Longevity Starts With Your Immune System, Not Your Serum Ft. Dr. Stacie Stephenson

0:02Hey guys, welcome back to Skin Anarchy. Today is a very special episode because we're going to be talking about a few topics that are now emerging emerging more and more when you look at health care.

0:30and really get professional, you know, experience and insight on all of this. So without further ado, I want to introduce you guys to Dr. Stacey Stevenson. She's a leading lifestyle medicine doctor and a true pioneer in functional and integrative medicine. So welcome, Dr. Stevenson. I'm so excited to host you. Thank you. And Stacey or Dr. Stacey is more fun, I think. Awesome. Well, we'll roll with that. But, you know, I want to actually figure out how you got into this. I mean, it's such a for us, it's such a new field, right? Functional medicine, translational medicine is now coming up in the, you know, the mainstream kind of thing.

1:09So how did you get involved with it and kind of pioneer the space? Well, it's kind of funny. Whenever I hear people say new, it really cracks me up. Yeah. No, and I mean that. I love that you said that because with all due respect. Well, I don't think it's new. I know it's not new because I'm in medicine. So yeah. But you make a very good point. A, it's sort of what is integrative medicine? What is functional medicine? There are all these terms that get thrown. Is it alternative? Is it integrative? Is it functional? Is it nutritional? Is it clinical? Is it? We could do 14 episodes just talking about understanding the entire healthcare terrain, candidly, which is a big interest in mine, but to be very, very simple.

1:55I was an athlete. I was a competitive figure skater. I had the world's worst year you could ever imagine, which would have been my Olympic year. So I had three significant physical injuries on the ice in one year. And concurrently, I had a series of three or four really yucky illnesses that I'd never experienced in my life from, from mono to, I got, I got rheumatic fever. I know you're going to have to like go to medical school to think what that is. Like nobody gets that anymore. I was like, I was just this kind of infectious, broken mess. Um, and I'm convinced it was stress over training a whole lot of stress for a very young person.

2:40But just imagine you're looking at somebody that's totally fit, you know, an elite athlete, and I'm sick as hell. But I, that wasn't my, I wasn't that girl. You know, I didn't have allergies, I didn't tend to have sicknesses, but I just had this horrible year. So that began to really make me think about I know one would help me, right? Because you're too young. They're gonna work on physical injuries. Of course, right. But the rest is like, Oh, oh, she'll be fine. Right? Oh, she'll get back. Well, you do sort of get better sort of, but all you use is time essentially and rest. And so that got me thinking very early on because I was very interested in health, nutrition, obviously physical training.

3:24Um, and that actually moved me into clinical nutrition and public health and clinical nutrition as an undergraduate and ended up, I have a feeling a little, some of our story might be in bits of ways, similar, traditional medicine first for me, and also very frustrating, and thought, what the hell? Honestly, aren't we here to help people? And I was really learning to help people in my vision. And you're young, and I had a vision of health and wellness and fitness and longevity. And how I got there, I have no clue other than I think my athletic career made me really think about that. Then I just kept searching and searching and searching and searching.

4:11And I began going to the Institute for Functional Medicine when it was essentially in people's living rooms. Dr. Jeffrey Bland, who is truly the father of functional medicine in the United States, I met as a very young woman and he, I think, chose my career. I lucked out with several, which is just getting boring, but I lucked out with several mentors that, um, another one in naturopathy who founded the first accredited naturopathic school in the United States, which is best year college of naturopathy. They were the first licensed, accredited proper program. Their founder is amazing. His name is Dr.

4:54Joe Pizzorno, well-known internationally. And then I had an acupuncturist mentor, but it was just like all these signals. I was on a traditional path and I kept meeting these wonderful people that were much beyond my years, 30, 40 years beyond my years, but ensconced in this fabulous world of functional and integrative medicine, it just kept pointing me in the right direction. And I always knew I had interest in clinical nutrition and performance as an athlete so that was a little bit natural i always had a natural inclination to entrepreneurship too and i hated medicine oh yeah yeah i mean i think it's a big game at this point too you know that's like a whole conversation on its own though i'm not gonna go down that rabbit hole insurance and all that i didn't love i should maybe say institutional yeah I had a hard time in institutional world and it wasn't because I was completely off off the ranch it's just there isn't much room for your personal view as as a doc yeah working super personally and individualized with your patients and I had dreamed of that yeah I really thought that's what health care was I was so naive no I mean you know what's it's crazy because I recently saw this I don't know if you caught it but it was a big YouTube video that went viral of a neurosurgeon and he was out in the middle of nowhere and he literally was saying all of this right because you think that in certain fields you think once you're there you're just you're good you know you have the control over your career you're you're doing what you want to do and you know you're treating patients the way you always envisioned yourself treating patients it's just not it you know that's it's not what it is anymore so yeah so it goes back a long way for me and i became dedicated immediately um to functional medicine and that was before there were national certifications and things like that but took a few blows along the way as most early adopters do that you know um kind of how it is you but we always i have a term that says i don't want to be on the bleeding edge anymore.

7:08I want to be on the leading edge. Yeah, I like that. I don't want to take the arrows as much anymore. But if I could boil it down, I just call it good medicine. Yeah, no, it makes sense. I think that it's interesting now, because I think a lot of people are getting to that place now, like, especially when I look at, you know, Gen Z, there are so many of them and i've said this before on the podcast where it's like why haven't we figured out acne yet you know like genuinely genuinely like why the hell are we still confused about a bacterial disease like it's insane and and so people are really turning towards what they're now thinking is a new buzzword right translational medicine functional medicine individualized individual right exactly you really hit the nail on the head of that that whole experience of frustration with the you know the medical system where it's like no matter what i do i don't get the treatment i need you know and that's where it really really is so crucial what you're doing and the message you're putting out there because i think people are looking for guidance here there's no blueprint right now for functional medicine when you look at it as just a layman everyday person you know you don't you don't see it i want to ask you about that like you know what are your what are the pillars in your mind like when you think about functional medicine like what are the big pillars about how we should be thinking about it and what it really means well i think my my guiding force in functional has always been which might sound simplistic but it's it's a good statement that i have to attribute to dr kellogg of death begins in the colon.

8:51I think that, you know, really that was, that was the, the foundational functional medicine world, which is the work in gut health, the microbiome. Now the microbiome thing, in a funny way, it's all sounds sexy now, right? I'm thinking, why wasn't all this fun 20 years ago? But, um, you know, we have core principles in functional medicine, gut being very critical, detoxification being extremely critical, the immune system. We basically break down just the systems that we all learned in medical school. Immune, what does our GI do? What does our skin do? What's the neurologic system? What's the orthopedic system?

9:30And we try to basically preserve and repair using principles based in food, movement, and supplementation as well, not necessarily using supplementation as drugs, although it can be. Herbs are drugs. I really enjoy speaking about herbs. I've had a wonderful relationship with herbs for decades. At the core, if I just had to say something very simplistic to consumers, functional medicine we just seek to really find the closest pause and wipe it and we know how to cover symptoms like if someone came to me oh my god doc i got a cold what's your best natural medicine well you know what how miserable are you do you have to get on an airplane because if you need to get on an airplane in two hours i'm not going to give you i could give you an iv vitamin C, which would boost your immune system.

10:31And you're going to probably feel a whole hell of a lot better in a couple of days, but it's not going to get you through that airplane flight. Yeah. By the way, you're going to need to take the antihistamine if you're willing. Right. So I also think it's blending the best of everything on the spectrum of functional docs, because I go so far back, but my core belief personally in functional and integrative is just helping a patient learn and select the best for them, for their needs, and basically being that filter for them. If they, doc, I never want to take a medicine. I never want to do this.

11:10Okay, I'll do my best. Great. That's your philosophy. I like to follow the patient's philosophy. Yeah. I like that. I don't need to fit them in my exact peg, but what I know is what you just said. People come to integrative doctors, whatever it is that people maybe are even gifted healers. I mean, that's not a function. We don't that's not functional medicine. But using the best of everything we have in our arsenal is what I believe it is. And that's actually quite difficult if you really want to get results. It's principles that you have to follow. your fitness being extremely critical, what you put in your mouth being extremely critical.

11:58And currently, these days, you have to supplement. I don't make any bones about that anymore. I can't see how many people love to say to me, well, doc, I mean, get all your nutrients from your food. Good luck. Yeah, that's not how it works. Yeah, there was maybe our, like my parents generation people growing up maybe in the 50s 40s obviously prior to some extent before the pesticides herbicides were so prevalent before the soil was in you know it wasn't in such poor shape as it is now um let's not even get into genetic modification of food which was already beginning in the 50s and 60s but it is intensely rampant now it's almost unavoidable at this point I mean, there's one of the most interesting things to me that I've seen over the last, I think, five years, or even probably in the last decade, we've seen this overall in the medical community, autoimmune diseases.

12:58They're a huge testament. The rise of autoimmune disease is a huge testament to how poor the quality of food that we're eating is, and how poor the quality of the water and everything that we're being exposed to. I mean a lot of the diseases that you know are kind of having this uptick things like Hashimoto's thyroiditis there's no it's not a genetically predisposed you know predisposed condition you're it's not happening only in women you know men are getting it more you know people always love to say like oh autoimmunity it's in women mostly right and that's just it's not true anymore 20 years ago you were right or they would be correct it was traditionally right a middle-aged a kind of peripostmenopausal lady, usually mom, autoimmune.

13:44Those formulas that you and I learned in school don't exist anymore. It doesn't exist anymore. Yeah. I want to learn a little bit about this from you because I think when I think about skin health, I mean, I've looked at almost every major brand in the industry at this point, you know, currently as of today. And there's a lot of great innovation here, but at the end of the day, you know, what we were saying earlier about acne right something like acne where is that balance between what we need to do for our overall body versus this very targeted approach where people are still going to the derm and they're getting things like you know accutane and really strong retinoid you know prescriptions that are just in my opinion bullshit okay i don't think we need it it's like what are what are your thoughts on that in terms of overall health and skin health tied in.

14:36You make a very good point. Targeted might sound good to a consumer. Oh, I want a targeted treatment for a problem, but I take care of a lot of acne anyway as well because to your point, Accutane has its substantial issues and the retinoids have their substantial issues. And at the end of the day, the person still has whatever milieu of environment physiologically still exists no matter what we use right if we give them antibiotics if we give them topicals all of your arsenal your arsenal essentially is either oral biochemistry through pharmaceuticals like you said you've got some fabulous products accutane was it was a game changer at the time for cystic acne, but we were asking ourselves the question, how the heck did the person get there?

15:29And if we knew how they got there, maybe we can backtrack. That's functional medicine. So acne, I have to tell you, the first thing I think of with acne is what the heck are you putting in your mouth? It's almost not so much about what they don't eat though. What you'll often find in acne cases, stubborn especially, is you really have to look at the GI. They have probably, I can't tell you enough, they've probably destroyed their microbiomic environment. It might have gone back to toddlerhood. It might not have happened two years ago. It could have happened when they were three and they've just been kind of hobbling along and now they're 13 or 14.

16:07And now the negative consequences of the leaky gut, maybe their gluten sensitive spectrum. Remember there's a huge spectrum of gluten and celiac. There's actually quite a spectrum of dairy. Dairy can pretty easily be linked to a good 40 to 50 % of acne, not cystic. I know that's, that's really another difficult story. You need to understand if they're eating anything that is triggering that acne response. So you have to do food sensitivity testing or you can do elimination you don't have to do blood testing you can just work on elimination it's slower it's harder you could do very detailed diet diary and begin to do the four-day type challenge like the um you know you remove this food for four days you you journal it you remove another one it's it's hard it's not it just takes discipline it's hard for a teenager to do i mean i couldn't do that you know how it helps you know if somebody brings me a three-day diet diary, you know what, it really helps me see what their go-to foods are.

17:14And that helps a ton, because then I can see if they're eating the same things every day. Doesn't mean they're allergic or sensitive, but it also can give me clues on their overall nutritional status. But I'm with you on the bacterial acne. It's sad. And that also we continue using topicals, right? Yeah, topicals that exacerbate the situation, you know, they're not meant to be, I mean, I think this is my biggest pet peeve in the skincare industry, is that we know so much about acne, and I'm not only trying to talk about acne, I just, I feel like this is the most obvious, you know, pathology that we can discuss with skin health, but like, I just see it everywhere, where it's like, okay, we understand there's fungal acne, there's bacterial acne, there's, you know, hormonal acne, but then you still see products that are literally only geared towards bacterial acne everywhere you know you got the acids you got all this stuff going on and it's like we know it but we're still not applying it and that's why i'm like so interested in this translational medicine route because i think we need to understand that you know there's a lot of knowledge out here but we're not applying it and we're not seeking like the true opinions of experts that understand how to apply it like yourself you know somebody who comes to you for acne, I'm guaranteed they're going to have a whole different experience than going to a standard dermatologist.

18:38You know what I mean? It's going to be a very different night and day kind of difference. Yeah. I'm going to look at their whole, I'm going to look all over their skin and you want to get a really good understanding of their diet. I want to get a really good understanding of their stress. I know it sounds obvious, but it's not because it takes time. I want to get a really good understanding of not just when that started, but I want to get an understanding going pretty far back. Like, tell me about your ear infections. Call your mom. Did you have, did you have them? How many did you have strep?

19:11How many, how was it treated? Tell me about your allergies. Do you have them? Do you not have them? What are they like nasal allergies and now for allergies and that sort of thing? I want to know all that. People are so terrified about cancer. And one way that I've always found is easy to ease their minds a little bit is, is I'll say, Hey, guess what? Like the easiest one to keep up on and eliminate and everything is skin cancer because Jesus, we can see it. Yeah, exactly. That's cool. Every other cancer we can't see. We have, that's why you die from them. They're too late. I mean, take pain. Now I digress.

19:52I would just close on acne by saying it's incredibly, it's this battle of what you put in, which is your food, what other substances you've put in that are generally antibiotics. Antibiotics essentially reduce, not essentially, I'm just going to say it, as you well know, general antibiotics disrupt the normal bacterial balance from the tip of your nose to the other end. Even though we do have more and more targeted antibiotics, and that's helpful. If you don't balance and replenish, when you take an antibiotic, you must replenish and balance with probiotics. There's no way around it. You just have to.

20:39I work my behind off even for myself and have to be very focused if I do choose to go a route like that. So a lot of it's in prevention. When we give out a medication, like any general antibiotic, let's just beat up on amoxicillin. If they were concurrently prescribing or giving information on how to restore, which isn't that hard, it's really not that hard. Yeah. We might not be facing the things later down the road. Same with autoimmune. Exactly. Yeah. No, I agree. I think that it's really about understanding what preventative means to an individual as well i mean i think that preventative medicine is has so much potential but at the end of the day you have to understand your own body and i think for patients it's very critical for us to do that homework you know i'm i'm a huge advocate for that is this idea of you know knowledge really is power you know the more you can learn about what you what your normal physiological state is where you're feeling your best, the more you can learn about that, the better you can inform whatever practitioner you're going to and try to kind of guide them in a way, you know, it's like, I really believe that, that when it comes to preventative medicine, like, people need to be involved with their own health, you know, you got to pay attention to what works, what doesn't work for you, whether that's food, whether that's topical treatments you're using, new supplements you're trying, you know, all of that really matters, and to keep a, you know, an account for that so that you can tell your doctor.

22:11I mean, if you go to like an endocrinologist these days, I mean, let's talk about the GLP-1 fad, right? That everyone's kind of hopping on board with this. And I'm all for it, honestly, because I really do think that the obesity crisis that we've been facing for so many years, it needed to be, it needed to be controlled at the end of the day. That's the bottom line. But again, you know, there's a lot more here to unpack than just that. So I think it's really helpful when people have an understanding of their own body and then they can go to somebody like an endocrinologist and say this is what my baseline is now tell me what i should do if i want to get on a glp1 you know something like that so but i would love to learn about you know what you think about the glp1 drugs actually what is your opinion on those i i'm a bit mixed from a just a gross numbers perspective of the obesity true epidemic in the country.

23:05And we track obesity worldwide, as you can well imagine, you've probably read the charts. And in 30 years, it has gone up and up and up, which means diabetes is up and up and up, cardiac disease is up and up and up, stroke up and up and up. And yet we have all this prevention. So it's really kind of twisted. But as far as the medications, the GLP-1 inhibitors, What I like is that it provides motivation. And when people begin to get going and move into their weight loss, generally, you will notice that they will naturally begin to make behavioral changes because they're excited. almost an emotional drug to some extent because they get the dial moving.

23:54And of course it's working better on people that have, that really have glucose and insulin dysregulation. So you will see that it isn't a quote, one size fits all and works for everybody. But when you look at the people that have been the, the, especially sort of the people battling various levels of overweight and obesity since childhood. Chances are they are glucose dysregulated, pre-diabetic, have been their whole life. And this thing is magic to them. It's a magic wand. And the lift psychologically that that would provide for a large group of people is transformational. and that makes me happy.

24:42I do worry about the long-term use because we don't have good clarity. I do worry a little bit about how it severely limits hunger to where people begin kind of having disordered eating. In other words, oh, I just live on a few and I had a coffee and it can take away your appetite like crazy. Yeah, like completely take it away. Completely take it away. And that's okay if you supplement appropriately. You could counteract the nutritional loss if you were just really crummy at your diet and you're the one that's eating 10 crackers and a half a sandwich and coffee and you're, you know, you're like, this is fabulous.

25:33I'm losing weight all the time. It's wonderful. All I really have to do for you is give you a really fabulous drink twice a day. I don't care how it tastes. I just want you to get better. I just want you to get better. I'm a little mean that way. When people would say to me like, oh my God, this is terrible. I can't drink it. I'm like, you're a grownup. close your nose and chug it down. And I literally, I'm like, watch it. I do it. And I'm a big baby too. But, um, and there's ways to make things a little more palatable and I have lots of tricks, but you know, at the end of the day, you just have to do what's best for you.

26:15I don't like exercise that much either, but you know, you, you grin and bear it. Um, I'm, I'm overall all supportive. Like you, I'm cautiously supportive. I worry a little bit from a nutritional perspective and I worry a little bit from a long-term use because when they, when they remove the medication support, the physiological factors are going to return. Yeah. Yeah. That's tough. The expense. So I'm not quite sure. Um, I think the gap in the space I'm thinking, and we're not doing it. I'm thinking we have to work at the education with those patients in the gap space. Okay. You start them at the GLP, you're doing fabulous.

26:59It's so exciting. You have your life back. It makes me cry almost, right? How about, well, but then we need to use that time, whether it's six months that you're using it or nine months or a year, maybe it's longer, maybe it's a year and a half because you had to go so gradually. Let's figure out in that time so you can calm down and feel confident how are we going to work with your food and nutrition and fitness in the long term of your life i don't think these are realistic long term maybe if if only for expense i mean are you seeing that that people are choosing their various dosages they're buying online odd who knows yeah it's gone it's gone kind of haywire like it's it's really scary in that way i know what you mean and you know especially when like you know like a pharmacy's quoting you 1300 for a month for your drug you know and then you're going to like you know weird sources to get it i mean yeah there's definitely that and it's it's scary you know to think that people are going to these crazy lengths to get it but i i mean i love what you said though about the diet component i would love for you to educate us a little bit there because i think a lot of um i think i do think a lot of people are on it or they know somebody who is and to understand that would be really crucial i think um you know to help educate right i'm all about that if you know somebody that's doing something educate them you know so what are your like recommendations you know for nutrition i guess you know that you should be mindful of if you're on the glp especially yeah i'd say um because i see that it so intensely suppresses appetite and wonderfully so it suppresses carbohydrate appetite very nicely, which I think is fabulous.

28:52It has an interesting, uh, more, it reduces your alcohol desire really, which has been a neat side effect. So a lot of times, you know, that's just empty calories. That's an easy one, but so that's all wonderful. But during taking the medication, I would say number one is your fats. or your fatty fish, you've got to eat it, or you've got to take the EPA DHA. You've got to continue with your healthful oils, like your avocado, for example, the good old Mediterranean, you know, olives and the fatty fish and the avocado. If I could put you on kind of the perfect diet, you don't need a lot of carb.

29:39You're going to get a little bit of carbon in some of that stuff anyway. I would be very careful with the essential oils. Okay. Not going to eat it the way you're feeling. You're not going to eat a lot of carb, which is fine. You really need a lot less than you realize. And then prioritizing your protein. So fats and proteins, you just really have to focus on lean fats. If it's animal, i.e., you know, your chickens, your lamb, things like that. If you're going to focus in fish as your protein, which I would recommend very much, I would focus in your healthful fatty fishes. The easiest one that people tend to like is salmon because it's highest in omega-6.

30:23I know it makes it sound like I'm going to turn into a salmon. Sometimes I think I am, but I think it's the most perfect food for brain because a lot of the fatty fishes are um people don't like them yeah like mackerel has actually higher than salmon um all of your your sardines and all the tiny little fishies those are super fabulous if you can eat them go for it i can do it i had to teach myself how to do it it's not an america traditional american palate but they are cold water fresh water very much more clean, high in omegas. You tend to add olive oil. But that's, again, not a traditional typical diet in America.

31:08But you need to prioritize your protein and your fats, period. What I also don't love is the irregularity of where the losses happen. The actual fat losses are completely erratic. And I know you're seeing a lot of that. yeah we're never i don't see how we're gonna figure out how to control that yeah it's it's a really i don't know what the body is doing honestly i'm gonna be honest like i when i see people's like results from this drug i'm just kind of like baffled you know because it's exactly what you said the fat loss doesn't make sense there's no like i don't know it's not predictive you could say you know everyone everyone looks different everyone looks different and there's a substantial amount of muscle loss so you have to prioritize you have to prioritize protein and fat in the food that you do eat while you're taking it yeah step two you have to work on strength training you must that is partly why you're seeing people look so weird um from a shape perspective.

32:17I mean, naturally, if someone was three or 400 pounds and they lose 100 or 150 pounds, their skin is not, it's not going to be elastic. They're probably going to decide whether they might need some surgeries down the line or something like that. I mean, but those are huge. You know, those are the actual more morbid obesity. That's a whole different long-term treatment perspective. If you're talking about someone at 40 pounds overweight or 30 or 40 or 50, those sorts of things, you are right. The fat, it's not just fat loss, it's muscle loss. And that's why they look strange and it's regular and unpredictable.

32:58I have to say, they're so excited about the weight loss, which I celebrate that they're not prioritizing the fitness because it feels like you don't have to do it. Yeah. Yeah. That was one of my questions actually was that because I think right now we've definitely, you know, created this culture now. I think these drugs have created the culture of like, well, you don't need exercise after all, but you do though. I don't know whether maybe the campaign is like, here's the goal and that this is what I think the physicians in the field are teaching. Some are. Some are teaching this, maintaining muscle mass and losing the fat.

33:42So if you choose to use the drug to lose the fat, there are only really two ways to maintain your protein status. And that's resistance exercise and ingesting protein. That's the only way it's going to happen. Otherwise, you are going to degrade the muscle mass and your weight loss is going to look even weirder. You know, it's a fair statement to say irregular. What I would say is, hey, think of it this way. You don't have to do two hours of cardio. We don't have to go back to the Jane Fonda years and Olivia Newton-John and get physical in the gym for three hours a day. We know you don't have to do that.

34:21You don't have to do that for cardiac health. You don't need to do that for weight loss. You don't need to do that anymore, period. However, you must do resistance work and it can be at home. It doesn't have to be in the gym. I'm here to tell you actually, you know, moderate to aggressive yoga is resistance work. Yeah. Hoisting your body in a down dog, you're lifting up three quarters of your weight. Yeah. That's actually, that's a great point. I mean, for anyone that's out there and you don't have time to like quote work out you know which means go to the gym and and and do this like you know incorporate it you could definitely do this anywhere like the resistance bands with you at all times you could you know use something like that and also i another sort of myth to bust is that you have to to do your resistance training all in one sitting like okay i have to get my 20 minutes or my 25 guess what you could have done seven minutes and 10 minutes and five minutes and 12 minutes it's the same that's a good point yeah a lot of ladies are finding that that's very nice in between meetings or you've got the 10 minutes or you you do you're listening to a podcast yeah while you're listening to us right now while you're gonna lift something yeah I mean um you know get get creative I I agree that it's hard for me I have three little I have three littles.

35:46I have twin boys that are three and a half years old and a little girl who's 16 months old. And you want to spend your time, you want to spend that extra time with them. I'm an evening. I like to work out in the evening, six o 'clock, seven o 'clock, for whatever reason, I'm not an early morning exercise. I like later in the day, but that's like perfect, perfect family kid time. So I'm like, darn, I got to choose or I have to change or I need to bring them with me with my exercise, which I've tried. Doing yoga with toddlers is interesting. I was going to say, like, how is that? I have. I mean, you know, first of all, it's a five-minute attention span, and they just think it's a big, hilarious game.