Full Transcript Podcast Introduction and Guest Welcome 0:00 Your genes hold the answers to your family's overall health. 0:04 I'm Dr. 0:05 Paula Kruppstadt and on the Get to the Root with Hope for Healing podcast, I sit down with experts in genetics, functional medicine, 0:12 and family care to explore what's really going on beneath the surface so you can stop guessing and start healing. 0:20 From personalized insights to practical tools, we bring you whole family wellness that starts at the root. 0:27 Welcome to the Get to The Root podcast, and on today's podcast I'm grateful to have Van Tran. 0:35 She's the owner and operator of Roebirds Pharmacy, which is a regular insurance-based pharmacy and a compounding pharmacy in the Conroe, 0:46 Texas area. 0:47 Welcome, Van. 0:48 Thank you, Dr. 0:49 Kay, for inviting me to podcast. 0:52 So I wanted to be able to educate our audience a little bit about what a compounding pharmacy is. 0:59 And also too, I think that your credentials are outstanding and they really serve our patient population well. 1:07 First of all, not only are you a PharmD, and could you just let the listeners understand what that is apart from just a regular pharmacist? 1:17 Sure. 1:18 So Pharm D stands for doctor of pharmacy. 1:20 So a while back, pharmacy school, before they implement the degree of doctor of pharmacy, they have registered pharmacists. 1:27 So that's shortened as RPH. 1:30 RPh and PharmD go through the same pre-pharmacy courses, and they go to the rigorous pharmacy-school program.
What a PharmD and Compounding Pharmacy Do 1:37 However, registered pharmacy stops at three years of pharmacist school. 1:41 Pharmd goes through that extra one year of clinical rotations when we do a lot of the clinical setting. 1:48 where we are an integral part of a patient health team to help come up with treatment plans for the patient. 1:57 So I feel that that one-year clinical setting really helped me in this setting as a compounding pharmacist today. 2:05 Okay, great. 2:08 Another question I had for you is, can you let everyone know what a Compounding Pharmacy is? 2:16 So compounding pharmacists, you know, we're going to compound pharmacy and we do customize medications for an individual patient that manufacture our commercial 2:27 products drugs do not meet their needs. 2:29 For example, if a patient wants a cleaner product, We can compound the capsule form like oral capsule, form and make it dye-free, 2:37 gluten- free, preservative free. 2:40 And then if the child needs a liquid, we can make it sugar free, diet free. 2:45 We can flavor it according to what flavor they like. 2:48 And an obviously preservative free dairy free not free all of that to make into a cleanup product. 2:56 Um, or if there's not a commercial product available in a certain strength, compound it into needing whatever the strength that they need or the dosage 3:05 that you need. 3:06 and also compounding pharmacists, what we do is medication review. 3:10 We work with the team to come up with a treatment plan for the patient. 3:14 And we do it to collaborate, we collaborate with providers to kind of work the treatment plans. 3:21 So compounding pharmacists do collaborate a lot with provider and the patients as a triad relationship. 3:27 I love it. 3:29 very grateful for pharmacists because there have been times in my career where I have recommended something and the pharmacist would give me a call back 3:38 and say, oh, by the way, this patient is on this medication and that interacts with this medicine. 3:46 And so that accountability and like you said, collaboration is very, very helpful. 3:52 So in the last year, The other thing I think that is so unique about you is that you are certified through the American Academy of Anti-Aging Medicine 4:03 and also through The Institute for Functional Medicine, and those additional certifications give you the framework from a functional medicine standpoint 4:14 on working with patients to just understand the processes and the reasoning behind why functional providers do things a certain way. 4:25 So I'm exceedingly grateful for that on a daily basis when we work together. 4:31 All right. 4:32 Thank you. 4:33 Yeah. 4:35 So I wanted to take a little bit of time. 4:37 There's been a lot in the news over the last year about leucovorin, and leucovorin's has been around for a really long time, 4:45 so if you were explaining to someone who knew nothing about lucovorine, what would you tell them? 4:54 Sure. 4:55 So leucavorine is known as folic acid. 4:58 It is a bioactive form of folate. 5:04 You know, not like the ordinary folic acid, it bypassed many conversion steps to give that folate for the body to use. 5:11 So if I'm explaining it to a mom or a parent regarding folates, I just say your child's brain is fueled by fola. 5:20 And so if there is a deficient in foli, they may not be able to do the regular central nervous system communication like, 5:28 you know a regular child. 5:30 Oh, sorry, my headset keep falling off. 5:33 And so the Foley, what it does, it builds neurotransmitters in a support myelination in the central nervous system.
Leucovorin, Folate, and Cerebral Folate Deficiency 5:40 So, and LucaBorne is FDA approved for a condition called cerebral Fole deficiency, ACFD. 5:50 And what is does is in theory, autistic kids tend to have issue with not having enough Folee in their brain. 6:00 where CFD, you don't have enough Foley in the brain, but you have normal blood Foly. 6:05 So that's the condition that leukoboron is FDA approved to be dispensed for. 6:11 Now there's also another condition, that is called a threat. 6:15 Fole receptor alpha auto-antibodies. 6:19 And so you go through that test and if the patient tests positive, That means leukovorons can be very beneficial for them. 6:26 because there are antibodies at the folate receptor in the brain that will not allow, you know, the full late to be utilized in brain. 6:34 So the patient is test positive. 6:36 There's a lot of clinical studies that, and also randomized trials that say leukoform is gonna be very, very substantially beneficial for these patients. 6:47 I kind of, give them an idea of what that does. 6:51 And you see great improvements in attention, cognition after, and then also language and also behavioral responsiveness. 7:00 In, in clinical setting, I talk a lot of parents that after they start taking the leukoborne, either liquid or capsule, just within a week, 7:08 they can see a great difference. 7:10 I presented to you a taste of a mom that texts me and she said a van, oh my God, on Mother's Day, my child came to me. 7:18 And start speaking and he was nonverbal previously. 7:22 And I was so amazed and she said it's because she got on our local warrant that she noticed a great difference. 7:28 And the father was just amazed as well. 7:30 The father said, this should be a father's day gift for me as. 7:33 Well, uh, but he started to express himself, um, you know, to them that he wants this and that. 7:40 and then hopefully in the next few months, I can hopefully, You know to hear from you, they're going to visit you again in a few and hopefully there's 7:48 going be more and more improvements from that Yes. 7:52 What's so remarkable specifically about this particular little patient is that he had been prescribed Leucovorin from a regular pharmacy. 8:04 And I believe that they were taking a tablet and crushing it and mixing it with water and they did not receive any of the benefits. 8:13 When they started using the Leukovorin that you made into the liquid for this child, it was absolutely 180 degrees from the way he had been behaving. 8:28 And observing this kiddo in the exam room, it was as if he just couldn't speak. 8:35 He was blocked, but he was listening and comprehending what we were doing. 8:40 But he could not get those words out. 8:43 So now what does the acronym PCCA stand for? 8:50 The Stanford Professional Center, Compound America. 8:54 And so they are based in Wilcrest in Texas, Wilquest Drive in, Texas. 8:57 We're very fortunate to have them in our background, our home here. 9:02 They've been around for a long time and they're a company that does, you know, API active pharmaceutical ingredients. 9:10 and, they also created their own bases. 9:13 they've, been, around, for, a, long, time as consulting. 9:17 consultants for compounding pharmacists. 9:20 And they were in the first wholesaler around when compound field actually started. 9:27 Yes. 9:28 The ingredients are extremely pure and that has been so very, very helpful. 9:34 Okay. 9:35 So Leukivorin, basically vitamin B9, a bioavailable form, folinic acid. 9:43 And it's very interesting what you were talking about the frat testing where you can have binding proteins or blocking antibodies to those folate receptors 9:54 in the central nervous system. 9:56 There's a difference between using something called 5-methyltetrahydrofolate versus folinic acid. 10:04 And if a body is still very, very inflamed, If you try using five-methyl tetrahydrofolate, you'll see a lot of anxiety. 10:13 So that's where you hear people say, well, I can't handle methylation. 10:17 I'm over methylated. 10:19 And what my clue is, is there's still a fire in this body and we have to dampen it. 10:27 The advantage of the Luke of Warren is it doesn't do what 5-methyltetrahydrofolate does. 10:34 If the body's inflamed, you don't get that kind of a response. 10:36 So just a little dabble, do ya? 10:40 And then, slowly increasing it to see how someone does, so thank you for making those clean alternatives. 10:49 And you can make liquid, like you said, a capsule. 10:53 What about a chewable tablet also? 10:57 So there's no studies on a chewable tablet yet. 11:00 And then also as well as trochee, you don't want to expose the gorgon to heat. 11:03 So PCCA has tried to done a formulation where it's a chewable and it involves like a troche you put in the mouth to dissolve in a buccal mucosa. 11:12 They said that the potency that came out is not as great, so they decided not to put it in that formulation. 11:19 Now, going back to that mom that you mentioned about getting the tablet and they crush it. 11:26 and make it into a liquid form, I see two problems with that. 11:29 Number one is the tablet does have lactose gluten, and some generic company may have dyes in it. 11:36 So I don't recommend taking the tablets and making it to the liquid for the kids, like the Luca Warren compound. 11:42 Also, some places may use a water soluble formulation to make the Luka Warren into the Liquid. 11:49 And I do not recommend that either, because Lika Warren is deactivated in water after about seven to 10 days and a lot of these patients are on it for 11:59 at least 30 days for the prescription and so it may not work as well. 12:04 So what we do is we use an anhydrous suspended phase from PCCA. 12:09 They just recently made it I think within a year or so and we used it to make leukoborne and you can make the dating all the way to three months because 12:19 there's no water substance in there. 12:21 So the leukogen is very stable in that anhydrous suspended base. 12:25 There's a difference in the formulation when the kids use it. 12:30 Yeah. 12:30 Well, I just learned from you about the longevity of this anhydrous base, so that's an excellent tool in our arsenal to have.
Why Clean Liquid Formulations Matter 12:43 All right. 12:43 And also, one more thing, the an hydro suspended is preservative free and it's sugar free. 12:49 I think the sweetener they use is monk fruit and then they also free of dairy nuts and all that stuff. 12:54 I've looked it up just to make sure it is good for our patients. 12:58 Yeah. 12:58 Yeah, so the big deal about gluten and dairy is both gluten in dairy make gluten or gliadin makes gliadorphin, casein which is in diary makes casomorphin 13:13 and those are short-chain opioids and indirectly through a series of steps not only do they bind to opioid receptors and that's addictive that and the 13:23 food industry knows it but also they bind to the cerebral folate receptors and block the ability of the benign to bind those cerebral foley receptors. 13:36 And you know, we check blood for this and you'll see one of two things, you will see greater than 20 a folate in the bloodstream, 13:46 but the patient is not on any folates in any form whatsoever. 13:52 And it just means that it can't get into the cell. 13:54 It's in blood. 13:55 Or we'll see it incredibly low, like two or three. 14:00 And that means they're so globally defeated of folate, no wonder they feel so poorly. 14:06 So we try to give the leucovorin or these forms of vitamin B9 twice a day so that there's a consistent production of dopamine. 14:19 And dopamine is just this beautiful balancing neurotransmitter between the excitatory neurotranmitters and the calming neurotrasmiters, 14:28 but also it just drives so many processes in the body. 14:33 And specifically, as you said, when we place a child on leukoborin, many times we'll see improvement in language. 14:42 improvement in presence, a decrease in their stimming and repetitive behaviors because you're giving them the folate to make the dopamine and they don't 14:51 have to do things to create that dopamine fix. 14:55 So I just love it. 14:57 I feel bad what, you know, When people say, can't this just go to a regular pharmacy? 15:07 And I use all the same arguments to just say no, it's not clean. 15:11 You're not going to get the effect that you would be getting unless you have this beautiful, clean formulation to fuel the brain and the body. 15:20 All right. 15:21 Well, another thing I wanted to bring up. 15:26 Now you're here in Texas, and so Van can provide through RoeBirds Pharmacy throughout the state of Texas. 15:34 Or if the patient flies in and if they're still in town, we'll have them go up to Roebird's to get their products before they leave the State. 15:42 And so she takes care of everyone that's here, in texas. 15:46 Another compounded formula that we find incredibly helpful is synapsin. 15:53 And I'm just going to pause because everything we do here at Hope for Healing is traditionally based on what the patient's unique genetic footprint is. 16:03 So we use something called the Hope for Healing Wellness Blueprint. 16:08 It's a proprietary genetic panel that Fagwan Genomics has allowed us to make, and everyone's genetics are unique. 16:16 If you have two or three children from the same set of parents, it's kind of the luck of a draw. 16:21 You know, you've got four different choices from each parent, so you can have a lot of variability among siblings. 16:28 So, SYN1 is a genetic marker that codes for some enzymes that help with the ability to create new synapses within the brain and also with what we call synaptogenesis, 16:47 brain growth. 16:48 And also, there's these cells in the brains called microglia. 16:52 And it helps them kind of, they're like little Pac-Men and they help clean up the brain. 16:58 So there's a patented ingredient within it, but can you kind go over what's within synapsin? 17:09 And I'd also love it if you teach our listening audience from the perspective of you as a pharmacist explaining what synapse does. 17:22 So it's a great product. 17:23 Synapsin actually was discovered back in the 1970s at Yale University.
Synapsin for Brain Support and Cognition 17:29 It was first found there, not until years later, a compounding pharmacist called Jim LaValle, he patented synapsine and it contains a few ingredients in 17:41 there including RG3, which is ginseng, it is derived from Panax genseng. 17:47 So, a neuroprotective and anti-inflammatory effect in laboratory. 17:54 And so they use that to hopefully help with the brain function and the synapses. 17:59 Then the second ingredient is nicotinamide riboside. 18:03 So that is an NAD plus precursor, and it is a B3 derivative. 18:08 NAB plus is the oxidized form of NED. 18:11 What it does is it helps with cellular energy production. 18:15 Not only that, it supports DNA repair. 18:20 And it also help with mitochondrial dysfunction. 18:23 It helps with the neuroplasticity, which means that it's the brain's ability to form and strengthen connection of the neurons. 18:32 So it is not so much of a brain grow larger or we form new region of brain, but all it does is it helps to protect, you know, 18:41 decrease down the neural inflammation and support the function. 18:45 Helps with my mitochondria and the energy. 18:49 Also, compounding pharmacists put B12 in it, and we like to ask the provider to write it the synapsin with methylated or hydroxylated B-12 because the 18:59 FDA considers synapse as an inactive drug. 19:02 So they won't let the providers prescribe it alone, so we have to add it with B 12. But it's good because B2 helps with methylation and also with nerve function. 19:13 We usually ask a provider prescribe a 0.5 to a one milligram per ml with the synapsin five or 10% and make it as a nasal spray or an oral suspension. 19:23 But we love it. 19:24 I mean, it protects the brain. 19:25 It helps with cognition, also in adults to help with memory. 19:30 You see kids having better attention and energy in general. 19:35 So synapse is a good product. 19:38 One of the best ones that we compound for autistic kids. 19:42 Yes, I think initially when Dr. 19:44 Lavalle, Jim Lavall, or I don't know if it's Laval or Lavally, when he patented that, it was used for traumatic brain injury and concussions, 19:56 and not that deficiency of SYN1, but it is just absolutely phenomenal. 20:01 So as you said, neuroprotective. 20:04 neuroinflammation and helps the mitochondria, which are the batteries of the powerhouses of cells, make ATP or energy. 20:13 So what I've seen directly is what parents tell me is that their children are able to engage in critical thinking when they've received synapsin. 20:23 And so, for example, a young man brought out, he was autistic, and he brought a toothbrush and a tube of toothpaste. 20:33 And he got his mom's attention and said, Mom, I want you to go to the store and get more of this, so that I can do this. 20:39 Brush his teeth. 20:43 and the connections. 20:45 She hadn't seen that. 20:46 So those little victories are fun things to share. 20:50 I've also just seen more spontaneous language, more vocabulary. 20:54 Much of the time when we think about people that have neurodevelopmental challenges. 21:06 It's as if they're in there and they need to be unlocked. 21:11 And I just see Synapsin and Leukovorin as just amazing, great tools to do that. 21:18 I appreciate your explanation as a compounding pharmacist. 21:24 The other thing I thought that we could talk about, just very briefly, is amantadine. 21:29 You know, amatadene is a plant-derived drug that I think came to market back in the 1960s, and initially it was for influenza A. 21:39 And I'm just going to let you talk about how you see a mantodine used, and then we can talk a little bit about some other ways that we like to see it used 21:51 or just as another tool in the toolbox to help with focus and concentration and calmness. 21:58 So I'd love to hear what you have to say about a Mantodin band. 22:03 Sure. 22:04 I'd like to thank Fagran Genomics for sponsoring our podcast. 22:09 Without knowing what your precision genetics are, you don't have a roadmap. 22:15 So please log on to our website, schedule a welcome call, and see what the Wellness Blueprint can do for you. 22:23 That's the premier and proprietary genetic panel that Fogran has allowed us to create. 22:29 Salmanteine, like you say, it was actually developed at first for as an antiviral, and then it's also being used for Parkinson's disease as well as drug-induced 22:40 movement disorders, but it is off-label use for autism. 22:43 Now, a lot of clinicians use that for impulsivity for patients, you know, in kids that have a hyperactivity, impulsivity. 22:52 What it does is it increases the dopamine activity in the brain. 22:56 It works on the neurotransmitters as well. 22:59 And besides that, it doesn't glutamate signaling via the NMDA receptor antagonists. 23:06 So it has several mechanism of actions, but it's often used in autism. 23:11 There's not a lot of clinical studies, But there was a big one back in 2001, I believe, that they did it for autistic kids and they see improvement in 23:21 speech and decreasing in hyperactivity in these patients. 23:25 So a lot of clinician functional medicine practitioners out there use amantadine as an add on for kids, especially if they have a of impulsive, 23:34 you know, acts as well as behavioral aggressiveness and things like that. 23:39 And it does help, calm them down. 23:42 Yep. 23:44 Yeah. 23:45 Now, one thing that one, thing you might want to also look at is it does really excrete it and metabolize 80 to 90%. Um, 23:53 so we need to make sure that we titrate the dose up.
Amantadine for Focus and Behavioral Support 23:57 We also looked at the renal function before putting the patients on a mantidine and also do a titration schedule to slowly increase based on their sleep pattern, 24:07 their, you know, cognition over time and their behavior. 24:12 Yeah, that explanation is very good. 24:15 I think that our colleagues in the mental health world, I thing a lot of psychiatrists use this as another tool in their arsenal too, 24:24 but if we find on our genetic panel that a child or an adult has something called GAD1, glutamic acid decarboxylase 1. It's like you said, 24:36 there's that receptor called the MDA receptor, and there are excitatory neurotransmitters and calming neurotranmiters, And glutamate is one of those excititory neurotransmitter. 24:49 And it spikes through the roof when you have head injuries, traumatic brain injuries concussions, things like that. 24:55 And a lot of times in the functional medicine world, you'll hear people for a leaky gut, they'll just say, use L-glutamine. 25:02 Well, a lotta times that will make people incredibly anxious. 25:06 And it's a tool, but for people who have GAD-1, you don't want to give it to them. 25:12 Same with their maybe an amino acid supplement. 25:15 If it has a lot of L-glutamine, it will make them crazy. 25:18 But what I hear, and we do a lots of titration, is we start at a low dose, And we have parents give about 25 milligrams twice a day. 25:31 and then do that for three days, and go up to 50 milligrams twice a day, do it for 3 days and keep going up. 25:39 Typically, the max that we use is about 100 milligrams, twice per day. 25:43 But I've heard people say, this includes individuals who are neurotypical, but they struggle with inattentiveness. 25:55 Even my children told me, She was doing dual credit for high school and college. 26:00 And she said, mom, when I take a hundred milligrams, I feel like a zombie. 26:05 But when i take 50 milligrams I can focus, i can concentrate,i can get all my work done. 26:10 I felt great.I can wrap it up. 26:13 So it's just like you said there's that, that sweet spot and. 26:18 hormesis is a word that we use. 26:21 It's like the Goldilocks effect. 26:23 We don't want too little, we don' want to much, We want it to be just right. 26:27 And I think with a lot of our medications or compounded things, that's something that We see. 26:34 So I have heard literally within a day of a child going on a mantidine, they've given it To their kiddo in the morning before they go to ABA therapy. 26:45 that's Applied Behavioral Analysis for Autism. 26:48 And the therapist said, so-and-so had a great day today. 26:52 They were much more attentive, they were a little more focused, and the parents are like, oh my gosh, this stuff is like a miracle. 26:59 So the right amount, yeah, the amount the time. 27:04 So just as an aside, so you mentioned a troche. 27:09 Can you explain to people what a Troche is? 27:11 A Troke is an oral dosage form that you put in the mouth that dissolve the medication slowly dissolve over about 10-15 minutes and you cut it between your 27:20 cheek and your gum. 27:21 It dissolves the medication through the buccal mucosa, and then it gets into the bloodstream. 27:26 And we do that a lot for hormones in general, but you know, we can compound any medication. 27:32 Obviously we have to look into formulation and stuff to make sure it is stable into an oral dosage form for them to do. 27:38 It's not so much chewable, it dissolved over time. 27:44 And as far as like topical creams and things like that, you have a lipodermal base. 27:51 Now, what is a lipo dermal based? 27:53 What does that mean? 27:55 So PCCA cream, that's one of the bases that they developed a while back. 28:02 It's called Lipoderma and you apply it into the skin and it gets under the scan goes into, the bloodstream. 28:09 And we use that a lot in pain, gel, compounding prescriptions. 28:13 And then anything that you want it to penetrate under skin, go to a bloodstream. 28:17 We use that. 28:18 Now there's other bases that we use for hormones that is tested, you know, by them and developed by then that it's specifically for. 28:27 So we just have to see what kind of drug that, we need to make, and then we're going to decide which base fits best, for that particular active ingredient. 28:37 Okay. 28:37 So there's a hormone base. 28:39 And then you all also have certain, we do this evaluation for people who are losing their hair. 28:47 We call it our alopecia panel. 28:49 That's like a hair loss panel, and then, you're also able to formulate either like an oil base or a cleaning base or a conditioner type base where people 29:02 can rub it into their scalp or they're losing their hair and they are not guessing instead of logging onto Nutrafol and saying I want this, 29:12 I wanted that. 29:13 It's not like everything works for everyone, it's unique and so having those choices are pretty cool. 29:19 I know I've called you many a time and said, what do I do about this? 29:24 What can I use here?
Troches, Topical Bases, and Pharmacy Collaboration 29:25 That kind of a thing. 29:26 So I want to thank you, Van, just for the outstanding customer service that Roebirds Pharmacy offers to our patients, especially for families of children 29:39 with autism and for some of our adults with the autism that are still, they're dependent upon the guardianship of their parents. 29:48 And also for providing just amazing, I don't want to overuse that word. 29:53 I'll just say high quality transdermal hormone bases, hormone cream bases just consistently across the board. 30:03 And your customer service at the pharmacy is so refreshing to me. 30:09 Many times I will call and it will ring once or twice, someone answers the phone. 30:14 And I just really appreciate that. 30:16 I wish I could do that at our office. 30:18 Instead, we have to go through the phone tree because there's not enough people to answer the phones. 30:23 So I find that just very refreshing. 30:26 There's a lot of pharmacies out there because of the same volume that we do also, but You know, I had the choice of making it into a voice recording and 30:39 they would just dial the options, but I'm like, no, the patient needs to get to us right away. 30:44 So I decided not to do that and just have a live body, just answer the phone. 30:49 And that's one of the things that PCCA stands out also is that when we call, they pick up the call without going through those voice recordings like the 30:57 other wholesalers. 30:58 One of things I want to add also regarding PCC, you asked earlier, We do work with a few wholesalers. 31:06 Now all of those wholesailers are based in the U.S. 31:09 and we only selectively pick certain ingredients and bases that we use and use all bases from PCCA. 31:15 But what I like about PCC or a similar wholesaler is that, we make sure that they go through their in-house third party testing before the powder gets 31:24 to us. 31:25 And that's very important because the certificate analysis of these ingredients in bases are super important for us to look at to make They pass the potency 31:34 that they say, they pass a microbial load, and then also certain testing for endotoxin, things like that. 31:40 Because if they don't do any of those testing, you don' know what you're putting inside your body or on your, yeah, for a long time being on these drugs. 31:48 And all these kids and adults that you are seeing, They do want cleaner products because they're pudding inside them. 31:55 They want to detox. 31:56 If you not reusing the right product, your putting more toxins in your. 32:01 So that's extremely important to us. 32:03 you know, for our patients. 32:05 And I appreciate you as well in your clinic because I see the challenges you're going through every day, you now, helping these autistic children as everybody's 32:17 body is different. 32:17 So they're sensitive to different things. 32:20 As you proposed one thing, You've got to customize it to the child. 32:23 You got a tweaking, adjust it according to how they respond. 32:27 If you don't do it right, they may have side effects. 32:29 Like you say that hormesis, That, that, you know, we talked about too much is not good. 32:36 Too little is good, so everybody responds to different things. 32:39 So you just have to start somewhere and adjust it. 32:42 And the patient just has to be patient, or the parents just to have be patients. 32:48 Majority of the time we get lucky and the kids feel better right away, and sometimes they're not. 32:53 Use our pharmacy is the first, they can call us anytime to ask any questions. 32:58 If we have any challenges whatsoever. 33:00 will represent the problem to you, but we are here to advocate for you and the patients. 33:07 Yeah, well, we're exceedingly grateful on a daily basis. 33:12 And also, as our team of medical providers at the office, the freedom to call and ask you or Mary or some of the other pharmacist questions, 33:21 it's so very helpful because there are just these details and things that we just don't know or that we need you to look in your database to see if there's 33:32 any interactions or other things. 33:34 I know patients ask me, can I use this? 33:38 And I'm so grateful. 33:40 And, I looked it up and I am like, no, you shouldn't because you're on this blood thinner in this particular supplement that you are reading about on social 33:49 media thinking, oh yeah, should use it. 33:52 It's contraindicated and it could lead to spontaneous bleeding and problems and things in you own body. 33:59 So, that's what you do for us as a pharmacist. 34:04 And so, all right, the chemistry lab or the symphony of our bodies. 34:09 So well, Van, thanks again for helping answer some of these questions and for talking about leukovirin with me, synapsin, 34:19 and amantadine. 34:21 and how these particular medications can so uniquely affect the body. 34:26 And you know, before we go, I just find it so interesting. 34:30 Many times I have people that come to me and say, well, it's a drug. 34:33 Don't you want to do things without a drugs? 34:35 And I'm thinking, these are so safe in many ways. 34:39 It's so much safer than, say an antibiotic, for example. 34:44 If you look at what an antibiotic does, yes, it'll kill the infection, but it can disrupt the entire gut microbiome and the longstream effect of that and 34:55 trying to rebuild the gut micro biome. 34:56 So, you know, there's a time and a place for everything. 35:00 And especially when we can drive our medication prescribing with precision. 35:08 And so thank you for being a part of the team and so very, so, very important for educating and reiterating certain things because repetition is the key 35:21 to learning and I'm so grateful for RoeBirds. 35:24 So thanks again, Van, for on today. 35:27 Yes, ma'am. 35:28 But thank so much for having me on. 35:32 Right. 35:32 Well, take care. 35:33 Thank you. 35:34 Thanks for joining us at Get to the Root with Hope for Healing. 35:39 If this episode helped you, follow and share it with someone who needs it and leave a review. 35:45 It helps others find us too. 35:48 For a free consultation, visit our website at gettotheroot.com with a number two and schedule a welcome call. 35:55 We'll see you soon.
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