Sulforaphane And The Nrf2 Pathway With Dr Christine Houghton

Lisa: Well, hi everyone, and welcome into Pushing the Limits. Today I have Dr Christine Houghton as guest. I've been very excited about this podcast and been studying something that she's an expert in, which is sulforaphane. You may have come across this on your travels on YouTube and Instagram and so on and so forth. Dr Rhonda Patrick talks a lot about sulforaphane, and sulforaphane is something that we make in the body when we have the precursors glucoraphanin and myrosinase, which are found in the cruciferous vegetable family. Today we're doing a deep dive into sulforaphane, what it does in the body. We're also talking about the Nrf2 pathway.

Lisa: Dr Christine Houghton has a PhD in nutritional biochemistry and nutrigenomics. She has 30 years of clinical experience as well. She has very much a food first principle in the way she approaches things, and some of her approaches have been, for me, quite an eye-opener and a change in the way I see things. She's a pioneer and educator in the sulforaphane and nutrigenomics space. She has a primary background in nutritional biochemistry, but she enjoys translating the complexities of the science into its core principles and ensuring that they're relevant to the needs of practising clinicians. She's a really highly regarded global expert in the phytochemical area, and especially in the clinical applications of sulforaphane. She's done three detailed scientific sulforaphane review publications that highlight the many clinical applications of this remarkable phytochemical.

Lisa: What's really exciting about this is that it's not about the disease. She goes further upstream in the process and really looks at what cells need, how do we get our cells into a state of homeostasis. So I'm going to leave it up to her to explain all the details, but pay attention. This is for everybody, with everything from gut issues, IBS, Crohn's, ulcerative colitis, coeliac disease, SIBO, right through to just dysbiosis in the gut, right through to things like Klebsiella, Morganella, through to Helicobacter pylori, right through to autism, diabetes, liver problems, kidney problems. Pretty much every system in the body is impacted by this pathway. So when you upregulate the Nrf2 pathway, you can have a lot of downstream effects on many of these ailments that you may be suffering from, or one of your loved ones may be suffering from. This approach, by going upstream — and she'll explain what I mean by upstream in the actual interview — makes everything so much more simpler when you really think about it.

Lisa: So I hope you enjoy this episode with Dr Christine Houghton. She's a superstar in the world of functional medicine and nutrigenomics, so I was really, really lucky to get a bit of her time. Before we head over to the show, make sure you check out everything that I do at lisatamati.com. If you're watching on YouTube, I really appreciate you subscribing and hitting the notification bell. And if you're listening on the podcast, please subscribe and do a rating and review for the show if you don't mind. It helps us get found. Share it with your family and friends. We love putting out fantastic content.

Lisa: Lots going on in my world, and you'll be seeing a few new changes coming. I've got a new website in development, and we have a new company in development too, a new biotech company. So watch the space for what we're up to over here. We also have the hyperbaric oxygen therapy clinic operating in Oākura in Taranaki, and if you need hyperbaric treatments, please reach out to my team, support@lisatamati.com. We also have the health consulting, we also do the DNA testing, epigenetic programmes and functional medicine testing. So lots going on, lots that we can help you with. Please reach out if we can do anything for you. Head over to lisatamati.com right now. Over to the show with Dr Christine Houghton.

Lisa: Well, hi everyone, and welcome back to Pushing the Limits. It's fantastic to have you join me once again for a fabulous episode. This is one that I've been excited to have for a number of weeks now and been learning a lot about. I have Dr Christine Houghton with me, who is an absolute superstar. Welcome to the show, Dr Christine. It's fabulous to have you here.

Dr Christine Houghton: Thank you so much, Lisa, and my absolute pleasure.

Lisa: You are a rockstar in the world of health and biochemistry, and your expertise is in the area of — well, can you give us a little bit of a background so that I don't butcher your incredible record?

Dr Christine Houghton: Well, I was in clinical practice practising nutritional medicine for about 30 years, and in 2004 I moved out of clinical practice. I had no idea what I was going to do, but I just knew I didn't want to be chained to an appointment book forever more. And I got into research. I've always been interested in food as medicine, that's always been my primary approach. Then as the years went by, we all got swept along by a lot of supplements. Once I got back into research and I started looking at the research that has been done on plants, particularly as medicine, I pretty much just reaffirmed what I'd always known, but now armed with 20 years of additional science. What changed a lot of this for me was, in the early 2000s, the Human Genome Project was completed, and that's when we started to understand how cells really work. And the way they work is not exactly the way I thought they did when I was in practice. So there are a lot of things I would do differently now if I was still seeing patients.

Lisa: One of those sort of paradigm-shifting things was the antioxidant theory. We had this theory, especially 20, 30 years ago, that we have all this oxidative stress that we hear about in our cells, that that's causing damage to our cells. That's a bit more of a complicated picture than that. And then we had this theory that came along that if we threw a lot of antioxidants at it — the vitamins A, C and E and so on — we would be able to counteract that oxidative stress and we'd be fine, we'd live a longer, healthy life. Why was that theory slightly flawed?

Dr Christine Houghton: Yeah, that was one of the biggest revelations to me, and that shocked me when I found out. When I said we understood how cells work — cells are constantly detecting their local environment. If they see some sort of a threat, in inverted commas, if a cell detects a threat, it knows it has to turn on its antioxidant defences. So we erroneously thought that because of the oxidative stress, as you mentioned, we should just dump as many antioxidants as possible into our cells. What that actually does is it masks those stress signals that the cell uses to pick up, to switch on its protective genes.

Dr Christine Houghton: That then helped us to understand why some of the clinical trials that have been done, where athletes, for example, are given high doses — well, not particularly high, so 400 units of vitamin E and a thousand units of vitamin C — and then measured their inflammation and metabolic markers, we found the athletes who were exercising and taking the antioxidant vitamins were much worse off than those who were just exercising and not taking any supplements. So that study by a German research group came out in 2009, and that kind of rocked the biochemical world. It hasn't filtered into the clinical environment as well as it should, but there have been studies since then.

Dr Christine Houghton: When you understand that the cell has many, many mechanisms to detect the threats that are around it, and it uses those signals to switch on its about 250 protective genes, which are all governed by this one switch which is in the cell. And taking large doses of vitamins — the thing about the large doses of vitamin supplements is there's no way you could practically eat that amount of food to get that amount of vitamin C or vitamin E. When we look at the fact that we need about 10 international units of vitamin E a day, and these studies are being done with 400, 800 units of vitamin E, that's a mega dose, and nature doesn't work like that.

Dr Christine Houghton: So basically what I try to look at is to say, how has nature sustained humans on this planet for however many millions of years or whatever? And I'm going to try and understand how nature does that, and I'm going to try and mimic that. That's what brings me back to this concept of looking at the signals that cells use and work out what foods can activate the signals. That gets into the other part of my research. So I'm very involved in a branch of nutrition science called nutrigenomics, and that is nutri as in nutrition, genomics as in genes. So it's basically foods that talk to our genes. What we've learned over the last 20 years or so since the Human Genome Project is that there are certain foods which can activate switches in the cell, and that's what the cell uses to upregulate its own defences.

Lisa: Yeah, it does. The food first philosophy that you have makes a lot of sense to me, and sort of going upstream, really, isn't it? Putting in an antioxidant — and I do have some specific questions which I'll save for last around certain antioxidants, because I'm trying to get my head around them. But having learned certain things certain ways, you're sort of like, oh, you know.

Lisa: But just like the Nrf2 pathway — if we dive into that amazing pathway that does this upregulation, this master switch, if you like. What was revolutionary to me when I was learning about this and your work and listening to you was that this really is coming at a level much, much higher. One of my teachers had taught me about redox signalling, and that we have to keep the balance in the cell, and that when we chuck in just lots of antioxidants, we're losing that balance. So I sort of got that concept, but that you could actually go upstream by using the Nrf2 pathway and actually activate hundreds of genes that govern, I think, 2,000 enzymes and things in the body that do different things — that really is a barrage of defensive mechanisms.

Lisa: I heard Rob Thomas talking on one of his lectures when he was discussing this about — well, no, I think it was one of your ones with Carrie Jones, where she talked about the Christmas lights, or you talked about the Christmas lights, where you actually turn one switch and all the Christmas lights come on. That was a beautiful analogy for me, because that just went, oh, I get it now. So I turn this one switch and then all of these downstream beautiful effects happen that have a huge effect on all systems and all cells of the body. It was this beautiful concept that I'm just like, wow, is this all we need then?

Dr Christine Houghton: Well, the way I look at it, Lisa, is that when we're working upstream — and you're right, there's hundreds of protective genes that are switched on by this Christmas tree switch. That's in my book, Switched On, actually, that analogy, the Christmas tree. And you get it, and I think that that helps to explain it. That mechanism is active in every nucleated cell in the body. So that means I don't care what your diagnosis is. You come to me and you go, I've got Hashimoto's disease, my thyroid is not working, da-da-da. I don't care what your label is. Now, that's not because I'm being dismissive; it means that I have some fundamentals I need to address first.

Dr Christine Houghton: It's governing all the cells of the body. And of course, if we're talking about thyroid, I've got a whole endocrine system that's going to be impacted by this anyway. I don't have the ability to micromanage what's going on in thyroid cells to that extent. So I go upstream, I fix those core processes, we restore homeostasis — that's the correct biochemical term — so we get that balance back. We're working in the gut, we're working in the brain, we're working in every system of the body, but I'm not targeting those systems individually.

Dr Christine Houghton: So when I go, okay, I think we've gone as far as we can go, and the patient says, yes, but I've still got such and such system — now's the time that I then focus my attention on that particular part of the physiology and try and work out if there's something else going on that's quite specific to that organ system. It could be all sorts of different things. But to start there, I think just wastes a lot of time. It certainly wastes a lot of money on testing, because I see no point in doing all of this functional testing when the patient first comes to see me. I've only got to speak to them for five minutes and find out what they eat and the nature of their lifestyle, and I know there's already things I need to fix. You don't have to tell me anything, but I need to fix these obvious things, and then we can talk about whatever you think you're here for.

Dr Christine Houghton: Again, it's not meant to sound dismissive, but it's meant to say if we're really going to address human cells, what's going on in one cell is pretty much going on in every cell of the body, so I'm just going to optimise that function. And that's the bit that I didn't know when I was in clinic. I just didn't know that, and it was a huge revelation to me to find that out. And that in many ways was the impetus to do a PhD in sulforaphane and nutrigenomics, and to be able to drill down more into those mechanisms and understand them better.

Lisa: And that makes so much sense, because it really does come down to — we're made of 37 trillion cells or something, and I don't think anyone's really counted, but it's a lot. And if we can get those cells operating correctly, then we can get the organ operating correctly, the system operating correctly, the body operating correctly. So you're going right to the root, or the upstream, however you want to see it.

Lisa: And I love that idea of not having to work directly with this disease, therefore this Band-Aid approach, because that is the way most things operate now. You go, well, you've got a headache, here's a painkiller, rather than why have you got the headache, and what is the root cause? And of course, that is especially — clinicians that are early in their career, the amount of testing that you can do in order to make a better picture for yourself makes it easier. But when you can find an approach like this — this is why I was so excited about this stuff. You don't need to actually be a specialist in everything, in every system and every organ of the body, in order to have massive impact with a massive amount of people. And that's what got me quite excited about learning about this. And one of the key things that you talk about and have studied is sulforaphane, and I really want to do a deep dive into sulforaphane.

Dr Christine Houghton: Can I, before we get into that, just say something else in relation to the general topic of treating upstream? I started practice back in the '70s, a very long time ago, and we had a fraction of the knowledge that we have now. There were very few supplements available, so we had to use food. So I know that food works, and patients got better. So fast forward now to 2023 and thereabouts, we've now got a whole host of label diseases I never heard of. We never had SIBO, we never had MCAS, we never had — well, we knew people had histamine intolerance, but we didn't make them cut out the long list of foods.

Dr Christine Houghton: And I sometimes now talk to practitioners and they go, I've got a really complex case, my patient's got SIBO and they've got IBS, IBD and — I forget all the other things. What are all the labels that we use now? I didn't know any of those. Oh, NAFLD is the other one. Now it's not a disease, but diagnosed with MTHFR — 66.6% of the population has, on one particular aspect of MTHFR. How did my patients ever get better? I didn't have methylated folate supplements. What I had was whole grain cereals, nuts and seeds, green leafy vegetables, all of which are good sources of 5-methylfolate. So nobody tells you that now. The folinic acid and the methylated folate that people are using as supplements — that's what's in food. That's why my patients got better, and I never even heard of MTHFR, and nor had anybody else.

Dr Christine Houghton: So the thing about my current approach is I never had those labels. I didn't need them then. Why do I need them now? And what I see happening is patients going into economic burnout because they spend a bucket load of money on a whole lot of tests up front which really don't solve the problem.

Dr Christine Houghton: So the only tests that I'm kind of inclined to do these days — I'm quite happy to do a nutrigenetic test, because it gives me a one-off impression of where a patient's genetic strengths and weaknesses might lie. That's helpful. I do like to look at urinary pH, because it's an indicator of how much plant food they're eating, so I find that one useful, and it's a test you can easily do at home. There are certain blood spot tests you can do now that look at vitamin D, that look at omega-3 fatty acids. I'm quite keen to look at continuous glucose monitoring as a two-week trial here and there. So those are the sort of biochemical markers that I find useful. Most of the others I would never want to do up front. I might use them later on, as I said before — I've done everything I think I need to do and the patient still has a problem, then we drill down.

Lisa: And then you wouldn't include the microbiome testing, and you'd start straight with the...

Dr Christine Houghton: I don't do the microbiome testing, because a sick person coming to me's probably got quite a perturbed microbiome. A couple of revelations that also came to me in the last 20 years — I learned that, unlike what I'd been taught for years, if I give a probiotic supplement, that probiotic does not take up residence in the gut. It might do something useful in transit, but it never takes up residence. So that's not how I fix the gut.

Dr Christine Houghton: If I did a stool analysis today and I'd be eating a high carbohydrate diet, and then two days later I decide I'll have a high protein diet and I do another stool analysis, I get a totally different picture. So if I can change the microbiome with simple dietary changes a few days apart, what do I need to know this for? So again, I'd only be looking for a pathogen, which may need some intervention that's far greater than I'm able to do nutritionally. Most of the time we're not dealing with pathogens, we're dealing with pathobionts, which are microbes that happily enough live in the gut provided our gut ecosystem is living in homeostasis and our own internal mechanisms can keep it under control.

Dr Christine Houghton: I think a lot of the dysbiosis that we're seeing in patients is easily corrected. And if I can just bring your question back in about sulforaphane — one of the most effective things that we can do with sulforaphane is to use it to address the gut epithelium. And some recent research has shown that it's actually the colonocyte, the epithelial cell lining the colon, which is driving the composition of the microbiome. So that was another big valuable revelation to me. And so when we start working in with patients who either know they have some sort of dysbiotic gut, or we soon enough find out when the sulforaphane gives them an exacerbation of gut symptoms, I know we're going to be able to sort that problem out.

Dr Christine Houghton: Everybody says good health begins with the gut. I didn't appreciate that when I was in practice; I certainly do now, now that we've sort of understood what's going on at the gut epithelium. This single layer of cells lining the gut are quite remarkable. They have such a lot of unique properties that other cells mostly don't have. And once we learn to get them back into normal function, lots of other things sort themselves out. We don't have to cut gluten out of the diet unless the patient is coeliac. We don't cut out a whole list of foods with names like histamines and oxalates and salicylates and this and that. Intolerance to food, plant foods with those molecules, to me is just an indicator of a very dysbiotic gut. And when I restore homeostasis to the gut, those intolerances largely disappear, with few exceptions.

Dr Christine Houghton: So the big problem I see now is so many patients are cutting out these sorts of food families and they end up with this ever-narrowing list of foods they can handle. And if they come to a practitioner with only five or six foods — and that's not an exaggeration, that's not uncommon to see — they certainly do not have the nutrients necessary to repair the damage. So they're in a pretty seriously severe way when they get to that stage. And a bunch of multivitamin tablets isn't going to make any difference, because they're not the signalling molecules. It's other molecules in plants which are the signals that turn on the protective cellular defences.

Lisa: And the epithelial cells — I've seen some of the diagrams in some of your charts that you've had, and the day in the life of the epithelial lining is absolutely fascinating. They should do a movie on it, really. We've got so many of these different cells doing different things in these little villi, and the Paneth cells and the stem cells and the antimicrobial peptides, and this is doing that and that's doing this, and it all has this beautiful harmony to it if it's operated correctly. And so you're working on restoring that epithelium, getting that epithelium right first as a part of your first line?

Dr Christine Houghton: Exactly, because the people who have the gut problems have a very inflamed gut. So those epithelial cells are churning out inflammatory cytokines, and those inflammatory cytokines are opening up the tight junctions between cells. I don't call it leaky gut deliberately. We're looking for an intact gut barrier, and the reason I don't call it leaky gut is these tight junctions are part of a continuous dynamic where the cells are opening and closing all of the time, depending on what foods they're exposed to and what environmental factors, just as much as foods, and also what biochemical and metabolic factors are occurring within the cell.

Dr Christine Houghton: So this notion that you've got to cut out gluten to cure your leaky gut, quote unquote — it's just so far from the way it works that it's really quite distressing. We've got a whole community of people now who are not only scared of the gluten in wheat, but they're scared of all grains. And we've had books like Wheat Belly by William Davis, an MD not trained in nutrition, which is designed to create weight loss. And now we've got Grain Brain from Dr David Perlmutter, who's a neurologist, not trained as a nutritionist, which has scared the daylights out of people in eating grains. And yet humans have been sustained for eons...

Dr Christine Houghton: ...on grains. And grains, because they're seeds which grow an entire plant or a tree, are a really rich source of micronutrients. And then we strip these things out and we're buying gluten-free breads which are just pure starch. They're absolute garbage. I've done a seminar just recently on this and looked at the additives, and one of the worst things you will find in a gluten-free bread is what's called modified tapioca starch. The tapioca, I always knew, was just plain starch — there's no micronutrients of any consequence there. It's the modified bit that's the problem. So modified tapioca starch is chemically modified by some pretty nasty processes and it becomes an emulsifier. And emulsifiers are one of the greatest irritants to the gut barrier and the major factor that opens up the tight junctions.

Lisa: Wow.

Dr Christine Houghton: So the patients who were taking gluten out of their diet because they think it's going to upset their gut barrier are now buying gluten-free bread. And I'm not blaming them at all, because the food industry has very sneakily led us down this path, and I need to expose it if I can. So this modified tapioca starch in there opens up the gut barrier. Now they're worse off than they were when they were having gluten, because this bread hasn't got any nutrient of any consequence in it. It's just a filler that's causing the damage that they're trying to avoid. And I think in many cases the patient would be better, as long as they're not coeliac, to look at a really good quality wholegrain bread that doesn't have the modified tapioca starch. And there's a few others of these emulsifiers. So the food industry has a lot to answer for, which is again why we try and get patients to go back to basics: buy the ingredients, get in the kitchen. It's fun.

Lisa: Yeah, I've been making buckwheat bread and flaxseed bread lately, and they're quite delicious.

Dr Christine Houghton: Oh yeah, I make mine every day. I love it. You'll never get a more wholegrain product than that.

Lisa: I mean, the buckwheat bread, it's basically buckwheat and water and it ferments itself. It's quite remarkable. Is there also a problem, though, with some of the grains that are glyphosated? I think in Australia now... obviously organic, I'm looking at organic whatever you're going to choose.

Dr Christine Houghton: Yes, it is an issue without a doubt.

Lisa: And I think you've banned it in Australia, is that right?

Dr Christine Houghton: No, not yet.

Lisa: Not yet? I thought you had.

Dr Christine Houghton: No, we're not so clever.

Lisa: Oh well, yeah, I'm hoping we will be one day. I think that's a big problem.

Dr Christine Houghton: It destroys the microbiota. They have the shikimate pathway that we use as a weed killer in the real weeds.

Lisa: Yeah, and that's unfortunately very high in some of the grains, so you need to go organic if you're going to have them. So those tight junctions — they're in flux. They're not just open or closed, that's what you're saying. But when we disrupt that too much, that's when we start to get the LPSs and so on coming out.

Dr Christine Houghton: Yes, the lipopolysaccharide on the gram-negative bacteria. We don't want them in the cells, they get into circulation, they affect the liver and metabolic syndrome and so on. However, a breastfed baby needs to have its tight junctions open, because that's absorbing the globulins from the mother's milk. And there are various other situations where molecules can be absorbed into cells.

Dr Christine Houghton: I should also caution at this point, we've also gone down the supplement track of trying to force polyphenols like curcumin into cells by putting them within a liposome or something similar to that. How do they get into the cells? They force open the tight junctions. Yes, you can force curcumin into the cell. Native curcumin has a bioavailability of about 1%, so you've got to eat an awful lot to get it into the cells. You can get 50, 60% increased bioavailability by using a liposomal form. Why do we think that's a good thing, to drive into our bloodstream and our cells a molecule which doesn't naturally find its way there in nature? At the same time as you're opening those tight junctions to let the curcumin in — and it's not the only one, there are other molecules that are in these forms — the LPS, the endotoxin which is floating around in the gut, it's going to come through as well, isn't it? We're not just letting in the curcumin.

Lisa: Wow, that's a revelation. I didn't think of it like that. Because we know that polyphenols have a positive function in the gut, but more because they're feeding the bacteria in the gut and the bacteria are producing short-chain fatty acids, and that's the way that we're getting benefit from polyphenols, more than just the polyphenol. The structure of these little molecules is way too big for them to basically get in on their own.

Dr Christine Houghton: There's a couple of factors there. So let's suppose we're at a barbecue and we had some steak, and the steak had been marinated in red wine and lemon zest or whatever, so there's lots of polyphenols in there. That red meat itself may have a fair preponderance of free radicals as part of that meat. Because it's been marinating, you do get a direct quenching of those polyphenols on those radical species, so you're reducing the burden of radical activity that's now going into the digestive tract. You're right, the polyphenols have such low bioavailability, around the 1% of curcumin, and that's pretty typical of a polyphenol. There's a few that have a bit higher, but you don't get much in.

Dr Christine Houghton: So step one is they're quenching radical activity, if you're having them at the same time as a meal. That could be the polyphenols in your extra virgin olive oil that you used cooking the meat. Then when it gets to the microbiome, now the microbiome is digesting those polyphenols. They are prebiotic in a sense that's a little bit different from the starches that we might use as prebiotics, but as you say, you produce short-chain fatty acids. The primary fuel for colonocytes is butyrate, which is one of those short-chain fatty acids. A lot of practitioners give glutamine for the gut. Glutamine is good food for the small intestine, not particularly for the large. We need that butyrate to do the job there, to produce the ATP etc.

Dr Christine Houghton: So in the process of digesting those polyphenols, the microbiota are breaking them down into tinier fragments, and some of those fragments actually are bioavailable. They're now small enough molecules, they can be taken in. So we don't know a lot about this, and that's because there are so many different variations on how that large polyphenol could be broken down. The types of microbes in your gut are not the same as mine or anybody else's, so we really don't know. But we do know that that's the way nature works, and we have to accept the fact that some of those will be absorbed into our system and they will have signalling effects when they get there.

Lisa: Yeah, so they'll become like a peptide almost, if they do get into the cell, would they be?

Dr Christine Houghton: No, they're not peptides, they're just their own little molecular structures.

Lisa: Yeah, and they will be beneficial, and they're definitely beneficial for the colonocytes and the bacteria. And the other thing that's interesting too — I often talk about fermented foods, the kimchi, the sauerkraut, kefir and so on.

Dr Christine Houghton: They should be a food group in their own right. And the reason I say that is there's been some research done on some of these polyphenol molecules. So caffeic acid is a very common polyphenol that's found in all sorts of plant foods, from apples to everything. When it's attacked by lactobacillus, it forms a molecular structure which is known to upregulate Nrf2. So that's that switch. So when you metabolise these polyphenols, you're now upregulating Nrf2 as well.

Lisa: As well. Oh, wow.

Dr Christine Houghton: So whereas we teach clinicians about using a molecule like sulforaphane to upregulate Nrf2, if we ate the perfect diet, lived the perfect lifestyle, had some fermented foods in there, we would more than adequately upregulate Nrf2, because that's how nature has designed us. It's just that our modern lifestyle and our modern diet and environment are such that most of us aren't in that category. So that's why something like sulforaphane just gives you a leg up and gets you up and part to where you should go.

Lisa: And with the sulforaphane, there's a lot to that story as well, isn't there? Sulforaphane is known to be in broccoli, very high in broccoli sprouts, but there's so much more to the story of getting sulforaphane into the body, whether you're taking it in a supplement form or if you're making your own broccoli sprouts, which I do. But I also take sulforaphane precursor supplements — yours — so that I'm making sure. But there's a "buyer beware" really, to understand what is the story behind sulforaphane, because I think a lot of people are not clear.

Dr Christine Houghton: No. And I should explain that. So let's start with the sprouts that you're growing. I'm sure they're beautiful little green creatures.

Lisa: Amazing, yeah.

Dr Christine Houghton: And they're all fresh and lovely, and the freshest vegetable you're probably ever going to eat because it's growing right there on your kitchen bench. Now, what's little known is that there's actually no sulforaphane in the sprout. There's a precursor called glucoraphanin, and there's an enzyme called myrosinase. And when you chop that up, bite into it, that now means the myrosinase enzyme acts on the glucoraphanin, it breaks off a glucose molecule, and that's what produces the sulforaphane. So you're producing that sulforaphane as you go.

Dr Christine Houghton: When you go to buy broccoli seeds to do your sprouts, you have no way of knowing how much glucoraphanin is in those seeds to start with. And there's actually a 20-fold variation known to be across the seeds. So for a company like us, Cell-Logic, manufacturing a broccoli sprout supplement, naturally we have to search high and low to find the seeds with the highest glucoraphanin content. So that enables us now to manufacture a consistent sprout that has a consistent yield of sulforaphane. When you do your own, you don't know that, because the store where you buy it, the health store or the merchant, wherever you buy it, nobody much ever measures this. It's a seed, it's fresh, it sprouts, it makes a lovely plant. You're getting plenty of folate and other vitamins and minerals from your sprouts. You'll get some sulforaphane, but you'll never know how much. So I think what you're doing is ideal — you're getting the benefits of a very fresh vegetable. If you want a therapeutic measured dose of sulforaphane, you might want to take a supplement where you say, "Okay, I've looked at the data on this, I need 15 or 20 milligrams of sulforaphane a day for my particular situation," and so I'm sure that I'm getting that when I have the supplement. And I mean, we talk mostly to clinicians, so they're dealing with sick people who want to get well, and so they need a measured dose.

Lisa: Yes.

Dr Christine Houghton: There's a dozen or more decent clinical trials that have been done over the years on sulforaphane, and we pretty much know what dose is needed to get a therapeutic response.

Lisa: A therapeutic response, exactly. And you don't know that when you get your broccoli sprouts. But I do think it's also good — I think it's probably complementary, because you're getting the complex of the whole plant and then you're adding in that, you're making sure that you're getting it.

Dr Christine Houghton: And that brings me to another point. So I think we may be one of the few manufacturers of this supplement anywhere in the world who has a 100% whole broccoli sprout. All we do is we grow it in a particular way, we choose our seed carefully, we extract the water, and you're getting everything there. We don't add anything and we don't take anything but water out of it. So that's our product, and we can...

Dr Christine Houghton: We test every batch, so we know what the sulforaphane yield is. Now, a lot of companies who started out before us produce broccoli — not even broccoli sprouts. They've sort of indicated they're broccoli sprouts, but they're actually seed extract. So they take the seed, they grind it up, they deactivate the myrosinase enzyme, so now you can't produce sulforaphane from that extract. It's basically glucoraphanin powder extract in a capsule or in a powder, and that's what people buy.

Dr Christine Houghton: The trick is, when they brought these out, they called that sulforaphane glucosinolate, which is not a chemical term, it's a marketing term. And as soon as the buyer sees "sulforaphane" in the name — they don't know what this other glucosinolate thing is, sounds like it must be all right — they think they're getting a sulforaphane-yielding supplement, and they're not.

Dr Christine Houghton: So when you quiz the manufacturers of these extracts — they're usually called broccoli seed extracts, they've stopped using sulforaphane glucosinolate or SGS as much anymore, basically because I've published a couple of papers and I've highlighted this under the biobehaviour category — when you challenge them, they say, "Oh yes, it doesn't matter about the myrosinase enzyme, because the gut bacteria will break that down for you." And if you have an intact microbiome, which mostly sick people don't have, you can break down 8 to 10% of that. So what you'll do is you'll get about 8 to 10% of the sulforaphane that you'd get if you had the whole material.

Lisa: Yeah.

Dr Christine Houghton: And because most sick people don't have an intact gut, they might not even break down 8 to 10%. And in any case, that's not enough to get a therapeutic dose, because when we're talking about nutrigenomics, food talking to our genes, you need a certain dose to activate the Nrf2 switch, to get it to start producing all of its protective enzymes. You won't get that from a dose that's too low.

Dr Christine Houghton: So I can't caution people enough about getting fooled by that. And they're not always little companies doing it — some of the bigger companies are doing it, and some of the practitioner supply companies are doing it. I think to a large extent it's because this concept of a supplement that has an enzyme in it, which doesn't actually have the ingredient you're trying to get, you've actually got to make it on the fly — there's only two plants we know that work like that. Garlic's the other one, which needs an enzyme to convert to the active. And all of the cruciferous vegetables, not just broccoli — they all work the same way. These sulfur-rich plants all work this way. So I think practitioners aren't used to this concept.

Lisa: No. And I think, like, yours is a practitioner-only, so you have to work with a practitioner in order to do this protocol, which is fabulous, because then people get guidance along the way. Because one of the other problems that can happen is that you can have a sort of a reaction to the sulforaphane, and you may have to back right off on the dosing and go very, very slowly. But people mistakenly think — and therefore working with a clinician is really, really important here — "Oh, I've had a reaction, therefore I can't tolerate this, this is not for me," and chuck it out the window, when actually if they've had a reaction, that's probably a sign they need it. They just need to back off.

Dr Christine Houghton: That's really diagnostic, Lisa. What sulforaphane does — it has a direct effect, as I mentioned earlier, on re-establishing the gut population, the microbial population. If someone has the sort of reaction you're talking about, what you're getting is you're killing off the bad guys in the gut, the pathobionts, and sometimes you're killing them off at a rate that creates a lot of toxic residue, and now the system reacts to this, it wants to flush it out. So bloating, diarrhoea and so on.

Dr Christine Houghton: We work sometimes with patients or their clinicians — the clinicians and their patients — where they have to stop immediately and go back to just the tiniest amount of powder on the end of a sharp knife blade. You're obviously familiar with this. And then we gradually titrate the dose up, little by little. So it doesn't happen to everyone, but it happens enough that what you mentioned earlier is always a concern. They go, "Oh, I'm allergic to sulfur, I'm allergic to broccoli, I can't tolerate this and I'm just not going to eat it anymore," when in actual fact you've just diagnosed your own dysbiosis without buying a test for anything.

Lisa: That's a really good point.

Dr Christine Houghton: And we just back it right off and we take it slowly. Now, most cases, a couple of weeks and people will be able to tolerate it, but we have cases where people can take three months to get up to that dose. And you go, "This is ridiculous, how can this be?" Well, it just is. But they are getting progressively better as time goes by, and as long as they're patient, and as long as the practitioner realises this is normal.

Dr Christine Houghton: Because sulforaphane is such a potent bioactive material, they are getting responses to dosing with that, but they may not get that to a camerin supplement or a curcumin or something else like that. It's just that sulforaphane has an 80% absolute bioavailability. Curcumin is about 1%. Most of the polyphenols are around about the 1 to 10%. Sulforaphane is about 80%. So it's a different shaped molecule, it's lipophilic, which means it's fat-loving, it just glides straight through the fatty membrane of the cell and it's inside the cell pretty rapidly, and that's why you get such a response.

Dr Christine Houghton: It'll do the same at the blood-brain barrier as well, because the blood-brain barrier operates much like the gut barrier, with tight junctions. So there are quite a lot of studies being done on sulforaphane in mental health and in brain function and different things like that, because it is one of those supplements — or one of those molecules — that will glide in through that barrier and starts working immediately. It has an anti-inflammatory effect on the microglial cells, which are in the nervous system.

Dr Christine Houghton: So again, it's this upstream effect. It doesn't really matter whether it was the gut epithelium or the hepatocytes in the liver, or neural cells in the brain or other parts of the nervous system. You are trying to have this upstream effect that says, let's try and just optimise the function of every cell in the body to the best of our ability, and then let's see what we've got left after that. Sometimes you don't need to do anything much else. Other times we do need to work specifically on the immune cells which directly underlie the gut epithelium. So there's a whole immune network in there, and there's sometimes other things we can do there that can help to restore that gut-immune interface.

Lisa: That's like the second product that you have, the ImmuneIB, which has got the LTA from the probiotics that have been killed off. So can you explain a little bit why the Lactobacillus plantarum L-137, I believe is the number, and it's grown to a certain age, and this has a lot of the LTA on the structure of the bacteria, from what I understand, and then they harvest that and actually kill the bacteria, so you're not taking it as a probiotic that's going to colonise. You're using it as a signalling molecule that goes on the toll-like receptor 2 and blocks LPS. Is that right?

Dr Christine Houghton: You put it perfectly, perfectly correct. So what the manufacturers have done — it's a Japanese innovation — and again, this was a huge revelation to me too, again, this idea that I've got to have a live probiotic, I've got to keep it in the fridge, it's going to replace the bad bugs in the gut. It's not doing any of that. So as you say, it's being standardised for its LTA, lipoteichoic acid, a signalling molecule on the outer wall of the Lactobacillus. So all of the Gram-positive bacteria pretty much have LTA and a number of other signalling molecules. That attaches to toll-like receptor 2 on the gut epithelium, and that now signals to the underlying immune network, and long story short, that has the ability to normalise immune functions.

Dr Christine Houghton: In this way, it helps infection control. It can similarly help destroy cancer cells — natural killer cells and so on. It downregulates the allergic response, downregulates inflammation and downregulates autoimmunity. So when you get that gut-immune interface in homeostasis, those are the functions that you're able to normalise.

Lisa: Wow.

Dr Christine Houghton: This was extraordinary when I discovered this. And the other advantage of using a heat-killed probiotic is those patients who claim to have the histamine reactions — and do — they usually can't tolerate a fermented food, because those fermented foods which have these lovely Lactobacillus are reactive to them. So this way you get the advantages and none of the disadvantages.

Lisa: I've got that bit of a problem with histamine, so I know this in family members with the same sort of thing. When you give them a probiotic, they're off to the races with all sorts of problems. So this is a beautiful thing, and it's a lovely synergy then between the sulforaphane and that. And this would be because your immune system is 80% or something residing around the gut, under the gut.

Dr Christine Houghton: You're right, yeah.

Lisa: So this is really a one-two punch for health in general. And when you say crossing the blood-brain barrier, the range of ailments that this can — we don't need to know the names of the diseases, like you said, when we're helping people, but it would be interesting for people to know, what is this going to help me with? If this is so powerful, what systems is it going to have an impact on? If I've got thyroid problems, Hashimoto's, if I've got adrenal issues, is that going to help with those? Or IBS, or Alzheimer's, or dementia, or TBIs, or diabetes? Can you give us a few things where studies have been done, where we've got some clinical research?

Dr Christine Houghton: Well, the clinical trials — there's a fair bit being done on just detoxification of environmental chemicals, like motor vehicle exhaust. We're all exposed to that. Aflatoxin, ochratoxin — and here's another case where I'm running into people all the time who all of a sudden have mould issues. Mould issues have always been with us. Now we've got this whole syndrome and this complex process that patients seem to think that they have to address. I mean, I live in Queensland, Australia. I'm not in Far North Queensland, but it's very humid there all year round, and people wash all the mould off their walls twice a year. They aren't all suffering from mould issues. Why not? Because a healthy immune system can address that.

Dr Christine Houghton: So again, I'm just going to digress a little bit, because what's common in the world of treating the gut these days is practitioners wanting to give antimicrobial therapies to kill off what the stool microbiome report told them was a pathogen or a pathobiont. You're also killing off the commensals. The commensals are the good guys, we want them there. We don't do any kill therapies at all. And the reason we don't is one of the cells lining the gut epithelium — you mentioned before, the Paneth cells.

Lisa: Paneth cells, yeah.

Dr Christine Houghton: They produce a range of antimicrobial compounds including defensins. The important thing about them is they're selective. They kill the pathobionts and they don't do anything to the commensals. How clever is nature? Much more clever than we are. That's why I say we don't have the ability to micromanage to that extent. So if we just go upstream and we go, we're just going to give Mother Nature a toolbox and stand back and let her do her thing — the biochemical pathways involved in all of these processes are so intricate and so complex and constantly modulating.

Dr Christine Houghton: From one moment, one nanosecond to the next. How do I know whether nature wants more glutathione at the moment, or it doesn't need it now, it needs less? If I go putting glutathione into the cells, what am I doing? I don't know what I'm doing. Whereas if I give Mother Nature the toolbox, it says glutathione synthesis and a range of other glutathione-related enzymes are all part of the Nrf2 activation process. And that activation process has got its own checks and balances in there, so the cell goes, "No, I don't really want that at the moment, just ignore you." Oh, an hour later, "Yes, I do need that now."

Dr Christine Houghton: So this is this modulation. I prefer that word to regulation and control. Modulation is just simply saying, I'm just observing this, it's coming and going, it's in a dynamic state. It's like the tight junctions — they're in a dynamic state, they open and close gently whenever they decide that they need to do this, not when I decide.

Lisa: And this is like, not just true with pharmaceutical interventions, which definitely force pathways and always have these knock-on effects, but also even with some of the natural compounds like oil of oregano, for example, that we use for antimicrobial purposes, can actually be destroying some of the good guys as well.

Dr Christine Houghton: Very much. Just because they're plants, they're not necessarily all that gentle. I mean, look at grapefruit seed extract. It's a very destructive effect on the gut microbiome. So I know a lot of people find it really difficult to believe what I'm saying when they're so used to getting a report and it says, right, these are the bad guys in your stool microbiome, and you're going to go, right, what kills that? Good, this, this and this. That is not how nature works. It never was, it probably is never going to be. And I see long, drawn-out processes where often patients are getting sicker and sicker because they're reducing the diversity of the microbiota living in the gut.

Dr Christine Houghton: Whereas we're saying we're going to let nature use its own antimicrobial defences, and we're going to now start introducing prebiotics gradually as the patient can tolerate them. So once we've got the homeostasis at least partially restored, once foods to which a person was intolerant no longer are reactive, so we can have a little bit of psyllium seed, we can have a little bit of resistant starch, whatever it happens to be, and little by little we're now feeding the diversity of that microbiome.

Dr Christine Houghton: And it's been shown that even if you've had a bad gut for a lot of your life, there are still residues of those important microbiota living in little niches within the gut. And if you start feeding them, there's enough of them there, they'll start repopulating. And people have found this — they've thought, for years I don't have this bug, I've killed it off. But often you can get quite remarkable recovery just by giving Mother Nature a toolbox.

Lisa: And giving it the right things in the right sequence. And when you go to your third product, the Phenix, that would be bringing in those prebiotics.

Dr Christine Houghton: Yes, so that's the starting point. But sometimes we don't even need the supplement. Sometimes I get people making their own homemade potato salad. If you take small potatoes, leave the skin on them — the little pink ones are good — cook them, leave them overnight, the starch molecules rearrange as that potato cools down.

Lisa: Wow.

Dr Christine Houghton: And that now forms a very effective prebiotic that you can use to feed some of the microbiota. So that's a very gentle way of restoring the microbiome bit by bit.

Lisa: You'll have to put a recipe book out, Dr Christine.

Dr Christine Houghton: And that's where the seeds, the whole seeds, the flax seeds and the buckwheats and all sorts of seeds come in. The more variety you have in the diet, the greater the diversity you have of the microbiota. They don't all like to eat the same thing. They eat different things, and the more we feed them, the better they get.

Lisa: That's another problem that I see with a lot of people: they have restricted their diet because they're told this is bad, that's bad. And sometimes you do get to the point where you think, what the hell do I eat, because everything's bad for me and the environment's bad, and then you end up in the stressed-out state because you can't eat anything and you can't go anywhere or do anything, basically. So by freeing your mind of that to a large degree — obviously processed food probably out, anything with chemicals, additives, all of that sort of crappy stuff, that's a given.

Dr Christine Houghton: That's a given.

Lisa: So if we can go with whole foods, real foods, organic real foods, then take your pick, and the more diverse your diet should be, the more diverse hopefully your microbiome will be. Diverse like a rainforest is better than one that's eating the same. You see a lot of people, they're on a keto diet or something, and they're just eating broccoli and chicken breast. It's gone too far when you're not having a variety of the beautiful foods that are available to us. And sprinkling, having a little bit of garlic in your cooking is different than having a garlic extract or an oil of oregano. Having a bit of oregano leaves sprinkled on your salad is different than when you're doing a very concentrated—

Dr Christine Houghton: Well, if you're talking about the oregano leaves, there's not much oil in them, whereas when you take an oregano oil supplement you have a very concentrated amount. Again, if it's not possible for me to eat enough of that food that I can get out of a supplement, perhaps I shouldn't be eating it. I mean, that's a pretty simple principle. It's like a thousand milligrams of vitamin C as a supplement — that's 16 oranges, for example. Would I eat 16 oranges every day? I could, but I'm probably not going to do that.

Lisa: I did have a question about that, because I've been a huge fan personally of intravenous vitamin C in relation to cancer, and done a lot of interviews with the scientists in the world of cancer research and intravenous vitamin C in particular for that and for sepsis. Is it a different thing, because it's a pro-oxidant when it's—

Dr Christine Houghton: Totally different process, totally different. Extreme situations. I see intravenous vitamin C as probably a safer form of chemotherapy, if we can be simplistic like that. Yes, it's highly pro-oxidant, and that's what it's supposed to be. But unfortunately a lot of the studies get conflated, and individuals see, you know, somebody had 10 grams intravenous C, I'm going to have 10 grams of tablets. Oh, that doesn't work. And it doesn't work.

Dr Christine Houghton: And the other thing that's not well known: you've got a saturation level of about 400 milligrams of vitamin C a day, as much as you can reasonably absorb for most people. You can get that out of food. You don't need those mega doses. This is part of the old science that comes from the '70s, where the old masters, Pauling and some of those people way back then, thought that that was what cells wanted. And there are mechanisms that you can describe. So Abram Hoffer, for example, used really high-dose vitamin B3 in schizophrenia. So he was driving a biochemical reaction to completion to try and force certain enzymes to work. We now know doing it that way — well, that's what we thought back then, and as time's gone by we've learned more, our understanding has grown.

Dr Christine Houghton: And as I mentioned earlier, the completion of the Human Genome Project in the early 2000s was pretty much a line in the sand where we had to start looking at how cells function in a different way. And so most of my work post-clinical practice has been in that post-genome era, if you like, where we've now started to look at the signalling molecules that are in plants. It's not the vitamins and minerals, it's 5,000-odd other molecules which include polyphenols and carotenoids and isothiocyanates and so on. You can't get that out of a multivitamin pill.

Dr Christine Houghton: And so this is where people on these highly restrictive diets can get into so much trouble. They go, look, I'm taking folate and I'm taking my multi, I'm taking zinc and I'm taking glutamine. They're still sick, because that's not activating these intracellular switches that nature uses to upregulate its own defences.

Lisa: And I think we just have to come at things from a humble point of view, that we're just still scratching the surface of the complexity of the human body and the way we work. And every decade that goes by, we're uncovering more and we'll be able to help people in much more efficient ways, like with your protocol, that's really taking it to a next level and simplified it. That's what I've been so excited about, is it simplified a lot of the things for me. And I think that's the beauty in simplicity, if you can have just a couple of concepts that you're getting that are really upstream of all the other stuff.

Dr Christine Houghton: You don't need to be a cardiologist or a gastroenterologist or a neurologist or whatever. Better that you're not.

Lisa: Exactly, because then they have more and more specialised knowledge about less and less. And you need those specialists, don't get me wrong, for when you're in extreme cases, and we're talking more for the person who's not in those extreme situations. But when you can go upstream and be in this preventative space, which is what I always preach at people — to try to be preventative.

Lisa: I do a lot of genetic testing in my company, and I do like to know the genetic predispositions and then look at the epigenetic side of it, how are they actually expressing, and how can we marry the two to give that person an ideal lifestyle framework to work from. But we're still not — just because you have the MTHFR genetic SNP or whatever, it does not mean you are sick, it does not mean that you have a disease. It just means that you might need to be a little bit more careful that you're getting certain things going, and if you feel like you're not well then maybe going and getting your levels tested, or taking an intervention that will help support that methylation. It's not a "you have this, therefore you are XYZ".

Lisa: I have very poor GST genes personally, which is the glutathione family of genes. I've got an absolute disaster. So for me, anything that supports that Nrf2 pathway and the glutathione and all that sort of thing is very important to me, because I know I have a genetic predisposition to having problems with detoxification and so on and so forth. And I'm the canary in the gold mine. I've managed to get myself to a level now — being quite a severe asthmatic, or very severe asthmatic as a child, and having all sorts of allergies, eczema and all of that. So I don't have any of that anymore.

Dr Christine Houghton: Well, that was back to your clinical trial question, so we got sidetracked with that, because asthma and eczema are two other conditions for which there have been sulforaphane clinical trials. Along with autism — there have been a couple of studies on autism.

Lisa: Who would have thought? That makes sense.

Dr Christine Houghton: Helicobacter pylori, the gut infection. So that's not related to Nrf2 — sulforaphane has another mechanism.

Lisa: That's the isothiocyanate.

Dr Christine Houghton: And we don't want to eradicate Helicobacter.

Dr Christine Houghton: We just want to bring it back under normal control. Most of us have Helicobacter, but we're not necessarily sick. And there's been studies on arthritis. I mean, theoretically, as I've said, I don't really care what the disease name is, because I'm trying to optimise the function of the cells in that person in front of me. And whatever their particular predisposition, their weaknesses are, their signs and symptoms, we would hope that all or at least some of those will disappear just by normalising cell function. And with the GEMM protocol, what we say is the science is complex but the implementation is simple. And in fact, sometimes it seems so simple that some practitioners are going, how can that work?

Lisa: Yeah, don't I need a bit of this and a bit of that on top? But I heard one practitioner talking about her experiences and she said basically 95% of people who come through the door, they're on the GEMM protocol before she's done anything, because she's found it to fix such a wide variety of problems. And then, as you say, dig in deeper into certain things once you've got that cell in a homeostatic state, hopefully, and then you can fine-tune with other things.

Dr Christine Houghton: But also part of teaching patients how to maintain that state of wellbeing. And it means you have to change your diet. There's no shortcut to this. If a patient is really not prepared to get their diet under control, you can't really fix this in the long term. But I think a skilled clinician who can work with food and talks to the patient — what sort of things do you like and dislike? — we can pretty much work an eating plan around maintaining the principles that are needed, but also taking into account, you know, I don't like asparagus and I do like beans, or whatever it is. We can work with that. I mean, we don't all like all the same things.

Dr Christine Houghton: And we don't have to eat according to the plan 100% of the time. Even when I was in practice I would say to patients, we have the 90% rule, and usually the 10% is going to happen on the weekend when you're out. Eat what you like.

Lisa: And we want to live, you know. And if we obsess all the time about every thing that you're sticking in your mouth, you make life pretty miserable.

Dr Christine Houghton: Short term, if you're a diabetic, I'm not very — I don't give much leeway on that until we get everything back into control. So to me it's a lifestyle. It's not impossible. And if a patient feels the benefit and then they stray off the track, they'll realise after a while, I've broken this rule and that rule, and they'll often go back to the clinician and go, can you just get me back on that again? Otherwise they'll do it themselves. So it's just learn as you go.

Lisa: In fact, actually, on that point, is there a point where you should go off sulforaphane if you are taking it as a supplement or even as a broccoli sprout? Can there be such a thing as having too much Nrf2 activation?

Dr Christine Houghton: Because we have those modulatory pathways built in. As I said earlier, if we ate the perfect diet and lived the perfect lifestyle, we are continuously upregulating Nrf2, and nature will go, okay, we'll just leave that alone today, but yes, we need it again tomorrow. So those checks and balances are built in. So no, you don't need to stop taking it. I mean, people do.

Dr Christine Houghton: In a paper that I published recently, I've got some photos of some skin conditions, psoriasis and eczema, for examples. That psoriasis patient that's in there, I've got photos once a week of his elbow recovering over four weeks.

Lisa: Wow.

Dr Christine Houghton: And this was back from 2011. I wasn't in practice then. He was actually the agent who was selling our house at the time when we got talking. And because he was an agent, he had white shirts on every day and blood was seeping through his elbows and he was embarrassed. So that's how he became my surrogate patient for a time. But he got such an immediate response from taking one of the sulforaphane-yielding supplements, he said, would you like me to take a photo every week? Yep, sure, please do. So I've retained those photos, and I still talk to him. He probably three or four times a year will go back onto about two months of one of these supplements and then he's all right. And he manages that. He starts to see his elbows and other parts of his body scaling up again, he'll go, uh-oh, I need to go back on it. Because we know psoriasis has a strong genetic component, so we can't change that gene, but we can change the way some of those genes are expressing themselves. And that's what we're doing with him. So he'll stop and start according to his own requirements, and that's because he understands now what he's trying to achieve and what works for him.

Lisa: And there's quite a lot of research around cancer, and without getting into specific types of cancer, but just as a preventative approach, this would seem to me like a good idea to be putting into your regime if you're concerned or have got a family history of cancers and so on — maybe to put this in your approach.

Dr Christine Houghton: Yes. And you mentioned doing your gene profile and your GST genes. There's another gene, the phase two gene, that should be in your profile called quinone reductase. And quinone reductase is an enzyme that is at the very last step of your detoxification process, just before DNA is about to be impacted. So if you're detoxifying some nasty petrochemical, let's say, and you go all the way through, your GST genes are letting you down a bit, they're not working as well as they should, you get to quinone reductase. So this is a fork in the road here. So either you will now mutate your DNA because that nasty chemical whacks onto your DNA, or a healthy quinone reductase will grab that partly broken down toxin, drag it back to the beginning of the phase one detox pathway, or phase two, and represent it again. So gradually you're breaking that down. That's the power of prevention. And quinone reductase is an Nrf2 target gene. So that is a very powerful preventive. And I just think nature is brilliant.

Lisa: So it's sort of the last step and it grabs it — second chance, go again, go again, and you'll finally get broken down and removed from the system. And that's important for oestrogen.

Dr Christine Houghton: Yes, exactly.

Lisa: And also for the dopamine pathway. With dopamine being broken down, it can go to that quinone, oxidised dopamine, unless you can break that down further. So there's just so many different pathways that are impacted.

Dr Christine Houghton: And if we can optimise the function of those pathways, even if we don't fully understand how they work, that's the power of food. That's food as medicine.

Lisa: Are there any other herbs and things that also create the sulforaphane in the body, or is it only the broccoli, cruciferous family?

Dr Christine Houghton: So it's only cruciferous vegetables. It just happens to be that the broccoli sprout is sort of the most potent, most powerful vegetable. Arugula or rocket, that's another one in that same family, which produces a similar kind of molecule called erucin. Cabbage produces sinigrin. So all of the cruciferous vegetables all have the myrosinase enzyme, they all contain a precursor that gets produced when you eat it. When you cook the vegetable you do kill the enzyme, so you lose some of that. So you need to have some raw and you can have some cooked.

Dr Christine Houghton: There are other molecules. Because I'm saying to you the perfect diet upregulates Nrf2, pretty much all plant phytochemicals have some ability to activate Nrf2. When you put them all together you're going to get sort of an additive or possibly even a synergistic effect. We don't know exactly how far that goes. But I have also published in some of my sulforaphane review papers charts which look at the ability of sulforaphane to upregulate quinone reductase — so that's that DNA-protective enzyme. So you see sulforaphane's way up there above the rest. The next one down is pinostrobin. That's a molecule we don't really hear of, but it's in galangal, and galangal is an Asian rhizome that's often used in cooking. And then, pretty much dropping pretty rapidly, andrographis is in there next, and then the others like the curcumin and the silymarin, they're pretty low. And it's interesting, because silymarin, or silybin — milk thistle — has been used traditionally as a liver detoxifier or protective, but its effect is very, very minimal compared to what you get from sulforaphane, andrographis and pinostrobin.

Lisa: Wow. What about rosemary? That's an Nrf2 upregulator, but through a different molecule too, isn't it? It's not through the sulforaphane.

Dr Christine Houghton: Yes, and you've got bioavailability issues again here. So rosemary oil is a very good antimicrobial and they're using it in the food industry on packaged meats and things like that now. So it has other properties. I mean, I'm really all in favour of encouraging people to use as many herbs and spices as possible, marinating foods, making all sorts of interesting, tasty different foods. And I think once people get the hang of how to do that, it's remarkable how many additional signalling molecules you're getting in your diet.

Lisa: Yeah, and we can put them all together and hopefully have a synergistic effect. That's the next 30 years' work probably cut out right there. Dr Christine, you've been absolutely fabulous today. I could talk to you for hours and elucidate a thousand more things, but is there anything major that we've missed out that you think, yeah, we need to say that too?

Dr Christine Houghton: Well, just back to the cancer story. So most of the sulforaphane research is done in prevention, which I think you alluded to. The issue of cancer treatment is a totally different one, and I don't think we really have any definitive answers on that. So I just want to make sure your listeners realise that I'm not promoting sulforaphane as a cancer treatment. I know there are lots of people who do take it and claim that it's helped them, but we just don't have the evidence for that. But certainly prevention — there's brilliant research on prevention, and there's a good mechanism there that we can see why it would help.

Lisa: And it's always with cancer, sometimes something that's fabulous to take as a preventative is not necessarily good when you've got an active case of cancer, unfortunately.

Dr Christine Houghton: And I think one of the real reasons for that is, by the time somebody has cancer diagnosed, there has been a whole chain of protective mechanisms have failed one by one, and the patient didn't know — maybe some vague symptoms that they ignored. Finally, by the time double-stranded DNA has been mutated, you don't have the ability now to repair a double-strand mutation. That's when trouble really hits, and we don't have a really satisfactory way of solving that problem. We need more work done on those areas.

Lisa: Yeah, I think that's a really important thing to bring up. It's just absolutely fascinating. I think if you're not having sulforaphane or broccoli or cruciferous veggies in your life, you better start taking them. And if you've got access to a practitioner that can do the GEMM protocol — and where can people find, do you have a directory or anything like that of people they can work with, first of all, to sort of understand a little bit more about the protocol?

Dr Christine Houghton: If your listeners go to the Cell-Logic website, cell-logic.com, there's a section called Learning Centre in the top menu. Drop that down and there's some general information about GEMM. If it's a practitioner, they will have to register to get that information, because it isn't all available to the public. But there are three videos on that general information which explain different aspects of what we've been talking about today. And then if they go to the Contact section in the website, we've got a directory of practitioners who've been trained in the GEMM protocol. And most of those practitioners work online now. Some of them work face to face in clinics. It's a different world now, but it's fabulous, really, because COVID changed the world.

Lisa: Yeah, it did. And that's one positive thing to come out of the last few years. Well, Dr Christine, thank you so much for being so generous with your time. I know I've gone a little bit over, but I really appreciate all the hard work that you've done and the amazing science that you've put into the products that you've brought out, and this protocol that you've spent years working on, researching, doing the hard yards to bring it to people. And it's helping so, so many people. So thank you so much for everything you do. It's absolutely amazing.

Dr Christine Houghton: Thank you so much, Lisa, for having me on your show.