[00:00] About Dr. David Minkoff
[01:27] What is Exercised-Induced Asthma?
[13:59] Giving Supplements to Children
[18:13] Reversing the Child's Medical Conditions
[27:54] Regarding Soy Products
[29:37] Importance of the Practitioners
[33:14] End of the Podcast
Ben: Hey folks, it's Ben Greenfield, and I'm here with David Minkoff in the Lifeworks Wellness Center down in Florida. He's been on the podcast before, and of course, for the show notes to this episode, I'll make sure that I link you to all the other great calls that we've done with Dr. Minkoff. But today we're going to talk about asthma, and specifically exercise-induced asthma in kids because I actually ran this question by Dr. Minkoff a few weeks ago when I noticed that one of my children would run up a hill and would get to the top of the hill and be just great smiling and ready to move on to the next thing, and the other boy, his twin, would stop about halfway up the hill and complain that he couldn't breathe, and the same thing has happened during soccer games. It's happened during wrestling matches, and these are little five or four-year-old children. I know this type of thing happens to adults as well, and Dr. Minkoff's reply really surprised me, and it kind of went outside of what you would consider to be the mainstream response to something like exercise-induced asthma. So, Dr. Minkoff and I today are going to talk a little bit about this, what it is and why we see kids and adults struggling with this, possibly more and more. So, Dr. Minkoff, thank you for coming on the call today.
Dr. Minkoff: Yeah, Ben, I'm looking forward to it also.
Ben: So, before we launch into this, can you give me your spin on exactly what exercise-induced asthma is, how does it manifest or what causes it?
Dr. Minkoff: Yeah, my background, originally was pediatrics, and when a kid would come into my office who was wheezing, the traditional treatment would be to make sure that there was no lung infection, acute lung infection, and then give him something to reduce the inflammation in his airways, possibly reduce the mucus in his airways, and most of all, reduce the spasm in the small airways. So, when the air comes in, it goes through a big tube which is your trachea, and that divides into two tubes. One goes to each lung called your bronchi or your bronchus, and then it further subdivides like 12 or 14 times, and so the smaller little airways, right before the little air sacs where the gas exchange actually occurs are a very small. They're probably pencil thin small, and there isn't any solid structure to hold them open. In the bigger airways, there's cartilage, but in the smaller airways, they're very flimsy, and there is muscle in the wall of those airways, and that muscle can spasm, and what you see an asthma is that there is spasm in those very small airways, so that when you're inhaling, the pressure going in will open those up to some extent and get air in, but when you try to exhale, the force tends to close those airways, and the symptom you see in asthma is they're better breathing in than they're breathing out. Breathing out is very slowed, and so the shortness of breath that you see, if you try to imagine breathing through a straw and then walking really fast and breathing through a straw. The breathing out is very tough, and it can cause someone to be very scared. Now with asthma, there's also usually an inflammatory aspect to it, so it's not just an airway that's spasmy, but it's an airway that produces extra mucus, and the airway itself may thicken. The wall can get fluid in it, so that instead of being now pencil thick, it's even smaller. Pencil lead thick it's even smaller, and so that's what causes the symptoms that these, either children or adults, suffer from.
In little kids, it's worse because their airways are smaller, and when they spasm, there's just less room to get air in and out. So when your little guy's running up the hill., his ability to take in appropriate amount of air and then get it out, especially get it out, is very tough, and so his lungs won't empty completely, and so if it only empties 50% instead of 80%, then he's not getting much new gas in, and the lung stays full and there's no new oxygen to exchange or carbon dioxide to get out, and that's the cause of his trouble. So that's kind of what happens, and a traditional pediatrician would look at it and say well we're going to give you a medication to relax the airway. So, albuterol or some version of that would be given as an inhaler, to try to get that medication down there to relax that airway, so that it wouldn't spasm, and then something to reduce the thickness of the mucous and something if there's infection down there to treat the infection. Now my perspective now is, in dealing with children and in dealing with adults, is that there are reasons why this occurs. Some people have a higher genetic susceptibility, but oftentimes, there are environmental and internal health factors which have to do with it which predispose kids to getting this, and overall now, if you look at the profile of the United States, there's an epidemic of asthma. There's more children with asthma now than ever recorded, and I think there's reasons for that and we can weave into that, but that's the overview right there. I think I answered.
Ben: Yeah, have you noticed it more and more? I mean is this something that you think is becoming a bigger issue?
Dr. Minkoff: Absolutely, the incidence of childhood problems, medical problems overall is very much increased, where you look at other cancers or you look at childhood asthma or you look at childhood attention deficit, all of these things are on a very big upswing, up trend.
Ben: Now I might be opening a can of worms here, but why do you think that is?
Dr. Minkoff: Well, I think it's a mixture of things, and I think that this goes to the heart of what we want to look at. If a child's environment has a lot of things in it which when he breathes them in cause inflammation, he's going to have more trouble, so there's more asthma in Los Angeles than there is in Montana because there's more particles. The particles can be reactive, there can be problems. The other thing is that we that children, who in the first six months or the first year of life were breastfed versus bottle fed are causing or milk fed, have much lower incidence of asthma that the early diet, when they're very young, their intestine is permeable, and it will absorb whole proteins. Well, proteins are pretty reactive stuff. Wheat and gluten proteins are pretty reactive stuff, and the children that eat those foods early on, there are incidents of immune disorders or reactive disorders are much higher. We know that children who have gotten pertussis vaccine in infancy, have about a tenfold increase in asthma versus children who never got pertussis vaccine.
Dr. Minkoff: So again, you're injecting foreign proteins into a body, the body makes a reaction to it which then can make it hyper-irritable or hyper-reactive, compared to someone who doesn't have it. So, I think what occurs on bottom line is that the membrane is reactive, the immune system in the child is sensitive, it's irritable, and you know that if we can get their food cleaned up, so they're off glutens, they're off dairies, we can fix their leaky gut. Sometimes they have, especially these kids may have problems with ear infections and sinus infections, and they've been on a lot of antibiotics, and their gut now has colonized with candida and other bacteria which are resistant to the antibiotics that their normal flora, their normal healthy gut flora isn't there, and that makes them at risk for this because their whole immune system's get altered because with the antibiotics and with the candida their gut is leaky, which means that the foods that they eat can enter their system which makes their immune system very, very reactive. About 80% of the immune system is around the small intestine, and when the small intestine gets leaky, the immune system then gets a very charged up, and that charged up area can also affect the lung lining, and so you see it you see it as asthma.
For some people, it reacts in their skin, and you see it as eczema. Some people, it reacts in their brain. The brain has a whole immune system, and when the immune system in the brain is altered, or up-regulated as it says, you’ll see behavior problems, you'll see learning difficulties, and ADD, ADHD, depression, all these sorts of things because the brain is on fire, and then these children also are taking NutraSweet and yellow dyeing number six and drinking Mountain Dew and colorants and preservatives. These all are inflammatory things, and so really the treatment has to be to reduce the things like this that are coming into the kid. Put them on a restricted diet, so they're off grains, they're off dairy. No artificial foods, no processed foods. Real stuff and correct their leaky gut, and another thing, a lot of these kids are magnesium-deficient. Low magnesium causes irritable membranes, and we can measure their red blood cell magnesium levels, and oftentimes, they're low, and that can make a difference.
Ben: Is that a test that a lot of doctors do?
Dr. Minkoff: It's a test that very few doctors do. Most pediatricians aren't measuring magnesium and all. The rest of them that are measuring what's called serum magnesium levels, but 99% of magnesium in the body's in the cells, and if you measure the serum level, it often looks normal when the cell level of magnesium is low. So, there are laboratories that will measure cell level of magnesium, and we find it all the time. Low selenium, low zinc. All these things are really important factors in how the immune system works and in membrane stability, and I find these things in people every day, and when you correct them, their immune system settles down and works better.
The other thing, this is actually a study done in children. If you measure the amount of hydrochloric acid in the child's stomach, one of the studies, 80% of the children were low in hydrochloric acid in the stomach, and with low hydrochloric acid, you don't digest proteins, you don't absorb minerals, and so these kids are at risk, but what's interesting about this is some doctors are putting kids, they feel that the reason for asthma may be reflux, gastrointestinal reflux, and they're putting these kids on medications to block their stomach acid, and it's very common to see kids on Pepcid or Zantac, and this is actually not good because a little stomach acid may be part of the problem with their active airway. So, if you have a kid that's got this, my suggestion is that you don't go to your pediatrician or your pediatric allergist to start. Instead, you go to your naturopath or your nutritionally-oriented chiropractor to try to figure this out using their methods of muscle test or electro-dermal screening and get the diet right, because I think a lot of these kids can be handled without pharmaceuticals and actually recover and heal and be okay.
Ben: Now you talk about HCL and magnesium and gut flora, I mean with kids like this, can you safely give kids things some of the recommendations that I know you'd probably have for adults who had issues like this? Can you give a kid a hydrochloric acid supplement or a magnesium supplement or a probiotic? I mean are those type of things safe for kids to be taking?
Dr. Minkoff: Oh sure, yeah. I mean you just have to have someone experienced with, so the dosing is right, and that there's some way to monitor this on the kids so the guy that's doing it. I'm not suggesting that a parent should just do this in the blue because they're kids, and you've got to watch out, but with an experienced practitioner who used to seeing children, absolutely. Overall, the kids usually, they heal quick. Their bodies aren't over toxic usually, and they respond very quickly, and you can get them fixed up and then you just got to sort of keep in all of these things. It's hard to keep in a good diet as an adult, let alone a kid, and stay away from things that are preserved and that are full of chemicals and things like that, and so you have to monitor it with the kid and see what you can get away with and what can't you, to try to keep the kids in good shape. And overall you got to fix the gut. On most of these kids, we get what's called a complete stool digestive analysis where we can see is there enough hydrochloric acid in the stomach? Does the kid have enough digestive enzymes? Are there enough good bacteria growing in intestine? Does he have a yeast overgrowth? Does he have other bacteria, he's been on antibiotics and now his gut is full of antibiotic-resistant bacteria?
And then also, I do some sort of screening for foods, and then if it's in the budget to get the red blood cell mineral levels, and then sometimes there's a trigger. There's a cat or a dog or something like that where the kid is obviously sensitive to either desensitize the kid to the cat dander or the dust mites or whatever the particular trigger is. There's a lot of therapies where you can use acupressure, and you can desensitize a kid to things that they're allergic to, and you can get the kids to heal up then they're not reactive to stuff. If anyone wants to do… their website is naet.com. You can go on that and find a practitioner near you, and this is a marvelous treatment for children where it doesn't hurt. It's easy to do, and it can be very effective, especially with this asthma reactive airway disease, food sensitivities, things like that.
Ben: Interesting, I've actually seen that website before, and I'll be sure to link to it in the show notes for folks. It was one that I had looked into when one of my kids was showing signs of a peanut allergy, and we instead just gradually exposed him over the course of several months to more and more peanuts, and he ended up being fine, but that NAET was a fascinating concept and I certainly looked into it.
Dr. Minkoff: Can I just add something? This treat is so good that the California Medical Association are trying to get it outlawed. It's usually delivered by acupuncturists and chiropractors, and they're trying to get it outlawed so that it can't be used, it's that good. We've got over 20,000 treatments of adults and children. I think it's a terrific treatment for these kinds of things.
Ben: Wow, I'll certainly link to that. Now have you seen this condition of exercise-induced asthma and this autoimmune issue with children successfully reverse or successfully controlled? I mean, have you seen kids go from half a year earlier, not being able to run a soccer field to doing okay? What have you observed?
Dr. Minkoff: Oh, I have, and what it requires is compliant parents, so the parent will do the program. So much of it is what's the kid eating? Much of it is that. Can you give them the supplements? Will you control the foods? Can you get the kid's cooperation? We're going to do this in a six-month experiment to see if you can run again and if you can do all the things your friends do, and if it works, then we're got to keep it in, but if the kid won't do it, then it doesn't work very well or can't do it all very well, and it's like gluten. You give somebody who's gluten-sensitive a sandwich where they have some gluten, and now it's 10 days before that intestinal membrane is back in shape. So once a week, I'm just going to give them some brownies and cookies and cake. In a sensitive kid, it doesn't work very well.
Ben: Yeah, and it certainly is tough. It's something that I've been a little bit more hyper-sensitive to for the past couple months, and you don't really realize how often that a child is exposed to these types of environmental triggers, sometimes when you're around, sometimes when not. It can be a cupcake at a birthday party, a quick cookie, a day care where their decorating cookies. I mean, it's so prevalent in culture, for it seems part of our love or our fun with children to be based around a lot of these foods that are potential gut bombs in the gut of it of the kid who's got these autoimmune issues going on. I've certainly noticed it quite a bit.
Dr. Minkoff: Right, and if the parent is based where their kid has chronic ear infections, lot of antibiotics, lot of bronchitis with antibiotics, these kids really, you have to find a practitioner who will pull them off of the regular medical stuff because it's a doing milling spiral for most of these kids because antibiotics, they mess up the gut flora, they mess up with the gut membrane and the kids on antibiotics every six weeks that almost all these kids, if you can just get their foods right and get them on some good supplementation and get their gut flora restored and their leaky gut fixed, and if they need some hydrochloric acid, they get better. They really get better, and then if you can just keep them honest, so to speak, they don't do well, and then the other thing is this there is a lot of controversy now about immunizations and for anyone who wants some information, there's a great website which is www.N-V-like-Victor-I-like-India-C-like-Carrot.org which has a lot of information, and children are getting many, many, many vaccines now which didn't used to be the thing, and there are many people who feel like this is a definite contributing thing because you take a day-old baby who's given hepatitis vaccine, and then at two months, DPT and polio, and I think 26 vaccines in the first year of life, and in these vaccines are immune sensitizers. There are metals and acetone, and some of these vaccines are cultured in monkey kidneys or in duck embryos, and there are parts of these things in the vaccines, and a kid with a sensitive immune system is going to react to that stuff, and I think it's a part of the reason in addition to this deterioration of our food and are genetically-modified foods, and that is part of the reason why we're seeing the epidemic in children of all these problems.
Ben: Yeah, and it's certainly a polarizing topic, and I think a lot of people don't realize that you don't have to get your kids vaccinated against everything, certainly something my wife and I have gone through because we went with the minimal vaccination route, just because we traveled internationally with our kids when they were first born, and so we did do a few of the vaccinations. But since then, when we put our kids in the kids' camps and summer camps and things of that nature, we've had to actually go to our kids' pediatrician and have them fill out paperwork and sign a big waiver form that our kids haven't been vaccinated, and I know I'll probably get some angry comments from folks even for this podcast for mentioning that our kids haven't gotten all of their immunizations or vaccinations, but I've certainly seen some of the same things you are talking about, Dr. Minkoff, in terms of its effect on a kid's gut and immune system in autoimmunity, so I agree. It's a pretty serious issue.
Dr. Minkoff: Yeah, the other thing I just thought of is that in our office, we do bloodwork on basically everybody that comes through, and we see a fair number of children. Virtually, every child in the last three years that's walked through our practice, and its hundreds, if not thousands, has had a Vitamin-D level under 25, and Vitamin-D is a really important nutrient in immune processes. Now I'm in Florida, and there's a lot of sunshine here, and all these kids are plastered with sunscreen, so they never get any sunshine, and they don't eat a lot of oily fish, and there just isn't any other source of Vitamin-D, and their Vitamin-D levels are really low. I like to keep mine at about 75, and I'd like my kids to be at least above 50, and so if you don't take care of those basic nutrients… So, Vitamin-D is one. The other thing that is really important is we measured what are called carotenoids. Carotenoids are the things that are in fruits and vegetables, the colored substances in fruits and vegetables that are the main way that our body gets antioxidants to fend off things that cause inflammation, and we screened over a thousand people for antioxidant levels, and normal was above 50, and the average that we got was 18, and none of the children were above 18. So, we took dietary histories on these kids. How many things of fruits and vegetables were you getting every day? And the average child was getting zero to two servings a day of fruits and vegetables. Guess what the vegetables were?
Ben: Oh gosh, were they French fries?
Dr. Minkoff: French fries and ketchup. So we thought this was a disaster. They have no Vitamin-D, they have very low levels of carotenoids, and Vitamin-D is easy. There's drops you can give your kids, starting at two months of age, Vitamin-D, or get them in the sunshine every day. Now to the point of burning, but mild tanning is good, and you can give your kids powdered… We use Nanogreens or Doctor's Greens. There's hundreds of these products out there where there are canned dehydrated fruits and vegetable mixes. You could put a scoop in some juice or in some water or add it to a smoothie. Kids, if they're started out early, will drink it, and we found that everyone we did this, after one month of taking one scoop a day, their carotenoid levels went to above 50, and then they got basically 10 servings a day of fruits and vegetables in one scoop of powder. So that was easy.
The other thing that most kids are low in is Omega-3 fatty acids. They're not eating much fish, and that again, you need to supplement. You go to the health food store, you can find fish oil in gummy bears, things that the kids will eat, and these essential fats have a strong anti-inflammatory potential, and so again, if we have a membrane that's inflamed, having a good level of Omega-3 fats is it will not only make your kids smarter and have their I.Q. go up, but it will reduce inflammation in their body, and that's easy. That's easy, any parent can do that.
Ben: Right, and that's definitely an anti-inflammatory that can help out with a lot of these type of inflammatory conditions that cause that bronco constriction, right?
Dr. Minkoff: Exactly.
Ben: Now what about kids who were raised on soy formulas, I've heard some talk about how their gut flora or the lining of their gut may not have quite as tight a cell barrier as kids who are fed a colostrum from source of breast milk or, is there something to be said for that?
Dr. Minkoff: Well I think unless it’s impossible, breast milk is the ideal thing, and breast milk only for six months, especially if you're a family with an allergic history. Mom's got asthma or dad got asthma, or chronic hay fever or a condition like that. This is known that breast milk works. I don't like soy formula, the levels of genistein, which is a mild estrogen, is just way too high, and my kids, in addition to breast fed, this is 36 years ago now, were given soy formula, and the males are males and the females are females, so that worked out okay on that, but I don't like soy formula. If you had to do an alternative, mom can't breastfeed for whatever reason, I would go to a formula called the Nutramigen. It's a process formula, but it doesn't have grains in it, it doesn't have cow's milk in it, it doesn't have soy in, and it's acceptable. So, I go to that.
Ben: Okay, cool, so any other tips that you would have for parents listening in, or perhaps even adults listening in who struggle with asthma or specifically, exercised-induced asthma?
Dr. Minkoff: I think it's worth the investigation because it's tough on the kids, and it's worth finding out to find a practitioner near you who likes these children, and they can do the NAT treatments, or they'll do the gut analysis, or they work with you nutritionally, and they see a lot of kids, and where you are in the Northwest, there's tons of guys from best year. They think this way, they think nutrition, they think detoxification, and they can really help you and then work on your kid's diet, so that you eliminate these bad things, and add the good things. I think for the vast majority of children, they're going to be okay, and it's worth the effort from the parents.
Ben: Well it's fantastic information, and I'm sure that folks may have some comments and some feedback or some follow up questions, and so of course, if you're listening in you can go over to bengreenfieldfitness.com where you'll be able to access the show notes to this episode as well as other talks that we've had with David Minkoff on a variety of topics, from sports performance to the type of ways that he manages chronic pain in the folks that he works with to a lot of really cutting edge, alternative medical procedures, and another thing you may want to know is that Dr. Minkoff is interviewed twice a month in an Ask The Doctor episode, over at enduranceplanet.com, so that's another good way to hear more from the doc, and of course, he is the inventor of the formula that I personally use, the Master Amino Pattern, a whole amino acid supplement, and that's an incredibly impressive supplement, too, that we've talked about in some of those previous episodes with Dr. Minkoff. So, I'll put links to all of the stuff and resources in the show notes for you.
Dr. Minkoff: Oh, there's one thing I forgot to mention, it's with the fatty acids and the carotenoids, a lot of children, and we found this in the autistic kids that we see but it's true in all of them, most of these children aren't eating very much animal protein. They may be eating some eggs, but a lot of them aren't eating much meat or fish, and they actually could use more protein, and so I would urge parents to do that and, they might need hydrochloric acid to digest them better, but also MAP is easy to give to children. You can smash a couple tablets in some apple sauce and get your kid to take it, and the master amino acid pattern, it's an amino acid that the child's body will use to build protein, and if he's not getting much protein, like I said, in a lot of the autistic kids we find that there protein levels in their blood, and their amino acid levels in their blood are just really low, and they won't build the sort of stuff that they need to make their brain function right, and when we give them that, they do build that stuff, and it helps them to improve. So, it's another thing that a parent can easily do, it's give your kid a little bit of a MAP, and it'll help them out.
Ben: Gotcha, okay cool. Well folks, I hope that helped you out and certainly was an educational process for me, so again, we'll put more about Dr. Minkoff in the show notes, and Dr. Minkoff, thanks for coming on the call today.
Dr. Minkoff: Hey, welcome, Ben. I enjoyed it.
It broke my heart.
I was out hiking with my twin boys earlier this month, and suddenly realized that only one boy was by my side.
I looked back.
The second little guy was standing halfway up the hill behind us, bent over at the waist and struggling to get a breath – a look of sheer panic in his eyes.
This had happened before: a couple times, both during soccer games.
I calmed him down, waited patiently for him to catch his breath, and then we finished the hike.
That evening, I e-mailed one of the smartest doctors I know, Dr. David Minkoff, and asked him about exercise induced asthma in kids. What he told me was so ground-breaking and comprehensive that I just couldn't keep it to myself.
So I hit the record button and got him on a podcast call.
I immediately implemented the tips I picked up from the interview you're about to hear, and 7 days later, my son (pictured above) completed his first triathlon with zero breathing issues.
During this audio discussion, I ask Dr. Minkoff the following questions about exercise induced asthma in kids:
-What exactly is exercise induced asthma?
-Do you see patients that struggle with this issue, and have you observed at all that more people, and especially kids, are dealing with exercise induced asthma?
-What do you think are the reasons that this is an issue?
-Is there anything wrong with the current exercise induced asthma treatments, and if so, what are your alternative recommendations?
-Have you seen this condition successfully reversed or controlled, especially in kids?
During our discussion, Dr. Minkoff and I discuss the following resources:
-Keeping kids away from potential digestive irritants or foods that could trigger an autoimmune reaction, especially gluten (a very good book I recommend on this topic is “Gut & Psychology Syndrome“).
-Red blood cell test for magnesium (look for a naturopathic physician in your area who may be able to order this) and use of a magnesium supplement if deficiency is found.
-Considering use of a colostrum supplement in a child who was raised on formula and not breastmilk.
-Use of anti-inflammatory antioxidants and anti-inflammatory fish oil.
-Looking into allergy elimination techniques (i.e. NAET.com) to identify and eliminate potential allergenic foods that kids may be eating.
-Educating yourself on the realities and alternatives to immunizations and vaccinations. The website Dr. Minkoff recommends is: http://www.nvic.org
And there's more resources for you too, because Dr. Minkoff, in addition to being the creator of the “Master Amino Pattern” amino acid supplement, has also been on the following podcasts: