Sugar and Brain Health: How Diet Shapes Kids’ Focus, Mood & Microbiome | Dr. Elisa Song

Dr. Brighten: [00:00:00] Welcome to the Dr. Brighton Show, where we burn the BS in women's health to the ground. I'm your host, Dr. Jolene Brighton, and if you've ever been dismissed, told your symptoms are normal or just in your head or been told just to deal with it, this show is for you. And if while listening to this, you decide you like this kind of content, I invite you to head over to dr brighton.com where you'll find free guides, twice weekly podcast releases, and a ton of resources to support you on your journey.

Let's dive in. Are there things parents are feeding their children that are unknowingly sabotaging their gut health? 

Dr. Song: Wow. That's a great question. 'cause there are so many things. Okay. And, um, I mean, let's start with babies, right? We can do all the things by making our own food. And I did that. I had a Baby Baba, I think it was called, one of the best purchases I ever made.

Um, and then at a certain point there comes a time where you're gonna be going and buying some maybe baby yogurt or, um, some of the food pouches [00:01:00] that are so popular. Mm-hmm. Even organic ones. Now, one of the things that I think parents don't realize is that baby foods should have. Zero added sugars.

Mm-hmm. Like zero, from zero to two years of age, no added sugars. Well, I was shocked the other day, I was actually looking at, my kids are teenagers. I don't look at baby food anymore, but I looked at this yo baby Stony field, organic baby yogurt. Mm-hmm. I could not believe there was something like six grams or over a teaspoon of added sugar.

Yeah. Per serving in that yogurt, which, and it says, number one pediatrician approved. I'm like, well, not this pediatrician approved. Right. Um, and then even when you look at the, um, the baby purees it, according to the FDA, do not yet have to be called added sugars. So it's a way of getting basically high heat pulverized fruit purees.

This is not homemade. They're taking out. Every bit of fiber in it. Mm-hmm. And getting basically added sugars in your kid's diet. Mm-hmm. So I would say just as a caution, because sugars are one [00:02:00] of the most ubiquitous sources of inflammation and gut microbiome disruption. Mm-hmm. That really starts even when your kids are babies and you think you're doing a great job.

And I just want parents to know, let's stay away from a lot of the pouches. Those are on a pinch, like I know I carried them. If you're at the park and your kids are hungry, fine. Yeah. Right. But at home, we wanna keep the fiber in and we really wanna look and make sure they're not getting any added sugars.

There's gonna be plenty of time for that later. 

Dr. Brighten: Mm-hmm. So in the same vein, do you feel like children's tantrums can be tied to what they're consuming in their diet? Oh yeah, for 

Dr. Song: sure. Um, I mean, let's take the sugars. There's a couple of different pieces to that. Mm-hmm. So there's the sugars. So what happens when kids, especially if they start off their day with a sugar load.

Now what do I mean by sugar load? Because most parents are not at least listening to this podcast. They're not feeding their kids fruit loops for breakfast. Yeah. Right. But they're maybe getting, you know, oatmeal and they're, or a vanilla, a vanilla yogurt and putting some fruit on it. Um, and then sending their kids off to school [00:03:00] or preschool maybe with like a little bit of, um, those yogurt bites.

I keep saying yogurt because that's one of the biggest sources of sugar for kids. No, I, some 

Dr. Brighten: always bring up, especially for perimenopausal women, like when you're looking at weight loss, you have to look at added sugar. And I always bring up the yogurt. Mm-hmm. Because it is the one that appears to be a health food, but it's the most sneakiest source of sugar.

So I agree with you. Yeah. It's 

Dr. Song: really sneaky. So you send them off, it's a sugar bomb essentially to your kids' body. Their insulin spikes their blood sugar. Then. Crashes and then they're hangry and mm-hmm. You need to feed them. And you know, as a parent, those are the kids that you always have a snack. Like you don't go anywhere without food.

Mm-hmm. But then what do you reach for? You reach for, reach for maybe that squeezy apple beet pouch, right? Yeah. With blueberries or whatever it is. And then they have another sugar spike. Insulin comes and they crash. So the sugar rollercoaster is real. Mm-hmm. And as kids get older, I actually often will check a fasting blood [00:04:00] sugar and a fasting insulin.

Mm-hmm. To see what is going on. And even at young ages, like elementary school, you see signs of insulin resistance starting, and I'm not talking about your typical kid, you know, the picture that we have of insulin resistance and diabetes. At least type two diabetes. We think, okay, maybe overweight, sedentary, not eating in the right way.

These are kids who are slim, they look fit, they're running around. Mm-hmm. But their blood sugar is going like this. Mm-hmm. Right. I would love every kid to have a continuous glucose monitor. I think that would be so eye-opening for parents. 

Dr. Brighten: Super controversial thing to say these days though, right? I mean we, I've had guests on talk about wearing continuous glucose monitors in their pregnancy.

I think that's brilliant. I think everybody should be doing that because the idea of waiting and you know, in pregnancy for a glucose challenge to finally catch. Something that's been going on for months that's problematic. If you failed the glucose challenge, your metabolic health That's right. Has been in a bad place for a long time.

So we wanna catch things. Earlier you brought up, [00:05:00] you, you test this fasting insulin, you test the fasting glucose for a lot of people, I'm sure they're wondering at what age or what indications are you looking for to run that test? Yeah. 

Dr. Song: Um, 

Dr. Brighten: every 

Dr. Song: teenager, whether I'm, if I'm doing standard, just routine, well cure blood work.

Mm-hmm. Now what I call routine well cured blood work is not necessarily what's gonna be offered in the pediatrician's office. Mm-hmm. I mean, most pediatricians are not gonna be ordering blood work for a kid who appears. Well, yeah. Right. Yeah. Um, but I love getting blood work around 13, 14. Hormones are shifting so much.

Yeah. Thyroid function is changing so much and their diets are changing so much because they're choosing their own foods and so we no 

Dr. Brighten: longer get to good control plate's. Right. 

Dr. Song: So, so that's when I love to check. Also because we know that the rates of autoimmunity are increasing the most, mm-hmm. In our 12 to 19 year olds.

Yeah. So I like to do routine blood work then. But for a younger kid, any kid who comes in with anxiety, behavioral [00:06:00] concerns, attention and focus concerns, um. Autoimmunity. Mm-hmm. I mean, any chronic condition where I'm thinking, is there inflammation driving this? Which is probably everything, right? Yeah. I wanna know if blood sugar dysregulation is one of the driving forces for that inflammation.

Mm-hmm. 

Dr. Brighten: So you brought up this panel. I know everybody right now is like, what is an ideal panel to be getting your preteen especially, and we're gonna get into this conversation that you had brought up. So we see precocious puberty happening, girls are getting periods at like eight, but we're seeing delayed, at least you are in male puberty onset.

So I wanna talk about that, but for parents listening right now, what is the ideal panel of blood work to be asking to screen your child in those preteen teenage years? Yeah, and, 

Dr. Song: and I do want parents to be. Empower to talk to their pediatricians, even if they don't have an integrated pediatrician.

Getting the baseline mm-hmm. Is [00:07:00] such an opportunity. And here's the thing, 'cause sometimes there will be. Something that's off. Yeah. And it can be really frightening to a parent or even to a kid, but when we catch these before there are any problems, it's such an opportunity to be proactive. Mm-hmm. So what do I, what do I like to check?

I like to check a complete blood count, a C, B, C with differential and platelets. Um, a fasting, a comprehensive metabolic panel. So there, you're gonna have your fasting glucose, you're gonna have your kidney function, you're gonna have some of your electrolytes, and you're gonna have your a ST and a LT liver enzymes, which we know that non-alcoholic fatty liver disease is on the rise in kids.

Mm-hmm. Because of the sugar consumption. Yeah. Right. So, and with all of these, I'm looking at a, at it through a lens of not just what's normal, but what's ideal. Mm-hmm. For this body to function in the optimal way. I also check a ferritin. RBC Zinc or red blood cell zinc, red blood cell magnesium, A 25 hydroxy [00:08:00] vitamin D.

Now we can actually check an Omega-3 and omega six fatty acid penal. Mm-hmm. Uh, pretty easily through Quest. It's called an Omega check. Now why those? Because iron, zinc, magnesium, vitamin D and omegas are the top nutritional deficiencies in kids. Mm-hmm. I'm sure in adults too, right? Yeah. But we wanna optimize those.

And then I'll also add for teenagers a fasting insulin, a hemoglobin A1C. I do check a fasting lipid profile. Surprisingly, not necessarily because so many teenagers have high cholesterol. Sometimes it's the opposite. Mm-hmm. Where their cholesterol is too low. And what do I mean by too low? 'cause nobody really talks about that.

If your cholesterol is under one 30, you are not gonna be optimizing your teen's brain development. Mm-hmm. Or their sex hormone development. So I check a fasting lipid panel. Um, I'll check a homocysteine. I don't check homocysteine in younger kids because it's rarely elevated. Mm-hmm. But if it's elevated in a teenager, I know this kid needs [00:09:00] more methylation support, more b vitamin support.

And then I also check something called an a NA. Mm-hmm. An anti-nuclear antibody. And, um, this one is elevated in many, many kids. Too many. Yeah. In fact, it was the a NA level that was studied through different. Age groups through different, um, periods of time. And this study found that the age group with the fasting fastest rising rates of a NA positivity were our teenagers.

Mm-hmm. Double from the eighties to the nineties, and then triple from the nineties to now. And so that's like your little canary in a coal mine. What else do I need to do? Because then I'll dive into, if that's positive, let's check for celiac or gluten sensitivity. Mm-hmm. Um, let's check for other inflammatory things.

Um, in the routine panel, I also check a thyroid panel. 

Dr. Brighten: I was gonna ask that. 

Dr. Song: Yeah, absolutely. Because thyroid can go all over the place. We know thyroid is so sensitive to inflammation. I mean, you're the thyroid queen. And so, you know, during puberty for boys and girls, I [00:10:00] often see your thyroid stimulating hormone start to climb, climb, climb.

And in a, in the pediatric range, 4.5 is the upper limit of normal. Mm-hmm. So I'll see some kids at. 4.2. 4.4. Sometimes they're actually outright high, like 5.6 or, I mean, I had one kid who was almost a 10 and I was like, you know, jawed to the floor. Okay, they're not functioning well. Mm-hmm. Um, but then you check a free T four, free T three, reverse T three, um, in the pediatric conventional endocrinology world.

Thyroid, low thyroid hypothyroidism is not treated until kids' TSH is over 10. Mm-hmm. And that to me is criminal. I mean, a TSH over 10, your brain is already not working well. Yeah. The rest of your hormones are not working well. I mean, you're basically not allowing this child and teenager to develop in the most appropriate way because your thyroid is one of our master regulators.

Mm-hmm. So that's, that's the [00:11:00] baseline panel for younger kids. I don't necessarily do an a NA right away. Mm-hmm. Unless I'm worried about something autoimmune. Um, I don't do a homocysteine because just through the past 20 years, rarely, rarely does homocysteine rise until you are in adolescence. Mm-hmm. So now I don't bother, there's, you can only draw so many tubes of blood in a, in a little kid.

Right. Um, but I do, if I can get a fasting test, which sometimes for little kids is hard mm-hmm. But if I can get a fasting test, I do always like to throw in that fasting insulin. Mm-hmm. And fasting glucose at the same time. 

Dr. Brighten: Yeah. So you mentioned ferritin. That's the storage form of iron. We often see that going low before a child.

Is frank anemia in their CBC. Yeah. Do you brought up this a NA and I don't think everybody understands what anti-nuclear antibody indicates. So can you explain that a bit? Yeah. Why we wanna run this test. So a 

Dr. Song: NA is, um, what I tell parents if they, especially when they see something elevated, it's a very, very general marker that your immune system is tipping over [00:12:00] into autoimmune reactivity.

Mm-hmm. It is not happy. It is starting to attack your own body. It does not mean you have an autoimmune disease. And that's very important to distinguish because you can have a positive a NA and never present with a clinical autoimmune disease. Mm-hmm. Or sometimes it's decades down the road. We see this in things like juvenile or type one diabetes.

I wish we could call it juvenile and adult onset diabetes. Yeah. But we know that type two diabetes hits kids. Way too often. But with type one diabetes, we can see in some kids positive juvenile type one diabetes autoimmune markers for decades before they develop type one diabetes. And so this a NA, it just lets you know, okay, your immune system is not happy if you do not pay attention.

If you do not figure out what is causing your immune system to be so unhappy that it's starting to attack your own body. Mm-hmm. [00:13:00] Eventually you could develop an autoimmune disease. Yeah. So I don't look at it as doom and gloom. I never wanna do that. I mean, I would never order a test if there was nothing we can do about it.

But there's so much. If we have a positive a NA, then we look and see, okay, is it the sugar? Is it the gluten? Is it the psychological stress? Is it the lack of sleep? Is it the lack of movement? Maybe it's all of the above. Mm-hmm. But all of those things that I mentioned, we actually have control over. Yeah.

So we can. Start modifying that and at least talking to our teens and saying, look, this is a sign. Do you m you know, you have your auntie with rheumatoid arthritis, or you have, you know, your, um, your uncle with diabetes. We don't want you to head there. Mm-hmm. Right. So what choices can we start making now to empower yourself so that you don't have to.

Become someone who has this condition. And it doesn't mean that just because it runs in the family, it's gonna happen to you. 

Dr. Brighten: Yeah. I think that's so important to be measuring antibodies [00:14:00] early. So often doctors are like, we just wait until we have symptoms. And so in the case of autoimmune disease, especially for the thyroid, so I, I'm imagining your thyroid panel, TPO and thyroid globulin antibodies are in there as well.

We so often see those high. You have Hashimoto's, but you don't yet have hypothyroidism. You develop the symptom expression, the debilitating symptoms, sometimes after enough tissue destruction has happened. And so catching those antibodies early, like that is the best place to be because it's like, let's reverse that.

Let's bring your body back into balance before you actually have the tissue destruction, and then you require a lifelong medication, or you have, you know. In the, in the case of like arthritis, like you have these joint changes that we can never walk back from. Yeah. Well I love that 

Dr. Song: because it is, I mean, ideally of course we would never have these positive auto antibodies to begin with.

Mm-hmm. But that's just not the reality nowadays in our modern world. Sometimes we need a little wake up call and that a NA can be a wake up call [00:15:00] or those anti TPO or antithyroid globulin antibodies, which I do see elevated in so many teenagers. Mm-hmm. And it's like, no, okay, you don't have clinical disease.

Let's catch this before you go on to struggle with your energy and your mood and your periods and later on your fertility. And so really, um. I, I don't shy away from these labs. I view them as, you know, this is part of you get your checkup, let's check what's going on under the hood. Mm-hmm. Because you don't know what's going on under the hood.

You could feel awesome. I mean, think about how many of us moms, we feel awesome until we don't. Yeah. Right. And then our blood markers or urine markers or whatever, I mean, we know they've been simmering for years, maybe decades, right? Mm-hmm. And I wish I would've had a lot of the knowledge when I was younger to course correct.

When I had the chance. 

Dr. Brighten: Yeah. It's uh, I mean that's why we do what we do now, right? Yeah. We're like, we're, we're further down the road ahead. Let us give you some insights. That's right. You avoid the pothole that we fell into and it took us years to get out [00:16:00] of. So, you know, you were talking about thyroid hormone and future fertility.

This is something that's a big question mark for me, because now that we start to understand that within the follicular fluid, so as the egg is developing, we have thyroid hormone there. It's a big question mark for me of like. What is happening in these pediatric cases where we're allowing the TSH to be of above 10 before they get treated.

These girls are having late onset of their period or so. Men are either their first period or they're having irregular periods, and how is this po potentially affecting their future fertility because that thyroid hormone is so crucial. But it's the problem I think, in medicine that just still persists of like, that's a thyroid problem, that that exists only in the thyroid.

And it's like, well, no, actually it's, it's going to affect her ovarian function as well. And then as you were talking about brain development, 

Dr. Song: well, the brain development is, is so important to understand, you know, in. In America, right. In every hospital there is something called [00:17:00] the newborn screen. Mm-hmm.

And that's your baby. When, when they got their little heel prick and there were, if you ever watched, it's a sheet of paper where there's little circles and you get your baby's blood onto each of those circles, it's sent immediately to the public health lab. Mm-hmm. In every state. And it checks for several rare but metabolic conditions that if we.

Could tackle from the very beginning, your baby could have very different outcomes and stay healthy. Mm-hmm. If don't they could, for instance, become profoundly mentally retarded. Yeah. If we don't correct their thyroid, and thyroid is one of those markers that is measured on the newborn screen. Mm-hmm.

Well, okay, so let's say you don't have congenital hypothyroidism, but you have a, an elevated or a very high normal TSH for your age that is not optimal mm-hmm. For optimal brain development. And I, I wish. Endocrinologists would kind of change their tune around that. I've had several conversations and I've [00:18:00] yet to find an amazing pediatric endocrinologist.

If, if they're, if you're out there, let me know. Right. Um, because that, um, you know, in early development, um, from the time you're a baby to, um, toddler to elementary school age kids, that is one of the most important times to optimize thyroid. Well, let's talk about the adolescent brain too. Mm-hmm. I mean, so important.

And so, you know, what I would, um, really want is for every mom, of course, preconception and during pregnancy to optimize their thyroid. Mm-hmm. Because that impacts baby's brain development in utero. And then immediately understand how do we get this baby's thyroid on track? 

Dr. Brighten: Yeah. I also don't see enough gynecologists.

We're recommending that if you have Hashimoto's, that you actually see a maternal fetal medicine specialist. And I think that's so important. You're a high risk pregnancy. And I have seen patients who, they have elevated antibodies. We get those in remission, they get pregnant antibodies are back to their thyroid.

And that's where I [00:19:00] say, you need to see an MFM. And their gynecologist, their ob gyn is like, no, that's overkill. You don't need to do that. Those thyroid antibodies can cross the placenta in the third trimester. You need to actually have a third trimester ultrasound and look at that baby's thyroid.

Because if there is an autoimmune attack, you already know. You know, before you get those lab results back, baby thyroid's gonna be compromised. Yeah. And so again, it's that like, why are we being so late to the game? Why are we waiting until the labs are so bad before we intervene, when there's all these preventative measures that we can take?

And that's something I'll say if you're listening to this MFMs, maternal fetal medicine specialists are amazing at this. They, I, they are absolutely more on top of thyroid research than your average ob gyn is hands down. I remember in my last pregnancy, my ob gyn was like, your TSH is so elevated or so low.

Um, so it was super low. She's freaking out. I'm like, my free T three, that was like [00:20:00] 2.4. Like this is another thing. And I'm explaining to her like, see, my prenatal has biotin and I didn't know we were running that lab that day, so I was on biotin that can artificially suppress it. I'm explaining to her, she's like, no, we need to drop your thyroid hormone.

You need to be on a third of the dose. I'm like. Okay, no goodbye. Like, no way. And I talked to my MFM and she's like, God, I wish that these OB GYNs would actually get trained in thyroid before they start recommending things. And I'm like, we have too many disconnects happening in medicine. Because 

Dr. Song: to your point, you know, OB GYNs are trained to deal with this, right?

Yes. So your your female sex hormones, but thyroid is not considered in that axis. Mm-hmm. And so, I mean, there's, there's nothing that is not interconnected in our bodies. Yeah. And so it is, um, it is a shame to just view your body as separate organ systems when there's such a profound impact. And, and I will say one of the things that, that I wish that OB GYNs would do.

Before moms even think about getting pregnant and [00:21:00] talking to their adolescent girls mm-hmm. About when they're having horrible period pains or, you know, um, terrible PMDD anxiety, mood swings is really the power of their microbiomes. Mm-hmm. To shift their hormonal balance for the better or worse if they don't have an optimal gut microbiome.

Yeah. And, and not enough. Hormone docs are really talking about that. Mm-hmm. And so, and that is one of the areas where we have so much impact and we can actually move the needle so quickly. Yeah. On so many other things. Not just hormones, but brain development and mood and immune function. And so, you know, if we wanna tie in all the pieces, I mean, you start with your microbiome and all the ripple effect is going to really impact positively, pretty much everything in your body.

Dr. Brighten: Mm-hmm. I'm in a link to our previous, uh, interview that we did on the podcast. 'cause we talked a lot about the microbiome, about these Strobel, how to effectively change the microbiome. So every, [00:22:00] if you're like, why are you guys not talking about it? I have a whole episode for you, I'll link to it. But what I do wanna talk about is your observation.

So everybody's talking about young girls getting their periods sooner, but you said you're seeing teen boys having delayed onset of puberty. What is going on there? 

Dr. Song: You know, and it's just, I, I am a solo practitioner, I'm a clinician and I can only. Comments in what I see in my practice. Mm-hmm. And it's not, you know, the majority of boys, but it's been a significant enough number that it's really made me pause and think, wow, you know, I've been, I started my practice at, I actually started it as an integrative functional pediatric practice in 2004.

Mm-hmm. And, um, just over the past maybe. Eight years or so, six years, I've been seeing more and more boys where we're just watching and waiting. Mm-hmm. And they're 13 and no secondary sex characteristics. Okay. Maybe they're late bloomer. Mm-hmm. And then [00:23:00] they're 14, and then they're 15, and they're like, okay, now it's time to check some blood work.

Right. 

Dr. Brighten: Secondary sex characteristics, not everybody's gonna know what that term means, so. 

Dr. Song: You know, of course we have our hormones changing on the inside, actually long before you start seeing stuff on the outside. Totally. Right. And sometimes you can actually see the mood swings first as the, as the big signal.

I have a 12-year-old That's right. And it started like a year ago. Yeah. Um, but, you know, for boys, as testosterone starts to kick in, what do we start to see? We may start to see some acne, right. We may start to see some hair under their arms or pubic hair. If you look as a, as a parent, I don't expect, well first your boy may not want you to look, um, but you can see an increase in your testicular size.

So testicles start to grow. Mm-hmm. Um, there's actually, it's a funny, looks like a carton of eggs where there's like this growing size as you go through puberty and, well, it's 

Dr. Brighten: funny 'cause we have the same thing for breast development in girls. Yeah. Boys get the testes, the carton of eggs, and then girls have like the breast [00:24:00] development.

Dr. Song: Yeah. Um, and then your, your penis starts to see long teeth. Mm-hmm. Right? Um, voice starts to deepen. I mean, all of these signs that we know are. Are external signs that male hormones are kicking in. Mm-hmm. And puberty has begun. Right. So if I don't see any of that 13, 14, I start thinking, okay, is there something blocking the, you know, the gonadal access, the HP gonadal access?

And so then I think, okay, let's check some lab work. What I always with that I do check their microbiomes because the way their microbiomes impact with testosterone or estrogen is going to impact how they flow through puberty. Mm-hmm. So. I don't, it's my conjecture, but you know, we have so many hormone disrupting chemicals.

Right. Um, and, um, and so many of these hormone disrupting chemicals are really mimic estrogen more than testosterone. 

Dr. Brighten: Yep. 

Dr. Song: Right. And so if our, well, 

Dr. Brighten: and some of them were designed like BPA to actually be estrogen replacement [00:25:00] therapy. Yeah. And I don't think many people recognize that. Um, but, you know, to your point, endocrine disruptors being, playing a role.

Tell us more about that. Yeah. Well, so 

Dr. Song: these endocrine disruptors or hormone disrupting chemicals, we know that they can impact girls early puberty. That is one of the things that we're linking. But for boys now, we have to think, okay, is this flood of estrogen-like chemicals impacting their puberty? So then they're actually becoming more delayed in their puberty.

Mm-hmm. Um, and, and, you know, so many other impacts. Right. And so one article that I read, it was, um. One of the best articles I've read on endocrine disruptors and the, please send us the link so you send it in the show notes. I'll, um, and the researchers call for changing the description of these chemicals.

Instead of calling them endocrine disrupting chemicals or hormone disrupting chemicals to really shift, to call them microbiome disrupting chemicals. Mm. Because every single one of these endocrine [00:26:00] disrupting chemicals, whether the phthalates or pfas or parabens or BPAs, they have all been shown to profoundly disrupt the gut microbiome.

Mm-hmm. Cause leaky gut, cause gut dysbiosis or an admiral balance, you know, too many bad bacteria, not enough of the good bacteria. And that is why we see in our kids, not just impacts on their hormones, but impacts on their brain development, impacts on their immune system. I mean, these hormone disruptors have way more impact on children and teens than on hormones.

And so do 

Dr. Brighten: you mean on than on adults? 

Dr. Song: Well, I, I don't know the research on adults. Oh, okay. I'm sure it still does too, but in terms of like for if, for kids, babies who are exposed to these endocrine disrupters mm-hmm. Which of course we all are. Yeah. Right. No matter how clean we live. Um, but it can impact cognitive development.

Mm-hmm. Cause problems with cognitive delays, it can impact the risk of certain immune disorders, um, atopic allergy, all of which are on the rise in our kids. Mm-hmm. And so, you know, is it that it's just the impact of [00:27:00] these toxins or is it because they're shifting the microbiome, which then has a double whammy Yeah.

Of, of compounding and worsening the impact of these hormone disruptors. 

Dr. Brighten: Mm-hmm. So there's the things we can't avoid, but what can parents avoid and what can they be doing to safeguard their children's health against the ease hormone disrupting chemicals or potentially microbiome disrupting chemicals.

So 

Dr. Song: one of the things that, that parents don't necessarily think about, and we can do all the things to try to remove these hormone disruptors in our lives. Mm-hmm. So, BPA free, free cans, knowing that there might be some bps and other things that don't have to be reported, you know, um, paraben-free cosmetics and skincare and, and, and, um, you know, hair care products, um, forever, chemicals a little harder 'cause they are everywhere.

Right. And these microplastics are everywhere. Um, and they're not, you know, as they're not labeled right. Yeah. You're not gonna see a product with the amount of PFAS or the amount of microplastics in, in the, in the product. [00:28:00] But there are ways from an environmental standpoint, um, you know, household cleaner standpoint that we can reduce our exposures mm-hmm.

To endocrine disrupting chemicals. But we also have to make sure that we are able to process and clear out these endocrine disruptors when we're exposed to them. Mm-hmm. Your first pass is actually through your microbiome and what people. I was fascinated to learn. So I'm hoping that people are fascinated to learn that, you know, our livers have this thing called the cytochrome P four 50 enzyme system that helps us detoxify whatever it is.

I mean, even estrogens, right? Mm-hmm. And so our microbiota have very similar cytochrome P four 50 enzymes. And as we inhale or ingest these toxins that they go through our gut, that's our, one of our first exposures beside our skin. And our microbiota start to, you know, conjugate or detoxify some of these chemicals.

So we [00:29:00] have to have a healthy gut microbiome if we want the first pass to clear out as as many toxins as possible. And one study in teenagers found that, and eating a higher healthy eating index, what does that mean? Higher fruit and vegetable intake, basically. Yeah. Significantly lowered their PAS levels and increased their RBC folate levels, which is really important.

Right. Um, another study found that eating fermented foods could significantly decrease your PFAS chemicals. Now why do I point to PFAS in particular? Because parabens, phalates, um, BPAs, once we stop our exposures or lower our exposures, we can clear them pretty quickly from our system and they come out pretty easily in our urine.

Um, they can even come out in our sweat. EFAs don't come out in our sweat very well. Mm-hmm. Sauna's not gonna help. We don't pee them out. We have very few ways to get rid of them, so why not [00:30:00] load up or tell your kids we are gonna be exposed forever, chemicals for the rest of our lives. So hire. Fruit vegetable intake, higher fermented foods, that's gonna help your body, your brain, your hormones really become as resilient against these endocrine disruptors as possible.

Dr. Brighten: Mm-hmm. Except that children think they're invincible. That's right. And their prefrontal cortex has not developed for their executive function or their reasoning skills all the way. So what are other ways that parents can get their children to start shifting their diet? So, you know, one thing, um, we talked last episode about my toddler, like I have this like older child who's like the perfect eater, and then I have the, you know, very challenging eater.

And he went on this like peanut butter and jelly kick 'cause like all he wanted to eat. So it was like, fine, I'm mixing yogurt in there and I'm also mixing chia seeds in there, or I'm mixing flax in the meal in there. And so I would grind up. These fiber sources and put it in there, and then making sure that, you know, the bread also is a fiber source.

So are there, that's [00:31:00] one way that I was like, let's get more fiber in and a variety of fiber for your microbiome. What are other ways that parents can start taking action in this? Yeah. 

Dr. Song: Well I love that way, right? Because, um, in my book, I have a recipe for, call it, I hear 

Dr. Brighten: everyone 

Dr. Song: right here. I call it a gut hero booster.

Yeah. But you could just look in your pantry. What are the fiber sources that you already have? Mm-hmm. Or maybe you need to buy some, you just grind them up into a powder and you can store them in an airtight container. Mm-hmm. And you add them to things. I mean, if you pulverize them to fine powder. Yeah.

Right. You can mix them into nut butters. You can put them in your soups. If you're baking goods, you can throw them in pumpkin seeds. Well, so why, you know, why the fiber, right? Mm-hmm. We know that less than 5% of American kids and adults actually meet their minimum daily fiber requirements. Isn't that wild?

Yeah. That's including people who are. Eating healthy, right? Mm-hmm. I would bet on, on many days, especially, you know, I'm here in Mexico City with you. I am sure that I've [00:32:00] not met my daily fiber requirements mm-hmm. Except maybe with the vegan dinner last night, right? 

Dr. Brighten: Yeah. Well, I don't know about you, but I got a leak that was like the, the terminal end of the leak that nobody ever wants to eat.

And it was so fibrous and so chewy and, um, it was, yeah, I was having a hard time with my teeth, but I was like, Dr. Stacy, who we had on the podcast, great dentist, she would be very proud of me. But after I swelled it, and Bryce, my husband was like, I can't believe you ate that. I'm like, my microbiome. So help happy right now.

Like you have no, like my microbiome was like, this is new, this is different. This is interesting. We love you for it. 

Dr. Song: Yeah. Um, so getting those boosters in are really, really helpful. Mm-hmm. Especially until your kids' prefrontal cortex can kick in a little bit more Now. Even when they're younger though, what I love is, um, you just have to make it fun.

And I know there, you know, if you have a really selective picky eater, you may have tried all the things, right? Mm-hmm. And if you just keep reinforcing and making it fun, [00:33:00] not, not a battle. Yeah. It will change, right? It will get into their brains. But I always talk to kids about their microbiomes, and when they're little, I might call them their tiny little friends in their tummies.

Mm-hmm. Right? As they get older, I call them your microbiota. Right. There's friendly bacteria, there's friendly yeast, and not friendly yeast. And we talk about it, but also talk about what it means for them, you know, to really take care of the microbiome. Mm-hmm. How is it impacting their ability to make and keep friends?

Yeah. You know, stay in a good mood, um, fall asleep easily. Um, not have hard poops, not have itchy skin, right? Mm-hmm. For, for teenagers, the, the acne, right. The skin and the hair, right? Yeah. So always tying it back and then. I just have kids think about how we are taught to take care of our world around us.

Right? Our ecosystem around us. Mm-hmm. And, you know, even preschoolers learn to reduce, reuse, recycle, you know, all the things because we know. Our world is suffering and if we don't take [00:34:00] care of our world, we are not gonna have a world left that takes care of us. Yeah. And so I let them know that same ecosystem is inside of us.

The same care. Like most of us, if we, I mean, I don't know about most of us, but when I see someone throwing a can, you know, let's say, I don't know, whatever can of a drink into the regular garbage, I'm like, and I've been known to actually go and take it and put it into every, this is like the power captain 

Dr. Brighten: planet.

I, if people know, if you know, you know, but like we, we talk about this, my, uh, my husband and I had like this Captain Planet cartoon show that was on and all the messaging we got. And like you have a visceral reaction to it. That's right. Because it's how you were raised. It's how you were trained on repeat to live.

That's right. 

Dr. Song: Or like trash out the car window and you're like, oh my gosh. Yeah. So. I mean, our kids can learn that stewardship. Mm-hmm. Right? And, and in the same way they can learn that stewardship and the re responsibility of how we live and eat every day impacts the [00:35:00] ecosystem inside of us. And of course, they're gonna, you know, not make the, the choices that we would want them to make all the time.

Mm-hmm. But we also don't make all the choices that we know we should make all the time. No, but perfection is not the goal, right? No. It's what we want. It's what we do on the, on the whole, because. Well, and this is where I see a lot of parents, I think, um, we get a little too stuck on being perfect with the diet.

Mm-hmm. Or too stuck on, you know, getting rid of every toxin. The goal is not to be perfect, as you said. The goal is to create that resilience in our immune system and our microbiome so that whatever happens, we know it's gonna bounce right back. Mm-hmm. And in fact, in microbiome testing now, um, we can actually see and measure something called a resilience score.

Like how likely is your microbiome to bounce back to a healthier state after a round of antibiotics or exposure to like finals, weakened sleep deprivation. I mean, whatever is gonna be stressing your microbiome. 

Dr. Brighten: Mm-hmm. You brought up focus. Are there foods that parents can add to their children's diet to help [00:36:00] improve focus?

Dr. Song: Well, we wanna make sure, I mean, I would say there's two sides of the coin to that, right. Um, because kids need, when we think about amino acids and dopamine mm-hmm. For focus and attention. All of these neurotransmitters or brain chemicals, they're, they're built on amino acids. So kids have to be getting enough protein.

Mm-hmm. But high quality protein, it can't just be protein shakes and protein bars. Yeah. Right. So that's one thing. But there also have been studies looking at a, again, higher fruit and vegetable higher antioxidant load mm-hmm. To improve focus and attention. Yeah. Now, 'cause we know that, for instance, um, you know, all of these.

These conditions that we might think of, you know, quote brain issues, whether they're anxiety or A DHD, we know that there's an inflammatory component to it. Mm-hmm. Right? Yeah. It's not just, oh, it's something happening in your brain. There's overall systemic inflammation and brain inflammation going on.

Mm-hmm. And what do those colors, those [00:37:00] phytonutrients do? Implants and vegetables, they reduce inflammation, right? Yeah. They reduce that oxidative stress that, that we need to keep our whole body working well. So, so that's one thing. But then oftentimes I think, well, what do we need to. Get out. Mm-hmm.

That's really inflaming the brain more. Right. Um, we've already talked about the sugars. Um, all of those artificial dyes, which hopefully are on the way out now. Mm-hmm. Right. But those artificial dyes, they wreak havoc on, um, your gut microbiome and your brain. And I'm gonna talk about this category of food called emulsifiers that some parents may not be as familiar with.

Um, emulsifiers are the kind of food additive that are added to keep. Whatever packaged food from becoming a goopy mess. Mm-hmm. So you can find them in protein bars, you can find them in all sorts of barbecue and salad dressings, you know, barbecue sauces. You can find them in ice creams. It's not gonna say emulsifiers on the package, but what it will say is [00:38:00] something like C mc or carboxy Methylcellulose.

Mm-hmm. Or Monoglycerides. Or carrageenan or even xantham gum. So you have to know what to look for. You don't necessarily have to memorize, I actually have a whole list of a lot of different emulsifiers in the book that you want to avoid. Um, but once you just scan the package, like now my kids know if they see something says, that says mono something.

They just put it right back. Mm-hmm. Right. Um, but even during pregnancy, women who had a diet high in emulsifiers were found to have offspring that were more likely to have attention and focus problems. Mm-hmm. And emulsifiers in, uh, there's a study out of Japan that looked at emulsifier consumption and found that the rapid rise of emulsifiers in packaged foods correlated with a very similar trajectory of rise in autoimmunity because emulsifiers can directly disrupt your gut lining and trigger leaky gut and also [00:39:00] promote the growth of the wrong kind of bacteria, these gram-negative bacteria that also are highly linked with autoimmune disease risk.

Mm-hmm. 

Dr. Brighten: So I just wanna kind of put it together for everybody. So you brought up neuro divergent children. So anxiety, autism, A-D-H-D-O-C-D, um, ticks. We can see there's a lot of conditions that fall into that umbrella. We understand now. That the same gene clusters tend to be among those children who have a higher rate of inflammation.

Autoimmune disease can also be linked in that. And what we know about children who are neurodivergent, they have gut microbiome profiles that are different than their neurotypical counterparts. So the inflammation is a very key piece. I also, you know, you, you brought up what you consume in pregnancy and your child having this diagnosis or being noticed, um, that, you know, the attention focus issues are earlier on.

My question for you is that, did the diet actually cause these conditions or [00:40:00] did the diet exacerbate what was already there to which a doctor could pick it up sooner that they actually got recognized and diagnosed sooner? 

Dr. Song: So that's an interesting question. And also when I talk about prenatal diets or early life diets mm-hmm.

And lifestyles that can impact future health. One of the issues there is, okay, that's information and it's information you want because you wanna know how your child got to where they are today. Yeah. But it's, it's information that just tells you the story and we, 'cause we can't go back and change that.

Mm-hmm. Right. So I don't want any mom thinking, oh my gosh, no, don't moms here. We cannot, we never blame shame. Mom, you and I 

Dr. Brighten: are moms and we know there's plenty of things that were like, dang, if I knew that 10 years ago. That's right. That'd be so different. Absolutely. 

Dr. Song: Um, and what is fascinating is that the studies show now that even.

If your kids had a certain life that maybe included antibiotic exposure mm-hmm. And exposure to ultra processed foods, your child and your own [00:41:00] current diet can be shaped by what you're eating now. Mm-hmm. And your diet right now can really influence about 30 to 40% of your microbiome. Mm-hmm. It's powerful.

So if we can really start changing our diet to a more microbiome nourishing one, it will make a huge difference. I mean, in, in one rat city, they found that the change in your microbiome could be accounted 47% by diet. Mm-hmm. And so what we eat really matters. Now when we're talking about neurodiversity and we're talking about how do we support neurodiverse kids to really feel and function as optimally as they can mm-hmm.

Without trying to change who they are. Right? Mm-hmm. That's not what this is about. But we know when there's inflammation, you know, a lot of kids. Just they don't even know how poorly they feel. Yeah. Until that inflammation is gone. Mm-hmm. Right. They don't realize how much their Tums hurt or the fact that, um, their sleep problems.

We know A DHD and sleep disorders go [00:42:00] hand in hand that their sleep problems were actually, you know, driven by inflammation. You get everything, inflammation, you sleep better, and then all of a sudden, yes, you may still have underlying A DHD, but your symptoms are so much better. Mm-hmm. Right. Um, what I wish every would be routine in every single pediatric office was not just blood testing that I mentioned before, but gut microbiome testing.

Mm-hmm. Because we can see changes in your gut microbiome even before we start to see impacts on your immune system or, or, um, even on your brain. Mm-hmm. And mental health. And I'll just point to this one little girl. She was 10 and she came to me after she had been on three or four different psychiatric medications.

None of them helped. They all had horrible side effects. She stopped growing. And so, um, you know, she was diagnosed with, I mean, you named the acronyms, right? A-D-H-D-O-C-D-O-D-D, you know. Yeah. Um, she had dyslexia on top of that. I mean, the works. Right. [00:43:00] And so, you know, she, and she came and she told me honestly as this little girl, you know, 10 year olds can feel, you know, very grown up.

And she said that she was not interested in taking supplements and, you know, she was very selective in her eating. Um, so I just spoke with her about the microbiome and how it could be impacting her brain. Um, and you know, that I and I, and that I know she wants to feel better 'cause she was miserable.

Mm-hmm. And her whole family was, was miserable. Um, and um, and then we did some microbiome testing and I went through it. So she had. I mean, astonishingly high levels of this bacteria, particular bacteria called enterobacter. Mm-hmm. Or gram-negative bacteria. Really high levels of Klebsiella and Citra bacter, which in an adult that is an alarm bell for Oh, is an autoimmune risk.

Exactly. Yeah. And she had really high levels of this, this, um. Compound that is found on the cell membranes of these particular bad bacteria called [00:44:00] LPS or lipopolysaccharides. Mm-hmm. Really high levels. And so I said, look, you know, we know that this LPS that, that these bacteria producing, they can affect your brain function.

They can affect how you feel they can affect your immune system. What do you think about trying to get rid of those? And so she was game and we put her on some antimicrobials to get rid of those bad bacteria. I put her on something called serum derived bovine immunoglobulin to lower the LPS. She actually agreed to take some prebiotics and maybe try to get in like one more fruit or one more vegetable, you know, in, in her diet.

After a month her mom called back. 

Dr. Brighten: Mm-hmm. 

Dr. Song: And said her daughter was a different. Kid, her daughter felt it too, that she was finally getting her daughter back. She hadn't smiled in in months and was starting to smile. Yeah. She just felt so much more at ease and the only thing we really did was, was heal her gut.

So she still [00:45:00] has a DHD. Mm-hmm. Right. She still needs support in school. The dyslexia is still there, but she's now able to access the parts of her brain that she wasn't able to because of the inflammation. Mm-hmm. And, and be able to then succeed and feel the way that she wanted to. So there's so many things that we're not told.

You know, when, when, as a parent you're given a diagnosis and you're like, okay, I guess there's the meds and the therapy and the school supports. Mm-hmm. But what about beyond that? Yeah. 

Dr. Brighten: Yeah. And I think, you know, we're seeing currently, you know, politically and socially, people are very focused on how do you cure A DHD, how do you cure autism?

How do you cure these things? W we're not going to cure neurodiversity. Like these are the wiring of our nervous system. And what we can do though is help someone thrive optimally and we can address the differences, the things that are going on for them that are impacting their life. And that is my fear in the research, is that if we continue to look at only cure, [00:46:00] then we are missing all of the ways that we can support people.

And we are, you know, confusing sometimes conditions before you and I started recording of like. When people are talking about profound autism, I brought up that that is autism with intellectual disability. These are two separate diagnoses, and when you start just putting everything I, I see this a lot.

People are like, oh, everything is autism. And I'm like, hold up. Because if somebody is autistic and they're, they have anxiety, like we need to treat that anxiety differently. Just as I think it's very easy for people to understand, like some neurodivergent conditions are associated with seizures. We're not going to just call that neurodiversity and not treat the seizure, like we're gonna treat that separately.

And so we have to separate these things out. But also be looking at how do we support someone's lifestyle? How do we support their quality of life? How do we help them thrive without this idea of like, we have to absolutely change everything. I also always laugh [00:47:00] when I look at autistic research or I hear clinicians that are like.

We reverse their autism, and as they're talking through everything, I'm like, it sounds a lot like you taught that person to mask and you trained them and you healed them enough that they had the energy and the wherewithal to actually mask more, and so you didn't actually cure anything. But what you should celebrate is this person actually has enough of the energy, the mental, I mean, masking takes tremendous amount of mental energy.

Like to be able to do that like that is also a win. I mean, it's not that we want people masking all the time, but it has a time and the place, it's also a win that you can do that at that level of mental energy. You brought up gut microbiome testing. Everybody's probably wondering right now, like, what are you, what are you talking about?

We doing saliva, we doing stool. Like what? What are we doing here? We're doing poop. We're we're doing poop. Okay, perfect. 

Dr. Song: When you're looking at your microbiome, that's, well, we have several microbiomes, right? Mm-hmm. You had Dr. Stacy come on and you know, we have. An oral microbiome, which is part of our [00:48:00] digestive tract.

Yeah. Right. Yeah. But our oral microbiome looks very different than the microbiome that's lower down in our large intestine. Um, our skin has its own microbiome. Our uterus has its own microbiome. Our eyes have their own microbiome, so our brain does too. I mean, we're gonna be finding all of these different microbiomes and the different organisms that really are meant to be there.

Now, when we're looking at the gut microbiome, we're really looking at your large intestinal microbiome. Mm-hmm. And the only way to measure that is through poop. 

Dr. Brighten: It's super fun, guys. You get to scoop your kids' poop three times. That's right. That's right. We're looking old. You 

Dr. Song: learn they can learn how to do it themselves.

Right now, the microbiome testing, so earlier this year, I believe in February or March of 2025, there was an international consensus of microbiome testing in clinical practice. And it's a very important international consensus because it helps guide us on the, you know, the huge array of microbiome tests are available.

Mm-hmm. How do we choose as a clinician and as a parent [00:49:00] or, or as a patient, right. If we're an adult patient, and the consensus notes that really the gold standard now should be something called shotgun metagenomics or metagenomic testing. Mm-hmm. Because we have the ability now to identify, you know, all, not all, but many, many, many of the, you know, of the trillions of microbes that are in our gut down to the strain level.

Mm-hmm. Right? And also looking at their genomics, we can identify their function just because you have a good amount of, let's say. Kerman, right? Is it doing what you want it to do? Mm-hmm. Does it have the genomic profile just because you have enough bifidobacteria, is it actually making the short chain fatty acid acetate for you?

Does it have the genes to produce gaba or neurotransmitters for you? So it's opening up this fascinating world of not just identifying what's there, but are they [00:50:00] actually doing what we want them to do for us? Mm-hmm. Right. And also these abnormal bacteria or parasites or fungi, whatever's in there, are they actually causing harm?

Yeah. Right. Um, and then we mentioned, um, this LPS, we can now measure LPS in the stool and see if, if microbio, if our microbio are releasing that. And so. PCR testing really doesn't have a big role, except if you're trying to identify, you know, one bad player, then it can, I mean, through COVID we saw PCR testing amplifies the sequence mm-hmm.

Of the SARS cov to two virus, and sometimes we amplify it too much and we see something that really isn't a problem. Right. Um, same thing with PCR testing in the gut, we might be amplifying h pylori too much. Yeah. Or maybe candida isn't as much of a problem. Right. Um, so I do, I use a, a test called Tiny Health and just full disclosure on the Chief Medical Officer.

And the only reason I would've ever agreed to that is because I think this is the best test out there. Mm-hmm. [00:51:00] And, um, and using shotgun metagenomics profiling also some enzymes that practitioners are used to like calprotectin and lactoferrin to make sure that there's not inflammatory bowel disease.

Yeah. One thing with, um, with testing as well, we are gonna get to a point, and I'm, uh, and I think it's not too far from now where we can see a more precision, personalized microbiome analysis based on your age, your sex, your, you know, your menopausal status, right? Mm-hmm. Because we know your microbiome shifts, depending on hormones.

I mean, there's, you know, baby microbiomes, um, you know, at children microbiomes will go along the steady progression until puberty, and then when progesterone and estrogen or testosterone coming into the picture. Boys and girls by sex, their microbiomes differentiate. That is very important to know. So we can't just have a one size fits all approach for, you know, an [00:52:00] adolescent female who's having, you know, horrible PCOS symptoms.

Yeah. Or are we gonna look at a standard from like a general viewpoint, or are we gonna look at a, as a standard of what this developing adolescent females microbiome should look like. Mm-hmm. So we'll get there at some point. And then then the ability for us as practitioners to really hone in on the microbiome science and create a truly precision plan for you will be phenomenal.

Dr. Brighten: Who should we be running microbiome testing on? 

Dr. Song: Um, every woman who's trying to conceive mm-hmm. Every male partner. Who is helping that woman try to conceive? Because we also know that the paternal microbiome before conception, I mean it is wild. This is now, this is a rat study, but we're finding this now.

I mean, there, there are human studies going, but um, these, um, these, uh, rats who had dysbiosis, so they had, uh, antibiotic induced dysbiosis, right? Mm-hmm. Um, and there's epigenetic [00:53:00] signaling that changes when your microbiome changes. So then these sperm, um, microRNAs changed and those babies in utero had worse pregnancy outcomes.

Mm-hmm. Right? And, and even, um, you know, even those pregnant. Rats had worse outcomes, like, you know, let's say preeclampsia or gestational diabetes, the equivalent, right? When those male rats were given probiotics to correct their microbiomes, those pregnancy outcomes normalized. Mm-hmm. So we all, we think, oh, it's the mob's microbiome that shapes.

Mom's vaginal and gut microbiome that shapes the baby's microbiome after birth. It's also the paternal microbiome. We cannot leave the paternal microbiome out of this, right? Mm-hmm. Um, so I would love all, all, um, men and women before conceiving to optimize their gut microbiomes, women, especially if they have antibiotics during pregnancy.

Um, I would love a. Prenatal microbiome test and a vaginal microbiome test. Mm-hmm. Uh, we can see [00:54:00] signatures now in the microbiome, um, that indicate an increased risk for gestational diabetes or preeclampsia. So why not correct your microbiome to reduce that risk? Right. Yeah. And then babies, do they all need microbiome testing?

I mean, I, I would love to start babies off with the best microbiomes, but especially for babies who are born by C-section, um, babies who have had antibiotic exposure around the time of delivery. Mm-hmm. Um, uh, and babies who are formula fed, we know that that changes the trajectory of your child's microbiome to one that might increase the risk of things like allergic diseases and even mental health, um, concerns later on.

So I would love for those babies to have a microbiome test somewhere within the first month of life. Mm-hmm. So we can course correct if needed. 

Dr. Brighten: Yeah. And then in terms of neurodivergent children, do you recommend across the board they have microbiome testing? 100%. Mm-hmm. 

Dr. Song: Absolutely. So, in fact, any, any kiddo or teenager who comes to me with any chronic concern, whether [00:55:00] it's, you know, attention and focus issues, anxiety, um, pants, pandas.

Mm-hmm. Um, uh, autoimmune issues, eczema, asthma. Of course gut symptoms. Yeah. Right. All of those kids, I, I start with a gut microbiome test because I can, you know, there are some things where, by the pattern of what parents are describing, I can guess that there's blood sugar dysregulation and there's that blood sugar rollercoaster.

Mm-hmm. If I look at a kid with eczema, I am just going to assume that they have a zinc and, and an Omega-3 deficiency or insufficiency. I still would love to test because I don't know how much supplementation and how much to focus on which foods for you. Yeah. But your microbiome, I cannot tell what's there if I don't look.

Mm-hmm. Like you just have to look and then that can guide your diet and supplement plan because I don't wanna throw a ton of supplements at your child. Yeah. If I don't know that they're gonna be helpful. Mm-hmm. But when we know that they are, it can make a huge difference. 

Dr. Brighten: Yeah. [00:56:00] Right now social media, everybody's out there saying everything is due to parasites.

And we're seeing influencers putting children on parasite cleanses, recommending that everybody's child has a parasite cleanse. How problematic are parasites in reality and what do you think about all these parasite cleanses in children? Yeah, 

Dr. Song: it's, it's interesting 'cause I, of course, I'm getting lots of questions from parents.

Should we do a parasite cleanse? Mm-hmm. Does my child of a parasite now parasites, I will say they are hard to detect on the stool, super hard stool testing. We gotta te we gotta 

Dr. Brighten: get three collections and even then we're like even then. 

Dr. Song: Mm-hmm. Right now, metagenomics profiling is more accurate than just looking under the microscope and mm-hmm.

And seeing is in that one particular stool sample, do there hap, does there happen to be a parasite egg or the actual parasite in there? Right? Mm-hmm. But parasite testing is really challenging and so. Do I think that there are kids, more kids with parasites than actually are detected on stool testing?

Absolutely right. I [00:57:00] do think so. Um, do I think that every kid who has a a problem. Has a parasite. No. Right? Mm-hmm. Now I go through some, you know, I mean, there are some clinical patterns, and this sounds really weird, but you know, we as, um, as living creatures, all of us, including parasites and humans, um, are are sensitive to the moon cycle.

Dr. Brighten: Yes, we are. Right? 

Dr. Song: I mean, all of us. My mom, you know, was an O-B-G-Y-N, uh, you know, back in the, um, eighties and nineties. And, you know, she, she knew, she just, she never booked vacations during the full moon. Yeah. Because she knew it's baby time. She would be flooded. It's baby time, right? Um, so we see this, so we also see this with parasites.

So if your kids, I just have parents kind of track and see is there a cyclical pattern to your child's? Behaviors. Mm-hmm. Or their eczema or their sleep problems or whatever. It's Right. [00:58:00] And if there's a cyclical pattern that seems to correspond with either the new moon or the full moon, then I have a much higher index of suspicion.

Even if the stool test doesn't show a parasite that 

Dr. Brighten: mm-hmm. 

Dr. Song: You know what, maybe we'll try it. Maybe we'll try a parasite cleanse. Right? Yeah. Um, and uh, and it sounds very strange, but it is what it is, right? Mm-hmm. I mean, we, we just, we have to know that we are not in full control of our bodies and brains.

I mean, we have other forces, right? And so, you know, or itchy butts, right? I mean, pinworms. Mm-hmm. I mean, pinworms tend to, like I will tell parents if we're really trying to find pinworms, sometimes we'll treat, I mean, in other countries you just. D Worm, right? Mm-hmm. You know, every, whatever. Once years, no.

In Mexico, your children 

Dr. Brighten: are living on farmland in a rural area, they're getting ivermectin treatments. Yeah. I mean, my mother-in-law, she grew up in Puerto Rico and she's like, we got regular parasite treatments. Yeah. Because of what we were getting exposed to. So there's certainly areas where this can be problematic, but I always think about like the people who are [00:59:00] living in middle America.

They're cooking all their meat. Well, they don't even have a passport, so they've never traveled anywhere. Like they have a water filter. Like, you know, we, we start to look at like, what is your exposure really like Yeah. Of coming into contact with parasites. Like if you were a regular gas station sushi eater.

Yeah. I'm gonna guess you probably have a parasite. So, and with, with 

Dr. Song: parasite cleanses I should say. I mean, what does that mean? Mm-hmm. Right. And I do see some of the parasite cleanse protocols out there. They're pretty harsh. They're 

Dr. Brighten: super harsh. Some of them I'm like, do not all herbs are safe. 

Dr. Song: That's right.

Dr. Brighten: Some herbs are gonna raise. So as you talked about liver enzymes earlier, yes they're gonna raise liver enzymes. What does it tell us? It's a stress on the liver. And so I see them and I see the dosages and I'm like, that's high for an adult. And you would give that to a child? Yeah. And like I would not give that to a child.

Yeah, 

Dr. Song: no, absolutely. So I do not recommend myself any of the parasite cleanses that are out there, especially for young kids and and older kids. [01:00:00] And I wanna make sure that they have a good gut restoration program in place. Mm-hmm. Because one of the things that, you know, for. For us as humans, when we find out there's a bad bug in us, whatever it is, we wanna kill, kill, kill, right?

Oh, absolutely. That's like, you know, 

Dr. Brighten: like, I mean, I think it's also something like, I mean, I don't know how you feel about parasites, but I'm just like, oh, like the, the, the freeloader like sucking off my energy. Like it grosses me out so much. And so I know whenever I have patients and we do find a parasite and they're freaking out, I'm like, I feel this so hard, but I'm with you, like the seek and destroy and kill and wipe everything out approach, which we use in so many things.

That's right. Right. Like, we look at weed killers, we look at like how we treat pests in our homes, like those kinds of things. And, uh, as, as you say all of this, I'm like, this is back to your stewardship of the earth of like treat your body like you would treat the earth. Like it's not about just. Destroy everything.

That's right. But it's also about like, how do we prevent this? How do we rebuild, how do we nourish? Yeah. So how do we [01:01:00] do that? I know people are like, shut up Dr. Brighton. Let her say I, I mean, because it is true, 

Dr. Song: right? We have this kind of scorched earth policy and we're like, totally, you know what? You have to rebuild the rainforest.

Mm-hmm. Right? And, and that's where, especially for children, the younger you are, the more malleable, the more changeable your gut microbiome is. Mm-hmm. For better or for worse, um, as an adult. I mean, if, if you've been living with chronic yeast, you know how hard it is to change, right? Mm-hmm. But kids can change really rapidly their microbiomes especially.

And, um, and so one of the, the, the really most important foundations of any gut regimen where we're trying to get rid of abnormal bugs, the first thing is you have to regrow and really create that ecosystem mm-hmm. That is friendly to these beneficial flora. Right. Because that is gonna start crowding out already.

Mm-hmm. Parasites, they don't wanna live in a healthy gut. You know, these, these enterobacter, these gram-negative bad characters, these bad bacteria, they don't [01:02:00] wanna live in an environment that's full of phytonutrients and, you know, fiber and fermented foods. Mm-hmm. They would prefer to live in an environment that's full of emulsifiers.

Yeah. Right. Or, you know, high saturated fats and high sugar environment. Right? Mm-hmm. We know that that changes the microbiome for the worse. Um, or in, you know, in a diet that's loaded with glyphosate, right? So first thing, you don't feed those bad bacteria, you start feeding the good bacteria. Mm-hmm. Then you have that foundation there, you have, you're building, you're building up the terrain, the soil is healthy.

Now there's fewer bugs to kill. Mm-hmm. And so then once you get to the killing, it's not as hard. The, the reason I'm not really for many of these, um, gut cleansing and parasite cleansing protocols is, as you said, some of these herbs can be very harsh, and we know also that some of these herbs can cause just as much dysbiosis as antibiotics if we're not careful.

Yeah. Right. [01:03:00] People think, oh, it's natural, it's herbs, it's not gonna cause the same problems. That's not true. Mm-hmm. If we're doing higher dosages or for very prolonged periods, it could cause problems. So what do I typically do for a parasite? I actually do do a prescription anti-parasitic. Mm-hmm. I just find.

That layering in, um, either oxide, which is alinea, unfortunately very expensive, um, um, or metronidazole or fragile. Mm-hmm. Which tastes gross. I mean, you know, so, uh, but I'll, I'll usually layer that in honestly 

Dr. Brighten: though, like anything that is killing off like parasites or killing off in the microbiome tastes gross, whether it's an herb That's right.

Or an antibiotic, like, well, think 

Dr. Song: about the herbs, right? Yeah. Like Artemisia. Mm-hmm. And I mean, and berberine, they're bitter. Bitter, right? Mm-hmm. Um, but um, but I just like to get those in. I had this one kiddo who, the parasites in him, he had, you know, high levels of blastocystis, which, um, which did show up on stool testing and, um.

I wasn't sure what was gonna happen. He had lots [01:04:00] of behavioral issues and, and you know, really his ticks were getting worse and worse. Mm-hmm. You know, sitting in front of the tv, blinking shoulders, showing whole body jerking. I mean, yeah. It just looked painful, right? Mm-hmm. Um, started him on flag. Two days, tick's gone.

Yeah. I mean, it was fascinating, right? Mm-hmm. But then the, but then after we stopped, did a 10 day course or so, the tick started to come back. So what we did was then every full moon for the next three full moon cycles, I layered in the flag for that week around the full moon. Mm-hmm. And also added in some anti-parasitic herbal combinations.

I mean, there's some ones that are more gentle, um, and did that while we're in between those cycles really doubling down mm-hmm. On, you know, getting in a more microbiome friendly diet. Fixing, not fixing, but modifying the lifestyle as much as possible. Mm-hmm. Right. Knowing that, I mean, he's a. Right. I mean, he's gonna go out and, um, hang out with his friends.

He was old enough that he was buying some of his own food, [01:05:00] but, but he knew he didn't like the ticks. Right. 'cause his friends were starting to notice and it was uncomfortable for him. Yeah. Right. Um, so he had more motivation to try to stick with a diet that, you know, really got rid of the diets. And, um, you know, he started reading labels.

He started trying to choose healthier chip options. And when he bought candy, he was trying to buy ones that weren't as bad as some of the other candies that he used to have. 

Dr. Brighten: Yeah. Well, and I appreciate that you, you talk about how you leverage pharmaceuticals in this way. You know, it's often something that.

You know, it is like I think about a yeast infection. If a woman has a yeast infection, why wouldn't I give her Diflucan? So we can get rid of that right away and then we can start to work on everything else. Because the reality is, is that when you have something that is overgrowing, right, these are incremental flora, but it is causing inflammation.

It is distracting you, it is taking extra energy from your body and it becomes so much harder for you to actually focus on the nutrition and lifestyle components. And so, you know, I just appreciate you offering that [01:06:00] because I think so often people are like, well, if you're integrative or you're, you're natural, then it's just all about only doing herbs.

And you know, our perspective, and this is why I'm having you on, is that it's about the right tool in the right situation and making sure that we're meeting the patient where they're at with what they need. And certainly like when you're dealing with a parasite, it's like we want that gone as soon as possible, especially if you're presenting with symptoms.

We are rolling into back to school time soon. What can parents do to support their children's immune system so that they're not getting sick all the time? 

Dr. Song: You know, the foundation is still gonna be the microbiome, but when we focus on diet, I would say just keeping the sugars down, you know, less than 25 grams mm-hmm.

Of added sugar per day. Where does that mean? That's about six teaspoons of added sugar in a day. Mm-hmm. You're not gonna know how much sugar is in a food until you read the label. Right. Um, but that's, as we start heading back from the summer back into school, just, you know, I know summer vacations, diets can go all over the place, but just getting a better handle on let's, [01:07:00] let's get back to eating more vegetables.

Let's get back to cutting out the daily ice cream and popsicles, you know, can happen over the summer. Um, so that's one thing. Um, you know, when we think about, uh, a lot of parents wanna know are there's some supplements that can help support. I'll talk about probiotics, right? Mm-hmm. Because I don't. Now, I actually don't necessarily think that kids and adults for that matter, should take a probiotic supplement every single day.

Mm-hmm. We wanna know, well, why are you taking this probiotic? For what goal? Um, and does that probiotic supplement have the right strains in it for you? If you're supporting vaginal health, very different probiotic supplements and if you're supporting immune health. Mm-hmm. Um, but this one study, um, this huge, you know, uh, Cochrane review of studies, looked at probiotic supplements and cold and flu winter time, and found that.

I, if I get the numbers wrong, forgive me. But I wanna say something that was jaw dropping to me, that if every person took a probiotic supplement over the [01:08:00] wintertime, that there would be something like 54 million fewer missed days of work in school. Wow. Right. Yeah. Just the power of the microbiome and, um.

Uh, there are particular probiotic strains that we know in children can reduce the risks and rates of cold and flus and fevers and mist days of school. Mm-hmm. So why not? Right. Especially if you have kids who are really picking, like, I don't, I don't know if I can get any fermented foods into them. I don't know.

You know, if they're gonna, um, get, uh, if I'm going to get more, uh, fruits and vegetables into them, then probiotic supplements can be really helpful. Mm-hmm. I would say for immune functioning and winter support, I would want an immune probiotic, a vitamin D supplement. 'cause across the board most kids need more vitamin D, um, most adults and most adults of vitamin D.

Right. Um, and then, and then depending on the situation, I usually do suggest extra zinc and extra fish oils. Mm-hmm. Because most kids aren't getting enough. Right? Mm-hmm. Um, and [01:09:00] then when it comes to fermented foods, I mean, this is fascinating. Um, there's actually a, a. Kimchi Research Institute in Korea. 

Dr. Brighten: I love this.

I am like, sign me up for this. 

Dr. Song: So because kimchi and, and not just 'cause I'm Korean, but kimchi has amazing, amazing immune and brain and restorative powers. And there actually was this one study looking at kimchi. This was during the, uh, I'm sure you remember that long before the pandemic there was an H one N one flu scare.

Mm-hmm. And it was, I mean, panic, not on the level of pandemic, but I mean a lot of panic. Um. And, uh, and this research institute came out and, and showed that H one, that kimchi could kill the H one N one influenza virus. Wow. In vitro, right? Yeah. Um, and then I love, you know, there's another study looking at fermented foods and young women with social anxieties.

Mm-hmm. How many have that, right? Yeah. And found that fermented foods [01:10:00] significantly reduced. Their social anxieties and the researchers even comment, which I had to laugh about that. That could be a low cost intervention for these women. 

Dr. Brighten: Yeah. Right. 

Dr. Song: Like why not? Low cost. Low risk. Right. Totally. Totally.

Right. Right. But, but women don't know. But we're also, for many, many people, they're thinking about fermented foods as, um, sauerkraut or kimchi or pickles. Mm-hmm. And, and they're like, I, my kids don't really like that. Right. Um, but you can ferment foods in lots of different ways. Mm-hmm. Um, in the book, I have a fermented blackberry lemonade recipe mm-hmm.

That I've made with my kids' class classmates. And, um, super easy, super fun. It's a way to get fermented fruits in. Still has fermented power, but it's a little bit sweet. Um, kombucha if your kids like kombucha, keefer, I mean, there's more and more you don't have to make your own. It's super fun too. Mm-hmm.

Um, but um, but you know, I was at Trader Joe's and they had a whole row of, um. Water keefer is like this agua fresca water keefer that actually tasted really good. Mm-hmm. And so you have to watch the added sugars. That's the only thing. Yeah. Um, [01:11:00] but there are different ways to get fermented foods and besides just thinking, how am I gonna get sauerkraut into them?

Dr. Brighten: Mm-hmm. What specific strains of probiotics can help support a child's immune system as they move back into school or winter cold and flu season? 

Dr. Song: Okay. So, um, there are, um, a few of them, I'm not gonna remember all of them, but there's lactobacillus, uh, health as, I think it's lactobacillus acidophilus. NCFM.

Mm-hmm. Okay. NCFM. There's a Bifidobacterial Lactus, BIO seven, um, lactobacillus Rosis, gg. Um, those are probably three of the most common ones. Mm-hmm. That are, that really well studied. Um, now you'll notice the strain is important. Okay, so lactobacillus acidophilus, NCFM is going to be different than lactobacillus acidophilus l PC 37.

Mm-hmm. [01:12:00] Right. Um, you know, there, and I, I may be seeing the LPC 37 wrong, but you know, the strain matters because we have, you know. Probably hundreds of thousands of different strains of, um, bacteria in our gut. Um, and for instance, bifidobacteria, you know, this bifidobacterial lactus, BIO seven, that BIO seven is the strain of the Bifidobacterial lactus.

Um, when we talk about lactobacillus rosis, the GG is the strain. And so these are the strains that are most widely studied for immune support in kids, right? Mm-hmm. But lactose, bacillus gnosis has many other strains. Some of them are good for vaginal health. Some of them are, are good for gut health. Some of them are better for brain health.

So the strain can really make a difference. Mm-hmm. Now, if you're supporting your overall gut microbiome, then you wanna choose, you know, just a broad, broad array of different, um, microbiome strains. Again, do I use probiotics every day? Not necessarily. You [01:13:00] wanna get that, you know, get the fiber fermented foods a phytonutrients in, and then you can kinda sprinkle in probiotics here and there, especially after.

Time travel, you know, time, um, uh, going across time zones is a big stress to your microbiome. Um, going to altitude, antibiotics after a meal where you're like, Ooh, I didn't have, you know, that was not the best choice. Maybe some ultra processed foods got in there. Anytime you have that, then throwing in some extra probiotics can be a better me.

Um, kind of a, a safeguard against that, but bottom line, you just have the foundations in there. 

Dr. Brighten: Mm-hmm. For teachers who are listening or maybe room moms, what are ways to cut down on germs within the classroom? 

Dr. Song: So it's, that can be a double-edged sword too, because we don't want to clean. 

Dr. Brighten: Yeah. Right. And we know that some of the, but we don't want Lysol and hand sanitizer everywhere, right?

No, 

Dr. Song: because I mean, it's interesting because there are studies looking at hand sanitizers and excessive hand sanitizer use as disrupting your gut [01:14:00] microbiome. Mm-hmm. Now why is that? Well, we can think also, okay, anything you put on your skin is gonna get absorbed. So some of that antimicrobial property is going to get absorbed systemically.

So maybe that's part of it. But also if we're hand sanitize, if we're sanitizing everything, we know we're gonna get an inoculation of, you know, hopefully beneficial bacteria when we have some hands and mouth behavior. Right. If we're eating. Mm-hmm. So we don't want too clean at the same, um, washing with soap and water is, is fine.

Right. Washing with soap and water is, um, a, a regular soap, right? Mm-hmm. Dove soap, you know, um, we can actually, uh, keep your hands free and clear of abnormal microbes, um, and not disrupt your skin microbiome. Mm-hmm. That's really important. Right. Um, I do, you know, I would say, you know, what can we, we do, I, I mean, I, I look at this also from the lens of, you know, my pans Panda patients where I really don't want them to get sick, don't, you know, and expose, you know, to, to different illnesses.

I think that we just need [01:15:00] better policies overall to support kids to stay home. Mm-hmm. And allow parents to stay home until they are well now what does that mean? I mean, I. Okay, you might have some guidelines 24 hours after no fever, without any anti, any fever reducing medicines. I want them to be, well, like I want them to be, you know, back to almost their baseline energy.

They may still have some lingering runny nose or low cough that can linger. I mean, a cough can linger for three weeks after a cold. You're not contagious at that point. Um, but in those early stages where your kids are feeling crappy and they're still wanting to lay around, they're probably still somewhat contagious.

And they're also not ready to go back to school, be exposed to new germs, and be able to ward those off. Mm-hmm. Right. But we don't have a system in place where parents can take off that time from work when their kids are sick. And kids, if they have a whole, you know, whole. Stack of homework, feel comfortable and safe staying home from school.

Mm-hmm. And being able to catch up. Um, so I think [01:16:00] that has to happen. I think school snacks, school lunches, that has to change. I mean, so many of our school snacks and lunches, um, are filled with too much. I mean, we had my school, I love my school, you know, and, and most of the parents in my, in my school are more health minded.

But one of the school breakfast choices was Whole grain, you know, multi-grain Frosted Flakes. Oh man. 

Dr. Brighten: I thought you were gonna say Pop 

Dr. Song: Tarts. 

Dr. Brighten: I'm like, just as bad. I'm like, that is 

Dr. Song: not really. A great choice if we're gonna support our kids' immune system. Mm-hmm. Um, we should not be giving out candy and, um, you know, uh, sugary snacks as rewards, you know, the candy bucket for like the, you know, the a on the quiz.

Mm-hmm. I mean, that, that needs to stop. Um, so I dunno if that's what, what your, um. What you're looking for and, and what room moms and, and parent teachers can do. But I feel like, you [01:17:00] know, kind of systematically changing the school environment where food is not used as a reward. Um, where, you know, we encourage movement every day where, you know, we're really, um, allowing kids to fully recover is gonna go a long way and having fewer kids be sick.

Dr. Brighten: Mm-hmm. I mean, I feel like it is the, the obvious one, if you want to reduce germs in the classroom, you have to eliminate the vector from bringing the germs into the classroom, which is the child who is sick. And I think you're right, it's gonna take a big policy change because really at the root of all of this is that parents can't take time off work.

Schools have ridiculous, you know, requirements in terms of attendance. Like I know parents get like. Or they hate on the school 'cause they're like, oh, they have these strict attendance, but it's also funding issues. Absolutely. Yeah. So it's this upstream really something our politicians all control right now.

And I would say like if our politicians were truly invested in this Make America healthy again paradigm, we would [01:18:00] see, we would see maternity leaves, we would see, uh, sick time leave. We would see teachers getting better funding, getting better support. Like we would see a lot of these changes that we're unfortunately not seeing that absolutely have the biggest impact on the future of our children's health.

Well that is 

Dr. Song: one of the, um, my biggest concerns is we can, we can look at downstream, great. Let's change the crappy food industry. Mm-hmm. Awesome. Right. But that's downstream. We have to look at how do we get these kids born in as healthy state as possible. Mm-hmm. I mean, prenatal care, healthy foods, and microbiome testing for all pregnant women.

Precon uh, preconception care, supporting the mom. Mm-hmm. Extended maternity and paternity leaves so that that baby can have the richest environment mm-hmm. To support their microbiome setting instead of having to go for financial reasons to daycare at six weeks. Yeah. And mom's right back to full-time work.

I mean, we're not thinking [01:19:00] about these first, these critical first 1000 days. Mm-hmm. Which starts from the moment that baby is conceived until about three years of age, where we actually, from a public health standpoint and an individual health standpoint, have the. Biggest opportunity mm-hmm. To change that child's health trajectory and optimize their immune health and their brain health and their metabolic health.

Like if we don't target, if we don't tackle that, we are not, we're still gonna be fighting fires and putting out, you know, these, these fires everywhere. After kids are sick. Mm-hmm. So, so I'm hoping the conversation starts to shift. Um, it's not there right now, but it really needs to be. 

Dr. Brighten: Yeah. It is something that, I talked with some of the people that were involved when with Maha and they were talking about wanting to promote breastfeeding and getting rid of, you know, formula and making these shifts, like get more women breastfeeding.

And when I said to them, do you realize that the reason why we don't have [01:20:00] maternity leave is because Nestle one of Nestle, you're one of the most corrupt companies out there, and I'll say it every day, I said what I said, um, they have lobbied formula companies are the ones who've lobbied against maternity leave because that forces that mom back to work that baby into daycare.

And what happens? Milk supply dries up. That's right. When you're super stressed. And so then what happens? Baby's microbiome starts to shift immune health. They start getting exposed to things that they wouldn't necessarily get exposed to if they were at home. That's right. And even, even just having play dates, like they're in a completely different artificial environment that is incredibly stressful for the entire family.

And so I think, you know, you're absolutely right. It's the things that I look at with these policies where I'm like, we do have to go upstream. I have always said that mothers are the people who create and care take for the future of our species. So any society that's not taking care of their mothers is not a society that [01:21:00] cares about health outcomes of their population.

Absolutely. 

Dr. Song: Absolutely. I mean, I just even think about, you know, in, in my Korean heritage and the culture, um. There are certain foods that are supposed to be prepared for the mom. Mm-hmm. The mom is not supposed to do anything but sit at home with their baby. Yeah. And be, you know, laying with their babies.

I mean, I was even yelled at by my aunt for going outside for a walk. She's like, you can't do that. Right. Um, but there are, there are these traditions to nurture mm-hmm. The mom and support the mom baby dyad, which is really one of the only ways we're gonna successfully implement a breastfeeding initiative mm-hmm.

That is going to have women successfully nurse. There's too many factors against that. I mean, we know stress, like you said, immediately tanks your supply. Mm-hmm. And not all women have the ability to take a break every two to three hours to go into. A crappy bathroom stall and pump. Mm-hmm. You know, and [01:22:00] try to express milk for their babies.

So we just, we have to have more of a global, global outlook on children's health. Um, but it has to start, as you said, upstream. Mm-hmm. Um. We need upstream and downstream. What's missing is the upstream right now. 

Dr. Brighten: Mm-hmm. So well said. Well, thank you so much for coming back on the podcast. Like I said, we're gonna link to your previous episode because I think I would definitely, you know, uh, you can listen to 'em in any order, but I would definitely catch both of them because I feel like we built on so much of the knowledge that you shared before.

So thank you so much. Well, thanks for having me. Thank you so much for joining the conversation. If you could like, subscribe or leave a review, it helps me so much in getting this information out to everyone who needs it. If you enjoyed this conversation, then I definitely want you to check out [01:23:00] this.