The Missing Link in Chronic Illness? Structural Neurology + Functional Labs | Dr. Sarah Kotlerman, BS, DC, NTP

Many providers focus on symptoms but what if the real issue is hidden toxicity, neurological dysfunction and structural instability?

In this episode of the Vibrant Wellness Podcast, Dr. Sarah Kotlerman shares how her team combines advanced imaging, concentrated chiropractic care and functional laboratory testing to uncover the root causes behind chronic illness.

Topics include:

• Why toxicity testing should be foundational in complex cases
 • Heavy metals, mycotoxins, environmental toxins and PFAS
 • The importance of testing over guessing
 • NeuroZoomer insights and brain autoimmunity
 • Structural instability and chronic inflammation
 • Why objective testing changes clinical outcomes
 • How Vibrant Wellness testing supports clinical decision making

🔗 Dr. Alex Carrasco, MD

https://nourishmedicine.com/

https://www.instagram.com/dralexcarrasco/

🔗 Dr. Sarah Kotlerman BS, DC, NTP

https://averiohealth.com/

https://www.linkedin.com/in/sarah-kotlerman-bs-dc-ntp-583345255

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Transcript

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when you look at a body from the perspective of what's poisoning it, what's injuring it, what's the deficiency, what's the infection? And you keep your clinical focus on reversing those root causes. We can't cap the healing that the body goes through after that. Okay. And medicine loves to cap it. It likes to go, well, you have this and it's curable. It's not curable and this is your destiny. And I think it's about time for a paradigm shift, because when we use really excellent laboratory testing, when we use really excellent imaging, when we get to the core of why somebody is injured and then we focus there, we see marvelous things happen Thank you so much for joining us today, Doctor Cutler. And I'm so excited to speak with you and pick your brain. Your a brilliant mind. And to hear about all of the things that you're doing in the world. Well, thank you for having me. This is a pleasure. We love vibrant labs. We use you guys so much. So it's a pleasure to be here on the podcast. Tell us a little bit about your story. How you got into practice and the amazing things that you're doing in your practice. Well, honestly, I thought I was going to go out and be a lawyer. But then in my early 20s, I ended up hiking this 500 plus mile hike called the El Camino de Santiago. And in the last 100km or so, I had a revelation that the world needed something more in the realm of health care. And I have a lot of chiropractors in my family. Both my older brothers, my father's a doctor of chiropractic. My husband, my sister's husband is a doctor of chiropractic. My nephew is. So we have a lot of doctors of chiropractic. But there was a moment, kind of a God moment where there was a path that I needed to walk. And so I switched schools from lawyer school to Life West Chiropractic School down in San Francisco. And about four days after finishing that, that trip, I was on a plane heading to San Francisco with a duffle packed and just knowing that the doors would open. And here we are. Amazing. Yeah, so very, very dramatic start to becoming a doctor of chiropractic. And so after you received your training and started your own practice, tell me kind of what you what your passions are and what you decided to do within the field because there's so many things that, you know, doctor, Chiropractic can do. Absolutely. Perhaps, you know, they're not always recognized, but so, so many things there is there are a ton of different specialties. And I think that sometimes where people get a little bit tripped up is they think that everyone who has a DC behind their name is going to do the same thing. And what we do at a very health institute is very different. The the minimum amount of time that we will actually work with a patient is a week. So we have people coming in from all over the United States. We've got people coming in from New Zealand, Australia, the UK, and they are spending weeks to months in Washington state as we work with them in a concentrated chiropractic perspective. So the focus initially was how to get spines back to normal, right? How how to take spinal damage, whether that was motion damage or alignment damage. And in a very challenged demographic, how do we help the body reverse and heal up these damages? And that's where I took my chiropractic training and started to realize that there was a whole biochemical aspect to spinal physiology, and I'm actually starting to make some moves within the chiropractic profession, because I think it needs to be something that's in the chiropractic education, right? There needs to be an understanding that the biochemical and the nutritional affects spinal physiology. Okay. So that's where we moved from. Just looking at it from a neuro structural to looking at it from a biochemical, nutritional and neuro structural, which is a very good explanation to how we address health challenges today. And do you start first with neuro structural or how do you kind of yes. Open that pathway. Absolutely. We're really good at looking at spines. So we look at different types of advanced imaging. We take spinal X-rays, we computer analyze them. We take motion x rays, CBT. In some cases MRI would really like to get back to being able to do a lot of functional MRIs to look at, like Glenn Flow. At some point in time, I'd like that technology to come back to the Pacific Northwest. But here's the thing. That and this is why I think it goes back to education. There are things that we see on imaging that are red flags for certain biochemical issues. So one of the things that we discovered years ago was that when we saw patients who had really significant reverse curves and it's this is not a black and white thing, okay. It's not everybody who. Yeah, it's just a pattern. We see that if we see these really significant reverse curves, well when we look at the spine from the side, you're supposed to have a -42 degree cervical curve. And then you have a positive thoracic curve and then a negative lumbar curve. And this is what allows us to have good fluid transfer around the brain. So if you lose this curve, if you become injured it starts to affect how well nutrition through your system can get around the brain and how well toxicity and metabolites can get away from the brain. So this is a huge player in neurodegenerative disease. When we talk about amyloid plaques, when we talk about lesions on the brain, honestly from my perspective, the absolute first thing that needs to be looked at is C1, c2, C3. Is there damage there? Because if there is, this can significantly challenge fluid transfer around the brain. And depending on how significant the damage becomes, you can look at it affecting blood flow to the brain. It can affect the vertebral arteries. You can get certain types of forward head carriage that affects vagus nerve function and compresses it. You can get effects to neural function. A damaged spine is not a back pain problem. A damaged spine is a health care problem. And it's foundational to a lot of these complicated cases. So we look at the neuro structural first because it often indicates how we're going to address the biochemical right. Because as much as I would like to run every vibrant panel under the sun, that's too much information. It becomes overwhelming for the doctors that are managing the case and also the patient. I would say most of our cases, because of the chronic and complex demographic that we see, most of them, we are running a toxicity panel as a first step that that is, we have found that to be absolutely game changing in this demographic of patients. And when you said that when you saw the reverse curve, that's an indicator of toxicity. Yeah. You started seeing a pattern there. Correct. We started testing those patients and then you realized they have really, you know, probably in their history they have signs and symptoms of toxicity. And then there's a correlation there is that kind of I have never put much weight on the clinical history when we come to talking about toxins. And again, this probably has a little bit to do with the demographic that we're seeing. Some of these people already have very significant cognitive and memory challenges. They just do not remember. And most of these cases, they've been getting sick for decades. And. I don't think there's good understanding in the general public of how many toxin exposures there are. And I've played around with it. Doctor Alex, I've played around with changing intake paperwork, changing console form questions to try and gather. But the more I study toxicity, the more I realize we'd have to spend hours and and it might as well just test, because at the end of the day, it's not what you were exposed to anyways. It's what your body stored. It's not your exposures. And this is this is critical. When I take on patients who have a big military background, they come through and they go, well, I've been exposed to blah, blah, blah. I go, hold your boat here, okay? It really doesn't matter what you've been exposed to. It matters what stored in your body. That's what's making you sick. That's why we cannot guess here. We must test here so that we can make an appropriate intervention. Because even a couple of red level toxins is going to alter physiology. And when you see high toxicity, are you seeing mainly heavy metals or you see mycotoxins, or are you seeing pesticides or are you seeing all of it? That's a great question. In the beginning of me playing around with Toxicity Labs, because there is really no training in the chiropractic education. So what I've learned, I've learned post-doctorate, right? Yeah, very much so hard earned. But also it, you know, it makes you realize certain things when you have to learn things the hard way. We originally played around with single labs. We tried we tried to play the game of, oh, is this more symptomology of heavy metals? Or at this point in time, I do not do that. Okay. If we're going to run a toxicity panel, we are going to run a total toxicity panel. And while I have no hardcore accurate statistic for you, just based off of reviewing panels, I would say upwards of 90% of patients have red level toxins of all three categories, that being heavy metals, environmental chemicals, and mycotoxins. The one category where we see that trend break is with the PFAS. That doesn't seem to be as commonly found in a in a chronic and sick demographic. We see the other three all the time and at levels that are are quite honestly scary. And are you seeing mainly like, you know, is there any specific mycotoxin that you're seeing more of, like the master grant, you know, or are you seeing you see metals or is it just kind of a Hodge podge? We see all the metals, all the metals. Our facility has gotten quite a reputation for resolving high levels of uranium toxicity, and we have seen hundreds of cases of that. Okay. From the mycotoxins, again, I feel like we see all of them. The ones that we probably put a bigger focus on, you know, is going to be like OTA. I think OTA is a real bad deal. And we in all of the kidney failure cases that we have seen, OTA has always been super, super high. And that's not to say that if you get it high, you're guaranteed kidney failure, but it is a significant kidney toxin. So if we see OTA at play, that's that's one that we don't hesitate on. BPA is another one that we see. And because it's it's a high cancer causing toxin, we move very quickly on that aflatoxin. We see all the aflatoxin. I don't think people understand that we are getting exposed to aflatoxin and dairy products and that that's a high exposure source. So. Correct. Yeah. And this is really sad information. But this happens in all mammals. So if human women are breastfeeding and they have mycotoxins in their system they cross in the breast milk. So we are seeing that in the pediatric population that we're taking care of too, that children are not developing correctly. And when we run a toxicity panel, they come back with this host of red level mycotoxins, and they're two years old. There's no way you convince me that they got that exposure from their environment at two years old. Like they got it because mom was poisoned when she got pregnant. And this is a it's a really tough truth because nobody wants to make moms feel bad. Like, I never share that with any any intention to guilt trip any mother. But if we don't, as doctors tell the truth on hard things, then what we do is we let people continue to suffer from them and they go, oh well, it's genetics. Maybe not. Maybe your kids poisoned and you would have to run a test in order to know. Yeah. So when you were taking care of patients with high toxicity levels, what is your approach? Very, very good question. And it kind of depends on how high the toxicity level is. There is a threshold where if they go above that, then the only option that my office makes available to them is to stay under concentrated care. Because what we have found is that toxicity removal, this is something that the body is designed to do naturally. Okay. The reason people start to store toxins isn't as much that they got exposed to a lot of toxins, it's that they got exposed while they were compromised. And so the central nervous system made a different decision. Instead of going, yes, I feel safe enough to move these poisons out of the system, out in the bow of bladder, sweat, breath, all of that. Instead it goes, I do not feel safe enough to do this. I have to move these toxins into storage tissues as quickly as possible, because the intelligence of the body is always working for the person. It's always trying to give you the best quality of life and length of life that you can get right. So when we look at a certain level of toxicity, an interesting enough, it can go both ways. It can either go a panel that is the whole first page is read. Okay. I'd be very concerned about that, because I do not believe a take home protocol is enough of an intervention to support that person. And I've gotten more than one referral from Nature Pass who just do the biochemical. They don't do the neural structural. And patients were bleeding. They were bleeding from multiple orifices and couldn't stop bleeding because their body was trying to eliminate more toxins than it could handle safely. I don't want to ever be responsible for that. So if if there's a certain amount of red level toxins, then the option we give to the patient is the standard concentrated care. Because we have seen in multiple cases that staying under concentrated care, keeping our clinical focus on improving spinal physiology, improving brain to body communication will drop toxins faster than anything else that we have tried in the natural health care world. We actually had a case of a gal who had over 40 toxins on our initial panel, and we said, that's too much, can't give you a take home protocol. Don't feel ethically right about that. She stayed under care for two weeks, dropped 17 toxins in two weeks just with concentrated specific chiropractic care. I mean, this is groundbreaking because no other interventions, no ideas, nothing like that. Absolutely not. And nobody's even looking at this. Nobody is looking at chiropractic as potentially the leading health care intervention for toxicity removal that physiology, because I think a lot of people wouldn't understand that. So if you if you put the spine in a safe position, then things flow better. Or do you want to explain that? Sure. Yeah. Probably the easiest way to explain this is your body breaks down as a system and it repairs as a system. So if you look at the whole body and things have gotten compromised, there will be a breakdown in the brain because a part of your brain connects to every other part of your body. Your your system doesn't work via Wi-Fi. Everything is hardwired. So even moving your big toe requires an electrical signal to leave your brain. Go to your brain stem, cross to the other side, go down your spinal cord which is inside your spine, out nerves in your leg to stimulate the muscle so your big toe goes up okay, so that's normal physiology. So when these people come through the door and they are sick, they have broken down in multiple areas in the brain, multiple areas in the spine, multiple areas and end organ tissue. Okay. Now that trauma could be physical trauma. It could be toxicology. Trauma could be deficiency trauma. They may be lacking something that allows that keeps them from being able to go through normal regeneration cycles. Because just about every tissue in your body is designed to regenerate like healing. We have got healing so wrong. You don't you shouldn't be going to the doctor for healing. Healing is something that's supposed to happen 24 over seven. You yeah, you go to the doctor because you've stopped healing. Like healing is the normal for human physiology. Your small intestine is designed to 100% regenerate in five days. And yet if we go to the Google, there's like 130 million diagnosed cases, a small intestine disease in the United States, five days. So we don't understand how regeneration works. And our mainstream medical model is not supporting normal physiology and tissue regeneration. And just throwing stem cells at everything is goofy. Source. As far as I'm concerned, this your body has the ability to do it, but what a lot of big name influencers are not in health and wellness, they're not talking about is this is a narrow, regulated process. No tissue. Well then we got to talk. We got we got to get them to switch their understanding because this is this is in the science really, really clear tissue regeneration is a neuro regulated process okay. So when we take on these people how we address the breakdown, the brain, the breakdown, the and orientation is we from a chiropractic perspective we take on spinal damage okay. But when we take on spinal damage what we're doing is we are stimulating those damaged areas in a very specific way to turn on lights in the brain. And as soon as you turn on light in the brain, the brain can then see end organ tissue that it couldn't see correctly before. And if you do that enough, it will actually stimulate tissue regeneration cycles, which were normal to that person the entire time, which is kind of what we were talking about before we started rolling with like spinal ligament instability. That has been something that has been largely thought to be permanent tissue damage because of the avascular nature of ligaments. And yet we are published with 14 cases showing that that is very reversible even in people in their 70s, 80s and 90s. Through a concentrated chiropractic model, the body still gets 100% of the credit. What we get credit for is removing the interference that's keeping the body from going through those normal regeneration cycles. So this is a very different philosophy than let's just squirt some stem cells in there and hope something happens. This is yeah, this is a different philosophy in healthcare. It's a very humble. Exactly. Helping the body. Remember from a narrow, focused perspective how to repair itself and addressing the spine as the middleman. So you start with the spine and then you do is concentrated care. Yes. That in and of itself can help the body remember how to function. Correct. Because we are adjusting patients more than anybody else in the world is considering adjusting people. And it's not a big handed manipulation or popping adjustment. We use a sustained force, very, very gentle. So we're not stressing out ligaments when we adjust. But our typical adjusting for a week of care, it's not uncommon for us to get 50 or 60 chiropractic adjustments done in a week because the patients, they're on site for six hours a day under care. We get busy in the process of trying to give them an opportunity to repair, and it's interesting to see what's happened. So, you know, here's where it gets a little bit tricky from a legal perspective, because I'm not saying that this is a cure for anything, okay. The body gets 100% of the credit, but we've seen things like five and six inches of arterial stenosis in the abdominal aorta completely reverse. And so you can't go in and say chiropractic care is a treatment for arterials to gnosis. But what you can say is when you look at a body from the perspective of what's poisoning it, what's injuring it, what's the deficiency, what's the infection? And you keep your clinical focus on reversing those root causes. We can't cap the healing that the body goes through after that. Okay. And medicine loves to cap it. It likes to go, well, you have this and it's curable. It's not curable and blah blah, blah, blah blah. This yeah, this is your destiny. And I think it's about time for a paradigm shift, because when we use really excellent laboratory testing, when we use really excellent imaging, when we get to the core of why somebody is injured and then we focus there, we see marvelous things happen every single week. So after you do your concentrated care for your patients? Yes. Then what do you do when you send them on their way? And they go back to great question. Absolutely. So most of our patients are coming and doing multiple rounds of concentrated care. And the length of that is very customized to what that patients coming through the door and to some extent where they're coming from. If you're coming from another country, we're probably going to try to do more up front to shorten the overall length of your case because of how challenging travel is. Okay. So a lot of our patients are running vibrant labs before they even get on site. It's not uncommon for us to run a gut zoomer various blood labs. Neuro has been a game changer for us recently. Infections panels, nutrient zoomer. We try to get some some baselines before they get on site. Once they're on site, that's when we start to do imaging. We do try to do all of our imaging on site, because there are various levels of quality in medical imaging. And when we're talking about something as complex as spinal physiology, it is critical that the imaging is done correctly, that there are not artifacts, that the patient wasn't wiggling and the person was asleep behind there. So we tried to do that on site so that we are not having to do more imaging because the imaging the patient brought was crummy. Then we begin concentrated care when we have got and we do a lot of pre and post on site testing, we have segmental body comp, we're running modified CTC bees, we're running funk neuro stuff on site. I want to objectified exactly what's happening in physiology when we take people through this natural intervention. I am I am done with being the second class doctor, right. That that has to die in my generation. Just because doctors of chiropractic do not prescribe pharmaceuticals does not mean they can't be a powerhouse clinically, because there's a lot of things that are keeping people sick that are not going to get better with pharmaceuticals. So we need some other options. We can't just try to drug everything that's wrong in physiology. Okay? So we take people through concentrated care that could look like the difference between one to multiple weeks. And toxicity testing actually happens when they get to their last week okay. So that's correct. Yeah. So toxicity testing always happens at the end of their last week of concentrated care. Usually Thursday night is our toxicity class. And then patients are collecting their urine sample Friday morning after. Yes okay. All right. And then patients go home. They typically have a four week whole food nutritional protocol that they're being recommended to take. And the primary reason for that is we don't want somebody to stop healing because of deficiency. And there are just handfuls of deficiencies like, pull. My goodness, I probably could count on one hand the amount of patients I've seen in the last 12 months who did not have a glaring omega three fatty acid deficiency. It's almost all of my favorites. Yeah, it's nonstop a mega three. Yeah, well, and that's like one deficiency that we cannot allow to happen because it stops. Yeah, it stops tissue repair. It stops tissue regeneration. You need it for that phospholipid membrane. So a mega three fatty acids vitamin D, folate deficiencies, folate deficiencies in the elderly with neurocognitive issues. Oh, my mom went to her doctor and they told her that her B12 of 250 was fine. Well, yeah. Yeah. So the whole food nutritional protocol as they leave care is highly to keep them from having any deficiencies that would stop their regeneration. Ask you one more question about Colleen. How? I mean, we can't really test that. Very well. Do you just assume Colleen decreasing everyone? No. We look at well, we get two we use two tests to kind of give us an indicator on the gallbladder. One is going to be just blood work. Looking at it we see high or low free bilirubin in the system. But also I'm a big fan of looking at the gut zoomer and looking at how fatty acid metabolism is occurring. But in 90% of cases, if we're giving you any kind of fatty acid supplementation, we're going to be giving you support to digest it. Liver. Gallbladder is a chronically weak area for people, especially if they have toxins in their system. And then think about all the hose to people who've had their gallbladder removed and then weren't told by their surgeon or their GP that they have to take bile salts for the rest of their life. I mean, that is crazy pants that it's super common, but it's still crazy pants. And I don't know how that's not medical malpractice, because what we see from the literature is that when you have no gallbladder, because there's no storage of bile, you have no ability to break down fatty acids. It's the slow decline into dementia because you won't be able to repair as your brain goes through stress, right? So you send your patients home and they're on a whole foods diet. Yep. And then they that allows us to the timing to get the rest of our labs back. Yeah. They take some supplementation. They've got foundational support. They've got exercises bracing. We've got the whole activities of daily living kind of self-care package. And then during that four weeks, we get the rest of their vibrant testing back, and our clinical team works that up. And that's where we put a longer intervention into play. What they leave with that's that's foundational support for filling deficiencies. Primarily. The next protocol is where we get in heavy duty on what toxins do they have? What do we need to put into play to bind toxins, support the organs that are under the most duress from toxins, assist on a cellular level, assist on, on from. If they've got a pathological process going on, like how do we support not allowing that to get worse while we pull toxins out? Because one of the things, and I think this is why a lot of doctors don't do toxicity testing, and we don't want to talk about it as it's hard on the body to pull toxins out. There's no poof magic to this. You have to take toxins out of storage tissue into the bloodstream and then get liver kidneys, detox pathways opened up, which is where chiropractic care comes into so heavily so people can eliminate them. And the amount of cases that we've taken on throughout the years where people have been stuck detoxing for 15 years and they've got the labs to show it is astounding, and they'll just kind of be stuck on binders for forever. What is or what's your perspective? I think it's dangerous to detox your patients. What are your kind of approaches? My favorite approach is concentrated chiropractic care. But that's not reasonable for everybody okay. And we'll talk about this more. But it's probably not even available everywhere. No it's not. And that's something that well that's what we're working on. I mean there was a time, Doctor Alex, where chiropractic hospitals were frequent before. Well before the AMA trials, and they tried to exterminate chiropractic as a profession. I don't think most Americans understand that. The largest antitrust lawsuit that ever happened in our history was from the American Medical Association towards the profession of chiropractic, trying to exterminate it. There was a 15 year extermination process. If your medical doctor ever told you that chiropractors or quacks, it's because of that. It was a large scale, nationwide marketing plan to exterminate chiropractors because we were the only no. That was 1960s 70s. And then it got yeah, it wasn't the first time. I mean, and I don't get what medicine's beef is with chiropractic. I don't we're not trying to replace medicine. We're trying to fill a very necessary cap of addressing spinal injury. And to be honest, functional neurology that can't be addressed with pharmaceutical or surgery, in fact, might be made worse by pharmaceutical and surgery. So I don't know if it's just intimidation or chiropractic cares to effective or I don't know what it is, but it would be lovely if we could just work together. I would love that for the future. Yeah. So okay, so tell me then your detox strategies. We need to do a provoke first. So that looks like having a patient under care for a minimum of a week. Because what we have seen by doing vibrant labs without concentrated chiropractic care is we see about 15 to 25% of what's in that person's body. And from my perspective, there's a real danger with that, because if you start to bring in whatever your biochemical intervention is, but it's only going to work against a perspective like a percentage of what's in that patient's body, you risk them getting very ill. Most of my patients do not have detox symptoms. Now, there is a small percentage that do, but we see something very interesting in that small percentage. So our initial attempt within toxicity removal is let's get a chiropractic provoke. Let's get you under a week of concentrated chiropractic care. Then we run that urine test. The next step is going to be a three, typically a 3 or 6 months whole food binder and and nutritional plan. So we have dug through the literature to find out what all the different nutritional locks are. So I'd like to give you an example with lead, the nutritional lock for lead is vitamin C, so you don't have to get any more creative than that. You just need a really good whole food, vitamin C, and you'll pull that out of people's system. When we look at things like uranium, well, uranium loves to hang out and destroy kidney cells. So when a person has high levels of uranium, we're looking at vitamin A, we're looking at specific kidney supports in order to make sure that there's we can kind of bolster kidney function to move uranium out. And we've gotten very analytical to this, to writing everything down, citing it. These are our liver toxins. Well, sometimes sometimes we actually tell people to chill it on the green herbs because they can push toxins out of their system to quickly and they'll get sick. I mean, I've had people go online, Doctor Google and go, oh, cilantro is really good for this toxin or that toxin. And they'll start to do it. And then they send me a picture of how they broke it out and hit a belly full of hives. And I go, well, you your sin. Yeah. Your skin's an organ of detox. And you pushed harder than your body could keep up with. So we'll use that. We'll put together a protocol using all natural elements and have the patient run that for as long as we think they can before we go. You're too far away from concentrated chiropractic care, and you're going to need to get under clinical care again. And so the patient returns, we take them through another round of concentrated care. And then we post test. We don't run a test that we won't post because that's where authenticity is in medicine from my perspective, is being able to show objectively that there was a change from the intervention. So we post test anything that we're going to run as a test, we will eventually have the intention to post to show a change. And that's really changed our clinical methods because we get so much pre and post feedback in clinical care. Well, we know right away if something is or isn't working because we've got the post test to look at is really fascinating. It's such a different approach. I mean, probably to you it's not rocket science, but I don't think that even within the integrative medicine world, I mean, it sounds like you're pioneering something. I think we probably are. I think with the death of the chiropractic hospitals, when I've read old books and watched old documentaries, and I hear the old doctors who are all long dead at this point in time, talk about the chiropractic hospitals. I go, that sounds really similar to what I'm talking about right now, and even how they'd set up their facilities sounds really similar to what my ideal is for the future, but I think it is very unique in the state of health care in the United States. Now, I don't think we have this kind of aggressive test, not guess chiropractic, functional medicine, functional nutrition approach where patients can get under care and move very, very quickly. I mean, we're resolving cases in weeks of time, and it just couldn't be done in a traditional chiropractic model because you'd be going for years. Yeah, but you have to create a healing space. It's not like the disgusting hospital. Oh, you mean like feeding people chicken nuggets? And Pepsi does. Doesn't get people well. Elements of sunlight that people need, just nature, all of the different things. It's really interesting. So tell me about neural Zimmer and what you're doing with Neural Zimmer. Oh, neural Zouma is like my new favorite test. We branched into neuro at the turn of the year. I want to say we started looking at it like September of October last year. And now it is. It is a frequent test for us. The neurosurgery test lets us look at brain autoimmunity and it gives us a couple of different pieces. One, when we look at the yellows and we'll actually count them, okay. And it's not uncommon that we see between 7 and 20 yellow level autoimmunity factors. That gives us a generalized idea of how much movement there shouldn't be across the blood brain barrier. Right. Because there's all these antigens chewing on brain tissue. And it gives us an idea of how widespread brain losses, everything comes back to the brain, right. The biggest fault, if I was going to to put a fall out there on natural health care is we talk about the brain like it can function on its own. It can't. One of the most important things to the brain is the brain stem, which starts to go inside of the the spine inside a C1 and C2, the first two bones of the spine and then the spinal cord. And when we talk about fluid dynamics, well, that goes all the way down to the sacrum. And I don't think that's understood. Well, that one you have to move for brain health. You have to move. You cannot sit on your tushy all day long. You will get very sick. You have to move because when we move, it allows that sacrum to new tait and it pushes cerebrospinal fluid up and around the brain. So you have a couple of things playing into that. You have sacral movement. If I was to give you a top ten list of doctor least favorite medical interventions, anything that screws into sacrum would be on that list because it compromises fluid dynamics. All right. But you have that. You have the function of the heart okay. So like one of the tests that we'll run is a hard sound test to look and see how well the heart's functioning. And this gets way off people's radar. But you can actually change how the heart is functioning by changing the alignment and stability of the thoracic spine. Here. If we took it a step further and like this is really cutting edge and this is not we're not in the land of cure. We're just watching some interesting clinical finding observational findings. But we actually have multiple patients who have come through who are working with a cardiologist, and we take a thoracic image and we get an outline of their heart, and we can see how enlarged it is. And then as we pull the toxins out of their system, repair the nutritional deficiencies and fix their spine, we are seeing their heart go back to normal size, in some cases shrinking by 30mm. I mean aggressive amounts of going back to normal size. And I'm not a cardiologist, so I'm not going to speculate whether we're seeing fluid changes or we're actually seeing tissue changes. What I can tell you is that in all these cases, these patients are losing their cardiologist because they don't need them anymore. Oh, well, of course, of course. But from my perspective, that's the lowest bar because we can actually feel better and still be significantly abnormal. It's one of the the communications that we try to have with all of our patients is you're going to have to make a choice at some point in time, and the choice is going to be, do I continue to run my health off of objective measures, or do I quit care because my diagnosis or my symptom is gone? Because you will lose your diagnosis and your symptoms 100% of the time before you have fixed everything on tests. It's really fascinating because look at I'll speak for natural health care. Look at how many chiropractors go, well, I. I'm done because the patient isn't in pain anymore. And I would look at that same case because of the exposure we've had to so much pre and post testing. And I would go oh, oh what you've had is a neuroplasticity change. You have how the brain is perceiving pain. That's good doctor. But I guarantee that patient could not pass just about any test functional test you threw at them. Because people are so much more challenged than we are giving credit to. And the only reason we can work in that kind of ignorance is because we're not running the tests when we run the test. So the brain, the neuro, that is one of those tests, and it's one of those tests that will make patients sit up and doctors sit up. So we had a we had a dystonia case come through cervical dystonia okay. Been under medical management for I think 11 or 12 years. they were doing Botox shots. That's the common one. Okay. Let's again let's let's try and solve a poison issue with more poison okay. And we ran a neural pneuma on this patient. And the part of her brain I think it was anti contracting something something. But the type of her brain that literally regulates these muscles. And in the vibrant lab it lists dystonia is the primary issue that this gets if you get a red level here was off the charts and I we point this out on all of the vibrant labs because there's a moment where it will just sit there on the right level, because we're so many thousands of percent over safety limits. Right. And I always circle it and like go back to the number and circle it there and then circle what the safety level is because they're so far away from normal. I mean, we could work with this patient and do several neuro and knock it down significantly, and it would still be out there on the right end of the bar there that far out of normal. And I go, this is this is the root cause. This is why you have the dystonia. You have broken down in a way. And she's got toxins and omega three in the, in the ditch. You know, they just so low. But this gives patients a clear bullseye of how to indicate their health off of. Right. It's a great test. We will. I'm really excited because we've been using it enough that the preliminary post tests have been excellent, but we're about to get a big wave of post neural Zoomers in the next couple of months, and I'm really excited to see how quickly we can get people to a point where they can pass a neural test where they don't have brain autoimmunity going on. And then will your approach be similar where it's centralized care first and then more of kind of foundational care and then more specific care. Correct. So one of the biggest movers and shakers from our perspective in immune regulation is going to be spinal ligament instability. And this hasn't been studied well within spinal ligament instability. Probably because spinal physiology is so complicated. But it has been over studied in tendons and in knee and elbow ligaments. We have got hundreds, maybe thousands of studies that have looked at other white tissues in the body and have found that when they are unstable or chronically injured, it causes immune dysregulation. What's fascinating, it's fascinating. And the reason for this is what's called failed immune polarization. So if we break down the immune system, you have primary five pathways that the nervous system tells immune cells how to work. And what's really fascinating about this, Doctor Alex, is they are all anti-inflammatory except for the no system pathway. So the Gnosis pathway, that's the only pro-inflammatory where the nervous system will actually tell the immune cells to function within a pro-inflammatory environment. Every other system is anti-inflammatory, with the acetylcholine pathway being primary, the hypothalamic pituitary adrenal axis being primary, and then vagus nerve function being primary. So immune function systemically. Whether we're talking about viral infections, bacterial infections, fungal infection, Lyme infections or autoimmunity, I would wager a guess that this stuff can only be reversed if we are reversing the damage in the cervical spine, and most of the time, that's going to come back to a very specific type of damage called spinal ligament instability. And this has been in the AMA database, the disability guidelines, since the 1960s. We have got very good objective numbers for how much vertebral movement is required to categorize it as instability. But get this even with all of medical mainstream medicals trying to compromise and exterminate chiropractic, they have a really ingrained understanding of how bad spinal injury is. So spinal ligament instability is one of the highest disability indexes that you can be rated with, with one area of spinal ligament instability being a 25 to 28% in disability. It's huge. And if you actually run imaging to look for this, we'll see. Especially women come through the door. Exactly. Well, why do we see Potts and Ella's Daniels with hypermobility and then immune dysregulation. And then we go, oh, it's genetics. Is it genetics or do we have such unstable spines? Most likely because they're full of toxins and they can't regulate cartilage in college and development, every Ella's Daniels case we've ever taken on was so toxic. That was step number one. We had to support them through getting toxins out. We did not even touch spinal ligament instability until we got the toxins out because they had they did not have any ability to repair spinal ligament instability while they were so toxic, which is really critical. Why we do have some professionals that are able to look at both sides, because there's cases and these are usually chronic and complex cases where you have to dance, you have to dance between the biochemical and the neuro structural. And if you don't dance, the patient improves but doesn't actually get a resolve. And that's always our goal 100% of the time. And this is probably why we have kind of this aggressive model of trying to really look at so many different types of tests, but our goal is always to get to a sustainable resolution. What do you think about the like huge influx of kind of pods MCA's does Mia post Covid? Do you think that's what is it you can or I think it's probably more the straw that broke the camel's back. I think a lot of people went into Covid already compromised, and then regardless of whether they got exposed to the experimental medical interventions or the virus, which you could also say was an experimental medical intervention, whether you got exposed to either of those, if you're already compromised, I think you're going to see something very similar to what we see with toxicity. Remember how we were talking about it's not what you got exposed to, it's what you store. I think something very similar is happening with infections. I mean, we have this amazing adaptive immune system. So for people who were not compromised, Covid was no big deal. I think where you get into really big trouble and we see this mirrored really well in the mis studies with Epstein-Barr. I mean, for most people, Epstein-Barr, they'll carry that infection asymptomatic for the duration of their life. Yet it's a major player in in Ms.. I think it has to do with how neuro structurally compromised people are. So if you've got a bunch of ligament instability, your immune system is not going to function correctly. Period. End of statement. And very few doctors are having that communication because we think about the immune system like it's some separate system. It's not it's an extension of your nervous system. So if you have spinal damage, that is compromising how your nervous system functions, by default you have a compromised immune system. Especially if we look at upper cervical trauma, we look at C1, C2, C3 instability. Those are the most aggressive. Moments where we will see just very, very severe pathological presentation is when we see instability at those levels. Wow. this has just been such a wonderful and illuminating conversation, and I'd love for everyone in our audience to know how they can learn more about you and your practice, how they can find you. Sure. So a very health institute avr I o website is healthcare Thank you all for tuning in to the Vibrant Wellness Podcast. If you found this episode valuable, be sure to subscribe so you never miss a conversation like this. And don't forget to follow us on Instagram at Vibrant Wellness for more insights, education and updates. We'll see you next time.