Transcription
Hey everybody, thank you for joining, joining me for this Kalish Institute webinar, brought to you by myself, Duncan McDonald, from Origins Medicine. I am senior faculty at the Kalish Institute, so me and Dan Kalish are teaching all of the classes. And I wanted to start doing a number of webinar series about sort of common health complaints, common health conditions, and how functional medicine really has the ability to get to the root of of some of these issues, and thus, by getting to the root to them, we can actually do something about them.
I wanted to ask a favor, though. If someone wouldn't mind typing into the the chat box if you can hear and see me okay, just want to make sure that I'm not talking to a blank computer. Okay, awesome. Thank you. That happens more commonly than you might expect, and there's nothing more embarrassing than talking for like 15 minutes and realizing that nobody can understand a word that I'm saying.
So today, we're gonna be talking about autoimmunity, and we're gonna be looking at it from the perspective of functional medicine, which means that we're looking at a systems-based approach to a health issue, and we're using kind of advanced testing in order to try to uncover what some of the root causes are. And I'm going to try to get through this at a reasonable amount of time so that I can answer any questions that you guys might have at the end. Okay, so definitely, if you have questions, even if you have a question during the time that we're talking, I might not pause at that moment to answer it, but if you type it into the chat box, I will certainly try to get to it at the end of the presentation so that I can, you know, address everything that that is concerning you guys. Or, you know, a lot of the material we're going to cover here, depending on how much of Dr. Kalish's previous webinars you've watched or exposure to other functional medicine thought, some of this might be a little bit like, in terms of sort of showing you what is actually underlying some of the the autoimmune processes in the body. And autoimmunity is just one of those things that the more we look and study, the more we realize that this is a key component in most inflammatory health issues. So even things that you might not think are autoimmune can have this autoimmune component to them when we when we look a little bit deeper.
So once again, I'm Duncan MacDonald, and I practice both functional medicine and Chinese medicine in San Francisco. I also do telemedicine. So for people who are looking for functional medicine support and you don't live in the San Francisco Bay Area, that is no problem. We can always support you via telemedicine. Dr. Koh also does telemedicine as well. And yeah, it's good, it's good to this huh.
So I wanted to start by, so just one other thing about my background. So I've been in practice for 20 years, okay? So I'm not new to this. I've seen it clinically all the time. In terms of autoimmune diseases, Chinese medicine is also a systems-based medicine. So Chinese medicine and functional medicine really fuse together, interplay like all these advanced lab tests and stuff that we have that we test hormonal status or like these would have been part of Chinese medicine if it existed 500 years ago. It's it's just another way at looking at root cause pathology and correcting systems, right? Functional medicine is called functional medicine because we are restoring function to body systems that have been maligned by by some type of cause needs to be investigated. Oftentimes, people will refer to functional medicine practitioners as like health detectives or health sleuths, and that's very true. Like a big part of what we do is is always asking why, why is this happening, why, you know, what do we need to do to identify it, and how do we correct the furthest upstream that we can from the problem so that everything else downstream from it has the possibility of normalizing. If you don't take care of root cause pathology, it is extremely hard to get people better and have them stay better, okay?
So we're gonna look at this a bunch, and there is a like a whole lot of stuff that can cause root pathology that a lot of us never think about. I'm also gonna try to share with you guys some lifestyle tips that you can incorporate now to try to improve an autoimmune condition you have, and then also perhaps to think about maybe it is time to do some more advanced testing and figure out, you know, what exactly is going on. And I'm happy to help guide you through that, and I'll tell you a little bit about how to work with me at a point here. But this quote is wonderful. It comes from the Yellow Emperor's Classic on Internal Medicine, which was 500 BCE. This was like, kind of the first main medical text of Chinese medicine. "The physician who teaches people to sustain their health is the superior physician. The physician who waits to treat people after their health is damaged is considered to be inferior." This is like waiting until one family is starving to begin to plant seeds in the garden. Another way to put this from a Chinese medicine standpoint was that in sort of a classic model that they used for medicine, you would pay the doctor a small fee every month. However, if you got sick, you didn't pay the doctor because if you got sick, the doctor actually wasn't doing his job and he had allowed you to get sick, right? So a very, just a very different way to look at health. And this is a model that we are all going to have to adopt to some degree because otherwise, our healthcare system is going to bankrupt us. You know, we have to take care of these lifestyle purposes.
And so when we get to sort of the conventional model and conventional thinking on autoimmune diseases, you know, the thing that we really want to understand is that different medical systems serve different purposes. They are not at odds with each other. Like I refer to many great medical doctors all the time, and a lot of the referrals that come to me are from, you know, neurologists or other types of doctors. And the enlightened position is to understand that we all exist and we can sort of have a different purpose and take a different place in a patient's existence. If I go through my car windshield in a crash, like I want to go to the emergency room. That's not what my, that's not what my specialty is. But if you are suffering from sort of a, you know, a syndrome where, you know, fibromyalgia or chronic fatigue or something of which the doctor has no real treatment except to label you as having that syndrome, then that's when this health detective concept becomes very useful and is something that we want to look at, right? There's always a reason. Whatever you guys are struggling with, there's always a reason why it's happening. It just needs to be found. And a lot of that has to do with how the body perceives stress, and we're going to talk a whole bunch about that.
So, you know, the conventional kind of answer often when we go to the doctor and, you know, maybe they do some blood work and they flagged, you know, I don't know, maybe it's like a Hashimoto's thyroiditis or something. They they flagged some some, you know, some labs that showed that there's an immune response going on. And the answer is almost, for some reason, your immune system is attacking its own tissue. And that's where the explanation gets left. It's just, for some reason, this is happening. And I would challenge that and say, no, it's not for no reason. There is always something going on. And that is, you know, where we are going to spend our time looking.
All right. So once again, if your diagnosis, so in any type of medicine, it begins with the diagnosis. The treatment follows the diagnosis, and then hopefully, you know, the outcome follows that. But if your diagnosis is poor to begin with, it's impossible to have that natural flow to a good treatment outcome. So if your diagnosis is "for some reason," then the treatment strategy, you know, the only thing you've identified is that there is an immune issue happening or some type of immune problem that is is irritating the body's natural immune function. So therefore, suppressing the immune system becomes the next logical step, rather than looking at, you know, what could be happening underlying this. But there's some real issues with suppressing natural immune function. Like, you know, I always crack up. I mean, we all laugh about all the drug ads and everything they say, but when you look at something as simple as like, you know, like allergy medications like Flonase or Zyrtec or these types of things, we will see in the fine print and the quickly worded discussion that, you know, frequent viral infections are common with the use of a. And frequent viral infections are common because if you're suppressing the body's immune system, you leave yourself open to other not-great disease risks, like different types of infections or cancers. You know, our immune system, it is constantly monitoring what we have going on in our body, and it is, you know, it is clearing those precancerous cells. It's it's getting rid of these low-grade infections before they set. We're like, I was, you know, one thing we do in functional medicine a lot, and I'm going to talk about this in a few minutes, is we we test the body for infections. And, you know, in standard of care, that is not typically done. And we are all walking around in a sea of infections all the time. I'm not a germaphobe, so don't let me like that, don't think that I'm like, you know, going down that path. But why do some people have a bunch of infections and other people don't, right? Well, it comes down basically to the status of our immune function and our body's ability to to fight off those infections or clear those precancerous cells. So I would challenge this idea that suppression of the immune system is the best way to go in an autoimmune case. However, I'm gonna say that in a very measured way, because, you know, you can have an extremely severe and painful rheumatoid arthritis case or some kind of really bad plaque psoriasis or something. And while we are figuring out the root cause, while we are looking for, you know, what is driving this pathology, it may be necessary to use medications like that. And I'm glad that they exist. I mean, they can sometimes really help us get from point A to point B. However, I mean, you just got to look at the side effects on those medications to know that that's not something you want to do for your whole life. I mean, the best medicine is what provides the most amount of relief to the patient with the least amount of side effects at the time. And if we are thinking from that standpoint, you know, if there is severe pathology, like someone is in a lot of pain or they're really, really suffering, then those medications may be what we need to do while we're figuring out our other, our other stuff and doing a proper workup of what's going on. So don't feel like, you know, if you've had to take medications like that in the past, don't feel like that's some kind of failure or that, you know, the the pharmaceutical drugs are evil or something like that. That's not the viewpoint that that I take. I want to be on the least amount of medications as I possibly can and maintain my health. However, you know, there are times when some of those drugs are important and useful, and I wouldn't want you guys to think that my opinion on that is is something other than that.
So, you know, we can talk a little bit about the myths and the facts of autoimmunity. There's this myth that autoimmunity is a mystery, that we don't know what causes it. Like, who knows, like some people's immune systems just freak out and start attacking their own cells. And we know that this is not true. So one of the things that is a real strong point of functional medicine, and I kind of want to emphasize this to you guys, is that functional medicine is constantly trying to keep up with the latest science in physiology and treatment. Now, you would think that that would be true in conventional medical care as well. However, it takes a decade at least for our advances and science to actually show up in standard of care within conventional medicine. So like I can take just some kind of low-level example, like, you know, stuff that we've learned about the GI tract and the immune function within the GI tract and its role in autoimmunity. There are, for instance, there's a whole class of bacteria are known to be autoimmune triggers. Now, this is information we've just learned in the last decade. And yet, you have Prevotella, would be an example of one of those. There's some other ones too. But, you know, we have all of these patients who are suffering from, you know, quite severe autoimmune issues, and they are not being screened for these infections. Like, how is that possible? You know, like I've asked several GI doctors, quite frankly, like, why do we not test for these infections? And the answer is usually that it's inconvenient. The patient has to take a lab kit home with them. And usually, most conventional medical situations do not like to send lab kits home. They like to do their labs in the house. They like to do serum labs. They like to do blood labs. But we're gonna talk a bunch about why, I mean, blood is one technology, but not necessarily the best for everything that we want to measure. Blood only shows you what is actually circulating in the blood. It's not showing you a whole lot about the dynamic processes of the body. But that's another little aside.
So anyway, you know, one of these other sort of myths is that diet and lifestyle has no effect on autoimmune disease. And this could not be less true, okay? Now, they're not the only things that matter, but diet and lifestyle can exacerbate a situation that we have. And, you know, a classic example that we'll talk a little bit more about in a few minutes is gut permeability. You know, this is another good one with the idea that it takes time for knowledge to circle down from, you know, from the research into conventional care. So just as a little aside, like, you know, probably 15 years ago, I was looking at PubMed trying to find citations for something I was writing on gut permeability and how we test for it. There's serum and other, there's ways that we test for gut permeability. And at the time, gut permeability, and some people were referring to it as leaky gut. So that's what I'm talking about. If, if you know, you hear me mention gut permeability, I'm talking about leaky gut. Leaky gut's kind of the more culturally popular term for it. The more medical term is is intestinal permeability. And it was considered total quackery. Fifteen years ago, you could barely find, I could barely find any references on it for the paper I was putting together. If you search PubMed now for intestinal permeability, there are thousands and thousands of citations. You know, it just, it takes time for this stuff to to properly get into the public domain and then be used within medicine. So, you know, we're gonna look back on the stuff that we're doing now in a hundred years and be like, oh my god, what were we thinking? And that's always the case. But when you use a systems-based approach to medicine, you know, when you're looking at trying to restore function so that the body can self-correct, you get out of a lot of those pitfalls. You don't end up making the same mistakes because fundamentally, autoimmunity is not a healthy thing for the body to be doing. There is something that is aggravating and irritating the body into an autoimmune state. But if it wasn't there, the body would would normalize.
That brings us to our third myth, that it cannot be reversed. And this is just absolute nonsense. Like autoimmunity can absolutely be, it can be. Now, some of the tissue damage by autoimmunity may not be reversible. Like if 70% of your thyroid has been destroyed because, you know, even though you had an antibody showing up seven years ago, nobody ever did anything about it, and, you know, that you're unfortunately gonna have to take thyroid hormone forever. Your situation can probably be improved, and a lot of autoimmune diseases can be put into remission and thus reversed, okay?
Yeah, so this, you know, this is basically what I was just saying. The underlying cause of autoimmunity is typically just never addressed. The standard conventional care is to wait until symptoms are so bad that something has to be done, and then you are put on an immunosuppressive drug or put on heavy doses of prednisone or other things that, you know, methotrexate, you know, what you're talking about, basically a chemotherapy drug, things that are very powerful medications that have very significant side effects. And sorry if you guys hear laughter or something, that's my eight-year-old playing for tonight. And, you know, I don't really know what to say about that.
Okay, so a very interesting fact to think about in terms of why, why we want to address autoimmunity from the moment we see it. Autoimmunity is a process within the body. The way that it expresses itself, whether that's the joint pain or some skin type of issues or, you know, like a Hashimoto's thyroiditis type of thing, you can think of those as being the branches of how it's expressing. But the root cause pathology is still there. So if you have an autoimmune disease, you have three times greater chance of developing another autoimmune disease than people who do not have an autoimmune disease. So it's not like, you know, I have this rheumatoid arthritis and so I just need to be concerned about the joints, you know, because that's what's affected. I'm gonna be concerned about the joints and not think about other potential pathologies. Well, that is not a great idea because, you know, you're leaving the gate open for that autoimmunity to express in other ways, and also for just poor immune function in general.
So 50 to 75 million Americans have some type of autoimmune disease that they're struggling with. They estimate 12.5 million people worldwide. But, you know, these numbers are probably massively underreported, and that's just because of the the way that our healthcare system is fractured and, you know, diagnoses are sometimes not entirely clear. So that number is is probably way different. But, you know, what I want to impress upon you is just that idea that like, if you have an autoimmune disease, then that process is happening within your body, and you are three times more likely to, you know, come down with some other type of autoimmune disease. And to that point, let's get to our next slide here. Autoimmunity is often accompanied by all kinds of other disease states, and these are often diseases that are referred to as syndromes, right? And they, this is where I was saying that like many disease processes of the body have an autoimmune component, but they're not labeled as autoimmune necessarily because some of our testing technology has not yet identified that autoimmune activity. But like fibromyalgia or chronic fatigue would be two really great examples where there is a strong autoimmune undercurrent to these problems. And so, you know, we often see people struggling with, you know, with with fatigue or pain all over the body, you know, even though maybe they have plaque psoriasis or something. I mean, the thing that you have to understand, I think, that's very important is that any autoimmune process is taking up a significant amount of energy and resources from the body. Like you're basically fighting a battle. And that battle takes resources and energy, and that's resources and energy that can be used for something else if it was not being used by that process at the time. So, you know, it's something that needs to be paid attention to. And because we treat the underlying cause, we identify and treat the underlying cause, we see people getting better every day, both in my San Francisco clinic, but also with my telemedicine patients all over the country, all over the world. We see people improve all the time. And so if they're concerned, it's really not like, is really not rocket science. Like I didn't, I didn't, I'm not the genius who came up with this. However, the thing that we have to think about when we are organizing our brains around the idea of getting to this root cause pathology is that there is a system. We have to look at the body from a systems-based approach. And by testing and correcting those body systems in the proper order, we can identify and correct root pathology.
And so within the Kalish method of functional medicine, and one of the things that that Dr. Kalish did that honestly, I just got to say, is a total genius for doing this, and he did this because of some inspiration that he had around his own treatment with in experiences with Chinese medicine, but there's a real problem within the functional medicine community of this very disparate and all over the place. There's a million different tests you can take. And, you know, "Oh, I had this test and that test, and now I'm taking this bottle of supplements and this bottle because this test, that dad, this said this." And it gets crazy. It's unwieldy because there is no organization to how one is approaching it. And so coming to functional medicine with a systems mind state, just like Chinese medicine has, allows you to correct a system that then influences the other body systems. So we always test and correct body systems in the correct order. And so we have our neuroendocrine system, right? This includes things like our adrenal hormones, like cortisol, that probably everybody's heard of. You know, our neurotransmitters, female hormones would fall into this category. And our energy production, like our mitochondrial energy production, falls into this. Now, this is super profound because if you, you can think about the body's stress response and its adrenal function, like, you know, the production of cortisol and DHEA. This is like the capstone, basically, of our health. Like, if that stress response is significantly disrupted, then it's almost impossible to correct things below it and permanently correct them. And that's because the stress hormones have they play so many roles in our body. They affect so many different things. Like cortisol, which is the hormone most of us are probably familiar with, is a glucocorticoid steroid. So it has functions that help the body manage blood sugar. It is our main hormone of awareness and makes us alert. It surges up in the morning, and that's what like opens our eyes and gets us out of bed. And then it plummets down. Melatonin rises, and that's what creates our circadian rhythm. It is a corticosteroid. So, so cortisol is like cortisone. It's our body's main way that they would like shooting your elbow or something if you had tennis elbow thing. It's our body's main way of managing inflammation. So if cortisol is significantly disrupted in some way, then our body loses its ability to manage inflammation. And then cortisol also plays this really important role in our gut. And it, it basically allows, through this protein called secretory IgA, it allows a proper immune barrier of the gut. And here is where it gets very interesting and very important, and this is why these have to be tested and corrected in the proper order because if you're not supporting that immune barrier of the gut, you're gonna have proteins and other things that can leak across that can trigger immune responses in the body and cause all kinds of havoc. And, you know, there is a lot of good research now pointing to the fact that a lot of the root cause pathology of autoimmune diseases lies within the GI. However, wait, in standard of care, nobody checks it, right? So you could have something really bad going on right there. But, you know, just take some prednisone and some methotrexate, and, you know, it'd be just fine.
And then finally, we check the detox. Oh, so the GI system is the system that we test, test next, after our stress hormones. And we'll typically do these tests all at one time. But in terms of putting together a coherent treatment strategy, it's important to have all of it, right? And and this would include pathogens, like common infections, like Prevotella, that I was mentioning, you know, food intolerances, general microbiome issues, and then that intestinal permeability, that leaky gut concept. And then the detox system of the body is sort of what you would think it is. But proper functioning detox in the body is what protects us from the buildup of a lot of these these inflammatory products. So if we're detoxing properly, inflammation of the body will be low. You know, oxidative damage to the body will be low. So all of these things need to be kind of humming together in order for the body to exist in a healthy state and to have proper immune function. And, you know, if you don't test that gut, or if your stress hormones are just completely out of whack and therefore your gut immunity is poor, you could test the gut and find an infection and be like, "I guess I'll take an antibiotic again for this infection." But because that immune barrier, that mucosal immune barrier, hasn't been restored, you're basically leaving the barn door open for other types of infections. And so it just, there's a logical breakdown that is kind of mind-boggling to me. I don't understand why we allow it to be like that.
Okay, so moving along here. All right. So now we're talk about some more stuff about what you can actually do about it. What are the lifestyle factors involved? How do we identify these problems? Oh, and yeah, so if you decide that you want to take next steps in terms of figuring out what's going on with your autoimmune condition and you want to work with us here at Origins Medicine, so I'm gonna do, I think we have six open slots this month in the clinic, but I can always waitlist people on to next month. But I'm gonna give $50 off as a, oh no, I mean, if you're on this webinar, you are interested in your health and probably struggling with an autoimmune condition for God knows how long. So I want to encourage people to take that next step and find out what's happening. And so, you know, you may be watching this on a rebroadcast, and I just mentioned that you'd saw it webinars, just mention this deal that you saw it on the webinar, and I'm gonna give you $50 off of your initial consult, which would usually be $275, so it brings it down to $225. So that's just an offer for you guys should you decide that you want to take it.
A little bit about my own interest in autoimmunity was sort of a kind of an interesting one. So once I had gone through my Chinese medicine training and I was studying for my board exams, and I was studying 12 to 14 hours a day, stressed out of my mind, and I started to develop some some sleeping problems. And then I started to get this really weird rash all over my face, like my forehead, like my nose, my cheeks, and it was quite painful. And I went to Kaiser at the time, that's who my medical insurance was, and they were like, "Oh, you have rosacea." And I was like, "Why, why do I ever say, like, why is this coming up now?" And their answer was, "I don't know. You can use like hydrocortisone cream if it gets bad. We can give you, you know, some oral steroids." And at the same time, I was developing this like stomach pain. You know, I didn't have an ulcer, but like, it was the kind of thing where like, if I went out to dinner and and had a couple glasses of wine or something, I would be up like most of the night like struggling with like really bad heartburn, like it was very uncomfortable. And this was around the time that I started to get interested in functional medicine. And I was like, "Okay, I'm gonna figure out what's going on." So I tested my own cortisol output, and it was just terrible. It was completely messed up. And then I found that I had a raging H. pylori infection in my stomach. And that was probably present because of that low cortisol status had left me immune suppressed and allowed that infection to take hold. And that, and so rosacea is another one of those conditions that is sort of on the periphery of autoimmunity. It has an autoimmune component to it. Oftentimes, people don't think of it as necessarily being autoimmune. But my immune system was reacting to this H. pylori infection and some in some way that was confusing my body to result in this bad skin inflammation. And, you know, when we think of H. pylori, most of us think of ulcers, you know, it's the, it's the infection that causes ulcers. But it causes, like, H. pylori is no joke. It causes inflammation in everybody who has it, and not only of the stomach, but through the body. And it changes the pH balance of our stomach, so it compromises our main immune barrier from the outside world. And when I identified that and I corrected my stress hormones and I killed off that H. pylori, my skin issues totally went away. Like, if it hadn't been for Dan Kalish kind of leading me down this path, I mean, I was already a medical professional. I was doing everything within Chinese medicine that I could think of to resolve this, and, you know, all the dermatological formulas, all this stuff, nothing was having an effect. It wasn't until I identified this infection and took care of it, and then corrected my ragged stress response so that I could seal up that barrier and not leave myself prone to it. So that's a little bit about my own personal story with this.
So the first big secret, if we are to think about what are the the secrets and misconceptions around autoimmunity, is that stress is probably our number one player, okay? But when we think about stress, most of us always think about emotional stress, right? Like, I've got a really stressful job, or perhaps there are stressors within my family, divorce, death in the family. And these are all like hugely, hugely stressful events. But when we are talking about stress from a functional medicine standpoint, we're talking about a concept called the allostatic stress load. And that means it is sort of the accumulation of all the stressors that are affecting. And I kind of sometimes will talk to patients that this is like a bucket or something that all of our stress goes into. And that would be emotional stress, that would be infectious stress, like that H. pylori was for me. It can be toxic stress on the body, environmental toxins. You know, we're living in a very increasingly toxic world, and we are just, we're just catching a glimpse of like what this is doing to us. Like, you know, we are not separate from our environment as much as we like to believe this little bag of skin somehow keeps us separate from the environment. That unfortunately is not the case. And so these, this toxic load on the body causes significant problems. And the thing to remember about that stress response is that it sort of was designed for an ancient physiology, right? It was designed to keep us alive, and it was not designed for chronic stress. It was not designed to be constantly poked at.
And this is where that concept of adrenal fatigue comes in. And that's the last time you're gonna hear me heave said term because that term makes me almost a little nauseous. And the reason I say that is it does not describe what is happening physiologically with the body. And it is wrong for healthcare providers, such as myself, to use a term that is incorrect when we have better terms. It's confusing for the patients, and it is confusing when we are talking with other physicians of other types. So it's not that the adrenal glands become so fatigued that they can no longer like produce the hormones necessary for health. It's that the system becomes dysregulated. You know, we have this this HPA axis that we see here, and this is the way the brain signals our cortisol system, our adrenal system, in order to produce adequate amounts at the right time. And if that system is constantly poked at by some inflammatory stress or some grinding emotional stress, it will become dysregulated. It's like being in a super loud room or something, and like, you know, you can't really differentiate conversations. Like the body, the body can't have very, sort of, very poor signals in order to establish physiology. So cortisol's supposed to blast up in the morning, and at night, it's supposed to be really low. And it's this difference between the two that that makes us sleepy at night and alert during the day, and have good mood and manage inflammation. And, you know, when that system becomes broken down, then the body becomes catabolic. And if we were to think about from like an absolute, like 50,000-foot view, like what causes autoimmunity, it is this, this shift of our physiology from anabolic, meaning repairing itself, resting properly, building up, to this stress state of being catabolic. Now, when the body is catabolic, it's because it perceives that it is in danger, and it perceives that it's going to need resources quickly to react to escape the danger or something. You know, but we're not really under the same kind of danger that this system was designed for, right? A lot of our worries exist within our head, or perhaps, you know, we work at a gas station and we're surrounded by toxic fumes all the time that are stressing our body in a different way. And that catabolic system, one of the first things it does is it looks for something that is easy for the body to get energy from. And the gut lining is probably the absolute easiest thing to cannibalize and turn into sugar for the body. The body will be like, "Oh, you know what? Forget digestion for the next couple days. I'm going to take all that glutamine that is in the gut lining and I'm going to turn it into glucose so that I am ready to fight." And, you know, if I survive, I'll quickly rebuild the gut lining. No big deal. But if that process is happening every day, that destroys that mucosal barrier of the gut and it allows these proteins that can become immune irritants to move across that barrier and cause problems. So we really, really don't want this catabolic physiology. I mean, it's good that it exists in a pinch, but like, it's not the state that we're supposed to be in on a day-to-day basis. And if there was like one thing that I could do with every patient who came in my door or that I worked with via telemedicine, it would be to correct this stress response. Because if you have proper functioning cortisol, once again, that is like that capstone at the top, and it regulates everything down below it. So many symptoms that people have, whether it's anxiety or skin problems or joint inflammation, pain, or digestive issues, so many of these problems will take care of themselves if you correct that upstream stress response. So I cannot, like, emphasize that enough in terms of how important this is for us to deal with.
Okay, now once again, it's the allostatic stress load, that bucket of stress, that matters. And if you have an infection, and you know, maybe some kind of toxic exposure that's taking up a lot of room in that bucket, there's not a lot of room left for emotional stress. And so all of a sudden, you can become very easily overwhelmed and very sick from what would seem like not that stressful of a situation. And I'll have patients come to me who have, you know, some type of pretty pretty serious autoimmunity, and they'll be like, you know, "I'm not that stressed out. Like, I don't understand this. Like, you know, I'm my relationship is fine. The biggest stress in my life is dealing with this illness." But I don't consider myself that emotionally stressed. That's where the sleuth thing comes in. There's always something that is that is driving that process, and it, it can be found if one cares to look.
All right, I had to keep us moving through this. I'm one of those people who in sometimes go off on tirades a little bit, so I apologize. So once again, stress physiology, you get this stress hormone disruption that causes an immune response. You know, your body reacts to, you know, food intolerances or a leaky gut or a pathogen system. The body becomes overwhelmed with toxins. You have emotional, inflammatory, and dietary stress. Pretty straightforward. Just make sure this computer is doing indeed what I want it to do here. Okay.
So stress management. Let's talk about it for a minute. You don't have to sit like this woman is sitting with your hands in this position or something. However, there's a reason why meditation has existed, you know, since man has been writing stuff down, and that's because it is very, very important that we relax the nervous system in some type of profound way pretty much every day. Now, there are some technologies that can help us do that. Some people are like, "Oh, I cannot meditate." I would challenge you on that. I would say that if you find yourself to be a bad meditator, you probably haven't found the type of meditation that works well for you. So I struggled with this for years. I'm going then retreats and, you know, trying to do all these strict forms of meditation, and it was just a struggle. And for me, it, when when I found Transcendental Meditation, it felt indulgent. It felt good. I liked it. And so that became what I found. I have patients who use apps like these ones you see here, like Calm or Headspace, that allows you to explore different types of meditation, or they will guide you through meditation. You just put headphones on and listen to someone talk. People can get the same experience through prayer, or, you know, some deep spiritual connection to whatever your your own spiritual path might be. But it has to be something. It's not like some people will be like, "Oh, I read for relaxation," or "I watch, you know, TV." We are looking for something that really sinks you down, that deeply, deeply relaxes the body. And the reason is, is because it's that signaling problem again. The body needs to be stimulated at times, but then it needs to be relaxed and quiet. And we've lost a lot of that relaxed, quiet time in our lives, and we need to rediscover it. It's like a signpost being stuck in the ground of the nervous system being like, "Hey, this is what relaxation feels like. Remember this. This is where you should be tracking back to." And that's what determines that catabolic versus anabolic state of the body. And hopefully, I'm not throwing out too many terms that you guys are unfamiliar with.
Breathing exercises, once again, of course, there are, you know, just if you go into YouTube and just like look up, it's like basic, like four-one breathing or some basic breathing technique. Like there is very little else that can cause such a profound physiological change in the body as some of these breathing techniques. It's a simple tool that we can all learn very quickly. In terms of proper breathing, it makes a huge effect. I would challenge you to find any pharmaceutical drug that can cause the immediate physiological effects that breathing exercises can have. And so once again, that's a way that we can simply take a time to pause and relax. And it's, it seems so simple that like we would blow it off and think, "Oh, it can't be all that profound." But it's super profound. It's, you know, really makes a huge, huge difference.
So the other thing to think about would be the way that, you know, we can get other sort of relaxation through contemplation. There are technologies like float tanks and stuff, which I've been super interested in. Triangle. So there's actually a place in San Francisco. I just haven't had a chance to get in there yet. But, you know, there are people trying to answer this question of how can we get our wellness back by counterbalancing the stress. And the other concept that I use with patients a lot that I'll bring up here is this idea of it's almost like an equation, right? If you're gonna put a bunch of stuff on one side of the equation, you know, work stress, family stress, infectious stress, toxic stress, all these stressors, what do you have on the other side? And why do you think you're gonna be healthy? You know, like, if you have all this stuff piled on one side, and you don't have anything on the other side, like, you know, your body is going to break down. Whether that turns into an autoimmune condition or some other type of chronic illness, that's what happens. You know, that's what happens to us when when we break down. There's one of those float tanks, super interested in trying that. I gotta, like, oftentimes there's like Groupon deals for them and stuff. So I just, I really hate to get to do that. Anyway, this isn't a webinar on float tanks. And once again, emotional and spiritual time. And I'm not gonna get off in the weeds here. I'm not trying to be somebody's guru or something like that. I'm just saying that this has always been part of the human experience, some type of contemplation, some type of connection to others, or, you know, we all know what I'm talking about. It's different for every person in terms of what it is that they like. But there's often a connection to a community that is around that. And there is so much research now about about community and contemplation. I just read this super interesting study a couple days ago about forest baths. I don't know if you guys are familiar with this, but but just exposure to a forest can reduce stress hormones and regulate stress hormones for like a month following a 20-minute exposure. I mean, it's crazy. You know, like we were designed to be out in nature. If we can create that, our bodies appreciate it, you know?
So, you know, these are just some simple things that we can do to help get that under control. And then the next one I'm gonna eat here is like one that you guys probably seen coming from a mile away, but sleep is absolutely critical for our immune response. 40% of Americans get less than recommended sleep. I would bet it's more than that, actually. Here in the Bay Area, it's absolutely absurd. Like I have a lot of patients who come in and they pride themselves on the fact that they only get 4 to 5 hours of sleep a night. They wear it as like a badge of honor, like that's a good thing. You know, our body releases human growth hormone when we are sleeping at night, and that is what repairs a lot of tissue and problems in the body, including immune regulation. And if we are not sleeping, or if we're drinking alcohol that prevents the excretion of human growth hormone, or if we have to use, you know, Ambien or Valium or Klonopin or something in order to sleep, that changes the nature of this sleep. It changes that the level of sleep that we get down to. And unfortunately, that hormonally messes with us. Sleep is like a biological right. This is another one. I know that this is not our webinar today. It's not on sleep, although that's one that I really want to do because sleep is a biological imperative. We are meant to be able to sleep. If you can't sleep, there is something going on that needs to be sorted out. And we've gotten so good at tranquilizing ourselves with drugs like Ambien or something that we've thought of that as being a solution. And like it would be like, "Oh, I can't digest," or "I can't breathe," or something. Your body knows how to do it and fundamentally should be able to do it. And if it's not doing it, there's some up, and that is that's something that we need to figure out. You know, you want to give yourself time for bed to settle down. You know, a big part of this too is our exposure to blue light spectrum. You know, we sit there with like ear eaters or screens like three inches from our face, and then we wonder why we can't sleep. Well, the pineal gland produces melatonin in the absence of the blue light spectrum. You know, the sun is out, there's thirds, we're exposed to the full spectrum of light, melatonin is suppressed, right? And this is actually a super interesting point in my mind. So when the sun goes down, melatonin starts to come up, right? And that is the absence of the blue light spectrum because you can be sitting around for and red light, like you would have from like a fire, and that does not interrupt melatonin production. So this is probably how we evolved over millions of years of being around fire after the sun went down, and our body adapted to it. But even a small
amount of blue light exposure will just shut that down, just kill it. And then, once again, another big stress on the body and immune regulation is a shot, right? So, you know, another reason why we've got to think about sleep. All of these things, I know that you guys are like, probably like, "Oh, but I just want to know about my autoimmunity." This is the autoimmunity. Like, what we're talking about is what is causing it. I don't know what's happening at your case. We would have to like figure it out with a proper history and appropriate testing. But these lifestyle factors are what will keep you healthy once we figure out what's going on with you. It's correcting lifestyle that maintains our health. And one of the beauties of functional medicine and Chinese medicine as well is that it is this focus on, you know, on getting our lifestyle back into order.
So, once again, then we have our GI system. And, you know, stress, poor diet, drugs, all these things will impair the immune response and the gut. And that's like opening the barn doors. And then all of a sudden, we've got candida overgrowth, and we've got, you know, five different bacterial infections and some protozoa. All of those are poking holes in our gut lining all the time, irritating the gut and destroying our immune barrier, which then allows these proteins to leak across. And bam, all of a sudden, you can't get your rings on your finger anymore because your joints are so inflamed, right? And it's that process at work. This is just a picture of some bugs. I don't really know why I kept that slide in there.
Okay, so our progression of leaky gut type of stuff. This is just to show you the idea that, you know, it is that gut lining being cannibalized and broken down that allows all of these other things to do damage that they wouldn't normally do. Our digestive tract is really weird, right? Because it's sort of on the outside of our body. If you think about it, like, you know, we eat stuff and it goes through this tube in our body, and we selectively take what we want out of that and put it into our bodies and selectively get rid of other stuff. But that tube is not really like in direct contact with our insides, right? So it's this weird. That's why it's the biggest immune barrier of our body and where we have to look for autoimmune issues because it's that, that big long tube. Or this happens, and you know, then you get food intolerances and the other issues like we were talking about.
All right, I'm gonna kind of blow through a little bit of this because I want to be able to get to questions you guys might have. And I know that probably this isn't the only thing you want to do with your evening. So when we think about repairing the gut to repair that immune barrier, we've got to test and remove existing pathogens. We need to cut out the stuff that is irritating it to begin with. So, you know, possible food intolerances or maybe some medications that aren't working for you, toxic exposures. And then we need to eat a healing diet. And, you know, every almost every culture on the planet, besides us here in the US, eat some type of fermented food with almost every meal. Whether that is like miso or sauerkraut or like natto, which is a real struggle for me, or kimchi, which I love. Like most cultures have some fermented food. And we, we don't. We like to take probiotics, but fermented foods are far, far more powerful than probiotics.
And then we want to test and remove pathogens. So this is where we get into advanced functional lab testing. And so the test, it's kind of like an arms race in the test world. So there are, you know, everybody is trying to come at about the same price point of a few hundred dollars. And different companies will have different focuses for what they're doing. So my personal favorite right now is Diagnostic Solutions' GI MAP test. And the reason is is that it's a PCR test, which is a genetic test. So it's almost like crime scene technology, right? You're like, you're like looking for the villains by magnifying DNA from a stool sample and finding out what's there. And it's an extremely accurate test. So in this example that we're looking at right here, there's some Salmonella that was found, you know, a little bit of some viral pathogens. But this will show us all kinds of stuff from C. diff, which is horrible, to E. histolytica. To, you know, this, this test is designed to find the villains.
So there's other tests like Genova's GI Effects or some other ones that you may have heard of or be exposed to that tell us more about the actual biome itself and the relative amounts of different bacteria within the ratio there. And that's all super interesting stuff, but we don't really know clinically that much to do with some of that stuff yet. So for me, I like to stress the fact that you cannot have a healthy biome situation if these villains are present. They have to be identified and gotten rid of. And by doing that, you take a massive inflammatory stress off the body and you drain some room in that allostatic stress bucket so that you have room for other things in your lives before you become overwhelmed.
You know, inflammatory foods are what you guys probably know. If you're watching this webinar with me, you've probably read some books, maybe some of Dr. Mark Hyman's stuff, or you know, you've read some of Dan Kalish's stuff, or been on a few of these other webinars. You know, we typically want to pull back on immune-provoking foods like gluten, dairy, refined sugar, you know, this sort of stuff while we heal the gut. And it's never a good thing for us to have in any large quantity in our diets. Eating a whole foods diet is extremely, extremely important. However, the body should not be so sensitive to these issues, to these substances, if we have a healthy gut. If the gut is unhealthy, then, you know, all of a sudden these things really, really get to us. And of course, gluten, dairy proteins like casein, sugar, polyunsaturated fatty acids, these are all just inflammatory junk, right? We need to be eating a variety of vegetables. I like to think about two cups of vegetables every day. We want to have protein from clean, good sources. Pay money for your food, okay? Like, if there's, like, I forget what this statistic is exactly, but I remember reading about how as Americans, we actually spend the least amount of our income on food. So spend money on food. And, you know, things like bone broth, fermented food, probiotics, multipacks, you know, anti-inflammatories that are natural, things like curcumin, foods that heal the gut like L-glutamine and stuff like that. These are supplements that can help the body restore gut lining. But once, what are you gonna do? Dump a bunch of L-glutamine on a gut that's got E. histolytica in it? You have something that's that's destroying your gut lining, and all you're doing is adding more back in for it to destroy, which doesn't make a whole lot of sense. So understand where your food comes from. Eating in a relaxed state, enjoy yourself. You know, on the Origins Medicine blog, and I would please encourage all of you to visit my website, which is for Jan's Medicine dot com. You can book an appointment there if you want. But I have information on my blog about how to kind of eat well in a busy world like we live in, and in a sane way. And I've got an email list there that you could sign up for for what I think is an informative newsletter that I like to give people on how to stay healthy. And also our Facebook page to like, please sign up there. I give information weekly on on health-related information.
The detox system is, this is, this is like a topic that gets pretty nuts. So there's something called the CDC's Fourth Report. I'm not gonna freak you guys out by pulling it up right now, but it's basically a measurement of how toxic our environment is on a year-to-year basis. And the number of chemicals that we are being exposed to is accelerating at a rate that, you know, has people worried about all types of things from, you know, fertility type of issues to, I mean, you name it. Like, it's hard to have proper functioning body function if we can't detox some of these chemicals. And the things that we don't think of, like we think of food toxicity quite a bit, like, "Oh, I don't think I should eat that Snickers bar or something." But body and beauty products, our skin is our largest organ, right? And it is an absorbent barrier. And if we put stuff that can pass through that barrier, it's, it's like eating it, basically. You're getting it right into your, your system. You know, the quality of our water, which, like, you know, we need look no further than places like Flint or other places to know that this is an issue. Fire-retardant stuff in our old couches, and, you know, these are all, you know, none of this is good for us.
Nutritional deficiencies. Everybody likes to think, "Oh, as long as I'm hitting the US RDA, I must be okay." But remember that the RDA is the minimum amount of an identified nutrient to prevent disease progression. It says nothing about what the proper amount is that you should be taking. And it, it takes nothing about stress physiology into play. The more stressed our bodies are, the more magnesium we use, we use magnitudes more B vitamins, our vitamin C needs are much higher for oxidative stress. You know, every now and then, you'll see like a Yahoo headline that's like, "You know, oh, supplements found not to work or something." Yeah, they don't work if you don't need them. You know, like people taking supplements without doing testing is just mind-blowing to me. Like, how in the world would you know what you need? You know, you're just gonna waste hundreds and hundreds and hundreds of dollars a year just buying stuff that you don't even know if you need. And you're only going to improve your health if you are hitting something that you know is something that needs to be corrected. So it's very strange to me that, but, you know, that's sort of what we do.
So, you know, these toxins come in through our skin, our breathing, our air quality at home. We always think that the air is gonna be better inside our house. It's actually more toxic in our house than it is outside. Beauty products. And then for detoxing, we want water filtration. You want to think about both the drinking water, also the shower water or the water you're bathing in. Once again, that skin barrier absorbs a lot. You know, we want to filter our air if we can. I mean, in here in Northern California, like, you know, we had those terrible wildfires, and like, it was just crazy. Like I felt terrible, and I was trying to stay indoors as much as I could. But talk about toxic exposure. I actually, I haven't run an organic acids lab on myself since those fires, but I would be very curious to see like oxidative stress and what my liver is doing following those exposures because it's gonna be there still, for sure. Cruciferous vegetables, sulfur-containing compounds that are in cruciferous vegetables are very important for running the Phase Two of our liver detox. So all of these are important things for us to consider in terms of detoxing.
Once again, managing stress and infections and nutrient deficiencies and toxins is gonna make us less inflamed, and that's going to help our immune system function properly. Eating real foods, having real relationships, maybe actually try spending time with your loved ones. You know, try snuggling up a little bit. Let those hormonal changes happen that help our body so much. And then test, don't guess. Okay, that gets back to that supplement idea of eating supplements that perhaps you don't need. We in functional medicine, we test, we don't guess.
All right, I'm gonna blow through some of this stuff here. This is just talking about our liver detox pathways. Once again, it comes down to those body systems. If you don't have an organized way of thinking about how you're gonna find the root cause of this autoimmunity, you know, you're gonna wander around in the same quagmire, perhaps you've wandered in for however long you've been struggling with this. Like, if you don't know what to look for, you're not going to find it. And so an organized approach that is logical and that follows a logical progression of treatment to normalize the body is critical. And that's what functional medicine is all about. That's what I do in the clinic every single day and with my patients all over the country. I invite you to work with me if you would like to. Like I said, you've got six open spots this month in the clinic, and I can certainly put people on the waitlist should somebody drop out. I'm giving anybody that $50 discount for the webinar for you listening to me for an hour here. And I think that's pretty much what I've got.
You guys, if I want to say thank you for listening to me for over an hour now, which I know is a long time. And I had to breeze through some of this information because, you know, it is pretty relevant. So, so Joy says that Facebook is too stressful. Yeah, you're totally right. Like, I would love to know the studies on how social media has affected our stress levels overall. But yeah, it's a big, it's a big deal. So there's people asking some questions that are are pretty specific, and I can't really get into diagnosing or treatment within this webinar context. We would actually have to, you know, do our paperwork and stuff and have and have stuff thought about in terms of being able to do that.
Someone is mentioning that they have a huge cortisol surge at 2 AM. Cortisol rhythm disruption is the biggest problem. Okay, so, you know, it's supposed to go up in the morning and then be 1/20th when you go to bed at night. There's supposed to be a smooth curve down. And if that rhythm is disrupted, that's what people experience the symptoms like, like this person is mentioning now, wake up at 2 AM, like alert, like what's going on, maybe heart racing, maybe something else. And proper rhythm needs to be restored. Once again, otherwise, you know, you're probably tossing and turning for an hour before you wake up, then. And, you know, hopefully you get back to sleep. But oftentimes people have to get up at 6 to go to work. So how much real sleep are you actually getting? Not enough, I'll tell you that.
So someone's asking about my thoughts on autoimmunity in the form of allergies, like, you know, pet dander, hay fever, all these. Yeah, this is immune dysregulation. This is the same thing that we're talking about. We treat allergies all the time in the clinic. And this year in the Bay Area has been nuts. It's been terrible because we've had a ton of rain, which is great for us, but then we've had like these 80-degree days and high winds that are pulling pollen up to the atmosphere. I mean, it's been rough. And once again, calming and normalizing immune function is what we're looking to do, right? We want normal immune function. And so, yes, allergies would fall right into what I'm talking about.
So once again, someone's asking about an encephalitis kind of autoimmune disease attacking the brain. That's a little bit, once again, into the weeds. But one can think about the fact that this is, once again, a process that is then affecting a tissue of the body. So what is driving that is what needs to be checked. That could be a gut infection causing a systemic autoimmune state that is then affecting the brain. So we always need to look for root cause, you guys. That's what it comes down to. Root cause.
Thanks, guys. Thanks for, thanks for listening to me. I hope this has been informative. You know, once again, my website is foraging medicine dot com. You can always get hold of me through the Kalish Institute. I would appreciate it if you guys signed up for my, you know, for my newsletter and my mailing list because I really feel like I try to add value to people through there. I'm gonna be doing regular webinars through Kalish Institute, so you can please keep your eyes open for that. If you're in the Bay Area, I sometimes do live events. And also my Facebook page is a place that I try to keep connected and actually distress people through social media, which might seem like that's impossible, but that's what I try to do. So once again, you guys, thank you. And, you know, if I can help any of you, let me know. Okay. All right. Take care of you guys.