Webinar Replay

High Blood Pressure / Hypertension



In this week's webinar, Dr. Miller and Dr. Marbas answer all your questions about hypertension.

Questions Answered

  • (00:56) – What is Hypertension?
  • (10:09) – Can you treat a bacterial infection naturally?
  • (12:55) – How to lower cholesterol with a whole food plant-based diet
  • (20:31) – Recommendations related to triple negative breast cancer
  • (23:17) – What about white coat hypertension?
  • (30:42) – Effects of intermittent fasting on cholesterol
  • (31:10) – What about juicing?
  • (33:15) – About continuous glucose monitoring?
  • (36:43) – General cancer recommendations
  • (41:16) – What causes acid reflux?
  • (45:47) – How to reduce your blood pressure

Complete Transcript

Narrator

(00:06)
We are making plant-based lifestyle medicine available to everyone who desires it. With telemedicine, we are removing barriers that prevent many people from accessing this type of care. Lifestyle medicine promotes healthy behaviors and when adopted, individuals can expect improvement and in many cases reversal of chronic disease.

Dr. Laurie Marbas

(00:29)
Welcome to our live Q&A with Dr. Chris Miller, myself, Dr. Laurie Marbas. We're from Plant Based TeleHealth, if you haven't figured that out yet. If you want to check us out, plantbasedtelehealth.com. We're always here every week. We're trying to answer as many of your questions as we can and today we really like to focus on hypertension. Of course, we'll answer other questions, but we try to pick a topic just so we can really start educating and do a little bit deeper than typically.

Dr. Laurie Marbas

(00:56)
First of all, just a quick rundown on what actually hypertension is. Hypertension is number one risk for death around the world. Kills about nine million people annually, which is very sad. When you look at hypertension, some of the categories have changed. Normal is under 120, what we call that top number or systolic blood pressure. Under 80 is the diastolic blood pressure and that's normal, even better if you can get under 115 systolically.

Dr. Laurie Marbas

(01:28)
Now, what they figure is normal like I said is that 120/80. Then, there's this elevated blood pressure. That's 120 to 129 on top, but still under 80 on the bottom. Then, we have Stage 1 hypertension. This is a little different than some of the JNC guidelines that we had, which is something that doctors look at to see how we treat the hypertension and how you stage it, but that's 130 to 139 on top and above 80 on the bottom.

Dr. Laurie Marbas

(01:54)
Then, Stage 2 is anything over 140 on top and above 90 on the bottom. What just the numbers are real quick, and then we'll dive in is that systolic number is basically when your heart beats, the whole idea is all it is, it's just beating, beating, pumping out blood, then it rests between beats and it fills up with blood. There's pressure that you can measure and it's measured in mercury's… Excuse me. Millimeters of mercury, as it's pressure exerted on arterial walls.

Dr. Laurie Marbas

(02:21)
So as the arteries take blood away from the heart, that's a good way. A is away. That's one of our in undergrad, into medical schools like A is away. As the heart is contracting and it's pushing the blood into the aorta, the big artery that leaves the heart. That is where we're measuring that blood pressure is that top. That's why that number is higher, because it's actually pushing and contracting and pushing the blood flow out versus the diastolic or the bottom number is it's when the heart is not beating, it's resting between beats and it's refilling with blood.

Dr. Laurie Marbas

(02:55)
That's the blood pressure that's being exerted, the pressure being exerted inside the arteries during that rest period. That's what we call blood pressure, systolic on top with a contraction systole means contraction, diastole means relaxation and it's not contracting. Then, just one last thing is when you're measuring your blood pressure, when they're listening what they do is they pump up your, they literally cut off the blood pressure.

Dr. Laurie Marbas

(03:20)
You have this artery here and we're listening and we pump, pump, pump, pump it up. We usually go about 20 to 30 millimeters before we don't hear anymore. Then, you slowly release the valve about two millimeters of mercury a second. What we're listening for is the first sound. That's the top number, and then the very last sound we hear is the bottom number. That's literally blood pressure in a very quick nutshell. So we just add anything to that?

Dr. Chris Miller

(03:53)
No. That's great. I think that's fantastic. Yeah. I think that'll help understand as we start talking about treatment and management and why the numbers need to be a certain level. That's great.

Dr. Laurie Marbas

(04:04)
Perfect. Yeah. Because really before we dive into like, “Oh. Well, this drops your systolic blood pressure this much.” It's like, “Well, why don't we just set the ground with some basic definitions?” But here we go. We have some questions, let's see here. Everybody said they like the time too, which is great.

Dr. Laurie Marbas

(04:23)
Hopefully plant-based diet help with electrical abnormalities like AFib, atrial fibrillation, which is an irregularity. It's an arrhythmia yes. Yes. There is some evidence that there is… If you look at the IJDRP, the international journal disease reversal and prevention. We have an article that will be probably being published later in a month or two as it goes through copyrighting all that stuff. Chris, do you have anything to say about AFib, particularly maybe certain minerals and vitamins that might be helpful.

Dr. Chris Miller

(04:55)
Yeah. AFib is extremely common and the thing that's interesting about it is it happens for all sorts of different reasons. It can be related to heart failure. It can be from a heart attack, can be due to electrolyte abnormalities. It can even be related to things like stress, but basically what happens is the atrium contract the beat, it fibrillates. It gets like this.

Dr. Chris Miller

(05:20)
It's not able to push blood into the ventricle, and then get blood to the heart the way it's supposed to as Laurie had described. But like I said, there's so many reasons that can happen. It's not just one cause. So, a whole food plant-based diet is optimizing your whole health and your whole health greatly affects the health of your heart, of course, it does.

Dr. Chris Miller

(05:40)
So by eating a fiber rich whole food, plant-based diet high in antioxidants, low in fat, low in saturated fat and all these foods that we know affect the heart and the blood vessels you are softening the blood vessels. That's going to help this already start to contract. If it's due to things like heart failure, if it's due to things like electrolyte abnormalities that actually can start to improve with the whole food plant-based. That's some of the article that is in the IJDRP journal.

Dr. Chris Miller

(06:09)
Some of the patients that we see improving, so there have been patients that have significantly improved end result AFib, but not everyone. If it's been permanent damage, if it's scarred along the electrical system then that may not fully improve, but you're still benefiting because you're improving all the other risk factors that go with it. There are significant risk factors such as stroke with AFib, so everything you do to help benefit is essential, so very optimistic with that one.

Dr. Laurie Marbas

(06:35)
Absolutely. Exactly right, and so one of my dear friends is a cardiologist who specializes in electrical interferences or you could say arrhythmias of the heart. She's plant-based and truly believes it, so really cool thing guys is to go to a whole food plant-based diet and just make sure optimizing potassium and magnesium in your diet as well. We have another question. I've got about four questions running right here.

Dr. Laurie Marbas

(07:01)
This one is type one and a half, straight plant-based fat under 20% for four months. She says she's 5'4, 130 pounds. She says my blood sugar goes up for 30 minutes after I take Afrezza before it comes right down. Afrezza is a fast-acting insulin. Typically, these are working about 15 minutes after injecting ad it peaks in about an hour and will last about two to four hours.

Dr. Laurie Marbas

(07:29)
It's hard to say when you're taking it. If you're taking it 15 minutes before a meal, typically is what you do is you'll doses 15 or 20 minutes even before a meal, you eat and then you will have a spike and it may spike for a little bit as the insulin is being utilized to bring the blood sugar down. That's actually not uncommon. She says she's taking it part eating.

Dr. Laurie Marbas

(07:56)
Okay. Again, I think you depend on, one, where's your blood sugar before you inject it, and number two is what are you eating? Are you doing the carb insulin ratio, and so there's a lot of things that would be and kind of an intricacy. How high is it going? That would be a great one, honestly, for an appointment to discuss specifically, but Chris, do you have any other thoughts on

Dr. Chris Miller

(08:22)
No. It has so much to do with where you are before your meal and what you're eating. I agree with that and how much you're exercising as well and how sensitive you are. There's a lot of factors that would play in and that would help as you tweak all of those, you could get that in better control.

Dr. Laurie Marbas

(08:39)
Yeah. She says that it doesn't matter what the number on that when it happens as soon as I take the Afrezza. Honestly, that's where maybe a continuous glucose monitoring, you may already be doing that. Looking at the actual data and then when you're taking it and the food that she says she does, so test it. I don't know what state you're in, but it would be awesome if you'd consider making appointment with us. We'd be happy to dive into that with you can.

Dr. Laurie Marbas

(09:06)
Can it be a liver or the liver? That depends. Again, there's a lot of things to focus on when you're looking at especially type one and a half diabetic, which is later on set autoimmune diabetes. Again, we'd want to look at your food logs when you're taking it, how much? Maybe even changing out to a different brand and see how you feel, do that. There's lots of options to consider there.

Dr. Chris Miller

(09:32)
What time you're taking exactly. Sometimes tweaking that even just can make a difference.

Dr. Laurie Marbas

(09:36)
Yeah. Exactly. Absolutely. I'm working actually with one of my type one and a half right now just about this exact issue. They're seeing a huge spike and we're looking at what the blood sugars are before, their carb insulin ratio. We're looking at how much they're taking, when they're taking it and analyzing the data. We're playing around with that and we're seeing some really nice results.

Dr. Laurie Marbas

(09:59)
I'm going to go to the next one here. Thanks, Tess, for those. That's really helpful because I'm sure other people are having those questions as well.

Dr. Chris Miller

(10:06)
Yeah. That's a good question.

Dr. Laurie Marbas

(10:09)
Okay. Let's see here. Let me see. Sorry. I'm just going through lots of… Oh. Can you treat a bacterial infection naturally? Chris, I'll let you dive into that one while I start looking these other questions here.

Dr. Chris Miller

(10:27)
What kind of bacterial infection? That would sort of depend what you're talking about, but usually if it's become bacterial that we know it's bacterial, that's where we use antibiotics. I would say it's a little risky to not use antibiotics. If it's a pneumonia, if we suspect bacterial if it's… Now your body still has an immune system and it still can mount a response. It definitely overcomes viruses, but by the time it's something like a pneumonia or a cellulitis or something bacterial. Cellulitis is a skin infection. That's the point where I would use antibiotics.

Dr. Laurie Marbas

(11:04)
Exactly.

Dr. Chris Miller

(11:04)
Now, although I'm not sure what infection you're talking about so maybe-

Dr. Laurie Marbas

(11:07)
Yeah. Exactly, and then many times a bacterial infection you do require antibiotics.

Dr. Chris Miller

(11:13)
It's a little risky not to at that point.

Dr. Laurie Marbas

(11:14)
Exactly.

Dr. Chris Miller

(11:16)
But we do still have immune systems.

Dr. Laurie Marbas

(11:18)
We do and so all an antibiotic does is it augments what's occurring. The whole idea, hopefully, just to avoid the bacterial infection, but sometimes that's not possible. You get the cut in your hand, it gets exposed so I mean things happen.

Dr. Chris Miller

(11:30)
That's one of the miracles of modern medicine is antibiotics, because people really did used to die of simple little bacterial infections such as a skin infection or a dental infection and people would die from this. We don't die from this anymore because thank God, we have antibiotics so-

Dr. Laurie Marbas

(11:45)
But antibiotic resistance is on a huge rise so that actually we may be going backwards because now we're getting super bugs and all these things. The other thing is you look at the meat industry. They use 80% of antibiotic use in the United States is used on animal agriculture. It's not even necessary to treat infections, it's to actually grow them fatter. So some really interesting work with antibiotics and what they do to us as humans and you think about what's our gut bacteria, so much to consider.

Dr. Chris Miller

(12:17)
But hopefully for most of us who are plant-based eaters or we're concerned about the environment or the animals and we're eating less and less and less if any animal products, if you do need those rare antibiotics then you do need them. You can work on your prebiotic food and take some probiotics and build a healthy microbiome following antibiotics, because I know I have a lot of patients who are very resistant to wanting to take antibiotics and when it's needed, we still have to, we still do need them, but there's all sorts of things we can do afterwards to help restore the microbiome and get ourselves back in balance and have a healthy immune system following it.

Dr. Laurie Marbas

(12:55)
Exactly, and then we have a couple questions on the cholesterol, so kind of moves into the cardiovascular system here. Ross asks, are there any signs of cholesterol improvement following a whole food plant-based diet to look for other than via a blood test?

Dr. Laurie Marbas

(13:13)
Well, they're all not necessarily invasive without a blood test, but they certainly could be… I mean you look at your blood… No. I don't… I mean is there any indicators that I'm-

Dr. Chris Miller

(13:25)
I want to say that when people lose weight their cholesterol almost always, always drops, even if you lose weight from eating Twinkies every day, but you only eat one Twinkie a day, cholesterol will usually drop. People on a ketogenic diet, cholesterol drops under that short-term while they're losing weight and once they stabilize.

Dr. Chris Miller

(13:41)
I feel like saying if you know you're losing weight, I almost always can see my patients and my patients are so funny because they will, after three months, they've lost weight, they can't wait to go get their cholesterol checked. I can almost guarantee that if they've lost weight, it's going to be coming down and hopefully we're doing it in a healthful way by doing a whole food plant-based diet or is working in that direction. I feel like weight loss is something but I don't. I can't say that. But like-

Dr. Laurie Marbas

(14:08)
Yeah. I mean if you're looking for objective measurements, the only thing I'm aware of is actual blood tests, but it is interesting because I've worked with some individuals who were morbidly obese whose BMI is over 40 and when you look at their cholesterol, many times it's actually really low, which is unusual in the sense that you think, “Oh, they're obese and they should have it.”

Dr. Laurie Marbas

(14:31)
But from what I can find in the researches is that their liver just can't keep up with the cholesterol demands. They're actually probably have high cholesterol and as they lose weight, these super morbidly obese, we may see it trend upwards. That's the only caveat to that I've seen. Like you said everyone else who lose weight, but it's like the super morbidly obese it's a little tricky there, but any… Yeah. Very interesting.

Dr. Laurie Marbas

(14:58)
It says here that someone was recommended bergamot extract for reduction of LDL, which was you. She started taking 500 milligrams twice a day, any other recommendations?

Dr. Chris Miller

(15:09)
For high cholesterol, so I don't know anything about you, but hopefully you're doing a whole food plant-based diet, lots of fiber, things like oats for breakfast, beans, legumes, leafy greens, berries, flax, chia seeds. These are some of my standard lowering cholesterol type foods. Supplement wise once you've maximized your diet, because that's always going to be the most beneficial because it's more than just lowering the cholesterol number remember, it's also preventing the cholesterol from getting oxidized.

Dr. Chris Miller

(15:37)
It's when the cholesterol is oxidized, not the actual number that LDL becomes oxidized, but that's when it deposits. It gets sticky and deposits to the blood vessel linings and causes us problems. The whole food plant-based diet is really good for all the antioxidants and all the nitrate dilating benefits of the blood vessel, and so all of that is going to help the total picture. But if you still need some help, if you do have plaque, if you still have high numbers, if you're still at risk, bergamot is a good one.

Dr. Chris Miller

(16:07)
Then, also we like Amla powder. More and more data is coming out about that now. Indian gooseberry being a high antioxidant and significantly lowers both cholesterol and blood pressure. It's recommended to start with about half a gram a day and go to one gram, two grams, three grams, and it can be just as powerful as the statin actually. It is really bitter, so you have to-

Dr. Laurie Marbas

(16:30)
Very bitter.

Dr. Chris Miller

(16:31)
Yeah. How to get it into a smoothie or into a tea or we put it in just a little bit of almond milk and just kind of chug it, and then taste it with our smoothie. We get it in like that. That's another one that can be very beneficial for cholesterol. Then, you can also do things like stanols or sterols, which is a sort of a plant-based fiber. It helps pull cholesterol out so you actually excrete it, you poop it out.

Dr. Chris Miller

(16:57)
You're already getting so much fiber which is what oats are doing and flaxseed and all your green vegetables and fruits, but adding something like the stanols or sterols, one to two grams a day can also help poop out a little bit extra. There's a few other little tricks, but those are… I would start with sort of those and really maximize your diet. Also, soy also help lower cholesterol so doing a little bit of a whole soy like edamame soybeans, tempeh or tofu. Those can all be helpful as well. So really maximize your diet.

Dr. Laurie Marbas

(17:27)
Yeah and Brazil nuts probably two a week is all you need and they think, from what the research I could see it's something to do with the high selenium. That would be two Brazil nuts and the Amla, of course, ground flaxseed. Those type of things. Yeah. I think that's everything that-

Dr. Chris Miller

(17:46)
your cholesterol you're lowering too because remember things like alcohol are going to affect certain cholesterols a little bit more. Nuts are going to increase your HDL and if you have triglycerides, that's probably related to your fat intake or sometimes your sugar intake in your diet, even on a whole food plant-based diet, if you're eating processed foods or too much sweeteners, we can see numbers with that.

Dr. Chris Miller

(18:08)
Lowering fat intake can play so there's certain things we can do to adjust the diet as well based on each person, because people handle fat differently, and so even on a whole food plant-based diet we'll adjust that as well. Hopefully, those are some tips for you to start with.

Dr. Laurie Marbas

(18:23)
Then, there's just some individuals who have genetically predispositioned to have high cholesterol. It's even more important that you do everything you can that you can modify for sure. Then, just on occasion some people still need to have medications, unfortunately, but that's just the way it is. I would not-

Dr. Chris Miller

(18:40)
less and reducing all their other risks and they're reducing complications because they have such a healthful diet and lifestyle, but even… This is interesting. Cholesterol is actually a response to something going on your body, although the genetic one is when you're not getting rid of the cholesterol as well. Your receptors aren't as working, but it goes up acutely in response to things.

Dr. Chris Miller

(19:03)
So gaining weight, eating late at night, doing things like intermittent fasting, being stressed out. I've had patients come who are highly stressed and all of a sudden their number is up and we talk about it afterwards like, “Well, okay, what was going on here?” Often it's related to stress. We work on a mind-body program, and then we check it again in three months.

Dr. Chris Miller

(19:21)
I love following patients cholesterols in three months, because it gives them that goal, something to work with, but then it… Yeah. We can see it come down with one patient, you're supposed to fast overnight, and so one of my patients would work out in the morning before she came in. She went out and worked out and all of a sudden it was significantly higher and the exercise was just enough to raise it that little bit. There's other factors too, so be mindful of your mind-body and the stress that you're going on, as well as exercising, changing diet, and adding these supplements, because they all do contribute.

Dr. Laurie Marbas

(19:54)
Yeah. I just need to be careful with any type of red rice yeast just because that can, it can be damaging to the liver. I'd avoid that if I was-

Dr. Chris Miller

(20:03)
I know. I don't use it a lot. I know some people do, but I don't because it's not FDA regulated. You sort of-

Dr. Laurie Marbas

(20:09)
Right. You don't know what's in these supplements, because these aren't regulated so I'm very careful about that.

Dr. Chris Miller

(20:15)
I know. It does have a statin. It has low statin in it, the same chemical so you're going to get risks as being on a statin. If you do need it, then you might as well be on something that's regulated. We know how much it is and we know it's… That's sort of my feeling if I'm going to use it.

Dr. Laurie Marbas

(20:31)
Exactly. Let's see here. Got several questions. Kristen, I know Kristen. She goes, are there specific recommendations from triple negative breast cancer versus ERPR positive breast cancer? I'm familiar with incorporating whole food plant-based diet flaxseed, cruciferous specials, vitamin D. I wonder if there were other specific recommendations when you have triple negative breast cancer. Thanks for being pioneers in plant-based medicine online.

Dr. Laurie Marbas

(20:58)
Just from my own family risk factors, my mother had breast cancer, her mother, and all their sisters, cousins have died, so I'm ultra-paranoid about that. The things that would be besides what she mentioned here would be soy products, tempeh, tofu, those type of things, edamames, and then also mushrooms.

Dr. Laurie Marbas

(21:18)
Mushrooms are significant to help more for the estrogen positive, but for the triple negative, I mean all you can do is literally just work on your diet and improve your lifestyle, sleep, stress, like you're saying that mind-body experience is so very important, but then you have to look at genetics and sometimes the genetics are just not in your favor, but Chris, do have any other thoughts there?

Dr. Chris Miller

(21:47)
Exactly what you said. The whole food plant-based diet like for any breast cancer. I was also reading though that for breast cancer, just in general, that it takes more significant exercise than just moderate exercise. Moderate exercise, 30 minutes a day can help with many cancers, but for breast cancer that needs to be actually a sweat, more intense exercise, so that was interesting.

Dr. Chris Miller

(22:08)
Then, it's what Laurie said too and what you said about increasing the phytoestrogen. That's your flaxseeds, your green leafy vegetables, your soy products. I would do those same things.

Dr. Laurie Marbas

(22:22)
Yeah. That triple negative makes it a little bit tougher.

Dr. Chris Miller

(22:24)
There is a good resource, Dr. Kristi Funk. She gives a lot of talks and she's someone who might be interesting to read about.

Dr. Laurie Marbas

(22:32)
Yeah. She wrote a book called Breast, the Owner's Manual. I have it right here. I've been trying to get it on the podcast, so hope that helps Kristen. That's a tough case there. Let's see here. One of the questions, so here. My husband has Type 2 diabetes. He has been on metformin, ARB and hydrochlorothiazide and a statin. An ARB is just a type of blood pressure medication.

Dr. Laurie Marbas

(22:57)
He's not totally wholly plant-based. She says I am. He eats what I make. That's good. But we'll eat on an occasional chicken wrap, et cetera. I wonder if he still needs a hydrochlorothiazide, how can we determine that? I'm retired RN. He does not like me to check his blood pressure. He has always had white coat syndrome. Your thoughts?

Dr. Laurie Marbas

(23:17)
Well, I'm so glad this is kind of focused back around what we want to talk about today is high blood pressure. There's a thing called white coat hypertension that people get really nervous about someone… It doesn't even have to be in a white coat, but going to a medical practice and having someone's blood pressure checked, it can actually raise it because of the stress, which is exactly what we're talking about.

Dr. Laurie Marbas

(23:37)
A couple of things, number one, you shouldn't be diagnosing high blood pressure on a one time. Like if you go into your doctor like, “Oh your blood pressure is high.” Unless it's really high or something, but if they just the one time. Like, “Yeah. We're going to start you on meds.” It should be over a period of two to three or more and also maybe even there's ambulatory measuring and blood pressure, which is they hook you to a little machine and it does it automatically for a period of 24 hours or something.

Dr. Laurie Marbas

(24:03)
But then you can also check it at home, but you want to make sure your cuff is correct size that it's above the arm, you're holding your arm at heart level and you should be checking it first in the arm that has typically the highest blood pressure, which is often times the left side, but you want to check your blood pressure, then after you've been sitting, no talking, resting in an upright position for about five minutes. That will give you an accurate blood pressure. Not laying down, not after you're talking, not after you've been smoking or exercising or eating, you want to just give yourself half hour if you've been smoking or exercising or something.

Dr. Laurie Marbas

(24:35)
You want to be nice and calm and that would be the first thing would be maybe you can get a blood pressure cuff to check for himself. It could be an automated one, and then have him check his own blood pressure when nobody's around. That would be one thing for sure. I certainly, obviously being telehealth, I have to utilize and the key here is just understand. We don't know if he needs to stop it until we have data.

Dr. Laurie Marbas

(24:58)
Data is the key to making any accurate decision in medicine I feel. You can't just guess. That's one of the people, a lot of doctors we have struggles with our nutrition is that they're just telling you, “Oh eat a low-carb diet if you have Type 2 diabetes.” Well, that's really the opposite of what we should be eating. I'm not talking about refined carbs, I'm talking about whole food carbs.

Dr. Laurie Marbas

(25:18)
That's the unfortunate part is they're just guessing. They're just saying, “Well, this is what I've heard or this is what they're doing.” But it's not scientifically based. I would encourage, again, check out plantbasedtelehealth.com, make an appointment with myself or Chris, Dr. Miller. We'd both be able to help you with that, and maybe speaking to someone outside the family is more important even though you have the RN and you're very capable of checking blood pressures and guiding. Sometimes the family… It's got to be outside the family.

Dr. Chris Miller

(25:54)
within the family. That's totally… Oh my gosh. That's so true.

Dr. Laurie Marbas

(25:58)
Absolutely. It's so important, and then if he still a Type 2 diabetic there may be some things that we can encourage him to do to reverse the diabetes if possible, and then look at the statin and his other risk factors and the ARB, and so there may be a… The statin may be falsely raising some of his blood sugar. There's some other things there to consider that he would be perfect patient for us, so Tony, I hope you check that out, because that's-

Dr. Chris Miller

(26:25)
Yeah. I would add, remember that when someone has white coat hypertension, so that means that your thoughts and the stress of checking blood pressure are raising it, so your thoughts when you put yourself in your happy place, in a calming place, actually can lower by… I've seen it up to as much as 10 points systolic that it changes. You can kind of make it like a game. This is what I do with my patients.

Dr. Chris Miller

(26:51)
They'll sit down and I'll get a blood pressure on them while they're talking to me. “Oh, Dr. Miller, blah-blah-blah.” Whatever is going on and we're getting a blood pressure. I know it's going to be high because they're talking, what Laurie said, it shouldn't be high. I mean you shouldn't be talking, you should be sitting and resting and breathing and calm, so as they're talking to me, I'm trying to get a blood pressure and they're still talking and so it's going to be high.

Dr. Chris Miller

(27:11)
Then, I sit them down quietly and I say, “Go to your happy place. Where's your happy place? Go there right now.” We're not talking I just give them that few minutes to calm down to be in that happy place. It almost always drops by 10 points or whatever. That's the most. Something between zero and 10 points. It'll drop in many people, and so play with that with your husband, make it kind of fun or have it be like a game or see what the effects are. Can he re-calm it down by going to that happy place?

Dr. Chris Miller

(27:36)
It really does matter. Actually, white coat hypertension is now proven to be a risk factor. If it is high with that, that's something you do want to pay attention. Then, you want to work more in a mind-body program. There's a lot of little tricks in addition to everything else that you said, Laurie, that I like to play with my patients and kind of make it a little more fun.

Dr. Chris Miller

(27:56)
I'll often do a challenge with my patients, so if their goal is to lower blood pressure and they feel like they're getting the side effects of the medications, they don't want to be on them. Their goal is to work towards needing less medications over time, then let's do a challenge. Maybe we can, wherever he is in his diet right now, can he step it up for 30 days? What is he willing to do for 30 days doing these mind-body activities, having fun with checking his blood pressure, monitoring it, to get the data like Laurie was saying, and at the end of 30 days, oftentimes people will start to see results.

Dr. Chris Miller

(28:26)
Then, you can do another challenge 30 days and step it up even more like without going crazy or feeling like over committed or oh my god, there's no way I can do this, but find out where he is right now and what could he step up and watch because it really matters. The power of food and lifestyle, it's so powerful. If he commits to something, it's almost likely that he's going to see some change, and then want to keep going. Hopefully, that will help you and him and get inspired.

Dr. Laurie Marbas

(28:52)
It's been really interesting, I had one patient, it was really fascinating, stress and anxiety would drive up her blood pressure. We were just having a heck of a time getting it down. I taught her the four, seven, eight breathing, which we know we talked about and you're very familiar with Dr. Wheel in Arizona, but what that is it's just meditative breathing in a sense that you're going to do this in four cycles.

Dr. Laurie Marbas

(29:15)
You breathe in over four, you hold your breath for seven and you breathe out over eight. Her blood pressure, no kidding, I would check it beforehand, and we check it again after doing that breathing, drop 15 points systolic. That's the most amazing thing ever. There's lots of reasons for that. There's certain parts of the nervous system that are actually engaged and those deep breaths, your stress is decreasing because you're focusing on the counting and the breathing. Again, there's lots of things like that-

Dr. Chris Miller

(29:44)
It triggers your vagus nerve. Your vagus nerve is the rest and repair and dilates blood vessels so that's… Yeah. That's a wonderful technique to teach people. We should do a whole question on breathing techniques and we'll practice together, so at the end we'll all be so calm and we should check out all of our blood pressure beginning and the end so-

Dr. Laurie Marbas

(30:02)
Check your pulse too drop. If you don't fall asleep. Don't do this while you're driving. We don't want you falling asleep.

Dr. Chris Miller

(30:09)
that sounds, I bet we get more people come for that. That'll be a fun session we all get to do together.

Dr. Laurie Marbas

(30:13)
Exactly. Well, Tony mentioned something else. Tony, I would love for you just to mention maybe have them watch this. I really think that we could maybe talk to him about some of the side effects of those medications that he's on and that might encourage them to come off them a little bit more. We should definitely have a nice conversation.

Dr. Chris Miller

(30:32)
Yeah. We can

Dr. Laurie Marbas

(30:35)
Kit mentioned, intermittent fasting increases cholesterol?

Dr. Chris Miller

(30:38)
No. It decreases-

Dr. Laurie Marbas

(30:39)
No. Decreases. Maybe it was something that you might have misunderstood.

Dr. Chris Miller

(30:42)
If you eat late at night it increases all your inflammatory markers of which cholesterol is one of them. That's why people, in general, what we want to do an 8 to 12 hour fast. But, in general, if people intermittent fast and I have some patients with some tough high cholesterol issues and we work on more intermittent fasting with them, and so over time, we see even more of a significant lowering of their cholesterol with that trick. Yeah. That's a good one to play with for some people.

Dr. Laurie Marbas

(31:10)
Okay. Then, we have a question about juicing. What about having juicing? I feel like having carrot juice with apples and celery is bad. She wants to improve her eyesight health. Chris, I know certainly you have some experience with juicing and it's helped her a lot with some of the lupus.

Dr. Laurie Marbas

(31:28)
I just encourage, unless you have a specific need like Chris did to incorporate instead doing smoothies, you can do those same things. Just try to keep the fiber and more the nutrients because there are some things stuck to that fiber that you're going to lose as you discard it, and so that would be my, always my encouragement, but unless you have special GI issues or certain things that like Chris's, you probably should be able to answer that much better because you dove into that much more than I have.

Dr. Chris Miller

(31:56)
I think it depends on the person. Like you were saying, Laurie, totally. As someone who's diabetic or trying to lose weight, I probably wouldn't use juices as a first way to add in, but if you're someone who, if you're working on your eye health and you have a whole food plant-based diet and you're eating plenty of micronutrients and fiber to add about eight ounces of a vegetable juice and it needs to be a vegetable juice, but to add eight ounces of that once or even twice a day can really amp up the amount of nutrients that you're getting and getting it pretty quick.

Dr. Chris Miller

(32:26)
You want to be real careful though if you're eating both carrots and apples, both of those are going to be higher glycemic, so you want to keep it a lower glycemic. It's really three to one of low glycemic vegetables such as cucumbers, celery, lettuces. Those are low glycemic to one of maybe a green apple, maybe a little bit of carrot, maybe a little bit of beet if you're trying to get the color, maybe a few strawberries, but you use just a little bit of that one to three ratio, more than that it's going to probably spike your blood sugar a little bit too much.

Dr. Chris Miller

(32:57)
Yeah. I mean you can play with it and have all sorts of fun with making a juice, but I do think it has a role and you can get extra nutrients from that, especially some people are struggling with getting the nutrients, but you want to do your juice usually with a fiber based meal, in general, which will be even more beneficial.

Dr. Laurie Marbas

(33:15)
Absolutely, and another question was what time should we, our blood sugars be checked? Typically, when you're checking your blood sugars if you're a diabetic, you're fasting blood sugar in the morning is a great start, but it depends. If you're on insulin, you're going to be checking it maybe before meals and maybe two hours after. You may be checking it before bedtime.

Dr. Laurie Marbas

(33:35)
It really depends on the severity of your diabetes. Are you on medications? Are you Type 1, Type 2 or are you on insulin specifically or oral hypoglycemic, which are different from the metformin. It's a little bit different, works a little different. Those are things to consider and everyone's a definite individual. I'm a huge fan of the continuous glucose monitor.

Dr. Laurie Marbas

(33:56)
It has been fabulous. It's so much fun working with patients. I have four of them hooked up right now with my patients on my telehealth and they are the coolest thing. They're uploading all their data. You can see percentage above where our goal is and what they're doing when they're injecting, what they're eating. Oh my goodness. It is like a minefield for joy for me just like, “Yes. Let's narrow in on this.”

Dr. Laurie Marbas

(34:18)
They're not having to poke themselves. I'd say if you're really struggling with your blood sugars, again, make an appointment. Check us out or talk to your doctor about it, getting continuous glucose monitoring. Really focusing on what's going on with your blood sugar and learning how your body responds to certain foods like the juicing or something like that.

Dr. Chris Miller

(34:37)
The continuous glucose monitor, it's not as scary as it might sound. I have patients who are kind of worried about it, but you just stick it to your arm and you follow it on your phone with an app. It's not invasive like it seems like it might be. Your doctor prescribes it. We can prescribe it through PB TeleHealth or your doctor can prescribe it for you and insurance will cover it.

Dr. Laurie Marbas

(34:58)
Absolutely.

Dr. Chris Miller

(35:00)
It's really good tool. Laurie, when in general do you recommend if someone doesn't know their diabetic and they just want to check it, how do you recommend that person just kind of, what time of day or do you have a preference or-

Dr. Laurie Marbas

(35:10)
I would say probably a fasting blood sugar in the morning is would be the most reliable.

Dr. Laurie Marbas

(35:16)
Yeah. I think it's fairly interesting because I wore the continuous glucose monitor for almost two weeks, and then just got to the point it was like seeing the same patterns, because I pretty much eat the same, but it was really interesting to see the spike and the drop and exercise, and then it goes up a little bit, but it was a really neat thing. There's a few different continuous glucose monitors on the market.

Dr. Laurie Marbas

(35:40)
The one I like is the FreeStyle Libre, it's cheaper. You can get the free app, the reader as an app downloaded to your phone. They have a thing called Libre View, which is where you're connecting and there's some Dexcom and stuff. They tend to be more expensive, but they have an alert. So if you have a Type 1 or you have a brittle diabetic, those are really nice because you can set where you can actually get set an alert if you're turning down very quickly, someone needs to maybe eat something before they become hypoglycemic and actually symptomatic.

Dr. Laurie Marbas

(36:07)
There's so many things to do to get your diabetes on track and really feel well, Type 1, 1-1/2, Type 2, gestational diabetes. It's so amazing. It's just amazing.

Dr. Chris Miller

(36:21)
Fun, right?

Dr. Laurie Marbas

(36:21)
It is so much fun. It's fun to help people get better. We had another question… Okay. Oh, do you have recommendations for cholangiocarcinoma, a rare bile duct cancer? I'll let you go and start that one, maybe just with cancer in general because I don't know specifics to that one.

Dr. Chris Miller

(36:43)
Yeah. It's rare enough that it's not something we see all the time. I would just do general cancer recommendations. A whole food plant-based diet, removing foods that we know promote cancer and turn on cancer genes, such as dairy products, animal products. Really enhancing raw vegetables and fruit. That's the sort of a staple hallmark for helping with an anti-cancer diet, prevention and trying to halt it and who knows, sometimes even reverse certain cancers.

Dr. Chris Miller

(37:17)
I can't speak specifically to that one though. It's really increasing the raw greens and that is something that I would have do raw vegetable juices, especially making sure they get the greens in there, just a little bit each day. It doesn't need to be a ton, but then things like seeds, especially flax and chia seeds. Things like legumes, all your beans are going to be very beneficial. Things like berries, onions and garlic, mushrooms.

Dr. Chris Miller

(37:42)
Same things that support the immune system that we've been talking about are really going to support the immune system, again, to help with the cancer. Removing things like sugar and processed foods and being mindful of toxins in the environment. What's in your drinking water? What's the indoor, outdoor pollution of the air where you live? All those things are going to play a role. I would just…

Dr. Chris Miller

(38:07)
Oh, and then exercise, stress reduction, of course, sleep, because your body's healing during that. That's really important. There's so much with renewing and regenerating ourselves, how we restore ourselves that really matters. How we move? How we sleep? How we play? How we connect? How much gratitude we have, whether we're holding grudges on people. There's a lot of evidence with all of that really affecting the immune system.

Dr. Chris Miller

(38:32)
I know I personally had to work on that a lot, in addition to my diet. Really building a comprehensive integrated plan which is something I try to help with my patients. We build a comprehensive integrated plan that is from what they're eating to how they're restoring and revitalizing themselves to how they're moving, how they're sleeping, how they're living, all the, everything that's in their life and try to really get on track, but for that one specifically, Laurie, I don't know. I guess I don't know specifically about that.

Dr. Laurie Marbas

(39:03)
Not that I'm aware of this. It's exactly what you're saying. That's where I would say you want to optimize your health as best you can. So incorporating all those things that you described, your diet, your stress, your sleep, your exercise, and so that when you do have treatment that you'll respond more properly, you'll recover more. I've certainly seen that in patients of mine who have gone through chemo radiation and they went to a whole plant-based diet. They just did so much better than they probably would have continued eating standard American diet.

Dr. Laurie Marbas

(39:33)
I have to be careful what I say, but sometimes you'll hear advice from medical professionals to eat, just eat enough calories because you're a cancer. I don't agree with that. Still just eat the right calories.

Dr. Chris Miller

(39:46)
I agree. I'm with you on that one, Laurie. It worries me when they just want them eating like a milk based drink when that's going to promote cancer or giving them ice cream because that's all that they want. Because that is the sugar and that is going to promote cancer. I'm totally with you on that, but there is actually there's some good evidence and when we work with patients who have chemo induced type things like neuropathies or peripheral edema, the swelling in the legs.

Dr. Chris Miller

(40:17)
There is some evidence actually that a whole food plant-based diet and the lifestyle factor actually play a role. That's something that's even more important that you're addressing those.

Dr. Laurie Marbas

(40:31)
Yeah. Absolutely. I agree 100% on that.

Dr. Chris Miller

(40:33)
Yeah. Hope that's somewhat helpful.

Dr. Laurie Marbas

(40:36)
Yes. Here's another question. Oh, well, two questions. Kristen, sorry. I missed that question earlier. She's asking about the Wenckebach. I think it's how we say it's. It's actually a type of heart block, was asking if it's the same as AFib. It's not. Diet, I'm not aware of helping that.

Dr. Chris Miller

(40:56)
I'm not aware

Dr. Laurie Marbas

(40:57)
It's more of a structural issue versus a dietary electrolyte issue type thing.

Dr. Chris Miller

(41:02)
Although it's still good to optimize your diet your

Dr. Laurie Marbas

(41:07)
Always.

Dr. Chris Miller

(41:08)
… your heart function and your blood vessel function, so there is benefit, but I don't know that it will reverse that because it's structural.

Dr. Laurie Marbas

(41:16)
No. No. Not at all. Another question. I am whole food plant-based and what causes acid reflux? You want to dive in first?

Dr. Chris Miller

(41:25)
Yeah. Acid reflux is very interesting because it's so common, for one. People don't even often tell me about it when they come to see or you're probably the same thing, tell us about it as patients because it's so common, but it can be caused from a lot of things. Acid is in the stomach and it's made in order to help digest food. It plays a very important role actually.

Dr. Chris Miller

(41:49)
You need the acid to break down your food. It's part of the digestion. The first step of digestion happens in your mouth with chewing and then with the digestive enzymes, and then the acid in your stomach is going to help further break down your foods. It's important for that. It's also important to know in that it prevents bacterial or viral infections. If you were to eat something that's been exposed to something say either food poisoning or some other contaminant, the acid actually deactivates some of that. That's why there's evidence now that people on proton pump inhibitors have more pneumonias, because some of the acid you're not, the acid is not there anymore, and so you're not getting rid of the bacteria that's in from the food.

Dr. Chris Miller

(42:28)
Acid plays a very important role. It has to do a lot with the type of food you're eating. When people aren't eating fiber rich foods, fiber isn't moving through the gut very efficiently, and so it moves kind of slower. It has more chance of backing up. It has to do with if people, sort of people are eating the low fiber foods like meats and dairies and processed foods. That is basically standard American diet, which has no fiber in it. We'll see that pressure backing up.

Dr. Chris Miller

(43:00)
If people have something like diabetes where their gut isn't peristalsing and moving through the way it's supposed to or they're constipated, then that's also going to back up and they're going to see more reflux. If people are eating late at night and they're eating fattier foods, that is going to relax the esophageal sphincter, which is supposed to be holding the acid in the stomach, and so when they eat late at night or they lay down or they eating high fat foods or things like certain foods that relax it, the sphincter they'll have more heartburn.

Dr. Chris Miller

(43:33)
What's been really interesting in our practice is that it responds really well to changing your diet, actually, within one to three days, people can feel significantly better and something that they've had for their whole lives. It's really impressive how just adding the fiber and taking out those fiber less, high fat foods and a little bit altering the time that they're eating, that it's such a dramatic response and then we can taper, slowly taper off medications if they're on PPS.

Dr. Chris Miller

(44:02)
I tend to do that slowly because people can sometimes get rebound heartburn if you do it too quickly, but that one actually is really responsive to diet changes, so hopefully that's something that you are doing or working with to get the benefits of that.

Dr. Laurie Marbas

(44:19)
I would agree, and then some of the antacids actually contain sodium, which will drive up blood pressure as well. Exactly. Then, you can come off medications that might be causing secondary problems like high blood pressure or all sorts of digestion issues.

Dr. Chris Miller

(44:35)
Also, medications also prevent you from absorbing nutrients as well. So people that are on PPIs will also be deficient in things like magnesium, calcium, iron we'll see sometimes, and so this and even-

Dr. Laurie Marbas

(44:49)
B12.

Dr. Chris Miller

(44:49)
Right. Yeah. B12. Thank you. I knew there was another one. It's really important that you pay extra attention to those nutrients, and then you're at high risk pneumonias, and then high risk of heart attacks in fact from that as well, from those as well. Those medications were designed to be used for eight weeks or less acutely. If someone has an acute bleed or something going on. Those medications are there and they can play an important role, but it somehow became over the counter and people are on it for indefinitely.

Dr. Chris Miller

(45:18)
That's where they're getting into trouble. Really working with the diet and the lifestyle. Then, there are some herbs that can be helpful. They can kind of coat it, they're like demulsifier they're called. They kind of coat the stomach. I'll often use that with some people too while we're tapering off their medications. They're switching their diet to whole food plant-based. If they're not getting a full response or as quickly as we want, we'll use the herbs as well which can be helpful. There's a lot that we can do for that one, so hopefully, that helps you get on the right pathway.

Dr. Laurie Marbas

(45:47)
Fantastic in-depth answer. I do want to wrap up just by kind of going over back to the hypertension. Some things that we can do that are, you can modify in your life to reduce your blood pressure, so these are going to be things that you've probably heard. One is weight loss. For every kilogram of weight loss, which is 2.2 pounds. You can think to look, you're going to probably lose one point on your blood pressure.

Dr. Laurie Marbas

(46:12)
Of course, removing alcohol, excessive alcohol use can do that. We're keeping to a low sodium diet, which is 15 milligrams is what the recommendations are.

Dr. Chris Miller

(46:24)
1500 milligrams.

Dr. Laurie Marbas

(46:25)
Yeah. 1500 milligrams, and then seriously, that is really… You're going to get sodium naturally in the plant foods, but the thing is, it's really hard to do when you're not eating processed foods. You're just strictly eating whole plant foods and you're not adding salt to your cooking and things like that. The other thing is exercise. There's aerobic exercise. There's also resistance exercise, both of those are very beneficial. You want to aim to like 150 minutes per week with those.

Dr. Laurie Marbas

(46:50)
Of course, stopping smoking. That's huge. If you're smoking. I don't know what else we need to say, but please stop. There's some other things that you can incorporate into the diet if you're not already eating a whole plant-based diet is thinking about high potassium foods. Potassium around between 3500 milligrams and 5000 milligrams per day can actually blunt some of the sodium effects too. This low potassium diet is going to put you at high risk for high blood pressure. So make sure you're eating potassium-rich foods.

Dr. Laurie Marbas

(47:22)
Then, addition to that, what can you be eating? Coarse ground flaxseed also helps with breast cancer risk, but a quarter cup a day, you can spread it out through the day, however you like, freshly ground is great. High nitrate foods like your greens, arugula, beets, beet greens. There's all sorts of lettuces, rhubarb, cilantro, you name it. Greens are good for you. Beet juice, in particular, is really interesting, half a cup a day.

Dr. Laurie Marbas

(47:49)
Then, hibiscus tea. A cup with every meal is very helpful. There's just so many things that we can add into our life that's going to benefit, not just your high blood pressure, but also many other things, but Chris, do you have any other additions to that?

Dr. Chris Miller

(48:04)
No. That's an awesome assessment of it. Other things that I work on with patients is in addition to everything that Laurie just said, which I totally agree with. Sometimes for people if it's safe for you to do high intensity exercise can actually help a little bit too with lowering blood pressure a little further. So even just doing something like 20 seconds on 10 seconds off 20 seconds on 10 seconds off for like 3 minutes, if it's safe for you to do that.

Dr. Chris Miller

(48:31)
I don't know everyone's cardiovascular risk history, but if it's safe for you to do that and your joints will tolerate it. That can be helpful. You can just do like jumping jacks for 20 seconds, and then walk in place for 10 seconds, something simple in your house. Then, I do… Let's see. Green or white tea can be beneficial for lowering blood pressure in some people. Cocoa or cacao, the unsweetened basically just adding like the raw powder can be helpful because it's a vasodilator similar to like those green leafy vegetables that you were talking about.

Dr. Chris Miller

(49:03)
Then, of course, all the mind-body stuff which I can't ever stress that enough, so back to that four, seven, eight breathing or the five, five breathing, going to your happy place, meditating, yoga, all of those things are good. Walking outside, grounding, re-walking grass, forest breathing, all of that is calming down your nervous system and will help lower blood pressure as well.

Dr. Chris Miller

(49:26)
Sauna therapy has been shown to help lower blood pressure, so an infrared sauna or regular sauna can be another tool that people use. Intermittent fasting can also be helpful, so not eating late at night and trying to give yourself 12 to 14 hours where you if you stop eating by 6:00 or 7:00 PM, you don't eat the next morning until say 8:00 AM, you're going to give yourself 13, 14 hours and that's tremendous. That can actually help lower blood pressure as well .

Dr. Chris Miller

(49:54)
Everyone's going to be different. Yeah. It depends on how, what type of blood pressure and what's been going on in their lives. Some people will lower and I think, Laurie, you're going to touch on this. Some people's blood pressure will lower right away dramatically and fast. These dietary and lifestyle changes we're talking about are so powerful. It's more powerful than any medication I've ever seen. I'm sure-

Dr. Laurie Marbas

(50:15)
Yes. Absolutely.

Dr. Chris Miller

(50:17)
If you're on medications you have to be monitoring it, you have to be cutting back aggressively and that's what we've been helping people with in our practice to cut back the meds so it doesn't get unsafe, because you can get lightheaded, pass out, fall, hit your head, have all sorts of problems or even have a heart attack or kidney issues from your blood pressure being too low acutely if you change your diet and you don't make the appropriate changes.

Dr. Chris Miller

(50:43)
It's a dramatic effect that the diet and lifestyle has, so just being mindful of that and monitoring it and having someone help you if you're on medications-

Dr. Laurie Marbas

(50:53)
Exactly. Because it'll depend too on what medications you're on. Some are much stronger than others, how high your blood pressure is, how quickly you're responding, so maybe we cut it down three quarters, maybe cut it in half and we may do that over a period of a week to two weeks. This is really where it's important to have medical guidance in someone who's experienced in de-prescribing medications. That's not something that we go to medical school to learn to do.

Dr. Laurie Marbas

(51:19)
We learn to prescribe, but not de-prescribed, so super important that you're being monitored closely, because one of the things that you want to look for if you transition to this hopefully plant-based diet and you are already on blood pressure medications and you start, you feel good those first three, four days, a week, and suddenly you have this onset of dizziness with standing.

Dr. Laurie Marbas

(51:42)
That's what we call orthostatic hypotension. Meaning that as a change of position, your blood pressure will drop, because typically your blood pressure, your vessels will go, “Oh, she's standing. I need to squeeze, get the blood to the brain, get the blood to the muscles as we're moving.” That can be an issue when you're taking something, a pill that lowers your blood pressure, so that's one thing.

Dr. Laurie Marbas

(52:02)
The other thing is you feel dizzy and suddenly very fatigued. You were feeling great, and then now I'm just, I have no energy. You have to take a nap. You have to sit down. These are very, very, very important things, especially if you're doing outside work and you're dehydrated and you're not staying well hydrated. There's so many factors involved here, so please, either us or your doctor, just make sure that you're being followed carefully.

Dr. Laurie Marbas

(52:27)
The other thing just to keep in mind, kind of goes back to that question that we had earlier. She said, “Oh on occasion he'll eat a chicken wrap.” Well, chicken is a horrendous harbor of high sodium, because what happens is they… Remember, meat is sold by pounds, by weight, so what they'll do is they'll actually inject… You can't make this stuff up. They inject salt water to inflate the weight so they can sell it more of it.

Dr. Laurie Marbas

(52:57)
Chicken is not a healthy option, guys. People are like, “Oh I eat more chicken.” No. Stop. That's just some other considerations. There was another question here real quick. It'll be our last question because we want to keep this to an hour too, kind of be mindful of everybody's time. Robin asked, she heard an advertisement from a Dr. Lake, either Lake or Lakey about dermal repair complex consisting of hyaluronic acid, Saw Palmetto and some collagen, this rejuvenating skin or joint care.

Dr. Laurie Marbas

(53:33)
I know I have my thoughts on these type of supplements that people are pushing, but Chris, go ahead if you want to.

Dr. Chris Miller

(53:39)
I don't have much to say. I don't really use or recommend that a lot. I know things like collagen I don't typically recommend, because that's just amino acids that your body can build itself and by eating a healthier diet then vasodilates, I try to work more to increase blood flow to the skin and make sure they have all the nutrients through a colorful antioxidant-rich nutrient-dense diet. I don't use a lot of that. I guess I don't really have much that I can say.

Dr. Laurie Marbas

(54:06)
Yeah. I'm always wary when people are saying high potency this or high potency that or doing this. One, we don't know what's in it. It's not FDA regulated. People can make outrageous claims, so there are a few supplements that we recommend, B12, vitamin D, maybe omega-3, depending on the individual, but again these are individual, everyone should be taking B12 on a plant-based diet. No excuses and that's just what you need to do.

Dr. Laurie Marbas

(54:32)
But vitamin D, maybe your level is okay, maybe you don't need the omega-3. Again, these are things that depends, iodine, K2, but these are actually because the diet may not have sufficient quantities if you're not eating certain types of plant foods. Again, when you see someone touting lectin inhibitors or something crazy like that, there's typically a reason behind that. I'm always wary, and so don't listen, not look for shortcuts with supplements, but let's look at just supplements to make a already super healthy diet that much better.

Dr. Laurie Marbas

(55:09)
It doesn't take much. There's just a few things that we look at. I would say always be wary look and dive into the science if you're really curious, but honestly, I just typically just keep on strolling. Life's too busy to be drawn into these type of claims and remember, any high potency, anything, an herb, a supplement can be dangerous. You can even drink too much water, drink too quickly and it lowers your sodium.

Dr. Laurie Marbas

(55:32)
So too much of anything cannot be good. So just be very, very wary and careful. We don't want to fall victim to these type of marketing schemes.

Dr. Chris Miller

(55:44)
That being said, if it's your primary doctor or your doctor recommending it, then I would… Yeah. Definitely look into the research before I would tell you to stop it, but just be cautious.

Dr. Laurie Marbas

(55:56)
Yes. Be cautious or ask another physician on their recommendations. For sure. That's completely reasonable. I think we've answered all the questions and you guys have been a great audience

Dr. Chris Miller

(56:07)
Yeah. We really appreciate it questions you guys. I hope we talk, got you understanding a little bit about high blood pressure and everything else.

Dr. Laurie Marbas

(56:14)
Absolutely. We'll be back next Thursday same time, same place and we're signing off. Don't forget, plantbasedtelehealth.com if you need a plant-based doc. Please share to your friends and family about us. We really appreciate you guys being part of our community.

*Recorded on 5.14.20

Self-love, Fortified yeast, and Iodine | Love.Life Telehealth Q&A

In this Q&A episode our team of plant-based doctors discuss self-love, fortified yeast, iodine, and more! Questions Answered (00:03) – The concept of self-love (11:48) – Do you recommend fortified nutritional yeast or non-fortified? (16:58) – Could you please talk...

Welcoming Dr. Alon Sitzer! | Q&A | Ways to deal with fatigue

In this Q&A, our Plant based Telehealth doctors introduce Dr. Alon Sitzer and discuss ways to overcome fatigue. Questions Answered (00:04) - Introducing Dr. Alon Sitzer (02:54) - Dealing with fatigue (12:01) - 12 steps that you can do today to begin to reduce your...

How To Properly Recover from Injuries | Lifestyle Medicine Q&A

The PBTH doctors discuss the proper way to recover from surgeries, accidents, and much more! In addition, they talk about: -What you should eat to increase your recovery time. -Why your gut health is critical to your ability to recover. -Whether eating bread is...

Tips From Lifestyle Medicine Doctors | Improving Arthritis

According to the CDC, up to 25% of Americans have arthritis. Dr. Miller discusses how arthritis forms and ways to help prevent and treat it. In addition, Dr. Miller, Dr. Marbas, and Dr. Scheuer discuss ways to improve your weight, B12 supplement recommendations, and...

Improving Your Skin Health | Q&A with Dr. Apple Bodemer

In this episode, guest Dr. Apple Bodemer, whose specialty is dermatology, discusses ways to improve your skin health. Questions Answered (00:03) - is Dr. Apple Bodemer, could you give us a little bit of background on you, and what your specialty is, and how you got...

Improving Your Kidney Health | Special guest Dr. Sean Hashemi

Special guest Dr. Sean Hashemi discusses different ways you can improve your Kidney health. Questions Answered (00:04) - Dr. Hashmi, could you tell us a little about yourself? (02:04) - What would be the guiding principles for someone who is worried about their kidney...

Q&A with Plant Based Nutrition Support Group

Special guests Paul Chatlin & Lisa Smith discuss how their organization Plant Based Nutrition Support Group offers communities to anyone looking to use a plant-based diet to treat their chronic diseases. Questions Answered (00:33) - Introducing the Plant Based...

Lifestyle Medicine Doctors Q&A | Dementia, Iron, Osteoporosis

The PBTH doctors discuss how a plant-based diet affects iron levels, dementia, osteoporosis, and much more! Questions Answered (00:04) - Do you know a dietician that is wholefood plant-based and knowledgeable of hemochromatosis? (02:44) - I have been on a wholefood...

Essentials for Plant-Based Diet with Guest Dr. Michael Greger

  In this video our plant-based doctors answer your questions about suppliments, olive oil, and kidney disease, with quest speaker Dr. Michael Greger. Questions Answered (00:47) - Dr. Michael Greger, do you have any new projects that you like to share with us or...

PlantPure Nation | Q&A with Guest Speaker Nelson Campbell

In this Q&A, We welcome guest speaker Nelson Campbell and answer questions about PlantPure. Learn more about PlantPure Nation and Nelson Campbell https://www.plantpurenation.com/​. Questions Answered (00:12) - Can you tell us about PlantPure (10:18) - How can I...

Plant-based Nutrition | Live Q&A | GERD, Blood work, and A1C

In this Q&A, our plant-based doctors answer questions about plant-based nutrition, GERD, Blood work, and A1C. Questions Answered (00:40) - Silent GERD, Causes and Remedies (06:53) - Would you recommend surgery for a hiatal hernia for an 82 year old? (08:24) -...

What’s Missing from Medicine, Q&A with Guest Dr. Saray Stancic

On this Q&A plant-based doctors answer questions and discuss the many ways lifestyle medicine can improve your health. Questions Answered (02:38) - Introducing Dr. Saray Stancic (10:31) - Can you tell us about your film "Code Blue"? (15:55) - Where can I watch...

How to Monitor Your Health | Lifestyle Medicine Doctor Q&A

In this week’s webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas answer a series of questions asked by the live audience on all topics related to medical conditions, plant based nutrition, and lifestyle medicine. Questions Answered (08:01) - What are your thoughts on...

Live Audience Questions | Lifestyle Medicine Doctors

In this week's webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas answer a series of questions asked by the live audience on all topics related to medical conditions, plant based nutrition, and lifestyle medicine. Questions Answered (01:34) - Do you have any advice for...

Discussing Lifestyle Telemedicine

In this week's webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas discuss the incredible opportunities of practicing lifestyle telemedicine and how patients can best partner with their doctor to get, and stay, healthy. Questions Answered (00:52) - The complications of...

Getting Started on a Whole Food Plant-Based Diet

In this week's webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas, and special guest Julieanna Hever, The Plant-Based Dietician,  discuss and answer audience questions about getting started on a Whole Food Plant-Based Diet. Questions Answered (02:11) - Adding vegetables...

Protecting Your Child’s Health | Live Q&A

On this Q&A plant-based doctors answer questions and discuss key aspects of protecting your child's health. Questions Answered (00:03) - Children's immune system (09:21) - Getting children to eat fruit (13:23) - Make healthy eating fun! (15:05) - The "one bite"...

Skin Health

In this week's webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas answer questions about keeping your skin healthy. Questions Answered (00:39) - Understanding our skin, our largest organ (06:18) - Our skin as a reflection of our internal health (10:45) - Some common...

Habit Change

In this week's webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas answer questions about habit change. Questions Answered (01:00) - Why do we care about changing habits? (07:50) - What's needed to create behavior change? (10:28) - Developing a growth mindset (11:58) -...

Your Questions Answered | Sprouts, Weight loss, and Salt

In this week's webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas answer your questions. Questions Answered (01:25) - How to explore eating new foods, for overall health? (03:48) - What about sprouting? (05:53) - Are alfalfa sprouts toxic? (07:51) - How many is too many...

Gut Health

In this week's webinar, Dr. Klaper, Dr. Miller, and Dr. Marbas answer all your questions about gut health. Questions Answered (00:38) - Dr. Miller on why Gut Health is important. (05:37) - Dr. Klaper on the evolution of Gut Health. (15:33) - What about excessive gas /...

Welcome Dr. Klaper

In this week's live Q&A, Dr. Marbas and Dr. Miller welcome Dr. Michael Klaper to the PlantBasedTeleHealth Team. Dr. Michael Klaper is a gifted clinician, internationally-recognized teacher, and sought-after speaker on diet and health. In addition to his clinical...

Food Addiction

In this week's webinar, Dr. Miller and Dr. Marbas answer all your questions about food addiction. Questions Answered (02:40) - Dr. Miller & Dr. Marbas on food addiction. (11:27) - Assessing your susceptibility food addiction. (15:45) - Dealing with cravings...

Thyroid Health

In this week's webinar, Dr. Miller and Dr. Marbas answer all your questions about thyroid health. Questions Answered (00:47) - What is the thyroid and what does it do? (06:01) - Dr. Marbas's experience with Hashimoto’s thyroiditis. (10:34) - The importance of...

Plant Based Nutrition

In this week's webinar, Dr. Miller and Dr. Marbas answer all your plant-based questions. Questions Answered (01:53) - Getting started on a while food plant-based diet. (02:59) - Do food deliveries create a risk for coronavirus infections? (07:08) - Will drug-eluting...

Your Immune System

In this week's webinar, Dr. Miller and Dr. Marbas answer questions all about the immune system. Questions Answered (02:18) - The importance of a balanced immune system (04:47) - Stress and the immune system (16:52) - What causes IBS, or irritable bowel syndrome?...

Autoimmune Disease

Dr. Laurie Marbas and Dr. Chris Miller from Plant Based TeleHealth answer live Q&A questions about autoimmune disease. Dr. Miller discusses how diet alone was not enough for her to find healing. Questions Answered (02:28) - Can you please address hypothyroidism on...