The Science of Habits for Autoimmune Healing with Amy Behimer, PharmD

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons, and today I'll be speaking with Dr. Amy B. Heimer, a doctor of pharmacy, board-certified health and wellness coach, host of the podcast Autoimmune Health Secrets, and and someone living with autoimmune disease. She started her career in pharmacy, trained in medications, physiology, and evidence-based care. Through her own health journey and years of working with clients, she has changed her focus to helping people move away from chasing perfect answers and towards approaches that are sustainable, supportive, and actually fit real life. But before our conversation, if you haven't yet followed or subscribed to the show, be sure to do so. If you want to get transcripts of the podcast, pop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. You'll also get my recently updated free ebook, Find Your Root Cause Through Stool and Organic Acids Testing when you sign up. If you haven't yet done my quiz on which stool or functional medicine test would help you get to your root cause, you can find a link in the show notes and take that. Now onto the show. Welcome to the podcast, Amy.

Thanks so much for having me. Excited to be here.

It's my pleasure.

So could you tell me about your journey with MS and where you are now?

Absolutely. MS, multiple sclerosis. Was my third autoimmune diagnosis. The first time I heard the word autoimmune, I was 17. I was in high school and I started getting these white patches all over my skin and I didn't like the looks of it. I was a teenager, but didn't think much of it. I went to pharmacy school and I started to learn more about what was happening in the body and how autoimmunity usually clusters. And if you have one, you have more. And so I started to think, oh goodness, was this skin condition just the first one? And so next came a thyroid diagnosis, Graves' disease, which was also autoimmune. And then I really started to get worried and I kind of had this impending doom and I started to feel like something was not right. I was a runner and so I would be running pretty far distances and I started to get some foot drop, which is where my right foot didn't pick up quite as easily. And so there was a little bit of tripping happening and I just ignored it for a little while cuz I'm like, well, yeah, I'm running 20 miles. And so a A lot of people said, it's not really normal to run 20 miles, so your body's probably just reacting to that. So I kind of knew something was not right. And so I started getting this hunch that maybe it could be multiple sclerosis. And so a little bit of an effort to get some physicians on board that maybe this could be it. I got the testing that I needed and ended up with that diagnosis at age 27. And to say that I was shook. Is an understatement, a massive understatement. It was quite a blow to what I thought my life was and could be. And so it's been 14 years. I am turning 42 this year. And I have to say that's been some of the most work put in years of my life. But thankfully, like you asked, where are you now? I'm at a place where I really am using every piece of this diagnosis as a reason that I can be healthier, that I can live a good life, and that it doesn't need to dictate the direction of my emotional experience at all.

That's great.

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So I imagine, yeah, that must have been really devastating at such a young age to already have 3 autoimmune diseases.

Yeah.

Did 2 go away or impact you, or how did, how did those 2 play out?

You know, I like to say they're gone for the most part. The vitiligo has not spread. I have no active markers of any antibodies for the thyroid condition. I also had a fourth diagnosis at one point on biopsy. There was some IBD, inflammatory bowel disease, that didn't look exactly like Crohn's, didn't look exactly like colitis, but it was IBD is what it was diagnosed as. And we were a little stumped, the physician and I, but we now can see that that is also gone. And so I like to use it as a testament to the fact that, you know, these habits that we do, our lifestyle, our environment, this work that we are likely gonna talk a lot about, can really not only prevent future diagnoses, but also shape what happens to the ones you have and, and impact where they go from there. And so again, there's no way to prove what changes what exactly, but why not tell the most empowering story? And I like that story that these habits and this way of living are keeping the other ones at bay.

Yeah.

So oftentimes autoimmune diseases are preceded by gut health issues and a leaky gut. So you did mention in our intro call that you had had issues with constipation as a child and beyond. So I'm curious whether you address that and what helped.

That's my constipation journey is long and ongoing really. So I remember going to a GI doctor and when I was young, this was in the '80s, there weren't a lot of pediatric specialists, but it was bad enough that I went to a GI doctor and I used to have to drink mineral oil and my siblings would see it there. They'd make fun of me cuz it was, I mean, it was terrible, but that was a part of it. Constipation, it's still there. I have experimented with just about everything and I find different things that work at different times. And now for the most part it is good, but sometimes I will get a bout of constipation and I will have to look backwards and really be an investigator and say, what did I change? What threw this off quite a bit? I just flew in from a 4 national park in 4-day vacation with my mom, my aunt, and my cousin. And this may be TMI, but I'm guessing it's not because of your show and who you are, but I was experiencing constipation. And so travel, that can happen. Of course, you know, I don't have access to the amount of fibrous raw vegetables that I know my colon and my GI tract love and need. And I say the vacation was split into 2. There was the 2 days I was constipated. And then there were the 2 days after where I was relieved and wildly those national parks were more beautiful. I was more engaged. And so everybody on the trip was making fun of me cuz I loved the national park that is one of the least visited in the country. And they're like, I think that your lack of constipation is, is clouding your judgment. And I said, I, I don't care, but I, but I feel amazing. Yeah.

So what kinds of things have been helpful for you for constipation?

The most recent one, and this is wild, and I've shared this with a couple people who have tried it and it's worked and it's a little bit interesting, but, you know, vegetables and fiber are important, but my body responds very differently to different vegetables, different fiber at different times. And so kind of on accident, I was at a beach last year and I brought— I'm the person eating raw vegetables on a beach and people will at first say, what are you doing? And then they start eating some and they're like, okay, this feels kind of good. But I overbought vegetables and I ended up with way too many carrots, way too much broccoli, way too much cauliflower. And I didn't want it to go to waste. So every afternoon I kind of had this massive plate. And again, if you're listening, I've built my way up to a high amount of vegetables so I can take it from a bloating or comfort standpoint, but I kind of had this over sized plate of raw vegetables in the afternoon to eat these up. And I've never had better bowel movements. And so I've been trying to, again, just recreate that and really playing with what types and definitely the cookedness. A lot of people say, well, you have vegetables cooked. Vegetables for me just don't seem to register the same. And so really experimenting with different things. Magnesium is a big piece of my story. Absolutely different types of magnesium, really finding that balance, which also helps with my MS. So it's a good win-win. And another one that I have had some luck with is a buffered vitamin C.

I'm not sure if you're familiar with that, but yeah, very, very common, uh, constipation cure. Yeah. Yeah.

So that one, that one I do like, I have to say I've done colonoscopies, I've done 4 or 5 in my life. And I am the person that will do an entire colonoscopy prep and I'm not going. So, so it may be some of your listeners as well, but whether you've done that or not, my, my bowels can take that. And so it's some pretty extreme constipation, but the most effective thing that I have had, cuz I really try to use everything that's not meds. I am a pharmacist that doesn't love taking meds. And so. Yeah, experimenting with those fruits and vegetables really have done wonders.

Yeah.

I know that, that there's definitely studies out there showing that certain amounts of fruit per day will increase the transit time. So I know the fruits in particular are, are great for constipation.

Yeah.

And kiwis, I think obviously, and then things like prunes and such.

I love it.

Do you eat the kiwis with the skin?

Oh, I don't, I don't go in that direction. I am not prone to constipation.

Got it. Got it. That's funny.

So I am not eating, but what do you eat the skin? I do.

And apparently America is one of the few countries that doesn't. And so I eat it and people again will look at me and at first they're like, what is Amy eating now? And then I encourage them, just try it. Cause I really think that the skin is where the magic is at. And with my clients, we'll talk about what beliefs are driving our habits. And I grew up in a household where my mom, from when I was very young, constantly was saying, you need roughage, you need roughage. And so how many 4 or 5-year-olds are worrying about their roughage intake? But I look at food and I'm like, how much roughage, how much scraping of my colon is this going to do? And it's kind of how that belief came from my mom and it's one that has stuck and I really like it cuz I think it helps me.

Yeah. A lot of my knowledge about health comes from just having, yeah, grown up in my household and things I learned. And it's so funny now, my son, he'll go on to ChatGPT, like he, he had a gut health issue, like he got food poisoning.

Yeah.

And he's on ChatGPT asking what to do. I'm like, your mother is a gut health expert. Why are you sending me ChatGPT? I know what to do for you.

Have you met me?

Yes. I know.

I heard it called once that I, a poop positive household. And I was like, yes, I was a, we, I was in a poop positive household and maybe it's cuz I'm from German background and they are known to have more words for poop and defecation and things than many others. And so yeah, I can talk about poop all day.

Oh yeah. We always were talking about that kind of stuff.

So hopefully you, you schooled him on how ChatGPT was no replacement for the wisdom of his mother.

You know, you can only do so much. Anyway. So how is the typical American at keeping up with good lifestyle habits?

The statistics are a little bit shocking. It's 2.7% of Americans that are able to consistently over time, keep up with the four basic habits and the four basic habits that were used in this study are eating well, moving, not smoking, and maintaining a healthy body weight. And of course, what does eating well and moving— what are those thresholds and what does that mean? That is very variable and different. But I guess just ask yourself, am I eating how I wanna be eating? Am I moving as much as I wanna be eating or moving? Or kind of asking, or that's a self-report number. And so that is good to share only to normalize. That it's not your fault. If, if there's something you wanna be doing in your lifestyle habits and it feels hard, that is the reality for a lot of us because we are not taught at a young age about roughage and about movement and about the things that we can use our brain for to change in a way that doesn't feel like deprivation. And so overall we're not great, but I don't wanna say that in any sort of judgmental way. Other than the flip side of that is we have a lot of room to feel really good because we have a lot of room to experiment with these different habits that we know can help our guts and our energy and all sorts of things.

Yeah. So why do you think maintaining good habits is so difficult for most people?

You know, the brain is only interested in 3 things. It's called the motivational triad. It wants to seek pleasure. Avoid pain and it wants to conserve energy, which really means don't change, stay the way you are. And so once we are aware of that, we can see how it has gotten us to where we are. It has kept us alive as a species, but in our modern world where things that are pleasurable are immediately available to us in super concentrated doses, we can start to see, okay, maybe this isn't quite normal. And so once we understand that we are working a little bit against our biology and we find the strategies to do that, it becomes a whole lot easier and a whole lot clearer how to move past it and not get stuck in some of those ruts. Because so many people, you know, that you wanna maybe be doing things differently, whether it's scrolling on social media or again, back to exercise or food or anything that feels like you're doing it outside of your control. That's likely what's at play.

So I'm somebody who has pretty good habits during the work week.

I get up at a good hour. I go to bed at a good hour. I exercise. I do that on the weekend too, but on the weekends, oh, and I get up and I meditate with my husband and then we do breathwork before bed. But on the weekends, those good habits, especially regarding what we do after we wake up and before we go to bed, kind of fall by the wayside. Cause we're later and all this. So how might you coach me about doing better on the weekends?

Ooh, I would ask you about what you think needs to be better. Is it a problem that the more structured routine or habits exist on the weekends or exist on the weekdays and not the weekends?

I would say it's not a problem given there's only 2 days in the weekend, but I'm a little bit worried about what retirement is gonna look like and whether I'm just going to turn into a complete slug who can't even fit 3 meals in because I'm like getting up so late.

It's funny that that is normal to like think, oh my God, this is all going to go to crap. But I imagine if I had to advance and peek into what that looks like, that may happen for a little bit, but your body, again, you're a creature of habit. So thankfully you likely have a set point where you'll be like, whoa, I really need this thing. And this feels good. But, but I think that you highlight a couple of things that there are some people, and maybe you're listening and I'm kind of like that too, where, you know, the, the research shows it's somewhere in the 7 to 8% of people who decide what they wanna do and they find a why that is so powerful that it overrides all the things that I just talked about. And they just kind of change their habits and they can just do it and they can just follow through on it. And that could be because the, the feel-good benefits are pretty immediate that you, You stick to it, but most people are not in that big camp. And so one thing that's often missing from plans is the plan to rest, is the plan to be a little bit of a slug, maybe one day of a week, or to include some of those joyful moments. Because if you plan for the pleasure and you plan for the rest and the things you're afraid you're— that's gonna take over your life. Then when you go to do the thing that feels a little bit tougher, you can remind your brain really lovingly, oh, I have rest planned in, I have joy planned in, I have things that my body is craving right now. I have it in my big picture plan so I can get back to doing this because I know that I've created a balance with that. I'm not sure if that makes sense.

Yeah, yeah, no, that does, that does make sense because I was gonna say my other, my other bad habit that I can't seem to break is eating dessert in my I do, it's all like sugar-free made with allulose, like gluten-free, super healthy, you know, but nevertheless eating dessert before bed, like 9, 9:30, that kind of thing. I'm not doing it every night. I used to, I mean, literally my entire life I used to, but now it's probably only 2 or 3 days a week that I might do that.

Yeah.

It's still not great for me.

Yeah. What do you think helped you go from every night to 2 or 3 nights a week?

Well, it was seeing how it impacted my sleep because inevitably if I'm eating and drinking that late, I'm gonna have to get up and go to the bathroom and then I'm not gonna go back to sleep for like an hour and a half. And the, the, the cost benefit analysis, it just wasn't worth it, you know?

Yeah.

Yeah.

You were able to kind of tie it to a consequence that was worth it.

Yeah. And in some cases too, I would just like right after dinner eat dessert. So then I wouldn't be craving it later. I would just be done eating at an earlier hour. So that also stopped it. But for the most part, I just kind of ate too much at dinner to be able to fit in a dessert. So then I'll just let go entirely if I, in that scenario.

Yeah. You're kind of, uh, in some, some strategies naturally to shift, but the main thing, like when we're eating something that we don't want to be eating or we're eating more of something than we want to be eating, I like to, you know, talk about what's happening with that. We, have a world where again, this sugar, or sometimes it's ultra-processed foods. For me, it was, you know, I call it small crunchy things in bags where you really lose all sort of regulation and it can make you kind of mad when you realize that it's designed to do that, right? It's designed to hijack our dopamine reward system to make us feel like, oh my gosh, I need more of that. I need more. And so One of the first things we do is decide what is the goal? Is the goal not to eat dessert before bedtime or not to eat the small crunchy things in bags? Or is the goal to not to want to eat it? Because it's kind of two separate strategies. If you're trying to just not eat the thing, you can get it outta the house. You can, if there's any Sex and the City fans out there, Miranda one time took cake and put it in the trash and put soap on it. But when we do those things, our desire for it likely is just kind of building. And so the alternate approach with a totally different strategy is how do I turn down the desire for things that I know I don't want to be eating that much of? And so when we do that, then we start to get into the good stuff is where we're looking at what are we thinking and feeling when we get to that point where we are breaking our own plan or it feels like we're acting against ourselves in terms of what we know we want in the big picture. And like I said, that is where it gets fun because, and I say fun loosely, because sometimes it means, what am I avoiding in that moment when I keep eating? And I'm probably avoiding feeling bored or stressed or deprived and asking ourselves, oh, so the cost of getting this outcome I want, which is eating less of this thing, is to really sit and feel that emotion that isn't super comfortable. You know, when we get on board to do that, that's when we start to dial down that dopamine reaction and we start to resensitize ourself to the more natural joys of dopamine or, you know, the ways that we can experience dopamine that's not as hijacked by these food companies that, like I said, they're designed to keep us coming back for more. And man, are they effective.

Oh yeah. I mean, the crunchy things in bags, you know, it's funny because I used to never eat tortilla chips. Like that was just not, I wasn't interested, never touched them. And then somehow I've like developed over the years. I think it's because the art of the tortilla chip has been fine-tuned to something so spectacular.

You are so right. There's this meme that says, So what happens? Do they run out of tortilla chips? Do I die? Like, how do I stop eating these? And I've just, that's so true. And you're right. It's just that perfect profile. And so really learning how to dial down that desire is such a skill that we can use anywhere. Because if you think about it, we have an urge to do something and we allow that urge to be there without reacting to it. And The same skill applies. Let's move over to another area of our health that habits, you know, that we talked about is movement. Well, let's say we planned to do a 30-minute at-home video, or we plan to go to an exercise class. There's gonna be that moment where you're gonna have the urge not to go. And so it's the same skill of overcoming the very primal urges we have for what we want in the moment. That is competing with what we want most. And so that's the good news is we can practice this in any habit. And same thing, like I mentioned earlier, so many people, me included, have habit goals related to being on social media or being attached to our phone or these things again that pull us in in such a compelling way because that's what they're designed to do. And so having an urge to grab your phone is something that instead of reacting, instead of saying, oh, this is just the way it is, or having to throw your phone into the ocean, how can I be there with that urge and not answer it?

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It's funny cuz you know, I, we had this unit on advertising when I was in elementary school and I swear that that inoculated me against advertising for my entire life. Like, they talked about all the different— like, they had us do our own advertisements. They talked about all the ways they entice you. Is it food? Is it sex? Is it whatever they do? Yeah, celebrity. And so I've always felt inoculated to advertising, and maybe that carried over into social media because, like, I'll pull up— so I'm, I'm of the Facebook generation, right? So I'll pull up Facebook, and now of course they have these Instagram Reels, I guess, or the, or the stories or whatever that they, they come on Facebook and I'll start I'll start to watch one because it just pops up or I'm going to post to Instagram for my, for my podcast. So it'll pop up and I'll start to watch it. And I'm just like, what is this stupidity? Why am I wasting time? I literally will never make it through even a single reel before I just put a ridiculous waste of time. This is probably made up. It's probably AI. Like, who cares?

Yeah, that's really interesting. And again, back to mindset. So your belief or your thought was likely planted by that advertising class that this is a waste of time. And so it'd be cool to fast forward and see, does your son living in that house, you know, our habits are so contagious and they're the only form of medical intervention that affect future generations. So like people that you don't even know that are potential, you know, your kids, grandkids, all this will have a change because of the things you do. And so it's kind of cool because you, you know, likely just sharing that, if you ever share that thought out loud, you know, your son may be hearing it kind of like I heard roughage and he may feel the same way because he's borrowing that thought that you have. And, and those are what I call the inner habits. How are we thinking and feeling throughout all day that are driving what we're doing or not doing? Because when we're willing to go to the root of it and start playing in that land, it can feel a whole lot easier. You know, when we're, instead of just looking at what are we eating, how are we moving, you know, what are these different things, which are the outer habits.

Yeah. I'm not sure I succeeded with my son in terms of like food and that sort of thing. Like he's a little bit of a processed carbohydrate addict. Yeah. Social media, I think I was a complete success. He, he didn't get a cell phone until he was in 9th grade and he does not use social media by choice. I didn't force that on him, but by choice. And I mean, of course I made him like listen to many podcasts in the background about the harms of social media and how it destroys your— yeah, he does play video games, but you know, you can't win them all. Yeah.

But you, but you planting those seeds made it more natural for him. So I think that that is, I think that's really cool to see. Yeah, I call it the ripple effect of everything we do. It's not just about us. It's about someone on the beach picking up a carrot stick for the first time and being like, wow, you can eat fresh vegetables on the beach, which, you know, that doesn't mean that's all I eat. I mean, I definitely am human and have again, my planned, what's the word I'm looking for? I want to say excursions, but, but my planned, you know, indulgences, I guess we should say that. And that's the cool thing about the dopamine reward system is if I plan to eat a couple handfuls of chips and I follow my plan, it doesn't have the same kicking up of reinforcing that, ooh, if I tell her I need it, then she'll give me more chips. It's just, I'm following my plan. And so having those things that you want to still have in your life, but making it a part of a well-balanced plan is a secret that not enough people take advantage of.

Yeah. So why do the gut protocols that look perfect on paper often fail in real life?

Oh my goodness. So protocols in general, anytime we are trying to take one-sided advice or one-way advice, right? So if we're reading something, if it's on paper, if it's on a podcast with someone you're not interacting with, Even if you're listening to me here, you know, there's some risk of this, but if you're hearing about what to do and it's only one way, it's not taking into account you. And we, I kind of call it my secret sauce of autoimmune health or secret sauce of frankly living a good life with autoimmune disease. And there's the science, which I know you are well-versed in and your listeners are as well. But all the science in the world will fall flat if we don't bring in ourself, which is ingredient number 2. So again, me and the way my gut responds to broccoli may be different than how it responds in your gut. And so we have to bring in ourself into the equation. And the third one is strategy. So again, sometimes we have really good information, but if we can't follow through on it for long enough to see how something really impacts us, then we can't really see if it's really working because we maybe have not given it a fair shake. And so having real strategies to take out and apply in your real life is so important. And simplicity is the fourth ingredient because man, when things get complicated, like a lot of those protocols are, you know, it's like, wow, we just get frozen that there's so much we could be doing and you fall off in one area and it can really be counterproductive. And then the last one is support because, you know, support can be the difference between reaching a goal and not. And so always making sure that we normalize that doing hard things is something that support can make easier. Yeah.

It's funny that even when I'm working with people and they have my email, I make it clear that I'm there to respond to emails. They might start something and then something doesn't quite work or something disagrees with them. And then They fall off it completely. And then I check in 3 weeks later and they're like, oh, I haven't done any of this because this thing happened. I'm like, well, why didn't you email? That's why I'm here for your support.

Yeah.

Like, I think they, it's funny because people feel guilty. Like I'm letting you down. I'm like, it's your body. I, you're not letting me down. I'm here to serve you. I'm not here to chastise you or make you feel bad. We're trying to fix you, but you know, it's a joint project.

Or maybe that sneaky thought of, oh, I don't wanna bother her. And one thing that's really helped, I coach in a group. I have one-on-one as well, but for the most part, Miracle Club is where the magic happens in terms of the group coming in, learning this. And I love telling my, my clients that it's one thing to ask for yourself. And yes, I want you to ask for yourself, but please know that when you ask, you are giving a gift to every single person because they likely are that person that wants to ask, but doesn't want to ask. And so again, the power in the research on just being witnessed when we do these things and when we do hard things is amazing. And so I love that reminder that sometimes it's not for you, it's for other people and you get to benefit when other people ask your question too.

Yeah. Yeah. No, I always, I always thought it would be fun to do some sort of a group coaching thing, but gut health is one of those areas where not everybody wants to share all that kind of stuff with each other. So it's just never quite worked out. So I've always stayed one-on-one, but yeah. So you've got a, you've got a group that meets regularly, or is it new people come in and out, or is it a set period of time?

It's a membership. So I really love and try to make it as sexy to join for the year, just because realistically, I mean, you know, we're, like we said, we're learning these skills. We are learning how to work with our brains, work with our bodies, and change habits that we've had our whole life. And so I love the space to be able to say, You know, we're not in a rush. We are, we get to experiment, we get to do it. You can join monthly, but for the year is amazing. And yes, we meet every single week. We just make it a habit that we love to tap back in and set goals. I mean, it's a change for people to say, what, what am I working on? What, what is something that I am working towards? And not look at that as, oh my gosh, I have to do this, but wow, I get to do this. I get to keep finding new ways to feel better and new ways to think and new ways to explore how I'm feeling. And I love that live interaction because the best teaching I ever do is in response to a question that somebody I'm talking to has. And that is proved out time and time again. It's like, I can think I have an agenda or a plan, but if I just pause and open it up and say, what's on your mind? Because if we are listening for a question, are listening for an answer to a question that we have, we are so much more open to learning. And so yeah, that human interaction in the world of AI, I will never give up human interaction, being together, sharing our emotions and sharing real time. And yeah, the membership's been up and running for 3 or 4 years and it just, you know, I'm so grateful that I had a good idea because we have such good research on, on what helps, but a good idea on what components does this membership really need. And, you know, it just plays out year after year that goodness, it is nice to have a habit to come back and really take time out of your day or your week to look at what you need and what, what your future looks like.

And is that a group of people with different autoimmune diseases or people with MS?

It is. There's about 12 to 15 different diagnoses represented. So I recently started asking when people join their diagnosis if they want to share, just because, you know, I'm curious. I'd love to know what's represented, but that's the coolest thing is that autoimmunity brings us together. But after that, we just become people who are working to learn new skills and wanna celebrate each other and wanna be. Held accountable and want to learn new things. And it's really cool how it, the goals don't even matter. You know, I have some people training for half marathons and mountain races, and I have some people that are very limited on mobility, but we're all wanting to think, feel, and do better. It's just different versions for each of us. And when we can normalize that and that space together, it's really something special.

So how does living with autoimmune disease change the way that we should think about gut health, about energy, sustainability of lifestyle changes and that sort of thing?

You know, like you said, so much of the root causes can start in the gut. You know, the gut can be such a place for frustration, but on the flip side, the good side is it could be such a place for victories too. For successes. And so, so many of the things when, when we look at, will this be good for my autoimmunity? I mean, you could replace it. Well, will this be good for my gut? I can't imagine something that doesn't meet one, or, you know, if that, if it meets one, it's going to meet the other. And so if our symptoms are gut-related, I think that that can be a really good measure. I call it a measure that matters. When we go to experiment on a new habit or a new goal, if you experience gut symptoms, then what a beautiful thing to directly tie what you're doing to how your gut is feeling. You know, it can be a cause of what is cause of autoimmunity, but it can also be an effect because we can be stressed from autoimmunity. And so it could be a, either a vicious cycle that kind of pulls us down, or it could be a beautiful cycle that lifts us up when we start taking care of it. One of the, one of the things I always point to is this term called autoimmune health. And that was born when I first saw the diagnosis of health after I was diagnosed. And it said the absence of symptoms or disease. I was like, okay, so I'm never going to be healthy again. You know, I have symptoms. I have a diagnosis that likely isn't going anywhere. And so I had to redefine it. And so I redefined it as the health that I can create because of this diagnosis. And gut health is one of those, like, you know, if I didn't have the body screaming at me with this autoimmunity, I think I never would have again taken this different approach to how I'm thinking, feeling, and inhabiting. And I think my gut health is one of the most impacted because Yeah, it's just sitting there waiting to be loved on.

Yeah.

I have a client with Parkinson's disease and constipation is one thing that precedes Parkinson's by many years now and been established in the research. And yeah, I mean, it's, you know, I, I don't know about any connection in particular with constipation and MS, but, but I know if you have toxins sitting in your colon and not getting pushed out in good time, that that is a precursor to problems. So I'm sure, yeah, gut health is super important.

Yeah.

And something that I work a lot on.

If any of my MS brothers and sisters are listening, they're probably nodding like, yes, we are constipated. There's a lot of constipation.

Yeah. Yeah.

So how do food, rest, stress, movement, and mindset work together to support gut health? And what happens when we focus on just one in isolation?

So I have a framework, it's called the Habit Hub for autoimmune health. And it was born out of necessity, like all good things are. As I was sorting through my education in functional medicine and kind of digging into this new approach after I was diagnosed, and as I realized, oh, I need to help other people do this, this framework naturally came together and just has been so obvious of a balanced approach to all the different things we could be doing. And the 6 spokes, you kind of rattled them off, but mindset, food, movement, rest, and relaxation is number 4. Number 5 is connection or relationships. And number 6 is good stresses or challenges that we take on in the name of growth. And so the good thing about these 6 areas is that every habit that you think that you could make. So you're probably reading books. If you're looking for answers to feeling better, you're listening to podcasts, you're listening to this, you're on social media, watching these reels that are do this, do that. Having a framework to see where it all fits in is a science-backed way to help make sense of the information and not be overwhelmed by it. So when we know that we are gonna get to each of these areas in due time, it helps calm our brain down and say, okay, but what am I working on next? And so for me, I went all in on food when I was first diagnosed. I went all in on movement next, and it was a bumpy ride. I mean, it's a hub, but if you go all in on one and neglect the others, like I said, it can feel like a bumpy ride. And so it really is about zooming out and seeing What is a balanced approach to ensure that we are taking advantage and pulling the levers from these different areas in a way that is sustainable? Because any habit that we can do for 30 days or, you know, muscle our way through, we want this to become who we are. We want this to go from a goal to make this a habit to become who we are. And it's gotta work in real life. I mean, it's got to, be something that we're not trying to get the, to the end of, but instead it's just something we enjoy doing.

Yeah. I imagine there's a lot of people who are diagnosed with autoimmune diseases who are not meeting goals in a lot of those areas.

Yeah.

And it hits them like a ton of bricks that like, I'm supposed to go from this, say, typical American diet, no movement.

Yeah.

A lot of TV, a lot of social media, a lot of that kind of thing. And then somehow just like fix all these things all at once.

Yeah.

I know, you know, when I was doing a lot more coaching on lifestyle habits, it was baby steps. It was what is one small step you can take in the right direction? Is that, is that the sort of approach that you work with?

Yeah.

So I essentially, I became a habit nerd and, and honestly, I'm best friends with these researchers and experts. They don't know it. They've never met me. They don't know me, but I mean, I've poured through their books, their podcasts, their science. I mean, these are researchers and the scientist in me loves that we can test something out and then it's reproducible. When we say something's proven in the research, that means this works again. And we can go to this group over here and it works again. And so it gave me the confidence before I had all this evidence of helping people change in a way that feels good. It gave me confidence because the research was there. And so what I've done is I've taken from these various people and I can list all their names. I'm, I'm madly in love with them. Like I said, where the overlap is, I could see, okay, this person calls it this, this person does this. But for the most part, these are just words on a page to a lot of people. Everybody, I don't think I've ever met somebody who hasn't read or bought Atomic Habits, which is a book by James Clear, but if the information stays on the page and it's not again, put in real life, it's not doing us much good. So I have taken all that and it is in what I call the ABC Habit Playbook. And there are 20 plays. These are the strategies that are pulled from the research that we mix and match and we use any goal that we have. And sometimes, you know, similar, I grew up in a sports family, so I have a lot of sports analogies, but different opponents may need different strategies, different plays. And so we have this playbook that we keep coming back to and maybe we tried this one and trust in the tiny is one of those plays, which is kind of what you mentioned. Some people call it the 2-minute rule. Some people call it tiny habits. Trust in the tiny is pulling in that mindset piece that it's not just doing the tiny thing, but it's trusting that the tiny thing really is the answer because our actions are evidence of our belief. So if we believe that I can trust that 2 minutes of exercise today is what I need to get moving, I'll actually do it. Right. Or if I can trust that adding one vegetable to my plate, it over time is going to be the answer to shifting to a way of eating that I feel better, then we actually would do it. And so The playbook is really my secret weapon and I love to teach people not only how to use it on their own, you know, they start to use it and try it and they bring the more complicated things to coaching calls to talk about it. Or sometimes I'm like, did we consider this? Or like you, I loved when you were talking about what you were doing, cuz I'm thinking in my head, okay, she used this play, she used that play. It's always at play. It's just bringing it to the forefront. In a way that is so tangible that we're not going to learn a bunch of things or read a bunch of things. I'm gonna teach you a bit of the science, give you some examples, and then get you out in life, like practice it on that habit that you're working on so that you can really start to see the evidence of it working.

Yeah. I think I'm sort of within a, a small percentage of people. I'm kind of a willpower machine.

Like, there you go.

I've exercised regularly my entire life and I'll take a week or two of vacation and I won't be doing it.

Yeah.

I'll even quit. Walking and I'll come back and it's Monday. Of course I'm going to the gym. It's Monday, Wednesday, Saturday. That's what I do.

You are.

And I'm, I'm kind of in your camp, which is actually really fascinating that I ended up doing this work because, you know, a lot of people I talk to who are like us, they're like, what do you mean? Why can't, why can't people just do it? Like if you decide to do it. And I kind of went the other way and I'm like, I want to get in the trenches with them and really look people in the eye and say, I really believe, you know, there's that image of the decision tree of, did it work yet? And, you know, you can go, yes.

Okay.

Keep going. But if you say, no, it didn't work yet.

Okay.

Keep going. Like, we'll try a different strategy. We'll try a different play. Like, I, I never think that it's not going to happen for you. And that's a beauty of coaching is that I can lend you my belief in this playbook, in you, as you build yours up, because everybody needs to build up their belief that it's possible for them to feel better. I mean, that's, that's a huge root of a lot of, a lot of us is that, A, I'm just not consistent, or I am just a person who, you know, insert whatever thing that keeps us feel stuck, or these things can't really work for me. I can't really feel better. And I want to lend the belief that, oh my goodness, Both of those things do not have to be true and help you build that belief for yourself and find evidence in, in your own life.

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So do you ever have people who come to you who have a loved one who is sick and they're not doing what they need to be doing for their own health and they're trying to help them to, to want to have the even desire to live better?

That's a good question. I get comments on the podcast. I have a podcast called Autoimmune Health Secrets, and I will from time to time get comments of, I started listening because my sister has this, or my husband has this. Or so I know that there are those loved ones out there. I've had definitely people show up as couples or as families on calls when they're trying to decide if they want to join the club. One couple, this is a little different than you mentioned, but one couple, they were on for the consult and it was revealed that one person was living with one diagnosis. One person was living with another, both autoimmune.. And again, the research shows that the most effective unit of change is the household. So kind of how you mentioned, and I said, well, this doesn't make sense. I listen, if you join, you join for free. I was looking at the husband, wife, they're two of the most active, amazing members, and you join as a household. And so you only have to pay once and that offer still exists. I love it. I've had other people. You know, their spouses or even their kids will come on a call. Like, that is the coolest thing. But what I would say for anybody who's going through that is that you have to go first, right? So I can only be a coach for somebody who really wants to come in and do it because it just doesn't work. That force or just giving more facts or trying to instill fear is just not an effective way to change. And so I would say to anybody, you go first. That ripple effect is really magnetic. When you start looking at your role in your own health, it's kind of contagious. Other people can't help but take notice and start to get curious. It may take a little bit of time, but they, they do start to come around and ask what you're eating over there.

So one of the areas that you were mentioning, that's part of the, your, your rubric is relationships and connection. And that's one where I think people probably really want to have more of, but are finding it difficult. Are there any tips, tricks, you know, for, for building up connections, especially friendships? I think nowadays it's a little harder cuz people are so buried in their phones and their—

Yeah, that's so true. I use the same tool that I use for everything, which is habits. So if you think of relationships. I mean, the way we show up, we wanna show up on autopilot. We wanna show up regularly. We wanna show up consistently for these people. So that could look like scheduling out, you know, there's all sorts of— we use the playbook. You know, our goal is to probably feel more connected, or our goal is to see this friend more often or to make this friend. So then we start experimenting with, What do I think could help me get there? And then we use the playbook to make that the more habitual thing. And sometimes, you know, people have this thought of it should be effortless or it should be, I shouldn't need to put it in my habit tracker to call this person or to have this intimacy with my husband or, you know, these various things. But Why not? Why not put relationships, which are a key to happiness, they show over and over again. Why not put that as an important thing worth tracking and worth problem solving for? I mean, I am an aunt, I'm not a mom, but I'm a fierce aunt that loves her nephews and niece so much. And I started when my, my oldest nephew is 19. I started some habits as Aunt Amy. That are really coming to fruition almost 2 decades later that I can see it's because I made this a habit, you know, and habits can be daily, weekly, monthly, annually, but they are consistent and they've allowed a connection and a relationship that is worth it. So they may not pay off immediately. Some of 'em I think absolutely will. Let's say somebody that makes you laugh, you make it 2 times a week, I'm going to call this person for nothing other than to hear their voice, you know, and I'm gonna track it and I'm gonna make this an important thing that can pay off immediately. But some things it may be a longer burn, but there is nothing more worth it.

Yeah. So is this like you're putting in your calendar, call X friend on X day or text?

For sure.

Yeah, for sure.

That's a strategy from the playbook, commit to your calendar. So that would be one that we could pull in. There are so many other, you know, making a plan with people. There could be having people on your support squad, all sorts of things. Yeah. Commit to your calendar is a huge one. Never, never leaving a friend date without setting up the next one. You know, sometimes—

that's a good one.

Sometimes it's like 8 months in the future because our lives are that busy, but who cares? That 8 months is gonna be here in a flash.

It's funny cuz I have this thing, like if I ask them to do something again, we just saw each other, they're gonna be like, oh, why do you wanna see me again so soon? But I guess I wouldn't think that if somebody said the same to me, I'd be really happy. Oh, they wanna see me again.

Yeah, totally. They'd be like, heck yes. Heck yes. Sometimes for my connection habit, so I always say let's start with one or, one or two goals, right? Especially at the beginning if you're overwhelmed. But once you start to get a rhythm, I like to always have one habit goal in each of these 6 spokes. And so sometimes I will do for my connections spoke, what I'll do is I'll say to my husband at the beginning of the month, I'll say, what is something that you would like me to do to make your life like, like what's a habit I could make or break to help you in some way? You know, just from a place of love. And the first day he's like, oh, I don't want you to do anything. And I'm like, no, really, I want to do something. He's like, "God, please turn off the basement light when you go down." You know, like it kind of comes out and I'm like, okay, listen, this could make him happy. You know, this could be something that I can do. And so I will get out my playbook and I'm like, how do I break this habit of leaving these lights on? And I include that in the connection spoke because it just feels good to do something for somebody else. And so that one came from, I used to, I would leave my paper towel on my plate and it would get kind of icky and nasty. And my husband would always be like, "Ugh, put this in the trash." And one day he said, "You're so good." And I go, "Sorry, I just forgot." And he goes, "You claim to be so good at habits. Why don't you break the habit?" And I was like, "Oh, this'll be fun. I am going to practice what I preach and I'm gonna use my own strategies." And honestly, that habit was broken pretty instantly. So sometimes it's fun.

Just, he threw down the gauntlet.

He threw down the gauntlet.

I'll throw that napkin away. Watch me, watch me. Watch me throw it away.

This is my life's work. So clearly I need to figure this out. So, so yeah, it's fun to use the playbook on things. I one month had it as a, as a habit to do the two steps to help make it easier to make his coffee, you know, just, just little things of, yeah, relationships and, and we have fun with it because people think Oh, I have good relationships. And I'm like, oh no, but let's make them great. Like, let's become known for something. That's my favorite thing.

Yeah. So, okay.

Help me with this habit. I have a very bad habit. So I'm very detail-oriented and I, everything is supposed to be done a very particular way in the kitchen.

I'm married to you. Yeah. You are my husband.

Okay.

Great. So I tend to be critical when things are not done the way I think they should be done. And I also am sort of an extrovert, so I I speak before I think. So in other words, I'm just a constant flow of critical feedback, which is, you know, not great for any relationship, as you can imagine. How can I, how can I fix this habit?

Those are two separate ones. Let's go with the first one. And likely, so there is a play from the playbook I'm gonna pull out called Go to the Root, right? Go to the Root is acknowledging that those inner habits, that we have a thought or a belief that is driving what we're doing. So I'm gonna go out on a limb and say that there is some version of a belief at the root of that, that is, my way is the right way.

Oh, of course, without question.

So if you're believing that, if you're thinking that, then always, if someone's not doing it your way, that will be rubbing up against your core belief. So the first question I would ask you is, are you willing to let go of that belief, challenge that belief, or wiggle it loose a little bit to get to this thing that you say you want, to get to this goal?

This is challenging because I'm objectively correct in most of the things I'm like, like, like say cooking, for example, like washing vegetables before you eat them. Like I'm objectively correct that that's better choice than leaving a non-organic vegetable.

I challenge you.

Okay.

Do it. Well, well, only because a little bit, because there are people that don't wash their vegetables and they are living just fine. They're okay. Like we could find all these reasons, but, but like, what if we're just wiggling it loose a little bit? Like we don't have to go to, wow, you're right.

Maybe I might not have crunchy salad if you don't thoroughly wash it.

Yes. Yes.

It's possible. Yeah. So that, that one can be tough, but I'll give you one that really helped me. Cause like I said, I'm, I'm married to you. My husband is, woo, he's you. And, and one thing that I think has saved me is 3 little words, and that is when We're different. That's the bottom line. I go back to, we are different by design. Like, how are our differences our superpower? And, you know, and I don't know if different by design lands for you as much, but, you know, what if our differences are also what brought us together? We just like wanna find a version that when we think my way is the right way, Like, what could we redirect our brain to that gets us out of that rightness feeling that needs to critique and just allows us to be in that curiosity? What is he thinking when he is not eating? You know, like, like it allows us to shift our energetic state into one that maybe doesn't need to say the thing. So I wonder what about your husband? What, tell me something about him that is different and thank goodness it's different.

He's very laid back and not critical. Like he never tells me what to do or what I'm doing wrong or that sort of thing.

Yeah. And so it, so it could be something like, you know what, I wanna pay him back the favor. You know, like, so you see that there's one right way. But you know, you don't wanna say the criticism, you know, maybe try on, ooh, I can give him this little gift that he gives me all the time. How does that feel?

That's good. That feels good. Okay.

Because you gotta finding thoughts like this when we go to the root, I offer some, but it always has to be one like you try on and you're like, I kind of saw your body language shift a little bit. You're like, oh, that feels good.

Yeah.

So like, how do you know you have one? And then. Then just trust in the tiny and it's those little repetitions. Does that mean now you're gonna walk around the kitchen and be fine with it? No, but you keep redirecting that very human brain. You build a new neural pathway that instead of habitually going to, "You're doing it wrong," it goes to, "Oh, maybe it's okay if it goes this way. You know, maybe it doesn't need to be this way." Like we find the versions that feel true and that that we want to practice and lean into. And then one day after you've been practicing it, what we would do is that would be your goal, let's say for the whole month. And you wouldn't forget about it because you'd be practicing it. You'd be coming back to it. You'd be finding all the evidence that it's a good thing. And one day you may notice that you go to that thought first. That day, let me tell you, is the coolest thing because you just proved to yourself that you can change how you think or what you believe. And that is like, just, I remember one of the first times that happened for me. And every time I get to see that for a client, I'm like, oh my God, this is why I do what we do. It's awesome.

Awesome. Any final parting thoughts before we get off?

Oh my goodness. I don't know.

I feel like we, we danced a little bit everywhere. I, I love that you put me on the spot with a little bit of coaching. And no, I'm just grateful to you and all your expertise on the gut, because man, we need it. But final thoughts, I guess, would be if anybody wants to calm the overwhelm. So like we talked about, there's so many things we could do. One way to get started, I have a free quiz. It's 7 questions. It takes 3 minutes or less, and it will, again, pulling in what we know about the science, it will give you a result on one of these habits that we talked about, one of these areas, and you can trust, oh, let me just start here. And so not only do you get what the habit is, then you'll also hear from me on some of these strategies to actually make it happen. And yeah, I just encourage everybody to use focus as their friend and just start with one and really learn how to make that a habit because that's a skill that's gonna serve you for the rest of your life in, in all these different areas.

Great.

And where can people find you?

I have a podcast, Autoimmune Health Secrets. Of course, I'm coaching inside the club and I am on Instagram at Amy Bihimer Coaching. And the link to the quiz is on my website, which is www.amybihimercoaching.com.

Okay.

And we'll put that all in the show notes.

Great.

Thank you so much for being here and for sharing all this great knowledge and coaching me on my terrible habits. So I would, I I look forward to fixing this problem.

I love it.

I can't wait to hear what your husband says the first time he doesn't get corrected because you're fixing it.

Well, I think it'll, it'll accumulate over time. The fact I succeed in it.

I love it.

Okay.

Thank you.

Okay. Bye.

That was a fun conversation and hopefully will help me to be not such a nagging wife. You can support the podcast by buying supplements at a discount from my Fullscript dispensary, ordering tests at a discount from my Rupa Health Lab Store. Or using my affiliate links to iHerb, which is available worldwide, or Amazon. And just to note that you can use my Amazon link to buy anything, so I'd appreciate it if you'd bookmark my link and use it not just for supplements but for gifts and everyday items to support the podcast. And if you're a fan of my product Tributrin Max, if you could do me a favor and put out review on Amazon, it would mean the world to me. You can go to tinyurl.com/reviewtmax. If you'd like to connect with me online, you can follow my High Desert Health Facebook page, join my Gut Healing group or join my newsletter list at highdeserthealthcoaching.com, as well as follow me on Instagram, TikTok, Pinterest, Mastodon, and X. Links for those are in the show notes. Thanks for joining me today, and here's wishing you all the perfect stool.