WEBVTT - Inside the Immune System: How It Works and When It Goes Wrong 0:00:06.840 --> 0:00:10.960 My husband is a really incredible person and was so supportive, 0:00:11.039 --> 0:00:16.040 but together we were really struggling with just living this 0:00:16.079 --> 0:00:18.960 new life in a new city, not making a lot 0:00:18.960 --> 0:00:22.880 of money. But that really did not accommodate illness, you know, 0:00:22.960 --> 0:00:27.080 it didn't accommodate like a crisis so young. So I 0:00:27.120 --> 0:00:31.479 think I filed away the maybe I'm crazy because I 0:00:31.600 --> 0:00:34.360 just had to survive. And then that was the final 0:00:34.400 --> 0:00:36.680 thing that made me really figure out that I needed 0:00:36.680 --> 0:00:37.839 to be a part of the solution. 0:00:41.000 --> 0:00:44.720 This is Eating Interrupted, where we dig into the real 0:00:44.800 --> 0:00:49.519 stories and science behind how food can interrupt everyday life, 0:00:49.720 --> 0:00:53.279 from the very first bite to the complex journey that follows. 0:00:53.760 --> 0:00:59.560 I'm your host Cynthia McFadden. Well, today it's all about 0:00:59.600 --> 0:01:03.480 the immune system. It's the thing you're told to boost 0:01:03.520 --> 0:01:06.560 with a smoothie or blame when you catch a cold 0:01:06.600 --> 0:01:09.399 at exactly the wrong time. But if you had to 0:01:09.480 --> 0:01:13.640 explain what it actually does moment to moment inside your body, 0:01:14.160 --> 0:01:17.679 well I for one would have to start guessing. So 0:01:17.720 --> 0:01:20.920 today we're breaking it down what the immune system really is, 0:01:21.319 --> 0:01:23.800 how it works, and how the food we eat can 0:01:23.840 --> 0:01:27.160 play apart. We'll also take a big look into what 0:01:27.319 --> 0:01:32.000 happens when that system turns on itself. Because you see 0:01:32.160 --> 0:01:35.440 roughly now get this, eight percent of Americans live with 0:01:35.480 --> 0:01:39.520 what we call autoimmune conditions, and knowing how to work 0:01:39.560 --> 0:01:42.800 with a body that is actively working against you is 0:01:42.920 --> 0:01:47.680 not easy. Why do some people have autoimmune diseases? What 0:01:47.720 --> 0:01:50.840 does the road to diagnosis often look like? And what 0:01:51.040 --> 0:01:55.800 role can diet actually play and manage it symptoms? As 0:01:55.840 --> 0:01:58.520 always here to get the ball rolling is our go 0:01:58.600 --> 0:02:05.320 to gastro and tost doctor Mark Pimentel, Well, doctor pimin Tel, 0:02:05.360 --> 0:02:08.000 great to be back with you today. We're talking about 0:02:08.000 --> 0:02:10.520 the immune system and to start off, give us some 0:02:10.680 --> 0:02:15.600 bio one oh one. Explain how the immune system works. 0:02:16.080 --> 0:02:18.919 So you know, the immune system is critical for your 0:02:18.960 --> 0:02:21.320 life for a lot of reasons. First of all, let 0:02:21.320 --> 0:02:24.360 me start by saying, the brain is extremely complicated and 0:02:24.360 --> 0:02:26.639 probably the most complicated thing we have in our body. 0:02:26.919 --> 0:02:30.360 But the immune system comes in probably a close second 0:02:30.680 --> 0:02:33.760 because it has so many layers. So there's the what 0:02:33.840 --> 0:02:38.120 we call the innate immune system, which is basically all 0:02:38.160 --> 0:02:41.840 the layers that will protect you immediately. So let's say 0:02:42.160 --> 0:02:44.800 your skin, the skin of the inside of your body. 0:02:44.880 --> 0:02:48.400 Let's say in the gas run testinal tractor or the intestines. 0:02:48.960 --> 0:02:51.640 That's a barrier, and then if you do have something 0:02:51.720 --> 0:02:55.079 get through that barrier, then you have the immediate defenders there. 0:02:55.200 --> 0:02:58.359 Some of them are called neutrophils, other are called macrophages, 0:02:58.400 --> 0:03:03.839 and they're like the immediate warriors, but because they're warriors, 0:03:03.919 --> 0:03:07.760 they just want to break everything and try and destroy everything, 0:03:08.120 --> 0:03:11.240 and so they're not very finessed. But then there's the 0:03:11.280 --> 0:03:15.160 follow ons, which are the adaptive immune response, which is 0:03:15.960 --> 0:03:19.120 they're trying to figure out, Okay, who's invading, why are 0:03:19.120 --> 0:03:21.480 they invading, how do we protect against them? And they 0:03:21.520 --> 0:03:24.640 form antibodies, and then they remember those antibodies, so if 0:03:24.639 --> 0:03:28.360 it ever happens again, they're ready rather than sort of 0:03:28.400 --> 0:03:32.359 the smash and destroy approach of a first infection. 0:03:33.400 --> 0:03:35.800 It really is incredible that the body can do all 0:03:35.800 --> 0:03:37.960 of this. I mean to be honest, right, I mean, 0:03:38.000 --> 0:03:40.120 I guess we wouldn't survive very long if they couldn't, 0:03:40.560 --> 0:03:43.280 but it it really is an amazing system we got 0:03:43.280 --> 0:03:44.200 going inside us. 0:03:44.720 --> 0:03:47.760 Yeah, and you know, so, like with every system in 0:03:47.800 --> 0:03:52.120 the body, it's it's incredible how it can work. But 0:03:52.240 --> 0:03:54.800 because it has so many parts, it's like that Swiss 0:03:54.840 --> 0:03:57.000 watch with the one little part that doesn't quite work, 0:03:57.040 --> 0:03:58.240 and the watch doesn't work. 0:03:58.080 --> 0:04:02.240 Perfectly, So of course there's there's a very important relationship 0:04:02.240 --> 0:04:05.920 between the immune system and the gut. Explain to us 0:04:06.040 --> 0:04:07.560 what happens. 0:04:07.560 --> 0:04:10.200 Well, you know, when you talk about the skin, the 0:04:10.280 --> 0:04:13.320 skin is what we call squamous epithelia. You don't need 0:04:13.360 --> 0:04:17.640 to I can't remember the name. But it's sort of 0:04:17.800 --> 0:04:20.720 like a road with many layers. So there's many layers 0:04:20.720 --> 0:04:24.000 of skin, many layers, many layers, because it's exposed out 0:04:24.000 --> 0:04:27.320 here and it's hard to penetrate it, you know. But 0:04:27.360 --> 0:04:30.880 the gut has to absorb food. It has one single 0:04:30.960 --> 0:04:36.119 layer of cells, one layer, and it's absorbing foods and things, 0:04:36.120 --> 0:04:37.919 so it has to open up and allow things to 0:04:37.960 --> 0:04:40.279 get in. But I love the gut. 0:04:40.360 --> 0:04:40.520 You know. 0:04:40.560 --> 0:04:42.240 This is what happens when you start talking about the 0:04:42.240 --> 0:04:46.320 gut and I get all excited. But the immune system 0:04:46.440 --> 0:04:49.720 of the gut can tell whether it's a bad guy 0:04:50.400 --> 0:04:53.360 or a good guy. And it doesn't react to everybody 0:04:53.400 --> 0:04:55.560 because the gout is full of bacteria, and it says 0:04:55.720 --> 0:04:59.640 you're good, you're not. You go away, I'm going after you. 0:04:59.640 --> 0:05:03.840 You can stay, And it's so amazing that it can 0:05:03.880 --> 0:05:04.560 even do that. 0:05:05.320 --> 0:05:08.120 So food obviously plays a role in all of this 0:05:08.279 --> 0:05:11.960 as well. Right, are there some foods that help the 0:05:12.040 --> 0:05:14.080 immune system and some that don't. 0:05:14.680 --> 0:05:18.000 Well, so the answer is yes, but the jury is 0:05:18.040 --> 0:05:20.920 out on exactly what that is because we still don't 0:05:20.920 --> 0:05:25.040 even know what the normal gut bacterial composition should be, 0:05:25.200 --> 0:05:28.440 so and then adding food on top of that makes 0:05:28.440 --> 0:05:33.160 it very complicated. But there are foods that trigger immunity. Gluten, 0:05:33.720 --> 0:05:36.600 in the case of Celiac disease, is the trigger for 0:05:36.680 --> 0:05:41.720 this autoimmune reaction within the small intestine, creating the destruction. 0:05:42.360 --> 0:05:44.800 So that's a food that's a food item that becomes 0:05:44.800 --> 0:05:48.080 an antigen. Food allergies can also do that because you're 0:05:48.160 --> 0:05:53.200 getting an immune reaction because you have an allergic reaction, 0:05:53.360 --> 0:05:56.599 which is a form of immunity. So yeah, food plays 0:05:56.600 --> 0:05:57.120 a big role. 0:05:57.600 --> 0:06:00.919 So what determines whether some one has what we know 0:06:01.080 --> 0:06:03.120 is a sort of a good immune system or not 0:06:03.279 --> 0:06:06.680 so good a strong immune system or is that even 0:06:06.720 --> 0:06:08.039 the right way to think about it. 0:06:08.320 --> 0:06:11.279 I like to use my kids as an example on this, 0:06:11.720 --> 0:06:14.520 and they're twins, so twins are always interesting. But when 0:06:14.520 --> 0:06:16.840 they get a cold, one of them gets a fever. 0:06:16.880 --> 0:06:20.240 Of one hundred and five every time, the other one 0:06:20.440 --> 0:06:24.560 just poors snot never gets a fever, same cold, same virus, 0:06:24.640 --> 0:06:29.400 different reaction, And it's hard to understand and very difficult 0:06:29.520 --> 0:06:33.320 to pin that down. But when you say a strong 0:06:33.400 --> 0:06:36.880 immune system, sometimes that's a bad word because it means 0:06:36.880 --> 0:06:42.080 that you're overreacting to a particular infection. But we do 0:06:42.240 --> 0:06:45.280 know that there are people with weak immune systems who 0:06:45.320 --> 0:06:50.000 are born with very little antibodies combined variable immune deficiency. 0:06:49.800 --> 0:06:53.680 They're deficient in most antibody production, so they can get 0:06:53.720 --> 0:06:57.440 infections more easily. What we haven't defined well are people 0:06:57.440 --> 0:07:01.400 who are too strong a responder. We sort of assume 0:07:01.440 --> 0:07:04.640 that's the case for these patients with autoimmune disease, but 0:07:04.680 --> 0:07:09.520 there's no specific test that's generally used. There are specific 0:07:09.600 --> 0:07:12.640 tests that are used in the lab, but not necessarily 0:07:12.680 --> 0:07:14.080 generally used in the clinic. 0:07:14.480 --> 0:07:17.720 So with that in mind, what exactly are autoimmune disease 0:07:17.880 --> 0:07:20.960 is just in a very layman's terms. 0:07:21.520 --> 0:07:25.480 So autoimmune diseases are really sort of lumping together of 0:07:25.680 --> 0:07:28.800 patients who have a condition of some part of their 0:07:28.840 --> 0:07:32.760 body where the immune system is attacking for reasons that 0:07:32.800 --> 0:07:36.600 we don't quite understand. But we assume or have some 0:07:36.800 --> 0:07:40.800 data to suggest you're attacking yourself and can't stop. And 0:07:40.840 --> 0:07:43.040 it can be the thyroid, it can be the pancreas 0:07:43.040 --> 0:07:46.160 and type one diabetes. It can be Crohn's disease attacking 0:07:46.200 --> 0:07:49.320 the gut, it can be the joints for rheumatoid arthritis 0:07:49.360 --> 0:07:49.880 and so on. 0:07:50.480 --> 0:07:51.760 Are they hard to diagnose. 0:07:52.760 --> 0:07:55.960 So the challenge with autoimmune disease, to be honest with you, 0:07:56.160 --> 0:07:58.880 is that they don't always come at you like a 0:07:58.920 --> 0:08:02.240 two by four, right. They come at you very slowly 0:08:02.440 --> 0:08:06.360 and subtly and gradually and very non specifically. You have 0:08:06.440 --> 0:08:10.640 these vague symptoms and then you you know, eventually it 0:08:10.680 --> 0:08:15.200 becomes obvious. And so I think that's the challenge for medicine. 0:08:15.280 --> 0:08:18.960 The patients feel terrible, but we don't have all the signals. 0:08:19.080 --> 0:08:21.280 And what you don't want to end up happening is 0:08:21.320 --> 0:08:23.960 you're doing a lot, a lot, a lot of expensive tests, 0:08:24.000 --> 0:08:26.000 and then the patients have to pay for all those things. 0:08:26.360 --> 0:08:28.800 So it can be very confusing in the beginning for 0:08:28.880 --> 0:08:32.079 autoimmune disease because it could be subtle and then gradually 0:08:32.120 --> 0:08:34.320 build and then the story becomes more clear. 0:08:34.720 --> 0:08:36.600 It's funny you say that because We're about to get 0:08:36.600 --> 0:08:39.400 a real inside view into what that's like from the 0:08:39.440 --> 0:08:40.520 patient's point of view. 0:08:40.920 --> 0:08:42.520 Well, I'm looking forward to that. 0:08:48.040 --> 0:08:51.240 So I have Celiac disease, which I think is the 0:08:51.280 --> 0:08:55.200 easiest one to talk about because it means that I 0:08:55.280 --> 0:08:56.440 can't tolerate gluten. 0:08:56.960 --> 0:08:59.560 Mickey Truscott is an autoimpune patients. 0:09:00.120 --> 0:09:03.280 The second automune condition I have is hashimotives byroiditis, so 0:09:03.320 --> 0:09:07.080 that affects my thyroid gland. And the third automune condition 0:09:07.200 --> 0:09:09.720 is sorieta arthritis, and that's the one that I have 0:09:09.920 --> 0:09:11.360 recently been diagnosed with. 0:09:11.760 --> 0:09:13.880 We're going to get into what all that means, but 0:09:14.040 --> 0:09:19.560 first let's get to know Mickey a little bit. Well, Mickey, 0:09:19.600 --> 0:09:22.240 thank you so much for joining us. Welcome to the podcast. 0:09:22.640 --> 0:09:23.720 Yeah, thank you for having me. 0:09:23.800 --> 0:09:24.120 Cynthia. 0:09:25.600 --> 0:09:27.559 Tell me a little bit about yourself before we get 0:09:27.600 --> 0:09:29.280 into all of the details. 0:09:29.640 --> 0:09:33.199 Yeah, yeah, So I am a clinical nutritionist now. I 0:09:33.240 --> 0:09:37.560 write cookbooks and I support people who are interested in 0:09:37.600 --> 0:09:41.960 finding out how food sensitivities play a role in their 0:09:42.280 --> 0:09:44.400 autoimmune journey or their healing journey. 0:09:44.559 --> 0:09:47.160 So at the essence, that's what I do. You've been 0:09:47.200 --> 0:09:49.280 a private chef as well, yes. 0:09:49.240 --> 0:09:51.920 That's actually how I started before my illness, and then 0:09:51.960 --> 0:09:54.439 I got sick and then kind of circled back and 0:09:54.520 --> 0:09:57.600 got some nutrition training to kind of bolster that work 0:09:57.640 --> 0:09:58.319 that I did. 0:09:58.800 --> 0:10:00.720 Just out of curiosity. How did you end up as 0:10:00.760 --> 0:10:02.360 a private chef in the first place. 0:10:03.000 --> 0:10:06.839 Well, I graduated college in two thousand and seven with 0:10:06.920 --> 0:10:09.439 a degree in music composition. 0:10:09.360 --> 0:10:12.760 So so she became a chef. Yeah, exactly. 0:10:13.480 --> 0:10:15.760 I was living in Santa Barbara, which is an area 0:10:15.880 --> 0:10:18.600 with a lot of people who have household staffs, right, 0:10:19.200 --> 0:10:21.880 And so I got away and I had been a 0:10:21.960 --> 0:10:25.160 nanny before, and I found a very unique position working 0:10:25.160 --> 0:10:29.080 in a household that needed somebody to manage the kitchen 0:10:29.240 --> 0:10:32.959 side of their home. You know, they had some food 0:10:32.960 --> 0:10:36.800 preferences and they actually had actual trained chefs come in 0:10:36.840 --> 0:10:39.280 and cook for them, and they needed someone to be 0:10:39.520 --> 0:10:42.520 a facilitator and like go to the farmer's market, go 0:10:42.559 --> 0:10:44.880 to the store, communicate with all these people who were cooking. 0:10:45.320 --> 0:10:47.920 And then I started being the chef towards the end 0:10:48.000 --> 0:10:49.920 of my time with them because of all these things 0:10:49.960 --> 0:10:53.559 that I had learned. So yeah, I got really lucky, basically, 0:10:53.960 --> 0:10:56.679 and in a time that it was really hard to 0:10:56.760 --> 0:11:00.840 be graduating at that time with any type of degree, 0:11:00.960 --> 0:11:04.319 but a degree in music no less, so very cool. 0:11:05.120 --> 0:11:07.199 You know, it's really interesting to me because you started 0:11:07.200 --> 0:11:11.160 your career around food, and now food is at the 0:11:11.200 --> 0:11:13.600 center of your work again, but in a whole new way. 0:11:14.679 --> 0:11:18.000 There is quite a journey in between those two points, however, 0:11:18.160 --> 0:11:20.120 and I want you to take me back to when 0:11:20.120 --> 0:11:23.720 you started to not feel well. You knew something wasn't right. 0:11:25.200 --> 0:11:28.640 So I was about twenty four to twenty five years old. 0:11:28.880 --> 0:11:31.760 I had at this point moved to Seattle. I didn't 0:11:31.800 --> 0:11:34.280 have a car. I was riding my bike everywhere. I 0:11:34.360 --> 0:11:36.880 was very active. I worked at a coffee shop. It 0:11:36.960 --> 0:11:39.360 is quite a bit colder in Seattle than it was 0:11:39.400 --> 0:11:43.520 in California, right, And I was riding my bike really 0:11:43.559 --> 0:11:46.640 early to work at the coffee shop, and I was 0:11:46.720 --> 0:11:50.840 noticing that my fingers were kind of perpetually numb. I 0:11:50.840 --> 0:11:53.600 thought they were cold. I invested in all different types 0:11:53.600 --> 0:11:56.079 of gloves. And it was weird because I was, you know, 0:11:56.160 --> 0:11:59.440 riding my bike, working up a sweat, and I would 0:11:59.480 --> 0:12:01.760 get to the cop shop but have my warm mug 0:12:01.800 --> 0:12:05.240 of coffee and my fingers that numbness wouldn't go away, 0:12:05.800 --> 0:12:10.360 So that was really the first sign. The second sign 0:12:10.800 --> 0:12:12.640 was I was kind of traversing a lot of these 0:12:12.720 --> 0:12:15.240 hills to get to different coffee shops. I worked for 0:12:15.280 --> 0:12:18.000 a chain that had seven or eight different places, and 0:12:18.240 --> 0:12:22.480 there was this one hill that I started to get 0:12:22.559 --> 0:12:25.720 worse at being able to ride up it. So it 0:12:25.760 --> 0:12:28.880 was probably eight blocks straight up, and I started to 0:12:28.880 --> 0:12:30.760 be able to make it six blocks and then I'd 0:12:30.760 --> 0:12:32.880 have to walk, and then I have five blocks and 0:12:32.960 --> 0:12:35.160 I had to walk. So I went to my husband, 0:12:35.160 --> 0:12:38.200 who's very mechanical, he's the fixer and the family, and 0:12:38.240 --> 0:12:40.720 I said, hey, there's something wrong with my bike, Like 0:12:40.800 --> 0:12:43.360 it's getting harder and I should be getting stronger. I 0:12:43.360 --> 0:12:46.640 should it should be easier, right, And that was really 0:12:46.679 --> 0:12:50.760 the first manifestation that I actually had muscle wasting and 0:12:51.480 --> 0:12:55.880 my muscle mass was decreasing, my weight was decreasing, and 0:12:56.160 --> 0:12:59.120 along you know, with the numbness. Then I started having 0:12:59.160 --> 0:13:03.520 things like hair loss, not being able to sleep, being 0:13:03.760 --> 0:13:08.400 cold and tired. Just constantly. I would get off work 0:13:08.559 --> 0:13:11.240 with four shots of espresso, go home, take a four 0:13:11.240 --> 0:13:13.679 hour nap, wake up, go back to the coffee shop, 0:13:14.040 --> 0:13:17.240 get another quad espresso, to the point where I was 0:13:17.400 --> 0:13:21.400 just using caffeine to stimulate my body to just function, 0:13:22.280 --> 0:13:27.000 So the fatigue was debilitating. At one point, I couldn't 0:13:27.000 --> 0:13:30.440 even work anymore, so I lost my job and I 0:13:30.520 --> 0:13:34.080 had to devote really my full time physical and mental 0:13:34.120 --> 0:13:36.600 resources to trying to figure out what was wrong. 0:13:37.280 --> 0:13:39.800 So what was the no more moment when you decided 0:13:39.840 --> 0:13:40.920 you better go to a doctor? 0:13:42.080 --> 0:13:45.280 So I had been going to doctors throughout this. This 0:13:45.360 --> 0:13:48.520 is what's frustrating. You know, this is about twenty ten. 0:13:49.080 --> 0:13:51.720 I did not have health insurance. This was right around 0:13:51.960 --> 0:13:54.480 you know, a four bull Care Act was starting to 0:13:54.559 --> 0:13:58.559 be implemented. I didn't have insurance through my work. There 0:13:58.640 --> 0:14:02.240 wasn't really a good public option that I had access to. 0:14:02.520 --> 0:14:05.960 So I was saving up paying cash going to see 0:14:06.000 --> 0:14:08.800 a doctor. And most of the doctors took one look 0:14:08.840 --> 0:14:11.760 at me, and you know, I looked like a healthy 0:14:11.920 --> 0:14:15.920 twenty five year old cyclist living in Seattle, right, and 0:14:16.160 --> 0:14:19.680 they said, you can't possibly have a chronic health condition. 0:14:19.800 --> 0:14:22.920 They did the most basic, marginal lab work, which I 0:14:22.960 --> 0:14:24.800 know part of that was because I was paying for 0:14:24.880 --> 0:14:27.760 it out of pocket, and just took a once over 0:14:27.840 --> 0:14:30.600 and said, you know, maybe you need referral to therapy, 0:14:30.920 --> 0:14:34.760 you know, maybe you need an antidepressant. And some of 0:14:34.800 --> 0:14:39.480 the symptoms that I had were very nonspecific, So now 0:14:39.520 --> 0:14:43.520 I know I have thyroid disease. Thyroid disease symptoms can 0:14:44.120 --> 0:14:46.800 affect every single organ and system in the body, which 0:14:46.840 --> 0:14:49.800 is why some of us that have this just really 0:14:49.840 --> 0:14:52.600 feel crazy when we go to the doctor, because we're 0:14:52.640 --> 0:14:56.800 describing things that just seem so disconnected when really every 0:14:56.840 --> 0:15:00.200 cell in our body needs this thyroid hormone. And so 0:15:00.240 --> 0:15:01.920 I would go in and I would say, my body 0:15:01.960 --> 0:15:04.760 temperature in the morning when I wake up is ninety 0:15:05.040 --> 0:15:09.160 three degrees. Now this was before we had all this 0:15:09.280 --> 0:15:12.160 access to medical information online, but most people know that 0:15:12.160 --> 0:15:15.760 that's not normal, it's not okay. And I was still 0:15:16.120 --> 0:15:20.080 kind of shoot away. My husband was pulled aside and 0:15:20.240 --> 0:15:22.880 asked if I had an eating disorder or if I 0:15:23.000 --> 0:15:26.760 was having some mental health challenges. Right, So I would 0:15:26.840 --> 0:15:29.200 basically go to the doctor, I would work up all 0:15:29.200 --> 0:15:32.480 this courage, save some money, and then just be completely 0:15:32.560 --> 0:15:36.440 dismissed and then get by for another few months until 0:15:36.560 --> 0:15:38.600 I worked up the courage to do that again. And 0:15:38.640 --> 0:15:40.640 that cycle lasted about two years. 0:15:40.960 --> 0:15:45.520 Two years. Oh yeah, So I mean in addition to 0:15:45.720 --> 0:15:50.200 feeling lousy, you're sort of made to believe that you're 0:15:50.640 --> 0:15:55.320 making things up being whiny. Absolutely, I mean it must 0:15:55.320 --> 0:15:56.160 have been awful. 0:15:56.640 --> 0:15:57.200 Yeah. 0:15:57.440 --> 0:15:57.760 Yeah. 0:15:57.800 --> 0:16:01.160 And I had no healthcare literacy at the time, so, 0:16:01.640 --> 0:16:04.280 you know, twenty five years old, and I grew up 0:16:04.360 --> 0:16:07.640 actually in a family where my grandfather is a rheumatologist, 0:16:07.720 --> 0:16:11.600 my uncle is a surgeon. My youngest sister had cancer 0:16:11.640 --> 0:16:14.000 when she was two to eight, so my family was 0:16:14.040 --> 0:16:17.240 actually very involved in medical things. But me as a person, 0:16:17.280 --> 0:16:19.560 I was never taught that when I go to the doctor, 0:16:19.600 --> 0:16:23.440 I need to basically fight for survival. I did not 0:16:23.960 --> 0:16:27.880 expect to basically be completely dismissed by the system because 0:16:27.920 --> 0:16:31.520 I didn't fit into the picture of what these providers 0:16:31.560 --> 0:16:35.040 were looking for in terms of thyroid disease or celiac 0:16:35.160 --> 0:16:38.240 disease or connective tissue disease, which you know, these are 0:16:38.280 --> 0:16:41.360 the things that I suffer from. My husband is a 0:16:41.880 --> 0:16:44.960 really incredible person and was so supportive to me at 0:16:44.960 --> 0:16:49.760 this time, but together we were really struggling with just 0:16:49.880 --> 0:16:53.160 living this new life in a new city, not making 0:16:53.160 --> 0:16:55.720 a lot of money. So we were very grateful and 0:16:55.800 --> 0:17:01.840 happy to have paychecks, but that really did not commodate illness, 0:17:02.160 --> 0:17:05.600 you know, it didn't accommodate like a crisis so young. 0:17:06.720 --> 0:17:11.040 So I think I filed away the maybe I'm crazy 0:17:11.440 --> 0:17:14.639 because I just had to survive. And then that was 0:17:14.720 --> 0:17:17.760 kind of the final thing that made me really figure 0:17:17.800 --> 0:17:19.680 out that I needed to be a part of the solution. 0:17:24.000 --> 0:17:40.560 Eating interrupted will be back right after this. Well, it 0:17:40.680 --> 0:17:46.119 must have been an enormous relief to finally get a diagnosis, 0:17:47.000 --> 0:17:49.840 kind of okay, tell me about that. 0:17:50.240 --> 0:17:53.640 So in that two years I started to inform myself. 0:17:53.840 --> 0:17:56.280 You know, that was back in the days of Wikipedia 0:17:56.440 --> 0:17:59.800 was kind of the best online repository of medical information, 0:18:00.040 --> 0:18:02.760 which you know is pretty basic. Because I had been 0:18:02.800 --> 0:18:06.480 searching you know, cold hands and feet, low body temperature, 0:18:06.800 --> 0:18:10.720 hair loss, muscle wasting, and it comes up with hypothyroidism. 0:18:10.840 --> 0:18:12.879 So I had been going in talking to the doctors. 0:18:12.920 --> 0:18:16.720 They're saying, absolutely not, you as a thin person cannot 0:18:16.760 --> 0:18:22.280 possibly have hypothyroidism. And I came across hashimotive syriditis on 0:18:22.320 --> 0:18:26.040 Wikipedia and I just knew. I just I read about it. 0:18:26.200 --> 0:18:30.080 I read about how it was autoimmune, and so I 0:18:30.119 --> 0:18:33.120 had a word for something to ask for, which is antibodies. 0:18:33.359 --> 0:18:35.800 Do I have antibodies to my thyroid tissue. This is 0:18:35.840 --> 0:18:38.960 the definition of an autommune disease. And so when I 0:18:39.040 --> 0:18:42.479 finally got that, to go in and say, Hi, I 0:18:42.480 --> 0:18:44.280 know you don't think I have a thyroid disease, but 0:18:44.400 --> 0:18:46.720 this test is really easy. I'll pay for it again 0:18:46.800 --> 0:18:49.120 out of pocket. And when I got that test, of course, 0:18:49.160 --> 0:18:50.160 it came back positive. 0:18:51.080 --> 0:18:56.080 So you now live with three autoimmune diseases. Just walk 0:18:56.200 --> 0:19:00.560 us through each one, how they've impacted your life, how 0:19:00.560 --> 0:19:02.480 your diet factors into all of it. 0:19:03.000 --> 0:19:06.199 So I have coeliac disease, which I think is the 0:19:06.240 --> 0:19:10.200 easiest one to talk about because it means that I 0:19:10.240 --> 0:19:15.000 can't tolerate gluten, and I have to strictly avoid gluten 0:19:15.160 --> 0:19:19.280 both cross contamination, so at restaurants and in my own home. 0:19:19.680 --> 0:19:22.040 And as long as I'm not exposed, I don't have 0:19:22.240 --> 0:19:25.840 to worry about any of the other effects that coeliac 0:19:25.920 --> 0:19:30.159 disease can cause, which is malabsorption gut issues. I have 0:19:30.200 --> 0:19:34.359 symptoms that are actually neurological, mostly so I don't really 0:19:34.400 --> 0:19:38.320 know quickly when I get exposed. The second automune condition 0:19:38.359 --> 0:19:42.000 I have is Hashimoto's thyroiditis, so that affects my thyroid gland. 0:19:42.240 --> 0:19:44.840 The thyroid gland makes thyroid hormone that is used for 0:19:44.840 --> 0:19:46.840 every cell in your body, so it can cause tons 0:19:46.880 --> 0:19:51.399 of symptoms. For me, really it's fatigue, hair loss, cold, 0:19:51.400 --> 0:19:55.720 hands and feet, and I do take thyroid hormone replacement medication. 0:19:56.640 --> 0:19:59.879 One of the interesting things about hashimotos is that the 0:20:00.000 --> 0:20:04.359 the only treatment is this thyroid hormone replacement, but even 0:20:04.400 --> 0:20:07.639 when our thyroid levels are normal, when our hormone levels 0:20:07.640 --> 0:20:11.840 are normal, more than half of thyroid patients that have hashimotos, 0:20:12.040 --> 0:20:16.320 this is the autoimmune form of hypothyroidism, they report that 0:20:16.400 --> 0:20:19.200 they continue to have symptoms that interfere with their life 0:20:19.200 --> 0:20:21.800 even though they are given this medication. They're technically treated 0:20:21.800 --> 0:20:24.880 to target. There are no other treatments for that. So 0:20:25.200 --> 0:20:28.879 that's where things like diet and lifestyle come really in 0:20:28.960 --> 0:20:32.480 handy because I feel like they really enhance that thyroid 0:20:32.480 --> 0:20:34.800 hormone is one piece of it, but then the diet 0:20:34.800 --> 0:20:38.800 and lifestyle really helps that other piece. And the third 0:20:38.800 --> 0:20:42.080 automune condition is soritic arthritis, and that's one that I 0:20:42.160 --> 0:20:46.280 have recently been diagnosed with, but started fifteen years ago. 0:20:52.240 --> 0:20:54.480 This feels like a very good time to bring our 0:20:54.520 --> 0:20:59.240 doctor back in, So Mickey has a Hashi Moto, ciliac 0:20:59.240 --> 0:21:04.440 and starthritis. So if a person has more than one 0:21:05.280 --> 0:21:09.960 autoimmune condition, you would think what I. 0:21:09.960 --> 0:21:13.920 Would think, that she has a genetic predisposition to autoimmune disease, 0:21:14.040 --> 0:21:19.440 especially you know, hashimotos and celiac and soriatic arthritis. Those 0:21:19.480 --> 0:21:23.440 are big three autoimmune conditions of different organs. So that's 0:21:23.640 --> 0:21:27.760 that's a very rare constellation. I mean, they come together, 0:21:28.400 --> 0:21:30.920 but it's not that many people that have all three 0:21:30.960 --> 0:21:31.359 at once. 0:21:33.359 --> 0:21:36.480 Talk to me about treatment in general, what types of 0:21:36.560 --> 0:21:39.080 treatment are effective for autoimmune disease. 0:21:39.880 --> 0:21:43.359 So you've obviously got things that are anti inflammatory. You 0:21:43.400 --> 0:21:48.520 want to try and reduce the inflammation. Aspirin and Said's medications, 0:21:48.760 --> 0:21:52.440 they kind of just acutely reduced inflammation, turned the volume down. 0:21:53.080 --> 0:21:57.760 Then you go to immunosuppressants like steroids. Stereoids have been 0:21:57.800 --> 0:22:00.280 around for a very very long time, and that can 0:22:00.680 --> 0:22:03.480 cool things very quickly, but that's not the way to 0:22:03.520 --> 0:22:07.640 maintain because steroids have side effects. They can cause osteoporosis 0:22:07.640 --> 0:22:11.160 in the long term. So now there's been a tremendous 0:22:11.200 --> 0:22:16.359 amount of advancement in biologic agents, and you see lots 0:22:16.359 --> 0:22:20.320 of commercials on TV for soriasis and soiatic arthritis now 0:22:20.600 --> 0:22:23.120 because they have a lot of drugs for this condition 0:22:23.200 --> 0:22:26.440 to try and turn off that rampant inflammation. 0:22:27.760 --> 0:22:30.120 Do you think diet and lifestyle are a big factor? 0:22:30.400 --> 0:22:32.200 Should we be looking at those? 0:22:32.720 --> 0:22:35.440 So there's been a real big push for lifestyle in 0:22:36.200 --> 0:22:39.720 terms of autoimmune disease, trying to go what they call 0:22:39.800 --> 0:22:44.359 it low inflammation, less eggs, less knots, less shellfish, less 0:22:44.400 --> 0:22:50.240 soy the things that are immunogenic, and more Mediterranean diet 0:22:50.840 --> 0:22:55.000 is the approach meat, olive, oil, avocado. But are there 0:22:55.119 --> 0:22:59.920 randomized control trials or big large scale trials and soiatic arthritis, 0:23:00.119 --> 0:23:04.680 these diseases, Unfortunately, it's not clear yet. There aren't those 0:23:04.720 --> 0:23:06.280 good robust trials yet. 0:23:06.480 --> 0:23:09.800 You sort of reference the elimination diet, not specifically, but 0:23:09.920 --> 0:23:12.480