1 00:00:01,240 --> 00:00:05,800 Speaker 1: Welcome to Our Skin, a personal discovery podcast. I'm your host, 2 00:00:05,840 --> 00:00:08,320 Speaker 1: Holly Fry, and it is wonderful to have you here 3 00:00:08,360 --> 00:00:11,559 Speaker 1: with us. Connection is what this show is all about, 4 00:00:12,039 --> 00:00:15,680 Speaker 1: specifically connecting about things that we are sometimes afraid to 5 00:00:15,720 --> 00:00:18,520 Speaker 1: talk about. Today, we're going to be exploring the ups 6 00:00:18,520 --> 00:00:22,440 Speaker 1: and downs, past and present, personal and universal troubles we 7 00:00:22,520 --> 00:00:26,600 Speaker 1: have with our skin. Our skin is our most visible organ. 8 00:00:26,880 --> 00:00:29,800 Speaker 1: What happens on our skin affects the rest of our lives, 9 00:00:30,160 --> 00:00:33,960 Speaker 1: especially when dealing with a chronic condition. Getting diagnosed with 10 00:00:34,000 --> 00:00:37,480 Speaker 1: one of these, like psoriasis, can be overwhelming, but you're 11 00:00:37,520 --> 00:00:42,080 Speaker 1: not alone. Each episode features a personal story of resilience 12 00:00:42,200 --> 00:00:45,239 Speaker 1: and grace. But our personal stories are threads in a 13 00:00:45,320 --> 00:00:48,320 Speaker 1: larger tapestry, and there are lessons for us in the 14 00:00:48,400 --> 00:00:51,120 Speaker 1: history of how we treat our skin and the progress 15 00:00:51,159 --> 00:00:55,520 Speaker 1: we've made together. Caring for our skin is caring for ourselves. 16 00:00:55,880 --> 00:00:59,280 Speaker 1: Whether you're seeking inspiration for your own journey or curious 17 00:00:59,320 --> 00:01:03,320 Speaker 1: about the history of our skin, you'll find empathetic, transformative 18 00:01:03,360 --> 00:01:09,320 Speaker 1: conversations here on Our Skin. I am joined today by 19 00:01:09,360 --> 00:01:12,959 Speaker 1: the incredible Andrea wool And. Andrea is the founder of 20 00:01:13,120 --> 00:01:17,240 Speaker 1: Autoimmune Strong, an online hub and community for people who 21 00:01:17,800 --> 00:01:20,720 Speaker 1: want to find exercise that works with their body and 22 00:01:20,800 --> 00:01:24,800 Speaker 1: not against it. For people living with autoimmune disorders, exercise 23 00:01:24,880 --> 00:01:27,720 Speaker 1: can be such a double edged sword. Not enough can 24 00:01:27,760 --> 00:01:32,040 Speaker 1: result in stiffness, fatigue, and pain, while exercising in the 25 00:01:32,080 --> 00:01:35,319 Speaker 1: wrong way or too hard can also result in flare 26 00:01:35,400 --> 00:01:39,880 Speaker 1: ups and pain. Again, so it's very careful needle the thread. 27 00:01:40,040 --> 00:01:44,200 Speaker 1: And Andrea knows this Catch twenty two firsthand. Welcome Andrea. 28 00:01:44,319 --> 00:01:46,520 Speaker 1: What an absolute treat to get to spend time with 29 00:01:46,600 --> 00:01:49,200 Speaker 1: you and dive a little deeper and talk about all 30 00:01:49,280 --> 00:01:53,480 Speaker 1: things autoimmune. Thanks so much for having me, Andrea. We 31 00:01:53,760 --> 00:01:56,360 Speaker 1: talk a lot about psoriasis on this show, but I 32 00:01:56,400 --> 00:01:59,920 Speaker 1: do want to acknowledge that you personally don't have sarius. 33 00:02:01,160 --> 00:02:04,920 Speaker 2: I do not. I do have multiple autoimmune conditions, and 34 00:02:05,200 --> 00:02:08,600 Speaker 2: many of my auto imune strong members have soriasis, so 35 00:02:09,040 --> 00:02:12,120 Speaker 2: we work a lot with people with psoriasis. My husband 36 00:02:12,160 --> 00:02:15,640 Speaker 2: and son also have it, but I personally don't. I 37 00:02:15,680 --> 00:02:19,080 Speaker 2: have a cocktail of many other things, and I hope 38 00:02:19,120 --> 00:02:21,840 Speaker 2: that to never add another piece to that puzzle. I 39 00:02:21,919 --> 00:02:23,359 Speaker 2: hope we can keep it the. 40 00:02:23,280 --> 00:02:23,840 Speaker 1: Way it is. 41 00:02:24,040 --> 00:02:26,760 Speaker 2: I do know a lot aboutsoriasis, and there are lots 42 00:02:26,800 --> 00:02:30,200 Speaker 2: of ways that exercise and psoriasis really partner. Well. 43 00:02:31,000 --> 00:02:33,080 Speaker 1: I also want to talk a little bit more about 44 00:02:33,080 --> 00:02:36,640 Speaker 1: your story. You just mentioned you have multiple autoimmune conditions. 45 00:02:36,840 --> 00:02:40,360 Speaker 1: You also have fibromyalgia. Will you talk to me a 46 00:02:40,360 --> 00:02:42,360 Speaker 1: little bit about your diagnoses. 47 00:02:43,000 --> 00:02:47,000 Speaker 2: Absolutely, I was diagnosed after the birth of my second son. 48 00:02:47,240 --> 00:02:50,720 Speaker 2: I've had health issues my whole life, and even as 49 00:02:50,760 --> 00:02:53,680 Speaker 2: a young kid, I was always in and out of doctors. 50 00:02:53,760 --> 00:02:55,720 Speaker 2: My family didn't really know what to do with me 51 00:02:55,760 --> 00:02:58,040 Speaker 2: because I always had something. I had a pink eye, 52 00:02:58,080 --> 00:02:59,919 Speaker 2: or a strep throat or of some kind of IRA. 53 00:03:00,639 --> 00:03:05,520 Speaker 2: I was always very susceptible. I had reconstructive ankle surgery 54 00:03:05,680 --> 00:03:09,520 Speaker 2: when I was twelve, and at the time, there wasn't 55 00:03:09,560 --> 00:03:13,720 Speaker 2: a lot of information about autoimmune disease, so they just 56 00:03:13,840 --> 00:03:17,800 Speaker 2: knew I had ligament laxity. They didn't know why what 57 00:03:17,960 --> 00:03:21,160 Speaker 2: was causing it. We now know that I have EDS, 58 00:03:21,840 --> 00:03:25,800 Speaker 2: and so we're now understanding that that is a chronic 59 00:03:25,840 --> 00:03:28,840 Speaker 2: illness issue and that that is what led to the 60 00:03:29,000 --> 00:03:31,200 Speaker 2: surgery that I had when I was twelve, But I 61 00:03:31,240 --> 00:03:34,600 Speaker 2: didn't learn that until I was almost forty. So it's 62 00:03:34,600 --> 00:03:38,240 Speaker 2: so interesting to learn things about your own diagnoses and 63 00:03:38,280 --> 00:03:41,520 Speaker 2: then look back on your health history and be like, oh, 64 00:03:41,840 --> 00:03:44,600 Speaker 2: that makes a lot of sense. So I had all 65 00:03:44,640 --> 00:03:47,440 Speaker 2: these chronic health issues when I was young, but nothing 66 00:03:47,480 --> 00:03:49,840 Speaker 2: really came to a head until after the birth of 67 00:03:49,840 --> 00:03:52,200 Speaker 2: my second son. I was able to get to the hospital, 68 00:03:52,200 --> 00:03:54,600 Speaker 2: but not able to get into delivery room. I gave 69 00:03:54,680 --> 00:03:57,720 Speaker 2: birth to him in the hallway, almost in the elevator, 70 00:03:57,840 --> 00:04:01,040 Speaker 2: and it was a very fast birthway I learned later 71 00:04:01,320 --> 00:04:05,600 Speaker 2: is that autoimmune diseases can be triggered by traumatic events. 72 00:04:05,680 --> 00:04:08,440 Speaker 2: And even though the birth of my son is certainly 73 00:04:08,480 --> 00:04:12,240 Speaker 2: not an emotional trauma, it is a physical trauma, especially 74 00:04:12,280 --> 00:04:13,839 Speaker 2: when it happens in that kind of way. And they're 75 00:04:13,840 --> 00:04:17,560 Speaker 2: all sorts of stories of women being diagnosed with autoimmune 76 00:04:17,560 --> 00:04:20,600 Speaker 2: disease after the birth of a child because it is 77 00:04:20,720 --> 00:04:24,599 Speaker 2: so traumatic for their body. So I had two children 78 00:04:24,680 --> 00:04:27,520 Speaker 2: at home, I had a newborn, I had a full 79 00:04:27,520 --> 00:04:29,800 Speaker 2: time job that I went back to after maternity leave, 80 00:04:30,279 --> 00:04:33,640 Speaker 2: and over the course of eight months or so, I 81 00:04:33,960 --> 00:04:36,040 Speaker 2: was a mess. My hair was falling out, I was 82 00:04:36,120 --> 00:04:40,120 Speaker 2: falling asleep everywhere, I was gaining weight instead of losing it. 83 00:04:40,279 --> 00:04:40,479 Speaker 1: You know. 84 00:04:40,520 --> 00:04:44,560 Speaker 2: There were just so many problems, and I went to 85 00:04:44,600 --> 00:04:46,040 Speaker 2: a whole bunch of doctors and they were like, well, 86 00:04:46,080 --> 00:04:49,120 Speaker 2: your postpartum. You just need to get through this postpartum 87 00:04:49,160 --> 00:04:51,880 Speaker 2: phase and you'll be fine. And my husband and I 88 00:04:51,880 --> 00:04:54,279 Speaker 2: are looking at each other going like, I'm not fine. 89 00:04:54,320 --> 00:04:56,280 Speaker 2: When am I going to be fine? I went to 90 00:04:56,320 --> 00:04:58,600 Speaker 2: a GI specialist and she was like, I don't really 91 00:04:58,680 --> 00:05:00,880 Speaker 2: know what's going on with you, but I will tell 92 00:05:00,920 --> 00:05:03,840 Speaker 2: you that a lot of people have had success by 93 00:05:03,920 --> 00:05:07,200 Speaker 2: going gluten free. I don't know what your diagnosis is, 94 00:05:07,240 --> 00:05:09,880 Speaker 2: but you can try that. After a month, I started 95 00:05:09,880 --> 00:05:12,880 Speaker 2: feeling better and I was like, Okay, this is something. 96 00:05:13,040 --> 00:05:17,400 Speaker 2: What's next? And within three months I was functional. It 97 00:05:17,480 --> 00:05:21,120 Speaker 2: was my gynecologist who said to me, it looks like 98 00:05:21,160 --> 00:05:24,720 Speaker 2: you have a swollen thyroid gland. You should go see 99 00:05:24,760 --> 00:05:28,919 Speaker 2: an anthrocinologist. I did and he You know, true to 100 00:05:29,000 --> 00:05:31,839 Speaker 2: form in the medical system, it's never smooth. You know. 101 00:05:31,880 --> 00:05:34,080 Speaker 2: The nurse calls me after I went through a whole 102 00:05:34,080 --> 00:05:37,000 Speaker 2: bunch of testing and the nurse called me and said, oh, 103 00:05:37,040 --> 00:05:39,680 Speaker 2: you're Hashimotos. Do you need up your dose or what 104 00:05:39,720 --> 00:05:43,120 Speaker 2: do you need? And I was like, wait, did what hashimotos? 105 00:05:43,160 --> 00:05:43,240 Speaker 1: Like? 106 00:05:43,279 --> 00:05:47,120 Speaker 2: Can you rewind? Thank goodness for Google. I still do 107 00:05:47,160 --> 00:05:48,760 Speaker 2: this to this day. I take the blood test that 108 00:05:48,800 --> 00:05:50,800 Speaker 2: come back, I google it, what does this mean? So 109 00:05:50,920 --> 00:05:55,159 Speaker 2: hashimotos diagnosis came next. Eventually I was then diagnosed with 110 00:05:55,240 --> 00:06:00,520 Speaker 2: celiac disease, and then I was diagnosed later, like many 111 00:06:00,600 --> 00:06:05,600 Speaker 2: years later, with EDS, and there's suspicion that there's maybe lupis, 112 00:06:05,600 --> 00:06:08,400 Speaker 2: but they can't really tell me for sure yet, and 113 00:06:08,440 --> 00:06:11,039 Speaker 2: there's a lot of question marks. But at the end 114 00:06:11,120 --> 00:06:14,520 Speaker 2: of the day, I am able to work with my 115 00:06:14,640 --> 00:06:18,320 Speaker 2: doctors and they get surprised. They're like, I don't know 116 00:06:18,360 --> 00:06:22,400 Speaker 2: what magic this is happening because I'm not on medication 117 00:06:22,480 --> 00:06:25,799 Speaker 2: for my hashimotos. I don't say that everybody is able 118 00:06:25,839 --> 00:06:28,599 Speaker 2: to get off their medications, but I was, and I've 119 00:06:28,600 --> 00:06:30,480 Speaker 2: been unmedicated for the last five years. 120 00:06:31,000 --> 00:06:34,920 Speaker 1: For people that don't experience something like this where they 121 00:06:34,920 --> 00:06:37,760 Speaker 1: can eat kind of whatever they wish and it's not 122 00:06:37,839 --> 00:06:40,560 Speaker 1: going to lead them to having a horrible evening or 123 00:06:40,640 --> 00:06:44,400 Speaker 1: day or whatever, it's easy to think that there's wiggle 124 00:06:44,440 --> 00:06:47,880 Speaker 1: room where there isn't. But I'm really curious, was there 125 00:06:47,920 --> 00:06:50,560 Speaker 1: a moment where people that had maybe felt that way 126 00:06:50,600 --> 00:06:53,080 Speaker 1: in your life started to see the improvements that you 127 00:06:53,120 --> 00:06:55,680 Speaker 1: were having and that you were returning to yourself. Did 128 00:06:55,720 --> 00:06:57,440 Speaker 1: you see that light bulb moment where they were like, 129 00:06:57,560 --> 00:06:58,880 Speaker 1: I get it, now, I get it. 130 00:06:59,240 --> 00:07:02,440 Speaker 2: Oh yes, Nobody in my life questions any of it. 131 00:07:02,480 --> 00:07:05,039 Speaker 2: They're like, this is what Andrea does because look at her. 132 00:07:05,520 --> 00:07:08,719 Speaker 2: I run my own business, I am a full time mom. 133 00:07:09,040 --> 00:07:10,080 Speaker 2: I'm an athlete again. 134 00:07:10,280 --> 00:07:10,520 Speaker 1: You know. 135 00:07:10,760 --> 00:07:13,280 Speaker 2: I am able to travel, I'm able to go out 136 00:07:13,280 --> 00:07:16,200 Speaker 2: to dinner and still have energy the next day. I 137 00:07:16,240 --> 00:07:19,640 Speaker 2: live the life that I want. And everybody around me 138 00:07:19,680 --> 00:07:21,800 Speaker 2: has seen that so much so that even back in 139 00:07:21,840 --> 00:07:25,200 Speaker 2: the day, people would see me at the supermarket and 140 00:07:25,240 --> 00:07:29,040 Speaker 2: they would whisper to me and they'd say, you look amazing. 141 00:07:29,360 --> 00:07:32,440 Speaker 2: What did you do because they had seen me the 142 00:07:32,560 --> 00:07:35,080 Speaker 2: year before where I look like I was dying. What 143 00:07:35,160 --> 00:07:38,920 Speaker 2: I've learned is that autoimmune disease is an invisible illness. 144 00:07:39,160 --> 00:07:43,080 Speaker 2: Nobody knows what you're hiding. Right. All they saw was 145 00:07:43,640 --> 00:07:46,440 Speaker 2: what I had been and then what I became. They 146 00:07:46,480 --> 00:07:48,320 Speaker 2: would say like, what happens? And I'm like, oh, well, 147 00:07:48,360 --> 00:07:50,560 Speaker 2: I was diagnosed with these autoimmune diseases and I was 148 00:07:50,600 --> 00:07:52,400 Speaker 2: able to turn my life around in this kind of way. 149 00:07:52,440 --> 00:07:55,080 Speaker 2: And they're like, oh my gosh, tell me how, because 150 00:07:55,240 --> 00:07:57,440 Speaker 2: I have. And then they'd share their story with me. 151 00:07:58,000 --> 00:08:01,040 Speaker 2: I have X, I'm desperate what do I do? And 152 00:08:01,080 --> 00:08:03,760 Speaker 2: that actually led me to after I had gone back 153 00:08:03,760 --> 00:08:06,280 Speaker 2: to school, I opened up a health coaching clinic and 154 00:08:06,640 --> 00:08:09,440 Speaker 2: within a month I had a wait list of like 155 00:08:09,520 --> 00:08:12,720 Speaker 2: three to four months. And that's actually how otto I 156 00:08:12,760 --> 00:08:15,960 Speaker 2: mean strong was born was because I was teaching nutrition 157 00:08:16,240 --> 00:08:18,520 Speaker 2: and fitness and I was like, well, nutrition is hard 158 00:08:18,520 --> 00:08:21,080 Speaker 2: to do online, but I can put up some exercise 159 00:08:21,160 --> 00:08:24,480 Speaker 2: videos and the people who are waiting to work with 160 00:08:24,560 --> 00:08:28,200 Speaker 2: me can like start exercising at home. And those exercise 161 00:08:28,280 --> 00:08:31,600 Speaker 2: videos became so popular that it just took off from there, 162 00:08:32,160 --> 00:08:34,480 Speaker 2: and I think a lot of people were really desperate 163 00:08:34,520 --> 00:08:37,400 Speaker 2: for that healing, and my healing was palpable to the 164 00:08:37,480 --> 00:08:41,280 Speaker 2: people who hardly knew me, which shows you how how 165 00:08:41,320 --> 00:08:43,040 Speaker 2: bad it was and how good it became. 166 00:08:43,800 --> 00:08:46,040 Speaker 1: I want to talk too, about your own journey in 167 00:08:46,080 --> 00:08:50,600 Speaker 1: that regard of self education, because once you had this 168 00:08:50,679 --> 00:08:54,520 Speaker 1: diagnosis and you know that this is an explanation for 169 00:08:54,600 --> 00:08:56,559 Speaker 1: what's been going on in your life and that it's 170 00:08:56,600 --> 00:09:00,280 Speaker 1: something that you're going to have to deal with going forward, 171 00:09:01,080 --> 00:09:05,199 Speaker 1: what were the things that you immediately thought about? It 172 00:09:05,280 --> 00:09:08,439 Speaker 1: was this something you knew about? Did you understand the 173 00:09:08,480 --> 00:09:13,040 Speaker 1: idea of autoimmune diseases before you realized that you had one. 174 00:09:13,760 --> 00:09:16,400 Speaker 2: You know, the word autoimmune. I had never heard it before. 175 00:09:16,480 --> 00:09:19,280 Speaker 2: I never heard gluten before. I never heard hashimotives before. 176 00:09:19,360 --> 00:09:23,760 Speaker 2: I think nowadays, with social media, there's a lot more awareness, 177 00:09:23,880 --> 00:09:26,680 Speaker 2: but back then there was nothing. So I would go 178 00:09:26,760 --> 00:09:28,920 Speaker 2: home and google what are healthy foods? 179 00:09:29,440 --> 00:09:29,640 Speaker 1: Right? 180 00:09:29,679 --> 00:09:32,120 Speaker 2: You know, I didn't even know because I had been 181 00:09:32,160 --> 00:09:37,319 Speaker 2: taught that healthy foods were, you know, low fat packaged 182 00:09:37,400 --> 00:09:41,199 Speaker 2: food items. And so now fast forward twelve years, I'm like, 183 00:09:41,400 --> 00:09:45,480 Speaker 2: my food is delicious. Not only is it nutritious, but 184 00:09:45,920 --> 00:09:49,400 Speaker 2: I love what I eat. It is so much yamier 185 00:09:49,720 --> 00:09:53,600 Speaker 2: than the diet than I had prior. So that's the 186 00:09:53,640 --> 00:09:57,160 Speaker 2: food piece. And then the exercise piece. I had known that. 187 00:09:57,200 --> 00:10:00,160 Speaker 2: I realized that the exercise I was doing wasn't really 188 00:10:00,200 --> 00:10:03,160 Speaker 2: working for me, but I didn't really know what exercise 189 00:10:03,960 --> 00:10:05,839 Speaker 2: was going to work for me. So I decided to 190 00:10:05,880 --> 00:10:09,440 Speaker 2: become a personal trainer. What I learned there is that 191 00:10:10,280 --> 00:10:14,400 Speaker 2: you don't learn anything about chronic illness as a personal trainer. Nothing. 192 00:10:15,080 --> 00:10:20,280 Speaker 2: You spend about half a module on special populations, which 193 00:10:20,320 --> 00:10:22,440 Speaker 2: is what do you do when a client has like 194 00:10:22,600 --> 00:10:26,560 Speaker 2: heart disease or heart failure, and that's pretty much it. 195 00:10:26,679 --> 00:10:31,160 Speaker 2: You don't learn anything about how to treat someone with 196 00:10:31,360 --> 00:10:33,679 Speaker 2: autoimmune disease. And so I was like, Okay, well this 197 00:10:33,760 --> 00:10:37,240 Speaker 2: isn't very helpful. So that's when I started. I spent 198 00:10:37,360 --> 00:10:41,360 Speaker 2: like a year and a half putting together the science 199 00:10:41,840 --> 00:10:45,640 Speaker 2: on exercise and autoimmune disease because I wasn't worried about 200 00:10:45,640 --> 00:10:48,040 Speaker 2: helping other people at this moment. I was literally just 201 00:10:48,040 --> 00:10:51,480 Speaker 2: trying to develop a course of action for myself, and 202 00:10:51,520 --> 00:10:53,200 Speaker 2: so I was my own guinea pig, and I was 203 00:10:53,520 --> 00:10:55,640 Speaker 2: you did a lot of trial and error. There were 204 00:10:55,640 --> 00:10:58,000 Speaker 2: a lot of things I did wrong. And then as 205 00:10:58,040 --> 00:11:00,720 Speaker 2: I got these clients, I was open with them. I 206 00:11:00,760 --> 00:11:03,160 Speaker 2: was like, I'm still learning, We're going to try things. 207 00:11:04,080 --> 00:11:06,480 Speaker 2: And then once I put the videos up online, now 208 00:11:06,520 --> 00:11:09,440 Speaker 2: we have like thousands of people all across the globe 209 00:11:09,600 --> 00:11:12,959 Speaker 2: using these exercise videos and giving us feedback. So we 210 00:11:13,040 --> 00:11:16,400 Speaker 2: are really learning this works, well, this doesn't work. This 211 00:11:16,480 --> 00:11:19,160 Speaker 2: is what works, you know for someone with rheumatoriy arthritis, 212 00:11:19,160 --> 00:11:21,520 Speaker 2: but maybe it doesn't work so well for somebody with 213 00:11:21,600 --> 00:11:25,440 Speaker 2: something else. So you know, we're constantly learning and getting 214 00:11:25,480 --> 00:11:28,880 Speaker 2: feedback from everybody. Because everybody is a little bit different. 215 00:11:29,360 --> 00:11:32,160 Speaker 1: I want to talk a little bit more about autoimmune strong. 216 00:11:32,800 --> 00:11:36,160 Speaker 1: Do you see people that come in that are trying 217 00:11:36,200 --> 00:11:39,800 Speaker 1: to help manage their psoriasis and including movement in it 218 00:11:39,880 --> 00:11:40,920 Speaker 1: and what is that like? 219 00:11:41,840 --> 00:11:44,960 Speaker 2: Yeah, because what a lot of people have figured out 220 00:11:45,040 --> 00:11:49,240 Speaker 2: through their personal experience is that their psoriasis gets worse 221 00:11:49,400 --> 00:11:54,200 Speaker 2: when they exercise. But also, you're supposed to exercise for 222 00:11:54,320 --> 00:11:57,319 Speaker 2: your health, So how do you exercise for your health 223 00:11:57,800 --> 00:12:03,480 Speaker 2: but also not trigger us viais flair because that's super uncomfortable. Ultimately, 224 00:12:03,559 --> 00:12:09,040 Speaker 2: here's the link. Sooriasis is triggered by stress. Exercise is 225 00:12:09,120 --> 00:12:11,960 Speaker 2: stress on the body. That's how exercise works. And the 226 00:12:12,000 --> 00:12:16,760 Speaker 2: way I explain it is that all humans autoimmune ssoriasis 227 00:12:16,880 --> 00:12:21,600 Speaker 2: are not They have a baseline of stress tolerance. 228 00:12:21,679 --> 00:12:21,880 Speaker 1: Right. 229 00:12:22,040 --> 00:12:24,160 Speaker 2: Think of a glass of water. You have an empty glass. 230 00:12:24,480 --> 00:12:28,320 Speaker 2: That empty glass is your ability to handle stress. Then 231 00:12:28,640 --> 00:12:31,600 Speaker 2: you get a diagnosis of siasis or an autoimmune disease. 232 00:12:32,840 --> 00:12:34,880 Speaker 2: You have to fill up that glass with a little 233 00:12:34,880 --> 00:12:37,960 Speaker 2: bit of water, like add an inch. Now you have 234 00:12:38,120 --> 00:12:42,040 Speaker 2: less room for stress. You have water in there that 235 00:12:42,240 --> 00:12:46,520 Speaker 2: represents the stress. Because even when you're sleeping, your body 236 00:12:46,640 --> 00:12:50,679 Speaker 2: is fighting a chronic illness. Then you add in your 237 00:12:50,679 --> 00:12:53,880 Speaker 2: commute to work. Then you add in the it's super 238 00:12:53,920 --> 00:12:56,200 Speaker 2: hot out and your body is stressed. You add in 239 00:12:56,240 --> 00:12:58,120 Speaker 2: all the things that humans have to deal with, and 240 00:12:58,160 --> 00:13:03,199 Speaker 2: we have less stress tolerance then people without chronic disease, 241 00:13:03,400 --> 00:13:06,959 Speaker 2: crisis or autoimmune So you have to find that happy medium. 242 00:13:07,000 --> 00:13:10,280 Speaker 2: I call it the GOLDILCS principle that like sweet spot, 243 00:13:10,440 --> 00:13:13,400 Speaker 2: you can't exercise too little, but you can't exercise too much, 244 00:13:14,240 --> 00:13:17,040 Speaker 2: And that sweet spot is something that really only you 245 00:13:17,400 --> 00:13:20,400 Speaker 2: can determine. But I have lots of tools to help 246 00:13:20,440 --> 00:13:21,679 Speaker 2: you figure out what that is. 247 00:13:22,559 --> 00:13:25,120 Speaker 1: Sort of a tool that happens as a result of 248 00:13:25,160 --> 00:13:28,880 Speaker 1: autoimmune strong is that there is a huge community aspect 249 00:13:28,960 --> 00:13:31,280 Speaker 1: of it. Will you tell me what it's like When 250 00:13:31,360 --> 00:13:34,040 Speaker 1: people join the Facebook group or they start following you 251 00:13:34,080 --> 00:13:36,720 Speaker 1: on Instagram, even if they're not looking for a trainer, 252 00:13:36,800 --> 00:13:40,600 Speaker 1: there seems to be this really really active community of 253 00:13:40,679 --> 00:13:42,319 Speaker 1: support and information sharing. 254 00:13:43,200 --> 00:13:46,559 Speaker 2: Well, look, the reality is is that we've all been 255 00:13:46,600 --> 00:13:48,480 Speaker 2: to the doctor and the doctor tells us that we 256 00:13:48,559 --> 00:13:51,560 Speaker 2: need to exercise and lose weight, right Like, that's a 257 00:13:51,679 --> 00:13:55,240 Speaker 2: very common It is a very common You go in 258 00:13:55,320 --> 00:13:57,440 Speaker 2: here for your appointment for fifteen minutes you're like, I 259 00:13:57,440 --> 00:13:59,839 Speaker 2: have all these problems, and they're like, well, if you 260 00:14:00,200 --> 00:14:02,719 Speaker 2: exercise a little bit more, you know, and lost some weight, 261 00:14:02,760 --> 00:14:07,520 Speaker 2: I bet you'd feel better. It leaves people feeling hopeless, right, 262 00:14:07,880 --> 00:14:12,320 Speaker 2: And so what I try to do through my work 263 00:14:12,320 --> 00:14:14,600 Speaker 2: on social media and the work through auto I mean strong, 264 00:14:14,679 --> 00:14:18,160 Speaker 2: is to let people know, to educate them. It's not 265 00:14:18,280 --> 00:14:21,040 Speaker 2: that you're not trying hard enough, right, So I try 266 00:14:21,080 --> 00:14:23,680 Speaker 2: to help people have these light bulb moments being like, oh, 267 00:14:23,880 --> 00:14:27,160 Speaker 2: it's not that I'm doing something wrong. It's that what 268 00:14:27,280 --> 00:14:30,080 Speaker 2: I'm doing isn't the right fit for my body, and 269 00:14:30,120 --> 00:14:33,720 Speaker 2: I just need to try something different. And we actually 270 00:14:33,720 --> 00:14:35,920 Speaker 2: find that. Then they go home and they talk to 271 00:14:36,000 --> 00:14:39,880 Speaker 2: their spouses and their kids and their friends about like, oh, 272 00:14:40,000 --> 00:14:43,960 Speaker 2: I'm learning that my autoimmune disease has a side effect, 273 00:14:44,080 --> 00:14:47,040 Speaker 2: and that side effect is exercise intolerance. And then the 274 00:14:47,120 --> 00:14:50,440 Speaker 2: family is able to say, okay, well, maybe maybe we're 275 00:14:50,440 --> 00:14:52,360 Speaker 2: doing too much right now, maybe we need to help 276 00:14:52,400 --> 00:14:55,640 Speaker 2: you have more rest days. And it actually there's a 277 00:14:55,680 --> 00:14:59,440 Speaker 2: cascade where then people around you can start to participate 278 00:14:59,480 --> 00:15:01,960 Speaker 2: in helping you protect your health, you know. And then 279 00:15:02,000 --> 00:15:04,600 Speaker 2: you talk to your friends and they're like, oh wait, 280 00:15:04,840 --> 00:15:05,680 Speaker 2: that's a real thing. 281 00:15:06,280 --> 00:15:06,920 Speaker 1: I have that too. 282 00:15:07,120 --> 00:15:10,200 Speaker 2: I've been experiencing that too. So you know, the more 283 00:15:10,240 --> 00:15:12,880 Speaker 2: we can educate, the more we can have light bulb moments, 284 00:15:12,920 --> 00:15:14,040 Speaker 2: and the better we can feel. 285 00:15:14,600 --> 00:15:18,560 Speaker 1: You mentioned that your husband has psoriasis. Do you coach him? 286 00:15:19,520 --> 00:15:25,040 Speaker 2: Oh, that's a tricky question, IVET Yes, I do. I 287 00:15:25,080 --> 00:15:29,480 Speaker 2: mean he's learned a lot from watching me, and I 288 00:15:29,520 --> 00:15:32,840 Speaker 2: will say to him, like, you know, you're burning the 289 00:15:32,880 --> 00:15:34,960 Speaker 2: candle at both ends right now, Like what can I 290 00:15:35,000 --> 00:15:38,040 Speaker 2: do to support you? How do we reduce your load? Like? 291 00:15:38,080 --> 00:15:40,520 Speaker 2: You know, he wasn't. I go to the doctor a lot, 292 00:15:40,560 --> 00:15:42,680 Speaker 2: but he didn't, and so I was the one that 293 00:15:42,840 --> 00:15:44,760 Speaker 2: saw it, and I was like, I think you better 294 00:15:44,800 --> 00:15:48,280 Speaker 2: go see somebody. You know, it's useful to have people 295 00:15:48,320 --> 00:15:52,160 Speaker 2: around you watching out and saying, hey, that doesn't look right. 296 00:15:53,000 --> 00:15:55,560 Speaker 1: Andrea, thank you so much for sharing your story of 297 00:15:55,720 --> 00:15:59,960 Speaker 1: how you have managed to advocate for yourself and help 298 00:16:00,080 --> 00:16:03,200 Speaker 1: other people to train for the marathon of life. We 299 00:16:03,560 --> 00:16:05,480 Speaker 1: are going to come back here in just a moment 300 00:16:05,600 --> 00:16:08,080 Speaker 1: and we are going to zoom in on the immune 301 00:16:08,120 --> 00:16:11,760 Speaker 1: system and autoimmune disease. Through the lens of history, we 302 00:16:11,880 --> 00:16:14,280 Speaker 1: have learned a lot about how these conditions happen, but 303 00:16:14,840 --> 00:16:18,200 Speaker 1: you might be shocked at how recently. We'll be right back. 304 00:16:35,520 --> 00:16:38,680 Speaker 1: We know here on our skin that autoimmune disorders are 305 00:16:38,800 --> 00:16:41,920 Speaker 1: chronic disorders. But if you ask any old, average Joe 306 00:16:41,920 --> 00:16:45,560 Speaker 1: on the street to name some common chronic illnesses, they 307 00:16:45,640 --> 00:16:49,440 Speaker 1: might think of heart disease or diabetes. But autoimmune diseases 308 00:16:49,760 --> 00:16:52,720 Speaker 1: are the third most common cause of chronic illness in 309 00:16:52,760 --> 00:16:56,000 Speaker 1: the United States, and they are becoming more and more prevalent. 310 00:16:56,480 --> 00:16:59,960 Speaker 1: According to the National Institutes of Health, autoimmune diseases affect 311 00:17:00,120 --> 00:17:03,960 Speaker 1: somewhere between five and eight percent of the US population. 312 00:17:04,840 --> 00:17:08,760 Speaker 1: That's around twenty three point five million people, although some 313 00:17:09,040 --> 00:17:12,479 Speaker 1: estimates suggest that number could be even higher, possibly as 314 00:17:12,520 --> 00:17:15,399 Speaker 1: high actually as ten percent of the population. So to 315 00:17:15,480 --> 00:17:18,200 Speaker 1: put that in perspective, we're talking about as many as 316 00:17:18,240 --> 00:17:21,960 Speaker 1: thirty three million people dealing with these kinds of conditions. 317 00:17:22,440 --> 00:17:26,320 Speaker 1: And one of the more common autoimmune diseases is psoriasis, 318 00:17:26,400 --> 00:17:29,880 Speaker 1: affecting about three percent of the US population. That means 319 00:17:29,920 --> 00:17:32,919 Speaker 1: that's about eight million people. It's just one of more 320 00:17:33,000 --> 00:17:37,280 Speaker 1: than one hundred different types of autoimmune diseases, which include 321 00:17:37,280 --> 00:17:41,280 Speaker 1: conditions like Andrea has talked about today, including rheumatoid arthritis, 322 00:17:41,520 --> 00:17:46,920 Speaker 1: also multiple sclerosis, scleroderma, lupus, and thyroid disease. And each 323 00:17:46,960 --> 00:17:50,679 Speaker 1: of these diseases is unique, but they all share a 324 00:17:50,720 --> 00:17:55,119 Speaker 1: common feature, which is that the body's immune system mistakenly 325 00:17:55,160 --> 00:17:59,159 Speaker 1: attacks its own cells. So, Andrea, it is super easy 326 00:17:59,160 --> 00:18:02,960 Speaker 1: to say autoimmune diseases as though it's some obvious category, 327 00:18:03,520 --> 00:18:08,560 Speaker 1: but there are so many ways that autoimmune dysfunction manifests, right. 328 00:18:08,720 --> 00:18:10,160 Speaker 2: Oh, absolutely, it's a. 329 00:18:10,119 --> 00:18:13,720 Speaker 1: Little bit nuts that one mechanism can not only cause 330 00:18:13,720 --> 00:18:16,159 Speaker 1: all of these different diseases, but two people with the 331 00:18:16,200 --> 00:18:19,960 Speaker 1: same disease may exhibit it in completely different ways. I'm 332 00:18:20,000 --> 00:18:21,040 Speaker 1: sure you see that all the. 333 00:18:21,040 --> 00:18:23,640 Speaker 2: Time, all the time, all the time, and so it's 334 00:18:23,840 --> 00:18:26,360 Speaker 2: very hard to even know whether or not to see 335 00:18:26,359 --> 00:18:30,160 Speaker 2: the doctor about it because sometimes it feels like normal symptoms, 336 00:18:30,200 --> 00:18:32,240 Speaker 2: like oh, I'm just tired all the time because life 337 00:18:32,280 --> 00:18:36,480 Speaker 2: is busy. But these symptoms can be very hard. We 338 00:18:36,800 --> 00:18:38,800 Speaker 2: talk about a lot in our house, like am I sick? 339 00:18:39,080 --> 00:18:39,920 Speaker 2: Or is it a flair? 340 00:18:40,240 --> 00:18:43,120 Speaker 1: Right? It can be hard to tell, and it's been 341 00:18:43,200 --> 00:18:47,639 Speaker 1: hard historically and statistically, women actually make up about eighty 342 00:18:47,680 --> 00:18:51,119 Speaker 1: percent of the people with autoimmune conditions. That is a 343 00:18:51,160 --> 00:18:54,840 Speaker 1: staggering number. So it brings up the question why are 344 00:18:54,880 --> 00:18:58,240 Speaker 1: women so much more affected by autoimmune disease than men? 345 00:18:58,359 --> 00:19:01,000 Speaker 1: And today we're going to explore this bience behind this 346 00:19:01,200 --> 00:19:05,439 Speaker 1: disparity and try to understand why these diagnoses seem to 347 00:19:05,440 --> 00:19:08,800 Speaker 1: disproportionately affect women. But before we get into why, I 348 00:19:08,840 --> 00:19:11,480 Speaker 1: want to take a little historical detour and talk about 349 00:19:11,520 --> 00:19:14,119 Speaker 1: some of the key figures who have shaped our understanding 350 00:19:14,200 --> 00:19:17,399 Speaker 1: of autoimmune disease. So we're going to start with Paul Erlick. 351 00:19:18,119 --> 00:19:20,919 Speaker 1: Erlick was a German physician and scientist who worked in 352 00:19:20,920 --> 00:19:24,320 Speaker 1: the late nineteenth and early twentieth centuries. He's actually the 353 00:19:24,359 --> 00:19:28,240 Speaker 1: person who coined the term autoimmunity and proposed that the 354 00:19:28,280 --> 00:19:32,840 Speaker 1: immune system might sometimes fail to differentiate between the self 355 00:19:32,920 --> 00:19:37,600 Speaker 1: and the non self, leading to what he called horror autotoxicus, 356 00:19:38,119 --> 00:19:41,040 Speaker 1: which is the horror of self toxicity. In other words, 357 00:19:41,040 --> 00:19:45,080 Speaker 1: the immune system attacking the body's own tissues and also 358 00:19:45,200 --> 00:19:47,040 Speaker 1: potentially a great metal band name. 359 00:19:47,320 --> 00:19:49,560 Speaker 2: I love that name. I feel like it represents what 360 00:19:49,640 --> 00:19:53,080 Speaker 2: we deal with very accurately one hundred percent. 361 00:19:53,680 --> 00:19:57,480 Speaker 1: In eighteen ninety seven, Erlick proposed what he initially called 362 00:19:57,600 --> 00:20:01,679 Speaker 1: the side chain model of immunity, to account for his 363 00:20:01,800 --> 00:20:07,200 Speaker 1: experimental observations, so he imagined that toxins or bacteria could sometimes, 364 00:20:07,480 --> 00:20:09,960 Speaker 1: for lack of a better word, trick our body cells, 365 00:20:10,320 --> 00:20:13,239 Speaker 1: which are set up with receptors to absorb nutrients out 366 00:20:13,240 --> 00:20:17,280 Speaker 1: of the bloodstream, and during an infection, these receptors would 367 00:20:17,359 --> 00:20:21,359 Speaker 1: confuse microbial toxins with nutrients and thus get infected and 368 00:20:21,400 --> 00:20:25,000 Speaker 1: stop working properly. So to compensate, the cell would produce 369 00:20:25,040 --> 00:20:27,880 Speaker 1: more receptors to try to get the nutrients they need 370 00:20:27,920 --> 00:20:32,040 Speaker 1: as other receptors malfunction. Then these excess receptors would then 371 00:20:32,080 --> 00:20:35,400 Speaker 1: shed into the bloodstream once the infection cleared up, and 372 00:20:35,440 --> 00:20:39,760 Speaker 1: there they would accumulate and act as antitoxins or antibodies, 373 00:20:40,040 --> 00:20:43,800 Speaker 1: protecting against subsequent exposures to the same infection. So this 374 00:20:44,000 --> 00:20:46,919 Speaker 1: was Erlik's theory, and it turned out to be not 375 00:20:47,359 --> 00:20:51,040 Speaker 1: quite right. So right now we know that there is 376 00:20:51,080 --> 00:20:53,919 Speaker 1: a special cell called a plasma cell that is dedicated 377 00:20:53,960 --> 00:20:57,760 Speaker 1: to producing antibodies. Erlk of course thought that all cells 378 00:20:57,800 --> 00:21:00,960 Speaker 1: had this function in some way. But despite of shortcomings, 379 00:21:01,080 --> 00:21:03,960 Speaker 1: Erlick's side chain model was really really groundbreaking, and it 380 00:21:04,040 --> 00:21:08,280 Speaker 1: actually paid the way for the subsequent correct description of 381 00:21:08,600 --> 00:21:12,560 Speaker 1: antibody formation, and it introduced the lock and key concept 382 00:21:12,600 --> 00:21:16,320 Speaker 1: that became the basis of our understanding of adaptive immunity. 383 00:21:17,000 --> 00:21:20,040 Speaker 1: Another key figure in the history of autoimmune disease research 384 00:21:20,160 --> 00:21:24,280 Speaker 1: is William Damashek. Doctor. Damashek was named Zev at his 385 00:21:24,359 --> 00:21:27,120 Speaker 1: birth in Varnaj, Russia, and then at the age of three, 386 00:21:27,200 --> 00:21:29,159 Speaker 1: he was brought to the United States by his parents. 387 00:21:29,240 --> 00:21:32,159 Speaker 1: They settled in Medford, Massachusetts, and at that point they 388 00:21:32,200 --> 00:21:35,159 Speaker 1: renamed him William in nineteen oh three to more easily 389 00:21:35,160 --> 00:21:38,800 Speaker 1: adapt to his new home country. And then Damashek expanded 390 00:21:38,920 --> 00:21:41,840 Speaker 1: on the ideas that Erlik had set forth, proposing that 391 00:21:41,920 --> 00:21:46,760 Speaker 1: autoimmune disease Erlick's horror autotoxicus result from the immune system's 392 00:21:46,800 --> 00:21:51,439 Speaker 1: failure to recognize self tissues, leading to disorders like aplastic 393 00:21:51,440 --> 00:21:55,080 Speaker 1: anemia and other conditions. And in the mid twentieth century 394 00:21:55,119 --> 00:21:58,879 Speaker 1: he proposed that many autoimmune diseases might be linked to 395 00:21:58,880 --> 00:22:02,359 Speaker 1: the body producing anti bodies against its own cells. That 396 00:22:02,480 --> 00:22:04,920 Speaker 1: is a theory that has been supported by so much 397 00:22:04,960 --> 00:22:08,639 Speaker 1: research since then. So he's the one that really drilled 398 00:22:08,680 --> 00:22:12,080 Speaker 1: down and figured out the mechanics of how these disorders work. 399 00:22:12,560 --> 00:22:16,360 Speaker 1: One of The very first to apply Erlis and Damashek's 400 00:22:16,400 --> 00:22:19,960 Speaker 1: findings to dermatology was E. J. Van Scott, a contemporary 401 00:22:20,000 --> 00:22:22,359 Speaker 1: of Damashek's who was working in the US in the 402 00:22:22,400 --> 00:22:26,119 Speaker 1: mid fifties and man. Scott published significant findings on the 403 00:22:26,200 --> 00:22:29,879 Speaker 1: role of keratinocytes, the primary cells in the outer layer 404 00:22:29,920 --> 00:22:34,280 Speaker 1: of the skin, in the pathogenesis of psoriasis. He demonstrated 405 00:22:34,280 --> 00:22:38,320 Speaker 1: that abnormal overproduction of these cells contributed to that characteristic 406 00:22:38,400 --> 00:22:41,760 Speaker 1: scaling and inflammation that is seen in the disease, and 407 00:22:41,800 --> 00:22:44,760 Speaker 1: then by nineteen fifty seven he had introduced research proving 408 00:22:44,880 --> 00:22:49,360 Speaker 1: psoriasis was not really a skin condition, but an autoimmune 409 00:22:49,400 --> 00:22:53,000 Speaker 1: disorder that the body attacking skin cells once again, our 410 00:22:53,040 --> 00:22:58,399 Speaker 1: good friend horror autotoxicus caused abnormal skin cell turnover. In 411 00:22:58,480 --> 00:23:02,720 Speaker 1: nineteen fifty seven he suggested using methotrex eight and immunosuppressant 412 00:23:02,840 --> 00:23:06,879 Speaker 1: to treat psoriasis, which marked a significant advance in treating 413 00:23:06,880 --> 00:23:10,239 Speaker 1: the cause of psoriasis, not just the symptoms, and so 414 00:23:10,280 --> 00:23:12,560 Speaker 1: he truly really laid the groundwork for some of the 415 00:23:12,560 --> 00:23:17,399 Speaker 1: most modern treatments that we currently have for psoriasis, including biologics, 416 00:23:17,440 --> 00:23:19,240 Speaker 1: which we're going to get into a whole lot in 417 00:23:19,280 --> 00:23:23,480 Speaker 1: the next episode. So Andrea, the first biologic came to 418 00:23:23,560 --> 00:23:27,320 Speaker 1: the market in nineteen ninety eight, meaning that we got 419 00:23:27,359 --> 00:23:30,560 Speaker 1: to that development from this most basic understanding of the 420 00:23:30,640 --> 00:23:34,240 Speaker 1: roots of psoriasis in about forty years. And that seems 421 00:23:34,240 --> 00:23:37,320 Speaker 1: like why did it take so long? But that is 422 00:23:37,440 --> 00:23:40,080 Speaker 1: actually a very big leap in a very short time, 423 00:23:40,440 --> 00:23:44,080 Speaker 1: because if you consider there was basically no improvement on 424 00:23:44,119 --> 00:23:48,959 Speaker 1: the treatment of psoriasis from like four hundred BCE until 425 00:23:49,000 --> 00:23:52,200 Speaker 1: the fifties, because people knew it existed, they didn't really 426 00:23:52,200 --> 00:23:55,560 Speaker 1: know what it was. You have probably in your time 427 00:23:55,640 --> 00:23:59,159 Speaker 1: working seen some of these advancements that have happened very 428 00:23:59,240 --> 00:24:00,920 Speaker 1: rapidly in the last decade or so. 429 00:24:01,320 --> 00:24:04,760 Speaker 2: Oh one hundred percent the amount of knowledge that people 430 00:24:04,760 --> 00:24:07,920 Speaker 2: are coming in with. Now, a lot of people are 431 00:24:07,960 --> 00:24:11,600 Speaker 2: getting diagnoses because they're reading about their problems, and then 432 00:24:11,600 --> 00:24:13,359 Speaker 2: they're able to go to the doctor and say I 433 00:24:13,400 --> 00:24:16,240 Speaker 2: think I have They're able to communicate so much better 434 00:24:16,240 --> 00:24:19,240 Speaker 2: with their doctor, but also their doctor's knowledge is so 435 00:24:19,480 --> 00:24:23,000 Speaker 2: much farther along. Right, there's so much more medical knowledge, 436 00:24:23,000 --> 00:24:26,360 Speaker 2: and then also so much more knowledge from a patient's 437 00:24:26,359 --> 00:24:27,120 Speaker 2: side as well. 438 00:24:27,800 --> 00:24:31,920 Speaker 1: As we talk about history and the science of autoimmune diseases. 439 00:24:32,400 --> 00:24:34,920 Speaker 1: It is important to remember these conditions have been around 440 00:24:34,960 --> 00:24:37,960 Speaker 1: for a very long time, but our understanding of them 441 00:24:38,040 --> 00:24:40,800 Speaker 1: really is still very new. We have watched it played 442 00:24:40,840 --> 00:24:43,800 Speaker 1: out in Andrea's story as something that is kind of 443 00:24:43,840 --> 00:24:47,359 Speaker 1: growing along with her since her diagnosis. It's almost like 444 00:24:47,520 --> 00:24:50,639 Speaker 1: genewis right there at the NeXT's point of the beginning 445 00:24:50,720 --> 00:24:53,360 Speaker 1: of all of us learning a lot more, and in fact, 446 00:24:53,440 --> 00:24:57,800 Speaker 1: the prevalence of autoimmune diseases might be increasing. A study 447 00:24:57,800 --> 00:25:01,240 Speaker 1: published in April twenty twenty in Our Critis in Rheumatology 448 00:25:01,320 --> 00:25:05,240 Speaker 1: found that the prevalence of anti nuclear antibodies, or ANA, 449 00:25:05,320 --> 00:25:09,960 Speaker 1: which are a common biomarker for autoimmunity, is significantly increasing 450 00:25:10,000 --> 00:25:13,200 Speaker 1: in the United States. So these researchers looked at data 451 00:25:13,280 --> 00:25:17,320 Speaker 1: spanning several decades and found that ANA prevalence increased from 452 00:25:17,680 --> 00:25:20,600 Speaker 1: eleven percent in the late nineteen eighties and early nineteen 453 00:25:20,680 --> 00:25:24,600 Speaker 1: nineties to eleven point five percent in the early two thousands, 454 00:25:24,640 --> 00:25:28,080 Speaker 1: and then made a big jump to fifteen point nine 455 00:25:28,119 --> 00:25:32,800 Speaker 1: percent by twenty eleven twenty twelve. These percentages correspond to 456 00:25:32,840 --> 00:25:36,160 Speaker 1: twenty two million people in the earlier period twenty seven 457 00:25:36,240 --> 00:25:38,919 Speaker 1: million people in the middle period. And then by the 458 00:25:38,920 --> 00:25:41,600 Speaker 1: time you get to that twenty eleven twenty twelve statistic, 459 00:25:42,000 --> 00:25:46,400 Speaker 1: a whopping forty one million people by their most recent estimates. 460 00:25:46,440 --> 00:25:49,879 Speaker 1: So what's particularly interesting here is that this wasn't uniform 461 00:25:49,960 --> 00:25:53,080 Speaker 1: across all groups. Right. The rise in ANA prevalence was 462 00:25:53,160 --> 00:25:58,040 Speaker 1: most notable among males, non Hispanic whites, and adults over 463 00:25:58,119 --> 00:26:02,159 Speaker 1: fifty and adolescent. And this suggests that a variety of 464 00:26:02,200 --> 00:26:06,959 Speaker 1: factors age, gender, ethnicity might be influencing the development of autoimmunity. 465 00:26:07,400 --> 00:26:09,520 Speaker 1: And it's a big deal that men are one of 466 00:26:09,520 --> 00:26:13,520 Speaker 1: those categories where we're seeing more autoimmune disease, and that 467 00:26:13,640 --> 00:26:18,600 Speaker 1: every researcher we've discussed here is male. As mentioned earlier, 468 00:26:18,640 --> 00:26:23,359 Speaker 1: we now see autoimmune diseases disproportionately affecting women. Some eighty 469 00:26:23,400 --> 00:26:27,199 Speaker 1: percent of patients are women. So I imagine do you 470 00:26:27,280 --> 00:26:30,680 Speaker 1: see this in your work? Is the majority of your 471 00:26:30,840 --> 00:26:33,439 Speaker 1: client base and the people that you work with women? 472 00:26:34,040 --> 00:26:38,040 Speaker 2: Yes, we are ninety percent female in our membership, and 473 00:26:38,640 --> 00:26:41,720 Speaker 2: I think it's partly that there's a lot of women 474 00:26:42,480 --> 00:26:46,080 Speaker 2: who are diagnosed more women than men, but also a 475 00:26:46,119 --> 00:26:50,040 Speaker 2: lot of the men that I have spoken to are 476 00:26:50,080 --> 00:26:58,119 Speaker 2: not always as open to changeing It's very interesting. You know, 477 00:26:58,359 --> 00:27:01,240 Speaker 2: there's a kind of thought process us whereas I think 478 00:27:01,280 --> 00:27:04,600 Speaker 2: women are quicker to ask for help, so I am 479 00:27:04,960 --> 00:27:08,600 Speaker 2: over the last five years, I'm seeing that change and 480 00:27:08,680 --> 00:27:12,400 Speaker 2: we are having more men come to us. So I'm 481 00:27:12,440 --> 00:27:15,760 Speaker 2: excited by that because I think asking for help is 482 00:27:15,960 --> 00:27:16,480 Speaker 2: a good thing. 483 00:27:16,880 --> 00:27:20,880 Speaker 1: Yes, I concur to go back to this disproportionately affecting 484 00:27:20,920 --> 00:27:24,879 Speaker 1: women issue. What's interesting is there's no single clearcut answer 485 00:27:24,960 --> 00:27:29,040 Speaker 1: to why that's the case, but modern researchers have identified 486 00:27:29,080 --> 00:27:31,879 Speaker 1: some factors that might be contributing to this disparity. So 487 00:27:32,480 --> 00:27:35,560 Speaker 1: one of the most significant factors, it's probably pretty easy 488 00:27:35,600 --> 00:27:39,199 Speaker 1: to guess because it's a hormonal difference issue. Estrogen, the 489 00:27:39,240 --> 00:27:42,120 Speaker 1: primary female sex hormone, is thought to play a role 490 00:27:42,160 --> 00:27:45,520 Speaker 1: in the immune system, and some studies suggest that estrogen 491 00:27:45,600 --> 00:27:49,200 Speaker 1: can enhance the immune response, which might make women more 492 00:27:49,240 --> 00:27:53,280 Speaker 1: susceptible to developing autoimmune diseases. On the flip side, this 493 00:27:53,320 --> 00:27:57,040 Speaker 1: could also explain why women generally have stronger immune responses 494 00:27:57,040 --> 00:28:00,920 Speaker 1: to infections when compared to men. And there's another factor, 495 00:28:00,960 --> 00:28:04,280 Speaker 1: which is genetic predisposition. So if a person has two 496 00:28:04,440 --> 00:28:07,600 Speaker 1: X chromosomes, they're considered female and if they have an 497 00:28:07,760 --> 00:28:11,760 Speaker 1: X and Y chromosomal combination, they're generally considered male. So 498 00:28:12,160 --> 00:28:14,920 Speaker 1: worth noting here as we're having this discussion, right, sex, 499 00:28:15,000 --> 00:28:18,840 Speaker 1: chromosomes and genetic expression can vary a whole lot, and 500 00:28:19,000 --> 00:28:21,560 Speaker 1: gender is really a completely different thing. But for the 501 00:28:21,600 --> 00:28:24,399 Speaker 1: sake of this discussion, since most of the research we 502 00:28:24,480 --> 00:28:27,640 Speaker 1: have looks at a binary man woman model, we're using 503 00:28:27,680 --> 00:28:31,560 Speaker 1: those terminologies here. So the X chromosome carries a significant 504 00:28:31,640 --> 00:28:35,960 Speaker 1: number of genes related to the immune system, and having 505 00:28:36,000 --> 00:28:41,320 Speaker 1: two X chromosomes might increase the likelihood of immune system malfunctions. However, 506 00:28:41,440 --> 00:28:43,960 Speaker 1: this also means that women might be better equipped to 507 00:28:44,040 --> 00:28:47,880 Speaker 1: handle certain infections, but also at the cost of this 508 00:28:48,040 --> 00:28:52,560 Speaker 1: higher risk of developing some sort of autoimmunity issue. There 509 00:28:52,680 --> 00:28:55,320 Speaker 1: is also a whole other role, which is environmental factors. 510 00:28:55,640 --> 00:28:59,080 Speaker 1: Women and men are exposed to different environmental stressors and 511 00:28:59,120 --> 00:29:03,240 Speaker 1: that can influence the development of autoimmune diseases. So, for instance, 512 00:29:03,280 --> 00:29:08,000 Speaker 1: certain chemicals and toxins in things that are stereotypically associated 513 00:29:08,000 --> 00:29:11,560 Speaker 1: with womanhood, like cosmetics and cleaning products and even food 514 00:29:11,640 --> 00:29:14,520 Speaker 1: packaging can trigger autoimmune responses. 515 00:29:14,720 --> 00:29:17,240 Speaker 2: Are tampons, right, and. 516 00:29:17,200 --> 00:29:20,440 Speaker 1: Women might be more exposed to these substances due to 517 00:29:20,640 --> 00:29:25,560 Speaker 1: societal norms and roles. So given the complexity and the 518 00:29:25,600 --> 00:29:29,840 Speaker 1: interplay of all of these factors and how much that 519 00:29:29,880 --> 00:29:32,960 Speaker 1: would completely shift from human to human, it is no 520 00:29:33,040 --> 00:29:38,600 Speaker 1: wonder that diagnosing autoimmune diseases can be so challenging. On average, 521 00:29:38,720 --> 00:29:41,960 Speaker 1: it takes about four and a half years and consultations 522 00:29:41,960 --> 00:29:45,360 Speaker 1: with four different physicians for a person to receive an 523 00:29:45,400 --> 00:29:48,000 Speaker 1: accurate diagnosis of an autoimmune condition. 524 00:29:48,600 --> 00:29:52,640 Speaker 2: Isn't that a staggering number? I mean, that is it's unbelievable. 525 00:29:52,840 --> 00:29:55,479 Speaker 1: It's such a long time to live with symptoms. You 526 00:29:55,760 --> 00:29:58,480 Speaker 1: are the classic story of this that you're like, no, no, 527 00:29:58,560 --> 00:30:01,680 Speaker 1: it's wrong, and they're like, mah, it's going to go away. No, no, 528 00:30:01,720 --> 00:30:04,560 Speaker 1: I swear to you it's wrong. So the same thing 529 00:30:04,560 --> 00:30:07,120 Speaker 1: if you're living with things like chronic pain and fatigue 530 00:30:07,400 --> 00:30:09,920 Speaker 1: or skin rashes and you don't know what's causing them, 531 00:30:10,400 --> 00:30:13,360 Speaker 1: four and a half years feels like an eternity forever. 532 00:30:13,960 --> 00:30:17,840 Speaker 1: Once a diagnosis is made, treatment usually focuses on reducing 533 00:30:17,840 --> 00:30:23,320 Speaker 1: immune system activity, so this could involve immunosuppressive drugs, corticosteroids, 534 00:30:23,360 --> 00:30:27,920 Speaker 1: or biologics medications that specifically target parts of the immune system, 535 00:30:28,320 --> 00:30:30,840 Speaker 1: and while these treatments can be effective for some people, 536 00:30:30,880 --> 00:30:34,360 Speaker 1: they are also not without risks. Suppressing the immune system 537 00:30:34,480 --> 00:30:37,480 Speaker 1: can mean that a person is more vulnerable to infections, 538 00:30:37,520 --> 00:30:40,480 Speaker 1: and long term use of some medications can lead to 539 00:30:40,520 --> 00:30:44,560 Speaker 1: other health issues. So as we wrap with today's episode, 540 00:30:44,560 --> 00:30:46,920 Speaker 1: I want to leave you with a thought. The story 541 00:30:46,960 --> 00:30:50,719 Speaker 1: of autoimmune disease is far from over. We are really 542 00:30:50,960 --> 00:30:53,960 Speaker 1: just beginning to understand the full scope of these conditions 543 00:30:54,280 --> 00:30:57,200 Speaker 1: and how they affect millions of people around the world. 544 00:30:57,640 --> 00:31:00,960 Speaker 1: And while today's episode focused on the history current state 545 00:31:01,000 --> 00:31:03,960 Speaker 1: of autoimmune disease research, our next episode is going to 546 00:31:04,000 --> 00:31:06,120 Speaker 1: take us into the future because we are going to 547 00:31:06,120 --> 00:31:09,560 Speaker 1: talk a lot about biologics, those cutting edge therapies that 548 00:31:09,640 --> 00:31:11,720 Speaker 1: are offering new hope to a lot of people with 549 00:31:11,760 --> 00:31:15,680 Speaker 1: autoimmune conditions. Andrea, like you are as I said, you're 550 00:31:15,720 --> 00:31:17,560 Speaker 1: kind of at the nexus of the beginning, both with 551 00:31:17,600 --> 00:31:21,200 Speaker 1: your diagnosis and now as you are helping people find 552 00:31:21,360 --> 00:31:25,560 Speaker 1: maybe some unexpected ways to manage their symptoms and their 553 00:31:25,600 --> 00:31:29,240 Speaker 1: diseases and even thrive. I'm so grateful that you came 554 00:31:29,320 --> 00:31:31,959 Speaker 1: to share your story with us today. It is very inspiring. 555 00:31:32,320 --> 00:31:34,360 Speaker 2: Oh, I've enjoyed talking to you so much, Ali, It's 556 00:31:34,360 --> 00:31:36,800 Speaker 2: been so much fun, and that was such an educational 557 00:31:38,320 --> 00:31:40,240 Speaker 2: I love hearing the history in the way that you 558 00:31:40,280 --> 00:31:43,680 Speaker 2: framed it. It's really helpful to understand that it's not 559 00:31:43,800 --> 00:31:47,040 Speaker 2: just your own personal experience, but that it's a medical 560 00:31:47,080 --> 00:31:49,280 Speaker 2: problem that happens to millions of people. 561 00:31:49,600 --> 00:31:51,880 Speaker 1: Right. I can't help but think of people like in 562 00:31:51,920 --> 00:31:54,440 Speaker 1: the Victorian era being told like, no, no, you're just 563 00:31:55,200 --> 00:32:00,640 Speaker 1: you're just a very fragile lady. Yes. I love that 564 00:32:00,720 --> 00:32:02,920 Speaker 1: you are so open about sharing your story, and you 565 00:32:02,960 --> 00:32:05,479 Speaker 1: also bring the spirit of all your client stories with 566 00:32:05,520 --> 00:32:08,760 Speaker 1: you too, and all that they've taught you. I think 567 00:32:08,840 --> 00:32:10,720 Speaker 1: the answer is definitely going to be yes. But do 568 00:32:10,800 --> 00:32:13,200 Speaker 1: you consider yourself a bit of a spokesperson for the 569 00:32:13,200 --> 00:32:14,680 Speaker 1: autoimmune disorder community? 570 00:32:15,520 --> 00:32:18,640 Speaker 2: Oh? I mean I guess the answer is yes, because 571 00:32:18,680 --> 00:32:22,840 Speaker 2: I'm here behind a microphone speaking about it. So yes, Yes, 572 00:32:23,120 --> 00:32:25,719 Speaker 2: I think it's really important. The more conversations we can 573 00:32:25,760 --> 00:32:27,160 Speaker 2: have in the same way that you and I are 574 00:32:27,200 --> 00:32:29,520 Speaker 2: having them, and more people listen and then have their 575 00:32:29,560 --> 00:32:33,360 Speaker 2: own conversations, the more we can help everybody understand what 576 00:32:33,400 --> 00:32:34,520 Speaker 2: they're up against. 577 00:32:34,880 --> 00:32:38,680 Speaker 1: And then, lastly, if you could just send one message 578 00:32:38,680 --> 00:32:41,480 Speaker 1: to listeners who might be grappling with their own diagnosis. 579 00:32:41,720 --> 00:32:42,360 Speaker 1: What would it be? 580 00:32:43,000 --> 00:32:47,760 Speaker 2: You're not alone. Everybody who I've spoken to, all the thousands, 581 00:32:47,840 --> 00:32:51,480 Speaker 2: millions of people, everybody feels like they are in this 582 00:32:51,880 --> 00:32:55,960 Speaker 2: totally by themselves, and you're not speak up, tell people 583 00:32:55,960 --> 00:32:59,000 Speaker 2: what you need. You'll find that more people understand what 584 00:32:59,040 --> 00:33:02,160 Speaker 2: you're going through than you think, because it's an invisible 585 00:33:02,160 --> 00:33:04,560 Speaker 2: illness and we can't ever know what other people are 586 00:33:04,600 --> 00:33:07,480 Speaker 2: going through behind their own closed doors. So just know 587 00:33:07,520 --> 00:33:10,120 Speaker 2: that there are other people out there like you, and 588 00:33:10,360 --> 00:33:12,000 Speaker 2: that you don't have to go through it by yourself. 589 00:33:13,280 --> 00:33:15,200 Speaker 1: Andrea, thank you again so much. 590 00:33:15,760 --> 00:33:17,640 Speaker 2: Thank you for having me. It's been wonderful. 591 00:33:22,320 --> 00:33:26,080 Speaker 1: Our Skim is hosted by myself, Holly Frye, and executive 592 00:33:26,080 --> 00:33:29,720 Speaker 1: produced and engineered by Ryan Martz. Our senior producer and 593 00:33:29,760 --> 00:33:33,320 Speaker 1: writer is Meredith Barnes. If you enjoy the show, share 594 00:33:33,320 --> 00:33:36,160 Speaker 1: it with your friends. You can also listen and follow 595 00:33:36,360 --> 00:33:40,080 Speaker 1: on the iHeartRadio app, Apple Podcasts, or wherever you get 596 00:33:40,120 --> 00:33:41,000 Speaker 1: your podcasts.