Autoimmunity Recovery Roadmap: Foundational Healing and Advanced Therapies with Dr. Leland Stillman and Amy Arp

Welcome to Integrative Medicine with Dr. Leland Stillman, the podcast where we explore the best of East and West, old and new, conventional and unconventional, in search of answers to medicine's toughest cases and most difficult problems. This podcast is for informational purposes only. Diagnostics and therapeutics discussed on this podcast may or may not be right for you, so talk to a qualified practitioner before taking action based on what you learn here. If you'd like to become a patient at my practice, go to stillmanmd.com to schedule a complimentary discovery call. Thank you for listening and welcome to today's episode. Hello everyone. Dr. Stillman here, back with Amy Arp again for another episode on autoimmunity. Amy, hello. Today we are covering the autoimmunity recovery roadmap. So I look at this as how to get great results consistently, quickly, and for the rest of your life, or results that last. So here's what I always look for in patients. And it's funny, I'm recording this. I just got off a call with a woman who's been a patient at the practice. She's been a member and we have memberships and programs. And so memberships are sort of see me when you need me, not a structured program of care. Doesn't include supplements, doesn't include lab testing. It's very much sort of what you need when you want it, you know, within reason. And her autoimmune disease is really progressing. Significantly since I last spoke to her. And she's really frustrated and she is, is asking me, what else do I do? And we talked about the Autoimmunity Recovery Program and her booking a call with Amy to discuss whether or not it's a good fit for her. And let me break down what I look for, for people to get well in general. And it starts with what I call the essentials or the fundamentals or foundations. I am laying this out very clearly in my book that's coming up, but but you have to do the basic fundamental work of being and living a healthy lifestyle. Where she's gotten so frustrated is that she's already doing all that. We have to make sure all those fundamentals are in place with our patients in the program. So we build in time to essentially go over what's their diet, what is their lifestyle, how much technology do they use, what are their chemical or environmental exposures. You know, we have an aircraft mechanic right now who's got these crazy lead and cadmium levels. I couldn't— can't even begin to tell you how many cases we've had where we just find something weird in the diet or the lifestyle that they thought was healthy. Like last night we did a webinar and I went over a case of a guy who had Graves' hyperthyroidism and he had these high mercury levels. Well, it turned out he was eating a lot of fish. Well, fish have a lot of mercury, particularly the ones he was eating at high-end restaurants. So he ended up giving himself essentially sort of a subacute mercury toxicity manifesting as an autoimmune disorder. When we pushed that stuff out, he made a complete recovery. Amazing, right? He's a guy who would have gone to surgery or iodine ablation if we hadn't done things the way that we did them. And he's been in remission now for a whole year since then. So my point is, you need to make sure you've got all that dialed in. She does. And where she's frustrated is she's saying, well, I'm doing all this stuff right, spent money on supplements, and I go outside, and I don't use a lot of technology. And, you know, what else could I be doing? And you start with the essentials and the foundations because if you don't do that, everything you do is doomed to fail. And I learned this the hard way. I worked in destination wellness centers where it was very intensive, you getting IVs of vitamins and nutrients and glutathione and all kinds of things and using hormones and, and high-dose supplements and all kinds of very aggressive treatments, all of which have value, but they're not a substitute for the essentials. So what would happen is if people got better in those places, oftentimes it was better for a month, a couple months, a quarter, 6 months, but then they would regress. And it was funny, I was listening to a podcast with Pierre Cori and it was a podcast where Mary Talley Bowden had Pierre Cori and a bunch of other experts on it. And Pierre mentioned specifically that he saw his patients who came to him who'd gone to destination wellness centers and spent a lot of money on these things. He'd seen them get these fleeting results. And I knew exactly why when I heard him say that, it's because they didn't do the fundamentals. That's part of why we spend so much time educating and teaching and advocating for that element of care. But you also get to a point where you've done all the fundamentals and you're eating clean food and drinking healthy water, and you're wiggling your toes in the sand every chance you can get, and you're walking outside and you're, you know, you're thinking positive thoughts and you're thinking, I'm still not getting well, or I'm not getting the results I want as fast as I want them, or I'm doing all this stuff and I'm still getting worse, like the woman I just spoke to. And that's where having a framework with more comprehensive a more comprehensive approach is critical to make sure that the essentials are not just good, but that they're really dialed in. And then on top of that, what are we going to pick? And the way I think about therapeutics is I think about them as being on a tree, and I call it the therapeutic tree because there's a low-hanging fruit, which is taking walks and going to the beach and thinking positive thoughts and drinking pure water and all these, all these things that are basically free, but a lot of people don't pick them, and then they wonder why they don't get better. So there's the low-hanging fruit, start there, and then you've got to climb the therapeutic tree. It doesn't make sense to do it all at the same time. Sometimes there's interactions, like you can't do chlorine dioxide and high-dose vitamin C at the same time. One's an antioxidant, one's a pro-oxidant. They don't play well together. And people make all these mistakes that we see because they don't know these interactions. They don't know these contraindications. They don't know these ins and outs. And so they put the cart before the horse. They go to the destination wellness center before they've even, you know, started getting adequate sunlight. And it's not like there's anything morally wrong with this. It's just, we want people to get better as reliably, consistently, quickly, efficiently, and durably as possible. And so that's really in a nutshell, the roadmap is you start at the bottom and you work your way up the tree. And we're going to talk a little bit more in the rest of the podcast about what exact modalities I think of, and we'll do deep dives on these later because each of them really deserves its own, I its own episode, its own material. And I'm gonna let people know right now, we are putting together a school, Autoimmunity Recovery School, over on Skool, the platform, S-K-O-O-L, uh, where we're gonna be sharing all this material and teaching people, and we're gonna have weekly Q&As. It's gonna be very high value and very high touch. And so some of these will come out as podcasts, some of them will come out in the school community. So just letting you all know that's coming. Okay, Amy, I'm gonna end my opening rant.

I love it.

What are your thoughts?

It's good. It's good. Let's just start of the foundations. I 100% agree with you. People have to do the foundations. We were talking a little while ago how we've tried HTMA with a bunch of people. I was doing a lot of HTMA consults with people when I first started working with you, and we just had an HTMA program where they were taking supplements. I would do a consult with them and give them exactly what their body needed, but the people that got results were the people that were also doing the foundations. And so a lot of people come in and they just want a supplement to work like a pharmaceutical does or something. And foundations are so crucial. I live by them still, even though I'm symptom-free, I feel awesome. I live my life.

But a big part of that is that when you do the essentials and the foundations, you feel so good that you think, how could I not do these things?

Exactly. You think I have to do these things because I feel so much better. I know, even this morning I got first thing every morning when I get up. First thing I do, I go in my front yard, I stand on my grass, I look at the sun, I do some breathwork. It is so awesome. I take my baby with me now. It is very sweet. Um, but I do that every morning because I feel so good doing it. And we see this across the board with people that, as you said, a lot of people don't get better because they don't do the foundations. And I know we could have lots of podcast episodes on that, but one thing I did wanna say is that A lot of people also will come in and eat right and do some of the foundations, but their stress levels are still a mess in their life, whether they're working a very stressful job that's so many hours a week, or they just have a stressful life in general. And that is also really crucial to healing. And we can do a, a complete episode on that, on just on stress alone and how to help regulate your nervous system and relax and have some rest time. That's very, very crucial. All of the foundations are essential to someone's health. And when you get in the habit of doing them, it doesn't feel like a chore anymore. I think at first it feels like, oh, I have to do— have a list of everything I have to do. I was working with a patient and I said, write out everything you're doing because I want to see on paper everything you're doing. And they, you know, at this point in their journey, it feels like a lot. They're like, I get outside and I do this and then I take this and then I, you know, everything they're doing feels like a lot and it is. But as you do it, you get in a rhythm and then you can't imagine doing life any other way. Like I always, when I go, you know, have events or go hang out with friends, I remember you're right. I do live this life that's so different, but I love it and it's, it's good. So, um, I'm excited for everyone to do that and I want you to know it does get easier. So as you're on this journey, if you're in the middle of it, it's gonna get better.

Yeah, okay, absolutely.

We can talk about some of the other stuff now.

Here's the reality we've seen in the practice. So we start with those essentials and foundations, then we get testing. Based on the testing, we try to correct any imbalances or deficiencies we see. Very common for me to recommend that people try certain bioidentical hormones— thyroid, DHEA, testosterone, estradiol, progesterone. You know, the case I was just talking about that I saw before I jumped on this podcast Her illness is correlated with age, so more common in older people. And, you know, a lot of these autoimmune diseases tend to progress as people get older and their hormone levels drop. There's a huge predisposition for women to develop autoimmunity rather than, or more than men. We believe, and we have, we have every reason to believe that it's because men have higher testosterone levels. This also shifts the autoimmune profile. So for example, men get more ulcerative colitis than women. Women tend to get more Crohn's. Men get more psoriasis than women. It's not that they don't get it, it's that men tend to get it more. So hormones have these very powerful effects on autoimmune diseases, and I've used them in, in certain autoimmune cases to, to treat them and to slow down progression or stop progression. And I look at vitamin D as being one of the most foundational hormones out there. And we are currently working up exactly how to use high-dose vitamin D in the practice, because at high doses you will get these very profound therapeutic effects, you know, to the point that I've heard stories of people getting up up out of wheelchairs and walking again from things like MS. But you also have to worry about the very real possibility of calcium toxicity from vitamin D, excessive vitamin D. And so it does have to be done very, very carefully, which is part of why we can't just say, here's the high-dose vitamin D protocol. There is no way I would feel comfortable doing that safely. We can give it to practitioners and you can take it to your practitioner, but otherwise you've got to be in the practice for you to do it, or you got to be working with someone who's going to be monitoring it. But you, you have to, to climb this therapeutic tree and you have to go to things like high-dose high-dose vitamin D or high-dose iodine or bioidentical hormones. We start there and then we add as well the HTMA and the mineral supplements. And I'm consistently amazed by how much just those few things together do. To give you some context there, we're talking about several capsules of mineral supplements multiple times a day, or a big scoop of a powder twice a day, depending upon who we're sourcing it from, which we do tailor to the individual. Some people need powders. Some people do well with capsules. It just depends. And then we're talking about potentially 2 or 3 pills of hormones, and then we're talking about potentially some oils or some creams or some injectable hormones. So already we're getting to a pretty sizable list of things that we're taking. And then we add things like MSM and high-dose iodine and high-dose vitamin C. We may add other supplements to that. We have some very special things that are under, under construction in the autoimmune program that I'm not ready to talk about yet. And as we add those things and we see people getting better, We keep going right now. It's a lot. We will get through some protocols and then we'll taper back or fall off of those so that you're not on this continual— because one concept I share with patients is the therapeutic treadmill. The therapeutic treadmill is this idea that we've got a basically keeping up with your wellness. You have to sort of be running. And if we, if we burn patients out on therapy, we call that treatment fatigue, then it doesn't become— it's not sustainable. And if your wellness routine is not sustainable, you're not going to stick with it. And one of the top things I've seen in people who get better is they actually stick with it for long enough. And so we have to make it sustainable. That's an ongoing conversation. People have different bandwidths. I've got some patients where they can take 20 things for 6 months and they don't care. I've got other people where I give them 2 or 3 things to do and they feel overwhelmed. So we have to have that conversation. It's also why we don't just let people book the program. We want to make sure it's a good fit for you, that you're going to be able to do what you need to do in order to get great results. We wouldn't want anyone to book this and be disappointed. That just wouldn't be in keeping with our philosophy and ethos. So we do bioidentical hormones, we do the HTMA protocols, we'll add MSM, iodine, vitamin D, vitamin C, all these things. And then we'll get into things like antiparasitics, repurposed drugs. I talked to the woman just before this about hydroxychloroquine, which has been linked to treatment of this autoimmune disorder she's dealing with. Uh, we look at things like ivermectin, albendazole, high-dose antiparasitics. Amy had an amazing recovery using those. You know, in her story with MS, which she can talk about and we'll do a deep dive on later. Uh, and we just go up from there. There's all kinds of things we refer out for or that people can buy to do at home— hyperbaric oxygen, PEMF, ozone, chlorine dioxide, DMSO. We cover all of it. We just try and put it together in a way that makes sense for them and that we're not trying— we're trying not to skip steps. Very common for me to see people, and it's funny because this actually came up in the consult I did before this podcast, she tried chlorine dioxide and she said it wasn't working for her. But I know she hasn't been through even one round of mineral balancing recently, so how do I know she doesn't have a terrible deficiency that's actually what's holding her back from getting great results? And this is something that isn't apparent until you've been in practice for a while. So the people who get the best results with the more advanced stuff, you just don't get the same results if they don't start with the foundations, because those nutrients, those minerals, those frequencies of light and electromagnetic radiations are not present in the body to allow the body to respond to the therapeutics you're giving it.

So I agree. And I think one of the things, the question we get often is, do you just do standard protocols? And no, we do not. Everything is specific, individualized, tailored towards the individual. And so when Dr. Stillman's talking about hormones or specific protocols in your HTMA, everything is very specific to what your testing shows. So we don't just come in and say, okay, blanket, everybody is on everything that we do. And we have like 1, 2, 3, 4, 5 steps. No, what we do is we look at the individual and we look at the testing and then we tailor supplements and protocols and all of that to the individual. And as you mentioned, we also take into account their capacity, you know, in that season. And so, as you said, like, can you take pills? Can you take powders? What does this look like for you right now? And how do we help you get in a sustainable place so that you can continue and do this. And so I just wanna say that, cuz I often get asked that. Often we have calls, a, a practice membership evaluation or a complete wellness evaluation. And on those calls, people often ask me about that because a lot of people in the space have very specific protocols that they just put everyone through and they think, oh, this one thing is gonna get everyone better. And while we think the foundations are crucial for everybody, everything else is layered on top based on what we see in your testing and your symptoms. And everything you come in with. So I just want to say that for everyone out there, if they're concerned about that. I get that question almost every call I have, so I want to make sure I address that.

And it's very much— it's very much a judgment call as to what you do next. You know, I have multiple cases where their breakthrough came after they had mercury amalgams removed or a root canal removed or some other kind of major dental surgery. You know, you went through cavitation surgery, Amy, and then it's a question of, well, are we going to spend $5,000, $10,000, $15,000, $20,000 on a whole car's worth of, you know, dental procedures, or are we going to go over here and spend it on ozone or whatever? And that's really about what have we seen work? Where are you clinically? There's a lot of things that go into that decision. I will be honest, I, I generally err on the side of get the dental work done earlier. Because I've just seen it haunt people. They spend 6 months, a year, 10 years struggling, and they would've been way better off just getting the dental stuff done right away. To the point that I've had cases where they came back to work with me after we'd tried to get them better and not succeeded. And I said, look, I, I don't wanna work with you again unless you'll get this amount of dental work, because I just don't see how I'm gonna get you results. And I don't wanna waste your time, your money. I don't wanna waste my time. Respectfully, uh, I just, you know, I care too much about the quality of my work.

There was a case of a woman that I had talked with who she had been diagnosed with MS and was like at the point of like couldn't walk and a really horrible case. And she just did dental work and then detox for mercury after that. And she got completely better. There was no, not a lot of other stuff that went into it. And so it really is figuring out for each person, what are those root causes and what are the things underlying for that person? And so, yeah, sometimes it is dental work and it would be beneficial to get it done sooner. So, and it just depends on the case.

Absolutely. Another key element of this is time, you know, just having enough time. I sort of look at therapeutics and I think about, we can do more of what we're doing. We can do what we're doing even better, or we can do, or more intensively maybe. And then we can do new things, try new things, add new things. And one thing I've seen is, you know, we, I had to catch up the other day with a gentleman who's with us. He has psoriasis. He's a year. He's actually I think my first appointment with him was July of 2024, so we're now in September 2025. It's 14 months that he's been working with us and he's 50% better. But we didn't make that progress in the first 6 months. In fact, if I remember anything about the first 6 months, it was I was kind of thinking he's probably going to bail because he's not getting quick wins, which is frustrating for me. I wish I could just have— I wish I had a— and I'm actually— this is one thing we have under sort of under construction is like, how do we get people wins faster so that they can do more and they see the value and they, they know, okay, I'm on the right track, I just got to keep going. But, you know, we're 14 months in now, mineral balancing, and he still hasn't had any big eliminations of metals, but his psoriasis is, in his own words, 50% better. So there is an element of, of time to it, which we try to help people understand on their, on their wellness consult, because you do have to appreciate that there is a uncertainty. We, we, it's just built in, it's part of life. We don't know how long anyone's going to take to get better. And I'm amazed by this, you know, sometimes people come in and are very sick and 3 months later they're better. And sometimes people come in and 9 months later we're still hammering away at some problem. Psoriasis, I will say, is one of the more pernicious ones. It tends to stick to patients, but at the same time, you know, there's so much we can do for it.

But the overall roadmap— Foundations, Duexstra, advanced therapeutics— I always love hearing your perspective where you've worked in different, you know, destination medical centers or been in there and trained under them and how you have then pared down your practice to what it is. People often ask me about that. Why don't we do this? Why don't we do that? Why don't we do this like other functional medicine doctors do? And I know that you have done the work. You've seen out that you've been out there, you've worked with people and you have found that this approach really works and that you don't necessarily need everything else. Of course, we'll refer out when needed, but I think you found that this this really works. And I love that. It makes it simple. It makes it simple for patients to just to go on this path.

Absolutely. And we always can add more things. It's just that the reality of it is that if all of a sudden you're spending all of your time on your wellness and you're doing IVs and you're doing PMF and you're doing all this stuff, I mean, you know, then you can run into the problem of we don't have enough money in the budget to continue. And one of the worst stresses for people physiologically is financial stress. It is so toxic to the body. And so I'm very wary of people because I've seen colleagues, you know, recommend that people will take out a loan. If you want to, that's your business, but the real impact of stress cannot be discounted. And so when I see colleagues relying on loans or telling people to do things like sell their car, get a second job, I think you have no idea if that's going to give them so much more stress that you're actually going to set them back. Like, you know, MS is a case study in this. It's very well known that stress causes people with MS to relapse, very well known that it causes them to progress. So you have to be very sensitive to that. And that's why we just love getting to know our patients, understanding who they are, understanding what their bandwidth is, and having this communication. Because I find that part of how I built the practice was having seen so many people coming to me from other practices where they just said, I got disillusioned with this just constant treadmill of supplements and treatments and appointments, and I just felt like I didn't have any direction. I lost hope. I felt like they didn't see me as a person or a whole person. I just didn't have the bandwidth to do everything they wanted me to do. I refused to accept that I'm just broken and there's something wrong with me because I can't take 50 pills a day, you know. And we still get these people great results.

So yeah, no, and I've told you this before, but when, um, before I started working with you, I had had a lot of different other other practitioners had wanted me to work with them. And it was— it's always interesting when you evaluate a practice to want to work with them. And I had turned down multiple different places because I didn't fully agree with their perspective on everything. And so I, I remember when I was actually started working with you and getting to know you more, I thought, wow, he really gets it. You really understand and have something really special going on here. And that is— that was awesome because I I was on the path to medical school. I wanted to create a practice because I didn't see what I wanted out there. And I didn't feel comfortable partnering with different people because of some of the other things they were doing in their practice. And so it's been really fun getting to be here and do this because you've created a really wonderful practice where you understand the depths of people and also are able to pare things down and not make it as complicated, I think, as other people do. Because as a patient, when you have to still sift and sort things with the doctor that you're, you're working with. It's so hard. You just want to come in and say, I trust you. I want to do this. And you don't want to have to think about it much more than that. Because when you're sick, it's hard enough being sick. And so we've definitely really tried to do that here to make it as simple as we can.

Yeah. And I don't, I don't write or talk much about it, but I did try to work for other people and I just would get into the practice and be employed. And I would think there's just something I don't like about this for, and it was, I mean, I could go on and on and on, but it was always about You know, somehow you're underdelivering on your promise. And sometimes what I've been fascinated to realize is it's actually about their business operations. You know, they don't understand how to set up the customer experience or the patient experience, which took me a long time to really understand myself. But I had these instincts that later I would, I would do something like in the business, how we built it, and then I would look at what happened to the outcomes and I would say, I didn't even think about that, but I just had this intuition that that was how I should do it. And boom, it worked. It helped the patients and it worked better for them. So yeah, I, we're trying to build the practice of the future here and we're trying to build an autoimmune recovery program that's as dialed in as possible. So that's what I always wanted. I wanted a practice where it was, we're going to be continuously improving and we're just going to be relentlessly dedicated to quality. And it just, I, you know, I have great colleagues who I love. Of who I would consider working with, uh, and so to speak, for today. But I tried working with people over the years when I just got out of residency, and finally I just said, I give up, I'm starting my own thing. I've got to just build it from the ground up. I don't know what it's going to look like, but this is not it. We could spend all day talking about advanced therapeutics, which is really where this goes. It's what are we going to do? Yeah, we will, we will, but we'll do dedicated episodes for each one because there's just so much that goes into each one. It's impossible to give you even a quick overview in a reasonably sized podcast episode. So this is the big basic overview. This should be the frame, I think, for any patient trying to get well, uh, to understand sort of how the chessboard is set up for them in their journey. Thanks everyone for joining us. Amy, thank you for joining me. Great to see you all. Take care. Have a great day.