#65 - Immune Reboot with Dr. Robert Silverman, Part 2

Hi guys, Welcome to another episode of The Factor podcast. I'm your host Jessica Riddle. If this is your first time tuning in, welcome and thank you for listening. In today's episode, we wrap up our two part training titled Immune Reboot, A Guide to Maximizing Immunity and Optimizing Vitality, featuring guest speaker Doctor Robert Silverman. Today, Doctor Silverman will discuss the long term impacts of COVID nineteen infection on the lung, gut, brain, axis, and gut microbiome. We will also talk more about the role of systemic inflammation in what is now considered long hauler COVID. We will also chat about strategies for reducing inflammations such as diet supplements and lifestyle improvements, and we'll learn about some effective nutritional protocols for the omicron variant and immune support. Doctor Robert Silverman is a chiropractor and clinical nutritionist, best selling author, renowned prisoner, and the founder and CEO of Westchester Integrative Health Center. He serves on the advisory board for the Functional Medicine University. Is a chief clinical consultant for KBMO Diagnostics and Erconia Laser Ltd. And holds a science board position with Neutrodyne. With over twenty three years of clinical experience, Doctor Robert Silverman is considered a thought leader in his field and has contributed to several studies in peer review journals and other mainstream publications. As you listen to today's training, I'd like to challenge you pick out one or two things that you can start implementing in your practice with your patients right away. Let's cue the intro music and get started. So post COVID nineteen bottom line is fatigue, brain fog, headache, physical exertion. These are some of the common persistent symptoms. But the real takeaway here is the median time was almost one year, so long COVID is truly long, it's arduous, and unfortunately it hasn't truly abated over the last two year period. So digging in on the cognitive symptoms patients with long COVID once again in another study, difficulty concentrating, brain fog, forgetfulness, trouble recalling a desired word, maybe losing your proverbial filter, saying an unintended word. Huge takeaway. Many health outcomes of people who developed long COVID after mild acute stars to infection resolved one year later. So people say, oh, a year later, I mean it's a long period of time. I can never remember anything like a flu, a bad flu, everlasting, or the symptomology or the adverse effect of it lasting for a year. Now, full disclosure, I did have COVID four days. I was better, very happy, very fortunate. I do try and take care of myself. So fingers crossed, hopefully I don't have any more crosses to bear, if you will. That said, let's look at some of the biological changes of people post COVID disturbances in the circulatory system. There's a destruction of the enzyme that is a cellular receptor for the virus. So essentially we've got these triple spike protein. The reason they call it a coronavirus is a crown. You have what we call ACE two receptors that these spike proteins like to attach too. On top of the ACE two receptors, you have an ACE two enzyme. That enzyme is a protective mechanism in that it makes it slippery so that spike protein can attach or attach tightly. One set spit protein attaches and attaches tightly to the age two receptor. We lose in many instances that enzyme, so we lose the protection at the proverbial non valkral level ongoing state of inflammation in the body. Immune systems typically not return to the pre covid state. See that all the time in blood labs, abnormalities and T cell function and once again a high rate of autoantibody function, mitochondria distress and dysfunction. We will talk about that in the next five minutes. And for me again, the gut is the percent of your health eighty percent of immune cells or in your gut, it's where a macro micronutrients are absorbed. I had a conversation with my wife today and I said, we have to have to make sure before they buy any kind of vitamins that we test their gut health because if their guts too permeable, the vitamin won't be absorbed passed through. And many of our patients will think of vitamins don't work, and we know of the quality that they have and we know of the clinical outcome they can share with our patient base by utilizing these vitamins. So the gut microbiome actually may be damaged. First, you could have a loss of diversity in your ecosystem, a loss of anti inflammatory organisms, increased leaky gut occurrence. Of course, cellular danger response mitochondri regulates CELUI danger response that controls the innate immunity and healing. Chemical pollutants in the environment lowered the threshold believe it or not for cellular danger activation and persistent activation of cellul danger response inhibits healing and leads to chronic illness. So let me back to truck up just a little bit. What are we saying. Our mitochondria actually originates from bacteria, so it's a cousin or a sister to our gut, so it communicates with our gut and in so it actually allows for protection to the innate immune systm. So when you get sick, like with the flu, you can use up to about fifty five percent of your mitochondrial energy production and you shut that off to allow the immune system to function well, and you take a chill pill if you will, and you rest or you get quite fatigued. I'm sure everybody's nodding their head now, remembering when we had a flute, we got fatigue. Now Unfortunately, if we have this drop of energy, the mitochondria will actually senses it as a threat. It results in a mitochondria changing its primary function from energy to sell defense. It's called the cellular danger switch or response. We shut off all our energy producing properties. With the shut off of those energy producing properties, we are out like a light We feel like ultimate crap, no energy. Now, the question is that's a switch like a light switch to turn it back on? Is the cycle of sell the other danger response to get out of it? So the healing process is a dynamic circle that starts with injury and ends with recovery. This process becomes less efficient as we age, and the reason is because most people is age, we have mitochondrial dysfunction. Mitochondrial dysfunction is or mitochondria that is dysfunctional will stay around longer than mitochondria that is functional. So therefore, a healthy healing cycle starts with a wakeful activity, but inevitably some of stress or will eventually trigger mitochondria to move into the celliot danger response. You have to go through three different pit stops to get a healthy energy mode. After going through each three, each stage of these responses is energetically and metabolically distinct, and each has a checkpoint that must be met before the next stage is reached. So therefore the takeaway here is tell your patients it's a switch off, but it's a cycle on. And what have they done to train their mitochondria to go through this cycle efficiently and turn back on? Most people don't, Hence the idea of fatigue picking up the paste. Now, long covid epstein Bar. We talked about long covid epstein Bar being into related covid actually activating many viruses on blood labs, the one of note epstein Bar. So the impacts of long covid are numerous organs with a wide variety of pathologies actually shown. So you see chest pain, in the heart, you see lungs, you see the immune system, the pancreas, the gastrointestinal. You're also seeing neurological symptoms, kidney spleen, liver, blood vessels, reproductive systems. So what are the hypothesized mechanisms of long covid pathogenesis? Number one immune dysregulation. I've talked about that microbial dysbiosis, the unleveling of good and bead bacteria in your gut, autoimmunity and immune imprinting, blood clots and endol fiel abnormalities and dysfunctional neurological signaling, or any or all of these checklists could lead us down a path towards long COVID. So the real question is do we have a better answer, And I say yes, we have a resound, a resounding yes, and that we have a better answer. So here's my long COVID protocol. What you want to do is you want to deal with the gut health, mitochondria support, immune activation, manage and modulate inflammation. Obesity, blood sugar and anti inflammatory status are things that we want to deal with long COVID protocol. If you want to improve your mitochondria function and decrease fatigue, you want to make NAD plus. You want to make B vitamins. You want to utilize coenzyme Q, tencetylel, carnitine, alphalopulk acid. All your dosages are there, glutithion, magnesium, selenium, vitamin C. You also, if you want to have immune activation, you want to utilize mushrooms, rishi bataki lines main shanga in shataki. So long COVID, change your lifestyle, change your diet, utilize low glycemic index carbs as a macronutrient. There is no essential carbohydrates. I'm not trying to make them the bad guys, but you really want to utilize carbohydrates, or I should say minimize carbohydrates, especially those that are high in the glycemic index. Don't have any processed carbs as a chiropractor one, said doctor Jack Olaine. If man makes it, I won't eat it. You want to ingest good fats and amino acids, so fats and proteins are without question key macronutrients. Protein is the number one thing that I would recommend. I think that people are under consuming protein and the over consuming carbohydrates. And for a lifestyle everyday hack intimate and fasting is a great choice. Intimated and fasting. I'm a big believer in fasting and feasting in this same day. So it's really referred to as time restrictive eating. After about the thirteenth hour, you can stimulate something called ertophagy, which one of twenty and sixteen No Belt Prize in that it's the idea of breaking down old cells using the debris to make new and rich cells. So if you break down all immune cells, you can get immune rejuvenive cells. It's kind of like breaking down a raisin and giving yourself a grape. And also mitophogy to break down of old minochondria to new mitochondria. I'm a proponent of low level laser therapy. It is without question a great choice of electromagnetic transfer of energy. Sleep and exercise will also really support your immune system and clearly detox in the spring in the fall twice a year would be a great choice. A lot of people want to go back to exercise and have a little trouble. They've got them a lay and enlargening Invioli and C are two great supplements to help exercise. Post long covid nutrition can play a role or a key role than the management of post COVID nineteen syndrome. That was in February of twenty twenty two. I think it's a great statement. It's just a little late to the game. A third of long COVID patients suffer from persistent loss of sense of smell. This is huge in my area. This is huge in when I speak to our colleagues in front of the stage, many of their patients have lost a sense of smell. So here's a great protocol that I found to be extraordinarily effective. Use any central oil or a food that has a very strong smell, put it under their nose. Short it. My nutritional protocol is very simple. Alphao paulk acid six hundred milligrams daily, zinc sixty milligrams daily. Do it for a thirty day treatment protocol. We've seen between eighty and ninety percent of the people gather their smellback. Remember, the bulk of the reason that their smell is gone is the olfactory bulbs are swollen and you lose the ability to function those cranial nerves, loss of taste. In just glutamine two point five grams, not five hundred milligrams astrogallus one gram, includethio on five hundred milligrams Omega three fatty acids which decrease into leucn six four grams. Kircuemen decreases into lucan six one gram The fame JFK one set the time to repair the roof is when the sun is shining. If I could extrapolate, he was basically saying that take care of your body now, as opposed to wait till you get sick. So is it immune support or is it immune rejuvenation. Well, you don't want to support a dysfunctional immune system. You want to allow for immunal rejuvenation. You want to balance your immune system. You want to make your immune system more resilient, more flexible, the ability to bob in weave lateral movement if you would great study, great article on immune response. It really showed that you don't need to take twenty bottles if you want to balance your immune system. There are vitamins and minerals that are pleotrophic. They are the following. Vitamin A works for both the innate and the adaptive immune system. Vitamin C also vitamin D. Vitamin D is a virtue also of sorts. It's used for a swath or I should say it possesses a swath of different health promoting properties. Zinc. Zinc works with both the innate and adaptive immune system. You could probably write in magnesium in There also omega three fatty acids or a great choice to stimulate the innate immune system and the adaptive immune system can be boosted by utilizing pro resolving mediators a fractionated fish oil, which allow for the resolution of inflammation and the balance of the initiation and the resolution of inflammation. Here's some immune support supplements. Vitamin C, zinc mixed mushroom complex, Vitamin D three with the critical vitamin K two. K one and K two also are quite synergistic with vitamin D three because they allow calcium floating around, or they allow vitamin D to take calcium to the bone as opposed to leave it floating around and damage the soft tissue in plaque. Probiotics all about the gut. Probiotics are for life in the gut knack in lyposomal glutophile selenium, omega three fatty acids, elderberry, and vitamin A. If someone has to take a vaccine and the usage of the vaccine has dropped precipitously, here are some of the supplements that I would do to get a balanced immune response. Number one multi vitumin multimeneral vitamin D three with K two, Omega three fatty acids work the lining of the gut branch chain amino acids or glutamine NAC and glutathione, and probiotics post vaccine if they've just had a vaccine, now the prene post you want to do for thirty days before the vaccine and then the post obviously thirty days after. Turmeric resviratrol ginger Boswellia white willow bark extract detox formula, so fur of fane comes for coryciferous vegetables, Omega three vatty acids D three with K two and a multi vitamin multimineral omicron in all of its variants amicron number ninety eight. Whatever, we're at vitamin D three with K two melatonin, and we're gonna have a slide on melatonin. I am a big fan of melatonin, as dozymthin probably the number one antioxidant wants with its ability to pierce the cell easily. Kirkuit, quercatin, zinc, nap pro resolving mediators, l raveno, CNL, plantarum, res veratrol, and nad so. Out of a friend of mine that just loves to argue the data, very medically oriented, lots of respect for it. Here's the takeaway. There were seven clinical studies found with vitamin D. If your vitamin D level was over fifty, which I don't consider high. I consider a good level sixty to eighty, it was a statistical zero. Vaccinated or not of people dye, So vitamin D is something that all your patients should be taken for a multitude of reasons. Vitamin D also really can vanquish the cytokind storm. Vitamin D is able to stimulate interluken ten, which is one of the anti inflammatory interlukens, which conversely can decrease pro inflammatory TNF alpha I, inf gamma, interlucn six, and interluken beta, so it balances the inflammatory process. Possible applications of melatonin in long covid. Essentially, melatonin is great for sleep. Sleep is a critical element to help you get over along COVID. It's fabulous because it decreases oxidata stress, it decreases inflammation, and it supports ortophagy. So melatonin is a medicinimal nutrient COVID and hair shedding. I can tell you that the interesting thing is people have a lot of money not to lose their hair. I'm as vain as the next guy, and I get it, but a lot of people are losing their hair post COVID. Here's your COVID protocol. So yeah, vitamin A, vitamin C, vitamin E, vitamin D, biotin, panathetic acid, zinc hydrololized bovide in collagen. Big collagen fan, take collagen every day, Take it from my joints, Take it for my gut, great for the hair, and a strong amino acid blend. So let's talk about the gut and how COVID nineteen causes GI symptoms. Well, the virus enters in testinal cells using A to as a receptor. Despite protein binds to A two trigger cells to release cytokinds increase in inflammation in gisymptomology. Unfortunately, COVID nineteen can change the gut microbiota. The virus actually can travel through the portal vane, and the virus can impact vegas nerve, which we had more time. Maybe we can come back and have a whole hour just on vegas nerve. And all of this can occur because of viral shedding a factoid on the gut. One hundred times more ACE two receptors in the gut than there are in respiratory organs. Gisymptoms increase the likelihood of developing a severe incidence of COVID nineteen. SARS COVE two has been shown in data to actually cause more dys biosis and here's the study post acute COVID nineteen syndrome and gut dys biosis Linger one year after SARS COVE two clearance. So once again, for me as a functional medicine chiropractor, I integrate functional medicine in my chiropractic armamentarium. Every patient I ask have you had COVID? And if you have, I do want to test the gut barrier path. So when you take a look at this slide, there's a lot going on. I mean, here's a slide that I could spend fifteen minutes on. But the takeaway here is very simple, biological barrier alterations leading to mechanical barrier alterations ultimately leading to immune barrier alterations leading to bacteria translocation. So essentially, though breakdown from COVID is allowing bacteria to float through your body. What does that mean to you as a chiropractic aside, fifty two percent of people who had disc surgery were found to have a bacterial infection. That bacterial infection could be traced back to their leaky gut, so B cell expansion. B cells are your antibodies. So B cells are critical to proper function of immune system because the B cells actually protect and they also remember the number of B cells are greatly increased after any kind of bowel damage. So the takeaway here is B cell expansion doesn't allow guts to heal. So your gut heals on a five to seven day plan, stroma and epithelia cells come together, they are slowed down or your stem cells which release these cells are stopped because of expansion of a lot of antibodies. So when you have a condition that requires you to produce a lot of antibodies, you're never really going to heal your gut, and that's the reason you're susceptible to increased intestinal permeability and or a leaky gut. So let's look at these possible entries of SARS cove two into the brain. When you look at the letter A, it describes an entry of sarus cove two from the nasal epithelium to the olfactory bulb, entering the central nervous system B. This actually explains the entry of SARS cove two from the naso pharyngeal region to the cerebral spinal fluid, thus gaining access to the central net system. Letter C describes a binding of sars cove two to A two receptors on the endothelial cells of the blood brain barrier. Is thus invading the central nervous system and stimulating the cytokind storm by binding to A two receptors on glial cells and neurons. So, as you can see, it's very easy for sars cove two to pierce the blood brain barrier and adversely effect the brain. Covids tied to an increased risk of Alzheimer's disease in Parkinson's disease three point four times higher incidents of Alzheimer's in two point two times higher incidents of Parkinson's disease. This study an MRI and the brain actually highlights the damage in that lingering brain abnormalities and patients up to six months after the recover from COVID nineteen there was a high susceptibility of value in the regions of the frontal lobe and in the brain stem. Here's my super seven R action plan, and this is what I kind of house what I do in my office. I'm gonna do this in a very quick fashion because we're getting towards a hour mark and I do want to open it up for a few questions. So my super seven R action plan very simple. Our number one is reset, reset what, Reset your diet, reset your lifestyle, reset your mindset Get those sugars out, get those high carbohydrates out, Eat a more whole meal. The better choices. When you're in a restaurant, remove remove what unwanted pathogens. Remove unwanted pathogens. The first thing to do is take out is food sensitivities, food allergies, remove bacteria, viruses, and fungi that shouldn't be there. You can do so by utilizing a regular oil berberine garlic, serum bovine immunoglobin, which is the gold medal winner SBI or serum bovine immunoglobin actually is the mop of the gut. It binds with all different kind of pathogens and antigens and takes them out of the gut. The third or and HR is done singularly. R Number three is replace. You would replace digestive enzymes and stomach acids and pancreatic enzymes and increase bioflow. If you take any functional medicine courses with me, you'll see that bile acid is a critical element to avoiding leaky gut avoiding small intestinal bacteria overgrowth and you'll have a better cholesterol number on your serum tests. Four Regenerate, regenerate what the damaged intestinal muculsa heal and seal the gut lining by also creating an anti inflammatory environment in your gut. Reinoculate. Reinoculate with good pre and probiotics. The sixth star is you can reintroduce certain foods removed in step two. Remember taking a food sensitivity out is not removing the food for life. Food allergies may be the case. And lastly, retain your health and your gi integrity, and do so by a good diet, lifestyle mindset and substand supplementation like multivitamin multimineral'll make it. Three fatty acids, Vitamin D, probiotic and good quality greens and fruit drink said earlier. Can't control the virus, but you can control the host. So let me give you some lifestyle hacks before we close. Please avoid certain foods. Use my acronyms of GPS and DNA GPS, no gluten, no processed foods, no sugar, DNA, no dairy, no nicotine, no artificial sweeteners. Try not to use any vegetable oils and avoid anything that's deep fried. Filo anti inflammatory diet, a low sugar diet. Control your glycemic index and your glycemic load. Avoid those sugars. Detect and avoid food sensitivities. They are the hidden cause of inflammation. Decrease your environmental overload. Make clean eating a priority. Choose organic farm to fork food. If you're get to go for protein, have wild smat, fish, wild smash, salmon, macro anchovies, sardines, and harry either plant based or plant forward diet. Consume fruits and vegetables. Watch your sugary fruits. Grass fed meats are a great choice. High fiber is also nuts and seeds. Raw nuts sprouted even better makes the enzymatic reactions more available and kills all anti nutrients. Chicken sip, soup and bone broth is every ethnic soups, penicillin if you will, herbs like ginger and turmeric or great choices. Make sure you're consume an appropriate fluid intake. If you're gonna drink coffee and tea, and I am a coffee of fishionado organic coffee is the choice. The oils you want to cook with at a low flame over a duration of time, extra virgin olive oil, avocado, macedamianot and coconut oil. Consume mushrooms. Lifestyle hacks we talked a little bit before of vitemitt and fasting time restrictive eating, make sure you get good quality sleep, have a home extra size and on the road, and an exercise program every day if possible. Let's not forget how robust chiropractic care can make your immune system again. I'm a low level laser guy. I believe in modifying stress as much as you can support balance make your immune system more resilient because instead of reacting to disease, a pro active, healthy lifestyle can help reduce the risk and prevent it. As a successful evidence based chiropractor, you want three things to deliver the best possible treatment the results problems quickly, to attract existing and potential patients with your outstanding care and access to simple, scalable solutions that save you time. And with reimbursement increasingly based on outcomes rather than service is delivered. Shifting your focus from merely treating patients to applying best practices is more important than ever, which is why you're going to love iiro up. But don't just take our word for it. Join the nearly one thousand Cairo Up providers from around the world. We're working together to become the undeniable best choice for patients and payers alike. You can't afford not to give us a try. Visit Cairoweup dot com today to learn more. So again we're at the end. Shameless plug here. It is Immune Reboot. It was a bestseller in December. It came out in December. I really appreciate all the support. You can order it now on Immune reboot dot com or you can just go to Amazon. If you want to reach out to me, follow me on social media. I'm on Facebook. I'm posting twice a day. We're doing videos. We're doing health videos. They're sharable with your patients. Dr Robertsilverman dot com and I'll have to couplish quick short minutes for Jessica to come on and if there's any questions, I'd love to answer them. Thank you so much, doctor Silverman, and I have to second what he was just saying about his social media presence. Doctor Silverman does an incredible job featuring different guest speakers. From time to time. He comes on and does videos and trainings. Tons of great content going out, research articles posted all the time, so definitely check them out on those channels. We did have a few questions that came in through our chat feature. One of the things that you mentioned earlier on was that in terms of the T cell production in children and teens versus adults, in your practice and in your research, have you seen that there's been a difference between the type of long COVID symptoms that children and teens are experiencing versus adults. I see similar symptoms, but the children are not, fortunately, is getting as much as adults, which is a little surprising because they don't have a fully developed immune system yet. So it just goes to show that the health issue in America is real unfortunate in that the adults are just getting sicker and sicker and sicker because we're eating these crappy foods. So again, I don't want to get into political genre, but I would really love the TV to give an alternative doc I'll say myself or anybody a chance and say, hey, guys, there's all these options no matter what you want to do to your body. If your body's more resilient and healthier, you can respond better. Absolutely, And I know there's been a lot of news lately about this underlying kind of ADHD pandemic that's coming out of the COVID pandemic. New research is showing that adult ADHD cases have increased four times what they were in terms of the diagnoses versus pre COVID, and a lot of that they're saying may have to do with what they call this NCA or massed cell disease that happens as part of that CETA cane storm and as part of what happens with long COVID. Are you seeing a lot of that in your patients? How are you addressing some of the neurological symptoms that are existing and becoming chronic conditions after COVID. There's a lot of neurological conditions. There's a lot of damage to the brain. My mom, I mean, my mom's old, she's in the nineties or ninety I think it was one when she got COVID. I mean I came in and she was acting as if she had a stroke. So there are a lot of neurological conditions. Because if you adversely affect the gut, you're going to also affect the brain because they're bi directionally communicating whatevery duty gut your duty brain, whatevery duty brain, you douty gut. This particular virus is so small it's able to pierce the blood brain barrier and damage certain areas. And we can see that in a lot of the symptomology, like the loss of sense of smell, that's a cranial nerve issue. So I am doing a lot of chiropractic care. I'm using a lot of low level laser therapy, and I'm applying a lot of lifestyle changes to help people get through this onslaught to their nervous system absolutely, and I know that coupled with that, there's also been this worldwide shortage of medications that can treat some of the neurological symptoms. Medications that can treat again, ADHD is the one that's making news lately because there's been a shortage worldwide and people are looking for alternatives to stimulant medications. I think people are looking for alternatives now to prescription medication because of the rising cost of prescription meds. And then now that in this new post COVID world, there isn't a supply chain that's really reliable. So I know you had mentioned that you have this protocol that you implement with a lot of your patients when it comes to their immunity and next steps. Are you finding more and more patients are coming to you looking for alternatives to a lot of the prescription medications that they've been prescribed. Oh yeah, I mean, without question they are. Because I think there's a I want to be politically correct, I think there's a loss of trust, and I think people were let's say anti medicine, but they were looking for other options within that and realizing there's a whole toolbox. So all that being said, people are coming for alternatives. People are coming for ways to keep their body healthy. Listen, we've been fighting this, as an example for three years with nobody won. There's no real outcome other than we're living with it. So the soito we all get healthier. The soda we can deal with any kind of health issue. Absolutely. Another question that came in was regarding your typical new patient intake. The first part of the question was are you asking about things like past COVID on your intake forms? And then the second part of that question is can you give us kind of a thirty thousand overview of the type of testing that you do with new patients, whether it be blood panels, panels for food allergies. Can you give just a quick rundown of the type of testing that you usually do in your intake? Sure? So, first thing, I just say, did you have COVID? I mean it's a fair question. Now, remember I live in New York, so we have different laws than almost anybody else in the US. But I ask them, have you had COVID? Yes? He is the typical answer. Did these symptomologies start after COVID before? Have they gotten worse from COVID? And we have the conversation if there's a relationship, which in many instances there is, we have a conversation because no one's asking that. And if there's not, well, so be a ten to what the problem? Is My goal and I'm not at one hundred percent? Is my goal? Every patient walking in and are out of this office gets a full comprehensive blood serum test. I think that the number one thing where I've grown is in my analyzation of blood serums. And I do anywhere from twenty two to twenty six miles, so people think I am a vampire without question. So full comprehensive blood exam, food sensitivity test, got barrier paddle test those bearers without question, vitamin d omega three tests once in a while, a poop tests to see what's going on in your microbiome, so I can see what the body's doing from the inside out. I mean, most chilepractice take X rays, but they're afraid to take blood labs. The blood labs are quite revealing, wonderful, and just for our docs that might be on the call or our other healthcare providers, do you provide any services via telemed if they had a patient that they were kind of scratching their head with and just struggling with from a nutrition perspective, or to help with some of these immunity challenges. Is there a way that they could contact you for consulting? Do you offer any of those type of services? Yes, I do a lot of telemed. I have already dedicated a day and a half a week just to telemed for me. That is kind of where I'd like to see my nutrition practice go because I'm able to touch people that don't have to drive two hours or take two days to get here absolutely, and I know a lot of providers are beginning to offer the more telemed services again in this new world that we find ourselves in. You had mentioned also that you utilize laser as part of your treatment protocols and low level laser therapy. Could you expand a little bit on specifically how you're utilizing your laser in practice and what types of conditions you are seeing the best results from the conditions that I'm seeing the best results from are muscular skeletal, and then I apply to the gut barrier access, so I'm also doing it for the gut, the brain concussions TBI, and of course the vagus nerve. So I'm using multiple wavelengths and some wavelengths of four five another one's five point thirty two, which is green. I actually just completed with another doc. We were co lead investigators, and we got an FDA clearance for a particular laser that's green and violate. I also happen to use red, but I use real lasers. I'm not big on the infrared use lasers that come out of laser dials. And I found that laser has been for me a breakthrough modality and you can use it on its owner synergistically with any other type of soft tissue release like a factor intent. Wonderful, No, I always love to hear that, and great in creative ways that docs are using different modalities and being on the cutting edge. One final question and one thing I'd like to ask before we leave, So what's next for you, doctor Silverman? I know you recently released this book. I know that you're involved with a lot of teaching at conferences. You obviously offer your own education both online and in person, and then you are participating in a lot of research. Tell us a little bit about what's ahead in twenty twenty three for you. That's a great question because we just haied that conversation last night. We had it last year going into last night, if you will. My goal what's next for me is the expansion of the message. My dad taught me one thing when I was young. I always tease him. I said, Dad, you didn't spend a lot of time with me because I threw a ball and caught it. You didn't like that. You wanted me to fix doorways. But you did say one thing that you're never going to have a job as long as you love what you do, so I love what I do. I love getting the message out and trying to get the message on what chiropractice can do in the indelible mark they can make on our healthcare system. And I think that we are the forgotten physician in America today. Wonderful. Thank you so much, and I appreciate you coming on today and sharing this great information. I certainly would love to have a follow up second part to this at some point in the future on that vague nerve training that you mentioned. Again, thank you so much, Doctor Silverman. We appreciate you being on today and I hope everyone has a great rest of their day. That's all for today's episode. Be sure to tune in for episode sixty six, where we off a new training with doctor Tyler Kimp titled bone Stress Injuries, The Good, the Bad, and the Ugly. You won't want to miss it. Episode sixty six drops in two weeks. 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