My guest is Dr. Peter Kozlowski, author of UNFUNC YOUR GUT. Dr. Koz practices functional medicine and deals with each patient as a complete picture. He helps patients figure out how to manage or heal c Inflammation, IBS, autoimmune disease, and a myriad of common ailments we can experience, especially living in our modern world. We discuss when is a good time to get your heavy metals tested or SIBO (Small Intestine Bacteria Overload) and how you can really approach Chelation effectively. Dr. Kozlowski offers wonderful guidance and so many useful tips to help support better health, and the best way to approach getting to the bottom of some health issues.
Listen to the episode here:
- How it Began [00:01:19]
- Learning About Functional Medicine [00:05:54]
- Zeroing In on Gut Health [00:11:28]
- Heavy Metal Testing [00:17:19]
- Functional Medicine’s Thought Process [00:20:39]
- Understanding SIBO [00:24:05]
- Gut Literature [00:28:52]
- Recovery Barriers [00:30:40]
- Self Diagnosis Risks [00:37:44]
- Probiotics and Prebiotics [00:44:01]
Dr. Peter Kozłowski – Gut Health, Functional Medicine and Sibo
My guest is Dr. Peter Kozlowski, otherwise known as Dr. Koz. He has a great book out called Unfunc Your Gut. We hear so much about gut health and the importance of it, not only for our overall physical health but our emotional sense of well-being. Dr. Koz was on a traditional path. Because of some other doctors at the hospital taking these functional medicine classes, in addition to what they were doing, he started to check it out and decided, “It’s important that I want to get into the preventive side of things.”
We talk all about the importance of maybe first drilling down on some things like heavy metal testing or SIBO and how do you try to replenish your gut? What does that look like? It’s all confusing. There’s something like 22 million genes in your gut and 3 to 5 pounds of bacteria growing in our large intestines. It’s a complex thing but it’s something worth continuing to drill down on and he breaks it down in a simple and usable way. I learned a lot and I hope you enjoy the conversation.
Dr. Koz, maybe you could share a little bit about your journey, how you were heading in one direction in this notion of medicine, practice, and maybe why you decided to move into this idea of maybe mixing it a little more.
My parents are both doctors. I grew up wanting to be a doctor. I got into college and I got into the social life, the partying, and the going out. I went to Arizona State for undergrad and it was mostly because of the palm trees. My parents are immigrants from Poland so they didn’t know much about any college. I taught them English pretty much growing up. We went to different colleges and we saw Palm Walk at ASU. I was like, “This is where I want to be.”
Chemistry class was Monday, Wednesday, Friday at 8:40 AM. I had a hard time making it to the Friday morning class because Thursday was the big night. Most of my friends were in business school and business school was closed on Fridays so I ended up switching to a business degree in economics. I had a long way to go from the age of 18. They never pressured me when I went to school. When I switched majors, they were still like, “You’re still going to figure it out.”
During my senior year of college, my best friend got bizarrely sick. She came back from spring break with a rash, headaches, and fatigue. She didn’t know what was going on with her. She got diagnosed with lupus a couple of weeks later and passed away a week after we graduated. It was a couple of months after spring break.
During her illness, I felt hopeless. I’ve always liked to help people and I couldn’t offer any help. I remember having my mom mail me some medical books and reading about it but couldn’t do anything. That’s where I was like, “I want to be a doctor.” At that point, I already had an economics degree. I took the MCATs. I did not get into any traditional schools. I applied to Harvard, Stanford, and all the places I thought I should go but with my résumé, I didn’t get in.
At the back of this, US News puts out this book about the top medical schools, and in the back of it is Caribbean medical schools. There are four of them that are recommended. I applied to them and chose the school in Sint Maarten called the American University of the Caribbean. I was not sure about this. I didn’t want to go. I was like, “Is this even real? Is this legit?” It was my dad again who was like, “You get to live in the Caribbean for two years and be a doctor, are you nuts?”
I went through med school and got into residency as a family practice resident. We played beach volleyball every Friday on schedule for the two years that I lived there. That helped. The attrition rate was 33%. On the first day of med school, they said, “Look to your left and look to your right. One of you won’t be here by the end.” A lot of people struggled not from the school part but also living on the island is a different vibe than living and growing up in Chicago. I got into residency and everything was going amazing.
Do you know that in the Caribbean there’s a lot of alcohol?
Yes. When I was there, beer was cheaper than water at some point.
Was it a vow, the release?
[bctt tweet=”I thought that I was God’s gift to Earth. That comes crashing down when you end up in rehab.”]
I learned this through going to treatment and going through over ten years of therapy. It started when I was a kid and the immigrant thing is feeling insecure. I was the most outgoing person, social person, and friendly but inside, I was insecure in my own body and skin. The thing I discovered early on was alcohol completely took that away and that was the first year of high school. I was like, “This is everything I’ve ever wanted.”
I left residency and went to treatment. Treatment was nothing about alcohol. It was all about peeling back the layers of the onion. They told me I had trauma and I was like, “We struggled or whatever but I don’t have trauma.” I created trauma for myself by not feeling good enough and alcohol solved that. They say you stop maturing when you start drinking. At the age of 28, I went into treatment and I couldn’t even identify an emotion or a feeling.
I was the prototypical asshole doctor that had it all figured out, “I’m going to look down on you. I’ve done my research. I’ve read the books. I know better than you.” I thought that I was God’s gift to Earth. That comes crashing down when you end up in rehab. That changed my life and what made me open to functional medicine.
The majority of doctors that are in functional medicine, medical doctors like me, have an illness. Usually, it’s a physical illness like lupus, Hashimoto’s, or something. For me, it was a mental illness and treatment was acupuncture, exercise, meditation, yoga, and all these things I had heard of that I thought were made up. I saw them working in my own life.
When I got back to residency, I was back in the hospital working. You’re trained by different attending doctors every day, every week, every two weeks. We had one doctor named Dr. Batra that every time a patient was admitted to the hospital, he would put them on a multivitamin and vitamin D. We were the residents so we had to do the scut work and write those orders. He was the only doctor in the hospital that did that so naturally, we made fun of him. We thought it was a joke. We were like, “Why are you wasting our time? We could be writing opiates, blood pressure pills, or whatever.”
After treatment, I asked him, “Why are you weird? What are you doing?” He’s like, “I’m studying this thing called functional medicine.” I was like, “What is that?” He took me to the website and he’s like, “It’s all about the root cause.” “That sounds interesting.” As a resident, they require you to go to a CME and so I went to the IFM, AFMCP as an intern in residency. Within the first hour, I knew I could never look at medicine the same. It made sense from biology, from biochemistry, from anatomy, and physiology lab, it was all science-based, which is what I was taught. I was like, “I can’t argue with this.” I couldn’t look at medicine the same.
If you would have told me back then that I’d end up in functional medicine at any point, I would have said that you were nuts but that was over ten years ago and it was the best thing that could have ever happened to me. From a young age, I was the one if you needed to call someone, get something done, or speak to someone. I was an adult from a young age. I used to go home to an empty house at the age of 9 because my parents were both working.
When you’re entering, are you confident or are you thinking, “This is going to be hippie doctor medicine.” How was that received by your peers?
They thought I was nuts when I came home and I was like, “It’s this thing called functional medicine.” They’ve always been supportive, “We trust you that if you think this is the way to go, then we’ll support you however we can.” I brought my mom to some of the functional medicine conferences that I teach at. She’s always been interested in it and open to it. My mom’s a pediatrician. They thought I was a little crazy but they supported me. With my colleagues and friends, I’ve gradually lost pretty much all my friends from medical school because everybody else is a traditional doctor. It’s the same with residency. Those relationships that were strong were lost because we have a different approach towards medicine.
In the beginning, I had a hard time coming to terms with, “I’m going to do this alternative route. Going to med school in the Caribbean, is this real? Is this a legitimate thing?” At that first conference, I was the youngest one there and there were all these doctors there who were cardiologists, surgeons, and ophthalmologists. “You guys are 30 years into your career. Why are you at this conference?” They were like, “This is the future of medicine. This is where medicine is going. If you’re starting your career now, you need to do this.”
I met people like Dr. Mark Hyman and Susan Blum. Luckily, my residency program was super supportive and I got to do away rotations. I would leave my residency program and still get credit but I worked at Dr. Hyman’s and Dr. Blum’s clinic. I worked at Dr. Chopra’s clinic in Carlsbad where they were applying functional medicine with Ayurveda. When I was at these away rotations, I had all these yellow legal pads. I would follow everybody and take notes. It was the receptionist, it was the nutrition, and it was the life coach, the health coach, the doctors, and the nurses. I was learning from everybody.
[bctt tweet=”The majority of doctors that are in functional medicine, medical doctors like me, have an illness.”]
I finished residency and I started practicing on my own. I was in between a fellowship at the University of Michigan in Integrative Medicine and I went off on my own. That was an experience because even if you’re not in functional medicine, you work the first few years under someone. I was figuring it out as I went. I had the knowledge but it was learning to apply it. It was my patients that helped me a lot to learn to apply it because I was working with people that were attracted to me and people that were already in the holistic world. They had already been doing all these things that most of which were still new to me.
I knew family practice and functional medicine. I didn’t know anything about homeopathy, chiropractic, acupuncture, and supplements. It was a lot of books study, a lot of learning the lab work that we use, applying it, and seeing how treatments would affect people. Over time, we got more and more successful and it’s been an amazing journey.
I just trusted the people I was learning from in the Institute of Functional Medicine. Over and over all they said was, “Start with the gut. If you’re not sure, start with the gut.” They said that over and over and I was like, “That’s what I should do.” Apothecary said it 3,000 years ago. All disease begins in the gut. It’s amazing that he knew that. It’s even more amazing how we’ve done everything we can to damage our guts since he said that.
We’ve gone so far in the other direction when he figured this out so long ago and now you’ve got these rates of autism and all these other chronic disorders skyrocketing year after year. It was the training where they told me, “Gut health.” Functional medicine patients are educated. They knew that they were coming for their gut so that that helped because they were like, “I’m here to figure out my gut,” and I’m like, “Good.”
Somehow, we as a culture can believe that some of these things are connected to something like our gut that we can fix.
It’s like our traditional medical model that is much based on the pharmaceutical industry. There are not any pharmaceutical drugs that treat your microbiome. Almost over ten years ago, I remember seeing an article that Merck, Pfizer, or these huge companies were working on drugs for your microbiome. The day that they come out with drugs for your microbiome is the day your microbiome will go mainstream but I don’t think that’s going to end well.
You can heal your gut naturally. You don’t need medications. In my opinion and my experience, medicine is taught by the drug industry. You’re taught what’s the system, your heart, your cardiac system, and you’re taught what can go wrong and what medications fix that. At the end of the day, it always goes back to drugs. There are no drugs that you need for your gut.
It’s incredibly sad that people are left to believe that I was born deficient in antidepressants or I was born deficient in blood pressure meds. It’s not that way. Even with the pandemic, the people most at risk are people with metabolic disorders and chronic diseases. I hope that it’s more of a wake-up call to people and be like, “I need to get out some of this underlying stuff.”
We’ll stay focused on the gut even though we could get into so many other topics. You say, “I’m going to take a look at their heavy metal load.” Have you ever had someone come in and they didn’t have a lot of heavy metals?
Occasionally. I test a lot of people for heavy metals and I’ve found a couple of patients over the years that have never gone through chelation or detox and their levels are relatively low. I’ve never seen anybody’s heavy metal testing come back zero, which is the way it should be. It’s not possible in this environment.
What does chelation protocol look like? That sometimes feels daunting.
It’s not. Luckily, it’s pretty easy. I’m pretty sure it’s 100% effective, at least in my practice. This is a place where I do use a medicine called DMSA. What it does is pull the toxins that are stored in your body out. The most basic thing for people to understand about toxins is that toxins are fat-soluble. When we breathe them in, drink them, or eat them, they get stored in our tissues. In less, our toxic load goes way down and our body will wake up and be like, “I’ve got to get rid of this stuff.” Those things will accumulate in your tissues. Detox is a two-phase process that makes them water-soluble and you pee, poop, and sweat them out. That’s how you get rid of toxins.
For somebody with an elevated lead level, I start with pre and post-chelation testing. A pre-test is to measure active exposure because the first step in detox is always to stop exposure. The second most common thing I work with besides metals is mold. That’s a big one where if you’ve got a moldy house, you’ve got to get out. Metals, you can assess your water, your food, what’s going on in your house.
When you say food, do you mean the soil, the stuff you’re buying at your market?
Unfortunately, it could be anything. The scariest thing I ever saw or learned so far is Cesium and Thallium levels. I had a boy, who was 8, that had OCD behaviors that came in. His parents brought him in for an underlying cause. I was like, “Let’s look at metals.” This child had been on an elimination diet or an AIP diet his whole life. He had never eaten anything processed or anything. During the visit, I was like, “If you read my book, you’ll see that I’m pretty chill. What if you’re at a birthday party and you want a cheeseburger or cake?” He’s like, “I would ask for broccoli.” He ate a lot of vegetables and fruit.
We did his heavy metal testing and his Cesium and Thallium levels came back through the roof. This is bizarre. I don’t know why this is going on. I talked with a doctor at the lab. Cesium and Thallium are used in the oil industry in fracking. They create radioactive water and that water is left over. Guess who’s buying that water? It’s West Coast farms that are experiencing droughts.
A farm can be labeled organic even if they’re buying oil-water. This kid who had eaten the most perfect diet you’d ever seen or the healthiest diet was loaded with Cesium and Thallium. My experience is that we have to do our best. The more you learn about environmental medicine, you can go nuts. You end up in the mountains in Montana as I did.
You do the heavy metal testing. It’s two parts.
You take the DMSA, which is the medication that pulls the toxins out.
What’s it like?
I didn’t experience anything with it besides sulfur smelling urine. I didn’t have any real side effects and most of my patients don’t, especially for that test day. It’s based on your weight. You collect your urine for six hours after you take the medicine because the medicine is pulling what’s stored out and we’re collecting it. You shake up the jug and you fill up a little vial and send it to the lab. That’s a pre and post-chelation test.
If the post-test is higher than the pre-test, then you’ve got toxins stored. The biggest problem with this testing is I can never tell people when it got there. To me, heavy metal testing would be the most preventative medicine testing we can do. Instead of when you go to your family practice doctor and get a CMP and a CBC, the most useless testing, you would get a heavy metal test and this stuff wouldn’t build up. If it was starting to build up, we would catch it. I’ve looked at heavy metals in 3-year-old autistic children.
[bctt tweet=”The day that they come out with drugs for your microbiome is the day your microbiome will go mainstream but I don’t think that’s going to end well.”]
How long does the process of chelation take?
It depends on how high the levels are. I take an educated guess based on my experience of helping a lot of people detox, “This is going to take you 4 or 7 months.” My worst ever was a mechanic at O’Hare. His lead and mercury levels were in the hundreds, which I’d never seen before. I was like, “I honestly think this is going to take years to get rid of.”
I would imagine that was from the airplane exhaust, right?
I assume so. The biggest problem with DMSA is that it doesn’t pull metals out but it also pulls your vitamins and minerals out. The way that I help people detox is month number one is supporting your liver and your nutrients. We’re supporting phase 1 and phase 2 of detox. We’re supplementing vitamins and minerals to get you built up. There are different practitioners who use different protocols. The way that I’ve done it is, 4 days on and 10 days off. Four days of DMSA and ten days you’re replenishing so we’re doubling the amount of time that you’re replenishing. You’re taking DMSA for four days. We’re chelating, detoxing, and then we replenish you. You follow that cycle.
That’s where chelation is easy because there’s not a specific diet you need to follow except don’t be eating tuna rolls at the sushi restaurant every day. It’s remembering to take the right things on the right days. Otherwise, your lifestyle doesn’t have to change when it comes to metals. If somebody’s got mold, an infrared sauna is one of the best things you could do. Something that I’m always recommending is a sauna.
The sauna doesn’t affect metals the way it does mold. Metals are deeper dug in there and that’s why we use the medication to get them out. Based on somebody’s results, I’ll be like, “This is going to be four months. This is going to be a year.” We typically check in every six months because everybody detoxes differently. In less than 5% of patients, I’ve seen their levels go up after six months and that’s because we’ve been pulling. They had so much stored that this one test day didn’t work.
There are symptoms that show up for heavy metal versus mold. Is there anything or it can be completely various for different people?
The whole thought process behind functional medicine is we are looking for inflammation. We’re looking for what there’s too much of in your body and not enough of and the gut as your gateway to disease into your body. I could take 100 patients with heavy metals or SIBO and the symptoms overlap, are different, and change over time.
In general, high blood pressure is something that I would start with metals first. I’ve had a patient who was on three blood pressure meds who is now on zero after a year of chelation. High blood pressure, neurologic stuff, dementia prevention. If you’ve got a family history of dementia, I would get on detoxing heavy metals. Chronic pain and chronic joint issues.
In general, toxins affect three main areas in your body and it’s your hormones. Men, low testosterone, women, estrogen dominance and fertility, your immune system, autoimmune disease, and neurologic like MS, dementia, and things like autism. If you fall under those categories or you want preventative that that’s the one thing, I don’t need to hear anything in your history to be like, “If you haven’t tested for heavy metals, it’s a good idea.”
Unfunc Your Gut, in your book, the notion of small intestine bacteria to SIBO. That is something that a lot of people don’t realize is it’s probably more common than we realize and all the offshoots symptoms of something like that. We have 3 to 5 pounds of bacterial matter in our large intestine, supposedly, but there are times where some of that can end up in the small intestines and cause all kinds of issues.
I wrote a whole chapter on SIBO because it’s the most common thing that I treat. There’s a lot of misinformation out there about it so I shared my experience in treating it. The reason there’s so much misinformation is that every SIBO patient is different. The majority of SIBO patients have gut symptoms. You’ve been labeled as IBS or you’ve got abdominal pain, bloating, diarrhea, or constipation. I’ve learned over the years and from my patients that there are SIBO patients who have no gut symptoms. If you come to me and you have eczema, I’m going to recommend looking at SIBO and you don’t have any guts. Joint issues, brain fog.
The gut, as your gateway into your body, is why that stuff can happen. People have heard of that term leaky gut. Your gut’s most important job is to decide what comes into your body and what stays out. The inside of your gut tubes is a long tube that starts with the mouth and ends with the anus. There are openings on both ends. Something that has been in your gut hasn’t necessarily been in your body and it’s the guts job to decide, “This is good, come in.” “This is bad, let’s poop this out.” Due to all this stuff, the inflammation, we are damaging that barrier and those junctions that should keep things out are wide open and all this stuff in our environment is flooding through.
Going back to SIBO, your gut bacteria are alive. That’s probably the most important thing to understanding SIBO and your gut bacteria need to eat to stay alive. They eat fibers and sugar. That’s one of the reasons why we’re killing our microbiomes. In Western cultures, we don’t eat a lot of fiber. Like us, our gut bacteria die if they don’t eat. When they eat, it’s an anaerobic process without oxygen and it creates gas.
If you eat a bunch of sauerkraut and you get gassy, that’s great if your microbiome is healthy because your gut bacteria will eat it. If you have SIBO, the gut bacteria are now living in your small intestine. Small intestines should be lined with microvilli. That is where 90% of digestion and absorption happens. The small intestine should be reserved for absorbing all those great nutrients into your body. That area should not be covered in bacteria that are eating every time you eat. That’s what SIBO is.
[bctt tweet=”Functional medicine should be preventative medicine.”]
It’s easy when people have gut symptoms. If you come in and you have gut symptoms and you’re like, “I have a hard time with garlic, onions, or avocados,” I don’t need to do the testing. I still do it because I like people to see it and sometimes I’m wrong. If you come in with something like that, then it’s pretty easy that this is a SIBO case.
There’s a diet out there that I talked about in my book, The low-FODMAP diet. It is a diet low in fermentable foods. It is a diet to starve your gut bacteria. The most important thing about this is it’s not a long-term diet. You should not be on a low-FODMAP diet for a long term. It should be done as quickly as possible. When you’re following that diet, you’re starving your large intestine, which you need to feed over the long term.
The funniest thing and I’ve heard this quite a few times is I’ve met patients that have gone to their GI doctors and the GI doctors tried their acid blockers, colonoscopy, endoscopy and they’re like, “I don’t know what’s wrong with you. Try this low-FODMAP diet. I have no clue why it works but it’s helped some people.” I’ve heard this story multiple times and I’m like, “It’s because you have SIBO. That’s why it’s working.”
These are foods that wouldn’t necessarily ferment, is that right?
What are foods that don’t ferment?
Proteins like meat. My theory on a carnivore diet is booming. A lot of the carnivore people are SIBO patients that are not feeding their microbiome anymore.
It’s almost like they intuitively know or something?
If somebody is reading and they have garlic, it feels like we should be able to probably consume it without a lot of problems. It would maybe be beneficial to go and see if they have SIBO.
Apples, avocados, garlic, onions, mushrooms, soybeans, and dairy products are pretty much most fermented foods. If you know that you’re reacting to those, you should get tested for SIBO.
After working with all these patients, I would probably imagine seeing themes showing up. That’s why you decided to do Unfunc Your Gut. That’s a big undertaking.
It was a little bigger than I knew what I was getting into like everything else I do. I wrote it in seven months, which is pretty fast. The editing process took 1.5 years but it’s what I do every day. I also included quite a few of my patient success stories. It came out easily. It was something I always wanted to do.
I tried to focus on the things that are missed in the gut literature, which is a good understanding of SIBO and a crucial understanding of how much your brain affects your gut. My experience with my patients is the majority of patients come in and they want the right diet or they want the right supplements, which is going into the traditional medicine model. You’re replacing medications with supplements. I don’t like to stop there and do that.
You said at the beginning functional medicine should be preventative medicine. 99% of people I work with are coming in to reverse autoimmune chronic disease and 1% of the time see preventative medicine. It’s backward. It should be the other way. In our society, we react to things. As someone in recovery, I know how hard it is to change. You have to keep digging until you’re ready. You don’t want to dig any farther. People come in pretty desperate. They’re like, “I’ve been to Cleveland Clinic and Mayo Clinic. Screw it. I’m going to try functional medicine.” It’s not the first option ever. Maybe that’s going to change.
When you have them there, what do you see as the barriers that keep people from believing that they can make these changes? I see that a lot. If you do it consistently for a bit of time, there’d be so much progress but a lot of times there’s resistance or a barrier.
As someone that believes that mental, emotional, spiritual health is the most important part of health, that’s the greatest barrier. It starts as trauma for most of us when we’re kids. The definition I like of trauma is trauma is anything less than nurturing. I had to learn that in my own life when they told me I had trauma. I was like, “No, I don’t.”
Trauma could be as simple as coming home from school and wanting to show off your homework but your parents are working or busy. The signal is like, “I’m not good enough.” That shuts down your gut. Your gut is lined with a nervous system called the enteric nervous system. It’s over 200 million neurons more than your brain. It is connected to your brain by your vagus nerve. The vagus nerve carries signals back and forth from your brain to your gut, your gut to your brain. It runs on the automatic nervous system. It’s automatic. It happens in your subconscious. You don’t think about it. It is either in sympathetic response or parasympathetic response. Sympathetic is fight or flight. Parasympathetic is rest and digest.
Now that I live in Montana, when I’m out hiking in the mountains and I see a grizzly bear, the sympathetic nervous system is activated. Blood goes from the brain to the muscles. I’ve got to get out of there. I’m not going to worry about digesting my breakfast. I make it and I survive. I’m sitting by the campfire eating and my body’s like, “This is a great time to break down my food and absorb the nutrients.”
People nowadays are living as if they’re running from a bear 24/7. We wake up and the first thing we do is check our phones. It’s not parasympathetic. For most of us, it’s email texts, phone calls, breaking news, and social media. It spirals downhill. We’re watching the news or we’re answering emails while we’re eating breakfast and food is dropping down into your gut so your gut’s like, “We’ve got to digest.” Your vagus nerve is telling your gut, “Shut down. This is not the right time. You need to survive.”
It’s hard, especially with the pandemic. We’ve all gone through different traumas from that alone but for most of us, it starts when we’re kids. The stuff that I work with like SIBO, heavy metals, mold dysbiosis, and candida, that stuff is easy when your mental, emotional, spiritual health is balanced. That to me doesn’t mean, “I don’t have stress. I don’t have problems.”
We’re all going to have problems and stress and it’s unpredictable what’s going to happen but it’s that awareness around, “I need to work on this.” For me, I have to wake up every day and be like, “I need to focus on my mental, emotional, and spiritual health.” I have reminders in my phone that pop up that says, “Let go of control.” I’m a huge control person. What doesn’t work in recovery is being in control. You have to let go.
What are you trying to control?
This is something that took me a lot of years to get through to understand, at least this is my interpretation. Anybody successful has to take things in control in their life. I wouldn’t have made it to be a doctor and all these things if I wasn’t in control. Everything I have in my life is because I’ve been in charge of it. Having written my own book, business, and all this stuff, I had to do it myself. When you’re telling me, “Let go of control.” I’m like, “Screw you. I can’t do that. Do you guys want me to become lazy and not care? I can’t do that.” It’s controlling what I can control.
If I’ve got a lecture and I’m nervous about it, “Have I edited my PowerPoint? Have I done my research? Do I have my articles to back up what I’m saying?” If I’ve done everything I can, then I have to give it up. If I’ve done everything I can and I’m still focusing on it, “I wonder what’s going to happen when I go on Gabby’s show. Am I going to stutter? Am I going to screw up?” That’s going to make me nuts. I’m not going to sleep. I’m going to shut down my gut. To me, it means doing everything that you can towards a goal but then once you’ve done everything you can, it’s time to let it go.
If you have a female that comes in and let’s say, her hormones are out of whack, would you do the heavy metal testing?
I always say that the best thing we can do is stop the progression of things, which is a huge win. That’s never what people want from me. They want to reverse everything and that’s what we try to do. It’s never too late. You’re never at an age where it doesn’t matter what your gut is or what your toxins are. Hormone imbalance like women, we would look at toxins. I’ve also seen a lot of candida overgrowth of the gut. It’s a yeast that can overgrow your gut. That’s another thing that I find frequently when someone’s hormonally imbalanced.
Do you have to bite your tongue a lot when people come into your office and maybe you’ve had them a few times in and they’re on protocols but you know what’s holding them back is something more personal? How do you navigate?
That’s why some people love me and maybe there are some out there that don’t or patients that don’t come back to me. I don’t know if it’s my parents and the way they are. I don’t bite my tongue and I warn everybody on the first visit. I always start the visit with, “What are your goals and expectations from working with me?” I’ll also say, “Just to warn you, I’m extremely honest, and blunt.”
It comes a lot from my mom, she’s that way in her pediatric practice. I’ve had a number of people who have looked at me saying that I go on a little spiel and they’re like, “You’re saying I’m crazy.” I’m like, “That’s not what I was going for but yes.” Personally, we’re all nuts. It’s either we’re working on it or we’re not. I always say, “Don’t take it personally because we’re all crazy.”
When someone comes in to see me, we can do 40 pages of intake paperwork. They fill all this out. I review it before the visit but there’s a question on there that says, “Do you have an excess amount of stress in your life,” and it’s a yes or no. If they write no, I know that we’re in trouble, usually. 1% of the time, that’s true. The more they don’t think it’s an issue, the more it is.
It’s like something we were talking about earlier. The more someone comes in convinced that they have heavy metals, SIBO, or candida, frequently, it’s not that. They’ve found an Instagram doctor, a blog, or something that the more focused they are, the more my experience has been like. Usually, it doesn’t even turn out to be that.
I feel like I’ve learned nicer ways. I’ve been like, “Will you be willing to accept that this is something else other than candida?” The words stress, anxiety, depression, mental, emotional, spiritual health, are tough words. People hear those words and they already have, “I don’t have depression.” It’s difficult. To me, it’s life. We’re all dealing with life on different terms and different things have happened to us. It’s not easy.
What are you surprised about yourself the way you maybe are showing up in this relationship that maybe you never had the opportunity to?
I feel awkward when I say I love you to my parents. We don’t say that. She talks to our parents every day and they say I love you every time. We’ve done the love language quizzes. My love language is giving gifts or doing stuff like cooking or things like that. She’s like, “All I want to do is hug you or kiss you or say I love you.” I’m like, “I’m trying.” I’m getting better.
She’s had me run pretty much all of my tests on her. She had a bad mold issue. The hotel that she worked at was extremely moldy. The apartment she lived in, in Chicago was moldy. We’ve been detoxing her. We’re already done but we detoxed her. Besides that, I couldn’t find anything wrong. Everything was working in her body. Luckily, there’s not too much doctoring.
Chapter one of my book is all about why you should stay off the internet in regards to your health. That’s something we still work on because she’ll get a symptom and she’ll go straight to Google even though she has me. Now she’ll come home or she’ll call and be like, “I screwed up. I got onto Google. I convinced myself I have polycystic ovaries, cancer, or something.” Now she catches herself, “That was not the right move,” and getting back into what is in our control, what is real, and what is being made up from something you’re reading.
There’s nothing like self-diagnosing to make your day go the wrong way. People can still get appointments with you in a telecommunications way. How do you manage that? Do you do that through your office in Chicago?
A funny story that I like is that I have an email. In February of 2020, it was our first meeting. We had been introduced, “Can we meet on Zoom because I’m traveling in India right now?” My response was, “I don’t know what Zoom is but I’ll figure it out.” I had a policy in my practice. I would have people driving from all over the Midwest come and see me because I always wanted to meet in person. What I’ve learned during the pandemic is that our outcomes are as good. The care can be just as effective and I get to live in the mountains, which is good for my mental health and still help people.
You must have some interesting people holding the fort down for you. How do you do that?
My assistant, Jasmine, is like a third mom to me. She calls herself my mama bear. She takes care of me. She’s been with me for over four years and is amazing. She started as a receptionist but now she’s a life coach too. She has become an expert in diets and even the diet that we introduced in my book called The Koz Plan, which is an elimination diet, which is also low-FODMAP. That’s her, she created that.
She’s like, “I had three new patients call me today and all three of them called me crying and they’re already in tears before they call.” She’s that source that lets people know that there’s hope and she’s so willing to answer questions. A huge shout out to you because you were a huge inspiration to her and she wouldn’t be where she is now if it wasn’t for you. If she wasn’t where I was, I wouldn’t be where I am. Thank you.
We’re all participating. People can buy Unfunc Your Gut. Ultimately, if you said, “I wrote this because I wanted people to walk away or take away with tools,” what is that?
Our greatest job as physicians is to teach and educate. Whenever I do an initial visit, it’s all education on the first visit. All of that is in my book. More than anything, I wanted to offer hope. The whole reason I ended up getting into medicine was lupus because my friend Michelle got lupus and died. Now I’ve been able to help countless people put lupus into remission and it’s a gift. We’re taught in our traditional environment that we’re all going to get sick and we’re all going to be on meds. We don’t know why autism is booming or we don’t know why the rates of diabetes have gone up 100% in the last twenty-plus years.
There are underlying causes and it doesn’t matter. Your microbiome starts during vaginal delivery. One every three people are C-section. You get this bad gut to start with. You don’t get breastfed so you don’t get probiotics. You end up in a moldy house for the first ten years. This stuff seems bad but all of this is reversible. It doesn’t matter what age you’re at, when it happened, or how bad you’ve treated your gut for 30 years, we can turn your gut around in a few months if you stick to it. There’s always hope is what I’d say more than anything.
Do you do a basic blood panel on people and get a whole snapshot of their overall health?
I will do the CMP and CBC that I said are useless, which mostly are. Full thyroid panels, TSH, free T4, free T3, and thyroid antibodies. Men will look at free and total testosterone, PSA, advanced lipid panels. The basic lipid panel that they assume, the way they sold billions and trillions of dollars of statins. If your cholesterol is a little elevated, you need a statin. I can’t tell you how many people I’ve tested that have high cholesterol on your basic panel and we do their advanced panel that looks at their particle size, their particle number, it’s not in an inflammatory pattern.
I’ve had a lot of people that had normal cholesterol but their breakdown and their advanced panel look bad so I’ll treat that. That’s something that we do. I don’t use statins unless somebody’s is through the roof. We use natural things and we get a 40%, 50% decrease through natural supplements. I do a lot of your traditional blood testing because I do work with hormones quite a bit so I still use that.
It is confusing. Let’s say everybody gets lined up. Overall, do you test for metals once a year after that? Let’s say you get it in check, do you check every six months? What do you think is the best way?
If there’s no active exposure, if your pre-tests came back negative, you can wait five years if not longer unless there’s something that changes in your environment. Those metals have a long half-life. It takes them a while to build up. If you get a clean bill of health with your metals, I tell people to forget about it.
What about probiotics and prebiotics? All of that gets a bit dancey and confusing. We know that if you don’t have SIBO or fermented foods incorporated in a regular part of your diet, it’s quite good. Do you have something that you like as a probiotic? Do you say, “Morning, empty stomach.” What do you like?
Even though I’m known for gut health, I’m not pro probiotics because of how much SIBO I work with. A couple of reasons why are because the studies vary. Is there evidence that what you’re taking sticks in your gut? There have been studies that show that you could be on a probiotic for 30 years and once you’ve stopped it for two weeks, it’s like you never took it. The biggest thing is regular medicine and even with the microbiome, they’re like, “This bacteria equals diabetes.” “This bacteria equals this.”
The best thing we know about the microbiome is the more diverse it is, the healthier it is. When you take a probiotic, they’re pretty much all lactobacillus and bifidobacterium species. It’s the same thing over and over. If someone is like, “No, I want to take a probiotic.” At a minimum, we’ll change it every month. Every time you run out, switch the brand, switch the company, switch the type, and try to get some diversity in there.
Because of that, I’m more pro-prebiotics like inulin or arabinogalactans, which are powders or capsules that are the food for your bacteria. If you don’t have SIBO, that’s probably what I would choose to supplement. On an average day, you’re eating pre and probiotic foods, you don’t take it. If you’re going on a trip, you travel, or your diet sucks, take your probiotics. Use it as needed.
That’s great. Can you remind people of all the places that they can find you? If someone goes, “I’d be interested in exploring that,” how they can get a hold of you? The book is Unfunc Your Gut. Maybe you can direct everybody to where you are.
Unfunc for functional medicine. In my practice, we had a saying, “We put the func in functional medicine.” That’s where Unfunc came from. Speaking to my assistant, Jasmine, our phone numbers are listed on my website. The website is the best way. You can email us, Doc-Koz.com. Social media, Instagram is @Doc_Koz. On Facebook, it’s Doctor Koz. For people that want to work with us, get help, or have questions, through my website, emailing us is a great way.
To wrap it up, let’s say somebody goes, “I want to go see someone in person,” do we know of a website that says, “These are the functional medicine doctors in your state or area.”
IFM.org. On the top of the page, you can click Search a Practitioner. You type in your zip code and you could put 25 miles, 100 miles, 200 miles, or whatever. My advice is that there’s an
option on there to click for a certified practitioner. Like I passed my family medicine board exams, functional medicine has board exams. You can get listed on the website if you’ve been to one conference.
No offense to anybody but you probably have no clue what’s going on in functional medicine if you’re not certified. My advice is to focus on doctors that are certified and you can search through that website. You could do some research and be like, “I’m interested in working with SIBO.” You ask, “Do you have experience with it?” It’s a huge learning curve coming from traditional medicine to learning how to do this.
I don’t want to miss this opportunity, Dr. Koz. You mentioned EWG.org and that was an important tool for people.
Environmental Working Group, a nonprofit that studies how toxic our environment is. People have heard of the Dirty Dozen, the Clean 15. The Dirty Dozen is the fruits and vegetables that are the highest and toxins. The Clean 15 are the cleanest. That changes every year. They update it every year. My favorite thing is you can go on their website and type in the makeup you’re using, the household cleaning products you’re using, the food you’re eating, and see what is toxic. They’ll give you a rating of 1 to 10.
I want to remind people because sometimes they get overwhelmed so they quit before they start. Do you ever talk to the doctor that was prescribing vitamin D and such?
I ran into him at the annual International Conference for Functional Medicine. There’s one a year. This one was on Zoom. The one before that, we ran into each other and it was pretty cool. I thanked him because if it wasn’t for him, I wouldn’t be sitting here.
I appreciate your time.
Thank you so much.
Thanks so much for being here. If you’d like, rate, subscribe and leave us a review. All of my music was graciously done by Frank Zummo and Tom Thacker. If you want to see some of the behind-the-scenes action, follow me, @GabbyReece. Remember, don’t miss new episodes every Monday.
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About Dr. Peter Kozlowski
As a Functional Medicine M.D., Dr. Peter Kozlowski uses a broad array of tools to find the source of the body’s dysfunction: he takes the time to listen to his patients and plots their history on a timeline, considering what makes them unique and co-creating with them a truly individualized care plan.
Currently he works with patients online and in person via his Chicago, Illinois and Bozeman, Montana based offices. Dr. Kozlowski did his residency in Family Practice, but started training in Functional Medicine as an intern. He trained in the clinics with leaders in his field including Dr. Mark Hyman, Dr. Deepak Chopra, and Dr. Susan Blum.