Questions About Integrative Medicine? Listen to this.

(audio transcript below)

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

All right – Welcome back to Ask Dr. Jim Bob!  I am Dr. James Robert Biddle, MD.  I am an internist, I run Asheville Integrative Medicine, and we do this show to answer your questions and educate the public about important topics in Integrative and natural medicine.  Here to help me out is our new patient coordinator Joy.

Hello every one, hello Dr. Jim Bob! 

Hello – and today we don’t have a big topic like we sometimes do.  We just did a series of like 4 talks on heavy metal toxicity, for example.

That’s right.

But we are going to have the potpourri or the smorgasbord, or potluck if you will, of Integrative Medicine today.

Yes – so we have been listening to what people are saying when they call in to talk to us for various reasons, and we have been fielding questions from the public, what you want to know, and so today we have put together a list of questions that we are just going to go through and answer them.  If this inspires you and you want to learn more, please send us more questions so we can keep on.

Keep on keeping on.  What’s our first question?

So our first question today, which kind of dovetails off the series we just finished on metals, is – What are 3 simple lifestyle tips to help reduce exposure to metals and toxins?

Right.  I don’t know how simple these are going to be, but the first thing is don’t use antiperspirants because almost all antiperspirants have aluminum which absorbs into your body, goes to your brain, increases your risk of Alzheimer’s and other problems.  And the aluminum poisons your sweat glands.  That’s why it keeps you from sweating.  But it is poisoning you.

And we need to sweat – that’s part of how we detox.

We need to sweat.  You can use deodorants, preferably more natural deodorants, and that keeps your sweat from stinking so much. You can bathe regularly, and you can even sneak off in the middle of the day several times and get a wet paper towel and do a sponge bath of your armpits, which is basically my way of managing it for the most part.  But you don’t want to use antiperspirants, that’s #1.

Dr. Biddle, can I tell you a secret?


I have gotten off of antiperspirants and deodorants for over 2 years now.  I use nothing. Because I went through a lot of detoxing protocols that you helped me with, and to be honest everyone – that first week or two when you go off antiperspirant it can be brutal in terms of the odiferous factor coming out from under your arms, but once you clear that out and really help your body cleanse and detox, the smell dissipates.


And so now I don’t use anything.

Right.  The next thing I am going to say is not so simple, but it is very challenging.  Don’t live in an old house.  And here’s the problem – houses built before 1984 have lead paint and that lead paint also has mercury in it as a fungicide to keep the fungus from growing on your walls, and so older houses – you can paint over the lead paint everywhere except for the windows.  Windows that open and close you have to actually completely replace those windows to get rid of all that lead.  So people who are living in houses build before 1982-1984 are really in a pickle, and then they also have mold issues.


So I was happy to finally be able to build my own house, not that I built it – I contracted to have a house built about 4 years ago.

You’re very talented!

Yes.  And that can make a world of difference for your overall health.  Not everybody is in a situation to do that, so that is not necessarily an easy simple thing, but when you are house shopping it is very romantic to look at these old Victorian houses, but they are going to have lead paint and they are going to have unfinished basements, and that is going to be a humidity control issues all along and I’ve met a number of people that got really toxic trying to rehab those themselves, which is the same way I got really lead toxic scraping old lead paint off of old houses when I was a house painter.

Is the mercury in the paint something that would be from a topical exposure of touching the walls or is it releasing vapor into the air?

I think all of it, but especially topical.


Yes, and what’s interesting for example, adults absorb 10% of the lead that lands on their skin, but children absorb 50% of the lead that lands on their skin in dust form like that.  So it is a much bigger issue for kids.


Right.  And the other thing that is not very cheap or easy or simple is to get rid of your silver mercury amalgam fillings.  I had 12 of those suckers and I got them all replaced.  Not only do they release mercury for as long as they are there – the older they get the more pitted they get, the more surface area they have, and the more mercury vapor they release.  They do not run out of mercury relatively speaking and they are only designed to last for 15-20 years.  So if you’re 50 years old and you have fillings that were put in there when you were 15 years old, they are now 35 years old and they have far outlived their functional lifespan and they also expand and contract with changes in heat – so you drink an ice tea, you have hot coffee, they’re expanding and contracting and they crack your teeth.  The new ceramic and resin plastic fillings are actually better.  They hold your teeth together; they don’t crack your teeth.

Wow – that’s great to know!

Yes.  Now if you have amalgam fillings it is not only expensive, but risky to have them replaced in two ways.  One is if you do it with a nonbiological dentist you are going to get a huge mercury exposure, because they don’t really understand how to take those out of you safely.  They are going to drill into those amalgam fillings and you are going to get vapor, and we absorb 80% of that vapor very effectively.  It goes straight to your brain.

That’s an incredibly high percentage.

It’s a high percentage.  And the second way it’s dangerous is when you take a filling out you have to make a bigger hole to get a nice clean edge to put the new filling in and that filling may have to be replaced with a cap, a crown, or the tooth may fail and crack and you might get a root canal or lose the tooth and need an implant or a bridge.  There is no perfect solution at that point, so that’s always a risk.  So when I had my 12 fillings replaced I ended up with 2 crowns to replace a couple of the large molar fillings.

But back to simpler things you can do – shopping organically.  It’s a great time; people are eating out less right now with the pandemic.  They are cooking at home more.  It is very hard to eat organically when you eat out.  Even if you go to a restaurant that’s serving Hickory Nut Gap beef hamburgers – the cheese on your cheeseburger is not organic cheese.  The bread on the bun is not organic bread.

No it’s not.

So you still have all these different issues, especially with dairy products when you eat out.  So eat organic foods.  And the most important foods to be organic are dairy products: butter, cheese, ice cream –


Because dairy cows that are not organic have this estrogen pellet under the skin of their ears to make them make more milk, but all that estrogen goes into the milk and then we drink it and it causes this epidemic of prostate cancer and breast cancer – it makes our little girls go through puberty at 9 or 10 rather than 13 or 14 like they’re supposed to.


So it’s very challenging.  I like to eat out sometimes.  I like pizza, but every time I give my almost 5 year-old daughter pizza I go – oh, is she going to go through puberty a week earlier now?

It’s something to think about.

It’s really rough!  Because I don’t want her to be a freak around food and feel like she is being deprived, but I also want to protect her as much as possible.  So that is very challenging.  But when you eat at home that is a lot easier to do.

Because you can control what you are bringing in your home.

You can control that.  So besides the meats and the dairy products, when you get to the produce we have a list called the “Dirty Dozen” so the things that are the worst because they are thin-skinned and they absorb a lot of pesticides, and that includes strawberries, spinach, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes, and bell peppers.  And then you have some things that are classically GMO so the only way not to have GMO and a bunch Round-Up on them is to buy them organically and that is corn –

Corn is a big offender.  And GMO is genetically modified organisms.

That’s right.  And they are modified to resist Round-Up so that you can just saturate, and frankly wheat.  So all the things made out of wheat, they actually spray Round-Up on it while it is growing to kill off the weeds, but they also use it as a desiccant.  Right before they harvest the wheat they really spray a lot of Round-Up on it to dry it out so it’s easier on their harvesting machinery, and then we are eating all that stuff.  And the only way to avoid that is to get organic bread and other wheat products.


Right.  So what are the ones that you don’t need to be organic?  Because we all have a budget, right?

Oh, exactly!

So it is good to know that too.  So you don’t need to spend extra money on bananas, avocadoes, pineapple, cabbage, onions, sweet peas, asparagus, mango, eggplant, honeydew melon, kiwi, cantaloupe, cauliflower, broccoli, mushrooms, and papaya.

So those are our clean 15.

Those are the cleanest.  Now I like to get the cauliflower and broccoli organic personally, but the other ones – you know, there is a big difference between the price of organic bananas and not organic, and there is really not much difference.  They are very thick skinned, they are high up in the trees, you are not really getting that much of a difference.  So that is probably one of the simplest things people can do.

And we have all got to eat!

We’ve all got to eat, that’s right.  So that is a great place to invest your health care dollar, is actually taking care of your health.

Right, and not trying to manage symptoms after the fact.

That’s right.

All right – are we ready for the next question?

Go for it.

All right, next.  People want to know what is the difference between folate and folic acid?

Right – well, I’m going to start with why is it so important?  Folate is a methylator like   B-12, and it has been – people know about folate and folic acid because if you are low in it and you are a lady and you get pregnant, your baby has an increased risk for a neural tube defect, which is basically incomplete development of their brain and spinal cord.  And they can be born with a very serious condition called spina bifida that can range from very mild where the tip of the spinal cord is just open in the pelvis right above the butt, to horrible that their entire brain is open and they die after birth.  So this has been known for 40 years.  And an example of the horrible role of the FDA is not allowing companies to label nutrients for medical conditions.  So it took over 20 years of lawsuits to be able to put on bottles of folic acid “helps prevent neural tube defects”.

I am glad they are finally able to do that.

Yes, which is ridiculous.  So folate is the natural form that is in foods.  Folic acid is the synthetic or semisynthetic form that we put into foods to supplement them, and into vitamins generally.  It is more heat stable.  The folate is not very stable and doesn’t last very long.

And so if it is in the foods and it is not heat stable, then would the cooking process –

Breaks it down.

Breaks it down, so we’re not getting as much.

Right.  So if your eating raw foods straight out of the garden, that’s great, but if you are eating canned foods, or foods that have been stored long, or foods that have been cooked, there is not much folate left in there.  So the folic acid supplementation helps with that, but it’s kind of a mute point because the real issue is what form of folic acid do you use?  Because 41% of the population has a genetic defect in methylating their folic acid and B-12 called an MTHFR defect of one sort or another in varying degrees.

And you can find that out from genetic testing?

You can find that out from “23 and Me” and other genetic testing, whether you have that or not.  That’s right.  But it is more than a one in three chance – it is almost a 50/50 chance that you have that issue.  And then you can’t methylate your own B-12 and folic acid and use it very well, so what is important about that is in your multivitamin or in your supplement, you should take a methylate folic acid and a methylated B-12, and so that’s what we put into our supplements that we sell in our store.

Alright – good to know!  Next question: totally switching topics here.  How does screen time affect our bodies and is there such thing as too much and is this ok for our kids?

Yes, I’m getting a personal experience of this just this morning.  My girl who turns 5 next week was begging for her own computer screen.


That’s what she wants for her birthday.  “I want my own computer screen” and it’s always about earning screen time, and we let her have 20-30 minutes of screen time a day so she can watch her little cartoons and stuff, but it’s so addictive.  Even cartoons – everybody who is developing products, they actually develop it to make you addicted to it.  We know that from Facebook, we know the algorithms are all made so that you are more addicted and by tweaking your dopamine, just like gaming.  They actually develop these video games to make you addicted to them by giving you these little dopamine bursts, and Facebook does it too, and all the cartoons do it.  So you can make an argument that any amount is too much.  And I have friends who are raising their kids out in the woods with no Wi-Fi and these are wonderful kids who progress very early in reading and writing and things like that, and emotional health, and for most of us that is not very realistic. We need it as the occasional half hour of babysitting kind of, for this and that, if nothing else and we may find that we display some addictive behaviors ourself to our screen time.

If we are being honest.

If we are being honest, and that’s an important fact to look at.  So the way it affects our body is it creates surges of feel-good neurotransmitters like dopamine and then the problem with that is you can also get that from various drugs like marijuana and alcohol, and a lot of these do the same thing and if you keep doing that you get accustomed to doing it and then when you don’t do it you feel like life is not worth living.  You feel like life is flat.

Withdrawal – it feels like that.

You are getting withdrawal. You are having a drug withdrawal and you can notice kids will break down, have emotional breakdowns if they don’t get their screen time.

Oh yes!

Yes.  So I believe as little as possible and it’s a really tough topic.

All right.  Next question: anxiety and depression.  Is it always an emotional state? or are there things that we can do to medically address that?

Yes.  There are all kinds of levels to this.  We just talked about one, right, with screen time.  You spend 4 or 5, 6 hours a day on social media, you are going to start to develop anxiety and depression.

That’s why I got off of social media.

Almost guaranteed.  There is the emotional levels, a lot of depression is unprocessed, un-metabolized grief.  So grief is a very natural phenomenon that often takes up to 2 years, even when you actively grieve.  Most Americans are taught to avoid adverse uncomfortable emotions, so therefore they don’t grieve properly.  Greif is like weather fronts moving through.  Today we have hurricane Sally moving through and it’s going to be storming and maybe even flash flooding, and all that.  But you know what – we are going to survive it and in a couple of days its going to be sunny and the grass is going to grow and the flowers will be there.  So grief just kind of comes through in waves and the best approach to grief I believe is to kind of compartmentalize it, because we don’t live in a society where you can take 6 months and just wear black and nobody expects anything from you.


You still have to perform – right?  But set aside time.  Two, three, five times a week where you make a little altar to the person you lost or the dog or the cat, or whatever it is you’re grieving – the relationship, the foot – whatever it is you lost, and process that and be there with it for 15 to 20 minutes at time and allow those emotions to come in a way that at least contained so that you are not breaking down in front of the person running cash register at the grocery store.  How are you?  (crying sounds)

Been there.  Yes, it’s not a comfortable moment.

And the way to do that is called the ocean wave breath.  And this is a very simple breathing technique.  There’s no effort in it except the observation to not hold your breath.  Because as soon as emotions come up, the way we keep from feeling our emotions is we lock up our chest wall and we stop breathing.  So the ocean, you know if you are sitting there at the ocean on the beach watching the waves, they never stop.  They are moving in, they are moving out, and that top and the bottom, it’s not like they stop and the wave just stops at the top for 5 seconds.  As soon as it reaches its top it immediately starts going back out again.  And that’s the ocean wave breath.  And you don’t try to breathe more shallow, or more deep.  You just keep it moving and your observation is to see when it starts to lock up and as soon as you’re into that for a few minutes and you let yourself think about the topic at hand, those emotions will come up and you will notice that you try to stop breathing.  And if you just relax and keep breathing those emotions will then flow and you will cry, you will have an emotional release and then you will feel better.  And if you just keep doing that, you are going to process and metabolize that grief, and then you’re going to not be depressed.  If you don’t do that, you’re going to end up depressed.

Now do you recommend using any sort of visual or auditory aid in practicing that breathing?

Absolutely.  Like if you’ve lost a mother let’s say, or father, or heaven forbid, a child or sibling.  Have a picture of them there.  But even stronger, have something that smells like them, because smell is our sense that is most closely associated with our emotions and our memories.  So for example, if you have their hair brush, or if you have their pillowcase that they use, or something like that.  There is actually a company now, if you can get their smell, they can chemically reproduce that and you can have a bottle of their smell for the rest of your life.


Yes, there is a company on-line that does that now.  The science has gotten that good about this.  So, I wish I would have done that with my baby’s head.  You ever smell a baby’s head?

Oh, nothing like a newborn!

Nothing like that!

Just make sure you are smelling the head!


So there’s the grief.  And then there is neurotransmitter production.  So part of our anxiety and depression can be a lack of making enough neurotransmitters, especially dopamine and serotonin, and those all require factors and cofactors.  So for example, the precursor for serotonin is tryptophan, an amino acid.  The precursor for dopamine is tyrosine, an amino acid.  We can take those, we can frontload those and we can support our own body making more of those neurotransmitters rather than going to prescription drug of Prozac or something like that.  And then those enzymes that make our neurotransmitters have certain needs.  They need B-12, B-6, they need magnesium most importantly of all.  So we look at people’s nutrition and first we measure and identify deficiencies and those are the most important ones to replace and two thirds of Americans are deficient in magnesium.

Oh, absolutely.

So every time doctors prescribe any psychiatric medication they should always give magnesium.  Every time they prescribe any blood pressure medicine they should always give magnesium, but it never happens because it is not FDA approved.  And then gut health, I mean –

Wait, gut health?

Yes, you ever had gut feelings?

Oohhh, it’s a gut feeling – yes!

It’s a gut feeling, yes.  Well it turns out that the gut is called our second brain.  There is a whole book written about this.  And we make dopamine and serotonin in our gut too, so what is going on in your gut as far as gut health? Are you getting enough fiber for the good bacteria to ferment?  It is one of the most important things.  Americans are chronically constipated, we not getting rid of toxins, and they don’t have enough fiber to have the good probiotics ferment into the good stuff.  That’s how we make these neurotransmitters in our gut is by fermenting the right stuff, which is fiber.  So we always put people on ground flax seeds or acacia fiber or something like that, and of course eat actually real food, fruits and vegetables, and less processed food like bread and such.

That’s quite a powerful connection to think about our gut health having an influence over our emotional state of being. 

Right and we can do stool studies and see what is growing in your gut.  We often see people with excessive yeast and yeast makes neurotransmitters that basically hijacks you and turn you into a 5-foot 4, 120 lb. carb-craving machine to feed the yeast.  And now you are not Joy, you’re just a feeder for your yeast once they got hold of your brain, and that can be very powerful.  And the other thing is infections, so especially for example with obsessive compulsive disorder and ADHD, and anxiety all mixed together. There are a variety of infections, especially reactivated strep.

Right, which we have talked about before.

Yes, called PANDAS, Pediatric Autoimmune Neurological Disorder Associated with Strep and when the strep is reactivated which does not feel clinically at all like strep, in fact it may be in your gut, not in your throat.  It can be in your ears, your sinuses.  And we check that with a blood test called an ASO titer, but these types of things really affect your emotions.

All right.  Moving right along I believe to the next question.  Salt?  Sodium? Why does this make our blood pressure go up if we eat too much?

Because we did not evolve with ready access to sodium.  We evolved eating lots of magnesium and potassium and very little calcium and sodium.  So our kidneys are designed to pee off magnesium and potassium.  You can almost – as long as you have healthy kidneys, it’s almost impossible to overdose on potassium or magnesium, unless you are on medications that make you retain potassium.


Now I don’t suggest you test that out, because high potassium is very dangerous.


It’s almost impossible for that to happen with healthy kidneys unless you are on medications, whereas, we tend to hang on to the sodium, because it was rare.  I mean Gandhi, with the peaceful resistance, it’s because the English taxed salt and you cannot live without salt.  We are always trying to hang on to salt.  Now if you’re a thin person like me with adrenal fatigue, you need more salt.  But if you are a heavier person at all, especially if you have high blood pressure, then you easily retain too much salt.

And it’s the retention of too much salt that can drive up our blood pressure.

Yes, if you are in the category.  There are other things that cause high blood pressure for sure, like sleep apnea and lead toxicity and such.  Hardening of the arteries….but once you have high blood pressure salt will exacerbate it.

All right.  Next question – Why does acne happen:

Well, that depends upon the person.

Because it is not just for teenagers.

It’s not just for teenagers.  Certainly hormones because you hardly ever see kids with acne.

Right, not usually.

Right before puberty, and you hardly ever see postmenopausal people with acne, although a little bit.  But that is because postmenopausal women once they stop making estrogen and progesterone, their pituitary is still trying to drive their ovaries, but instead the adrenals respond with male hormones.  So postmenopausal women are making male hormones from their adrenal glands which is why they get chin hairs, and acne sometimes.  So it’s those types of hormones affecting things, but also nutrient deficiencies, and we know that vitamin A, zinc, and selenium are intimately involved with this.  And I just had a an 18 year-old patient who had terrible acne, had been to the dermatologist, and then eventually – they tried everything and they wanted to put her on birth control pills and she didn’t want to do that.  And we did a bunch of testing on her, but before we even got the test results back, just the simple nutrients we gave her cleared it up.

Wow – that’s wonderful!

After years of suffering, so that is a wonderful thing to see.  That’s the way to change somebody’s life in one visit.  It is just awesome to see.

So this is not just a fact of whether or not you wash your face enough.

It’s not.  You have to have the right nutrients.  Sometimes too much toxins can cause it, and hormones are definitely involved.

Ok.  And our last question for today – Am I actually hungry just because I feel hungry?

No, not necessarily.  Very rarely in fact.  Often you are thirsty.


Most Americans misinterpret thirst signals as hunger signals, and if you just start drinking water, then you will notice that that goes down a lot.  I already mentioned yeast.  If you have been eating too much carbohydrates, especially refined carbohydrates, then you are feeding your yeasty beasties and they are having a party and they are making chemicals and they are hijacking your brain and telling you you are hungry for – again my 5 year-old will say “I’m hungry” so we will offer her dinner types stuff.  She goes “oh, no – I’m snacky”.

Snacky!  So that’s not her, that is literally her gut bacteria telling the brain “Hey, we want more!”

Yes, probably.  I mean, it’s kind of like that dopamine surge right?  You eat sugar, I mean you feel what it is like when you eat sugar and then you want more sugar.  So it’s the neurotransmitters, it can be the gut.  I hate to think that my 5 year-old has yeast, but we all have yeast.

To an extent.

It’s like staph on your skin – you can’t eradicate it.  It’s part of the natural flora.  We all have yeast in our gut, but you can easily overgrow it and that becomes a problem.  And then I think a lot of people also misinterpret other emotions.  They hide their emotions with a feeling of hunger.  We eat to medicate ourselves very often.

Well, the whole comfort food.

Comfort food – exactly.  So there is one local nutritionist who has an ad that says “What are you really hungry for?”  And it is about working through those compulsive eating patterns by self-realization and healing the emotional issues.

Well, and cravings – sometimes you get specific cravings, I mean so specific that it’s like I really want this protein, or I really need this vegetable, or I really want this treat.

And that might be body wisdom.  When I eat okra my body goes “yes – eat more of that”.  Maybe there is a nutrient in okra that I need.  Maybe the slimy stuff is healing to my gut which is irritated from too much coffee.  (laughing)  Some of that is healthy and some of it is probably dysfunctional, so you have to try to figure out what’s the healthy and why when I eat a seaweed salad I get the same reaction.  It’s like, well there’s probably something in there that is really good for my body.  It’s not like it’s a dysfunctional – like people are getting sick off of seaweed salad, it’s not making yeast grow, right?  So with those things it’s probably something very good signal from my body.

So if I think I am hungry, but it maybe hasn’t been that long since I had a meal, maybe just try some water?

Try some water, maybe go for a walk, activity.  And maybe you’re bored, or maybe you’re avoiding an uncomfortable emotion, so sit down for 10 minutes and do the ocean wave breath and see what comes up.  Maybe – it takes a lot of work to keep what I call being emotionally current.  Are you up-to-date on processing your emotions?

Not enough.

I practice medicine – right?  I went through medical school and residency, and I remember people would die and I cannot sit and grieve, I’ve got to go take care of the next person.


So, I’ve got to catch up with that later.  I’ve got to be present to that.  Otherwise I am going to stuff that and I am going to be reactive in some way later on and not be the best doctor I can be.

Yes, we have to take time with ourselves.

Exactly.  So keep emotionally current and see if that’s part of it.

All right – well thank you so much!  And please send in your questions for next time.

Y’all come back now, ya hear!

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