Risks for Autoimmune Disease
Talia Lavor, PA: All right. I am sitting literally inches from my dear friend Dr. Emily Parke.
Dr. Emily Parke: Hello.
Talia Lavor, PA: We are enjoying a nice hot tea, because it’s Arizona and it’s 103 degrees out and that’s what we do.
Dr. Emily Parke: Why not have green tea?
Talia Lavor, PA: Hi!
Dr. Emily Parke: Hello.
Talia Lavor, PA: We are recording this episode together and we are doing some video. So, we are having fun here today. But today we are going to talk all about autoimmune disease and we are gonna answer some of what I found to be women’s most pressing questions that they just need to get some straight talk, some straight answers with.
Talia Lavor, PA: So, Dr. Parke’s gonna introduce – I did a little intro for her, but she’s gonna kind of say hi and tell us a little about what she does, because she practices functional medicine and just give us a little intro about how … what she does and how that kind of autoimmune disease plays into her practice.
Dr. Emily Parke: Yeah, awesome. So, I’m Dr. Emily Parke and I’m the owner and founder of Arizona Wellness Medicine, which is a functional medicine practice here in Arizona. And I actually came from complete traditional training. So, I did medical school, internship, residency, all on the traditional side, then got trained and certified in functional medicine. Functionstal medicine’s all about finding and treating the root causes of whatever signs and symptoms are going on. It’s getting to the bottom of it. It’s really the deep detective work. Finding out the why or more commonly whys plural, meaning figuring out all of the root causes that triggered your symptom or disease process to come out in the first place.
Dr. Emily Parke: And in the case of autoimmune disease that’s especially true and really, really crucial, because if you never figure out what the triggers are you’ll never truly heal. You may be prescribed a traditional medication or even supplements and things like that, they can just be band-aids until you really figure out what all your root causes are and reverse those. That’s your best hope of treatment with an autoimmune disease. And functional medicine is great for autoimmune diseases, so besides the advanced laboratory testing, there’s also obviously big roots in lifestyle. So, this is where we get really specific with nutrition, sleep, exercise and movement, stress management, and toxin reduction. Those are the foundations to help, right? So, you know Talia like if we don’t have those in a good place, we can’t expect our health to be in a good place, but they’re especially important for someone with an autoimmune disease.
Talia Lavor, PA: And I think this is really helpful because a lot of women by the time they come to me they’ve maybe been diagnosed with an autoimmune disease. Maybe they haven’t. Maybe they have some thyroid issues. Nobody’s told them that they’ve got an autoimmune component, but maybe they’ve looked into it and think maybe I do have this or they know they have an autoimmune disease, but they go to their doctor and their doctor just says, “Well, you’ve got this disease and there’s just not much we can do about it or you’ve got to take this prescription drug for the rest of your life.” And women come to me a lot and they get frustrated, because they ask their provider, “Is there anything I can do to make a difference?” And a lot of times they’re met with resistance. And again, I always kind of put this out there that it’s not necessarily that their provider is being malicious or has bad intentions or anything like that. They just may not know themselves.
Talia Lavor, PA: So, women have this intuition that I always encourage you to … and I’m speaking in this case about women, because that’s my audience, but have this intuition that there’s something deeper going on that they do have control over and that they can make a difference. And we’re gonna kind of dive into that today. So, I’m really, really excited. I think we should kind of get to the nitty gritty and talk about just basic stuff, because we throw around this term autoimmune disease, but I think sometimes people don’t really have a grasp of exactly what an autoimmune disease is. So, tell me a little bit about what your definition of an autoimmune disease is.
Dr. Emily Parke: Yeah. So, generally an autoimmune disease means that your own body, your own body’s immune system to be super specific is attacking a part of your body. And depending on which autoimmune disease you have will depend on what part is being attacked. So, I’ll give you some examples that a lot of people would know about. So, celiac disease is a perfect example. Celiac disease is an autoimmune disease of the small intestines that’s triggered by eating gluten. Now you do have to have a genetic predisposition in order for it to get turned on, which I know we’re going to get into in a minute, but that is an autoimmune disease meaning that the small intestines are being attacked by the body so the small intestines are kind of being destroyed. Specifically the microvilli, the little fingers that are in the small intestine, look like this normally, but when you eat gluten and you have the celiac gene what happens is it gets really, really swollen. So then all the little villi kind of close up and then the surface area for absorption of food nutrients and whatnot get significantly decreased. So, in the case of celiac disease it’s your body attacking the small intestine.
Dr. Emily Parke: So, then there’s of course one of the other ones that’s really common in women especially is Hashimoto’s thyroiditis. That is obviously an autoimmune disease of the thyroid. Again, there are auto antibodies meaning your body’s own immune system is creating an attack against the thyroid gland itself. And there’s two antibodies that we can check for. There’s thyroglobulin antibodies and thyroid peroxidase antibodies.
Dr. Emily Parke: So, basically those are a couple of really common examples. There’s many more autoimmune diseases which we can talk about, but it’s the body is attacking a specific part of either a gland, an organ, or a specific type of cell like in the case of Multiple Sclerosis. It’s not really an organ per se that’s being attacked. What happens is the myelin sheath, the smooth coatings that go over the nerves that line the nerve cells actually get destroyed. So, it doesn’t necessarily have to be an organ per se, but something in the body, a cell, a nerve, an organ system is being destroyed or eaten really by your own body.
Talia Lavor, PA: Right, and I think that’s important for people to understand is that if we get really frustrated with autoimmune conditions, but these are the same mechanisms or the way that your body works to actually protect you against so many things. I mean, we’re assaulted every day by invaders and we don’t even know it, because we are so good at defending them and it’s just where this journey goes a little awry. So, there’s a little confusion there and it starts attacking these parts of our body too.
Dr. Emily Parke: Yep.
Talia Lavor, PA: And we talk about … I’ve even done episodes on like anti-sperm antibodies and all these different things. It can attack any part of the body. So, that brings us to … we kind of alluded to this a little earlier, but what causes autoimmune disease? This is a very common question. What caused this to happen? Why did I development Hashimoto’s thyroiditis? Why do I have lupus?
Dr. Emily Parke: Right. Exactly. So, of course there’s a couple of key components here and one is you have to have the genetic predisposition. Now, for some autoimmune diseases there’s an actual gene. Like I mentioned earlier, there’s a celiac gene. That’s HLA-DQ8, HLA-DQ2. There’s a specific gene that we know of, but there’s not a specific gene for every single autoimmune disease. Like for Hashimoto’s thyroiditis there’s not a specific gene. Does it run in families? Yes it does. So, there’s a genetic predisposition, but there’s not a specific gene we can do a blood test let’s say and say, “Oh, you have this gene. Watch out. You might get Hashimoto’s.” Right? So you have to have a genetic predisposition.
Dr. Emily Parke: Then you have a trigger or triggers, more commonly, meaning multiple things that trigger, turn on the autoimmune disease and one of the key things that we know about autoimmune diseases is that most of the time the trigger actually has to do with our lives within the gut, because about 80% of the immune system is located inside the gut. So, these are where disturbances in the microbiome. So, not having enough good gut bacteria or having a chronic infection that you don’t know about that’s going on inside the gut outside of the gut as well. Or you don’t have enough nutrients to supply the lining of the small intestine. So, what happens is you end up with this kind of chronic inflammation for some reason. And we can talk more about the reasons in a minute. But what happens is the lining of the intestines gets inflamed and then it gets leaky. So, instead of the cells lining up like locking into place. Lining up and not letting anything through, what happens is the junctions, they’re called tight junctions in the small intestines themselves, kind of start to loosen up a little bit.
Dr. Emily Parke: So, what that means is that things that normally don’t seep through the intestinal lining into the blood stream are getting into the blood stream. So, what happens our immune system just like Talia said earlier, it’s set up to help us defend against invaders, right? So, when we get exposed to an infection our immune system kind of pumps up and fights it and creates antibodies against it. But what happens when let’s say when you’re eating gluten or soy or eggs or anything that your body’s immune system is not used to seeing now all of a sudden a protein comes through that your immune system’s not used to dealing with and it goes, “That’s a foreign invader.” And it will kind of create an immune system response and that’s how food sensitivities happen, but that phenomenon can also happen with other chronic infections that are located or stem inside the gut as well.
Dr. Emily Parke: So you have to have the genetic predisposition and then there has to be one or more, more commonly more than just one, trigger, but things going on inside the gut, chronic infections or overgrowths or undergrowths are really, really common. Food sensitivities are really common too.
Talia Lavor, PA: Toxins.
Dr. Emily Parke: Toxins, right. So, we haven’t even talked about that yet. That’s like whole ball of wax. But heavy metals, environmental toxins, mold toxins, and then are there nutrient deficiencies, because the nutrient deficiencies like I was mentioning not only supply things for the lining of the gut but for your whole entire body. And a great example of that is Vitamin D. So, Vitamin D is crucial for the immune system and there’s very well published studies on low Vitamin D contributing to autoimmune disease. There’s great studies for years on M.S. with this phenomenon specifically. So, there’s multiple contributing factors that can lead to an autoimmune disease getting turned on. And stresses. Let’s not forget about stresses.
Talia Lavor, PA: Of course. Stress always comes in there somewhere.
Dr. Emily Parke: It does. It does. And so you can’t ignore it too. That’s why in a good functional medicine visit, every single one of my visits we review what’s going on with stress in life and what are you doing for stress management, and that’s why I ask for a daily relaxation practice, because I have seen stress by itself with no other factors changing trigger an autoimmune flare.
Talia Lavor, PA: Right. And I always talk about too how stress can be lots of different stress. You can have emotional stress. You can have physical stress. So, you can have the stress of pregnancy along with other shifts that happen with pregnancy and that could kind of trigger things too. So, I think that things to remember are that … and we kind of talk about this subject of epigenetics or the fact that we have these genes and but they’re just kind of sitting there. They’re like a blueprint, but somebody has to interpret them. And so, they can be turned on. They could be turned off. So, you’ve got this blueprint, but it doesn’t mean you have a house that’s built. So, with the genes we’ve got his genetic predisposition, but there’s usually something that needs to come on and tell the body, “Okay. We need to turn these things on or turn them off.” That could be that genetic trigger.
Talia Lavor, PA: Then we’ve got the leaky gut. Where we no longer have, ’cause we are kind of assaulted from the outside through our skin or through our nose and then we have our mouth. From our mouth to our toushy. That’s how we can be exposed to a bunch of other things too. So, if that is not a nice tightly sealed system, we have leakiness, we have inflammation, then that allows things to come into the body we’re not normally used to. And then we put on top of that other triggers like toxins, infections, nutrient deficiencies, stress, all those different things. So you really have to have these kinds of … it’s like a perfect storm.
Dr. Emily Parke: Yep. Absolutely.
Talia Lavor, PA: And so sometimes you may not know. I mean you may be able to identify Epstein-Barr virus or something like that. You had some sort of identifiable thing, but it was probably a bunch of things working in concert that put us at risk.
Dr. Emily Parke: Yes.
Talia Lavor, PA: So, that’s kind of what we talked about. You touched on this before. If a family member had an autoimmune disease does that mean that I’m at increased risk for an autoimmune disease? Can we inherit them? Can you talk a bit more about that?
Dr. Emily Parke: Yeah. So, some autoimmune diseases we know are very much inherited like the example of celiac disease. There’s two main celiac genes that we know of HLA-DQ8 and HLA-DQ2. You can test for those in blood work very easily. So, if you have a family member that was diagnosed with celiac disease, you can get yourself and your other family members tested so then you would know you have the gene. So, having the gene and having the disease are two different things like Talia said. We’re talking about epigenetics. So, just because you have the gene doesn’t mean you’re necessarily gonna get the disease. But how I look at it in functional medicine. I know you practice the same way, Talia. If you know you have a gene, a predisposition for the disease, aren’t you gonna try to do everything you can to prevent that from flipping on?
Dr. Emily Parke: So, in the case of celiac it would be like, “Okay. I know I have a celiac gene. I feel fine right now. I don’t have any stomach symptoms. I don’t have any diarrhea. I feel fine.” Cool. Probably want to avoid gluten on a regular basis, because you don’t know when you might get hit with an infection or with a big stress or a million other things could be the last straw that breaks the camel’s back that does turn on the autoimmune disease, right?
Talia Lavor, PA: Right.
Dr. Emily Parke: Okay, so that’s one example of an autoimmune disease that has a very clear gene. There are some other genetics involved with lots of other autoimmune diseases, but there are a good number of them that we don’t know all the genes or we don’t have even any genes. Like, M.S. there’s not … to date there’s not a Multiple Sclerosis gene. But there are for example for some things like ulcerative colitis, like there are some genes that can predispose you to it that you might want to check for if you have it in your family. So, if you have a family member with an autoimmune disease you wanna maybe bring that up with your doctor. Even your traditional primary care doctor should be able to run genetic testing for you for whatever disease runs in your family. So that way you would know as a patient if you even carry the gene or not. Then I always say knowledge is power, because some people look at it the opposite. They’re like I don’t wanna know if I’m gonna get this disease. I’m like well, I look at it like cool opportunity to not get the disease.
Talia Lavor, PA: It’s like it somebody said, “Okay, in three years and two days your appendix is gonna rupture.” So, you’re like, “Okay, I’m on top of this.” Like, I know, right? Like, I mean I agree with you. A lot of time people get down. I think they see it like, “Oh, my gosh. I’m doomed. I’m gonna have x, y, z.” But I think it all comes down to though if you’re educated about what you can do to put yourself in the best place possible to keep that. So, same with the Hashimoto’s. I mean, if your sister has Hashimoto’s thyroiditis or if your mother had it or has it, you could easily … that is something that could possibly happen for you, but there’s so much you can do and so much power you have to decrease the likelihood of that happening.
Dr. Emily Parke: Yes, and there’s also … so there’s testing for the genes, but then there’s also doing blood tests for the antibodies, ’cause there’s some data out there that kind of says that in many cases you’ll start to see … and I see it all the time in my practice … ’cause I test for these things more than your traditional doctor would test for them. You’ll start to see antibodies in the blood before you really get significant symptoms or any symptoms of the disease and I see it a lot. Hashimoto’s is a great example. So, someone can have completely normal thyroid function –
Talia Lavor, PA: And this could happen for years.
Dr. Emily Parke: For years. Five years, ten years even, they’re thinking. So, if I, and I have caught several patients like this in the practice. When I see it I’m like, “Ooh. Hey, your thyroid function is great right now. Perfect. TSH, free T3, free T4, reverse T3, everything is looking great, but you have these thyroid antibodies. There at low levels, but let’s figure out what the triggers were and let’s see if we can’t reverse those thyroid antibodies.” Because if you check regularly, you’re likely to find more autoimmune disease and be able to prevent it in someone that maybe doesn’t have those exact symptoms. They usually have something. There’s a reason why you’re testing, right?
Talia Lavor, PA: Right.
Dr. Emily Parke: There’s a reason why people are coming to see us. You know what I mean?
Talia Lavor, PA: So, you can be even symptomatic, slightly symptomatic, but have normal function of whatever that glad is.
Dr. Emily Parke: Yes. Right.
Talia Lavor, PA: So in this case thyroid is such a common one. I think it’s a good one to use as an example, but you could maybe be a bit symptomatic maybe with fatigue things like that and that’s because your thyroid is getting attacked so it’s got these antibodies that the body is producing against the thyroid, but it’s able to keep up.
Dr. Emily Parke: Yes.
Talia Lavor, PA: So, it hasn’t done enough damage that it truly compromised how well that part of the body could keep up and it’s gonna do its best for a while.
Dr. Emily Parke: Right.
Talia Lavor, PA: This is the issue with just checking just the TSH or just the T3 or T4. So, that’s why I tell everybody like there’s not option you have to check the thyroid antibodies. We’ve gotta keep an eye on those.
Dr. Emily Parke: Yes.
Talia Lavor, PA: So, I agree with you. I like this because like I said they feel either doomed because they have other family members or they feel like they’re kind of backed into a corner like well, there’s nothing I can do about it. But there is, if you find the right people to work with.
Dr. Emily Parke: Yeah, and that’s a good point. Like, a lot of the traditional and again, both Talia and I were traditionally trained by the way, so we get this.
Talia Lavor, PA: Now rogue, but traditionally trained.
Dr. Emily Parke: So, we get these issues very well and I have to tell people all the time, “Don’t get upset or mad at your doctor.” I didn’t know this stuff before. You didn’t know this stuff before. We sought out extra training and education in integrative and functional medicine. So, the traditional doctors will say, “Oh, I’ll check your TSH with a reflex T4. If everything’s fine, you’re fine.” Or if you even take it to the next degree. Let’s say you know you have, let’s use Hashimoto’s again. You go to the traditional endocrinologist and until your thyroid function actually starts to fail, they’re there to say we don’t have anything for you. And in our world it’s like, well hold on, let’s go figure out what all the triggers are. How did this autoimmune disease get turned on. Let’s see if we can either turn it off meaning either reverse it or at least get the antibodies down as low as possible.
Talia Lavor, PA: And I think that’s a great point. It is that if you can identity an autoimmune disease in the early stages, your chances of reversing it or at least keeping it really well controlled are much better.
Dr. Emily Parke: Yes.
Talia Lavor, PA: Because after a certain amount of damage has been done –
Dr. Emily Parke: Correct.
Talia Lavor, PA: There’s a point where you can’t reverse it.
Dr. Emily Parke: Yes.
Talia Lavor, PA: So, the tissue damage can be, and I’m not saying that to be down, but that’s what’s so empowering about this and about teaching people and so even if you’re a mom and you have a daughter or something like that, but now you know better, right? We know better, we do better. But that’s where the power is. It’s in that kind of silent early phases.
Dr. Emily Parke: Exactly. So, to use another example of an autoimmune disease. Let’s talk about rheumatoid arthritis. So, if someone comes to me and they’ve had 20 years of rheumatoid arthritis and they’ve got joint deformities. Can we undo those joint deformities? Not really, because as Talia mentioned, the destruction has already been done. The damage has already been done. But in that same person it doesn’t mean we have nothing for you.
Talia Lavor, PA: Right.
Dr. Emily Parke: Can we get you feeling better?
Talia Lavor, PA: Absolutely.
Dr. Emily Parke: Yes. And can we maybe stop the disease progression? Exactly. But it’s the same thing with the thyroid. You can’t grow a new thyroid gland. Yet, right?
Talia Lavor, PA: Bionic thyroid.
Dr. Emily Parke: Yeah, exactly. So, if your Hashimoto’s has been going on so long that you destroyed most of your thyroid gland, yes you are going to need thyroid medication. There’s noting we can do to replace the gland, but again, getting the antibodies to come down will surely make you feel better, because the circulating antibodies of any kind and this is true of any autoimmune disease. So, everyone thinks of like rheumatoid arthritis is just the joints and Chrones and ulcerative colitis is just in the GI tract and Hashimoto’s is just the thyroid, but the circulating antibodies create symptoms literally from head to toe. For all of those diseases.
Talia Lavor, PA: Yeah. That’s why you could potentially have joint pain just from having Hashimoto’s or something like that.
Dr. Emily Parke: Exactly. About 20% of Hashimoto’s patients have musculoskeletal complaints. Exactly.
Talia Lavor, PA: And that’s why it all makes sense. And that’s one just as a side note, ’cause I’m thinking about this. That’s why when I work with people I say, “Tell me anything that’s going on that you can think of even if your left pinky toe hurts, because even if you think that it doesn’t make a different or it’s not related, it may jump out to me and we might even find a reason for it.” Right? “Your left pinky toe hurts because you’ve got these antibodies depositing in the joint.” Who knows, right?
Dr. Emily Parke: Right.
Talia Lavor, PA: So, another question I get asked a lot is: Why does it seem like you get one autoimmune disease and then there’s other ones? People often use this term like they “run in packs”.
Dr. Emily Parke: Yes.
Talia Lavor, PA: So, is this true? And why does it happen?
Dr. Emily Parke: Yes. Yeah, so there is some truth to that. You know, does it mean that everybody with one autoimmune disease is eventually gonna get you know, three or four of them? No. But there is a phenomenon where ’cause if you think about it logically, some of them, like we mention actually have genes. So, what if you had a celiac gene and your mom had a history and your sister and your aunt or whoever had a history of Hashimoto’s. So, there’s kind of two things in there not the same gene, but to Talia’s point earlier on the epigenetics, you still have to trigger the autoimmune disease, right? So, if you’ve got predisposition to more than one autoimmune disease, it makes sense that the same triggers are going to flip on possibly more than one autoimmune disease, especially the longer the triggers are kind of left unmanaged or undealt with.
Talia Lavor, PA: And that’s another point is that when you’ve got an autoimmune disease your immune system is heightened anyway. That leads to more inflammation. It’s not a question of if, it’s there. And that could be another trigger, so it’s kind of like the self perpetuating cycle. I think too that can deplete your nutrients. It can cause issues with imbalances of hormones and so I think once that kind of perfect storm starts, if it’s not taken care of early, then that can just perpetuate that cycle. So, then you can get more than one.
Dr. Emily Parke: Yep. Perfect.
Talia Lavor, PA: So, we talked about, I think we really kind of touched on some of the triggers, we talked about how you can have this leaky gut, we’ve got inflammation, nutrient deficiencies, toxins, infections. So, I think that kind of touches on this point that I get asked a lot as well and this is sometimes more from people who are a little bit more hesitant about what’s going on in the world, but people will say, “Why does it seem like everybody’s got an autoimmune issue?” Or “Everybody’s got Hashimoto’s now.” It’s everybody and their mom. Oh, you’re tired. It’s because you got Hashimoto’s. Right? Oh, okay. Well, maybe it’s ’cause you haven’t slept in 24 hours.
Dr. Emily Parke: Sleep’s another big trigger by the way.
Talia Lavor, PA: Yeah. Right.
Dr. Emily Parke: We didn’t talk about that too much, but that’s a huge stress on the body not getting enough quality sleep. Sorry. Go ahead.
Talia Lavor, PA: No, but a lot of people come to me. If they’re more skeptical about a unique approach to healthcare or to wellness and they’ll say, “Well, everybody seems like they’ve got thyroid issues now.” Which is actually true.
Dr. Emily Parke: Yeah. So, Synthroid is historically every year in the top four prescriptions written in the United States and Synthroid is the top medication that’s prescribed by traditional doctors for thyroid medication. So, yeah that’s true. And yeah, the autoimmune disease rates are clearly on the rise. And you know, there’s just some staggering statistics about that. So, it’s more and more common. To Talia, your question like “Why?”, right? If you think about it now, aren’t we in kind of a really, we live in a really toxic world and not just toxins like chemicals and metals and things like that, but electromagnetic frequencies, right? So, we’re exposed to … we’re doing a giant experiment by the way. A lot of scientists kind of say this where it’s like, “We haven’t really studied the effects of all these wifi signals and electromagnetic frequencies that are out there on our bodies.” So, we’re exposed to that. We’re exposed to chemicals and toxins on an exponential level now, right? And the government especially keeps allowing in substances that have not been really tested or substances that have been like a new chemical spin on a substance that was tested to be toxic.
Talia Lavor, PA: Or substances that are tested and known to be toxic, but lobby heavily in.
Dr. Emily Parke: Exactly. Yes.
Talia Lavor, PA: Like Round-up.
Dr. Emily Parke: Yes. Things like Round-up or glyphosate. So that’s why it’s important to eat organic. Aside from that, even all the chemicals. Our toxic load, and these are things you don’t even know you’re being exposed to through foods, through your water. Everyone thinks of chemicals as something that has to smell really strong.
Talia Lavor, PA: Like lead. Manufactured in a plant.
Dr. Emily Parke: Yes. Yeah, or heavy metal, but a lot of these things you don’t even know you’re being exposed and so I think there’s an increase in our toxic load. I think that as a society we’re really pretty sleep deprived. And sleep gets blown off. It seems to be some badge of honor, you know, how busy we all are and how, “I only got four hours of sleep, and I’m still working my 12 hour day.” That kind of thing. Where not getting enough good quality sleep is a huge stress on the body. So, I think there’s toxins. I think there’s stresses. And that’s like, Talia said, emotional stress. Physical stress can be by the way working out too much or it can actually be on the opposite end, sitting on your butt too much. The bookends tend to not be great.
Dr. Emily Parke: Then the poor nutrition state that American is in. We have the highest obesity rate, the highest Type II diabetes rates. Chronic disease is on the rise. It just is, and so if you think about all the things that keep us healthy – the foundations to health: nutrition, sleep, exercise and movement, stress management, toxin reduction – our Western society that we’re living in right now, we do a bad job with all of those typically unless you’re taking control of your health.
Talia Lavor, PA: And I think something people don’t realize is that it’s almost that we can’t adapt quickly enough, so our bodies can adapt to things over time, but things are changing so rapidly. So, even if you looked at what your great grandparents ate versus what we … and that’s not that long ago.
Dr. Emily Parke: Right.
Talia Lavor, PA: You’re gonna see a huge difference.
Dr. Emily Parke: Totally.
Talia Lavor, PA: In what they ate, how the food was prepared, how fresh it was, how it was farmed, what did they use to fertilize the soil. All those different things. So, I run across a lot of resistance on this, because for example, some people know that my daughter has a lot of food allergies. And food allergies are on the rise, like tremendously.
Dr. Emily Parke: Oh, yeah.
Talia Lavor, PA: For the same, like we were talking about. Same kind of principles happening here. So, people will ask me all the time, “Oh, my gosh. Just 20 years ago, nobody had a peanut allergy or it was like the random kid that had the peanut allergy in school and now everybody’s got a peanut allergy.” Some people look at that as like people are just crazy, they’re super sensitive, but it’s not. So, for my family, it’s a life threatening thing. And so, it’s a long conversation to get into, but I think a lot of it has to do with all these, again, it’s that perfect storm of all these different things.
Dr. Emily Parke: All the triggers.
Talia Lavor, PA: It’s impossible to say it’s just one thing or another. But when you’ve got these toxins, when we’re killing off the good bacteria and allowing the bacteria that tends to be more detrimental to our health, ’cause there’s always a balance of certain things, when we’ve got these toxins in our lives and that goes down to everything from what we brush our teeth with, what lotion we put on our skin. All these different things, then we are really kind of assaulting our body with a lot of things that were never there before.
Dr. Emily Parke: Right.
Talia Lavor, PA: So, that’s my opinion too of why it seems like, and it’s not just it seems like, I mean this isn’t in people’s heads. If we go in and we check your blood and you’ve got antibodies to your thyroid, that’s not in your head. That’s an autoimmune issue going on there. So, this is not just made up. This isn’t just the fake news, right?
Dr. Emily Parke: Right. Yeah. It’s data driven. Absolutely.
Talia Lavor, PA: So, if we know … again, we’ve talked a lot about these triggers. So, we can have this genetic predisposition. We can have just a predisposition. We can have an actual gene. We can have this leaky gut. We could have these triggers. That brings us I think to then how are we empowered. If we’ve got increased risk for autoimmune disease or if we actually have an autoimmune disease, what are some key things that you talk to your patients about as far as what they can do to decrease their risk or to manage their disease or put it into remission, so on and so forth?
Dr. Emily Parke: So, about 80% of that is really the lifestyle factors we’ve talked about, and so I would say nutritionally like the biggest thing you can do for yourself is to eat real food. Like, eat real food. Decrease processed and packaged food. Decrease your sugar intake. Now, obviously you want to eat organic when you can. On your proteins, you want to make sure they’re well sourced. If you eat beef, find organic grass fed beef. If salmon, wild caught and so on. I mean definitely organic produce as I mentioned when you can.
Dr. Emily Parke: But you also want to test to see if you’ve got any food triggers on the nutrition thing. So, that’s why I actually will put people through a 30 day reset to help you figure out what your food sensitivities are. We know a couple of triggers that are really common for autoimmune disease. Gluten and dairy are just the top two triggers, but it could be other grains too. It could be soy. It could be the legume family. It could be other things like eggs and the nut family. There’s a lot of different potential food sensitivities.
Talia Lavor, PA: And remember this is not necessarily, like I eat something and my throat’s swelling and all that stuff. So, your only manifestation may be your autoimmune disease. Now, there’s probably others that maybe you’re not connecting the dots, but maybe you’ve got some eczema.
Dr. Emily Parke: Yes, so this is a great point, because food allergies. So allergies are IgE, so that’s the body’s immediate immune system response to something. So that’s like what happens to your family if they eat nut, right? You’re gonna right away, you’re gonna go “Ooh.” You’re gonna have hives or your throat’s gonna swell closed. Something profound’s gonna happen pretty shortly after you are exposed to it.
Dr. Emily Parke: But the majority of issues with foods are more like sensitivities. So, the sensitivities can be delayed, and so this is where it can take anywhere, it can take up to three to four days for the immune system to create a response after it’s seen the item. And so, if you eat, let’s use peanuts. So, if you eat peanut butter, you might feel fine initially. You may feel fine the next day. You may feel fine the day after that. Might be on day three where you’re like, “Ugh.” You might get any symptom from head to toe. You might get a headache. You could get muscle aches, joint pains. You could have headaches fatigue.
Talia Lavor, PA: A runny nose.
Dr. Emily Parke: You could get nasal congestion. Yes, so that’s one of the key thing that I do for my patients is I help them get through a 30 day reset. I use paleo nutrition, because it does automatically take out the top triggers. And if you have an autoimmune disease, I would actually recommend doing a paleo autoimmune protocol, ’cause it takes out extra things that are known to be immune system triggers for autoimmune disease specifically and so you go through that process a minimum of 30 days. And 30 days is key. There’s a reason why everyone says 30 days, it’s because it takes your body’s immune system 23 days to calm down by only half. That’s the half life of the immunoglobulins.
Talia Lavor, PA: The antibody.
Dr. Emily Parke: Exactly. So, at the end of the –
Talia Lavor, PA: So, when we make those, their little proteins, right? So, we make those antibodies and they stick around for a while and they do their job and then they slowly get broken down. So, the body’s gonna break those down. So that’s why we have that half life. So, the body’s like, “Okay. Send out the troops.” And the troops go out. You’ve got all your antibodies. It’s like, say you’re doing the elimination or you’re doing this 30 days, so right before you ate something that triggered this response and then it’s like, “Okay, we sent the troops out. Now we can relax.” And slowly, they’re like, “Okay. We haven’t seen anything in a while.” Right? We don’t need more troops out, so we start slowly getting rid of the troops until they finally go. That’s just an idea of thinking about those antibodies and how your body’s gonna break them down and slowly get rid of them.
Dr. Emily Parke: Yeah. Totally. That’s awesome. Thanks for breaking that down for guests, for non-doctory people.
Talia Lavor, PA: Sometimes we get together. We get people and it’s just crazy.
Dr. Emily Parke: Yes. No, totally. So, Talia’s right. So, it takes your body’s immune system at least 23 days to calm down by half is kind of the in a nutshell. So, 30 days gets you well past the half way point to where at the end of at least 30 days and for some people it takes more than 30 days. It may be 60 days or 90 days to really get you to a point where you feel good, because everyone’s immune system’s set up a little differently. But 30 days would be a minimum. Then let’s say at the end of the 30 days, you wanna figure out, oh, I want to find out –
Talia Lavor, PA: Oh, can I have eggs?
Dr. Emily Parke: Yeah, or do eggs cause me an issue. Is it a trigger for me? Cool. You add eggs back in the diet one serving three times a day, three days in a row, the only new thing that you’re showing your body. Then you track how you feel and you have to take a scan from head to toe. If it’s GI, if it’s gut, beautiful ’cause we all connect that with food.
Talia Lavor, PA: You start getting bloated. You can start getting diarrhea, constipation.
Dr. Emily Parke: Right. Something will happen. But it could not just be the GI tract like we mentioned, right? It could be anything from head to toe.
Talia Lavor, PA: And you will get more … I think people will become more intune, because sometimes we get used to living with all these different things going on. And even when they go away, we’re not as aware of it, but when they come back … so, for example for me, I do have a sensitivity to wheat or to gluten and non-gluten wheat. I never knew it. I did blood testing. But now that I know, if I do get something that there’s some wheat in something, I will get, like I said, like stuffiness in my nose. It’s nothing I was aware of before until I started to do this. So, you really start to really develop a good communication with your body. I think it really grows your confidence too, because you really get to know yourself. It’s like you should be proud of that. I’m listening to everything that you’re talking to me about.
Dr. Emily Parke: Because no matter what any blood test say, your body is still tells us. Your body’s a giant biochemistry experiment in there. I say that all the time, because no matter what the blood tests say, and by the way, there’s not one blood test that looks at every part of the immune system’s response. So, your body is still the gold standard. So, walking through to answer your question. So that was the nutrition piece. So, nutrition, right? So, that’s what you would do.
Dr. Emily Parke: Getting enough good quality sleep as we mentioned. Because not getting enough good quality sleep is a huge stress on the body that can have a waterfall effect on the gut, the adrenals, the thyroid, and the sex hormones. So, you definitely want to make sure you’re getting enough good quality sleep.
Dr. Emily Parke: You want to make sure you’re getting enough good quality exercise and movement. As I mentioned, you can go too much on that and you can underdo it as well. So, getting enough movement in.
Dr. Emily Parke: Then, of course the stress management part, and that’s a big ball of wax to tackle. But one of the easy way I have my patients start is by starting a meditation practice even just for five or ten minutes before you go to bed. Keep it simple. Make it doable. You can do it any time of day. If it’s first thing in the morning that works for you, great. Yes, if traditional meditation wants you to do it first thing in the morning, but I say you do it when you’re actually going to do it instead of, “Oh, I didn’t wake up at five a.m., I can’t do my meditation today.” You know, you wanna create the habit.
Talia Lavor, PA: And I want to create a whole highlight on meditation, because it is so powerful but even I feel like I struggle with meditation. And I want to put that out there, because I think people, we always go to meditation because it’s so profound the effects of meditation.
Dr. Emily Parke: Oh, yeah.
Talia Lavor, PA: If done properly, the effects that it has on your health are profound, but so many of us feel like I can’t do it. I don’t know what I’m doing. I don’t have time for it. Blah, blah, blah. And it doesn’t have to be just meditation. I think swimming sometimes is very relaxing or actually studies show –
Dr. Emily Parke: So, it’s a moving meditation. Yes, okay. Or floating.
Talia Lavor, PA: Any water, being in water in any way, shape or form actually is very relaxing to a lot of people. So, I mean, whatever it is for you to just turn down the … calmate. Calmate a little bit.
Dr. Emily Parke: Yes.
Talia Lavor, PA: I think that’s gonna be for most people one of the hardest things.
Dr. Emily Parke: Yep. Yep. Exactly. So, then of course you have the toxin reduction part that we talked about already. So, that’s where you’re gonna take a good look at your personal care products and your household items and do everything you can to decrease your total toxic load, ’cause at the end of the day, the triggers for autoimmune disease, there’s one medical term called total allostatic load. So that’s the total load of every single stress on the body, which includes all the things we talked about. Chronic infections, nutrient deficiencies, not moving enough, doing too much exercise, not getting enough good quality sleep. All of those things will add up to toxin exposure. The big load on the body, and then if your body’s overstressed, you’re gonna activate the sympathetic nervous system.
Talia Lavor, PA: Right. That cup just overflows.
Dr. Emily Parke: Yeah.
Talia Lavor, PA: I love it. So, I have two more questions. One is then, and I think we touched on this a little bit, but can autoimmune diseases be “cured”? If you use that word cured.
Dr. Emily Parke: Yes. I don’t use the word “cured”. Only because if you think about it logically, based on everything we said so far, if you put yourself back I the exact situation that turned on the autoimmune disease, it will surely come back, right? So, if you know that gluten’s a trigger and that you had a lead exposure overload, and you had a chronic infection, all those things, if you treated those and your autoimmune disease is reversed, which means we can’t see antibodies anymore in your blood or the antibodies have calmed down. If you do those things, if you ate gluten again on a regular basis, you might retrigger that for example. Or if you had, if you unfortunately got hit with an infection of some kind, you know, that could trigger your autoimmune disease. If you had a huge stress in your body or your life, that can trigger an autoimmune disease to come back.
Dr. Emily Parke: So, I like to say reversed, as in it’s reversible, because I’m very clear with people, “If you do back to doing, you know, recreate the situation that turned it on, it’s gonna turn it on again. So, you really cannot say “cured”.
Talia Lavor, PA: But I like the idea of it being reversed.
Dr. Emily Parke: Yes.
Talia Lavor, PA: And remember not for everything can we, like I said, if there’s been extensive tissue damage where the body has destroyed too many of the cells at this point, you’re not gonna get those back. So, again, the importance of addressing it early on and catching it early on if you can. But we can halt progression. We can manage symptoms really, really well. And in some cases we can revere it.
Dr. Emily Parke: Yes. That’s exactly right.
Talia Lavor, PA: So, you recently went to a functional medicine conference.
Dr. Emily Parke: Uh-huh. (affirmative)
Talia Lavor, PA: I venture to say the biggest one that there is.
Dr. Emily Parke: Yep.
Talia Lavor, PA: And there’s always new and exciting things. So, I just wanted to end with some of the new and exciting things as far as management of autoimmune disease.
Dr. Emily Parke: Yeah, cool.
Talia Lavor, PA: Yeah. This is how we geek out. This is how we roll.
Dr. Emily Parke: That’s right.
Talia Lavor, PA: We like text each other, “Oh, my gosh.”
Dr. Emily Parke: Yeah, seriously. We both have issues. So, I’ve been to four conferences already this year. That’s part of functional medicine. You have to have nose the ground. You have to stay really current. So, in May of this year was the Institute for Functional Medicine’s Annual Conference and it was all on autoimmune disease this year. So, it was awesome. It was so good. It was great to get updates on things that had actually been around for a little while, but there was more research to support it. There’s some pioneer practitioners that have been doing things on their own that know what work.
Talia Lavor, PA: Outside the box.
Dr. Emily Parke: Outside the box, but now there’s research to support, “Hey, this actually works. This isn’t just these ten doctors doing this. There’s actual studies.” So, a couple things that, and there were so many things, we definitely won’t have time to talk about them all, but two things I want to mention. One is the use of low dose of Naltrexone, and we’ve known this for years and I’ve actually been using LDN in my patients for a couple years now. Low dose Naltrexone is super supportive of the immune system and there’s really good data on autoimmune diseases, cancers, and even some other chronic illness too. It’s a pretty benign medication. It is a medication. It is a prescription.
Talia Lavor, PA: One of the very few medications I recommend.
Dr. Emily Parke: Yep, exactly. It needs to be compounded specially at a pharmacy. So, Naltrexone, what it is is traditionally it’s in a category of what are considered opioid antagonists. What the heck does that mean? That means it’s usually used to reverse the effects of an opioid, like a morphine like compound, right? So, in the hospital if you had an overdose of morphine let’s say, they would give you a medication like Naltrexone. They would actually give you something else called Maloxone. Our Narcan, but same family to reverse the effects of opioids –
Talia Lavor, PA: High doses.
Dr. Emily Parke: High doses of it, right. So, what they’ve been studying over the past decade of two now is that low doses of Naltrexone actually have been shown to help support the immune system and in some really small doses. I will start with you know, 0.5 milligrams, one milligram, and work up from there to a total of four milligrams a day. But I will say this, it’s not like other medications where the next week you’re gonna be like, “Oh, I feel amazing. It’s kind of the slow and steady wins the face there and it’s a long game with it. But what you’ll notice over time is that they’ll be symptom reduction or I’ll see antibodies in the blood come down. You see laboratory evidence that the LDN is doing its job.
Talia Lavor, PA: And basically what it does is it kind of tricks, I hate to use that word, but tricks the body to make its own opioids. And we now know that the immune cells have a ton of receptors. So, they communicate with us. Those opioids tell our endorphins tell the body what to do and the immune system in particular. And I’m gonna do a whole episode on this, because I feel like it’s so underused. It’s a little complex when we talk about what’s happening, but it’s really interesting. So, over time your body’s just naturally making more of these. And something to is that it’s actually very hard, very few things increase these levels in your body. Very few things. Even if we inject them directly into the body.
Dr. Emily Parke: So, the half life’s super fast.
Talia Lavor, PA: Yeah.
Dr. Emily Parke: They get broken down and integrated really quickly.
Talia Lavor, PA: So, really the body making them them selves, is the best way to do it, and so you as you temporarily kind of tell the body to make more of these, then they go in and they tell the immune cells, “Like, hey. Whoa. Whoa. Whoa. Whoa. Whoa. You guys are getting crazy over there. That’s for our thyroid. Let’s take it easy. Okay, they’re on the same team.” And people do great with it. I’ve used it in infertility patient. I mean you can use it and it was a little bit out there for a long time. Still for infertility it’s still a little bit on the edge as far as the research and stuff like that, but providers are using it. So, you do need a provider, you need a licensed provider to prescribe it. And she said, it’s compounded, but I will tell you it’s very, very inexpensive.
Dr. Emily Parke: Inexpensive, yeah.
Talia Lavor, PA: Probably 30 to 40 dollars a month. We’re here in Arizona. I have a very good friend who is a compounding pharmacist and that’s what he charges. So, if you’re getting charged a lot more, think about it. The side effect profile is petty low.
Dr. Emily Parke: Yeah, so LDN and the other exciting thing that we didn’t even talk about. I’m just gonna spring this on you. That has really exciting, good data is something called the fasting mimicking diet. Do you know FMD?
Talia Lavor, PA: No, but I’m really interested into fasting right now. Intermittent fasting. So, let’s talk.
Dr. Emily Parke: Yes, okay. So, fasting mimicking diet is exactly what it sounds like. So, you’re not actually fasting, but you’re doing something that mimicks fasting. There is a great scientist our of USC. His name is Dr. Valter Longo and he actually has a book out there.
Talia Lavor, PA: Valter.
Dr. Emily Parke: We go way back.
Talia Lavor, PA: We go way back.
Dr. Emily Parke: Okay. He actually wrote an entire book called “The Longevity Diet” that’s actually very accessible to the lay person.I actually, his main laboratory assistant spoke at the Institute for Functional Medicine’s Conference and it was a great 90 minute lecture, and after that I was like, I gotta know more. So, I actually read the entire book in like 10 days.
Talia Lavor, PA: I’ll have to see if we can get him on the podcast.
Dr. Emily Parke: Yeah, totally. So the fasting mimicking diet is 100% plant-based diet and it’s for five days only. Yes.
Talia Lavor, PA: I’m making this face: really?
Dr. Emily Parke: Really?
Talia Lavor, PA: For those of you who aren’t seeing the video. The really face.
Dr. Emily Parke: Yes and so there’s great data for autoimmune diseases, for cancer. He’s also got data for obesity, Type II diabetes, inflammation like the CRP marker, but anyway, so this is all out again, about USC and Dr. Valter Longo. So, what was very well studies was doing five days of this fasting mimicking diet, so the calories are dropped and it’s all plant-based. Your protein levels are actually very low during this time. So, what he proved was that if you do blood markers before and you do blood markers after, significant improvement, but what was extra cool was that if you test later, like months later, there was still improvement in the blood markers. Not as big of an improvement as when you very first finished the five days of the FMD, but it was better than when before you did it.
Talia Lavor, PA: And how frequently do you do it?
Dr. Emily Parke: Love it. We’re on the same wavelength there.
Talia Lavor, PA: Yep.
Dr. Emily Parke: So, for people that have complex chronic diseases, the recommendation is to do one cycle of the fasting mimicking diet, so five days. You do it three months in a row and then you kind of do it quarterly after that. But if you’re a pretty relatively healthy person you might do it twice a year or if you’re a really healthy person you might go through it once a year. So, it’s a very benign, very easy thing to do.
Talia Lavor, PA: So, it’s plant-based.
Dr. Emily Parke: Yes. So, Dr. Longo actually created a specific called Prolon. Excuse me. And it’s P-R-O-L-O-N. Prolon. It’s by a company called El Nutra, which he created and by the way all of his proceeds go completely back into his research foundation called createscures.org. Another reason that’s amazing. But he wanted to make the fasting mimicking diet accessible to everybody so he created this entire … basically I call it a fancy shoebox, ’cause that’s kind of what it reminds me of.
Talia Lavor, PA: A kit.
Dr. Emily Parke: It’s very beautifully packaged, yes. But it has in there what you’re eating all of your food for the five days. Yeah, so there’s soups that obviously you reconstitute with hot water. There’s some olives in there. There’s some nut based bars. There’s some cracker type things, like some kale crackers and whatnot. But it’s very specific and so that product is what’s studied in his study specifically, and so you do that for five days and it’s very simple.
Talia Lavor, PA: Do you know how much it costs?
Dr. Emily Parke: Besides water.
Talia Lavor, PA: I’ll link to you.
Dr. Emily Parke: I think I want to say it’s around 220 or 225 bucks or something like that for the kit.
Talia Lavor, PA: Not bad.
Dr. Emily Parke: That’s all you’re eating.
Talia Lavor, PA: You could even … this could be an interesting experiment, because if it’s pretty benign the risks are really low, right? So, people could be checking their levels prior to this. So, they check immediately after.
Dr. Emily Parke: And then of course months later. I think like six months later on a lot of the studies and they were looking at what happened to blood sugar and cholesterol and CRP and IGF-1. They were looking at those markers and of course other markers like weight and waist circumference and stuff like that they were looking at as well.
Talia Lavor, PA: So it mimics fasting.
Dr. Emily Parke: Uh-huh. (affirmative). Yes.
Talia Lavor, PA: Fascinating.
Dr. Emily Parke: So, it turns on … there’s really good research in cancer too. We’ll get into that another day.
Talia Lavor, PA: Yes. It’s gonna need its own episode.
Dr. Emily Parke: Yes. There’s another –
Talia Lavor, PA: I’m gonna read the book. Here’s what’s gonna happen. I’ll read the book, and then we’ll come back and we’ll do a whole episode just on that.
Dr. Emily Parke: Yeah. Let’s do it.
Talia Lavor, PA: I love it.
Dr. Emily Parke: But so yeah, it’s accessible to people if you want to go ahead and give the fasting mimicking diet a try. It’s pretty low risk. If you do get the kit, they will go over what to watch out for ’cause it’s a huge change in the diet so you want to be sure you don’t get dehydrate and you want to make sure blood pressure doesn’t go too low.
Talia Lavor, PA: Yeah, especially if you’re an athlete or something like that.
Dr. Emily Parke: Yeah, or if you’re not going to do your hard workouts during that time. If you are on blood pressure medication or on medication for blood sugar, you definitely need to be supervised by a physician.
Talia Lavor, PA: Oh, I love it. We will come back with more from that. I’ll link to it thought. I’ll link to any resources we talk about.
Dr. Emily Parke: Perfect.
Talia Lavor, PA: Oh, I am so excited. So, I just think I want people to recognize a couple things. Number one recognize that what risk factors are and how we minimize those. How women in particular, ’cause that’s what I work with, can really have a lot of control. I think this is a big thing for us. We just need … we feel like sometimes that we’re just on this rollercoaster and grasping for anything and we just have no control, but there’s a lot we can do with autoimmune diseases. And we need to respect them, because they can be very intense. The consequences can be very severe. So, we need to respect them, but there’s so much we can do and there’s a lot on the forefront, because I think with this expanding, I think I said the other time it’s like the eighth leading cause of death in females. So, this is serious stuff. It impacts everything from fertility to everything in our lives. So, I love the fact that there’s so much that we can do to really take the reins and take control of our health and to know this isn’t just a death sentence, you’re not just stuck in stone. There’s a lot you can do to make some changes there. So, I am for real. I love it.
Dr. Emily Parke: Awesome.
Talia Lavor, PA: All right. Well, if you happen to live in Arizona or perhaps you live somewhere that’s cold and snowy and you want to frequent Arizona, because we’re really yes. Yes, it’s 105 degrees today, and that’s okay. The rest of the year we are super amazing and super awesome. So, if you are here, if you’re visiting, if you live here and if you want to work with … I’m not saying this just ’cause she’s right next to me.
Dr. Emily Parke: Oh, okay.
Talia Lavor, PA: But Dr. Parke is a phenomenal … not only is she just an insanely intelligent woman, a phenomenal functional medicine provider, but she is literally one of the most wonderful most nicest humans I know.
Dr. Emily Parke: Oh, thanks Talia.
Talia Lavor, PA: You must come here. I work a lot with women and I basically teach them what they can do without a provider, but there are times for example low dose Naltrexone or all these different things where you need somebody or maybe you’re making progress, but you get stuck and you need anther pair of eyes on it. So, it is wise to expand your team. Your health and vitality team. So, I will link to her website here and not only does she see patients, but she offers her own videos and information to people. But if you are in the area, you may way to stop by and say high performance or schedule a tripy trip.
Dr. Emily Parke: Thanks Talia.
Talia Lavor, PA: All right. Well, we’ll be back for sure. We’re gonna be doing several episodes together. So, I’m so excited. So, thanks Emily slash Dr. Parke.
Dr. Emily Parke: You’re so welcome Talia.
Talia Lavor, PA: Love ya.
Dr. Emily Parke: Okay.
Talia Lavor, PA: Until next time.
Dr. Emily Parke: Sounds great.