Health Trend: Cannabis Therapy with Dr. Marissa Magsino

INTRO: Welcome to Qualgen’s podcast where we talk about all things health and wellness related, including hormones, pharmaceuticals, health trends and ways you can help better your life.  

JP: Hi everyone! Thank you for taking time out of your day to listen in. Toda,y I am talking with Dr. Marissa Magsino! Dr. Magsino is based out of Florida. Her practice is centered around helping patients rediscover vitality and energy through bioidentical hormone replacement therapy, PRP therapy, cannabis therapy and much more! Dr. Magsino thank you so much for joining me today!  

MM: Good morning, Jennifer. I'm so excited to be here. Well, thank you for inviting me.  

JP: Absolutely. I've been looking forward to this conversation for a while, but before we get into the medical side of things, can you just give us a little background on how you got started in the industry you're in?  

MM: Well, I've been trained as an internist pediatrician. That's my background, practicing in general medicine for over 25 years in Orlando. And one point and, and at a time in my life, I realized I was getting going through anxiety and mood disorder when I was in my forties, I realized that it was horrible because it was causing so much burden for me as a clinician. And, you know, a conventional doctor would be working many hours from 80 to 120 hours back in the hospital days, you know, rounding. And I said, there's gotta be another way here. And so I happened to chance on the spring convention of the A4M or the American Academy of Anti-Aging Medicine back in 2006. And lo and behold, I saw myself, I said, oh my God, I'm peri-menopaused. I'm going through the change. That's exactly me. What I did is I saw this treatment which is bioidentical hormone. Back then, I was in my early peri menopause possible time and was started on hormone therapy and I'm so grateful for that, this fast forward that has changed my life maybe more complete as seeking more functional and not just. I diverted my practice to a nonconventional practice. And so embracing the physiology, biochemistry of how diseases rather than the knee jerk reflects of reacting to illnesses. Reactive medicine is what's conventional. I value the preventative side and realize the epigenetics of diseases where you can prevent cancer by fixing body, mind and spirit. So it was so natural for me when into 2017, the state of Florida have opened up and made and legalized medicinal cannabis. So aside from my bioidentical hormones, I, in 2017, I started to think really a route where I said I'm going to dedicate this functional medicine and all integrative medicine here, including medical cannabis, biodentical hormone, plasma therapy for regenerative medicine. And I've never been so fulfilled in my life and happy. So that's my story.  

JP: That's amazing. I love that. I think it's awesome that, I mean, you chose to go that route because of how it affected your life. I feel like so many people do it because they see other people doing it. But I mean, it's truly something that's worked for you to make that difference in other people's life. I think that's awesome.  

MM: One thing I learned at this age is you have to follow your heart and your gut not worry about the “okay, will I make money?” Because most conventional doctors, we were not taught much for business, always saying okay, will it be profitable? Will I be making money? No, follow your heart. And that's what I did wholeheartedly, my heart and my soul because I believe in the passion of healing patients that way and knew that if this will be the way. And so I got some even awards for being an innovator in this field and I forgot I, I also do sexual medicine. So I combined everything and it's such a great energy to share with other practitioners that you need to just be bold and daring and pursue what you're passionate about. You'll be fine. You'll be OK.  

JP: Yeah, that's amazing what awards did you get? 

MM: Oh, I got the award in 2018 in London as one of the top overall women in all different fields. Mine is in the fields as an innovator in the field of medicine. So that was amazing around the world, meeting all these wonderful women, Asian women who had excelled in their fields from business and commerce and education. And mine was in the field of medicine. So they value that they talk about sexual medicine, hormones and cannabis. So that was, that was really very empowering for me. And from then on, it propelled me to even speak more about this. So, I speak locally for communities and you know, women empowerment. I'm so much big on that.  

JP: That is so great. So, on the lines of cannabis therapy, I know that it's a newer therapy being used. Can you explain what it is?  

MM: So cannabis is actually just rediscovered, that's how I would say because back in 1936 it was used as an elixir, back then it was used for naseau and pain. Fast forward, some situations in the 1970s prompted them to ban this and, and noted it to be, you know, the forbidden, the gateway drug. So it was switched to schedule one in 1976 and everybody was afraid it was in the likes of heroine. The rediscovering was 30 years ago by Israelian scientists, Gaoni and Mechoulam which are Israeli physicians and they discovered the endo cannabinoid system like respiratory system or our endocrine system or nervous system. We have these receptor sites. So they discovered that the human being has receptor sites in the brain, in the joints, in the heart, in the uterus, in the vaginal wall, in moat muscles, in tissue, in the gastrointestinal tract. So think about it like a lock in a key. So you have a lock and the key is the plant, the medicinal cannabis or you know, the cannabis itself have the exact match to this lock in a key fashion like a perfect fit. So they discovered that there are things that will alleviate. For example, anxiety, depression, mood disorders, insomnia, there's gastrointestinal symptoms resulting from chronic like Crohn's disease, inflammatory bowel disease. When the receptor sites are binded, there's alleviation of symptoms like the spasms stops, the headache stops. So there is a complete like reversal of symptoms versus treating them with multiple prescription medication. And they, because I'm really up on their support for women and women's health, pelvic health, women suffer a lot for pain, pain around the pelvic floor, especially those that are still have menstrual cycle. They cycle, they have PMS right before the cycle and when they have cycle, they have pain menstrual cramps, receptor sites are there. So taking cannabis like THC and CBD combined can alleviate that PMS disorder where you feel like you're off and you don't want to talk to anyone. And then when the menstrual cramps come in, it helps with relaxing the uterine lining. So I actually, because women have more receptor sites than men, I always emphasize the women take more of your medical cannabis, specifically THC, right when you're having your menstrual cycle, because that cramp would be relieved. And at the same time, the CBD component helps with moods and irritability. What's also was found in most research is, is this women because they feel relaxed during their intimacy, whether they're young or menopausal women, they're finding that their intimacy is even improved because they're more relaxed. So this is the reason why I said absolutely, this is needed to be in my practice. I have a combination of bioidentical hormone optimized. And at the same time, you know, if they have any of those symptoms like insomnia, which is common in menopausal women, anxiety, pain during intimacy, then yes, you can combine and these are the happiest most completed female patients of mine. They give me their testimonial and we do have the studies. A few of the studies have been already printed regarding the receptor site for women. In fact, the A4M is now asking for that for women's health because they're supportive of this. This is like new that I'm discovering since I shifted my practice. So I'm so delighted next week for you to talk about they're inviting me because March is the month for women and we're gonna talk about women in and I will be in the panel to talk about the sexual side, sexual and hormone side of that.  

JP: Yeah, that is awesome. So what's the difference between THC and CBD? 

MM: THC stands for tetrahydrocannabinol and the CBD is. So there are two receptor sites, by the way, the two receptor sites will be specific for THC and CBD and CBD is the one responsible for the neuroplasticity for intervention of hyperexcitability of the nerves. For example, CBD is primarily used for seizures or epilepsy or post herpetic neuralgia, diabetic neuropathy, anything related to nerves, nerves like PTSD, you know, nerve pain, post traumatic, even from a traumatic brain injury, you will have hypersensitive nerves including like Parkinson's even dementia. The THC component is that the cannabidiol and the receptor site is responsible for relief of muscle spasm or relaxation. Yes, it is known to give euphoria or what we call high. However, the difference is when you have medicinal, you're not gonna have the munchies or high because it always comes in combination with THC and CBD. In other words, you're combining to occupy the two receptor sites versus some that you get from the streets where you don't know what strain you're getting and primarily it could just be full THC. So there is specificity, there's about 200 cannabadiols. These are the substances sub strain that are found in the cannabis plant in each one has, for example, specific function where it can lower blood pressure like CBG, it can stimulate bone marrow reduction or increased bone strength. It has the capability of having boosting of antioxidants, anti fungal and antiviral. And so it's just phenomenal, boosting the immune system. It's not just from THC, CBD because there's other substances in the cannabis plant. In fact, what gives the pungent smell is what we call terpines and terpines are the flavor. It could be mango and it could be lemon and adding these attributes to the plant causes that formation of the substance that makes you feel good. It is called anandamide, it's a word for feel good. So when all the receptors are binded and, traditionally, we only know those two substances, but in real life, there's 200 cannabadiols in a plant plus the terpines - combine it all together and it's called the entourage effect. Like whoa, when it hits you, it feels good, you have relief of muscle spasm, pain, irritability, joint pains, the most important thing is the person relaxes. And as a hormone specialist, I just don't deal with sex hormone, you deal with cortisol being the most important hormone from COVID-19. The craving for sugar and salt is driven by fear of the new thing, a change. Cortisol surges and that makes you crave for sugar and salt. So when you're relaxed, the cortisol level comes down, inflammation is prevented. Then the patient loses weight, they're more relaxed and of course, combining with bioidentical hormone that also mitigate those symptoms of anxiety, depression, I'm gaining weight, I'm off, I have no libido, so can you imagine a combo of all plant drive medicine that's alleviating symptoms in men and women? But you know, I'm more definitely have seen this more in women. Their blood pressure comes down. I even have one male patient who I had mentioned, has a pacemaker. He came in for lumber spino his back pain and he is seeking medicinal cannabis for pain and lo and behold serendipitously, he noticed that his heart rate, his pacemaker is not firing as much as it used to be. But you know what's interesting is we have receptor sites in our heart. So, I even, you know, jokingly told my cardiology friends, maybe you can discover like the latest CBD cannabis capillary, those arrhythmia and everything will be cool. You know, because these are, we're still finding it. It's just the tip of the iceberg. We're finding more and more.   

JP: Yeah! 

MM: There are different modalities that we use. So, the way it's given, it's not just you smoke it. We even have inhaler, we have tinctures, we have the gummies, we have edibles.  

JP: Wow.  

MM: Yes. And you have topical cream where you can apply directly and it could be given in a vaginal suppository.  

JP: How do the different ways that you take it, how does that, does it affect you differently? I mean, obviously like hormones, you know, if you use the cream or the troches or something compared to the pellets, like, it's going to have like the highs and lows is that kind of the same thing?  

MM: Yes. So, the very simple rule when I tell patients, especially if they're a newbie, they've never smoked medicinal. They always think, oh my God. I don’t like to smoke, I don't want to smoke. The, the simple rule is anything inhaled, whether through an inhaler because we do have an inhaler, a cannabis inhaler that just looks like any old inhaler. Anything inhaled vape or smoke will be in your body and giving you efficiency for relief symptoms between 2 to 4 hours and anything you take orally, whether it's a capsule because they are also available in capsule and tinctures, you put the drops and the edible, which that, that would be efficient and good in your body for 6 to 10 hours. But like you said, in edible, anything oral, it takes about half an hour to an hour for it to hit your system and relieve your pain. Just like pellets are efficient because it consistently relays. When you take an inhaler in 2 to 5 minutes, you get it right away. The cream form of cannabis would be about, the topical forms would be about half an hour to an hour. So anything oral, topical takes longer to get into your system whereas it's spray now that will be efficient within 2 to 5 minutes. 

JP: That makes sense. And does this smoke, how does it affect your lungs? Like, is it, I mean, obviously it's not like a cigarette smoke with the tobacco, but does it affect, like, have any negative effects on the lungs?   

MM: Well, you know, it's really not like a negative effect but it depends. I always ask, you know, physician clinician, we always ask the patient if they have an existing lung condition, if they have asthma, COPD, because if they do, then I wouldn't recommend that to be the route of therapy. If they're in pain, they should prefer oral with capsule or inhaler. Just like anything. Anything if you have existing preexisting condition, I wouldn't advise that. But fast forward if you're thinking about that can cause lung cancer, I don't think so. There's not any studies that shows it can cause cancer in fact because you don’t have to smoke like there in rolls. There is also the option to get the grounded material and put it in, like people call it the bong, but most through a medium like water, they could be also dry inhalant where you don't have to smoke it. So that does not, there are other ways to alleviate it without having to cause damage. And of course, the most controversial last year was the question of vape. It's the oil. So it's not an MCT oil or those type of oils that were reported that cause lipoid pneumonia in young cigarette smoker vapors that are young people, they're not using that type of oil. The medium is their cannabis or if it's MCT is very minimal. And so a lot of times the patients do not, I have a, I have over 1,000 patients. None of them have new onset asthma or have developed COPD because when, when you have, when you smoke, you're not smoking it forever, you probably would puff maybe two or three. You're not gonna finish the whole joint in one session. That's not the case. It's why you're really, you get it twice, then you're OK. All right. So that whole joint takes too long. It's not something that you have to finish. So micro dosing is important like gummies, you don't consume the whole gummy, start with a quarter. OK? Then advance even with tinctures start with .25 to concentrate. I have one lady who took the whole syringe and they couldn't wake her up. They took her to the hospital but you're not supposed to do - 

JP: Oh, no 

MM: So it’s important for the physician and patient relationship is to let them know, be careful, micro dose, high treatments, it’s personalized is not one size fits all. You may get a healthy patient with high tolerance to cannabis and delivery time is lower. We are limited in the state to 2.5 ounces in the state of Florida every 35 days or, or amok flower and everything else in the recommendation are given every seven months.  

JP: Interesting. And I know you've been helping many patients with that have breast cancer with cannabis. Can you tell us more about that and how/what you've been doing there? Because I think that's amazing.  

MM: Yeah, I'm affiliated with a local community here of women that have survived breast cancer. With breast cancer, those are actively in therapy. The chemotherapy induces severe nausea and vomiting and that's where medical cannabis takes an important role that they're awake, alert and they take the oral tinctures or they smoke it, vape it and they have relief of these horrible symptoms of nausea, vomiting, the gastrointestinal part where you feel like retching. Instead of being medicated, overly medicated, with those anti vomiting medication, anti drugs can cause so much side effect like, you know, the pain and things like that. Another part of the ongoing treatment will be headache, insomnia, you know, they're gonna be stabbed, especially those that cannot, they're not given hormone. So, and most of these women have concomitant symptoms of insomnia, anxiety, pain. That's where THC is so important to control pain, headache, post surgery, they would be swelling the lymphoedema which is handled so much with the combination of CBD and THC. So we maintain them for therapy from the time they're diagnosed, going through the therapy and post therapy and even in the support group, because after all of the radiation, chemotherapy, surgery is done, what's left behind is a woman feeling like I feel off, I'm depressed. You know, these things were horrible. It's how do I go from here? I still can't sleep and it's like being hit with menopausal symptoms all over again. This is where I find that obviously we can't give hormones, but you can give the cannabis to alleviate sleep deprivation, pain, depression, anxiety, they can have a lot of the swelling, which is also alleviated. And of course, they're high risk for infection. We give medical cannabis for immunocompromised patients, AIDS patients, and so this is one of the things that you know, when I share with them, they find that compared to taking morphine or pain prescription, they find that they're not totally just in bed and nonfunctional. They find that when they taking medical cannabis versus pain prescription, they're awake, alert, they're able to have relief of pain, but they don't feel like drugged. You know what I mean? They're sleeping the whole entire day and no interaction.  

JP: You don't have the, you know, the possible effect of the addiction that comes with that pain medication too.   

MM: The pain medication that you know that that was approved here because of that, there were about 56,000 deaths from opioid addiction right before we had the medical cannabis. And then since then, it dropped 40,000 and there have not been any reported cases of dying from medical cannabis because technically you have to consume, you die 10,000 brownies in 10-15 minutes. Can anyone do that? Obviously not, you can't smoke as much to really die. So no one has died. The most common adverse effect will be if you take too much, you're just gonna be nauseous or you sleep too much. Yeah, of course, we have to caution you don't smoke and drive, don’t do that.  

JP: I know we were talking about COVID earlier, have you noticed, and this is kind of going towards the hormone side of it. The stress that comes with COVID that you were saying with all the changes and everything, people going through their, like their pellets faster because of stress. Have you noticed that last year?  

MM: Last year was a game changer, because we're discovering new things even as from a clinician point of view, you're absolutely right. This has never happened before. I've been a hormone specialist since 2009, and what I'm finding because we closed down, we, I couldn't do the pellets for a few months and I had to switch them and I noticed because I had to run all of their full hormone panel. I was alluding earlier. Their cortisol was skyrocketing high. They have adrenal stress, dysfunction from what was going on with COVID and, and so they were relying on the hormones to also help them alleviate insomnia, anxiety, pervasive during that time because you're fearful. And the fact that, you know, the aches and pain and I guess even, even sexual dysfunction was causing this because, you know, all of a sudden everybody's in the house and then all these new things. So from the definition of a physician clinician, the hormonal pattern are they use it up because cortisol is on the rise, there's deprivation, there's a momentarily shut down of their sex hormones because the primary pathway, if you remember the physiology, the primary pathway during COVID and a fearful situation of 2020 was to produce cortisol, the fight or flight hormone. Thus, they needed more to alleviate the sex hormones to come up because this cortisol level was high. So in, in that adrenal pathway from bringing along to tunneling down to and then to testosterone at this post, think about it. It was so imbalanced cortisol was rising and too high, but then the sex hormones were dropping. So we had to repellet. I had had to repellet it every four months when we open up when we were allowed to be open and oh my gosh, we were just going through. Even up to now, people have realized they realized, oh, no, it's the best thing ever that was the test for them because switching to oral/topical was no good for them. And it was not enough to sustain. So, to me, as a clinician, I'm, I was like, oh, my goodness, this just makes sense that we give them and now I'm giving it to them every 4 to 5 months, not six months because definitely that started working out now in the gym, in their home and they need that testosterone boost, because they're using it up. They're all looking good.   

JP: They're flying through it. 

MM: We're flying through it, we're using it up. I said, yeah, your body is using it up because now you're concentrating on your health, you're exercising and we're alleviating, everything's balancing with your cortisol coming down because your, your sex hormones are coming up as well to catch up. But that, yeah, that's what I notice too. I'm sure the other clinician have noticed that as well. That's the reason why the cortisol what can bring down cortisol in my practice is medical cannabis because they, in a moment, they're like I could sleep, doctor. Sleep is important because sleep deprivation messes up your cortisol level that the urinal clock will be messed up. And so when cortisol is high, you're going to gain weight because you're craving for all this very salty food. And then I explained them the physiology, then they get it and they said, oh, that makes sense. So 10% weight reduction for my medical cannabis patient when they come back in seven months. And I would always tell them listen, your cortisol will come down when you're relaxed and that's through the cannabis and even better if you have an bioidentical hormone, that's the best value. I am one the clinician who's taken care of by a hormone therapy pellet and at the same time, I'm also a legal card holder and that alleviates my pain, my insomnia. And so I feel so much I'm going to be 60 this year, but I feel like I'm just 40 because I can function. I can help my patient be productive. You know, focus on my health. As a healer, you need to heal yourself and that's what I found. I, I'm hopefully sharing it. Why, why not it educational as well to realize as healers don't give, we have to be healed as well in order in order to provide. 

JP: Absolutely, what I do think is really neat. I mean, you're doing the hormone pellets and the cannabis and they were both so common back in the 1930s and I don't think people realize that about pellets is that it was started back in the 1930s and then they both dropped off.  

MM: You know, I got, I, I found out about that because I did my certification for the International Hormone Society in Belgium.  

JP: Oh, wow! 

MM: Yeah. So in 2016, I went there, I said, what, what are they doing in Europe? How are they managing? That's where I found out about pellets. We are actively doing that more in Europe and in Australia than us here, which is slowly. So it was fantastic. That's how I know 1936 that was golden moment for cannabis and hormone pellet in particular.   

JP: Yeah, no kidding. It's amazing. What is your favorite thing about functional medicine?  

MM: My favorite thing about functional medicine is because it is so simple. It makes sense when I explain. Why do you feel this way? Think about it. I'm not your waitress giving you everything you want to order. I'm here to sit down, listen to you explain to you the physiology and yes, you can change it, relieve it, change your epigenetic even though you have breast cancer or diabetes in your history. It is you because it's a body, mind and spirit concept and patients find it that it's more valuable. I spend about an hour at the minimum is half an hour. They find the value of a clinician explaining the physiology going down to the root of the cause of their illness. And it, this is what they tell me. It just makes sense, Dr. Magsino. You know, I said absolutely. Listen to yourself on to yourself, love yourself, know yourself well. Confucius have already said that many times. We've never believed it. Don't look outside and look for them. And you know, the, and that's what functional medicine is when I diligently spend the time fixing the physiology. They get it. Simple. When optimizing this I say, OK, you were given a number, you're up to 10. Do you want to stay at one or do you want to stay at close to 10? And it makes sense when I'm driving the hormone level up, you're not gonna settle for this amount of hormone when you could be higher, feel younger and more productive and have more vitality. There's no question asked when I said that when they come back for their post pellet labs. And I always do. I said there's evidence based in what I do here as a clinician for hormones, you come back in 8 to 10 weeks, we're gonna run your test again. I want to see how you feel, because that can help me modify how much are you, are you using up with your pellet? You're using it quickly, you're using it up. Yeah, depending also your lifestyle. So the numbers guide me when they come back and now they value that. They said, oh, I love that. So now even my practice started growing because not just by word of mouth, but they love the fact that we take the time to explain. I said it makes sense.  

 JP: Yeah. Well, and, and listen, I mean, I feel like it's so hard to find providers that listen to actually what you’re saying and like you said, instead of just throwing a prescription their way, let's find out what's wrong. And let's fix it.  

MM: Yes. And I always tell them we have to be patient because it's a process. It doesn't happen overnight. One thing COVID taught us is we need to just be patient. It will all soon pass, but we just have to be patient. Nothing is going to be perfect.  

JP: Amen to that.   

MM: Just relax. 

JP: Just chill out for a little bit. Absolutely. Well, is there anything else you would like to add?  

MM: I think that's about it. Unless if you have any other question, there's nothing else I would add. I think I talk so much about my new passion of combining resources in plant medicine and I'm just so thrilled to share this with any practitioner who wants to get my feedback because I have, I have really data on how many female males on both combination therapy and it's advancing more like I'm finding more relativity and, and as a healer, of course, at the end of the day, I've done the best that I can and to see results of patient having have happy lives, more focus, more endearing lives to them, more gift for them to pursue what they're passionate about. So, I love to share. But thank you for inviting me to speak about this.   

JP: Yes, thank you. I really enjoyed it.  

MM: Yes. Thank you, Jennifer.  

JP: It has been great. For more information on Dr. Magsino, please visit her website at marissamagsino.com or you can find her on Facebook at Marissa Magsino MD. 

MM: Thank you so much.  

JP: Thank you everyone for listening! Please make sure to subscribe and follow us on social media to stay up to date on Qualgen! 
 

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