OneMedicine Podcast

Rob Lutz 00:02
Hello and welcome to the OneMedicine Podcast with Today's Practitioner. In each episode, we share the expertise of a respected thought leader. Some you'll know, and others you'll probably meet for the first time. We cover topics important to you, always with a focus on improving the health outcomes of the patients you treat, while expanding your understanding of the many healing modalities being used today.

Rob Lutz 00:21
Hello and welcome to this episode of the OneMedicine Podcast. I'm Rob Lutz, your host and the founder of Today's Practitioner. Dr. Gaetano Morello joins us today, and we'll be exploring natural solutions for depression, stress, and anxiety. Before I introduce Gaetano, I will mention that today's episode is sponsored by EuroMedica, the makers of AnxioCalm. EuroMedica is also the sponsor of the Stress and Anxiety Resource Center on Today's Practitioner. We'll provide links and other--to the center and other relevant educational materials in the show notes. Dr. Gaetano Morello is a board-certified naturopathic physician with over 30 years of clinical experience. He practices at the Wellness Health Center in West Vancouver and serves as a clinician in the Complex Chronic Disease Program at BC Women's Hospital, the first naturopathic doctor to hold such a hospital position in North America. He's a recognized expert in integrative and functional medicine. Dr. Morello is the author of Whole Body Cleansing and Cleanse: The Ultimate Inside Out Approach. A contributing author to a textbook of natural medicine, a frequent speaker and consultant in the nutraceutical industry, he specializes in complex chronic conditions and evidence-based natural approaches to stress, anxiety, mood, and overall wellness. Welcome, Gaetano. I really appreciate you coming on the podcast today. Anything else you want to just share with us about your background or provide any other context for the the conversation we're going to have around depression, stress, and anxiety?

Gaetano Morello 01:56
Well, you know, a lot of people ask me, "How did you get interested in depression, anxiety, and stress?" And for the last 12 years, I've been dealing with complex chronic diseases. And to explain what those are, those are things like, well, conditions like chronic fatigue syndrome, fibromyalgia, malignant encephalomyelitis. Chronic Lyme can be categorized in that arena, and now long COVID. And so, what these conditions have in common is that they have this fatigue that's ongoing. They have something called post-exertion malaise, where they exert themselves and then they can't function for a period of time. They have cognitive dysfunction in the form of brain fog and memory loss. They have IBS symptoms, gas, bloating, constipation, diarrhea, or both. They have something we call unrefreshing sleep, where they can be sleeping for 10 hours and felt like they haven't slept at all. They have--especially the fibromyalgia cases, even the the ME cases--they have this form of pain that we call centralized pain or nociplastic pain. It's really an amplification of pain signals. And they have concomitant other symptomology, so they have--those are the symptoms of commonality, and there's some symptoms of individuality as well. So we classify them in this arena, and when we look at blood work, we very seldom find anything wrong with the blood work outside of low ferritin levels. And so they're complex because, "Okay, so how do you treat them?" We don't have a marker.

Rob Lutz 03:29
Right.

Gaetano Morello 03:30
And so what we now have identified is the fact that there's a mitochondrial issue with these patients. The ability to produce energy, or ATP, is compromised. And therefore, if every cell type in the body is a factory producing something, like you know, muscles produce extension and contraction, well, if you don't have enough power, you can't do it efficiently. And I'm getting to my point, for somebody to give you that background. And so, one of the things that I found with these patients--so one of the questions you always ask is, "What makes it worse? What makes it better?" Right, that's like, a fundamental medical question. And so, what makes it worse with all these--I've interviewed over 10,000 patients. What makes it worse is uptick in stress levels. So when their stress increases, their symptoms get worse, all of them. Every single symptom. When they're in a happier state or they're--something is happy with them, that's parasympathetic response. They feel better. So that's how I started. So if I can downregulate their sympathetic tone, can I improve these patients? And if so, what is sympathetic tone or stress, depression--what is causing them, their symptoms, to get worse? So that's where I started doing my research in that arena, and started playing with, you know, how can we reduce their stress, their anxiety, their depression using natural products, because they've been using other things and they haven't worked.

Rob Lutz 05:04
Sure.

Gaetano Morello 05:05
So that's--I just want to give you kind of that background, so yeah.

Rob Lutz 05:08
Yeah. I mean, it sounds like it's almost.

Gaetano Morello 05:09
Yeah, they're trapped within that.

Rob Lutz 05:10
I mean, it sounds like there's really kind of a feedback loop maybe that's happening. They have this chronic condition; it may even be stressing them out. They're not sleeping well, they're in pain, and it's causing this feedback loop to probably make it worse. So you're trying to break that cycle, maybe.

Gaetano Morello 05:25
Yeah. Trying to break the cycle.

Rob Lutz 05:26
With some of the things you're doing.

Gaetano Morello 05:27
Because what's happening is it's impacting energy production. So how can stress, anxiety, how can that downregulate energy? You always ask the question. Right? So you ask the question, then figure out how could that be possible? There's a simplistic way of explaining it, that we know that stress creates the fight-or-flight response. So if we think about a zebra meeting a lion--you know, that's a common one everybody uses.

Rob Lutz 05:57
Yeah.

Gaetano Morello 05:57
You know the zebra is going to either fight the lion or he's gonna run away. He's going to run away from the lion. So what does he need? He needs blood in his peripheral tissues. Just like when I work out, my muscles get bigger. I look so much bigger. Where's the blood coming from? It's coming from the core. So when the blood of the core loses, or moves, blood into the peripheral tissues, what happens, it's kind of interesting. Right? I call it the one-cell paradox. What separates everything inside your gut from entering your bloodstream is actually one cell, which is bizarre, when you think about it.

Rob Lutz 06:24
Yeah.

Gaetano Morello 06:25
You mean life and death is in balance with this one cell? That's hard to believe. And when you look at those epithelial cells of the gut lining, each one of those cells is held together by over 100 different proteins. That's bizarre, you know.

Gaetano Morello 06:25
Yeah, that's incredible. So it's very--so think about it. That one-cell lining has to be strong enough to block bacteria from getting inside the blood. At the same time, it has to be permeable enough to allow nutrients to get inside the blood. So, it's in essence a paradox. And this has been measured. What happens when you lose blood in that area, there's an increase in permeability of the gut. When that permeability increases, you get translocation of compounds inside the bloodstream. So I've created.

Rob Lutz 07:03
Wow.

Rob Lutz 07:03
I've never heard of it explained that way. That's interesting. That's real--yeah.

Gaetano Morello 07:13
So, I've had to explain this to patients so they can understand it more. So I have a theory as how this impacts the mitochondria. And so, the theory is it's about redox. So think about this: when you slice an apple in half, it browns, it rusts, it oxidizes. If you squeeze lemon juice on it, it doesn't oxidize, right, because lemon juice acts as an antioxidant, or you know, anti-rust agent, you might call it. And what it really is doing, I mean, what all antioxidants really do is they give electrons. They're electron donors. That's all they are, just electron donors. All antioxidants are just electron--which is, when you think about it, really? That's what an antioxidant--it gives electrons. That's it? It doesn't do anything else. Wow.

Rob Lutz 07:57
Antioxidant sounds so much more sexy and impactful.

Gaetano Morello 08:01
They're just, you know, electrons.

Rob Lutz 08:02
Yeah.

Gaetano Morello 08:02
So my theory is, which--you can't find this in books. This is my theory. Because I wanted to kind of explain this that, you know, what may be happening. So my theory is--and we know that, you know, each cell doesn't have two mitochondria that we saw in high school. Right? There are hundreds and thousands. So my theory is, and so this is my--it's a theory, I mean, it's not accurate, but it's a good descriptive that can give us an idea what's going on mitochondrially. So, my theory is that the mitochondria can never rust, under no circumstances, absolutely zero. If it rusts, it dies. If it dies, we die. So that's my theory that I use to explain to patients this kind of idea that explains to some degree why uptick in stress will cause symptomology to get worse. So my theory is this: that the mitochondria can never, under any circumstances, rust. So how does it do that? It has glutathione, which is well-known, and SOD, superoxide dismutase. That's why it doesn't rust. And so, to better explain that, so I can visualize, because I like to see things--if I don't see things, I can't get them--each mitochondria produces 100 lemons a day. That's why it doesn't rust. Okay, now we're under stress. We get the translocation of compounds going inside the blood because the stress is not just for three minutes when the zebra runs away from the lion. It's constant.

Rob Lutz 09:25
Right. Yeah.

Gaetano Morello 09:26
So these things, these damps and pamps--that's what we call them--they go across and they go and they rot 50 of your lemons of each mitochondria in the body. What's going to happen to the mitochondria? It needs 100 not to rust.

Rob Lutz 09:38
Right.

Gaetano Morello 09:38
So what's next? Well, it can only do one thing, not to rust, reduce the uptake of oxygen by 50% and reduce the output of energy by 50% And therefore, all of a sudden, you lost 50% of your energy capacity in every single cell in your body.

Rob Lutz 09:52
Right.

Gaetano Morello 09:52
It changes everything. There were some studies done with electron microscopy where they were actually able to see in fibromyalgic patients a hibernation of mitochondria, where the cristae, where all these, where the electron transport chain is located, it fades. They're hibernating. And so this is what kind of explains, to me, anyways, in my mind.

Rob Lutz 10:18
Yeah.

Gaetano Morello 10:18
The hibernation process. So, having said that, how can we improve this? Well, what are we improving? You can get electrons, but if you can reduce the permeability of the gut, then you can reduce, and this is why they get better--this is why they feel better, and why they feel worse. Anyway, so that's where I--so, now you're seeing where all this started from.

Rob Lutz 10:44
Yeah. I mean that is really interesting. I had Jacob Titlebaum on the podcast over a year ago. I mean, we talked about long COVID and chronic fatigue, and he described things differently, but it's very similar. It was an energy problem, is how he described it.

Gaetano Morello 10:58
Well, Jacob's a good friend of mine. No, it's an energy problem. Yeah.

Rob Lutz 11:01
Yeah. So, but it's really interesting. Yeah, it's--what I took away from what you said, if this is accurate, the mitochondria kind of go into self-preservation mode. So, they hibernate, and then there's not as much energy into the system, and they feel tired and, you know. all the things that go along with that.

Gaetano Morello 11:17
Without that energy, nothing works.

Rob Lutz 11:19
Right.

Gaetano Morello 11:19
I mean, we are reliant. So I weigh about 186 pounds. I produce about 186 pounds of ATP every day.

Rob Lutz 11:26
Wow.

Gaetano Morello 11:27
That's what the belief is.

Rob Lutz 11:28
That is, yeah.

Gaetano Morello 11:29
I checked that out. That's accurate. That's what you produce. You produce your body's own weight in power. That's how much power you're using, so we're so reliant on it. When you start thinking about it--like when you really start thinking about these mitochondria--they're very unique. They have their own DNA, and here's something really interesting, and you probably know this, but mitochondria are not inherited from the father. They're only inherited from the mother.

Rob Lutz 11:53
I did not know that.

Gaetano Morello 11:54
Isn't that interesting? Fascinating. And then, the other thing that's only inherited from the mother is the microbiome. So you have the microbiome and the mitochondria only inherited from our mothers, and what we're learning is that there's communication that occurs between these two entities. They talk to each other, and Dr. Minerbi out of McGill did a really interesting study that I think is pretty mind-boggling as well, because I think the gut plays such a big role in this. So, what he did was he found that fibromyalgia patients--and we see this with long COVID, as well--they have altered microbiomes. So, what he did was he he went into healthy subjects, isolated their microbiomes in anaerobic states, because most of these bacteria are, they don't like oxygen.

Rob Lutz 12:38
Right.

Gaetano Morello 12:39
And then he encapsulated them, fed them to these fibromyalgia patients, and he saw improvement, significant improvement in the symptomology of these patients, just doing that.

Rob Lutz 12:50
Wow!

Gaetano Morello 12:50
Wow is right! It was a small sample--I think it was about 12 patients. Now he's doing it with a much larger group.

Rob Lutz 12:56
Yeah.

Gaetano Morello 12:57
There was a presentation in Vienna, Austria, a couple years ago, and it was pretty remarkable what he discovered. I thought that was pretty mind-boggling. Again, you know this thing with the mitochondria, like it's deep, so that's how, kind of, I got going on, "Hey, if I can reduce sympathetic tone behind these patients." So that's how it kind of started.

Rob Lutz 13:21
So, I've got a few questions I'll ask as we go through this, because it's bringing up some things that are interesting to me but I think will be also interesting to the audience. But kind of some basic questions. So you talk about really focusing on chronic conditions, these really challenging conditions to treat and impact for the patient, but stress, depression, anxiety is a pretty common thing that practitioners are seeing patients for, whether they're coming in because they're clinically depressed, or they just don't have the energy, or the drive, or whatever. They're just not feeling like they're on. What is the difference really between stress and anxiety? I'm just curious. What's your take on that?

Gaetano Morello 13:59
So stress is--it's like a physical or emotional response to some kind of external pressure of some sort. You have a huge bill that gives you stress.

Rob Lutz 14:08
Right.

Gaetano Morello 14:09
You're walking through the bush and there's a bear that comes in front of you. Right? That's stress. And your neighbor stressing you out because they keep--loud noises, traffic, you know, bump stops. That's stress. That's a stress. Right?

Rob Lutz 14:22
Yeah,

Gaetano Morello 14:23
So that's actually an emotional or physical experience of stress. When you work out, I mean, there's stress on the muscles, so those are--anxiety is a little bit different. It's like you're walking through the bush and you think you're going to see a bear.

Rob Lutz 14:35
Right. You're anticipating. Right?

Gaetano Morello 14:38
Right. So you've created an anxiety based on some past experience. So I always tell people the bee story and how that impacts the amygdalas. So you're five years old, and a bee lands on your hand, and you know, you don't know what a bee is. It looks like a fly, but it's got little gold things on it. And you touch it, and it stings you. And boy, that hurts! And you're running to your mom or your dad, and you're, "Oh god!"

Rob Lutz 15:06
Yeah.

Gaetano Morello 15:07
And it swells up. So all of a sudden, you have the memory of the bee, what it looks like, the sounds, the pain, all stored in your amygdala. Well, next time you see a bee flying around, you're going to be, anxiety. You're going to run. It's going to create this anxiety in you. Right? So, that's what happens. And so you build--so everybody has different levels of anxiety based on experiences and based on possible neuroinflammation in the brain and all sorts of other things that can occur that is not being adjusted. So, that's kind of the difference between the two.

Rob Lutz 15:43
Okay. Yeah, that makes sense.

Gaetano Morello 15:44
Yeah, yeah. It makes sense. Yeah.

Rob Lutz 15:46
Okay, so we talked a little bit already about stress as kind of a root cause of disease, particularly some of these chronic diseases. Do you want to go into a little more detail about that? You know, how you see stress as a, you know, kind of a root cause.

Gaetano Morello 16:00
Well, because what what happens is, what I just explained is, when you have this stress, these stress levels elevated, things get inside the--well, I mean, I can explain it with my house analogy. People like this one. So, if you think of a house, inside your house is your body. So, the hinges on the doors are your joints. The TV set is your brain. The leather sofa is your skin. So, leaky gut is like having holes in the roof, and so water comes in, hits the hinges on the doors, and they rust. That's like getting arthritis. The water leaks and goes into the TV set. That's like getting a brain fog or depression. The water comes in, it goes onto the sofa, and creates mold. That's like getting eczema. So, that's kind of what happens in the body. You get leakiness. You got these things coming inside the bloodstream. Antibodies are created, and they start attacking different tissues. And that's one form of what occurs. And then the other form that occurs is it impacts energy production. So if it impacts energy production, well, how are you going to produce the neurotransmitters you need? 90% of your serotonin is produced in the gut, the body's center. That's a lot of serotonin produced in one big store. So, does that interfere with the production of compounds that are essential for homeostasis in the body from a physical well-being state? Does that affect it? And does that leakiness or stress--stress which creates the leakiness--does that, you know, create neuroinflammation as well? Because now we're linking neuroinflammation to a lot of brain conditions. Wow. So you see, that's it.

Rob Lutz 17:32
Yeah.

Gaetano Morello 17:35
You're opening up the--everything's coming in. Like, what we need to, kind of, view is the fact that the gut is an external system. It's not even internal. It's external. It's not in the body. It's outside the body. Well, wait a minute. It is inside my body. It's in here.

Rob Lutz 17:59
Right. Yeah. Explain that.

Gaetano Morello 18:00
It's external. So if I swallow a marble, it's going to go right through me. It's not going to come in my body. It's going to go through this--so it's a barrier. So, it's an important barrier. If you break that barrier, just like breaking barriers in your house. You know, you got the roof leaking, I mean, the house is going to be a mess. And that's, I think, physiologically in the body, and stress is one of the main causes of them, because that opens the gut barrier. You know, think about conditions, even gut conditions like, you know, ulcerative colitis and Crohn's disease. Patients become very debilitated by those conditions.

Rob Lutz 18:28
Absolutely.

Gaetano Morello 18:31
Because that barrier is broken.

Rob Lutz 18:36
Yeah.

Gaetano Morello 18:36
That barrier is really critical, and we need to maintain it. And so that's why there's so much research now on the microbiome and its impact on that barrier. It's huge. So if we can slow down or improve that gut barrier, I think you can go a long way in improving a lot of conditions. And that's why everybody blames stress for everything. Right? I mean, you've heard how many times.

Rob Lutz 18:36
Right.

Gaetano Morello 18:58
I got a cold, because I was really stressed. I got the flu, because I was under so much stress. I got this, I got that because of stress. So, there's something to it. So, I've tried to figure out from a simple perspective, that this is no big secret, but you know how I can explain that in my own mind. And so that's the way I explain.

Rob Lutz 18:58
So, just to go back to stress and anxiety, I think I understand the way you describe stress. And the way that I'm thinking, I'm understanding the way you're describing anxiety is it's more of a mental process that's causing a stress response. Is that it? So, I'm afraid I'm going to get stung by a bee, and I'm so afraid, I'm having kind of a.

Gaetano Morello 19:38
I'm never going to go out again. I'm wasting my health. I'm going to lock myself up. Yeah, that's what can happen when it goes to a high, that level.

Rob Lutz 19:45
Yeah, and you're getting those same hormones released, you know, if you're in a high-anxiety state or a high-stress state, high cortisol, and it's doing all those cascade of things that you've mentioned. Okay, so there's another question, and again this is an area I've got some thoughts on as well, but you know the endocannabinoid system, right? We hear a lot about how that is--you know, particularly around CBD. I think that's what really, for whatever reason, obviously, but you know, brought the endocannabinoid system into the conversation. But there are a lot of other botanicals that can impact the endocannabinoid system. But let's briefly, if you wouldn't mind, just talking about it, what exactly is the endocannabinoid system? What--how do you look at it?

Gaetano Morello 20:27
Well, you know, it's kind of an interesting name for it, but it's the largest receptor system in the body, and it's formed by a combination of omega-3s and omega-6s, make it. And so it impacts the central nervous system and the peripheral nervous system, so it has a lot of different impacts. And so, the reason why it's called cannabinoid is because one of the first compounds that seemed to activate it was, were cannabis-based ingredients. So you know, we always talk about CBD and THC, but there's over 150 different cannabinoids.

Rob Lutz 20:51
Right.

Gaetano Morello 20:53
And so, there's cannabinoids found in cannabis, obviously. There's cannabinoids, endocannabinoids, that your body actually produces. So it produces something called anandamide, the molecule of bliss, which makes you super happy.

Rob Lutz 21:18
Right.

Gaetano Morello 21:19
That the body produces. And then also 2-AG, which has a similar effect as CBD, just to kind of relate the two. And so, your body's actually making these. And so then, we know that there's plants out there that can make things that mimic some of these internal cannabinoids. There's--the body makes another endocannabinoid called PEA, palmitoylephenylamide, which is now, you know, something in the market space. And you know, I was introduced to PEA 12 years ago by one of my patients. You know, I--my theory with patients is, well, I tell them, "I have a patient that I'm interviewing. I was told the same thing." The doctor thinks he knows it all. He knows nothing. And so, you always want to be open to what patients tell you, because then you can learn a lot from them. And so this patient brought the PEA in, and she said, she goes, "I'm using for my fibromyalgia pain, and it's working." She goes, "What do you think? I go, "I don't know what to think. I haven't even heard of it."

Rob Lutz 22:19
Yeah.

Gaetano Morello 22:20
So, I did some research on it, and I found that it was, you know, it came out of Europe, and so I, kind of, started working to try to get it approved up here, and we got it approved.

Rob Lutz 22:30
Yeah. So, I know the endocannabinoid system, they have a couple, what, the CB1 and CB2 receptors.

Gaetano Morello 22:36
Yeah, those are the two. Yeah, those are two of the receptors.

Rob Lutz 22:39
Yeah.

Gaetano Morello 22:44
But, where I was going to get to that is these things impact so many different areas. So you know, for example, PEA impacts centralized pain because it's an autacoid. An autacoid is very different from a hormone. A hormone goes all over the body. An autacoid is only developed in the area where the inflammation, the pain, is derived, so that's an interesting proposition. But here, I'll tell you what's really--the reason why I brought it up, it might surprise you, because I'm sure you've heard of PEA. What's surprising about it--it surprised me six years ago that they did a study where they compared PEA, CBD, and a placebo in leaky gut. So they gave patients leakiness. How you do that? Tons of aspirin. It'll produce leakiness. Then, they divided into three groups. They were all taking the aspirin. One group took a placebo pill, the other group, CBD. Another group took PEA. And they found that the CBD and PEA groups had significant reductions in leakiness in the gut. So not only does it impact pain, it impacts leakiness, because the endocannabinoid system impacts so many different parts of the body, and one of the areas that it impacts is the gut. So is the effect of PA not only as an anti-inflammatory, but does it have an impact on gut permeability as well, which you know, it does. And here's something that's going to shock you even more. I think it was four or five years--you can look this up. The FDA approved a study for PEA for the treatment of COVID-19, which is remarkable. They approved an actual study.

Gaetano Morello 23:58
There's CB3, as well. I mean, you know, they're still trying to work on it.

Rob Lutz 24:15
Yeah.

Rob Lutz 24:16
Wow!

Gaetano Morello 24:16
Because, well, it's used as an antiviral in the Czech Republic, so that's kind of interesting. Right? So, it has all these different applications. Anyways, to move on to the endocannabinoid system, but I'm going to tell you, you know, because I want to get to the to the storyline because we only have about 20 minutes left. So, one of the interesting parts of this was that I heard of this research being done in Hungary with this ingredient that was found in echinacea. And so echinacea--so these scientists were studying, you know, that the endocannabinoid system had an impact on the immune system, and so they wanted to see was there any any association with the way echinacea works in the immune system? And so when they were doing this investigation, they found an alkamide in echinacea that looked like anandamide. So, anandamide is the molecule of bliss. Drug companies have been trying to increase the levels in the bloodstream forever, and they just--it always fails and causes a lot of side effects, because they're trying to block the enzyme that breaks it down. Just like the serotonin uptake inhibitor, they're trying to do the same thing with the alkamide, but it doesn't work. So, the scientists they started analyzing this alkamide and giving it to--they started doing some animal studies, and they found it worked in animals. And then they did human studies, and they found that it reduced anxiety in humans.

Rob Lutz 25:36
Wow!

Gaetano Morello 25:37
And so, I started using on patients, and I found, "Wow! This stuff really works." So it can reduce the feeling within, like, within an hour of taking it. So it's pretty, you know, it's pretty shocking, but I guess not shocking, because the body makes a similar substance.

Rob Lutz 25:55
Yeah, so this is an isolated, you know, active component, echinacea. It's not just a strict.

Gaetano Morello 26:03
No, you know, that's the endemic problem, right, because everybody gets confused. "Well, why aren't all the echinacea users seeing some of this?" So, they isolated compounds out of the echinacea, so they take that compound out, and so that's what they isolate. So they--because it needs it in certain levels, and it has to be picked up a certain time of the year to get this alkamide level. And so it kind of teaches us that different compounds and different plants have different effects, and also the dosing is really interesting as well. I mean, you can have the same compound but have completely different applications. So, for example, I don't know if you ever heard of low-dose naltrexone.

Rob Lutz 26:42
Yeah.

Gaetano Morello 26:43
You've heard of naltrexone, right? So, naltrexone at 120 to 150 milligrams is used for opiate addiction.

Rob Lutz 26:49
Right.

Gaetano Morello 26:49
At 0.5 milligrams to like four milligrams, we use it for complex diseases because it can, you know, reduce pain. It can do all sorts of like miraculous, in patients--so a drug that has two different applications. For example, erythromycin at 750 milligrams is an antibiotic. At 50 milligrams, it's a prokinetic. It stimulates the migrating motor complex, which pushes bacteria out of the small intestine into the colon. Two different applications for the same drug. Does--do plants do the same thing? Yeah. This is a really good example of something that has different applications. it's pretty remarkable.

Rob Lutz 27:29
Yeah. So you know that, I know that's an ingredient in AnxioCalm from Euromatica, which you know, we mentioned they're the sponsor here. How--do you use that in your practice? How do you integrate that into your practice? Can you talk about that a little bit?

Gaetano Morello 27:44
Yeah, well, you know, I use it as something that patients can use when they're having that, when you have that stress, anxiety that's coming up, some things, and it calms you right--I think it really takes the edge off remarkably quickly. So even when I'm going through my stressful period, an emotional, and this anxiety, my brain is just--I take these, this product, you know, two tablets, and it, within an hour I feel different. I started getting it--this is way back. We'll go back maybe 18 years or so to kids that were having anxiety issues, flying, writing exams, crossing bridges, I mean, and it just takes the edge right off. And it's quite--and it's right. So, there's no, there's--anxiolytics are very addictive. Right? So this is not addictive, and so what an interesting ingredient, and you know.

Rob Lutz 28:39
Absolutely.

Gaetano Morello 28:40
Oh this should be like a really--everybody should know about this.

Rob Lutz 28:44
It should, absolutely. You know, if it doesn't have the side effects that some of the others have, it works quickly.

Gaetano Morello 28:49
Yeah, it really does work.

Rob Lutz 28:50
That'd be something, it should be in the toolkit for every practitioner.

Gaetano Morello 28:53
Yeah, it's just surprising how fast it works. But it works really quickly, and it's consistent. You'll see, you know, not everything works on everybody, right? So, but this is something that works very, very quickly. So it's really impressive that way.

Rob Lutz 29:06
Are there any other targeted botanicals that you look to when you're looking at stress and anxiety and treatments for patients?

Gaetano Morello 29:14
Well, you know, yeah, there is. Because one of the things you want to do is you know the core of neuroinflammation--the core of a lot of issues is neuroinflammation of the brain. So, we start to learn that and its impact on something called the default mode network, which it's an area that has five different parts of the brain. And this is an area where rumination occurs, where--right now, our default mode network is sleeping. It's not active. But when we're alone, thinking, it becomes active. And this--it's like a brain's internal kind of compass. It's responsible for self-reflection, introspection, emotional regulation, how you think the world sees you, how you see the world. I mean, it's pretty--and so when this thing gets inflamed, you can get increases in stress levels and anxiety and depression. And so, having said that, can we reduce inflammatory reactions, and can that help with this? So things like curcumin--you know, you're probably familiar with curcumin.

Rob Lutz 29:15
Sure. Yeah.

Gaetano Morello 30:03
One of the spices I take every day. Things like saffron--saffron is another one that could really have an impact on the default mode network. I also use a form of--it's a fermented GABA that can help as well. You know, there was a study done where they found that bacteria of the gut ferment compounds that produce GABA, which is kind of interesting as well. Again, you know, when you have a dysfunctional microbiome, it can impact the body. You know, there's some really interesting takes on what happens in the gut. Does the gut bacteria see compounds, metabolize them into other ingredients that we don't even know what they are, and they come into the blood and they do their work? Is this why diet is such an important component to everything? You know, we can say all we want, but you know, does diet play a role in it? 100%. If you actually look--yeah, you know, I know I bounce all over the place, but just the way I am. Right?

Rob Lutz 31:15
No, this is great. I'm following it.

Gaetano Morello 31:17
So, there was a study on mortality rates, and they found that mortality rates from 1945 to 2022 from infectious diseases just drop significantly. Well, why is that? Well, because of antibiotics and hygiene. That's why.

Rob Lutz 31:35
Right.

Gaetano Morello 31:36
But deaths from chronic diseases like, you know, diabetes, heart disease, cancer, it just skyrocketed. As a matter of fact, there's an 80% increase in people 50 years and younger getting cancer. And so, what's the change? Well, the change was from 1945 to 1955, the introduction of over 50,000 chemicals in the foods we consume. So, have we been poisoning our DNA all these years? In 2006--yeah, 2006--Discovery Magazine had a really interesting story that, you know, really kind of influenced me, and they had a picture of two guys. One guy was 6'1", large frame. The other guy was 5'11", medium frame. I have a picture. I always use it in my slides. And what was interesting about those guys, they looked different, and they had different diseases. They were identical twins. Their DNA was exactly the same. And what happened was they were separated at birth, and they grew up in two different environments. The food they consumed, the water they drank, the nurture was--that differential changed the way their DNA behaved. And the article--DNA is not a destiny. The reason we get everything our parents get is because we do the exact same thing our parents did. So it's, I mean, again, you know, this thing with diet and what we put into our bodies will impact what we become. And Rob, here's something for you. Yeah, think about it. Your body--outside of your, the majority of your nervous system--is constantly being killed, dying, and getting remade. You're rebuilding your body all the time. Skin cells die; new ones are made. So the aging process is also related to that. So it takes two things to create things: 1) building blocks; and 2) power. As you lose power, your ability to restructure things diminishes. So the mitochondria are a key to that, because we lose more and more every year, and they're not as functional. So, if you can improve the functionality of those mitochondria, and you put the right building blocks in the body, the aging process will slow down, and health will increase, which is simplistic, but isn't that pretty--that's true, isn't it?

Rob Lutz 33:55
Yeah.

Gaetano Morello 33:56
And your listeners can go and look at this. This is one of the things I look at. So you look at identical twins, smoker versus non-smoker, and you'll see about a 10-year difference in the way they look. It's a pretty--that's a simple one. Right? You can't.

Rob Lutz 34:09
Yeah.

Gaetano Morello 34:09
Yeah, you--and what is that? Well, that's--what is smoking doing? Well, it's probably blocking energy production for sure. It's interfering with oxygen exchange. Right? That's one. There's a lot more free radicals. Is that impacting the mitochondria? It probably is.

Rob Lutz 34:22
Absolutely.

Gaetano Morello 34:23
And one of the only things that we have, and you know, we have lots of theories of aging, but one of the main ones nobody can argue is mitochondrial decline. Right? I mean, that's pretty well established, so.

Rob Lutz 34:32
Anything you recommend? And just as a side note, so if you want to support your mitochondria, any--what do you recommend to a patient? Any supplements, you know, activities?

Gaetano Morello 34:44
Well, yeah, so there's hits and misses with all these things. Right? So, I got some hits. One of the main hits is 25 grams of protein in the morning. Take that, and you're going to feel better. I guarantee you, in three to seven days, you're going to start feeling better. Why? Well, all your DNA makes is proteins. Well, there's a simple recommendation. You know, sometimes you tell patients, "Listen, I know you're waiting for the incredibly, you know, long name of some medicine," you know.

Rob Lutz 35:08
Take one pill, and everything's gonna be fine from there.

Gaetano Morello 35:09
Everything's gonna be fine. Let's just start with some simple things, right, doing that. There's one thing, you know--magnesium, that's another. Magnesium is remarkable. I mean, that's another hit, and it works with people. So, those are what--and then, you know, sometimes, electrons are important, because the mitochondria just thrives on them. Right? I mean, they need electrons. The whole thing works on electrons. It's, you know, that oxygen molecule that comes in--I mean, think about it. Oxygen is the most important element in life. If I don't have it--a stroke victim, there's a lack of blood flow to a particular area of the brain. I can get paralyzed. And all oxygen goes inside the mitochondria to produce electricity, and that's all it does. It doesn't do anything else.

Rob Lutz 35:47
Yeah.

Gaetano Morello 35:48
That's it. The most important element in life is mitochondria-related. Hard to believe. So how do we get more electrons? Well, you know what? Here's a simple one. You don't even have to take a supplement. Grounding. The biggest electron dome that we have is the planet. That's where all the electrons come from. How does a tree grow to 200 feet? Well, if it grows to 200 feet, it needs atoms. How does--what's an atom? Protons and electrons.

Rob Lutz 36:11
Right.

Gaetano Morello 36:11
Where are those electrons coming from? So, that's why when you walk the beach, you feel like a million bucks because of exactly that. So it's kind of--so anyway, so that's one. And you know, one of the things that your body makes a lot of is ubiquinol, and that's, you know, a compound that when you look at the electron transport chain, it's right after the first complex that takes that step, because it's like this electron that keeps bouncing all over the electron transport chain to create that gradient, which allows the turbines to turn and produce your energy molecule, which you need. So, that's something. Acetyl L-carnitine is something that can help with beta oxidation, which creates energy for--you know. I tell patients, you know, that can travel 1,000 miles without ever landing because it uses fat as energy. And what brings that fat inside the cell is acetyl L-carnitine. So, that's something that is another compound that we use. It's a hit and miss. It doesn't work on everybody, but there's a whole bunch of these things that don't work on everybody. And then you know what we talked about in this podcast was reducing stress and anxiety, because if you do that, you reduce translocation of compounds in the blood, which are impacting the cell, which are impacting energy production.

Rob Lutz 37:20
Yeah.

Gaetano Morello 37:22
I mean, and that's a pretty simple recommendation in a sense, you know. So, that's important. So, there's a number of compounds that--you know, omega-3s are important. And your diet. And everybody asks, "Okay, what diet should I take?" Well, I mean, I think you already know. Stay away from all the chemicals. Stay away from sugars. Stay away from all these things that you don't even know what they are. And you know, what's the best diet that's been proven over and over and over? Everybody, all these authors, come up with all these new diets, and it drives me crazy. So, I go, "Just do the Mediterranean diet." I mean, it's been proven. It's 100% proven.

Rob Lutz 37:55
Right. I think the other thing is a patient, once they get through the adjustment of missing all the foods that they think that they love and what their body doesn't necessarily really love, they will feel better. You know, they will--you change your diet; it's a little painful for a while, just you know, new habits and things like that. But they will see benefit from it. It's absolutely true.

Gaetano Morello 38:16
I think you will. You'll see it. You'll see it in your skin. You'll see it in the way you feel. You'll see it.

Rob Lutz 38:21
Yeah.

Gaetano Morello 38:21
You see it in lots of things.

Rob Lutz 38:23
Yeah.

Gaetano Morello 38:23
We can't avoid stress. I mean, it's all around us. Right? But we can make it.

Rob Lutz 38:27
Yeah. So, that's where I wanted to go next. So, we can't avoid stress. We talked about anxiety, and that's that kind of mental rumination process, you know, other things as well. But lifestyle, dietary, what are you recommending to patients? Because it can't just be, "Take a pill, and everything's going to be fine." Right? I mean, that doesn't work, I don't think. What are you recommending from a lifestyle standpoint for a patient? Mindfulness--you know, what types of things do you think can help a patient?

Gaetano Morello 38:58
Well, one of the things the patients--you know, I always tell them, you know, "What makes it better?" Right? That's what you always tell them.

Gaetano Morello 39:03
Yeah. Behavioral modification has helped. Amygdala retraining has helped. I go, "Okay, why don't you keep doing it?" It's too much work, because they're so fatigued. So what you need to do is--you know, that's where supplementation can help, because it's the bridge that gets them to the other side, so they can start doing all those things.

Rob Lutz 39:04
Yeah.

Rob Lutz 39:19
Right. Right.

Gaetano Morello 39:21
They can start going for a walk. They can start moving. Your body's made to move; the muscles need it. And some of these complex patients that I have, you know, they can't utilize, because they can't recover. So, we work on getting them to produce more energy by doing a protocol, a program, that helps them. And then, once they've got that, then start doing some light movements that can help, grounding, where they ground to the earth. This is sometimes bizarre to think about it, but it helps because there's electrons coming into the body. So that's it.

Rob Lutz 39:57
It's funny. Some of the most simple things really are the most powerful: grounding, the way you breathe, you know, actually the way that you're--those can make a huge difference. And it's hard to believe, right, that those things can make a difference. Yeah, yeah.

Gaetano Morello 39:59
Because we're used to taking a pill that's going to get rid of the headache.

Rob Lutz 40:15
Right.

Gaetano Morello 40:15
But we're not thinking, what's causing the headache to begin with?

Rob Lutz 40:18
Yeah.

Gaetano Morello 40:19
And is it insulating ourselves from--Rob, I mean, there's so much stuff going on this planet right now. You're like, look, I always tell people, "Look in this room, in this room." Even if this cell phone that I have in my hand is--say that this phone is actually an Italian phone. I use Italy; that's where I'm from. Say this is Italian. So, it's from there. Well, I can open--right now, I can download anything from Italy, from wherever.

Rob Lutz 40:45
Wherever. Yeah.

Gaetano Morello 40:46
From here, and it'll--the picture will come up. You know, say somebody is sending me a picture from Africa, whatever they're sending me.

Rob Lutz 40:52
Yeah.

Gaetano Morello 40:52
It'll open up. So how in the heck is that picture coming here? That means it's all over this room. All that information is already in here.

Rob Lutz 41:00
You've got a chance to see it. Yeah.

Gaetano Morello 41:01
How is this interpreting that? And if so, is that information coming into me as well? Is it interfering with my own system? Is that possible? Yeah, that's possible. How do I protect myself from that? Well, you really can't. You can't. So, is there--from a nutritional perspective, can I do something? I don't even know--I don't even know the answer to that question. I'm going to try to do everything possible to take as much protection as I can, as much electrons as I can, as much antioxidants as I can, and try to make my cells as healthy as I can through diet and supplementation. So I'm a big believer in supplementation.

Rob Lutz 41:40
So, tell me--you know, you've got me thinking about something. So what do you do personally to manage your own stress, to put yourself in the best position to remain healthy long-term? What are you doing?

Gaetano Morello 41:51
Well, I've got a whole supplement regimen that I take. Right? So I do that. Right now, I'm going to put them in a little baggie that's going to--and take the meal. I've been doing that for probably, I don't know, 37 years.

Rob Lutz 42:04
Yeah.

Gaetano Morello 42:04
And that's--so, that's one. Two, I try to get enough protein every day. Three, I try to have vegetables, a salad of some sort with a couple of fruits every single day. I drink as much--I don't drink anything with sugar in it. I do have coffee. You see my cup right here. See, I've got my coffee. I do have coffee.

Rob Lutz 42:28
Coffee.

Gaetano Morello 42:28
And then, I exercise. I do resistance training three times a week, at minimum. And one of the things--I need to do more walking. But then, you know, in the hospital, I'm up and down the stairs.

Rob Lutz 42:42
Sure.

Gaetano Morello 42:44
You know, I walk mostly, so I try to do those things, you know. You know, when when you hit your 60s, you know, you got to continue to do this.

Rob Lutz 42:52
Hundred percent, yeah.

Gaetano Morello 42:53
So, I do that quite a bit.

Rob Lutz 42:55
Yeah.

Gaetano Morello 42:55
And then you know, I try to manage the different stresses in family life as much as I can. You can't--I can't control everything, and so I do take, you know, when I'm stressed or something's going on in the family, I'll take the AnxioCalm. I'll take two of those tablets, and it calms me right down.

Rob Lutz 43:12
Yeah.

Gaetano Morello 43:12
GABA before I go to sleep, 200 milligrams, you know, because that helps as well, so I can get some real deep sleep. Sleep's really important, and so, you know, pretty simplistic things that I make sure that the food I eat is not fast food. Well, I remember Andrew Weil on Larry King, way back in the 90s. I'll never forget this. He goes, "Larry, we can solve 80% of America's problems." He goes, "Well, how do we do that?" He goes, "Let's charge huge amounts of money for fast foods, processed foods, and let's make natural foods really cheap." He goes, "You will solve 80% of America's problems." And I go, "Wow, you know what?"

Rob Lutz 43:56
Yeah.

Gaetano Morello 43:57
"That's probably true."

Rob Lutz 43:58
Yeah.

Gaetano Morello 43:58
That is so true. So my my parents are in their 90s now, 92. They live in a 3500-square foot house. They manage everything themselves, and they've been growing their own stuff for, ever since I was little in the backyard, and they continue.

Rob Lutz 44:13
Yeah. They live in Italy? Your family's in Italy?

Gaetano Morello 44:15
They live here. They manage their own house, but they maintain a lot of traditional things, like you know, we go and we'll buy 600 pounds of tomatoes and make tomato sauce for the year. So those kinds of--and there's no preservatives in them, just tomatoes. You know, for basil, we grow the basil in the backyard and we put it in there, and that's it. So that goes a long way. I know, you know, it's boring when we talk about you know simplicity and diets, but that's a big--you know, the identical twin story is a really good one.

Rob Lutz 44:48
Yeah, absolutely.

Gaetano Morello 44:49
Imagine identical twins that look completely different. They have different heights and sizes.

Rob Lutz 44:53
Yeah, yeah.

Gaetano Morello 44:53
That's not possible. Well, because one eats right.

Rob Lutz 44:56
Well, the genetics are their potential in a way. Right? Genetics are kind of your potential. And you feed one differently than the other, it's going to take that potential and take it where it can go. And the other one that wasn't fed very well isn't going to get there.

Gaetano Morello 45:08
You got it.

Rob Lutz 45:09
Right? I mean, yeah.

Gaetano Morello 45:10
That's it. That's totally it.

Rob Lutz 45:11
So, one other thing we didn't talk about yet is in regard to stress and anxiety, and we talked about rumination. What about mindfulness? Do you incorporate anything like that? Do you recommend it? Do you do it yourself? Do you recommend it for patients? Yeah, anything?

Gaetano Morello 45:27
Yeah, you know, these patients usually have some counselors and, that they go see where they start doing mindfulness, because I think it is important, you know, these things. So, sometimes people just don't have the time to do it, but they do have the time. You know, they have time to watch TV or a football game, but they don't have 10 minutes to do mindfulness. Right? So, it's getting into the habit, and so habits--creating the habit is not easy, or getting out of a habit is not easy.

Rob Lutz 45:54
Right, right.

Gaetano Morello 45:55
Yeah, so you know, you have so much time to spend with them, and then these other physicians that specialize in those areas can help with those.

Rob Lutz 46:05
Yeah, I'm just thinking about mindfulness, especially when you're talking about the brain.

Gaetano Morello 46:08
I guess you think it's an important thing to do. Right? I agree with you.

Rob Lutz 46:09
With rumination, you know, if you're kind of dwelling on this, "What if? What if? What if?", and your stress hormones are going crazy, I think mindfulness can kind of help you stop that cycle. It's not easy though, and I think the challenge is they want it to be quick, but they're like, "Oh, I couldn't focus on anything during my mindfulness session." Well, that's true for everybody, you know. It's the--anyway, there could be a whole 'nother conversation around that, but I do think.

Gaetano Morello 46:37
Oh, we could do--conversations about the gut can take two hours. I mean, the gut can take 10 hours, I mean.

Rob Lutz 46:43
Yeah. Yeah.

Gaetano Morello 46:43
It's all there. I mean, there's so many things right now that are--the data that's coming out every month is just out of control right now. Like, there's just lots of information that is pouring out.

Rob Lutz 46:58
Right.

Gaetano Morello 46:58
Even, I mean, you've got to be careful with probiotics. You've got to be careful with lots of things. I mean, it's not simple.

Rob Lutz 47:02
Yeah. Too much of something isn't going to be good. Just, you know, more is not always better.

Gaetano Morello 47:06
It's not.

Rob Lutz 47:07
Are there other things that you want to really touch on, or any other takeaways from today, or things that we haven't covered yet? I know we've covered a lot, but you know, we want to go back to the natural solutions for depression, stress, and anxiety. Is there anything else?

Gaetano Morello 47:22
I can give some good starting points.

Rob Lutz 47:25
Yeah.

Gaetano Morello 47:25
You know, the AnxioCalm is really good to get down anxiety. Saffron is excellent as well, just 30 milligrams a day is really a help. Curcumin, you know, I take a gram a day of curcumin every single day. I mean, is that gonna hurt you? No. Is it gonna help you? Yeah, it's gonna help you. Believe me.

Rob Lutz 47:43
Yeah.

Gaetano Morello 47:43
That stuff really does work. Right? It's got 6,000 different types of studies from all sorts of different arenas, and it can reduce neuroinflammation. Boswellia, I mean, there's--ashwagandha is another one that is a great adaptogen. I mean, so all these things will be a benefit. Well, is it natural to take these? Yeah. I mean it's natural because we have so much unnaturalness around us.

Rob Lutz 48:08
Right, we're trying to counteract some of that.

Gaetano Morello 48:10
We're trying to counteract that. That's why we do it. In the early 90s, you know, I was taking all these supplements. All my MD buddies were laughing at me, you know: expensive, weird and expensive. Now, you know what? Everybody's on my program.

Rob Lutz 48:21
Yeah.

Gaetano Morello 48:22
They changed their minds, because they've aged so quickly from all the stress, and so they're realizing that supplementation does--I mean, that's why it's becoming so popular. I mean, it's incredible.

Rob Lutz 48:31
Absolutely, yeah.

Gaetano Morello 48:32
What's going on in that supplement world, now, like, it's just exploded. Why? Because medicines are important, or pharmaceuticals are important, but they don't have all the solutions.

Rob Lutz 48:45
They--a lot of times they come at a cost, you know, with the side effects and things like that.

Gaetano Morello 48:48
Well, I do a commercial. It's, you know, it's a nonprofit, and I tell them about a vision that I had. And and the vision was, so I live here on the west coast, and there's a great ski resort called Whistler that you might have heard of.

Rob Lutz 49:01
Of course. I've ridden my bicycle over there.

Gaetano Morello 49:02
Yeah, you can drive there. You've got to drive along the, right on the side of the mountains. Get up there. So my vision was, at one of the turns, it says, because it's on a cliff, it said, "Slow down to 10 miles an hour." Well, nobody does that. They just go 30, 40 miles an hour around that curve. Guess what? The car falls down the cliff, goes to the bottom. So now, you've got to call the ambulance with the helicopter to get the victims out and bring them to the hospital. So, what medicine did--so this is my vision--what medicine did is they built a hospital at the bottom of the cliff. So, as the accidents occurred, they could bring them right into the hospital. Well, that's not stopping the accident.

Rob Lutz 49:44
Right.

Gaetano Morello 49:45
So, what alternative medicine, or holistic medicine, tried to do is they wanted to carve a hole through the mountain and make a tunnel, so that there's no curve. So that's what prevention kind of does, and that's what we're trying.

Rob Lutz 49:58
It makes sense.

Gaetano Morello 49:58
It makes sense. RIght? So, that's kind of the visual. So, and that's what we can do. We can't stop everything, but we can reduce this one turn right now, where we can stop cars from turning off.

Rob Lutz 50:10
Yeah.

Gaetano Morello 50:11
And that's how we can prevent--you know, there was a study done just, this is an interesting study. You might be interested in looking into it. 19,000 patients studied globally, they found that those patients that consumed three mushrooms, or 18 grams of mushrooms, a day had a 46% reduction in cancer rates. That's hard to believe.

Rob Lutz 50:30
Which type--did it mention which type of mushroom or just mushrooms in general?

Gaetano Morello 50:34
Shiitake mushrooms. There was a lot of research that's been done, but that's really hard to believe.

Rob Lutz 50:38
Yeah.

Gaetano Morello 50:39
But I did a video on it, because I think it's so important for people to go out there. I mean, I'm not selling mushrooms. Just look it up yourself and see for yourself what you can do, because that's really fascinating. And it's, you know.

Rob Lutz 50:52
It is fascinating.

Gaetano Morello 50:53
That's just a tidbit of information, and people are really interested in that kind of information.

Rob Lutz 50:58
Yeah.

Gaetano Morello 50:58
And so that's why information is so important, and why diet is so important.

Rob Lutz 51:03
Yeah. So many simple things that we overlook because they're so simple or they're right there. We've always had them, whether it's your diet or exercise or whatever it might be. Yeah.

Gaetano Morello 51:13
All right.

Rob Lutz 51:13
Well, thank you so much. This was really great. I appreciate you coming on, and lots of great info. I'd like to have you back on the show sometime. We've got other things we can talk about.

Gaetano Morello 51:23
Yeah, well, we'll talk about mitochondria.

Rob Lutz 51:24
Yeah, I would love that. Oh, hey, thank you again, and we'll talk soon.

Gaetano Morello 51:29
Sounds good. Thanks, Rob.

Rob Lutz 51:30
Okay, yeah. Take care.

Rob Lutz 51:33
Thanks for listening to the OneMedicine Podcast. I hope you found today's episode interesting and came away with a few insights you can apply to your practice. If you're looking for the show notes, they can be found in the link below. If you want to go deeper on this topic or anything else, please visit todayspractitioner.com and consider registering for our weekly newsletter as well. Thanks again, and I hope you'll join us next time.