Alex Laid: We co-evolved with plants and so we are complex and we need lots of complexity. So while modern medicine became really good at doing and dealing with acute conditions and still does, don't go and see a herbalist if you're knocked down on the street.
Dr Rupy: Absolutely.
Alex Laid: And thank God for painkillers and so on. So there's lots of good things about modern drugs, but they're not really designed for for for chronic disease, for long-term things which actually conditions which we tend to contribute to ourselves through lifestyle or food or whatever. So in 1864, got this group of people together who said we want to support the professional use of plant medicine, inform it with the emerging science. And that's really where we are still today.
Dr Rupy: Welcome to the Doctor's Kitchen podcast with me, Dr Rupy, where we discuss the most important topics and concepts in the medicinal qualities of food and lifestyle. These are some of the things that I've written about in my latest book, Eat to Beat Illness. And today I'm speaking with medical herbalist and author of the amazing book Root to Stem by Alex Laid. She runs one of the few NHS medical herbalism clinics at Whipps Cross Hospital in London alongside a consultant dermatologist where she sees everything from acne to rosacea to eczema and has over 20 years of experience. She's trained in phytomedicine and plant pharmacology. She's also a visiting lecturer and has published numerous research papers and she's also co-founder of the charity Living Medicine. Now, she's a firm believer in using food and forged plants to help support wellbeing. And eating for your health is not like food as a pill, but as an important consideration for health. And that's why I believe that nutrition training is vital for all medical practitioners to grasp an understanding of as well as the public. There is a lot of evidence-based, safe dietary and lifestyle change that we as practitioners can be confidently discussing with our patients. And that's why I think medical herbalism as a complement to other therapies is something that needs a lot more attention and could potentially have a lot of benefits. As a general practitioner, I've anecdotally seen a lot of improvements with medical herbalism as an adjunct to therapy. This is not something to have in isolation. We work collaboratively and that's why I was so impressed by the fact that she works in an NHS hospital alongside conventionally trained practitioners. I'm trying to steer away from the term conventional actually because in essence, we are all practitioners and patients are what we need to focus on most. We're going to be cooking an adapted recipe from her book Root to Stem and I'm fascinated by her role as a as a herbalist and her knowledge of plant pharmacology that will definitely come through in our conversation. Listen to the end for a summary of our discussion. You can check out the video of the recipe that we made on my YouTube channel, The Doctor's Kitchen, as well as a whole bunch of other things on the website to improve your overall wellbeing. On to the podcast. Alex, welcome to the kitchen.
Alex Laid: It's an absolute pleasure to have a medical herbalist here.
Dr Rupy: And so, why don't you tell us a bit about medical herbalism itself as a specialty? Because there's very few of you in the UK. It seems to be quite a close-knit community as well. Everyone knows each other. So what is medical herbalism to you? How did it start? And I'm fascinated by the fact that you're working in the NHS as well at Whipps Cross Hospital.
Alex Laid: Well, I yeah, I'm very lucky to do it. So in 1864, some people got together, it included doctors as well as lay practitioners of herbal medicine. And they wanted to really bring, if you like, the more modern science to bear and to inform tradition. So the tradition, I suppose, that had been used, all doctors were using plants as medicine because that's what plants were. And it was whole plant medicine pretty much. And then, of course, as the scientific method came in, there was this change of in medicine and using mercury and all kinds of other things. And of course, there were some lots of good things and lots of intelligent approaches and rational approach. But it was believed that we shouldn't chuck out the beauty and the the value of whole plant medicine. And I suppose now we know the reason for that, because we know that we're highly complex creatures. And single use, taking out one active ingredient of a plant, and one of the earliest that was turned into drugs, as you know, is digoxin or digoxin, which is an alkaloid from digitalis, from foxglove. That has major consequences on the body because you're take, you know, we're not normally used to taking out one ingredient. Exactly. We are, we co-evolved with plants. And so we are complex and we need lots of complexity. So while modern medicine became really good at doing and dealing with acute conditions and still does, don't go and see a herbalist if you're knocked down on the street.
Dr Rupy: Absolutely.
Alex Laid: And thank God for painkillers and so on. So there's lots of good things about modern drugs, but they're not really designed for for for chronic disease, for long-term things, which actually conditions which we tend to contribute to ourselves through lifestyle or food or whatever. So in 1864, they've got this group of people together who said, we want to support the professional use of plant medicine, inform it with the emerging science. And that's really where we are still today.
Dr Rupy: Right. Yeah.
Alex Laid: And it's looking much more as maybe you understand with functional medicine, the functional medicine. So it's very much now a functional approach. We look at what different, how the different organs are functioning, you know, the the health of the cell. How we eat. I mean, back to Hippocrates, who is the father of medicine, food, sleep, bowel function, you know, digestion, absorption, and also really, really key thing, which is now understanding much more about the circadian rhythm. So that's where, if you like, the more modern science comes in, is understanding kind of complexity. And we've been doing complexity for a long time, but now we're learning much more from science as to refining our knowledge about our relationship with plants. We know more about what's in them, what might be less beneficial, like people have been using borage for hundreds of years. And now we know that that particular plant family is contains pyrrolizidine alkaloids, which we know actually cause liver cancer and are really damaging to us over long term, long term, not not in the short term.
Dr Rupy: Exactly.
Alex Laid: So yeah, that's really it. And there are probably actually about five or 600, possibly more medical herbalists. But the reason that we all know each other is because we many of us trained together at the College of Practitioners of Phytotherapy or College of Phytotherapy in Kent, which was in Sussex, which was um a later incarnation of one of the original schools.
Dr Rupy: And you've brought some wonderful treats with you as well. Do you want to tell us a bit about that actually?
Alex Laid: Well, it's very exciting this time of year because now we are July. And um my garden is I'm very blessed to have a garden and it is overflowing with a second flush, if you like, of roses. Now these are old roses and they are so, so smelly.
Dr Rupy: They look and smell.
Alex Laid: They are amazing. In fact, you just have to smell that one. Just have a whiff. Oh, wow. That is so powerful.
Dr Rupy: It is amazingly powerful.
Alex Laid: So this is actually an old rose. She's called Madame Isaac Pereire. So watch out. And this one is another old rose. Have a whiff of her. Wow. Okay. Yeah. Very distinct.
Dr Rupy: You're really transported, aren't you?
Alex Laid: This is actually a this one is called Comte de Chambord. So this is the count of Chambord. So he's a he's a he's a man, apparently.
Dr Rupy: Anything in French, it just sounds delicious.
Alex Laid: I know it does. It sounds delicious. So these are two of the most fragrant roses you can have. And and in traditional medicine, which we try as medical herbalists to inform, you know, with science and so on as well, but not lose the spirit and the soul of understanding the relationship of plants to us. This rose is really associated traditionally with the heart. It's also been used, believe it or not, in impotence. There's been some research into impotence for men. Um but it's it's full of these wonderful flavonoids and and pigments which actually support circulation, but it's particularly used in menstrual, menopausal conditions, but it's also astringent. So it's very, you know, we use it, you know, rose water.
Dr Rupy: Yes, yeah, yeah.
Alex Laid: It's a classic thing for for skin.
Dr Rupy: We use that for so many different things in Indian cuisine, Persian cuisine as well. They love rose rose petals and stuff.
Alex Laid: One of the great things about this is that it's absolutely full of, I mean, maybe even as many as a thousand phytochemicals. Um and the beauty is, as you say, about the use of rose water and the floral waters, which you get when you gently actually distill, you water distill, you pass water, hot water over over a whole mass of beautiful petals. And what you get then in the distillation is the floral water picking up the water that picks up some of those phytochemicals. But the beauty, one of the beauties of those, which can be used in food, of course, as astringent for the for the for the face, for skin, is that it's these floral waters are brilliant for using with kids as well because they're very it's a lovely way of getting medicine into them in a gentle way. So things like um orange leaf and petitgrain, floral waters and chamomile floral water. Yes, you can make a tea, but you can also use the floral waters.
Dr Rupy: Yeah. And my mum will attest to that actually because she's always making uh skin preparations with rose water and different essential oils and stuff. She will never give me the recipe because she believes that I'll just give it to everyone, which is why I can't.
Alex Laid: She's probably right. She's probably right. Yeah.
Dr Rupy: So.
Alex Laid: Would she distill her own?
Dr Rupy: Uh I'm not too sure actually. She wouldn't give me the recipe.
Alex Laid: Because that's quite a fun thing to do. You know, you could do it on your own cooker. Very simply, you know, you can distill your own.
Dr Rupy: Absolutely. Yeah. And in India, we have like a whole bunch of um uh rose farms and stuff and they actually make the rose water and you see how they make it from scratch. It's pretty amazing. That smell is wonderful. And you've got some other goodies here as well.
Alex Laid: So we've got some other things. So we've got um geranium. Now this is really easy, like those two roses are, to grow um in a garden, but when the winter comes, you need to bring them in because this is a pelargonium, pelargonium graviolens. So it's a culinary geranium, if you like. Um and the smell again, it's so full of essential oil. So you know. Yeah, wow. I mean, that really is strong. Tiny little flower. Again, very similar to rose.
Dr Rupy: So I'm going to start growing this in the studio.
Alex Laid: You are going to start growing it, exactly, because you just plonk that into, maybe take the bottom leaves off a little bit, and then put it into some soil and really it just is so vigorous, it will really grow easily, but it doesn't like the frost, so you have to bring it in in the frost.
Dr Rupy: So what are the uses for this?
Alex Laid: So this in a way is quite similar to the rose. It's astringent, it's good as a face facial tonic. It's very uplifting. In fact, that's the thing about the rose, why it's connected to the heart because it's it's kind of in a way a bit of an antidepressant. You know, it makes you feel good.
Dr Rupy: It's um yeah.
Alex Laid: So that's what this does, but it's also linked to fertility and menstrual problems and menopause and so on. So we use it either as a tincture or what we're going to do actually is to make a tea.
Dr Rupy: Okay, yeah.
Alex Laid: With with that and the rose, just to show that you can and how to how to do it. And then this is from is a honeysuckle. And I don't use this so much in Western herbal medicine, but probably should, but in Chinese herbal medicine, it is the herb for lung conditions. But this one doesn't quite smell as much, but although it's beginning.
Dr Rupy: Yeah, it's coming out actually, because I yeah.
Alex Laid: It is. So you just make a a tea, which I infuse for a long time. None of this dunking a tea bag in and taking. That is not really a proper herb tea in my humble opinion. I think it's about letting these flavours in gentle, not in this case because these are delicate, not in total boiling water, but off the boil and letting them infuse for maybe half an hour or an hour or longer till actually I prefer them tepid myself, but that's just a matter of taste.
Dr Rupy: Amazing. Yeah. I think I think it's absolutely fascinating to witness this renaissance of lifestyle medicine that has a basis across all different cultures. One of the wonderful things I love about your book is um the dedication of it being to nature essentially and how nature is the greatest teacher. And how when we put ourselves in the best environment, we're actually looking after ourselves um better than any singular drug element. That isn't to discredit the utility of pharmaceuticals. I use them every day as an emergency physician and as a general practitioner. But the there's a wonderful term I came across, um salutogenesis, which is the creation of wellbeing. And actually, when you look at the factors behind salutogenesis, it's things like your environment, it's things like plants, it's things like um support networks, community, sense of purpose, all these different things. And I think it's a fascinating way because in medicine, we're taught pathogenesis. So the mechanism behind illness and everything is geared towards sick care, which is very much what we do every single time, every single day. But I think we're witnessing a renaissance in medicine where we're actually looking at ways in which to improve the health of people and prevent them from getting ill in the first place. And one of the things I loved about your book actually is how you go through the different seasons and you weave in different lifestyle factors as well and how relevant they are to different parts of the year. Um which is is absolutely wonderful. And I learned quite a few things from your book actually, which I'm hoping to to chat about a little bit later as well. But essentially, one of the the key points that I got across was uh got from the book is variety of plants and the complexity that we have in plants that is very, very hard to mirror with singular elements that we take out and we put into pharmaceutical or even supplements as well. You know, resveratrol is very popular, curcumin is very popular. They definitely have certain uses. Um but for the majority of people, I like to think about uh wellbeing, the creation of wellbeing in terms of food and what we combine in the supermarket and what we can forage as well. So I'm not a forager, but I'm fascinated by this whole hobby or you know, um way of life. Um so and you do some foraging, is that is that right?
Alex Laid: Well, I do. I mean, in my own garden actually. So now we're going to get you to do some foraging. Okay, yeah, yeah, for sure. Because if we grow, you grow some nettles. I should have brought you some nettles as well. But I have brought some nettles cut, but I'm not sure that they'd take and grow um roots like the geranium does. But um that means that you could be a forager in your own garden. And I am now foraging because I want more complexity. I want more um you know, I want I want to eat plants that are really robust and complex and got lots of lovely phytonutrients and minerals and so on in them. And the wilder ones are the ones that have had to uh I don't know about this fight because I'm not too sure about that as a metaphor really. But they've had to respond. They've basically had to have salutogenesis. They have had to respond to their environment in order to get strong, healthy, resilient. And so they've developed many phytochemicals, plant chemicals, phyto, I'm a phytotherapist, I'm a plant therapist in in European terms. Um to develop their strength and ability to talk to other plants, to resist disease, whether it's antiviral, antifungal, antiseptic. Um talk to, lure in insects like that's part of the job of those phytochemicals that are aromatic, the essential oils, they produce those in order to lure in chemicals in um their predators or their insects and so pollinators and so on. And those are the very things that we've co-evolved with. We've co-evolved with these plants in that complexity and we need them to have to be able to create that complexity in them.
Dr Rupy: Yeah. This is what attracted me to the whole field actually of food and medicine initially was the study of phytochemicals. So the chemicals that we find in plants that uh essentially give us health benefits. Um and just reading some of the papers, I think I came across Diana Minnick, who's a she's a practitioner out in the states. She's done a PhD in therapy in um plant therapy as well and written some incredible papers with Jeff Bland. And just the way she took, she has a wonderful way of of explaining it to lay people using colours and a lot of like Chinese herbalism terms, but also a way of describing exactly what she means by the the mechanisms behind which plants uh confer benefits to us in scientific terms as well. So for someone who is I'm pretty reductionist when it comes to I want to know what the mechanism is, what impacts B, what impacts C and what the ultimate outcome in. Obviously, as you know, it's not as easy as that and it's it's very, very simplistic to think about those terms. But for me, it's fascinating. I absolutely love learning about, you know, plant hormesis, for example, the the mild stresses that actually elicit a resilient response from the organism, be it our body, um which leads to uh improved resilience to stress later on, which I don't think a lot of people understand either because they think of, you know, you introduce this food and it cleanses you or you introduce this food and it reduces inflammation. Whereas actually, it's your body doing that. It's the relationship between the food and what it elicits in the body itself.
Alex Laid: Do you know, I think there's one really easy way to understand this or easier way. And that is if I'm lifting a heavy thing, okay? So let's say I'm lifting this.
Dr Rupy: It's a pan. It's very heavy.
Alex Laid: So what that's doing is that immediately I lift that, there is a a light stress on my on my bones, on my muscles, and what are they doing in response to that stress? If they didn't respond to that, and that's the principle of, you know, weightlifting or any kind of exercise, um it simply wouldn't be strong. I wouldn't be strong enough to lift. So and if I go on lifting heavier things, this again will keep responding. But it's mild stress that it needs in order to grow or in order to get stronger. And it's the same for our heart. You know, you just start panting every day a bit. And you know that that heart muscle is going to get bigger with in a good way. Um and it's will have more oxygen in the blood and it'll have better perfusion, you'll get more angiogenesis in a good way. Yeah. Because you can have pathogenic angiogenesis. So it's really understanding that stress, good stress, not too much. It's like that seesaw. If we have too much stress, we're dealing with the effects of too much stress in ourselves and in our patients.
Dr Rupy: Yeah. Absolutely. And I think that that balance that you're alluding to with angiogenesis, that uh that homeostasis, that, you know, medium balance, it's true of every single pathology I find, whether it be inflammation, whether it be stress reduction, whether it be, you know, everything. You want just enough to elicit the health benefits, but not too much that can turn it into a pathogenic mechanism.
Alex Laid: So our job really, I suppose as medical herbalists and in functional medicine, what you're trying to do is identify from a really good case history that doctors used to be taught how to take. And um how to actually reduce the load, identify what the load is, the over stress load that's causing disruption in this system that says that's too much. The body system. And looking at different aspects of the body, the different functions and so on, the liver, the heart, the circulation, the immune system. And then say, well, how can we now nourish those systems? How can we provide every nutrient, the right rest, follow our design. Because I think about design, the circadian rhythm, you know, what are we actually designed to do over practically 4.5 billion years, not us as humans, but life. And most of life is subject to light and dark. And that means that daylight is all about is about activity and nighttime is all about repair for body and mind. And understanding when we need to do that. So plants come into this in terms of um that complexity which can begin to nourish some plants work very well on the liver because of the particular phytochemical mix or the groups of phytochemicals. And other plants work better on the heart muscle, just like digoxin, but digoxin comes in with lots of other glycosides and other compounds as well in the um what's it called? fingers in foxglove. But we don't use that in herbal medicine anymore because it's really difficult to get that right. So, but it's this complexity that happens in plants that we really thrive on. And the body decides what it wants of that and it might be in you that some of the compounds, let's say in nettle or in an ordinary broccoli, you know, even monoculture grown broccoli, you won't be using because we don't use everything in a food that we take in. But um and I might use slightly different ones. So it's it's you know, the body decides really in its highly complex.
Dr Rupy: I am actually fascinated with that sort of evolutionary approach to medicine. How have we designed to be in an environment and how can we mimic what we're designed to do with the benefits and the advantages of modern living as well? So the very fact that I can turn on my lights gives me an advantage that I can work longer, but perhaps it's disruptive to my circadian rhythm. And you know, so it's it's marrying that and trying to figure out exactly how that works. And I think there are simple principles that you allude to in your book as well and that I've done in my my second book, Eat to Be Honest, where I look at lifestyle 360 measures and how that all kind of comes together. Um but there are very simple ways of doing it. I think there's there's where I'm probably guilty of this myself actually by over complicating the science uh and you know, really the principles are very simple.
Alex Laid: This is absolutely it, Rupy. The principles are simple and it is about variety, complexity, yes, but how do you serve complexity? You serve complexity with variety. Yeah. Yeah. Actually. And that's that's the way nature's designed. So you I mean, I love this because talking to patients, you do have to if you want to help them understand and they're I mean, we're all fascinated, how do our bodies work? And actually, you can get it across in in
Dr Rupy: Yes, simple ways.
Alex Laid: And and things like, you know, I see, I know stressing that, you know, arm is strengthening it. And that's the principle for nature. And that is hormesis. Hormetic stress is is having enough of that stress to actually create salutogenesis if we're going to throw a few, you know, Greek terms around.
Dr Rupy: One of the things I found, uh it's it's frustrating, but I suppose it's just the scientific process whilst uh being on my nutrition medicine masters, you know, trying to figure out whether the phytochemicals that we find in berries, for example, actually can have an an impact on a defined uh pathology. So let's say colorectal cancer, for example. You've got to figure out, okay, what are the phytochemicals, of which there are thousands? What degree are what amounts of those phytochemicals are found in specific berries, which, as you know, will vary across berries and the varieties, but also across season.
Alex Laid: Across where they're grown.
Dr Rupy: Across land.
Alex Laid: More vitamin C in higher grown um rosehip, for example.
Dr Rupy: And then trying to test that, it it would be naive to test that certain phytochemical that you find in a raw berry compared to what you find once it's been digested. And so you have to mimic what digestion is in a stomach, and then you have to mimic what the microbiota could look like and what the metabolites of said phytochemical would look like and whether that's having an impact. And then you've also got to negate the fact that when you eat a berry, you're eating fibre, you're eating probably a little bit of, you know, some other macronutrients, so probably a little bit of protein in there as well.
Alex Laid: And fats and oils, which are super important.
Dr Rupy: Exactly. And so all of it affects you. Exactly. And so it's so complicated to find a robust study that will determine that yes, berries are good for XYZ. And isn't a preventive, not in a uh a preventive way. We know they're definitely associated with prevention. But with cure, not cure, but uh treatment, it's very, very hard, right?
Alex Laid: But here's the thing. I think we need in medicine to develop new um approaches to what is complexity. And unfortunately, in medicine, it's been very reductionist. That's given us some benefits, definitely. Because it's like looking in a with a pair of, you know, really, really good um uh what's not a pair of binoculars, the opposite, you know, the things that look at things more micro microscope. Thank you very much. Yeah, a microscope at what's going on at that tiny level. And maybe we still don't know what's going on on the quantum level. I mean, heaven knows. But it seems to me that if that like the meteorologists and the volcanologists, at least, and not least many other branches of science who have had to recognize they have to take nature's design is about complexity. So how do we design trials, you know, that reflect that complexity? But pharmacologists hold their hands up in horror and say, oh, we can't do that. But actually, that's the reality of nature. So maybe we have to think differently about how we do that work and do more outcome studies or whatever.
Dr Rupy: Absolutely. And so that we can see, you know, because you've got so much variation in you and me and, you know, 200 people in a trial.
Alex Laid: Absolutely.
Dr Rupy: Yeah. And that's why it's it's easier to be as reductionist as possible. Like at the moment, I'm I'm designing sort of a research uh study to to test uh a digital product that improves people's uh consumption of fruits and vegetables. I would love to say if we increase people's uh vegetable consumption of these particular vegetables, this has an impact. It's near impossible to do that. I think it's rather than unlikely, it's probably near improbable that's ever going to be done. But I think uh to your point, we do need to be a little bit more accepting of the variability and actually uh pragmatism and what we see and what we uh advise patients on with those in front of us has to be based on some scientific evidence and then also a little bit of autonomy as well, the clinical.
Alex Laid: But it's what evidence is, you see, because uh Sackett, who's who's student, um Gordon Guyatt, uh coined the term evidence-based medicine. He is the one that's best known for evidence-based medicine, but he said evidence-based medicine is three things. It's it's yes, scientific trials, gold standard, so-called. Um clinical experience, which is actually in fact what what you're doing, I guess, in a lot of A&E, a lot of emergency medicine is a lot to do with what's worked. Because you can't exactly replicate that in a trial, can you? And thirdly, patient values. And so-called patient-centered medicine is saying, do I feel, you know, for example, do I feel better? I feel better. Oh, but the doctor's not interested if I feel better. So I think that that's what Guyatt, that's what um Sackett said, David Sackett was said was really the triad of those things. And I think we need to take more account of that.
Dr Rupy: Absolutely. Yeah. I think um I I know exactly that Venn diagram of, you know, evidence-based or gold standard randomized control trials, etc. and the intersection with clinical autonomy. Uh it's something that I think is gradually being eroded as we rely almost too much on data and uh clinical evidence because there's never going to be enough clinical evidence. And particularly when it comes to food, and this is one of my pet peeves, I think, and I don't want to get on my high horse about this. But particularly when it when it comes to food, we're never going to get those uh that evidence base that says this is 100% going to be improving your skin or your whatever elements there are. However, there are some reasonable things that we can say and one of the things is variety.
Alex Laid: But maybe that's what we need to say, Rupy. I mean, and maybe we don't have to say 100% because what's 100% for you, if we ever discover that, you know, and the changing, it's a dynamic state of health, salutogenesis. Um you've got this change all the time. The gut flora is not the same. That's going to make a difference to all those messages going up here, the amount of, you know, fiber that you take in is going to change. I mean, everything changes all the time. Yeah. Yeah. So it's I think it's about these principles and it does come back to, you know, what Hippocrates said. Yeah. And we need to, I think one of the most important things that we need to do actually, and we can do in in medicine, whether we're a conventional medic, ahead of the game, as you are, and Ron as well, you know, and all these others and increasing number of fantastic young doctors who are saying, we just want to do what is more human, you know, and and bring in all our scientific knowledge, but not throw out, you know, what we can see in front of us. Um is to um what we can do as people involved in medicine in one way or another and health and creating health is actually to value our food growers. And the you know, what is derogatorily known as a peasant farmer around the world, they're doing fantastic work. They're keeping both most of the population alive. And mostly with complex, traditional, non-monoculture, which is really valuable. And we can be baby peasants ourselves, you know, growing little bits and pieces, for example, on our um window sills or if you have a garden, you're lucky enough to have a garden or a or a um a balcony and grow things like little like bits of um nettle and uh geranium, I've got now. Geranium, exactly, and maybe parsley and some of the really concentrated uh uh plants, so-called herbs that are concentrated in all these phytonutrients and minerals and so on, parsley, for example. Because
Dr Rupy: That's one of the things I tell people all the time actually, you know, if you don't have access to ingredients that are perhaps less well known. Honestly, simple kitchen herbs are perhaps one of the most nutrient dense ingredients you find, very accessible.
Alex Laid: Very accessible.
Dr Rupy: And you can get them all supermarket.
Alex Laid: What I'd say to patients all the time and when I'm teaching, go to the supermarket. When you've got a tickle in the back of the throat, go to the supermarket, buy even that rather watery, not very nutrient as nutrient dense as it should be because it's probably been grown on hydroponics, which is not very good because it's just grown too fast, so it hasn't had a chance and it hasn't been stressed enough to develop all that lovely complexity of phytonutrients. But thyme is still one of the most antiseptic plants you can have. Chew it. Bit bit, you know, a bit hardcore maybe. It won't taste very nice. But instantly, you don't have to go and sit for hours or wait to get to see your doctor. Just go and get some thyme or some sage and chew a little bit or rosemary. And instantly you've freed up those essential oils which are known for their antiseptic action in the throat where you want them to go and gobble up those bacteria or or help to disarm the virus. Mustn't use these these these warlike because I don't think that's I don't think that's really like nature.
Dr Rupy: We're we're trained to sort of like think about things as a fight and things as attacking and and that kind of stuff. And I don't think it really it's kind of like the immune system, like, you know, boosting it or or uh making the analogy of it being a military force. In in the book, I talk about immune system as more of as a peacekeeper. So we're keeping everything in harmony. You know, we're detecting what uh cells are malfunctioning or mutated and we clear those away. And we're also accepting, okay, that's not foreign, that's self. I'm not going to attack that. And when that goes out of disarray, that's when you have issues with uh poor immunity or or uh an excessive immunity. Um and leading to autoimmunity, which is a fantastically complicated subject. Um and now, as I'm sure you're aware, last year, there was a Nobel Prize awarded for immunotherapy for cancer, which is why I'm I'm looking at this like rigorously. I know it's going to be a huge, huge thing going forward. And you combine all these different things like angiogenesis, um the gut microbiota, as well as the the microbiota of all different parts of our body.
Alex Laid: Yes, exactly. Our mouths, the vagina.
Dr Rupy: The skin, the vagina, ears, scalp. Yeah, yeah.
Alex Laid: Absolutely. Yeah. Which people are not really aware of.
Dr Rupy: Yeah.
Alex Laid: And and the other thing is it's also the microbiome that's actually sitting on that leaf, even on that inert, there's biofilms and microbes. Because they're just the invisible. Of course, in the soil, there's fermentation going on all the time and so on. Um
Dr Rupy: We should probably get cooking.
Alex Laid: We'd better get on. I can talk to you for hours on this because it's so totally fascinating and and important actually. It's really important that we do shift these paradigms into complexity.
Dr Rupy: Totally. So, um tell us what we're going to do.
Alex Laid: Okay. So, what we are going to do is, I think there are two, what I teach is like there are two really basic dishes to which are so simple to make and are designed to get people who don't like cooking to cook in with no time being wasted and really easy. And one of them is a is a kind of smoothie dish with oats, nuts, seeds and fruit on the one hand. So a good breakfast to last four hours in the body, no snacking needed, feel full and so on. Then what we're going to do is the next thing, which is to make a base dish which every culture has used, which is combining a grain on the one hand and a legume, a bean or a lentil on the other. And by putting those two families together, families are really key. You're getting all your protein. Now, there are other plants like quinoa,
Dr Rupy: That's one thing I learned from your book actually about how quinoa is related to the beet family. I had no idea. No. It's crazy. I had no idea. Yeah.
Alex Laid: And you can eat the leaves.
Dr Rupy: Yeah. Yeah.
Alex Laid: Yeah. No, fantastic. And amaranth is another one. And many, many cultures use that. Um so a gooey, which is even better, it's gel-like, which is very good for our gut flora. But anyway, so in the Caribbean, you've got rice and peas, albeit often white rice, which we're not so keen on because that's stripped away most of the nutrients. Uh in in India, you've got dal bhat or in the east, you've got um majadra, excuse my Arabic, anybody who's listening who speaks Arabic. But um and I've learned, you know, this is why we need diversity again, because then we teach each other. You know, we all learn from each other. So because humans are prone to, as we know now, a lot of mistake, not just mistakes, but getting it wrong a lot of the time. Not not sapiens, not sapiens. So, um what we're going to do is mix that grain and the lentil, in this case, because they're really quick, well, quick to cook in that they're only 35, 40 minutes. But you can go away and do something in that 35, 40 minutes. So effectively, it actually only takes about five minutes of your time. And we could time it for fun, but we won't. We won't. So let's say we're making four days. And the reason that I suggest four days is that probably if you as long as you've got a cold fridge, it probably won't keep longer than four days and we shouldn't really do that. So, shall we go for it?
Dr Rupy: Yeah, let's go. Yeah. So we've got some short grain rice here. Yeah. And we've got what I actually prefer more, which is the black rice because we're always talking, you're always talking about phytonutrients, phytochemicals, particularly the pigments in food. And um black and dark, they aren't the only foods we should eat because we want variety. And the Japanese say 30, it's said in 1985 or six to the whole population, aim to eat 30 different foods a day.
Dr Rupy: 30 different foods a day.
Alex Laid: Actually, it's not that difficult. My breakfast has 13 elements in it.
Dr Rupy: Okay.
Alex Laid: And that would include and now we're going to do something, well, you we're going to count as we go. Okay, well, let's just let's count as we go. So I've already had almost half that element and I on my first meal of the day. So we've got this gorgeous black rice. They call it black Venus rice. You can also get an amazingly beautiful rice, which is really long, um black.
Dr Rupy: The wild rice.
Alex Laid: Well, yeah, I don't know if this is wild or not. I mean, I I don't know.
Dr Rupy: The ones that I the the ones I'm thinking of are like really long spindles and they're quite chewy. They take a little bit longer to cook, but they're they're wonderful.
Alex Laid: What was the one you were saying was something in India?
Dr Rupy: Forbidden rice. It's also called. Yeah. So this is also this is also called forbidden rice, this black Venus rice. Um there's a story I think about how it was forbidden for peasants to eat it because that was reserved for the uh the royalties as as
Alex Laid: Well, now we can big up the peasants. And and the royalty is very, very naughty, these rich people right around the world saying we want our stuff. But it was interesting that they don't because normally you think of the rich as having unfortunately led us down this path of refined white food. White, no, we don't want that. That's a treat thing.
Dr Rupy: We want colours.
Alex Laid: We want colours. We need colours to help us live. So we're going to put, I would just put roughly half a cup of each. So there's no um actual amounts as such, but roughly half a cup of each will do about four days worth. And what the aim is.
Dr Rupy: I've got this on a low to medium heat in this uh pan.
Alex Laid: Yes, that's fine. So maybe lovely plate by the way. So these are black, they're called beluga lentils. And of course, you can use, you know, puy lentils.
Dr Rupy: Those are my favourite.
Alex Laid: Yeah.
Dr Rupy: I love puy lentils.
Alex Laid: I think these might be your favourite from now on.
Dr Rupy: Okay, fine. Okay.
Alex Laid: So you can't really see them, but they're the sort of grey, brownie ones. Sort of black. They're also fantastic. The key thing is not there's not one better than the other. We need variety. Exactly. Yeah. Um and but just I'd probably avoid the red lentils. I mean, have them, but they've taken the skin away and they're quick to cook, which means that they're not going to last as long in us. And the idea is to have food that you need to chew, that will break down slowly and that's what means our blood sugar is nice and even and our insulin that is released to take up blood sugar is again a low level. And that's what is the beginning and the end, well, not the end, but certainly the beginning of keeping our inflammation under control.
Dr Rupy: Exactly. Yeah. So keeping your homeostasis.
Alex Laid: And all chronic disease is is too much inflammation and this is lovely anti-inflammatory food. So, the aim is.
Dr Rupy: I've got this on a low to medium heat in this pan.
Alex Laid: Yes, that's fine. So maybe lovely plate by the way. So these are black, they're called beluga lentils. And of course, you can use, you know, puy lentils.
Dr Rupy: Those are my favourite.
Alex Laid: Yeah.
Dr Rupy: I love puy lentils.
Alex Laid: I think these might be your favourite from now on.
Dr Rupy: Okay, fine. Okay.
Alex Laid: So you can't really see them, but they're the sort of grey, brownie ones. Sort of black. They're also fantastic. The key thing is not there's not one better than the other. We need variety. Exactly. Yeah. Um and but just I'd probably avoid the red lentils. I mean, have them, but they've taken the skin away and they're quick to cook, which means that they're not going to last as long in us. And the idea is to have food that you need to chew, that will break down slowly and that's what means our blood sugar is nice and even and our insulin that is released to take up blood sugar is again a low level. And that's what is the beginning and the end, well, not the end, but certainly the beginning of keeping our inflammation under control.
Dr Rupy: Exactly. Yeah. So keeping your homeostasis.
Alex Laid: And all chronic disease is is too much inflammation and this is lovely anti-inflammatory food. So, people might say, oh, but I'm very windy.
Dr Rupy: Yeah. You've got to go you've got to go slow.
Alex Laid: I'm not because I've got I've got used to this.
Dr Rupy: But I've had loads of patients that, you know, if you were to eat this straight away, you went from having a refined diet to having lots of different um uh high fibre foods. You'll know about it and everyone else will know about it as well.
Alex Laid: The idea is variety, you know? So that's that. And then all we do is we put double the amount of water on.
Dr Rupy: Cool.
Alex Laid: So
Dr Rupy: Cold water or hot?
Alex Laid: Probably cold because it gets a chance to then bring up to the boil. Okay, fine. Let me. But yeah, cold water is fine. So maybe that's about enough, I should think. And if we overdo it, well, it doesn't matter. We'll just boil it off quick.
Dr Rupy: Just let it cook for a little bit longer.
Alex Laid: Yeah. Okay, fine. The idea is really 40 minutes, 35, 35 to 40 minutes.
Dr Rupy: Okay.
Alex Laid: I mean, these are all just so it's double the amount of water basically.
Dr Rupy: Yeah. And look at the colour of that. It's gone like a deep, deep black already.
Alex Laid: But you could use that with a different rice grain, a different lentil.
Dr Rupy: That's the beauty of this.
Alex Laid: You can vary things a lot. So we've got short grain brown rice, which I really like. I like it and unlike basmati, but I think long grain brown rice, I find really boring. And that's what a lot of people get put off by. But this is nutty and delicious. And that along with the lentil, it could be an orangey, it could be a, you know, what are the more sort of orangey brown lentils you could use as well. Uh you could use aduki beans.
Dr Rupy: Oh yeah, I love aduki beans.
Alex Laid: And what's the other one? Mung beans because they're really they don't need soaking overnight. And in fact, we've come to that in a minute. So combinations.
Dr Rupy: Yeah, sure.
Alex Laid: Yeah. And and lots of different, you can you could chuck in some quinoa, even though it only takes 10 minutes to cook. And you can get black quinoa.
Dr Rupy: You can. Yeah, yeah. You can get tricolour quinoa in some supermarkets now.
Alex Laid: All proteins in the quinoa. Very unusual. Whereas here we're combining the two to get all the protein. Yeah. Um so barley, barley which looks very much like that, pot barley or
Dr Rupy: And something you told me just before recording that it costs
Alex Laid: 99p a kilo, even in Whole Foods because you can self-service. It's it's in bulk.
Dr Rupy: Incredible. Yeah. I'm going to start eating more barley.
Alex Laid: So we need to put a lie to this idea that you've got to be rich, have a big income to eat well. The best food, in fact, you know, and I work sometimes with the homeless and it's something I really want to do more of. People that don't have a kitchen. How can you eat well and without a kitchen, without security?
Dr Rupy: Absolutely. This is something that we have started on the new modules of culinary medicine at Bristol Medical School and soon to be at UCL as well. Um we put a module in food security because um there's 4 million people, I think, in the UK that worry about where their next meal is coming from. So it's a really, really big issue. 4 million people using food banks in one of the richest nations in the world. And I think most people don't understand that a lot of a lot of households only have a microwave or they don't have a hob or, you know, they don't have kitchen utensils. So I'd love to hear a bit more about that actually, about how you work with them.
Alex Laid: Well, I would say, and this is this is the principle that say I don't have time to do this. I'm very blessed not to be homeless, but if I don't have time to make my this particular mix, and this by the way is 40 minutes, we're pinging on. Um is that getting tins of beans and tins of, if you aren't a vegetarian, tins of oily fish in brine, in spring water, probably even better than what they call olive oil, you know, olive sardines and olive oil, unless it's really good quality. But they're cheap. It's I mean, possibly too cheap, you know, because of the fishermen and the work involved. But it's 48p or so on for a tin. And that tin, it's all your protein, it's all your anti-inflammatory nourishing for the skin, for the head, for the nerves. So just those two things, Rupy, you've got your your tin of beans, even if you have a third of a tin of beans, and some oily fish, and let's say you could go and pick your own nettles or I mean, it's not so easy to pick your own parsley wild, but you know, something, dandelion leaves. Okay, we have made a dish that is probably 50p plus 20p maybe of the beans, the third of the and plus free dandelion leaves. Now, of course, if you've got a little balsamic vinegar or lemon juice and some olive oil or of course, that transforms it. But you know, you've got you you can't you could pay 20 pounds for a for a meal, but you won't get the nutrition you've got in there. So there we are. I rest my case. We have affordable, the most delicious and best for our human body food is there in three ingredients.
Dr Rupy: I'd love to hear a bit more about um your work with living medicine actually because uh I had a look at your website and what your aim is to to create a um uh a centre in the middle of London where people can actually learn about how to forage, to grow their own, to utilize herbs and spices and to cook as well, which really marries well with my sort of vision of all GP surgeries having a community kitchen affiliated with them. Um but yeah, so so how far along have you gone with
Alex Laid: Well, I started, inspired by Tim Smit.
Dr Rupy: Oh yeah.
Alex Laid: And the Eden Project. And he wrote a book about how to do it. And telling future truths, which is that he, anyway, that's another story. So, um and Fulham Palace was coming up and uh to the Hammersmith and Fulham was saying, what do you want to happen to this to this walled garden in Fulham Palace? And I thought, oh my God, we need to put a world herbal medicine food centre to complement Chelsea Physique, to complement Kew, a garden where it's actually you can actually pick and make and use. So it's the people's medicine, you know, to perhaps coin a phrase. Um but bringing all the cultures of the country together to celebrate and value their traditions. Nobody's really doing it and saying, what you know, even you who is, okay, you're a doctor, but you have a mother who maybe used some of these. All our cultures have got this valuable knowledge, but who's really saying, look, it's valuable. You're saying that actually. But we all need to do it. So it's a great world herbal medicine food centre could be grown by the world, by the British public of all our cultures on their window sills in schools and so on. And we would co-create it. It would be the first great centre of excellence that is, you know, not top down because that's not the way nature works either. So we've got, but to do this big idea, we have to sow the seeds of knowledge first, I realized, because we're not like the Garden Bridge, you know, in London didn't work for all kinds of reasons. But um and huge amounts of money spent on an idea which didn't involve the public in a way. And yet it's a lovely idea, but if it's not going to be something that's usable, that's a huge resource that also draws on all our wisdom. I think that's the thing. It's something that we've all got this knowledge. Let's pool it and make something together.
Dr Rupy: One of the wonderful things about living in London actually is the fact that we do have an array of different cultures. And one of the things that I noticed in your book was, you know, you talk about Arabic culture, you talk about Indian culture, you talk about Chinese culture. And actually, we're living in a hotbed where the traditions are still exist to this day. We still have a lot of culture, but it is gradually being eroded actually. And so we need to sort of get back to that way of living and and to support health, like we talked about salutogenesis. You know, it's not about shunning Western medicine, it's not about like uh stating that pharmaceuticals don't have a role. They absolutely have a role, but also self-care is something I'm very passionate about. And when you look at the proportion of lifestyle related issues burdening the NHS at the moment, you know, without assigning blame, it is a lot to do with personal care. And if we can actually have societal, community groups in uh communities, that's that's how we actually instigate change. From a governmental point of view, it doesn't sound very sexy. There's no four-year cycle there. There's no like, you know, hard and and and fast results to be gained in the next few years. It's something that is definitely long.
Alex Laid: But this is the beauty about, you know, your younger colleagues, the the student student medics are now saying, we need to know about nutrition. It's clear, you know, because we all know it's lifestyles, which isn't about blame, it's because that's the environment we're all growing up in with rows and rows of supermarket, you know, sugary cereals, which people think are healthy to give their kids, which we know now is the absolute opposite. So it's priming them for diabetes. It's about the way our industry runs, it's about the food industry, so many things. So it's not about, quite rightly, it's not about individual blame, but it's about what we can do is now that we're a bit more enlightened and we certainly don't know the whole story, but we can start to share that knowledge and how do you feel when you eat slightly differently like you're designed? And that's what the medical students have really understood. You know, in Bristol and right around the country, they're saying, yes, we must teach people how to eat and learn ourselves how to eat.
Dr Rupy: Absolutely. Yeah. Actually, we took them to um uh Penny Brohn, which is a cancer centre.
Alex Laid: Yeah. Yeah. I know them very well.
Dr Rupy: Brilliant. Yeah, because we had a day there, like an afternoon and uh they got taken around by nutritionists and our registered dietitian and they got taught about the different sort of herbs and and things that they grow in the grounds and stuff and that connection. And it's it's absolutely incredible. It really is. And there's so much knowledge. And I think, you know, it was a shame for people who unfortunately were living with cancer that it took that long for them to even get that knowledge because that should be accessible to everyone. Not to say that, you know, it would have prevented cancer or anything like that, but just that the knowledge around how intertwined we are with nature was was pretty amazing for the students to see that as well.
Alex Laid: But in fact, and of course, Robert Thomas at Addenbrooke's and Keith Mokbel in London, a surgeon, a lot of them, you know, they're beginning to be much more aware of this on the
Dr Rupy: Robert Thomas in particular.
Alex Laid: Yeah. And I work, I've worked at breast cancer for 20 years in breast cancer support. So I'm helping at the breast cancer haven in London. There are now several branches around the country. And that's all about how do we support ourselves to prevent recurrence, to deal with the side effects of drugs, to help us through um you know, the operations and chemotherapy and all of that. And actually, you do reduce risk of recurrence. And it's changing lifestyle, knowing about alcohol and the risk in breast cancer and ramping up hormones that grow tumors. How to reduce those. So it it does reduce risk. I mean, these are preventative. Um many of the approaches emotional and it's taking again the whole human being.
Dr Rupy: Absolutely.
Alex Laid: So I think reviving the kind of knowledge um that we have around all of this lifestyle, circadian rhythm, how to sleep, when to sleep, when to eat, all of this information is now at hand and we just need to make it more available.
Dr Rupy: Absolutely. I I think I like to think of different interventions, particularly with people living with cancer as divided into macro and micro. So macro uh things factors would be sleep, your uh general exercise, um uh activity levels, uh alcohol, um a whole bunch of of things on a macro level. And the micro level, and forgive me if I'm um belittling the subject because I'm not. But I think the micro level are some of the supportive factors that medical herbalism can offer, conventional medicine can offer, psychological treatments can offer as well. Perhaps that's a macro.
Alex Laid: I think that's a macro.
Dr Rupy: Um but yeah, there's all these other sort of uh complementary therapies that we can actually have to support people.
Alex Laid: No, I mean, I I completely agree. I mean, with something like, basically health is about many, many factors. So as a medical herbalist, we have something to contribute because we've got these strong um uh multi-factorial medicines, you know, complex medicines to give people. But it's not the only, none of us have got all the answers. And certainly the macro factors are, well, that's what's probably changing the environment around us, you know, how you eat, how you sleep, you're changing the internal environment and how we live, love, friendships, isolation. I think actually the emotional component is huge. I'd say that's a macro macro. I'd say it's well, it's almost more important, possibly even than food because it's the most direct thing. You know, it's in the bloodstream already, all those neurotransmitters, neurochemicals that are having a big effect, let alone hormones. So, yeah, I think that's that's and it's back to environment. So we're always taught in medicine, well, in in life, unfortunately, that, you know, that plant, well, how did that develop that plant? It actually developed in an environment and it developed with a bee or a pollinator. Without that pollinator, it wouldn't be there. So it's it's it's the environment and the the thing, that's the system. So that's what we have to really understand and we really need to rethink education in terms of seeing things as a whole and not as separate parts. We can do a bit of separate part. That's great. Drill down, but then keep lifting the head and looking at the whole. And people get it, I think, you know.
Dr Rupy: As a conventional medic, sometimes I'm uh discouraged from thinking about food in sort of a a health context or a medicinal context. Um and I think there's been some cases where people have almost gone to the extreme of like just relying on plant pharmacology or herbal medicine and stuff to treat and to cure. What are your thoughts on that? Because I'm sure you've probably come across that yourself given your
Alex Laid: Well, I think this is one of the things in in in cancer or any kind of life-threatening disease that people are grabbing at straws in a way. And also partly what's underpinning that is that they want to do something that feels human and natural to their body. And of course, with all of us, you know, the idea of having something very mega chemical that's going to destroy part of the body in order to help another part. I mean, how sophisticated is that really? But the point is that herbs are only one part of support. And and given that we don't have all the answers, I think to be able to use herbs alongside drugs, um is really sensible and lots of other things. I mean, with cancer and most chronic disease, you know, whether it's eczema that's been going on for years and years, it's not just about taking one thing and it's all going to be better, even a herb that may be doing lots of different things in the body and that's usually not enough. You've got to look at lifestyle, you've got to remove the stresses, you know, and that's looking at the macros. You remove the stresses or reduce them and you up the support. And then the body can actually deal with its functions. Not spill over into, you know, excreting through the skin or disabled barrier or whatever it might be.
Dr Rupy: Yeah. I think it's a really important topic because I think um a lot of people, particularly across social media, uh when we're easily influenced by very small nuggets of information, sometimes that can explode in people's minds and it leads to a, the detriment to their personal health, but B, the detriment to the different professions working collaboratively in the future because you get an impression of medical herbalism that's all about people trying to kill themselves with plants.
Alex Laid: Hopefully not because of the word medical, i.e. not trying to, but you're right. There may be there may be a perception like that. And that's certainly not how any responsible, I mean, we're taught medicine. And so by learning, not to the level of a doctor, some of us are medics, some of us are scientists, but but what we're trying to do is to say, what can we learn? And by learning about physiology, you absolutely, the first thing you learn is one herb or a few herbs is not going to be the whole thing because it's just so much more about working together.
Dr Rupy: Absolutely. And it's almost like the the body is like an ecosystem in which case we need to work like an ecosystem where everyone has their specialty and everyone has their ability to support. Uh and and some patients are probably more receptive to that than others. I mean, I certainly have people in general practice that just want a pill. Like, you know, I try and talk to them about lifestyle factors and how this might uh be impacting it. A, I'm restrained by the eight-minute consultation time I have. And then B, I'm also restrained by trying to maintain and uh start a rapport with the patient, trying to get to the the underlying diagnosis and then trying to offer treatments that are um respectful of their beliefs and values as well. And there's a shared sort of relationship there. When you try and add other things to it, it's it's quite a tough one to to take.
Alex Laid: And it's not like you're trained. You're trained to take a case history, which certainly would take longer than eight minutes.
Dr Rupy: Absolutely. Yeah. And and almost the scary thing about doing the stuff that I do on social media and and YouTube and all the rest of it and podcast, you never want to be seen to be doing harm. You never want someone to look at a sound bite of something and say, oh, that doctor's talking about food as medicine and this is why I'm just going to go for food and I'm going to shun traditional medicine. That's not that's not what medicine is. First of all, it's not just about just drugs or food or or herbs or anything. It's about looking at the patient holistically. And I think it takes a clinician, someone who actually sees patients to to to realize that and and talking of patients, I'm fascinated by the work that you do at Whipps Cross. And you work with a dermatologist, is that right?
Alex Laid: Yeah, I'm just part of the team. And my colleague as well, who um uh is is part of the team too, because we we we so we run two day-long clinics a month. And um we're paid by, not by the NHS. So this is not an NHS service. It happens to be in an NHS hospital and I'm part of the team. But um for yes, now 20 years, which is astonishing. But it's been paid for by the universities or colleges that have been training medical herbalist students. So they sit in and we get medics coming sitting in and you can come if you probably don't have any time. But uh yeah, and medics sit in and and so on.
Dr Rupy: Well, a colleague of mine actually went, her name is Joe. She was she's also doing a masters with me. Yeah, yeah, in nutrition medicine. Yeah. And she was like, you need to go, you need to go and and try it out because yeah, so you work alongside some dermatology consultants.
Alex Laid: Yeah. So how it works is that um and we have a room, you know, we come there and we're all day in a room in the in the in the dermatology area. And the nurse practitioner, the whole team basically refer patients to us, those who are either not doing well on their drugs, can't tolerate the drugs, don't want the drugs, or are having the drugs, but things are not improving. So we then, I will get this a whole hour for my first patient. That's a standard thing for us as medical herbalists. Some of us actually take an hour and a half. So I have to get an awful lot in. Because I'm trying to do what you're trying to do. How you do it in eight minutes, I don't know. But I know because of the person you are, you probably can. But um so I'm trying to get make the rapport, get the information down, a whole lifetime of of material. And then teach, share, find out where they are, what's interesting to them, what their diet is. I ask them to give me a food diary. And then work with the food diary and say, right, how about adding this in or how about adding and very simply explaining, keeping your blood sugar level even is the number one to me. I mean, apart from the brain, you know, and the emotional stuff, but that comes into. So how do we keep our blood sugar level even? How can we eat, as we know, TRF and Satchin Panda and all that, you know, all the work that's being done around the circadian rhythm, when to eat, I eat mostly during the day. But these are broad principles. So mostly eat during the day, less in the evening and earlier. That's not difficult. I mean, it might take a little bit of doing, but then you shift your food like we're doing here to a bigger lunch. Just check this isn't going. It's doing beautifully. Beautifully. Um so we shift some of our food to breakfast and lunch. And if not breakfast, because some people don't want to eat that, but that may be because they've had a big meal at night, so you're not less likely to be so hungry in the morning. Um shift it to say, you know, 11 or 12. You could even have two meals a day, a big meal during the light hours in the morning, late morning, and then another meal like they used to do in the old days, uh old days as in, you know, even in the last century, where you had tea at about four, which is a great idea. That was of course all because of the industrial revolution and you finish work at four, start much earlier. And then you have your your biggish meal, but at least a biggish meal, lunch and then four or early breakfast and four. But then you are, you've got all that time to digest that food. And then when you go to sleep, then you have got your body is going into repair mode. It's not dealing with digestion. So it can actually repair the villi on the inside of the gut that make up the surface area which are sluffed off. And do all the other repair jobs. So it's a lot to do with that. And people, oh, yes, of course. And you need to get, you know, your first four hours ideally of the night's sleep is when your growth hormone is highest, hormone is highest, and that's when you're repairing. So there's a lot of that sort of stuff. So, yeah, that's how we work. And then if appropriate and as long as there's no herb drug interaction, I would give um herbal medicine for or four or five herbs or maybe up to seven herbs in a mix, usually as an alcoholic tincture, 100 mils a week. So that's a teaspoon and a half twice a day ish. Maybe more, maybe some tablets if I need a little bit more or tablets if people don't have alcohol, for example, or teas or decoctions, which is boiling up a raw herb, a dried raw herb usually. But there are so many ways that you can give herbal medicines, shots. You can even make a shot with say those lovely uh nettles, which are so rich in practically every neurotransmitter that's in here, that's in that nettle. Um you can whizz a little bit of that, just a sprig with some water in a Nutribullet, like a half glass and have a shot. The sting won't be there when you whizz them.
Dr Rupy: When you cook them or macerate them, the sting goes.
Alex Laid: Yeah. Yeah.
Dr Rupy: Amazing.
Alex Laid: So there's lots of ways to do it, you know, with different cultures who don't want alcohol. So you can
Dr Rupy: Yeah, especially in Whipps Cross. I mean, like, yeah, it's it's a very diverse population. What kind of things do you tend to see in in your clinic?
Alex Laid: Well, we've got acne, a lot of alopecia, alopecia totalis sometimes. And it's not about, well, say, okay, alopecia, eczema, lots of eczema, quite a lot of autoimmune conditions, rosacea. I mean, really the kind of common
Dr Rupy: Common ailments that I see in general practice.
Alex Laid: But sometimes bullous pemphigoid.
Dr Rupy: Oh, really? Okay. Yeah.
Alex Laid: Um you know, autoimmune conditions because what we're doing, as you know about the anti-inflammatory actions of some of these herbs, albeit that they're not really in your terms as you started off saying, you know, refined down to exactly what's happening as well. But we've got, you know, TLR, anti-TLRs or pro-TLRs, whatever, and and um interleukin, anti-cytokine, anti-inflammatory. And we know something about the different plants and how they work, a bit about how they work, or that they definitely do both in vitro and in vivo have anti-inflammatory actions. So we can use those plants, you know, whether they be things like astragalus and feverfew and milk thistle, um rosemary. Rosemary actually is being looked at for rosmarinic acid is one of the important constituents which has a very anti-tumor action in vitro. So anyway, there's lots of um
Dr Rupy: Yeah, there's lots of mechanistic evidence, right? And I think that's one of the um uh criticisms of of herbal medicine and food and nutritional medicine because we can determine what's happening in vivo, for example, uh or in a test tube or across a cell line. However, it doesn't always translate to uh what happens in a human model. And to my frustration at the start of this pod, you know, it's very hard to to actually create those trials and actually create enough evidence base that will demonstrate, you know, this is actually having an impact. Um so how do you get over that? I mean, is it just see what you what you see in practice or you just going off the fact that, you know, it's most likely going to be safe and potentially beneficial as long as there's no drug drug interactions?
Alex Laid: Well, I think we should be doing more outcome measures because that's where outcome studies, but you need to first of all, of course, as with trials, and I've done one in OA, herbal medicine and OA in a GP surgery some time ago with colleagues where we actually took about 13, tried to reduce the variables and so we just used 13, just 13 herbs uh in different combinations for different people, but it was only about looking at the the um the feasibility. It was a feasibility study. And that I mean, it it it did show significance that we helped with reducing pain and stiffness and so on on on a classic measure. But um I think if we if we were able to design more of these, yes, using complex mixtures of medicine, but we then could power them up and have bigger, but somebody's got to pay for this. More people in those trials, then we would actually begin to show benefits. Absolutely. You know, against placebo, let's say. Because we did a placebo, a blind, randomized placebo controlled trial in this, but there aren't enough of them. And I think we need to do those as whole interventions.
Dr Rupy: Absolutely. Yeah. And what kind of successes have you had in the dermatology clinic? I'd love to know.
Alex Laid: Well, we have a paper. We've done reviews. We've done outcome, we've done reviews because all patients, we we use something called a modified mymop, um measure, it's a self-reported um self-reported outcome measure. Let's have a look. Have we did we time it?
Dr Rupy: Uh I haven't timed it. I'm just going by eye.
Alex Laid: Let's let's have a let's have a little look. Do you want to taste? Yeah, yeah, go for it. I think it's practically done.
Dr Rupy: Really?
Alex Laid: And and the other great thing that we didn't mention, I mean, I am your bean queen. I am the bean queen, the legume queen. Because and particularly whether whether we're men or women or anything in between, these are the bean family, the legume family is the one that's richest in protective phytochemical phytoestrogens, which means that they have lots of other things too. But the phytoestrogen, the plant estrogen, which is very different, looks similar, but it actually acts very differently in our body. Um means that it helps to moderate our own much too powerful growth hormones like estrogen and testosterone. So it's kind of acting like a a serm and an AI. It's acting to block too much estrogen. It's sort of sitting on receptors to protect them from our own too powerful estrogen. But it's also um can tickle receptors in menopause, for example, up here saying, where's my estrogen when suddenly you get those drops. And then it can tickle them, but not to grow a tumor.
Dr Rupy: Yeah, yeah, exactly.
Alex Laid: Food from different sources like lignans and flax seeds and and beans, legumes and stuff may be protective against um estrogen related uh cancers.
Dr Rupy: Well, exactly. This is it. And so, um there are at least three three classes of phytoestrogens. You've got your lignans, your coumestans, and your flavones, isoflavones and the flavonoid family, and also steroidal saponins, saponins and so on. And these um are all doing something like that. So it's beneficial to have those. And that's where the Mediterranean diet, which has a big component, which is the best studied, has legumes. But so do most cultures.
Alex Laid: Yeah, absolutely. Yeah. It's great.
Dr Rupy: And we need to revive them and get them back to back to our wonderful peasants and our farmers. Yes.
