Körperliche Traumasymptome aus Sicht der funktionellen Medizin

In this interview, we talk about what narcissistic abuse really does to your body, to your nervous system, your gut, your hormones, and above all, how you can get out of it, how you can regain not only your emotional but also your physical strength. Today, I get to introduce a very special interview partner to my wonderful community, my brother Adrian, a physiotherapist, trauma coach, functional medicine specialist, but I think you can introduce yourself best right now. Yes, a warm welcome. It's great that you are all here and listening, and especially great to start our first or one of our first joint projects. So, I would say, first and foremost, I am a brother and I feel very honored to be invited here, and as you already hinted at. So, my journey began, actually, my journey began even earlier, namely with unsuccessful study attempts in business, where you particularly supported me in finding my true path. I came to physiotherapy through detours, always said that studying medicine would have been an alternative. That's not possible. That's not possible given our history with parents who had already charted paths for us. I always said, no, I don't want to go into that world, but physiotherapy, that would be it. And so I came to physiotherapy and completed the training, and I was always very interested in holism. I always wanted to know everything, how does it all work together? We always got pieces. This is a system, and this is a system, and this is another system. But how this system connects with that one and that one with the other was never really conveyed. And I was always the one who searched for how can I build these bridges, because I have to understand, I'm not the type who can learn by heart. And that's how it started. I threw myself into my physiotherapy work, and after two years, because I had the opportunity, I opened my own practice, and in retrospect, I must say, luckily, I ran headfirst into a wall. Within 3 months, I developed sleep disorders and scratched myself bloody every night, and I wasn't doing well at all. I worked myself to death, and it was actually a consequence of stress, but I didn't want to admit it at all. I thought, what do I have now? What's going on with my skin, and what's not right? And I tried all sorts of things until I finally admitted to myself that it could actually be a consequence of stress. And that sent me on a completely different journey, namely to pursue my interests and see what else I could do. Then, through another training, I came to coaching, and there, many things suddenly became clear to me about myself, but also an interest was awakened in this interplay. It's not just the body, there's the mind. How do they work together? That didn't let me go, so I did the first coaching training, then the second, and during that time my practice was still running, and a colleague was working with me, and she was studying psychoneuroimmunology at the time. Psychoneuroimmunology, endocrinology should also be mentioned, namely exactly this study of the different systems in the body, so the psyche, the nervous system on the one hand, the immune system, the digestive system, the hormonal system, how everything plays together and works, that fascinated me immensely. But at that time, because I was still in other training, it wasn't anything yet. But later, a few years later, when that same colleague stopped working with us, I thought, no, this knowledge cannot be lost. What can I do to build this bridge myself, this bridge between the body and the soul? And then I discovered that there is training called Functional Medicine. Functional Medicine Coaching, training. And Functional Medicine teaches exactly these contents of psychoneuroimmunology but has brought them to the ground in a more structured form. And that's what interested me, because you don't have to guess, you don't have to stand there and, well, there are some people who say, "Yes, and if something is wrong with the gallbladder, then there's always bitterness in your life," or such somewhat common, but not always really applicable connections. You don't have to speculate and guess, but there are now very well-researched methods to see what stress, for example, does to my body in general, but also individually to me, what does it do? So I came to functional medicine, and now I'm trying to bring it all together, which is very exciting because sometimes you start with the body, sometimes with the psyche. But ultimately, everything always works together. We can imagine physiotherapy, but what makes functional medicine different from conventional medicine? Can you give us some insight into that, please? Functional medicine is more about root cause medicine. You can easily imagine it. A symptom can have many causes. For example, let's take migraines. Migraines can be caused by food intolerances. Migraines can be psychologically induced. Migraines can actually be caused by too much tension or jaw misalignment. It can actually have many, many causes. If I simply treat the migraine as a symptom and always treat it the same way, I'm not actually solving the underlying problem, but I'm making it more bearable to deal with. And functional medicine says, "Aha, this migraine can have many causes. How do I investigate that? How do I go upstream to the source of the problem, and how can I work with it?" And what functional medicine also does is it recognizes how important our lifestyle is. So what we eat, how we digest, how we move, how we sleep, what environmental factors affect us, how our stress and resilience are in general, and it takes all of this together and gives the patient or client more self-efficacy. By knowing that I can do something for myself in this whole process, and it doesn't matter how I live. And it follows a few principles that also come from positive psychology, which are very, very important. I need to have a good, emotionally motivated goal. I need to know why I want to go somewhere. It's not just about getting rid of something. For example, the grandmother who comes and says, my knee hurts. And it's not just about wanting to get rid of my knee pain, but it's about what I can do again when I've gotten rid of my knee pain. Then I can get down on the floor again and play with my grandchildren on the floor, and then joy comes, then the emotional goal comes behind it. So, that's what functional medicine tries to do. It tries, on the one hand, to go to the root cause, to practice root cause medicine as much as possible, to involve the patient with their lifestyle, and to include both conventional and alternative medicine methods, but always on the basis of evidence-based interventions. Great. Regarding the question of where the limits are, I think we'll come back to that later. My community, many women and men, come from years of emotional, narcissistic abuse, have experienced psychological as well as physical abuse, psychological violence, but also other forms of violence. What happens to the body when you live in such a state of violent stress for years? First of all, it's important to say that there is only one type of stress. Previously, people distinguished between what they called eustress and distress. That's actually nonsense. There is no good stress. Actually, there is no bad stress either, because these are all just ways the body has of dealing with something. And what's always important in all of this is modulation. So, we live in a world, and we are humans, we actually function cyclically. There is day and night, there is full moon and new moon, there is ebb and flow, there are so many cycles in which we live. There are macrocycles and microcycles, and it is incredibly important that we can live such a back and forth, live different cycles, also of tension and relaxation, because when we are active, then we are achieving, and then we naturally consume material. Yes, our body has to perform. Our organism is active, it consumes nutrients, it consumes neurotransmitters, hormones, and so on. That's consumable material, I'd say. And then it needs times when it can replenish itself. And in the relaxation phase, all regeneration happens, digestion happens, regeneration happens. You always think that not much happens during relaxation, but during relaxation, you can say, I'll lean back and let my body work, because it's working at full speed when I'm not doing anything. Muscle mass grows when we sleep. Cells are regenerated when we sleep. Our entire nervous system can recover. our brain mentally processes, sorts, and organizes everything that happened during the day. We enter completely different states, and it is absolutely important for us that this cycle is always maintained, and in that sense, it's also energy shifts. It's not just energy on and energy off, but it's actual energy shifts. The energy is simply used for regeneration. And now we need to look at how this works in the body when we talk about tension. So, we have a task to solve, a challenge to overcome, a problem to solve, to get from A to B, from the task to the solution of the task, we always need energy. That's a tension arc that is built up. How does the body provide us with energy by releasing stress hormones? Primarily adrenaline first, and then cortisol, which is released and provides us with energy. Just seeing you now, exactly. A need can also be said, yes, your body signals, oh, I have a dry mouth. What is the need? I am thirsty. The need is for this thirst to be quenched. To get from the problem of thirst to the solution of quenching thirst, you have to expend energy. And if it's just lifting your cup to your mouth, and your stress hormones provide this energy in a well-regulated manner, and it cascades upwards a bit. If a little bit of stress hormones isn't enough to get you from the problem to the solution, then more of this cortisol is released, and it can escalate accordingly. And now it can happen that a situation occurs where all the available means at your disposal are not enough to solve the problem. And you recognize, more or less consciously, I am powerless, I am helpless in the face of the problem. And then these stress hormones cascade upwards, and then what we ultimately call trauma can happen, because something can tip over in the body, where we reach a point where we can neither solve it nor actually endure it. And then our body comes to our aid again, and in addition to all the stress hormones, it releases endorphins. It helps us to emotionally detach from it, because we don't have the capacity at that moment to emotionally digest it. This leads to these events, these experiences, these strong feelings from that time being stored in a different part of our brain than our normal everyday experiences are stored. And that ultimately means the problem is not solved. It is postponed. The trauma remains in the body, and it's as if the body is saying, I'm putting a memo here. We can't deal with it right now. Memo, I'll remind you later that it would be important to deal with it. And it will keep reminding us. And various mechanisms play a role in this. This leads to the fact that this relaxation from this tension arc, which I just mentioned, this relaxation, never really happens, and we are always switched on, always on, and never really recover. And this naturally leads to us depleting our energy reserves in various ways. One possibility is that it can affect the adrenal gland, which becomes exhausted over time because it can no longer release so many stress hormones. It can also be an exhaustion of our neurotransmitters, because they simply can't keep up over time, because we can no longer supply enough nutrients to cope with these high demands. Then imbalances in neurotransmitters can occur. On the other hand, stress also always affects our immune system. The immune system, in turn, interacts with the gut. Inflammation can occur there, and that's the tricky part, all these systems are connected. They all influence each other, and so there are various ways in which physical consequences can arise from this, which we can look at in more detail later. I find what you're saying so important, because, to put it in a nutshell, it means that these symptoms that we experience after extreme situations or through trauma, these physical symptoms are not just psychological. There are psychological symptoms, but there is also the body in a traumatized state. There are really also symptoms that have a physical cause. So, I find that so important because I repeatedly have patients who come to me and say, "My doctor said it's all psychosomatic." In other words, my patients then think, it's all psychological, it's all just psychological, I don't have anything, it's all just psychological, but that's not true, is it? Then there really is something in the body. I think it's safe to say that every psychological reaction ultimately has a counterpart in the body, or rather, works together with the body. And especially when long-term systems are affected, let's take the gut, for example. Normally, you hear about the autonomic nervous system with its two counterparts, the sympathetic and parasympathetic. The sympathetic is about activity, and the parasympathetic is about recovery. And it's certainly very common to hear about sympathetic activity under stress, the stress reaction, fight, flight, or when neither helps, freezing, these are the stress reactions, so fight and flight, and on the other hand, we have the parasympathetic, and that's rest and digest. So, regeneration of the body and digestion. This means that for the gut to really work, it needs a state of relaxation, then everything works well. And the connection, when you look at it, this connection from the brain to the gut is incredibly strong. The vagus nerve, our tenth cranial nerve, is a really thick bundle, and it's not a one-way street, it works in two directions. In our gut, we have a network of neurons. There are millions, several hundred million neurons, nerve cells, that weave through our abdominal plexus. And that is again connected to the vagus nerve. So, it's no wonder that stress can cause stomach aches. No wonder that severe stress has an impact on digestion. And now it depends, is it only for a short time? If it's only for a short time, the body can recover from it. But if it lasts for a long time, then inflammatory processes set in. Then the gut microbiome is altered. That means the entire composition of all living beings that populate the gut, without which we would not be viable, hundreds of trillions of bacteria, but also fungi, other living beings that are there, this carefully cultivated balance is disrupted, and then in imbalance, bacterial species can take over that don't digest well. Bacterial species, populations, that normally produce our B vitamins can suddenly die out. B vitamins are produced by our gut bacteria. B vitamins, in turn, are very, very important for the function of our nerves. So, it's obvious, it's understandable, that there are many different ways our body can be influenced by this. And then, finally, stress leads to the tight junctions, which are the connections that hold our gut cells together, so that nothing can get into the body between the cells, causing these tight junctions to loosen and these cells to move apart. And now the body is much more exposed to everything that is out there. And out there is equivalent to in here, in this long tube that goes through our body. Yes, now things can enter our body that don't belong there and activate the immune system. That's the leaky gut you're talking about. That's leaky gut. Yes. And through this activation of the immune system, there can be interactions that go back to the brain. And act through enzymes that control our brain metabolism, influencing them so that our neurotransmitters can no longer be formed correctly. So, there are many cross-connections in there. If we now dive into the practical aspects, how would I notice, for example, that my microbiome is disturbed, that I might have leaky gut? Leaky gut, meaning it leaks through, can cause very unpleasant symptoms. If we look at the gut, the gut that is constantly stressed by trauma, what symptoms can I develop? The worst thing is if you develop no symptoms at all, or no symptoms that primarily have to do with the gut. You can certainly feel that despite leaky gut, everything is fine with your digestion. That's actually the worst, because then you never look there. But what else can it cause? Because leaky gut activates the immune system, you can develop food intolerances that weren't there before. Yes, suddenly you start reacting to something because you've become more sensitive. You can suddenly develop allergies that you didn't have before. For example, hay fever that appears later in life and was never there before, or I suddenly can't tolerate gluten-containing foods anymore, or yes, I develop some intolerances. That can be a symptom. It can also be migraines, as I mentioned earlier. Leaky gut can be a cause of migraines. It can also be just a non-specific exhaustion. Which, if leaky gut also leads to leaky brain, meaning it effectively influences neuroinflammation in the brain, then it can become much more serious. States of exhaustion. I can also develop depressive symptoms that are purely physical, purely physical depressive symptoms, because my neurotransmitter metabolism has changed and my serotonin levels, for example, have dropped, and at the same time other substances have been upregulated. I can develop a full-blown depression. I can develop anxiety disorders because suddenly, due to the entire inflammatory situation, more histamine circulates in my body, more histamine is produced by the gut, and through the blood-brain barrier, which has now become more permeable, it also influences brain metabolism, and histamine in the brain triggers panic attacks, for example. So, it can cause skin symptoms, because through leaky gut, more gets into the body. So, not just free-floating in the abdominal cavity, that would be the wrong idea of a leaky gut, but more simply passes through, more components enter the bloodstream. And what is the first point of contact? The blood, it flows into the liver. This means the liver has to work much harder. It has to do much more detoxification. And we are not even aware of how much energy liver detoxification requires. And then the liver can develop, for example, non-alcoholic fatty liver as a late consequence, but also with the entire metabolism, then the metabolism switches, and the liver, the entire sugar metabolism can be influenced by this. Yes, and sugar metabolism is also a topic, because ultimately, cortisol is the antagonist of insulin. Cortisol releases sugar from our tissues and makes it available to the body, while insulin is responsible for opening up the cells so that the sugar can be stored in the cells. If we always as fat, please, as fat, or no, just no, no, fat is a consequence of that. So, the sugar has to be made available to the body so that the normal combustion processes can then take place. And the excess, if we still have an excess, then it is stored as fat. And the more oxidative stress we also have, the more it goes into our infamous visceral fat. So, in other words, the perception of many of my patients, especially those who are traumatized, that they are gaining weight, that trauma can lead to a rapid weight gain that is almost uncontrollable, is correct. Absolutely. When cortisol goes up, more body sugar is available. This means more and more insulin is pumped into the body. This ultimately overwhelms the pancreas. And because so much insulin is circulating in the body, the cells that have these receptors for insulin become less sensitive to insulin. This can lead to so-called insulin resistance. Now the cells are no longer so sensitive to it. Cortisol remains high, sugar remains available in the body. Unfortunately, unhealthy eating habits often accompany this, which can further support it, but they don't have to. And all of this leads to the cascade where fat accumulates more and more. And if you look at it from an evolutionary perspective, it makes perfect sense. Because in times of crisis, the body, now I'm facing a crisis, and I have to fight out there, and I can't fight and search for food at the same time. So the body mobilizes my food reserves that I have within me, so that I have enough reserves, so that I have enough energy to fight. So, from an evolutionary perspective, this makes a lot of sense. Or in a crisis, the inner mammal says, the inner mammal says, we need to store a lot of fat, as much fat as possible, so that we are prepared if there is no more food or if we have to fight for a long time, right? Exactly. And then there's something else, there's something that fascinates me particularly, if we go back to the gut, because you said the microbiome changes, right? So these gut bacteria change, the balance of all these microbes in the gut changes. And now there's this fascinating bacterium. It's even named similarly to nasty, nasty-mur or something. Can you tell us something about these bacteria, what this little rascal in our gut does? You mean the Firmicutes? Yes, the Firmicutes, not the Visimates. So, these are large families in the body, and these are the Firmicutes, which have different subfamilies, and their counterparts are the Bacteroidetes, also with different counterparts, and both are absolutely necessary, they are both very, very important. But there are ideal ratios between Firmicutes and Bacteroidetes. Why? Because Firmicutes have the ability, they can break down more complex carbohydrates. And that's good, because it's also important, we need to be able to process more complex carbohydrates. But if we have too many Firmicutes compared to Bacteroidetes, then it's nasty, because then the body can make even the most complex carbohydrates available to the body. So, in other words, I eat a few slices of cucumber, but in effect, I've eaten a cream cake. Exactly. That's why I say, they are just nasty creatures. And that can, that is often a consequence when this microbiome can be rebuilt. It doesn't always happen. Yes, but it can happen. I mean, something like this can also happen after antibiotic treatment, or after a colonoscopy, or if you've had to take certain medications for a long time. But it's just, you don't have real control over how the microbiome rebuilds itself cleanly. Yes. Yes. And so, it can come together from many different sides. If you look at a full picture, you can develop insulin sensitivity on the one hand. You can't get out of the cortisol cycle, which is constantly available, and the liver changes its metabolic functions and weakens itself. And the gut microbiome is disturbed. And then we already have four different factors that contribute to the whole thing. And then, perhaps due to lifestyle, you might have this frustrating experience. Perhaps you start and say, okay, now let's do radical fasting cures, deprive the body of calories, do it for a long time. Which is also not good. Then you can have an effect on the thyroid gland, which is also an important player in the whole system, and if you fast too drastically for a long time, for example, the thyroid gland says, wait, wait, wait, I can contribute to the solution. Let's lower the body temperature a bit to save energy. Yes, so that we can contribute a bit more calories to the body. And suddenly, your calorie expenditure is no longer 2000 calories per day, but only 1500 calories per day. This means as soon as you start eating normally again, you have a lot of excess that can now be processed by the body. And then, with these crash diets, right, also diets over a long period of time. Not only fat is burned, but muscle is also eaten away, right? That's unfortunately often the case for women. And that also reduces our basal metabolic rate. That's also something I hear from many of my patients, thyroid problems. So, really up to the removal of the thyroid, hypothyroidism, hyperthyroidism, I see very often in my traumatized patients. And of course, that can also have various connections. We talked about leaky gut. Leaky gut, as we said, leads to components entering the body that don't belong there. Now we have our innate and our acquired immune system. We have our specialized immune system. So, these cells that function according to the lock-and-key principle, you say that what enters the body is the aggressor. It's the antigen, and the body then forms the antibody for it. So, a matching lock for the key that attracts this key, then a so-called antibody-antigen complex is formed, and this is then marked by another type of cell and eaten by a third type of cell. Yes, that's how our immune system works. So, an aha, enemy, we make a clever counter-reaction. Zap, we come together, it's marked, tagged, eaten, gone. The problem is, with leaky gut, substances can enter the body that resemble self-tissue in their molecular structure, and this seems to be particularly common with thyroid tissue. So, in other words, the body now develops an antibody to an antigen that enters the body. And these antibodies, of course, circulate in the bloodstream throughout the body. And then a little Pac-Man comes by the thyroid gland and sees, oh, that looks like it, and attacks the thyroid gland. And that's how, for example, Hashimoto's thyroiditis can develop. Yes. Yes. So, Hashimoto's thyroiditis is never a disease of the thyroid gland, if you look at it from the root cause. It only affects the thyroid gland, okay? But it's an autoimmune reaction of the body. Many of these autoimmune reactions are probably triggered by leaky gut, according to current knowledge. Yes. Yes. And of course, the thyroid gland itself. The thyroid gland is like the master regulator of metabolic processes in the body. The thyroid regulates temperature. But the thyroid also regulates, for example, how the digestive enzymes in the body react. So, if the thyroid goes haywire, the digestive enzymes can no longer work properly. Then the food components cannot be properly broken down. Then you have another interaction from there to the gut. Yes. Yes. I'm just remembering my studies. I studied mathematical biological psychology. There was an experiment they told us about. It involved white-tufted marmosets. And these white-tufted marmosets were subjected to extreme stress for a period of time, and then they were returned to their mothers, who also accepted them back. Mostly, at least. The effect was that most of them died, and when they were autopsied and examined to find out why, they found that they had literally starved to death, they could no longer absorb nutrients. Is there any indication that this is also the case in humans, that we can't utilize micronutrients optimally under stress? Yes, you can look at it from two sides. One side is that when we are under a lot of stress.

To have, then we must make more of these neurotransmitters available. Then we must produce more hormones. Let's look at it this way, that the body is the machine that must produce certain starting substances, like a factory, to be able to produce other substances from them later. So neurotransmitters are not just there at a constant level, but they are constantly being newly produced and constantly being broken down again. Newly produced and broken down again. For them to be produced, however, we must have the corresponding starting substances, for example, the amino acids, the so-called essential amino acids, because an essential amino acid means that it is an amino acid, a protein component, that the body cannot produce itself. If we do not supply it in sufficient quantities, the body will starve over time, as far as amino acids are concerned. And now this usually goes through certain steps. For example, if we take the example of serotonin, our happiness hormone, the starting point is the amino acid tryptophan. Tryptophan, in turn, is first processed as a metabolic intermediate step to 5-hydroxytryptophan, simply another further developed form of tryptophan. This finally becomes serotonin through intermediate steps, and from serotonin, melatonin is then formed. For every conversion step, so-called cofactors are needed. This can be magnesium, B vitamins, trace elements like copper or zinc, and so on. So for each of these steps, additional cofactors are needed. Yes, the body has an increased need. The question is, does it get more at that time? So, you have an increased need. At the same time, your gut might not be functioning as it should, as we said earlier. So, you might be bringing enough into the body in theory, but it can't absorb it, then you also have too little. Or you bring enough in, but it's not enough for the additional tasks the body has to manage. Or it can also be that genetic factors are added, namely that you break down these neurotransmitters faster, detoxify faster than other people. The percentage is not that low. It's up to 20, 30% that either detoxify too much or too little. This means that depending on the situation, you have a completely different metabolic state. Yes. It's always the question, for what the body has to achieve, are you giving it enough building blocks for it? Yes. Yes. And can they then also, so and that, in other words, with such a demand, one would probably have to eat so much to have enough building blocks that it becomes difficult again in terms of calories. H, that is very difficult. So, if you are in a state of deficiency, then I believe it is very, very difficult, even for people who eat incredibly consciously and healthily, to replenish the reserves first. I believe that if we are at a good level, then there is not much that we need to supplement to really maintain our good state. There are some things, I would say, that we can hardly get enough of in today's society. But other things, most things can be achieved with a balanced, good diet. Yes, before we look at what we can actually do now, let's get down to business. Let's address something very important, and that is something I hear again and again from my patients, this trauma exhaustion. And above all, it interestingly shows itself, I do a lot of trauma integration, it often only shows itself after the trauma integration, i.e., when the trauma has actually been defused, when one is calmer, when one can stay with oneself again, when the triggers, that's what you said, the fight, flight, or freeze response, when these triggers no longer take hold, one can really stay with oneself, which is actually a great thing. And now this exhaustion, a real trauma fatigue, strikes very often. And what my people are often told by their GPs or, well, just eat sensibly, sleep a lot, exercise well. What do you say, firstly, to this trauma exhaustion, and secondly, to this all-encompassing advice of just eating well, just exercising a lot, and just sleeping well? Yes, to all of that, but it's probably not enough. Yes, because what has probably happened there? When the body was still in its trauma loop, it managed to cover up an exhaustion that had probably been in this body for a very long time. Yes, because it just drives you through. It drives you through, and cortisol is high and whips you through, even though the body actually couldn't anymore for a long time. And now, when the body is so far in its exhaustion, then you take away the cortisol from it. And it's not obvious that one collapses and says, "Wow, now I can't go on anymore." And now one would have to start, yes, with all that the smart doctor said. So, sleeping a lot is incredibly important, or exercise, good exercise, dosed exercise, building up, but probably one would have to replenish some reserves now, and if there were also inflammation in the system, neuroinflammation, then these measures would unfortunately not be enough. One might have to look into it. Under certain circumstances, seal the leaky gut, under certain circumstances, calm the inflammation in the brain, under certain circumstances, simply replenish reserves, under other circumstances, the adrenal glands. Yes, care for them again and say, thank you, incredible, what you have done for me in the past years. Thank you for that. And now I'm taking care of you. Yes, now I'll take a look and maybe give you some nice plant-based substances, a little Rhodiola, a little Ashwagandha, a few things that really do you good, and one takes care of these different systems that really need it. Yes. And the difficult thing about it is, it's really, it's individual medicine. Yes. One, that means, how do you proceed? Let's say, someone comes to you and says, well, trauma integration is over. I'm actually doing well, I've detached myself from everything that bothers me in any way, but my gut is acting up, I'm overweight, I'm exhausted, I can't sleep properly. Actually, I'm doing well, but physically I'm just not doing well. How do you proceed? What do you do now? So, if someone comes as you just said, I take care of the gut first. Because if I, if someone comes and already says my gut is acting up, then I want to know what's going on. And I start there, because if I don't start there, then it's one of the most important sources. It will always flow back into the system. That won't help. All other measures will be useless if I don't take care of this gut. That's why in functional medicine, they always say gut first, right? Because it's simply the center. And now there are different possibilities. We can try to get a clinical picture of it as much as possible. This means sitting down, taking time, at least an hour and a half, to sit together and look back, and look far back. This sometimes starts with birth. Was the birth normal or was it a C-section birth? Did the gut microbiome even have the opportunity to develop? Were you breastfed? Because with breastfeeding, the microbiome is also formed, because with breastfeeding, important antibodies enter the body. Did you have inflammation in your childhood? Did you have to take antibiotics in childhood? How was it, for example, especially for women, how was the onset of menstruation? How did it go? Were there hormonal problems? Was there any bullying or trauma in the history? How did that affect things back then? I first collect all the information and then collect it from then until today to really get a picture. And even today, we can differentiate with many questions, which systems are likely affected. We can create a clinical picture, and based on a clinical picture we have, we can make initial interventions. That's good, but it can be done better. It can be done more precisely. Especially when we think about the microbiome. I would definitely recommend a stool test, because the stool test will show me if it's just a bacterial imbalance, if we have inflammation in the gut, if we have a leaky gut. All of this is demonstrable today with modern laboratory tests. If so, do we have parasites in the system that have taken over? Do we have, for example, candida overgrowth, this yeast, and if we know that, we can proceed in a targeted way, do we have an imbalance with these Firmicutes, for example, and then we can say, okay, how do we intervene to intervene as precisely as possible? Yes, and what do you intervene with? So, if it's in the gut, if it's, let's say, a so-called dysbiosis, i.e., an imbalance of gut bacteria in conjunction with a leaky gut, then the first thing is to rebuild the gut. And that takes at least half a year. Yes, so I say, okay, what are my options to calm this gut, to close the leaky gut? For example, one works with the amino acid L-glutamine, which is very good, it works very well on the gut cells so that they can regenerate and close again. Vitamin D is absolutely essential there too. Everyone who is not feeling well with their immune system should have their Vitamin D checked and aim for high-normal Vitamin D levels, it's not enough to be just below or above the lower limit, but one should go into the upper range of Vitamin D. Vitamin D is also important for the tightness of the gut cells, and then definitely give probiotics, i.e., build up beneficial gut bacteria. Depending on the situation, if you have parasites, you have to get rid of them first. For example, one can work well with oregano oil, with myrrh, with a combination of these. And then one can decide which bacteria best suit the problem that presents itself individually. Yes, so that would be the component of gut rebuilding. At the same time, know that if the brain metabolism is out of control, there are also possibilities, for example, through a urine test, to measure the entire ratios of neurotransmitters and to intervene there to influence them as well. So, one always has to decide, there is excellent laboratory diagnostics nowadays. But the annoying thing is that we are not yet at a point where this type of diagnostics is covered by health insurance. And one simply has to be prepared to bear these costs oneself. Yes, it requires a lot of personal effort. Yes. And as I said, one can do a lot. There are, and when one is at that point, it's not enough to say, yes, I'll try this approach. One usually has to be on several paths. Do something for the immune system, do something for the gut, regulate a bit, and at the same time, definitely incorporate these lifestyle adjustments, find a good stress-recovery balance. All of this has to work together. So, if I understand you correctly, it requires, in some form, detective work, investigation. It requires parameters that one can really read. That's what's happening in the body, and then it requires a plan, and then it requires a lot of personal initiative. H, as always in life, if one wants to be well or wants to shape one's life, it requires a lot of personal initiative. Now, where would you say, with these symptoms, go to the doctor immediately? And with this symptom, you can gladly try functional medicine first. Is there a dividing line where you would say, h no, better go to the doctor? Yes, definitely if it were going in the direction of more acute diabetes, for example. That must first be medically managed. So, even a developed type 2 diabetes that has been acquired can initially present so acutely that one cannot continue without insulin. But it can also be, I just experienced it with a patient who got rid of three high-dose diabetes medications. Confirmed by the doctor, you no longer have diabetes. He invested an incredible amount in himself. Really, he pulled out all the stops. He trained, he rebuilt his gut, he also did hypoxic training, took supplements, went into coaching, all together, and had very, very good results from it. Yes. Mm. Mm. But something like acute diabetes, I wouldn't play around with. What else? I think as soon as it concerns the heart, yes, if it's cardiac symptoms, I would definitely have them checked. Otherwise, I find it difficult, and it's very difficult to answer. To which doctor would I ask that, to which doctor? Because the gap, it's not like that, one might think that listening to me, there's a gap between functional or alternative medicine practitioners and conventional doctors. That's not the case at all. These gaps, functional medicine, it comes from within the conventional medical professional world. It was developed by doctors, and this gap runs through the entire medical profession. There are those who have this affinity and say, "Yes, and I want to deepen this knowledge, and I want to know how I can get by with as few medications as possible, how I can practice more root cause medicine." But that also requires a high degree of idealism on the part of practicing doctors and so on, and yes, and that's difficult in today's world where doctors are so overworked, it's incredibly difficult to take care of that. I bow to anyone who does. Yes, however, one can perhaps say, first have it medically clarified for safety, just to make sure that there is really nothing that is acutely life-threatening in any way, and if the doctor says, yes, that's often the diagnosis, it's functional. It's functional. Functional means without, it's functional. So your complaints are functional. That means, in other words, there's nothing, I believe you that you have complaints, but there's simply nothing. Or that one says, with these functional complaints, you go into functional medicine. That would be nice if one could think like that. Yes. Yes. And in any case, one can take this step first and say, "Okay, look, let yourself be medically checked first." And then I would emphasize that certain things be investigated, that if one does a thyroid panel, for example, that one doesn't just measure the TSH, but that one also definitely checks for thyroid antibodies, so that one would detect Hashimoto's thyroiditis, for example, that one does the whole panel. Or if one takes cardiovascular markers, that one also measures homocysteine, which is a much better marker for cardiovascular health than many of the things tested today, including blood lipid values, for example. So that one simply gets a more complete picture. So, but a complete blood count is a very, very good basis. Then one knows, above all, what the other person doesn't have. Okay, so it seems to be a huge field, right? Functional medicine. We haven't even touched on one topic. I don't think we'll open that can of worms today, and that's hormones. So, I think trauma stress also has a massive impact on sex hormones, right? That would be another topic. Now, if someone were to seek advice, where can they find you? I think we'll just link it below, right? Exactly. Just get in touch. I usually do it this way. The first introductory meeting, the relationship has to be right. That's the most important thing for me. A good therapist-patient relationship is the foundation for being able to go a good way together. And that's why I always say, a half-hour free introductory appointment by phone or online, then one can address certain topics, but actually, it's about grasping the problem and saying, okay, what are my ideas? What does that trigger in me when I hear it? What possibilities do I see? And on the one hand, and on the other hand, to see if one can imagine working together. Yes. Yes. Yes. Good. So, your contacts are linked below the video. Definitely check them out if you feel you need support in any way, because you know, I always say, narcissistic abuse is actually bodily harm. And I think this traumatization should not be underestimated. Trauma must go, and then it really goes into physical healing, and it's possible to get a lot back. That's the beautiful thing about it, right? Great. Thank you very much for being here and for answering all the questions. Yes, and I think we'll hear a lot more about this in the near future. I think we're in a very interesting time where knowledge is increasing so rapidly, and the pressure from below is also slowly increasing, do something. And that's something I find incredibly exciting, to say how will our medical system change in the next 10, 15 years to be able to do justice to that. Exciting. Yes, we're very much looking forward to it changing, right? In many parts, wonderful. In many parts, it still needs to change. Yes, we both have another idea, right? So now, we've been very serious, right? But we can also be different. We can also be different. We prefer to chat together, which we do a lot. We've been very tame, right? But what we can do a lot is to argue. We can argue. We used to not be so constructive, now we are more constructive, right? To enter into a dialectical dialogue and to consider whether we shouldn't open a channel together, just with ideas, with things that we discuss together, that we also discuss controversially. If you can imagine that, if you're interested, write it down in the comments below, but if you want to hear more from us together. But I would already argue with you again and say that we can not only argue, we can also inspire each other quite well. We have the ability to keep throwing the ball back and forth to each other, and so we can develop things together, and I think we can do that too, but that also includes rubbing against each other's ideas a bit. Yes, of course, of course. Great. So, thank you again for being here and for having me. See you soon. And all the best to all of you.