Healing Autoimmunity from the Inside Out, What Most Doctors Miss - Transcript

Dr. Mark Hyman
Coming up on this episode of The Doctor Hyman Show.

Dr. Sunjya Schweig
The biggest lever that we have to pull that can affect how, our our body is receiving information from the outside world is through the diet.

Dr. Mark Hyman
Now before we jump into today's episode I'd like to note that while I wish I could help everyone by my personal practice there's simply not enough time for me to do this at scale. And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out Function Health for real time lab insights. And if you're in need of deepening your knowledge around your health journey, check out my membership community, the Hyman Hive. And if you're looking for curated and trusted supplements and health products for your health journey, visit my website at DrHyman.com for my website store for a summary of my favorite and thoroughly tested products.

Dr. Sunjya Schweig
Yeah, so autoimmune disease is really this idea of, I think of it as like the immune system gone haywire. And you mentioned the word inflammation. Inflammation is really one of the core concepts. And so we think about several main factors. Genetics, of course, are important.

But really, that's a minority. We think genetics and the contribution that they have to autoimmune disease is maybe only a third of really what's going on. And the other factors are, again, diet, lifestyle, environmental triggers, infections. The genetic factors, again, can create a predisposition, almost like this fuel, but then that spark and also more fuel can get stacked on there from the environment or chronic infection and some of these lifestyle factors to then activate these processes and make the autoimmune disease more clinically apparent. There's probably over 100 different autoimmune diseases.

Yeah. 10 most common, or you mentioned some of them, but rheumatoid arthritis, Hashimoto's, autoimmune thyroiditis, celiac disease, Graves' disease, type one diabetes. The list goes on. The LIGO, rheumatic fever, it produces All the colitis. Yeah.

Yeah. And the cost to us personally is huge for the individual but also to society. The National Institute of Allergy and Infectious Disease estimates that the cost of treating autoimmune disease in The U. S. Is more than $100,000,000,000 annually, And we think that that's probably actually a vast understatement because estimates around just seven of these one hundred plus known autoimmune diseases, estimates of cost annually ranges from 50 to $70,000,000,000 Woah.

Well, that's a lot of money. And I

Dr. Mark Hyman
think I think the costs are so staggering for the drugs that we're using. There are immunosuppressant drugs, increased risk of cancer infection, and they do help a lot of people. I'm not going to say they don't. But, you know, the average cost is about $50 for a year per patient. And and I know I've seen so many people be able to get off these compounds when they actually are changing the underlying causes.

And you mentioned all the different things, toxins, allergens, you know, the gut, diet, infection, stress and so forth, sleep. You know, aren't often one thing that's causing it in a single person, but it may be multiple things. So you have to kind of deal with all the factors. So so we as traditional doctors, what was our sort of a basic approach? What is the sort of the basic approach?

We sort of touched on a little bit, but I think it's worth sort of talking about it and then the disconnect between like that and how we deal with with it with functional medicine.

Dr. Sunjya Schweig
Yeah. So you mentioned these very, very expensive drugs, the monoclonal antibodies of which the pharmaceutical companies have a lot of incentive to develop because they make a lot of money. Right? And your point is good, which is they can help people. But really, it comes down to this central divide of what is conventional medicine trying to do.

And I don't want to make it seem like doctors are bad people. I have incredible respect. Just some incredibly smart people. And most doctors are so, so dedicated to taking care of their patients and trying to find them help. But it's really just from the top down of how we trained in this idea, this conventional approach to autoimmune really is kind of like this codifying of a lot of how Western medicine works, which is suppress, which is make it stop, control the immune response, turn these inflammatory pathways off.

And the problem is that it's not asking why. It's not asking why is the inflammation there in the first place? Why is the immune system being triggered in the first place? The main things that doctors reach for are steroids, corticosteroids like prednisone, methylprednisolone, dexamethasone. These work quickly and they work well.

They turn off the inflammation, they shut down the immune system, but huge side effects, really, really staggering side effects, increased type two diabetes risk, weight gain, infections, osteoporosis, etcetera. Other medications, other immune suppressants are used, like methotrexate, also shut down the body's immune response. But a lot of toxicity, liver toxicity, increased risk of infections, cancers, leukemia, etcetera. And then we've talked about these monoclonal antibodies, some of the biological response modifiers. Again, they can be helpful in the short term, but they're really just targeting one pathway.

They're not taking care of why that pathway is inflamed in the first place. And so it makes sense that they might help in the beginning, but a lot of times there's this escape phenomenon that happens where they stop working. Right? And so it's really like a short term, kind of very myopic approach, which if we stack in all these other lifestyle factors that we know about how to intervene within functional medicine, the potential for true healing is much, much greater.

Dr. Mark Hyman
Yeah, it's pretty quite amazing. It's one of the most satisfying things for me as a functional medicine doctor to treat because, you know, I can just tell you patient after patient with all kinds of weird autoimmune diseases, some of which I've never even seen before. If you follow the basic principles, it works. And I always say functional medicine is more about creating health than it is treating disease. And so when you create the conditions of our health and you take away the impediments for health, it's quite amazing.

So let's talk about a case and let's talk about sort of how we diagnostically approach these patients and what we do therapeutically that makes the most difference. So maybe share a case. If I can think of one, I'll share one, too. But I'd love to hear a case from you about how someone presented, what you did to them, what you tested for, what you found, how you treated them and what the outcomes were and what the sort of objective results were that you got.

Dr. Sunjya Schweig
Yeah, so as I was getting ready for our talk today, looked through our work and cases, one case came to my mind. So a 43 year old woman who we'll call Sarah. And when we first met Sarah, she was experiencing some joint pain, mild to moderate joint pain, brain fog, trouble thinking clearly. She's had some mood swings, intermittent anxiety and a lot of fatigue. And she also had some gut symptoms, some bloating and gas, occasionally some loose stools, disrupted sleep, especially in the week leading up to her period.

So some hormonal fluctuations happening there. Usually we would fall asleep okay, but we'd wake up in the middle of the night, some trouble falling back asleep. And like many of us, she was successful. She was very busy. She was working as a pharmacist with long shifts, three kids, very involved in their activities.

And historically, always been able to manage her busy schedule, but she's feeling like she's having more and more difficulty keeping up, more fatigue, decreased resilience, not waking up, feeling rested, etcetera. Interestingly, when we talked about her family history, though, it's definitely a strong family history of hypothyroidism. So that was kind of including us in the beginning. And she was also on track with that. She was wondering about that.

So she had been tested a bunch of times, but always only with the TSH, the thyroid stimulating hormone, which is kind of like the go to test for a lot of the primary doctors and internal medicine doctors. And it always had been normal. It was in the normal range. But her TSH had been trending up, so remembering that TSH is inversely associated with thyroid function. So a lower TSH is higher thyroid function and that higher TSH means lower thyroid function.

Yeah. Her numbers were 1.2, then 2.3, then 3.6. But she was always told that this was, quote, normal, right? And so her backstory during childhood, we did have some frequent ear infections, needed antibiotics, not infrequently, seven or eight times. I was concerned about some early gut disruption there.

She also had a history of some stomachache episodes but never diagnosed with a problem. Was traveling abroad at one point, got food poisoning, some increased gut symptoms after that, etcetera. Really, it was just trying to watch her diet. And I said, I drink a lot of kombucha. I try to eat a healthy, balanced diet.

But there was some disruption there, too, because of how busy she was. She would skip breakfast. She would frequently get home late from work and not have time for dinner until eight or nine and maybe just have a bowl of cereal, etcetera. So in her words, she came in and she was trying to improve her energy. She wanted to be able to exercise without being sore for days afterwards.

She wanted to feel like an athlete again. She wanted to improve her moods and lessen her brain fog so that she could work more efficiently. So we started off at the start gate with our patients, we tend to do a pretty deep dive. We cast this really wide net, and I know that you guys do this too.

Dr. Mark Hyman
Yeah. So what do you look for? Like when you think about these patients, what are the kinds of things that come up for you as I got to find out what the root cause is? How do you start to think about those?

Dr. Sunjya Schweig
Yeah. So we do a comprehensive blood panel, you know, looking at the thyroid again, but also adding on the three hormones, three T3, three T4. We looked at reverse T3. We looked at thyroid antibodies. You know, we looked at markers of inflammation, markers of blood sugar dysregulation and insulin.

We're also testing it for celiac, for celiac genetics and a celiac panel, given the history of abdominal pain and the strong family history of low thyroid. We did gut testing. We did a stool test, a comprehensive stool test, as well as a SIBO breath test, a small intestinal bacterial overgrowth test. And this was kind of correlated with that history of food poisoning, of the GI complaints and also the cognitive, the brain. The gut brain access is so, so critical to consider and to look at.

And then we also did a deeper dive on the hormones, looking at her adrenal function, looking at her sex hormones, etcetera. We know that a lot of times high functioning people, high achievers, tend to maybe have higher cortisol. They're pushing that envelope early on in their lives, but then that can drop and they can then have low cortisol, which can manifest with increased susceptibility to illnesses, fatigue, brain fog, trouble getting out of bed in the morning, etcetera. So you take a good look

Dr. Mark Hyman
at the gut, you look at kind of hormones. You know, I often often think about looking at other things that are sleepers like heavy metals or environmental toxins, food sensitivities, gluten. Obviously, you did mention that, but that's a huge one. I check for anybody who's got any autoimmune disease. I check for gluten, anybody that is doesn't have to be full celiac.

You can have just low level elevations in these antibodies that can cause significant problems without actually being true celiac. And I think that's often a problem with traditional medicine. It's this on or off. You either have it or you don't have diabetes or you don't. It's not a gradient.

It's not a continuum. So in true in truth, the body is just a continuum of function or dysfunction. And that's the traditional function of medicine. And so it's kind of arbitrators that upset a number like diabetes, one hundred twenty six or while it's 01/2024, you Okay? No.

So the same thing with everything in terms of all the numbers we look at. And I think the ability to kind of find these things are quite impressive. So what did you find when you started to dig in and you looked at the gut and you looked at the hormones, you looked at what else was going on nutritionally with her and how those play a role?

Dr. Sunjya Schweig
Yeah. So this is kind of one of my favorite parts of the work that we do when you have these folks who have been struggling. They've been to a bunch of doctors and they have been kind of told that everything's normal and maybe they've absorbed that. And they've said, okay, I guess it's just I'm getting old or maybe I'm a little bit depressed. But we got all those labs back and we dug in with Sarah and there was a lot of things that we found that were levers, I think these are levers, potential levers that we can pull to help her get better.

So her TSH was 3.8, which on the lab test shows as normal, but you and I and most functional medicine doctors know that that is not optimal. From our functional range, we like to see that at around two or less. So I was definitely concerned around low thyroid function. And in fact, her free T3, the most active thyroid hormone, was in the low normal range. Her reverse T3 was elevated, signaling inflammation and immune activation.

Then she did have elevated antibodies. So her TPO antibodies to her thyroid were high and the Thyroblobulin antibodies were also a little bit high. And importantly, she had an antibody against gluten. She had a positive anti deamidating gliadin peptide, mildly elevated, but certainly very, very significant in my opinion. In The U.

S, that's not necessarily diagnostic of celiac, but in Europe it is. And so there's a little bit of a difference of opinions on sort of how we interpret these, but for me, that's a highly significant marker. For those of you out there who might want to look at testing this on yourself, LabCorp can do this. So can Quest, but the LabCorp test code for the comprehensive celiac panel, I'll just throw it out there for folks, is 165126. So look that up.

If you want to get tested just through your insurance, through LabCorp, it's a great test to look at. She also had low vitamin D, low vitamin B12 and low ferritin, which is the storage form of iron. So all three of those together are telling us that she's not absorbing very well. She's having trouble on the level of the gut and that there's inflammation there. And in addition to just needing to get those levels up, it's sort of a proxy marker for this bigger problem going on.

Her stool test showed dysbiosis, imbalanced bacteria. There was some dropout of the good bacteria. We call that an insufficiency dysbiosis. She had positive H. Pylori, Eulicobacter pylori.

Yeah. And so H. Pylori is a super, super interesting bug. It's one of the it's sort of a model for persistence and for chronic inflammation, and it has been linked in the research literature to autoimmune thyroid. So right there, I got really excited.

Was like, Okay, cool. Here is something which we can treat, we can eradicate. It could explain your local gut symptoms, but could also explain some of the bigger picture autoimmune activation that we're seeing in your body.

Dr. Mark Hyman
Incredible. So so with her, you know, how would you go about starting to treat her? Because there's so many different things. She's got nutritional deficiencies. She's got gut issues, bacterial overgrowth, gluten issues.

I mean, we didn't really check for heavy metals or other things that could be tricky.

Dr. Sunjya Schweig
Yeah, because there's down the road for me. I'd love to just kind of jump in with all these things and see if we get the traction. But yeah, you're right. It's a very important factor.

Dr. Mark Hyman
Yeah. And, you know, she had all these different things. So we

Dr. Sunjya Schweig
had Sarah start an anti inflammatory Whole30 Paleo Reset diet. And in particular, really focused with her on, you have to get rid of gluten 100% for at least thirty days. I like to do it for longer, but sometimes I break it up into bite sized pieces for folks. We wanted her to minimize sugar. We wanted her to avoid dairy, limit alcohol.

And just with that one change, within a couple of weeks, she reported that her energy was better by about 40 or 50%. Her lung was better by about 40% and her joint pain was better by about 60%. And so this is one of the things I love about that is just not only like, okay, she's feeling better, but this is really, really good reinforcement for her that she has control over her health. If she can put things into place that are going to possibly affect her, we're going to stack in some supplements, we're going to stack in some prescriptions potentially, but she immediately has this sense that, you know, her health is in her own hands and she can she could be an active participant, which is what we love.

Dr. Mark Hyman
That's so great. And so let's talk about the diets and autoimmune disease, because I think there's so much controversy on what should eat. Should you be lectin free? Should you be gluten free? Should you be paleo?

Should you be vegan? Should you like, what what are we learning about in terms of food and autoimmune disease? What are the biggest drivers in our diet of autoimmune disease from the dietary perspective? What can people do therapeutically? And like, how do we sort of stack up against choosing what to do for which person?

Dr. Sunjya Schweig
Yeah. So there is no one size fits all approach, but I think there are some basic tenets that we can really factor in. And I think this idea of, you know, we talk about the exposome, right? So there's the genetics, there's the epigenetics. Genetics are hardwired.

The epigenetics is how are your genetics read out, and that can be turned on and off based on environmental factors. And there's this idea of the exposome. These words sound complicated, but they're not. The exposome is basically

Dr. Mark Hyman
I call it the exposome because it sounds better.

Dr. Sunjya Schweig
Yeah, exposome. Everything that you've ever been exposed to from the time you were in your mom's belly until now. Actually, if you want to go deep, it goes back before you were in your mom's belly, right, because it's sort of this methylation and way the epigenetics affect offspring. But really, for simplicity, everything that you've ever been exposed to from the time you were in your mom's belly until now, and we can modify that, right? We can take charge.

And so the diet is, you think about the amount of information that your immune system is being exposed to on a daily, monthly, yearly basis. The food and drink that we take in by our mouth is by far the biggest factor of information that is hitting that immune system in the gut. The next would be air and skin. But again, the biggest lever that we have to pull that can affect how our body is receiving information from the outside world is through the diet. So you want to take out all of the things that are going to be triggering aberrant inflammatory activation.

So the biggest culprits are the processed foods, the sugar grains are frequently made sugar for people. Then eating organic grass fed is really critical because otherwise you're getting chemicals, you're getting pesticides, you're getting hormones, you're getting antibiotics. All of these are drug disruptors, right? And so the really easiest way to start with an anti inflammatory diet or a Whole30 or a Paleo Reset is just to take out all of the junk and eat real food, right? You'll eat real, clean, nutrient dense food and do that for a period of time.

Downstream from that, we sometimes have to specialize. We have to go into more like what's called an autoimmune paleo diet or a low lectin diet or something like the Walls protocol. These are all variations. We don't usually go there first with people, but it's kind of like based it's very individualized based on the response that somebody has. Amazing.

So talk about some

Dr. Mark Hyman
of the things that are controversial, like lectins. Is that something people should focus on or is that just of a marginal thing?

Dr. Sunjya Schweig
I think it's been helpful for a lot of people, but I don't think it's everybody. And so what we do is we kind of go step by step down the list. If people are doing a paleo or a Whole30 and they're just feeling great, I don't necessarily feel the need to go down into the next steps. If they're not feeling well, we go into an autoimmune paleo. But it's also the case, the foundational intervention of anti inflammatory diet in naturopathic medicine, in functional medicine, is get rid of things that might be triggering you and then add them back in one at a time in a systemic way and see what your body tells us.

The food sensitivity testing that you mentioned, that's helpful. I've definitely used that and we like it. But it's imperfect for a lot of reasons. But what does your body tell you? What is your body reading out to you in terms of symptoms and reactions?

You can argue with that.

Dr. Mark Hyman
So what is the approach then from a functional medicine perspective for Raynaud syndrome?

Dr. Cindy Geyer
Yeah, so from a diagnostic standpoint, as I mentioned before, we want to look at all those cardiometabolic risk factors. We want to look for the underlying tax are up regulating the immune system, whether it's gluten or food sensitivities or something going on in the gut microbiome or an infection. And then from a treatment standpoint, a lot of the same lifestyle things that we normally specifically help those arteries be more resilient, less reactive. So we know for example that studies on meditation, yoga, biofeedback can show improvements in Raynaud's and artery elasticity after six weeks of a regular consistent practice.

Dr. Mark Hyman
Oh, this yoga makes Right.

Dr. Sunjya Schweig
That's great.

Dr. Mark Hyman
So you can you can basically meditate your blood vessels healthier. Right? That's good.

Dr. Cindy Geyer
Yeah. Who what was that story years ago of somebody meditating and they could change the temperature in one hand versus the other.

Dr. Mark Hyman
Oh, they yeah. Yeah.

Dr. Cindy Geyer
Five degrees or something incredible. Yeah. So we have more control over that autonomic nervous system than what we thought.

Dr. Mark Hyman
Mhmm. You know, I've often found, you find any other things you've run around diet or supplements helpful for these patients?

Dr. Cindy Geyer
Yeah. There's a lot. So, against specific food components, omega-three fatty acids have benefits on artery elasticity, whether that's fish, fish oil, nuts and seeds. Arginine is an interesting amino acid. It's used by the arteries to make their own version of nitroglycerin, it's a precursor of nitroglycerin which of course dilates blood vessels.

Dr. Mark Hyman
Nitric oxide,

Dr. Cindy Geyer
yes thank you, nitric oxide. So getting nuts and seeds or maybe even supplementing arginine, The deeply pigmented foods that are rich in bioflavonoids, a lot of those polyphenolic foods also relax the arteries, things like resveratrol for example. Folate rich foods, stark leafy greens, another powerhouse for the arteries. So if we think of that extrovertent olive oil, another food that has natural benefits on relaxing the arteries. So Yeah.

Dr. Mark Hyman
Could really- That's really a lot of what I use, Cindy. I often I'll supplement with arginine. They're very symptomatic if they're going out, often even ginkgo, which is another product. But I think the nitric oxide is interesting. You can increase nitric oxide by your breathing too.

Just practices. We had Lou Ignarro on our podcast who won the Nobel Prize for his discovery of nitric oxide and its role in improving overall health, reducing inflammation. It's incredibly important for lung health as well. With COVID, they're finding nitric being very effective treating COVID patients. He talks a lot about that on the podcast.

But the nitric oxide can also be increased by Viagra or Cialis or any of those drugs that are used for sexual enhancement, but they actually they actually work by increasing blood flow and circulation. So that's a good thing. So, you know, maybe if you have Raynaud's, that might help as well. So arginine, you can take or you can do the, those drugs or, you know, you can actually use Inco and other things, bioflavonoids, I used to use quite a bit. And combining that with the root cause, the medical detective piece.

Because you can't just give those so they got renal, give them Arginine. No. Well, why do they have Raynaud's? Like, what is the cause? What is the root?

And I think that's what often people miss. Even in integrative medicine, they'll say, oh, well, you have Raynaud's, use Argin. I'm like, No, no, no. Why do you have Raynaud's? What is the root cause?

This is the part that we often miss in medicine. That's why at the Ultra Wellness Center, we really have such a robust practice because we are the medical detectives looking for the root cause. And I just tell you, I just say like an anecdote about a patient I just had this week that was just, you know, it's one of those stories. He's really awesome guy and he developed a tick ticks when he was, not tick bites, but he developed like motor ticks, you know, when he was eight. And I started asking him about his story.

The doctor was nothing he can do, take these drugs, whatever. So I said, well, what was it like? What was happening? You know? Did you get infection?

Did you have this? You have that. I started digging into his story. And we had tons of infections and Swapping. Kinds of things.

You know, we know there's a syndrome called PANDAS, which is pediatric autoimmune disease of neurologic blah blah blah. Don't know it stands for, but so long. And and and that is associated with strep infections that cause behavior issues, OCD, ticks. And when I checked his labs, he had super high antibodies to strep. On the cutting panel, he had really high antibodies against some of the components in his brain related to strep.

Yet no one had even thought to ask the question of why. So whether it's tick and disorders or whether it's Raynaud's or whatever, if you get into the habit of thinking, which is what I love about functional medicine because it makes you think as opposed to just rote memorization and knee jerk reaction that's what we get in medicine, which is we make the diagnosis, then we don't have to think anymore. We just basically say, Here's a cookbook protocol that is in 2021 for XYZ disease. Functional medicine is different. We have to start thinking, we call it thinking and linking.

We know your fingers get cold and turn white and you have no circulations because you have Raynaud's. Like, no, that's just the name of what it looks like. That's just the name of the problem. It's not the cause of the problem.

Dr. Todd LePine
All right, so lupus actually comes from the Latin word meaning wolf. And typically people with classic lupus have, well, they have a facial rash, it's called the malar rash. It's like a butterfly rash, and over time they can actually, say that you develop like a wolf like appearance.

Dr. Mark Hyman
Yeah, cheeks get all red and and all eyes.

Dr. Todd LePine
Exactly, and that's due to photosensitivity. And so lupus is one of those conditions which we see a lot. Interestingly, it's about nine times more prevalent in women. So that raises a question, well, what's the difference between women and men, and why are women

Dr. Sunjya Schweig
I'm still trying to figure that out.

Dr. Todd LePine
Oh, actually think I have an insight into that. It's really quite interesting.

Dr. Mark Hyman
How men and women are different?

Dr. Todd LePine
Yeah, how men and women are different, right, right. And then the other thing that is also interesting is that we traditionally treat it with medications like steroids, methotrexate, Plaquenil, those kinds of things, which all have their significant side effects.

Dr. Mark Hyman
And

Dr. Todd LePine
in my opinion, one of

Dr. Mark Hyman
the the These are powerful immune suppressing drugs. Right?

Dr. Todd LePine
Oh, yeah.

Dr. Mark Hyman
And they even use biological agents Biologics. Which really shut off your immune system. And they they can work, but they're often fraught with danger, including the risk of cancer and overwhelming infection if you get a bad infection. So Right. They're not they're very expensive, up to $50 a year per Yeah.

Per person.

Dr. Todd LePine
Yeah. And then also to, you know, one of the things that I always used to, it was intriguing to me when I was doing my training was drug induced lupus. Because we were taught that lupus is an autoimmune condition. Yeah. But there is a condition called drug induced lupus.

So that always raised my question, well what's, how is a drug causing lupus? And what we see is that in, I think one of the major drugs was an older drug called procainamide. I don't remember if I remember using that. Yeah. It was an antiarrhythmic.

Yeah. And in certain patients who got procainamide, they would develop lupus. Looks just like, you know, what we call lupus SLE, systemic lupus erythematosus. And that always fascinated me that a drug would be triggering this. And when I actually went down that sort of rabbit hole, what we find out is that procainamide can actually damage DNA.

Uh-huh. And it's probably theorized that, some types of things like drugs or stealth infections like viruses, may trigger, the body and cause some, damage in the DNA. And when we test for lupus, I mean some of the tests that are, are double stranded DNA antibodies.

Dr. Mark Hyman
The traditional blood tests look at what are the autoimmune antibodies that

Dr. Todd LePine
we Yeah, and it's interesting because there's a whole bunch of different markers that are used in the diagnosis of autoimmune conditions. You have autoimmune panels, the traditional one is ANA, the antinuclear antigen, typically in patients who have lupus that's positive, and then you can look for other biomarkers like double stranded DNA and such.

Dr. Mark Hyman
And the DNA can be positive in many, many people, even if they don't have lupus, and there's this whole phenomenon of pre autoimmune disease where you're starting to have these autoimmune antibodies, but you don't really have a lot of symptoms yet, but your body is pre diabetes. This is like pre autoimmune disease.

Dr. Todd LePine
Exactly. And I always tell my patients that's like when the check engine light comes on in your car. Exactly. If you ignore that, you're gonna get, you know, smoke coming out the hood soon.

Dr. Mark Hyman
Traditional medicine ignores.

Dr. Todd LePine
Totally ignores.

Dr. Sunjya Schweig
If you

Dr. Mark Hyman
don't meet these five criteria for this diagnosis, then you don't have it, and we can't treat you.

Dr. Todd LePine
Right.

Dr. Mark Hyman
It's like the patient I had who came with a blood sugar of 120. I said, Jesus, your doctor checked that out. He's like, oh, yeah. I said, what's happening? What do you recommend?

He says, well, said I should watch it until it's 126, and then he'll give

Dr. Todd LePine
me treatment for diabetes. Is that crazy? Yeah, it's, yeah. We'll wait till the horse's on the barn and we'll try to corral it. Yeah.

Yeah, it's unfortunate but I guess you know when you look at how many people do have conditions that are, you know, even subclinical hypothyroidism, there's a lot of things that if you look early enough, you'll, it's a lot easier to treat them when you catch them early. You know, if you're starting to have early cognitive decline, Alzheimer's is a lot easier to treat when you catch it early. Diabetes is a lot easier. Heart disease, autoimmune conditions. So preemptive personalized medicine is the way to go.

Dr. Mark Hyman
That's what we do at the Ultra Wellness Center here in functional medicine. So this patient had this condition that was treated by traditional medicine, was she on a bunch of drugs?

Dr. Todd LePine
She actually came in, had done courses of primarily Plaquenil and Prednisone. And she was actually pretty proactive in her sort of self care.

Dr. Mark Hyman
Plaquenil by the way, for those listening is the same as hydroxychloroquine that they're using for COVID-nineteen.

Dr. Todd LePine
Right, and we also realized that Plaquenil is actually an anti microbial. Yeah. It's used for malaria. That's the original use for it. But they found, somebody must have had malaria and then developed lupus, and you know, they said, hey, this is working.

So it's, you know, that's sort of how they sort of discover other uses for medications. So, but this particular, she was actually involved in the healthcare field, I think she was a therapist, if I recall properly. And so she done a lot of stuff on her own. The big thing with her is that, and she told me this, that she felt that her lupus was actually triggered by stress. She had a son who had some medical issues and was having issues both with, you know, dealing with a teenager who had some illness and that sort of tripped it over.

And oftentimes if I take the history of patients who develop an autoimmune condition, it's oftentimes followed by a period of chronic stress that's unrelenting. It's a very, very common thing.

Dr. Mark Hyman
Well let's talk about stress for a minute because you know my thinking about stress is it sort of sets the table for other things to sort of take over. So it doesn't cause that. Not in and of itself. It may it may cause some illnesses for some people, but it it for the most time it exacerbates whatever is going on. So if you're stressed, your immune system is suppressed, you're gonna get more inflammation.

Dr. Todd LePine
Yep.

Dr. Mark Hyman
And then if you have underlying issues like this woman did, they're gonna come out.

Dr. Todd LePine
Absolutely.

Dr. Mark Hyman
So tell us how you approach this from a functional medicine perspective. How do we think about autoimmune disease in general from a functional medicine perspective and lupus particularly?

Dr. Todd LePine
Well when I see a patient who has lupus, and I go down sort of the checklist. So I look at, okay, do they have sensitivity to gluten? The other thing which I find in a lot of lupus patients is Epstein Barr virus. So Epstein Barr virus is the virus that causes mono, and mono stands for mononucleosis because the virus infects your white blood cells. And the thing about Epstein Barr virus is it's very common, about seventy, eighty percent of the population has it.

Most of the time the immune system will clear it. It's a herpes class virus, just like a cold sore. Once you get a herpes cold sore, that virus stays in your body all the time. Most of time the immune system keeps it in check, but there are certain individuals where the virus will reactivate and the herpes virus will come out or the mono can actually reactivate.

Dr. Mark Hyman
So a cold sore in your lip is basically a herpes virus. Herpes And it doesn't come out all the time, it comes out under stress. Cold Cold weather, emotional stress, getting a cold, sunlight. So it's sort of a latent virus. We all live with hundreds of viruses in us.

When we're stressed it allows those viruses to emerge. Exactly. So this is what happened with these patients.

Dr. Todd LePine
Yeah, so I always like to go down and ask the question, so why is this? Do women have lupus more than men?

Dr. Mark Hyman
Well, functional medicine, it's why, why, why.

Dr. Todd LePine
Right, then interestingly, when you go into the medical literature in autoimmunity related to lupus, the Epstein Barr virus is associated with seven different autoimmune conditions. Multiple sclerosis, rheumatoid arthritis, lupus, type one diabetes, ulcerative colitis. So what happens is the virus, in some cases patients will reactivate and it causes a stimulation of the immune system and the immune system will then start reacting to it. And then interestingly, I've always been curious about photosensitivity. Like why does photosensitivity happen in patients who have lupus?

What's going on there? Why is it when they get sunlight, is it affecting them? And what I found out in literature is that the virus causes the body to produce more interferon gamma. And interferon gamma is our body's, one of the cytokines that help our bodies to fight out viruses. And when we have high levels of this interferon gamma, it sensitizes the body to sunlight.

So that's why you get that sort of lupus like photosensitivity, especially with exposure to sunlight.

Dr. Mark Hyman
And interferon is one of the treatments we're looking at for fighting

Dr. Todd LePine
Yes, they have, what they do is they have an overabundance and it may be a genetic predisposition. There may be some single nucleotide polymorphisms that certain lupus patients have and they produce lots of interferon gamma and that actually gets involved in the skin cells and it can make them more photosensitive. So it's an interesting phenomenon. And then the other thing about, you know, when, I've seen this with a lot of regular mainstream doctors, they'll say, well, you can't really check for Epstein Barr virus because everybody's, you know, antibodies are positive, it just means that you've been exposed to it. Well, that's true.

But if you actually do specific testing for Epstein Barr virus, so there's a panel that we do which checks for antibodies to the nuclear antigen and cytoplasmic antigen, and then also the early antigen. And then I'll also throw in the Epstein Barr virus by PCR. So is checking for the DNA of the virus.

Dr. Mark Hyman
You're actually seeing if there's live virus around circulating in your blood, not just your immune Exactly,

Dr. Todd LePine
so what typically in the panel that we use, if you have the three out of four antibodies that are positive, especially with the early antigen and or with the PCR of the Epstein Barr virus, you know proof positive that the Epstein Barr virus is exactly reactive. And that's where, you have to ask yourself, well, what do I do to calm down that particular virus? So there's a lot of things that you have to look at.

Dr. Mark Hyman
Yeah, mean that's true, feel like she really has a different perspective and that's why we we see so many patients here at the Ultra Wellness Center who've tried so many things and then they get better because we look at all the factors. So when I think of an autoimmune patient or just any disease in general, there are really only five main triggers. It's a toxin. So I've had patients with lupus have autoimmune disease triggered by heavy metals for example. Could be Mercury.

An infection like lupus or it could be the microbiome changes. Yes. I mean, the allergen, something they're eating like gluten. Yep. And it could be poor diet which is inflammatory and has you know, for example, a lot of the emulsifiers in our food like carrageenan and all these gums.

Yes. There they cause leaky gut driving inflammation, and it also can be stress like you said. Often it's many of those things together.

Dr. Todd LePine
Exactly. Yes. For her, was

Dr. Mark Hyman
a few of those For her, was stress and the virus, and also her gut was a mess too.

Dr. Todd LePine
Yes. Her gut was a mess. Yeah. So the other thing that she noticed is that if she ate foods that were high in lectins, things like the nightshade family, that her symptoms actually got worse. It was interesting, some of the work by Peter D'Amo, who was the author of The Blood Type Diet, he's the guru of lectins.

And what we find is that in certain individuals, when you have high lectins in your diet, and these are compounds that are found in plants, which actually act as a defense mechanism for the plant so that animals and insects are less likely to eat them. Lectins, there's in the medical literature, a case study of a hospital that thought they would have a healthy eating day, they served everybody red kidney beans in some type of a casserole or a soup, and then everybody got sick from it because it was very high in lectins, and it actually caused transient leaky gut. They had an immune response to the lectins in the plants. And I've had a number of patients, it says not everybody will have that response to lectins.

Dr. Mark Hyman
Mean there's a lot of promotion out there of lectin free diets as the cure for everything.

Dr. Todd LePine
Or low lectins, low lectins. Yeah. It's impossible to get this A

Dr. Mark Hyman
low lectin diet. And I think it can be helpful for some specific

Dr. Todd LePine
patients.

Dr. Mark Hyman
Exactly. Think the thing is that everybody finds the latest fad and thinks it's the cure for everything. Exactly. It's really not. And when you're in functional medicine you get humbled by understanding how complex things are.

Absolutely. How everybody's really different, how one person may tolerate gluten and another person may not. One person may be fine with lectins, another person may not. But if you have an autoimmune or inflammatory condition, it's something worth trying.

Dr. Todd LePine
Absolutely, it is. And I'll interject here because this is an interesting finding. Stumbled upon this, and again, this was actually by Peter Dudamo who got me down this rabbit hole. I just recently had a patient who had five autoimmune conditions, including lupus. And I checked for a lab test called mannose binding lectin.

Dr. Mark Hyman
Have you checked for Actually no, but

Dr. Todd LePine
I know about it. Right, it's one of those things and he's the one who got me to understand this. So mannose binding lectin is a compound that our body makes to bind mannose. A lot of Is

Dr. Mark Hyman
it sugar?

Dr. Todd LePine
It's a sugar, it's a mannose is a sugar. And what you find out is that people who have mannose binding lectin deficiency are at higher risk for lupus. And hers was undetected.

Dr. Mark Hyman
Yeah and I think the other thing I wanna just point out is that you you're talking about this patient with lupus and she had gluten, she had gut issues, she had stress, she had this virus, she had lectin sensitivity, but that was her. You take 10 other patients with lupus, they're all different. The problem with traditional thinking is that everybody with lupus gets the same treatment. Once you make the diagnosis you stop thinking. And in functional medicine when you have the diagnosis that's when you start thinking.

It's just the first step of solving the problem. It's like okay, This is what your picture looks like. Okay. What are the potential factors that we need to think about to get to the root cause? Then we have to treat the cause, not the symptom.

Let's talk about what is autoimmunity? What causes it? And, you know, why should we be so concerned? Well, autoimmune disease, like I mentioned, things like rheumatoid arthritis, psoriatic arthritis, lupus, type one diabetes, Graves' disease, type two motor disease, multiple sclerosis, Crohn's disease, colitis, I mean, the list goes on, are all diseases where the body is attacking itself. The immune system is out of control.

It creates systemic inflammation. And depending on your genetics and the various issues you have, it attacks different parts of the body. But, essentially, the process is the same where we create autoantibodies. We create antibodies, which are normally designed to fight infection or even to kill cancer. We create antibodies to then attack our own tissues, and that's when we get into trouble.

So, basically, we have this run of inflammation. We have an immune system that's confused, and our immune system is supposed to empty up when we have foreign invaders, like, or we have cancer, killing cancer, and that's good. And when we're maybe trying to deal with our gut and creating antibodies and different food food things that are in there, although that usually is because of a leaking gut. And so, basically, your immune system is is your first line of defense, but when it goes awry, it causes widespread destruction in the body, and your own cells and tissues and organs get caught in the crossfire. And it's not a good thing.

It's just not a good thing. It's good when it comes to the cancer, when it comes to infections. We want that. What we see now is a a total epidemic about immune disease that that has been completely misunderstood. In fact, now there's even a conversation about pre autoimmune disease that a lot of people are seeing positive levels of ANA antibodies, you know, we test for at @functionhealth.com, which is a testing platform where you can order your own tests essentially and get the results and have an interpretation figure out what's going on.

So we pick we're picking up a lot of people, probably thirty percent of the people that we see, just young, very healthy people, nonrelatively sick people generally, are showing up with an elevated level of an antibody called antinuclear antibody, which is an early sign of autoimmune disease. So this is really scary to me as a doctor. So the question is, you know, you know, why is the body doing this? What is the root cause? You know, most doctors when they think of a patient will essentially go, well, here's the symptoms.

Here's the lab tests. Okay. You have these tests. You have these symptoms that are off. It means you have this or that disease.

We name the disease, and then we blame the disease for the problem. Now this young girl, Isabelle, I I was talking about before, she came to see me when she was 10 years old, and she had a severe autoimmune disease called dermatomyositis. Dermatomyositis is nobody's best friend. Essentially, it's one of the worst autoimmune disease you can have with everything. Your joints, your skin, your liver, your blood vessels, your muscles.

I mean, pretty much everything gets affected, and so you have widespread destruction throughout your body. Now the doctors didn't say, gee, why is her immune system so pissed off? Instead, they gave her a pilot drug, steroids, cancer drugs to suppress her immune system. They're about to put her on an immune blocker called TNF alpha, which is a antagonist, which is basically blocking the inflammation marker in the in the blood that's responsible for a lot of autoimmune disease, which can be helpful. But, again, nobody was asking a very simple question is, why is she so inflamed in the first place?

Why is her immune system so pissed off? Now as I mentioned, it's about one of the most severe cases of autoimmune disease I've ever seen at 10 years old. She had severe skin rashes. That's the dermatitis. It's pretty much it is means inflammation.

She had every kind of it is. She had vasculitis, which is inflammation of your blood vessels causing Raynaud's. She had gastritis causing inflammation of her esophageal tract and causing trouble reflux. She had hepatitis affecting her liver. She had inflammation of her blood cells.

I don't even know what you call that. It's like she had low white count and low red cells. She had severe muscle damage, so she had myositis and and very severely elevated. She had also severe arthritis and joint swelling. So, basically, everything was under attack.

Now this cute little girl, Isabel, was 10 years old. She's from Texas. She loved riding horses. She couldn't do the most basic things anymore. She couldn't squeeze her hand or make a fist.

Her tips of her fingers and her toes were totally numb all the time from Raynaud's disease, which is the damage of the blood vessels, autoimmune condition. She had rashes all over her body that were irritated. She was exhausted. She felt miserable. Her hair was falling out, and she was being treated by doctors who were doing the best they could but were using the old paradigm.

They were saying, okay. Well, she got inflammation. Let's get that under control. So they give her a huge dose of steroids, something called Stolu Medrol, which is essentially a horse dose of of twelve hundred milligrams intravenously. Had to go to the hospital and get intravenous steroids every three weeks just to sort of be able to function.

She was on methotrexate, which is a chemo drug because that suppresses inflammation. She was on also aspirin to thin her blood because of inflammation that caused her blood to clot. She was on acid blocker because of the reflux from her stomach. She was on calcium channel blockers to help open up her blood vessels because of her Raynaud's. I mean, little she was on more drugs than I've seen even an 80 year olds be on.

And despite these megadust of medications, she wasn't better. I mean, she was managed they call it managing her disease. Her labs were all abnormal. Her skin was still inflamed. Her joints were still inflamed.

She just wasn't in the hospital, basically. And and her doctors wanted to add another drug called the TNF alpha blocker, something like Remicade or Humira. You might have heard about it. You probably saw the ads on TV because there are tons of ads for these drugs on TV, which is a whole another topic because farmers should not be advertising on TV. But, anyway, it basically, this drug can be helpful, but if you don't have anything else to do to fix the problem, but it increases the risk of cancer and also infections because it suppresses the immune system.

Right? So it turns off the inflammation. And we need inflammation from cancer and infection, but not for autoimmune disease or allergy. Right? So that's the problem.

Now her mom was not happy with this plan, but she brought her to see me, and and we we did a pretty simple program. It wasn't that hard, but I asked a very different set of questions. I asked not, you know, what's the inflammation, but what's the cause? Not what's the name of her disease, but what's the cause of her problem? What's pissing off her immune system?

And so that's the job of a functional medicine doctor, to be a detective, to look deeply into the root causes and to try to understand why. And I always say functional medicine is the medicine of why. Conventional medicine is the medicine of what. What disease do you have, and what drug do I get? Not why.

In fact, I always say, just because you know the name of your disease, it doesn't mean you know what's wrong with you. Say it again. Just because you know the name of your disease, let's say dermatomyositis, it doesn't mean you know what's wrong or what's causing it. Right? Dermatomyositis just means skin and muscle inflammation because those are the two most prominent symptoms.

It doesn't mean anything. It's just a fancy medical word describing the symptoms. Nothing to do with the cause. So functional medicine gives us a map to help understand why, to understand inflammation. I often call myself an informologist, and that's what we should be, informologists.

And for back to inflammation, you know, immune disease is a is a real issue and, obviously, in allergy and asthma, but also in heart disease and cancer and diabetes and obesity and dementia. Pretty much all the age related diseases or all disease of inflammation. In my book, Young Forever, I did talk a lot about how one of the hallmarks of aging is inflammation or what we call inflammation. So when we look at the causes, how do you start to think about causes systematically? How do we have a organized approach to diagnosis about what is causing the body to react to something?

Now what I what we really know is that that the body's not really attacking itself on purpose. It's trying to do the job that it's supposed to do, which is fight bad things. Right? Bad things. What are the bad things?

Allergens, bugs, microbes, and mostly imbalances in your gut or your microbiome. We'll talk about that. Toxins. And, you know, also stress and poor diet also drive inflammation, and psychological stress, physical stresses. But but, basically, there are really five causes of almost all disease, allergens, and that can be a food sensitivity.

It can be a true allergen, phenology. It can be microbes. It can be something like, you know, Lyme disease or hepatitis or anything like that. Plus it can be just dysbiosis, imbalances in the floor in the gut. It can be toxins, petrochemical toxins and metal toxins, from pesticides, herbicides, plastics, well as heavy metal toxins, flame retardants.

I mean, the list of. So in fact, there's a whole school of research now on what we call auto gems. Auto gems are environmental toxins that trigger an autoimmune response. So all these factors need to be investigated. We need to look at each person's, okay, do they have any allergy stuff?

Is there gluten sensitivity? Are they harboring latent infections that might be confusing their immune system? Do they have a toxin like heavy metal or pesticides? What's their diet like? Are they eating an inflammatory diet?

How much stress do they have? All these things need to be considered and need to be investigated. And that's really what functional medicine does. It helps you investigate the root cause. It's really a diagnostic model to think about an operating system to think about the body as a system, to think about root causes, and to help the body restore balance.

That's the goal. So, basically, you gotta figure out the cause. If you wanna fix if you wanna fix autoimmune disease, you got to get to the cause. And, you know, unfortunately, medicine, we don't do a good job with that. We get a little bit of that, but not much.

Right? If you have pneumonia, it's caused by streptococcal infection. Okay. You get penicillin. That's fine.

But most diseases are chronic diseases, By the way, six out of ten Americans have, which are accountable for over eighty five percent of our health care costs, which are now $4,300,000,000,000. Yeah. It's caused by an infection like streptococcal pneumonia or, you know, hepatitis C. I mean, are real. They need to be treated, but that's not really the majority of problems people are seeing.

So functional medicine docs really understand the body of the system. It's an ecosystem, and we seek the cause. We understand the basic interactions between them. We know when things go wrong, how to fix it, and and understanding interconnections between symptoms and organs and systems rather than all these specialties. You know, I always say, you know, I don't really know need to know anything about, you know, the fine points of a particular autoimmune disease or be a specialist in that area.

Uh-huh. But I need to understand explanation. I need to see the root causes. And I and I can treat I'd never seen a case of dermatomyositis in my life other than, you know, with traditional medicine care when I was in residency and early early practice. But when a as a functional medicine doctor, I'd never treated one before, but I knew exactly what to do because I followed the methodology of functional medicine.

It provides a fundamental different fundamentally different way of solving medical problems, gets to the root of the illness, and understand the disturbances that that really are going on. So let's talk about Isabelle a little bit more. So she she you know, I was seeing good doctors, and their response was to shut down this kid's immune system. You know? Let's let's this kid's suffering.

Let's just throw the whole kitchen sink, the whole bar, and everything. And and that would have been okay. She might have done improvements in her symptoms, but she would have had a high risk for cancer infection, osteoporosis, muscle weight things, psychiatric illnesses, and, by the way, would have cost a huge amount of money forever. Right? This is a 10 year old girl.

She's gonna be on a drug that costs $50 a year for the next sixty years. You do the math. That's one person. So we're talking about an untenable thing. So I asked really a simple question as well, which is why?

I didn't folks know what the name of the disease was. I wanna know why it's been fucking morning. Inflammation started. How we can really find the root causes, how we get to restore balance in her immune system. So besides she's not finding the cause, it's also understanding how to get the immune system working better, taking out the bad stuff, putting in the good stuff.

So some insults usually are triggering some confusion. We call it molecular mimicry. There's a theory about a musical molecular mimicry that that the for example, some food you're eating or gluten, you know, somehow confuses your immune system and it thinks your your thyroid is, you know, some foreign object, but it's just cross reacting with the gluten antibodies, and that's why you end up with immune disease. So we were looking for toxins, removing your allergens, looking for bugs, your dysbiosis. And by the way, a lot of autoimmune disease starts in the gut, and and a lot of it starts what we call leaky gut, which clearly she had.

So when I kinda did her history, I have very detailed history. It's really important. She takes to find out what the story is. You know? Not just how here's your disease, but, like, what is your background?

Right? She had exposure to severe toxic mold, and that can be a trigger. That's a toxin. Stachybotrys is black mold, and that was in her house. And her mother also worked in limestone pits when she was pregnant, and she just floats a lot of toxins and fluoride, even heavy metals.

And she also also had her immunizations before 1999. And before 1999, the American Academy of Pediatrics and the CDC had not removed from vaccines for childhood vaccines. They're eating a lot of, like, a 67 times the amount of mercury in the vaccines until they go, oh, wait a minute. We have that in our all mercury. So they did remove it except for flu shots.

And so if you're getting a multidose file flu shot, which is what most people get, single dose doesn't have find aerosol, but it's a preservative. So when you're sick and you're going over and over, you got a multidose vial, you use it. But it it it's in the flu shot. So she was getting flu shots every year. And now she also loved to eat sushi.

So she had large amount of tuna, sushi, which she had regularly gotten more mercury. She also had dieted very high in sugar, lots of dairy. She also had many infections over her life, ear infections, sore throats, and and because she was a lot of immunosuppressive drugs too. And steroids also caused problems. She had lots of antibiotics.

So lots of antibiotics, lots of steroids, which causes real damage to the gut. So mold, mercury, antibiotics, sugar, dairy, gluten, junk food, all were potential irritants. So when I when I dug in, I looked at her lab tests pretty carefully. And, you know, on the conventional labs, they were a mess. Right?

So they were, you know, high levels of muscle enzymes called CBK. Her liver function tests were off the chart. She had many autoimmune antibodies that were just slightly high and they were off the chart high, like, highest I've ever seen. Anti nuclear antibody, rheumatoid factor, anti SSA or Sjogren's antibodies, anti double stranded DNA, anti or RP, leukocyte anticoagulant. Lot of big mumbo jumbo medical terms.

But, basically, the whole soup of autoimmune antibodies were just off the chart with her. And, by the way, most autoimmune specialists do not check antibodies after the initial check because they go, oh, they don't ever go back to normal. Like, no. They don't if you don't get rid of the cause. They knew if you get rid of the cause, and we saw that with Isabelle.

So she had also a lot of problems. She had other lots of elevations and other markers of inflammation like protein. Her white count was really low. Her red cells were low. Her vitamin d was moderately low.

She had really high antibodies to gluten, which by the way is a common cause of autoimmune disease, probably the most common, and can trigger significant inflammation, a leaking gut. Her mercury level, we did a challenge test, was off the chart. And and the only way to really check is is to actually give people a drug that pulls out the metals like the MSA, and she had a a level of 33. Normal is less than three. So it was very high.

And then the first visit, I simply didn't do too much. I just put her on an anti inflammatory elimination diet. So no gluten, no dairy, no sugar, no processed foods, got rid of the most common allergens. I gave her multivitamin. I got her vitamin d, vitamin d twelve, folate because of the acid blockers blocking that.

I get fish oil, which is anti inflammatory, even primrose oil, which is anti inflammatory. So I get kinda gave her some basic nutritional support. And I also gave her an antifungal. Nystatin, it's not absorbed, but it's used to treat yeast overgrowth. And I suspect that she had that due to the multiple course of antibiotics with the steroids she'd been taking.

I also gave her liver support, chemical enestyl cysteine, support her liver and boost her methionine. And I told her parents, probably, over time, she's fine. She'd taper off her acid blocker, the calcium channel blocker, her Raynaud's, and the steroids if she could. Two minutes later, she comes back. And, you know, I didn't know I know what to expect.

Two minutes later, she came back, and she said her symptoms were completely gone. Her rash was gone. Her joint pain was gone. Her hair was growing back. Her muscles weren't hurting.

Offer medication. Her autoimmune markers are much, much better. Her muscle enzymes, her liver function, her c reactive protein, all normal. Now this is just two months. Then I added, probiotics to help her digestive system heal a little bit and reduce the gut inflammation.

I got her an accumulating drug called DMSA to bind the metal from her tissues and operate it and help get off the prednisone. I gave her some herbs to help her adrenal glands because she was on in a lot of steroids, and she tapered those down. Seven of them, months later, everything was normal. All of her lab tests were normal, including her white count, her liver function, her muscle enzymes, the autoimmune antibodies, except for one called RNP, but every other autoimmune antibody that we mentioned that were off the chart, ANA, factor, all that stuff, Completely normal. Never see that.

Right? Her mercury came down from 33 to 16. After eleven months, her mercury came down 11. Her gut inflammation was gone. Oh, yeah.

She had a lot of gut inflammation. You know, she had digestive symptoms. She had a test that we look at stool testing. And why would I look at stool testing an autoimmune patient? But, basically, every autoimmune patient should have a stool test.

Right? We use GIFX by Genova. Essentially, at calprotectin, which is a marker you can actually get at a regular lab like Quest or Labcorp. And calprotectin is a marker of gut inflammation that is super important because, it's used for colitis or Crohn's disease. But if you have just slight elevations, it all indicates a low level of inflammation.

So really, really important. Now after a year, she was off all her medications. Her labs are normal. She felt great. She was able to ride her horse again, the show, and she was just so excited.

And and I, you know, I checked in with her, like, many years later, and she was great. And she was still fine, and we fixed the problem. So you get rid of the cause. It's not like stuff keeps coming back. Now I've treated autoimmune disease for decades this way, and I've seen patient after patient we've got resolved.

Not everybody a %, but the majority get better if not cured. Now her case really isn't rare, and I take a similar approach pretty much with all autoimmune diseases. You have to be detective and be an informologist and what's going on. Now if what I'm saying is true, like I said before, this should be a major effort from the NIH and the US government and private donations to actually fund research to look at this in a different way. But everybody's in their silos.

Everybody's got their specialty. Nobody's thinking out of the body of the whole system. The you went to the clinic when we we did research looking at psoriatic arthritis and rheumatoid arthritis, comparing top rheumatologists there to our clinic, the functional medicine doctor, our patients did better in terms of all the objective metrics and the scoring systems for rheumatoid arthritis and psoriatic arthritis. So I think this is really possible. So what are the 10 steps to think about your reverse autoimmune disease?

Well, it's really, really easy. First, take out the bad stuff, and you have to find it all. And so for Isabelle, it's a lot. It was mold. It was mercury.

It was yeast in her gut. It was gluten. It was green metals. You know, it was all the stuff. And we have to add back the good stuff.

We add back the good stuff, all the ingredients for good health. Right? Whole foods, right, levels of nutrients, the balance of hormones, light, inner water, movement, connection, meaning, love, purpose. All these things are really essential ingredients for health. So if you have an autoimmune disease, I really encourage you to find a functional medicine doctor and work with them.

We see patients at the Ultra Wellness Center. Check your labs out. Try FunctionHealth.com. Get your panel done. You can see if you have pre autoimmune disease or other markers.

And and I think, you know, you'll be able to really move forward. So what do need do? First, get tested for hidden infections. Now there are a lot of things that can go wrong. When I say infections, it can also be dysbiosis, which is imbalances in the gut flora that cause gut and cause damage where, by the way, 70% of your immune system is in your gut.

So if there's a damaged gut lining and you're getting food and and bugs leaking in, your immune systems get seeing that, it's like, ah, with an immune response, That's essentially what happens. But that's probably the most common cause. Gluten is a big factor in causing leaky gut. It's probably one of the biggest factor because it increases something called zonulin, which disturbs the tight junctions in the cells and hold them together and allows food and bacterial proteins and things to leak in. But other things can be factors too.

You can have a parasite. For example, parasites are associated with rheumatoid arthritis. It can be Lyme disease, which has been linked to autoimmune disease, other tick infections. You need to be a detective and be able to figure that out. Check for heavy metals.

Check for environmental chemicals. Really important. Like mercury. Fix your leaky gut. Really important.

And that's so important. I think we just talked about leaky gut, but get rid of the bad bug, go to cheese, parasites, bad bacteria. Provide the the this this program that you need to actually heal your gut. We call it five r program in functional medicine, which is removing the bad stuff like bad foods and inflammatory foods and allergens, bad bugs, and then replacing things that are missing, like digestive enzymes or prebiotics, reinoculate with healthy bacteria, probiotics, repair which is by the nutrients for gut lining healing, for example, glutamine, zinc, and fish oil, eating primrose oil. Many other compounds are really important.

Vitamin A for healing gut. And and then the fifth r is restore, which is to reset your nervous system and be dealing with stress differently. Super important.

Dr. Mark Hyman
If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Doctor Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the doctor Hyman show wherever you get your podcasts.

And don't forget to check out my YouTube channel at Doctor Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Doctor Hyman show. This podcast is separate from my clinical practice at the Ultra Wellness Center,

Dr. Mark Hyman
my work at Cleveland Clinic,

Dr. Mark Hyman
and Function Health where I am chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services.

If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at UltraWellnessCenter.com, and request to become patient. It's important to have someone in your corner who is a trained, licensed health care practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible.

Thanks so much again for listening.