Why “Your Labs Are Normal” But You Still Feel Awful - Dr Gabrielle Lyon

You had two original pillars of health which were eat and exercise but then you had to add a third one. >> I did. >> The third one uh was environment and is environment. I do you have time for a quick story? >> Yeah. Yeah. I graduated medical school obviously and then did my fellowship and when you finish your fellowship and go into private practice you kind of think you know everything and I was convinced the key to health was diet and exercise. It was all lifestyle and I was wrong. I had this patient very successful patient CEO of a major company. She was a female as she was doing everything she was supposed to diet and exercise-wise and she was feeling terrible and also gaining weight. I said, "No, no, no. It's definitely diet and exercise." And in fact, a handful of years later, I had to call and apologize because it wasn't just diet and exercise. She had significant exposures that really affected her health and wellness. And I think these exposures affect a lot of people and um you know at the time when I was beginning my practice it wasn't common and we weren't even thinking about it. >> So is it getting more common? It the talk of complex illness caused by mold, gut health, BPAs, heavy metals, lime, parasites, like this whatever this world is >> seems to be kind of gaining speed. Is this because more people are getting it or because we are detecting it more uh effectively? What do you think's going on there? >> It's both. We have more exposures than arguably we've ever had now with microplastics. And we are getting better at acknowledging and detecting it, but we're still not there. So, for example, mold, mold exposure. This is we hear a lot about it now in terms of buildings with mold or locations and this musty smell. And often times we think that it it really doesn't affect people. However, there are certain people that will move into these buildings, walk in there, break out in a rash, have brain fog, fatigue, feel terrible, and it's this exposure to mold micotoxins. But the reality is for a testing perspective, we don't have validated tests for mold. However, I I think it's really important that we test for it. But it's not like you walk in and you do a a blood glucose test and there's this diagnosis of diabetes. >> Cut and dry. We don't have that. >> Well, no, we don't. Well, you do get stuff like the total talks test. Now, obviously, um, sort of peering under the skirt of what my last two years has been like, this is a a topic of particular interest to me because this is what I've been battling through. But since releasing the health vlog thing that I did a couple of weeks ago or a couple of months ago now, I guess the number of people that reach out and say, "I lived in a house that had mold or I had parasites or I had I'm dealing with lime or I'm dealing with leaky gut or I had, you know, [ __ ] H pylor." Um, this yeah, like multi-system challenge. Um it really is kind of like a silent epidemic and it doesn't matter which angle you come into it at. Um but yeah as you say you can say you are a mold person like you have been in a house with mold but you can do stuff like a total tox test right which comes back and you can see wow those numbers are right off the chart. Um, but yeah, I the main sort of takeaway I think that I've learned from the last couple of years is how many people are living a life that they thought was just getting older or a natural byproduct of I'm just tired. You know, people are tired. Like people get tired all the time. Like yeah, my mood maybe it used to be a little bit high when I was young, but who doesn't get a bit more moody as they age or whatever. you know just chalking up to entropy something which can be explained by environment >> you know there's a a component to what you're saying that I think is really valuable and there's a level of diagnostic uncertainty and people go to their doctor and get all of these blood panels done and everything looks quote perfect when the reality is these are just a series of biomarkers that we're aware of and that are important and when I say biomarkers I mean testosterone and thyroid, things that are common and we need them to be functioning well. But there is now a whole host of other influences that really end up affecting the way people show up in their lives, the way that they think, the way that they function, their mood, their energy, and often times it's unexplained. or what about this uh arthritis or myalgas or joint pain this inability to recover the way that they used to. We are seeing a lot more influence from the environment whether it's mold whether it's lime parasites I mean the reason that I got interested in this was because I started my practice I finished fellowship started my practice in New York City started with celebrities and um professional athletes and as much as I loved them as humans it wasn't it wasn't my calling then walks in the first operator and when And I say operator, I mean seal. This was a guy who'd been all over the world, came to the office, and his blood work looked weird. And he had been to all these other places. So he had just transitioned out, been to the Mayo Clinic, had been to the Cleveland Clinic. And oddly, he felt terrible. Even though his testosterone was optimized, his sleep was great. He was exercising and he had some weird inflammation of markers that showed liver elevation and just some really non-specific type stuff. And it turned out that he had a weird parasite called shistaminasis that he had gotten from swimming in some obscure river and ended up really affecting him. Here's this big dude who was uh becoming anemic and also had issues with his liver. Had we not caught that, I hate to think about the downstream effects have having gone undiagnosed. >> What would have h what happens if you leave a parasite undiagnosed and untreated for too long? >> Well, for things like shistanasis or antimiba which are really common, it can it can end up damaging your liver. And that is a major major problem. >> How many people do you think have got parasites that don't know it? >> A lot. And a lot more that are going undiagnosed because parasites are not just in isolation. So for example, you don't just go eat sushi and then get giardia. You might go eat sushi, which I hope no one does, and then you go to the bathroom and you're living with someone and that person goes to the bathroom and then they get it or you get your >> Slow down. Slow down. First off, >> I'm so sorry. >> No one should eat No one should eat sushi. >> You I never recommend eating raw fish. Period. End of story. And also rare meat either. >> Too many parasites. >> Yes. how that's more common than people would realize. >> Yes. Um in fact globally parasitic infection especially these worms hookworm, whipworm, uh round worm, they are one of the leading causes of iron deficiency anemia which is extremely common because they cause this chronic blood loss that's slow. So for example, you go to your doctor, everything else feels fine but you're feeling fatigued. Maybe you're having a little diarrhea or just something that seems very non-specific and it turns out that you have a helmet or a hookworm infection. It's much more common that you think. And because food is all globally sourced now, it's not as if we're going to this fancy restaurant and because we're at this restaurant, it's safe. It It's just not that way. >> Okay, that was the first slow down a second. the the sushi. The second the second slow down the second thing, >> the impact of parasites being left for too long is very very intense. And if you go and have that and then go to the bathroom, your the people that you live with can catch your parasite from you going to the toilet and then them going after you. >> Yeah. So, I found this out the hard way. Not for me personally, but I found this out from uh a patient of mine. And what happened was this woman would seem to continue to get these cyclical parasites. She was symptomatic. And these symptoms were not crazy. They were abdominal bloating, a little bit of diarrhea. It didn't matter what she ate. We would treat her. She would have an infection, a worm infection, you know, you pick it. And then a few months would go by and she would catch it again. Meanwhile, her husband was totally asymptomatic, but we ended up having to test him too because what we see often is one partner has symptoms and the other partner doesn't. And that partner who is untreated continues to give it back to the other partner. >> How do you know it's from the toilet? >> Well, it's one of the most common places. Could be toilet. It could be sheet. >> Wow. Okay. So these parasites will find their way into the human body however they can. >> They can and when someone is feeling uh again these non-specific symptoms, one of the first places that we always look is to a parasite. And I will tell you this and this is quite disappointing is the way that we test for parasites is standardized and it's called a PCR test. Someone goes and you do a stool sample, maybe you do a 3-day stool sample, something of that sort. It is supposed to catch nearly all of it. It's very sensitive. 95 to 100% sensitivity. That is not what we have found. And you know, I've had one patient where we would continue to do these PCR testing, but they were very symptomatic and we couldn't figure out why he wasn't coming back positive. We sent him to an old school paracytologist where they do a rectal exam, take a stool sample, look at it under a slide, and it turned out that he had a handful of worms. I know it's gross and disappointing, but the reality is while we think that these parasites are easy to test for, and in theory they should be, I and many other providers are not seeing that in real life practice. What's a better approach to testing if somebody wanted to do that? >> Microscopy. And again, this is not the standard of care. So, an infeious disease doctor listening to this would be like, "No, it's PCR testing. You're going to get it and you're going to find it." And the reality is we don't see that. We see that if someone is still symptomatic and also doing multiple stool tests where it's negative, you have to take a step back and think, okay, I hear that your test is negative. But the reality is when it is done in this old school fashion, which is under the microscope, things show up and when they show up, you actually can treat it appropriately. What are some of the other places that parasites are coming from that uh outside of sushi and the toilet bowl or sheets of your infected partner? >> Animals, dogs, giardia. Unfortunately, there's many people that love their animals, right? Of course. But when that dog is licking you in the face or sleeping with you in the bed, it is oftent time a vector for some kind of parasite. >> Okay. So, treat the dog first, the husband second, and yourself third. Is that the >> That's That's about right. Yes. >> Okay. The priority. All right. Um, dig into the mold stuff for me. Obviously, I don't know whether it's going to be as common outside of the US. Uh, I I get the sense that the US is particularly bad because you guys build your houses out of timber. You decide to build them out of organic material and it gets wet and hot and wet and hot while it's being built. So like the skeleton of this building that you live in is now primed to be able to get to to produce mold. And then there's leaks and water ingress from outside and cracks. if something gets cold and there's a bit of water and then it cracks open and then water can leak in and then it gets in there and then it gets hot and wet and all the rest of the stuff. Um, in the UK it was never anything that I'd heard of. Um, but our houses tend to be built out of brick and our country doesn't get as hot. So miserable in terms of weather, but I guess good in terms of stopping the spread of mold in quite the same way. But yeah, what have you been seeing from the environmental exposure on the mold side? >> Mold is really tricky. parasites. If you talk about things that go underdiagnosed or this idea of complex illness which is again multiffactorial and context dependent parasites you can test for even if you miss it there are ways to test for it whether it's PCR or microscopy and then of course symptoms and then thinking about where this person traveled to or if they were making out with their dog. Number two, mold is a real challenge for people and there's a number of reasons to why that is. I will say that according to the American College of Medical Toxicologists, which these are in the group of individual doctors that look at the environment and these exposures, there is according to them, there's not really a diagnostic criteria for mold, which >> what does that what's a diagnostic criteria mean? meaning um meaning uh if I were to to state this simply, we have a diagnostic criteria for something like diabetes. Diabetes is uh elevated blood sugar, you know, either from one blood sample or two hours later you still see this elevated level of blood sugar. This is a diagnostic criteria saying you have X therefore you have Y. Yeah, >> when it comes to mold, there is a lot of controversy around this space. So, the traditional environmental doctors that this is their area of specialty do not recommend these deep mold detox protocols. They don't recommend urinary mold testing. And I will say I understand that body of work and there's a whole host of other physicians that are seeing something different. And so there is a little bit of a disconnect. I will tell you for myself, I got extremely sick with mold 10 years ago. And I had no idea it wasn't in my mind. I just moved to New York, moved into this apartment, I don't know, a month after I got there. I could not get out of bed. My vision changed. I couldn't get out of bed. I was exhausted. I had terrible brain fog. I could barely function. All my labs look perfect. I found this environmental doctor. She's out of practice now. And we did a whole host of obscure at the time blood work that looked at lipohilic solvents like tuine and VOCC's and mold and you know mold byproducts and I had extraordinarily high levels and then I had my home tested and I there was a ton of black mold. Um all this to say that um mold is not necessarily recognized as something physicians diagnose and treat yet. This is where the art of medicine comes into play. And I'm hoping that the medical field in some aspects will catch up because we are seeing this. Meaning if someone goes into a house and they smell that musty smell, this is something typically created from a mold or a um an offshoot of mold and it it's there and whether someone believes that they are sensitive or not and and perhaps there's a genetic component to it. I personally in am in medical practice and I am seeing more and more patients extremely sensitive to their environments and again mold is one of them. What is happening in the body? So, you live in a house with mold. Um, what does that do? What's the vector? How's it get are you breathing it in? Are you is it is it in water? Like, what's going on? >> Um, well, if you look in the literature, the literature will say that foods are the primary source of mold and microtoxins. However, in the environment for those individuals that are sensitive, one of the first things that we see is we see a ton of brain fog, ton of headaches. Um, often times we see rashes or they break out. They walk into a room and they get this massive response, you know, and of course there is that allergy, allergic rhinitis, uh, coughing, congestion. Um, you know, we see these environmental exposures that they can affect brain function, cognition. Again, I I have to say that it's very tricky because we're not there from a medical standpoint in the literature, but us individuals that are seeing patients, we do see this. I don't know if you've ever experienced that when maybe you're in a new hotel room, but these things are real problems. Well, I mean, the house that I was living in, uh, as you know, really sideswiped me. And I I was getting shouted at by the guys that do the filming for the podcast, saying, um, why do you keep going in the sauna before you come on set? You're always coming on set super red. But I wasn't in the sauna. It's that I'd been in my house and I was leaving the house and all of my neck and my face was really flush, which must be some sort of reaction, I guess. Um, and uh, yeah, we tried to remediate the house or the the landlords of the house I was living in tried to remediate it. I was I lived in hotels for three and a half months. go back into the house and within 30 minutes of being in there and they've spent three months cleaning and removing this stuff and and micro air filtration things and like dehumidifiers and all of this [ __ ] for ages and within 30 minutes of being back in the house like boom I'm just I'm like a a stoplight. It's crazy. >> And I want to I want to pause and and just point out that it's not in your head. And I think a lot of people listening to this experience symptoms and they cannot figure out why they're experiencing them. And people will say, "But your labs are normal." It has to be all in your head. And it's not. We are very affected by our environment. And um especially depending on where you live, you know, we live in Texas. Texas is moist and humid and hot. It facilitates mold growth. Well, the other thing as well is most of the issues with whatever you want to call it like environmental complex illness stuff, uh the symptoms aren't visible and the injury isn't visible either. And what this leads people to is kind of an inverse version of pretty privilege where if you look okay on the outside, people assume that you're operating fine on the inside. And honestly, like the two things that you never want to hear as a patient, the first one is from a doctor saying, "We don't know what's wrong with you." And the second one is from a friend saying it's all in your head. Um because given the choice, do you not think that you would get yourself up and get out of bed and and be happy about this sort of thing? Like there is a huge psychological component for sure. you know, your level of hopefulness, your level of energy, all of this stuff is largely um uh influenced and in some ways maybe even primarily influenced by the frame that you place around the present moment. That's not the same as you saying, oh, the bottomup sensation that you've got, oh, you're turning your neck red, you're giving yourself tonitis, you're, you know, these things. It's not the way it works. So, I guess the way that it seems to me is environmental illness is kind of like the new hysteria. It's it's real but misunderstood. >> I think that that's a brilliant way of saying it because right now, think about it. We're seeing a huge interest in hormone therapy, testosterone for both men and women, all of this stuff around hormones, and those have to be treated and those have to be uh within an optimal range if you're going to feel great. Thyroid, these are all things that are treated, have been treated. We have standards and this new influence or one that we're becoming more increasingly aware of is definitely environment and it comes and you can't get away from it. The influence of parasites and mold and heavy metals. You know, let's if we were to think about this from a broad perspective. Let's say someone has a parasite, relatively asymptomatic outwardly, but they're starting to get more fatigued. They are getting their blood work done and maybe they're starting to be anemic. However, if you think about it, their ability to absorb nutrients that they're having now decreases. So, you're starting to get low levels of inflammation, less absorption of your nutrients. So, it's not just that the parasite is then affecting iron. It's then affecting other nutrients and your ability to absorb and metabolize to your fullest capacity. Super common. And layer that on with then going to a home or living in a home with mold or water damage that you may or may not know that you have. Compound that with brain fog, fatigue, not very easy to diagnose. There's diagnostic uncertainty unless a provider is going to say, you know what, >> I understand that maybe in traditional medicine, we don't look at mold, but for you, listening to your history and understanding that, you know, every time you walk into this house that uh you get a headache or every time you are in this area, maybe you're just exhausted. And we have to recognize that there's that there's something else. And there these compounding effects and then layer on I don't know just pick your pick your poison metals lead mercury cadmium arsenic these things that are now within our environment and there is human exposure that can affect fertility brain function. I mean, gosh, seems like we're living in dangerous times, but the reality >> you're really sort of slipping and sliding through the environment. And um I one thing you mentioned before about the mold, you said uh genetic factors that can kind of influence how people respond. Uh if 10 people live in the same house and it's moldy, but only three of them get sick, >> what makes those three people different? There seems to be, again, I would caution the listener and the physicians that are listening, this is somewhat of a bit uncharted territory that we're getting more and more data on, but it seems as if there's a genetic component to those individuals that become affected versus those that are not. And I will say, you know, we recently moved because we had mold in our house. My son and myself are sensitive. My husband and my daughter are not my kid. He woke up, he was like coughing, not feeling well, really low energy. And um I ended up having a forensic um inspector come in where they took wall cavities. And it turned out there was mold on every floor of our house. >> That's it. We had to move. But had we not done that, my husband and my daughter, they are fine. >> Yeah. Well, I mean, I lived Zach uh lived in the last house with me, which was the one that had all of the mold in it, and he was sweet. He was absolutely fine. So, we had the perfect split test. And that was another thing that made me think, well, maybe it is. Maybe I am, you know, just being I should push through or I should, you know, this is it's maybe it's not quite in my head, but, you know, like Zach seems to be fine. Maybe he's more resilient. Maybe I'm more like feeble or something like that. >> No. And I will tell you some of the toughest people I know have had exposures. So I have um one of my patients I I think I messaged you about her, Evie Pumporus, former Secret Service agent who had a ton of exposures in 9/11 when the towers fell. She not only was there but then went back in and there's a heavy body burden of exposures. Other people might not be affected but you know she can't afford to be tired. She's she's an analyst right now. She's an NBC analyst for um policing and crime, all of these shootings, whatever it is, she's doing it. She had a level of exposure that again, they might track these individuals, but they're not necessarily then thinking about the big picture of, you know, how much of this are you able to get out of the body? Typically, we can only get those that are the majority of those that are lipophilic, meaning stored in fat versus those that are water soluble. And you compound that onto uh environmental exposure. So, there's the acute exposure, 9/11, burn pits, someone lives, I don't know, New York City, and maybe they live in a very busy exhaust place, >> and then they go into a home that is also moldy. the these exposures end up compounding over time and the challenge is is that people will be told that it's all in their head and they can't afford to not be functioning at the highest level and these people typically push through like yourself or like Evie and it's important to recognize that underneath this all that if you are listening to this and you know you are the type of person that pushes but for some reason you do not feel well then It is critical to have more exploration. I mean, think about lime. Lyme disease is another one of those kind of silent epidemics that is now getting more and more attention. But someone comes in and maybe they have this weird arthritis or this weird joint pain and they're having neurological symptoms and they don't even think to connect it to a hook bite that happened perhaps over the summer or they're getting these weird rashes because these things don't commonly come up in the standard blood work. Well, the thing [clears throat] at least with lime for me was I had no idea I was ever bitten by a tick. I had no idea where it came from. If there is another way that you could get it, if you could get it from eating sushi, maybe it came from sushi. But um yeah, it's just this you start to sort of build this picture now. And this is what I mean about sort of having to slip and slide throughout the entirety of the modern world. There's so many different ways that you can be exposed to stuff that is going to contribute, you know, 5% here, 10% here, 20% here, 5% here. And over time, you actually end up accumulating more uh stress than your immune system is able to handle. Um, and yeah, the the the lime element to this, each one of these for the wrong person, like mold for the wrong person is the end, right? Michaela Peterson and Jordan, like for them, they didn't need they don't need lime, they don't need parasites, they don't need anything else. They just need mold and that is like the middle of the bullseye of their uh weakness uh their immune systems sort of dysfunction, I guess you would say, or like their immune systems vulnerability perhaps. Um, and for somebody else, it might be a different thing. And then for other people, it's this uh multiffactorial approach where it's a lot of different stuff. But the likelihood, the likelihood that you as somebody living in the modern world doesn't have one of these is actually probably pretty low. I would guess the difference is if you're operating fine, if you're moving through life and you feel great, then it kind of doesn't really matter. You know, like you said about your husband, well, you know, you can kind of live in a house with mold, but he just doesn't seem to have the constitution or whatever it is that makes him susceptible to it in the same way that somebody else does. One person gets a parasite, they're fine. Their partner keeps on re getting triggered from the same parasite and and they get wrecked by it. So, yeah, obviously in the same way as some people deal with stress better than others, like just emotional stress. Or some people can eat gluten and others can't. Or some people love to eat first thing in the morning and others can't. Some people like running and others like to do weightlifting. Everyone's system idiosyncratically, psychologically, physiologically, they're all different. And um I guess the problem now is first off, we're living way longer than we ever lived ancestrally, so we're into I'm already on [ __ ] borrowed time at 37. Um but more than that, these exposures are novel. Uh and even more than that, you'd say, well, you know, these things must have been around for a long time. He's like, "Yeah, and they would have probably killed you. You'd have just been dead." Presuming that we don't want to just accept, oh, death is the only way out of this thing, we actually need to work out a way to fix them. >> And I I think that it's really well said in the way that we are living in this modern day era. So microplastics, there's a lot more information coming out about microplastics and I am certain we are going to continue to find more. The challenge is we have to have a clear diagnostic path because you can't answer and solve for questions that you're unwilling to face or that you don't even know exist. And you know, the reason I started treating all of these things 10 years ago is because I had these military guys coming in and they were told that this is all that there was to do for them, that their blood work was fine. And you know I think inherently if we are there to serve people because physicians are they are their main role is to care for people. Period. End of story. whatever you hear about doctors um you know at the end of the day it's a profession that people choose from my perspective to care and I wasn't comfortable with the answer that these people were fine and that their blood work looked fine all suffering and they were suffering so deeply and think about it this way you have these tier one operators you have these war fighters. They're not in their head about it. If they're telling you that every time they eat something that um they feel nauseous or that they have diarrhea, it's not in their head >> and that their other um the other individuals in their platoon, their teammates are also suffering from the same thing. It's not in their head. Even if these tests are negative, it's our responsibility to figure it out and to come up. >> I'm noticing I'm I'm noticing as you're talking through this um how do you say sort of the clinician's caveat I would say which is you uh what it feels like having to jump through a good bit of hoops because being somebody who is a doctor and is working in this industry you're having to say look this is sort of um tip of the spear stuff. This is frontline research. It may seem, it does seem. I I'm going to guess that there is a huge contingent of the medical industry that sort of looks at this stuff and scoffs or doesn't really see it as being that big of an issue. Is that am I interpreting your uh red tape correctly? >> That's exactly right. And here's here's the reason why I provide all those caveats because I am a fellowship trained physician and I recognize that in the landscape of social media there are lots of individuals giving lots of information and then there are handful of experts and there's standardized care. In order to truly get the message to people, there has to be a balance between both. There has to be real information, vetted and important, validated literature and there has to be an open-mindedness within clinicians. What we're seeing is a swing right now in the medical field in a way that I've never seen before. You have individuals that are believing uh one extreme and that is everything should be natural, all medications are bad, we live in a totally toxic environment, etc. And then you have the other uh group and I recognize that this is very black and white. This other group that is okay well here's what the evidence says and we should follow the evidence. But a good practicing physician and I think anybody that wants to get better has to recognize that there is a balance between the art of medicine and then truly listening to what the patient is saying. Even if quote the labs are negative. Listen, I treat we treat mold all the time. We've had I can't even tell you how many patients that have gotten better, including myself, from these environmental exposures. I recognize that what is in the literature is saying don't test and just remove them from the house. And I would say as a N of one or an an antecdote, I didn't get better that way. I had to be removed. I had to go through sauna protocols. I had to figure out ways to detox. And yes, I tested both blood and urine before mid- treatment and after. And so even if this large body of uh standardized medicine says this isn't a thing, I would argue that there are a whole host of people that are suffering and not people that quote just want answers, but people that clearly are exposed to things and they are being told that they're crazy. Listen, Parkinson's when I was doing my fellowship, um, so I finished that 10 years ago, but during that time, there was murmurss of pesticides influencing the increase in Parkinson's disease. And now we're looking at more clear data that shows there is a relationship between chemical exposures and Parkinson's. And so you just don't want to miss things because you are thinking ahead, right? I mean, it's there and it's our responsibility, I think, not just as providers, but also uh in this new social media landscape to be able to recognize that we might be thinking ahead, but we have to recognize that there's this whole continuum and to not ignore the fact that it's there. >> Yeah. I think anybody, especially anybody that gets ill, um, or anybody who is a doctor that has found great success treating the same pathology over and over, there is this sort of tendency to make your entire life about it. You know, it's somebody who has gluten intolerant in their Instagram bio. It's the equivalent of that. That um, this this is who I am, right? Like I got molded or I got EBV or I got CMV or I got whatever. Um I and I understand because it's for me it was the most important thing in my life for two years. It still is. It's it's the priority. It's what I'm focusing all of my attention on because I want to become better. And it influences your quality of life so much that when you get out the other side of it, you think, okay, if you too feel what sad, tired, moody, brain fog, inflamed, whatever. Uh, this is I felt that and I got this. Therefore, allow me to, you know, turn you into an evangelist to come on board with with this stuff. Um, so I understand why people do that and I think that uh clunky as it may be, it's probably pretty important to say, look, this is emerging research. We think that this is the case. We feel like D. Um, I guess another another element that's interesting on this is uh the gut. So you've mentioned there about digestive problems in special operators. Uh, I know that for me, at least based on what I learned, in order for an autoimmune uh, sort of system cascade to kick off, it seems like you needed three things. You needed to have genetic predisposition, an environmental stressor, and gut permeability. Um, on top of that, you could be looking at H. pylori or SIBO or candida or roundorm, liver, like, you know, some of these things. What are you seeing from a gut perspective at the moment? What are people dealing with? Mostly >> a lot of gut permeability, a lot of digestive problems. So, let's say someone has like ulcerative colitis or Crohn's or ciliacs. These are already states of decreased absorption. You know, it's not what you eat per se, but it is what you digest and how you absorb these nutrients. individuals. What we're seeing a ton of is things like uh well actually with the use of GLP1s, one thing for sure that we're seeing is slowed digestion and slowed gastric emptying, which is important in the way that if you are not getting nutrients, you're going to feel terrible just overall. But aside from that, we see a lot of H pylori. H pylori is um can be asymptomatic. So it's a bacteria. What it does is if someone say they have reflux and they are having a lot of reflux no matter what they're doing oftentimes we see H pylori it's very common some people are asymptomatic you can pass it along through saliva so if you're obviously kissing or you are a very sloppy drinker someone might drink out of your cup and they could also get H pelory but the reality is over time this is a risk for cancer H. pylori there can be virilent strains that um are risk factor for certain types of cancer um and that has to be treated and it's not treated naturally by the way typically uh again we're kind of in this zone where it's either all or nothing this is something that you know I typically treat with medications but I have to test >> what what do you what what is gut permeability when for the people who don't understand what that is. >> You have something called tight junctions. And if you imagine your intestines, so if someone is listening to this, if you put your fingers together, you imagine that your intestines are in lock step. So they're very locked in. Gut permeability is when these intestinal membranes, they become somewhat separated. So these tight junctions become a little less tight. You might see this with an increased level of zulin. This is protein that someone would test in your uh your stool or other inflammatory type gastric markers. And when this happens, this creates a cascade of effects because again your digestion is your first line of defense. It's the closest you're going to be to the outside world. whatever you eat or you know obviously it goes through and passes through your digestion and how someone would feel if their gut integrity let's just call it that was off is you know a number of things they might feel bloated they might have diarrhea they might have constipation you name it but at the end of the day you should never be thinking about your gut you should never be it should not be something that's on your mind you shouldn't worry about oh my gosh if I eat that I'm going going to feel like I'm 10 months pregnant. >> Yeah. Well, it what it causes and you know people can start to get the sense is sort of an odd cautiousness around the world. Like you're always on tent hooks. Like am I going to go into a house that's got mold or maybe I have a friend who owns a [ __ ] multi-billion dollar business and he got popped with VOCC's. That's the blowoff stuff from paint, right? >> Yeah. >> Yeah. Yeah. He got popped with VOCC's. >> How did he know? Did he test for it? >> Yeah, tons of tests. She had tons of tests and unlimited amount of resources and uh then was staying in a hotel. The hotel was relatively new. They were blowing off the VCs from one area of the hotel into the area he was in and it all restarted again. Um but what it means is you're always, oh, what's in that food? Maybe that house is going to have that. Oh, I better be careful about, you know, it's a it's trepidation. Going through life with a lot of trepidation. And obviously that ambient stress that is not helping either. That's you know making things significantly worse. >> But I think that you can solve for that once you figure out what you're sensitive to. Those things can be solved for. If you know that you are sensitive to VOCC's then obviously um you're using low VOC paint or any of these other things air filtration. If for example this guy has unlimited resources what I would do if I was him is I would ship an air filter to be in my hotel room. I know it sounds crazy, but you can also bring these um air devices where you can actually test the air. Again, this is one extreme, but if you know what you are sensitive to, if you know you are sensitive to mold, or if you are someone that just you're going to eat sushi no matter what, then perhap 3 months you should do or quarterly some kind of parasite testing. >> There's a cost of doing business. If you are someone that you know that you're sensitive, having a great sauna protocol, right? There are certain solvents that are able to be sweated out. Knowing what you need to do will allow you to effectively perform. And maybe you're someone that needs, I don't know, ketones, you know, you name it. But you can build a program and and Chris, you've done this really well. I think you know very much what you are sensitive to, what you have to do to be able to function at your highest. And I will also say that you're willing to push through no matter what. And there are a lot of people that are willing to push their bodies to be able to perform when they need to be able to perform. It's just sheer will. >> I think everybody, so many people are doing that. And that was my, you know, archetype of the person that says, "Well, this is just what getting old is like." Or, you know, who's really that happy when they're in their 40s or 50s or whatever. Um, yeah. just conceding a lower standard of life and cognition and mood and energy as a byproduct of of of aging. Uh so you mentioned sauna there. What are the this is not medical advice. What are the typical go-to modalities for the environmental illness stuff that people that usually seem to have a positive impact on people? Like what what what are the areas that people look at first? Well, number one, remove yourself from the exposure. Understanding where you're living, you ha you have got to move. I'm sorry, it's super inconvenient, but you cannot continue to be exposed to these things. Something else, and actually for my um my next book, which is coming out in January, the playbook, I did a ton of research. I wanted to look at what was available in the evidence, not just for overall health and longevity, but what modalities were very supportive in general. And the number one that came out on top was sauna. So there again, there is, you know, questionable data depending on what you're looking at in the literature. However, with sauna protocols, and this could be typically 30 to 60 minutes at from uh 113 degrees Fahrenheit to 176° F. This which is important obviously you talk to your physician but this is a way for lipohilic chemicals so the chemicals that are stored in fats to be released through the skin excretion of these organic solvents. >> What about binders? How important is it to be looking to use like a colistyamine or a charcoal? Does that make that big of a difference or is most of it coming from the sauna? >> I think it's a great question and there's not a ton of in the literature data on choleistyramine. However, there are a lot of practices and physicians that are using it and also using binders. Again, this is more of the art of the treatment. Which is more important? I would say um I think that sauna we know how it works is critical and that would be if I were to say okay what is really important many people cannot tolerate the heat >> and that would be then you would think about using an infrared sauna and of course there's a ton of other reasons why someone would sauna I sauna all the time I sauna and cold plunge I love it but sauna has good data for decreasing inflammation, for decreasing things like HSCP, which is high sensitive high sensitivity C reactive protein. These are inflammatory markers. Again, hot sauna has been used for uh you know, probably hundreds of years. Binders, again, depending on the physician, you will get a different protocol for that type of uh compound. What about emotional stress and how that sort of interacts with environmental illness? >> Probably one of the bigger levers, believe it or not. Here's why. If someone doesn't believe that they will get better, it's a real struggle. There has to be an innate belief in one's ability to heal. again. Um, you know, I graduated medical school in 2006. I have been seeing patients and still see patients for a long period of time. From my perspective, there are two types of patients. There's number one, the patient that is so overburdened with their illness and they are somewhat neutral, right? They're not thinking about getting better. They're not thinking about getting worse, but they are consumed by dealing with this situation. There's somewhat of a turning point once you can identify what it is and you pull that off the table. You see how this person responds. And if that person comes out the other side and then is on a at a landscape where they go, "Okay, this is the path forward. I'm going to put one foot in front of the other." Those patients, they will get better. and the other group if they do not believe in their own ability to heal and you know this is not woowoo I'm not even talking about the placebo effect I am just talking about um years and years of seeing patients if they do not believe that they will get better it's it is nearly impossible because now what's happening is you are fighting against your own physiology and when we you know without this idea of going to um some woo woo land. When you are perpetually consumed by negative thinking, there is a level of stress that this generates in the body and you can see it. Conversely, if there is a belief in one's own ability to heal and they know they are with such high conviction that they will get better, these people they will get better. It's so interesting. It's such a vicious cycle that you start off not choosing this thing and then you end up being puppeted by your own beliefs about this thing and that restricts your ability to recover and then yeah I it [clears throat] seems to me do you think it's a fair assessment to say that medicine is sort of fundamentally built for simple problems not for complex ones? >> That's a great question. Medicine is built for following algorithms. Medicine is built for being able to create a standard of care. If you have a heart attack, you're in the ER, you will get this, this, and this. This is when you go to the Kath lab. This is when you don't. And that is how from my perspective, medicine is created. And where we fall back on. Where healing comes from is the ability to solve both the complex problems but also recognize the entity i.e. the human that is experiencing these problems >> these challenges and that is where there is the art of medicine and the art of healing comes in. Why is it then that people with environmental illness, this sort of complex stuff, why do they end up as medical nomads? Because there's very few people who say, "I've just I I went to this doctor and they they it was they were the first one. They were great and they carried me through the entire journey." Um why do people end up with this Avengers assemble of of of medical practitioners? Typically physicians are trained in one area and so they look at the lens through the lens of where they were trained and again as we have this increasingly complex dynamic of the world and how medicine should be handled is with a team right it's let's say you are going to an individual for fertility this individual who's assessing fertility would also really benefit from thinking about how is their lifestyle, what is their diet and exercise, what is their hormone um balance look like, but what about their gut health and what about their environment? You know, there what about their cardiovascular health? So there are all these systems in the body yet we really end up isolating it to one provider and that's not typically how medicine should be done and it's certainly not done in what's so fascinating in teaching institutions in teaching institutions it is a team and that seems to be lost in private practice but I think a really good private practice and a really good doctor is a team player >> it's not my way or the highway way it's, you know, if someone is because it's never about the provider. It's never about the physician. It's about the patient. And typically wellness is a team sport. And with more providers, and granted, if an individual gets sick and they're going to 10 different providers, this is a recipe for disaster. Typically, it should be a core group, a handful of very competent individuals. Maybe it's three individuals. you have one quarterback and then you have um individuals placed in various specialties. Maybe it's three. And that's the way healing really should happen. But the only way people get better is if they can identify the problem. It doesn't help if it's some enigma of an issue. You have to be able to ask the right questions to begin to chip away at what the challenge actually is. What else are you concerned about at the moment? You know, we've spoken about a bunch of different things. I guess we haven't talked about EBV or CMV or that kind of side of of stuff, but if you were to bet some money on the roulette wheel of the future pathologies that you think people are going to notice more, are going to be bigger, what are the ones that that you're concerned about? definitely these environmental exposures because the individuals that are sensitive I think are going to becoming increasingly sensitive and when I say environmental exposures I don't just mean mold I think that there this idea of forever chemicals we're constantly evolving to make things quote more convenient and I think that that convenience is going to come at a cost uh I don't exactly know what that is but I I definitely believe it is going to come at a cost I think environmental medicine is certainly the way of the future. And I'll say something else. I think that we have to re-evaluate the old biomarkers that we've been using. I know this is going to sound crazy, but we've been focusing on body fat percentage as if this is just an example. As if this is the biomarker. I think that that is going to become less of a valuable biomarker. I think that we're going to begin to see that it's the fat, the intramuscular atapost tissue. It's the the quality of the muscle tissue, the fat that infiltrates into that tissue is going to be arguably more valuable than understanding someone's body fat percentage. In the next 5 years, what I'm hoping to see is a re-evaluation of the current way that we are looking at medicine and the current standard biomarkers because humans are funny. They have this anchoring bias. Once they hear something, once they're taught something, then this is what they always go back to. >> As opposed to, so for example, if we are taught that body fat percentage is the problem, it closes our minds and our ability to think that, you know, maybe we should reevaluate that. Maybe body fat percentage isn't the problem, but maybe it's the fat that is infiltrated into skeletal muscle that's the actual problem. And then perhaps we compound that by if there is then fat in the tissue and I'll just go on a li and say this sounds crazy but what if the exposures that are fat soluble are then then embedded into skeletal muscle because they're embedded into not just the visceral fat and the subcutaneous fat but the fat within muscle tissue. And in order to actually get well, we have to ask the right questions. Otherwise, we're going to always miss the mark. >> What do the right questions look like? >> Why are you not feeling well? If the lab values don't show, then we're not looking at the right labs. Period. End of story. >> Is there anything? It's an interesting question. So, like one of the things that's come up today is there's sort of two worlds. There's one where somebody feels bad but their labs are okay and somebody uh feels bad but their labs are off. Uh it seems like well the the answer is just better different more labs until you find out what that is. How many issues do you see that are undetectable even with we'll switch from a PCR test to microscopy test or we'll go for an EKO stool sample and send it off to have a look at a guy look at your poo under a microscope like you know like all of these different things. Are there areas still where you say oh we we actually do not have any solution for when it comes to detecting this thing very well. Well, number one, it would be foolish for me to say no. However, it would be difficult for me to say that there are areas that we are not testing and identifying. You know, um, when it comes to the influence of the environment, we know it's going to be the foods you eat. We know it's going to be the exposures. We know it's going to be either it's the sick building or your sick room or uh, whatever it is that you're breathing in. You know from my perspective the only untapped area would be the influence of technology and again this >> that's interesting >> but again that might be a foolish statement but from my perspective that is the one area that we have not really begin to or begun to explore for its health effects and I'm not even sure that we have a great language around it, right? So, we have ionizing radiation and nonionizing radiation. So, right now, we believe that nonionizing radiation is is no problem, whether that's cell phones or um you know, Bluetooth, but radio waves. But is that true? And again, the data would suggest, you know, I had someone on my podcast um uh he's a physician. He's our uh radiation oncologist. And he would say, "No, radiation is there's nonionizing and then there's ionizing. And the nonionizing is safe." And is that true? Or are we missing a whole influence on human health because of the way that we are surrounded by technology? I mean, we are in a a place where we we've never been there before. >> Yeah. I mean, look, I've heard a lot of people talk about this. I I'm [ __ ] tip of the spear when it comes to iPod users, so I really hope that nonionizing radiation's okay. Um, but yeah, I you know, Ben Greenfield's entire new house is there's hardwired copper wiring running throughout all of the floors and you just Ethernet cables strewn all over the place. And if you want to use the internet, you hardwire your computer into the floor as opposed to using Wi-Fi because he's worried about Wi-Fi. Or he might be worried about Bluetooth. There's no Bluetooth stuff floating around. And we've made sure that um like radio waves and and the the way that you can um amplify signal by the electrical wiring that exists inside of the house. All of this stuff sounds really kooky and very well maybe. But I suppose you're you're right to call me out for being for asking the question, hey, are there any tests that don't do what the tests do? And how would you know? Well, if I can't test for them, what do you mean? Like what is it? What what what's the question that you're asking? Um but yeah, the area of the impact of technology. Interestingly, I asked one of the guys that does um biological home surveillance stuff, like biological home assessment. Uh, I asked him about eight because a few of my friends have said, "Well, eight's amazing because it cools you down, but what about the sensors that are in the bed that track your heart rate and it's circulating water through and maybe there's an electrical current and you're sleeping on it for, you know, 8 hours a night like you're basically living wearing this thing." Uh, and what was interesting that I found out from uh this guy was there's no uh real concern about the blowoff from the mattress, but there is some coming from the uh tower unit. So, all he did was he just moved the tower unit a bit further away from his bed. And uh but you know, is this total pie in the sky cookie stuff? Maybe. And I suppose this is one of the problems that not long ago your Parkinson's example uh that was experimental fringe probably get mocked for it by bringing it up science uh and then after a while it turns out oh actually this has got some legitimacy to it. The same thing might be true around nonionizing radiation but you don't know until you test it. And I think this is >> this is one one of the advantages of uh >> having people who are more open-minded. Now the difference between being open-minded and being non-evidence-based or being uh hysterical about stuff. Um I heard who the [ __ ] was it I was speaking Elon Musk. Somebody asked Elon about why he'd stopped his focus on longevity. Apparently, for a while, Elon had been really concerned about like life extension. He was, you know, kind of like a Brian Johnson type approach. And uh Elon thought for ages and then said, "I don't think it's a good idea that we have people live for hundreds of years." And his justification for this was social that people don't change their minds very easily. Therefore, science and human progress occurs one death at a time because the person who held this oified view that they weren't prepared to update their perspective on is gone. They've had to leave the party and they've been replaced by somebody who is, you know, 5% closer down this particular way because the world they came into had developed a little bit and developed a little bit, developed a little bit. Um so yeah that perspective that sort of science and life move forward the death of one lite at a time even if that person wasn't a lite when they came around they sort of relatively are now because their reference frame is so far in the past and uh I I'd never considered that before but I I think that it is one of the explanations for why this conceptual inertia the fact that stuff doesn't move forward that quickly um it explains it to me and it must be frustrating if you're a forward thinking incl clinician in the world because you're having to fight on two fronts. First off, you're having to explore this new territory and try and work out what the [ __ ] is going on with this illness or this exposure or this metal or plastic microplastic whatever. And then you've got to fight the battle inside of the camp too, which is against your other uh peers and colleagues who are saying, well, you know, this is very speurious science. This doesn't seem to be evidence-based. We can't find any legitimacy in the sort of studies. It's rodent blah blah blah blah. and um it it doesn't particularly engender a exploratory approach to human health, especially given that people have got lots of health problems at the moment. >> It's extremely insightful. It's extremely insightful and I would say that's very accurate. Is very accurate. And we're up against a lot. There is a lot that we are up against both physically and emotionally and then within the system itself because if you think about it I mean listen they believed that uh smoking was fine. They had a a cigarette diet the lucky diet they you know felt empetamines were great. Fenfen and we medicine seems to follow these trends where for periods of time we believe things are benign and lo and behold they are really deadly and and that is a part of what I think the reality is that we are facing and you know as a practicing physician I am seeing these things and then you go and you look at the literature and you're reading uh you know what about these VOCC's and what about these solvents And and the reality is is it would be irresponsible to ignore what I'm seeing from a patient perspective. You know, if I have a patient that comes to see me, they've been to 13 other providers because they're not feeling well, there has to be an answer. >> It it it's not in this patient's head. I mean, if you look at the the archetype of the individual, people want to get better. And yes, do they want to have a name for what it is they're suffering? >> No. >> But the reality is there is always a reason. >> It's just a matter of finding it. And if there was um more unification and less division in medicine, I I think that we would continue to be uh further and move forward than uh where I see that we are today. >> What would unification look like? collaborative efforts, collaborative efforts saying listen um this is the experience we are seeing multiple people having the same experience there has to be a reason there just has there has to be and then exploring that you know finding instead of no we've looked at that it's it's not VOCC's or no we've looked at that it's not micotoxins um no you're probably wrong there's certainly a component and so this unification of probably physicians and then also physician scientists and researchers to be able to solve for some of these problems because we are in a new precipice. We are in a new era. The reality is is we are here and yet we are still looking through the lens of um traditional medicine as to how to solve problems. There has to be advancements. And listen, there are on multiple fronts, but within environmental medicine and within the the complex illness world there, especially when it relates to environment and technology exposures and all of these solvents and these forever chemicals and these plastics, there we are going to be foolish to think that we can just turn a blind eye and that it's just going to it's going to go away. It's not. What are you working on next? What can people expect of you? >> Um, well, I'm doing uh, so this book comes out. I have another book coming out, but I'm doing a lot of research on hormones. And I think that that is going to be the way of the future for both men and women and not just the standardized hormones that we think of. So testosterone, estrogen, progesterone. I think that there is a place for anabolic agents that we're going to see more of when it comes to health and longevity as it relates to muscle mass. You know, I recently published a paper on sexual function and muscle mass and quality. There are going to be a handful of other papers like that. >> Very exciting. Dr. Gabriel Line, ladies and gentlemen, Gabrielle, you're great. Uh, I appreciate you being um keeping your feet on the ground while you're sort of looking up to what's going to try and kill us all next. Where should people go? They're going to want to keep up to date with everything you do. >> Um, yes, you can find me at on my website, Dr. Gabrielle Lion. I also have a new playbook. This is the original book that I had wanted to write, my first book, Forever Strong, but this the Forever Strong playbook is the book that I wish that I had had. Protocols, sauna protocols, training protocols, eating protocols, thinking protocols, probably the most important. Um, yep. You can find me at Strong Medical, which is a medical practice. I have a great podcast. Still trying to get you on. It's number three in medicine, my friend. >> Um, yeah, Instagram, newsletter, you name it. >> Awesome, Gabrielle. I appreciate you. Thank you. >> Thank you so much. >> Congratulations. You made it to the end of an episode. Your brain has not been completely [music] destroyed by the internet just yet. Here's another one that you should watch. Come on.