Stress and Autoimmunity (Part IX)

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Stress is something that is unavoidable.  We will all experience stress on a daily basis in some way shape or form.  Stress can be anything from mental and emotional stress to exercise and food sensitivities.  All of these things have a breakdown mechanism in the body that elicits the the same physiological response.  Stress activates the autonomic nervous system and you can’t control this.  It’s very difficult to recognize that is happening and actually stop it.  For example, when you lie, your body has a stress response.  This is the reason people say “Secrets keep you sick.  Or Secrets kill.”  This is the exact reason we use lie detector tests!  You can tell your conscious brain to settle down or you’re not nervous all day long, but most of the time, if it is stressful, you still express stress physiologically.  Your palms get sweaty, your voice may waver, your heartbeat increases, and you breathe a little more rapidly. We use those to our advantage to detect stress but what about the hormonal response?  The release of cortisol, the decrease in immune cell production, the disruption in hormones and catecholamines?

The more you experience stress, the more your body runs on sympathetic (fight or flight) dominance.  This leaves you feeling like you wish you could just disappear tomorrow.  Maybe disappear to an island far far away where you could be in silence.  This is often why most people cry at the thought of coming back from vacation.  You body is exhausted from living in this state and if you fall asleep on the couch an hour after coming home from work, you know what that exhaustion feels like.  This is probably hitting home for a lot of you right now in a very doom and gloom way.  Why? Because heaven forbid you have an autoimmune disease, feel there’s no way to get away from stress, you are slowly killing yourself, and there’s nothing you can do about it.  I’m here to tell you that without changing your situation at all, you can reduce stress.

The most important thing you have control over is your thoughts.  They will creep in and try to dictate, but simply recognizing that and repeating what’s really happening in that moment, you won’t get carried away by “what ifs. ”  I see this a lot with people when it comes to work relationships.  A boss said something the wrong way so the employee gets instantly freaked out that they may lose their job, and if they lose their job they will have no money, if they have no money they will lose their home, if they lose their home then their kids will get taken away, then they will have no insurance and they’ll just die because they won’t have any healthcare options for their illness.  STOP!  If this is the type of road your mind takes you down, get good at recognizing when you start down the path.  Bring yourself back to present.  Close your eyes and breathe deeply in one nostril and out the other.  Do not let yourself entertain ideas of things that may or may not happen UNTIL THEY HAPPEN.  The funniest part is that I have asked every single person whether any of these things have actually happened and not a single one has lived this story.  All that time slowly killing our cells over something that has no real likelihood of happening!

Step one is controlling your thoughts from spiraling down a path of worst case scenarios.  The second step is to smile and laugh.  EVEN FAKE ONES.  You heard me right.  There’s also a proverb that laughter is the best medicine because it REVERSES the physiology of the stress response.   You could say that it’s impossible to be stressed and joyous simultaneously.  Go to a funny movie, watch a hilarious youtube video, talk to your friend about old time shenanigans, go to a comedy show.  Smile at everyone you see.  When they are real, they have a huge impact.  When they are fake, they STILL have the same impact.  Laughing reduces cortisol, soothes the nervous system, and improves hormone regulation.  In our society, we tend to become more and more isolated by technology and busy schedules.  Keeping your social connections is so important.  It is not a luxury.  It’s actually good for your health!  I may even dare to say that having a beer with a good friend has more positive effects on your physiology than negative despite the fact that your consuming glutinous alcohol!  That’s how important these things are to your health.  Even a tough love doctor is telling you laughing with friends is possibly more important than what you eat in some instances!

That brings me to the third thing that you can do to reduce stress.  Exercise outside.  We can make this life scenario even more appealing by saying “Go for a walk with a friend, tell stories, laugh, and “touch” goodbye.”  I say “touch” because anything from a hug, a high five, a kiss, whatever, it all has a positive impact.  Movement helps distract the nervous system from obsessive behavior.  It likes to move forward.  You see this with dogs, too.  They are much more behaved in a pack, walking because it is calming to their nervous system.  We are animals, too.  Going to a group fitness class is the same thing.  Moving with friends, laughing, and making connections.  Doing some of this outside is that much better because of the air quality and restorative nature of nature.  No pun intended. ;)

The last and final thing you can do is engage in physical touch.  In my profession, I would be touching people all day long.  However, sometimes patients would come in and that would be the first touch they experienced all day.  I am not a touchy feely person, but that doesn’t mean I don’t experience the same physiological effects of touch.  I’m just more choosy about who I touch! hehe, I couldn’t resist.  Back on track.  Hug your child or spouse goodbye, hug a friend when you see them, get a massage, go to the chiropractor, hire a professional cuddler (that really does exist), have sex or kiss your partner.  These things are not luxuries either!  They are hugely necessary to our well-being as humans.  They counteract stress.  We are hardwired to need touch.  Think about yourself as a child.  Everyone wanted to hold you, give you kisses, touched you constantly to help you maneuver the world.  Then you became a little more developed and touch can be misconstrued as sexual so it happens a little less.  That is until you go looking for it from a teenage boy/girl.  What if you find yourself as a single adult.  You may literally go days without touch.  Heck, the way we greet people in ANY country has to do with TOUCH.  Maybe its a handshake or a kiss on the cheek.  May it’s a hug.  It has and always will be imperative to normal nervous system function.

These are simple, free, yet hard things for some people.  For those less expressive, it may be good to start with the thoughts and movement.  From there start planning social activities to get out there and connect with friends and family!  If you are a single person with an autoimmune disease, even seeing a massage therapist can gain you touch benefits.  Hope you guys are enjoying the series as it is coming to an end!  I will have one final article to address a few questions people had for me.  If you have a question you would like answered in that article, please let me know!

 

Why I Call Myself a “Belief System Doctor”

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Every single thing you do in life is based on a set of beliefs.  Some decisions are deep, important, and based on belief systems instilled in you at a young age maybe through parenting, religion, or early schooling.  Some decisions are made on less significant belief systems that often dictate preferences and things formed by direct experience. From the moment you wake up to the moment you go to bed, you make hundreds of decisions a day.  You wake up because you believe it’s important to get up and tend to your morning responsibilities.  Maybe you believe it’s extremely important to be early.  When you decide to eat breakfast, you probably have a belief about whether this is a healthy behavior or necessary.  You also make decisions about what you should eat.  These decisions are based on taste, how the food will make you feel, whether you believe it to be good/bad for you.  This decision making process is fairly subconscious because we would be exhausted if we felt as though every tiny decision needed a huge weighing of the pros and cons.  We have all met people like that, and most likely you were exhausted after an hour!  In order to bypass this, our brain forms belief systems to help that decision-making process effortless and energy efficient.

When it comes to health, nutrition, and food, where did you get your belief system?  It starts pretty early with taste preferences based on what your parents fed you.  If you grew up in another country and only had exposure to ethnic foods, you would likely have preference for those.  If you grew up on processed foods, you likely believe these foods to be what people eat.  This is one reason why I encourage parents to keep whole, nutritious foods in the house.  The more your kids expect to find these foods, the more they believe those foods are what they should eat.

You then get information from other homes based on what other parents feed you, babysitters, school, etc.  In school, we take it one step further and teach you the basics in health class.  Health class will often have some version of the food pyramid available for your viewing pleasure.  This is when you go home telling your mom and dad about all the foods you should be eating on a daily basis.

In later years of school, you have peers that will influence your food decisions just like they influence everything else.  Maybe someone makes fun of the food you eat at lunch and you then believe those foods are weird, not cool, or things no one else eats.  Maybe you share foods at lunch, and develop beliefs about foods based on the people who bring them.

Then you graduate and go off on your own.  Now you are making real decisions about what you will spend hard earned dollars on.  Now there is input from media, commercials, billboards, celebrities, athletes, and so on.  If your prior beliefs prioritized whole foods, you will likely continue to buy them and not think twice.  If your beliefs up to this point were steeped in convenience, marketing, expense as ways to prioritize, you will likely follow the fast food frenzy with a side of packaged treats.

At some point you decide you aren’t invincible and maybe you should try to be healthier because you have gained weight or watched Dr. Oz.  This is where confusion hits the fan because up to this point, you brain had no problem choosing foods it enjoyed, prioritized, and could afford.  But now, you may be trying to force yourself to eat things that you don’t enjoy, think are too expensive, or are completely too much work.  This contradiction in beliefs and behaviors will end in failure every single time.  Most people will revert back to the same old habits because they haven’t changed their belief system.

My job, as a doctor, is to help recreate the belief system that accurately depicts the consequences of food choices, the knowledge around nutrient density, debunk the lies that have been fed to you over the years.  Once someone truly learns what certain foods do to their body, what health consequences they see as a result, the truths revealed about why certain foods are so cheap and convenient, they no longer have the same belief system.  They now believe eating packaged foods is going to result in sickness, possibly weight gain, toxicity in the body for generations to come, and is slowly hindering the functioning of every cell in the body. They understand where real nutrients come from, how important those nutrients are for healthy bodily functions, and how every penny spent on prevention saves hundreds in treatment.  If you can change someone’s belief system, then you change their behavior by default.  This is why every patient leaves appointments with me with HOMEWORK.  The real work happens with the belief system.

One of my favorite questions to ask is “What is your favorite food?  What if I were to serve you that food but I placed arsenic in it?  They look at you like you’re crazy and say they would never eat it if you put arsenic in it.  But let me ask you why because arsenic has no flavor, no texture, no smell.  It won’t change the experience or enjoyment of eating your favorite food.  All I did was change the perception of what that food would do to you.  Boom.  Instant change in belief system and you just said “No way, Jose “to your favorite food.  I didn’t change that food. I didn’t take that food away or say you can’t have it.  But I did change your belief system.  Now you have a different perception from which you decide to make that choice.  If you have tried to eat better, exercise more, and make healthier decisions in general and found yourself reverting right back to your old ways, it is because you didn’t change the belief system.  You were working on willpower and that will only last for so long.  Knowledge is power because it develops belief systems.

Autoimmunity and Exercise (Part VII)

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At this point in the autoimmune series, you can understand why I was reluctant to write an article in the first place! It is so complex, complicated, and multifaceted. So, if I were going to touch on another lifestyle change someone can easily implement, it would be exercise. Unfortunately, exercise is one category where you can have too much of a good thing, especially if you suffer from autoimmunity. There is a point where movement is healthy, beneficial, and will IMPROVE your immune system. On the flip side, if someone’s system is under extreme demand, their adrenals are shot, and they are often stressed, you can easily overdo it. Then the question becomes, what types of exercise are best, and how much.
Exercise is very closely related to your adrenals and the production of cortisol. Cortisol is a steroidal hormone that helps you keep up with stress and is important in the fight or flight response. These spikes in cortisol production should be short-lived and not chronic by any means. However, many of us live stressful, hectic lives and some add tons of exercise on top of it. This is a recipe for adrenal fatigue, and if you want to read more on that, click here.  The more intense you exercise, the more cortisol you release.  This disrupts something we call the HPA axis, which is important in regulating hormones and the immune system.   The types of exercise that stimulate the HPA Axis disruption the most are chronic cardio and and high intensity exercise.  That means that if you have an autoimmune disease, you may be doing more damage than good if you try to run marathons (or any long distance) or Crossfit.  It doesn’t mean you can’t participate in these workouts, but it does mean you need to be smart about it!  Resistance training does not have the same effect on cortisol if it is practiced alone.  This means that weight lifting or body weight movements at lower intensities may be a great option for those with autoimmunity or adrenal fatigue! If you decide to participate in physical activity that is too strenuous for your body to keep up with the cortisol production, guess what, you can CAUSE LEAKY GUT.  We talked about how leaky gut is how this whole thing got started in the first place!  It’s a classic case of too much of a good thing.  Balance is key and more doesn’t always mean better.

As far as how exercise affects the immune system, it can cause a huge inflammatory response.  Any exercise someone does at more intensity that usual for longer than usual, is mobilizing neutrophils and natural killer cells.  This type of exercise also stimulates phagocytosis and increases the production of inflammatory compounds.  In studies, we see that following acute exercise,  the number of T and B cells (immune cells) drop below the levels they were BEFORE every working out.  This quickly recovers if someone has adequate recovery time.  However, if there isn’t sufficient days between these types of workouts, then it is common for athletes to get sick!

Now we understand that we may need to back off the intensity, how often should we be working out if we have an autoimmune condition?  I like to say High Intensity work should not be done more than 2 times a week.  That would include intervals, Crossfit, intense cardio.  You should leave at least 2 days between those sessions for proper cellular repair and recovery.  In between, yoga, walking, leisurely biking are all amazing, repairing options.  You can also add some resistance training  like weight lifting or body weight movements like squats, push ups, pull ups, etc to the mix.  The key here is to keep your heart rate down when you are avoiding high intensity.  This may mean doing less initially which seems counter-intuitive because we all want to look good naked. However, chronic cardio and too much high intensity activity are driving your adrenals into the ground.  Once that happens, your body will begin taking building blocks from hormone production in order to try to keep up with cortisol production.  It doesn’t care how fertile you are, heavy your periods are, or how horny you are if it is trying to survive a flight or flight experience! As far as our genetics are concerned, stressful situations are life and death.  That is why de-stressing is so important.

If you have cut out gluten, upped your fat soluble vitamins, addressed you stomach acid, and quit taking miscellaneous medications, this could be your next step in the equation.  Exercise should be a positive challenge to the body.  If overdone, it most definitely acts in the opposite direction.  Choose something FUN.  I like group classes because community makes every second fun for me.  I really enjoy sports. Join a sports club.  Take family walks.  Movement does not have to be a dreaded to-do on the endless list.  It should and could be something you ENJOY and LOOK FORWARD TO!  If you haven’t found that type of movement yet, then keep searching.  Different strokes for different folks.  The more you can do outside, the better, too.

Want a Glimpse? I Will Share One With You….

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As I wake up every morning, I decide what inspires me, I post something about it, and I get up to start the morning coffee. The first moment that coffee hits my lips, may be one of the moments I look forward to the most. It is part of my perfect day, and I savor it, I enjoy it, and it’s simple enough to have every day for the rest of my life. That certainly makes for a lot of perfect moments. Then I check my emails, texts, messages, which can equate to a good hour sometimes. I never have any idea what sorts of things are going to pop up in those updates, questions, or inquiries. I am blessed to say that 90 % of the time, I get to have good news flood my technology for the first hour of every day. This past week, I have been cracking up, smiling, tearing up at some of the things so let’s just visit some of those. Let me give you a glimpse…

A patient that we have been working with her adrenals and anxiety:
“No anxiety. No depression. No anger. No eyes watering. No headaches. I feel empowered.”

A patient that has Hashimotos:
“This may be TMI, but I had sex 3 times and actually wanted it.”

A patient that has anxiety and apathy:
“You are turning me into a nerd! I am sitting here reading a cookbook! What have you done to me!?”

A patient with anxiety, thyroid issues, and high blood pressure:
A pic of a pill on the counter and the text “I had that in my back pocket and didn’t have to use it!!! Thank you!”

A Hashimoto’s patient with kids:
“I made your chicken strips…holy delicious!”

An anxiety patient:
I feel so much more even and steady if that makes sense. ;)”

A consult with a patient that has MS:
“I feel healthier now than when I was diagnosed with MS!”

A consult with a patient that has Ulcerative Colitis:
Tears….many tears. Because she’s exhausted from trying to do the right thing all the time. I’m grateful she called me for help.

A consult with a patient who has anxiety, some bowel issues, and knows something isn’t right since having her child:
“I don’t know why I didn’t just do this sooner. I’ve been meaning to call you for over a year.”

A meeting with a colleague:
“I hear you’re a really good adjuster from patients that have seen you at the other office.” (Well that just made me blush.)

I really could keep going on and on. Every day I could share a story of inspiration, strength, exhaustion, renewed hope, relief, health, struggles, and triumph. This is my life. My life everyday before 10am. I live a pretty great purpose. I have so much to share sometimes that I am paralyzed by which one I should put out there?! I have so much information to get to you, that I sometimes I focus very heavily on the science articles. Sometimes I just want to give you guys tips, things to do TODAY. Sometimes I just want to sit and drink my coffee with a smile because I am blessed with a gift and amazing people to help me fulfill it. Not very often, but sometimes I am speechless. When that happens, I just soak it in. Feel every good feeling there is to absorb. I will need it to help the next patient through an obstacle, a hard moment in the journey, a setback. They may have met me at the beginning of their journey, but I will find a way to let them fly and meet them at the finish line. I am overwhelmed with pride when it comes to each and every person I work with. No one can see me right now, and I’m not an overly emotional person, but I will take every tear welling up in my eyes right now knowing what they stand for. What they have been fighting for. What joy they represent. I hope every single person reading this finds that in their life. Don’t lose the pursuit. Listen to your heart, no matter how crazy it may sound at times. Entertain the dream.
Maybe next time I can get through all the amazing that happens AFTER 10am. ;)

The “Yes” That Changed My Life

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I probably think about life too much, ponder issues in the world excessively, and spend too many hours nose deep in research; however, I make no apologies because that is who I am.  When you know who you are, your actions are very distinguishable as yours.  You are driven by forces that keep you from conforming.  If there were no money or recognition in the world, you would still be the same you, doing the same things. This makes success fulfilling.  When we look at people who are successful in whatever sense of the word “wealthy, accomplished or happy, fulfilled,” you will notice that they have a couple things in common: 1. they failed over and over 2. they often had one “yes” or “ah-ha moment” that changed their trajectory.

I have thought about this for myself.  I have gotten so many messages since opening up my practice to social media about how I inspire people, how I’ve helped people, how people are jealous because I have their dream job.  When I think about how I got here, it’s not like there was magic, or a template of how to do it, etc but I do fit the two criteria that I spoke about previously: I failed over and over, and I had a “yes” that while small, was probably the one that changed my trajectory.

When I started college, I had been “following the rules of accomplishment” my entire life.  Any award you can think of, I earned it.  Highest grade you could get, I got it.  Any degree or letters available, I was in the running.  Why?  Because I thought that’s what made you successful in life!  Accomplish all this stuff and you will make good money, have nice things, have little to worry about, and live happily ever after.  Then I got to college where someone asked me what I wanted to do.  Insert blank stare. I don’t know what I said but I thought to myself how I know I could do extremely well in any degree, just tell me the most difficult and that’s the one I will pursue.  Good thing for me, pursuing a medical degree also had components that I found myself extremely interested in.

In college, I always had a job, if not 2 to help pay for tuition.  I took notes for disabled, I worked at the Finish Line, I was even a Bacardi girl.  Yes, hanging out passing out free drinks after getting off my first job. In addition to working, I applied for every scholarship under the sun.  Let’s just say that I spent more hours trying to prove why I was worthy of a donation than I care to admit.  I failed over and over.  I’m not exaggerating when I say OVER AND OVER. It may have been my first real sense of rejection.  The kind that sort of says “You were great in your small town, but you’re in the big leagues now, and you aren’t good enough this time.” Ouch. I was terrified about the debt I would be graduating with and often contemplated leaving. (If I’m being honest, my mom forced me to take the SATs and apply to ONE college or else I wasn’t even going to go! That’s how much I was afraid of student loans!) Then one day I applied for something different.  I applied to be accepted into a 400 level biology course that allowed you to study in Costa Rica.  I specifically remember filling out the application asking myself why I was doing so.  They had NEVER accepted anyone as a sophomore and I had barely even declared a major.  Oh well, the worst they can say is “no, thanks.” As if I hadn’t heard that enough lately.

They didn’t say “no, thanks.”  They said “congratulations on being accepted as the youngest person to get into this program.”  I was PUMPED!  I was going to study in the rain forest.  Peace out!  What I didn’t anticipate, but was how that one “yes,” would snowball.  Not only did I make huge decisions about what I wanted after that trip, I met the people that I would then take my medical mission trips to Honduras with.  I would then sit on the board of that organization.  I would then have several experiences that primed me for the Peace Corps.  I would then use those moments to get accepted to my doctoral program where I would teach anatomy and physiology labs.  I used that degree to become the doctor I am today and the teaching experience to become a professor at our local college.  I know who I am because the qualities that make me, me, drove me to the “yes” that changed my life.  If they had said “no, thanks” I have no clue what might have happened.  Would I have applied again? (probably), would I have given up?, would I have changed career directions? would I have quit college because of money?, would I have ever met the same people that led down the same path?  I don’t know.  But I do know that when you are being you, doing the things that make you, you, it all happens the way it’s supposed to.  Those things may lead to perceived failure; however, the beauty of “doing you” is that you aren’t doing it to please others.  You would’ve done the same thing if no one was watching. I have heard “no thanks” and failed many more times since then, I assure you. Those moments may matter just as much as the one “yes.”  They open the door for that “yes.” Do you want to be successful?  Be you, fail over and over, and be aware of the moment you may need to grab a hold.  It could be the catalyst for everything to come.

Medications and Autoimmune Healing (Part VI)

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Before we get started, let me say that I am not rendering advice on what to do with your medications in this article!  I am simply going to explore how some common medications may be obstacles in your healing process.  If you have followed this journey, we started with how an autoimmune disease happens, touched on the involvement of heartburn, gluten, nutrient deficiency, and discussed how leaky gut is involved.  Most of the medications I talk about, I will place in the category of things you can control.   That means I will not be talking about immunosuppressants or other common autoimmune meds; I will be talking about drugs like: antacids, antibiotics, birth control, steroids, and pain relievers. Let’s get started with heartburn meds because we talking about heartburn and stomach acid one of the first articles.

PPIs (aka Nexium or Prevacid) and H2 blockers (aka Pepcid and Zantac):

If you would like a reminder of how important stomach acid production is, feel free to re-read the heartburn article.  If we consider that any disease healing process requires adequate nutrients, we also must consider if we are able to get those nutrients based on the health and performance of our digestive system.  Stomach acid is a major component for the beginning of our digestion and without adequate amounts, we develop issues such as GERD, heartburn, H. pylori, and intestinal dysbiosis.  If you are taking a stomach acid reducer, you are hindering the first step in food breakdown.  This sets you up for impaired digestion, decreased nutrient absorption, possible infection, and leaky gut.  That’s a very basic understanding.  If we get more technical, PPIs have been shown to interfere with antigen presentation mechanisms by affecting lysosomes.  They also obstruct the work of cytotoxic C cells. These are IMPORTANT for immune function, so you can imagine if you have created the perfect environment for leaky gut, which can trigger an autoimmune disease, then impaired digestion setting you up for infection which can trigger an autoimmune disease, then took a medication for the heartburn that interferes with appropriate immune system functions…insert cry emoji here.

Birth Control Pills

I have spoken before in brief posts about hormone health and how taking the pill to correct hormone imbalance may be doing more harm than good.  I have also been vocal about the pill and it’s ability to significantly increase clotting risks in women that can result in strokes or pulmonary embolisms!  This is not a medication to be taken lightly, and from first-hand experience, I know these risks are not brought up.  I was speaking to a nurse the other day about how interesting pregnancy can be in autoimmune conditions and how that speaks to hormone involvement.  I have had autoimmune patients tell me their autoimmune condition completely goes into remission while they are pregnant, and they wish they could trick their body into believing it’s pregnant all the time!  Sex hormones play a role in immune system function, so the decision to artificially alter them, may be causing an immune system issue.  In addition to directly changing hormones, they cause disturbance in the gut flora resulting in dysbiosis and many times leaky gut.  Remember leaky gut being how autoimmune issues start?!

Antibiotics

Antibiotics save lives.  Period.  However, they are way over-prescribed and many people take them multiple times a year.  If you are doing everything right, it can still takes months for the assault of antibiotics on your gut flora to fulling repair.  If we KNOW that the bacteria in your gut account for the majority of your immune system, then how could you not be worried to take a medication that would wipe them all out?!  Antibiotics are often broad spectrum and will have no issues wiping things clean, good and bad.  Imagine having to rebuild your house every time it got messy.  That is the task you ask of your body when you take antibiotics for every sniffle, sneeze and infection.  It is often common for antibiotics to be prescribed without a culture which means your infection could be viral.  Viral infections are not killed by antibiotics.  Antibiotics kill bacteria.  Oops.  In a nutshell, antibiotic need may be more scarce than you think, it has a dramatic effect on the bacteria balance in your intestines, and they should be avoided if possible.

NSAIDS (aspirin, advil, aleve)

These anti-inflammatory drugs are non-steroidal but they are used widely to control pain and inflammation.  So widely, that you probably have bottles in your purse, your bathroom, your desk drawer, etc.  I can say that I don’t even have a single bottle of these around and if I needed one on some off chance, I would have to go purchase them.  Most people know the dangers of taking too much because your doctor will warn you about how bad it damages your gut, which can result in ulcers.  I hope this connection is screaming at you before I tell you….wait for it….if they damage the gut, and your gut houses your immune system, then it can’t be good for conditions concerning the immune system! A SINGLE DOSE OF NSAIDs damages the intestine of even a healthy person.  It does this by inhibiting an enzyme called cyclooxygenase which is essential for maintaining the gut mucosal barrier. They also inhibit the formation of the proteins that keep tight junctions together (remember that cell lining gate being damaged).  These drugs are popped like candy because most people see them as harmless when you can buy them in the store.

Well, those are the major ones I wanted to hit because so many people are unaware of the negative side effects.  If these are part of your “health” routine, you may be causing more damage than good.  If you have an autoimmune disease, these may be a part of your routine that you can control.  There are tons of natural compounds that fight infection and decrease inflammation.  These can be found widely in foods and many supplements now exist.  Try cooking with turmeric, adding garlic to everything, using onions abundantly, and fresh herbs are crazy good in the medicinal department.  Funny how all this complex material always lands us back at basic lifestyle changes.  Nature is so smart.

 

Wednesday: The Day Anything (stressful) Can Happen

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I totally got schooled Wednesday morning by a patient about Wednesday being the day anything can happen.  Apparently that’s from the Mickey Mouse Club?!  I’ll take his word for it!  What he didn’t know was that even though it was first thing in the morning, many “anythings” had already happened!  Since the toll road is having issues, I have been taking an alternate route to the office I am filling in for, which extends the drive a little bit, but is worth it if I can avoid sitting in standstill traffic.  Monday: fine.  Tuesday: raining but fine.  Wednesday: accident that shut down 94!  Ok, I left myself time.  Just take the detour maps gives you.  Detour route…closed.  Umm…now I am DEFINITELY going to be late.

In my younger years, this would’ve been disaster.   I had an agenda, planned ahead, thought of all the possible issues and accounted for them.  I would’ve freaked out for two reasons: 1. I am going to be late!  How bad does that make me look?! 2. I’m being detoured off the highway into some random place in Gary!  How am I supposed to know where I’m going?!  In my older age, none of this even bothered me.  It was sort of life’s metaphor for having a path, but not being stressed about detours.  You’ll get to where you’re going eventually.  I planned ahead, I was doing everything I could, and it DOES NO GOOD TO STRESS ABOUT THINGS YOU CAN’T CONTROL.  Getting worked up, upset, stressed, worried would not get me or anyone else anywhere faster!  How many times a day do things not go as planned?!  A lot!  Do you find yourself stressing about the circumstances out of your control?  That unneeded stress is killing you.  Well, maybe not you yet, but your adrenals.  They can’t keep up with the constant barrage of stress!  Give them a break!  They already have to keep up with stress over things you CAN control, vigorous exercise, caffeine, and all that wine you are drinking.  Quit demanding more from them or you will find yourself in a heap of hormone hell, eventually.

I wanted to tell you this story because this is an everyday situation like many that my anxiety patients would get into a tizzy about.  Always evaluate a situation calmly.  Things don’t get done faster because you are yelling, or crying, or complaining about how it didn’t go as planned.  Ask yourself one simple question: Is this something I can control?  If not, relax.  Do your best.  It is what it is.  Silly human.  To think you could control things in the world, sort of makes the universe laugh.  In my case, I used the extra time to turn up the radio and sing to my jams.  Not because I didn’t care that I would be late, but because I couldn’t control an accident that shuts down the highway and puts me an extra hour and a half behind!  When I showed up, I was more than ready to give 100% to my patients, good vibes for days, and it all worked out in the end.  I would’ve made my biochemistry a mess by worrying, and what kind of doctor could I be to my patients if my mind is stuck in panic mode over something  I can’t control.  Breathe.  You’re a tiny speck on a spinning planet in the middle of the universe.  It’s going to be ok.  I promise.

Vitamin Deficiency and Autoimmunity (Part V)

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For this section, I am going to focus on fat soluble vitamins specifically, which means vitamin A, D, E, and K. Fat soluble vitamins can be stored for later use unlike water soluble vitamins and tend to be the most deficient in the American diet for various reasons.  Each one of the fat soluble vitamins has potent effect on the immune system and therefore, deficiency in any of them, can put us on the path to immune system disorders (if we aren’t already there).  Fat soluble vitamins are found widely in animal products, so this tends to be a sticking point in the world of plant power.  Don’t worry though, even if you are a vegetarian, you can still get these vitamins without having to eat meat.  If you are a vegan, however, this may a trickier component to address.

Vitamin A. Vitamin A is important in the scope of autoimmunity because it is important for maintaining mucosal barriers.  You know just how imperative this is for the avoidance of leaky gut which is the precursor to every autoimmune disease if you read my previous articles.  Vitamin A also plays a major role in inflammation due to its connection with neutrophils, macrophages, and natural killer cells.  If someone has depressed immune system due to Vitamin A deficiency, they are at great risk for repeated infections.  One can always turn to supplements, but I would rather have someone get this nutrient through food.  I will never quit saying “food is medicine.”  You can find it in grassfed butter, liver, and pastured egg yolks.  If the animals producing these products are not eating their appropriate diet, however, these are not present in nearly the same quantities.  This is the reason I hit home the idea of food quality being worth every penny.

Vitamin D. Vitamin D is my favorite to talk about because most patients come to me with standard blood work including vitamin D.  This is a testament to the agreement among most all health professionals how important it is! We have the most research on Vitamin D; therefore, we know it plays key roles in the expression of over 200 genes and the proteins associated with those genes.  We need it for mineral absorption and bone health.  Vitamin D is essential for healing via its pathways that help cell growth.  AND, it is important in immune system regulation.   Vitamin D is so closely linked to autoimmune diseases that it has been suggested the deficiency may be the  CAUSE (via environmental trigger) of lupus, diabetes type 1, MS, rheumatoid, psoriasis, and IBD.  We see geographic implication too when we consider RA.  We know for a fact that stats show higher rates of RA the further away from the equator.  Why would this matter?  Because most Americans are relying on sunlight as their source for Vitamin D production.  It is synthesized from cholesterol found in the cell membranes of skin cells when we absorb UVB rays from the sun. Someone reading this may be thinking “Great!  I’ll go get some Vitamin D supplements today!”  I wish it were that easy.  Vitamin D works alongside other fat soluble vitamins in addition to plant nutrients  and hormones.  Just taking a Vitamin D supplement doesn’t address the increased need for the other nutrients.  This gets crazy and complex in the world of supplementation.  You’d take 1,000 supplements and still not touch all the things you get from real food.  Additionally, if you didn’t address the dietary aspects like wheat, then you are ingesting foods that actually reduce Vitamin D in the body! Lifestyle matters.  There is no shortcut to going outside in the sun, ingesting healthy fat sources, and avoiding toxins and inhibitors.  Let me repeat: there is NO DRUG OR SURGERY that can make up for a lifestyle issue.  Period.  *Vitamin D levels for someone with an autoimmune disease need to much higher than the general population; therefore, being within normal range is not adequate!

I’m going to skip Vitamin E and say a quick word on Vitamin K because this one tends to be gaining clout in the health industry. Vitamin K is also essential for bone and tooth health and studies are being done on its link to osteoporosis for this reason.  It also plays a role in protecting against oxidative damage and regualtes the immune system.  Unlike other fat soluble vitamins, you can get this from fermented foods in addition to pastured animal products!  Bacteria produce this when they are doing their job and therefore, your bacteria in your gut can also make Vitamin K in your small intestines by converting K1 that they find in your leafy greens!  Let’s hope you haven’t been taking antibiotics regularly, or you may be at a deficit here, too.  Your bacteria levels are so important, and anything working against them is also helping the disease pathways catapult.

So, let’s just think about this full circle for a moment.  You were born with genes that give you a predisposition for some of this.  However, you don’t have it expressed necessarily unless you create the right environment.  You create that environment by taking antibiotics, heartburn meds, staying away from the sun (or blocking it), lacking grassfed animal products in your diet, eating things like wheat (possibly every meal!), and we haven’t even talked about the connection of stress! or exercise!  or sleep! or chemical exposure! You can now see why we have taken a massive wrong turn in our society when it comes to our food supply providing us nutrients, our lifestyles prioritizing stressful and depleting behaviors, and then our tools for correction are not addressing the underlying causes.  That is why we are not getting better.  That is why people get sick and stay sick.  That is why, despite the fact that I am ONE PERSON, I am on a mission.  Even if you read this and never do anything about it, I have done my job.  I am not here to make a decision for you.  But if you choose the same decision given all the information, then at least it’s informed decision making.  That’s more important to me than anything.

The Golden Spiral: Nature’s Evolution

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Recently, I have become obsessed with something known as the logarithmic spiral, aka “the golden spiral.”  I’m not a math geek, so I won’t go into the formula, however, I do want to explore the meaning.  The other day, I decided to wear my nautilus shell to work.  I very rarely wear any jewelry that doesn’t have some meaning to me.  You’ll very rarely ever see me wearing rings because I use my hands with patients, the barbell isn’t kind to any sort of metal, and sand has an uncanny way of getting forever wedged in crevices. Therefore, I prefer bracelets and necklaces.  As I  put on my necklace, I started reflecting on what the shape of the shell really represents.  The Swiss mathematician, Bernoulli, said it best when he described the spiral as representing the latin motto: Eadem mutata resurgo.

In Engish, this means “Changed and yet the same, I rise again.”

A logarithmic spiral gains speed as it moves further from the center.  It’s shape remains the same but it’s growth is exponential.  This is a direct reflection of organic growth.  You see it in the Milky Way, romanesco, plants, the nautilus shell, etc.  The bigger these things become, the faster they grow. This pattern is also seen in people and their lives.  I work with so many patients that have stories, stories of misfortune and triumph, stories of change, stories of loss, stories of life….

Everyone has a story that represents them and their journey thus far.  From a small child to the point in time which they are alive today, they are the same being.  They have the same DNA, their soul is the same soul that entered this world; however, they are larger in form, and have grown exponentially in spirit.  Every trial, every triumph has compounded itself to growth that is bigger than the lesson before.  People change, yet are still the same.

I am no different from everyone else.  I get giggles and crazy looks when I talk about how I can’t wait to be 40, 50, 60.  I say this because I have enjoyed my entire journey of life thus far and have grown exponentially with every day, every experience, every gift, every fail, every breath.  I can only imagine how much wiser I will be if I continue on this path of exponential growth.  Everything I have done up to this point has created a foundation for the growth to come.  I never thought I’d be where I am today based on the foundation I put down 10 years ago.  For this reason, I never try to predict the future, yet I am excited for its arrival.

I am so grateful to be on the journey of life changes with patients and I see this growth with my own two eyes on a daily basis.  From the day I start working with my patients to the day they are released, they have changed, yet are the same.  They rise again as a changed being ready for the next chapter.  They will change again at some point.  However, through all the change, their core being is still the same.  Nature is my constant source of inspiration and I couldn’t have said it better when it comes to this golden spiral.

Adrenal Fatigue: Understanding Cortisol

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This is a condition that really doesn’t discriminate between healthy and unhealthy individuals.  I have had countless patients end up at my door with relentless fatigue when they believe they live a healthy lifestyle.  They workout, they don’t eat excessive carbs, they have successful jobs, and they take their daily supplements!  Then why are they SO tired all the time?!  These cases are almost always issues with cortisol production and the ability of the adrenals to keep up with stress.  Athletes especially can be affected by this issue because of overtraining, chronic stress, or lack of appropriate recovery.  Sometimes less is more, but let’s take a look at what actually happens in someone with adrenal fatigue.

Adrenal Glands: You’ve go these two little organs that sit on top of your kidneys that are responsible for releasing epinephrine and norepinephrine, aldosterone, cortisol, sex hormones, and precursors such as DHEA.  Cortisol is a steroid hormone that is responsible for all kinds of things in the body including:

  • mobilizing protein stores
  • water excretion and electrolyte balance
  • mobilizing fatty acids from adipose (fat tissue)
  • precursor to cortisone (and anti-inflammatory agent)
  • directing immune function
  • stimulation/inhibition of gene transcription
  • affecting bone calcium
  • affects behavior, mood, and hormones
  • affects numerous CNS biochemistry

Basically, it has a hand in tons of things.  Like most body chemistry, it is definitely not on an isolated island!  When stress levels are high, the demand for cortisol production goes up.  However, the building blocks are things like progesterone and pregnenolone which are needed for the production of other hormones.  When your body starts stealing these building blocks to keep up with stress, it will eventually let your other hormones like estrogen and testosterone suffer in order to keep up.  This is important because many people are known to have hormone imbalance, but if you never assess the adrenals, how do you know this isn’t the reason?  If it is, then the answer is not hormone replacement, the answer is stress reduction that will in turn lower cortisol demand.

When you start thinking about how important hormones are to the body, one may ask why on earth your body would make that kind of sacrifice?!  The simple answer is that our body is still expecting stress to be a short-lived event driven by a life or death incident.  In that moment, we would sacrifice anything in order to get out alive.  We never adapted a mechanism to take care of chronic stress.  Stress that never goes away. Stress that takes all we have.  Stress that leaves us feeling defeated at the end of the day and dread the start of the next.  Am I ringing any bells here?  Life is HARD these days!  We have all kinds of stress!  Work!  Kids! Relationships!  But, we also have stresses that people don’t think about like food sensitivities, sleep deficit, overtraining at the gym, and infections.  There are ALL stress to the body.

This is how people can function from day to day, still go to the gym, think they are doing it all, and still feel like crap.  When I run cortisol panels, it’s not uncommon for me to find cortisol levels that are in no way keeping up with the demand.  There are symptoms many complain about:

  • hypoglycemia
  • chronic fatigue
  • ligament/cartilaginous injuries
  • depression/anxiety (this one I see a LOT!)
  • insomnia
  • irritability
  • short term memory issues
  • pain that persists
  • poor wound healing and workout recovery
  • frequent colds
  • hypothyroidism (tons of my ladies out there have this along with adrenal fatigue!)
  • PMS
  • infertility
  • menopause symptoms (can we say hot flash club?!)
  • insulin resistance
  • fat around the trunk

The test for this is pretty simple, but it’s important to have it checked multiple times throughout the day.  So, many physicians will test it once.  That is not helpful unless there is pathology.  We are looking for optimal function.  Therefore, we want to see a high number in the morning and a gradual decrease until it bottoms out at night so you can go to sleep!  If we don’t see that, we need to assess where we are in order to know where to go from there.  In the early stages, people will make too much.  They usually don’t come in for help at this stage because they are “keeping up” as far as they’re concerned.  By the time we hit stage 2 or stage 3, we are starting to not be able to keep up and we start stealing those building blocks from other hormone pathways.  THIS IS USUALLY WHAT BRINGS THEM IN!  On top of fatigue, they now have stray hairs growing in random places, excessive fat that won’t budge, inability to recover from their workouts, trouble sleeping, up and down emotions, loss of sex drive.  At this point, we can’t just fix it with food, typically.  We need to “help your body over the hump” so it can catch up and produce enough cortisol again on its own.  This not only takes time, it takes lifestyle changes that may include cutting things out that are contributing to stress.  This is the toughest thing for patients to do.  If they don’t workout as much, say no to responsibilities, sleep more, etc, they feel LAZY!  You wouldn’t call a cancer patient LAZY!  This is taking care of yourself, and I can’t stress it enough (no pun intended).

If this sounds like you, and you like help, my door is open.  The saliva test I use to measure cortisol, DHEA, hormones, and melatonin is around $200 and it is done at home.  Doesn’t get much easier than that for a little piece of mind and direction.