Dr. Will Cole and Dr. Robert Whitfield Discuss Breast Implant Illness

I always appreciate Dr. Cole. I've heard this food several times and really he talks about gut formation and inflammation as it pertains to our gut and how our gut brain access work. Welcome, everyone. Today we have Dr. Will Cole, a leading functional medicine expert who consults four people around the world via webcam. Having started the first functional medicine telehealth centers in the world, named one of the top 50 functional integrative doctors in the nation. Dr. Cole Cole specializes in clinically investigating underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular the Art of Being well podcast and the New York Times bestselling author of Intuitive Fasting, Gut Feelings, Ketotarian and the inflammation spectrum. Welcome, Dr. Cole.

Thanks, my friend. I appreciate it. Nice to see you.

Nice to see you too. Well, to get right into it, I. I always appreciate Dr. Cole. I've heard him speak several times and really, he. He talks about gut flammation and inflammation as it pertains to our gut and how our gut brain access works. So having a whole group of patients who have problems with chronic inflammatory symptoms from breast implants, breast implant illness, and just the kind of environment at large, I wanted to hear your thoughts about how best our patients can help with their guts and their inflammations associated with that.

Yeah. So important. I mean, many people, I think maybe opening it up to people that don't even know because it kind of is a nebulous term in the sense of, like, they know inflammation's not good, but maybe they haven't pinpointed it as being a culprit to being why they feel the way that they do. Because people find when they talk about inflammation, maybe it's joint pain, aches and pains. I think people get it from a musculoskeletal standpoint, but it's so much more than that. Right. For people that are new to this conversation, I mean, inflammation is a product of the immune system. 75% of the immune system is in the gut. So to understand the full breadth and expansion to deal with inflammation, you want to look at where the predominance of the immune system resides, which is in the gastrointestinal system. So inflammation is the commonality between pretty much every health problem out there. I mean, mental health issues even. I mean, there's a whole field of research looking at the. What's called the cytokine model of cognitive function is how. How does inflammation. How does inflammation impact how our brain works? And we have a massive issue like 1 in 5 kids, about 15 million American children have a diagnosable mental, emotional or behavioral disorder. Anxiety and depression are on the rise. Things like brain fog and fatigue are on the rise. And I mean why, I mean we have to ask the question why these are inflammatory in nature. As far as the research is concern. Autoimmune conditions, same thing. 50 million Americans have an autoimmune disease, millions more somewhere on this autoimmune inflammation spectrum. So we, it is so much more than just aches and pains, I guess is what I'm trying to say. But your audience gets that from a breast implant illness and these other inflammatory problems that people are kind of experiencing. And what my job and your job are like, what are the variables to that? What are the contributing factors to this inflammation? But if you're looking at gut centric components to inflammation specifically, and I do think that a good place to start, like you're going to get more bang for your buck, if you will, you're going to get more significant needle moving capacity by going upstream to these sort of root drivers of inflammation for many people. So to be clear, it's like the gut's not the healing someone's gut isn't the only variable to consider with inflammation, but it is a more significant piece of the puzzle. But it starts with the foods that people eat, right? But I'm finding so much clinically over the past 15 years as people, even healthy foods that are, you know, completely fine on the surface from a nutrition standpoint, right, it's nutrient dense whole foods, but it's caught, it's stressing and already stressed out gut health. So we have to realize we do live in a different world now. Our microbiome, our gastrointestinal system, the human immune system is living in a brave new world when it comes to foods. So the sort of cliched healthy foods, like let's talk about salads for example. Like that's. I don't wanna pick on sal. Not just about salads, but lots of salad is like the personification, the epitomization of a healthy food, right? But a lot of people are trying to do the right thing, but they're feeling bloated and have digestive problems from salads. It's not the salad's fault, it's the human gut and the human microbiome's lack of resilience that it's being stressed out. From raw vegetables, raw plant foods like salads, there's tons of other examples like that. So for a lot of people, if you're looking at how do you calm inflammation specifically originating from the gut, it's taking a sort of Ayurvedic, traditional Chinese medicine, a lot of indigenous ancient medicines approach to things like soups and stews and going through times of brothing, through times of fasting, Giving your gut this sort of proverbial siesta, this break, this reprieve, to not be so stressed out and think of it as like a proverbial cast. If someone breaks their wrist or something, they have to keep that cast on for a while. Well, times of brothing, souping and fasting still being nourished, but a calming grounding period when it comes from comes to a food protocol or nutrition protocol can be a great way to untangle these inflammatory cascades that are originating in the gut. That's just one tip, but I think because it starts with food, many times we should start there.

Yeah, I appreciate you bringing up fasting because obviously there's lots of different protocols and things that people have tried at the time they see me. And one of the key things I would ask them that would always enlighten that discussion for me was, do you feel better if you just fast? And many people will say, oh, yeah, I feel a lot better actually. And so that, to your point, that lets you know, then you're making yourself ketogenic, basically when you're fasting anyway. And then they become, you know, in more inflamed. To your point, when they're trying to eat what they. They feel is healthier. And intuitively, you know, we're not necessarily meant to ingest a bunch of raw vegetables like obviously you've talked about on your show a bunch and you just mentioned previously, But I always am keen to listen to that. And if you listen carefully to patients, they'll tell you exactly what's. What's wrong.

Yeah.

You know, to your point, I try to get people because I have to get them recovered after surgery. We concentrate more on increasing protein in their diet. And I don't discriminate on types of protein. I just want more protein in their diet. So they'll. They'll offer an opportunity to heal more quickly.

Yeah, it's a. And that's a great stabilizing tool for blood sugar and repair, even gut repair. Right. I mean, these essential amino acids are needed for that gut lining, which is one cell. Th. And a lot of people have. Are. Have this sort of functional malabsorption issue. They're not really Getting a lot of the cliche of you are what you eat, we are more, you know, we are what we absorb. And a lot of people are having protein malabsorption issues, fat malabsorption issues, nutrient deficiencies across the board. And it's complex. It's not just one reason that's causing that. But their meals are not optimized from a nutrition standpoint, you know. So yeah, I certainly after surgery, but even for me on our telehealth side of things, poor protein, not being optimized is one of the most common things I see initially they're not having enough protein throughout the day to support muscle mass and energy throughout the day. Or it's not the most bioavailable types of protein. It could be maybe a lot more plant protein powders or they're more plant based. And it may work if you have a great gut and you're absorbing things appropriately. But if it's causing bloating and digestive problems and you're trying to do the healthy thing, you have to meet your gut where it's at. And these are the balancing acts that we always have to consider when you're kind of monitoring this from a patient standpoint.

And do you think with the advent of. Because you and I both will have people use supplements trying to help support them. I found people whose experienced a lot of trouble with their personal either protein supplement meal replacements, which I don't think it's great to do meal replacement, but just I feel like that's changed a lot in the supplement industry in general has put a lot more fillers into products and that's creating more of what you're describing which is more bloating and absorptive issues, I guess.

Yeah, yeah, I agree with that. I think people, supplements are good, right? I mean supplements are there. We live in such an amazing time where we have access to things, especially if we're on the go or busy or like I said, if someone is maybe more plant based, they need to focus on different nutrient deficiencies or protein intake. Supplements are there. And even for the omnivore out there or carnivore out there, there's a, the convenience factor for supplements. They're a blessing. But we have to be informed consumers and it can be overwhelming. Right, because there's so much stuff out there. The Wild west when it comes to qual and a lot of greenwashing and marketing jargon that can make it difficult to just distinguish what is right for you. And just because it has nice branding, does it Necessarily mean that you need it and add it to your supplement graveyard that we lovingly call it. But you know. Yeah, you're right. It's, it's. I want people to focus on food for we're talking about protein and healing and all of that. Focus on food first. But I, I do think there's a great place for protein supplementation when you are look for your looking convenience or hitting certain marks right where getting maybe it's hard to chew all that and get it from meals alone. So you can actually consume quite a bit of protein through liquid and people enjoy the taste of it and the convenience of it. So I like, like whey protein, A two way protein. I think that's a great source if you tolerate dairy. But the A2 makes it more tolerable. But grass fed A2 protein is great. Like a beef isolate can be a wonderful collagen protein. Obviously longtime fan of that, fan of that. So different mixtures of these complete protein sources or near complete protein sources can be a great idea.

Yeah, I'm glad you mentioned it because it's my patients when we often have the discussion about expectations where I really elevate the consciousness of how much protein needs to be taken in, in the recovery phase. Because we feel very strongly that in our programs just preemptively raising protein intake before even remotely getting you know, scheduled and all the things that come with you know, surgery itself. If you're already thinking of that and, and really trying to, you know, you said hit a mark. I try to give everybody like a simple like C Note like at 100 grams like I know and you'll have. Most of my patients are female and they're, they're smaller in terms of body weight. That's a lot.

Yeah, yeah.

Not really cognizant of how important that is. And, and once you start elevating that in your diet, whether it's with a away or a vegetable or beef based, you know, I don't care the source. I want you to get good, you know, protein and the, the quantity. You'll notice big differences for sure.

Oh yeah, I'm sure you see it in recovery. I noticed such a difference with energy like someone that has focus issues, brain fog, fatigue repair, just recovery after exercise. So I, yeah, these are important things. We know it's a glucose sponge. It's needed for our bodies as we age definitively. So protein optimization and then strength training is another one that these sort of low hanging fruits that we take for granted that many people kind of overlook that can be Significant needle movers in healing and feeling your best.

You've done so much work with, you know, functional medicine and understanding autoimmunity and everything and the gut plays such a big role in immunity. Can maybe for my audience, you explain how you feel about terms like or leaky gut and, and how, you know, autoimmunity predates, you know, it's from the 1800s, basically autoimmune disorders and then we still have them in a very, you know, complex environment and ever becoming more complex environment.

Yeah, well, yeah, there's over 50 different autoimmune conditions, or let me say it this way more expansively. There's over 100 different autoimmune conditions and an additional 50 above that 100 that have an autoimmune component. So we're talking about 100, 150. And you're right, every few years there's new diseases or there's diseases that are found new mechanisms as to having autoimmune components to their pathogenesis. Like they're finding autoimmune components to things that were otherwise, otherwise not considered autoimmune. And with time, if you think about this, what can happen in another 10 years of research and understanding these mechanisms of actions for different diseases? I think most chronic diseases are going to be found to have autoimmune components at the very least of them because it's this, this seminal event of molecular mimicry when you know, the immune system kind of has this case of mistaken identity and is attacking different parts of the body. Like you said, it's been around for years. I think Hashimoto's is the first autoimmune disease to be discovered. And these people named diseases after the guys that discovered them, like Hashimoto's and Addison's and Sjogren's and all these different things. So there's nothing new, but there's more and more being labeled as autoimmune and more and more people being diagnosed with them. I mean now it's, it's significantly higher, exploded since the 1980s specifically. I mean it is pretty remarkable how, how common these things are, but not normal. And we should not normalize these things that Even since the 1980s, I mean we are significantly more. The rate of someone being diagnosed, diagnosed today is significantly, significantly higher. So it is something that we need to explore and the researchers are exploring and researchers are really looking at the mechanisms, the pieces to the puzzle. But the trickle down effect to the mainstream model within that sort of rheumatology setting, the conventional, even pcap as you Know this. I mean, we're at the front lines of these convers, hearing these conversations that people are having with their. Their doctors. There's. There's not a lot of answers. There's not a lot of direction. There's not a lot of insight. They're basically told, you know, there's a lot of medical gaslighting going on, but by the time somebody actually is diagnosed, diagnosed, okay, they're labeled with a diagnosis code, but they're really kind of left to fend for themselves. Maybe they're giving, if it's appropriate, a steroid or immunosuppressant. Other than that, there's really not much being told for them. So they're having to be their own doctors in many ways, seeking people out like yourself and myself, trying to get answers to what they do. But look, we're just applying what researchers are exploring. When you're looking at things like microplastics and pfas and unhealthy gut and chronic stress, unresolved trauma. This isn't my idea. This is not your idea. This is what researchers are looking at. It's just not being applied in everyday people's lives yet. Obviously, we are doing it, but it's not being done en masse in the conventional model yet.

Yeah, I'm glad you brought that up, because I feel like, I mean, I'm sure you felt this way for a long time, like you're doing the right things, but you feel like you're out there when you discuss some of this, and I was discussing with a patient a little while ago, microplastics and trying to give them some insight into. And they already know because of my show or shows like you've done where you discussed. It's important that the container that you're drinking out of be like ceramic or metal or glass and not be plastic so that it's not going to contain bisphenols and create this microplastic situation. You can't avoid all of it, but you have to become aware of it. And the patient I was just talking to, she's aware. And. And then there's this kind of like, oh, my gosh, I didn't know this, and I've been doing this for a long period of time. So there's that kind of almost guilty kind of, you know, feeling about it. And then, you know, they grew up around someone who smoked. I mean, they couldn't have parent who smoked. So now they're going to have nace, which is going to be from secondhand smoke. And that's going to be in their system and you can just talk to them long enough. No, they don't detoxify. Well, they're sensitive to mold and they're, there's just going to be these things that from a genetic standpoint, they, they can't really escape, but they can learn. You know, we can teach them better habits to help them.

Yeah, you're right. I mean, depending on the. And I'm sure your patient base is similar to mine as far as the sets of epigenetic and genetic variables to consider. Like I, depending on the study that you cite, what we're talking about here, it's like 77 to 91% of the variables here is due to epigenetics. It's some environmental factor, whether it's exposure to toxins, chronic stress, unresolved trauma, nutrient deficiencies, biotoxins like bacteria, viruses, or mold. And then there's that smaller one third of a puzzle. Piece of the puzzle is genetics. And it's. I don't know if you see this, but like almost a hundred percent of our patients have specific hla, human leukocyte antigen haplotypes that make them more sensitive to biotoxins like bacteria, virus or mold. Almost all of our patients have homozygous gene variants, significant homozygous gene variants with methylation. When it comes to things like MTHFR and other methylene gene variants, where to look at that one third of the puzzle, to look at the genetics, you have to see that. I mean, if you're looking at labs all day long, like, we are, like, you can't ignore that. And I think of that as, like that bucket. Like, some people have big buckets, some people have smaller buckets. And you can't change your bucket size. We can't change those genetic variants to how your body responds to stressors like biotoxins or methylates, detoxes. But you can change what you put in that bucket. And that's, you know, things like you're doing, like you're significantly emptying that bucket by dealing with the sources of inflammation. And same here with us, like we're, we're. By healing the gut, by, by dealing with these environmental toxins, dealing with these other variables, here we're emptying that proverbial bucket. So while it's sobering, when you look at the, you know, the rise of autoimmune and fertility issues, which we didn't even talk about, like these other chronic health problems, but we know, we know more about these issues now more than ever before. Right. Whereas like, if you look at our parents generation or the, you know, grandparents generation. Yeah, they were exposed to less. Less, I get that. But they still dealt with chronic disease and they still like had had like no answers. Right. It was like there was five stations on the television and if a guy on the white coat said, said it, it was the gospel. But I think now there's a lot more diversity of thought with and, and research and information out there for people to have choice when it comes to their healthcare.

Yeah, I, I, you know, I often think, you know, when we were going through school and, and then subsequent training, so many things were and continue to evolve, especially as a, as it pertains to genetics and epigenetics. I feel like I don't really.

I.

Listen to hear how someone copes with and handles toxicity like you, you can just hear them when you just, when they discuss it. You know, they don't handle it very well. You know, they stay sick for prolonged periods of time. They just cannot handle inflammation. And that's very indicative of somebody with a MTHFR mutation. You know, it's extremely common in my practice and if someone has just horrible fatigue and, and you know, you listen to them, it just sounds like someone with a SOD2 mutation who can't cope with, you know, you know, the biotoxin burden. Like whether it's mold or something else, like you can just, you hear it over and over and over again. It's the same. And it's almost like when we were trained to recognize somebody with a particular, you know, disease state. You know, I was like, before CAT scan was used for, you know, appendectomies, you had to understand right lower quadrant pain and peritonitis signs and symptoms and then, you know, decide and make a decision. So I feel like, you know, now I'm, I'm kind of in that world again. But now it's just listening for someone's. Yeah. Snips and trying to, you know, make heads or tails out of that. And it's not always obviously the easiest, easiest thing to do. I mean, you talked about other things which are super difficult, which are, you know, stressors that we don't know about either at home or work or unresolved trauma. Like maybe, maybe just speak to that because that's a really complicated issue that it is for patients who are undergoing explant surgery. I've had some of the most enlightening conversations with patients of like that dredges up some really traumatic events in their Life.

Yeah, it's every single new telehealth patient we have, we talk about this where they may be wondering like why, you know, I'm talking about childhood trauma when they're coming to someone in functional medicine. But it is really important. And for some people it's a big piece of the puzzle. For some people it's the biggest piece of the puzzle. And for some people it's a small piece of the puzzle. So that's down to somebody's own health history and context of their case and understanding the science and art of them. So I don't want to be over simplistic or make paint this with broad strokes. It is different from person to person, but it should be looked at and it's oftentimes not looked at. So we have every telehealth patient fill out what's called an ACE questionnaire. ACE score, it stands for adverse childhood experiences or events. And we're talking about really heavy things like sexual trauma, growing up, physical abuse growing up, neglect growing up, parental relationship growing up. And the higher your someone's ACE score, the more likely research shows to be diagnosed with autoimmune problems, metabolic issues, hormonal problems, mental health issues. Of course. And again, you could have someone can have a high ACE score and they have very high resilience and very low epigenetic physiological factors. The psychological factors are not really manifesting in their life so much. Right. It's a piece of the puzzle, but not significant. Maybe they've done a lot of trauma work already and they've dealt with the mental emotional stuff by the time they've met us, but it's still part of their story. And for some people it's still living in their body very much just as much as a physiological toxin, like just as much as like herbicide or pesticide or a microplastic. Their unresolved trauma, that toxic burden is living in their body as well. And you have, but have to have to detox, if you will. Both. But it's a lot more linear, prescriptive, straightforward for us to say, yeah, this herbicide, pesticide, heavy metal, whatever microplastic that we find high on labs, let's implement a protocol to clear that out and retest it. It's a lot more complex, non linear to unpack things like chronic stress and unresolved trauma stored in the body. You can't just say, you know, don't have that trauma anymore or let's like detox that trauma. It's a lot more complex to unpack, but it's one that's very much, you know, is. Is a necessity if it's a piece of the puzzle for you to heal. And I see people kept back and stuck at these roadblocks with their healing because they haven't faced it. And it's one of the reasons my most recent book was called Gut Feelings for that reason, because we dealt with both the gut and the feelings and this bidirectional crosstalk between the physical, physical's impact on the mental, emotional, spiritual, and then how does the spiritual, the feelings of gut feelings impact our physical health? Because it's something that I see play out in people's lives all the time. And look, you don't necessarily have to deal with it at the same time. Sometimes it's a lot. It's overwhelming. That's clinically what we can do is kind of. Or prioritize what needs to be done and do it in a realistic, practical way. But if somebody is kind of learning about this on their own, you know, just to be aware of the fact that this could be a piece of the puzzle for you, and then lean into resources, lean into tools to start to face these challenges that can keep people back. Because it trains that neuroimmuno endocrine axis, that intersection between your nervous system, the immune system, that is inflammation and the endocrine system, somebody's hormones. A lot of people are in that sympathetic fight or flight tone where that's impacting their body. Where, yeah, maybe it's the breast implant, maybe it's environmental toxins, but maybe it also is unresol solve trauma. And we have to look at this sort of comprehensively and have a both and not either or approach when it comes to understanding that mental health is physical health.

So what resources? Because if that's a very complex issue and you've given it a lot of Runway. So what other, you know, resources have you found to be helpful? Because obviously I'm not. I'm not a psychiatrist, so.

Ologist. Yeah, yeah, yeah. Well, we have. Look, we integrate this into telehealth patient protocol. So people want a clinical setting. Like, we have people on staff that are trained in these sort of somatic practices and things like breath work and meditation and practices like emdr, which is another great resource if people want to look at that on their own. Eye movement desensitization and reprocessing is a great therapeutic style that is great at dealing with past trauma without just talking like the traditional CBT therapy. Talk therapy has its place. Certainly has a lot of great research around it but when you're looking at these stored things, oftentimes just rehashing the story over and over again, it comes to the point where you only can get so far sometimes with these complex past traumas that something somatic meaning something that involves some sort of body movement and in this case EMDR involves eye movement to retrain the nervous system to not have that same hyper vigilant response when that thought happens after the therapeutic setting. So that's a. EMDR is a great Further learning. Further reading. I little bit more out of the box but I think I'm very much interested in the research is our psychedelics and more specifically I think microdosing psychedelics and and I would just say further learning like learn about the maps is a great resource for this. Where there are researchers looking at how psychedelics can be used in a clinical setting, we're not talking about recreational use, we're not talking about flippant use on the streets. We're talking about really a proper set and setting. But I'm fascinated about how it can shift the body's biochemistry from things like unresolved trauma. And I've seen it do remarkable things in people's lives. Breath work. I mentioned breath work. But breath work's a great endogenous psychedelic if you will. If you look at holotropic health breath work which should be done with a facilitator or a guide because it can kind of elicit similar responses as a psychedelic just through breath alone. But there's more simple, you know, breathwork techniques that you can do on your own that I do talk about it in the book as well in Gut feelings. I've seen DNRs be another great resource for people. It's Dynamic Neuro Retraining System Believe is the acronym. But it's a great online based nervous system retraining process that involves some somatic practices. But there's different somatic therapies. I mean drumming, yoga, tai chi, dancing, these are different things that our ancestors would have done that was a way to cathartically clear things stored in the body that we kind of through modernity we've divorced ourselves from things like movement and things like the earth and our connection to earth to be able to metabolize this. But all of that stuff are some further things that people could look into. I talk about it in Gut Feelings. I've talked about it at length on my podcast as well.

Yeah, I'm glad you you mentioned that because I think many times, obviously patients, it's a huge decision to come and have an explant surgery. Like nobody wants to have that. Nobody wants to be in Austin seeing me. And then once they've made that decision, I try to let them know, like that's just part of that journey. And much to what you just described, there are a lot of other components that need to be incorporated in that process that I can't and you can't facilitate completely. Like, you know, it's almost like taking a, a more active role in recovery. Like I have a big program and you know, within the, the confines of our clinic and, and our team do a lot to facilitate recovery. But these are issues that need to be explored certainly. And I appreciate you mentioning them on my show. Yeah, of course. When you, you know, are caring for patients and what do you see, like maybe that are, are missteps they take, whether it's in their diets or in the protocols or programs you install in, in the healing process that maybe, you know, we could help patients avoid.

Common pitfalls with food specifically. Yeah. You know, I think really digging in deeper to that point that I mentioned earlier of meeting your gut where it's at. Like something like if your body is having flare ups from otherwise healthy foods, Mike, we have to create that therapeutic setting and stability, to use that cast analogy that I talked about, if the cast isn't hard enough, if you will, if it's not secure enough, if your body's still cutting flare ups with that proverbial cast, that's a problem. So because you, we can't be living in these sort of low grade to high grade flare ups with the food protocol. So sometimes we have to have a heavier handed approach from a food standpoint and other, you know, interventions from a healthcare standpoint to create stability, to allow that gut, brain, immune system access to mend and gain resilience and set and to heal. So I would say if you're applying any sort of food protocol yourself, right, let's talk to that person out there that's doing that. And there are maybe better off than they would be if they weren't doing what they're doing. But it's not like they're still having issues. Now, two things come to mind. Do we need a heavier handed food approach? Maybe we do. Number two, keep in mind it's not just about food. There may be other variables, other epigenetic variables that are independent, like the things we're discussing throughout this conversation. So sometimes it's the balancing act. And that's why we can be as a clinician, an objective Perspective around this is like. Yeah, because it could be maddening, right? It could be maddening if you look at just food and say, well that's the only piece of the puzzle. And then you blaming everything on food and you become unintentionally orthorexic about these sort of things, which is disordered eating around healthy food, orthorexia. So it's, that's not a good thing. Right. But it can easily understandably happen when you're looking at real, very real flare ups from food, at least in part. But then it can get to such a place where the stress and anxiety and hyper focus about the food becomes its own beast, it becomes its own identity, own entity that's creating, you know, they almost identify with that entity of stress and anxiety around food. So I know that's a lot more abstract thought, but I think it's really important to talk about, to just check yourself, I think check yourself if you're talking about food. And yes, food's a piece of the puzzle, it doesn't mean it's the only piece of the puzzle. And stressing about healthy food isn't good for your health. So if you find yourself in that state, I'm not saying it's gonna be solved over, but your relationship with the food, your relationship with your body matters. And to start to heal your relationship with your food, heal your relationship with your body is part of the healing. So that's part of that mind body connection that I was talking about earlier in finding what we call for, you know, as we're healing these, these both physiological and psychological things like finding food peace, finding body peace around these things, which is easier said than done. It is certainly not non line. But as we heal the body, we also need to heal that mental emotional relationship. So that's really complex, especially when you are dealing with an unhealthy gut or a system that is very hyper reactive. But to go, we have people do carnivore, for example, we have people do carnivore protocols for a time as almost like the ultimate elimination diet for a season of their life. So maybe they've gone paleo, maybe they've gone whole foods, maybe they've done an elimination diet, but they're still having problems. So if the random fruits or vegetables or other plant foods are causing reactions, taking it down to whether it be a carnivore, ish, well formulated, nutrient dense whole foods, carnivore diet is a great way for some people, not everybody, to kind of find out what's causing the reactions Some of these plant foods that are otherwise seemingly completely fine. It's not the food's fault. It's the immune system's overreaction to it. So maybe there's things like, like implants or maybe there's things like mold or maybe there's things like environmental toxins or unresolved trauma that are causing these food reactions. But to get their head above water, so to speak, for a time, a food intervention could be something like that. Or a carnivore adjacent, really low lectin, low oxalate way of eating is a great way to kind of wipe the slate clean. Kind of for us to determine what does that, that, you know, process of reintroduction looks like over time. I don't recommend for people to eating a strict protocol, protocol like that forever and ever. Reintroduction is really important long term, but in the short term it can be that, you know, metaphorical cast.

Yeah, I'm glad you put it that way because I, I have this kind of thing where I go like, you gotta reduce gluten and dairy and histamine and oxalates. And by the time you get, get through that, then you're discussing what you just.

Yeah, yeah. And look, not everybody needs to do that. Not everybody needs to do that. So there's a million. If you look at the concept of elimination diet, right, there are, There's a myriad of different forms of elimination because it's just what is a low antigenic, low inflammatory way of eating and what does reintroduction look like. But because our microbiome and our, the human immune system is living in that brave newer world, sometimes that elimination diet approach has to look a lot tighter for a time to allow us to find out what is actually irritating the immune system. And again, the food may just be exacerbating all of this. It's not the food's fault. These other things that we have discussed on this conversation oftentimes are the culprit and the food is collateral.

Yeah, I also get really strict about like timing of, so the last meal, trying to give yourself more of a break at night to digest. In my book, I prioritize sleep above all else, and I do that with all my patients. It's not a supplement, it's not a dietary thing that I'll prioritize. It's your recovery period, which is sleep. And trying to get them to really not eat up against their rest period or not drink up against their rest periods to make it easier for their bodies to adapt and become. You use the term Resilient. I mean your recovery periods and your heart rate variability. And we've all these wearables now to measure this and they're all super interesting. Maybe not the most accurate at times, but they give us a trend, if you will. And certainly the closer you eat to the time you rest, the harder it is for your body to recover. Especially if you're someone you're describing as experiencing all sorts of complicated issues with their relationship to food or which is going to affect their digestion and their parasympathetic activity for sure.

Yeah, you're absolutely right. And yeah, I've seen all the wearables and measuring whoops band and oura rings and all that. I find them to be pretty the same. I don't know what you found, but like I have patients that just want to test them all and they wear them all on the same night just to see, just to see and like what the, which was what, which ones they want to use ongoing. And I've seen many cases where it's like they're pretty much the same. But you're right, they're trends, snapshots in time. They're always advancing over time, like their sensitivity. But yeah, I find them to be good as long as they're not causing stress. Right. It's like, then people stress about not sleeping because they're like wanting to beat their own score. And it's like, like that's not good either. But I do feel like checking in at least periodically. I like seeing REM and deep sleep and heart rate variability improve. And we're improving things like vagal tone and improving that gut brain axis that I talked about. So I do like them. But not becoming hyper focused and orthorexic about the biohacking devices are important too. Right?

Right, exactly. I don't, and I try not to as a provider, like make it like, because I get asked about them just like you do, like what are the best ones? And yeah, they all have their probably pros and cons and I don't take any money from any of them. You know, basically the, the, the, the rings and the straps. I've, I've, I've tried them all and I look at them now as something that will give us a trend that can be beneficial. And I don't want the patient, you know, obsessing about hrv. And I have had people come to me and say, you know, I'm in the teens, what do I need to do? And they're really worried from, from that standpoint. Try to make some plans for them to help them. And certainly to recover, you need, need both the quantity and quality of sleep and non REM and REM balance and sleep cycles in order to do that. So the lymphatic system really has a chance to recover. If someone listening is feeling super overwhelmed by everything, obviously in their own personal world, what are probably some first simple steps you recommend, maybe prior to even interacting with you or, or someone in the functional world, like what are some simple habits maybe they could change just to start taking care of themselves better?

Yeah. So if somebody is overwhelmed, you know, here's the first thing I would say, easier said than done. But just like I was just saying, like stressing about this stuff isn't good for your health. So sometimes the secret here is leaning in and what can you handle today? What, what can you do productively to nourish yourself as a form of self respect and self nourishment do today? And we live in such a, an amazing time, but it's a double edged sword. We have a lot of information at every click of a button. You could scroll endlessly and learn endlessly and listen to all amazing podcasts, read all the amazing books and just, yeah, use AI to learn even more. It's like the human body, we wasn't necessarily meant to consume that amount of information. And especially when you don't feel well. Especially when you don't feel well. So I would say the first, you know, cleanse or detox, whatever you want to say, healthy boundaries is what's your healthy boundaries with technology? What's your healthy boundaries with information? Because if you look at like the, I think sometimes there's so much information that the vessel can't contain it and that creates more anxiety and more stress. So sometimes it's like, all right, learning when to stop consuming content. Learn when to stop consuming information. Can you be diligent with what you already know? Because sometimes it's not the next thing, the new thing buying another thing, going to the next thing. It is just staying consistent with the things you already need to do. Because people can get paralysis of analysis with this, this constant inundation of information. So I would say check yourself with that because oftentimes it's just clearing the noise and starting with what you need to do here and now and being present with that and being loyal, I think, to, to that. So that's more of a, and that could go, you could go into social media and like a tip that I would say here is just, maybe it's, I'm following people that are causing you stress and anxiety. It's like not, not them but it's like where you're at on your journey. It's just not good for your nervous system to really take inventory of the things you are consuming. Online information, entertainment, otherwise is it lowering your frequency? Is it creating more nervous system dysregulation in the body? The next tip I would say is to look at what I would call the inflammatory core for and if I could add plus one it would be things like. Which we kind of if you touched on briefly but if you haven't taken this out of your diet then I would start doing that. Gluten, industrial seed oils, added sugar and dairy. There's better versions of all of that like gluten, you can get sourdough, it ferments some of the gluten. Right. Or an ancient grain. Right. There are people. There's a lot of nuance and context to this conversation. So I don't want to make blanket statements. But no matter if we're looking at the majority of people that are listening to this, that are interested in this conversation somewhere on the inflammation spectru then what is the better for you version of these things? So I explore this all actually my book called the Inflammation Spectrum. I talk about this but I don't like broad sweeping statements and over generalizations of it. There are better for you versions of this and a really deep conversations about the hybridization of the grain supply and the herbicides and pesticides. So is it really the grain or is it what we've done to the grain and really having that conversation. But looking at gluten containing grains in all its different forms, looking at industrial seed oils, which is another kind of hot button topic. But things like canola oil, soybean oil, vegetable oil and in my mind I think the manufacturing, the processing of these things that can be quite toxic, the oxidation of these oils can be pro inflammatory and the over consumption of them. When you look at the Omegas 3, 6 and 9 ratio and the lower Omega 3s and the higher Omega 6 is in the modern western diet, it's shown to be in a pro inflammatory state. So it's not all or nothing. There's organic versions of these, you know, things like sunflower oil that I could, someone could make the argument that it's better than like your random canola oil. But I would just look at the amount that you're consuming in a day and start to decrease the amount of these industrial seed oils. Third, I said added sugar, even the Nicer sounding euphemisms like the greenwashing that can happen with sugar. But look at the, at the, maybe an inventory for a week or so track in a food tracking app, the Chronometer or my fitness Pal and what's the grams of added sugar you're consuming in a day and just be mindful of that and decreasing that over time. And then dairy would be the other. The fourth one I would say again better for you versions would be like an A2, raw grass fed dairy, something like that. Fermented dairies like cheeses or yogurts or kefirs. There's a spectrum. But look at dairy's implication, especially the conventional average kinds into being and contributing to a pro inflammatory state. And then the plus one would be alcohol. There's no healthy amount of alcohol. The healthiest amount of alcohol is none. And being mindful of that implication. So I look at the food side of it and then the mental emotional side of it is bringing in this, what I would call acts of stillness or these metaphysical meals if you will. Because you could be eating the best foods under the sun. But if you're serving your body a big slice of stress every day or, or reliving unresolved trauma in the body every day, that's just as inflammatory if not more as that food that doesn't love you back. So looking at about these principles and practices that I talked about earlier in the conversation like breath work and meditation and grounding and I talk in the book about Shinrin Yoku or forest bathing in the research out of Japan and South Korea and start to retraining the nervous system in that way because that's, that's information that you're consuming too, right. And it's the good kind or it's the kind that allow your physiology to be more in homeostasis. So these are some initial tips. I know it's a lot but I think at least leaning into these things.

That I'm talking about, I really appreciate you bringing in the unresolved or the stress. I think that is something that's not appreciated enough and you can sense it in your patients. I mean they, they definitely. And surgery brings it out. I mean obviously you know, we care a lot about patients and, and care for them and you know, you can never appreciate what's going on and completely in their world and you want to meet them as much as where, where everyone is like everybody's going to start in a different place. Want to thank Dr. Cole for coming on discussing this. I knew when I I. I got him, you know, scheduled. This would be a great conversation, but I didn't know it would take as many great turns as it did. So, Dr. Cole, like, if someone wants to work with you or get your books, where are the best places for them to go find you?

Thanks, my friend. Thanks for the opportunity. I really appreciate it. Everything is at drwillcole.com that's-r W-I-L-L-C-O-L-E.com. but, yeah, that's where they can learn about the telehealth clinic and the book links, the podcast. All of this stuff's there.

Thank you so much for coming on.

Thanks for having me.