The Dr. Hyman Show - What Really Causes Autoimmune Disease with Dr. Todd LePine

Episode Date: July 13, 2020

What Really Causes Autoimmune Disease with Dr. Todd LePine | This episode is brought to you by AirDoctor Autoimmune diseases are a huge issue, affecting over 80 million Americans. They include type 1 diabetes, lupus, rheumatoid arthritis, multiple sclerosis, colitis, Crohn’s disease, and dozens of others, but they all have one thing in common: The body attacks itself. Conventional medicine uses pharmaceutical drugs to treat autoimmune disease but fails to answer one simple question: Why is the body out of balance to begin with, and how do we help it regain the proper balance? Functional Medicine, on the other hand, applies a personalized approach to treating autoimmune disease providing a map to find the root cause underlying autoimmune disease. In this episode, Dr. Hyman sits down with Dr. Todd LePine to discuss the Functional Medicine approach to treating autoimmune disease, and lupus specifically. Dr. LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine’s focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders and the neurobiology of mood and cognitive disorders. Dr. LePine teaches around the world, and has given lectures to doctors and patients at American College for Advancement in Medicine (ACAM), Age Management Medicine Group (AMMG), the University of Miami Integrative Medicine Conference, The Kripalu Center in Lenox, MA, and is on the faculty for American Academy of Anti-Aging Medicine (A4M). Dr. LePine is the head of the Scientific Advisory Board for Designs for Health and a consultant for Diagnostic Solutions Laboratory. He enjoys skiing, kayaking, hiking, camping and golfing in the beautiful Berkshires, and is a fitness enthusiast. In this conversation, Dr. Hyman and Dr. LePine discuss: Common indicators of lupus Traditional treatments and medications used to treat lupus Pharmaceutical triggered lupus  Pre-autoimmune disease and preemptive personalized medicine How Dr. LePine treated a patient with lupus  The connection between Epstein Barr virus and autoimmune disease Five main triggers of autoimmune disease Lectins and mannose binding lectin deficiency Ozone therapy The relationship between lupus and hormones Foods to eat and to avoid for autoimmune disease For more information visit drhyman.com/uwc This episode is sponsored by AirDoctor. We need clean air not only to live but to create vibrant health and protect ourselves and loved ones from toxin exposure and disease. Learn more about the AirDoctor Professional Air Purifier system at a special price at www.drhyman.com/filter Additional resources: Getting to the Root: Taking the Overwhelm Out of Autoimmunity https://drhyman.com/blog/2015/09/04/10-steps-to-reverse-autoimmune-disease/ A New Approach to Autoimmune Disease https://www.ultrawellnesscenter.com/2018/06/27/a-new-approach-to-autoimmune-disease/ Top 5 Diet Changes for Autoimmunity https://www.ultrawellnesscenter.com/2017/06/30/top-5-diet-changes-for-autoimmunity/ 10 Steps to Reverse Autoimmune Disease https://drhyman.com/blog/2015/09/04/10-steps-to-reverse-autoimmune-disease/ Is There A Cure For Autoimmune Disease? https://drhyman.com/blog/2010/10/09/is-there-a-cure-for-autoimmune-disease/ How to Stop Attacking Yourself: 9 Steps to Heal Autoimmune Disease https://drhyman.com/blog/2010/07/30/how-to-stop-attacking-yourself-9-steps-to-heal-autoimmune-disease/

Coming up on this episode of The Doctor's Pharmacy. When you go into the medical literature in autoimmunity related to lupus, the Epstein-Barr virus is associated with seven different autoimmune conditions. Multiple sclerosis, rheumatoid arthritis, lupus, type 1 diabetes, ulcerative colitis. Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman and that's pharmacy with an F. F-A-R-M-A-C-Y, a place for conversations that matter. And if you suffer from an autoimmune disease, if you've had lupus, this conversation is going to matter to you. Or if you know anybody who's got these problems because they affect 80 million Americans, one type or another,

which is more people than have heart disease, cancer, and diabetes combined. So it's a big problem and has very poor answers with traditional medicine. And we have today with us my colleague at the Ultra Wellness Center, Dr. Todd Lepine, who's an incredible physician. He's one of the leaders in functional medicine, teaches all over the world. He graduated from Dartmouth Medical School. He's been working with me for, I don't know, God, now 25 years together. We've been on this road. He looks the same as the day I met him. I don't know how he does it. He doesn't have one gray hair on his head. And he is going to talk to us today about a patient of his with lupus who had autoimmune disease that is a very common problem

with very bad outcomes. It can lead to brain issues, kidney failure, lung issues, joint issues. It's a really horrible problem. So, Todd, tell us what is the lupus and what is the traditional approach in medicine to this problem? All right, so lupus actually comes from the Latin word meaning wolf. And typically people with classic lupus have, well, they get a facial rash. It's called the malar rash. It's like a facial rash. It's called the malar rash. It's like a butterfly rash.

And over time, they say that you develop wolf-like appearance. Yeah, their cheeks get all red. All red, yeah, exactly. And that's due to photosensitivity. And so lupus is one of those conditions which we see a lot. Interestingly, it's about nine times more prevalent in women. So that raises the question, what's the difference between women and men? And why are women-

I'm still trying to figure that out. Well, I actually think I have an insight into that. It's really quite interesting. How men and women are different? Yeah, how men and women are different. Right, right. And then the other thing that is also interesting is that we traditionally treat it with you know medications like steroids methotrexate Plaquenil those kinds of things which I'll have their you know significant side effects and in my opinion one of the these are powerful immune suppressing drugs oh yeah and they even use biological agents

biologics which really shut off your immune system and they they can work but they're often fraught with danger including the risk of cancer and overwhelming infection if you get a bad infection so right they're not they're they're very expensive up to 50 grand a year per yeah per person yeah and then also to you know one of the things that i always used to um it was intriguing to me when i was uh doing my training was drug-induced lupus because we were taught that lupus is an autoimmune condition but there is a condition called drug-induced lupus and i always raise my question well what's what how is a drug causing lupus and what we see is that in i think one of the uh major drugs was an older drug called procainamide. I don't know if you remember using that.

It was an antiarrhythmic. Yeah. And in certain patients who got procainamide, they would develop lupus. It looks just like what we call lupus SLE, systemic lupus erythematosus. And that always fascinated me that a drug would be triggering this. And when I actually went down that sort of rabbit hole, what we find out is that a procainamide can actually damage DNA. And it's probably theorized that some types of things like drugs or stealth infections like viruses may trigger the body and cause some damage in the DNA. And when we test for lupus,

I mean, some of the tests that are, are double-stranded DNA antibodies. The traditional blood tests look at, you know, what are the autoimmune antibodies? Yeah. And it's interesting because there's a whole bunch of different markers that are used in the diagnosis of autoimmune conditions. You have autoimmune panels, like the traditional one is ANA, the anti-nuclear antigen. Typically in patients who have lupus, that's positive. And then you can look for other biomarkers like double-stranded DNA and such. And the ANA can be positive in many, many people, even if they don't have lupus. And there's this

whole phenomenon of pre-autoimmune disease where you're starting to have these autoimmune antibodies, but you don't really have a lot of symptoms yet. It's like pre-diabetes, like pre-autoimmune disease. Exactly. And I always tell my patients, that's like pre-diabetes it's like pre-autoimmune disease exactly and i i always tell my patients that's like when the check engine light comes on in your car exactly if you ignore that you're gonna get you know smoke coming out of the hood soon which which traditional medicine ignores it totally if you don't meet these five criteria for this diagnosis then you don't have it and we can't treat you right it's like the patient i had who's came with blood sugar of 120 i said jesus doctor check that out? He's like, oh, yeah.

I said, what's happening? What do you recommend? He says, well, he said I should watch it until it's 126, and then he'll give me treatment for diabetes. Isn't that crazy? Yeah. We'll wait until the horse is on the bar, and then we'll try to corral it. Yeah.

Yeah, it's unfortunate. But I guess when you look at how many people do have conditions that are even subclinical hypothyroidism, there's a lot of things that if you look early enough, it's a lot easier to treat them when you catch them early. If you're starting to have early cognitive decline, Alzheimer's is a lot easier to treat when you catch it early. Diabetes is a lot easier. Heart disease, autoimmune conditions. So preemptive personalized medicine is the way to go. That's what we do at the Ultra Wellness Center here, functional medicine. So this patient had this condition that was treated by traditional medicine. Was she on a bunch of drugs? She actually came in, had done courses of primarily Plaquenil and prednisone and she was actually pretty

proactive in in her sort of self-care. Plaquenil by the way for those listening is the same as hydroxychloroquine that they're using for COVID-19. Right and and we also realized that Plaquenil is actually an antimicrobial. Yeah. It's used for malaria. That's the original use for it but they found somebody somebody must it somebody must have had malaria and then developed lupus and they said hey this is working so that's sort of like

how they discover other uses for medications but this particular she was actually involved in the healthcare field I think she was a therapist if I recall properly. And so she had done a lot of stuff on her own. The big thing with her is that, and she told me this,

that she felt that her lupus was actually triggered by stress. She had a son who had some medical issues and was having issues both with dealing with a teenager who had some illness, and that sort of tripped it over. And oftentimes, if I take the history of patients who develop an autoimmune condition, it's oftentimes followed by a period of chronic stress that's unrelenting. It's a very, very common thing. Well, let's talk about stress for a minute because my thinking about stress is it sort of sets the table for other

things to sort of take over. So it doesn't cause that. Not in and of itself. It may cause some illness for some people, but for the most time, it exacerbates whatever's going on. So if you're stressed, your immune system's suppressed, you're going to get more inflammation. And then if you have underlying issues like this woman did, they're going to come out. Absolutely.

So tell us how you approach this from a functional medicine perspective. How do we think about autoimmune disease in general from a functional medicine perspective and lupus? Well, when I see a patient who has lupus and I go down sort of the checklist, so I look at, okay, do they have sensitivity to gluten? The other thing which I find in a lot of lupus patients is Epstein-Barr virus. So Epstein-Barr virus is the virus that causes mono. And mono stands for mononucleosis because the virus infects your white blood cells. And the thing about Epstein-Barr virus is it's very common, about 70,

80% of the population has it. And most of the time the immune system will clear it. And it's a herpes class virus, just like a cold sore. And once you get a herpes cold sore, that virus stays in your body all the time. Most of the time, the immune system keeps it in check. But there are certain individuals where the virus will reactivate and the herpes virus will come out or the mono can actually reactivate. So a cold sore in your lip is basically a herpes virus. Herpes virus. And it doesn't come out all the time. It comes out under stress.

Under stress. Cold weather. Exactly. Emotional stress. Too much sunlight. Getting a cold, sunlight. So it's sort of a latent virus. We all live with hundreds of viruses in us.

When we're stressed, it allows those viruses to emerge. Exactly. And so this is what happened with this patient. Yeah. And so I always like to go down and ask the question, so why is this? Why do women have lupus more than men? Less functional medicines. Why, why, why?

Right. And then, interestingly, when you go into the medical literature in autoimmunity related to lupus, the Epstein-Barr virus is associated with seven different autoimmune conditions, multiple sclerosis, rheumatoid arthritis, lupus, type 1 diabetes, ulcerative colitis. So what happens is the virus, in some cases, patients will reactivate and it causes the stimulation of the immune system. And the immune system will then start reacting to it. And then interestingly, I've always been curious about photosensitivity.

Like, why does photosensitivity happen in patients who have lupus? What's going on there? Why is that when they get sunlight, is it affecting them? And what I found out in the literature is that the uh virus uh causes the body to produce more interferon gamma and interferon gamma is our bodies uh one of the uh cytokines that help our bodies to fight off viruses and when we have high levels of this

interferon gamma it sensitizes the body to sunlight. So that's why you get that sort of lupus-like photosensitivity, especially with exposure to sunlight. And interferon is one of the treatments we're looking at for fighting COVID-19. Yes. So what they do is they have an overabundance, and it may be a genetic predisposition. There may be some single-declared polymorphisms that certain lupus patients have, and they produce lots of interferon gamma. and that actually gets involved in the skin cells, and it can make them more photosensitive. So it's an interesting phenomenon. And then the other thing about, you know, when, and I've seen this with a lot of regular mainstream doctors, they'll say, well, you can't really check for Epstein-Barr virus because everybody's,

you know, if the antibodies are positive, it just means that you've been exposed to it. Well, that's true. But if you actually do specific testing for Epstein-Barr virus because everybody's, you know, if the antibodies are positive, it just means that you've been exposed to it. Well, that's true. But if you actually do specific testing for Epstein-Barr virus, so there's a panel that we do, which checks for antibodies to the nuclear antigen and the cytoplasmic antigen, and then also the early antigen. And then I'll also throw in the Epstein-Barr virus by PCR so PCR is checking for the DNA of the virus. You're actually seeing if there's live virus around circulating in your blood not just your immune response. Exactly so what typically in that the panel that we that we use if you have

the three out of four antibodies that are positive especially with the early antigen and or with the PCR of the Epstein-Barr virus you know proof positive that the Epstein-Barr virus is reactive, exactly reactive. And that's where, then you have to ask yourself, well, what do I do to calm down that particular virus? So there's a lot of things that you have to look at. Yeah. I mean, that's true. Functional medicine really has a different perspective. And that's why we see so many patients here at the Ultra Wellness Center who've tried so many things and then they get better because we look at all the factors. So when I think of an autoimmune patient or just any disease in general, there are really only five main triggers. It's a

toxin. So I've had patients with lupus have autoimmune disease triggered by heavy metals, for example. Could be an infection like lupus, or it could be the microbiome changes. Yes. Could be an allergen, something they're eating, like gluten. And it could be poor diet, which is inflammatory and has, for example, a lot of the emulsifiers in our food, like carrageenan and all these gums. Yes. They cause leaky gut, driving inflammation. And it also can be stress, like you said,

and often it's many of those things together. Exactly. Yeah. So for her, it was a few of those things. For her, it was stress and the virus, and also her gut was a mess too. Yes. Her gut was a mess. Yeah.

So the other thing that she noticed is that if she ate foods that were high in lectins, things like the nightshade family, that her symptoms actually got worse. And there's interesting, some of the work by Peter Dodamo, who was the author of the Blood Type Diet, he's the guru of lectins. And what we find is that in certain individuals, when you have high lectins in your diet, and these are compounds that are found in plants,

which actually act as a defense mechanism for the plant so that animals and insects are less likely to eat them. Lectins, there's a in the medical literature a case study of a hospital that thought they would have a healthy eating day so they served everybody red kidney beans in a in some type of a casserole or a soup and then everybody got sick from because it was very high in lectins. And it actually caused transient leaky gut. They had an immune response to the lectins in the plants.

And I've had a number of patients. It's not everybody will have that response to lectins. I mean, there's a lot of promotion out there of lectin-free diets as the cure for everything. Or low lectins, low lectins. Yeah. It's impossible to get. A low lectin diet.

And I think it can be helpful for some specific patients. Exactly. I think the thing is that everybody finds the latest fad and think it's the cure for everything. Exactly. It's really not. And when you're in functional medicine, you get humbled by understanding how complex things are. Absolutely. How everybody's really different.

Yeah. How one person may tolerate gluten and another person may not. One person may be fine with lactans, another person may not. But if you have an autoimmune or inflammatory condition, it's something worth trying. Absolutely. It is. And I'll interject here, because this is an interesting finding. I stumbled upon this. And again, this was actually by Peter Dodamo, who got me down this rabbit hole. Because I just recently had a patient who had five autoimmune conditions, including lupus. And I checked for a lab test called Manos Binding Lectin. Have you ever checked for it?

Actually, no, but I know about it. Right. It's one of those things. And he's the one who got me to understand this. So Manos Binding Lectin is a compound that our body makes to bind Manos. And a lot of- It's a sugar. It's a sugar.

Manos is a sugar it's a sugar it's a mannose as a sugar and uh what you find out is that uh people who have mannose binding lectin deficiency are at higher risk for lupus and hers was undetected yeah i think the other thing i want to just point out is that you know you're talking about this patient lupus and she had gluten she had gut issues she had stress she had this virus she had this virus, she had electin sensitivity, but that was her. If you take 10 other patients with lupus, they're all different. Hi, podcast listeners. It's Dr. Hyman. I want to take a pause from today's episode to talk about something pretty important. Air. If you're listening to my podcast, it's likely that you have a piqued interest in nutrition and health. You might be eating healthy and exercising and meditating, but one area that a lot of us tend to neglect is something we literally cannot live without. I'm talking about air, specifically clean air.

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forward slash filter you can access the air doctor filter for 329 that's 300 off the normal price so head over to drhyman.com forward slash filter to access this deal today and stay safe out there the problem with traditional thinking is that everybody with lupus gets the same treatment. Once you make the diagnosis, you stop thinking. And in functional medicine, when you have the diagnosis, that's when you start thinking. It's just the first step on solving the problem. It's like, okay, this is what your picture looks like. Okay, what are the potential factors that we need to think about to get to the root cause?

And then we have to treat the cause, not the symptom. And that's the beauty of functional medicine. So for her, how did you treat the causes of her lupus and what happened? Well, for her, it was really focusing on, she already actually was doing very well. I actually tested her. Even though she said that she was eating a clean diet, I made sure. So she said she was avoiding gluten, avoiding dairy, avoiding lectins. And her testing was negative for any reactions to gluten. So I said, you're doing a good job. Keep it up. It was negative for leaky gut. You're doing a great job. Let's do that.

But what I did do, and she had never had done, is she did tell me that she had a bad case of mono when she was a teenager. And my theory with her is that she probably, when she went under this very stressful time period, that the Epstein-Barr virus reactivated for whatever reason. And hers was, she had a positive PCR. So the DNA of the virus was floating around in her blood. And also she had positive antibodies. Three out of four of her antibodies were positive. That was to me, a smoking gun that her Epstein-Barr virus was really driving her lupus symptoms. So initially what I did is I treated her with some medicinal mushrooms, things like turkey tail. I used also lysine, which is an amino acid, which can help. And I combined that also with some monolaurin. Yeah, lysine is often something people take to

prevent herpes outbreaks on their lip. And it works incredibly well. It works quite well. Because it helps inactivate the virus and other foods that contain arginine like nuts, which are good for you, but in this case they have high arginine levels that actually can activate the herpes virus. Yes, that's an interesting observation. So that was one of the ways in which I initially treated her. And she did get some improvement with that. And then another thing which I added to her regimen is low-dose naltrexone. And I'm sure you used that yourself. And I've been really amazed at low-dose.

What is naltrexone? So naltrexone, this is an interesting thing. So naltrexone is an opiate blocker. And I'm not sure how they actually stumbled upon this, but if somebody takes too much opiates and they overdose, you can give naltrexone to block the effect of the opiate. Yeah, when someone has an overdose of heroin or a narcotic, they give them Narcan, which is naltrexone, and that stops them from dying.

Exactly. And it's theorized that when you give naltrexone, and that stops them from dying. Exactly. And it's theorized that when you give naltrexone at very low doses, what you do is you block the body's own opioid receptors, and the body senses that, and it starts producing more natural feel-good molecules, endorphins. These are our own body's pharmacy for the pain molecules, which in turn modulates the immune system. So when you upregulate opioids, you're actually modulating the immune system. And I used to use it primarily in patients with ulcerative colitis and multiple sclerosis, but now I'm using it in a lot more patients.

And I find that it works really quite well in a whole host of autoimmune conditions. So I used it in her. And it's very low toxic. It's probably the safest thing. Yeah, very safe to use. Yeah, you can have a couple of side effects in a few people, but it's probably one of the safest medications that I prescribe. Absolutely.

It has to be compounded, and you slowly work your way up on it. What I experience with it is that it can help, but unless you deal with the root cause, again, it's a symptom manager. So it can help mitigate the symptoms, but it's not going to address the underlying biology. Exactly. You're actually true. It's not going to reverse the condition,

but it's one of those things where the risk-benefit is so good that it's worth doing in a lot of patients. So I actually added that to her. And then we went to the next level, which is that we tried the natural route, and then she got some benefit, but it wasn't really where she wanted to. So I said, well, let's go ahead and we'll give her an antiviral. So I actually gave her some Valtrex at high dose. I gave her two or, I think, three times a day. I think you probably have done that yourself, high-dose Valtrex for Epstein-Barr virus. Um, there is no simple one size fits all treatment for Epstein-Barr virus. I've learned

that there really isn't. Um, and she actually responded remarkably well to that. Uh, within a couple of months, she was like 80% better using the Valtrex. And I've had a few patients that that was very, very, uh, yeah, I think that's right. I think, you know, it's interesting. It, it, the more you do this, the more I think, you know, it's interesting. The more you do this, the more you realize, you know, what works with one person may not work with another person. So another person, I have Epstein-Barr,

you give them Valtrex, it may not do anything. And I think I've had the same experience. There's some patients, you know, you give them this relatively benign antiviral, like Valtrex, and it works well. Others don't respond to that. I've had other patients use something called Valcyte, which is very expensive,

has higher levels of toxicity, but it actually can be effective in select patients. But I think there's other therapies that she used, which are also important to mention because as I've gotten more experience in this, I'm more interested in how do I activate the body's own healing systems? How do I use therapies that are regenerative? How do I use therapies that are facilitating the body's own ability to fight things? And she ended up using one of these therapies. So can you talk about that? Sure. Yeah. Well, before I actually talk about that, the other thing that also I've used in patients is intravenous vitamin C. And that's actually in the medical literature. High B vitamin C at fairly high doses, about 25 to 50 grams,

has been shown to be very effective also for Epstein-Barr virus. So that's another thing. In her particular case... But by the way, how does that work? How does that work? Well, at high levels, it actually works as a pro-oxidant. So we think of vitamin C as an antioxidant, but actually it's working as a pro-oxidant.

Which goes into the next therapy, which is the therapy that... And how does it do that? Do you want to explain how it becomes... Well, it's a yin and a yang because there's reduction, which is the adding of electrons, and oxidation, which is the removing of electrons. And it has to do with coupling, coupling of the oxidative forces versus the reductive forces. So it's a little bit like a magnetic pull. And at high doses, vitamin C increases the release of hydrogen peroxide from the white blood cells.

So people don't understand this, but how does our white blood cell kill bugs? We bleach them. It produces bleach, hydrogen peroxide, and ozone, which are all oxidants. Yes. Right? So that's exactly how our bodies kill things. And it sometimes can't do the job. And using these other therapies, like high-dose vitamin C, can help actually increase the

body's ability to kill infections. Exactly. And they've actually studied it in ICUs. They're using it in COVID-19. Yeah, you bring up a really interesting point, which is that, you know, actually there's a term in medicine called redox signaling molecules. And when you have these redox signaling molecules, which of ozone will be one, it actually upregulates your body's own reparative forces.

So talk about what she did with ozone. Yeah, ozone was a game changer for her. She ended up using ozone and she said it was like a game changer for her, which is really interesting because it was the first time I had a patient who had lupus who responded to ozone in that way and was really quite quite amazing it was I was how did she get the ozone she got it she um she got it um uh actually she got it uh she it was administered by a local uh physician who she was seeing because she was seeing me in consultation and she she actually got it rectally and intravaginally. So not even intravenously. She didn't even get it intravenously, yeah, and she had that response.

It was really quite good. You can give it intravenously. You can give it in the muscle. You can give it rectally, vaginally. It gets absorbed, and it can be very, very effective. And rectal and vaginal treatments you can do at home, and you don't even need a doctor to order it. Yeah.

I mean, it's basically oxygen on steroids. That's really what it is. Yeah, it's high-dose oxygen and a little bit of ozone right so if you ever go out after a thunderstorm and you got that that that nice clean smell afterwards that's ozone in the air yes that's the lightning producing ozone yes it's it's an as a it's a special uh species of reactive species of oxygen and it's one of those oxidative therapies just like vitamin c that it gives you a little bit of a stress, but it also activates your body's own anti-inflammatory mechanisms, antioxidant mechanisms. Absolutely. Yeah.

It can be antiviral and kill bugs, which is powerful. So I think it sounds like a wacky therapy, but it's something we do here at the Ultra Wellness Center. Yeah. I mean, it's something that is, I know we were talking about earlier that when we both heard our patients talking about this, and I often heard this, you know, Dr. Hyman, I tried everything and I did ozone therapy and it was the thing that made me better. And I was like, oh, that's interesting. And I, you know, I had a little footnote in my head, but I was like, that's a little weird. I don't know about that.

And when I got sick with mold toxicity and autoimmune and colitis, it was the thing that actually flipped my body into a healing response. And it doesn't treat any disease. It just activates your body's own healing mechanisms. Very powerfully. Very powerfully and very quickly. I mean, I had autoimmune disease, brain fog, and within a few days, it wasn't like it took weeks.

It was in a few days I really turned around dramatically. Absolutely, yeah. The other thing which I'll mention as it relates to lupus in women, and I've found this and actually again, whenever I see something that's sort of out of the box thinking, I'll go into the medical literature, see if it's substantiated. And what I found is a pattern in patients who have lupus is their estrogen detoxification pathway and when we check estrogen levels and hormone levels in patients we don't just check your estrogen and maybe your progesterone we check all of the

hormones and then we also check the metabolites of the hormones and I found this pattern in not all lupus patients but some lupus patients is they have a increased pathway for metabolism to what's called the 4-hydroxyestrogen. And 4-hydroxyestrogen is not, you're not going to go to your regular doctor, your OBGYN. They won't check that. They're not going to check that. It comes out in the urine. It comes out in the urine, exactly. It comes out in the urine. And I learned about this through Jeffrey Bland. And it's one of the things we test here at the Ultra Wellness Center. Exactly. And Jeffrey Bland, he basically called this the dancing Shiva. And in some individuals, because women's hormones go up and down,

and they have to be detoxified throughout the monthly cycle. And you oftentimes will see patients who have lupus, they'll flare with their cycles. And when you measure their 4-hydroxyestrogen, they're very high. And the 4-hydroxyestrogen is what's called a quinone adduct. So it damages DNA. And when you have high levels of this over time, it actually increases your risk for breast cancer. This is why you think women might have a higher risk of lupus. Absolutely.

Absolutely. And I've got, I've got, actually I have, I have a literature paper that cites this and I've been doing it in my own little cohorts of patients and I oftentimes check it. And in a lot of patients, they have that. And then the other thing that's interesting— So wait, wait, wait. Before you—I just want to unpack that, because that was very powerful, what you just said. What you just said is that there are some women who have trouble metabolizing estrogen, and it goes down a pathway that produces a toxic estrogen that damages DNA, which is

what we see in lupus. And that by fixing that—and we know how to fix that with functional medicine using food and various nutrients and herbs that actually help upregulate or fix those pathways, these patients can get better. Absolutely. Yes, absolutely. And the other thing that- So by the way, most traditional doctors would not be looking at your hormones if you have lupus. Right. And then the other thing that we then do is we then look at the genetics. So we look at your genetic pathways. So there's a specific polymorphism called the 1B1 pathway. And when that has a variation, you are more prone towards producing the 4-hydroxyestrogen. So typically,

you start, you know, lifting up. And how would you fix that? Well, what you do, and interestingly, the particular SNP that's involved in that particular pathway, that gets actually upregulated by polycyclic aromatic hydrocarbons. Basically, if you eat a lot of charcoal-boiled food and barbecue, you're going to be upregulating that pathway. So a patient who's got lupus, you don't want them eating. Whether you're grilling your vegetables or grilling your steak, it's going to cause the same problem.

Exactly. It's the ash. It's those compounds. The blackened stuff.. It's the ash. It's those compounds. Blackened stuff. Blackened stuff, exactly. That upregulates that enzyme. The other thing which you can do is by adding through your diet cruciferous vegetables, supplements like DIM helps to shift that pathway in a different direction. So it's very, very powerful stuff.

And when you start doing the testing and start looking at it from all different angles, you can really move the needle. And I'll never forget this one patient where I first learned about this. The patient basically told me in her history that everything started after she got mono as a teenager. Her life changed after that, and she was never able to clear it. And when I checked her estrogen and estrogen detox pathway, she had the highest 4-hydroxy I've ever seen. She was very, very sick. And that's where I sort of understood, okay, this may be playing a role with the sex differential between men and women and lupus,

because it's like nine times more prevalent in women. Yeah. So this is such a great example in a case of someone who has an autoimmune disease, which is so common that you acted like a medical detective and you found all the various things that were going on with her. She had sort of this chronic Epstein-Barr infection that was reactivated by stress. She had gut disturbances. She had lectin intolerance. She had gluten sensitivity. She had this hormonal dysfunction with abnormal estrogen metabolism. And these are the kinds of things that we do here at Telchewana to help us navigate to how to treat each person as an individual. This is really personalized medicine, personalized nutrition, and it's very sophisticated. It's very effective. And it's something that helps relieve suffering for so many people when they get stuck.

And I feel like this is where we're going in medicine. It's where the science is going. Functional medicine is just an approach that helps us apply the science of systems medicine and network medicine today. Rather than waiting 10, 20, 30 years, we actually know how. And we're learning every day. I mean, when I think about how little we knew about the microbiome when we started this 25 years ago

and how much we know now, we were literally groping in the dark, but we had the basic idea and we were able to apply these principles and get people better, even if we didn't quite understand what was happening, right? Exactly, yeah.

And it was quite amazing. So, I mean, I think it's important people understand that this is one case of lupus and this was her issue, but these are common themes. And for somebody else with lupus, it might be something else. And this is really the beauty of functional medicine is why we have such great success here. We have providers, a collection of doctors and staff here who've been working on this for 60 years. We're collectively treating these complex patients from all over the world. We're now doing virtual consultations. Given COVID-19, we've switched over because now we have the ability to do that. And I just encourage anybody who's struggling to think about getting help.

And they're welcome to come see us at the Ultra Wellness Center. They go to ultrawellnesscenter.com. And we're here to help you and navigate through some of these complex issues and figure out what it is that is your issue that needs to get treated and i think that's so so encouraging to me because i i love doing this because i remember working in as a traditional doctor and i was good at prescribing pills and matching the pill to the ill and people would you know manage manage their symptoms but i got sick of managing and i wanted to fix things.

Yeah. And that's the beauty of functional medicines that we help relieve need to suffering for millions of people all over the world from practitioners in every country. And this is the future where it's going. We're just a little ahead of the game. So encourage people to not lose hope and to seek out answers

and to learn more about functional medicine. And I encourage you to share this podcast with your friends and family on social media. If you liked it, leave a comment. We'd love to hear from you. And subscribe wherever you get your podcasts. And we'll see you next time on The Doctor's Pharm Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do

and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health.

And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Hi, everyone.

I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It's important that you have someone in your corner who's trained, who's a licensed

healthcare practitioner, and can help you make changes, especially when it comes to your health.