When Medicine Doesn’t Know What To Do It Calls It Anxiety

Welcome back once again, everybody. We are in our series talking about medical gaslighting, the things that our healthcare system thinks to be right, they're just plain wrong, and how it results in medical gaslighting. It's when people with real symptoms, real complaints, are told it's all in their head, they can't be helped. Um, and the result is with us becoming medical feminists, we have to realize that the individuals that are affected by this the most are actually our female patients. I think educating people about this just helps us to take charge of our health. And realize if you have symptoms, you have concerns, you have things that are real, it's not just you, it's not in your head. And working with someone that can help you figure that out is paramount. I don't know if you have any comments before we dive into— Yeah, the gaslighting aspect.

I mean, I just think it's— I didn't realize how ubiquitous it was as an XER doc. You didn't see a whole lot of this because we were like the ground where everyone came when they, they were scared, they were unheard, uncared for. And so, and we had to see everybody and we did. And so you just saw a little bit of everything, but you made people feel a little bit better. And oftentimes you caught really bad diseases and, and, and even saved some lives or lost them along the way. So I didn't really fully understand this concept until I, I started working here and saw it in so many of my patients and just by listening to their stories and listening to how they came to be sitting in a chair across from me, um, just wanting help. And, and it's not uncommon for them to break down in tears and start crying. And, and I, we haven't discussed anything other than their health history, but they feel heard or they feel a little bit of hope, a glimmer of hope amidst that conversation for the first time in 15, 20 years. And to me, that was that light bulb moment of, oh my God, like gaslighting is horrible and it's ubiquitous and it's affecting this main demographic of female patients and it's contributing to their disease burden. It's, it's now one of the epigenetic phenomenon that's hurting them. And it's not necessarily, um, you know, malicious. It's often just ignorance. It's like, you know, there's a quote that you have here. Gaslighting begins when medicine treats unexplained symptoms as illegitimate. Instead of unfinished science. That's the difference between saying you're crazy, or I don't know that answer, but let me keep trying and looking it up and let's test more, or here's a specialist. It's, it's just, it's harder to do that second one. You have to be invested. You have to want that person to be better. You need to maybe dedicate some of your own free time. Well, a lot of people are going to say, screw that. And they're just going to call that person crazy and, and give them an SSRI. It's the harder work that gets the conclusion. So a lot of this hits home. A lot of this is really kind of personal at this point in time.

Actually, I was looking at, um, we should have said this last episode. There's a great quote: what if one of the deadliest blind spots of medicine was solved by soap? Yeah, and that's back to the Simulvies thing, like hand washing. Like, literally soap. Yeah, soap and water is one of the biggest health changes like in the last two centuries. And when you think like that, like what is the stupid simple thing we're missing right now? Yeah. That's been overlooked for all the cool, the cool fancy gadgets. And we've had all these great conversations about that. So, what I have, you know, as far as the blind spots turning into gaslighting. Gaslighting. I think about gaslighting. I think about fibromyalgia as like probably the, the biggest one. I think most people realize now, like, yeah, it's a, it's a thing.

Definitely.

But it originally was a psychiatric issue. When I was in my training in 1996, I was told it was a psychiatric issue. We treated with an SSRI, Prozac, Paxil, Cymbalta worked really good for it as well. If you have sleep issues, 'cause people with fibromyalgia tend to have sleep issues, right? Yeah. Energy issues, pain issues. And so, well, let's help with the sleep. Use nortriptyline, use a tricyclic.

Ambien.

Yeah. Which I don't use Ambien anymore, but, but the thing was is that the symptoms were treated. The patients, typically females, were told it's all in your head, psychiatric. And they got better with sleep and with the SSRI. Now we know it's in your head. It's 100% psychiatric. It's like, well, now we know. Fast forward 30-ish years. Now we know that fibromyalgia is an issue with microglia. It's actually a brain on fire phenomenon. And all we know that now SSRIs have— are anti-inflammatory. They help lower your cortisol. Okay. We know sleep is super important for your health. I mean, I remember my mantra for about 8 years of my life during medical school and residency was, I'll sleep when I'm dead. Yeah.

Because that's what we all say. Because I don't think we're 10-foot tall and bulletproof.

Oh yeah, we have— it's kind of, kind of happened. Yeah. But, um, but now it's like, oh my gosh, I'm turning 53. I'm like, I need my 8.5 hours every night.

Sleep is my religion. And, and the other thing, like, that makes just— that makes sense if you understand what's happening during sleep. Yeah, your lymphatic system's kicking in, right? So the brain's lymphatic system, the supporting cast, is housekeeping. And so if you're not sleeping, and this is a microglial issue, and the glial cells and the astrocytes are active at night when they're supposed to be cleaning and being less inflamed, but you're, you're also not sleeping. You're pouring gas on the fire. And so ultimately you're getting to a point where, yeah, these people are going to be symptomatic in some centralized way. That's not really easy to quantify. So they make that diagnosis and they say it's all in your head. But, but like, it's, I think there's even ways to isolate certain markers now. Um, is it, can't you get cerebrospinal fluid markers that can confirm fibromyalgia? So like we're even having some quantifiable objective measures that we can see. I mean, that's a, that's a phenomenal example. What are some other good examples of gaslighting?

I mean, the, I think the perimenopause, like going through the change when women's hormones are coming down. And now that we understand the, the effect of cortisol and as you know, the, the buffer for high cortisol is adequate estrogen and sex hormones. And as you lose those, you lose the buffer. So all of a sudden hot flashing vasovagal symptoms, sleep disturbances that can all be caused by the nervous system being overactive is actually uncovered. You know, the thing I tell patients is estrogen is your superpower. So, we have high estrogen when you're in your 20s, you can have a family, have a career, get a graduate degree, start a business, do all this stuff. And then, you hit 50, go through menopause and everything, or 47, or now 42, 43, I'm seeing younger and younger. And you also, you lose your superpower. And cortisol has been sitting there for 20 years.

Yeah.

And all of a sudden now you're like, oh, miserable. I ache, I hurt, got brain fog, all these things. And it's like recognizing that actually giving someone in that stage, you know, your testosterone's low, a little bit of testosterone, your progesterone, you have progesterone, you have luteal phase deficiency.

Yeah.

I think most women these days have heard that term.

Yeah.

Luteal phase deficiency. Need a little progesterone. All of a sudden you can make that so much better. And then like with all the symptoms, if you have mold or Lyme or you've had a concussion or injury or your vitamin D is low, or your inflammatory markers are off, or your gut's a wreck, which is where 75% of all neurotransmitters are made, addressing those can actually help the symptoms. But saying this is a female-centric psychiatric thing we've all gone through, you'll be fine, ignoring that. And now we know that you lose, you know, 2%, 3% of your bone during that perimenopause in the first 2 years. The hot flashes are actually a surrogate marker for risk for cardiovascular disease.

Cardiovascular disease, yeah.

So all the symptoms that they're having now are like, these are all big deals. These are not all in your head phenomena.

And yeah, and you don't just throw Biosa at it. You can, but you can't, but you got to figure out what's going on and help that person.

Yeah. So there's, there's many other, you know, gaslighting phenomena. There's actually the, um, the story I'd written down here of Incline Village was actually a—

yeah, tell that one.

Yeah. Well, it was, it was interesting because it was a, it was a, a small grouping of individuals at a school at this, at this place, Incline Village. This was in the '80s, if I remember correctly. Which is around Lake Tahoe. And they reported, hey, there's some teachers having aches and pains and fevers and feeling awful. Eventually got to the level that the CDC sent a group out to investigate. Like, ah, it's a bunch of teachers, mostly women. Don't worry about it. Kind of blew them off. About 10 years later, they found out actually it was water damage building. So it was mold. Shocker. Yeah, I know. 'Cause there's never any mold anywhere, is there? And so this whole, but this was not just like, this was actually a group of teachers at a school, at a building, and they were totally blown off. And eventually it got to the level, and the CDC came back later and acknowledged it. And they said, but it was the point, it's like something happened at an environmental level to enough people that it got the ear of government officials. And the response was, Eh, it's all in your head.

Yeah.

And it took over a decade to realize that this was actually something. And then, you know, Shoemaker comes along and with Fisteria overgrowth, and we realize, oh, biotoxins. Yeah. And all of a sudden, this idea of biotoxin, which is a big bucket, can cause fibromyalgia, can be related with POTS and dysautonomia, autoimmune issues you've mentioned before. A lot of these things are illnesses or diseases that predominantly affect women. And so all of a sudden they get gaslit. It's all in your head. It's hard being a mom. It's like, yeah, it's no, it's— this is a real pathology.

It's just part of being a woman. I mean, labs are normal.

Labs are normal.

Well, it's just anxious.

One of the things I tell a lot of my patients is, you know, the, there's the female physiology is way more complex than male physiology. In order to have a baby, a tumor inside of your womb, and not reject it and actually bring forth that. If we could figure that out, we could eliminate organ transplant. We could probably eliminate most autoimmune diseases if we could figure out how women's bodies do that. Yeah. So that crazy miraculous thing, there's a cost with it. And unfortunately, a lot of times the cost is women's bodies get, you know, how many moms will say they're having their kids have wrecked their health, you know? Yeah. Yeah.

A lot of them.

Yeah. And so it's all of a sudden like you have to realize there's a different need, just like just like we have pediatricians for kids and realize that infants are different. We have geriatricians for older people. We need to have people that actually realize the nuances of the female physiology and the female body at different ages, at different hormone levels. Yeah. And to date, the response of our healthcare system has been, it's all in your head.

Yeah.

Psychiatric. You're stressed. You're right. You need to take a vacation.

Yeah.

You need to go away.

And I'm so hopeful that the tides are finally turning. And I think it needs to start with management of perimenopause and postmenopause and hormone replacement and some of the stuff we've already talked about. But I think just fluctuating hormones and understanding hormones at different chapters, in different chapters of a woman's life, um, it just needs to be better. Because also part of the gaslighting that we have, the examples like endometriosis and PCOS, like these are Not a hormone withdrawal syndrome. This is excess estrogen. And, and, you know, the metabolic dysfunction that goes along with PCOS is what gets gaslit because they tend to be overweight and have prediabetes and metabolic syndrome. And so it's just like, oh, you're distressed. Oh, you're not exercising. Oh, your diet sucks. There's a hormone phenomenon. There's an inflammatory metabolic phenomenon. There's usually a high toxic burden in those patients. Why not help them through that and teach them what that means? You know, I'm a huge proponent of a 24-hour urine estrogen detox test to, to look at your estrogen metabolites and see how well or not well you're breaking estradiol down into estrone and what 3 subtypes. I think it could be really informative about what's going on in that woman at that time. Like if you do that at an early age and teach that woman, okay, stop drinking out of plastic, filter your water, eat more fiber, Eat flaxseeds, get more broccoli in your life, stop drinking alcohol, exercise more, manage your stress, use natural cosmetics, like all the lifestyle hacks. Now that person maybe never has 3 miscarriages. Now that person maybe never has PCOS or endometriosis or an early breast lump in her 30s that's malignant because you stopped it in its tracks at an early age because you asked some questions and did a little bit of expanded testing. That's, that's the problem that I have with all this, like I see so much pain and suffering that could have been avoided. Like the ER, that was it. Like that was 100% it. I got, I tried to get away from that. Right. I did. But like our patients are not emergently suffering, but they're suffering. And the issue is on top of their suffering, they don't look outwardly overtly sick. So they're not taken seriously even by their own families. This is not just gaslighting by healthcare professionals or in that story, the government. You're gaslit by people that say they love you. Like everybody, like I'm about to start dropping F-bombs. Like this is really like serious, you know?

Yeah. Well, POTS is a great example of, of that. Um, my first patient I saw with POTS, it's really interesting cuz the physician I, when I came here to Virginia, um, I've actually talked with him and he specifically told me not to mention his name, so I won't mention his name, but. He was old school physician, trained up clinic, very, very clinically adroit. And he realized that, you know, he had to, you know, I ended up adopting some, you know, some patients from him. And one of them in particular had passing out episodes. She was in the marching band. She'd stand up straight and like get overheated really easy, pass out, had anxiety. And he realized, you know, she had a volume issue. He'd look at her pulse. So he gave her fludrocortisone. And all of a sudden, like her anxiety got better and she was able to get through high school and go to college. And, he just intuitively realized that some of these people had a fluid volume thing and would have them do more fluid, do— Salt and electrolytes. Yeah. Do spironolactone. And I'm sorry, fluidocortisone to hold onto— Yeah. Intravascular volume. And all of a sudden it's like, now we use fluidocortisone routinely with our POTS patients. And he kind of intuitively saw that, but he was an outlier. Most at that point in time, most physicians would see a young female that gets overheated easily, who has, you know, low blood pressure, pulse is a little fast, has bouts of anxiety hitting her, will wake up from sleep sometimes with a panic attack, with heart racing. Sometimes they'll be sitting down watching TV and just happens all of a sudden. Always a little bit of low-level anxiety, startles easy, maybe gets some modeling in the hands, weird color, you know, These are all stereotypical examples of a POTS, dysautonomia POTS patient that even today in Richmond, there are neurologists and cardiologists who don't really believe or treat dysautonomia POTS. Even though now, like some of the POTS expert places near Mayo, Hopkins, Anderson, like there's, it's accepted. There's actually textbooks on this now, but POTS is something that was That still is.

And still is.

Yeah. And who, who's the expert with POTS? It's like, it, it's a hormonal problem. It's an autoimmune problem. It's a neurologic, it's an, um, cardiovascular, cardiovascular. It's an electrolyte volume thing. It's much more, and there's 5 things that are associated with it. Hypermobility, mast cell activation syndrome. We got the POTS, autoimmune issues and GI problems. And like all these things are like the functional world du jour. Yeah. And so like, there's not a home for POTS.

Nobody wants to take ownership of it. Nobody wants to, no field wants to be the POTS field or, or subspecialty of some field. No one's claiming it. So you're lucky if you can find a clinician, like in the cardiovascular or neurologic world, who's willing to like dabble in this and maybe do a tilt table or an asoline or have suspicion or do a trial of beta blockers or fludrocortisone or whatever. Or even just counsel you on how to move and wear some Spanx and eat a bunch of salt. Like there's, there's low-hanging fruit and you don't need to be a specialist to be able to treat some of these patients. Small thing, small changes can make profound impact on someone who comes in naive to this. Now, if it's someone who's like seen all the people and they've tried all the drugs, that's a lot harder. But if it's someone who's like has the symptoms, like the list of symptoms in medicine that get minimized, fatigue, pain, autonomic or dysautonomic symptoms, hormone transitions. For me, I wrote down extraintestinal GI dysfunction. You know, that person has no GI symptoms, but you know inherently that their gut is the source of their eczema or their mood or their inflammation. That's a hard sell. Like, trying to get somebody to poop in a box because they have eczema is not always easy. But then you show them how inflamed and leaky and dysbiotic their gut is, and you work on that, and they get better. So like, just understanding the ties between these things. Um, toxic symptoms, they're, they're all over the place. And in medicine, diseases follow traditional kind of, um, organ system maps, so to speak. And like, when someone has like different symptoms that cross all party lines, they don't know what to do. They get confused by it. So it must be psychiatric, but that's SIRS. That's usually toxin-induced, environmental-induced. These are a lot of the symptoms that get kind of pushed to the, to the fringe.

Well, I think, you know, taking that and going, you know, right now I feel like neurodivergence is like a buzzword. Neurodivergence includes things like ADHD, dyslexia, PANDAS/PANS, includes a lot of your Asperger-ish kind of autism spectrum. Yeah, pervasive, it used to be called pervasive development disorder. It's had 3 names in my career, you know, but just spectrum-y kind of kids. And I think most moms, most parents, most people realize that this is, this is a thing now. But back in the '70s, the moms were diagnosed with kids with, with these kids that had eye avoidance, that didn't have appropriate social play. The issue with the kid was refrigerator mother syndrome. Yeah. Refrigerator mother syndrome. It's mom's fault. Just imagine you worry about your kid. They seem a little quirky, a little off. You go to the doctor and the doctor's like, it's your fault. You're not loving enough. You're not caring and compassionate enough. Now what we know now— You're too cold. Like, you're too cold. Yeah, yeah, exactly. Now what we know now is neurodivergence is in families. So the moms are probably on the spectrum a little bit. So they're probably a little quirky, a little, you know, off, you know, on the spectrum. Their kids are a little more. But at that point in time, the healthcare system was like, it's your fault. Yeah.

And just quite literally, it was like, it's your fault.

'cause you're a refrigerator mother.

Yeah.

And so, and now we acknowledge, okay, but then we, you know, we see our patients in like hypermobile, you know, there's a, if you're hypermobile, you have a 400% increased instance of being neurodivergent. And then you talk about the whole fascia thing. It's like, now we understand how if your fascia is stretchy, 80% of all the neural pathways are sensory to, from your body to your brain. So if all your tissues are stretchy, 80% of the, the neurological inputs are overactivated. What happens? Your nervous system gets a little wound up and gets a little like on edge a little bit.

Yeah.

Okay. So now that, that makes biological plausibility why hypermobility, you might see more nervous system overactivation, et cetera, et cetera. But not so long ago.

Yeah.

Not so long ago we said it's even now, like what we do with, what we do with, you know, when you see a kid on the spectrum, I'm thinking nutritional. Like you have all these kids that have protein, All my hypermobile patients, when I do organic acid testing, they all have low protein, low amino acids. Yeah. Yeah. They all have the D levels are all low. They need like 5,000 to 10,000 units a day just to keep their D levels normal. They have micronutrient rare earth mineral deficiencies. Because the connective tissues are a little saggy, they tend to be more prone towards IBS kind of stuff, autoimmune issues. Yeah. They need more self-care. They also tend to be, you know, one of the things I've noticed a lot is a lot of these Individuals are empaths. And so all of a sudden it's like, great, you got your spidey sense. Dr. Jensen, you got your spidey sense. But if you, the spidey sense gets traumatized or is chronically stressed or chronically ill, all of a sudden now you get this like microtrauma that keeps your nervous system ramped up. It's like, okay, now there's a paradigm I can think about this with. But now our healthcare system, if you're neurodivergent, it's like, what's your disease? You go to your psychiatrist to get on your medications for whatever, or neurologist if you're 'cause a tick disorder, tick disorders are dopamine issues. We use clonidine, guanfacine to treat those. I've used those in my training. Well, now we use that stuff in POTS patients. It's like, but that grouping of individuals right now is kind of in this gaslighting weird world. But my point is at one point in time we used to blame the moms for that. Yeah. Which is like, again, just bonkers to me that that was a thing. It's horrible.

What are some of the other flagship cases? I mean, we talked about heart disease, talked about Tahoe, endometriosis, POTS. I mean, the main issue with this is, is ultimately people get hurt in the process, right? And then they, they have self-doubt, they have mistrust of the system. Um, it just potentiates negativity and negative stereotypes about healthcare in general. And then these individuals have a hard time trusting you when you become somebody who is an advocate for them. And that becomes part of the problem. I mean, I think this is a lot of, um, the stuckness or limbic dysfunction that we deal with. You know, a patient hits a wall, objective measurements are getting better, but symptomatically they're not. To me, that's where they're stuck. And the stuckness is usually limbic dysfunction. It's usually predicated on some backstory that sounds a little bit about what we were talking about. And you might have to go back and deal with it, or send them to a therapist or have them do neurofeedback or some limbic retraining on their own. But like, there's, there's a lot of this out there. It just, it just needs more, more airtime.

Yeah. And one of the things we skipped a bunch over the week is I had a list of things including like how we got peanut allergies wrong. Like literally we were telling people not to give their kids peanuts and usually moms are the ones that are doing this stuff. And fast forward 2015, 2016, 2015, there's a study showing that if you give your kids peanuts earlier, you lower the risk for peanut allergies 83%. And by what we did, we actually increased the peanut allergies 400 to 500%. And so all of a sudden it's like, this was actually a successful thing that was pushed by the American Academy of Pediatrics that resulted in lots of peanut allergies. You know, fats. I mean, we got the whole fat thing wrong for half a century, you know, literally just January this past year, fats are back. They're not waiting for it sometimes. So the top of the food pyramid is huge. You get this big fat section. Yeah. But it's interesting how many of my kids with, um, on the spectrum, when I check their cholesterol levels, all their cholesterol levels are low. Low. Yeah. And so how many of these kids have fatty acid deficiencies in their brains? And I haven't read that study, but I do know there's a drug called Vyarin, which is FDA approved to treat ADHD. And it's prescription DHA. It's a prescription fish oil. I'm like, huh, maybe there's a subset, a significant subset of people with, of young, young people with ADD, ADHD that simply have an omega-3 deficiency. Yeah.

Interesting. Makes sense.

Yeah. And so all of a sudden there's all these examples of our system getting things wrong. Making a recommendation that was bad. And, you know, decades later we're like, oops, you know? Yeah. And so realizing the system, you know, the dogma, you know, science creates a dogma. It's a paradigm we see the world through. And that's good. You need students need to learn that, need to have some kind of frame of reference. But when you become an expert, you're now thinking outside the box and you're seeing past your paradigm and your paradigm's changing every month or two or three as you learn new things. Not the paradigm, dogma is the standard of care, which that's what it's become. And so again, who's that hurt the most? It hurts, it tends to hurt in our population, women more.

Yeah.

Yeah.

Well said.

So I guess we'll move on to move on to the next one. Yeah. So if anybody, if this, if this is resonating with anybody out there, you know, I feel like we can just ramble aimlessly about different topics, trying to make it pertinent. We'd love to hear your stories if you've had an example of you being medically gaslit. Yeah. Especially if it's something we missed.

I mean, 100%. Yeah. The goal Our goal is for us to compile these videos and these podcasts to, to provide information. But neither one of us believes that we know everything. So whatever you can teach us, whatever you can send, an example of something that you may feel isn't being spoken about enough, please send it. We'll, we'll read it and we'll do something about it.

Yeah. We can also look into it and research it. Yeah. I'll learn from my patients.

Yeah. Me too.

Yeah.

Cool.

Hope this is helpful. Take care and we'll talk to you soon.

All right.