Tiger Protocol - Dr Akil Palanisamy
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Kara Wada, MD: Welcome back everyone, and welcome to our new listeners to the Becoming Immune Confident Podcast. My name is Dr. Kara Wada. I'm a board certified pediatric and adult allergy, immunology and lifestyle medicine physician, certified life coach, and systemic Sjogren's patient.
Today I am so excited to welcome one of my esteemed colleagues, Dr Akil Palanisamy. He is a harbor trained physician, author, and holistic medicine expert in the integrative and functional medicine spaces. He has a new book that's coming out May 9th called The Tiger Protocol, which I've been able to be reading in the background, which integrates the best of conventional and holistic medicine.
Dr. Akil presents a comprehensive protocol to help you treat and heal your autoimmune conditions, including rheumatoid arthritis, Hashimoto's, MS, lupus, Sjogren's, and more. Groundbreaking and timely, the Tiger Protocol teaches you how to eat right, detoxify, resolve infections, optimize your microbiome, and relieve stress to feel better than you've ever felt before.
Based on his own experiences helping thousands of patients, Dr. Akil provides definitive, practical guidance on diet, lifestyle, and supplements that can heal autoimmunity. He presents a revolutionary plan that utilizes nourishing foods, powerful healing spices and targeted supplements to help you reduce inflammation, improve energy, and transform your.
Welcome Dr. Akil, and thank you so much for joining us this week.
Akil Palanisamy, MD: Oh, yeah. Thank you, Kara for having me on the podcast.
Origin of the book The Tiger Protocol
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Kara Wada, MD: Yeah. If you wouldn't mind, you know we learned a little bit in your bio about the protocol, but how did you end up here? How did you end up writing the book?
Akil Palanisamy, MD: I first got into integrative medicine through my own illness journey like many of us and that started about 20 years ago during my medical school where I developed this mysterious illness that no one could diagnose, and developed severe fatigue, chronic pain, and weight loss. I couldn't sit up I couldn't use a computer. I had to stop my training because all the conventional treatments were not working.
I was doing physical therapy, prescription drugs. But I took that a year off and I then I just had to seek out other options and it was actually integrative medicine that really turned my health around and helped me to, feel better than ever before and I knew that I wanted to train in that.
So after residency, I did a fellowship in integrative medicine with Andrew Weil and then in the topic of autoimmune diseases, it just grew organically in my practice. I started seeing more and more patients with this issue, it's very rapidly growing, and then they would get some good results and they would share with their friends. So, my practice grew more and more as I saw how integrative medicine can help with the immune system.
What is Integrative Medicine?
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Kara Wada, MD: I know we've talked on the podcast with a few other guests about Integrative Medicine, but maybe for those who haven't listened to those episodes yet, can you explain what that means?
Akil Palanisamy, MD: Yeah, great question. Integrative medicine basically refers to integrating conventional and alternative therapies. So things like diet, lifestyle, herbal therapies, other systems like traditional Chinese medicine or Ayurveda. It is still evidence-based. So we try to find what is the research-supported things we can draw from other therapies, alternative systems, and then integrate that together with Western medicine so we can have the most number of tools to help our patients.
Kara Wada, MD: That's what I very much appreciate. The both end approach rather than either or.
Akil Palanisamy, MD: Right.
What TIGER stands for
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Kara Wada, MD: Maybe we can jump in. Can you tell us what TIGER stands for? I love a good acronym.
Akil Palanisamy, MD: Absolutely, yes. The five root causes of immune dysfunction and inflammation, which affects not just autoimmune disease, but I believe, all chronic diseases, and those are: Toxins. I for Infections, G for Gut Health, E for Eating right and R is for Rest. The R covers stress and the mind body connection. There's no kind of silver bullet for autoimmune disease. It really does take a multi-pronged approach and that's why I chose these five elements to put in the protocol.
Problematic Day-to-day Toxic Encounters
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Kara Wada, MD: Makes for a very compelling title and it all works together. So maybe we can jump in a little bit. We have had a series that we haven't had an episode labeled as such for a while, but this idea of going non-tox without the nonsense. What are some of those things that we may be encountering in our day-to-day existence that we may not realize could be problematic?
Akil Palanisamy, MD: Yeah, absolutely. When I did the research for this book, I was very surprised to find so many toxins linked to autoimmunity and inflammation. So in the book I actually reviewed 20 different toxins that have each been individually linked to autoimmunity and the problem is when you start combining them, like in all of us, we have chronic low level exposure to multiple toxins. This could be from the air, the drinking water, the food, the environment. So the the goal with The Tiger Protocol is not to make people afraid or overwhelmed, but to share this information, to empower them, to just remind them that they do have their own detox capacity, their body has a system for that. So just trying to up-regulate and boost that a little bit and then reduce toxin exposure. That's like the two-pronged approach I like.
Kara Wada, MD: Yeah and some of those toxins would include things from like plastics, personal care products, heavy metals. All sorts of things.
Akil Palanisamy, MD: Exactly, yeah. Then one thing which is not as well appreciated is waterborne toxins. Studies have shown that there's many people, like in the U.S., are exposed to low levels of certain chemicals. For example: PCBs, and then there's PFAS, which is a different kind of chemical, and then there's TCE and then there's perchlorate. So a lot of these have been environmental ly used and they don't break down, that's the problem. They stay there for hundreds of years and then they make it into the water supply. So that's why getting a good water filter is I believe, very important.
Kara Wada, MD: Yeah, it's really good timing. So it's interesting, we have a community that I help lead with a dietician friend of mine called Belong and the theme for this week's private podcast in the group was we're doing a hydration challenge, but part of it was going through how to filter your water- the ins and outs. A lot of that comes from my dad's. He is retired now, but was in public health. Groundwater was like his thing. So I remember from a really early age, he would have this model he would bring to the county fairs and it would show what would happen when someone would inappropriately dump gasoline or oil down the drain or in the backyard and how that then could end up in our water supply.
Even as a little grade school kiddo, I found that, so first of all, the model, any type of diorama is really cool, especially in a pre tablet. I just think it's really neat how things come full circle and here I am, 30 plus years later, we're still talking about the same things because they're still really important.
Akil Palanisamy, MD: Yes. I couldn't agree with you more. Yeah. Yeah.
Tips to avoid toxic encounters & Infections
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Kara Wada, MD: One of the tips he's given, I live in an area where we have municipal water supply, so you can look up your data, and I know you provide some resources for that through EWG and link to that in the book. But growing up we had well water so it's one of those things you may not know. You are then the one responsible for typically obtaining that testing and making sure everything is is safe.
Akil Palanisamy, MD: Exactly and I'll just add one other tip which is that they've studied, the bottoms of shoes tend to carry things like pesticides, heavy metals, potentially toxic bacteria so leaving your shoes near the front door so you don't track all those things into the house. That's something in Asian cultures. But that's something very beneficial as well and no cost to do that..
Kara Wada, MD: Absolutely. Every time we have someone come over, my husband's like, "Yep, sorry, asian household"
Akil Palanisamy, MD: Yeah, perfect. Yeah, we do the same thing.
Kara Wada, MD: I don't know that I've ever shared with him that was the rule in our house growing up too, but I'm totally on board however we spin it.
Akil Palanisamy, MD: Yeah, exactly. Yes.
Kara Wada, MD: It's smart and sometimes those common sense things really do have the research to support them as well.
Prebiotics, Probiotics & Postbiotics (Gut Health)
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Kara Wada, MD: One of the other things I really appreciated in reading, I will admit I have not gone all the way through I've gotten about 80% through- I was binge-reading last weekend, was, I've been able to recommit to making some changes that I've done before, but to improve gut health. So one of the things you talk about a lot are these probiotic rich foods. So the difference between prebiotics, probiotics, postbiotics, let's jump in.
Akil Palanisamy, MD: Yes. To start with defining those terms. Prebiotic is something that feeds your good bacteria, and that could be foods or supplements and I really emphasize prebiotic foods.
Then there are probiotics, which are good bacteria. Fermented foods have probiotics, those beneficial bacteria, and then the postbiotics are actually metabolites that your good bacteria are supposed to produce, and they have a big effect on the microbiome.
I think fermented foods are very beneficial, and I do emphasize them, but what I really believe prebiotic foods are less well known and so what I've tried to do in the book is go through all the main categories of prebiotic foods, like, polyphenols, arabinoxylans, resistant starch, inulin, and then list the top 20, 30 foods for each of those so that people can choose. You don't have to eat everything, but select what you like and then you have more options because the more different types of foods you can eat, especially plant foods, the more diversity you'll have in your gut microbiome and we know that's the key metric for health and resilience and also longevity and reduced risk of all diseases.
Kara Wada, MD: And then we get to just eat so many other like delicious things too.
Akil Palanisamy, MD: Yes, exactly.
Spices and Herbs' Prebiotic Effects:Tips to Eating Right
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Kara Wada, MD: And one of the other emphasis that you talk about in addition to this, plays into the diversity in plants, that includes spices and herbs too.
Akil Palanisamy, MD: Yes. So, I'm very influenced by Ayurveda, which is one of the systems I've trained in and in that, they believe spices are medicine, they're really considered their own category of therapeutics. Now, modern research is confirming that because spices actually have prebiotic effects, they feed your good bacteria, they have very powerful antioxidants to combat oxidative stress, they reduce inflammation, which is very well known now with turmeric and other things, and then finally, they are really good for your gut. In Ayurveda, what is called the agni or the digestive fire, just keeping your gut functioning well, so, a big part of my protocol is teaching people how to use more spices because they can help not only with the gut healing, but also with eliminating infections.
In Ayurveda, a lot of spices are used for their goals of antimicrobial, getting rid of viruses, fungi, parasites and so forth. So , I teach people how to use common spices like turmeric, ginger and garlic, but then also less well known like black cumin is very powerful antimicrobial. There's ajwain, which is another spice that's great for the gut. So there's so many spices I think we can take advantage of and it makes the food taste better.
Kara Wada, MD: Absolutely. It makes me look back at my childhood though, and just laugh a little bit because to be quite honest, until the Food Network came about and we got cable, which was well into maybe middle school, high school. Bless my mom's heart, she learned from her mom how to cook. My grandma was a mom of six kids. She was just trying to survive that 1950s housewife kind of mom. So, my mom didn't know how to use an herb or a spice until like these things changed. So, my whole like teens and adulthood has been this evolution into like, "oh my gosh, food with flavor, how amazing".
Akil Palanisamy, MD: Yes, exactly. Yeah.
Kara Wada, MD: I think it's just testament that some folks will say, "Oh, I don't like that, or I don't know", some encouragement from both of us to say, give it a try you never know. What's the worst that could happen if you take a little taste and you don't like it? Just try again in a little while.
Akil Palanisamy, MD: Yeah, exactly. What I like is that there are many options that are not just very spicy hot. Most people think about like chilis or super hot spices and that's true, they have some benefit, but many people can't tolerate that level of spice, it upsets their stomach. But all of these other spices that I've talked about are more mild, they're savory, some of them are even sweet like fennel and coriander. You can use herbs as well, like mint, parsley and cilantro.
So even if you don't tolerate like very hot, spicy food, you can still incorporate spices in.
Kara Wada, MD: Yeah and a little bit really does make a considerable difference. The amounts you had mentioned in many cases, half teaspoon.
Akil Palanisamy, MD: There was interesting study which looked at clove powder and its effect, and that only showed like one eighth of a teaspoon.
Kara Wada, MD: Yeah. Little sprinkle.
Akil Palanisamy, MD: Little powder every day for seven days and it reduced blood inflammation markers in seven days. So just one eighth of a teaspoon.
Kara Wada, MD: You think about, it pairs so nicely in a lot. Just thinking of homey Midwestern- americany type, cinnamon nutmeg type recipes to add a little extra clove in there. It folds in so nicely, and then you're getting one more plant to get towards that 30 to 40 plants in a week. You're getting that extra anti-inflammatory punch and it tastes good too.
Akil Palanisamy, MD: Yes. Yeah and I love about clove also the fact that it's the spice that's the richest in polyphenols, which are those prebiotics that feed your microbiome. The second is actually dried peppermint. That is quite good as well. But these are very high, like, two or three times what you might get from like cacao powder or other things. So, clove powder yeah, I'm a big fan of that. We use a lot of it.
What can we add back in? Don't stay in a too restrictive diet long term
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Kara Wada, MD: And what I'm hearing is this idea of what can we add?
Akil Palanisamy, MD: Yes.
Kara Wada, MD: Taking precedence over, I know you, you mentioned exploring some elimination type protocols, but you really always are coming back to that, "okay, what can we add back in?"
Akil Palanisamy, MD: Yeah, that's my whole approach because I think that, there's a place for an elimination diet taking out possible food sensitivities but I always believe reintroduction must be a priority and you don't wanna stay on too restrictive of a diet long term, because then you'll start to lose some of that diversity of the large intestine microbiome, which we know is really key for longevity. So that's very important.
Fermented foods and high histamine
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Kara Wada, MD: One of the questions I'm asked all the time: social media and especially in the office, because I have, predominance of patients who are dealing with allergies, asthma, that Th2-type inflammation, histamine rich inflammation. There are a fair number of folks who say, "Hey, I can't tolerate fermented foods because they are high in histamine". Any tricks that you've found that I can pass along?
Akil Palanisamy, MD: That is a really good point. Yeah, that is a challenge because many patients can't tolerate fermented foods with the histamine. What I find that, with histamine is that you have to look at the the breakdown of it that's supposed to be done by our good bacteria. So when you have bacterial overgrowth or imbalances, then your ability to process and break down histamine is really down regulated. So, in some patients I've seen that if we can correct their bacterial overgrowth, correct, their dysbiosis or the balance of bacteria, then they start tolerating some of those foods in small quantities because their bacteria are starting to process histamine now. But it doesn't work in everyone and in those cases, I think finding the prebiotic foods is equally powerful in terms of supporting the microbiome
Kara Wada, MD: Awesome, thank you. That's what we've been working on, but sometimes you just get between a rock and a hard place
Akil Palanisamy, MD: Right? Yeah. Yes.
When rest comes into play
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Kara Wada, MD: Let's talk a little bit about rest and where that comes into play and how some of the places where our stories come together and have overlap is seeing harm in our own health. During our training, years and experiences and what that puts our bodies and our minds through.
Akil Palanisamy, MD: Yeah, no doubt. I think that this is a really critical piece, rest, because we know studies have shown that stress is one of the key factors in the development of autoimmune disease and also, in exacerbations or remissions where there's a flare up and worsening symptoms.
Many times when I talk to my patients about stress, their eyes glaze over and they just zone out because maybe I think people are maybe have heard too much forced on them. So, I tell people to really find what works for them and to know that there's a lot of different ways to approach this.
You don't have to meditate for an hour every day. There's good research on meditation, but there's equally good research that other tools for mind, body. Relaxation are helpful. Other practices like psychotherapy, counseling, gratitude, forgiveness, practices, prayer. For some people, their spirituality and religion can play a key role.
Also, play. Encourage people to try to incorporate more play, incorporate more just passive downtime. So there's lots of different ways to tackle it and finding what works for you and then making sure you're consistent. Doing that like several times a week is important to clear stress out of your body before it builds up and starts to have negative effects.
Kara Wada, MD: It's not necessarily a trip to the spa, although that is nice.
Akil Palanisamy, MD: Yes, yes.
Kara Wada, MD: Gimme these little things. Some ways that we've tried to sprinkle it throughout our week is when we sit down to dinner, everyone around the table shares what they're thankful for or in the case of my four-year-old, what made her happy that day because she don't know what grateful or thankful exactly means. Or having fun, I'll just try to get into reading the bedtime book. So there's a particular book my girls love to pick, The Book with No Pictures. I don't know if you're familiar with this one.
Akil Palanisamy, MD: Yes. My daughter love that book.
Kara Wada, MD: Yes. Yes and so, I lean into it. Why not have fun with it and allow those happy chemicals that the rest and digest the oxytocin, all those sorts of things to get some of our benefits from that.
Akil Palanisamy, MD: Yes. I love the way you're approaching that.
Importance of the Right Mindset
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Kara Wada, MD: It's fun to have then building some of those connections, like you said, you know that book with your daughter or what have you as well. Let's see. We've talked about the toxins, we've talked a little bit about the infections and the gut and eating and rest. If you had kind of one take home piece of advice for folks who are on this journey, what would you share with them?
Akil Palanisamy, MD: Oh. So I think mindset, the importance of having the right mindset I think is not emphasized enough because I see many patients that don't believe they can get better. They're been told by their doctors that they have to be on this medication for their whole life and their disease is incurable and just things that also lead them to conclude they can't feel better, which is not necessarily the case. So I think the very first step is believing that you can feel better. And often when I say that to patients, they say, I'm the first doctor who's told them that, they could feel better. And I think having that right mindset is very important because if not, It's easy to get overwhelmed with all these negative factors like toxins and infections and to just give up and not even try, but having that right mindset I find is important to set the stage to make further growth.
Kara Wada, MD: It's so helpful and I think for any of our healthcare professionals that are listening, remembering that our words have power and just as much as they can be healing, when we have that trusting therapeutic relationship, there's also the nocebo effect. So we can do harm in how we're talking with our patients, our clients as well.
Akil Palanisamy, MD: For sure.
What Becoming Immune Confident means to Dr. Akil
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Kara Wada, MD: So critical. So the last question I always like to ask folks, as we're wrapping up our conversation is, we recently have renamed the podcast, The Becoming Immune Confident Podcast, and I just always love to ask folks, what does that mean to you? And how does that kind of relate to the work that you're doing?
Akil Palanisamy, MD: Oh, I love that, yeah. I think that's exactly aligned with what I am trying to do, which is empower people and realize that you have tools that you can implement to help your immune system and also to build up resilience, because life happens. My goal is to help people achieve their own dreams and live their life and not to be like not challenging themselves or trying to close down their opportunities or anything.
But I want people to be empowered to know that all these tools will help their immune system so they can go out in the world and do the things they want to do and still, achieve their dreams and have a healthy and happy life.
Kara Wada, MD: Sounds good to me. Where can people find The Tiger Protocol? I know that they can order it ahead, correct?
Akil Palanisamy, MD: Right, exactly. Yeah, they can pre-order it on any book seller's website like Amazon or Barnes & Noble. It's available and it's coming out on May 9th, but it's available for pre-order now.
Awesome. So we'll make sure to link to that in the show notes and then if someone wanted to come see you in practice, where do you see patient?
Yeah, so I see patients in Sacramento, California, but I see through video visits people from throughout California. I do a lot of group visits as well. So, best way to learn more about how to connect with me is through my website, which is doctorakil.com and that has all of those resource.
Kara Wada, MD: Excellent. We'll make sure to have that link as well. Thank you so much Dr. Akil. I appreciate your time, your energy, all the work you put into your book, and I can't wait to have it on hand..
Akil Palanisamy, MD: Thank you so much, Kara. Yeah. This was a really fun conversation and thank you again for inviting me.
Kara Wada, MD: Yeah and we'll throw a quick little plug. We're both going to participate in an upcoming Lifestyle Medicine Virtual Summit being put on by SoMeDocs or Social Media for Doctors. So once that is up and running, we'll add that to these show notes once we have that information and you'll be able to watch presentations from us and from many more of our colleagues that are similarly minded and thinking about how we can use our everyday lives to help improve our health and healing, so that'll be really fun.
Akil Palanisamy, MD: Yeah. Yeah.
Kara Wada, MD: That's mid-June, I believe.
Akil Palanisamy, MD: Yes, exactly. That looks to be a great event.
Kara Wada, MD: Yeah. Oh, great. Thank you so much Dr. Akil. I hope you have a fantastic rest of your week, and we'll definitely be talking again soon.
Akil Palanisamy, MD: Thank you. My pleasure.
Kara Wada, MD: Hey, everyone. I am going to ask you once again to go into Apple podcasts and submit a review of the podcast for me.
But first I'm going to share a review from Dr Lex RX.
"Dr Wada's unique perspective is amazing considering she's both an auto-immune patient and physician. Her experience, expertise and insight make this podcast so valuable. Keep them coming."
One other from Amanda Katherine.
"Wow. So informative. Thank you for bringing more attention to autoimmune diseases. Each podcast is so informative and well thought out. Very impressed with all that you do."
Thank you so much, Dr Lex Rx and Amanda Katherine. I really appreciate the feedback and the review.
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