Dr Baldeep Bains MD - 23rd Jan 2019 (LDN, low dose naltrexone)

Dr Baldeep Bains MD - 23rd Jan 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Dr Bains, and he is the younger brother of Dr Harpal Bains, who you may have remembered we had on the show a few months ago now. Thank you for joining us, Dr Bains. First of all, can you tell us your background and about you and all the wonderful things that you've done to date. 

Dr Baldeep Bains: I grew up in Malaysia as my sister did, but then I was educated in the UK. I then went to university in Scotland and went to med school in Scotland. While I was in medical school, I had this mad idea that I wanted to join the military and before I knew it I’d signed on the dotted line and probably half of my life to the military. Upon finishing university, I'd spent a bit of time in Virginia. I joined the Navy, the general Navy. Upon finishing the officer's training, I spent about three years getting deployed in nice places, some not very nice places. As a Navy doctor, I’d look after old Marine commanders.

For the first five years after graduation, I spent most of my time doing the two operations. Upon completing them, we have to decide what you're going to do. I initially thought of a surgeon. I started off training to be an orthopaedic surgeon. I spent about four years doing orthopaedic surgery. I enjoyed it up to a certain extent. Then I realized that I was reaching a point where I wasn't passionate about surgery. I think I was passionate about something a bit more so I decided to quit surgery and joined general practice. I did my GP training and I qualified as a GP in 2009. 

My wife got pregnant in 2014 and when I was deployed for six months and I got back just in time before she gave birth. I think reality struck me that I can't continue with military life, I was having a family.

So I left the military in 2015 and then worked as a GP for a short while before my sister suggested that I should join her practice which is where I am now. So I've been at my sister's coming close to a year and a half now and working alongside her is where I heard about LDN. 

I've got to say it was quite a paradigm shift for me because when she first spoke to me about what she was going to do, I thought she was absolutely bonkers. I'm not going to lie to you all. We use nice guidelines and when she was talking to me about functional medicine... we had many arguments about how she was practising medicine and I was like, what are you doing? Are you crazy? Are you mad? Are you dead? I've got to say that we didn't see eye to eye initially with what she's doing. I think fortunately she persevered and she agreed. Even if I could see the way she does things and the way functional medicine works. I’m by no means trying to criticize the general practice. She’s done a fantastic job and I actually appreciate what my colleagues do but there's a certain extent to which we can actually help them and they're quite stuck with the reason I didn't blame them because they are guided by guidelines. A lot of the people who sit in the committees of guidelines are people who've got some vested interests elsewhere. I'm not gonna mention names, but I can understand the restrictions they have and why they can't. 

Yeah. It's quite hard for them to go explore other avenues. That's another way of doing things. I'm really glad I can introduce it as well because had I not been introduced, I think I would have been missing out on a lot, I love my patients. So I'm actually finding it harder and harder to be a GP now because of what I do know.

Linda Elsegood: What would you say are the main conditions that you are treating in the clinic?

Dr Baldeep Bains: I see the lion's share of the male patients. A lot of the male patients that we come across do come in with quite prominent symptoms of testosterone deficiency. That's one of the things, but I'm seeing a lot of patients with some degree of autoimmunity as well. I've seen patients with Hashimoto’s thyroiditis, chronic fatigue, Crohn's disease, bowel issues, etc. Increasingly I'm seeing more patients with autoimmune and bowel type issues. 

Linda Elsegood: When a patient first comes in to see you, how long is the initial consultation? Do you do lots of form-filling, questionnaire-answering with all of them? What's the procedure?

Dr Baldeep Bains: Most of the patients, we're looking to get one of their main symptoms, what their diet’s like, how their condition is affecting their activities of daily living. We can be asking quite a lot of questions. We spend anywhere between 1-2 hours with the patients. We try to read the evidence in order to find the root cause. Again, we will see a patient and we will treat the symptoms and the majority of the time that's what we do. But they keep pulling back the same issues again and again. If you don't look into food it takes time to look into a root cause, you can't just expect to spend five minutes with a patient talking about their history and find the root cause. You need to go into a lot more detail, which is what we try to aspire to do; just get into the nitty-gritty and hope to find what might be the root cause for a lot of these symptoms. 

Linda Elsegood: What other testing do you use? 

Dr Baldeep Bains: The majority of the time we will carry out a comprehensive blood panel. It’s one of the baseline things we do. So in a certain comprehensive blood panel, it would include the likes of a full blood count. You carry out a comprehensive biochemistry analysis looking into things like your liver function, kidney function. In our practice we do quite an in-depth hormonal evaluation, looking into quite a few different hormone levels and trying to see if anything that needs to be addressed. Beyond that, if a person does have a lot of bowel type symptoms, we will potentially do something along the lines of a comprehensive, thorough analysis, which is not a simple as microscopy. It gives you a lot more information. We would offer that if your bowel symptoms are quite prominent. I think we might do as well if something known as SIBO testing, small intestinal bacterial overgrowth, complaints of quite significant gut symptoms. We'll do something along those lines. We do allergy testing as well, and we use Cyrex. Personally, I feel it's one of the best kits out. I think it has been extremely comprehensive and they will probably them give us an overview as to what is going on, to keep eating the same foods and which is stimulating an inflammatory response. I think that that's the first few stages. Plus, I would normally offer a test when I first see a patient.

Linda Elsegood: When you ask patients about diet, are they honest with you as to what they eat or drink or do they tell you what they think you would like to hear?

Dr Baldeep Bains: That's a tricky one. I like to think my patients are honest with me. I think the majority of the patients we have are quite honest because by the time they come to see us, they're quite desperate. They've tried everything. I think they like to be as open and honest as they can with me. I think they are honest because of how they're feeling and their determination to get better.

Linda Elsegood: I was only asking because my mother lived with us for a few years. Unfortunately she, she got cancer and died. Before that, we would go and see the doctor and the doctor would say, “have you taken salt out of your diet?” I used to hide the salt because she was at the age where she used to use lots of lots of salt. I would sit there and I'd say, “you put so much salt on it, mom. It looks like snow, doesn't it?” And butter. “Have you cut down on the butter?”, “Oh yes. I don't use it as much.” “Mom, you use as much butter. It looks like cheese because it's so thick” but she didn't want to upset them. She wanted to please the doctor by letting them think she had done what she was told, but she didn't use, to tell the truth. I now have to hope that when I get older, my daughter doesn't come with me,

If we just continue treating symptoms and not the root cause, that root cause could be creating a lot of damage. It's vital to find out what that is. That is what's so good with functional medicine.

Dr Baldeep Bains: I completely agree with her. I think we actually have the luxury of time, which is what a GP doesn't have. I've got 10 minutes per patient, and in that time I've got to get a history from the patient, I’ve got to sort dates, I've got to get ready for my next patient. It’s especially complex with complex patients and complex patients are increasing in numbers. I've seen more and more patients with more and more complex problems coming in. I don't think treating symptoms is the answer to that. 

Linda Elsegood: You're seeing more and more people who have chronic conditions. What would you say is the difference between now and 40 years ago? Is it because we're eating different, or due to the fact that food is treated differently? When I was a child, everything was cooked from scratch. There were no additives. I hardly know how to pronounce some of them, let alone know what they are. What do you think is the cause? 

Dr Baldeep Bains: Reverse back 40-50 years ago, you're not seeing the problems that we had in those days. Compared to the number of solid issues we have nowadays it is just phenomenal. I've got no doubt it's to do with our diet. It's all about the fast food, and then you can get your hands on processed food, anything that's microwaveable, low phosphate and nothing else. No one has time to do things, you want everything in an instant. The busy lifestyle, the stress... life is a lot more stressful now because we've got a lot more demands and you've got everything in your face due to social media. I think stress has got a much more significant influence and the fact that we are actually doing less as well. Spending huge amounts of time in front of computer screens and TVs. Get yourself out, playing, get some sunlight, get exposed to sunlight. I can say my childhood is very different from the childhood experience now. 

Linda Elsegood: You were talking before we started and I'm sure you're quite an outdoorsy person, but what is your diet like? I mean, are you gluten-free, dairy-free? Are you a vegan? What is your diet? 

Dr Baldeep Bains: I am none of those, but I am quite careful about what I eat. I limit the amount of processed food I have. My kids have significantly reduced their intake of sugar. I use just for taste, such as half a spoon in my tea or in my coffee. I don't have any fizzy drinks. I drink water or milk. I'm quite fortunate in the sense that I don't really have many intolerances so I can actually cope with gluten. I've got a very narrow relationship to gluten. If I'm going to define myself, I've significantly reduced them on process over refined carbs. If I do have carbs, it traditionally would be half a plate or a quarter. I do love exercise and I need energy. So I still have carbs. Probably half my plate is protein. But I'm currently 43 and I feel fantastic. I train hard and I can sustain my mind. A craving I've got no real issues. I don’t have any fatigue issues, I'm not obese. I’d like to say that I'm in quite a decent shape, I think it's working for me. I don't eat junk. I've read a lot about intermittent fasting and I probably do that about two or three times a week. I try to fast for 16 hours and then tried to eat in the daylight hours which has been shown to be quite effective. I suppose if you say any dietary routine, but that's been quite recent, probably 2-3 weeks ago. I don't find it too hard to do.

Linda Elsegood: We’ve nearly run out of time, but very briefly, for parents who want to make sure that their children grow up as healthy as possible, what would you recommend to do diet-wise with children? Because it's very difficult with all the crisps and sweets and biscuits and advertising on television, how do you go about trying to establish healthy habits?

Dr Baldeep Bains:I think you get a vibe from them whilst they’re a baby. You've got to introduce them to good food and fruit and vegetables. We try to make everything from scratch, making home-cooked fruit. 

Linda Elsegood: You don't buy Robinsons or anything along those lines?

Dr Baldeep Bains: Nothing whatsoever. They drink water. That's the only thing they seem to pick. Once in a while, my daughter has fresh fruit juice, but apart from that, it's water and milk. That's all they have. I think trying to develop habits from the start and you're trying to give them a good breakfast. I try to avoid sugary cereals. I think even a traditional English breakfast as well, they'll have sausage, which I do try to get good quality sausage just for kids. Try to make a lot more home meals and try to get them less processed food. It's not easy on junior kids, even seven done. Life's extremely busy at that time. Everyone's quite time poor. It doesn't take a lot to make a decent kitchen. We know what we need to be doing and we should practice it. 

Linda Elsegood: We've come to the end very quickly. If patients would like to come and see you, how do they get in touch with you?

Dr Baldeep Bains: They can visit our website, www.harpalclinic.co.uk We have two practitioners there: my sister and I. I have a lot of patients with her too. You get the benefits of two practitioners and hopefully, when you come and see me, you can appreciate the frustrations and a lot of patients as well. I can understand what's going on and I can sense the limitations that they face and be able to give them a bit more of a balanced view. I think one thing we pride ourselves on is ongoing support. Most of my patients have an open email conversation. They can email me anytime and I will get back to them and I would advise them. I think on a lot of occasions patients find that quite reassuring. At the end of the day, I do things which are not very conventional. They didn't think their potentially own GP should be asking them, why are you doing such a thing? A good example is I prescribed LDN to one of my patients and I had a bit of a nasty email from a Polish GP asking me, what am I doing now? I think once the people are educated, once the GPs are educated, then you can get a GP alongside the patient and the GPs can work together with a patient and ultimately what we're doing, what we're looking for is to make the patient feel better. That's the aim. 

Linda Elsegood: That's fantastic. We'll have to have you back another day and thank you very much, Dr Baldeep for being our guest today. 

Dr Baldeep Bains: Thank you, Linda.

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Any questions or comments you may have. Please email me at contact@ldnresearchtrust.org. I look forward to hearing from you. Thank you for joining us today. We really appreciated your company. Until next time, stay safe and keep well.