Ep. 44: Howard Weiner, MD - Navigating Multiple Sclerosis & Gut Health - Brigham and Women's Hospital
We're so happy to have Dr. Howard Weiner on this episode of Health Gig. Dr. Weiner knew he would be a doctor since he was tiny boy and he has left a big impact in the medical field. He is the director and co-founder of the Partners Multiple Sclerosis Center at Brigham and Women's Hospital. He also happens to be a film writer and a film director.
In this podcast Dr. Weiner explains MS in basic terms, outlining the stages, the known causes and the evolution of MS medical interventions from the 1990’s into the 2030’s. He predicts the first vaccines will be tested in 5 to 10 years.
He also shares that studies have found the further you live from the equator the higher chance you have of contracting MS. Dr. Weiner breaks down Vitamin D3 and gut health. The microbiome of the gut is one of the big revolutions in medicine now. The gut and the microbiome, now considered our second brain, could be the reason we are seeing and increased in some of the autoimmune diseases like MS and Type 1 diabetes. If you were born with a vaginal birth, you get the microbiome from your mother.
Dr. Weiner is happy that he can now tell patients with relapsing remitting MS that they can live a normal life.
Dr. Weiner is not only a doctor, he is also a book author and a film director. He books include such titles as, Children’s Ward and Curing MS: How Science Is Solving the Mysteries of Multiple Sclerosis. He studied philosophy in college and made a documentary called What Is Life, where he went around the world and interviewed people to ask them the big questions. He also made the film Abe and Phil’s Last Poker Game. He is currently developing two new projects Fire in the Brain and Subways of the Mind.
More From Howard L. Weiner, MD
Website Brigham Women’s Hospital
Linkedin Brigham Women’s Hospital
Book: A Children’s Ward
Book: Curing MS: How Science Is Solving the Mysteries of Multiple Sclerosis
Film: What is Life (Watch Now)
Film: Abe and Phil’s Last Poker Game
Book Mentioned in the Podcast
[02:25] What we believe causes MS is the immune system attacking the brain.
[02:40] It's a complex combination of their genetics (although if this isn't a genetic disease) and the environment.
[03:20] Smoking can help make you more susceptible to MS. Also, where you grew up. Interestingly, the farther you are from the equator the more you have a chance of getting a MS.
[04:08] Vitamin D3 can affect the immune system, it can also affect the gut.
[05:20] Seventy-five or eighty percent of MS is relapsing remitting. So common symptoms is they can go blind in an eye. They can have trouble speaking. They can have numbness or tingling in their extremities. They can have trouble walking. Interestingly you usually recover from an attack the body can recover itself. After you have a number of attacks you can enter the progressive phase and that's when the brain itself becomes inflamed and then you have trouble inside the brain and that's called progressive MS. That's actually the type of MS that causes the most disability in many many people if they're untreated who have relapsing MS will then go into progressively MS.
[06:44] We have treatments for relapsing disease that stops the cells from going into the brain.
[09:44] Then we've identified many genes that are predisposed to MS and they all relate to the immune system but generally is not genetic like certain other diseases that if you have it then there's a 50 percent chance that your family has it or whatever. Most of the MS is sporadic. So a question that may ask many times what are the chances my children. So the chances are increased a bit but not a lot.
[11:41] I say to my patients I can keep you healthy till your 90 but then you're on your own.
[13:34] I think we can begin early vaccines in five or ten years. But if you think of the experiment it's a twenty year experiment because if you take a group of children who are five to 10 and they're going to get MS when they're twenty or thirty you got to give the vaccine and then you get to wait twenty years to show they don't get it but one day that'll happen.
[14:03] Microbiome of the gut is one of the big revolutions in medicine now.
[14:11] The gut is your stomach, your upper intestine, and your lower intestine.
[14:26] There are a hundred trillion bacteria in our gut, one hundred trillion.
[15:00] If you're born by normal vaginal delivery you get the microbiome from your mother. If you're born by C-section you don't get the microbiome. And they did studies in children who were born by C-section when they get older have more allergies and other diseases because they didn't get the normal microbiome.
[15:23] Your microbiome changes as you get older as you go through puberty when you get middle age or older the microbiome isn't as strong as it was before.
[15:51] There's increased now in some of the autoimmune diseases like MS and type 1 diabetes and some people think it relates to what we call the hygiene hypothesis that we live in too clean of a world. The microbiome affects MS, it affects cancer, it affects obesity, it could affect autism it can affect everything.
[16:48] The gut communicates with the brain. We know that in one way if you get nervous you feel in your gut. I mean you know there's nerves that go back and forth and there's things in the gut that communicate with the brain. So it's very important.
[17:12] I would say the gut is the second brain because it's so complex. The brain interacts with the whole body and the gut interacts with the whole body. In fact there's some data that I saw yesterday related to autism in children who get autism and that can relate to the gut.
[17:59] So one of the things are probiotics we actually did a trial where we gave some of our MS patients probiotics to see whether we could affect the gut and to see whether we could affect the immune system and we could.
[19:22] If I have to recommend anything I recommend a mediterranean diet.
[19:58] I don't know anybody that doesn't have stress.
[22:45] From the time I was born my mother told me that I should be a doctor.
[22:58] So when I was born my mother said, “You know my father wanted you to be a doctor”. On the day I was born she said that to me -- I didn't remember that of course but when I was five years old I remembered it. And when I was eight or nine or ten I always felt when I walked by a hospital I belonged there. So that's kind of a destiny so I kind of feel we all have our own destinies and I think my destiny was in medicine for whatever reasons. I felt that.
[23:27] When I was in medical school I made music videos of Beatles songs.
[23:59] I was also a philosophy major in college and I was interested in life's big questions. So I made a documentary called What Is Life, the movie. And I went around the world and interviewed people and ask them the big questions.
[27:56] I think that there's a common humanity that we all have -- and that we all have to deal with it. We have to deal with bad things that happen to us. How do we deal with it? We are very connected to our families. How do we look after our families? We are worried about the earth. And I think we need to leave the world better than when we came. I think that's kind of everybody's mission in life.
[29:24] There's some patients who've said to me interestingly that, “My life is better now that I got MS because it puts my life in perspective gives me a focus.”
[29:38] So I saw a young woman, a medical student, who came down with the MS and of course she's scared. I mean she reads everything, she knows everything. So I'm able to say to her, “Don't worry we have medicines that you can take. You can get married. You can have your kids. You can be a doctor”. For a physician to be able to say that to a patient is very very gratifying.
[33:01] When you think about death you have to then put more energy into living your life.
[33:16] I think that we have to realize that our time as we know it is limited. And so we need to take advantage of it. We need to feel blessed with what we have. I mean in terms of all the wonderful things in life. That should give us energy to live our lives better.
[34:07] Winston Churchill: “Never ever ever quit.”
Thank you for joining us on HealthGig. We loved having you with us. We hope you'll tune in again next week. In the meantime, be sure to like and subscribe to this podcast, and follow us on healthgigpod.com.
“I say to my patients I can keep you healthy till you are 90 but then you're on your own.” – Howard L. Weiner, MD
“I think we can begin early vaccines in five or 10 years.” – Howard L. Weiner, MD
“There are a hundred trillion bacteria in our gut, one hundred trillion. The microbiome of the gut is one of the big revolutions in medicine now. ” – Howard L. Weiner, MD
“If you're born by normal vaginal delivery you get the microbiome from your mother. If you're born by C-section you don't get the microbiome. And they did studies in children who were born by C-section when they get older have more allergy and other diseases because they didn't get the normal microbiome. ” – Howard L. Weiner, MD
“There's increased now in some of the autoimmune diseases like MS and Type 1 diabetes and some people think it relates to what we call the hygiene hypothesis that we live in too clean of a world. The microbiome affects MS, it affects cancer, it affects obesity, it could affect autism it can affect everything.” - Howard L. Weiner, MD
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