AUTOIMMUNITY & INTEGRATIVE MEDICINE

Good day and welcome to Medicine Health with Dr. Paul Anderson. That's me. I am Dr. Paul. We'll get everything clicked on here so everyone's happy. Well, welcome back. Last week we did autoimmunity and I had mentioned I got a whole lot of questions and got more since then. And of course, like usual, we didn't really get through everything that we were going to talk about. So I thought, well, let's just do a part 2 so This is part 2. What we wanna talk about today is autoimmunity from the point of view of where's it come from and what are some of the more common questions people had, such as, you know, are all autoimmune diseases the same? Do they, you know, obviously they're not the same in symptoms, but underneath, are they the same? Do you interact with them the same way medically speaking? And then the thing that we really didn't get to last time was, uh, what do you do as far as, uh, um, trying to treat the underlying problems? And that's really what we'll spend the bulk of our time today talking about. So we have a few things. So first off, for those of you who listen on one of the Podburners or on YouTube or on CTR Network, thank you very much. You can go ahead and if you haven't, you can subscribe, like, share, all of those good things. Thank you very much. And the YouTube channel keeps growing, uh, because we move all of this video content over there. So we start out with this on CTR on the radio, and then we do a Facebook Live concurrently, and then we move it over to YouTube. So go take a look at the YouTube channel. The other thing is people ask, well, where can I have one access point that has all your links and your newsletters and all that stuff? That would be over on dranow.com. So dranow.com. So just dranow.com, and that's got all the links and everything going on there. And so once we get it over, uh, there, this will be up on YouTube tomorrow, and then of course they stay up there. So, and there's a lot of other content on YouTube. So last time we kind of talked about, you know, what, what is autoimmunity, what are the common diseases, etc. Um, Just to recap the idea between— behind autoimmunity. So it's autoimmune, so immune against oneself, is that your immune system has decided for some reason that there's some— something about you that it wants to attack. So that's literally the base for all autoimmunity. And these are things such as, you know, rheumatoid arthritis, type 1 diabetes, Crohn's disease, ulcerative colitis, Addison's disease, Graves' disease, Hashimoto's thyroiditis, myasthenia gravis, vasculitis— many of the vasculitis family are autoimmune— and on and on and on. So what you have is the disease is hallmarked by what is the immune system attacking. So if it's rheumatoid arthritis, then it's attacking the lining of your joints where it's supposed to have nice smooth fluid, and this synovial membrane is supposed to make the fluid and keep the bones apart and all of that. Imagine if your immune system is attacking that, what that's going to do to the amount of mobility you have in the joint, the amount of pain you have in the joint, and eventually to destruction of the joint. On the other hand, what if the autoimmunity is attacking a part of your nervous system, you might wind up with something like multiple sclerosis or myasthenia gravis, etc., or it's attacking hormonal systems. Then you might wind up with type 1 diabetes, might wind up with Hashimoto's thyroiditis or Graves' disease, may wind up with other problems elsewhere in the body. So when we're looking at all that, it's pretty clear that we have this problem in autoimmunity, which is your immune system has gotten off track and has decided that it wants to attack you somewhere. Okay, now we talked a little bit last time, we talked a lot about kind of standard therapies. The, the standard therapies include things like steroids and disease-modifying drugs and biologic drugs. So talked a lot about that. But what we want to kind of segue to this time is we talked about what causes autoimmunity, and there's a number of publications, some of which I linked last time, some I'll link this time if you want to get into it. But, um, there are a number of commonalities that we see with autoimmunity. For example, there are some autoimmune diseases that affect more of one gender than another. Generally, autoimmunity affects more women than men, but there's some more specificity to that with different diseases. There are autoimmune conditions that affect people in different racial groups genetically. And then there are different— now that we understand genetics a little bit better, we certainly don't know everything about it, but now that we understand a little bit better, there are certain genetic underpinnings that seem to lead people to more autoimmunity. So then that leads to, well, what's the cause? Now, what we talked about last time was the cause is a lot more multifactorial. There's a lot of reasons for the cause. And when you have something that's multifactorial in a cause, often one treatment isn't going to really do a great job with something that's got a bunch of causes. So this is why steroids are used to calm down autoimmunity when it really gets out of control, because as we talked about steroids sort of calm down the inflammatory immune response across the board. Downside of steroids, of course, is while they're doing all this good stuff for your autoimmune inflammation, etc., they can be suppressing other parts of your endocrine system, your hormone system. They can create damage. For example, if you get a steroid shot into a joint, it's good Temporarily, but the longer you do it, the more damage you get to the joint. Steroids can create immune suppression, which is why you're using it for autoimmunity. But on the other side, what if, what if I have an infection I need to fight off? You know, is that going to help me out or not? Well, no, it's not going to help you out. You become immune suppressed. So then we go to disease-modifying agents, which kind of work similar to steroids, although not exactly the same, of course. Then we go to the biologic drugs. We talked about a lot of biologic drugs last week. And the bottom line with them is they go to more specific areas. So whereas steroids might shut down a whole bunch of reasons for inflammation, the biologic drugs may go to 1 or 2 or 3 little areas and turn them on or off, and thereby downstream decreasing your disease state. So it's a little bit better in that respect. The problem is whatever you shut on and off up here might lead you to the same kind of, say, immune suppression or immune dysregulation, etc. So there's never any fully free trade-off when it comes to autoimmunity when we're looking at drug treatment. Now, can drug treatment Decrease your immune reactivity and the symptoms that come from that? Yes. Can the drug treatment extend people's lives? Yes. In many cases, we have to use these drugs in order to get the disease under control in the beginning. Are the drug treatments, if possible, the best long-term answer? The answer there is usually For many people, no. But you have this balancing act where you cannot leave an autoimmune condition untreated, or you wind up with fully spiraling autoimmunity, and the person becomes more and more in a disease state, and they can become very sick or even die from that. So there's that one side of the balance is we don't want to leave it alone. But then on the other side, we have these treatments that are rather shifting of the immune system and have some side effects, etc. So if that's all we do is that, then we take, you know, over for the autoimmunity and we lower its disease state, but now we've bought these other side effects. Well, the point of today that I really want to talk a lot about, because we didn't really get to it, is what if we had something in between? So on one side of the spectrum, we've got do nothing with the disease and just let it go, and you will have more more and more disease, and you probably will die younger than you should if you don't treat the disease. On the other hand, we have these disease-modifying agents or steroids or biologics, and they can be very life-saving and very helpful, but you've got all of these side effects. So with all of that, then how would we find a middle place? And the middle place, I just want to be clear about this, might mean that we have a mixture of some standard drug therapies and some other therapies. The middle place might mean that we have minor amounts of drug therapies, so not so much in the standard realm of treatment and dosing, but in the minor areas. And then we have a lot of other things going after the autoimmunity or the underlying reasons for autoimmunity. So what would the middle place be? Well, the middle place would be looking at treating the underlying diseases and disorders that feed into autoimmunity and the triggering of the autoimmune disease. So when we think about that and we come and we look at even some of the basic sort of research and papers, and even I think I put in a couple of popular articles— popular meaning just popular press articles from last time— we see these publications that say, well, There's obviously reasons that even if you have a genetic underpinning to your autoimmunity, that why doesn't everyone in your family get the same autoimmune disease, or at least everybody with those genes that are expressing? And the reason is, is that you have epigenetics, which are what turn on or off your genes. And most of the research papers that write about this basically say, we know that there's these Heritable genetic reasons. Then we know that there are gender differences, which are more epigenetic than genetic. Well, of course there's differences in genetics there, but there's more epigenetic triggering there. And then we have— and they always list things such as toxins, infections, immunologic problems. etc., etc. Now, what are all these things? If I have a toxic exposure, I have an infection that won't go away, or I have an immune dysregulation that's not autoimmunity but it's pro-inflammatory maybe, or I have some of these other problems, what are those? Those are all epigenetic signals. So when you look at epigenetics, you want to think of the genetic code is literally like a code It's like a menu or recipe, really. The epigenetics can turn on or off pieces of the menu. And so you can either— for those of us that cook, we know this— if you come upon a new recipe, you can have 5 people cook the exact same recipe and you'll get 5 different tasting sort of dishes out of it. Some things might be really close together. Other things, like especially if you're baking or something like that, you might get 5 totally different baked goods out of the other end of your recipe, even though you all read the same recipe. Well, in epigenetic triggers, what happens is it's like if someone came along and you had 5 people making the same recipe, but the epigenetics would be like somebody with a Sharpie who came along and drew a line through 1 or 2 of the ingredients or 1 or 2 of the instructions on your recipe. So if you're the person then who has a black line through one of the ingredients, you're not going to put that ingredient into your, you know, cake or pie or your recipe. It's going to taste and look different when it comes out the other end without that ingredient. So you say, well, how does that relate to epigenetics? Well, if the genetics are sort of like the recipe, epigenetics can come in and turn on or turn off a particular gene. Or turn it up or down. That is very important in that if I have, say, 5 things that are coded to happen and they all happen, then normally what will go on is whatever that code is for turns out in my body or my physiology. If I have 5 things that are coded in my genes and they code for a tendency towards autoimmunity or any other disease, but let's say autoimmunity. What happens is I may be born and not have those turned on, so they'll all be turned off. But then the epigenetic signals, like the person with the Sharpie that goes through and colors out some of your recipe stuff, the epigenetic signals come and they beat on the genes and those things turn on. And so either as a younger person, like in juvenile autoimmunity, or as an older person, I suddenly, quote unquote, develop my autoimmune disease. So that is the effect of epigenetics. So epigenetics, you say, well, what can come and bang on my genes? Well, anything in your body that is associated with health or disease promotion can be an epigenetic signal. So you might say, okay, so do those match the things in the research that says we think these are some of the causes? Well, an easy one to think about is toxic exposure. Toxic exposure is an incredibly common reason for epigenetic problems. So if you think about it, the toxin gets into our body. The toxin is not meant to be there. We have not developed as humans with that toxin in our body. And so all of a sudden, let's say it's a chemical toxin that is very soluble and goes into the body and gets into our cells. And let's say it's either in the membrane of our cells or maybe in the nucleus or somewhere else in the cell. Then my immune system may come along and try and clean that cell up that was all toxic. While it's doing that, it may do something called presenting antigen, which is literally taking a piece of the dysfunctional or diseased cell and showing it to the immune system and saying, what do you think of this? Now, there's a number of steps that take us to this place, but the bottom line is, if we do that and we take this— say, you know, let's say there's a part of our cell that's full of a toxin, and the cell gets cleaned up by the immune system, and that piece with the toxin gets, uh, presented as an antigen, a non-self, a non-you thing— then your immune system suddenly says, huh, We kind of thought that was part of us, but apparently it's not. And so maybe what's going on here is we have an invader. So you start this immune triggering where your immune system believes you— now a piece of you is an invader. And so the toxin is more like the trigger that causes the cell to be dysfunctional. The immune system cleans it up, and then the immune system sees this piece of the cell that the toxins change somehow And it says, that's not right, that's not us, let's clean that up. We're going to make more, you know, T cell or B cell or both antibodies or cell-mediated responses against that. And that's what you see in autoimmunity. Now, the other thing that toxins can do, whether it's chemicals or metals or mycotoxins from mold or other stuff like that, the other thing that it can do Is those toxins can go in and they can change the function of the cell. They can either change the gross function of the cell, or they can change the nuclear function of the cell— well, where the genetic code for the cell is. So imagine if the toxic gets to the point of the outside receptors, or the genetic code changes it. That's another thing that will bring your immune system to the place where that cell is, and it'll say, we got to clean this up. This is a mess here. Okay, and so it'll start to develop an antibody or an anti-T cell against it. So just like we talked about with regular immunity, you have a B cell side of your immunity that makes an antibody-based problem and a T cell that makes a cell-mediated or cell-directed response. And there are different types of autoimmunity. So everything that your immune system can do, the autoimmune triggering can do. So there's B cell autoimmunity, T-cell, etc. So what about infections? We talk a lot about infections. How does that work? How does that get triggered in the body, etc.? Well, infections are damaging to your cells as well. So if I have infections in one area of my body, and it's hanging out around the cells, and there's a lot of infection there, the immune system comes in to clean it up. It might inadvertently clean up some of my cells along with it. One of the reasons that intracellular things like viruses and certain bacteria, etc., are more associated with autoimmunity is because the virus especially goes in the cell. Immune system comes along and cleans up the cells, takes the whole cell out, and if it's not careful, it will make a memory against that cell. We see this a lot with things like the thyroid. Yeah. conditions, Hashimoto's and Graves' disease. They can come on with chronic viral illness, etc. Viruses love all cells, but they really like the endocrine cells where you make your hormones, for example. So we have all the toxin, the world of toxins, and that doesn't matter whether it's metals or chemicals or mold toxins, the biotype toxins, etc. We have chronic infections that are never cleaned up, like chronic viruses and bacteria, even parasites and other stuff can trigger this sort of thing. Then you also can have a problem where if your hormone system, your endocrine system is out of balance, it can trigger you into having a response that's exaggerated. So now we talked about last time in a lot of our immune and COVID stuff, how the normal thing with the immune system is we have this big upswing, we get infected, that's great. And we get fever and maybe, you know, cough or mucus production or whatever, that's all an immune response. But then after we have the initial response, we're supposed to kind of tail off and decrease that immune response. Well, that tailing off is triggered largely by our hormonal system, which responds to the immune system. So immune system goes up, hormonal system is permissive to let it do its thing, and then the hormonal system kind of rises to the occasion and calms the immune system down. Imagine if my hormonal system couldn't rise to the occasion appropriately, calm the immune system down, I am going to wind up then with an imbalanced, uh, immune reaction to the infection that's going on. And then that may trigger these inflammatory chemicals, inflammatory cytokines, etc., that wind up, um, basically, uh, creating another epigenetic trigger for autoimmunity. So there's all sorts of these things that can happen, and I'll, I'll put— if you're curious about looking and reading around it and all that, we'll put that in there. Now there's other things that can do this, such as chronic digestive problems where the GI immune system or the GI bacteria, the good ones versus the bad ones, or the GI nervous system gets thrown off. That's another big way to have a trigger. allergies and sensitivities, because the presence of a lot of allergy can throw your immune system off in a direction that can be an epigenetic stress on the rest of you, stress on you and your immune system, etc. And then there's a lot— and I put 2 different papers in the notes that look at the neuro-emotional connection. So there are these connections where there's more autoimmunity of different types and different types of neuroemotional patterns and neuroemotional balance and all of that stuff. And so you can look at that, but it's— that's another well-known, uh, well-known association. Now, is it that the neuroemotional stuff creates the autoimmunity or vice versa? And it kind of goes both ways, but that's a real long subject, and it gets into a lot of different areas. But the bottom line is, is that there is an association between certain types of neuro-emotional balance issues and autoimmunity and vice versa. And there's a lot of good reasons for that. Now, while we're moving along, then what we want to talk about for the last half of the program here is What do we do, uh, to treat these underlying autoimmune triggers? And that's that middle way that I was talking about. So remember I said one way is don't treat it at all. That's just going to give you a lot of disease and damage to your body and probably earlier death. The other is treat it, and you can use standard treatments which can get the disease under control, but there's always side effects and collateral effects that go on. So we have to be careful. with those. And then there's sort of a middle path where we try and do a lower amount of the standard treatment but treat these underlying epigenetic triggers and try and get the disease under control. Now, just one thing really quickly. When I say look at the links and all that, you won't see it on the live feed today or on the CTR Network. If you're on a pod burner, you know, whether it's Google or Apple or, or Any of the pot— we're on all the pot burners. They won't be on there. You have to go to the YouTube channel. Uh, it's Dr. A Online is the YouTube channel. Uh, and on the YouTube channel, down in the description box, uh, so if you're on your device, your phone, on the right side there's a little down arrow or chevron. Click that, you'll go to that down there to the description box. If you're on your laptop, it's on the left side. It says Show More. Click on the word Show More. They don't look like a link, but click on them and that'll open all that stuff up. So I'm just going to click this button here real quick. And so in this section, we want to talk about, okay, if autoimmunity has this sort of middle path treatment where we try and modulate the standard drugs that we're doing down as much, what do we do about all these triggers, all these underlying endocrine problems and toxic problems, neuro-emotional problems and gut problems, allergy problems, etc.? Well, the idea there very simply is, why don't we target those things and treat them, and by doing so decrease the amount of epigenetic signaling that's going into you or, or your patient, etc. So that is the underlying idea behind treating underlying diseases and getting autoimmunity at a lower intensity. If I can keep your autoimmunity at a lower intensity, I may not make it— be able to make it go away, but if I can keep it at a lower intensity, then I will be able to treat you with less drugs and sometimes no drugs. It just depends. Now, there were some really great questions that came in, I think either the same day or after we did the last one of these installments. And so one said, you know, are all autoimmune diseases basically the same? And the answer is At an underlying microscopic or molecular level, yes. Now, once you have that recognition of non-self and your body immune system decides to beat up on you, because that could be a T or a B cell response, you need to know it's not the same after that. And that largely leads to, if it's the same thing, why do some people have joint problems and some people have, uh, you know, neurological problems, some people have GI problems, etc.? Well, that's after the initial insult, where the insult is, how the immune system responds, whether through the B cell or T cell side or some mixed thing, and then how much epigenetic damage there is in the area. Those things get together and create the disease that you get. So on the other end, they're not the same in that rheumatoid arthritis is attacking against the synovial membrane in your joints. It's largely a joint disease. Multiple sclerosis is an attack against a part of the sensitive nerve transmitting nervous system. And that is not good because it breaks it down, then you get dysfunction in your nervous system. Graves' disease is an attack on the thyroid cells to cause overproduction, whereas Hashimoto's disease, attack on the thyroid cells to cause underproduction. So autoimmune diseases are the same in the beginning, and then how they express gives us the wide variety of diseases. The next question I think is really critical to our discussion today, which is, once I am diagnosed, can it be reversed? And based on my personal experience, my answer to this is always, it, it can in some cases, and in other cases it can't. So there are people where I have seen where they treat all the underlying things for long enough and they weren't extremely autoimmune for years and years and years. So earlier cases where they treat all the underlying conditions and they actually do start to get better over time and their labs go back to normal. And if they take care of the underlying conditions and keep them moving, then they stay that way. Okay. Now, that doesn't work for everybody. And the longer you've been autoimmune, the more of a problem it is. But the other side of it is functionally, meaning really in reality for the way your body reacts, I've seen a lot of people where if they're treating all the underlying problems, they may have a diagnosable name-brand autoimmune disease, such as say lupus or something like that, but the labs go back to normal. And until they flare, they really don't have a lot of the symptoms of the disease. And we've had patients where without the use of a lot of the standard therapies or really low-dose standard therapies, um, and we treat the underlying problems, we've had them stay pretty much disease-free literally until, you know, their later 80s, uh, where, you know, they are going to get sick and pass away from other things. But then there's other people I've encountered where we get to them with their autoimmunity and they've had it for 5 or 10 or 20 years And we can still decrease the amount of drugs they need, and we can increase the amount of collaborative support that they get. But because they've had the underlying disease so long, there's probably some tissue damage, or, you know, whether it's your joints or your GI tract or whatever. We can't fix all of that. We maybe can't get the labs to go back to normal. So it's a real spectrum as far as when you encounter the person, how much they can do, etc. Next question was, does targeting the underlying triggers really help? And I'm here to tell you, yes, definitely targeting the underlying triggers is how you get to the epigenetic triggers that turn on and off autoimmune disease. So unless you're just going to go with the standard medical route where we might give you, you know, as I said, steroid disease-modifying meds, biologics, which is all fine if we got to get your disease under control, if we work on all the underlying things, that can decrease the amount of intervention we need and lengthen the amount of time that you have to deal with the disease with the drugs that we have available. So this is another thing that's really important. If you have, you know, a lot of people are diagnosed with autoimmunity fairly young. The longer you live, the longer you're prone to get more flares and maybe need more treatment. So the more we can treat you on the earlier end of the spectrum, the better. And the more on the early end of the spectrum I can treat you and get all these underlying epigenetic triggers controlled, the better across the board. And so the final question, which segues into our treatment area, is how does integrative medicine fit in? So the idea behind integrative medicine, and in some states you'll find physicians that are naturopathic physicians or integrative medicine physicians and practitioners, etc. But whatever they're calling themselves, um, the idea between integrative medicine is trying to, uh, integrate and, and make what I was saying, um, sort of a middle path for you. And so normally with integrative type therapies, you're not throwing out all the standard things, uh, and you're also not throwing out all of the integrative treatments or natural treatments. You're trying to blend them together And in my personal experience, that actually works better than a lot of other approaches. And the reason for that is, is that there's a lot of disorders and diseases where the underlying problems need a lot of varied help, a lot of broad interaction. And that's the, the beauty of this sort of integrative treatment. So I talked a little bit about autoimmune cases that kind of, you know, appear and then they go away and they come back and go away. We have a lot of our chronically ill patients who, when their chronic illness— so some non-autoimmune chronic illness, a lot of those folks have transient autoimmune activities— when they are feeling well and we're treating all of the underlying problems from their chronic illness, their autoimmunity, maybe the labs will be negative and they'll feel better and all that. Or maybe the labs are a little positive, but they don't have symptoms. And that's great because we can move forward and just do that. But then they will flare up, and when they're flared up, sometimes their autoimmune labs will flare as well. So another thing about autoimmunity, especially if you have other chronic illness associated with it, is it's not static. It's not like you're always at the same level and you always have that. And so what you want is as long periods of remission and as long periods of low or no disease state as possible. Because that extends the amount of time before you need other interventions. So the treatment targets— the first treatment target is one that we probably said the most with autoimmunity, and that's toxins of all types. So the first thing is you can be tested to look into toxins, and that's a good thing to do. And a lot of these tests are screening tests that can be done with urine. So we can take one urine sample in the morning from somebody and send it usually to 2 different labs, and one lab will give us a screening for exposure, especially acute exposure to metals, heavy metals and toxic metals. The other lab will look at, say, chemicals and mold toxins, etc. Sometimes we might do follow-up tests that include some blood tests and other things, but the screening tests and toxins and toxicity are largely urine tests, at least on the screening end. So that makes it fairly easy. Now, if somebody comes up and they have a large amount of toxins in their urine, the first question we have to ask is, are you exposed right now? Because there are some things that are in the chemical end of toxins that are called persistent pollutants. and there's transient pollutants. If you have a persistent organic pollutant, for example, that you've been exposed to, that may go in you and stay and then just keep coming out. If you have a transient type pollutant, it's gonna be in and out same day or in a short amount of time. So if we see something and it's high, we look and see which end of the spectrum it's at. The next thing would be mold toxins, mycotoxins. There's a lot of different type of testing for that, but again, the screening is often urine. And again, It can be that you're detoxing the mycotoxins, or it could be that you're exposed in your house or at your work or in your car. Why are these so important? Because chemical and mold toxins are immune suppressive. They're also immune dysregulatory. And of course, metals are not good for most functions. They're not supposed to be in there. Another area that we like to look into and try and treat and clean up if we can would be chronic and stealthy type infections. So people that have chronic, say, Epstein-Barr virus or cytomegalovirus, the human herpes virus family, people with chronic reactivated chlamydia pneumonia or mycoplasma pneumonia. And there's some people even that have the acute problem strep that goes chronic, and that can be quite a problem along the way. So chronic infections are things that we look at. Endocrine or hormonal imbalance, that's fairly easy to check usually with tests testing for the hormonal system. Diet and lifestyle triggers. So lack of exercise can trigger into this, a pro-inflammatory diet, kind of get the picture there. Digestive system imbalance in the good flora, the good bugs in your GI tract, that often is triggered by, you know, the diet that's not working really well for your body. Allergies and sensitivities, as I mentioned. So sometimes we have environmental allergies like, you know, the grass pollen, Sometimes we have, you know, environmental type allergies where they're, they're not, you know, it's not seasonal, but it's persistent, which could be to other parts of the mold cascade. It could be to certain types of chemicals. It could be anything really. And then you can have sensitivities to things like food where it's not really an allergic response, but it still inflames you. Anything that throws your body off, whether it's an allergic trigger or a sensitivity or a bad food, food or digestive problems or whatever will trigger an inflammatory response. That inflammatory response can be perceived by your body in a direction that can lead you to immune imbalance. And when we lead to immune imbalance, we lead to a lot of trouble in regulating the immune output. And then if we have those genes that are underlying, uh, that, that are not turned on yet, when we have all this immune dysregulation, that becomes an epigenetic signal to those genes, and they can turn on all sorts of things, autoimmunity being one. And then, as I mentioned, there's neuroemotional things. So, um, you can go and read— as I said, this is a very long discussion— but you can go and read into some of the neuroemotional types of things that are associated with autoimmunity. If you look up and just do a general search on, uh, you know, the autoimmune personality, or is there an autoimmune personality, you'll see a lot of interesting back and forth in the community around, um, autoimmunity and personality types and all that. And that's not, um, you know, to say, well, there's better personalities or worse personalities, uh, certainly. But what it's trying to say is that there are things that can leave us us in a chronic state of, uh, often chronic stress. Chronic stress will throw off parts of our steroid hormone cascade. It'll throw off parts of our neurohormone, our brain hormone cascade, and it'll throw them off in a direction that's not commensurate with keeping a balanced immune system. So the idea behind chronic stress and some of the other neurohormonal things is this nebulous thing out there. It's actually this very finite pathway where the chronic stress dysregulates our neurohormones, neurotransmitters. Maybe it dysregulates our peripheral corticoids, etc. So there's a lot of good direct sort of reasons, you know, that this is not good for us. So again, you can work on all these things. So I was asked a lot of questions about targets, and so targets lead us to some big areas that affect all of those underlying areas. So the first— and these don't go in any particular order— but the first one is diet. So when I'm thinking about diet and autoimmunity, there's as many answers to that question as there are people that you will ask. Not really gonna promote one over the other. I'm just gonna tell you stories of what I have seen and heard and all of that. But I, I have had some people where they go on diets that restrict certain types of food proteins, such as some people will go on a gluten-free diet and that'll really help particular autoimmunity. Other people will go on a dairy-free diet that will help certain types of autoimmunity. Other people will go on a high vegetable diet, uh, and, uh, with, with very you know, low amounts of animal proteins, and that'll help. Other people, interestingly, will go on a carnivore diet or a, you know, a ketogenic diet or something on the other end of the spectrum, seemingly, from a vegetarian diet, and all their symptoms will go away. So you start to see this, and people will ask, well, I was told you have to be— and you can fill in the blank— you have to be dairy-free, you have to be gluten-free, you have to be soy-free. You have to be vegetarian, you have to be a vegan, you have to be a raw vegan, you have to be keto, you have to be carnivore in order to have an effect on your autoimmunity. Well, the answer is maybe for, for you. For you, it's going to be individualized. I have people who didn't get any traction removing certain types of proteins. such as doing a dairy-free, gluten-free diet, and they, they go on a ketogenic diet and all their symptoms amazingly improve. I've had people who were on certain types of, you know, like a paleo diet, wasn't working for them. And so they went over and they, they became vegetarian and that worked for them. There are many ways up the mountain when it comes to diet. And so the biggest thing is it's not usually one So there's a sort of a misnomer. People will say, well, most of the time, you know, dairy fuels autoimmunity. Well, no, it fuels autoimmunity if you have a problem with dairy. It's your body's decision. Maybe your body really doesn't like, you know, gluten and really doesn't like a couple of the proteins you eat. Maybe it doesn't like you eating chicken, or maybe it doesn't like you eating beef or whatever. You take those out and And, you know, it's, it's gonna, it's gonna be better. Maybe dairy is or isn't a problem. So everything is your body. It's not everybody else's body. So when it comes to diet, that's a huge thing. Now, remember I said that, that the GI tract has an immune system and a nervous system? Where do those go off the rails? Those go off the rails really when the diet takes the, takes the digestive tract into an inflammatory space. Okay, next thing would be, and again, no particular order, constitutional treatments. So constitutional treatments, and again, just like with diet, these work different for different people, but the idea is that they're treating your whole body in a way that tries to bring your body back to balance. So it's not— a constitutional treatment is not aimed at, I have pain in these joints today, treat that. It's aimed at my body is out of balance, and so I want to bring it back to balance, so treat my body to bring it back to balance. Constitutional treatments— many people have heard of constitutional or acupuncture. Chinese medicine is a constitutional type of treatment. There are botanical medicine or herbal medicine approaches that are not symptomatic but are constitutional. Those are another way to go. There are things like hydrotherapy. There's actually things called constitutional hydrotherapy. So body-wide hydrotherapy. And again, all of these things you would work with a specific provider to, uh, to enact these. These are usually not do-it-yourself things unless you happen to be an acupuncturist or hydrotherapist or something like that. But usually we don't do those to ourselves anyway. So you want to work with somebody. Also, homeopathy is another constitutional treatment, and there are many, many others depending on where you are in world. So constitutional treatments can be very good. Now people will say, well, I changed my diet 3 weeks ago and I'm not feeling better. Shouldn't I be feeling better? Or I started doing acupuncture 2 weeks ago, shouldn't I start to feel better? Well, maybe, but probably not. Constitutional treatments and dietary changes take quite a long time because you got to figure with your diet you're sort of affecting trillions of cells in your body And if you've been eating one way for a long time, your body's going to get used to you eating a new way before it's really going to give you a lot of input. Now, I have seen people where they went through a medically supervised fast and then went into a different diet change. That kind of speeds it up. But again, you're going to be working with somebody, a medical provider, to do that. People also ask a lot of questions about vitamin D, D like dog, and why is the— a So, you know, universally, like we hear about it with COVID better your vitamin D levels are, the less severe your illness with COVID is and all this stuff. Why? How does it affect the immune system? Well, what you want to remember with vitamin D is it's really a steroid hormone and it's structurally a lot like cortisol, cortisone. And so vitamin D goes in and it does lots of things. So it's not just for your bones. Okay. Vitamin D and vitamin K work together And largely the vitamin K addition to vitamin D is there to help so that the vitamin D going in your system does the right thing with your bones using vitamin K and its protein manipulation. But also then the vitamin D goes beyond your bones and does its hormonal manipulation, and the hormonal manipulation that vitamin D does is crucial to keeping your immune system So again, with autoimmunity, we don't want high or low, we want level. Low vitamin D and inappropriate metabolism of vitamin D both lead to inflammation and an out-of-balance immune system. So vitamin D levels, again, you gotta work with somebody to keep your vitamin D levels level. Another one that we think of and give lip service to, but we often forget, is our nutritional and antioxidant status, which really goes back a lot to diet and lifestyle and all that stuff. Antioxidant status. So those are the things like vitamin C, glutathione, vitamin E, and then there's other things that get involved in the fat end of the spectrum. But the antioxidant status in our body becomes crucial because remember I was saying there's you know T cell autoimmunity and B cell autoimmunity, and sometimes there's mixed versions. But they often start to go astray early on, where your immune system doesn't have one promoter; it's got a whole bunch of promoters, and they all have to. to kind of be balanced to promote things. So if our promoters, the T helper system you've heard of, maybe the Th system and other stuff, the promoters get out of balance, then we can trigger autoimmunity of different kinds. There's literally T and B cell autoimmunity triggered different ways. So what's the answer? Balance. What— before we get to vitamin D, before we get to the other hormones, before we get to other things we're going to talk about, what keeps us in balance. What keeps us in balance is our antioxidant status in our cells shutting off the inflammatory chemistry, the inflammatory cytokines that trigger some of this bad immune signaling and bad epigenetic signaling downstream. And in modern times, we're bombarded by all kinds of environmental toxins, environmental radiation, environmental all kinds of other things. Our antioxidant systems in our body are not really set up for the toxicity of the modern world. So we have to make sure that they— that we have enough. We have enough antioxidants, enough balance going in. So antioxidants are really important. They start with nutritional dietary intake. Again, why your diet's important. But then also it's sometimes we have to to take extra to do that. Then there's natural immunomodulators. So then we might go beyond, say, getting good antioxidants, good diet, good lifestyle like exercise and movement and all of that business and constitutional treatments. Natural immunomodulators are usually from the plant kingdom. So you can eat many of these things, and that would be a good idea. Plant polyphenols are very important. That comes from the colorful part of plants that we include in our diet, but then we might actually take them, or your doctor might actually recommend that you take them as a supplement with autoimmunity. These would be things like curcumin from turmeric. Okay, so you can eat turmeric, great idea. You can take curcumin, you can do both, that's an even better idea. Then there's the artemisia plants, which are the wormwood plants. And you think, well, that's a little weird, we rarely eat wormwood. Wormwood. It's a very bitter plant, but it is used a lot. We use a lot in infectious disease. There are drugs made from the wormwood plant. You know, artesunate is a drug for malaria that comes from the wormwood plant. Artemisinin, another extract. But the other thing about artesunate, artemisinin, wormwood that happens is it doesn't just kill bugs, it actually creates an immune balancing effect as you take it. So in rheumatology, the study of autoimmunity, inflammatory joint diseases, etc., there's a lot of research that is going on and has gone on with the wormwood plant family, especially artesunate and artemisia, as a potential treatment to help people out who have autoimmunity. Well, the wormwood family, like artesunate, etc., has double effect because it allows A decrease in some of the infectious markers and then an increase in some of the immune modulation. Another one that's very commonly used nowadays that I do a lot of speaking about is called low-dose naltrexone. Now, high-dose naltrexone is used for drug overdoses, so that sounds like a weird drug to use, but high-dose naltrexone is a really big dose and it blocks opiate overdose. Low-dose naltrexone is these tiny little doses that are just enough to go in and switch the receptors that, uh, that are— you think of opiate receptors. So if you big dose naltrexone, you can die from an opiate overdose because you stop breathing, etc. So you give someone naloxone, or naltrexone goes in, it blocks the opiate receptors so that you don't die. Okay, if you give somebody a low dose of naltrexone, it goes in and it doesn't really block. It'll block a little bit of the opioid activity if you have those, but mostly what it's doing is going in and blocking the receptor complexes that are related to the opioid receptors in your— and we have them all over our body, but it's not doing it really for a pain reason, although it can be used that way. It's doing it because those receptors also trigger balance and imbalance with your immune system. So low-dose naltrexone might actually be something that your physician may, you know, promote to you as a potential treatment, etc. We're just in the final moments of the podcast here. So we got through pretty much everything. Remember, the middle path is treating as many underlying problems as possible, starting with treating the triggers, decreasing them, get your body, you know, detox, work on constitutional things, diet, nutrition, and then supplemental things, etc. And then decreasing as much as possible the standard therapies so that we have them to last us longer in our life. And if we do need them during a flare, they're going to work better anyway. But we're out of time for today. Remember, when you see this over on Any of your pod burners, please subscribe to the podcast. If you're listening on CTR Network, keep coming back there. Facebook Live, we put it over there every week. And then YouTube, uh, please continue to like, share, and subscribe. The channel's growing over on YouTube. We put all of these over there, and YouTube is where you can find the notes. I'm gonna put the show notes in there and the links. But that takes us to the end of the program time. So, uh, like, share, subscribe. Remember, you can find me at D-R-A-N-O-W, dranow.com. Otherwise, I will see you next week on the radio. Thanks.