Transcript: #32 An Epidemic of Absence with Moises Velasquez-Manoff

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  • 04:04 Bacteria, probiotics and parasites: “old friends”?
  • 13:59 Probiotics
  • 15:56 Probiotic foods
  • 18:00 An unhealthy gut causes disease
  • 20:28 Autoimmune disease
  • 24:23 Autism
  • 28:29 Food sensitivity
  • 36:33 Worm therapy
  • 42:16 Tips to increase probiotics
  • 45:36 The most pressing health issue in the world today: Addressing Symptoms, Not Root Causes

Wendy Myers: Today I’m so honored to have our guest Moises Velasquez Manoff on the show today. He is a fellow blogger at moisesvm.com. Moises has written extensively mostly on science and environment for The Christian Science Monitor. His work has also appeared on New York Times magazine, Chicago Tribune, and the Indianapolis Star among other publications. Moises Velasquez Manoff’s first book   An Epidemic of Absence is a brilliant, cutting edge exploration of the dramatic rise of allergic and other immune diseases and the controversial ground-breaking therapies that scientists are developing to correct these disorders. His book explores why we’re so vulnerable to immune system malfunction evident in the dramatic rise in the cases of allergies and other immune diseases. So Moises, thank you so much for being on the show.

Moises Velasquez Manoff: Thanks for having me.

Wendy Myers: Why don’t you tell the listeners a little bit about yourself and why you wrote An Epidemic of Absence.

Moises Velasquez Manoff: Well, basically because I have been afflicted by these diseases my whole life. I’ve had food allergies my whole life. I’m allergic to peanuts. I grew out of my allergy to eggs, but I’m still allergic to peanuts and sesame. I have asthma, and I have an autoimmune disorder called alopesia areata where my immune system has essentially attacked my hair follicles leaving me hairless.  So, it’s been a  constant presence in my life. And I think when you’re a kid you ask why, and the doctors can’t answer you, because they don’t know why this happens to you. They don’t know where it came from. What they try to do is to treat it in this case, the treatments aren’t very effective. No one knows how to deal with autoimmune disease generally. And in terms of allergic diseases, everything is about managing symptoms. It’s not about fixing it entirely, so as a science writer, as I am starting a few years ago, actually some time ago at this point. So as I started, I looked into this question again, why did these diseases first of all happen to me? And the first thing I discovered is that they weren’t just happening to me; they were happening to everyone. One of the alarming trends of the late twentieth century was that these diseases were increasing pretty dramatically in prevalence, like two or three times for allergic diseases and even more for some of the other immune diseases, up to three times, four times. Far more times for things like inflammatory bowel disease.

So everyone was using the word epidemic to describe this increase at the end of the twentieth century. And I decided to write around one of the really interesting theories, trying to explain the increase in these diseases. The theory has been called the Hygiene Hypothesis that almost everyone who works in this area thinks that’s a horrible term even though that’s the one that stuck. Very, very briefly it is we are too clean for our own good but of course, this is not about personal hygiene; this is not about taking showers. This is about what we’ve done as a society and lost contact with the rare organisms that actually properly calibrate our immune system. And not taking a shower it’s not going to really help you with that regard. So that’s the genesis of the book.

4:04 Bacteria, probiotics and parasites: “old friends”?

Wendy Myers: Well, you referred to bacteria, probiotics and parasites as “old friends” in your book. What exactly do you mean by this?

Moises Velasquez Manoff: So that’s a term I borrowed from a scientist named Graham Rook. He’s trying to think of better ways of formulating the Hygiene Hypothesis, because everyone thinks about showers and we’ve talked about it. What he’s getting at is that these organisms that have been with us  ever present during human evolution. There’s an important distinction there. This is not about infections like pandemic infections like the plague or small pox or some of the measles even, or the flu; because those organisms, some of which are bacterial, some are viral, are the very recent arrivals to the human body. Most of them jump over from animals.

So we settled down on farms about twelve – ten thousand years ago; got all these animals, domesticated them then we started acquiring their viruses and some of their bacteria and those became human pandemic diseases. And one way to look at it is that, organisms that cause these diseases, they haven’t figured out what to be in your body without killing you essentially. So if you look at it from the perspective of an organism that’s trying to survive, which they’re trying to do, just like you are, that’s a bad strategy in small groups of people because when you killed all your potential hosts then you’ll have nowhere to go. So the organisms that are old friends have much older kind of strategy that goes back to the times that we’re small groups of people. What they do is that they persist in your body and they don’t kill you, because it’s counter-productive. Those include intestinal parasites which they don’t reproduce on most of the species in any case. They don’t reproduce inside your body so you can tolerate a certain amount of parasites and not have to evict them, because you don’t have to worry about them replicating like, say, the small pox virus and basically overwhelm you, kill you, turning you into kind of like mush. They just sit there and you can tolerate them; in fact, tolerance is a kind of survival strategy for the old friends. Of course, I’m talking about the bad old friends; that is, the old friends that have a cost on your body.

Also if you think of a certain gradient of organisms, on one side of parasites that  have a cost but they also may properly calibrate the immune system. On the other side, there are the purely good mutualists and those are the sort of the intestinal bacteria that are more like symbiotes that more like the bacteria in, let’s say, cows that help them digest grass or bacteria in any organism that needs this bacteria, which are most organisms to digest its food. We haven’t thought of ourselves as belonging in that category but we do. We have this very highly evolved long-standing relationships with bacteria and they help us digest food, they help cover our immune system, and maybe most importantly they protect us against organisms that otherwise may come along and just turn us to mush. Those are the old friends.

Wendy Myers: Now don’t the old friends just become a problem say, when the host itself, the person, is nutrient-deficient, or ill, or toxic and then these parasites are able to grow out of control? Then they start causing problems, just kind of like the level of infections?

Moises Velasquez Manoff: Well, I’m not willing to say that. I think that parasites are parasites because they are stealing something from you. It’s a survival strategy, where instead of getting into a relationship where they’re purely contributing to some greater whole, what they’re doing is just taking from you. So what they do is that they take from you a whole bunch of stuff  depending on the parasite. Let’s say hookworm, hookworms are actually eating you. At the same time they’re manipulating your immune system and the way this theory works, at least with regard to parasites is – okay so these animals, or that is, parasites like hookworms have been always present in the human body, and they are always present in most animals you look around in the animal kingdom. They have a very powerful, persuasive influence in your immune system. That kind of influence was always there.  In some respects our immune system maybe is optimized to operate under those conditions.

You may think of it as if you had a ball on chain on your foot, and you just always had a ball on chain on your foot. You’d have various compensatory mechanisms to deal with that, and then you suddenly remove the ball on chain. In some ways you are free, but in another respect, you’re going to be worn off with that because you’re not going to have this weight that you expect pulling you back, and you might over-compensate in other ways.

The analogy is that the immune system is not hyper reactive. It’s more responsive than it really should be because of lots of parasites. But where I am willing to go so far is to say that parasites are purely good if  a bunch of conditions are met. Possibly, if they are well fed, they won’t have any obvious cost, but if you have too many they cause disease. And if you have different types they can cause some to live in the veins, around your colon and bladder, they pierce your skin in the tropics. When you’re waiting in clear water, they can cause bloody urine and all sorts of things. If you have blood in your urine, that’s just not good, that means that there’s some damage being caused.

I know there’s a tendency to want to say that because it’s like to deal with the idea of having something that’s hurting  you also helping you, but I think it’s important to resist against that tendency and keep a nice, strong, clear view of the fact that these things like parasites are here for a reason because they haven’t been raiding when they’re stealing from you.  Just because you have a thief present doesn’t mean a thief is always good.

10:38 Antibiotics

Wendy Myers: Another thing I want to talk about is antibiotics. What are antibiotics doing to our health and the health of our families? Because there is growing body of evidence that suggests that the very steps we’re taking to combat infections are also killing organisms that keep our bodies in balance and modulate our immune systems.

Moises Velasquez Manoff : The clearest way to think of that is there are organisms that want to kill you and there are your symbiotic organisms. Antibiotics take them both out. They don’t distinguish. So you are going after a horrible infection you take the course of antibiotics and you end up knocking out also all these symbiotic organisms that do all the good things that you just mentioned like calibrate your immune system, your metabolic function and synthesize things for you. And maybe worse of all, at all times you have an array of bacteria in your gut. Some of them are called pathobionts. They don’t cause harm when they’re in small amounts. They just sit there. But then you knock out everything else that’s holding them back and they expand. They balloon. They come out, in sort of like one of those toxic allergy balloons in the ocean. You know the allergies are always there, it’s only when they have the opportunity they sort of overwhelm everything. With antibiotic, there are several ways that they could be dangerous, at least according to this emerging picture.

One is that they kill bacteria that are very good for you and some of the bacteria in fact are actually most important for the kind of immune  stimulation that we want that we need, which is to calm your immune system down, are more vulnerable to the broad spectrum of antibiotics. So you end up knocking out particularly healthy bacteria accidentally. The second way is that you end up opening the ecosystem to these bacteria that are already there, not causing any problems in small amounts but then expand and start causing big problems. The classic example is Clostridium difficile the deficit which is this horrible infection. It’s antibiotic resistant.

A lot of people actually have had Clostridium difficile and had no problem. Because it was just there intact, just sitting there, waiting for its chance to expand. And then you knock out all the bacteria, it gains a foothold somewhere new, and then the numbers explode and you have this horrible infection that can lead to death very often. It basically causes inflammatory imbalances where you can dehydrate to death or bleed to death. And of course, what’s the cure for cdef infections? Stool transplants, it’s like the most effective cure that anyone could have dreamed of. That means taking a little poo from someone who’s healthy and putting it in the gut of someone who has this infection. And what’s so interesting, and the lesson from that example is that you don’t kill off the bad bug. You just restore the ecosystem and that bad bug just goes back to the corner where it came from.

Wendy Myers: Yeah I have been reading a lot about it lately. It’s really interesting. It makes a lot of sense.

Moises Velasquez Manoff:  It’s ecosystem theory. An ecologist gets this stuff right away.

13:58 Probiotics

Wendy Myers: So if someone knocked out the good bacteria with antibiotics can they simply be replaced with probiotics? Some people scramble to get their probiotics after their course of antibiotics. Is that enough?

Moises Velasquez Manoff: There’s some indication that probiotics what they do is, first, just let me back up. The current generation of probiotics would often be untested for many of the applications for which people buy them. It doesn’t mean they don’t work; it just means it is not showing that they have worked.  Number two there is sort of arbitrarily chosen in the sense that they say ok, this is found in fermented milk. Let’s manufacture them, we’ll feed it to people. It’s got to be good to people, that may or may not be truth no one really knows. The bacteria we want, are bacteria that are native to the human gut. Again, they’re not the same ones that are going to be in fermented milk. Those are bacteria that are native to fermented milk. It doesn’t mean that they are not good for you.

Again, we just don’t know. So, one way though that even those bacteria can help is it colonize you transiently, and there a few studies at this point or at least one that shows that when you take antibiotics, if you take probiotics it lowers the risk of one of those opportunists moving in just by occupying the niche transiently. When you take probiotics often what they find is that, it doesn’t permanently move into your gut. You take it once and you got a new bug in there and it’s good for you. But it doesn’t work that way. You have to keep taking it. If you stop taking it then it goes away. It’s transient colonization. But that may be enough to prevent some of these infections that we’re talking about. And since there is very low potential cost and a lot of potential benefit, I don’t understand why doctors aren’t doing this routinely, just prescribing a probiotic when you given an antibiotic to prevent this horrible outcome that sometimes occurs.

15:56 Probiotic foods

Wendy Myers: It drives me insane. It doesn’t make any sense why physicians aren’t doing that. It makes no sense. So, is it reasonable for people to start eating probiotic foods or foods that promote the growth of probiotics like garlic and onions, Jerusalem artichokes and things like that that promote growth of good bacteria?

Moises Velasquez Manoff: Yeah. I think that is going to end up having a better effect actually than some of the probiotics that are currently available for purchase, because what you do in that case, is just you are feeding the bacteria that you already have that are good for you. You are actively feeding them. There’s a lot of ongoing research in that area. But what you notice there though is, instead of taking a pill or capsule, just eat real food because it is part of the food already if you’re eating well. Think about how big a capsule is, and think about how big an apple, potato, or an actual Jerusalem artichoke is. Which I have never had actually. And as I understand they are not actually artichokes. Think about the bulk of what real food is compared to a capsule. Just design your diet to be full of real plant foods, that are full of these digestion-resistent starches and full of polysaccharides. Basically, the Mediterranean diet is full of that kind of stuff. I don’t know much about the paleolithic diets but as I understand there’s a lot of vegetable eating there too. Vegetables and nuts.
Wendy Myers: Oh yes. Lots of vegetables, not all meat. Haha.

Moises Velasquez Manoff: Right, so just eat well. I don’t think it’s necessary to go taking pills to get these effects.

18:00 An unhealthy gut causes disease

Wendy Myers: Yeah it makes more sense to me to eat foods that just promote the growth of bacteria that is already there. So a huge topic in the health field today and the topic of your book is how unhealthy gut microbiotic contributes to all manner of disease and health conditions, including autism, autoimmunity, allergies, depression, obesity, you name it. So how does an unhealthy gut contribute to such a wide range of health issues?

Moises Velasquez Manoff: Since my focus is on the immune system, I will just point out that right now there seems to be an explosion of literature that implicates the immune system in just about every disease that we’re afflicted with. And that is not communicable diseases which are the main source of disease in the developed world, that the immune system is doing a lot is causing a lot of problems. There are two ways that happens. One is if you are sort of chronically inflamed that causes damage. You know that because say if you have an infected cut there’s a kind of inflammation that’s going around the infection. That can cause a lot of pain. Think of a pimple or something like that. A lot of that pain is from your immune system response, not from bacteria that are causing the infection.

But the second thing is a little bit more subtle and that is, when you have chronic immune activation, all the normal stuff that keeps you healthy and alive; it doesn’t stop, but it goes to a bare minimum. For the short term that’s fine; you have an acute problem, say you have fever you get rid of the bug, and then you go back to normal, you return to homeostasis. But the problem with having changed our gut bacteria is that our immune system is chronically active so that, there is chronic interference in every neurotransmitter and metabolic function which has to do with things like insulin. It’s almost like you have this smoldering fire in your kitchen or something that is just going on not allowing you to live your life normally but in your body. That’s biologically happening. And that contributes to every single disease of civilization. Well, maybe I shouldn’t exaggerate. But many diseases, from dementia, especially obesity which is linked to the other ones but leads to heart disease and arthritis. I mean, everything we have essentially.

20:28 Autoimmune Diseases

Wendy Myers: Let’s talk about autoimmune diseases, one of the fastest growing subsets of diseases in the world, attacking five to eight percent of the US population alone. So why is autoimmune becoming such a plague?

­­­­Moises Velasquez Manoff: Well, I’ll use an analogy to illustrate one reason why. There’s some genes that are involved in making your white blood cells. So you have white blood cells, they are there to protect you and fight bad bacteria and they make sure that those pathogens don’t turn you to dinner, basically. But there are some white blood cells that turn the other white blood cells off. You can think of them as the canine patrols, they are handlers of the dogs, the guys who holds the dogs backs. If you take away the handler, you have a bunch of nasty, gnarly meat-eating dogs. And genetically there are genes that correspond to that kind of function. There are genes that you turn them on and turn these cells to handlers. They allow those cells to hold back the other cells. There are certain genetic mutations that occur spontaneously. With those genes you’re taking offline. And what happens? Those kids, they usually don’t live very long, they would have a meltdown of auto-immunity where all their attack cells turn against their own tissues. They also have this horrible responses to viral infections where they essentially self-destruct and they have sort of eczema allergic disease. Basically the immune system has no ability to restrain itself, it goes haywire, it goes crazy.

In majority we know that in the last late twentieth century the list of diseases has increased. We have done probably what that mutation did environmentally, without any mutation. What we’ve done is, we could think of it as, we are not expressing that set of genes as much as we need to and as much as we used to, and the reasons are environmental for everything we are talking about because the expression of that subset of genes was dependent on contact with all of the old friends. It basically lost contact with all the old friends. That’s the explosion of auto- immunity. Many people think of it as something must be broken to be exposed to infections or to toxins to provoke it. Toxins may be able to provoke it, but one really easy way to provoke it is just to simply remove the handlers of the dogs, and the dogs will go crazy.

Wendy Myers: I’ve heard that to have an autoimmune disease that you need to have a leaky gut first? Is that true?

Moises Velasquez Manoff: It’s unclear only because no one has ever prospectively followed that. First of all, no one knows who’s going to get an autoimmune disease, you can sort of predict because there’s some in the family sometimes. But to answer that question what you do, is you follow someone who has the autoimmune disease in the family and take measurements of the gut and see what happened first. It’s certainly likely that there are many roots to what we call the auto-immune disease. So one root may be that there are gut problems that triggered it, so that things get through the gut. But I also think that if you have an auto-immune disease, you may subsequently develop leaky gut. So I think there are many ways that end up at the same endpoint, there are many paths to the auto-immune disease  endpoint.

24:23 Autism

Wendy Myers: My daughter was diagnosed with a mild form of autism, so this is a topic of special interest to me. Can you elaborate a little bit on why you think autism is reaching such epidemic proportions and what this has to do with gut flora?

Moises Velasquez Manoff: The hypothesis I find most compelling, because it is supported by so much epidemiology, is the idea that something happens during pregnancy that triggers the maternal response. It’s not really a trigger; it’s more that the maternal immune system is a little bit more activated than it should be, and then some of the immune-signaling proteins can cross the placenta, and the brain is developing and it turns out that this is what some people don’t understand: neurons, as they are migrating into place and developing the brain, actually use the immune system signals to get into place to figure out where they need to go. So what happens is you’re changing the signaling of where they need to go a little bit, and you end up with a brain that’s slightly differently wired. And so the evidence that supports this idea is that the factors that are predictors of autism include infections of mothers who happened to get infections when pregnant. They also include if mothers happen to have an auto-immune disease while pregnant, and they include if mothers had an allergic disease or a metabolic disorder. And one of the symptoms of metabolic disorder is this low grade inflammation.

So there are all these things that point to inflammation being the factor in pregnancy plus it is supported by a number of animal studies, including on primates. So if you back up for a second and then you think, our immune system maybe operating differently than it did in the past because of these changes to the environmental inputs. It has changed our contact with our old little friends. The immune system has its fingers in a lot of different aspects of being alive because that’s really important. One of those aspects is pregnancy of course. It’s a very intricate balance of tolerance and non-tolerance that has to happen during pregnancy because the mother is tolerating something that’s born inside of her. That’s what a baby is. There is this weird parallel of a baby and a parasite because both are inside. Haha. When you look at the pregnancy literature you’ll see that there’s an analogy where they call a baby a parasite, because it’s actually sucking stuff out of your body like the calcium for your bones, it’s actually taking out all the nutrients.

Wendy Myers: That’s how it feels too. You’re so depleted after you have the child. Haha. They’ve robbed everything.

Moises Velasquez Manoff: Haha. It’s just a parasite that lasts 25 years or in periods of economical uncertainty even longer. But you would expect that if you change the immune function you would see accidents during pregnancy more often, and it may be that autism is one of those. The hypothesis as to gut flora would be that it’s actually the mother’s gut flora changing her immune function or altering it, and then changing the development of the fetus via its modulation of the maternal immune system. That said, a number of studies have also shown differences in gut flora of autistic children themselves. Again, it’s the cause and effect: problem number one, number two, the studies are all over the place, some studies don’t show any difference. Number three: the difference is they do show and never quite the same. So it’s totally undecided at this point. I think the prenatal stuff is much more compelling and consisting with itself.

28:29 Food sensitivities

Wendy Myers: It’s really compelling and that point makes sense. It makes a lot of sense. So let’s talk about food sensitivities a little bit because it is a huge, huge factor and it affects 70% of the population.  I’ve heard some new theories on food sensitivities and that they’re not only caused by leaky gut, but can simply be the result of not having gut bacteria to digest our food properly. Now take grains for instance. Chris Kresser spoke about the idea that we don’t handle grains well due to impaired microbiota in his speech at the 2013 Ancestral Health Symposium. It may not be that grains are the problem, but our gut dysbiosis. What are your thoughts on this issue?

Moises Velasquez Manoff: I’ve written about that in the New York Times especially. With regard to grains, I obviously agree. I never really bought the idea that the grains themselves were changing because I don’t really think that you should be responding to proteins that aren’t so damaging somehow. In other words, your body should be able to distinguish between things that are attacking it and things that aren’t. And a grain, the peptides in wheat that seem to bind to those receptors are simply not attacking. The argument has always been, with people with those genetic variance, the grain binds more tightly to the receptors and that’s when they’re more vulnerable to having celiac disease. That may be true. But there’s a deeper understanding in terminology where your white blood cells can bind to proteins and not present them to the rest of your body as a threat; it can do the opposite. So the question is not whether or not they bind; the question is why they’re suddenly presenting them as a threat. It turns out there’s all the terrific research on what microbes are present can determine whether your white blood cells perceive these patterns, these proteins, these glutens, as a threat or not; or whether they perceive them as what they are, which is just another protein coming down the alimentary canal. This is hugely important, and I think that it’s also the answer to why we have food allergies, the answer to why we are increasingly allergic to just about everything. It’s what else is there that’s determining that how you respond to the incoming proteins.

31:30 H. Pylori

Wendy Myers: That’s really interesting. That’s a huge impact on people who just improve their gut flora and they can start eating more foods that we previously thought are bad for us.  Because I don’t buy a lot of the arguments in the Paleo world. I don’t take things on face value. I want to know why, as I’m sure the listeners do as well. Let’s talk a little about H. pylori because this is another big issue because this parasite infects roughly 50% of the population. Medics say they are a bad parasite, something that must be eradicated with antibiotics.  I went to my doctor and they said, “You have an H. pylori infection. Let’s give you antibiotics” And I said, “Woah.” I just did  some manuka honey and the so-called infection went down and was reduced.  Is it possible that this organism is not as problematic as many think?

Moises Velasquez Manoff: Were you having symptoms?

Wendy Myers: No I was not. I was having some health issues. I have been vegetarian for a couple years and I didn’t feel good. And I just didn’t have any energy. All kinds of little weird issues. Thyroid issues. So I just checked everything. That’s where that diagnosis came from, just in my blood work. But I was reasonably concerned because my father died of esophageal cancer. Studies show that H. pylori can lead to stomach cancers and things like that. My question is: This organism can lead to certain cancers, but is it as problematic as we think?

Moises Velasquez Manoff: It’s definitely linked to stomach cancer which you don’t want to get. It’s definitely linked to ulcers which you also don’t want to get. But it’s a little bit more complicated, let’s back up a second. The reason that worms, the way they manipulate the immune system is they basically induce these cells that are suppressive. I talked about the handlers on the attack dogs. They basically conjure up handlers for attack dogs. And then there’s something that’s called the bystander effect. Which is that all your immune activity going on is suppressed. These handlers run around and grab off the dogs. H. pylori does the same thing. The way that it is able to live in your body for so long and not be fought off is that it convinces your immune system to tolerate it on some level. If you get cancer or ulcer from it, that is actually a failure of tolerance, and a failure of it to induce those cells in you.

One reason that may happen is you don’t get it early enough so it seems that there is something called the African paradox which suggests that Africans can harbour H. pylori without as many troubles as Europeans. Part of that is rain that is in Africa, but it’s also that if you get earlier, some animal studies show, you tolerate it better. That’s number one. Number two, it induces more of those cells. Number three, it’s more protective against asthma later because it induces those cells. Let me just emphasize though. If your doctor says get rid of your H. pylori because it’s causing gastritis or what have you, you should probably do it because it’s probably a problem. Now if they just happen to find it and told you to get rid of it proactively then that’s a different question. It’s funny that you mentioned it because I was at a gastroenterologist a while ago and he said he was refusing to get tested for H. pylori.

Wendy Myers: Haha.

Moises Velasquez Manoff: Because he knows all these signs. He knows also that it seems to protect against diseases like Harper. If you get rid of it immediately you start getting Harper. Harper is not actually that easy to treat if you have it chronically. So anyway, this stuff is like making inroads. There are doctors who refuse to get tested because if you have a carcinogen, which H. pylori is classified as, you’re supposed to get rid of it. That’s what the manual says. Anyway, like all things is way more complicated. It may protect from allergic diseases and other inflammatory diseases, but it’s also even more so than multi-cellular parasites, than worms. It has a dark side because how you respond to it really determines whether it hurts or helps you. And how you respond to it is determined by why you get it, by your genes, by what other bacteria are also present. There are some really interesting studies that show that if you have a lot of lactobacilli you tolerate H. pylori better. So there are those second party factors that can determine whether or not you come down with gastric cancer, which is a big deal. That said, Martin Blaser pioneered the whole H. pylori re-branding. I don’t know if he’s being provocative, but he does argue that kids should have H. pylori and then  have it eradicated as adults when it becomes a risk factor for cancer. That way you get the benefit but not much of the cost.

36:35 Worm Therapy

Wendy Myers: That’s interesting. Let’s talk about worm therapy. In the book you told the story of how you went to Tijuana, Mexico, to infect yourself with hookworm. I keep hearing about studies where individuals are healing themselves of hookworm or get fecal transplants that you talked about earlier. Can you elaborate on these terribly interesting new treatments? Haha.  And why you played guinea pig?

Moises Velasquez Manoff: Yeah so there’s all this science suggesting that parasites protect against everything in animals.  Then there are these human studies where a scientist named Joel Weinstock developed a parasite native to pigs for the treatment of an inflammatory bowel disease. Had these incredible results is first very small trials on humans with Crohn’s and all sorts of colitis. As far as I recall 75% cure rate remission. This is a disease that’s very difficult to treat, very painful. Horrible disease. They had this amazing rate. So there was other work as well studying parasites in naturally infected people showing that they have fewer diseases. You put all that together. Some human studies, animal studies unequivocal, and then a correlative observational of studies where populations that have hookworms for example have less asthma. And what you get are a bunch of desperate people deciding to take things into their own hands and start treating themselves with parasites. And the parasite of choice in my case was hookworm. People are selling it. I arrived on the scene a few years ago and became aware of the underground movement which I called the Hookworm Underground. I found some people who have remarkable stories of remission that I’m able to confirm. I also found people who don’t do so well, who, I’m also able to confirm, basically made things worse for them. I just decided to go test it myself because you don’t know what to believe unless you test yourself.

Wendy Myers: You’re a brave soul.

Moises Velasquez Manoff: Haha. So I go down to a clinic in Tijuana of course where everything that’s not approved by the FDA goes and I get 30 hookworms. They go through your skin. You feel itching. So to make the long story short, I had some not pleasant symptoms but it’s also true that I see some improvements. My eczema disappeared.

Wendy Myers: Hmmm that’s good.

Moises Velasquez Manoff: The best part actually was that season of hay fever. For half the season, I had no hay fever. I had this incredible clarity in my nose. And that’s actually been reported in literature before, by scientists who experimentally infected themselves. That was the other thing though. Is  I knew a bunch of scientists experimentally infected themselves, so I knew it couldn’t be that bad. If scientists could do it, people who are actually trained about how horrible these things are were willing to do it, it couldn’t be that dangerous. It couldn’t be that bad.

Wendy Myers: Yeah.  If it didn’t work out you can just eradicate them, right?

Moises Velasquez Manoff: In theory, yes. But the truth of the matter is actually I did eradicate them after about two years. I keep on forgetting how long I had them, but first of all the beneficial facts are very variable. One, I had them. Two, the side effects never really went away. Now I did interview people who had no side effects so I can’t figure that out. I don’t know if there are primary conditions so terrible that anything was an improvement. It was relative, since my autoimmune diseases is essentially cosmetic. I’d feel very different if I was going through inflammatory bowel disease to the symptoms of a hookworm infection which are probably less. But I interviewed people that said they had no symptoms. I suspect that part of it is genetic. Everyone responds differently. I suspect maybe some of them have taken immune suppresses prior to trying the worm, so what hurts you with this infections is your own immune response so if they already have a kind dampened immune response it’s not going to hurt them as much.

41:01 Poop pills

Wendy Myers: So what’s next? Are we going up to Canada and pop some poop pills? Haha

Moises Velasquez Manoff: Well, poop pills haven’t shown any indication for anything that I have. That would be like a C. Diff. If I got C. Diff, yes. I wouldn’t go to Canada.  I’ll just find a donor from my friends.

Wendy Myers: Yeah. I heard there’s a guy that’s developing an actual poop pill where he tried triple-ply coatings so that it only disintegrates in your either small or large intestines.

Moises Velasquez Manoff: Yeah that’s a group, M. Allan Berico’s group I think.  That’s very promising.

Wendy Myers: That’s interesting to me. It’s fecal transplant reversed just going in the other end.

Moises Velasquez Manoff: I spoke to microbiologists during the course of my book that we’re doing this back in the 50’s. And then they were told to stop doing it. They didn’t understand why it worked; they just knew that if you’re into surgery and give someone antibiotics you should give them some of their own poop after. And then whatever the administration of the hospital discovered that they were feeding people their own poop in pills, they were told to stop. But here we are 60 years later, and it’s like this miraculous cure. This is not total news.

42:14 Tips to Increase Probiotics

Wendy Myers: Yeah. So what are some of the best approaches or lifestyle changes that you can give our listeners to increase “old friends” in the body and their benefits?

Moises Velasquez Manoff: What I always say to that question is, what I’m only willing to recommend things that I know that have no cost and lots of potential benefits. Nothing is proven yet. So the answer is we don’t know, but there are things you can do, like eat better. Eat more real food. Lay off the refined foods. Lay off the junk foods. All that’s stuff is for unfriendly bacteria. That’s not gonna hurt you it has a lot of potential benefits, very low potential cost. Exercise. Do stuff you already know right?. Do all that stuff. The kind of stuff that you could maybe take away, just from thinking differently, is when you take your kid to the doctor, and the doctor says, they have an infection. Maybe what you have to say is, we have to use antibiotics. I wouldn’t say, “don’t use antibiotics” as a hard and fast rule. Because if you don’t, kids die from infections but you may find your pediatrician is surprisingly receptive to the idea of waiting until something clears up because it might be viral. Because they are worried of antibiotic resistance these days. So that’s another other thing. Again, I don’t think you should just swear off antibiotics as a rule of your life.

Wendy Myers: Yeah. They save lives. They’re effective.

Moises Velasquez Manoff: And then the other thing is, day cares have been shown to be protective against allergic disease, and thinking that just because the kids are in there swapping bugs, that is native bacteria. So don’t worry so much about that kind of stuff. It’s true that kids in day cares get sick more often because they swap bad bugs as well, but in the end it might be good for them.

Wendy Myers: Yeah. We need that to modulate their immune system, to make them mature.

Moises Velasquez Manoff: Yeah so I wish I could say, go get tapeworm. Haha. But we don’t know the cost and benefits yet of that stuff. That’s actually being studied in people, and then we will know some of the potential side effects, like in a small number of people do these parasites that aren’t native to humans and end up in the wrong places, which could be really unfortunate—like your brain.  There’s that kind of thing that you always have to think of. That’s why I’m not always willing to be so willy nilly about this—like the Hookworm Underground. Hookworms used to be native to humans, but again, it’s totally unregulated to experiment where a bunch of people who grew up in a first world who never encountered such parasite are suddenly introducing it into the body. No one really knows what could happen because of that. People who have parasite infections are typically grown up with infections which is a very different proposition than a 40-year old taking parasite and bringing it in the body. I doubt that’s a problem. Parasites seem to be relatively safe to the body, but you never know. It can trigger something else. It could end up being worse off. You just never know.

45:36 The most pressing health issue in the world today: Addressing Symptoms, Not Root Causes

Wendy Myers: Yeah I’ve always fantasized about infecting myself with a tapeworm to aid my weight loss. To eat all the food that I’m eating. Haha. But that is just fantasy. But I have a question that I like to ask to all of my guests. What do you think is the most pressing health issue in the world today?

Moises Velasquez Manoff:  Well I think the most pressing issue is our lack of textualizing. The current sweep of diseases in an evolutionary context. That is, instead of focusing on symptom management not trying to look at the root cause. It’s like a vision problem. I guess I’ll use another analogy from psychological science which is, there’s something called shifting baselines. Let’s say four hundred years ago we started whaling very crazily in the ocean. Kill all the whales,  there are no more whales. You started fishing. You killed all the fish, and what happens is each generation is used to a different baseline of marine life. The first generation like in Boston there were actually whales in the Boston Bay. In the last generation, there’s no more caught anywhere in the North Atlantic. The stocks are extremely depleted. That’s normal for the current generation. No one backs up and looks up what the ecosystem looks like in its pristine state, what it should get back to. And I think in a lot of ways that’s the problem we get with the disease and with the immune system.

No one backs up and says, what does the immune system looks like in its evolutionary context. What else was there? How it really worked when there’s bunch of parasites? We know that parasites were over there all the time. How does the immune system work with these parasites? It works very differently. The irony is, there are some really interesting studies out of Israel, where they have immigrants from all over the world. Some of them come from Ethiopia. Immigrants from Ethiopia have all these parasites infections. They come, they try to vaccinate them, the vaccines don’t take because they have all these parasite infections, and their immune system is so surprised. They complain about it. They say, well we gotta deworm it, and we’re going to make these vaccines work. But here’s the irony, they might be seeing the way the immune system is supposed to work. Will they call hypo responsive as in not responsive enough? May actually be the way it’s always operated.  It’s the least responsive. It’s the least easily provoked. Those people are still alive. They still survive and clearly we can survive with less immune activity than we think. So that’s my analogy. I guess that my exhortation is that if people would back up a little bit, would look at the bigger picture, we could probably sort of ask the right questions for the kind of diseases that are afflicting us.

48:30 About Moises Velasquez Manoff

Wendy Myers: That’s very compelling. Absolutely. Can you tell the listeners a little bit more about you and where they could find you and what not?

Moises Velasquez Manoff: I’m a science writer. I’m a journalist. I write for the New York Times fairly regularly. I have written for Mother Jones as well. You could go to my website moisesvm.com and my book is available at Amazon, the Epidemic of Absence if you want to read it. I have more stuff coming in the near future. I’m getting a TED x talk next month. Just go to my website. All my stuff would be there: moisesvm.com.

Wendy Myers: I’ll definitely  have to check that TED talk. Absolutely.

Moises Velasquez Manoff: That will be on November 16th. It should be up after that.

Wendy Myers: And will that be up on the website?

Moises Velasquez Manoff: You know it’s a TED x event. The main TED website puts up stuff from TED x events that they like. They don’t always put up everything. It will be on my website.

Wendy Myers: Okay, great. Well, Moises, thank you for coming on the show. I’m thrilled that you agreed to come on and help people understand why they should be afraid of not having enough healthy bacteria in their body. Thank you for writing this invaluable book to explain the true underlying cause of many health issues plaguing our society today. It’s really a good read. I really enjoyed the book.

Moises Velasquez Manoff: Thanks for having me.

Wendy Myers: I started reading it, thinking, oh, another probiotic gut book. But it really drew me in how you wove your points into the stories that you told. It was really, really well written. I really liked it.

Moises Velasquez Manoff: Thanks so much. I appreciate it.

Wendy Myers: Everyone, if want to learn more about health, you can find me on Facebook, Twitter, at iwillliveto110. I’m also on YouTube at wendyliveto110.

If you want to learn more about weight loss and the modern Paleo diet, my version of Paleo, go to myersdetox.com and sign up for my free 30-plus page Live to 110 by Weighing Less E-Guide © and my 14-part email series about the Modern Paleo diet which are all about how to live a long, healthy, disease-free life.

Thank you, listeners, for tuning in. Remember, the time to be thinking about your health is while you still enjoy it, not waiting until you get sick. Thanks so much for listening to the podcast. I’ll see you very soon.

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