331: Resiliency Radio with Dr. Jill: Immune Resilience: The Future of Longevity w/ Dr. Isaac Melamed

Hey everybody, welcome to Resiliency Radio, your go-to podcast for the most cutting-edge insights in integrative and functional medicine. I'm your host, Dr. Jill, and with each episode, we dive into the heart of healing and personal transformation. Join me as I interview medical experts, thought leaders, innovators of all types helping you on your journey to healing and optimal performance. Today is no different. You will want to stay tuned if you have any questions about the immune system or IVIG. We're talking to one of the world's leading experts and my personal immunologist, Dr. Isaac Melamed. I'll introduce him in just a moment, but I promise you will enjoy this show. If you haven't yet, um, liked or subscribed, please hit that button. It helps us reach more people. We're just about to a million subscribers on YouTube. Leave us a review and hit the bell to be notified of future episodes. 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You can do a free introductory call with one of our providers, 303-993-7910, or email info@flatironfunctionalmedicine.com. Okay, let me introduce my colleague, Dr. Isaac Melamed. He's a nationally recognized immunologist, physician, and researcher with more than 35 years of clinical experience and over two decades dedicated to advancing the understanding of immune-related diseases. Founder of Vera Health, he's known for his pioneering work in primary and secondary immune deficiencies and the critical connection between the immune system and the nervous system, which we're going to talk about today. He has authored more than 100 scientific publications, lectured internationally, and received numerous honors for his contributions in clinical immunology. Let's welcome one of my favorite people in the world, Dr. Isaac Melamed. Dr. Melamed, you have been a very special person in my life because you have been my personal immunologist, and I say this very publicly, so often I really believe you've been part of saving my life after cancer and all the things I've been through. So, you have a very special place in my heart because the complexity and fascination with the immune system is so profound, and you are one of the few brilliant physicians who I feel really understands and continues to learn and study and pull in all of the things that we're finding out about the immune system. So, today we're going to talk about that. But, before we jump into the immune system, I want to know just a little bit about you and your personal journey into medicine and then into immunology. >> So, that Thank you, Jill, and it's my honor to help you and many other patients that what I'm doing for almost 40 years. Um how I started my life, um I you can see from my accent that I was born in Israel. And in Israel, you have to go to the Israeli Defense Force. I was lucky that I went to medical school before, and I served as a physician in the army. And in the last two years um of my army, I was involved in research. And um I my plan in medicine was neurosurgery. I started when I was 15 years old. And um and one of the question that they >> [clears throat] >> presented to me while I was in the army, so soldier with splenectomy, how's the immune system after splenectomy if they can continue to serve? So, I tried to figure who's the expert in immunology and splenectomy and then found my mentor that passed away and his name Professor Shapiro. And I can say that definitely his mentor in terms of how to approach patient for many, many years. And he is as a mentor as he said, "You know, Isaac, you really need to go to to be my successor in immunology." We end up he sent me to uh Canada to Toronto to continue one of my fellowship. And actually in Toronto when I started to work on the immune system with the hope to get back to Israel, the chairman from uh in Toronto just moved to National Jewish. And he said, "Isaac, before you get to Israel, just be in National Jewish for another 2 years." And the reason I came, which actually is the introduction for what I like to discuss with you today, is that I found two kind of a major area in the immune system. The first one, find a receptor that's called NGF, which is nerve growth factor. And I found that this nerve growth factor is existing on the immune cells, on B cells. And actually more than that, we found that there is a genetic mutation of patient that it's called CIP, which is CIP A, which actually it's a summary of congenital insensitivity and pain. And this mutation of this NGF actually started for me a journey, a 40-year journey, of two major stories. One of them is the cross talk between nervous and immune system. And the second one to try to look at the immune system as a core uh mechanism to different disease that I will share with you today. But the chairman of National Jewish the chairman from Canada moved to National Jewish and he say Isaac just come to National Jewish to be an attending in the National Jewish and I came. Just as a personal disclosure my son started medical school and he's a neurosurgeon today and the family decided to stay in in the in Colorado. But I switch my being just in academic life to a private which we develop over the last 40 years. And there are two I will say key element from the story that I share with you Jill. As I mentioned one of them is this NGF that's crosstalk between nervous and immune system. What's the meaning? >> Yes. >> The second one is that the immune system is a core that for our discussion today because if you look at the mainstream medicine today one of the challenge of mainstream medicine today is actually it's a very this it's it's a health care that really focus on your symptoms and your organ. So if we speak about disease that can be chronic fatigue if we speak about disease as pain if we speak about cognitive changes the approach is how we can help you with the symptoms. We all know in United States we are dealing with an epidemic that cause pain and the answer is opioid. >> Yes. >> And the question is what's the underlying for the pain? That's kind of the question. And then so that's took me kind of this crosstalk between the nervous and immune to the question is what's the cause? What's the underlying disease? And as my I will say focus is immune system I focus on the immune system as a core. The immune system as a presentation actually We are talking about three major presentation. One of them is in the infection history. The second one is in the autoimmune or inflammatory condition, and the third one is in cancer. >> Yeah. >> And you just discussed Jill in your uh patient journey that as a patient disclosed it with all the audience. This is unfortunately a story today in 2026 that we do have patient that going almost 20 years in this journey. >> Yes. >> It start with cancer or infection and autoimmune disease. And and the reason is that the medicine today maybe it's going to change with AI. AI may be a very sophisticated story to try to bring all of them together to look at the cause. But today we are very very focused on the symptoms inside. So that's how I started my journey. Um and another thing that I like to share with you, which is kind of interesting for the history. >> Yes. >> One of the physician, Jim Jones, that has been in National Jewish that is a faculty um and being sharing a room with me, and he told me, "Isaac, I don't know why, but everybody with chronic fatigue syndrome does have allergies." And that's what I like to share with you, Jill, today that when we say the definition of immune system, >> Yes. >> what we see today and what's unique today is actually the partner of the immune system. I really like to really emphasize that when we say immune system 20 years ago, 30 years ago, in terms of B cell and T cell, that's the only player. And now we say there's some other partner. >> Yeah. >> And long time ago, when he mentioned that chronic fatigue is connected to the allergies, 30 years fast forward, I would say that the allergies as a partner of the immune system is a key story in some evolution of how we look at disease. When you ask me about what's the role of mast cell activation, >> Yeah. >> what's the role of EDS in terms of the immune system, what's the role of disease that we call them angioedema, and then my answer is that all of them connected because the immune system is not fragmented. Right. It's specifically that they talk with each other, and the beauty is to look at all this symphony and to divide it in three category in the immune system. One of them, which is a challenge, is what are the epigenetic trigger that leads to the activation of the immune system, what's the partner of the immune system that respond to this epigenetic, and the consequential this interaction is basically what we call it today the consequent, which is autoimmune disease, cancer, or infection. And I will use one of the disease that is the most common immune deficiency, but the most unknown immune deficiency today. And I would like to quote a sentence that can represent what I'm trying to share with the audience. It's a disease that we call it CVID or common variable immune deficiency. And this disease is actually the people describe it is an old disease with new faces. >> Yes. >> What are the new faces? The new faces that we are the talking today is we see some new faces that they present with a different presentation. You can see patient that I see that present with autoimmune first, >> Yes. >> and then the infection. Some people can present with cancer that have leukemia and then infection and then autoimmune. So, the new faces is the evolution of the immune system in presentation can be over years. And one of the challenge is that actually even you speak about physician, there's no training or there's no fellowship that's called autoimmune disease. >> Right. >> It's a disease it's kind of a looking at different disease from an eyes of an immunology and try to understand it. And that's what I've been doing for 40 years. >> Hey guys, just a quick interruption to this incredible interview with Dr. Melamed to remind you that my book Unexpected talks about my own journey through my strange immune system with cancer, Crohn's disease, mold-related illness, and all of the things in between. It's a deep dive into a true immunology case like mine and I often get comments from patients that it was encouraging just to help them on their journey. I share a lot, I share deeply, I share authentically about all areas, spiritual, physical, emotional, and healing on all levels. And there's practical tips if you're suffering from autoimmune disease or immune deficiency or anything in between. So, check it out. You can get a copy at readunexpected.com. You can get one on Amazon, anywhere books are sold. And if you want a signed copy from me, go to drjillhealth.com. Okay, back to our show. Amazing how you put that together because and again, I don't mind sharing my personal history. I've talked about it before. So, anything we want to share here that's relevant because I am a prototype of this having had cancer at 25, multiple autoimmune diseases, Crohn's and Hashimoto's thyroiditis, and other autoantibodies, and then also multiple infections that have been under control with your treatment and the IVIG. But what's interesting is like you mentioned, we can have this present any number of those could be the forefront, the first thing that we see. And what's in in some ways kind of counterintuitive that you would have an overactive autoimmune attack of self and an underactive, maybe T or B cells for fighting infection can all occur at the same time. Can you talk a little bit about what we know, the state of the research as to what might be some of the mechanistic causes or um besides just genetics, are there other things that are contributing to this in our patients? Is it increasing in in incidence? >> So, first of all, it's a great question and in kind of a quick answer, there's a lot that we don't know. >> Yes. >> And we continue to explore. I will share with you um first in terms of uh as a patient that you just disclosed. >> Yes. >> And I always remember a lecture that was in Budapest. And there was a lawyer from England, very similar to your story, very very similar to your story. Again, Crohn's disease, cancer disease, and autoimmune and autoimmune that you have. And what she done was diagnosed with immune deficiency 20 years later. And she described her condition as a prison of her disease. And the problem on this, and I think this sentence always for me is a huge, I would say, drive force to try to help the patient. And I say, "How can I help you to get out of this prison and to get seen?" Because it's kind of the the challenge is, and I will share with you somewhere we're going to the research area, but there's a lot of, I would say, area of um timing between science in medicine, practice of medicine, >> Yes. >> and also insurance companies. So, the vision of some of in the American community, some in the insurance, some of the patient, there's a lot of kind of a not clear. And uh and one of the question that we always have to ask ourselves and we may come to this later is what do we we feel is the reason that some of the impact of autoimmune disease and longevity in United States is different from European and different from other states? What what is the role of the immune system in this discussion? So, go back to your first question is where the science is going today. I will start with the research that we are involved in the last almost 15 years in terms of the symphony of the immune system in one major question that we have. >> [snorts] >> And that's the interaction between I I like to use the name infectious and immune >> Yes. >> in various autoimmune or neuroimmune. And I think that the model that I'm talking about this interaction between infectious and immune in the science it actually started long time ago and there's a paper in 1926 we're talking many years ago. And that was in related to a child, a teenage that has been exposed to strep infection and develop some tics and some movement disorder. But in the same time develop some type of psychiatry in terms of anxiety and OCD and depression. That was many years ago. Then the concept of Korea has been described connected to the strep. Fast forward, we've been talking about EBV and the connection of EBV to chronic fatigue syndrome. >> Yes. >> One of we are my um organization has doing a quite an extensive collaboration with Stanford and with LSU in New Orleans. In Stanford there is a very famous scientist named Larry Steinman and Larry Steinman is looking at the connection between EBV and the immune system leading to multiple sclerosis. >> Mhm. >> Which is unclear that multiple sclerosis is an autoimmune condition and all the therapy that we have today is really try to target some of the uh lesion but not really to understand the immune underlying disease. So, when we speak about the connection between EBV and the immune system, almost 30 years of research and we are not clear. Then we came to the COVID and the COVID actually has been leading with a high percentage of patient that develop multi-organ effects specifically with neurologic symptoms. And those multi-organ can be cardiac and joint, pulmonary, and GI. And the question is, is this uh COVID is one of the interesting interaction between infection and immune that leads to pandemic of autoimmune disease specifically neurologic symptoms. So, all the connection between EBV and COVID and there was a lot of work and discussion about Lyme and post-Lyme and immune system. >> Yes. >> And by by various research. So, this interaction between infectious and immune system is one of the research that we are working. And part of the work that in the research we also explore that it's not just the B cell and the T cell. >> Yes. >> We do have some other partner that we have seen involved like what you just mentioned, the mast cell activation. >> Yes. >> Like the complement system that we have. Like alpha-1 trypsin that we've seen. And we've seen some in- some other player like the innate immunity. >> Mhm. >> So, the innate immunity, the I N N A T E immunity which was an immune system including the complement that we basically ignored it for years and years and years we say yes, but it's a very basic immune system that is really a core in our future research and why? >> Yes. >> The reason is that if we speak about an immune system I want to bring two kind of the area of the research that are relevant to our store. The first one is the question is that this relationship between infections and immune system does it play a major role in some autoimmune disease, but what is the relevant in terms of longevity for example? And I will give you one example. Is why do we give a vaccine against shingles as you get older? And the answer is that your immune system that has been educated how to respond to the shingle is losing its mind or losing its memory to the shingle and suddenly you need to renew the shingle the vaccine and to re-re-educate the immune system to this vaccination to the shingle. That's a memory defect that depends on the innate immunity that lost the immunity to the shingle but this loss of the immunity to the shingle can happen to you earlier in life. >> Mhm. >> And I defined it in one of the paper I published, I used the name Alzheimer of the immune system. >> Ah, brilliant. >> And and and the it's a very interesting because a paper just recently published about they say and they saw that people who get the vaccine against shingle has less incidence of Alzheimer and we will come back to this connection that serve with Alzheimer. So I saying that our research is trying to understand that actually the innate immunity respond to different type of epigenetic and what are the partner that may lead to this Alzheimer? If it's the complement, if the mast cell, if the alpha-1-antitrypsin, and part of this dysfunction between the infection and the immune system is actually leading to this area that we have interest, which I like to call it neuroimmune. >> Yes. >> So, I'll give you a few example in the clinical setup. The first one is actually this paper that was published more than 100 years ago on the Korea and the children with type of anxiety and even in this paper he mentioned increase in suicide um attempt. So, 10 years ago, um we started to get explore to a condition that we see in teenage and children. And the story with the children is that they get sick. And after they get sick, the mother is telling, "You know, it's not the same child." >> Yes. >> I know my child. This is not the same child. And the child is getting anxiety, the child is getting tics, getting OCD, he doesn't want to school, he gets in the middle. And the first response that I want to mention it to you, Jill, and this is what I'm trying to teach new residents and new students, and I try to teach them something that from me being 40 years in medicine and for there are few things that you know. When somebody when the mother is telling you a story and he tells you, "Well, this is my child." Just listen to the mother. The mothers knows the child better than everyone else. Even that you are physician and if you don't know the answer, it doesn't mean it doesn't exist. It just mean that we just don't know. We need to do more research and we need to understand. But don't tell the mother it's just in your head and and it's not an issue. It took me many many years and we're doing quite a lot of research with as I mentioned with Stanford and with um Dr. Frankovich and Dr. Verso passed away in this area. And the point is that what we try to understand if this connection between strep and the immune system leading to some psychiatry is the immune system is involved. And fast forward for almost 10 years of research, the answer is yes and we found in the research that basically what happened we do have the interaction between the infections and the immune system. And that's what I want to go back to what I share with you. One of the failure most probably is the innate immunity which we evaluate it's called toll-like receptor that we look at the signaling of toll-like receptor. And we see that the TLR is actually low in the patient with infection. And as it is being low, what happened is the immune system is producing pro-inflammatory mononuclear cells. So there is in the immune system a balance between pro-inflammatory mononuclear cells and anti-inflammatory mononuclear cells. So basically when you do have this interaction between the infection immune those pro-inflammatory cells are over activated. We see now that they are moving to the brain to the blood-brain barrier. So those type of mononuclear cell can affect the permeability of the blood brain barrier. >> Mhm. >> And from the blood brain barrier, they are getting to the microglia. They're affecting the microglia. And we see that using IVIG, for example, that knows how to immunomodulate the system, those anti-inflammatory monocytes get upregulated and able to reduce and get the balance. And that's how we see the clinical response and But that's The point is that I want to share with the Jill that this is science that speaks about an interaction between infections and immune in the straight condition, but presented with a psychiatry world, which is anxiety, depression, and OCD. And as this patient mentioned so many years ago, which is suicide. >> Yes. >> Which brings a question to the scientific world. And there's a lot of science that we are involved in all other places in the world from different psychiatry that speaks about a condition that we define it psychiatry, which is depression, anxiety, and fatigue that actually it's an inflammatory condition that the immune system is involved. And we just need to continue to understand and research and how we can model it. So, that's one area that uh we've been in in our relationship between infections and immune. The second one that I want to mention in our research is actually this the COVID and the interaction with COVID and immune system. And here we really evaluated few partner, which is the complement system and um other system of the immune system that as I mentioned the alpha-1 antitrypsin and the innate immunity. But the end results now brings to a very interesting um panel that I think that the future is is the cognitive changes and all what we see in the cognitive and the deterioration to the disease like Alzheimer and the cognitive change is the immune system is involved and I think that the answer is yes. Some of the area that we don't understand but more science is coming and more and more that it's coming uh to the concept that we use the name mitochondria and that's the mitochondria that we are bringing to the picture is is just imagine that you have the innate immunity that as like a bridge that is trying to support all the different epigenetic and you know very well because you describe it many well and you doing much better and describe it the innate immunity about the stress and epigenetic that and nutrition and other component that lacks in the innate immunity and as a failure we get some inflammasome or we get some inflammation area that's affect the mitochondria and affect the mitochondria and suddenly a paper that just published in nature by my corporation in LSU that showed that those mitochondria injury and fragmentation can actually move and lead to some of the effect on the cognitive. So that's all those are the area that in the neuroimmune is focused on my research from as he described it I like to describe myself as a translation medicine taking the patient story and going to the science and try to get some answer. >> Wow, that was so much great information and what I really love is you're also teaching medical students and residents to really listen to the patient and the mother because I know in my own journey of being a physician, so often if I'm just curious and I listen, even if it doesn't make sense from the training, we can start to learn because we're like, "Huh, that's an interesting pattern that we're seeing. Let's look deeper." And then what happens is over time we start to find the reasoning, which you just described, you know, way back in the day, early days in the 1920s of first describing this neuro psycho-neuroendocrinology and the connection between Um so, one thing that I think patients uh suffer from is there's inflammation in general and then there's um weak immune system fighting infections and then there's also um autoimmunity. Uh and the one of the big tools that you have used is IVIG, which is um intravenous immunoglobulins. Can you tell us a little bit about the story and the history of IVIG because I feel like you're one of the world leading experts and it can it's not always the uh answer, but many, many times it can be very powerful. >> Sure. Um first of all, I like to talk always I compare to the patient the IVIG to red wine. >> Uh-huh. >> And the reason I compare it to red wine is A, we start with the same grape >> Mhm. >> and end up with a different wine. >> I love it. >> What happened between the grape and the red wine, we just don't know. >> Yes. >> And and the research of IVIG has been almost more than 35 years and some of the leading research that we collaborate to try to understand the mechanism of IVIG has been going for almost 35 years and the beauty is that this is nature. I like to call it holistic nature that produced the IVIG and we really don't um understand and I will share with you um a first of all, what's IVIG? So, one of the thing that if we look at the immune system, um I like to kind of uh speak about a little bit for for all the audience. Some part of the basic mechanism of the immune system. And um, the immune system actually, if you look at the cell, you can imagine that the cell has some membrane, which is the cover of the cell. And it has a nucleus. And what I published many years ago that actually even the structure of the cell, which is called cytoskeleton, plays a role in transition of signal. So, just imagine that you have a cell and you have a cover of the cell. You have the nucleus in. So, the signal between the membrane into the nucleus, which we use the name signal transduction, this has been the focus on research almost the last 40 years. And um, many many protein involved in this transaction of signaling from the membrane to the nucleus. But the end result of this journey that takes only few minutes from the membrane to the nucleus is the end point of two major thing that I would like to which I think it's basic. One of them we use the name apoptosis. So, the name apoptosis, just imagine that every cell in our body supposed to die. This is the nature. And the cell needs to die and to rejuvenate with a new cell. So, the process of rejuvenation, it's a normal nature process. As we get older, this process, which is controlled by the immune system, is getting weaker and weaker. And as the apoptosis process get weaker or dysfunction, you basically end up as a result to an inflammatory consequence. Basically, just imagine that you have a very long his journey that the immune system supposed to clear the junk. Let the inflammation. And it doesn't matter if the junk or inflammation is the skin or it's in the joint, or it's in the brain, or it's in the cardia, or in the in your any organ, it's the same process, inflammation process. Then the second story from the membrane to the nucleus, it's the signal that leads in the nucleus what we use the name activation. So, activation of the nucleus, it has about few, at least seven that we know today, but maybe more, which it's called check and balance. >> Mhm. >> So, the immune system is doing check and balance on this activation. And sometimes that you get some dysfunction in the check and balance, that's what you end up with cancer. So, you see two major process that we call apoptosis and activation of the cell controlled by the immune system. Now, all this what I share with you, which is a very complicated and continue on the research, start most probably in some receptor that sits on the surface of this membrane. And some of this receptor sitting in many different cell. And this receptor has a name FC. So, this receptor is called FC receptor. So, just imagine it to for simplicity, so this FC receptor is like a key. So, now you have a relationship of a key and a lock relationship. So, if the infection is the is the key, and this FC is the lock, you have a key and a lock relationship. So, suddenly the relationship between the key and the lock are dysfunction for some reason. So, now what you do, you take an IVIG, which is build the same story. IVIG also has an FC receptor. And this FC receptor is coming to this FC receptor that you are in this dysfunctional immune system. And one of the mechanism can be in this dysfunctional reason, it has a name, it's called mimicking. >> Yes. >> So, what's a mimicking? The mimicking is that let's use what I discussed a little bit before on EBV. And let's say that your FC receptor, which is the lock, is looking at EBV as a key and says, "I want to produce a good relationship, but somebody is get confused." Yes. So, instead of producing a um [clears throat] response to the key, is doing a mimicking and producing antibodies again your brain, again your joint, again that's what we call autoimmunity. >> Mhm. >> So, now the FC is coming to this receptor and try to train the FC how to behave and how to really produce the antibodies in a normal way. That's one mechanism. Second mechanism that has been as a potential, if you look at the key and the lock relationship on the FC, so basically the FC suddenly from key and the lock become a master key. >> Yes. >> So, now instead of one key, you have master key. All the keys are the same. So, the key can be opened by this EBV as a key can open all the keys. And then we use the name super antigen. So, this super antigen leading that we use it in the immunology, in the post-COVID people are using a lot of the name which is called cytokine storm. >> Mhm. >> What is cytokine storm? Is basically imagine that the immune system producing an inflammatory storm. >> Yes. >> And this inflammatory storm can be an autoimmune, joint, brain, and cardiac, and etc. So, then the IVIG is coming and training this key to behave and not don't be a master key, just be a So we're using a name in the IVIG, we're using a name in two property. One of them that it's used immune replacement, >> Yes. >> prevent infection and immune modulation. And the immune modulation, what I share with you is trying to really modulate the immune system. And and I will share with all of you many of the area is that even that started, I'll give you two example here that happened and I was involved actually 40 years ago in the research on both of them when I was in Canada with the rheumatology team. The first disease that I would like to share with you is called Kawasaki. >> Mhm. >> And the Kawasaki story is mean in the 80s. And the Kawasaki story, we saw children that had some exposure maybe to infection, we're not clear. But they showed a full autoimmune inflammatory skin and joint and high fever. We had no clue what is going on. There was a lot of speculation in the 80s and research in different and people tried to do steroid, people treated, we had no clue what is going on. And when we've been in Canada and and was a good immunology rheumatology team together, we say maybe it's an immune related is maybe. >> Yes. >> So we use IVIG as a as a holistic approach. If it's an immune system, let's use it and see what happen. We gave the first infusion of IVIG and immune modulation and and I will never forget the child who was with a high temperature, with joint, he's been overnight is getting better. >> Wow. >> And so IVIG now it's a been a treatment of choice. Now I will share with you one interesting story that happened. So, we gave the IVIG to the Kawasaki, but not everybody agree and not everybody So, years later, maybe 10 years later, we have seen teenage that playing basketball and they suddenly fall and die from cardiac arrest. >> Mhm. >> So, children has been dying from cardiac arrest and nobody could understand why. So, the science went back and found the children that died from cardiac issue actually had Kawasaki early age in life >> Wow. >> and never been treated with IVIG. >> Yes. >> So, what interesting is that the immune system doesn't stop with the Kawasaki, it just it continually lead to some cardiomyopathy and cardiac issue. And now, it's a mandatory when you have a Kawasaki to treat you with IVIG. >> Mhm. >> You'll ask me, Jill, do we know what is the actual mechanism in Kawasaki that happened today? We don't know. >> Yeah. >> But what I'm trying to say is not only is the full science will give you all the answer. >> Yeah. >> The question is that we like to do is to try to figure if the immune system is involved. And now, it's a mandatory rule. The same happened about the pandas. The other example would also happen in Canada and I will never forget it. That's another disease which we call Guillain-Barré. >> Mhm. >> And Guillain-Barré is a disease that you get exposed to an infection, unknown infection, and you get paralyzed. You just get paralyzed. So, you're speaking about the connection between infection and immune system that the paralysis. And IVIG has been shown to really the recover all the neurological doing. It's a mandatory now in Guillain-Barré. But still, we don't [clears throat] understand the mechanism of the IVIG in gambling. And it doesn't mean that it doesn't work. So, I think that IVIG that I am looking at IVIG is in two kind of a statement. >> Yeah. >> Is your disease immune? >> Mhm. >> And we will do all the efforts scientifically with all the signs that we are trying to understand who are the player of the immune system. And I think that that's a beauty. We are going to learn more and more about the immune system. And then to try to have the tool how to do the immuno rehabilitation. And IVIG is a is one of them. And now there are many interesting because the prediction that we are going to see what I call biologic therapy in all immune related there are flaring because the immune the industry is understanding that the immune system is a key player. >> Mhm. >> So, now you have so many new biologic that really focus on the immune system. In the allergy world, and if it's an asthma, if it's hives, if it's a chronic hives, if it's any disease that's affect the connection between allergies and immune system. And so many in the area of angioedema and so many other example. And the other area that we are going to see more and more in the future is the concept of cancer. >> Mhm. >> And the immunotherapy in terms of the cancer. The second I would say protein in our body which is a very interesting body that all is well needs more research and more understanding, but I like to bring in to your question on IVIG is called albumin. And I think the albumin is another interesting protein that sits in your major plasma. And the albumin has many interesting binding sites to the And those binding actually seats is a nature issue to say, "Okay, I understand that your immune system is not doing so well. >> Mhm. >> You're getting old. You are your immune system is not doing well as you would like to see. And the end result is this inflammation that we discussed. So, we are bringing the albumin is produced and circulated and continuing with the binding site to get and get your bind get get all those inflammatory that I just mentioned from the mitochondrial failure and the inflammation failure and really get all of them clear and get them clear from you. And the albumin is also a been target in terms of research to say, "What can be done? Let's speak about super albumin. The albumin has more binding site. The albumin is more effective. And there was a kind of a very interesting paper in the New York magazine New York Time magazine about albumin in terms of our body is like oil change. You are basically this is the oil that you need to change your machine. And this is a world that has been involved. People have been using it today in longevity or other reason in normal that we have. >> So, that's a perfect transition to talk about something that you and I've been really excited about is bringing some of these services. What happens and maybe you can speak to this as well as there are certain covered indications for IVIG and unfortunately I think a lot of the indications that may have use are not always covered and I know one of your things in your clinic is for the patients who really need it. For example, a Crohn's or colitis patient that isn't a typical indication for IVIG, but you and I have shared several patients who have benefited from the indication and if it can get covered. So, one of the things with plasma exchange with albumin or IVIG or even um IVs with vitamins or nutrition or glutathione. We have both seen a big need for these offerings to patients to be able to pay for the kinds of things that they want to get. And I'd love for you to talk just a little bit about your vision and and what we sat down and had a a discussion about your legacy, which I really love because I think no greater thing than we leave a legacy in the world. And I I really love your heart around this in creating a whole new entity for providing these services for patients who want them. >> No, thank you uh Jill uh for my your nice work. Um I think that the the are two few area that I like to focus when we mention >> Yeah. >> what I'm doing for so many years and legacy. I think that number one issue is the patient that I see and I feel that they are frustrated um in terms of the complex. But let's speak about I'm saying three major area today >> Mhm. >> that we see uh that there is some challenge in health care. And we can speak about number one is pain that we can speak we can speak about cognitive deterioration. >> Yes. >> And we can speak about a question is why we still see the story of depression and suicide. >> Mhm. >> So just my granddaughter that she is in high school and she's 16 years old just called me 2 days ago about a child 16 years old in her high school committed suicide. And just four kids in her high school committed suicide. So I assume that the question is >> Yeah. >> from medicine standpoint is that I brought all those three area that we have. >> Mhm. >> From a concept is we from my approach is to try to understand the role of the immune system in the three area that I share with you, which is the pain, the psychiatry, and the cognitive issue. And when I say the immune system, the immune system is not an isolated everything that I share with you. The complexity of the immune system is something that we need to learn and to research and to understand and to work with the manufacturer to develop some new drug and new super algae or super albumin and to try to help the patient. But in the same token is what you are contributing and that the huge interaction and complement with you're doing and we're trying to do is I always compare it to the gun. The gun can be loaded with your gene, but if you don't trigger the gun, it's not be active. So, the trigger is that we all speak about the epigenetic that >> Yes. >> I can talk about them, but you are the expert and and them how to really do it. So, we all agree that this immune system is really and the gene that you have is really responsing very very intimate to stress. >> Yes. >> Very intimate to all nutrition, very intimate to your physical activity, very intimate to the sleep, very intimate to the other environmental if it's a mold or other environment. All of them are very very important over the time and a very important is to discuss how they work with the immune system and more and more study to have and discuss. So, this epigenetic is a key element in terms of the complement that the two of us can do to understand the interaction between epigenetic and immune. We'll do our best to understand the immune system and I think that the cellular immunity, the mitochondria immunity, the the player of the immune to understand it's just the diagnostic the next years that we'll have more and more to information. And the next one that is very important I think that all what I mentioned to you, that the pain and the cognitive change and the psychiatry, I think that the approach that we need from a patient standpoint to listen them to early >> Yes. >> as much as we can get to the early diagnosis of the patient and focus on the prevention concept >> Mhm. >> versus to go to the crisis mode. >> Yes. >> Because we all know very very well we know it. When you do have a patient with Alzheimer's disease and he does have the plaque, all the area that we call plaque delivery or plaque distribution, it's not working. >> Mhm. >> And we know that. And the question is, who is in the age of 30, 40 to 50 that we know and what do we need to do to change it from immune system and epigenetic to to change it? We all know that any cancer and what cancer and how it's involved. Yes, gene is gene, but there are some other effect that can affect it. So, I think that the pain is a great example is, do we understand why the pain is there? And what are we want to do with the pain? And and are we going to tell the patient the only thing that you have an option is use opiate? >> Yeah. >> And you get to the opiate crisis? Or to try to say, "You know what? I agree that you have pain. Let me try to figure that thing." >> Yes. >> And I want to bring the pain as a something new in our research that we are collaborating with South Carolina. And that's a condition that I I don't have an answer >> Uh >> to explain you why. Maybe because we have more patient that come to It's a new condition. We call it hypermobility or EDS. >> Yes. Yes. >> So, this EDS and hypermobility that we start to see more and more, young female that have a history of hypermobility and some joint dysfunction. And all of them have some pain. >> Yes. >> And the pain also being diagnosed by neurology by a condition called small fiber neuropathy. >> Yes. >> Meaning you have a biopsy and you have an evidence that small fiber neuropathy is there. And you do have pain too. And And I will say from our approach on the medical we have no approach. >> Mhm. >> The only thing is get on tramadol or any opioid. Do physical therapy and live with it. >> Mhm. >> And I can see I'm speaking about young female that I can see them in wheelchair. Um and they cannot function. And and we are trying to figure what is going on. So, there is very interesting now signs that we are involved in all of this. We start to understand with the genome and all the testing I'm doing that actually there are few partner of the immune system that are involved. And we're trying to explore if this partnership of the involved is leading to this EDS and how we can address it. The question comes is to that I had a discussion with Dr. Maitland. Her name is professor in South Carolina and she is seeing a lot of patient with a with a EDS one of the image she sent me, you know, we've been going to the same direction for many years. She is working on the muscle activation and the complement and we are getting together in this EDS and it's interesting. So, my a proposal was because I'm interested in doing a lot of research on the connection between infectious and immune is the COVID really trigger some of this immune underlying leading to the EDS is that kind of the underlying. She raised a very interesting point that I like to bring to you, Jill, and uh because it's kind of a a one of the leading in this theory that she is claiming that some childhood stressful event is leading to some autoimmune. >> Mhm. >> So, I'm sure that you know more than person, Professor Maté from Budapest. >> I think he's very famous and he done a lot of work about childhood stress and autoimmune condition. >> Yes. Yes. >> The reason I'm mentioning is that I absolutely believe Dr. Maté. I believe with others. And that I'm going back to the first what I share with you about what I my disclosure about this NGF. And it's clear >> Yeah. >> that when you get exposed to stress your NGF production is much higher in some susceptible immune system. >> Yes. >> So, this NGF production is linked to stress. >> Mhm. >> And this NGF we have now more data how it's related to neuroimmune and pain and others. So, it's very interesting that we all agree >> Mhm. >> that stressful environment is a very important point either from childhood stress that we had in terms of life or from ongoing stress that we have daily in life. >> Yes. >> And I think that again in medicine when you see your physician he can mention that stress is important, but how we reduce it? How what is the lifestyle that we need to have? Which brings another point that you raised it before and I agree with you. And just to mention that as much as I will focus on the immune system, I cannot ignore the stress and the physical therapy that is associated with reduction of the stress because this is a tool simple tool. >> Yeah. >> Physical activity. >> Mhm. >> Keep your lifestyle. >> Yes. >> Keep everything that you're doing help your immune system to function in a better way. >> Yeah. >> So, lifestyle and nutrition and stress relief and everything that you can do I cannot give you advice because I myself lives in in this stressful environment. Um I never found any recipe. But I will share with you. My answer is I love what I do. >> Yes. >> I love to help patient and that's my legacy and that's what keep me and to help people and to continue to do what I'm doing. >> What a beautiful synopsis of this thing we call psychoneuroimmunology and all the ways the systems interact and and really even though we have so much more information, we're still kind of at the doorway of the complexity of the system and like you said, maybe AI will start to even bring more research to the table and and and we'll understand it better. But I just want to say first of all, thank you for your 40 plus years of work and all the many many patients. We've shared many and you and I'm one of them that you have helped. I'm super excited about the immuno wellness concept that we're going to hopefully bring to the Denver area. And if you want more information, um I think they can find information about your clinic at immunoehealth.com or veroshealth.com. Is that correct? >> That's correct and thank you again, Jean. It is it was a pleasure to work with you and to have I I the beauty with you is really is from your experience as a patient. You took it to help other people in the world. And I think that that's it that's a great great um Thank you again for inviting me and thank you. >> You're welcome. I look forward to our future collaborations. Hey guys, hope you enjoyed that fascinating deep dive into immunology with Dr. Isaac Melamed, one of my favorite humans and someone I deeply respect for his own role as a physician in my health and recovery from cancer and Crohn's. If you haven't yet subscribed on YouTube, please join us for the nearly 1 million subscribers. Hit the like button. Uh leave comments. I always go in and check and answer those if you have any. And do share this with a friend if you find it helpful if they want to know more about IVIG. As you know, we have new episodes out every single week on Wednesdays they're released and I look forward to seeing you next week for another episode of Resiliency Radio.