Digestive Issues – Causes – Solutions

00:05-03:20Who is Dr. Bryan Rade?
03:21-20:31Dr. Rade on IBS
20:45 – 31:36Acid Reflux and Measuring Stomach Acid Levels
31:43- 34:54Celiac Disease and the Gluten-free Diet
35:27-38:01Do SEBO Diets Harm the Microbiome? 
38:48-43:37Nausea and Constipation with Dr. Bryan Rade 
44:54-50:13The Truth About Probiotics! 

Who is Dr. Bryan Rade?

Dr. Clayton Roach: [00:00:06] So let’s get started. Bryan, let’s give a quick intro for the ones that weren’t there last month very quickly. Who you are, what you’re doing right now. What’s inspiring you in the clinic and then we’ll get going.

Dr. Bryan Rade: [00:00:25] Ok, so I practice at the East Coast Naturopathic Clinic in Bedford. I’ve been practicing for 12 years and my practice primarily focuses on these more challenging or treatment-resistant cases. I treat a lot of chronic digestive disorders. I also treat a lot of chronic pain. So hence our chatting about or discussing regenerative injection therapies last month. I also work with a lot of patients with chronic infections. Things like persistent Lyme disease or other types of chronic viral infections.

A lot of patients have a cancer diagnosis. I treat patients with neurological conditions like Parkinson’s, Alzheimer’s, GMS, things like autoimmune conditions, children on the autism spectrum. If it’s anything complicated or difficult, then that’s what I specialize in. Apparently, I want to have as much gray hair as humanly possible and I’m doing a pretty good job. Lots of gray in there. So that’s what my practice is all about things that are inspiring me or exciting me these days.

Dr. Bryan Rade: [00:01:40] There’s just always stuff. So I could. There’s something new like every week that that I get excited about. But the thing I’m probably the most excited about right now is just read this really great book. It’s called the thyroid diet thyroid reset diet. It’s by a naturopathic doctor named Alan Christiansen. He goes into the scientific literature about how we are being over-iodized in our society. We add iodine to all of our salt and there’s lots of salt and in many processed goods, for sure.

But even folks who are buying Himalayan sea salt. It’s pink. It must be must be healthier than regular white salt, boring old white salt. He makes a strong case that many thyroid issues might be induced or exacerbated by excessive amounts of iodine. So anyways, that’s been really fascinating. That’s kind of been blowing my mind lately. So that’s my most recent thing that I’m excited about.

Dr. Clayton Roach: [00:02:53] Oh, that’s very cool. Always glad to be with people surrounded by people that read and still want to grow at this point. You’ve been in practice for a while, and sometimes it’s easy to kind of dove into a rut. And obviously, these patients keep you thinking and on your toes because you don’t pick the easiest of cases. So I definitely commend you for that because that’s a challenging way to go about practicing. And every day you’re you have to deliver on your promise, so to speak. So let’s jump into this topic of digestive issues. I think it’s a very pertinent and popular topic nowadays.

I see it in clinics and a lot of people have these issues. And unfortunately, a lot of them don’t get diagnosed. They go month after month and year after year with an improper diagnosis. They don’t know where to turn to. So they jump on these bandwagon diets and, you know, a one size fits all type of approach. One of the things that I feel is true is that there’s an increase of those issues. I don’t know if it’s because of the quality of the food that we’re eating or of stress. I’m assuming that it’s a multifactorial problem. Maybe we’re not seeing an uptick, but I feel we are. Can you comment on that right?

Dr. Rade on IBS

Dr. Bryan Rade: [00:04:13] Um, yeah, as I say to my patients all the time, I live in a bubble, so, you know, I’m surrounded by my patients and my patient population. Most of them have been struggling for a long time. And then my, my wife, the naturopathic doctor. So I’m immersed in that at home as well. We lead a naturopathic lifestyle, have lots of naturopathic friends, so I very much live in a bubble. But I would say that it’s really quite rare that almost regardless of what a patient is coming in to see me for, whether it’s for like they’re they need PRP for their knee or they have Alzheimer’s or they have an autoimmune condition. I would say that the vast majority of my patients have digestive issues, so I would say it’s very prevalent.

I treat a lot of chronically ill folks or more complex cases. Probably 80 percent either speaks to there’s a digestive root component to a lot of their issues. Also, correlation doesn’t equal causation. But I definitely I would definitely say it’s very prevalent in my practice, for sure.

Dr. Clayton Roach: [00:05:24] Yeah, that’s well said, because I know I live in a bubble as well with my practice, and I don’t necessarily focus on digestive issues, but obviously within the health history intake process, those issues do come up. One of the ones that I hear a lot about is IBS, right? So this might be a good one to start with, Bryan. Enlighten us a little bit about IBS, what it is and what can be done in terms of testing. Because with those testing, you’re shooting blind darts. I always say to corral your way through a maze and it’s dark and you’re not seeing where you’re going. You’re kind of grasping at straws in terms of figuring out why you’re going through periods of hardship and then it’s OK and shut a little bit of light on that issue. That is IBS.

Dr. Bryan Rade: [00:06:13] Sure. Yeah. Anyone listening who has IBS know knows what it’s all about, but for anyone who’s not familiar. So oftentimes there are symptoms like gas and bloating, abdominal discomfort. There’s three subtypes of IBS, so there’s IBS. See if there’s more of a constipation-predominant. There’s IBS D. If there’s more of a diarrhea-predominant, then there’s IBS, which stands for mixed. So i.e. it’s an acknowledgment or diarrhea. Oh, you learn something new every day. So. Those are the three subtypes of IBS. And then there can be other associated symptoms as well, kind of touching on what you mentioned earlier. Dr Ben, where there’s there, can be a mental-emotional component to things.

Oftentimes there can be a stress with IBS. There can be an exacerbation or an induction of symptoms when a person is feeling more stressed. So that’s kind of a little bit of an overview of IBS. And then with IBS, it’s really quite fascinating because it had so many patients. With IBS there are certain pharmaceuticals or dietary interventions or fibre supplements that can help with symptoms. Most patients are told that IBS is just something you’re going to have to learn to live with. Like there’s no cure for IBS. And indeed, like there is no pharmaceutical that’s known to cure it. There’s no surgery for it. Granted, there is the odd patient who does phenomenally well on a given prescription medication. It might be curative for them.

Dr. Bryan Rade: [00:07:57] But generally they’re told you just have to learn to live with this, and that’s a drag in general. And it’s especially challenging when you’re told that at fifteen or twenty-five. Hopefully, have another seventy-five to eighty-five years ahead of you on this planet, that’s a challenging thing to live with. It’s not rewarding when we identify these root cause factors through some testing or just figuring it out clinically. Not everybody wants to have testing done. Not everybody can afford to have lab testing done. The test that I find to be the most useful is the ones that aren’t covered through provincial health care.

The tests that are available through provincial health care, they’re very, very useful. You know, you may need a colonoscopy or a biopsy or whatnot to rule out inflammatory bowel disease like Crohn’s or colitis or getting H. Pylori ruled out because that could be a cause of what is maybe presenting as IBS like symptoms that can be really helpful. But most of the patients I see, they’ve already run through the gamut of everything they can do with their family doctor, which makes sense. And then many of them have gone on to see a gastroenterologist maybe had some additional testing or recommendations there, but they don’t really.

They don’t come to see me if they’ve got, it’s already been fixed. So I see the folks who haven’t been fixed yet. And so in those cases, they’ve kind of tapped into the testing or treatments that are available through the health care system. And if they’re not 100 percent better, then we have other tests and things that we can work with thankfully.

Dr. Clayton Roach: [00:09:21] So IBS irritable bowel syndrome is kind of general, right? What could be the potential irritants that would create that inflammatory state we hear about like leaky gut? How the gut wall can become eroded or irritated? So let’s talk a little bit about that in terms of what could be the potential causative factors.

Dr. Bryan Rade: [00:09:46] Yeah. So kind of reverse-engineering the whole process of kind of looking at, well, what kind of things have resolved the IBS symptoms or like put it into remission or whatever kind of language you want to use. So in some cases, it is as simple as a diet and, you know, changing your diet, it’s not the easiest thing. Some have said that changing your diet is harder than changing your religion, so it’s a little maybe a cheeky thing, but that some people have said that. And for some patients, I can say it’s probably true because they really don’t want to change their diet. And sometimes it’s as simple as cutting out gluten, and then their IBS goes away and got to love those cases because like, how easy is that?

Where I’m at in my career, patients who come to see me have already done gluten-free, dairy-free, sugar free, they’ve been on a low FODMAP diet, paleo diet, keto diet, low oxalate diet, low salicylate, diet, low like they’ve done everything and then they’re still not better. That’s not going to be as easy as just cutting a gluten. But food triggers can be huge. Stress can be a big factor as well. I see a lot of in my practice as we do this functional test to determine if somebody has low, low stomach acid. Oftentimes they do, and it can sometimes be pivotal, beneficial for them to work with something to help boost up their stomach acid level. Sometimes like they’ve done lots of other treatments and tests and this and that, and it’s the stomach acid that makes the biggest difference.

Dr. Bryan Rade: [00:11:12] At the end of the day, it’s like, Wow, how simple is that? But what’s one of the biggest drivers for depleting your stomach acid? I mean, aside from advancing age, so granted, as we get closer and closer to one hundred, our stomach acid slowly goes down. But that being said, plenty of octogenarians in my practice and their digestion is just fine. So it’s not a guaranteed thing. But that is one immutable factor that will start affecting stomach acid levels. But the other big thing, at least in my experience that can affect stomach acid, is stress. When we don’t get into that parasympathetic relaxation, you know, rest and digest mode, then it really, really does impact and impair your digestive capacity.

I have a lot of patients who are just like type A or they’re anxious or this or that, and they’re like, I’m doing all the right things diet-wise, and I’m treating my microbial overgrowth and my gut and some of the things I’m sure we’ll talk about coming up soon. Yet I’m still not one hundred percent better or my gut still so touchy. Get them onto stomach acid supplements. Sometimes it just makes that all go away because they’re just literally not able to get into that restful enough state that common estate where they can actually make enough stomach acid to break their food down. Stomach acid is not technically not the first step of that process, but I would say it’s certainly the first most impactful step in the digestive process. If that’s not present, you’re just really setting yourself up for failure, digestion wise.

Dr. Clayton Roach: [00:12:32] That’s really cool. So a couple of weeks ago, Dr.

Dr. Ben Boudreau: [00:12:35] We had a conversation together about the idea of sleep, and so we were talking about how these patients just aren’t able to get into that parasympathetic state. And so do you find that there’s a connection between people who have the condition like IBS or other stomach issues and a lack of sleep?

D.r Clayton Roach: [00:12:52] Like sleep apnea. Right? Be a good example.

Dr Bryan Rade: [00:12:56] Yeah, I mean, definitely have definitely seen a correlation with insomnia. I don’t know if I can say with sleep apnea specifically but definitely insomnia. Whether that’s being contributed to by sleep apnea or caused by it. But I would definitely say, like the folks that have a hard time getting into that rest and digest mode. They have a hard time with the digest and then they have a hard time with the rest to, you know, to be able to fall asleep and stay asleep. There’s this constellation sort of picture that I did this two year fellowship program of five or six years ago now with one of my colleagues and something called Endo Biogenic Medicine, which is kind of like the French version of naturopathic medicine. Naturopathic medicine is really a North American phenomenon in Germany and Switzerland.

They have something called biological medicine, which is kind of their version of naturopathic medicine and biology is kind of a French version. So this is a trivia question. If you were playing Trivial Pursuit, if anybody actually remembers what Trivial Pursuit is, if that question comes up, that’s what medicine is the French version of natural medicine. So I did this two-year fellowship, and one of the most useful things I got from that whole program was learning about something called alpha sympathetic dominance, where these are the folks who kind of get into like this, they’re just revved up.

Like sometimes they’re physically revved up or they have like heart palpitations and they’re just kind of jittery and the muscle spasms and like, they just can’t calm down, but they can also be very mentally revved up as well. Or like they just have a hard time sleeping. They ruminating a lot. They’re worrying about things like a classic worry word type, a person who says, like, what’s a coach like? I never sit on a couch to watch TV, like I’m always

Dr. Clayton Roach: [00:14:37] The ones in your waiting room that just never sit down. There you

Dr. Bryan Rade: [00:14:40] Go. Yeah, the pacers. And so those are the folks where it’s very common that you’ll see the digestive issues because they’re not getting into the rest and digest from that perspective. They’re having trouble with sleep. They have anxiety and oftentimes their adrenal glands get burned out like they have adrenal fatigue. Over time, like they’re the Energizer bunny through the day. But then as soon as the stimulus goes away, they just crash like nobody’s business or they they’re great during the work week, but they crash on the weekend.

That alpha sympathetic pattern, that kind of constellation of digestive issues, sleep issues, feeling kind of stressed, having a hard time relaxing. It’s a really common pattern that we see, and it’s it’s hugely important for those folks to work with things to help calm the nervous system down because we can treat really downstream and take the stomach acid. Treat the microbial over in the gut. Change the diet. Maybe work with certain things like GABA or five FTTP or things that help calm the nerves of the town. Melatonin at night time to help them sleep or valerian root or whatever it happens to be. But ultimately it really. And that can really help, symptom wise. But it really it’s all stemming from inside of them. It’s there like that. The underlying factors that are ramping up their off the sympathetic nervous system.

And so that’s where sometimes it’s, you know, we got to talk about Work-Life Balance. We have to talk about maybe some cognitive behavioral therapy, maybe work with a like a psychologist or something like that just to kind of help with that. If we really want to get to the root cause aspect of things that sometimes is necessary in those patients. Hmm.

Dr. Clayton Roach: [00:16:14] So you go through the inventory of what they’ve done, so somebody comes in with you to you, Dr. Reid, and they have IBS. You take an inventory of what they’ve done. If they try gluten-free dairy-free, all the stuff gets a sense for their lifestyle. And then that helps you determine where you’re going to start with that patient, potentially with testing, whether it be whatever bowel testing you’re going to do. And then based on the results of that test, then you can guide you towards whatever treatment plan you’re going to do and recommendations correct?

Dr. Bryan Rade: [00:16:50] Yep, yep, exactly.

Dr. Clayton Roach: [00:16:53] And most of those tests, we’ll talk about that maybe a little later, but a lot of the ones that you’re going to do obviously haven’t been done from a medical standpoint, which is why they’re coming to you. So a lot of them and I know this from our family, when we’ve seen you, a lot of them are not covered, but they’re not, you know, you’re not talking about a $4000 test either, right? So a lot of them can provide a lot of great information that again, unfortunately, it’s not going to be provided most of the time by the regular medical testing per say, like a scope or whatever they’re going to do, right?

Dr. Bryan Rade: [00:17:25] Yeah. Yes, absolutely. And I mean, with the testing like just to give folks listening a sense of it because, you know, like not expensive is that five dollars is that only eight hundred dollars? Like, what does that mean? So just to kind of give a rough sense, like a very common test that we do? Is this actually this breath test, which assesses for this condition called small intestine bacterial overgrowth? And that’s going to range depending on which clinic somebody goes to, in which lab they’re using in this? Like, so I’ll just speak to the prices at our clinic just because I know what those are.

And so that’s like one hundred and twenty dollars to do that test. Or if you’re going to do a stool test that might look for large intestine, bacterial overgrowth or yeast overgrowth in the gut or we want to get a sense of probiotic levels like there’s a combination test that does that there aren’t any Canadian labs that do that testing. So the prices are in US dollars with those labs, some clinics do you pay the clinic directly and then they pay the lab at our clinic? We don’t like getting involved in that at all costs, really, because quite frankly, the tests, if we just don’t, we just don’t like to get involved with that. We figure, you know what?

Patients are paying us for our services. You can pay the lab directly. We don’t want to get involved. We don’t make any money, whether they do the tests or not. We’re happy with that. And so with that type of testing, it’s one hundred and seven dollars us or if we want to do like the big daddy of all stool tests, something called the comprehensive stool analysis that’s going to look at the probiotic levels, the bacteria, the yeast, but it’s also going to measure a bunch of these what they call stool chemistry parameters.

Dr. Bryan Rade: [00:19:05] So it’s going to tell us about the level of something called short-chain fatty acids, which is a fuel source for the intestinal cells. That’s going to tell us about something called secretory IGA, which is the main type of antibody that’s produced in the intestinal mucosa. So if that’s really high, then that might be an indication that the guts really irritate her to being attacked by something. If it’s really low, then it might mean that the patient’s gut is more susceptible to damage or rather microbial overgrowth.

Or it might be that they’re not producing enough bile in their liver and being excreted by their gallbladder because you need bile in order to make secretory IGA, for example, the test tells us about how well they’re digesting their carbohydrates or fats and their proteins. There’s inflammatory markers, so we can get a lot of really great information from a comprehensive stool analysis. So it tests like that, which is quite a bit more comprehensive. That’s two hundred and thirty. I think they just actually increase the test by like ten bucks. I think two hundred and thirty five bucks us now. And that’s like it’s a good chunk of change, but it’s not like several hundred dollars, thankfully. Yeah.

Dr. Clayton Roach: [00:20:09] And for somebody who’s been going down this rabbit hole, you know, time and time again, that is a small exchange, you know, in terms of being able to find out information that you didn’t know about your gut prior, that probably is, you know, impacted your life for 15, 20, 30 years for some people and shedding a little bit of light on what could be done to rectify the situation. So guys, I don’t know how you feel about this, but I think it’s good information. I’ve learned something already. So just give us a few a few thumbs up there. If there’s if there’s a little liking going on here with what you’re hearing a little question here. Is there a test for stomach acid levels?

Acid Reflux and Measuring Stomach Acid Levels

Dr. Bryan Rade: [00:20:51] So, yes, there is the there is kind of an official test that can be done for that. And it’s a really, really cool machine that’s used. I’ve honestly had it on my wish list for a while, but the functional test that we do instead just work so well. I just haven’t been able to justify buying this machine. It’s expensive. But anyways, there’s something that’s called a Oh my goodness, I’m blanking on the name. I think it’s called the gastro gastro scan. But basically what you do is you swallow this pill that has a some type of like a radio frequency emitting technology in it. And then a scanner is put over top of the person’s stomach and it will.

The pill sends data about the pH, so the acidity level of the stomach as it’s sitting there. Then what it’s really, really cool about it is that you can actually then track the pill because you know what goes in one way must come out another way. About 20 minutes after they swallow it, then they can actually use the tracer over top of the patient’s abdomen to actually track it as it’s moving through the intestinal tract. You can get a sense of the motility of the transit time of the gut, the acidity level in the small intestine and this and that. That’s the best test to my knowledge. No one’s offering that in Atlantic Canada, and you would be the first one. I would be, I know, and that’s the other job.

Dr. Clayton Roach: [00:22:15] I would consider you amazing if you had that test.

Dr. Bryan Rade: [00:22:18] I will put that in the list of motivators to spend the money to survive that machine. But honestly, like and I have lots of tools and toys, you could ask my wife, you should interview my wife at some point, ask her how much money I have spent over the years on gadgets and gizmos because I have no hobbies. Oh, you’re a gadget guy, too. Yeah. So we yeah, we get along so well. And so just the cost of that little fancy pants pill that you swallow the cost of consumables for that. It’s like about one hundred and fifty bucks per four per test. So it’s either that or we do this free because we just have we give it the material for free to do the functional test, which I’ll describe in just a minute.

So it’s either like I could ask patients to spend one hundred and fifty bucks to do this test, which granted is really cool and fancy. And granted, I’m going to give us a really precise info. But the functional test is zero dollars and it works really, really well. And that’s what I’ve been doing for 12 years in practice. So I haven’t been able to justify that, you know, getting the machine. But the functional test is. And bearing in mind that nothing that I’m saying right now should be construed as medical advice or me asking anybody to do this, but just for information sake.

Dr. Clayton Roach: [00:23:35] All medical advice. What’s that? Sorry. This is all medical advice.

Dr. Bryan Rade: [00:23:39] Ok, well, I’m going to save it. I’m saying is not medical advice. Contrary to what Dr Roach might say, this is not medical advice that I’m saying at least. So basically, it’s a test where a patient takes a capsule of stomach acid. So we have an open bottle at our front desk, so we just give out a few capsules and little packets to patients. That’s why that’s why it’s a zero dollar test at our clinic, at least. So we give them a few capsules and then basically they take a certain amount of acid. They’ll be a little elusive here. So I’m not my colleague.

You won’t get mad at me for saying this, so it’s not construed as medical advice, but basically, they take a certain amount of stomach acid capsule at a certain time and then depending on their response to that, basically whether they feel nothing when they take it or they get heartburn from when they take it. And I won’t say whether it’s with or without food, so please don’t do this at home, kids. But unless your naturopathic doctor or somebody else prescribes it for you, but depending on their response to that, then that will.

That gives us very useful clinical insight into whether they have low stomach acid or not, and I found that to be incredibly predictive and very accurate. That’s why I just have not been able to buy the fancy machine. But that’s the functional test to determine if someone has low stomach acid, also known as hypochlorite Adria. And hopefully that answers the question.

Dr. Clayton Roach: [00:25:00] Cool. Great. Great segue into the next topic. Heartburn, acid reflux. Go.

Dr. Bryan Rade: [00:25:10] Hmm. Yeah, so in terms of things that can drive that, so I mean, foods are like food triggers can be huge. And quite frankly, I’ve had many patients who come in and they say, like, Oh, like, I’ve got IBS. I’m like, Oh, and I had my intake forms as I’m sure you folks have it too. It’s like, do you have these conditions? And if so, are they present like, do you have this or you don’t have this or have it? Have you had it in the past? So we’ll say, Oh yeah, I had heartburn in the past and like, Oh, what? How did that go away?

Like, Oh, I just stopped eating certain foods that my family doctor or my nutritionist or my gastroenterologist told me to avoid. And my heartburn is gone. But I still have my IBS or whatever it is. And so I have foods like chocolate and spicy food and tomatoes, particularly cooked tomatoes, anything like really acidic, like orange juice, that kind of stuff. So food triggers can be huge, but there can be other food triggers, too. I’ve had patients who go gluten-free or go on a paleo diet or things to that effect and that resolves their heartburn in some cases.

And then I’ve had many patients where we need to either ideally test for or at least do a therapeutic trial treating for something like small intestine bacterial overgrowth, which is a really common correlation or common thing, rather that I’ve seen in the really challenging cases of heartburn or reflux. It’s not to say that every case of heartburn or reflux, if we find sibo, it resolves it, but that’s oftentimes a big trigger. There can, of course, be mechanical factors which you guys could talk more about than me in terms of like hernias in this and that. But in terms of things that I see in my practice, oftentimes it’s a food triggers and microbial overgrowth in the gut.

Dr. Clayton Roach: [00:26:52] But really, I know, like I treat a lot of kids as well in my practice, and one of the things with newborns is, you know, a lot of them are often diagnosed with reflux, right? So they can’t keep, you know, the breast milk down or. Do you see that a lot in your practice is that oftentimes not necessarily misdiagnosis? They may have it, but in terms of the cause? It’s not really I would say it’s not really push to figure out why is it happening, I guess is what I’m concerned about.

Dr. Bryan Rade: [00:27:27] Yeah, I have seen many cases of infant reflux over the years, and I have found that I don’t even know if I can think of a case where when it was either a food trigger or maybe we did like a stool test on the little one and found that there was like a yeast overgrowth or something like that. Oftentimes with kids like you can really tell clinically, it’s like, Oh, mom’s having, you know, yeast infections around on her breath. It’s like, OK, then the kid has, you know, maybe yeast in their gut. And so we don’t even need to test sometimes. But yeah, it’s really, really common that I find that those cases are very amenable to treatment.

Dr. Clayton Roach: [00:28:05] So Nexium and all these pills like proton pump inhibitors. Are you concerned by those?

Dr. Bryan Rade: [00:28:11] I’m a little bit concerned by them. I mean, when you really dig into the literature on them like to me, I understand there are some studies that show that being on them for a prolonged period of time might increase the risk of certain health conditions it might cause. A vitamin B12 deficiency might be associated with certain types of cancer, might be associated with higher risk of osteoporosis. To my understanding, when those studies really have their feet put to the flame, so to speak, it’s not hard and fast, definitive evidence. So if you really kind of look into it deeply, it’s not necessarily like a huge risk.

But I do think that at the end of the day if we can avoid fiddling with natural physiology and a patient can feel good without needing to, that’s probably the best thing to do because I haven’t seen any literature out there looking at, oh, like if I’m on Nexium for twenty-five years, like how does that? How does that impact me? It’s like, I don’t believe they’ve done studies that long, and some people are on it for like 40 years. So it’s I think there’s still some unknowns there. And so it’s like, well, what is next to do? It inhibits your ability to make stomach acid. It’s like, well, your body wants to make the stomach acid, it’s doing it for a reason. So maybe we should try to fix the problem so you hopefully don’t need to be on the Nexium?

Dr. Clayton Roach: [00:29:33] Yeah, I had a patient one time and not a patient. Sorry, I had a conversation with. With a doctor, and I kind of relayed that information to the to the patient, I might confuse people here, but. And maybe I’m the one that’s confused. But if I understand correctly, acid reflux is actually a problem of the stomach not secreting enough acid. Is that correct?

Dr. Bryan Rade: [00:29:58] Yeah, it’s a really good question. And in my practice, I’ve seen many cases where the reflux got better or went away when we put them on stomach acid. So it’s like, Oh, it must be a deficiency. And there are certainly cases, though, where the patient goes on stomach acid and actually really exacerbates their symptoms. And in those cases, I do wonder, is that because they have some underlying gastritis and just the extra acid is just too harsh on their stomach? Or maybe their esophagus is just so cranky that the stomach acid, if it is reflux up a little bit, it’s causing an aggravation of that tissue. But I’ve looked I’ve spent I don’t have a social life, so I spend a lot of time looking at studies and things like that.

Pubmed is my home away from home, looking at which for folks who don’t know, it’s a database of every study ever done. Pretty much. And I have not been able to find a study looking at the link between low stomach acid and reflux. So there are theories that have been like kind of pieced together with supporting evidence from the research literature. But I haven’t found any distinct literature to date saying that there’s a causal link there between low stomach acid and reflux. What is of interest is that the incidence of reflux goes up over time and the ability of our, as I mentioned earlier, our stomachs to make acid goes down over time. So that’s some interesting correlated data or info. But I have found that in a lot of cases, it winds up being a low stomach acid issue.

Celiac Disease and the Gluten-free Diet

Dr. Ben Boudreau: [00:31:36] Ok, so just switching gears from condition, the condition here, moving on. I was wondering if you could speak a little bit to celiac disease and what patients can do for themselves or is it just simply adopting a gluten-free diet? And here we go. We’re rolling now. So what can patients do to help manage some of those symptoms other than adopting a gluten-free diet?

Dr. Bryan Rade: [00:32:00] Yeah, that’s a great question. So, yeah, with celiac disease, you know, for folks who are diagnosed with celiac disease and they cut out gluten and then all of their problems go away, in my opinion, that’s all of their digestive problems anyways. Maybe not life problems, but any digestive problems, at least. Then in that case, it’s problem solved open a book or open and shut case like you’re just, I think, probably good to go. You probably don’t need to do anything beyond that where but then there are some patients where, and I would say it might be like in my experience, maybe like 30 percent of the time, maybe 20 percent of the time, they’ll say, like, Oh, I was diagnosed with celiac disease.

I’ve stopped eating gluten, and I’m not all the way better. Like, I’m better, but I’m not all the way better. I still have significant symptoms. And in those patients, a lot of them have that small intestine bacterial overgrowth condition that I mentioned. So it’s really, really common to see that in those patients. And what’s really interesting, just a little bit of history, and I forgive me, I don’t remember all the exact details, but the punch line anyways, is that back in, like the nineteen twenties or something like that a long time ago, there was this issue where kids would have celiac disease and nobody knew what it was at the time and like the kids would get really sick and die.

Dr. Bryan Rade: [00:33:18] And it was really, really awful, obviously. And so there is this doctor, and I don’t remember his name, but he would put he developed something that became known as the banana diet because kids were it was a very strict diet. A lot of the calories came from eating bananas and calling it the banana diet. So basically, it was a like it wound up being like a it was gluten-free, which is why it worked so well. But it was also very, very low in complex carbohydrates, which are the main food source that feeds the sibo bacteria. So he was putting people, kids, on the banana diet.

They were doing great. And then over time, it eventually was discovered that, oh, it’s gluten and then the banana diet fell out of favor because it’s a lot easier just to kind of gluten. Then, like a bunch of other foods and eating tons of bananas. And so I just think that a little bit of history really interesting because he actually kind of like, you know, bio hacked a an anti sibo anti celiac diet. And I think that’s really interesting because as I mentioned, for some folks with celiac, it is more complicated than just gluten.

Dr. Ben Boudreau: [00:34:27] Yes, I just speak to that. Yeah, I wanted to be able to to just sort of bring that up because I know that there are a few select people that don’t respond completely to the gluten-free, gluten-free diet. And so definitely there’s some folks that are watching here tonight, and celiac disease is just so common. I mean, I feel like it’s so common everyone’s trying to get on a gluten-free diet now. And so it’s great that you can speak to that. So thank you so much.

Dr. Bryan Rade: [00:34:52] Yeah, sure.

Dr. Clayton Roach: [00:34:54] There’s a specific question regarding a patient’s case. Let’s continue this conversation if we have time. You know, and I’m sure you guys can appreciate this, like it’s hard for us to have a case and say, Well, this happens when I do this and I have this and I have that. But you know, it kind of takes away from the whole process of actually sitting with a person looking at the whole picture. And, you know, we kind of can’t give medical advice, as you’ve alluded to earlier, on a specific case. So it’s hard to answer some of these questions. This one I can answer that can ask, though, do you agree with the new advice out there that sibo diets harm the microbiome?

Do SEBO Diets Harm the Microbiome? 

Dr. Bryan Rade: [00:35:34] Um. I would not agree with that. I and the reason I say that I mean, somebody like that’s I guess the question would be like, what does that specifically in reference to like an ANTICIPO diet could be a low FODMAP diet. It could be a gaps diet. It could be a specific, specific carbohydrate diet technically could be a keto diet, technically could be a carnivore diet. So it would really kind of depend on what diet it is to read.

Dr. Clayton Roach: [00:36:03] Just hold on a symbol for the people that don’t know what SIBO is. It’s called small intestinal bacterial overgrowth. So just so that we’re saying this for somebody lost there, so go ahead. Sorry?

Dr. Bryan Rade: [00:36:13] Sure. So with those diets, I would say that I’ve had patients on who have been on all of those diets, either by my prescribing it or somebody else or the self prescribing it or whatnot. And I haven’t seen any patients develop digestive issues or other health issues that would be indicative that they might have a compromise of their healthy microbiome after having been on those diets. And so from my clinical experience, at least, I don’t think that it disrupts the microbiome. I think our microbiomes are really quite adaptive. It’s really quite fascinating where when they do studies looking at the microbiomes of different folks who eat different types of diets.

Whether it’s more of a plant-based diet, whether it’s more of a carnivore or a meat-based diet, whether it’s more of a truly balanced omnivorous diet like they have totally different microbiomes. But when you go from eating one way to another way or like kind of back and forth like your microbiome shifts as you go along, I think as long as you have a pretty healthy microbiome to start with, then it probably doesn’t really matter what you eat, you know, don’t eat junk food and things like that. But it’s your gut should be really adaptable because human beings like, evolutionarily speaking, you know, it hasn’t been that long that food has been just like a guaranteed pop over to the grocery store.

You buy whatever you want. We had challenges, you know, evolving up to this point as a species. And so like our guts had to be really adaptable. And so I don’t think that shifting a diet, even if it’s like an extreme diet, like a carnivore diet, for example, even for, you know, maybe in a few months, like, I don’t imagine that would cause a negative shift in the microbiome. I haven’t seen it. I certainly haven’t seen any studies looking at that. So that’s just based on my clinical experience and opinion.

Dr. Clayton Roach: [00:38:02] That’s a great answer. And she was satisfied, said Thank you. For those of you just joining in or if you’re on YouTube, which means that you’re not live and the following day or whatever, just make sure you subscribe to our YouTube channel. For those of you who are joining now, this is Dr. Bryan Rade from East Coast Naturopathic Center. It’s our 30th episode. Once a month, we do a live guest interview. And tonight we’re talking about digestive issues. If you’ve enjoyed this so far, make sure you give us the thumbs up. I want to Segway a little bit, but still condition-based.

Nausea and Constipation with Dr. Bryan Rade 

Dr. Clayton Roach: So we’ve talked about irritable, irritable bowel syndrome. We’ve talked about celiac. Just a second ago, we’ve talked about acid reflux. Before we go into kind of at the conclusion and stuff like that, what would you say would be the number three or number four digestive issue that you see in your practice? That’s pretty prevalent nowadays. Dr Rade.

Dr. Bryan Rade: [00:38:58] Well, I think in terms of prevalence, I would say kind of a toss-up between nausea and constipation, but I’d say constipation would get for the more like for the folks who aren’t, like, really, really sick. It would be definitely constipation will be more prevalent. I think that nauseous. Maybe I’ll pick that one. I’ll take. I’ll take constipation for two. Yeah.

So the in terms of constipation, there are a lot of different factors that can affect that with. You mentioned earlier, like the there’s the IBS Type C, so like the constipation dominant IBS, the small intestine bacterial overgrowth that we’ve touched on a few times now, there’s actually three subtypes of that one. And one of the subtypes is where the bacteria are overproducing. This gas called methane, which happens to be like when you think of people and think of this too often. But if you were to think of like just classic stinky bowel gas, that’s like the methane smell. Usually now that smells like rotting eggs, that’s more hydrogen sulfide.

So there’s now you’ll learn something else new. So classic stinky gas is methane. It smells like eggs, hydrogen sulfide now, you know, so methane gas is associated with a reduction in the motility of the gut. So it actually precipitates constipation, which is really tragic because one of the biggest things that can encourage small intestine bacterial overgrowth is poor gastrointestinal motility. So methane dominant sibo is actually kind of like a self-fulfilling prophecy because constipated tendency could lead to that sibo.

Dr. Bryan Rade: [00:40:37] The methane can make you more constipated, and then it just can be hard to get out of that cycle without appropriate treatment. So constipation can be triggered by. So it could be related to IBS. Could be sibo related. Could be due to eating just a, you know, inappropriate diet. Folks listening might be thinking like, Oh, he’s going to say like a low fibre diet. And fibre is really interesting because granted, some folks certainly do find that they take their Metamucil or psyllium or whatever it is selenium, but they take their fibre supplement like, Oh yeah, I just have amazing bowel movements and that’s great, you know, keep doing that if it’s giving you amazing bowel movements. It’s a beautiful thing.

Don’t stop. But there is some interesting research to suggest that fibre doesn’t necessarily actually have the bowel movement promoting properties that are kind of stereotypically associated with it, at least not for everyone. So just as a point of interest, but sometimes eating the wrong type of diet can precipitate constipation, stress as well. So everything that we talked about earlier with that alpha sympathetic, dominant type, you know, just not getting into that rest and digest mode, that’s a great way to develop constipation. And there are other factors as well, but those would be some of the big ones that would drive it.

Dr. Clayton Roach: [00:41:54] Dr. Rade, you mentioned nausea as well. How would you explain somebody getting up in the morning? And having that nausea-like to the point sometimes like wake up waking up in the middle of the night vomiting or feeling very nauseous in the morning. Mm-hmm.

Dr. Bryan Rade: [00:42:12] So yeah, it can be due to a few different things, potentially. But the most common thing that I see is actually low being related to low stomach acid. And I’ve had just like probably a few hundred cases over the years where that more like it’s when somebody tells me I have nausea like it’s mostly in the morning or maybe in the wee hours, and it’s bothering me. First thing of the day, I never wish any symptoms on my patients, but when I hear that I do a little happy dance in my head because it’s like, I’m like, ninety nine percent confident I know what the issue is for you.

And then we test and find out you have low stomach acid. It oftentimes makes a huge difference for people. So that would be the most common by far the most common cause of that that I’ve seen. Of course, we have to know or figure out what’s causing the low stomach acid and all of that good stuff. But just even symptomatically, it can. It can make a big difference for that symptom. Even before we get the root cause, I’ll figure it out.

Dr. Clayton Roach: [00:43:07] And is that a supplement or just dietary changes?

Dr. Bryan Rade: [00:43:11] So I mean, in terms of getting the stomach acid levels on track, I would usually recommend the stomach acid supplement so that we can get the levels boosted up faster. But it could be done through diet alone if we found that, oh, the patient is eating the wrong types of foods or eating a sibo friendly diet. So it’s perpetuating the sibo. You could do it through diet, but I would usually recommend the supplement in addition to that’s very cool stuff.

Dr. Ben Boudreau: [00:43:39] Right, and so there was another question asked, and this may speak to the exact same question that you just answered about nausea. Along the same lines would be something like sea sickness. Someone had posted in the comment section about someone that they know who travels out to sea often. And they oftentimes will get seasickness out there. Is this something that you see in the practice, Doctor Ray, that all the people that some of your patients would struggle with?

Dr. Bryan Rade: [00:44:05] Well, my medical clinic, I see that all the time. No, just joking. I have not treated patients for seasickness more than like a handful of times, and it’s not something I could really shine a whole lot of light on. Some people like work with things like ginger or they take gravel or something like that. Or there are these things you can buy at the drugstore called see bands, which are like a little rift. It’s like a How am I going to kind of like a bracelet or a wristband? That’s the word. And it’s got like a little piece of plastic and you put it right about here and it pushes on this acupuncture point called pericardium six, and that that helps some people, some women use it when they have morning sickness. I’m not a seasickness expert.

The Truth About Probiotics! 

Dr. Clayton Roach: [00:44:53] Well, Dr. Ray, one of the questions I get a lot when people are in our clinic or purchasing like a probiotic. What would be your minimum like if you’re going to buy a probiotic in terms of the number of strains because you see them four billion and 10 billion? And what is your take on that in terms of a general probiotic? And do you feel that most people should be on a probiotic? Just because we typically may not eat a lot of, you know, fermented vegetables and stuff like that would create a natural, diverse microbiome.

Dr. Bryan Rade: [00:45:30] Yeah, that’s a great question. So I have seen a number of cases over the years and more in my earlier years of practice when I was getting more like I wasn’t getting a lot of the hard like I’ve seen everybody and I’m desperate kind of cases. And I had, you know, in many cases in my earlier years where, you know, just maybe a little bit of dietary tweet going a probiotic and like all their digestive symptoms go away and everything just beautiful. And so that it can be really, really helpful for folks in my practice. Now, what I found is that there are there’s the occasional patient that does really well with a probiotic, but it makes a significant difference with their symptoms.

But I find that for a lot of the conditions I treat like whether it’s, you know, the IBS or the reflux or nausea or whatever, it happens to be like, I find it, it’s somewhat hit and miss whether a probiotic makes a big difference. And almost everybody who comes to see me is either on a probiotic or has tried them, at least. And so I ask that question of like, Oh, you’re on a probiotic. What changed when you went on that?

And sometimes it’s like, Oh, like, I don’t get UTIs anymore or like, Oh, it does help me to be more regular this or that. And if it does, that’s great. But a lot of the times, like, I’m just on it because like before I came to see you, I went to the health food store and picked up a probiotic, or I saw or heard a podcast or whatever it was. So it’s not like I really wish it was like a panacea across the board.

Dr. Bryan Rade: [00:46:59] But just in my practice, again, more complicated cases, it’s a little bit it’s more of a niche kind of population that I work with in terms of the numbers, actually. But I will say is that with probiotics, where I do find them to be very, very helpful is if a patient needs to go on an antibiotic. For some reason, I absolutely put them on quite a robust dose of probiotic. I won’t say exact numbers for reasons mentioned earlier, with not wanting to give anything construed as medical advice. But I would definitely be thinking something like above the number of like 50 billion per day or something like that.

And then the other patient populations that I’ve seen who really benefit from probiotics or folks who have had like, say, like food poisoning that they just never recovered from or folks who have like C. difficile, like Clostridium difficile or folks who went on an antibiotic and just have had digestive issues since then. Like, that’s been really, really helpful. It can be sometimes curative for some cases. I don’t recommend that all my patients go on probiotics.

I think it’s fine to be on them, but I’m just really a results-driven guy. And so I’ve asked my patients this question all the time. It’s like, Oh, you’re on this thing, whether I prescribe it or somebody else to do, they picked it up with their own volition and to say, you know, is this making a difference? And if it’s not making a difference in a reasonable amount of time, then I recommend that they drop it like a hot potato.

Dr. Clayton Roach: [00:48:30] Um. I think I lost my train of thought. Oh, the probiotic. Do you have to wait until your antibiotics are over or can you take them at the same time?

Dr. Bryan Rade: [00:48:41] Um, so the approach that I take because I have not yet found a research study that’s looked at that question to tell us what the right answer is. So just based on what I’ve seen clinically, what I’ve seen clinically is that I have not seen there to be an interfering effect from taking a probiotic with an antibiotic. And I found that when folks take probiotics at the right dose along with their antibiotics, like I can’t think of a case where they developed a yeast infection, a UTI, antibiotic-induced diarrhea thing, like as long as they’re taking the right dose, they get. It’s very, very protective, and I think it makes all the sense in the world to work with them at the same time because if a granted like lots of folks go on antibiotics, no problems at all.

It’s no obvious problems like their guts just fine. But you never know if it’s going to be that fateful time where it does cause a problem. So to my mind, it’s like, Well, if the antibiotic is decimating your good bacteria in your gut, I probably don’t want to wait until that two-week course is over. Before I start then picking up the pieces like Let’s just protect those little critters at, you know, at the same time. And it does not seem to interfere with the efficacy of the antibiotics in any way, but that’s the way that I approach it.

Dr. Clayton Roach: [00:50:00] Yeah, that’s great, I always wondered because again, you know, 14 days, I was like, man, the guts being destroyed and then going to rebound infection, and they’re on and off and on and off the antibiotics. And now it’s killer.

Dr. Bryan Rade: [00:50:14] It can be. Yeah, yeah.

Dr. Ben Boudreau: [00:50:16] So for everyone who’s like this conversation tonight, who’s been here listening with us from the beginning to now, or maybe you’re just starting to listen right now, this is day conversations, and that’s Dr. Bryan Rade from East Coast Naturopathic Center. So for those of you who like this, give us a like right now, some love. This is a conversation that I’m sure a lot of people will benefit from. So make sure that you’re liking and sharing the conversation as well so that this information is getting out there to those who may need it. And for those who might need the help of Dr. Bryan Rade at his clinic in Bedford, Nova Scotia, Canada. So, yeah, great conversation tonight.

Dr. Clayton Roach: [00:50:56] I have one more question, Dr. Rade. One of the things that I see a lot and because it’s got a link with musculoskeletal problems as well as colitis. And the reason I say there’s a link is for many reasons, but a lot of people that I see with colitis, come and see us. They have back pain. One of the things that they’ve been using to manage some of the pain is Toradol. Have you seen in the literature a link because there was a documentary on NHL players instead of using Percocets and a lot of the opioids? The major pain they went to Toradol, which later has been found to affect bowel issues and specifically colitis, have you seen that in your clinic?

D.r Bryan Rade: [00:51:41] Dr. Reid? No, no, that’s really interesting. But no, I have not seen that link.

Dr Clayton Roach: [00:51:45] Ok. Yeah. So, you know, listing, you know? Medical journals and stuff in that documentary and how that was linked and how it’s become a little bit of a. If you use the word pandemic, a lot more people suffering from colitis because of the effects long-term effects of Toradol. Um, anything else you want to offer, Dr. Rade, in terms of digestive issues and people that have these long, long-standing issues. The number one approach they can take, you know, the first step so that we can kind of chunking down everything we said tonight, the number one step that they could take and then how to move forward with you if they decide to do so.

Dr. Bryan Rade: [00:52:27] Sure. And sorry, just to clarify, like the number one step they could take with respect to what exactly?

Dr. Clayton Roach: [00:52:33] Well, what’s the first step in terms of having them contact you and how this works and all that stuff when if they decide, OK, this is it. I’ve been everywhere. How do I do this and how do you get in touch with me? And how does that all work? Do I need a referral?

Dr. Bryan Rade: [00:52:50] Okay, sure. Yeah, good. Good question. Yet so I don’t need a referral. I mean, there are some insurance plans where you need to have your medical doctor write a referral note to access the private insurance coverage to see an acrobatic doctor like myself. But that’s relatively few and far between. You just have to check with your private insurance if you have it. But yeah, generally just called the front desk or email. So our email address is just East Coast naturopathic at gmail.com.

We’re also on Facebook under East Coast Naturopathic Clinic and look me up on Instagram or Facebook. Just it’s Dr. Bryan Rade And so just contact the front desk and then they’ll kind of take it from there. It’s really handy if you have had testing is done or imaging or that this type of thing just to let us know. We can always requisition that information in preparation for the appointment. If you do come in to see me just having like a little list of the things that you have tried working with and ultimately, what I’m going to want to know is what have you tried?

And then that next question would be like. So did it help? Like what happened? Did it make you feel better or worse? No difference. What kind of diets have you tried, et cetera? Because as I’m also fond of saying, fond of saying a lot of things, fond of saying this to the even if a patient has tried like a million and one things before they come to see me.

Dr. Bryan Rade: [00:54:18] And like, even if nothing has helped, it’s like, well, the silver lining to all that is that at least it gives me a heck of a lot more information, you know, Oh, you did every single diet under the Sun? Well, now I know that it’s definitely not a diet thing that’s primarily driving this. So that saves us a whole bucket load of time. Oh, you’ve been treated for Siebel already, and your test results have normalized and you’re still not feeling all the way better? Well, at least we’re not going to waste your time going after sibo right now, so it’s really handy to know what’s been done.

And that’s just really the most crucial thing with like a good intake is just knowing what is a patient done like, what’s helped, what hasn’t helped, and then we can kind of narrow things down. And then for patients who haven’t done anything like, Oh, I just didn’t know that there was something I could do for my IBS because I was told fifteen years ago that I just have to live with it. You’ve done nothing. It’s like, OK, we can figure that out too, can we start from scratch? And that’s OK. And that’s where the testing comes in and this and that. So but yeah, that’s that would be the first step.

Dr. Clayton Roach: [00:55:17] Dr. Rade, have you seen over the years like an increased interest from the medical field and what you do like? I hear that frustration a lot with patients and say, I wish you know, we could all, you know, come together and, you know, talk about my case and you know, the doctor, be OK with me seeing the chiropractor and understand what you’re doing and naturopath. And are you seeing a growing interest and openness? And, you know, I don’t know an acceptance. I hate to use the word because, you know, anyway, are you seeing that changing?

Dr. Bryan Rade: [00:55:53] I’m not sure about general trends. I know in my own personal experience I’ve had the opportunity to connect with several medical doctors over the course of time here in Nova Scotia. And so like, the number is growing in that it seems like every maybe year or two like I’ll connect with one and we get along really well, and there’s a nice synergy there. So from that perspective, there seems to be a trend in the right direction, but I’m not really sure about general trends or not.

What I will say, though, is that when there is actually that opportunity to like, chat and collaborate, whether it’s with a pharmacist talking about like proposed things to work with alongside a chemotherapy regimen or it’s, you know, I have a patient right now who we’re trying to figure out. Like, what the heck is driving like this chronic kidney disease? And you know, me and the pharmacists, you know, both think that it might be like one of the like 15 meds that the patients on. So like, we’re collaborating a bit and then interplay with the family doctor and this and that, like whenever we actually have the opportunity to directly collaborate, kind of build those.

Bridges go really well, and it’s like, oh yeah, we actually all kind of speak the same language just when we’re kind of all in our different worlds or different silos, like it’s like, I’m not sure what they’re doing over there and that chiropractic silo and what are those pharmacists really doing over there? But when we start to actually communicate like it’s, we’re all just on the same team and all just trying to help people. And so I find that when there are opportunities to communicate it, it generally goes well and I enjoy it quite a lot.

Dr. Clayton Roach: [00:57:33] Yeah, it’s, you know, it should be about the patient and not, you know, not the egos at the egos, go away and collaborate as much as we can. And like you said, you know, it usually goes a whole lot easier when there’s collaboration versus independent advice that you know, well, you can see me, but at the same time, you can’t see him know at the same time because it can mess. I’m like, Come on, you know, let’s just let’s grow up and get out of that, you know, philosophy and, you know, be together.

So listen, Dr. Rade, it’s you know, in respect to your time, I can’t get over how humble you are. I really appreciate every time we get to chat and the information that you provide. I don’t know if anybody here watching can appreciate the time and effort that it takes to be able to answer questions on the spot like this and have the pedigree that you have and the amount of time and the balance and the work-life balance that goes into doing the post-graduate work and all that stuff. You know, I kind of understand it because, you know, I’m passionate about learning and Dr. Ben as well.

But I just want to say this that, you know, and you probably don’t hear it enough. And you know, thank you so much for everything that you do in the time again that we’re asking of you to be here tonight and our listeners, you know, many comments and hearts and thumbs up are because of the time that you’re willing to give. So I really appreciate that.

Dr. Bryan Rade: [00:58:53] Thank you. Very nice of you to say.

Dr. Ben Boudreau: [00:58:57] And know for those of you who have been watching the entire time, don’t forget to share the episode because we want to be able to help people. That is the reason why we’re doing this so that we can connect and help as many people as we can by offering this type of information. So when you have the information, then you then have the tools to use to find yourself the help that you need. So yes, from the bottom of our hearts here at Roach Chiropractic Centre. Thank you, Dr. Bryan Rade, for talking with everyone tonight, and I think we all learned a thing or two from you. Dan, thanks so much.

Dr. Clayton Roach: [00:59:33] My best saying is that the quality of the life you get to live is based on the quality of the questions you get to ask. There are quality questions tonight, and I think the quality of the questions you get asked is based on the knowledge that you have. This is what we aim to provide our knowledge and information. So again, thank you so much, Dr. Rade. We’re going to be doing this again next month. We’ll be promoting it. As always, it’s going to be a different topic. I appreciate you doing this a third time and we’ll be live next week again at nine o’clock. Atlantic time and we’ll be talking about.

We don’t know yet, but we’ll come up with a topic. So thank you so much for all of you that we’re living. And if you’re watching us on YouTube, thank you so much for being on YouTube. Make sure you subscribe. And right now everybody is live. Please go ahead and share this episode and, you know, share this information that is so brilliant and free. Where else are you going to get this right? But Hump Day conversation? Thank you so much, Dr. Reid. Thank you so much, Dr. Ben. We will see each other next week again, at nine o’clock on Wednesday.

Thank you, guys. What’s up, guys? Listen, if you like this episode, you’ll probably like the other ones. The chances are pretty good. So here’s what you need to do. You need to like us and follow us on Facebook. Following means, you get notified when these two guys are alive. Next, family, friends. You need to share these episodes because you never know you might help them because they need this information as well. And guys, if you ever miss an episode, make sure you subscribe to us on YouTube. That way, you can watch the episode over and over and over again. Guys, we love you and appreciate you. Take care.