The complete transcript of the Webinar Back to Basics: An Introduction to IgG Food Sensitivity Testing, from October 10, 2019, is available below.
Hello and welcome to US BioTek webinar: Back to Basics, An Introduction to IgG Food Sensitivity Testing. Today's webinar will be presented by Dr. Chris Meletis. My name is Chase Winterroth and I am the Director of Marketing here at US BioTek and I have the honor of introducing Dr. Meletis to you all today. Dr. Meletis is an educator, international author and lecturer. He has authored 16 books and over 200 national scientific articles in journals. Dr. Meletis served as Dean of Naturopathic Med icine and Chief Medical Officer for seven years at the National College of Naturopathic Medicine in Portland, Oregon, now known as the National University of Natural Medicine. He was awarded the 2003 Physician of the Year by the AANP and has a deep passion for helping the underprivileged and has spearheaded the creation of 16 free natural medicine clinics in the Portland area.
We here at US BioTek are honored to have Dr. Meletis as a clinical consultant on the application of our laboratory tests with his years of clinical experience. If you have any questions throughout this webinar, please feel free to ask at anytime by typing your questions into the question pane in the GoToWebinar control panel. All questions will be answered at the end of the presentation. Now, without further ado, I'd like to hand over the webinar to Dr. Meletis.
Well, welcome everyone. It's so great to see such an international gathering of like minded, forward thinking providers. Today we're going to talk about IgG testing and most of us do IgG testing in our clinical practice but there's a lot of things, which we want to chat about, and also clarify as there continues to be a lot of how would you put it?...Ramblings about the utility of IgG. We all know that IgG provides our patients phenomenal opportunities to gain insights into their diets. We're going to go over the clinical research today, share some pearls, and I hope to challenge everybody with a new tidbit that you can bring back to your practice.
The foods that patients consume, of course, as Hippocrates said, "Food is your medicine and or possibly your worst enemy." If how whether the food elicits no reaction or even has a healing property, we have to also ensure that maybe if I were to be told to eat broccoli, broccoli might not be the best thing for me. Once again, individualized medicine. Or, I have patients that end up with high sensitivities to beets. Of course, with all the beet craze out there to increase nitric oxide levels, beets may be good for 80% of the people, or not. If your patients are one of the 20%, then clearly it is not the right food for them and will do more harm than good.
Exposure to food antigens can lead to elevations and different kinds of antibodies IgM, IgA, IgE, IgG4. All these antibodies are different ways in which our bodies can respond. Now the question is we are trying to elicit, what is the most common way that our patients respond? One of the points, which is very important for us as functional medicine providers is to realize that when we're talking to our conventional colleagues, which are counting on allergist and immunologist, of course, when we use the word food allergy, we're talking about IgE. US BioTek offers IgE testing as well. When we do an IgG test we're looking for sensitivities and intolerances. We don't really want to have that misnomer saying well this your food allergy, it's your food sensitivity.
Once again, we know IgE reaction; a person who eats a shrimp, a person eats peanut; Johnny has an egg exposure and now he has asthma or hives or anaphylactic reaction. That's E and I tell my patients think of E as emergency, it's an emergent issue. As we're going to go into IgG, we're going to look at that with a different little same. My patients I tell them, "Hey if you have an IgE reaction, no matter what your IgG scores are you're still going to avoid your IgE's." Now with that said, IgG I tell my patients think of G for gradual. These are like little sneaker waves along the coastline, they will creep up on you and sometimes you don't even realize it. We have a food, let's say I eat a food today this morning I had a couple eggs. Those eggs may not cause me symptomology for 24, 48 or possibly even 72 hours. If I was to complain to my wife of 30 years, "Boy, I got this terrible migraine headache. What did I eat? Maybe it's this is that well, it might have been what I did on Thursday."
Once again, that's the sneakiness of it and why we have to test and not guess, because otherwise we won't know what's really causing the problem. It might be constipation, diarrhea, nasal congestion, chronic sinus infections, joint pain, eczema. But once again, I have a remarkable case where I have a whole I guess, I would say flurry of young pediatric patients, because I did an IgG test, I found out which foods they were sensitive to, and the child's eczema went away and this is a tennis player who likes to wear tennis outfits, young girl. All of a sudden now her eczema is so much better. Well, how about this person's eczema? How about that person's eczema? Once again, as a result my practice has grown as a result of the fact that we're figuring out that unto them even though they thought they're eating healthy and they're vegetarian ish, they eat a lot of salads or even the wrong things at that salad bar. Once again, determining what's the right food for a given individual is absolutely critical.
Here's an interesting case, this was a patient of mine, 53 year old, she has tremendous anxiety and panic. She also has lots of gut dysbiosis and we've already tested her and she was one of the highest CBOE patients I've ever seen. You're going to say, "Well, Dr. Meletis well this you would imagine they should be much higher." The reality is when we look at these results, you want to look at the purity of the antigen being used. And, the purity of the antigen will determine whether or not you're going to have background noise. Some laboratories don't have as pure antigens as others. What we want is really crisp surgical precision on: is this reaction truly a blue mussel? or a halibut? or a sol? It's important when we look at these results to look at whether or not this person is a big reactor, a moderate reactor, or a low reactor. We will discuss that today too.
As you can see, you might say, "Well, everybody has dairy issues. Everybody has an egg issue." Well, not for her. Once again, we're going to chat about that and teasing out, how can a person be miserable the GI tract, but what's what seems to be fairly modest scores? Remembering that every patient responds differently, just like some of us have empty HF polymorphous. Some people get to have either higher or lower immunological responses. This patient has not that high. Going back to that first page, you'll see okay, well, we have a two and a half. We scroll down, we see what are her other results, a two and a half a very pronounced score for her. What we generally recommend is sure some patients are going to have such a leaky gut, they're so hyper immune response. They may have threes and fours, but don't expect threes and fours to be the things you have to avoid. You want to avoid things that are also, in this case, in the ones. You're treating the patient, and you're not just treating the lab. Guava, cantaloupe, coffee, honey, these are all things that, in her case, you would actually want to avoid. I'll chat more about that.
I'm going to take her off the gluten, which I have. I also took her off chickpeas, but only because of the lactin component of things in that regard, because she is Ethiopian by her heritage and she eats a very Ethiopian diet, and chickpea flour is really quite popular as I found out within that cultural diet. I'm going to want to look at, "Okay, well if something is at one I'm going to start avoiding those. If they're in twos, threes, and four we're definitely going to avoid those as well." We'll chat more about that as we go along. Remember, some people will be low reactors, I chose her specifically one of my patients, which is a low reactor. When she stops eating the foods, which are even in the ones, she doesn't remarkably better, because those are big scores for her.
With that said, another thing to ponder is, what about a reaction? Let's say we go back here we pick malt, better yet, let's pick something interesting, honey. Honey is a moderately good score for her. Now, if she has honey on Tuesday, that reaction for IgG, I tell my patients where E is for emergency, remember G is gradual. That reaction can last for 72 hours in the body. Now all of a sudden she has some honey, and or it could be an egg, but let's make it honey for the conversation. She has this reaction, and then she does some more of it on Wednesday, and then some more of it on Thursday, maybe it's her favorite food to use.
We now have the last 24 hours of the first reaction, the middle 24 hours of the middle reaction and the first 24 hours of the third reaction, or as my very simple emojis will demonstrate, we have a stacking effect. She's going deeper and deeper, and higher and higher into immune reactivity. Because, a one time interaction, in the acrylic well via the ELISA technology, created the score that she had. Once we do it day in and day out, day in and day out, just like we over exercise too much, we do anything too much, there's an accumulative effect. That's how even little scores can become big scores. We'll chat a little bit more about that and recap this slide towards the end of our presentation. If you want this presentation, and you want to have these emojis so you can explain it to your patients. There'll be an email at the end and we'll be more than glad to send this to you. Because I reuse this all the time for my patients and I have Intel and Nike executives and as a vast majority of my patients, but they say, "That really makes sense. That's a great little visual." It's simple, little visual, but it's a great little visual.
How about this one? This is a 37 year old man with ulcerative colitis. Once again, because there's not the background noise that you often will see with other laboratories, the purity of the antigens are there. But you think, "Ulcer colitis as you talk about, that's a hot mucusy, bloody mess." I've seen his stool. He takes pictures of them for me. It's like, "Yeah, it's a hot bloody, mucusy mess." Why would you not see threes and fours? You could, but his immune system, this is what it does. This is him hollering. It's like if you have a friend or a family member, but they whisper. They whisper that special little way but that's the equivalent, they're hollering. This is equivalent of his immune system, hollering, how can not ulcer colitis patient not have an immune system that is hollering? He's not on a biologic drug, by the way, he's not on immunosuppressive.
You can see here we got that dairy going on. By the way, if you're not already familiar, dairy and particularly casein cross reacts with gluten and glutamine. Gluten and glutamine cross reacts with yeast, and yeast cross reacts with the gluten, with the casein, with coffee. When you have those challenging patients that have gone gluten free, they've been diligent, they have been following your advice. You say, well, maybe there was a cross reactivity when you went out?? It's like or maybe you're still drinking the coffee. Maybe you got some cream in there with the casein? Or maybe it's a yeast cross reaction. Once again, cross reactivity is come to play a lot. I gave a whole webinar, which I gave about a year ago on cross reactivities, which is available on demand @usbiotek.com. This is not going to be an in depth cross reactivity presentation, but we as clinicians look at these results and say, "Well, what would I avoid for him?" Well, clearly anything in the ones I'm going to avoid for him. Anything that is an IgA, which we're not talking about IgA today, but I'm going to since I have an example here, I'm going to avoid anything that's even slightly IgA related.
We don't generally see a lot of IgA with the ultra pure antigens, but when they do pop up the mucous membranes, and since this gentleman has ulcer colitis, there's mucous membranes of all. Anything along the way, I'm going to play it very conservatively, really clean up his diet, because if I want to heal up leaky gut, also clients groans, whatever it might be, or just address the dysbiosis that's clearly going on and I have a stool test, which I'm not going to share today. Also, that shows he have quite a bit of dysbiosis going on. I need to gentrify the neighborhood; I need to clean up the graffiti; I need to create an environment; I need to make sure there's plenty of butyric acid, short chain fatty acids, that the mitochondria are happy within the colonocytes and enterocytes, because we're really rebooting the system.
We all know about a leaky gut can lead to a leaky brain. One of his big problems is he's a recovering addict, and stress and anxiety is very real for him. When he gets gut flares, just like any of us, when we get a messed up tummy, we don't feel well. The patient is like, "Okay, so it's not all in my head?" No, it's actually in your tummy and in your head. They feel a little validated knowing that they're not just weak minded, but there is really something going on.
What is IgG? Well, it's gradual. It's not an E for emergency. Once again, two different data sets. It's not a true allergy test, it's a sensitivity test. It's most prevalent antibody in the bloodstream, but you can measure other antibodies of the US BioTek IgA, IgG4 or IgE. If you want to measure all of them and really get a really beautiful data set. You can but IgG is always my immediate go to for the last 27 years of my clinical practice, it's my starting point. Now, if I have a colitis patient I'm going to do IgG, IgA. And, there's different combinations, and you'll hear my presentation at usbiotek.com on IgG4 and some interesting things about eocenicaphalicus esophagitis, IBS, IBD, as well.
There's some cool little factoids that are in the peer reviewed literature, this has been studied, and there's a lot of validation. When we measure an IgG at US BioTek, you're measuring all four sub classes and an aggregate. You could measure, if you choose to, IgG4 as a standalone, it's known as the blocking antibody. As you can see here, IgG4, its once again, it's negative for binding compliment, whereas IgG 1, 2 and 3 bind compliment. It is the Yin to the Yang, the Yang to the Yin, it's a teeter-totter, Tik-Tok, it's a balancing factor. When you're measuring that gray line for IgG as an aggregate of all four sub classes, you're getting a sense of the body. Now, if you were to measure the IgG along with an IgG4, you'll get a different sense of is their tolerances are not tolerance? Also, for the conditions like IBS, IBD, Autism, cephalicus, esophagitis, is it also might be a driver for some of these conditions as well. Once again, that's another presentation I've given.
IgG Immunology, why is it important? Well, IgG delayed hypersensitivity reactions are cell mediated responses, they occur after food is eaten and then taken up by antigen presenting cells, which are then exposed to CD4 T-cells, known as the Helper cells. These T-cells generate Th1 cytokines, Interferon gamma, Tuner Necrosis Factor alpha, Nuclear Factor Kappa beta. Once again, we're also seen that we also have the TNF beta. What's interesting be cell specific for food allergens react by transforming into IgG3, this is a current thought and you can see the reference. IgG is delayed sensitivity, it is an immune cells such as macrophages, basophils, CD8 suppressor cells, T-cells that trigger symptoms rather than antibodies. This cell media reaction leads to the synthesis of reactive oxygen species, prostaglandins and leukotrienes.
This is why a lot of our patients will have the "itisis" and I as I described my patients, C-reactive protein or total combination of cytokines is your accumulated itisis - can be a sinusitis, bronchitis, tendinitis gastritis, colitis, but all your "itisis" combined is your inflammatory burden that your body has. It can also be, of course, inflammation in the brain. This inflammation leads to all kinds of symptoms, which we see every day with our patients.
IgG testing is critical and patients with gastrointestinal issues, depression, asthma, but also anxiety. This whole concept that if I can eat a food and get a migraine, if I can eat a food and feel hungover, and without having a fermented food, but you actually just feel zombified when you eat a food, but an inflamed brain is not a happy brain. If any of you have ever had a cold, or the flu, and we know are just the inflammation is so high, the last thing you're thinking about doing is checking your banking online, paying the taxes, or do anything a high functional intellect. Because, when skin and a flame brain is not a happy brain, and we also know as our gut goes, so do we.
We want to look for things also like you can see the third bullet here, nasal congestion, chronic sinus infections, joint pain, headaches. There's an article I just wrote on the research on IgG for a whole litany of things including possibly its application of avoiding foods relative to weight loss and obesity, as well. Once again, it only makes sense we are only as good as the food we put in, but it's also is how agreeable is this food unto us. Of course, that whole concept of sitting quietly getting the gas or cephalic reflex going, having our mouth salivate, taking time to chew our food, which we'll chat about, and then allowing digestion to occur. Otherwise, we're in such a sympathetic drive, the last thing a rabbit that is being chased by a wolf is going to want to do it is digest properly. We need to have a more Kumbaya approach to allowing the food into our body with mindfulness.
You'll see lots of references at the bottom of the next three slides. This is once again from the peer review literature. They look at migraines and double blind, randomized, crossover trial. Exclusion of foods to which patients had raised IgG and has led to a significantly reduced number of headaches and migraine attacks. Case report, look at the elimination of IgG as a response to reduction of asthmatic symptoms, less dependence on medication and improved quality of life. Once again, IgG there. Now could there be also an IgE component? This is why sometimes we'll do not just IgG, we'll do the IgE antibody, we'll do the IgA antibody, because our body can respond in different ways. When we're hunting for a patient symptomology, I generally start with IgG. Most of my patients will have a sense of what their IgE, and once again that's the emergent through allergies are, but once again, if they don't know we'll test for that. We'll also talk today about cross reactivity.
Well, what about sleep? Well, elimination of foods that triggered an IgG reaction along with health coaching, helped with, not only obesity and weight, but help people sleep. Also, people with heaviness to them, weight to them, and thin people can have this too, they may have sleep apnea. If you have indigestion inflammation of this, it's further going to narrow and cause congestion. I've actually lectured on sleep apnea and wrote an article and Townsend Letter, which I'll be more than glad to send to you about sleep apnea, very pervasive. When we think about what we're talking about today, we're talking about food. Well, we can all live weeks without food with rare exception. We can live about three days without water, but only moments without air. Either it causes airway issues, which includes foods, and we're not talking about IgE only, we're talking about anything that irritates that pathway is going to be a problem limiting our oxygenation and we won't function optimally.
Lots of research on colitis, irritable bowel syndrome, and I will go over all this literature, you can see the references, these slides are available, they will be archived on the website. Once again, where it's just going to be a position paper, which will have all of this information, plus a unique approach at US BioTek takes to doing reproducible reliable sensitive results. Then major depression, well of course, we know that 70 to 80% of our serotonin is in our gut, that 60% of our dopamine is argued to be in our gut. We know we have internal chromatin cells within our GI tract, and we know when our tummy hurts, we don't feel good. They look at age adjusted healthy controls, and they looked at things such as antibodies against celery, garlic, gluten, and compared to the healthy controls. More than 80% of the teens with major depressive disorders had prolonged food intolerances with highest certain levels of histamine.
Yes, there could be a histamine component, we all know about the histamine diets. We all know about FODMAP diets, and there's all these other components we want to look at. Once again, IgG testing helps us to identify in the buffet of life, which foods are critical on our salad plate or not. There's a local favorite food bar it's called Sweet Tomatoes. I was trying to find a word for it without saying the name of the place but Sweet Tomatoes, a salad bar, large salad bar, and it's my favorite place to go. I know based on my IgG testing what I should not put on my salad, but it's just the salad bar how can you go wrong? You could argue a salad bar and say is it organic, is it GMO, is sprayed, is it not sprayed. Can you imagine if I went along and put something on like beets, which I don't get along with, or if I went ahead and put on lima beans or peas that up my body doesn't get along with, I thought, "Well, I'm doing good for myself."
Then a buffet of life we want to have that sense of, "I can choose to be naughty or I can be choose to be good, but at least I can make that conscious choice," and that's how I educate my patients. "I don't know if I want to know." Well, you can ignore it, but when you are feeling crummy, you can be really stringent. Of course, you have the patients that are so desperate they'll do anything. Then of course they want to know because they want to know how can I liberate myself from this plight. I think we all have those chronic migraine patients, for example, or the chronically depressed people that are feeling like Eeyore more often than Pooh or Tigger, and "it looks like hurricane weather," opposed to "Hey, I'm happy. It's a nice day outside." They're just muddling through life because their chemistry is so off and inflammation and neuro-inflammation is a big problem, like anxiety and depression.
It's important to remember that there's often cross reactivity between IgG mediated hypersensitivity and pollens. If you're doing a test in the spring, and in fact, this morning, I was speaking to a doctor in California. She had done a test, and then she had a patient that redid the test. In the spring, she had done the first test, now it's coming into the fall/autumn and she went ahead and did the test is a little different. So today, I had the opportunity and privilege to educate on cross reactivity. We'll chat about that too. Reproducibility, all the tests at US BioTek are ran in duplicate, they're barcoded and ran through the technology, blinded with known positive and negative controls. Most laboratories don't take that effort or expense, but US BioTek does to ensure internal controls. That's very, very important, plus a positive and negative controls. Reproducibility is very important, I'll share an article with you on that. If you want to learn more about how food allergies and the environment collide, that's a presentation also available at usbiotek.com.
Imagine you tell a patient and they're all gung-ho, they want to be better and you're going to say, lose the technology, go out in nature, leave your cell phone in the car, and sit on the ground, connect with the earth connect with nature and you'll feel better. You've educated them about the Dirty Dozen foods. Now, don't eat any of these foods unless you're Non-GMO and they're organic. This patient is really looking to please, looking to feel good, wants to come back and say, "Doc, I've done everything you told me to do and I'm feeling better." She comes back and she's like, "I'm terrible. I actually ever since I've been doing this, I'm miserable." You're just like, "What's wrong?" Well, if you look at the trees she's around, she's around birch trees. Well, guess what? Birch trees and these foods don't get along. There's nuts there, carrots, apple, celery, and organic, Non-GMO tofu. Lo and behold, birch trees, cross react with apples, nuts, carrots, celery, soy, possibly hazelnuts.
Once again, sometimes when we look for that reproducibility, we want to know, are we retesting at the same season? If it's a little off, just remember, there's different pollens, different environmental things that might have been going on that also causes cross reactivity. Just that educational point, as you're educating your patients, you've done the retest, which is really important. You're saying okay, well, and these are some reasons why the results may be different. A - we've healed your gut, we've worked on leaky gut, we worked on dysbiosis your results are remarkably better as we would possibly expect. We haven't done antibiotics or other things that would cause disruption. Or the other aspect of things, is you'll do a test and you'll find that, well, that didn't move at all. That scores just as high as it was before. Everything else went down and I haven't eaten that food for... one of my Docs I was talking to, that patient hasn't eaten it for 10 years, it was almonds. That's what's called a fixed reaction.
That is, thanks to mom and dad and the combination of makes up us, or the patient, they just have an almond issue. There's no way you're going to convince your body to like almonds. Just like with those patients with IgE reactions, they are born with anaphylaxis often to an egg or a peanut, that's what's in genetics. Genetics are working for us are not, just like methylenetetrahydrofolate reductase or any of the other lovely genes E34 so forth and so on. Cross reactivity, I've created cross reactivity charts, which you can also request from the US BioTek front desk, or your sales rep, and I'll be more than glad to send them to you as well.
It all comes down to the straw on the camel's back, that I mentioned and I know I did that I work with a lot of executives for very high powered firms. About half of them don't get this concept. As you saw, each of those foods got loaded onto our little virtual camel. Well, which one broke the camel's back? The last one on was the celery. About half of my patients are saying the celery broke the camel's back. I'm saying, "Okay, let's do this again." These are five things, in total, broke the camel's back, lead to symptoms, right? One of them said, "I don't have the celery at the top. The celery was the first thing on, the carrots were the last, which one broke the camel's back?" They said, "The carrots." I'm going, "Okay, no, it's actually all of them in concert." Often our patients say, "Well, I ate that food and I felt poorly." Well, you ate that food into that food category, remember cross reactivities. Once again, it's a total burden that got that patient feeling to that threshold that they notice it.
When I gave a lecture in New York about six years ago now, it was 7AM in the morning, I was a keynote speaker, hundreds of doctors, I said, "Any of you tired?" I know I'm tired, because of course, it's four o'clock, I'm in Oregon. I just flew that night in. It's four o'clock my time and I always make a joke about my hair do I said, "Of course, I have all this hair, not." I said, "I've been up since three." Lo and behold, I said, "I have a question for you all, how many cells in my body have to be tired before I feel tired?" I said, "I've looked in the literature, I consider myself pretty well learned, and I don't know the answer to any of you know?" Hundreds of doctors and very brave broad group. No answers, this is rare. I'm going to tell you things about epigenetics and other things today, which I will back up with research, but I don't know the answer to that either.
Let me ask a simpler question, remember, we're talking about food allergy burden here, apply that to this little conversation. Imagine my finger hurts, my thumb, and I asked five providers, "What should I do?" One might say, "Take Arnica. Arnica works beautifully." One might say, "Ice it." One might say, "Put pressure on it." One might say, "Take Tylenol or acetaminophen." Others might say, "Ibuprofen." One says, "Well, can you just remove the splinter?" Once again, we have to figure out how do we get here, but once again, how many cells in my thumb hurt from that splinter? We don't really know how many cells it takes. Likewise, we don't know how bad a person has to be. Some people's inflammatory cytokine food reactivity, may be higher or lower before they have overt symptoms, or they may not even know how miserable they are, how good they can be. Because once again, they've never had wellness at that higher level.
US BioTek Food Sensitivity Testing, duplicate testing with known positive and negative controls, they exceed accreditation and regulatory requirements. They have three to four PhDs on staff at all times, and very high tech. If you ever need a good excuse to go up to the Seattle area, you will be amazed at the technology and the methodicalness, micro pipetting robotics, obviously, there're humans there, but once again, they're kicking out a lot of that human error, because they're committed to that higher level. Before I became an educator at US BioTek, I toured their facility as I do whenever I go and educate. Studies demonstrate that US BioTek reliability, this was a 2010 article and Natural Medicine Journal that US BioTek ELISA IgG testing that US BioTek offers, is both reliable and reproducible.
In addition, the study's authors sent blood samples from a single patient to US BioTek, in another lab, under different names. Can we know what the results should be, it's a single person's blood? They sent them in and say, "Hey, well, is it reproducible or not?" On the first day, the researcher sent two samples at each lab, split samples. Then the same week, two more samples were sent to each lab. The researchers then determine results according to within tests repeatability on the split sample, within test variability during a week, and variability between the two testing methodologies. Once again, we're creating an arranged marriage, we put a little bit of your blood sample a patient in there, and remember it's done in duplicate, once again at the labs expense, and ran as internal control with known positive and negative controls. This is what ultimately pays off is that level of retentiveness.
They looked at the IgG testing, it was superior to the other testing methodology, with a big lab that will go unnamed, and the sample undergoing US BioTek technology, the 96 food test 91 foods, 95% were identical between the split samples. That's great news. The reporting results were consistent on both a split sample over one day and during a week. The other testing methodology from the other lab had lots of different random results. The study's authors concluded within the sample size, though small, these tests are completed for individual patients and clinical assessments and setting, and thus variability and must be minimal for the test to be valid. Here were the results. Once again, US BioTek did phenomenally well and once again, compared to another very big a well known lab. The concept is, it's not about the other lab, it's about US BioTek being held to a standard, and our patients count on us to make the decision on which supplement, rattle-rattle to take? Which therapy or laboratory test to do? What you do when they get the laboratory results back? Once again, I wanted to share this, not as a promo, I'm not part of the sales team or anything, but just one clinician to another about why you have the confidence you do and why I have used US BioTek for 25 plus years.
How would you look at food reactions? Clearly, if a foods in a three or four you're going to avoid it. If it's a zero, you're going to generally either feel like now this close to the line of one that's a clinical decision you need to make, how symptomatic is that patient? if it's close to that one line, you might as well count it as a one, if it's close to the one going on to two line, I'd up score. Much like if I tell you 9.98, well, are going to round that down or you're going to round it up? You'll round it up.
I generally avoid my twos, my threes and fours for my patients, unless they have such huge reactions, that if I was to do that, I'd have put them on a starvation diet. If I put them on starvation diet and they die of starvation, I really I've done that "do no harm" thing, not very much justice. If they don't have a remarkable number of scores, I will actually count things at a very conservative level, and say you can eat the zeros freely but, if it's close to a one, I would not. If you're closer to one every four days, and anything above that I would actively avoid.
That rotation diet is a four day rotation diet. Remember how we were talking about 72 hour leg on a reaction, hence why I call it IgG gradual. G is for gradual as I tell my patients, even though immunologically we know that's not why it's called G, I want to clarify any of you Immunologists out there. "Okay, I don't get why Dr. Meletis says the G is for gradual." For my patients education it's gradual, just like E remember? Emergency room, for IgE. If you're going to eat food that you're rotating on day one, you will not have it for at least 72 hours, and then you can possibly eat it again, if a person tolerates it, on the fifth day. Day 1, 2, 3 then we can start doing after a full 72 hours. Now I eat a food at the tail end of the first day, then I have to wait till the tail end of that third, whole cycle of 24 hours.
The concept is the average human being in the United States eats the same 25 foods day in and day out for a lifetime. I've had people challenge me, including my kids, which are now 21, 25, "Dad, that's not true. Earlier today I had a french fry." I don't want to take any credit, they're adults. I get no credit for this example. "I had a french fry, then I had some tater tots. Then I had a mashed potato. Then I had a baked potato, then I had potato augratin, then potato pancakes." I said, "You had a potato? You had a potato." Okay, well, likewise, "I had a roll. I had noodles." I said, "You had wheat." Once again, we think of as all different kinds foods, but we are really creatures of habit. "I had an avocado on my salad, and I had one on my sandwich and I had guacamole." You had an avocado. You get the idea, we won't belabor it anymore.
Remember that concept of rotation diet is once again, very simple. G is for gradual, that's how I explain to my patients, 72 hours, and there's a stacking effect. Because of their 72 hours, just three days in 72 hours. That's every fourth day, every fifth day you allow the person, or encourage the person that allows an overstatement to eat that food, because here's the reaction to waiting to have a reaction. They've eaten the food, they've eaten the food again, the next day, they've eaten the food again. This is where the little scores become big scores. This is why we want to consider when we look at these reactions, why we're avoiding the ones, because ones can stack up to be big scores. If our patient is really inflamed, very miserable, they got migraines, they have poor quality of life. We find that balance between eating to live, and living to eat.
How do I reintroduce foods? I avoid problematic foods for two to three months, minimally, with my patients. This is my preference, over 27 years as a naturopathic doctor. If they're highly reactive, either IgG or IgA, I'll wait six months, unless they're just saying, "I got to have it." Then we'll talk about what's the cost of doing that. Because, we're not doing just cytokines and leukotrienes and prostaglandins management. We're trying to create an environment within the GI tract, the friendly bacteria, that dysbiotic bacteria, we want to create the eubiosis. Where do we don't use as often we've talked about dysbiosis, which is the negative word. This means we have dysfunction. How do we all talk about that? We're going to work on eubiosis, would it be great and we just talk, we're going to work on positivity.
I have my patients that just can't live without a given food, reintroduce one highly desired food after this week period. I tell them, you can do it twice in a week. Why am I doing it twice in a week? Assuming they don't have a terrible reaction with the first time they've consumed, if so then it's out, I'll have them redo it. I'm looking for a little bit of a stacking effect, and I want to track their symptoms. Before I have them reintroduce their foods, I have them write down, on a little three by five card or a sticky note, the three to five symptoms that they don't want to see come back, that were bothering them before. I want to have it in print, and I want them to be very objective. How am I doing with my headaches? How am I doing my joint pain? How am I doing with my bloating? My bowel cramps? My mental well being? Because I want to look at, and I want to quantify, if I just introduce the food they're like, "Well, I felt okay." What I wanted how did you do on these three to five points? Try to objectify a subjective thing as much as you can.
Option two would be to avoid problematic foods for three to six months, and then redo the food sensitivity test before you even consider reintroducing the food. The concept there is okay, you've done your GI work, you've worked on leaky gut, you've worked on dysbiosis, you've eliminated offending foods, which created an inhospitable neighborhood. As a result, now you want to see how good is good, after you've been very, very strict. And then you can do the rotation. Because if you avoid it for three to six months, having eaten the "offending foods," then all of a sudden, you can say, "Well, did it quiet down?" Like in the case of the woman with the almond score from the Doc I was talking to you earlier in the week, she had to avoid almonds for 10 years. As she went back and started eating almonds, you can say, "Well, it's high because I eat almonds again." No, it's high because it's a fixed reaction, almonds just aren't your thing. As with any relationship, it has to be a mutually beneficial thing, otherwise, it's a disharmonious relationship.
We may like our food, but the food doesn't like us, isn't really a healthy relationship with that food. Then after doing the food sensitivity retest, which is my preference (option number two), then I will do option number one, Part B and start introducing the foods at that juncture. Now, my personal advice, I never reintroduce IgE foods. Some conventional doctor will say, "Well, there's enough IgG4 we may try that food." I have an IgE reaction to the latex family of foods. I have an EpiPen, and I may like avocado and I may like kiwi, and I might like other latex foods. We eat to live and need to be alive to eat, I don't like those foods enough to risk it. Why would I want to trigger my immune response, whether it be IgE or IgG for the savoring and morselling of a food, which is not doing my body well? My personal very narrow bias, but this is how I share with my patients.
Leaky Gut associated conditions, what we're looking at here, is that we have all kinds of conditions with association with the leaky gut. In my September presentation of this year 2019, actually, I spoke about how the toxins, toluene, benzenes that go through our bile into our GI tract as we detoxify on a daily basis, cause further leaky gut, and further reactions either at over allergy or sensitivity. Athletes and postmenopausal women are also very susceptible to intestinal permeability changes. The athlete of course, is planning on their glutamine for muscle, but we know that with andropause and menopause that estrogen testosterones are dropping, and the mitochondria within the intestinal mucosal cells aren't fueled like they used to be. At the age of 30, we actually made 143 pounds, 65 kilograms of ATP, "if we're healthy." For every decade after 30, we lose 10% of our mitochondrial function. That includes our GI tract, that includes our muscles that includes our pancreas, that includes our whole body, including our heart.
Once again, we want to know that we're taking care of the mitochondria as well. So, it's more complex than that. Remembering that when our little bacteria are eating inulin, other fibers, they're producing butyrate. Butyrate actually goes through the lumen, and actually helps nourish the mitochondria. Another reason why that the butyric acid is so critical as we're measuring short chain fatty acids. Of course, I give a simple example and you're welcome to share the slides with your patients of a colander, a strainer. Well, once again, imagine this is your gut, if there's too large of holes, all that rice is just going straight down the drain, or in this case, straight into our bloodstream. Then of course, we're going to trigger all these immunological problems for our autoimmune patients, our patients with chronic infections, patients with a pro inflammatory response within the body. We want to ensure tight junctions. Of course, when we eat offending food that further perturbs and inflames those tissues creating not only a dysbiotic environment, but a dis-ecological environment, then of course nothing flourishes in a poisoned ecology or a controversial conflict zone.
The glutamine, we all know this, we all learn this, but often we forget that when our patient start going CrossFit or lifting heavy, or one of my chiropractor friends, his wife does lots of marathons. She'll run from their home 13 miles away to his office, and then like, "Okay, well, I ran 13 miles" and once does this multiple times a week. I was like, "What about that?" We're looking at how much glutamine is she using? Might she start having mitochondrial function issues? Might she start eventually tapping out or capping out on her muscles? Might she have an immunological challenge? The answer is yes, yes and yes. Plus, the gut is going to be the last thing in line. It's called conditional deficiency. Glutamine is a conditional amino acid. Once again, very important, but imagine you're exercising, wow you're looking great. "Yeah. But, my gut it's really bothering me." Could it be glutamine?
When I go to reestablish GI integrity, I do a lot of gut work, lots of stool work, lots of testing, but we want to identify and eliminate the offending foods triggering disharmony within the GI tract. If you haven't told your patients of "Fletcherize," it's time to. Of course, the word Fletcherize means to chew the food into small morsels. It's actually from a nutritionist, his name was Fletcher. You want to Fletcherize your foods. The patients do best when you tell them how to Fletcherize, not how to chew. I say, "I want you to Fletcherize your foods 20 times before you swallow." I also tell my patients do not drink liquids more than three or four ounces at a given meal. Why? Because we have a tendency to wash our meal down, we will wolf it down and wash it out. If you are chewing your food, you don't want to have to wash your food down.
You tell your patients to Fletcherize. Plus, by doing that you're creating greater surface area so that your salivary amylase, protease, GI tract that of course, stomach the pancreatic functions of the pancreas brush walls, it's already minced into smaller pieces a better surface area, better digestion. As a result, you're breaking up those amino acid sequences and antigens, so that you're not going to have the full amount of reactivity. Most all of us know about the Bristol chart, but every once in a while, I find somebody that does not know about the Bristol chart. The goal is to have two to three bowel movements a day, and you want them ideally, in my opinion to be a 4 on the Bristol chart, and why two/three bowel movements a day? Because, a babbling brook does not grow mosquitoes a stagnant pond does.
Once you get you're going to reabsorb toxins if you have a dryer stool, if you have a one or two or even possibly a dryer number three, well a number two, which is a number three, which I guess would be a six, that's a whole nother conversation. If you have a dryer, what happened to the muddy water, you're reabsorbing the toxins, pollutants, the byproducts of the bacteria, good and bad within your GI tract. Once again, to the three bowel movements, and if you've ever had kids or you've been around kids, you know that's about what they do. They eat and, as my father-in-law would say, "Make room."
Test for and eliminate environmental pollutants. Once again, my presentation in September, actually spoke about how environmental pollutants caused leaky gut, and dysbiosis. You're working to heal a person's GI tract, but you haven't quantified the environmental pollutants. There's an environmental pollutant panel that is part of the O test, or it can be done as a standalone, from US BioTek, and it actually speaks to the fact that what happens if you're detoxifying every day? Well, our liver is all day long, phase one, phase two, phase three; which phase three is the GI tract and urinary tract. Now it's going and you're trying to create this healthy environment. It's like you're trampling your garden you just planted with little fledgling seedlings because of the environmental pollutants are going down there and poisoning them, literally.
Of course, our glutamine we're all very familiar with that, we were just chatting about that. Butyric acid, if they're not sensitive to dairy, organic butter and ghees might go to ,or you do Butyric acid in some form of sodium or magnesium or calcium butyrate. What's going to be a good source of that you can email me at drmeletis@gmail, drmeletis@gmail. NAG, N-acetyl-Glucosamine. But, you want to be careful on NAG because NAG is usually made from crustacea. If a person has an allergy to shrimp, crab, you're going to want to be aware of that before supplementing them with that particular supplement. Obviously, probiotics, prebiotics go without saying.
Fueling the mitochondria, we often forget about those lovely little mitochondria. Every cell your GI tract, you work on a patient, you're trying to heal the gut and you know those tissues can heal, you know lining of the stomach can replace itself in about five days. That's the first lining of course, and the GI tract can heal itself. It has to have the energy to do that. It's like giving a carpenter a hammer, but they haven't eaten so they don't have the ability to hammer. The genetic, nuclear genetics of us, our nuclear DNA, half mom, half dad, hence us, has to have the mitochondrial energy to heal. If they've actually already had gut issues or other systemic issues, often the mitochondria aren't functioning well. Remembering certain medications like propofol, they went in for the colonoscopy.
Well, propofol poisons the mitochondria. Going to the dentist, lidocaine poisons the mitochondria, lots of the anti inflammatories, certain antibiotics poison the mitochondria. A lot of other meds, including not only antidepressants, but even the statin drugs have been shown in the literature to poison the mitochondria. I go over that in one of my other webinars that US BioTek, that's why I like to do O testing, because that O test is very important to quantify how's that inner matrix doing? How's that citric acid cycle doing within that GI tract, within that brain, within that liver, within that pancreas, to allow the tissues within our body of trillions of cells? As I point out, our microbiome is only as good as our mitochondria. Because, if our mitochondria aren't sustaining our bodies, there's no place for a microbiome to live. It's a lecture I give called the M & M Lecture.
Leaky gut factors of course, food sensitivities, processed foods, alcohol abuse, antibiotics, including in our food sources, just like we have herbicides and pesticides. That's why we avoid those dirty dozen foods, which you can find out the Environmental Working Group, ewg.org. We want you to look at what's compromising our barrier of our GI tract. Athletes are more susceptible to leaky gut and apart, they're just wearing and tearing. They're challenging their mitochondria, they're challenging their glutamine stores. As a result, we need to take better care of them. Some of the literature picks on high fat diets, we know a lot of people are very pro keto. When they pick on a high fat diet, or they pick it on the standard American high fat diet, or a high quality fat diet, with adequate fiber and prebiotics. Once again, we see some of this literature like, "Well, now the high fat diet studies." Yeah, but what fat were they eating? Were they actually supplementing or augmenting their diet with some fiber, which is not high in carbs, counting carbs. We want to work on that, and knowing that once our gut becomes leaky, once it becomes unhealthy, we actually start not absorbing the very nutrients we need to heal.
This is a webinar available at US BioTek called The Catch 22 of GI Disease: Celiac, Crohn's, diarrhea, constipation, ulcerative colitis are all conditions, which in the peer reviewed literature have been shown to cause certain micronutrients to drop, which are the same micro nutrients necessary to help the lumen and quiet down the system. Once again, it's all about education, and I have learned so much the same with each of you. When you do a new test with US BioTek, I'm available to do consults, organic acid, the celiac test, the Candida test, new food panel, whatever it might be. These are the webinars available right now on demand. You literally put your name in, and boom, you get to watch whatever you want to watch. I'm always open to feedback as well. You'll see here that September lecture, you'll see how detoxification hormone disruption that was the August lecture, I remember that day because it was with my wife's birthday.
Of course, how the mitochondria works, you want to learn more about organic acid testing, how phthalates can increase the chance of non neuro typical AST offspring. How parabens cause a whole nother pervasiveness. Also, once again how foods and the environment collide; the leaky gut; attention deficit, different things I see in my practice. I love lecture on topics, which, once again, I see every day. I get to actually create a presentation, go deep in the medical literature, and then come up with a, "Wow! I know more than I did before I did it!"
Our conclusion is IgG testing is that they give G for gradual, and there's all kinds of assays we can add on to it IgG tests. And, they're all a la cart, you're going to add the IgE, you can add IgG4, you can add IgA. I'm going to open up for questions because I probably ran a little long, I'm known for being a quick speaker and lots of energy put forth. I am open for questions, Chase.
Thank you Dr. Meletis that's such a great webinar. As you know, I've been in food sensitivity testing for over 10 years, and I can tell you how many times I have seen patients who have been chasing symptoms and going to see a specialist over the last 20 years, and been falsely diagnosed with different types of diseases and ailments over that 20 years and when they finally got a food sensitivity testing, it all went away. I mean, like you said food sensitivity testing just really changes people's lives and how they live their life.
Let's get into the questions here. We have a lot of them, hopefully you guys have time. One of the questions is:
That is the great thing about US BioTek panels. We have many panels that fit the dietary restrictions of your patient base. We have our general food panel, which applies to the North American diet. We have a Japanese food panel, Asian food panel, Mexican food panel, and we also have a Vegetarian food panel as well. If you do have a patient who eats more culturally specific, there are panels for those patients.
I would just chime in here, Chase. I routinely actually cater it to my patients persuasion, or now with our 144 new panel, because it includes all the extra spices and a lot of mentally. My wife's favorite food is Hispanic influence foods, now there's a lot of additional things added to the 144, which for all these years, I was just doing 96, I was excited about the 144.
The answer is how messed up is the gut? I think the answer is yes. Because otherwise, you're basically starting if you're if you know what a manual car is, because most people drive automatics. You're starting at the bottom of a hill in fifth gear, because you're actually continuing to irritate and inflame the gut, with the offending foods, which is creating that inhospitable ecology for the gut. Is it still possible to heal leaky gut? Yeah, but just so much hard. It would be like having one hand behind your back. I usually avoid the foods, which are causing that disharmony and disruption within the gut as part of my healing of the gut. I usually do it before and then after, and also the patients have that tremendous sense of like, "Well, I'm so much better."
Yes. Actually, if you go to either Natural Partners, which is of course full scripts, Emerson, which is a Welavate or Care Well, they all actually have sodium butyrate supplements. I won't promote a special brand, but if you contact me, I'll tell you, which one I use at email@example.com.
Probiotics. Well, interesting enough, I've done this for a long time. I have a wonderful wife of many years. She is very sensitive to probiotics. In fact, she usually only can find one probiotic, and it has taken me probably the better part of 10 different brands to find the right probiotic that she can tolerate. In terms of effectiveness, just like with US BioTek, you want to ensure that the laboratory, just like US BioTek does.The supplement company actually has not only GMP, but you're also wanting to make sure that they test out with excess amount of colonies by the end of that two year period of time.
Also, you want to have a laboratory, or a supplement company, which is doing their own assay of every run reading that comes in, like US BioTek, tests all the antigens. Even though a certificate of analysis like me saying, "Hey, this is okay." Well, it'd be like you saying, "Well, I'm going to test that to make sure it's okay." Well, a good laboratory or good supplement company does that. You really want to get to know your supplement company very well. Whenever possible good excuse, tour that facility make it a family vacation. Who knows maybe it's a business expense too.
We're getting a lot of comments from our neighbors up North in Canada. Hello everyone from Canada, welcome. Our testing, we include free shipping, both to and back from Canada. We're getting some inquiries from doctors based in Ontario. Our testing is available in Ontario through In-Common Laboratories, which is based in North York, Ontario. I believe their website is icllabs.com, our testing is available through them for those who are based in the province of Ontario.
Here's another question:
Great question. Yes, sometimes. No, sometimes. It depends on once again a principle a colloquialism that I've created, is it fixed or is it earned? If it's a really pronounced issue, they will go ahead and it'll still show up. If it's something they already know is problematic, then the question is that healthy relationship with food is it good for them or not good for them? Some Docs will ask, should I do a provocation? Should I just have them eat a whole lot of different foods? I would never have a patient eat a food that we know is problematic to them because of course do no harm. I would never have them eat foods that they would normally not choose to eat out of proclivity.
With that said, I'll go ahead and measure a person and I'll give an example of one of my patients - they do not like vegetables, do not like vegetables at all. Yet they came highly sensitive to lettuce, crunchy water Iceberg lettuce. It's like okay, without definitely wasn't earned that which is a fixed one. I will actually have my patients do the test, even while avoiding the food to see how good or bad is it, then when we retest in three to six months, and if they decide to reintroduce the food, A, why are they reintroducing - is it because it's a food, or is it because it's like their favorite food? Then once again, when there's a person with a problem with a food the most I'll ever encourage them to do, I can't say let, that would not be proper. Once every four days even with a previously problematic foods because otherwise they're going to probably re-earn that problem long run unless you did a phenomenal job of healing the gut.
Yeah. It's that like tapping the back of the toilet, if you hold the toilet down, the toilet flusher down, you're going to let the water constantly run and that's the purge. I find with my patients, assuming there's no hyperthyroid issues and no lower back nerve innovation issues, that just finding the titration either vitamin C or magnesium up to but not causing the purge, and that will vary on their hydration as well. For me it's magnesium and vitamin C those are my go-tos, once again going up to but not causing.
Excellent, thank you.
Well, great question. This is one of the most philosophical topics in my mind, and I have it routinely with my patients. When I do a very broad IgG, IgG4, IgA, IgE, I just go for it. Then the question is the immune system is having to allocate energy to produce that IgG4, the body is. Then the question is, if your body did not have to allocate the resources to make that IgG4, would your immune system be doing something different? That's a philosophical question. Then the question is, if the IgG4 is commensurately high, I give this silly but I think the true example, if I was to be bit by a snake, but the IgG4 represents antivenom, would I choose to be bitten by the snake? The answer's no, I would actually avoid being bitten by the snake. I would just avoid that snake encounter or in this case the food encounter.
Does IgG and IgG4 vary over the course of time? Certainly, it does. They're depending on what the immune response. It's no different than our lymphocytes or neutrophils, relative to the bacterial and viral load, you will see some fluctuation. If the IgG4 is something that's been earned through either immunotherapy, allergy therapies and so forth, you might have a fairly commensurate memory of that IgG4. I think it does crank up, from what I've seen in my clinical practice, based on what burdens put onto the body. I look at IgG4 in two ways, I look it as a helper or protector, is a blocking antibody. In addition, it is telling us that in certain conditions like IBS, IBD, eosinacaphilus esophagitis, autism, which you'll see my presentation that I gave on that topic. That it is also potentially a problem in and of itself, and for those of us that are really into IgG4 knowledge base, we know there's entire disease states driven by IgG4. It's not always totally innocent in the body.
We're getting a lot of different forms of questions about frequency of testing.
Once again, my personal preference is somewhere in that three to six month mark, it depends on what I'm doing with the patient. If they come in as "a hot mess", flaming in like a comet from the sky, it's going to take six months for me to do what I need to do. In terms of working with their bodies and educating them, and getting their leaky gut under control or whatnot. Six months is usually my window. Sometimes it takes a little longer, sometimes a little less, but it comes down to how well healed the patient is financially. Some of my patients have discretionary incomes of $10,000 a month for clothing and cosmetic stuff. For those individuals, obviously, retesting is not a big issue, sometimes under budget, but I would say usually run the six month mark is when I like to retest.
Well, once again, the false positives, that's background noise. False positives, the purity of the reagent, the antigen is very important. You want a super clean antigen, otherwise you have background noise, a static, much like a radio station, you have to dial it in to get rid of all that static. You really want to have something that's not only reproducible, reliable, and very specific. The reason I have chosen personally, and once I'm not on the sales team, I'm just an educator. I've chosen US BioTek is my patients count on me to make the decision of a test that I know is reliable, and it's not going to over report. Because when I start taking foods away, lots of us like to say, "Well, look it is a thyroid, I found it."
I wish no bad news upon any of my patients. I just want a good accurate result that is very concise, and that's what US BioTek offers me is that reliability. When you come up to the Seattle area, if you take a tour of the facility, you'll see why you've chosen US BioTek. Because you meet the staff, you meet the PhDs, you see the high tech automation and the effort that's gone into reproducibility. Other ones too much background noise, too much and not enough specificity. I want to know of a food is a problem or is not a problem. I want to be analytical.
I have my patients eat a normal diet, some people believe in provocation and that's a personal clinical decision. You say, "I'm going to provoke it." Much like you would do with a heavy metal test or some other tests. You can say, "go out there and just go for it and see what you stir up." Well, some of my patients are so fragile, or so non-well, they come in a mess that would never consciously do that. You could have them eat freely, go to two or three buffets, or go eat the unusual foods, you normally wouldn't see if there's a triggered reactivity and that's fine. I just have my patients eat their regular diet. I don't have a limited diet by any stretch, when I do this test. Usually, my patients come in, and this is one of the first test I do for all of them. Because, food is our medicine own and our worst enemy.
Every patient is basically getting this test, with rare exception to identify, are they really fueling their body well? And as we enter cold and flu season, as right now we're in October, I don't want my patients immune systems dealing with a potato if potatoes aren't good for them.
Yeah. I mean, I've always said we want to see the body of the here and now. We don't want them going out and eating foods that they normally would never eat, because just messes with their body's natural biochemistry.
Yeah. I'm already getting emails for questions at Dr. Meletis, drmeletis@gmail. I will start answering those after the webinar. Thank you, everybody.
Yeah, I mean, we're getting a lot of questions. I don't think we're going to be able to get to them all today. I mean, thank you guys all so much for being such an interactive audience. I mean, this is just fantastic.
I do and US BioTek I'm more glad to share those with the attendee that's asking that or all the attendees for that matter.
I've been tested... Can you please share your email again?
Well, you can always email us at firstname.lastname@example.org, we will give you an answer. Also, Dr.Meletis if you'd like to share your email.
Well, certainly it's Dr. Meletis, M-E-L-E-T-I-S @gmail.com. Just email@example.com. For those that don't know how to spell my name, because my most famous misspelling is Mellitus like diabetes mellitus. That happens quite often. It's M-E-L-E-T-I-S. I will answer in a very timely fashion. I love talking to colleagues around the country and actually the world. It's just actually a tremendous delight to visit with you all. I learn every time I visit with somebody about something in that, like, "Wow, that's impressive." We are all pioneers our own right and together we are the health change that we want to see in the world. I think together we're stronger and we're making a happier, healthier humanity.
Well, we're going to have to cut the webinar short here. Like I said, we'd love to get to all of your questions everyone, but I mean, we have to stick to a schedule here. Unfortunately, we've gone a little bit over our time but thank you guys for being such a great audience. Like I said, if you have any questions, please, you know, email Dr. Meletis, call US BioTek, email us firstname.lastname@example.org we're here for you to answer any questions. Like I said, we want to see, as many people positively impacted by this testing as possible. Thank you all very much.