Minerals, Metals, and Autoimmunity

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. Good morning, everyone. Dr. Stillman here, back again with Amy Arp. Good morning, Amy.

Good morning.

Today we are going to be talking about minerals, metals, and autoimmunity. So Amy's been getting a lot of questions recently from people interested in the Autoimmunity Recovery Program about the role of metals, minerals in their autoimmunity, as well as one of the tests that we run as a standard practice called hair tissue mineral analysis. I'm going to tell this as a story of how I got into hair tissue mineral analysis, which almost no other doctors do, because I think it's really interesting and it's part of why I think we're actually on very much the cutting edge of integrative functional medicine practice. So when I originally trained, mentors I mentored with were very interested in blood testing, sometimes urine, but tons of blood work. I mean, crazy amounts of blood work. And as a result of that, I saw huge amounts of data in a very, very short period of time on people with all kinds of different problems that got diagnosed as everything from mold to Lyme, you name it. I saw a huge range of outcomes in these folks. Some got better fast, some it took forever, some never got better. And what fascinated me was, first of all, a lot of what makes the difference for these folks is just doing the fundamentals for long enough. Which is very frustrating for a lot of people to hear because they want it to be quick. They want it to be easy. They don't want to overhaul their lifestyle. But as we've talked about in prior episodes, it's actually very, very important to really just tackle that and be intense about it and just go ahead and commit because it's how you get the best results no matter what else you do. But then beyond that, I learned and saw over and over again that testing was invaluable. And I, you know, did this sort of— there's this paradigm in integrative functional medicine, which is I wouldn't call it in the functional medicine camp, but there's a paradigm in the, let's call it integrative alternative medicine camp of we just need to eat real food and you just need to get outside enough and you just need to do all these basic things and that's all you need. That's not true. We get people incredible progress, like more progress in months than they've had in years with targeted supplementation. Where this came to life for me was I had this very smart mentor who will remain nameless for various reasons that I also won't discuss. And he taught me how to interpret blood and urine, urine labs., and I was blown away by the results we got. And then I started to ask deeper questions. Well, what other testing can we do? And I started to look at the hair tissue mineral analysis, and I had learned how to interpret this very big, beautiful $400-some panel with hundreds of metabolites from gut markers to toxin breakdown markers to B vitamin markers, branched-chain metabolites, Krebs cycle markers, you name it. It was a huge panel. And I still love running that panel for the record. But what ended up happening was I started to look into HTMA because I'm just, I'm incurably curious. And I've always, I always want to be learning new stuff and I always want to be learning the next thing that I'm going to do to get better results in the practice. And I started to run HTMAs on myself and I was very confused by what I saw because the test didn't make any sense. I ran this by the only person I knew who was deep into the HTMA world, Clark Engelbert. And we ran a program in HTMA interpretation and science of minerals and metals for 2 years, which we're just winding down now. He's going to continue it, by the way, if you're curious and you want to learn more about it. But I started to study these with him and he studied with Lawrence Wilson, who studied with Dr. Ek. So he's got this long lineage and he's got 10 years of HTMA experience now. He's seen thousands and thousands of tests. He's got a deep experience. And he started to teach me a completely different way of looking at minerals. That I'd never heard anyone talk about. And I started to implement some of the things I was learning in my practice and was blown away by some of the results that I saw. And what I was furthermore curious about was I would start to— I started to run the HTMA alongside this much more expensive blood and urine marker test. And I was shocked when 80% of the recommendations, maybe 90% of the recommendations that I made based on the hair covered what was found in the blood and the urine. So all of a sudden I was able to take a $100 test and for all intents and purposes replace a $400-something test. That was really exciting for me because one of the things that people don't realize in functional medicine is to get really great results that last, you cannot just do one round of lab testing. It is like showing up for the first 3 innings of the ballgame, scoring a bunch of runs if you're lucky, and then walking away for 6 innings and let the other team have at-bats. You're like, expect to lose. You're going to lose. And I'm not saying you can't sometimes. I mean, sometimes I'll get people, it's like, oh my gosh, 3, 3 months, you're all better. Great. Rarely does that happen. Usually there's ups, there's downs, there's 2 steps forward, 1 step back. It's, it's much more. Complex than just that one. And I want people to know that going in because you deserve to know that going in. And it requires a process and it requires continuity. Like one other thing I'll see is people will come in, they'll do 3 months of supplementation, they'll disappear for 3 months, they'll get busy with life, they'll get distracted. They'll come back, we'll retest their labs. They're back at square one. They're like, what happened? Like, you did the work for 3 months. It's like, it's like if you paid your credit card bill down half and then you went back to spending like you would a drunken sailor on Fleet Week. For 3 months, you would have the same amount of credit card debt or more as if you'd not bothered to, you know, save your money and cook at home and all that stuff. Right? So it's just these basic concepts that you live in daily life in countless ways applied to lab testing. Sometimes not what people want to hear, but that's okay. So I was blown away by the fact that I could get the same results or better results with the hair test that I was getting with this blood and urine test. And I was getting all this extra data that I had never tested before. So I'd never done aluminum levels and no one does aluminum levels. And I got to tell you, aluminum is probably the most ubiquitous metal all in modern life, and it is really scary what it does to people. It makes them really sick.

Our—

some of our most impressive case studies in healing are people who pushed out crazy amounts of aluminum. I joked that we could use their hair to make aluminum cans. I know, right? And, you know, we've, we've seen this twice in the last 6 months. We had a guy come in with MS, and we had a guy come in with a whole bunch of other— just like multi-organ system problems. I'm just going to leave it at that. And both of them are aircraft mechanics. One of them also teaches welding, and they have the record cadmium levels in the practice. We had a super successful gentleman using a very, very expensive hair product. We found that it was contaminated with lead. You know, I had a young mom the other week. She has crazy arsenic levels. Turns out she's eating brown rice protein powder protein bars, and she had no idea. We find this over and over and over and over and over again. Now, if you check the blood, you will sometimes see a whisper of toxicity, but it is never, or rarely I'll say, high enough to warrant chelation therapy. And I'm concerned that it's, it's, you're only catching sort of the valleys. You're not seeing the peaks. The beauty of the hair test is that the hair is being laid down over 3, 4 months if you take a long enough sample and you're not missing anything. You take a blood draw, it's what's circulating that minute. Your blood mercury levels change dramatically when you go out and you have a spicy tuna roll. And likewise, they can change dramatically when you take something like a chelating agent. And so what are we missing with blood and urine labs? That's what I found out when I started testing the hair. And I get the same results or better for less money spent on lab testing. And then I don't even get me started on, there's an ice storm in Memphis. So all the samples from this week are toast because it's blood and urine and it spoils. So you're going to have to reschedule all all of your patients for the next 2 weeks, and we don't know when FedEx is going to get back online. Not throwing them under the bus, I think they're a great company, but these things happen. Your hair— I've had hair sit in customs for people internationally for weeks and months. It still gets to the lab, it's still got the same mineral content, it's not gonna go bad.

It's so true.

So I love that about the hair testing. And so we do that quarterly, ideally, because it gives us the best window into what's changing in the body. We don't miss eliminations of heavy metals, we're able to tailor everything. And if you, if you really study the hair if you really learn the hair test, then you're going to understand things that other people don't understand, and you're going to be able to dose minerals. And this is what— something that got me really excited. You can dose higher levels of minerals if you understand the hair test along with the blood tests safely for prolonged periods of time. I'll never forget one of the first cases where I went to 100mg of zinc a day, really high dose of zinc. She felt worlds better. And the funny thing about that is I just saw a guy the other day, he had 140 level of zinc in his blood, and he had a 70 for his copper, which means he's copper deficiency with zinc excess. And so you will get these people— he was not doing that on my recommendation, for the record. He was just taking it because he thought it was good. And so you'll, you'll start to find out that, oh my gosh, different people need different ratios and different levels of different minerals. And there's dozens of minerals that you can supplement someone on. And then there's amino acids, B vitamins, and other vitamins that synergize with the the minerals. So you have to understand all these interrelationships in order to come up with a comprehensive plan for somebody. And that's the key to getting these great results that we get with the hair tissue mineral analysis. And that's why we run it, even though people may never have heard of it, they may not be familiar with it. They may have heard that it's like not this, it's not effective. It's only not effective because people don't know how to interpret it. And that's a whole nother story.

So I get a lot of questions about what's the difference between the hair sample and in blood. And I know you touched on that a little bit, but let's explain because they would say, well, my, my number in the blood was this, but in the the hair, it looks low, or maybe it's high in the blood. And so explain the difference. It's not like taking a blood sample. And so I have to explain that often to people. It's a very different sample. So maybe just expound upon that a little bit.

The way I think about it is really all about where these things come from. So I want you to think about minerals coming into your body. Predominantly, they're coming in through water and food. You can get a contribution from your personal care products, but the bulk of it is from water and food. In most cases, it's going to go into your gut. From your gut, it's going to be transported across your gut barrier, which may be very leaky if you have autoimmunity or any other kind of serious disease state. And then it's going to go to your liver and your liver is going to try to clear it up. It's going to try and balance it. If you have too much copper coming in, it's going to sock the copper away. If it's got— you've got too much iron, it's going to try and sock the iron away. When we get overload of these minerals, we can actually get really severe disease states where people really need aggressive elimination of minerals with various agents, all kinds of interesting cases that I could get into there. And so the liver is going to try and clean things up and balance things and get you the right minerals to the rest the body and then out of the liver. The liver's gonna then push out minerals to the rest of the circulatory system, or they're gonna get past the liver. They're not gonna be taken up, and that's what's going to nourish all your cells and tissues. And then it's gotta go through the blood system up to the scalp. It's gotta go past the hair cell, and then the hair cell's gotta grab that mineral and it's gotta pull it into the cell, and then it's gotta push it back out into the hair. And one of the most interesting things to me about the hair is that the hair is truly an expression of our bodies. That reflects our health, which, you know, you don't think about, or I should say everything else that leaves your body is mostly a waste product. And when we say waste product, I mean your body's actively trying to get rid of bad things and it has no interest in making it nice, pretty, whatever. When you're healthy, your hair should be supple, strong. It should have this luster, should fall just the right way. It should blow just the right way in the, in the wind. It should look good. And that's a marker of vitality. As people get older, it gets more brittle. That shine disappears. It may not just break. It may be it doesn't fall or lay the right way. I don't know anything about this. This is like, I just think, I think this is how it is anyway. So, so the hair changes, right? This is a combination of things. And this is part of what makes it such a powerful window into, into aging. It reflects what's going on with the total body metabolism. What's going on with your hormones? What's going on with your what's going on with your vitamin levels, what's going on with your oxidation state, your ability to metabolize glucose. It has all of this in it. Now I'm not going to pretend that it's some kind of like crystal ball, like, oh yes, you had tomatoes for breakfast on Tuesday. There are limits to this. Okay. And there's a lot of noise. You know, I mean, I see, I see values all the time. I'm like, that's weird. That's a weird value. I don't know how to make sense of that, but we were able to read enough out of it to really tailor great supplement protocols to people and get great results. And so when you When you're looking at the numbers in the, in the hair, you've got to think about, well, what is this mineral and how hard is it to get and move it? And so iron's a great example. So iron tends to accumulate in the liver and in the blood, and it is very common for people to have very high levels of iron in their blood and in their body and have very low levels of iron in their hair. It doesn't mean they don't have enough iron because their hair value is low. It means their body doesn't have the energy necessary to get that iron out of the cell and into the hair. And that's part of why it's such a great test. We know we're making progress when levels and ratios normalize. And of course, I'm always my own, like, first patient for anything I find and try and whatever. I have stuff like stacked up to do and try myself to maybe mid, mid-spring or late spring, early summer, because I just keep finding cool things I want to try. But I know from my own testing that my levels were crazy all over the place. Highs, lows, big inversions. Big, broad ratios. You don't want that. You want tight ratios. You want your ratios to be really balanced. And as I've gone through this process of learning about HTMA and doing it myself over the last 2 and a half years, I have probably 10, 15 hair tests in that period of time. As I've done that, what I've found is that the ratios get tighter and tighter and tighter around the ideal, and I feel better and better and better. And now I'm doing some validation of my my work, and I'm doing these provoked heavy metal tests of my urine. And the first one's back. I'm going to do the second one sometime here in the next month, but I can't find any heavy metals in my body. I seem to have eliminated all of them, which is amazing. And I'm not going to declare that as victory yet because I really like to confirm everything in triplicate, which means I run the lab 3 times instead of just once. But I've now run 6 without any kind of agent or drug to provoke the metals. And now I've got one where I've done everything possible to try and get the metals out of tissue. It's pretty— it's pretty involved, to be honest. And so I know what we're doing is working. And we get this from patients all the time. And one of the things we get from patients that Amy wants me to talk about and wants to talk about is detox reactions. So when we get the, the, the protocol right and you take enough of a dose and you're doing all the other things, the sunlight and the walking and the eating healthy food and thinking positive thoughts, all the other stuff we teach patients to do to get well, it's very common for patients to feel worse and then they'll stop their supplements and they'll feel better. Now I would know if something in the supplements was bad. We actually just had a case of a gentleman we know, not a member of the practice, but he documented a very high level of lead in his blood and his hair in conjunction with the use of a herbal supplement. So I know that many of you are using products, you think they're vetted, you think that the influencer selling them to you is very nice and maybe handsome or pretty or whatever. But I gotta tell you, toxic, we find the dirty laundry and boy, it's just sobering. It's really sobering. Part of why I test my own physiology so frequently is I'm a little paranoid I'm going to pull some new product and I'm going to poison myself. I want to find out right away, but, and I'm, I'm laughing, but it's, it's actually quite, it's quite tragic because many of the people who are trying the most supplements are the most sick and they so badly need to get well. So anyway, this phenomenon of detoxification reactions is stuff will start to pour out of the body, when they stop taking the supplements for a few days, these symptoms will abate, but then they start at a lower dose. And then 2, 3, 4 months later, if we get the dose right, and I try to modulate the dose down, I try to, try to adjust it so that people are not, their life's not derailed. They don't feel terrible every day. We will regularly get someone in. We have one, I just met with him the other day, Tuesday. He's like, I don't care if I feel terrible for the next 6 months. I just need you to get me sort of back in the saddle. I'm like, okay, we can drive the car as fast as you want, but you said it. You asked for it, so don't, don't come crying to me. Anyway, that's, that's the long and the short of detox reactions. And it's fascinating to watch people go through them because often, not always, but often we'll get their hair back and they'll be blowing some huge level of aluminum, cadmium, and mercury, whatever it may be, as they're going through the detox reactions. And we, we truly validate what we're doing by documenting that.

Yeah. And I think that's where people often report that they get the symptom relief. So, you know, sometimes just as we give them minerals, even without eliminations, they do feel better. But most of the time, a lot of people have those metal eliminations and then they'll have symptom relief. So during the metal elimination, they will have a detox reaction, which is unpleasant, not fun. But then afterwards, they report that the symptoms have gone away, which is awesome. And I think you've showed that so many times with different autoimmune cases and all the cases in the practice. You're going to say something.

It's true. But what I find a little bit frustrating about the whole process is that I just cannot predict who is going to feel better or worse. Some people sail through eliminations and they have no symptoms, and other people, they have these tiny eliminations and they feel like it's the end of the world. Now, some of this has to do with the fact that, all right, I've said all these nice things about the hair test and I do love it. But it is flawed. People excrete at different levels. And one of the top criticisms of the test is, and this is the, what we call the poor eliminator concept. So the sicker you are, the less vitality you have, the more nutrient depleted you are, the more your toxic burden is, the more infections you may have, the lower your heavy metal and trace element or trace mineral levels are going to be in the hair. That's elements like iron, copper, zinc, manganese, and then the toxic metals, aluminum, cadmium, lead, arsenic, mercury. And so the, the The worse off somebody is, the lower their toxin burden is going to look in their hair, which is very misleading, but it's that they don't eliminate the metals well. So we have to restore their vitality so that they can eliminate the metals again. And that's the name of the game when it comes to getting the HTMA interpretation and protocol right. We have to get that stuff out. Now, there's other things we do, by the way, that are not typically done in the HTMA world, like high-dose vitamin C, high-dose vitamin D, which we're getting into now in the practice, and we'll talk more about as we, as we go. We just came up with our internal vitamin protocol and consent, which I'm very excited to be used now in some of our tougher cases. But you have to understand that you shouldn't expect to see your high levels in the hair first. You should expect to see them later. And it's possible, particularly these cases, I have more than one case where they feel so much better after a year and a half or 2 years. They've been doing HTMA like clockwork every 3 months, every 4 months, because they've been so gratified by the results. And it's, it's not like people just wake up and say, well, I would like to do another quarter of that. It's, time, expense, you know, effort, right, to do this work. But they see such great results. And yet I never see a heavy metal elimination and maybe it's coming or maybe we missed it because maybe they got a haircut and some was lost. But either way, the proof of the pudding is in the eating, is in the clinical results. And one of the things that I, and we actually need to, I need to get this data from one of our teammates who's been putting it together. But, you know, we routinely see people come in with elevated levels of inflammatory markers. And they will generally fall 50 to 100% is what I recall over 6 months to a year, depending upon the degree of compliance of the patient. So I know what I do works in part because I've seen these massive improvements in inflammatory levels that are not subjective. They're objective. They're based on this is what your blood level is, and these are validated markers, and this is what they mean.

Well, and I think a huge part of that is we are balancing the mineral system, hence why we call it mineral balancing. And so even without metal eliminations, we are balancing their minerals, helping them to get the better ratios, the right amounts of them for their body. And so that's a huge part of what we do as well, is we're going to look at the minerals that are coming out in your hair and we're going to work to balance them. And so from that, we're going to give you different doses of vitamins and minerals. But we understand the different interactions between them, which Dr. Stillman was talking about before.. And I think a lot of people miss that because a lot of functional medicine is what we would call replacement therapy. You're low in zinc, take zinc. You're low in calcium, take calcium. You're low in potassium, take potassium, whatever it is. But what we're really doing is we're taking the whole mineral system and then saying, how do these minerals interact with one another? And then how can we balance them to give your body what it needs at this time, remove what it doesn't, and then as a byproduct, it gently detoxes your body. So I often tell people that, like, we're really just balancing your mineral system, giving it what it needs, and then it's going to kick out what, what it doesn't need through this, like, a more gentle detox process. And yeah, a lot of— you've talked about ionic mimicry a lot, of, you know, these metals, these toxins, they will replace the minerals in your body, but they can't do the same thing as the minerals. So then we have these issues with our bodies. And so what we're doing is giving your body what it needs, and then your body can kick those out and then allow them to be eliminated and then actually restore the minerals and the function that they had before. So it's just, it's a whole process. And I think that oftentimes, because of the way that we're so used to thinking about blood tests or replacement therapy, it's— this is a harder concept to understand of like what we're actually doing with the mineral system. So we really wanted to talk about it and help people understand this test is very different than a lot of the paradigms that you've been taught or, you know, of, or you've been learning in the world.

Yeah. And there's a lot of value in, in things that other people tend to emphasize that we don't emphasize. What I found is that they don't get you the lasting results and they don't get you the results for the tough cases that we tend to end up taking on because they've already seen everybody else.

So yeah, it's very true. Yeah. And then I would say with detox reactions, every week I work with people and we are helping to minimize detox reactions, navigate them. But you, you said the other day, and I told the patient this, where you said we should probably send flowers to people when they start having detox reactions. I thought that was awesome because it's a balance. Like, we want people to be able to eliminate things and we want you to live your life, and we don't think that you have to have these massive detox reactions to have good results. But when they do come, it shows that the minerals are doing what they're supposed to do. They're kicking out out the things that they— we don't need in our bodies. So I think that's really funny. So if you're having detox reactions, one, it's very normal. Everybody will have them at some point in time. It doesn't have to be horrible, and we'll work to minimize those so you can live your life, and they will happen. So just know that they're normal.

That's right, they're going to happen. Well, I say that— I think that we do have some cases where they don't happen. I can't say I've ever had a detox reaction that I'm aware of, but I got into this really as just, well, I've got to do this as an N of 1 myself, and if I'm gonna in good conscience recommend to patients. And so I did all the testing every quarter, all kinds of testing. I don't even know, it's got to be like $10,000 in testing in 5 years or something like that, and that would probably be the low end. But I just felt like I had to do it. And then I had to do the supplement protocols I was going to recommend to patients. And then difference in performance, vitality, energy that I have now compared to 5 years ago is night and day. I don't know how I got through residency or medical school. I was exhausted. I was miserable. I didn't sleep well. Life's, life's great when you are this well nourished and dialed in. Just part of why I'm so passionate about what we do. It's like, feeling terrible every day, that would be awful. That would be so terrible compared to feeling this good. So true. We want everyone to feel great.

Yeah. And then on the other side of that, I have had all kinds of detox reactions, so I know what it's like to go through very, very extreme detox reactions. And I don't think I needed to have gone through them at the pace that I did. I was is being very aggressive. And so I don't— I make sure to tone it down for everybody else, but it— they're miserable and I know what they feel like.

We'd love to answer more questions you may have. Feel free to submit those through the Q&A link that we include in every email through Substack. If you're watching this or listening to this somewhere else, if you go to Substack, you'll find a Q&A link. Amy, any closing thoughts?

That's great.

We have some exciting new webinar topics coming up. I'm going to release those a little bit more detail on those through Substack later, but make sure you tune into the masterclasses we're running. They are very interesting. We do a lot of deep dives into case studies. We just had one last night. If you're interested in the Autoimmunity Recovery Program that we're running, get in touch with us. You can go to my website, click the apply for consultation, fill out the form. You can get on a call with Amy or another member of the team, and we will see if we are a good fit to work together.

All right.

Thanks everyone for joining us. Take care. Have a great day.