Autoimmune Disease with Dr. Holly Lucille: Rational Wellness Podcast 94
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Dr. Holly Lucille discusses Autoimmune Diseases with Dr. Ben Weitz.
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5:08 Dr. Lucille explained that she has become more interested in treating autoimmune diseases because more patients with autoimmune diseases have been walking in her office door. And she has found that the simpler, least invasive methods that in the past would really help patients, like simple diet and lifestyle recommendations, are not working as well anymore. These tend to be more complex patients.
6:45 Dr. Lucille said that women are more affected by autoimmune diseases (75% of patients with autoimmune diseases are women) because the androgenic hormones in men, like testosterone and DHEA, are somewhat protective.
9:18 In the US 90-97% of patients with hypothyroidism have Hashimoto’s (autoimmune) Hypothyroid. Most MDs and endocrinologists do not run the thyroid antibodies (TPO and TGB) to confirm this because they have no ways to treat it, other than putting patients on thyroid medication like synthroid. If the autoimmune component is not also treated, they are more likely to have autoimmunity against another organ, such as their ovaries. This can lead to premature menopause. One controversial situation is when you have a patient who has elevated thyroid antibodies and elevated TSH, though normal T3 and T4 and no symptoms of low thyroid. The elevated antibodies is telling us that there is an autoimmune condition that we can try to get under control before too much damage to the thyroid gland occurs and they need thyroid medication. Dr. Lucille mentioned that food sensitivities, infections, medication, poor food quality, poor air quality, and poor water intake are among the triggers for autoimmune thyroid. You have to take a careful history and probe what potential environmental exposures they might have, such as mold or other toxins. We also have to look at gut health, since leaky gut and bacterial or fungal dysbiosis can be underlying factors. And then you have to do some of the good Functional Medicine testing to confirm your suspicions.
18:08 With a patient with autoimmune thyroid, if there is nothing suggestive in their history of environmental exposures, Dr. Lucille will look at vitamin D levels. She will also look to see if there is an Iodine deficiency, since Iodine is needed to produce thyroid hormone. And other halogens, like flouride, bromide, and chlorine can all block iodine from working properly, so you need to try to avoid these. If you do give iodine, too much can spur an autoimmune reaction, so she prefers starting with 100-200 mcg and not the higher milligram level advocated by some Functional Medicine practitioners. You must also make sure that there are sufficient antioxidants, like selenium, since the production of thyroid hormone from L-tyrosine and iodine produces a lot of free radicals. Dr. Lucille also likes to test inflammatory markers like CRP (C reactive protein) and Homocysteine and she has started to use the cytokine panel from Diagnostic Solutions, CytoDx, which measures the TH1:TH2 balance.
23:10 If Dr. Lucille is concerned about a possible food sensitivity in a patient, she may just tell them to eat gluten free for 60 days or follow an Autoimmune Paleo diet. If they are someone who likes to see the data, then she may run some food sensitivity panels. Such test results can help with patient compliance and adherence, which is stronger than compliance. She finds such data helpful, but it is expensive for the patient. She may have them start following a modified blood type diet from Dr. D’Adamo which may help them avoid foods that they are reacting to as well as junk food.
27:07 If you suspect a patient may have exposure to toxins, you need to teach your patients to avoid further toxins. She relies on the EWG.org website from The Environmental Working Group to figure out which skin care, health and beauty aids, and cleaning supplies do not contain toxins. You have to stop exposing yourself to the toxins and then you can start to detox yourself. She likes to start by opening the emunctories by supporting the liver and the detox pathways and also using movement, saunas, steam, and getting hydrated. The emunctories are the pathways and organs which help us eliminate waste and toxins. You want to make sure the patient is pooping and urinating and sweating and even crying can be good. You want to support the gut, the liver, and the kidneys nutritionally.
29:00 When we get exposed to toxins like mercury and other heavy metals, what happens is the immune system reacts to the toxin like the heavy metal, and then it will find a protein in the body that looks similar and then it cross reacts and attacks that organ. This is how autoimmune diseases get started. Dr. Lucille discussed a case history of a patient who had Hashimoto’s had high mercury from eating fish that came up on a NutrEval panel. She had the patient avoid sushi and use The Detox Qube from Quicksilver that includes liposomal glutathione, lisosomal vitamin C with Lipoic acid, and silica binders.
33:48 Stress can dysregulate the immune system and play a role in contributing to autoimmune diseases. Dr. Lucille explained that she asks patients to do You Musings in the morning and a daily autopsy at night.
37:07 Dr. Lucille will sometimes recommend the following supplements for patients with autoimmune diseases: 1. Vitamin D, 2. Essential Fatty acids, 3. Curcumin, 4. Resveratrol–200 mg twice per day, and a good gut protocol such as the 4 R protocol. Here’s an interesting paper on resveratrol for autoimmune diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748756/ Resveratrol Role in Autoimmune Disease–A Mini-Review.
Dr. Holly Lucille is a Naturopathic Doctor and can be reached through her web site, http://drhollylucille.com/ and she is available to see patients at her office in The Body Well at 7235 Santa Monica Blvd., West Hollywood, CA 90046 by calling 323-658-9151.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com.
Dr. Weitz: This is Dr. Ben Weitz with the rational wellness podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to rational wellness podcast on iTunes and YouTube and signup for my free ebook on my website by going to Dr. Weitz.com. Let’s get started on your road to better health. Hello Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness podcast, please go to iTunes and give us the ratings everyday. That way more people will find the Rational Wellness podcast. Our topic for today is autoimmune diseases with Dr. Holly Lucille and how to treat them with a functional medicine approach. Auto immune diseases have been on the rise for at least the last four decades and they are between 80 and a hundred different autoimmune diseases and at least 40 other diseases are suspected to have an autoimmune basis.
According to Dr. Thomas O’Brien, if we include diseases that have an autoimmune basis, autoimmune diseases are the third leading cause of death in the United States. Since most of these diseases are chronic and often life threatening and in fact, if we include heart disease as a autoimmune disease, autoimmune disease probably is the number one cause of death. Some of the more common autoimmune diseases include Alzheimer’s disease, Parkinson’s, asthma, Hashimoto’s hypo thyroid, rheumatoid arthritis, Lupus, psoriasis, alopecia, Crohn’s, multiple sclerosis and Type I diabetes. Our immune system is designed to protect us from bacteria and viruses and parasites and to protect our tissues from damage that occurs on a regular basis. What happens in autoimmune diseases is that our immune system becomes dysregulated and it starts to attack our own cells and organs. The conventional medical approach is to treat autoimmune conditions either by controlling the symptoms, such as providing thyroid medication in the case of Hashimoto’s thyroiditis, or by using medications that suppress the immune system such as corticosteroids, chemotherapy agents, or the newer, injectable TNF Alpha blocking agents like Humira and Remicade, which are in very common usage today. These drugs simply block part of the immune system and this is a problem because you do need a properly functioning immune system and these drugs have potential side effects like infections and cancer. But Functional Medicine in contrast treats autoimmune diseases by trying to look at the underlying factors that lead to the immune system getting dysregulated. These include leaky gut, food sensitivities, toxins, infections, nutritional deficiencies. This is very important. If I have a patient with Hashimoto’s hypothyroid and most women in the US with hypothyroidism have Hashimoto’s and all this patient is treated with is with thyroid medication, which don’t get me wrong is very helpful. It doesn’t do anything for the smoldering fire of the autoimmune disease that has been attacking the thyroid gland. And chances are that will continue. The patient may need higher dosages of thyroid medication over time or they may end up with another autoimmune disease. So not just regulating the thyroid but also putting out the smoldering fire of autoimmunity is crucial for this patient’s long term health. And that’s something that we want to discuss today. Dr. Holly Lucille is with us today. I’m very happy that she’s here. She’s a Naturopathic doctor, a registered nurse and a nationally recognized educator, national products consultant and TV and radio host. She’s the author of several books, including Creating And Maintaining Balance, A Woman’s Guide to Safe Natural Hormone Health and The Healing Power Of Trauma; Comfrey. Dr. Lucille is the host of the popular podcast Mindful Medicine and she’s in private practice in Los Angeles. Dr Lucille thank you so much for joining us Today.
Dr. Lucille: It is my pleasure always. I’ve never thought about this as much as I was thinking about this when you were talking about, I love the name of your podcast. It just makes so much sense.
Dr. Weitz: Cool. Thank you.
Dr. Lucille: Yeah. Rational Wellness.
Dr. Weitz: We’ve had a few challenges getting started today and of course just as got started, one of my lights went out, but …
Dr. Lucille: I’m sure it will be epic.
Dr. Weitz: So how did you become interested in treating autoimmune diseases?
Dr. Lucille: You know, Gosh, like I have become interested in treating anything else, if my practice informs me. My patients inform me, I mean like you, I hold a license to practice medicine and I need to have continuing education credits each renewal period and certainly get those and more and always continuing to learn. But I have to tell you what I have to pay attention to and what gets my attention most is what walks through my door. And then as you said, in the last decade, for me, I have seen it, the increase of people walking in actually diagnosis in hand, right? So they’ve already been through the conventional, Western, reductionistic process and they’ve been diagnosed with one, two, maybe other autoimmune diseases. Or I’ve got these more complex cases that with the least invasive methods, I’m used to using all throughout at my last 20 years in my career that could really get people far in their wellness and healthcare desires aren’t working anymore. So I’m thinking, “Hey, what’s going on?” And more and more those folks, we’ve ended up diagnosing with one autoimmune disease or another and having to get in there and treat and identify the causes of those. So it’s really been my practice that has informed me to get started down this sort of Naturopathic, Functional Medicine, comprehensive overview of helping people with autoimmune diseases.
Dr. Weitz: Why do you think women are so much more affected by these?
Dr. Lucille: Yeah, it’s true. I mean more than 80 immune mediated diseases that we looked at and seven in a 100 people aren’t affected. 25% of men, 75% being women. And I don’t think that we know all of those answers. I know that there are some associations with the X chromosome when it comes to sort of a genetic predisposition where a certain excellent gene appears to be critical and then I think on the other side, testosterone, if we look at it, it reduces the number of B cells, which is sort of, that type of lymphocyte that releases those harmful antibodies. So we’re maybe looking at more protection for men because of their higher levels of an androgen like testosterone.
Dr. Weitz: Oh, interesting. I was thinking that maybe estrogen was a factor in this.
Dr. Lucille: Yeah. Not so much as being protected at all. I think we’re looking more at being able to in treating, looking at optimizing hormones, especially the androgens when we’re looking at DHA and testosterone. That’s what my clinical assessment has been.
Dr. Weitz: Interesting. I’ve really been enjoying this discussion, but I’d like to pause for a minute to tell you about our sponsor for this podcast. I’m proud that this episode of the rational wellness podcast is sponsored by integrative therapeutics, which is one of the few lines of professional products that I use in my office. Integrative therapeutics is a top tier manufacturer of clinician design, cutting edge nutritional products with therapeutic dosages of scientifically proven ingredients to help our patients prevent chronic diseases and feel better naturally.
Integrative therapeutics is also the founding sponsor of Tap Integrative. This is a great resource for education for practitioners. I’m a subscriber to Tap Integrative. There’s videos, there’s lots of great information constantly being updated and improved upon by Dr. Lise Alschuler who runs it. One of the things I really enjoy about tap integrative is that it includes a service that provides you with full copies of journal articles and it’s included in the yearly annual fee. And if you use the discount code Weitz ,W-E-I-T-Z, you’ll be able to subscribe for only $99 for the year. And now back to our discussion,
Dr. Weitz: Let’s talk about Hashimoto’s hypothyroid and what percentage of patients in the US who have hypothyroid have autoimmune disease and when you’ve seen some of these patients, what do you find in some of the more interesting triggers for this?
Dr. Lucille: Yeah, so depending on the reference that you look at from looking at all of the Americans that have hypothyroidism, you’re looking at 90 to 97% of them having an autoimmune related hypothyroid, Hashimoto’s. And it’s interesting and I’m sure you’ve had this conversation and I’ve had this conversation with many esteemed endocrinologist in wondering if those are the stats. “Hey, why don’t you run antibodies TPO, thyroglobulin, why?,” and their answer I think from their scope of practice is quite good. It’s because they wouldn’t change their treatment.
Dr. Weitz: Right.
Dr. Lucille: So if you’ve got a high TSH, relatively low T-four, which is pretty much all that they’re going to see, you’re going to be diagnosed with hypothyroidism and then given a thyroid replacement therapy, most likely Synthroid or what have you. And of course our argument is, okay, as you said in your introduction, that’s great. We can get TSH within normal limits again but we’ve got this raging fire of inflammation behind us that I don’t believe the symptoms are going to stop for that patient just because the TSH is within normal limits. And also that autoimmune disease can continue on. And I’ve seen it way too many times and I’ll tell you where with women, and we don’t really have a test yet for this, but pretty much sure. And I say that clearly, premature menopause because their ovaries end up being affected. Another gland being attacked by the patient’s own immune system and I’ve seen it over and over and over again in my untreated Hashimoto’s patients.
Dr. Weitz: Interesting. Yeah, no, it’s true. The average patient who goes to their medical doctor doesn’t get the thyroid antibodies measured. They basically just look at TSH and that’s all they really focus on.
Dr. Lucille: Yeah.
Dr. Weitz: I have found a number of patients who had elevated TPO antibodies and actually didn’t have symptoms of thyroid disease and I always find this an interesting phenomenon and I feel as Functional Medicine practitioners, one of the things that we can do is try to prevent some of these autoimmune diseases and if we can see some of these autoimmune markers happening, what it’s telling me is that there is this underlying smoldering fire and maybe now we can put it out before their thyroid gland gets so destroyed that they actually need thyroid medication.
Dr. Lucille: Yeah. It’s a tricky thing with, I always say you can’t treat lab tests. You have to treat people. But in this situation, if the patient isn’t really presenting with overt symptoms, you have to look at that lab test and go, “Huh, is this an earlier stage of the disease appearing? Is this something that could be prevented?” And I would say yes, because the other thing too, which I’ve found very interesting in the patients that I could get a hold of their labs all the way back, is that if you think about, if that thyroid starts to get attacked, and of course we remember that at the thyroid level is where the thyroid hormone isn’t made. Okay. T4 is inactive, we have pro hormone almost. We haven’t really identified a receptor for it. We have four months of stored T4 in our thyroid. So at first if you catch it early, and I’ve seen this, you got that T4 being released in flush into the bloodstream, converted into T3 in the peripheral tissues of course. And you’ll actually see a hyperthyroid that almost and you catch it early it’s Graves’ disease honestly. But that subsequent attack over and over again, you’re going to start seeing a decline in the hormones being produced. And also, of course, your blood work is going to then start showing. But I think when we look at thyroid as a whole, if a patient is having any abnormalities in their blood work, they are already in dire straits from a tissue perspective. It’s been going on for quite some time. So I think the biggest take home is when we’re looking at thyroid health and we think about metabolism, aerobic and anaerobic in every single cell in our body. It’s so important to know that it’s not a numbers game and look at it very comprehensively certainly those lab tests, especially if they’re not presenting with overt symptoms and you still got those antibodies on the rise, that is a great opportunity. Prevention is always the cure.
Dr. Weitz: So what are some of the triggers for autoimmune diseases for thyroid and others?
Dr. Lucille: Okay, so just think about it. Certainly, there’s a genetic predisposition I’ve seen for sure, environmental influences, you think all the way through, food sensitivities, infections, medication, poor food quality, poor air quality, poor water intake. There’s so many contributing factors and that’s really the key I think is to help identify what are the contributing factors that are stirring on the body’s ability to attack itself.
Dr. Weitz: So when you have a patient that presents in your office and they have some indication or symptom of a autoimmune disease. How do you work that through? How do you decide it, try to figure out whether it might be a food sensitivity or a chemical toxin exposure or an infection, a mold exposure. How do you work that up?
Dr. Lucille: Yeah, it’s a lot. I mean it’s tricky, but I think that with Functional Medicine and in Naturopathic medicine, we’ve got all the tools and I do think it first starts with that clinical acumen. I mean here you and I live in the Los Angeles area and we just had four or five days of straight on rain and thankfully because we need it so much, but I have to tell you the buildings that I had been in in the past week or so, a lot of people are exposed to mold and that is an infectious agent. If you do not identify it, it can continue to contribute to a chronic autoimmune disease. So getting that history from a patient, looking at their environmental exposures, drilling down into that specific part of the case is extremely important because we’ve been … if you’re 30, 40, 50 years old, you’ve been living on a surfer, that time had been beat up a little bit because of our increasingly toxic environment. And so that is just a place where you do that investigation. And of course the way that I played in my practice is my clinical hypothesis is so important and for everybody it’s individualized because everybody comes with not only different genetics, different biochemistry in a sense, but also their different histories.
And then we’ve got these incredible Functional Medicine labs to confirm our clinical suspicion. So as I said before, at least invasive methods to diagnose and treat. And I used to get away with a lot less and it helping people sort of clean up their diet a little bit, get moving a little bit more, open the emunctories and it’d be amazing, right? The outcomes from a clinical perspective, not to work really hard to drill down and understand all of these environmental triggers, but also there’s gut health and we can talk much more about that cause that’s extremely important when we’re talking about the immune system. So the testing I think is really important and also that good clinical acumen taking that case history, especially if you are at all suspicious of an autoimmune condition.
Dr. Weitz: Yeah. Alessio Fasano, one of the experts in autoimmune diseases, he talked about having this triad where you have food sensitivities and you have leaky gut is being a major factor. So there’s no doubt that gut health is super important for …
Dr. Lucille: Oh, you think about it because I mean you’re looking at 70% of the immune system, the gut associated lymphatic tissue. We’ve got our stomach acids, we’ve got these tight junctions. When there’s any amount of dysbiosis, whether it’d be a bacterial dysbiosis or fungal dysbiosis, you know those tight junctions get a little bit more loose because of those endo toxins that are produced. And then we’ve got larger protein molecules getting into our bloodstream. Our immune system is like, “Hmm, what are you doing there?” And what does it do? It mounts a response, exactly what it’s supposed to do, but if that continues on that it’s gets chronic. And I think that’s a huge underlying cause for autoimmune diseases.
Dr. Weitz: So let’s say you have a patient in your office and there’s no obvious cause. You go through their history, they don’t tell you anything suggestive of mold exposure. Of course it could be they think they’re sort of okay with gluten and there’s nothing obvious. What direction do you go? Do you do a stool panel? Do you do serum lab work?
Dr. Lucille: Yeah.
Dr. Weitz: Urine testing. What direction do you tend to go to? And I realize there’s intuition and other things that go into this.
Dr. Lucille: Yeah. So I look at other common contributing factors like vitamin D deficiency. So I want to make sure I’m checking that out. Iodine is really important because Iodine deficiency I think is a contributing cause to autoimmune disease, especially Hashimoto’s, but very controversial subject because if you have Iodine deficiency, what do you have? You have, because Iodine obviously T4, T3, we’re looking at Tyrosine the T part and the three or four being iodine molecules. And if the iodine deficiency is there, you’ve got these little friends that hang out on the periodic table, the other halogens that are toxic, that can come in and search, create and stimulate this immune response.
Dr. Weitz: For example fluorine.
Dr. Lucille: Yeah. Bromides, chlorine, all those things. And so I want to understand that I will jump to treatment because I have seen if you give iodine, it can spur on an autoimmune reaction. But in my clinical experience, the way that I get around that is to make sure that the free radical load is down, the antioxidant status is up, especially with selenium. Once that I’m assured that is happening, I can start successfully putting iodine on board and watch those antibody numbers and they continue to go down. So that’s my quick tip right there.
Dr. Weitz: Are you talking about modest dosage, like 100, 200 micrograms or you’re talking about milligram dosages like some practitioners recommend?
Dr. Lucille: Well, I definitely start slow because we’d want to watch the antibodies and obviously there’s been some controversy and I do think that dosing iodine, heavy doses of iodine can be more harmful to Hashimoto’s if we’re not doing it in the correct way, which I think is that antioxidant status needs to be preserved first. And so then I start very, very slowly go up and watch the antibodies. But you know the other things too, I’ll run inflammatory markers, certainly C reactive protein, homocysteine. That’ll give me an idea if I should do more genetic testing. You had mentioned a great lab. It’s fairly new, the test for Cytokines, I think it’s the CytoDX from Diagnostic Solutions. That’s a nifty nifty serum blood test.
Dr. Weitz: That tells us about TH one TH two balance, which is an important factor in autoimmune disease. Talk about that.
Dr. Lucille: Absolutely. I mean that’s the fun thing about sort of thinking through this and the way that we do is that there’s always a balance and there’s a balance with the immune system. Those pro inflammatory cytokines are important because they’re going to react if we need them to. But I think what happens is once it comes out of balance and those TH1 mediated cytokines which we see all the time, elevated and autoimmune diseases, they just take over. So our goal is to understand that imbalance get things on board that we can actually balance that out and quell that inflammatory response.
Dr. Weitz: For those listening who aren’t familiar with the importance of iodine. I just wanted to clarify a few points in sort of the history of hypothyroidism in this country is, we used to have commonly people would have hypothyroidism from iodine deficiency and they would get an enlargement of their thyroid called the corridor. And there were parts of the country in the Midwest called the goiter belt. And then we started adding iodine to the salt. It was a nationwide supplementation program to take care of this. And interestingly rates of hypothyroidism from iodine deficiency plummeted, basically went to super, super low levels, but then autoimmune thyroid took off. And we’d seen the same phenomenon in countries around the world where they went from having Goiter causing hypothyroid to supplementing with iodine and then autoimmune disease taking off. And so iodine is super important in your body making thyroid hormone and part of the process stow in making thyroid hormone is that it produces a lot of free radicals and those free radicals cam create problems. So you were mentioning taking antioxidants to help quell that if you’re using iodine. Okay, so let’s go back.
Dr. Lucille: Nice clarification.
Dr. Weitz: Let’s say you’re working up a patient and you think they might have some food sensitivities. What approach will you tend to take? Will you either one, say “Let’s just cut out gluten, dairy, soy, do an elimination diet,” or will you use one of these panels to look at food sensitivities from Cyrex or when these other labs, what do you think is the best way to go about this?
Dr. Lucille: Yeah. You know, and I hate to keep coming back to this, but it’s just the gosh darn truth in my practice–is everybody’s so different. There are people that I can say, “Listen, I need 100% gluten free for 60 days, and I’d like you to go on an AIP.” So an autoimmune sort of Paleo type diet. And they’ll do that. They’ll do that sight unseen. They don’t need to see a test. They don’t need to see whether it’s acute allergies that they might have. Even these delayed sensitivities. If I do food allergy testing, I like to do at all just to get that in their IGG, IGA, IGM, all of it. But some people were okay, just let’s clear things out.
If we choose to do, because also and people don’t pay me to mind their pocket book. But when this is a chronic case and there’s a lot of different things to suss out. We’re looking at, I did a talk, Ben, I’m sorry I’m interrupting myself. But I did a talk a couple of weeks ago in Hawaii called Superpower in your patient self care. And my whole talk was centered around the idea that I end up teaching in my practice all the time, because Docere right? Doctor in Latin means to teach. Here take this, like as you said, Humira. Here take this is easy, easy medicine when it comes to an autoimmune disease. You get that prescription, you take it down, pay your copay, open that bottle up. It’s easy medicine. What we ask people to do when we’re trying to excavate and identify and treat the cause and have an outcome of being able not to shed this diagnosis and not have this be as chronic or as debilitating and as life threatening and it can be, it’s not easy and it’s not inexpensive sometimes. And so I’ll also take that in mind. I mean if money wasn’t an issue, I think I would love all the data in the world because then I’d have it, I let my patients see it. We could connect the dots together. They could have more of an adherence. Compliance is like, “Yeah she told me to do this.” Adherence is a faithful attachment to something and I have those patients that just need to see it. So if they need to see it, I’m going to run it, I’m just going to get that data so we have it, so they know it and they can be more motivated.
Dr. Weitz: So what you’re referring to in case there’s some patients who are listening who aren’t familiar with this, is there are a bunch of Functional Medicine oriented labs that are available. And except that they tend to be fairly expensive and they tend to be out of pocket. So it’s not unusual to run a big panel of food sensitivity tests. It’s very comprehensive, but it could cost 1000 bucks and it won’t be covered by your insurance. And so patients who are used to just paying a $20 copay and getting all your lab tests done might come as a shock. People who are used to the Functional Medicine world would understand though.
Dr. Lucille: I have to say this because I’ve been using it clinically. With a certain amount of success, whatever I’m doing to get started. And if we are collecting more data, I will have people sort of just following a modified blood type diet, kind of just really not their food sensitivities by avoiding their avoid foods based on D’Adamo’s work. It gets us started, it gets us started cleaning up the diet, excavating certainly process students because that’s what it does. Gluten for sure. So we’ll get some parameters on board first and wow, we’re getting more data.
Dr. Weitz: Yeah. Interesting. So let’s say you have a patient and you suspect maybe they might have some exposure to toxins. How will you try to suss that out?
Dr. Lucille: Yeah, so, certainly we want to avoid any other exposure. So a lot of education on all of that. I mean, I always use ewg.org. environmentalworkinggroup.org as a resource as you do for my patients because it’s all right there when it comes to the things that they put on their skin, health and beauty aids when it comes to the cleaning supplies. So that dossier, the education and avoiding exposure is primary. We’ve got to stop at whatever the offending agent is. And then of course you have to an on the way that we talk about it, open the emunctories, we have to get those detoxification pathways really cranking. That’s extremely important. We’ve got to start helping to get things out that might have accumulated and that are continuing to contribute to this sort of-
Dr. Weitz: For those of us who aren’t familiar with the emunctories can you explain?
Dr. Lucille: Yeah. So when we think, so among Montreal, this is an old word. It’s where we get things out. So if you think about detoxification and how we get out toxins, it’s your defecation, is through urination, is through perspiration. I mean heck, even a good cry, right is emoting, is can be very detoxifying. So this is where we want to look at the detoxification pathways and of course the gut is involved in that too. Liver, very important and all of the nutrients that drive the cytochrome P 450 pathways in the liver to do that, supporting those and as well then movement, Saunas, steam, like I said, staying hydrated, very important.
Dr. Weitz: For those who aren’t familiar with the concept, if we get exposed to toxins, let’s say you have mercury from eating fish or I just heard about a new test from doctor’s data that looks at heavy metals from a metallic implants, which is kind of interesting that a lot of us are as, as we’re getting older or getting knee replacements and other joint replacements and we’re told that they’re using titanium and other substances are totally not a problem with it. Turns out that of these metals are getting into our system and creating problems. What happens is your immune system detects that there’s this toxic near and then there’s just cross reactivity. So what happens is immune system that’s attacking the metal then recognizes some protein in your body that’s maybe in your thyroid gland or your liver or somewhere else and it starts attacking that organ. So that’s how we end up with these autoimmune diseases from exposure to toxins.
Dr. Lucille: Yeah. Then there’s two cases that comes to my mind when you’re talking and this is the art of medicine, right? This is a process that we go through but one of, I mean she loves her heart riddled with them. A couple, she walked in with Scleroderma and as well as Hashimoto’s and I’m thinking, “Whoa, what is going on here when into genetic panel.” Just because we’d had some genetic family history with her, but guess what? Their family own dry cleaners all throughout the Santa Lucia, after school, where would she go? What was her first job? She had solved the exposure. Entire growing up years.
That was huge. Another woman where when you get this down, it’s great because you can start to see people get better and your antibodies come down. Because once again, if we’re looking at Hashimoto’s, you and I are not just looking at the TSH. My metric is those … Well, my metric is the patient has to start feeling better. That’s number one. Number two, we want to see those antibodies come down because we want to see that the fire is not like raging, that it might just be there still and we can do things to put it out. Let him see those antibiotics come down. When that’s not happening, I always have to say, okay, why? Because the body has an ability to heal itself. That’s sort of one of our biggest tenants. And so what’s in the way we’re obstacles to cure.
And that was another one. This woman was doing everything and I thought, and her mercury, finally we did this testing. It’s her mercury was off the charts. So as soon as we effectively detoxify from mercury and she didn’t have any mercury amalgams, she was only 29 years old. And so hers was mostly her Sushi Habit. And so as soon as we’re able to detox that mercury, her antibodies, everything else she had been doing and having on board starting to drive down. Had my last case and I’ll tell you about, we’re talking-
Dr. Weitz: By the way, how did you measure the mercury and then how did you get rid of it?
Dr. Lucille: Yeah, so I’m very sensitive. I used a NutraEval for her, which is as a couple as a classroom and just for the patients that are listening or watching if you have the right insurance, we can tuck it under something called Pay Assured. And there are some interesting ways that we can make these sometimes cough rebutted tests and so that’s where that popped up because I had felt like she had done so much, so I really wanted to do the Mac daddy mac just to see what else that was missing. And that’s really a nice test to do that.
Dr. Weitz: No, we use that quite a lot. It’s a great nutrition panel that also includes heavy metals through serum.
Dr. Lucille: Yeah. And you can see those malabsorption markers, you can see dysbiosis, markers. And for me that’s kind of like a great test to do because it can spin off and make me focus and concentrate on additional testing and additional areas if needed. It will totally red flag a part of my brain to go, okay, this is where we need to start focusing and then for her, I use a detox cube from Quicksilver Scientific which is really, really comprehensive, has the glutathione in there sort of like the catch and release when it comes to pulling mercury out. These heavy metals have such an affinity for our tissues. And so I’ve had great success with that.
Dr. Weitz: So for those who aren’t familiar, it uses agents like glutathione, which is designed to help start to pull the mercury out of the tissues and then it has binders to bind to it, things like charcoal, and then make sure that they leave the body through the stool. Right?
Dr. Lucille: Yeah.
Dr. Weitz: And the urine. What role does stress have on autoimmune diseases?
Dr. Lucille: Oh, boy. This is a big one because if you think about it, so stress, obviously we need to quantify, but unhealthy, prolonged stress.
Dr. Weitz: Yeah. Chronic stress.
Dr. Lucille: Compounded. Those stressors. Because once again, we’ve got this wonderful fight or flight. We’ve got this autonomic nervous system that can help us respond to multiple stressors. When it becomes chronic. You’ve got sort of an over adaptation. You’ve got, we’re supposed to adapt to stressors, but when that hypothalamus, pituitary adrenal access starts to over adapt, one of the things that happens is a dysregulation of the immune response, which you can see in the final stages of sort of this HPA access exhaustion or dysregulation. It becomes blunted. And I think that’s where we start seeing the contribution of chronic stress to these autoimmune diseases.
Dr. Weitz: How do you handle that?
Dr. Lucille: Wow. Biggest thing. I mean, what do we do? We’ve got to start decreasing and reducing our chronic stressors. What I have people do-
Dr. Weitz: Meet the modern world, go live in a shack in the woods.
Dr. Lucille: Yeah. Well No, like right. Who will climb up to be a Zen monk. That’s never going to happen for a lot of my patients. There’s a couple things that I have people do and for some reason I’ve seen that adrenaline and meditation have not been effective as far as that way of framing them. So I have people do You Musings in the morning, I just want you to muse about what you want to do. And I have them do it for like three or four minutes, not a lot of time, but before they start getting connected to their devices before they start getting connected to anything else on the outside, I want them to at least to be able to stay connected to themselves. People just are so disconnected from themselves that when it comes to, as I said, not easy medicine where we’re looking at dietary interventions, we’re looking at lifestyle modifications especially with stress reduction. So I have them do that. And a little other trick I have them do at the end of the day is simply called a daily autopsy because that day is done, of taste. Hey it’s gone. It’s dead. You’re never going to get it back. How did it go? What happened? Was there a piece of bread? Not that bread is evil or anything, but that you unconsciously sort of stuffed in your mouth at dinner after a glass of wine that you promised yourself you weren’t going to have. And so those two things are really important to just frame the day for folks. Then I just, I have them do it. We share it, we talk about it. That’s really important. But of course, any other thing, meditation, whatever works for that patient, whatever for that patient is gonna create a parasympathetic response, that’s the opposite of fight or flight. That’s why we rest, relax, repair. Some people, it’s spending time with their grandchildren. Some people, it’s not spending time with their grandchildren. Some people it’s like taking a bath, lighting candles, carving out time to just read a book instead of watching television. So all of those things are so important to help. Cortisol is very inflammatory and we’re trying to quell the inflammation, so all those things need to be on board.
Dr. Weitz: That’s great. We can talk about autoimmune diseases forever. I’d like to hit on one more topic and recognizing that every patient’s individual in a specific patient in your office, you would have very specific recommendations. But just in general, what are some of the more helpful dietary, nutritional supplements for autoimmune diseases?
Dr. Lucille: Yeah, so from a research, and pretty much what I see in my practice, general support, I’m looking at vitamin D, definitely getting them up to optimal levels. 60 to 80, I think you’re not just one click above rickets, which I see a lot of people coming in with their lab test and they’re like, “Oh, your vitamin D is within normal limits.” Look for optimal. Definitely healing the gut. So we’re looking at that friendly and good bacteria, which is part of the immune system as well as the stomach acid in the gut associated with panic tissue. And we’re looking at the gut. Essential fatty acids I think are important. Curcumin, I’ve written a lot about curcumin especially in higher doses. Potent anti-inflammatory, potent antioxidant. Inhibits the TNF alpha and other interleukins. So that I think is extremely important. Resveratrol. This is actually something that folks that I’ve been talking to from a colleague perspective. It helps to reduce oxidative stress. Yes. But it also inhibits that cell differentiation, which is extremely important. And so I’ve really seen resveratrol, be quite effective in treating Lupus, for sure, Rheumatoid arthritis, Hashimoto’s. So I use that all the time as well.
Dr. Weitz: 200 or 400 milligrams. How much?
Dr. Lucille: What did you say?
Dr. Weitz: How many milligrams? 200 milligrams. 400 milligrams.
Dr. Lucille: Usually 200 milligrams BID or twice a day.
Dr. Weitz: Okay, good.
Dr. Lucille: And then you’re always looking at digestive health. The Rs we know the Rs, so removing those microbial the viruses or fungus. Certainly I do, I just want to touch on because they know we’re almost out of time, but Epstein Barr virus has been indicated is especially in a contributing factor to the initiation etiology of Hashimoto’s. So I am testing for that more and getting on that as soon as possible. Any antimicrobial herbs …
Dr. Weitz: Are you testing for that through serum or through stool or?
Dr. Lucille: Through serum. Yes. And I mean, and if there are cases that are just ringing in my head once again, why aren’t those antibodies coming down? We’re doing everything that I know to do. That virus was, I mean this one woman bless her heart. I’ve never seen an Epstein Barr, not only just reactivation of a past infection, chronic activation and those titers are so high. So we needed to kind of pull our attention with antiviral support, immune support, really important. So I could go on and on. But those are the big ones that I use.
Dr. Weitz: Yeah. Another thing I wanted to point out, GI Map from diagnostic solutions or a stool test, I found that helpful with some autoimmune patients. They actually have a series of potential autoimmune trigger bacteria and sometimes that gives you some hints for things to try to target to clear out, to help reduce that.
Dr. Lucille: Yeah, that’s a great point.
Dr. Weitz: Okay, good, good, good. So any final thoughts and then how can everybody get hold of you?
Dr. Lucille: Sure. My website is always the best to send Dr. HollyLucille.com and for patients, I just want to say that there is hope if we look at this in much more of a comprehensive way and you help get your skin in the game and partner with somebody like Ben, myself, a functional medicine doctor, an hepatic doctor that is going to excavate and identify and treat the cause and ask those questions about why your immune system would start to attack itself. There is hope. So hang in there and then as you said, Ben, I can’t say this enough. Even though my parents both being pharmacists, there are medications out there that are being given every single day, these direct consumer marketing from the commercials. Because we’ve got more and more autoimmune diseases because of our environment and other contributing factors. But they do come with toxic side effects that they suppress the immune system. We’re looking at increased risk of cancer and other devastating things. So if you look at the cost:benefit ratio, there’s a better way. There’s a more comprehensive way. Here, take this is easy, but if you do everything else, when we’re looking at lifestyle dietary, all the things that need to happen, you’ve got a chance for better outcomes and the quality of life that you’re going to soar with.
Dr. Weitz: Awesome. Talk to you soon Holly. Thank you so much.
Dr. Lucille: All right. Thank you so much.
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