Dr. Alan Gaby | 52 Years in Nutritional Medicine

• Why has nutritional medicine remained on the fringe despite more than 50 years of published research supporting its use?
• How can increasing magnesium intake dramatically improve anxiety, migraines, cardiovascular health, fatigue, and metabolic function?
• What does the evidence really say about folic acid versus methylfolate — and are current trends ahead of the science?
• Why do hidden food allergies to wheat, dairy, corn, and eggs drive so many chronic conditions, from migraines to Crohn’s disease?
• How can eliminating refined sugar and ultra-processed foods reduce inflammation, stabilize blood sugar, and improve long-term health outcomes?

Who is Dr. Alan Gaby?

Dr. Alan Gaby is a pioneer of nutritional medicine and one of the most respected voices in evidence-based dietary therapy. With more than five decades of clinical and research experience, Dr. Gaby has dedicated his career to systematically reviewing the scientific literature on vitamins, minerals, and diet-based interventions for disease prevention and treatment. His work bridges conventional medical training with a deep commitment to biochemical individuality and therapeutic nutrition.

After earning his medical degree and completing graduate training in biochemistry, Dr. Gaby embarked on a lifelong mission to compile, analyze, and categorize research on nutritional therapies. The result is his landmark textbook, Nutritional Medicine, a comprehensive reference built from tens of thousands of peer-reviewed studies dating back to the early 1900s. Now in multiple updated editions, the book serves as a clinical guide for practitioners seeking to use nutrients safely, effectively, and with scientific rigor.

Throughout his career, Dr. Gaby has combined patient care with scholarly research, lecturing internationally and mentoring physicians and naturopathic doctors alike. His clinical focus has included magnesium therapy, niacinamide for osteoarthritis and skin cancer prevention, intravenous nutrient protocols such as the Myers’ Cocktail, and elimination diets for hidden food sensitivities. Known for his thoughtful skepticism, commitment to safety, and dedication to clinical outcomes, Dr. Gaby continues to advocate for a more integrative and research-informed approach to medicine.

What did Dr. Alan and Jodi discuss?

00:00 How Linus Pauling sparked a lifelong mission in nutritional medicine
02:00 From Yale rejection to 50+ years of research
04:30 Building a 30,000-study nutritional database by hand
07:45 Why nutritional medicine is still resisted in conventional care
10:00 Hidden food allergies and why doctors miss them
13:30 Magnesium: the one mineral most people are deficient in
17:00 Magnesium forms, dosing, and fatigue research
20:30 Folic acid vs methylfolate: what does the evidence actually show?
27:00 Vitamin C: oral dosing, IV therapy, and orthomolecular medicine
31:00 Why Dr. Gaby rarely relies on advanced nutritional testing
34:00 Sugar addiction, blood sugar swings, and withdrawal
41:00 Elimination diets: wheat, dairy, corn, and hidden triggers
45:00 Alcohol, caffeine, and the nuance behind observational studies
52:00 Niacinamide for osteoarthritis, skin cancer, and glaucoma
55:00 The Myers’ Cocktail: IV nutrients for migraines, asthma, and fatigue
1:00:30 Rapid fire: magnesium, mindset, and living smarter

Full Transcript:

Alan Gaby: [00:00:00] Well, that's partly what got me interested in this field. I read Linus Pauling's book in 1972, vitamin C in the Common Cold, and he cited all of the available evidence at the time that Vitamin C reduced the duration. And he also went into a long discussion of, of how the medical community can't relate to this.

Alan Gaby: Mm-hmm. So that's partly Roger Williams and Linus Polly's book books were what got me interested. 

Jodi Duval: Mm-hmm. 

Alan Gaby: But over the years, uh, vitamin C has a lot of, uh, uses and, uh, often it, it's supportive for general health. I mean, it prevents bruising, it helps prevent heart disease to some extent. There's some evidence that helps prevent cancer, many different things that you can use it for.

Alan Gaby: I typically recommend a minimum of 200 milligrams a day.

Jodi Duval: Welcome to the show, Dr. Alan [00:01:00] Gabby, it's a pleasure to have you on Smarter or Not Harder podcast. 

Alan Gaby: Thank you. Nice to be on. 

Jodi Duval: So, Alan, I love to ask this question and it's curiosity in me also, is that I love to know why and how people land where they, where they do. And so for you, nutritional medicine, what, what was the journey there?

Jodi Duval: What drew you to that? 

Alan Gaby: Well, I'd like to think that I haven't quite landed yet, that I'm still flying, but I understand the question. So, uh, I came from a medical family. My dad was a surgeon. Mm-hmm. And he, uh, pushed me to go into the medical field as a youngster, and I looked at what was being done and I didn't really relate to it.

Alan Gaby: Um, so I, uh, I went to college. I went to Yale University, which is a, a good college, but I didn't try very hard and I didn't do very well. And I got rejected for medical school, which was kind of fine 'cause I didn't wanna go. Yeah. [00:02:00] But then the following year I read a book by a biochemist named Roger Williams.

Alan Gaby: The book was called Nutrition Against Disease. Roger Williams discovered one of the B vitamins, pantothenic acid. He also named folic acid 'cause it comes from foliage. So he called it folic acid. And this book was amazing to me. It was a, an eye-opening thing showing that nutritional supplements and dietary changes can be useful for preventing and treating a wide range of illnesses.

Alan Gaby: And at the same time, uh, it was being totally ignored by the medical profession. So I was 23 years old. This was in 1973. And I had an epiphany, uh, Einstein would've said that epiphanies are God's way of remaining anonymous. And I had a moment of clarity. It was in an instant. I was kind of lost in my life, not knowing what to do, and all of a sudden I was given this idea that I was gonna learn everything I could about nutritional therapy and teach the world.

Alan Gaby: [00:03:00] So I went from a aimless life to a purpose-driven life. And it's been going that way for 52 years now. Uh, so what I did is I went to, uh, graduate school in biochemistry for one, to give myself a basis in nutritional medicine and to two, for two to demonstrate to the medical schools that I could be an acceptable student for them.

Alan Gaby: So I got all A's in grad school and did well and got into medical school, learned what I was supposed to learn there. And on the side, I just did this other track. I read everything I could find on the nutritional medicine. Uh, after graduation, I was very fortunate to be able to go into the practice of a, a noted pioneer in this field, Dr.

Alan Gaby: Jonathan Wright. So I practiced with him for a couple years and during that time and afterwards I spent half of my time seeing patients and half of my time in the medical library, uh, this was around 1980, going through the table of contents of all of the medical journals in the library that had any irrelevance.

Alan Gaby: This was a two year timeframe [00:04:00] just going through the table of contents. Uh, and I continued after that, we went all the way back to 1900 and then continued looking at all the new journals as they came in, which have continued up to this day. So it takes a lot of time. Uh, we didn't have the internet back then.

Jodi Duval: It was very different, wasn't it? 

Alan Gaby: Now we do. And so I can just do literature searches on National Library of Congress. It's much faster. But, so during that time, I compiled, uh, all of the relevant articles all the way back to 1900 and now currently up to 2025. And summarized them, categorized them, analyze.

Alan Gaby: When the Microsoft office came out, I was able to use that. It allowed me to, to do my work 20 times faster than I ever would've been able to. So I had about 30,000 articles categorized, keyworded, and, uh, was able to organize them into conceptual frameworks, individual nutrients, how you use them, uh, what they interact with, what the adverse [00:05:00] effects are, things like that.

Alan Gaby: And then specific diseases and how you can treat them nutritionally. So, uh, it was a, a 30 year project, half of my time seeing patients, half of my time working on this. And finally I was able to come up with this large textbook, which, uh, uh, when you look at other large textbooks, they had 50 or a hundred contributors.

Alan Gaby: I did this all by myself and I remember I used to go to the holistic medical meetings and I'd tell people, I'm working on this book in, in the 1980s and then in the 1990s, so what you doing? I say, oh, I'm working on this book. And then in the two thousands you still working on that stupid. Anyway, it finally came out in late 2010, and it's been updated twice now.

Alan Gaby: And that's, that's been, uh, my life's work. And I, uh, am very happy with it because what I think it does is it helps doctors practice nutrition safely and effectively. And, uh, it, it, it looks at what's really effective and what's not. As you know, there's a lot of hype in this field. People are trying to make a lot of money.

Alan Gaby: [00:06:00] So if I don't think something works, then I say so. And if I think something does work, I say so. And if I read an article and it appears that it might be fraudulent, which I'm finding more and more studies from Iran and, uh, sometimes from Egypt, uh, Japan, Italy, surprisingly, uh, you read these articles and they're impossible.

Alan Gaby: They wrote these things about research they never even did. So that's becoming more and more of a problem. And in the third edition, I actually got much more tuned into that and took out some stuff that I'd put in the first and second edition. But all in all, the field has not changed that much. I mean, what I wrote in 2010 is not in, not that much different from the updated version.

Jodi Duval: Yeah. Yeah. That's, that was my next question to you was what you have noticed, uh, you know, across the over 50 years of work and what an incredible compilation and how lucky we are to have access to something like this that you have put blood, sweat, and tears into. Because [00:07:00] as you said, it's just so hard to be doing that research back when you started because it, it was a different level of dedication.

Jodi Duval: Now we have even ai and sometimes it, you know, I don't think it's always the best because again, you get searches and some of those, um, you know, the articles like you said, who are fakes or weren't even done in terms of the research are showing on there. So how are we even able to discern what is real?

Jodi Duval: Um, it, and it's, it's only from reading in, in, in depth about these, so, yeah. So in, I guess in the last sort of 15 years, you say it's not changed too much, which is, which is, you know, good. We obviously need more research though, that's sort of pointing out. But what have you noticed since starting over 50 years ago in the nutritional field?

Jodi Duval: Is that becoming more accepted? Are you still feeling that, um, doctors and practitioners, uh, are still very resistant against this? Um, comparatively to how you would wish it would be? 

Alan Gaby: Well, let's put it this way. When I started in 1973, people thought I was [00:08:00] a complete lunatic. Um, nowadays there is a significant percentage of the medical community in the United States that still thinks that, um, but nutritional medicine, and as you know, naturopathic medicine embraces this greatly, uh, naturopathic, uh, education started in the United States around 1980.

Alan Gaby: And there are several thousand practitioners here. There are a lot of chiropractors that are interested, some dieticians, depending on their philosophy. Mm-hmm. And then there are other groups, nutritional therapists and, uh, medical doctors. There's a minority that would call themselves, say, integrative medicine practitioners, which includes nutrition and many other things.

Alan Gaby: But I would guess it's, it's still less than 5% of medical doctors in the United States, but it is growing. Uh, I, I get surprised sometimes. I got invited. I'm in the state of New Hampshire. Mm-hmm. And I was just invited a few weeks ago to speak to the, uh, New Hampshire Academy of Family Physicians about [00:09:00] nutritional medicine.

Alan Gaby: It's like, wow. 

Jodi Duval: Yes. 

Alan Gaby: Hope they don't throw eggs at me. Um, so, yeah. Uh, people, medical doctors are very dedicated. And when I gave seminars with Dr. Wright back in the eighties and nineties and two thousands, we'd get the practitioners from all over the country. We'd say, why did you come? And they said, well, I just get tired of seeing the same patients every month.

Alan Gaby: Same problems. I give 'em a new drug, it either doesn't work or it causes side effects and I wanna look at something new. And then, uh, they start doing some of this nutritional therapy and I get emails from them and said, well, I'm getting results that I was not able to get before. And it's not a cure l but there's definitely, for example, physicians who do not look at hidden food allergy as a cause of illness, in my opinion, cannot possibly be getting optimal results.

Alan Gaby: I saw so many patients over the years that had seen multiple specialists. 

Jodi Duval: Mm-hmm. 

Alan Gaby: And in many of those situations it was just a hidden food allergy, dairy products [00:10:00] or wheat or eggs or corn or things like that. And you get 'em off of three different diseases for which they're seeing specialists. Yeah.

Alan Gaby: Again, it doesn't work all the time, but, uh, it's so safe and so inexpensive. In my view, if the, uh, medical community would embrace this, we would reduce the cost of healthcare by 30 or 40% within a few weeks. Well, maybe not that fast, but you know what I'm saying. 

Jodi Duval: Yeah, yeah. Absolutely. I couldn't agree more.

Jodi Duval: Um, at home Hope, we encourage and we teach about the IG G testing and we encourage and teach, uh, about doing organic acids testing, doing, you know, serum appropriately and doing gut, um, microbiome testing, you know, appropriately because it is so important. And this is why I was very excited to speak to you 'cause you have been in the industry much longer than I have.

Jodi Duval: Ah, okay. And yeah, it's, I have so many frustrations as you would've heard many, many times with, um, [00:11:00] talking with, you know, general practitioners or even specialist surgeons. And, you know, cardiovascular diseases going in for huge surgeries coming out. You know, the clients will be asking, what, what do I need to eat?

Jodi Duval: What do I need to be doing? Or nothing. Nutrition doesn't do anything. Oh, 

Alan Gaby: they're saying that about heart disease. That's pathetic. I mean, if the, the one area where conventional medicine should know it has an effect, 

Jodi Duval: uh, yeah. Should 

Alan Gaby: be heart disease. I mean, if they wanna say it has nothing to do with arthritis or migraines, which is wrong, then I can at least understand that.

Alan Gaby: But not heart disease, not diabetes. 

Jodi Duval: It's, it's crazy. And they, they don't get any advice in terms of how to change their lifestyle diet, um, after having these, these huge life changing surgeries. And that's what blows me away daily. But it, from my perspective, when you look at the biochemistry, there's nothing without nutrition.

Jodi Duval: They are the co factors which run our cellular environment. It's, it's essential and our microbiome, so. [00:12:00] For me, it's a complete no brainer. And, and I just look at people when they, when they give me comments as such and, and think, where have you been? Did you even do your biochemistry? 

Alan Gaby: Well, you didn't go to conventional medical school.

Alan Gaby: They kind of drum a certain viewpoint into you. Right? And they don't teach any of this. My son is now in his second year of medical school and we talk about various diseases. And I say, for example, do they say that weed allergy is a common cause of migraine? Oh no. They don't ever say anything like that.

Jodi Duval: Mm-hmm. 

Alan Gaby: Yeah. Um, so it is slow, but it's, at least it's going in the right direction. 

Jodi Duval: Yeah. Yeah, I agree. I think it is going in the right direction. All right, so let's dive in. Um, it's hard 'cause I wanna start everywhere at once. So the, obviously your, your book, um, looks at so many different factors associated with nutritional medicine and you list out all the different.

Jodi Duval: Vitamins, minerals, and you're looking at all these in an individual sense, and [00:13:00] obviously we have to look at them as, you know, entourage effect in the body, that we're looking at them, they all work, and they all, um, interact in some way with one another. So what, uh, in your mind is, is sort of the first pick for educating practitioners, doctors in nutri in nutritional medicine, um, what are the, the, the key ones that you would pull out that may have not had enough ground in the literature or ground in education?

Alan Gaby: Are you talking about the key nutrients or, uh, dietary factors? 

Jodi Duval: Let's go, let's dive in, you know, narrow first and then we'll, we'll come out Okay. A little bit broader later on. But let's go into, um, individual vitamins, nutrients, minerals, um, you know, so from that perspective. 

Alan Gaby: Okay. Well, um, I would venture to suggest that if, um, Western Society increased their magnesium intake by about 50 to 70%.

Alan Gaby: We would have a dramatic reduction in a wide range of health conditions. [00:14:00] Um, the recommended dietary allowance for magnesium is around 400 milligrams per day. And, uh, 70% approximately of people, uh, do not achieve that. And many of them don't even get two thirds of it. In addition, there's some evidence that the RDA is too low because it does not account for, uh, various other factors.

Alan Gaby: And the way they measured it is open to, uh, to, uh, criticism. Uh, in my clinical practice, and based on the literature, uh, I've seen so many people with a wide range of conditions, anxiety, depression, fatigue, migraine headaches, uh, muscle weakness, muscle spasms. Mm-hmm. Uh, restless leg syndrome. Mm-hmm. Uh, the list is very, very long.

Alan Gaby: And of course, cardiovascular disease, diabetes has a component as well. So, uh, for example, somebody comes in, uh, they drink a little more alcohol than they should, but not terrible. They're suffering from anxiety. Mm-hmm. Try 400 milligrams of magnesium, bam. 24, [00:15:00] 48 hours later they say, wow, I'm so much better.

Alan Gaby: Say, okay, maybe you can stop drinking too now. But, uh, uh, so a wide range of, of problems are benefited from magnesium. So I often recommend a supplement, uh, as far as, uh, which type, yes, there's conflicting literature on that. Uh, magnesium oxide has a bad reputation because there's one study that says it's poorly absorbed.

Alan Gaby: Uh, and also it's very inexpensive and you can get a lot more elemental magnesium per capsule. So if it was effective, I would actually prefer that for, for those reasons. And I'm aware of at least six studies with six different health conditions where they gave magnesium oxide versus placebo, and the magnesium was effective.

Alan Gaby: Hypertension, premenstrual syndrome, anxiety, things like that. And the urinary magnesium went up. The symptoms got better. So the fact that the urinary magnesium went up means it got absorbed. So maybe it's not as effective. [00:16:00] It's, uh, certainly, excuse me, more likely to cause, uh, GI side effects than magnesium glycinate.

Alan Gaby: Mm-hmm. But magnesium glycinate is more expensive and you have to take more pills to get the same amount of elemental magnesium. So most of the time, unless I think somebody's got an absorption problem, I'll go with the cheap kind. Uh, and if somebody wants to use mag glycinate or other forms, then, then that's perfectly fine.

Alan Gaby: Mm-hmm. Um, with respect to specific conditions, sometimes I'll use a specific form of magnesium. For example, there's a whole body of research on the use of the potassium and the meat and magnesium salts of spartic acid. Mm-hmm. It's called potassium magnesium aspartate. 

Jodi Duval: Mm-hmm. 

Alan Gaby: And there are four or five randomized controlled trials from the 1960s.

Alan Gaby: And parenthetically, you asked me about what's new and whether things get outdated. These studies have never been followed up. There were five or six studies in the sixties and they all showed the same thing that mag potassium, magnesium aspartate [00:17:00] is an effective treatment for unexplained fatigue. About 85% of people who take it improve compared to only 15 to 25% of people who take a placebo.

Alan Gaby: So if somebody is, uh, experiencing fatigue of unknown cause or muscle spasms, it also seems to help more for that. I'll go with potassium, magnesium, aspartate, and otherwise, uh, like I said, the oxide is perfectly fine. Mm-hmm. Yeah. So that would be magnesium would be my first. Other ones that are very important.

Alan Gaby: Folic acid, vitamin C, uh, B vitamins. But you know, specific, uh, conditions, you look more at specific vitamins. 

Jodi Duval: Yeah, absolutely. Yeah. I think it's an important point on magnesium. And also another important point that you made is meeting people where they're at. And so sometimes you have to start with something and uh, that's what I find in my clinical practice is that you have to be really good at knowing what is gonna work on the person at that time.

Jodi Duval: Because if you start really big and they're not ready for it, then you're, you're never gonna help them. And so starting at a place where [00:18:00] they can afford it or they can take enough of a, of, of, you know, a specific vitamin or mineral that's going to get them through. And, and that bridge to that next point right, is I think, essential, you know, for, for making movement in this field.

Alan Gaby: Well, I agree with your viewpoint and, uh, one of the things I've seen over the years is patients come in with a big shopping bag of 30 or 40 bottles and, you know, I read that this is good, so now I'm taking this and is there any way you can reduce my number of pills? Because all I'm doing is swallowing pills that I'm spending all my money.

Alan Gaby: So yeah, it is important to try to prioritize. Um, I generally start with a multivitamin, multi mineral. Extra magnesium and calcium. 'cause a lot of the malts don't have enough of that, particularly the one a days. 

Jodi Duval: Yeah. 

Alan Gaby: And then from there, uh, based on what their problems are and what their risk factors are, I'll try to build a program.

Alan Gaby: But, but I agree, you don't want to load too many pills on, and though diet is crucial, diet is as important, if not more important than supplements. Mm-hmm. But there are many people who are [00:19:00] not willing or able to make the change. So you, like you said, you meet them where they're at. Uh, this fellow as Saul recently had Crohn's disease.

Alan Gaby: And, uh, he told me that it, that when he went to Italy, it went away. I'm thinking, what could that be? Could it be mold? He said, no, it wasn't mold doesn't have a moldy house. One thing I've been aware of over the years is the wheat that they grow in Europe is quite different from the wheat that they grow in the United States.

Alan Gaby: Mm-hmm. And I've seen many people who told me that they do not tolerate United States wheat, but when they go to Europe or Israel or some other countries, they tolerated fine. So based on that one clue, I said, well, maybe you've got a, a wheat sensitivity. Because we know from old literature that hidden food allergy, particularly wheat dairy products, corn and eggs, can trigger ulcerative colitis and Crohn's disease.

Alan Gaby: And I knew this kid was not willing to do a big elimination diet. You know, no wheat, dairy products, corn, eggs, citrus coffee, tea, alcohol, [00:20:00] sugar. He wasn't gonna do it. So I made an educated guess say, let's see if you can just get off the wheat, which he did, uh, very diligently. And he's much, much better now.

Alan Gaby: So, you know, like you said, you have to meet them where they are and what they're able to do. 

Jodi Duval: Yeah, absolutely. And I, I too notice this, you know, not only are the bags of, of supplements, but I have clients also who can eat wheat everywhere else. Well, except for Australia in the US definitely improves and they feel so good.

Jodi Duval: And I think it helps with maybe sunshine and walking and being more relaxed as well. I think it increases the healing potential there. Um, but yeah, it's, it's a very important point because we have that close, obviously the integration with the, the gut and if we are irritating that with any food allergies and that's where the, the testing, the intolerance testing can come in because it's so easy then to know, well this is the things that are at irritating now and that's what we can remove.

Jodi Duval: Yeah. So I wanna move into food in a minute, but for, um, [00:21:00] particularly vitamin C and B vitamins. You mentioned folate and that's an interesting one. And I've, you know, read some of your, your, your blogs on this as well. So we obviously hear a lot about it. There is a lot about methylated vitamins out there.

Jodi Duval: There is a lot about the MT THFR genes. Um, so your perspective on that, and then also into vitamin C and B Bs particularly, and obviously the methylated versions. But my segue is because with foods nutrition, we don't have the value of the nutritional quantity in them at the moment. And, and that's what I think is declining as IC as I've read.

Jodi Duval: Um, so, you know, what do we do about that? And so that's my segue into that. So let, maybe we start with the vitamin C and Bs. 

Alan Gaby: Okay. So regarding folic acid or folate? Mm. Um, folic acid, uh, does not occur in any large amount in the body. And it has to be when you take it as a supplement, the reason they use it is 'cause it's [00:22:00] stable.

Alan Gaby: Mm-hmm. And it's, uh, inexpensive. Um, and so they put it in most of the malts, uh, but it has to be activated to, uh, methyl folate and some other related compounds. Mm-hmm. Um, so a lot of manufacturers in the past 10 years have decided to use methylfolate instead of folic acid. Uh, and some doctors won't use any malti that has folic acid in anymore.

Alan Gaby: So, um, I looked at that, uh, from a couple perspectives. Uh, number one is virtually 100% of the research on the use of folates as a preventive for various problems and as a therapy has used synthetic folic acid. Mm-hmm. So, since we have not used five MTHF as a therapy, we can't be a hundred percent sure that it would work, uh, as well.

Alan Gaby: I mean, theoretically it would work better. Mm. But until you do the research, you don't know for sure. Mm. One of the problems is it's less stable. So when you have it in a multi, there's a potential. For degradation when you mix it with, uh, [00:23:00] redox agents like vitamin C or copper or thiamine, that has been clearly demonstrated with vitamin B12.

Alan Gaby: It degrades in multivitamins because of those reactions. Whether methyl folate does that too, we don't know, but it, it's a possibility. The other thing is we don't know how the transport mechanisms work. Does methylfolate get into cells as efficiently as folic acid does? Uh, as an analogy, you know, people with Parkinson's disease, they have a dopamine deficiency in their brain.

Alan Gaby: But if you give them dopamine as a therapy, it won't work. 'cause it will not cross the blood brain barrier. Mm-hmm. So you give them levodopa or L-dopa, L-DOPA crosses the blood brain barrier where it gets converted to dopamine. Mm-hmm. So, uh, by analogy, I don't know whether that applies to methylfolate, but there's a theoretical possibility that it wouldn't work as well.

Alan Gaby: So we need to do the research. Mm-hmm. The research that's been done has been sparse. But one thing that was surprising [00:24:00] was that when you try to lower homocysteine levels, folic acid actually works slightly better than methylfolate. And when you look at the specific group, the, uh, M-T-H-F-R 6 7, 7 C to t, uh, allele that you're, there's a couple of 'em, but that's probably the one you're referring to.

Alan Gaby: Mm-hmm. That's the one where supposedly you cannot convert folic acid to its active substances and therefore you have to take the active form. When you look at that folic acid actually worked even better for homocysteine lowering than it did with people without that, uh, TT gene. So, uh, that research does not support the clinical use of MT of Methylate.

Alan Gaby: The other place that they've looked at is as an adjunctive therapy for depression. They've given people fluoxetine, which is Prozac. And they tacked on either folic acid or methylfolate. Methylfolate is actually a prescription drug in the United States. I think it comes in [00:25:00] seven and a half milligrams. Uh, and what they found is that as little as half a milligram of synthetic folic acid can support or improve the benefit of fluoxetine for depression, whereas you have to get 15 milligrams of the methylfolate, and seven and a half milligrams was not effective.

Alan Gaby: Hmm. So for those reasons, I've been skeptical about routinely using methylfolate. Now, are there situations where it's more effective? Probably, um, I don't necessarily know what they are, uh, but I'm, I'm sticking with the old form until I see better evidence. 

Jodi Duval: Mm-hmm. Really, that's a really interesting point you make and, you know, the fads, I, I don't call 'em fads, but I, I think it's experimentation for the purpose of, of getting, you know, further in, in nutrition and medicine.

Jodi Duval: Um, but you, you don't always know until there is long-range studies and this is the thing, right? Or more, you know, uh, together. And so you, you are trying to assume and test and just throw things at, at [00:26:00] patients to be able to guess this. And so you don't always know, but there is a, a big body of, um, practitioners and educators speaking on methylfolate, isn't it?

Jodi Duval: Yeah. And I 

Alan Gaby: can't say they're wrong. What I can say is it's premature to, uh, to be convinced a hundred percent that they're right. 

Jodi Duval: Yeah. Yeah, 

Alan Gaby: absolutely. There's a, there's a medical legal issue, at least here in the United States. The United States preventive health service recommends folic acid for all, uh, women of childbearing age to prevent neural tube defects.

Alan Gaby: Hmm. It does not say anything about methylfolate. Hmm. And so if you give methylfolate and, and a baby gets a neural tube defect and you get sued, and then you, the lawyer says, well, where does it say you should be giving methylfolate? 

Jodi Duval: Mm-hmm. 

Alan Gaby: Now, did they do something wrong medically? Probably not. But from a legal standpoint, that's a concern too.

Jodi Duval: Mm, absolutely. Yeah. I, I want to get into some of the interactions and everything in a minute, but I think I'll, I'll, I'll come to that after we talk about the, talk [00:27:00] about the nutrition part. But before we move to that vitamin C, now, I, I, I'm, I'm seeing a, a, a relatively huge deficiency state in many people.

Jodi Duval: Um, and even from the metabolite testing that we do as well. Um, I, I notice this quite often and I think it is because of the processing component of our food and highly, um, you know, you know, packaged foods that we eat and also shelf stable and, and picked early, and all these other things that we talk about.

Jodi Duval: So in terms of the body of evidence around vitamin C, what have you noticed over the years and what's changed? 

Alan Gaby: Well, that's partly what got me interested in this field. I read Linus Polling's book in 1972, vitamin C in the common. He cited all of the available evidence at the time that vitamin C reduced the duration.

Alan Gaby: And he also went into a long discussion of, of how the medical community can't relate to this. Mm-hmm. So that's partly Roger Williams and Linus Poly's books were what [00:28:00] got me interested. But over the years, uh, vitamin C has a lot of, uh, uses and, uh, often it, it's supportive for general health. I mean, it prevents bruising.

Alan Gaby: It, uh, probably helps prevent heart disease to some extent. There's some evidence that helps prevent cancer, many different things that you can use it for. So, um, I typically recommend a minimum of 200 milligrams a day. Uh, that's probably sufficient for the average healthy person that's about twice the recommended dietary allowance.

Alan Gaby: Smokers, as, you know, need more. Uh, for people with chronic illnesses, that's another story. A lot of times they, they might need much more and you just, uh, take it, uh, one case at a time. One of the things that, uh, Pauling cited, he cited the work of someone, someone named Irwin Stone, who was not a physician, but he was very smart.

Jodi Duval: Mm. 

Alan Gaby: And he, uh, pointed out that humans are among the few species that do not manufacture [00:29:00] their own vitamin C. And among those that do manufacture their own vitamin C, they make dramatically more than humans can get in their diet. 

Jodi Duval: Hmm. 

Alan Gaby: And when they are stressed biochemically or, uh, cold, cold stress, or they give 'em an infection or they give 'em a trauma, there's one thing that happens.

Alan Gaby: The liver starts cranking out more vitamin C up to the point of approximately 19 grams per 70 kilograms of body weight. 

Jodi Duval: Mm-hmm. 

Alan Gaby: And so that was the basis of, uh, a lot of the orthomolecular medicine theories of why people might benefit from very large amounts of vitamin C. And in some situations I use that, I used to give, uh, people that.

Alan Gaby: Got recurrent urinary tract infections, uh, who didn't tolerate antibiotics, we would hook 'em up to 25 grams of vitamin C and drip it in through a vein over a period of an hour. And that would knock out the, uh, the problem. Some people with, uh, infectious mononucleosis, high dose intravenous [00:30:00] vitamin C would get them well in a matter of days rather than weeks or months.

Alan Gaby: Mm-hmm. And that was based on, uh, the work of a man named Frederick Klenner from the 1930s and 1940s. And I cited this all in my book, and there has not been a whole lot of followup. There's some doctors who are doing work now with cancer and vitamin C and they, they publish occasionally. But, uh, again, you look back at some of this work and I wish it was being followed up.

Alan Gaby: And maybe if we keep, uh, banging pots and pans and screaming and yelling, people will start doing some of the work. But, um, I think vitamin C both orally and intravenously has great potential. 

Jodi Duval: Yeah, I absolutely agree with you. No, great. I speak to many doctors and, and patients as well who are, and have been on vitamin C therapy for cancer and various other immune issues and incredible benefits that I've seen as well.

Jodi Duval: Yeah. So it brings me to my next question before we sort of come away from some of the, the micronutrients, um, [00:31:00] minerals. How is there a, a set protocol when you are seeing clients, patients? Is there a set, um, yeah. Protocol testing that you like to do in terms of how you determine what patients are missing and how, you know, I know it's a, it's a big question.

Jodi Duval: I know, I know that. Yes. Um, but maybe, maybe some guidance on, on what you are looking for when you are seeing patients. 

Alan Gaby: Okay. Well, I'm different than, uh, many of the practitioners that, that do the same kind of therapies. Mm-hmm. I give a, a good history. Mm-hmm. Good physical exam. And standard laboratory tests, you know, chem profile, complete blood count, serum iron, things like thyroid function.

Alan Gaby: Um, but I almost never have used any of the nutritional testing. One reason is that I think a lot of people who benefit from nutritional therapy are not deficient. I think what we're doing sometimes is we're cranking up enzymes by giving supra physiological doses, you know, above, [00:32:00] above the amount that you would normally get on a diet.

Jodi Duval: Mm-hmm. 

Alan Gaby: Sometimes we're inhibiting enzymes, sometimes we're, we're activating them, sometimes we're having pharmacological effects. For example, uh, with vitamin C. Uh, vitamin C uh, in the, uh, in the urine can partly sterilize organisms. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Uh, so it can reduce the risk of UTIs. Mm-hmm. Uh, magnesium in the urine increases the solubility of oxalate.

Alan Gaby: There are studies over the years that showed that if you give 300 to 500 milligrams of magnesium per day to people that had recurrent calcium, oxalate stones, kidney stones 

Jodi Duval: mm-hmm. 

Alan Gaby: Then the recurrence rate drops by 90%. And the, the presumed mechanism is that the, it increases the urinary solubility of oxalate, which we know chemically magnesium does.

Alan Gaby: So, you know, they, they always disparagingly say, all you're giving people is expensive urine, but in this case, that expensive urine is worth it. Um, [00:33:00] so it's going a stove back, back to your question. So I, uh, have a familiarity with the literature, what's been used for what conditions. 

Jodi Duval: Mm-hmm. 

Alan Gaby: And, uh, based on that and based on the patient's history and physical exam and standard laboratory tests, I basically wing it, uh, educated guessing, if you will, and that seems to work pretty well.

Alan Gaby: Now, am I missing some things because I'm not doing the testing. Maybe, but my success rate was pretty good. Uh, and the failures, uh, I just chopped them up to failures there. I would say at least 80% of the people that I worked with responded well based on what we'll call empirical therapy. 

Jodi Duval: Hmm. And there, there is a, a huge amount of intuitive analysis that goes on, isn't it?

Jodi Duval: Yeah. And I, I, I think we don't talk about it enough because it, it is hard to, um, quantify and any practitioner that, or doctor that's been working with patients for longer than a couple of years, you know, you, you will [00:34:00] read someone as soon as you walk in, you'll see signs without, you know, you, um, actually registering it in in your intellect.

Jodi Duval: Yeah. So we, we work with so many different tools and techniques, don't we? And sometimes, you know, patients, um, you know, that many work with including myself, can't afford the testing. And so it, it's not cheap in some, in some regards. So we have to work with what we've got. And so then you are reading the patient and you're knowing what is working for them and how their body is responding and teaching them what to be looking for.

Jodi Duval: And so it, it is that nutritional counseling that goes a long way, I feel. 

Alan Gaby: Absolutely. And you know, if, if one starts to pat themselves on the back too much for being smart and coming up with, uh, intuitive therapies or based on your knowledge, I always remind myself of this one case this woman came in. I don't remember what her problem was, and I don't remember what I gave her, but I was patting myself on the back of how smart I was.

Alan Gaby: She comes back four weeks later, I said, how you doing? She says, I am so much [00:35:00] better. And I'm thinking, oh, I'm, I'm so smart. And then I says, well, which portion of the program do you think helped? She says, well, I didn't do anything you recommended. I just decided it was time to get well. 

Jodi Duval: Exactly. 

Alan Gaby: So that was a, a nice humiliating experience that I think good for the soul.

Jodi Duval: Yeah. But you know, in part it was some of your doing, you know, it's, it's that interaction that made them realize and that, you know, that that commitment to actually just come see someone and that in their head was enough. 

Alan Gaby: Oh, yeah. The therapeutic, uh, visit is therapeutic. I mean, the visit can be therapeutic, as you say.

Alan Gaby: Uh, but you know, when we start thinking about the nutrition is the only thing you can do, obviously, you know, maximizing the placebo effect if the placebo just means to please 

Jodi Duval: mm-hmm. 

Alan Gaby: It doesn't mean you're giving them a fake thing. Mm-hmm. Uh, one patient came back and I, I gave her a therapy and she came back and she was better and she said, doctor, I appreciated the knowledge you put forth to give me this therapy.

Alan Gaby: But what I appreciated most. Was that you cared about me. [00:36:00] Mm. And it's like, wow. And I did care about my patients and I wanted them to get it better, partly 'cause I cared about them. And partly because from an intellectual perspective, I wanted to, to know if my therapies actually worked. Mm-hmm. And I was always, yeah.

Alan Gaby: If it worked. So I mean people, it was kind like a cheerleader in a way, and 

Jodi Duval: mm-hmm. 

Alan Gaby: That does have therapeutic value. It does not diminish the benefit of the, the diets and the nutrients and things like that. But, you know, good practitioners will utilize both. 

Jodi Duval: Yeah, absolutely. And I, I, I love your perspective on this, and I don't, I don't hear it often and with the people I, I speak to, and I, I really appreciate the way you view that because we are the cheerleaders and we also cheerleaders for ourselves because.

Jodi Duval: We are trying to collate information, you know, and I always tell my patients that, you know, tell me every little tiny thing that has worked, not worked, how you feeling? Little signs and symptoms of the body? Tell me so much about what is going on for you. And it's all for my, um, you know, clinical data over the years I'm gaining in my own textbooks, in my, [00:37:00] in my head.

Jodi Duval: Sure. Not written them like you did, um, or have so into nutritional, um, dietary therapy. So what and how do you feel? Is there a specific way you tell patients to eat and or is it very individualized and personalized to everyone that you see? Um, so let's dive into that and where we can really access the power of nutritional medicine through diet.

Alan Gaby: Well, it's both. Uh, it is, uh, general and it's also specific, the general recommendation that applies to almost every. You've gotta cut down on the, the refined sugar, the added sugars. Um, and in some cases, based on their story, you have to cut it out completely. Mm. Uh, some people tolerate moderate amounts.

Alan Gaby: Other people, they have what we've called hypoglycemia. It's kind of a misnomer. Uh, we should call it maybe sugar intolerance, blood sugar, irregularities, endocrine [00:38:00] irregularities due to consumption of sugar. So, um, if we were to ban sugar in the world 

Jodi Duval: Mm, 

Alan Gaby: uh, after people survived their withdrawal symptoms, which can actually be quite severe in some cases, 

Jodi Duval: yeah.

Jodi Duval: C 

Alan Gaby: would improve in, in many ways. You know, just talking to people, everybody knows somebody who feels really bad when they eat too much sugar. And, uh, it's not just obesity, but it's psychological problems, it's achiness, it's fatigue and things like that. Um, the problem with telling people to cut out sugar is it's easier to sit than done because sugar is very clearly an addictive substitute.

Alan Gaby: There's a couple different mechanisms. Number one is the, you get wide swings in blood sugar. The blood sugar goes up really fast because it's a rapidly absorbed carbohydrate. You get an insulin overreaction and then the blood sugar drops, uh, too far. So you get a cortisol and norepinephrine or epinephrine reaction and then it shoots back up.

Alan Gaby: And so it's kind of like bouncing up and down like a big [00:39:00] sine wave. And so, uh, people become addicted because when the level's too low, they know somewhere in their brain that if they eat sugar, they're gonna feel better for at least a short period of time. Hmm. So you gotta deal with that. And then there's probably an opioid mechanism too.

Alan Gaby: They did a study in rats where they gave them either the standard rat food, uh, with drinking water or the same diet with drinking water that contained 10% of sucrose. 

Jodi Duval: Mm-hmm. 

Alan Gaby: And uh, the ones that got the sucrose when they gave them naloxone, which is an opioid antagonist. They went through both behavioral and biochemical, uh, changes that looked like opioid withdrawal.

Jodi Duval: Hmm. 

Alan Gaby: So, uh, there is something that interacts with, with refined sugar in the opioid system, and that's partly why there's an addiction there. So, with all that said, uh, when I say you need to cut out sugar and you look at their reaction, some people say, okay, I'll do it, and that's fine. Other people say, oh, I'm [00:40:00] addicted to sugar, or they, they don't necessarily know it, but I know it.

Alan Gaby: And I say, okay, it is an addictive substance. If you've ever been addicted to anything, you know that you're gonna suffer for a few days. And so just stay with it. Call me up if you need any, uh, any support. We got a few ways of dealing with it. Eat more protein, eat small frequent meals throughout the day.

Alan Gaby: Uh, take B vitamins, vitamin C, and maybe chromium, which helps stabilize the blood sugar. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Uh, and I, I always say, call me anytime day or night if you have a problem. Nobody's ever called me in the middle of the night because once they know you're there for them, they don't wanna bother you. Yeah. It's the ones that don't like you, that call you in the middle of the night.

Alan Gaby: So, uh, anyway, um, they go through this withdrawal 'cause they know it's gonna happen and I tell them, you're probably gonna feel much better around the corner after the withdrawal, uh, is gone. And that's usually the case. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Um, so that's the sugar thing. Mm-hmm. And then there's all the chemicals. I don't know how many chemicals are in the food in [00:41:00] Australia, uh, but in the US it's, it's horrifying.

Alan Gaby: It's less so in European countries. 

Jodi Duval: Yeah. 

Alan Gaby: Uh, and there's so many chemicals in the food that it's almost impossible to figure out which ones might be causing problems and maybe none. Maybe multiple ones. Mm-hmm. Uh, but so what I tell people to do is buy from the edges of the, of the supermarket, uh, not the packaged foods that have a, a long list of chemicals in them.

Alan Gaby: Mm-hmm. And many, many people say they feel much better, and when they eat the processed additive based foods, they feel worse. We never necessarily know which portions of it it is. Mm-hmm. So no sugar, try to avoid the refined, processed foods with the additives. And then we get into, uh, the food allergy.

Jodi Duval: Mm-hmm. 

Alan Gaby: About, uh, in my practice, probably 50% of the people who came in had an unrecognized or hidden food allergy, excuse me, that was, uh, responsible for one or more of their symptoms. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Now that was a, uh, a [00:42:00] biased sample because the ward was out there that Gaby did nutritional medicine, and so we got people who thought they had a nutritional problem.

Alan Gaby: So it's probably somewhat less than 50% of the general population, but it's a lot. So, uh. Based on their history. Uh, you look at family history of conditions that might be allergic. You look at personal history of conditions that might be due to food, algae, asthma, eczema, migraines, irritable bowel syndrome, rheumatoid arthritis, other kinds of arthritis, uh, fatigue.

Alan Gaby: And then I always ask them, uh, do you feel better or worse after meals are the same? And if they say, I feel worse after eating, that's often a clue that they're allergic. If they feel better after eating, it's often a blood sugar problem. Not a hundred percent, but a good place to start. So based on what they, uh, they tell me, I often recommend an elimination diet through weeks.

Alan Gaby: Often it's listed in the appendix of my book, but in the short form, it's no wheat, dairy, corn, eggs, citrus, coffee, [00:43:00] tea, alcohol and sugar and additives. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Um, and so that's pretty hard to do. We had a, a staff member who would spend anywhere from a half hour to more than an hour teaching people how to do that.

Alan Gaby: Because if you don't do it right, it's not gonna work. And there are people who wouldn't do it anyway. Yeah. Um, but most of the people that, that I recommended this to did it. And, uh, um, probably 75 or 80% of those who did it noticed a beneficial change. So, so that's where I go. So the sugar, uh, then, then you're talking about caffeine and alcohol.

Alan Gaby: Mm-hmm. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Um, there's, um, I have many observational studies show that moderate alcohol drinking is associated with reduced risk of heart disease. But as you know, observational studies don't prove causation. So is it really true that alcohol prevents heart disease? Um, I'm skeptical. Mm-hmm. It does raise HDL levels, so maybe there's a surrogate marker.

Alan Gaby: But, uh, one of the [00:44:00] things that I've postulated and I wrote about this in, uh, the chapter on heart disease, is that, uh, many people who don't drink alcohol don't drink it 'cause it makes them sick. What is it about their biochemistry? Um, there is a fairly high proportion of a, uh, of a polymorphism of a, uh, enzyme called the aldehyde dehydrogenase.

Jodi Duval: Mm-hmm. 

Alan Gaby: Alde dehydrogenase breaks down acid aldehyde, which is ethanol, which is alcohol, goes to acid aldehyde, and that's what causes a lot of the side effects, the hangovers and the risks. Mm-hmm. Acid aldehyde is broken down to non-toxic materials by aldehyde dehydrogenase, 

Jodi Duval: excuse you. 

Alan Gaby: And there are, uh, a fairly high minority of people that have an allele, which makes them inefficient at breaking down acid aldehyde.

Alan Gaby: Mm-hmm. And so they don't drink. Mm-hmm. Now, what is the deficiency of this enzyme also gonna do? They're not gonna be able to break down other aldehydes. Mm-hmm. [00:45:00] They're, uh, endogenous aldehydes produced in the brain and in the periphery. Um, there's formaldehyde in the environment, so I've postulated that.

Alan Gaby: Uh, the failure to be able to detoxify aldehydes might be the cause of more heart disease rather than the fact that these people don't drink. 

Jodi Duval: Hmm. 

Alan Gaby: Uh, or that, that, that they do drink. Hmm. So, anyway, that's speculative. But, um, the bottom line clinically is if somebody says, I drink because it helps me prevent heart disease, and then they're lying about how much they're drinking anyway, I, I have to be skeptical about that.

Alan Gaby: And then others say, should I start drinking to prevent heart disease? And I usually say no. 

Jodi Duval: Yeah. 

Alan Gaby: And then caffeine, the other one is caffeine. Um, there's observational studies that show that coffee drinking prevents a number of different diseases. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Other studies suggest that it might increase their risk.

Alan Gaby: Uh, it may not be the caffeine. There are other compounds in coffee such as chloro, chlorogenic acid. [00:46:00] Mm-hmm. Which might be beneficial. Mm-hmm. Um, so it's kind of an open question and I take it individually. But certainly the caffeine is a problem for specific groups. Those with chronic anxiety, those with insomnia, uh, those with, uh, cardiac arrhythmias mm-hmm.

Alan Gaby: And some others, those with fibrocystic breast disease, often they get all the caffeine out of their diet and they do much better. Mm-hmm. Um, many people are unaware of the fact that, um, the half-life of caffeine can be very long. They did a study in people with insomnia and the, their, their half life was as much as 11 hours for caffeine.

Alan Gaby: They'd ingest caffeine and 11 hours later they'd still have half of it in their system. 

Jodi Duval: Mm-hmm. 

Alan Gaby: So, if people say, I only drink coffee in the morning, but I can't sleep, uh, that has not proven to me that caffeine is safe for them. So I always tell people with insomnia, try two weeks with no caffeine and see if it makes a difference.

Jodi Duval: Mm-hmm. 

Alan Gaby: Uh, sometimes it does, sometimes it doesn't, but it's, it's worth a look. 

Jodi Duval: Yeah, I've noticed that too. [00:47:00] Incredible. I wanna, so a few points, um, that I want to mention that, you know, back to chemicals in our foods. So we don't really have the data do we, on the combination and we have them singular and we have safety ranges, but we don't have the combination and same in context to multivitamins and, you know, pushing all of these different compounds, you know, micronutrients together in multivitamins.

Jodi Duval: We also don't really have the data on that, do we? 

Alan Gaby: Well, we've got some. Okay. But, uh, not nearly as much as we'd like. For example, we know that zinc interferes with copper. 

Jodi Duval: Yeah. 

Alan Gaby: Absorption. Uh, and then people say, well, should I take a multi that's got both of them? And I say, yeah, because you will get some of the copper in.

Alan Gaby: But if somebody's got a zinc, uh, multivitamin that's got zinc, but no copper, long-term use of that can be a problem. Uh, and then, uh, what else do we need to know? I mean, they say that iron. [00:48:00] Vitamin E interact, that iron destroys vitamin E. So, uh, what are you gonna do about that? One of the things I do is I recommend, uh, I often recommend iron free supplements because, uh, a lot of people don't need iron.

Alan Gaby: You can do lab tests. This is one area where I always test baseline for iron status. Mm-hmm. And if they're, they're in good shape, um, and they're not having, for example, excessive menstrual bleeding, I won't give 'em an iron supplement. 

Jodi Duval: Mm. 

Alan Gaby: Um, but if they do need an iron supplement, you're looking at things that interfere with iron absorption such as calcium, other minerals, uh, vitamin E might be destroyed by iron.

Alan Gaby: So I have them take the iron separately as an individual pill mm-hmm. In those situations. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Um, other than that, you know, it's a lot of guesswork and it's possible we're doing some things wrong without knowing it. 

Jodi Duval: Yeah. And I, it is. And it is much like that with pharmaceuticals in, in some instances or sometimes all instances when we're multi prescribing.

Jodi Duval: So, yeah. 

Alan Gaby: Yeah. And, and the [00:49:00] side effects of the pharmaceuticals that inter interact can be much worse. Uh, and if you, if you have a, a drug that causes the level of another drug to go up, you can end up with liver toxicity, kidney toxicity, many different problems. And, uh, there was a drug that was, uh, used for, uh, for GI problems that they took it off the market, not because it was toxic in itself, but because it interacted with other drugs and made the other drugs dangerous.

Alan Gaby: And despite sending, uh, letters to all the doctors in the country, and despite putting a black box warning, physicians were still prescribing it in combination with contraindicated drugs. So they took it off the market because it was dangerous because of the way doctors were prescribing it, not because it was dangerous.

Alan Gaby: So yeah, you gotta know about interactions. Absolutely and s interact with drugs. They interact to some extent with each other, but mainly, uh, I have a, a large chapter at the end of my book on the clinically relevant drug nutrient interactions. 

Jodi Duval: [00:50:00] Mm-hmm, mm-hmm. Yeah, and that's one thing I really like about the naturopathic education is that we go into detail because obviously we are doing so much, um, you know, phy, pharmaceutical, um, medicine, and so herbs, we, nutrient interactions, we are learning about that in, in detail.

Jodi Duval: Um, and because it is serious and mean, we need to know those interactions and they, they are medicine, so we, we have to take it seriously. And so it's, it's a very important thing to understand. Yeah. 

Alan Gaby: Yeah. In my experience, I, I know a lot of naturopaths. I, I taught at Basier University, which was one of the naturopathic schools in the United States.

Alan Gaby: I taught there for nine years to where I met my wife. She's a naturopath. And, uh, I was very impressed with, uh, the depth of knowledge that they have. Um, they're, it's not the same education. I mean, they wouldn't be able to do hospital care with prescription drugs and all that stuff, but that's not what naturopaths wanna do anyway.

Jodi Duval: No. 

Alan Gaby: Um, but in terms of what they're trained to do, uh, they, most of 'em do a [00:51:00] very good job. And, uh, when I get calls from former patients who want to know who to see in their area, I usually recommend an naturopath. 

Jodi Duval: Mm-hmm. Mm-hmm. Yeah, no, I agree. We, we, we have a slightly different, um, perspective of it in Australia to America, but, you know, we are becoming a, the, the most growing, um, industry for clients and patients to come to versus traditional medical care because they're not finding the answers or the healing that they want to.

Jodi Duval: And so it is driven by, it's driven by them, which is, is great. And so we are just trying to be the best that we can be and, uh, know as much as we can. 'cause it's. It's always continually changing. And this is what my next question will be to you is, is, you know, there's always these new exciting, or for me it's also about how the nutrients are absorbed.

Jodi Duval: You know, so the digestive, the microbiome, the, um, small intestinal, you know, the, the, um, [00:52:00] ability for it actually to pass through into, um, areas of the body and actually be absorbed in different ways to measure that obviously is available. Um, but there are so many different things coming out as we've talked about with folate.

Jodi Duval: There's sort of like the, the new fads that are coming through, but, you know, not sort of giving too much value to the fads, but what are the things that you are excited about that you want to research next, or things that you've heard about, um, what's sparking your interest in the field at the moment?

Alan Gaby: Yeah, well, um. Niacinamide vitamin B three. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Uh, it's always been one of my favorite nutrients. Um, I learned when I first started in this field that, uh, there was a book written in 1949, uh, that showed that it's very effective as a treatment for osteoarthritis. Mm-hmm. And that has always been my primary therapy.

Alan Gaby: I think it works as well as are better than glucosamine sulfate. Mm-hmm. Uh, it also causes many side effects, which are very positive, more energy, better mood, better sleep, things like that. Uh, it has to be done, [00:53:00] uh, carefully because excessive doses can cause liver toxicity. So we do monitor liver enzymes, but when we keep it at a safe level, um, I've never seen Pepto toxicity.

Alan Gaby: Uh, but niacinamide, uh, back then was, was, uh, one of my favorites. And in recent years there was a study published in the New England Journal of Medicine, uh, that it helps prevent skin cancer, non-melanoma skin cancer, so basal cell carcinoma. Squamous cell carcinoma, which are huge problems. 

Jodi Duval: Yeah. 

Alan Gaby: And it reduces them about 25%, which is a statistically significant, uh, benefit.

Alan Gaby: And it was published in the New England Journal, which is a conventional, highly respected journal. And because of that many, but not all of the dermatologists are actually recommending niacinamide to many of their patients. What is less well known, but very intriguing is some evidence that it might be useful for preventing and treating glaucoma.

Alan Gaby: Yeah. And that's new, new information that's coming out. Uh, [00:54:00] they, there's an animal model genetic strain that, that gets glaucoma automatically when they get, uh, older. And they gave them high dose niacinamide and it prevented it. Uh, it appears to work by stimulating, uh, defective mitochondria in the, uh, in the eye, in the retinal ganglion cells.

Alan Gaby: And they've done preliminary work in humans, and it does appear to be effective as far as improving visual fields. Or, uh, improving various surrogate markers of glaucoma. And that's still in its early stages, but that would be a dramatic benefit if, uh, if it pans out, if it turns out to be effective. 

Jodi Duval: Mm. 

Alan Gaby: Um, as far as the newest stuff, you know, like I said, there's a lot of stuff.

Alan Gaby: The main problem in nutritional medicine is not the newest stuff that's exciting. It's the old stuff that nobody's using. 

Jodi Duval: Yeah. Resurgence of. Yeah. 

Alan Gaby: Yeah. So, so my, uh, my goal is to, uh, to make people aware of many of the things that have been studied over the [00:55:00] years that are effective and safe and are not being used.

Alan Gaby: One of the things that I help promote a lot was the so-called Myers cocktail, which is an intravenous combination of nutrients, magnesium, calcium, B vitamins, and vitamin C. And I actually took over the care of Dr. Meyer's patients in Baltimore, Maryland when he died. 

Jodi Duval: Wow. 

Alan Gaby: And they all had these amazing stories of how this IV therapy, uh, was so dramatically effective for them.

Alan Gaby: Nobody knew what he was giving them. None of the charts said it. He had never written about it. So I kind of had to figure it out. And I changed it some, and I still called it the Myers cocktail because he was the guy that gave me the idea. Yeah. But based on that, there, there, if you, uh, wanna read about this, I wrote an article that's available in PubMed.

Alan Gaby: Just Google, just, just go in the search engine, GB ar and scroll down. It's called Intravenous uh, nutrients. The Virus Cocktail talks about how to give it and what it's good for. But you can knock out asthma attacks in two minutes. You can knock out migraines in two [00:56:00] minutes. I saw one guy who was a, um, morphine addict and he was withdrawing and he was pacing around and sweating and anxious and crazy.

Alan Gaby: And I hooked him up to this iv. I had to walk up and down the hall with him with a butterfly needle on his arm 'cause he couldn't sit still. But literally, literally within five minutes, he was completely, uh, normal, at least, uh, appearing so. 

Jodi Duval: Mm-hmm. 

Alan Gaby: And it lasted 36 hours. We did it again. And again, it knocked out the withdrawal symptoms within minutes.

Alan Gaby: So there's other things you can, can knock out. Uh, viral illnesses, uh, fibromyalgia, chronic fatigue syndrome seems to respond. But, uh, it's, it's not something that's new. It's just something that, uh, that I used a lot in, in my practice and, uh, have tried to get doctors interested in. 

Jodi Duval: Yeah. Uh, I see it coming back a lot and I, I recommend it myself to many patients and having their IV of the Myers and mm-hmm.

Jodi Duval: Tried it many times myself and a nice dose of magnesium in the veins is a very nice [00:57:00] feeling. 

Alan Gaby: Well, that's what they say. We won't get into that. What if Well, nevermind. 

Jodi Duval: Something for off the podcast. 

Alan Gaby: Yeah. 

Jodi Duval: Um, so yes. All right. Brilliant. I, I'm also excited about, I love niacin and, and the flushing component I've used in, in, in sauna therapy and things like that as well.

Jodi Duval: It's not a nice feeling. It can feel quite dramatic in the skin. Yeah, I see generally in, in most of my patients when I'm even doing the testing in multiple ways that we are so deficient in B vitamins B six particularly I also see B three, um, B two, you know, B12 as well. It's, it's quite, um, a demand I think on the body.

Jodi Duval: We have a lot of usage for all of these things. 

Alan Gaby: Absolutely. 

Jodi Duval: Yeah. 

Alan Gaby: So is regarding niacin, uh, I don't use niacin a lot because of the flush, because it's so uncomfortable. Yeah. I mean, if you're doing detoxes, you mentioned according to Ron Hubbard, that's, that's the way to do it. Yeah. [00:58:00] But niacinamide does not cause the skin flush.

Jodi Duval: No. 

Alan Gaby: And it's also not as taxing on the liver. Um, so there's reasons to use, one of the reasons to use the other, uh, but if you want a lower cholesterol, you have to use niacin. Niacinamide won't work. But for most other indications for the skin cancer, for, uh. For glaucoma, for osteoarthritis, uh, things like that.

Alan Gaby: I always have used niacinamide. 

Jodi Duval: Mm-hmm. And what were the dosages? Do you know in the studies what they were aiming towards for the dosages of the niacinamide? 

Alan Gaby: Well, um, there was a randomized trial where they gave 500 milligrams six times a day. Uh, and it was definitely beneficial for osteoarthritis.

Alan Gaby: That's, there's a citation in my book. It's in ager, it's in a journal, I believe it's called inflammation. That's the name of the journal. 

Jodi Duval: Mm-hmm. 

Alan Gaby: Um, and the liver enzymes did go up. 

Jodi Duval: Mm. 

Alan Gaby: But not outside the normal range, but because of the, the risk of hepatic toxicity, which has extremely low. April Hoffer who treated schizophrenia, said one out of 2000 people who take [00:59:00] three grams a day of niacin or niacinamide will get chemical hepatitis.

Alan Gaby: So that's one outta 2000, but it's still chemical hepatitis. So because of that, I've always limited myself to 500 milligrams four times a day instead of six times a day. Um, yeah. Or you know, 1,003 times a day, that's. Um, I don't wanna risk the, uh, the adverse effect, even though it's rare and I, it does seem to work at the lower doses in my experience with patients.

Alan Gaby: So 504 times a day for the skin cancer prevention, what they're using is 500 milligrams twice a day. Uh, that's probably reasonable for glaucoma, but again, if you're prescribing this, if you're any more than 1500 milligrams a day, or if you're dealing with somebody who's at risk of liver damage like an alcoholic or somebody who's got chronic hepatitis, you want to err on the signs, caution and definitely keep a check when the liver enzymes by blood tests.

Jodi Duval: Hmm. There's, there's so many things I lecture often on, on cannabis and endocannabinoid system, which was what I'm doing in America at the moment. And it's, it's, you know, live [01:00:00] enzymes are always one to watch for many things, isn't it? That we're doing even herbs that we use, you know, all the phy pharmaceuticals, um, because it's, yeah, the liver is the important part that's processing everything, isn't it?

Alan Gaby: You only got one one. 

Jodi Duval: Exactly. It is lucky. It regenerates though, so we are, we are lucky about that one. 

Alan Gaby: That's true. 

Jodi Duval: Oh, it's, it's such a pleasure talking to you, Dr. Gabby. Um, and, uh, such, such a, a commonality between beliefs and I love talking to people like yourself and just hearing about the wonderful work that you're doing in the world.

Jodi Duval: So, at the end of their podcast, we always ask sort of a three rapid fire questions. 

Alan Gaby: Good. 

Jodi Duval: So I've got, um, you know, one, one in relation to, to you and your, your specialty. The next one would be your top trick to live smarter, not harder. And the other one will be your top tool or trick, um, or supplement for health.

Jodi Duval: And so we're just, it's just a rapid fire. So I'll let you think about those. But for you, um, as a starter, what, what is your, [01:01:00] yeah, so if you could fix one global deficiency, what would it be? 

Alan Gaby: Okay. Well, I'm not sure you're talking about nutrition, but I think, uh, one of the major deficiencies, at least in, in my country, is attitude.

Jodi Duval: Yeah. 

Alan Gaby: I think we need to improve. People hate each other in this country because of politics and, uh, you know, people are not willing to, uh, to do the work necessary to be healthier, to be successful. It's not everybody, but it's, it's, um, too many people. So I think we need to be grateful that we're here on Earth and we need to, uh.

Alan Gaby: Consider, uh, that we have a, a body that's been given to us and we're, we're obligated to take care of it. Mm-hmm. And in countries where, uh, medical care is free because of, you know, national healthcare in the United States, it's largely that way. We've got Medicare, we've got Medicaid, we've got health insurance.

Alan Gaby: I think people should view being healthy as a [01:02:00] charitable donation because then you're not spending tons of money being in the hospital where it could be spent, uh, in other more beneficial ways. So I've always thought, uh, have a good attitude and, uh, do whatever you can to, to keep yourself healthy. 

Jodi Duval: Yeah.

Jodi Duval: I, I like that. That's a different spin I didn't expect. Great. Okay. Well, that's so very good. So the next question is a top trick to live smarter, not harder. What would you say 

Alan Gaby: live smarter, not harder? Well, um, it, it goes to attitude to, but for me, for example, I know that if I eat after 8:00 PM. I gained weight and I feel terrible.

Jodi Duval: Mm-hmm. 

Alan Gaby: So what do I do? I eat after 8:00 PM and I keep telling what I gotta stop eating after 8:00 PM and then I went like six months not eating after 8:00 PM and I lost 20 pounds and I felt great. So, uh, find ways to do what you need, you what you know you need to do. 

Jodi Duval: Yeah. You generally [01:03:00] know what to do, don't you?

Jodi Duval: You just don't, 

Alan Gaby: we just don't do that. I know what I need to do and I don't always do it. So, you know, that goes back to the attitude and, you know, be grateful that you've got what you've got and do what you can to keep it. 

Jodi Duval: Yeah, I love that as well. That's brilliant. And so the next one you can either trick, you can, you can, you can, uh, choose the trick or the supplement, but top tool, trick supplement for health.

Alan Gaby: Okay. Well, as I said earlier, 

Jodi Duval: yeah. 

Alan Gaby: Um, if everybody, you, you don't want to give it to people with end stage renal failure and people on certain medications, but it mm-hmm. As most other people increase their magnesium intake. Um, there would be dramatic improvements in health. And actually I was so sold on Magnesium that I wrote this little book.

Alan Gaby: It was really a pamphlet book. It was just called Magnesium. Mm-hmm. And it was written many years ago, and I reviewed the literature and the way I started an Off is hardly ever a patient leaves my office without the recommendation to increase their magnesium take intake. 

Jodi Duval: Yeah. Oh, I love that. All right, [01:04:00] so where everyone can find you, so you have your amazing book, which is Nutritional Medicine, and you can, they can find that on your website.

Jodi Duval: So doctor D-O-C-T-O-R Gabby, GB y.com. Dot 

Alan Gaby: com. Com. 

Jodi Duval: Doctor 

Alan Gaby: gave you.com Right. 

Jodi Duval: Anywhere else that people need to mind. And there are 

Alan Gaby: sample chapters up there. It's an expensive book. 

Jodi Duval: Mm-hmm. 

Alan Gaby: And shipping to Australia is frightfully expensive. There is an ebook version, electronic version, which does not have a shipping charge, but there are sample chapters on the website.

Alan Gaby: Dr gave you.com and, uh, you can see if it resonates with you and you think if it's. For you because it is an investment, but the purpose of it is to teach practitioners how to, uh, practice expert nutritional medicine. Do it safely and effectively. 

Jodi Duval: Yeah. And I, and I think we need to said, know how to discern the evidence and really look at that properly and then make our own judgements around that.

Jodi Duval: And we need good literature like you've written to be able to do that. And we can't always have the time if we're seeing patients actively and hours after hours to [01:05:00] do the incredible research that you've done. And this is why we pay and the investment for the resources. 

Alan Gaby: Well, 

Jodi Duval: thank 

Alan Gaby: you. 

Jodi Duval: Yeah. So Dr. Gabby, it's a pleasure.

Jodi Duval: Thank you again. Um, wonderful conversation and I look forward to hearing more about your adventures and your research as the years come by. 

Alan Gaby: Okay. Thank you. And enjoy Colorado. 

Jodi Duval: Thank you.

Find more from Dr. Alan Gaby:

Website: https://doctorgaby.com

Nutritional Medicine (Textbook): https://doctorgaby.com/nutritional-medicine/

LinkedIn: https://www.linkedin.com/in/alan-gaby-44310721/

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