Feeling breathless can be frightening and the automatic response is to take a deep breath, right?
Who would think then that controlled, relaxed, shallow breathing would help with getting oxygen to tissues?
This is what Buteyko Breathing is all about and this is exactly what Mim Beim teaches to hundreds of practitioners and patients. According to Mim, Buteyko Breathing has not only helped with their breathing but sometimes dramatic reductions in the need for medications.
In today's podcast, Mim takes us through the somewhat surprising results with Buteyko and shows us how it can aid in monitored reduction of medication use in such conditions as asthma, allergies, anxiety and sleep apnoea.
Covered in this episode:
[00:42] Introducing Mim Beim
[02:32] Mim's career history
[05:37] What is Buteyko?
[09:05] How fast does it work?
[10:13] It's all about carbon dioxide (CO2)
[13:22] Deep breathing vs. Buteyko
[17:41] Switching on parasympathetic nervous system
[20:04] So much more than Asthma..
[27:51] The Bohr Effect
[29:52] Understanding acidity
[33:03] Benefits you may not associate with breathing
[41:36] Current evidence and barriers to research
[45:38] Australian and International Training
[48:41] Resources and final thanks to Mim.
Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook. And joining me on the line today is naturopathic royalty, Mim Beim. She's been practicing naturopathy for nearly 30 years. She's written nine books, was a long-term columnist for Sunday Telegraph's Body and Soul, Sun Herald's Tempo, Good Health and Medicine, and Family Circle. She appears on ABC radio out Orange way, Regional ABC. She helped create and star in two Foxtel series and is a regular on morning television. She was the Triple J naturopath for seven years in the early 1990s and another four years with ABC's nightlife host, Tony Delroy.
Mim lectures to naturopathic students at the Australian College of Natural Therapies, ACNT, and Endeavour College, in Sydney. She has two practices, one in Bowral in the southern highlands, the other in the heart of Sydney. She is a fellow of the Naturopaths and Herbalists Association of Australia, NHAA. A full member of the Australian Society of Authors and also a fellow of Buteyko Professionals International. Recently, she's been honoured with the award Excellence In Practice Naturopathy and Herbal Medicine by the 2017, BioCeuticals Integrative Medicine Awards, the BIMAs.
In 2011, Mim traveled to the U.S. to study with Patrick McEwan, world-renowned expert in the Buteyko breathing technique. And since that time, Mim has been teaching the Buteyko breathing technique and says it has transformed her practice. Mim, I warmly welcome you to FX Medicine to talk about Buteyko breathing. How are you?
Mim: I am very well and thank you so much for asking me.
Andrew: You are naturopathic royalty, Mim, I've got to say. You've done so much for not just your patients but also the profession, indeed…
Mim: You make me blush, Andrew.
Andrew: The up-and-coming new Mims. So take us through a little bit of this career history because by-goodness, you would have seen some changes.
Mim: Yeah, Andrew. I absolutely have. And I am so happy the way the industry is now and it’s just growing and growing. So you know, when I first started, no one knew what a naturopath was. They'd often say, "Can you read my tea leaves?" And now pretty much everyone and their dog has a naturopath. And so I think it's become in the, you know...and I think that Blackmores/BioCeuticals. Blackmores/ BioCeuticals...the companies have helped it grow in the public mind as well. So I think there's been a bit of a partnership there.
Andrew: Yeah. Well, indeed that's where Blackmore started, wasn't it? With Maurice Blackmore's, up in Queensland.
Mim: Yep, with Maurice. Yep, absolutely Maurice and then Marcus taking over the reigns.
So I actually worked at Blackmores in the 80s when I graduated, when there were just three naturopaths there. And now it's huge, yeah. So it is really interesting the way it's gone. And you know, I guess we're embracing evidence-based medicine and now, you know, people...although the general public are aware of naturopathy, I don't think that the knowledge of how well we're trained, the depths of knowledge that we have and that we can hold our own. We can say, "Well, you know, yes, I want you to have ginger, I want you to have Gingko, whatever it is," and actually say, "And here are the studies." And so even though it's been used for years and years, we now actually have the, you know, research backup which, fortunately/unfortunately, you need nowadays.
Andrew: Yes. That's right.
Mim: So I think that that's the next step for the general public to realise how professional our industry is.
Andrew: I think the downfall that people can fall into with evidence-based medicine is thinking that it is only the double-blind placebo-controlled randomised trial. Whereas that, you know, I famously quote a famous paper, Smith and Pell that was published, I think was 2003, in BMJ and that's basically, you know, avoiding gravity...avoiding traumatic injury from gravitational challenge via parachute jumping. Who wants to go in the placebo arm of that trial? You know, and it's kind of...Professor Karen Phelps famously quoted this and saying you know you need to look further than just the RCT. And certainly, you know, it is important to develop guidelines and things like that, certainly on a population level. But when you're dealing with Mrs. Jones who's in front of you, the population treatment might not work for her. So you then go down the levels. You find something that helps her. In the end, you have to help somebody. And that is...
Mim: No, I agree entirely and it's often the most simple things, like breathing, for example, that will make the change. But I am pleased that we're able to hold our own.
Andrew: Yes.
Mim: Nowadays.
Andrew: So let's talk about Buteyko because I remember years ago...and I thought it had level 2 evidence for helping people with asthma. But it seemed to be going through this sort of, "Do we agree with it? Don't we agree with it? Does the medical profession accept it? Doesn't it?" Where is it at the moment?
Mim: They didn't know about it.
Andrew: Yeah.
Mim: So the only trials--and this is something we need to look at in ‘Buteyko land’--the only trials have been on asthma. And they've actually been outstanding. So symptoms are reduced and medications reduced. And I think...so, look, I will put up the journals. I don't have them. I can't remember them. But, you know, I think there's about five or six trials that were very positive, all positive. And so that...and that's the way I was introduced to it.
So, in fact, I was on triple J at the time. And in the late 80s...no, early 90s, and a fellow who taught Buteyko was pestering me to try it, so I could promote him, really. And I had asthma and so I knew at that stage that it was meant to be good for asthma. So I did it. I just did it for three days in a row, one hour a day. I never had asthma from that day to this.
Andrew: Well.
Mim: So I always thought, "Oh, it is good for asthma," and I'd always say to my patients with asthma, I'd say, you should check this out, which they never did.
So in 2011, I decided that I would actually then become a Buteyko practitioner so that I just have another string to my bow that I'd be able to help those patients with asthma. And I looked around, I didn't like the way it was taught in Australia. So I found a guy called Patrick McEwen, who's an Irishman, he studied with Constantine Buteyko.
Andrew: Right.
Mim: So Buteyko was a Russian medical researcher, researching the effect of breathing on hypertension. He died in 2003, so I was just a little bit late to learn from him. So I decided that Patrick had studied with him, so I went over to Los Angeles where Patrick was giving a training. And I'm pretty glass half empty, Andrew. I went over...it was at the end of the year, you know, when your practice is not so great. No one really wants to see a naturopath to be told they can't have that champagne and rum pudding.
So in December, I went over and I thought, you know, I'm going to hate him, I'm going to hate people, I'm going to learn nothing, it's going to be waste of time and money. That's, you know, that's the way my mind goes. And instead, I am the used car salesman, of breathing.
It would just bowl me over what this simple technique can do and it's not just asthma, it's anxiety. And, you know, the effects of anxiety and stress on the body. It's for...so there are a number of ways it works and it works at a very deep level. And what it does is it actually changes via neuroplasticity the respiratory centres. So you learn the technique by doing some breathing exercises but then the changes stay. It's not that you then need to keep on doing it.
Andrew: Ahh….
Mim: And it's such an elegant treatment. You know, I mean, herbs are fantastic, supplements are fantastic. But, you know, if a person needs to keep on taking them, then that's now a bit of a pain in the neck. You're running into patient compliance and it's expensive and a lot of people don't like taking stuff.
Andrew: Yeah, compliance falls off. Yeah. So forgive me here, because I thought the Buteyko was something that you had to, you know, continually practice, like meditation. Is this not the case?
Mim: This is not the case. What happens is we've got the chemoreceptors or respiratory centres in the blood vessels leading to the brain and in the brain. And they get used to; so basically they get used to a level of carbon dioxide in the blood. And if you raise that slightly...and you can, and the brain will...initially, the respiratory centres are saying, "No, no, no. That's normal. I want to go back to the way I was." And that's why you need to do a bit of a training. And I actually teach it over a four-week period and give people homework exercises that they can integrate into their lives. And after that, usually the symptoms have either completely gone away...and this is things as serious as sleep apnea, definitely asthma, sinus, IBS. So, you know, I'd love to talk to you about the mechanisms of how this actually occurs.
Andrew: Yes. Yes.
Mim: It's permanent.
Andrew: Wow. So this is something that really interests me. And forgive my poor review of physiology and anatomy prior to this podcast but my memory of the sort of capneic [edit: respiratory centre] areas of the brain was that they were set for… and I used to constantly get this wrong.. they were set for not looking at oxygen, but actually trying to detect rising carbon dioxide. Is that correct?
Mim: Correct-o-mundo
Andrew: Right. Okay, so, therefore...
Mim: Yeah, it's all about carbon dioxide.
Andrew: Yeah. And this was the problem in, like patients with chronic obstructive pulmonary disease where it was...it is dangerous to give too much oxygen because their [respiratory centres] are flipped and they're now looking for low oxygen, not high carbon dioxide. So if you raise the oxygen, there's no trigger for them to breathe and you knock them off.
Mim: Yeah.
Andrew: Is that right? Oh, okay. So I am right.
Mim: So carbon dioxide gives the trigger to breathe. Now, we're really talking only a small amount. Carbon dioxide is toxic, but your body is never going to let you get to that kind of level. It's all about tweaking it at a very fine level, a very small level. But that's enough to make the difference. So the exercises.. and there are a variety of them, are about slightly increasing carbon dioxide levels.
So for a start, if somebody is a ‘mouth breather’ and, you know, that's the detested ‘mouth breathers’.
Andrew: Yes, yes.
Mim: They are losing carbon dioxide.
Andrew: The snorers….
Mim: Yeah, well, that's through snoring. So there are a whole lot of symptoms or signs that your breathing is dysfunctional.
Andrew: Right.
Mim: So, snoring is one. Believe it or not, sniffing and sighing, yawning. These are all signs that your breathing is not optimal.
Andrew: Right.
Mim: So certainly no one's going to come to see a naturopath because they're sighing a lot. But I'm going to know...
Andrew: Well...
Mim: No, Not really. And what are we going to do about that?
Andrew: Yeah. No, to me, it was one of the little things you used to look for though in chronic fatigue patients, is like, did they sigh a lot? And I found it was...
Mim: Okay.
Andrew: ...you know, whether I was seeing what I wanted to see, I don't know. I didn't have that much, you know, I didn't have a world-famous chronic fatigue patient practice. But I just used to notice it and when I'd ask people, they'd go, "Oh, yeah."
Mim: And interestingly, chronic fatigue and fibromyalgia, which is kind of like a similar animal. Do really well with the Buteyko. Really, really well. And they're the patients that are like really hard work.
Andrew: Okay.
Mim: You know, often it's kind of...because not one of them is the same. But they respond really well. In fact, Patrick, he has classes entirely made up of CFS and fibromyalgia patients. And so, yeah. Interesting.
So it's the breathing...and this is the thing, you know, I mean you can tell how excited I get. But it may be that the breathing is not a hundred percent of the problem. But if you can take that part of it, the rest, whether you're using herbs or acupuncture or whatever your modality, it's going to be easier for you to then do the rest of it.
Andrew: Yeah, that's one of the top three free nutrients: air, water, sunlight.
So here's something that I'm confused about, though. Like, I'm thinking about what we would normally class as deep breathing exercises to draw in ‘oxygen’ and relax your body because your muscles are now getting oxygenated blood to the tips of your fingers.
Mim: That's not how it works.
Andrew: That's right. And this is going against that. So we're not talking of yoga.
Mim: No, we're not. Well, this explains physiologically, biochemically, how yoga and meditation actually works. So what...let me explain, if I may.
Andrew: Please do.
Mim: So a slight increase in carbon dioxide relaxes smooth muscle. So not skeletal but smooth muscle. So smooth muscle lines the hollow surfaces of the body. So, if I'm able to relax smooth muscle of the respiratory tract, this is how it can help with asthma.
So if you've got a spasming of the bronchioles or the bronchi, your...and then producing mucus on top of that, then we have asthma. And so if your smooth muscle of the respiratory tree is always slightly more relaxed because of this increased carbon dioxide, no matter what the trigger is, there's going to be, you're going to be less likely for that incident, that asthmatic incident, episode to occur. So that's how it worked for me.
Mine was exercise-induced asthma. I at the time actually, I was an aerobic instructor, complete with G-string. Don't even think about it too much.
But, you know, so I still exercised but my bubble was bigger. So the respiratory...the smooth muscle lining was always just a little bit more relaxed, so even though there was a trigger, it didn't go into an episode. And there's smooth muscle lining the entire nasal cavity. So the sinuses. So this is how we can help with that. So where else is smooth muscle in the body? Well, it's the bowel, the whole bowel. The oesophagus right through..
Andrew: Uterus, cardiovascular.
Mim: Yeah. So with the bowel, how it can help is with things like reflux, it can help with IBS. Any of the kind of the mechanical spasming of that whole tube. Even the gallbladder is, and the common bile duct, that’s smooth muscle, relaxing that. Yeah, you know, like...it's phenomenal.
So we've got the bowel, we've got the uterus, as you said, and we've got the cardiovascular system. So the arteries. And this is what...
Andrew: Yeah, I'll catch myself there. I said cardiovascular but it's actually probably cerebrovascular because you've got cardiac muscle which is different. But...so let's say cerebrovascular.
Mim: Well, that's right.
Andrew: Go on.
Mim: So this is the blood pressure thing. And I have got amazing results with people. And you take their blood pressure. I’ve got with one patient in-fact, it's the mother of a patient in the highlands, and the blood pressure was over two.., like the systolic was over 200. I was like, "Oh, my God."
But I'd been warned that her blood pressure was this high, it was incredibly high. And we did a 4-minute exercise and it went down to 160/90. She was absolutely...couldn't tolerate any medication, she had slight dementia. So I actually gave her a breathing exercise on a CD and I got an email, this is last year, that the blood pressure had consistently been down.
So relaxing or, if it’s an artery, of course, if you've got a constriction, that pressure is going to be higher and relax that smooth muscle, and that's going to...for some cases of blood pressure, lower the blood pressure.
And as you were saying in the brain, you know, so certain headaches, if they're constricted headaches then you are going to be able to help those because that blood vessel in the brain is going to be slightly dilated.
So that's, you know, that's the smooth, that's...increasing carbon dioxide slightly dilates or relaxes smooth muscle. So happy days about that. But also...the other thing with carbon dioxide, increasing carbon dioxide, is that it switches on the parasympathetic nervous system.
Andrew: Right.
Mim: The sympathetic: flight and fight, parasympathetic: rest and digest.
So that's the kind of like the whole...the bowel thing again. And, you know, this is what a large part of my naturopathic practice is, reducing the effect of stress. You know, however they manifest. Whatever the, kind of, the genetic weakness that person has, however that stress will manifest. If you can reduce the stress hormones and you do that and you can see this. So you'll give a little exercise that will slightly increase the carbon dioxide and after a couple of minutes, I'll say to them, "Do you have more saliva?" "Yes, I've got more saliva." It's a sign that the parasympathetic nervous system has been activated. And if you can do that throughout the day, you are going to be suppressing the adrenaline and cortisol, the hormones of stress. And switching on that parasympathetic.
The example for me is, like a year or so after I trained, I had done a tree change from a Sydney practice, and then I decided I couldn't actually afford trees anymore. So I then opened up another practice in Sydney. And so on this one day, I opened up the practice, which you know the attendant kind of dramas and, you know, dramas with that. I had six patients in a row, then I had--this was one day--six patients in a row. Then I gave a lecture at Sydney University at women's college for 250 people. And then I was doing my masters and I had an exam for my masters. So this is all in the one day. And I went from public transport to all of them. And the next day I thought to myself, "So, a few years ago I actually would have been pretty stressed about today..."
Andrew: Really?
Mim: And I, you know, I didn't stuff up the lecture too much and yeah. And it was like, what changed? Have I, you know, am I taking little pink pills? No, not now. I'm like, "You know, do I have a new therapist?" No. The only thing that's changed is the breathing.
Andrew: So people that you treat or indeed, people that you train and then the people that they treat, do they get the same sort of results on a widespread basis?
Mim: Yep.
Andrew: Not just with asthma for which it's known for but also anxiety?
Mim: No, well that's right. Well, that's why I just went, "Oh, my God." When I went over there, it's like this is much more than asthma.
You know, it's stress, it's snoring. So what we're doing is, we don't want big breathing. And this is the thing people say, you know, isn’t deep breathing good? Well, deep, meaning diaphragmatic, yes. But not big because big breathing means you're going to be losing that carbon dioxide. We want it slow, and you know, we don't need to use all of the lungs.
We can use two litres of, you know, the lungs can hold two litres. But that's if you're running up a hill. You know, if you're sitting down, talking, walking, you don't need to use that. So the Lao Tzu quote of the perfect man breathes as if he does not breathe.
Andrew: Right.
Mim: Now that's really interesting. Because as we've been taught about breathing, you take a big deep breath in, big deep breath out, using your mouth. And this is, you know, people have been looking at breathing for centuries. Like the word for breath in Latin is 'spirit'. 'Spiritus'. You know, so inspire all of these in our language. In Sanskrit, you know, like chi is breath.
So, all of these about how breathing has been so important through the centuries. We've lost it. When I say to people I teach breathing they go, "I'm all right, I'm alive." And I go, "Well, you know, you can be alive and your diet is crap. You can be alive and you don't do any exercise but how well are you?"
Andrew: Yes. I gotta say, like I had oversimplified, I pigeonholed it into mainly asthma. I knew there was some work on, I think, migraines or something, is that right?
Mim: I don't know of that. Like that’s… I should, I’ve got them all, you know, in a file.
Andrew: Yeah. Yeah. But.…
Mim: It is, practically, it's insane what it can do. And people, like, this is the thing, you know, you can learn just a quick little four-minute exercise. And in that consultation, you don't need to be a Buteyko teacher, but in that consultation, you can teach them a little technique, that alongside your herbs, alongside the dietary change of taking out caffeine or, you know, decreasing sugar and things like that, you are going to make a major, major difference to their day-to-day, you know, feeling of wellbeing. And they've got control. They've got control...I'll stop...
Andrew: No, no, no, no. This is a major thing about control. giving back the patient control. But I do have a question for you. And that is basically...
Mim: Most of them have got noses, you know, that's the thing.
Andrew: That's right.
Mim: They've got a nose and this is all you need.
Andrew: So with regards to asthma, when you're looking at, for instance, exercise induced asthma--a major trigger--but then you've got viral induced asthma as a major trigger, particularly in kids, you've got dust mite allergens and other inhaled allergens.
Now, I remember speaking to a guy years ago who said, "You know, the therapy for asthma is basically to widen the airways as much as possible." That is the, you know, treat your airways and we want a beta-agonist. So therefore, what you want to do is widen it, medically. What are you going to do then if you've got a pollen? You're going to get more pollen down into the arterioles, into the alveoli. So you're actually going to worsen the pollen...
Mim: Well, you know, you’re not if you’re breathing through your nose.
Andrew: That's true...
Mim: If you breathe through your nose, that filters everything.
Andrew: Right. So this is the thing. Is like, he was saying about Buteyko breathing having this effect about balancing the inhalation of these allergens, danders, whatever they are, whatever you're talking about. So they don't actually penetrate so much.
Mim: Well, they’re not going to go into the lungs at all if you're breathing through your nose. So then the whole...the membrane, the mucous membrane lining the nasal cavity--which is enormous, it's a third of the skull--if you are using your nose to breathe, any of those particles are just going to be neutralised by either nitric oxide, of which that membrane is the greatest producer in the body.
Andrew: Right.
Mim: You know, more than even the arteries. And also we've got lymphocytes there. We've got, you know, if you are breathing through your nose, you're not going to get those. You're going to neutralise it. So that's...if you're breathing through your mouth, different story. And that's what we teach. You do not breathe through your mouth.
Andrew: Gotcha.
Mim: Ever.
Andrew: Gotcha. Okay. So going further, a little bit further, so you've still got an allergen to somebody that might react to a pollen or something like that. How then do they treat that part?
Mim: Well, it's not, it's like...okay, the trigger may...and this is the thing, that you may still have a trigger. But because the ambient stage of the smooth muscle is always more relaxed, more open, then the trigger may, you know, constrict it a little bit more. But it's generally, tensed. And I'm not talking about anaphylaxis, but just that, you know, a general I have a dust allergy, whatever. We're not saying, you are not going to be an allergic person, what we're saying is you're not going to react...
Andrew: Right.
Mim: ...as much.
Andrew: So the twitchiness of the airbase.
But I guess where I'm going with this is the inflammatory component of asthma, that's, you know, you get your relievers which is your beta-agonist type medications, and the newer forms, but now you...then you've got the preventers. So your steroidal-type things to decrease the chronic inflammation.
Mim: Yeah, but this is the thing, you’re going to need less, I mean, and that's where it's like the studies show decrease medication both...
Andrew: Of both?
Mim: ...you know, the preventers and the dilators. Yeah.
Andrew: Really? Preventers as well.
Mim: Yes. Yes, yes, absolutely. Absolutely, but you see...
Andrew: This is defined by like, peak flow monitoring or spirometry or?…Like you can use less but does it...what's their actual lung health?
Mim: I mean, you’ve got less symptoms, I mean, the medications decrease as the symptoms decrease. So it doesn't...it's not going to...because the smooth muscle is more relaxed all the time, then you're going to, you know, there may be a trigger, but it's not going to constrict to the level...
Andrew: Right.
Mim: ...where it did before and then the mucus production on top of that.
Andrew: Yeah. Right, okay. So then, I mean, I would always espouse objective monitoring of something like asthma, particularly where, you know, what I used to commonly see when I was nursing was people would say, "Oh, my asthma was really bad last week but now it's okay." Really? What did you do last one last week? "Last week I mowed the lawns." And this week, what have you done? "Nothing. I've been sitting in my chair." Well, of course, it's not going to get as many symptoms. So we need to look at objective monitoring. Something like, you know, peak flow monitoring at home, spirometry every now and again whenever you can get a GP to do it.
Mim: Yeah, sure, but how many times do you need to use the Ventolin? You know, you can...and with hay fever how many tissues do you use? You know, you can do it more simply.
“No, I haven't needed to use my Ventolin at all.” Then I say to them, you know...and of course when you're teaching, you used to say, "Please, do not stop your medication," of course. But, you know, if they say, "Well, I was using my Ventolin four or five times a day and now I'm not using it at all," I'd say, "Well, now's the time to have that discussion with your doctor. Can we start maybe reducing some of the steroids?"
Andrew: Yeah. With using objective monitoring, like peak flow or spirometry, yeah?
Mim: Yeah, sure. And you know, just symptoms, you know.
Andrew: Yeah. And so we've spoken about anxiety. Cardiovascular, though, where you've got cardiovascular issues where nitric oxide will relax the smooth muscle but if you've got an atheroma there or a fatty streak then you're starting to actually impinge on the relaxant, the relaxability, the elasticity of the arterioles.
Mim: Sure. And I mean, you know, as I was saying...but I mean, it's also the capillary. So you're, you know, opening up the capillaries so you've got more blood flow, therefore nutrients, therefore oxygen.
But Andrew, so then there's finally, what increased carbon dioxide does is initiate the Bohr effect. B-O-H-R, after Niels, no, not Niels Bohr, but Christian Bohr.
Christian Bohr was Niels father and Niels Bohr got the Nobel Prize for understanding the atomic structure. So his father, Christian Bohr, discovered this technique, oh, not technique, this physiological effect. Whereby increasing carbon dioxide releases more oxygen into the bloodstream.
So you've got your haemoglobin on your red blood cell carrying oxygen and it's very…so from the lungs we're breathing, the gas exchange, the carbon dioxide goes out through the lungs, the oxygen comes in, jumps onto a haemoglobin molecule, on a red blood cell, travels around the body. And it's the presence of higher carbon dioxide which will mean that the oxygen will leave that haemoglobin molecule more readily and that's known as the Bohr effect.
So, regardless--and this is with someone with COPD--this is the benefit. We're not, you know, if that lung tissue is damaged or compromised, the breathing's not going to change that. But it's going to change the amount of oxygen available in the body and brain because of this Bohr effect.
Andrew: I'm wondering about, with regards to acidity...
Mim: Okay. All right. lovely.
Andrew: ...and we get this common naturopathic theory about measuring acidity, the body's acidity. And I have issues with this. Where are you measuring that?
Mim: Okay, okay. So we measure acidity in the blood by the anion gap. So, you know, you add your...you put your potassium and your sodium and you subtract your bicarbonate and your chloride. And then you can have your anion gap. And you kind of want it to be about 10. All right. Yes, absolutely, CO2 is an acid but what the thing...well, the anion gap just doesn't measure…. it is measuring the other metabolic acids.
Andrew: Right.
Mim: All right?
Andrew: Right.
Mim: And these are from the food, these are from stress, these are from inflammation. And that is going on intra and inter-cellularly, full stop. And the blood is a snapshot and it's going to be...it will be, you know, the bicarbonate ions are going to be mopping up any acid all the time, all the time, all the time. So when naturopathically we're talking about some of these acids, we want them more alkaline, we're talking really in the cells.
Andrew: Well, we'd like to but we're not measuring that. We're measuring urine and things like that and I just wonder how reflective of the actual intra and inter-cellular state these measurements that we make is.
Mim: I think the anion gap is a pretty good indicator of that. The breathing, the change that we're doing with CO2 is really marginal. You know, it's instant but it will have these...what we're doing is we're wanting those respiratory centres to be kind of, just acknowledging that that little bit more of carbon dioxide is okay. And that's why we do the exercises to kind of like, we're changing the habit. We're changing a habit of sometimes a lifetime. And so it's not...it's...yes, carbon dioxide is an acid but it's going to be mopped up real quick and utilised by bicarbonate ion. So it's this moment by moment change. So we're not making the body more acidic.
Andrew: Yeah. Because of its elegant control mechanisms, yeah.
Mim: Yeah, yes. So, it's...and I know this is a question that comes up. So it's...and it's not a major amount either. We're just talking a tiny shift. And that's I guess what health is. It's like let's move it just slightly.
So look, you know, this is the carbon dioxide theory of how this works. And I actually, I was, you know, Rosalba Courtney? I had a conversation with Rosalba who did her Ph.D. in Buteyko.
Andrew: Got you.
Mim: And, you know, she thinks that there's more than just the carbon dioxide to this. And I just think that there's not been research on any level yet. But, you know, what? And this probably doesn't satisfy a whole lot of people but it works, and I get great results. And, you know, happy days.
Andrew: Yeah. What about things though that aren't due to what we'd normally think about, you know, breathing and the cerebrovascular system, where we commonly think about nitric oxide working and having an effect? What about things like pelvic floor issues?
Mim: If the bladder is twitchy, so you know there's something called irritable bladder syndrome.
Andrew: Yeah.
Mim: And, you know, it can help with that. But, yeah No, sure. I mean if there's pelvic floor weakness, the breathing, it's not gonna help. And this is made worse by the stress.
So yeah, of course. You know, the musculoskeletal stuff.. but I mean the other... where… and this isn't strictly Buteyko, but I can't teach a breathing course without talking about diaphragmatic breathing.
Andrew: Yes.
Mim: So if you're using your diaphragm to breathe, the real breathing muscle, then you are not going to be using...if you don't use the diaphragm, then you are using the accessory muscles for breathing. Which is the sternocleidomastoid, the scalenes, and the trapezius. So when people say, "I store all my stress in my shoulders," I say to them--well, probably not as smarty pants as it sounds--but I say to them, "No, you're probably just not using your diaphragm."
Andrew: Right.
Mim: And so, and this is bruxism and temporo-mandibular joint pain.
Andrew: Oh, Really?
Mim: You know, yes. Absolutely. If you can relax that sternocleidomastoid, if you can, the scalene...
Andrew: Right, right.
Mim: ...if they're not used 30,000 times a day and you're using the breathing muscles and the breathing muscle, the diaphragm--oh, back to pelvic floor, thank you. Perfect segue--the diaphragm will activate the pelvic floor. It's a kind of...it's a bag and so using the diaphragm will actually help with the pelvic floor and the core. I just have so many issues with core, I can't tell you because we use...the core should not be on all the time. But the belly should be soft and relaxed.
Andrew: People get the core wrong. They think it's this hard thing. How do you run with tensing your muscles all the time? How do you do backward flips by tensing your gut muscles? It doesn't work. The core is stability.
Mim: I don't know.
Andrew: The core is flexism.
Mim: I tell you Andrew, the last time I did a backwards flip was.. my last life.
Andrew: But I remember hearing professor Paul Hodges, a physiotherapist at UQ, talking about this. Just going...like runners, they just get this concept of core wrong. That we need to have something that's flexible and malleable, pliable, and strong.
Mim: The core switches on when you need it.
Andrew: That's right.
Mim: Like if you're listing, your core should automatically go on. So this is…yeah, I talk a lot with...I have a lot of osteopaths, I have a lot of physiotherapists come and do my course. I learn, you know, it's like, “Ooh, great, come on in and just teach me too,"
But if you've got the diaphragm working, that actually helps the pelvic floor. Because it's just this bag. The pelvic floor is the bottom of it and the diaphragm is the top of it. So if you're using that, you're not using those...the neck, the shoulders, and so, things like grinding of the teeth and temporomandibular joint pain. Which people spend thousands and thousands of dollars on splints and things like this. Like, Ummmm. You know?
And then just the way the tongue is, you know, it helps with the position of the jaw and that opens the airways and softens the breathing. So last year I did a sleep medicine course at Sydney Uni. And, who were the inventors of...one of the professors who taught us was the inventor of the CPAP machine. So I was in kind of, enemy territory but I didn't let them know what I did. But, you know, this breathing opens up the upper airway. And so things like sleep apnea, which is such, you know, people...
Andrew: A huge, huge issue.
Mim: ...it's a huge problem associated with diabetes, you know, heart disease. So reducing sleep apnea, because people do not want to use 50% compliance has a CPAP machine. And the CPAP machine is kind of the benchmark. But people are spending thousands on that, thousands on dental splints. And just by changing the breathing, you can really improve, if not, take away sleep apnea and snoring.
Andrew: Okay. What about structural impedance of the nasal passages? I mean obviously, you've got a physical thing...
Mim: If you've got a bony, if it's a bone, if it's a septal deviation and bone cartilage, no. Probably need surgery. But if it's soft tissue, so if it's polyps, any soft tissue swelling, absolutely. This will...
Andrew: It will help?
Mim: ...help with that.
Andrew: Okay. So without...obviously, this is something that people evidently have to learn, obviously. And, you know, we're going to talk about where they can learn from you a little bit later.
Mim: Thank you, Andrew.
Andrew: But just before we get into that, a couple of little hints and tips and techniques maybe for our practitioners, just to whet their appetite.
Mim: Okay.
Andrew: Here's my first question. You've got a polyp, a polyp in the right side of your nose, totally impeding airflow. How do you then initiate Buteyko breathing when you're trying to get past a physical mucoid obstruction?
Mim: Well, if that person can breathe at all just...they will probably be mouth breathing, because they'll find it easier. If they can breathe at all with the mouth closed, that will start the process.
Andrew: Got you.
Mim: Because we're already not losing so much carbon dioxide.
Look, if, you know, I guess if someone is totally blocked up, maybe we do steroids too, you know, to...just reduce it so that they can then start the process of breathing through their nose. And then you can start...so a little, an example is what we call reduced volume breathing. And that's blocking one nostril. So if someone, you know, speaking to someone last night, someone did have a polyp, and you know, that's the nostril you block.
Andrew: Right.
Mim: And then you can start to slightly occlude the other nostril. So what this is doing is increasing the carbon dioxide. It's uncomfortable, for sure. It's not comfortable but it's very, very powerful medicine. It's a very powerful message to those chemoreceptors to be okay.
You know, basically, the brain is saying, "What the? Just take that hand away from your nose." So it takes a little bit of getting used to, and then...but then some people start to say, "Oh, my nose is so much clearer."
Andrew: Over what time period do you get these effects?
Mim: Thirty seconds.
Andrew: Really?
Mim: Yeah.
Andrew: But over what time period do you see benefits in asthma and things like that?
Mim: Two weeks.
Andrew: Wow.
Mim: Yeah. Look at that. But you know, it's chronicity : severity.
Andrew: Yeah, sure. Sure.
Mim: I mean, you know, just like, so this is it. This is why I'm like, oh my God.
These are really some really powerful mind blowing effects. People just, you know, it's...and you can get that, you can see some of that. Like, I’ll always… ”What’s your anxiety level out of ten?" I'll ask them. You know, with ten being a panic attack. And like last night's woman was eight. I did a four-minute small breath hold exercise. It went down to four, in four minutes.
You know, and I'm not saying that when she went home, she’s a mother with dementia and, you know, it sounds like life's pretty difficult. I'm not saying that she's not going to then….but, you know, that's what I had told her. I mean she felt...you could just see the difference in her face after that.
And so like, just do that, throughout the day as much as you can. You don't have to do it for four minutes. Just small breath in, small breath out. Hold the breath out for a few seconds. What we're doing is increasing the carbon dioxide. What we're doing is switching on the parasympathetic nervous system, suppressing the release of adrenaline and cortisol. So you do that, you kind of do it in spurts during the day. And then it's going to be...the body likes to be calm. And so we...and as opposed to this kind of ongoing...when people are stressed, and Andrew, you will have come across this too, the adrenal glands get kind of used to it. Like, "Okay, the stress may have left the building, but the adrenal glands are going up. Well, this is what we do. This is how we live." And it needs a re-education to then change the normal. This is homeostasis.
Andrew: Wowee. So with regards to research, I mean obviously, you know, a paucity of high-quality research to conventional medical practitioners. Who's doing the research? Who's controlling this? What are they looking at? Where is it heading now?
Mim: Yeah. Fantastic. No, we are just this...look, I was reflecting this the other day. When I started naturopathy 30 years ago, this is where Buteyko is now.
Andrew: Well.
Mim: You know, it's like, "Oh, this is amazing, this is amazing," and anyone who comes in contact with it like, "This is amazing." Really? "This is amazing." And I was like, "Mmm, no one knows about it. Everyone thinks it's, you know, baloney."
Andrew: But...and yet, I remember being at...but I remember it being on the website of, was it the Asthma Foundation or the National Asthma Campaign or something?
Mim: Yep, yep, yep…
Andrew: Some years ago. I can't find it now.
Mim: Andrew, I know this is, you know, like just between you and me. I don't know….
Andrew: And the listeners of FX Medicine.
Mim: And the listener, and our listener. And our listener. It's politics. It's politics. Yeah, someone wanted to kind of own, this is.. I’m bringing out Patrick, I bought him out last year, I'll bring him out this year. I want everyone to know about this.
Andrew: Absolutely.
Mim: And that's what happened. And I think that is what happens in certain industries, particularly small ones. It's politics, people want to own it, and not share it or just kind of like greedy. I can't, you know.
Andrew: I can't believe when you've got serious issues like sleep apnea, people spending thousands...and the worst thing is getting poor compliance. So where that's a known poor compliance and you've got something that might help them, surely, any reasonable GP would be investigating Buteyko breathing. I just don't understand it.
Mim: Well, I mean I have quite a few GPs who refer to me and send their patients to me, for sure. And dentists because...I'm going to be cynical, but the splints cost between $2,000 and $4,000, the CPAP machines costs between...it's an industry, it's a huge industry. And the CPAP world, it's like every single student, they're doing so many studies. So it looks amazing.
Andrew: Evidenced based.
Mim: It's totally...it's totally, and I'm in the same position as 30 years ago. But, you know, but it actually works. It actually works. This little bleat. And, you know, so I feel like, you know, naturopathy has come so far, it’s like where we began.
Andrew: Here's a call for you, Mim. You know how you've done your masters.
Mim: I'm too old.
Andrew: You need to do your Ph.D.
Mim: I am a dinosaur and I don't have the energy, time. I'm not an academic. I'm just, I'm not academic material.
Andrew: So Rosalba Courtney?
Mim: This is what... Rosalba did a Ph.D. in it. And Rosalba, you know, is no spring chicken either. I mean, you know, she's got more energy than I do, possibly. But, you know, this is absolutely where we need some research. An allied profession is orofacial myology. Am I talking to too fast?
Andrew: No.
Mim: Anyway. Orofacial myology, they're doing the research and they're doing the research on exercises for the throat, mouth, and showing that that...what journal was that in? But that has been shown to reduce sleep apnea and people are watching that, you know, watch this space.
So Buteyko and orofacial myology are actually obviously often taught together and I did an orofacial myology course last year. And so, you know, strengthening the muscles around the pharynx, keeping...because they get lax as we get older, just like every other muscle. And so the exercising and also softening the breathing, because if you’re...like the the Bernoulli effect, you know, sucking on a straw, a hard, like big breathing or snoring, you're going to narrow that airway. You're going to narrow that tube. So if breathing is gentle and soft, it's going to like be like, you know, the airway is going to be more open and reducing snoring and reducing sleep apnea.
Andrew: So you mentioned that you're bringing Patrick McEwen out to Australia. Where can...
Mim: For a practitioner...yep. For a practitioner's training.
Andrew: Where can international practices learn more about Buteyko breathing from reputable sources like Patrick McEwen? And also, what's happening with Patrick McEwen and Buteyko breathing in Australia? Can you take our listeners through what's happening internationally and Australia, please?
Mim: Well, internationally, Patrick is the leading Buteyko practitioner in the world.
Andrew: Gotcha.
Mim: And he travels incessantly. Like, the man is home in Ireland like two weeks a year. He is talking at sleep conferences, he's talking at dental conferences. So, he's in demand all over the world. And so I'm, you know, absolutely blessed to be in contact with this man. And then he made me a fellow of his organisation. Very nice.
But I'm really committed to widening this knowledge in Australia. So he came out last year, as I said. And you know, various practitioners, we had a number of dentists. Dentists are very, quite interested in this. But you know it's such a good thing for a naturopath, it really adds to your practice.
Andrew: Absolutely.
Mim: Like it's not a very...you don't need to...you only need to teach a couple of little exercises and you're going to really, you know, value-add to your treatment.
Andrew: Yes, absolutely.
Mim: So I teach a lot of physiotherapists. In fact, I teach at physiotherapy practice. I don't know whether you know Louis, Anna Louis Bouvier, quite a well-known physiotherapist.
Andrew: No.
Mim: And I teach all her physios, like 18-20 physios. And they integrate this into their practices as well.
Andrew: This is awesome.
Mim: Yeah, it's fantastic. So it's like psychologists, physiotherapists, dentists, dental hygienists and naturopaths, you know. And massage therapists, it's fantastic. There's this little, tiny little extra little thing you can do which is really gonna make a big difference on top of what...how, you know, whatever your modality is. So I really thought it was just gonna be a little string to my bow but I'm obsessed now.
But, you know, I think it could really value-add. So even doing one of my, I do courses for the public, and the two organisations, ATMS and NHAA, they gives CPD points for practitioners doing my little four-week course. And that's, you know, a lot of...are doing it for your own personal reasons if you identify with any of those conditions. And I've got a checklist on my website.
Andrew: Ahh, Great.
Mim: Yes?
Andrew: So what's your website, where practitioners can get further information?
Mim: If you go to mimbeim.com, M-I-M-B-E-I-M.com and go to the Buteyko...it's about to be changed into a fantastic website but it’s still serviceable at the moment.
Andrew: And Patrick McEwan's clinic is, is that buteykoclinic.com? Is that where you find...
Mim: Yeah, that's right.
Andrew: Yeah, that's right. So for international listeners, buteykoclinic.com. And for Australian listeners of FX Medicine, go to mimbeim.com. These will obviously be up on FX Medicine website, post-haste, as soon as we get those up. And we'll...
Mim: Thanks again, Andrew.
Andrew: Oh, my pleasure, Mim. I gotta say, you know, you've been so devoted to the naturopathic profession for so many years. And the be all and end all of it is that you write books, you know, you teach people how to make medicine their food and food their medicine, you teach people how to take care of them, you teach people Buteyko so they can transform their lives. And you do this for the patient, for the people, for the welfare of the people. And this is what I love about you. So, well done.
Mim: Thank you, Andrew.
Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook.
Additional Resources
Research explored in this podcast
DISCLAIMER:
The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.
