Episode 42: Fix Your Fatigue, with Dr. Evan Hirsch

Hey beautiful, it's Dr. Tabatha. I want to share something with you that I believe God is doing right now in women's health. We're in the middle of a massive movement and most people don't even know it. Every single day, 6,000 women in the U.S. enter menopause. That's over 2 million women a year, and by 2030, that's more than 1.2 billion women worldwide. So here's the thing, most of these women feel exhausted, bloated, anxious, disconnected from themselves, and the medical system is Doctors are handing out prescriptions and quick fixes, and no one is helping women heal from the root cause of their issues. That's where Fast to Faith coaches come in. As a certified coach, you'll be equipped to help midlife women balance their hormones, heal their gut, regain their energy, and reconnect their faith, the foundation that so many of us have been missing. And from a business standpoint, woo, this is one of the most lucrative untapped opportunities in the entire health coaching world. The global health coaching industry is expected to reach over $33 billion by 2023, and midlife women are the fastest-growing, highest-spending demographic in that space. Most importantly, these women stay with their coaches. They invest deeply because they are desperate for lasting transformation— body, mind, and spirit. So if you've been feeling that pull and that whisper that you're meant to do more, This is it. Now is the time to rise, to serve, and build a purpose-driven business that not only changes other women's lives but transforms your own in the process. Because when you help one woman heal, you help her family, her marriage, her faith, and her future. That's the ripple effect that we're creating with Fast to Faith. So join me, click the link to come watch this webinar. It might be the one thing that really moves the needle for you in this next— Season. I can't wait to see you in there. Hi, I'm Dr. Tabatha, the Functional Gynecologist. I'm a board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, and Insomnia, you name it, then you've come to the right place. I want to be your functional gynecologist, so welcome. Hi friends, I'm So excited about this episode because this was one of my main issues that I struggled with forever, and I reclaimed my health by doing what Dr. Evan Hersh is going to talk about today. He is the chronic fatigue expert. So you may not know my story, or you may know parts of it, but I got pregnant in high school And developed Hashimoto's thyroid disease from that stress— physical, mental, emotional stress— at a young age. And I did not know anything about Hashimoto's or how to treat it, so I pretty much ignored my issue for about a decade and went on to become a physician, which is like one of the most grueling physically and emotionally draining things that you can do as a young person. And so I depleted my body, body, mind, and spirit to take care of other people, and I gave it my all to the point where I had nothing left to give. And what I learned way long after the fact was I had depleted my body, my mind, my soul, in every way you could imagine. I gunked up my detox pathways so that my body wasn't functioning well, and it was deficient in very important minerals, vitamins, and nutrients. And then I had increased my toxic burden substantially over my lifetime by being exposed to so many pesticides in my horrible diet, Being exposed to heavy metals, too much fluoride treatment as a child, too much chlorine swimming growing up, too much of everything. And it took me many, many, many years of pain and struggle while trying to be a physician and take care of everyone else, trying to figure out how to heal myself. And what it took me a long time to figure out and fix, Dr. Hirsch has put together in one beautiful book called Fix Your Fatigue, where he goes through and explains the different causes, the root causes of why you would have chronic fatigue. And it's never just one. But then he talks about how you need to replace your deficiencies in order for your body to even begin to heal. You need to optimize your detox pathways in your gut, your liver, your kidneys, your spleen, your lymphatic system to be able to even decrease your toxic burden going forward. So I really hope that you will take the time to listen to this episode today because it might change your life. It might give you your life back or a loved one of someone that you know. So if you know someone who's struggling, Please make them listen to this episode because it's really informative. And if you need one-on-one help, please don't hesitate to reach out to Dr. Evan because he has the answers. He also went through this the same way I did it, and he knows from firsthand experience what it takes to heal. So sit back and listen, you know. And the awesome thing with podcasts is if you can't listen to the whole episode now, You just come back to it later whenever. Like it's always here. It's always available. It's like TV on demand, but it's podcast on demand. So don't be afraid to listen to an episode because it's too long. It's longer than your drive or longer than your walk or whatever you're doing when you're listening to your podcast because you can always come back later. So thank you for joining me. Please stay with us, and I just want to sing Dr. Hirsch's praises before we get going. So Dr. Evan Hirsch is the bestselling author of Fix Your Fatigue: The 4-Step Process to Resolving Fatigue, Achieving Abundant Energy, and Reclaiming Your Life. He's also one of the world's only fatigue specialists and leaders on finding the root causes of fatigue and resolving them. He suffered with fatigue for 5 years before he achieved resolution using the Fix Your Fatigue program that he developed in his medical practice. He has helped thousands of people optimize their energy and is on a mission to help 1 million more through his online programs and training of providers. He mainly works with health-conscious, mission-driven high achievers and works remotely so he can support people around the world. He's lectured nationally and internationally on topics in integrative and functional medicine and is board certified in family medicine and integrative medicine. When he's not at the office, you can find him singing musicals, playing basketball, traveling, dancing hip-hop, spending time with his wife and daughter. So this is a fun episode. Dr. Evan is a great guy, and you're going to learn a lot. Make sure you follow Dr. Evan Hirsch on on Facebook. He has a free group called Fix Your Fatigue Group. It's pretty awesome. And then on Instagram. He's the Fatigue Doc. So I will have all the links in my show notes, but make sure that you connect with him if you're struggling. But definitely listen to the whole episode and take one nugget from it to try and start incorporating to your life and keep moving forward. All right, here we go. Well, welcome, Dr. Evan, to the Functional Gynecologist Podcast.

Thanks so much for having me on.

Oh my gosh, I'm so excited to have you on because your expertise is unfortunately really, really needed in this day and age. And I need all my listeners to hear you out today because I see it every day in my practice and I lived it. So when I read your book, Fix Your Fatigue, I felt like I was reading my own story. And I just feel like we have to get the word out because it's not okay to live with chronic fatigue, to feel like you can barely function and get through your day, right? What drove you to write this book?

It was that need, you know, and it was a need that I had as well. Interestingly enough, I actually entered residency, fell in love with my wife, And then she got chronic fatigue for 3 years and I couldn't help her. You know, I was going through my family medicine residency and I felt incredibly powerless. I asked everybody that I knew about fatigue and they really couldn't help me. So then I started looking outside of conventional medicine and, you know, she got better with sauna and with adrenal support and a number of other things. But then I got fatigued. She got better. We got married, had a child. I started a practice. I came out of residency, started a business, and then I got fatigue. And it lasted for 5 years and it was awful. It just about destroyed my life. Like I had brain fog so bad I couldn't remember the person sitting in front of me. Thank goodness I had an electronic medical record. Yeah, it was, it was an awful time. Just about destroyed my relationship because here my wife is coming out of fatigue and she's asking me, I mean, I couldn't even do the dishes. I would come home and just crash out on the couch. I couldn't— I had to tell my daughter that I couldn't run around and play with her. So it was really a hard time, and I don't want anybody to suffer like that.

Yeah. And for people who haven't experienced chronic fatigue, you know, I can explain it like I remember my daughter spilled something on her brand new coat, and I got down on the ground with a rag to wipe it off to hopefully not have to, you know, put her brand new coat in the washing machine. And my arm became exhausted within like 15 seconds of trying to scrub that out. And I just thought, why am I having such muscle fatigue? You know, and this was in addition to falling asleep at lunch, never making it through a movie with my family in the evenings, you know, falling asleep while driving any sort of distance, that type of thing.

It's just Overwhelming.

Is that how you would describe it?

Oh yeah, absolutely. It's, you know, it's kind of like, you know, the water is slowly rising as like fatigue increases. You know, you feel like you're, you're running out of breath, but like it's this slog. Everything just takes so much more effort. You know, you can't think properly, you can't move properly. Everything just takes longer periods of time. I've got some people who they can get up and they're lucky if they can do the dishes and then they have to go back to bed. There's all sorts of different— it runs the gamut, but it's definitely incredibly debilitating.

Yeah. If you're at that point, you definitely need to listen to this episode. But like you were mentioning, we need to get people before they get to that point. Before you're at a point where you're calling into work, you're missing your children's events, you're not participating in life, you've given up the exercise and movement you enjoy because you can't do it, you know, or it wipes you out for 3 days after, which was my case. So I would love for you to talk about this 4-step process where you, you know, you practice individualized medicine, obviously, you try to get to the root cause of each person. But tell me what your thought process is when someone presents to you with chronic fatigue. Like, what are the first Things that you're thinking and running through your head.

Absolutely. So yeah, let's talk about the 4-step process. But the big takeaway of this talk, we're going to put it out there real quick right here early on in the talk, is that it's all about the causes.

Yeah.

It's all about finding the individual causes that an individual, that somebody has. Because in step 1 of this process, it's all about assessing the causes that that individual has, that you have because there's actually 33 potential causes of fatigue and everybody that I see has 20+ causes.

Wow. That's crazy.

It can feel overwhelming. It's not that overwhelming when you actually get into brass tacks, but it's a lot. That's why it's so important that you find yours because actually if you have fatigue and you're listening to this, the causes of your fatigue are going to be different than somebody else's. And in fact, if you have causes 1, 3, 5, 7, 9, they have causes 2, 4, 6, 8, and 10. And so consequently, your treatments are going to be very different. And this is one of the big problems that I see is that people are all about the treatment. They're like, hey, maybe it's ozone therapy that I need or high-dose IV vitamin C therapy. And unless you're actually starting with the causes, you're not getting down into exactly— you're not getting focused enough. into which causes you have. So that's step 1.

Okay.

It's figuring out the causes. And I should say that if, if, um, when you're breaking these causes up into categories, you can actually look at them as deficiencies and toxicities. So deficiencies are things that aren't in the body that are supposed to be. These are deficiencies in hormones, which I know you look— work a lot with, nutrients, Mitochondrial function, lifestyle habits like not enough water, not enough sleep, not enough good food, not enough movement. And then the toxicities are things like heavy metals, chemicals, molds, infections, allergies, negative emotional patterns, electromagnetic frequencies. So you can kind of see that, you know, how those things can be grouped, and that helps simplify things a little bit.

Yeah, I love that you're listing the deficiencies, and I was thinking, yep, that was me growing up. You know, I got pregnant in 11th grade, which was a little bit stressful, and I had a very traumatic labor and delivery experience, and I ended up with Hashimoto's afterwards. So I developed this autoimmune response to my body. I was eating this Sad standard American diet. I was, you know, abusing my body. And so I just think I had so many deficiencies, so many toxicities. And when you list those, I'm like checking them off in my head. And that is how I ended up in the place of chronic fatigue, right? So—

Mm-hmm.

First, I think it would be great for our listeners to just assess, you know, where are your deficiencies, but find someone that you can work with, right? Because we want to test and see what is going on in your system. We don't need to guess, right?

Right. Well, and, and interestingly, what I've actually found as well— I mean, we learned this in medical school and it's still true— is that 90% of diagnosis is history and symptoms, you know. So what I actually see is I see a lot of people coming to me who have tested And their doctor is so focused on the test that they actually don't— they're not paying enough attention to the symptoms. And that 75% of those 33 causes can actually be determined more from symptoms than they can from tests because our tests are great, but they're all really imperfect. And so we have to— I tell when I lecture to physicians, I say, if you lean too heavily on your test, you're going to fall over. You have to make sure you're combining the best of all the data, right? And so we still have to, we still have to look at those symptoms because people will come to see me and they're not better, not because they weren't looking for a particular cause. It's because a doctor saw that there was a negative test, let's say like Lyme, where it's co-infections, and they're like, oh, this test is negative, means you don't have it. Well, actually, the test is really an epidemiologic test.

Yeah.

It's not great for clinical use. And if you have these symptoms, you're a lot more likely to have those infections. So then we treat them based off their symptoms and then they get better.

I love that. That's a great point. You know, one thing that you talk about in your book is sleep and sleep deprivation. That deficiency can be, you know, such a huge cause. And often doctors don't ask about that, right? Or if they ask about it on the questionnaire, it doesn't really get addressed. So talk, talk to me about, you know, any little tips or tricks that my listeners could start to think about changing today, you know, in addition to the, like, more specific in those deficiency areas.

Absolutely. And then I'd love to come back to the 4-step process. Yeah, because we did step 1, we'll do the other ones. So some practical tips. That I think are really important are what I call like level 1 problems, where you fix those and that gets a certain amount of people better. And then there's level 2 and level 3 that we can talk about as well. But like a level 1 problem is a lifestyle problem. So basically, if somebody's not getting enough sleep, they're burning the candle at both ends. You know, I find that I really have to be in bed at 10. I mean, ideally, if I'm falling asleep at 10, I like to read for a couple minutes before I fall asleep, but that's 10 to 10:30 is my window. If it gets to be after 10:30, then I have a really hard time sleeping. And so you have to know what your window is. And then you want to sleep until you wake up, so without an alarm clock, right, ideally. And you just want to make sure that you're getting 7 to 9 hours of sleep a night, right? So, and then you want to make sure your diet is optimized. So, you know, eliminating gluten and dairy, those are kind of like the really big ones. But, you know, living mainly a vegetable-first diet while still consuming some meat. That's generally what I recommend is more of a paleo-type diet, but vegetables first. You know, half of your plate should be vegetables at just about every meal. And then making sure you're consuming enough water, you know, half of your body weight in ounces. So if you weigh 150 pounds, you should be consuming 75, 80, somewhere around that ounces per day. Which is close to 3 liters. So if you're not getting that much, then you really need that kind of support. If you really do have fatigue where you're tired all the time, then putting in a little bit of sea salt is a really great tip because that helps the adrenal glands, which manage stress in your life. It manages your blood pressure. A lot of people are tired because their blood pressure is low because their adrenals are compromised because of all the stress that they have on them. So that can be really helpful as well.

Yeah, those are great tips. Thank you. And the sea salt is a good tip as well. I remember one morning I got out of bed and I went to grab the handle of my bedroom door and I started shaking violently and passed out and woke up on the floor. And I went to my conventional doctor and he was like, I don't know, it's just Fluke. I don't know what to tell you. And, you know, he did all the typical blood work and I was quote unquote fine. Looking back, I had such bad adrenal fatigue. I just, I couldn't even raise my blood pressure enough to handle getting out of bed in the morning, right?

Right.

So I think even though the things that you're recommending for these first line are so basic, I think so many people Ignore them because they're basic and don't think— don't give them as much importance as they should. Drinking water, getting sleep, you know, all of that. It literally is that important. So I would highly encourage people to get that squared away before, you know, really going down the rabbit hole looking for other stuff. But you are the king of, you know, going down the rabbit hole and finding all the hidden So let's talk about that. Let's talk about the other issues that it could be.

Absolutely. So yeah, so I'm going to go back to the 4-step process because I think that that'll be helpful. So first step is to assess those causes by symptoms and labs, and then the second step is to start replacing deficiencies. So in reality, this process is really all about the toxicities. Because toxicities for the most part have actually caused the deficiencies because they've caused stress on the human organism. Okay, now stress can be mental, emotional, physical, or spiritual. So mental, emotional, we know it's like stress at work, stress with family, whatever. Spiritual is like not living your life path. And then, and then physical is more of these toxicities, whether you got heavy metals, chemicals, molds, or infections. All of those are going to stress out the human organism and they're going to cause these deficiencies. So the question is then, why don't we go directly after these toxicities? And the reason is, is because if you don't go through steps 2 and steps 3, you actually will feel worse and you won't be as successful in step 4. So we have to replace the deficiencies first because this is going to make you feel better as soon as possible. This is going to help open up detoxification pathways. This is going to enable you to start to change your diet because your energy is going to improve. Your sleep is going to improve. So this is where we focus on the big 3 first, which is supporting the adrenals, supporting the mitochondria, which produces about 70 to 80% of all the energy in the body, is found in every cell except for red blood cells, and then supporting the thyroid. You know, most of the people that I see who have low thyroid are undertreated because a lot of docs are relying on thyroid testing. They're not looking at all of the different components of thyroid that they should be, and they're not doing a subjective ramp-up. So here's one of those instances where your symptoms are so much more important than your labs, because people come to me and they'll say, you know what, I still have— I've been told that I, that I don't have low thyroid, but I have all of these thyroid symptoms. Which is it? And it's like, well, it's— the fact is that you still— your thyroid is not working optimally. And so we replace the adrenals and the mitochondria first because that actually makes thyroid function better. And then we see if they still have thyroid symptoms and we do a ramp-up. So I basically ramp them up to optimize their thyroid function. So that's the, that's the big 3. And then at the same time, you're also working on all those lifestyle habits that I mentioned. You're replacing any sort of nutrient deficiencies— B12, magnesium— all of these things are going to help with multiple different biochemical pathways in the body. And so all that really elevates your life, you know, and that really is going to help people with their energy and their sleep. But then we have to move into prepping for step 4. Now, one of the— I should also say that one of the reasons also why we boost adrenals, mitochondria, and thyroid first is because that helps to manage the stress of removing the toxicities from, from step 4, okay? Because it is stressful and we don't want to put stress on or re-stress that organism, so we want to boost those things. Then step 3 is opening up the detoxification pathways. So when you have toxicities, most of your detoxification pathways are clogged, clogged per se.

Uh-huh.

You want to envision all of these pathways being like tubes and there's a bunch of crap in those tubes and you have to open up the crap in order to be able to grab the toxicities, pull them into the bloodstream and actually get them out of your body. You got to make sure that you're having a bowel movement 1 to 2 times a day, ideally twice a day. You know, I was actually constipated for the first 20-some-odd years of my life. I pooped once a week, and I didn't know that that was abnormal.

Yeah, I hear that all the time with my patients. Like, I just thought that was normal for me, and meanwhile they feel miserable, right?

Right. Yeah, well, I think it was a big part of my— the reason why I got Because if you can't poop, you're basically reabsorbing all of the toxins that you're trying to get out of your body.

Yes, exactly. It's so true, especially with women. We just, you know, all those estrogen metabolites, we start recirculating and reusing them, and that leads to estrogen excess. So thank you, we need to be pooping. So what else do we need to optimize for our pathways?

Yeah, so then we're opening up the liver and the kidney pathways, which are our filters. And then we're opening up the lymph pathways, which is like the garbage system in the body. And then we're opening up the neural lymph, so basically the lymph system, the glymphatic system that's in the brain. Because you want to make sure if you're dumping, you know, if you've got this tube essentially that's your detox pathways, if you're dumping something from the brain into the lymph, the brain lymph into the regular lymph, if the regular lymph is not open Then guess what? It's just going to go back into the brain or it's going to go into someplace else.

Yeah.

So we have to make sure that those are open. So that's the next step. In step 3, we're opening those things. And then we can go into step 4 and start removing the toxicities. And so that's the heavy metals. You know, there's over 100,000 pounds of mercury that are dumped into our oceans every year that we consume in seafood and sea vegetables and the like. You know, a lot of us have mercury fillings. Which are called silver fillings even though they're 50% silver and 50% mercury because that sounds better than mercury fillings, right?

Right.

But every time you bite down, it releases mercury vapor and you swallow it. That's incredibly toxic for your body. Then lead, and there's some other ones as well that are really important to look at. Then chemicals, 84,000 different chemicals we're exposed to on a regular basis, and most of those haven't been appropriately evaluated by government bodies or others. You know, and so this is cosmetics, this is pesticides, this is glyphosate or Roundup, these are plastics, you know, so there's just tons of toxicities. Gasoline additives, that's a huge one that I see. And so that's, that's something that has to be evaluated as well. And then molds, we find that about 50% of all buildings in this country and in the modern world have water damage. And most of those have mold. And most of the time you're not going to see mold, you won't even smell it, but you could have mold in your home, which makes it incredibly insidious and really challenging for people to actually believe. And so it's like one of those things that I talk about where it's like, okay, if you have money to get one test, you test your home for mold. Because that's one of the things that I can't— like, I can't help people You know, sometimes people ask me, when can't you help people? And I can't help them if they're still living in a moldy environment.

Yeah, that's so true. And it's just really hard to evaluate the level of exposure and, you know, and to pull out the mycotoxins and get any results if they're still being exposed. You know, I live in a town on Lake Michigan, and so it's really common for people's houses to smell musty. And, you know, they think that's normal. I'm like, it's not normal. If you can smell it, that means you're beyond exposure. Like, you are at a toxic exposure level, and you probably—

Right.

need to get that evaluated, or you need to move, because that is a huge reason why you are so exhausted and why we can't get your thyroid functioning right. So don't rely on just whether you can smell it or see it. I think that's a big point. But if you know you've had water damage, things like that, we will put a link in the show notes because it is so important to get that evaluated.

Right.

Right. And then there's a couple infections that aren't very common that people don't check for that you talk about. Can you explain Can you explain those a little bit?

Absolutely, yeah, that's, that's one of my favorite things to talk about. So there's infections in the gut that may show up, yeast and bacteria. There are also stealth infections or infections that are traveling in the bloodstream, in the lymph, and sometimes these are classified as Lyme-type infections, but they're pretty insidious and they, they can hide very easily from the immune system. And they like to oftentimes present with a conglomeration of symptoms. So for example, if we take a look at something like Lyme or Borrelia, if you're looking at symptoms, there's very few things that can actually look like Borrelia. So if you have symptoms that come and go, so some days are better than others, and you have— so that you can't even schedule an appointment because usually you're not sure whether or not it's a good day, or you're worried about scheduling an deployments. And then if you have symptoms that move around the body, so whether this is joint pain, nerve pain, or muscle pain, then it's likely that you have Borrelia. But if you don't have those symptoms, you really can't have Borrelia. It's very specific. And then there's an infection called Bartonella, which runs usually in our domestic animals. Upwards of about 50% of all animals can carry this. So, you know, I call my cat my Bartonella baby. Because I'm sure that, you know, that's one of the reasons why I had— there was a correlation between getting this cat and getting Bartonella, at least for me. And that can be common for people as well if you track that back to your animal.

Well, you're obviously very brave because you have kittens right now that you're fostering, right?

It's true, yes. And we're like deworming them, and I'm like, do not let them lick your face. When they lick your hands, you know, wash them off, you know. So, so yeah, I'm trying to counsel my family remember as best I can. But yes, absolutely. It's, uh, now I have a lot more tools at my disposal, and, and, uh, 2-week-old kittens are quite cute.

Yeah, well, it's a good point. I mean, we're always going to be exposed to different things, right? But we just need to get educated and smart about it. You know, you're sleep deprived because you're feeding these little kittens every couple hours, right? So you're gonna have to make up for that. But yeah, sorry to interrupt. Keep going.

Yeah, no worries. It's true. So yeah, so Bartonella, and I should also say that, you know, you can acquire these, not— you can acquire these infections in many different ways. So you can get them from your mom through the placenta. You can get them from a tick bite. You can get them from anything that really transfers blood from another animal. And so that can be mosquitoes, that can be chiggers, that can be biting flies, you know, so you bite something and then they bite you. It can be from sexual activity, sexual contact, from kissing other people. They call Epstein-Barr virus the kissing disease. It can get from a blood transfusion. There's lots of different ways to get it. These bugs don't really become opportunistic until you have a number of stressful hits, whether they're mental, emotional, or physical. If you've got heavy metals, chemicals, molds, all of a sudden—

Stress.

You're going to start getting these opportunistic infections. That's one of the reasons why I'm less concerned about having these cats in our house and in our family is because we run regular lab tests to look at the toxicities of all my family members so we can make sure that we're removing those things so that these bugs are going to be less opportunistic. That's part of the reason why we're so much sicker now than we were 50 or 100 years ago is because of the amount of toxicity that we're being exposed to because we still have those bugs back then, you know, but we didn't have a lot of these other things.

Right, exactly.

Yeah, so then jumping into back into Bartonella, so oftentimes these people have pain or dysfunction on the bottom of their feet where sometimes the feet are really sensitive where they get out of bed and they step on the floor and they're like, you know what, I need to put on some slippers in order to walk around the house. Or they might have actual burning on the bottom of the feet. Sometimes they have pain in the joints in the hands and the feet, so kind of in the small joints. And then they'll have pain in the muscles. So oftentimes these people are misdiagnosed as plantar fasciitis— or sorry, as fibromyalgia. They'll also be misdiagnosed as plantar fasciitis from the burning in the feet.

Hmm.

They can have headaches or migraines, neck pain, problems sleeping. Either problems staying asleep or falling asleep, anxiety, depression, thyroid issues. In fact, the only times that I've ever actually been able to get people off of their thyroid medicine significantly is by treating Bartonella, and that was really serendipitous where I had somebody who was on thyroid. I started treating them for Bartonella, and then all of a sudden they became hyperthyroid, and I couldn't figure out what was going on. I was like, well, you're hyperthyroid. Let's start weaning you off. Let's take your thyroid medicine down. And that worked, and we were able to wean them completely off of their thyroid medicine. So I find that people who have Bartonella and low thyroid, oftentimes about 50% of them, I can get them off of their thyroid, if not completely, down to a very low level where maybe they just need a thyroid glandular.

Yeah, that's really awesome. I mean, that, that could be life-changing. So I personally have not had that checked. Do you check that with Is that standard blood work in your patients or is that a special lab through functional medicine?

Yeah, that's a great question. Those guys are actually, I believe, to be better diagnosed by those clinical symptoms. Now, the best test that I have found is the DNA Connections PCR urine test, which is unfortunately $650, but it really is the best test available. Now, it's not perfect because it's telling you whether or not the bug is there. It's not telling you necessarily whether or not it's active.

Uh-huh.

But a serology test in terms of looking at the immune system's reactivity to a bug, I think, is one of the worst tests that you can do because it requires an intact immune system. When you have heavy metals, chemicals, molds, and infections, all bets are off. The immune system's off in left field. These bugs are opportunistic. I think the likelihood— it's It's very rare when you actually get a positive serology test. So usually you can go by the symptoms, the conglomeration of symptoms, which are pretty unique, and then you use an herbal-specific combo that is specific for a particular infection, which can essentially provoke the infection. So if you feel better or worse when you start taking a tincture that's specific for Bartonella, that can tell you that you're on the right track. Because if you feel better, you're killing the bug and you're able to clear it. If you're not feeling better, it means you're killing the bug and you're having die-off or a Herxheimer reaction where you feel worse when the bug is dying. If you don't feel anything, then you're not on the right track.

Okay. That is really awesome. I love that. And you talk about all of that in detail in your book, right?

It's, it's, it's in there. The book is a couple years old, so I definitely go more into it in my current programs and my But there is some of that in there in the book.

Okay, and if people want to work with you, do you work one-on-one with people?

I do, yes. I mainly right now have a program that includes group visits and one-on-ones with me and my coaches. I've got a health coach, I've got a nervous system retraining coach to help address— because what I'm finding is that I want to address all of the causes of fatigue and provide the best possible program to help people through this, going through my 4-step process. And so I, I hired a health coach to do some more one-on-one hand-holding. We've got an online community to support them from a community and social aspect. Then we have the nervous system retraining coach to help reset the emotional and the nervous system. And then we have the content, the workbook, as well as a course with videos to kind of guide them through the process. So if anybody's interested, they can get on a call with me or a member of my team, and, and we'll see if you're a good fit.

I think that's awesome. I love that it's such a comprehensive program. You know, it's like the analogy you use when you got 20 tacks in your foot, you take out a couple, you're still going to have pain, right? You have to remove all the tacks to get rid of all the pain. So I think with chronic fatigue, Fatigue, it's never just one thing, is it? I mean, have you ever seen it be one thing?

No, it's never— like I said, it's always, you know, 20+ causes that people have. Now granted, the deficiencies are caused by the toxicities, right, and those are included, but yeah, it's always multiple causes because you have to have the— you know, the body's really accommodating and you have to have multiple hits, you know, where oftentimes people are saying, well, you know, My parents got divorced at 7, and then I had— we lived in a home that was moldy that the basement flooded every year when I was 10, and then I had a breakup at 16. I got Epstein-Barr virus at 20, and then I got mercury fillings along the way, or whatever it is, and I'm eating gluten and dairy or whatever. It's like all of these hits until the body can't compensate anymore, and it's like, I'm out.

Yeah, exactly. And, you know, another good point is that when you are treating, getting treated and trying to heal, you're still going to be encountering new exposures and things going forward. So it's really important to get educated and learn what to avoid, like you said. Speaking of which, can you just enlighten my listeners on the whole gluten situation? Because I like— I think gluten's the devil. I recommend everybody stay away from it, but people do not want to give up their bread and pasta, I swear. And I just, I love how you explained it in your book. So if you could just like explain to people how nasty it really is, I think that would be so helpful.

Absolutely. Yeah, I'm trying to, I'm trying to remember what did I actually say in my book.

Just how you describe it, how it's like glue.

It's like glue. Yeah, yeah. I tell people that eating gluten is like eating a sock. It's incredibly foreign to our bodies. You know, we encountered grains and wheat about 10,000 years ago, but we've been in this form for about 3 million years. So there were many, many years there where we were not encountering gluten or encountering wheat. Now, the wheat that we encountered back then was 7 chromosomes. But through hybridization, not genetic modification per se, but hybridization, where basically you just have grasses that are being cross-pollinated with each other, which is natural. But through that cross-pollination, now we have wheat that is like 49 chromosomes.

Which is more than us.

Right? And we are 46 chromosomes, right? 23 pairs. If we were 100 chromosomes, what would we look like? We would have 9 eyes and 12 arms or whatever it is, right? It's just— there's this disconnect. We have continued to evolve, but we haven't continued to evolve with gluten. We see it time and time again in our practices, right, where you remove gluten and amazing things happen.

Right.

Now, what's important to remember Yeah. Is that you don't have to get rid of your bread and your pasta. In fact, I recommend initially taking baby steps and just switching everything to gluten-free. There's actually good gluten-free bread options now. Most of the time you have to toast it. I like some of the bagels. There's some good gluten-free pasta options. There's everything from kelp noodles to zucchini noodles. There's a lot of cool options that you can play around with. Then eventually you get away from all of that processed stuff, but just going gluten-free initially and making sure you've got the soy sauce out and all of the stuff that's really sinister as well, it's sneaking in, it's going to make a huge difference in your life, decreases your inflammation. I mean, every time you consume gluten, it damages your gut. Every time you consume gluten, you produce gluteomorphins in the gut, so basically morphine. You're producing morphine in your gut. Which slows down your gut, causes constipation, and guess what? Puts you into withdrawals when you're not having it, right? Kind of like sugar.

And it makes you feel good when you're eating it, so that makes it even harder, right?

Yeah, absolutely. And that's, and that's the hardest thing too, is the association with the emotion. Like, how could Grandma— Grandma, Grandma made the best whatever with gluten, and how come, how can that be damaging How can that be harmful to me? Your goal right now is to create those memories for your kids with good foods, with good healthy foods. You can recreate those foods from your grandparents just in a different way, in a gluten-free way. That's what we try to do in my family. You're just setting your kids up for success. If you're not going to do it for yourself, do it for your kids.

Yeah, I love that. I think that's so important. Going gluten-free was life-changing for me. That is really how I got control of my Hashimoto's thyroid disease, and I, I never— I wouldn't be able to do what I do now hadn't I quit eating that. So it's super important. Anything— Yeah, go ahead.

I should say too that it's important to remember though that the reason some people may say, well, why do I have a problem with gluten and then other people don't? And once again, it comes back to the total toxic Yes. When you look at your toxicities and you're looking at heavy metals, chemicals, molds, or infections, if you're looking at your body as a barrel, the more crap that you have in this barrel, the more reactive your immune system is going to be. The more it's going to react to foods. Food allergies, if you want to really remove your food allergies, you have to get rid of these toxicities. Now, I don't believe anybody should be eating gluten and dairy, but let's say you have a tomato allergy. Or you have a histamine issue, right? The more of this crap that you can remove, you poke a hole in the bottom and you let it all drain out, the less reactive the immune system is going to be, and then you can eat a lot more foods.

Yeah, it's— you're absolutely right. And I usually tell people, you may not have an issue yet, you know? Like, my mom is, I think, 70, 69 or 70, and she just now got diagnosed with Hashimoto's. How long it's been going on, I'm not sure, but I think that it developed over the past five years because her toxic burden became too high and some other incidents that happened. So I feel like you are just playing Russian roulette when you're eating gluten pretty much, right? Yep, it's true. It's just not good for us. So do you have any other wisdom for my listeners who? Hopefully are not at the point where they're dealing with chronic fatigue, but if they are, how they— what's the best baby step to even get started?

Well, like I said, it's all about the causes. So it's all about figuring out which causes you have and making the investment in your health. Yeah, you know, that's one of those biggest things. And you can do the low-hanging fruit, like by going after the lifestyle habits like I mentioned That's like a level 1 problem. If you fine-tune your lifestyle habits where you're sleeping more and you're getting better food and drinking more water, etc., and you resolve your fatigue, great. It means you had a level 1 problem. If you still have fatigue and then you start to replace the deficiencies that you have, then— and you can fix it that way, then that's a level 2 problem that you fixed. But if you still have fatigue, then you've got a level 3 problem and you have to get rid of these So it's just kind of going through that process and just making sure that you're leaving no stone unturned.

Yeah.

You know, 33 sounds like a lot, but it's not when you're kind of going bit by bit and you just want to stay in action, keep moving forward because you're going to be successful. If you're following a proven process, you're going to be successful. It's just how it is. That's why you need to find somebody like us, right?

I love that.

We're gonna— we can help you through that.

Yeah, I encourage my listeners to check you out and get hooked up with you if they need it, because you have the proven protocol. What you're doing is life-changing, or it's, you know, life-repairing. So definitely I will have those links to my show notes. So important. I wish I would have known you and all of this 10 years ago, you know, but I don't want other people for it to take 10 years for them to feel better like it took me. I want it to be a much quicker process, and it can be if you— like you said, you're making the steps forward, you're leaving no stone unturned, and you're working with someone who knows what to look for, right?

Right.

So thank you so much for all your wisdom. It's so good, so needed. So thank you, Dr. Evan.

You're very welcome. Thanks so much for having me on.

All right, take care. All right, I hope you got a ton of information out of that. It's so important. So if you're not personally struggling with chronic fatigue, I am so happy for you, and I pray that you never get to that point. The way to never get there is to prevent yourself from getting exposed to the things we talked about today on a chronic basis and becoming deficient with your different nutrients and vitamins, because that is what sets you up for chronic fatigue. So if you are at that point, it's time to replace those deficiencies, open your detox pathways, and remove those toxicities. So check Dr. Evan Hirsch out at gofixyourfatigue.org and find out how you can reclaim your health. I will have all the links in my show notes. Don't hesitate to search him out. His last name is H-I-R-S-C-H, MD. fixyourfatigue.com. As always, make sure you take one golden nugget from this episode, start incorporating it into your life, add it to the nuggets that you've taken from your other episodes so that you can start building and creating a new life that is full of vibrancy and wellness so that you can reclaim your health. I'm so thankful that you've shared your time with me today, and I'd be honored if you would leave me a review so that iTunes knows you want to keep listening to all these important topics on women's health. So follow me on Facebook at Dr. Tabatha or on Instagram. Shoot me your questions. I am here for you. Thank you for letting me be your functional gynecologist. Now go out and have a kick- Bye, friend! Bye, friend!