Webinar Replay

Lifestyle Medicine Doctors Answer Your Questions | Guru syndrome, Sinus issues, Sodium



In this Q&A, plant-based doctors answer questions about Guru syndrome, hair loss, eating plant-based while traveling, and much more.

Questions Answered

Complete Transcript

Dr. Laurie Marbas

(00:03)
All right. There's a good one. Kip always brings a good question. Thanks, Kip. We love your support and your great questions. He says, “I've been whole-food, plant-based for years.” Smile face from him, says, “I've been whole-food, plant-based for years, continuing to make improvements. Last winter, the skin on my hands, primarily left hand, became inflamed in various places with cracking and sores that sometimes bled. My mostly plant-based ACLM doctor prescribed a pretty strong steroid betamethasone ointment, that didn't seem to help. Everything healed up fine as a winter warmed. It seemed to be coming back a couple weeks ago. Any suggestion?” Do we go for that? Sound like-

Dr. Niki Davis

(00:44)
Is this just on one hand or is it both hands?

Dr. Laurie Marbas

(00:49)
I think he mentioned left hand.

Dr. Chris Miller

(00:52)
He said skin and hands here. Oh yeah, primarily left hand.

Dr. Niki Davis

(00:56)
Okay. But on both, but maybe worse on one side?

Dr. Chris Miller

(01:00)
[crosstalk 00:01:00]

Dr. Laurie Marbas

(01:01)
“Both are fragile,” he says.

Dr. Niki Davis

(01:03)
Okay. Yeah, because sometimes people can have something that's hereditary, that's like peeling hand syndrome, that gets worse as the weather changes. So usually it's between fall and winter, and then even again between winter and spring. So it's just really kind of being cognizant of that and knowing when it might start to occur. What I've seen help people with this is just really keeping them really well moisturized. And so moving up with some really thick creams, not a lotion that's water based, but like a thick, heavy cream. And then you can even put gloves over and have that on at night to just really help keep that moisture in. And then of course the other thing is just making sure you're drinking enough water and staying hydrated to kind of help prevent that dryness and cracking, but it could possibly be something hereditary. Of course, without seeing it and being able to really look at it more, it's hard to know for sure what's going on, but that's just something to consider.

Dr. Laurie Marbas

(02:03)
I think so. Yeah. Typically, it's like an eczema type thing, and it can be pretty uncomfortable. Typically, the steroid will work, but it takes a little bit of time, but definitely want to just keep it well moisturized. That's a very good forward question.

Dr. Kim Scheuer

(02:18)
The other thing that I've found with this, if it's a dyshidrotic eczema kind of thing, is making sure you're not having any foods that will trigger you on it. Like some curries can have some metals in them that can trigger it and things like that, so just be careful. Notice what you're eating around that time too. And I agree with everything else that everybody else said.

Dr. Laurie Marbas

(02:41)
Perfect. If I look down, it's because I'm answering or looking at questions from the Facebook page. Next question from Joan. Hi, Joan. “There seems to be a lot of veggie chips out there. Is there any brand you would recommend?” That's actually a good question. Any thoughts of you guys? Or making your own, any good recipes?

Dr. Chris Miller

(02:58)
I don't know of any brands, Joan, of veggie chips, quite personally. So maybe someone else or someone in the audience knows as well. But I definitely make my own, so I like to make sweet potato fries and you can cut them thinner into chips. So that's kind of the main thing that I will do, but I imagine you can lightly bake other vegetables, you can put your own seasoning on and make your own chips at home. That way you're sure there's no oils or anything in it, too much salt or anything that you don't want. So that's my thought [inaudible 00:03:29]. I don't know, maybe you guys know some veggie chips.

Dr. Kim Scheuer

(03:31)
I agree. I make my own or Chef AJ has something, some chips that she makes on her podcast. She makes some delicious ones. That's I think the safest way to avoid oils and salts.

Dr. Niki Davis

(03:48)
Yeah, I've used my dehydrator, you can also just use a regular oven as well, but you could bake your own corn chips using just a corn tortilla. That's just corn and water and lime usually. You can find those in a regular grocery store and just cut them up. And those are really delicious. Doing kale chips. I've been doing this jumpstart program with the Rochester Lifestyle Medicine Institute and they just recently posted a kale chip recipe, and it's basically just kale. You don't add anything to it, because a lot of people will put oil on it and salt and things like that. But really, as long as you can get them nice and crunchy, you don't need anything extra. I think you can probably just google, “kale chips, no oil”, and find a pretty good recipe.

Dr. Niki Davis

(04:38)
I'm assuming Chef AJ has probably done that with kale before. And then I love the idea of doing the potato or sweet potato chips too. Getting them really cut really thin, if you need like a Mandarin or something where you can slice it super thin and that way, because you really just need to get that crunch, right? Dehydrate it and get it really nice and crispy. But buying something in the grocery store, that's a package, that's veggie chip, you're going to get oil in it. So making it yourself is key.

Dr. Laurie Marbas

(05:06)
Yeah. I do like my air fryer. [crosstalk 00:05:09].

Dr. Niki Davis

(05:11)
Yes

Dr. Chris Miller

(05:11)
You guys all have air fryers? I don't have one.

Dr. Kim Scheuer

(05:13)
Oh, it's awesome. You should have one.

Dr. Chris Miller

(05:18)
No, I wonder how many people in the audience, how many of you guys have air fryers? I'm curious.

Dr. Laurie Marbas

(05:22)
Someone else said, “Thinly slice red bell peppers in the food dryer is yummy.” That's interesting. Yeah. We actually have the Breville. It's the smart little oven and it has 13 different functions. So it has the air fryer, it roasts, it bakes, it dehydrates, it does all sorts of things. My boys actually made a industrial size dehydrator, it's taller than I am, and they put all sorts of stuff in it. But yeah, the dehydrator is pretty cool too. Either way, I think you still have to wait a little longer.

Dr. Niki Davis

(05:59)
We use the Breville, as well, and we just absolutely love it. It's been great. And our oven, at home, has not been working for a very long time and I was able to cook all of Thanksgiving dinner in just my Breville oven.

Dr. Laurie Marbas

(06:14)
Wow. That's actually impressive.

Dr. Niki Davis

(06:17)
You can make small pizzas. I mean, you can actually do quite a bit. It's not as big as an oven, definitely, but for the three of us, we don't have a big family. It works.

Dr. Chris Miller

(06:29)
Yeah, nice.

Dr. Laurie Marbas

(06:29)
Absolutely. Here's a question. Hi. It says, “My eight year old daughter has sinus infection problems and just had surgery on Monday.” I hope she heals quickly. “To remove a pocket of infection, I strive to have her eat fruits and vegetables very often at Grandma's treats,” I [inaudible 00:06:45] Grandma's, “Treats and holidays don't help for the process junk. Any thoughts on recommendations to help with sinus issues?” Any thoughts there?

Dr. Laurie Marbas

(06:57)
I found her moving the dairies key, which it sounds like you already probably plant-based, but just really talking, this is where communication and that family is so very important. And understanding that grandmas don't want to harm their grand babies, not the grandmas that I know, and just say, “Listen, you really can't be giving anything that has dairy in it. At least use alternative dairy products like soy milk or other things if you make it, because this is probably what helped lead her down.” Not blame it on Grandma, but at least pointing out that these products are not helping because they do cause inflammation including in the sinuses. That's where the talk comes in. You got to lay down the laws sometimes, Mom.

Dr. Niki Davis

(07:39)
Well, and definitely I would say, it's hard to have that conversation when you're just saying, “Hey, I really want my kid to eat healthier. Please don't give them these snacks.” Like, “Ah, it's not that big of a deal.” But if you have something where you can say, “Listen, my child has been having these sinus issues. My doctor, Dr. Marbas, told me…

Dr. Laurie Marbas

(08:00)
You can say that. I'm happy to be the…

Dr. Niki Davis

(08:02)
Yeah, exactly. Use one of us like, “I've been told that my kid cannot have this. That we can't have dairy, we can't have these sweets, because it's not helping things.” Maybe that will help the conversation a little bit more if you have a good reason for why they can't be having those things.

Dr. Laurie Marbas

(08:23)
Yeah, absolutely. Kim?

Dr. Kim Scheuer

(08:26)
Oh, no. I was just looking at Francine's question next. So if we have [crosstalk 00:08:30].

Dr. Laurie Marbas

(08:30)
Oh, okay. Oh, try to use the Q and A box, you guys, instead of the… if you're on the webinar. “Don't we want to keep the water content in the food?”

Dr. Kim Scheuer

(08:39)
And that was when we were talking about the air frying and [inaudible 00:08:43] chips. And so yes, overall we want to keep bulk in our food. So yes, we want to keep the water in and keep it as whole-food as possible, but every once in a while you need that little crunch, and you can add that in if you're not trying to lose weight or trying to do some other things. So we don't want to be so strict that you can't have some enjoyment sometimes. And the safest, the best way to have the enjoyment is to make it yourself, so what's in it. Do it every once in a while and just enjoy it.

Dr. Laurie Marbas

(09:18)
Absolutely.

Dr. Niki Davis

(09:19)
Agreed.

Dr. Laurie Marbas

(09:20)
Exactly. It comes back to what I call the guru syndrome, where people get so many messages, “You can't do this and you can't do that.” And they're trying to follow all these little special rules. I feel like it can really be exhausting and very frustrating for folks where they just give up, right? So at that point you're just like, “I'm done with it.”

Dr. Chris Miller

(09:43)
Yeah.

Dr. Laurie Marbas

(09:44)
Yeah. So focus in on what works for you as long as it's staying in the whole-food, plant-based diet realm. My goal would be definitely oil free. If we can avoid the processed foods, that's great. Less added salt, the better. But again, don't get hung up on, “Oh, you can't have this or you can't have that.” And if it's still in the plant-based realm like, “You can't do any nuts.” I don't agree with that. You can have a modern amount of nuts. They're calorie dense, so you want to limit them to a degree, because, again, sometimes that does goes against your weight loss goals or whatever, but it doesn't mean you can't have nuts. Nuts are a healthy option.

Dr. Laurie Marbas

(10:18)
So again, just focus in on what works for you, make it at home as much as possible. If you go out and have a dinner, even once in a while, unless special circumstances, on your birthday or you're celebrating something, that's okay too. Again, just try to make the healthier choices. But this life is short, guys, enjoy the food that we're making, all of it. Don't feel guilty for eating healthier options that are cooked in air fryer. Any other thoughts? That's just constantly, conversations with the patients, and I feel so bad for them because they're so frustrated.

Dr. Chris Miller

(10:52)
No, but I agree. Well, exactly, the guru syndrome, people will hear someone say something and then they're worried, “I can't do this. I can't do that.” And so then when we're making a plan together, people are having a little bit of a hard time. My recommendation is the same thing, to keep with the healthy foods, and then to find what works for you within that healthy realm, depending on your goals, whether you're trying to lose weight or reverse a disease or just stay healthy and age well. And so it's hard with all these people out there telling that, “This is how it is. It's the only way.” So yeah [crosstalk 00:11:26]. We're trying to get away from that a little bit.

Dr. Kim Scheuer

(11:29)
If chips are your trigger to get you to eat more and more and more, try and avoid that. Like, I have an addictive personality. So if there's chocolate in my house, I eat it no matter what. So as Dr Marbas said, make if what works for you. And don't worry so much about, “I can't, I can't, I can't,” we certainly can when we make the right choices and the healthier choices.

Dr. Laurie Marbas

(11:58)
And if you have a question about that, that's where we would step in, right? So you can go to Plant Based TeleHealth and make an appointment with this. Or if you're already one of our patients, message us, say, “Hey, what about this?” And we can share that with you. We want you to be successful, but we don't want you to feel so deprived. Remember, I always tell patients, “You can't go in this with a deprivation mindset.” You have to be thinking, “what am I gaining?” You're gaining health, you're gaining energy, you're gaining all these wonderful things. You're depriving yourself of diabetes, high blood pressure, obesity, chronic disease of any sort. So that's what you're leaving behind.

Dr. Laurie Marbas

(12:30)
So again, but the guru syndrome and all the rules, simple, guys, fruits, vegetables, beans, whole grains, some nuts and seeds, try to stay away from the oil if can, and you're going to be good. So, anyway, here's a question, “Hi, everyone. My hair has been falling out dry and brittle. My vitamin D, iron, B 12, and TSH levels are normal. What other tests can I ask my doctor to do for my next annual checkup? I am whole-food, plant-based, SOS free.” Any thoughts? We get the hair falling out question quite a bit. And I'm actually bringing out the dermatologist again, Dr. [inaudible 00:13:05], to my podcast, to discuss just hair loss. But, you guys have some thoughts?

Dr. Chris Miller

(13:10)
So for hair loss, there's so many different reasons and hair has a cycle that it goes through too. So it kind of depends on the cycle. So you covered some of the big ones, like iron deficiency can cause hair loss, omega-3 deficiency can contribute to hair loss, basically any nutrient deficiency, some of the B vitamins like biotin is known to help with hair growth, but any deficiency like that. And then I also think, make sure you don't have an inflammation related disease going on. So people with odd immunity or inflammatory state, because that can definitely contribute to hair loss. And then medications people are taking, that can contribute to hair loss as well. So kind of a comprehensive overlook at everything. I don't know, what else do you guys have to add? But those are some things that I'd look for.

Dr. Kim Scheuer

(14:00)
Stress.

Dr. Niki Davis

(14:03)
Yeah, stress for sure. And if it's stress related, hopefully, eventually, once that stress is gone, your hair will go back, if it's simply stress related. But I was going to say hormones as well. So any sort of abnormality, [crosstalk 00:14:20], thyroid. We see a lot in menopause too, where women have their hair just thin, just because of those hormonal changes. And there's some hereditary stuff too, where people just have their hair thin over time. I think it is a good idea to get a good workup. So having a doctor who knows what to look for, and any of us would be happy to see you for that.

Dr. Laurie Marbas

(14:46)
Yeah, absolutely. So sometimes it's called telogen effluvium, and basically it just means as your hair… You have 100% of hair. So 90% of the time, these hairs are in the growth phase. There's 10% that are in a phase of dormancy or about to fall out. When you switch your diet drastically from a standard American diet to a whole-food, plant-based diet, you go through, let's say, death of a family, or something drastic, weight loss. For whatever reason. It could be a variety of things. Even though it's a good stress going to a healthier diet, you may see that shift from 10% to 30% to 50% sometimes, but it's diffused hair loss, right? So when that occurs over time, to be reassured, it should start growing back. You should see the hair growth within that six month period. For example, if you're pregnant, you'll notice hair grows dramatically and then suddenly you lose all this luscious… I already have thin hair, so any hair loss is kind of unnerving to me.

Dr. Laurie Marbas

(15:41)
So those would be, you lose that hair, it's just going back to your normal state of affairs. So there's that, there's hormonal shifts. The other thing is, sometimes, very rarely, but sometimes I'll get patients on a plant-based diet who are not eating enough calories, they're struggling to gain enough weight. So that could be a calorie deficiency issue as well. So I know you get really full on a plant-based diet, especially if you're a smaller person, so maybe you want to look at that as well and make sure you're getting sufficient protein with the calories. The calories come with the protein. Protein comes with the calories. So it may be a calorie deficient issue too. So, but again, this is where these lovely ladies, and all of our other docs would be a great resource for you.

Dr. Laurie Marbas

(16:23)
Another question, concerned about iodine deficiency, which is very interesting, I have some interesting comments on that one. “Is there a test in order for an iodine level?” TSH level looked normal from what I'm reading in here. Yeah, [inaudible 00:16:42]. Okay. Looks like her thyroid tests were fairly normal, except for her T3 might have been a little bit low, her free T3. But that test is not really accurate, it shouldn't be used for clinical decision making. Just because it's very rapid and very quick, it's not a very accurate test to be looking at. But any thoughts on iodine?

Dr. Kim Scheuer

(17:02)
You definitely contest it with a 24 hour urine, which we can order through Plant Based TeleHealth. Any one of our docs can do that. That is one of the things that we don't necessarily get enough of when you're plant-based. Because we try and take away salt, so we don't have the iodine salts. So that is one thing that we should think about. A way to help with iodine deficiency is a little bit of kelp every day, or there are some vitamins out there that can work. So those are some of the things, but there is a good test.

Dr. Chris Miller

(17:40)
And we are definitely seeing people who are whole-food, plant-based who went off salt. Like you just described, Dr. Scheuer, who comes back iodine deficient and are having thyroid issues. And actually, when we test it and then we supplement the iodine, it's improving. And so the thyroid actually can improve when we catch it early. And then I've also had patients, I'm sure you guys have too, who have come in hyperthyroid or having thyroid issues and their iodine is high and they're eating all this sea vegetables or seaweed. So if you do decide to go up the sea vegetable weight, make sure you read labels and you really try to keep it within the range about between 100 to 300 micrograms a day of iodine from the sea vegetables and test it. Make sure that you're not overdoing it or underdoing it. So yeah, it's been interesting. So now, when people say they don't eat salt, I say, “Well, where are you getting your iodine from?” Just to make sure they're aware and they have a source of iodine.

Dr. Niki Davis

(18:35)
And then on the other side of that too, is making sure, don't take a supplement of iodine unless you've been told to do so, if you've been deficient, because it can be toxic. And there is research that shows that taking to too much iodine can cause thyroid problems. So you might be giving yourself a problem. So that's something that I have seen people just taking iodine because they want to make sure that they're not deficient, but you do have to be careful.

Dr. Laurie Marbas

(19:01)
Yeah. So typically, what they recommend is 150 micrograms in supplement form per day, but what you'll see is people taking a thousand micrograms a day. And I'm like, “Back up the horse guys.” Just some other things to keep in mind with that, if you're pregnant in a plant-based, you're going to need a little bit more. If you are breastfeeding and an infant that's strictly plant-based or have plant-based kiddos, get their iodine checked as well, because that's going to be an important thing to monitor. And that's where maybe iodine salt can come in, there's other things you can do. But test, don't guess. All you have to do is collect your pee for 24 hours in a jug and turn it in. It's so easy, right? But the serum iodine is just not as accurate.

Dr. Laurie Marbas

(19:46)
So you do need to do that 24 urine test, whether you have one of us or one of our amazing doctors do that, or your local doctor. So those are really good questions. And iodine is really important. And having your thyroid tested is really key. If you're seeing some changes, have that iodine checked and it can really change things. I can think of at least three in the last six months, just from that exact same thing. So two restrictive diet, again, goes back to the guru syndrome. All right. Someone was mentioning, “Greetings from New Orleans, Louisiana. I'm enjoying a whole-food, plant-based lifestyle, which is quite challenging in this region of the country.” And if you guys want to give, maybe we should give some tips on when you're traveling or when you're living in a place that's hard, what would you do to really try to stay in this whole-food, plant-based diet?

Dr. Niki Davis

(20:36)
I will jump in with that. If you have the ability to do so, using a meal delivery. So there's MamaSezz, which is a great one, because it's whole-food, plant-based, and oil free, and it can be SOS free if you want. But it's M-A-M-A-S-E-Z-Z. And that one's nice because they ship it every week. And so if you know you're going to be somewhere, you can have it just shipped to wherever you're going to be if you're traveling. And it's all freshly made food that just needs to be heated up. So that's something that I've done before. There are also some other… It's a company called LeafSide, where they use Dr. Gregor's list to make sure that you get most of the things that he recommends, your daily intake. And those are more like a dehydrated meal that you have to reconstitute with water.

Dr. Niki Davis

(21:27)
They're okay. They're not like the most delicious thing ever, but it is something that's nice that you can just throw in your bag. And as long as you've got a mug and the ability to get some hot water, you can have a good whole food plant-based meal. That's really easy. The other thing that I would say that I've done before is batch cook some potatoes. Just do some baked potatoes. I wrap them in parchment paper and then aluminum, stick them on my pocket. When I'm in the airport or I'm in a hotel then I've just got something that I can just eat. I just eat just that. So just kind of preparing yourself to just knowing where you're going to be, and if you don't have the ability to get healthy food from a restaurant or you don't have access to a grocery store, just things like that could help.

Dr. Laurie Marbas

(22:16)
And someone asked, “What was the name of the first delivery service?” It looks like Kim is typing an answer there.

Dr. Kim Scheuer

(22:20)
I was, but then I thought…

Dr. Laurie Marbas

(22:21)
MamaSezz.

Dr. Kim Scheuer

(22:21)
MamaSezz.

Dr. Laurie Marbas

(22:21)
No.

Dr. Niki Davis

(22:25)
MamaSezz. Yeah.

Dr. Laurie Marbas

(22:26)
And that's M-A-M-A-S-E-Z-Z .com. Great.

Dr. Niki Davis

(22:31)
One of the things I do want to tell people about too, with the LeafSide, I have had… Be a little careful with some of those, don't use them as your regular meal every day, use them only when you're traveling or if you absolutely need to. And some of them do have a little bit more sodium than calories, which you want to be a little careful of if you have blood pressure or something like that. So just be aware. Chronometer is a nice way to look at what it might have, or just look at what it has on it. For me, traveling, love, love, love my apps, like HappyCow. I think it's a great way to find… I found vegan restaurants, which you can ask to have oil free or salt free. In places like a small town in Northern Scotland or in Vietnam, I found the most amazing places. I find places in airports that I didn't know about where you can go and find some great healthy food.

Dr. Chris Miller

(23:28)
When I'm traveling, I often just do, I bring stuff with me. So like Niki said, the potato. I haven't done a potato, but that's a good idea. But I might make oat bars if it's a long trip. I brought veggies and hummus with me before, hummus that I made in little containers. I brought salads before. The salad dressing's already dressed, so it wasn't a liquid, and I was able to bring that through. I always can get fruit. So if I'm in a pinch, I can buy an apple or banana at the shop in the airport. So that's helped me.

Dr. Chris Miller

(24:01)
And I always prepare in advance. I always think like, “What am I going to eat for dinner? What am I going to eat for breakfast?” Every single meal, I'm making sure like, “Where's a grocery store?” If I need to grab a cab and get myself to a grocery store or somewhere where I can get something to eat and I'm always thinking in advance so that I don't find myself in that pinch where I have nothing to eat. And then who knows what I'll do at that moment. So if you fail to plan, you plan to fail. So take the time in advance to figure out what you're going to eat when you travel.

Dr. Kim Scheuer

(24:34)
Last thing I can think of for people who are in food deserts, besides ordering, which is a great idea, is PCRM has some information on their website about how to eat in food deserts. And that's really kind of nice to look at.

Dr. Laurie Marbas

(24:50)
Yeah, and just planning bulk, when you can travel somewhere. Because when I lived in Western Colorado with, again, limited groceries, I had to travel maybe 20 miles to the new, better grocery store. So I would buy in bulk and just keep things in the freezer and did some different things. But also, when you're traveling, I pay a little extra to get the hotels with a little bit of some type of a little kitchenette or something or at least a refrigerator or microwave, just because that's really helpful. And then find the nearest grocery store. Sometimes you get the hotel room next to the grocery story, so that there's some other options there too. Oh, yes. Someone says, “Sprouts are easy to grow anywhere.” Hamama has a great little sprouting system. I actually just finished a big batch of mung bean sprouts.

Dr. Laurie Marbas

(25:38)
So those will go on some smoothies and some soups coming up this week. So yeah, it's amazing. Here's a good question, “I've had ulcerative colitis since I was 25, with some episodes of moderate severity, mostly low grade and managed with meds. I've been off all meds for the past four years since going plant-based, have no symptoms anymore. And the last two colonoscopies have been healthy intestines. My GI still wants to do a colonoscopy every two years, including [inaudible 00:26:07]. What are your thoughts?” This kind of goes to the question too about getting some your traditional doctors' advice and then they come to us. People ask us for our second opinions, but I'll let you guys go ahead. And then I'll see what you guys say and I have my own thoughts, but go ahead.

Dr. Chris Miller

(26:24)
Well, my thought is, I guess, with the plant-based diet, it's awesome what you've done and that you feel so much better, but it would be a good idea to test it just to make sure. I probably would follow up at least and get at least one or two to make sure that it was clear and that nothing was happening. And if you're completely symptom free and no inflammation and nothing, my thoughts would be that at that point you would be able to back off it and you wouldn't need it so much, because it can actually heal and recover and then you wouldn't need to keep getting it retested. I would just be cautious that it is fully result before you drop off. That's my thought on it.

Dr. Niki Davis

(27:01)
Yeah. And I would say, whenever you're making a decision about your health, you should definitely take in the opinion of your healthcare provider. And even like Lori was saying, “Get a second opinion,” but you want to make a decision based on the information that you have for yourself. So for some people, they might say, “I just want that peace of mind. I want to know that things are looking good, that they're continuing that way every two years.” There might be other people that say, “Well, to me, it's not worth the risk,” because a biopsy is not a benign thing, right? There is an increased risk of getting an infection and things like that, and so it's not just a benign test. So you really have to kind of weigh, is it worth it to me to have that peace of mind to take a little bit of a risk with this test or I'm feeling so good, I'm having no symptoms.

Dr. Niki Davis

(27:53)
I would be fine with not being tested and maybe looking at the middle ground too, doing a colonoscopy without a biopsy. And maybe doing it instead of two years, every four years or five years. So really kind of looking at the risks and the benefits of all the different options, talking with your doctor. Not only the doctors that you're already working with, but if you have a plant-based doctor, talking to them as well and really looking at all the options that what is the most important to you, what's going to make you feel comfortable. Because there's no right answer necessarily, it really is going to be dependent on you and how you feel.

Dr. Laurie Marbas

(28:32)
Yeah, I would agree. I think you definitely should consider even a second opinion from a plant-based GI doctor. Your doctor is making those recommendations based on certain guidelines. And those are certainly things that you don't want to ignore. But at the same time of them will not think that you'll [inaudible 00:28:48] any dietary intervention. They're like, “Oh, the drugs has cured you.” So you still need to be on this regular regimen of colonoscopies and biopsies. Again, which I agree with everything Nikki and Chris are saying, and it's a personal decision, but at the same time, look at the evidence. You've had no problems for four years. Ask your doctor point blank, “Why am I having to do this every two years? I've been well for four. Can we go every four years, five years?” I think that's a reasonable ask, and saying, “What is the evidence of you saying this, when I know the one intervention that I did that finally helped this was my dietary intervention?” And there's evidence in the research showing that.

Dr. Laurie Marbas

(29:26)
So push them a little bit and ask them, “Tell me why. Show me the evidence.” And you have every right to do that. That is your body and your health. So as for the reasons why they're making their decisions and if they, again, kind of push you away and say, “Because that's kind of what I suggested,” then find yourself another doctor. And there's nothing wrong with that either. Not everyone can click with everyone. I think you're right to ask questions. That's always a good thing. So, okay. One more question guys? We have time for [crosstalk 00:29:58].

Dr. Chris Miller

(29:59)
Yeah.

Dr. Laurie Marbas

(29:59)
Okay. Someone says hello from South Beach. So, hello.

Dr. Chris Miller

(30:03)
Hi.

Dr. Niki Davis

(30:03)
Hi.

Dr. Laurie Marbas

(30:04)
Okay. And there's a good one here. “I find myself using a lot of canned black beans and chickpeas, but I rinse them. Am I still getting a lot of sodium? And could that be the reason for my blood pressure being higher than it ever has been? I never had issues with blood pressure before.” Any thoughts on blood pressure?

Dr. Niki Davis

(30:26)
Well, first of all, if you're buying canned beans, you can buy them salt free. So you just can look into that. Rinsing them certainly does help. And yes, there is some evidence that shows that increased sodium can increase blood pressure, but it's not by a lot. So looking at some other possible reasons why your blood pressure is increasing would be important I think.

Dr. Kim Scheuer

(30:49)
You want to make sure you're getting plenty of exercise, not drinking alcohol, other things that can increase your blood pressure or is there another reason your blood pressure is up. So it would be important to make sure you talk to a doctor to make sure that there's nothing else going on that you're missing.

Dr. Laurie Marbas

(31:06)
Yeah, absolutely. I agree. Monitoring your sodium, make sure it's like 1500 milligrams or so below if you're going to be salt sensitive, but again, don't ignore the higher blood pressure. Go ahead and start looking. And make sure that whatever you're testing the blood pressure, is this the doctor testing the blood pressure, is this like… Oh, [inaudible 00:31:23] you're testing at home. That can be sure be a problem as well. Make sure your blood pressure is being tested accurately. And that's something we could walk you through again at probably TeleHealth. We have handouts about this. We talk you through that or having someone available who can do a stethoscope and listen. That is the absolute most accurate way because someone's listening and seeing them number. So again, I would also make sure that whatever tool you're using is accurate. So those are my thoughts there, but we're already past the half hour mark. Any questions at all, any comments left for you ladies? Okay.

Dr. Niki Davis

(32:01)
I guess we won't get to see people until after Thanksgiving?

Dr. Laurie Marbas

(32:05)
Yeah. So that's true. Thanksgiving is the next Thursday. So we'll see you on that second Thursday of December. But I do want to mention, here it says, “Each and every one of you is fantastic. I just love this plant-based doctor group and really appreciate the webinars. Thanks to all.” So there you go. Thank you and you're welcome, and thank you for watching. So thanks everyone. Happy holidays. And we'll see you in December.

Dr. Niki Davis

(32:29)
Yeah. Thanks everyone. Happy Thanksgiving.

*Recorded on 11-12-21

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