Recently I interviewed Dr. Aimie Apigian, and we chatted about stored trauma and thyroid autoimmunity.  If you would prefer to listen the interview you can access it by Clicking Here.

Recently, I did an interview with Josie Warren, who personally dealt with multiple autoimmune conditions. She mentioned that chronic stress was the single most important factor in regaining her health. In this interview, Dr. Aimie will differentiate between stress and trauma. Even though I did the interviews about a month apart, I relistened to the episodes on my own back-to-back. While I always bring up stress to my patients, Dr. Amie made me realize that it’s not just about dealing with the fight or flight response and blocking out time for meditation, as it goes well beyond this.

I am very excited because I am going to chat with Dr. Aimie Apigian about stored trauma and thyroid health. Dr. Aimie is the leading medical expert on how life experiences get stored in the body and restore the body to its best state of health through her signature model and methodology, The Biology of Trauma. She is a double Board-certified medical physician in preventative medicine and addiction medicine. She has a Master’s in biochemistry and a Master’s in public health. In addition to her medical training, she is also a functional medicine physician. Dr. Aimie has trainings and certifications specifically in neuroautoimmunity; nutrition; genetics for addictions, mental health, and mood; and behavioral disorders. She has several certifications in various trauma therapies, including the instinctual trauma response model; somatic experiencing, which was developed by Dr. Peter Levine; and NeuroAffective Touch by Dr. Aline LaPierre. Thank you so much for joining us, Dr. Aimie.

Dr. Aimie Apigian:

Absolutely. I am really excited for this conversation. Such an important conversation. Thank you for the invitation.

Dr. Eric:

You’re welcome. I agree. Definitely a very important conversation we’re about to have. Can you start out by giving your background? How did you start helping people with trauma? Getting into how you developed your signature model and methodology, The Biology of Trauma.

Dr. Aimie:

When you were reading my introduction, it takes me down memory lane of all the different trainings I’ve had, yet at the end of the day, this was actually just for me to save my own life and to try to help my son Miguel, who I had adopted. It was while I was in medical school at Loma Linda University. 2008 was when Miguel came into my life. He was a foster child at the time, four years old, landed in my home. I thought I knew what to do. I thought that my love was strong enough to heal him of all of his prior wounds that he had had up until that point. I had so much to learn. He was really the one that opened that door up for me. I made a commitment to him to figure out what he needed in order to help him be happy. I wanted him to have some happy years in his childhood.

What I saw happening was that he was bringing his past with him as if it were still happening. My love continued to actually be a trigger for him, and he would be very reactive and not want to connect with me because that did not feel safe to him. When I saw that not changing with time, I got very worried about his future. I started diving into trauma at that time. It was specifically around attachment because that’s what I recognized was his core issue.

Then I went on to general surgery residency after medical school. I was finishing up my third year of general surgery residency. I am on transplant surgery rotation of all things. My body broke. I got so sick that I could not even get out of bed for a period of time. I saw my conventional medicine doctor and found from my lab results that I had high autoimmune markers, that my thyroid levels were off, but not yet to the point where they would diagnose me with anything. They did diagnose me with chronic fatigue because they couldn’t figure out why I was so fatigued that I could not get out of bed. I actually ended up having to take a medical leave; that’s how sick I got.

In the process, what I realized through my studies on trauma was that all of the health symptoms and conditions that I was having, or at least that I was on the pathway to having, all of them were related to adverse childhood experiences. I had no idea why because that was not me, or at least I thought. That was my son. My son had had a lot of childhood trauma. I had not. Why was I having the same health issues as one of them?

It started me on this pathway of asking questions around, well, what exactly is trauma? What exactly are those things that happen in childhood that create these adult-onset diseases? Through that process, I started learning and tracking my own system, experimenting with my own system, then started all of my trauma therapy trainings, all to help me better understand what was happening in my own body and how to get my life back. What I was experiencing was not what I wanted my future to be.

That is how I developed all this. That is how this started. This was never intended initially to go out and help other people, and certainly not to start a professional training program, where I am training professionals around the world in my methodology. This started with me having to figure it out for myself, not knowing if it could be done, not knowing if as an adult, we could actually rewire these trauma and stress patterns that have been in our system since childhood. I was willing to figure it out and do everything that I could in order to see if it could be done, just to get my life back.

Dr. Eric:

That is some story. Thanks for sharing. When working with any chronic health condition, most listeners have a thyroid or autoimmune thyroid condition, be it hypothyroidism or hyperthyroidism. A decent number of people will respond just to diet and lifestyle, stress management, getting proper sleep, taking supplementation. There will be people who just don’t respond, not to say that with all of these people, it’s adverse childhood experiences. Is it still safe to say that at least in some of these people, that is playing a role in them not getting the results they or I are expecting to get?

Dr. Aimie:

I may say something really controversial here. Many people might not want to hear me say this. This is what I have found: When it comes to these chronic diseases, especially autoimmune, all autoimmune conditions fall under the category of being trauma-related, not stress-related. That opens up this whole can of worms to be like, well, then when would you have experienced trauma? We need to redefine trauma because just like me, you may look back on your life and be like, “Me? I haven’t had trauma. I relate to being stressed, but not traumatized.” I had to relook at what is trauma? That’s why I call it the Biology of Trauma. There is a whole biology of trauma. Autoimmune conditions are squarely in the freeze response or trauma response category.

Dr. Eric:

That brings us to the question: What is the difference between stress and trauma? Why don’t we dive into that right now?

Dr. Aimie:

Let’s do it. This is a really important distinction. Most people aren’t aware of this distinction. Most professionals, even practitioners, you will still hear them say, “fight, flight, or freeze,” as if all three of those are the same. They’re not. Many people are being diagnosed with stress or even chronic stress when they should be diagnosed with trauma. You are in a trauma response. Your body is chronically in a trauma response, not a stress response. Here is the difference.

There are three ways you can tell the difference between stress response and a trauma response. One is your body’s sensations. One is the thoughts you’re having. The other one is the physical health conditions or symptoms you are experiencing.

Let’s go with body sensations first. When you are in a stress response, it is that state when you are actively running or facing and fighting the danger in your life, whatever that danger is, whatever that problem is. It is when you are running from that dog who is going to bite you. It is when you are racing towards your meeting in order to get there on time. It is a very high energy state. Your senses are very alert and tuned into the problem. What are all the different factors contributing to that problem? What do I need to do to face that problem? Stress response is when you don’t want to go to bed because you actively have a problem, and you want to solve it. You’re taking action to solve it.

The trauma response is when it feels like things have been too much, and all you want to do is go to bed. In fact, you don’t want to get out of bed. You want to pull the covers over your head. There is a problem in your life, but it feels like you don’t have the energy to face the problem. There is this sensation of a collapse of energy, a low energy. In fact, when you feel into your body, it’s when you want to curl up into a ball.

A fight response is, “No, I am going to fight you.” The trauma response is, “I’m done fighting. I don’t have the energy to fight anymore. I may still go through the motions because I still have responsibilities. I still have a job, I still have kids, I still have a partner, I still have life.” That is what it feels like. “I’m just going through the motions” rather than experiencing the aliveness and energy and joy and feeling like you’re actually present and engaged.

The trauma response will have you feeling like you’re distanced, like things are a little foggy. Things are a little numb. You don’t feel like you belong. You feel like you’re on the outside looking in, sometimes at your own life, let alone at a group of people. You can be surrounded by a group of people yet still feel very alone. That is the trauma response. That is the difference between trauma and stress.

Dr. Eric:

If someone is dealing with chronic stress, oftentimes, you will hear practitioners, and that includes myself, talk about blocking out time for stress management and incorporating mind/body medicine, whether it’s meditation or yoga or biofeedback or tai chi, or anything else. Is it safe to say then that with trauma, that is not the solution? Let me ask this differently; Does mind-body medicine play any role when it comes to trauma? Is it for those who are chronically stressed?

Dr. Aimie:

Like you say, there is a lot of different modalities. Rather than focusing on which modality, I teach the principles of what the trauma response needs in order to come out of the trauma response. What does the stress response need? Those are two very different things. When we think that it’s stress, and we apply tools for stress, but it’s actually trauma response, those tools aren’t going to work.

That’s when people can get stuck, or they experience resolution of those physical health symptoms, but then other physical health symptoms appear. I have seen this quite often in people who do some of these different modalities that maybe their gut issues resolve, their thyroid issues resolve, but then it shows up as something else, like chronic pain or inflammation somewhere else. It always shows up somewhere until we actually work with and resolve the true underlying and root cause.

What the trauma response needs is three things. The trauma response has to have a felt sense of safety. I’ll come back to that because it can be tricky for some people. The other things are time and energy. The trauma response is an energy problem, so that’s where the biology factors come in. We need to look at all of the things that are draining our energy that are contributing to us continuing to go into the trauma response. It’s become this conditioned pattern. Now we just go automatically into it without really even needing a trigger because that’s what we’re conditioned to do. It needs time.

There are two triggers for the trauma response. One would be when things happen too much too fast. The body hasn’t had time to process what’s happened. it hasn’t had time to integrate what’s happened. It overwhelms it. it goes into the trauma response. The trauma response is in a sense our protective adaptation to buy us some time.

Then it needs a felt sense of safety. If you were a turtle, and you had danger approaching, you’d pull your head back into your shell. That’s like a trauma response. We close up. We retreat within ourselves. We’re not sticking our head out until it’s safe outside. We don’t want to get our head bitten off. That’s the same thing with the trauma response. We’re not going to come out of that trauma response until we have a felt sense of safety.

Here’s the problem: So many people live in their heads. They are used to thinking about things and talking about things and analyzing things. They have no idea that they actually don’t feel safe in their own body. They tell themselves that they should feel safe. They maybe even say affirmations and mantras and do mind/body medicine that tells them. Is it a felt sense? Do they actually feel safe in their body? Until that is in place, the body itself will stay in its trauma patterns. Doesn’t matter what the mind does.

When we look at the different modalities that are out there that can help us, that is the question we want to ask: Does this help me create a felt sense of safety, time, and energy? If so, then it’s the right tool for the trauma response. If it doesn’t, it still maybe the right tool, but it’s not the right time to use this tool.

The stress response needs different tools. Those may be better tools for the stress response. We are not in the stress response yet; we are still dealing with the trauma response. Anybody with active thyroid issues, especially autoimmune, is in the trauma response. Unless you have a thyroid storm, and then you are clearly in the sympathetic stress response, but otherwise, if you have any version of hypothyroidism, the fatigue, the heaviness, the low metabolism, those are all symptoms of the trauma response. It doesn’t need to be emotional. It can be our biology that pulls us into that trauma response.

Dr. Eric:

You’re explaining that connection between the physical trauma and emotional trauma. That’s one of the things I wanted to ask you about.

Dr. Aimie:

It can be both. When we look at adverse childhood experience studies, for those who may not be familiar with those studies yet, I encourage you to look at those. They came out of the work of Dr. Vincent Felitti in San Diego at Kaiser, working with obese women and noticing that a high percentage of them had had sexual trauma in their childhood. It opened up this question for him: Is there a connection here? He was willing to ask the questions that no one else wanted to ask, let alone talk about.

Since then, it’s opened up all these other questions of if that’s the association with obesity, what about with autoimmune thyroiditis? What about Hashimoto’s? Yes, there are clear connections between adverse childhood experiences and autoimmune thyroid conditions. There is a great paper that came out in 2009 by SR Dube. If you search “adverse childhood experiences, thyroid, 2009, Dube,” you will find the article. There is a very clear association. What they also found in that is it’s not only the association with the thyroid issues, but it’s also the severity of symptoms that you are likely to experience. The more stress or the more adverse childhood experiences you had as a child, the more that predicts you will even be hospitalized for the severity of your thyroid symptoms.

There is another article that was published in 2018. This was looking at subclinical hypothyroidism in pregnancy. What they found is that the childhood stressor or abuse is associated with increased risk of mothers experiencing subclinical hypothyroidism when they are pregnant. This was published in the journal Psychoneuroendocrinology in 2017.

There is another article on post-traumatic stress disorder and the incidence of thyroid dysfunction in women, which was published in 2018 by Cambridge University Press. They found there is this association between the diagnosis of PTSD having a higher risk of hypothyroidism. Of course, it does. Hypothyroidism by itself puts us into a trauma response. We see these connections that the earlier in life, and the more times in life that you have experienced overwhelm, that is what actually promotes the nervous system changes that cause the immune system changes that cause autoimmune. Stress does not cause autoimmune. The trauma response is what causes autoimmune. The autoimmune causes the trauma response. It goes both ways.

Dr. Eric:

Obviously, you brought up these examples because you know my audience consists of people with thyroid and autoimmune thyroid conditions. If you did the same studies on multiple sclerosis or lupus or rheumatoid arthritis-

Dr. Aimie:

All autoimmune. You can’t ignore the facts. That’s why when my autoimmune markers came back high, and my doctors wanted to make it insignificant, “Well, you haven’t had any of the clear symptoms yet. Once you have those symptoms, come back, and we will diagnose you with lupus.” How do I get off of this path? I don’t want an autoimmune condition for the rest of my life, but I am clearly on this path. That’s what my studies led me to, “Aimie, you can’t ignore the facts.” This is related to what I thought at the time was stress, and I have since learned it’s trauma response. That became my focus of how do I work with my trauma response so that it is no longer driving my health?

Dr. Eric:

Can you talk about some of the things you do? Some of the therapy modalities or methods you use to regulate the nervous system.

Dr. Aimie:

In the approach I have created, which is The Biology of Trauma, there are three arms to this approach. One arm is what I call somatic work or body work. This is where I use my mind to put attention on different sensations on my body so that I can be aware of what’s happening and provide it a felt sense of safety, which is what the trauma response needs; provide it a felt sense of support, which is what the stress response needs; and provide it with a safe experience of growth and expansion and joy and healthy anger and boundaries and all of these other things that autoimmune people need to work on as well. The somatic work, which is working with the body and body’s sensations, using the mind to put attention on the body.

The second arm is our thoughts and belief systems. I classify this as parts work. Anyone who is familiar with internal family systems, this is how I frame this. There are different parts of us. There is the part that experienced a situation in life. What were the belief systems that we made coming out of that? What were the stories we told ourselves about ourselves coming out of that experience? Those now have continued to drive our belief systems about ourselves, our views of ourselves. I actually incorporate parts work in our belief systems with the body work so that they are actually done together.

Then I bring in the biology piece. As we can see, whether we’re talking about stress or trauma, but especially trauma, it has chronic effects on our biology. Now it’s no longer enough to go back and process the trauma, which I will mention that we can’t process trauma until we have some tools in place. We can’t process that trauma and expect everything to be resolved because now we have had this downstream effect. It’s our biology that will keep us stuck.

We also do need to address how our biology has been affected by the trauma. The tools that we have to use include what we call regulation. Regulation, you can think of as stabilizing the body.  I did 3.5 years of general surgery residency. When a person goes into surgery, surgery can be thought of as processing trauma. We are going to fix the problem. We are going to rewire the nervous system. We are going to do this big release, or whatever it is that we’re processing. That is what happens in surgery. You just don’t take anybody to surgery at any time. You have to do a pre-surgery assessment. Are you ready for surgery? Are you ready for processing that level of trauma, that depth of trauma? Are we actually going to retraumatize you by trying to help you?

That is what a lot of therapies do. They try to help people process when they are not yet ready to process. We haven’t stabilized the system yet. The body has to be stabilized to go into surgery. You wouldn’t go into surgery without anesthesia. You would create more harm than good. That’s what we do with therapy. We are trying to do good, but actually putting them in a place where we are asking the body to do more than what it’s prepared to do at that time. It’s not yet stabilized. Doesn’t have the tools yet.

Those tools are called regulation skills. The short of it is, the regulation skills are the body work. Our being able to shift my own states of my nervous system to be able to recognize when my system has gone into the stress response, the trauma response, and have the tools in the moment to create a felt sense of safety or a felt sense of support or to bring my system back into parasympathetic.

So many times, we have relied on other people to do that for us, whether it’s a therapist, our partner, our friends. We have relied on other people to help manage our emotions, to help stabilize us, to help bring us back down to a place of settling and feeling okay. We go to therapy in order to help us feel safe in an area of life that we don’t feel safe. That is why the therapy doesn’t work, no matter what modality you use, because a person needs to go into therapy feeling safe for their body to be ready and open and able to process what happens in that therapy session. Otherwise, we can retraumatize people by even a good thing causing too much too fast.

There was one other trigger for the trauma response other than too much, too fast, which is too little for too long. Too little of something that you need for too long, be it too little of support, love, touch, whatever it is. Too little for too long is the other trigger for the trauma response in our life.

Dr. Eric:

Wow, this is quite a process. You said the reason why therapy doesn’t work, or if someone goes to a psychologist, is they need to feel safe prior to seeing a therapist or psychologist. On top of that, they are not dealing with the biology. They are just dealing with the psychology. That’s why someone might be seeing a therapist or psychologist for months or years. Maybe they are getting a little bit of progress, but not where they could be by seeing someone like you, who focuses on the whole picture.

Dr. Aimie:

Yeah. One thing I discovered that I’d love to share is how to know when the therapy that you are doing is actually retraumatizing you. Sometimes, we are not aware enough of our own bodies yet to be able to recognize that. It shows up in our health. If you are experiencing a flare-up of your physical health conditions, of your chronic health conditions, for me, I would experience a flare-up of my autoimmune stuff. I would wake up and feel inflamed, and my gut issues would flare up. Those are signs that what you are doing is too much for your body. You are actually retraumatizing yourself. That is how it’s manifesting. That’s how it’s expressing. That’s how it’s trying to talk to you and get your attention of, “This is not the right thing at this time. This is too much too fast for us.”

We can use our physical health as a measure, as a monitor for how we are doing any therapy process, and whether it’s helpful, and maybe it’s a good thing, but not just the right thing at the right time.

Dr. Eric:

After or while someone is working with you, a lot of people don’t know this, but my bachelor’s degree is in psychology. If someone works with you, is it completely unnecessary to see a therapist or psychologist? In some cases, is it still beneficial to see someone in addition?

Dr. Aimie:

Great question. I’m not going to say that no other process is going to be helpful. I don’t call what I do therapy because what I’m doing is teaching you how to give your body what it needs to heal itself. That’s very different than going to somebody else and saying, “Will you please fix me?” This is a natural part of the trauma response. We lose our own sense of power. We feel powerless. We feel like it’s too big for us. It’s a very important principle in my methodology to empower people and teach them so much of what they can do for themselves.

It is my belief in my experience and certainly with the thousands of people who have come through my courses that when they have the skills to do a lot of this themselves, the rest becomes clear. For some of them, they’re good. Their health conditions are better. We have had some come through with their thyroid levels off. Then they regulate their nervous system and provide a felt sense of safety and support, and their thyroid levels come back to normal. It’s been phenomenal the health changes that happen.

For some people, it becomes clear to them that “This over here is another piece I’m missing. This is a piece that is the next best piece for me.” It changes the feeling of being lost. “I don’t know what to do, so I’m going to randomly pick something and hope that they know what they’re doing.” This process changes that, where now they are making decisions that are coming from a place of clarity. “I can tell what my body needs. I know what my body needs. Let me go find someone who will fit that piece and be able to do that for me.”

It’s a very different place than feeling like you’re spiraling out of control and grappling for something, someone, somewhere that can help you versus “I know my body, I’m an expert on my system, I’m an expert on my trauma, and I know that this is the next piece for me. Let me go find that specific person.” It’s completely different. It’s such meaningful work to see people go from a place of feeling very lost, feeling very broken and being able to see that through this process, they come to their clear path forward.

Dr. Eric:

This is important not just in regaining someone’s health, but in maintaining their health, too. Flare-ups will happen. Obviously, you can’t undo the past, the trauma(s) that people have experienced in the past. If someone is dealing with Hashimoto’s or hyperthyroidism/Graves’, and maybe they just haven’t gotten the results that they expected by changing their diet and doing other things that I teach on the podcast and other functional medicine practitioners teach, what are some next steps that you would recommend they take?

Dr. Aimie:

I would recommend they start to look into the trauma. I know this is scary, and it can be daunting to look at trauma work. Or maybe I have been doing trauma work, but I have been doing it wrong.

I have created a starting place for people, so that can be a helpful place. It’s a starting place for doing this type of body work, trauma work through the lens of what were the overwhelming experiences that I’ve had in my life? Let me start with the superficial layer. Let me do things gently. Let me learn how to build in these felt senses of safety and support rather than what I call jumping off the cliff of the emotions where I hope you have your parachute because that can be a hard landing if you are trying to go process something.

I have starting place retreats, and I do them over a weekend, Friday-Sunday. Very low time commitment. 30 minutes for Friday, an hour and a half on Saturday, and an hour on Sunday. It is a starting place to show people this is what this type of trauma work means, so you don’t have to be afraid of it. You know what it’s like. They can make a decision to continue on with me, or they now have a better sense of what it is that they need. They sometimes go and find that in their local area, someone they can meet with in person. They don’t do an online course with me.

I do a 21-day journey for those people who want to do that journey with me and have me guide them into their own body, their own nervous system, and start to become the experts of their system. There are options, but they need a starting place.

My strong recommendation is get to know what it is that you actually need, what your body needs. From there, things start to become clear. If that is coming to my Starting Place Retreat, come. Experience it. Be able to make a better informed decision of what do you want your next step to be? Do you want it to be one of my longer courses? Do you want it to be something in person, but now you have a better idea and sense of what it is that you’re looking for? How gentle or fast is your body ready to go? That is something that each person needs to know in order to keep it safe and not have it be an experience that retraumatizes them.

Dr. Eric:

The three-day retreats are in person, not virtual? Is that correct?

Dr. Aimie:

Those are all virtual.

Dr. Eric:

Okay. Anywhere, people can do them. You mentioned the 21-day program. Obviously, that’s online. Anybody can do that as well.

Dr. Aimie:

Yes. The 21-day Journey is what I designed. I was taking all of my patients through. At that time, I was still having my own clinical practice. I noticed that if I could teach them these skills first, their health/baseline was at a very different place. We could do so much more and faster with their actual medical care. I started having all of them do just 21 days of some very simple, basic somatic work. These are short exercises. I teach these exercises. They are 10 minutes every day.

The whole first week in that 21-day journey is me teaching them the seven different exercises to create a felt sense of safety. This is where most of them tell me, “I didn’t even know that I didn’t know what it felt like to be safe. I didn’t know.”

The whole second week is me teaching them seven different exercises to create the felt sense of support. When you feel like someone has your back, my goodness, you can do anything. We are able to stay in that stress response and not have our stress turn into trauma because we felt all alone, and no one understood what we were going through.

The third week of that 21-day journey, I teach them different exercises on how to safely step into growth and expansion and joy and healthy anger and boundaries, all of these things that we need to bring into the trauma work, but we also need to bring it in at the right time. That is never at the very beginning. We need to create a felt sense of safety and support first. Then we can move into these more expansive things.

Dr. Eric:

Would you say this is something that everyone can benefit from?

Dr. Aimie:

Every single person.

Dr. Eric:

I’m asking because especially those with an autoimmune thyroid condition, but you said every autoimmune condition, trauma is a factor.

Dr. Aimie:

Who in our life today does not experience stress and overwhelm? Everyone, to some degree. I really do consider this as the manual for our human bodies and knowing what our bodies need to get through life in the most healthy way possible.

Dr. Eric:

I probably need to go through that too, then.

Dr. Aimie:

I would love to have you in it.

Dr. Eric:

I know we covered a lot. Is there anything I didn’t ask you that I should have asked you? Anything else you’d like to share?

Dr. Aimie:

We did cover a lot. I imagine there are some people who already feel overwhelmed with all that I shared. I just want to share hope. There is so much hope, no matter how old you are, no matter how far you are in your disease process. No matter what, no matter how your life experiences have been up until now, there is so much hope. It’s just using the right tools in the right way in the right order. That is what we have not been doing. That is what will give us so much more freedom and change for our future.

Dr. Eric:

Well said. Thank you so much, Dr. Aimie for sharing your knowledge on trauma and relating it to thyroid health and autoimmunity. I am sure the listeners learned a lot. I did as well.

Dr. Aimie:

Thank you so much.

 

Recently I interviewed Josie Warren, who shares how she regained herself after dealing with eight different autoimmune conditions, all by addressing a single trigger. If you would prefer to listen the interview you can access it by Clicking Here.

With me, I have Josie Warren. She will be discussing how she overcame multiple autoimmune conditions. Josie is an autoimmune expert. She used to have Graves’, Hashimoto’s, and six other autoimmune disorders. She completely resolved all of her autoimmune conditions and now takes people down the same path of healing she has traveled. Thank you so much for joining us, Josie.

Josie Warren:

Thank you, Dr. Eric. It’s great to be here. Excited to speak with the Save My Thyroid audience.

Dr. Eric:

Great to have you. Why don’t we go ahead and start off by giving your background? How did you start doing what you’re doing today, which is helping others with autoimmune conditions?

Josie:

That’s a great question. Like all of you listening out there, I also had multiple autoimmune conditions starting in high school. I started with arthritis. Seems like you can’t just have one. They snowballed over the years, as I continued to not deal with my life and stressors.

By the time I was 28, I had to leave my profession. I used to be a licensed professional counselor; I worked at the Betty Ford Center. I loved it, but it was very stressful. I decided to set out on a quest to figure out all my health conditions. I had about eight autoimmune disorders at this point, and some mental health conditions as well.

I found an organization here in Denver who I was told could help me because I was someone that doctors didn’t have any explanation for. I came here and was able to learn a very unique and novel perspective on healing from autoimmune. Within a number of months, all my autoimmune disorders resolved and went away. It so profoundly changed my life and gave me my life back that I knew I had to learn and teach this.

I left my profession as a licensed counselor. I trained for five years. Now, I teach the same educational program that I learned, but we’re always updating it and making it more current. That’s what I do now. I am an autoimmune expert, taking others down this same path.

Dr. Eric:

That’s some story. What autoimmune condition were you diagnosed with first?

Josie:

The first one was rheumatoid arthritis. I believe I was about 17 years old, 16 or 17. I didn’t think much of it. I didn’t see that as a red flag, that there was something not right in my immune system, and I should be noticing there was a dysregulation happening.

Dr. Eric:

As you probably know, I was diagnosed with Graves’. One question I had for you also is family history. When it came to Graves’, I honestly don’t know anybody else in my immediate family or even distant family who had Graves’. There are some hypothyroid cases. I’m not sure if they had Hashimoto’s. Either way, is there a history of autoimmunity in your family?

Josie:

There is. My sister has lupus. My mom had hypothyroidism. Back in the day, I had many great-aunts who had what I now believe to be some autoimmune conditions that they were going more misdiagnosed. My grandmother had autoimmune. Yes, autoimmune definitely runs in my family.

For me, for many out there, if it’s genetic, I thought that I was trapped, and there was no way out of these conditions because of that genetic factor. I always like to teach people and talk about how we are not a prisoner thankfully to our genes. For me, even though I have a history of it, now, not having any autoimmune, I can attest that the genes do not hold us back.

Dr. Eric:

I agree. The reason I ask is because you had so many autoimmune conditions. As you said, regardless of whether someone has one autoimmune condition, like I did in the past, or many conditions, like you dealt with, genetics is still a factor, but it’s not the most important factor. I’m glad you brought that up.

Can you discuss some of the similarities between different autoimmune conditions, what they have in common?

Josie:

Absolutely. I’ll speak for how I was taught back then, and now what I understand. When I had all of these autoimmune conditions, I was taught that they were all separate and to treat them separately. I was seeing different specialists to treat all of these conditions. Different endocrinologists, immunologist, rheumatologist. I was also doing functional medicine and seeing nutritionists and doing herbs. I was trying the whole spectrum for all of these different conditions.

What I have found is not only do they share very similar symptoms, symptoms such as brain fog, fatigue, body pain, but I have also found they are all coming from the same place. That is what I did not understand when I had them for all those years. All of my autoimmune conditions were coming from the very same singular root cause, which we know here is stress and chronic stress. I focused on the one root cause that was causing my immune system to go overactive and to malfunction, all of the autoimmune conditions resolved, and all of the symptoms resolved, just by working on one thing. Before, where I was working on everything separate, treating them all as separate conditions, I actually would never have found for myself a way out of them.

Dr. Eric:

You brought up a great point. In the conventional medical world, you go to different specialists depending on the autoimmune condition. If you have an autoimmune thyroid condition, you will see an endocrinologist. If you have rheumatoid arthritis, chances are you will see a rheumatologist. If you have some kind of gut disorder, you will see a gastroenterologist, even if it’s autoimmune. There is not an autoimmune specialist amongst conventional medical doctors. They are not focusing on that autoimmune component, like you said.

In my experience, you could have multiple triggers when you have different autoimmune conditions, but in your experience, there was one main factor, it sounded like. Once you resolved that, you got everything under control, which was great.

How important was diet when it came to restoring your health? I imagine it had to be at least a piece of the puzzle. I wanted to get your opinion as far as what type of diet you followed then. What type of diet do you follow now, now that you’re in a state of wellness?

Josie:

Great question. Thank you for asking. What I will share is going to be different than what you are hearing out there. Up until I got healthy, those years of autoimmune conditions, I was really focused on restrictive food diets. Like many out there, I went from diet to diet. I did elimination, AIP, the LEAP program, low-FODMAP, gluten-free, sugar-free, the Candida diet, Bulletproof, paleo, just to name a few. I was really on a lot of diets.

By the time I came to the organization I work for now, A New Life Center, I was only eating five foods. That’s all that my body could handle. If I remember right, it was kelp noodles, spinach, garbanzo beans, coconut oil, and something else. That was my daily diet. I could not handle anything else because of the years of restrictive food diets I had been on.

In my body healing and self-repairing, there wasn’t a diet component to that because what I found here was that the reason my digestive system wasn’t working properly, the reason my gut was leaky, and the reason I had all of those digestive issues wasn’t the foods I was eating. It was my immune system. My body was stuck in the sympathetic nervous system due to chronic stress. When I worked on my chronic stress, my body was able to exit out of the sympathetic, enter into the parasympathetic nervous system, and in that, my gut naturally healed and self-repaired. That process happened all without a food diet.

My experience, and the experience of my students that I work with, we don’t work with any diets. I didn’t do any diets to resolve my conditions. Now, to give people hope out there, I’m happy to report that it’s almost been eight years since I’ve had these conditions, and I am not on any restrictive food diets. I eat a normal, healthy diet. I enjoy barbecues, birthday parties. I have a birthday coming up in a few weeks, and I will be getting a cake. I don’t have to worry about foods I eat because I don’t have these conditions anymore.

Dr. Eric:

You mentioned a normal, healthy diet. It sounds like most of the time, you’re still eating healthy. You’re not going to McDonald’s every day.

Josie:

No.

Dr. Eric:

You’re not eating cakes and cookies every day. Maybe for your birthday and special occasions. Maybe more frequently than that. When it comes to working with clients, there is no special diets like AIP or paleo. Do you tell them to restrict anything as far as gluten or dairy or any other foods?

Josie:

Like myself, many of the students I work with who come in with different autoimmune such as Graves’, Hashimoto’s, fibromyalgia, and other chronic illnesses like migraines are often on special food diets. They are coming in severely restricted on foods, oftentimes AIP, gluten-free, dairy-free, etc. I just let them know, “Hey, it’s up to you if you feel like you want to continue this” while they are in my program. Some do. Some choose not to.

I know that at the end of the program and working with me, the immune system will go back to normal; the digestive system heals and self-repairs. Regardless of if they are on a food diet or not, they are then able to start reintroducing foods that they were once maybe sensitive or allergic to back into their diet.

While I don’t work with food diets, and some choose to stay on them and some not, every person I work with who is/was on a food diet, I teach how to reintroduce foods just like I did for myself. They are able to go back to eating those foods that they were once allergic to, even things that they were sensitive to, like gluten. I work with people with Celiac who can now eat gluten. Even people who had anaphylactic experiences to things like nuts are, over time, able to go back to eating those as well. I focus more on the reintroduction versus the taking out.

Dr. Eric:

Very interesting. It sounds like stress was a big factor. I also listened to some of your other podcasts. I try to get acquainted with my guests before I interview them and learn about them. I know you had a journey with regard to stress and mental health. Can you talk about that, as far as how that ties into autoimmunity, not just your condition but your students?

Josie:

Yes, I love talking stress because it’s the thing that I find no one is talking about when it comes to autoimmune, and it is, from my experience, the singular root cause. What I didn’t understand, and this is true for myself and anyone that I have worked with on autoimmune, is that we are not good stress people. We are born into this world not well wired to handle stress. Unfortunately, what happened with myself and everyone with autoimmune is that we unconsciously suppressed stress in our bodies.

If you think about a lifetime from birth on, suppressing the stressors that we have been through, things such as, even at a young age, moving, siblings being born, maybe a parents’ divorce, heartbreaks, graduations, new jobs, marriages, we just suppress that. All of that stress layered into our body until our body reached a tipping point. Physically, it could not handle any more suppressed stress.

That was my experience. I had a lifetime of suppressed stress. I had the health to show it. We all have different kinds of conditions that led up to these autoimmune that we had. They didn’t come out of nowhere. There is actually a term for that, “allostatic load.” That is a term that talks about the accumulative wear and tear of our bodies due to increased stress in our lifetime. If you were to take a timeline of the conditions you had, say, even, strep or sinus infections and things like that, and you layered it over the stressors of your life, you will see them line right up.

For people like us with autoimmune, from my perspective, you have reached that stress tipping point, and we have one stressor that is one too many. It pushes our body over into a nervous system called the sympathetic, which is where fight or flight exists. Our fight or flight kicked on, but it unfortunately stays on due to the chronic stress of our life. It thinks we are under a constant threat. From that point forward, people with autoimmune are stuck in the sympathetic. The immune system goes overactive. People with thyroid conditions, it starts attacking our thyroid. That’s where it all comes from.

For me, stress is everything. The reason we haven’t healed is because we haven’t dealt with our stress. Deal with the root cause: chronic stress. I have found fight or flight will always turn off. Then the body can fully heal and self-repair. The immune system goes back to normal. The body no longer has autoimmune anymore. That’s why I no longer have these autoimmune disorders and why my students don’t either. Love talking stress.

Dr. Eric:

Stress definitely was a big factor in the development of my Graves’ condition. A lot of people are in a sympathetic state, and we need to make the switch more to a parasympathetic state.

I’m sure you’ve spent a lot of time with your clients as far as trying to help them overcome the stressors. We don’t have time to go over everything during this call; that’s why they would see you. Can you go over at least some of the basics? What do you do? Do you do testing to look at their adrenals? Do you just assume everyone has stressed-out adrenals, and you have people do mind/body medicine? If you could give some pointers of what you do to help your students deal with stress or eliminate the stress, whatever approach you take.

Josie:

There is a lot of misconception about stress out there. Our society likes to deal with stress after the fact that we’re stressed. Then we’re told to work out or sleep more or eat healthier. That’s not really getting to the reason of why you are stressed in the first place.

What I do and what we teach here is an educational program. There is no need for any kind of lab testing or bloodwork. We let their doctors do that testing. People I work with have already been diagnosed, so they can do that testing before they work with me and after, or within the program if they feel like it. I know definitively stress is the way out. Everybody I work with, I do the same stress work with, and everybody gets better, regardless of age, what or how many autoimmune conditions or chronic illnesses they have. I know it’s stress. We just have to learn a new perspective on stress.

When we learn a new perspective of life and stress, our experience changes internally, and we are no longer feeling chronically stressed anymore. Fight or flight picks up on that and turns off. You enter into parasympathetic. Autoimmune resolves. The body heals and self-repairs.

I have three tips I can share to give you an idea of what I’ve done and what I teach my students. The first one is we have to normalize stress. We have to realize that our stressors are really not unique. If I think the things that have happened in my life are worse than others and more unique, I make them too big, and I can’t handle them or overcome them. We have to realize that as humans, we all generally have the same kinds of stressors in our lives, give or take. If you wrangled up a group of 100 people, you’d find the same things. I needed to learn that for myself to normalize my stress. We can know and anticipate the stressors we have because that’s what humans have. It’s what our ancestors a couple hundred years ago had. It’s what the people who come after us will have. First, we have to normalize stress.

The second thing is I teach people that stress is an internal experience, meaning it’s not given to us by the things, events, and circumstances. Our stress comes from inside of us. That’s why if you fly on an airplane, you will find five different people with five different experiences or stress responses to the same stimuli. Some people might be relaxed; some people might be taking medication to help them with the stress experience; some people might have the bag out. You don’t know. That’s because stress comes from us. If it comes from us, which it does, the key is there is something you can do about it. Remember, stress, from my perspective, is the root cause of the autoimmune condition in the first place. If there is something you can do about it, that’s wonderful. You will be your own solution.

The third thing that I teach people is that to resolve our experience of stress, we have to activate and grow and build the resolution of chronic stress, which is our natural resilience. I know “resilience” is a buzz word. It’s our ability to be adaptive and bounce back quickly in times of stress. It’s our ability to go out into life to grow and learn. Our ancestors had strong resilience because they had to deal with all these day-to-day events for their survival. We have a very easy life these days. Resilience has gone a little weak.

I teach my students it’s by going back out into life, into the stressors, not hiding from them, willingly, to grow and learn, and to build our own internal strength, that your body and self is able to handle your stress. You grow that resilience. Again, your body picks up on that, and your fight or flight will turn off. That is how you enter into that parasympathetic nervous system.

In a long nutshell, that is my framework of what I teach on stress. It’s not after the fact. It’s prevention and doing it before it happens, by changing our perspective.

Dr. Eric:

It’s not getting rid of the stressors. Many times, that’s not possible. Even if you can eliminate some stressors, we are always going to be faced with stressors in the future. Some of them are unexpected. You are teaching people to deal with their current stressors better as well as from a preventative perspective. Improve stress management skills and their perspective of stress, so that future stress won’t have that same impact on their health.

Josie:

Yes. It’s changing us. You make a great point. Our society teaches, and I did this for some time before I knew better, “Oh, I’m stressed. I have to leave that place. I have to move. I have to leave that job, that relationship, etc.” That is no solution because wherever we go, there we are. Stress is in us. We are the creators of our stress. I was the one who had to change my perspective. Then I could keep the same life I have. It’s no longer feeling chronically or overwhelmingly stressful anymore because I have the resilience and the ability to handle it. From that, our body will heal and self-repair our autoimmune and chronic illness.

Dr. Eric:

You said you don’t do any testing. You leave the testing to the practitioners. Correct?

Josie:

That’s correct.

Dr. Eric:

If someone with Graves’ or Hashimoto’s came to see you, how do you know that they are in remission? Is it based on the tests that they are getting with another practitioner, like they go to an endocrinologist, and their thyroid panel stabilizes, their antibodies normalize? Maybe you don’t look at those. How do you determine if someone has restored their health?

Josie:

Great question. I have two answers to that, but I want to touch on remission. I was taught back before I learned this and healed that remission was the best I could do. That was the top of the pyramid. Everyone is searching for remission. What I have found and what I teach is the step beyond remission, which is the condition is actually no longer present anymore in the body. In remission, we are still in that sympathetic state. The immune system has still malfunctioned. Unfortunately, no one taught me this, but it’s only a matter of time before a flare-up will pull a person out of remission. You don’t know when, but you know it will. That is the problem there. With remission, it doesn’t mean the condition is gone.

What we teach with stress is that when you can get the body out of that sympathetic nervous system state, when you can get it into the parasympathetic state by eliminating the experience of chronic stress, the immune system actually goes back to normal functioning. In the case of Graves’ or Hashimoto’s, that immune system permanently stops attacking the thyroid. When your immune system stops attacking that organ, you no longer have an autoimmune disorder. That is actually beyond remission; that is a permanent elimination of the autoimmune disorder. There is nothing that needs to be done to maintain that. That’s why I don’t have to be on restrictive food diets or take supplements to maintain my health. My immune system is healthy and back to normal.

For testing, it’s very interesting. What we find is that when a body gets into that parasympathetic state, when you eliminate chronic stress, the immune system goes back to normal, the autoimmune disorder resolves permanently, and the symptoms do as well. People don’t always test normal right away. We recommend for people outside of my 10-week program to give themselves six months or a year. Give their body some time to get in that parasympathetic nervous system for all the levels to test normal.

Regardless of levels testing normal right away, it is undeniable when a person no longer has an autoimmune condition. You will feel physically tangibly that internal health of you’re no longer fatigued. I used to have almost no hair up here. Your hair grows back. Your weight stabilizes. You wake up in the morning with energy. Your skin is moisturized again. For hyperthyroidism, you’re not anxious all the time, your heart isn’t palpitating, and you’re not sweating abnormally anymore. You go back to living a normal, healthy life. You can feel that regardless of testing or not.

We don’t do testing because we’re education. People have gotten tested, and I have gotten retested outside of the program. We don’t have anything anymore. Our immune system has gone back to normal.

Dr. Eric:

It’s an interesting perspective. I have written articles like “Remission versus Cure.” I have been in remission since 2009, but everything is normal. I feel like I am cured. I am hesitant to say that because there is that genetic component. Even though it’s not just genetics, obviously environment plays a much greater role. I definitely agree with a lot of people who relapse, it’s just the stressor getting out of that sympathetic state, and not just shifting to the parasympathetic, but staying there.

This leads me to what you’re currently doing to maintain your state of wellness. Diet-wise, you spoke about. You’re not following any specific diet. Are you doing things on a regular basis to stay in that parasympathetic state?

Josie:

Just to answer a little bit from my perspective on what you shared to clarify my understanding, I want all the listeners out there to know, like I shared earlier: What I have found is regardless of if we have it in our genes or not, whether you have the genetic component or markers, it is no factor in the body’s ability to heal itself. It’s a nonfactor. It’s so wonderful because I know for so many of us, like myself, I felt that pulled me back. I couldn’t heal because of that.

Dr. Eric:

I agree with that. The environmental factors definitely are a greater factor. If you have the genetics, I agree, that’s not going to prevent you from getting into that parasympathetic state.

Josie:

It’s a great thing. I was so excited because I felt so trapped by environmental toxins, foods, GMOS and allergens, and when I threw in my genetic background and my family history, I thought there was no way I could ever heal.

What I teach, working on what we know as the singular root cause here, which is chronic stress, that’s all we work on. That’s all I was taught. Move my body from the sympathetic to the parasympathetic, and it’s been in the parasympathetic for almost eight years. I do not need to do any specific maintenance to keep it there. I eat a normal, healthy, all-American diet. Nothing too out of the ordinary. I don’t take any supplements anymore. I used to be on at least 12 a day. All I do is work on dealing with my life, going out into life to grow and learn, continuing to activate and grow my natural resilience and ability to do life. That is what reinforces my body in the parasympathetic. It’s my approach to life that is keeping me healthy.

I have worked with so many people. We have been doing this here for over 15 years. I have seen people who have done this work and resolved their conditions. They have been healthy for 12, 13, 14 years. They are all still in the parasympathetic state. When we really lock in there, it takes a lot of work for someone to get out. You’d have to be intentional, if that makes sense.

Parasympathetic, it’s not challenging whatsoever to stay in there. It really comes from how I’m approaching my life.

Dr. Eric:

No daily yoga or meditation or any type of mind/body medicine? Just your approach to life, your perspective on the stressors.

Josie:

Correct. I did come from a background of doing meditation. I did a lot of yoga leading up to this. I still had all of my autoimmune conditions. Did the supplements. Did all the restrictive food diets, like I shared. What I didn’t realize at the time was that was all symptom management, which was great if we want to manage our symptoms. But I want not to have the autoimmune disorders anymore.

It didn’t click with me that working on a symptom was never going to resolve the actual condition. I was having these symptoms because I was stuck in the sympathetic nervous system. Working on the foods, the supplements, the meditation, or even the yoga, that was me managing my symptoms in the sympathetic. When I got to the real root cause, and worked on stress, all of the symptoms and the autoimmune disorders resolved. I didn’t have to and don’t have to use symptom management because I no longer have the conditions anymore.

Dr. Eric:

You mentioned leaky gut earlier. That also ties into the stressors since the stress is the root cause of everything in your experience and with your students. In order to heal the gut, you found in your experience that it’s not so much the diet or other factors, but just the resiliency, the perspective on the stress, switching from the sympathetic to the parasympathetic nervous system state.

Josie:

Yes. Here is what made so much sense to me, and I wish someone would have told me this earlier. I asked, “Why am I having these autoimmune?” In addition to this, I had food allergies, leaky gut, candida, digestion issues, constipation, all the stuff that we have with autoimmune.

What I did not realize was that trapped in the sympathetic nervous system, not only does our immune system go overactive, and for a thyroid condition, it attacks our thyroid. In the sympathetic, the digestive system becomes compromised as well. In that fight or flight state, the body is turning off what it deems nonessential functioning. The digestive system is one of those. That is actually where the leaky gut is coming from.

Stuck in that sympathetic nervous system, our digestive system isn’t functioning properly, and we get leaky gut and those other digestive conditions. The way to resolve that is to get out of the sympathetic by eliminating chronic stress, so that the digestive system can then go back to normal functioning, which it does in the parasympathetic. It does it naturally all on its own. That leaky gut will naturally heal and self-repair without the need for supplementation, cleanses, and diets.

For me, that was almost a miracle. As stressful as my autoimmune conditions were, dealing with my leaky gut and the symptoms of my leaky gut were just as or more stressful than that as well. Again, parasympathetic heals and repairs on its own. The reason we have leaky gut is we are stuck in sympathetic.

Dr. Eric:

Thanks for sharing that. Are there any questions that I didn’t ask you that I should have asked? Anything else that you’d like to share?

Josie:

What I want to share is I want to give you all hope. I have been in your shoes. I know what it’s like to be trying diet after diet, supplement after supplement, maybe even different medications, changing doctors, and feeling so stressed, like “What is wrong with me? What is wrong with my body? Why did this happen to me?”

I want you all to know that there is nothing wrong with you. I say that with so much love. There is nothing wrong with you. You’re just like I was. Your body is just stuck in the sympathetic, and it’s staying there because you just haven’t been taught how to deal with life’s stressors. When you learn to handle your stress, your body will heal, and it will self-repair. I’ve worked with women who are 74 and have had these conditions for decades, and I have also worked with students as young as eight or nine who have autoimmune conditions. Everybody’s body can heal and self-repair by eliminating chronic stress. You’re not too far gone. You haven’t had these too long. There is nothing wrong with you that will keep your body from going back to the natural state that you were born into and healing and self-repairing on its own.

Dr. Eric:

If anybody listening would like to get in contact with you, work with you, can you tell them where to find you?

Josie:

Yes, I love hearing from people. I know what I’m sharing here, no one else is talking about. It brings up a lot of questions. If you have any questions, reach out to me on email. My email is Josie@TheHashimotosFix.com. My website is TheHashimotosFix.com.

I want you all to know that while my niche is Hashimoto’s, because it is the most common autoimmune disorder for women, as I’ve spoken about today, the work I do works with almost all autoimmune conditions, whether that’s Graves’, fibromyalgia, Celiac, Lyme, or chronic conditions like chronic pain and migraines, and other chronic conditions, like anxiety and depression. They are all coming from the same root cause from my experience: chronic stress. Reach out to me with questions. I love to hear from all of you.

Dr. Eric:

It was great chatting with you, Josie. I really do appreciate you sharing your knowledge on how you overcame multiple autoimmune conditions. I’m sure they learned a great deal.

Josie:

Appreciate it. It was great to be here. Thank you for having me.

 

Recently I interviewed Dr. Shane Steadman, as we chatted about the brain-gut-thyroid axis.  If you would prefer to listen the interview you can access it by Clicking Here.

With me, I have Dr. Shane Steadman. We are going to discuss the brain/gut/thyroid connection. Dr. Steadman is an expert in treating and supporting tough cases, such as concussions, migraines, vertigo, peripheral neuropathy, autoimmune conditions, thyroid and hormonal disorders, and other health conditions. Dr. Shane became a chiropractic neurologist in 2003 and is one of only a small handful of chiropractic neurologists in the state of Colorado. Dr. Steadman is the owner of Integrative Health Systems in Denver, Colorado. He has completed numerous hours of post-graduate and advanced studies in functional neurology and functional medicine, including functional blood chemistry and thyroid issues as well as neurotransmitters and brain function through the University of Bridgeport. Thank you so much for joining me, Dr. Steadman.

Dr. Shane Steadman:

Thanks for having me. It’s going to be fun. I’m happy to be on.

Dr. Eric:

I’m excited as well. The first question I have, just like many podcasts, hosts ask the person they are interviewing to give their background. My question is can you discuss what a chiropractic neurologist is? Then discuss why you became one. Why do you do what you do today?

Dr. Shane:

Chiropractic neurology is newer to the public but has been around since the early ‘80s. Chiropractic neurology is the idea of understanding the functionality of the brain and trying to identify which areas of the brain are working and are not working as well. To make it easy, it’s so much like a physical therapist. If you hurt your hip, you go to a physical therapist, and they say, “This muscle is not working. This one is overactive. The range of motion is not great.” You are able to identify what is going on with the hip, so you can develop a treatment plan.

That is the goal with chiropractic neurology. Sometimes, people might hear a term, functional neurology, which is the same concept. If you get a head injury or have vertigo, why? Why are you having these symptoms? What areas of the brain are overworking, not working, not communicating? What therapeutic strategies can we prescribe to make it so that those areas are doing what they are supposed to be doing? When everything works together in the brain, that is when you see really cool things happening.

Dr. Eric:

You have been a chiropractic neurologist for almost 20 years now, correct?

Dr. Shane:

Yep, that’s a long time.

Dr. Eric:

You have seen a lot of different cases. Let’s dive in. I don’t know where you want to go, if you first want to focus on brain/thyroid or brain/gut or cover it all.

Dr. Shane:

This is where my practice has evolved over the years, trying to understand- You always hear the brain/body connection. That is so generic. We are trying to understand how these systems interplay with each other. When we look at brain function and something like the thyroid, or the gut. This is a great topic because we can explain to people that everything is so intertwined that you can’t just look at the thyroid.

When you talk to patients who are coming in, people are starting to understand that there is more to the story than just TSH. A lot of people say, “My TSH is high, so I was put on this medication.” What we have to figure out is why is the thyroid not working? Now we start looking at all the pieces.

The brain becomes one of those pieces that is still overlooked to this day. To give the story on brain/thyroid function, what a lot of people don’t realize is that the signal to the thyroid- When we look at TSH, it’s a signal or message that comes from the pituitary down into the thyroid. It tells the thyroid what to do. If that signal is off, then we can actually go look at the brain. What is the pituitary doing? If we take a step back from there and ask, “What tells the pituitary what to do?” it’s the hypothalamus.

The hypothalamus is your big regulator of all sorts of things from temperature to growth to sleep to adrenal stress. Your hypothalamus has to tell the pituitary what to do. But we can’t stop there. We have to take a step back and figure out who tells the hypothalamus what to do. It has all these things that integrate from different areas of the brain and the body that say, “Hey, this is what’s going on.” Everybody reports back to the general or president. This is what the army is doing; this is what the National Guard is doing. This is the economy and the financial economy. All of these pieces come together. Based on all of those signals, the hypothalamus knows what it needs to do to make sure that homeostasis is always there.

Two of the biggest things when we look at hypothalamic function or what activates it are serotonin and dopamine. A lot of people wouldn’t even think about that. Serotonin and dopamine play a role with mood and motivation and joy and happiness and all of these things. If you have imbalances in serotonin, we are going to see imbalances in mood. Does that same imbalance affect the thyroid? The answer is big possibility. That is where we see these brain to thyroid connections. It’s much bigger than just looking at this gland. There are so many factors involved.

That is what we have tried to do over the years is understand that connectivity between brain and body, brain and thyroid. When you throw in the gut, that’s another animal because the brain and the gut have a relationship with each other. If we truly understand that the brain controls the whole body, if we fix the brain, how does that fix the body? If we fix the body, how does that impact the brain? Obviously, I am biased, and this is a passion of mine, but this is how we work in the office.

Dr. Eric:

Amazing. Imbalances in serotonin or dopamine ultimately affect the hypothalamus, which could affect the communication between hypothalamus and pituitary. That can in some cases cause thyroid dysfunction.

Dr. Shane:

It could.

Dr. Eric:

As you know, most thyroid conditions are autoimmune in nature. With hypothyroidism/Hashimoto’s and hyperthyroidism/Graves, the immune system plays a big role. In these cases, the brain could be affected as well. You can’t just assume that the immune system is the problem?

Dr. Shane:

Yes. The brain can come into play. What is even more interesting is that your brain can actually play a role with autoimmunity. Depending on the balance within the brain, looking at right/left, the cerebellum, they have roles in autoimmune conditions as well and controlling the immune system. You can have a brain that is causing an alteration of the immune system, so the immune system is impacting the thyroid.

When you said, “The name of his clinic is Integrative Health,” that’s why we named it that. Everything affects everything. How do we address it? Where do we start? When you go fishing, you throw the line out there, and you reel it in. If for some reason it was tangled- I swear I don’t understand how your line gets tangled in the water, but sometimes it gets so tangled that it looks like a bird’s nest. Where do I start in unraveling it? Sometimes you sit there for 20 minutes and are trying to find the one thread or loop in the fishing line. You think you got it, but it takes a while to figure out where to start.

A lot of these complex cases that patients are struggling with are similar. Where do we start? Brain, thyroid, gut, neurotransmitters, autoimmune, inflammation? Sometimes it’s so messy, and that’s what’s important about learning about all the different pieces.

Dr. Eric:

You’re right. Where do you start? If someone comes in, I assume you go through a comprehensive health history. Is it safe to say in most cases you don’t start with the thyroid? Maybe you start with the brain or the gut. Maybe you do start with the thyroid in some cases.

Dr. Shane:

What I try to do is look at each system. We do a consultation, but that’s to see if we would be a great fit. On the exam, we say, “Let’s do a neuro exam. Let’s see what the brain is doing.” Then we will do a health history. If the health history dictates that somebody is on antidepressant medication, and we have a history of depression and traumas, maybe that is a player. Then we start diving into the history and find out what you’ve taken, what you’ve gone through, what life has been like. Then we look at bloodwork, lab testing, cortisol levels. We look at all of it. By looking at all of it, then I can decipher is this a neurological condition? Is this a thyroid gland dysfunction? Is this an autoimmune condition? Are there other systems like hormones and gut dysfunction that are playing a role? I look at every single system and try to decipher which systems to go after. Sometimes, it’s one. Sometimes, it’s all. That’s where I think everybody is so uniquely different.

Dr. Eric:

If I understood you correctly, before, you said that the brain can actually lead to an autoimmune condition. If someone had a concussion, traumatic brain injury, in some cases, that could be the trigger to an autoimmune condition?

Dr. Shane:

Absolutely. There is fascinating research looking at things like the cerebellum has a pretty significant role with natural killer cells. There is some research that shows the right brain deals more with the B cells, and the left brain deals with the T cells. Some literature out there looks at concussions and what their implications can be in sparking an autoimmune condition. Sometimes in the office, we see when someone has a car accident, and they developed multiple sclerosis or another autoimmune condition. It’s interesting. There is another world of looking at neuroimmunology and how it influences. In the same token, autoimmune conditions can create imbalances in the brain and fire up areas of the brain that don’t need to be activated, but they are being activated because of the autoimmunity.

Dr. Eric:

Very interesting. How about the brain-gut connection? Can you talk about that?

Dr. Shane:

Yes. The gut is a rest and digest system. Everybody is familiar with that term. The opposite of that is fight or flight. The gut, we need to make sure it has motility. It needs to move. It needs to absorb. That is a connection that goes from your frontal lobe or cortex into your brain stem. Your brain stem houses the vagus nerve. That vagus nerve then goes into the gut to help with motility, function, movement, absorption, and digestion. You have this connection from cortex to brain stem to gut.

They have done some really cool studies, where they have this group of mice that they activated the vagus nerve and caused a concussion. Because the vagus nerve was strong and sustained, it kept good gut function in that mouse. Another mouse, they created a concussion, and they found all these gut issues. There is a lot of connectivity from the brain to the vagus nerve into the gut.

It’s fascinating that some of your first signs of Alzheimer’s and Parkinson’s is constipation. Some of the biggest struggles in most kids with special needs is constipation. It tells you how much that brain-gut relationship is there. On the flip side, we see a lot of people with anxiety disorders and PTSD, if you are in constant fight or flight, you get this inhibition of the rest and digest. You start seeing decrease in motility and all sorts of gut issues stemming from that. The brain has strong, powerful connections with the gut.

Dr. Eric:

You mentioned the vagus nerve. Are there tests that you do? Is it part of your neurological exam to determine if someone has dysfunction in the vagus nerve?

Dr. Shane:

Every single patient, we look at vagus nerve function. If someone has gut issues, do they have true gut issues, or is there gut issues because of a neurological condition? Part of our neuro exam is looking at the vagus nerve because it’s an idea of what the brain stem is doing, specifically because that vagus nerve has such a major role in a lot of your visceral function: kidney, gallbladder, stomach, liver. All those things come from the vagus nerve. We want to make sure that the vagus nerve is working and not just assume that you have a liver issue, so you need supplements. That may not be the case. You may have a liver issue because of the brain-gut or brain-body connection through the vagus. We check on that in almost every single patient.

Dr. Eric:

If someone does have problems with the vagus nerve, I know there are different exercises like vigorous gargling or singing loudly. How about plain old mind-body medicine? Is that not typically enough as far as getting someone more in a parasympathetic state?

Dr. Shane:

It can be, but clinically, it takes longer, and it’s harder. We’ll use a lot of those exercises. There are some vagus nerve stimulators that we use in the office. You can put them right along the vagus nerve and activate it. Besides the exercises, we use some equipment that stimulates the vagus nerve. We will do some stimulation through the tongue or the face to drive simulation into the brain. These ways to get into the vagus nerve, back door into the vagus nerve, or hit it directly to try to turn it on, so we can get some activation.

That is where testing comes in. If we test, and it’s not working, then we stimulate it, and now it’s working. We have made a change.

Dr. Eric:

Many listeners are familiar with a leaky gut, increased intestinal permeability. Can you talk about leaky brain, the disruption of the brain-blood barrier? There is some overlap with the two if I understand correctly.

Dr. Shane:

Within leaky gut, the best analogy I have is a picket fence. When you look at gut function, you have the barrier that protects you from the world. It’s like a fence in your backyard. Leaky gut is when those fence pickets are broken. They got bumped into with somebody’s car on accident, or your kids were playing soccer and broke the slats. If you break a slat or are missing one or the wind blows your fence over, like we had a few times in Denver this year, now you have a gap in your fence. Animals can get through, and kids and trash, that shouldn’t be getting into your backyard. Everything in your backyard should stay there, and everything on the street should stay there. That is the best analogy for leaky gut.

What ties the slats together are two different bonds, like shoelaces that hold it all together, called occludin and zonulin bonds. Those same exact bonds are formed in the blood-brain barrier system. You have these things that tie it all in together. It keeps everything in the brain, and everything that should be out is out. When you start affecting those bonds, you don’t only affect the gut, but you also affect the brain. If you have a big cheeseburger with fries and a Coke for lunch, and now you have brain fog, you probably also have gas and bloating. You see this gas, bloating, and brain fog as indication that you have messed up those bonds and broken them down a little bit, so you have some slats missing now.

The symptom of leaky brain is brain fog. If anyone is walking around, saying, “I have gas, bloating, and brain fog,” that tells us your barrier system needs to be fixed, and you need to call a fence repair guy out there quick.

Dr. Eric:

Do you do any testing for leaky gut or leaky brain? I know there is one test out there from Cyrex that relates to the blood-brain barrier. I don’t know if you just assume that someone has a leaky gut. I used to use the Cyrex intestinal permeability test. These days, I just assume that most people have a leaky gut. What approach do you take here?

Dr. Shane:

It’s similar. There are times where I will use those tests that look at blood barrier proteins that includes zonulin bonds. You can measure those in the bloodstream. If you have a lot inf the bloodstream, you are probably breaking those bonds down, and they are floating around in the body. We will look at those markers.

I make assumptions now. Most patients that come in now have some kind of brain fog. Usually, the thing we are going to do initially is repair the fence. There are definitely some supplements that can repair the fence. Reducing inflammation is a great way to help repair the fence. I try those things. Usually, people say, “My migraines went away. My brain fog went away. I am able to focus. My mood is better.” We have probably been fixing that blood-brain barrier. I will test more if I get stumped, or something is not fixed the way I think it should be.

Another thing I have done before is straight GABA, which I know you’ve heard about before. It’s too big to go through the slats in the fence. If a basketball shouldn’t get through the fence, but you are finding them in your backyard, there are probably holes in the fence. GABA is too big to get through. If people experience symptoms from GABA that could be good or bad, that could be indicating there are some gaps in your barrier system.

In my career, I do more assuming than testing at this point because if I am going to use dollars for testing, I want to use them toward something else that might be more beneficial.

Dr. Eric:

Agreed. Can someone have brain fog without having that disruption of blood-brain barrier? Can there be other causes of brain fog?

Dr. Shane:

There can be. There are different immune mechanisms that take place in the brain. Any time you create inflammation, you can create that brain fog feeling. We see that with food most commonly. You also hear that with people who talk about spilled gasoline, and they have brain fog. “Somebody’s perfume gave me brain fog.” “When I get stressed or don’t eat, I get brain fog.” There are some other mechanisms that can take place, but they usually involve your immune system in some form.

Dr. Eric:

Let’s talk about thyroid-gut connection now.

Dr. Shane:

The thyroid self-produces a hormone called T4. It produces some T3, but T4 is the primary hormone that it produces, which is inactive. It doesn’t do much for us. We have to convert that into T3. T4, the reason why the number 4 is there is because it has four iodines attached to it. Your body takes off one of those iodines, so it is now T3. This conversion takes place within the gut and the liver. About 20% of this conversion takes place in the gut. It uses some enzymes that are produced via your flora or normal gut bacteria, meaning that you have to have good digestive function and a good number of bugs. They all have to be in balance in order to help convert your thyroid from T4 to T3. There is a big role that the digestive system has in this. If you’re not converting that properly, then your active T3 is now on the low side. You can start having thyroid symptoms not because the thyroid gland is not doing its job, but because the digestive system is imbalanced. That starts to look at some of the thyroid-gut function.

What is unfortunate sometimes is that one of the causes of gut dysfunction is hypothyroidism. Now we get into this chicken or egg concept. Do you have gut issues because you have hypothyroid? Do you have hypothyroid because you have gut issues? Who’s what, and what’s what? A lot of times, with patients, this is where you have to develop a treatment plan that catches all aspects of those vicious webs. If we can get the thyroid function better and the gut function better, then we are getting both ends of the story.

I see too many practitioners that focus on one and not the other. The patient is getting frustrated because they are not seeing the results they want. With listeners, it’s always good to say, “When you are talking to a doctor, do you know the whole concept of thyroid function because focusing on one might not get me to where I would love to be?”

Dr. Eric:

In a situation where someone is hypothyroid, and they have a lot of gut dysbiosis, you might recommend for them to take thyroid hormone replacement. That wouldn’t be the only recommendation. You would also do things to help restore the gut as well?

Dr. Shane:

Yes. We have a nurse practitioner in the office. There is a time and a place for medication. Maybe medication is great while I am working on their gut. You might find they don’t need the medication now because you are converting hormones properly. Having a nurse practitioner that we can put them on and take them off as needed if it’s possible. There are other times where we can utilize supplementation to support the thyroid gland while we are working on the gut and then retest and see how we are doing. These are very plausible treatment plans that we see quite often. It’s that functional neurology piece of trying to understand what is their function or dysfunction? How do we improve it? That becomes the goal of working with patients.

Dr. Eric:

Do you recommend any type of gut testing, like a comprehensive stool panel or a SIBO breath test in some cases?

Dr. Shane:

In some cases, we will do that. I don’t run stool panels on every single patient. I think they can be very beneficial depending on patients talking about constant constipation or diarrhea or bloating. You want to find out what is causing that? That is always a question I try to explain to the practitioners I have worked with: We are always trying to ask why. We can’t simply stop at saying, “Someone has gut dysfunction.” It should be, “Why does somebody have gut dysfunction?”

When we are going to the core, we have to ask why. Sometimes it’s really easy. Someone loves to eat pizza and Cheetos every day. But there are other patients who are eating perfectly, so why do they still have issues? That is where testing comes in. That’s what’s cool about lab testing and technology these days. We have different styles of testing to figure out those whys. The further we can dive in to figuring out the why, usually the faster we can get someone feeling better.

Dr. Eric:

Let’s talk more about constipation. I wasn’t planning on going in this direction, but a lot of people experience it. You mentioned earlier the connection between the brain and Parkinson’s, where an early sign is constipation. In a situation where someone is constipated, and they are doing everything from a diet perspective, it seems like they have good gut health and everything is in line, from what you said, it could be the brain. Not to say it’s related to Parkinson’s, but it could be a potential brain-based disorder causing it?

Dr. Shane:

It definitely could be. This is where sometimes in the functional medicine space, they are using everything, every supplement, and they are not getting anywhere. That is where you can look at brain function to find out what’s going on. That is where the neurology testing or degree comes into play, which is helpful because I know not everybody has that capability. If you start looking at frontal lobe function, they are losing their gait mechanisms or their ability to walk smooth; they are losing some of their eye coordinations, not blinking; there is something funky going on that we need to investigate more. Or someone could have a concussion, and maybe their brain stem was impacted, so that Vagus nerve is simply not working the way that it should be. These are all different things from a neurological standpoint that can cause constipation.

That is why it’s so important to look at so many different mechanisms. It’s not always just take magnesium, and everything will be fine. Why do they have constipation? You brought up SIBO earlier. You can have it from too many bugs that produce too many methane gases. It could be a parasite or a virus or an autoimmune condition or IBS-C (constipation). There are so many causes. One that does get overlooked is the brain.

Dr. Eric:

How about blood sugar? Can you talk about the impact of blood sugar imbalances on brain health and even maybe immune health?

Dr. Shane:

Blood sugar might be one of those top things that we are trying to stabilize. A lot of people have either too much or too little, or they are rollercoastering all day long. They are experiencing these highs and lows.

Blood sugar is simple. In some regards, it’s one of those things we can control. We can control what we eat, how we eat, and when we eat. Stress can play a role in blood sugar, which can mess it up. There is a lot of things we could do, so we usually try to focus on it. We know that blood sugar affects the brain because if you have ever met anybody who gets hangry, that’s a neurological change. Did your blood sugar drop, and now you’re anxious, irritable?

I was just working on a kid earlier, and his blood sugar was low, and he started crying during the exam. Mom is like, “Your blood sugar is low. You haven’t eaten in a while.” We know that blood sugar affects brain function by looking at mood.

What people also forget is that that’s one of the main fuel sources for your brain. In neurology, we always talk about your brain needs three things to function: glucose, our blood sugar; oxygen; and stimulation. If one of those three things is off, then how is your brain going to function? Are you able to take a road trip without fatiguing, read, go to work, exercise? Your brain is involved in all those things. Once your brain fizzles out, it’s hard to function and do life.

Dr. Eric:

You mentioned oxygen. That also then ties into anemia. You want to correct not just iron deficiency anemia, but other types of anemia.

Dr. Shane:

Yes. When you’re anemic, it’s hard to deliver oxygen everywhere. You have to have iron to make hemoglobin, which is what attracts oxygen to carry throughout the body. Those are important things. Anemia, sleep apnea, shallow breathing can all impact how the brain functions.

It’s important when you look at brain function to make sure you are getting enough fuel, so glucose, oxygen, and activation, which means going for a walk, getting good sleep, having a good community, figuring things out, learning. All those different things that keep your brain engaged. That stimulation is important for long-term growth.

Dr. Eric:

One of the questions I wanted to ask was how do you diagnose brain-based disorders? I guess you kind of answered that. I don’t know if you want to expand on that. It’s putting people through that neurological exam, correct?

Dr. Shane:

It is. When you put someone through a neuro exam, you are able to look at systems. For instance, if we look at the frontal lobe, we will look at things like certain eye movements are associated with the frontal lobe; fine motor movements; certain aspects of coordination; memory. Then we get into the history side, which is multitasking, motivation, mood, libido, being able to finish a task that you started. Those are all ideas of the frontal lobe. We can see what the frontal lobe is doing by our testing.

Then we can look at the parietal lobe, which is mainly sensory. How well can you feel the right side of your body, the left side of your body with sharp, dull, light touch?

The temporal lobe is more smell, short-term memory, math.

The cerebellum, which is in the back part of your head at the base, looks at balance, gross motor, some aspects of memory, some of your eye movements.

All that to say, certain tasks go to certain parts of the brain. By looking at different parts of the brain, we have the patient go through certain tasks. If they can’t do something, we get an idea of where the dysfunction is taking place. If someone has a hard time with fine motor movements and gait, their long-term memory is getting thrown off, they have lost their motivation, they are more depressed, libido is decreased, they are great at starting tasks but have all these unfinished tasks around the house, you start to go, “I don’t think your frontal lobe is working as well as it should.” That is how we are able to diagnose these dysfunctions.

There are things you’re taught on looking at more pathological conditions as well. Mostly, what we see coming into the office is functional disconnect or functional deficit disorders.

Dr. Eric:

I know you see a lot of tough cases. If you happen to have someone who had Hashimoto’s, and their symptoms weren’t too severe, maybe they were referred to you by one of your tough cases, but this particular situation didn’t seem too challenging, would you still recommend for them to go through a neurological exam? Do you put everyone through that exam?

Dr. Shane:

Yeah, we do. Sometimes, patients will come in thinking that it is a very simple issue. When you start doing the exam, you start finding out these little things that shouldn’t be there. Sometimes, patients go, “You know, I’ve been dealing with that for a while.” You see this twitch in their face or their head, and you go, “Do you have restless leg syndrome?” “Oh my gosh, for the past 20 years. I don’t talk about it anymore because I thought it was normal.” There are a lot of things patients think are normal that are not normal. As you go through a test, you figure it out.

I remember one time, I was working on a 14-year-old girl. Her parents brought her in for simple Hashimoto’s. When we started doing the finger to nose test, where you are looking at your cerebellum, it was terrible. She couldn’t even touch her nose. Her hand was jerking all the way. She ended up touching her cheek. Her parents were like, “What’s wrong with her?” Through the course of it, we did some testing. She had a mix of Hashimoto’s and Graves’, but she also had an autoimmune condition that was affecting her cerebellum. There are some interesting ties between cerebellum and thyroid function, too. The whole case took a left-hand turn. Okay, we have a lot more things going on than just Hashimoto’s.

That is kind of common to see those things. People might be so focused on Hashimoto’s that they miss everything else, or they didn’t think to tell the doctor because they didn’t think it was important. “No, you’re the Hashimoto’s person. I didn’t think to bring up my vertigo to you.” For me, it’s important to do a thorough evaluation on everybody.

Dr. Eric:

You have been practicing for a long time, so you probably have people who have been in past traumas, but until you go through that health history, they don’t even think about it. Maybe they had a car accident 10 years ago. It could be severe, but to others, it might just be a rear end, and they felt fine after, or maybe they had a fall. I assume you see some of those cases, where it might be impossible to pinpoint it was due to that trauma, but they are not coming to see you because of that trauma. When you go through the health history, you can relate some of the symptoms to a past trauma. I’m sure sometimes, you can’t. Again, what are your thoughts on that? If someone had a trauma 20-30 years ago, after that, maybe they felt fine. No pain, no discomfort. Could that, decades later, lead to some of these issues that we’re discussing?

Dr. Shane:

We see that all the time. When you start doing the history and timelines, “When did this start?” “It started in 2008.” “What happened in 2008?” “In 2007, I was in a car accident.” Or, “I slipped and fell and hit my head on the concrete.” “We went through a really traumatic experience.” “I went through a bad divorce.” “Huh. What else has happened since then?” Sometimes it seems like everything ties back to that one moment in time. Then we can start working our way forward.

If there is a trauma, like a car accident, maybe there is a neurological imbalance. If they had a loved one pass away, I’ve had counselors in my office. Counseling might be a great thing for you because maybe counseling is now part of your treatment plan.

“I was sick in 2007. I don’t know what it was, but I was really sick during that time.” Maybe they had a viral infection. We know that Hashimoto’s, the #1 virus that impacts it is Epstein-Barr or mono. Sometimes you go back and realize, “What did you have?” “I don’t know, but I was so exhausted for like three months. I had to take time off from work.” All right, starting to see how this picture is unfolding. A lot of times, things in the past are dictating the future events, but it’s been a slow brew of dysfunction over the next 5-10 years.

Dr. Eric:

When it comes to treatment, obviously everybody is different, so I’m sure you don’t treat everybody the same. Across the board, are there some things you recommend for everybody? With diet, you may not recommend the same exact diet for everyone, but I would imagine an anti-inflammatory diet consisting of whole, healthy foods. Can you talk in general about treatments?

Dr. Shane:

Usually, our treatments are multi-factored. If we are doing a neuro exam, let’s say there are findings that seem to be relevant to the case. Here is our neurological treatment plan. We have a more metabolic treatment plan. Metabolic might be working on adrenals, thyroid, gut dysfunction. We have an immune side of it. A lot of times, we have had that three-pronged approach of neurological, metabolic, and immunology. We combine those worlds together. You can’t, in my mind, do one separately all the time for everybody. That is our protocol, so to speak.

A lot of the metabolic, we have to work on foundational stuff. We have to make sure you are eating an anti-inflammatory diet. If you can’t get someone to sleep, you won’t get far with them. We have to work on sleep, but, blood sugar stability, adrenals. If they are anemic, we have to fix that. That’s that metabolic arm.

With neurologic, if it’s a frontal lobe issue, we work on the frontal lobe. If it’s a vagus nerve issue, we work on the exercising and stimulating of the Vagus nerve. If there is Hashimoto’s, what do we do to support the immune system? that’s our treatment plan.

That’s probably the easiest way I can say that is our protocol for all patients. The only way they don’t get those three arms is if I do a neuro exam, and I go, “Dang, this is one of the best brains I’ve seen in a while,” then they don’t get anything in that treatment plan because it doesn’t make sense. Someone might stimulate the Vagus nerve because that could be a great way to get the gut moving. Maybe they have a healthy Vagus nerve, but I will use that mechanism to get the gut moving and functioning better.

Dr. Eric:

You shared a lot of amazing information. I learned a lot. I’m sure the listeners did, too. Is there anything I didn’t ask that I should have? Anything you’d like to discuss? We could easily go on and on and on. Anything that I missed that you have a burning desire to cover?

Dr. Shane:

No, we talked about a lot. This might be one of those podcasts that they need to listen to several times to get some more nuggets. That’s always my goal. I like coming on podcasts and sharing a bunch of nuggets because not one size fits all. Everybody is a little different. Maybe that is a great way to end.

Sometimes, people get stuck on they did a food allergy test, and it fixed them. Everybody has to do a food allergy test, and that is the end-all be-all. That is not always the case. Everyone is so different with their own history and circumstances and genetics. It’s important to find practitioners who are talented at looking at the whole person. That is the fastest way to get better. In the holistic field, I like holistic medicine and practitioners. If you have a hammer, and everything looks like a nail, I don’t care if I do parasites or adrenals only or food allergy testing or everybody has to gargle. If you have a hammer, and everything looks like a nail, finding somebody else might be a better option. Life is too complex, as are our bodies, to think that one thing can fix everybody.

Dr. Eric:

Well said. Where can people learn more about you?

Dr. Shane:

There are two websites that we use and update. One is IntegrativeHealthDenver.com. I live in Denver, Colorado. The other one is IntegrativeBrainCenters.com. We have two arms. We get people who come in with concussions, so they use the brain website to find us. We are trying to be active on social media. @IntegrativeHealth and @IntegrativeBrainCenters on Instagram and Facebook. It’s good to sign up because we are throwing stuff out there. We do webinars. I am doing one tonight on migraines. We are trying to disseminate information and articles and nuggets and pearls, whatever you want to call it. We want the world to be a better place. Follow us and like us and share. We will keep putting it out there.

Dr. Eric:

Sounds good. It really was a pleasure chatting with you. I learned a lot about the brain-gut-thyroid connection.

Dr. Shane:

Thanks for having me. It was a lot of fun.

 

Recently I interviewed Dr. Julie Greenberg, as we chatted about skin conditions and thyroid health.  If you would prefer to listen the interview you can access it by Clicking Here.

With me, I have Dr. Julie Greenberg. Dr. Greenberg is a licensed naturopathic doctor and registered herbalist who specializes in integrative dermatology. She is the founder of the Center for Integrative and Naturopathic Dermatology, which is a holistic clinic that approaches skin and hair problems by finding and treating the root cause. Dr. Greenberg holds degrees from Northwestern University, Stanford University, and Bastyr University. She lectures at naturopathic medical schools and is sought after to speak at conferences across the United States on the topics of hair, skin, and nails. Thank you so much for joining us, Dr. Greenberg. Appreciate you agreeing to do this.

Dr. Julie Greenberg: Thank you so much for having me.

Dr. Eric: I’m excited just because this is really the first time we are diving into the skin, which is relevant with any chronic health condition, but I do see it a lot with both my Graves’ and Hashimoto’s patients.

Can you start out by giving a little bit more of your background? How did you start to focus on dermatology?

Dr. Julie: Yes. It is actually apropos for this podcast because I got to dermatology through my thyroid. If your listeners don’t know, I am a naturopathic doctor. Naturopathic doctors say, “Treat the whole person,” which means we look at how the organ systems interconnect with one another. It was a very naturopathic way for me to get to dermatology.

I went to business school in my 20s. I graduated and started having symptoms that will sound very familiar to you. I was very tired. I was gaining weight. I was having some hair growth, some brittle hair, some dry skin. It turns out I had developed Hashimoto’s thyroiditis. When I finally got diagnosed, it was a very jarring experience. It was my first real experience with a chronic health issue. The doctor who diagnosed me was like, “Well, you have this autoimmune disease. We don’t know why it’s happening. We don’t know how to fix it. Here is some thyroid hormone. You will be on this for the rest of your life. You will probably have trouble with fatigue and weight the rest of your life.” Out the door I went shell-shocked.

I really had no interest in being a doctor or anything medical before that. I started researching. That just doesn’t feel right, that that’s the answer I’m getting from my doctor. How could that be the end of the story?

The more research I did, the more I found that other things in the system affect the thyroid. A lot of the chemicals that we use on our body everyday for personal care products—women use around 125 different chemicals on their bodies a day—can impact the thyroid. We have endocrine disruptors. I started making that connection between the skin and the thyroid. I started trying to make my own skincare products. I got the chemicals out and saw I could make myself healthier. That was my first foray into health and dermatology.

I became so passionate about the skin and dermatology and what we were putting on our skin. That was the impetus that ended up in me going back to naturopathic medical school to become a naturopathic doctor and specialize in dermatology.

Dr. Eric: Maybe I misheard you, but did you say that the average woman puts 125 different chemicals on their skin every day?

Dr. Julie: Yeah, you did not mishear me. When you think about the number of products that a woman puts on her skin. You wake up in the morning and are putting on deodorant. You wash your hair with shampoo and conditioner. We are applying all sorts of makeup, gels to the hair, lotions to the body. If you pick one personal care product, turn it over, and look at the ingredients list, you will see a very long list of multisyllabic chemicals that are only made in a lab. Add those up. You get to about 125 for one day.

Dr. Eric: Wow. I knew it was a lot, but if I were to guess, I would say maybe a few dozen, not over 100. That’s crazy. And that’s the average. Some people apply more than 125 chemicals on their body.

Why do so many people have skin issues? I think I know the reason. The gut plays a big role, which I know you will talk about. If you could dive into why it is so common in people with not only autoimmune conditions, but other health conditions as well.

Dr. Julie: Great question. Our skin is a very complex organ. It is enormous; it is our largest organ. Obviously, it is covering our body. Its job is so complex because it is outward-facing at all times, and it has to keep out most things but let some things in. It has to keep in most things, being our blood and water, but it has to let some things out. We have to sweat. You think about something like a turtle shell. That is much easier. They build a hard exoskeleton. Nothing gets in; nothing gets out. That’s it. It’s a much simpler job. Skin has to be soft and supple, but it has to be tough because it’s outward-facing. It’s really a very complex organ.

We’re going to get to the gut as you said, but when we think about how did we evolve? How are we supposed to be taking care of our skin? If we lived out in caves still, we probably weren’t showering all that often. We weren’t using detergents and soaps.

I talk to my patients about this: pH is really important when it comes to skin. Let’s take a scientific detour, and we will come back to the skin. Most of us maybe got introduced to the concept of pH, which is a scale of acids to bases, in junior high school. One day, your science teacher handed us these litmus paper strips, and we were dunking it into different solutions, trying to see what color it would turn up. If it was something yellow or orange, it was an acid. If it was purple or blue, it was alkaline or base. That scale of pH runs from 0-14. 0 is acid, and up high are basic or alkaline. Right in the middle at 7 is neutral. Things like water are neutral, for example.

Our body has evolved to operate efficiently at a different pH, depending on where you’re at. Our stomach is the most acidic. That can be down at a 2. That is because our stomach needs to digest food and kill organisms that we bring in through our mouth. Our blood is about a 7, so fairly neutral.

Every single patient gets educated on this. I always ask patients, “If you had to guess, where do you think skin would be? Nobody knows because we don’t get user manuals. If you need a clue, I’ll give you one.” If they don’t take a clue, everyone guesses neutral. If they do take a clue, I say, “Covering your skin is something called a fatty acid mantle. Let’s break it down. What word did we just hear? We heard the word ‘acid.’” That’s our clue. Our skin is surprisingly acidic. It needs to be acidic to be healthy.

Down at a 4 or a 5 is where we want our skin to be. Let’s pause and look at our Western hygiene protocol. We are obsessed with cleanliness. For a lot of reasons, that’s good. We tend to use soap and water multiple times throughout a day, especially on our hands. Most people shower maybe about once a day, and we’re soaping up. If we look at soap, soap is made with a substance called lye. We combine that with fat, and there is a chemical reaction that makes soap. Lye is super alkaline. It’s at a 12. All soap or cleansers by nature are alkaline.

Now we look at the fact that we want skin to be acidic, yet we are using water, which is a 7, and soaps, which are quite alkaline. Some soaps can be as high as 12 in pH. Every time we wash our skin, we are stripping off the fatty acid mantle, and we are raising the pH of our skin. We are compromising our skin. Most people then are putting on lotions and moisturizers with chemicals that are more easily absorbed through the skin now. Our whole Western hygiene protocol is compromising our skin because it keeps stripping off the fatty acid mantle and throwing off the pH by pulling it up.

I have never treated as much hand eczema as I did during the start of COVID. People were hysterically washing their hands with hot water and soap 10-20 times a day. If you want a recipe for hand eczema, that’s a great one. All you have to do is stop, and the hand eczema will go away. Unfortunately, this kind of hypersensitivity to cleanliness and all the chemicals we’re using is compromising our skin barrier and putting us at risk for skin issues. There is a lot of gut/skin relation as well that is driving the bus on this.

Dr. Eric: I’m guessing it probably depends on the person, but as far as how frequent do you recommend showering? Is it not a matter of don’t shower daily, but maybe be cautious about the soap that you use when you shower?

Dr. Julie: it’s a combination of those things. I definitely counsel patients to use more natural soaps. I counsel patients to read your skincare products the same way you would read food. Most of us now are wise to the fact that they can sneak stuff in food, and we should look at labels if it’s packaged and see what we are putting in our mouths and eating.

Same thing with skin care. If it’s a long list of multisyllabic chemical names that you don’t understand, probably shouldn’t be putting it on your skin. There is no need for products like that. With soap, you just need basic five ingredients: some plant oils, sodium hydroxide (that lye that has to happen for the chemical reaction). I don’t like fragrances, but maybe some natural essential oils. A couple of items in your soap with names that you recognize. That is the start.

The second is I tell patients unless you really get out and get dirty, pits and palms. We need to wash our armpits and our groin; those are areas that could probably use soaping once a day. Palms, so hands and feet.

Our hands, there is a very good reason to wash our hands several times a day. If we use the restroom, if there is COVID exposure, moms who are changing dirty diapers, anyone who is preparing raw meat. We are going to wash our hands, but we are going to try to do it when appropriate. I have patients follow up that soap with natural products that help reacidify the skin. As soon as we’re done washing, we can do things to help pull that pH back down again and restore where the skin was meant to be.

Dr. Eric: You’re hopefully not using chemicals. The products you use can definitely impact the skin. Let’s talk about the gut. How about that gut/skin connection?

Dr. Julie: As a naturopathic doctor, I think naturopathic doctors have been talking about the gut for upwards of 30 years. The gut microbiome. In case that is a new term to your listeners, the microbiome is the collection of organisms. A gut microbiome is the collection of organisms living in our gut. We definitely have them. The average adult human has about 3-5 pounds of microorganisms living in their gut. The vast majority are bacteria. There is a whole host of different types of organisms, including fungal, like candida and yeast; viruses; protozoa; worms; archaea; and other things.

The reason why we have those pounds of organisms is we have coevolved with them. They are really there to help keep us healthy. We can’t survive without them, and they can’t survive without us. As long as we know we have them and we need them. When it is the right organisms, they keep us healthy. When there is dysbiosis, which is a disruption of the gut microbiome with what’s supposed to be there, they put us at risk for illness.

As a naturopathic doctor who specializes in dermatology, I only treat patients with dermatological complaints. I see a lot of the spectrum of what’s in the population: a lot of eczema; acne; psoriasis; rosacea; alopecia areata, which is an autoimmune attack on the hair follicle, vitiligo, an autoimmune attack on the melanin sites and the skin. What I have found is I have to go in and treat the gut in order to treat the hair, skin, and nails. 100% of my patients have that gut dysbiosis.

Not only that, after doing hundreds and hundreds of these tests, I started seeing patterns by disease of different types of dysbiosis. My patients with acne tend to have a set of at least three problems that keep showing up. I call that the acne gut. As opposed to my eczema patients, who have a different set of problems that show up again and again. It’s not just that there is gut microbiome dysfunction or dysbiosis. It really interestingly falls into patterns by disease. It’s intrinsically related. The root cause of a lot of the skin illness is the problems in the gut. I can do some things topically to help the situation. If I can’t get in and test and treat the gut, I’m not going to be able to get to the root cause of their skin issues.

Dr. Eric: What type of testing do you do? Do you do a comprehensive stool test or a microbiome testing for the gut, or both?

Dr. Julie: There is two main tests that I do on just about every patient. One is a comprehensive stool test. One is a urine test called an organic acids test, OAT. The stool test does an excellent job at showing me the specific bacterial organisms that are living in the gut as well as agood overview of digestive function and protozoa. Those are single celled animal organisms that can exist in the gut. For example, I see those in about half of my acne patients.

I don’t find the stool test does a great job on fungal organisms in the gut. For that reason, I also use the OAT. That does a much better job on showing me things like candida overgrowth or molds, like aspergillus or fusarium. Maybe if there are indicators of some toxic exposure or methylation issues, which is related to the MTHFR gene. It gives me some B vitamin status and other information as well.

I use those two labs together to try to paint a comprehensive picture of all the things I need to fix in the gut.

Dr. Eric: Can you talk about the importance of diet when it comes to skin? Is there any specific diet that you recommend? Does it depend if someone is autoimmune or not?

Dr. Julie: There are some overarching principles to follow. Then there can be some specific ones by various diseases. Overarching, for all my adult patients, we are working up to 35g of fiber a day. I can go in and fix the dysbiosis that I see with herbs and supplements to correct it; I don’t use pharmaceuticals 99% of the time. I can’t keep things healthy if the fiber isn’t there. Most of the healthy organisms in our gut, their food is fiber. We want nice big colonies of these healthy ones. Just like any organism, if you don’t feed them, then they die. Most Americans eat the SAD; it’s pretty low in fiber. Most people are not ever going to eat 35g of fiber a day. We really work on that because ultimately, I want people to get off my schedule, and I want to keep their gut healthy. The fiber is that path forward for them.

Dr. Eric: I was going to ask if you mainly accomplish that through vegetables.

Dr. Julie: It depends. If we are working with teens and kids, and fruit is the only plant they are willing to eat, I call that my gateway fiber drug. We will start with anything we can get. But for adults who have more self-control, vegetables are the key.

I know there is a lot of debate over legumes for various reasons. I like beans and legumes. They are very high in fiber. All of the blue zone populations in the world, which means populations who have centenarians or people who live to the age of 100, more than other populations, they all tend to have beans and legumes in their diet. I do think they are beneficial.

We really work on a variety as well. Variety is not just the spice of life. It is crafting a healthy gut microbiome. The two targets are 35g a day and 30 different plants a week. That includes spices, herbs, teas, nuts, seeds. We don’t want people just eating the same thing day in and day out. Those are the two elements I work on.

Yes, definitely. Low sugar, which is vegetables. That brings me to the next point. For skin, sugar ages you. It ages skin. There is something called glycation. If anyone has ever had a hemoglobin A1C test, then you have been testing glycation. Hemoglobin A1C tests basically how much sugar is attaching to your red blood cells.

When it’s very high, people have diabetes. They are eating too much sugar, so there is too much sugar in the blood. The sugar has nowhere to go, so it starts attaching to things like our red blood cells. It also attaches to skin cells. When you have glycation or sugar attaching to skin, think of it like a crispy, crunchy caramelization. It literally makes for crunchy skin. The more sugar someone eats, the more they will age their skin. I really recommend low sugar if you want healthy, naturally younger-looking skin.

All of the vegetables that we talked about, all of those nutrients will feed skin. Fruits and vegetables that are rich in bright colors, they contain things called polyphenols, which are fantastic for both the gut microbiome and skin health.

The things that we are doing for gut health and overall health are the things that are going to build healthy skin. Sometimes, I will supplement patients with collagen. There are very good studies at this point that show at least 3-4 months of supplementation with a high-quality collagen will help reduce wrinkles and improve elasticity and suppleness of skin.

Dr. Eric: You just add a scoop of collage powder to a smoothie or water per day?

Dr. Julie: Exactly. People can also drink high quality bone broth, and that will get you a lot of collagen as well.

Dr. Eric: 30 different types of plant-based foods per week to get your fiber. That is not just vegetables, but you mentioned other plant-based foods like legumes, nuts, and seeds.

Dr. Julie: Yes. Herbs and spices. The more people cook with herbs and spices, they are just so rich in things. If you look at the ORAC scale, which is an antioxidant scale, something like cloves is one of the highest. Cooking with herbs and spices makes our food taste great, and it’s really good for us. It’s really easy to get to 30 different plants a week when you are cooking with herbs and spices.

Dr. Eric: When it comes to vegetables, do you recommend specific vegetables? Maybe more cruciferous vegetables compared to green, leafy vegetables.

Dr. Julie: It comes down to diversity. All of them. People want to say, “I eat a lot of kale.” That is fantastic. Kale gives you a lot of nutrients. We don’t want just to eat kale.

What I instruct patients to do is eat the rainbow. By that, I tell them when you go to the market or farmers’ market, if you have kids, you can play this rainbow game with them. Go to the produce section. Do your normal shop. Get the stuff into your basket. Then go through the colors of the rainbow: red, orange, yellow, green, blue, violet. Look in the basket and see which of those colors are missing. You will go back out, and you or your kid will pick a vegetable from that color group and get it in the basket.

Worlds of color will start to open up. There is no purple; look around, and then this world of purple will bloom before your eyes. You will see purple onions, purple carrots, purple broccoli, purple sweet potatoes, purple regular potatoes. You can try different things. That way, you will build in the diversity.

It’s really about having different things in the diet and all the different groups. We definitely want cruciferous vegetables. We want green, leafy vegetables. We want orange things, like carrots or squash. We want diversity.

Dr. Eric: I agree. I don’t know if you have heard of Dr. Jason Hawrelak. He is also a naturopath. When I went through my Masters in nutrition, he was talking about eating 40 different types of vegetables, not just plant-based foods. 30 different types, including nuts, seeds, legumes, is attainable. 40 vegetables is very difficult. To get 40 different types of vegetables per week… I do what you say. I try to eat green, leafy vegetables and cruciferous vegetables. I could probably do an even better job than I’m doing now, like most people.

How about probiotics? Do you recommend for people to get more through the food they eat, through fermented foods, or supplements, or a combination of both?

Dr. Julie: You mentioned Jason. He is a probiotic guy. When it comes to probiotics, people can overestimate. I have a lot of eczema patients or eczema infants whose moms come to see me, and they’re like, “I have them on a probiotic, but it’s not working,” thinking somehow the probiotic will be magical and fix everything. That is not the way it’s going to work.

Eating fermented foods and getting probiotics naturally in your diet is always the best. But I do think there is a role for probiotics in helping, and I do prescribe a lot of probiotics. There are different types, and I use different ones in different people. I am always recommending those fermented foods, things like sauerkraut or natto or small amounts of kombucha, so we are not getting too much sugar.

For probiotics, for kids and breastfeeding moms and infants, the most common strains are the ones you get in the refrigerator section. There is strains of lactobacillus and bifidobacteria. Those I find work best in kids. That’s not usually going to magically clean up the eczema. As part of a comprehensive protocol, it can be helpful.

For adults, I like bacillus strains. Those are known as spore or soil-based probiotics. Those are a little bit different. I don’t use those in kids and breastfeeding moms because I’ve found that those species don’t work well in the guts of little ones.

There are more specialty strains. There is a bacteria called akkermansia muciniphila, which is- Its name tells us it’s a muciniphile; it loves mucin. It helps prevent leaky gut. There is a company that makes akkermansia. Sometimes I prescribe that as well.

I use a variety of probiotics. It will just never be the only thing I recommend. It’s part of a comprehensive plan where I am treating the issues I saw in the stool and OAT, using herbs and supplements to kill unwanted organisms and trying to regrow and rebalance the gut more toward the back end.

Dr. Eric: With the akkermansia, I assume if you recommend it, it’s based on it being low on a comprehensive stool test?

Dr. Julie: Exactly. If it’s either low or missing. A lot of patients show up with low detectable limits, which basically means it wasn’t found. We don’t think there is a single spore or something of akkermansia, but it’s just so low that it’s not coming out on the stool test. Akkermansiais a delicate bacteria. It can get to that point where it’s low or not found with antibiotic use. There is collateral damage in the gut. Antibiotics can be life-saving and amazing and wonderful, but at the same time, they can kill off beneficial organisms like akkermansia. A lot of patients who aren’t eating enough fiber, or if they are doing for a long time a low-FODMAP diet or a keto/paleo diet, and there is no fiber, that also can lead to low or no akkermansia.

Dr. Eric: You mentioned dysbiosis, imbalance in the gut flora. That doesn’t just pertain to low good bacteria. You mentioned candida overgrowth. How about gut infections like H-pylori or parasites? Do you see those leading to skin issues in your patients?

Dr. Julie: Yes. Just so your listeners know, H-pylori is a bacteria that lives in the stomach. I find H-pylori in almost 100% of my acne patients. I mentioned there is an acne-gut connection. The acne gut, almost all of them have H-pylori. It doesn’t even need to be massive amounts. It can be just low levels that are present. They also have candida overgrowth.

Half of my acne patients have something called protozoa. They are a type of parasite. Protozoa is Latin for “first animal.” These are eukaryotes, which is in the animal kingdom, single-celled organisms. Definitely my acne patients, I am expecting to see H-pylori in them.

Rosacea has a pretty strong connection with H-pylori and SIBO (small intestinal bacterial overgrowth). I see a lot of H-pylori in psoriasis patients. It can show up in my eczema patients as well.

The stool test that I use to test H-pylori standard, there is a lot of different bacteria that are tested for. I see everything from pathogens like C-difficile or even enterohemorrhagic e-coli can show up. Even things like pseudomonas comes up a lot. Or morganella or klebsiella. Those are high histamine producers. In my eczema patients, that high histamine level being cranked out in their gut is driving that allergic response and itch. I see a lot of different things. I don’t usually see worms, but protozoa can show up in patients in terms of parasites.

I feel like a lot of people have this idea that they need to do a parasite cleanse. That’s not really what I see in my experience with skin. It’s much more that there is dysbiosis. There is overgrowth of these unwanted organisms and not enough or lacking of the good guys. We need to switch that around and heal up the gut.

Dr. Eric: I think you did say there are times where you use herbal antimicrobials.

Dr. Julie: Every time I do, yeah.

Dr. Eric: You do. Protozoa or H-pylori, you mentioned pseudomonas or these other bacteria. Protozoa are not bacteria, but these micro-organisms. You do use every time some herbal antimicrobials.

Dr. Julie: I do, yes. Types of herbs vary by the organism I am trying to address. I usually see patients every 2-3 months for follow-up visits. The plan changes every time. We are working through different things. That’s why at first, when I sit down and am assessing the stool and OAT, I am making a list in my mind of all the issues. I am sorting them in terms of order of importance. What do I need to go after first? That will be addressed in the first protocol. I want to address massive candida overgrowth, so I will use a lot of antifungal herbs to start. Now for the second plan, I really want to go after that H-pylori, so it’s a different set of herbs and supplements. Maybe the third visit is more going after the protozoa and some bacteria.

The nice thing about using herbs is they are what’s known as broad spectrum. They address a lot of different issues. Even though we have herbs that are really good at addressing fungal organisms or things like protozoa, parasites, they are still going to cast a wider net and work with bacteria or other things.

That is not true with pharmaceuticals. Pharmaceuticals are in classes. If you use an antibiotic, it is only capable of killing bacteria and only certain types of bacteria. You can get problems. A lot of women who take antibiotics will then get vaginal yeast infections. The problem is that the pharmaceutical has killed off the beneficial bacteria in the vagina that was keeping the microbiome normal. We have a microbiome everywhere, including in the vagina. You can get fungal overgrowth. Then you need to use an antifungal. Antifungals will only kill off fungal elements, not bacteria or viruses. If you have viral, you need an antiviral.

The beautiful thing about herbs is they are broad spectrum. Plants need to exist out in nature and fight bacteria, viruses, fungal elements, parasitic elements. We don’t tend to get those kinds of symptoms and overgrowth when we are using herbs. Even though I am like, this is maybe a protocol that is focusing on the protozoa, It’s not that I am completely ignoring the fungal or bacterial overgrowth, and I won’t be driving problems with these other types of organisms. Obviously, I am an herbalist and naturopath and am using herbs for that reason.

Dr. Eric: Are there any supplements that you give directly for the skin? You spoke about probiotics for the gut. We just spoke about herbal antimicrobials. It doesn’t even have to be directly for the skin. If there are, that’s great. Do you recommend things to reduce toxic load, which might relate to the skin issues? I’m sure you recommend many of the supplements depending on the situation. Maybe a few common ones that you recommend that you find to be helpful. Or, like I said, silica as far as skin health, anything like that. You mentioned collagen.

Dr. Julie: Aside from supplementing with collagen powder, my goal as a naturopathic doctor is to restore function to the body. Most of the time, if I can clean up the gut and make their system healthy again, their skin is going to be healthy. I don’t usually give skin supplements.

That being said, I’m looking at labs. If it looks like they need liver support, the liver is the main organ of detoxification, and it relates to skin health. If they need liver support, I might give supplements like burdock, dandelion, artichoke, something like glutathione or NAC, n-acetyl cysteine. That can support the liver and thereby support the skin.

I tend not to give hair, skin, and nail supplements because I don’t really need to. If people are getting proper nutrition, their organs are functioning properly, and we are doing things topically on the skin like we talked about, not really messing with the pH and restoring the pH with things like aloe vera gel or hydrosols or water-based plant extractions. It’s part of the essential oil making process. It’s kind of like a tea. Diluted apple cider vinegar, teas, and using plant-based moisturizers to moisturize the skin. That is all you need.

We talked about not eating a lot of sugar, not eating a lot of junk. A healthy diet. Your skin is going to look and feel great naturally as long as we are supporting all the systems. We don’t need to throw a lot of vitamins and stuff like that at it.

Dr. Eric: I’m glad you said that just because there are times when my patients will ask me, “Can I have a supplement?” not so much for the skin, but especially for the hair. I say the same thing. Trying to address what is causing the hair loss. Is it a thyroid hormone imbalance? Is it a nutrient deficiency, which might be tied to the gut?

The last question I have is when it comes to skincare products, how do you recommend people find- There are databases like the Skin Deep database. Do you recommend people use databases like that to look at ingredients as far as finding clean products?

Dr. Julie: For my patients, I am giving very specific recommendations on very specific products for their condition. In general, I do think that the Environmental Working Group Skin Deep database is helpful. I don’t agree with every single thing that’s in there. But it’s a good guideline.

Reading the ingredients and getting up to speed on things, there is no substitute for it. Even sometimes within a brand, there will be one specific product which I will use, and another specific product I won’t use. I’ve read the labels, and this one is totally fine, and this one has stuff I do not want my patients putting on their skin.

What is difficult about the product market is it is not really well-regulated in the United States. It is buyer beware. A lot of chemicals that we can have in our products here in the United States are banned from Europe and other countries. The same product that you might buy by the same manufacturer, if you buy it in Europe, it’s actually a better, healthier product than if you buy it here. Europe has banned a specific substance, so it’s not in the European product. But it’s cheaper, so they will put it in the American product.

Things like fragrance, I don’t recommend patients use anything with fragrance in it. Fragrance is a catch-all for over 2,000 chemicals that are untested, and a lot of them are quite toxic.

I have a site called RootCauseDermatology. For free, your listeners can sign up for a video on this exact topic. What kind of skin care products should they be using? What should they be looking out for? If they put their email address in there, they will get this free 15-minute video of me talking about this exact topic and how to look out for themselves and get healthy skincare products.

Education, reading the labels, and I would say only buy products that you know what those ingredients are. The only exception is natural products have to have the common name and the Latin name. For example, something may list rosemary and then Rosmarinus officinalis next to it in italics. That’s fine. That’s just the Latin name.

If it’s a lot of multisyllabic chemical-sounding names, and you don’t know what it is, it’s probably things like parabens, emulsifiers, and preservatives. A lot of those are endocrine disruptors. They are things you want to get out of your products, particularly if you have thyroid issues.

If you know what all the ingredients are, and you see things that has lavender essential oil and aloe vera gel and shea butter and coconut oil, you know what those things are. Your body knows what those things are. Those will not contain endocrine disruptors. Those are not going to mess with your thyroid.

Dr. Eric: Anything else that I didn’t ask you that you wanted to chat about? I know we covered a lot, but I wanted to make sure there wasn’t anything else you wanted to cover specifically.

Dr. Julie: When I was talking about food, I didn’t really talk about gluten. The stool test that I use does have a gluten sensitivity test. This is different than testing for Celiac or a food allergy. A sensitivity is that you have issues with it. I bring it up because a lot of thyroid patients and Hashimoto’s patients have issues with gluten. If that marker comes up in my patients, I do have them eliminate gluten. Gluten can trigger something called zonulin. Zonulin contributes to a leaky gut.

Gluten is an issue for some of my patients, especially if they have thyroid disease. Thyroid is the #1 autoimmune disease. A lot of my patients have skin issues + thyroid. Autoimmune diseases go together. Especially if it’s something like an alopecia areata or vitiligo, they are more likely to have something like an autoimmune thyroid disease.

I think we eat too much gluten in our diet. I don’t think everyone needs to completely eliminate it, but I do think it’s helpful to know if you do have a gluten sensitivity, and if so, really cut it out completely. There are so many other grains and options. Some people are eating gluten morning, noon, and night. It’s really not great for their gut, thyroid, or skin at the end of the day.

Dr. Eric: How about dairy? Does that depend on the person? Do you usually let people eat dairy?

Dr. Julie: It depends. About 100% of my eczema patients should not be eating dairy. I have never met an eczema patient where dairy does them any favors. Unfortunately, we are not baby cows. That is not an appropriate food source.

I kind of tongue and cheek ask my adult eczema patients, “Do you still breast feed from your mom?” Of course, they look at me like I’m completely insane. The reason is if we were meant to drink dairy as adults, we would still be breast feeding. No mammal on the planet breast feeds past infancy. Every mammal mama cuts off the baby at a certain point. That mammal will never have milk again and will never drink the milk from another species.

We like milk because it’s delicious, and it makes things like cream and cheese. It releases endorphins, so there is an addictive nature. None of my eczema patients and none of my acne patients should be drinking milk.

Some people can get away with it, but it’s really not an appropriate food source. We weren’t meant to drink dairy as adults. We weren’t meant to drink dairy of other species.

Dairy and gluten are not my favorites. Some people can get away with it, but they are not great food sources.

Dr. Eric: I definitely agree with that. Can you take a minute to wrap this up? Maybe some action steps if someone with Hashimoto’s or Graves’ is listening to this, or another health condition or non-autoimmune thyroid condition listening to this. Working with a practitioner such as yourself is an option. What are some initial steps even before that that they should do?

Dr. Julie: We can break it up to topically and internally. Topically, the best thing you can do is turn those personal care products over. Start reading labels. Ask yourself if you understand what is in it. If you don’t, think twice about whether you should be using it. There is lots of good options. You can start with my course or the Environmental Working Group Skin Deep database to educate yourself. That’s for topicals.

For internals, if you can get 35g of fiber a day and 30 different plants a week, a lot is going to change. Your thyroid symptoms will improve. Your gut is going to improve. Your skin will improve. It is the way we were meant to eat. There is nothing we can do to get around that.

Topically read your labels. Focus on 35g and 30 different plants a week. You will see big changes in your skin health and your thyroid health.

Dr. Eric: Thank you, Dr. Greenberg. Where can people find out more about you? You said your website is RootCauseDermatology.com. I know you have some courses, besides the free video, that you offer.

Dr. Julie: Yes. I have a course on eczema, acne, rosacea, hair loss, and something called seborrheic dermatitis and dandruff. If you live in California, Oregon, or Washington, those are states where I’m licensed and where I can legally see patients. My clinic site is IntegrativeDermatologyCenter.com. If you’re interested in potentially seeing me as a patient, you can go there and sign up for a free 15-minute consult. I can talk to you about your condition and how I treat it.

Dr. Eric: Wonderful. Thank you so much again for doing this. Appreciate it. I learned a lot. I’m sure the listeners did, too.

Dr. Julie: Thanks so much for having me. It was a pleasure.

 

Recently I interviewed Dr. Eric Kempter, who is my biological dentist. And so not surprisingly, Dr. Kempter and I chatted about biological dentistry and thyroid health.  If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky: It’s pretty cool that I get to interview another Dr. Eric. With me, I have Dr. Eric Kempter, who is an accredited member of the IAOMT along with serving as the chair of their student scholarship program, which allows students to attend IAOMT meetings at no charge. He is also certified in atraumatic restorative treatment, ozone therapy, and a member of both the Academy of Laser Dentistry and the American Laser Study Club. Dr. Kempter provides specialized services at Kempter Holistic Dentistry. He is one of only a few infant lip and tongue tie release providers as well as treating all ages for lip and tongue tie releases. He is also a certified Invisalign provider, ozone treatment provider, and certified platelet rich provider. I also need to mention he is my dentist. It is a pleasure chatting with another Dr. Eric. Thanks so much for being here.

Dr. Eric Kempter: You’re very welcome. I’m happy to be here. It’s interesting I get to talk to another Dr. Eric. It doesn’t happen for me very often either. This is a fun thing for me to do. Glad I can come on and talk a little bit about what I do.

Dr. Eric O: Why don’t we start by how you started doing biological dentistry? If you could give a bit of your backstory, I’m sure the listeners would enjoy it.

Dr. Eric K: It’s not just me in our practice. We also have my older brother, Dr. John Kempter. I will give him credit that he did get me interested in dentistry at first. I can thank him for pushing me down the dental path.

As far as biologic dentistry, I don’t think most people go into dental school thinking they want to be a holistic or biologic dentist. It’s something you come to the conclusion of after doing your research and critically thinking about some things you’re being taught at dental school.

How we got into this, it was a journey with my brother and me at the same time. My grandfather actually had a pretty bad case of Alzheimer’s. John and I both have degrees in chemistry and backgrounds in microbiology. He had had a mentor that he worked with that started mentioning safe mercury removal and this organization called the IAOMT. That’s the International Academy of Oral Medicine Toxicology. It’s a fancy, long acronym for the biologic dental association or holistic dental association. We got talking when I was in dental school. He did some research into the IAOMT. We attended a meeting together. It’s history from there.

It opened our eyes to a lot of things about the danger of using amalgam or mercury fillers. It’s dangerous to us as practitioners because if we had a grandfather that had Alzheimer’s with a mouth full of mercury fillers, now we are in a profession where nobody seems to care about drilling these things into people’s mouths. We worried about our long-term occupational exposure. I certainly didn’t want to end up down that path. We started there.

Of course, in biologic dentistry, you start with mercury removal and end up down a bunch of rabbit holes. You get trained in all these different things. You start putting the big picture together: how your mouth ties into your overall systemic health. It’s not just drilling and filling cavities; it’s looking at everything from a 30,000-foot view and how all the puzzle pieces fit together.

My brother had opened the practice when I was in dental school as a traditional family dental practice. Once I got out, we took a deep dive and wanted to be honest with people about being a holistic practice. We changed our name to Kempter Holistic Dentistry.

Dr. Eric O:The name, Kempter Holistic Dentistry. I want you to talk a little bit about the difference between biological dentistry, conventional dentistry, and even if you might want to expand on the difference between- Years ago, before seeing you, I actually saw a holistic dentist who really wasn’t a holistic dentist. They did some holistic things, but they weren’t really a biological dentist. If you could talk about the differences between conventional dentists and what someone would look for if they are truly looking for a biological dentist, someone who will get into the root canals and all that.

Dr. Eric K: In terms of biologic and holistic, that is pretty much apples and oranges. They are both fruits. They are both relatively the same thing. What makes us holistic versus a conventional dentist, especially, is knowing what we’re putting in your mouth, looking at things from a 30,000-foot view, working with people like yourself, working with some sort of systemic doctor to make sure that oral health is not negatively contributing to your overall body’s health. On top of that, more things like using laser, using ozone. There are dentists out there who advertise as holistic, but they just dabble a bit. I’m not sure if it’s because they don’t believe in just about everything we believe in in holistic dentistry, or they are worried about having some sort of consequence for it. We’re not. We want to provide the best for our patients.

For holistic stuff, using things like PRF. Making sure we are not using toxic things. Not settling for using things like root canals. Saying, “That stuff is not healthy for you.” We will get into fluoride and root canals, and I will explain why. The best way I can put it is there are some dentists out there who just dabble.

If you want a holistic or biologic dentist that is actually certified, make sure they are an accredited member of the IAOMT. On their website, they have a search directory. The accredited members will be highlighted. That indicates somebody who has done extra training. They have been vetted for sure for the IAOMT. They make you send pictures of your procedures, state your removal process. They are making sure you are doing it the right way. Anybody can sign up for the IAOMT, but you want an accredited member because they have been properly vetted at that point.

As for what other things to look for, is that dentist offering root canals? That’s a big one. We don’t do them here in our office. It’s not that we don’t say patients can’t go get one. People can make whatever decision they want to. We openly don’t recommend them. There are more biologic and healthy options. If you see someone who says, “I think you should go get a root canal,” that’s a pretty big red flag in my book in terms of how holistic they are.

Knowledge of the materials you’re using. We do compatibility testing with our patients if we are concerned about reactivity. We know about what materials we’re using. You can ask us questions about it, and we have knowledge of what it does and whether it’s biologically compatible or not.

The other thing we do differently from a traditional dentist is we don’t believe in metal in the mouth. We will talk about titanium implants. There is an exception to the rule, but in certain instances with certain people. For the most part, you are not born with metal in your body, so you should not have metal put into your mouth, the gateway of your body, because it’s not naturally supposed to be there. There will be an immune reaction to it. It might be small, but it creates an electric charge in your mouth. It shouldn’t be there naturally, so we believe it shouldn’t be there. That is the most basic thing I can say. If it’s not natural or biologically compatible, we are not going to use it.

Dr. Eric O: Speaking of root canals, that was my experience when I went to a so-called holistic dentist. There was a tooth that was too far gone. He was trying to convince me to get a root canal. I knew that biological dentists didn’t recommend root canals. I found you on IAOMT, which I’m glad I did. As you said, they can go through a weekend conference and still be listed on the website. As you mentioned, they need to be certified because there is a big difference between attending a conference and going through the certification.

Dr. Eric K: The IAOMT, I love them as an organization. But they will put your information in the directory if you have been to a conference. This goes for just about any doctor you see. You have to do your research. Look at somebody’s website. Get a vibe for what they are all about. What is their knowledge level? You can read on the website however many meetings they have attended and whether or not they are accredited. There are people on there that aren’t even safe mercury amalgam removal technique certified. If you have attended a conference, you will be on that directory. It’s something I hope they’ll change in the future. I’ll have to push them toward that at some point.

Dr. Eric O: Agreed. Can you dig a little bit deeper into root canals? Why biologic dentists don’t recommend root canals. Why you don’t either in your practice.

Dr. Eric K: If somebody is asking me their opinion on an existing root canal, or whether they should get one or not, I think the dentist community does a bad job of explaining what exactly they are, what the purpose of a root canal is. If I were to ask you, Dr. Eric, what would you say the purpose of a root canal is? If you were to go to a conventional dentist, and you asked them why you needed one, what would they typically say? It’s okay to say that you don’t know.

Dr. Eric O: As far as why they would recommend one, it’s to save the tooth. It’s a less extensive procedure than having an implant, is some of the rationale they would give behind it. You can clean out the canals, which we know is not true.

Dr. Eric K: I don’t think they even get into the canals. For your basic dental consumer or patient, they are going to tell you, “Hey, this tooth still really hurts, and the pain is not going away, so you need a root canal.” They don’t explain what the purpose of it is. You have done research, so you know, given your situation previously, what a root canal is trying to attempt.

Basically, what they are trying to do is disinfect the inside of the tooth. In a situation where you need a root canal, either the nerve has died, and there is pain, or a cavity has gotten too deep, and there has been a bacterial infection into the pulp of your tooth, which is not just your nerve, but it’s your blood supply, your artery and vein that goes into the life of your tooth basically. Your pulp is not just the main root canal that they treat. The inside of a tooth is that main branch, but it’s like a tree. It’s almost like a mini circulatory system inside of a tooth. There are all these accessory canals that come off of that main canal that range in size from pretty big to microscopic. Bacteria are pretty small, so it can live in just about any part of that. It reproduces asexually, so it doesn’t need a partner. It can just grow and grow and grow inside the tooth.

A root canal, they will try to shape the main canal, so they can get their liquid bleach in there. They actually teach you in dental school to call it sodium hypochlorite. Those of us with a chemistry degree know that’s conventional household bleach. They will have a special version that is dental rated. They are trying to put that liquid bleach down into that tooth to try to disinfect that tooth. That liquid cannot physically penetrate all of those accessory canals.

An interesting statistic that they figured out with cone beam technology is that there is almost up to three miles of canal structure inside one tooth if you stretched it all out. A single upper molar, you can find up to three miles’ worth of canal, which is insane to me, that you can find that much in a single tooth. I don’t think liquid bleach is traveling three miles. While it’s disinfecting that first part of the canal, it won’t get everywhere. If you leave a single bacteria inside that tooth, it’s going to reproduce at some point, especially the type of bacteria that is down inside a tooth. It’s anaerobic. It does not need oxygen to survive. It likes an environment that doesn’t have any light in it. A root canal inside of a tooth, you go and seal it off, and you seal this bacteria off inside this tooth with no oxygen, no light. You have given it the exact environment it needs. Essentially, you have left the dead, infected tooth in your mouth. Yeah, it doesn’t hurt because you don’t have a nerve in there.

From a biologic standpoint, as a holistic dentist, my problem with it is that it is a locus of infection. Your immune system has to contend with it. Especially given your expertise with the thyroid, it can exacerbate autoimmune issues. If you have underlying thyroid problems, that is not a great thing to have.

There are certain associations with teeth called meridians. We believe that if you put a root canal there, you are blocking a meridian. You will have some dysfunction, some association with some other area of the body. The most common one that I hear, and we have observed in terms of a correlation, is upper molar root canals and breast cancer. A study was done in Germany where researchers found that out of a select pool of their cancer patients, 97% of them had an upper molar root canal onthe same side as their breast cancer. Knowing that there is that correlation—and I’m not saying cause and effect, I’m saying correlation, so there is an observation they noticed—that is enough for me to sayI wouldn’t recommend a root canal pretty much anywhere in anybody’s mouth. Who knows what systemically it’s going to do?

The other problem I have with it is you hear about people needing root canals retreated, or it got reinfected. “I had this one done X number of years ago, and now I am back with a huge infection in it. ”They will say, “It got reinfected.” Yeah, it got reinfected with the same bacteria that was already inside the tooth. It just happened to find its way outside the tooth. You will then pull this thing anyway. It’s rare you will have it retreated a third time. I wouldn’t go back into the well a third time if something fell twice.

We feel in our practice, and this is our professional opinion based off some of the research we have done and some of the clinical observations we have made in our office: If you have a tooth that is failing with pain and bacterial infiltration, it is a much healthier and safer option to have that tooth removed, as daunting as that sounds. It’s healthier for you to have that infected, dead tooth taken out of your mouth.

It’s 2022. We have great replacement options for teeth. Implants work great. Is it a longer procedure? Does it take a little bit more work to do it? Yeah. This is our health we’re talking about here. In the grand scheme of things, the whole implant process can take as short as four months. Usually, our average is about six months start to finish. That is a relatively short period of time in somebody’s life, to have a healthy situation rather than having a root canal in your mouth for 15 years, dumping endotoxins into your system, and causing potential other problems.

That’s our main issue with these root canals. They can cause more problems, and it’s not worth it for us just to keep holding onto a tooth when we have a better replacement option that’s healthier for you.

Dr. Eric O: I think I heard on another podcast where a holistic dentist was talking about possibly Lyme being harbored in the root canal. Have you heard about that when it comes to infections?

Dr. Eric K: I have heard they are similar bacteria. The one thing I have heard, and the thing they have observed, and this is traditional researchers doing this, traditional allopathic medicine. If you scraped the plaque inside of a clogged artery, somebody who has had a heart attack, the bacteria that populates that plaque build-up in the coronary artery is the same bacteria. The only other place it’s found in the body is endodontic infections in teeth. The American Academy of Cardiac Prevention, if you check their website, they will tell you 96% of all heart attack-associated problems stem from bacteria in the mouth. Root canals are a huge source of that.

Dr. Eric O: Not physically removing the root canals, but assuming someone doesn’t have root canals, and that also leads into the importance of regular dental hygiene, seeing a dentist a few times a year, flossing. Some people will blow off the impact of gingivitis or periodontitis. That can be a big deal as well as far as cardiovascular health, it sounds like.

Dr. Eric K: If you have a periodontal disease in any fashion, bear in mind gingivitis is a form of periodontal disease. I’m not saying it’s localized. Everyone gets a little bit of bleeding here and there. If you have general gingivitis with constant bleeding, that same bacteria is going to affect cardiovascular health. People with periodontal disease, there is a much higher correlation with high blood pressure, diabetes, the chances of having cardiovascular problems. That same bacteria they find in the coronary arteries is not just endodontic infections; there is gum infections and periodontal infections that play the same role in that.

If your front door is dirty in your house, you have mud and all kinds of unsafe situations there. You are dragging all these things into your house. That is the best analogy I have. If your mouth is dirty, you are swallowing bacteria constantly; you are introducing bacteria not only through your bloodstream, but also through your digestive system, your gut health. It’s going to make it through there. This is one of the only accesses into your body. We only have so many, and your mouth is by far the biggest one and the one that is most used.

Dr. Eric O: What are your thoughts about oil pulling? If you have periodontal disease, oil pulling won’t reverse that, but as far as a preventative measure along with brushing and flossing?

Dr. Eric K: It’s the best adjunct in terms of mouth, that’s for sure. If everybody had 14 minutes a day to do oil pulling, we overall as a country would have much better oral hygiene. It’s such an effective natural way to do it. Everybody likes the minty flavors of mouth rinse. If you asked my colleague Dr. Gerry Curatola up in New York, who is a big-time oral microbiome specialist, anything that has alcohol, mint, anything like that is going to destroy your microbiome.

Coconut oil pulling or sesame oil pulling is not going to affect good bacteria like that. It will pull the bad bacteria out. There is a reaction that happens there. It’s the one thing that I see clinically in my practice. If I have a patient that has a gingivitis problem, and they change their oral hygiene habits to add oil pulling, it’s a night and day difference between that first recall and that next recall for your cleaning appointment. It’s something I highly recommend. People have been doing it for thousands of years. There are records of it from thousands of years ago.

I wish some of these oil pulling direction websites would have this on there: If you have mercury fillings in your mouth, do not oil pull. It will pull mercury off of those fillings. You will dose yourself with mercury moreso than even just chewing or drinking a hot cup of coffee. It is areally bad thing to do. I have patients say, “I have been oil pulling for the last six months,” and there is a mouth full of mercury. I tell them to stop until we get all of it out. If you have no mercury fillings in your mouth, and you want to add it in as your adjunct, it is by far the best adjunct you can use.

Dr. Eric O: Good to know about the mercury. That makes sense to me. With that being said, if you don’t mind shifting to talking about mercury a little bit. One question I have along those lines is: Is there risk with doing other things, like taking chelators or alpha lipoic acid, things that people use to detox mercury, if you have mercury amalgams?

Dr. Eric K: Detox is definitely not my specialty. I obviously do work with a lot of people that do it. From a logical standpoint, if you try to do a detox, and you still have these things in here that are dosing you with mercury, it’s kind of pointless, if you think about it. Most of my naturopathic referral sources and colleagues I work with, they almost require their patients to have all their mercury out before they go through any sort of detox protocol. Again, it doesn’t make sense to be dosing yourself in your mouth with mercury, releasing mercury vapor, and then you detox. You are just rebuilding up the mercury again. Especially heavy metal detoxes, makes no sense. My recommendation from a dental standpoint, you need to have your mercury fillings taken out.

Dr. Eric O: What do you say to patients who have had their fillings for 20-30 years, and they seem fine? They have 5-6 fillings, or only one or two. They’re not convinced that mercury is causing harm.

Dr. Eric K:That is ultimately their choice. I’m a big proponent of patient choice. If somebody says, “Doc, I’ve had these mercury fillings for 25 years, and I have never had a problem with them. I’d rather keep them in my mouth.” That’s your choice. We are not going to polish those fillings when you come for cleanings because that will expose my staff if they are not wearing the proper safety gear. I always explain to them it’s healthier to have them out. By no means do I force those people.

The analogy I try to give them is you might smoke cigarettes for 20 years and not have a problem. That doesn’t mean at year 22/23/24/25 and so on and so forth, you might not find some lung cancer after that. It’s something I’d rather be safe than sorry about. Ultimately, when it comes down to it, if they don’t want to remove it, that’s their choice. I can arm them with the information to make that conscious health decision.

Dr. Eric O: That is where I was getting at. You can’t force them to get their amalgams out. As far as education, just because they are feeling good, doesn’t mean that A) maybe it’s causing some underlying problems they are not currently aware of, or B) it may cause problems down the line as you mentioned. Of course, most people listening to this have a thyroid or autoimmune thyroid condition. There could be that connection, too. I don’t know if you want to talk about, or me to talk about how mercury can affect thyroid or immune system.

Dr. Eric K: It’s your podcast. I’m all for it. I love hearing about thyroid issues. It just reinforces the toxicity of these mercury fillings.

Dr. Eric O: Yeah, the immune response is my concern. Most people with thyroid conditions, as you mentioned, Hashimoto’s, the most common autoimmune thyroid condition. I have a history of Graves’. Everybody has different triggers. If someone comes in with Graves’ or Hashimoto’s, and they have a bunch of mercury amalgams, I can’t say definitively that’s what’s responsible. It’s just a potential trigger. There are a number of different potential triggers.

Like you said, in a perfect world, you’d want to get those removed. Not everybody I work with will get them removed. There are numerous reasons: cost associated with that or fear of going to the dentist. Ideally, in the future, you would want to get those removed, if not presently.

Dr. Eric K: Yeah, the way I try to explain it when I have someone with a health issue, and they are asking me what the benefit is of taking the mercury fillings out. The better example: You have a crown that is porcelain fused to metal crowns. A lot of crowns that were done back in the ‘80s and ‘90s due to constraints of labs, they used to do these metal-based crowns that they layered porcelain on to look like teeth. The problem with those is 1) they are made of nickel, and 2) we can’t see what’s underneath them. If you have an underlying issue, or potential for it, I would rather know than not know what’s underneath these things.

If you’re having an issue, while you said, taking the mercury out may not be the trigger that fixes their problems, I look at it as more like an elimination diet. You want to take any potential cause out, especially people with thyroid or other odd health issues. A lot of my patients are coming to me because traditional Western medicine has failed to help them with their problem. They are going down the natural way of approaching different things. Dentistry is one of those things where I get the question a lot, “Doc, is taking my mercury out going to fix my problem?” I don’t know. I know it’s not healthy for you. It very well could be the straw that breaks the camel’s back here in your situation. We have seen that. It’s just not healthy to have it. If I am in a situation where I have a thyroid issue or a gut issue, I’m going to want to make sure that my playing field is completely clear. I want to give my body the best chance to heal itself, to fix this issue, that I possibly can.

Dr. Eric O: It’s similar with root canals, too. If someone has a chronic health issue, and if they have one or more root canals, you can’t guarantee that removing the root canal will cure or help to restore their health, but maybe it’s a factor. Maybe it’s the straw that broke the camel’s back, and it’s a piece of the puzzle.

Dr. Eric K: It could be part of the equation. You could have root canals causing this bacterial buildup, and it could be one of the things that is making an autoimmune issue worse. It could be one of the things plus another couple issues that is causing your problem. We happen to catch people at the end, and this happens to be the last thing they need done that will solve their issue. We see really crazy health turnarounds with people.

I have others who are sick and do all this stuff, and they need other work done. They need other detox done. Sometimes, I get some discouraged patients, but I try to explain the elimination diet. This is just one piece of the puzzle. You need to see a naturopath. You need to check out other things. Get chiropractic care. Make sure we are on top of all that stuff. Optimize your body for healing. You may find that they go to another practitioner, get ozone IV therapy, something like that, that detoxes them out. The next thing you know, they are doing great. It just all depends.

For our side of things, we know these things are not good for you. The ADA may get mad at me. I know root canals are not good for you. I say it in the sense that there are better options out there. Nobody can prove to me that a root canal is going to last longer than an implant. Statistically speaking, nothing beats an implant in terms of longevity, safety, and the integration into the body is much better. While the dental board will take the company line here, those root canals fail pretty often. I believe in my professional opinion that they are not healthy for you. We think there is a better way. For those out there dealing with thyroid issues, if you just keep taking away pieces of the puzzle, a lot of times, that is where you find your success.

Dr. Eric O: You mentioned making the ADA mad. I don’t know if you want to touch upon fluoride because I’m sure they frown upon dentists- Do you mind talking about fluoride, why biologic dentists don’t recommend it?

Dr. Eric K: Dr. Eric, I’m pretty secure in terms of what I believe in dentistry. My brother and I have taken the stance that I’m not going to be afraid to speak my mind. We never have been, even since I was a kid. I am not afraid to speak my mind about what I believe because it is what I truly believe.

Fluoride is one of those things that the ADA has glommed on to. It’s at the forefront of dentistry, standard of care stuff. I’ll start off with this: Fluoride works in remineralizing your teeth in some fashion. I will say that. It can desensitize your teeth. It has to be on there for a really long time. I don’t think people realize that. The most effective fluoride is fluoride varnish. They paint it on your teeth at the end of your cleaning. They do it for kids a lot. It’s sticky, and it sticks there for 24-48 hours. That is when it’s effective.

Going into the history of it, they used it as rat poison in the early 1900s. If you type into your web browser, “fluoride rat poison,” you will see advertisements from the 1910s and 1920s. They used to sprinkle it around to kill rats. It’s not safe. It’s the most electronegative chemical on the periodic table. It’s the most reactive species on planet Earth in terms of elements.

In your body, it reacts in a lot of interesting ways that are not very good. Fluoride is an endocrine disruptor. It settles in your bones. It essentially in the most basic of terms can make your bones weaker. The thing I try to explain to people, and traditional dentist friends, about why I have a problem with it is if you look at kids’ toothpaste, it doesn’t have fluoride in it. I don’t think anybody has ever asked why. The dirty secret is that kids are not very good at spitting toothpaste out. If you look on the back of your fluoride-containing toothpaste, they tell you to call poison control if a kid eats toothpaste. It’s because of the dose of fluoride in there. As adults, the conventional thinking is an adult will spit their toothpaste out. How many people use mint toothpaste and swallow it because it makes their breath smell good? While it’s not a huge dose of it, over time, constantly swallowing fluoride is not great for you.

There was a study that was done with kids. My big problem with using fluoride in a pediatric sense is fluoride has a tendency to calcify the pineal gland. For those of you out there who are not anatomy specialists, the pineal gland is what they call the essence of life. It’s the gland that controls timing in your life. When it calcifies, it’s indicating to your brain that you’re getting older. Especially for preadolescents, it’s a good timer for when you’re supposed to hit puberty.

An interesting situation they did was they went to rural communities in China. There are a lot of these outreach programs about fluorinating the communities in well water areas around the world. In this particular village, they overfluorinated the water. Their conventional thing was, “We probably should give them more fluoride because their oral health is bad. Let’s up the dose of fluoride in the water.” They started noticing that girls as young as 7, 8, 9, were hitting puberty. That’s not normal. They had to knock back the levels of fluoride in the local drinking water because there was too much in there. It was calcifying the pineal gland. Their bodies were saying, “It’s time for us to get to child-rearing age. Let’s move along with this.” Here we are.

This probably applies to a lot of people in my age group. I’m 37. I don’t know if you had this in school: they had this swish and spit program with your school nurse. You’d swish some fluoride and spit it out. These were dental programs they did in the ‘90s. A lot of people my age have white spots on their teeth. I’m sure some of your listeners have them. What do these really white spots come from? That is actually a form of dental fluorosis. Too much fluoride can damage your teeth. You are trying to find this happy medium in a general public that does things like swallowing toothpaste because it tastes good and makes your breath smell good, even though it’s not healthy for you.

Our problem is it’s a toxic material. The long and short of this is you don’t need fluoride on your teeth if you have the proper hygiene regimen at home. The biggest driver of cavities and problems in your mouth is plaque and bacteria. While fluoride will demineralize your teeth and prevent cavities, which I don’t believe that it does, because I think some of the studies are really flawed.

I actually think there is a study out there that shows that rates of cavities are even in fluorinated versus non-fluorinated communities. I think it’s a moot point. I could go deeper into how fluoride got in our drinking water, but that’s another thing. The rates of cavities are the same. Why would you expose yourself to something that was used as rat poison back in the day when all you have to do is mechanically clean your teeth every day; use coconut oil pulling, which is much healthier; and even find a nice mineralizing toothpaste? My friend Dr. Gerry Curatola has a wonderful one  called Revitin online. We also offer Risewell Toothpaste here. We are not sponsored by them, but it’s a great mineralizing toothpaste. They are out there. There are better ways to do it without having to expose ourselves to a pretty toxic chemical.

Dr. Eric O: The reason why I wasn’t sure is if you would share is because one of my past podcast interviews was a medical doctor, not a dentist, was talking about environmental toxins. When I brought up fluoride, she was like, “Yeah, fluoride is bad, but I can’t talk about it.” She didn’t want anything to do with it.  I got the impression that she was concerned about getting in trouble.

Dr. Eric K: If you know some of the members of the IAOMT that I’m with, we have the science behind us that shows it’s not great for you. There is a documentary that is available on YouTube called Fluoride: Poison on Tap. It will give you a good idea of where our modern-day fluoride comes from in our drinking water. People would probably be appalled if they saw where it actually comes from, what it can do, and some of the effects it’s had on people. It may not get into it from a dental standpoint, what it does to your teeth, but it does show how we got to the point of- It’s a prescription drug. It’s the only one that our government forces you to consume by putting it in your drinking water. I encourage your listeners to check that out.

If you don’t have a filter at home, a Berkey water filter, which is what I recommend for most people, it’s a pretty reasonably priced water filter. Getting a reverse osmosis filter in your whole house, hopefully with some sort of remineralization in it, so you’re not drinking pure water, where you are getting cramps. You do need some minerals in your water. That’s the best thing I can suggest to get the fluoride out of your water and drink the safest tap water and shower in the safest tap water.

Dr. Eric O: Fluoride toothpaste. Cut that out.

Dr. Eric K: All of your brands of toothpaste should have non-fluoride toothpaste. Be careful about even if it’s a “natural toothpaste,” you need to check out who owns that company. The big boys like Proctor & Gamble, Colgate, those guys, have started buying up a lot of these smaller toothpaste companies that are “fluoride-free” and changing the formula on them. Keep a lookout for what you’re using. A base thing for toothpaste is making sure it’s slightly abrasive, so it will polish your teeth. Any other things in there are bonus.

Dr. Eric O: Cavitations. Can you talk about what cavitations are and why they are a concern?

Dr. Eric K: Yes. A cavitation is a locus of infection in your bone. How I can describe this is when you get an extraction done, a tooth removed, the things left over are the socket where the tooth was, where your roots used to be, and then the ligament of the tooth. The teeth are held in your head; they are not just fused into your bone. They are held in like any other bone to bone connection through a ligament. In your mouth, they are called the periodontal ligament.

After the extraction is done, if your dentist or oral surgeon doesn’t take the time to clean that site out completely, scraping the entire ligament out, treating the area with ozone, if you leave any of that material in there, the body is going to heal the bone over. That ligament tissue is going to turn into a necrotic bacterial infection essentially. While you may not notice any pain directly with it, you may have some health problems that are associated with it.

Some of the thinking of it amongst my holistic practitioners is that that locus of infection is located on a meridian, and it’s causing a problem with another organ system. The general gist of this is you need to find, if you are going to have an extraction done, somebody who will definitely clean it out the right way, and someone who uses ozone gas, which kills bacteria; sterilizes sites; and ensures that that ligament tissue is not alive and any bacteria associated with it is dead.

The other side of that is with the advent of using what we call platelet rich fiber, and I know you mentioned that in my intro, which is essentially stem cells. We take your own stem cells and white blood cells that are in that layer we extract and mix that with bone graft material or just put the membrane in on its own. That’s another way you can ensure you won’t have a cavitation form.

We have people come to us with really odd health problems. Usually, we’re looking at not only root canals and mercury fillings, but we are also looking for cavitations. The notorious place is wisdom tooth extractions. Generally, the lower jaw area, we will take a look on our cone beam CT. It’s an MRI for your mouth where we can look at your jaw bones and structures in all different directions to get a good diagnostic on it. If you go to a dentist, get a CBCT done. Get it analyzed by a radiologist. We do that for every single patient that comes to our office.

The CBCT will show an area of low density bone. Bone is supposed to show up white on a CBCT or an MRI. A cavitation will typically show up very dark looking. We will still see the outline of the old tooth root that was in there because that is the ligament tissue that hasn’t been scraped out or cleaned out properly. That is where we can see that infection. I have seen some really obvious-looking ones. Normally your gum tissue is healed over. We have to get in there, open the gum tissue out, and almost 10/10 times, we get in there and see that the bone is actually brown and soft. You can clean it out and scoop this material out. If somebody gets that treated, we clean it out, ozone it, put some PRF in there, stitch it back up. A lot of times, they will notice a big change.

That is where we see the most change with people after doing these cavitation surgeries. They start having a problem and notice that the problem got a lot better. “My immune system, I feel like I have more energy.” Their immune system is not constantly having to attack this area of necrotic bone that is here.

It is something we do recommend you have checked with your biologic dentist. Make sure they are checking for these areas here. Notoriously, it’s usually wisdom tooth spots.

Dr. Eric O: It seems like most dentists recommend for everybody to get their wisdom teeth pulled. Are you against that?

Dr. Eric K: It depends on the situation. From an anthropological standpoint, we have gotten smaller as a species. That includes our jaws. In ancient times, our jaws used to be bigger, so we had room for wisdom teeth. Some people still have room for those teeth, and some people can keep them clean. If you can keep your wisdom teeth clean, you can keep them. I don’t want to take teeth out for no reason.

The fact of the matter is that in most cases, people’s wisdom teeth are coming in weird. They are partially up. They are partially soft tissue impacted, so there is a soft tissue pocket around the tooth. They get infections on them. It’s hard to keep them clean and floss them. Rather than constantly having infections or the potential for very large decay that will cause an abscess in somebody’s teeth, we recommend you get them taken out.

Who should you have them taken out by? That’s the million-dollar question. I have several oral surgeons in my area I recommend. It’s because we’ve had that discussion about using ozone. They are open-minded to it or using platelet rich fiber therapy. I know for a fact they are really good practitioners and will take the time to scrape that site out and clean everything how it’s supposed to be cleaned the proper way.

Oral surgeons like making money, like anybody who owns a business. If they are seeing a high volume of patients, they will pull that tooth out and quickly scrape it out, not really taking the time to make sure it’s fully clean.

The best answer I have is it depends. It depends on the individual situation. That is a discussion for you and your holistic dentist.

Dr. Eric O: I’m one of the few people who have all their wisdom teeth.

Dr. Eric K: If I remember correctly, you have the room to clean them and do quite a good job of that. That is the rule of thumb.

Dr. Eric O: Thank you. You help with the cleanings regularly when I go to you as well. One question I had, which you already answered, is what newer treatments or procedures, technologies, like ozone isn’t new, but you don’t see conventional dentists use ozone. You mentioned the cone beam, which you do, and the platelet rich fiber. Are those the main things that you do that other dentists don’t do?

Dr. Eric K: That’s probably what you find as the most different in our office. People say ozone is this new thing. It’s been around since the early 1900s in terms of disinfecting surgical suites. They used to use it. It’s so old in terms of a technology from a medicine standpoint that it’s actually grandfathered in under the FDA. In other words, there is no regulation on it because the FDA can’t do it.

Platelet rich fiber therapy is relatively new. We use that pretty much in every extraction. That is something that has been around for about 12 years.

Another newer technology is CEREC. That is a relatively new thing we do. About 20 years ago, they came up with this German technology that can make inlays and porcelain crowns in office. You have taken out the middleman and given the dentists a lot more control in terms of custom-fitting your crown. I know there are plenty of people out there who have made a crown traditionally, where they send it to the lab. You wait two weeks, and the temporary doesn’t really fit well. You come back in two weeks to have the final crown put on, and it doesn’t fit. Then they have to put the temporary back on and take anew impression. It’s a very antiquated way to do crowns. The CEREC system has taken 3D technology to mill out porcelain crowns in house. You get instant feedback. They are much healthier, and you can pick the materials you are using.

The other technology I would say is relatively new is laser therapy in dentistry. They are now developing really nice lasers that can actually do fillings without anesthesia. The wavelength of laser light used under the erbium laser is done in such a way that it doesn’t irritate the nerve of the tooth, so you don’t feel pain. Is it perfect? No. It definitely will need more research and usage and clinical trials. But we definitely can do it where we don’t get pain during a filling.

For kids, I use the laser a lot on kids because I don’t want to get kids numb if I can help it. They are not the most fun people to give anesthesia to. And adults who are anxious about getting dentistry done. There are a couple lasers out there. If your dentist is using it, they usually advertise it. It’s a photon laser or water laser, something of that nature.

As for thinking of philosophy-wise in our practice, we have added a lot of things like making dental sleep a big deal. How is your sleep affecting your dentistry? I don’t think a lot of people realize when you snore, that can cause clenching of your teeth, which can damage your teeth. It’s not a new technology but a new philosophy.

There is a lot of cool stuff out there. I leave it to my patients to do their research into who they are seeing. If you are not in the Charlotte area and can’t come see us, research the technology. Ask your dentist what their technology is all about. They should know what it is, what it does, and how it works. If they can’t answer those questions, don’t have that technology done to you.

Dr. Eric O: The last thing I wanted to chat with you about is implants. You mentioned earlier how you don’t recommend titanium, but you recommend ceramic, zirconia. That is something most conventional dentists don’t do; they stick with titanium. I imagine if someone comes to you and already has a titanium implant, you won’t tell them to switch to zirconia. If someone needs a new implant, that is where you will recommend the zirconia.

Dr. Eric K: Preference is always to use zirconia. Zirconia is a ceramic implant. The technology is relatively new. We have placed thousands of these things. We have had some really good success with them.

Dr. Eric O: Including me.

Dr. Eric K: I was about to say that you have one, too. You know this intimately. It is always the preferred implant in our view because your body’s immune system doesn’t recognize zirconia. The integration into your bone. Implants aren’t in your jaw mechanically. You don’t screw it in, and it stays in that way. Your body fuses it to the bone. They found that the rates of zirconia, because your immune system doesn’t recognize it as a foreign object, and there is no electrical charge associated with it like a titanium implant has, your body integrates that thing really well, if it does it well.

The technology is limited in terms of, and I can get into it really deep, the connections inside of zirconia implants are still researching and developing those perfectly. In the next five years, it will probably be the standard of care. It’s the safest, most healthy implant to put in your mouth, in my opinion.

That being said, there are situations, like if I am working with very thin bone or certain bone type, a titanium implant that is mixed with zirconia, they have ones that are titanium/zirconia alloy. I am 100% okay with those because sometimes, you have to take the balance and weigh the good with the bad. Do I need teeth to eat? Yes. If I don’t have teeth, I need to have implants placed. If the titanium ones are the ones that are going to connect to denture the right way, which titanium has the best connections, zirconia can’t handle the type of forces on there quite yet. I’m sure they will get there.

The titanium zirconia alloy ones, we use in our practice because we find that people are not reactive to them, especially moreso the traditional titanium implants that have a titanium nickel alloy. That is my problem with traditional titanium implants. It’s alloyed with nickel. Titanium itself, while it’s a metal, is probably biocompatible. We use them in knee replacements all the time. People tend to do it pretty well. Titanium is not strong enough on its own. It needs to be an alloy of some sort in order to be strong enough to handle the forces in the body, like chewing.

Preference is always zirconia implant. 7/10 times, we are placing a zirconia implant. 3/10 times, we might need to place a titanium zirconia mix in there. They are okay. It’s not my 100% favorite, but I’m okay with it. If my mother needed one, I’d be fine putting it in her mouth.

Dr. Eric O:I didn’t realize that titanium implants weren’t pure titanium. You’re saying it’s titanium and some nickel in there.

Dr. Eric K: Most metals are actually pretty brittle on their own. Titanium especially. It will be malleable and bend and shatter. It won’t be able to take that tensile strain of chewing. It has to have some sort of alloy to strengthen it and make it flexible and give it some other properties to it. While somebody might advertise 100% pure titanium, that is patently false. There has to be some alloy in there.

Dr. Eric O: Thank you so much for sharing all this information. Anything else that you want to share? You shared enough, so it’s fine. We spoke longer than intended.

Dr. Eric K: No, you’re good. The message I have for people is just always do your research. My brother and I take our holistic dentistry very seriously in terms of how we treat people. if you can’t find someone who does that, if you can’t vet them properly, and they can’t explain what makes them holistic, or if they offer you a root canal, or they aren’t questioning these things, then you need to find someone who does. Don’t settle for your practitioner. Don’t settle just because somebody lists themselves as holistic. Do your research.

I tell my patients all the time don’t just take my word for things. I know a lot about dentistry, and I have done my research. Please do your research on your own. Question what I’m asking you. Ask me to show you proof. You should be asking every doctor that stuff. If they get mad at you, they are not the right person for you. Just make sure you do your research with it.

If you ever have any questions, or if anybody wants to contact us, it’s KempterDentistry.com. Our email address is Info@KempterDentistry.com. You can reach us there.

Dr. Eric O: You have locations in Concord, North Carolina, which I used to go to before you opened the location in Charlotte, North Carolina. Awesome dentist, or else I wouldn’t continue to go.

Dr. Eric K: Appreciate it.

Dr. Eric O: I have seen other dentists over the years, including other biologic dentists. Very open to questions. I mainly see Dr. Eric. When getting the implants, I saw your brother. I think I have seen all the dentists in your practice at one time or another.

Dr. Eric K: We have a good group here. We pride ourselves in training everybody the same way, having strict protocols, and keeping a high standard of care. We don’t get offended if you prefer other dentists here. I do work with my older brother, and I always say I’m the younger, better-looking Dr. Kempter. I always say come see me. He is a great dentist, too. He is my dentist.

If anybody needs more information, or if you want help finding someone in your local area, you could always shoot us an email. We’d be happy to help.

Dr. Eric O: Thanks for sharing your knowledge about biological dentistry. I look forward to my next teeth cleaning. I think it’s a few months from now. I appreciate this.

Dr. Eric K: You’re welcome. It was my pleasure. I look forward to seeing you in the office soon.