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Kevin Tin, MD
Gastroenterology
- Triple board certified in Internal Medicine, Gastroenterology and Hepatology, and Obesity Medicine.
- Medical Director of the Gastroenterology and Hepatology division of Excelsior Integrated Medical Group, which is one of the largest multi-disciplinary groups in the New York City Metropolitan area.
- President and founder of Fujianese Medical Association of America, a 501c3 approved non-profit organization geared to eliminating healthcare disparities for underserved populations.
Dr. Tin completed his undergraduate studies at Stony Brook University. He later completed his medical education at the American University of Antigua College of Medicine as well as a Master’s in Healthcare Administration at Plymouth State University. He completed his internal medicine residency and gastroenterology fellowship at Maimonides Medical Center and completed a clinical transplant hepatology training at New York University Langone Medical Center. He was selected as Chief Fellow during his gastroenterology training and hold affiliations with Maimonides Medical Center and New York Presbyterian-Brooklyn Methodist. He is certified in performing advanced endoscopic procedures including endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP).
He is an active member of various professional societies including American Medical Association, American Society of Gastrointestinal Endoscopy, American Gastroenterological Association and the American College of Gastroenterology. He had the honor of becoming a Fellow of the American College of Physicians. He has been active in clinical research and has presented at multiple national conferences as well as publishing multiple articles in globally recognized journals. He is a consultant speaker for Gilead Sciences and AbbVie Inc. He has also been recognized in the New York City community for outstanding community service.
View ProfileEpisode Information
July 28, 2021
Gastroenterologist Dr. Kevin Tin talks about his unconventional youth, the important role of probiotics and the gut microbiome, his fight on behalf of under-represented populations, new developments in gastroenterology and hepatology, and more.
Topics Include:
- Kevin’s upbringing and working in his parents’ Chinese restaurant
- His fascinations with various internal organs
- New research into the gut microbiome and fecal transplants
- The mysterious workings of Eastern medicine
- Kevin’s organization and what it aims to accomplish
- The benefits of colonoscopy and when you should get one
- Why he joined Doctorpedia and his plans for the Gut Health Channel as CMO
- Exciting new developments in gastroenterology and hepatology
- His personal wellness routine and diet
Highlights
- “The liver has a lot of different functions. Just has so many different processes. It metabolizes all the nutrients, metabolizes alcohol, and has a number of different enzymes that help with different processes. It’s just a very vital organ. And it’s almost like a Brita filter of your body, essentially.”
- “When I was a kid, I sprained my ankle. And then my mom takes me to this Chinese herbalist who treated me by making some sort of concoction. And he spread it all around my ankle and then wrapped it up and the next day, the swelling was all gone. I have no idea what he put in it, but things like that actually treated me much quicker than sometimes what we as doctors can only recommend.”
- “We created the [Fujianese Medical Association of America] to help educate, help a patient navigate and make sure these patients are followed up appropriately with the latest guidelines. The other main point also is to help the younger generation kind of help guide their path, give them opportunities in the medical field to let them really decide what they want to do with their future.”
- “In terms of the antibiotics and probiotics, it goes back to the composition of bacteria that we have inside our microbiome. And what happens sometimes is when you take antibiotics, yes, you are killing the bad bacteria that’s causing whatever issue it is. But at the same time, you’re also wiping out the good bacteria. So most physicians recommend probiotics to kinda keep that good bacteria colony afloat.”
- “The [gut] microbiome, again, is a very, very interesting topic just because a lot of it we don’t know. And it does seem to have a major, major impact on one’s health.”
- “[What I’ve learned from COVID-19 is to] never take anything for granted. Treating every patient to the best of our abilities, and just ensuring the safety and overall health of our patients. I think as a healthcare provider and as a physician, we chose this pathway to help the people.”
- “Spacing out your meals appropriately, making sure you get a solid breakfast in the morning and eating a high fiber diet [is how I stay healthy].”
Episode Transcript
Daniel Lobell: (00:00)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only and should not be taken as medical advice since every person is unique. Please consult your healthcare professional for any personal or specific needs.
Daniel Lobell: (00:19)
Hello and welcome to the Doctorpedia podcast. I’m your host Daniel Lobell and I’m honored to be joined on the line today by Dr. Kevin Tin. How are you, Dr. Tin?
Dr. Kevin Tin: (00:29)
Doing well, Daniel, thank you.
Daniel Lobell: (00:31)
Well, thanks for doing the show. I got the great opportunity to watch some of your videos on Doctorpedia.com before doing this interview. And I’m really excited to talk to you about them. They’re really well done, but let’s go first back to the very beginning. Where are you from? Tell us a little bit about your childhood, please.
Dr. Kevin Tin: (00:48)
Sounds good. So I was born in Manhattan, New York.
Daniel Lobell: (00:54)
I’ve heard of it. [Both chuckle]
Dr. Kevin Tin: (00:57)
Yeah… It’s a tough place for people to find, every now and then. So pretty much lived there till I was about to go to middle school. And then my parents took me, kidnapped me and brought me to New Jersey where life was completely different for junior high school and high school.
Daniel Lobell: (01:12)
What’d you do in Jersey?
Dr. Kevin Tin: (01:14)
Half the time I was going to school and the other half the time I was working in my parents’ restaurant.
Daniel Lobell: (01:18)
What was that like?
Dr. Kevin Tin: (01:18)
They really wanted to enforce the value of hard work and not to have any friends —
Daniel Lobell: (01:25)
Not to have any friends?! [Both laugh]
Dr. Kevin Tin: (01:26)
So pretty much you’re like, okay, your schedule is eight to three. You go to school, you come home, do your homework, and then you go to the restaurant when everyone’s about to eat dinner. And that’s about it.
Daniel Lobell: (01:38)
What kind of restaurant was it?
Dr. Kevin Tin: (01:40)
It was one of those Chinese takeout restaurants.
Daniel Lobell: (01:42)
All right. Are your parents Chinese?
Dr. Kevin Tin: (01:44)
Yes, my parents are Chinese.
Daniel Lobell: (01:45)
It’s all starting to come together. [Both chuckle]
Dr. Kevin Tin: (01:48)
Yes, yes. It makes sense.
Daniel Lobell: (01:50)
How was the restaurant? Was the food really good?
Dr. Kevin Tin: (01:52)
You know, I actually miss them having a restaurant. Just being able to order whatever you want off the menu at any time.
Daniel Lobell: (02:00)
And then your mom has to cook it. [Daniel laughs]
Dr. Kevin Tin: (02:02)
Yeah, well, yeah. Now my mom would make my dad cook it.
Daniel Lobell: (02:08)
Oh man.
Dr. Kevin Tin: (02:08)
Yeah. You get the point of it. But yeah, I miss those times a little bit just for the privilege of having food at your disposal.
Daniel Lobell: (02:16)
Yeah. Definitely. I’m sure that there’s a certain nostalgia looking back at that time. Although at the time you were probably pretty pissed that you couldn’t go out and have fun.
Dr. Kevin Tin: (02:25)
[Kevin laughs] Exactly. Exactly. Everyone’s going to like prom and clubs and having sleep overs, I was just working.
Daniel Lobell: (02:32)
Yeah. You’re like, “I don’t care about beef and broccoli. Let me go out with my friends!” [Both chuckle]
Dr. Kevin Tin: (02:38)
Exactly. I tried to raise my voice one time and then I got a lot of repercussion for that. So I kind of left it at that.
Daniel Lobell: (02:47)
Yeah… I’m sure. You’re working in a restaurant and I guess you decided food business was not for you. [Both laugh] How early on did that decision come to you? And when did you decide you wanted to go into medicine?
Dr. Kevin Tin: (02:59)
Probably my first year being at the restaurant, I was like, “Oh boy, this is not looking good for me.” And I kind of stuck with it. Had to go to a college that was far away from my parents or at least a good distance away from my parents. Yeah. And then I decided to go into medicine probably sometime in college. My brother is actually a doctor as well.
Daniel Lobell: (03:21)
Did he also have to work in the restaurant?
Dr. Kevin Tin: (03:23)
He did. Definitely not as much as I did. He was kind of like a weekend shift person. And then I was like a full time, six, seven day a week type of person.
Daniel Lobell: (03:32)
As soon as this interview is over, I am turning off my equipment and I’m going to open a Chinese restaurant so that my daughter becomes a doctor. [Kevin laughs] It’s like the smartest move ever. Make them work in a restaurant. And they’re like, “I don’t want to do this anymore!”
Dr. Kevin Tin: (03:47)
If you need any business tips, let me know. I’ll deal with the recipes and everything.
Daniel Lobell: (03:51)
Thank you. Good to have that hookup. So where did you go to college?
Dr. Kevin Tin: (03:55)
I went to Stony Brook in Long Island.
Daniel Lobell: (03:57)
I know Stony Brook. I’m a Long Island, New York kid, too.
Dr. Kevin Tin: (04:01)
Oh, very nice. Whereabouts?
Daniel Lobell: (04:03)
I was born and raised in Flushing, Queens. And then my family moved to Long Beach, Long Island.
Dr. Kevin Tin: (04:08)
I’m actually in Flushing, Queens right now —
Daniel Lobell: (04:11)
You’re kidding!
Dr. Kevin Tin: (04:11)
— as a matter of fact.
Daniel Lobell: (04:13)
You can go visit my childhood home! I mean, how much fun would that be for you?
Dr. Kevin Tin: (04:16)
[Daniel laughs] That would be great. Give me the address, I’ll go there right now. [Both chuckle].
Daniel Lobell: (04:20)
How far are you from Union Turnpike?
Dr. Kevin Tin: (04:22)
Not too far, actually.
Daniel Lobell: (04:24)
So do you live in Flushing?
Dr. Kevin Tin: (04:26)
I live in Long Island. I live on the border of Long Island and Queens, about probably 10 minutes away from Union Turnpike.
Daniel Lobell: (04:33)
Well, you’re in my old hood. This just got personal. [Both chuckle] So you went to Stony Brook, you decided you want to go into medicine. And then at what point do you decide what you want to specialize in?
Dr. Kevin Tin: (04:45)
That’s a good question. So I think in my senior year, I was just kind of deciding, but actually going to be an MD or actually going to PA school. At that time my brother was advising me not to go into medical school because he was in residency at that time. And then he’s like, “No, don’t do it. It’s miserable.”
Daniel Lobell: (05:04)
He just wanted to be the only doctor in the family.
Dr. Kevin Tin: (05:06)
Exactly. So I thought he was like trying to trick me. And then I was like, “You know what, I’m going to go.”
Daniel Lobell: (05:12)
You can’t make me not go. [Daniel laughs]
Dr. Kevin Tin: (05:14)
Yeah, so at that time I was just thinking about taking the MCATs or whatnot. And I ended up applying to American University of Antigua where we didn’t require the MCATs at the time. And I got in and they were like, “Okay, you’re accepted, let’s do it.” And then two of my friends and I were just like, “You know what, let’s just go for it and see what happens.”
Daniel Lobell: (05:35)
And at some point you got — forgive the pun — a gut feeling, I suppose.
Dr. Kevin Tin: (05:41)
[Kevin chuckles] Yes. I had a gut feeling for it.
Daniel Lobell: (05:43)
So you went into, I’m sure there’s a better term for it than gut health, but you went into gut health.
Dr. Kevin Tin: (05:48)
Yes. I went into gastroenterology and hepatology.
Daniel Lobell: (05:52)
Ah, those are the fancy terms. I know there’s no way on earth the doctors are going around, “I’m a gut guy!” I do the gutters.
Dr. Kevin Tin: (06:01)
Yeah. It’s a more general term, but at least everyone has, so they can’t relate to it. [Daniel chuckles]
Daniel Lobell: (06:06)
So gastroenterology is the gut, right? It has to do with — what’s the easy definition? It’s the gas system that’s in your stomach, or how do you break it down for people?
Dr. Kevin Tin: (06:15)
It’s essentially all the digestive organs, whatever you put in your mouth and whatever comes out. It’s every organ that has to do with that process.
Daniel Lobell: (06:23)
So that’s like every organ, right?
Dr. Kevin Tin: (06:25)
Yeah. All the organs dealing with the digestive process.
Daniel Lobell: (06:29)
But they’re all affected, aren’t they? Like the lungs, the heart, maybe not directly, but they’re all affected by what you put in your body.
Dr. Kevin Tin: (06:36)
Yeah, in a sense you’re absolutely right. Just because there’s a lot of different research on things going on about that. But I think in more simpler terms, we mainly just focus on the organs that literally affect your digestive process.
Daniel Lobell: (06:52)
So like the stomach, the intestines…
Dr. Kevin Tin: (06:52)
Exactly. So pretty much it starts from the esophagus — well, it starts from the oral cavity, to the esophagus, the stomach, the small intestine to the large intestine and then out the anal canal. And then the other organs that have to interplay into the digestive process secrete into the pancreas, the liver, the gallbladder, which kind of support their metabolism. And that’s just a process.
Daniel Lobell: (07:17)
Favorite organ, quick.
Dr. Kevin Tin: (07:19)
Shoot. Uh, I’ll go with stomach. [Both chuckle].
Daniel Lobell: (07:21)
Why the stomach? Or were you just kidding?
Dr. Kevin Tin: (07:23)
It’s a simple organ. It mainly just kind of grinds down the food and kind of pushes everything into small intestines. I like things simple and it kind of fits that.
Daniel Lobell: (07:32)
The stomach is the one I’m always most at odds with.
Dr. Kevin Tin: (07:35)
Yeah. But next time I would definitely say probably the liver because the liver is actually a very interesting organ.
Daniel Lobell: (07:41)
I want to hear more about that, but I don’t want to lose the thread. I know that you said you did gastroenterology and another specialty as well. What was that one?
Dr. Kevin Tin: (07:50)
Oh, so that’s hepatology. So that has to do with the liver.
Daniel Lobell: (07:53)
Oh, so we’re right on track. So tell me why the liver, can you go into that a little more?
Dr. Kevin Tin: (07:58)
Aside from keeping things simple, the liver has a lot of different functions. Just has so many different processes. It metabolizes all the nutrients, metabolizes alcohol, and has a number of different enzymes that helps with different processes. It’s just a very vital organ. And it’s almost like a Brita filter of your body, essentially. So everything, all the blood from the body, has to surpass the liver, the liver cleans everything out and then pretty much pumps everything back to the heart. And everything’s kind of cleaned afterwards.
Daniel Lobell: (08:32)
So when we talk about a bad metabolism or slow metabolism, are we talking about liver function?
Dr. Kevin Tin: (08:38)
Not necessarily. There’s actually many different definitions from the patient’s perspective in terms of what slow metabolism is. Some patients think that if they’re bloated, they may have a slow metabolism. Some patients where they think if they’re constipated, they may have a slow metabolism. And some patients who are thinking that maybe they have weight gain and things like that, they think that may be attributed to a slow metabolism.
Daniel Lobell: (09:02)
Oh, we love blaming the metabolism, believe me. [Both chuckle] It’s all the metabolism’s fault.
Dr. Kevin Tin: (09:09)
Exactly. Which is genetics.
Daniel Lobell: (09:11)
Definitely not that giant bowl of pasta I just ate. It’s that damn metabolism. There’s a comedian, I forget whose joke this is, that talks about people who complain about how they look in photos. It’s like, that’s not how you look in the photo. That’s how you look. The photo is not the problem. It’s not the metabolism’s fault.
Dr. Kevin Tin: (09:29)
Exactly.
Daniel Lobell: (09:29)
But, with that said, it is interesting to me that there are different speeds of metabolism and different bodies are able to break down food or retain fat in different ways. And I haven’t heard anything explained to me that makes any sense of any of that.
Dr. Kevin Tin: (09:48)
As you mentioned, calories in, calories out, that’s kinda one way to look at things. Another way to look at things is, there’s a lot of research that’s talking about like the microbiome, the gut microbiome. Essentially, what it is is a diversity of bacteria that you have in your gut. So there’s billions and billions of bacteria in the intestines and kind of the makeup of that, of the whole population of bacteria, research has shown that there’s some effect with that in terms of weight loss and weight gain. For instance, there was a study in another lens on rat models where they took the stool of a thin rat and instilled it in a more obese rat. And that obese rat start losing weight.
Daniel Lobell: (10:34)
That obese rat must have been shocked. Like “What are you doing?” [Kevin laughs].
Dr. Kevin Tin: (10:36)
And vice versa.
Daniel Lobell: (10:38)
Should we be putting skinny people’s stool inside of overweight people? Is that the answer? Or is there another way to look at this that’s less disgusting?
Dr. Kevin Tin: (10:48)
Yeah, exactly. So I think that becomes kind of like an ethical issue and it’s kind of like a study protocol type of thing where people would be willing to actually do it. So I don’t think we’re at that stage right now, but there has been cases of what we call fecal transplantation over the past few years in terms of treating colonic bacteria known as Clostridium difficile. So that’s kind of the first experiences we have in human patients.
Daniel Lobell: (11:17)
Have they been successful?
Dr. Kevin Tin: (11:18)
Surprisingly, extremely successful. So the Clostridium difficile, it’s a pretty contagious bacteria. We see it more in like hospital, nursing home settings, what we call a nosocomial infection. Some strains of it can be very resistant to antibiotics that we have. And for those extremely resistant cases, fecal transplant is where some patients who have recurrent bouts of Clostridium difficile, were treated with fecal transplantation and there was a, about 90 and greater percent cure rate afterwards.
Daniel Lobell: (11:47)
Wow. That’s pretty impressive.
Dr. Kevin Tin: (11:49)
Right. Right. So definitely very interesting in terms of, again, the kind of bacterial makeup or what we call again, the microbiome.
Daniel Lobell: (11:58)
Has anybody thought about isolating the bacteria from the feces and making it more palatable to people with regards to weight loss?
Dr. Kevin Tin: (12:07)
That’s a good question. I think there’s still a lot of research going on with that. There’s definitely a lot of analyses on the different types of bacterial species and the composition. There are certain bacterial species that tend to have a, kind of like a protective effect or, how would you put it, like a anti, almost like an anti Clostridium difficile effect. So they were able to isolate some of those species. In terms of weight loss, they haven’t really, as far as I know, have isolated these species.
Daniel Lobell: (12:39)
They gotta get on that. Tell them I said so.
Dr. Kevin Tin: (12:44)
[Kevin chuckles] That would be great. Me and you can do something on the side for that.
Daniel Lobell: (12:48)
Well, that’d be cool. I’ll be the guy who, through you, discovers the miracle cure for obesity. [Kevin chuckles] You mentioned bloating a little earlier. Can you talk to what causes bloating and how people treat that?
Dr. Kevin Tin: (13:03)
Sure. So bloating is extremely common and there is a whole number of different disease processes that can cause bloating. So there is definitely a lot of overlap between conditions. So the first step is to watch the diet and see if there are certain food triggers that can cause bloating such as lactose intolerance, such as gluten sensitivities. So generally when patients have been coming to my office and have been complaining about chronic bloating, we’ll give them some medications to help relieve the bloating a little bit, but also would need some diagnostic workup. And that may include, again, some stool tests and blood tests and maybe a endoscopy or colonoscopy.
Daniel Lobell: (13:46)
And once you get those workups done, what would they do typically?
Dr. Kevin Tin: (13:50)
So after the workup is complete, if we find any disease process, if we find any, let’s say I do an upper endoscopy, the patient has a gastric ulcer and treatment would be to treat the ulcer, give them a high dose anti-secratory therapy, which are medications such as Omeprazole to help heal those ulcers and then kind of see how they respond to it. But again, there’s just so many diseases that can cause bloating that sometimes we don’t even really find too much of a disease. And then some of those cases, we can also attribute to the microbiome, again.
Daniel Lobell: (14:27)
I just find this stuff so fascinating because I feel like there’s so much going on in the gut and we know so little about it. I mean, you may know a lot about it, but we, the people walking around with guts, we know so little about it. And I can’t think of a conversation I’ve ever had with a friend who said, “Hey, what are you doing for your gut health?” Although I did once have a carpet cleaner come over the house who told me that he’d lost a hundred pounds by taking care of his gut. And what did he say, woodworms or something like this. Does that ring a bell to you?
Dr. Kevin Tin: (15:06)
Woodworms? Yeah, I’m not too familiar personally with that.
Daniel Lobell: (15:11)
It sounded pretty “out there.”
Dr. Kevin Tin: (15:11)
Like tapeworms or ringworms?
Daniel Lobell: (15:15)
No, some type of worms that he said you ingest and they clean up your gut. I didn’t take it too seriously because he’s a carpet cleaner and not a doctor. But imagine if you’d told me “Yeah, that’s the thing.”
Dr. Kevin Tin: (15:28)
Right… [Both chuckle] That’s the first time I’m hearing it. So I probably wouldn’t — that wouldn’t be the first thing I recommend.
Daniel Lobell: (15:33)
Right. Yeah. It just stuck with me because it was so bizarre, but I know that you’ve done some studying into Eastern medicine. What do you think Western medicine can learn from Eastern medicine?
Dr. Kevin Tin: (15:44)
That’s a very good question. I do believe in some aspects of Eastern medicine, because I have some experience with it personally.
Daniel Lobell: (15:51)
Can you speak to that for a second?
Dr. Kevin Tin: (15:53)
For example, when I was a kid, I kind of sprained my ankle, it was swollen. And then my mom takes me to this Chinese herbalist who treated me by making some sort of concoction, it was like a very green, dark, very smelly type of thick paste. And he kind of just spread it all around my ankle and then kind of wrapped it up and then the next day, the swelling was all gone.
Daniel Lobell: (16:17)
Wow.
Dr. Kevin Tin: (16:17)
So kind of things like that. I have no idea what he put in it, but things like that that actually treated me much quicker than sometimes what we as doctors can only recommend. Kind of the response that I got from that. So I do believe in some of it, but again, a lot of it is we don’t know the exact science behind it.
Daniel Lobell: (16:37)
That’s a pretty good answer, and a good story to go along with it. I wonder what was in that green concoction. It could have been like the old oil from your parents’ restaurant they brought back.
Dr. Kevin Tin: (16:48)
[Both laugh] It’s quite possible. My mom does see him pretty often.
Daniel Lobell: (16:54)
So you have an organization called the Fujianese Medical Association of America, and I understand that you guys help to eliminate health disparities of the Fujianese Americans and other undeserved populations. Can you tell us a little bit about what you’ve accomplished with that to date?
Dr. Kevin Tin: (17:10)
So the organization was formed in 2018 with a few other medical friends of mine. We really noticed the lack of education in the population, the Fujianese population. And I’m sure other maybe smaller subsets of populations can attest to that. But for instance, like hepatitis B is very prevalent for some reason in the Fujianese population. The people don’t really know what to do about it, where it came from, and they’re told all sorts of different things about it. So I think we really just created this organization to help educate, help a patient navigate and make sure these patients are followed up appropriately with the latest guidelines. With that being said, we also try and do as many community events as we can, sort of for instance, when COVID-19 hit, we were helping out with screenings and vaccinations and things like that. And then I think the other main point also is to help the younger generation kind of help guide their path, give them opportunities in the medical field to let them really decide what they want to do with their future.
Daniel Lobell: (18:14)
Yeah. That sounds like a noble pursuit. And what have you found personally from doing that? How has it changed your doctor-patient relationships?
Dr. Kevin Tin: (18:23)
I think when you kind of just go out in the community, patients without insurance, patients with lack of education, you really appreciate and have a feel for what’s out there and you really see that gap that’s there. So for me, I really try to just relate to my patient and explain to them as much as possible, just so that way they understand what they have, the disease they have and how we go about treating it. That’s important for any patient to kind of know what’s the cause and effects of their disease and how to really manage it and prevent long-term complications.
Daniel Lobell: (18:56)
Absolutely. I’m a big fan of not being kept in the dark when it comes to this stuff. What would you say you wish your patients knew coming in to you?
Dr. Kevin Tin: (19:04)
I think any patient that comes to see me and referred, maybe just having just some understanding or the willingness to accept what they have and really trying to be willing to make a change to improve their health.
Daniel Lobell: (19:20)
Is that the biggest challenge? Getting them to actually take the advice you give?
Dr. Kevin Tin: (19:24)
Right. Right. I would say definitely a few patients who come in and their doctor referred them for something, we tell them what it is, and sometimes they’re in denial. Sometimes they don’t think it’s anything. For instance, such as a screening colonoscopy, right. A lot of patients come in referred for a screening colonoscopy and then they always say, “My gut is fine. My colon is fine. I’m using the bathroom fine. I don’t have any pain. Why am I getting a colonoscopy?” And a lot of them don’t want to do it just because they think that they’re fine. So it’s always kind of like an explaining process of why we have to do it. We do it because we need to prevent colon cancer. And they don’t understand that sometimes colon cancer may not develop any overt symptoms until it’s too late.
Daniel Lobell: (20:08)
What age do you recommend people go for colonoscopies?
Dr. Kevin Tin: (20:11)
So previously the general population was age 50 and for the African-American population, 45. And then this year they switched to 45 years old all around. And that also depends on one’s family history of any colon cancer or any genetic disorders.
Daniel Lobell: (20:30)
What about weight? Is that a factor that people bring into it?
Dr. Kevin Tin: (20:34)
That’s a good question. Weight has been associated with more colonic polyps in some studies, but the guidelines don’t really have that integrated into their recommendations.
Daniel Lobell: (20:48)
Does having a colonoscopy clean your gut at the same time?
Dr. Kevin Tin: (20:51)
In a sense, yes, because you have to take a prep to essentially wash everything out. Some patients who are a little bit baseline constipated after they take the prep, they actually feel better after taking the prep and cleaning everything out. So in a sense, I would say yes.
Daniel Lobell: (21:08)
Maybe we should just do the prep every now and then.
Dr. Kevin Tin: (21:12)
[Kevin chuckles] Yeah. That’s not the first time I’ve heard that.
Daniel Lobell: (21:14)
That’s the first time I’ve thought of it. Can you send me one in the mail? [Both chuckle]
Dr. Kevin Tin: (21:17)
No problem.
Daniel Lobell: (21:20)
I want to get a little bit more into the health, the way that you can take better care of your gut health. Are there certain things that you recommend people do as general advice to keep a clean gut and to sort of manage the bacterias in there? And as a followup question, or as part of this question, I know that there’s a big war going on between probiotics and antibiotics. I’m not sure if it was won, but whenever they give me antibiotics, they make sure to tell me to take probiotics, which I feel like just cancels out the antibiotics. What is going on with these biotics and should you have more pro or anti and how do you know what’s going on in terms of your biotics?
Dr. Kevin Tin: (22:06)
Another very great question and controversial question. Thank you for that. So, I mean, in terms of maintaining a good gut health, I think a lot of it has to do with the diet and the exercise, just eating healthy and avoiding the more unhealthy foods, oily greasy foods. And then just exercising also helps promote gut health. And also staying very well hydrated. Generally we recommend eight ounces or eight glasses of water per day.
Daniel Lobell: (22:33)
So 64 ounces.
Dr. Kevin Tin: (22:34)
Yeah. 64 ounces a day of water. So I think that is probably the majority of the battle, is to just maintain a healthy diet, eating, again, healthy foods. In terms of the antibiotics and probiotics, it goes back to the composition of bacteria that we have inside our microbiome. And what happens sometimes is when you take antibiotics, yes, you are killing the bad bacteria that’s causing whatever issue it is. But at the same time, you’re also wiping out the good bacteria. So most physicians recommend probiotics to kinda keep that good bacteria colony afloat. And that comes back to the Clostridium difficile thing, we see that more prevalent in patients who have just taken a course of antibiotics. So when antibiotics is taken, it wipes out all the bacteria and then the bad bacteria, the Clostridium difficile, sometimes flourishes and then causes you to have diarrhea and those types of things.
Daniel Lobell: (23:31)
And then what do you do? What do you do to battle bad bacteria?
Dr. Kevin Tin: (23:35)
[Kevin laughs] So you got to give them more antibiotics. So sometimes it ends up being like a endless cycle, but all in all, the microbiome, again is a very, very interesting topic just because a lot of it we don’t know. And it does seem to have a major, major impact on one’s health.
Daniel Lobell: (23:53)
If I was able to line up, let’s say six or seven different bacterias in a police station, would you be able to identify which is the bad bacteria?
Dr. Kevin Tin: (24:01)
[Kevin laughs] I would have a sense.
Daniel Lobell: (24:07)
This topic is so fascinating to me because there’s so much going on in there that we don’t know about as we walk around throughout the day, and I’m sure there’s stuff we should be doing. Like, I don’t know much about medicine outside of what I do, interviewing doctors on this podcast, but I do believe there must be something that we should be doing to be able to monitor the bacterias going on inside of us. I feel like that might be the answer to immortality or something. I don’t know, but maybe we’ll live to be 300 when we figure this out. [Kevin laughs] We have no — it’s like we’re totally clueless. We know certain things, but the bacteria, I think that might be the key to it all, this bacteria that’s going on inside of us. And we have absolutely no clue. Is there any home test I could do to know what my bacteria levels are? Like, I could — I have a hot tub, not to brag, [Kevin laughs] but I can test the pH levels in there and I know if the bacteria is bad in the hot tub, you could kind of tell, there’s tests you can do, I can’t do that for my own body, or can I?
Dr. Kevin Tin: (25:12)
Yeah. And I mean the pH level in the stool, it does correlate. There are studies again that have tested the pH levels, and more alkaline pH levels have been associated with poor health status in relations to, again, the bacteria. The Clostridium difficile and things like that. There are some centers that do bacterial or microbiome analysis for research purposes. I’m sure there’s probably some companies that will give you like a, maybe like a home kit to help you determine what your bacterial composition is. Yeah, pretty much 100% sure that there is a company that does that.
Daniel Lobell: (25:49)
It’s like 23 bacterias in me.
Dr. Kevin Tin: (25:54)
[Kevin laughs] That would be millions. There’s so many different bacterias and all their names are like super long that no one can even remember any of it. That’s a very, very interesting thing that you brought up with us just because I think that it may be the future actually. If we’re able to kind of measure the composition of bacteria and then kind of tailor it a certain way. You can possibly prevent a lot of diseases.
Daniel Lobell: (26:17)
You’re saying I’ve done it, doctor. You’re saying I’ve cracked the code to science.
Dr. Kevin Tin: (26:21)
I think so. I think I’m going to take your idea and run with it.
Daniel Lobell: (26:24)
All right. [Kevin chuckles] Make sure you got good shoes on, because it’s going to be a long run. What’s the biggest compliment a patient could give you?
Dr. Kevin Tin: (26:31)
I think the biggest compliment is just telling me that they feel much better and they’re very grateful about the treatment that they had and kind of just improving their quality of life. And of course, for those patients who we kind of diagnose cancer and then kind of guide their treatment pathway and then they’re cancer free, I think those are always gratifying.
Daniel Lobell: (26:53)
What are some of the lessons that you’ve taken away from the past year with COVID-19 that might affect the way you practice in the future?
Dr. Kevin Tin: (27:00)
Definitely never take anything for granted. Treating every patient to the best of our abilities, and just ensuring the safety and overall health of our patients. Just because this has been a year to remember in many different ways. I think as a healthcare provider and as a physician, we chose this pathway to help the people.
Daniel Lobell: (27:24)
Let’s shift gears for one second and talk about the online health space. Obviously this interview is being conducted on behalf of Doctorpedia. So there’s a bit of a bias when I talk about this topic, but what are your views in terms of the online health space and do you encourage or discourage patients to look online for information before they come into you?
Dr. Kevin Tin: (27:45)
I think if they look at any information online, it has to be from a trusted resource. There’s just too many things that are out there that aren’t verified and people making their opinions and just a lot of junk out there also. And also there’s very credible resources. So I think the vision of Doctorpedia is to create that trusted resource where, when patients go to it, they can get information for real doctors at the tip of their fingers and have access to just trusted information. So that’s kind of one of the main reasons why I wanted to participate in Doctorpedia, just because of that, but again, just too much stuff out there and just really just find a resource that is verified and trustworthy.
Daniel Lobell: (28:31)
Right. Now, you are currently the CMO of the Gut Health channel at Doctorpedia.com. I mentioned at the beginning that I’ve watched some of the videos and they were really good, very interesting, well-produced and informative. What else do you hope to accomplish with the channel? Any hopes, dreams, and goals that you can share with the listeners?
Dr. Kevin Tin: (28:51)
Yeah, I mean, I think just really expanding on the library of the content that’s there and also providing, again, that trusted resource for patients to go to. We want patients to be able to — just any patients. So many patients have different types of GI issues and GI issues kinda interplay in many different diseases. So anything we can do to just create that content where patients can go on, see what they, get a kind of an outline of what they should do and some information about the disease processes. So that way they can seek further help if they need it, but also to educate them on the disease itself. So that way they can make those possible lifestyle modifications to really help them.
Daniel Lobell: (29:33)
Very cool. I’m excited to see all that as it unfolds. We talked a little bit about the experiments that you mentioned with regards to the fat rat, or I think it was a mouse, and the skinny one and bacteria being transferred. Are there any developments on the horizon with regards to gastroenterology, or, what was the other one?
Dr. Kevin Tin: (29:54)
Hepatology.
Daniel Lobell: (29:56)
Right. Or hepatology, that are exciting to you that you think are really going to change the landscape of how doctors operate in these fields?
Dr. Kevin Tin: (30:05)
Yeah, absolutely. There’s so many different new innovations, technology that, in the field of gastroenterology, that have been developed over the last couple of decades that have actually minimized the need for a lot of different surgeries. For instance, we do things like endoscopic submucosal dissection or all these other different fancy procedures, where it’s almost like a minimally invasive procedure to save them from a much larger procedure. So this field is always expanding and some new developments are always happening and that’s always exciting.
Daniel Lobell: (30:42)
What’s like one thing that you recently heard about that raised your eyebrows?
Dr. Kevin Tin: (30:46)
In terms of a procedure or…?
Daniel Lobell: (30:48)
Well, in terms of any new development in gastroenterology.
Dr. Kevin Tin: (30:51)
Yeah, one of the new developments is integrating artificial intelligence into the equipment. For instance, they are now able to have a program integrated in to recognize polyps as they’re doing a colonoscopy. So a lot of the polyp detection rate is dependent on the operator. And now they have this program where, as you’re kind of guiding through the colon, this artificial intelligence is able to pinpoint where a polyp may be, or is that on the screen. And then that will lead to higher polyp detection rates and also save patients from developing colon cancer. So I think artificial intelligence integration is very, very cool.
Daniel Lobell: (31:35)
Amazing. So it’s like basically a little polyp robot that goes in.
Dr. Kevin Tin: (31:38)
Yeah, exactly. In a way. Yeah. So it’s like having an extra set of eyes, out of a computer that’s — extra set eyes for you to find out where these polyps are.
Daniel Lobell: (31:48)
Does the screen start blinking red and it goes “Polyp detected. Polyp detected.”
Dr. Kevin Tin: (31:52)
From what I’ve seen it’s like little green square boxes that will kind of flicker where it thinks a polyp may be.
Daniel Lobell: (31:59)
It’s not as cool as the one I came up with, but it’s better than nothing.
Dr. Kevin Tin: (32:01)
Yeah. [Both laugh]
Daniel Lobell: (32:02)
So, I don’t think all polyps are dangerous, right? There are some that could be cancerous. There are some that are just nothing, right?
Dr. Kevin Tin: (32:11)
You’re absolutely right. There are different types of polyps. There are benign polyps, usually what we call hyperplastic polyps. And then the general polyps that are pre-malignant are called adenomas. So those adenomas are the ones that are pre-cancerous and that can develop cancer over time.
Daniel Lobell: (32:29)
Is the artificial intelligence able to detect the difference between them when it goes in there?
Dr. Kevin Tin: (32:33)
I would say no. So I think it was just any polyp that it may be, it may just flicker and then sometimes the way it looks may be a little tricky also. So I think it’s just kind of like a one for all type of thing.
Daniel Lobell: (32:45)
So is it a type of swab that you do to find out? What’s the way to figure out if it is or isn’t a dangerous polyp?
Dr. Kevin Tin: (32:50)
Oh, so usually what we do is any time we see a polyp, we will biopsy or we’ll remove it, and then we will send it off to the pathologist who will review it. And then we’ll determine that it’s a benign or pre-malignant polyp.
Daniel Lobell: (33:05)
Now let’s say somebody is diagnosed, God forbid, with colon cancer, what are their survival chances these days? And have there been any developments that have helped in that area?
Dr. Kevin Tin: (33:15)
For patients that have survived colon cancer?
Daniel Lobell: (33:18)
For patients to survive colon cancer. Has it become an increased survival rate lately, or are there any new developments that are promising?
Dr. Kevin Tin: (33:25)
I would say, I mean the chemotherapeutic agents have been, as far as I know, pretty standard over the last decade or so. So I think in that regard, when patients come in with metastatic colon cancer, I think that it hasn’t really changed or budged too much. So, I mean, again, the key becomes a preventative measure. So colonoscopies are preventative as diagnostic and preventative, it’s not like a mammogram, which is just kind of diagnostic, but a colonoscopy kind of does both. And that’s kind of the key way to preventing colon cancer.
Daniel Lobell: (33:59)
I never realized that. So is there anything detrimental about getting a colonoscopy when you’re under 45 years old?
Dr. Kevin Tin: (34:06)
We do do many colonoscopies for patients under 45, depending on their symptoms and their family history. When you say detrimental, I, I would say no. Generally colonoscopies, the risk of anything happening with colonoscopy is pretty much standard within all age groups. Again, it just becomes operator dependent and things like that. But the risks associated with a colonoscopy is still very generally low.
Daniel Lobell: (34:31)
So I may as well go get one tomorrow if it’s not only a diagnostic, but preventative. I mean, and there’s no downside. I don’t see why I’m not scheduling one in.
Dr. Kevin Tin: (34:40)
I will find you your local doctor. [Both laugh].
Daniel Lobell: (34:42)
He sold me. Sold on the colonoscopy!
Dr. Kevin Tin: (34:47)
No, it’s definitely really important. And I saw a blog that Will Smith made about his experience with getting a colonoscopy. So the gastroenterology community was very excited that he actually did that. Just kind of walking them through, what he had to go through.
Daniel Lobell: (35:03)
You got a plug from the Fresh Prince, you’re in good shape.
Dr. Kevin Tin: (35:05)
[Kevin laughs] Exactly.
Daniel Lobell: (35:09)
So doctor, it’s been an absolute pleasure getting to speak with you today and very informative and fun. I’m going to round off this interview with the question that I end all of these with, which is, what do you personally do to stay healthy?
Dr. Kevin Tin: (35:23)
I’m a big basketball fan. So I like to play basketball whenever I can, outside of being at home and taking care of my two girls and just eating right. Trying to stay in shape.
Daniel Lobell: (35:37)
Whoa, whoa, whoa, let’s not gloss over it. I want the real, the REAL, come on. Like eating right. What do you recommend? Staying in shape. What are you doing to stay in shape?
Dr. Kevin Tin: (35:45)
Probably basketball and then just push ups mainly. Time is a little bit limited lately. So, I do whatever I can to just get it in.
Daniel Lobell: (35:52)
What do you recommended with regards to eating?
Dr. Kevin Tin: (35:56)
So, eating… Oh man, this is like a very big discussion again, but yeah, just spacing out your meals appropriately, making sure you get a solid breakfast in the morning and eating, again, like a high fiber diet. So my morning breakfast usually is like sometimes oatmeal and chia seeds, those types of things. It just has to be kind of the right balance of what works for that individual.
Daniel Lobell: (36:22)
I feel like I got cheated because you said it’s a really long conversation and I’m like, “What else are you doing?” I’m like, this is interesting. Also side note, are you making oatmeal for the whole week on Monday or do you make it fresh every morning?
Dr. Kevin Tin: (36:34)
[Kevin laughs] Fresh every morning.
Daniel Lobell: (36:35)
Wow. Okay. That’s commitment. So what else. You said there’s a lot there and I’m really interested.
Dr. Kevin Tin: (36:40)
Yeah. So for instance, for lunch, I’ll mix it up. It’ll be either like a sandwich or salad or sometimes, but everyone has their cheat days also. I’m a pretty big foodie, so I like to try a lot of different restaurants and things like that.
Daniel Lobell: (36:55)
You’re in New York, so…
Dr. Kevin Tin: (36:56)
Yeah. So we have a lot of that for us here, but let’s say if I eat unhealthy for one meal, I’ll try and eat healthy for the other two meals of the day or the next day, that type of thing. So just kind of finding that right balance. Only you know what’s the right balance for yourself, depending on how you’re feeling and how your bowel movements are and those type of things.
Daniel Lobell: (37:17)
Right. And how close are you to finding that time machine? So you could go back and get your dad to cook for you again in that restaurant you grew up in? [Kevin laughs]
Dr. Kevin Tin: (37:23)
I don’t know about building a time machine, but maybe I’ll try and jump later tonight.
Daniel Lobell: (37:34)
It’s not as easy now. You can’t just put the order in.
Dr. Kevin Tin: (37:38)
I know, I know. Let’s see where it goes.
Daniel Lobell: (37:42)
Dr. Tin, thank you so much. It was really fun talking with you today.
Dr. Kevin Tin: (37:45)
Likewise. Thank you for having me on.
Daniel Lobell: (37:48)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only and should not be taken as medical advice since every person is unique. Please consult your healthcare professional for any personal or specific needs.
