Probiotics and Rheumatoid Arthritis

Probiotics and Rheumatoid Arthritis

In this episode you will learn:

– The benefits of consuming bacteria to assist our own bacteria for RA and all health conditions
– Probiotics, best sources from food
– Probiotics, best sources from supplements.
– Best practices for consuming probiotic foods/supplements to ensure they get into the colon
– Can we overdo probiotic consumption?
– Diversity importance
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This podcast does not constitute medical advice. All changes surrounding medications, diet, and exercise should be made in consultation with a professional who can assess your unique health circumstances.

Clint: Welcome back to the Paddison Podcast. I’m very excited to say that we have, on this episode, our most popular guest in terms of podcast downloads, Dr. Richard Matthews, author of the Symbiont Factor. You may recall Richard from just a couple of podcasts ago where we had him on and we talked about gut bacteria and the impact of gut bacteria, and actually bacteria throughout the body on your overall health. And we dug deeper on that and looked at how gut bacteria can influence autoimmune diseases like rheumatoid arthritis. And Richard was happy to come back on for part two of this discussion, so that we can dig a little deeper into bacteria, and how we might be able to improve the quality, diversity, and numbers of our bacteria in our body. Welcome back, Richard.

Richard: Thank you. Thank you for having me again. It’s exciting to do this one more time. I love talking about gut bacteria and about our symbiont complement and how they help us be healthy.

Clint: And I think that people like hearing about it too, because I’ve had at least seven people write emails to me saying how much they’ve enjoyed the podcast, but not just that, but those particular seven have said that they’ve purchased your book.

Richard: Oh, fabulous.

Clint: Yeah. A bunch of other people saying how much they love the podcast, but I know seven people who’ve reckoned that they’ve bought the book. And one person said they bought it actually before we did our interview, and was thrilled that she was able to then hear you also on the call. So you’ve got a lovely reach going on, and within autoimmune areas, I think that your message needs to be shared as much as possible.

Richard: Thank you. Thank you. That’s wonderful news to hear.

Clint: Yeah. So let’s go over some more content. So we truncated at the end of our last call because we just had so much to cover. We went over the hour mark and thought, “Let’s break this out into a part two.” Now, in part two, the stuff I want to go over today, has to do with what we can do mostly through what we put in our mouth through our diet or through supplements, in an effort to improve the cultures inside us, and the best practices in ways that we can do that. So obviously, we can get bacteria in our food sources, but how might one, starting from scratch, think about doing so, and put in place some good strategies for doing that?

Richard: Well, essentially, there are some parallel strategies for either adding to, or altering our own micro-biome. The most obvious one that comes to mind is ingesting something, eating something that has a population of beneficial bacteria in it. That can be a probiotic capsule, a supplement, or it can be some type of fermented food, or wild food that has its own micro-biomone on the outside of it. Those are one approach.

Another approach is to consider that some of all of the good ones may still be present within us in small numbers, but aren’t doing very well because they aren’t getting what they need. That approach focuses more on looking at either altering the diet, or using supplements that are prebiotic in nature that preferentially feed certain categories of organism, or even specific organisms. And then of course, there’s some degree of behavior or lifestyle issue that very often needs to be addressed as well.

Clint: The lifestyle one, we touched upon last time. And I think we can maybe cover that in brief now, so that then we can dig into more detail with the other parts of what you just said. We talked about how stress can negatively impact our healthy gut bacteria and living an extreme type A personality lifestyle. I guess on the flip side, if one was to meditate, if one was to calm down or reduce the amount of distractions in their life, that gut bacteria, they are inherently conditioned to try and repopulate like any living species. So there’s an opportunity for them to replenish naturally, to some extent, with those kind of efforts. Correct?

Richard: That is correct. And the emphasis that I’ve written about in the Symbiont Factor that I’ve not seen in the other books out there, has to do with the fact that all of these changes are a two-way street. For example, we know that if somebody meditates and does yoga, or just really, really tries to relax, that they end up being a more relaxed individual. But what we don’t often think about is that our change in behavior changes our micro-biome. But then the change in the micro-biome will also change our behavior. So they tend to fuel whatever we’re trying to do, and that can either work for you or against you. We’ll come back to this point later, but research tends to look only at one change in one direction. But in biologic systems, nothing is really isolated and most things work on a two-way street.

Clint: So we’ve got that feedback loop that can be positive, and we have a feedback loop that can be a negative to us in our life?

Richard: Absolutely.

Clint: Okay. Well, that is great, but let’s now move across to some of the stuff that I’ve getting more questions about, which is, first of all, you mentioned about consuming foods that contain the healthy bacterias. And we know that this has been going on for many years. Like, German cultures have consumed sauerkraut. We know that miso soup or miso paste has been something that Japanese culture has been embracing for as long as they’ve been around. And also for the Koreans, they’ve enjoyed what I consider a really difficult taste to endure, which is the kimchi. And if we were to look in other parts of the world, I’m sure we could find areas in which they are consuming, either knowingly or unknowingly, some bacteria with their food. Would that be fair to say, and is there a great benefit to doing so?

Richard: There is a great benefit to doing so, because for two reasons. One is that if you’re eating the food that is a cultured, fermented food, the food itself is obviously something that the bacteria will thrive on. So you’re also, by nature, eating a prebiotic with it. And when we combine a prebiotic and a probiotic, it’s usually called a synbiopic, S-Y-N, because each one helps the other. The fermented foods, historically, have really been used more to prevent spoilage. For example, one of the examples that I wrote about in the Symbiont Factor is the Maasai tribes people that use just a skin hide sack to hold the milk from their cattle. And they don’t have refrigeration in their traditional villages, but it ferments. They have a different name for it, but it’s really another version of [inaudible [00:08:29]. And because of that, it just never really seems to spoil for them. And they enjoy a great deal of benefits, in particular, reducing their cholesterol level even though they have the highest cholesterol intake of any population known on the planet. Their blood levels are normal. So other foods, sauerkraut, for example, choosing what bacterial culture to put in it, allows it to ferment instead of decomposing.

The other category to consider when we compare the ancient micro-biome with the modern micro-biome, and the question of why do we have to do this, why do we have to choose specific fermented foods, in the past, wild foods, even if they weren’t actively fermented, if you pick a piece of fruit out in the wild, or a leaf of lettuce, some edible plant, and you eat it, you are also consuming whatever bacteria and organisms exist on the surface of that food. And by nature, they’re going to be whatever organisms would thrive on that food. So that is a form of wild probiotic, if you will, possibly with the highest diversity accessible. The only modern equivalent that I’ve seen is in wine making. Some people that get very serious about making their own wines will talk about a wild yeast. And a wild yeast is when you simply take grapes and you don’t disinfect them or wash them or anything, you just mash them up and let them ferment. Whatever culture is on it, it’s what makes the wine. So we know those organisms are there just from the practical sense that you can make wine without adding yeast and it becomes wine.

I really believe that ancient peoples throughout all of human history ingested a great number of organisms in that manner. But of course, when you shop at the supermarket and you see the studies that show how much fecal bacteria is on the handle of the shopping carts and whatnot, you realize that, well, even if it was organic produce, you’re probably better off to wash it and disinfect it some because that’s not really the native organism on it. High chance you might get something pathogenic instead of something beneficial. But having to do that really robs us of an opportunity to ingest some healthy natural bacteria.

Clint: Well, this brings my mind to the concept of why vegetarians or vegans are encouraged to take B12 supplements, and why there’s the weak argument that a vegetarian diet or a vegan diet doesn’t actually contain or isn’t a natural diet for the human body because it’s lacking a vitamin that’s required. And the vitamins, actually the B12, which used to be in a plant based diet if you lived close to the earth. Because as I understand, the B12 is produced via bacteria, that if we were to go out and eat plant based foods close to the earth, we’d be naturally ingesting some of that bacteria because we’re simply not quite getting off all of the dirt when we eat the carrot. Or we’re not quite getting off all the dirt when we prepare our potato or whatever might be. So that’s my understanding on that.

Paddison Program

Richard: Yes. Yes, I would agree. Well, it’s challenging to even understand exactly what is the micro-biome supposed to be. And perhaps it’s a little bit different. The optimum is a little different for each individual, but certainly the studies that I’ve read suggest that today’s micro-biome is not nearly as healthy or diverse as it used to be.

Clint: Well, we can see where the problems lie. Even if we try and go to the shop and buy sauerkraut, we think we’re doing the right thing, but then the sauerkraut that we’re buying, unless we’re very diligent, is pasteurized. And so it’s being placed through a high temperature. And so then you’re thinking you’re doing a wonderful thing and then you’re still not getting the benefits.

Richard: That’s exactly right. Just like if somebody shops indiscriminately for their fruits and vegetables and doesn’t select the ones that were raised organically, there may be enough pesticide residue on the outside or even herbicide residue for weed killing, that there may not be any beneficial bacteria left whatsoever, even inside the plant.

Clint: Disturbing, isn’t it?

Richard: It is. Then you eat that stuff and the same thing happens inside you.

Clint: All right. So I think we’ve set up a good problem situation for us now to try and solve. Let’s talk about actual foods that contain high amounts of beneficial bacteria that everyone could consume on a regular basis if they can try and find it, or make it themselves. Keeping in mind that what we have found is that, through studies and conclusive personal hands-on experience working with a lot of people, the dairy format of a lot of the popular cultured foods tends to do as much harm as good in terms of providing other problems to a person with an autoimmune disease. So if you could list all the good suggestions. And we just need to be careful for our listeners, to consider that dairy formats of probiotic foods can do as much harm as good. But I want you to list them all anyway, in terms of foods that could be great sources of healthy bacteria.

Richard: Very well. That applies to me as well because I appear to be quite sensitive to cow dairy and somewhat sensitive to goat based dairy as well. So I avoid both of those, too. One of the easy alternatives that I make quite often is to ferment coconut milk into kefir or kefir, however we would pronounce it. And done properly, it makes a nice white, creamy substance that is very, very similar to cow milk kefir without any of the problems that go along with it. It’s quite easy to make. Put a starter culture in a jar with some coconut milk, but not one that has no vanilla flavor and everything, just plain coconut milk. Some of the brands are little bit sweetened. I just let it ferment on the fridge.

Clint: Let me jump in there. Because I actually would like a bit more detail here. Can you go on a little bit? Do you make this at home?

Richard: I do make it at home.

Clint: All right. Where do you get your starter culture? What sort of containers do you need? What temperatures can it be? All of that, let’s get into that.

Richard: Okay. Wonderful, wonderful. I generally use about a quart sized mason jar. While it’s fermenting, I leave the lid on it, but I leave the lid loosely on it so that gases can escape. It’s good to agitate it from two or three times a day, or else it tends to clump up at the top and not really ferment evenly. So you just reach up, tighten the lid down, give it a couple shakes, loosen the lid, set it back on top of the fridge. This seems to ferment quite well in room temperature or slightly higher. Right now, I’m in Arkansas and it’s been almost a 100 degrees Fahrenheit every day. So even in the air conditioning at the top of the refrigerator, is probably about 80 degrees Fahrenheit. And the starter cultures, you can actually buy a starter culture that’s powdered. The same ones that work for cow milk kefir appear to work just fine for coconut milk.

I believe what happens, over time, is that the organisms sort themselves out. And some of them thrive and some of them not quite as much, but you end up with the ones that do well on coconut milk. And if they absolutely had to have some ingredient in cow milk, well, they just don’t really persist much in the culture. It works out just fine. After you get one going, it tends to grow and grow. They look a bit like waterlogged cauliflower. The actual cultures is a little spongy, rubber looking thing that looks a lot like cauliflower. I’ve read that in some parts of eastern Europe, that’s the part that they actually eat, is the culture itself. Matter of fact, one of the images in my book shows a little bowl of it with a spoon next to it and that’s what the things look like. After they grow like that, the cultures are generally shared person to person because it keeps growing and you have to do something with it. So you’re really going to end up eating it, throwing it away, or giving it to somebody else to experiment with on their own.

Clint: That thing’s called the mother, isn’t it?

Richard: It is, and it spawns off a lot of little babies. Another food that is similar… Oh, and wait. I generally leave that fermenting for two and maybe three days, and then I’ll put it in the refrigerator intact for one whole day. And then at the end of that day, I’ll tighten the lid down and give it ten or fifteen seconds of moderate shaking, not enough to pulverize it but enough to knock all the clods loose so it looks like there’s nothing clumped up at the top of the jar. You’ll see exactly what I mean if you actually do this. And then I filter it through maybe a three-sixteenth inch size hole colander or a little screen, a grid. Works better if you don’t use one that’s metal. They don’t seem to like metal. And I filter it actually into a quart jar that fits on my NutriBullet. So all the liquid part goes into the jar for the NutriBullet, and that just leaves the solid parts in the little strainer. The solid parts, I just dump back into the jar, or into the second jar, and fill it back up with fresh coconut milk and put it on the fridge.

And then the liquid part that ends up in the NutriBullet blender, I’ll blend for just maybe five to ten seconds. And it just makes it much smoother. It won’t separate very much after that, it just stays creamy. Otherwise, a lot of people won’t want to drink it because it’ll seem like a semi-translucent, milky solution with white clumps in it. If you just blend it up, then it’s nice and creamy and smooth. That seems to work better for us than when we drink something and find clods in it. Nobody really likes that. We don’t want your drink to coagulate. Another one that we’ve done quite a bit…

Clint: Hang on one second. I have a question. Do you just buy commercial coconut milk? You just go and buy coconut milk from the store, or which coconut milk?

Richard: I do. They don’t have a brand for it but it’s the stuff that we get just at Walmart. Actually, if you can get it organic, it’s best that way.

Clint: After the call, if you could just email me through the brand of what you buy. Because not everyone’s living in the United States. People outside the country can then also Google that product, look at the list of ingredients, and then find something similar around the world. Because we see a lot of problems with some commercial milk style things. A good example is almond milk. So I don’t know what it’s like around the world, but here if you go to the supermarket and you buy almond milk, there’s a good chance that only 10% or less of the product is actually almond milk. A large part of the contents are other fillers. And so this is something that I want to make sure that we don’t stumble over. And I want to make sure that everyone’s getting what works for you. Because the variations in the products are pretty enormous.

Richard: Absolutely. I’ll email you a picture of the front label and the back label that shows the ingredients.

Clint: Great. And then I’ll put that up with the transcription. Well, that’s great. I’m really pumped about that. Here we have some commercial coconut yogurts, which I’ve found really, really good. They’re very rich. I guess it’s because I haven’t eaten something like that for a long time, and so I only handle a couple of spoonfuls and then it just feels a little bit overwhelming for my taste. But it’s very, very tasty, and I guess it’s probably a similar kind of process.

Richard: Yes, yes. We have that here, too. I get to enjoy that quite often also. Although most of the stores that I get to shop in, don’t have the coconut yogurt. They just have cow’s milk yogurt. But coconut yogurt is wonderful, very, very tasty.

Clint: One thing that some people might be wondering about and it’s something I just want to comment on before we hear some of your other fermented food options, with the fermentation process, a lot of the fats break down to fatty acids. And the proteins break down to the amino acid constituents, and the carbohydrates, even in small quantities, will break down into simple sugars. And so I expect that people who are still having trouble with their fat intake – and we talked about this last time on our call with Richard – may still be able to handle fat content that’s present in fermented foods because of what I just mentioned. So that presenting at the gut wall not whole fats but only fatty acids which are harmless to the immune system.

Therefore, I just want to encourage people, even if they find that they can’t eat avocados if they’re in early stage of the healing because of the fat content and other high fat foods, that fermented foods may be still able to be tolerated. And if so, then this is a double win because not only are you being able to enjoy some high fat foods which will help with energy levels and meeting calorie intake, but also in a format that’s tasty, and in a format that provides tons of healthy bacteria. This is really something that I would encourage people to look into.

Richard: It really does improve the digestion of the plant material itself when you got fermented foods, because our gut doesn’t have capacity to digest everything without the bacteria digesting some of it for us. Even a horse really can’t digest grass without its bacteria digesting the cellulose. And that’s an integral part of obtaining proper nutrition from any diet, including a vegetarian diet. Personally, I’ve known vegetarians that have done incredibly well, like yourself. I’ve known some in the past that never really seemed to get it to work for them. And I really believe, at this point, that the ones that could not get it to work for them had an imbalance in their bacteria. And that’s quite possibly why they didn’t see all of the benefits that the diet really should be able to convey to us.

Clint: Absolutely. Completely agree with that. There’s plenty of junk food vegans and junk food vegetarians, isn’t there?

Richard: Absolutely, absolutely. That speaks just a little bit to the issue of lifestyle. When you look at what kind of micro-biome somebody has, it’s a result of how they’ve been living and what they’ve been eating. So it’s important to realize that you have to change some of those things if you expect the micro-biome to change. In this case, adding fermented foods is a fairly substantial change, because they don’t have that at McDonald’s.

Clint: No, it’s not one of the options, is it?

Richard: If they did, they’d probably find a way to ruin it anyway. So yes, one the next ones that’s one of the most, I don’t know, entertaining ones to make is Kombucha.

Clint: It’s like my favorite thing on the planet. Yeah, let’s talk Kombucha.

Richard: I have some funny pictures of Kombucha scobies [SP] on my blog. They even put on Twitter. The scoby is an acronym that stands for the symbiotic culture of bacteria in yeast. That’s sort of a cute name that we give to the clump of organisms that does the fermenting for us. I’ve even heard that used with reference to kefir. But Kombucha is a fermented tea, and it can be made either with black tea, or with green tea. I’ve heard of it being made with mocha tea, although I haven’t tried that yet myself. Each of the teas conveys a slightly different type of health benefit because it cultures a slightly different blend of bacteria, and they produce slightly different by-products that have more health benefits.

Kombucha is a bit trickier to make in some ways, because if you let it go too long, it gets increasingly more vinegary. There’s probably a limit to how vinegary we should let it go and still consume it, because the PH starts to become quite acidic. That probably provides the only significant safety limit to Kombucha. If it’s too acidic and you drink too much of it, well, certainly there’s a place there. Somebody drinks a gallon of vinegar, we wouldn’t expect them to feel very well afterward. It’ll make you quite sick. But Kombucha should be fizzy but not so acidic that it’s unpleasant, should have a little bit of a bite to it. It produces a lot of by-products that themselves may be prebiotics for other bacteria in our guts.

That’s important to recognize because out of all of the different types of known beneficial bacteria, different foods and different fibers, different nutrients, will preferentially feed one or the other. That’s the whole concept of prebiotics. The things that funguses and yeast make can really, really help with lowering inflammation and lowering the levels of fat in the blood, decreasing inflammatory markers, and increasing lactobacillus species, fecal bacterium Prowse Nitsae [SP], Collinsella, all of these different organisms that researchers have found are good for us. So when you grow on Kombucha, you end up with what really it looks like a wet rubber pancake that grows on top.

It’s quite an ugly process in some ways. And as it ages, it can have little brown dangly slimy things that go down into it. We’ve kidded about Kombucha mushrooms at our house for quite a while, because the things try to escape. I’ve used one of those iced tea jars to make it, that has a tap on the bottom and a screw-on lid on top so that you can just keep adding tea to the top and you get Kombucha out of the bottom a few days later. But after you do that for a few times, a few batches, it’ll stop coming out of the bottom. And when you take the valve apart, you find that the tea has actually grown the mushroom itself. The Scoby has invaded the valve in its attempt to get to the atmosphere.

Clint: I actually predicted that. I could see where you were going with that. I thought, “That thing’s going to grow in there.” Yup.

Richard: We’ve intentionally or inadvertently done some funny experiments with Kombucha. We had one jar that grew quite nicely and it ended up being neglected. Everybody got a little bit burnt out on drinking it, and before we knew it, six or eight weeks had gone by and it was just there on the back of the refrigerator. And I realized, looking at it one day, the tea is not evaporating. And what happens is that in its effort to preserve itself, the Scoby actually seals off the atmosphere to prevent the evaporation of the thing that it lives in. It’s rather fascinating. And I decided to leave it there. And after about four months, it actually looked about the same. It was kind of dried on the surface but nothing grew on it. It didn’t mold. It didn’t seem to have any infections. It successfully inhibited anything else from growing in that. And it just smelled like vinegar. We just took it out and put it in a fresh batch of sweet tea and it took off and grew again.

Clint: Wow. That’s fascinating stuff. I’d love to see some demonstrations of how you make these. Have you ever put together some YouTube videos or some training videos of how you make your kefir and your Kombucha?
Richard: I have thought of it, but I’ve not done that yet. But that is one of the things that I intend to do. Maybe even a Google hangout video or something so it can be a bit interactive.

Clint: That is awesome. Over the little while, I’ve been thinking about holding a live event, either an online live event or a real live event. And if I do that, I would love to have you involved with either of them. If we do do it using video style, then that would be something that I think a lot of people would love to see. Because a lot of it’s in the details, isn’t it? We tried to make a couple of fermented things over the years, and boy did we have some disasters where basically the atmospheric bacteria was getting into our mixes and it was going vial. We had some bad times. We’re not stupid people but we did it in the middle of summer and I don’t think that helped. We just were a little bit complacent. It needs a lot of attention to detail, trying to get an environment for the bacteria to thrive, and to find a comfort zone to grow, I feel.

Richard: It does. For example, one of the things that I found helped a great deal with growing Kombucha, is we would take a coffee filter and put it over the top of the jar. And when we do that,, we just put a rubber band around it to hold it on there. It keeps the dust from landing on it, but dust includes a great number of bacteria. And when you keep it from getting dust, even though it’s exposed to air, it seems to do much, much better. It cuts down on the number of opportunistic invading organisms. The other thing is there’s a certain point of no return where if the colony, the Scoby, is healthy enough, once you get it to that point, then it’ll pretty much kill anything else that tries to grow in it. But before that, it can be quite vulnerable. So yes, some of it is just a bit of practice and learning involved in getting it to work.

Clint: Absolutely. And we didn’t have that patience and so forth when we were living in a one bedroom apartment in the inner city trying to grow Scobys. So can we just maybe knock it out with a few bullet points steps for your Kombucha, in the same way that you nicely bullet pointed out your kefir production.

Richard: Absolutely. My typical batch of Kombucha is made in a eight or ten quart pot, where I’ll heat up some filtered water or spring water, just like you were making a very, very large pot of tea. I’ll put about six or eight teabags in it. I don’t recommend tea bags that have all sorts of added flavors, just plain old tea. Even something like Earl Grey, because it has an added ingredient. Seems to foul up the mix. It doesn’t work as well. Plain old black tea, or green tea, or mocha, and just put that in there and let it steep. I leave it in there quite a while. I also add the sugar then. I think that it’s better to use a raw sugar, turbinado sugar, raw sugar, that is one of the colored sugars. Because that includes a lot more nutrients than plain white sugar. I’ll confess I’ve made it with plain white sugar and the Scoby does not seem to care.

But I feel better about it if I’ve put some sort of raw, natural sugar in there that’s not chemically bleached and so forth. The ratio of that for about eight quarts, I end up putting maybe two cups of sugar in there. It’s actually a fair amount of sugar. It makes it about as sweet as most people would ever drink it. This is Arkansas, southern United States, people drink some really sweet tea. But if you make it about that sweet, you’ll get it right. It’s easier to mix the sugar in, of course, while the water is still hot. If you wait until it’s cold, it takes a lot more stirring to get it all dissolved. Oh! And I would not recommend using honey, because it seems that honey actually inhibits the growth of bacteria. It’s not like it can’t be done, because it can work, but I think it makes it much harder than it needs to be.

Clint: Is that processed honey, or have you tried it with raw, unheated honey straight from the hive?

Richard: That’s a good question. I don’t recall which it was. It might have been processed honey. It might work better with raw honey.

Clint: Well, sounds like you have the solution anyway.

Richard: Yes. Just mix it up and put it in a big jar. The ones that we’ve used that work quite well, are three or four quart jars. You can make a couple of them. Or we have one that’s two and a half gallons that has the tap at the bottom, so it makes a pretty righteous batch of Kombucha, two and a half gallons at a time. I’ve even seen it made in five gallon buckets, which makes a monster of Scoby because it grows on the surface of the tea. So you end up with a Scoby that looks just like a paint bucket lid but made out of wet rubber pancake. It’s really quite a sight. I don’t know that there’s any limitation to how big you can make. You could probably use a swimming pool full and the thing grows Scoby across the entire pool. That’ll be something to call the Guinness World Records’ people about.

Clint: I’m picturing The Walking Dead, that zombie TV show of all people with rheumatoid arthritis all around the edges, all munching on this big scoby, trying to get rid of it.

Richard: Oh, that’s good.

Clint: Because I would have done anything to get my hands on that Scoby at the period of my disease path.

Richard: The Scoby is like that out. They grow, and they grow a new layer every time you add some more tea. So the things can get quite thick. And typically what we do, is we peel off the bottom layers. Because the bottom layers are the old layers, and they’ll look kind of ugly after a while. They get all dangly, slimy things that dangle down into the tea and make people not really attracted to it.

Clint: Sure, sure.

Richard: My kids call it, “dad’s science experiment,” until they figured out that tasted good, then they like it. So we peel off those layers, and you have this Scoby again. You can give it away, you can throw it away. I’ve heard you can cut it up in pieces and make stir fry out of it. I actually plan on trying that. It might be some degree of meat substitute in a way, although I don’t know how much protein it has in it. It’s mostly cellulose. But from what I’ve read, it’s actually edible and kind of durable, really. I’ve frozen them. I’ve dried them. You can actually put them out on a couple paper towels, and just leave it out and it dries. And it dries into this cellulose membrane kind of thing that almost looks like a biologic plastic. And you can reconstitute it from that by acidifying the water, putting some sugar in it, and just put that thing on top. And it’ll revigorate itself back into a living Scoby. It’s quite miraculous.

Clint: It is. It’s fascinating stuff. How long does your Kombucha sit before you start consuming it?

Richard: Well, that depends. I generally sample it and taste it from time to time, just to see what it’s like. And when it tastes about right, then I know that it’s good. That ranges anywhere from a week to two weeks. I’ve had some go as long as three weeks and I still like it. Sometimes we’ve made Kombucha in just batches, where you make a batch and then you can put it all in little glass bottles and put it in the refrigerator to halt the fermentation cycle. You can also mix it with apple juice, for example, and put it in the refrigerator in bottles. And then it’s quite convenient. You just grab a bottle and it’s good to go. Or sometimes we’ve made kind of a rolling batch, like in that two and a half gallon jar where every couple days, you just dump in another pot of sweet tea at the top. When you have it like that, it’ll consume the added sugar just in a day or two.

Clint: That’s awesome.

Richard: Because it’s a lot of organisms in there.

Clint: I’d really love to see some videos on this, because that’ll just make the whole thing so much easier to follow. So if you do do that in the future, make sure you let me know and I can retro fill the transcription on my website with the videos down the track if you do do those.

Richard: Excellent, excellent. I will do that.

Clint: Now, in the thoughts of time, maybe if we could just list some other probiotic foods that you consider beneficial. I did at the top. Certainly the one that I encourage most people to have the most, just because it’s convenient to eat with the other foods that I encourage people to eat in the early stages of their healing, is the miso paste. And I encourage people not to put boiling water over the miso paste, but just a warm water because otherwise with the boiling water, I’m concerned about killing enzymes by just really too many high temperatures on the miso paste. So that’s one that I encourage a lot. What are your thoughts on that? And what are a couple of others that they can go and do their own research on?

Richard: I definitely like miso. And miso comes in several different styles that I understand are from different areas of Japan, but slight difference in the fermentation process, in the aging, and in the type of bean that it’s made from. I think in all likelihood that also equates to slight differences in the microbiome that’s growing in it. So it’s probably a good idea to vary the types that we use: red, or light colored, or dark. We have a lot of different kinds here. Miso, I would definitely agree you’re going to get more benefits from it if you don’t douse it with boiling water. There’s still some benefits from the by-products of the actual culture even if it has boiling water on it, but it’s not going to be nearly as powerful as if it is able to retain some of the organisms. Many of the Japanese restaurants that I’ve had miso soup in, don’t seem to serve it scalding hot.

Clint: Exactly.

Richard: They serve it so that you can eat it right away. You don’t have to blow on it or anything; it’s ready to go when they’ve put it on the table. I think that may be one of the reasons that that’s the traditional way to do it.

Clint: I think so. And the first time I went there, I thought why isn’t the soup they give you… I didn’t even know the name. I might have learned it on the first day that I went to Japan. And this was before I even had health troubles, and I’m like, “Why don’t they make the soup a little bit warmer?” And you have to drink it straight away, otherwise it gets cold pretty quick. That’s fascinating. This stuff’s fascinating, isn’t it?

Richard: It is.

Clint: I mean, I reckon if you asked half of Japan, and asked them, “Why isn’t the miso soup super hot?”, I don’t know if they’d be able to tell you it’s so that the living cultures within it, the enzymes, aren’t destroyed by really high temperature.

Richard: You know, they must have had very good instincts when they started doing this, is all I can say.

Clint: Someone knew what they were doing, but I think it gets lost in modern society.

Richard: Yes. You’ve got a lot of different kinds of sauerkraut. We tend to think, in America, sauerkraut is just the thing that you put on the hot dog. But there are so many different kinds of sauerkraut, different cultures, different processes, different combinations of cabbage and other vegetables. You can do a lot there. There are entire books written just about sauerkraut fermenting. And there’s one book that’s become somewhat the Bible of all fermented foods, and it’s written by a man named Sandor Katz. And there is so much in there about fermented foods that it’s unbelievable. I don’t think anybody will ever write a book that has more diversity of fermented food history, products, and recipes.
Clint: So it’s for the hardcore people who want to see it all?

Richard: Well, yes. But you know, all of these things are somewhat geographically limited as far as what ingredients you can get. So you may need a book that has a bazillion recipes to hit on six that you can actually make with what you can get locally. And then there’s tempeh. Tempeh is fermented soybeans, fermented beans, actually. I don’t know that they’re soybeans. It’s made from a lot of different types of bean. They can even be made from chickpeas. Now, same thing applies there. There are some brands of it that you can buy pre-made that are probably pasteurized, that don’t have nearly the benefit. Or you can make it yourself, or you can get it quite natural. I know some of the Whole Foods stores in America carry tempeh that has live culture in it. So that’s another one.

Clint: Yeah. If you do purchase that yourself and you’re comfortable with a particular product range, then that would be great to list as well. But if not, no problem.

Richard: I’ll think about that. I haven’t actually purchased tempeh in a while.

Clint: No. When you’ve got so much bacteria in your fridge already, you don’t need more. All of this talk about bacteria, there are some nay-sayers who say that a lot of the bacteria that we consume can actually get past the high stomach acid content inside the gut. And so I just want your thoughts on that so we can clear up some concerns there. Certainly, my feeling was that the more fermented foods I was eating… And again, for me it was mostly through Kombucha teas bought commercially, but mostly through the miso paste which I was consuming at least one meal and usually two meals a day for at least 18 months. We’re talking a lot of fermented food content. I felt that it was making a tremendous difference to my health, as well as a huge amount of leafy green salads which I felt was the best pre-biotic for my bacteria. So I believe that it played a tremendous role for me. And what are your comments about the bacteria in the food actually ending up in the places that we want them?

Richard: Well, there’s several studies, first of all, that do show that the bacteria, either in a supplement or in a fermented food, do persist in the gut. One of the things, again, to consider is eating a fermented food doesn’t necessarily guarantee that it will persist, because you may have to change some other things to create a good environment for it. But there are studies that show bacteria from yogurt, for example, or there’s a type of Nigerian fermented cereal that’s been studied, and they found that the organisms did persist and they survived the stomach acid just without any problem. Another factor to consider is that unfortunately a lot of people don’t have enough stomach acid so it’s really not much of an issue. Stomach acid levels tend to drop through life so that older people almost always have much less stomach acid than younger people.

Even though, at least in America, the use of antacids is extremely high. In many cases, it’s been found that they give relief for other reasons, but it’s not because they’re reducing stomach acid. Neutralizing stomach acid actually creates a poor environment in the gut for the beneficial bacteria. But the researchers have found that these organisms do survive normal stomach acid and bile salts, and appear in the gut. And it may take some time before it’s completely understood how that’s possible. There’s a certain element of biologic magic or biologic sleight of hand involved in how these organisms end up where they’re supposed to be. Consider that there are studies that show that a woman who is pregnant or breastfeeding, if she takes a probiotic, those probiotic organisms end up in her breast milk. And that’s been measured in measurable changes in the same species of organism that show up in breast milk.

But if you consider how that actually could happen, there’s not a direct pathway from here to there. I did find one study that suggested that the human immune system has the ability to encapsulate a beneficial bacterial organism in the gut, transfered across the membranes into the blood vessels, and ferry it wherever it needs to be in the blood vessel and then release it back into the lymphatic circulation, or out into breast tissue. It’s very hard to explain how that’s possible through any other way other than sort of an armed escort as it were with the immune system, escorting the beneficial organism while blocking the ones that are not beneficial. So if you think about beneficial gut bacteria ending up in breast milk, how in the world that’s possible than beneficial bacteria in foods that we eat ending up in the gut? Well, that seems a lot easier, actually, at least as a direct pathway that gets from here to there.

Clint: Most definitely. And a couple of comments on that. Melissa, my wife, during pregnancy and during the early stages of her breastfeeding of our daughter, Angelina, was taking a probiotic supplement that claims exactly what you’re saying, that the beneficial bacteria ends up in the breast milk. And they’re leveraging that as their sales tactic. So that your baby is going to get additional beneficial bacteria in the breast milk, on top of what’s already there naturally. So there is that. So if products are claiming that they’re basing on that, then obviously it’s sort of somewhat matured as an established fact in a way.

But then also, with regards to the arguments against the bacteria making their way in the gut, I think that this is a very, very small segment of the uneducated overall views on this. Because attending very large conferences and conventions on this exact topic, no one’s questioning with a strong education in this area, that the bacteria end up helping out your existing bacteria and making their way to where it needs to go. I think, yeah, they might be an attrition, but you’re not throwing your money away by taking probiotics supplements. That’s where I’m going.

Richard: Absolutely. Even when somebody is taking antibiotics or undergoing chemotherapy for cancer, two medical interventions that are extremely toxic to beneficial organisms. The studies still show that taking probiotics does confer a benefit, and that the organism still survive in larger numbers, even during those types of therapies. And there are some really interesting examples of that, that showed just how far that goes, where researchers have looked at patients undergoing liver resection, or undergoing a colon resection where they have to have a section of bowel removed typically because there’s a cancer in it, and adding probiotics to their diet before their surgery, greatly, greatly reduces the number of infections that occur after the surgery. Just a really quick synopses of it, in the colon resection study, the number of post-surgery infections dropped from 38.8% to 13.3%.

In liver transplant, they looked at several different studies to write that study. And the rate of infections went from 35% to 7%, from 16% to 2%, and from 11% to 2% in the different studies. That’s a huge reduction in post-surgery infections, and it’s not attributable to anything except the taking of a probiotic before surgery. And the patients are already on an antibiotic before surgery as a prophylaxis and it still works.

Clint: Well, okay. Well, it just really validates everything we’ve been talking about for the last 50 odd minutes. It’s just really, really emphasizing the benefit of consuming foods that contain beneficial bacteria or supplements that contain beneficial bacteria. A question that I often get, and I’ll tell you how I answer it, and it is: what should I take in terms of probiotics? What brands should I buy? And when should I take them? And I’ll tell you how I answer that, and what seemed to work for me. And then you tell me whether or not there are some tweaks that you would feel would be appropriate to the answer that I usually give. So what I normally say is that the quantity and the diversity of high importance. And so I say, “Take the probiotics as much as your budget can afford,” because I’ve always found them to be quite an expensive supplement. And especially if you’re buying refrigerated ones, they tend to chew up your money pretty quick.

And so I would say take as many as you can afford without doing too much damage to your financial situation, and also buy from a number of different brands so that you’re able to get different cultures from different brands. And so a good strategy that I used to do is just buy anything that was on special. Some were non-refrigerated, some were refrigerated. I would buy ones that were basically on a weekly special or the deal of the day. And then I would also recommend that they were taking both some with meals from times, but then also make sure that some are taken in-between meals or when there is an empty stomach, just to reduce any concerns about anything in the stomach preventing them from getting their way to the colon or the large intestine. So that’s the answer that I’ve been giving. What are your thoughts on that answer, and how would you make changes to it?

Richard: Well, there are different degrees of intensity that a person can go into that type of, I guess we could say, therapy intervention. What you’re describing is perfectly logical, and it’s going to increase the species diversity in that environment of our gut inside. We call it a microbiome because it’s a biome; it is an environment. Just like the macro-biome, the outside world is an environment. The same rules of biology apply. The more diversity there is of species, with of course not very many harmful ones, species diversity provide stability. If you lose species diversity and your environment has many fewer species, it’s always a more vulnerable environment. That happens whether we’re talking about a rain forest or the Arctic Circle, or the inside of our gut. All of these organisms depend on each other for support, to some extent. When there are less of them, well, there’s a smaller team that’s more vulnerable. Shopping for different brands that are on sale, yeah, that’s not bad. It worked for you. You’re proof of the concept right there.

The other thing that I would add, particularly for people that might find that that approach is too expensive or too challenging moneywise, or if you just want to really amp up that approach and get the most bang for your buck, is adding prebiotic fibers or prebiotic foods specifically. For example, recently there have been a lot of studies about an organism called Akkermansia muciniphilia. It’s an organism that lives in the gut, and it actually feeds on mucus. That’s why it’s called muciniphilia. But it’s one of the organisms that’s been found to reduce obesity. And it’s greatly reduced in people that are obese, and it’s in much higher concentrations in people that are lean and muscular. It also has been shown to reduce inflammation, which is very, very significant, as you know, for rheumatoid arthritis, and as well as for hormonal response. Inflammation reduces hormonal response.

But that particular organism is fed, it lives also on things like pomegranate, for example, and cranberry. There are plants that have a lot of polyphenols. [inaudible 00[57:43] from red wine or from grapes is a phenol. You can get many times those type of foods, or capsules of those type of fibers, very inexpensively. But then what you’re doing, is you’re using your probiotic as a true starter culture, and adding enough food so that culture can flourish and grow. It makes your probiotic supplement go much further. You can take enough probiotics to really populate the gut, but you won’t need nearly as much if you have enough of the fibers to feed the things. Because they’re going to eat up whatever’s there to eat that they thrive on.

Clint: If you’ve got more to say, continue, otherwise I just want to ask a question about that.

Richard: Go ahead.

Clint: Okay. This may be a little bit simplistic, but my thoughts were tons and tons of foods that are prebiotics, and for me, that was tons and tons of leafy greens. I would eat the biggest salads that anyone’s ever seen. And I would also consume things like onions and garlics, and foods in that food group that I’ve never actually said out loud but read a thousand times, [inaudible [00:59:03] or along that line.
Richard: Yeah, many of them are not pronounceable in any normal language.

Clint: Thank you for not making me look ridiculously stupid just then. And of course, the Jerusalem artichoke is another one along the lines that get tailed along the same lines. And so my thoughts were eat lots of foods that, according to the information I had received, were good for feeding healthy bacteria, and then throw as much bacteria into my body as I could. So I think I went along the same kinds of lines without targeting any specific organisms. I was just using foods to try and feed those healthy bacteria.

Richard: Well, that leads to the next point in this line of thinking, which is if somebody has an actual disease condition, or things that they’re developing, one, like rheumatoid arthritis as an example, and you want to look at your microbiome as one avenue for helping it, obviously that is a tremendously successful strategy. You can now be quite specific with this by doing a gut bacterial analysis and looking at what organisms are deficient, and what organisms you already have in large numbers. And then if you look at the beneficial organisms that are deficient, you can then look up what do those organisms thrive on? And you can boost that quite a bit. There are a lot of different prebiotic compounds, ITF, which is Inulin-type fructans, GOS, which is Galacto-oligosaccharides. That’s typically for milk, but you can get GOS as a supplement separately. Arabino-xylans, they’re an extract of a fiber from grains, typically. And anyway, Xylooligosaccharides, XOS.
Clint: Some of them are those I was trying to say earlier.

Richard: Yeah, there you go. Those are all ones that feed, for example, bifido bacteria, Akkermansia, and lactobacillus. But there are other types of prebiotic fibers that come from mushrooms, mushroom extract, and fungi of one type or another. And those can feed some different organisms. And then there are phenolic [SP] compounds like the pomegranate grapes, those type of things, cranberries. And you can fine tune which of these supplements you take, or which of these foods you eat much more of, based on which organisms need an extra helping hand, if you actually have the gut bacteria analysis from a stool sample to use as a bit of a guide.

Some of the analyses that I’ve looked at, for example, I’ve seen people that eat what I would consider quite plentiful amounts of leafy green vegetables of one sort or another, and yet they still seem to be deficient in a couple of vital species, bifido bacteria and lactobacillus, for example, that are really kind of a core species at a healthy microbiome for us. The only thing I can think is that there’s something else that happened, or maybe they were that imbalanced to start with. But those organisms obviously need something extra in order to get out of their low levels and become dominant forces in the microbiome. Anyway, you can tune that quite specifically and get an even better result.

Clint: Where do you recommend people get their stool tests done? Because a problem that I’ve seen with people who have shown me their stool test results in our community forum, often it just shows up the problems that they’ve got. Overgrowth in XY and Z, overgrowth to a lesser extent in, say, ABC, but not really a wonderful, large spectrum of bacteria cultures and their presence. So is there a place that’s really excelling in this that I can recommend people to go to?

Richard: Yes, but I’m not sure which ones are available in Australia.

Clint: Don’t worry. More than half of our audience is in the US and the rest is all around the world.

Richard: Oh, okay. Well, good enough. I know, for example, in the United States, Genova Diagnostics, which is gdx.net now, they offer a comprehensive digestives stool analysis, CDSA, that looks at all of the categories of organism. It will also give you an idea of parasites and yeast. The simplest and least expensive one that I found useful is Ubiome, which actually they’re compiling data to document what the human microbiome is in different individuals. They have you fill out a survey, also as part of their research process, that will categorize you into one of many different groups. It can be vegetarian, somebody on a paleo diet, somebody that drinks a lot of alcohol, somebody that’s been on a lot of antibiotics.

Those are some of the examples of categories that they look at. And then they’ll take your microbiome and compare it to all of those. But they also provide the raw taxonomy data, that you can copy and paste into any number of other utilities, that will break it down into what lives there and how many of each category. The only part of it that gets a bit complicated is looking at the – how do I describe it – tree of life. The way that organisms are categorized and cataloged can become a bit complicated, so it’s necessary to do a little homework on that. Because we have class, order, family, genus, species. In an order, we’re used to looking at genus and species, homo sapiens, canids [SP] lupus. And most organisms we see are named that way.

But that continues into larger groups. So some of these analyses, you have to understand that to understand what you’re looking at. Or you can think, “Oh, look. This is high and this is high also.” Well, yes, it’s high because it’s a subset of the other thing that’s high. So you sort of have to do a bit of homework to understand that, or ask somebody that does that. And there are a number of us online that are getting more and more specific with it every day.

Clint: Well, certainly you’d be the first person I would go to if I wanted a stool sample read.

Richard: Well, thank you. That website is ubiome.com. And the last time I checked, the last time I sent one in, they were only charging $89 US for that, which is really quite a bargain considering the amount of data that comes out of it. They’ve also expanded their research, just in the last few days, to additional projects that you can read about on their site. It’s quite fascinating.

Clint: Okay. Well, that’s some great tips right there. And I just want to close this off, because we’ve now done a classic [inaudible [01:07:06]. We’ve taken over the hour again. I just want to close off by asking you can you over do it? Can you consume too much of a good thing?

Richard: Yes, yes, absolutely. And how much is too much is a very individual thing. And that’s a good point to close on because it’s important for anybody listening to understand that our ideal microbiome, if you think of that as a concept, what is the perfect microbiome compliment to you, is very different for every one of us because it’s based partly on our genetics. It’s based on what we were exposed to as we grew up, which determine part of what has our immune system learned. The microbiome only exists as much as the immune system permits it to exist. But then reflexively, it influences the growth, development, and function of the immune system. These two dance together throughout your lifetime. And some people’s immune system is not going to permit just a huge amount of one particular organism without reacting to it. So certainly, there has to be a degree of common sense. If you find that you’re getting better, you’re getting better, and then you do more of something and you find, “Oh, wow. I had a lot more problems in the last week,” you have to go back and think, “Well, what was different?” Maybe there’s another variable, or maybe you actually reached your limit of how much is better.

One example that comes to mind goes back to Kombucha, because many of the organisms in a Kombucha Scoby are yeast based organisms. If you drink way too much Kombucha, I’ve seen people drink like two quarts of it a day to get to this level. But it tastes good, it’s refreshing, so it’s not that hard. Well, if you drink too much of it, your immune system won’t really tolerate that much. You can actually get a yeast infection, or you get yeasty, itchy spots on your skin and whatnot. That’s simply because while there are a few too many of those particular ones just back off on it some and it all goes away. So I think, in theory, there’s always a limit, and some people will never find their limit and others will. So you have to look at how your body is responding. Sometimes with the aid of lab work, if you see your inflammatory markers are continuing to drop, you know you’re on the right track. So that and a healthy sense of just self-analysis with an open mind. Well, really, how are you? I think that can really go a long way.

Clint: Would you say, just as a last thought, that most people are far too much to the side of an insufficient intake of bacteria? This is the very few minorities that are getting skin rashes from Kombucha.

Richard: Absolutely, absolutely. The vast majority of people that I’ve ever looked at do not have enough bacterial diversity, and their levels are constantly suppressed by pesticides and poisons in our food, in our medicines, in the air, in the water. Even just chlorinated municipal water seems to be bad for the microbiome. So we have so many things that are bad for us. You might really have to work at it quite hard to find how much is too much, but you have to say, “Well, it’s probably possible.”

Clint: Okay. Well, Richard, thank you once again. You’ve been really generous with your time once again. I’ve had an absolutely thoroughly enjoyable time chatting with you. And the depth and the diversity of your knowledge is just astounding. And it’s a real pleasure to be able to ask you all these questions, some of which are still floating around in my mind after looking at these things myself now for many, many years. I’m sure our listeners will be really grateful for you to have shared all this with us today. You’re moving to Maine, I believe. If people want to get hold of you…I’m sure a lot of people would actually like to come in and be one of your patients, and you look at them not just from a chiropractic point of view but also consider what they’re also doing in other aspects of their health. If people wanted to consult with you in the near future, how should they go about doing that? Should they contact you first, or if you’ve got a physical place that you’re now setting up in Maine?

Richard: I have a physical place that I’m setting up in Maine that will be there probably beginning in September, because I have to move all my other earthly belongings and family up there before I can really be there to work. But I’ve also been structuring what I do, so that much of it does not have to be so geographically dependent, let’s say. I can look now at somebody’s complaints, their health history, what sort of issues they have, and make at least some suggestions as far as what kind of lab work or what kind of dietary change. And in some cases, I’ve gone very, very specifically with that down to the lab work and the stool sample analysis, be able to identify which organisms they really need to boost up, and then make recommendations for lifestyle changes, nutritional changes, what supplements, what prebiotics. Putting all that together does not always necessitate being face-to-face. For example, you and I are on opposite sides of the planet, yet we’re virtually face-to-face. And there’s a lot that can be shared that way without actually having to touch and feel physically.

I can be reached through my email, neurodocforyou.com, that I’m sure is on one of the links there. I’m always on Twitter where I’m @symbionthealth. I get some interactions through my blog when I write posts. That’s the symbiontfactorblog.com. Because I’m working a little bit here and a little bit there now, I’ve actually set up a toll free number that connects to my cell phone, and that number is [please do not call Richard – use email instead]. It was an expedient solution because I did not want to have to redo all my cell phone contacts, and I didn’t expect people in a new location halfway across the United States of America to understand and approve of dialing an out of state area code for somebody that claims to be next door. So it’s an 800 toll free number in it. It just rings into my cell phone. So it doesn’t matter where I am, I can still get it and they can not have to pay for the charge.

Clint: Well, that’s nice. Except I think if you’re outside of the country, then it doesn’t quite work. I’ve tried it. I’ve tried to ring the toll free number.
Richard: Email works.

Clint: I think what we might do is just strongly encourage email. Because that way, with all the time zone differences with the audience listening to this or reading this on my website, we don’t want you waking up in the middle of the night for a question of [inaudible [01:14:30].

Richard: Who knows what answer I might come up with in the middle of the night.

Clint: That’s right. So thank you very much. And once again, I encourage everyone to go and buy the Symbiont Factor. You can get it on Amazon. It’s a great read. And as I’ve said, many people have already told me they’ve bought it, they love it. And so it’s a great way to get more information about what Richard Matthews does. And what he does is awesome stuff. So thanks, Richard.

Richard: Thank you, Clint. You’ve done such an incredible job putting together this program, and helping so many people. I just really admire what you’ve accomplished, and how you’ve been able to take your own adversity and turn it around to help so many other people. That’s truly admirable. It’s a wonderful thing to see. And I’ve greatly enjoyed being on your show here. I love it.

Clint: Thank you very much. Well, it might not be too long before we may have you back again. You never know because there’s plenty of things that you know about, that we are always looking for answers on. So we might be in touch again soon, particularly if we get a lot more requests like we did for you to come back a second time.

Richard: I’ll be glad to do it. There’s always more to talk about. Researchers keep chipping away at understanding more and more, so lots of material there.

Clint: Awesome, awesome. Well, thanks again.

Richard: You’re welcome. Thank you.

Paddison Program

Clint Paddison

Clint Paddison has recovered from crippling Rheumatoid Arthitis and now assists others with this disease via the Paddison Program for Rheumatoid Arthritis, the Paddison Podcast and the blogs on www.paddisonprogram.com