Language of Love with Dr. Laura Berman - The Impact of Trauma in our Body with Dr. Sara Gottfried

Episode Date: May 1, 2024

Did you know that 50 million Americans have some form of dysregulated immune system? But here's the catch - you may not even realize that you are one of them. Perhaps you've been given a diagnosis that you don't fully understand or have been told that you have an autoimmune disorder. The truth is, it's not just a medical issue, it's also an emotional one. In this Language of Love Conversation, I'm excited to be joined by Dr. Sara Gottfried, a Harvard-educated medical doctor, scientist, researcher, and author of four New York Times best-selling books.  We dive into the connections between trauma, autoimmune diseases, and how our bodies keep everything in check. We are chatting about how trauma can throw our systems out of whack, messing with our immune system and sometimes leading to autoimmune issues. Dr. Gottfried is here to shed light on why catching these autoimmune diseases early is so crucial, especially when the signs can be pretty vague. In this conversation, we break down: The connection between trauma and dysregulation in the body The pine system and its role in responding to trauma Understanding autoimmune diseases and the immune system Potential treatments for autoimmune conditions To learn more about Dr. Gottfried's latest projects and to read her latest book, Hormone Cure, visit her website. Explore the connections between trauma, autoimmune diseases, and how our bodies keep everything in check. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hey, I'm sex, love, and relationship therapist, Dr. Laura Berman. And for the past 30 years, I've been helping people just like you learn to love and be loved better. Here on the Language of Love Conversations, I'm talking to some of the world's most influential and revolutionary experts, thought leaders, spiritual teachers, and celebrities about love, sex, and relationships from a mind, body, and spirit perspective. and that way my goal is to awaken your mind body and soul it's time to become fluent in the language of love this episode of language of love I'm really excited about I'm going to be talking to Dr. Sarah Gottfried she's a scientist a researcher a Harvard educated medical doctor with 25 years of experience and the author of four New York Times best-selling books She has dived into hormones and aging and all kinds of fields of exploration of medicine.

And now in her latest book is doing an amazing job, I feel, of diving into autoimmune diseases, but also disorders. I think you're going to be pretty fascinated. I mean, we already know that 50 million Americans have some form of dysregulated immune system, but you may not know that you do, or you may have been given a diagnosis that you don't even know or were told is actually an autoimmune disorder. and here's the good news and also maybe the not so good news. It turns out that it's not just a medical issue. It is also an emotional one. And there is a tremendous amount of research that we're going to be kind of spreading out on the table for us to consider during this interview about the role of trauma and other triggers that have turned your body against you. And most

importantly, what you can do about it. We're diving into your immune system in particular, how your autoimmune disease or disorder or system may be dysregulated in a really cool and fascinating way with Dr. Sarah Gottfried in this episode of The Language of Love. Dr. Sarah Gottfried, thank you so much for joining us on The Language of Love. I'm really excited to dive into this conversation with you. Me too. Can't wait to get started, Dr. Berman. And we were talking before we went live.

We've kind of known each other and been in the same sort of health and wellness world circling each other for decades, more than decades, it feels like. And for both of us, it's really interesting too, because in some ways, both of our focuses in our own lives, but also in our practices,

yours and your medical practice, obviously, and my practice as a therapist and an educator, is really starting to dive into the world of trauma. We get this in your new book, The Autoimmune Cure, but you talk about how you started to kind of, at a certain point in time, after a really busy, successful, all fires and cylinders burning career that you had some trauma to work through. And that journey was so healing and inspiring and opened up a whole avenue of what really changed the way you looked at medicine, it sounds like. And that certainly has happened. I mean, not that I didn't know about trauma and had trauma and was aware of my trauma when I started of my career, but the deeper I've dived into my own trauma and as I've had more and more trauma

that I've had to work through, the more I've discovered about how far reaching those tendrils of trauma are. So I wanted to just invite you to at least talk a little bit about the backstory of how you came here. But just so you guys understand my peeps here, that we're going to dive into not only trauma in this episode, but something super important. And this is one of the reasons I'm so excited about this book, is that there are 50 million Americans, and that's just in America, not to mention around the world, that have a dysregulated immune system. And there's this whole concept that we're starting to hear more and more about autoimmune disease. We're going to get into exactly what that is and what that may look like. You very well have a diagnosis

or been given a diagnosis that would fall into that category. But what's really fascinating and that Dr. Gottfried gets into in this book is how trauma, early childhood trauma, later trauma actually significantly impacts our many factors, our hormones, not just our brains and our emotions, but our bodies, our hormones, our immune system, our gut, a lot of these autoimmune diseases that doctors are pumping us full of medications for. That's not to say there isn't a place for medication, but nobody is talking about the causal factors that have to be resolved in order for effective treatment to happen. So that's what I'm super excited to dive into after that long windup. I remember when I first met you, we were talking before we hit the record button.

I met you at Berkeley like 25 years ago. And I just, you know, I'm sort of visualizing how beautiful I thought you were and you were talking about sexuality and I was a gynecologist and really interested in hormones and sexuality. And I don't remember us talking much about trauma 25 years ago, right? We were sort of innocent. We were talking about bioidentical hormone therapy and all the different components that are related to sexual health. And so now we fast forward 25 years later and it's so interesting to me because I feel like I see trauma almost everywhere that it's become so pervasive and

you see it too. So I do more physical health, you do more mental health, but here we are having a conversation because trauma impacts both. Yeah, for sure. Right? Not does it only lead to things like post-traumatic stress disorder, anxiety, depression, and other mental health effects. It also dysregulates what I think of as the pine system, the psychoneuroendocrine networks of the body. And a lot of folks just don't realize how dysregulated they are until you start to pay attention to it. So I'm just really happy to be in this conversation with you. And the way that I got into it was to see my own dysregulation. Frankly, I had a big fight with a family member, and I had this experience of, at age 50, feeling like if trauma is behind this difficulty that I have in this relationship with someone that I really care about, I'm going to do everything possible to try to resolve the signature of trauma in my body. Yeah. So that got on this path five years ago. And since then you've really been diving into, we're going to get into some of the most effective treatments, which by the way, I am right on board with, but we're going to be digging into, not that that matters to you,

but it does to me and my peeps. So, but I do want to talk about the, let's just dig into the pine system? Cause I, that was one of the things I wanted to ask you about and you kind of just, you know, it rolls off your tongue, but to the rest, to the lay person, we need a little bit more. So, but I think it's super important to kind of set the stage of this conversation. So can you talk a little bit about pine, the acronym and what it is? Yeah. So pine stands for psychology, psycho, immuno, so immune system, neuro, so neurological system, and then endocrine, So the endocrine system, the way that you make hormones. So together, it's this whole network.

And trauma affects so many different aspects of your physiology and your body and your psyche. But I think the pine system is maybe a simplified way to think about the systems that are most affected by overwhelming experience and the way that that can live on in your body. Yeah. So I think of, you know, when I went to medical school in Boston a million years ago, we would talk about psychoneuroimmunology and I was always like, oh yeah, yeah, whatever. I didn't think it was hard science, but oh my gosh, I've been completely convinced that when you look at things like the immune system, 70% of which is in your gut and, you know, can be affected by the food that you eat. can be affected by the permeability, kind of so-called leaky gut, can be affected by the stress that you experience, the cortisol that's squirting through your veins that can poke holes in your gut lining. So now I realize, yes, there are these physical systems that become

so completely disrupted by trauma. And we talk on this show all the time, And I know you discuss it in the book, too, that trauma is not just like being held at gunpoint or going to war or being having the crap beaten out of you every day growing up. I mean, obviously, those are in the categories and there's much many more traumas in the categories of what we call big T trauma, like big, obvious trauma that most people would agree with trauma or would agree is trauma. But then there's the little t traumas, right? All those times where maybe you had a critical and controlling parent or your basic needs were met, but there was a tremendous amount of fear of punishment or retribution or you were abandoned by one or both parents or emotionally abandoned. You know, not in a way that sacrificed your safety, but in a way that really made you as a child feel extremely unsafe and needing to be hypervigilant. Like anything that happened in your childhood that left you, it's a gift today in many ways, not physically, but cognitively, you know, many people who are more psychic or more intuitive or can read people or can read situations really quickly. you know, it comes in handy, but they developed those techniques due to trauma, you know, and keeping themselves alive and safe in their environment. So I think that's really important

to mention that all of these different kinds of traumas, and I'm going to ask you to kind of dive into this in a minute, Sarah, about, because, you know, you described so beautifully in the book, what I know as well, this idea that it's not just what happened, and Gabor Bate, if you listen to my interview with him too, he talks about this, that it's not just what happened to you. It's how you as an individual, your sensitivities, your personality, your environment, how you were responded to after, you know, so many different variables. Those are the variables that play a role in how trauma is going to affect you. It's not the effect itself. So two people could have the same experience and one is going to really

experience the trauma in their system in a really dysfunctional or damaging way and the other maybe for a million different reasons doesn't and so I think that's important to say too but let's get into that a little bit because you know I thought you lay out the science and just in a really understandable way all the different ways that our gut our brain our hormones our immune system are all affected by childhood trauma. Yeah. Childhood trauma, adult trauma. And at this point in our lives, I think that there are very few people who are untouched by some degree of trauma. And yes, there's so many mitigating factors, things like when you were a kid, did you have a trusted adult that you could turn to and, you know, sort of talk about

what you were experiencing? And as you said, yes, there are the capital T traumas that everyone can agree is traumatic. And then there's these smaller T traumas that can have the same effect in terms of the dysregulation that lives on in the body. So I got really interested in this because I started to notice a pattern first in my patients who had autoimmune disease, but then also in myself and some of my family members of a degree of dysregulation that suggested trauma. And what do you mean by dysregulation, just so they understand? Yeah. So the way I like to describe it is that if we just take a moment to think about regulation and maybe we all together take a really deep belly breath and exhale really slowly.

So that's a process of regulation. It's a really effective process, especially when you take a big abdominal breath, you use your abdomen and then you exhale more slowly than usually would, that is a physiological state that we know is really good for you. It slows down the heart rate. It reduces your blood pressure. It has these effects on your physiology that are beneficial. So that is regulation. And there's lots of ways that you can do that. You know, it's like calming down your nervous system in a way where you're not in fight, flight, freeze, which is what happens. This is what we're always talking about with the triggers, right? And when you get triggered, when those thorns get touched

of our traumas, the big T's and little t's, and you kind of fly off the handle or you move into a state of anxiety or fear, or you go to worst case scenarios, or you feel like you have to jump into management mode, anything that like accentuates the nervous system, you know, puts the nervous system into gear, danger, danger, you know, something that needs to be taken care of here. That is dysregulation. And I think, you know, if I understand you correctly, Sarah, what you're saying is that when we, and this makes total sense to me as a therapist, that when we have these traumatic events that don't get resolved and healed, that they become those thorns, right? Or those triggers that when touched react without thinking and are, and even if we're not

overtly outwardly reacting, and this is a really cool part that I think is so powerful about what you're bringing to the table here is that our body, whether we're doing it out loud or reacting or blowing our top or blowing up our world or anything, even if everything on the surface seems fine, more or less, internally, it takes a toll on the hormone system, on the gut system, on the immune system, on the microbiome system, on all kinds of systems, right? Did I say that correctly, more or less? Yeah, you said it beautifully. And I think the way that you've described it paints this larger picture of, yes, we're

talking about nervous system regulation, but it's broader than that. So it's probably the nervous system, it's the psychology together with the nervous system regulation, the two talking to each other, that leads to kind of the initial stress response that might be prolonged. And as you said, that fight, flight, freeze, and I would throw fawn in there too, because so many women respond to stress that way and it's habitual and people pleasing. And then it just branches outward to affect your immune system and lead to your immune system. You know, the three things you need for autoimmune disease is number one, genetic predisposition. Number two, increased intestinal permeability.

And the number three, some kind of trigger. And that could be trauma. It could be a stressor. It could be an infection. It could be COVID. So those are the three things you need to set off an autoimmune disease. So people who've got that nervous system dysregulation, the psychological dysregulation, and then they've got a vulnerability with their immune system, they've got this greater risk

of developing autoimmunity. Other people have more of an endocrine response. And so their cortisol, their stress hormone becomes dysregulated. And that can also affect some other hormones like your thyroid and your estrogen, testosterone, DHEA, progesterone. So this is how the pine system kind of works behind the scenes. So yes, regulation is that state of optimal physiology where you're in what we call homeostasis or balance. Dysregulation is when you're in fight, flight, freeze, or you've got a trigger as you described, maybe an emotional trigger, relationship trigger, a thorn, as you said, there's something that's just not quite right. And you can measure this. You can measure this. It's not like some fake thing that you can't measure. You can look at your heart rate variability like I look at it with my ring. You can look at your blood sugar like I look at with my continuous glucose monitor. And we know that trauma is associated with changes in these different metrics that we can track.

I'm curious because I keep hearing about these glucose monitors for weight management and for menopause management and because we get a lot of changes in insulin resistance with changes in the hormones. But so are you saying that in the moment, the glucose levels will change when you're in a fight, flight, freeze, or fawn situation when you're in a trigger? So it changes in the moment. Wow. And what does it change to? What happens? Well, typically what happens is that your stress hormones go up. So cortisol goes up. That raises blood sugar. Why does it do that? It does it so that if you're in fight or flight. Fight the saber-toothed tiger. So that's the physiological system. The problem is that we often get triggered all the time,

right? We get triggered by an email. We get triggered by a conversation with a spouse. And it's not just once a quarter you encounter a predator. So that's the short-term consequence. But we know over time, for people who've got elevated adverse childhood experiences scores, high ACE scores, they've got a greater risk of glucose problems. They've got a greater risk of type 2 diabetes. That's why I see no one has ever said that to me. I eat really, really well.

I'm really careful with sugar and simple white flour, you know, all the things you're supposed to do. And I'm hormonally supported through my perimenopause. So there's no real reason for my insulin levels and even my cholesterol levels to be as high as they are. And I can't, I'm like, what is it? Maybe it's cortisol, but I don't really, but maybe it's just trauma. And so you're saying that just longitudinally, even, even if I can regulate and I don't get easily dysregulated anymore, that that still can have an effect on those factors. It still lives on in your system. So cortisol has a relationship with insulin. We also become more insulin resistant, kind of numb to insulin as we get older. So after 40, typically your blood

sugar goes up about 10 points. So all of this is interdependent. And a lot of the focus with continuous glucose monitor and I run the precision medicine program at Marcus Institute of Integrative Health in Philadelphia, a lot of people just 100% focus on food. Okay, I got to cut back on fruit. I've got to cut back on potatoes or whatever it is they think is triggering their blood sugar to be elevated. And they don't understand that trauma, stress, toxic stress, these other things can also influence their blood sugar pretty dramatically. Even one night of bad sleep can impact your blood sugar the next day.

So we need to look more broadly. So let's talk about autoimmune disorders because I think that I find, I mean, I was just talking to a girlfriend the other day and she was just mentioning in passing, she's having all of these different inflammatory issues, it sounds like to me, and a lot of joint problems,

a lot of pain, a lot of different things. And then she just mentions in passing, like, yeah, you know, I have Hashimoto's. And I was like, well, that's an autoimmune. She's like, no, it's not like had no idea that it was an autoimmune disease, because I don't think the doctors like take the time to qualify it. Maybe they don't want to scare the patient or call it something or whatever. But it feels like it's really important to know when you have a condition that is a result of your immune system attacking itself, which is essentially what an autoimmune disease is. So can you talk about examples?

I mean, I gave Hashimoto's disease, but, and I know you write about, and I think this is so important to know that even long COVID is in that category as far as you're concerned of an autoimmune disease. You know, people have a really, that kind of long symptomatic thing after having COVID, that that's an autoimmune response as well.

but I would love for you to talk a little bit about the examples of those so that people can recognize and then we can get into what we do about it. Well, I'm so glad you raised the point about Hashimoto's thyroiditis because a lot of people don't realize that it's not an immune disease, as you mentioned. So there's a long list about immune diseases. There's more than a hundred that are classical things like rheumatoid arthritis, multiple sclerosis, type one diabetes. so there's more than a hundred lupus is a really common one this is a really common one scleroderma psoriasis so those are the classic autoimmune diseases and to make a diagnosis generally you see a physician who's looking for particular criteria maybe you've got joint pain like your

friend has or you've got some other constellation of symptoms muscle pain fatigue you know weakness And then that's put together with some laboratory work. So typically a measurement of an antibody, which is basically what the immune system uses as a weapon to fight its own tissues. So autoimmune disease is when your body is attacking your own tissues, and it develops to a point where it is a diseased state, like rheumatoid arthritis, like Hashimoto's thyroiditis. Now, there's a period of time, typically seven to 14 years, where you don't quite meet criteria for a disease, but you've got autoimmunity. You're starting to develop these antibodies. So, you know, some people, I've got a lot of patients, I always check with Hashimoto's, I'm looking for autoimmune disease in every patient that I see. So I'm running antibodies against the antithyroglobulin antibody, the thyroid peroxis antibodies. I'm looking at thyroid function and kind of an expanded panel. And I have lots of patients

who have got positive antibodies, but their thyroid is still functioning normally. So that is called autoimmunity. That's the 7 to 14 years before you've got an autoimmune disease. And you know, this flies below the radar of most mainstream physicians. And I don't think it should. I think we should be measuring some of these things. All right. So let's take a pause here then, because I really want to accentuate this. I want, if you're willing, you mentioned them, but let's just do it in a really concise way so that what are some of the most common symptoms we might see if we're in that seven to 14 year period where we're just not feeling our best. We're experiencing these symptoms, but there's no quote unquote diagnosis that any,

we don't meet the criteria for anything. And so we just, or we do what I would do and just be like, I'm just tired and stressed. Oh, it's just natural. You know, I just like would blow it off. And once we get into the treatments, you'll see why guys, it's important to kind of know that this is brewing inside you because you can catch it much, much earlier. And so it's much easier to treat. So what are some of the common things that someone might be seeing symptoms-wise? The most common are joint pain, joint aches, joint stiffness, fatigue, weakness, the sense that things are not quite right. A lot of women experience that and they go to their clinician and they get dismissed. We sure do. Yeah. You're just like,

I'm not feeling right. I'm not feeling the same energy or the same sort of ease. And also those stomach issues, the SIBO and the irritable bowel and all the things that come up. I mean, after my son died within two weeks, I didn't even know what SIBO was at the time. In two weeks, I had SIBO, just like, boom. It was like my body was like, and went into trauma mode. So I mean, that's an extreme example, but I think for many of us, it develops over time. As most of you know, for the past several years, I've been on a pretty intense grief journey and it's been a path of healing. I've shared lots of that healing with you and lots of the healing resources that I found. And I am so thrilled to announce that I am doing my first ever retreat for grieving mamas.

So if you or someone you love is a mama who has lost a child in any way, at any stage, at any age, I would love for you to come join me at 1440 Multiversity in the Redwoods near Santa Cruz, California for four amazing days of beautiful, uplifting community and healing. We've got David Kessler. We've got Paul Selig. We've got Catherine Woodward Thomas. We've got me. We've got body work. We've got organic food, beautiful rooms. Go to 1440.org.

Check it out. It's right there on the homepage. I really hope you can join us. So any other symptoms that... Well, you mentioned gut symptoms, and that's a critical one because 70% of your immune system is in your gut. a lot of people do experience gut symptoms, but you don't have to. There are some people with autoimmune disease who don't have gut symptoms and yet their gut is not functioning

normally. Like their microbiome is not quite as diverse as it could be to support their health. There's visual changes, you know, thinking of things like multiple sclerosis and some of the neurological based autoimmune diseases. You might have double vision or dryness in your eye. there's a list of a lot of different symptoms. And part of what makes it so hard to diagnose is that the symptoms are nonspecific. It's not like you get one symptom. It's like, okay, that's MS until proven otherwise. The problem is we've got all these different symptoms to manage. And that leads to people seeing about four to six doctors before they get a correct diagnosis and often waiting four to seven years until they get that diagnosis.

So that's what's got to change because we are failing people who struggle with autoimmune disease and we have to do a better job. We have to catch it earlier. We have to get clear about diagnosis and not wait until it's too late to reverse. Yeah. And we're going to get into in a minute some of the things that can help as well as I want to ask you, you know, if somebody, cause I, you have the center for precision medicine in Philadelphia, right? Am I saying that right? In Philadelphia. I also want to get to, so I don't

want to forget what we can advise people to do to ask for from their doctors or what kind of doctors to find, right? If you're listening to this and you're like, whoa, we're going to get into now some of the things that you have found and found evidence, you know, there's lots of citations and science that she puts in underpinning all of this, but we're going to get into in just a second, some of the treatments that you have found that are most effective for this autoimmune syndrome, right? It doesn't even have to be a disease. It's just something, I think you feel the same way, that this is significantly more

prevalent than we even understand. I mean, if you think about how many people, we know 50 million Americans we know have dysregulated immune system. tens of millions of people, not only in America, but around the world had trauma, are dysregulated, just living their lives and are relatively, they're functioning enough that they don't think there's an issue and are starting to develop these things or even living with these things and not knowing it. So I think it's much more prevalent, just like trauma is much more prevalent that we talk about. Yeah, it's a silent epidemic. And when you look at it that way,

when you look at how many people are suffering, I talk about a couple of different types of conditions in the book. So certainly classic autoimmune disease, like the ones we've mentioned, Hashimoto's, multiple sclerosis, type one diabetes, lupus, but there's also kind of the non-classical autoimmune disease. And that includes types of irritable bowel syndrome. It includes other conditions where you're attacking your own tissue, like endometriosis, even fibromyalgia is thought to be autoimmune in origin. And what we want, because so many people are suffering with these symptoms and they're not kind of putting the constellation together and thinking about whether it's autoimmune

disease. we want to be able to empower people to ask for the right testing and to start that path toward addressing the root causes. So you asked, what kind of doctor do you go see? What kind of clinician? The people who are trained to do this kind of work typically practice functional medicine. So you can go to the Institute for Functional Medicine. They've got a list of clinicians that are certified by them. That's a great resource to go to. Folks who do precision medicine also have this approach. So there's lots of different ways to work with it. But I find that most of my mainstream colleagues who are rheumatologists or immunologists, they're not

thinking this way. It's just like the OBGYNs that used to be about sex, and many still are. You know, it's like, how in the hell can you not be asking and addressing this and treating this, and yet they're not. And so you talk in the book and we won't get into the minutiae of what kind of testing, even like the phraseology that you can use when you go to the doctor, you say, I feel like I have an autoimmune thing happening. I don't know if it meets a specific criteria for a disease diagnosis, but I feel these symptoms and I'm noticing these symptoms and I'd like to get testing done and pursue possible treatments. Like even that, if you go to a functional medicine or precision medicine person could be a great place to start, right?

It's a great place to start. So that allows the clinician to then start thinking in terms of, okay, are there symptoms of autoimmune disease here? And then once you get a full history, you can put it together with some laboratory testing. And there's lots of basic laboratory testing that you might be getting every time you see your primary care doctor that can point us in the direction of autoimmune disease. things like a complete blood count. When you do that with a differential and you look at your neutrophils, a certain type of white blood cell versus the number of lymphocytes and you divide,

you do your neutrophil lymphocyte ratio, NLR. That's a really good indicator of the amount of inflammation in the body. You can measure high sensitivity C-reactive protein. A lot of people get that regularly, seeing their clinicians. You can measure the ESR, erythrocyte sed rate. You can look at some of the antibodies that we've talked about, and that includes anti-nuclear antibody. We know that the number of people with positive anti-nuclear antibodies, so what does that mean? It means that their immune cells are fighting the nucleus of their cells. they're making antibodies to the nucleus of their cells, the rate of that has increased pretty dramatically over the past few decades. Yeah. And part of that is not only toxin exposure

and higher stress than ever before in our modern world, but you also talk about genetic, and you mentioned this earlier, your genetic predisposition and even the ways in which trauma is genetically the threshold for managing trauma and its impact on your body or not. is also can be, is starting to be seen as something that is carried genetically. And so, or at least gets changed and then gets passed on, right? So if your grandparent or your parent or whoever had trauma and has troubles with self-regulation or whatever else, that that actually is not only passed on in their behavior and the way it impacted you, but on a cellular level. It can be passed on. It's a critical point because there's some folks who say,

I don't have trauma. I've done the ACE questionnaire. My ACE score is zero. My parents didn't get divorced. I wasn't neglected. No one went to jail. No one had a use disorder or addiction. And yet they've got a great-grandmother who survived the Holocaust, or they've got a mother or, you know, someone else who went through a terrorist experience. And so when these epigenetic changes, we're still in the early stages of understanding how this relates to development of things like autoimmune disease, but it's really critical. You've got to look at those epigenetic changes along with the genetic predisposition. Yeah.

Okay. So we've laid out a lot of the risk factors, the variables involved, how to find out or at least begin a diagnosis. Now let's get into what the hell we do, because, you know, there are all of these drugs out there which may or may not help with different conditions, rheumatoid arthritis or whatever. But a lot of those just circle back and repress your immune system more and make you vulnerable to cancers and other things. And in my experience, and I'm not an MD, I'm a PhD, but Lord knows I've been ushering enough people through health traumas and dramas over the past 30 years that often, you know, the medication will only, the typical pharmaceutical medications, whatever the condition is, can only take you so far. There's certainly not a panacea or a magic pill that's going to address an autoimmune dysfunction or disease. So you have this kind of milieu, all these different kind of practices and interventions that you discuss in much more detail than we'll probably get into here in the book, starting with self-regulation techniques, which we talked about, which is really just kind of cooling the fire, as they say in Chinese medicine, calming your cortisol levels down and your anxiety down and your heart rate down and your vagus nerve stimulation and all of that. that there are these different techniques for calming your nervous system down in the moment

and on an ongoing basis. You get into some of those in the book. There's lots of resources for those. I have a bunch of meditations on my website that are essentially the open-hearted meditation, the coherence meditation. Those are all forms of self-regulation that move the electromagnetic fields of your brain and your heart into synchrony, which moves you into self-regulation. I want to get into some of the other things you mentioned. One, which is I love that you're talking about because I'm fascinated by it and have referred many of my clients, my patients to really good practitioners who are guide people on this. But you talk about MDMA assisted therapy, ketamine assisted therapy, psilocybin, this whole new field of, let's just

say substance and psychedelic. I mean, you do a much better job of just, you know, of getting into all this in the book, but all these different modalities of whether it's plant medicine or psychedelics that when used with a good practitioner who's guiding you through it, I'm not talking about taking it recreationally, can really help. So that's the first thing I want ask you about. Yeah. I've been tracking how different medicines and supplements and lifestyle practices can affect the immune system, as well as kind of this larger level of regulation in the nervous system, the endocrine system, the pine network, and nothing works like psychedelic medicine. It just doesn't. And that is an unbiased scientific opinion because we know

if you look at the phase three trials that have been done with MDMA for post-traumatic stress disorder, we've got two randomized trials that are published now. The first one in 2021 showed that when you give two to three treatments with MDMA and you've got prep and integration, associated with them, so MDMA-assisted therapy, and you treat severe post-traumatic stress disorder, about two-thirds of people no longer meet criteria after they finish their course of treatment. And the effect is durable. It's not like it's just that day. It's true for years afterwards. One of the criticisms of that randomized trial was that it was mostly a white population, and it wasn't sufficiently diverse and they were looking only at severe PTSD. So what about

more moderate symptoms? And so the second randomized trial was just published a few months ago showing that in a more diverse population, 50% non-white with moderate to severe post-traumatic stress disorder, there's a similar sort of effect where about 71% no longer met criteria for post-traumatic stress disorder after going through two to three treatments. And what's the theory as to why, I have a theory myself, but it's just my theory. What's the theory as you understand it, studying the research as to why this works to resolve the PTSD or the symptoms of it? There's a lot of different mechanisms that are being proposed. I can tell you as someone who has done MDMA-assisted therapy and I'm now certified to provide

psychedelic medicine, I believe that it's a combination of being able to go back to some of those memories that you might have and to look at the story that you've told yourself yourself about the situation with fresh eyes, with less fear, with fresh eyes, with beginner's mind. And that's where I think having a therapist is so critical. I'm not saying, okay, everybody start taking MDMA because it's going to result in your trauma. You got to pair it with the right therapist. Yeah. It opens, and I agree with you. I mean, it's similar to what I'm thinking and have been thinking as I've been watching this unfold in the world. And by the way, a lot of people are, you know, are abusing this. They're like, you know, claiming that they're being all

conscious and woke and they're doing ayahuasca every weekend with no integration and no support. Like it's, it's weird. It's getting bastardized a little bit, but that aside, when we're talking about MDMA or any of these assisted therapies, to me, it feels like exactly what you said. When you have someone who can, understands your intention, understands the wound and the trauma. And then when you take it, it's like not only beginner's mind and fresh eyes, it almost gives you the benefit of leaving your ego behind, leaving your stories behind and seeing it through the, the only way I can describe it, and these guys are used to my woo, is seeing it through the lens of your soul, right? Like your higher self, your God self, not your personality self. And one of the things that all these things do, whether it's psilocybin, they do it in different ways, is that it taps you and entunes you into that higher realm.

So it's like if your soul, your highest self, your God self, not your ego and personality and all the other things that we need and operate with in the world, if that were to look at what happened to you. How would that aspect of you process it and understand it? And it integrates that understanding into your ego personality self. So you can carry that forth. Does that make sense? Beautifully articulated. So I totally agree with that. And as a researcher, it's hard to demonstrate, right? So yes, that was my experience. It's the experience of hundreds of people that I've talked to who've gone through MDMA-assisted therapy. And there's a reason why we call these medicines empathogens and theogens. They help you to connect to that

healing state of consciousness, that universal consciousness of realizing that we're not so separate from each other. And really the purpose here, the purpose of this whole thing called life is love and connection, you know, pretty simple things, but we often forget and often the ego gets in the way. Yeah, it's fascinating. So there's all kinds of resources around the country and in some states it's legal and other states it's becoming legal. But the main thing I want you guys to take away is that this does seem to work. Not everyone obviously is a candidate or wants to do it, but if you are going to do it, please make sure you are doing it with a certified person who does the integration. So they should be having like two or three sessions with you

before you even do it with them at the plant medicine or the MDMA or whatever you're doing. And then when you're doing it, they are with you and they're guiding you according, you know, that they're trained to do that. And then after it's done, they have two or three sessions with you to make sure you're integrating and processing all you learned. It's not about going to some party in Ibiza and all sitting around doing it together and deciding you are healed, it doesn't work that way. I mean, you can have fun doing that, but that's not going to help you. That's a different thing. That's a different thing. But I do see that. It's annoying the crap out of me, all these quote-unquote spiritual teachers

doing that. Okay. So there are a couple more things. There's a lot more things. I mean, there's so many treatments available that Sarah talks about in the book, including, which I'm fascinated about. I'm going to put a pin in this because there's something I'm even more fascinated about, but microbiome kind of restoration, these fecal transplant. I mean, there's all kinds of cool stuff that you get into in the book that people can explore. But I want to ask you about Plaxone, which I've become very familiar with in the advocacy I'm doing to get Narcan and other things available to people with all the fentanyl poisoning going on in the world. So that's how I know about it. But I've been hearing about it more and more in terms

of low doses of the same thing that was created, or at least FDA approved for opioid overdoses or opioid poisoning is in the case of so many people a day, you know, up to 300 people a day from fentanyl poisoning right now. But it's also in a low dose has a really significant effect on autoimmune issues. That's right. Tell me, I had no idea about that, but I've been hearing about it more and more. So can you talk about why that works? So this is low-dose naltrexone. It acts as a, as you said, an immunomodulator. So we know at higher doses, so 50 to 100 milligrams, that's what we use for opioid addiction. It's also used for people who dissociate, kind of functional dissociation, which that's like a whole other conversation you and I could

have, because I think that's so common with those of us with trauma, but then at a lower dose. So about a 10th of those doses, or even a one 20th, somewhere between one and five milligrams, it can be this beneficial agent in terms of your immune system, the mechanism, how it works. We don't totally understand it, but pretty much every patient I have with either autoimmune disease or some kind of pain syndrome where they're sensitized, like with endometriosis, I'll do a trial of low-dose naltrexone for three months to see if it helps. And I mentioned earlier, sometimes I'll see patients with elevated antibodies against their thyroid, but they don't yet have an effect on their thyroid hormones or their

TSH, thyroid stimulating hormone. That's a situation where sometimes I'll use low-dose naltrexone just to try to modulate the immune system, do some of that gut rehab that can take a while. It can take three, six months to really get your microbiome kind of optimized. And it can help to reduce symptoms and to reduce the progression of the condition. So some of this opinion and like my empiric experience, there's not a lot of randomized trials on this, but I can tell you a lot of people really swear by it and I'm impressed with it. Is it alleviating the symptoms or is it changing? Like when you look at those markers for autoimmune, you know, response or immune, when you look at those things you were talking about measuring before, are they better or

Or is it more of the individual's experience of the symptoms that's better or both? So it's actually acting as a tonic. The way that I think of it is, you know, we use different tonics to try to move physiology in one direction or another. And this is acting as a tonic for the immune system. So what happens with people, I mean, especially women in perimenopause, this is kind of the group that has the highest rates of autoimmune disease. there's something about the change in the estrogen, progesterone, testosterone that leads to

more vulnerability with the immune system and the immune system becomes overactive. That can also happen after you give birth because your immune system goes through such dynamic changes. And so things like low-dose naltrexone go to the root. They go to that overactive immune system and seem to calm things down. So interesting. And so a lot of the other things you talk about or things that I talk about all the time, so I don't want to spend too much time, but this idea of somatic experiencing, huge, huge, huge fan, especially for any kind of trauma that you've had, internal family systems work or any kind of therapy that inner child work, soul retrieval, whatever you want to call it, that really kind of works and helps you heal and address and kind of

reintegrate those parts of ourselves that we almost abandoned and left behind when during those traumatic incidents or experiences. But in the little bit of time, we could talk about this one thing probably for an hour because it's so complex. But in the little bit of time we have left, I do want to just introduce this idea of microbiome restoration. It is complex. And like you said, it takes a while. This came up with my doctor when I was diagnosed with SIBO, but also So it comes, you know, with a lot of these autoimmune things, especially because we were saying, as we were saying, the gut is such a central part of our immune system and our mood, by the way.

So there's all these new developments. I feel like, I mean, maybe I just was out of the loop, but it feels like it's been in the past three to five years, new research and new developments and ways to rebalance your gut microbiomes. That's right. I would say that this is probably the most accelerated part of medicine. We're really moving so fast in terms of knowing what is the most impactful. And so, of course, food is so impactful.

We want to start there. I've got a food first philosophy. There are certain foods that just feed the benevolent bacteria in your gut. We know that there are certain bacteria that are associated with autoimmune disease. and you can measure it. You can do a poop test and you can look at the microbiome and you can say, okay, you've got, you know, an overgrowth of these three bacteria that are associated with autoimmune disease and you can address it. Yeah. I think because my doctor so desperately wants me to do that poop test and it's been under my sink for a year because I can't bring myself

to poop in the little French fry looking carton. It looks like a little French fry carton that I French fries. Yeah. I mean, the good news is there's a couple of tests that do a wipe. That would be better. I would do the wipe. I take care of an NBA team and no one is going to poop in a French fry container. So they use the wipe and they're good with that. So yeah, the wipe I highly recommend. And so you want to test it. You want to see where you are. You want to track it over time, like with all of these things. And then there are prebiotics, the things that feed the benevolent bacteria. There are certain vegetables that are famous for that, like artichokes and leeks and asparagus. And then

there's a particular bacteria that you may want to promote, like acromansia. They like pomegranates and cranberries. You could throw those in your smoothies. And then there's also the probiotics, which can, you know, we don't think of probiotics as sort of repopulating the gut bacteria, but we think of them as modulating as they go through the system and creating this more beneficial signature. So it's a somewhat complex process. A big part of it with autoimmunity is whether you've got leaky gut or not. And I can tell you probably about 70% of my patients have leaky gut. And so knowing that is also important. And then there's things like L-glutamine that can help with healing leaky gut. My doctor has me on that. I mean, basically,

since I won't take the poop test yet, now I will ask him about the wipes. He's been basically treating me like I have it, you know, but until I take the test or maybe I won't take the test, I don't know, but I still have some of the symptoms. So I probably will. I'm going to ask him about the wipes. But this is all so fascinating. And I think it's so important. The book, guys, is called The Autoimmune Cure. Subtitle is Healing the Trauma and Other Triggers That Have Turned Your Body Against You. Even if you don't have an official diagnosis, if you have any kind of trauma, big T or little t trauma, and you're having any of these symptoms, which I feel like, it feels like almost every perimenopausal woman I know, but certainly more than women,

you know, but, but we do seem to see those starting. I see them starting in your thirties and forties more than an early childhood, these autoimmune disorders. But if you have any of these or you love or know anyone, definitely check out the book, look for a functional medicine doctor. I love that the Institute of Functional Medicine will put that website along with Dr. Sarah Gottfried's website to her precision medicine practice. You can also Google and look for precision medicine practices in your community. Thank you so much for joining us. My pleasure. So good to be back with you, Laura. You're just like my sport car, drivin' fast, you go far

When I'm sittin' by you, we get high This song is about you, and my lips are cravin' for One kiss