The Missing Piece Behind Chronic Illness Recovery

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 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 back again with my friend Jim Laird, and today I am very excited about what we are gonna talk about. So in part 1 of Jim's journey, we talked about his journey with ulcerative colitis, autoimmune GI disorder, and what he did to overcome it. And today we're going to talk about what I would sort of look at as basically part 2 of Jim's whole story. And this episode for me is actually very, very important because Jim's story, of all the cases that I've ever seen, is probably the single best illustration of the power of the environment to determine our health or disease. And I really don't say that lightly, having seen I don't know how many patients and cases and consults with other doctors and all the rest of it, right? And what I want people listening to this who are going through or who are helping someone go through a health crisis of any kind is to understand that the story you're told at the beginning of the illness is often just a piece of the puzzle. And we see this all the time. People will come in, they say, I've got Lyme or I have mold toxicity, or I have, you know, weird autoimmune disorder, I have, you know, cancer, anything like that. And there's a place for obviously conventional care, but what often gets lost in translation in these cases is people will say, Well, I have Lyme disease and I'll say, well, what symptoms do you have? They say, I'm tired, brain fog, can't sleep, anxiety. This is creating depression, GI issues. It all started after a walk in the woods with a tick bite, with or without rashes and other things. And they'll say, well, I was either Lyme negative or I'm Lyme positive or whatever. And I get better with antibiotics. All that's well and good. But what I found when I looked into the literature on this was that people get the idea that antibiotics solve infections. Here is the problem. The failure rate of antibiotics goes up as the immune system and function goes down and immune power and function are not actually easy to measure. What I mean by that is you can have a patient whose labs look completely normal and they can actually behave as though they're immunocompromised. And so we'll see that when we nourish them, fix their environment, fix their diet, their immune system will come back online. And in many cases, something they were told they would need weeks or months of antibiotics for, they actually just really needed to radically change their diet and their lifestyle. And people often don't believe me when I tell them this, and I do appreciate and understand their skepticism. And sometimes there is a place for antibiotics. I'm going to prescribe some later today, which is rare for me, but people— and Jim and I were talking before we hit record. Jim said something really funny to me. He said, people sometimes don't understand how much time they have to invest in getting well. As much as we try to streamline it, sometimes that's like the key thing, you know? It's like, look, this may just take a radical lifestyle change. And that's what we're going to talk about today. So Jim, thank you for coming back. Anything you wanna say before we jump into part 2?

Yeah, I, I think you summed that up really nicely, but I think the caveat is as well as you can take that lifestyle change too far.

Oh yeah.

And there's, there's, there's, yeah, we're, you know, there's more than just one factor and it's a multi, you know, the human experience is so complex and we're so resilient.

Mm-hmm.

But you can take it too far and go too far with it. So it, it's, it's, it's gonna be a, a good discussion. I'm looking forward to it.

Absolutely. So Jim, one fateful day decided that he was gonna get a pedicure.

Yes. And then what happened? Well, let's set some context here. So coming outta my colitis, I learned that I needed to manage my stress better. I was doing a good job. I was going to float tank once a week. I actually had a float, I think I had a float tank put in my gym. I was literally sleeping in it sometimes. I was doing a really good job of doing my meditations and, and then I, I basically was eating a paleo style diet for the most part. I was. Doing pretty good. I still had some, like, what I would call gluten sensitivity. I was like, oh, I guess I just can't eat gluten anymore. I'd get sick when I got exposed to it. And then I was seeing a young lady and I ended up getting a pedicure. And several days later, I started having some pain up my right leg, like in my groin. And I was like, wow, you know, I just trained legs hard the other day. And then all of a sudden my legs started getting red and I was limping a little bit. And one of the ladies on my lifting team She's like, what's wrong? I'm like, well, I don't know, my legs. I don't know. I did something to my leg. And they're like, show me. And I pull my, I, I wore like these Adidas track pants and I like pulled 'em up. 'Cause I always wore shorts and they're like, why are you wearing track pants? And I pulled my leg up and she like, she turned white and, and, and, and literally called over another girl that was in there who was, who was the head of a certain department at a certain major hospital in Lexington who literally got on the phone and literally called the infectious disease doctor, and literally she's like, you go out the door right now. So literally it was 10 minutes away. And so I went out, I went to, to the infectious disease center and I walked in and they sent me right to the back. And, uh, the doc came in and, or the nurse came in and looked at my, she like looked at my leg and turned white. And then the doctor came in and called all the interns in and is like, okay, this is a really bad case of cellulitis. And like, Sir, I can tell you're a really like highly driven person. And he is like, you gotta take this seriously. 'Cause if this is like MRSA, like you're pretty much gone. Like there's nothing we can do for you. And it turned out just to be staph. They were able to get it under control with antibiotics, but I got the world famous speech. You need to be on an oral antibiotic for the rest of your life. You've gotta wash your body down with this crazy stuff every single day. You know, if you ever cut your foot, if you ever like, You know, anything ever hap— you need to keep your legs covered at all times. You know, cuz you're gonna have these recurring infections and it's not gonna show up as like cellulitis. It's gonna be more like a chronic sepsis everywhere. You're gonna get like flu-like symptoms, fever. Sure enough, like 6 months later, I'm in, I'm in the gym training people and all of a sudden I just get this weird feeling and I was like, I looked at one of my staff members and I was like, I gotta go. I literally got in my car and, and where I was going to the hospital was literally 10 minutes. So by the time I got to the hospital, the gorilla's running up and down the street. And I think I was running, I can't remember, like 104 temperature by the time I got to the hospital, maybe higher. I know I went super, like, what's the, what's the cutoff?

104 is high.

Yeah.

But you can seek is over 104, 105.

Yeah. Yeah. So I've, I've flirted with some pretty high temperatures, so I knew that. And they, they had put me on like a special list at the at the hospital.

That's not a place where you want to be on a special list.

Yeah, no, no, it's not. So literally they just, they, my name's on the list. So I basically, cuz this infectious disease center is in this hospital. And so they literally call the doc. They literally sent me right to the back. We're talking alcohol bath, the whole deal, trying to get my fever down. And then they, you know, so this was going on repetitively every few months. And I was just like, man, this is, this really sucks. You know, like. And so I was doing everything I could to take care of myself. I was just like, what's going on here? And of course I'm sitting in the, in the room getting an IV and everybody in there is like, you know, popping their Metformins and drinking Diet Coke and eating donuts. And, you know, I'm, I've, I've got like a tray of like chicken breast with rice and a little bit of, you know, and they're like, dude, you're freaking, you're in great shape. Like, you know, everyone else is there as a diabetic. Yeah. You're getting, they're getting all their limbs cut off. And here I am like, at the time, you diet and you exercise, right? Yeah. I diet and I exercise. And so, so I was like really like, kind of like, oh, you know, so what, what's going on here? And so I was—

how did that feel?

Well, I overwhelmingly, you feel helpless, but I, my cur— my curiosity is just like, you know, it was getting to the point where, you know, vancomycin wasn't working very well. And I just, my curiosity, and I just kept reading and listening and, you know, I was listening to all sorts of different people online.

So hold on, you were, you were taking vancomycin. Were you on anti— IV antibiotics outside the hospital as well?

No, only when I had flareups. So, okay. And then they discharge you on oral whenever I had, I refused to take the oral antibiotics because I was like, I've already got colitis or I've got colitis under control. I'm like, no way I'm gonna take an oral antibiotic. Like, yeah, that, that was just that, you know, I'm not a medical doctor, but to me that's really interesting.

Into the record, like this is just education, obviously we correct.

Correct.

Yeah. Don't, don't do anything crazy just 'cause Jim Laird told you he's not necessarily right.

Right. You don't want to follow me. It's not a good path. The good Lord, the good Lord has funny way of teaching me very hard lessons by hitting me over the head with a hammer. So, but it's, it's good. I've been able to help other people from my, my stupidity. I just, I, I can't, you know, I was, I went to speak at a, at a conference of Paleo FX. I think, I can't remember if it was in Austin or I spoke at a number of Paleo FX. I can't remember which one it was, but I heard Dr. Jack Kruse talking and he just absolutely, the room just went insane because he basically told people that they were stupid for eating a banana in Boston in December, you know? And people started losing their mind, you know? And I was like, this dude, this dude, I like this dude. He's kind of, you know, he's pissed all these people off. I started listening to his stuff. I, you know, I, I listened to his talks on cold. And then I, I ran into, I just started interacting with him online.

Hold on. Would you give people a little bit of context who don't know Cruz and don't know bananas and all that?

So, so Dr. Jack Cruz is a very, how's the right word? Very controversial, intentionally inflammatory. I like the guy personally. My personal relationship.

Actually kind of hard not to like him. I find it.

No, I, I really do like him cuz he's a, he's like me watered down. There's a lot of, I have a lot of similarities in our personality, but I'm, I'd say, you know, he's on level like 16 and my volume's on like 7 and I can turn it up to 12, but I don't very often.

But he can be very pugilistic in his attitude.

Yes. Yes.

Very confrontational, provocative.

Well, he's very, he's very much an absolutist. Like he makes a lot of absolute statements.

Mm-hmm.

Uh, which I don't think is very wise to make very many times unless you're dealing with like having to pay taxes or something along those lines that's guaranteed, or you're gonna die one day young. That's pretty much an absolute statement. But other than that, there's not very many things that are completely absolute. So, you know, I listened to him talk and I just became, I just kind of started interacting with him and he was very generous with his time. And then I joined his group and he said to me, he is like, dude, like, okay, so tell me about your day. Like, so I get up at 5 in the morning, I train people till 8 o'clock at night. He's like, dude, do you ever go outside? I'm like, Not really. When I do, I wear sunglasses. And it's like, when's the last time you saw a sunrise? I was like, ah, every little while when I go fishing, but I'm still wearing polarized sunglasses. Maybe since I was like 16 or 17 years old. He's like, dude, you do realize like the sun runs your entire immune system. Everything in your body is driven by sunlight, hormones, the whole shebang. And so here I had all this other stuff in order and I was like, well, gosh, started diving into the literature and I started reading and you know, I read John Ott's book and I started reading and listening to all these different people talk and I was like, holy crap, like how could I not see this? Right. And, and so pun intended, right?

I mean, it's, it's, I know, yeah.

I'm like, this is a huge, this is a huge missing component. So, so Dr. Cruz was like, look dude, like you really should move south, but I couldn't. And he is like, so you need to get outside as much as you can. So I immediately basically canceled all my morning sessions or I handed them off to other coaches and I moved my schedule to 10 o'clock. And I literally stood, spent from sunrise to like 9 o'clock outside. I immediately bought a big red light panel for my gym. And then I put black lights in the ceiling, kept the doors open more often, and I did everything I could and I would get in and out during the day outside.

And let me unpack a few, few things you said that were really important. So I remember when I started to look in the literature on this, that I was, cause I had a similar experience. I wasn't dealing with a health crisis, but I found Cruz's work and I thought, this is wild. I can't believe I missed this. The thing that stuck out to me was the literature on sleep deprivation and shift work. So just being a shift worker and what that means is you get a significant amount of artificial light at night because you're working overnight. Now that could be a 4 to midnight, 8-hour shift as a nurse. It could be a, you know, 7:00 PM to 7:00 AM overnight shift as a doctor, nurse, paramedic, whatever firefighter, you name it. What you have to understand about this dark, this day-night cycle that we have as diurnal, which means we have a, you know, day and then night, we're awake during the day, we're asleep at night, as opposed to nocturnal mammals, like, you know, rodents or like many rodents or owls. No, owls are not a mammal, but you get the idea. Animals is that at night your body is basically doing a lot of repair and it's, it's fixing the immune system, which is supposed to run during the day. And so the analogy would be basically imagine if the city never cleaned up or never did maintenance on its buses and its fire trucks and its police vehicles. Well, eventually you'd be calling the police and they'd be like, we cannot physically get to your location because the cruiser has has not been maintenanced in a long time and it won't start. And so people get very confused, like, why am I constantly sick? Why am I always tired? Why am I this? Why am I that? The repair process isn't just a matter of raw materials, it is a matter of time. You know, like, you can have the motor oil, the axles, the wheels, the different things that fix the vehicles in stock. You can be pouring them into the warehouse. If you do not have time with the vehicle jacked up on a lift— and you're not cars, but I'm oversimplifying for the sake of the analogy, then it won't matter. It will not matter at all. And this is where we get so strict with light environment. As little artificial light as possible at night. And I really can't stress this enough. Every single case in the practice that has a really amazing story, not just like a big improvement, but a significant sustained improvement. They were pretty radical with their light environment, sometimes indefinitely. And if you look, and this is a study that really stood out to me, is if you keep animals sleep deprived day after day, week after week, it's not even day after day. In 48 hours, if I recall correctly, lab rats kept awake will die of spontaneous bacterial infections and it won't matter what you do. They'll just die. So people don't, don't do that, right? Like sleep deprivation's a torture technique that I think is, I don't know if it's outlawed, but anyway, it doesn't come up in clinical practice.

You know, you never follow the rules anyways. You know that.

I know that, right? But anyway, doesn't come up with, with patients, but patients just limp along from infection to infection, antibiotic to antibiotic, wondering, well, when am I going to get off what I call the therapeutic Ferris wheel. Like we're going back up with another round of antibiotics. When do we get to get off of the ride? I want the misery and the craziness and the nightmare to end just like you were feeling.

Yeah. And, and, and so, you know, and the funny thing is, is people today do self-induced, you know, sleep deprivation by scrolling on their phones at 10, 11 o'clock and never going outside. So they do self-induced sleep deprivation and they wonder why they can't stop eating and all those other things. But, you know, that's besides the point. So basically once I started doing that, all of a sudden, like one month went by, two months, three months, four months, six months, a year goes by and I haven't had another infection. And they called me and they're like, are you okay? And I'm like, yeah.

I love that they called you.

Because they're expecting me to like come in every four to six months and like, I was getting pretty grim. Then I ended up going to a seminar where I met you. So that was one of the benefits of being introduced to Dr. Cruz. And then he kind of planted this, you know, I made this decision myself, but you know, with how powerful intervention was for me, I was like, man, I really need to move south. You know, I've got this, this underlying health condition and all this stuff. And so I started, my wheels started spinning about moving to Florida cuz I wanted to open a gym on the beach and I was like, I need to live a more outdoor lifestyle. And that's where that started spinning in my head. And, and so Dr. Cruz kind of planted that seed and then I, I basically determined in my mind that I had to move south. And when COVID hit, I was like, man, I can't, I can't live in a place that is going to shut my business down for 8 months. And I, you know, I learned lesson number 1 about basic absolutes during COVID I was like, I was so excited because I was like, all right, I had property on a farm. I had a house on there. There was no electricity. There was no EMFs. There was nothing. Nothing. I was like, I'm gonna be superhuman. I'm gonna go out there, you know, cuz I'm thinking I'm gonna be barefoot every day. I'm gonna have all the light. There's not gonna be any Wi-Fi. There's not gonna be anything.

Yeah.

And I'm gonna be like, I'm gonna be this like, right. Freak show in a good way. Yeah. In a good way. I, I was gonna be like, you know, Superman. Right. And within, within 2 weeks I was literally making runs to town for booze and like ice cream. And I was, I was miserable.

You started calling me. We had some great conversations.

Oh yeah. And I was, I was abs cuz I had nothing to do and I would go like walk around in the woods and stuff and it was like, and then nobody during COVID no one wanted to interact or do anything. Eventually I kind of opened my gym up, like, you know, kind of backdoor kind of thing cuz I was literally going insane. But like I was really struggling and then I was also dealing with some hormone replacement issues that I was experimenting with because I was like, oh, my light environment's right. For context, I, I did performance-enhancing drugs when I was competing in powerlifting against other people that were doing performance-enhancing drugs.

Yeah. So testosterone and related things. Yeah.

I was out, it was after my football career was over. I was like, I wanna be the strongest guy in the world. And part of trying to be one of the strongest guys in the world is taking performance-enhancing drugs. That's just the way it is. So I had done that from the time I was in my mid-twenties all the way through, I was in my mid-thirties, so I was still, and, and then of course You know, I was like, oh man, you know, get my environment right. I should be able to, you know, come off the testosterone, right? And I, I tried to come off and it, it didn't, it didn't work so well. And then I ended up having to, to get on an HRT dose. But it took me a little while to, to figure that out.

I wanna unpack that for a minute too, cuz actually this comes up a lot as well. Sure. So, so let me sort of set this up. A lot of patients come to us and there's a big question of, you know, what's wrong with me and why? We'll often look at hormones and often the levels will be low or low normal. Our standard approach, because what Jim is, is mentioning here is basically that if you live in nature, particularly if you really get your diet dialed in, you're getting enough protein, it's from a variety of sources, it's a nutrient-dense, nutrient-rich diet, you're not poisoning yourself with aluminum-based personal care products or baking soda or mercury-rich fish or all the things that we know really derail the immune system. You don't have toxic exposures, so to speak. The, the theory is that if you fix that, then hormone levels should normalize. And this really in the natural integrative wellness movement, people tend to say things like, well, if you just eat this and do this and do this, you don't need to take any hormones. This is very context dependent because the reality is the glands of the body that produce these hormones can have sustained damage already. Listen to what Jim said. After my football career, he didn't, I don't think, mention today his MMA fighting career, his career in personal security, the car accidents he's been through. Yeah. You know, just because that wasn't already enough. You know, he's had significant head trauma. The more trauma the brain takes, the more global function tends to decline. And you know, this could happen to your brain where your glands, your, your sort of control glands sit, which are all regulated by the way, and, and also controlled by the way, by the hormone of darkness and light, melatonin, which is also why we should expect hormone levels to decline with chronic sleep deprivation. The brain literally can't repair itself to optimize function to increase hormone production, right? So what you'll see is that you have to meet the patient where they are. If they have severe— 'cause this is also turns into a vicious cycle of I don't have any energy to do the things I need to do to be well because I don't have enough hormones to have energy, and then I don't do the things that I need to do in order to support healthy optimal hormone levels, and then I feel terrible because my hormones are terrible because I haven't done the things I needed to do to feel well. It's just— it's miserable. We'll often use hormones as what I call a bridge to a better place where we take a low or a low normal value, we give them the hormone back, the body starts to respond, we nourish them, we fix the environment, we fix the lifestyle. Then we stop the hormone later, but we always need to be mindful that what can happen is what exactly Jim is talking about. Hey, I tried to do everything right. I did all the natural stuff. I ate the sardines and I did the earthing and the sunlight and the sunrise and the this and the that, but my hormones were still tanked and dysregulated because of prior exposures or prior traumas. And so, you know, all of this gets into what I'm so passionate about, which is that you are not some lab rat in a study. You're an individual person with a context and history and a biology and a biochemistry and biophysics that defy our quantification in some ways, and you have to be treated as such. And it also isn't just like, well, do this for 3 months. Sometimes we can give you a recommendation for 3 months and then follow up, but a lot of times we actually need like week-to-week or month-to-month iterations and changes and modifications because, you know, you can make big mistakes. And if you just wait every quarter to try and course correct, it's easy for years to go by feeling horribly, not being optimal. And sometimes patients don't realize, they'll say like, well, I want to optimize this and that and the other thing without taking the drugs. Totally reasonable. Happy to work with you and try and do that. But at a certain point, we're 6 months in, we're a year in, you don't, you're not where you want to be. You're not making progress. You're doing all the things, you're trying all the things, You don't feel like there's anything else to fix about your diet or lifestyle. We may or may not agree with you, by the way, but it's time. We just gotta make a plan that's gonna work for you so that you can actually achieve your hopes and dreams and not just continue to sit and, and stew and be miserable and, and watch your life kind of go by. Fair.

Very fair. But you know, and in context, I'm gonna say something very controversial. Imagine that. I think one of the reasons I'm still here is because I did take performance enhancing drugs for a long period of time. You think about my football career, which started when I was like 8, plus hockey, plus wrestling, plus rugby. I mean, there are football practices I can't remember cuz that was back in the day where you just lined, you did Oklahoma drill for 4, for 30 minutes. Like you literally, and I was a fullback and my, my whole shtick was like punishing people. Right. You know, from, yeah, that, that, I mean, that, that, I mean, I literally, there, there's videos of my dad has of my dad filmed all our Like games, I mean, I knocked people unconscious. I knocked myself unconscious. There was games where, you know, back, that was back when they brought out smelling salt and I'm like, I see 3 guys and the coach is like, just hit the guy in the middle, you know? So the amount of concussions that I've had in my life, like I can't even fathom. Yeah. Like, plus motorcycle accident, all that stuff. So the performance enhancing drugs I think kept me functional. It allowed me to drive my body like a stolen car for a long time. Yes. And I got away with it from the time. And that's the thing you can get away with a lot when you're young, particularly, you know, I grew up playing outside. I grew up running around on the street in the cold, playing outside for hours. So I bought myself a lot of forgiveness and then I got older and things started to change. But I'm not telling people to go out and get on performance-enhancing drugs. Obviously I've been hit in the head so many times, plus, you know, car accidents and all that sort of stuff. I have to take like an HRT dose. Probably for the rest of my life, and I'll wean it down as time goes on. You know, so the, these, these people that are like, you can't, you know, you shouldn't do this or you shouldn't do that. There's so much context to a lot of the, you know, look at how many NFL players like Junior Seau or my friend Chris Benoit, who I grew up with, who, who murdered his wife and his son and then killed himself. I mean, he, he was so messed up from all the head trauma. You know, you gotta tell a guy like that, that he, you know, he shouldn't be on stuff to support himself. I mean, it's, uh, You know, it's crazy.

Yeah. You, you use the term performance enhancing drugs. I think that we need to unpack that because I think people, you know, I remember when Barry Bonds and Mark McGuire were competing for like the home run record, right? You may remember this better than I do, Jim, but there was a big question, are they doping? And I think, were they both?

Oh yeah. There was at that time that steroids were not illegal in baseball.

Yeah.

And here, here's the thing you gotta understand about sports, the argument that steroids are illegal because they're bad for your health is irrelevant. It is not a good argument. If you want to make the argument that, that it's unfair because it's a performance advantage, make that argument. That's a better argument than they're bad for your health. The Major League travel schedule is bad for your health. The NFL running into each other, the sports themselves, like do the, do the Tour de France drug-free. You're insane. I remember there was an exercise physiologist that was like, You would be stupid not to do the Tour de France without the assistance of drugs, because if you try to do the Tour de France natural, it's gonna destroy your hormone profile. It's gonna be so hard on your body. You need anti-inflammatories, you need EPO, you need all these things. This is kind of a weird perspective for people to understand that, you know, baseball, they're playing 200, 300 games a year. They're taking, they're not taking massive dosages. They're taking enough to keep themselves healthy. You know, Lance Armstrong was taking, and plus Lance Armstrong was a freak already. He was taking these things to keep him going.

Yeah.

Right. So a lot of these sports are horrible for your health. And so it's, it's a really weird, like when you tell people this, like if you really want people to look out for their health, like it's not the steroids that are, that are killing people except in bodybuilding. It's the sport itself. Like you gotta understand that sports at the highest level is not good for your health.

Yeah, I agree. When we say, or when Jim says performance enhancing, I want to, I want to unpack that for people. So let's talk about what drugs we're talking about. Right. So first of all, when you get into the world of performance enhancing drugs. And if you're listening to this and thinking, I, I don't think this is relevant to me, believe me, it's relevant to you because what people may not realize is the best treatments we have for autoimmunity are technically performance-enhancing drugs. Let me explain. So there's a very strong correlation between low testosterone and autoimmunity. Very strong. It's not even close in the practice. The men who have significant autoimmune disease burden symptoms, whether we're talking about you know, psoriasis, vitiligo, you know, autoimmune hepatitis. I mean, I could go on. They all have low T, and if they don't have low T on labs, they have low T function and symptoms. And what's really interesting about it is, you know, we have to remember all of this is— it has to be considered in its historical context. And here's some historical context around testosterone. Just as one example, the average American man's testosterone level has been declining 1% per year for we don't know how long. We started measuring it, like we became capable of measuring it in, if I recall correctly, the 1960s. So the 1960s, think about it, we'd already invented microwave, radio wave radiation, artificial light. We were already churning out who knows how many millions of tons of pollution with heavy metals and pesticides and all this stuff. Fast forward 50 years, we've got even more chemicals, we've got even more EMF. I mean, just the last 5, 10 years the global burden of radio and microwave radiation that has a measurable and demonstrable effect on hormone production, and I believe on function at a quantum level, although that's a more tricky issue. It's a totally different clinical setting we're in. It's why patients are sicker. It's why there's more patients. It's why the treatments are not working well enough. Like, it's not a coincidence that the autoimmune drug market went from under a billion dollars in the 1950s and '60s and '70s. It wasn't even know, in the millions in some of those years. It's, it's on track to be a massive, like, multiple— I don't know if it's 7, 9 figures. It is a giant market. This is not a coincidence. Now, part of it is the drugs are on patent, so their prices are inflated. But a big piece of it is that people are sicker, they need more drugs, they need higher doses. And all this comes back to the hormones. Why? Because you will find that people will need higher and higher and higher doses of hormones in order to respond. And this is the difference between, or, you know, the difference really between our environment now and our environment then. And so we'll often use, and basically any hormone your body makes is technically a performance-enhancing drug. It will enhance your performance in some way, directly or indirectly. So like progesterone for women will enhance their performance. Why? It will deepen and improve sleep. For many of them, it will reduce anxiety and it will improve focus, right? Estrogen. Same thing. Well, won't increase sleep, but it will improve metabolism. It will improve brain function. It protects bone, muscle, brain. Testosterone, DHEA— they're not just hormones for men, they're hormones for women. So they're all technically performance-enhancing drugs. And when I say performance enhancement, I don't want people to think performance in terms of like how fast you can run, how far you can jump, how strong your bones are so you can resist more torque, more stress, more whatever. These things literally make all of the systems of your body in general work better, faster, stronger, including the immune system. So what happens when hormone levels drop out? The immune system absolutely drops out with them. And that's part of why all these things are impossible to disentangle. You know, you tug on one thread and you find it unraveling the whole picture. And so if we're talking about performance-enhancing drugs, we use them every day in the practice to control autoimmunity. And the reason the book that I'm writing is called The End of Autoimmunity is that I think it's really sad that we're having to use more and more doses of these things. I think it's really sad that there's people in the practice who are 20, 30, and if they don't have these, these drugs, I didn't even mention nicotine, which we talked about last time, but nicotine's an amazing performance-enhancing drug, totally natural, found in nature, very benign. In fact, beneficial for many conditions over the long, a long period of time. I think it's unfortunate that we're dealing with this increasing burden of disease and why I, why I wrote the book and why I titled it the way that it is, is that I see this universe of people managing autoimmunity, talking about autoimmunity, studying autoimmunity. There are more studies are needed. More treatments are needed. We need more drugs and we need more clinics and more centers. All of this is solvable. And what patients need to know is that right now, because of our environment, because of our world, you might need some of these things to control symptoms, particularly to get on track. And honestly, if you need some of these things for the rest of your life, because we live in this dysfunctional environment and world, that's preferable to constantly being dealing with symptoms, flares, in and out of the hospital, right? And I really think that's important for people to realize because we've seen in the practice that some patients will say, well, I, I don't want to do that dose of vitamin D, it's too high, I'm scared, or I don't want to do progesterone because I'm concerned about its effects on this, that, or the other thing. We totally understand, but the patients who get the best results do the full program, and that often includes bioidentical hormones and other, you know, suppose, you know, as Jim calls them, performance-enhancing drugs because they're of clinical utility. They get results sometimes when nothing else will.

The problem is, is when you use those things to continue what's gotten you in trouble. Yes. The peptides fall into that as well. I, you know, how many guys have I worked with that they've done BPC-157, they've done TB-500, and the problem, the reason their elbows and their shoulder hurt is the exercise selection and the exercise program they're doing. And it's just like you change that and, you know, but if you need to want to take something, you know, I've seen, we had a guy we worked with who used a peptide in combined with lifestyle change to help manage his, he had a problem with alcoholism and it was a game changer for him. He used it just, just enough to take the edge off his alcoholism until he could get his life under control. Yes. And he did the work, but most people will just like take big boluses of that stuff and they don't do the work to to change, fix their circadian rhythm and they just keep living the life, you know, stimulants, the same thing with, for CEOs, hormone replacement for CEOs. I'm just gonna continue to like not sleep and burn the candle and I'm just gonna take hormones to keep myself going. That's where you get yourself in a lot of trouble.

And that's another important thing to, to talk about is that, you know, people who want to try to do everything naturally, you know, we, we really need to stop and think, well, what, what should we expect to be able to naturally do? So, you know, the first guy to run a marathon, who— because of the stories that he ran from the Battle of Marathon to, I think it was Athens, to tell the Athenians that they had won— the guy dropped dead. That's a clue that maybe we're not supposed to do that. Now, people do it all the time, but don't expect to do it and be fine. Like, I had a couple cases in the hospital when I was still working there where, you know, a guy came in after doing a 5K or something with a heart attack, and he's like, I thought I was in good shape. Yeah, You, you were in good shape, but you know, you can be in good shape and this can still be too much for you. And when you really stop and think, well, what should we expect to be able to do? Well, in early life, I'm going to say, say like 20 to 40, totally arbitrary timeframe there, 20 to 40, you're at your peak physical fitness and ability. And even in your 30s, those of us who are there, we all know that we don't function. We're not as flexible. We're not as strong. We don't bounce back as quickly. As when we were, say, 30 compared to 35, let alone 40, right? And as time goes on, this is not a linear decline, it's actually exponential. So you see the decline, you know, from my perspective, in patients in their 80s, from year to year, it's a steeper drop in their function than it is from 30 to 31 or so, right? And you got to realize that. And then, so then look, let's look at what people do between 20 and 40 in a state of nature. They're having kids, they're working hard, they're feeding their family, you know, you you look at like a subsistence agriculture slash invir— agriculture nomadic people, like you might find in the Amazon, Native Americans, you know, native or indigenous Europeans, wherever you go, you'll find this pattern. They tend to work like 20 to 40 hours a week, and 40 is a lot. But you got to remember too that in the places where they work 40, 60, 80 hours a week, guess what? A lot of those places are places where it's very dark during the winter and you can't work at all meaningfully because you're covered in snow and you're just trying to not freeze to death, or it gets too hot.

Yeah.

Or it gets too hot.

I mean, I lived, I lived in a rainforest here for 8 months and all the older folks in that area, they all did manual labor for about 3 or 4 hours a day. Machi. Climbing up and down trees. My gardener who's 65 or 66 could literally climb up and down a coconut tree 8 or 10 times with no nothing. Just climb the tree up and down.

Yeah.

Like go pick coconuts.

Yeah, let's talk about that, because he didn't do it for 16 hours a day, did he, Jim?

No.

And so people are like, well, I scrolled on my phone, or I sat at my desk, or I was busy from the time I woke up to the time I went to bed, and now I don't understand why I'm exhausted. Compare this to how your ancestors lived. Like, the, the pace of life, the stimulation of your brain, your body was totally different. And so people come to me, they're like, I basically, I'm frustrated that I'm not able to achieve my goals And I'm, I'm whatever age I am. And then I go through kind of like, well, what's your life like? And I'm like, well, look, in the broad scope of history, has any group of people ever expected to be able to do what you're doing on a daily basis for a prolonged period of time? The answer is usually no. And so you have to have this. I don't know how people practice medicine without having this dialogue with patients because it basically is setting of expectations and goals. And if you don't do that, well, what are you even doing? You're kind of just putting out fires. And managing symptoms with like this and that and the other supplement or medication. And a lot of the time people come to us and what they need most is actually, let's clarify what is possible, what is reasonable, and what is it actually going to take for you to get there? Because it may not be spending another $100 a month on supplements. It may not be a biohack or peptide or hormone or whatever. It may be that you actually need to radically alter your day routine, right? And that's something people often don't see coming. They also, I've been really struck by the fact that we'll say like, well, look, maybe shifting your schedule back 2 or 3 hours during the day like you did will have this massive shift in their health. They're like, well, I don't really believe that. Part of why I wanted to talk to you, Jim, is like you're living proof that it actually worked.

See? Yes. Well, I think some context here, we've got two extremes. You've got, if you look at like Weston A. Price work, He, he studied traditional cultures that had incredible longevity other than obviously infant mortality and all that stuff.

Sure.

Yeah. But then we've got, you know, you go back 100, 200 years, you got people working in coal mines, you got people, you know, peasants and all sorts of things doing really hard manual labor. We've got this other extreme, obviously that's horrible. The conditions those people were under. Yes. They didn't have great life expectancy. But if you study like the hunter-gatherer tribes, the Inuit, You know, the people here that live an outdoor lifestyle that are working in, you know, I, I see, I see 70, 80-year-old people in rural communities here riding around on motorcycles. Like that, that just doesn't happen, uh, you know, in Western culture. But then the reason we're in so much trouble in Western culture is that literally people don't move at all. Right? They sit all day, they're on phones, they're on screens. The media is just blasting you away. People are death scrolling, doom scrolling all day. They're doom scrolling at night, so they're destroying their circadian rhythm. They're not getting any movement. And then there's a certain percentage of those people, you know, they're, they're, they're high-level CEOs, they're running around and they're, they're either driving in their car, talking on the phone, or they're eating while they're driving. They never relax, never take time. They're exhausted during the day. They're popping things to help them focus. And then they get home, they're like, I can't wait to sleep. And then they wake up again, you know, and then they start drinking alcohol. They smoke weed to try to calm down. Yes. They, they fall into this loop where they just keep constrict, destroying their circadian rhythm, and then they wonder why they have to take GLPs and all this to, to, to basically get their appetite under control.

And they don't get consistent. They, there's no consistency in their diet. One day it's 40 grams of protein, the next day it's 90. The body gets confused. It's not sure what to expect.

Yeah.

Yeah.

I see this all the time with women. They go on some crazy 800-calorie diet for a whole week and they're just like, you know, and then they blow it out on the weekend with their friends drinking lattes and cheesecake, you know? Ate 4,000 calories in one sitting. Oh, the big problem we have.

Is that really that many in one sitting?

Oh, I've seen, you know, you eat half a cheesecake and, you know, I just did a, I just did a spinning class and, you know, or you drink those lattes with all the heavy cream and stuff in 'em and the sugars and yeah, the really fancy ones from Starbucks.

Yeah.

You can drink like a 2,000 calorie thing like really easily. And some of the cheesecakes, like you eat 2 or 3 pieces of cheesecake cuz you just did a spinning class and you feel I'm so tired. I just ran a marathon, so I'm gonna eat half a cheesecake. I mean, you can, you can put away some pretty big calories or, you know, eat a whole, like a, like a, like a giant supersized meal from McDonald's. I mean, that's 2,000 or 3,000 calories right there. So, you know, when you don't eat enough food regularly and then you basically binge eat, you can put away tons of calories. So trying to get people to step back from modern life and it's not like you have to become a monk, but simple things like getting outside, going for walks. And the thing that happened for me is when I did do a better job of taking care of myself, you know, I've had 2 mild flareups, one when we went to Mexico.

Of your, of your skin infection in your leg.

Yeah. Yeah. I had, I had 2 mild cases of sepsis/cellulitis, one in Mexico, which we were able to take care of with IV vitamin C, a mild antibiotic for about a 7-day IV treatment. And the same thing happened here. I, I had a little flare-up, wasn't anything spectacular, but I was able to do IV vitamin C again, a little bit of antibiotics and a little bit of cortisol and, and, and it took care of it. And it caught both times. I think it cost, I think it was like $70 for a week in Mexico and it was like $70 here.

Yeah.

They hook you up with an IV at the pharmacy. They don't even, what, remember we walked into the doctor's office in Mexico. I pointed at my leg and I'm like, I got this. And he is like, yes you do. What do you want to do? And I said, let's do this, this, and this. And he's like, that sounds good to me. 5 minutes later, 5 minutes later, I have an IV in my arm. And you know, like whatever we did, like 3 or 4 days of treatment. Cause that's how long we were there for.

Yeah.

Same thing here in the, here in the far, in Nicaragua, the pharmacies, all the pharmacists are nurses. So they can, they can stick an IV in you. And so I'm like, hey, I got this problem. They're like, yeah, what do you want to do about it? You know? So.

And I want to be clear, we're not belittling anyone. Both Jim and I have, I mean, I haven't had a health crisis like any of Jim's, but you know, we all live this every day and it's about once you make it a habit, once you make it your default, once you just get this set, it makes it easier. And I always tell patients, it's like the thing that is really tough for the human brain to understand about consistency is how it compounds. And the analogy I'll use is if you double a penny every day for 30 days, it turns into over $5 million. If you double a penny every every other day for 30 days, it's only $163 and change. Stop and think about the difference between $163 and $5 million. You know, it's not our brain's default reasoning to think, well, if I double my input, I'm going to, you know, 25x my output. But that's exactly what happens. And if you really stop and consider everything in your life where you've done that, if you've ever done that with anything, that's the case. Guys like Jeff Bezos, you know, who started a multi-whatever billion— I don't know how much money Amazon is worth— like, he doesn't have a side hustle. He doesn't have hobbies. The guy's all in on one thing. And whether or not you think that's great or terrible or bad, or you could care less, you ask anybody who's done something really incredible— and Jim's recoveries from both of his illnesses are incredible in my opinion, having seen a lot of cases, so I have a pretty good context and frame of reference— it wasn't just a matter of like, well, I started some nicotine patches and I took some aloe and I, you know, went out and wiggled my toes in the grass for 5 minutes and watched the sunrise for 5 minutes over a morning cup of coffee, and then went into a dimly lit indoor environment and never saw the sun again until maybe I left before sundown from work. It was, no, I completely rearranged my day. I didn't quit my day job. I didn't, you know, like give up my career. Right. But thank goodness you had the flexibility to do that. Right. But it was also not just, you know, 5, 10 minutes. It was more than a lot of people are prepared for. But it paid off in spades, right? They, they basically, by telling you that they were surprised that you were not back more often than you were, or that you've been out for a whole year, they were tacitly telling you that they were expecting you to need an amputation and eventually succumb to your illness. And we would see patients like that in the hospital on a regular basis, and it was always the same thing. They have a terrible diet. I mean, not that that was— that was not the case for you, right? But they had a terrible diet, terrible lifestyle, all that. And it was predictable. It was not at all a mystery. Right? But most people are not willing to do the work that you were willing to do.

And then some people, some people don't have to like blow up the whole world. Like I've seen people, we've seen people, they just make 3 10-minute walks and it makes a huge difference. And absolutely. This changes. For example, I unfortunately I had to put my dog down about 3 weeks ago and it was unfortunate, but it was for the best for him and for me because he was having so much time trouble walking and stuff. It was affecting my walks. And I wasn't able to do my 10-minute walks. And it was over a few weeks I'd noticed it started to affect me. I started craving alcohol more. I started craving junk food more cuz I wasn't getting my relaxation time in. So it's always evolving. This stuff is always changing. And, and your bath, your stress bathtub is constantly evolving and changing. Like for example, like performance-wise, your like maximum sprint capacity or maximum lifting capacity can change minute to minute by up to 20% in either direction. So you think about that on like a 500-pound deadlift, that's a big amount of weight. So it's the same thing with your body's capacity.

20% of a 500-pound deadlift is 100 pounds, right?

Yes. So you could come in one day, you could come in one day and try and pull it and not be able to get it off the floor. And then the next day you smoke it because that's how much your nervous system is affected by stress or whatever else you have going on, like a death in the family or whatever else it is.

Yeah.

So you're, you're constantly in this like constant adaptation mode. You just want to do as many things as you can handle to keep emptying that stress bathtub. Because the bathtub's getting smaller as you age. So you want to do the appropriate exercise, you know, get outside, all those things to make the bathtub stay as big as possible for as long as possible. But people think, oh, I'm just going to do this one thing and that's going to fix things forever. This is a constant process that you're constantly having to work on. Until you decide, the Lord decides to take you away. And the difference between the like slow descent and the drop off a cliff is, you know, how well you take care of yourself. So you can either have a nice, easy, like gentle landing, or you can like go straight down, or you can have like a miserable, like where you're, you know, getting things cut off and all that kind of stuff. I call it living longer, wronger. The body is an amazing teacher. And most of these symptoms and issues, the body's trying to teach you something. And are you present enough to listen to what the body's actually trying to teach you instead of you trying to impose your will on your body? And there are times when you have to impose your will on your body, you know, like you're in an emergency. You know, for example, when I drove down here 2 years ago, when I drove through Guatemala, I had to drive overnight. 'cause the protests were going on at the time. There was tons of, you know, protesters coming up the road during the day. The roads were blocked off essentially. And by the way, Guatemala has the worst roads in Central America. It's terrible. I hauled out all the tricks, caffeine, nicotine, some stimulants, modafinil. I have these things on emergencies for emergencies. I pulled them all out and I did it for, you know, one day because I went from 5 in the morning to one morning. Till like 10 o'clock at night the next night. 'Cause I went all the way from Mexico to San Miguel, El Salvador without stopping. But there are people that are pulling out all those stops just to function every day. Like, you know, to do that for a day or two, that's fine.

Then you, it doesn't end well if it's a long-term strategy.

No, but the, you've got people that are like, well, I'm gonna take this, you know, to fix my mitochondria and I'm gonna do methylene blue and I'm gonna, I'm gonna take nicotine and they're doing it just so they can function and keep a certain level of pace. Mm-hmm. And you know, while they're sleep deprived, while they're not getting outside, while they're not relaxing, they're basically taking an engine that isn't running well and like, well, let's just throw a turbocharger on it instead, or a supercharger instead of, if you want to put a turbocharger or a supercharger on your car, let's at least make sure it's mechanically sound at first. Right. And then And then understand that if you do put a turbocharger or a supercharger on your car, you're gonna replace your tires more often. You're gonna have to do the oil changes more often. More things are gonna break. You're gonna suck down more gas. Just understand there's trade-offs. And that's what this is all about is like getting people to understand, okay, if I do this, that, you know, there's these consequences. And then educating people on take care of all the things you can control. It's a process. It's just, uh, and, and that's the one thing I've learned is it never ends. Like I, every day is like, okay, what am I going to do today to empty my stress bathtub? And then what am I confronted with that's, that's causing a problem?

We've got to wrap it up here, but I couldn't agree more. And helping people figure all this out is what we do with practice, what Jim does with training people. If you want to get in touch with Jim, Jim, what's the best place and the best way for people to get in touch with you?

Probably just vitalitybrotherhood.com. I have a men's and women's community there. Or Instagram, which is G-Y-M-L-A-I-R-D. Uh, those are two good places to get ahold of me.

Yeah. Great. And, uh, this is what I wrote the book all about. So there's lots and lots of information in there for people who want to learn more. And it's coming out at the end of June, 2026. Jim, this has been great. It's good to see you. Thanks for catching up and dropping another podcast.

You're welcome. Anytime.

Take care, everyone. Have a great day. We'll see you next time.