Elizabeth Stein 00:00
Hi, everyone. I'm Elizabeth Stein, founder and CEO of Purely Elizabeth. And this is live purely with Elizabeth, featuring candid conversations about how to thrive on your wellness journey. This week's guest is Dr. Akil, a Harvard trained physician who practices integrative medicine, blending his conventional medical expertise with holistic approaches including Functional Medicine and ayurveda. After completing his family medicine residency training at Stanford University, he graduated from the fellowship in integrative medicine with Dr. Andrew Weil, a widely known speaker and educator. Dr. Akil is the author of The Paleovedic diet, and his newest book that just launched the tiger protocol, an integrative five step program to treat and heal your autoimmunity. In this episode, we dive into the foundation of autoimmune disease, what causes it, why it's so prevalent today and why an integrative approach is one of the best ways to heal the body. There are actually hundreds of types of autoimmune disease that affect an estimated 25 million people in the US. It's the fastest growing category of disease. Dr. Akil shares his personal health journey and years of working with patients which led to his five step healing protocol that works to address the root cause of immunity instead of treating just the symptoms. We talk about prevention, detoxing, some of the best foods and lifestyle shifts you need to make so that you can heal your body. Dr. Akil was such a wealth of knowledge I absolutely love his approach. Keep listening to learn more. If you haven't had the chance to try our grain free granolas yet, head on over to Walmart to now find them in the gluten free Healthy Living aisle in select Walmart locations. Our grain free granolas have crunchy clusters of nuts, superfood seeds and creamy nut butters, all baked with organic coconut oil and sweetened with coconut sugar. They are gluten free paleo and keto certified. Use the link in the notes section to find purely Lizabeth products at a Walmart store near you. Dr. Akil, welcome to the podcast. It's truly such an honor to have you on today. And I'm so excited to talk all things about your latest book.

Dr. Akil Palanisamy 02:23
Thank you so much, Elizabeth. Pleasure to be here.

Elizabeth Stein 02:26
So we always start the podcast with your personal wellness journey. And I know for you, there was a story on your own health but I'd love to get into the background of really what led you into integrative medicine melding that with our ayurveda which I'm a huge fan also of the ayurvedic philosophy.

Dr. Akil Palanisamy 02:46
Yeah, absolutely. So for those who don't know, integrative medicine is a branch of regular medicine that combines holistic and alternative therapies together with conventional medicine. So I think it's the medicine of the future. And in terms of how I got into it, it was through my own illness, which was very severe. When I was in medical school, I had developed this mystery illness that gave me severe chronic pain where I couldn't sit up or use a computer, severe fatigue, weight loss, and then I had to stop my training, because it was really I was doing all the conventional treatments, and it's really not improving. So during my year off of school, I went through a process of like discovery, learning about, you know, ayurveda and holistic therapies and diet. And it was really seeing some integrative doctors that helped turn my health around, and then I felt better than ever before. And so I saw the power of that approach, and then decided I really wanted to train in that do the I did a fellowship with Andrew Weil, who's a big mentor for me. And yeah, I've just been practicing ever since.

Elizabeth Stein 03:53
Wow, amazing. So can you explain the difference between integrative medicine and functional medicine?

Dr. Akil Palanisamy 04:00
Yes, so functional medicine looks at optimizing the function of different organ systems. And they use specialized lab testing, like stool testing, or saliva testing. And integrative medicine is broader. So it includes functional medicine, but it also includes other systems like ayurveda, Chinese medicine, and so forth. So integrative medicine is a bigger, broader category.

Elizabeth Stein 04:25
Okay, wonderful. So you have had a practice where you are melding the two together today. What are the big themes, you would say, just from an ayurveda perspective that you're bringing in to your practice? And maybe touch on what that is at a high level for people?

Dr. Akil 04:44
Yeah, so absolutely. So in my practice, I see a lot of patients with chronic diseases of all types, especially autoimmune disease, and I think what the strength of ayurveda that is is the emphasis on diet. So really using food as medicine and you using spices or lifestyle, you know all these natural things that really have the power to shift our health.

Elizabeth Stein 05:06
So you have this thriving practice where as you started, you were going to the root cause to figure out your own health issues. And that's something that you certainly practice today. And I suppose that it's become clear that autoimmune disease is a huge area where it's on the rise, there's patients who come to you, and so many questions surrounding that. So what was sort of the aha moment getting into researching and writing your latest.

Dr. Akil Palanisamy 05:35
So with my practice, it really came to develop and grow organically, I started seeing a lot of patients with autoimmune disease. And as they got better, they referred their friends. And it just grew until it became like a specialty of mine. And many patients with autoimmune disease and other chronic diseases are looking for holistic solutions, looking for diet changes what they can do in their lifestyle, and usually their regular doctor, you know, in medicine, we tell them, do whatever you want. And there's not much effect there. So people are hungry for these additional tools. And so as I saw how effective they were, then I decided to put them together into this protocol, and then eventually the book.

Elizabeth Stein 06:15
And I suppose to a big part of it, not only are conventional doctors saying, hey, this, but it's also that's just take a pill to try to solve it, which doesn't solve it right, or, you know, some other kind of bandaid that isn't getting to the root cause which I love your approach here, which we'll get into. But it's really peeling so many layers back and even more layers back then, I think, to the earlier point about functional medicine, which might be starting at the gut, like you're going deeper and deeper than even the gut, so excited to get into all of that. But let's kind of start with laying the foundation for what is the current state of autoimmune disease in America, like, what are we dealing with here? What are we talking about?

Dr. Akil Palanisamy 07:02
Yeah, so autoimmune diseases, the fastest growing category of disease in the world. And in the US, some diseases have grown by like 500% in the past just 20 years. And it now affects anywhere from one in five to one in six Americans, depending on the study. There's more than 100 different types of autoimmune disease like rheumatoid arthritis, lupus, MS, inflammatory bowel disease, there's a lot of different diseases, but the mechanisms are the same, the same kind of five root causes. And autoimmune disease disproportionately affects women. So 80%, yeah, 80% of those with autoimmune disease are women. It's a really big factor. But because it's so prevalent now, both men and women are experiencing very high rates of autoimmune disease.

Elizabeth Stein 07:53
And I guess even taking a step back, what is the definition of autoimmune disease?

Dr. Akil Palanisamy 07:58
Yes, great point. So autoimmune disease is basically where your immune system, which is supposed to defend your body against disease and infections, turns on itself. So it starts to mistakenly attack your own cells, your own tissues and cause damage. So that autoimmune kind of attack then leads to autoimmune disease.

Elizabeth Stein 08:21
And as you said, there's 100 different types. So it manifests in many different ways under this broader umbrella.

Dr. Akil Palanisamy 08:31
Yes, it all depends what's the final target. So what is the ultimate like tissue or organ that's being damaged. But going upstream, you know, it all starts with those five root causes, disrupting the immune system, and then the manifestation could look a lot of different ways.

Elizabeth Stein 08:48
So one of the things I thought was super interesting in your book, which is an integrative approach to healing, but as I read it, it's also like, this is a integrative approach to prevention. And one of the things I thought that was super interesting was how long it takes to develop or how long it can take to develop an autoimmune disease, which that was like very eye opening to me to hear what you're doing today is, it may be in your body already, and like you might not have the symptoms for X amount of time. So you can talk a little bit about that process.

Dr. Akil Palanisamy 09:27
Yes, yeah, excellent question. So autoimmune disease, most people don't realize is a very slow process, it can develop over 10, 20, 30 years. And the way we know this is there actually studies where they find the initial blood markers of early autoimmunity, sometimes 25 years before a patient is diagnosed with the disease. These are studies that are done in the military where they just collect blood all the time and they have these long standing, you know the data but it applies to other populations too. So I think you're exactly right. The same things that treat autoimmune disease are also preventative. So addressing these root causes following the tiger protocol for like a healthy person will prevent their development of autoimmune disease. And also many times, the very earliest stages could just be mild symptoms like, you know, feeling tired or having slight gut issues or, you know, some aches and pains. And then in that situation, doing this protocol can hopefully help people feel better reduce inflammation, and then prevent the progression of any of anything into autoimmune disease.

Elizabeth Stein 10:37
So is that something that in your practice that you suggest to get bloodwork done? To see if you have any of those viral biomarkers for an autoimmune disease that's could be happening in 20 years from now? Is that

Dr. Akil Palanisamy 10:51
No, no, it's still an area of active research. So we're not there yet, in terms of like, you know, having that perfect blood test to know in the future. So I think the better approach is to Yeah, just automatically start addressing all these factors, you know, that impact not only autoimmune disease, but you know, heart disease, diabetes, all the the main killers of people. So I think it's a good healthy way to start living. And that's more what I emphasize.

Elizabeth Stein 11:20
Okay, great. One of the other things I thought was a really interesting point was talking about epigenetics versus genetics, when it comes to autoimmune and something that's I think, a newer term for a lot of people's if you could first tell us about what epigenetics means, and then how that relates to autoimmune.

Dr. Akil Palanisamy 11:37
Yeah, sure. So the genetics are basically what's determined by your genes, your DNA that you get from your parents. And then epigenetics is how those genes are expressed. So a lot of things which we didn't know before we are learning can have a huge impact on how the genes are expressed, like your gut bacteria, like your diet, like stress levels, and that is probably a more powerful effect than genetics. And we know this through studies showing that you know, with autoimmune disease, more of the risk really comes from epigenetics than genetics. So that's, you know, both empowering and also can be a little bit scary, because then you realize, you know, all of these things matter that you are doing everyday in terms of choices you make, but the data is clear that epigenetics is more important than genetics for autoimmune disease, although genetics does matter. But that I think, is an empowering message for people.

Elizabeth Stein 12:35
Yeah, I think that's hugely empowering. And I think in a world right now, where we're learning so much, there's so much more research, and there's so much more information about our health. It is nice to not just think like, Okay, I'm predisposed to this because my mom had X, Y, and Z, and really, that we are our own best health advocates and what we put on the end of our fork every day, and do everyday matters so much.

Dr. Akil Palanisamy 13:05
Yes, absolutely. Yeah.

Elizabeth Stein 13:08
So as we talk about more research, I'm curious to hear how long did it take to really research and put the book together? But then my question was going to be what was most interesting or surprising for you really putting together your book?

Dr. Akil 13:25
Yeah, you know, I've been practicing now about 20 years, and in the past 10 years, I've really focused more on autoimmune disease, and been fine tuning the protocol. And then the book took about three years to write, you know, read over like 1000 research studies and tried to put up put them all together. One thing that was really surprising was this concept that I came across called neuroplasticity. And neuroplasticity just refers to the power of the brain to change. Because in medical school, I was taught that, you know, you're born with certain number of neurons, you can never grow new brain cells, they just die as you get older. But the newer research is that that's not true. You can actually change your brain, you can transform your brain cells. There's lots of powerful ways to do that. Mind Body techniques, imagery, visualization, meditation, yoga. So I think it was really exciting to see that because again, my whole goal is empowering people. And this concept also really is a very positive one.

Elizabeth Stein 14:26
So it's similar, in the same vein as epigenetics of being able to really take your health in your own hands. What are some of these other ways in which we can grow our brain cells?

Dr. Akil Palanisamy 14:39
Yeah, so I think the probably the best studied one is meditation, which has been shown to help with growing both the gray matter and the white matter, which are two the two different types of brain cells. And then also, meditation helps to grow your hippocampus which is the part of the brain that controls stress and deals with stress. So meditation, that's why it helps you manage stress better, because literally your brain is getting bigger. The part of the brain that handles stress is growing in size. So I think those are some of the pretty exciting things about meditation.

Elizabeth Stein 15:16
I love hearing that, because I think it's so easy to think that meditation is just this, like woowoo concept out here that I don't know if that means anything for people. But then when you hear the science behind it and the facts, it's pretty empowering. So in this study, what, in order to really have that neuroplasticity and grow? Does that mean we need to meditate? What's the protocol? I guess is that every day for 10 minutes, but is what does that really break down to?

Dr. Akil Palanisamy 15:47
Yeah, so in the studies, many of them look at mindfulness meditation, which is one of the like, there's several different types of meditation. So in my book, I teach people like five different techniques for meditation, so you can see what appeals to you. And in terms of the neuroplasticity, about eight weeks is the the length of time that it takes to make those brain changes permanent. And in the studies, they were only practicing about 15 minutes a day. So it doesn't have to be a super long meditation, but consistent practice over a couple of months will will have huge impact. For you personally, what do you do? Yeah, so that's it this big part of my routine, because I've been meditating for you know, for many years, and I try to do at least 10 minutes a day, I use different apps that I enjoy.

Elizabeth Stein 16:36
What's your favorite app?

Dr. Akil Palanisamy 16:38
I like this one called smiling mind, which is it's from a nonprofit in Australia that is more mindfulness based and I really like they have short, you know, three minute meditation five minute like, if I don't have time to do the full 10 minutes, I'll do a three minute session and even that makes a subtle difference.

Elizabeth Stein 16:54
Wonderful. Okay, so that's walk through your Tiger protocol. I love also the acronym because it makes it super easy to remember. But so let's walk through what that looks like.

Dr. Akil Palanisamy 17:06
Yeah, absolutely. So like you said, Tiger is the acronym and it covers The Five Root Causes for immune health, which are toxins, infections, gut health, eating and rest and rebalance. So going through each of those I thought maybe I could you just mention like one food that I highlight, you know, the whole protocol is based on food, because I think food is medicine and diet is really the foundation. So with T toxins. I think one food that's under appreciated is the beet greens, which is the leafy tops of the beet root. So that's the richest food source of something called betaine, which is very important for the liver. And the liver is the main organ that does detoxification. So beet greens have a unique ability to really support your detox capacity and you can even if you cook them, you know that doesn't take away their benefits. Yeah, so we love having beet greens you just have to find the beets with the tops attached and then cook both you know, that's kind of what we do. And then for infections. So in ayurveda we use spices a lot because spices are really medicinal. So turmeric is really well known for its anti inflammatory effect, but it's a very good anti microbial it gets rid of bad bacteria, yeast you know parasites and you know ayurveda it's used a lot for that purpose so I would just encourage people to use turmeric you know find ways to incorporate it you can have golden milk you can incorporate you can cook rice in it you can do all kinds of different things. And I think it's more about the cumulative dose like over your lifetime how much turmeric can you get so the more the better just in your in your daily cooking.

Elizabeth Stein 18:48
I made a smoothie this morning knowing that you were coming on and I put tumeric in it, but I put probably teaspoon is that too little?

Dr. Akil Palanisamy 18:58
No no, I don't think so. Yeah, I think if you put a pinch of black pepper in there as well that there was a study that showed that that boosts the absorption of turmeric by 2,000% So that's why many Indian curries they have black pepper and turmeric and then some fat is beneficial to for absorption. So either Ghee or MCT oil or coconut oil. And then for the G the gut component, I really like collagen powder for a couple of reasons. One is that the collagen is very healing for the gut. It heals something called the leaky gut, which is increased intestinal permeability. Often we recommend bone broth for that purpose but a lot of people you can't have it or don't have access, but collagen is a good substitute so powder easily dissolves in water and then excellent source of protein. So many of my patients don't get enough protein. I know that this is a common issue you're aware of. So collagen powder is a great way to get a little extra protein in your day and and also help heal your gut. So I think that is very important.

Elizabeth Stein 20:04
I love the point about collagen because I think so many of us just think about collagen as protein and really knowing that there's so much more benefit to it from a gut perspective and healing is so important.

Dr. Akil Palanisamy 20:17
Yes, absolutely. Yeah. And then with E in terms of eating, there's many foods that are healing for the gut. I think one that's not well emphasized is prebiotic foods. So a prebiotic food is different from a probiotic foods like a fermented food, which has actual bacteria in it. prebiotic food has no bacteria, but it feeds the 40 trillion bacteria in your gut microbiome that are really critical for many functions, like your immune system, longevity, inflammation, your brain health. So I think that the prebiotic foods are really important. So I spend about 50 pages of the book talking about like all the different types of prebiotics that are there in the diet, resistant starch, a rabbit oxymorons, poly phenols SQ sugars, and then I go through all the top foods for each of those. So I'll just give an example. So in the category of nuts, chestnuts are actually the highest source of prebiotic Yeah, compared to you know, all other nuts are healthy too. I mean, I have almonds and you know, walnuts regularly but chestnuts were shown in the research to have the highest levels of a kind of prebiotic called polyphenols. So I wanted to include a lot of those kinds of surprising things where it's not a food you might think is really healthy, you know, just you have them over the holidays. But chestnuts are very good for the gut bacteria. So that's part of the the whole prebiotic foods I want to kind of teach people about that aspect. And then finally, our Yeah, so there's not a food necessarily that comes to mind. But our is really about rest and the mind body connection. And we spoke about meditation, but I know that's not for everyone, you know, doesn't appeal to everyone. So many other things have been shown to be helpful, whether it's psychotherapy, counseling, gratitude practices, forgiveness practices, prayer in your spiritual community. And some people prefer more movement based like yoga, or tai chi or Chi Gong. So find something that works for you in terms of stress, and then try to practice it regularly.

Elizabeth Stein 22:26
Really getting yourself into that parasympathetic state.

Dr. Akil Palanisamy 22:29
Yes, exactly.

Elizabeth Stein 22:30
Which is not easy for some of us. Smoothies are one of our favorite meals or snacks here at purely Elizabeth. But you know what we love even better, a smoothie bowl. That's why we've partnered with Smoothie King to add our organic original granola on top of their new smoothie bowls. For the perfect salty, sweet crunch, all six new smoothie bowls, features an acai or pitaya base with a variety of fresh ingredients such as locally sourced fruit, dried coconut, goji berries, honey, or peanut butter and our granola. It's super easy to order directly through the Smoothie King app, or you can order in store starting April 6th, I can't wait for you to try it. I know you're gonna love it. Enjoy. Okay, so a couple of questions, jumping back up to toxins because I kind of as we started, I love how you are peeling back the layers and in my mind and looking at this sort of like a pyramid. I don't know if that's the right way to look at it. But you know, really having to address the toxins and infections first, before jumping to the next pieces of the protocol. So we obviously live in a world with a lot of toxins around us. And some of them we can control some of them we can't control. What are the worst toxins that we should be aware of where we do have some control, right?

Dr. Akil Palanisamy 24:00
Yeah, no great question. So I think toxins we're not talking about like the obvious toxin like smoking or asbestos, you know, things that you know, are like really severely bad for you. We're talking about low level exposure to toxins that all of us get through our food and water and air, things like heavy metals, you know, lead Mercury pesticides, like glyphosate. And there's and then other chemicals are things like PFCs, which are found in plastics and that's why filtering your drinking water is very important because the low levels of these in the environment can get into the drinking water. So I think a simple tip is to eat organic whenever possible, because then you're greatly reducing those pesticide levels. And then with the seafood that's often the biggest source of mercury. So I tell people to have what's called the SMASH fish which is, salmon, mackerel, anchovies, sardines, and herring, those are the lowest in mercury and highest in omega threes, which are what make fish so healthy. And then one tip that also is very surprising to people is that a way to reduce toxins in the house because indoor air is a actually a big contributor to issues for some people. But one is you can get houseplants that they they do filter the air. And then second is if you leave your shoes at the front door, that actually reduces a lot of the toxins that can be stuck to the bottom of the shoes that studies have shown things like heavy metals and pesticides and bad bacteria are found there. So if you don't track them all around the house, that is also better.

Elizabeth Stein 25:46
What about a couple of dogs running around your house? How bad is that?

Dr. Akil Palanisamy 25:50
Yes, there's a lot of benefits to having the dogs. And you know, I think that in our modern world, we have been too sterilized and you know too much on sanitized living and of course, the COVID that pamper the pandemic made that made that worse. So I think we've got too much to that extreme. And we really need to be exposed to more bacteria. So one way to do that is having animals and dogs, cats, you know, studies show that reduces the risk of like allergies in kids and, you know, through helping the immune system by exposing you to like new different bacteria. Plus, there's all the mental health benefits of having a dog which are huge.

Elizabeth Stein 26:29
Absolutely. I can attest to that. So given all the toxins that we have in our environment, you obviously mentioned that beet greens is a great way to detox the liver. What are some of your other favorite ways to detox the body? I know in ayurveda I've done a Pancha karma a couple of times, which is obviously a much bigger thing, but that is certainly in ayurveda about cleansing with the seasons, etc. So curious to hear, from your perspective, how we should be thinking about the best ways to detox the body and not detox in, in a negative way, I guess but just making sure we're clear.

Dr. Akil Palanisamy 27:11
Oh, yeah, absolutely. So I think sometimes we overlook the basics when it comes to detox, which is that hydration is very important. So just do it. Most people don't drink enough water. So drinking like plenty of water, half your body weight in ounces is what I tell people are day, that is really helpful. And then digestion and elimination. So having like regular bowel movements, you know, we talk about poop a lot in integrative medicine. So if that's the main way or body clears toxins is through the gut. And so if you're having issues not having healthy elimination, then you're really impairing the detox pathways. So I think we should not ignore those kind of basic steps. And then in addition, yeah, there's so many foods that are helpful for detox. I think the all have the cruciferous vegetables are especially powerful. Broccoli, cauliflower, Brussels sprouts, and then I'm a big fan of this compound called sulforaphane, which is found in the broccoli sprouts and broccoli sprouts can have like 100 times the sulforaphane as broccoli. And sulforaphane is something that helps with detox helps with inflammation and helps your brain there's so many benefits to that. And then one other food I'll mention is these algae like chlorella and spirulina are real are real superfoods in terms of the ability to help us detox and also all the nutrients they contain and easy to throw into a smoothie. So that's the way that I tried to get them.

Elizabeth Stein 28:44
Well, it's funny because reading the book, I was at my local Whole Foods, and they had broccoli microgreens, which is that Oh, yeah. That's the same. Yeah. Okay. So I bought them. I've been incorporating them all week. I was curious to hear a how much to be eating and then b is it okay to cook them or should they be raw?

Dr. Akil 29:05
Ideally raw. Yeah. Because when they hear Yeah, yes, because sulforaphane is damaged by