How to Fight an Autoimmune Disease | Interview with Dr. Micah Yu, an Integrative Rheumatologist

shows every day it's a lot of editing your show is amazing well thank you yeah i've met the best people i'll tell you i never would have met half the people i'm meeting if i had to keep doing my job which was traveling so this has been wonderful thank you so much i cannot wait it's going to start any second hello everyone and welcome to chef aj live i'm your host chef aj and this is where i introduce you to amazing people like you who are doing great things in the world that i think you should know about today my guest is going to talk about how to fight autoimmune disease and he is not only a rheumatologist but he is a plant-based rheumatologist and he's an integrated rheumatologist so we're going to find out a little bit more about what that means his lovely wife dr mandala has been on the show already and if you haven't seen that episode i can link to it below in the show notes but please welcome today dr micah you it's so great to see you again oh thank you so much chef aj you know i love your show and i think what you're doing is so great for the community bringing all these plant-based people together with healthcare professionals or people in the healthcare field um it's just amazing and chefs and all over the world so i really love your show and i'm so honored to be on your show i appreciate that and i didn't start out really with a with a goal like that the goal was really just to create a sense of community during the pandemic and then when hundreds of people were like can i be on them like of course and you know the one bright spot about the pandemic is there are some people that are just not doing anything right now that would never be on the show but because they they're jumping at the bit to like speak i've been getting some you know just wonderful guests and and i as i was saying like i yes we met once at the fasting escape but a lot of people i would not have met if i continued my life just going from city to city just like yesterday's guests and so what were you doing at the fasting escape checking it out to see if yeah for your patients yeah so me and my wife dr mandala we we believe in fasting and we got connected to nathan at the fasting escape so we're there just to see what it's all about um and how the program worked and luckily we ran into you there as well i'm so glad we got to reconnect uh after a year yeah well you don't like like your wife neither of you look old enough to be a doctor but that's so cool i mean i just love it that you guys are like this plant-based power couple now yeah thank you so much i and i think people like you really helped um us doctors like you know to get to know about this to really understand how plant-based really helps the body and you're a living example of that yeah and i love that you're in a field that is not i i don't want to say inundated because there's really no field that's inundated by plant-based doctors but you know lots of them seem to turn to cardiology which makes sense because cardiology is it's pretty easy to prevent reverse if you do it right but rheumatology i don't know if there's a lot of plant-based rheumatologists out there i i'm the only one that i know of in the whole nation um i mean i you know dr laurie marvas and all these other doctors i asked them who are the other promised rheumatologists there's no one else out there so so ologist means study of what i i think i kind of know what you do but what is a rheumatoid rheumatologist because what is what does rheum even mean yeah so um i'll be talking about that in my powerpoint but i can talk about briefly here so uh the field of rheumatology you need to do three years of internal medicine residency to start and then you do two years two or three years of specialty training after that and the field of rheumatology the study of autoimmune diseases uh can that are related to connective tissue so either muscle bone joints or even some vessels as well and it's also the study of arthritis also so osteoarthritis osteoporosis is one as one of our specialty gout we've heard of gout as well that's in our one of our diseases also so a lot of autoimmune diseases wow how did you get into i always i always wondered because both my brothers are doctors all of my cousins almost all my nieces and nephews and i always wonder what makes you like decide to choose your specialty did you know going into medical school or like why rheumatology because i i myself have a rheumatic disease so i'll be talking about that also i have autoimmune disease also so i'm and i use plant-based nutrition to really help myself overcome my disease so i'm i'm a patient also so i understand how important plant-based nutrition is and it's so scientifically sound as well that's great because then you probably have you really can empathize with the patients i always felt that that um that men should not be gynecologists because they have no idea what's going on down there with us but you can actually have empathize with your patients when they say it hurts like i know i know what you mean it really yeah i say that every visit one patient says i heard i'm like well how does it hurt because for me the pain is like an achy pain is it an achy pain for you so that's how we connect and it's so much easier to understand what a patient goes through you know it's interesting that you mentioned arthritis and i'm i'm in the midst of hosting or not well i'm doing the interviews for the truth about weight loss summit which that's why this screen is up instead of the usual chef aj screen which starts airing free next month and i just interviewed dr stefan esser who is a sports medicine doctor and what he said yesterday in his interview is something i never heard and i'm wondering if you heard that he said because we were talking about the ramifications of having excess weight with all kinds of diseases and particularly because he sees a lot of joint disease and he was saying that that you even people that are overweight can get arthritis in their hands even though their hands are not you know the weight-bearing part of the body and i thought wow that is that's i never heard that before yeah i see arthritis in very skinny people overweight people it doesn't matter what size you are you can get arthritis um and autonomy disease starts at a very young age i've seen autism disease at three years old two years old and they go up to like your 80s and 90s but osteoarthritis is not an autoimmune disease it's uh more of the wear and tear on the joints and that can happen on the hands also interesting well one of your patients is watching nan says dr you is my plant-based rheumatologist who told me that i don't need them because i'm no longer symptomatic because of my whole food plant-based nutritional plan he is terrific so people can if i understand correctly you work at the institute of plant-based medicine so you could i used to work at institute based medicine i opened my own clinic with my wife uh called dr lifestyle clinic in newport beach okay well the reason i asked is can you still do telemedicine because i know that okay that's that's what i was getting at i apologize for not realizing you switched but that's great because there are people probably watching that have autoimmune disease that would like a plant-based rheumatologist since it seems like you're the only one yeah so i've seen i've been seeing patients all over the u.s i have like 16 state licenses um so they can message me or go on my website afterwards and i've also seen patients internationally i'm seeing someone from canada i saw something from peru um last month as well nice great well whenever you're ready i know you've prevented uh prevented you've presented you're preventing us from you have a i can't speak it's sunday but you have a powerpoint presentation and if there's time maybe you could take some questions that are appearing in the chat oh of course yeah so my powerpoint is kind of long but i'm gonna keep this succinct as much as possible well it's sunday so we have extra time because i don't have an i don't have another show today so you take as much time as you need because this is a subject that we just haven't really delved into yet because we haven't been able to find a plant-based yeah or an integrative one and that's interesting too because you know i've had there are people that are integrative physicians but they're not plant-based and they're plant-based exactly integrated if you're like you're both yeah i'm trying to do it all um so i spent a lot of time on this uh powerpoint because i love your show and i i want to give my best to your audience so i'm gonna there's about 86 lives but we're going to zoom through some of them right yeah just if you could just do it in a slide mode because i'm still yeah perfect perfect okay so the title of this talk is fighting autoimmune disease with an integrative rheumatologist so i'm dr micah yu i'm the co-founder of the doctor lifestyle clinic in newport beach and you can find me on instagram facebook or twitter uh at my automd so about me i got my bachelor of science in this administration at uc riverside and then i got my doctor of medicine at chicago medical school i then went to loma linda university for my internal medicine residency and rheumatology fellowship i'm double board certified internal medicine and lifestyle medicine through the american college of lifestyle medicine and i'm also in my second fellowship now at the integrative medicine fellowship at the university of arizona so i'm going to talk about my childhood and how i got to where i am today as a plant-based rheumatologist so as you see here this is back in uh elementary school i was probably eight years old at the time six i think but i'm the one in the middle i'm the chubbiest one in the group here um i was eating a standard american diet my mom's right behind me chicken nuggets anything you get from costco the frozen food you name it so nothing really plant-based and maybe some chinese veggies and then high school went on i was still overweight um i played football i was probably 160 i was a defensive lineman it's the basically the players in the middle of the pack where all the action is so i was um i was trying to get strong at the time i was trying to lose weight after football so i want a high protein diet i went on the atkins diet okay so i ate a lot of dairy a lot of protein powder a lot of steak a lot of chicken and fish and what happened i end up getting gout so gout is a rheumatic disease gout is a disease of inflammation and of high uric acid levels as well you can get gout if you have normal uric acid also however this disease was known as the disease of kings because what the kings do back then they ate a very very um rich diet full of seafood food of meat back then so i believe king henry the eighth had gail nostradamus the uh the prophet also calgal benjamin franklin had gout as well and you can die from gout because gout not only affects the joints but it can affect the kidneys your arteries also if it's uncontrolled but luckily we have medications these days that can help with that so i was weighing about 160 pounds i went down to 130 pounds on a um atkins diet but i got gout and i was eating about 200 grams of protein that is not normal so i end up getting this arthritis diagnosed by my father who was a family medicine doctor and then as the years went on you know my joint pains really transformed into something else that cannot be explained um this is a picture in 2013 when i was in medical school as you can see here my left foot the top of my foot was inflamed i will get flares every month so gout usually attacks me one joint or two joints i started getting pain all over my body and my tmj where my jaw is i got in my fingers my wrist my toes my knees you name it i got it i got swollen joints or red sometimes i couldn't even eat for a week two weeks three weeks because my jaw was so inflamed that i couldn't really open my mouth i went to different doctors even different rheumatologists they could not explain what was going on because all my autoimmune labs were negative but my inflammatory markers were positive so they said you have gout but you have something else going on that we cannot explain luckily when i got to residency i went to the rheumatology division at loman university and my bosses who keep my bosses later on um they were able to diagnose something called spondyloarthritis this is a disease um so if you have ankylosing spondylitis or psoriatic arthritis you have something called spondyloarthritis i have a subset called peripheral spondyloarthritis so i did not get the back pain that you typically get in closing spondylitis but i have pain everywhere else shoulders wrists knees elbows you name it and i got it and i did get the tendon pain as well which i'll go into so this is an autoimmune disease so i had two diagnoses actually three because they did get fluid from my ankle um at one point and i was diagnosed pseudogal which is knocked out it's another crystal that they find in the microscope so f3 diagnosis actually so i said you know what enough was enough i was introduced to plant-based nutrition by my wife she was doing a lifestyle medicine certificate and fellowship at the time during my third year of residency and during thanksgiving she cooked a plant-based meal for me and i was like this is not tasty i'm not used to this so this was back in november of 2017 when i was first introduced to plant-based meals as you can see here i was very overweight from 2009 and then now 2019 i lost a lot of weight i dropped from 165 pounds 260 pounds to i'm now 130 i was as low as 125. so i was overweight at the time so after being introduced to my first plant-based meal it took many months for me to actually try it consistently i went to guam for a medical rotation in april of 2018 and in may of 2018 i watched forks overnight and i um read michael greger's um how not to die and i looked at his website nutritionfacts.org and i studied it and i said you know what let's give this a shot let's see if my pain does go away so my pain within three months went away completely my c-reactive protein which is an inflammatory marker on labs went negative after 10 years my other lab was still positive but half what it was before so my pain i mean went quite completely i could not believe it it was like magic i was offered medications by other doctors uh for my spondyloarthritis i never took it and up to today i still don't need it i do take medications for gout every now and then um but that's all i need so that's when i was inspired to create my social media my audience md because i want the world to know that there's something better out there that you can do other than medications so i'm on instagram and on facebook to spread the word of plant-based nutrition and the importance of lifestyle medicine to fight autoimmune disease and then we went on to create the dr lifestyle clinic with me and my wife uh where she specializes in primary care and lifestyle medicine and i specialize in rheumatology lifestyle medicine and integrated medicine so we are a duo here in the clinic i'm trying to offer uh the world a message of healing so what is rheumatology i know chef aj you asked me um just a couple minutes ago on what rheumatology is so just to give your audience if they're just coming out now rheumatology is the field of diagnosing and treating muscle skeletal diseases systemic autoimmune conditions commonly referred to as rheumatic diseases sometimes we're known as detectives of medicine and also immunologists of medicine as well so if you've watched house md i would say at least two of the diseases every season was related to rheumatic diseases because our diseases are rare and they're fascinating and sometimes patients go from specialists to specialists never knowing what disease they have until they come to the rheumatologist because our diseases are puzzles and that can affect every system of the body so what are the diseases of rheumatology so this is just a few of the diseases that we treat um so very common ones that you've probably heard of are rheumatoid arthritis osteoarthritis scalp pseudogal lupus psoriatic arthritis and cholesterol spondylitis but we get to some pretty rare diseases here vasculitis um sarcoidosis although still disease autoinflammatory conditions from my other is not an autoimmune disease but it's a disease of widespread pain and sometimes brain fog that rheumatologists treat and osteoporosis um which you've probably heard of as well bone thinning that's one of our diseases as well so i'm gonna go through some diseases and just go over some of the symptoms and signs of it so i try not to put too many graphic uh images on here because our disease can be pretty graphic so this is pretty much an end stage rheumatoid arthritis rheumatoid arthritis is an autoimmune disease and it can affect patients as young as two three one years old but when it's that young it's called juvenile idiopathic arthritis or juvenile rheumatic arthritis but when they turn 18 it becomes rheumatoid right they change the wording of it and the signs are morning stiffness joint pains um you can get um positive lab markers your joints um you can get something called erosions where you start getting holes in your bones because the inflammation starts eating away at the bones the hands are a typical spot for it to affect but it can affect any other joint in the body and you can get problems that affect our symptoms outside of the joints so i've seen patients that affect the lungs only so they come into the hospital and they're in the icu because they can't breathe and that was a very that's one thing that i remember very closely um is a patient that came in that had rheumatoid arthritis um on labs but never had any joint symptoms and had trouble breathing um it can also affect your brain your skin your heart as well so there's extra articular manifestations lupus is another disease you've probably heard of very very complicated disease as well on the left is a picture of a patient with something called a butterfly rash which is a very typical sign of lupus um you don't have to have this sign of course but there's other lupus signs as well so you have hair loss you can have mouth sores you have body rashes you can have a face rash joint pain chest pain you can get kidney involvement as well brain involvement so lupus is a disease that can affect every single organ of the body and it can affect your blood cells as well um so you can get anemia you have low white blood cell count as well because your antibodies are killing off the blood cells so this is another autoimmune disease that i treat gout i mentioned that gout so this is end stage gout here so there's something called uric acid that we naturally produce in the body but when you eat red meat seafood it can elevate your uric acid levels and when you don't control your gout you can get uric acid deposits that become something called tofus which is a chalky um sediment that can build up in your joints so i've seen patients with this are much severe than this that are wheelchair bound in the 20s and the 30s because they don't take my medications um they don't see their doctor so this is what happens um and luckily we do have medications that can actually shrink these chalky deposits um it's an iv infusion and i don't think food can reverse this um it'll take a very very long time probably many many years if it's even possible no literature shows that food can reverse it but medications can't ankle losing spondylitis is an autonomy disease attack of the lower back and the pelvic bones this is a healthy spine on your left ear when you have ankylosing spondylitis your bones start to fuse in the spine and ankylosing spondylitis signs are you can get so this happens um a lot in 20 year olds 30 year olds and even in the teens and typically patients wake up in the middle of night from back pain they wake up with back pain stiffness and they get undiagnosed for many years because they go around from doctor to doctor doctors think that oh you're so young um this is not an issue or you probably just pulled a muscle or you just have some back um spine issues but they don't think of autoimmune disease and so i've seen patients that come to me after being undiagnosed for five years ten years and they finally come to me and sometimes um i've seen patients that are wheelchair bound from this disease or they're so hunched over because their spine is fused it's called bamboo spine when this happens um so this is another very typical disease that i see as well myositis um i don't know if you've heard of this chef aj but myositis there's two terms there's a couple variations of this dermatomyositis polymyositis are typical autoimmune diseases of myositis typically these patients come to my clinic they have trouble raising their arms up they have trouble walking because their um autoimmune disease is attacking their muscles um it's eating away their muscles their muscles are breaking down and you can also get rashes trouble breathing you can have difficulty swallowing as well um it could be very mild where the patient is walking to my clinic saying i have muscle weakness um and that's pretty much it i have a little rash here but i've seen patients in the icu they don't get diagnosed until they're in the hospital and they're intubated in the icu with a tube down a throat um they have full-blown myositis going on and we have to give our strongest medications just to get them out of the hospital um and there's other variations of this necrotizing myositis is another autoimmune disease that many people have not heard of you can get it from statin use so your cholesterol-lowering medications can cause necrotizing myositis where you have a breakdown of the muscle however that's very rare but i have seen it in my clinic so that's a side effect of cholesterol lowering medications such as stems psoriatic arthritis is another arthritis medication that's another autoimmune disease and you can see it with psoriasis um which is an autumn disease of the skin so there they can be linked you don't have to have psoriasis you have psoriatic arthritis but this is just another sign another arthritis out there so typically you see pitting nails in these patients um they might have a psoriasis rash morning stiffness and they can have the tendon pain as well called emphysitis enthositis is the connection so a species is a connection between your bone and your tendon or your ligament and the point of the connection that's inflamed is called an emphysitis so it's a very small point that's inflamed so that's another sign of this shoguns is a very typical autumn disease as well you typically get dry ice dry mouth because this autoimmune disease attacks the salivary glands um and other mucosal glands as well and you can get rashes you can get joint pain you get lung involvement with this disease as well vasculitis is a very rare disease that i saw a lot at loma linda university during my training um and different pockets of america have more um some that some doctors see more of this than others um but these are just names of the different items of vasculitis vasculature is literally the inflammation of vessels and every single vessel in your body can be inflamed whether small medium or large and these are all the different kinds of symptoms that you can see so sometimes i have patients coming in into the hospital or in my clinic coughing up blood or they have chronic sinus issues and sometimes these are just early signs of their vasculitis it can affect the kidney you can die from these um from vasculitis i've seen death from vasculitis before so all these autoimmune diseases can be very serious um i've seen patients die from them every single one of them i've seen someone die from rheumatoid arthritis of course they weren't on medications they didn't want to see doctors so that's what happened they were not eating a plant-based diet or anti-inflammatory diet okay but if you take care of your body your health and you and if you need to you take medications you can control these diseases one in five americans have an autonomy disease that's why bringing up this topic is so important that's 20 and this is from the american autoimmune related disease associated this is the president she said that the rapid increase in arms disease is clearly suggested that environmental factors are at play due to a significant increase in these diseases genes do not change in such a short period of time you know our genes in the past 120 200 years i don't think they've changed that much but our environment has the industrial revolution refined food processed food all these have played a role so let's see how many people in the world have disease american college of rheumatology says 1.3 million americans have rheumatoid arthritis about point 62.4 has fungal threats which i am one of them lupus about 300 000 people um systemic sclerosis or derma which is a thickening of the skin that's what one of the symptoms of fifty thousand people dinosaur arthritis which is a vasculitis is about two hundred thousand people which affects usually people over the age of fifty iron diseases on the rise across all boards across all different specialties and it's going about seven percent a year if you look at the average and i give medications called biologics to my patients and these patients these medications can get side effects such as cancer which however the side effect of that is very low but it does give you more infections um and you can't do certain things when you're on these medications and these medications can cost up to twenty thousand dollars on average so they're very expensive these are medications you see on the commercials all the time sometimes they're injectables and it's like insulin you inject it in your belly you inject it on your thigh just to calm the immune system down because in autonomy disease your immune system is overactive so what we're trying to do is calm down the immune system in the body but sometimes when we're doing that we're calming parts of parts of the muscles that are down that are necessary to fight infections that's why you can get more infections with these medications so our autoimmune disease is part genetics and part environment that's why your show is so important chef aj because you talk about plant-based nutrition and the importance of diet and diet is one key role to calm down inflammation and help prevent autoimmune disease so why is integrative rheumatology or integrated medicine so important to rheumatology and this includes lifestyle medicine i i clump it together so the reason why it's so important because not only are genetics at play but diet is involved your sleep your stress your exercise are using drugs you smoke tobacco your environmental toxins how about previous infections and also trauma did you have abuse growing up did you have bullying when you were in high school or middle school and um stress levels i can't emphasize stress enough i've had patients that went through a divorce a parent died a family member died and they come to me flaring or that's one of the first that's one of the things that preceded their onset of their autism disease so i asked all these questions in my clinic and that's something that a lot of rheumatologists and doctors don't have time to ask their patients or they don't know to ask the patients those questions because they don't look in the literature and they don't have that extra training of lifestyle medicine and also integrated medicine as well so the american college lifestyle medicine is a new field it was developed in 2004 at loma linda university and i am one of the lifestyle medicine um sports certified doctors out there and is so important um to medicine now and i'm very happy that it's now going into different medical curriculum and at loman university um they do have a lifestyle medicine fellowship which my wife went through and there's six pillars here that are so important healthy eating centered around whole food plant-based nutrition increased physical activity managing stress forming healthy relationships improving your sleep and avoiding risky substances and this is a foundation to the blue zones which are cities in the world where people live the longest and loma linda is one of those cities and this is a foundation to my practice as well and if you study um integrative medicine or even functional medicine lifestyle medicine is the foundation to each of these so lifestyle medicine is not new so in the field of integrative medicine has been talking about lifestyle medicine for many years before the field of lifestyle medicine that was integrated medicine that was um andrew wilde was the uh grandfather of lifestyle medicine but they don't they didn't talk about whole foods plant-based nutrition necessarily but they talked about the importance of fruits and vegetables and how training towards that was really important and that's how lifestyle met the field of lifestyle medicine um it's a little bit different american health lifestyle because we talk about whole food plant-based diet but overall this is the core foundation no matter what kind of integrated field you go into so let's go to the meat of our talk today so we're going to talk about nutrition mainly in this uh powerpoint because there's so much to talk about and i can't go through everything it'll take many hours so let's go over what about nutrition you always talk about the chef aj a whole food plant-based diet why is it so important because the phytonutrients eat the rainbow we always talk about that in lifestyle medicine okay each color has a different phytonutrient phytonutrients are little micronutrients in these fruits and vegetables and beans that can have really good benefits for our body but everyone's always asking what should i eat there's so many autoimmune disease heights out there some people say they get better on autonomy protocol diet carnivore diet which we're not happy with keto diet vegan diet mediterranean diet whole food pampers pescetarian vegetarian diet so what should we really be eating for a human disease diet so one of my favorite anti-inflammatory phytonutrients and vegetables is turmeric turmeric is a vegetable it's a herb that we use indians love to use it in the asian population you probably use this as well chef aj i love it it's very anti-inflammatory we see it used in many different things band-aids ice cream coffee lattes even books i don't know how effective those are but they're being sold they're even using it for dodging buy this on amazon for a nice price of 25 dollars and i was studying um turmeric on lupus at loma university um however it kept my study short because of colvin 19. but there are two studies in the world on tumeric and lupus i ran indonesia um the studies were not i don't think they made a profound effect um because some of this showed that it helped a little bit but it wasn't that impactful there's over 6 000 studies on turmeric and kirby in the literature and if you combine it with black pepper which is piperine you increase the absorption by over two thousand percent that's why it's so important to include black pepper when you're cooking with turmeric and when you're taking the supplement it's important to look at the label in the back to make sure there's black pepper or else you're just peeing it out and there's an anti-inflammatory mechanism on curcumin so there's something called t regulatory cells which is your anti-inflammatory t cells so you have t cells and b cells in your body t regulatory cells are your anti-inflammatory t cells so i love territory cells okay these are your psychologists of your immune system so when you're fighting an infection whether it's a virus or bacterial infection reticulatory cells tell your body look we're done fighting this infection you don't need a fight anymore so your t-retory cells say let's calm down we're done in autoimmune disease what it does is it tells your body look this is a cell of our body this is our friend do not attack it however in audible disease we know that t regulatory cells are down so when they're down your body has a more difficult time of um avoiding your um making peace with their own body cells so it starts attacking itself and creating autoimmune disease so there's an anti-inflammatory effect of curcumin because curcumin is the final nutrient of turmeric so these the three things i'm highlighting here are medications and rheumatology that we fight against so tnf interleukin-6 and to look in one they're called cytokines cytokine are um cell to cell communication signals that we have in our body that um that can incite inflammation so we have medications that attack these inflammatory cytokines or inflammatory signals and curcumin in literature has been able to fight all these all diseases not even on autoimmune disease but cardiovascular cancer neurologic disease so these are all just examples of what curcumin has done whether it be on the lab level or in animals or humans another phytonutrient that has been proven to be anti-inflammatory is resveratrol which is found in grapes so if you love wine this is one of the reasons why wine they say it can be beneficial because of resveratrol resveratrol has been shown to fight many different diseases not only autonomy disease but metabolic disease cardiovascular cancer as well infectious disease so whether it be animal studies or human studies there is some proof out there in literature resveratrol has also been able to show that it can fight and help with the joints as well it has an anti-inflammatory effect that's why i love grapes i recommend it to all my patients eat the rainbow and also eat your grapes so let's talk about fiber i know you love fiber chef aj i love fiber all the plant-based people love fiber and it's so important the usda recommends that we eat 25 grams of fiber for a woman and 38 grams for men but this is the minimum only five percent of americans are meeting this goal and why is fiber so important fiber is important because sites have shown the more fiber you eat the lower your metabolic syndrome so metabolic syndrome is high cholesterol high blood pressure and diabetes so you can lower that risk of that you can lower your inflammation levels and you can also lower your chances of getting obesity so this is from the m haynes survey from 1999 to 2010 from the american journal of medicine fiber has also been done in studies in arthritis so in our rheumatology journals as well so this study showed that the higher dietary fiber intake you had the lower the the risk or relation of knee pain in osteoarthritis patients so this is i don't think this is an autoimmune disease patients but osteoarthritis so remember osteoarthritis is wear and tear of your joints and this can happen whether you're older um this typically happens in more older individuals but you can see it in younger individuals if they've gone through trauma whether it be car accidents extreme sports like football or if they were in the military so military i worked at the va for two years or five years actually and i saw a lot of knee pain in these patients because they jumped out of helicopters um there was a lot of trauma involved and they were typically very young 20 30 year olds that were coming to my clinic for this and osteoarthritis i want to mention even though it's not an autonomy disease studies have shown that there is inflammation at the area of the joint so you don't have to have vitamin d to have inflammation um so this is new data that's coming out in the past couple years let's talk about omega-3 and omega-6 fatty acids so we're about to get to the inflammatory part of our talk but we were talking about the anti-inflammatory part earlier so omega-3 fatty acids are so important for inflammation um and there's a balance in your body there's omega-3 fatty acids are always fighting your omega-6 fatty acids omega-6 fatty acids are pro-inflammatory now let's look at the pathway here what is pro-inflammatory so when you eat a western diet standard american diet is very pro-inflammatory it has a lot of omega-6 fatty acids your fast food your refined oils your french fries because it has oil it's not the potatoes that's the issue it's the oils it's you're frying it your red meat your chicken um so all these things your chips your cookies all these different things are omega-6 fatty acids okay your omega-3 fatty acids are your plant-based foods your mediterranean diet so they say that fish in all the studies fish has an anti-inflammatory but what's wrong with fish it's very it has a lot of toxins in it oil spills give it the toxic pcbs from the environment going to the fish so that's why fish if you can avoid it because it can be detrimental some people can tolerate some people can't because it can be a very dirty seafood but plant-based foods are very anti-inflammatory so your chia seeds your flax seeds are anti-inflammatory that's what the studies show and what is happening when you eat omega-3 fatty acids you are producing resolvence and protectants these are your signals that are active when you're going getting over joint pain you're going over inflammation this is what is resolving your inflammation that's why it's called resolvent and protectants and um your plant-based foods are your vegan your algae-based omega-3 supplements will help you up regulate these things to help resolve your inflammation that's why omega-3 fatty acids are important to help inflammation so let's go on to the next part of pro-inflammatory foods this food and our past lives was what we ate every day okay um hamburgers uh your french fries your donuts all this stuff that we ate in the past um or some will still eat it's pro-inflammatory uh we try to avoid it and salt is can be very poor inflammatory as well um so remember how i said t-regulatory cells are anti-inflammatory when when you eat a high salt diet you are decrease your t-regulatory cells because your your pro-inflammatory t-cells which is your t-helper one and t-over-17 sales are increased because of salt so i know chef aj you love the no salt no oil no sugar um your your that kind of diet which i also advocate in my clinic so this is why you don't want to eat that much salt because it can increase inflammation and we do have the pathway for that we talk about it for this one in new indian journal medicine okay the title of this talk was salty taste to autoimmunity and your injury medicine is the premier journal for doctors and here it shows all these different inflammatory signals or cytokines that are upregulated from salt that produces autoimmune disease and why do i harp on this because look at this all these things i'm highlighting here in red are medications that decrease inflammation and across different autoimmune diseases and these medications on average can cost up to twenty thousand dollars a year so why would i be giving you these medications without talking about why salt is inflammatory and why you should minimize it so i will be just doing you a disservice as a rheumatologist if i don't talk about all these pro-inflammatory foods um and just giving you medications and that's what typical doctors do these days because we don't have time and we don't have knowledge of this so when i i actually gave a grand rounds or um a talk at my university when i was in training on something similar to this i took parts of that slide into this and a lot of doctors did not know about this okay because as doctors what we what studies do we look at we look at the newest medications uh how did what are the newest labs or the diagnosis to help our patients we don't look at diet and and this is uh lupus in the fridge or lupus of the kidneys it also shows that a high salt diet affected lupus of the kidneys as well and let's go on to talk about advanced glycation end products also known as age age is when your proteins are lipids um or your fats become attached to sugars that's what it is okay why am i talking about this because it's inflammatory in excess okay this is from the american journal of lifestyle medicine when you have high age it can activate something called nf kappa beta which is one of the little signals in your cells that sparks up inflammation this is what you want to block in your body and what increases age uh your diet exercise um yeah so if you have poor diet if you don't exercise if you smoke these all elevate age and then inflammation so this is not aging as an age this is more it's called advanced glycation end products and this is contributing to diabetes cardiovascular disease and kidney disease as well just not autoimmune disease and what why am i talking about also because of food food affects advanced glycation and products as well if you cook at a higher temperature it increases your age remember like when you cook with oil the higher the oil every oil has a smoke point and that becomes carcinogenic when you cook over that smoke point so another reason why you shouldn't cook at a higher temperature when you cook with much moisture it decreases the age meat has a highest age okay highest and advanced glycation and products salmon has the lowest one out of all the meats products out there fried bacon's the worst we always want to avoid bacon even if you're not plant-based you want to avoid bacon that's the worst thing to eat for yourself vegetables and fruits have the lowest one look at roasted potatoes grilled vegetables bananas cooking beans very very low french fries all the way up there even though it's potatoes has oil in it you're frying it that's why you want to have air fried french fries okay potatoes without oil to season it with herbs or something and then processed food and fats has the highest has high age as well not as high as animal products but you know butter has the highest one of all of them chips has is high as well but this is general guideline here it's not the nlp all but you should take this into account when you're talking about nutrition science and has age and study and autoimmune disease and rheumatic disease yes it has this is very something surprising to my doctors at my university as well when i was in training there so they studied advanced glycation and products in something called adult onset still disease which is an autoimmune disease that affects that gives you rashes gives you fevers and gives you joint pain and also it's been studying on lupus as well so they found that when the blood levels of the advanced glycation end products were high and the patients had more active disease of lupus and adult steel disease when there are lower advanced digestion and products the disease was less active so that's the end of the anti-inflammatory foods and pro-inflammatory foods there's much more to talk about but that would take hours so i'm if you're any questions i can answer after this talk um let's go on to obesity so obesity is a contributor to autonomy disease as well your fat cells are just not sitting there when you're fat their hormonal cells they increase your hormone levels um they're active in the immune system so you have your innate immune system and your adaptive immune system or your acquired immune system your innate immune system is your immune system that is on the go it's ready to fight whatever disease or right ready to fight whatever bacteria or virus is invading your body so i like to think of your immune system as your military or body that's why you need to take care of it your enemies is your army it's in the front lines it doesn't matter who is the enemy is it's on the go your adaptive immune system which is your t cells and b cells they're the ones that are more selective your innate immune system um turns on your adaptive immune system so when you get vaccines or when you um fight viruses again that you encounter for a second time your your b cells and your t cells are ready to go because they've seen it before and when you talk about antibodies this is where b cells come in because there's different type of antibodies that you can create to when you do vaccines and your fat cells affects both parts of the immune system and they can increase inflammation as well through these pathways they're called adipocytes these are your fat cell hormones and obesity has been studied in different autoimmune diseases rheumatoid arthritis lupus inflammatory bowel disease muscle sclerosis type 1 diabetes psoriatic arthritis psoriasis and even thyroid disease so that's why you need to decrease your weight you need to eat a plant-based diet as much as possible even if you're a whole food plant-based a plant-product diet is key here the meat of the topic uh of today is the gut microbiome we cannot leave this talk without talking about the gut microbiota and i'm sure chef aj you've had many doctors and nutritionists talking about the gut microbiome on your show well i'm going to give you another viewpoint of this so your gut microbiome is affected by nutrients nutrition and infection nutrient metabolism drug metabolism your protection against viruses and bacteria and also affects the immune system as well medial modulation and that's what we're talking about today on the left side nutrition metabolism and immunomodulation is a gut microbiota important because 60 to 70 percent of your immune system is located at the gut our gut has over 100 trillion bacteria there not only on our skin but in our intestines alone that's 100 trillion and what we're finding out nowadays over the past decade or two decades is that the gut microbiome does affect autoimmune disease almost every single audience disease nowadays we have literature coming out but what do our doctors always talk about at our conferences we talk about how there's something called gut dysbiosis where the bad gut bugs are outweighing your good gut bugs but they're not talking about nutrition they talk about how can we use our medications to um modulate the bacteria and of course we don't have a technology of that right now we do have studies showing oh this bacteria is lowered in this autoimmune disease or this um this bacteria is higher in this autoimmune disease but they always talk about how does medicine affect it we don't talk about nutrition that's why today's talk is so important what affects your gut microbiome how you're born were you born vaginally or were you born by c-section because if you're born vagina you get your mother's flora but if you're born by c-section you're getting the hospital flora your diet are you male or female your genetics is a very important role because your mother your grandmother your genes get passed down and it makes your microbiome as well have you had previous infections as well did you take a lot of antibiotics when you were younger are you stressed out all the time stress plays a role your sleep plays a role how old are you as you get older your generate more inflammation your microbiome changes and because it affects your microbiome it affects your autoimmune disease it's all tied in it's a cycle so gut dysbiosis like i mentioned earlier is um other your gut microbiome out of balance and that's been seen in lupus achilles spondylitis psoriatic arthritis rheumatoid arthritis sjogren's vasculitis and many other animals as well this is just a sample and it's been talked about in many prominent medical journals nature review um american college of rheumatology journals arthritis union general medicine this is not myth this is not pseudoscience this is actual in medical journals and the basis of affecting your gut microbiome is through short chain fatty acids short chain fatty acids affect your immune system so what are they their fatty acids are short chain okay they're made up of 10 or less carbons and what affects it what helps it is fiber dietary fiber that's why plant-based diets are so powerful because we're always eating fiber and fiber affects the bacteria at the gut in the best official way where it tells the bacteria to suggest short-chain fatty acids and short-chain fatty acids generate anti-inflammatory signals that's why plant-based diets can help prevent and potentially reverse autoimmune disease okay so it promotes territory cells which i mentioned earlier is anti-inflammatory t cells and inhibits nf kappa beta which is the signal in your cells that generates inflammation so that's why soy chain fatty acids are so important that's why fiber is so important and it's the same theme here plant-based diets plant-based diets plant-based diets and short-chain fatty acids not only affect the immune system they affect the lung they affect the brain the liver pancreas and i know chef aj you had doctors from all different fields on your show whether it be the sheriff's eyes on the brain or um uh dr vanessa mendez on the gut dr will be um matching diabetes talking about diabetes we're all talking about the same thing here fiber short-chain fatty acids got microbiome affects everything the gut brain connection the gut joint connection the gut lung connection these are all things that people doctors know about um at least doctors that are studying nutrition um and are plant-based they know about these things and your diet affects the t cell balance at the gut so diet affects your gut microbiome which she's talked about in the past few sites and then affects your t cells so when you um eat a poor diet it starts lowering or blocking your t regulatory cells okay your anti-inflammatory t cells and then it up regulates your inflammatory t cell your t helper 17 cells and it up regulates your inflammatory cytokines the cell cell signals your inflammatory ones and you look at 17 just an example and then it creates autoimmune disease okay and autoimmune disease just doesn't happen overnight audibly disease takes years to develop and that's why you see patients going from doctor to doctor because they have science early symptoms and their doctors ignore it and then it becomes serious then you start shopping around for doctors and doctors send you to specialist specialists and you never get an answer until five years down the road and studies have shown that lab markers are elevated in lupus 10 years prior to the diagnosis even rheumatoid arthritis and what does gut dysbiosis cause it causes a leaky gut or in medical terms increased intestinal permeability so when your gut's inflamed you have autoimmune disease or it gets out of balance you have leaky gut and it affects your immune system at the gut this is what this picture is showing and let's take a wider view here this is the gut here your gut immune system is right here powers patches also which is also um can be called the gulf as well and this is your circulation and your lymph system as well so when you eat um anti you're a pro-inflammatory diet you take antibiotics you have infections you're very unhealthy um it can cause inflammation and those inflammatory signals cause a leaky gut leaky gut goes into the immune system goes through your circulation and then talks to all the other um immune cells at your lymph nodes do the circulation as well so this is what this picture is showing also this is a very busy slide but this is the basis of this picture not only is the gut important so but so is your oral flora your oral microbiome so studies have shown and this is something that's well known amongst all rheumatologists that when you have something called periodontitis or inflammation of your mouth you generate some a bug called p gingivalis p gingivalis generates a enzyme called pad or peripheral adenosine deamness i think i'm saying that correctly it's a long word and when this is up regulated this enzymes upregulate you start generating antibodies in that that affect rheumatoid arthritis so that's why i always look at the mouth in my patients because i want to make sure the mouth is doing okay because if your mouth is sick and has a lot of issues like a lot of cavities you are at risk of getting rheumatoid arthritis especially have a genetic component to it as well and if you smoke you also generate um this pad enzyme as well which contributes to rheumatoid arthritis i always ask his are you smoking or have you smoked in the past because if you smoked in the past you also are a risk of rheumatoid arthritis so smoking is a big risk factor that can cause rheumatoid arthritis so not only the smoking cause lung cancer but it can cause a lot of autoimmune disease as well and rheumatoid arthritis is a major example of that epigenetics we're still on the microbiome here so epigenetics is your genes are not fixed your genes can turn off and turn off based on your lifestyle sure if you're eating a plant-based diet you're trying a lot of genes that can potentially give you diseases if you're eating right if you're exercising if you're stressing less if you have healthy relationships um if you did not take a lot of antibiotics in the past you're you're turning off the epigenetics um that can help you okay so there's something called histone the acetylase so when you decrease your histone deactivates you're decreasing inflammation this is what it's showing here when you're eating seeing this has some deodorant increasing information so we're able to turn off certain things and our genes to help it prevent disease and why is it so important or it's all ties back to food so if you look at this so why so why are we talking about this so we study this in rheumatoid arthritis it's in our journals and they've talked about this they've looked at different drugs that can help this of course there's no drugs that can help this right now but food we're talking food here's a chart of different foods phytonutrients and fruits and vegetables that are natural histone deceleus inhibitors we want to inhibit histone deceleus which can help our epigenetics so garlic cruciferous vegetables turmeric soy bitter melon all these things are so good for you keep eating them eat the rainbow we're going back to the same theme here let's talk about fasting next i love fasting that's why we met at the fasting escape chef aj uh because i love fasting it helps autoimmune disease and fasting can be hard for people that's why people say no thank you i'm fasting so negan journal medicine last year talk about the effects of intermittent fasting on health aging and disease and i'm talking about it because i'm talking about autoimmune disease and what what it does when you fast okay it it up it down regulates something called mtor mtor can be up regulated in inflammation so this is a molecule this is the pathway that a fasting effects this is the main pathway so when you're fasting also it increases beta hydroxybutyrate so when you have type 1 diabetes you do not want to be fasting because it increases beta hydroxybutyrate and when you have that type 1 diabetes you can increase your beta hydroxybutyrate and potentially cause diabetic ketoacidosis which will send you straight to the icu so you don't want to do that when you have type 1 diabetes so you don't want to fast but when you have other conditions fasting can be beneficial so the building blocks through mtor so what increases mtor i'm going to rehash this mtor increases inflammation we need mtor in the body okay but when you have too much of it it's not good so amino acids come from proteins glucose come from carbohydrates or refined sugars and it up regulates mtor and mtor can upregulate inflammation but you also need mtor to help build the body up so it's not something that's bad for you but when it's out of balance it's bad so how do you block mtor um so fasting can do it and when mtor is too much like i said earlier it increases your pro-inflammatory t-cells and it blocks your anti-inflammatory t-cells so t-r-t cells is a theme here we want this to be high because when it's high it can tell your um body to stop fighting infections when it needs to and can also tell your body to stop fighting itself to stop causing autoimmune disease we want that to be high here and antoine blocks that so this has been studied in different autumn diseases and rheumatology cereal arthritis intermittent fasting has a study it's helped psoriatic arthritis also in rheumatoid arthritis in the study from fasting to a vegetarian diet this this study also helped rheumatoid arthritis patients as well so fasting and intermittent fasting can be pretty effective it's not um the solution because the solution is your lifestyle and what you eat but it can be a jump start to helping you so in summary autoimmune disease is a very complicated topic it's it's created partly from genetics and partly from your environment nutrition plays an important role for autism disease and the gut microbiome is tied directly to your immune system fasting can help and can decrease inflammation it's important to eat a plant-predominant diet for an anti-vibratory diet and a great option is a whole food plant-based diet i'm a big advocate for hopeful tempest diet because you're eating all the anti-inflammatory foods all the time you're not really introducing pro-inflammatory foods so future discussions we can talk about that weren't touched on this session lifestyle factors says sleep stress exercise environmental toxins um infections and trauma as well childhood trauma of bullying but there's other things that can help you that we don't talk about lifestyle medicine that's why integrated medicine can be so helpful this is the other part this is what i'm studying also because i'm trying tying everything acupuncture tai chi of chinese medicine reiki aromatherapy deep breathing mind body medicine ayurveda botanical medicine these things and balance with allopathic medicine can be so helpful another thing i'm studying in functional medicine right now functional medicine some people say pseudoscience some people say it's helpful lifestyle medicine is a core component of functional medicine there's value to all these different types of fields you just have to tease out what's important what's not and what's real and what's has evidence of it so that's the basis of my clinic and my foundation as a doctor i'm located in newport beach my website's dr lifestyle.org i see patients all over the usa and internationally just reach out to me my social media is my honoring md on instagram facebook twitter and tick tock i dance on tiktok so thank you very much chef aj and that's my talk wow that was amazing that they're just you know one of the things i hear about a lot from people is hashimoto's is that something you deal with a lot is that an autoimmune condition as well yeah that's an autoimmune disease of the thyroid that goes to endocrinologist i don't treat that in my clinic but as i go through my integrated medicine training um i'll probably be starting treating that as well because you can use um the theme that in my clinic is the same theme for thyroid disease and also there's certain herbs and supplements that can help that as well and that's something i'm learning integrated medicine in the american college of lifestyle medicine you don't like about herbs and supplements and these can be very helpful and and through my second fellowship at university of arizona i'm learning what are the side effects of supplements and herbs and how to balance that out with medications how to interact with medications right because one of the things because that because you mentioned fasting and one of the people that we have on the show quite frequently dr goldhamer says that for people with that to avoid gluten that there seems to be some link with gluten yeah so that's a great talk um that's a great subject as well so gluten is something that's not recognized by rheumatologists as something causing at least rheumatic disease but there's data for that and when you study functional medicine when you study integrated medicine when you look at literature gluten does cause something called a leaky gut okay i'm sure you've heard that chef aj as well um and nikki gut does contribute to autoimmune disease and there's dr fasano at harvard he's he studied um he's produced a lot of literature on gluten and the leaky gut so gluten it's a it's a double edged sword here because the people that live the longest in the world that are the healthiest are eating gluten so i don't tell all my patients to avoid going because i put patients who remission even in gluten so i think it's very patient dependent when you eat your wheat when you eat certain carbohydrates your complex carbohydrates the healthiest foods that we eat they have gluten in it and people generally do fine but certain people can't tolerate it so that's where elimination diet and individual medicine comes into play right so many people are saying what an incredible presentation and i was especially interested in the part you did unfortunately we're done with the interviews this year for the truth about weight loss summit but the part about the the link between obesity or being overweight and autoimmune disease because it seems to be linked to just about every disease and and yet as hard as it is to lose weight if if that's what's gonna it take to get rid of your autoimmune disease i think it would be worth it because people with autoimmune disease suffer terribly oh yeah so obesity when i see an obese patient that is not eating right the first thing i tell them is you gotta lose weight if you don't lose weight i can't take you off your medications you're gonna flare frequently so weight loss is the number one thing it's inflammation is the foundation to almost all diseases that we have cancer autoimmune disease um heart disease it's all inflammation so if you decrease the obesity though and you increase weight loss i mean decrease obesity increase weight loss you're giving yourself a chance to get off medications so myself i have put patients to remission on a plant-based diet and we've kept my patients there even off medications i know there are different um patients out there that have done it themselves as well through different diets out there but whole food plant-based diet is the foundation of my practice and then we go from there because not everyone will go to her mission on a plant-based diet and there's so many um mysteries out there right now i'm sure you've heard the lectin plant paradox diet from dr um steven gundry i don't believe in that i think it's overblown however legumes can be an issue for some patients and um there is a study on lessons out there in 2013 which i will talk about in the future and it does generate some information at the gut but this is one study out there there needs to be more studies out there um lectins when you soak it you kill off the lectins so lectins is not a huge issue i think it comes down to individualized physiologies and when you have autoimmune disease your gut is already out of balance that's why some people can't tolerate the legumes the beans and that's why some people can't eat a fully whole food pan besides because the gut is already issue already but most people can tolerate and get better that's wonderful i'm so happy that you're doing that so doris says what about alopecia areata yeah so alopecia areata is uh can be an autonomy disease affecting the hair i have only seen it once and when i did my pediatric rheumatology training at lowell university i'm not an expert in it but because i'm learning integrative medicine i am going to be learning about different supplements and herbs that can help that so if you follow me on social media i can give you more information in the next year and i'll probably be seeing patients with alopecia areata in my clinic because usually these patients go to a dermatologist and once they if they don't get better by dermatologists they go to rheumatologists so i'm one of the doctors that do treat it but i haven't treated my clinic yet cool um people are asking about nightshades is that something you ever deal with telling people not to eat them yeah so that's a great talk as well so nice shades is there's no scientific evidence right now that nightshade affects autumn disease and arthritis some people i do believe it can be an issue for some people because i do see patients coming and saying oh doc so light shades are a group of vegetables that um are includes eggplants um tomatoes potatoes bell peppers i think some chili peppers as well um and they have a certain component of them that cause issues for certain patients but there's clearly no scientific evidence of this i tell my patients if you do notice an issue of it afford it but i tell them make sure you're not eating oil salt or any other foods when you're eating nightshades because if you're eating those foods those are inflammatory foods so it might not be necessary those night shades are causing you an issue uh so it's very rare um and i don't tell my face to avoid it unless we have gone to a whole food plant-based diet already and they're still having issues then we start teasing out the individual um in physiology physiological um problems of food yeah you know your talk was so good i got a bunch of donations today so i need to thank you yeah i need to thank queen of aries thank you so much thank you for having me well no it's been my pleasure i mean how long would you like to go because you know whenever we have a doctor there's like a lot of questions some of these people probably would benefit from consults if they have the disease themselves but this is just a general question from cat what came first the obesity or the autoimmune disease yeah so everybody's different you can't be skinny and have a lot of diseases i have patients that are underweight or normal weight that get autoimmune disease so that's always a great question you know when it's when you talk about the gut microbiome when the gut is out of balance get dysbiosis that's the questions that us doctors are always asking rheumatology what came first they got dysbiosis or the autoimmune disease and right now we don't know i believe it's both because there's studies coming out now that um because you have genetic markers that are risk for autoimmune disease like ankylosing spondylitis your gut is already out of balance and i think it plays a little role in genetics and your unhealthy lifestyle just makes it worse and so i think it's both it depends on the individual so when you are getting uh going overrate already your gut is already getting out of balance and then autoimmune is a risk factor already but you cannot have autoimmune disease if you don't have the genetic risk factors that's why not everyone in the world has autoimmune disease because they don't have their genetic risk for it right okay so maybe the genetics loads the gun but but having the lifestyle condition of obesity might pull the trigger for something exactly i i think dr dean ornish came up with that right dr s i forgot which uh doctor came up with that quote but yes gen x always said genetics loads a gun and uh lifestyle food uh pulls a trigger nice so there's a question from jay do you see patients with renault disease i do so ray knots is a disease that i do see in my clinic uh reynolds is basically the fingers term white blue red and basically an autonomy so when you you can get primary reynott's which is not an autoimmune disease where your vessel spasm in the cold it can be in the cold and basically it turns blue but when you have an autoimmune disease you're there's inflammation at the vessels that cause rain knots and raynaud's disease can be a risk factor it can be a symptom of different autoimmune diseases as well it can occur by itself but it could be from vasculitis it can be from lupus or something else or systemic sclerosis great sorry i'm typing answering the chat asking people about um to keep it on topic with autoimmune diseases and so there's so many i can i tell you i can go another 15 minutes okay great all right let's see uh this one isn't like i don't want to get to this that you know we've got questions about vaccine and that's so that's like a dangerous territory to try to i i covered the code vaccine i covered that in my uh facebook um i can cover that i i give a pretty objective viewpoint of it yeah because kay says what do you think of the cove vaccine as a rheumatologist and a rheumatology patient i also have spon arthritis that's such a hard word to say managed with a sugar oil salt free diet but i am nervous about getting the vaccine at this stage so that's it yeah that's excellent question so let me just say this um i'll be talking about this on my social media as well so vaccines can give autoimmune disease it's known in the literature but it's very rare so that's an objective viewpoint okay i'm not gonna get into politics or anything like that so general vaccines can give autoimmune diseases whether it's a hepatitis vaccine your um hpv vaccine it's it's rare but it's been proven and it's called the asia syndrome i'll be talking about that as well but in general in the american college of rheumatology we recommend vaccinations for patients because that is so rare as far as the cold vaccine is concerned this there has been no studies that have been done on autoimmune patients getting the cold vaccine the cold vaccine studies from the pfizer and modern vaccines were done on patients that had heart disease diabetes or healthy but they were not done in autoimmune disease patients or patients that were um taking like injection medications for autoimmune disease so we don't have studies for that so i can't say what will happen but in general if you look back at the previous vaccines um patients did okay on them i myself being an autoimmune disease patients have gotten the first shot three weeks ago i'm getting my second shot and tomorrow and after my first shot i just had some shoulder soreness and i did fine um i'm kind of worried about the second shot because that's where you get a little bit more symptoms um some fever some chills um some headaches but that's expected because your body's generating an immune response you want an immune response um so i would say in general it's up to you you and your rheumatologist there is no right or wrong answer here when you get coveted you can also get autoimmune disease and when you get cold you can flare viruses can cause autoimmune disease where they talk about ebv cmv or are you talking about herpes virus um hepatitis and covalent i saw a patient in my clinic having she got coveted and then she ended up getting arthritis right after that so now i have to train for rheumatoid arthritis um you can get lupus from viruses so because so it's a double s store here if you don't want the vaccine you're a risk of getting covet and when you get covert you can flare and can make your autonomy disease worse or you can get a new autoimmune disease when you get a vaccine i think you're much less likely to get an autoimmune disease and when you get the vaccine you are much less likely to flare as well um but it's not 100 bulletproof either one so you got to make it um informed decision and on discussion with your doctor great thank you so a lot of people like colleen are asking about vitiligo and sorry doopy trend i'm not terrible pronouncing yeah and can a whole food plant-based diet help i have not seen it help i have not seen too many of these i mean i've seen vitiligo in my clinic but these patients usually had something else going they had lupus rheumatoid arthritis and vitiligo is a dis uh more of a autumn disease uh that is seen by dermatologists so i really don't see it by itself in my clinic and i have not seen it improved from a whole food plant-based diet but that's not to say it's not possible and for duper trans contracture that's more of um your skin is sticking in the the fascia the conduction is thickened in the hand and i personally have not seen it improve in my clinic either um but everybody's different just because you have one autumn disease doesn't mean the other person with autism cannot get better everybody's different because you it's not only diet that is a role here you have to understand um that environmental toxins is important how are your stress levels are you exercising and how strong are your genes if your genes are so strong that sometimes diet doesn't help as much as the person next to you so that's why some people get honest some people don't and it's all the genes that are passed down from your grandma your great grandmother that's why the food you eat today will affect many generous to come because of the epigenetics there was a um i don't know if you read the book ecb disease by dr william lee um so there was a study in there or was that in dr greger's book i forgot which one but there was a study on rats and they put a set of rats on the whole food plan they started a high fiber diet and they put the other set of rats on a hot on a high uh fat diet like a keto diet and they found that after nine generations of rats the rats with the on the high fat diet last lost all the good bacteria so your the way you live will affect your offspring and your future generates to come so that's why i keep eating a whole food plant-based diet right because even even if somebody had an autoimmune disease that couldn't be helped by eating a whole food plant-based diet it's still going to prevent heart disease and all the other things that could happen to you so there's no reason not to do it even if it didn't help with one little thing yeah i mean because because like people you know i get i get you know when you're on social media you get these people and like they'll write things like because you know i was born with asthma i i mean everybody smoked in my house until i was 18. there were three smokers come on so you know i have allergic asthma but i don't take medicine i'm fine and people will write like well you know if the whole food plan-based diet work you wouldn't have had this that's not that doesn't mean yeah you know it does exactly chef aj it's it's really a balance you can you can have us you can have a very clean household that never smoke you still get asthma because there's things in environment there's pollution pollution increases the risk of rheumatoid arthritis we know that and there's a new study that came out from patients uh the people in the military when they were burning when they're exposed to burning pits and when they're burning things they also have more rheumatoid arthritis if you're abused when you're younger if you were childhood bullying um studies have shown that you have more risk for rheumatoid arthritis as well so it's just not about eating right eating right will decrease the risk of different diseases but it will not eliminate it for everybody everybody's different right so that because uh tencia said actually was newly diagnosed with ra will the diet help i mean it's certainly worth a try because it's free yeah so yeah so it's i i would recommend you try a whole food plant-based diet if it doesn't work then you have to at least work with a whole food plant-based doctor so they can get you on the right track and they can play around with the diet because i have patients you know hopeful peppers that may not work 100 all the time like and then not put them to resolution and then but there's supplements there's medications yeah but even if the whole food plan basically didn't work for a specific disease it's not like going on keto or the standard american exactly gonna help no you only make it worse yeah no never go on the keto diet don't go on a carnivore diet because these things will negatively affect your gut microbiome and your gut microbiome is so important all there was a new study that came out from a keto basically on a keto diet their gut microbiome was um severely um affected in a detrimental way because of the high fat diet so even if okay so i have i've had patients who come to me saying they want to keep that they got better right but i'm thinking long term so you've you've you've probably heard of story or oh people say i had tattoo diabetes i want to keto diet and i got better but what does um pcr say what do a lot of doctors say you have to look at the long term data just because you get better a little bit better from a keto diet doesn't mean long term you're not going to get worse again you're you're pretending yourself for heart disease you're sending out cell phone for diabetes all these different things one of the reasons why some people get better on the keto diet short term is because you're eliminating processed food processed food is the number one contributor to autoimmune disease you're in limited refined sugar you're letting maybe dairy um your living um was it uh chips cookies all these things and some people that's all they need to eliminate and they get better but because they go straight to a keto diet they think the keto diet was the main thing or a paleo diet they think because i went to a period i got better but maybe if you eliminate this processed food you would have gotten better already so um so it's not just like a keto diet is the answer or paleo diet that's not it and that's why people get it wrong absolutely it's never the answer parker asks why do people which trojans have trouble swallowing and does it affect the kidney and the liver yeah so sjogren's is a systemic autoimmune disease just like all the other army diseases i treat and just by systemic i mean it affects different organs in the body so strogans is an autonomy disease that attacks the um that can take the salivary glands the mucosal gland attacks the lacrimal glands of the eyes where you have trouble tearing you have trouble uh fruiting saliva and saliva is so important to keep your teeth healthy that's recommended if you have strogans to see your dentist frequently and people have trouble swallowing because you're not getting saliva and sometimes that can affect the swelling as well strogans can also affect the lungs you can have trouble breathing it can cause inflammation in the lungs they can give you arthritis and give you um rashes as well so sjogren's typically it's known as dry ice dry mouth but it affects so much more nice this is a actually a really good question not that other ones weren't really good but i like this question from deborah which is how do we know if we are really in remission if we are feeling good can we really not be developing the joint damage yeah that's a great question uh a study just came out i think in the past six months uh i think it was on rheumatoid arthritis and just because a patient does not have any clinical symptoms does not mean their bone is not being chipped away um so there was a study on this i don't remember the detailed study but i remember the conclusion and basically the patients they looked at patients that were remission and some of them were still having radiographic um damage still even though they were remission so that's why i always tell my patients even though you are in remission you don't have any joint stiffness you don't have any joint pain you still have to go see your rheumatologist or your doctor every so often at least every three months because you can have something in the labs that's brewing or you your x-rays can just be showing disease still so you want to work very closely so there's some people that say they're remission and they don't ever see the doctor again i think that's very dangerous because there's disease such as lupus where you have to get labs and you can only sometimes you can only tell from labs where their lupus is active wow so when you mentioned salt before people were asking well what about things like miso and soy sauce and coconut aminos and those kind of things yeah so i would say salt in excess is very inflammatory everybody's different some people have to cut out salt completely some people can eat a little bit of salt so everybody's different um i notice when i eat a lot of salt it's very bad for me so even if i'm eating vegetarian sushi i don't eat i don't touch the salt the soy sauce soy sauce is a very processed okay um i would say even sea salt himalayan salt um i try to avoid i just try to cook without salt as much as i can because once you cook blend your taste buds will adapt to that kind of cooking um once you cook bland everything tastes grand exactly if people just knew if people would just get over themselves in the hump and just do what dr goldhamer says eat sos free every meal is like delicious you can actually it's like if you've smoked your whole life you can't taste food you know it's funny because i i used to work with a couple of chefs at different jobs different restaurants but only two actually smoked and they had the worst tasting food because they couldn't taste because their taste buds were literally being burned every day and their food was just not very good they used too much pepper because they couldn't taste their food and it's like when you use salt you can't taste what food tastes like and until you stop that addiction you don't know how good food really tastes exactly that's why when people they are they're omnivores and they go hopefully that they they don't they they have a hard time adjusting because they're not used to eating that that's why i love fasting because when you fast like for 24 hours your taste buds start adapting so even um something that doesn't taste that tasty you can taste all the nutrients in it you can taste all the flavor because your taste buds have reset after fasting um so i would say everybody's different you some people can tell you some coconuts you know some soy sauce but in general i avoid as much as i can you know my feeling is if you're eating good food you don't need to adulterate it with sugar oil and salt exactly the thing is is it's such an addiction that people just they can't stop and i get it because for some people it can take just a couple days some people can take a couple months but once you're there because the thing is is you know people that don't eat the salt like dr verma dr or dr goldhamer and they do you know dr goldhamer for 40 years we wouldn't be eating this way if it was a punishment the food tastes better but until they you know i'm i'm very passionate about this can you tell me yeah no no i i'm on the same way like you i say try go sos as much as you can um and then you know we i always go back to your theme try to eat the way we did thousands of years ago they had this egg from the natural tree from the floor um people didn't really add all these refined things into their food back then all right well i know you have to go in a minute so just one more question because people keep asking is fibromyalgia an autoimmune disease yeah so that's a great question uh fibromyalgia is not an autoimmune disease um it's a it's a disease where you're hypersensitive to pain where when you can get other symptoms such as um brain fog and all these different things but it's a disease that is your central nervous system the pain receptors are hyperactive for whatever reason i don't think we have the complete answers right now you know research needs to go into it but conclusively we can say that right now as the research shows it's not an auditing disease but i can't say that in 20 years it won't change um but across the board across all rheumatologists we know it's not an autoimmune disease and we the reason why i say that is because we traditionally we treat patients with antidepressant medications with fibromyalgia um like um gabapentin duloxetine and lyrica and patients do get better from just antidepressant medications or just pain medicine or sleeping right or exercise does help with fibromyalgia so um there's other ways to treat fibromyalgia hopefully plant-based diet is definitely helpful as well because your gut microbiome is out of balance as well in fibromyalgia so i treat fibromyalgia differently than a typical rheumatologist am i and i treat disease differently than a typical rheumatologist because the typical rheumatologist and musical doctor you'll go to the clinic and you'll basically talk to them and they'll send your diagnosis your symptoms and they give you a treatment and bye-bye you're out the door but that's not the way i practice that's not the way my wife practices in my clinic my wife is a primary care doctor she's lifestyle medicine trained and we go over your whole spectrum your diagnosis your nutrition your stress your exercise and um and integrative medicine i talk we talk about that as well mind body medicine acupuncture all these different things and um i know you recently had dr dysinger on your show he's a good friend of mine um oh yes he's the best oh yeah he's awesome yeah we talked together um we had dinners together back at melinda he's another great resource and that's not the way these lifestyle medicine doctors like me and my wife and dr dyson treat patients you know we have and in our model at dr lifestyle we we are out of the insurance model because we we want to give our patients time and patients can contact us after hours as well and we come to our client it's a relaxed visit and especially with my wife's model for primary care she spends an hour two hours on visits with patients so you get a complete care so it's very different than your average doctor wow i know i said one more question but i we haven't go okay good well we have a we have a physician watching who is an emergency room physician who is going to be board certified in lifestyle medicine dr marino wants to know what is the autoimmune protocol diet yeah so the autumn provo diet i think that was developed by um multiple sclerosis patients um i think that was one there's something called the walls protocol that's very similar um and this patient had muscle sclerosis who basically put her disease to remission on a paleo diet so that's what the autoimmune protocol diet it's a paleo diet so that's why the paleo diet is so popular because some people do get better on the pale diet um but you know the whole food pants diet can also put muscle sclerosis and autumn disease which is to remission i don't know if you've heard of dr sarai static she's a good friend of mine as well well she's going to be on the show tuesday i'm talking about her new book and brooke goldner i think next friday talking awesome see i've got you guys covered whatever the disease i'm getting you somebody awesome yeah vocal owner's another great resource um so dr sarai stanczyk is a infectious disease doctor um who won a whole food plant-based diet and put her multiple sclerosis to remission um so there's different ways to go about it but in general the healthiest okay so my so the pale diet does work for autism disease i'm not going to deny that because um there are a lot of patients that claim that have happened and a lot of doctors that do that but it's not the answer the reason why i say this is the reason why i say the whole food plant-based diet is you have to try that first that's the key answer is we have to go back to the foundation we have to go back to the blue zones and people that live the longest who are the healthiest people in the world you know these patients are eating a plant predominant diet they're eating grains they're eating a lot of fiber and you want to tend towards that you don't want to go to a pale diet because you're cutting out a lot of grains and grains have a lot of fiber and it's the healthiest and you want to live the longest too because just because you put an allergies disease to remission doesn't mean that you can't develop other diseases you can also patients with autonomy such as rheumatoid arthritis lupus they have a higher risk of getting heart disease lupus patients have a 50 higher 50 times higher risk of getting a heart attack than your average person and what are they eating out pale that they're eating a lot of meats a lot of chicken and a lot of um other meat products and that's why you don't want to go on a pale diet okay when you go on paid you can go on remission but you eat you're cutting out processed food and but that's what a whole food plant-based diet does you cut out dairy too that's what hopeful puppy diet does but you're kind of a lot of fiber so you i do not recommend the pale diet always go to a whole food puppy study thank you i promise this is the last question this is a fun one because everybody wants to know every guest what does doctor you eat in a day yeah so i i love eating oatmeal uh with blueberries i just uh berries in the morning i love eating um smoothies in the morning as well i love putting kale spinach and whatever frozen fruits and vegetables i like adding flax seeds turmeric powder into my smoothies i like chia seeds to it as well um i can't eat you i can't put too many vegetables how to balance out fruits or else gets too bitter for me um i eat my wife's cooking also so um my wife uh dr mandela she likes to cook with tempeh we do some asian cooking as well so i mean my parents eat out a lot so i don't live with my parents but when i eat with them there's eating out there's a lot of oil in it so i tell them try to decrease the oil salt in my foods but there's so many good foods in asian cooking there's bok choy we eat mushrooms black mushrooms enoki mushrooms um i know you talked about miso so i do eat miso soup as well um you know i saw i do okay with it organic tofu edamame um i mentioned tempe already so there's just a lot of different foods out there that you can eat on a whole food pancake diet even though it's asian there's a i think there's not too many asian whole food peppers doctors out there and wait do you know dr collins zoo i do yes he's a good friend of mine we met oh my god you guys should go into practice it could be zoo and you or you and zoo i love that i haven't thought of that because he's a chef he's he's one of the guests on the summit he actually did a cooking demo yes yes yes so so yeah he's he's one of kind there's not too many chef doctors out there so he's great i think he has a stomach coming up too as well but um yeah there's so many good um cooking asian vegetables out there asian fruits you have bok choy you have chinese broccoli if you go to an asian grocery store there's a whole eye of just asian vegetables out there and also you have asian fruits dragon fruit mangosteen things you can't get in america like mangosteen it's so good i always go to asia i always eat that and like she can get it here but it's always tastier in asia when you get it from the source so there's so much good food out there you just have to explore different cultures and there's so much variety what did you grow up eating uh-oh can't hear me now this happened the other day with dr mcdougall oh my this is so weird i bet you guys can hear me can you guys hear me but not him is that correct one second oh now i can hear you again do you know what just happened do you do you know what just happened because that's oh had my bluetooth and it turned off because we were on too long i'm so so you know because this happened the other day with well this is a sign from the universe we need to stop i was just curious what you grew up eating if it was different oh yeah no i grew up the second american diet um so i would eat fried food all the time you know the asian um diet you know back then traditionally it was very healthy um like dr campbell his book like the china study back then people in china ate a very very healthy diet but until the standard american diet came along um and like this i started in a standard american diet um i grew up in america i was born in california so i grew up eating mcdonald's uh fast foods um frozen foods uh popcorn chicken uh pizza bites lean cuisine even and when we ate out with asian food it was always very processed oily fried um a lot of fried um lobster beef and broccoli you know all the all the stuff that is pro and flat material i ate it and eventually caught up to me when i went on my high protein diet wow well i'm glad that i'm glad that you're eating well looking well and feeling well now and just tell people not to be afraid of rice i eat rice and i eat white rice and i'm not ashamed to admit it it's delicious yeah i know that's outpatient you know eat rice you got to eat carbohydrates it's always refined carbohydrates so healthy for you and you lose weight naturally i lost 30. i know you had your own weight loss story too your chef i just seen your before and after pictures it's amazing but i also i've lost 30 pounds i lost 25 pounds in the past and one year i lost 25 pounds or a year or two so i feel i weighed less than i did in middle school so i feel the best ever yeah i weigh less than i did in high school it's amazing yeah amazing and every time people bash white rice i'm like well yeah talk to with dr walter kempner he reversed diabetes with it so yeah yeah well i'm sorry you know it's just you're so fun to talk to and you're such a wealth of knowledge maybe have you back with your wife that might be kind of a fun show doing you both together you know oh yeah for sure and then maybe we could talk about uh yeah we'll talk whatever we want to talk about and then in the future i can talk about my integrative medicine because there's so many ways to treat autoimmune disease um not just food there's maybe you guys can even make a recipe together in your kitchen it'd be fun we'll do a show with the whole family oh yes we can do that even with our dog yeah no i love the dogs are always welcome anyway i know i kept you way too long but thank you so much this was just a wonderful presentation oh yeah thank you so much jefferson i think what you're doing is um so healing for the world there's nothing really out there like what you're doing and being as a chef you're coming from a different perspective and being a patient yourself um so thank you so much for inspiring all of us and um and if you if you guys aren't following me just follow me on my social media i talk about science a lot and hopefully pepe's diet and autumn disease right absolutely well i feel like i want to be don king but for vegans i want to promote all the great people that are doing great work like you so that one day i can just retire and i also want to thank all of you for watching another episode of chef aj live please come back tomorrow when we have two shows the first show and they're both cooking demos is maggie niola she is a registered dietitian at pcrm and then at two o'clock jill dalton's going to be making gluten-free bread from her brand new book thanks again dr you you are fantastic

Channel: CHEF AJ

Views: 39,334

Keywords: chef aj, chef aj live, chef aj recipe, vegan, plant based, plant based diet, diet, vegan cooking, vegan kitchen, plant lifestyle, vegan life, coach, author, podcast, food addiction, healthy, health, nutrition, weight loss, weight loss recipes, how to lose weight, 2021, autoimmune disease, disease, doctor, how to fight autoimmune disease

Id: g26h6FF7gX0

Length: 94min 25sec (5665 seconds)

Published: Sun Jan 10 2021