Episode 281

Ask the Doctors: An Exact Plan For When You Get Sick (+ How To Prevent It In The First Place)

Learn how to fend off and shorten the duration of oncoming colds and viruses and boost your immune system to keep from getting sick in the first place in this conversation with Dr. Will Bulsiewicz, Dr. Mark Hyman, and Dr. Aviva Romm.

Episode Show Notes:

Feeling an early winter cold coming on? There’s no worse feeling than knowing you’re about to be sick but not being able to stop the symptoms. Learn the methods to prevent and stop colds, flus, and upper respiratory viruses from Liz Moody’s conversations with three doctors: Dr. Mark Hyman, Dr. Aviva Romm, and Dr. Will Bulsiewicz. 

Dr. Bulsiewicz emphasizes the importance of taking care of your gut microbiome to maintaining your health, and he gives tips on how to make sure your gut is getting the nutrition it needs to keep you healthy. Dr. Romm discusses the importance of hormones and stress to your physical wellbeing, and how changes in these areas can cause changes to your health. Dr. Hyman gives his favorite early cold remedies and explains why they work.

  • 02:12 Dr. B on Gut Health and Immunity
  • 04:38 The Role of Butyrate and Fiber
  • 07:40 Daily Habits for a Healthy Gut
  • 11:50 Raw Garlic: A Natural Remedy
  • 18:01 Immune Support for Families With Children
  • 23:35 Dr. Mark Hyman’s Daily Health Tips
  • 25:54 Boosting Immunity: Vitamin E and Cold Prevention
  • 27:07 Immediate Remedies for Oncoming Sickness
  • 29:01 Lifestyle Tips for When You’re Sick
  • 32:13 Hormones and Immunity: A Surprising Connection with Dr. Romm
  • 34:41 Building Stress Resilience for Better Immunity
  • 38:20 Practical Tips for Preventing Illness
  • 43:04 Herbal Remedies and Natural Treatments

For more from our guests, you can find:

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If you like this episode, check out The Health Effects Of Alcohol Part 1: Gut Health & Cancer with Dr. Robynne Chutkan & Dr. William Li and The Health Effects of Alcohol: Hormones & Brain Health with Dr. Aviva Romm & Louisa Nicola.

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Formerly the Healthier Together Podcast. 

This podcast and website represents the opinions of Liz Moody and her guests to the show. The content here should not be taken as medical advice. The content here is for information purposes only, and because each person is so unique, please consult your healthcare professional for any medical questions.

The Liz Moody Podcast Episode 282.

Ask the Doctors:</b> An Exact Plan For When You Get Sick (+ How To Prevent It In The First Place)

Ask the Doctors: An Exact Plan For When You Get Sick (+ How To Prevent It In The First Place)

[00:00:00] LM: What are some connections between our gut health and our immune health that people might not be aware of?

[00:00:05] WB: When you have a healthy gut before you get sick, it makes it a lot easier to protect yourself while you’re sick and to recover after.

[00:00:12] AR: Those three things have actually been shown to reduce the frequency of colds and also the severity and how long they last.

[00:00:20] MH: You have to create a host environment that is resistant to infection. We take care of ourselves and we prioritize that, that we don’t really have to worry so much about these chronic infections.

[00:00:31] LM: Hello friends and welcome to the Liz Moody podcast where every week we are sharing real science, real stories, and realistic tools that actually level up every part of your life.

[00:00:41] I am your host, Liz Moody, and I am a bestselling author and longtime journalist. I am so excited to share today’s episode with you. It is very highly requested. I tapped three of the world’s best doctors from different fields to hear exactly what they do themselves when they get sick, what they recommend we do, and their best [00:01:00] advice for not getting sick in the first place.

[00:01:02] First up, we have Dr. Will Bolshevitz, or as most of us know him, Dr. B. Dr. B is an incredible gastroenterologist, he’s the New York Times bestselling author of Fiber Fueled, and he’s the founder of 38 Terra. Then we sit down with Dr. Mark Hyman, a functional medicine doctor, 15 times New York Times bestselling author, host of the podcast The Doctor’s Pharmacy, and co founder of Pulse.

[00:01:26] Function Health, which is revolutionizing medical lab testing. And then finally, if that wasn’t enough, you will get to hear from Dr. Aviva Ram, who is a Yale educated MD, who is also a master herbalist and the best selling author of seven books, including Hormone Intelligence. We are covering getting sick from all angles, and we are sharing so much little known information, and information that you will not hear.

[00:01:53] Dr. Rom actually shared insider info that she has about avoiding getting sick while traveling that I have never heard [00:02:00] anywhere before and that is towards the end of the episode. So definitely make sure that you stay tuned for that. We’ve got remedies, we’ve got recipes, we’ve got myth busting, we’ve got a ton of science and a ton of action tips.

[00:02:12] So let’s dive right in with Dr. B talking about all things immunity and gut health. Dr. B, what are some connections between our gut health and our immune health that people might not be aware of?

[00:02:23] WB: This may surprise people, but I actually think that your gut microbiome is the first layer of your immune system.

[00:02:30] So hear me out on this. Yes, we have an immune system. It’s not actually inside your gut. It’s right at the wall of the gut, which we call the gut barrier. But within the tube of your gut are these microbes. And they actually are defending and protecting you right now, and we know this because in moments where we destroy them, such as unintentionally when we need antibiotics, we put ourselves at risk for consequences such as an infection, and that infection could be a bacterial [00:03:00] infection, like a C.

[00:03:00] diff infection. Or it could even be a yeast infection. We know that many different forms of yeast infections, whether it be thrush in our throat or a woman’s vagina, vaginal yeast infection, these things tend to occur when we take antibiotics. So I would actually argue that our microbes are the first layer.

[00:03:19] And then I actually think that the second layer is our gut barrier. Our gut barrier is a single layer of cells that is designed to basically separate the intestines from where you enter into the body and the bloodstream. You can think of it a little bit like if we were in Game of Thrones and we had a castle.

[00:03:38] The wall of the castle would be our gut barrier. And we want that wall to be intact because then it, it keeps the invading barbarian horde outside of our castle and we’ll have soldiers and our soldiers will be prepared to defend our castle, our space, and they’ll be right there at the wall, right? And [00:04:00] that’s your immune system.

[00:04:00] I would actually make the argument that the gut barrier is the second layer. And of course we want the castle wall to be intact, like every invasion movie, not to be super nerdy, but in Helm’s Deep in the second Lord of the Rings movie. Yeah. Well, okay. Okay. I’m just kidding. Okay. I’m just kidding. I gotta finish it.

[00:04:16] I gotta finish it. So, but it’s like, look, if they can’t break the castle wall down, if they can’t get through, they would have never done anything. It all, all the bad stuff happens because they broke the castle wall down. We got to protect the castle wall. So that’s the second thing.

[00:04:29] LM: Can you give us one tip for protecting, for bolstering our castle walls?

[00:04:35] If we are coming into cold and flu season?

[00:04:38] WB: First of all, the most powerful tool for repairing and restoring the gut barrier is actually Butyrate. Butyrate is a short chain fatty acid. They are the most anti inflammatory chemicals that I’ve ever come across and they are produced by our gut bacteria when they come into contact with [00:05:00] prebiotic fiber or resistant starch.

[00:05:02] Those things come into the colon, the microbes actually transform them, they stop being fiber and resistant starch. And now they’re short chain fatty acids like butyrate and butyrate. You can think of these cells that are lining your colon and they’re held together by these proteins called tight junctions.

[00:05:21] That’s like the cement between bricks and butyrate is basically spackling that cement. Butyrate is basically making the connections between those cells and making it, fortifying it and making it strong. So to me, like you have to start there with 95 percent of America being deficient in fiber. You should start with the place that it’s like, Hey, here’s your greatest opportunity to transform your immune system.

[00:05:47] for cold and flu season. Start with that. So fiber, of course, comes from fruits, vegetables, whole grains, seeds, nuts, and legumes. And it’s not that you have to make that the entirety of your diet, but including those foods in your [00:06:00] diet is how you get an adequate amount of fiber that feeds and fuels a healthier gut microbiome and repairs and restores your gut barrier.

[00:06:07] LM: And would you specifically be looking for resistant starches like cooked and cooled starches or, what is it, asparagus, those woodier vegetables?

[00:06:16] WB: Alright, so the woodier vegetables tend to have things like inuin. From my perspective, when I think about plant based foods, when I say that, many people will hear, oh, well, the vegetable section and fresh produce.

[00:06:28] And to me, I want to open your mind to the fact that legumes and whole grains and seeds and nuts and of course fruit and vegetables, these are all excellent sources of dietary fiber. They don’t all have resistant starch. You will find resistant starch when you cook and cool starchy foods. Classically, the mashed potatoes that you crated and then you put into the fridge, those have resistant starch.[00:07:00]

[00:07:00] But also whole grains, legumes, when you cook them and then cool them. They will form resistant starch. Now that’s not the only form of resistant starch. You’ll also find it in green bananas. I mean, you’ll find it technically in potatoes, but you’re going to cook the potato. So ultimately you have to let it cool.

[00:07:16] LM: I love it because it’s such an argument for leftovers.

[00:07:18] WB: Yeah. Well, and have you ever noticed that some foods get better?

[00:07:22] LM: Oh, yes. Yes. The flavors marry more. I feel like it hits more. I don’t know. Yeah. A hundred percent. I’m such a leftover girly.

[00:07:29] WB: This is an example of the food is not exactly the same. There are changes that take place because you let it cool.

[00:07:34] And this is an example of one of the changes that takes place that’s kind of interesting and like great for your microbiome.

[00:07:39] LM: A hundred percent. I love that. Okay. What are some things that you do in your normal daily life to keep from getting sick?

[00:07:45] WB: So in addition to fueling my microbiome in the way that we described, it’s about adding diversity to our diet.

[00:07:51] I would say to the listeners, I’m not trying to say that you need to count the grams of fiber in your diet. I’m trying to say that you need to count the number of [00:08:00] different plants in your diet. So variety is key. That’s one of the ways. What else can we do? If the gut barrier is so important because ultimately when you have an intact gut barrier, then the immune system is actually protected and it’s able to actually like do its job more readily.

[00:08:19] So what are things that we know can improve the gut barrier? Well, one of them is fermented food, so fermented food because it has live microbes and also transformation of the protein and the fiber and vitamins because you get all these additional nutrients. There’s research that was published out of Stanford a few years ago.

[00:08:41] Where they found that just a few weeks of increasing fermented food in a diet actually added diversity to the microbiome. And this is not a surprise based upon what we’re discussing. Lowered inflammation. When you create a healthier microbiome, you lower inflammation. Okay. Boom. Fermented food.

[00:08:59] [00:09:00] Additionally, we can also exercise. So exercise has actually been shown to improve the gut barrier and simultaneously make the gut microbes healthier. So we’re sort of. going after the sections that we want. Vitamin D. I used to check vitamin D levels all the time, and of course this is in a population of people that have digestive health problems as a gastroenterologist, and they were almost always low.

[00:09:25] And I want people to hear something. It’s not just whether or not you take a vitamin D supplement. It’s also about the health of your gut microbiome. When a person has an unhealthy gut microbiome, actually their vitamin D levels drop. But one of the ways that we can support our microbiome is with vitamin D, which can come from light exposure or supplementation.

[00:09:46] During the winter, cold and flu season, in the majority of places, you’re not going to be walking outside and getting adequate sun exposure in order to build vitamin D. So that’s the time to be supplementing. How much to take depends on the [00:10:00] individual. I tend to take 5, 000 units. There’s no evidence that taking anything at 10, 000 units a day or less is problematic.

[00:10:09] I’ve never seen any evidence for this with the exception of some people may have a medical condition such as having kidney stones that you would have to be careful with that. So to me, 5, 000, the guidelines may say 2, 000. Sleep is another one that we can do. So actually let’s just tap into our circadian rhythm in general.

[00:10:27] When we get a good night’s rest, this helps to restore the microbiome. The other thing is, you and I have talked about this, that actually it enhances melatonin. And melatonin, which we get when we sleep, actually is good for the gut microbiome and also good for the gut barrier. But the fascinating part is that if you get morning light exposure, that morning light exposure creates serotonin and that serotonin gets converted 14 hours later into melatonin, which again [00:11:00] is good for the gut.

[00:11:00] As I paint this picture, I want to look at a person’s diet and look for opportunities to make some changes and elevate the quality of the diet, but I simultaneously want to look at your lifestyle and how you spend your day and try to create a daily habit. Where you wake up, you get morning light exposure, and that morning light exposure results not only in you having better days, but also deeper, more restful sleep at night.

[00:11:29] LM: What do you do when you wake up and you have a little bit of a sore throat, you feel a little bit low energy, you feel that sickness coming on, and you want to prevent it as much as possible?

[00:11:39] WB: A couple things that I do. First of all, if I haven’t been taking my vitamin D, I make sure that I start taking my vitamin D.

[00:11:44] I might, in that setting, even bolus it. That’s it. So I might start off with 50, 000 units to jumpstart. I actually have had great success with raw garlic.

[00:11:55] LM: Yay, I’m glad you said this. This is my go to remedy and I know there’s great research [00:12:00] behind it, but I don’t know if I’ve ever actually asked a doctor on my podcast about it.

[00:12:04] So go off on raw garlic.

[00:12:05] WB: Okay. First of all, the allium vegetables, like we’re talking about onions and garlic. are so good for our gut microbiome. And there’s a number of different aspects to this. Part of it is the prebiotics that they have, but they also have special phytochemicals, which means plant based chemicals, that shape the microbiome and are bad for the pathogens.

[00:12:25] LM: When I read this, I was like, mind blown that they essentially act like antibiotics except for they leave all the good bacteria and even nurture it, but they get rid of the bad bacteria. And I was like, this is incredible. Why aren’t more people talking about this?

[00:12:39] WB: Yes. So when your gut is in a bad place, let’s talk about dysbiosis, which is a damaged gut.

[00:12:44] Then what you have is you have too many bad guys and not enough good guys. And what we’re seeing here is that with raw garlic. You actually are feeding the good guys to make them stronger and simultaneously you are suppressing the bad guys with those natural phytochemicals that are not [00:13:00] the same as taking Cipro, right?

[00:13:02] It’s not the same. Like you’re not destroying the entirety of your microbiome. You’re targeting the bad guys though. They don’t like it. They’re uncomfortable. It’s so cool. Yeah.

[00:13:09] LM: It’s so cool.

[00:13:10] WB: There’s a hack. You probably know this Liz, but I want to make sure that your listeners know this. When we take our garlic, we actually want to release the full nutritional value of the garlic, and it has this chemical that it will create called allicin.

[00:13:26] In order to release this, you have to actually disrupt the food matrix, that means like chopping it or whatever it may be. What I do is, is a practice called chop then stop. I will chop my garlic and then I’ll walk away for 10 minutes. All right. So I cut it up into little pill sized pieces, whatever size you’re comfortable with in terms of like, you don’t have to chew it.

[00:13:49] You just swallow it.

[00:13:50] LM: Oh, you just take it like a pill.

[00:13:52] WB: I take it like a pill.

[00:13:53] LM: Oh, that’s so interesting. I make like a garlic toast on sourdough. So I’ll toast sourdough bread. I’ll chop my garlic. I’ll let it [00:14:00] sit for 10 to 15 minutes, and then I’ll put some olive oil in the bread. I’ll put the garlic on that.

[00:14:04] I’ll put a little bit of sea salt and then whatever dry herbs that I have around. And then I’ll eat that. But a pill sounds much easier.

[00:14:12] WB: Yeah. Well, yours sounds quite delicious. Now yours is still raw though, right? Like you’re not still raw.

[00:14:17] LM: Yeah. The, the bread is toasted. I find that the fat from the olive oil and the salt, it cuts the raw.

[00:14:22] I mean, it’s still an experience to eat it, but I find that it cuts it a little bit.

[00:14:27] WB: Yeah. I mean, I have a pretty hairy chest, and so I don’t know if I need to grow even more, but nonetheless, whatever way works for you, honestly.

[00:14:36] LM: No, I crave it now when I’m sick. I literally, the only thing I crave is this raw garlic toast because I’ve essentially Pavlov’d myself and to be like, this will make me feel better.

[00:14:44] But I love the idea of just taking it, as a pill. How many cloves do you usually do?

[00:14:48] WB: So, you know, these cloves can be different sizes, right? So to me, if it were like a larger size clove, I’d probably do three.

[00:14:56] LM: Okay.

[00:14:56] WB: Three, maybe four.

[00:14:58] LM: I do want to caution [00:15:00] people. And I’m curious if you would agree with this. I would not do it on an empty stomach and I would not overdo it because I have done that before and I’ve gotten a very intense stomach ache.

[00:15:08] WB: It can definitely do that. These types of vegetables like garlic and They actually are quite densely concentrated with A type of FODMAP. FODMAPs are the fermentable parts of our food that, by the way, are good for the microbiome. But for people that have your old bowel syndrome or gut issues, actually you can make them feel unwell.

[00:15:26] And these are called fructans. So, fructans are a broad category. You also find fructans in wheat and barley and rye. Yeah, so it could definitely do that if you overdo it, if you’re a person who has underlying gut issues. So, just be aware of that. And what I’ll do is I’ll, I’ll do this probably twice a day.

[00:15:42] LM: Okay.

[00:15:43] WB: And I’ve actually had quite remarkable results by doing this. All I know, because it’s, I’m experimenting on myself, right? All I know is that when I have a bad cold, it lingers. And sometimes when I do this, it just kind of feels like I had the sniffles for 12 or 24 [00:16:00] hours.

[00:16:00] LM: I love that. That’s amazing.

[00:16:01] Is there anything else that you add in when you are actively sick? So not in that preventing, I have a little bit of a sore throat, I’m trying to keep it from developing, but. I have a fever. I’m actively unwell. We’re doing the garlic twice a day. What else are we doing?

[00:16:15] WB: We clearly want to be actively hydrating.

[00:16:17] This is where like any sort of liquid based thing, but like I’m a big fan of broth in that setting. I like it to be a little bit warm. I find that it’s very nourishing and inviting to my body. I also am a big fan of ginger and turmeric teas in that setting, and they both have an anti inflammatory nature to them, both ginger and turmeric.

[00:16:34] Ginger is profoundly soothing to your gut, but it also, I think, helps to orient the immune system. in that setting. So I’ll definitely be doing those things. I’m actually of the belief that melatonin supplements can be a part of what we do within this context. And then the other thing I’ll add, I’ll add is zinc is interesting.

[00:16:52] LM: I got a lot of questions about zinc.

[00:16:54] WB: Yeah. So zinc is interesting. So back in 2006, I was an intern at Northwestern in [00:17:00] Chicago. I started taking care of people with complex liver disease who were like on a liver transplant list. And many of them get this condition called hepatic encephalopathy where they get confused.

[00:17:09] Well, here’s what’s interesting, Liz. We’ve discovered. That hepatic encephalopathy, where these people with serious liver issues are confused, actually is a gut microbiome issue. And the way that we know this is like, if you were to go to a doctor right now, they would probably start by treating you first with the antibiotics called rifaximin.

[00:17:28] All right. So antibiotics are the first treatment. The other treatment is one called lactulose. Lactulose is a prebiotic, meaning that it fixes the good gut bacteria. And then the third thing, this is what we used to do back in the day. This is not as common now, is we would use zinc. And I think that the reason why is because zinc helps to improve and restore the gut barrier.

[00:17:46] And I find it quite fascinating the data that exists around zinc, both zinc supplementation, or if you have something going on, for example, rhinitis, where like your nose is running, using zinc swabs can actually help [00:18:00] to shorten the period of time that you’re sick.

[00:18:01] LM: What is your best advice for not getting sick when you have kids?

[00:18:05] All of my parent friends are sick. Constantly, and it scares me as somebody who maybe wants to have kids in the future.

[00:18:13] WB: So this is complex because if your kids go to daycare, they’re going to bring stuff home and it’s almost impossible to avoid that.

[00:18:20] LM: And it’s like not thought of in a good way to just leave them out in the yard when they get home, you know, make a little tent.

[00:18:27] And then

[00:18:27] WB: they

[00:18:27] LM: never come in. Yeah. .

[00:18:29] WB: Uh, yeah. No, I don’t, I don’t know that that would be thought of in a good way, particularly in the wintertime.

[00:18:33] LM: Okay.

[00:18:33] WB: It’s hard because like inevitably this does happen and then it gets passed around the family and it can be quite miserable. Let me speak to our family, number one in a way.

[00:18:41] Like, I’m not gonna say that being sick, we should want to be sick. I’m not gonna say that, but in a way. Some exposure to these things is good for us because in a way, it’s our immune system having the opportunity to practice.

[00:18:54] LM: Okay, I have a question about that because I thought that was why kids do get sick so much because their [00:19:00] immune system simply hasn’t been exposed to all these things.

[00:19:02] But then I’m like, why are all of my adult friends who are, you know, parents getting sick too because hasn’t their immune system already had that exposure?

[00:19:10] WB: Our immune systems evolve in the same way that our microbiome is evolving during our lifetime. This is, I think, part of the reason why certain health conditions can be more common, such as certain autoimmune conditions can be more common at certain age points in our, in our lifespan.

[00:19:23] So it does vary. But the other thing to keep in mind is that Many sicknesses are viruses and they’re being transmitted through touch. So, and that gets easily disseminated when you have kids that they’re never washing their hands. They may be coughing on one another. They don’t cover their mouth. It’s getting on their hand and then they’re touching their friends, right?

[00:19:44] So it’s much more easy because kids are constantly doing this kind of stuff. Whereas as adults, we wash our hands, we cover our mouth, we, there’s certain things that are sort of like basic protections that we have.

[00:19:53] LM: Okay, so with your four kids at home, what are you doing to keep those things from going around your house all the time?

[00:19:59] WB: If I’m, I want [00:20:00] to sit here and advocate for people to enhance the quality of their diet and eat a higher quality diet, we have to pass this to our children. And in order to do that properly, you have to normalize. Eating healthy food when you normalize it, meaning this is the way that we do it in our house.

[00:20:16] And it’s just like, you’re not asking them to do something different. You’re just eating the way you always eat. When you do that, they don’t ask any questions. This is what they’re used to. They were raised that way. They ask questions when you normalize something else. And then you ask them to eat broccoli.

[00:20:30] That’s complicated. That’s really hard. So trying to maintain and ultimately as parents. It’s not easy, but one of the things that we have to keep in mind is that we’re the ones with the credit card. We’re the ones that determine what sits in the pantry. One of the things that I find actually quite deeply disturbing is it bothers me that in the United States, 60 percent of our calories come from ultra processed foods.

[00:20:52] Now, I am not sitting here pretending that I don’t consume ultra processed foods. I do. It’s just the overwhelming nature of it where [00:21:00] it’s dominating our diet 60%. That’s my issue. 60%. And the sad part is on our kids, it’s even worse. It’s 70%. Right? So going back to the beginning of this conversation, I said that the best thing that you can do To protect your immune system and make it strong is to heal your gut barrier.

[00:21:18] And the strongest thing that exists to heal your gut barrier is butyrate that we get from fiber. And 95 percent of adults are deficient in fiber and our kids are just as deficient, if not worse. We have to ultimately start with this. Because if we’re on a high quality diet from the very beginning, this is how we protect ourselves.

[00:21:37] And when you have a healthy gut before you get sick, it makes it a lot easier to protect yourself while you’re sick and to recover after. To me, it starts with these types of things. Beyond this, when someone’s sick, there’s a lot more washing the hands than usual. We have four kids, so we’ve had times where we have an infant at home and we will at times isolate for the infant.

[00:21:57] So when COVID was going [00:22:00] around, for example, if I tested positive, I would separate from my wife because I knew that sleeping in the same bed two feet away from her, I’m going to ultimately give it to her and then she’s going to give it to the baby. So it’s protect my wife and the baby and I’ll go to my separate part of the house and stay over there.

[00:22:18] LM: I’ve gotten COVID twice and my husband and I have isolated from each other and I’ve not given it to him either time, which I think is fascinating.

[00:22:26] WB: Those are some of the general concepts that we use in our house.

[00:22:30] LM: Love it. Are there any other immune support secrets that you want to share or myths that you want to bust?

[00:22:35] WB: You know, I think that the thing from my perspective is we all want like that cool protocol of like take these five things and like in super high doses and that’s going to fix all of our issues. And I think that the problem from my perspective is that we’re kind of losing sight of just the foundational basics.

[00:22:53] So let’s get back to those foundational basics of like a healthy diet and getting a good night’s rest and staying well hydrated and a [00:23:00] little bit of movement of the body and getting outside and getting exposed to nature. And let’s get back to that.

[00:23:05] LM: Love it. Well, Dr. B, it was a pleasure as always. I love our chats.

[00:23:08] WB: Uh, thank you, Liz. Thank you everyone for listening.

[00:23:11] LM: If you want more from Dr. B, you can listen to his other episodes of the Liz Moody Podcast, where we bust gut health myths, we dive deep into how to optimize our microbiome. I will link them in the show notes. You can also find more from him at theplantfedgut.

[00:23:26] com, where he has an amazing newsletter. And if you’re looking for ways to help support your gut, definitely check out 38Terra to get your daily microbe nutrition. And now we are going to jump in with the world famous Dr. Mark Hyman. Dr. Hyman, what are the things that you do in your normal daily life to keep from getting sick?

[00:23:45] MH: Everybody has kind of had the freak out of, oh my God, I don’t want to get sick, and understands the seriousness of getting sick. And of course, you don’t want to get a cold or flu. How do you prevent that? Well, you have to create a host environment that is [00:24:00] resistant to infection. So what can we do? The first thing is to eat a whole food, real food diet with lots of phytochemicals because nutrition really is important for your immune system.

[00:24:09] The second is to make sure you have adequate levels of nutrients that fight infection. Vitamin D levels should be over 50 nanograms per deciliter. Most people are under that. over 80 percent of people are under that and that is really easy to do by taking a vitamin D supplement to get your level up and you need to test and that’s why I created Function with my co founders FunctionHealth.

[00:24:29] com where you can actually check all your levels. The third thing I do is make sure that I get enough sleep because when you don’t have enough sleep your immune system is suppressed and so getting eight hours sleep, good sleep is really important. exercise also, not over exercise, but exercise does boost your immune system incredibly well.

[00:24:48] And that, and that’s important for keeping healthy. And there’s other things you can do, like meditation and relaxation, because we know, for example, if you inject a cold virus into somebody’s nose, if they’re stressed, they’ll get a cold. [00:25:00] If they’re not stressed, they won’t get a cold. You literally, we’ve done these experiments where you just inject the virus directly into the nose.

[00:25:04] And it’s not everybody who gets, you know, exposed to illness will get sick. And the last thing is there’s kind of fun techniques you can do if you can get access to it. Like a sauna, for example, will up regulate something called your innate immune system that boosts your immunity. And so that’s really an important thing to make sure you have access to that.

[00:25:20] If you can, I think it’s almost a fundamental life, life thing to have a sauna, but it’s hard. You can get a sauna blanket, but you can go to your gym, but. Saunas are great because they boost the innate immune system and cold plungers too. And then also there are nutrients besides vitamin D that are really important, having adequate zinc and vitamin D and selenium.

[00:25:36] And then lastly, if you really want to become more resilient, there’s a whole cocktail of Chinese herbs. They’re very helpful with boosting immune function. I’m not affiliated with this company, but Host Defense has a great one, uh, and there’s a number of ones out there that you can use, that I use in my practice, that are very helpful for helping people become more stress resilient.

[00:25:54] And they don’t get sick. So people say, Oh, I’m getting sick all the time. I always get a cold. I put them on this regimen and they almost never get sick. [00:26:00] And I don’t remember the last time I had a cold.

[00:26:02] LM: Is there anything that you If you’re coming up on cold and flu season or your patients are coming up on cold and flu season, is there anything that you have them add in or they’re going to have a lot of exposure?

[00:26:13] Is there anything that you have them add in so that they can have more protection during that time?

[00:26:18] MH: Yeah, I mean, if there’s one thing, I think it’s getting your vitamin E level up over 50. They’ve shown that if your vitamin E level is over 50, you will reduce your risk of getting the flu by 75%, which is more than the vaccine.

[00:26:30] So this is a treatment that literally is It’s very safe. It costs literally pennies a day, has no side effects, that has many other benefits that you can do. And the way you need to know how to do that is you need to test your levels, because some people might need a thousand units, some people might need five thousand, some people might need ten thousand to get to a level over fifty.

[00:26:52] And so the best way to do that is to test, and again, that’s why I co founded Function Health. To allow people to get access to their own lab data, it’s a really simple membership model for [00:27:00] basically 1. 37 a day. You get twice a year testing, including vitamin D and a whole host of other things that are important for your immune health.

[00:27:07] LM: If somebody feels like a tickle in their throat or they feel that really run down feeling where they’re like, Oh no, I’m going to wake up sick tomorrow. Is there anything they can do in that moment? What is my trick? Yeah.

[00:27:16] MH: Yeah. I’m pretty sure. There’s a few hacks that I have. One is five days. of, and it can’t be more than five days, but five days of 50, 000 international units of vitamin A and a vitamin D3.

[00:27:30] So two separate things. As soon as you feel that little twinge of, I’m think I’m getting sick, just immediately have it in the house and go take 50, 000. Can I ask you about that?

[00:27:40] LM: Cause I have this idea that vitamin A is quite toxic to us in heavy doses. Is that wrong?

[00:27:45] MH: Yes, correct. No, it’s not wrong. If you, you know, in fact, the way the, the Inuit up in Alaska used to kill the early settlers was they feed them polar bear liver, which was super high in vitamin A and they would die from vitamin A poisoning.

[00:27:59] [00:28:00] So you can get sick from it, but five days is fine. Okay. Five days is fine. And that’s why I said five days. I also take obviously about one to 3, 000 units of vitamin D, make sure I have really like 30 to 60 milligrams of zinc. Also I’ll take adaptogenic herbs and I take a cocktail of things like reishi and cordyceps and a number of other herbs.

[00:28:20] herbs that are in a cocktail. And, and also if I feel like I’m sort of really getting sick, I’ll get a product that I like, which is Super Echinacea by Herb Farm. Again, no affiliation. It’s liquid. It’s kind of strong tasting, kind of burns the back of your tongue a little bit. And I, I basically almost drink a whole bottle a day.

[00:28:35] Like I’ll just have a teaspoon every maybe four or five times a day. That really helps to reduce your risk. Now there’s peptides out there that are quite amazing. Like if I miss an alpha one and L37, which are harder to get. There are things that are really prescribed by a doctor, but they, they’re really great to have around.

[00:28:50] And they’re a little tiny injection you can give yourself, my assistant. Was getting sick the other day. I gave her a couple of shots in one day and she didn’t get sick at all. So that’s a that’s kind of a little more [00:29:00] advanced trick, but that’s a great thing to do

[00:29:01] LM: when you are sick Is there anything that you recommend doing or not doing like should we be moving our body?

[00:29:06] Should we be laying all day? Should we be getting outside exposure? Should we be staying inside? What’s the vibe? Yes

[00:29:12] MH: Yeah, I mean you want to nurture yourself getting more sleep than you would normally get making sure you’re eating eating healthy and make sure you do a little bit of exercise walking.

[00:29:21] Also saunas and cold plunges can help with the immune system. And then in terms of diet, I have a, my kind of cold soup, I call it. You can make like chicken soup. You can put a straggler sticks in there from Chinatown. You can put ginger, garlic, shiitake mushrooms. You can sort of make this This sort of chicken soup, but you can also do a tea, which I make, which is a little bit intense, but it really works.

[00:29:42] What you do is you take a ginger, you slice it up, like probably a good finger long stick of ginger and you slice it up thin and then you boil it in water for like 10, 15 minutes, just really get it boiled up. And then you take a big jar mug. So you want like 16, you know, 24 ounces. And you crush a [00:30:00] clover to a fresh garlic in it.

[00:30:02] You put in a little bit of honey, a whole juice of a lemon, and a little bit of red pepper flakes. And then you pour the ginger tea on top of it, let it steep for a few minutes, and then drink that. You won’t have any friends because the garlic will make your breath smell, but it will help you get better so much faster because garlic, ginger, and the chili peppers all really help boost your immune system.

[00:30:24] So that’s, that’s kind of another trick. And I’ll sip on that all day.

[00:30:27] LM: I love it. And just to clarify, it’s okay to sauna and cold plunge while sick because I always thought of them as preventative, but when you’re sick, you shouldn’t be stressing your system out?

[00:30:37] MH: No, actually, saunas and cold plunges are great when you’re sick.

[00:30:40] They both help stimulate immune function. And if you feel like cold plunge is too much of a stress, you can just do the sauna. That can really help a lot because that boosts your innate immune system, which is not antibody regulated, but just your general overall defense system. And that, that can really help that.

[00:30:55] LM: Okay. Amazing. Are there any other immune support secrets that you want to [00:31:00] share or myths that you want to bust?

[00:31:02] MH: I think I gave you most of my secrets. I mean, there’s, there’s certainly a, you know, I give you all my special cocktail of stuff. I take, I gave you my special team, my special soup. I think I gave you a lot of the hacks.

[00:31:14] I think people are often not aware of how important it is to keep this amazing gift of a body we have. Resilient. And that’s why I sort of talked about this idea of how do you keep your host healthy? Because by the way, not everybody who got COVID got sick. Not everybody who got COVID got very sick. And so why is this their larger ability in the population?

[00:31:36] It’s because of the health of the person who got COVID. the disease. We really can understand that if we, we take care of ourselves and we prioritize that, that we don’t really have to worry so much about these chronic infections.

[00:31:48] LM: Amazing. Well, thank you so much, Dr. Hyman. I really appreciate you sharing your wisdom.

[00:31:52] MH: My pleasure.

[00:31:53] LM: If you want to hear more from Dr. Hyman, you can find him over at his podcast, The Doctor’s Pharmacy, or at Function [00:32:00] Health, where he is working hard to make Thank you in depth lab testing available to anybody who wants or needs it. And now last but certainly not least, let’s hear from the absolutely wonderful Dr.

[00:32:11] Aviva Rom. Are there connections between our hormones and our immune systems that we might not be thinking about?

[00:32:18] AR: Yes. Okay, this is crazy wild. Probably if you think back, most women can say, Oh, like I do get more colds right before my period, or I do feel a little like. more vulnerable and susceptible. And it’s a real thing.

[00:32:35] So as those hormones go down, as estrogen and progesterone go down, it is actually having an impact on various aspects of our immune system. Our white blood cells, our natural killer cells, our immune TH1, TH2 balance, that’s what we’re all of our inflammatory markers. Actually, the immune ones go down, the inflammatory markers go up.

[00:32:56] So we feel more inflamed. We’re more susceptible to getting sick. [00:33:00] Also, we know that women who have autoimmune conditions are more susceptible to flares premenstrually. postpartum and in menopause because there are immune protective effects. Like our immune system talks to our hormonal system, talks to our nervous system, they’re not these separate compartmentalized things.

[00:33:24] So absolutely. major connection between immunity and hormones at different various life cycle phases.

[00:33:32] LM: Okay. I have always wondered this because I definitely do feel like I am more likely to get sick before my period. So what can we do about that other than just like be a hermit right before we start to menstruate?

[00:33:43] So

[00:33:43] AR: the main things we can do are one, just try to do everything we can to stay well rested. Did eat the foods that help protect our immune system, keep our inflammation healthy with our diet and with movement and sleep, all the things that can help keep that immune system regulated, [00:34:00] reducing stress.

[00:34:00] There is a huge connection between stress and immunity as well, so it’s really fascinating when we think about the word resilience. What is the word resilience have to do with two things, immunity. and mood energy, right? Like we’re more, we’re more emotionally resilient and we’re more immune resilient.

[00:34:19] And there is a deep, deep connection between the two of those. So the more we move toward a high stress or subtle chronic burnout phase of like our cortisol rhythms and our health, the less resilient we actually are. So we’re just burning ourselves out on a lot of levels and our

[00:34:41] How can you build stress resilience? And I think That is easier in some ways than thinking about reducing stress, because some of the stressors in life are kind of fixed, where like it’s shocking how much it costs to rent an apartment or buy a house right now, especially if you’re like a millennial, forget it.

[00:34:57] It’s so overwhelming. Groceries are insane, [00:35:00] floods and fires and global catastrophes, and you can’t just like mitigate all of that. But what we can do is try to build resilience to how we respond to stress. internally, and the things that we’re doing in our lives to buffer ourselves from stress. All of those things are going to help our immune system across our cycles.

[00:35:23] The other thing to think about is the more dramatic your hormone drops are, the more susceptible you are to these immune dips premenstrually and menopause. So let’s say you have really high estrogen, you’re getting, you’re producing or getting more estrogen from the environment than is optimal for you.

[00:35:46] Or let’s say you’re not ovulating and producing more progesterone in the second half of your menstrual cycle, in your luteal phase. That big drop in estrogen may predispose you more as a person, [00:36:00] not you Liz, but listeners, or either of us too, to susceptibility to getting sick or to having more inflammation.

[00:36:08] And then also if you’re not producing progesterone during that luteal phase, which acts as kind of more of a buffer to stress, and then that also drops, that can trigger. So you want to have relative hormone health to help prevent those risks. So no, you don’t have to be a hermit.

[00:36:26] LM: Okay, I do need at least one good tip for building our stress resilience though.

[00:36:31] AR: Okay, it’s easy to say get better sleep. More sleep and better sleep absolutely builds our resilience. Healthy diet, good blood sugar balance builds our stress tolerance, and it’s not dinging our stress response and making it worse. But I do really think that nature, fresh air, and exercise as a combination, so the nature exercise combination is probably the best thing we could do for our hormones, our mood, our immune [00:37:00] system, our resilience.

[00:37:01] I mean, it’s just like, it’s really hard to be stressed out. When you’re taking a walk in nature and you start to pay attention to the beauty around you, it kind of starts to de escalate our stress. I know for me that when I get somewhere beautiful, like I see a beautiful vista, or, you know, if you can get to the ocean or you can get to a mountain even better, but even if you’re just walking in the city, I think we start to feel like We’re part of something bigger and it takes the attention off of our own problems quite as much and it helps us to regulate a lot.

[00:37:36] So that’s a really huge thing that you can do to build resilience. The other thing is I just think spending time with people who make us laugh, who make us smile and who we feel really safe and comfortable around. That’s huge. And it’s not just that, but we know that that helps us produce more oxytocin and that also builds stress resilience and immune resilience.

[00:37:59] Getting with a [00:38:00] girlfriend or a guy friend, a they friend, whoever it is that you love being around, good laughter, I think is so important. I mean, there’s nothing more than I love when I’m feeling stressed than watching some just stand up comedy, even if it’s like 10 minutes of watching Maya Rudolph doing something or, you know, Watching an hour of a good stand up.

[00:38:20] LM: What if we’re in one of those seasons where it feels like everybody around us is sick, or you have like big travel coming up, you have a big event coming up, is there anything that you’re doing to ensure that you’re protecting yourself a little bit more during those times?

[00:38:32] AR: Yes. Okay, so one thing is gonna sound so basic, but okay, it’s two things really, but they’re interrelated, you’ll feel me on this.

[00:38:40] Don’t shake hands, give hugs. Give a side hug. Side hug, it can be a little mm mm, you know, mm mm, off the cheek, not on the cheek. Because the minute you shake hands with someone, human beings, we touch our faces like 300 times a day. Actually, it’s bizarre, but we do. And every time you shake hands, and then you rub your eyes, or you rub [00:39:00] your nose, or you put your food in your mouth, you’re basically self infecting yourself with everything you’ve touched.

[00:39:05] So, hugs instead of handshakes is a big motto for me. And then the part that makes sense that goes with it is wash your hands, wash your hands, or use some alcohol hand sanitizer because it’s, there’s something called fomites. It’s when viruses and stuff are living on doorknobs and elevator buttons every couple of hours.

[00:39:25] Or if you’ve had a lot of contact, you’re not sitting at your desk or at home, sanitizer, go to the bathroom, soap and water, sing the happy birthday song once or twice. That, in and of itself, can be huge. Sleep. Staying hydrated is really important because when your mucous membranes get dried out and irritated, you’re more likely to actually pick up viral infections.

[00:39:50] Similarly, have a humidifier in your home. There are studies that show that you can reduce transmission of viruses as much as 70 [00:40:00] percent by just being in an environment that’s more humidified. And that’s for the same reason. Those respiratory passages stay more nourished, more moist. They’re healthier.

[00:40:10] They’re not irritable, cracked, et cetera, et cetera. So you’re actually more immune protected. Those are just like high level tips. We also know that taking vitamin C, it doesn’t have to be a lot, like a thousand milligrams a day. Zinc, it doesn’t have to be a lot. It can be like 30 milligrams a day. Quick tip on that.

[00:40:28] Make sure to take it with food so it doesn’t make you sick to your stomach. And a probiotic. Those three things have actually been shown to reduce the frequency of colds. and also the severity and how long they last, the duration. These studies have been done in different populations that don’t necessarily relate to everyone, so like high intensity athletes, elder people, and children, actually.

[00:40:50] So there’s no reason it wouldn’t relate to all the rest of us, too. And then, if you want to go another level, because you’re somebody who does get sick more often, I would say [00:41:00] It’s a good thing to explore why, what’s going on, that every September you get this respiratory infection. I can’t tell you how many women have come in like, every September I get a respiratory infection, then it turns into a bad cold, then I get pneumonia, then I’m on an antibiotic, like the whole thing.

[00:41:15] If that happens to you, that’s a good time to see someone in May so they can start. I do this all the time. Start helping someone get ready, but you can use things like echinacea to support your immune system, and it has been shown to help prevent colds. So I’m a big fan of that. Um, changing your diet seasonally so that you’re not eating as many sugary things, or in the summer, you know, there’s the more ice cream and the things like that.

[00:41:42] Kind of switch to more seasonal foods that are more warming. during that transitional time when the weather gets cooler and everyone’s getting sick. Those are kind of like basically the high level things. Weirdly, drinking hot tea, the studies have been done on green tea, particularly so drinking hot [00:42:00] green tea because we’re breathing in that moisture but also maybe some elements of the green tea, has also been shown to help reduce colds in cold and flu season.

[00:42:10] So that’s another thing you can do.

[00:42:12] LM: Yeah, I read that tea study a while ago, and I don’t think this is the mechanism of action, but I do picture it kind of like going down my throat and kind of like scrubbing off any viruses that I’ve been exposed to on its way down.

[00:42:24] AR: Love it. I think about the tea. I think about the steam, like moisturizing.

[00:42:28] It’s like doing your own head steam. You’re doing a steam facial, and then you are getting all of those little volatile essential oils from the tea that can be protective too. So I think that’s a nice little one that you can do.

[00:42:40] LM: Okay, follow up questions on that. I’m afraid of humidifiers because I feel like I’ve heard so much about the negative impacts of mold exposure.

[00:42:47] How do you think about those two things?

[00:42:49] AR: Yeah, if you keep your humidifier clean and use cold water in it instead of hot water.

[00:42:54] LM: But it’s not going to like make my walls more likely to get? No, I mean, unless your

[00:42:59] AR: house [00:43:00] is already damp or something like that, it should not make your space moldy. No.

[00:43:04] LM: Okay. And then you are an herbalist.

[00:43:06] You mentioned echinacea. Are there any other herbs that you like either to prevent getting sick or in that day where you like wake up, you feel scratchy throat, you feel like you’re getting sick or when you are like full blown sick?

[00:43:19] AR: Yeah. Interestingly, adaptogens have some nice studies on them that can help prevent frequency and severity of colds, but especially really our susceptibility.

[00:43:30] It really is much more about preventing susceptibility. And what a lot of folks don’t know is that medicinal mushrooms as a whole are adaptogens. So you can use the adaptogens like ashwagandha, holy basil. Those are great. But you can also use medicinal mushrooms like shiitake, reishi, cordyceps. Those are wonderful immune boosting tonics.

[00:43:53] And so you can use those. preventatively. So I would add that to my list. There’s another herb called [00:44:00] andrographis, which can be used preventatively. There are some Chinese herbs like astragalus that are used preventatively. I love those. You can get blends that are made for that. And I love medicinal mushrooms for immune support and you can get them in capsules, tinctures, coffee and adaptogen blends and put powders in your smoothies.

[00:44:17] There’s lots of different ways to do it. When you do start to feel that little, I know that feeling like that. Uh, Is this just my throat’s dryer? Am I getting a scratch? I hate that. Like, uh, you know, often you’ve noticed you’re feeling a little tired for a couple of days. The typical time that I’ll find that happening is like if I’m taking a plane trip and there’s a lot of air conditioning and it’s cold and flu season doing all the preventative things.

[00:44:39] While you’re traveling can is especially important if I do feel that feeling the first thing I do is I really simplify my diet so I go to like me so soup broth chicken soup steamed vegetables and brown rice like some steamed kale some steamed squash or sweet potatoes or carrots like something [00:45:00] green and orange for all that vitamin a that’s when I would say a hundred percent if you drink alcohol if you’re putting milk in your coffee dairy sugar, juice, take all those things out just for a few days.

[00:45:13] Okay, if you can’t live without your coffee, I get it. But you know, don’t go cold turkey, but all the other things, yes, take them out because those things depress. Sugar depresses our immune system. Alcohol depresses our immune system. Dairy for a lot of us is congestive. So take all those things out. Super, super simple, warm, basic, nourishing diet.

[00:45:34] And that is when you can take echinacea. You can use echinacea and propolis. Propolis comes from bee pollen, very immune supporting. The things I mentioned like the vitamin C and the zinc and the probiotic can also be helpful when you do get sick. If you have a runny nose or a little bit of a sore throat, but you don’t have a sinus infection, there’s actually some interesting data supporting using a neti pot.

[00:45:58] So you can use a [00:46:00] nasal saline rinse. You just need to make sure that you’re using. distilled water because you can really get infections from not using appropriate water. I

[00:46:09] LM: know it’s not likely, but I do every time I neti pot, I’m like checking my water 15 times and I’m like, is this distilled blah, blah, blah, you know?

[00:46:16] Okay, so we’re neti potting. Is there anything else that’s on, on the list of when we actually are sick?

[00:46:21] AR: Keeping it super simple. I love the echinacea, the herbs I’ve mentioned. For me, ginger tea is like a sworn tried and true go to. So what I will actually do if I’m ever feeling something coming on or I do get sick and I actually lived on this for like my five days of COVID basically, or my five days.

[00:46:39] I grate fresh ginger. I, I literally always have fresh ginger and fresh garlic in my, I grow my own garlic. So I’ve got like a thousand bulbs of fresh garlic and it’s not a thousand, but like 200, but it’s amazing growing my own garlic. I haven’t bought garlic in like five years. Okay. You’re bragging now.

[00:46:56] But, okay. Just a little, but I love it. It’s so special [00:47:00] to grow it. Always have garlic in your kitchen. Always have fresh ginger. What I do is I grate some ginger on a mesh grater and then, what are those called? Like a plate? A microplane. Right. Microplane. Yes. Thank you. A microplane. And then you get that pile of ginger that’s grated.

[00:47:18] You’re squeezing the ginger juice into a cup. And then if you can tolerate it, squeeze a clove of, press a clove of garlic in. You don’t have to do the garlic. and then pour boiling water in and add a couple of teaspoons to a tablespoon of miso paste. If you’re going to use white miso, do a little more. If you’re going to use red miso, do a little less.

[00:47:40] Stir it all in, let it sit just for a few minutes to get cool. The garlic, I would let sit a little bit longer and you’re not going to get like a big hot bite of garlic because it’s washed down. And I’m talking like for 40 years now, that has been my go to. go to thing for that first onset, and it’s really nourishing.

[00:47:58] And then as you feel better, you can [00:48:00] pair it with some toasted butter or tahini, whatever that you like. Chicken soup, it’s not a myth. Make yourself some chicken soup if you like it, or a vegetarian version of it with, again, miso is great. And what else? So there are other herbs, like there are herbs you can use for fever, like yarrow tea or elder tea with, mint.

[00:48:20] If you have the flu, you could add elderberry syrup into that. The dose for the flu is one tablespoon three times a day for adults, and you want to do it within the first 48 to 72 hours of the onset of symptoms. It can help with colds too, but it’s more effective for the flu. You can use elderberry extract too.

[00:48:40] It doesn’t have to be syrup. Syrup tastes so good. Ginger is great for fever, for aches, for tummy discomfort. Elderberry for flu, echinacea for general immunity. I usually recommend echinacea tincture. It’s actually the most effective. For sore throat, I like either zinc lozenges. Again, I mentioned the propolis.

[00:48:59] Saltwater, [00:49:00] warm saltwater gargles are great for sore throat. Ginger can help with headaches, fever. Those are some of my big go to things. I’ve got some remedies for cough. Honey, believe it or not, is a phenomenal and especially buckwheat honey, but any honey will do. But buckwheat is where the research studies have come from, showing that it can help with cough and irritable, like tickly throat.

[00:49:22] So those are some wonderful things. Yeah.

[00:49:24] LM: Do you mask it all preventatively anymore?

[00:49:28] AR: I do on takeoff and landing on an airplane. And the reason for that is I actually have a friend who I will leave nameless for his own reasons. You know how like people were looking and are still looking at sewage from poop on airplanes in the airplane potties to check the viral load during COVID.

[00:49:48] Like they were studying how much viral load is in the air, how much viral load is in the stool and wastewater in planes. And through all of these studies, I don’t know how they did it with the wastewater, but. Through all of these [00:50:00] studies, what they have determined is that the highest rate of circulating virus with COVID, and so we can assume other things as well, is during that critical period You’re welcome.

[00:50:14] Before the plane takes off and when the plane is landing and is your deboarding because you know how it gets really hot and stuffy during those times. It’s because they don’t have as much air circulation. So he actually and his family and they told me. And so I’m still we’re still doing this when you’re taking off and landing until the plane is like, Okay.

[00:50:36] You know, you get the like cruising altitude, you can un fasten your seatbelt. Yeah. Basically you can take out your computer. Now that’s when I’m asking unmask, if I were in any super small space, let’s say I was, maybe it’s like mid-winter, if I had to go to like the DMV or. be in the post office and it was crowded.

[00:50:56] I do keep a mask in my bag. I might mask up. Cool.

[00:50:59] LM: [00:51:00] Awesome. Well, thank you so much for all of your wisdom. Dr. Viva Ram has been on the Liz Moody podcast twice before in her own episodes, and then we also featured her in the Health Effects of Alcohol series. I will link all of those episodes in the show notes.

[00:51:13] You can go and listen. They are Absolutely incredible. She shares so much wisdom. You can also check out more of her work at AvivaRom, that is RomWithTwoMs. com. I hope this episode was helpful. I hope that you got lots of tips and tricks that you can use in your life. Thank you so much for listening and I can’t wait to hear what helps you the most.

[00:51:34] this cold and flu season. If you loved this episode, you will love my series where we ask multiple doctors to break down the health effects of alcohol, including how they personally approach drinking in their own lives. There are similar multi doctor episodes we cover. We cover gut health. We cover cancer risk.

[00:51:51] We cover heart health. We cover brain health. We cover all of these different ways of approaching the health impacts of alcohol with the leading experts in those [00:52:00] fields. I will link that series for you in the show notes so you can go and listen next. Oh, just one more thing. It’s the legal language. This podcast is presented solely for educational and entertainment purposes.

[00:52:11] It is not intended as a substitute for the advice of a physician, a psychotherapist, or any other qualified professional.

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