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174. Why Your Anxiety, Depression and ADHD Might Actually Be Gut Health Issues · Radically Genuine

• Roger K. McFillin, Psy.D, ABPP (00:01.206) Welcome to the radically genuine podcast. I'm Dr. Roger MacFillin. Tend to receive a lot of questions about gut health and its impact on our mood, sleep, overall health, of course, our mental health as well. But what does gut health actually even mean? What are gut microbiome? How do we achieve optimal gut health? How do we even know if our guts are healthy? 72 % of Americans complain of gut issues once a week. And when we look at the data, the trajectory of illness becomes pretty clear. 93 % of the leading causes of death in the United States appear to stem from chronic inflammatory conditions that can all be directly traced back to the gut. In the United States, less than 5 % of the world's population, and according to the CDC, it has 50 % of the world's cases of inflammatory bowel disease. So what happens when you see a conventional doctor in the United States? You're probably going to be prescribed a drug, drugs that potentially have more negative impacts on our overall gut health. Many people in my field, those who come to my center struggling with irritable bowel syndrome are prescribed SSRIs as a frontline treatment. So I certainly have to learn more about gut health and I want to welcome Josh deck onto the podcast. He's a holistic nutritionist and physicians consultant specializing in Crohms colitis, severe IBS. He's got this great podcast called reversible. You know, he's interviewing some of the largest experts in this area across the globe. And after reversing over 300 cases of Crohn's and colitis, which were previously thought to be impossible to fix. He's now been connected to some of the world's most renowned doctors. He's also a medical lecturer. He helps educate doctors on this holistic approach to gut health and inflammatory bowel disease. This is our opportunities to start simple and kind of build off of it. Josh Deck, I want to welcome you to the Radically Genuine Podcast. Josh Dech - CHN (02:16.238) Roger, thanks so much for having me here, man. I appreciate it. Roger K. McFillin, Psy.D, ABPP (02:19.466) Well, let me learn a little bit about you first, your background and how you got interested in this area of healthcare. Josh Dech - CHN (02:28.942) You know, I can honestly say, I think I fall into the same category as most practitioners in this space where we lived it. And so we had to learn it. You know, it's one of those pain to purpose stories. I've dealt with gut issues my entire life. My mom had them, my dad had them. My mom had emergency bowel surgery, nearly died when I was probably 11, 12 years old. Had to have an emergency bowel resection. They cut out 12 inches of colon because she had a perforation. It was leaking contents from her bowel into her abdomen. and she was going septic. And the surgeon said, like, another couple of hours and you would not have made it tonight. So I've been down this road through my family, through my personal history. I had irritable bowel syndrome my entire life. Josh Dech - CHN (03:12.994) back when I was in high school, you know, I was a very high level competitive athlete, competitive wrestler. And I remember before tournaments, I'd have this quote, nervous belly. I have to run and use the bathroom, particularly some moments where some of the high schools used to compete at, there was no doors on the toilets. So you're just sitting there having the worst time of your life and 15 people come look at you, turn around and walk away. So you get pretty comfortable with bowel stuff pretty quickly. And it wasn't until my... mid-20s sometime when things really started ramping up. was dealing with joint issues, severe acne. mean, chronic arthritis inflammation as a strength athlete, it hurt to train. It hurt to do anything. My brain was a mess. ADHD was just an all-time high. And when I was probably at my worst, I'll bet you I was up to 15 plus bowel movements a day, 10 minute transit times, I could see whole undigested food in the toilet. I was put on Vyvanse for my ADHD, which gave me suicidal thoughts, manic episodes, I'd have these peaks and valleys and crashes, should have been divorced by the time, God bless my wife. And I got to a point where I was having a fluctuation between constipation, diarrhea, blood in my stool, you name it, it was just... at the bottom of the bottom, I never got any formal diagnoses. Looking back, it was probably an undiagnosed form of colitis or ulcerative colitis. But that was my journey back to having a healthy gut where I can go and eat a whole pizza and feel perfectly fine. So that's really, I think there's a misunderstanding that we get these diagnoses. You go, you have IBS, you have Crohn's, you have colitis, you have whatever. We go, well, I just have it. I didn't accept that answer. And I don't let my clients accept that answer either. you are experiencing symptoms of dysfunction. You have dysfunction, not a disease. And that's really where my story stems from. Roger K. McFillin, Psy.D, ABPP (05:08.086) All right, so let's start with the basics as we're throwing around these words, gut health. And I think we hear it in popular culture all the time, but people don't actually know what that means. So let's explain what is actually gut health. And we hear words like gut microbiome or biome. What does actually refer to? Josh Dech - CHN (05:28.654) That is such a great question that I don't think we really define enough in the broad spectrum of things. Now will tell you, I think when you define gut health, this one will be contextual practitioner to practitioner, microbiome is a consistent. For me, having good gut health doesn't just mean healthy feelings within my gut, that I'm not bloated. I don't have constipation, diarrhea, acid reflux, nausea, vomiting. I feel good all the time. I could eat whatever foods and even like my wife, she could eat rocks and her gut feels fine. that can be considered good gut health. On the other hand, I believe the ones who are lucky experience gut issues within their gut because they feel bad in their gut and go, oh, I ate this thing. It made me bloated or gave me loose stools. Therefore, it's bad for my gut. The ones who are unlucky experience brain fog. They experience joint pain or acne like I did. There wasn't an inch on my back that wasn't covered in acne in my late teens, early twenties. And I was told it was genetic. Those who experience any kind of mood swings, sleeplessness, or maybe you're experiencing other diseases or conditions, anxiety, depression, bipolar. Any of these things that we look at, liver disease, heart disease, even Parkinson's, 30, 40 years down the road can stem from the gut, but you don't feel it inside of your gut. So to me, a healthy gut is not only how do we experience the sensations of bloating or not within our digestive system. but how it's connecting to the rest of your body and can those diseases be traced back? If they can be, even though you're asymptomatic, so without symptoms in the gut, you still have a gut problem. That's how I define gut health, both inside and outside of the gut. Roger K. McFillin, Psy.D, ABPP (07:09.086) Okay. So that makes it more challenging here because there are the typical symptoms that you described usually with your bowel movements, for example, or just feeling nausea or experiencing the digestive issues. But what you're saying is that you're, you might not be optimizing or achieving gut health, but you're experiencing other symptoms that appear to be unrelated, right? It could be things that we label in the medical system, depression, anxiety, bipolar disorder, ADHD, but then it's like, could be you know, joint pain or a number of other things. How would one even know if the really the core of the issue, the recall the root cause of the issue is related to your gut health? Josh Dech - CHN (07:49.23) Hmm. That's a really powerful question. I'm going to throw a blanket over this statement. And I do this with caution because not 100 % of cases, but go back to Hippocrates 2400 years ago, quoted for saying all diseases begin in the gut until mid 2000s when Dr. Alessio Fasano rediscovered this, he actually published a paper titled All Diseases Begin in the Leaky Gut. And this comes back to be true time and time and time again. We have connections. You mentioned in the introduction about 93 % of the leading causes of death. What's 13 out of 15 per the CDC, we're talking heart disease, cancers, cerebral vascular disease, respiratory disease, diabetes, Alzheimer's, kidney and liver diseases, hypertension, Parkinson's, all these things come back to the gut and how they impact our digestive system, therefore contributing to disease down the road. So. I think if we're to look at gut health as a general whole, to put a blanket over everything, all of it comes back to the gut, if you're sick ever at all. However, I wanna say this with a grain of salt because I like to say, I should say my dad would tell me, if you give me a hammer for long enough, everything looks like a nail. So as a clinician, it can be really easy for me to go, well, all diseases begin in the gut and here's the paperwork, here's the proof, but the reality is there will be some things not gut related. but for the vast majority of us, if you're wondering if it comes back to the gut, it probably does for the 98, 99 % of us. Roger K. McFillin, Psy.D, ABPP (09:25.48) Okay. So then the next obvious question is what are the root causes here of poor gut health? I'm sure you're going to go over, you know, everything that we automatically assume related to our diet and lifestyle, but let's just like start, you know, from the beginning. How about just like birth, for example? Josh Dech - CHN (09:45.602) I love that you went there. Let's talk about the basics. I wouldn't be doing my due diligence if we didn't. First things first, anybody who is eating frosted flakes and pizza and beer and candy or junk food, basically anything your great-grandmother would not recognize as an edible substance, it's causing you gut issues. Let's just throw a blanket over that. If you're low stress on a chronic basis or high stress frequently, that's causing gut issues. If you're not sleeping, it's causing gut issues. So that's our basics. But there are three reasons why we get sick and all these three things also contribute of course back to your gut. So we'll tie them all into one pretty bow. Three reasons I've distilled it down as to why human beings get sick ever at all. The first thing is going to be toxins of some kind. So whether that's going to be recirculating indoor air. According to the EPA, indoor air is one of the top five biggest pollutants for humans in North America, recirculated air. Maybe your toxins are mold. Up to 70 % of US homes have an active mold issue. Up to 40 % of cases of asthma are attributed back to mold, for example. Maybe it's heavy metals or glyphosate or some kind of food you shouldn't be eating, whatever it is, right? High stress, high blood sugar, these are all toxic to the body. So number one, we get toxins into our system that shouldn't be there. The second reason we end up getting sick is going to be due to deficiencies. So your basic micronutrients, macronutrients, vitamins, minerals, fats, proteins, water, electrolytes, all these basics we need. If you think about it, your body is kind of like one big city, all working together. All of your organ systems are the factories and the shops and everything that keep a city running. Well, those workers inside those factories need tools to do their jobs, right? Ford Motor Company can't build cars without tools. Well, if we look at your body, All these organs are individual factories of sorts. The cells that make them up are the workers. Those workers need tools, vitamins, minerals, amino acids, peptides, whatever they need to do their job properly, to build, to restore, to clean. They need these things. If we lack them, your body is constantly turning over cells and breaking down. If you do not have the tools you need to rebuild, you're only ever breaking down. If you get sick, you need excess tools and abundance to clean up the mess. Josh Dech - CHN (12:09.058) This is why deficiencies will make us sick. So the first reason we get sick is toxins. The second reason is deficiencies. And the third is going to be microbial imbalances. And this will circle back to a prior question. What is the microbiome? Well, again, much like cities within your body, you have these communities called microbiomes. You have an ecosystem. Microbe is just tiny and biome just means ecosystem. of all these little microbes. have parasites and bacteria and fungi and yeast and all kinds of stuff living inside these ecosystems, working in harmony. It's kind of like Willy Wonka's chocolate factory. It really is that obtuse and magical. And they're all doing things. Now, the microbiome in my mouth is different than the one in my sinuses. It's different than the one in my scalp. It's different than the microbiome in my groin. It's different than the vaginal microbiome or the rectal microbiome or the small bowel microbiome. They're all different. And these ecosystems all work in harmony together. So the third reason we get sick is an imbalance of these microbes. You have too many good guys, that's a problem. We maybe call that one SIBO or small intestinal bacterial overgrowth. You have too many bad guys, it's an active infection, candidiasis, it's a parasite infection, it's E. coli, whatever it is. These imbalances of the microbes are what contribute to illness. Because when they're perfect and working, they help regulate our immune system. 70 to 90 % of your immune cells are made and matured inside of your gut. Up to 90 % of your neurotransmitters, which are going to be used in your brain, are made inside of your gut. We have so much that goes on, regulating hormones, production of certain vitamins, detoxification, all these things happen inside of your gut. So an imbalance there causes a problem. So the three things that make us sick, toxins, deficiencies, and microbes, and those microbiomes, those ecosystems. are all in one big part working together as different communities. They all communicate. The microbiome in my gut actually communicates to my brain. The microbiome in my skin, for example, communicates to the rest of my body as well. If I have a problem inside of my gut and it pushes out through my skin in the form of acne psoriasis, it's disrupting the skin microbiome. I might have eczema, for example. So everything communicates. Roger K. McFillin, Psy.D, ABPP (14:27.84) So Josh, we live in this ultra sanitized world and there's a fear of germs. And here we are in the wintertime recording this and you this idea that you catch a cold from another person and it's cultivates the stress and fear around illness. Would you argue against that idea? I've heard others argue against the idea that you can actually catch a cold from another person. It's more related to what you just described. In fact, aspects of like toxins, deficiencies, imbalances. that like impair your ability to be able to be in a state of balance and then the elevated immune responses to them are our sickness. Josh Dech - CHN (15:08.194) You're absolutely right. And there's a lot of theories behind that. But if we tie this back to the original question, which is how do we develop good gut health, for example, versus bad gut health right from birth, that first skin inoculation, and there's actually now some interesting research suggesting we get microbes in utero from mom, right? So let's say you're born vaginally, you're covered head to toe in the vaginal microbiome. That's your first inoculation. Second would be breast milk and breastfeeding. Then you have your environment around you. Now, where we see people getting sicker, one of the things that contribute to this gut imbalance or gut issues is going to be generational dysbiosis, meaning an imbalance of gut microbes. And this is actually researched by Erica and Justin Sonnenberg at Stanford, where they've shown in mice studies that if we start to kill off, you talk about hyper sanitization, generationally we are losing microbes due to toxins, due to infections. But let's say for example, grandma has a thousand microbes. Let's say great grandma, thousand microbes, late 1800s, gives birth to mom. Right at the industrial revolution, the late 1800s, 1890s, toxins get into the system, some microbes die. Well, mom's a child now, right? She's running around, becomes a young adult, young woman in her 20s, right at the introduction of penicillin. She gets sick, gets penicillin. So she loses more microbes. And then she gives birth to the next. And then next with industrialization, with sugar, with pesticides, glyphosate, chemicals introducing into the system. We used to have five, now we have 20,000 pesticides. We see microbes dying. And so that original inoculation of what a healthy gut would be, best case scenario, you're living on a farm in the middle of nowhere, hands in the dirt, playing with the animals. That's full inoculation, vaginal birth, breastfed. But then we have to today where we are getting sicker. We are losing this inoculation. And this will tie back to what's called the hygiene hypothesis, which you mentioned, which is, is it that we are too clean in our modern world, which is contributing to illness? I'll pose this question to you. We talk about the three reasons we get sick, right? Toxins, deficiencies, and microbes. Now we know we're losing a lot of microbes. We have the studies to show, for example, compared to rural Nigerian farmers living on the land, just doing what they do, they have much more diversity in their gut microbes. Josh Dech - CHN (17:28.802) than we do in North American cities full of chemicals and the junk in the air we breathe. So we know that. But let's take it back a little bit. If we start diving into some of the research, we can see if 5 % of the globe being North America has 50 % or so of the cases of Crohn's colitis, these are typically severe immune imbalances, imbalances of microbes, toxins, whatever it might be. So we're losing a lot of microbes. But if we believe toxins to be the primary driver of why we get sick, why do we not have more cases of bowel issues and other illnesses like we have here in China or India, where they have some of the highest levels of production industrialization per capita in the world? You would expect then that per capita they would have more diseases than we do. But we have both toxins and microbial deficiencies, whereas they have just the toxins without the microbial issues. Have you seen some of the street food in India? A lot of them walking bare feet. There's still public defecation in a lot of major cities in India, right? So there's an immense amount of microbes. not saying we need to roll around and street meat in our own feces, but the idea is that if we're exposing ourselves chronically to the exterior environment, to fresh air, to the dirt, to animals, we have a much more robust immune system and possibly detox pathways to get rid of the junk in our system. So to circle back to your question, are we too clean? I would say absolutely, which is contributing to these microbial imbalances, which is one of the three reasons we get sick. Roger K. McFillin, Psy.D, ABPP (19:01.27) Okay. Well, let's talk about, first of all, how the current medical system recognizes this. So if you went into your typical alip, typical allopathic medical doctor in Canada or the United States, and you're experiencing an inflammatory bowel condition, okay. Um, how do they go about, uh, first diagnosing the condition and then what are their courses of treatment? Josh Dech - CHN (19:30.958) So if we're talking inflammatory bowel diseases, just to clarify, we're talking Crohn's colitis, a really severe inflammation, okay. If you go to your doctor with symptoms, there's two ways you get sick with IBD. One, very quickly, over a couple of days, weeks, or months, you went from healthy to sick and you're highly inflamed and bleeding from the bowel, whatever it is, they go, yep, you have this condition. The second, maybe you had irritable bowel syndrome, for example. Upwards of 20 % of Crohn's colitis cases have a previous diagnosis of IBS. so irritable bowel syndrome, before it became IBD or inflammatory bowel disease. So you go to your doctor, instead of looking at, did this come on suddenly or a long time, like a wear and tear, like wearing a pair of shoes without socks that heel rubbed raw and blistered and bled, they don't look at that. They go, well, you just have this condition. What they do is look at certain diagnostic criteria, which in themselves aren't technically diagnostic until you combine the pieces, but they'll look at things like calprotectin. just a measurement of how much white blood cell activity is in the area, white blood cells called neutrophils. They'll look at your symptoms. Of course they'll do biopsies. They'll do colonoscopies and visualize is there inflammation of the small or the large bowel? What does your blood work say to look for certain markers like CRP? But it's interesting because they say, these are genetic autoimmune idiopathic conditions, meaning they're genetic in the sense where they blame your genes and say there's nothing we can do. It's just God plays favorites. The second, They say that it is autoimmune, meaning your body is attacking yourself. And then the third is that it's idiopathic, meaning no known cause. We don't know what's happening or why it's happening. What we can do, now that we've given you this diagnosis based on all these criteria, we can then give you medications to manage your symptoms. And they go on, course, a line of treatment, typically at steroids for an acute, prednisone, bedesthenide, something else. And if those don't keep you in quote remission, therefore keeping the disease at bay, they will then move on to biologics, example, like immunosuppressive drugs. Let's wind the clock back on this one. Josh Dech - CHN (21:36.566) Immunosuppressive drugs can be a temporary band-aid solution, but they're not a permanent solution. Think of it this way, Roger. If you went outside and you were going for a walk and you stepped on a nail and that nail goes through your foot and you go into your doctor, imagine he looked at you and was like, Roger, that looks really bad. It's really inflamed. Unfortunately, there's nothing we can do. It's just part of your body now. well, I'm gonna give you numbing cream for the rest of your life to manage this disease. this pain you're experiencing, if it doesn't work, we can cut off your foot. That's their solution, that would be insane. But now you go to your doctor, having been previously healthy for years, decades sometimes, the amount of people who come in to see me at 30, 40 years old, recently diagnosed, your doctor goes, yep, it's just genetic, it's part of your body now, there's nothing we can do. I'm gonna give you these medications to manage your symptoms for the rest of your life. If they don't work, we can consider cutting out some of your bowels. Why is this conversation not just as insane? You cannot go from healthy to sick and there not be a reason. It's either one of two things. One, a slow wear and tear. Prime example, Louis. 18 years, severe ulcerative colitis. Planned his funeral three separate times. Thought he was gonna die. Turns out he had a little issue way early on, parasites or something. It ended up leading to gallstones. He had his gallbladder removed. which led to him not digesting fats, which led to dysbiosis and imbalances in his gut microbiome, which led to wear and tear inside of his intestines, which led to ulcerative colitis. We wound back that clock, he's now four years completely symptom free, never a pain in the world, no sign of any kind of anything, got a scopes, he's perfectly healthy. You'd never know the guy had colitis and almost died three times had you not looked at his medical charts. That was a slow wear and tear. Another example, had a young man come in, 21 years old, diagnosed recently with ulcerative colitis. His doctor said, yup, it's just genetic. There's nothing we can do. It's because you're Jewish. I shit you not, Roger. He says, it's just genetic. Jewish people get this disease more than others. There's nothing we can do for you, but here's some misalamine. Take it for the rest of your life. If it gets worse, we'll give you better drugs, blah, blah. Well, it all 15 minutes to sit down. This gentleman started working a brand new job in HVAC. So he's working in ventilation systems, new homes, old homes, renos, whatever it is. Didn't wear his PPE, so he's not wearing his masks. Josh Dech - CHN (23:58.914) His symptoms lined up, his history lined up. I said, I think you've got a mold infection, toxins, why we get sick. Did a urine test, he wanted to confirm, came back positive for a mold called okra toxin A, highly toxic, well known to cause bowel disease. 10 weeks in, no symptoms, no drugs, no nothing. A couple of binders for a few more months after that to keep it out of his system. He's great, never came back again. So doctors diagnose and treat with a lot of assumptions. We can dive down the rabbit hole as to why it's not genetic, it's not autoimmune, and it's not unknown, but that's the gist, is that they diagnose based on symptoms with a lot of assumptions which frankly are wrong and they give you drugs to manage rather than pulling the nail out of your foot. Roger K. McFillin, Psy.D, ABPP (24:41.206) Yeah, it's no doubt that this this feeds the pharmaceutical industry, I mean, this is ever never ending loop of pharmaceutical influence in medical education and in developing drugs to suppress symptoms. So let's compare then the standard medical care with like functional medicine, more functional or naturopathic kind of approaches. If you went and saw a functional medicine practitioner with Josh Dech - CHN (24:51.502) Absolutely. Roger K. McFillin, Psy.D, ABPP (25:08.08) similar symptoms, how would they go about diagnosing and treating? Josh Dech - CHN (25:14.114) This one's a little bit of a gray area because I have seen a lot and I have a lot of respect for naturopathy, homeopathy, all these different natural functional practices. I think you need to see someone who specializes in your condition. I've seen a lot of people with bowel disease, for example, or severe IBS even go to a naturopath who's more of a generalist. What they end up doing is they say, well, you're really inflamed. You've got all these ulcers in your bowels, you're bleeding, you've got this, you've got that. Here's a bunch of plant-based anti-inflammatories. to manage your symptoms. Well, medications do that. Medications manage your symptoms. They don't remove the nail. Neither does curcumin or ching dye or slippery elm or whatever, DGL, glutamine that they give you to manage your symptoms. That's plant-based medication. So unfortunately, even in the functional space, quote, functional space, we do see a lot of practitioners managing symptoms without going after the roots. So my caution would be find a specialist for your condition who understands the roots, not just management. That being said, in true functional approach, what we're looking for is what is the nail? Let's go back to David, 21 years old with a mold infection. His doctor, the traditional system, you come in, you got five, seven, nine minutes if you're lucky with your doctor. They assess your symptoms, check enough boxes to put you into a box to give you a medication. Okay, check, you have this symptom, you got the ulcers, you got the blood, you did these tests, you're positive, therefore you have this condition. Therefore I can give you these medications in this order check check check if they don't work next option is surgery check check check. It's cookbook medicine But their job is to get you in and get you out. It's an insurance based model So a lot of these doctors some yeah, they're frankly dicks and they don't care and they're just here for the money and the payouts There's been accusations There was a doctor in Detroit in the early 2000s who prescribed a whole bunch of chemotherapy medication to something like 1500 patients who didn't have cancer just for the kickbacks from the drugs He went to prison for a very long time. But the idea is it's an insurance-based model. That doctor wants to pay off his quarter to half a million dollars in medical debt. If they want to pay their nurses, their staff, their upkeep on the clinic, if they want to pay all the expenses they have to run a clinic, they got to get you in, get the $25 kickback from insurance, get you out in seven minutes, see the next patient, get the kickback from the medication. This is how the system works. If they want to keep their jobs and keep their clinics. If you want the safety net from insurance. Josh Dech - CHN (27:42.168) This is why the system is broken. So that's their system is a cookbook, checkbox, get you in, get you out, categorize you, give you a drug, move on like an assembly line. Whereas functional medicine will spend one, two, sometimes three hours just diving into history, into symptoms, reviewing labs, going over quote functional labs, like certain urine tests, like an oat or an organic acid test or a stool sample, looking at your GI microbiome, that gut bacteria we talked about. We spent hours pouring over this. And for example, I don't know, a lot of practitioners, maybe they'll see you once a month. I see my clients weekly because things can change on a dime. I need to see you nonstop. And what we're looking to do is micromanage your processes to make sure you're getting better. And that's the difference between insurance-based, seven minutes every six months, here's a drug, come see me if it gets worse, versus sitting down and working with someone who understands your body and is there with you through the entire walk. That's really the functional versus allopathic or traditional medicine difference. Roger K. McFillin, Psy.D, ABPP (28:41.942) So you mentioned earlier parasites, now it's peaked my interest. You know, it's kind of associated here in the United States. It's like a third world kind of condition. You you can't get parasites here in the United States and North America. So let me ask you, like, how common are parasites in the United States, Canada, and how are they related to gut issues? And then I guess the follow up question is what do you do about it if it is the case? Josh Dech - CHN (28:45.271) Yes. Josh Dech - CHN (29:10.242) That is a great question. So first thing, there is an understanding that parasites, like you said, are a third world problem. They're not, they can't possibly be. at even the basics of imports, exports, immigration, travel, destination travel. There's no way that parasites would just be third world anymore, not in our modern world. So that's number one. Number two, depends on who you ask. My mentor, for example, has told me from his parasitology experts he's learned from and the information is trickled down. that if you have a pulse, you have parasites. And we know there are parasites that live inside of our gut anyway. There's actually been a research for beneficial parasites like Trichorus suus, which has been shown to improve the outcomes of bowel diseases like Crohn's or colitis. I'm not saying go infect yourself, but the idea is even they have a positive role in our ecosystems. The challenge is so many of us through, again, generational dysbiosis, loss from great grandma to grandma to mom to you, As we're losing microbes in diversity, we're losing balance. Therefore, even Candida, which is actually a good microbe, in so many of us is now overgrown due to artificial foods, sugars, everything we have in our system that feeds them, they have imbalances. So maybe these parasites could have been good for us, but now because there's nothing to regulate them, they are bad for us. That's what we gotta consider here. So how many of us have parasites? Probably all of us. How common is it in bowel disease? I'm willing to bet 70 to 90%, I see parasites as an important layer of getting someone better. In fact, parasites are thought to be this mythical creatures, but there was a recent paper that came out, I believe it was a New England Journal of Medicine, that actually showed a visible scope through the bile ducts, these tubes inside of your liver that showed a physical parasite look like a tadpole crossed with a manta ray, for example, these little floppy things, these liver flukes. They live in there, they block up, physically can clog your drainage and exit pathways. They can actually burrow certain parasites will get through your gut lining and they'll burrow into the muscles in your body. The challenge is we try to remove them with things like an Amazon $20, know, over the counter parasite removal tincture of some kind. And instead of removing and eradicating the parasites, we agitate them, they burrow deeper. And then during your brain and pancreas, you got cancer there 15 years down the Josh Dech - CHN (31:34.786) So we have to keep in mind that parasites are everywhere. We probably all have them. The vast majority of cases I see have active parasite infections. Some will argue, they're mucoid plaques, for example, another conversation, but parasites might not look like this nice seamless worm. You only see about 30 % of what you actually excrete. They make enzymes that break themselves down and they can coat themselves in cholesterol, kind of like an armor to protect themselves, which can cause these lumps and bumps and make them look like not. Parasites for example, so it can be very hard to detect even a parasite test for stool 30 40 percent accurate at best So you have to look at symptoms and then the removal process is very catered You have to open up drainage pathways in the body, which are your exit doors You then have to work on some killers or paralytics to excrete them from your system There's all kinds of ways to do it But again work with a specialist who understands parasites because if not, you're gonna be looking for some problems and potentially worse in health issues down the road. Roger K. McFillin, Psy.D, ABPP (32:34.804) So you wouldn't suggest like as part of a typical health routine that you undergo some parasitic treatment, because those are advertised out there. Like you do it at a certain time of the month, like around a full moon and so forth as part of a natural health routine. Josh Dech - CHN (32:52.846) You know, that's a great question, Roger. I maybe misspoke or didn't clear on that one. Let me clarify that and I'm glad you asked. I would recommend it. However, if you're somebody who believes you have an active parasitic infection contributing to an active disease, I would work with a specialist who can help you drain, help you open these pathways, regulate your immune system, do what you need to do to get the bulk of it done, and then an annual or biannual self-administered cleanse, absolutely recommend. In fact, it's common practice. countries all over the world, especially Southeast Asian countries, South American countries, even Japan. When you buy sushi over here, for example, the little green leaves that you'll get, well, traditional sushi in traditional Japan, that would actually be an anti-parasitic herb you eat with your sushi, for example. Or wasabi wouldn't just be horseradish and green dye, it would actually be from a wasabi plant, much more expensive to make, but these things would be beneficial and anti-parasitic. But over here, Roger K. McFillin, Psy.D, ABPP (33:39.401) Interesting. Josh Dech - CHN (33:50.476) Doctors many doctors even will say, no, it's not a big issue I've literally got a video up on my screen from the other day that I was I was watching I bought this some six foot tapeworm. They pulled out of a lady's body. Well, those are parasites, right? So we know they exist. It's just the question is Will we let hubris get in the way as a clinician or a medical practitioner say well, they don't exist I don't know them. Therefore they don't exist versus I don't know but that's interesting. Let me see if I can get you some answers Roger K. McFillin, Psy.D, ABPP (34:18.294) So what would be some symptoms that someone might be experiencing if they have parasites? Josh Dech - CHN (34:23.032) So many things. This is a tough one because everyone's going to be different but some very typical symptoms that we can look at for parasites that I'd say are pretty well broad spectrum. Now again, you don't have to have all of these. You can just have some of these. But if you have pain when you press on your liver, gallbladder, or even your appendix, you might have parasites. They hang out in those areas, create pressure. So the pressure you put is extra pressure causes pain. If you have lower back pain that doesn't go away with exercise, especially if you're fit. physiotherapy, chiropractic, acupuncture, you might have parasites. Some with seasonal allergies or a lot of excess sensitivities, rectal or vaginal itching, for example, especially symptoms that may be in your gut or your skin like psoriasis, eczema, sinus issues that ramp up either around your menstrual cycle or around a full moon. If you have unexplained high levels of cholesterol or liver enzymes, could be parasites. If you're chronically anemic, especially if you're not bleeding anywhere, you're eating food, you're eating lots of meat you're getting your iron in and you're still anemic, parasites might be eating that for food. If you're someone with dry, itchy skin, maybe you use steroids that have minimal impact, white spots on your fingernails, chronic yeast infections, rashes, hives, these can all be signs of parasites. Whether you have one or have all of them, the more you have, the more positive. even if you have like psoriasis, eczema and gut issues, the first place I'm looking at is parasites. Roger K. McFillin, Psy.D, ABPP (35:48.618) Got it. All right. So let's get into number two and three here as far as, you know, reasons for illness and disease. said, like nutrient deficiencies, number one, and then number two, number three was microbial, microbiome imbalances. So is there an optimal human diet and, what is your recommendation for this optimal human diet to optimize your gut microbiome? Josh Dech - CHN (36:15.8) This is a really good question. It depends who you ask. I've spoken to all the carnivores. I've spoken to Anthony Chafee and Sean Baker and Robert Kiltz. And I've spoken to all the carnivore guys and they swear by it. And truth be told, the more I dig into the literature, the more I dig into the history, the more I recommend these things for my clients, the more I see better outcomes on a meat-based, red meat, high fat diet. That being said, I've also seen people heal on a vegan diet. Do I generally support vegan? No. But here's where the nuances come in. There's so much individuality. Do I believe that the plants themselves, especially like things like fruits that grow on trees, you know, yes, they've been engineered for more sugar, so that can be a problem. But I believe it's the engineering and the chemicals we spray on these plants that are more of the problem than the plants themselves. Does that mean that a meat-based diet is safer and less modified? Also, yes. but now they're looking due to the food, right? The mRNA they're putting into the food, they're giving these new products to cows to stop their farts, which actually changes the digestion of the cow, which will change the meat and the outcomes. The food, everything's poisoned. Honestly, the bureaucrats gotta go, because they're poisoning our system more than anybody else in the world. They are poisoning the planet, modifying our food. We see, for example, there was a study back from somewhere between 08 and 2011 from the University of Texas that showed we would need eight oranges back then. to get the same nutrients as your great grandmother would have gotten in one orange. So we know our soil is depleted with nitrogen sprayed all over the chemicals, sprayed all over the microbiome of the earth. The top soil is destroyed, spraying in the air, heavy metals, aluminum, strontium, barium, all these silver iodide, whatever they're spraying in the air now, that's polluting our soil. There's this whole idea that chemtrails are a conspiracy. not. They've literally got air samples that people have tested from these trails with high levels of aluminum. We know they're real. Government websites publish them and talk about it. It's not a theory. It's happening. We're just not looking at the facts. So we know the air is sprayed, the food is sprayed, the animals we're eating are given chemicals and junk. It's a train wreck. So these are creating nutrient deficiencies as a whole. So is there an optimal diet at this stage of the game? I believe we're better off getting our nutrients from animals because they are more bioavailable. They are not as covered in chemicals. They're not as sprayed. Josh Dech - CHN (38:43.34) the ecosystems from the earth, we get more accumulation inside the animal tissue than we would from say a salad now, but maybe 50 years ago a salad was fine. So is there an optimal diet? Honestly, eat what feels good. What do you find gives you healing? I don't subscribe to any particular dogma around those because I've seen people get well in all spectrums. The problem to me isn't the food, it's the food supply. The problem to me isn't the dietary recommendations, it's those recommending the diets based on legislation and government, everything. That's where the problem is. It starts at the top. Roger K. McFillin, Psy.D, ABPP (39:18.39) So when you see so many people who claim to be gluten free, the example of this is that it's not necessarily the gluten, it's the glyphosate that's causing the problem. Because you see this with people in the United States who are unable to eat anything with gluten and they go to Europe and they're able to eat bread and pasta without any problems. Josh Dech - CHN (39:40.142) Here's the thing, if you talk to the gluten experts like Peter Osborne, Tom O'Brien, these guys will tell you across the board, right back to ancient grains and traditional gluten is bad, bad, bad. I absolutely agree with the fact that it is the glyphosate. Glyphosate is known, 100%. mean, Bayer just paid out what, $11.5 billion or something to settle over 100,000 lawsuits for the glyphosate causing cancer. We know it punches holes in your gut. We know it completely decimates your gut microbiome. We know it causes disease, unquestionably causes disease, but it's still allowed to be used. So that's again, a top-down legislative issue. But the problem is they'll spray this glyphosate on these fields, on the wheat while it's growing, and then as a desiccant, so a drying agent after harvest, they spray a fresh coating on it, and then it goes right into your mouth. So it's not even getting washed off some of it by the rain. It's absorbed into the plant. It's into the roots. It's into the soil. It's sprayed fresh on top. And then we eat it. Absolutely. You're eating straight poison if you're eating non-organic wheat. The question about gluten, I'm not an expert. I've been told by experts it's bad across the board, but you're right. You can go to Italy and you can eat the non-sprayed stuff. It's not sprayed in folic acid, which again is artificial and bad for a lot of people. It's not sprayed in glyphosate and you're fine. So the question is, is gluten inherently bad? Is it made worse by the glyphosate? Or is it one of these situations where, well, gluten is bad for you, but you have a tolerance level, provided your gut is, for the most part, healthy. You can take a little bit of damage and heal faster than you break down by eating gluten chronically. Either way, the chemicals we spray are poison, and that's the first thing that we need to address. Roger K. McFillin, Psy.D, ABPP (41:24.916) Are there specific super fruits? know you mentioned the importance of like animal products and you know, I've done carnivore, essentially kind of settled down on primarily carnivore, but I will add like some local locally sourced honey and some like organic fruit to my diet just because I need a little bit of those carbs. you know, just for energy and for feeling, feeling well. But then there's these other super for their claim to be super foods for optimizing gut health, like kefir or fermented vegetables. Do you recommend any of those type of foods to like really provide the diversity of the gut? Josh Dech - CHN (42:11.82) I'll give you a personal anecdote. So I can't touch dairy. Any dairy I've ever had, goat's milk, you could give me bloody armadillo milk and it'd probably give me diarrhea as well, right? Like any animal. I've tried goat, I've tried cow, I've tried sheep, I've even tried camel milk and all of it gives me issues. But here's a little interesting tidbit. My dog, I got a six year old wiener dog named Bruce and he's also had like a really foul, smelly breath. He's a high stress doxy. We're working on it. I don't know what to do about it. but his gut is always just smelled, his breath smelled like death. We'd brush his teeth, nothing would help. like, did he eat something that's dead and it's just sitting in his body? It never came out, you like he smelled that bad. Well, I went down to the pet shop down the road from me here and I picked up some raw goat's milk. Here we are one week later and his breath, don't even notice, it just smells like a dog. Nothing unusual about it whatsoever, but it's raw. I cannot drink, I've tried milk, I've tried cheeses, everything over the years. A little bit of dry cheese, three, four year age, like sheep's cheese, I can have some, but again, gas, bloat, diarrhea. I can drink a gallon of this raw goat's milk a day and I'm perfectly fine. In fact, it's making my gut feel better every single day. So again, is the dairy the problem? And there's all these arguments, well, raw, it's poison, it's bad, it's, you know what? Statistically speaking, you're more likely to get damaged and dead from E. coli from spinach. and carrots and the recalls are doing on veg now than you are from raw milk. So the data is what I'm worried about, not the dogma. The raw milk, when you pasteurize it, I can't speak to all milks, but I'll ballpark the numbers. did a podcast episode on this a bit ago, so I'll try to remember. But there's something like 67 different enzymes inside raw cow's milk, which helps you break it down, digest, absorb, it makes it usable. Something like 18 different fatty acids. All of these get destroyed. Roger K. McFillin, Psy.D, ABPP (43:37.428) Yeah. Yep. Mm-hmm. Roger K. McFillin, Psy.D, ABPP (43:44.875) Right. Josh Dech - CHN (44:07.074) when you go through a pasteurization process, even short, they get destroyed. This is what makes milk intolerable. Now the question that was actually brought up in a group of doctors, we meet together as a community once a week. And one of them, advocate of raw milk as well, brought up the question, is it a lactose, so a milk sugar deficiency or an issue or a lactase issue, which is the enzyme. Os is sugar, As is enzyme. Now when you pasteurize it, It's not so much the lactose. The enzymes change, so it's lactase. So if you go back to raw milk, you're probably gonna be fine. Now this is a fermented goat's milk. It tastes like kefir, almost like yogurt, but the consistency of milk. And it's wonderful. I feel incredible. My dog's breath is amazing. His hair, he's six years old and he's perfectly fine. He's still a young dog as far as doxies are concerned. We can live 18 years, but his coat is better. His eyes, there's no goop whatsoever. He eats a raw diet, so he's got his bones and organs and beef. When it comes down to optimal, here's the thing. If we were living barefoot, running in the grass as tribesmen still, and we have hunter gatherer tribes still today, how do they eat? They eat raw milk, they eat meat, sometimes raw meat, which depends. mean, that's still up for debate, but they eat raw meat, they eat milk, berries, and honey. And that's about it, because that's what they have, that's what they find. For us, 60 to 80 % of the standard American diet acronym, SAD, comes from a package or a box or it comes from somewhere unnatural. We wonder why we have 90 % of the diseases we have now never existed 90 years ago, neither did 90 % of the food on the shelves. These people and these hunter gatherer tribes, they do not have these diseases, they do not have infertility like we do, they do not have diabetes, obesity. early onset Alzheimer's or dementia. We have elderly rotting in nursing homes. They have elders hunting and gathering and contributing to society. So when you talk about the ultimate diet, what could you find outside in the wild if you were in the right location? That's what matters to me. Roger K. McFillin, Psy.D, ABPP (46:16.768) What about I've heard mixed kind of results on this taking prebiotics or probiotics? Is that something that is beneficial? Josh Dech - CHN (46:26.178) Well, consider the three reasons we get sick, right? Toxins, we talked about that glyphosate, poisons, food, mold, whatever. We talked about nutrients, how our soils depleted, the best diet. Microbial imbalances, toxins imbalance your microbes. Nutrient deficiencies can imbalance your microbes, bad foods, whatever you're eating. If you have an imbalance of microbes and you feed prebiotics, just to clarify, if you think about pre, pro and postbiotics like fish in a fish bowl, the probiotic is the fish, the living organism swimming. The prebiotic is the fish food, the postbiotic is fish poop. It's what is created as a byproduct by these living organisms. So if you have a bunch of unruly fish in a fish tank that shouldn't be there, you have abundance of overgrown fish and you feed fish food, who eats first? The overgrown, the dominant ones are gonna eat first. So you could be feeding a bunch of bad guys or imbalances by throwing prebiotics into your body. Now, if you introduce a bunch of probiotics, Do you know if you're introducing good guys? Maybe you have too many good guys and you're crowding out the fish tank. That's a problem as well. So to arbitrarily throw pre and probiotics at somebody's system, I think can be problematic. But generally speaking, post-biotics like butyrate, for example, or tributerin, these can be really beneficial. They're great food for the colon cells. They're really beneficial anti-inflammatory, I modulating the works. But I think we have to know what are we feeding before we feed it. You wouldn't put your hand with a stake into a cage where you couldn't see inside of the cage. You want to know what animal you're feeding. Is it a bear that's going to bite my arm off or a dog is going to lick my hand? We don't know. And so when I'm feeding prebiotics or probiotics into an ecosystem, I want to know before I go. Roger K. McFillin, Psy.D, ABPP (48:11.222) All right, let me ask you a question. I'm going to identify a somebody who's been struggling with gut issues the for most of their life. So let's say for example, they were born via c-section. They were not breastfed. They were on formula. They took a lot of antibiotics because they were getting sick a lot as a kid, they antibacterial soap grew up in the city disconnected from nature, which is a large amount of our population. Josh Dech - CHN (48:31.676) Yep. Roger K. McFillin, Psy.D, ABPP (48:40.232) Unfortunately, is this reversible? Like they're chronic disease reversible? Is like, is there something that can be done for that type of person? Josh Dech - CHN (48:45.016) Okay. Josh Dech - CHN (48:51.53) You know, Roger, and I'm not laughing at the scenario. I'm laughing because I have literally done an episode on this exact thing. You're not vaginal birth or C-section. You are not breastfed, you're bottle fed. You are given antibiotics, you're inside, you're standing up. I've used this exact scenario as a worst case possible outcome many times before. And that is worst case outcome. Is it rebuildable? Here's the thing. Research has suggested now that we're going back years to when I've been in school and other things too So maybe it's changed truthfully. I'm not up to date on this research, but previous research has indicated that your microbiome Imprints like sort of like a fingerprint between ages three and five, maybe six years old And so that becomes sort of the norm that your body tries to constantly bring itself back to its now program to say this is what we're going to do and what we're going to try to maintain Therefore should you have been vaginal birth breastfed? Exposed to the environment living on a farm, etc. No pesticides and you have to take antibiotics at 15 years old your body goes back to say when we were six This was the best balance. Let's go back to that. That's your homeostasis However, we have seen a lot of benefits of change. So who knows how wishy-washy that is The best thing I can say for someone in these situations Stop making the problem worse, right? Stop eating the junk food. If you need antibiotics, try to go to plant-based where you can Again, mixed research in my experience, plant-based antimicrobials, antibacterials tend to spare the good and kill the bad. Tend to. But there are some antibiotics that can do both, but again, they have more risk to them. So do what you can to not make the problem worse. If you're hyper sanitizing, stop, dude, stop, right? Get exposed, go traveling, hug people. If you're still wearing a mask in your car by yourself now in 2025, stop, get exposed to things. After that. We can then look at things, some probiotics, yes. Getting more adventurous with your foods, yes. We can look at certain things like spore biotics. Think of probiotics like actively eating the fruit of a tree, whereas spores are the seeds. The seeds can come in, they can plant, they can grow, and they can develop more of them and colonize. Whereas most probiotics are transient, they come in and out. There are some species that will come in and plant and colonize, but the vast majority, Josh Dech - CHN (51:13.718) research so far, at least to my understanding, has shown that they're transient. come in, it's the post-biotics they've already created that have the benefits, they signal, they come in, they come out. Maybe it's like a Lactobacillus roideri, for example, which comes in, it kills, it's a bacteriocin, which means it kills off a bunch of bad guys or overgrows, it comes in, comes out, does its job, it's done. So you have to keep taking it, or inoculating. But spore-based probiotics can come in and seed. and colonize, living with more diversity. Or you can go extreme and get fecal transplant. Stephen Gundry calls them crapsules. You can actually take freeze dried stool in a capsule, which has been tested of course, and you're working with gastroenterologists and professionals to re-inoculate with a super microbiome. Or you can do kind of the face down ass up enema retention. You can do colonoscopy based with a go in, clean you out and plant stool. but right now it's only approved for recurrent C. diff and bowel disease in the USA. But there's a lot of ways to re-inoculate yourself. Expensive surgeries, expensive therapies, fecal transplant, we're talking five, 10, $20,000, right? Depending on what you're doing. But they come from tested super donors. But either way, you're inoculating with known healthy microbes. And that's how we bring you back to balance. It's been shown, William Lee talks about this, curing, big capital C-U-R-E, cure. Parkinson's, other diseases by FMT and changing the microbes. So there's power there for sure. Roger K. McFillin, Psy.D, ABPP (52:44.758) Fascinating. All right, final question for you. If you had to give us top five recommendations, you know, for the average person to optimize their gut health, they really just want to get healthy, protect themselves against disease, they care about longevity. What are gonna be your top five recommendations? Josh Dech - CHN (53:04.078) This is a really great question and maybe I'll take this from a slightly different angle. There's a process that I use, we call it the five Rs. It's pretty common practice in most, I'd say functional cases or functional practices. Because here's the thing, you can't empty the bathtub till you turn off the tap. So I can say yes, go in and re-inoculate yourself and take these capsules and shake hands and see people and kiss your partner and all these things, stop sanitizing. Stop using mouthwash. Right? Your mouth is atop of your butt. What starts in the mouth ends up in the colon. If you're sanitizing your mouth, you're causing disease, hands down, right? So here's what I will say instead, because a lot of people will tell you, take probiotics, do these things. Let's try a different approach. First, number one, remove the problem. If you are constantly exposing yourself to something that is damaging your gut microbiome, your immune system, stop. If you're in a moldy home, renovate or move. If you're in a high stress environment, deal with that stress or remove yourself. Remove yourself from the problem or remove the problem from you. That's the step number one number two Replenish your nutrients if you are depleted on something in your your gut Just like every other ecosystem needs tools to heal you your immune system to clear things out needs tools Replenish your nutrients if you're not getting nutrient-based foods or you're depleted on food fatty red meat high quality, methylated B vitamins or vitamin complexes, minerals, trace minerals, get the tools your body needs into you. So the first we're gonna remove the problem, we're gonna replenish our nutrients, then we can look to rebuild the microbiome. If you need to re-inoculate, you wanna try spore-based, you wanna try new foods, maybe you're on the carnivore diet, and the reason carnivore diet works, yes, it's a very traditional diet, but also you're not feeding bad guys. You're not consuming, if you have a candida overgrowth, you're not consuming the carbohydrates and sugars that feed them. So the foods we're eating are gonna rebuild the microbiome. You can re-inoculate with probiotics or whatever it is to get that ecosystem rebuilt and rebalanced. The fourth R is repair. You could not and would not live in a home that is on fire, where there's holes in the walls and the windows are broken, raccoons and spiders and junk are gonna move in. You don't wanna live there. Neither do your gut microbes. Josh Dech - CHN (55:27.394) The good guys do not wanna live amongst an overgrowth of bad guys in a destroyed system. So we have to repair the leaky gut. We have to repair the gut lining mucosal membranes. That can be done through supplementation, slippery elm, DGL, aloe vera. It can be done through all kinds of goodies that you can take in. L-glutamine, whatever. There's tons of gut lining repair supplements out there. So we've removed the problem. We've replenished our nutrients. We've rebuilt the microbiome. We've now worked to repair the tissues of our gut lining. The fifth R is to rejuvenate the immune system. Inflammation amongst bowel disease, for example, is a dominance of certain immune pathways like TH2, TH9, TH17. These are the ones that activate inflammation on a mucosal level, histamine layers, they lead when they're overactive to strictures and fistulas and ulcers. We have imbalances or... downregulations of our TH1, for example, some of these innate immune pathways, which regulate these other guys. So you have a dysregulated immune system, which is now hyperactive, leading to inflammation, sensitivities, et cetera. So we don't wanna just boost our immune system. We wanna rejuvenate and rebalance. And those are the five Rs to restoring your gut. Remove the problem, replenish the nutrients, rebuild the microbiome, repair the tissues and rejuvenate or rebalance. the immune system. Roger K. McFillin, Psy.D, ABPP (56:53.77) Great. Thank you. So Josh, if people are interested in working with you, learning a little bit more about you, where can they find you? Josh Dech - CHN (57:00.79) Easiest place to find everything all in one shot from social media, you name it, is just gutsolution.ca. That's gutsolution, all singular, .ca for Canada. You can find me on social media, at joshdeck.health. And I've got two podcasts out there if you guys wanna listen. The first is called Reversible, reverse A-B-L-E. Again, looks great on paper. It reverse Able. Terrible to say over the air. But it's Reversible, the ultimate gut health podcast. And the second one I also have is called Reversing Crones and Colitis Naturally, greatest free resource the internet's ever seen for IBD. But again, if you're confused about all that stuff, you can just find it at gutsolution.ca. Roger K. McFillin, Psy.D, ABPP (57:44.374) Great. mean, this was excellent information. mean, we're throwing tons of questions at you. I really do appreciate your time. I've said for a while right now on the medical side of things in mental health, if psychiatry transitioned from being pharmaceutical salespeople to being experts in gut health, I mean, we could really improve people who've been struggling with many mental health conditions that really, I think, they're mislabeled as psychiatric conditions. when they're just consequences of really poor health and really inconsequences of gut health. And we haven't been integrating that into mental health enough. And I think you answered questions I think a lot of people have from the basics to some of the more complicated aspects of this. So Josh Deck, really want to thank you for having a radically genuine conversation today. Josh Dech - CHN (58:34.976) I really appreciate you Roger. Thanks so much for having me and being so open to the crazy stuff. Roger K. McFillin, Psy.D, ABPP (58:39.798) Thank you.