We decided to sit down and have a chat with our practice owner and MD, Dr. Philip Oubre, and functional nutritionist, Aubree Steen.
There’s been a lot of questions directed towards us trying to figure out the root causes of medical issues in the practices. We like to refer to these root causes as the “5 Fingers.” We dive into these toxins a bit more in depth, and how they affect your overall health and wellbeing.
Feel free to watch the video, or read our transcript below.
Dr. Philip Oubre: Hey guys, it’s Dr. Oubre. And I’ve got Aubree Steen here, my nutritionist, with me. And today we want to talk about root causes. And one of the things I frequently was wondering as I was transitioning from a conventional medical kind of traditional doctor into functional medicine was in functional medicine, they kept talking about root causes of problems. And if you can get down to that root cause, then you can technically get reverse the disease or symptom or autoimmunity, whatever it may be. But what I didn’t know is what are those root causes? So today, we’re going to talk about a bit about those root causes and Aubrey is going to lead us off with some questions. What’s your first question for me?
Aubree Steen: So first and foremost, I always have patients go, “What kind of patient do you see? What is the most common root cause of what we treat in the practice?”
Dr. Philip Oubre: Okay. That’s fair.
Aubree Steen: It’s big vague.
Dr. Philip Oubre: It is vague. Every person kind of has their root causes or multiple root causes. And I swear, I’m going to get these tattooed on my fingers one day. Not really, mom, I won’t. But the five root causes that we really boil things down to are the five fingers. And so the first one is the gut. We typically blame a lot on whatever’s going on in the gut as far as the root cause. Whether it be poor digestion, not enough digestive enzymes, stomach acid, bacterial overgrowth, whatever it may be.
The second finger is biological toxins. Actually, all four of the other fingers are toxins. This is the only kind of gut and non-toxin issue. Biological toxins involve what’s going on in the gut, whether it’s a klebsiella overgrowth, which is a bacteria that lives in the bowels, or yeast or candida, some sort of biological organism that’s actually making toxins. That’s not that far fetched. We frequently talk about toxins and we think of Roundup and chemicals and all the bad stuff, but bacteria and fungus make toxins in order for them to survive and thrive, right? It’s survival of the fittest out there or in there. So biological toxins are a big problem to humans.
Number three is actually mold toxins. Now, mold toxins are technically at biological toxin, but they’re so difficult to remove, difficult to identify. They get their own special category, not entirely appropriate. Number four is environmental chemicals. So that’s the chemical industries, the plastics, the Roundups, the Teflons, the God knows what all the chemicals that are in our environment.
Aubree Steen: Right. And also all the food additive chemicals, right? The coloring, the preservatives, the flavorings, things that make food stay shelf stable, things like that.
Dr. Philip Oubre: And then number five is heavy metals. So that’s the leads, the mercuries, the arsenics, all the gadoliniums and things that we’re exposed to on a daily basis. So those are the five main root causes. There’s a lot more as you dive into each category, though.
Aubree Steen: Yeah. Cool. And then we usually see that every patient has one or more of these fingers, I feel like, involved. Always the gut first and foremost though.
Dr. Philip Oubre: I was going to say, that’s actually kind of the order we treat is you cannot get out in any of the other toxins very well or very efficiently without treating the gut. And if you treat the gut, you’re treating the biological toxins, then you go after the other toxins.
Aubree Steen: Right. I think the biggest mistake is when patients come in here and they’ve heard detox, get toxins out, everything like that. If you don’t have an intact gut, you will retox or retoxify and get sicker. And I think that’s kind of crucial for everyone to know that no matter who you are, even if you have no GI symptoms, sometimes those are the worst cases, you have to fix the gut first.
Dr. Philip Oubre: Absolutely. One of our favorite things to see is actually, as we repair the gut, you actually start to see the natural detox processes of the body get stressed because once the gut is working, once you’ve got an exit for detoxed products to actually get out of the body, then the liver actually speeds up and starts detoxifying more powerfully.
Aubree Steen: I love it. Perfect. And so how long, when patients come in, I know we’ve seen kind of a wide range of time they’ve been suffering with this, how long have patients been suffering these conditions before they actually come to a functional medical doctor?
Dr. Philip Oubre: That’s a good question. Too long is usually the answer, unfortunately. Most of the people, many of the people that come to see us have already seen eight, nine, ten doctors. We saw a new patient this week that, gosh, she was probably over 10 doctors she had seen. And kind of the medical merry go round, we call it. And so normally, now the complicated patients that we get, they’ve been sick and been tossed around for a good three to five years. It’s pretty rare to catch someone sooner than that right now. And we’re trying to get that message out. So stop suffering, seek a functional medicine doctor before you reached the five year mark, whether that’s us or someone else. Go to ifm.org, there’s a find a practitioner button. Just to plug us a little bit more, we can see you anywhere in the world right now because of COVID. We can do our medicine online via Zoom without your first visit in person, which we used to require before COVID.
Aubree Steen: Yeah. Which is great. And I feel like a lot of those patients, too, even if you feel like nothing is wrong, I think people are scared to come in because they’re like, “What if I find there’s ABC and D? You’re just going to tell me all these things that are wrong with me.” But I feel like we don’t look at it that way. We go, “How can we make you live optimally and vitally and kind of as increased longevity, but your quality of life, right?” Because inevitably, if you don’t feel bad right now and you have a bunch of issues going on, then it’s going to affect your entire life and the way that you move forward.
Dr. Philip Oubre: I agree. We really don’t market a ton to the well population. But the truth is the well population has heart attacks and strokes and all that. And they were well before that. And then they had that heart attack. So if you never do that deeper dive looking at your inflammatory markers and things like that, then you don’t even know that you’ve got a problem brewing until that problem hits. I was a prime example of that. You laughed at me last video because my CRP, my inflammatory markers were really high. I was destined to have that early heart attack if I didn’t make any changes. And so yes, the well population needs to get evaluated also by a functional medicine doctor in order to find out what are those inflammatory markers that are happening? Because it’s ultimately all about preventative medicine, of course. Why wait until you’re sick to prevent that illness? Right? So that’s why we eat healthy, that’s why we exercise, that’s why we take care of our bodies even if you do feel well to prevent that.
Aubree Steen: Kind of like that patient that we had recently who said, “I couldn’t fathom feeling better and I feel better and we’re just getting started.” And that’s someone who’s like, “I don’t really think I need help. I don’t think I need to go anywhere.” But then you still can feel better. If you don’t think that you can feel better, I promise you, you can. Promise. So for those patients that we talked about, like in the medical merry go round, how long do you think patients have been suffering? I mean, well, we answered that. Let me rewind. Why do you think conventional medical doctors missed some of their root causes?
Dr. Philip Oubre: That’s a good question. We’re just not taught it in traditional medical school. We go through medical school and we are really good at name it, blame it, tame it is kind of the paradigm. That’s what we say in functional medicine. So conventional medicine is really good at naming your disease or symptoms or whatever. Then once they name it, then they blame it. Oh, all your symptoms are because of this name. Then once they have that name, then they have the appropriate treatment or the appropriate drug for that name. And so functional medicine goes even further and says, “Well, yes, this is the symptoms that’s causing the name, but let’s actually go a little bit further and say, ‘Well, what is the root cause that caused those symptoms that caused the name that caused you to be on that drug?'”
And so it’s just not something we’re taught. It’s not that conventional doctors or traditional medicine doctors don’t care. It’s that if you’re never taught, you don’t know what you don’t know. So that’s been one of the fascinating things I’ve really enjoyed about getting into functional medicine is that with gut health and mold, and we’ve seen any issue cause any symptom and we keep getting new and incredible things that, well, I’ve never seen that reversed before, but it turns out if we make the human healthy, that symptom disease goes away. And we don’t know the magic behind it, we just believe in the magic of the human body’s ability to heal. And if you make the body healthy, those things go away.
Aubree Steen: Right. I agree. 100%. Okay. So you know how we’re talking about the patients in the medical merry go round, I kind of understand that when you go to a gastroenterologist and they’re like, “You have inflammatory bowel disease,” right? And they send you a packet and you go home. How is our approach different from that kind of diagnosing?
Dr. Philip Oubre: So our approach, of course, we would work with the GI doctor, we would work with the primary care doctor, whoever else we need to work with. And in that scenario, once you have a diagnosis of inflammatory bowel disorder, usually by the time your symptoms are bad enough that you’ve made it to the GI doctor, you actually may need medications. And we would agree with whatever the GI doctor would put you on. But the idea is we go further beneath the surface and look at how is the gut health? Those five causes, right? We start investigating those five causes, start treating those five causes. And eventually, you just wouldn’t need the medication any longer. And of course, we would work with the GI doctor to do that. Although sometimes we step on toes as we’re coming off of medications. But no doctor will argue with you. If you stop a medication and have no symptom, no one will stop you from doing that. They may not understand the functional medicine principles of why you got that way. We may not even understand how you got that way. We just got your body healthy and it resolved.
There’s a common thing from conventional doctors, and I was the same way, that if they look at something that a holistic doctor does like, “Oh, that’s not studied. That’s not founded.” They disprove it just from shooting from the hip. And if there’s one thing I’ve learned is that just because you don’t know about something doesn’t mean it doesn’t exist. So for instance, celiac or gluten sensitivity is kind of a hot topic, a fad diet, some people would say. There are thousands of articles on non-celiac gluten sensitivity. And GI doctors will tell you gluten doesn’t matter, gluten doesn’t matter. But there are thousands of articles about non-celiac gluten sensitivity. So if something were that fake, it wouldn’t be out there. So because your GI doctor doesn’t believe gluten is an issue doesn’t mean he’s right. Go to the article. You can Google this stuff. All of these scientific journals are open usually. You may not have access to all of them. But anyway, I digress.
So ultimately, I think the answer to the question was I can prescribe medication. I would continue most medications that the GI doctor is on, but I would also use functional medicine principles, things like a conventional medication’s Enteragam. We use a supplement version of Enteragam that’s well-studied for IBD. The GI doctor doesn’t necessarily use it, but it’s a promising product because it works and it’s been proven to work. So we use both versions of the … That was probably a lot longer response than-
Aubree Steen: No, it’s okay. I get you, I get you. I think also the same time we were sort of the function of what may have fallen off. Right? So digestion, kind of proper nutrition, but teaching the body. I think people don’t realize that the body can remember how to function again. They think that it’s broken, right? Once it gets to an IBD state, right? Then it’s like, “What can I do? I’m kind of SOL.” So I think the good thing is that we go in there and we help restore it and we help the body remember. We’re like, “It’s okay. You know how to do this.” It just needs a jump start like cables to a car.
Dr. Philip Oubre: Right. One of the things I want you to talk about is we’re a big believer in you got to fix the first domino in order to fix the second domino, third and fourth domino. And one of the things you’ve really brought to my attention is digestion is one of the most crucial parts. Because if you don’t digest, none of the rest works. So what’s your take on how the digestive process is one of the root causes?
Aubree Steen: It’s inevitably the number one thing that people miss. You have to think about I know that-
Dr. Philip Oubre: Including me.
Aubree Steen: Yay!
Dr. Philip Oubre: That’s why she reminds me.
Aubree Steen: I remind all the time. But if you think about it, from our mouth to our anus, basically, is the only way to absorb nutrients that our body needs to function. It goes through that tube, right? It goes through a thin cellular lining and that’s how we absorb it. It’s our bacteria that break it down, right? And our gut function that helps absorb those nutrients. But it’s actually a north to south process, right? So you’re thinking of it starts with sight, smell, and taste, right? Starts with eating hygiene. And then it goes down to your stomach, your upper GI, lower GI.
Dr. Philip Oubre: Stop. You said that so fast.
Aubree Steen: I’m sorry.
Dr. Philip Oubre: No, no, no. I particularly have been paying attention to that lately. Sight, what did you say?
Aubree Steen: Sight, smell, and taste.
Dr. Philip Oubre: And I’m totally guilty of this. Sometimes I don’t even heat up my food. I just eat it cold because I’m in a rush. If you don’t heat it up, you don’t have the chance to smell it because let’s face it, cold food doesn’t really have that much of a smell. But that whole process of cooking your food releases that aroma and gets … That’s starting your digestive process.
Aubree Steen: It does. That’s why there’s sense to help increase salivary flow to help actually increase your digestion. It’s why when you smell food at your mom’s house or someone’s house and it smells good and your stomach rumbles. Your brain has a sensory kind of objective and it tells you, “I’m ready to eat.” Right? But you also have to have a mind connection with what you’re doing. It’s mindfulness, right? So it’s kind of like if you want to be good at the computer, you sit and you have to focus at the computer. I know computer is very vague. I just sound like an old woman, but you know what I mean. So if you want your body to understand what’s going on, A, I’m about to eat some food. This is nourishment. I need to make sure my digestion’s ready. You have to focus on it and you have to tell your body, “Great. This is my food.” Away from distraction. You can’t do it while you’re driving. Talking is usually okay because you’re pausing and really being kind of with the food and the person at the same time. But that’s the most important part.
And taste is the next one. In functional kind of nutritional therapy practitioner programs, we do a full head to toe evaluation. And there’s actually something called lingual-neuro testing. And there’s neurons in your tongue. And it tells you kind of, it gives your body … Or your body tells you if it likes or doesn’t like something, correct? But it also can use it to kind of trigger different domino cascades, right? So if you chew for 30 seconds, you start to produce salivary amylase, which is an enzyme that breaks down carbohydrates, right? The longer you chew, the more brain signaling happens from your brain to your pancreas and to your stomach, your gallbladder, your liver. It starts to start that entire digestive cascade. The problem is in when people miss that. If you miss anything up here, you can have a whole negative kind of reaction here below. Constipation, bloating, hiccuping, burping. I mean, inflammation even. So I think that’s the biggest part.
There’s a lot that goes into digestion with each patient. There’s going to be different steps that may be off. Not everyone may need hydrochloric acid to help the stomach, right? Not everyone may need liver and gallbladder support. They usually do. But you have to figure out what is what’s working. And at the end of the day, if everyone’s doing everything right and there’s still an issue, then we need to look into things like pathogens and yeast overgrowth in the intestine or toxic burden, everything that he kind of mentioned with the five fingers.
Dr. Philip Oubre: A lot of people come to us already taking probiotics or already taking this stomach and that supplement. And they’re like, “Well, I’ve already done gut healing. I don’t need that.” And we’re like, “Whoa, if you didn’t start north to south, you can start on the south side, but it’s not going to make any difference if you don’t start in the north side.” And as far as north goes, it really starts before you even taste the food. Your stomach is not a magical organ. And in fact, what happens between mouth and anus is fairly magical. You’re taking a whole food and changing it into molecules and your body has to absorb, your gut has to absorb molecules. That is not an easy process. So the more raw food, the less chewed, the less smelled, and the less digested that food is, do you think your gut’s going to absorb that? No.
So one of the common sayings is you are what you eat and that’s partially true, but we say you are what you absorb. So you can eat the best diet in the world, but if you’re only absorbing the sugars because you can’t break down the proteins and fats, then you’re on a high sugar diet and you don’t realize it.
Aubree Steen: Right. And sometimes it’s more than just eating hygiene, right? If you have it all taken care of, but you have other stressors in your body or if you’re living in a chronically stressed state or if you’re not caring about your sleep as well, all these other factors can affect digestion. So it’s a multifactorial approach of what we do for digestion for patients. But I’ve been to conferences, and some of the biggest ones, and the speaker’s looking at PhDs and MDs and people who are specialists in the field and telling all them, “You all missed digestion. You all missed this part and you all need to go back.” And have people who are specialists in their field for decades hear that, it’s a little shocking, but it’s why we start first.
Dr. Philip Oubre: That’s right. Needless to say, to get back on topic-
Aubree Steen: I know. Sorry, guys.
Dr. Philip Oubre: Digestion is one of the main root causes. It’s the thumb. Remember we have an opposable thumb in order to touch the other fingers. Without your gut, you cannot touch the other fingers, right? Trying to get them to touch each other is kind of hard. That’s why you have the gut.
Aubree Steen: Aw, that was good. I thought because you need them.
Dr. Philip Oubre: Well, you need them all.
Aubree Steen: Yeah, that’s true. I guess you need them all.
Dr. Philip Oubre: So what differentiates us from a lot of animals is the opposable thumb. Right?
Aubree Steen: So I kind of want to ask you more about, so what we see is the toxin bucket. So that five fingers, the more full your toxin bucket, is the more issues there are. Right? So I kind of want to get into when someone has a small amount or a large amount of toxins, how does that affect their sensitivity to issues? Right? So let’s say if I had mold toxicity, heavy metals, bacterial overgrowth, now I’m almost to the top of that toxin bucket. I’m more sensitive for one thing to kind of push me over the edge. Does that make sense?
Dr. Philip Oubre: Yeah. I think you did a great explanation just right there. So I’ll say kind of the same thing again. We all have our ability to hold on to toxins. Whatever the liver can’t clear in that moment, it’s going to store away into usually a fatty tissue. So whether it be your adipose tissue, your fat tissue or other fatty organs like your brain, your brain is one of the fattiest organs, it’s going to store anything that it can’t handle. And so we see it all the time where people’s toxin buckets, as we say, are full of the fingers, whichever one it may be. And it may not be an overwhelming amount of any one thing. It may not be Roundup toxicity or mercury toxicity. Maybe a little bit of mold, a little bit of candida, a little bit of Roundup, a little bit of mercury. All that mixes together, it makes a terrible synergistic effect on the body. So that’s what we talk about with the toxin bucket is full.
And when it’s full, it’s overflowing. And once it’s overflowing, then it’s causing symptoms. Toxins by themselves, especially more biological mold toxins by themselves, heavy metals too, can trigger autoimmunity by themselves. So a lot of times people try to go after those toxins in particular like, “Oh, I got to get the mold toxin out in order to treat my autoimmunity.” And while that’s true, you got to go back to the gut. If you don’t have a functioning gut, you can’t get rid of the mold. So yes, you do need to get rid of the mold. But without the gut, you can’t. So really, to go back, you got to fix the gut and then you can start reducing the toxic burden that’s in the gut. Or I’m sorry, in the bucket. And we look at the toxin bucket as I find …
[crosstalk 00:18:20] Our nurse practitioner has the most cute, beautiful drawing.
And maybe we’ll link to it. But the idea is that everything you eat, drink, consume, breathe, whatever it may be, that’s a loading into the toxin bucket. So if you’re eating nonorganic foods or fast food or drinking dirty water or living in a moldy place, all that stuff’s going into the toxin bucket. And based on how well your gut is functioning, how well your detox pathways are functioning, that’s how well the spigot is working. So if you got a big old water hose for a spigot, then you can put as many toxins as you want to. Some people are genetically blessed that they can do that. They can smoke and drink and still live to their 90s somehow. And we don’t know how, that’s incredible. Others, like us, can’t do that and live to their 90s. So it’s all about that spigot.
Aubree Steen: We’ll live to our 90s.
Dr. Philip Oubre: Hopefully, but not drinking and smoking.
Aubree Steen: I was like, “Hold on.”
Dr. Philip Oubre: So it’s all about that spigot. So as you improve your gut function, you actually enlarge the spigot in order to dump more toxins out faster. Not that you should be adding more toxins in. We call that retoxing at the same time you’re detoxing. But ideally, we’re focusing on opening up that spigot so that you can drain your bucket, you can reduce your toxins faster than you can get them. Because we live in an industrialized society now, there’s no way to avoid all toxins. That is silly. The trick is to avoid as many of them as you can that you can control so your body doesn’t have as much of a burden. Because it’s not only got to detoxify the ongoing burden that’s coming in, it’s got to catch up on your backlog. And that takes years. It’s taking me years.
Aubree Steen: Yeah. And I think patients get very overwhelmed when they’re like, “You want me to change my water and you want me to change the food I’m eating and you want me to change my makeup and all these different things.” But it’s kind of we go back to the toxin bucket. You have all these toxins in makeup, being an industrialized society, and your hair care products and your food, right? In your water supply, in your air. And so what we do, the reason why we touch on all bases, is because if you knock a little bit of that off at least, you can drastically reduce that load in your toxic bucket, giving you more room to be healthier and fix the other issues in your body. My next question was to talk about how do we address those toxins, but it’s kind of in that way where we address all different aspects of life.
Dr. Philip Oubre: Well, I have a couple things I want to add to that. Yes. Nowadays, we can test these things. So many times before, you’d say, “Oh, you’re toxic.” Now you can test your toxic burden. Sorry, there’s a garbage truck outside. So you can test your toxic burden as far as how much you have inside you, what’s coming out of you. Number two is you don’t have to clean up your environment. If you don’t, you’re just going to end up buying more supplements and vitamin infusions from us. And we like that. Kidding aside, that’s one of the goals is there’s no use in speeding up your detox pathways if you’re just retoxing as fast as you’re detoxing. So we really focus on the big key things first. We’ll help guide you. Because you can spend infinite amounts of money trying to clean up your environment. So we help you narrow down like, well, these are the big ticket items you need to go for first. Then we can maybe spread those finances out as far as getting whole home water filter, whatever it may be. We can help you do that.
But I’d say the one thing that was surprising to me was that you can actually test your toxic burden, this toxic bucket. We can now get you an actual answer of how much you have inside you. And that’s a game changer because it’s no longer saying, “Oh, take these detox supplements.” It’s a, “Hey, there’s your toxic burden. Take these detox supplements. Let’s check it again in three months, six months. Let’s see how far it’s gone down.” And that can determine how long you’ll need to be on there. Or, “Wow, that one didn’t drop at all. It actually went up. So time to fess up.”
Aubree Steen: Right? Well kind of like when we see patients with kind of acute exposures to a chemical in the environment or something like that, drastically jumped the test within a day. It’s wild. And so I think what we do is we help reduce the big triggers first, the big environmental toxins. Let’s say if you get environmental toxin tests like the GPL-TOX and it’s outlandish, we’re going to help knock that down. But what we’re also going to do is going to put you on a route. So you don’t accumulate toxins faster. And so you’re on this kind of ongoing natural cleansing process and avoiding toxins as much as possible. So we hit it from both ends, which I think is really nice.
Dr. Philip Oubre: Yeah. What else?
Aubree Steen: Yeah. That’s it, honestly. So I think I just wanted to touch base because we have a lot of patients asking more of the root causes and things like that. And inevitably, we kind of speak to, well, we see everything. We’ve had cancer patients, chronic illness patients, autoimmunity, mycotoxin.
Dr. Philip Oubre: And well patients.
Aubree Steen: And well patients. The best-
Dr. Philip Oubre: Who think they’re already well.
Aubree Steen: Right. Who think they’re fantastic and they are fantastic. And they just feel-
Dr. Philip Oubre: Find out they have metals and inflammation and all kind of older arteries. You know who you are if you’re watching this video.
Aubree Steen: And then the well ones who even just go, “Great, I look better. I feel better now.” They didn’t think that their skin could get better, that their energy could get better than it does. And I think that’s the big thing is that we do see everybody.
And I think regardless, because we live in this industrialized society, you will always have something to work on. But to preface that, I know there’s a lot of people talking to all you guys from blogs or Instagram or something like that and making you feel consistently self conscious about what you’re doing and what toxins are around you. But I think we just want you to know that inevitably, you just have to do the best that you can because we’re not going to be in some secluded island with no toxins, right? We’re not going to have 100% organic food. We don’t have complete control over our life. But the one thing we do have complete control over is what we put in our body. So as long as you are doing the best of what you can with that and working with us, then inevitably you’ll be healthier. Without a doubt.
Dr. Philip Oubre: What a perfect ending.
Aubree Steen: Great.
Dr. Philip Oubre: And with that, we’re done. Thanks for watching, guys. Bye.