Prolozone and Nutritional Therapy for Osteoarthritis with Dr. George Papanicolaou - Transcript

Dr. George Papanicolaou (00:00): It's oxygen-ozone therapy because part of the benefit comes from getting oxygen into the joint and then the ozone plays another role. Dr. Mark Hyman (00:13): Welcome to the Doctor's Farmacy. I'm Dr. Mark Hyman. And that's Farmacy with an F, F-A-R-M-A-C-Y. A place for conversations that matter. If you suffer from arthritis, this is an important conversation to listen to, or you have chronic pain this is a conversation you need to listen to because it's a special episode of the Doctor's Farmacy called House Call. Today my guest is Dr. George Papanicolaou, one of our physicians here at the UltraWellness Center in Lennox, Massachusetts. Welcome, George. Dr. George Papanicolaou (00:40): Thank you, Mark. Glad to be here. Dr. Mark Hyman (00:41): So, George, you're doing an incredible new kind of therapy that is helping patients with osteoarthritis when other things often aren't working, so let's talk about this epidemic of osteoarthritis we have in America. How common is this, how big of a problem is it, and what do we do traditionally to deal with it? Dr. George Papanicolaou (00:59): So, Mark, 27 million Americans over the age of 25 have osteoarthritis and the joint that is most commonly affected is the knee. It creates a great deal of morbidity, meaning that- Dr. Mark Hyman (01:14): Suffering. Dr. George Papanicolaou (01:15): Suffering- Dr. Mark Hyman (01:15): I think that is a fancy metaphor for suffering. Dr. George Papanicolaou (01:17): Right, it is. Dr. Mark Hyman (01:17): Pain in the ass. Dr. George Papanicolaou (01:18): Right. So, yeah, and our traditional therapies basically help you control the symptoms but might not necessarily do anything to reverse it. So using MOTRIN, or Advil, or TYLENOL are common things people will use. And then your orthopedic surgeon may inject it with a steroid or they may use something like a lubricant- Dr. Mark Hyman (01:44): Like hyaluronic acid. Dr. George Papanicolaou (01:45): Yeah, hyaluronic acid. And so, it's only a lubricant effect though. Dr. Mark Hyman (01:48): Many need a knee replacement. Dr. George Papanicolaou (01:49): Right, and then you're getting towards a knee replacement and then we know that 40% of people that have their knee replaced still continue to have pain and loss of motion, so we don't have a lot of real successful treatments out there that are really changing people's lives. Dr. Mark Hyman (02:06): Yeah, right, it's true. And I think we often used to think about osteoarthritis as a wear-and-tear problem, you know you just beat up your joints too much, but it turns out it's really an inflammatory problem as well. Dr. George Papanicolaou (02:20): Yeah. So what's interesting, it certainly increases with age and trauma to the knee is certainly part of which creates an inflammation, and that trauma can be repetitive use. It doesn't have to be an ACL tear from a football injury, it can just be repetitive use on a person who's carrying too much weight on their body. So, obesity is a risk factor for arthritis. Dr. Mark Hyman (02:45): But obesity is also is a generally inflamed state. Dr. George Papanicolaou (02:47): Right. Dr. Mark Hyman (02:48): So, when your obese your fat cells are not just there holding up your pants they're producing tons of inflammatory compounds that are making your whole system inflamed. Dr. George Papanicolaou (02:58): Right. And so if you have an inflamed system and you're creating micro-trauma to your joints, you're going to have an over-reactive response in the joint. And joints I think we should understand and know about them is that the cartilage and the ligamented structures of the joint have lower oxygen tension than the rest of your body. Meaning that they don't have an enormous oxygen supply. It's a little bit different than the rest of the body and that plays a big role into why as we age that oxygen supply actually decreases, blood flow to those vital areas of the cartilage and ligaments decrease so that when you injure them they're less likely to repair, more likely to have an inflammatory response that leads to degeneration. Dr. Mark Hyman (03:45): Yeah. Interesting. What we're also learning about osteoarthritis that's fascinating to me was that while they're doing biopsies and doing analysis they're finding microbes in the joints. Dr. George Papanicolaou (03:54): Mm-hmm (affirmative). Yeah. Dr. Mark Hyman (03:54): Not infection, but just like dislocated microbes from the gut- Dr. George Papanicolaou (04:00): Yeah. Dr. Mark Hyman (04:00): So we're seeing the microbiome- Dr. George Papanicolaou (04:02): There we are again. Dr. Mark Hyman (04:02): ... of the gut in the knee, which is crazy- Dr. George Papanicolaou (04:05): Right. Dr. Mark Hyman (04:05): So that maybe also triggering an inflammatory response, right? Dr. George Papanicolaou (04:08): Yeah, yeah. We are really only 10% human. We understand that because we have 100 trillion bacteria in and on us and there are only 10 trillion human cells, som you know- Dr. Mark Hyman (04:20): So conventional medicine basically your knee hurts you go to the doctor and you get an X-ray and then you have osteoarthritis, here take some Advil, maybe do some strengthening exercises for your legs, maybe if it gets really bad you get a couple of shots in your knee of steroids, that doesn't work anymore you need a knee replacement. It's kind of a bad trajectory. There's no way to really recover from this. And from a functional medicine perspective, we do a different approach. Dr. George Papanicolaou (04:48): We do. And well we are going to talk about that approach but exercise does help, nutrition does help, losing weight does help. So, there are definitely things that we can do with a person's lifestyle and help them intervene. I worked with a patient that was 45-pounds overweight, was eating a totally processed-food diet, was drinking too much, and was scheduled for knee replacement in September. I saw them in early July and I said, "Hey, look if you do these things what I'm about to tell you I bet you you could be playing golf in January in Miami with your friends instead of recovering from knee replacement." And he said, "Okay, I'll take you on." I said, "Okay. If you win any money in Miami I get 10%." All right. Dr. Mark Hyman (05:37): That'd be good. Dr. George Papanicolaou (05:37): So, guess what? Dr. Mark Hyman (05:38): Did you get the 10%? Dr. George Papanicolaou (05:41): He got what he wanted. I didn't get what I wanted. Okay. So, he lost 45 pounds. Dr. Mark Hyman (05:46): Amazing. Dr. George Papanicolaou (05:46): I put him in physical therapy with a really good functional physical therapist, strengthened his knee. He canceled the knee replacement and came into an appointment walking and he opened up an envelope with his tickets to Miami. Dr. Mark Hyman (06:03): Oh, that's so amazing. Dr. George Papanicolaou (06:05): And so- Dr. Mark Hyman (06:05): But just to be clear, it wasn't just like eat less, exercise more. Dr. George Papanicolaou (06:09): No. Dr. Mark Hyman (06:10): You put him on an anti-inflammatory diet. Dr. George Papanicolaou (06:13): Diet. Yep. Dr. Mark Hyman (06:13): Which is speaking to the point that osteoarthritis is not just a mechanical wear-and-tear breakdown, it's a chronic inflammatory process- Dr. George Papanicolaou (06:20): It's multiple things. Dr. Mark Hyman (06:21): And so from functional medicine perspective, we deal with chronic inflammation holistically. So, what are the things you did diet-wise and supplement-wise that actually helped with his chronic inflammation that helped his knees and the weight loss? Dr. George Papanicolaou (06:35): The really key thing was is to get him to decrease his alcohol and also to get him to decrease his intake of processed foods. These processed foods are fast carbs that go into your body, they have toxins in them and they also create an inflammatory response driven by insulin- Dr. Mark Hyman (06:54): So, sugar and starch are inflammatory foods. Dr. George Papanicolaou (06:56): Right, yeah, yeah. Right. So, we took that right out. So, we just basically put him on a Mediterranean diet- Dr. Mark Hyman (07:00): But not gluten and dairy-free? Dr. George Papanicolaou (07:02): Gluten and dairy, oh, absolutely gluten and dairy-free. Dr. Mark Hyman (07:05): But why is that important? Dr. George Papanicolaou (07:05): Because as we've talked about before multiple times, they're both inflammatory and so gluten can actually trigger leaky gut, which again triggers that whole process of inflammation in the body and then if you have any micro-trauma to your knee, that inflammation, it's cytokine response is going to lead to degeneration of cartilage and even boney structures in the knee. Dr. Mark Hyman (07:26): So, here's the deal, not everybody needs to be gluten and dairy-free. Dr. George Papanicolaou (07:30): No. Dr. Mark Hyman (07:30): But if you were inflamed- Dr. George Papanicolaou (07:31): You got to be. Dr. Mark Hyman (07:32): And if you have a chronic problem it's number one, two, and three on the list, right? Dr. George Papanicolaou (07:37): Yep. Dr. Mark Hyman (07:37): You got to give away- Dr. George Papanicolaou (07:37): Gluten, dairy, sugar. Dr. Mark Hyman (07:38): ... gluten, dairy, sugar- Dr. George Papanicolaou (07:39): Done. Dr. Mark Hyman (07:40): ... and inflammatory foods. As the first step, and then you say, "Well is it better? Is it not? It is something else?" Because it's sometimes something else. Dr. George Papanicolaou (07:47): Yeah. Dr. Mark Hyman (07:47): But it's really powerful when you put people on an anti-inflammatory diet- Dr. George Papanicolaou (07:50): Oh, absolutely. Dr. Mark Hyman (07:50): So if you have osteoarthritis, is diet is one, two, and three, and it's really getting on a whole foods, plant-rich, good fats- Dr. George Papanicolaou (07:58): Absolutely. Dr. Mark Hyman (07:59): ... like lots of anti-inflammatory foods. Getting off gluten, dairy, sugar, starch, processed foods. Dr. George Papanicolaou (08:03): So, yeah. And you put them on really good healthy fats because fats are a really important part of the anti-inflammatory process. I put him actually ... One of my favorite things to do when I'm dealing with inflammation is high-dose omega-3s. Dr. Mark Hyman (08:17): So lots of omega-3s. Right. Dr. George Papanicolaou (08:18): Yeah, so I use 4,000 or more. So, I put him on omega-3s. I use an anti-inflammatory botanical called curcumin. So, it's sort of like a botanical Advil. So, I put him on that. Oh, I also used something like it's a super-charged omega-3, it's refined from omega-3s, it's called specialized pro-resolving factors- Dr. Mark Hyman (08:42): Mediators. Dr. George Papanicolaou (08:42): Mediators and they are very potent at- Dr. Mark Hyman (08:44): SPM. Dr. George Papanicolaou (08:45): SPMs. So, they're very potent anti-inflammatories. So between his diet- Dr. Mark Hyman (08:49): It's sort of like taking all the good juju out of the omega-3s- Dr. George Papanicolaou (08:54): Right. Dr. Mark Hyman (08:54): ... and concentrating them. And there's a lot of research done at Harvard on this. Dr. George Papanicolaou (08:58): Oh, yeah. Dr. Mark Hyman (08:58): And your body has this ability to resolve inflammation. It has an auto-built-in system- Dr. George Papanicolaou (09:06): Right. Dr. Mark Hyman (09:07): ... that's called resolvins. So, resolvins are molecules in your body that resolve inflammation. So, these are called specific pro-resolvin mediators. Dr. George Papanicolaou (09:19): Mediators. Dr. Mark Hyman (09:20): So, they're really effective- Dr. George Papanicolaou (09:22): They are. Dr. Mark Hyman (09:22): There's a lot of research on these. So, would you- Dr. George Papanicolaou (09:23): And a lot of research particularly with post-surgical recovery, post-trauma recovery that these will actually enhance recovery and you will have a shorter recovery time when you're using SPMs. Dr. Mark Hyman (09:36): Yeah, so they're going to be very effective. So, diet, the supplements and- Dr. George Papanicolaou (09:40): Targeted supplements. Dr. Mark Hyman (09:41): Yeah, even vitamin D may be helpful- Dr. George Papanicolaou (09:43): Right. Dr. Mark Hyman (09:43): ... because it strengthens bones. Dr. George Papanicolaou (09:44): Oh, absolutely. Dr. Mark Hyman (09:45): Right. Dr. George Papanicolaou (09:45): Yeah, vitamin D and omegas are pretty much standard for me when I'm dealing with anybody with any amount of inflammation because of the impact that vitamin D has on the immune system, inflammatory system, mood, it just does so many things. In addition, physical therapy's very important because we do know that the muscular strength around a joint will protect that joint and keep it from the constant damage it can get from repetitive use, so as physical therapy- Dr. Mark Hyman (10:11): Yeah, I never had any knee problems, knock wood. But I have very big thighs because I was a runner most of my life and biker, so I have really big thighs and my knees, my leg thighs are strong is my knees are always well-protected. Dr. George Papanicolaou (10:23): Right, yeah. So, I can tell a personal story. I had my right hip replaced. I had no pain. And then I fell, I injured it, it got inflamed and then within four months I had to get a hip replacement. And I asked the surgeon, "Why did I have end-stage arthritis and not know it?" Well, I had been running and I had been racing a bike for 10 years. I mean, I had really strong legs, and he said, "A couple of things, George. One is you've got so much strength in the leg and you may have been a person because of your diet you're not very inflamed and so your cytokine response at the joint limited the pain you are going to feel." So, strength and anti-inflammatory living can actually keep you from even knowing you have arthritis. Dr. Mark Hyman (11:08): Yeah, it's amazing. I had a lecture I did recently and there was this woman who was like, "I did your 10-day reset." And basically is a anti-inflammatory detox from sugar and starch and gets rid of gluten, dairy, and sugar. It's a really nice program and you can go to getfarmacy, with an F, and you can learn about it, you can download the program free, you can get the extra version if you want, but she did this, not seeing me as a patient, just on her own and she said, "I was scheduled for a bilateral knee replacement. I did this program, I did it for more than 10 days obviously and I canceled it because my knees are fine now." Which is a pretty amazing story. And I've heard this over and over. Dr. George Papanicolaou (11:46): Yeah. Dr. Mark Hyman (11:46): So I think if you're facing that level of surgery,.I mean a knee replacement is not easy. Hip replacement you get the hip, you're up and going pretty quick. Knee replacement you're out for a long time, a lot of hard work, physical therapy, you don't really get back to perfect. I mean, it can be great for people who need it. But there's some other intermediate steps before you get there, even if your diet's great and everything's great and you've done all these things and it's still not working, there's another therapy that has emerged that is really powerful. Dr. George Papanicolaou (12:15): And yeah, this is very powerful stuff and I wanted to make sure we talked about that the lifestyle and those important things, but what we really wanted to talk about was ozone and Prolozone and what it can do for the joints [crosstalk 00:12:31]. Dr. Mark Hyman (12:31): Take us through this because most people hear the ozone, they think the ozone layer, and it's bad for you and what? Dr. George Papanicolaou (12:36): Right. So, ozone is a gas. We know that there's oxygen and oxygen is actually two oxygen atoms that come together and they have to be together because they're very stable together. Oxygen by itself it needs another electron so it shares it with a partner. So you have O2 and they're married and they're very happy together. But, if they get any solar activity placed upon them or any electrical activity it'll split and it's happening constantly all the time, but they'll come back very quickly together, but sometimes they come back and there's a third person there, right, there's another extra molecule that's latched on because he couldn't find a partner. So, now you have this what we call triatomic oxygen or O3 and now there's not enough electrons for all three to share, so the two oxygens are like, "I've got to find a way to get rid of this third wheel." So, that becomes a very unstable molecule and it's that very thing that makes it so effective in treating- Dr. Mark Hyman (13:36): Tell us how it works. So, how would you use that with arthritis? Dr. George Papanicolaou (13:39): So, the way it works is is that we have an ozone machine, we have a machine- Dr. Mark Hyman (13:45): Ozone generator. Dr. George Papanicolaou (13:46): Ozone generator. Dr. Mark Hyman (13:47): This takes oxygen and runs it through the machine that was invented by Nikola Tesla. Dr. George Papanicolaou (13:50): Oh, you. I was just ... You did it again. He steals- Dr. Mark Hyman (13:53): I get to say stuff too- Dr. George Papanicolaou (13:53): He steals my ... Dr. Mark Hyman (13:54): ... it's my podcast. Dr. George Papanicolaou (13:54): I know it is. Dr. Mark Hyman (13:54): It's my podcast. Dr. George Papanicolaou (13:56): So, Nikola Tesla in 1890, I think it was 1893 or so, he patented the first ozone machine, which is a really cool thing. So, now we have ozone machines and we have an ozone machine that we hook up to medical-grade oxygen and in that machine, it will take that oxygen, it will hit it with electricity and create ozone, and it can be modulated as to how much ozone you can actually make. And you can make anywhere from 1% to 5% oxygen-ozone mixture in different concentrations and we can adjust that concentration. So, we pick- Dr. Mark Hyman (14:33): So, it's mostly oxygen with a little ozone. Dr. George Papanicolaou (14:35): Yep. Mostly oxygen, a little ozone. And that's really critical because it's oxygen-ozone therapy because part of the benefit comes from getting oxygen into the joint and then the ozone plays another role. So, we then take this ozone and we inject it directly into the joint. It can be the shoulder joint, it can be the knee, it can be the hip, it can be the ankle, any joint you can put ozone in. Dr. George Papanicolaou (15:06): The way ozone works is pretty interesting. Because it's unstable it actually has what we call a hermetic effect. It actually by the fact that it stimulates the body to do something better by irritating it, so it's a little bit- Dr. Mark Hyman (15:23): Yeah, like if you're lifting weights you'd tear some muscles and you'd get bigger, stronger muscles. Dr. George Papanicolaou (15:26): Right. So, what happens inside the joint is that it will actually modulate the cytokine response. So, when you have that damage to your knee and you're constantly moving it, you're constantly creating that inflammatory response and there are cytokines, and those cytokines will then, this inflammation will lead to the breakdown of cartilage, and eventually even bone, and it also mediates pain. Ozone has been shown to modulate that response so that it will actually produce more of the anti-inflammatory cytokines versus the pro-inflammatory cytokines. So that's- Dr. Mark Hyman (16:03): So, it also activates your antioxidant system. Dr. George Papanicolaou (16:05): Right. Dr. Mark Hyman (16:05): So, it's like an antioxidant for your knee and anti-inflammatory directly in there. Dr. George Papanicolaou (16:09): Exactly. So, you get anti-inflammatory, it stimulates an antioxidant effect, but remember what I said earlier that the knee and well cartilage anywhere and ligamented structures don't have a great oxygen supply, and when you have that much inflammation in an older person and then oxygen supply and circulation has been diminished, now you don't have any of the healing capacity that you would've had without inflammation or if you were younger. What does ozone do? Ozone actually increases blood flow, it increases oxygen delivery and oxygen utilization. Dr. Mark Hyman (16:48): Wow. That is good. Dr. George Papanicolaou (16:49): And it stimulates chondroblasts and fibroblastic activity so that you can actually build up cartilage and build up the soft tissues around the knee. Dr. Mark Hyman (16:58): Amazing. Dr. George Papanicolaou (16:59): It's pretty amazing stuff. Dr. Mark Hyman (17:00): Amazing stuff. I'm just going to tell a personal [inaudible 00:17:02], so I also have been trained in ozone and we do this here at the UltraWellness Center proloz and other forms of ozone therapy for chronic illness which are really effective for so many things and definitely on the margins of medicine but very powerful. I had a broken arm a number of years ago and went to get training in how to do this and my arm wasn't healing and then I had a frozen shoulder, I could not move my arm above 45 degrees from my body, and it was so painful and he was like, "Yeah, I can inject your shoulder." The guy who was training us and he took ozone and injected into my shoulder joint and literally within five minutes I was doing this. I was completely mobile, moved my arm everywhere. There was another doctor in the training as well who had a frozen shoulder and not just for six months but for years. Same thing, injected his shoulder, we're all like, " Wow, this is a miracle." Dr. George Papanicolaou (17:55): Seen it over and over again. It's amazing. Dr. Mark Hyman (17:57): Then I remember a patient, not that it was mine, but when I was in training there was a guy who had been a NHL hockey player and he had won five Stanley Cups, part of the New York Islanders and his knees were shot, he couldn't walk. And he come in for a number of treatments at his doctor, and after the ozone treatments in his knee, in which I saw him administer it, he literally was up and walking. I've seen people come in with canes and danced their way out. It's pretty amazing. Dr. George Papanicolaou (18:20): I know it sounds ... Dr. Mark Hyman (18:22): It sounds wacky, right? But it's ... Dr. George Papanicolaou (18:23): It sounds sensational, but it is. Dr. Mark Hyman (18:27): I mean that convinced me. I really could not ... And I had to go to physical therapy for a year and had to maybe go under anesthesia to mobilize my shoulder and all these things I was getting recommended and I'm like, it was like five minutes and it was painless. Dr. George Papanicolaou (18:39): Yeah, it is- Dr. Mark Hyman (18:40): It was a little needle poke, but that was it. Dr. George Papanicolaou (18:42): And when we do it, we not only inject the ozone in but because we know it's happening and the joint hasn't been getting the blood supply it needs, the nutrients it needs, we'll add in some nutrients that are part of the healing process. So we'll add in some methylcobalamin, some magnesium and Procaine. We use Procaine also because it actually changes the action potential of the cell and membrane, which has been disrupted by the inflammation and it allows for the cells to become healthier, so the Procaine actually is not just for the anesthesia but it's also to help the cells heal. Dr. Mark Hyman (19:25): That's amazing. So tell us about this patient you had who you treated with- Dr. George Papanicolaou (19:28): Oh, yeah. Dr. Mark Hyman (19:29): ... ozone here at the UltraWellness Center using Prolozone which is a form of ozone that you inject into joints or soft tissues to help with pain. Dr. George Papanicolaou (19:36): Yeah, so this was a woman who just two years ago went on a pilgrimage and hiked through these very, very high mountains in Spain. On that hike she'd been having pain in her knee on and off but nothing that ever inhibited her doing anything she wanted, but on this hike, suddenly it blew up and she couldn't finish her pilgrimage. So, she came home to her doctor, X-rays were done, and she had pretty much bone-on-bone in her knee. Dr. Mark Hyman (20:04): Wow. That's terrible. Dr. George Papanicolaou (20:05): And so over the past two years she has had steroid injections and she's had a lubricant injection with hyaluronic acid and she had some benefit, but she still wasn't able to hike. So, she asked if I would treat her. I evaluated her and I treated her with ozone and after her second injection just three days ago ... Well, she had her second injection almost two-and-a-half weeks ago, three days ago she went on her first hike in two years. She hiked six miles. Dr. Mark Hyman (20:38): Wow. Dr. George Papanicolaou (20:39): And went over mountains that were very high and she didn't have a problem and the day after she said, "I didn't have any swelling." Dr. Mark Hyman (20:48): That's amazing. Dr. George Papanicolaou (20:49): That is amazing. Dr. Mark Hyman (20:50): So how many treatments do people often need? It doesn't sound like that many. Dr. George Papanicolaou (20:54): Usually, I tell people between three to maybe eight injections. Usually somewhere between three and six is the sweet spot. Dr. Mark Hyman (21:02): I think you can come in for a tune-up if you need it. Dr. George Papanicolaou (21:04): Absolutely. Dr. Mark Hyman (21:05): Is it painful? Dr. George Papanicolaou (21:05): Not at all. Not at all. I mean you'll feel the needle going in initially, but once I'm in the joint it's not painful. You may feel the pressure of the ozone going in, but I monitor that very closely when I'm doing it and I can actually feel it and- Dr. Mark Hyman (21:21): You can feel the knee fill up with gas, right? Dr. George Papanicolaou (21:23): Yeah, you can. Dr. Mark Hyman (21:24): And it's basically a disinfectant, so there's microbes in there that shouldn't be there- Dr. George Papanicolaou (21:26): Gone. Dr. Mark Hyman (21:27): It activates the anti-inflammatory system. Dr. George Papanicolaou (21:29): Powerfully. Dr. Mark Hyman (21:30): It's a powerful antioxidant and it's like a- Dr. George Papanicolaou (21:33): And it manages the cytokine response which causes the inflammation and the pain. Dr. Mark Hyman (21:37): It's pretty remarkable. I mean- Dr. George Papanicolaou (21:39): But here's the [crosstalk 00:21:39]. Dr. Mark Hyman (21:39): ... if I hadn't experience myself like that I would like, "This sounds really quacky." And actually, it's a real procedure that's being used all over the world- Dr. George Papanicolaou (21:46): For years. Dr. Mark Hyman (21:47): ... in many countries for years. Is used here- Dr. George Papanicolaou (21:48): Years. Dr. Mark Hyman (21:49): ... to some degree, but in many other countries like Cuba and South America and- Dr. George Papanicolaou (21:53): Spain, Italy. Dr. Mark Hyman (21:54): Spain, Italy, Russia, I mean they're doing this- Dr. George Papanicolaou (21:55): Russia. Dr. Mark Hyman (21:56): ... extensively. Dr. George Papanicolaou (21:57): Yeah. Dr. Mark Hyman (21:57): It's extremely inexpensive. It's super effective. It's probably more effective than most traditional treatments for osteoarthritis- Dr. George Papanicolaou (22:04): Absolutely. Dr. Mark Hyman (22:04): ... and it's got very low downside and very low cost. Dr. George Papanicolaou (22:06): Right. Dr. Mark Hyman (22:06): If you inject steroids in anything over time it's going to degrade the cartilage, it's going to degrade the knee, it's going to make things worse. Dr. George Papanicolaou (22:11): Right. Dr. Mark Hyman (22:12): You'll get a temporary benefit, but then you end up with worse situation. Dr. George Papanicolaou (22:14): 10% of people- Dr. Mark Hyman (22:14): This actually helps restore cartilage. Dr. George Papanicolaou (22:16): Yeah. That study that came out in 2019, 10% of the people that get steroid injections actually their arthritis gets worse- Dr. Mark Hyman (22:24): Yes. Dr. George Papanicolaou (22:25): ... and they end up with unexplained fractures.. Dr. Mark Hyman (22:27): Yes. Because it weakens their tissues. Dr. George Papanicolaou (22:29): Yeah, so we know that. Dr. Mark Hyman (22:31): And with Prolozone we've seen cartilage regenerate. Dr. George Papanicolaou (22:34): Right and that's the difference. That's what I wanted to make sure we made that point because it stimulates chondroblasts. Chondroblasts are the cells that rebuild cartilage. It can rebuild the cartilage and again, what we love in functional medicine is we find those modalities just don't maintain disease but will actually reverse it and Prolozone fits the bill. Dr. Mark Hyman (22:54): And you were saying this patient, she's hiked six miles and she was told she needed a knee replacement? Dr. George Papanicolaou (23:00): Yep. Dr. Mark Hyman (23:01): Okay, so- Dr. George Papanicolaou (23:01): Yeah, I'm telling you it's pretty amazing. And she was pretty near bone-on-bone. Dr. Mark Hyman (23:06): That's incredible. Well, it will be interesting to see her follow-up X-rays. Dr. George Papanicolaou (23:09): Yeah, I'm interested, yeah. Dr. Mark Hyman (23:09): When you continue to do this and track it, but I think people out there suffering from osteoarthritis, the focus really should be on lifestyle and people need to understand they need a lot of power to transform the inflammatory state of their body. And what often is considered disease of aging are often inflammatory diseases. We call it inflamaging, right? Dr. George Papanicolaou (23:27): Yeah. Absolutely, yeah. Dr. Mark Hyman (23:27): And I think the arthritis is part of that. Dr. George Papanicolaou (23:29): Oh, yeah. Dr. Mark Hyman (23:29): It's not just bone-on-bone mechanical issue, it's an inflammatory issue. So, using an aggressive lifestyle approach, 10-day reset, for example, using Prolozone as an adjunct can be incredibly helpful for those people who need it and I think it works for all kinds of joints, all kinds of orthopedic and soft tissue issues, back problems and I think it's really such a great service we offer here at the UltraWellness Center. Dr. George Papanicolaou (23:50): It is great. And it's safe. Dr. Mark Hyman (23:53): And it's safe. Dr. George Papanicolaou (23:54): They did this study in 1980 in Germany where they looked at 650,000 treatments that were provided by 644 docs, to 300 and some I think 50,000 patients and they're complication rate there was only 40 complications reported which was .000007% complication rate. Dr. Mark Hyman (24:23): Seven in 100,000. Dr. George Papanicolaou (24:24): Yeah. Dr. Mark Hyman (24:25): That's not too bad. Dr. George Papanicolaou (24:26): Yeah, you're pretty good at math. So, yeah, that's a great safety record. And it's been used in Europe for at least a half of century for treating viruses, infections, wounds. Dr. Mark Hyman (24:39): Yeah, I mean this was not Prolozone, but this was other forms of ozone so- Dr. George Papanicolaou (24:42): Other forms of ozone, yeah. Dr. Mark Hyman (24:43): But it is very safe and I think we're so excited to be able to introduce this here, not just for orthopedic issues but we have different forms of ozone we give intravenously and through other methods to help people with all sorts of chronic issues. So, I encourage you all to check it out, learn more about it. Go to, check out the Get Started page, learn how to become a patient. We'd love to see you hear. We can do all virtual consults, but you can't do Prolozone over Zoom- Dr. George Papanicolaou (25:07): Not yet. Dr. Mark Hyman (25:07): ... which is a problem, but we are offering this service still. We're open. Our clinic is open. We'd love to see you and if you love this podcast please share it with your friends and family on social media. Leave a comment, we'd love to hear from you. Subscribe wherever you get your podcasts, and we'll see you next time on the Doctor's Farmacy. Dr. George Papanicolaou (25:23): My word.