3 Mistakes People Make When Trying To Heal Autoimmune Disease

Coming up on this episode of the Doctor's Pharmacy.

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Super staggering. And maybe we can even start off by listing these three things big picture and then talking a little bit about why the heck is autoimmune disease so quickly on the rise. So, Mark, you made a list of three things, three things that are common mistakes that people make when trying to get to the root of their autoimmune.

Mm.

Whatever that might be, Hashimoto's, Grave's disease, whatever, in that category, rheumatoid arthritis. So what are the three things big picture? And then let's talk about why autoimmune is so on the rise.

You know, what's challenging about our current medical system is it, particularly on autoimmune disease is there's a belief that there's no often cause that can be identified. And so what we have to do is shut off the immune system. with powerful medication, chemotherapy drugs like methotrexate or cyclosporine, immunosuppressive drugs that using transplant cases with biologic, we call biologics, which are powerful suppressors of immune function that block TNF alpha and other mechanisms. And these drugs cost 30 to $50,000 a year and they increase risk of cancer, increase the risk of infection. So relying on medication as the only solution, compiling more and more medications is usually what happens to people. And the disease can sometimes be kept in check, but it's not cured. And that leads to the second mistake, which is thinking that autoimmune disease is incurable. And that's what I certainly learned. That once you got it, you got it. You got MS, you got rheumatoid arthritis, you got lupus, you got Hashimoto's, you got whatever, and there's a bazillion autoimmune diseases that affect over 80 million people, more women than men for different reasons. But the basic belief is it's a one way street. And I've even talked to rheumatologists about this and said, gee, they said we never rechecked auto antibodies because the way we often diagnose it in addition to symptoms is looking at the antibodies your body produces against itself. So autoimmune disease is essentially is where your immune system turns on you. You start attacking your own tissues. You start attacking your brain, your nerves, your heart, your muscles. There's all these different organs and systems in your body that can be the targets of your immune system. So it's almost like, you know, it's kind of like things gone crazy in your body because you're all of a sudden don't recognize self. You know, why don't you attack yourself? Because your body knows it's you. Right? If you get a blood transfusion from someone who's not a type, you'll get a transfusion reaction. If you get a kidney transplant from someone who's not your type, you get a transplant reaction because your body's like, that's not me, that's foreign. But all of a sudden your body's confused and goes, Ooh, this joint or this brain or this liver or this kidney, whatever, is foreign. So I'm gonna start attacking it to protect myself. The problem is that doctors never check the antibodies after they diagnose the disease because they say, oh, well, they never go down. And the answer is, yes, they never go down if you don't know what to do. In other words, if you don't know how to reverse it, if you don't know how to actually can correct the autoimmune disease and deal with the root cause, then obviously you don't want to check them. So there's a sense that it's irreversible. And that leads to the third issue, which is the reason people think it's irreversible is that In medicine, we haven't been very effective at looking at the root causes of autoimmune disease, which are food, toxins, allergens, microbes, including the microbiome, which is a huge part of it, and stress. So in the absence of looking for those triggers of immune dysregulation, we just pour on more and more drugs to shut off the immune system.

So, Mark, let's take even a further step back than that. What are the underlining conditions that are contributing to an explosion of autoimmune that's going on in the world that the world has never seen before? Yeah, it's incredible.

I mean, Drew, I remember seeing a graph years ago in a medical journal, I think it was New England Journal of Medicine, it showed the declining rates of infectious disease, you know, polio, tuberculosis, you know, all that stuff. and measles. And then at the same time, the graph was like all the autoimmune diseases, MS, rheumatoid arthritis, lupus, Hashimoto's, and lots more, all on the rise. So it's not like we mutated our genome in the last hundred years. What happened? It was a fundamental change in our environment. One, we stopped having to deal with infections. So here's an interesting example. In Sardinia, there's a beautiful book called the Epidemic of Absence, which is the absence of healthy gut flora and the absence of the microbes in our gut that keep us healthy, but also the absence of things that we had to deal with before. So historically, you know, we were like, you know, cavemen and then we were hunter-gatherers and, you know, not exactly the most hygienic things. There wasn't hand sanitizer at every counter or like there is now.

Not our modern version of hygiene.

Yeah, so there's this whole concept of this hygiene hypothesis where we over-sanitize our life. And in Sardinia, they had a particular adaptation to malaria, which allowed them to not suffer the consequences of malaria, but it turned out that that protective mechanism against malaria also left them predisposed to MS. So they have high rates of MS, even sickle cell. Sickle cell trait is a trait that if you have one copy of the sickle cell gene, you are very resistant to malaria. But if you have two copies, you're, you're kind of in bad shape. But, but, but sickle cell protected you also against malaria. So there were adaptations that we had to deal with all these infections, parasites, worms. I mean, we lived with all this stuff, and all of a sudden, the immune system's like, oh, I don't know, you know, I don't know what to do. I'm gonna go find something else to attack, right? That's part of that. So the hygiene hypothesis is really essential to this. So when one happens, our diet's radically changed. So when our diet changes, it's way more inflammatory. It's highly processed sugar drives inflammation, but also the quality of the food that we're eating has changed. So, you know, I was in Sardinia last summer and they had this grano cappelli, which is this ancient form of wheat. Now we eat mostly dwarf wheat, which is hybridized wheat that has high levels of gliadin protein, super starch, and glyphosate, which destroys your microbiome. So you're getting like a triple whammy. You're feeding tons of sugar into your gut, you're getting glyphosate, which destroys your microbiome, and you're getting all these additional gliadin or gluten proteins that are more likely to cause inflammatory responses. So you've got the quality decreasing in our diet, you've got processing increasing, you've got increasing antigens in our diet that are from like I said, from, for example, the wheat that we're eating, which is highly antigenic with these extra gliding antibodies. And then on top of that, we flooded our society with antibiotics. There's about 37 or 38 million pounds of antibiotics used every year in America. 29 million are used for animals, not for treating infection, but to prevent disease because of overcrowding and bad conditions and so forth. And that leads to overexposure to antibiotics, which destroys our microbiome. and then of course breastfeeding has been an issue. And so we end up with lots of problems with a decrease in breastfeeding and that is important in regulating and developing the immune system of the baby. And then we have this flood of C-sections, up to third of all births are now C-sections, which prevents you from going through the birth canal and colonizing your gut. And on top of that, even if you did colonize your gut, the mother's probably taking antibiotics, which kills off a keystone species that we've talked about in the podcast called Bifidobacterium, infantis, and this particular bacteria is critical for regulating and developing the immune system in babies. So even when a baby's being born vaginally, which is good because it imbibes the vaginal flora which colonizes their gut and helps them stay healthy and helps them develop their immune system, the mothers most likely had antibiotics in her life. And there probably aren't too many Americans and humans on the planet left who have not had antibiotics at some point in their life. and antibiotics are particularly toxic to a particular bacteria, this keystone species called Bifidobacterium infantis. And what's fascinating, this is really amazing to me, is that breast milk, 25% of the calories in breast milk are not available to the baby. So why would nature slash God, goddess, the divine, or whatever, put 25% of energy in breast milk that the baby can't even use? It's to feed this particular bacteria and other bacteria called oligosaccharides. They're undigestible starches that are so big the body can't break them down, but the bugs love 'em. And so I encourage, you know, women to, when they're having babies, to actually take the, this bifidobacterium infantis and also for the, for the babies once they're born to start taking it. 'Cause even, even the mothers are likely to have had killed off their species 'cause of all the antibiotics. So we've got, and then we've got increasing stress, which is just because our society is just so connected, stressful. You know, you could be living a little village somewhere in a town and never know what's going on in the world and everything's good. Now every second, you know what's happening everywhere. And it's kind of stressful, like the war that's going on now in Ukraine. It's, it's, it's, it's, it's, our bodies just register that and it's not good. And stress causes an immune breakdown. And then lastly, there's been 80,000 new toxins that have chemicals that have been, you know, introduced into our environment since the 1900s, and many of them are toxic. And so there's a whole, there's a whole phenomena of research going on about what we call auto gens. We've talked about obesogens, toxic chemicals that make you gain weight. These are autogens. These are autoimmune triggering toxins. So I, I just tell you a quick case of a patient I had years ago at Kenny Ranch, who had ulcerative colitis, and he was like wasting away. It was just stomach was just a mess. He tried everything. I did all my functional medicine tricks on him. Nothing worked. And I'm like, what is going on? I'm like, you know, so go back to basic principles. What could be a trigger? What's what, what it could be pissing off his system. So I did a heavy metal test on him, and he had extremely high levels of mercury. We chelated all the mercury, and boom, his gut got better. And he was better. so I think we often miss the obvious things we can do. And there's many, many books written about the role of toxins. So there's a lot of things we can do to identify what's going on, even when you have a microbiome problem in the gut that leads to increased allergens, which also can be inflammatory and lead to autoimmune disease. So we are, from a functional medicine perspective, we are so good at this. And I just tell you a little anecdote about, what's not an anecdote, it's a published study, from the Cleveland Clinic, where we had our rheumatologists who were collaborating with the top, this is, I think, the number two rheumatology department in the world. These are top, top doctors compared to our functional medicine doctors, which are good. And so we compared our autoimmune patients with their autoimmune patients. We matched them and we saw who did better. And you think, you know, these guys are the world's experts. But, and they're great and they're my good friends and what they do is amazing. And, and they know a lot more than I do about most autoimmune diseases. But when we focused on cleaning up their diet and dealing with these, the microbiome and optimizing their health, the outcomes were amazing. And our patients did better on all the objective rheumatology metrics that are standardized metrics that the rheumatologists use to determine the effectiveness of a treatment. So it's like, and the thing is we didn't actually do the study. We gave them our data. So they did it. The rheumatology department analyzed the data and wrote up the study and I obviously helped edit it and published it, but it was like, wow, okay. And so then I think it starts to get their attention and they start to realize that, oh, there's something more we can do for our patients. I remember I had a, one patient was dealing with a lot of inflammatory stuff and we thought maybe autoimmune and she saw this rheumatologist and in California at Cedar Sinai. And she's like, would you mind talking to my doctor? And when I get these requests, I'm like, sure, of course I'll talk to your doctor. In the back of my mind, I'm going, oh, this is going to be a conversation. It's not going to be fun. And they're going to be resistant to what I'm saying and they're going to be a little bit standoffish and blah, blah, blah. So I get on the phone with this guy. He's like, Dr. Hyman, I've been using all your anti-inflammatory diet with my rheumatology.

Patients and you know what? The results are amazing. I'm like, oh God, thank God someone gets it.

I think things are changing.

You were talking about toxins and saying we have to look at the obvious things, but the thing about mercury in that instance is that that's not obvious to a lot of people. So just help them understand, not that everybody who has autoimmune is dealing with toxins as the primary driver, right? There are people. In fact, Terry Wahls in the Wahls Protocol, she's been on your podcast before and says that a big contributor of her autoimmune condition, MS, she feels was living on a farm as a young kid. basically bathing in pesticides on a regular basis. So how is it that something like mercury or toxins can encourage autoimmune to take place in the body?

Yeah, I'm going to explain that in a minute, but I want to just back up for a little bit because the fundamental principle of functional medicine is this. Just because you know the name of your disease doesn't mean you know what's wrong with you. You have MS, you have rheumatoid arthritis, you have psoriatic arthritis, It doesn't mean you know what's wrong with you because you could have 10 people with psoriatic arthritis or MS or rheumatoid arthritis, which have 10 different causes and need 10 different treatments. So even though the end result is the same, one might be caused by an excess of toxins, one might be caused by gluten, one might be caused by leaky gut and microbiome problems, one might be caused by some latent infection that confuses the immune system to attack itself. There, there, there's really important sort of framework of like what I'm saying about, you know, this particular case or this patient doesn't necessarily apply to all patients, right? With, with autoimmune disease, it's very specific. So we'll talk about toxins. Here's the problem. You know, we're all loaded with toxins. I'm on the board of the environmental group, working group, and they did a number of studies. They did the 10 baby study where they looked at the umbilical cord blood of newborn babies before they even took their first breath. And there were 287 known toxins in there, 210 of which were neurotoxins. including phthalates, PCBs, heavy metals, flame retardants, dioxins, DDT, stuff that's been banned for 50 years, still float around and are in us. And there's another study where they did fat biopsy where they looked, if you get a tummy tuck or you get a breast reduction or you get liposuction, and they'll send that off to the lab, and they did a study where they found that every one of us is basically a cesspool of toxins. and dioxin again, things like DDT, PCBs, phthalates. And so all of us have a background level of these toxins. The challenge comes when they sort of overwhelm our system. And so I'm always focused every day on how do I continually activate my detox system through the foods I eat. I upgrade my diet through broccoli and the collard cabbage kale, the brassica family, onions and garlic, a lot of herbs and spices. I use things like high fibers and volatile fibers help bind toxins in my gut. Sauna therapy, hot and cold therapy, upregulate glutathione with supplements like N-acetyl cysteine. So I do a lot of things to actually constantly help my body eliminate this stuff, but it's just there. So it's important to think, okay, well if I have an autoimmune disease, it's one of the things I have to check for. And there are ways to check. We look at heavy metal testing. Again, most doctors will not check heavy metals or if they do, they'll just take whole blood, which can be helpful if you're constantly eating something like tuna. But if you haven't eaten tuna for six months and but you ate tuna for the 10 years before every day, it wouldn't show up because your body clears it and it stores it in your tissues and your organs and your brain. And so you have to do a challenge test. There are also tests you can look at. For toxins, the urinary markers. So we do often for people come in who have high risk diseases that are toxin related, like autoimmune or like, for example, Parkinson's disease. I'll look at urinary levels of pesticides and phthalates and BPA and various toxins. You can also actually look for other toxins in the urine that are excreted, that are metabolic toxins that you can tell that are occurring. and then you also can look at actually your immune response to toxins. So we do a whole panel of tests in our clinic that looks at antibodies to a whole slew of toxins, metals, pesticides, chemicals, all the stuff we're exposed to. And we can see if somebody's immune system is starting to get really pissed off about these things. So there's a lot of tests we can do to look at these things, help determine whether they're playing a role or not. And you don't always know, like if I see some with a high level of mercury or whatever compound, I'll get rid of it, assuming that it, it's gonna help, but until we get rid of it, we don't actually know if it's gonna help or not. Cause it may be three other things and often there's three or four or five things that are going wrong that.

You have to all deal with. One of the things that functional medicine is really good at is kind of like catching autoimmune like behavior in the body before it really has the full blown diagnosis of autoimmunity. And maybe that might be Lupus or Hashimoto's or that. What are some of the tests or methods that you've practiced or that the doctors at the Ultra Wellness Center, Cleveland Clinic, other functional medicine doctors that are out there, that if somebody's sort of, they're starting to like quack like a duck, they're starting to walk like a duck, but in there, they're in that subclinical range where they don't have a.

Diagnosis yet, but they're on their way. How do you detect that early autoimmune activity in the body? Yeah, you know, it's interesting. We talk about pre-diabetes and pre-hypertension. I mean, now we talk about pre-autoimmune disease. But it's all nonsense. There's a continuum of disease from super optimal health all the way to full-blown end-stage disease. Most doctors will not take care of someone until they're actually have crossed that line to a full-blown diagnosable disease.

Which is like, you're finally bad enough, I can do something with you.

Yeah, yeah. Well, doctor, my ANA or this antibody is high. What do I do? Oh, nothing. It's just, Come back if you're sick, you know? And when I see those things and my, my radar goes off, I'm like, this person's heading for trouble. And before you asked, you know, what, what, you know, what, what, what are the conditions that have changed that allow people to kind of end up with autoimmune disease? And I can tell you it's not universal, but the stories I hear with people who get autoimmune is so common. And usually they happen in like 30s and 40s. But, you know, what, what I often see is a story of, C-section, not breastfed, early antibiotics, maybe colic, maybe eczema, maybe allergies, irritable bowel syndrome, and then boom, autoimmune disease. So it's a lead up of decades of dysfunction with the gut microbiome and with food and with all kinds of stuff that leads to a full-blown autoimmune disease.

It's not like a lot of them were like healthy one day and like everything was going great and then they woke up one morning and snap, there.

Was an autoimmune condition. Now sometimes that can happen, for example, if you get Lyme, if you get Lyme disease, you know, these are things that can show up as autoimmune. If you just Google, you know, on PubMed, the National Library of Medicine, autoimmune disease or Lyme disease and autoimmune disease, you'll come up with a whole slew of articles that connect the dots. But, you know, how many rheumatologists are actually looking for that? I mean, they should and many good ones do, but how many rheumatologists actually check your poop? I would probably say close to none, but it's probably the most important thing to look at. They might check gluten antibodies if they're thoughtful, but often not. And, and the truth is if you, if, and this was a paper written, I don't know, 15 years ago or something in the New England Journal of Medicine that I read, where they looked at celiac disease and all the conditions it causes. It was like 50 different diseases that it causes. So you could have rheumatoid arthritis, you could have lupus, you could have MS, you could have all these labels, but in actual fact, you're celiac and getting rid of the gluten will fix all these downstream problems. Hey, Hey everyone, it's Dr. Mark. Now a few years ago, I went through the worst hell crisis of my life. And as a key part of my recovery, I had to revitalize my gut, which meant encouraging the growth of a specific good bacteria called Akkermansia muciniphila. Yep, that's a mouthful, but it's essentially the bacteria that keeps the mucus layer in your gut and protects from leaky gut. Now back when I went through my healing journey, I kind of had to be creative and I used lots of different ingredients to support the right kind of growth in my gut of Akkermansia. But now, it's easier than ever to up your Akkermansia thanks to Pendulum Therapeutics. They've done something nobody else could do because they're the first and only company to offer products that directly contain Akkermansia muciniphila. Now, Akkermansia is the bacterial strain known for strengthening and regulating the gut lining. And is also one of the most important determinants of maintaining your long-term health, your weight, your metabolism and so many other factors. Increasing the acromancy in my gut has such a big payoff for my health and I've become a real super fan. If you want to try it for yourself, Pendulum is offering my listeners 20% off their first month of acromancy subscription with the code HYMAN. Just head over to pendulumlife.com to check it out. That's P-E-N-D-U-L-U-M life.com with the code HYMAN for 20% off. Now, let's get back to this week's episode of the Doctor's Pharmacy.

Going back to your opening, you said women are more likely to get autoimmune conditions than men. What are some of the factors that play into that?

Honestly, Drew, I don't think we really know. It could be hormonal, it could be some genetic factor on the X chromosomes. I don't think we really know. I think there's some theories about it, but I don't think we really know.

There's a couple prominent Functional medicine practitioners, both women, Dr. Amy Myers as well as Dr. Isabella Wentz, who's a pharmacist and functional medicine practitioner. And both of them extensively write and have both suffered from different autoimmune conditions. Isabella once had Hashimoto's and Amy Myers, I believe, had Graves disease, was the autoimmune condition that she had. And one of the things that I've heard them talk about and speculate is that We know that the modern day stressors that we go through, societal stressors, the fast paced life, working out all the time in a very intense way, like a CrossFit type way, the modern stressors that we go through today that women, biologically, right, women tend to seem to be more impacted by those things and infecting their hormones. Not that men are not as impacted or other things, but there does seem to be a different way that some people, and of course there's, Differences with even, you know, you know, there are going to be some men that are more susceptible to, you know, stress. There's going to be some women that are better at handling stress. So there's a lot of unknown that's there. But I think it's a good thing to highlight because if we don't start having an honest conversation about it, we may not think about the things that need to be done on a societal level to protect, for example, in this case, women from suffering from a lot of autoimmune conditions.

It's for sure, Drew. You know, I just, I think that's really important point. and I think there's more and more investigation about the differences between men and women. I mean, I think the government finally mandated that scientists who were doing basic science features have to use female rats or female mice too, not just male, which is kind of amazing. Until Bernadine Healy, who was the head of the National Institute of Health for a while back in, I think, the eighties, said, Hey, you know, there's no research on women. We need to start research on women. She started the Women's Health Initiative, which is a billion dollar study. You actually see how women are different and what, so now there's changing research to incorporate women. And just rolling back a little bit about this pre autoimmune disease, I actually had pre autoimmune disease. Talk about it. Yeah, we want to hear about it. I had chronic fatigue syndrome and I had mercury poisoning. And when I did my lab work, I found an elevated ANA, which is anti-nuclear antibodies, an antibody against your own nucleus of your cells. And I, and, and now I don't because I fixed it all and, I also developed another autoimmune disease as a result of a complication from a dental procedure where I had an antibiotic that led to me taking something called clindamycin, which causes C. Difficile colitis. And I never, this is C. Difficile, I cleared out the C. Diff, but then it resulted in this full-blown colitis. So I had inflammatory bowel disease and ulcerative colitis for five months until I figured it out, and then I cured it. and now I don't have any problems and my gut's fine. I just did a poop test and it's perfect. So I think, oh, a nice poop. So I think we really know how in the 21st century using the filter of functional medicine and the framework of understanding the body as a system to understand where things go awry and how to regulate inflammation and how to deal with the root causes. So it's really, really important. And I think people can go, well, I'm on an autoimmune paleo diet and I'm not getting better. I'm like, yeah, okay. Some people, it works like that. I had a guy come up to me at Cleveland Clinic, he said, Dr. Hyman, I did the 10-day detox for 10 days and my rheumatoid arthritis went away. Is that possible? I'm like, yeah, if it was something you were eating, if it was gluten, for example, sure, absolutely. Another person was like, I'm not better. Well, yeah, maybe you have Lyme disease, maybe you have mold exposure, maybe you're mercury toxic, maybe you have parasites. We know that rheumatoid arthritis, for example, can be caused by parasites. because we've seen literature on it. There's a thing NQ4, which is a particular gene that makes you susceptible to this, and it can be caused by Entamoeba histolytica, which is amebiasis. So we know this in the literature. There's a phenomena of inflammatory, infectious spinal myelopathy. So this isn't something really new to medicine. We understand that there are triggers. It's just that we're not very good at looking for them, and we're not very good at treating them. And so as a doctor, as a functional medicine doctor, I'm an inflammologist, I'm a toxicologist, I'm a microbiomeologist. That's what I'm, I'm a nutritionist. I'm a stress expert because those are the things that actually matter when you're.

Trying to unravel this puzzle of chronic disease. Can you talk about some of the tests that you might run that a typical doctor may not run or may not even know of necessarily when it comes to seeing if somebody has autoimmune factors that are going on in their body.

For sure. So there's layers, right? The first tier and the second tier testing, third tier, so we can get really deep. But the first tier, almost everybody who comes in with autoimmune just gets food sensitivity testing. So I'll do a lab I use like Cyrex I like a lot. We'll look at all like 20 different antigens for gluten. Cause the regular gluten test, you might not pick stuff up. I'll look for cross-reactions, dairy and other things, other grains.

I look for leaky gut markers. So there's a whole panel. I look for leaky gut. Cause if they have a leaky gut, that's the target. and one question on those, you know, people often ask, like, what's the test that'll tell me the exact foods that.

I can eat and can't eat? There isn't one.

There isn't one. There isn't one. There isn't one.

So you're still running those tests, but explain why. What are you looking for? Well, I'm looking for a minute. I'm looking for how pissed off is your immune system to food? Because if it's really pissed off to a lot of different foods, it means you have a leaky gut. Leaky gut is a core pathology that happens and drives so much autoimmune disease. And what that means is the barrier between you and the outside world is broken. I mean, basically you think of your intestinal tract, it's a tube that's outside of you from your mouth, your anus. It's like a closed tube and you put pounds of foreign stuff in there every day and your body has to go, oh, what do I do with it? And they will break it down and I'll absorb the good stuff and I'll poop out the bad stuff. So there's no foreign molecules that should be absorbed into your body, no bacterial toxins, no food proteins. I mean, why when you eat a piece of chicken, you don't become a chicken?

Right?

Because your body takes the chicken-ness out of it, it breaks it down into all its component parts through digestive enzymes and the whole process of digestion, and you get amino acids and you get sugars and you get, you know, free fatty acids and you get really different basic raw materials. So it's like a recycling plant. Basically you take all this stuff, you deconstruct it, and then you can take a plastic bottle and turn it into a Patagonia sweater, right? So fine, but how do you get back? So your body does that. But when the gut is damaged and gluten is the biggest damager, toxins are damaging, infections can damage it, stress itself can cause a leaky gut. I mean, they've studied, for example, forced marched young soldiers who were 18, 20 years old, were healthy guys, put them on a forced march overnight, you know, and in the morning, all that leaky gut, you know, and their thyroid's suppressed, their testosterone's suppressed, and all these other things are happening. So stress can also be a factor. So I really look at food sensitivities, I'll look at celiac panel testing aggressively, I will always check vitamin D because that plays a role. And then I, and I always check poop. I always do a stool analysis and I want to look at a whole cast of things in there. I look at inflammation, digestion, what the balance of flora is, whether there's parasite. I just look at the whole thing. Another test often do is a heavy metal challenge test, like a urine toxic element chest where I'll give people a chelator, DMSA, and then check the urine for 6 hours and see what's going on. So between looking at their sort of nutritional status, their poop status, their toxic load, food sensitivities, leaky gut, that for me is the basic starting point. Then I might start to go down deeper and do a mold analysis. I look mold antibodies, looking at mycotoxins in the urine, I might look at infections. Maybe I'll look at tick-borne illnesses, viruses, start to sort of dig a little deeper. might even go looking at urinary toxic loads people have. So I'll look at, look at a lot of different things depending on their story. You know, if they say, well, I never ate fish in my entire life and I don't have fillings, I probably won't check the mercury. But I'm gonna check their lead. Like, oh, I grew up in a house, an old house, and, you know, I ate paint chips because they were yummy. So I think, I mean, God, I had a woman the other day. I, I just never seen such a high lead level in my entire life. and she had autoimmune disease and she was really sick. And so we've been working on getting rid of that. Now there are three other four things going on with her as well, but that can be a precipitating factor. So I start to sort of dig into all that. And of course there's the normal test you look at your autoimmune antibody test. Like you took look at antibodies for MS or anybody from rheumatoid arthritis or lupus or this or that disease. There's a whole cascade of antibodies we can check. But all that tells you is Yeah, you have an autoimmune disease. Doesn't tell you why, just like, okay, great. Thanks. Thanks for telling me. Now what? You know?

It's so true.

And, you know, I just tell you another story. Can I just do another story?

Please, please.

So there was a little girl that came to see me years ago who was named Isabel. It was 10 years old. She was from Texas and she had that just cutest Texas twang and accent. And she loved riding horses and she was suffering from something called mixed connective tissue disease, which is like an autoimmune disease from hell. So not only does it affect a particular organ or joint, it affects everything. So it affected her muscles. Her muscles were inflamed. Her liver was inflamed. Her blood vessels were inflamed. Her joints were inflamed. Her skin was on fire. Everything was just crazy. And she, when I took her history, she ate a lot of sugar and dairy. and she also ate a lot of tuna. She liked sushi, so she ate a lot of tuna. And so I said, okay, well let's start looking. And she was getting treated with chemotherapy drugs. She was treated with something called Solu-Medrol, which is like prednisone, intravenously every three weeks, which was enough to kill a horse. I mean, this is massive, massive doses. She was swollen because of the steroids. She took drugs to stop the effects on her blood vessels, like the Raynaud's syndrome that she got, like nifedipine, which helps out blood vessels. She took blood thinner because her blood was inflamed and clotting. She was anemic because it was affecting her bloods. Everything was, was bad. And I found that she had high levels of gluten antibodies. I found out she had tons of, she had tons of antibiotics in her life and tons of sugar, lots of overgrowth of yeast in her gut. And she had high mercury. So I got rid of the mercury, the yeast, fixed her microbiome. and got rid of the gluten. And two months later, she came back and she was symptomatically better. And we were getting her off her medications. After a year, she got off all her medications and was completely healthy. And what was remarkable was that she had every single autoantibody. You could just go down the list. I'm not gonna name 'em 'cause they're a little technical, but she had probably six or seven extremely high levels of various autoantibodies. and all of them went back to normal, except for one, which stayed a little bit elevated. And she was fine. And I literally haven't talked to her in years. And I recently checked in with her. I was like, how you doing? She said, oh, I've been in college. Everything's great. I'm healthy, no problem. All good. And then this is a woman, I mean, a woman who would have been really suffering her whole life from this problem. I just talked to another patient who.

Had- by the way, I think you.

Made a video with her.

And it's like on YouTube. We can share it.

We can share it. Yeah, we'll have the link in the show notes.

There's an actually an article I wrote about her at a whole article called Isabel Overcomes Autoimmune Diseases.

So, we'll link to that in the show notes. Yeah. And, I just had another patient the other day who was suffering from juvenile rheumatoid arthritis her whole life and she's, you know, 30 years old and was struggling with arthritis. And, we treated her and she is completely better. So, I see over and over again, if you figure out what the root cause is, if you use the strategy we use in functional medicine, you can help people to reclaim their health in a powerful way. And, to me, you know, autoimmune disease is one of those grand slam superpowers of functional medicine. And if you have an autoimmune disease, I encourage you to seek out a functional medicine doctor. Go to ifm.org, go find a practitioner, put in your zip code, look who's certified. Everybody has different skills and different interests. Some people are more focused on one thing or the other, but most of them are equipped to actually deal with this.

So I would encourage you to do that. And even ask them for a consultation call. Like, how would you approach this? Have you treated other people that have gone through this pathway? because again, like you mentioned, there's different degrees of education that are there. So dig in a little bit. It's not always easy. There's not a ton of functional medicine doctors that are out there, but there's a decent amount. And maybe we can link to a few of them. All right, Mark, this is great information on autoimmunity. We have a couple questions from our community that we're gonna go into, and then we'll go into a little bit of a recap of some things that people can do starting today to help them get them on the right path and track to getting to the root cause of their autoimmunity. that they're dealing with. All right, first question. My daughter-in-law has scleroderma and keeps trying different diets, but she believes she is dying from it. Are there actual diets to help slow this down? Can people live longer with this condition?

Yeah, so scleroderma drus is a common autoimmune condition that's based on the hardening and stiffening of connective tissue. So basically your skin gets tight, your esophagus gets tight and everything starts to stiffen and you're like the stiff man and it's inflamed. And it's basically the same exact approach that we take to all autoimmune diseases is look for the root cause, get rid of the root cause and, and do a lot of things to help the immune system to reset and rebalance. And, and there's a lot of options out there for people. It's essentially starting with an autoimmune anti-inflammatory diet, which could be the 10 day detox diet, or it could be a more aggressive version, which is called autoimmune paleo. Autoimmune paleo is essentially getting rid of all the potential inflammatory foods that are.

Not necessarily bad foods, but they can.

Potentially trigger problems like lectins or night shades. So essentially it's protein and vegetables. You get rid of nuts, which is, you think is healthy. eggs, which I think is often healthy, but can be a trigger. Obviously dairy, gluten, grains, beans. So it's basically paleo plus. It's paleo, but no nuts and, and no eggs. And, and that can be, and also no nightshades, which can be very inflammatory. So tomatoes, peppers, eggplant, so forth, potatoes. That's a good place to start. Then working on your gut is really important. Probiotics. anti-inflammatory foods, getting omega-3 fats in, making sure your levels of nutrients are at the optimal level, dealing with stress, exercise, all those things help. And I, I had a patient who was a doctor who had really bad scleroderma, and she came to see me, and a lot of my patients are doctors, by the way. And, and she really did the program and got so much better. And her scleroderma halted and even reversed, so. Yes, the answer is yes. If you understand what's underneath all these diseases, you can really fix them.

Yeah, and one thing I'll add to that, you've had Dr. Terry Walls on your show, and she also talks about how she used the principles of functional medicine to take some of the autoimmune Paleo stuff and go even a step deeper, and two things that she shared, and I really recommend everybody go watch that episode. We have a couple episodes with her, we'll link to it in the show notes. She recommended that she was doing pretty good, she saw a pretty strong reduction in her symptoms, but she really kind of hit a floor where she wasn't getting any better. And she started bringing in two things that was a game changer for her.

Organ meats.

It was organ meats was number one. And then it was making sure that every day she ramped up slowly to having about nine cups of vegetables. Yeah.

So it's not only what you don't eat, it's what you actually eat.

Right, because sometimes people go on a paleo diet, right? And they end up restricting so many things and they're limited because they react to a lot of stuff.

No.

But slowly ramping up. which should take some time. You don't want to start off right away and she's got a whole process.

Of going into it. Yeah.

So that's where, you know, these layers of how people combine things and share their experiences is very unique because they.

Can be the missing ingredient. It's true. And, and, and so just as food can be the cause, it also can be the cure. And within plant foods are these phytochemicals. There's 25,000 of them, and many of them are anti-inflammatory, medicinal, reparative, fix the gut, the microbiome, prebiotics, probiotics. It's amazing what you can eat. so for her, she really breaks down the food into a number of categories, right? Brassica family, which is all the collard kale cabbage, the garlic and onions family, really important components with sulfur and detoxifying compounds, quercetin and other anti-inflammatory compounds, mushrooms, which are full of these immune modulating polysaccharides that are anti-cancer but also help the immune system, and also pre and probiotic foods to help the microbiome like sauerkraut and various kinds of prebiotic foods like artichokes or juice some artichokes or asparagus or plantains and other foods. So There's, there's a way to actually use food as pharmacology. It's not just, oh yeah, food is medicine and it's kind of cool. If you eat healthy food, you'll be healthy. No, no, no. There are specific components in different foods that regulate different biological pathways and you can optimize those by choosing to eat those foods. And that's what I do when I go to a grocery store. I'm thinking in my head, okay, where am I gonna get my drugs? You know, I'm like, oh, artichokes. Okay. that has prebiotic fibers, it's good microbiome, but it also has these special compounds that are detoxifying for my liver. Oh gee, I'm gonna have these shiitake mushrooms because they have the polysaccharides that are helping my immune system and cancer and oh, my Taki, that's really good for cancer too. I'm gonna have that. So I kind of go through, oh my, I'm gonna get this really good Olay high oleic olive oil, which has got oleic acid and also these olive polyphenols, which extremely anti-inflammatory and helped my heart. So I'm constantly, like, looking at the grocery store like a drugstore. And that's, I think, you know, that's.

Why I called the podcast, the doctor's Pharmacy with an F. All right, Mark, here's the next question from our audience member. They're asking they have a history of Hashimoto's in their family and thyroid issues, but their doctor isn't running their thyroid antibodies and. they want to know, what I'm assuming from this question is what really should be the complete test and how much do you pay attention to things like thyroid antibodies?

Yes. So typically as doctors were trained, all you do to track thyroid disease is check TSH, which is the thyroid stimulating hormone. If it's low, it means you're hyper. If it's high, it means you're hypo. And if those show up, then you go further to the next level testing, which is looking at antibodies. But here's the trick. A lot of people walk around with subclinical hypothyroidism, where it's very kind of minor, but has real significant clinical effects. And large data sets have shown that it increases your risk of death and heart attacks and subclinical hypothyroidism isn't really subclinical. It just means it's not severe, but you can still have depression, fatigue, weight gain, cholesterol issues, skin problems, hair loss, constipation, fluid retention, I mean, all the hypothyroid symptoms. So, and we also know that even if your TSH is quote normal, and by the way, the range used to be 0.5 to 5, and so doctors wouldn't even start thinking about looking at anything until it was over 5. Well, the American College of Endocrinology came out with a new guideline saying, no, it should be 3 or 3 and a half, right? But what is optimal? Is 3 optimal? No, it's probably 1, or maybe around between 1 and 2, or maybe a little less. so I always check antibodies along with free T3 and free T4, thyroid peroxidase and antithyroglobulin antibodies, because many, many times I've seen, quote, normal thyroid tests, like normal TSH, normal T3, T4, and very high antibodies. And these people are having clinical symptoms if you pay enough attention. And even in, you know, looking at how we're doing things now, you know, one in 10 men and one in five women have thyroid problems or hypothyroid, and half of them are not diagnosed. And the ones who are diagnosed are not adequately treated because they just give them T4, which is the pre-formed, is the precursor for the actual important thyroid hormone, which is T3. They give them T4, like Synthroid. That's not okay. So I, I wrote a book years ago. I was Ebook called the Ultra Thyroid Solution. We'll link to it. And I go through everything in there. What causes hypothyroidism, what tests you should do, what nutrients you need, what foods you should eat, what supplements to take, and how to get to the root cause of it. Because it's often missed and it's tragic because it's like a miracle. It's like one of my favorite magic tricks.

When someone comes in and they have this and that, oh, just take a little of this thyroid and you're like, boom, it's like light goes on and they feel great.

So I've also done a lot of.

Really good episodes with practitioners who've had autoimmune disease themselves.

Yes.

Doctors themselves.

Yes.

I went on really long journeys. We'll link to those as well.

For sure.

All right, Mark, next question from our community member. What is on the cutting edge when it comes to getting to the root of autoimmune issues? And are there any emerging technologies that you're super excited about?

Yeah, so much, Drew. It's so exciting to be a doctor right now. I mean, I'm, you know, God, almost 40 years in since I started medical school. God, can I say that 40 years? Geez. Anyway, but biologically I'm 43, so it's okay. The truth is that there's so many exciting advances in our understanding of how to modulate immune function and autoimmune disease. I would say though that it's really important to always deal with the foundational basics. Food, toxins, allergens, microbes, stress, diet, really, really, really important. And all the things we talked about are first step. then there's a bunch of technologies that are emerging that can be really helpful for people who are stuck or have challenges. And one of them is really exciting, which is peptides. Peptides are small molecular weight strings of amino acids that aren't long enough to be a protein, but they're like mini proteins. They're called peptides, and they're signaling molecules that the body normally makes. So, for example, thymus and Alpha one is really an important one that regulates immunity as we age. Our thymus shrinks. If it's a baby, you've got a big thymus and that's the immune organ and it shrinks as we get older, you can actually grow it. The thymus and alpha 1 can be very helpful in modulating immune function, helping your immune system work better. So there's a whole class of peptides that can be effective. Second is ozone therapy. Now ozone sounds wacky and crazy in the ozone layer and whoa, ozone is dangerous. If you Google ozone, the FDA is gonna tell you it's gonna kill you. Well, yes, it will actually if you breathe it. But so will water, it's called drowning. So it doesn't mean it's bad, it just means you have to put it in the right hole. and so ozone, ozone actually is what we call a hormetic therapy, which is a stress, it's an oxidative stress. So it creates ozone is O3 and you inject the gas directly or you can do it rectally or you can give it in a mix it with blood and then put it back in. And essentially it creates this, this bounce back effect in the body where it's like danger, danger. And then all of a sudden the body kicks in its own repair mechanism. So it decreases the NLP, NLRP3 inflammasome, which is a whole inflammatory cascade that happens. It inhibits NF kappa B, which is another inflammatory gene transcription factor. It, it, it up regulates your antioxidant enzymes, which help control inflammation like catalase and glutathione peroxidase and superoxide dismutase. Lots of big words. I know. I'm just trying to explain to you how powerful this stuff is. And, and it, it also kills stuff. So if you have Lyme disease, viral causes, other things, it can be extremely effective in helping to reduce the burden of those infections. Sometimes we don't get rid of them completely, but it's just a matter of like, you know, are they taking over? Like, for example, all of us have yeast in our gut, but if it grows too much, you get all these problems, right? So it helps to keep the infections down and it helps to re reset your immune system. So it's very powerful. It was really effective for me. And then and then there's another, a few other things that are being explored, which I think are really exciting, which is exosomes. Exosomes are little packets of healing compounds that are in stem cells that the stem cells use to do their magic. So rather than having to take the stem cells, which means sucking your bone marrow, sucking your fat tissue, and spending a bazillion dollars, you can spend half a bazillion dollars. It's still expensive, but it's like probably a tenth the price of stem cells. and actually get these grown in a lab, purified and extracted, and you can take billions of these and inject them into your vein or into different areas of your body, and they help to reset the immune system. They can be very, very effective. So exosomes really help to modulate the immune system, and I got dramatically better from the ulcerative colitis symptoms, and I was doing other things too, but it was part of the solution. And of course, people are using stem cells. So often there's stem cell treatments for autoimmune disease. So there's a lot of stuff coming down the pike. It's very exciting. And lastly, there's a procedure that we've been doing a long time in medicine called plasma pheresis. So there's really fascinating advances in understanding how there's compounds floating around in our blood that actually cause inflammation, that make us age, that we can actually do something about. So plasma pheresis is this technology that is being used now for this purpose, for autoimmune disease, inflammatory issues. It has been in the past, like it is something we do. but it's coming up as a new treatment for autoimmune disease. And it kind of reminded me of this story that's being emerged, emerging story around actually longevity, where they've sewn together the circulation of young mouse with old mouse. And the old mouse gets the young mouse's blood and it rejuvenates them and they act like young mouse, like a young mouse. So it's kind of cool. So that means there's this, components in the blood that are degrading or inflammatory as we age and we can actually clean them up. So I've had plasma freeze. I'm trying all these things on myself. So I'm just seeing how it feels. I'm trying this and that. Maybe that's why I'm 43 biologically. I don't know, but I'm plasma freeze.

I've done exosomes. I've been peptides. I'm like experimenting.

Yeah.

And a lot of these things are experimental, but we need people to go.

And try them and we need to popularize them. And the hope is that one day that more people have access to it. Well, what really needs billions of dollars of research to go into showing how these strategies that are not what I think are medieval practices are continued. So right now, we're basically treating autoimmune disease except for a few little tricks like biologics, pretty much have we been done for the last hundred years, like steroids, prednisone. I mean, they would grind up the adrenal glands of animals and that was where they get the cortisol and then they'd give it to patients. back in the 50s as a treatment for autoimmune disease. So, we haven't come that far from that and it's unfortunate. But I just had a patient who was diagnosed with this sort of terrible autoimmune syndrome with massive muscle pain all over and joint pain and aching and fatigue and his doctors were giving me huge doses of steroids and it kind of helped. But I sent him to get treatment with plasmapheresis and exosomes and ozone. and it just was like, it was like a miracle. He dramatically got better. So I think we have to kind of look at, you know, what are the first steps we can do? The things that I just mentioned are, you know, what's down the road, what's coming, what's available. Right now, unfortunately, they're very expensive, but I think this all will get sorted out as we begin to figure this out. Because think about it, you know, if you can take a treatment for $10,000 and get rid of your autoimmune disease, or you have to take a drug that costs $50,000 a year for the next 50 years, what do you think we should be paying for? Right now we pay for the drug for 20, 30, 40, 50 years, but we don't pay for these other things, which are short term a little expensive, but actually in the long term save a ton of money.

Right, and as they continue to get more attention, maybe even a little bit of research, they're spreading awareness, who knows what becomes available to folks. So, Mark, I think this is a great opportunity to do a little bit of a recap of some of the top things that you think People can be thinking about, you know, we covered a lot of different stuff, but you had three things at the beginning of the podcast that you shared when it comes to the top three mistakes people make when trying to heal their autoimmune disease. So let's do a little bit of a recap on those three things.

Well, the first is thinking that drugs are the only solution, that immune suppressants, steroids, biologics, chemo drugs are the answer. They're not. They're a stopgap if you need them. They can save your life if it's really bad. I'm not opposed to using them in the right circumstance. but it ain't the answer. The second is believing that once you got it, it's a lifelong sentence. It's not. And third, it's complete missing of the root cause analysis for autoimmune disease. And that's what functional medicine is. It's a system of thinking about how to navigate the landscape of disease by addressing the root causes and getting rid of them and identifying the ingredients for optimizing health and immune function. that we're missing and adding those in. So when you do that, it sounds pretty simple and it is quite simple in concept. It's actually remarkable what happens. And this is when I started practicing functional medicine, Drew, I didn't believe what I was hearing. Like my patient, I was like, try this thing that I heard about, do this elimination diet or take this thing and fix your tummy and see what happens. And people come back like, I'm better. I'm like, Wow, really? You are from that? Okay.

It was like theory that you were learning about, but you were actually getting a chance to see and put into use.

Yeah, I'm talking like 30 years ago and I was like, geez, this stuff works and it works way better than anything I ever learned in medical school. Cause I remember first hearing about it, I'm like, this stuff is just quackery and nonsense or it's genius and I gotta figure it out. And so I said, well, it seems pretty low risk to tell people to change their diet and do a few simple supplements and take this and that. Let's try it. And I would say to my patient, look, you got this horrible thing and, and yeah, the medications may manage it, but it's not going away and you feel like crap. So why don't we try this? It's a little experimental, but, you know, give me a sample of your poop. Let's do your food allergies. Let's look for heavy metals. Let's try these things. Let's take you, you know, down this course and see what happens. And time after time after time. And when I get stuck, it's usually because I'm missing something and I'm like, oh, maybe you have, you know, like a latent infection or a tick infection, or you have some toxin I didn't find, or there's some, something that I missed. But usually if I, I'm persistent, I'm like a bulldog, and I, I don't let go. And I, I kind of keep digging.

And I usually find stuff. Yeah. And I think that's the, really the key is try to find a doctor. You know, you're not really taking on new patients right now, so don't throw in a flood over here, but try to really look for a doctor. that can continue to dig with you because sometimes it does take some time. People are what I hear from a lot of functional medicine doctors, including your colleagues at the Ultra Wellness Center, Liz Bohem, Dr. Liz Bohem, and Dr. Todd Lapine, and Dr. George, they say that the patients on average that are coming to them right now are so much more complicated than even five years ago. There's just so many layers. So really, find a doctor who can sit with you, talk with you and continue to dig because there does seem to be a higher burden of things that are contributing to a lot of the diseases that people are suffering with, including autoimmune.

It's true. I think, you know, we're living in an increasingly complex world with increasingly challenging inputs that we're dealing with, whether it's, you know, screen time or disruptions of circadian rhythms or sleep deprivation or chronic stress from the divisive society, the burdens of loneliness and COVID, not to mention the total toxicity of our diet, the overload of environmental toxins. I mean, just the list goes on and on and on. So, you know, we're living in the best and worst of times. I mean, it's a great time to be alive, but it's also a challenging time to be alive because we're having to deal with things that we never had to deal with. I mean, people say, oh, Dr. Hyman, do I need vitamins and supplements? I'm like, no, you don't. you don't need, nobody should ever take vitamins or supplements, but only if you meet certain conditions. One, you hunt and gather on your own wild food. Two, you drink pure clean water. Three, you sleep nine hours a night and wake up with the sun and go to bed with the sun. Four, you're exposed to no environmental toxins and have no chronic stress. And if that describes you, you do.

Not eat any vitamins. But everybody else, yeah. Well, Mark, this has been great. And another episode in the books on our masterclass series. I'm going to pass it back over to you to go ahead and conclude us out for today's episode.

Well, thank you, Drew. This is a great conversation and I think autoimmune disease is one of those challenging diseases that's so prevalent and thought of in really the wrong way because it's siloed. There's a neurologist deal with the MS, the rheumatologist deal with joint arthritis issues, the gastroenterologist deal with inflammatory bowel disease, the endocrinologist deal with thyroid problems, and so we don't really understand the magnitude of this problem. So when you add all the autoimmune conditions together, it's the number one disease in America other than obesity, right? Which, by the way, is related to it. So the good news is that we really have the capacity to deal with this in a very different way. It's an exciting time. And if you have an autoimmune disease, I encourage you to really dig into this topic and take ownership over your own health. B, as my friend Chris Carr said, the CEO of Save youe Ass Technologies, Inc. So, because you're not going to get it from your typical doctor. And if you've been listening to this podcast and you've had an autoimmune disease, you know anybody who's had it, you know who's struggling, share this podcast with them in social media. Leave a comment. What have you learned about your health and autoimmune disease? Have you managed it? We'd love to hear from you and subscribe wherever you get your podcast. And we'll see you next time on the Doctor's Pharmacy. Hey, everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to DrHyman.com/picks to sign up. That's DrHyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health. and get healthier and better and live younger longer. Hi everyone. I hope you enjoyed this week's episode.

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