Unlocking Health Secrets with Functional Medicine: A Conversation with Dr. Sheila Saltzman

This podcast episode delves into an enlightening conversation with Dr. Sheila Saltzman, a physical therapist, exercise physiologist, and functional health expert with 25 years of experience. The discussion begins with a personal account highlighting the serious side effects and quality of life issues stemming from conventional treatment plans, underscoring the importance of considering functional medicine as a supplement to traditional healthcare.
Dr. Saltzman shares her journey from being a personal trainer to discovering the integral connection between nutrition, lifestyle, inflammation, and overall health, which ultimately led her to functional medicine. The conversation covers a broad range of topics including the significance of digestive health, the impact of stress on the body, food sensitivities, and the importance of a balanced approach to health that includes mindful eating, laughter, and managing stress.
Dr. Saltzman also touches on the innovative concept of fecal transplants for treating certain diseases and potentially for weight management.
Throughout the episode, Dr. Saltzman provides insights into how functional medicine seeks to identify and address the root causes of health issues, offering a more holistic and personalized approach to achieving optimal health.

https://www.mindfulhealthslo.com/
Instagram: @MindfulHealthSLO


00:00 The Personal Journey to Functional Medicine
00:35 Discovering Functional Medicine: A New Approach to Health
02:02 Dr. Sheila Saltzman: From Athlete to Functional Medicine Expert
04:17 Understanding Functional Medicine vs. Traditional Healthcare
07:00 The Impact of Medication and Seeking Alternatives
10:48 Gut Health: The Core of Functional Wellness
14:10 Navigating the Complexities of Gut Health and Microbiome
14:33 The Comprehensive Approach to Diagnosing and Treating Gut Issues
16:29 The Importance of a Balanced Microbiome and Personalized Probiotics
20:59 Addressing Stress, Nutrition, and Hormonal Balance for Overall Health
25:52 Unveiling the 5R Gut Healing Protocol
26:09 The Importance of a Comprehensive Approach to Gut Health
28:21 Exploring Beyond Gastro Symptoms: The Wide Range of Gut Health Indicators
28:55 Understanding Food Sensitivities, Allergies, and Intolerances
30:39 Personal Stories and the Impact of Diet on Gut Health
33:06 The Intricacies of Wheat Sensitivity and Dietary Adjustments
34:40 The Unique Nature of Individual Health and the Role of Various Factors
36:20 Navigating the Medical System and the Importance of Advocacy
39:26 Healing and Homeostasis: Strategies for a Balanced Body
43:05 Practical Tips for Improving Gut Health and Overall Well-being
45:56 Exploring Innovative Treatments: Fecal Transplants and Their Potential
47:52 Closing Thoughts and How to Connect for Further Guidance

Transcript

0:00

Had I known I was trading quality of life, you know, like I did at one point get to a place where I told my mom and my husband, if my choice is to, Live until I'm 80 and feel the way I do right now on this treatment plan, or die at 40 and feel better like I did before I started this treatment plan because I didn't feel bad when I was diagnosed. I was having some issues, but I didn't feel bad like I did on the treatment. I said, I'd rather die at 40 truly, like not a life worth living. And you know, this is why. And. Functional medicine is so great to use as a supplement to your traditional health care, because you found me earlier and you said, okay, great. You're going to do the prednisone. That's great. That's going to take care of a lot of what's going on. But let's also do this. We are doing this right. I think every time we do this, we do it a little bit writer, right? I think so. Yeah. Practice makes perfect. I agree. Do you regret prompting me to start episodes by talking about we're doing this right? Right. Okay. I know I love it every single time because I think I have a different answer and sometimes I feel like I'm not doing it right and sometimes I feel like I am like crushing it. Today I feel somewhere in the middle of those things. Okay. Okay, good. I just don't want to annoy everybody with my routines because it turns out I'm a creature of habit. I didn't know. I love it. Yeah. Today we have a guest and it is Dr. Sheila Saltzman. She's my functional medicine doctor and she's my physical therapist. So she is a physical therapist and exercise psychologist, physiologist, a functional health expert. She has 25 years of experience, has been both the provider and the patient and is truly an expert. And obsessively dedicated to helping others put together the pieces of their health puzzle to figure out what works best for them so they can achieve optimal health. Hi Sheila. Welcome. Good morning. I'm so excited to be here. So I have a pretty complicated health puzzle, which is how I found my way to Sheila. And she was very, very. Helping me just feel human and better. And so I sing her praises constantly. So Sheila, tell us, tell us how you got here. Who are you? Yeah. Yeah. Well, it's a long journey, but I feel like it's been a pretty linear path in terms of profession. So I started out doing exercise physiology. I was always an athlete. I was really interested in fitness. And first graduated and became a personal trainer, like most people do, that study exercise physiology. The personal trainer for a long time, seven, maybe eight years, and I started to see a lot of people had injuries. I really wanted to help them a little bit further, really have a better understanding of the human body. So I went back to school and I got my doctorate in physical therapy. And, And then of course came out of PT school and realized that there was more to the puzzle than that. Everybody had more going on than just their injury. And I was noticing like some people would get better. Some people wouldn't. And I started to see that there was a connection with nutrition and a connection with lifestyle and a connection with inflammation. And that just led me deep down that rabbit hole of understanding more of a holistic picture of health, which ultimately led, ultimately led me to functional medicine. And that's. That's the path that I've been on since and it's taken a while, but I feel like I've got this nice collection of all three professions and it kind of all comes together and I've got this nice bird's eye view of the human body when I'm working with my patients. And that's been my professional journey. I think one thing I, yeah, I didn't say about you though, that is very important is you're also a female entrepreneur. I am. Yeah. I forget that sometimes, but yeah, I am. Yes, you are! You run a bad ass business. Thank you. When you talk about functional medicine, what does that mean and how is that different from me just going to see like my primary care physician or like a regular PT? Yeah, I'm glad you asked that because the term functional medicine doesn't really tell people that what it is and I think more recently I'm noticing people are using the term functional health in lieu of functional medicine, which I really like because it's functional health. It's how the body is functioning. So when we go to see our primary care doctor, traditional medicine, as you would, they're really treating diseases, right? They're looking to looking for the big ticket item. They want to see if you've got something that requires surgery or medication. So they're running tests to rule out disease and they're prescribing to treat the disease. Yeah. practicing medicine in functional medicine. You know, we really want to be a little bit upstream from that. We want to catch things before they become a disease. We want to look for the dysfunction before it becomes disease. So we're looking at the whole body as a whole. We're looking at how the different body systems interact with each other. And that's what really drew me to functional medicine, because in, you know, as you guys know, you've been to doctors, there's a specialist for everything, the rheumatologist, the oncologist, you know, the orthopedic doctor, and they're not looking at all the other different body systems, but they're very, very much intertwined. You know, your gut affects your hormones. Your hormone affects your mood. It's all full circle. And so in functional medicine, we're looking at the big picture. We're looking at all those things and putting it all together. Yeah. That makes sense because if you're in, you know, I'm not an expert, but it, but I have experience in this space. Like it did never made sense to me. Like people would be like, well, just. I'm not picking on chiropractors because I love chiropractors. They'd be like, just go to the chiropractor and you'll be fine. And it's like, okay, cool. There is a space for a chiropractor to do the adjustment, but then what's happening, that's causing the, the malalignment of the spine and there's a muscular, what's happening there. Like there's too many, our bodies are not independent systems. They all rely on each other, right? Is that the idea of functional medicine? Yeah, and there's, you know, and they call it like root cause medicine for a reason, right? Like when you go to the doctor, they primarily treat the symptom, right? Like, oh, you're having reflux, here's a medication for that. You're having pain, here's a medication for that. That doesn't get rid of anything. Like, you have to go, hmm, where did things go off track? Like, what caused this? Like, what, you know, what in my life made my body go haywire? And that's root cause. And, you know, really finding the root can prevent, you know, injury or illness in the future. For So same thing with chiropractic and physical therapy, right? Like what caused this issue? Yeah. And I argue that pharmaceutical drug that they are giving you to treat this one symptom over here is oftentimes causing other symptoms over here. So my kidney disease, when I was treated for that, which was aggressive and Western medicine was a, the thing to do for that. And I do know that based on conversations I had at the time, you know, they gave me my primary prescription and they gave me then four other prescriptions to support all of the symptoms that that was going to cause for me. And that, that drug also, I mean, I think triggered several autoimmune diseases in my body and I have never been the same after taking that. So bummer. Yeah. Yeah. There's consequences, you know, and then they don't offer, you know, treatments. Alternatives, you know, like this is what you have. This is the solution. They don't go or that or that, you know, it's like, this is the medication that we treat this with there. And that very often isn't a conversation. What those side effects are going to be right. Disheartening. Yeah. And you're No, sorry, knowing what I know now, when I get a diagnosis or when I hear anybody get a diagnosis, I'm very quick to say, get a second opinion, talk to people with that disease, look a different route, like see what all options are out there before you take a single pill. Because by the time I took that first, I mean they put me on 80 milligrams of prednisone, by the time I took that first week of 80 milligrams of prednisone, I was locked in. I had to now taper off that 80 milligrams regardless of what I did. So we were committed to that treatment path where then I learned, Oh, some doctors don't. Do that. Right. And now I know 10 years, 12 years later, actually that treatment method has completely gone away. So. Yeah. Not to belabor the point, and I want to ask you so many questions, but also like when you talk about treating with a pill for a specific thing, you're also treating your whole body with that pill, right? Like that moment that you ingest that medication, it's not only going to your kidneys, right? It's going. Yep. Yep. Yep. Through your bloodstream. That's systemic. Absolutely. Yeah. So when people I think are like, well, you should go to like a traditional doctor or whatever it's like, or whatever those like that kind of viewpoint is, it's like, okay, but like that actually doesn't even make any sense because how can we pinpoint it's like when you're like, oh, people want to lose belly fat and it's like, okay, well you can do a billion sit ups, but that's not going to be, I can't pinpoint where your body decides to lose weight. Wait, you know, exactly. You can't spot tree. Exactly. I think a great analogy, right? You can't spot tree. You can't like take an autoimmune, an autoimmune, an immune suppressant and say, Oh, it's just going to turn off this disease. Like you're suppressing the entire immune system. It's going to affect other things. So, yeah, absolutely. There's consequences. And, you know, I don't want to poo poo. Traditional medicine or conventional medicine, there's absolutely a time and place for medications, but I love to Cheryl's tweet, like, get a second opinion, see what your alternatives are. You know, I see this a lot, like with thyroid disease, for example, the medical treatment is medication. And then I have a lot of patients that come to me and they're like, well, I haven't tried lifestyle change yet. I haven't tried diet change yet. What are those options? What can I do in my life before I do the medication? And I think a lot of people are starting to think like that. They're like, well, okay, medications there. I'll put that in my back pocket. I'll take it if I need it. But what can I do first? Yeah. Yes, I agree. A lot of people are moving that direction. I hear it more and more people asking for referral for functional wellness and functional health. And so you are passionate about a number of things and you have such a breadth of information. When I asked you, what was the one thing that you think All women and we might, and our four men, we have probably four men listeners. We might have five now cause Sky was on, so he might be an avid listener now. For our five male listeners too, what do we need to know? What do we not know that we really should be knowing? Yeah. A topic that I love talking about, especially with women, is the gut and primarily, I mean, with everybody, of course, men get gut issues too, but with women, it really plays a role in our warmup. And I think a lot of women find functional medicine because, you know, they go to their gynecologist and the gynecologist is like, I don't take birth control. And they're like, that's not the solution. Right. And so eventually it leads them to functional medicine, but we still have to look to the gut because that plays a big role in our hormone balance, our ability to detoxify these hormones, our mood, all of the things. And so gut health is really one of my biggest passions. My, I mean, my whole life I had gut issues until I figured it out. And I think people learn to just live with these issues, you know, whether it's Diarrhea, constipation, gas, bloating. They're just like, Oh, this is my new norm. This is how I live. Yeah. And I think that we don't have to live like that. I think, you know, and even, you know, going back to that whole conventional medicine model, patients go to the doctor and they're like, great, I'll put you on this acid blocker that will fix all your problems. And that actually, you know, temporarily they get a little bit of relief, but how do they get off of that acid blocker now? What's the next step? And I think the doctors don't really dive into the next step. The diet change coming off of the medication, all that. So I love talking about gut health and I'm happy to dive into that today. Yeah. I mean, let's totally geek out about it because I feel like there's, I mean, Cheryl, you made a mention of like how taking the prednisone change or maybe not an autoimmune disease. And I think, like, I recently realized I'm 41, that like gluten is not, it's not good for my, for my body. It makes me really inflamed. I, my aunt is like a diagnosed celiac and my daughter. I didn't diagnose her because I don't want her to take that. I don't want her to do the biopsy of her gut, but very obviously celiac. But that is something that maybe changed in my life. Like that wasn't always the case, or maybe I just am noticing it now. I'm not sure. But to your point, like my aunt went her whole life until she was in her fifties. It's just feeling sick all the time. And that was just normal, like having, you know, diarrhea all the time or having stomach problems all the time. And, and was either told like, you're just anxious or, you know, you know, it's something you aid or whatever, but it was just her normal. And then with the, you know, doing a little bit more research and the more prevalence of celiac disease, they were able to kind of diagnose it. But, I mean, I can't imagine going. 50 plus years feeling like shit all the time. Yeah. And so many people do, you know, and if you're not, if you're not digesting your food, well, that system is not working. You're not absorbing your nutrients. Well, if you're not absorbing your nutrients, you're not supporting your body in all the ways that it needs to make neurotransmitters to make, to make everything that makes your body function. Well, so digestion is really, really critical. It starts with digestion. And you know, and, and really a lot of people are trying to self treat their gut too. There's so much information out there with other podcasts and books and all that, but it's really very specific. You know, I try not to be very dogmatic in my approach. I don't put everybody on a keto diet or paleo diet or vegetarian diet. You know, we do, I do use elimination diet quite a bit, but the key is how do you come off of that elimination diet? How do you start to reintroduce the food? And I'd love to talk about that today because I think that's one of the areas people come in and they're like, I went on a low FODMAP diet two years ago and I can't seem to reintroduce food. You know, that's not a way to live. Yeah. So yeah. Yeah. So talk to us about that. So say I come in and I'm like, listen, I think I now have some sort of inflammation situation going on just because that's kind of how I feel and I'm feeling really tired and I'm feeling kind of yucky. And I'm 41 and like, I don't know, maybe I'm, maybe I'm perimenopausal, maybe I'm not, I don't know. Like, so how does that conversation, like somebody comes into you, then how do we get, how do we go from there? Yeah, perfect example, because that's a good portion of my patient population. And you know, initial visit, we're We're going to talk about the symptoms of hormone and how their cycle has changed and lifestyle, stress, sleep, energy, mood, everything, but for the gut stuff specifically, you know, I really love to do functional lab testing and this is one of the areas where functional medicine really shines because the conventional doctors will do a colonoscopy, maybe an endoscopy and everything looks good. You're fine. And the patient's like, I'm not fine. Like I get gas and bloating every time I eat. I'm going to the bathroom eight times a day, or some people, you know, go to the bathroom twice a week. I mean, people are, but functionally things are not well. And the doctors go in and they look for mechanical issues. They look for, you know, esophageal issues or bowel issues, polyps, something that's causing issues, something mechanical. But that's not always the issue. There's a functional issue. And so with lab testing, we can really get to that functional issue because we can look at the microbiome. We can look to see your digestive enzymes. We can see if there's unregistered food particles in your stool. We can look for markers of inflammation. So there's so many different things that we can look at. And then that guides the treatment. So everybody's a little bit different. You know, sometimes I look at the microbiome and there's an overgrowth of bacteria. And, you know, patients come to me and they go, Oh, my friend said to try this probiotic. It worked great. I've been on this probiotic for six months now and it's not doing anything. And I'm like, Oh, maybe we need to stop the probiotic. And test your microbiome, you could have an overgrowth which is causing the issue. And how often should that microbiome be tested? Yeah, that's a good question. You know, in a healthy person, you potentially don't even need to test your microbiome, but your microbiome does shift over time, our diet shifts it. So diversity in our gut will shift it. So let's say you're a vegetarian and you test your microbiome and then you continue to be vegetarian for six months and you retest your microbiome. It's probably going to look very similar, but if you change the diet up, you start getting more variety of fiber in your diet. You know, shift some things around that microbiome change. And so, and the microbiome is just, it's also one piece of the puzzle. And it's actually an area that I, I tread very carefully because again, people just want to take that probiotic. They think that that's going to be the thing that fixes everything. And very often I don't even recommend a probiotic unless I've tested the microbiome because you don't want to start. Yeah. Yeah. So like the guy, I always think of the gutted, like a garden. And I love this little analogy. If you guys will humor me before you say it, but, um, in our gut, I think of your gut, if you think of your probiotics as like seeds in a garden. So whenever we're taking a probiotic. We're eating foods rich in probiotic like sauerkraut or yogurt or kefir. We're planting seeds in our garden. That's great. We want seeds in our garden, but then we also want to fertilize our garden. So if you were taking a probiotic, but then you just ate like junk food all the time and you never ate good digestible fiber, you're going to have to keep taking a probiotic, right? Because you're not fertilizing the garden. You have to keep planting seeds. On the flip side of that, if you've got a good microbiome, good probiotics in your gut and you're eating good digestible fiber and lots of variety of plants and fruits and vegetables and seeds and you're feeding that microbiome, you're fertilizing the garden. So in a healthy gut with good seeds and good fertilizer, you're going to produce what you need to produce, which are called short chain fatty acids. I like to'em Postbiotics, you may have heard that term before. And postbiotics are really critical for gut health because they lower inflammation in the bowel. This is really preventative for us, for reducing, um, risk of things like ulcerative colitis or Crohn's or, you know, any type of inflammatory bowel disease or in colon cancer. So this is why you hear like, you know, heavy meat eats and a higher risk of colon cancer. It's not the meat, it's the lack of fiber, it's the lack of those short chain fatty acids. And so we really want this system, this metabolism of our microbiome to work well. We want the seeds, we want the fertilizer, we want the postbiotics. And so when we test, we can see where that breakdown is. And in my case, I see very active population. I work with like, very like type A, hard charging, you know, go get them kind of gals. And a lot of times they're eating really nutritious diet and they're like, I don't know what I'm doing wrong. I'm eating all this, you know, all this variety of veggies and my gut is just a mess. And lo and behold, they've got an overgrowth of bacteria. And so it's not just bad bacteria. We can have too much. good bacteria in our gut. You know, you have to get the wheat or seed. We've been guarding every once in a while. If you just keep fertilizing, you never read it. You're just going to get an overgrowth. That is so another place we need to figure out how to balance. Yeah, exactly. Because I like, I want to say like, I have never heard like, everybody is always like, everybody should be on a probiotic. Like everybody should be doing. And you're like, okay, I'm, and I think this Yeah. Obviously makes sense, right? Like, but I, it's just, it's the thing that you hear all the time. Like, yeah, if you wanna lose weight, you should be on a probiotic or you should be, anytime you hear gut health, people are like, oh, just take a probiotic. Like it's no. Yeah, yeah, totally. And you walk into a store, it's so, and they're selling like just bulk package probiotic. And what I'm hearing from you is like. Oh, no, you very, you need, you may need a very specific probiotic for your microbiome and what's happening in your gut. It's so, so very nuanced. And then, and now, you know, to confuse the general public even more, you go to get a probiotic Oh, this one has prebiotic in it. What if I get the prebiotic, you know, and that can create a lot of gas and make things worse before it gets better. And so, yeah, it's really, it's, it's good to have somebody kind of guide you in this and be like, well, okay, let's, let's, you know, come off with all the probiotics for a little while. Let's find your new baseline. Let's see where you land. And then we'll go from there. Okay. So we come in, we do the blood work we do, and you're analyzing obviously more than just the gut. And what are some of the other key things that you're looking at in that blood test? Yeah. So, well, for the, for the gut health, it's a stool test, but absolutely we can do blood tests too. So, you know, looking for markers of inflammation, I very often look at micronutrients and that's a good sign, right? So if your hormones are out of balance, your thyroid is off, feel tired all the time, there's a good chance there's some, some nutritional deficiencies behind that. And again, going back to the gut, if you're not, you know, there's microbiome that we're talking about, that microbiome plays a really big role in how well we absorb nutrients from our gut, from the food that we're eating. And so if you've got nutritional deficiencies, we have to heal the gut. Otherwise you're going to be on a multivitamin the rest of your life. But I love to look at nutrients. I love to look at like omega fatty acids, or your omega 3 to omega 6 balance, which plays a really critical role in inflammation in the body. We can look at markers like CRP, which is a, which is a sensitive marker, specific marker, but it tells us that there's general inflammation in the body. It can also be kind of the first sign of possibility of an autoimmune condition. So looking at your blood sugar, your A1C, you know, a lot of times when people have gut issues or hormone issues, there's chronic stress behind that, you know, going back to that root cause chronic stress is the source of a lot of our problems, right? Just kind of just go, go, go running a business, doing a podcast. You have kids, you got a lot going on and we're always in fight or flight. Yeah. You know, we've got fight or flight. That's our, you know, running from a tiger and there's fighting, fight or flight and rest and digest. And I know you guys have talked about this in other podcasts. So that sympathetic nervous system versus parasympathetic nervous system, rest, digest and repair. We need to be in that state majority of the time when we're living and existing and eating our food. When we're in fight or flight, we're not even digesting that food. If you're shoveling food in just so you can get back to work, you betcha you're not breaking it down and digesting it well. You're not even making enough digestive enzyme when you're in fight or flight because your body's preparing you to run from a tiger, right? Not sit under a tree and digest. And that fight or flight actually is, it releases cortisol, right? It's adrenaline. So we can release cortisol. Well, cortisol is a hormone that's very catabolic in our body and I think Cheryl could attest to that because that prednisone they put you on is essentially, it's a, it's a corticosteroid. And so. That can elevate our blood sugar. So blood sugar can be out of balance. That can affect your sleep because you can be getting these drops in blood sugar in the middle of the night, which then triggers more cortisol. And so cortisol, when I say catabolic, it means it breaks down tissue. It's the opposite of anabolic. So when we think anabolic, like steroids, growth, repair, catabolic breaks down tissue. And so when that happens, we can actually break down our gut lining and that's leaky gut. If you guys have ever heard that term or it's an increased gut permeability. So there's enterocytes and the cell wall of the gut start to open up. And so like celiac, we can kind of go through the gut wall a little bit. So you've got the, the celiac or the little, when you have celiac, the little on that wall are kind of flattened out and damaged. There's a few layers of that wall of your worst behavior, your small intestine specifically. Your small intestine's got a cell wall. It's a lot like a cheesecloth. It's woven and it should have really tight junctions. Nothing should be getting out of there. On top of that cell wall, we've got those little villi, which kind of pick up food particles and move them along. And then on top of those villi, there's a nice new console barrier where your immune system is. So there's a lot going on in there and your immune system is, they're not supposed to fight pathogens that are coming through. That's your first line of defense. And so, you know, when we're under stress, a lot of this breaks down, we get a wearing away of that immune wall, which makes us more likely to get, you know, overgrowth of candida, overgrowth of bacterial overgrowth, viruses, anything that comes in the body is a better chance of getting in. And then we can get an opening in that cell wall and food particles can get out. And so now your leaky gut can actually lead to food sensitivities and a heightened immune state, which could also lead to autoimmune conditions. And so, you know, you have to look at all of this because it's got a downstream effect that can lead to other diseases. And so the prednisone gave me leaky gut, which led to autoimmune disease, also made me pre diabetic and gave me insomnia, like you described. So many of the things that I was going through while I was on it. And post. Yeah. And they never told you that, you know, they said, okay, here's what you have. Here's your solution. Here's your prednisone. That's the treatment. And like, you know, had they presented you with like, okay, there's a possibility of this, this, and this, you'd be like, okay, well, what could I try before this? You know, in your case, you did have pretty serious issues going on and that might've been the only treatment option at the time, but you didn't have that information to make that decision, which isn't really fair to you. Right. And like, had I known I was trading quality of life, you know, like I did at one point get to a place where I told my mom and my husband, if my choice is to. Live until I'm 80 and feel the way I do right now on this treatment plan or die at 40 and feel better like I did before I started this treatment plan because I didn't feel bad when I was diagnosed. I was having some issues, but I didn't feel bad like I did on the treatment. I said, I'd rather die at 40. Truly, like not a life worth living. And you know, this is why functional medicine is so great to use as a supplement to your traditional healthcare, because you found me earlier and you said, okay, great. You're going to do the prednisone. That's great. That's going to take care of a lot of what's going on. But let's also do this. Let's look at your gut health. Let's make sure that you find good gut integrity and that's a good variety in your diet. Let's do some baseline testing before you jump into this treatment so that you could prevent yourself from getting a lot of what happened. From taking that medication. Yeah, right. Is the gut, um, I mean, I guess the answer is maybe yes, but I, but I don't know, like, is it repairable? Like, when you talk about like, leaky gut or that being permeable, like, are, can it go repairable? It can regenerate. Yeah, it can, it can fix itself, but really you have to take the step. And I'm, I love that you asked my question because I think a lot of patients come to me and they've done like half the protocol and they're like, I'm not, I'm not there, I'm not getting there. You know? So when a patient comes to me with a gut and butt issues, I do what I call the five R gut healing protocol. And so that's remove, replace, re inoculate, repair, and rebalance. And you have to do all five of those steps. So think of it like the five fingers of your hand. If you do four of those steps, You might get somewhere, but you're not going to completely heal a perfect example. I have patients that come to me and they've got, they've said, okay, I've been on an elimination diet. I did elimination diet. I did it for three months. Nothing changed, you know, and brought the boots back in. I'm exactly back where I started. And my favorite analogy for that is if I said to you, okay, I'm going to renovate my office and I'm going to remove everything from my office. I'm going to pull out my computer. I'm going to pull up a bookshelf and then pull out the chairs and we're going to wait 90 days and we're going to bring it all back in. I haven't renovated my office. I haven't changed. I haven't changed anything. I haven't painted the walls. I haven't changed the floors. I haven't done anything to change the surface. I And so that's really the remove part is the, just the first piece of the puzzle. When you're talking about that healing, it's also nice time, really opportunistic time to do the rest of the protocol so that you can heal that tissue. You've got those gnarly foods out that are causing the trigger, that are causing the gut distress, that are causing the inflammation that are, you know, causing, causing all these issues in your body. Those are gone. Great. Now, let's. Let's replace digestive enzymes. Let's bring some things in that can help you heal. Let's do a little bit of fish oil. Let's do alkalinity. Let's heal that gut wall so that we can eventually and successfully bring those foods back in. And I love teaching people that because that's like the aha moment. They're like, Oh my God, I've just been banging my head against the wall, you know, restricting myself and keeping all these foods out for so long. And here I am back where I started. Yeah. Like, great. Let's, let's make good use of that time while you're doing an elimination so that you don't have to be on my elimination diet for life. Yeah. Cause that's sucky. Like I, I feel like for my daughter, she's like, doesn't do well with gluten and she doesn't do well with dairy. And at one point, like soy. You know, she's like two and she's got no gluten, no dairy, no soy. And it was like, you know, then, especially when it comes to kids, and I think we're seeing this now, I see it a lot more in kids, at least at like our school with different food sensitivities and allergies and stuff like that, it really limits what they are eating and what they're willing to eat and what they can eat. And I think that has, you know, that's an interesting thing for us to maybe even track as these. Kids turn into adults and how that affects them. You know, their adulthood, but one of the questions I wanted to ask you is like, with all of this, how do like, like, say you just, you're not feeling right. Like, what are some of the other symptoms of like, that there might be something going on in your gut besides just like gastro symptoms, right? Like, yeah. Yeah. Is it always just gas? Like, or are there other? It can be so many things. So that's actually a really good question too, because if it's gas issues, if it's bloating after you eat, that's kind of easy to figure out, right? You eat this and then something happens, right? If you can put it down with food sensitivities. And I do want to specify there's a difference between a food sensitivity, a food allergy, and a food intolerance. These are three different things and allergy is what we call an IgE reaction. These can be life or death. These are things that can cause an anaphylactic reaction. And these are things that your conventional doctors, your allergist, your ENT doctor, they can do testing for true food allergy. That's a totally separate beast. And an intolerance means that you don't have the enzyme. So to break down a food. And so most common one that we hear of is lactose intolerance. Different than a food sensitivity. That means that you don't have that lactase enzyme to break down that lactose. And that's easily solved too, because you can take capsules that contain these enzymes that can help you break down these foods. And they make those for, for dairy as well. A food sensitivity is a little bit harder to pin down. A food sensitivity is kind of, sometimes some people call it a delayed onset reaction because it can take up to 72 hours to happen. So it's, you know, you eat something, you eat it on Monday, Thursday, you've got a rash on your arm. Or brain fog, you know, it can cause anything that inflammation causes. So the things that I see them as brain fog, heart palpitations, if somebody has anxiety and they're sensitive to food, that food can trigger those anxiety symptoms, rashes, itchiness, um, mood dysregulation, you can just feel cranky for, for no reason. Menstrual irregularity, bloating, bloating is a huge one. Once people figure out what they're sensitive to and they pull those foods out, they just feel so much less inflamed in general. Joint pain is a big one. I think that's the way a lot of people find me because, you know, from PT to functional medicine, I've seen patients that are like, this back pain just won't go away. And we do some testing and lo and behold, there's some foods in their diet that they're eating very regularly that once they remove them, they're like, pain's gone. And, you know, I'm not saying that that always fixes the pain, but it is a big piece of the puzzle. Yeah. And that is something that we have kind of tried to not to make this all about my kid, but here we are. But that's that we've seen with Vivian is that her reaction is almost. 24 to 48 hours later. Oh, okay. And it is mood related. It is headaches. It is anxiety. It is, she gets like a really, really bad eczema around her mouth around the mouth. Yeah. That's why it took us a bit when she was little, she was off it. And then we kind of put her back on because we went to an allergist and the allergist was like, She doesn't have any allergies. Yep. Testing no allergies. And so we're like, okay, but what I started to notice was, was her mood, was her anxiety, was what was presenting as anxiety and in this like, but it wasn't the stomach, she wasn't, she was having stomach pain, but it wasn't like she ate a bagel and then got diarrhea. Which is, I think sometimes what we think is going to be. So it took us a bit to kind of suss it out and realize like these symptoms are not because she's just a cranky eight year old. It's because she feels like shit. You know? Yeah. She didn't flames. Yeah. She's a perfect example. Like she's a perfect, perfect example for us to talk about. So the celiac, you know, I get, she's the one that you haven't, you haven't tested because you didn't want to have her do the biopsy. So you make a really good point. Like celiac would be, yeah, you eat the bagel. You have stomach pain, you have diarrhea. Like that's true. Celiac and celiac is an autoimmune condition. Food sensitivity can be separate, completely separate. You don't have to have an autoimmune condition to have. Food sensitivity. So there are people that don't have celiac that can still have food sensitivities, but those are perfect examples of things that people experience, especially like a periorbital dermatitis, like those rashes around the mouth and people will get sores in the mouth. Some people can like, have trouble swallowing. They're like, for some reason now all of a sudden they can't swallow. And so there's, there's all sorts of different ways that this can manifest in the body. And again, for healing. So we can use your daughter as an example. First, we have to identify what food she's sensitive to, because if she's got the wheat and the dairy and the soy out of her diet, but she's still having these weird reactions, there could be something else that's going on. And now, like I mentioned earlier, Oh, she doesn't have them when we're, when we're off gluten, she doesn't have it. That was like a very quick identification that we realized, like, Within a week, it all stopped once we eliminated it. It was insane. Wheat is a great case. Wheat is interesting and I should mention this because wheat, you know, we always think wheat gluten. And I hear people say that. I was actually at lunch with some friends the other day and this woman was talking about how, you know, Oh, this whole gluten sensitivity thing is so overrated, blah, blah, blah. There's such a small portion of the population that's celiac. And I'm like, what? Yes, but it's not just the gluten reaction. People are having celiac is its own beast. Celiac is a diagnosable auto immune condition. People can have a wheat sensitivity and there are tests that you can do to see if you're actually reacting to the different proteins in wheat. Gluten is only one protein in wheat. Those are not synonymous terms. Gluten and wheat are not the same. Wheat is like the umbrella. Gluten is one protein. There's other ones like gluteomorphin and gluten and gliadin. And so you can test for those other proteins. Proteins in the wheat. And this is where people again, another aha moment. We test them like, you know, you're not actually reacting to the gluten. You can do some barley. You could do rye if you want to, but it's the other proteins in the wheat. And I love using sourdough as an example, because people always ask, can I eat sourdough? I'm like, well, if you were celiac, you might be able to get away with sourdough because it ferments all the gluten and that's, that's your, you know, your nemesis, but if you have celiac, but if you have a wheat sensitivity, that flour is still wheat flour. There's other proteins in there that could be the trigger for you. So I suspect your daughter might have a wheat sensitivity. Yeah, I mean, right now we're like even things like we look at ingredients like malt has wheat components to it. And so we'll like, she can't eat rice krispies where we, everybody thinks rice krispies are gluten free. Yeah. Malt in it, which makes it technically not good for her. So it's anyway, it's so it's so what I, what I, I think the point of all of this is like, it's so intricate, right? Like that's what I'm getting from you is like, everything is so like everybody's body is so special, but so intricate and so specialized. Yeah. Well, we can talk about, you know, like you said, you know, there's no just panacea of like everybody do this thing and your gut's going to be. We're all unique. Spring flakes. We really, really truly are. Cause there's so many different variants, right? Like it's not just your gut health, your gut health doesn't live in a. test to by itself, like there's other variants, your sleep, your stress, what's going on in your life, how much sunlight you're having, your vitamin D level. Like there's so many other influences that could be impacting your gut health. If, if everybody got the same healing protocol, this would be easy. We would all have perfectly functioning guts, but there's so many other variables. And like, but you know, that's why I think a lot of people kind of hit a dead end with their gastroenterologist. Again, they're wonderful. I think, you know, I love when people patients go to the gastroenterologist first to rule out the big things, but then they hit a dead end. They're like, that didn't help. You know, again, colonoscopy was normal. So now what? And so we have to look at those other factors that are playing a role in the function of your gut. When I was investigating my kidney disease, the first specialist they sent me to was a urologist because we were hunting down blood and protein in the urine. And the urologist said to me when they finished my bladder scope and realized there was nothing like functionally wrong, like sometimes people just have blood and protein in their urine. And I was like, like unexplained and I'm like, I don't think so, bro. Like, how is that an explanation? That's not a It's scary. It's scary. And I think sometimes, you know, doctors are, you know, we think they're supposed to have the answers and it's, it's rare for a doctor to admit, like, I don't have the answer for you. You know, maybe you should see somebody else. Sometimes they do. Sometimes they pass you off to a different specialist, but a lot of times they present it in like, well, I don't see anything. So there's nothing there, you know, and that's really daunting and frustrating for the patient because they don't know who to go to and scary, you know, because you see that a lot. I have, I mean, at the time I didn't know, but over years I've like gotten educated enough to know like, okay, don't accept that. Like, keep going, keep going, keep going. But so many people just accept what they're told. So many people don't question authority. It's not in people's wheelhouse to, and that is, that's also like kind of culturally specific. Like I'm a very privileged white woman and I'm allowed to question authority, but there are different demographics of the population that don't have that privilege, that have been raised to not question authority because it's not safe for them. So like, what are we doing to their population by sending them to modern medicine? And then they hit a roadblock and they just accept it. And then, you know, what's happening to their, their death rates and. Yep. It's a big scary thing. Yeah. Yeah. And even generationally, like I'm, I'm loving now the younger generation, they're referring their parents. Like I have a lot of patients here. There, there are demographic, there are Asian. They're like, my mom has been dealing with gut issues for years and her doctor just keeps putting on this medication. I want to do from shape testing on her. We want to figure this out. And it's, it's, it's great. It's the thing that gets the momentum. Again, it's gets the ball rolling in the right direction. Otherwise they would have just kept taking that acid blocker that they'd been taking for years. Yeah. You know, and I think also that generation, like our parents, right, there was such a diet culture that was happening in the eighties that probably just destroyed everybody's guts. Oh, absolutely. Absolutely. Yeah. The low fat, but it was also like the, I mean, this is the Because this was the world that I grew up in, my family, but there was a lot of like, do this diet. No, do this diet. No, you got to do this diet. And I can just imagine like, like if I think about, unfortunately the amount of diets that I did as a child and into adulthood, like. That is probably fuck the shit out of my gut, right? Because you're like, Oh yeah. I'm going to be low fat and we're, then we're going to do Nutra systems and eat this weird processed food, plastic food, then you're going to do the cabbage soup diet. Then you're going to do, and your body's like, drink the slim fast diet coke, the hell is going on? Like you just, Real nutrients. Right. And I think that that, and maybe that's something that why maybe you see women more like, cause that diet culture is so more prevalent in, in females versus males, but not exclusive. I always think about that. Like, God, what have we done? What have those women done in the, you know, like the seventies and eighties, the damage done? It's so awful. Yeah. And nothing, you know, that's a big part of healing is that we want to bring stability to the body. We want to find homeostasis. If you're constantly doing a different diet or you're starving yourself and then you're binging, you can want to find homeostasis. The body will heal. If it knows that you're not in a, you know, famine or a war zone, right? Like you don't want to be in that fight or flight. You want to know that food is coming. Nutrition is coming. You know, you're getting those micronutrients, you're getting good sleep, you're getting out and getting natural sunlight. These are all really critical pieces of healing, whether it's the gut, the hormones, mood, whatever you have you, we need stability. Um, so I do want to just kind of give a nugget, but you know, anybody's taking notes at home that find our healing protocol. I know I said it really quickly, but I would love to say it again, if anybody wants to write it down, because these are the fifth component of it is a really important one. And it's rebalancing the nervous system. And so the first one, again, we talked about remove. And so you want to remove those foods that you're sensitive to because the body's not going to heal if you're still eating triggers. The second one is replace and that's digested enzymes. Again, when we've got that elevated cortisol on the time, the body is not digesting. And so we can have really low hydrochloric acid in our stomach. And, you know, I don't want to give specific supplements because I don't want people to try to self treat. I'm happy to have that conversation with people on a personal level. But digestive enzymes, apple cider vinegar capsules, you know, things that can really help, you know, pancreatic enzymes. We want to re inoculate the gut. We touched on that a little bit, but with the right microbiome, we don't want to just willy nilly take probiotics. We want to repair the gut. Again, that leaky gut, so there's specific amino acids like glutamine that we can take as a powder in our water that can really help to close up those empirocytes, heal that gut wall so that you can stop having the food particles getting out into your bloodstream. That'll calm your immune system. And then that last component is rebalance. And I love that piece because it's the nervous system. But again, if you're doing steps one through four and you're taking all the supplements and you got all the foods eliminated, but you're super, super stressed out trying to navigate this food elimination, it ain't going to work. You know, and I always tell people like, be realistic, have grace with yourself. If you're doing an elimination and you know, you had, let's say you had cilantro was on your food. That's going to be the cilantro showed up in a salad. Don't beat yourself up because you have the cilantro, you know, just Be mindful of how it made your body feel and then go back to eating the way that you were, because the more stressed we are, the slower that healing is going to happen. So we really want to get into that parasympathetic state, that rest and digest, that's having fun with your friends. That's getting away from work. That's getting out into nature, you know, all those things that are going to let our body come back down. Really, really critical for healing. Man, that is, I love the way that you put that because. First of all, I've never heard rest and digest. Did we talk about that before? I don't know, but I don't remember hearing about it, but I want to spend like 45. 75 percent of my day resting and digesting. No, we shouldn't be, but we shouldn't be. It's crazy. So yeah, big tip. If anybody's having that issue, your homework is your homework is just to slow down and disconnect when you eat your lunch. You know, if you're eating at your computer, you're eating, standing up in the kitchen while you're feeding your kids. That's not helping. You have to slow down and you, and I always tell people, we're not going to tell you to chew every bite 30 times or chew to applesauce consistency. That's really tedious. Set a timer. See how long it takes you to finish a meal. If you're finishing your dinner as fast as my French bulldog, we've got problems. You know, it's taking you five minutes flat to eat a dinner. That's a little too quick. You know, we shouldn't be shoveling the food in. We should be kind of focused and being present and enjoying and savory and tasting. Thank you. So sit down at your meal, you know, turn the phone off, turn the TV on, kind of connect with the food and the, you know, the people that you're with, chew the food, slow yourself down. And that can do wonders for the rest of the cycle downstream. And Sheila, what are like, if you, you gave us amazing tips there, like what are some just other, I know it's everybody's specific, but like, what are some like quick things like you mentioned, like getting sunlight a couple of times, like what, like if we're talking about it, a perfectly healthy human, like what are. Three other things we should be doing during the day to, like, create that homeostasis in our body. Yeah. Number one, eating. So a lot of us just go, go, go and forget to eat or we're just shoveling food in mind, you know, eating what's on the kids plates. Like, oh, I'm just going to eat these little chicken nuggets. Get some food in my belly. Be mindful about what you're eating. You know, think about again, that homeostasis is stable blood sugar. So if you're going long periods of time, especially, you know, like keto and intermittent fasting and all that has had its day, people are really trying to do intermittent fasting. If it's working for you, great. If it's not working for you, great. It's not working for you. We need to change gears because if you're intermittent fasting and you're going a long period of time without food, your body needs blood sugar. So it's going to, it's going to send a signal to your adrenals to make cortisol because cortisol is what tells your liver to break down your muscle and turn it into glucose. So eat your food, eat your food, make sure it's, you know, protein at every meal. So you're keeping stable blood sugar. That's number one. And again, like I said, just having, having fun, disconnect, disconnecting, you know, it can be going outside and getting sunlight. It could be laughing with your friends, believe it or not when we laugh, laughing is like it stimulates the vagus nerve, which travels down our throat. And so things like gargling, people may have heard this or read this before gargling can actually stimulate the vagus nerve. So can laughing. So if you're living a laughless life, I would say, try to find some joy, try to have a time with friends and laugh and stimulate that vagus nerve. Okay. Laughless life. I hope nobody is living a laughless life. That's all there is to it. Yeah. Well, yeah, I hope not. But yeah, laughing is a good one. The third one would be junior food. Really, you know, take the time to savor those meals. You know, when you think about other cultures and other country, right? The country's like shut down for two hours in the middle of the day and have time to sit and eat and socialize with their families. We don't do that in the US, you know, so it's great. I think the opportunity to eat lunch with friends, eat lunch with friends. Oh, I love that. I love that. Yeah. Okay, I've been hearing a lot about legs up on the wall. Have you heard about this? Like, does that like, when you put your legs up for 20 minutes on the wall, it's supposed to like, decrease like, your stress levels and like, activate your vagus. nerve or what? Have you heard about this? Is this heard about this? I mean, it's a great position and it's really good for lowering inflammation in the legs and improving venous return and decreasing inflammation. But I'd have to dig a little bit to see the relationship between that and the vagus nerve. That I'm not familiar with. I've been doing. Okay. And what do you think about fecal transplants? Ooh, ooh, that's a whole nother podcast. So fecal transplant can be a game changer in the world of infection, like clostridium, C. They're legit. They're legit. So our microbiome plays a big role. And I think we're moving in that direction actually. So now that it actually is used in the medical world, when people have an infection called C. Because it's very resistant to antibiotics. And so they can actually take the transplant. It's exactly that transplant, the fecal matter from another person. And, and totally regenerate and change and shift your microbiome and it can actually help people to heal. And I think we're going to move in the direction where they're doing fecal transplants for weight management, right? Because our microbiome plays a role in how we extract calories from food and keeping our weight stable. So I think we're definitely going to be hearing more about it in the future. Where are we transplanting it to? Your rectum, it's going, yeah, it's going, it's being transplanted into your large intestine directly to the source. Wow, okay. Do not try this at home. This is not, this is not a DIY. Well, I've heard like warnings around like, You could like your mental state could change too, based on like the microbiome you take, like, because it affects everything. So like, don't insert a crazy person's, like, just because they're skinny, don't take that person's microbiome because it might like affect, if they're crazy, you might become crazy and skinny. I mean, pick your poison. So, yeah, it's so true. I do. I hear that a lot. We need to source out the really happy, skinny people and take their Exactly. I hear that all the time. Patients will tell me, you know, they've had anxiety their whole lives. They just thought that's who they were and how they were. And then we heal their gut and the anxiety is gone for the first time in their life. And it's mind blowing. I didn't even know I could feel like this. There's very, very much related. Yeah. Super cool stuff. Well, Sheila, You've been a wealth of information as always. Where can people connect with you and do you provide services virtually? I, yes, I do. I do. So yeah, I'm here in San Luis Obispo for Lyme acquaintance, but I do also offer telehealth video consultation and I can be found at mindfulhealth. org. I have a website, MindfulHealthSlow. com and also on Instagram, DM me there, MindfulHealthSlow on Instagram as well. Yeah. And for our listeners, S L O, there's no W at the end, correct? For our non SLO. Yeah. It stands for San Luis Obispo. We're so cool out here. Well, and I am accepting new patients, so I'm happy to, I'm happy to meet with anybody that I'd like to connect. Oh, awesome. Thank you so much for being here. Take care. We just made Alexa's day, June joined me for the last five minutes of the interview, everybody, in case you don't have your camera on and you started to hear little tiny voices that said, don't say booty hole. That was my three year old. Oh my God. I'm going to have to go back and listen just so I can hear that. Awesome. guys.