Dr Stephen Cabral – The Rain Barrel Effect

Dr Stephen Cabral, Naturopathic physician and qualified Ayurvedic practitioner joins me to discuss The Rain Barrel Effect. Stephen combines his years of training with a personal approach to healthcare to effectively treat the individual. Stephen brings to light ancient wisdom in a modern setting to help his patients get well, lose weight and feel alive again.

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Dr. Ron Ehrlich: Hello and welcome to “Unstress”. I’m Dr Ron Ehrlich. The rain barrel effect. Well, you will hear it. It’s a metaphor and your bodies are of the barrel but a bit of background before I introduce my guests. A personal approach to healthcare is where we’re headed, and I think it’s worth establishing a few definitions because you’re going to be hearing these a lot. It’s not just in this episode but in general.

Functional medicine. Now that is a term you will hear not just today but, in the future, and it refers to an individualised medical care that recognises the interaction between genetics and environmental factors and how they impact on the body’s interconnected system. As opposed to the way 90% of our current medical system works which is just focus on an individual symptom as being somehow separate requiring some sort of pharmaceutical intervention. A drug to manage it. Well, as they are not separate those symptoms your body is a whole that is W-H-O-L-E with a nervous system, digestive systems, circulatory respiratory immune lymphatic system, the connections between mind and body between the gut and the brain. It’s really a holistic approach to medicine. So, that is functional medicine. Nutritional and environmental medicine is I think pretty self-explanatory it incorporates nutritional and environmental factors that impact on an individual’s health. Incorporating knowledge of how those factors might impact on an individual and really uses a functional medicine approach.

Now integrative medicine is another term you hear, and it refers to the treatment and care of the whole person. Again, a partnership between patient and practitioners. That’s something that underpins a holistic view of health care. It’s a common denominator in all holistic approaches recognising the interconnectedness of the mind, the body and the spirit but it integrates therapies of conventional medicine taking the best of medicine with other practices sometimes referred to as complementary and alternative medicine. So, there’s another term. Integrated medicine really takes the best of Western medicine with other modalities like acupuncture, manipulative therapies meditation etc. And above all of these, whether it’s integrated medicine, functional medicine or nutritional and environmental medicine, all of these methods facilitate the body’s incredible innate healing response.

So, what about Ayurvedic medicine? Well, Ayurveda is a Sanskrit word that translates as the science of life. It’s the world’s oldest holistic healing practice, it’s around, well, that’s been around for thousands of years and it originated in India where the tradition is still widely practiced today. Ayurveda is based on the belief that everything in the universe is connected I like that idea because it’s true. We’re all connected so we’re all affected. And Ayurveda refers to the universe being made up of five key elements earth, water, fire, air and space. Remember this was well before quantum physics confirmed that every atom in the universe is both mass and energy but I digress.

According to Ayurveda, everyone in the universe is unique with each of us made up of a unique constitution dosha. I think it’s called dosha or body types and they referred to three doshas, pitta, vata and kapha. But it also recognises that it’s not as simple as that. Our constitutions are made up of all three to varying degrees. We each have a dominant dosha that determines our individual mind-body type. Central to Ayurveda medicine is the idea of maintaining balance. The key is following a diet and lifestyle that is best suited to your body type. Interestingly in the early 20th century Western medicine in a sort of a revolutionary move coin the term homeostasis which is pretty well what an Ayurveda medicine has talked about 5,000 years maintaining balance.

Now if you want him to explore your body type or dosha there will be a link in our show notes on my webpage right here at this point. It’s an interesting exercise but remembers we are all combinations of the three to varying degrees and if you’re really interested in pursuing this obviously consult a qualified Ayurvedic practitioner. That sets the scene for my guest today naturopathic physician Stephen Cabral. Stephen has spent literally thousands of hours not just studying but interning in various parts of the world and has clearly been influenced by the Ayurvedic principles. He consults both in-person and online from his clinic in Boston, Massachusetts. He’s had over 20 years of clinical experience, he is himself a prolific podcaster with over a thousand podcasts in the last three years and he’s the author of the “Rain Barrel Effect” which I will let him explain. I hope you enjoy this conversation I had with Stephen Cabral.

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Welcome to the show, Stephen.

Stephen Cabral: It’s great to be here, thank you for having me on.

Dr. Ron Ehrlich: Stephen, before we dive into some of the topics, wanted to cover today, I wondered if you could share with our listener your own journey which brought you to this point professionally, personally.

Stephen Cabral: Yes, so, for me it started right about when I was 17 years old or that’s when I thought that my journey into health started. But truly, I didn’t have the healthiest childhood I was on antibiotics and I was drinking Kool-Aid as a child eaten Little Debbie snacks eating fruity pebbles every morning, a lot of the processed foods which we know now aren’t the best for us with all those dyes and sugars and all of that. But at 17 years old I got extremely sick and it was at that point that my immune system started to dysfunction. So, I came down with a number of diseases that took about two years to finally diagnosed. I went from specialist to specialist and I ended up being diagnosed with what’s called Addison’s disease and so, your body stops producing cortisol, so you have no energy, your brain fog, fevers, joint pain swollen glands. And I had rheumatoid arthritis I type 2 diabetes and basically a host of other issues namely IBS and I had depression, anxiety, all sorts of different issues that the conventional medicine system had plenty of pharmaceutical-based drugs to provide to me that did help to mask the symptoms. But the more I took them and the more I began to read about them the less interested I was because of what it was going to do to me I found later in my life. And so, that’s where my journey started, and it led me on essentially a decade-long path getting my health back which now today I can honestly say more than 20 years later I feel better today than I ever have in my life.

Dr. Ron Ehrlich: Fantastic. Wow, what a list of things for a 17-year-old although sadly in this day and age that’s not so unusual, is it really?

Stephen Cabral: A lot of these adults-based diseases of the body such as rheumatoid arthritis and type 2 diabetes yes can absolutely happen now with teenagers. And I’ve seen it is young in my practice at 10 years old with a girl I’m working with rheumatoid arthritis and that should just never happen.

Dr. Ron Ehrlich: Wow, that’s quite a story. And what was its breakthroughs for you?

Stephen Cabral: So, the real breakthroughs for me and this was in the late 90s I met a functional medicine doctor, and this was very, very rare back then because the term hadn’t really been coined. So, what you were looking at were some integrative doctors who decided that they wanted to do something in their practice that involved more of a healthy lifestyle rather than just conventional medicine pharmaceutical drugs. And again, I want people to know that I’m not against pharmaceutical drugs in acute based circumstances where someone’s life is in jeopardy and of course then I believe in that without a doubt. But for chronic based conditions all, it’s really doing is masking the symptoms meaning if you were to ever come off the drug the disease would come right back.

So, I went to this doctor and he started to do specific labs that had never heard of before such as a saliva hormone test and a hair tissue mineral analysis and a food-based test from an IgG perspective and all of a sudden, I found out I was sensitive to a lot of the foods I was eating. They were healthy foods like almonds and chicken and then I did a saliva test and I found out I had a great imbalance of course with the low cortisol. That’s when I took it to my PCP and they tested for Addison’s disease use an ACTH test and they found that obviously then I could be diagnosed with this disease.

In the beginning, what I found is this in my practice is that everybody wants to know they want the diagnosis of what do I have but the truth is that the diagnosis is just to make you feel better and to be able to prescribe a pharmaceutical. Because a diagnosis of a disease is really a collection of symptoms and not a real disease. Meaning like yes, with rheumatoid arthritis you have joint pain of inflammation there’s an autoimmune issue but it’s not rheumatoid arthritis. I mean like what is rheumatoid arthritis? So, you’re looking at a symptom that we need to look at a deeper level. I began to go from one functional medicine doctor to another to make a long, long story short to finally meeting my mentor who combined Ayurvedic medicine with state-of-the-art functional medicine lab testing in genetics and that’s when I truly got better.

Dr. Ron Ehrlich: Well, I know that you have travelled through Sri Lanka and India and you’ve mentioned Ayurvedic medicine we’ve touched on it and a few of our guests have talked about it. Talk to our listener about Ayurvedic medicine, what were the things that you learned from it?

Stephen Cabral: So, for me and again especially growing up in that Western base science-based mindset it was hard for me to accept anything to do with our Veda or true whole Chinese medicine or the Constitutions of the body in the beginning and so I would read about it and then I would put it down I would read about it put it down but my mentor believed in it so much and I believed in her that I said okay I’m going to look into this more. And what I was a deep rabbit hole and realising that Ayurvedic medicine is the original form of medicine, not many people know this.

So, I went from Ayurvedic medicine to traditional Chinese medicine to a lot of the Egyptian forms of medicine and we have Native American medicine, but these traditions were all passed around originating with Ayurvedic medicine. And when I was over in India the biggest breakthrough was seeing all of the different pharmaceutical agencies there. I was all over India, but one places I was the foothills of the Himalayas. And what they were trying to do was actually look at the herbs because they know they work and then try to see which ones they can patents and to make into pharmaceutical drugs. So, when I saw that I said okay I said why don’t we just use the herbs that use the great vitamins and labs we have to help people get better.

That was amazing to see that herbs for sure they can help but in Ayurveda, one of the big things that differentiate it from a lot of the other forms of medicine is they do deep detoxification-based protocols in order to help people heal and that is what I found to be the biggest breakthrough in my practice. It is that we don’t live in a society. For most people this in this podcast where you’re really you don’t want for anything you have all the food all the herbs all the gadgets all of everything that you want and a lot of times the secret is actually removal rather than addition.

Dr. Ron Ehrlich: Yeah, look I’m going to get on to that because it’s another favourite topic of mine because I find that so interesting. I mean here is this ancient form of medicine what is it we’re going back 5,000 years?

Stephen Cabral: Five-six thousand years of recorded history right.

Dr. Ron Ehrlich: Yeah and their view at that point was detoxification was important. Boy, is that relevant in today’s world?

Stephen Cabral: More so than ever, right. So, they didn’t have the 77,000 man-made chemicals in their environment, yet we do, and they still believed it was important back then. So, if you thought it was important six thousand years ago it has to be paramount.

Dr. Ron Ehrlich: Yeah, and the other thing that I think distinguishes Ayurveda medicine and it’s so interesting for you to mention functional medicine because part of functional medicine is a more individualised approach to healthcare and Ayurvedic really identified at least three body types, broadly speaking I wonder if you could talk to us about those.

Stephen Cabral: Sure and that’s why I do believe you can combine the lab testing of functional medicine, not just blood work but the saliva that your and the stool the hair with knowing someone’s constitution you can basically know a person inside and out. And that’s why I believe that’s the future of Medicine. I truly do, a true integrative approach not just I mean don’t get me wrong I love functional medicine orthomolecular medicine with all the great vitamin therapy that we have but there has to be holding on to the roots of ancient traditions and they’re around today because they work.

So, in Ayurveda, they have three main body types just like you stated the vata, the pitta and the kapha. But within those, we have ten total subtypes. So, you can be vata, pitta, kapha. And we the thing is we all have a piece of all of that inside of us, but we lean more towards one main body type. And it’s fairly once you studied and don’t get me wrong this is quite in-depth it takes more than just an online quiz to look at it because I know that’s very popular right now, but I worry about that because then people just start to eat a vata diet or a kapha diet. And there is something that we know from modern medicine called the genotype versus the phenotype and it’s the same thing with Ayurveda. They have what’s called the Prakrit which is the genotype versus the very T which is your phenotype.

Now, what does that mean? Well, a genotype is how you’re born, it’s what your genes are but the vina the phenotype or your prakriti is actually what you are today because of your diet, your stress, your sleep, your lifestyle. So, you can’t always treat the individual based on their genetics. You have to actually treat them and I’m using that air quotes of how they are today while helping them then get back to their natural constitution.

Dr. Ron Ehrlich: Again, isn’t it fascinating that we are now learning about epigenetics, not just genetics which is the genotype? Or what was the Ayurvedic description of genotype prakriti?

Stephen Cabral: Prakriti, right.

Dr. Ron Ehrlich: But we’re also aware now that our environment, our thoughts out there that this affects the way the genes express themselves and that’s the epigenetic effect which is the phenotype which is the Vickrey. Wow, this is fantastic I mean this is all going back 6,000 years fast-forwarding to 2018 / 19 we’re so close but do go on. Yes, these subgroups.

Stephen Cabral: Well, essentially, we’re relearning what they knew 6,000 years ago and that’s why when we overlook ancient based medicine because we believe we have it all figured out today with our and again don’t get me wrong we have amazing technology. I mean I run lab tests every single day my practice. I probably read I would say I read somewhere between two and three hundred labs a week and with that I get amazing information what’s going on in someone’s side of someone’s body but I never discount a person’s story in their current situation and Vickreti their phenotype of where they’re at because that tells me a lot as well.

So, with the body types the easiest way to just start to look at them and differentiate it from a physical structure standpoint because there’s mental structure, the physical structure is that someone with a thinner joint structure meaning like they have very small calves, they have thin wrists, they have a long thin neck they have a more oval shaped face is more of the Vata body type. Those are the people they can eat all the carbohydrates and they never seen the beginning of the way. And then on the opposite side of the spectrum we have the kapha or the endomorph body type. Endomorph is are now like modern-day speak about it because again we’re just relearning Ayurveda. And so, with this body type it’s more of the round or shape face it’s more of the larger calves, it’s more of the larger wrists and ankles, it’s a stronger bone structure, it’s more robust. It does not mean overweight.

People mistake coffin with overweight. That’s actually not true, it just means a robot more robust structure that’s all. And everybody shape is absolutely fantastic now the thing is we just have to keep our weight to our proper weight.

A Vata body type ectomorph is going to be thinner. That’s okay, that’s great, they’re not going to have as much of a hit-based structure if they’re a female whereas the cop is going to have a little bit more hips. And again, both great. So, what we do is we have to understand that this person who’s an endomorph or kapha body type is not supposed to look like the vata body type if they do, they’re going to become very sickly. And if we get that vata body type to gain the weight of the kapha or just size-wise they don’t have the physical structure or frame or even digestive system to be able to hold that type of weight. So, when you look at that you can begin to have respect for each human’s body and not try to force them to be anyone body type.

Dr. Ron Ehrlich: Okay, well look you mentioned those three Vata, Pitta, Kapha. Can we just explore how those may affect how we should be eating, what sort of exercise our sleeping? How do those body types affect? You touched on a few things, but can we just sort of let’s can we start with one type and work our way through?

Stephen Cabral: Absolutely. So, the Vata body type is the type that I did say it looks better of a thin frame or just at least thinner. And they have typically thinner hands, thinner fingers but again you can’t just go by that. They’re a hallmark of the vata to body type though is if they’re not trying, they lose weight. So, what’s happened now you can be a vata-based right, so let’s say you’re for more for a kapha body type and you’re very, very stressed and you start to lose a lot of weight. Well, that doesn’t mean you’re a vata of body type it means you’re in a vata-based state. A higher stress catabolic state.

So, if you’re more catabolic like the vata body type that’s why there’s this hole and it’s really, it’s an issue of saying that everyone should be on a low-carb high-fat diet. And this is detrimental to the Vata body type that actually runs more of glucose. And the reason they run a little bit more of glucose and carbs and they do better with it is because they don’t put on a lot of fat in the first place so we don’t need to turn them in to this fat burner that we like to talk about but the truth is that when they eat carbohydrates it actually cuts cortisol. Carbohydrates are the only macro it’s the only food that does a good job at calming the sympathetic nerve system producing more dopamine and serotonin and serotonin namely and then reducing cortisol. So, the vata body type needs not as intense exercise more hatha yoga, walking more sleep than the kapha would and they need a little bit more carbohydrates.

Now it’s kind of easy to figure out the kapha because they are the exact opposite body type. So, they need fewer carbohydrates more vegetables as the carbs rather than starches such as sweet potatoes. Although some are not bad especially after a workout or some fruit in the morning, they need a little bit more rigorous exercise. And that’s because their metabolism is typically a little lower and slower. So, for them we need to rev up the engine where the Vata body type is pretty much always revved to rep they have a little bit more insomnia at night or can a little bit more anxiety where the endomorph or kapha body type can typically sleep pretty well at night. And so, vata body type more sleep and a kapha body type they can do a little bit less.

Dr. Ron Ehrlich: And pitta is that somewhere in between?

Stephen Cabral: It is somewhere in between. So, for the Pitta body type they are a very athletic body type, so they can typically put on a fair amount of muscle, but they stay lean at the same time. So, I did a show on this where actually did celebrity body types because everybody wants to know like what do these look like and the pitta body type is typically more of a muscular almost like it will at least here in America like a tight end in football or it might be like a wrestler, it’s more of like the more muscular kind of stocky body type. That’s at like a pure pitta but remember the pitta can swing towards the kapha or the vata. So, if you’re a pitta that tends to gain more weight while we need to do a little bit more of a vita-based routine rather than the kapha base routine. And if you’re a pitta that tends to lose more weight to become a little bit more catabolic well, we need a bit more carbohydrates than and a little less intense exercise.

So, each one has its pros and cons. Pitta more prone to inflammation, acid reflux, hair loss for men. The kapha more prone to sluggishness lethargy a little bit lower hormone in terms of the thyroid which can to a little bit more of that weight gain the more prone to type 2 diabetes, metabolism-based issues and the Vata more prone to bone loss osteoporosis, low blood pressure, light-headedness, burnout etc.

Dr. Ron Ehrlich: All right, that’s a great overview there because of course, we do hear about low carb. What do you think about low carb when we talking about vata as being more carb, being able to tolerate more carb? This whole more low and more carb is open to so many different variables. I know I was on the USDA site advice for healthcare professionals. I’d love to explore how the government advises us and I put in my weight and my height I didn’t put in they didn’t ask me about my whether I was Vata, Pitta or Kapha but it came up with a carbohydrate recommendation of between 350 and 450 grams of carbs a day which is in anybody’s language I think not even approaching low carb, that’s pretty high. If you were kapha and you were advising a patient to eat low carb what does that mean? And if you were a vata and you said you could eat more carbs what does that mean?

Stephen Cabral: That’s a great question.

Dr. Ron Ehrlich: Or do you still work in grams and have you worked in any way? Give us a quantity.

Stephen Cabral: Sure. And I what I do is I never have people fixate on counting calories or even counting grams. So, what we do is we do look at the type of food and then we’ll make adjustments at the six-week mark if needed because we need some actual data. So, everything, in the beginning, is going to be working on bio individualisation and its constant feedback. So, for the most part, carbohydrates should make up the majority of our diet however, what we want to do is qualify the carbohydrate.

So, for a vata when I say higher carb, I actually mean higher starch. I mean sweet potatoes, yams, yuca, some people do find with oatmeal rice ancient grains etc. So, for that body type since they don’t get, I mean you can I use glucometers, I use haemoglobin a1c testing. I use all sorts of different factors they just don’t get the blood sugar spikes that everyone talks about because they use that glucose because there’s sympathetic nervous system dominant and it just gets used up. Because when you start to basically get into a fight or flight your body used preferentially it uses glucose no it doesn’t use ketones in the same way. It doesn’t tap in a body fat because you need a fast fuel source in fat, it has a slower fuel source.

So, we’re going to be higher in starches because it also is easier to break down than a lot of the deeper cruciferous vegetables. Now, well, I still recommend broccoli and cauliflower? Absolutely but now let’s talk about the kapha. So, let’s just say each person should have about let’s say two-thirds their plate carbohydrates. Well, for the vata the majority of that may be easy to digest root vegetables such as cooked yams, cooked parsnips, cooked carrots, cooked celery. And then for the kapha it might actually be well it’s not going to be the starch but it’s going to be spinach and it’s going to be some green leafy vegetables and it might be some of the more raw foods if they’re digesting strong enough. So, what I’m doing is I’m still giving them about two-thirds, it could be more of their plate vegetables, but the type of carbohydrate is differ. So, for the kapha we have a low-calorie nutrient-dense carbohydrate versus the vata has a higher calorie still nutrient dense but easier to break down food. Does that make sense?

Dr. Ron Ehrlich: Okay, now, what about we hear a little so a lot about intermittent fasting and fat. What are your thoughts on that? And again, I guess it’s individualised.

Stephen Cabral: It is individualised but for the most part most people shouldn’t be doing a 16 hour fast from dinner to lunch the next day every day. And the reason is that everything could work in the short-term, but I don’t honestly like sure I want to help people get results right away, but I also want to help them live a long life and not have to deal with repercussions of that a year from now. So, what we see in my practice is people do we recommend a 12-hour fast to almost every individual.

So, that’s basically seven o’clock at night or two-three hours before you go to bed to seven o’clock the next morning. You’re trying to get in twelve hours now that’s part of our natural die phasic beam meaning when it gets dark at night we should stop eating. When it starts to get light, we can begin eating again. So, for some individuals that get a little bit more hypoglycaemic or they are more of the vata body type we absolutely do recommend breakfast. Anybody who’s going to spike the sympathetic nervous system spike cortisol, spike stress because of stress in the morning getting the kids ready or getting off to work or being stuck in traffic, your body once it gets into that fight-or-flight it’s going to use glucose no matter what. You don’t get to choose.

So, what happens is you get to choose if you’re not in a stress State that’s true but if you get into stress state it’s going to look to your liver for glycogen first to break down into glucose and then next it could start tapping into your muscle tissue and you can actually start losing muscle tissue and because you need more glucose and your muscle store lots of glucose. So, it doesn’t go just a body fat right away. So, for the most part, twelve hours overnight. I’ve seen men do much better with the longer 16 hours fast. For a lot of women, I think because of and I can talk about this if you’re interested but more for genetically based reasons and being able to carry on life and children that their thyroid starts to go lower.

So, we do a lot of adrenal and we do thyroid based testing and so their TSH starts to go higher and that means that they’re actually becoming a little bit more hypothyroid and so, they stop getting the great weight-loss benefits and they start to get a little bit lower mood and a little hold on to a little bit more fluid and a little bit more weight it’s harder to lose. So, it is individualised. Most people do great on a 12 hour but I don’t think that we should all be fasting until lunch and skipping breakfast.

Dr. Ron Ehrlich: And what do you think about in our annual over a 12-month period should we be incorporating a fast or some fasting into our annual routine somewhere?

Stephen Cabral: Besides that, every day for 12 hours?

Dr. Ron Ehrlich: Yes.

Stephen Cabral: So, that’s exactly right that’s what I recommend. So, instead of us doing a daily fast for 16 hours is that every week we could do a 24-hour fast. And this is something that I like to do on Mondays. So, typically on a Saturday I’ll have a nice we call it a flex meal but it’s basically the food that I want to eat that I don’t eat the rest of the week. So, I might have some pasta and I might have some bread things that I truly enjoy eating that I don’t want to cut out of my diet. Now that I’m healthy I can do that, and it doesn’t affect me.

So, I do that once a week I have a normal day on Sunday and then from Sunday night because I’ve dinner I’ve two young girls and we have dinner Sunday night and then on Monday, I just do a water-base fast or sometimes I just do a liquid shake base fast and I don’t have anything until dinner that night. And so, I still have dinner that night with my family, but I’ve gone 24 hours and that’s a great way to take advantage of this thing called the Tofu G which your body then when you’re on up new food coming in it goes around and its scavengers necrotic tissue, so basically dead tissue or cancer-based cells.

So, once a week is great and then even just once a quarter a 2-day to three-day we do a functional medicine detox but people may decide just to do hot water and lemon fast. Ginger tea fast or a green juice fast and I believe in all of those as well. And then the last one I’ll say is some people annually decide to do a much longer fast and that’s totally their prerogative if potentially supervised and if they’re healthy enough to do.

Dr. Ron Ehrlich: So, that quarterly fast is a 2 or 3 did you say? 2 to a 3 day?

Stephen Cabral: Correct. Yeah, we essentially do from Sunday night till Wednesday afternoon at lunch. So, we go all of Monday, all of Tuesday but we still get a half a day on Wednesday and a little bit of that night from Sunday. So, it’s almost three days but we start eating again on that Wednesday and we break the fast right there.

Dr. Ron Ehrlich: And how should we be breaking the fast when we do something like that?

Stephen Cabral: So, if it’s not a long very long fast. Now two and a half three days is starting to push it where you need to wake back up the digestive system. And one of the best ways to wake back up the digestive system is just with a little bit of soup or broth or you could do a little bit of fruit. And what that does is just starts to signal the body after not having eaten for the two days to start to bring back the digestive juices to the stomach whether it be hydrochloric acid and pepsin start to bring back the enzymes that’ll be released as well when the food moves to the small intestine. So, it’s more important that you do that when you do a week-long fast which I know not a lot of people will decide to do but that’s what it really matters. You need to take a day to two days to break that fast slowly with some broth and some fruit.

Dr. Ron Ehrlich: Fantastic. And another thing we hear a lot about is fermented foods. How should we be approaching that?

Stephen Cabral: I’m not the biggest proponent of fermented foods. And the reason is you have to be healthy in order to eat fermented food. So, the interesting thing that I see in my practice is we have an overgrowth of bacteria in the intestines called SIBO small intestinal overgrowth. And we have an overgrowth of Candida. Now, these can only be tested for on a urine-based test like an organic acids test and a stool-based test. So, what happens is and there this is very simple as to why it happens, we just most people don’t know about it they just know about it as some bloating excuse me some bloating some gas in suggestion, just feeling a little sluggish after meals.

Well, what happens is after taking antibiotics or birth control or alcohol or Advil, ibuprofen, tap water with chlorine and fluoride in it, all of these things begin to imbalance our gut microbiome and they begin to remove a lot of the good bacteria. Well, our intestines never stay sterile. That’s the one thing about them something will always grow. So, the candida will grow when you’ve taken antibiotics or any antibacterial and bacteria will begin to overgrow some of the more negative forms such as Klebsiella or E. coli overgrowth or even c-diff. And these need to be removed before we begin to populate with a lot of the probiotics that come along with fermented food.

Dr. Ron Ehrlich: Right. Well, that’s quite a proviso, isn’t it? That people’s gut should be in good health before they embarked on fermented foods because there are a few people out there with some digestive problems.

Stephen Cabral: And I would say the majority they did a lot of people just don’t even know, it’s just low-grade now but it is leading to other issues. But the easiest way to think about it is if you have a in your intestines your whole digestive tracts about 28 feet if you have an overgrowth of bacteria you don’t want to add more bacteria to it.

Dr. Ron Ehrlich: Yeah, yeah, and I think this idea that people just accept this some of the signals that bodies send us every day as normal I think we need to take a step back from that and reconsider.

Stephen Cabral: Without a doubt. And then maybe the fermented food could be great for them after that. And so, that’s why we always we never discourage it we just say are you ready for it and that’s all.

Dr. Ron Ehrlich: And what about bone broth? You mentioned it as a way of breaking the fast. What are your thoughts on bone broth?

Stephen Cabral: Bone broth could be a great source of easy to digest minerals, some vitamins in there and it’s really like an electrolyte-based tonic plus it contains, well, you can’t have it with some collagen depending on how you make it but the other part too is it contains glycine. Very high amounts of glycine. And glycine helps to work what’s called phase 2 detoxification of the liver, so it removes a lot of these toxins that we have.

Now it’s not the only thing in bone broth is certainly not going to be  the best detoxifier but it could be a very nourishing thing for the body a lot of people that I work with try to do a little less animal protein and that’s not of course not everybody but I’d like to stand biased and I can’t discount that bone broth is easy to digest, very high in nutrients and it could be very great with healing and sealing that digestive tract as well.

Dr. Ron Ehrlich: Fantastic, thanks for that. Now listen you’ve coined this phrase rain barrel effect. Can you explain that to our listener?

Stephen Cabral: So, the rain barrel effect is the title of my new book and what I wanted to do with that book is really explain to people that there’s always a reason why you might not be feeling your best. You’ve gained weight you’re not at your peak health or you’ve been diagnosed with some disease of the body or you’re not aging as well as you feel that you should be. And so, our bodies are essentially we’re in that state because of two reasons. One is we have a deficiency and it might be a B vitamin because we have digestive issues, we can’t break down all the great food that we’re eating so we can’t extract all those great B vitamins, so we can’t manufacture them in the intestines.

But the other part is that we can also have toxicities. And living on this planet for the last however many live how many how for many years’ person has been a lot alive is you pick up a lot of toxins. And the one thing that I’ve learned from Ayurvedic medicine and every form of medicine essentially except conventional medicine is that you need to take breaks throughout the year to remove a lot of these things that have accumulated. And that’s something that we never do. We never stop, we’re getting now into fasting which is a great thing but again in our Western-based mindset we always take fast so it’s like well, I can fast longer than you for more days and so it’s not supposed to be a competition, but it is supposed to be working with the natural mechanisms of their body.

So, the reason why I’m calling at the rain barrel effect and although I did not make up that term, I read about it many, many years ago in terms of allergies. Most people have low levels of allergies that don’t present themselves until they eat the food or springtime or fall time whatever it might be and then it’s the pollen from a tree or whatever it fills up their rain barrel and then it begins to overflow. Well, essentially a rain barrel collects water that comes through the gutters off a house. You never really pay attention to it until it begins to overflow. When it overflows that’s when you say all of a sudden, I have rheumatoid arthritis, all of a sudden, I have Addison’s disease or type 2 diabetes. Well, it was accumulating over the years. I had taken 3,000 capsules of amoxicillin for the previous three years before I got all these health issues. I was highly stressed, I was playing three sports, I was working a job after school.

So, all of these things were filling up my rain barrel and then all of a sudden, I got sick and nobody could figure out why. Well, if we look back, we asked somebody about their health history, not just well like okay well you’re poisoned or something like that you can begin to see how this progressed and it happens.

Dr. Ron Ehrlich: It’s so interesting, isn’t it? Because the question perhaps thirty or forty years ago would have been, have you been exposed to a toxin? And today the question isn’t that because we all are, we can’t escape it really. The question is how are toxins affecting your health? And how would we know that? What’s a starting point for people starting to deal with these toxicity issues?

Stephen Cabral: So, that is the part where genetics matters. So, our genetics they’re truly just hiding in the background and they wait for their opportunity the negative ones to express themselves in a way that we would rather not have. So, my genetics when my rain barrel did get full express them in terms of rheumatoid arthritis and type 2 diabetes. Now Addison’s disease is because I was, I truly burnt out my HPA axis or my adrenals meaning they would no longer produce cortisol or called glucocorticoids.

Dr. Ron Ehrlich: Hey, Steven for our listener, HPA hypothalamic pituitary adrenals?

Stephen Cabral: Exactly, correct.

Dr. Ron Ehrlich: Go on.

Stephen Cabral: It’s the signal that our brain talks to our adrenals to produce adrenaline or to produce cortisol. So, we talked about cortisol as that was a bad thing, but cortisol is actually a natural anti-inflammatory and it gives us our get-up-and-go. So, it’s not necessarily a bad thing we just don’t want to overproduce but we also don’t want to under produce because when you under produce you have constant joint pain. You can’t regulate energy it’s a terrible thing it’s basically like living with flu-like symptoms every single day of your life.

So, what we’re talking about that but that was from a different issue that was also for me taking 3,000 caps of antibiotic destroying all the mitochondria because yeah, people take antibiotics and think nothing of it but our body is essentially bacteria, our gut, all of our cells the thousand mitochondria or a couple of hundred mitochondria at least in every cell or bacteria. And all of these things that were taking antibiotics for a Lyme disease and for everything are affecting our mitochondria. So, we stop, we have fewer mitochondria, we could produce less ATP, so we have less energy. But besides that, in my genetics, all four of my grandparents had rheumatoid arthritis. Both of my parents had rheumatoid arthritis so that’s why my genetics when I filled up my rain barrel went right to rheumatoid arthritis because that’s in my genes. But for someone else it could have been Hashimoto’s, or it could have been MS, or it could have been any number of issues, psoriasis, but that’s not what it was for me.

So, again you can look at well what’s toxicity doing? Well, toxicity and I gave basically ten examples that I was talking about the book and that is heavy metals and its gut-based toxins and its stress and then it’s the phthalates and the plastics in the environment. So, there’s a lot of different ways we can be exposed. The average person walks out of their hosts being exposed to a minimum of a hundred and twenty-six cancer-causing chemicals before they leave the house. Shampoos, toothpaste, I mean it’s remarkable.

Dr. Ron Ehrlich: So, how do we establish this toxic load? We do need lab tests I guess and what do we need?

Stephen Cabral: So, you can absolutely do lab testing and that is available, you can do a simple urine-based test for environmental toxins so that’s an easy way to do it. It’s called well it’s just called a bi GPL tox. There’s another one which is a mould toxicity test and that’s also a urine-based test to test for a mould base tox and so a lot of people in their home right now and they don’t know if they have a mouldy damp basement and those mould spores move up through their living area or it’s behind the walls because of a water damage in the past.

So, that’s a big one we see in our practice. Another one is another urine-based test which is for candida overgrowth a bacterial overgrowth where your intestines are actually there’s an increase in permeability now, they’re naturally permeable but not to larger proteins or bacteria or yeast. But when they become more permeable those things can escape into the bloodstream and we can test for that with a urine-based test as well heavy metals could be tested with the hair tissue mineral analysis or also a urine-based test.

So, these are things that people can do right at home. They’re very easy to do and if someone says well, I don’t want to do the lab tests or I can’t afford the lab tests whatever it maybe you can also complete just a quarterly functional medicine detox where you’re giving your body the phase 1 and phase 2 nutrients that it needs to eliminate these toxins from your body. Now, won’t do that for Candida bacterial overgrowth but it will for the environmental toxins you’ve been exposed to.

Dr. Ron Ehrlich: And of course, the empowering thing, it sounds all very depressing when we hear about a hundred and thirty or whatever chemicals we were exposed to before we even leave the home, but we can make some decisions which can make a big difference, can’t they?

Stephen Cabral: Absolutely and that’s the thing these are people unknowingly using the chemical base shampoo and conditioner and toothpaste because there are very healthy alternatives. And so, there’s a great company called ewr.org and that’s the Environmental Working Group it’s a free non-profit organisation that you get to type in the product you’re using right now and actually see its toxicity score. So, I think they’re doing amazing work, I love promoting their work and because they are a non-profit and they’re just dedicated to helping people and educating them as to what products are more toxic than others.

Dr. Ron Ehrlich: Yeah, now, I agree I have that referenced in my book as well. Listen if our listener was wanting just listening to everything you’ve said today and if you wanted to leave our listener with a few tips to explore some of the things we’ve discussed, what would they be?

Stephen Cabral: My biggest thing is to if we’re focused on the issue of feeding the body the nutrients that it needs to do exactly what it was born to do, that’s eating a predominantly plant-based diet. So, low glycaemic berries and fruit, a lot of produce in the diet. You might not do well with raw salads but maybe you do better with the cook-based vegetables. But you can’t go wrong with a predominantly plant-based diet. I did a show called the only proven anti-cancer diet and I just went through all the medical research. There’s not a single study telling people to eat bacon or red meat or a lot of heavy foods in order to prevent cancer. There’s a lot of back-and-forth between people saying does it cause cancer or not? The question is we can keep going back and forth for the next 100 years or 200 years but what I found was this is that there’s no disagreement that brightly coloured fruit and vegetables helped to kill cancer cells and prevent cancer.

Since cancer is going to overtake all other causes of mortality by 2030, I think it’s something that we should focus on. And so, I would just love people to stick to organic produce sure you can have some meat you could have some fish you can have some eggs. I don’t have a problem with that. If we make the majority of our diet plant-based I honestly don’t believe that it matters too much if you do a little bit of meat or a little bit of fish or a little bit of these other types of fats because the majority is going to be high antioxidant enzyme rich food. So, big, a big proponent of that start your day with a smoothie or like whatever you can do. Even if you can’t eat all organic then choose the to buy organic for the Dirty Dozen or don’t eat the mud all and then if you need to for the clean 15 you might buy those more conventional based. So, do that and then do a quarterly functional medicine detox, run a couple of laps if you’re able to start to really invest in your own health and that’s a great place I think for people to start.

Dr. Ron Ehrlich: Right, now, listen we’ve almost come to the end and I just wanted to ask you this one last question. Taking a step back from your role as a naturopath, an author and an educator, what do you think the biggest challenge is for people on their health journey through life in our modern world?

Stephen Cabral: That’s a great question. I’ve never been asked that before. And I would say it’s the multitude of choice that they have. So, things were easier many thousands of years ago when you only had a handful of choices to make in terms of food and what you were going to do and what you could be stressed about. But now we have the ability to literally work 24 hours a day, we have a light that throws off of from our natural rhythm of going to bed when it’s starting to get dark a couple of hours later and waking up as it starts to get light.

So, the issue is always a choice. And so what I recommend that people do is especially as we’re moving into 2019 and we’re setting our new goals for ourselves is what are we going to do for this year. And I like people to set a course for themselves and it’s to focus on I’m going to create rules and philosophies for myself that I don’t break. So, for myself there are so many great foods that I would love to have all week long, but I know they’re not healthy for me and I know that I prize and really cherish the energy I have now that I would never be willing to give that up. And so, what I do is I say I’m not going to drink alcohol, I hardly do that anymore because of how bad I feel the next day.

But I’m going to not have any of the pasta in the bread and those types of things during the week. And what I’m going to do is set certain rules myself I go to bed by 10 o’clock, I wake up but basically before the rest of the world. I start to get too deep into this, but I do these things because it allows me that my quiet time in the morning so what I recommend to people is they basically set up rules for themselves that makes their life easier and this routine and these rhythms actually create freedom. So, you just say I’m not the type of person who uses all these different chemicals or these non-organic foods and then it makes your decision easy. You just don’t do that. So, I know it’s kind of broad-scope advice, but this allows people their freedom to take control of their own life and health.

Dr. Ron Ehrlich: Steven that’s fantastic and thank you so much for joining me today. We are going to have obviously linked to your webpages there are so many great resources you’re an incredible podcaster yourself and this new book that you’ve got “The rain barrel effect” and so much more. So, thank you for joining me today.

Stephen Cabral: It was my pleasure thank you very much for having me.

Dr. Ron Ehrlich: Isn’t it interesting to see how these ancient forms of medicine, this ancient form of medicine Ayurvedic has some important principles dating back thousands of years which are just as important if not more important or relevant today than ever before? The importance of balance is obvious, but it also recognises the importance of detoxifying. This was well before people were exposed to the literally thousands of chemicals, we are today not to mention Wi-Fi radiation. These are subject we’ve covered in several of our podcasts this year. You can search for environmental health and toxins on my websites podcast page. It also recognised again, perhaps this is obvious that we’re all individuals.

Something that a functional integrative approach to medicine is now championing. It also acknowledged that there were your genes, on the one hand, Stephan referred to this as prakriti and how these genes were expressed. Today we refer to it as epigenetics, how your environment, your thoughts, the nutrients you are exposed to cause your genes to express themselves. Fascinating, isn’t it? I’m definitely going to do a program on an evader next year. Stephen also used the word Autophagy and you may have missed that but it’s actually a really important point because Stephen and many of our other guests have talked about the power of fasting.

Autophagy is the natural regulated mechanism of a cell that allows for an orderly degradation and recycling of unnecessary or dysfunctional cellular components. Autophagy is a metabolic process occurring during starvation and certain diseases. Now I’m often asked if all stress is bad and the answer is no. Intentional stress is good, it’s called hormesis. We discussed that with Professor Mark Cohen. Its why exercise is good, it’s why a sauna or sweating is good. Its why fasting is good. You see if you are constantly eating three meals a day with snacks that are constantly eating. As almost every professional health organisation tells you to do and that’s a whole other story. You are constantly producing insulin which either puts glucose into the cell or stores excess glucose as fat. If you fast insulin goes down, it’s as simple as that and if you’ll know from so many episodes the lower the insulin levels, the better every health measure is full stop. We’ve done programs on heart disease cancer, autoimmune diseases. And then the body starts to burn when your insulin level goes down, your body starts to burn this fat. Fasting does that and also gives the body to clean up. That is Autophagy.

Now, remember if you are going from the standard diet of three meals a day and following the authorities a food pyramid plate or healthy eating guidelines going straight to fasting you will find very difficult. So, go low carb for a few weeks or a month or two before you start doing that. I also like Stephens approach to fasting. 24 hours once a week and every three months a two to three day fast. I mean wow, I’m going to be working towards that myself and it’s the theme we’re going to explore a whole lot more next year.

Look, we’re going to have links to Stephens websites, got some great resources. He’s a prolific podcaster is amazing and of course, his new book, “The Rain Barrel Effect”.

So, until next time, this is Dr. Ron Ehrlich. Be well.

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.


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