URBAN HEALTH METHOD

Stephanie: Hello, I'm Stephanie Webster. I'm nutritional therapist on Harley Street London, specialising in gut health hormone optimisation therapy and fat loss. Today on the Urban Health Podcast we have the pleasure of having Dr Wendy Denning on the show.

Dr Denning is a highly respected GP with over 25 years’ experience. She is a passionate advocate for the integration of Traditional and Complimentary medicine. For three years in a row now she has been named in Tatlers top 150 private doctors and she's well known for co-presenting the very successful TV series, the diet doctors inside and out.

She's also served for two years on the GP steering group for the Prince of Wales foundation for integrated health and is currently serving on the committee for an integrated approach to gynecology in this country. Great. So, Wendy thank you so much for coming onto the show. 

Dr Denning: Thanks for inviting me, especially to talk about some of my favorite subjects. So, thank you. 

Stephanie: I've always liked your opinion about bioidentical hormones, about integrating Western and Complimentary medicine. That's very much my ethos. I believe that Western medicine has a lot to offer but also is not the only route to someone's treatment part. So that's the reason why I was very keen to interview you today. Tell us about how you became a GP and particularly how you became involved in Traditional and Complimentary medicine. 

Dr Denning: Well, I'm probably one of those few people who went into medical school interested in the integration of the two things because I'd been brought up in my own home with a father that had a back problem and had called in the osteopath, but at the same time had to have spinal surgery at one point. So, we knew that they both worked together and that was very clear.

My mother was on the other hand, very interested in nutrition before Organic was even on the market. You used to buy the equivalent, what we can now call Organic in Health Food stores. She would go and buy all the food from Health Food stores. If I got sick, I was more likely to get a Homeopathic remedy than I was to get antibiotics. There still were moments where I did have to have a course of antibiotics. I still remember having antibiotics for an ear infection when I was five. So, I was brought up with that.

Relating back to my family, there's always been a strong interest in nutrition because my grandmother was a juvenile diabetic, so nutrition has always been very important in our household. So, I took that interest into medical school. I in fact spent the first year in medical school helping people and getting speakers to come and talk about some of these subjects, running a society that puts on talks on these subjects.

Funnily enough, I went to a reunion with my medical school card a couple of years ago and they said, well, you're still doing the same things that you were talking about when we were in medical school. So that was nice. I liked that. 

Stephanie: Well, they are foundational. 

Dr Denning: Yes, my father was businessmen and his view was very much that, if you were going to do Complimentary Medicine alongside Traditional Medicine, you needed very good training in Traditional Medicine. So, I pursued the Traditional path very much to get that training. Very glad that I did because I do feel very competent in Traditional Medicine, which means I know what Traditional Medicine has to offer and it actually makes it easier for me to branch out to something else because I know what the end result of the Traditional part might look like. Of course, that's always changing. You must stay up to date with that, but it's still a strong feeling to know what might be on offer and then to branch out to something else. 

Stephanie: Yes, and also, it's about helping us understand our patients better. If they don't feel well, they go to a doctor who has been trained in Traditional methods and they would follow a set of protocols that are tried, tested that we have evidence on. But that doesn't mean that we can't be open minded to other methods should they be more effective, or should they be more appropriate for the patient's values, beliefs or comfort zone.

Dr Denning: Absolutely. And often it's, it's a combination of the two. I find often you get the best results with this, but sometimes that depends on how chronic the situation is. Acute things tend to respond well to conventional medicine, chronic things often not as well if you're just purely relying on conventional medicine because there are many other things that you need to do to support the body. 

Stephanie: I couldn't agree more. When it comes to Homeopathy that you just mentioned there, some people that believe in it, some people don't. What's your opinion on that? 

Dr Denning: Well, I was really wanting to use Homeopathy as a child. I think homeopathy works quite well for children. It doesn't always work as well for adults because what you're doing in Homeopathy is giving a signal to the body. What you're trying to do is to make that signal a little bit louder than the signal already going on in the body, in order to get the body to react and to start a sort of healing process. The problem with adults is often we can be quite toxic and therefore our body can't listen to what I consider Homeopathy to be quite as subtle signal. 

Stephanie: Yes. I would say Homeopathy is subtle. A lot of Complimentary Therapies are subtle, which is why they need to be repeated often and long term. Whereas Western medicine is very aggressive and caustic, but they give a very immediate response. Sometimes you don't respond at all. In some mental health situations, a lot of treatments for depression have resulted in Complimentary Therapies being more effective. I just think it's nice to have a selection of options.

Dr Denning: Agreed.

However, when it comes to diagnosis, my personal philosophy, this is all subjective and my opinion. When it comes to diagnosis, I do quite like Western Medicine for that. I do like a selection of treatment options.

Dr Denning: I couldn't agree more on that. In fact, it's what I say to patients. I'm very up for getting a diagnosis early. I like Western diagnostic methods and I use a lot of them. I'm very much of the view that if I have got a very bad headache and everything's been looked at before, I want to make sure I haven't got a brain tumor. I don't want to wait five months or six months to get an MRI or want to know, have I got that problem or not.

I'm thinking about one of my patients who was told he probably didn't have a problem, but he couldn't settle into anything until he'd had his MRI. So, I'm very hot on getting early assessments for people then ruling out things that aren't there, ruling in things that are there and looking at how we might optimise that patient's health. 

Stephanie: Yes. And speaking of optimisation, you specialize in bioidentical hormones and it's about optimising. So, a male or female doesn't necessarily have to be deficient, but if they are sub optimal, that's something that you can really help with. So, talk to us about your bioidentical hormone therapy, who it's for, what it does, a bit about that. 

Dr Denning: Yes, obviously most patients looking at hormones are in the menopause because that is obviously when hormones start dropping in the body and when people start noticing what their hormones have been doing for them. So, I'll talk about that to begin with.

People say to me, are you in favor of hormone therapy? And my answer to that is always, that it depends on the patient. But there is no doubt in my mind that a lot of patients do very well with bioidentical hormones and that is because of what we want people to do as they hit the menopause. We want to have optimal energy. We want to be able to work; we want to have a sharp brain. We want to have our bones protected. We want our hearts protected. So very often people are looking to get hormones. 

So, what is this word, bio-identical? Some people are concerned with the word and they think somehow, it's something natural. They're not natural hormones, they are identical to the hormones that our bodies produce. I think that's an important one. It’s not natural, it's just what our body is used to. So, if you're going to replace something, why would you replace it with something, or the body isn't used to?

It was quite understandable in the olden days because the only things available were horses’ hormones that were brought out from horse's urine and were made into products that women could then take in a pill. That was in the 1950s. We're well beyond that and we now have hormones that are identical to the hormones that our bodies produce.

So that's the first step is making sure you get hormones that the body produces. Then the next step to that is, how you give those hormones. Then the second step on that is what proportion of those hormones do you get?

One of things I think that's not looked at very well by Conventional Medicine is the fact that when women, for instance, go into the menopause, it's not just about estrogen and progesterone. It's also about what's happening to their adrenal glands. It's also about what's happening to their thyroid because all our hormones work together. So very often as one tips, another one might tip. So, you may have a permanent problem with the thyroid, or you may have a temporary problem with the thyroid but all of it needs to be looked at.

Women who've been working and had very stressful lives who hit the menopause, have been living off their adrenals. Then suddenly the thing that happens in the menopause is the body expects the adrenals to sort of take the place to some extent of the ovaries but if you've been lagging your adrenals for years, suddenly that body's ability to rely on the adrenals is not there and very often these are the women that have the most problems in the menopause.

So, we do use bioidentical hormone for women before the menopause. Then in that situation, it tends to be the use of progesterone and that is because particularly in the leading up to the menopause, the perimenopause women are often having non ovulatory cycles and they're often not producing progesterone in the second half of the cycle, which can lead on quite a lot of problems.

So, by supporting them with progesterone we may reduce their risk of breast cancer. We may also make them feel a whole lot better. Probably over my lifetime, I've had more calls from women who've been given progesterone in their perimenopausal years telling me how much better they feel than almost anybody else. 

Stephanie: that's so interesting because in my clinic, it's mainly male hormones that I look at. I use the test from a Nordic Laboratories, called the Dutch plus. You take six saliva swaps in a day and that looks at the cortisol, the adrenaline, the testosterone, the human growth hormone, DHE.

I like to see the balance across that, what's happening to this stressed out executive over 40 because yes, the menopause is spoken about, but what about men? I find that low testosterone in stressed out executives is very common and that can have a lot of side effects that are just negative. So, I think that's not spoken about enough. 

Dr Denning: Well, I think you're quite right and most people are absolutely talking about bioidentical hormones in women, but you're quite right. I see a lot of men in my practice and very often sent in by their wives, girlfriends, mothers and I have been shocked that how in theory, men should not be hitting a low testosterone level until about 60 but in practice I see 40 and 50 year old’s with very low testosterone in my office. You're quite right. I agree. It's a really under discovered area and talked about area and an important area because we know that men with low testosterone are more likely to have a cardiovascular event. We know that. So, it is an important area 

Stephanie: It affects sex drive, the same with women. Their hormones affect their sex drive and how able they are to be intimate with their partners and that can affect relationships, marriages, a who wants to contribute to more divorce or more unhappiness if these things can be spoken about in the open and you just get help if you think you need it. 

Dr Denning: I agree, and I think we are living longer, and we are healthier for longer in many ways and we need those hormones to support that in my view. 

Stephanie: Yes, and it is about optimal health and the world health organisation used to define health as merely the absence of disease, but I know that you and I are a bit more ambitious than that. So, I'm going to read it to you if I may, what the world health organisation says today. They changed it recently. They said ‘Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.’ So, they've done a quite a lot of work their definition. They've moved on because it is more optimal.

So instead of just thinking, I'll go to the doctor when I’m unwell, what I like about your approach is you're proactive. Never mind not being unwell. How about what's the best you can be? What's the most athletic you can be? What's the most vibrant, most energy? How can we not let the old come in and just be the youngest version of you all the time? So, my question for you is, what does optimum health look like for you and your patients? 

Dr Denning: I think it's a good question because very often patients come in with a blood test and they're just scraping into the normal range. They say oh my results normal. I say, yes but do you want to be normal or do you want to be optimal? I think that is the point. None of us want to be just normal. We want to be optimal.

Optimal is sleeping well, having good energy, having zest for life, being optimistic about the future, being out of pain, having the weight that suits our body, having good gut health, not having bloating and constipation, diarrhea, gas, being nutrient dense. What that means is you've not got nutrient deficiencies. Your hormones are balanced. You don't have inflammation in the body and all of that’s reflected in what we look like because you might have clear skin and eyes, shiny hair and just look vibrant.

Now, that's for someone who's got no health conditions. Obviously that definition of optimal health with someone who's got a chronic disease might look different to that but the concept is still the same. Yes, we know that you've got this ongoing issue going on here, but let's optimise everything else so that this becomes less of a problem.  Very often you can minimise that by optimising everything else in the body. 

Stephanie: Also, you are a private GP and you offer personalised advice. So those normal ranges that we see on a blood test or on any test whatsoever are normal ranges for a subset of the population they're not necessarily normal for you and they're certainly not necessarily optimal for you as a patient. So, what is normal? I can't be normal if I try firstly, but what is normal for me is not necessarily normal for the general public and what’s optimal for me is also not optimal for the general public. So, it's very much about an individual personalised approach.

I say that with caution because sometimes for are very keen patients who are either hypochondriacs or perfectionists. I say, you were not born to be perfect. You are born to be the best version of you. You're born to be awesome and that is in the constant striving and the constant pursuit of growth in this area that you feel vibrant.

It is in progress, not perfection that you find happiness when it comes to your health, particularly if there are knock-backs and you can handle those better if you've got multiple points of progress in your plan. And that's what I like about your progressive approach and your personalised approach when you're handling clients. 

Dr Denning: Thank you. Yes, to me that makes it much more fun, figuring out how to get them to be the best version of themselves and how to make them embody themselves in the best possible way. I think one of the most interesting experiences I had was years ago when I was at the American holistic medical association conference and there was a woman there in a wheelchair who had a progressive neurological condition and she talked about how she came to love her body and how she came to use everything that she's gotten in her life optimally. It was really sobering because there I was, a young woman in my thirties, everything going for me and I didn't have any of that to struggle with. To see her really living her life from a place of optimal health was inspiring. It was truly inspiring. 

Stephanie: Yes, it is inspiring and it's inspiring because your entering the concept of dreams and you're saying, what would the best version of you rather than that let's just put a plaster on. The giving permission to our clients to dream. What's the best version of me? The mind must go there first. If I'm helping somebody go from 130 kilos to something like 80 kilos in a year, losing fat and not muscle, and we're very hard on that. Then the psychology of that, the ordeal of chipping a little bit away every day so that you know that by this time next year you're going to be practically half of your original body weight, but it's his body fat that we're focusing on. It is very inspiring. It's very motivating and it's very psychologically exhilarating really.

We only had one mental health day a month ago. People are talking about depression, suicide, anxiety. If you're on a positive trajectory, it puts all of that at bay because you believe in yourself. If you've become that overweight, and I know you don't get many overweight or obese patients in your clinic.

Dr Denning: I certainly get plenty that need to lose some weight. I certainly get some that need to lose weight, in fact, many that need to lose weight.

Stephanie: But it's more of the comfort zone. They’re not pushing themselves to the edge, but if they're vastly gone over on some level, they have stopped making good health decisions because they don't think they care. They don't think they matter, and they hate their bodies. Really, it's about loving the body and giving it what it needs and nothing that it doesn't need and that the fat will sort of gently melt away obviously with exercise and nutrition of course. But the standpoint is very much, I love you, I want to look after you rather than I hate you and I want to punish you.

Dr Denning: I couldn't agree more. Nothing changes from punishment. It might change temporarily, but long term, the changes come from love.

Stephanie: It's true. Well, having been born a Catholic and now not, that took a lot of learning. That particular modal.

Dr Denning: You had to get over your guilt, the guilt that was loaded onto you. 

Stephanie: That was fun. That was a fun decade. Gilt, shame! It’s just understanding the human condition. It's quite funny really. The final thing I'd like to ask before I let you get on with your work is the Myers cocktails that you do. Before we started this call, we were talking about how Iron is no longer done intravenously and Folic acid and B12. The Folic Acid, B12 and Iron I’m interested because I have many anemic patients now. However, the Myers cocktail. Let's start with that. So, it’s a vitamin infusion? Let's talk about that. 

Dr Denning: Well, we do several vitamin infusions. Myers is one of them. It's one of my favorites, probably because 20 years ago, that's what got me interested in IV vitamins. I got interested when I was living in Canada. I had been sick for a week with a bad flu and I didn't know how I was going to get home to London to see my family. One of my friends said, go and see that doctor, he'll give you a shot. And you'll be bouncing off the plane and sure enough I was!

The Myers' cocktail has the capacity to lift people's energy, lift their detox pathways, lift their adrenals and help them with things like jet lag and general fatigue. It contains Magnesium, Calcium, B6, B12, B complex. B complex has some Folic acid in it and alongside that, it has vitamin C. It's been around for probably 40 to 50 years. So, it's the one that really puts IV vitamins on the table I would say. It remains one of my favorite ones.

If I'm traveling to the U S for instance, I always take a cocktail before I go and when I return, I get one for jet lag. I have a lot of patients that come either on a regular basis to prop their levels up or I have them coming as and when they need it. Patients who are postnatal, people who've had been in hospital with an infection, people who've been having serious treatments for other conditions.

We also run several other IVs, and that is for people who've got nutrient deficiencies, Amino acid deficiencies. We've got immune protocols for these people, we've got detox profiles that help people if they're going through detox pathways, that includes things like Gluteus iron and Vitamin C. We also do IV vitamin C that people use alongside cancer treatments.  So, we run a number of these things.

I think what I've seen over the years is that some people have very good absorption from their gut but many don't. Many need to boost their energy in the body so they can get the best out of their food and get the best out of their nutrients that they've been given by their nutritional practitioners. So, I feel the vitamins sometimes take the body up a notch so that it can then utilise everything that other people are trying to do with it. So that's how we use them. And that's how we see them.

Stephanie: So, for those who are listening who need a little bit of understanding. When we eat food, it goes inside the stomach, inside the digestive system. Eventually it gets into the bloodstream. If it's not getting into the bloodstream, you're not absorbing the vitamins and the minerals from your food properly, which is where IV drips can become very useful Because the vitamins and minerals go straight into the bloodstream directly bypassing the digestive system altogether.

So for my patients who have Ulcerative colitis, Crohn's disease or any other malabsorption issues in their gut, this is why I like the Myers cocktail but also all the other ones that you do. The Myers has the B and the C. These are water soluble vitamins so I wouldn't be concerned about overdosing of that because you would just pee out the excess as it were.

Dr Denning: I totally agree with that. It’s funny, I was asked to give one to a patient over the weekend and someone said to me, well, aren't you just peeing out expensive vitamins? And I said, well, that's the case with any drug that you take, the body takes what it needs and then it excretes the rest of it. So no, you're not. The body has a chance to get a hold of those things because if your digestive system is very slow, it may not be able to absorb any of it. Particularly the Myers, it’s what we call a hypertonic solution. It not only is going straight into the bloodstream, but it's added at a stronger concentration, which forces it into the cells. 

Stephanie: Isn't it amazing that the body just takes what it needs and disposes of the rest? Isn't it a fantastic machine? 

Dr Denning: It's fantastic and that’s how all drugs work. That's how vitamins work. I think you made a very important point though. None of the vitamins that we give are fat soluble. You do have to be careful with fat soluble vitamins. With water soluble vitamins, the body takes what it needs and pees out the rest. But with the fat-soluble vitamins, you can cause a problem. That's why we never give fat soluble vitamins because of that reason, because the body may not be able to excrete it in the way it needs to. 

Stephanie: So that would be, for example, A, D, E, K and so on.

Dr Denning: Yes, in fact, we do give vitamin D shots because most people are so deficient in vitamin D and it's such an important vitamin and thought these days to be more of a hormone. We do that very carefully though. We don't put it straight into the bloodstream, we put it into the muscle. We do it after a blood test that shows a patient is low and we follow it up with a blood test to make sure that we're not giving too much.

Stephanie: It must say, I haven't seen someone who's high or just make normal. Vitamin D3, I’ve seen everyone's blood test is low, particularly the UK.

Dr Denning: You're right. The only people I've seen with higher, had been taking 10,000 units daily for a very long period. 

Stephanie: Interestingly enough, I have been giving 4,000 units daily to a patient and his still was low. So, I had to supplement with bile salts and now it's normal. 

So, it's about understanding what is stopping this. It's not about just taking D3. It’s understanding that the fat is devoid in the diet. You won't absorb that D3 and if you're not producing enough bile, you won't break down that either. So sometimes you need to get a bit more specific.

Dr Denning: I agree. And I very often I find that people are taking their D3 as you said, in a meal. This is very common in a meal where there's no fat, but it might well be taken the first thing in the morning and there's not really any fat going in. I always say there's no point in taking D3 if you haven't got fat going in with it. I like the bile salts. I think that's helpful to stimulate the bile to make sure that it gets absorbed well. Also, K2, some people have a genetic deficiency that stops them absorbing the vitamin D if they don't get some K2 alongside that. 

Stephanie: So, Wendy, before we close the last question, I have it. What's your favorite organ? I know that sounds random, but this sort of infinite fascination with the body. Is there an organ that you particularly like? 

Dr Denning: Oh, that's so interesting. I never thought about it. Where would we be with or any of them? I suppose the liver is probably one of the most fascinating organs in the body because one hand, it detoxes everything and on the other hand produces so many things at the same time. It has branches running, if you like. It's probably the organ that we look that many people look after the least well, in our society, particularly in London. 

Stephanie: Well, Dr Wending Denning, you have been wonderful. Your website is www.thehealthdoctors.co.uk.

Thank you so much for coming onto the show. You have been fabulous. 

Dr Denning: Thank you for inviting to me. It's been a real pleasure. Thank you. 

Stephanie: And for everybody listening, thank you for joining the urban health podcast, keeping busy people healthy.