Are we giving enough credit to the role of nutrients in brain health and emotional wellbeing?
Dr Bill Walsh is a world leading expert in the field of nutritional neurochemistry, he joins us today ahead of his speaking engagement at the 8th BioCeuticals Research Symposium. Dr Walsh has been educating medical professionals all over the world how to implement his clinically proven and evidence-based methods for restoring imbalances in neurochemical pathways. In this episode Dr Walsh shares his expertise on the biochemistry driving violent behaviour and other mental health conditions and how he has successfully used nutrients to correct these imbalances.
Covered in this episode
[00:40] Welcoming Dr William Walsh
[01:35] The biochemistry of violent behaviour
[05:56] Determining nutrient imbalances in the brain through lab tests
[08:05] Using nutrients to treat imbalances
[14:13] How diet factors into mental health
[21:09] Discussing copper and other nutrients that influence behaviour
[28:12] Nutrient Power and the future of nutrients in mental health
[29:40] What to expect from Bill at the 2020 BioCeuticals Research Symposium
[31:56] How to find a “Walsh-educated” physician and using nutrients as adjunct treatment to mainstream psychiatric medication
Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook. Joining us on the line today is Dr William Walsh. He's the President of the nonprofit Walsh Research Institute near Chicago, and a key scientist driving the development of nutrient-based psychiatry. His book, "Nutrient Power," which describes an evidence-based nutrient therapy system is the result of his over 30 years of research and clinical experience. In addition to ongoing research studies, Dr Walsh directs an international physician education program in the US and in Australia, teaching advanced biochemical nutrient therapies, which is now used by over 800 doctors throughout the world. Welcome to FX Medicine, Dr Walsh, how are you?
Bill: I'm just fine. I'm really looking forward to coming to Melbourne next April to speak at the BioCeuticals Research Symposium.
Andrew: I am champing at the bit to meet you in person and to learn more about what you have garnered over the years of research and experiences as we said. Let's go back a little bit in history though. You studied the biochemistry of violent criminals for many years.
Bill: Now, that's how I started. Exactly. I was actually a prison volunteer and I wasn't involved originally in research but I was working at Argonne National Laboratory. And my program basically just grew and grew and eventually I had 125 people volunteering and helping at Stateville Penitentiary. But as we went on, I started a ex-offender program trying to help prisoners when they got out, helping them to not repeat what they had done. And I met the families that had produced a criminal, and that's how I really got started. I learned that many of these people, many of the criminals came from really good families with other brothers and sisters who turned out fine. And we realised we didn't understand what was the cause of violent behaviour. And since I was at a research organisation, I started doing chemical testing trying to see if I could find differences. And that's really how it all began.
Andrew: Okay. So just going back a little bit further than that. What tweaked in your mind that it might be biochemistry based, you know, this cause of violent behaviour?
Bill: Well, the reason was that before that, myself and most people in America, and probably Australia too, had the belief that criminals basically were that way mainly because of trauma, especially early in life or poor parenting and life experiences, basically. And what I learned in talking to the families was they were telling me that these children were, some of them were doing terrible things by the time they were two years old, and they were shocking and horrifying the parents. And so I began to believe there had to be something else, something innate, that they were born with a tendency for bad behaviours, or at least I was questioning that. So I started doing experiments to see if they were different, focusing on doing blood and urine testing to see whether I could find something related to brain chemistry.
Andrew: What about nature versus nurture? What about just being born bad, your genes?
Bill: Well, what I learned is that the recipe for a criminal really is to have inborn, bad chemistry that predisposes to that, and then to have a bad environment. That would be the worst possible combination.
Andrew: Right, so the perfect storm. And what about the most common nutrient deficiencies or imbalances that you see in individuals with mental health, behaviour, learning disorders, that sort of neurobehavioral disorder?
Bill: Well, that was one of the biggest surprises to me because anyone who studies biochemistry knows there are hundreds of important nutrient chemicals and biochemicals. And what I found was that the same chemistry of balances were turning up in behaviour disorders, learning problems, depression, mental illness, and I kept wondering why we keep seeing the same ones. Well, it turns out that we learned eventually there were six, there basically are six nutrient imbalances that dominate mental health. And this is a really fortunate thing because it would be really hard to try to do lab testing for hundreds of factors and even more difficult trying to normalise dozens and dozens of factors. And this is really the good news. It turns out that there really are only six primary nutrient imbalances. And the reason is they're the ones that are directly involved in the synthesis of neurotransmitters or in the functioning of neurotransmitters, and that's why they keep turning up. So there are six of them. And we focus on testing and normalising those six imbalances. If a person happens to have an imbalance, we normalise them. And it's been very successful so far.
Andrew: You know, I've always remembered something that my psych nursing lecturer said to me, and that is, it is only a matter of years, perhaps 20, now this is back in the '80s, where all mental illness is deemed to be of a biochemical nature. The questions though still persist about how do you measure what's going on in the brain by measuring what's going on in the serum or the urine? So how do we get to that sort of stage? What's the correlation there?
Bill: Well, that certainly is the challenge because we're not going to be able to do samples directly in the brain or brain fluid.
Andrew: Certainly not willingly.
Bill: Unless you want to do cerebral spinal fluid testing…
Andrew: No.
Bill: …which I've never found anybody yet who wanted to do that, including the doctors. No. What we've learned is that I've now seen more than 30,000 patients for whom I've done pretty extensive lab testing.
Andrew: Wow.
Bill: I think I have the world's largest chemistry database for depression, for schizophrenia, for behaviour disorders like ADHD and even autism. And by looking at these studies and mining this data and studying it, we find that there are distinctly chemical imbalances related to specific mental disorders. And there also are symptoms and traits associated with specific mental disorders and specific chemical imbalances. For example, people who are undermethylated are, in general, they have about 10 or 15 really typical tendencies that are different from other people. So we could do a good job of diagnosis by doing first a really quality, careful medical history, which gives us a lot of clues to their chemistry. And then of course, to do some of the lab work that can, the two together, can make us very confident about diagnoses. And I think we're maybe 95% accurate in this process.
Andrew: Yes. So when we're talking about these nutrients, like the ones that always stick up in my mind are the very simple ones, zinc, B6, magnesium over and over and over again. But, you know, when you speak about methylation, then we'd be talking more the B12, the folates, and things like that, perhaps the zinc as well. How do you clinically tease apart what's happening in methylation depression? And do you work on the methylation cycle per se, or do you look upstream with what's happening biochemically?
Bill: Well, I've learned that the methylation cycle is important. However, doing that alone and looking at the SNPs is not nearly enough to learn how to help a patient. You have to fold in the epigenetic effects and the combination of mastering methylation and also taking into effect the epigenetic effect, which is not the SNPs. The SNPs have to do with the quality of the proteins that are genetically expressed.
Andrew: Yep.
Bill: The epigenetics has to do with the rate, the kinetics of gene expression…
Andrew: Right.
Bill: …and they're equally important. And you cannot just study one by itself, or else you'll often get the wrong answer. And I think that's really been a major advance in being able to help patients is to do the both together. One classic example is a large number of undermethylated people have low serotonin depression. And we know that if you want to improve methylation, you might want to give them Methylfolate or folic acid or folinic acid, and that would help their methylation, the problem is these patients would get dramatically worse. Worse because of epigenetics. Because of epigenetics, folates lower serotonin neurotransmission. And so you really need to be aware of both and make sure that you are counting for both together. Really works out beautifully.
Andrew: And what about substrates here, like for instance, you know, tyrosine, tryptophan? How effective are those? Years ago they were used, tryptophan in very high doses until of course there was an issue with manufacturing. But how effective are they in making substrates for say serotonin or dopamine?
Bill: Oh, that's absolutely an important question, and just to go back historically, starting in about 1965, that was the time when the biochemical revolution hit psychiatry and people started focusing on neurotransmission and receptors and the biochemistry of the brain. And for about 30 years, up until 1985, the focus both in pharmaceutical companies and in researchers and people like us was trying to change the amount of the neurotransmitter, like the, trying to use the precursors for say, serotonin…
Andrew: Yes.
Bill: …and tryptophan and that sort of thing. And however, 1985 was a key time because they asked when science learned that the amount of serotonin and dopamine and norepinephrine, the amount of the neurotransmitter is not nearly as important as reuptake. Reuptake is sort of a 90% effect whereas just the amount of serotonin and tryptophan and that's only about 5% or 10%. And so we're now focusing on nutrients that can affect reuptake and basically we can we can adjust neurotransmission through epigenetic therapies. So it's a far more effective than working with the precursors.
Andrew: The Orthodox physician would say, "We'll just go the SSRIs or the SNRIs and be done with it." But we still can lack the substrate going in there. I mean, a reuptake inhibitor only works on that which is there to reuptake. So how do you balance that?
Bill: Well, with nutrients, we can do exactly what Prozac and Paxil can do. What is, what do Prozac, Paxil, and serotonin and all these antidepressants do? They get into the body and into the brain rather quickly and they interact with reuptake, that is the process by which neurotransmitters like serotonin injected into a synapse quickly return to that original neuron. And what they do is they disable these passageways, these reuptake passageways, they're called transporter proteins, they’re really ion channels. And what we can do with nutrients, we can affect the population of those passage ways. So what we, the way we could do this with epigenetics and methylation, we can use something like SAMe or methionine…
Andrew: Yep.
Bill: …and we can reduce the genetic expression of those reuptake proteins on the neurons. And so while the drugs can sort of inhibit the function of them, we could adjust the number of them. And so we could actually accomplish the same thing. We can only have nutrients therapies that are very effective at changing neurotransmission rates, and we could do it just as well as the pharmaceuticals, although the pharmaceuticals could do it more quickly. They can make you do something in two or three days that might take us six or eight weeks to accomplish.
Andrew: Right.
Bill: But we can get the same thing done without side effects. It's more inexpensive and it normalises the brain. We don't have to put a foreign molecules into the brain like psychiatric medications. We can use nutrients and we can actually normalise the brain and correct many of these problems without any side effects.
Andrew: And what about general healthy diet? You know, and here I'm going to obviously concentrate on vegetables. You know, we've got Professor Felice Jacka in Melbourne doing really good work showing that a good diet affects mood. You've got Julia Rucklidge at Massey University in New Zealand using just a very...it's not an extremely high dose multivitamin mineral and yet she's showing mood improvements as well in certain cohorts like ADD, that sort of thing. So how important is just general diet? Because we know that people from lower socioeconomic groups are more likely to commit crime and we also know that people from low socioeconomic areas are more likely to have a poor diet. So where does the diet fit in and the nutrients on top? You know, like, how do you balance that nutrient-specific versus broad nutrient intake?
Bill: Well, a bad diet, an improper diet can actually aggravate a problem. And it's more of an aggravation than the cause itself. And the question really is what is the proper diet for a person? And what we've learned is that, that really all human beings have biochemical individuality. And the best diet for one person might be the worst diet for someone else. For example, a person who is overmethylated, and we can identify that with testing, they thrive on green vegetables and fully rich nutrients. However, undermethylated people, for them that usually makes them worse…
Andrew: Oh.
Bill: …and they thrive on a protein-based diet. So it's highly individual. And it's important to know what a person's individual biochemistry is, even with diet, not just with nutrient therapy or other methods of treatment. You need to know a person's individual diet. Every person, if we were to do it, yourself or myself or anybody listening to this, were to a complete metabolic analysis, they would probably find that they had four or five or six key nutrients that they were deficient in because of genetics. And they would thrive, they would do really well if they had many times the RDA of that because they're fighting genetics. But the truth is that nutrient overloads usually cause more mischief than deficiencies.
Andrew: Right.
Bill: And that's why I never recommend multiple vitamins indiscriminately to someone because included in those multiple vitamins and minerals are things that are really harmful for the individual.
Andrew: Got you.
Bill: So it's all individual.
Andrew: Could this suggest that your data can actually group different types of patients with various mental illnesses?
Bill: Well, absolutely correct. It took a while for our database to get larger and larger, but a couple of years ago, I went to the annual meeting of the American Psychiatric Association which there were I think 20,000 psychiatrists from all over the world, and I basically told them they were doing...I thought they were doing depression all wrong. Mainstream psychiatry believes that most forms of depression involve low serotonin activity and the treatment of choice usually is to start with antidepressant medications. What I explained to the group was that my database indicates there are at least five completely different disorders that are biochemical disorders that are that are called depression. It's like an umbrella term for completely different disorders involving different neurotransmission abnormalities or different neurotransmitters and requiring different treatments, yet we're giving the same thing pretty much to everyone. And so I showed them what the different types, the biotypes of depression and the neurotransmission abnormalities that needed to be corrected and how each one needed completely different treatments. And I believe that's exactly what's going to be happening in future years.
Andrew: Right.
Bill: Depression is not a single disorder. It's a name given of completely different disorders.
Andrew: Why though isn't nutrient therapy more widely accepted with treating mental illness?
Bill: I have to say that in our physician training programs that are now in several countries, our most enthusiastic doctors are psychiatrists.
Andrew: Right.
Bill: They absolutely love to be able to take a patient and instead of just spending half an hour, an hour with them, stroking their beard wondering, "What medication shall I give this person?" They can now do an extensive lab test. They can identify which neurotransmitters are misbehaving and in what direction, and it could guide them even with identifying the best or the most promising medication, but also like it could show them how they could help these people by correcting their chemistry in more natural manners.
But I wondered the same thing. I wondered why after all these years? I mean, I presented at the United States Senate, at the Surgeon General's office, at neuroscience meetings and you know, all the major meetings. Everybody would say, "Gee, that's interesting," but, you know, nobody would believe it. And I finally realised they didn't believe that nutrients would have the power to help people. They would say, "Don't you really need a powerful drug to get the job done…
Andrew: Yeah.
Bill: …if you got a person who's got a serious problem like suicidal depression or schizophrenia?" And the answer is, not necessarily. And that's why I finally decided to write a book, I called the book, "Nutrient Power.” I think that's what is really needed with mainstream medicine, for them to realise that nutrients can have great power, especially now that we understand methylation and epigenetics far more better than we did before.
Andrew: Yeah.
Bill: But it's really changing. I went through more than 30 years of frustration trying to convince the world that this can be really helpful and is the wave of the future. But it's really getting better. Just in the last seven years, sorry the last seven months, I've been invited to be a keynote speaker at six different conferences in Europe.
Andrew: Why?
Bill: So I think people are finally getting it or at least are starting to question it.
Andrew: Yeah.
Bill: So I think we're just recently starting to make real progress and we're getting closer to being accepted by mainstream medicine. And I really think what we do has to become mainstream medicine essentially.
Andrew: Right. You must have had some great cases you've been involved with over the years. Are there any specific ones that either got a dramatic improvement, which we'd love, but also any ones that you've had a dramatic deterioration in their mental health?
Bill: Well, right. Anything that can really help a person can harm them if you're doing it in the wrong direction. We, for example, methylation is always extremely important to get that diagnosis right. We need to know whether a person is overmethylated, undermethylated, or through one of the 80% who have normal methylation. Because, if for example, if you gave folates, methylfolate to an undermethylated depressed person or undermethylated bipolar or schizophrenic, they will get worse, even though the folates would improve their methylation. Another example is postnatal depression. That's one of the five types of depression that our databases identified. And these people basically have postnatal depression because of extraordinarily high copper levels, the copper levels escalated more than 100% during the 9 months of the pregnancy, and they don't have the genetic capability to normalise copper. Their copper level is supposed to come right down after the baby is born. And they don't have that capability. Well, it's really high copper levels. That means you're going to have extraordinary high norepinephrine and adrenaline levels. And that's a recipe for high anxiety, for depression, and in some severe cases, psychosis. And we've now done hundreds of postnatal depression patients and they're probably the easiest people of all to help. It takes about six months to carefully normalise their levels of copper, and zinc is the primary nutrient…
Andrew: Yeah.
Bill: …that helps you do that because zinc stimulates the metallothionein proteins that are genetically expressed and they're the ones that have the job of regulating copper. But that's a group that we're more than 90% successful with. And the typical patient with bipolar, I’m sorry, postnatal depression who may have suffered for 20 or 30 years with this condition, most of them become quite okay after two to three months and they can throw their medications away.
Andrew: Right. Can I just ask a quick question here about genes? What genes influence copper metabolism?
Bill: Copper is primarily managed by the genes that, the metallothionein family of genes.
Andrew: Right.
Bill: There are four members of, four genes that are metallothionein genes. And they have a number of roles in biochemistry, but one of them is to regulate copper. And they do that, if for example a person's copper level elevates in their blood, that will be sensed and what happens then is that there's a great increase in the genetic expression of metallothionein which then essentially grabs onto some of this copper and prevents it from getting into the bloodstream. And that's how copper is regulated. Copper is so important to a human being, especially for mental health, that we need to have copper normalised for that pretty narrow range. And most of us have a system that works really beautifully. And you could actually be chewing on copper bars all day long and your copper level would be okay if your natural biochemistry is working.
Andrew: Yeah.
Bill: But some people don't have the ability. Some people have SNP mutations in their metallothionein genes. And they're the ones who are prone to postnatal depression or other conditions involving high copper, or even that's one of the biotypes for schizophrenia, by the way, is really elevated copper.
Andrew: Right. Yeah, I see in Australia, it's not quite a paranoia, but it's certainly an aversion to copper, and yet it's an essential nutrient, an essential mineral. However, some areas of Australia, particularly Western Australia, have intrinsically high copper levels, not necessarily due to the piping that was used, just high copper in the water. But it seems also to be, you know, sort of moving its way over to the Eastern Coast. I'm not so sure about this. My question to you is do you see geographical influences of behaviour, if you like, from nutrient availability in soils? Do you find that this plays an important part or is it more just that person's genes and how they handle things?
Bill: It's an important part. It's definitely an important part. And Australia is well known for mining of metals. And I don't think that's a coincidence that people in Australia, or when I've been there, I've tested more than a few thousand people, that they have a higher incidence of metal metabolism disorders.
Andrew: Gotcha.
Bill: The Middle East, I was contacted recently by government people who wanted me to participate in a study of zinc levels in the Middle East, in Iraq, Iran, Afghanistan, places like that. And turns out the zinc in their soil and in their waters is extremely low. And so the question is, is that one of the reasons why they tend to be a bit more violent than other populations? Yes, I think that that is an important part of it. You have to have the right substrate, the right nutrients going into the body in order to have the proper levels.
Andrew: Yeah.
Bill: And again, I want to mention, elevated levels are also especially important, especially if you have high exposure to things like mercury or lead nasties.
Andrew: Ah.
Bill: But also if you have too much copper or too much iron, that can cause all kinds of problems with the population. So, yes, it's important.
Andrew: Yeah, okay. Bill, I have to ask a question regarding zinc and the forms of zinc, the ligand that zinc is joined to. For instance, we know that in Wilson's disease, it's zinc acetate that's the preferred or accepted treatment. How different is the ligand to carry the zinc to where you want it to go?
Bill: It really doesn't matter that much. The reason why zinc acetate was used for Wilson's is that Dr Brewer who basically discovered this therapy, which I think is a wonderful achievement by him, he patented zinc acetates for that.
Andrew: Right.
Bill: But basically any form of zinc will work very nicely with Wilson's.
Andrew: Bill, you mentioned your book earlier, "Nutrient Power." What was the spark that drove you to write that book?
Bill: The drive to write the book was the frustration that after years and years of having of what I thought was wonderful data and good science and presenting it at meetings and journal articles, and that I was just simply was not able to really dent mainstream medicine. And I thought I needed to write a book to get this all in, you know, get at least part of it in print, and to try to basically change the system. We need to know the importance of nutrients and how they can be really effective in treating some of these major conditions.
Andrew: You've also said that there's growing interest, especially amongst psychiatrists with regards to your treatment programs. We know that, say, behavioural modification, CBT DBT, that they're showing dramatic improvements in mental illness, but I wonder about prolonged influence in mental illness. Do you think nutrients will ever replace drugs fully in the treatment of mentally ill patients?
Bill: Yes, I'm convinced that's going to happen. I think as science advances, as time passes, I think psychiatric medication, most of them will fade away from society.
Andrew: That's pretty powerful statement. I'll tell you, we have so much to learn from you. And so without giving too much away and taking five hours to do it, you'll be speaking at the BioCeuticals Symposium in Melbourne in April 2020. What topics will you be covering in your talk that we can change our treatment for our patients?
Bill: Well, I'm going to be describing recent breakthroughs, especially in epigenetics, methylation, and neuroscience, and these breakthroughs have greatly improved our clinical capability. We can do so much more now than we could 10 years ago because we basically understand more. And a lot of it's been neuroscience, because our focus is on mental health and brain function. Specifically, some of the things I'll be talking about, I think everybody needs to know about the, especially practitioners, need to know the six nutrient imbalances that have a greatest impact on brain function. And I'm going to discuss how to correct them without drugs and really change and improve mental functioning. I think I should spend quite a bit of time on methylation and how to master methylation. And it's a lot more than just getting SNPs and looking at the genetics. And then another topic, I really think that the last 10 years, the greatest advances we've had are these novel epigenetic therapies that can regulate gene expression. See, in the past, prior to epigenetics and understanding that, we could give people tryptophan and you know, we can work on the reactants that create neurotransmitters.
Andrew: 5-HTP, yeah…
Bill: A really powerful thing is the regulation of gene expression, the epigenetics, the reuptake, we can do that now. We can now change the expression rate of enzymes. We can actually with nutrient therapy with science, we can know what we're doing and we could actually up regulate or down regulate specific enzymes, and we never had that power before.
Andrew: Right.
Bill: I guess those are three of the major things I'd like to talk about.
Andrew: And I do want to do a bit of a call out, if you like. For those individuals, for those practitioners, who, you know, it may not be their area of expertise and they might be faced with a patient with a behavioural or neurobehavioral issue, where can individuals find a Walsh-educated physician so that they can pass them on to a more appropriate practitioner?
Bill: Well, we now have just past 800 of them. And on our website, which is www.walshinstitute.org, we have a list of many dozens of them. I think we must have at least 30, 40, or 50 from Australia who we give their contact information. We've got some really brilliant doctors from Australia that are some of the best nutrient therapists in the world.
Andrew: I do have to also ask, you were talking about before throwing their medications away. That may not be appropriate certainly with for a non-medical doctor in Australia.
Bill: I'd like to talk about that. I think medications, psychiatric medications have helped millions of people, and I don't think they should just throw them away. We need to, and for science to advance, to learn how we can achieve the same results that they can get with medications, I'm certain that we'll learn how to do that without having to resort to foreign molecules like drugs. But at this time, medications are extremely important. And I think that we'll gradually, as science advances, learn how to replace them with better treatments.
Andrew: Yeah. I do remember, I do recall a study that used even just, I think it was zinc, to help SSRIs to work more effectively and it was shown to be safe. So I guess there's this period, I'm interested in about this period where nutrients can be used as an adjunct to help the patient in, particularly through a difficult time.
Bill: You're right. And actually, with these 30,000 patients that we have worked with, I would say that probably 80%, 90% of them were on a psychiatric medication that was helping them to some degree, in some cases totally, in other cases partially. Once we would do our clinical work and we could identify chemical imbalances that can be corrected with nutrients, what we would do is we would demand, we would insist they stay on their medication at least for three or four months and do both treatments together. Do the drug medication together with our nutrient therapy.
Andrew: Right.
Bill: But after we have normalised their chemistry and we have a new reality, then we suggest that they go back to their psychiatrist and very slowly and carefully test lower and lower levels, really to see what the optimum dosage of the drug medication is now that there's a new reality, some of the problem's corrected, in some cases, all of it. And so the drug medications are a key part of our nutrient therapy in that they're in harmony with each other. Nutrient therapy is in harmony with pharmaceutical medications and they work well together. And what happens with depression for example, about 80% to 85% of the patients we work with, with depression report to us or their doctor's report that they are greatly better. And so we also find out that when they do this, try to wean from the medication or at least to see where they're at their best, that roughly 80% tell us that they're at their very best was zero that occasion.
Andrew: Ah.
Bill: However 20% of our patients who have done the nutrient therapy tell us that if they go all the way to zero that they lose something.
Andrew: Right.
Bill: And we say, so be it. We are not against medications. We just want people to be functioning at their best.
Andrew: Sage advice from a true expert. Dr. Bill Walsh, I could talk to you forever. There's so much to learn. And I'll tell you, I feel like I've just chipped the very tip of the iceberg. I would urge everybody who's interested in helping their patients with mental health disorders, neurobehavioral disorders to learn more from Bill Walsh, either, if they're medical doctor from Bio-Balance in Australia and the Bill Walsh Institute over in America, and certainly by attending 8th BioCeuticals Symposium in Melbourne in 2020. Dr. Walsh, thank you so much for explaining some of the neurochemistry to us today. This was very, very enlightening. Thank you so much for joining us on FX Medicine.
Bill: Oh, you're certainly welcome. I enjoyed talking to you and I look forward to the symposium.
Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.
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