When Your Gut Reacts to Everything: How to Think About Healing After You’ve Tried It All

My gut's been struggling for 10 years and some things I've tried have actually made it worse. Now I react to almost everything. How do I start healing when my body can't tolerate the very things that are supposed to help it? Good morning, everyone. Dr. Stillman here for another fun and exciting Q&A. Thank you all as always for joining me. Today's topic, when your gut reacts to everything, how to think about healing after you've tried everything. We hear that a lot in the practice. I've tried everything. And Today's question is from a young gentleman in Norway, currently out of work because of his health, spends most of his days at home in bed. Fatigue and gut issues began over a decade ago. He's tried, well, he started antibiotics for acne, which is what kicked all this off. Then he tried antifungals, probiotics, keto, carnivore, mineral balancing, all these different things. Now he reacts to fatty meals, high FODMAP foods, acidic vegetables, fruit, sugar, dairy, and gluten, and can tolerate only One supplement, even though his colonoscopy and biopsy show nothing wrong. He says, I just don't trust mainstream doctors. We hear that all the time. And he just wants to have a normal life again and to be active socially with friends and family. So we see this a lot. My heart goes out to you, whoever you are out there dealing with these issues. So the core question here is really, my gut's been struggling for 10 years and some things I've tried have actually made it worse. Now I react to almost everything. How do I start healing when my body can't tolerate the very things that are supposed to help it? We get these cases in the practice and I always just start from the beginning. How did you get this way? What have you tried already? What's worked? What hasn't worked? What made you worse? What, if anything, made you better? And then from my perspective, the only place to go with cases like this is number one, you have to make sure all of the fundamentals are in place. It's funny that I'm recording this now. You know, I had a friend who her office was next to a clear source of significant Pollution. I'll leave it at that. I talk more about what kinds of pollution are important in The End of Autoimmunity. Pick up a copy of the book. I write more, way more about it there. I also write more about it in what we call our companion resources online at stillmanmd.com/autoimmunity. Those are like other articles that I couldn't fit in the book, but I still wanted you to have because they're really important. So she had this really horrible occupational exposure. She ran labs. She had all kinds of elevated Markers for heart disease and inflammation. She's a practitioner. She leads a healthy life. She eats a healthy diet. She has a healthy daily routine. She knows a lot and she helps other people get healthy and here she is really sick, right? Well, she discovered or realized how bad her occupational exposure was because often we know that there's an exposure, but we also don't necessarily know how severe it is. She found what the exposure was or how severe it was, and she left her office. She gave up the lease. And actually left town. She completely changed her life. And all of her inflammatory markers are now trending into their normal range. She feels great. She's lost 20 pounds. This is the kind of thing that you'll see in these kinds of cases is we didn't realize there was this hidden pollutant, hidden poison, hidden irritant, hidden allergen in this person's life. Sometimes testing is the key there. You know, I've seen patients who, you know, had an allergy test showed that they were, they were reacting to something that they eat every single day. And they avoid or eliminate that food or a food additive or whatever it may be. And boom, their symptoms just practically disappear overnight. That doesn't happen for everyone, to be really clear. I don't know if that's 1 in 10, 1 in 5. I don't really care when you're talking about a disease where you have no quality of life, 1 in 5, 1 in 10 chances are worth taking, in my opinion anyway. So we get the fundamentals right, because we can't have some kind of big occupational exposure. We can't have some kind of terribly dysfunctional lifestyle. We can't have some kind of You know, horrible toxin hazard, et cetera, in the home. Again, chapter 4, my book is where I cover all this in all the detail you need and more in the companion resources if you need even more detail. Anyway, so you can't have a mistake like that in a case like this because the person's physiology is already very fragile. So you have to figure out what are all the different things that will help them to be healthy in their day-to-day life, their daily routine, their daily habits, their, and so on, right? You definitely have to go beyond the diet. You know, in this particular question, what came through was a lot about what foods and, you know, oral supplements and things like that have been tried. You'll get a lot of interesting case studies. And I include some in my book in chapter 3 of people who had a radical shift in their environment, like my friend, for example, I just mentioned, and the radical shift in their environment then gives them different wavelengths of light, different types of food. I mean, you know, people will often make the comment, the food in Europe doesn't set off their allergies or their GI issues the way that the food in America does. Why is that? This is hard to quantify, hard to pin down. There's many different factors, but just these little things matter in a case like this. So then what do we do beyond the simple fundamentals and making sure that there's nothing glaringly wrong with their diet, lifestyle, daily routine, et cetera, et cetera? Well, then we go on to more advanced things. So something I saw that was funny to me this morning was a friend of mine who I have great respect for, by the way. She's a coach and she posted something about, you know, vitamin D and She lists all the benefits of sunlight, and then she just lists that the synthetic vitamin D pill will give you synthetic vitamin D. I happen to be a great enthusiast for high-dose vitamin D therapy because I didn't used to use vitamin D at all. Then I kept hearing from mentors, you should use this. You will see better results. I started to use it and I was actually rather blown away by the difference in the patients who took high-dose vitamin D versus not. Now, what do I mean by high dose? I will start patients usually at 10,000. In our immune wellness program. And that means that if they have a serious allergic problem, which we often see, or they have a serious autoimmune issue, I will usually go to a 10,000-unit dose. And then if there is a rationale, like I can see in the literature or from prior case studies or, you know, from case series, and there's been many of these done, not as many as I'd like, but there's some diseases, psoriasis, multiple sclerosis, very prominently have a very strong foundation in the literature for the use of high-dose vitamin D therapy. Yeah. We'll put patients on, you know, 1,000 IU per kilo or more, which if you do the math is like 86,000 units a day. Don't try this at home. You need physician supervision. We trend these patients' labs. They have to restrict calcium so that they don't become hypercalcemic and cause kidney damage or create some other kind of complication from hypercalcemia, which by the way, can be life-threatening. So again, don't try this at home, get physician supervision. But I just mentioned this because you'll see in this wellness world of, well, I feel like I've tried everything. You've probably tried everything that people, or you may have tried everything that people talk about and write about, but there's more than that that's available by prescription only, or only with careful monitoring. And in these tough cases, we've just had some really life-changing results when we've used things like high-dose vitamin D or off-label drugs, which I also write about in the book in chapter 6. And my high-dose vitamin D guide is coming soon. It's really good. It would be the kind of thing to print out and take notes on if you were going to take it to your doctor and do it yourself. Or of course you can become a patient at our practice and we're happy to manage your high-dose vitamin D for you anyway. Before I get any further and forget, drop your questions in the comments. I will answer them as we go. And then also, if you would like, you can ask me a question to answer on one of these lives. The link is below and you can book an evaluation with a member of my team to join our practice. All right. So when years of gut and energy problems follow a long course of medication, how should you think about what's really happening in your body. So I talk about this in chapter 1, where I talk about repair deficit, the fundamental concept behind modern disease as I view it. What happens with medications in the body depends largely on the medication class. With antibiotics, what you're seeing is an effect on the gut microbiome in most cases. Now, the microbiome then has this very complex interplay with the immune system. And so changes in the microbiome can result in changes in immune function. You can also get with antibiotics, you know, bad bacteria or pathogenic bacteria will grow back after a course of antibiotics sometimes. So you'll have to treat with another course of antibiotics. Then you'll want to use probiotics and prebiotics in order to make sure that the right microbiome flourishes. All of that, by the way, and this does not get enough attention, I think, you know, your microbiome, your gut health, it all actually ties back into your circadian rhythms and your environment, your light environment, your energetic environment. So you'll get stories from patients like, I started taking 3 10-minute walks, which we recommend in general, and I stopped having issues with my gut, or they improved somehow, right? So that's really important. The other thing you'll see with meds is that they have often underreported effects on different organ systems. Now, in my daily work, that usually means the immune system. And so what you'll find in some cases is that the drug that's being given can create Immunological dysfunction. Usually this gets labeled as drug-induced autoimmunity. You can get drug-induced lupus, drug-induced arthritis. We just recently saw an issue of drug-induced skin autoimmune skin condition that was very debilitating for the patient. And it actually required, they happened to find the link because it was a rare drug association. But now we routinely screen all the drugs that patients are on in the practice so that we make sure, okay, did we potentially miss anything that could be contributing to their problem? And then if there is something that's contributing to their problem, And can we taper it or completely discontinue it? So anyway, that's how I think about what happens to the body after a medication makes someone worse. They can have these very interesting effects on your physiology in general. And then getting out of that scenario, which we see a lot, can take a lot of tinkering, a lot of day-to-day modifications to your diet, your lifestyle, week to week, month to month. And then, you know, we rely of course on serial lab testing in those cases. All right. Why can one event seem to break or totally disrupt a gut that was already fragile? And what does that tell us about the person's clinical This really depends. If something like, for example, coffee enema really makes someone worse, I think there's a question of could they have had an actual allergy to the coffee? Now, if the, and I know that might sound weird, but we do occasionally get people who really have severe reactions to coffee that are not just bread and butter caffeine withdrawal, because of course we know what that looks like and their degree of symptoms just doesn't correlate with that. So first of all, there's the allergy piece. Then there's, but that's the question there, I think is usually allergies or an allergic response or some kind of sensitivity as well, which is different from an allergy for the record. Those patients will usually bounce back pretty quickly. If you have a scenario where there's lasting dysfunction or symptomatology after something like a coffee enema for days, weeks, months, then it begs the question, did it do something else to the system? I've never heard of that actually happening with a coffee enema, but it doesn't surprise me that it's possible. That I would have to really dig deeper into on a, on a case-by-case basis. But where I would start is everything I said earlier. What are the fundamentals? What's going on in this person's life and how can we fix those? And then how, what might we use that's more advanced as a therapeutic to help them improve? How do you make sense of normal biopsy results from colonoscopies or endoscopies? We actually hear this all the time from patients. My biopsies are normal. No one knows what's wrong with me. Just as often we'll get the story of my biopsies show XYZ pathology and the treatment is this drug and they really have nothing else for me, but I'm frustrated by this because I want more in terms of my diet and lifestyle that I can do that will have a meaningful impact on my life and wellbeing. Now, we always come up with a comprehensive program of care for patients with that. It's always along the lines of what I write about in my book, because here's the reality. All of the habits that make you healthy and help you live a long time are also the ones that help you to have a balanced, healthy stable immune system. And so incorporating those right away is one of the first things that we focus on with our patients that we talk about very frequently because of that. When biopsy results come back as normal and someone can't make sense of all their symptoms, what do you do? You start with those fundamentals. You make sure that they're all in place. I call them the essentials in my book, but I would also throw in with that, you know, the hazards and the principles, which is chapters 2 and 4. So there's a whole lot that we cover with patients. And again, it's in the book. So pick up a copy. It's great. By the way, for a limited time, if you book an evaluation with a member of my team, we just ship you a copy of the book. So it's actually a great opportunity to get a copy of the book and get our take on your case. And we're also currently piloting a 90-day plan for people who book an evaluation, which I'm really excited about. It shows you exactly from our framework, the exposures and risk factors that you have for whatever illness you're dealing with. And, you know, we can link back to the literature to those, and the links are in the book and in the companion resources. Because patients often come to us and they say, well, what's, what's the most likely cause? This is a really simple way for us to write it down and send it to you. I love this new feature of our evaluations, but anyway. So how do we deal with it beyond that? That's when we start to get into, well, what could it be? Or what have we seen before that's responded well to this, that, or the other treatment that we've used that's more advanced? And that goes back to things like high-dose vitamin D, off-label drugs, things like that. Okay. Next question. What's the difference between trying to fix a single injury and understanding the whole system that's struggling to Recover. I always view the system holistically, for lack of a better term. I mean, I guess that is exactly the right term. I never view organ disease and symptomatology in isolation. It's always part of a bigger picture. And usually what will happen is that when you take a careful history, which of course we do, you will find that patients have way more than just one complaint. They just often don't either have the time to bring it up to a physician, or they weren't even sure if it was an illness, or they weren't even sure if it was, you know, anybody sure if it was an illness. I mean, they weren't sure if it was abnormal. Hopefully that makes sense. Why haven't antifungals, probiotics, and special diets given lasting relief, even though each one seemed reasonable at the time? We see this a lot with patients who've come in. They say they've tried everything. That includes all the things I just mentioned and more. So what we see overwhelmingly is that something's been missed in the essentials or hazards or principles, chapters 2, 3, and 4 in the book. And if we tackle those, a lot of things will get better. Now I've mentioned today in particular, a lot of off-label drug use, high-dose vitamin D. I want to You know, rewind and also mention that we often don't get into any of that with patients. And what we find is that if we give them the right complement of vitamins and minerals for their unique biochemical context, their labs, their case, what they've already experienced, and we'll adjust these things based on, you know, I'm sensitive or I reacted to this in the past, or I reacted to that in the past. And then we'll look at the labs. And so we come up with a very comprehensive and very personalized supplement protocol, just that gets most patients to where they want to be. Now I'll be clear, most of our patients are not this sick. So in these cases, I hope that what we're going to do is going to get them that kind of improvement. And I'm always prepared when it doesn't, and I always expect to have to go in and do more. We always start with the same program of care because it's generally speaking so effective. So why are the minerals and the vitamins so important and why are they so foundational? And why do I lead with that before antifungals, before probiotics, before special diets? To be fair, I will sometimes recommend a special diet along with the minerals and vitamins, but generally we use a very simple and also very practical approach that most people like. It's in my 14-Day Reset, which is available at drstillmanuncensored.com. Just search for 14-Day Reset. That diet plus the minerals we use usually gives people the nutrition they need to really feel well. And recover their health and their vitality. Why do these things fail so often? Often it's because there's something in the environment, the lifestyle, the diet that is so wrong. And it could be, again, a sensitivity and allergy, occupational exposure, chemical that you're not aware of that you're being exposed to. We've seen well water poison people. That comes to mind for some reason. Something hasn't been addressed over there, or you've tried all these different things, but none of them were the right thing for you. And if we find on testing, something interesting, we may find, aha, the next thing for you is this. And I'm going to leave that at that because most of the therapeutics we do in the practice, I just prefer— there's a lot of complexity there and I prefer to just not talk about them on social media for many reasons. Okay. I cover this all, and by the way, in chapter 2 and also 3 and 4 and 5 and 6, I guess, to be fair, they're in the book. That's what I got for you guys today. Thanks for joining me. Take care, everyone. Have a great week.