whole list of what you can do if the cholestyramine constipate you. And, you know, this mold treatment ends up being so individualized. So I have a handout I give people that I modify for each person depending on what their molds are and what kind of treatment we're gonna use. But I think in big bold colors, like, 3 times in the handout, it's do not let it make you worse. Because remember I said your point in treating the mold is to take down the mycotoxins without really pissing off the mold and making it double down, try harder to reproduce.
Kind of like Lyme disease. You kind of want to sneak up on it, disarm it, and see if you can starve it. Rather than bumping it on the head, it's a living organism. It will do its best to survive.
Chris:
And how often are you seeing problems, like, concurrent with chronic respiratory symptoms, shall we say, since COVID. I don't know whether this is everyone's paying more attention to it now than before, but I know a bunch of people that have had a cough or a cold that, like, they got in 2021 and, like, things have been the same since. Do you know what I mean? You know, even my son has been coughing a bunch recently, like, for months, and he's got this, like, postnasal drip. It's worse when he's sleeping, you know, when he's prone.
And I worry about taking him to jiu jitsu because, you know, oh, god. You can't possibly show up for something like that if you've got a cough. And then, you know, he's on the mat, and about a third of the children are coughing exactly the same way. Like, what's going on here? Like, it and it's like a bunch of people I know.
Do you are you seeing the same thing? Do you think it's got anything to do with sensitivity to mold?
Deborah:
I am seeing a bit of the same thing, and I don't think of it so much as mold as having learned something from both mold and COVID that overlaps. And it's something we've learned from managing gut health over the years. If one of these infestations, whether it's a viral a particle from COVID, or a mold, is a living organism. It's gonna try and withstand what the body throws in its way, and it's going to shield itself with some sort of a biofilm. So take using a biofilm disruptor, sometimes it's all the body needs, and then the body takes care of it.
So for instance, for a chronic cough that might be from a postnasal drip, the first thing I would suggest is that over the counter nasal spray called Exelir because, surprisingly, xylitol, which is, you know, in chewing gum as a sugar substitute and wreaks havoc on some people's guts, so you have to be careful. Xylitol, that excellular spray, can break up a nasal biofilm and then either just saline or swimming in the ocean. That's what he needs, more swimming in the ocean, your son. Yeah. He
Chris:
does do a lot of swimming in the ocean. Yeah. It's funny you should say that because I have been sitting on him and squirting this, like, one of those xylitol sprays up his nose. I'm not exactly sure what brand it is. Laura gave it to me actually.
He absolutely loves that. As you can imagine, it's like our favorite thing to do together. But yeah.
Deborah:
I bet. So, dad, do it again now.
Chris:
Okay. Well, that's been super helpful. Is there anything else about MALT? I really wanna pivot and get you to talk about osmopenia, ensarcopenia, and hormones, like and again, we can just do this sort of 60,000 foot view of that topic because obviously you don't have time to go into it in detail. But is there anything else I should have asked you about, Moe, before you give us a sort of a teaser, shall we say, of the next topic?
Deborah:
I'd encourage people to know that particularly if they're older, they can get this and if they're not older, you can test your you can have a high index of suspicion for mold. The urine test is not prohibitively expensive if you're doing it yourself through some provider who knows how to order tests or have you order them for yourself. And as you just said, you can take this visual contrast sensitivity test. And if you pass it with flying colors, it's not a clean bill of health because some people's visual contrast isn't affected. But it is an illness that each person should remember because, of course, you are your first physician, and I'm only here as your second consultant.
And it's for me to remember too. And it's good to talk about it with you like this, Chris, because I'm in the process of accepting new patients again. I have Are you really? Oh, wow.
Chris:
I wasn't even gonna ask. That's why I'm glad you mentioned it.
Deborah:
Yeah. Megan actually sneaked the first one in. Great patient. Thank you, Megan. And I've realized, oh, I'm not gonna retire.
So I'm accepting appropriate patients for me, which means cognitive impairment, which means always checking for mold, bone health, and hormones, and all those 3 go together.
Chris:
I see. Well, I'm glad you mentioned it. I will, of course, link to your practice in the show notes. Talk to us about because I can note just our conversation offline in email. It seemed like you were very excited to talk about osteo and sarco and hormone and protein and hormones.
Can you expand on what you said in email? Obviously, email is very terse and I'm not exactly sure what you were getting out there, but I'd love for you to expand on that.
Deborah:
Thank you for giving me this opportunity because bone density has been an interest of mine as long as I've been interested in prescribing hormone replacement therapy for older women, which has really been the last 20 years. Because kind of unexpectedly, I've seen bone density improve. So I was taking what I consider a kind of kindergarten approach to it and telling people, hormones are really good. They're really important for bones. Let's replace your hormones.
We'll fix your bones. And in the last year or so, I've been acquainted with the work of a brilliant chiropractor named Keith McCormick, who's written 2 books. And his encyclopedic book, Great Bones, has given me a lot of meat to work with, so to speak, chewing on the bone of bone health. And I would say hearts, brains, and bones are of equal importance to aging people. And the approach to them is pretty much in line.
Taking care of 1 properly will do a lot to take care of the other. The part that is most important really for bones is getting enough protein, which I will assume your listeners have been well exposed to. Yes.
Chris:
Every every client I see this one of blood chemistry, they're all walking around with a blood urea nitrogen in the 20 something. You know, like, they're in danger of being referred to the nephrologist for late stage kidney disease. But it is, in fact, just because they a ton of protein, like, you know, upwards of one gram per pound of body mass per day sort of levels. And I'm very much a fan of that for myself. Yeah.
And it is. That way, my body composition is much better when I eat that way as is my clients.
Deborah:
You know, somebody I was talking with online today said that there have been an alarming number of children admitted to the hospital in the UK recently with protein malnutrition as their chief diagnosis. And so people are getting a lot of calories, but if you don't make them full of protein, you'll eat too many calories for one thing. Anyway, you've had people talk about protein. So what I've learned about bone density is so fascinating. People are worried about having a heart attack or losing their brain function, but people should also be worried about slipping on the ice if they go outside at all, and falling and breaking their hip.
The mortality rate in the year or 2 after you break your hips is greater for men than it is for women. Not sure all the ins and outs of that, but it's significant for both sexes that falling and breaking your hip is no small matter. We've seen people's health go incredibly downhill from that, so we want to prevent it. I'll just share briefly with you what I've learned about the testing from this doctor McCormick. So doctor McCormick is a chiropractor who didn't really like manipulating people that much, and he would have wanted to listen to your podcast.
He was a runner. He was an ambitious runner, wanted to go to the Olympics. And in his forties, he began having what we call pathological fractures, meaning you lift up a glass of water and your arm breaks.
Chris:
Oh, wow. That's nice. You do
Deborah:
nothing meriting a fracture and your bones start breaking. So he's become a real expert on maneuvering the steps of restoring bone health short of resorting to the medications you see advertised on television.
Chris:
And so what did he find? So, you know, I know this from personal experience. My mom is you know, she's in the UK. She went to see her they call them general practitioners, GPs in the UK. And he just put her on some, like, free calcium supplements and some vitamin d.
And I kinda got a little bit upset about that, but, like, I guess that's the standard of care. So what did he find? What do you think is should be the intervention?
Deborah:
Well, I what I think the first intervention should be a like we said, with mold, a high index of suspicion and looking at bone density much earlier than we look at it. He suggests looking at it. So we have our peak bone you know, all our lives, we're continually taking our bones apart and putting them back together again. And the peak, we are on the building side of our bones to excess about the age of 30. Men may be at 40.
So at either 40 or 50, we should start checking bone density because if he'd done that, he would have seen good heavens. I'm supposed to have my peak bone density, and I look like an old person. So you do bone density testing earlier, and then there are actual blood tests that measure bone metabolism.
Chris:
Oh, did you
Deborah:
So there's yeah. I just learned about it and I'm like, order it on everybody. But most of my patients are older. So c telopeptide measures the rate of bone demineralization. And pro collagen 1 peptide measures the rate of bone remineralization.
And sometimes people need tweaking of both those numbers, and sometimes people need tweaking of only 1. And then if you're going to start diving into how you would do, that's where you get to the protein and the vitamins. And nobody should take vitamin d at any level at any age without taking vitamin k.
Chris:
Oh, K2, you mean?
Deborah:
No. I mean really K. So K for your bones has to be k 1 and both forms of k 2. Okay. You know, you and
Chris:
I multiple isotopes of k. Right? Like the MK Chris Masterjohn has a massive article on this. I was looking at it recently, and it's, like, all different types of MK, this, that, and the other. Right?
1 through 7 or something.
Deborah:
Right. And for bones, it's really MK 4 and MK 7, but here's one of my interesting curiosities. So, you know, there's been really a marked increase in the rate of atrial fibrillation in middle aged and older people in the last 10 or 20 years. I would also say in the last 10 or 20 years, we've all learned about vitamin k 2 as MK 7 and a lot of vitamin d's include vitamin k 2 as MK 7. And it's really easy to have too much of that.
And you know what it causes is rapid heart rate arrhythmias. So you need the MK 4. You kinda have to take it every day because it doesn't last as long in your system as the MK 7. And you have to take a k one. And you have to take some fish oil and proper revitamins for it to all work together.
Naturally, if you're rebuilding bones. But if you're losing bones, that's where I get to pull out my hormone expertise and say, okay. We've got a lot of hormones that could help hold your bones together better.
Chris:
What are those hormones? This is in men and women. Are you talking about estradiol and testosterone or something else?
Deborah:
No. Exactly those. So the estradiol is important for men and women, and they're at different levels. In the recent cognitive trial we did, there was a man I we did genetic testing and found out that his estrogen receptors in the brain and in his bones were very hungry for estrogen. Well, if he was a normal American male, he would have been metabolizing testosterone in his visceral fat and and giving himself an estrogen level of 20 or 30, which would be enough for his bones.
But his level was immeasurably low because he was particularly lean. So for him, we gave an estrogen analog, the supplement Genistein. Do you know that it's a soy isoflavone or it can be derived from pomegranate, but even people with soy allergies can take it. And it activates estrogen receptors in the brain and in the bones. So, you know, if a man I'm not gonna give a man estrogen, but I give women estrogen.
I'd like both sexes to have some testosterone. And if they need muscle development, maybe DHEA as well. And then melatonin has an important role to play in bone metabolism. And I've never heard if you have a guest on that specifically talks about melatonin. It's a fascinating hormone, and people my age don't make it.
Chris:
Yeah. I've had, you know, Greg Potter, my friend with a PhD in physiology, talk a lot about melatonin, and the effect of artificial light at night, of course, suppresses it is perhaps the main concern. But are you talking about something different from that?
Deborah:
Well, I'd say passing your 40th birthday is another concern. And, you know, there's a graph on the normal distribution of melatonin production by age, and it's you start falling off at about age 40. But by the time you get to be 60 or 70, it's the rare person who has measurable melatonin production. And, even if they sleep great, they can sleep great because they have great sleep habits and they get exercise during the morning and the daylight hours and no daylight, you know, no artificial light at night. So they sleep great, But they're sleeping great for self calming reasons and not because they make melatonin.
And melatonin is also really intrinsic to the function of your immune system and your bone metabolism. So I like so there's a urine test I do that includes a screen for melatonin, and I've only found one person in the last it's the Dutch test. And when you do their complete organic acids, and it would probably be in Mosaic's organic acids test too. When you test for melatonin in the urine, everybody over 50, except for this one guy, was no longer has melatonin in their system unless they take it.
Chris:
So And that wasn't someone that was taking it.
Deborah:
No. When they take it, their levels are super normal, and he wasn't taking it. And he had a level like I'd expect any young adult to have, but he was an old adult, at least if he's yeah.
Chris:
You don't worry about melatonin being antagonistic to insulin. Right? Like, you don't want melatonin and food to be available at the same time. Right? And that That's
Deborah:
a little bit of of a concern in that so people who take high doses of melatonin can have a higher fasting insulin level. I remember exploring this with you and Tommy Wood about, it seems like, 20 years ago, but evidently, you're telling me it wasn't that long ago. And recent work on that supports the idea that time release melatonin has less of an effect on insulin and glucose levels than the initial release melatonin. But I suggest to people that they take the level they're comfortable with. I'm happy if they do 3 milligrams.
If 5 or 10 milligrams helps them sleep better or calms down their restless leg syndrome at night, great. 5 or 10 milligrams.
Chris:
And so this is above and beyond all the I'm sure you're doing all the usual diet and lifestyle stuff with your patients. Right? So these are all people who are eating enough protein and lifting heavy things and they're carefully managing stress and, you know, all their sleep hygiene and everything is all in order, and they have adequate social connections, all this, and still you think there's something there with melatonin and hormone replacement that would maintain both muscle and bone density?
Deborah:
Muscle, bone density, cognitive function, immune function, you know, that's one of the reasons older people get more sick than younger people is melatonin helps your immune system function well. I think particularly works through white blood cell function. So, yeah, on top of all that and, when you were talking about protein and it showing up in their renal function, I wanted to make a little plug. I assume your listeners have been encouraged to take creatine as a supplement.
Chris:
Yeah. So that has been mentioned many times before. Actually, Greg, again, who I mentioned earlier, his reason and well-being super interesting. And I don't think we have a client that's not taking creatine. I'm super interesting.
And I don't think we have a client that's not taking creatine. I'm actually not taking it at the moment because I'm on, you know, on holiday, but it's, like, kinda hard to travel with, like, a big freaking football sized thing of creatine. Right? But, actually Yeah. Will, Laura's partner, did bring some creatine, so now I feel sort of bad.
But so you're basically putting everyone on creatine at this point even though they're not athletes?
Deborah:
I am putting everyone on creatine, but I'd encourage them to be whatever level of athlete they can be. And then you have to learn how to test kidney function differently. You know, about 20 years ago, I was seeing a physician whom I no longer see, maybe 30 years ago. And I can look at my chemistry panels from that time and she's has the creatinine levels circled and she says kidney failure. But she never told me what she saw.
Well, at that point I was getting into rowing. It was about 20 years ago. And I was working out like a mad woman, harder than I'd ever worked out in my life. And when I saw, finally, myself, that kidney failure lab, I just skipped exercise for a day, and my kidney function was perfectly normal. So with anyone who's taking creatine or exercising hard, I do a different blood test called cystatin c, and that'll properly measure your kidney function so your nephrologist doesn't have to sign you up for dialysis.
Chris:
We do see that. Yeah. So everyone's supplementing with creatine. And you as a result, you see slightly higher levels of creatinine in the blood. But it's not crazy high.
It's just like, you know, around 1 or slightly higher.
Deborah:
Oh, I've seen it. No. I've seen it quite high depending on, you know, really how early in the morning they take it and whether they worked out and took creatine yesterday. So I've seen it up to 2.
Chris:
Okay. And are you doing testosterone replacement in men? Do you think that's important for the aging guy or even Yes. Regardless of what the blood levels are? Like, if it's like a I mean, so when I look at the data for all cause mortality, it doesn't seem like there's much of a benefit of being above 500.
It seems like more is not necessarily better. But would you disagree with that? A total testosterone this is.
Deborah:
I would only say that your 500 would be different from an obese man's 500. If an obese man has a level of 500, most of it is free and available, and he's got a high level of circulating testosterone, and you're lean and fit. And one way or another, it's not directly measurable easily, but it's directly estimatable. You know, how much actual active bioavailable testosterone do you have? And the leaner you are, the more it's tied up in a protective protein sex hormone binding globulin, and you don't have much testosterone.
Testosterone. So if a man or woman has sarcopenia, sleep difficulty, cognitive impairment, I'd like to see how they do with testosterone. And I'd say 90% of people, you have to tweak around and find some dose that is right for them because some people are very sensitive. 90% of people, I think, feel better on testosterone. They sleep better.
They feel stronger. They're they can tell that their exercise is helping them build muscle.
Chris:
Yeah. That makes sense. I've definitely seen that. And I have in fact, I can you know, Tommy wrote about that, and I'll link to it in the highlights how sex hormone binding globulin and is very much related to metabolic health. And the better your metabolic health, the higher your sex hormone binding globulin.
That's likely a good thing. My understanding is that, you know, so sort of even the bound testosterone is active in some ways. And so, you know, to myopically focus on the unbound, the free testosterone is perhaps a mistake. But, hey, what do I know? I'm just asking the questions here.
Deborah:
No. I think there's some merit to that. And those would be the people whom you replace it. I'm really happy with the labs, or I'm not happy because here their testosterone looks great, but it's changed their red blood cell count in a disadvantageous way, or they don't like it because it turns them into a bitch or a bear at home, and or they can't sleep, or it makes you know, I have one woman recently who was getting something like panic attacks when we started her on testosterone. And her levels didn't look bad, but we'll back off on it and see you know, it's so interesting to have people report, there's it's a complex response to somebody saying, I just started this supplement or medication, fill in the blanks, and I think it gave me side effects.
And when I was really early in my practice, I remember, and I'm ashamed of this, having a woman tell me that when she took something for her strep throat, it gave her an upset stomach. And I said, it can't do that. You know? And, like, I am forever doing penance for that mistake. I think I made disbelieving people.
But you also have to have people subject themselves. So I had a patient this week who told me she had a response to a supplement I use fairly often called Pregnenolone, which is kind of like the myelin of the brain, helps the nerves transmit better. And she had a very strange response to it. So I told her to stop it. It went away that I'm asking her to repeat the experiment and to take it again the following week because it could just be temporally related, you know, a bus drove by and let off a lot of fumes.
And that's why you have a headache this day, not because you started vitamin c in high doses. So
Chris:
Could it not be a nocebo? It's as effect. Right? Like, the expectation of harm. And certainly, for testosterone replacement therapy, my understanding is, like, I think it's 80% of men who go on to it will have stopped taking it within a year.
You'd seen that data. You know, you're expecting some adverse effects. Right? Like, maybe some rosacea or roid rage or whatever it is. Like, there's then this expectation of harm that could be the thing that leads to the harm.
Right?
Deborah:
Right. But and I would say the my expectation of harm so when I prescribe anything that's like anything that I could then measure its effect in either you or your blood, I would never start testosterone and not check it in the blood. But 90% of gynecologists and family doctors choose an estrogen prescription based on your age and they never test
Chris:
the level. It's
Deborah:
crazy. Body's really complex. You're gonna handle a testosterone prescription differently than the guy sitting next to you.
Chris:
I see. I see. But that is is that because you're working inside of a different system than those other physicians? Because maybe you've got cash patients and not everything is going through insurance and
Deborah:
All the blood tests are going through insurance. I will pride myself that I might be you're paying out of pocket to see me. And it's so funny, you know, Chris, because you're in California. All my patients who've moved up from California think my rates are very reasonable. Like, how do you practice for so little money?
And all the people who are born and bred in Southern Oregon go, how can you charge so much? But 95% of the tests I order are covered by insurance.
Chris:
Oh, that's great. That's great.
Deborah:
You just have to have a really smart office manager who knows how to code the request. So it validates that I'm looking for real information.
Chris:
That's excellent. Well, what else should I have asked you about hormones, protein, osteopenia, sarcopenia, all of that good stuff?
Deborah:
We could go on and on about that, but I be
Chris:
respectful of your time, you know.
Deborah:
And and yours. But I would say that, you know, everything that is better for your heart is better for your bones. And these bones are a circulatory. We think of them as just these sticks that we walk around with, but the circulation to bones is just as essential as it is to your heart and brain. So take good care of your heart and brains, and you'll probably be taking good care of your bones.
Chris:
Yeah. That totally makes sense. Like, yeah, we think you're right. We think of them as these static things, like, that's an inanimate object. But, of course, they're not.
And you just mentioned 2 blood tests that essentially looking at the difference between or the activity of the what's building up and what's breaking down, which like there suggests that this thing is constantly in flux. And of course, it's mostly a mineralized protein matrix that's like, it's like anything else. Right? You either use it or you lose it. And so strength training is important.
And, of course, that's something that I wonder about that with your older patients, like, how compliant they are with strength training because there's no way in hell I'd ever get my mom to strength training. I'll say a funny story. I said, oh, why are you not strength training? That's probably the most important thing in eating enough protein. And, you know, she sort of shook her, like, bingo wing across the kitchen table at me and said, look at that.
Look at that. Look. I can't possibly I'm not strong enough to straight straight. And we just my wife and I just looked at each other and started laughing. You know, like, I'm not sure she was trying to be funny.
But I do wonder about that in your patients. Now if it's an older population, are they strength training? And how easy do you find it to get them to strength training?
Deborah:
That's a good question. So that we have a couple great gyms in our area that are particularly suited to older people and more
Chris:
remotely all over the world. Right? It's not just local.
Deborah:
Not so much all over the world because, you know, I could see anybody all over the United States during the pandemic when all the telemedicine regulations were relaxed. But now, you know, they have to come see me in person. So and and a little bit all over the world. But we have a trainer on our kind of extended staff who just wrote an article on our newsletter about you can't go to the gym. This is how you strength train at home.
And I'm a great one for getting up from my desk and jumping down on the floor and showing them ways they can do simple things and having them do that in the office. But I'd say for the most reluctant people, I have taken on the recommendation of Peter Attia, which is, yes, I know you go for a walk every day, but walk uphill and put a weight on your back. And that's a form of strength training, particularly if it's hard and particularly if it's hard for them going downhill. So I'd like to think that the ones with bone density issues are paying attention because I scream about this in their ear every time they come into the office.
Chris:
Yeah. I'm definitely sympathetic. I also think about the, like, the framing of it when you tell a patient that this is indeed strength training. It's not necessarily some complicated thing that happens in a gym with all this. I mean, even just the little gym I walked to into today in Lisbon, like, the amount of equipment in the free weights room was kind of overwhelming, actually.
And then not just, you know, the fancy machines, but even the number of different types of bar and all the different plates and dumbbells and kettlebells and, like Right. There was, like, all kinds of equipment in there that I'd never seen before. And it's only not been that many years since I've been in a gym, and it wasn't that fancy of a gym. And I could see how people could be overwhelmed by that and feel like they're not doing it well enough and unless they're going to one of these places and having, you know, a personal trainer show them stuff. But just you telling them, oh, actually, if you walk uphill, you know, carrying something heavy and you find it hard, then congratulations.
Your strength's riding. Right?
Deborah:
Or, you know, I'm looking at my fireplace hearth. And if you were here, I'd run over there and get up and down from a squat on my hearth and say, and what if I were holding a 5 gallon jug of milk? Or a gallon jug of milk, I guess they are. You know, but you can take weights from around your house. And I will say that someone who's not done anything, like squats or lifting heavy objects, I really do encourage them to work with a trainer, and we have a trainer that will go see people in their homes.
So he's worked with some of our patients who don't go to a gym. Because you can hurt yourself. Right?
Chris:
Oh, definitely. Yeah. I'm very much a fan. I've worked with Mikey Nelson was on the podcast recently. I've worked with him and Zach Couples and then our own colleague, Zach Moore.
I've worked with him too. He's very good. And, actually, when I was in the gym today, it was with Laura, and she has done a significant amount of work as she talks about on the podcast recently when I interviewed her with strength training. And, I think it's very com or at least for me, very comforting to know that someone's looking over your shoulder, especially if you have a history of endurance athletics. And, you know, those tech people tend to be kind of, you know, sleek and mobile.
Yeah. Lean, prone to, you know, like, strong in very specific ways, but not others and prone to hurting themselves when they start strength training. So, yeah, definitely, I couldn't speak highly enough of personal trainers that specialize in strength and mobility.
Deborah:
And are cognizant of the timidity with which an older person might approach the whole venture. Make it doable. Drop on the floor. Show me what kind of push up you can do. I will show people just against my desk at your dining room table.
Start doing push ups on that.
Chris:
That's great. Well, tell us about your practice then. So people have to do they have to come and see you in person once and then you can do telemedicine, or is it all a 100% in person now?
Deborah:
No. So people who are from out of state need to come see me once and ideally annually. I do have a new person in my practice, a nurse practitioner, who's very interested in cognitive health and hormones. And she's licensed in more states, so she can see people completely remotely who live in Washington, District of Columbia, a few other states. But I love it when people are local enough to see me or passing through the area and can come by.
That makes it better, but we can do a lot remotely too. And Ashland's a wonderful place to visit once a year.
Chris:
It certainly is. Yeah. I've been there. And, yeah, if you're a mountain biker, there's some really good trials there. You just have to wait until the snow melts before you can ride them.
Deborah:
Till the snow melts and before the smoke comes.
Chris:
Before the smoke comes. Yeah. I remember that. But they're really cool, swoopy trails that are very fun to ride. Excellent.
So where can people find you online? I will, of course, link to that and your scientific publications. Is there anything else I should link to?
Deborah:
No. Is it you know, I would just say I have 2 websites, and one of them is doctordebramd.com, and that's just really me. And I encourage anyone who goes there and finds an out of date article to please bug me because I'm trying to bit by bit, you know, redo these articles that I maybe wrote 10 years ago.
Chris:
Yeah. You changed your mind a bit.
Deborah:
Yeah. And then my practice is Northwest Wellness and Memory Center. And you can find us online both at Northwest Memory Center and Northwest Wellness dotnet. And we recently rebuilt that website, so I'm pretty sure it's just northwestwellness.net. But if your genius, Elaine, can't find it, let me know and
Chris:
I'm sure she will.
Deborah:
You're in the right direction.
Chris:
Excellent. Well, Deborah, thank you so much for your time. I really appreciate you. Thank you.
Deborah:
Chris, so nice talking to you. And as always, and I hope we get to see you in person sometime, come up and mountain bike.
Chris:
We definitely will. Yeah. We've been living a lot of van life where it's recently, and so we'll definitely be headed your way.
Deborah:
Sounds great. Take care.
© 2013-2024 nourishbalancethrive