Neurological Assessments – Brain Health and Other Issues | Podcast #173

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Dr. Justin Marchegiani welcomes Dr. Russ Teams, a functional neurologist who practices in Arizona’s leading chiropractic center for Functional Neurology and Functional Medicine. Join them as they engage in a very informative conversation about brain health and the conditions affecting it. Learn about the assessment process, diet, nutrition and find out how the brain is connected to the gut.

Gain valuable information as Dr. Russ Teams drop some knowledge bombs and answers the listeners' questions about vitamin D and how it helps the brain, medical marijuana, and brain concussion.

Dr. Justin Marchegiani

In this episode, we cover:

11:05                        Self-assessment and tools

11:46                        Diet and Brain

21:12                        Nutrition for brain inflammation

27:51                        Nutritional Debt

32:02                        Brain and Leaky Gut Connection




Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Welcome back to Beyond Wellness Radio. Fabulous Friday here down in Austin, Texas. I have a good friend Dr. Russ Teams— Dr. Russ Teams. I actually went to Chiro school together. So blast from the past. Great to see you again, Dr. Russ. Again, you do a lot of functional Neurology brainwork. Your website Will put the link in the show notes. You also have an excellent coaching functional neuro- program at so more information about some of the things we’re gonna be talking about can be grabbed at those sites. Will put the links below in the show notes as well. Dr. Russ, welcome to the show, man.

Dr. Russ Teams: Hey, Dr. Justin. Thanks for having me. It’s good to see you again. It’s been a while. I feel like we’re old men now.

Dr. Justin Marchegiani: [laughs]

Dr. Russ Teams: Five years out. So you gotta be like what, six or seven and?

Dr. Justin Marchegiani: Yeah. Yeah. You got it.

Dr. Russ Teams: I’ve been following you a lot. So, thanks for having me. I’m excited.

Dr. Justin Marchegiani: Well, thank you. And anyone listening, feel free to chime in with questions. Try to keep it pertinent more to the functional neuro- brain stuff. At the end of the show, we’ll take a few minutes at the end and roll through your questions. So if you guys are liking the content, feel free and chime in. So, Dr. Russ, tell me a little bit about what you're seeing kinda on average every day in your clinical practice. What's the typical patient looking like? What are they coming in with? What's their presentation?

Dr. Russ Teams: So a lot of people that we see are kind of actually going through the gamut. They’ve already been here. They’ve been here. They’ve seen the specialist.

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: And—and I’m sure you notice it a lot. Those specialists just look here. This specialist just looks there.

Dr. Justin Marchegiani: Uhm.

Dr. Russ Teams: This guy is a big toe on the right foot kind of specialist. And so what we try to do is we bring it all together with brain help, the whole brain, plus the functional medicine side of thing and nutrition to make sure that we’re really understanding all of the components and systems so that they all work well together.

Dr. Justin Marchegiani: Got it. So what are those typical symptoms? There are people coming in the brain fog, anxiety, depression. I mean obviously there’s probably people that have already had like neurological damage maybe like a stroke or have autoimmune conditions like Parkinson's and MSO kinda like—kinda give us the rundown. Someone comes in uh— ADHD, OCD versus maybe uh—a more progressive, generative condition like MS. What are those treatments look like how are you working them up? What does it look like?

Dr. Russ Teams: So, everybody that comes in has a brain, right? So what we do is, we first start off with just evaluating their brain. It doesn't matter what diagnosis you have, it’s gonna show up in this evaluation and history. So starting from a young age, we—I’ve been seeing a lot of genetic diseases lately uh— where the system doesn’t get a chance to really activate. And so my job is to and activate that system so you get functional or functionality from the baseline.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: Like vagal nerve activate, ocular motor and vestibular stuff, uh— through ADD, ADHD. So you're looking frontal lobe which means focus, attention and inability to sleep, can't remember stuff, so working memory uh—so moving on to adults, you’re looking at more __03:09

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: Which lead to brain-gut dysfunction, right? So once you’ve opened up that brain-gut access, I mean, really, anything is possible. Autoimmunity, chronic pain fatigue, uh—open up to infection. I mean, you name it. You deal with a lot of this stuff, too. So, uh—I mean we can go off on a deep end on this, but—

Dr. Justin Marchegiani: So—

Dr. Russ Teams: It’s anything— anything out there.

Dr. Justin Marchegiani: Yeah. So what are like the some of the neurological testing you're doing, right? I know you guys do a lot with the eyes, you know tracking, things like that. So give me a rundown. Someone comes in—what are the first couple of tests that you're doing to assess what's happening?

Dr. Russ Teams: So the three things that we do right out of the gate are autonomic testing, which is blood flow, blood pressure, heart rate, uh— respiration. So all those centers are located in the lower brainstem, which is kinda like where that brain-gut access and vagal nerve is. So we— we assess that and then we go to a full balance test, where you do, eyes open, eyes close and you put them on a surface that’s a little wobbly. So it challenges them. And we actually do what’s called the cervical challenge where we put their heads in different positions uh—kind of mimicking some vestibular activity and seeing how well—how much the neck is involved. And then we assess the entire eye or oculomotor system. All the eye movements that we can have— fast, slow, stable, uh— quickly moving, repetitive and then we put people on the dark and we rotate them so that we see how their system is working when there is no other activation.

Dr. Justin Marchegiani: Got it. And what are you typically seeing with some of these patients? How are they presenting with some of these test?

Dr. Russ Teams: So often—everybody— not everybody. Sometimes people are super good but they have major neurological symptoms. When their symptoms or when their exam is normal, that’s when we know we need to do all functional medicine immune base control or uh—management. When we see breakdown, we’re gonna see sleep patterns where people are moving forward, backward, side to side and because they're moving, they’re firing motor patterns differently and so they’re having pain, typically. Low back, neck. This chronic pain that is coming out with these neurological or uh—you know, this instability in their system. So just a slight difference from side to side over time that tends to build and then we build things like a shoulder or head tilt or uh—flexed posturing and that presents in pain a lot of times.

Dr. Justin Marchegiani: Got it. And how are you incorporating a lot of the adjusting that you're doing? Like someone comes in, let’s say you see some—some deficits with eye or our muscle tone. Like you’re a chiropractor, so you're doing current chiropractic work. You're also doing neurological work, maybe exercises, different things. So, how are you prescribing adjustments? How are you prescribing some of the exercises or some of the auditory stuff? How are your prescriptions based on what you see?

Dr. Russ Teams: Well, first, I must say that as a chiropractor, I don't just see something and do something because I have that tool. I have to assess and think, “Why is this here?” “What is the root cause of this problem?” So, in an adjustment situation, I may do—if I see a right-sided cerebellar problem, which is gonna be eyes closed the nose, eyes closed, touch the nose. If you’re off on one side, my right hand, then I might do an adjustment in the neck or low back or foot or hand to try to stimulate that area. So just—the adjustment is so powerful, sometimes it can be too much in some cases. So talking about brain health and concussions, sometimes I don't even adjust anybody for the first month or two until the brain becomes stable enough to receive an adjustment.

Dr. Justin Marchegiani: Got it. So, when you're looking at brain function, right? We have like cerebellum—just kinda back part of the brain by the brainstem area which helps to balance. And then we have the cortex kinda the higher function of the brain. Can you just kinda differentiate the cortex and the cerebellum for?

Dr. Russ Teams: You got it. So, the cerebellum is considered the little brain. I talked about cerebelIum like an old school switchboard with cables going in and out. You know, you got somebody, “Hey, you need to talk to this guy and move here, move everything here?” So it’s constantly calibrating everything that’s going in and out of the brain. Thoughts, emotions, eye movements, head movements, vestibular activity, motor control, autonomic tone, so blood flow. All those things are helping to be controlled by the cerebellum. That cerebellum sends information to the parietal lobe, which is where we basically feel and receive all information. Then that information is sent to the front lobe. That frontal lobe creates a response or motor activity.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: Blod flow, thought, emotion, actual physical movement and then the cerebellum make sure that that is very coordinated. If the cerebellum's off, you’re gonna get things like movement or dysmetria, things like that.

Dr. Justin Marchegiani: Okay, Got it.  And then when you and—can you kinda talk about some of the— so when you adjust, you’re—you're helping the opposite brain, right? Because the brain tends to cross paths, right? So an adjustment on your right side may help bring up that left cortex and vice versa on the other side. Is that true?

Dr. Russ Teams: Yes. So, yes and no. So, in some cases, like the diversified technique—

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: You will contact one side and then you give a quick rotation in the opposite direction. So, yes, you’re adjusting the neck on that side.

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: Based on muscle spindle activity, as the muscle shortens, you’re getting an increase in information; as it lengthens and you activate, you know, GTO, for you and I –

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: Basically, if you inhibit a muscle, it decrease hold in the tendon. More information, less information. But here’s the – here’s the kicker. As you rotate your head, you’re actually activating the opposite side, vestibular system. So you’re getting a bilateral effect. The technique that I used is—is called Coupled Reduction. So it’s a lateral bend. And that bend is only in one side the majority of it. There’s no way you can do just one little piece, but the majority of inflammation is a little more specific from one side.

Dr. Justin Marchegiani: Okay. So if someone has let’s say a—a weak cortex on the left versus the right or right versus the left, what kind of symptoms would they see or express?

Dr. Russ Teams: So the left brain is highly associated with language, with numbers, with letters, with speech, with logistical and logic motor-based planning. So a lot of these folks tend to be—also it’s kinda the go side. So the right brain is the opposite of all those. Creativity and whatnot. So you may see some lack in understanding like dyslexia is a very common left brain issue. Uh—you may have focus and attention issues. You may have some gargling up of words, you may have some issues with, you know, articulating words and things like that. You may have some changes on the right side of the body with sensory issues. You may have issues with memory with face and other things of learning new objects versus understanding who that is kind of thing even though you’ve met them before. So, lot of different things can be in that left brain.

Dr. Justin Marchegiani: Okay. Then how about if you’re having issues with the cerebellum in the back?

Dr. Russ Teams: That cerebellum is going to be highly associated with the coordination, right? So you may sway to the right side when you close your eyes. You may have a little bit of a tremor in that right hand. You may have an issue knocking things over. If you’re gonna grab your phone and then you knocked it over or a glass or a beer for that matter.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: You may bump into things on that right side as well. You’re gonna have changes in muscle tone on that side. Meaning like chronically uh— rolled ankles. You’re gonna, you know, stab your fingers, stab your toes. And you may have an increased startle response from that side coz you’re not really sure if where that right side of your world is.

Dr. Justin Marchegiani: Okay. So if someone’s listening at home right and they’re like, well, I am thinking about going to see a functional neurologist, someone like yourself, what are some things that people could do just on their own right now to kinda help with overall brain balance? Are there any self-assessments or tools that they can utilize?

Dr. Russ Teams: Sure. There's a really good test is—put your feet together, close your eyes and see if you can stand still. You could try one leg versus the other, right? A good—that's a really good test to count down immediately. There is a research project that says if you can't stand on one leg for 15 seconds, your gonna have an increased risk of developing a neurodegenerative disorder, which is cerebellum to front lobes. So all this activity is brain-based. Uh—finger to nose. Just close your eyes and try to touch the tip of your nose right here, right? So bringing that to the tip of your nose, if you’re off a little bit, or if you hesitate or you poke yourself, that's a problem in the cerebellum on that side.

Dr. Justin Marchegiani: Got it. And let's talk about the diet component. How much does the diet affect the brain? I mean, we know gluten, protein and wheat barley and rye and other types of cross-reactive grains has major effects on antibodies in the brain. Whether it's gangliocytes or myelin or increasing antibodies, what's your take on diets and we can even go into blood sugar imbalances on health.

Dr. Russ Teams: So, in our clinic, we see a lot of concussion. Usually, it’s post concussion syndrome. Now, the reason that these people got to this post-concussion status is because their brain was in a state of unhealth or disease, so to speak. So, it wasn’t all healthy to start with. And so there is something wrong with the gut. There’s something going on in the brain. There’s inflammation. There’s a bad diet. So many different things go into it. So when you look at that presenting to my office, go on gluten-free, go on dairy-free. That’s the easiest thing to do.

Dr. Justin Marchegiani: Foundational. Yeah.

Dr. Russ Teams: Foundation. So, we don’t need to beat that horse anymore. But the things that I like to do right out of the gate, are decrease blood sugar by decreasing carb loads so that promotes what’s called autophagy, right? You increase your health fats, decrease your blood sugars or carbohydrate intake and food and in drink and that helps to promote autophagy. Autophagy is a big word for bring the garbage trucks in, clean up all the junk, and move on, right? That's why a lot of people feel so good with this ketosis or ketogenic diet. Not necessarily long-term because you need glucose to fuel those cells eventually, but in the short phase, we almost always do like a ketogenic type of diet uhm along with some other similar—I’ve got a whole bunch of supplements that that we use to promote brain health after the fat. But you can always do them before the fats as well.

Dr. Justin Marchegiani: Totally. Right. So the brain is really important uhm—you know, when it comes to blood sugar and insulin resistance, we know the insulin degrading enzyme it's partly responsible for degrading insulin and breaking down insulin. It is also responsible for cleaning up a lot of the plaque and the inflammatory kinda proteins in the brain. So if you have a lot more insulin in the system because your— your carb load’s much higher and you got insulin resistance, that enzyme is gonna be too busy over here cleaning up insulin versus mopping up the plaque. It’s like having one janitor where the mess you kinda need, too, right? So that's why getting that insulin resistance, getting your cells more sensitive to insulin makes a difference. Is that the true?

Dr. Russ Teams: Absolutely. And one of the things you said, basically, when there's too much junk and there’s too much insulin, what does that create? It creates free-radical activity and inflammation. So once you develop inflammation of the brain, there's something called microglia cell. They’re like the janitors, right? All the sudden, it’s like there's 10 times as many janitors in the brain as there are neurons. So when these __ got ticked off, they clean up everything. They’re taking trophies out of school.

Dr. Justin Marchegiani: Right. Yeah.

Dr. Russ Teams: They’re taking the trophies, the pictures off the wall, the chairs out of the room. They’re ripping apart stuff. So they’re basically cleaning up anything everything in their site and that starts to break down other neurons. So that inflammation is what we as clinicians and you guys as—as patients need to start thinking about. The more inflammation you have, the worse your brain is gonna do. So, right out of the gate, we get people on turmeric and Resveratrol. I like turmeric with black pepper for—

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: ..better absorption.

Dr. Justin Marchegiani: Better absorption. Right.

Dr. Russ Teams: Unless they have sensitivity to black pepper. I’m actually seeing that in a lot of cases. So we have options for simply turmeric or we hide those other things as well. So Resveratrol—great antioxidant to help keep free radicals from __ 15:24 things up. Right after head injury and long-term, you’re gonna lose blood flow by about 70%. So we use a—a component or a nutrient called Vinpocetine or vinpocetine, which helps to improve basically capillary perfusion. So, you start immediately getting more blood flow to your brain. On top of that, omega-3 fatty acids, right? It’s probably gonna be like that’s every patient should be on those unless you have sensitivity or you can't tolerate fats. That's another issue altogether, we can address that separately. Uh— you know, I usually use anywhere from 3 to 5000 mg a day, personally. I’ve heard dose as high as 10,000 mg or 15 in in severe cases. Uh—glutathione or N- acetylcysteine, uh—Glucoraphanin is a product that I use in one of my lines that we use in the office.

Uh—it’s phenomenal. Uh—let’s see, what else? Oh! Mag Threonate or __16:24 I use Hydrogen__, but uh—it’s a great, great product. Mag Threonate helps to keep your brain from over firing so you got this cell that wants fire on its own. I just goes, “boom” and each cell around that cell starts to go “boom” “boom” so you get this was called spreading cortical depression that’s seizure like activity. So, when you get symptoms that show up for no reason, you're having a seizure activity occur. And so one of the things that can help stop that overfiring is that Magnesium Threonate and it is phenomenal. We use Mag Threonate coz it passes the blood brain barrier.

Dr. Justin Marchegiani: Yeah. It makes sense. I know the Kynurenine pathway or the Quinolinic Acid pathway, which is an inflammatory pathway in the brain gets dampened by higher magnesium. I know Magnesium Threonate is one of the Magnesiums that can cDr. Russ Teams the blood brain barrier, so that makes a lot of sense. And when someone is having kind of a seizure episode, what's actually happening in the brain? I know ketogenic diets have been recommended since 1920 by the Mayo Clinic to help with seizures. So we know there's a blood sugar component. How it—what’s the mechanism happening with the brain that's causing the seizure? How’s the blood sugar or maybe the increasing ketones? How is that stabilizing the brain?

Dr. Russ Teams: So, essentially every brain in a simplistic form, you need multiple things to make a cell work.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: Glucose, proper amounts of glucose, oxygen inactivation. All three of these things help to create ATP or energy, right? So ATP is our energy source think of it as, I mean, just oxygen in this case. If we don't have oxygen, we’re toast. So that ATP consider it like a lifeline and so all these things have to be in proper amounts in order to make proper amounts of energy. When you start having excessive firing of these cells, you start using up your glucose, you start firing randomly. So ultimately, it lets too much calcium in and that starts popping onto cell. So that’s why we do magnesium and actually magnesium is that— is a little plug that plugs that that receptor that allows too much calcium. That’s why magnesium is so important in that case. Blood sugar instability as you as you drop too low, you start to starve and the cell start to fire up to try to survive. So that's where blood sugar stability comes in. If you have too much, you develop insulin resistance so fuel can’t get in. If you have too little, you don't have any fuel so the cells start gasping for air essentially and it starts popping off and firing off saying, “Hey, somebody help me, I’m gonna die.” And that’s what happens. As they fire off, they release excitatory neurotransmitters, which are called glutamate or cytotoxicity.

Dr. Justin Marchegiani: Right.

Dr. Russ Teams: So you excite all the other cells around you and if those are unstable enough, they will fire off to the point where they die, too. And so you actually get dying of cells and fatigue of these cells so then you lose your ability to talk, you lose your ability to balance, you lose your ability to have a proper emotional response to somebody asking a simple question, you can't sleep, right? All these things, all these symptoms come from, many times, unhealthy brain tissue.

Dr. Justin Marchegiani: Totally makes sense coz we have this kind of Goldilocks effect with high blood sugar, you know, it decreases enzymes in the brain that cleanup junk and then you have this decrease in cellular autophage or autophagy, pronounce either way. And then you have the low blood sugar side, where blood sugar drops and that can create increase in interleukins and various cyto_. Interesting fact, though, you mentioned that the magnesium—coz when that cell needs the contract and that action potential happens, where that nerve impulse, that, there’s a release of calcium. So that makes sense that magnesium kinda keeps that down so it decrease decreases the excitation in the cell. Is that what you're saying there with the magnesium?

Dr. Russ Teams: Yup.

Dr. Justin Marchegiani: Okay. Cool. And then also, couple other things, too. You mentioned, you mentioned the magnesium component. Let’s go back to some of the antioxidants. So we have things like Resveratrol and turmeric which kinda, they’re like in these nerve to pathways which really helped clean up brain inflammation.

Dr. Russ Teams: Yup.

Dr. Justin Marchegiani: I was at the seminar last weekend where, there was a couple of strength coaches at a major university. I think it was University of Oregon and they would— their players would come off the field, they would actually make their players consume grape juice. And it is interesting because it makes sense because the grape juice is very high in resveratrol. I think they could probably do better with the supplement without getting all the— the excess glucose in there. But what's your take with some of these nutrients and— and the nerve, too? Just cleaning up brain inflammation, let’s say your kid is an athlete in they’re involved in contact sports, what can they be doing to help with that?

Dr. Russ Teams: Two parts.

Dr. Justin Marchegiani: Yup.

Dr. Russ Teams: There’s—people who like sports like for me, I was playing every single day. I know there are lots of kids that are going from one practice to another. So there's this such thing as overtraining, right? The—the difference in building versus breaking down. So, you have to really watch that stress response, your adrenal glands, your changes in blood sugar, that—that fatigue rate and keep an eye on your ability to make energy. So, number one, just watch out for overtraining and especially young kids and especially things like triathletes, okay? So, when we get into, what where you after or you will do prior to these contacts is number one, you got to make sure they have good, healthy blood brain barrier and a good healthy gut, right? If you just focus on those two things, the majority of your inflammation will probably be taking care of, right? So, having somebody on probiotics is excellent. You’re gonna be having—you’re gonna be promoting you know, multiple strains, not all of them, but a lot of strains that are— that are supposed to support gut. You can use things like Glutamine or Aloe Vera to help impair— repair that gut lining to make sure that these—you know, you’re not having too many of these critters coming in uh—that are you know, you can breakdown all your foods so you don't have to be exposed to a lot of these gluten stuff and food sensitivities developing all that. Uh for brain, you’ve gotta have your omega-3's, you want to have turmeric at least covered at all times, right? And then your gonna wanna have something to make sure your blood flow which is that__22:49 as well as—honestly, the three products that I’m on or four products that I’m on, all day long, every day of the week are uh— is __ form of omega-3, monoglyceride in the delivery system so it’s a little easier for me to get that. It’s a little more effective. __23:09 which is a Mag T or Mag Thre as well as uh—some B vitamins and what else do I got? Uh—T__ So it's another form that helps promote dopamine activation keeps your frontal lobe firing and building. So it’s a D1, D2 activator. And then I use—you just mentioned it. I’m just gonna show this, Nrf2 Activator.

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: Though I’m not promoting any products there, but that’s what I’m—

Dr. Justin Marchegiani: That’s okay.

Dr. Russ Teams: And then uh—MemorAll Supplement. All the stuff is from Xymogen. MemorAll has Huperzine in it which helps with memory. It’s a __ And then __

Dr. Justin Marchegiani: And what pathways in the brain acetylcholine is hitting?

Dr. Russ Teams: Uh—temporal lobe and hippocampus. So the memory component which is what breaks down in Alzheimer’s.

Dr. Justin Marchegiani: Interesting. So if someone is doing contact sports, you gave some of those nutrients that can be helpful. I'm going through Tom Brady's book the TB 12 Method and he’s— he's all about pliability when it comes to lifting weights. So really interesting coz he’s trying to get his muscles to be as pliable as possible. His kind of theory is that the muscles get, you know, more dense, harder. The training is you know, contributing—creating concentric contractions. And the problem with that is the muscles are harder and they— they have less eccentric capabilities so they have less ability to absorb. So his thing is he’s trying to make the muscles softer, more pliable so they absorb force. And that I know, I’ve looked at the supplement regimen, he's doing a lot of green tea, Resveratrol, probiotics. He’s doing a lot of curcumin uh— pre-and post workouts ors pre-and post games. So, I think he's on top of this stuff, too.

Dr. Russ Teams: Sure.

Dr. Justin Marchegiani: I think he's also doing potentially some O2, you know, uhm—O2 chamber stuff and maybe even some laser stuff, too.

Dr. Russ Teams: Sure. Oh, laser. Glad you brought that up.

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: It’s right here, actually. [laughs]

Dr. Justin Marchegiani: Oh, great. Erchonia Laser—wonderful.

Dr. Russ Teams: Erchonia Laser—if you guys don't have any—do you got—do you have a laser over there? Do you use laser therapy?

Dr. Justin Marchegiani: I’ve done in the past. I do not currently. But I think it’s phenomenal. I think if you’re—If I was letting my kid play sport that is contact related, I’d have all those nutrients on board and I would also have some kind of a laser therapy on board to help with the inflammation. What’s your take? Would you let your kid play contact sports without utilizing these techniques?

Dr. Russ Teams: Absolutely not.

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: No way. I mean—I’m considering them getting into a sport where the contact is not involved in every play. I don’t have a kid, but moving forward, I’m a golfer, so, the odds of you sustaining a concussion in golf—

Dr. Justin Marchegiani: [laughs]

Dr. Russ Teams: You know, you’re not playing fast enough, but uhm—you know, in football and soccer and baseball, I've been knockdown in baseball before. The risk is always gonna be there no matter what sports you’re in. But if you choose to put your kid in a sport where they’re hitting bodies every single play, I mean, what do you expect the outcome to be? Honestly—

Dr. Justin Marchegiani: Yeah. Exactly.

Dr. Russ Teams: I always—my job is to educate not to make decisions for people. So, so that’s kinda— I don't like to speak out of turn but, for me, that kid is going to be on certain products, nutrition everyday of the week and it's really all about promoting brain health and gut health because any people that I see, and this is a clinical thing, anybody that I see that has had gut issues, anxiety issues, leaky blood brain barrier, leaky gut, autoimmunity, long-term standing chronic illness prior to hitting their head, those are the worst cases that I have seen. Meaning that nobody can help him them until we address all of these different things together and we have the brain on top of it.

Dr. Justin Marchegiani: Hundred Percent. It makes sense. And again, most kids today their diets are absolute crap.

Dr. Russ Teams: Yup.

Dr. Justin Marchegiani: Here's the analogy—I’ve kinda built over the last few years. It makes a lot of sense. A lot of people look at food as calories and that it's like going to the gas tank and you just put fuel in your gas tank, it doesn’t matter what fuel you get. The difference is when your engine starts running on low, when you're driving that car, your car doesn't start metabolizing the bumper or the seats for fuel.

Dr. Russ Teams: Right.

Dr. Justin Marchegiani: The difference is our body will do that. And it's also not looking at calories which is just a measurement of heat, right? It’s also looking at the micronutrients and we, today, we can have a whole bunch of calories with very poor micronutrient levels.

Dr. Russ Teams: That’s true.

Dr. Justin Marchegiani: Meaning low minerals, low vitamins, low amino acids and plus when you're having excessive in the carbohydrates primarily refined, when you throw that fuel into the Kreb’s cycle and glycolysis, it takes B vitamins and minerals and magnesium to run the system. So if you get less than what the system cost to operate, then you actually go into nutritional debt. Can you talk more about that?

Dr. Russ Teams: Yeah. And that’s what I was talking about with the—that overtraining.

So the thing—and I’m kinda getting divert and then come back to it.

Dr. Justin Marchegiani: Yeah. Totally.

Dr. Russ Teams: Stress is one thing that I feel has to be addressed in every single patient. Stress cranks up your cortisol, cranks up blood sugar, starts sending those cytokines you talked about. They start lighting up the areas of the brain which is essentially the fight or flight area, the midbrain, right? That area is what keeps you awake at night, it's what keeps you from focusing, it’s what—it’s what leads to basically depression and anxiety. And so all those things were you're not firing optimally, right? Optimal firing would be here. This is where we wanna be. When we go here, not so good. So when we go to blood sugar and all the things that you're talking about, uh—it’s— it's really— you just have to address everything. I hate to say like that, but you really a look at every different system and how they interact.

Dr. Justin Marchegiani: So we kinda have like the chiropractic side, where its’ working on stimulation and kinda giving one side of bump or—or you know, a knockdown. And then we have nutritional side, which is really getting rid of the inflammation and then providing extra nutrients to support healing. Uh—the laser, kinda of the same way. You’re really helping those cells, you’re stimulating those cells in a way to help with recovery and reduce inflammation coz a lot of these wavelengths are very anti-inflammatory, which is— which is great. If someone gets head injury, I know some the therapies are kind of a low-calorie fast for a day or two to help increase that cellular autophagy. Some will say, you know, even some progesterone uh— maybe 50-100 mg a day even for guys can be helpful. I mean the turmeric, the Resveratrol, those kind of things. What else would you be doing if someone had a concussion or head injury? How would you be treating that therapeutically outside of just a laser and maybe O2 therapy?

Dr. Russ Teams: Tahough it works, so outside of that acute everything that you just mentioned.

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: We’ve already been talking about.

Dr. Justin Marchegiani: Good.

Dr. Russ Teams: Glutathione, Omega-3’s,__, Resveratrol, uh—you’ve got your Turmeric. You can go right into blood brain—I’m sorry—gut support and rebuilding the gut because—

Dr. Justin Marchegiani: Probiotics.

Dr. Russ Teams: Yup. There it shows that if you injure your brain within minutes to hours, you develop a leaky gut. So you have to not only fix the gut from nutritional side, but you have to fix it from a brain-gut axis. So, typically, what we’ll do is—we’ll wait—we’ll get going on the nutrition and bring people in for laser only. If they’re—if they can tolerate it, we’ll run an exam and evaluation at first day and then we’ll say, “Hey, come back about a week and then we’ll check you out again.” Coz most concussions should heal in 2 to 4 weeks, but we like it a baseline so we know that in four weeks if they’re not healing, we’ve gotta—we can show how well they have healed, right? And so, that's the stuff you need to be doing in the acute phase. Uh—hyperbaric chambers, if you can do, more so in the acute phase. They seem to do better. The chronic phase is kinda the, you know, the injury is still out on them. And then chronically, basically, the whole system is involved because you developed that leaky gut, you start to ramp it up— inflammation— you start breaking down the blood brain barrier, microglial cells are going crazy, you know, all your neurontransmitters are off, now you’ve got the HPTA, you know, uh—hormone access. All these stuff is starting to fall apart. So ultimately, once you get into that chronic phase, you just gotta start evaluating. Especially when it comes to hormones in women. You’ve gotta—you’ve gotta lab, you’ve gotta look at your—all the, you know, comprehensive metabolic stuff, which is all the labs that we run uhm as well as you can do specialty testing. So, I mean, you really gotta— if you're not seeing, if you have that stuff going on, like a concussion or post-concussion syndrome and doctors that you're seeing are not running these labs, you’ll find somebody who will.

Dr. Justin Marchegiani: Can you talk more of the mechanisms? I seen this so often where there’s an incredible stress response. We know cortisol can break down areas of the brain especially in the hippocampus, which is involved in the memory. And we can see that then creates a leaky gut or we see it, a head trauma like a car accident and then we look at their history and then from that point onward things spiral out of control with other digestive issues and then more autoimmune stuff. What's that mechanism? Why is the trauma in the brain? How is that causing that leaky gut? What’s the mechanism there?

Dr. Russ Teams: So I’m gonna draw this out—kind of—Can I draw this? Is there a way to do that?

Dr. Justin Marchegiani: Of course. Yeah. Uhm—not sure. But if you’ve got any paper, just draw it out and hold it up on the screen.

Dr. Russ Teams: So this is just super quick. Alright. If I have a whiteboard, this would be so much easier. Okay. So right here—

Dr. Justin Marchegiani: Yup.

Dr. Russ Teams: It’s kinda where we’re looking at. Right brain, left brain. This is our brain stem. So this is the midbrain we talked about. The pons and the medulla. This part here is the parasympathetic part. This part here is the parasympathetic part. This big guy right here in the middle, he is the sympathetic dominant guy. He gets lit up in head injury. Everything else starts to break down. Now, it’s interesting is basically through here, is a major conduit of—I’ll call it like a freeway. All information that gets from the brain to the body has to go through this brainstem. And this is the area that gets hit the hardest in concussion. So these two big lines the vagus nerve, that’s part of the conduit or that freeway system. So as you get whacked, immediately inflammation goes up, decreases your sympathetic tone, I’m sorry— decreases your parasymphatetic tone, increases sympathetic.

Dr. Justin Marchegiani: Right.

Dr. Russ Teams: And fight or flight, your not gonna worry about digestion, right? So, right away that’s what starts breaking down your gut.

Dr. Justin Marchegiani: That makes sense. So the blood flow starts going more towards the extremities away from the organs.

Dr. Russ Teams: Yup. It’s basically saying, “Hey, you need to survive. Run. Get the heck out of here.
Dr. Justin Marchegiani: That makes total sense. Alright. Interesting. And then you said the area right in the middle part of the sympathetic. So when that gets lit up and that basically decreases the parasympathetic tone, couple people on the chat here wanted to know ways to help increase the parasympathetic tone. I mean, in the functional neurologic—Do stimulators like singing or kind of a gag reflex kind of thing. There's obviously you know, breathing to the nose, right? Coz of the olfactory nerves. Uhm— Obviously eating an anti-inflammatory diet and lifestyle can help. What else? Is there any other more nuanced things that you're working on patients with?

Dr. Russ Teams: Absolutely. So gargling. Gargling is probably easiest and most cost effective way that isn’t like gagging yourself. That’s still effective, too.

Dr. Justin Marchegiani: Right.

Dr. Russ Teams: Though anybody who needs more parasympathetic tone, they start gargling. It’s as simple as taking to drink of water [gargling sound] Gargle as long as you can, as hard as you can. If you can go like one or two seconds, that vagal tone or that parasympathetic tone is dampen. So we need to get better at it. We’re gonna practice at it. And then you can do things humming and singing which activates the back of the throat. You can do what I call tongue push-ups. Push tongue into the side of mouth. So that’s cranial nerve 12, it’s right below the vagus area. Uhm—any sensory stuff, so, take in your toothbrush, tap in the back of your throat. Best way that I found is actually push down on the back your tongue, don’t jab yourself back in the throat. Uhm—and then, what you can do—well, I’m not gonna give away neuro- rehab because it would be inappropriate for me to give somebody an exercise to do..

Dr. Justin Marchegiani: Right.

Dr. Russ Teams: You know, not specific to them. But we use what’s called the vagal nerve stimulator. And so it’s got two prongs, we can use it in the ear on the vagal afferent here, on the conchae. We can also use it on the SCM to the point that the muscle actually contracts a little bit because the vagus nerve runs right along that SCM. We personally stay on the right side of it because it has more to do with rate of the heart versus rhythm. You don’t wanna disrupt the rhythm per se, but if that’s what the evaluation indicates, then we go ahead, go very cautiously with a pulse option on finger.

Dr. Justin Marchegiani: Now if we don't have the low-hanging __. Like this person is, let’s say consuming gluten, poor sleep, blood sugar instability, just doing some gargling won’t be enough to overcome all of the sympathetic habits and the other side of the fence. Is that true?

Dr. Russ Teams: True. It won’t fix the problem, but it will start activating that pool of neurons to—it’s like—if you like going to the gym and eating like crap—

Dr. Justin Marchegiani: Got it. Great analogy.

Dr. Russ Teams: And so, at least you’re getting some type of brain activation. Sorry to interrupt. Meditation.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: Meditate mindfulness. De-stressing yourself. Huge.

Dr. Justin Marchegiani: Makes a lot of sense. That’s excellent. And then regarding the gut component, right? We didn't really talk much coz you talked about the brain and then you talked about that could cause leaky gut. We also have leaky gut and leaky brain starting from the gut. We can have H. pylori or dysbiotic bacteria with lipopolysaccharides, but then open up those tight junctions in the gut and then those things can get past the astrocytes or the blood brain barrier. Can you talk about gut to brain issues? We just addressed brain to gut and then what percent of our brain are microglial cell? Which are the immune cells. Is it 20% or is it higher?

Dr. Russ Teams: It’s higher. Well, let’s put it this way. I don’t know the exact percentage, but you have 10 times as many microglial cells as you do neurons.

Dr. Justin Marchegiani: Neurons. Perfect.

Dr. Russ Teams: So, there's a lot. Uhm—when we talk about the gut-brain, let's say it’s more than likely gonna be from an infectious side or a food side because that vagal nerve, if that’s not firing well, you are going to break down your gut anyway. So you're talking about that brain-gut axis kind of as a general assumption, right? So, let’s say we got out of town, we’re feeling great, we get a parasite. Or we get an infection, right? That starts to cause up internal inflammation, down regulates and crowds out all your good bacteria, starts screwing with everything. Inflammation shuts down your motility. Motility means how well we move stuff through our system. So we started constipation and/or mixed diarrhea, right? With H. Pylori, it’s kind of a little bit of both. And so when you have this break down of the gut, you start to develp that leaky gut. What's interesting is the blood brain barrier is the same type of connection including zonulin these tight junctions. So, the stuff that breaks down the gut is the same stuff that breaks down the brain. That’s what will fight you. So, leaky gut equals leaky brain or gut on fire equals brain on fire.

Dr. Justin Marchegiani: Great. Excellent. And how many people are you seeing, just in general. Where you are seeing the neurological issues are starting from the gut versus starting from head trauma? Is it 50-50 or you’re seeing more on the brain just because your your market is a neurologist. What are you seeing?

Dr. Russ Teams: Okay. This is gonna sound weird. I’d say 50-50, but a 100%.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: Right? So, if it starts from the gut and it’s like there's an emotional trauma early in childhood, you’re gonna have that that uh— sympathetic stress-related response, which is great going to break down your gut. And that’s gonna open it up for opportunistic infections if you're eating poorly, leaky gut-leaky brain. If you're super healthy and you’re able to travel the world, you expose yourself to more infectious stuff, right? So that’s always part of the history is, you know, when did this start? Where did you go? Did you emotional trauma at that time? an injury? An infection? Whatever it may be. So, on one hand, it’s like 50-50. But on the other hand it’s like a 100%.

Dr. Justin Marchegiani: Great. Awesome. So, I’ll ask one more equals. Any other key kinda concepts or issues you want to get across to the listers? If not, I’m gonna go into rapid fire mode. Anything else?

Dr. Russ Teams: Oh, man. Just take care of your brain. Seriously, it’s the only one you got. If you know somebody with laser and it can handle the side of nutrition just like you do—

Dr. Justin Marchegiani: Uh-hmm. Uhm—you also know somebody who can fire the right parts of the brain at the right time at the right frequency, then you're gonna be in pretty good shape. So, if you're struggling with any of that stuff, you need that holistic approach. So people can work on all these systems at the same time. Not one system this week, one system next week, you know..

Dr. Justin Marchegiani: Awesome. Great. So, I’m gonna go into rapidfire mode here. So, if you can try to answer everything like 1 to 2 sentences, maybe 3 max, we’ll roll through it.

Dr. Russ Teams: Yup.

Dr. Justin Marchegiani: So, vitamin D, how does it help the brain?

Dr. Russ Teams: Uh—it helps with—basically helps with immune system balancing. So, T- regulatory cells, you gotta have it.

Dr. Justin Marchegiani: Excellent. Marijuana—Do you recommend it? And then, THC versus CBD for brain.

Dr. Russ Teams: I personally don't go into that because I don't know stuff changing every day. I know, anecdotally, some people do well with it, other people feel horrible on it. So, I'll refer to another practitioner for that.

Dr. Justin Marchegiani: Got it. Uhm, let's see, here another one, here—x intermittent fasting, ketogenic diet, is that the foundational diet you recommend?

Dr. Russ Teams: Yes. So, I do it probably two – three days a week. I’ll do an intermittent fast. I’ll go through breakfast so I won’t, you know, eat dinner, won’t have anything after. I’ll go through breakfast and I’ll try to have a high-fat, uhm, good quality fat. Lunch, I’ll try to carb up, you know, sometimes you’re just in a hurry and then it happens, but uhm, I’ll go past 1 sometimes. I know, Dr. Barry, the guy I work with, uh, phenomenal physician and he does a 24-hour fast once every three weeks, I believe. I haven’t gotten enough courage and I'm sure that my staff will hate me for it, so, uh, so there’s that. Yup.

Dr. Justin Marchegiani: Very cool. Can you lose use fine motor skills and be dizzy without an injury like showing a clean CT or MRI?

Dr. Russ Teams: Uh, after a concussion?

Dr. Justin Marchegiani: I would say, well, I would say after in general, this person has you know, they went to the ER and they got these neurological test on but they still have these fine motor issues.

Dr. Russ Teams: Sure. Absolutely. You can have it at anytime. If the brain breaks down in anyway, frontal lobe and cerebellum, you’re gonna have issues, you know, with dexterity, fine motor control, dizziness. If it’s a cerebellum, vestibular thing. If you just— if you have—if you break an arm and you don't move it for six months, you might develop a dizziness problem because you’re losing feedback from your world. That’s one way. Another way is inflammation in the gut, you can develop sensitivities, you know, gluten, you can get TTD, TTG G6 and neurological autoimmunity and that can cause dizziness. You can hit your head, that causes the symptoms we’re talking about right away. You don’t have to hit your head to get a concussion. It’s like flexion-extension whiplash injury. You can have a concussion without heating your head based on the neurochemical result.

Dr. Justin Marchegiani: Right. It makes sense. Yeah. We don’t have a seatbelt holding our brain in place, right? You see like a woodpecker outside kinda banging their head against the tree, so to speak. They actually have ligaments that actually hold the rain in place. We don't have that. So that makes a lot of sense. Uhm, regarding TCE Traumatic Chronic Encephalopathy. That's the concussion issue. Uh, what's your take on it? And what’s your take on the new test that can supposedly test the TCE protein within 20 minutes after injury.

Dr. Russ Teams: Uh so, well, I guess technically you're probably looking at more of the inflammatory response with that test. So that’s gonna tell you if you have an injury or not. It doesn't tell you what you need to do nutritionally, right?

Dr. Justin Marchegiani: Right.

Dr. Russ Teams: So, getting a diagnosis is important. I always assume that there's a concussion, if there's any type of impact. I just—for instance, I just had a patient chemically concuss two weeks ago when they got infection. They got this run-of-the-mill, cardio—uh like a lung infection and it ended up with __in my office. So, you can chemically re concuss yourself. So, you don't have to hit your head. And, I mean, really, it what it comes down to. So, CTE is a major problem because—and it's obviously in the spotlight right now. Do all these things that we’re talking about nutritionally, fire the brain the right way and you’re gonna make a better connection with those neurons that you have left so that you can improve your quality of life.

Dr. Justin Marchegiani: Do you think microglial activation is part of the mechanism with TCE?

Dr. Russ Teams: Yup. Hundred percent.

Dr. Justin Marchegiani: Okay. Excellent. And then regarding—also, some of these injuries too could be autoimmune. They could be on the lower kind of subclinical autoimmune side, too. And you could have to start these neurological issues. It may not even be a chronic—a trauma, right?

Dr. Russ Teams: Right. So, what’s the root cause autoimmunity?

Dr. Justin Marchegiani: Leaky gut, gluten sensitivity, blood sugar infections.

Dr. Russ Teams: So, this CTE and brain-based dysfunction is really not that much different in the process of autoimmunity, right? You develop CTE, you have all this other stuff whether it’s chronic traumatic. I mean trauma can come from emotional trauma.

Dr. Justin Marchegiani: Uh-hmm. Like I see people that have had one concussion her whole life and it was a minor one, and their brain has shrunk to the size of like a grape versus an orange, right? I mean, they have all these atrophy and then your nerve just inflamed, they got anemia, everybody, all the doctors are saying, “Oh, it’s no big deal. You just take iron.” Well, it’s a B12 deficient anemia. So, you gotta have somebody that’s gonna look at this stuff.

Dr. Justin Marchegiani: Totally. Makes a lot of sense. And then regarding—we talked about the marijuana component, you talked about leaky guts. Uhm— when people get a concussion, do you make them stay up the whole next day. What’s the mechanism with making someone stay awake and not letting them go to sleep essentially.

Dr. Russ Teams: So, honestly I’m getting to the point where ICYA or I covered my ass.

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: I sent people to get a CT in the acute phase. A couple of hundred bucks to to make sure that you’re not bleeding is the number one thing, right? So that’s—if somebody’s like, “Hey, I just hit my head.”  “Alright, go get an image.” “Well, it’s just this symptom.” I’m like, “ Hey, that’s up to you.” My recommendation is to go get that image. So if you're still experiencing these weird symptoms a week later, they’re probably gonna run an MRI, okay? Now, if everything is clean, then you’re gonna rest a little bit. But we need to actually get that body moving, start doing some of these nutritional stuff right away. And start instituting some of these uh—some of these supplements and nutrition pieces. One thing you don't want really do right away and it kinda goes 50-50. We go back and forth with this, honestly. Depending on the presentation, you may not want to dampen that microglial response right away because you want them to clean up junk.

Dr. Justin Marchegiani: Right.

Dr. Russ Teams: You want to over clean stuff up. So, most of the time, I do nutrition, glutathione, Omega’s, Vinpocetine, Resveratrol. And then based on the symptoms, as they start to improve, then I’ll start hitting the uh—the turmeric in heavy dose like firehose, so to speak.
Dr. Justin Marchegiani: That makes a lot of sense. And then regarding the staying up, is it just because it’s a sign there there there's not a bleed happening where they could they could be asleep and you don’t know if they’re passed out because of the bleed. Is that the main reason why?

Dr. Russ Teams: Yes. So, a lot of people, I mean, you can have a slow bleed that takes two weeks to really create a life-threatening symptom, right? So that’s what I just—I just default to that, CYA. And make sure instead of guessing, right? I'd rather run this and be wrong than not run it and you know what I mean?

Dr. Justin Marchegiani: And in the conventional medicine, I mean, they really don't have much. It’s like keem them up for 24 hours and then wear some sunglasses, right? I mean that's pretty much the conventional medicine treatment, right?

Dr. Russ Teams: Yup. Yeah. So just watch and wait. That’s—they’re like, yeah, watch and wati and learn to live with it.

Dr. Justin Marchegiani: Wow. And then with progesterone— we talked about that as having some really good effects outside of just fasting. What’s the dose of progesterone you like? So that’s actually one thing I was talking to you uh—my business partner before this. Uh— we don't— currently we do not give progesterone. Although in the research, it has show to be neuroprotective. You’re not sure what— where that person's progesterone levels are, especially in women.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Russ Teams: It’s all based on where their cycle is. If they’re at a certain place and their progesterone is low, and they hit their head, they’re gonna have a way worse response then if it’s elevated.

Dr. Justin Marchegiani: Right.

Dr. Russ Teams: Though—when it comes to hormones, based on that H—HP H, I guess, hormone axis.

Dr. Justin Marchegiani: Yeah.

Dr. Russ Teams: Uh, we don't do that. We have lab for it.

Dr. Justin Marchegiani: Okay. Got it. But if it’s a guy that does not have a cycle, is there  a 20 mg dose? 50 mg dose?

Dr. Russ Teams: I’ll tell you what, I’ll follow up with you once we—once we—once the verdict is out on that. In the notes—

Dr. Justin Marchegiani: Perfect. That sounds great. Well, Dr. Russ, is there anything uh—that you wanna highlight?

Dr. Russ Teams: Sorry, can you repeat that?

Dr. Justin Marchegiani: Yeah. No problem. Is there—that answers all of our question here. But if there’s anything else you want to highlight that maybe you missed that you want to emphasize?

Dr. Russ Teams: Uhm—yeah. You know, if you have—if anybody out there is looking for a functional neurologist or chiropractic neurologist, feel free to either post a message here or contact me directly uh— through the website. Either or and I’ll try to get you in contact with somebody in your area. Uh—if you can't—if we can’t find you anybody close, we do intensives all the time or we get like six weeks of treatment in in one week. Uh—try to get just good as possible and then we return you home to somebody who can manage your condition at that point.

Dr. Justin Marchegiani: Do you work with any patients over Skype or a computer?

Dr. Russ Teams: Uh—we do uh, a lot of times, it’s over the phone. Like right now, I’m talking with somebody in the London. I’m getting him set up with some nutrition and some uh laser therapies. So we’re actually, they’re getting to the point where they’re gonna buy a laser because they can't travel very much. Uhm, we see people— we we have more people fly in for the neuro- rehab component, uh, than we do the nutrition over over the phone. I mean, just stuff like this, is invaluable, too. To be able to get this information out there like we have.

Dr. Justin Marchegiani: That’s awesome. Dr. Russ, thank you very much. He’s got health coaching for various doctors. WE’ll put the links below. Dr. Russ, thank you so much for coming on the show and dropping some serious knowledge bombs. We appreciate it. Have a good weekend.

Dr. Russ Teams: Well, last thing.

Dr. Justin Marchegiani: Yes.

Dr. Russ Teams: We have a seminar coming up next weekend in San Francisco. Saturday and Sunday. Dr. B, myself, Dr. Barry and Dr. Jared Siegler from the Living Proof Institute.

Dr. Justin Marchegiani: Oh, great.

Dr. Russ Teams: We’re gonna be hammering autoimmunity, brain-gut axis, so, expanding on everything we just talked here today. So, you guys, if you anybody or any doctor you want to know uh more about this stuff, we’re happy have them.

Dr. Justin Marchegiani: That’s great. And Dr. Jared was supposed to be on the podcast last week. I had to reschedule him. He’ll be on here really soon as well. Well, thanks for sharing that. Dr. Russ, we look forward to connecting soon.

Dr. Russ Teams: Okay. Sounds good. Thanks, Dr. J.

Dr. Justin Marchegiani: Take care.


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