Episode 328: Inflammation Hunting- What Does It Mean?
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"Inflammation hunting" is a term we use often here at TFN, but what does it actually mean? Erin sits down with Rachel, the Lead Practitioner and Lead Clinical Mentor of FNA, to discuss all things inflammation - what it is, what causes it, and how we use functional labs in our practice to take a deeper dive. This episode is great for practitioners and clients alike!
In this episode:
Inflammation hunting - what does it mean & why do we do it [3:27]
Common symptoms & lab markers that signify inflammation [9:32]
Using functional labs to confirm inflammation [14:20]
How to keep inflammation at bay [19:50]
Food considerations to lower inflammation [26:23]
Case study examples of patients with chronic inflammation & how our team resolved it! [30:02]
Resources mentioned:
Funk’tional Nutrition Academy™
Functional C.A.R.E. Method™ 1:1 Services
Ned Natural Remedies (get 20% off your order with code FUNK)
LMNT Electrolyte Replenishing powder (Use code FUNK get a free sample pack with any purchase!)
Qualia Mind (get up to 50% off and an extra 15% off your first purchase with link + code FUNKS)
Organifi supplement powder (save 20% on your order with code FUNK)
Learn more about Functional Nutrition & Strictly Biz
Related episodes:
197: Secretory IgA & Gut Health: What You May Not Know
327: How to Increase Your Value by Adding Functional Labs to Your Practice
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Erin Holt [00:00:02]:
I'm Erin Holt and this is the Funk'tional Nutrition Podcast, where we lean into intuitive functional medicine. We look at how diet, our environment, our emotions, and our beliefs all affect our physical health. This podcast is your full bodied, well rounded resource. I've got over a decade of clinical experience, and because of that, I've got a major bone to pick with diet culture and the conventional healthcare model. They're both failing so many of us. But functional medicine isn't the panacea that it's made out to be either. We've got some work to do, and that's why creating a new model is my life's work. I believe in the ripple effect.
Erin Holt [00:00:39]:
So I founded the Funk'tional Nutrition Academy, a school and mentorship for practitioners who want to do the same. This show is for you if you're looking for new ways of thinking about your health and you're ready to be an active participant in your own healing. Please keep in mind this podcast is created for educational purposes only and should never be used as a replacement for medical diagnosis or treatment. I would love for you to follow the show, rate, review and share because you never know whose life you might change. And of course, keep coming back for more. Today's episode is all about going inflammation hunting. So I sat down with lead practitioner and lead clinical mentor of FNA, Rachel, to talk about this term that we tell our mentees often you have to go inflammation hunting. And we're going to explain exactly what that means.
Erin Holt [00:01:29]:
We're going to talk about what inflammation actually is and what causes it, the difference between acute and chronic, and how to use functional labs to do a deeper dive. That's something that you hear me say often on this show, we want to do a deeper dive with our clients, but what does that actually mean? What does that actually look like and how do we do it? So this is a great show for practitioners and non practitioners alike. We also get into specific case studies. So people we worked with that came to us where we said, gee, we have to go inflammation hunting here. One case study is looking at weight loss resistance and pain. Another one was a client who came to us. She was catching every single cold that went around. She just felt like she was constantly sick.
Erin Holt [00:02:10]:
Another one looked at is looking at the connection between gluten sensitivity and high blood sugar. And then finally we talk about a case study for chronic UTIs and painful sex. So these are all cases of somebody coming to us where we said, oh, geez, we have to do a deeper dive here. We have to go inflammation hunting. So if this is the type of practitioner that you're looking for definitely check us out thefunktionalnutritionist.com. You can apply to work with us one on one, and if this is the type of practitioner that you want to become, highly recommend FNA, the Funk'tional Nutrition Academy.
Erin Holt [00:02:43]:
It's our 14 month practitioner training and mentorship, where you are going to learn to practice in the same way that we are about to talk about. Enrollment is currently open, but not for long. We close right at the end of the month. Our fall cohort starts October 1, so be sure to get your application in head to funktionalnutritionacademy.com. We'll link it up in the show notes. Get your application in. You can schedule an advisory call with Rachel, who you're about to hear from, and she will help you determine if FNA is a good fit for you. Without much further ado, enjoy the show.
Erin Holt [00:03:15]:
All right, my friends, we're back with another episode. Today I have Rachel on with me. Rachel's the lead practitioner at TFN, and she's also the lead clinical mentor at FNA. So welcome, Rachel.
Rachel Mistry [00:03:27]:
Thanks, Erin. We can just dive right in. Each month in the Funk'tional Nutrition Academy, you host a Q&A, and I host a Q&A. Students submit questions ahead of time, and then we all get on a Zoom call and chat through them. And a question was submitted in last month's call that I thought was a really good topic for a podcast. I figured we would chat about it. Essentially, the student asked, because you and I use this phrase a lot, we say, let's go inflammation hunting. And she essentially wanted to know, okay, what does that actually mean? Like, how do we address this? Where do we look?
Erin Holt [00:04:00]:
Yeah. And I thought it was such a great q because we do talk about it all the time. And so we're going to address, what does that phrase actually mean? Go inflammation hunting. And why do we say it all of the time? And I think I'll cue this up. The way, that I think about functional medicine is that, like 80% totally made up, but, like, a big percent of what we do, a big percent of our goal of what we do is to try to get people to make dietary and lifestyle changes, because we know that dietary and lifestyle changes are really are the things that are going to move the needle. And then the higher level work, the labs, the supplements, the protocols, is like roughly 20%. And I think think about it like this. If you're just focused on that 20%, if you're just focused on the labs and the protocols and the supplements, you can maybe get people, like, 20% better, but we need to really use that information to get people to make the behavior change when it comes to diet and lifestyle, how they're living their life.
Erin Holt [00:05:02]:
And we really teach FNA students to start here before jumping into any protocols. And I think our students and our grads are, like, all stars when it comes to this. And so we really want to make it a goal to bring down inflammation, um, through dietary and lifestyle changes first. Sometimes that doesn't happen. Um, or sometimes people can be making these changes, and there can still be signs of inflammation and, like, kind of wonkiness in the body, and that's when we have to go inflammation hunting and be like, geez, what's going on? And what can we do to resolve this? And this is why, by the way, we spend an entire month of FNA curriculum covering the basics, even though it's not, like, the sexy, glamorous stuff, like, if you don't nail this, if you can't be an incredible coach with the basics, it's really hard to be a functional medicine practitioner, just, like, adding labs and stuff. So maybe the first place that we start is by defining inflammation.
Erin Holt [00:06:06]:
Inflammation is essentially a part of the body's natural defense mechanism. It's part of, or it's a part of the immune system, I think that's fair to say. So the immune system will recognize a harmful or foreign invader and then it attempts to remove that thing so that it can begin the healing process, and inflammation can really be looked at as either acute or chronic. Acute inflammation is tissue damage. So you, like, get a cut, and then you see swelling, you see redness, and that's the inflammatory response coming to the scene to try to heal and repair that tissue, essentially. So we might see that in response to a trauma, like you cut your finger, or a bacterial infection or maybe a toxicant that your body comes in contact with. And so, usually with acute inflammation, it starts pretty rapidly, and then it's really taken care of and resolved within a couple of days. With chronic inflammation. And that's usually, when we're talking about inflammation in the functional medicine space, we're usually talking about chronic inflammation.
Erin Holt [00:07:15]:
This is, like, slower, long term, low grade, unchecked inflammation that's kind of just running amok in the body. It's going on for prolonged periods of time, whether that's months or even up to years. So the reason that we might see chronic inflammation can be multifactorial. One is that we just have not removed the thing that's causing the inflammation. So, like I said earlier, the goal of inflammation is to remove the agent, and so then the healing process can begin. So if we haven't removed the agent, if the body's just kind of coming in contact with that thing, then the inflammation is just going to continue, and that would lead to chronic inflammation. And so that's kind of like why we go inflammation hunting is because we're trying to look for the thing that's stimulating this chronic inflammation.
Erin Holt [00:08:08]:
Another. Another reason for this is exposure to a low level irritant. So maybe this is a food allergy or a bacterial infection in the gut or some type of toxicant. So, like, maybe heavy metals in your water, maybe mold. It's just this ongoing exposure to a irritant that's going to just kind of lead to that ongoing inflammation. We can, of course, see this with autoimmunity. Unchecked inflammation is a hallmark of autoimmunity. And this is essentially when the immune system recognizing a part of your body, your own tissue, as a foreign invader, and then we can also see inflammation with oxidative stress and mitochondrial dysfunction.
Erin Holt [00:08:56]:
So there's a lot of free radicals, advanced glycation end products, which is oftentimes a result of ongoing hyperglycemia. High blood sugar. It's why we say high A1C, high blood sugar, long term, can lead to a lot of inflammation. Oxidized lipoproteins, homocysteines, these are other things that can. Other biochemical inducers of inflammation. So there's multiple things that can lead to inflammation, which is why we attempt to go looking for the thing if we can't find it. So, Rachel, what would be some of the symptoms that a client or patient would come to you with that would make you suspect inflammation?
Rachel Mistry [00:09:45]:
A bunch of them. Honestly, I see a lot of people with just, like, general joint pain, like aches and pains, not related to working out. A lot of skin related issues. I mean, acne can definitely be a sign that there's some underlying trigger. We see a lot of skin issues in our practice, but like rashes, eczema, acne, you name it. Increased food reactions or increased amount of reactions to foods can be a biggie, too. So a lot of people will come to us when they're like, oh, I used to just react to gluten and dairy, and now I'm also reacting to, like, leafy greens and beans and, like, all these random foods that should be really health promoting. It's like, okay, there's something else going on. Frequent illnesses and infections in general.
Rachel Mistry [00:10:31]:
For instance, sometimes people, they just get sick all the time. For some people, they struggle with really bad allergies, and then these allergies lead to, like, sinus infections and then general digestive issues. Right. Because your gut is home to so much of your immune system, that, to me, is definitely a sign of inflammation. Brain fog, fatigue, like, low energy, low motivation. And then even, like, depression, I can think of as, like, a sign of inflammation in the body as well.
Erin Holt [00:11:02]:
Yeah, for sure. Especially with that inflammatory model of depression. How about labs, whether it's blood work or functional labs, that you would see that would make you suspect inflammation in somebody?
Rachel Mistry [00:11:18]:
So kind of like what you mentioned on a blood work panel, if you see a lot of oxidized LDL, if you see irregular blood sugar markers. So signs of, like, glucose mismanagement. If someone has really high A1C, insulin or glucose, and they're like, I feel like I'm eating in a way that's supporting my blood sugar. We do a diet recall, and it's like, this doesn't make sense. Sometimes that can be a sign of inflammation. HSCRP, high sensitivity C-reactive protein. It's a marker of inflammatory activity in the blood vessels. We run this on our blood work, our lab panels with our patients.
Rachel Mistry [00:11:52]:
But it can look at your risk of, like, a cardiovascular event. High ferritin. Ferritin is your iron storage marker. And ferritin, when it becomes elevated, can also be a sign of inflammatory activity. If we see that someone has positive thyroid antibodies or a positive ANA, that can suggest autoimmune activity, which is dysfunction of the immune system. And then sometimes, if someone has just a lot of nutrient deficiencies, if it doesn't make sense, I'm like, there's probably something else deeper going on as well. So I see that a whole host of those on blood labs with patients, and a lot of times we see these irregular markers, and it's like, okay, well, why? Why is this happening? We usually need to do a deeper dive as well. On the DUTCH test, sometimes when we see really high cortisol, we know that high cortisol can be inflammatory, and then high inflammation can contribute to high cortisol.
Rachel Mistry [00:12:50]:
And then low melatonin on the DUTCH test can be a marker that we can see. It's like melatonin is an antioxidant. Why it low in the first place? Why are we not producing enough? Maybe it's because of, like, poor sleep hygiene and screen use. But is there a deeper reason? We always like to investigate that. And then on the Organic Acids Test, there's a marker called pyroglutamate, which looks at glutathione status. And if this marker is really high, it means that there's really high use of glutathione. And we want to take a step back and think about, okay, why is that? If it's really low, it means that glutathione is depleted. And then the same concept, we're wondering, like, what is burning through your glutathione so rapidly?
Erin Holt [00:13:31]:
So a lot of these markers we would see, and we would say, oh, okay, we have to go inflammation hunting here. Like, something off, something's a little suspicious. So we need to figure out what's going on. And it's especially with. I shouldn't say especially, but oftentimes, it's like, when I see a lab and it makes me scratch my head, that's usually where I'm like, this is not what I was expecting to see. This doesn't really make sense given the context. Like, the math isn't mathing. There's probably something deeper going on here.
Erin Holt [00:14:02]:
So what would be the labs for you that would really confirm inflammation?
Rachel Mistry [00:14:08]:
I love a GI Map stool test because it looks at your levels of good bacteria, bad bacteria, and it also looks at secretory igA, which is essentially a marker of your digestive immune system function. Another marker on the GI Map is calprotectin, which is a marker that's used in conventional and functional medicine. It's looking at inflammatory activity in the colon. It's used in conventional medicine to rule out issues with IBD. But I'll catch calprotectin that's, like, moderately elevated in a decent amount of my patients, where it's like, let's get this controlled. Let's use this as more of a preventative opportunity. And then another marker on the DUTCH test, it's quinolinate. They recently added this marker within the last, I feel like year or less maybe.
Rachel Mistry [00:14:55]:
And this is a marker that can be associated with neurodegenerative diseases. But basically, when I see that this marker is elevated, the way that I'll explain it to my patients is like, hey, there's a high likelihood that the inflammation that you're experiencing in your body could be impacting your brain. So, like, mood, anxiety, depression, or some of those more serious issues as well.
Erin Holt [00:15:17]:
How often are you seeing that, like, as a percentage of the DUTCH tests? You see. How often are you seeing that one elevated?
Rachel Mistry [00:15:24]:
Like, 10-15 percent of the time? That one's not super frequent. It definitely is, like a big red flag, but it's always really significant when we do see it very validating for people.
Erin Holt [00:15:35]:
And just sort of as an aside is, like, I think when you start to, when you're first learning labs and you're first doing this stuff, it's hard to really know, okay, like, is this a red flag? Is this not a red flag? Because you just don't have the experience. You haven't seen enough labs to be like, okay, like, where on the spectrum is this? Is this, like, uh, oh, sound the alarms? Or, like, oh, this, like, kind of most people have this marker. And I would say this is kind of the benefit of having a mentor in FNA is that you can run this by somebody else so you're not overreacting to the things that maybe you don't need to be or under reacting to, like, the real big red flags. Um, so I'll just throw that one out there, because also, um, I feel like that that's one that's not elevated that frequently. So when you see it, you'd be like, oh, okay, this is a thing.
Rachel Mistry [00:16:22]:
And a lot of times, so I do office hours with students in FNA. So we'll meet one on one, and we'll chat about patient cases. Sometimes just, like, big picture concepts, sometimes tricky cases where people are not seeing success like they would have hoped for. And sometimes we go through labs. And so what I've been seeing definitely recently is students are coming to me when calprotectin, for reference, I believe the lab, the GI Map, it goes from, like, one to 175 or 200, and it'll tell you when it's higher. Or the normal reference range is between zero and 175. You know, I like to tell my patients, we like to see this as low as possible. We don't want to see any inflammation in the colon, if possible.
Rachel Mistry [00:17:04]:
But what I've been noticing is, in lab reviews, sometimes students will see a calprotectin of, like, 50, and they're like, holy crap. Like, do we need to refer out to GI? Do we need to bring in, like, they'll put together a loose treatment plan of, you know, five different supplements to address calprotectin. A lot of those instances, we can bring in some anti inflammatory support, but we don't. We can treat the terrain of the gut, address why calprotectin is high in the first place and not need to bring in, like, six calprotectin specific supplements. So that's also where it can be really nice to have a mentor, get a second set of eyes on your treatment plans and all of that good stuff, too.
Erin Holt [00:17:41]:
Yeah. And none of this is to, like, I'm not saying any of this to, like, call out the noob, you know, the new practitioner. It's like this. This is, like, really common stuff. I remember the first few GI Maps that I saw, like, the first 25, probably. I was probably overreacting to some stuff and under reacting to others because you just don't have the context. I was very lucky that I did have a mentor, so that was very, very helpful.
Erin Holt [00:19:50]:
Let's talk about some things that people should be doing from a foundational perspective that can help to keep inflammation in check.
Erin Holt [00:20:03]:
And so, you know, if you're listening and you're not a practitioner, these are things to work on. And if you're listening and you are a practitioner, this is kind of that, like, 80% that I was talking about at the beginning of the show. Like, these are really what we're trying to, like, help our clients do. So where would you start with that?
Rachel Mistry [00:20:19]:
I would start with lifestyle and nutrition, 100%. So definitely a good starting point is, what is going on with your daily routine in terms of how are you managing your stress and what are your exposures? What's, like, really maybe creating a stress response in your body? What's going on with your sleep habits and your bedtime boundaries? And then are you moving your body? Right. Are you really sedentary and sitting all day? I work from home. I see patients, like, sitting at a desk. So I have to be really intentional about going for walks and using my walking pad. Otherwise, I'd just be. My step count would be, like a thousand for the day. And then nutrition, you know, we think about being really intentional about eating those antioxidant rich foods, regulating our blood sugar through nutrition, and limiting or being aware of food sensitivities, food intolerances, and being intentional about our intake of, like, processed foods, refined sugars, and alcohol.
Rachel Mistry [00:21:18]:
We really want to limit those as well.
Erin Holt [00:21:22]:
I will say that. So with the movement piece, sometimes if there's a lot of inflammation, it can be really painful to move. And so we always want to strike that balance where we're not pushing the body past its capacity. But, I mean, I was just speaking with a client a couple of weeks ago who has RA, and she said, if I don't move, I am in more pain. If I don't move, I have more inflammation. And so we're always trying to find that line stretching ourselves a little bit, but not pushing past the capacity. And then the sleep thing, I think, is just overlooked, and it's not talked about enough when it comes to inflammation. Uh, everybody wants to talk about diet and stress, and, like, sleep just gets so overlooked, but it's very, very hard to keep inflammation in check if you're chronically and constantly underslapped.
Erin Holt [00:22:07]:
So that's a really big one to think about. Um, what else should we be thinking about with inflammation?
Rachel Mistry [00:22:14]:
With inflammation, obviously, the nutrition and the lifestyle are the foundations. And then if we're thinking about doing, like, a deeper dive, that's where we want to think about, okay, what's going on with overall gut health and your microbiome? And this is a lot of data that we would gather on lab testing. Right. But some of the things that we look at when we're evaluating someone's stool test results are what's going on with their beneficial bacteria. Right. The lower your beneficial bacteria levels are, the more prone to inflammation you're going to be.
Erin Holt [00:22:48]:
100%. And because we're talking to some practitioners here, I think it's fair to get into, like, the nitty gritty, because if you're a practitioner, you probably know what short chain fatty acids are. And we know that the beneficial species produce short chain fatty acids. Short chain fatty acids help our immune system create t-regulatory cells. They essentially turn on those t-reg cells in the gut, and that sends messenger proteins out to the rest of the immune system. So t-reg cells modulate the immune system. And so if there's low beneficial species in the gut, then it's very, very likely, like Rachel said, there's this, like, body wide inflammation, but there's also this immune dysregulation that kind of goes hand in hand with it, too. So it's super, super, super critical that we are supporting the microbiome.
Erin Holt [00:23:37]:
I think people love to go in gangbusters and look for the pathogens, because that's a fun. That's sexy. We find the thing, we can kill the thing, but sometimes it's really more about supporting the growth of the beneficial species.
Rachel Mistry [00:23:52]:
Definitely. And I feel like I see deficient beneficial bacteria more often. I do see pathogens and bad bacteria. Overgrowing yeast, parasites, SIBO, don't get me wrong, but I feel like I see deficient beneficial species more common in practice than overgrowths.
Erin Holt [00:24:11]:
You heard it here first, folks. That's such an important thing. And I just, I don't know if that is. I don't hear that often enough. I don't think, like, because. And I know I've talked so much about, just, like, don't go in gangbusters and try to kill, kill, kill, murder, murder, murder. And, like, take these, like, super extreme kill protocols with a clients. But it's like, you know, this is a way to, like, support and nurture the microbiome rather than just try to, like, decimate everything there.
Erin Holt [00:24:42]:
But also, sometimes we do find bacterial overgrowth, too. Right?
Rachel Mistry [00:24:46]:
We need that. We need the kill protocols, too. But, like, while also respecting levels of beneficial bacteria, 100%. I had a patient that had these awful digestive issues. I was like, oh, my gosh. Her GI Map is going to be a mess. We're going to see so many overgrowths. She had, like, no pathogens, no parasites, no opportunistic bacteria.
Rachel Mistry [00:25:07]:
It was just her beneficial bacteria species were, like, so depleted. Her secretory iga was also depleted. So she had started to develop this, like, loss of tolerance to foods, and it really was. We spent a good amount of time building up her good bacteria, building up her digestive immune system function, and she did so, so well. We didn't need to bring in any antimicrobials, which was really nice.
Erin Holt [00:25:30]:
Amazing. Anything else we should be considering? When we're going inflammation hunting in the gut?
Rachel Mistry [00:25:36]:
We need to make sure you're appropriately digesting your food right. We need adequate stomach acid and enzymes for digestion to occur. And also in the gut, we need to think about what's going on with your gut lining. Sometimes, you know, a poor intestinal permeability or aka a leaky gut, this can be associated with an increased risk of developing autoimmunity in the body. So, like, a cliff notes version of leaky gut is basically on a microscopic level, things are leaking into the bloodstream that don't belong there. So partially digested food, toxins, bad bacteria, they enter your bloodstream, and this elicits an immune response. This is a burden on your immune system. And we can just see so many random side effects and symptoms from this as well.
Erin Holt [00:26:23]:
Yep, for sure. Inflammation and immune dysregulation. How about other things from a food perspective that we might want to be considering if we're going inflammation hunting?
Rachel Mistry [00:26:36]:
We want to make sure that you're eating enough fiber really foundationally. And we want to be limiting your intake of seed oils, processed foods, alcohol, and added sugars. But really thinking about diversifying your diet, your antioxidant rich foods. The less processed your foods are, the better. The shorter the ingredient list. I know this can't always be applied to every single product, but the shorter the ingredient list, the better. I've kind of trained my husband. Like, when he's picking out a product or a food, he's like, what do you think about this? He now knows, like, to look at the ingredient list and, like, check the oils in it, check how many grams of added sugars are in it, like, before he brings it to me and asks my opinion on it, too.
Rachel Mistry [00:27:19]:
So that's definitely a biggie. And something that we've kind of, like, hinted at and include, too, is just like blood sugar management. So if your blood sugar is up and down throughout the day, your cortisol will be up and down throughout the day as well. One of the main purposes of cortisol is to regulate blood sugar if it does get to be too low. So let's say you're doing like, a really prolonged fast. You haven't eaten in a while. Your blood sugar dips, cortisol will be released to bring your blood sugar back up. And, you know, this is going to happen occasionally, and that's life, and that is okay.
Rachel Mistry [00:27:55]:
But if this is occurring all of the time, this can also be a source of inflammation and a source of stress on your body, and as a result, your immune system to constantly be producing that cortisol to regulate your blood sugar. You can't regulate your hormones without balancing your blood sugar.
Erin Holt [00:28:11]:
And then, like I said earlier, too, those elevated A1C's. Uh, inflammation babe. That's inflammation babe. Um, and so you might not need to go inflammation hunting. You might have found that, like, the real contributor to inflammation, especially when the diet, makes it makes sense that the, the A1C is elevated based on what the person is eating. Um, and then anything else that we haven't talked about that could be contributing to inflammation.
Rachel Mistry [00:28:41]:
I don't always start here, I don't always jump here, but, like, environmental toxins can be such a biggie just in your personal hygiene routine. But also, mold can sometimes be someone's root cause. It's very, it can be very inflammatory and heavy metals as well. I had a patient where basically they had amalgams removed, and four to six months after the fact, they started to develop a lot of just kind of neurological symptoms and a lot more inflammation. And so, again, we don't immediately start our work there, but that can also be an area to explore if we're not seeing the needle move with some of the other strategies we've spoken about.
Erin Holt [00:29:19]:
Or it's like, like, I'm thinking, like breast implant illness. Yes. That's like another thing, because it's like, if the exposure stays there, if the exposure to the thing that's triggering the inflammation doesn't get removed, then the inflammation can't be removed. So we could see this, like, with food sensitivities, for example. So wheat zoomer, or if somebody's sensitive to gluten and they're constantly eating gluten, well, they're constantly getting exposed to the thing that is causing the inflammation. So the inflammation is never going to go away.
Erin Holt [00:29:50]:
So it's like, we do need to remove the exposure to the stimulus, essentially, if we want the body to be able to get into heal and repair mode, which is why we go inflammation hunting. All right, let's talk about some case study examples of patients that came to us with inflammation where. Or came to us with symptoms, and we had to go inflammation hunting. Let's talk about, like, bring this into actual practice.
Rachel Mistry [00:30:21]:
Full circle. So, I was recently working with a patient who was struggling. She had a lot of aches and pains all over her body. She also had, like, a lot of cysts. She had cysts in her breasts, cysts in her ovaries. She struggled with mental health concerns in that she had experienced, diagnosed with PTSD and just, like, general anxiety as well. Her energy wasn't great. She was bloated.
Rachel Mistry [00:30:46]:
And her weight, she was gaining weight even though she hadn't changed her nutrition or lifestyle. That weight gain can also be a sign of, like, something's not right in the body. Like, inflammation is kind of running amok. And she also came to me saying, like, I get sick all the time. And when she does get sick, it knocks her out. Like, it took her a long time to recover. She would get a cold, a flu, like, nothing super major, and she'd be knocked out for three to four weeks. And her blood, her white blood cells on her blood work would remain elevated for a while after getting sick.
Rachel Mistry [00:31:18]:
So this, to me, was like, okay, something's going on with, like. There was, without a doubt, some general immune system dysfunction. And the theory behind our work, or, like, what I share with a lot of our patients is your body has this awesome ability to repair and recover and heal itself when we remove those antigens or those stressors or those triggers. And so she came to me at the first appointment with outside blood work that she had run through her PCP, and this did reveal poor blood sugar control. She had high A1C. She was classified as pre diabetic, and then she also had high glucose. When we spoke about her nutrition, she thought that it was better to fast because she was told she had high blood sugar. She was not eating breakfast, sometimes not even eating lunch, but then she was just, like, binging at night.
Rachel Mistry [00:32:09]:
A lot of times, she wasn't getting enough protein, she wasn't getting enough nutrients to fuel herself. And, like, right away, I was like, we need to get you on a more normalized eating schedule. We spent a lot of that first appointment, of course, talking about her health history, what she tried, and what she hadn't. But a lot of that first call was spent educating on blood sugar control and, like, helping with, like, meal ideas and recipe inspiration. And then at that first appointment, I recommended some additional labs because I was like, why are you getting sick? Why are your white blood cells so high? And maybe it was just the blood sugar, poor blood sugar control, but I, like, just had an inkling, like something else was going on. And so we ran a stool test. Her stool test results came back, and it revealed that she had really depleted beneficial bacteria. This made sense because she wasn't eating a ton throughout the day.
Rachel Mistry [00:32:58]:
She wasn't consuming enough food and nutrients and fiber to feed her good bacteria.
Erin Holt [00:33:03]:
Okay wait, because this is. Let's just take a moment of silence so we can just really reflect on what Rachel just said, because that's a huge thing when we're trying to support beneficial bacteria, they do need to be fed. And so if we are not eating, it's really hard to feed those bacteria, and it's not an uncommon. When we see deficiencies, we can see, like, deficiencies across the board. So nutrient deficiencies, immune system deficiencies, and beneficial bacterial deficiencies. It's like everything's knocked out.
Erin Holt [00:33:41]:
These things need food. We need food as fuel. And I love that people want to support their body and do right by their body, and maybe the information they've been handed is that the only path to this is fasting. And I get that. I really, really understand. We just don't consistently - In years, in years of practice combined, we've worked with hundreds of individual clients, thousands through programs. We just don't see this serving most people. Restricting food and fasting usually does not set people up for long term success.
Erin Holt [00:34:16]:
Okay, soapbox over.
Rachel Mistry [00:37:14]:
So she had this insufficiency dysbiosis. Her good bacteria were low, so again, this aligned with getting her eating more frequently and consistently. Not surprisingly, her secretory Iga was low from, I think, frequent illnesses, long term inflammation, and infection in the gut. She did have a lot of problematic bacteria overgrowing, which also wasn't surprising, just given, like, the illnesses.
Erin Holt [00:37:41]:
And do you sometimes feel like, with secretory Iga? So, by the way, that's an immune marker, in case you're not familiar. We have a whole episode on it. But do you sometimes feel like. It's like. I don't know if I'm using this analogy right, but, like, the cat chasing its tail. So with low secretory IgA, the immune system is suppressed. So we're going to be less likely able to fight off pathogens and bacteria and viruses, but so we're getting more and more exposed to them, or maybe not. The level of exposure isn't change, but our level of resiliency to be able to defend ourselves against them has changed, but the immune system kind of keeps fighting.
Erin Holt [00:38:16]:
And so then we continue to perpetuate this, like, low secretory igA. It's like, is it the cat chasing its tail? Am I using that right?
Rachel Mistry [00:38:23]:
Chicken or the eggs?
Erin Holt [00:38:24]:
I don't know, but it's something. Some type of cycle.
Rachel Mistry [00:38:27]:
Yeah, feed forward cycle. Okay, so for this patient, too, again, like the foundations, we really had to work on the foundations. She worked in the medical field, so also we just had to work on, like, boundaries with screen time and, like, building in routines to unwind and decompress after her long patient days. And then we did also run a Wheat Zoomer on her because she shared with me at the initial call, she was like, I just don't feel super great when I eat bread products. But she was the type of person who needed the data in order to determine, like, do I need to eliminate, restrict, reduce. And so her Wheat Zoomer came back. She tested positive for a leaky gut, gluten sensitivity. And alongside cleaning up her diet, cooking more, balancing her blood sugar, she went gluten free.
Rachel Mistry [00:39:17]:
And we didn't even start treating the bad bacteria that showed up on her GI Map, probably for three or four months, because we had so many other things to work on. And it was a really nice stepwise approach that we took for her. And she actually saw, she was seeing weight loss. She was needing to buy new clothes, and she was having such a hard time wrapping her head around the fact that she was eating more and seeing weight loss, because we're taught eat less and exercise more if you want to eat. And for her, she actually needed to eat more. Her blood sugar imbalance was definitely a source of stress, like, a biggie for her. But we cleaned up her gut, we removed a food sensitivity for her, balanced her blood sugar, and, yeah, she didn't get sick the whole time that we were working together also. So things are in a really good space as well.
Erin Holt [00:40:05]:
Awesome. Awesome. I'll share a client case study to just kind of, like, drive home this inflammation hunting point. So she came to me, really, for immune system health. She's like, I keep getting colds. She's like, I keep getting Covid, I keep getting colds. They have a tendency to turn into sinus infections. She had been on, when she came to me she had been on a Z-pak twice in that month.
Erin Holt [00:40:31]:
Seasonal allergies were a big thing for her. She also had. She was kind of like an afterthought. She started to talk about this rash she had on her neck. It's like, yeah, it's a little weird. Sometimes on my neck, sometimes on my mouth, and I'm like, where else is it? And it was between her boobs as well. So immediately I was like, there's something like, fungusy going on here. So those are, like, the big things that she came to me with.
Erin Holt [00:40:57]:
She had been diagnosed with lymphedema, so she had a lot of swelling in her right leg. So to me, I'm like, yeah, there's, like, some inflammation going on. By the time she had left, I'm going to actually, I pulled up my soap notes. I'm going to read verbatim what she said. More energy. She's high on life. I feel like myself for the first time in a long time, I have more energy.
Erin Holt [00:41:16]:
I feel good. I'm sleeping amazing. First time in over a year that I haven't gotten a migraine with my period, and I'm ovulating again. I started feeling better a week or two after starting the Candex, which is a yeast treatment that we used. My hair stopped falling out, and I was able. I'm able to use my Peloton again. So, like, what happened between where she came to me, dragged ass, and then she's, like, hopping on her peloton and having, like, a lust for life. What happened between those two, you know, those two ends of the spectrum? I ran a GI Map stool test on her. So that was a big one for the immune system.
Erin Holt [00:41:56]:
I also, because of the fungus stuff or my fungal suspicion, because of her rashiness, I also ordered an Organic Acid Test and then a Wheat Zoomer as well. So not dissimilar to some of the stuff that Rachel was just talking about. She had some of the lowest bacteria I've ever seen. They were just decimated. They were crushed. And this is probably in response to some of the antibiotics that she was using. So she was just getting so many infections, and she was constantly being put on antibiotics, which is just, I guess, to use Rachel's feed forward cycle. It was just continuing to crush her beneficial species and continue to keep her immune system suppressed.
Erin Holt [00:42:38]:
So she was in this cycle, she had low Ackermansia, which just can be challenging to keep that gut barrier strong and reinforced when we have low levels of Ackermansia. So there's a higher likelihood that she would have some degree of leaky gut. She also had low secretory Iga, which we discussed. On the Wheat Zoomer, we saw that she had elevated LPS, lipopolysaccharides, super inflammatory. So if you have high LPS with any type of leaky gut, this means that these LPS is on the outside of bacteria, and they can gain entry into the bloodstream, and they're really, really, really inflammatory. And where that inflammation shows up is kind of like wherever your weakest link is. It's kind of like pouring gasoline on the flame there.
Erin Holt [00:43:27]:
So we definitely saw that she had some inflammation. She was also super reactive to gluten, but she was eating gluten, so that was an exposure that she was getting that we needed to reduce. On the Organic Acid Test, definitely some indications that there was a fungal overgrowth, low b vitamins, and low vitamin C as well. So we knew that that was an area of intervention, and so the approach that we took was to put her on a gut protocol. So we addressed candida. This particular client didn't have a lot of trust or faith in medicine, so she refused to go to a doctor. I really like Nystatin prescription, if we can get it, for a fungal overgrowth that wasn't available to us. She didn't have a relationship with the doctor, and she didn't want to go to one.
Erin Holt [00:44:12]:
So we used Candex. There's a lot of different yeast treatments. This is the one that I just. Because her immune system was so revved up, I didn't want to do this, like, heavy hitting, hardcore kill the yeast protocol, because I just didn't think her immune system could really withstand that. So I like Candex. It's a product that kind of explodes the cell walls of the yeast. So it's a different. Kind of a different.
Erin Holt [00:44:36]:
Am I saying that right? Explodes the cell walls of the yeast. Is that right?
Rachel Mistry [00:44:40]:
Breaks them down?
Erin Holt [00:44:42]:
Yeah, like, pew, pew, pew. That's a weird way to describe it, but I think that's actually what it does. Anyway, it breaks them down, and it's just a little bit more of a gentle approach. So when somebody's immune system is super suppressed to the point that they're catching everything that goes around, and their secretory iga is low, we want to be really, really careful in discerning with the type of kill protocol that we put somebody on. And we use a lot of binders in this particular case, too, to kind of mop up any of the stuff that we might have done with killing the yeast. We did high dose probiotics to support the immune system, Secretory IgA support.
Erin Holt [00:45:22]:
We did vitamin A support, which can be really therapeutic for immune dysfunction. And then we hit her with B's and C's. So this one was a little bit more heavy handed with supplementation. She's open to it. She actually really likes supplements, which is why we kind of went balls to the wall. We were kind of just, like, hammering her system with support. She already ate really well. So for context, ate really well, took care of herself. Um, really wasn't exposed to a lot of toxicants.
Erin Holt [00:45:53]:
And so I was like, you know what? You're eating so well, like, let's just give you a lot of supplemental support. And so that was the approach. That's how we figured out where the inflammation was coming from. It was a lot of immune dysregulation, but really, the candida, or the fungal overgrowth, was kind of driving a lot of that, as well as her exposure to gluten and then the leaky gut. And then there was some other little cleanups that we had to do from a bacterial perspective in her gut, too. But it really moved the needle for her. How about one more case study? Because I think that people learn a lot through hearing how we practice.
Rachel Mistry [00:46:32]:
I might have more than one. I was going to say I was working. I worked with this patient. He was young, he was in high school, ate really healthy. He was an athlete. His mom was a nurse, and he was diagnosed with diabetes. And she, as a nurse, was like, gung ho on all of the conventional medicine treatment. She's like, he's not eating any carbs.
Rachel Mistry [00:46:54]:
And his A1C keeps going higher and higher and higher. It, like, logically, logically, it did not make sense. And that's where functional medicine really shown for him. He ended up being. I promise, not everyone is gluten sensitive, but he ended up being gluten sensitive. And his blood sugar, like, was so significantly improved. And then we ran a GI Map on him.
Erin Holt [00:47:11]:
What do you mean? It was so improved? Just from removing the gluten?
Rachel Mistry [00:47:14]:
Yeah, because she even got him one of those continuous glucose monitors, because she was like, what is going on? So going gluten free. Within seven days, maybe ten days, his blood sugar was already trending down. And that kind of, like, built some trust into his mom, who, again, like, is a nurse. She was like, I'm doing what the doctors are telling me, and it's not working. And she didn't want her high school son getting on Metformin, like, medication at such a young age. And then we cleaned up his gut on a Gi map, and he saw continued improvements. It was kind of crazy. And I feel like he just rebounded so quickly.
Rachel Mistry [00:47:50]:
Like, within two months, he was, like, within a normal reference range for his age.
Erin Holt [00:47:54]:
Oh, to be young.
Rachel Mistry [00:47:55]:
I know, I know. And usually we say, like, give it at least three months before you retest. Maybe it was like two and a half, three months, but it was, like, pretty rapidly. He got so much better so quickly. So that was awesome. And then another patient that I worked with, she came to me primarily. She did have PCOS, and she had irregular cycles, and she definitely wanted to get that figured out, but she primarily came to me because she would get a UTI every time she had sex with her husband. And so she was taking antibiotics prophylactically after she would have sex every time.
Rachel Mistry [00:48:32]:
And she's like, this is not sustainable. And we, for her, we went that inflammation hunting. We took that approach to addressing her gut and figuring out, why are you getting all of these infections? And we didn't even do a ton of work on the testing her hormones. And actually, like, by treating her gut, she saw, like, a normalization of her cycles. She started to, like, she started to experience regular cycles every single month. She was able to conceive naturally, but it was so hard because taking antibiotics multiple times a month just was depleting her good bacteria. It was keeping her immune system weakened. Like, you said that, like, like we said that feed forward cycle, and she was eating a really nutrient dense diet.
Rachel Mistry [00:49:23]:
She was like, she had her nutrition and her lifestyle locked in. She's like, I'm doing all of the right things. What is going on? We spoke about stress management. We addressed the findings on her GI Map. And, yeah, she stopped needing to have to take antibiotics, which was amazing. And, like, quality of life, too.
Erin Holt [00:49:41]:
Totally. Exactly. And that's. I mean, I think that's so rewarding about the work that we get to do. It's not just, it's not just like seeing a clean GI Map at the end of this. It's really about enhancing people's quality of life. So I would say if this is the kind of investigative research that you are ready for with your own health, definitely reach out to us to apply to work with us today. We do have a few spots opening up at the, the beginning of next month, maybe now, depending on what this gets aired or around this time, but we would love to help to improve your quality of life.
Erin Holt [00:50:16]:
And if this is the type of practitioner that you would like to become, learn with us in FNA because this is exactly what we do for 14 months together. Even longer if you want to hang out with us in the graduate membership. And there is a lot of handholding, there is a lot beyond just the curriculum where you're going to really learn how to do this deep dive. And it's not just like, oh, what labs do they need? But it's really using context clues to be like, okay, what could be going on here? And then building out that discretionary muscle of like, okay, and what data do we need? If we need more data, we teach you all of that. And then we also have group coaching calls. We have one on one support like Rachel mentioned at the start of the show. So sign up.
Erin Holt [00:51:00]:
We're open for enrollment. We close at the very end of the month, and our new cohort starts October 1, so we would love to see you there.
Rachel Mistry [00:51:07]:
You can head to funktionalnutrition academy.com today and fill out your application, and I'd love to chat with you over an advisory call.
Erin Holt [00:51:15]:
Awesome. See you guys there. Bye. Thanks for joining me for this episode of the Funk'tional Nutrition podcast. If you got something from today's show, don't forget to subscribe, leave a review, share with a friend, and keep coming back for more. Take care of you.
