Recently I interviewed Dr. Izabella Wentz, and we talked about the adrenal transformation protocol. If you would prefer to listen the interview you can access it by Clicking Here.

I am beyond excited to interview today’s guest, Dr. Izabella Wentz. If you have Hashimoto’s, then there is a very good chance you’ve heard of Dr. Izabella. Just in case you haven’t, I will dive into her bio. Dr. Izabella Wentz is a compassionate, innovative, solution-focused integrative pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis of Hashimoto’s in 2009, following a decade of debilitating symptoms. She is a New York Times best-selling author of three books on Hashimoto’s. Her newest book focuses on adrenal health, The Adrenal Transformation Protocol: A Four-Week Plan to Release Stress Symptoms and Go from Surviving to Thriving. Thank you for joining us, Dr. Izabella.

Dr. Izabella Wentz:

Thank you so much for having me. It’s such an honor to be here with you. It’s so great to see you again.

Dr. Eric:

I agree. So great to catch up and chat with you about adrenals. As we were talking prior to the recording, years ago, we swapped interviews, and we were focusing on thyroid. We’ll integrate thyroid into today’s talk as well. Really doing a deep dive into adrenals.

People know about your background with Hashimoto’s. If you could maybe elaborate a little bit more, tie in your experience with adrenals, and why you decided to write the new book.

Dr. Izabella:

Sure. I was diagnosed with Hashimoto’s in my 20s after almost a decade of some debilitating symptoms. I was never really interested in thyroid gland and thyroid medications during pharmacy school. I just thought they were boring. I really came to appreciate the condition. All of that was going on with Hashimoto’s.

When I was diagnosed myself, I started taking thyroid meds. I felt a little bit better but not fully better. I realized there were a lot of dysfunctional patterns that were in my body. Some of them were causing me to have Hashimoto’s. Other parts of that were consequences of having hypothyroidism for a while or were worsened by the hypothyroidism. I wanted to figure out if there was anything I could do to make myself feel better and feel human again.

I really focused on looking at the research and patient forums and trying to figure out if I could find out a plan to get myself better. I did, thankfully. I then wrote a book about it in 2013 called Hashimoto’s: The Root Cause. Throughout that process, part of what was really fundamental to my healing journey was changing my nutrition. I went gluten-free and dairy-free, which helped me tremendously. I was able to eliminate acid reflux, joint pain, carpel tunnel, and IBS that I had had for many years prior that was barely responding to medications. This resolved the acid reflux and the IBS and bloating within three days. Holy cow.

Then I still struggled with brain fog and fatigue, especially morning fatigue. I was a night owl, where I had a hard time falling asleep at night. I felt anxious and wired but tired throughout the day. I was always wearing sunglasses and would step outside. Man, I feel like a vampire right now, being outside with these bright lights. I had seasonal affective disorder. If I would stand up too quickly, I would feel faint. Always startled and always anxious in that fight or flight state.

Somebody brought up adrenal fatigue to me. Okay, that’s interesting. What are the adrenals? What’s going on? I go to Google it 10+ years ago. Some reputable medical sites said, “Adrenal fatigue doesn’t exist. It’s a quack diagnosis.” I was a skeptical pharmacist, not going to go down that road because that’s a fake thing.

Finally, it probably took the 15^th person who happened to be my local compounding pharmacist, Mr. Carter Black. He said to me, “Hey, have you looked into adrenal fatigue?” Maybe I had a moment of weakness when I was like, “Fine, I will look at that.” Sure enough, I had all the symptoms. I tried the recommendations. I got better. I talk about adrenals in my Hashimoto’s book, in all of my work on Hashimoto’s. That is part of the healing plan: to support the health of your adrenals.

I have worked with thousands of people with Hashimoto’s and hypothyroidism at this point. 90% of them had some degree of adrenal dysfunction when I tested their levels. I had a pretty straightforward protocol for the adrenals. I thought it was straightforward and made a lot of sense. It helped me get better. I was trained through functional medicine.

Then this all came to a big moment when I was a new mom of an eight-month-old baby, who was still waking up a lot throughout the night and needed to eat at night. I was his main source of food. I found my adrenals were dysfunctional again, but I couldn’t utilize the hormones that I had normally recommended for others because I was nursing. I didn’t feel comfortable taking a lot of supplements. I wasn’t going to sleep. That was one of the big things people recommend to heal adrenals. Yes, but I’m not sleeping, so I need something else. People also recommend cutting out coffee. I was like, “But coffee is the reason I function during the day.” I had to come up with a new way to heal and resolve brain fog, energy issues, and sleep issues for myself.

Being a guinea pig, I stood out to my community. It’s now helped over 3,500 people resolve all these symptoms in just 3-4 weeks. That’s how I began to talk about adrenals. I’m not changing my name to the adrenal pharmacist or anything, but addressing that adrenal dysfunction is a key component to healing when you do have thyroid issues.

Dr. Eric:

I agree. When I dealt with Graves’, the stress and adrenal issues played a role in the development of my condition. Over the years, I have worked with both hyperthyroidism and Hashimoto’s. As you know, I have more of a focus on those with hyperthyroidism and Graves’. Like you see most people with Hashimoto’s having adrenal problems, I would say the same thing with those who have hyperthyroidism or Graves’. It’s even in the literature. If you do some research, I wouldn’t say adrenals are in the literature with Graves’, but stress and Graves’, there is a number of journal articles. If someone is dealing with chronic stress, it’s almost definitely going to affect the adrenals. Your book, your protocol, is definitely well needed.

Let’s talk about why many people have compromised adrenals. I mentioned chronic stress. I’m guessing that’s a big reason why a lot of people have adrenal imbalances.

Dr. Izabella:

Absolutely. Current stressors can cause a whole host of issues. I typically will ask people that I work with: What was going on in your life before you got sick? Most of them will say something very stressful was happening in their lives. Maybe they were going through a divorce. Maybe there was a death in the family. Maybe they were fired from a job or had a major terrible life change.

There was a study that was super interesting talking about a woman who was thrown down the stairs and developed Graves’ shortly thereafter because of that traumatic, stressful experience she had had. That is a big connection for a lot of people: something bad happens that overwhelms your ability to cope and handle it.

There are also good stressors. You have a baby. Yes, bundle of joy, but yes, it’s stressful for your body. Growing a baby takes up nutrients. Then the life change is big. Not sleeping, being nutrient depleted. That is a happy life change for a lot of people, but also stressful. Getting married, getting a new job, getting a job promotion, going to graduate school. All of these things can be incredibly stressful.

We were just talking about the medical profession. How many times doctors have to do 80+ hour weeks at the hospital. I personally had to do two or three exams every week when I had to wake up at 5am and get to those exams. I loved going to graduate school, but I wouldn’t say it wasn’t stressful because it was stressful, right? All the deadlines and all that pressure you can have from creating very positive change in your life, from the personal growth that you can experience, starting a new business or starting a family, moving across the country or going to graduate school.

There are also stressors that happened to us a long time ago that we may not even remember. History of childhood trauma. Something happened when you were three. You may not even have a clear recollection of it, but it stayed with you. It’s this unprocessed stress that could also be present in our bodies and lead to low levels of inflammation. There are a ton of studies that have connected childhood trauma to autoimmunity later on in our adult life.

Then we have physical stressors, things that are in our lifestyle. Sleep deprivation. One of the fastest ways to wreck your adrenals is if you don’t get sleep. I have been there, done that. I have written the book. This is a key component to getting back in balance. If that’s an issue for you, you need to address that.

There are things like overexercising, undereating, being nutritionally deficient, having blood sugar imbalances. Some of these habits of hustling. You have your job, and you have your side hustle, and you have your side hustle. That can be incredibly draining on a person.

There are some of these stressors that I feel like unless you’re working in functional medicine or with a functional medicine doc like yourself, you’re not even aware that they’re present. These could be infections like H-pylori. Such an important trigger for Hashimoto’s and Graves’ and for all kinds of digestive issues. This leads to inflammation and stress in your body. There are protozoal parasites that can be an issue for some people. There are toxic exposures, like people don’t even know they might be exposed to mold or another type of toxin that is sending these stress signals to the body.

Really anything that overwhelms our ability to cope is going to be what I consider a stressor and can get us into that adrenal dysfunction state, where we’re stuck in that stress response rather than going through a stressful time, shaking it off, and then you move on with your life. You feel good again, and you feel normal. Instead, you get stuck in that fight or flight mode. Your body is not really repairing itself, and then you end up having really low levels of energy, fatigue, anxiety, sleep issues, all the things.

Dr. Eric:

I agree. One factor that resonates with me is overexercising. That was also me prior to my Graves’ diagnosis. Emotional stress definitely played a part in my adrenal imbalances, but I was overtraining. With my background, I should have known better, but I didn’t. Looking back, that was a big tax on my adrenals, so I’m glad you mentioned that.

You’re correct about everything you said: the infections potentially could be a factor when it comes to adrenals. We live in a toxic world, so we tend to overlook the impact that these toxins have on our adrenals as well as other areas of the body.

When you dealt with Hashimoto’s, you felt like you had some of the classic symptoms of having compromised adrenals. When it comes to finding out whether someone has an adrenal imbalance, would you recommend relying more on symptoms, do you recommend testing, or a combination of both? The question I’m asking is how does someone know if they have an adrenal imbalance?

Dr. Izabella:

I personally love testing. If I could have my little way, I would have everybody take every single test. Let’s collect all this data. I force my husband and my son to do all kinds of tests. We do stool tests. We don’t do a lot of blood tests with my son because he is little. Let’s test your urine, let’s test your stool, let’s test this, and see what’s going on in your body and how we can optimize it. That testing can be incredibly helpful to figure out if you have adrenal dysfunction.

I love the ZRT adrenal saliva test. I love the Dutch urine test. For the 10 years I have been talking about people getting tested, people oftentimes will go to their endocrinologist and ask them to test for adrenal issues. They test them for Addison’s, and they say they don’t have adrenal issues. There is a disconnect between integrative, functional, natural medicine and conventional medicine, where conventional medicine doesn’t recognize this adrenal dysfunction as a real thing. They are not testing for it.

People get the runaround from their conventional docs, so I’ll be like, “No, you need to find an integrative doctor.” The integrative doctor is too expensive, or they have to pay out of pocket for them, and for these tests because they are not covered on insurance because they are experimental. That’s another barrier to people getting that test and getting the help that they need.

Another part would be they do see the doctors. They get the tests. The tests would be sitting at their house for however long because you have to get off of caffeine and all of that to get an accurate test. They just can’t do it. They don’t have the energy not to have caffeine for a day.

Then you have the test results. Great. They took a few weeks to get back, or sometimes a few months because the person didn’t do the test right away, or the lab had a backlog. Then you are sitting on six months to a few years from the time that you knew you had these symptoms to when you get the plan.

Then you get the plan. For whatever reason, you react to the hormones, or you react to something else. You can’t comply with the plan. Part of the traditional plan is to get off of caffeine, get lots of sleep, take hormones, and take glandulars. Some people took glandulars and had palpitations, or the hormones gave them back-ne, or they are now estrogen dominant because they took too much of the hormones, or there is no way you are taking coffee out of their cold, dead hands. They won’t do it. There is a lot of barriers to it.

The beauty of my program is that it focuses on symptoms. If you have these symptoms, there is a chance your adrenal stress response is off. Here is the good news. Let’s rewire that stress response so that you feel good. I don’t necessarily focus on adrenal testing throughout the program. That’s not a requirement for you to feel better. I hope that eliminates the barrier for people to feeling better.

People can absolutely do tests, and they will be incredibly helpful if they are working with a practitioner. I want to eliminate that one barrier because there are so many people who are suffering, but they don’t have the ability to access these things.

Dr. Eric:

I have been using saliva testing in my practice to look at the Circadian rhythm of cortisol. You mentioned Dutch testing; I also like that test. But you’re right. There are some people who either can’t afford to do the test, or they can afford it, but it sits on their shelf for a few months before they send the test in. It’s nice to know that there is a way where they can just read your book and look at all the symptoms and get a good idea if they have an adrenal problem by looking at the book and bypassing the testing.

If you go to a conventional doctor, they are not going to do anything unless you have Addison’s or Cushing syndrome. They will just do blood testing or ACTH stimulation. When it comes to looking at Circadian rhythm, they won’t go there.

I used to use adrenal fatigue all the time years ago. It kind of gets a bad rap, adrenal fatigue. It’s not really adrenal fatigue; it’s dysregulation of the hypothalamic pituitary axis. We are going back and forth. We’re not saying adrenal fatigue, but we’re saying adrenal dysfunction. What are your thoughts on if adrenal fatigue really exists, or if it’s just a term that was used in the past, and now it’s adrenal dysfunction, or HPA axis dysregulation?

Dr. Izabella:

I think adrenal fatigue has been cancelled. Is that what happened? When I was trained in functional medicine, I understood—this was over 10 years ago—adrenal fatigue as you are fatigued because your adrenals are not functioning properly and because your HPA axis has a disconnect. Your adrenals are capable of making the right amount of hormones at the right time, but they’re not doing it, so we need to reconnect that wiring between your brain and your adrenals.

What I now understand as the original definition and intent of the term “adrenal fatigue” is that the adrenals were actually fatigued and unable to produce adrenal hormones. That’s what people used to think back in the day. Now the endocrinologists are like, “Adrenal fatigue doesn’t exist. Only Addison’s is a thing. We test these people, and their body is capable of producing cortisol.” I do agree with that, that in people with this HPA axis dysregulation, they can produce cortisol in the right amounts at the right time of day, but their body is just not doing it.

I scratch my head because doctors will say, “Adrenal fatigue doesn’t exist,” and they will call it HPA axis dysregulation, where that doesn’t necessarily roll off the tongue. But that is where all of the evidence base is. If you do a search on PubMed, which is the largest database of medical journals, you will be able to find HPA axis dysfunction, but it doesn’t necessarily roll off the tongue, does it?

I call it “adrenal dysfunction.” The symptoms of adrenal dysfunction are the same as symptoms of adrenal fatigue and burnout. It is how the body responds to stress. They are not the same as Addison’s. Addison’s, you would have all of the symptoms of adrenal fatigue, and then some. Addison’s is a different kind of condition. It just happens to be tied in with our stress hormones.

I hope that clarifies it. It’s one of those things where I feel like 10 years ago, people were like, “Leaky gut doesn’t exist.” You would search for “intestinal permeability,” and there is all this research behind it. For a while, I didn’t say “leaky gut.” I said, “intestinal permeability.” People were like, “Okay.” But if I said, “Leaky gut,” they would be like, “Quack! I don’t know what you’re talking about.” Now you have to say, “adrenal dysfunction,” even though we all know it’s the same as adrenal fatigue or burnout. What our bodies do for a prolonged period of stress, that’s how it adapts to stress.

Dr. Eric:

I agree. Definitely easier to say “adrenal fatigue” or “adrenal dysfunction” instead of “HPA axis dysregulation.” Thank you for clarifying that. Can we get into the different components of your adrenal transformation protocol?

Dr. Izabella:

I really focus on figuring out why your body is in this fight or flight mode. What are the signals you’re sending to your body that is telling you that you’re in danger right now? Things like sleep deprivation over exercising, over- and under-eating. These three things that are part of modern culture of “Lose weight, and exercise, and burn the bridge at both ends.”

Oftentimes, if you were thinking of caveman/cavewoman times, the cavewomen, if they were doing this, they would be like, “Okay, I’m not eating enough because there’s a famine. I’m overexercising because I’m being chased by bears. I’m keeping watch because there is some tribe trying to attack me. That’s why I’m not sleeping at night.” They would get shifted into this high alert, fight or flight response. There are things we’re doing in our modern life that are kind of doing the same because we have our ancient genes and ancient wiring that isn’t necessarily tuned into an abundance of food. I’m under immediate threat right now, and I’m not sleeping because there are deadlines. Our body shifts into this survival state.

Part of what I do is I focus on what are the safety signals we can send your body in a language that it understands that we are safe, and we do not need to be in that survival mode. How to shift the body into thriving. When we are in that survival mode, our body is not repairing itself. Our body is essentially breaking itself down. That can be very problematic when you have antibodies because it’s not balancing the immune system or the inflammation. It’s not repairing itself. We want to shift into that repair mode.

What I focus on is replenishing. First, we focus on replenishing any kind of nutrients. We focus on micronutrients. We focus on B vitamins and vitamin C, which are incredibly helpful when people have been under stress for a long period of time, as are magnesium and electrolytes. They help us come back from all that stress.

Then we focus on making sure we get enough protein and fat. Part of what’s happening with the adrenal dysfunction is we’re utilizing amino acids to fuel the stress response. Amino acids are like the little bricks our body uses to fix itself. By eating more protein, we’re getting more amino acids into our system. Protein is made up of amino acids. That’s a big part of the beginning part of the program.

You focus on nutrition safety signals. Nutrient dense foods, not starving yourself, eating frequently every two to three hours for some people to start yourself that way.

Then we go through additional safety signals, which focus on reenergizing. Part of that is you get connected with the Circadian rhythm. You figure out how to give your body more energy throughout the day and less energy at nighttime, so you can sleep and replenish and really heal and save your body another part of that safety signal.

Then we get into revitalizing. This is probably a favorite part and a little bit of what makes my book a bit unique from some of the others out there. We really focus on pleasurable activities that tell us that it’s safe. We focus on things like a lot of us have goals. If you’re an ambitious person, sometimes it feels like you’re just knocking things off of your to-do list. You have your family and your work and your parents who are getting older to take care of. All of these adult responsibilities, where that can make us shift us into that survival fight or flight mode.

Taking some time throughout our day to focus on pleasurable activities. Maybe you like painting, and that brings you a lot of joy, but you haven’t done that for a long time. Maybe scrapbooking is your thing, putting a bunch of stuff on the floor and making some cute scrapbooks. Maybe that brings you a sense of joy, but you haven’t done it for 10 years because you have been on the stress rollercoaster. I give people a prescription for pleasure, just to do the things you love and enjoy. That is such a powerful way for them to shift out of that survival mode into more of a thriving state.

Then we also focus on rebuilding resilience, which is figuring out what weighs you down and how to get rid of those things. A lot of times, it’s past trauma. We focus on giving people trigger tools. If there are things that are really setting off your fight or flight response, like annoying people being one example, then you would focus on that. What do you do if somebody really drives you nuts and annoys you? Here is a list of ideas. Let’s develop a trigger toolkit, so you don’t get into that angry survival state. You figure out how to work with that.

Then we focus on how to build up your body and how to be more resilient to stress. Even though we all have stress in our lives, you can’t always get rid of it, but you have to cope with it and let it bounce off of you rather than absorb into our system and overwhelm us.

Dr. Eric:

That’s amazing. I want to talk a little bit about replenish. In this day and age, intermittent fasting is popular. I’ll admit, I do some intermittent fasting these days. For example, when I dealt with hyperthyroidism, I wanted to do intermittent fasting for a few reasons. I was losing tons of weight due to hyperthyroidism; I lost 42 pounds, so I definitely was not thinking about intermittent fasting back then. A big reason is also now you see it all over the place. Back then, in 2008/2009, it wasn’t as popular. I also mentioned how if someone has compromised adrenals, you do want to be cautious about intermittent fasting. It sounds like we’re on the same page. You’re talking about replenishing, making sure you’re not undereating. Can you talk more about that?

Dr. Izabella:

Of course. I’ve had a lot of ladies go through my program who are struggling with weight issues, so their goal is to lose weight. They are restricting calories, trying intermittent fasting, trying things like the keto diet, doing lots of exercise. They are doing all of these things that are supposed to help them lose weight. I will say these things work really well if you’re a 20-year-old fitness guru. They work so well, and you can get a six-pack that way. But if you have dysfunction in your stress response and your thyroid, these things can actually backfire.

People with flatlined adrenals, where they have this flatlined adrenal curve, where they just don’t produce enough cortisol throughout the day, stressful things will overwhelm them. Doing things like cardio, which is supposed to be really great for most people, when it’s balanced with proper atabolic exercise, like lifting weights, they will do that and be exhausted. “Everybody said if I wanted more energy, I should exercise more. This did not work for me.” Or they will hear things like, “Skip breakfast,” but part of the whole presentation is you will have blood sugar swings. Fasting can actually make you feel worse, and you can crash. Your body is like, “Oh no, we’re in a famine.”

When you have a really balanced response, at this point, you can do fasting because you have worked so much on your health. I can do fasting. I can do aerobic exercises. I can do all the things. But when I was trying to heal my adrenals, and even a few years ago, when I was a new mom and sleep-deprived, a lot of these things were stressors. They were shifting my scale of you have this thriving here, or you’re surviving here, and depending on how many things you put on each side of the scale, your body will shift that way. If you’re a new mom who is sleep-deprived, you already have that stressor. You want to counteract with eating lots of great foods. If you have inflammation, autoimmunity in your body that’s very present right now, that’s a big stressor. We want to reduce that stressor and send more safety signals.

I think it’s simple math. You put a little bit of weight here, and you can do that. If you are overall in a good healthy, balanced state, doing a little bit of intermittent fasting can be game-changing. But if you already have too much stress on your plate, that will cause you further issues. That’s been my experience as well as yours for people with adrenal dysfunction. That’s one of the things I’m trying to raise awareness about for people who beat themselves up. “Well, I must be exercising enough. I must not be fasting enough. Why is everybody else getting results, and I’m not?”

Dr. Eric:

Adrenal imbalances could also be a factor when someone is trying to lose weight. If they are doing everything from a dietary standpoint, they are exercising regularly. Like you said, it could backfire because if they are doing those things. Getting back to exercise, even simple cardio sometimes, but especially these days, you see high intensity interval training. Someone might be doing HIIT along with the intermittent fasting, and that’s just continuously taxing their adrenals, which could make it even more difficult to lose weight. You’re right. It becomes a vicious cycle.

Dr. Izabella:

It does. I’ve had so many women who were so reluctant to take my advice of eating more calories and doing less exercise because they were trying to lose weight. “Is it working?” A lot of times, they’d be like, “No, I’m gaining weight. I do all this exercise,” and it’s further suppressing their metabolism because they’re getting stressed. Part of the plan is you eat more protein, and you get more nutrients, and you focus on destressing your body.

We have had people who have started the program underweight, and we have had people who have started the program overweight. The beauty of adrenals is if your weight issues are caused by adrenal issues, destressing is going to help you get to a healthier weight. We have had 80% of people trying to lose weight, “You know what? I did lose 5-10 pounds on this plan.” 5-10 pounds is a healthy amount of weight to lose over 4-6 weeks. You don’t want to lose 40 pounds in a week or anything like that. The people who were wasting away, we help them shift into gaining more weight.

One of the things I utilize throughout the program is carnitine. People with thyroid issues often get into this state where they’re muscle wasting, and carnitine can be incredibly helpful for that and the resulting brain fog, fatigue, blood sugar issues, supporting their mitochondria. People find they feel better. Weight isn’t a focus on the program, but it tends to normalize as people go through the program.

Dr. Eric:

Do you recommend acetyl-L-carnitine or regular L-carnitine tartrate?

Dr. Izabella:

I recommend a combination, just because L-carnitine is going to be helpful for muscles. Acetyl-L-carnitine can be helpful for the brain to waken people up with that brain fog. I find a combination of one supplement that has both of them in there, and the L-carnitine has more with a little acetyl-L-carnitine. You don’t want to do too much of the acetyl-L-carnitine. That tends to work well for the brain fog. 92% of people in my program have had their brain fog resolved. That’s one of our biggest success symptoms in the program.

Dr. Eric:

You mentioned the Circadian rhythm. How important do you feel it is to get sun exposure to get back on track with the Circadian rhythm? Do you recommend getting morning sun exposure? At night, I imagine you tell people to limit blue light and other things just to get back on track there.

Dr. Izabella:

I have lived everywhere. Maybe not everywhere. I have lived in Europe and many parts of the United States. Right now, I live in sunny Austin, Texas. I was in Los Angeles for a few years. I was also in Chicago; Boulder, Colorado; Poland; and rainy Amsterdam. Bear with me. I know people can roll their eyes when they’re like, “Get morning sunshine. Step outside. Spend time in nature.”

If you can do this, this can be incredibly game-changing. If you can get sunshine first thing into your eyes when you step outside, that’s going to let your body know it’s time to wake up. That will raise your cortisol to healthy levels without needing to rely on caffeine to raise your cortisol to wake up. That also sets the clock for your body, so your body knows that it’s waky waky time now. In this amount of hours, it’s going to be time to unwind and go to sleep.

I know it’s not always possible. I have lived in Chicago and Amsterdam and Colorado. Sometimes, I’ll recommend a dawn simulator or light therapy boxes. I actually have a list of things throughout the book and the program. People are like, “Great. If you live in perfect weather year-round, you can do this.” But it’s not realistic for people living everywhere in the world. There is a way around that. Even if it’s raining and snowing on your doorstep right now, which sometimes in Colorado, it would be end of May, and there would be snow. How is there snow in May?

Dr. Eric:

I’ve seen photos of not just snow but lots of snow in May. There have been a few snowstorms over the last few years. I don’t know about last year specifically, but I have seen at least a couple of different years in May where it was completely covered. I’m sure you’re glad to be in Austin, Texas, so you don’t get the May snow.

Dr. Izabella:

Yes, I miss Colorado. I love Boulder so much. I miss all my friends. We miss Colorado so much. But we are also loving our time in Austin. My husband’s family is here, so we’re excited to be here with our little one. I am one of the people who doesn’t mind the heat. I’m saying that now. Ask me again next summer. It is nice to have access to the morning sunshine and nature because that can be really regulating for our Circadian rhythm.

Dr. Eric:

I’m glad you mentioned the light therapy boxes. You’re right. If someone lives in Seattle or Portland, where it’s rainy a good part of the year, they might not be able to get that sun exposure waking up. That’s an excellent idea. Check out her book for some of those resources.

I promise we will get to the supplements. Before we get to that, we can’t have an episode with a thyroid pharmacist without talking about thyroid and adrenals. What connection have you seen between thyroid and adrenals, whether adrenals are affecting thyroid or thyroid affecting adrenals?

Dr. Izabella:

Our hormones talk to each other. It’s not like we have these individual hormones in a vacuum separated from one another, like naughty children that have to be separated in the backseat.

The first thing that can happen is if a person is hypothyroid, when their thyroid is underactive, cortisol will accommodate for that. When we are low in thyroid hormone, our cortisol clearance decreases, so our body keeps cortisol in our system longer. Typically, people will say, “Oh, I’m kind of tired, but I’m kind of wired.” That wire is coming from that cortisol. It’s trying to help you out and keep you alive and not sloth-like. That’s part of the feedback loop system.

Then as people get onto thyroid medications, their cortisol clearance increases. You get on thyroid medications, and it normalizes your thyroid function, but your cortisol clearance increases. All of a sudden, you’re left with really low cortisol. This can be unmasked. Hyperthyroid states as well. Then you have increased cortisol clearance. It’s one of those feedback loops that occurs with thyroid issues.

Then we focus on what’s happening with people who have too much stress. Sometimes, they will have more production of reverse T3, which can block thyroid hormone receptors. People aren’t able to utilize their active thyroid hormone properly. It’s a feedback loop system. For people listening, you don’t have to memorize this. You won’t be quizzed on it. This is us talking about the nerdy things.

The key to remember is if you have a thyroid problem, your adrenals have probably been compensating. There is some kind of feedback system. Oftentimes, people with thyroid issues, 90% of the time, I’m not sure if that’s your experience as well, with hypothyroidism, we do have to support the adrenals for a person to get rid of all their symptoms.

Dr. Eric:

Yeah. I agree. You mentioned cortisol clearance. I don’t do dried urine testing on everybody. It’s interesting because they look at that cortisol metabolism, so you can see that. If someone has hypothyroidism, typically, you’ll see not only a lot of times cortisol low (not all the time). You almost always will see the low cortisol metabolites.

Opposite with Graves’. If someone has hyperthyroidism, you will see on that test where the cortisol metabolites are elevated. Exactly what you said. You usually do see that pattern with hypothyroidism and hyperthyroidism, increased cortisol metabolites because you are getting the increased cortisol clearance. Also with elevated cortisol, there are a lot of different factors that could affect the conversion of T4 to T3. Also, elevated cortisol could affect that conversion.

One other thing I’ll say: This isn’t really a connection between adrenals and thyroid directly, but just the impact of chronic stress. Chronic stress of course affects adrenals. It could also decrease secretory IGA, which lines the mucosal surfaces of the body, including the gastrointestinal tract, and make someone more susceptible to infections, for example. It serves as a form of protection, which in turn could be a trigger, as you mentioned earlier, talking about H-pylori and parasites. Stress is directly affecting adrenals, but that whole connection between stress affecting adrenals and stress affecting secretory IGA, which can make someone more susceptible to an autoimmune condition such as Graves’ or Hashimoto’s.

So supplements. Let’s talk about some of your favorite supplements. You mentioned L-carnitine, which is a mixture of acetyl-L-carnitine and regular L-carnitine, like L-carnitine tartrate. You mentioned earlier B vitamins. You mentioned Vitamin C. I know there are others, like ashwagandha, rhodiola, licorice root. I’ll shut up and let you talk about supplements.

Dr. Izabella:

We already talked about carnitine. It’s traditionally been used for people with Graves’. People used to think it had antithyroid effects. It’s also been used successfully now for people with hypothyroidism. What we’re learning now is it tends to act as more of a stabilizing effect with thyroid hormones. That’s been really fabulous for thyroid fatigue.

I try not to give too many supplements. I try to pick ones that have multiple uses. The carnitine helps with balancing blood sugar; clearing ammonia in the body, which can cause a lot of the brain fog; muscle strength; brain health; helping our metabolism utilize fatty acids; and a lot of things. I utilize that as part of the protocol. It supports our mitochondria.

Then I focus on saccharomyces boulardii. It helps to raise our secretory IGA levels, even when we’re stressed. Whatever is living in our gut or wants to live in there, we have this extra layer of protection. We talked about how infections can sometimes be a trigger or exacerbating factor for thyroid issues. The saccharomyces boulardii can help you clear out the infections naturally, whether it’s candida or mold or parasites or H-pylori. Sometimes, just the saccharomyces boulardii can do that on its own. Other times, you might need deeper protocols, especially with H-pylori because that pathogen tends to be notorious and can make biofilms and can be something that is resistant to various things. Always having that extra layer of defense will be helpful.

It’s also helpful for preventing infections; preventing some food reactions and making us tolerate more stuff. This is one of the hacks that gives people a little bit of an edge, where they can start recovering a bit faster from the effects of a lot of stress in their bodies.

I focus on utilizing adaptogens. There is a whole host of different herbs, and all of them have different personalities. These herbs can make us a bit more resilient to stress.

Rhodiola is a great herb that I like because it’s helpful for balancing the stress response. It’s been shown to be effective for anxiety, depression. It also helps us grow new mitochondria, which mitochondrial dysfunction is oftentimes a part of the whole fatigue adrenal presentation.

I focus on B vitamins and Vitamin C, which get depleted during a stress response. I will often try to put that in one supplement formulation, but it’s not right for everybody. I have a few options for people.

Licorice is something I really love if you have low cortisol and low blood pressure. If you have high blood pressure, don’t do it because it can make your blood pressure even worse.

I focus on magnesium. Magnesium can be incredibly helpful. It’s a cofactor for hundreds of biological systems in the body. It’s great when people are saying, “I have cramps. I’m anxious. I have trouble sleeping.” This is incredibly helpful for so many people. It gets super depleted when you’re stressed out.

I utilize electrolytes. They have lots of Vitamin C and D ribose. Electrolytes help us with recovery. People with adrenal dysfunction tend not to have enough electrolytes. I use powder. I don’t use Gatorade or anything with junk in it.

The other thing is utilizing myoinositol, which is helpful for blood sugar balance. This is something that many people have found to be very helpful for anxiety and even OCD symptoms.

I have this handful of supplements that people utilize. Of course, not every supplement is right for everybody. I have a section that talks about the pros and cons of each supplement and which ones you might wish to utilize as part of your healing journey.

Dr. Eric:

Wonderful. Thank you for sharing. I like adaptogens as well. I definitely will reinforce what you said about the licorice root. If you have high blood pressure, you don’t want to take it.

Last but not least: stress management. I probably should have brought this up before the supplements. Stress management is not all about taking supplements, like you said. You admitted you don’t want to give people a bunch of supplements to take, but they do help to speed up the recovery process. In some cases, they can be beneficial for adrenal health. But if that’s all you do, it’s not going to fix your adrenals.

You mentioned getting sufficient protein in your diet and fats. You just mentioned myoinositol to help with blood sugar imbalances, so you want to minimize sugar. That’s important. I don’t know if you want to talk about that as well.

Let’s finish up by talking about sugar and stress management, your thoughts on those two things when it comes to adrenal health.

Dr. Izabella:

Most of us need to eat more protein and fat and probably less carbs than we think we need. I don’t recommend necessarily a keto diet for most people, but we focus on whole food sources of carbohydrates. We focus on proteins and fats. The diet template is very similar to a paleo diet, where we don’t eat a ton of grains, just because they can have an impact on blood sugar.

Blood sugar imbalances are part of that adrenal dysfunction. People end up on this blood sugar rollercoaster, and they end up feeling anxious and tired and very off when their blood sugar is out of balance. They end up storing fat instead of burning it. We shift the nutritional safety signals to focus more on that protein, fat, and lower carb intake to help people balance their blood sugar. People feel more calm, steady throughout the day. They don’t get that 3pm crash. They don’t wake up at 3am, like, “Where am I? Who am I? Why am I so hungry?” That 3am wakeup is usually a person going hypoglycemic and cortisol trying to save us. People get that cortisol surge at 3am. We really focus on how you sleep better and how you have more energy throughout the day. That’s balancing your blood sugar.

Yes, we don’t eat candy. I do have people drink orange juice first thing in the morning to help raise their glucose levels. Oftentimes, glucose is low in the morning when we have low cortisol, and blood pressure is low. We combine that with some protein and some fat from coconut milk. We add some sea salt or electrolytes to that, so you slow down the effect of what I call the blood sugar rollercoaster. If you have orange juice by itself, you go up and you crash. When you combine it with all the different proteins and fats, you have a much smoother ride throughout your day. You get the boost of glucose, so your blood sugar improves in the morning, and you feel a little bit better. You have more energy. But you don’t get the crash. That is part of the nutritional program.

I’m so glad you asked about stress management because people are so willing to take supplements and change their diet, and there are free things you can do. Your stress adjusts. That’s the easiest and the hardest thing to do.

I talk a lot about trading coping mechanisms. We talked about the trigger toolkit. If somebody triggers you, how can you respond? What can you do to soothe yourself? We talk about creating the space for healing and figuring out what in your life is making you feel worse and what is making you feel better. Generally, we try to focus on doing more of the things that make you feel better. If there is a way to eliminate the things that make you feel worse or find a way not to impact you so much, that will be huge for the healing journey.

Dr. Eric:

Is there anything else that I didn’t ask you that I should have asked you? Any final words? Any last things you want to chat about?

Dr. Izabella:

I just wanted to mention to people that if they are struggling with brain fog, fatigue, mood issues, anxiety, trouble sleeping, you do not have to feel like this forever. Just because it’s common doesn’t mean it’s normal. A lot of people are stuck in this survival mode. There is a very targeted way to get out of that with sending your body these safety signals, so you can thrive and feel amazing and have lots of energy and sleep really well and have your brain work and feel strong and fit in your body and pain-free. I hope you will take the time to learn more about your health. Thank you for joining us. Hopefully, this will help you on your healing journey.

Dr. Eric:

I’m sure listeners learned a lot, and I’m sure they will learn a lot more by reading your book, The Adrenal Transformation Protocol. Your website is ThyroidPharmacist.com.

Dr. Izabella:

Yes. I have a free guide at ThyroidPharmacist.com/ABCs that talks about the ABCs of Adrenals, B vitamins, and C vitamins, and some of the stress management techniques. My book is available on Amazon and Barnes & Noble and wherever books are sold.

Dr. Eric:

Since we talked about adrenals, focus on Dr. Izabella’s adrenal transformation protocol book. Highly recommend her Hashimoto’s book and her other books. They’re wonderful. I think I have even listened to some of them on audio.

Dr. Izabella:

Yes. One strategy I hadn’t mentioned for people who maybe cleaning their house they find stressful, or driving in the car they find stressful, consider listening to an audiobook when you’re doing these tasks. This can actually take the stress out of that task. That might be a fun way to get all your reading in rather than focusing on the traffic or whatever is frustrating.

Dr. Eric:

I do that all the time. I listen to books these days more than I read them. I read some, too, but I definitely knock out books quicker listening to them. That’s a great point.

Thank you so much, Dr. Izabella. I appreciate you taking the time. Excited about your new book. I definitely recommend all of your books, like I said. Look forward to not only reading but listening to your new book. As of recording this, it hasn’t come out yet, so I preordered it on Audible. Once it comes out, I will be listening to it as I work out and do my chores.

Dr. Izabella:

That’s amazing. Thank you so much for the wonderful work that you’re doing to save thyroids. Really appreciate you. Thank you for having me on.

Recently I interviewed Dr. Krista Coombs, and we chatted about the foundations of thyroid health. If you would prefer to listen the interview you can access it by Clicking Here.

With me, I have today’s guest, Dr. Krista Coombs. We are going to be talking about the foundations. Dr. Krista came up with his headline, and then I will dive into her bio. The headline is “Getting Back to the True Roots of Functional Medicine and How to Apply That Foundational Approach to Better Management of Complex Autoimmune Conditions, Including Hashimoto’s and Graves’ Disease.”

And Krista’s bio: For over two decades and counting, Dr. Krista Coombs has been helping patients learn to manage complex health issues using a foundational approach, integrating Chinese medicine and functional medicine philosophies. Her expertise in autoimmune condition management using easy concepts empowers her patients, giving them hope of mastering helping themselves and increasing their health span. Thank you so much for joining us, Dr. Krista.

Dr. Krista Coombs:

Super awesome to be here. Love talking to fellow colleagues. We can always learn from each other.

Dr. Eric:

Definitely agree. As usual, I love to get the background of the person I’m chatting with. I know you have a history of Hashimoto’s, so if you could dive into your personal journey and how that influenced you becoming an integrative health care practitioner? I know you combine Chinese medicine along with functional medicine.

Dr. Krista:

It’s probably a tale as old as time. Hashimoto’s is pretty common. I didn’t know about it until I was 42. I look back at my life, and I see all of these flares that I was having. I didn’t know what I didn’t know. Nobody told me any different.

When I got into Chinese medicine, I always wanted to be in medicine. I always wanted to be a vet, and I worked with 11 vets in emergency care. I have a degree in science. I have done Chinese medicine for four years. I have been practicing for a couple of decades. I was always really in the thick of it. Then I got into functional medicine. That is when I got diagnosed.

I had to force one of my physicians to test for me because I was starting to suffer so much once I got into perimenopause. I looked back and think, “Gee, maybe I could have saved myself a lot of trauma.” In fact, it’s probably a good thing. Now I have delved heavily into functional. I have become integrative. Got certified by the Institute of Functional Medicine, which was no easy feat.

I have since tried to dial in how to go from really complex ideas. Functional medicine can be pretty complex. You have to know some stuff, and you have to be able to read papers. We are saturated, geeks like us, in this. It’s this deep rabbit hole of information that you never want to leave. How do we make that simpler so that we can actually start living a great life and having a longer health span? I didn’t really come to terms with all that until probably last year.

I was managing Hashimoto’s pretty good but not good enough for what my goals were in life. I am going to be 51 here in a month and a half. I feel like I have de-aged in the last year just by following my own ideas. It’s been quite a journey. Working with hundreds and hundreds of patients like yourself, I have all kinds of complex autoimmune diseases—Hashimoto’s is one of the top ones, especially when I deal with a lot of fertility in my practice or one-on-one.

I just got down to the foundations that were overcomplicated. Now we just try to make it really easy for people to pick those off, figure out how to do that, and empower people to take control of their own selves instead of having to give all their power away to medications, other doctors who don’t believe them, or even to us. They can learn the easy stuff without huge investment, move the needle pretty significantly, drastically really, and heal themselves, even with these complex illnesses. We really get to play and finesse the stuff left over, which is what we’re studying the depths for, so we can help those things instead of teaching them how to drink water.

That’s my story. Man oh man, I can’t imagine not doing integrative care. I can’t imagine. I can’t even imagine retiring. I love it that much. It’s such happy bliss for me. It wasn’t always. Now it’s genuinely happy bliss. I get so much joy out of it because you can make things simple. It’s incredible. That’s my story.

Dr. Eric:

I agree with you. No intentions of retiring in the future. I love what I do. How long have you been dealing with Hashimoto’s for?

Dr. Krista:

Probably most of my adult life when I look back. I have been diagnosed formally since I was 42. I started getting really sick when I was about 41. I look back, and I think, Gosh, how did I not know? But I didn’t. Even with all my education, I still didn’t. Once I started putting the pieces together, it was clear.

I will tell you that the day I got diagnosed, I remember it was May 2016, 8am. I got diagnosed. I sat in my truck and did a little cry because I knew that this was going to be the end, the diagnosis. Then I said, “Okay, next.” I knew I needed to change my diet, so that’s what I started with. Within a week, I was a completely different person. No pain, less inflammation, my brain fog was gone. I could put a sentence together; I used to stumble over words constantly. Then I devoured everything, like you.

I think some of the best practitioners are the ones who go through it. They go through big fire, and they come out the other side going, “Ahh.” I have the fireman’s hose to put out all these fires. I just have to have people learn how to hold the hose and put out their own fires. I will be 51, so almost nine years. This past year, I just learned how to make it so that I think I’ve slowed down the progressions dramatically, even just with easy stuff. I’m a big fan. Now the rest of my life can be awesome.

Dr. Eric:

We’ll definitely talk more about that. Also like myself, you mentioned you went through the Institute for Functional Medicine’s Certified Practitioner Program. It’s not just about functional medicine; you also integrate Chinese medicine. Can you talk about how that has also impacted you?

Dr. Krista:

I think Chinese medicine was pivotal in making me the practitioner I am for sure. I have a really heavy foot and love of Western science. That was my first degree. I love that stuff. However, I have a real desire to learn how to holistically look at us as physical beings and spiritual beings and how that integrates with the environment.

Chinese medicine is very much about that. It’s about looking at systems, biology already, but just not from the Western science point of view, but another way of talking about it and looking at patterns. Everything is about patterns. Instead of just going, “Oh, it’s a liver issue,” it’s not. How do those systems interact with the heart, the lungs, and the rest of the body and the environment?

Learning Chinese medicine was pivotal for me. It made learning functional medicine really simple. It was already the approach I had, looking for patterns and learning how to support where you get the most bang for your buck. It may not be always the gut. It might be something else, some genetic thing that has to do with detoxing the liver for example. You learn how to support that to get massive fallout for the rest of the body. I think that’s where Chinese medicine helped me the most.

I have been an acupuncturist as well, which is one of the tools of Chinese medicine, for 22 years. Starting to age myself. It’s been a passion. I now apply all this integrative knowledge even in my brick-and-mortar one-on-one with acupuncture patients. It’s really changed things. I can’t unthink looking at things as patterns. You must think the same, coming from a chiropractic background. You guys have something fundamentally simple. I think Chinese medicine is a little more patterns oriented. Now you are functional, so you see all the patterns. You can look at somebody and go, “It’s pretty clear,” especially when you have been doing it for decades. It’s easy to help them make some shifts once they get the mindset in play. That’s how it worked for me.

Dr. Eric:

You do acupuncture. I don’t know if you can answer this, or I am curious to see what your answer will be as far as what impact you think acupuncture has on your Hashimoto’s patients, the ones that you see in person. Over the years, I’ve had a good number of people ask me about acupuncture, that they considered going to an acupuncturist. I have been as well. I didn’t go to one when I dealt with Graves’; it was years later. I went through some treatments. I like acupuncture. I have written an article on it. Now that I am chatting with someone who does acupuncture, how can it potentially benefit?

Let me backtrack. Chiropractic can benefit everyone, I think. My guess is you probably think the same with acupuncture. Acupuncture, chiropractic are treatment modalities that can help many people, if not all people. Have you found that it’s an important piece of the puzzle when it comes to improving the health of someone with Hashimoto’s?

Dr. Krista:

Good question. Of course, everybody thinks their profession is good for everyone. I think there is a time and a place. It needs to be a personalized approach. Everything needs to be personalized. It’s not necessary for everyone. Some people can really benefit from it. I do a lot of virtual care in my practice. I am not going to give them acupuncture. If they go to someone else, if they don’t have some of the background, it’s a little easy to coordinate the efforts.

However, that said, acupuncture, I look at it as one of the tools in the toolbox that can help move the needle. Same with chiropractic actually. It’s one of the tools in the toolbox. I do believe a lot of healing can happen if someone is empowered to make better choices for themselves in the day to day. Tools like acupuncture and chiropractic, any kind of body work, can get them to their goals at a faster rate. If they are in a bit of a rush, it can do that.

Where I’ve seen it work the best when it comes to Hashimoto’s management is for people who have a lot of anxiety. They haven’t come to terms with it all, or there are aspects of their physiology that get really agitated when they’re in a flare, and it perpetuates a flare. Acupuncture is good at realigning some of that energetics.

The way I explain it to my patients is I say I’m like a mad scientist. I’m like a mad chemist actually. I’m always playing with people’s chemistry. You do something similar. I am always playing with people’s chemistry. When I look at a body and see these patterns, I go, wow, I have all of these points, almost unlimited, on the body that I can play with in patterns and shift their chemistry. I can turn some stuff down or off or trigger it to go back on. You do that repetitiously, and whammo, they are feeling way better.

I do that a lot with my Hashimoto’s patients who come to visit me. I do acupressure that they can sometimes use in those situations that they can do on their own. I am all about empowering people. There is so much they can do on their own, so they are not spending all their time coming into doctors’ offices. Not all doctors will like me saying that. But it’s the truth. We want to be living our lives, but well. I give them tools on how to do that.

Acupuncture is great like that. It even changes the chemistry. I have even done it on myself. I remember when I first was diagnosed in May 2016. I was like, “Okay, I am going to throw the whole kitchen sink at this.” I would just lay on my own tables and do my own acupuncture, which is not always the easiest thing to do. I’m influencing my own chemistry. I did it twice a week for five weeks, just to get the ball moving and get me feeling a lot better faster. I just thought it’s a beautiful technique. I don’t damage much tissue, just slight microdamage, microtrauma, but it influences the body’s intuitive knowledge of how to clean up those little microtraumas. It really gets things going very quickly. I love it for that.

I’ve coordinated with chiropractors in the past. My clinic was right beside one of the first six years of my practice up in Labrador. They go over to the other side in their bare feet and get an adjustment after getting acupuncture. It used to last longer because we have relaxed the muscles, calmed them down. The energetics were peaceful. They go over there, get their treatments, and hold their adjustments way longer. I’m a huge fan of that. You’re using body work that supports each other.

If they’re doing things to change, uplevel their lifestyle, which is what we could talk about, man, the healing is rapid. It’s like a week, two weeks, and they’re different. I’m always looking for tools like that. But it is one tool in a big toolbox. I think people need to go with what they resonate with. Give it a try.

If you have a great relationship with your chiro or acupuncturist, and you feel comfortable in their presence, and they understand you or at least are trying their best to help you, that’s the person to see. You add that to your toolbox for a little while. If you feel like you might be going into a flare, which is common with autoimmune, you’re anticipating that that could happen because you maybe are getting a root canal done, which you would hope to avoid but gotta happen. Or somebody wants to put you on an antibiotic, or you’re going on a big trip, or you have some tragedy in your life. You can interrupt that and use tools like acupuncture and chiropractic to alleviate that stress and shorten your flare. That’s my experience anyway in the industry.

Dr. Eric:

I agree. You’re right. We’re all probably biased and believe everybody needs our treatment. I will say for the most part, I don’t tell people I work with they need to see a chiropractor. I don’t think it’s essential, like you mentioned with acupuncture. In some cases, maybe it could accelerate the process of healing. I go for regular adjustments even though I admit I’m a little bit overdue. Usually, I try to go for monthly tune-ups.

Dr. Krista:

We’re our worst patients. I’m not anymore though. I have to say I learned my lesson.

Dr. Eric:

That is true. I wanted to switch gears a little bit and talk about the expense of functional medicine, which makes it difficult for a lot of people to work with practitioners such as you and I. How do you approach this in your practice? Regardless of the price, there will be people who say they can’t afford it.

Dr. Krista:

I have been practicing integrative medicine since I was about 42. Just to get the knowledge costs us how many thousands of dollars and time. It’s a pretty remarkable skillset that we have developed. Doing all this tech stuff and teaching, it takes its toll. We already have our autoimmune conditions that we’re managing, and stress is part of that.

In order to offer one-on-one care in a functional medicine paradigm, it costs money. It costs more. Here in Canada, we have subsidized care in the medical industry. People aren’t used to paying for much healthcare. I have really struggled with that: How the heck do I deliver high level care, not necessarily personalized, but teach people how to personalize, get the basics done, and then if stuff is left over, geeks like us can say, “It’s worth investing to work with us because we will take you to the next level. You will get closer to the top of the mountain sooner if you do that.” They are already aware of the power of looking at their body systemically and saying, “Look what I can do.” Then they are really inspired to work one-on-one with us. It costs them a ton less money.

I learned that this year. I have tried to sell one-on-one programs. I have a needle mover membership program where I work with these really complex cases one-on-one. It’s intense for three months, and a lot of them stay. We get a lot of momentum. I am always teaching the foundational stuff. I feel like that’s high cost to teach the foundational stuff. Once they learn it, they can just practice it if they have a good mindset and are not self-sabotaging so much. They have commitment in the game. Then it’s fun for me to add to that and finesse. That’s what I ‘ve learned this year.

I’m saving people a lot of money by offering the foundational stuff. Functional medicine is amazing. However, it’s still in its infancy. It’s still 30-some odd years old. Really catching on the last 10. I don’t know if you agree with me on that. There are a lot of us now in the industry but not enough of us.

I know I hear this all the time: “I’d love to work with you, but you’re too expensive to get that care. The supplements are too expensive. The testing is too expensive.” It is. It’s expensive. I know people say, “Test, don’t guess.” When you have been in it a long time, there is a lot you can see that you don’t have to do the expensive testing for. If they get the basics in line, they don’t even need the testing because it’s really clear. Everything starts to clean up.

I have learned to make it accessible to most people. For those people who still need more of a financial advisor than what I can give, or they are so debilitated that they can’t work, I understand that. You want to have low hanging fruit things they can use to move the needle. They spend their money on quality diet for example. As they get their life back, maybe they can invest in some mini courses or a book that you write. Maybe they will decide to do one of your online programs or challenges. You do a lot of those. Those kinds of things If they are inspired to work for themselves, they haven’t invested a lot of money, but they have learned a lot about the foundational stuff. That’s how I approached it. I think you’re doing something very similar. That’s the way to help people.

This very heavy knowledge-based, information-based world that you and I live in, they don’t have to know all that stuff to make big, massive, beautiful changes to their lives. It doesn’t have to cost a lot. We just have to find ways to teach them how to help themselves at a more reasonable price level. That has been missing in the functional medicine industry for probably the last six years or so, in my humble experience. It’s just been very driven toward really expensive testing.

I know some practitioners who, just to work with them, you have to do three, four, five big tests that are thousands of dollars. Plus an initial visit with them is also thousands of dollars. We probably know as much as they do. I don’t think that they need to do that. It keeps the practices alive, and they can pay all kinds of staff. Maybe that’s wonderful for a certain type of person.

But for the majority of us, when we’re suffering, brain fog, a lot of pain, you can’t focus properly, maybe can’t work, you’re emotional, it’s overwhelming, you’re losing your life, and your experience of it is really poor, concentration is off, you need to start with the foundations. You pick them off, and within a week or two, you’re different. Then you get more inspired to do more for yourself. I don’t think that has to be expensive to learn. But it has been missed.

You go to all these conferences and courses. How many courses do we do a week? I do at least one. People glance over the foundations. They call it basics. “Of course you got to do an elimination diet.” I don’t know, sometimes that needs to be personalized. How do you teach people how to do that? You just assume they understand what the basics are. We understand them because we’re in it all day long teaching it. The average person who is suffering may even forget that water is that essential for example, or sleep is that essential. They don’t have that dialed in. Until they get that dialed in, there is not much you can do for them.

I like lifestyle-focused, lifestyle-first approaches. Get to the very basic foundations, like you’re building a house. Before you start putting in a window or a door and a doorbell with ten supplements or something outside of you, instead of going what can I do, this is my philosophy, Eric. Why is this body having all these symptoms that look like what we call Hashimoto’s, Graves’? This collection of symptoms suggests very strongly that the body you have currently is not in alignment with the environment that it’s in. If you try to change your body, it isn’t going to work. You have to change the environmental inputs.

Once you start seeing your life that way, “I have influence, there is a lot I can do,” it is extremely good, very powerful, I think, from my experience with people, and even myself, when you start gaining confidence that you have say. All of a sudden, your body is going, “Thank you. It’s about time. Thank you for listening.” Some of those symptoms that look like Hashimoto’s start to go away because the body starts to support itself. Then you need less help from geeks like us. Really focused help, then we can move the needle way cheaper.

I will say it’s more expensive to be sick because you lose so much of your life experience potential, not just money. A little bit of investment, you can learn a ton. If you commit to yourself. You do just a little bit more if you want to move the needle a little faster with people like us. That’s been heavily missed.

There is a movement for people like us coming to that place and helping more people at a lower cost point learn how to navigate this complex stuff. I’m excited by that. I think that’s needed. You can’t just learn from a book either. Books are great, but they’re general. If you really want to learn, you have to learn how to personalize it, and you need guides for that.

I always say I’m not a sage on the stage; I’m a guide on the side. That’s what Joe Polish says, and I love that. He always says, “I don’t want to be the smartest person in the room all the time. I want to be in a room where everybody’s getting smarter.” I think that’s why offering these ideas to people in group environments instead of always one on one, which is super pricy, is where the magic lies. Everybody is getting smarter from a guide on the side. You do the same stuff.

Dr. Eric:

Everything you said I agree with. Obviously, the foundations. Then you mentioned not just changing yourself but focusing on the environment. Actually just yesterday, I chatted with someone who was talking about a moldy environment. There is so much you can do with diet and stress management if you’re not getting rid of the mold. It sounds like she did do something; she is aware of that.

Dr. Krista:

It’s also not having fear around what you don’t know, or not knowing what you don’t know. You probably hear this, too. Dr. Google’s great. I do like Dr. Google. A lot of practitioners complain about it, but I like it. I like people are seeking. I like seekers. They are striving to understand how to help themselves. I love that.

What I hear often is people say, “I was looking at all of these different pages, but it seems like everything’s contradicting each other.” Yeah, because you’re not everyone. You’re unique. You need some of the foundational comprehension in order to piecemeal all of the things you’re reading to make it apply for you.

Instead of getting too saturated with that and having all this fear response, which keeps you sick, let’s go down to the basic stuff, the foundations, and say, “What’s not in alignment? What could I do?” It’s the low hanging fruit. You have the beautiful apples on top that are getting a bit of sunburn. That’s a very expensive program, surgeries, tons of meds. That’s high level, out of reach apples. You need somebody to help you get up there to get those apples.

You have apples that are easy to pick. You don’t need anybody to help you get those.

The ones that are on the ground that are still viable, you can bend over and pick those up. You don’t need anybody to help you with that. That’s my role. That’s what’s been missing. I wasn’t always doing this, but I see that as my role to show them the stuff that’s on the ground. Those are the easy ones. You get those, and you won’t be hungry. You don’t necessarily need the ones that are starting to ripen. You definitely don’t need the sunburnt ones at the top. They’re not better. The ones that are protected are better. They are the foundation.

That is the philosophy I have been developing: start with the low hanging fruit first. Then you have so much left over, and the cost of that is way less.

Dr. Eric:

Agreed. One of the questions I wanted to ask you, which I think I know the answer now, but if you want to expand: What do people with autoimmune conditions need to do to manage their conditions, their symptoms, and overall health? It sounds like start with the foundations.

Dr. Krista:

Yeah, I’m a broken record, right? Anybody who hears this will recognize the truth of it. The truth is where it’s true for everyone. It’s not just true for you; it’s true for everyone. That is look at your life. What’s out of alignment? What can you do to create better alignment? I call it the four EASY pillars. I do everything through this lens. The lenses say easy all the time. Joe Polish says have an ELF life: Easy, Lucrative, and Fun. How do you develop an ELF life, practice, relationship? How do you do that? Focusing on what you can do to make it easy.

For all the autoimmune conditions, I don’t care which one you have, I don’t even care how far along you are with it. If you don’t dial in the foundation part, the easy stuff, you’re always needing to do really hard things. You will always decline at a faster rate. It’s inevitable in my experience. I would think you probably agree.

The four EASY pillars. E: anything to do with eating and your philosophy. That’s your immune system, your microbiome. You can start with the first layer of that. Nail it. That lets you graduate to the next layer. You can add complexity if needed.

A is everything to do with activities: mental, spiritual, physical activities. You don’t want to miss one of those. They are all important. Start with the very basics. You don’t have to chew off everything.

S is sleep and rest. There are seven forms of rest. There are different ways to approach sleep. I could argue that’s probably one of the top things that if you’re not working actively on prioritizing that, it’s pretty hard to heal. There is lots of reasons for that.

Y is saying yes yesterday. I am committed yesterday. I am committed to myself. I am making myself a passion project. If the mindset is not in alignment, and you are not consistently trying to find non-negotiables, where you have wiggle room, giving flexibility to your life, it’s pretty hard to maintain even the easy stuff.

If you do that, that’s so easy. If you do that, all of a sudden, everything goes into place. All the organ systems start to uplevel with support. It’s a very food forward, lifestyle forward, not supplement-based program to think about. It doesn’t mean you can’t try those things. But it’s not needed in most cases to move the needle. Some meds might be of course, like for Graves’, just to control things once you have progressed that far with that much damage. Generally, it’s a pretty lifestyle-focused approach.

I will tell you, in my experience, so far, especially this year, for myself even, I started putting these practices in place. I was perfecting it for myself. I have lost 45 pounds in record time just because the inflammation started to go away. Now, my metabolism is reset, I think. I have more flexibility with my food choices. I never thought that would happen. I thought I was going to have to be white knuckling it forever, just to keep my head afloat and be able to consume research papers and talk with patients and stay at work at a high level of function. It’s just so easy. I don’t have to white knuckle everything anymore.

How do you not share that? How do you not go, “Dr. Eric, teach the people?” This is so good. It would help you help them and help you help yourself. Have an ELF practice. That’s why I wanted to geek out with you here today.

That’s the four EASY pillars. I can’t think of anything to add to that. That’s the foundations. It houses literally layers of possibility to look at. They don’t need to be able to recite the Kreb cycle for energy production. We can because we like that. They don’t need to be able to understand that in order to influence it. It’s all about influencing the physiology they have so that the body systems work in more coordination together, and they start to heal. You see people come off meds, like diabetic medications, in record time because we are resetting metabolism, the relationships with sugars and fats. They are resetting the mitochondria and getting more biogenesis because we are doing some intermittent fasting and learning how to personalize it for each person. It puts the power back in these people’s hands. Then they realize, “Oh my god, I have been giving my power away to the powers that be forever. How indoctrinated I have been. I can do all this stuff myself and then have a great life.”

This is what I have always said. I am trying to help people have a better-quality life experience. I am not trying to fix people because I don’t think that’s possible. I don’t think we’re broken. I am always trying to influence them to have a better life experience. Now I am also trying to say how we increase the life span. I have no control over longevity. What if we have some say on health span? That means your quality of life is automatically better. The only way to do that is to be consistent with the basics. If you’re consistent with the fundamentals, your body declines at a very slow rate.

Dr. Eric:

Just to repeat: E is eating. A is activity. S is for sleep. Y is yes to yesterday.

Dr. Krista:

It’s about saying I am committed. If the mindset piece is not there, if the sleep piece is not there, if the appropriate style of activities aren’t there to help with various organ systems, and if the eating and daily choices to support that physiology aren’t there, the basics, you cannot out supplement that. You cannot out medicate that. No surgery in the world is going to fix that. That’s why I can’t see anything else to add.

I came up with that idea. It was at my 50^th birthday last March. I was at a cabin, which I love to go to. I am an avid kayaker. Anything I can do in nature is bliss for me. I couldn’t go kayaking because there was still ice on the water. Most of the lake was frozen. I was all ticked off because I couldn’t go kayaking in March. I am in Canada. It’s not like I can go kayaking. I was laying on the beach and I was kind of moody. What the heck? How come I can’t make my health get better with all of this information that I have, all of this knowledge? I have helped lots of people. Why am I still struggling? I laid down and did some tapping. Have you heard of tapping? Emotional freedom technique.

Dr. Eric:

Yeah.

Dr. Krista:

I take it most of your listeners have as well. I love that. That’s foundationally built on acupuncture. It’s acupuncture points that we’re tapping. I am tapping and trying to shift my physiology. All of a sudden, I said, “Why can’t I make this easy?” I snapped out of it and thought, “Why can’t I? Of course I can.”

I am always overcomplicating things. I sat right up and was looking at the water and was really calm. I came up with what could EASY stand for? That’s how I came up with the four pillars. I was so excited that I couldn’t even wait to get home and talk about it with patients. What if this was all we looked at? Then I started doing that and setting up a program. We got so many people feeling better really quickly, losing weight, normalizing their metabolism. That’s really all I do now.

Why do I need to complicate something that can be so simple until I need to complicate it? I have the skillset like you. I have the knowledge we can pull from and dial things in for people because that’s what functional is, right?

That’s my little story. I thought that was kind of neat. Mindset work, getting yourself into that cool space where all these beautiful ideas just come from the universe, and they just gel.

Dr. Eric:

That’s wonderful. I love that EASY way. Quick question with the eating part of that. I’m sure some listening to this will wonder if there is a specific diet you recommend. Do you eat whole, healthy foods?

Dr. Krista:

Specifically for autoimmune management, everybody in your listenership is aware of this because you’re preaching to the choir. They understand what you’re talking about. We’re not talking to an ignorant audience.

There are times where there are non-negotiables for foods. If you have developed an autoimmune disease and have cross reactivity with certain proteins or peptides, leaving them out because the immune system has a memory is smart. It’s not an eating disorder. It is smart. There is no fear around that. It’s a choice you make because it serves you, and it helps your body survive.

There are some non-negotiables. Research is pretty clear what those are. I’m sure you talk ad nauseum about them to your people. The top of course is the gluten protein. We know this. Maybe not just the protein itself, but things that are in those particular parts. It doesn’t mean that gluten is bad. It means it’s not so great for you in your life. That’s it.

Same with dairy cross reactivities and the proteins there. If there are any digestive insufficiencies, you will have more insensitivities. Corn, eggs, grains. You can personalize that, absolutely, but you have to start from the basics to be able to do that. Your gut needs a rest. Your immune system needs a rest. That is why we do something like an elimination style diet.

My approach is basically a reset. It’s about resetting the metabolism, resetting how your body handles sugar, which is huge for inflammation and stimulating the immune system; how it deals with fat; and how it deals with trying to help the cells recover function. I call it a metabolism reset. It involves four phases.

We start with a couple days where we are overeating and doing all kinds of things. A goodbye to inflammatory foods party. If you are gluten free or dairy free already, you still do this part and trigger all kinds of cool chemistry in your body to get yourself ready for a reset.

That’s 6-8 weeks where it’s an elimination style diet, but it’s not really AIP. It’s a little different. We can tweak it. I have ideas on how they can individually do that to personalize it for themselves. They know themselves best, right? There is no one diet that fits all. We reset the metabolism.

Then we start bringing some things back. The body learns how to tolerate that and increases tolerance. A lot of healing has already happened. On average, everybody is losing about 25-30 pounds in 6-8 weeks. It’s rapid. People who are already on the thin side lose a little bit, but their brain fog goes away, and their pain goes away. They just learn a better way of structural eating to serve their body. It’s just so easy.

Then we dial in activities for each phase. We dial in how to improve sleep strategically. That’s not an extra added stress on the body. How to work on their why for getting well and making that detailed so that they always have a reason to be committed, not just, I don’t like having pain.” It’s “I want to go kayaking,” or “I want to start a business,” or “I want to walk my kid down the aisle in six months.” That’s the why. It has nothing to do with the autoimmune disease. It’s about putting the body in a better environment by changing the environment you are putting it in.

The body thanks you. That works for the body. You just go, “Oh, wow. Look at the power I have.” That’s what I do. I feel that timing of meals, figuring out what works and doesn’t work for your body, gives you so much power. It really does. Once you realize what it really means, that’s what we know.

I teach people you don’t have the fear anymore. You just know what everything means when stuff happens. Then you can make better choices. You can recover from flares pretty quick. They create their own first aid kit. You anticipate a flare, and you know how to eat for that. You know how to live for that. You know how to recover from that much more rapidly, so you are not causing more decline and developing more autoimmune diseases.

We know that with Hashimoto’s and Graves’, you are probably 5x, if not more, likely to get another autoimmune disease. How many people have you seen who has more than one autoimmune disease if you dig? Probably hundreds. If we do pretty comprehensive testing, you can see if they have elevated antibodies against other organ tissues. They are suffering.

Everything you do fundamentally, the foundations, influence every single one of those autoimmune processes. It’s all related. The immune system is protecting you. It’s pretty wise. When you start resetting your relationship to food, mentally, and your relationship to yourself, everything starts to get better.

I sound like an evangelist. I’m not even selling. It’s so real. It’s so empowering to watch people learn that they can actually help themselves instead of coming to our practices and always saying, “Please help me,” and they are crying and have nowhere to go. I can teach you how to help yourself get somewhere. That’s my passion. That’s bliss.

Dr. Eric:

Thank you for sharing all this great information. Can’t agree with you more about the foundations. A lot of practitioners, including myself, sometimes overlook them. Of course, everyone who comes into my practice, we don’t skip over diet and stress management. Sometimes, we go down a rabbit hole of complexities.

Dr. Krista:

That’s because it’s fun for us. We love it. And you and I are people who really love this stuff. We want people to feel better. We are almost overwhelmed if we can’t do it fast. We’re used to being fee for service. We want things fast so people like it and do well. I’m always trying to do it fast. We feel an innate sense of responsibility to do that. But we also love the science. It’s fun. You don’t have to be a geek to be able to personalize your own care. That is what we sometimes forget.

At least I did in my practice for 20-odd years. I really did. I glanced over. I just assumed people are drinking their water and going for a walk and sleeping. I’m looking for big stuff. We have to over supplement. Green medicine is everything. This herb for that. Adaptogens for stress management. Seriously, get rid of the stressor. What could we do to reduce some of the stressors or learn how to adapt to those stressors a little better with mindset, so you don’t need another supplement or thing that could be maybe even triggering the autoimmune process and spreading things?

Listen, I want to offer your listeners. They are obviously in alignment with you, and you and I are in alignment. I have a mini course called “Building Immune Resilience the EASY Way.” It’s 10 modules. I will give it to your people for free. Would that be okay?

Dr. Eric:

Yeah, that would be wonderful.

Dr. Krista:

I guarantee it would be in alignment with what you teach them.

Dr. Eric:

Thank you so much, Dr. Krista.

Dr. Krista:

If they use the code EASY100, they will get 100% off. Free for them as a complimentary thing because I want your people to get that little boost, so that when they are working with you, it makes even more sense. They can have that. It’s pretty awesome, and it’s easy to consume and apply over time. Everything I do is easy. Give it to your people. You take a look at it and see what you think.

Dr. Eric:

I’ll check it out as well. Anywhere else you want to guide people where they can learn more about you?

Dr. Krista:

Sure. My signature program is affordable, and we have an awesome private group. I am not the sage on the stage; I am the guide on the side. I like coaching in a group. I think it’s something I’ve missed in my whole career. I love it.

We have this private group called The EASY Way with Dr. K. It’s an online course that you get to teach you through those four phases and reset your metabolism and your life pretty dramatically. You’re in a group of like-minded people. All those people are coaching each other. It’s peer coaching. It’s accountability. I have a lifestyle coach in there who is excellent. She also has training in functional medicine. Then there is me. You have a doctor teaching people how to do stuff.

I’d love to have you in there and do a Q&A or a live on some cool thing any time. We have a few people in there with Hashimoto’s and other autoimmune diseases. Everything you talk about would work for them. I’d love to cross-pollinate. They would learn a lot from you. That would be brilliant. I love having those cool conversations with like-minded people. That’s TheEasyWay.ca. They can always reach out to me on Facebook with questions.

Dr. Eric:

Thank you so much, Dr. Krista. Appreciate you joining us here and sharing your knowledge about the foundations.

Dr. Krista:

Thanks for the opportunity. This was brilliant. I love this. How can you not want to do this all the time, Eric? This is awesome. I’m glad you do it. You help a lot of people.

Dr. Eric:

I agree. I definitely love what I do. As you said earlier, definitely don’t have any intentions of stopping anytime soon. I’ll admit, I love doing Facebook Lives. I love doing podcast episodes. But I love the guest interviews because I’m always learning stuff, too. I enjoy these even more than just doing the solo episodes because the solo episodes are honestly more work. I’m doing all the talking and not learning anything.

Dr. Krista:

You know what I find, too? When you get minds like us together, it’s like a hive mind. You come up with these beautiful ideas that you would never maybe have thought of before. It expands your potential to help other people, which is what we’re here for. We love helping people. You learn more through conversation. Thank you for the opportunity.

I wish I’d reached out to you a long time ago and gotten to know you. I bought your book years ago when I was first diagnosed with Hashimoto’s. That really helped dial things in for me. That was part of my evolution in functional medicine. I’m very grateful to you for that. I bought it in 2018.

Dr. Eric:

Which of my books?

Dr. Krista:

The one on Hashimoto’s.  I think you had just posted it on your website. I was following you at the time. I don’t know why we never communicated before.

Dr. Eric:

I don’t know. I’m glad you reached out to me. I’m glad we did this interview.

Dr. Krista:

I’d like to have you in my groups, too. I have a group that’s called Hey Hashi and Healing Inspiration: The Easy Way. That’s all about Hashimoto’s. I have DrKristaCoombs.com as my Hashimoto’s website. But I work with all autoimmune. My practice sees everything. I am not as dialed in as you are even though I deal with Hashimoto’s myself because I think they’re all related.

Dr. Eric:

Thank you again, Dr. Krista.

Dr. Krista:

Thanks for listening.

Recently I interviewed Carrie Vitt, and we chatted about how castor oil packs can benefit people with both hyperthyroidism and Hashimoto’s. If you would prefer to listen the interview you can access it by Clicking Here.

I am excited to have Carrie Vitt with me today to talk about castor oil packs. This is a topic that has not yet been discussed on the podcast, so I am going to go ahead and give Carrie’s short but sweet bio. Carrie is a functional nutritional therapist at Our Well House. She is the publisher of the health and wellness site Deliciously Organic. Carrie specializes in teaching about how to use nutrition, detox therapies, and live cell changes for those with thyroid disease and autoimmunity. Thank you so much for joining us, Carrie.

Carrie Vitt:

Thanks for having me. I’m happy to be here.

Dr. Eric:

I meant what I said. Obviously, I am excited when I speak with anybody, but I don’t know if there is anybody who has been more excited to talk about castor oil packs. I have been looking for an expert for a while. We met years ago at Dr. Izabella Wentz’s Thyroid Mastermind, I think it was in 2015. I don’t think we chatted about castor oil packs then, but I’ve been following you. I’m glad you agreed to this.

Carrie:

Definitely.

Dr. Eric:

Why don’t you start out with your backstory? How you got into what you’re doing with the castor oil packs, but also just helping people with thyroid and autoimmune thyroid conditions.

Carrie:

I got started in this whole world, I guess you could say, about 20 years ago. I had chronic migraines and IBS and eczema and discovered it was through my food. Pretty soon after that, I started my site, Deliciously Organic.

Then years later, I had an amalgam filling removed. Amalgam is about 50% mercury. I didn’t know at the time I needed to go to someone who was properly trained. It was a very long appointment. As soon as I sat up from the chair, I knew I was sick. I actually told the dentist, “Something’s wrong with me. I don’t feel well.”

Over the course of a couple months, my health took a nosedive. I became allergic to literally every single food. There was not a food I could eat that I didn’t react to. I was reactive to tap water, perfumes. I couldn’t do anything. I had 24/7 hives on my neck and all over my face. I was very miserable. I couldn’t sleep. My hair was falling out. Depression. You name it.

My doctor wasn’t taking me seriously. I knew something was wrong with me, and they just kept saying, “You have dry skin. Go home.” It took me nine months to find a doctor who would run just literally basic labs on me.

I also went to an allergist because I was reacting to everything. Of course, I must have allergies. Everything came back negative. She actually said, “You know what? I’ve heard of people with Hashimoto’s that get hives. Let’s test for that.” Lo and behold, I have Hashimoto’s.

They offered me thyroid medication, and I was already coming from the perspective that food and lifestyle changes and all that can heal and change the body. I asked the doctor, “How is this going to heal my thyroid?” He was like, “Yeah, no, that’s not how it works. Your thyroid is going to stop working. You’ll be on meds for the rest of your life.”

I said no thank you and started working with a holistic nutritionist who helped me with a nutrient dense diet. I used a lot of castor oil packs and some other detox and drainage therapies. Whole food supplements, which we changed according to my labs and symptoms.

One of my biggest root causes, because we always know there are multiple when we have autoimmunity, was the heavy metals. My liver had gotten overloaded. It took me a while, but fortunately I was able to get the disease into remission. I still don’t take any medications, which I’m very thankful for.

It gave me a passion to start helping other people that are in the same situation. When I went through all this, I didn’t know that millions of people have thyroid disease. When I came out on the other end, I went back and got my certification and actually joined the practice that my nutritionist owned. I mentored under her for many years. She unfortunately passed away a few years ago. Now, I continue to work on sharing and teaching other people all the things that honestly she taught me. I feel like 95% of what I know is what she taught me through working with her and her mentorship.

It’s really fun to help people now that have thyroid issues. Even if it’s giving them little steps that they can take to feel a little bit better.

Dr. Eric:

Thanks for sharing that. Great that you’re not on any thyroid hormone replacement. You have never been on it?

Carrie:

I never took it. I look back at my labs, and I’m like, “Wow.” I was kind of a mess. Deep down, I knew this was not what I wanted to do. I know that’s not for everybody. I think thyroid hormone replacement can be very helpful. It just wasn’t for me. We were able to get my thyroid working again, the conversion going again. So far, I have never needed it.

Dr. Eric:

Awesome. It does depend on the person. If someone listening to this is taking thyroid hormone replacement, it might be something you need to take. Unfortunately, probably just about all medical doctors, once they see that elevated TSH, even without testing anything else, some of them don’t even test the antibodies, but they will put someone on thyroid hormone, and that’s it. You need to take it and stay on it. Great that you have avoided it.

Before we dive into the castor oil packs, can you talk a little bit about the lymphatic system and why it’s important?

Carrie:

The lymphatic system runs all throughout the body. It’s super interesting that from the neck up, there is over 300 different lymph nodes. There is a lot in the neck around the thyroid and above the neck. Basically, it helps get rid of waste, if we are going to put it super simple.

It doesn’t have a pump. It’s very important that we move our body so that it can pump, and things can move through. A lot of the lymphatic system also goes through the liver. It’s important to keep it moving, if we are just going to keep it really basic and simple so people can understand. But it’s really important to have that movement. If you don’t, then the system can get congested, and we can start to see, especially in the thyroid, nodules and swelling and things like that.

Dr. Eric:

That is perhaps the main way that castor oil packs can benefit people, by helping to support that lymphatic system.

Carrie:

Yes.

Dr. Eric:

How about nodules? If you could talk a bit about your experience, either your personal experience, because you did say you used castor oil packs when you were dealing with Hashimoto’s. I know it’s not just the thyroid. Did you just use it on your thyroid? Do you recommend it for people with nodules? Is it just for people with Hashimoto’s, or can people with Graves’ also use them?

Carrie:

It can be used for a lot of different things. You have a piece of cotton flannel, and you put some castor oil on it, and you put it on you. We can talk about the details of that if we want. When we do that, it soaks into the skin. Studies have shown that it actually helps raise your lymphocyte count. These are the white blood cells, the soldier cells that get things done. They can raise them for up to seven hours, which is cool. I really love using them for myself and did use them for myself.

For my clients, doing a castor oil pack at the end of the day because it will raise those lymphocyte levels. You take that pack off and go to sleep. When you are sleeping, your body does all sorts of work, like rest and repair and detox and healing and restoring. You have those lymphocyte levels up. It is like hitting a boost button on your system to help the system heal and get the things done that it needs to do.

I always advise people using it over the liver first. It’s very important to start doing that first before you start using it on other parts of the body. If you immediately start using them over the thyroid, in my experience, and in practitioners’ experience I have studied under and talked to, it can cause a negative reaction, like a rash or itching or raised bumps. It’s a really good idea to do them over the liver about three times a week for a month. Then you can start doing them over different parts of the body.

They can be used for thyroid cysts and nodules, for your liver. They are also great for ovarian cysts, uterine fibroids, constipation, inflamed joints. Obviously, lymphatic drainage. Headaches, migraines, or conditions where you have poor elimination in the body. You can kind of use them anywhere. If you sprain your ankle, you can use it on your ankle. If you have ovarian cysts, you can use it on the lower abdominal area.

You asked about how to use them with the thyroid. I found that it helps slowly and very gently drain the tissues. If there are things in there that need to come out, if we are going to keep it real simple, then it helps with that. I recommend you do one over your liver for a few weeks and then try and do it over your thyroid. You can do that for about 15 minutes and then follow it up with one over your liver.

If you have Hashi’s, you can use them. Hypothyroid. When it comes to Graves’ and hyper, you just want to be careful using it over your thyroid, especially if you have elevated T4 because if you do that over the thyroid, it could cause the tissues to just be too active. You could have a negative reaction. You just want to go very slow.

Of course, it also helps to know, even if you have been diagnosed hyper or with Graves’, what are your thyroid hormones up to? I’m sure you’ve worked with clients who have Graves’ who have antibodies, but they don’t have elevated thyroid hormone. It’s always good to know that and gauge and go very slowly.

Dr. Eric:

That’s good to know. If someone has overt hyperthyroidism, like if their T4 is specifically elevated, they probably want to stay away from putting castor oil packs on the thyroid, but they can still put it on other parts of the body, like the liver three times a week, and continuously do that until the thyroid hormone levels normalize, or at least the T4 normalizes.

Carrie:

Yeah. You can use that and just go slow. If you have been diagnosed with hyper or Graves’, just five minutes, and see how you do. Slow is the name of the game when it comes to all of this stuff.

Dr. Eric:

I agree. In a lot of things, you want to take it slow. When you start putting it on the thyroid, maybe start with five minutes. Would you want to build up? With the liver, is it the same thing? Eventually do three times a week for the thyroid as well?  

Carrie:

Eventually, you’d want to do I’d say about 15 minutes over the thyroid. You can work up to doing that every day. I would say go super, super slow. But you can do that three times a week just for 15 minutes. Always do it for 15 minutes, then follow with a pack over the liver. That’s the same for if you’re doing it anywhere else on the body. Castor oil packs are also great for cysts in the breast tissue. Let’s say you do it over the breast tissue for 15 minutes. Follow it up with the liver. Always follow up with the liver afterwards.

Dr. Eric:

For another 15 minutes?

Carrie:

45 minutes. 15 minutes over the other part of the body, and 45 over the liver.

Dr. Eric:

How about larger goiters? Have you noticed it helping in some situations, if the person is not hyperthyroid, but for whatever other reason, they have a large goiter? Have you noticed it shrink a goiter?

Carrie:

For goiters, cysts, and nodules, I have seen it help all three. I always combine that though with iodine supplementation. I am in the camp and was trained, because I know that’s a controversial topic. Of course, we can’t make thyroid hormone without iodine. But also, that iodine supplementation, especially with goiter, because a lot of goiter is rooted in iodine deficiency, that can really help to bring down the inflammation when you use iodine supplementation along with castor oil packs. I have seen it happen in my practice, and even members of my thyroid course have let me know, “My doctor let me know my cysts have shrunk, or they are gone. My nodules have shrunk, or they are gone.” Do you want me to talk about iodine for a second?

Dr. Eric:

I didn’t know we were going to bring this up, but I love talking about iodine. I don’t know if you use Ioderal. What do you recommend or use?

Carrie:

I always go very slowly. Slow is the name of the game, again. I usually start with Prolamine Iodine from Standard Process.

Dr. Eric:

Very familiar.

Carrie:

Sometimes, I’ll have them do half a tablet. A lot of times, we will start with one and slowly start working up. The way I was trained, and the way I have seen it play out with clients in my practice that I have worked with, is you have to make sure that T4 is not elevated. If T4 is up, let’s not supplement with iodine right now because that could cause that to go up. If that’s not elevated, then usually iodine supplementation can be used. I have found even for those with Graves’, a lot of times, they are iodine deficient.

We often think iodine is needed for the thyroid, but we need it for so many other tissues in the body. Sometimes, when people supplement with iodine, they might have a negative reaction. There can be different reasons for that. Maybe they just don’t need it because we don’t all need these different kinds of supplementation. Or their T4 could be up. The third reason is liver congestion. It’s causing the thyroid tissues to detoxify too fast, and it’s causing a negative effect.

If I see someone that has a negative reaction, I have never seen it in the years I have been working one-on-one with clients. You can work on the liver for a bit longer and then go back and start supplementing with iodine.

I wish I had a number. Dozens and dozens and dozens of clients I have worked with with Hashimoto’s, I supplement them with not mega doses by any means. Maybe we’re at 1mg or something like that. But we supplement with that. Of course, doing nutrient dense diet, detox, all those things, and their antibodies come down. I have never seen it add fuel to the fire, ever, when I do it in the way that I was trained. There are things you want to watch out for. I’m a big fan of it. It has antiviral properties to it. It’s really important. I think that’s one of the things in the thyroid community that we have missed.

Dr. Eric:

I’m definitely not anti-iodine. I will say I am cautious as far as taking really large doses. I have had a good experience with iodine in the past. I am very familiar with Prolamine Iodine from Standard Process. I read Dr. David Brownstein’s book on iodine.

Carrie:

Oh yeah.

Dr. Eric:

It’s interesting. You said usually you also don’t go real high doses, like 1mg usually.

Carrie:

Yeah, that’s not super high, compared to Dr. Brownstein, who was doing 50mg.

Dr. Eric:

Exactly. I think a maintenance dose is 12.5mg, according to Dr. Brownstein. Do you do a urinary test, or you just do it slow and see how they respond?

Carrie:

I always look at their thyroid numbers first, so we can know if we’re hyper or not. I obviously don’t diagnose or anything, but I just look. Then we have some signs: If you have nodules or cysts, or maybe you’re not sweating, or maybe your eyes aren’t tearing, we’ll just slowly start to add it in. Usually, I will get up to 1-2mg, but that’s also with them eating foods that contain iodine. I’ve seen such good results. Especially going back to the goiter, the nodules, the cysts, using that supplementation along with supporting that liver and doing those castor oil packs over the thyroid, it’s just a good combination. I have seen it work over and over.

Dr. Eric:

You gave a few reasons why someone might have a negative reaction to iodine, including liver congestion. On top of that, iodine competes with the other halides, like bromine. If someone has higher levels of bromine, for example, and they take iodine, you could have a detox reaction by excreting the bromine.

I didn’t expect you to talk about iodine, but I’m always interested in chatting about iodine. I am on the cautious side, like I said, but I am not overly cautious, where some will say don’t even give a multivitamin with iodine and avoid all foods with iodine.

Carrie:

Which I hear a lot. Any time I talk about iodine on social media or my sites or my email, people always come back, going, “Wait, I thought iodine was bad for the thyroid. I thought it was horrible if you had Hashimoto’s.” I hate that people think that because there are caveats. Yeah, for some people, you might need to pull back a little bit, but we need iodine for salivary glands, to be able to sweat, for the breast tissue, for so many things. It’s not just for the thyroid.

Dr. Eric:

Well said. Let’s go back to the castor oil packs. If you could talk about how can people use the castor oil pack, and where should they get the materials to put them together?

Carrie:

Like I was saying, the reasons that we could use them are for goiter, nodules, cysts, just to support your immune system. If you get sick, they are a great thing to have on hand because they raise your lymphocyte levels. They can be really helpful for your liver, especially if you struggle with migraines or are struggling with converting free T4 to free T3 or are constipated. There are lots of different ways to use it.

I personally am a fan of just buying a piece of cotton flannel. You usually have to order them online, or some small health food stores will carry that. Then a bottle of organic, hexane-free castor oil. Hexane-free is not hard to find; it says it on the label.

I know there are companies selling kits. It’s just a lot more expensive, so I don’t see why you need to spend more money on a pack like that. Get your cotton flannel and your castor oil.

I recommend a hot water bottle, an old towel. Now I’m not big on plastic, but a Ziploc bag. You take that piece of cotton flannel. You drizzle the castor oil on it. Then you lay down, and you put that over your liver. That’s on the right side under the ribcage. If you’re a woman, it goes up over the breast tissue. Men have breast tissue as well. But you know what I mean. Or it goes on the lower abdominal area, that’s totally fine. You have that cotton flannel there.

I put a Ziploc bag on top of that. Then I put an old towel. The reason I do this is because castor oil stains anything and everything. If you just put the old towel, then it will start seeping into the towel, and it gets everywhere. Having that Ziploc is a barrier. Some people have written in and said they want to use parchment paper. Great! You would need to use a new piece every time.

So you have the flannel, the Ziploc or some kind of barrier, the old towel, and on top of that, a hot water bottle. I prefer a hot water bottle over a heating pad, so you are not dealing with any electric currents or being exposed to that. Plus a hot water bottle is really nice to have on hand. If you don’t have one, they’re just nice, especially in the winter. If it’s cold, fill it up with hot water, and put it on your stomach. If you’re just having a day where you feel down, it’s very comforting to use a hot water bottle on your abdomen or something like that.

When you have the castor oil pack on you, just lay there for 45 minutes. Read, watch TV, whatever you want. Sleep. You can do 45 minutes to an hour. I know it’s trendy right now to sleep in it. But that’s really messy, first of all. It will get all over the place if you roll around.

Second, I have talked to some practitioners who’ve said if you keep it on for too long, then toxins could start coming out of the skin into the pack. You don’t want that. You just want the body to absorb it, and then you take it off. 45 minutes, and you just wipe it off, like whatever residual is on your abdomen, wipe it off with that old towel. That’s how you do it over the liver.

If you are going to do it over any other part of the body, let’s say the thyroid, because that’s our main area we’re talking about. Just cut a little rectangle off of that cotton flannel. That’s also why I don’t like to buy these packs that are a certain shape or size. You just want it to hover over this part of your neck where your thyroid is. There is enough warmth coming from your neck that you don’t need to use the hot water bottle. Just put that there, and a little towel. You just want to lay there with your head back. 10-15 minutes, the first time. If you have any kind of negative reaction, just stop, wipe it off, and it’s okay. Just means your thyroid is not ready. Then you do it over your liver for 45 minutes.

Dr. Eric:

How long can this person use the same castor oil pack? If they do it three times a week, or with the thyroid, they could use it daily if they wanted to.

Carrie:

6-9 months or so. If it starts to discolor or smell, switch it out. Usually, around 6-9 months, I just switch it out. I have never had one discolor or smell, but that’s the general rule of thumb. You can use it for a long time, which is really nice.

As I mentioned, it’s great to have on hand if you get sick. Maybe you have an infection in your lungs. You can use it over your lungs. I used to use those on my kids when they were sick all the time to help them recover.

Dr. Eric:

That’s interesting. I didn’t know that either. If you’re having any type of respiratory infection?

Carrie:

Yeah, they’re super gentle. Might as well.

Dr. Eric:

I’m going to ask you a question that you might not have an answer to.

Carrie:

Okay.

Dr. Eric:

That’s fine. Or maybe you do. You mentioned that castor oil packs help to increase the lymphocytes. If you had a CBC (complete blood count) with differential, and the lymphocytes prior to doing anything with castor oil packs, were elevated, would that be a contraindication? Would you say they don’t want to do the castor oil pack?

Carrie:

I know that raises the T11. I guess you would have to know specifically- I feel like you’d need a little bit more detail. Maybe I don’t really know the answer.

Dr. Eric:

Okay.

Carrie:

It’s pretty rare that I’d even see someone with high lymphocytes. All of my clients that are open to castor oil packs just do them. I have never had anybody have a negative reaction.

Dr. Eric:

I don’t see a lot of people with elevated lymphocytes. I have seen them over the years. What I do see a decent amount of is if you look at the CBC breakdown of white blood cell count, neutrophils ideally should be greater than lymphocytes. I will see frequently where lymphocytes are greater than neutrophils, but they are still within the reference range. I just wanted to pick your brain. It sounds like it’s probably not a big deal. You haven’t seen anything negative with someone in that situation.

Carrie:

No, I have never seen negative reactions, unless it’s like a little rash or something. Just stop doing them for a while. Let’s work on diet and sleep and other basic things, and then try them again.

Dr. Eric:

Sounds good. Is there anything else that I should have asked you about castor oil packs that I didn’t ask you? Anything else you think people should know?

Carrie:

When should they not be used? In general, if you are pregnant or nursing, you shouldn’t use them. Some people say it could be okay. If you are thinking about that, definitely talk to your practitioner. See what they have to say.

It is contraindicated if you have an IUD. It could cause extra copper to leach out if you have an IUD with copper. Or it could cause it to dislodge. Don’t use it then.

If you have internal bleeding, you don’t want to use a castor oil pack.

If you have Crohn’s or severe diarrhea, IBS, you need to be careful. Maybe just use them for 10 minutes over the abdomen.

Any time you have a kind of serious issue like that, always talk to your practitioner. A holistic practitioner might understand castor oil a little bit more and give you more guidance, but those are the situations where you wouldn’t want to be using it without talking to your practitioner first.

Dr. Eric:

There is a good chance if you went to your primary care doctor or an endocrinologist and asked them about castor oil packs, they probably wouldn’t have any idea.

Carrie:

Probably not. It’s always good to ask, I guess.

Dr. Eric:

It’s always good just to play it safe. If you’re not sure if you should take it, run it by your medical doctor, and see what they have to say. Just saying, chances are, they’re like, “I don’t know. I have never had anybody ask me that question. I’m not sure.” Just be prepared for that response.

Carrie:

Yeah. If you have an open wound, that’s probably self-explanatory. There are some situations.

In general, I have seen so many people be so helped by them. A lot of people tell me that it is really very relaxing. I don’t know if that’s just because it’s forcing you to sit down. I know that we live in a pretty hectic world, and a lot of us don’t really sit down.

I’ll just add to that that some of these kits that are sold are sold with the idea of Velcroing it to yourself, and you just go work. I think part of it is that you want to lay down. The body needs to be in that parasympathetic state to detox, heal, repair, rest, restore. I think it’s a good idea to not work on your computer. Allow yourself some time to sit and chill so that it can have better benefits for you.

Dr. Eric:

That’s good advice. Do you currently still use them on a regular basis?

Carrie:

Yeah. I’m in maintenance mode for my thyroid and immune system. I’ll generally do them once or twice a week. If I’m not feeling well, or sometimes we come in contact with toxins, I know the different symptoms that I can have if my body was exposed to something, so I need to help clear this out. Then I will do some extra packs that week.

Dr. Eric:

I know you also have a lot of experience with essential oils. I didn’t want to spend too much time on this; I wanted the focus to be on castor oil packs. If you could just discuss some of your favorite essential oils that relate to the thyroid or could support the immune system for those with Graves’ and Hashimoto’s.

Carrie:

I think the #1 thing when it comes to essential oils with thyroid disease is any oil that makes you feel more relaxed, that’s probably a good fit for you. The HPA axis balance, the adrenals, that’s really important. Helping your body shift into that rested state is really important. Diffusing whatever it is that you like is going to be beneficial.

When it comes to oils that are more specific for the immune system or thyroid, frankincense is the mother of all of them. It is amazing. Using that daily. Frankincense, using it topically instead of diffusing it, you will find more benefits.

Some of the other ones I like for the thyroid are myrrh. It’s been used for thousands of years. It contains properties in it which can erase or deprogram miswritten codes in cellular memory, which is cool.

Lemongrass is another one to really support the thyroid.

Basil is great for the adrenals. That endocrine system is all connected. I like to use oils that are going to support different parts of the body altogether.

Margarine helps support the spleen. The spleen is an important organ for the immune system when it comes to antibodies and white blood cells. It can be a good one to put in there.

I really like a blend. Hundreds of people have written back to me to tell me it’s helpful. It’s clove, frankincense, myrrh, lemongrass, basil, and margarine. I like to do 10 drops of each in a glass roller ball and then top it off with fractionated coconut oil. If you think that’s too potent, use fewer drops. Totally fine. Whatever you’re comfortable with. Another controversial topic we don’t need to get into. I find using it on the bottom of the feet or the spine is really helpful.

There are some people who have told me they have used it on their thyroid, their neck. Lemongrass, you can be more sensitive to some of those oils. For me, my skin on my neck and face is more sensitive. When I use stuff like that, I get a rash. I don’t like it. I can use it on my spine or the bottoms of my feet.

I have actually had women tell me they use this blend daily. I am not making any claims or anything. They use it daily, and after a few months, they were able to lower their thyroid medication. Wow, that’s cool. I don’t know what else they were doing. They could have also been pairing that with a lot of other things. I find it to be very beneficial.

If you’re just wanting to use some oils to help generally, then diffuse some that help you feel less stressed, whether it’s lavender. I love rose and magnolia and jasmine. I am very much a floral kind of a girl when it comes to those.

I don’t know if you have seen the dōTERRA Emotional Wheel. If you Google it. Let’s not Google it. The wheel is really cool because it has a bunch of emotions on the inside, and on the outside, it shows you different oils that correspond with those emotions. The first time I ever saw the wheel, I’m like, “No wonder I like the florals so much.” Those correspond with different emotions that I struggle with more. I just find that wheel very helpful, regardless of whatever brand you use. It could help you realize what kinds of oils might be best for you to help your system chill out.

Dr. Eric:

The essential oil blend you mentioned, that’s fine for people with Graves’/hyperthyroidism, too?

Carrie:

Yeah. Use it for everybody. If you’re sensitive, pull back. Use fewer drops. Do one swipe instead of three swipes. Everybody is different. You do have to figure out what works best for you. I have found that blend amazing across the board for people with thyroid issues.

Dr. Eric:

I know you said you didn’t want to go there as far as the controversy with the dosing. Is it because most will recommend one or two drops, and you mentioned 10 drops of each?

Carrie:

I feel like no matter what dosage I recommend, there is always somebody who says, “Why would you say that?” I feel like it’s up to you. I personally like the 10 drops of each. I like it when that roller ball blend is more potent. I personally find that that really helps me. Some people might be more sensitive, or their body doesn’t like it. They can use less.

Dr. Eric:

Like you said with going slow earlier, same thing could apply with castor oil packs. They could always try one or two drops. If they feel that’s working well, that’s great. If not, they can always try to increase the dosage.

Carrie:

Exactly. Slow is the name of the game. That should be our theme today.

Dr. Eric:

Yeah, that’s a good theme. Thanks for chatting about castor oil packs and a little bit about essential oils. Where can people find out more about you? I know the website is DeliciouslyOrganic.net. Also, you have a thyroid course. Do you want to talk about that?

Carrie:

Yeah, I have a thyroid course that I put together several years ago. It is a step-by-step program to help you understand the root cause of your disease, how to support your body. It has a 90-day protocol, meal plans, all of those things.

One thing the members love about the program is I do a Q&A session every single Wednesday. If you have questions as you go along, you have access to me, and you can ask those questions. You can check that out.

Also, you can find me on Instagram. I’m @CarrieVitt over there. I’m sharing recipes and thyroid tips and autoimmune tips. Whatever comes to mind each day is what I share.

Dr. Eric:

Wonderful. Carrie was also nice enough to give a coupon code for the course. Thank you so much, Carrie. It was really great chatting with you. Thanks for sharing your knowledge with regards to both castor oil packs and essential oils.

Carrie:

You’re welcome. Thanks for having me.

Recently I interviewed Elizabeth Yarnell, and we chatted about redefining autoimmune conditions and how to address them naturally”. If you would prefer to listen the interview you can access it by Clicking Here.

With me, I have a return guest: Elizabeth Yarnell. Excited to speak with Elizabeth again. We will be talking about her upcoming book. The title of this episode is “Redefining Autoimmune Conditions and How to Address Them Naturally.” While I have read her bio before, I am going to read it again. I think it’s been a year since I interviewed you, so I will read it again for those who haven’t listened to the first interview.

Since being diagnosed with multiple sclerosis way back in 1999, Elizabeth Yarnell has been on a mission to redefine MS and autoimmunity naturally. As a traditional naturopath and certified LEAP therapist, she has worked with hundreds of MS and other autoimmune sufferers in her nationwide clinic, using unique, personalized, non-pharmaceutical therapies to empower them to reclaim her health. She is a TEDx speaker; award-winning author, whose cookbook has sold more than 70,000 copies; a patented inventor; and has been featured on CBS, NBC, ABC, and PBS as well as in Good Housekeeping, Health, Martha Stewart Living Radio, and many other outlets.

Her next book, which will be about redefining multiple sclerosis, will come out in March 2023. We will chat more about that later.

Thanks again for joining us, Elizabeth.

Elizabeth Yarnell:

Thanks for having me back! I feel so special that I get to do a repeat podcast with you. The first one was so much fun, so informative. I heard from a lot of people afterwards that they learned a lot of good and new information. I assume this one will be the same, so I’m excited.

Dr. Eric:                        

I got a lot of feedback as well, which is a big reason why I’m having you back. There will be some overlap here, but there will also be some different things that we touch upon.

Why don’t you briefly talk about your background, for those who maybe didn’t listen to the first one? How did you get started doing what you’re doing now? What led up to you writing your future book?

Elizabeth:

For me, this journey began one night in 1998 when I was working on an article for a newspaper, The Denver Post. I was a freelance journalist. I had been really wrangling this article about cross-country skiing that I had been working on for a couple weeks. I’d gotten it to a place where I thought it was a pretty good draft. I printed it out. As I was brushing my teeth to get ready for bed, I was looking over the pages, and I thought, well, I see three places where I want to make small edits. Other than that, I feel it’s pretty good. I’ll do it in the morning. I went to sleep.

When I woke up the next morning, it was almost like goblins had stolen into my apartment, taken an eraser, and erased huge chunks of my printout. I couldn’t see the words. I couldn’t make out or understand the words that I could see. I wasn’t sure what was going on. In due course, I went to an eye doctor, and he diagnosed me with optic neuritis, or inflammation of the optic nerve. That was impeding my vision and clouding my thinking. Almost immediately after that, I went in for an MRI, and that is where I received a diagnosis of multiple sclerosis. That really sent me down this path.

Multiple sclerosis is a disease that affects a million Americans every year. It is a degenerative, autoimmune disease that affects the nervous system. The biggest thing that I learned after my diagnosis was that 80% of MS patients experience significant disability within 10 years of diagnosis. Here I was about to turn 30 years old, learning that by the time I turned 40, I could be in a wheelchair.

Dr. Eric:

That’s really scary. Obviously, that didn’t happen, which is wonderful, not just for you, but just like myself, diagnosed with Graves’ and able to help people with Graves’ and Hashimoto’s, same thing with you. Your experience has helped you help others with MS and other autoimmune conditions.

Speaking of which, as you know, most of my audience consists of people with thyroid or autoimmune thyroid conditions. There is a lot of overlap with different autoimmune conditions. For those who are thinking, “Your story is about MS. What does that have to do with Graves’ or Hashimoto’s?” What you will discuss here really relates to any autoimmune condition. Is that correct?

Elizabeth:

That is correct. In fact, I like to say the term “autoimmune” is really an oxymoron. If we take it apart and look at the root, “auto” means “self,” and “immune” means “allergic.” Allergic to self. If we really think about this, evolution will say, “Nay, nay, not possible to be allergic to yourself. Your species would die out pretty quickly.”

I think that the key to understand about being diagnosed with an autoimmune condition, any of them, is that what it means is you have chronic inflammation. The secret to understanding how to work with these types of conditions is that they are all about inflammation. If we focus on the inflammation rather than where in the body it might be manifesting, the thyroid or the eye or the joints, we have to remember that any condition that ends in “it is” means “inflamed.” I had optic neuritis, inflammation of the optic nerve. You could be diagnosed with gastritis, inflammation of the gastric cavity. You could be diagnosed with appendicitis, inflammation of the appendix. Anything that has to do with inflammation can respond to anti-inflammatory strategies, regardless of where it is manifesting in the body.

I love that you brought up in the beginning, we’re talking about MS. Will somebody with Graves’ or hyperthyroidism or any other thyroid issue benefit from this information? Yeah, it’s all inflammation.

Dr. Eric:

Let’s dive into inflammation. What are some of the factors that cause inflammation, some of the potential triggers?

Elizabeth:

One of the big things that causes inflammation that I see so often in my clinic is these additives and preservatives and toxins and chemicals that have been added and filtrated in our food supply. I gave a TED Talk about this in 2014 called “Poisons in our Everyday Foods.” Our processed and packaged food industry has become so dependent on adding these artificial flavors, artificial colors, artificial sweeteners, not to mention the whole masquerade of “natural flavors” that is going on in our world. All these things are derived from non-food-based sources.

To go back to evolution, we evolved on this planet to eat, thrive, and use the materials into our bodies to create life that evolved on this planet with us: the plants, the animals that eat the plants, they transfer the energy to us. What we did not evolve to deal with were substances that were mined from two miles underneath the earth’s surface, like petroleum. Food dyes and chemicals are petroleum-based. A lot of additives and preservatives, a lot of artificial sweeteners, a lot of pharmaceuticals, based in petroleum. That’s hard for our body to synthesize and process and excrete the toxins afterwards.

Part of being diagnosed and tipping into autoimmunity is that overload of toxins in your body. Everybody has a unique tolerance threshold as to how many toxins they can manage and still maintain a healthy appearance and healthy lifestyle. Once you fill up that toxin bucket inside your body and tip over into autoimmunity, where you’re now having chronic inflammation, which is the body’s defense against what it considers to be foreign invaders, then it takes a lot of sustained effort to bring yourself back below that threshold.

Dr. Eric:

You mentioned tolerance. Everybody is also different. I know your experience with certain food dyes, I forget which food dye. We will get into the foods as well, but the food dye, is it yellow food dye?

Elizabeth:

Yellow food dye is a big one for me. I call it the limoncello incident.

Dr. Eric:

Elizabeth sent me a manuscript of her future book, and I have been going through and reading about the different incidents that she had with the yellow dye. It explains a lot.

I’ll go back to last year. Elizabeth and I met at a conference last year in Tampa that involved different health care practitioners. I remember they also served meals there. I don’t know if Elizabeth remembers this, but one day, they had these cupcakes, and the cupcakes were gluten free. All these health care practitioners, a lot of them alternative practitioners, were eating the cupcakes. I’ll admit, I had a cupcake, too. I’m not going to lie. Elizabeth was inspecting those cupcakes because the topping, she was like, “I don’t know if it has the dye.” I’m pretty sure you did not have the cupcake. You did refrain. They also had these natural beverages, and I remember you were looking at the bottle and the natural flavors.

I am bringing this up because Elizabeth does walk the talk, like she is not just saying this. I saw her in action at the time, not really knowing the backstory. After reading the manuscript, I realized, “That’s why she was carefully inspecting it. The negative reactions that she has.”

A lot of people, like if I eat things with food dyes, I typically don’t feel bad, which is kind of good and bad. You might think it’s good. For years, I thought it was good. In a way, it’s bad because either way, it’s having a negative effect, maybe not as bad as someone who is having overt symptoms, such as Elizabeth. Sometimes, it’s nice when your body tells you that you’re reacting. Regardless of whether you’re reacting or not, certain foods are bad for you. I’m sorry to go on a rant here. After I was reading your manuscript, I was like, “Wow, that’s why you were super careful compared to everyone else there.”

Elizabeth:

That’s a great thing to notice. One of the things to remember is that you may not notice that things like food dyes are creating small amounts of inflammation in your body, or that you might be reacting to them until you bring down the level of inflammation far enough to where you can feel it and recognize it.

Most people are walking around 50-80% inflamed every day. That’s just how it is for them. They feel fine. They pretty much eat whatever they want. But they are walking around with a pretty high level of inflammation. In fact, I have an inflammation quiz we can talk about later that has questions that might make you look at different ways your body is functioning and recognize that it’s actually due to inflammation, even though it might not affect your daily life in the way that for me eating yellow food dye does, when I can no longer walk when I eat it. Until you bring that level of inflammation in your body down to maybe 10-20%, and then you eat something that jumps it up to 80-90%, now you’re going to notice.

You have to do that work to bring the regular level of inflammation, your baseline level, down far enough to be able to recognize clearly if you are having a reaction to something like food dyes.

Dr. Eric:

Another lesson: You need to be an expert in reading ingredients. In a situation, getting back to Tampa, there were no ingredients because the cupcakes were out. If you don’t know, better to avoid, especially if you’re inclined to have negative reactions to these things. Again, even if not, I probably shouldn’t have had the cupcake, but everyone else was having the cupcake, except Elizabeth. I’m going to have it.

Elizabeth:

I believe in treats. I also try to err on the side of caution because the results can be pretty devastating for me. I certainly didn’t want to miss out on the last half of the event that we were at because I couldn’t function.

Dr. Eric:

Obviously, eating whole, healthy foods is a way to avoid food dyes. Sounds like you do indulge every now and then. You’re just very careful. If you do purchase something that is not a whole food, you make sure you carefully read the ingredients. We’ll talk more about the MRT, other ways people can know they are reacting to things. You know your body, but you also are very cautious when buying things. I guess we’ll leave it at that.

Let’s talk more about food triggers. It’s not just about the dyes. With your experience, one of the foods you reacted to was lettuce. We spoke about that last year during the last time we interviewed. For some people, that might be surprising because I and a lot of other health care practitioners are focusing on gluten and dairy. Those cupcakes were dairy free, too.

Elizabeth:

They were.

Dr. Eric:

Gluten and dairy free. Corn, soy, some of the more common allergens. Even eggs in some cases. You don’t hear about being allergic or having a sensitivity to healthier foods, like lettuce, broccoli, or avocado. Why don’t you talk a little bit about that? How did you find out that you had a problem with lettuce?

Elizabeth:

That whole part of my journey really started when my oldest child was born. He was sick from the get-go. He had terrible constipation, even as an infant. He would have this projectile vomiting that would happen, sometimes three times a day. It continued beyond infancy and into his preschool years. He was still vomiting all the time. Finally, by the time he was six, he had fallen off the height and weight charts.

He loved to eat. He was a huge, voracious eater with a really diverse appetite. But every time he would eat, he would just vomit it back up. He is a professional vomiter in our household. I was really concerned about him because between the vomiting and the constipation, this poor child is going to die young. He is not releasing any of the toxins that are supposed to be coming out in your poop. The way that your body processes them.

We took him to the pediatric clinic at Children’s Hospital. We took him to get his DNA mapped. We did abdominal X-rays to see if maybe there was something structural wrong with him. All of those things came up empty-handed. We could not figure out what was going on with this poor kid that he could not really stop vomiting, and he could not poop.

Finally, I took him to a naturopath. This is when I was still just beginning my own studies. She said, “I think this sounds like food sensitivities.” I said, “Well, he doesn’t have hives or anaphylaxis.” She says, “Those are food allergies.” She explained that what she was talking about were food hypersensitivity reactions that caused inflammation in the body.

This was like 2006 or something. I thought she was kind of crazy. I’d never even heard of this. My parents were doctors. Nobody had ever talked about anything like this. We’ve tried going gluten-free, dairy-free, soy-free. We have tried all these things, and nothing has worked. It’s been a huge waste of time to restrict his diet that way. Whether or not we take out these things, he is still vomiting all the time, and he is still terribly constipated.

That is when she told me about the Mediator Release Test. This is a single blood draw. It’s only offered by one labin the entire country. They are based out of Florida. Most doctors don’t know about this. Most rheumatologists don’t know about this. Most medical doctors are not familiar with this.

The reason is because the company, instead of hiring a sales force to go out and treat doctors for lunches and do junkets to try to get them to encourage them to prescribe their test, and then the doctor would receive the test results back and not understand how to work with the patients because as you know, Dr. Eric, there is not really a lot of nutrition education in medical school. You had to learn this outside of that. Instead of that, they devoted their resources to designing a 40-hour certification course for registered dieticians and other nutrition professionals like myself.

As soon as we tested my son, I now have done a thousand of these tests, just about. His is still the worst I’ve ever seen. Fully 1/3 of the items on the test, he was hypersensitive to. Even though we had taken out all these common culprits, there were still so many other things that were keeping him in this state of constant constipation, constant inflammation. Some of the things we thought were healthiest for him, like broccoli, garlic, and lemon, turned out to be things that were making him constipated.

Once we figured this out, the change was amazing. Within two months of changing his diet, he had grown an inch and a half. He had gained 15 pounds. He was now back on the charts, thank goodness. He started sleeping through the night for the first time in his entire life. He’d always had such terrible acid reflux that it would wake him up constantly through the night. He stopped wetting the bed at six years old. Overnight, it was not a behavioral modification thing; it was an inflammation issue. Inflammation had been pushing against his ureter and prohibiting him from feeling like he had to pee before.

All of these things changed. The biggest, most impactful, for me as a mom, came one day when I was passing by his room, and the door was open. I heard him singing to himself. Now, children don’t sing to themselves when they’re miserable. He had never been happy enough to sing to himself. That’s really when I decided to focus my naturopathic practice around the MRT and this food sensitivity testing as a foundational piece to tracking down inflammatory triggers inside people who are suffering.

Dr. Eric:

Your son is the one that did the MRT initially before you found out that you were reacting to lettuce on MRT, correct?

Elizabeth:

Yes. Once I discovered how he was reacting, and while going through the certification course, one of the tasks involved going into the Johns Hopkins Medical School websites and watching animations of what actually happens at the cellular level during hypersensitivity reactions. That is when I heard the narrator of this animation start to say that it’s the T cells that make the assessment. You eat the food, and it goes into your stomach. The food is presented by some presenting cells to the T cells, a subset of white blood cells in your immune system.

I literally almost smacked the computer screen and started yelling at it, “Do you understand that T cells are what are implicated in MS?” Any MS doctor will tell you, “MS happens when the T cells go rogue, and they start reacting for no reason against your own body.” That’s why they say you’re allergic to your own body.

I realized at that minute, oh my gosh, the T cells in my body for MS are not reacting for no reason. They are reacting to triggers that we haven’t been looking for. We haven’t been looking in the right places. First of all, no doctor ever asked me how my diet was or how my bowels were functioning. None of that. Of course, I can’t imagine any doctor asking anyone, “Do you eat lettuce? Maybe that’s your problem.”

Dr. Eric:

A lot of practitioners do food sensitivity testing. It seems most do IGG food sensitivity testing. How does MRT differ from IGG?

Elizabeth:

You’re correct. Most do IGG testing. The way I like to explain this is we just came through this whole COVID vaccine development process. The purpose of the COVID vaccines is to stimulate the creation of the antibodies in your own body, to protect you against exposure to COVID. Now, that’s what antibodies are for. They are there to protect you against exposure. They can only be created after you have once been exposed to something.

The MRT on the other hand doesn’t look for antibody creation. It looks for mediator release. Mediators, the most famous one we all know is histamine. We know that if we have a bee sting or a poison ivy encounter, and we take some Benadryl, which is an antihistamine, we can get relief from the swelling that is so painful with those encounters. Histamine is only one of 80 or more mediators that the bloodstream can release upon exposure to what it deems to be a threat. Every mediator that is released into the blood triggers or causes inflammatory activity.

Now we are going beyond antibodies, which are unreliable markers and really should be protecting us against, say if I have antibodies to mangos, I should be protected when I eat a mango and not experience inflammation. Instead of that, we are going further back, before antibodies even get created because they only get created in hypersensitivity reactions, not all of them. When mediators are released, they always cause inflammation.

The MRT looks at 150 foods and 20 or so chemicals and additives in our food supply and tests those against the whole blood to see which ones incite the blood cells to release those mediators which cause inflammation in the body.

Dr. Eric:

With IGG testing, I know in order for that to be “accurate-” I’m like you. I have been skeptical about IGG testing for years. I can’t say I’ve never done it, but there are practitioners who do it on all their patients. If I do it, before I found out about MRT, it would be usually toward the end of, well, nothing else seems to be helping.

One of the things with IGG food sensitivity testing, you have to be eating the food in order to test for the food. If you have been avoiding any food, whether it’s gluten or eggs, and then you do an IGG test, you would expect it to be negative because your body is not going to be developing the antibodies. With MRT, looking at the mediators, it doesn’t work that way, from what I understand. Even if you were avoiding the foods, you could still do MRT, and it would be accurate.

Elizabeth:

You are absolutely correct. When we tested my son, he was six years old. He tested red, reactive, to coffee. He had never had coffee. He was six years old. I could be pretty sure about that. That never would have come up on an IGG test because he had never had coffee.

If you are looking to get a Celiac test, same thing. They are going to ask you to start eating bread for the two weeks leading up to that test so that your body is accustomed to seeing it again. How painful would that be if you already know that eating bread causes you problems? Now you are forced to put yourself in misery for two weeks to get a positive test result.

Dr. Eric:

It’s funny because last year, when I interviewed you, we didn’t spend too much time on MRT. We spoke a little bit about it. After the interview, I had a few other people I interviewed who mentioned MRT, which is funny because prior to that, I don’t think I had anybody bring it up. It’s not as well-known as IGG, but it is out there. I have noticed more and more practitioners are using it.

I can’t say I use it on all patients. I probably do need to use it more. Again, maybe this interview will encourage me to have more of my patients use it. You did introduce me to it. Even though I’d heard about it, I never signed up and started using it until speaking with you. I’m grateful for that.

When you do the test, and you test positive—you don’t have to go into great detail about the test—but you could either be red, yellow, or green. If you’re red, you have to avoid the food for a longer period of time. If it’s yellow, you should still avoid it, but not as long. If you’re green, then you’re good to go. Is that a summary of the test?

Elizabeth:

That is a pretty good summary although that’s a basic approach to working with the MRT. What you learn in the certification course is how to apply the test results and develop and design something called LEAP Dietary Therapy. LEAP: Lifestyle, Eating, and Performance. It is a trademarked name. I didn’t invent it. Very scientifically designed.

This is kind of the polar opposite of an elimination diet. If you were doing the IGG test or the IGE test, and you were to get the test results back, they would say to eliminate the things that turned up. You can eat everything else. You’re fine. Just eliminate these problem foods. That’s not very helpful because maybe now you’re eating foods that are also inflammatory for you but maybe not as inflammatory for you. It’s just really not that effective and not that helpful. I look at it as an antiquated way. 300 years ago, we might put you on an elimination diet. Just stop eating this one thing, and let’s see if that helps. That didn’t help, so stop eating that other thing. Now you are in this years-long cycle of trying to figure out what’s causing you problems.

The MRT speeds this up. With LEAP Dietary Therapy, instead of looking at the test and saying, “A, B, and C turned up high on the test. Avoid those things,” we are going to look at the test results and say, “X, Y, and Z turned up low on the test. You should be focusing on creating a diet out of these items that we know to be non-inflammatory for you.” If it’s implemented correctly, inflammation starts moving out of your body within the first week or two. Symptoms start to decrease so rapidly. The entire LEAP Dietary Therapy is six weeks to get you on the right course because it takes six weeks to move inflammation out of your body. As you finish, you understand how to move forward and keep that inflammation out.

Most importantly, how do you recover when you’ve been accidentally triggered? This happens even to me, as much as I try to be aware and stay away from what I know to be triggers. There are also times where either I was unaware, or I even sometimes, and I tell this to my clients, you just make an informed decision. “Well, I’m going to choose to eat this even though I know it’s going to make me not feel good.” After you get through this LEAP Dietary Therapy, you have an idea of how that’s not going to make you feel good. You can choose. You’re not flying blind anymore.

It might be even as simple as saying, “Am I going to choose the chicken or the steak at this meal?” You understand which one will keep you in an uninflamed place, and which one might trigger inflammation in your body.

Dr. Eric:

With those foods that you react to, the ones that show up positive, most of them, would you be able to reintroduce in the future? I don’t know if you can eat lettuce now, or if it’s a food that you have to permanently avoid.

Elizabeth:

You know, that’s a good question. I haven’t challenged myself on lettuce because I can eat arugula, spinach, kale. I just can’t eat anything that’s called lettuce, like red leaf lettuce, iceberg lettuce, Romaine lettuce. At that same test, when lettuce turned up reactive for me, also avocado turned up reactive for me. That was very surprising because I always advocate avocado as one of the best foods for people with MS and other nervous system conditions because it has very healthy fats in it. It’s also one of the first foods I fed my babies when they moved to solid foods because I think avocadoes are so wonderful.

As it turned out, avocadoes were definitely inflammatory for me. When I would have avocado and lettuce together in a salad, double whammy, that would throw me out of commission for days.

But that test was maybe 2012. Every couple of years, I would challenge myself on avocado because I missed it so much. For the first couple of years, I would react and react and react. Now, 10 years later, I’m fine eating avocadoes. They don’t cause any inflammation for me.

Dr. Eric:

Interesting. For a few years, you weren’t able to eat them. It just took a certain amount of time for you to get below that threshold with regards to the avocado then?

Elizabeth:

A lot of that has to do with that toxin threshold. Also, the immune system’s memory, how long it might take for that memory to clear those T cells to forget that they were offended by avocadoes and to be able to accept them again. That’s all part of the healing journey and part of the process that I teach and people learn after taking the MRT.

Dr. Eric:

I do want to touch a little bit on parasites, but I didn’t know if there was anything else you wanted to mention about MRT.

Elizabeth:

I think I’m good with the MRT. Let’s move to parasites.

Dr. Eric:

Parasites are something else you focus on. Why are parasites a problem for everybody?

Elizabeth:

Unfortunately, it is super easy to pick up a parasite in this world. We don’t have to have had foreign travel although if you have, that could be a clue. You can get them from eating sushi, playing with your dog, swimming in a lake or a river or even a public pool. Every summer, I watch on the news as they find Giardia in water parks around the country. You can get them from eating vegetables that haven’t been washed well or well enough, produce, things like that. You can get them from cleaning out your kitty litter box. In 2018, there were a dozen McDonald’s around the country that they found cyclospora in the salads. In the ‘90s, the entire town of Milwaukee was infected with Cryptosporidium through their municipal water supply. It’s just really easy to pick up parasites.

Those same T cells are the sentries in our body’s immune system. They go through the whole body looking for foreign invaders. Most foreign invaders in the human body, up until the last couple hundred years maybe, have been virus or bacteria, or maybe mold, too. That could be one. Now, there are just so many things that the T cells can find to react to. One of them is parasites because parasites are foreign invaders.

Typically, when the T cells find those foreign invaders, they trigger that inflammatory process and start sending inflammation and heat and antibodies. Those work pretty well against bacteria and viruses but not at all against parasites. If you have parasites living in your body—let’s be clear, the goal of the parasite is to find a host, move in, and reproduce forever more—the T cells see foreign invaders, and they sound the alarm constantly in this vicious cycle. They send out the inflammatory cascade, and the inflammation goes. But the parasites don’t care at all about that, so they’re still there. Then the T cells come back and say, “The foreign invaders are still there. We need to send out more inflammation.” You just end up in this vicious cycle.

The longer I work in my clinic, the more and more convinced I am that hidden parasitic infection is at the root of most, if not all, chronic inflammatory conditions.

Dr. Eric:

You take an herbal approach when it comes to parasites.

Elizabeth:

I do. Myself personally, I have done the pharmaceutical approach, too. In 1998, my then-fiancé and I did a two-week horseback trip across the Eastern Tibetan Plateau. When we came back into Chengdu, China, we had a huge feast at a five-star restaurant. We will all meet there at 6pm. It was such a great celebratory atmosphere. By midnight, 12 out of 15 of us were worshipping the porcelain gods. That is a very clear indication that something was wrong.

For people who are listening, you might have had an experience similar to this. You might have called it food poisoning. You might have called it a 24-hour flu bug, or something didn’t agree with you. That could be the genesis of your infection. It’s called the acute phase of parasitic infection.

When I came back from Asia and submitted my stool sample to my GI doctor, it made its way to the CDC. They actually picked up the phone and called me and said, “Where have you been? We have identified five parasites in your stool.” But that is unusual, as you probably know. Parasite testing is notorious for false negatives.

At that time, this was 1998, I didn’t know anything about the natural health world. The doctor put me on Flagyl, which is a very potent antiparasitic. Still one of the first line antiparasitic pharmaceutical medications that we have. First of all, antibiotics don’t work against parasites.

Flagyl wipes out every bit of flora and fauna in your system. One GI doc said to me, “Using Flagyl to kill Giardia is like using a shotgun to hit a mosquito. You might hit it, but you’re going to have a lot of collateral damage from all that buckshot that is going everywhere else, too.” That’s kind of what Flagyl does. It leaves you this empty shell that you now have to rebuild your whole microbiome from the inside out and recover from it. And you might have gotten the adult parasites, but you probably didn’t get the eggs. Some parasites lay 2,000 eggs a day. You might not have gotten the larvae, which are teenage parasites.

Yes, I prefer an herbal approach. I have a formulation or a protocol that I have developed that is a 30-day protocol that is very effective and super gentle. I use it with babies when their moms find worms in their diapers. I have done it myself six or seven times. I did it most recently at the beginning of the pandemic when I felt like I was having inflammation that was out of control. My kids have done it. It is just very gentle, very well tolerated. Most people don’t feel anything while they go through it unless they are in a fairly recent infection, and then they might feel remarkably different within the first week.

Dr. Eric:

Since parasites are so widespread, when someone follows the protocol, there is a chance they could always get reinfected, I imagine. I don’t know if you personally do cleans every so often, like follow your protocol a few times a year. Do you just base it on symptoms? I think the approach you take with all clients is you treat them as parasites. How do you know if six months later the parasites haven’t come back? Or do you just do something from a preventative standpoint?

Elizabeth:

If you treat for parasites, and that person gets better, then you should have a pretty clear causality. Oh, well, I gave you the parasite protocol, and you got better. You probably had a parasite. Then they start going downhill again after a certain point. Usually, I will say six months, sometimes a year or two years or three years even. That is when I recommend, they do another parasite protocol.

Some people have to do more than just the 30-day protocol. I have a client right now who is in the Bahamas, still seeing parasite eggs coming out in her stool. Sometimes, I add in another protocol. When we added in this other protocol, she started seeing more worms come out, even though she’d already been doing parasite protocols for at that point three months, something like that. There are so many kinds of parasites, and some are harder to evict than others. The 30-day protocol I like to start with is a very gentle way to start.

Dr. Eric:

I know some practitioners, before having someone follow a parasite protocol, they will do things like support lymphatics, so they will almost have a pre-protocol before parasites. Do you find that to be necessary, or do you just put them on the herbs?

Elizabeth:

I usually just put them on the herbs because for a lot of people, it is enough to have to remember to take the herbs and follow the dosing calendar three times a day for 30 days. If I were to add in more things that they had to do, they might throw the whole towel in and feel too overwhelmed. Overwhelm is a big part of it. You can do other things, like you can do hydro colon therapy or colonics, but you don’t have to. It will work itself through your body pretty efficiently, whatever needs to come out.

Dr. Eric:

Obviously, you’re still doing what you’re doing because it works. Different practitioners have different methods, so I wanted to ask because I have been asked that, too. There are four-month protocols out there involving parasites. The first month or two are really preparing the person for the parasite protocol. When I spoke with you last year, I got the impression you didn’t do that. A lot of practitioners just jump into the parasites. I wanted to see what you do. It sounds like that’s pretty much what you do.

Elizabeth:

It is what I do. Just recently, I had a consultation with a 16-year-old girl who has been suffering from debilitating migraines and nausea and constipation, all kinds of systemic issues. It was affecting her, keeping her out of school, missing a lot of work. She was very distressed.

When we started speaking, and I mentioned that I would want her to begin with the parasite protocol, her mother remembered that when she was eight or nine, she had been on the beach in Mexico. When they came back, they had noticed a red line moving up her leg. It kept moving up, up, up her leg. They took her to many doctors who didn’t know what it was and thought itwas just a rash or something. Then they found a doctor who said, “This is a parasite.” They had put her on a pharmaceutical; probably anti-worming would be my guess. Maybe Ivermectin. It resolved that particular trail that was moving up her leg.

As we know, there are probably eggs still in there. Now, 10 years later, she is having really debilitating symptoms. I believe that the origin is that Strongyloides infection that she received.

Dr. Eric:

It’s amazing how healthier foods, let alone foods we know are inflammatory and things like food dyes. It’s also sad because most conventional medical doctors will just completely dismiss this. If someone were to ask to do a parasite test, unless they are having diarrhea and the traditional parasite symptoms, but obviously people don’t have to have diarrhea and gastrointestinal symptoms to have parasites, but most of them will dismiss that. Same thing with MRT. Most of them probably have never even heard of that. Fascinating.

If someone is interested in MRT, or they found this conversation fascinating with regards to parasites, where can they learn more about you? Also, I want to briefly talk about your upcoming book.

Elizabeth:

I am on all of the socials. Please don’t DM me there because it might be months before I actually see that DM. If you are interested in learning more about this, the best place to go is my website, ElizabethYarnell.com. You can get on my newsletter. You can start following me on the socials because I do post on the socials; I just don’t always get the DMs very easily.

Anyone who is listening, if this is resonating with you, and you want to explore further, at the bottom of every page of my website, there is a link to schedule a complementary naturopathic health assessment with me. Happy to do that with anyone.

Lots and lots of information out there. I have been doing a mad circuit of podcasts and summits lately. If you get on my email list, you will start to learn about all of that stuff as well.

Dr. Eric:

Can you take a minute or two and talk about your future book? What can people expect?

Elizabeth:

Yes, I’m so excited about this book. In 2011 or 2012, I spoke with my literary agent because you can see my first book is up on the wall behind me, Glorious One Pot Meals. That’s my cookbook. I was speaking with her, and I said, “I’m ready to write another book. I want to write it on inflammation.” She said, “Nobody wants to read about inflammation. They want another cookbook.” I didn’t want to write another cookbook.

Here I am, 12 years later or so, and I have finally written my book on inflammation. It will be coming out to coincide with MS Awareness Month, which is March 2023. I am super excited about this book.

As you mentioned at the top of the show, Eric, even though my focus is on MS, my history is with MS, inflammation is the common root of most if not all chronic disease. If we focus on the inflammation, that is what I talk about in the book. That is where I want to point and shine the light on. Inflammation is the common root of all of this. Even though the inflammation may manifest differently in different conditions, it has inflammation at the bottom. There are triggers, and we need to be looking in the right places to identify those triggers in order to reduce inflammation and eliminate the symptoms.

Dr. Eric:

By the time this episode is live, the book will be out. Thank you so much, Elizabeth. Again, this was a great second interview. Like I said at the top of the hour, I expected there to be some overlap, but I also wanted to ask you some follow-up questions, which I did. The first call was more on parasites and a little bit on MRT. This was the reverse, where we focused more on MRT and did a little bit on parasites. Thank you for getting together. Also really looking forward to your book.

Elizabeth:

Me, too. I wish I could announce the title and have everyone look for it, but I have changed the title, I don’t even know, 30 times so far. I don’t even want to venture an idea of what the title will end up being.

Dr. Eric:

You’ll come up with it soon because it will be out in a few months.

Elizabeth:

The clock is ticking!

Dr. Eric:

Good luck with that. I’m sure it will be a great title when it’s out. Like I said, I look forward to reading it. I know a lot of listeners will look forward to reading it as well.

Elizabeth:

Thank you for having me on. I really appreciate it.

Recently I interviewed Dr. Vincent Pedre, and we chatted about his new book “The GutSMART Protocol”. If you would prefer to listen the interview you can access it by Clicking Here.

With me, I have Dr. Vincent Pedre, and we are going to be chatting about his new book The GutSMART Protocol. Dr. Pedre is the medical director of Pedre Integrative Health, founder of Dr. Pedre Wellness, and CEO and founder of Happy Gut Life. He has worked as a nutraceutical consultant and spokesperson for NatureM.D. and is a functional medicine certified practitioner with a concierge practice in New York City since 2004. Dr. Pedre believes that the gut is the gateway to excellent wellness. His newest book The GutSMART Protocol, featuring a 14-day personalized gut healing plan based on the GutSMART Quiz, is the culmination of years of research and clinical experience as a functional gut health expert. Thank you so much for joining us, Dr. Pedre.

Dr. Vincent Pedre:

Thanks for having me. I’m excited to have this conversation with you.

Dr. Eric:                                      

Same here. Excited to talk about your new book. Before we start that, can you give a little bit of your background? How did you start doing what you’re doing? You wrote a first book. What led you to write this newer book?

Dr. Vincent:

For one, the research that has come out on the gut and the gut microbiome has just exploded in the last couple of years since I finished my first book, which was over seven or eight years ago. I really wanted to consolidate all the new knowledge that we have but also take everything that I’ve learned, the feedback I’ve gotten, and write a new protocol for gut health that really puts together all of my experience with dealing with gut patients and realizing that there is no one size fits all when it comes to gut health. The approach to healing the gut, especially when it comes to nutrition, has to be personalized.

The biggest distinguishing factor between the books, aside from the GutSMART protocol being a 14-day program versus a 28-day program in Happy Gut, is the GutSMART protocol is powered by the GutSMART quiz, which personalizes the program to the individual based on the score that they receive on the quiz. The quiz is not just looking at gut health issues but also what I call gut related health issues. I talk about that in the book, the difference between a gut centric issue and a gut related health issue, which can happen in all different parts of the body, like the brain, the skin, the lungs, the airway. I wanted to educate people on the interconnectedness of how gut health is really the foundation of the rest of your health.

The update in the research, some of the most recent science, and a personalized protocol not only distinguishes this book from Happy Gut, but also distinguishes it from the majority of the books out there that come out with a prescriptive plan that is a one size fits all. I don’t think that’s right for everyone, especially when dealing with gut health issues, from my experience treating patients now for over a decade with gut health issues using a functional medicine approach.

Dr. Eric:

I agree. It’s funny because one of the questions I have prepared is is there an ideal diet for optimal gut health? I guess you already answered that. No, there is no perfect diet.

Dr. Vincent:

There is more that we can dive into. There are several things we can look at. There was a study done as I was writing the book that was published at Stanford University, where they took a small group of women and divided them into two groups. It was about 16 women per arm. They did it for 10 weeks. They looked at a high fiber diet versus a high fermented foods diet.

They were looking at some important markers, like immune function. We know that 70% of the immune system is all along the gut lining and is very much controlled by what’s happening in the gut. We learned that during the world pandemic, how important the gut was in determining whether people ended up being hospitalized with COVID and how severe COVID they got. They looked at the differences between them, and they also looked at 19 inflammatory markers. Very objective measures you can take from a blood test. They also looked at the stool microbiome. They looked at the diversity of bacteria in the gut. They tested before, and they tested at the end of the program.

Even within the personalization, we can make some general assumptions. What was surprising is if you hear people talk about gut health, you will hear fiber, fiber, fiber. It’s so important. It’s important for the health of the colon. That’s true. What they found was that fiber was a very powerful immune modulator. What does immune modulation mean? It means that your immune system is in balance. It’s not working too much, but it’s also not underactive.

What was surprising though is you would think by everything we have learned about fiber and how it gets gobbled up by the bacteria in the gut, and then they produce all of these incredible post-biotic nutrients. We know short chain fatty acids have effects all over the body, including the brain. You would think that that’s what creates microbial diversity, feeding the microbiome fiber. It didn’t.

What increased diversity was a high fermented foods diet. That was about 2-4 servings of ferments per day. And I think even more importantly, what they found is when you increase diversity, you also lower 19 inflammatory markers. It lowered inflammation. That was a very surprising finding from the study. It’s a small study. It’s not a big group of people. It has to be repeated in a bigger cohort to see if it remains true. But I think it does lead us in a certain direction.

If you take my GutSMART quiz, and you score Severe as your score, what you will find is when you go into the food list, you’re not allowed to eat fermented foods. When you have severe gut dysfunction, you won’t be able to tolerate ferments. I always think of it like the old days when we use transparencies in school. You put one transparency on top of another. You have to interlay, okay, we understand, yes, eating a good amount of fermented foods on a weekly basis is good to lower inflammation and to improve microbial diversity.

For anyone who is listening, microbial diversity is the holy grail. The more diverse your microbiome is, the less inflammation, the better your gut barrier is. It’s what you want. The problem is that in our modern world, we are losing diversity, starting from a very early age. Kids are exposed to too many rounds of antibiotics unnecessarily for viral infections.

Even for ear infections, a number of years ago, the standard used to be if a child has an ear infection, you automatically give them an antibiotic. Then they found that you actually don’t need to do that unless it’s a severe ear infection. The problem is that we are already getting exposed to antibiotics from an early age, and it’s damaging the diversity of the gut microbiome. There is a theory that the diversity never fully recovers.

For me, I was on 20+ rounds of antibiotics from the age of 10 through my late teenage years. That is extraordinary. It destroyed my gut microbiome; it led to leaky gut and food sensitivities, and my immune system was shot. I just kept getting sick. I was a hypochondriac. Part of the reason I went to medical school was I wanted to biohack how not to get sick. I wanted to understand my body. Little did I know that was going to lead me down this rabbit hole of gut health, gut microbiome, fixing my gut, working with hundreds of people on their gut health issues, seeing whole hosts of health issues improve and get to this point.

Just to circle back, we can say fermented foods are good, but it depends on your gut type, which is what I determine using the GutSMART quiz. You can figure out is it okay to incorporate ferments? Do you have to wait for some gut healing to happen, and then you can start incorporating them?

Dr. Eric:

From what I understand, at least according to the study, which like you said, a smaller study, probably needs to be repeated in a larger setting. But it sounds like fermented foods are superior to fiber when it comes to diversifying the gut microbiome. But if you have certain gastrointestinal disorders, such as maybe SIBO, which a lot of those people have issues with fermented foods, then they should avoid fermented foods. The good thing is it sounds like your quiz will guide them in a direction to tell them, “Now is not the time for fermented foods.”

Dr. Vincent:

Exactly. What happens sometimes is the nuances get oversimplified. You might read an article that says ferments are good for your health, but maybe you have an underlying SIBO or SIFO (fungal overgrowth, candida). You start eating ferments, and you feel horrible. You get more bloated. You get inflamed. You don’t feel well because it’s not the right time. What I did with my book is try to get through those nuances to help people understand when is the right time to eat those foods? What are the right foods, depending on your gut type or GutSMART score, as I call it?

Dr. Eric:

You mentioned candida. Different trains of thought when it comes to fermented foods. If someone has candida overgrowth, do you typically recommend those folks to avoid fermented foods completely?

Dr. Vincent:

It depends on the person. Sometimes, what I find is they can have such a powerful die-off from incorporating a fermented food that it’s overwhelming, and it makes them feel horrible. That’s where you really need to be working with a functional doctor/naturopath who understands how to match things together. If you have one of those issues, you might just start with a quarter teaspoon of a ferment and test it out. Then slowly increase from there.

I talk about that because I think in our magic bullet philosophy in America, with pharmaceutical-driven medicine, you hear something, and you think, “Well, if a little is good, then a lot is even better.” But that’s not the case. I talk about that in my book. It’s really important to start slow. Test the water. Then slowly increase over time.

Now candida treatments can get more complex. When you’re killing off candida or yeast, you’re going to release toxin. It’s helpful when you’re doing that type of treatment to use binders that will help bind the toxin and keep it from entering your body. You can use things like activated charcoal, bentonite clay, but also, I personally like, if the person has no objection to them, using SBIs (serum-derived bovine immunoglobulins) because they bind those toxins.

SBIs have been shown to bind endotoxins released by bacteria in the gut, which protects the gut lining and can help the gut lining start to heal. Inevitably, if you have SIBO or candida overgrowth or dysbiosis, you’re also going to have leaky gut. That’s where the problem is. The leaky gut is like having a leaky border that is allowing all these inflammatory substances to get into the bloodstream. They have done tests where they have shown bacteria and bacterial DNA gets into the bloodstream. We know that endotoxin, which is released by bacteria, causes a whole host of inflammatory cascades in the immune system, the brain, the liver, muscle tissue. It increases insulin resistance and leads to weight gain.

Dr. Eric:

Very interesting what you said about the SBIs. If someone were to use SBIs, they wouldn’t need activated charcoal or bentonite clay? Do you usually recommend a combination?

Dr. Vincent:

Sometimes, I might use the SBI by itself. It depends. If you’re working with a practitioner, you might incorporate different types of binders because they all have different binding properties, depending on what you want to bind. Also, SBIs tend to constipate. If you are working with a patient who is already constipated, then you have to be really careful with an SBI because you could really stop them up. You need to make sure you are going to give them some sort of support so that they are going to the bathroom regularly. Again, it depends on what type of SIBO they have. You want to make sure they are getting the right amount of fiber, but you have to be careful not to give too much fiber. It will get fermented, and they will get really gassy, bloated, and uncomfortable.

Dr. Eric:

Makes sense. Going back to the fermented foods. I have two hopefully quick questions. Would you recommend a diversity of different types of fermented foods rather than someone eating sauerkraut every day? Do you recommend on top of that a probiotic supplement, or if someone is eating fermented foods daily, would that be sufficient?

Dr. Vincent:

In this study, for example, the participants were not taking a probiotic supplement. They just added ferment, and it did improve the diversity of the gut. In my clinical practice, when I’ve worked with patients with severe dysbiosis, with candida overgrowth, sometimes you really need to use a high potency probiotic as well to get in there and help reset the microbiome.

There are different types of probiotics, like soil-based organisms that are spore-based that actually produce their own antimicrobial peptides. It’s like having little, tiny, antibiotic-creating factories that are delivered specifically to where they’re needed, but they’re actually not going to kill off your good bacteria. They will increase the diversity of your gut microbiome. There is a place for that as well. That’s really important.

In terms of the types of ferments, I think diversity is kind of like the key to happiness in life. If you start doing the same thing over and over, you will get bored with it. Maybe your body will get bored with it. I really think rotating the types, so sauerkraut, pickles, yogurts. I think for a lot of people, because dairy sensitivity is very high in the population, and even just lactose intolerance is super high, it’s probably better to go with a coconut yogurt or non-dairy yogurt. Sometimes, it can be helpful to use a kefir that is made from organic milk, grass-fed cows. Or even goat milk kefir. It depends on your sensitivities and what’s going on in your body at the time.

I’ve personally used kefir as a way to help my gut recover from having had a parasite. During the pandemic, I went to Guatemala, and I ended up getting giardia. I was really, really sick to the point that it became really hard to eat. The two things that helped me recover were kefir and bone broth. It seems strange, and I can’t explain why I thought. Of course, I also took a probiotic. Intuitively, it felt like that’s what my gut needed at the time. That’s something that I know is hard. How do you doctor yourself?

I talk about intuitive eating and really understanding before-meal intuition, during-meal intuition, and after-meal intuition. It’s important to understand before you eat, how hungry are you? Intuitively, what is your body craving? There is an intelligence there. Your body is going to let you know. Over the last 20 years, as a doctor, I’ve had for example women come in who eat very little red meat and then might say, “My body is craving red meat for some reason.” If you’re going to eat red meat, eat grass-fed beef or bison or lamb. Very humanely sourced meats. There is a wisdom there. Usually, if that’s happening, there is iron deficiency, and the body knows.

It could be that you’re craving a big bowl of vegetables. If you have severe gut dysfunction, then it’s going to be hard for you to digest non-cooked vegetables. Raw vegetables are going to be really hard, especially if you have leaky gut. You might have pancreatic insufficiency, so it will be hard to break down vegetables. If you see a salad green in your poop, automatically you can assume you’ve got some element of leaky gut. You’re not digesting your vegetables properly. You’re probably not making enough enzyme, so you have to revamp your diet.

I took your question and went on a whole tangent on intuitive eating. I think it’s important because even when you’re incorporating ferments, start at a quarter teaspoon, then go to half. A lot of it is dependent on the person listening to their body. The one thing I learned over the years from working with patients is that for some reason, people don’t know how to listen to their bodies. They just are not listening to the signals. Sometimes, I used to think, “I’m just a body whisperer. I’m just telling people what their bodies are telling them and helping them learn how to listen to their body.” That’s why it’s so important to have that after-meal intuition where you’re tuning into your body and seeing, “I ate this meal. I now feel really sleepy and tired and bloated. I’m not feeling so great.”

I had a professor I listened to give a lecture, and he said, “We should be eating for our microbiome.” I also like to think that I eat based on how I want to feel and the time of day. There is a Circadian rhythm to what your gut is doing and how your body will respond to different types of food.

Dr. Eric:

You mentioned leaky gut a couple of times. I want to cover this. Especially when it comes to testing, I used to do testing all the time for leaky gut. Then I just saw most people were positive, so I assumed people have a leaky gut, and that’s what I do these days. A lot of practitioners do testing. Maybe your quiz points them in the direction of whether they have a leaky gut. I wanted to get your approach.

Dr. Vincent:

If you end up with moderate or severe dysfunction, you pretty much can confirm you have a leaky gut in the background. I agree with you. The testing for leaky gut is not foolproof. The lactulose mannitol test that can be used for leaky gut is really only picking up leaky gut in the small intestine. If the gut is leaky in the large intestine, it won’t pick that up. It’s much harder to pick up. For example, patients with Parkinson’s tend to have increased intestinal permeability or leaky gut more in the large intestine than in the small intestine.

I did the testing for a while. Sometimes, I do food sensitivity testing. If someone lights up across the board, lots of high sensitivity, moderate sensitivity reactions, you can assume they have leaky gut. If I do wheat metabolite testing, looking at different wheat breakdown proteins in metabolites, and look at antibodies to zonulin as well as antibodies to actin or vinculin, which are basically cytoskeletal structures that hold the cell together and help create those tight junctions between the cells, you can assume that if you have developed antibodies to those structures, you have leaky gut.

We are working like Plato. We are looking at the shadows against the wall. We can’t exactly measure it directly. You could put somebody under an ultrasonic endoscopy, where they can do micro ultrasound and look at the gut lining. We’re not going to do an invasive procedure on every patient that we suspect has leaky gut.

Just like you, after testing for a while and seeing how people even just react to putting them on a leaky gut protocol, I decided that I am going to go by the clinical because it’s very obvious who has leaky gut and who doesn’t have leaky gut and how they respond to these interventions.

Dr. Eric:

It sounds like the test you use is similar to- I’m sure you’re familiar with Cyrex Labs. I used to use the Array #2.

Dr. Vincent:

Yeah, Cyrex does that. Vibrant America also looks at wheat metabolites, food sensitivities, dairy metabolites. The thing is that it’s like you’re building the evidence, and it’s nice to have data. I’m very much into collecting data on patients, but there is a point where the data is not perfect anymore. I know there are labs that are looking at stool PCR patterns, so microbial patterns that might be indicative of increased intestinal permeability or leaky gut. Even that I think we still don’t 100% know. We are just making assumptions. As we get more pooled data from more stool analysis and start seeing what patients with leaky gut microbial makeup look like, maybe we will start seeing a microbial signature that identifies leaky gut. We also know that there are different microbial signatures even depending on what part of the world you live in and what your diet is like.

Dr. Eric:

Another flaw of the test is they don’t tell you what is causing the leaky gut. Are you eating gluten on a daily basis? Do you have a gut infection? Is there another factor?

Dr. Vincent:

Absolutely. I know you had a question about gut pathogens and infections. The thing is that when you find them, depending on the pathogen, you always have to line up the test result with the story of the patient. If we’re interlaying those transparencies, I hate medicine where you just treat the test result, and you’re not taking into account the person. You’ve got to overlay that we have this test result. Does it make sense with what’s happening with the person, with the story, with the symptoms, with how they’re presenting? If it does, then you treat. We have to be really careful about being trigger happy and treating everything that appears on a piece of paper. Sometimes, it doesn’t quite honestly correlate with what’s going on with the person. Some people may be able to tolerate having certain imbalances better than others.

Dr. Eric:

I don’t know what your answer to this question will be, but I kind of think I do based on what you just said. There are some practitioners out there who will treat everybody for parasites. I have interviewed people who do that. It sounds like that wouldn’t be your approach because that’s-

Dr. Vincent:

It depends on the parasite. For example, Blastocystis hominis, one of the most common parasites worldwide. Very common in India, but I’ve seen it in patients in the United States many times. If you do a Google search, you will find literature saying it’s a benign parasite. You don’t need to treat it; ignore it. If you dig a little deeper, you will find research studies connecting Blastocystis hominis with leaky gut. We know leaky gut is the first step down a chain reaction that increases inflammation, overactivates the immune system, can eventually lead to autoimmune disease and other chronic degenerative disease in the body.

Always putting it in context of that, who the patient is, and figuring out what is the right thing for that person? If they have amoeba in their stool, of course I’m going to treat that. It’s incredibly inflammatory. It’s invasive. If they have any other sorts of parasites, yeah. I tend to err unless there is evidence that the person is not showing any signs of any issues, including blood markers, having elevated C reactive protein and other things that are important.

Something like H-pylori is a great example of a “pathogen” that infects the majority of the people in the world. When they first found it, they connected it to peptic ulcer disease and said, “If someone has H-pylori, we need to treat it.” Of course, the pharmaceutical industry is on top of that, coming out with all sorts of regimens including Clindamycin, which is one of the worst antibiotics you could ever take because it increases your risk for C. diff diarrhea, which is a very bad diarrhea that can even lead to what we call mega colon and, in the worst case scenario, death or ruptured colon. You’re increasing the risk of that by going on these antibiotics for H-pylori. We know there is also increasing antibiotic resistance.

The fact is that’s an example where say you find H-pylori in a person. Could be just a colonizer. Is it an active infection? It depends on the way that it was tested. Is the patient symptomatic? If you do an endoscopy, do they have an ulcer, or do they have metaplasia, like signs of precancerous changes in the stomach, which can be caused by H-pylori? If they don’t have that, probably shouldn’t treat the H-pylori because it may be serving a certain purpose in there. Taking into account the risk/benefit ratio of putting the person on this crazy two antibiotic regimen plus a proton pump inhibitor, which can then lead to SIBO and all sorts of other problems that I have seen. Yeast overgrowth, it depends on the situation, the person’s particular individual case. What they might be at risk for or the other underlying issues they have at the same time.

Dr. Eric:

That’s pretty interesting. H-pylori doesn’t always cause symptoms. If they have ulcers or reflux, that might be an indication to treat H-pylori. How about if they have an autoimmune condition in the presence of H-pylori, but no symptoms? It sounds like even in that case, you might not decide to treat them just because they have an autoimmune condition.

Dr. Vincent:

Yes. You have to think the treatment itself is putting them at risk for developing a severe dysbiosis, leaky gut, which is only going to aggravate the immune system and possibly make their autoimmune condition worse.

Dr. Eric:

I agree with the antibiotics. I should have mentioned taking an herbal approach for example for H-pylori.

Dr. Vincent:

I’ve seen and used different herbal approaches. They’re not incredibly successful. I say the phrase “50% successful” with people. If a person has it, then I think you have to be judicious about deciding is this something that we should treat, or is it “Okay, we found it”? Instead of treating it, because you have no symptoms, let’s work on improving your microbial diversity through the diet. Let’s improve gut permeability, so let’s reduce leaky gut. Let’s reduce inflammation in the body. Let’s work on it from a different angle. Rather than attacking, we want to rebuild the gut and the immune system.

Dr. Eric:

Just one more thing with parasites. There are a lot of practitioners who will treat parasites. No stool tests, no symptoms, they just assume everybody has parasites, and they treat for it. It sounds like similar to H-pylori, you wouldn’t treat for parasites unless they have a finding on a stool test. There is a possibility of false negatives. Maybe they have a false negative, but they have symptoms that are indicating they have a parasite.

Dr. Vincent:

It’s a bit of a rabbit hole. If you start investigating, most of us have some sort of parasite. We could have a worm parasite. Parasites might actually serve an immunomodulatory purpose in the body. If you look at India, where people are colonized with parasites, before they started introducing more antibiotics and more of a Westernized processed foods diet, India had very low rates of autoimmune disease. If you track what’s happening in India throughout the 1900s, as antibiotics are introduced, more of a Westernized sugar, processed foods type diet, you start seeing autoimmune disease rising in India. That might be an example where having some level of parasites in the gut actually serves a favorable purpose. It’s part of microbial diversity.

The other thing I would say about it is if you don’t know what the parasite is, how do you know that you’re treating it correctly? To make it even more complicated, we have all these tests, the stool PCR, stool culture. Some of these tests are really poor at detecting parasites, especially if it’s a culture. PCR maybe will detect the parasite. Not always. I think it’s great when you find one. Whenever I’ve found a very specific parasite, and I can do a targeted treatment for that patient, patients always improved in some way, whether it’s their energy or joint aches that other doctors thought were due to an autoimmune disease. When you find a parasite and can do a targeted treatment, where you know you are treating exactly what you have, that’s very helpful.

I have a doctor friend who sends stool samples to Africa in a lab in Nigeria, where it gets analyzed under a microscopy. They find parasites that are missed by other labs. The question is are we using the right testing to look for these parasites? Do the patient’s symptoms correlate with a parasitic illness?

On one side, you could say you can assume people have parasites. It might not be a bad thing to do a parasite cleanse. It might clear you up. If you do that, and you don’t feel better, then maybe the treatment didn’t kill off the parasite. Maybe it was the wrong parasite. Maybe it was the wrong treatment. Maybe it wasn’t for long enough. Like anything in medicine, there is never a black and white, “Yeah, do this. Don’t do that.” It’s a matter of understanding each individual case.

Dr. Eric:

On a stool test, if you see some opportunistic bacteria, like commonly you will see Staphylococcus, Streptococcus, Klebsiella, Pseudomonas, are those usually not a concern? Is that something you usually address?

Dr. Vincent:

It totally depends on the full clinical scenario of what’s going on with a patient. Let me qualify it by saying that over the years that I have been taking care of gut patients, I went from being much more aggressive to being much gentler in my approach. Now, if I see that, I might say, “Okay, let’s build up the gut. Let’s work on leaky gut. Let’s work on microbial diversity. Let’s use a spore-based organism that is going to go in there and fight and claim territory away from these pathogens. Let’s approach it from a different direction.” That’s where I’m at now. Being gentler with people and having an approach that maybe is a little bit slower, but long-term, it actually works better for them.

Dr. Eric:

Makes sense. I agree. You don’t want to be aggressive with everybody. There is a time and place. Treating everybody who has increased Staphylococcus or Streptococcus, especially if they aren’t having symptoms, is probably not a good idea.

Dr. Vincent:

Certain things we do understand. Say you have an E.coli infection, and you have campylobacter. That will give you massive diarrhea, and you will feel horrible. Because of those situations, sometimes we apply that reductionist thinking to all of these fancy stool tests that we can get. Whole genome sequencing.

What we don’t understand is when you find that in a patient who is not having acute diarrhea or any other acute findings, what is it actually doing in the balance of the entire microbiome? Is its presence pathological, or is its presence part of the normal background? All you need to do is a little tweaking to improve it.

I think that’s kind of where I’m at more now: restoring gut microbiome diversity and letting the gut rebalance itself rather than thinking. I just see people treat people with strep or staff, and sometimes it goes well, and sometimes it creates more problems.

Dr. Eric:

I have one more question. I can’t let you go without asking about gluten. I assume you have people avoid gluten, but I also heard on another podcast you were talking about why some people avoid gluten. They might have not had issues with gluten, but then they avoid it and reintroduce it. All of a sudden, they are reacting to gluten. Or maybe it’s a different food. If you could expand on that?

Dr. Vincent:

Totally. Gluten is one of the most inflammatory substances. It’s been found to trigger a molecule called zonulin that is found inside the cells that line the intestine. It controls gut permeability like a dimmer switch. They have looked at gluten and its effect on people with Celiac, non-Celiac gluten sensitivity, and normal individuals. They found that depending on the degree of disease, gluten is going to have increasing effects on the person, but it is not neutral for a normal person. Even for someone who is normal, it will cause a slight increase in gut permeability.

What might be going on because- I don’t know if you have gotten into this in other podcasts, but how wheat has been hybridized. The gluten content in the wheat, especially here in the U.S., is 30-50% greater than it was 50 years ago. We are being exposed to gluten at a much higher rate than our digestive system can handle. It’s a very different molecule to digest and break down.

If you have leaky gut, and you have partially digested gluten molecules that didn’t get bound to an enzyme called tissue transglutaminase, then you get these chimeric molecules that your immune system will look at and say, “This is foreign.” Then it has molecular mimicry that can cause your body to attack things like your thyroid for example.

I think it’s a stepwise hit problem. Maybe you start off normal, but then you go on antibiotics. Your gut permeability increases a bit. You’re eating a lot of bread, pastries, things like that. Your diet is not perfect. There is an accumulation over life issue that eventually you can reach that threshold, where it causes disease in the body. That’s the same theory for all disease in the body. We need to apply that also to gluten.

Why is it that maybe during your 40s, you were not gluten sensitive, but in your 50s, now you are starting to find that you don’t feel so good when you eat gluten? You get achy and mental fog. I think it’s that multi-hit hypothesis over time. It could be genetics, genetic expression that changes over time. Our genes are controlled epigenetically by the foods that we eat. I think that’s a dynamic process. It’s not something that is just set in stone.

We used to learn that Celiac disease was a disease that was diagnosed early in life in pediatrics. We learned about Celiac in medical school. This was only 20+ years ago for me in our pediatric rotation. Now, we know that Celiac disease can evolve later in life. You might have the predisposing genetics, but it’s a multi-hit exposure after exposure after exposure to gluten that eventually just cracks the camel’s back, and then you get Celiac disease.

My oldest patient with Celiac disease who also had Hashimoto’s, which is very much linked to Celiac, I diagnosed her with Celiac at age 52. She had positive markers. No other doctor had picked it up. I think also it’s because I asked the question, and I thought, this is not what I learned in medical school, but what if she has Celiac disease? She would get sick whenever she ate anything that had wheat, gluten. She would get nauseous.

I think we have to have a really broader understanding of how disease evolves over a lifetime. Even if you were fine when you were younger, what I like to tell people is that your body is like a board game that changes the rules, but it doesn’t tell you that the rules have changed. You have to find out that the rules have changed by playing the game. You have to figure it out. If you can be astute to that and understand that your body, your blueprint is slightly changing as you get older, your body is going to get a stronger read of what’s going on.

Say we find that you’re gluten sensitive, and you take gluten out of your diet. You create this blank slate. When you were eating a lot of gluten, it was overwhelming your immune system and causing immune complexes that maybe weren’t allowing for the full expression of the effects that gluten was having in the body.

For example, you mentioned that one patient where she had taken gluten out. She was feeling great. A month in, she went out for a pasta dinner or something, and she broke out in full body hives. She was upset. She was wondering what happened. Did I make myself gluten sensitive by taking gluten out of the diet? That’s not what happened. What happened was you create a blank slate. When you reintroduce gluten, now your body is going to give you a very clear read of what that gluten is doing to you. It causes this massive activation of the immune system that led to hives in this person. I think that’s something important for people to understand.

If you follow my GutSMART protocol and do the protocol for14 days, then retest, do the quiz, and see if you can progress, or if you are still on the same level. Say you progress from severe to moderate, and you can start to introduce new foods into the diet. I tell people there is still a powerful individuality that goes into what your body can tolerate. Even though I have determined these are the foods that are okay under the moderate, I still want you to be intuitive and listen to your body. What might be right for one person might not be right for everyone.

Dr. Eric:

Thank you for talking about that. Definitely agree. Where can people find out more about you? I know you have a free gift as well.

Dr. Vincent:

I’d love to share a free chapter and some special surprise bonuses from my book. If you go to GutSmartProtocol.com/gift. If you want to learn more, go to GutSmartProtocol.com. You can learn more about the protocol and the benefits of doing it and what people have found from following it.

Dr. Eric:

Awesome. Thank you so much for your time, Dr. Pedre. Appreciate it. Learned a lot. I’m sure the listeners did as well.

Dr. Vincent:

Thank you. It was great being here.