Tag Archives: immune-resilience

Address Your Stress To Build Your Immuno-Resilience


As we tread lightly through a new reality of measured social distancing, infection prevention, and economic uncertainty, stress has risen to the forefront of many people’s lives. This month’s theme is immuno-resilience. In this third blog post in the series, we dive into how stress can directly affect the functioning of the immune system through the interface you all know I love to talk about — the gut. 


If you are like most people, you are experiencing an amplified amount of stress these days, or you’re living with someone who feels amped up by the circumstances, which adds to your stress. Whether you turn on the news or read the latest headlines, you can quickly feel the effects of stress and how they impact our bodies and minds, including the functioning of the immune system. 


A Gallup poll found that 55 percent of Americans often feel stressed out. Researchers noted that for so many of us, stress, worry, and anger have become intensified.1 That poll was from 2018. With the Covid-19 pandemic unfolding, I can assure you that number is most likely higher.


You cannot control what happens outside of you or what happens to you, but you can certainly control your internal state of mind. Ultimately, how you respond to stressful situations is really the only thing that you have control over. It’s as simple as that, but not so simple to implement.


Stress Impacts the Gut and Immune System

Worrying, getting angry, and arguing with others does not change the external events that have transpired. In fact, they damage you by promoting the release of stress hormones and putting you into that fight-or-flight response that sets your entire body — including the immune system and the gut — on high alert.


Stress is a huge factor for how your gut behaves or misbehaves. If you’re constantly feeling stressed out, your gut is also unhappy. I often say that… 


Stress is like an attack on your gut!


And what impacts the gut — more specifically, the quality and diversity of the bacteria within the gut — can also impact the immune system.2 


A little bit of stress is normal and even healthy. But that stress response, when it stays in overdrive long after it no longer serves you, can exacerbate symptoms throughout the body, including increasing autoimmune symptoms and susceptibility to infections.


Even before this pandemic began, for years I have seen how stress plays out in various gut-related problems among my patients. I think of stress as the unmentioned proverbial elephant in the corner of the room — it is omnipresent, but often ignored. And we cannot ignore it any longer, because…


Stress sends ripple effects throughout the body.


Chronic stress can lead to digestive enzyme deficiencies. Stress is a common cause of low stomach acid, which can lead to multitude of issues, including SIBO (small intestine bacterial overgrowth), an increased risk of bacterial infections, and an inability to efficiently break down protein. As a result, some patients also struggle with depression because of a deficiency of the amino acids (from inadequate protein breakdown) that are needed to create neurotransmitters for healthy brain function, happiness, and satisfaction.3


Over time, these gut imbalances can contribute to problems including leaky gut syndrome. Studies show that chronic stress can increase permeability of the gut lining.4 Over time, that condition — more commonly called “leaky gut” — can lead to obesity and increase your risk of infections.5 6


The take-home message here is that there is a clear and strong connection between stress, your gut health, and your immuno-resilience


If you want a strong immune system, you need to work on lowering your stress levels…


which very likely will involve increasing your mental resilience to what life throws your way.


Stress, Gut Health, and Mood Disorders

The inflammation that stress can create can actually change the levels of neurotransmitters and increase the secretion of stress hormones. Many of these neurotransmitters are made in the gut.


Consider serotonin, one of the molecules of emotion and the signal for a “happy mood” in the brain. More serotonin receptors are found in the gut than in the brain. In fact, 


95 percent of serotonin found in the body is produced by the gut’s nervous system. 7


Being in charge of producing so much of this “happy chemical,” along with 40 other neurotransmitters, it’s no wonder the gut is central to feeling happy and feeling balanced.8 I’ve talked elsewhere about how yoga, meditation, and breathing exercises can help you balance the parasympathetic (“relaxing” arm) and sympathetic (“fight-or-flight” arm) of the autonomic nervous system. You can learn more breathing exercises here.


When you find yourself getting wound up because of stress, you can easily access the parasympathetic nervous system through breathing and meditation to return your body to a natural state of balance. Through yoga with coordinated breath and movement, you can change your internal focus towards health, connection and calm within minutes.


What Impacts the Gut Also Impacts the Immune System

About 70 percent of the immune system exists in the gut as the gut-associated lymphoid tissue or GALT.9 When production of serotonin and other neurotransmitters becomes imbalanced, the immune system also suffers.10 


Gut health can impact the immune system in so many ways. Studies show that various stressors such as maternal separation can alter the composition of the gut flora, contributing to dysbiosis or an imbalance between good and bad gut bugs. The ways that you manage stress can influence both the diversity and complexity of that gut flora, which when negatively affected can subsequently weaken the immune system.11 

 The overall consensus is that when you learn to manage stress, the gut improves. When the gut lining is strengthened, the immune system becomes stronger. I for one know this, because 


“I suffered from a weakened gut and weak immune system throughout my teenage years, and as result dedicated my life to figuring out how to improve my gut health and fortify my immunity to build immuno-resilience.” 


Learning to manage how I reacted to stress was a key part of this journey. 

What ultimately matters with managing stress is to find tactics that work for you. With the recent increase in stress levels, some of my (virtual) patients are asking me about additional ways they can lower stress levels without resorting to pharmaceutical drugs and other invasive measures. There’s not one right way to do so for everyone, but there are scientifically proven avenues to dropping your stress-o-meter.

That’s why I wanted to provide these Four Anti-Stress Strategies. Along with eating a Happy Gut®-friendly diet and maintaining healthy lifestyle factors to nourish the gut-brain connection, these are additional and sometimes overlooked ways to help manage stress levels.



Anti-Stress Strategy #1: EAT FERMENTED FOODS

One of the most powerful, effective ways to lower stress levels and boost immunity is with foods. I’m talking about things like leafy and cruciferous vegetables as well as berries and low-sugar fruits, of course, but also fermented and cultured foods, which can support the growth and proliferation of your “good” bacteria


Probiotics including Lactobacillus and Bifidobacterium can help the brain better manage mood disorders including stress.12 These probiotics are found in:



[1] Cultured foods, such as yogurts or kefir

[2] Fermented foods, such as fermented vegetables, sauerkraut, and kimchi 

[3] Cultured beverages containing favorable live bacteria, such as kombucha or Coconut Water Kefir 


Among their many benefits, probiotics or healthy gut flora can help improve mood disorders. In animal studies, the probiotics in these foods can lower anxiety levels.13 Another review that looked at a wide range of probiotic strains concluded that overall, they had a positive effect on depressive symptoms.14


Probiotic foods also support the production of gamma-aminobutyric acid or GABA, the brain’s major inhibitory neurotransmitter. 


GABA can help you relax, reduce stress, feel more calm, maintain a balanced mood, reduce pain, and improve sleep levels. 


Some foods that contain GABA include teas (green, black, and oolong teas) and fermented foods such as kefir.15 


A century ago, researchers found how kefir can impact mental wellbeing. George Porter Phillips observed how patients in a London hospital with depression struggled with severe constipation, which showed up in their appearance. Whereas others believed depression was the cause of these problems, Philips had another suspicion: THE GUT.


Phillips gave these 18 patients kefir, which contains lactobacillus bacteria. His experiment was among the first proof that…


To improve well-being, you need to start with the gut. 


Of those 18 patients, 11 were completely cured and two more showed significant improvement. Even 100 years ago, we knew about the healing powers of this fermented drink.16 17


Maintaining healthy levels of GABA can help you better manage stress levels.


In one study, mice were divided into two groups. Some got probiotics; others received broth. They then measured GABA levels. Overall, the mice that received probiotics had a lower stress response. Interestingly, the mice that had their vagus nerves severed didn’t get those benefits from the probiotic. This highlights how the probiotic can communicate from the gut to the brain. When the vagus nerve becomes impaired, as often happens under stressful situations, that communication can’t happen.  


Anti-Stress Strategy #2: DRINK HERBAL TEAS

If you’re familiar with essential oils, you know the calming benefits they can provide. Lavender, for instance, has a long history of benefiting conditions like stress, anxiety, depression, and insomnia.18 


This flowering herb is grown for its essential oil, which can be applied topically. Lavender tea also supports a variety of issues, including:

  • Anxiety
  • Insomnia
  • Depression
  • Restlessness
  • Digestive issues such as vomiting, nausea, intestinal gas, upset stomach, and abdominal swelling
  • Pain from headaches, sprains, toothaches, and sores
  • Prevent hair loss19


A variety of herbal teas can help manage stress levels. Some of my favorites include [1] passionflower, [2] chamomile, and [3] kava. I encourage people to experiment with their own herbal teas to discover their unique stress-relieving properties. 



  • Contains Apigenin (antioxidant) that binds to specific receptors in the brain to promote calmness20 
  • Helps Soothe an upset stomach, and makes a great post-dinner digestive
  • Supports Intermittent Fasting to get you through those late night hours (topic for another future post)


Gut-Soothing Calming Tea

[1] Purchase dried chamomile flower pods at a health-food store

[2] Bring to a boil in a pot

[3] Simmer for 10 – 15 minutes. 

[4] Drink it warm or make a refreshing iced chamomile tea with a sprig of fresh mint leaf.


Some teas might combine calming herbs for a synergistic effect. To make a stronger, more medicinal tea, simply steep the tea bag for up to ten minutes. 


While it’s not an herbal tea, green tea provides its own unique stress-managing benefits. It contains a calming amino acid called L-theanine. One study found that students who drank green tea had a lower stress response than those who didn’t. Caffeine could inhibit that calming benefit, so opt for a decaffeinated green tea.21 Or go for my favorite combination of green tea, lemon verbena, spearmint and lemon grass in Tazo® Zen Green Tea.


Anti-Stress Strategy #3: TRY CBD OIL

A newer but very powerful supplement to manage stress, support the immune system, and so much more is CBD oil. 


This oil is derived from cannabidiol (CBD), a cannabinoid found in cannabis plants. CBD oil often comes from hemp flowers, which are rich in CBD but low in the tetrahydrocannabinol (THC) that gives cannabis its psychedelic, mind-altering qualities. As a supplement, CBD is attached to a carrier oil so the body better absorbs this chemical compound.

CBD interacts with specific receptors in the nervous system. It can impact levels of serotonin, your “feel-good” neurotransmitter. Low levels of serotonin are associated with depression, anxiety, and increased stress levels.

Studies show that…


CBD oil can help reduce anxiety and stress-related conditions. 


In fact, CBD can help address generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive–compulsive disorder, and post-traumatic stress disorder.22 



[1] Lowers Inflammation 

[2] Supports Digestive Concerns, including stomach swelling and bloating

[3] Helps Gut Mobility, the stretching and contractions of the muscles within the gut23 


Research has shown that CBD oil may help with irritable bowel syndrome or IBS, which stress and anxiety can worsen, by lowering inflammation, improving gut motility, and lowering the frequency and intensity of spasms in the gut to help better manage discomfort.24


CBD oil is also ideal for immune system support. It binds to the CB2 receptors in the brain, spleen, and leukocytes, helping to lower inflammation and support the immune system.25 CBD oil also increases the body’s white blood cell count to better handle infections.26 27  


We are still learning about the effects of CBD oil on the immune system. Some research shows that CBD is immune-suppressive: It can promote apoptosis or cellular death, for instance, eliminating harmful cells. CBD oil can also suppress or enhance cytokines, suggesting that it serves a role in regulating the immune system and inflammation. Other research shows that CBD oil is immune-enhancing, perhaps due to its stress-reducing effects. Because of its anti-inflammatory benefits, CBD oil also shows great promise for autoimmune diseases.28 


CBD oil shows a lot of promise for many other conditions, including:

  • Anxiety
  • Depression
  • Acne
  • Brain Health
  • Heart Health
  • and even for some Cancers


Research for CBD oil is still in its infancy, but what we’ve learned so far shows great promise to help people manage these conditions better.29 


Anti-Stress Strategy #4: TAKE DIGESTIVE ENZYMES (to increase protein intake)

One of the best things you can eat to manage stress levels is protein. The amino acids in protein help form the building blocks for neurotransmitters, such as serotonin. As I’ve said before, balanced levels of serotonin30 and other neurotransmitters will help you better manage stress levels.


Getting sufficient protein can help stabilize the body’s blood sugar levels, eliminating the spikes and crashes that can make you moody, irritable, and stressed out.  


Without a sufficient amount of digestive enzymes and hydrochloric acid in the stomach to break down that protein, however, the gut wouldn’t be able to absorb those critical amino acids that play important roles to support the immune system, repair and build tissue, and provide the building blocks for all the enzymes that power your cells. A plant-based digestive enzyme can provide that support to help break down protein and other nutrients the body needs to thrive.


I wasn’t happy with the digestive enzymes on the market, so I created my own with HAPPY GUT® ACTIVATE. This full-spectrum digestive enzyme includes everything the gut needs to break down food and properly absorb nutrients; 

  • Carbohydrate-digesting Enzymes: amylase, glucoamylase, cellulase, hemicellulase, diastase, beta-glucanase, and invertase
  • Protein-digesting Enzymes: protease, acid protease, alpha-galactosidase, protease SP
  • Fat-digesting Enzyme: lipase


This digestive enzyme is also helpful for the improved digestion of plant foods like grains and beans, as well as dairy products, which commonly induce digestive upset.


That’s why I include HAPPY GUT® ACTIVATE in my 28-day GUT C.A.R.E.™  Program that I outlined in Happy Gut® . To ensure that you are getting sufficient protein, the program also includes 2 canisters of HAPPY GUT® CLEANSE SHAKE. This gut-healing, fructose-free, hypoallergenic, vegan protein powder supports gut health, supports the immune system, and balances blood sugar so you no longer struggle with hunger and cravings.


Starting your day with a protein-rich meal provides the support your body needs to thrive throughout the day. Many patients have told me they don’t have time or the appetite for breakfast. A protein smoothie makes the ideal solution. In fact, research shows people who eat protein at breakfast tend to feel less hungry throughout the day and consume less calories, not only helping to keep your mood happy but also your waistline trim.


Amidst the Covid-19 pandemic, immune health support has become a very hot topic. What some experts overlook, unfortunately, is the gut-immune connection. 


When the gut is healthy, the immune system has a strong defense system…


against the viruses and other pathogens the body is exposed to. A strong gut forms a barrier against these invaders. It can break down and absorb nutrients to provide what the immune system requires to work well. A healthy, happy gut manufactures the right neurotransmitters to better manage stress levels.


The 28-day GUT C.A.R.E.™  Program provides all the foundational tools the gut needs to heal and stay strong. This is the same protocol that I’ve used with thousands of patients to heal gut problems and support their immuno-resilience

You want to do everything possible to keep a peak-performance immune system. That starts with the gut, by providing the nutrients it demands… So that you can thrive and build immuno-resilience during this pandemic and beyond.



 Given the significant impact the Covid-19 Crisis has placed on us from the limited nutrient-dense foods available, toxins from cleaning solutions, and added stress — ALL gut-compromising — we want to provide for the first time ever, not $100, but $200 OFF* the HAPPY GUT REBOOT:  28 -Day Cleanse.

We KNOW this to be our best offer not only because of the price, but rather because of the results this program has provided to many patients of my practice who have reversed their gut-related health issues by treating the underlying cause — the GUT.




The HAPPY GUT REBOOT:  28-Day Cleanse includes: 

  • HAPPY GUT® CLEANSE SHAKE: support for the overall metabolic detoxification process (two 14-day containers)
  • HAPPY GUT® ACTIVATE: support for digesting all three macronutrients
  • HAPPY GUT® RESTORE: 100B CFU shelf-stable, dairy-free, broad-spectrum probiotics, to support healthy gastrointestinal health
  • HAPPY GUT® ENHANCE: comprehensive support for optimal gastrointestinal health and function
  • HAPPY GUT® CLEANSE: support for healthy gastrointestinal microbial balance
  • HAPPY GUT® RELAX: support for bowel regularity as well as cleansing and detoxifying
  • HAPPY GUT® APP: FREE download containing recipes, shopping list, daily guidance, tracking, push notifications, and MUCH more
  • HAPPY GUT® Private Facebook Group: direct access to our team while completing the cleanse and provides additional gut-health info


Kickstart your #happyguthappylife!


*$200 off 28-Day Cleanse ONLY, use code: TAKE200OFF. Offer ends May 31, 2020 11:59pm EST



1 https://news.gallup.com/poll/249098/americans-stress-worry-anger-intensified-2018.aspx
2 https://www.sciencedirect.com/science/article/pii/S2352289515300370
3 https://www.healthline.com/health/hypochlorhydria
4 https://pubmed.ncbi.nlm.nih.gov/11040188/
5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140100/
6 hhttps://www.nhs.uk/conditions/leaky-gut-syndrome/
7 https://www.ncbi.nlm.nih.gov/pubmed/29909048
8 https://www.kenhub.com/en/library/anatomy/neurotransmitters
9 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/
10 https://www.sciencedirect.com/science/article/pii/B9780128000502000103
11 https://www.sciencedirect.com/science/article/pii/S2352289515300370
12 hhttps://www.pnas.org/content/108/38/16050
13 hhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010276/
14 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319175/
15 https://www.psychologytoday.com/us/blog/sleep-newzzz/201901/3-amazing-benefits-gaba
16 https://www.bbc.com/future/article/20190218-how-the-bacteria-inside-you-could-affect-your-mental-health 
17 https://www.cambridge.org/core/journals/journal-of-mental-science/article/treatment-of-melancholia-by-the-lactic-acid-bacillus/8FFA58CD6E82E8F015379F1D30552CD4 
18 https://clinicaltrials.gov/ct2/show/NCT01809067
19 https://www.medicalnewstoday.com/articles/265922#benefits 
20 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995283/
21 https://www.jstage.jst.go.jp/article/bpb/40/6/40_b17-00141/_article
22 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
23 https://usa.inquirer.net/31501/cbd-oil-benefits-the-best-cbd-oil-digestive-aid 
24 https://greenthevoteok.com/cbd-oil/studies/ibs/ 
25 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768535/ 
26 hhttps://www.sciencedirect.com/science/article/abs/pii/S104366180900108X?via%3Dihub
27 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190025/
28 https://www.liebertpub.com/doi/10.1089/can.2018.0073 
29 https://www.healthline.com/nutrition/cbd-oil-benefits 
30 https://www.psychologytoday.com/us/articles/200301/brain-power-why-proteins-are-smart

Avoid Obnoxious Toxins To Build Your Immuno-Resilience


Adding real, whole, nutrient-rich foods is the ideal way to strengthen the gut and immune system.


But as I discussed in my last blog, what you avoid consuming is equally important to better support the gut and build your immuno-resilienceOver time, many of my patients become aware of how… 


Food sensitivities can damage the gut. 


These food sensitivities can develop from eating foods such as corn and soy that create chronic reactions, over and over. They damage the gut wall and as a result weaken the immune reaction, ultimately setting them up for an increased risk of infections — from chronic sinus infections to the common cold.



Artificial Sweeteners Impact the Gut and Immune System

Beyond eliminating food sensitivities, I pinpoint other obstacles that can also impair the gut and immune system. Some of them aren’t always obvious, such as drinking diet sodas.


These sodas, which are often sweetened with aspartame and other artificial sweeteners, can make you gain weight and increase your risk of obesity.1


Artificial sweeteners in diet sodas also raise your risk of stroke, heart attack, metabolic syndrome, and cardiovascular disease.2


Studies also show that…


Artificial sweeteners can alter the gut microbiome. 


Certain sweeteners, including saccharin and sucralose, can impact the quality and diversity of gut microbiota


Human studies have shown that saccharin can alter metabolic pathways linked to glucose tolerance and dysbiosis in humans.3


These artificial sweeteners can promote the growth of bacteria that make more calories available to the body.4



Obnoxious Toxins are Ubiquitous

For some patients, even after eliminating food sensitivities including artificial sweeteners, gut problems still persist. Even with a healthy diet, I’ve found that certain exposures can continue to damage the gut — and, by extension, the immune system


One of the biggest and often-overlooked problems are environmental toxins


These obnoxious toxins are everywhere. In the food you eat, water you drink, air you breathe, and in many everyday products you use — including cosmetics. 


We live in a toxic world, and so completely eliminating toxins isn’t possible. However, you can reduce your exposure to them, and by doing so also reduce the impact they have on your body.


A key role of the gut is to eliminate waste and toxins from the body. 


If your gut is not functioning properly and/or your gut microbiome is imbalanced, these toxins accumulate within the body, causing harm to the gut, immune system, and much more.


Along with necessary evils (antibiotics) and eating the wrong foods (processed, packaged sugar-laden snacks), the toxins you are exposed to in your environment can eventually result in a dysbiosis — an imbalance between favorable and unfavorable microorganisms in the gut. These things persistently damage the intestinal lining and contribute to what we call intestinal hyperpermeability, aka leaky gut.


As these partially digested food particles, toxins, and microbes leak out into the bloodstream from the gut wall, your immune system goes into high gear, leading to increased inflammation throughout the body.



Avoiding Toxins is the Primary Name of the Game

One of the best ways to heal the gut and build immuno-resilience is to reduce the amount of these toxins that you are exposed to, and a good place to start is with the pesticides in the foods you eat. 


Pesticides protect crops and help farmers yield the maximum amount of a particular crop. They can even determine how many times crops can grow. 


Worldwide, there are over 1,000 pesticides used in food. 


These pesticides protect crops against insects, weeds, fungi, and other pests.


Every year, American farmers use about a billion pounds of chemicals on crops. In 2016 alone, California used almost 210 million pounds of pesticides. 


But what protects plants can harm you. Many of those pesticides are classified as potential carcinogens or cancer-causing agents, endocrine or hormone disruptors, and reproductive or developmental toxins.5 They can be toxic, creating short- and long-term damage to the gut and other organs.


Many of them show up in our food supply. 


About 70 percent of fresh produce sold in America, in fact, contains residues of potentially harmful chemical pesticides.6 


In their most current study in 2020, the Environmental Working Group (EWG) looked at 47 fruits and vegetables. They found that over 90 percent of samples of strawberries, apples, cherries, spinach, nectarines, and kale had residues of two or more pesticides


Researchers here found that kale carried a whopping 18 pesticides.The pesticide most frequently detected in kale was chlorthal dimethyl or DCPA, an herbicide used on a wide range of vegetable crops.7


The Environmental Protection Agency (EPA) classifies DCPA as a possible human carcinogen. And in 2009, the European Union banned DCPAAs a result of this pesticide assault… 


Over 90 percent of Americans have pesticides in their bodies


mostly from eating conventionally grown fruits and vegetables.8 



Pesticides Flow Deep In Our Water

These pesticide residues are ubiquitous in our food, but they can also seep into our drinking water.9 


Over 700 synthetic organic compounds have been found in American drinking water. 


This contamination comes from a variety of sources, including household products and leakage or improper disposal of chemical water. 


Researchers have detected 22 pesticides in U.S. wells. Under certain conditions, that number can increase to 80 pesticides in groundwater.10 Just as with food, the body absorbs these pesticides, many of which are fat-soluble and get deposited in body fat. Over time, they take a toll on the gut and can create widespread health problems. 


While the EPA sets limits on acceptable rates of pesticide exposure, many of them can cause harm at even low doses. Exactly how toxic these pesticides can be depends on the type. Insecticides, for instance, tend to be more toxic to humans than herbicides. How often you’re exposed to these pesticides also determines how harmful they can be.11



GMO Foods are Higher in Pesticides

The serious health risks these pesticides can precipitate aren’t always immediately apparent. They can take years to show up, in fact. 


Consider glyphosate, the most utilized herbicide in agriculture. Patented in 1974 by the Monsanto Company, glyphosate is best known as the active ingredient in Roundup®-branded herbicides, and the herbicide used with Roundup Ready® genetically modified organisms (GMOs).  


A GMO, or genetically modified organism, is a plant or other organism whose genetic makeup has been modified in a laboratory. This creates combinations of genes that don’t occur in nature. 


The number of GMO crops increases every year.12 


Along with that increase, we are exposed to an increasing number of pesticides. In fact, studies show that over a 16-year period, farmers have increased the use of pesticides on genetically engineered crops by around 404 million pounds or seven percent.13 Additionally, farmers will spray up to 6x the amount of pesticide on a Roundup Ready® GM crop than they would otherwise use.14 


Some of the most harmful foods to the gut are also genetically modified. 


Around 90 percent of corn and 94 percent of soybeans in the U.S. are engineered to tolerate herbicides. 


Since Roundup Ready® GMO crops were introduced in the U.S in 1996, our exposure to this herbicide has increased 500 percent.15 


But some genetically-modified corn and potatoes are engineered to produce their own pesticide, known as Bt (for bacillus thuringiensis, the soil bacteria that produces an insecticide that kills insects by poking holes in their digestive tract after eating the GMO). Can you imagine what that could do to your gut lining? Well, it’s been tested in mammalian cells and found to do the same thing!


In the scientific community, 


Glyphosate is notorious for being carcinogenic or cancer-causing, disrupting hormones, mineral-depleting, and an antimicrobial. 


Over time, glyphosate can cause dysbiosis, or gut bacteria imbalances. This disordered overgrowth of bad bacteria can impact every organ, including the brain.16 


In animal studies, glyphosate has been shown to disrupt gut bacteria, killing beneficial forms and causing an overgrowth of pathogens.17


Keep in mind too that scientists usually study pesticides such as glyphosate in isolation. We aren’t entirely aware of what the added impact of being exposed to multiple pesticides at once can cause. 


However, what we do know is when it comes to toxins, 


1 + 1 does not equal two; in fact, with toxins, 1 + 1 = 3. 


In other words, their effects are more than just additive, they augment each other’s toxicity in the body


Products containing glyphosate, for instance, usually contain other ingredients that help the glyphosate get into plants.18 The exponential effects of these ingredients is yet to be fully understood.



Food Preparation is Paramount

It isn’t just what you eat or don’t eat that impacts the body’s toxic burden. 


Everyday items used in food storage, cookware, and cooking utensils often harbor engineered compounds that pose potent, silent health threats to our bodies. Many of these compounds bioaccumulate over years and are stored in the fat of the body.



Nonstick pans and cooking utensils are convenient, but at what price? 


PFOA (perfluorooctanoic acid), an ingredient in nonstick surfaces such as Teflon, has been implicated as a causative environmental toxin in autism spectrum disorders. 


Persistent organic pollutants (POPs) enter our bodies when we eat the foods we prepare on these surfaces, and then they have no easy way out. That is why they are called “persistent.” 


They stay in your body for a literal eternity, pocketed wherever fat is stored in the body. In fact, over time these POPs slowly poison your cellular energy machinery, leading to weight gain, fatigue, and leaving you prone to diseases that are not easily traced back to an exposure. 


Organic pollutants have even been implicated in the worldwide explosion of the rates of diabetes and obesity. 


“Cleanse” your kitchen with cookware labeled “PFOA-free” and “PTFE-free” 


Avoid PFOA and PTFE (polytetrafluoroethylene) in nonstick surfaces.


Some of my favorite pots and pans for green cooking:

  • Ceramic. coated nonstick, such as Bialetti’s Aeternum Collection
  • Porcelain. enameled cast iron, such as Le Creuset
  • Stainless. steel (great for making rice and soups and steaming vegetables)


For example, 360 Cookware Stainless Steel products with Vapor technology offer a healthier alternative to cooking with oils. With my 360 Cookware sauté pan, I make perfectly steamed broccoli in less than five minutes, using very little water, thus retaining all the nutritional value of the food. Who said preparing a healthy, gut-friendly meal had to take a long time?


Also remember that your utensils are often manufactured with nonstick surfaces as well, which can be toxic to you. Instead, use utensils made from:

  • Bamboo (a renewable, nontoxic resource)
  • Stainless Steel



We all appreciate the convenience, environmental consciousness, and anti-wasting influence of food storage containers. 


However, avoid plastic food storage containers, which contain BPA or other bisphenols. Instead, use containers made from glass or Pyrex. 


Avoid plastic wraps that use polyvinylidene chloride (such as Saran) and choose a wrap that is made from polyethylene (less evil). An example of the less toxic version is Glad ClingWrap. Even better yet, forgo the plastic wrap and instead use old-fashioned wax paper with tape to hold it together if necessary.



Avoid triclosan, an antibacterial agent, and just use regular plant-based detergent, such as Seventh Generation Natural Dish Liquid. You don’t need an antibacterial agent unless you are sterilizing your apartment like a hospital.



6 Ways To Avoid Obnoxious Toxins

Like I said, you can’t completely eliminate these toxins, but you can minimize your exposure to them. 


Years of treating literally thousands of patients suffering from the negative effects of toxicity — and by default an assault on their gut — led me to craft a program to take the guesswork out battling gut-related health issues.  With the intent of battling these effects head on, I put together my GUT C.A.R.E Program® to minimize exposure to pesticides and other harmful chemicals


Here’s how to put the program into action.



To minimize your exposure to pesticides and GMOs, I encourage you to buy organic fruits and vegetables whenever possible


To qualify as organic, farmers must abide by strict guidelines to avoid using pesticides and synthetic fertilizers.19 


Organic fruits and vegetables usually contain lower levels of pesticides and higher levels of nutrients 


that can help support the immune system, including vitamin C and magnesium.20 


This is because organic produce has to produce more antioxidants to protect itself from bugs and infections, whereas non-organic produce has been stripped of this need by being bathed in pesticides, making the later plants weaker, more susceptible, and less nutritious.  



Certifying a food as USDA Organic costs money. Some local farmers bypass that certification but still grow their crops as organic. 


The best thing you can do is visit your local farmers markets, talk to them about how they grow their food, and develop a relationship with them.



Sometimes, eating organic isn’t possible. Maybe it’s too costly, or you can’t find organic produce at your grocery store. 


That’s where the Shopper’s Guide to Pesticides in Produce™, created by the Environmental Working Group (EWG), can help. They identify the fresh fruits and vegetables that are most and least contaminated with pesticide residues. 


Their Dirty Dozen™ provides a list of fruits and vegetables with the highest levels of pesticides. These are the foods you don’t want to compromise on — BUY ORGANIC. 


The EWG’s Clean 15™ lists the least-contaminated fruits and vegetables. If you can’t buy organic, these are your best choices. 


I encourage you to print out these lists or save them to your phone, so you’ll always have them available when you shop for food.



While you’re at it, check out some of EWG’s other guides to minimizing toxic exposure, including their Skin Deep® guide for cosmetics and their Guide to Healthy Cleaning for cleaning products.



Even if you buy organic produce — and especially if you can’t — I encourage you to wash off pesticides with a homemade vinegar solution. Combine four parts water with one part vinegar, and soak fruits and vegetables for 20 minutes.  



To reduce the harmful impact of pesticides, you’ll want to reduce your exposure in every way possible — one of the best ways to do that is with your food. 


Equally important, you want to support the body to eliminate these harmful toxins


Without sufficient nutrient support, the liver cannot effectively eliminate the toxins in our food, water, air, and more. 


As a result, they are reactivated and reabsorbed into the body, where they continue to cause damage.  



How To Eliminate Toxins And Remove Gut Irritants 

The body requires the appropriate nutritional support for effective functioning of the liver’s detoxification.  Things such as environmental pollution, increased stress — and yes you guessed it — obnoxious toxins, all point to the body needing supplemental amounts of amino acids, minerals, and other factors essential for healthy detoxification.


To assist the body in that process with balanced Phase I and Phase II detoxification pathways, I created the HAPPY GUT® REBOOT:  28-day Cleanse that I outlined in Happy Gut®


The goal is to minimize the amount of toxins the body is exposed to, as well as provide all the necessary nutrients to support the body’s elimination of those toxins — so they don’t accumulate and damage the gut, brain, liver, immune system, and more.


Avoiding obnoxious toxins and supporting the body’s ability to detox helps you build Immuno-Resilience.


In fact, JC, a patient of mine who came under my care after contracting Covid-19, had this to share with regards to the HAPPY GUT REBOOT: 28-Day Cleanse after his recovery:


“I never want to feel ‘helpless’ and on the brink of not being in control of what could very well save my life. Getting my gut in order with the 28-day cleanse, after recovering from the coronavirus, was by far one of the best things I’ve ever committed to AND completed!  I’ve never had so much energy from cutting things out – so much that I’ve returned to working out while at-home. Then there’s the uhm how do I say…’happy butt’ — I’ll spare you the details but know this, my tummy troubles are next to none. I never thought that would be the case after having them my entire adult life. With all the unknowns that lie ahead, I can say this with 100 percent certainty — my immune system is ready to shield off things I’ve always been susceptible to like the flu or my case, Covid-19.”  — JC, Brooklyn, NY


This comprehensive program gives the gut all the nutrients it needs to heal. You can feel confident knowing that you’re giving the body everything it needs to detox, digest, and defend against infections as well as thrive in any type of environment.   


Pesticides and environmental toxins are everywhere. They can sabotage the gut, immune system, nervous system, hormone system, and so much more. 


Your immunity shield is yours to build and the gut is the gateway.


Given the significant impact the Covid-19 Crisis has placed on us from the limited nutrient-dense foods available, toxins from cleansing solutions, and added stress — ALL gut-compromising — we want to provide for the first time ever, not $100, but $200 OFF* the HAPPY GUT REBOOT:  28 -Day Cleanse.

We KNOW this to be our best offer not only because of the price, but rather because of the results this program has provided to many patients of my practice who have reversed their gut-related health issues by treating the underlying cause — the GUT.




The HAPPY GUT REBOOT:  28-Day Cleanse includes: 


  • HAPPY GUT® CLEANSE SHAKE: support for the overall metabolic detoxification process (two 14-day containers)
  • HAPPY GUT® ACTIVATE: support for digesting all three macronutrients
  • HAPPY GUT® RESTORE: 100B CFU shelf-stable, dairy-free, broad-spectrum probiotics, to support healthy gastrointestinal health
  • HAPPY GUT® ENHANCE: comprehensive support for optimal gastrointestinal health and function
  • HAPPY GUT® CLEANSE: support for healthy gastrointestinal microbial balance
  • HAPPY GUT® RELAX: support for bowel regularity as well as cleansing and detoxifying
  • HAPPY GUT® APP: FREE download containing recipes, shopping list, daily guidance, tracking, push notifications, and MUCH more
  • HAPPY GUT® Private Facebook Group: direct access to our team while completing the cleanse and provides additional gut-health info


Kickstart your #happyguthappylife!


*$200 off 28-Day Cleanse ONLY, use code: TAKE200OFF. Offer ends May 31, 2020 11:59pm EST




1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210834/
2 https://www.ncbi.nlm.nih.gov/pubmed/22282311
3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363527/
4 https://www.scientificamerican.com/article/artificial-sweeteners-may-change-our-gut-bacteria-in-dangerous-ways/
5 https://www.thenation.com/article/archive/pesticides-farmworkers-agriculture/
6 https://www.ewg.org/foodnews/summary.php
7 https://www.ewg.org/news-and-analysis/2019/03/ewg-news-roundup-322-kale-vaults-dirty-dozen-california-takes-chemicals 
8 https://www.thenation.com/article/archive/pesticides-farmworkers-agriculture/
9 https://www.epa.gov/safepestcontrol/drinking-water-and-pesticides
10 http://psep.cce.cornell.edu/facts-slides-self/facts/pes-heef-grw85.aspx
11 https://www.who.int/news-room/fact-sheets/detail/pesticide-residues-in-food
12 https://www.nongmoproject.org/gmo-facts/what-is-gmo/
13 https://enveurope.springeropen.com/articles/10.1186/2190-4715-24-24
14 Rodale, Maria. Organic Manifesto: How Organic Food Can Heal Our Planet, Feed the World, and Keep Us Safe. Rodale Books; Reprint edition (March 1, 2011).
15 https://usrtk.org/pesticides/glyphosate-health-concerns/
16 https://www.ncbi.nlm.nih.gov/pubmed/31442459
17 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945755/
18 http://npic.orst.edu/factsheets/glyphogen.html
19 https://www.medicalnewstoday.com/articles/327414#organic-food
20 https://pubmed.ncbi.nlm.nih.gov/20359265/

Add The Right Foods To Build Your Immuno-Resilience


“Whatever is going around the office, I’m almost certain to get,” my 42-year-old patient Melinda told me during our first consultation. 


Along with digestive issues such as bloating and constipation, Melinda struggled with allergies and chronic sinus inflammation. And now with NYC as the U.S. epicenter of the COVID-19 pandemic, she was particularly worried.  


Especially in the afternoon, she often felt tired. She relied on a large hazelnut coffee from a nearby donut shop to pull her through, flavoring that takeout coffee with skim milk and a few packets of Splenda®. (“I use stevia at home, but I forget to bring it to my office,” she told me.) Melinda’s situation is very common among my patients. 


When the gut becomes compromised by poor diet choices, the immune system suffers. 


After all, the gut is the gateway to your immune system. If you want to keep your immune system strong, you’ve got to start with your gut.  


One of the five key roles of your gut is to maintain an immune barrier to the outside world. In fact, the gut is also the largest stronghold of your immune system


A healthy gut keeps the immune system strong. When working properly, it creates a semi-permeable barrier that keeps out bad bugs and other threats that can result in illness. In fact, almost 70 percent of the entire immune system resides along the gut wall1.


When gut health deteriorates, the immune system follows. 


The wrong foods, chronic stress, environmental toxins, and antibiotics all wage war with the gut and your gut microbiome.


By her own account, Melinda was doing everything correctly. She did Barre classes three times a week, closely monitored her caloric intake, and ate healthy foods. Regardless, Melinda couldn’t lose those last 15 pounds.


Along with describing her symptoms, Melinda’s food journal revealed what was causing these problems. Many of the foods she thought were healthy, including her skim milk and whole wheat bread, were resulting in food sensitivity reactions


Even though she had restricted calories (for example, with an artificial sweetener) and was watching her carb intake, certain foods that she considered healthy had made it very difficult for Melinda to lose weight. In fact, 


artificial sweeteners have been shown to increase the risk for metabolic syndrome


(a problem with processing sugar) and weight gain. To worsen matters, her former doctor had put her on several rounds of an antibiotic called Augmentin for her chronic sinus infection.


What resulted was a dysbiosis, an imbalance between the favorable and unfavorable bacteria in her gut. Over time, dysbiosis can damage the gut wall, resulting in a leaky gut


This leakiness or “hyperpermeability” means that partially-digested protein molecules from food can easily slip through the gut wall. The immune system does not recognize these so it mounts an attack by producing antibodies, which results in food sensitivities. When your immune system is distracted by these over-reactions to foods, it is not as well equipped to fight infections.


Melinda was shocked when I told her a food she commonly ate and considered to be healthy may be at the root of their problems. I explained to her that unlike food allergies, the response is not immediate: The symptoms and characteristics of 


food sensitivities manifest between several hours up to 48 hours 


after exposure to a problematic food like gluten. When the immune system becomes activated by these foods, it sends out messages that tell your body to create inflammation in distant regions as a response to an onslaught of food proteins that have been classified as enemies of the body. 


When you continuously eat these foods, you may register only a general feeling of malaise and not be able to pinpoint any specific body symptom. The immune response those foods can trigger can last up to six months.


Leaky gut syndrome is at the root of many of the gut-associated diseases we are working to reverse. The symptoms of a leaky gut overlap with those caused by food sensitivity reactions, and they may include seemingly unrelated symptoms like: allergies, asthma, migraines, hives, eczema, psoriasis, acne, headaches, mental fog, chronic fatigue, body aches, autoimmune disease, and even depression at its worst.


Underlying how well the immune system functions is the gut microbiome.  


It is composed of about a hundred trillion microbes — which include up to a thousand different species of bacteria — living in balance between good and bad.  It also includes a few dozen types of yeasts and fungi, an unknown number of viruses, and an occasional worm — which may actually help prevent autoimmune disease.


Your lifestyle, what you eat, and your exposures to antibiotics can all change the balance of your gut microbiome for the worse. The state of this internal microbial milieu literally dictates how your body feels, how well your immune system behaves, and how you digest as well as assimilate foods.


A diet rich in the foods that you are sensitive to, in combination with a leaky gut, leads to fluid retention and inflammation — and, as a result, WEIGHT GAIN.


So, when we talk about building immuno-resilience and preventing yourself from contracting a virus, first we want to remove that which is bogging down your immune system. It’s like when your computer gets stuck running too many processes, you need to clean out the drive and any temporary files that are slowing it down. For your gut, this means removing food sensitivities. 


The good news is that when you remove the foods that trigger these reactions because they activate your immune response, weight loss happens more easily and naturally. In as little as one week, you can start to feel better and your symptoms disappear as the fog your chronic immune activation had over you lifts. 


For Melinda, the first step was removing the foods and beverages that contributed to the immune weakening she was experiencing. Many of the foods that she considered healthy were making Melinda sick, tired, weight loss resistant, and immune repressed.


In my book Happy Gut and many of my blogs, I explain why many of these are a problem. For Melinda, we pinpointed how these five were taking their toll on her gut and immune health. Understanding this really helped her commit to the HAPPY GUT® REBOOT:  28-Day Cleanse.


1-SUGAR. Strictly monitoring calories and reading labels helped Melinda eliminate many sources of added sugars. She rarely ate cookies, cake, donuts, and other foods high in sugar. However, added sugars were slipping into places she didn’t suspect, such as marinara sauce and a bottled green tea she reached for some afternoons. The gluten-free, high-fiber cookies she was buying at her favorite health food store were sweetened with agave, a sweetener more likely to lead to fatty liver and pre-diabetes. Even the flavored mineral water she was sipping on contained sugar; almost as much, in fact, as a sugar-sweetened cola! 


2-DAIRY. Melinda told me that she wasn’t a fan of cow’s milk, and that she rarely ate yogurt or ice cream. She didn’t consider that “splash” of skim milk in her coffee to be a big deal. Dairy can also slip into unsuspecting places, such as the stevia she put in her coffee. (Lactose or milk sugar is sometimes used as a bulking agent in these products.) I explained that even a little dairy could be damaging to the intestinal lining and cause the wrong types of bacteria to overgrow


3-GLUTEN. The health glow of wheat bread and other foods Melinda regularly consumed distracted her from the symptoms that gluten can create. Every time that Melinda ate gluten, she was activating her immune response. A word of caution, though: Packaged gluten-free foods, which are often sweetened and contain other potential food sensitivities, are not any better. 


4-ARTIFICIAL SWEETENERS. I’ve heard countless stories from patients who struggled with problems like achy joints for years. They never associated these problems with artificial sweeteners. Once they gave up diet colas, though, these problems disappeared. Artificial sweeteners can be inflammatory and compromise your immune system. Studies show that sucralose, marketed as Splenda®, can disrupt healthy gut flora and increase the number of inflammatory gut flora that lead to weight gain and pre-diabetes2. 


5-ALCOHOL. Melinda confessed that especially after stressful days at the office, she would reach for a second and even third glass of red wine to unwind. She wisely noticed, though, that her sinus pressure would flare up a day or two after too much alcohol. It’s no coincidence: Researchers find a higher risk of infections, including acute respiratory distress syndromes (ARDS) after consuming alcohol. If you do get sick, alcohol slows down how quickly and how well you recover. Studies show that alcohol disrupts immune pathways, impairing the body’s ability to defend against infection and more3.


To eliminate these foods and support the healing of her gut, I had Melinda do my 28-day Gut C.A.R.E. Program® that I outlined in Happy Gut. 


To support the gut and immune system, I asked Melinda to increase her intake of organic leafy and cruciferous vegetables, including broccoli and spinach. We also upgraded her intake of animal foods to include more wild-caught seafood, which contains anti-inflammatory omega-3 fatty acids along with immune-boosting protein.


She also included more cultured and fermented foods, such as kimchi and coconut kefir, into her meals. The probiotics in these foods help reduce the “leakiness” of the gut and bolster our immune system in ways that help protect us.


Food is medicine — it can be the source of your greatest woes, but also the fountain for your greatest healing. 


To develop a strong gut and immune system, here are the Happy Gut principles to live by:

  • Focus on getting healthy, omega-3-rich fats in nuts, seeds, avocados and fatty fish like wild-caught salmon. 
  • Look for organic, non-GMO vegetables
  • Eat clean proteins that are hormone-free, grass fed, wild-caught, or from wild game.
  • Promote friendly flora with pro- and prebiotic-rich foods
  • Speaking of, incorporate plenty of fiber, which is your immune system’s best friend, because it builds a strong, friendly gut microbiome that will work overtime to keep your gut lining healthy and fit.


To further fortify the immune system, you want to add these to your weekly diet:


Immuno-Resilience Superfoods

1-Shiitake mushrooms: These mushrooms, which have a rich, savory flavor, can help strengthen the immune system and lower inflammation. They are rich in immune-supporting nutrients including zinc and manganese. One study found that eating shiitake mushrooms for four weeks helped improve gut immunity4. 


2-Ginger: This pungent spice provides a variety of immune-supporting benefits. Ginger is anti-inflammatory to help the body manage inflammation that can contribute to illness and disease. As an antioxidant, ginger can help support the body fight free radicals that contribute to disease. Ginger is also an antimicrobial, which helps fight a variety of viruses and other pathogens5.


3-Turmeric: Among the compounds in this bold spice, which you often find in curry powders, is curcumin. The anti-inflammatory support that curcumin provides can help the body manage a variety of immune cells, including  T cells, B cells, macrophages, neutrophils, and natural killer cells. Curcumin can also help support the immune system by enhancing antibody responses6.


4-Alkalizing Greens: leafy greens and cruciferous vegetables provide a variety of nutrients that help support the immune system, including vitamins C, K, and folate. They also contain immune-supporting compounds such as sulforaphane.


5-Camu Camu: the Peruvian superfood high in Vitamin C, which has been shown to protect the body from oxidative damage.


When your gut has been in disarray, your immune system weakened, and your gut lining compromised, the only and best way to reboot it is to do a full-on cleanse. For Melinda, that meant going through the HAPPY GUT® REBOOT:  28-Day Cleanse


As part of the Gut C.A.R.E. Program®, I developed a series of complementary supplements to fast-track her along the path to wellness. For the morning breakfast smoothies, Melinda used the HAPPY GUT® Cleanse Shake, a gut-healing, fructose-free, hypoallergenic, vegan protein powder designed to support gut health and promote balanced detoxification. 


In addition, I carefully selected a series of easy-to-swallow encapsulated supplements to support digestive wellness, along with a high-potency probiotic to promote healthy gut microflora. 


You can access this same 28-Day Gut C.A.R.E.® Program that I’ve successfully used for hundreds of patients such as Melinda. This comprehensive program gives the gut all the nutrients it needs to heal. These nutrients also create a strong immune foundation.


During her follow-up consultation three weeks later, Melinda told me that her sinus condition had improved and she had only one minor allergy flareup during that time. She no longer needed that midafternoon caffeine pick-me-up. And during the first week alone, she had lost four pounds.


Most importantly, Melinda began to see how the foods she ate regularly impacted her gut and immune system. She was shocked that so many of these “healthy” foods were creating problems, such as fatigue, weight loss resistance, and weakening her immune system.


I’ve seen great results like these when patients remove food sensitivities, eat plenty of whole, unprocessed foods, and get the nutrients they need to fix the gut and make the immune system strong and resilient. This is what everyone needs to be doing now as we get through the next phase of this worldwide pandemic. This is how you build your immune armor for the long-haul.


A Strong Immune System Starts In The Gut!


Given the significant impact the Covid-19 Crisis has placed on us from the added stress, limited nutrient-dense foods available, and lack of sleep for many — ALL gut-compromising — we want to provide for the first time ever, not $100, but $200 OFF* the HAPPY GUT REBOOT:  28 -Day Cleanse.

We KNOW this to be our best offer not only because of the price, but rather because of the results this program has provided to many patients of my practice who have reversed their gut-related health issues by treating the underlying cause — the GUT.


>>>TAKE $200 OFF*<<<


The HAPPY GUT REBOOT:  28-Day Cleanse includes: 


  • HAPPY GUT® CLEANSE SHAKE: support for the overall metabolic detoxification process (two 14-day containers)
  • HAPPY GUT® ACTIVATE: support for digesting all three macronutrients
  • HAPPY GUT® RESTORE: 100B CFU shelf-stable, dairy-free, broad-spectrum probiotics, to support healthy gastrointestinal health
  • HAPPY GUT® ENHANCE: comprehensive support for optimal gastrointestinal health and function
  • HAPPY GUT® CLEANSE: support for healthy gastrointestinal microbial balance
  • HAPPY GUT® RELAX: support for bowel regularity as well as cleansing and detoxifying
  • HAPPY GUT® APP: FREE download containing recipes, shopping list, daily guidance, tracking, push notifications, and MUCH more
  • HAPPY GUT® Private Facebook Group: direct access to our team while completing the cleanse and provides additional gut-health info


Kickstart your #happyguthappylife!


*$200 off 28-Day Cleanse ONLY, use code: TAKE200OFF. Offer ends May 31, 2020 11:59pm EST


1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/
2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522834/
3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/
4 https://pubmed.ncbi.nlm.nih.gov/25866155/
5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665023/
6 https://pubmed.ncbi.nlm.nih.gov/17211725/