"If we could help somebody have a healthy brain, then everything else will follow."
This one statement sums up how Dr David Haase approaches his clinical practice. Dr Haase is a passionate expert when it comes to optimising brain health with a mind-body approach, grounded in science. Dr Haase tells us that neurons in the brain start to make physical changes in as little as two minutes in response to a new stimuli and as these behaviours are repeated, reinforced and recurrent, neuroplastic changes will take place over 21-35 days.
In today's podcast shares his approaches to cultivating wellness in patients by building better brain health.
Covered in this episode:
[00:52] Welcoming back Dr David Haase
[04:22] The path to functional medicine
[08:59] Medicine: outside the box
[13:08] David's take on adrenal fatigue
[19:22] Peeling back the layers of the onion
[24:59] The practise of gratitude for wellbeing
[31:59] Working on inner-dialogue
[37:18] Neuroplasticity
[47:28] What role is there for supplementation?
[54:33] Professional biases
[1:00:23] Thanking Dr David Haase
Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook.
Joining us today is Dr David Haase, who received his medical training at Vanderbilt University completing his residency in Family Medicine at Mayo Clinic in Rochester, Minnesota. He is board-certified in Family Medicine and Integrative Holistic Medicine. Early in David's clinical practice, he realised that something very important was missing. He went to medical school so he could better understand and address the root causes of illness and dysfunction, and thereby facilitate the creation of health for individual patients. Instead, what he found his training was largely limited to was naming disease, that black box that we call "diagnosis," blaming disease, the context had nothing to do, really, with the problem, and taming disease, often with powerful drugs not tailored to the unique genetics of the individual.
To fill the void, he sought out additional medical training and certifications in nutrition, integrative and holistic medicine, functional medicine, health coaching, neuro-feedback, systems biology, genomics, bioinformatics, and precision medicine. By identifying and treating the unique root causes of their conditions, Dr Haase saw remarkable improvements in his patients' health. And you are, I've got to say, the salt of the earth. Dr David Haase, welcome to FX Medicine. How are you?
David: Oh, AWC it's so great to be here. Very thankful to share this time with you, and I'm feeling great.
Andrew: Excellent. I've got to say, I so enjoyed having you speak at the symposium. Now, gosh, was that two or three years ago now? And indeed, when my wife and I left early in the morning, we had to drive away and you were already up. Do you remember that? That final meeting? You were in the lobby waiting for a plane?
David: I do. I do. Exactly. And one of the other things I remember from that symposium is me nearly passing out on stage.
Andrew: That's right.
David: If you recall, right?
Andrew: I recall.
David: Because all of a sudden, I...yeah, it's right, because...you know, there's a time lag, and I didn't really...I took in far more of Sydney than I maybe should have before the symposium began. And I got far too little sleep. And so, here I was giving a lecture on brain function. And all of a sudden, everything starts to go quiet, and the lights start to get dim. And I thought, "Oh, my gosh. I'm going down."
And you know, I think it was just the energy of the crowd itself that kept me sustained and able to go on. But I developed a huge respect for all of you down under that travel to the States for education. Because oh my gosh, what a...wow. What an experience to be up there lecturing about the brain and having...losing my own, right?
Andrew: From a clinical perspective, though, there's nothing like a health practitioner having the symptoms that their patients’ experience to really have a full appreciation of what their patients go through, you know? And I was really quite enamored by the way that you came back, I've got to say. Because you pulled it together like a Trojan.
David: Well, thank you. It was a great energy and just the best people on earth there.
Andrew: Thank you.
David: So it was a deep joy to be there.
Andrew: Now I've got to say, reading your bio, "Holistic Medicine, Functional Medicine, Health Coaching, Neurofeedback, Systems Biology," do you have a life outside of your clinic?
David: Yeah, that's called "applied attention deficit disorder." Absolutely.
Andrew: What sculpted like this? Like, you know, we've gone through that, you know, you really sort of realised the limitations of the orthodox medical model. But what was it that tweaked your interest to look further, rather than just falling into the, you know, what I call "hamster medicine"? You go to work, you see your patients, you come home. You go to work. What twigged you to search further, to look deeper?
David: Well, I… unlike many of my colleagues in integrative and functional medicine who have a belief or a personal health challenge that drives them into this field. That was not the case for me. I just became disillusioned with a... this beautiful science, this amazing science of Western medicine; incredible biology and genetics, and all the systems and the sub-specialties. And yet not seeing a theme where it all fit together. I mean, it literally didn't fit together. And I grew up on a farm in South Dakota. I have a very practical family that was always focused on doing what is wise and works. And I didn't see that same drive necessarily present. Instead, it was "Do what your superiors tell you to do, do what we've always done, follow the rules." And it hit me over the head one day that we actually call it "medical training."
Andrew: Yes.
David: We don't really call it "medical education" after the first two years. And that's that whole idea. Instead, we should be really continuing the education, continuing to figure out what's the mystery of the human. So I can't say that there was any one event that happened for me. It was just a deep satisfaction with a reductionistic view of the world. Because it didn't seem to describe reality. And I don't have much time for things that aren't real.
Andrew: And so, how has that evolved your practice?
David: Well, it started with...I started the Evidence Based Medicine Club at Mayo Clinic, actually. And that's when I got disillusioned with conventional healthcare. Because there was so little that we actually have evidence for...
Andrew: Yes.
David: ...to promote. And so, that got me looking...I had my conversion experience at the hands of Jeff Bland, you know, over 20 years ago now. And I was like, "Ahhhh, here's...everything's a system." And then I started to look at things as a system. And pretty soon, once you've done some biological evaluations, some understanding, then you realize, "Wow, so much of this is lifestyle."
So I sought out the best health coach I could find. Which was...gosh, now, 15 years ago when the term "health coaching" was not a popular term yet," and dove into that model of healthcare. And so, I came from this place of having allopathic training, having functional medicine training, being trained as a health coach, and still having people that despite really good intentions and having good resources of society, of money, of influence, they still couldn't cross the barrier. And they had one thing in common, and that was the brain. The brain is what held them back.
Andrew: Right.
David: Either they have an attention issue, an anxiety issue, a mood issue, a memory issue. And for me, that switch flipped about 12 years ago, and everything became brain-centric. Because if we could help somebody have a healthy brain, then everything else was going to follow. And then very interestingly enough, everything else, the rest of the body, is what enabled the brain to be healthy.
Andrew: Yeah.
David: So just a bi-directional network. That's where I've been. Continuing to grow, and trying to figure out what's the most direct path to any one particular person to get well in the deepest way possible. That's the quest.
Andrew: So I guess part of that is...you know how we talk about the gut-brain axis and the HPA axis? Do you sometimes open up these rabbit holes within rabbit holes with regards to where you can treat? Or do you tend to stratify it a certain way?
David: Oh, absolutely. No, you know, I think the whole idea of an axis is useful for letting us know a few things are connected in a deep way.
Andrew: Right.
David: Like the hypothalamic – pituitary - adrenal axis. That's a useful idea, but it's not reality.
.
Andrew: Right.
David: What's a reality is that all of those organs and systems also are inside a greater whole. And so, when we approach things from assistance medicine standpoint, from a functional medicine standpoint. The whole goal is to recognize that we, as humans, are networks of networks. We are systems of systems.
Andrew: Yep.
David: And we have hubs that are very...that are malleable. Hubs that are influential with regard to our health. And so, the quest here is not to find and treat everything, but it's really to find "What's the most influential hub that we can intervene upon so that we shift the health of the system as a whole?" And that's where I think the art and the science are converging...
Andrew: Right.
David: ...we're working on an augmented intelligence platform right now with some IBM engineers. It's fascinating to see how we start thinking about and organising our thoughts of "What is the most direct way to help somebody create health in their particular situation?" Yeah. I have a real bias against somebody saying, "Oh, everything begins in the gut."
Andrew: Yeah.
David: Well, those sorts of people know a lot about the gut.
Andrew: Yeah.
David: And then, there's the hormone docs and everything’s you know..."You've got to fix your hormones and everything's going to be okay." And then you have structuralists who say, "Man, as long as we can get your spine aligned, everything's going to be good." And then you have, you have...you know, just pick whatever group. You've got your mitochondrial people saying, "Everything's energy."
Well, no. Reality is reality. And what happens, at least for that individual, that's the interesting thing. That's where the opportunity lays in changing the trajectory of health.
Andrew: I am so enlightened by you saying that because I've seen the natural medicine community fall down the same sort of issues that we castigate orthodox medicine for, and that's the compartmentalism. And I've seen us doing it. You know, over the last 15 odd years, I've seen natural medicine do that themselves. "Oh, I specialize in fertility." Or "I specialize in hormones." I spoke to one doc who thought that cortisol was the next panacea, was the answer to everything.
You know, I really had these worries in my brain going off going "Oh, this is too good to be true" sort of thing, you know? So I'm so encouraged to hear you say that we've got to get back to the reality, and that is the patient in front of you.
So I've got to ask then so...
David: AWC, that was really well said. And when we lose sight...now, all of those things; cortisol and hormones and the gut, and the brain...hey, I fall into this bias of the brain. I've always said, I'm giving you my bias; I'm a brain-centric functional medicine doctor, right?
And so, it's okay to have those biases, that you need to recognise them. And then, you have to sit back and say, "You know what? If something's really powerful, that means it's a hub." It's a hub.
Andrew: Yep.
David: It doesn't mean it's everything, but it means it's connected to a lot of things. So it doesn't mean we have to throw out those people's good ideas and intentions and insights. But instead, recognise that it's integrated into a larger whole, that we can only see with the help of our colleagues who think differently.
Andrew: Yeah. So I'm going to ask you this question, and it's basically to clear up something for me. You and Dr Andrew Heyman changed this for me. And that is this two words, "adrenal fatigue." What's the correct term? What should we be really saying?
David: Well, adrenal fatigue, I think it's such a powerful term because there's this mystery organ buried somewhere inside of you, and it's tired. And it really, I think, speaks to kind of a Chinese medicine-like view of this...the jing, right? The life force seems to be eroded from us, right? So it's a powerful...even marketing term or educational term.
Andrew: Yes.
David: But when we really step back and we look at adrenal fatigue, it has much more to do with brain fatigue. You know, this is...it's the signaling systems that seem to be primary in this entire process. And our shifting hormones occur in a way to protect the system that we can live another day. That's what we fall into a misunderstanding of oftentimes. We think that the changes that are seen are pathologic, when really, they're adaptive.
So if an individual is being absolutely catabolic and they're breaking apart at the seams with huge amounts of inflammation, well, cortisol is going to rise to cop to meet that need. And then there can be additional adaptations so that the brain basically says, "Okay, we had enough of sending out that signal. That has been exhausted as a neurologic signaling system. And now, we're going to pull back on how much cortisol is made."
And to make the adrenal glands the center of it is to misunderstand just how incredibly resilient the adrenal glands are. Rarely, there's very few individuals who die of Addison's disease. Just a pathologic variant to that.
Andrew: Yeah.
David: But sometimes we can get trapped. I mean, these concepts are wonderful. And I do not want anybody who's done good for their patients or themselves using these concepts. Boy, I don't want to disenfranchise them or anything. But I think it's important to recognise the brain is what's really central in this whole adrenal fatigue issue.
Andrew: So can I ask...like, you know, there was this concept, if you like. And forgive me, was it Hans Selye who started the adaptation sort of syndrome...
David: Yeah...
Andrew: ...theory?
David: General Adaptation Syndrome.
Andrew: General Adaptation Syndrome, thank you. But are the adrenals actually affected by weight? Do they actually "shrivel" or lose their potential to secrete herbs. Or is it really the hipocampal and other areas of the brain which physically decrease in volume when you're under chronic stress? Do we need to change that term "adrenal fatigue"?
David: You know, I think that...like, the term is useful if we recognise it has limits.
Andrew: Right.
David: If everybody that comes in with tiredness is now labeled with adrenal fatigue, that's inappropriate. But if we step back and look that there is modifications that's… that's on a reticularis in long-term stress, that is adaptation. So there is both and… but there is also a tremendous adaptation in the hippocampus.
Do you know what I find even more interesting than the general adaptation system? Is what happens as a result as early life stressors. You know, an early life stressor, either in the womb or a mother who is depressed during the early years or a violent upbringing, or surrounding. That will induce a...that's a genetic change in the hippocampus, selectively in the hippocampus. Matter of fact, it induces a hypermethylation of the glucocorticoid receptor genes in the hippocampus effectively decreasing the effectiveness of the off-switch for stress.
Andrew: Right.
David: So when we're asking about these things of adrenal fatigue and tiredness and hippocampal atrophy. You know, we do a lot of volumetric MRI analysis in our practice now, along with quantitative EEG analysis. So we're looking at the physical structure of the brain and measuring that. And there is...we need to step back and think of not just what toxic environment is present in these last months or years, but where does this individual come from, and where did their parents come from? We now know that there's...especially their mother, there's generational effects here.
So I think early life trauma is actually a much more important thing to recognise...
Andrew: Right.
David: ...and to address the autonomic nervous system and the general adaptation of the autonomic nervous system. And there, we can make huge changes rapidly. If we nurture the autonomic nervous system, we see very rapid shifts in adrenal hormone secretion. If you deal with sleep cycle abnormalities and oxygen deprivation and inflammation, you see the adrenals respond, as would be appropriate for a new environment.
But I don't think they're mainly primary. I think the adrenal actions tend to be responsive to the rest of the body in that way.
Andrew: I want to delve into some of the testing that you do, because I was just awestruck by the stuff that you do for your patients at the symposium a couple of years ago.
But firstly, you mentioned cortisol before, and as I said, you know, there was the cortisol fad here in Australia that this seemed to be this treatment for everything. But you and Andrew Heyman, as I said, you really shook the pillars and said, "Guys, wake up." You know, if you think that you should be giving cortisol to raise cortisol when it's low without looking at why cortisol is out of balance, you know, you can really go down quite a dangerous path with regards to, you know, a latent infection, let's say.
But with regards to symptomatic treatments, particularly regarding hormones, I guess. Or those things that affect hormones. Do you tend to go one step further back and talk about nourishment and, you know, exercise and relaxation and get that really honed first before instituting these changes of endocrine function? Or do you do it all at once?
David: Well, we have many different art pieces in our office of onions. I love onions.
Andrew: Yeah.
David: I love the idea of peel the onion. You know, you start, with the layer that's right in front of you. Because you really don't know what layer is actually going to be necessary. And the first layer is, of course, belief systems. What does that individual believe about themselves and their health, and how they're approaching this clinician-patient relationship, and how are they going to engage together.
Andrew: Yeah.
David: You know, that’s… if you really want to make, you know, light-year changes, address somebody’s these belief systems, and then amazing things can happen.
Andrew: Right.
David: And then we go to behaviour. You know, what is going on...and remember, my foundation is in health coaching. I think with inspiration, education, and support, that's the fundamentals, right? It's the fundamentals. You don't have any business really going on if you haven't nailed those fundamentals.
Andrew: Right.
David: I mean, it's...you know, yes, we've done some amazingly interesting tests in metabolomics and probiomics and genomics and brain mapping. But we don't do that for everybody, you know? People that typically get to me have already been to quite a few other docs. The first thing that we actually do is a record interview. We actually look at the other information they've already gotten done, which there's a lot of data there oftentimes, right?
But the lifestyle is so important; sleep, exercise, the quality of the food, the experience of eating. Even just... go back right to adrenals and sympathetic upregulation. If you're jacked up and nervous and rushing and shoveling food down your mouth at the time of every meal, you're not inducing...you're not allowing the parasympathetic nerve system to create the enzymes and the saliva. You're not inducing good gastrin secretion, hydrochloric acid secretion. You're not allowing that gallbladder to squirt out. It's magic… the pancreatic juices to flow. And you're not allowing adequate peristalsis to occur.
And so, that's a mind/body issue. So simple interventions such as awareness. Nobody has ever thought of this. They can't ever actually change. So a baseline educational program of "What are the fundamentals of health?" has to be the foundation. And why would you use nutritional supplementation? Well, it's...the word...why you use it is right in the word itself...
Andrew: Yes.
David: ...it's supplemental. You know, the idea that this should be your plate, no. Because we know the body runs on raw materials. And having the right raw materials present enables a more effective metabolism, an engine. That's...there's so much utility there for rebalancing of the system. But not without the context of effective lifestyle interventions. So that's...and I think we've missed the boat.
And then, I'll tell you, there are health coaches also that run this problem of bias, where that's all you need to do. If you only change your lifestyle and diet, you do these things, then you should be fine. Because those are the individuals who often came to this entire realisation because that's what worked for them. And I think… So we could get trapped even in the lifestyle assertion.
Andrew: That's our own practitioner bias. That's very interesting.
David: Right. And I think maybe, because I didn't come to this field because of a personal transformation. I don't have that particular experiential bias that occurs. Which can be wonderfully healing for individuals that are served by those practitioners. Again, not to disparage it, but to just acknowledge it.
Andrew: Again, you know, I love what you’re saying. Because I'm not a religious person, but I do believe there was a function for religion - way back, and that was to knit communities together and society together. And one of these...or a few of these practical things is when you're sitting down to the table saying grace. And people think that's a religious thing. I'd like to move that forward into the 21st century. About what is it pushing...you know, engaging your parasympathetic nervous system, pushing away the day's stressors, and leaving them...you know, just having a white light around you and your meal. And just really focusing, as you said, that awareness of the food.
So I've got to ask you, how well do you find this works for an overweight, diabetic, or pre-diabetic truck driver who's just given up smoking because his doctor said he was going to die. And he's not happy and he's finally made his way to you? How do you change or get under their skin to really look at these simple interventions. That are really alien to so many people?
David: Well, first of all, AWC, I just have to say a big "Amen." When you're talking about, you know, this idea that...creating space at the beginning of your meal, for gratitude, for an acknowledgement of safety, for an acknowledgement of community, I love what you said. The white light that surrounds us here. That is...man, I feel my digestive juices moving just you saying that, right.
But it very much is. We have this amazing bidirectional interface. We talked about the brain-gut axis. Well, wow, is that not a powerful component to the brain-gut axis? We're using our mind to shift our sympathetic nervous tone and our parasympathetic nervous tone and allow our digestion to occur in a way that now is going to create molecules and information that's going to nurture the brain again. It's a beautiful feed forward cycle, this grace.
And I also find it fascinating that going back to all kinds of traditions. Most of them monastic traditions have some type of a rosary, some type of a chant. And the pacings of those breathing patterns often correspond with the type of patterns that augment parasympathetic nervous activity. It's a beautiful, it’s a beautiful thing.
Andrew: Wow.
David: Yeah, it is. So it's a...exactly. I listened to this "Family Radio Rosary Hour" for hours, when I was trapped in the dairy barn as a child and I couldn't reach the radio knob. So I understand these things.
Andrew: And I've got to ask, I know this is going "Back to the Future" sort of thing, but you're growing up on the farm. I mean, you know, you tend to be rather pragmatic about dirt, excreter, you know, poo. Because you have to clean the stables, you have to clean up the yards. And then you tie it in with this old friends theory. Do you think that that really, really...not "resonated" with you, but helped you? Like, do you think that pragmatism from...
David: Oh, my gosh...
Andrew: ...just doing stuff?
David: Oh, this is...I practice, absolutely. I practice agricultural healthcare. I mean, if you think about how a good farmer approaches the land, that's exactly the way a good, functional, integrative, holistic...provides focus on creating health. If you want to create the bounty of the land year after year, you have to nurture that. You bring in good things to your land. You prevent the land from being eroded. You hold back the seed from excess stress, and then you get a bounty year after year.
And that is exactly the model of how you recreate health. It is really nurturing. It is a cultivation of health. And that gives us incredible opportunity. And I do think that our removal from the land, our urbanisation and our, really, alienation from things that are real and natural, has shifted our mindset away from what is real.
Andrew: Yeah.
David: And then how you approach things that are real. And how do you approach those things with humility? You know, I can't stand the word "control." When people say, "Well, I can't control my weight..." and we can get to your trucker story in a second here.
Andrew: Yep.
David: Well, if I can't control my weight. All I have to do is say, "You're absolutely right. You cannot control your weight. But you can influence it."
Andrew: Right.
David: We have to become creatures that embrace influence and abandon the idea that we can control. Control is a reductionistic model. Control is an allopathic, linear model. Influence is a systems-based model.
Andrew: So much in even the language we use.
David: But I digress.
Andrew: No, it's not a digression; I think it's really interesting. And there was another word that you said there. Lise Alschuler constantly reminds me of this, and it's just her natural vernacular, it just flows out of her like a breathing in and breathing out. In saying the word "gratitude." And it's something that I constantly...and here's another word that I need to get rid of, "wrestle with," how's that one?
But it's something that I constantly remind myself. I said, "Dude, you know, you've got to be...have gratitude for what you have in your life." I mean, I have a wonderful family, I live in a great place on earth with a beach three kilometers away. It's not like I'm doing it tough, you know? And there is so much that I have to be grateful for in my life. And we so often get caught up...I, so often get caught up in the day to day stressors. "Got to go here, haven't done this. What about that?" And we forget to give true gratitude to the base things that we have around us. And then we wonder why we're caught up in this sympathetic drive.
David: Exactly. We have this neocortex. We have a neocortex that can create reason. And you can create hallucinations of gratitude, you know? You know, we get to create our story. And we can create a story of gratitude. Or we can create a story of fear, and of need, and of want and of oppression. It is up to us to craft the story that is most useful to us. That is our responsibility and our freedom, and that they go together.
Andrew: Well done, well said. So with that, when you've got somebody that's got the negative mind-talk going on. You know, the constant self-beration or the constant self-worry, you know, what are those...the words that you should never say is "should?" The word that you should never say is "should" or "could." You know, I choose to or not, you know, that sort of thing. How do you change somebody's self-talk, their inner-dialogue?
David: That's a great question. The answer is you can't. I can't change it. It's always they that do...that they are the ones that do the change.
Andrew: Right, yes.
David: And so, I can seek to influence it, right?
Andrew: Yep, yep. Yep, yep.
David: The influence I would seek in that area, is to help them access their salience. So salience is a neurologic term. "Salience" means "This matters." The brain is constantly sorting out information. As you're listening to this, you probably don't feel the weight of your feet on the floor, right?
Andrew: Yeah.
David: But now you do. Now, because I've called your attention to it, you are now aware of your feet...that your feet are on the floor. It becomes salient because it's part of the conversation...
Andrew: Right.
David: ...right? And you still don't feel the wetness of your tongue, which now, you do, of course.
Andrew: Right.
David: But that’s what’s hard. Salience is what matters. And when individuals are seemingly trapped in their repeated life cycles, the first thing to do is to ask them to engage in creating salience around that. And I do that by asking them the question "What is your health for?"
Andrew: Ooh.
David: "And what is your health for?" And… Oh, I've written a book. I've actually...I'll put a book plug in right now because there's actually a little tool in the book that actually helps this. It's called Curiosity Heals the Human. And in Curiosity Heals the Human, actually goes through this exercise in written forms so if that’s helpful to anybody out there. And the exercise is, you know, "What do you want your health for?" And then when they give an answer, it’s a simple step, after that "Oh, that's great. Yeah." So what's important about that?
Andrew: Right.
David: And what's important about that? And keep quizzing about "Why is that?" But if you keep digging, you're going to get to a layer of identity. They're going to get to "I am statements." They're going to say, "I am...I am a good father."
Andrew: Right.
David: In order to be a good father, in order to be a provider, in order to be a man of faith, in order to be a good citizen, in order to be...they're going to come down to an identity that matters to them. And now, they have accessed an infinite source of energy for positive change.
But until...now, some people walk in the door with that knowledge. They're walking in the door fearful of their life, but they… and they may even have tapped into their meaning and purpose and identity. And those individuals are so potent. And you sort through their needs, and you will come down to this amazing occurrence. They create health so rapidly because they engage so deeply.
But the individuals who don't quite know why they're there really...they'll never take off until they recognise they are worth it, and that their identity, their meaning is enough to fuel the changes that they need to make. And it may not be kind of what you're asking, but to me, you're really going to help people change. Like I said, you can do all the fancy tests under the world. You can make all the most complex recommendations. But until you can know who that person is and honour them. And not do this exercise in a manipulative way...yes, and what I've created here is kind of a formulaic way, but it's just training wheels for being that clinician that wants to know the deepest parts of the patient, so that we can speak into their hearts and their soul, as they're making these most monumental efforts to change their health and their wellbeing.
Andrew: Wow.
David: So it's a wonderful tool. It changed my practice.
Andrew: Yeah. Words of wisdom, David.
David: And that all came from health coaching AWC. That all came from the world of health coaching.
Andrew: Wow.
David: That didn't come from the world of medicine, or even integrated medicine. That came from this idea of being the partner with this fellow sojourner...
Andrew: Yep. Yeah.
David: ...and that model shifted how I looked at medicine and being a MD from that time forward.
Andrew: Talking now about how that affects the physical, though, with regards to neuroplasticity. Especially when the patient is set with broken circuitry. I remember this quote that you said at the symposium a couple of years ago, and that was "Neurons that fire together, wire together." So again, I'm going to sort of, be this "Please help," you know, sort of how long do you find it takes to affect a change, I guess, with a habit? And does that change stick? When...you know, do you actually rewire permanently the circuit board, or do you have a broken circuit board that's being patched up, and so therefore, it can break again?
You know, I guess we're talking here about, you know, "Old habits die hard," you know? How reticent do these patients have to be from then on about giving honour to themselves and being present and, you know, having gratitude for where they are in their life? Do you find that there's this constant reminder going on that they've got to sort of say, "Ooh, it's, you know, six monthly, uh-oh, I know what's happening, I'm falling back into the bad habits"?
David: Oh AWC, you have asked a mouthful there. Because I've spoken to bias several times as I've been...on this call already. And bias, to me, is not a dirty word. Bias is more of our pattern. Bias is our electrical set points that we have in our brain.
You're right, neurons that fire together are wired together. Whatever we think, whatever we do, whatever we do on a repeated bias, we start to soft wire those pathways to become more and more electrically efficient, and therefore, the brain is almost always going to seek the most electrically efficient answer to whatever is in front of it.
And I think if we think of our habits as brain reps. As, literally, electrical patterns that have been created. And that there are associations that are triggers, that are backdrops to a habit. Nothing exists in a vacuum. Nothing exists in a vacuum. The brain is an amazing network of networks; 100 billion neurons and, you know, 1,000 trillion synaptic connections. It's unbelievably complex.
And so, when we make these statements about a brain connection, or a synaptic connection, we always have to recognize what's happening in the context of a larger whole.
Andrew: Right.
David: And therefore, any changes that we make can be reinforced from a multitude of directions, and can be distracted from a multitude of directions. So one of the common things we do in our practice, we do quantitative EEG. A quantitative EEG is we put a cap on the brain... we put a cap on the head, and we measure the electricity coming off of the scalp. That's the EEG, often used for diagnosis of seizures.
You can use that same information and put it through an FDA-registered algorithm, a database of average, normal brains, or a database of high-performance brains, and get a brain map. Get a picture of the internal electrical activity and internal electrical associations in the brain, and find "Where are their pockets of inefficiency? Where are there pockets of static? Where is this brain electrically not at the potential it can be?" And then through the process of neurofeedback, you can train the brain. Much like you can train yourself to play piano or train yourself to become a sprinter. The brain learns; the neurons that fire together wire together.
So when you make a habit change, when you make a habit change, do you know how fast neurons start to physically change in your brain?
Andrew: No.
David: With a new stimulus? Two minutes.
Andrew: Really?
David: Two minutes. Two minutes. And then, there are subsequent changes...remarkable changes have happened even in the first two hours after a new stimulus has occurred.
So remember this: changing your mind is a physical event. Changing your mind is a physical event. You actually have to have healthy biochemistry. You have to have a healthy you know, you, in order for that to brain to change. Because changing your mind, you have to actually rewire in making the connections and then solidify and improve those connections.
So when we change a habit, the initial changes happen very quickly. But if you don't reinforce that new connection, it's going to pair off.
Andrew: No, right.
David: You're going to leave the connectivity there. And so, it matters tremendously to be reinforced, reinforced, reinforced. And typically, substantial neuroplastic changes take approximately 21 to 35 days. It depends upon the age and the health of the individual and the part of the brain that that's working. But when you start to set it up...and it's fascinating. They always say...many times, lifestyle programs are 30 days, 28 days, 30 days, 40 days. That fits pretty well with neuroplasticity. So if you're going to change your habit, you need to stick with it for a period of time while you wire in those real associations.
Andrew: Yeah.
David: And AWC, I want to say one more thing. Because when you show somebody a brain map...when you show them the areas of the brain where they have poor electrical efficiency, the amount of shame and guilt that they get to let go of is amazing.
Andrew: Wow.
David: All of a sudden, they're recognising that "Oh my gosh, there's this organ in my head that is it functioning at the highest capacity it could." And while they are still responsible for all of their actions, they may not have the level of free will that another individual does. They may not have a healthy enough brain to be able to make choices that are in their best interest on a regular basis.
And that's why I am such a fan of neurofeedback because you just...you literally help the brain become more electrically efficient. So you've removed one barrier to their good intentions. You've removed a barrier to wiring of a better behavioural output.
Andrew: Yeah.
David: So I think that the saying has been said that, you know, psychiatrists are the only specialty that...psychiatry is the only specialty where you don't examine the organ you treat.
Andrew: Hopefully, yeah.
David: Right. And that's silly. It's just silly now in our present-day when you can have in-office diagnostics that can quickly, easily, inexpensively, and safely assess the function of the...not just the organ as a whole, but the neurologic system as a system.
Andrew: Yeah, as a working system. You said that they've compared this as an FDA algorithm with regards to performance brains and healthy brains, things like that. Has anybody out there ever looked at things like, successful brains? Or even better, successful, happy brains, or meditative brains, or something like that, you know? Like the monks of Nepal or...
David: Absolutely.
Andrew: They have?
David: Oh, absolutely. There have been many...and that's the cool thing. You can create a database for just about any group of individuals. And the...absolutely, the brains of a long-term meditator, is very different from the brain of a fighter pilot.
Andrew: Right.
David: We have… One of the peak performance databases that I could use for individuals is from a group of Marines Special Forces recruits. These are Marines that qualified to be in the Special Forces.
Andrew: Yeah.
David: I mean, these are some high powered dudes right?...
Andrew: Absolutely.
David: And now, is that a normal database? No. Okay? "Normal" means the middle of the bell curve.
Andrew: Yeah.
David: And so...but there are...you would see a very different database if you pulled together the world's greatest pianists. Or if you pulled together the world's, you know, most successful...the most spiritually elevated members of the clergy. You know, there are different layers to what peak performance is.
Andrew: Yeah, yeah.
David: And I love how you asked...have you done databases on people who were happy? Well, I would say the monks are probably the happiest group, and that actually has the theta/gamma associations and alpha regulations. There's some beautiful patterns that occur in these monks.
And so interestingly enough, you can train these patterns. And it's fun to actually have people who are then long-term meditators engage in these types of advanced neurofeedback and go, "Whoa. I couldn't believe how deep I got so fast," right? So that's really fun.
Andrew: Putting supplementation, I guess, in its place...and I totally agree with you that it's a sup-lement, and that is not a foundational thing.
One of the really great experiences I found was a guy who I treated for prostate issues, prostate cancer, indeed. And he was a real narcy man when I first met him. Indeed, nobody else liked him. They basically palmed him off to me. And I got on with him, but this man changed throughout his treatment. His PSA went down dramatically, it was incredible. But this man changed. His demeanor changed. He became happy. And I don't think it was just worry. You know, there was a real core change in this man. He became a "happy, grateful man." Who would walk past and wave.
What do you find the...is the word relevance? The place of supplementation, how powerful do you find it is given that you've put the correct foundations in place? I don't believe that supplements and McDonald's work very well together at all. But given that you've got everything in place, how powerful do you find that supplements are? Do you find they're just the nipping off the end of the bud, the twig? Or do you find that they can have a next hurdle? You know, like, I guess my analogy here is sportspeople; you know, they want the 5% or the 2%.
David: Yeah, you know, it's a great question. I think that there's too many practitioners that are overly apologetic for recommending supplements. And recommending supplements at doses that are meaningful.
Andrew: Right.
David: For heaven sakes. Look at the size of the plate. That's a lot, I mean, you bring in over 30 tons of food through our body during a lifetime, right? That is a huge amount of information that is coming through our gut, informing our cells, informing our DNA of expression patterns.
So I absolutely have found great value with supplementation. And I have to tell you, I used to be an anti-supplement guy.
Andrew: Yep.
David: When I was at the Mayo Clinic and I first heard about this stuff, I thought, "You know, this is...it's a nice idea, but why does everybody talk about the snake oil?" Turns out, there's quite a bit of Omega-3 in snake oil. Fascinating, huh? Anyway, but...which I thought that was really pretty funny.
But if you go back and really...and ask "What are the fundamental precepts of how you create health?" well, I think it's three major areas. One is you either remove a stressor or a toxin from that system. You know, disinhibit the networks from its intelligence, right?
Andrew: Yep.
David: Or two, you can teach it something new. You can break a dysfunctional cycle. That's like neurofeedback or immunotherapy or exercise. You know, you're going to give it a stressor, or you're going to give it a challenge so that system becomes smarter, more adaptive, and breaking out of its old rut.
But thirdly, it’s, you give the body what it needs to function. And so, nutritional supplementation...unfortunately because these things are shaped like pills and they looked like pharmaceuticals, people have a pharmaceutical mindset to them. As opposed to thinking, "You know, these are amazingly concentrated foods." You know, they have been put into a form that is highly accessible, and I don't have to taste how awful they are. Because some of these things taste hideous.
Andrew: They taste shocking, yeah.
David: And we didn't bring them into...right… We wouldn't bring them into our body terribly willingly in a Western diet, but we did bring those things into our body under a frequent basis on an ancestral diet. And so, many of the ways...so I use nutritional supplementation as it were, of course, the multivitamins and multi-minerals. And certainly for, you know, holding back the storm of the course of aging, the damage and degeneration of aging. But also to send out positive signaling messages to the body to wake up genetic complexes to perform at higher levels.
You know, one of my favorite compounds is Curcumin. Curcumin has an amazing popping of power to it. It has a multiplicity of activities, of decreasing NF-kB, which is one of the...decreasing the activity of NF-kB, which is one of the major inflammatory signaling pathways. It turns on NRF2, which is a gene cassette that, in turn, turns on our antioxidant response system. Helping increase glutathione peroxidase and superoxide dismutase, and a whole host of enzymes that serve as antioxidants.
Now, I...could I start eating tumeric and eating more curries with black pepper? Aint that kind of cool.. that black pepper, you know, helps Curcumin get absorbed, and that's actually how traditionally these were in foods. I love that poetry of food. But instead...and I do that, I absolutely bring that into my diet. But I find it very convenient to be able to have that in a capsule or a pill. And then likewise, I do a lot of work with neurodegeneration and brain function.
And the Omega-3 fatty acids are incredibly important in proper neurologic functioning. And I...you know, it's actually for individuals who have head injuries. We will often push that dose very high, even up to 15 to 20 grams of EPA/DHA a day. Yes, I mean, that is a massive dose. And that's also in highly selective cases, and we're following them carefully. But the amount of brain awakening can occur has blown my mind.
Andrew: Yeah.
David: So we need to think of foods, of these nutritional supplements, not as drugs. You know, they're not forcing the body to do something. But instead, they are nurturing agents. And proper dosing should be...and I think these things should be overseen by knowledgeable individuals. Not just, you know, somebody who's marketing it on the internet, right?
Andrew: Absolutely.
David: So it's a...I'm very thankful. I get results that I could never get without nutritional supplementation.
Andrew: I've got to ask, when you see some of this negative research out there, do you think there's mischief? Or is it ignorance?
David: Oh, so I haven't been talking about bias the entire time I've been on this call?
Andrew: Yes, you just reminded me now, thank you.
David: So I don't...believe me, I think of my medical school class mates. And while they practice very differently from me, they are just some of the best group of humans I've ever known in my life. And so, do I believe that there...by and large, there is some plot? No, not at all.
However, let's step back and look at things from a structure standpoint. In the late '70s and '80s, the U.S. cut a lot of its public funding to medical schools. And the medical schools had to scramble for financing. And so, the one place they could get prior financing was the drug companies.
Andrew: Right.
David: You know, before that time, it was kind of low end to be doing drug research. You know, the good professors always got federal grants and, you know, they would do research, and there was a ton of nutritional research coming out in the '70s and early '80s.
And then...but when medical schools had to fend for themselves in the States, all of a sudden, the pharmaceutical industry rises up. And so, if you can't have a patent on something...the other question no longer became "Is it useful?" but rather "Is it patentable and then useful?" And for instance, nutritional products are not patentable, by and large, they fell by the wayside. And they certainly do have...the funding was there.
And so now, you have the highest-end professors getting their funding from drug companies. Well, neurons that fire together wire together. And what you know, you become...you develop an affinity for.
Andrew: Yeah.
David: And so, you actually start to see data in a different way. Our opinions shape how we actually bring in different sets of data. So I'm always amazed to see different meta analyses on the same topic come up with such very different results because of the presuppositions of the individuals that created that study.
So I don't believe there's malicious intent. As a matter of fact, what I have seen in my 20 years in this field has been massive progress and shifting. I have so many conventional colleagues that are my patients that are taking supplements...take way more supplements than I do. And you know...now, do they recommend them to their patients? Not yet. They don't, actually. They don't bring them up. And you know, and some of them...you know...one of them is a pure hypocrite, actually. He actually tells people not to take them...
Andrew: But he does himself.
David: ...he's got a huge list that he's incredibly ardent on, you know? But that's only going to persist for a time, you know? And that will see change. He's in a position where it would actually endanger his job if he came out to make that particular issue.
You know, in medical school, it was said...you know, the only progress that happens in healthcare is when enough old doctors die.
Andrew: Right.
David: And that's for...that's literally what is happening, and there's a changing of the guard, and the understanding of precision medicine, systems-based medicine is winning today because it's a better descriptor of reality.
And nutrition and what we put in our mouths and the toxins that we're afflicted by, all of those things are part of reality. And we can no longer just step aside and not account for them, and believe that this magic pill is going to cure every ill. We have to instead embrace the mystery of human health. And this is why artificial intelligence, or what I like to call "augmented intelligence," is so important. Because it's going to allow us to account for those multiplicity of data points that we in our human minds can't hold on to simultaneously. And it's going to help us start to sort through some of these preset points, these biases.
And as a result, we're going to start having different answers. Answers that come out of complexity rather than reductionism. And I'm going to guarantee you that the answers that are going to come out are going to be relatively simple. They're not going to be this magic potion, but rather a Whole Food diet. Eating in love and community and with activity and sunlight. We're going to find that the health outcomes of those types of interventions are drastically more efficacious in time and human effort than other things.
So I'm very hopeful for the future. I think that we're at an incredible tipping point. It's just amazing to get to be alive at this point in time, and to witness these changes that are going on in healthcare. And I bless all of those who have different viewpoints than myself because they continue to teach me on what I do not know, and make me aware of my blind spots. That's what science is, right? We need...you have to have open discussion and engage with full heart and full mind and be fascinated with a better outcome.
Andrew: David Haase, you are the epitome of a functional medicine practitioner. And by that, I mean everything has a function. But you embrace things with such humility and care, obvious care, for your patients. Not for you to do something to them, but for them to realise something for themselves. And I just...I so...I'm giving you a virtual hug here over the phone, over the miles and miles. I so have loved...
David: Ooh, feels good. Feels good AWC. Feels good.
Andrew: I so have loved talking with you. And I really want to delve further into other conditions where we can talk about specific black boxes...let's call them black boxes, and how you approach them from a truly holistic framework. I'd love to delve into that at another date, if that's all right with you.
David: That sounds great. I think there's many follow-up conversations to be had here.
Andrew: Oh, yes. Dr David Haase, thank you.
David: Great spending time with you AWC.
Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.
Additional Resources
| Dr David Haase |
| The Mayo Clinic |
| Book: Curiosity Heals the Human by Dr David Haase |
Other podcasts with David include:
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