Dr Christabelle Yeoh on Mast Cell Activation and Why You Might Be More Sensitive Than You Think

Dr Christabelle Yeoh, an integrative physician, join us to talk about the important topic of nutritional and environmental medicine, mast cell activation, and why you might be more sensitive than you think. Christabelle is a wealth of knowledge. I hope you enjoy this conversation I had with Dr Christabelle Yeoh.

Dr Christabelle Yeoh on Mast Cell Activation and Why You Might Be More Sensitive Than You Think Introduction

The topic of nutritional and environmental medicine is an important one. It’s one that has certainly informed my professional journey over many years. People often ask what is nutritional and environmental medicine. We’re certainly going to be answering that today.

My guest is Dr Christabelle Yeoh, who has lectured extensively on these very topics. And Christabelle and I have served on the board of the Australasian College of Nutritional Environmental Medicine.

She’s a past president of the college and so am I, of course. But she is a wealth of knowledge. And actually, I found it very interesting to hear about her own professional journey.

That always intrigues me, how practitioners vary in their approach to what are very complex health problems for many patients. And those complex health problems require time. And one of my mentors in my life once told me, she was a medical practitioner with 70 years of clinical experience, and she said, if you ask your patients the right questions, they’ll not only tell you what’s wrong with them, but they’ll often tell you how to fix it.

And the key here being, firstly, to have the time to ask those questions and secondly, to have the knowledge to understand what those responses actually mean. Look, I’m not going to spoil it for you. I hope you enjoy this conversation I had with Dr Christabelle Yeoh.

Podcast Transcript

Dr. Ron Ehrlich [00:00:07] Hello and welcome to Unstress. My name is Dr Ron Ehrlich, and before I start, I would like to acknowledge the traditional owners of the land on which I’m recording this podcast, the Gadigal People the Eora Nation and pay my respects to their elders, past, present, and future.

Now, the topic of nutritional and environmental medicine is an important one. It’s one that has certainly informed my professional journey over many years. People often ask what is nutritional and environmental medicine. We’re certainly going to be answering that today.

My guest is Dr Christabelle Yeoh, who has lectured extensively on these very topics. And Christabelle and I have served on the board of the Australasian College of Nutritional Environmental Medicine. She’s a past president of the college and so am I, of course. But she is a wealth of knowledge. And actually, I found it very interesting to hear about her own professional journey.

That always intrigues me, how practitioners vary in their approach to what are very complex health problems for many patients. And those complex health problems require time. And one of my mentors in my life once told me, she was a medical practitioner with 70 years of clinical experience, and she said, if you ask your patients the right questions, they’ll not only tell you what’s wrong with them, but they’ll often tell you how to fix it.

And the key here being, firstly, to have the time to ask those questions and secondly, to have the knowledge to understand what those responses actually mean. Look, I’m not going to spoil it for you. I hope you enjoy this conversation I had with Dr Christabelle Yeoh. Welcome to the show, Christabelle.

Dr. Christabelle Yeoh [00:02:01] Hey, Ron, good to see you. Thanks for having me on.

Dr. Ron Ehrlich [00:02:04] It’s a pleasure. I’ve been looking forward to this for many years, in fact, and you’re a difficult person to nail down, but here we are. We’re finally chatting. And there’s so much I want to talk to you about, a lot about, you know, nutritional environmental medicine. But before we did, I wondered if you might share with us your journey in your medical practice, right?

Dr. Christabelle Yeoh’s Journey

Dr. Christabelle Yeoh [00:02:27] Yes. So I went to medical school in London. But before that, I had my own grounding into medicine because my father is a nose and throat surgeon and he was rather unorthodox enough to think that nasal polyps and tonsillectomy surgery and doing that again and again, and particularly when nasal polyps come back, a tonsillectomy doesn’t necessarily fix the issue.

So he was looking for what else is going on. And he stumbled across the American Academy of Otolaryngology Allergy and he started learning about food intolerances and airborne allergens, which was already known about, but it wasn’t usually actively treated with immunotherapy. So usually they would just do the surgery, remove the polyps, and then slowly they come back again. So he was rather unorthodox when, in fact, a patient would see him, and then the ENT surgeon would say, well, I’m not going to do surgery.

I’d like you to remove this food or that food or do immunotherapy for the dog and actually treat the allergies. So and this was in the 80s. And so all his surgical colleagues say, well, how are you going to make money as an ENT surgeon if you don’t do surgery?

Dr. Ron Ehrlich [00:04:06] Yes. Well, yeah, good question.

Dr. Christabelle Yeoh [00:04:10] Yes. So I kind of grew up seeing that and what he was doing with patients with avoiding environmental allergens. And it was just normal to me. And I didn’t really think much of it, frankly. When I went to medical school, I decided I couldn’t stand in surgery for five hours and that I was going to be a physician instead.

Dr. Ron Ehrlich [00:04:34] Right.

Dr. Christabelle Yeoh [00:04:35] And I ended up being a physician and I was working in hospital medicine in London. And I was starting my training as a gastroenterologist. And then it dawned upon me when I was in clinic with the seven minutes that you have and seeing patients with irritable bowel syndrome and that sort of thing, and then just, you know, after you excluded cancer and excluded all the nasty things, which is many patients, then you’d still have many more patients with irritable bowel symptoms and no treatment.

So then I sort of remembered, oh, hang on, I do remember that you can remove things, irritants, foods, intolerances. And I went back to university to do a post-graduate degree in clinical nutrition. And then after that, I went full time into nutritional and environmental medicine.

And I worked with a mentor who had a lot of experience with immunotherapy and treating allergies and allergens in the physician way in America, that those were the people who went to the American Academy of Environmental Medicine that was the physician equivalent of the American Academy of Otolaryngology Allergy.

Dr. Ron Ehrlich [00:06:03] Just remind our listener about the difference between a medical practitioner and that step up a physician.

Dr. Christabelle Yeoh [00:06:12] So after leaving medical school, you do your residency and then you decide you’re going to be a GP or you’re going to go into surgery, or you’re going to go into the medical specialties. So cardiology, gastroenterology and you trained first as a general physician. So it’s hospital medicine. You do your general physician training, and then you finish off with your specialty, like cardiology, respiratory medicine.

Dr. Ron Ehrlich [00:06:45] And the seven minutes that just you just mentioned that in passing and people may have missed it, but the significance of the seven minutes or if you were really into it, 15 minutes is the typical length of an appointment in a general practitioners practice. Is that true? Is that right?

Dr. Christabelle Yeoh [00:07:04] So this is in England that in the National Health Service when I was saying and it’s a bit different to hear that you can have a private practice or you could be in full bulk billing practice.

So in England, the National Health Service is equivalent to the bulk billing here where you really have to work fast. You don’t have time because time is money and you don’t charge patients for anything. Whereas if you did charge patients or they pay the gap right, then you would have more time.

It’s up to the doctor how they want to work. So in the National Health Service, there’s not a lot of time. And in bulk billing general practices here in Australia, there’s not a lot of time. And yes, about seven to 15 minutes.

Dr. Ron Ehrlich [00:07:57] And once you’ve eliminated that, I don’t have cancer. And I’ve now got another five minutes to go in my appointment. I guess the next step typically and a lot of people who suffer from this kind of conditions or any condition, really the next step is to work out what the medication is going to be, what prescription this patient will need to not cure but control this condition.

Dr. Christabelle Yeoh [00:08:24] Yes.

Dr. Ron Ehrlich [00:08:25] That’s basically the model.

Dr. Christabelle Yeoh [00:08:27] That’s basically the model. And that’s not a bad model for acute medicine. When you can figure out quite quickly someone’s having a stroke or heart attack, pneumonia. You know, that’s quite good cellulitis, it’s very obvious infections were obvious, and that’s a very that’s a sufficient model.

But most people with lingering symptoms and chronic conditions these days, of course, that’s not a good model, even if it wasn’t a recurring infection or sinus issue. That’s in the context of your nose and throat surgery. But let’s say it’s diabetes, blood sugar issues, or putting on weight then certainly medication might just ameliorate the highest blood sugar situation, but it’s a lifestyle condition.

Dr. Ron Ehrlich [00:09:25] Which leads me to this question about which you and I are very familiar with and that is what is nutritional and environmental medicine, right?

Dr. Christabelle Yeoh [00:09:36] Yes. So you know, as well possibly better than I do Ron.

Dr. Ron Ehrlich [00:09:42] Well, I know that you have lectured a great to many doctors in Australia through the college that you and I both associated with. But I think this is something that may be well, certainly some patients don’t know. And the report the public doesn’t know. And there are many health practitioners that are also surprised to learn this is a whole area of medicine. How would you say? Well, give me nutritional environmental medicine 101.

Dr. Christabelle Yeoh [00:10:13] OK, so it’s an area of medicine where we’re looking at the effect of nutrition on a person. Whole human health and how nutrition changes our hormones, changes our metabolism, changes our immune system, changes our digestive function, so across all the systems. And it’s not just looking for a deficiency disease like, you know, like Kwashiorkor or Scurvy, for example.

So it’s much more about how nutrition really optimizes a person’s whole health and then environmental medicine, looking at all the factors in the person’s environment that could be actually making them ill, whether it’s if they’re really allergic to dust, whether it’s dust, that’s super simple, but that can be much more complex factors in a person’s environment, like heavy metals that they may be exposed through a job, let’s say, as a dentist, being exposed to putting amalgams in people’s mouth or having had some water damage at home, and then the building material has gone moldy and releasing mycotoxins that certainly causes a lot of symptoms, chronic symptoms.

So those are just examples of you have to go do detective work in the environment to look for what in the environment is making someone ill.

Dr. Ron Ehrlich [00:11:52] And that, you know, you studied in England, and I know we have been connected with the British College of Ecological Medicine. Is that semantics? Is the difference? What’s the difference between ecological medicine and nutritional environmental medicine? I’ve never quite understood why they’ve called it the ecological medicine. Is that the same thing?

Dr. Christabelle Yeoh [00:12:17] It’s semantics today in that we all do the same thing. We practice the same way. But ecological medicine historically was what it was named at the very beginning because there were these group of ecological doctors or ecological medicine doctors where they were really very much more focused on understanding what in the environment made people sick. And it sounds like I just said that already.

But these are specifically they were this unusual breed of people, patients, which didn’t fit any other category in medicine. And then that stumbled into an ecological medicine doctor’s office, and realized, for example, that the electrical wiring in their house was responsible for the seizures they were having or the trembling or insomnia. And it’s just really unusual things that was just not normal as far as everyday life was concerned.

This is 40 years ago, 40 to 50 years ago, when the first breed of ecological medicine coming up in America and they connected to the wireless radiation self, you know. At that time there wasn’t even so many cell phone towers, but there was certainly the electrical pylons making people ill. And it was much more uncommon then to realize just this thing in your environment could make you so ill, really symptomatic.

And that’s where the ecological medicine doctors came from. And so now in what we just heard much more in the modern way environmental medicine, the types of patients that was so unusual, they call them the canaries of a coal mine.

Now, it’s so much more common. And many people are like canaries, and the coal mine is no longer on the coal mine surface, but all the pollutants, intoxicants are everywhere in our environment.

Dr. Ron Ehrlich [00:14:39] And I think one of the things that people think about when they think of allergies, they think, well, if I’m allergic to something, I will start sneezing or I will break out in hives or I’ll get a runny nose, and that is allergies. And if I don’t have any of those reactions, then I’m fine. But it’s not quite as simple as that, is it? I mean, there’s a difference between allergies and sensitivities. Can you just tell us a little bit about that difference?

Dr. Christabelle Yeoh [00:15:09] Yes. So for the classically trained allergist and immunologist, allergy is really a very narrow definition of how a person with allergies should look.

They have what’s called IgE-mediated allergies, Immunoglobulin E, and IgE is an antibody that our immune system makes, but then recognizes those big, bad, obvious allergens like bee stings and dust mite and egg and peanut that might make your tongue swell or give anaphylaxis. So that anaphylaxis is a purely IgE-mediated allergy.

That’s a well-recognized entity. And then you can have less severe versions of that, causing hives and itching and a bit of tongue swelling, a bit of reaction. So that, by definition is allergies, IgE-mediated, where sensitivities and intolerances, both sensitivities and intolerances is everything else. That is not that. And when you understand the immune system, then there are many, many other mechanisms of how reactions in people can occur when they’re not IgE-mediated.

Dr. Ron Ehrlich [00:16:35] And that doesn’t normally happen on contact. It can happen. How long after an exposure to a toxin or something you sensitive to, could that reaction occur? How long could it take?

Dr. Christabelle Yeoh [00:16:52] So reactions could occur, so if we put the category because you mentioned toxins, so let’s not talk about toxins, but we talk about just normal things in everyday life, like eating wheat or corn or eggs. So those reactions could be immediate or could be two, three, four days later. And that’s when we start to get lost in the woods of what is going on with this patient. And then particularly, it’s not usually just one reaction people have to one food. It could be a handful of them.

Dr. Ron Ehrlich [00:17:39] Are we becoming sensitized to our environment? Is that what’s happening

Dr. Christabelle Yeoh [00:17:44] in a nutshell? Yes, but that’s because our environment has changed so much to a few decades ago. I mean, it’s changed hugely since the 60s and 70s and then just exponentially every year with a number of additional new chemicals being introduced into the environment.

And, well, we can always say stress, but as you very well put, stress is due to many different factors, physical and all of that. But our nervous systems, our bodies are getting stressed to the max and that stress impacts the immune system and all the barriers around the immune system that normally would have barricaded the environment to a degree. So we’re not so reactive to it. So all those barriers are wearing thin and somewhat dissolving or being getting more and more toxic.

Dr. Ron Ehrlich [00:18:54] What sort of reactions are you seeing from patients coming in and once you’ve eliminated the big ones of cancer and an infection, what sort of other reactions are people presenting with fear with you?

Dr. Christabelle Yeoh [00:19:11] So, you know, when I was thinking about our meeting today and what I’ll talk about, there’s this I’ll give you this one condition and then it kind of goes down from there, like this tip of the iceberg condition, you call it, that is a Mast Cell Activation Syndrome.

Sometimes it’s known as a Mast Cell Activation Disorder. And that mast cell, which is in an immune cell that sits on all of the body surfaces that literally touch the environment like our skin, our eyes, our nose, our throat, even the environment on the inside, because from mouth to anus, our GI tract is the outside on the inside, it’s constantly communicating with the foods we eat and all the outside things we put into our insides.

So those mast cells are reading the environment constantly. And this, the worst of the worst kind of condition where the immune system is just reacting to everything in the environment is Mast Cell Activation Syndrome.

Those immune cells, those mast cells are being highly activated and they’re literally just spewing out all these immune chemical mediators, and these mediators are very well-known substances like histamine, proteases, tryptases as in like well known allergic mediators down to very not well-known mediators that actually could be driving other pathophysiological processes like cancer and like all sorts of types of inflammatory responses.

So these small cells that are over-activated by what’s going on in our environment are releasing like over a thousand mediators. And so if you extrapolate all the way down, these mediators could be doing God knows what in the body really. And so in just the literature alone, most cells are connected to the whole spectrum of allergy.

So just now we mentioned just that one small spectrum, but there’s a whole spectrum of them asthma, autism spectrum, all the autoimmune conditions, Ehlers-Danlos syndrome, celiac disease, chronic fatigue syndrome, esophagitis, gut thing, reflux, interstitial cystitis, kind of moving down all the organs, interstitial cystitis, that’s the bladder, irritable bowel syndrome, and then there’s migraine, and then there is, all the neurological symptoms you could care to think of has been connected to mediators relating to histamine.

So all sorts of mood disorders, bipolar, anxiety, depression, the whole range, and then even autonomic disorder, so that’s when the nervous system is not quite coping with its autonomic or unconscious functions like the heart rate and the blood pressure and the temperature regulation. And whether you’re lying or standing like the nervous system is doing all these automatic things to keep its system homeostasis in balance.

So when that starts to go wrong, that’s the autonomic system going down. So really classic one is POTS, Postural Orthostatic Tachycardic Syndrome, it just means that when people stand up, the system can’t deal with gravity. That’s pretty bad. Yes, that’s a kind of a chronic fatigue where people have to be horizontal. So these mast cells and intolerances and our reactions from mast cells really being connected to so many chronic diseases, you can’t begin to.

Dr. Ron Ehrlich [00:23:41] But I mean, the common, I mean, we’ve said this before, but you’ve actually touched on some on the actual mechanism here, that chronic inflammation is the common denominator running through all diseases and this is actually what’s going on at a cellular level that explains that.

Dr. Christabelle Yeoh [00:24:00] Yes. Yeah. I mean, there’s so many inflammatory pathways, but if you just tear it down to the mast cell because if we’re talking about environmental medicine and the pot, the face of the immune system that’s looking at the environment and deciding I don’t like this and I’m going to react, then that certainly that mast cell-driven inflammation, it’s a big category, but it would be different to that, let’ say, getting a bacteria deep into your, like a sepsis that say a system would be a different inflammatory mediator and again, would be different to the inflammation that you might think about with metabolic syndrome, for example, of being a diabetic or being overweight.

But they do eventually all start to merge down the same road of ramping each other up. One ramps up, eventually the others start to ramp up. So eventually, of course, they do merge into this big basket of inflammation. It’s just the initial trigger might have a different pathway, a different route.

Dr. Ron Ehrlich [00:25:18] And it’s the way they manifest themselves. Is that where the genes come into it, like a muscle activation in one person and another person? The way they manifest is determined by their genetic susceptibility. Is that a way of looking at that?

Dr. Christabelle Yeoh [00:25:34] It’s absolutely got a genetic aspect when we just talk about mast cells, but it’s probably much more than that than just genetic. And I think it’s all the possible mechanisms are still being studied and it’s more than just genetic because if you look at all of the possible conditions that it can be linked to the main groups of conditions related to the mast cell activation is gut. So but it’s IBS or motility problems.

So you probably heard of SIBO, Small Intestine Bacterial Overgrowth, or people who are constipated and just motility is poor. So that’s one big category. Another big category is autoimmune, and that’s huge. The category is dysautonomia, so then that nervous system path. Another big category is Ehlers-Danlos, so connective tissue. And so because these are all very multifactorial conditions that are also not just genetic, but big one is epigenetics.

So once something is epigenetic, then it’s got so many factors. And methylation is a part. How much infection and how much viral load is a part, how much toxicity is a part, how much, you know, we don’t eat well, sleep well. The problem you start to load up like the nervous system resilience or immune system.

Dr. Ron Ehrlich [00:27:18] So I guess it’s interesting to hear you talk about the complexity of this because the appeal for the 15-minute consultation and the prescription pad to determine which corticosteroid or what level of corticosteroid did you require to control this is appealing.

I mean, this is now, I mean, some medical practitioners, this is news even to them, isn’t it? I mean, I know this is an obvious one for you and me, but it is true, isn’t it? I mean, there are some practitioners who just don’t want to know about this kind of thing.

Dr. Christabelle Yeoh [00:27:59] Well, I think they may well know that they’re much more complex things. And there are many specialists who understand that. And I think it’s just whether they currently work in a model of care where they don’t have the time or space to do it.

I think it’s really it’s not that people are ignoring it or not believing it, they do because the literature is, you know, huge. It’s just in the day-to-day practice and care of patients. If they have time or space or a team to help to look after patients, then they just can’t do it.

Dr. Ron Ehrlich [00:28:42] Yes. And how does one diagnose these problems? How do you approach these?

Dr. Christabelle Yeoh [00:28:49] So because, well, it’s through the history first and foremost, and we take a lot of time to go through a functional medicine timeline or which just means the history from data because you are saying how we’ve got all these different various systems and immune barriers in our body. And you know that if somebody has had antibiotics for recurrent tonsillitis since they were kids multiple times, you know that that gut barrier, that microbe microbiome, part of the immune system is going to be wanting, so to speak. And that will be a weak part. But all of you.

So we ask a history from birth to the present day and environmental history in terms of where do you live, what is it like, you know, do you live in like rural and living next to fields, being sprayed with glyphosate and chemicals? Or maybe you’re a dentist that still uses amalgam fillings and just finding out all the possible toxic exposures, then we do a deep dive into their diet history, deep dive into their family history, and that’s where some of that genetics plays out. So because that certainly plays a role.

So it’s a long history taking and that’s really by the time you finish taking history, you get a good idea already. That’s it. And of course, because we want to be rigorous with our diagnostic processes, then we might use, you know, like a research-based question as to like, OK, you know, you really have 20 out of 40 of these, so that rubber-stamping, that condition and then with some conditions now with mast cell activation, it’s not so easy to diagnose it on a blood test, partly because of how fleeting these mast cell mediators are in the blood, but you might try and do some blood tests to catch some of these mediators.

So usually diagnoses for complex conditions with all these layers would be a good questionnaire and then that’s a big take. You will always have like two or three major criteria, two or three minor criteria. So then you might have a questionnaire, you might have all the symptoms in at least two or three organ systems. Then you might have a lab test that show one or two things.

Then you might have a biopsy that shows something. So when you then piece it all together, you can absolutely say it. And I am sure of this diagnosis, quite a few patients, at least in my clinic, because they probably the most severe [00:31:41]end of the spectrum [0.4s] will mean all those tick boxes. But perhaps in general practice, where patients are not as severe or GP’s are just learning how to pick up these initial presentations, it’s really just asking the right questions and having the nose for it.

And then when you do one or two modifications of the diet and lifestyle, the symptoms improve, then you just know that that’s the right pathway because often the diagnosis criteria itself, these mind major and minor criteria. One of them is response to treatment.

Dr. Ron Ehrlich [00:32:20] So you’re using the treatment almost diagnostically to establish if you’re getting a reaction, then obviously that’s a good thing. What is the easiest elimination of food sensitivities, environmental, or how do we support that as well? How do we improve the adaptive capacity?

How do we improve adaptive capacity?

Dr. Christabelle Yeoh [00:32:43] It is very much first and foremost removing all the stresses in the environment and around the body so a book like yours would already be a good stepping stone because these muscles also respond to emotional stress, like when you have high adrenaline, high cortisol, and then it responds to infection stress and physical stress like vibration and temperature, or somebody is working out in the sun all day with vibration tools at very physical stress on the body.

So somebody has a full-blown mast cell activation syndrome, they have to go through all the possible physical stresses, diet stresses, environment stress in terms of, you know, perfumes, smells, chemicals, cleaning products, you know, all those things that release solvents, actually, they are quite soluble toxins, you know, so it is going through all of it systematically and the diet is absolutely a big part because the GI tract surface is one of our biggest surfaces of meeting the outside world on the inside.

Dr. Ron Ehrlich [00:34:16] Yeah, you said that. And I think in case somebody missed that, I think that’s a really important point that we kind of think gastrointestinal tract right down to our anus is on the inside of our body, which clearly it is. But it’s the community, it’s almost like on the outside because as we put things in, it travels through us.

Dr. Christabelle Yeoh [00:34:41] Yeah.

Dr. Ron Ehrlich [00:34:41] And that that is something I think a lot of people don’t even really think about. In fact, you probably wouldn’t if you weren’t in this. But it has an effect, doesn’t it?

Dr. Christabelle Yeoh [00:34:53] Yeah. Because we put things in the outside well into our mouths and then it comes out at the bottom end and then and so the GI tract has got so many layers of needing to deal with all the possible toxicity we put into our bodies.

And of course, much of it is supposed to be the natural world, the natural world, the food we eat, that sort of thing, but we put so many things now that’s unnatural into our bodies, all the preservatives, and chemicals in our food. Yeah, too much alcohol, lots of unnecessary things.

And actually, a big part of treating mast cell activation is going right back to all the medications people take, even the supplements. You know, let’s say even if someone is trying to be all-natural and then they’re taking a lot of herbal tablets and multivitamin tablets and heaps of tablets, that tablets have got a lot of fillers in them.

So it’s going, OK, your system can’t do with so much, so many external fillers and additives and talc and so carbon dioxide and titanium dioxide, all the things we fill tablets in, so it’s cutting right back on. That’s not necessary.

Dr. Ron Ehrlich [00:36:22] So the supplements is another part of nutritional environmental medicine. One of the criticisms of supplements is, isn’t it the same paradigm as writing a prescription? You know, you’re just writing the supplement. How do you respond to that? How do you respond to the use of supplements?

How do you respond to the use of supplements?

Dr. Christabelle Yeoh [00:36:44] I think I do agree that some practitioners can certainly overdo supplements, and I’ve probably been guilty of that myself. And because there’s so many well, firstly, we’re prescribing supplements firstly, hopefully, that practitioner is doing it with good reason where, you know, you are using these nutrients to target these particular pathways that you want to up or down, regulate or support or maybe is for deficiencies you’ve measured or for methylation cycles you think are slow and you want to speed up.

So there’s lots of good reasons that we might end up with a huge shopping basket of supplements. And I would say a lot of the time maybe people are fine with that. But then the more we start to take, the more you have to be really specific and more targeted because you don’t want to take all the extra stuff like I alluded to before, that the supplements come with so that you want to minimize that. And then you also want to choose products that are as clean as possible in order to help you achieve your goal.

So many over-the-counter products are just packed with, you know, those hard tablets are packed with all sorts of fillers. And I wouldn’t use that in my practice at all. Usually, I would use very clean brands that have hardly any fillers, or I would compound things that have zero fillers, especially for these sorts of patients. For the average person, that is not so much of a concern, but that’s how I would gauge that what you were asking.

Well, and I think some people can overdo it, but sometimes we do have a good reason to want to overdo it. And therefore, we have to be very selective in the products that we choose and very often herbal substances, herbal mixtures are 20 percent ethanol.

It’s a lot of alcohol for someone who perhaps has a very weak gut or compromised an intestinal permeability, alcohol is not good for that. And certainly, mast cells react to alcohol and ethanol. And one of the things to cut right back when there’s a diagnosis of mast cell activation is alcohol.

Dr. Ron Ehrlich [00:39:15] Another thing is we hear about his detoxification. People hear I’m going on a detox this tor detox there.

What would you say to somebody who has heard that or is thinking about that? You know, what do you think, detoxification? How would you advise somebody to approach that? I mean, apart from obviously getting sound advice, what are some of the alarms or some of the things people should be aware of?

Dr. Christabelle Yeoh [00:39:43] So firstly, living in the world today in the chemical soup we live in, I think everybody needs to detox. But how much somebody needs to detox, I guess, depends on how ill and what chronic conditions they’ve got.

But if it was just a detox lifestyle, I’d say somebody is not too ill or not at all, I would say living on the world today, everyone needs a detox lifestyle, which is organic food, mostly, at least with the dirty dozen. So just avoiding chemicals when necessary, don’t spray your house with insect repellent and all that stuff is just a good old detox lifestyle by cleaning products, eco ecological products, organic food, meat that’s being raised well with no hormones and antibiotics and not a lot.

So that’s just the basic detox lifestyle for food and then sweating because sweating is the, when nature designed our bodies to get rid of that soluble toxins and then having good bowel movements because in that get rid of the toxins that the liver pumps up, drinking lots and therefore paying lots to get rid of the water-soluble toxins that the kidney would filter.

And then I would say that’s probably a minimum that people should be doing and of course, exercising with removing lymph and blood and sweating. And then from then on, there’s a whole grade of all sorts of additional detoxing, so I share with you some of the things that I get my patients to do.

Dr. Ron Ehrlich [00:41:46] Yeah, well, I think what you’ve just said there in terms of, you know, we’re exposed to this incredibly polluted environment. There’s no escaping it. But by making some informed decisions you can have, you are detoxing by definition. And then those other things that you’ve mentioned, you know, in terms of sweating and peeing and pooing, you know, great stuff but then it can get a little bit more, you know, give us some more. Let’s dove a bit deeper into the world of detox, not to suggest that this is what people should be doing because some of it needs to be done under supervision. But it’s interesting to touch on this a little bit more.

Dr. Christabelle Yeoh [00:42:26] Yeah, OK. So because I see a lot of people who are constipated and have motility issues that I recommend colonic hydrotherapy. It’s sort of it’s not just detox but assisting a problem and then allowing the system to detox. And I do recommend coffee enemas.

Dr. Ron Ehrlich [00:42:48] Right.

Dr. Christabelle Yeoh [00:42:49] So coffee up the bum. It gets absorbed into the intro hepatic circulation. So the blood system around the gut, it’s not like when you drink coffee and you get pumped up with it going around your brain. It’s a different kind of circulation and it upregulates glutathione production in the liver.

Dr. Ron Ehrlich [00:43:12] And glutathione, for those that may not have heard of it before, is?

Dr. Christabelle Yeoh [00:43:18] Glutathione is a really, really critical antioxidant and a molecule needed for some very important phase to pathway detox pathways in the body. So coffee enemas, I’d like to do that. And then certainly a lot of it not just sweating from exercise but going to sit in a sauna, probably be it a normal hotbox, albeit an infrared sauna, depending on what a person can tolerate. That’s how we choose the sauna selection and duration

Dr. Ron Ehrlich [00:43:56] Christa, hang on. With saunas, that’s an interesting one too, because, you know, 20, 30, 40 years ago, people would go into a steam sauna or something with hot rocks that they’d pour water onto, but infrared had become a lot more popular now. Why is that? Why infrared? What it was it about infrared saunas that’s better?

Dr. Christabelle Yeoh [00:44:22] I’m actually not sure that it’s a much, much better. The first goal is to sweat. And if a person sweats in the traditional, you know, saunas and can tolerate it, then that’s already very good. And that’s also like a heat therapy too.

But a lot of people can’t tolerate those as well. And that’s where then the infrared saunas have really been very popular because it allows people to sweat in a more tolerable manner. So for that reason, yes, and that’s better. But if at the end of the day, you just get a good sweat, whichever way you sweat, it’s not that one is better than the other.

The infrared frequency just transmits a particular wavelength frequency that has a vibration that then transmits heat internally and then that makes you sweat rather than get really hot from the outside in. So perhaps that’s more efficient, therefore, and that’s why it’s more tolerable.

Dr. Ron Ehrlich [00:45:29] I mean, it’s really important. I think this is great because it reminds people of something that they do all the time and don’t think about it. And that is, as you said, paying, pooing, sweating, a great detoxes.

Dr. Christabelle Yeoh [00:45:42] Yes.

Dr. Ron Ehrlich [00:45:43] Important detoxes. We sometimes and the coffee part of the enema. Let’s come back to that a little bit because that is something putting some liquid into the anus and allowing you to hold it for a period of time. It’s alright.

We’ve done a program called What Does Your Poo Say About You? So this is an important topic. I love to tell people you get a report card every day from your bowel movements. You should be looking at it listening to it. It’s true. So why coffee in an enema? What is it about coffee in an enema that is better than just, say, warm water?

Dr. Christabelle Yeoh [00:46:20] OK, well, because coffee is a plant polyphenol.

Dr. Ron Ehrlich [00:46:29] Right.

Dr. Christabelle Yeoh [00:46:30] And you’re probably aware of the research around cognitive decline, brain performance, in fact, that’s the most common drug around the world, coffee, as well, you know, I actually don’t drink coffee, but that’s what most people do to get going and function better at work. And that polyphenol has got some stimulant effects. And it’s quite good for the brain if you’re not abusing it, but using it to stay up all night, for example.

And the research shows that coffee is actually quite beneficial for brain function, cognitive decline, prevention, that sort of thing. So in the same but different sense. So this plant, polyphenol caffeine, if you put it up your bum and it gets absorbed through the bowel into the entire hepatic circulation, it’s carried to the liver, that polyphenol then stimulates the liver and the enzymes and it just does what polyphenols do.

They speak to our bodies different ways. The chemical mediators say, hey, do this, hey, do that. And the coffee polyphenol upregulates the production of glutathione.

Dr. Ron Ehrlich [00:47:51] Right. But without the stimulant, the neuro stimulant activity. So it’s not going to keep you up at night.

Dr. Christabelle Yeoh [00:48:01] For some sensitive people, it certainly can do because it might spill over to the right into the brain circulation.

Dr. Ron Ehrlich [00:48:10] Now, another thing that I think’s become really popular, and it’s ironic really because it’s been popular for millions of years, is fasting. Tell us, what’s your view on that? Does that have a role to play in our detoxification or in our lives in general?


Dr. Christabelle Yeoh [00:48:26] It really does. It absolutely really does. Because when we are eating, then metabolism in our mitochondria is focused on processing our food and dealing with the free radicals that come from it, the oxidative stress that comes from it, which is a normal part and parcel of energy production after you’ve eaten, that’s just normal.

And therefore, when you don’t eat, then our metabolism can change its focus into the fasting state of like throwing out its own internal rubbish. So first it’s like, OK, if I’ve eaten, then I have to go and feel the things out there, the food, energy production, the reactive oxygen species.

But if we don’t eat, then our mitochondria can take the time to then deal with its own internal cellular requirements, its own work, repair, regeneration. You know, it’s like putting the rubbish up. You can’t eat and put the rubbish out at the same time.

Dr. Ron Ehrlich [00:49:33] That’s good. Now, listen, I mean, we’ve given people a lot of food for thought here today. And I just wanted you to take a step back because we’re just going to finish up now.

I just wanted to take a step back from your role as a physician and clearly dealing with some very complex patient problems because we are all on a health journey together. And you may have already touched on this, but what do you think the biggest challenge is for people, for us as individuals on our health journey through life in our modern world?

The Biggest Health Challenge

Dr. Christabelle Yeoh [00:50:07] Is that one of those complex questions that you ask everyone?

Dr. Ron Ehrlich [00:50:12] I do and it’s quite interesting to hear people’s initial response to that without perhaps having given it a lot of thought.

Dr. Christabelle Yeoh [00:50:20] OK, well, so my response to that is probably not really anything to do with like, oh, avoid toxins or detox or the environment is toxic. I think that we live in such an amazing technological world and things are evolving at such a crazy pace.

I think it does come down to a lot of what you say, Ron, like your book [A Life Less Stressed: the five pillars of health and wellness], it comes down to managing stress, and I think a lot of the stress management, there’s absolutely the requirement of the physical looking after the body. So detox, eat well, sleep well.

But I think a huge amount of it is actually, how do you maintain balance and how do you keep up with this crazy world, technocratic world that we live in? Because we have, I think that with living in such a technologically advanced world where machines and computers and algorithms and AI can do so many things for us, what have we forgotten or what do we need to remember about our values, wisdom, common sense, things that have that lay deep in our culture and history? And I know you talk a lot about the food culture and the history of that.

So that’s just certainly one stream of an example that we’ve just gone nuts and we totally forgot how our culture and history taught us how to eat. And that’s certainly one stream. But that applies to everything, really, our choice in health care, our choices of relationships, businesses. Yeah.

So I really think that moving forward in the world today is actually questioning and revisiting what our values, where there’s wisdom and common sense come from, from our cultural, historical background and what’s true so that the word integrity means a lot to me, like what’s true to that, our past. And then, of course, what’s true to us from a spiritual perspective. And so finding our center and balance.

And I think that’s what’s important, because once we get that, then we get that for like our bodies, our health, our relationships, our families, and then our work. Yeah.

Dr. Ron Ehrlich [00:53:15] Well, what a night to finish on. And Christabelle, thank you so much for joining us today and sharing your wisdom with us. Thank you.

Dr. Christabelle Yeoh [00:53:23] Thank you, Ron, it’s been a pleasure. Thank you.


Dr. Ron Ehrlich [00:53:29] And what a great note to finish on and for us to be in touch with what is important to us in life, to feel centered, to look at not just the food we eat, but the relationships we have, the way we live our lives and feel there’s a sense of integrity and being centered in that process.

I love that. I love. I love asking my guests what they feel the greatest challenge is. And if they haven’t been paying attention, that question elicits some fantastic responses.

In fact, I think we’re going to do highlights of all the responses because there are just some real pearls, and Christabelle was one as well. And we’re going to have links to some of the wonderful material that Christabelle talks about and covers in her own practice, which is in the eastern suburbs of Sydney, GenBiome.

So we’ll have links to that. Look, we’ve got some great things planned. We’re building a whole wellness program. Don’t forget to download the Unstress with Dr. Ron app, Dr. Ron Ehrlich app, and that will keep you informed.

And of course, don’t forget to get on to iTunes and leave us some reviews, because that apparently is how one drives up the ratings and the coverage this podcast receives. So I hope you enjoyed today’s podcast. I hope this finds you well until next time. This is Dr. Ron Ehrlich. Be well.

Find out more about Dr Christabelle Yeoh and her work through the following links:


This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.