Akil Palanisamy, MD

The TIGER Protocol: five step program for autoimmunity

Aired on: July 28, 2023

Episode Description

Autoimmune diseaes are becoming increasingly prevalent affecting approximately ten percent of the population. In the US autoimmune diseases affect an estimated twenty-five million people. It is the fastest-growing category of disease. It can take decades between the start of this process and the time of an accurate diagnosis. Autoimmune diseases include: Hashimoto’s Disease, type 1 diabetes, celiac disease, lupus and allergies. Dr. Akil Palanisamy describes his TIGER protocol, which is an integrative treatment approach combining his work as a functional medcine practitioner with his training in Ayurveda (the tradional medicine of India). His five step protocol includes -removing toxins -healing infections -improving gut health -Eating right -Consciously resting and rebalancing. His holistic approach is a guide for building up health, reducing the occurent of flare-ups, and attaining remission with a minimum of medications. With his approach you can feel better so you can live life to the fullesst. The tiger Protocol gives you the tools you need to start on the path toward healing and freedom

The Tiger Protocol

Akil Palanisamy, MD

Our bodies have a remarkable ability to heal
Autoimmune diseases are increasing
His path
- He became sick with chronic fatigue during medical school, and had to take a year off
- He reversed this by improving his diet, physical activity, managing his stress
Integrative medicine
- Integrates conventional medicine with evidence based alternative and complementary practices
- Holistic approach looking at body, mind, spirituality, community
- Focuses on root causes of disease
His book The Tiger Protocol
- TIGER is an acronym standing for the five root causes of infection
  - Toxins, infection, gut health, eating right and rest/managing stress
- Toxins
  - Reduce exposure by improving diet and care with household and cosmetic toxins
  - Enhancing detoxification
  - Toxins are synergistic and are everywhere
    - Glyphosate
      - Interferes with intercellular communication, Opens up blood brain barrier, opens the gut, interferes with detox pathways, inhibits the shikimate pathway which make tertiary amines such as serotonin and tryptophan
    - EMF
      - Interferes with intercellular communication, opens gut and brain barriers
    - We cannot avoid toxins, we must reduce exposure
      - Filter water with reverse osmosis
      - Choose organic food to reduce pesticide/ herbicide exposure
      - Things we put on our bodies and face go right into the body
      - Our couches, rugs and flame retardant clothes have chemicals (bromides) that interfere with thyroid functioning
      - Heavy metals lead, mercury, arsenic, cadmium
        Arsenic Conventionally grown chicken are fed feed containing arsenic to fatten them up
        Mercury avoid large fish and eat smaller fish
        Lead found in lipstick, cookware
        Goes to bones and comes out during menopause
        Heavy metals get into brain
      - BPA free may contain BPU or BPS which are just as bad
      - How to detox
        Hydration so kidneys can filter blood for kidney
        For intestinal Regular bowel movements for elimination
        Liver, main detox organ, packages toxins into bile which go into stool
        Sweating (sauna, steam room)
        Can excrete dozens of toxins
        For lymphatics: Skin brushing activates lymphatic system which detoxes
        On vibrating plate helps lymphatic
        Oil pulling (swushing oil in mouth) is an auyvedic practice
        Good for detox and oral microbiome
        Chlorella- helpful
        Glutathione- antioxidant; helps liver detoxify
        Cruciferous vegetables supports liver function
- Infection
  - Bacteria, viruses, fungi, parasites
  - He focuses on terrain, the inner environment of the body so that it is inhospitable to infection
    - Optimize intestinal pH which drives the gut terrain
      - If terrain not hospitable, pathogenic overgrowth of bacteria, yeast (such as candida), parasites
      - pH is driven by short chain fatty acids (SCFA) which breakdown needed fiber
      - fermented foods which contain lactic acid
        kefir, sauerkraut, kombucha
        fiber vegetables, fruit, seeds, spices
        need varied diet
      - apple cider vinegar
        helps with pH, digestion health, acid production, helps metabolism
        also lemon
        baking soda anti inflammatory, helps kidney function
    - Oral microbiome has hidden infections and inflammation
      - Oral microbiome is second only to the gut microbiome
- Gut
  - The microbiome has large role in immunes system and health
  - Focuses on healing the gut and optimizing the microbiome
    - If gut not optimal are symptoms
      - Bloating, constipation, loose stools, flatulence, pain, heart pain
  - Heal gut
    - Three key gut disruptions
      - Reduced microbiome diversity
        Boost number of different plant fibers as each feeds a different bacteria
      - Dysbiosis
        Is overgrowth of pathogenic bacteria
        Need to optimize pH because many of these bacteria can grow only with suboptimal pH
      - Increased intestinal permeability (leaky gut)
        Address with bone broth, fermented foods
        Glutamine, colostrum
        Prebiotic foods fibers that feed bacteria which encourage SCFA production
        Inulin
        Resistant starch
        type 1in whole grains, oat, quinoa, barley
        type 2 green bananas, plantains
        type 3 potato salad, rice
        Arabinoxylan
        Polyphenol
  - How to tell if there is a leaky gut
    - Leaky gut does not correlate with symptoms
    - Can measure zonulin level in stool
    - Zonulin is a protein involved in gut barrier
    - Can measure LPS in blood which indicates increased intestinal permeability
    - Lactulose (large)/ mannitol (small) test
  - Other recommended supplements
    - Glutamine reveres intestinal permeability
    - Colostrum
    - Curcumin
    - Probiotics
      - Depends on the situation
      - Sacraomyces boulardi beneficial yeast, anti inflammation
      - lactobacillus ramnosis GG (Culturelle)
      - spore probiotics patients do well is loose stools

How leaky gut leads to autoimmune disease
- Large proteins (bacteria, undigested food, toxins) get through intestinal wall into bloodstream
  - Immune system gets hyperactivated because these are not supposed to be in the blood
  - These toxins can travel to distant organs
  - The antibodies against the undigested proteins get confused and attack similar body parts that are genetically similar to the undigested foods (molecular mimicry
    - E.g. Antibodies against gluten can attack the purkinje cells in the cerebellum (balance) which can lead to gluten ataxia
    - Antibodies against gluten can also attack the insulin making eyelet cells in the pancreas which can lead to diabetes 1.5 (LADA)
      - (One measure is the GAD65 antibodies)
- Increased sensitivity to fragrances
  - Person is toxic, liver is overloaded
- Leaky mouth
  - Bacteria have direct access to blood stream e.g. with gum disease
    - Triggers immune activation and inflammation
    - His recommendations
      - Prevent dry mouth need lots of saliva with its enzymes
      - Breathe correctly
      - Green tea swish in mouth
        Antioxidant with cardiovascular benefits
        Improve heart disease and diabetes risk
      - Tongue scraping
- Eating
  - Phase 1 diet; at least two months
    - Elimination of some foods
      - Gluten, dairy, eggs, soy
      - Nightshades
        Includes potatoes, tomatoes, eggplant and peppers
        For a minority of people, triggers inflammation
      - Alcohol and caffeine
      - Other foods based on individual
      - Note: sugar uses up magnesium in its processing
    - Eat plenty of fruits and vegetables
      - Good source of protein such as grass fed beef, fresh fish
      - Oils: Olive oil and coconut oil, butter, ghee
        He believes one can cook with olive oil and is heat stable
        Vegetable oils: highly processed, rancid
        Corn oi, canola oil, vegetable oils
        These get into our cell walls and damage intercellular communication
      - recommends chicory, dandelion root as coffee substitute
      - artichokes, asparagus
      - garlic, onions, leeks as source of sulfur
      - jicama, taro root, green bananas
      - mushrooms
        whole kingdom of life
        unique compounds like chitson, chitosan not found elsehere each feed different bacteria
        co
  - Phase 2 diet
    - Reintroduce foods
    - Reintroduce foods one at a time every three days
    - How to tell if sensitive to a food
      - Keep food journal
      - Look for
        GI symptoms,
        systemic systems
        fatigue, brain fog, aches, pains, digestive changes, skin rashes
    - Is long term diet
      - Get as much diversity as possible
        Helps microbiome
- Rest/ managing stress
  - Getting enough sleep
    - Poor sleep risk of cardiovascular disease, inflammation
  - Meditation or a practice one can do regularly

Autoimmune disease takes years to develop

Antibodies occur years before the autoimmune disease
- His protocol can be sued to prevent and help cure autoimmune disease
- In rheumatoid arthritis antibodies were evident 12 years before disease
- In autoimmune liver disease, the antibodies developed 25 years before the development of the disease

Allopathic/ Wester medicine approach to autoimmune disease

Suppressing immune system with strong drugs steroids, oral or IV medications
- Suppress immune system; this suppresses autoimmunity but weakened the immune system leading to increased susceptibility to infections
  - Side effects of steroid medication
    - Elevated blood sugar, permanent bone damage, affect fluid retention changing the appearance
    - Mood disorder, depression, bipolar
    - To stop steroid medications, they must be stpped to stop
- Does not look for underlying cause, or how to maintain remission and how to stay healthy
- His approach looks for the underlying causes

Healthy foods

Bone broth
- Has gelatin, glycine
- Can do grass fed collagen powder or gelatin powder
Fermented foods reduces inflammation and improves 19 immune markers in adults
- Kefir, sauerkraut, kombucha, yogurt (dairy or non dairy yogurts)
- Fermented cod liver oil
  - High in vitamin A, vitamin c, omega 3s ,good for immune system
Prebiotic foods help feed microbiome
- Hi resistant starch, inulin, polyphenol

Other

Work with stress; is driver of every disease including autoimmune disease
Get sufficient sleep (at least 8 hours
Physical activity with resistant training
Incorporate mind body practice that you enjoy
- Can be gratitude, journaling, forgiveness s practices psychotherapy,
Cold exposure
- Helps boost immune system
- 90 seconds is minimal exposure
- Reduces inflammation
- Hormetic challenge to body
  - A challenge to body that makes body come back stronger
Intermittent fasting
- Anti inflammatory
- Helps in MS, rheumatoid arthritis, psoriasis
Light therapy
- Can be powerful especially for muscle, joint and back pain
- Brings down pain and inflammation
- Brings about healing
If not getting better,
- consider SIBO, Lyme, mould,
- consider balancing hormones
- Consider microbiome test
- Consider ayurveda, traditional Chinese Medicine
Vitamin D, vitamin K, Magnesium, Zinc
Exercise, resistance training