stop the grainflammation: end pain & autoimmune...

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Stop the Grainflammation: End Pain & Autoimmune Issues Guest: Peter Osborne The purpose of this presentation is to convey information. It is not intended to diagnose, treat, or cure your condition or to be a substitute for advice from your physician or other healthcare professional.

Donna: Welcome, everybody. I've got a fantastic guest today. I've been excited all day long for us to do this interview together. My guest is Dr. Peter Osborne, and he's the clinical director of Origins Healthcare Center. It's in Sugarland, Texas. He's a doctor of chiropractic medicine. And he's a board-certified clinical nutritionist. Now, that's really special when you get a chiropractor who studied all that anatomy and knows all about how the body works and then goes on and gets more training to become a certified clinical nutritionist. So right away I knew this was a great person for us to talk to. He's an expert in orthomolecular and functional medicine, which is even better. And he's been practicing since 2001. So he's had lots of experience. That's fourteen years now. His clinical focus is the holistic, natural treatment of chronic, degenerative diseases with a primary focus on gluten sensitivity and food allergies. So you can tell already that that's going to be an important part of our talk today. He's helped thousands of people recover from serious medical illnesses. I'm sure you can relate to this. You've been to all kinds of doctors and experts, and nobody's helped you yet. I know that Dr. Osborne can today. He founded the Gluten Free Society in 2010 to help educate patients and physicians on the far-reaching effects of gluten sensitivity. And today we're


going to talk in a way that people that are lay people can understand this. If you don't have much training on this topic, or if you are a physician and you've had a lot of training, we're going to give you a lot of great, new information that will be helpful when you treat your patients. Dr. Osborne is the author of Glutenology. I love that name. I'll say it again. Glutenology, which is a series of books designed to help educate the world about gluten. Peter, thank you very much for being a part of our summit. Dr. Osborne: You're very welcome. Thank you so much for having me. I'm always happy to share my knowledge and information. Donna: Well, before we actually met in person, I had already been following you because I love the way you educate people on the Internet because I think education is the most important product or tool that people can pick up. They're out there buying all kinds of products, but they don't even have the education to be able to know if those products are right for them. And you are a fantastic educator. Dr. Osborne: Oh, thank you. Donna: A while ago I was watching television, some while ago actually. And it was late at night, and Jimmy Fallon was on. He did a really funny skit on gluten. He was talking about here in L.A. where I live and he lives, everybody's gluten free. And so he went on to explain that for him that didn't work because gluten free meant pizza free, and he couldn't be pizza free. So he wasn't going gluten free. But he was really amazed at how gluten had become the devil, so to speak. So they took a microphone, and they went out into a park somewhere. And they interviewed all these people running around, stopped them from their run, and then they asked them, "Are you gluten free?" And over and over and over again people said, "Absolutely." They said it with great pride. They


thought they were just really happy to say that they were. Then they went on to say, "Well, why are you gluten free?" And they came up with answers like, "Well, my friend told me that it was really good," or "My friend told me that I'd lose weight if I went gluten free," or "It's got some bad stuff in it." But the bottom line is when they asked them, "What is gluten?" actually not a single person could answer that question. So it made me realize that even though you and I talk about gluten all the time…At Body Ecology, the diet, we've been gluten free in Body Ecology for twenty-five years. So I've always been telling people, "Don't eat gluten." So for us it's a piece of cake. And it seems like everybody should know, particularly when you walk into the store and there's gluten free signs hanging everywhere. So people are doing it, but they don't know why they're doing it or what it is even. So could we start with some real basics and just tell those people that don't know, what is gluten. Dr. Osborne: So very simply. This is a great question. I saw the same interview, by the way. It was hilarious, but sad at the same time. Gluten very, very basically defined is the name of the family of storage proteins found within the seeds of grass. Now, I back up just a little bit. Gluten we use it as a singular term and it's actually a plural term so it should technically be glutens not gluten. So we have glutens or gluten is this family of proteins. There's several thousand different forms of gluten that to date have been identified. And they exist within the seeds of grass. Now, the seeds of grass are technically grains. So that's wheat, barley, rye, oats, corn, rice, sorghum, millet, teff, and triticale. So there's all these different seeds of grass that we call grains. And within them there's this family of proteins that are stored. And the job of glutens is to help the seed sprout so that it can grow and sustain a new plant. But when humans eat them that are


gluten sensitive, then it creates a lot of problems. Donna: But you mentioned rice. And a lot of people think that rice is on the okay-to-eat list or oats if the oats haven't been contaminated with gluten or they haven't been cross-contaminated with say wheat or rye or something that that's okay, too, but sorghum. Those are considered gluten free. Dr. Osborne: They are considered gluten free by the traditional definition, which if we go back in 1952 there was a physician during World War II treating children in the hospital with celiac disease. And this was over in Germany. And his name was William Dickey. And what he observed is that these kids with celiac disease went into spontaneous remission when grain was no longer available to the hospital because of the war. And so he was the first doctor that actually recorded and made that observation that not having grain led to remission of celiac disease. Now, the staple grains in Germany are wheat, barley, and rye and oats. And so this is where that initial came to be. And so corn not a staple grain of the region; rice not a staple grain of the region. They really weren't adequately studied. They really were just put into a safe list without ever actually being studied to be safe. Now, here's the thing, Donna, we have studies that show that corn can actually create villous atrophy. Now if we define celiac disease which is this biopsy-proven villous atrophy of the small intestine. In other words, people with celiac disease, when they get a biopsy, their intestinal lining has been eroded away. And we can see that on a microscopic evaluation. That's the way we classically define celiac disease. And it's been traditionally thought that only wheat, barley, and rye proteins were the culprit there. But we've actually identified other things can create that same villous atrophy. Corn is one of them. Soy has been shown to cause


villous atrophy. Parasitic infections have been shown to cause villous atrophy. So there are other things that can cause villous atrophy. But doctors that find villous atrophy when they're doing a patient examination, always default to this celiac condition. And so you might have somebody with a severe soy reaction that has villous atrophy as a result of soy. But they're being told they're gluten sensitive. And do you see what I'm saying? So there's a lot of room for misdiagnosis or for poor interpretation here. And that is really what I want to shed a light on. We know corn can cause villous atrophy. We know that the type of gluten in corn can damage people with gluten sensitivity even worse than the type of gluten in wheat. There have been a number of studies that show that people with corn or with gluten sensitivity react worse to corn gluten than they do to wheat gluten. Donna: Interesting. Well, you've used this term a lot. What is "villous atrophy?” Dr. Osborne: So villous atrophy is imagine that your small intestine, it's this long tube. But this tube has a lot of folds and a lot of tentacles in it, almost like a shag carpet, in a sense. And in these little tentacles are called villi. And so when we say "villous atrophy," we're referring to these little tentacles are inflamed and they become damaged and they erode away. And the whole purpose of a villi is that it increases the surface area of the small intestine so that a person who's eating their food has more space to digest and absorb the vitamins and the minerals from their food. So if we were to take the small intestine, for example, and unfold all of the folds in it, it would have the surface area of a tennis court. So it's that vast. And so somebody with villous atrophy, their surface area of their small intestine is eroded because those villi are basically being inflamed and being basically destroyed.


Donna: And you can see pictures of this on the Internet, right? Like go to YouTube or just type it into Safari, and you'll actually see pictures of the gut looking basically like a desert. Dr. Osborne: Yeah. Yeah, you can see a healthy picture of the villi. And then if you type in "villous atrophy images," you can see just compare the difference between a healthy-looking gut and an atrophied villi. And you'll see there's a remarkable difference microscopically between the two. Donna: I know. That alone, that image alone is enough to get you to stop right there from ever eating gluten. Genes, let's talk a minute about the genes because more and more people are getting their genes tested, and I've had mine tested too. And I do not have the genes that are normally considered the genes that would tell me that I had celiac. In other words, according to my genes, I'm not carrying the DQ2 or the DQ8. Those are green for me. So technically a doctor would look and say, "Oh, you're good to go." Let's say I was a child, and my mother had my tested. And the doctor would say, "Oh, she's fine with gluten." But I wouldn't have been. So can we talk about that? Why are these genes not an accurate diagnosis basically? Dr. Osborne: Well, actually I feel like the genes are the best diagnosis. Let me define. Donna: I mean, in other words, let me just clarify that because you're saying that if you had red there, meaning that you definitely have an issue, your genes are definitely not allowing you to digest gluten, then that's your best. Of course, you should avoid gluten. But what about the rest of us? Dr. Osborne: So let's define a little differently. So we have gluten intolerance. We have gluten sensitivity. We have gluten allergy. And so maybe that's probably a place to start because if a person understands the differences between the three, then they'll understand a little bit better the differences


between the tests that are being used to diagnose the different conditions. So whereas you have an intolerance, an intolerance defined is the person lacks the ability to digest the food itself. So lactose intolerance for dairy, people that don't do well with dairy, it's not an allergy. But when they eat lactose, the sugar in dairy, their stomach bloats. And they get IBS-like symptoms because they don't have the enzymes to be able to digest that sugar in the dairy. Well, gluten intolerance is much the same way. People can have an inability to be able to break down the gluten proteins. And so you've probably seen a lot of doctors and a lot of people will recommend digestive enzyme supplements to help people. They recommend avoiding gluten. But they recommend that if you're eating out and there's that risk for cross-contamination, that these types of people take a digestive enzyme to reduce any potential exposure to help break that gluten, hard-to-digest gluten protein down. So an intolerance is again it's a digestive issue more than it is an immune issue. Now, there's also gluten sensitivity. And gluten sensitivity, the consensus that doctors think right now, so in other words if you ask all the experts in the field of gluten sensitivity and celiac disease what kind of a reaction is somebody with gluten sensitivity, how do you define that reaction, the vast majority of them believe that it is a type of immune reaction. And there's a type of immune reaction from a side of your immune system called the innate immune system. So what we would call an innate immune reaction. Now, think of the innate immune system as the immune system that you're born with. It includes the skin and the mucous in the gut. It includes the gut lining itself. So when we talk about leaky gut, the gut wall and the gut lining is part of our innate immune system. It includes specialized types of white blood cells that don't require any type of maturation. These kinds of white cells are they


circulate around in our bloodstream and then just basically they're like guard dogs. Anything they see they don't like, they generally will attack it in a generalized way. So our innate immune system we're born with it, and it's kind of a generalized way to attack things that the body is recognizing as potential threats. And so that's a sensitivity. It's an innate immune reaction. But then you have this other word, this allergic word, right? We hear about gluten allergy. And that's a different kind of immune reaction. It's what we would call a humoral immune reaction where our bodies are making antibodies against the actual proteins themselves. So when doctors run a lab test to say are you are gluten sensitive, do you have celiac disease, what they're really measuring is the humoral immune system and its response to one form of gluten. Remember earlier I said there were thousands of different kinds of glutens? Well, the primary one that gets measured when a doctor does their testing is something called alpha gliadin. It's an antibody that people can make to the protein, one of the forms of gluten proteins found in wheat, barley, and rye called alpha gliadin. Now, to give you a scope of how inaccurate that can be, in 2010 a group of researchers out of Australia discovered 400 new gluten proteins that were not alpha gliadin. And 40 of them were more toxic than alpha gliadin. And they were found in multiple different forms of grain. And none of those commercially are tested for today. In other words, there's no commercial lab where you can go to and say, "Hey, can you test me for all the different kinds of glutens?" So generally when you go to a lab to get tested for gluten sensitivity or you go to a doctor and be tested for an immune reaction to gluten, you're only having generally one of those types of glutens tested. And you're only testing one part of the immune system's response. So the doctor is measuring what is called IgG or IgA reactions to alpha gliadin. And that is all part of the humoral immune system as opposed to measuring the innate immune system's


reaction, which is a completely different ball game. Donna: Well, innate immune system meaning that your own white blood cells, for example, are attacking. Dr. Osborne: Correct, like natural killer cells that generally are just circulating through our bodies at any given time. They see it in somebody who's gluten sensitive, these natural white blood cells see gluten as an enemy. They don't see it as a friend, and so they just go and attack it. And so they're secreting all kinds of chemicals like tumor necrosis factor and interferon gamma. These are just different chemicals while blood cells can create when they see a threat to try to eliminate the threat. Donna: So our body really is trying to protect us when you have a reaction like this. But we're the problem because we're putting these dangerous substances in that makes the immune have to attack. We're the one who has to change. Dr. Osborne: Right, I like to look at so if we're trying to define gluten sensitivity, the best way to identify it is through genetics because if a person has the gene pattern where their immune system cells see gluten as an enemy, we can look at certain patterns genetically and see that a person's normal response to gluten is going to be an inflammatory immune response by the innate immune system. And that can be measured. It doesn't tell you whether or not a person is reacting to gluten. It tells you whether or not they have the genes that give them the propensity to react to gluten should they choose to eat it. Donna: Well, not that many people have the genes. There is actually a really tiny percentage of people when you look. Although among the people with gut dysbiosis, like if you get a bunch of people in a huge stadium that say, “I have gut problems,” those among that population of people, you're going to see a very large number of people with those genes.


Dr. Osborne: Well, that would be what are called HLA-DQ2 and HLA-DQ8 gene patterns. Those are not super, super common. But when you add the other non-celiac gluten sensitive gene patterns, then it becomes a much more common finding. And so that's when we are looking for gluten sensitivity in someone with a history that would match the symptoms of gluten sensitivity or autoimmune disease. We're actually doing a more in-depth genetic test than just measuring those HLA-DQ2 and HLA-DQ8 genotypes. Donna: Great. Well, that's a wonderful explanation. Now, again, this is a term that you would think everybody in the world listening would know this term very well by now, but just in case they don't. Let's talk about leaky gut and then that relationship to the autoimmune reaction that you were talking about. Dr. Osborne: So there are a lot of things that we've identified that can cause leaky gut. One of them absolutely hands down is gluten. But you can also have infectious microorganisms, bacteria, parasitic, yeast overgrowth. These types of infectious agents can also contribute to or trigger leaky gut. Heavy metals can contribute to and trigger a leaky gut. Some studies have been shown that pesticides can contribute to leaky gut. Drinking, eating, or storing food in plastics can contribute to a leaky gut. And then we have a more recent study on potato. There's an alkaloid family in potato that has been shown to cause leaky gut, also known as intestinal hyperpermeability. Now, once you have a leaky gut…And let me clarify this. Intestinal hyperpermeability is different than intestinal permeability because the intestine serves as a gate. Sometimes it opens up to let things in, but most of the time it's closed. So there is some degree of permeability in all people and all intestines. It's when those gates stay open and they fail to close because the proteins within those gates get broken.


And so the flood gates are open. And so all kinds of things from our food- bacteria, bacterial waste products, proteins in our food- can now leak into the bloodstream. And, Donna, 75% of the entire immune system is concentrated right behind the gut wall. So when things leak in, they're directly leaking into the immune system where the attack is going to be the most vicious. So what happens is the immune system sees all these things that are leaking through, and they're not going through the proper gate. They're not going through the proper checks and balances. And so the immune system is recognizing things that would otherwise be considered friends as foes because it's being overwhelmed and over bombarded. And so what happens is over time the immune system is attacking and attacking and attacking the food. And this is how we acquire allergies. This is why some people with gluten sensitivity who continue to eat gluten develop allergies to lots of different kinds of foods. But what can happen over time is some of these proteins leaking into the bloodstream, they look like our tissue in our body. So for example, let's say you're eating a particular type of food. Let's just say potato, as an example, and your immune system's been attacking that potato because you've got this leaky gut. And some of the elements of that potato also look like the cartilage in your wrist. And so your immune system has been attacking this potato and attacking and attacking it. And now it starts looking at the wrist and saying, “Hey, we've been attacking this potato that looks like the wrist. Let's attack the wrist, too.” And now the person's developing joint pain. They're developing autoimmune arthritis as a result of this prolonged immune response. And the name of this process is actually called molecular mimicry. It's when the immune system attacks something that we're eating. That something is leaking into the immune system through that leaky gut. And


over time that tissue mimics or that food that we're eating can mimic our internal tissue. Sometimes it's joints. Sometimes it's skin. Sometimes it's a thyroid organ. And so now we start to develop an autoimmune attack. Our immune system starts to attack our own tissue because it's confusing our tissue for those other foods that have been leaking in and it's been reacting to as well. Donna: Now, you mentioned something that I'd like to go deeper into. And that's pain. Grain causes inflammation, and then you said it causes pain. And I know as a chiropractor, you're very familiar with people coming in in pain. But now you're saying that basically what they're eating is causing a lot of that pain. Dr. Osborne: Right, so imagine, first of all, if we look at grain itself, one of the things that we know contributes to and causes leaky gut is grain, grain consumption. And that's because it disrupts these specialized proteins in the gut, and it opens the gut up. And so now we get this leakage, this leakage of foods into the bloodstream. The immune system is attacking these foods. And again two things can happen here. One, as I said before, the immune system can confuse these foods for cartilage and now we're getting molecular mimicry and so we start to develop an autoimmune arthritic condition. And I've seen it affect any joint in the body. I've seen it affect the knees and the elbows and the wrists. I've seen it affect the hips in the low back. And there are different names for autoimmune diseases that impact these tissues. For example, rheumatoid arthritis can affect the wrists and hands. Psoriatic arthritis can affect the spine. Spondyloarthritis can affect the spine. There are conditions of soft tissue like dermatomyositis that will affect the muscles, tendons, and ligaments, and soft tissue. So we have these different names for different painful autoimmune conditions that oftentimes are being triggered as a result of leaky gut.


So part of that process is this molecular mimicry. But the other part of that process is what we would call collateral damage of the immune system. Imagine just like in wartime if you've got friendly tanks shooting mortar shells into enemy buildings and the building blows up but the debris kicks up a cloud of dust and some of that might fly off and damage our own troops, right? In wartime we would call that collateral damage, meaning it was the unintended consequence of attacking the enemy was to damage our own people. And so this happens within our joints, as well. This happens within our body, as well, is that our immune system is attacking whatever is leaking through, and as part of that attack is occurring, it kicks up a collateral inflammation. And if that just so happens to be in the muscle tissue, then we can get muscle inflammation. If that just so happens to be inside of a joint, then we can get joint inflammation. And so this is where a lot of the process of developing pain in the muscles, joints, tendons, and ligaments can be associated with eating the wrong foods. Donna: Well, another area that's very common today…It’s such a sad thing because I think every generation's been getting weaker and weaker. And now in your twenty- and thirty-year olds, we're seeing so many young women with Hashimoto's. And this is exactly what we're talking about. Their immune system is attacking their own thyroid. Could you talk about that a little bit? Dr. Osborne: Yeah, so with Hashimoto's, we can get an immune attack on our own thyroid gland itself. We can get an immune attack on our actual thyroid hormone. And we can also get an immune attack on our own thyroid hormone receptor. So if you attack the gland, then you reduce its ability to properly produce thyroid hormone. If you attack the hormone, then you interfere with its ability to basically increase the metabolic rate because the hormone's broken and it's not working. And if you attack the hormone receptor, then basically you


intercept the communication between the hormone and the DNA of the cell so that that message of the hormone cannot be delivered. And at the end of the road, all that leads to, the thyroid hormone is the master metabolic regulator. So we get reduction in overall metabolism. Now a lot of people think of metabolism as this process of fat loss or this process of energy expenditure. But metabolism is loosely defined as the sum of all chemical reactions in the body. And here's why that's important to differentiate. Half of the reactions in our body are reactions where we're breaking things down like breaking down fat to generate energy or breaking down carbs to generate energy. But the other half of the reactions in our body are what we call anabolic reactions meaning that's how we repair. And so when you interfere with thyroid hormone, not only do you interfere with the breakdown of calories to burn and make energy, but you also interfere with the body's ability to heal and repair tissue. And a normal part of our body is wear and tear. We're going to have wear and tear every day if we exercise, if we take a walk, we've got some general wear and tear that our body keeps house with. And if you don't have thyroid hormone then you start to lose the ability metabolically to repair damaged tissue. But you also lose the ability to generate energy. So now you're in an energy deficient and you have tissue that's inflamed and damaged that doesn't have the ability to heal. So now these thyroid patients, not only do they feel lethargic, but they're incapable of healing. And then they get in this vicious cycle. Donna: One of the things I want everybody to do right now is to be sure to write down your website and go to an article that you have on the site about the thyroid and the nutrients it needs. I've been trying to tell people this for


years. Part of the problem with the thyroid also is we're just not giving it the nutrients it needs to function. And it's beyond the scope of this interview today, but I think it's a must view. People need to look at this. The thyroid, as you said, is extremely important, and this video that you did—again, you're a fantastic teacher—does a beautiful job of explaining how important these nutrients are and which ones are important to the thyroid work. So it's just not the gut. It's also that we've got to get the right nutrients into the cell too. And I just want to throw that in there. And can you give people the name of the website, which website that's posted on? Dr. Osborne: Yeah, that's GlutenFreeSociety.org. Donna: Over the years, I've worked with lots of people with gut problems. And I will say that some people, if they go on an all protein vegetable diet, they start getting in trouble. They have trouble sleeping. They become too wired. So basically what you're saying and what other people are saying today is avoid grains altogether. And I've actually seen some people not be able to do that. And over the years of trying to figure this whole thing out—actually I'm in that category too—I need to have some quinoa or millet or something that's like a grain because I sleep better at night. And even at times when I've really had problems sleeping because I'm under a lot of stress, I'm go and get some gaba rice. That's the rice that was developed with the Japanese that's very, very high in gaba. And a couple of nights of eating that, I feel more relaxed and calm and I start to sleep. Now, what I've found is key is the amount. I always promoted an 80/20 ratio. So 80% of what I'm eating in that meal is vegetables. And then only a very small portion is actually the rice or the quinoa, the millet. Of course, I'm


preparing it real carefully and soaking it and cooking it a really long time, cooking it with a lot of vegetables, cooking it with healthy sea salt. And then I don't have a problem with that. So if I do all that and eat fermented foods in that meal, I'm fine with it. Now, the fermented foods, I think, are actually playing a key role. Now, I don't think anyone's looked at this very much. It's because you've got all this bacteria in the vegetables that are going to be eating up the sugars in that meal, the sugars that might be in the grain, for example. And I think that that's why it's worked for me. So I just wanted to throw that out there. I know it sounds controversial. But it is something I've noticed because I've noticed some people just can't do protein and vegetables only. But also I don't want people to feel like, “Well, we're listening to this interview. And everybody seems to be saying go grain free. And I've tried that, but I don't feel good.” So can you add to that or argue with me? Argue if you want. Dr. Osborne: Absolutely. You bring up a very good and valid point. And I would preface the entire answer to that conversation, first of all, by identifying whether or not a person a gluten sensitive. I think that has to be the delineating factor because if the bottom line is a lot of people, a lot of doctors, a lot of nutritionists are telling people to just go gluten free without testing. And they may be using the gold standard test. People call this the gold standard test, which is trial by fire. Go gluten free. If you feel better, then you're gluten sensitive. Well, that's not a very scientifically sound argument. And the reason why is because as you just said, a person could avoid gluten and feel better for many other reasons than just gluten. For some people, their carbohydrate intolerance or the types of carbohydrates that are commonly found in grains, certain FODMAPs are very hard to digest. So some people that think they're gluten sensitive are actually FODMAP


sensitive. Some people who cut out grain and feel better, it's not that they're gluten sensitive. It's that there's a heavy level of chemical pesticide that they're reacting to. Or like rice, for example, is very high in arsenic or cadmium. And so they're reacting to heavy metal exposure. So there are a lot of reasons why a person might feel better going grain free or gluten free, for example. But I would never have somebody embark upon a diet like that without first testing them to discern what foods they should and shouldn't eat. And I do that in a multitude of different ways. We do genetic testing. We do immune testing where we measure there are seven different ways the immune system can have a reaction to a food. And so we're measuring all different seven pathways. Most in my experience measure one or two pathways, most doctors, nutritionists. We measure seven different pathways because I want to be able to justify. If I'm telling somebody, if I'm telling a patient, “Look, you need to do this,” I want to take as much guess work out of the equation as possible. And in doing so, I like to know what is your immune system tell me? And there are some people out there that are not gluten sensitive. And so avoiding 100% of all the grain is not the right move for them. There are people who are better suited for a vegetarian diet. There are people that are better suited for an all meat and vegetable diet. And not everybody's the same. And I think celebrating biochemical individuality is the answer to that that you just posed is that there's not one right blueprint for absolutely 100% of the population. The best way to really, really niche it down and to get individualized advice is to work with a functional medicine doctor who's really well-versed and trained in the art of determining what your body should and shouldn't be eating that you haven't already been able to intelligently discern by doing an elimination diet.


Donna: So for the practitioners listening in, what would be some of the tests that you use in your office that they can use? Dr. Osborne: Well, first and foremost, to determine gluten sensitivity or reactability to grain, we do HLA-DQ alpha 1 and beta 1 genetic testing. But we go deeper than just the DQ2 and DQ8 genotype patterns. So we look at what are called non-celiac gluten sensitive gene patterns, as well. So that would be one place to start to determine whether or not gluten is right for that person in their diet. Some of the other testing we do, we do what's called lymphocyte response. So if we go through the different types of immune reactions for practitioners and for lay people—feel free to write down and talk to your doctor about whether or not he's testing you this thoroughly—you can measure what's called IgE. IgE is a type of antibody. Generally it's what we refer to as an acute antibody response. In other words, this kind of a reaction you've heard of if you've ever seen somebody or heard of somebody having a peanut reaction where their lips swell or their throat constricts. Well, a person can have an acute reaction and it not be life-threatening. So just because you don't have your lips swell or your throat constrict doesn't mean that you don't have an acute allergic response to something. Some of the responses are as mild as an increase in heart rate or as having excessive mucous production in your throat after the meal or having watery, teary, itchy eyes. These are some of the more mild, acute symptoms that people might experience. And we can test that by measuring what's called IgE. And a lot of your traditional allergists will skin prick you, and their skin prick testing for what's called IgE. It's better to do it in the blood, but a lot of allergists do skin prick testing.


Then we can measure IgG and IgA and IgM. These are three other antibodies, and these are traditionally these are called delayed-hypersensitivity immune responses, meaning the immune system is creating antibodies to go after these particular food agents. And there's three primary ones that can be tested for. But then you also can have a reaction, it's called an immune cell reaction where the immune cell itself is actually going after the food. And then you can have something else called a complex reaction, an immune complex reaction which is a different chemical pathway that leads to inflammatory mediators being produced in response to of having the exposure to a particular food or environmental agent. So we will test every one of those ways using lymphocyte response technology. In other words, we actually take the person's white blood cells and watch them light up as they're attacking different things in different ways. And so this, to me, this is the most advanced technology that exists to be able to measure it with any degree of accuracy because a big problem with a lot of the other types of testing is you get a lot of false negative, or you get a lot of inconsistency under double-blind examination. So what I mean by that is if I take Jane Doe's blood and I take four vials of Jane Doe's blood and I mark two of the vials with Jane Doe's name and I mark two of the other same, exact blood draw, but I mark it under a different name, let's just say Cheryl Doe, and we send it off to the lab on the same day, many labs the variation that you would get under a double-blind circumstance would be as high as 34%. And this is one of the determining factors that I use clinically to make sure that I'm not using a lab that has huge variability rate is I want to make sure that if I'm double-blinding them, that I'm getting back the same results on the same sample because if not, then how valid is that going to be in clinical practice to help somebody determine what they should or shouldn't avoid? So we do lymphocyte response testing to determine those other six pathways that


a person might be having a reaction with. Donna: Now, people listening to the summit are all over the world—and obviously they can't all come to Sugarland, Texas and work with you—what would you recommend they do or what type of doctor would be able to do these same type of tests? Dr. Osborne: You've got to find a good functional medicine doctor, and I will say it like this. And I'm not trying to be offensive to any doctors out there. I think all doctors by nature are good-hearted and have great intentions. But there's also another old saying that the road to hell is paved with good intention. And again I'm not saying this to talk bad or ill of any doctor. But you want to find a functional medicine doctor, first of all, who's got experience and who's at least partially or somewhat or on the track to being certified. And there are a number of institutes that will certify doctors to practice functional medicine. The American Clinical Board of Nutrition is one of the agencies that I belong to and am a part of. There's also Institute for Functional Medicine. There's also Functional Medicine University. Now, those are just some examples of some good programs that people can go, doctors can go, and get an accelerated education. And most of these programs are 300+ post-graduate hours of education. And they require some type of dissertation or publication and research and paper writing and things of that nature. So those programs are designed for doctors to meet a minimum required quantity of knowledge before they can be considered experts in functional medicine. Now, that's the first place to start. But then the second place to start is if it were me and I were looking for a doctor for a family, my first question would be does the doctor have the training? And my second question would be okay, great, the doctor has the training. How long has the doctor been practicing with that training?


Because a lot of doctors are new to this. And they've got credentialing, but they've been doing it six months, right? Maybe they've been in practice thirty years, but they've only been practicing functional medicine for six months. And that's not to say that they're not good doctors. That's just to say, look, if you're trying to pick the best of the best—and most people with chronic health issues are because they've already been to eight or ten or twelve doctors and not gotten answers—if you're trying to find the best of the best, the two questions to ask is one, does the doctor have the training and two, how much experience does the doctor have in the application of that training? Those are very important questions to ask. Donna: Can you handle thousands of people coming to Sugarland, Texas? Dr. Osborne: Well, I cap my practice because functional medicine cannot be rushed unfortunately. But also that's the nature of it is that to be highly individualized with patients, that takes time. And there's no scaling of it. It's not like another business model that you can scale it by adding machinery or technology. You don't scale good care. You don't scale bedside manner. You don't scale one-on-one communication between a doctor and a patient. I would say the best way to scale it would be to have 10,000 really, really well-trained doctors who are all networking together, who are all communicating together across the country saying, "Hey, there's somebody in my area I don't have time for. Do you have time for this person because my schedule's overly booked?" I think we're seeing the ground swell of functional medicine, but it's in its infancy. And the problem is we have more consumers in need of functional medicine than we have functional medicine doctors capable of providing that type of care. So it's a problem everywhere right now. And part of that is I'm working on that. I actually train practitioners. I train doctors to use a lot of the technology that we use, lab testing and things of that nature. And also I


train them how to do a lot of what we're doing in our clinic here in Sugarland. Donna: How does someone get that training? Dr. Osborne: They can contact my assistant, my assistant Casey. And her email is [email protected]. And she's my liaison for that program. We run that program, and even that program has a cap. I believe just as much about educating doctors in the same way I educate patients. And that is you can't scale the training of doctors really well either. It has to be done in a smaller setting, in a smaller environment, where they can get the questions they need answered. And they can get the clinical help and their needs answered so that they can deliver greater care. Donna: And this is a live training or an online training? Dr. Osborne: It's both. I have an online training. It's a twelve-month platform. And in order to qualify for my one-on-one training with doctors, they have to go through my online course first because if they don't, it's too much. And so we break it down into a minimum of well, I say twelve months. We're contemplating tightening that up into six months. But I wouldn't tighten it up any more than that. But they got to go through our online program before they can come to our actual live program. Donna: That's fantastic. I mean fantastic that you're offering this training because I agree with you. I've gone through the A4M advanced fellowship program, which is fantastic, and I'm constantly learning beyond that program. I've continued to take modules. I'm constantly listening to webinars. A whole lot of us are what are called functional medicine geeks, stay up late at night listening. But there's so much to know. And again education is where it all starts. So the doctors are being educated, but at least they are because I will say


twenty years ago back when people laughed at me when I said sugar's not good for you and all this wheat and bread and stuff it's not good for you and it causes/feeds the yeast infection, people literally would laugh at me. So it's very exciting to see how far we've come in the last twenty-five years. But like you said, it takes time to go to somebody really, really good and experienced. And then there are people like you are who are training other doctors. So I'm very glad we got that out in this interview. Now, one thing you did say a little ways back was about being a vegetarian. Now, let's talk a little bit more about that because how can you be a vegetarian without grain? But I do want to add a little gene information because that's my passion and what I study a lot. The APO4 gene which is the 3/4, the 4/4, that's the one that puts people more at risk for cardiovascular disease, and it scares people because that's the possible risk for Alzheimer's. Those people really can't have a high-protein diet, and they cannot have a high fat diet. So they need to skew their whole diet more toward a vegetarian diet. But how would you tell that person or many people even for spiritual reasons are just, you know, I was talking to a woman a couple days ago and she's actually got a terrible case of Parkinson's. She's very crippled by it, but she's insisted on being a vegetarian. She's real spiritual. She can't eat eggs and even dairy or anything. So what would you say to those people? Dr. Osborne: I would say you can't eat against your genetics. I'm going to give you an analogy that's super easy to understand, Donna. And that imagine a person going under water and trying to breathe. If I gave you two options, option A, they're going to grow gills and they're going to start breathing, or option B they're going to choke and probably drown if they stay under the water, obviously the answer is B. Some people fail to listen to their body and continue to do things against its will for multitudes of different reasons, some just because they like a way a


food tastes, some there are religious implications for some people. Without getting involved in what somebody believes religiously or spiritually, I think that any religion in the world the first rule has got to be your body is your temple, and if you destroy yourself for the name of a religion, then to me that just doesn't make a whole lot of sense. And I go back even to some vegetarians because I've treated a number and converted a number of vegetarians who whether religious reasons or otherwise their bodies were not suited for vegetarianism. It was the wrong move for them. And at the end of the day, they're getting sicker. And so you have to weigh, do you want to be sick and do you want to have a life full of autoimmune disease and misery, or do you want to feel better? There's a choice to be made. You either have to come to terms with the fact that you're going to treat your body the way, well, I'm religious. I will say the way God would want you to treat your body, which is to treat it as if it's your temple and to hold it above all things because you only have one. And if you abuse it or misuse it or use it incorrectly, then it will deteriorate. And then you lose the ability to help others in the world. You will lose your ability to function within the world. So I'm not going to convert somebody from one religion to the other. But I'm going to try to speak intelligently to them in terms of whether or not that's the right diet for them to follow. And if it's not the right diet for them follow but that's what they choose to follow, then there's nothing that anybody on this earth can do to help that person because they've already made and sealed their fate. Donna: That is beautifully said. And I 100% agree. And you have to realize, too, that a lot of the religions, when they came to be, there was very little understanding of health and diet. Like probably none and certainly nothing about genes and there were no tests people could check out and see what


their body needed. So they made up these laws or rules because they thought they were the right thing to do spiritually, the God-first thing to do. But I 100% agree with you. I believe that the Creator wants us to be healthy and happy and of service in the world and bright and cheerful. And you can't be doing that if you're feeding your body exactly the opposite of what it needs. And I'll give you an example. Just recently, again, another insight I had. A friend of mine had her genes, did her gene test, and I got the results. And I was reading it for her. Every morning she has coffee, and I think she has what's called the 1A2 gene—I have to go back and look—which means she doesn't clear caffeine well. But the big deal was that she does that APO4 gene. So she was putting a lot of butter and fat in her coffee in the morning and just loved it. She felt it metabolized. It didn't give her a jolt. It seemed to go in better and metabolize better. And then I said to her once I saw this in this report that, “This is not good for you to do this. You've got to stop doing this.” But you know what? She wasn’t having a bad [reaction.] She wouldn't drink the coffee with the butter and then have a stomach ache all day or free brain dead or something. She felt fine. She thought it was good for her. She's a very athletic person. I think when people are, they can get away with murder more than other people. But I mean that's one of the things that I love about the genes and love about testing is because you can't guess. You can't just guess and think, oh, I think this coffee's good for me. It's really popular right now. Everybody's thriving on it when your body, in fact, you're harming your body and there's not a sign of it which again is why the testing's so important, what you just shared with us about the proper testing was just priceless. So I have one last question. I could talk to you all day long, and I'm sure


people could keep listening to you all day long. As I said, you're a fantastic teacher. What about, when somebody goes off the food that's not good for them, gluten for example. How long does it take to get that reaction, that autoimmune reaction, for example, that gut reaction, how long does it take to get that out of the person's system? Dr. Osborne: About eighteen months. Donna: Whew, that's a long time. Dr. Osborne: Yeah. Well, there's a reason why it takes that length of time. Now that doesn't mean that a person doesn't feel better quicker than eighteen months. But the immune system has a turnover time of about six months. So every six months, just like a red blood cell, the hemoglobin A1C test that measures blood sugar averages for three months, that works because they're using the red blood cell to do that. And the red blood cell has a life span of three months. And so the immune system has a life span of six months. So every six months you've got brand new circulating immune cells. That's an opportunity for those overly aggressive autoimmune reactive immune cells to die off and give birth to new cells that are going to be less aggressive. And so it takes about three generations of those cells to really, really get an autoimmune condition under great control. Most people notice, though, if truly gluten sensitive will notice improvements within the first month or two of the diet change. It's just that I call it a danger zone where when you feel so much better compared to where you were, right, that now you have this tendency to want to start back pedaling and cheat or potentially kind of fudge what you were doing to get healthy in the first place, and that's where it can take longer. I generally in my patients I see about eighteen months is the time frame for


which we'll see an autoimmune disease go into full remission. Sometimes a little bit quicker, but sometimes a little slower. But again, every person's unique but about eighteen months. And we've seen this time and time again when we confirm repetitive antibody testing. Somebody comes into me and they're got positive rheumatoid factor or positive Hashimoto's antibodies like thyroid peroxidase or positive antinuclear antibodies for lupus. Then what we do is we try to re-measure those each six months just to see that we're moving in the right direction, see if that autoimmune reaction is getting less and getting less and getting less. And generally eighteen months we're down to zero reaction. Donna: Now, I can see why they'd feel better almost right away too because the gut lining is turning over every three, four, five days so at least you're constantly irritating the gut. So three days, another three days, another three days, within a month you've got a significant turnover of the gut lining. And that's going to definitely have less inflammation. That's definitely has to have a positive factor to it. Dr. Osborne: Absolutely. And the gut is the window to nutrition, so if the gut's working again. And we get everything working better when the gut's working. Donna: As they say, “First fix the gut.” Thus The Gut Summit. This is really a great interview. Thank you so much. We've been talking with Dr. Peter Osborne. It's been brilliant. Is there any last minute tips that you want to give us, something that you want to, there's so much information here. When people finish listening and especially if they go on to listen to something else or they need to listen to this three or four or five times which I highly recommend, what would you really, really want them most of all to remember? Dr. Osborne: I think the most important thing is there is no one right for


everyone. There are books. There are podcasts. There are blogs. There's all kinds of wonderful information that's available at our fingertips online. But if you're taking that information and you're using it to generalize about yourself, that's not always the smartest thing to do. There's never one right plan that's 100% right for absolutely everybody. You have to take into consideration your own uniqueness, your own biochemical individuality. If you're healthy, and you're just trying to be healthier, generalization is fine. If you're sick chronically and you're really trying to get answers to discover how to restore your health, you've got to work with somebody who can help you tease out your biochemical uniqueness and give you a blueprint to success because without it you're going to struggle for years. I see this every day in my practice, people who've been to eight or ten or twelve doctors and have been struggling needlessly for years for no more reason than the doctors they've worked with didn't ever sit down and give them a blueprint of what they needed as a unique person. So I'd say end the suffering and end the frustration by getting very, very specific and very, very unique to you. Donna: So obviously it's not just a money thing. Like somebody listening would say, well, I don't have the money for all this testing. Where do I start? But also if they're going to other practitioners or have in the past, they've already spent a ton of money. They've got some money. So how much of an issue is the money thing? Dr. Osborne: I would say the money issue is irrelevant because if you multiply the time for hospital visits, if you multiply the time for other doctors and for other ailments and for trying other generalized programs and reading books and all this other stuff, the time and suffering that you lose, to me there's no greater value then health, right? Virgil said, “The greatest wealth is health.” And without it, you don't have an ability to function in the world.


And to me finding a good functional medicine doctor isn't, most of them are going to charge, from what I've seen, anywhere from $1000, some charge up to as much as I've seen as much as $20,000, but this is for really, really advanced stem cell injections and things of that nature. So the average is nowhere near that. And it's very well within the affordability cost of most people if they're prioritizing their budgets. Just think of a cell phone, most people will not hesitate to spend a few thousand dollars a year on a cell phone. Don't hesitate to spend that on your health. Dr. Osborne: For those people that want to get started and they have to save up that money, you started selling your new book in early November. It's available. So it's been available for pre-sale all that time. And January 26 is the official launch date where they'll actually be able to buy the book and receive it in their homes. But why should they read the book? What would they get out of the book that would start them on this journey to wellness? Donna: Clarity. A big section of the book is dedicated to functional medicine, what to look for, why. To me the greater good coming out of this book is yes, recognizing that going gluten free is so much deeper than wheat, barley, and rye. And I think a lot of people need to come to that clarity to improve their health and to get better. But I think even the bigger message here is what functional medicine is, what it has to offer, what it can do for you. If people really want to find and get better and find the right tools and the right methods and the right way to get better, that's what they'll get out of it. Dr. Osborne: It's for practitioners and lay people too, right? Donna: It is. It's science. The first five chapters are very science-y but written in a way that's easy to understand and very heavily referenced. We've got over thirty pages of references in the book itself. But the last six chapters are very,


very much applicable, laid out, easy to follow. Dr. Osborne: That's fantastic. So the practitioners listening have a great book, a great resource, a place to start educating themselves. And everybody else can benefit too. So what is the name of the book? Donna: It's called No Grain, No Pain. Dr. Osborne: And how do they buy it? Donna: Well, currently if they just look it up on Simon and Schuster's website. Or you can find it on Amazon or Books-a-million. But if you type in "no grain, no pain: a thirty day diet for eliminating the root cause of chronic pain," you'll find it right there. Dr. Osborne: Well, I'm going to be one of the first people who purchase it. Thank you so much for this interview. It's just priceless. Great information for everybody listening. And just keep doing the work you're doing because it's so important. The world needs you. Donna: Well, thank you so much, Donna, for having me on. And thank you, as well, for the work you're doing, reaching out to this many people and helping educate the thousands and thousands and thousands of people that you're reaching is a very admirable thing. And so I appreciate all of your efforts as well. Dr. Osborne: It's true. We've got this great knowledge. We've got to get it out to people so I'm really grateful that people are purchasing this summit. And I hope people don't just listen once, that they really purchase it because it's priceless information so thank you for that acknowledgement too. It's a lot of work. It's so worth it because that's what we're really all about is changing the way the world eats. That's my mission sort of. What is yours, Peter? What's motivated you most of all?


Donna: I think we live in a very Alice in Wonderland like medical world where up is down and down is up. And that, to me, has always been the biggest ultimate frustration both as a doctor trying to practice amongst peers who don't quite see eye to eye but also as trying to deliver quality care to people in the face of such great skepticism. So to me what pushes me and gets me out of bed every day is we've got to see functional medicine come to the forefront and we've got to see doctors trained in it because I think not only will, well, we could make bold claims. But if we look at the end of the day, we subsidize grain with taxpayer dollars to feed people who can't afford food to make them sick so that then we can subsidize the healthcare to them. But the healthcare we're subsidizing to them doesn't really make them better. So what we're really doing is we're expending a huge amount of effort and dollars on food that isn't healthy and healthcare that isn't really healthcare. And I think functional medicine changes all of that and would have a huge impact on the world but on the country that I love, the United States. Dr. Osborne: Great. Thank you so much.

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