Habits & Health episode 95 with Dr. Joe Mather. We discuss how important gut health is to other seemingly unrelated areas of health and how to find a good functional medicine doctor.
Dr. Mather is a board-certified Family Practice physician and the Medical Director of the Ruscio Institute for Functional Medicine. He graduated from Tulane University School of Medicine and Tulane University School of Public Health in 2011 and completed his residency in 2014. He is passionate about delivering cost-effective and practical medical care with a focus on GI health and environmental toxicity. He spends a lot of time working with patients suffering from complex and chronic diseases.
In this episode, we discuss:
02:48 How Joe got involved with Functional Medicine
10:33 Gut care
12:42 The gut is more than just bloating and diarrhea
14:40 How on earth does looking at the gut help arthritis!
17:51 Environmental toxicity
22:13 Toxicity testing
24:15 Health recommendations Jow gives
27:58 How do you find a GOOD functional medicine doctor?
29:20 The problem with integrative/functional medicine
30:33 Benefits of various types of fasting
34:35 Don’t pick one thing and roll with that forever
35:33 Favourite book
37:20 Joe’s fave quote
Don’t forget, there is a transcript of every episode (scroll down the page).
Habits & Health Links
95 – Dr. Joe Mather MD
[00:01:16] Tony Winyard: Habits and health. My guest today, Dr. Joe Mather. How you doing, Joe?
[00:01:20] Dr. Joe Mather MD: Doing fantastic Tony. How are you?
[00:01:23] Tony Winyard: I’m pretty good. And we’re in, is it New Orleans today?
[00:01:27] Dr. Joe Mather MD: You got it. That’s right. It’s a beautiful day in New Orleans.
[00:01:30] Tony Winyard: I think this may be the first time we’ve been there. We’ve been in a lot of places around North America. I can’t recall having a guest from there before.
[00:01:38] Dr. Joe Mather MD: Man, its, we’re a unique city. We’ve got a lot of soul, a lot of music. Small enough that you don’t spend your whole life in traffic, but big enough that you can still watch the Saints play and see some fun festivals. So I think it’s a fantastic place to be.
Just come visit.
is it where you’re from?
[00:01:52] Dr. Joe Mather MD: No, I grew up in the north. I, grew up in upstate New York, you can think Canada really. But, I got tired of freezing all the time. So I went south
[00:02:02] Tony Winyard: And is that what was it that initially drew you to though in the first place?
[00:02:06] Dr. Joe Mather MD: to New Orleans to music. I, I spent a lot of time as a kid listening to blues music as it is. And, when I was applying to medical school after, after. I was like, I think it would be pretty fun to be in New Orleans. And, as luck would have it, I got into the medical school here and, fell in love with the city.
know, you walk through the city and there’s just music playing and you’re like, ah, this is great.
[00:02:26] Tony Winyard: Sounds, sounds pretty cool. I’m very much into music myself, but we won’t go down that avenue, but yeah, it sounds
[00:02:32] Dr. Joe Mather MD: Maybe we could do another podcast.
yeah. Yeah. I know that you are,we had a quick chat before and I’ve looked at some stuff on the, on the website as well, and that you are the medical director of the, I have to pronounce this right.
Is it the, Ruscio Institute?
Close. It’s Ruscio Institute.
[00:02:47] Dr. Joe Mather MD: Institute,
[00:02:48] How Joe got involved with Functional Medicine
[00:02:48] Tony Winyard: And the Institute for Functional Medicine. So tell me more about that. how did that come about? How long have you been there? What is it you?
Michael Ruscio is a chiropractor who specialized in gut-based functional medicine, and I’ve teamed up with Michael after, blazing my own path and running an internal medicine practice and opening my own private practice and that the. Question I’ve always had as I practice medicine is how do I get patients with chronic disease better?
[00:03:16] Dr. Joe Mather MD: And functional medicine is this field where the whole idea is what is the root cause of disease. And if you fix that root cause of a disease, you’ll get patients better. And so I’ve really spent the last 10 years just cycling through all of the claims and functional medicine, what works, what doesn’t, and one of the most consistent avenues to get patients with all sorts of chronic disease.
Fixing and optimizing gut health. And so early in my career when I was trying to sort through what works and what doesn’t, I found Michael’s work really resonated. And it was one of those cases where I tried it and it worked real quick on a couple patients I’d struggled with. And so I said, oh, there’s a signal that really worked.
And then the more I did it, the more I worked through with patients, the better it got. And so I said, okay, this is one of. Main root causes that we have to pay attention to. fast forward and, Michael and I became fast friends and we, have teamed up and our kind of mission is to simplify functional medicine because there’s a lot of, a lot of nonsense in the field, if I can be frank.
And we’re trying to do our very best to get cost effective, effective care to people. And so we focus on the gut because that’s one of the best avenues.
[00:04:22] Tony Winyard: There’s a few areas we can dive into from what you just said. So let’s start with the functional medicine because there’s, it seems like anyone can just call themselves a functional medicine practitioner,
[00:04:34] Dr. Joe Mather MD: You’re correct.
[00:04:36] Tony Winyard: and that’s crazy, really, in a way, isn’t it?
[00:04:39] Dr. Joe Mather MD: It sure is. so I’m an MD and and I consider myself a functional medicine practitioner, but you can be a health coach and say, I’m a functional medicine practitioner. You can be a dietician. You’ll see functional medicine, like physical therapists, physios, and there really is no one governing body.
So I was trained in family medicine as a gp. Y’all would have it in the uk. And so I have a pretty broad background, but that could be very different from someone who goes to a couple seminar. And then says they’re a functional medicine dietician. So it’s a little bit the wild west and it’s a really amazing field in a lot of ways.
[00:05:16] Dr. Joe Mather MD: And it’s growing, right? So what it is now is different than I think it was even 10 years ago when I first leap in. but you’re absolutely correct. There is no one governing board or one, set of degrees. In fact, at our. I’m an md. I’m the medical director. We have a large diversity of clinicians.
Michael is a chiropractor at dc. Dr. Scott is a naturopath, so n d and then Dr. Hannah. She’s a do. So we kinda have the run of the gamut of medical degrees, which we think is helpful at bringing a diversity of.
[00:05:50] Tony Winyard: And so if someone has decided that is the route they want to go down, maybe they’ve tried, they’ve been with their GP and they haven’t been getting results they’ve been hoping for, and so they think they’ve been hearing about functional medicine, what would be some checks that they could take themselves to find someone good to work?
[00:06:10] Dr. Joe Mather MD: The. I think the biggest problem with the field right now is an over-reliance on laboratory testing, and so I would be extremely concerned that this is not a red flag all the time, but often if a doctor is asking for, four to five tests at a fairly significant financial cost without meeting you, that’s a red flag to me because that suggests that doctor is, overly reliant on laboratories that quite honestly are not that.
and that usually leads to a clinical process. It’s very expensive and laboratory driven. And the laboratories, because they’re not as accurate as many doctors and patients believe them to be, leads to a path where they don’t get very good outcomes. And they pay way more than they need to you can order here in the states’s, standard blood work will typically go through insurance, or it can be done for cash for relat.
An expensive, say, under $200 for most cases, right? Many of the functional medicine tests are four to 800 each, right? And so if someone is asking you to do multiple tests without listening to your story, without listening, what happened? What are their symptoms? Who is this patient in front of me?
that’s a pretty big red flag.
[00:07:23] Tony Winyard: And so if they, if that is the case and the practitioner they’re talking to is suggesting many different tests, is it as simple as just finding someone else or what would you say
[00:07:35] Dr. Joe Mather MD: I think so. I think that particularly with medicine, just like in therapy or if you’re hiring a therapist or an architect or a physio, You need someone that you connect with at a pretty, pretty good level. And it’s almost like speed dating. You need to find someone you connect with and you can build some trust with.
And most patients have a pretty good intuition if the person they’re working with is trustworthy and honest or not. And yeah, I would say I wish it was easy. I wish there was enough functional medicine docs out here that, that it was as simple as just finding a new one. But, it’s a growing field and so I think it’s trying to find.
and so what was it that made you, I mean we, we touched upon this before we started recording, that made you go into functional medicine in the first place after doing your,
[00:08:15] Dr. Joe Mather MD: I was frustrated. I was frustrated at, I’ve always wanted to be a doctor, right? The deepest level. I’ve always felt I, I am called to be a healer. That’s just how I’ve always seen myself from an early age. And so naturally I wanted to go right into medical school and I was able to make that happen and was lucky to be able to do that.
And I just figured it would be as simple as that. You get your medical degree, you get broad training in family medicine, and then you’re off to the races, right? I care about getting patients better and I went to a great university and so I was, I thought that it was gonna be as simple as that, but I got to the tail end of my conventional training and it was just like, my patients aren’t getting better, right?
I’m doing all of the diets that the American Diabetic Association is telling me to. Following all the cholesterol guidelines from the American Heart Association, I know exactly how the pulmonologist would treat this C O P D, but nobody got better cuz I had a clinic for three years where I would see people sequentially over many years.
And at the end of the third year, I’m like, man, no one’s better. So I’m either a bad doctor or the tools I’m using are not helping. They’re not. and thankfully , it wasn’t the former, it was the tools were not appropriate to help the patients with chronic disease, and so then became the journey of, okay, what actually works, because there’s lots of claims out there on what works and what
[00:09:36] Tony Winyard: And so how did you make the next step?
[00:09:38] Dr. Joe Mather MD: doesn’t. I did training with the Institute of Functional Medicine. I read
[00:09:44] Tony Winyard: and so before that, how did you find out that were you already aware of functional medicine and what happened?
[00:09:49] Dr. Joe Mather MD: One of my professors, my, my mentors in residency put on a lecture with Dr. Mark Hyman, who, is one of the major, I think educators in functional medicine. and he just said some things that clicked and I said, oh, this is interesting. I haven’t heard that talked about in this way before. And he helped, was pretty influential in the Institute of Functional Medicine, which is the.
Educational group. And so I went through their training and I read about 50 books and I, I couldn’t tell you how many hours of podcast interviews and just started reading and listening to patients and, applying it step by step, one thing at a time. And here we are 10 years later.
[00:10:28] Tony Winyard: And so you are, you mentioned about your, specializes in, was it, gut, the gut microbiome? Was it
[00:10:33] Gut care
[00:10:33] Dr. Joe Mather MD: Yeah,we specialize in all things gut care. I wouldn’t label us as just working, with the microbiome. We could talk about that, why we don’t do exactly that. But, we have focused in really selecting the tools that make a difference from the GI perspective. And the reason why, what we’re pinpoint on the gut is that is one of the major systems that’s easiest to change, right?
From a dietary perspective, from a supplement per. From a lifestyle perspective, we have a lot of leverage of being able to change the gut. and the gut in our experience, is the system most likely to help other systems improve. so by fixing someone with irritable bowel syndrome, we often see improvements in brain fog.
The neurologic system, we’ll often see, improvements in anxiety or depression. Again, neurologic, we’ll often see improvements in. Dermatologic, we’ll often see improvements, in joint health, arthritis, right? And so that is like one of those,major root causes. When you’re seeing multiple systems in different domains go away, it tells you that truly is a root cause worth pursuing.
So we spend a lot of time on the gut for those reasons.
[00:11:37] Tony Winyard: And isn’t it the case? I dunno the situation in the States, but it seems to me here in the UK, if you go into your local gp, there’s real time constraints for one thing. So you don’t really get to spend much time with them. So therefore, It’s rare that they’re gonna suggest to look at the gut if as a cause of an issue.
[00:11:55] Dr. Joe Mather MD: it is. It’s really unfortunate. we have the privilege of seeing patients across the world and it’s not better in other places. I can assure you. I just dealt with a wonderful guy from Canada the other day, and similar story, went to the gi, they threw an antidepressant at him in some fiber, did a colonoscopy and said, go away.
There’s nothing else I can do. I see the same thing in people from Australia. I see the same thing, Brazil, Italy, us, we see people all over now, and it’s really disheartening. I’ll be honest. There is a time constraint and there is a lack of good training on the things that help, and the doctors haven’t caught up, I think, to the latest medical literature on the gut, but that’s okay cuz we’re doing podcasts like this.
Tony, , get the word out,
[00:12:41] Tony Winyard: But do you think that’s changing?
[00:12:42] The gut is more than just bloating and diarrhea
slowly. there’s definitely more of a. Awareness that the gut can do more than just help with your bloating or your diarrhea. I, that seems to be true to me, but, I think I’m biased because, I’m in that world every day. so it’s a little bit hard to put myself, outside of that world.
do you feel that is changing.
it seems to me there’s a lot more awareness about it now. II remember. I dunno, what was it, three or four years ago? I used to often hear maybe on a podcast episode or on different books, some doctors criticizing things like leaky gut saying it was ridiculous. There is no such thing that doesn’t seem to be happening so much anymore.
my, my observation is, most conventional doctors, because they have. Handcuffs on with time. They have handcuffs on with training and they have, handcuffs based on how they’re paid from usually insurance companies. it’s just easier for them to dismiss something out of hand than give it some thought.
[00:13:33] Dr. Joe Mather MD: And so it’s much easier for them to say, oh, a basic elimination diet is bunk. here’s a drug. Or, but, and then what happens inevitably is for the things that are true is that all of a sudden you’ll hear all the GI doctors saying, of course a low FODMAP diet is helpful. Of course, probiotics can help reduce brain fog and joint pain.
of course an elemental diet can help resolve sibo. We were saying that years ago, and here’s raise your hands and you’re okay. . They’ll come on board eventually cuz it works. And that’s what it comes down to is that we’re looking for the things that make people better. We don’t care about the ideas.
it just has to translate into outcomes for patients. And if it gives my patient a better outcome than I’m all.
[00:14:16] Tony Winyard: So we’ve got probably got audience people listening to this who maybe aren’t so knowledgeable around the whole gut, and they may be wondering, why is the gut so important? Why does that make such a difference and how? How are you able to help someone with, one of the things I mentioned I wanted to talk to you about was arthritis.
So say we’ve got someone listening who’s got something like arthritis. How is it that by looking at a gut, you can help them?
[00:14:40] How on earth does looking at the gut help arthritis!
[00:14:40] Dr. Joe Mather MD: Absolut. So the first thing I think about is that the gut by surface area is by far the largest entranceway into the body, right? So much bigger than, the outside skin, much bigger than the nose, right? the internal lining of the gut from top to bottom is the single biggest entryway to the body.
So it’s a huge input on how the body regulates homeostasis, right? The, it’s how we get our nutrition. It’s how we expel waste and toxin, right? So there are major functions wrapped up into it, and it’s extremely important to realize the density of the immune system around the small intestines, is extremely high.
Again, because that’s a major entrance way to the body. The body has an incentive to protect itself by wrapping the first party intestine with a ton of immune tissue, right? A ton of nervous cell activity, right? and because of. , you get immune function wrapped up in the health of the gut because of the proximity of both the nervous system and the immune system to the gut because it’s an entranceway.
So because of that, by improving the health of the gut, that holds hands with the immune system. And that’s one of the ways that, that we see a reduction in joint pain. So what we find is a decent number of patients come into our clinic with ibs, irritable bowel syndrome. They have fluctuating diarrhea, constipation, usually some bloating, nausea.
And they may have tried a few things and they’re still feeling ill. And I would say of the patients with, ibs, maybe 20% report joint pain. And the really neat thing is that in many of those patients, not all, but in many of those patients with joint pain, when you get the GI symptoms better, their stools become more regular.
[00:16:24] Dr. Joe Mather MD: They’re having less nausea. If they’re able to eat more, the heartburn goes away or their ref. When that happens, you almost frequently see other systems heal, so the joint pain goes away, and that we assume and think that is primarily due to, a less active immune system. We think that the joint pain is immunologically driven, so this would be something like rheumatoid arthritis where the immune system is inappropriately activated against some of the tissues around the joints, be it the collagen, the joint capsule, or the joint. The simplest, best way to calm the immune system is often to heal the small intestine and the gut. Did that make sense?
[00:17:02] Tony Winyard: Yeah, absolutely. Yeah. And it, and I was thinking what it, of all of the things that you, so you mentioned you often look at the gap to, to help people with different issues.
[00:17:13] Dr. Joe Mather MD: Absolutely.
[00:17:14] Tony Winyard: Is there, what do you think would surprise people the most? An issue that they would never consider? The gut could have any influence over that.
[00:17:21] Tony Winyard: That does help.
[00:17:23] Dr. Joe Mather MD: Rosacea comes to mind. we see a lot of rosacea in our patients with small intestinal bacterial overgrowth, and in my mind, if someone comes in with rosacea, that’s a clear sign that there’s a gut problem because I would say about 75% of patients with rosacea respond brilliantly to the tools we use.
So that would be one that probably people may not consider rosacea being a gut driven condition, but in our experience, it’s heavily dominated by the gut.
[00:17:51] Environmental toxicity
[00:17:51] Tony Winyard: , environmental toxicity, how much? Does that play a role in poor health now?
[00:17:59] Dr. Joe Mather MD: I think this is going to be the thing that in 10 years we all say, I couldn’t believe that no one was thinking of this. This is a huge part of our work, and all. I’ll say because a few reasons, right? So number one, we see many patients with mold toxicity who’ve been sick because they’ve been living in damp water damage buildings, and they are made sick from the allergic response to mold.
They’re being sick, from the. Infectious load of the bacteria and the fungus that tend to grow in water damage buildings. And they’re being made sick by the toxins that mold can produce, right? So we see patients who are sick from a mold perspective. we see patients who have been made sick from air pollution.
there were forest fires, or are forest fires in the western portion of the united? I observed a really interesting, horrible, but interesting pattern of people having lots of symptoms flare as the particle count from the forest fires went west to east over the country, joint pain, brain fog, anxiety, diarrhea, constipation, whatever their main symptom was, it seemed people flared.
so air pollution is increasingly problem. We see, one of the more disheartening cases over the past two years was a gal who came in early fifties really fit, really healthy, doing so many things right, and but losing her hair, right? Her eyebrows were falling away and her hair was thinning and falling away, and she was fatigued all the time And it came down to, she had seen a practitioner previously who had recommended that she eat a lot of green leafy vegetables.
[00:19:32] Dr. Joe Mather MD: So she was eating, I think between four and six, cups of kale and spinach a day in a smoothie. And it turns out that kale and spinach, although it was organic, was contaminated with Valium and her urinary Valium levels were as high as I’ve ever. And it was just so disheartening that we could have a patient doing something that was, seemed to be so healthy.
Eating green leafy vegetables in a smoothie right, was being poisoned because of Valium and a contaminated food supply. So when I think of environmental toxicity, it’s one of the major problems I think that are causing poor health outcomes across the world. I see it most here in the us.
My, my breed is, The environmental protections, that the UK has put in. and most of, I think Western Europe is quite a quite a degree better than what we have here in the States. Unfortunately, I think it’s a major problem.
[00:20:32] Tony Winyard: And so if, so in a situation like that where you mentioned about this girl having the, these smoothies, seemingly eating very healthy, so and how did she discover that, what was it she was just ill, and she couldn’t understand why, and she came to say, you what?
[00:20:46] Dr. Joe Mather MD: Exactly. Yeah, she was ill. and we, she had GI symptoms, so like many patients, I began with the gut. She didn’t respond, So we had spent about two months really working on tweaking her diet. We used, broad spectrum probiotics, I believe I pulsed in an elemental diet. And we tried a round of herbs, one at a time, and at the end of two months, she just hadn’t moved the needle.
Anyway. So that’s a big sign to me as a clinician that what I thought was the case was not true. It was not a gut case. Gut was not the root cause for her, right? And so I scratched my head and then I listened a little bit. And, we did a urinary heavy metal test. just have her wake up in the morning, pee in a cup and see was there anything there.
and this was a, I’d become aware of fall toxicity and green leafy vegetables and kale particularly. And so I wondered with the hair loss that was the case. And sure enough it was. And so what we did with this gal took her off the kale, right? if you’re being poisoned, the treatment is to stop the.
[00:21:43] Dr. Joe Mather MD: Then we did a detoxification program. We used binders, to pull the heavy metals, things like modified citrus pec in and chlorella. used some sauna and I used glutathione and she responded beautifully. So hair started growing back within a week and three months later it was where she was prior in the fatigue.
And that joint pain and depression settled away. So that told us that we hit on the mark, right? The root cause was the Valium cuz she improved when we address.
[00:22:13] Toxicity testing
[00:22:13] Tony Winyard: If the average person did. Tested for toxicity would many people show? I’m guessing many people would show signs of toxicity much more so than say 20, 30 years ago.
I think so. I think that’s the truth. the, I spend a lot of time looking at the CDCs report. It’s called nhanes, N H A N E S, and it’s a longitudinal. Study and documenting many things, many environmental exposures, but heavy metals being one of them. And we’ve definitely seen an increase in many metals and many substances, many plastics over the last, few decades.
[00:22:48] Dr. Joe Mather MD: So I think that is the truth. I do want to quibble a little bit. we can. Chemical exposures and toxin exposures and mold to, exposures without necessarily being toxic. So you could even have some Valium at a higher level in your urine than maybe someone standing next to you.
But the question is it manifesting as a problem? This gal had hair loss, which is one of the cardinal manifestations, right? And so that she very clearly was toxic, right? So we just wanna be careful because I saw a case last week where, A gentleman had some elevated mercury in his urine, right?
And, I thought I did a good job of communicating that it’s something that we should work on, but it’s not something to panic about. And he sends me an email saying oh, about the mercury toxicity. I said,no. You’re not toxic. Like we wanna optimize your health and I’d rather get it out.
you’re not about to explode. , you’re okay. . So I hope that helps.
and I guess it. In today’s world with the scare stories that we are subjected to all the time in, in the media about toxins and various other things, it’s hard for people to, and just that those scare stories alone create additional stress, which is the last thing
[00:23:58] Dr. Joe Mather MD: Which exactly.
[00:23:59] Tony Winyard: it’s hard for people who do like that girl that you just gave as an example. Someone who really wants, goes the extra mile to try to be. And so how, what recommendations, Ido you give to people to try to just stay generally healthy?
[00:24:15] Health recommendations Jow gives
[00:24:15] Dr. Joe Mather MD: we spend an inordinate amount of time on sleep. Sleep is the lifestyle factor that in our western world is just has been decimated, with light exposure. with people not having exposure to dark with the chronic stress levels, with the diets that we eat, and with our lack of activity, right?
We, the number that I read at some point was that our earliest ancestors may have walked 13 miles a day on average to hunt and gather, right? And, I’m lucky if most of my patients are walking a mile a day. And so the lifestyles that we are living, I think are contributing to a big sleep deficit.
This has a range of effects on the body and we often see gut problems because of this, we see chronic fatigue, more pain, more anxiety, depression. So sleep is a really important piece that is often missed. most people know that they should be exercising and dieting, eating healthy, that seems to be things where people are doing a pretty decent job.
The sleep, is probably the thing that’s missed.
[00:25:16] Tony Winyard: Does it surprise people when they, maybe they come to you and they’ve got some kind of issue, which is, in involved with the gut somehow, and then you talk to ’em about sleep. Is that a surprise?
[00:25:27] Dr. Joe Mather MD: Yes, it is. and, being a clinician, it’s always when is the right time to introduce an issue. and what we try to do as best we can at the RU Show Institute is. Kind of rank order the treatments for each patient that we think is most likely to help. And almost always, there’s at least one or two major lifestyle pieces that someone can do better that we wanna pull the trigger on first, right?
Because if someone is coming in and their diet is really inappropriate, right? They’re just, let’s say they’ve got small intestinal bacterial overgrowth and they’re eating small meals nine times a day because they’re, weight. , right? And then we can say, Hey, I think it’s your meal spacing issue that needs to happen.
And we’ll give you three or four hours in between meals, maybe cut the carbs a little bit. let’s see how we go from there. We’re also gonna maybe give you some basic GI support. Come and see me in a few weeks. I think that may be enough. If not, we’ll go to number two. so we try to order the operations for what’s most likely to help.
And my big picture point is almost always the lifestyle’s being missed. If you, let me go on a slight tangent. One of the reasons why we end up seeing patients who’ve failed multiple doctors. Our general patient who comes in, who’s seen a couple gps, maybe a specialist and is still having an issue, or they’ve seen a few integrative or functional medicine doctors and they’re still ill.
There are basics that are being missed all the time in these patients, and I think the major reason why is that many of the functional medicine doctors have bought into the Kool-Aid that I need to do organic acid testing and adrenal testing and get a microbiome profile and advanced thyroid labs, they’ve bought into that idea that if they just optimized the numbers on a page, their patient will get better.
So they spend all their intellectual bandwidth thinking about thyroid ratio. , right? And they miss the fact that the patients sleep in four hours a night.
And so we get a lot of mileage out of doing the basics. we’ll almost always do some gut support because of the reasons I’ve already talked about.
And then if someone is not improving, then we’ll say what might be missed. Is this an environmental exposure? Is there a, limb or a amygdala imbalance? . there’s lots and lots of things, heavy metals, mold. the list goes on and on, and it’s more about thinking individually based on the patient’s story, what are the things that happened right before they got sick and that will point us into maybe a different direction than another patient.
So we try to do that, that, that thing called listening , which is often missed,
[00:27:51] Tony Winyard: which is so important.
[00:27:52] Dr. Joe Mather MD: that advanced, the advanced medical skill of listening to your patient,
[00:27:58] How do you find a GOOD functional medicine doctor?
[00:27:58] Tony Winyard: So that kind of takes us back to where we started. Say we, we were talking before early in the episode about maybe goes to see a function medicine practitioner who as you talked about, Recommends lots of different lab tests and that’s probably not someone that would be advisable to have a long-lasting relationship.
But so and I asked you the question, so how would, what to look for, so is it a case of someone’s decided they are gonna go to functional medicine route? Should they start looking into. where they trained, for example, should they, if they’ve trained with the ifm, does that, is that normally a good indicator that this is probably someone to work with?
what is it someone who could look for who doesn’t have any training in this whole area?
I, I think you want to look for someone with an open mind who’s not, who doesn’t seem sold, that every case has to be a hormone deficiency. Every case has to be, a missed thyroid case and we’ve gotta throw more thyroid. you don’t want someone thinking that everything is the gut, even though we love the gut, it’s not always the gut, right?
so you’re looking for someone who’s not dogmatic, and I think the early functional medicine, practi, Try to say nice things. Let me see if I can say this in a polite, respectful way, many people who become integrated or functional medicine doctors had a really bad experience with the conventional medical system, and so they become dogmatic in a different way.
[00:29:20] The problem with integrative/functional medicine
[00:29:20] Dr. Joe Mather MD: So the dogma in the conventional arena is everything is a drug. It’s a drug. It’s a drug, and if the drug doesn’t work, it’s in your head. It’s a little bit of a over exaggeration. There are so many brilliant, amazing conventional doctors, so please don’t hate me if you’re a conventional doctor, but I think most people will recognize the, overgeneralization of truth there.
the problem is that a lot of people are turned off by that approach. They go into the integrative medicine, arena, and then they become almost dogmatic in a certain small subset of integrative medicine. They saw a thyroid really fix someone. So they think it’s always th. They found a, a lower carb, lower insulin approach, really helpful for someone as they become low carb alts.
[00:29:59] Dr. Joe Mather MD: You’re looking for someone who, who is looking for just the tools that help. And there are tools in the conventional world that help, right? There are tools in the integrative world that can help, but what will actually move the needle for patients? You’re looking for someone who doesn’t seem like they’re, dogmatic or just trying to push one idea. harder. Easier to say, harder to do. we are taking patients, if you like what I’m saying. we have a clinic, we see people all over the place, all over the world at the GR Show Institute. so I’m biased, I’m the medical director, but I think we do a great job, . We’d be happy to talk to you.
[00:30:33] Benefits of various types of fasting
and we’ll get onto all your,how people can find out more about you, but just before that, so some of the things, something you touched upon about five minutes ago. You talked about how if someone is trying to gain weight and they’re eating 6, 7, 8, 9 times a day, whatever it might be, what are your thoughts or do you ever suggest to many of your clients about things like intermittent fasting, water fasting,
[00:30:56] Dr. Joe Mather MD: Absolutely. both of those things for the right patients, it’s always a, it’s always a question of is this the right tool for the right patient? But we love intermittent fasting. for weight loss. My clinical experience is that most patients need to do more than intermittent fasting.
intermittent fasting, most people would think of as like 18 hours of not eating six hours of eating a compressed eating window. What I have found is that most people need to go past a 24 hour. To have, enough clearance of, glycogen stores in the body to lower and to kick up more of a ketogenic state.
[00:31:28] Dr. Joe Mather MD: So usually when I’m having people use this for weight loss, I have them do at least a 24 hour fast once or twice a week. I, my feeling is that intermittent fasting is excellent for health, but it should be pulsed in where there’s times where we do this and then maybe times where we back off of it.
I haven’t found it be enough kick for weight. But we love it. It’s very helpful for the gut. The more rest you can get for the gut, the better. So we find that fasting can be curative for some gastrointestinal conditions. we could spend 30 minutes talking about fasting. I love it. There’s excellent studies showing reduction in inflammatory markers and symptoms in rheumatoid arthritis from water fasting.
So periods of water fasting can be extreme. Helpful to the immune system. We see deep changes in the immune system with fasting, and we see it, eradicate a lot of the bacterial problems in the gut. So we’ll frequently do elemental diets, which is a variant, a fasting, for our patients with, inflammatory bowel disease or ibs.
So we love fasting. It’s just gotta be the right tool for the right patient.
and that well, that
[00:32:33] Dr. Joe Mather MD: who have eating disorders. And so if you have someone with an eating disorder and a background of bulimia where they’re underweight, then you’re not gonna be pushing that, right? So it just depends.
[00:32:43] Tony Winyard: And then on that, Iknow, we’ve talked about, you’ve talked about the how beneficial it is for people trying to lose weight and therefore then turns people off who are trying to gain weight, they’re trying to build muscle and they think, oh, that’s definitely not the route I should take.
I don’t ever wanna be doing anything like intermittent fasting. So what would you say to, to people with that approach?
[00:33:01] Dr. Joe Mather MD: We say the body. The body is the boss, right? Your response to the treatment is the only thing that matters. So it doesn’t matter how many studies there are for XY condition, it just really matters. Does it work for you or not? And we stop doing things that aren’t working. So many times. If I have something where someone’s like really keen on fasting, and I’m not sure, I say give it a try, do, gimme a 24 hour fast twice a week, do that for a month and let’s track your body fat and your weight and let’s see, is this moving you in a good direction or not?
Because if it’s not, we’re gonna stop this strategy. But maybe I’m wrong and maybe the fasting is a good fit for you. It just comes on just meeting the patient where they’re at and not being dogmatic about these things because you, I think any good clinician will be surprised, right?
if their mind is open and they’re just trying to be objective, they’ll be surprised. Things that they didn’t think were gonna work all of a sudden are the thing that worked. so I did, I don’t know if I answered your question, Tony. I’m sorry.
it was more about guys, there’s a lot of guys who are trying, especially say in their late teens, early twenties, who are. Feel they’re really underweight and they’re trying so hard to gain weight and they just can’t gain weight.
[00:34:06] Dr. Joe Mather MD: Yeah.
[00:34:07] Tony Winyard: they will often think, I would, I should never do something like intermittent fasting because that’s the last thing that’s gonna help me.
some, so what they could think a little bit broader, right? So they could maybe pulse in one day of fasting a week, but if they’re eating six outta seven days, a caloric surplus and they’re gonna gain weight. So they may be able to eat enough six days of the week so that, a period of, Zero calories on the seventh day would net not be a problem, and it might be a helpful reset.
[00:34:35] Don’t pick one thing and roll with that forever
[00:34:35] Dr. Joe Mather MD: My perspective on all things diet is that you shouldn’t pick one thing and roll with that forever. The body does need to change, and so I don’t think we should always be, I’m always gonna be keto or I’m always gonna be, carnivore, I’m always gonna be low fod, meth, whatever it is. I think the body deserves some, curve balls thrown at it.
I think that probably is the way to keep it, the health. for the guys trying to lose weight. my, my latest realization is just the obvious importance of protein. I don’t think I really understood until recently how critical protein intake is and how, easy it is to undereat protein.
the guidelines that I was taught in medical school are really under what people need, I think for optimal health, particularly if they’ve been chronically ill. so these days I’m recommending quite a bit more protein, for many patients.
we are drawing to towards the end of the episode. So before, before we go, there’s a couple of things I wanna ask you. One is a question I ask all my guests. Is there a book you can think of that’s moved you in for any reason?
[00:35:33] Favourite book
I’ll give you, I’ll give you the answer I’m supposed to give as medical director. And it’s also a true answer. It’s Michael Russo wrote Healthy Gut, healthy you. That was one of the kind of turning point. I read that book and I said, ah, I think this Michael Guy is not crazy, and in fact has the best answer for how to get the gut well.
[00:35:50] Dr. Joe Mather MD: And the nice thing about this is at the end there’s a how to do this kind of practical problem solving yourself. And so for 20 bucks, I think patients who’ve struggled with their GP and not having a good map for how to get their gut health petty better can read this book and figure. . so Healthy gut, healthy you is just phenomenal.
Iit honestly should sell for 50 bucks . It is just phenomenal. And then, I read quite a lot, so I’ll just answer with the book I’m reading right now is a really neat novel called, green Bones, A Green Jade by Brenda Lee. it’s a kind of like the Godfather with kung fu, and like a fantasy city.
Fantastic. So I was in the airport all day yesterday reading that book. That was fun. If you’re looking for a non-medical just fun book, right?
we’ll have both of those in the show notes so
[00:36:38] Dr. Joe Mather MD: There you go.
[00:36:39] Tony Winyard: those out. So if people wanna find out about you and the institute you’re working on, where would they go to?
[00:36:44] Dr. Joe Mather MD: there. Go to the ru show institute.com. That’s R U S C institute.com and there’s a. We onboard all patients online, so if they’re interested in working with us, they’ll see it become a patient page and they’ll just click through the process and, we’ll be happy to work with them.
[00:37:03] Tony Winyard: are you guys active on social media at all?
[00:37:06] Dr. Joe Mather MD: Yeah, we are. And but I’m a poor interview subject because I couldn’t tell you the, I know.
I think Instagram, we are active and
we’ll put the links again in the show notes for your
[00:37:17] Dr. Joe Mather MD: Thank you. Thank you.
[00:37:20] Joe’s fave quote
[00:37:20] Tony Winyard: So finally, Joe, is there, is there a quote that particularly resonates with?
I’ve been thinking about kind of the dogma and people just going to one solution, and that’s the way to fix people. And so quote that I’ve been thinking about lately, and I’ll butcher it, but it was, one of the huxley’s, I think it was El Huxley, said the. The mark of a first rate mind is the ability to hold two contradictory ideas in it at the same time, something like that.
[00:37:46] Dr. Joe Mather MD: But the idea that the truth is not just one, right? That there may be some things that are both true in certain situations and how can we reconcile those ideas. And I always like that quote. I think it’s.
[00:37:58] Tony Winyard: Yeah, it is a good quote. Yeah. So I’ll make sure we have that. Yeah, we have that one in the show next as
[00:38:03] Dr. Joe Mather MD: But maybe just get the actual, so we’ll not so Mr. Huley is not rolling in his grave. Maybe we can get the actual quote
[00:38:11] Tony Winyard: Yeah. Yeah. Cause I can’t remember exactly what he said either, Yeah. Joe, it’s just been an absolute pleasure. So thank you for your time and for giving us so much great information on many different areas. yeah, thank you.
[00:38:22] Dr. Joe Mather MD: You’re welcome. My pleasure. It was fun.
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