Do You Actually Have an Autoimmune Condition? What Most People Miss About Early Signs

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 today, joined by Amy Arp. We are here today to record our first episode of a course on autoimmunity that I wanted to put together to help people really understand what it is, how it works, and how to recover with an integrative, holistic, natural approach, because I see a lot of frankly, noise and confusion out there that isn't serving patients and is often causing them to waste a lot of time, money, and then they suffer needlessly when there's actually a, a much simpler way I find to think about a lot of these things. So welcome to the course. We have an Autoimmunity Masterclass that I host every month where you can get on, ask me questions afterward, learn about our approach, exactly how we do what we do. That is a webinar every month because I say some controversial things that I don't put out on social media. And you know, on that note, I'm not going to be entirely candid about things here because we will be pushing this out on conventional social media channels where the truth gets censored regularly because it threatens some very large vested interests who very carefully create a narrative that prevents their profit centers from being hurt by the reality of what's going on in the world. So that's my introduction. Amy, anything you want to add before we dive into today's topic?

I think the only thing is that I do agree there's so much misinformation out there, so much information in general, let alone misinformation. Information, I think that it's overwhelming. And so I think what we really want to do is help take the information, put it together, package it in a way that's easily digestible for people, and also can help you pare down everything that you hear. I feel like there's so much out there, and this is something that I wish that I had had when I was going through healing, my healing. And so I just— we hope that this is going to be helpful.

And for people who don't know, Amy works in my practice with me. She runs our autoimmune recovery program. She recovered from multiple sclerosis. Years ago now.

Yeah.

I made a full recovery after a very, very severe case. And that's why she joined the team to head that up. So she speaks from experience. And you can listen to her story in a two-part podcast we recorded, I think a couple months ago now.

Yes.

So you can really hear in her own words what worked, what mattered, what it was like, and so on.

Mm-hmm.

So today we are talking about, do you actually have an autoimmune condition? What most people miss about early signs. So I decided to start the Autoimmunity Recovery Program at the practice because I found that people were just naturally coming to me with autoimmune conditions. They were extremely severe. They were disabling. They were really changing people's lives for the worse. And often they were so aggressive that patients were worried about their longevity. They were worried they might actually die because of their autoimmune disease. Often they'd already exhausted all of the conventional treatments. They were on max doses of things that weren't working and they said, "I, I just can't live this way and no one seems to have an answer for me, so I have to try something new." However, I also had a lot of patients coming in who weren't that sick, but their symptoms were troubling enough that they wanted a second pair of eyes on the case and a new solution, a new approach, which is why they came to me. They may not have had a formal diagnosis, but as I saw more and more of these cases and I read more and more about autoimmunity and learned more about it and saw people get better and some people not frankly get better depending upon different reasons and factors in the case. I started thinking about autoimmunity very, very differently than people hear about it in the conventional world and in the mainstream narrative. And I wanted to unpack that in today's episode. I also think it's a really useful starting point for talking about autoimmunity because a lot of people out there are wondering, do I have an autoimmune condition? And if I do, what does that mean? And some of this comes down to the limitations of our testing. Like, I had a mentor in residency who was a rheumatologist. They specialize in autoimmune disorders. He told this joke, he said, you know, a rheumatologist is a doctor you call when you're not sure what's going on, but it's really weird and strange and a little bit alarming. And they come by and they run all these tests, and then they say that the tests, when they're back, are uninterpretable, and they start the patient on prednisone, which is our bread and butter, most common immunosuppressant. And what he was making fun of was the fact that often rheumatologists, despite having all this testing, despite having all this lab work, will not be able to say, well, you've got rheumatoid arthritis, you've got celiac disease, you've got— and there's all this controversy then— well, you've got you know, non-celiac gluten enteropathy, or you've got gluten sensitivity, or you've got gluten intolerance. And so there ends up splitting all these hairs, and people are like, well, I don't even know what I have. But at the end of the day, what I realized was— and this is based on real clinical practice, not just reading papers and scientific studies— these patients all lacked critical nutrients. They all lacked some element of recovery and rest they all had some combination of stressors, toxins, and sometimes pathogens that were driving their illness forward. And always the symptoms they had that turned into autoimmunity, usually they preceded the actual diagnosis. So you will have people who, you know, one day they just develop ulcerative colitis or they just develop Crohn's disease. But almost always, if you listen to those people, you really take a history, they'll say, you know, I was struggling with fatigue, I was struggling with brain fog, I had bloating, I had abdominal pain, I couldn't eat this, I couldn't eat that, I had joint pain. There's all these clues in the picture. And the more I looked at this, the more I said, "Okay, the symptoms of autoimmunity start to manifest years sometimes before the disease actually takes off and we're in a position to deliver them a diagnosis." And this is the best time to intervene because these patients are usually very functional. They can go to work. They can go to school. They can, you know, do lots of different things in daily life. They're not, say, bound or constricted or confined, I should say, to home as many patients with autoimmunity are if it's their joints or it's their GI issues or it's their brain fog or their fatigue. So they have more bandwidth to get well, and their body is less frankly racked with disease. And I think about Sina McCullough, who's a friend of mine who's a PhD, and she had a very rare form of rheumatoid arthritis that she finally cracked open as far as her healing when she got a very specific allergy test. But she waited years and years and years to find that. And she even waited years and saw multiple specialists before she even had a diagnosis. So do you have an autoimmune condition? When I'm thinking about autoimmunity and I'm thinking about the symptoms and the signs, I really go head to toe. People with autoimmune conditions or autoimmune processes can manifest with a huge range of symptoms, and this is part of what makes arriving at a diagnosis so frustrating. People will say, well, I've got the joint pain of rheumatoid arthritis, but I've got the fatigue of lupus, but I've got the GI issues of Crohn's. Do I have all three, or do I have one, or can I have one with some of— and so it just gets really confusing. But at the end of the day, what I found was if you look head to toe, you look for these symptoms, and these people may and often do have some kind of autoimmune process. If not fully in, in swing and underway, it's coming. And now's the time to intervene. So head to toe, brain fog, headaches, fatigue, which I really think of as a brain, although it's also got bodily manifestations, obviously. Sometimes fevers, chills, and night sweats, which really start in the brain where temperature is regulated. Skin issues, hair, skin, and nail coarseness, brittleness, even loss of hair, particularly weird aches and pains, joint pain, chest pain, sometimes shortness of breath, GI issues, bloating, abdominal pain, nausea, vomiting, constipation, you name it. If it's a GI symptom, it can go along with autoimmunity. You will sometimes have weird blood or vascular issues. They'll have low platelets. They'll have abnormal white cell counts. They may have strange things going on with their red blood cells. Frequently they're too large or maybe they're too small. They may have venous congestion. They may have things like— I was looking this up just the other day. Varicose veins. They may have painful veins. That's a recent case we had in the practice that was very unusual. So all these different things manifest, and I'm gonna dwell a little bit more on arthritis cuz it's such a common symptom. The arthritis is often very confusing. It'll show up in a knee, then it'll show up in a shoulder or an elbow. There's many different categories of arthritis. So some of these are not autoimmune, they're infectious, but there's a relationship there that maybe we'll unpack later. Sometimes it's always the same joints. It's both knees. It's both hips. Usually it's both if it's autoimmune in nature, uh, but it doesn't have to be all of the joints, which is interesting. So they have all of these different symptoms and all of this comes back to one unifying process in my mind, which is they have a repair deficit. And so when patients come into our practice, I worry a lot less about what are the exact constellation of symptoms they have. Obviously I want to make sure that their headaches are not a brain tumor. Their joint pain is not a septic joint that's going to, you know, explode into sepsis and wind them up in the ER, the ICU. I want to make sure their chest pain is not a heart attack. I do all of that, but then I look at why is their body not in a state of balance and equilibrium. And that's what I look at as repair deficit. And then it's a matter of, okay, well, what do they need to do every day in order to repair the body? Because when we see pain, when we see inflammation, when we see brain fog, when we see forgetfulness, when we see any deficit in any organ system, I look at that as That organ system does not have the energy necessary to perform. What does cellular energy generation depend upon? It depends upon the right balance of nutrients. It depends upon a relative absence of toxic things that derail or impede metabolism. And it depends upon that cell not being overwhelmed with pathogens, whatever you want to call those—molds, fungi, parasites, bacteria, viruses, et cetera. So long as the cell has the nutrition it needs, hasn't been physically damaged in some way, which is another story, isn't under overwhelming stress, isn't full of pathogens, isn't loaded with toxins. The cell generally works. And if you just reverse engineer that, okay, the patient has some combination of those problems, and that's why their organ system, their brain, their joints, their immune system, their heart, their lungs, whatever, is not working at optimal capacity. We have a very clear game plan and roadmap that I'm writing a book on now that'll hopefully be out soon, maybe not before we release this, but soon. And if you're looking for it, there'll be links everywhere. So just, just look below this video wherever it is and you'll get a link. We know exactly what people need to do in order to repair. It's a very specific diet. It's a very specific lifestyle. There's a lot of latitude. You don't have to do everything perfectly. And we don't have a one-size-fits-all diet. We just have some general guidance. And we do occasionally have those odd people who, if they eat anything other than meat, they feel terrible. Or if they eat too much meat, they feel terrible. And that's okay because people are different. You're not all the same. I can't expect you all to eat the same things, and I can't even expect you to eat the same things this week as next week, as next quarter, as next year, as next decade. People's needs change over time. But that right there in a nutshell is how I really think about do, do you have an autoimmune condition? Is some combination of your clinical— I look at it as a constellation of findings. Is, are some of these symptoms related to inflammation? Are some of these symptoms related to a dropout or a loss of cellular energy production? And how is that production related back to toxic exposures that I can elicit in your history? Maybe you live downwind from a lead smelting plant or parasite exposure, pathogen exposure. Do you have a history of, say, living in a third world country where you were exposed, you know, you were exposed to parasites, or did you maybe get better when you took an antiparasitic, but you didn't get all the way better and you're not sure which one to take or how much to take of it. All of these things inform us as to why we think the repair deficit is there. And then we roll out the same or very similar game plan for everyone in different variations in order to help them finally get the lasting resolution of the symptoms that they need. And this is how we prevent the people who don't yet have an autoimmune disease from getting an autoimmune disease and how we help the people who do have a formal diagnosis get off medications or minimize the need for medications and maximize their quality and quantity of life. And on that note, I really feel this is important. A lot of people think that because they take a medication and their symptoms or, or signs of disease are controlled, they're healthy. But unfortunately, we don't have data that shows that using medications to control diseases reduces the risk of many of the complications associated with them. And I cover the exact numbers behind this in the Autoimmune Masterclass that I offer every month. But there's a really significant increase in risk of cancer in people who have autoimmunity. You can't infer that just because you control their symptoms with medications, that cancer risk is not still there. That cancer risk is gonna come back to diet lifestyle factors that we use in the practice in order to get people well so that they don't wind up with worsening autoimmune disease, or if they don't have it yet, autoimmune disease at all. So it's very different from what I hear out there, and it means that a lot of the people who don't have a formal autoimmune diagnosis, I look at them as autoimmune cases. And I treat them the same way and they get better. And that's why we started the program. And that means that people who have mystery illness, which is probably the most common diagnosis in the practice, I don't know what's wrong with me, but it's bad enough that I want your help. And no one's been able to figure it out. And I've been to all these doctors and tried all these things and nothing's worked. What is it? How do I tackle it? How do I fix it? That's what we help people with. So Amy, thoughts on that? Anything you wanna add?

I absolutely agree. I think it's so interesting cuz I agree with you. Every person that you talk to, if they have an autoimmune diagnosis, if you go back in time them in their history, they will have had something. Every single time it's something. Like, I just even think for me, I, I had joint issues in my early 20s. I shouldn't have joint issues in my early 20s, you know. I was all these different random things. I had digestive issues, these different things that now when I look back, oh, I wish I would have thought about that in that way back then or figured this out sooner. But everybody has something. If you dig deep enough, they will say something, and you're like, okay, there was something there. And I also just think it's so interesting, this, the model that everyone waits for the diagnosis. They, they want to have some formal diagnosis before they can move forward or move forward with healing. And I think that what I wanna say is, you know, as we, as the medical system, the way it is right now, when you get a diagnosis, your body has had some sort of progression for a long period of time. And then now it has some set of symptoms that they would say is the diagnosis. But that doesn't mean that your body all of a sudden, just as you had mentioned, like doesn't mean that they all of a sudden got something. There's rare cases, but most of the time it's been going on. And so I think when people start having symptoms of some sort, that is the best time to come get help so that you don't get to a point of a diagnosis. Absolutely. Yeah. When you have some sort of diagnosis, it doesn't mean like, I, I feel like a lot of people come to us and they say, oh, well, have you treated X or, you know, X diagnosis, or have you treated this, or have you treated that? And what I wanna say to them is like, hey, It's great that there's a formal diagnosis now, but that doesn't impact or impede our ability to get to the underlying factors of what's happening in your body, because all of these things are symptoms. But that doesn't necessarily mean that the diagnosis is this, this big thing that, you know, we have to treat. And so when people have symptoms, digestive issues, joint issues, anything that would be seen as inflammation, or just any weird symptoms that someone has, that's the best time to look and say, okay, what do I need to change in my life? Can I get testing to figure out what's going on underneath. Are there small things that we notice in blood work that if we fix them now, you don't have to go to a formal diagnosis? I also had a lot of very small things in my blood that I wish I had known before. The different size of white or red blood cells were off continuously. And, um, you know, when you first get that, the doctors are saying it's fine, it's normal, it's within range. But really those were the first signs of, oh, there's something wrong with my body, there's something going on. And I, I feel like that's just the challenging thing. I— the conversations I have with people is they say, well, I don't have a diagnosis, or there's nothing really wrong. I have this little thing here, but I'm okay, I can manage it. And everyone has these little things. But I— what I try to tell people is you don't have to have that. What if we actually could get to the root causes of those things and you could live this thriving life with it before you get some sort of X diagnosis over here? I just always have this conversation with people. I feel like it's a hard concept to wrap your mind around, symptoms versus a diagnosis.

I think it's so important though And I think it's part of the shift from focusing on illness to focusing on wellness. And I try to get patients to focus on wellness. And the way I look at it is physiologically, if your body's systems are failing and having, having symptoms that prevent you from living your day-to-day life, is your body's physiology starting to fail? It's not normal. And you might think, well, I can handle this, or I can deal with this, I can adjust my life. But if you don't get to the underlying root cause, it's just going to turn into a runaway train. And that's one thing we've seen in the practice, right? You know, We have some very tough cases that come to see us, and we had one recently that came to see us and got amazing results in the first few weeks and was feeling so much better, and I was so encouraged by how much better he was feeling. And then he was on all these medications that he'd been put on because of his illness, and I won't get into too many details out of respect to him, but he was on all these meds and he tried coming off of them too quickly and he wound up in the hospital, very much against my advice. I was very candid with him. You cannot just stop these medications. You've been on them for a long time. You've been very sick. Your physiology has adapted to them, and I wonder about what kind kind of result we're going to be able to get for him because it's been years since he became ill. And his— I look at illness, and I think this is so important for patients to understand— I look at illness as being like a plant, like a tree. If you have an illness and it just started 6 months ago, how long does it take for a tree to really turn into a tree? It's not just a sapling, it's not just a sprout, right? It takes months. But if you have a 10-year-old disease, it's a big tree, and you have to get out the truck and you have to get out the power tools and you might have to burn that stump out of the ground, or you've got to do— it's, it's very hard. And so a lot of people have an expectation of, well, I just take a medication and I just control a symptom. It isn't that simple if you want to really practice root cause medicine, which is why a lot of people don't do it. In fact, a minority of people do it. But when you do it the right way, you're not just getting rid of symptoms and a disease, you're optimizing function, you're optimizing performance. People ask me all the time, How do you do it? How do you deal with a packed back-to-back schedule? How do you write articles and write a book and have a team at a medical practice and have all these other things on the side and your dad and your husband? The secret is that I'm really good shape and I'm not in good shape because I go to the gym all the time. I just ran back to back to back heavy metal tests on my body and tried to provoke metals with different herbs and supplements. Not herbs, actually, just supplements and nutritional supplements. And I couldn't do it. I have apparently no heavy metal burden in my body whatsoever, which is wonderful. I'm very excited about this. I'm also skeptical of it. I'm gonna repeat the tests and do different things in order to really make sure I have no heavy metals, I didn't miss anything. But, you know, we'll look at patients' heavy metal levels all the time, and they're, they're insane. And we don't run all the other— and we'll talk about testing in a future episode of this series because it's a— there's a lot to it. There's a lot of nuance. We have to really unpack it. But just the heavy metal variations we see in patients, and the patients who come in with that autoimmune disease diseases and the heavy metal levels they push out. Just having that around is setting you up for all kinds of chronic long-term disease. And that's why the world is so sick right now, is people are not getting rid of these toxins. They're not fundamentally addressing the stresses that are degrading their body. And that's really what we do in the practice. We help people identify these things, come up with a reasonable plan to tackle the problem, address the problem, and then move forward and into resolution and healing. So, but the first step is, do you actually have an autoimmune condition? And for me, that's about reframing the problem, not of do I have a formal diagnosis, but am I headed for— am I currently in a repair deficit that could manifest as an autoimmune condition? Because if it doesn't manifest as autoimmunity, I guarantee you it's going to manifest as stroke, heart attack, cancer, mental health issues, you name it, because all of these are linked back to repair deficit. And that's why autoimmunity predisposes people to all these other chronic diseases.

Yeah. And I think that right there, that point is so important and challenging. Often these conversations I have with people, it's challenging for them to wrap their mind around because they think that a diagnosis means they have something. Like, you know, for example, people are— they always ask, well, you had multiple sclerosis. And I'm like, okay, well, this diagnosis is not a thing. It is a set of symptoms that my body showed and then they put a diagnosis on it. But really it is a repair deficit. And I think that that is where if people stop thinking about, I need formal diagnosis, or I need something to label myself as, and just say, hey, my body is not functioning optimally. Clearly it's not getting what it needs. Then people can understand that that really is more of a definition of autoimmunity as opposed to a thing. But I, for whatever reason, I feel like that concept— I have these conversations all the time and it's just so hard for people to really wrap their minds around. And so I wish that people would take that more seriously. And when they do have some symptoms in the beginning or something that's not going well, go and get tested, get help, get work with someone. So they don't have to have the future diagnosis of anything.

Absolutely. And everything I do for autoimmunity, everything we do for autoimmunity in the practice, I'm baking into the book, which will be out probably not before the end of the year, but maybe we'll see. And so if you wanna learn more about how we do that and what we do, how we do it, what matters, what we've seen help and really make a difference for these folks and also hurt them, you know, really not work for them. Thanks everyone for joining us. The next episode is what your autoimmune diagnosis really means and what your doctor isn't telling you. Thanks for listening. Take care, everyone. Have a great day.