Intrigued by the stark contrast between Eastern and Western medical traditions, Dr. Harry McIlroy decided to pursue both and incorporate the fullness of his educational background into his career as an M.D. and a certified functional medicine practitioner.
Dr. McIlroy has expertise in osteopathy, meditation, and yoga, and treats his patients by incorporating natural medicine, acupuncture, Chinese herbal medicine, medical cannabis and other health optimization modalities. We discuss the extensive validity and versatility of marijuana as a powerful medicine, from symptom control to treatment protocol.
With his passion for underserved patient populations, and community outreach, Dr. McIlroy devotes much of his time to caring for these groups in the Bay Area. Dr. McIlroy shares his knowledge and perspective on the long repressed movement to adopt psychedelics as primary movers in trauma healing, cognitive up-regulation, and as tools for evolving consciousness. Concerned with the narrow reductionist paradigm of modern Western medicine, Dr. McIlroy reaches far and wide for his knowledge base to offer a systems wide approach to health and healing, embracing even the stigmatized paths. He has invoked such a unique spectrum of tools in his practice from ketamine to osteopathic adjustments, that the combinations of ideologies and treatments he uses are nearly unheard of.
In This Episode We Discussed:
2:15 Curiosity and travel experience shape Dr. McIlroy’s unique academic path.
6:06 Phonic induction using powerful subwoofers, priming patients for therapy.
9:14 Life, the body, and diagnostics from the perspective of Eastern medicine.
14:45 Chemical components and clinical applications of cannabis.
16:42 THC and CBD products: Dosing and modes of consumption.
25:54 Cannabis dosing based on age and medical condition.
31:57 The importance of testing the purity of your herbal remedies.
40:20 The progress and potential in psychedelics and MDMA.
47:03 Microdosing psilocybin may positively affect mood and cognitive function.
49:38 Quieting the default mode network in the brain, quieting the ego.
51:24 The luminal space between stimulus and response.
53:28 Psychedelics, the God Molecule, set & setting, and integration.
1:01:31 Ketamine therapy.
1:13:33 Foundational health, healing pathology, and up-leveling health.
1:16:03 Taoism in Chinese medicine, whole body-mind environmental approach.
1:15:50 Full systems approach to health and wellness.
1:21:44 Western modern medicine is stuck on form and reduction instead of function.
Related & Recommended Links:
Dr. Harry McIlroy’s Website
Complete Episode Transcript:
Dr. Heather S.:Hi there and welcome to the Collective Insights podcast. I'm your host today, Dr. Heather Sandison. I'm a naturopathic doctor and on the medical advisory board here at Neurohacker Collective, and I'm also the medical director of my clinic, North County Natural Medicine. Today I am absolutely delighted to have Harry McIlroy, a medical doctor who completed a master's degree in traditional Chinese medicine, and is also a functional medicine certified practitioner, with extensive training in osteopathy, yoga, and meditation, on the show today.
Dr. Heather S.:So, Dr. McIlroy has additional expertise in the clinical use of medical cannabis, as well as health optimization, and he definitely integrates his deep knowledge of both Eastern and Western medicine to serve every patient's health and vitality. One of the reasons I'm so excited to have Harry here today is that his background is so unique. I've never met anyone who has the expertise and the combination of things that he does.
Dr. Heather S.:The conventional medicine doctorate, then the IFM, the functional medicine certificate, the Chinese medicine master's, so does acupuncture day-to-day, then this interesting cannabis research, and also into psychedelics. So, he's also currently working on a psychedelic certificate program, so we're going to go through all of those things today, so buckle your seat belts, get ready for this ride. We're going to cover a lot. Harry, thank you so much for being with us.
Harry McIlroy:Oh, Heather. Thank you so much. This is exciting. I really appreciate the opportunity and looking forward to our conversation.
Dr. Heather S.:Would you just start with it sounds like you're a lifelong student. Where have you gotten all this education?
Harry McIlroy:Yeah, that is a good point. I think that curiosity has certainly been a driving force. I grew up around basically thick as thieves with Western doctors. My dad was a physician, both my grandfathers, and I think growing up, seeing people that are engaged and enjoy what they're doing, I think that was a natural gravitation to pursue that.
Harry McIlroy:I got to college and I think my second quarter at UC Santa Cruz in the library, I got stuck at anthropology and agriculture, and pivoted. Ended up spending most of the next four years really working with [inaudible 00:02:51] garden project, doing a lot of community outreach and really being more grounded I think, in the Earth, and studying different cultures. I got out of school and traveled for a couple of years, I spent three months down in the Amazon with the Curandero, learning from them and spent some time in Asia.
Harry McIlroy:Both of those experiences, when I was starting to get the itch to go back to school, I was much more gravitating towards a natural healing system and traditional Chinese medicine was something that I think intrigued me from the standpoint it was so different. The way that they see the body and the way that that whole system and the evolution of the medicine was so different and stark from Western medicine, that I hopped in a little bit. But it [inaudible 00:03:39], I hadn't had some remarkable healing journey with Chinese medicine which half my classmates, that's how they got there, but I was intrigued.
Harry McIlroy:To this day, it's still one of the best academic choices I've ever made. I really enjoyed that process of education. I got done, I finished in New York, I went to the Pacific College of Oriental Medicine actually down in San Diego, and then transferred for that, finishing my clinical in New York. Enjoyed it out there, started working for a while and then got the bug to keep on studying, and that's when I moved to Arizona and did a postdoc and applied to and got into the University of Arizona where Andrew Weil was doing, just starting his integrative fellowship.
Harry McIlroy:That's how I landed there. I thought I was going to do more integrated medicine in medical school, but that was not the case. It was a very prescribed curriculum, I had some nice dinners, but for the most part, got through that education and then finished or started and finished a residency in family medicine in the East Bay, about 20 or 30 minutes East of Oakland. And then kept going. I had met Jeff Bland, one of the founders of functional medicine, while I was in med school and saw him talk, but really didn't have an application or the time at that point, so finally getting done with residency, I really turned to really taking a deeper dive into functional medicine and going through the IFM certification process.
Harry McIlroy:Now, I mix my time between a couple different things. I continue to do two weeks of urban underserved care in the East Bay which I really like. I have an acupuncture clinic there, do a lot of groups with diabetes, and really appreciate working with that population. I then come across the Bay, and I have a very different practice in downtown San Francisco where I work a lot more with health optimization, a fair amount of cannabis consultations. I'm doing acupuncture in that clinic, I've got subwoofers on one of my tables. We just do different things and meeting the patients essentially with where they're at, have a mix between those two practices and then do some online consultations.
Dr. Heather S.:So are the subwoofers part of your treatment?
Harry McIlroy:They kind of are. It's this thing called the so-sound system that I found outside of Boulder. I think they're called heart sounds, yeah. You put them on the bottom and it puts a vibration into the table, almost it reminds of that movie Contact with Jodie, is it Jodie Fisher?
Dr. Heather S.:Foster, yeah.
Harry McIlroy:Foster, sorry. Jodie Foster, where you have this, there is a resonance that it creates. The story is that the creator was a musician and I'm not a musician, but he went into the woods and meditated and said that the sound of the universe is B flat minor. He came back and created this system so that when you lie on the table, it's almost like a phonic induction where you get on the table.
Harry McIlroy:Often times we'll just have people get on for 15 minutes before they're even ready to come in, and it really starts the treatment.
Dr. Heather S.:Wow. This would be like before an acupuncture treatment or any treatment?
Harry McIlroy:Absolutely. Mostly acupuncture. I mean, I think that could be beneficial before bodywork. Or osteopathic stuff, but yeah.
Dr. Heather S.:Is this on the continuum of the bowls, this healing sound bowl kind of a thing, or different?
Harry McIlroy:I think so. I would say the healing sound and the sound baths is while you are really receiving that, I think in your physical body, a lot of that's auditory. Whereas, this is absolutely you're feeling it.
Dr. Heather S.:In a vibratory sense?
Dr. Heather S.:Ah, interesting.
Harry McIlroy:Come up through the table, and you can put on different music but they actually have a specific, this guy made a specific CD and it creates better resonance in the table.
Dr. Heather S.:Interesting. Is there an understanding of the mechanisms of how that affects cells, or?
Harry McIlroy:I don't know. I mean, I think that it definitely brings a sense of peace to the patient, right? Lying on the table. There is a rich history of sound therapy in Ayurveda and a lot of the Indian traditions. I think it's more auditory, unless you're like holding the vibration, right? I do think that this is causing subtle vibration to go through the table.
Harry McIlroy:I mean, there is, that's helping to shift things within your body. It's very easy to integrate. It's not a real hard sell for folks, it's just like a different [crosstalk 00:08:24]-
Dr. Heather S.:It sounds like almost zero risk, right?
Dr. Heather S.:Probably relatively inexpensive. Very little risk. If it helps, fantastic, and it sounds like you get to lie down on a massage table. Who wouldn't say yes to that, right?
Harry McIlroy:With a little bit of heat, a little bit of heat and sound. I had a good friend I went to acupuncture school with is in Boulder and I went out to visit him. He had one, he's like, "I'm getting a second one because people are fighting over what treatment room they get to go to."
Dr. Heather S.:That's great.
Harry McIlroy:So I got it, and just have the one, but it's been a lot of fun.
Dr. Heather S.:That was a bit of tangent into something I didn't even realize that you have some experience with. Let's start with, we'll follow your path. You started with a traditional Chinese medicine and now I have half of a master's degree in acupuncture and oriental medicine, so a little bit of background here. What I remember when I studied it was just how overwhelming, right?
Dr. Heather S.:Chinese medicine is like, it's like Western medicine, right? It's like there's orthopedics and gastroenterology, and gerontology, and I mean, it's just this wide, wide world of lots and lots of different modalities and approaches and there's so much meat on that bone to chew on here. What inspires you about Chinese medicine? You mentioned the cosmology and the approach that it takes to the systems of the body.
Harry McIlroy:Yeah, and I think that really is, at least from a beginning standpoint, is just really looking at how Chinese medicine views the human body, in relationship to the environment, which is something that I've never heard that sentence brought up in Western medical school, right? It's not really looking at it from the same way, and it's also something that really is deeply rooted in history.
Harry McIlroy:I mean, one of the seminal texts, the original texts of Chinese medicine was called the yellow emperor's classic, and it's basically a conversation between Huang Di, who was the yellow emperor, and then Qibo, who was one of his magistrates or something. They would just have this conversation back and forth, sometime, I think reportedly 2 or 300 BC, but it really was a question about how to live a life, right?
Harry McIlroy:It wasn't necessarily, " If this, then that." It was this idea that we are beings, living between heaven and Earth, right? Between the yang of heaven and the yin of Earth, and all of the interplay that comes with that, and we need to pay attention to the seasons. We need to pay attention to the types of foods, the season, when we're putting these foods into our body, and through that, and really taking very much a Daoist perspective. This was not traditional Chinese medicine.
Harry McIlroy:Taking these perspectives and these learnings, really allowing that individual to exist in a state of harmony, right? That really was the goal of I think Chinese medicine in general, and when we started to have either external pathogens or internal derangements, then that's where you come in, you take the pulse diagnosis, you look at the tongue, you're talking about the diet and nutrition, and then make subtle adjustments based on that, and then often doing the acupuncture and then herbal medicine, depending on what the malady is.
Harry McIlroy:But that idea of having I think just cosmology in general, I mean talking about the wind and water and fire, I mean this is something that I think for most of us, and I grew up studying science in Southern Indiana with a very ... I mean, it was a stretch I think for me, and I think for a lot of my classmates to really open our mind to really look at the world in a very different way than we grew up in, right? I think that that was ...
Dr. Heather S.:Are you applying all of these tools? You mentioned pulse diagnosis and tongue diagnosis and herbs and the needles. Are you applying that day-to-day in your practice and how do you meld that, how do you combine that with the functional medicine?
Harry McIlroy:Sure. I mean, the short answer is no, not all of them all of the time. I mean, a lot of what i do with the acupuncture is really more based around musculoskeletal pain. In my experience, the tongue coating is not as important, right? Especially if it was from a traumatic injury. The pulse diagnosis too, those are more for internal assessments and then we'll drive your herbal formulations I think a little bit more.
Harry McIlroy:I do do the pulse, especially if someone's coming in and I think there's any sort of weakness or underlying heat. I'll absolutely do that, and then apply the acupuncture through a variety of systems. I mean, sometimes it'll mostly be auricular, right? Where I'll just be putting needles in the ear, especially if there's any addiction issues that we're dealing with.
Harry McIlroy:Otherwise, needles all over the body, and then often times, I do a fair amount of manual stuff with my hands, whether that be tui na, which is Chinese medical massage, or I have a fair amount of extra training in traditional osteopathy. Working on the hip primarily.
Dr. Heather S.:Is this a cranial sacral approach or different?
Harry McIlroy:Yeah, it was through the Cranial Academy. I spent a month with Stefan Hagopian who's a pretty well known osteopath up in Santa Monica. Very traditional. You're putting your hands on the sutures and very slowly and precisely, moving them around. I've just found that to be one of, especially for patients with anxiety, one of-
Dr. Heather S.:And sutures are these articulations or the connections between the cranial bone?
Harry McIlroy:The cranial sutures, yeah. It's just one of those things where I think acupuncture works beautifully. It can really help, certainly relieve pain, but also it's a wonderful anxiolytic. But I've also just found, I've had numerous patients say, "Oh wow, I loved that last 10 minutes of your acupuncture. That really took me out" and that's almost always doing cranial work.
Dr. Heather S.:Wow.
Harry McIlroy:The needles are out, and it really is that much more sedating and opening I think. Again, depending on the patient.
Dr. Heather S.:Yeah. What an incredible tool belt that you have. Tell me about your interest in cannabis and where that started, and how you're applying that in practice.
Harry McIlroy:Sure. Interestingly enough, I mean the Chinese Materia Medica that most of us are picking up and learning in school are a couple of thousand years old, right? Revamped, but nonetheless, they're that old. Hemp and cannabis is in the old texts, right? It was used variably, there's evidence that they were using the roots, there's evidence that they were using it as teas. Sometimes for poultices.
Harry McIlroy:The issue with this is that cannabis and the potency of that cannabis 2000 years ago, while it might be the same species, is radically different than what we're able to deal with today. I think California really being ground zero in the US, you had the Compassionate Use Act that passed in 1996, quite honestly that was ... I was doing this quite then, but I have friends that were. That really around the [inaudible 00:15:53] of symptoms where patients had had HIV/AIDS and certainly people that had cancer, so that was helping with nausea, maybe helping with weight gain.
Harry McIlroy:That's how it proceeded for a while, until the early 2000s when a couple of strains from Northern California that had higher CBD instead of THC, had higher CBD, which is more of the anxiolytic, antiinflammatory cannabinoid, they started checking this out and they're like, "Oh, this does other things," right? This helps with the immune system and also helps people relax. I think that, Heather, really opened us up to like, "Well, what else is in there?" They have now really fleshed this out and they're probably well over 100 endocannabinoids in the plant, right? Endocannabinoids. I think with this, we're continuing to do more research, THC and CBD by far still being the major drivers, but now THCA which is the uncarved boxylated, decarboxylated THC which doesn't have the psycho activity, but has a lot of really good early date on helping with inflammation, and especially around the GI tract.
Harry McIlroy:I know some folks that are working with Crohn's, that are trying to formulate something that delivers just THCA to the GI tract. Then also looking at THC and certain types of breast cancer. We've got great researchers that are showing, in petri dishes and then extrapolating that to animals, and then we've got a lot of anecdotal data with female patients, but that showing that when you introduce the THC to certain cancer cell lines, they cause apoptosis, right?
Harry McIlroy:Moving from a place of, "Oh, this is helping with symptoms" to, "Wow, this is actually, we're working on treating."
Dr. Heather S.:We've had another guest on this show who has a specific focus on cannabis research and then clinical applications, similar to you, and one of the things that I brought up to him was as a provider, I get overwhelmed by how many indications there are for this. Like, the THC, CBD, plus there's these phytocannabinoids, plus you can vape it, you can smoke it, you can suck on a lozenge, you can put it on topically. Where do you start? If somebody comes into you with a certain complaint and you're thinking, "Okay, maybe some CBD/THC, some cannabis product is going to be helpful for you," how do you even start to ... I mean, it's like Chinese medicine, right? It's just this huge door that opens.
Harry McIlroy:No, absolutely, but I do have some shortcuts. First and foremost, depending on ... I do a fair amount with cancer. The reason for that is that there are many types of malignancies that have shown again, in the lab, and in animals, that they respond both to THC and CBD. Especially some of the lines that have this ID1 gene which is more related to HPB and colon cancer also expresses it. Then that will be more CBD predominate, right?
Harry McIlroy:Then, there's some lines that are more THC predominate, like a glioblastoma, typically it's more THC. But all in all, most of them respond to both THC and CBD. These are the ones that are being tested more, right? I mean, you alluded to all the other cannabinoids that are coming online and we need more research and study. THCA is certainly one of the ones that's coming on, but once you get this understanding of what you're treating, then it really becomes a, "Okay, are we going to do a one to one ratio?" Typically, right? Starting with that.
Dr. Heather S.:One to one ratio of CBD to THC?
Harry McIlroy:Yeah. In most medical literature they lead with THC first and CBD, so that's how I'll talk about it. There are companies like Care By Design that are 100% with the CBD first, but most of the literature is THC and nobody's completely agreed on how they're going to talk about it.
Harry McIlroy:Yeah, one part THC and one part CBD, and then the next question is, it's really, "Well, what's the dosage going to be?" This is something that I'm sure in three or four years will change a little bit, and if anything, in the last five years those initial target doses have come down. There was something called the Rick Simpson oil that got a lot of popularity in the early 2000s, and I think he brought a lot of attention to it.
Harry McIlroy:I think the downside of the Rick Simpson oil, it's one size fits all and essentially like a gram a day, which is expensive and also very, very hard to tolerate. It was typically THC, like-
Dr. Heather S.:Yeah, can you talk about the tolerance? Is this like, a cancer patient's basically getting high?
Harry McIlroy:Yeah. Let me put it this way. If I'm working with a patient with insomnia, and I'm very conservative with this, in my sense that I'm pretty sure I'm going to be able to help them, but it might take a week. Part of the reason that I set that up with them is that I want this to be a good predictable experience. Because I have so many patients that somebody gave them something, they had a horrible time, they couldn't get out of bed, and then they didn't want to talk about it for six months when in fact, cannabis ends up being a really great treatment strategy for them.
Harry McIlroy:I think that's the first place to start is this idea that we're going to have the THC, CBD, and at what dose? For the sleep, I'll start at five milligrams. Like, 30-60 minutes before bedtime, usually 95% of the people, it's a THC dominant. I prefer sublingual because of the way that you're able to get some [inaudible 00:21:47] absorption and then it gets processed through the liver. It's got a longer duration of action, right? It's not so up and down like the vaping.
Harry McIlroy:I start with that and then you gradually go up until that person finds their sweet spot, and that person, maybe five milligrams is it, but maybe it's going to take them three or four days to get to 15. But I like this, and this is the herbal medication part of it, is that there's a lot of agency with the patient. They can really play with that. This is not ambient.
Dr. Heather S.:Right, they can really dial in their dose. They don't need a pharmacist, or they don't have to have a pill cutter.
Harry McIlroy:No, absolutely. It's even more precise than even if you had a pill cutter, because one of the things and I see this a lot with insomnia, and insomnia's by far one of the low hanging fruits for cannabis medicine, 'cause it works so well, and then if you start talking about people in their 70s and 80s, not only did it work well, it's also much safer than our alternatives.
Harry McIlroy:But you start people, I mean I had an 89 year old woman, I started her at a half a milligram, and then she went up by about a half a milligram or a milligram per day, and she finally after a week, got to like eight milligrams and was sleeping better than she had in years. I'm also very comfortable in the fact that she knows what that is. I'm not worried about her doubling it, because this is part of our conversation, and so 'cause a huge part of that for me is safety.
Harry McIlroy:Cannabis is safe, if you take too much you're going to metabolize it out, but if you're in your late 80s and you're taking it for sleep, and you wake up in the middle of the night, I would hate for someone to fall going to the bathroom.
Dr. Heather S.:Yeah, break a hip on the way to the bathroom, right, exactly.
Harry McIlroy:Yeah. It's really starting with that initial ratio and then it really is around the dose. What's driving the dosing, I alluded to initially it was like a gram a day for 60 days, everything's going to get better. As you know, nothing really works like that in medicine.
Dr. Heather S.:This was the Rick Simpson protocol that you're referring to, the gram a day for 60 days.
Harry McIlroy:Yeah. 100% not criticizing him. I think he brought a lot of attention to treatment rather than to just amelioration of symptoms, but as with what happens on the internet, it just has exploded, and I don't know any people, like there's a society of cannabis clinicians that I belong to, and we get together for quarterly meetings. I don't know anybody doing a gram a day, right? I mean, they're not seeing the efficacy, and in fact, when you super saturate the system with one ingredient, there's also receptor down regulations. I've even seeing people who are doing a gram a day and not happy with it because they can't get out of bed, or this, that, and the other. And then also maybe not helping their pain as much, or some of the other indicators they're not as happy with. Well then we start, we'll typically almost cut that in half right away. They'll perk up a little bit more and have a better sense and sensation.
Dr. Heather S.:It sounds like there's some diminishing returns. If you can dial in that dose, you can absolutely save money, reduce-
Harry McIlroy:Which is huge, too.
Dr. Heather S.:... the side effects. It makes it more sustainable.
Harry McIlroy:Yeah. Because I mean, 500 milligrams a day is a lot of money, right?
Dr. Heather S.:Right, yeah.
Harry McIlroy:I mean, [crosstalk 00:25:01]-
Dr. Heather S.:Whether we're talking about Chinese herbs or hormone replacement, [inaudible 00:25:05] hormone replacement, whatever it is that we're talking about, [inaudible 00:25:10], right? If we can reduce that dose so that you have less to swallow, less to consume, less to pay for, but still get the maximum benefit, that's the goal, right?
Harry McIlroy:Well, and I think this is the beauty we'll get to in a little bit, the beauty of formulation. Whether it be Chinese herbs, not having them be single herbs, but really getting so much more of the potency and the mojo by putting them together, while able to use smaller doses of each and it's the same thing with Qualia, right? You're able to really be focused and get that synergy for better performance, but also not having to have so many things go down the gullet.
Dr. Heather S.:Right, that synergistic effect of using things together.
Harry McIlroy:Yeah, using that intelligence. That's it, and then really the dosing, what drives the primary place of where we're going to start is typically around age. We know that the younger pediatric patients, especially the ones with epilepsy or other types of seizure syndromes typically need larger doses. This was really brought on by some of the early Charlotte Figi stuff in Colorado, where her daughter was having 3 and 400 seizures a month, and they started using predominately CBD and got it down to, I don't know what it was, but under 10, right?
Harry McIlroy:That was at a specific dose, and if that dose was decreased, then the seizures would come back. We can see that, I think one of the things too, I think sometimes the enzyme system in the pediatric patients is a little bit more primed, so I think it processes the cannabis through the CYP450 enzyme system a little bit more rapidly. As we age, it doesn't process as quickly, right? Especially if we're starting to take more medicines as we age, just the complexity of life, the liver doesn't quite have the oomph that it did when we were younger, and so those doses can be lowered.
Harry McIlroy:I find that to be pretty darn predictable, right? Again, it's a target dose. I mean, there are going to be some people that they're exquisitely sensitive to the CB1 receptor and the psycho activity that it can cause. Some people, we're just not able to get to what that initial target dose with the THC is. There are ways that we work around it. We have them go up slowly, if they get to the point where it's too much, we have them go back to the previously well tolerated dose. Stay there for two or three days to build some tolerance through slow titration, and that typically works. But again, you occasionally have an outlier that it just doesn't. You've got to be [crosstalk 00:27:44]-
Dr. Heather S.:That's why you practice individualized medicine, right?
Dr. Heather S.:For exactly that reason.
Harry McIlroy:Absolutely. I will just say that I don't think I've ever found someone that in the end, we didn't find help for them. I mean, I think that's the amazing thing about it.
Dr. Heather S.:Wow.
Harry McIlroy:But that comes down to having those sublingual doses and really being able to parse out the potency. I think that that's incredibly important. Again, that's why the sublingual is by far the one that I champion the most, just because you've gotten the most agency over controlling the dosing.
Dr. Heather S.:Do you have any thoughts about the new FDA approved medications that are cannabinoid derived?
Harry McIlroy:You mean like the GW pharmaceuticals?
Dr. Heather S.:Yeah, exactly.
Harry McIlroy:The Epidiolex. I think that they went through the whole system, I think that for some patients they're getting I think pretty positive results. It's not as whole plant extract, which I am not sure how that's totally going to parse out. They're really expensive, right? Even more than the cannabis. But I also, Ethan Russo who's a very well known cannabis physician and was one of their first medical advisors or directors and who I've had multiple conversations with. I do think there's some good stuff coming out of it. I just don't know that it's going to be better than whole plant, lab tested cannabis.
Dr. Heather S.:Got it. And this comes back to some of that philosophy from Chinese medicine about the synergies of the different complex parts versus taking out that one active ingredient.
Harry McIlroy:Yeah, yeah. And they do. They've got two products. One's kind of a one to one, and one's predominantly a CBD, but there's a chemovar in California, and the names are all ridiculous, but called ACDC, and it's typically ... And everything changes, as we know, depending on where and when it's grown, but it's typically about 1% THC and about 18 to 20% CBD. So that's a really good base for a lot of the formulas working with epilepsy, just anything that's high CBD. If you're wanting an anxiolytic, something to help people relax, that's also a really good chemovar and is at the base of the majority of the big products in California.
Dr. Heather S.:Chemovar, I'm not familiar with that term.
Harry McIlroy:It's like a strain.
Dr. Heather S.:Oh, okay.
Harry McIlroy:It's essentially like a strain. It's just like-
Dr. Heather S.:So this is like if you walk into a dispensary and you said ACDC ... So this is like unicorn poop and what they have all these ridiculous names. Okay.
Harry McIlroy:Yeah. Oh, my God. People are working on changing it because it needs to be done. The other issue with that is that sort of alluding to where it's grown and when it's grown makes a difference, but if we're going to kinda really sort of bring dosing up to as close as we can to like a pharmaceutical or a very advanced herbal place, we need to be able to be consistent with what we're talking about. And that's the thing. It's like if you are growing ACDC indoor in January versus outdoor in northern California with a certain soil, the terroir or something of the soil, it can be different enough that you want to know that. Maybe only by two or three percent, but there certainly can be these differences.
Harry McIlroy:And so I think it really brings back this point of this is herbal medicine and there is a place between completely turning it into an isolate, which is not really what GW's doing, but one of the things that's happening is they're extracting CBD and turning it into little crystals because then it's shelf stable, very easy to ship around. From a financial standpoint, I think a lot of the venture money coming in is excited about that. I'll tell you that when they do the studies with that, a hundred percent it doesn't seem to do as well, which I'm super happy about as the whole plant extract. There really is that mojo. It's the same with like bee pollen. You cannot in these complex systems ... You cannot completely reduce the parts and have them be equivocal.
Dr. Heather S.:To the whole, yeah. So there's another thing that comes up with herbal medicine, whether we're talking about cannabis or we're talking about Chinese herbs, is going back to the Hippocratic Oath, "First do no harm," and if there are pesticides and herbicides sprayed on these things, if there're heavy metals in the soil, high levels of heavy metals, like arsenic and it's grown in that type of soil, or if there's contamination or it's potentially coming from China, so things aren't as well regulated or even here in the U.S., a lot of these herbs are not well regulated, do you have any advice for patients that you see about how to make sure that they're getting good high quality products that aren't going to have contaminants?
Harry McIlroy:Absolutely. And I think that's a big issue for acupuncturists, depending also on where they live because there were ... I live in San Francisco, and there were two people admitted to the ICU at one of the hospitals here last year because they got some bad aconite at one of the Chinatown herb stores. There's a long history of adulteration. I love Chinese herbs, but there's a long history of adulteration. They used to shoot lead into the body of the cordyceps to make ... I mean this has happened. This is not lore ... To make it weigh more because it was such an expensive herbal. And this is known.
Harry McIlroy:And all the dyes, and I've had patients in clinic come in. I have a fair number of Asian patients in county, and they'll come in. They're like, "Oh, gosh. My left knee is so much better. The acupuncture helped a little bit, but what really help are these Chinese pills I got at the Chinatown in Sacramento." And I say, "Well, will you bring those in for me?" And they will, and it's actually a pretty good blood moving formula, and then it's got dexamethasone in it.
Dr. Heather S.:So you got a steroid.
Dr. Heather S.:You're basically taking steroids-
Harry McIlroy:And so, "I bet you feel better." So it is very much from a professional standpoint, that's something you have to be cautious of. Now that said, there are a good hand full of herb companies in the Bay Area and down into L.A. that triple test everything, third party testing, and those are the companies I use. So Mayway up in Oakland is a really good company. And a lot of them are organic, but they test that, and so then you can have a lot more confidence.
Harry McIlroy:I would say the other thing ... We all learned how to make raw herb formulas in acupuncture school, and we burn them all the time, and our patients burn them all the time. And I think it's much more common to have different tinctures that we combine. So we'll make the formula-
Dr. Heather S.:When you say burn them ... I'm sorry ... Like incense or like [moxa 00:34:40]?
Harry McIlroy:Because you're cooking them down for 55 minutes.
Dr. Heather S.:Oh, like boiling. In water? Okay.
Harry McIlroy:Just saying the concoction of the tea takes attention, and I think that a lot of patients didn't want to do that, right?
Dr. Heather S.:Right. It takes a ton of time and effort.
Harry McIlroy:It takes a ton of time. And if you're really sick and have some congestion, and it's more of an upper respiratory type presentation, and you really love playing with herbs and cooking, then absolutely, and I still do that sometimes, but if you're more of a like, "I want you to take this three times a day," and you work downtown and this and the other, it's either, "Here are your three bags of herbs. Try to find a place to cook it down or cook it down at night and warm it up," or "Here are your three two ounce tincture bottles and do two droppers of each." Right? It's just-
Dr. Heather S.:More accessible.
Harry McIlroy:It's accessible. And I think the efficacy is still there. I think they're still real high quality products, and so I think that, that's a great way to do it, and so those things have definitely changed, but really making sure that, again, I'm sort of saying four to five. Essentially, that's it. There aren't that many ... And certainly the-
Dr. Heather S.:Companies.
Harry McIlroy:No, no. There aren't that many. Sun Ten, Spring Wind, but they're out there, and the acupuncturists ... If you're an acupuncturist in the Bay area, you know who they are, and it's unfortunate that you can't just send people down to Chinatown just 'cause that culturally can be such a fun experience.
Dr. Heather S.:Or on the internet, right?
Harry McIlroy:Yeah. Yeah. I wouldn't do it myself. I mean so-
Dr. Heather S.:And then with cannabis, can you send someone out to a dispensary? 'Cause my understanding is that ... Okay, you can give someone a recommendation. That's not a prescription because there's no federal legalization of marijuana, but you can give someone a recommendation. Now, can you also dispense it? So can you the way you can with Chinese herbs so that you have some control of what patients are getting? Or are you sending them to a dispensary where you don't really know?
Harry McIlroy:So this again, comes back to the complexity it is too, and especially it being a schedule one substance, hopefully not for too much longer, but still is. And this is also changed, Heather, since January when Prop 64 went through, and you don't need a recommendation at all anymore. You need to be over the age of 21 with a government issued ID. That's it. There are some reasons for people that are using lots of medical cannabis, typically for cancer where it makes sense for them to spend the other hundred dollars to get registered and to get a specific ID, but not many people are doing that. So the medical recommendations, I think has gone done quite a bit just because there isn't the need.
Harry McIlroy:But you bring up a good point. It's I think somewhat analogous to where you get your organic food. There are some places that aren't going to have it or the quality's not going to be as good, and then over here, you've got this great farmer's market, and you know and reliably go to every week. So kind of what that looks like is essentially I will go through these consults or a 50 minute to an hour consult going through everything, their medical record, their history, certainly their medications. Some medications don't play so well with larger doses of cannabis and the enzyme system in the liver. And then going through based on what their presentation or pathology is, starting low, going slow, but really building up to a treatment plan. Typically, most of the time, it's having a bottle of THC rich infused oil and a bottle of CBD rich infused oil for almost everybody. And then starting that titration protocol.
Harry McIlroy:The oils, you want to make sure that they've all been lab tested. And really double tested. You want to make sure that the flowers have been tested before they started making, and then once they make the product ... There's heat involved. There's olive oil, or MCT, or coconut oil, but things can get adulterated, and so when they've made that final product, you also want that to be tested, as well for fungicide, pesticide, mold, all this stuff.
Harry McIlroy:And then the second part about that is when you get it tested, and this is, I find, fairly remarkable, even with some of the brands that are very medically forward. You get that bottle, and it'll say, "600 milligrams in this bottle." There is no gradation on the dropper. You really have to kinda do some math. Whereas other companies, you buy it, and it says, "40.3 milligrams per mL of THC," and then they've got hash marks at ever quarter mL on the dropper, and you're like, "Oh, I can have agency over this. I know exactly what five milligrams is." And so, while that's not imperative, I certainly recommend those companies more than others.
Harry McIlroy:I think being a physician, I don't say, "Oh, go get this from Pfizer or go get this from Lilly," as far as recommending certain drug companies. The flip side of that as we alluded to with the potential dangers of Chinese herbs, I also feel some responsibility of not just saying, "Hey, good luck." There are three or four really solid brands in the Bay area that I will mention and sort of leave it at that. And if someone says, "Oh, we already found this," and it's one of the really good ones, then I'll say, "I don't think you need to go any further, but again, I don't work for any dispensaries," and it's really about the consult.
Dr. Heather S.:Got it. So then, you also have this other sort of controversial, very exciting piece that you are diving into with the psychedelics. So how did you end up going in that direction?
Harry McIlroy:This is coming back to Santa Cruz for college. When I was a sophomore, there was actually a big psychedelic conference at Harvard. Not a Harvard. Sorry, at Stanford, and I went to it, and Alexander Shulgin, who died a couple of years ago, but probably synthesized more psychedelic medicines than anybody in history, was there. Rick Doblin, who was the founder of MAPS. This was fresh. I think he had started MAPS a couple of years ago, and a lot of the other luminaries. Timothy Leary was there. I don't remember if Ron [Goss 00:41:10] was, but just it was this great conference, very much alluding to all the wonderful psychedelic research that had been done in the fifties and sixties. Then it was like 1992, and what are you going to do, and that was sort of it.
Harry McIlroy:And Andrew Weil has been a longterm friend and mentor to me, and this was a big part of what he did after finishing his internship here and going down and spending time in the Amazon. So this had been something that had been part of my, I think, life for a long time, and then going to acupuncture school and coming back to the hemp and the cannabis.
Harry McIlroy:I think when CIS, the California Institute of Integral Studies started this initial cohort ... This is this third year ... Three years ago, it was really around taking the luminaries that had been doing this the longest, and they're actually doing the research and bringing them out to California for these long weekends, sometimes week long, and educating clinicians on how we can hopefully start to implement this into clinical practice. And that ranges everything from Bill Richards, who was doing this in the early sixties with psilocybin. He's part of the Roland Griffiths Lab at Hopkins, and Tony Bossis up at NYU. There's a wonderful movie they made called A New Understanding, and it's around psilocybin, and end of life, existential issues with anxiety and death. Great movie.
Harry McIlroy:And then another weekend will be focused on holotropic breath work, which was really instituted by Stanislav Grof who had done more LSD research, I think, than anybody else, but then when it became illegal, they're like, "Well, what can we do at [inaudible 00:43:01]? What can we do with [inaudible 00:43:02] to help sort of get us into that state a little bit more?" And then we also spent six days with Annie and Michael Mithoefer, and they are by far the people that are doing all the MDMA and setup all the protocols with MAPS. There was a great segment on the CBS News last week about a veteran with PTSD and his essentially miraculous recovery by going through process with them.
Harry McIlroy:I think that one of the exciting things about this is, "This is not 1992", and we have MDMA that just went into phase three trial in the last couple weeks at, I think, 13 sites. With the early data, it looks very promising, and most around PTSD. And then the psilocybin phase three, which as a much larger range of what they're going to be able to treat with that or at least, right now, everything from smoking cessation. It was a small cohort, but one year smoking cessation after, I think, one or two psilocybin sessions was 80%. Chantix, which is the pharmaceutical we prescribe that I don't ever prescribe 'cause it doesn't work, but it's like 22%. So I think that a lot of this is really encouraging, and the psilocybin for depression.
Harry McIlroy:So that's a lot of where the interest comes from, and then recognizing by going through these trainings, the MDMA specifically, and this really has a lot to do with the vets. It's working incredibly well with a very challenged population where, I think, the rate of suicide is still about once every 12 minutes, and then forget about mortality entirely and just all the morbidity that these men and women are facing by not coming home and having a life. And so by going through this process, and also very well prescribed and very well controlled, but people are really able to have amazing changes. We spent six days watching these videos. I have never seen anything like it where you basically have someone who is a shell and excited, but not very confident that anything's going to change, and then three months later, their eyes are open and shining, and they've grown their hair out a little bit, and everything's changed. And that's their feedback.
Dr. Heather S.:That's incredible. Yeah, so there's a ton of potential here. Of course, there's all of what happened in the sixties, seventies, eighties that has created this stigma around psychedelics, and then there's this resurgence with the popular press and certainly Michael Pollan's recent book, How to Change your Mind.
Dr. Heather S.:Yeah. And so as a practitioner, as a medical doctor and an acupuncturist who's interested in herbs and the power of plants to help, what do you see the future of this being? In an ideal world in five, ten years when you're treating a patient, what does that look like?
Harry McIlroy:Yeah, I think that specifically with the MDMA, they're most likely going to be able to get schedule one. Those of us that are in this training get schedule one licenses next year, and so as part of expanded access. This might start happening, and I don't think it's that much of a pipe dream, even next year.
Harry McIlroy:I think that then there are some things that are much more standalone. The MDMA works so well that I don't know if I would be jumping into, at least initially, and I think there needs to be caution around some of this too, just so that it rolls out appropriately, play with it as much. Now, on the flip side, doing something like psilocybin and having music and different sorts of sound and maybe having them on the soundboard, on the sound table, and using some aromatherapy, giving people different inputs to sort of enrich that experience, I think is absolutely a way that this can go.
Harry McIlroy:I think another thing too, and this is so common, I'm sure, down there too, but up there is this whole idea of micro-dosing. I think that if we can get to a place of legality with the psilocybin, I think that not only for depression, but I also think for health optimization and cognitive function. Many people are benefiting from doing very low doses, 0.2 to 0.5 grams of psilocybin and having a really positive effect.
Dr. Heather S.:Right. So if we can prove or establish the safety and then not only the use for what you're saying ... It wouldn't only be for the use of helping with some sort of pathology, some diagnosis, like a PTSD or anxiety or whatever it is, but you could also be using this in a healthy population to increase potential.
Harry McIlroy:Absolutely. And in my experience of seeing people using it in that way, it's been a fairly resoundingly positive experience where people are just like ... And Mark [inaudible 00:48:06], Ayelet ... I can't remember her last name. She wrote a book. He's an author though, like I see in the Brand New Day. Ayelet Waldman, she had longterm, severe depression and had gone through electroshock therapy, I believe, like a lot. She started, I think, more out of desperation than anything else micro-dosing, and that's what fixed her depression, and then she wrote a great book that came out a couple years ago. I think it's called, A Really Good Day.
Dr. Heather S.:Okay. So there are these two approaches, and you talked about this a little bit in cannabis, but this dosing idea. So you're talking about both micro-dosing and then there's this other approach that's more like this mystical experience, right? The really high doses probably with a guide, somebody who's going to help you set an intention, and then have this journey or this experience, and then help with integration. And so do you see your role as sort of focusing on one or the other? Or you see a potential for both?
Harry McIlroy:I think a potential for both. If psilocybin was legal, I think that working with a lot of patients around micro-dosing within this realm of optimization and inter-playing it with [qualia 00:49:26] and other products where you're really able to really to tune in and find balance, something that works for that individual patient in a way that's very predictable and safe, I think.
Harry McIlroy:I think when you start talking about these larger doses of psilocybin or a fairly regular dose of MDMA, I think one of the efficacy, and Michael Pollan talks about this a lot, but we have this area in our brain called the default mode network, and it's comprised of four, five different regions in the brain, and we think that this is probably where the majority of our ego is generated. And they've been able to see through fMRI, through functional MRIs, putting people through the tube when their on the psilocybin and MDMA that there's a significant quieting and down-regulation of the default mode network.
Harry McIlroy:And I think one of the things that is happening there is you are able to take a step out of all these things that are happening to you. In your mind, this is, "Why is this happening to me? Why am I having all these struggles?" And it gives you a little bit of distance. It gives you a little bit of room away from your ego, and this is what people often report, and they're just like, "Oh, that was awful, but in there, in this space, I kind of have a choice of how I want to integrate it and how I want to move forward."
Harry McIlroy:And I think that it almost opens up this envelope of time between stimulus and reaction, and so you really are able to give people, and then having followup integration, but this idea of, "I don't have to be afraid in this spot." And I think that, that's talking to a lot of the people that have gone through it, and then watching a lot of the videos, and then understanding more of the science, I think that's where a lot of this is going. And again, it's been successful with the majority of people that are completely psychedelic naïve.
Dr. Heather S.:So you just mention this break, this space between trigger and reaction, triggered response, and how we have a lot of these ingrained patterns. And this is the goal of mindfulness, meditation, I think, neuro-feedbacks, like therapy. There's been a lot of different modalities that have been attempting to give people that, that space between trigger and response, so that we have that decision making, that ability to decide, "Okay, am I going to fly off the handle and yell at this person? Or am I going to take a deep breath and see what the gift in the situation is?" And most of us would like to be the latter, right?
Harry McIlroy:For sure.
Dr. Heather S.:But it takes some training, and it takes some skill. And it almost seems, like with the literature is saying is from a psychedelic perspective is that there's a shortcut that you can rewire the brain. Certainly, if you believe the Michael Pollan book and the ... That's the other thing. There's a ton of great literature and research that was done that says this, is that you can rewire the brain by using these substances.
Dr. Heather S.:And now, you mentioned MDMA and psilocybin a couple times, but there's also LSD. There's also ibogaine. There's also San Pedro and ayahuasca. Do you put all of these in the same category? Do you start breaking them apart? The holotropic breathing?
Harry McIlroy:Right. Right. So I think that they are all coming from a different context, and so sort of to break it down one by one ... The iboga I have not had as much experience. With someone in my cohort this year, left after our June, and flew to Gabon and was hanging out with the Bwiti people and doing iboga, I think, for a couple of weeks and had an exceptional experience. And you can't have access to it closer to where you guys are. They do have clinics down in Tijuana. I have not done it or had experience with that. I think that's typically more around addiction. For whatever reason, that's what I've also heard. It's also a much longer acting. It can last up to 24 hours, and so it's typically done in clinic.
Harry McIlroy:And to segue to LSD, I think that's a lot of the reason that psilocybin who's been chosen over LSD, is a little bit the stigma from the sixties. A lot of people don't know what psilocybin is, but it's also the time duration. If you're gonna have people that are going to be sitting and guiding for six or eight hours on psilocybin, great. Well, LCD's then gonna be 12.
Dr. Heather S.:Got it. So it's just the practicalities and the logistics?
Harry McIlroy:Yeah. I don't think that there's necessarily something inherently better or worse. Some people also-
Dr. Heather S.:5-MEO is another one that comes up, and that's the other end of the spectrum, where isn't it like 90 minutes? I don't have a kind of experience with [inaudible 00:54:09].
Harry McIlroy:Rather like 20 or 30.
Dr. Heather S.:Oh, wow. Oh, even faster.
Harry McIlroy:I think the thing with that ... They call that the God molecule, as well. I think some people have that experience, and it is so fast and overwhelming, I don't think there is this sense of integration, as much as it's just blowing everything apart. And I think some people that essentially that total destruction or you going out into the galaxy gives them a place to assess, as well. I don't know-
Dr. Heather S.:And destruction, you mean destruction of the ego? Or what do you-
Harry McIlroy:Destruction of the ego and like destruction of a lot of your thought structures. And that's the thing with all of this, and this is the same with herbs. There are some many choices now that we have available that maybe some people will use the majority of them, but most people will gravitate towards something that resonates with them more. There are certain things, like chaga which is a herbal product that has DMT in it. Typically has a bit more of a [inaudible 00:55:17] vibe, and it lasts for five or ten minutes, and it's much more soothing. And there're going to be people that that's going to be something that they're more amenable to. Whereas like the 5-MEO, it's not for the faint of heart and don't watch the videos on YouTube first.
Dr. Heather S.:I've heard ayahuasca referred to as the grandmother medicine. San Pedro referred to as the grandfather medicine. So there are these archetypes maybe.
Harry McIlroy:Yeah. And I just a saw Peruvian [inaudible 00:55:46] speak last week in Berkeley, and she was ... This also comes to the mixing too. She was from Peru, and someone said, "Oh, what do you think about psilocybin?" And she's like, "I don't think much about psilocybin. Someone gave me some from southern Mexico one time. I was like it's not my thing. That's not where I'm from." And so really coming back to the traditionalism of it's not just mixing things from all over the place, like the pharmahuasca and the psilohuasca where they're mixing Western pharmaceuticals with ayahuasca, and psilocybin with ayahuasca. They're doing that in Holland.
Harry McIlroy:And so you talk to someone traditionally, and this almost comes back to the Chinese medicine. It's just like this really needs to be in the context of home. She wants the [abuelitas 00:56:35] in southern Mexico to do what they are doing with psilocybin, but recognizing that you don't necessarily need to be dabbling in all these different places.
Dr. Heather S.:Might not necessarily mean a more is better kind of thing, and there's some wisdom in the tradition perhaps?
Harry McIlroy:Absolutely. And I think there's conversely some danger in combining some of these things too, especially if not done in the set and setting. And the set and setting concept has been around forever. Timothy Leary was actually one of the ones to first coin it, but-
Dr. Heather S.:Would you go into that? Would you describe what set and setting means?
Harry McIlroy:Yeah, just the idea of the set is what your mindset is, like, "Are you ready for this? Is this something that you're engaged in and present with?" And then the setting is the, "Where are you doing it?" And so-
Dr. Heather S.:So is it like, in the woods, at the beach, or in a medical facility with bright fluorescent lights?
Harry McIlroy:Yeah. Right, but those would be different places, and I think that the one most of us would say, "Oh, what a great set and setting," is being at the beach or being in the redwoods. What I will say, and I think where the outcomes which have just been so positive universally through the psilocybin, MDMA studies is that they are in medical rooms, that they dress up. They soften them, and it's a nice couch, and they've got a bathroom there, but I think a lot of it is there's music that's consistent and I think that provides a greater container. It's another trigger to sort of keep you in a safe place and then I think also having two guys there that are essentially there if you need them. But it's very reproducible. And so as much as I think doing these things, like I said, out in the woods or in the mountains, can be great. You're not really, from a pathology standpoint of really wanting to focus in on something and really dig in and really be able to come back to that same place as quickly as possible the next time. I think having fewer variables, having to be a very contained certain setting with your variables seems to be fairly reproducibly a much better paradigm.
Dr. Heather S.:So I want to go back to a word you said. It was destruction. And I think that that, even just as I think about this personally, so we're talking about kinds of psychedelic and these journeys you can go on and there's different ways you can do it. But there's this destruction that's happening. Is that just my ego attached to the way I'm used to doing things? Or the way my brain is used to working? Is this this opportunity to build something new from the chaos of the destruction. What's going on there? I have fear come up. How do you grapple with that with patients?
Harry McIlroy:So I am very specifically talking about 5-MeO.
Dr. Heather S.:Oh, okay.
Harry McIlroy:So that's how it's been described, not at all with Psilocybin and MDMA, 100%. So that was very much just about how abrupt and like young and like explosive the 5-MeO experience can be. It's variable person to person. Some people ar kind of lying there just saying love, love, love, and then other people are convulsing, right?
Dr. Heather S.:But very high intensity it sounds like.
Harry McIlroy:Unbelievably so. And that's really, that's the Bufo Alvarius, that's the 5-MeO DMT. And that's why I was saying ... And Michael Tollin sort of alluded to that as well. For him it was too fast. But then there are other people, his last name is Orac. He wrote the "Tryptamine Palace" and is a paraglider, like competitive paraglider. He's aggressive, right? James Orac I think. And he loves it. It's his molecule, right? And it's the same thing. I've met people who have done just about everything and then they did Iboga and they're like, this is it.
Dr. Heather S.:Interesting. All right. So it's not a one size fits all kind of a thing.
Dr. Heather S.:It can be a little bit overwhelming, maybe a little tempting to mix them, do too much. There are options depending on your archetype or your bio.
Harry McIlroy:Absolutely. And ways to work with it too. I mean, the Changa per se, I have a good friend who's a medical doctor in Mexico City and she works with Changa with patients, mostly physicians, and the Changa lasts for five or six minutes. It's fairly short acting. And so they'll go through two or three Changa sessions in an hour and have integration within that. So it's just, I think there are a lot of, what's sort of happening with all this mushrooming of experience and ideas-
Dr. Heather S.:Pun intended, I hope.
Harry McIlroy:Yeah, exactly. Is the application in how you're going to do it. And so I just started doing, I do a fair amount with ketamine in my practice downtown and it's had really good success with it. And one of the things that I started doing on one of the patients that I've been working with for longer and that I know pretty well is like I'm starting to do optic haptic adjustments while the Ketamine's on and it's been universally a very positive thing because one of the experiences that people often have with Ketamine is the sense of like an eerily floating and like a lightness and then if your finial features are being adjusted and expanding even more, it really helps to amplify that sensation.
Dr. Heather S.:You keep blowing my mind with the different modalities that you're combining. It is so unique. I cannot think of one other provider who has the tool belt that you do. So this Ketamine plus osteopathic manipulations. I've never considered it. Tell me a little bit more about the Ketamine's. You put that in the basket with the other psychedelics or is this very different? How does it work? How's it-
Harry McIlroy:No. And I've really been excited about its use case. I mean, A it's legal, right? So we can do this now. And I think it's also the efficacy has shown not to the degree that the MDMA and the Psilocybin. I mean, I think for most people that get a good effect from the Ketamine, there's typically somewhat of an ongoing pattern of maybe once a month, once every six weeks, people will come in.
Dr. Heather S.:[crosstalk 01:03:04] versus some of the other psychedelics are one or two treatments?
Harry McIlroy:Yeah. Sometimes the Psilocybin it's just like one dose. The person looks at their cigarettes in their hands and says these are gross. Why would I ever want to do this? And like, that's it. And I think with the ketamine, and it also works differently. It's working with the MDMA receptor antagonist and more of a scrubbing in some ways. I think that what it does is, and I've seen this repeatedly, will help someone especially if they're having some, they're stuck. Having some treatment resistant depression. They'll go through the experience, which is profound for them. And I'm in the room with them. And then it will often last for a week or so and we'll come back. I typically do three sessions a week apart and have that be the kind of the baseline and then see where people fallout. I mean, for some people that's enough and they won't come back for three months. Other people be like oh, that worked great but come in once a month just for the quick visit is much more amenable. The other thing that I really like about ketamine is the time course. So we come in, we do initial patient employment just to make sure that this is appropriate. It's not done on everybody.
Harry McIlroy:But if it's appropriate then we'll have them come back the next visit and we'll spend some time about intention setting and really getting into what they're hoping to get out of it. And I'm also working with psychotherapists. Sometimes in the room but also sometimes for aftercare. And you, it's an intramuscular injection, typically in the shoulder. They will within three or four minutes, they'll lie down and start to feel it. It's fairly quiet from my standpoint. Like, I'm sitting there and sometimes they'll talk but it's much more of an internal process as is the Psilocybin. I mean, those folks might be there for six hours with Psilocybin and speak for five minutes. It's a very internal process. I [inaudible 01:05:03] on. But the thing about the Ketamine is once you've done that injection, they're through the peak of it in about 30 minutes and then really by an hour they're pretty much ready to, if they came on BART or on ride share, you know, they're 10 or 15 minutes from being able to go home. So that's a very different thing than saying I'm going to be in this room for six hours.
Dr. Heather S.:And then what about costs? Is this like stem cells? Is it $15,000.00 to do?
Harry McIlroy:No. Everyone can do this differently. And I would say the biggest determinant on cost for Ketamine is how they're doing it. So you have someone who ended up writing this book called "The Ketamine Papers", his name is Phil Wilson. He was at [inaudible 01:05:47] in the 70s. He's a psychiatrist. And he's been doing this for a long time. He works with the same psychotherapist as he has for a long time. I think they do three or four hour visits in the room and I think they charge like $1,500.00.
Dr. Heather S.:So they're administering the ketamine and doing the psychotherapy at the same time?
Harry McIlroy:At the same time.
Dr. Heather S.:So they have a couple of providers in the room and then it's $1,500.00 per session, is that what you're saying?
Dr. Heather S.:Okay, so-
Harry McIlroy:That's a lot.
Dr. Heather S.:It's not free. By any stretch.
Harry McIlroy:Less than stem cells but and that's sort of the feeling of the ketamine. Because you're essentially paying for time. The medicine, stem cells are expensive. Ketamine is three bucks a dose. That's not expensive. The other side of that, and there's a psychiatrist named Terry Early down in Santa Barbara who's just a great guy and has been doing this kind of on his own clinically for longer than most people, doing the ion injections and he ... Primarily what he does, he does a couple of things that most of his patients are ketamine and they've got, he's in actually in the same office as Becker, who I think has been on this podcast.
Dr. Heather S.:Maybe. I haven't heard from [crosstalk 01:06:56]
Harry McIlroy:They've got quite a power little house on State Street in Santa Barbara and Cole Marta who's also one of the MDMA PI's in LA. Anyway, he basically goes in, talks to them for a couple minutes, very loose check in. And then gets an injection, puts music on, hangs with them while they're on the couch. These are people he knows really well. After about 20, 25 minutes he can kind of ask them as they're coming out of it, hey is it all right if I go onto the next patient. And if it's not then he can have an admin person come in. But 100% safe. Like, the workflow, it was great. But then that allowed him to go into the next room and treat someone and so his volume was much higher and so consequently his charging was much less.
Dr. Heather S.:Right. His rates could be lower. Could be more accessible to more people.
Dr. Heather S.:So who's the classic person who would benefit from a ketamine treatment?
Harry McIlroy:Yeah. I mean, I think certainly somebody with some mood disorders circled more around depression.
Dr. Heather S.:Anxiety, depression.
Harry McIlroy:Yeah, for sure. Yeah. He's doing it on much higher QE stuff than I do. For me, it really is this idea of anxiety, depression. And sometimes when someone's just been doing a lot of different things and not getting there and they're just feeling stuck, I think that this really helps to lubricate, right? And so that's often what people feel is they just feel a little bit more of an opening, right?
Dr. Heather S.:Yeah. Get them unstuck, okay.
Harry McIlroy:And it's not scary. It's not really psychedelic.
Dr. Heather S.:It doesn't have the stigma. It's legal.
Harry McIlroy:Absolutely. And it's one of the reasons I think that it's exploding so much. At least up here.
Dr. Heather S.:Who would be a terrible patient for this? Who would it be contraindicated in?
Harry McIlroy:I mean, I think some ... I'm so tied up on not even doing initial interviews with people that I don't think it would be good. I mean, if someones on, for me anyway, is psychiatrically unstable, I would be less likely to engage them as a patient.
Dr. Heather S.:So like suicidal, or schizophrenic, bipolar?
Harry McIlroy:Probably, maybe not to suicidal. But certainly the schizophrenic bipolar. It just, I mean, I've done a lot of mental wellness and a lot of extra training. I'm not a psychiatrist and don't have the staff to, I don't have like the overnight call staff to, so I think that's part of-
Dr. Heather S.:Would you refer out to a psychiatrist who does ketamine and would they ... So it's not an absolute contraindication, but just for you in your practice setting it doesn't make sense. I see. Okay.
Harry McIlroy:No no, for sure.
Dr. Heather S.:But that could serve, so it could serve a patient with bipolar disorder to do ketamine, potentially?
Harry McIlroy:Potentially. Yeah. Absolutely. I mean, and Kaiser in the East Bay has it.
Dr. Heather S.:Kaiser Permanente? The big-
Harry McIlroy:Mm-hmm (affirmative).
Dr. Heather S.:Oh wow. I had no idea.
Harry McIlroy:Yep. And I had a patient that I just saw in my private practice who was coming in for the lozenges, like the Troche's that will also send people home because she got started and they were treating her like on a Monday, Wednesday, once a month, and she was doing great. And they didn't have the access and so it got down to once a month. And then it was once every six weeks. And so something that was working very well for her, by the way that the system was set up, at least what she told me at Kaiser, they weren't able to get the same frequency in and so we're using the Troche's as a bridge. And so these are something that they self administer at home.
Dr. Heather S.:Okay. So you don't have to do an IM injection? There are other ways to administer. So the Troche's and the IM injections, are those the only two options? Or is there another medication?
Harry McIlroy:So the third option and the option to use it at Kaiser and it was the one that was the one that was the NIMH study protocol, is IV.
Dr. Heather S.:Oh, okay.
Harry McIlroy:And that's how the anesthesiologists that are doing this are typically doing it via IV. And some other folks. Certainly Kaiser is IV. You know, it's a little bit easier to run that. You can have a nurse basically doing an infusion on two patients. Yeah, I've had patients that have done the IV and they did the IM, unequivocally they enjoy the IM experience a little bit better. I just, it is, you definitely go somewhere when you're doing this ketamine and the idea of having a line in your arm is, I don't think is that attractive and so if it was clearly more effective, that would be one thing. But I don't, that's not been my case and that's not what I've seen in the literature. And so to do a little diabetic needle injection into the Deltoid is typically a lot better tolerated-
Dr. Heather S.:And then not have a catheter in.
Harry McIlroy:Yeah. I mean, I haven't had experience with IV, but you know, there are some advantages. You can turn it off really quickly. But it's a lot more complicated. And I do, that sense of, I mean and watching some of Doctor Early's patients. I mean, they got up and walked, kind of in a trance, right? We were there protecting them. But they were standing up and moving around and like you're not doing that in an IV.
Dr. Heather S.:Oh, I see. Okay.
Harry McIlroy:I just, it's just-
Dr. Heather S.:So yeah, you sound like you don't decrease the efficacy but you increase the comfort if you do the IM, if that's an option.
Harry McIlroy:And you decrease the cost and just from my standpoint like doing IV in the office is like need a crash cart. It's just like it created a medical complexity that I wasn't interested in.
Dr. Heather S.:And then the Troche's, is the efficacy there the same with the lozenges?
Harry McIlroy:They're a little bit different. I actually like them a lot for a couple of different use cases. One is okay, here's this patient, they're getting a good six days of efficacy, but they can only afford to come in once every two weeks or their schedule only allows that. Then you can give them a prescription for these Troche's from a compounding pharmacist and they kind of have the whole setting but at home. It's like okay, if you're planning on going to bed at 10, you get into your bed at 9:00, you put a Troche in, it starts working within about 10 minutes. It's much more subtle than the IM, absolutely. But you feel it. I think one of the use cases, and I'm sure there are a couple of therapists in San Francisco doing this. For couples therapy I think it would be phenomenal.
Dr. Heather S.:Interesting.
Harry McIlroy:Because they bring it down enough to where you're just a little bit more relaxed and a little bit less combative. I mean, breathing can do the same thing but this is a little bit more reproducible.
Dr. Heather S.:Interesting. So I want to just pull back into sort of more as a philosophical line of questioning. You've got these tools in your tool belt. And it sounds like one of the things just like a neurohacker that types all these things together, is helping people achieve their potential. Can you speak a little bit more just sort of your philosophy around medicine and your goals as you collect all these tools and add them to your belt?
Harry McIlroy:Yeah, I mean, I think a lot of this does come out of Chinese medicine training. It's essentially being able to provide foundational health but then through our diagnostic to be able to see the beginning of pathology and then be able to fix that and so when there's an imbalance then here are the tools to bring the body back into balance. And that's a great place to start. But then they also have, especially from the Dallas perspective, which is still alive, barely, but this whole idea of tonification. Which is we don't have that in western medicine per se. So it's like here we've got a balanced body. Everything's going well. You know, this is a young person, they haven't had a lot of traumas or they've been eating well, but how can we then up level them? And that is where I think that a lot of the Chinese medicine, there are applications of that. Different types of blood types, different types of Yin Tonic that you can really help up level. Ginseng is one of them.
Dr. Heather S.:So this is the bio hacking, neuro hacking of 2,000 years ago and-
Harry McIlroy:I mean, I think it kind of, I mean it's definitely in of one, right? And I do think in a lot of ways it was the bio hacking. I mean, and now that's kind of being extrapolated. There's something called Synapsin which is a compounded nasal spray that I use with some of my patients with dementia and cognitive decline. It's James LaValle, the compounding pharmacist created it. And it's got Nicotinamide riboside, so NAD B12 but then it's got RG3 which is one of the ginsenosides from Panax Ginseng. And I haven't used it but I have three patients that are using it and like getting refills. They really like it. And so that's not traditional Chinese medicine but that is using Chinese medicinal's to help up regulate the function. And then putting in, even in quality. I mean, like the [inaudible 01:16:05] which I think is one of the best standalone. You know, it comes from a Chinese herb. It was never really used as a whole herb. But like, they've been working with this idea of when the mind, which is connected to the kidney and the heart, when that becomes more deficient, what can we do to bring that up and so that's typically, again, to go to Chinese medicine that certain formula and not single herbs per se.
Harry McIlroy:But they have been using termites forever, they've been using Ginkgo Biloba which is like [inaudible 01:16:39]. So many of these different ones to help bring in that level of optimization along with Qigong, Tai Chi, some of the other movement things they can really be helpful as well.
Dr. Heather S.:And the mindfulness practices.
Dr. Heather S.:Yeah.
Harry McIlroy:Absolutely. No. Just being quiet. I mean, it's interesting because when you study Chinese medicine and especially the historical text, I mean you're really studying Daoism. They're like, if you go to China today you're going to have a hard time finding it. It's just very different. Like, nothing against China but it is very overwhelming young. The meditation has been replaced by building large objects and drinking [inaudible 01:17:22] rice wine. It's just a-
Dr. Heather S.:It hasn't escaped modernization, right? And access?
Harry McIlroy:No. It's heating up. That's just like in so many ways it's just the epitome of young. And so when you lose that balance, like the Daoism really goes by the wayside as well. Because it was much more about containment and really nourishing the Yin so that when you needed the Yang it was like you were very well supported. Essentially creating resiliency, right? Creating resiliency to how you live the seasons. Creating resiliency by the foods you ate. Creating resiliency by the herbs that your practitioner was having you take so that when something did come up, you were ready for it. And I think that that's so much that not just in China, that we're being confronted with here too. People aren't sleeping enough, they're not getting adequate nutrition personalized to them, they're not meditating. They're going from emotion to motion on their phone and I think we're losing resiliency more than anytime that I remember in my life.
Dr. Heather S.:And when we need it most.
Dr. Heather S.:So pretty amazing. That sounds like you have the tools to help people get that balance back. Regain that balance, regain that resilience and really be optimized so that they can come help us all with the creative solutions that we so desperately need. So what else would you like to share with our listeners today, Harry?
Harry McIlroy:Trying to see what else we talked about. We definitely talked about the psychedelics and the cannibus. You know I think that just a little bit, it's maybe a slight plug for Chinese medicine in general. Just that I went to acupuncture school in the late 90s and then I went to med school, 2005 to 2009 and it was really all about, and even with friends who are already doctors, it's like where's the evidence? Where's the evidence? Where's the evidence? And it's this recognition that when you are working with a system that is paying attention to the [inaudible 01:19:28], paying attention to the individual. You know, so many different things. That makes it very hard to reduce into its individual parts and study. And so I think that one of the things that this functional medicine and this whole system's biology approach is done has really brought us back the idea of like well these are systems approaches. And it's not directly analogous to the five phases in Chinese medicine. But we really are at a time where yes, there was something to be able to dig down in a cell and find out the golgi apparatus apparatus or quark in an atom.
Harry McIlroy:But that only gives it so much utility and it's very separated. And I think that life in the world is more dynamic than that and so I think this idea of bringing functional medicine and Chinese medicine and more of these systems approaches to health and wellness. Not only does it make sense it's the people are asking for it. I mean, Chinese medicine is continuing to explode. They've got the Institute Functional Medicine has a clinic at Cleveland Clinic with Mark Hyman and Patrick Hanaway and so I mean I do think, and then that dovetails into the money that we're wasting by not applying these projects. By not getting people that have been diagnosed with Type 2 diabetes the education, food, and exercise they need to so that it can be reversed for their own health and vitality but also from an economics perspective so that it doesn't take away from public schools. I mean-
Dr. Heather S.:This conversation is really a complex one and there's a couple directions we can go here. One is, say for instance the psychedelics. The research is incredible. Like, the research on psychedelics is like it blows everything around out of the water. Like, what you said about Chantix versus suicidal. It's 20% effectiveness with Chantix with the pharmaceutical, 80% effectiveness with one dose of Psilocybin. I mean, when people start checking the literature and the research and oh there's not enough to support this, it frustrates me sometimes because I'm like, well maybe you just haven't read it. You just aren't aware of it. Because there's so much out there. And I think the same thing goes for Chinese medicine. If somebody says there's not literature out there, like bullshit. There's a ton of literature out there.
Harry McIlroy:So much.
Dr. Heather S.:That supports it and there's also millennia of experience then the other piece is that not everything fits into this double blinded placebo controlled hierarchy of medical research that is supposed to inform how medicine is practiced. And then on the other side, conventional medicine and doesn't keep up with the double blinded placebo controlled [inaudible 01:22:15] that they say is their gold standard. And then-
Harry McIlroy:It's ridiculous.
Dr. Heather S.:Right. But the things that don't fit into that, so at my office we practice the Bredesen Protocol, the Neurocognitive ISM has embraced that and to help people with Alzheimer's and dementia. And over and over again my colleague, Cambria DeMarco, who is a nurse practitioner who works in my office and does a lot of it, she had applied for a research, gotten a grant, and then the IRB turned them down. Which is the story over and over and over again with medicine. It's that there's too many variables.
Harry McIlroy:Too many things.
Dr. Heather S.:Too many variables. And it just doesn't fit the paradigm. But what do they say? Can you tell us more about it? Can you tell us more about what your, what would you do? Because we want to tell our friends and our family and help our parents. So I get fired up.
Harry McIlroy:No. Because I think it's really frustrating because they're so stuck on form and reduction and not really on function, right? And I think that's so much of Chinese medicine. It really deals with spirit and function. And it is that ability to change function is really what we're talking about. And if we are not allowed to have that discussion within a Western pharmaceutical context then we're in trouble.
Dr. Heather S.:The system is letting us down. The system doesn't fit anymore.
Harry McIlroy:Yeah. I mean, there is a lot of people, there are a lot of people that are sort of eschewing the double blind. Because at some point it's just we need to be doing things differently. We need to be moving faster. It's just unfortunate because I do love integrative medicine that we all can't be at the table together making decisions that make sense and that are helpful to patients.
Dr. Heather S.:Right. And hopefully that's the direction that we're going. It's starting the conversation and continuing to do the best we can as we learn more.
Harry McIlroy:Yeah. And I think it is too. I am hopeful about that.
Dr. Heather S.:Yeah. Well hey, thank you so much for your time and expertise and I really can't tell you how tickled I am. I'm curious about the things you do. I'm excited to get the continue the conversation as we work together.
Dr. Heather S.:Because you do have this absolutely unique and exciting skillset that I know is part of the future of medicine. So thank you for sharing it with us today. And I will look forward to continuing conversations and learning more and more from you.
Harry McIlroy:That sounds good. Thank you so much for taking the time. This was really enjoyable. And I also look forward to the next time.
Dr. Heather S.:Wonderful, wonderful.