Chronic Inflammation: The Hidden Driver Behind Autoimmune Disease, Fatigue, and Gut Health | Daniel Cardenas

30:21Yeah, the termic paper, the receipts that you get in all the stores is full with BPA. Yeah. That it's a bad toxin for you, for your hormones. So I think we have to get into know what things we can avoid. Of course, smoking is not a good idea because cadmium, that is not acceptable in any ways. But I think it's that way. I think also we sometimes have a misunderstanding of the liver. And they say, like, this detox is going to help your liver to work harder. I think we have to pet our liver. We have to— Be gentle with it? Be gentle with it. Yeah. It's not because he's lazy. No, no, no. The liver is not lazy.

31:07That's what they told us because of marketing, because you have to take this pill and your liver is going to work like that. No, we have to be gentle. First of all, is get to know where we're living. What are the toxins that we're getting in touch with? Like, for example, these tickets with the BPA, avoiding the alcohol, the fructose. And then you can have other things like help, like selimerine, I think, like milk thistle. It will help. But I think the first approach that you have is to be gentle with your liver and reduce the exposure most of you count. When you say fructose, people hear fruit and they're going to want to know, are you saying avoid fruit?

31:47What are you talking about? Yeah, no, no, no. Fructose is, for example, like box juice, they put a lot of fructose. I think it's the main thing that they use to put sweet, no? Yeah, high fructose corn syrup. High fructose corn syrup. And it doesn't, of course, it sounds like fruit, but fruit has something that is very interesting. Yes, it has, of course, like sugar, but it has fiber. So it's not the same amount. You can take the same amount of sugar, but in a fruit, when you have the fiber, it helps you like not getting into your bloodstream like so fast. Like, for example, if you take it like in a drink with a lot of sugar, with the fiber, it reduces the time that your body is getting into the sugar, into your system.

32:36So, of course, if you eat a lot of fruits, it could be over. You have like diabetes or something. you have to be careful, no? But it's not. And yes, it's a very common misunderstanding about fructose and fruit. Yeah, and it's not the same. You see two ends of the spectrum when it comes to liver detoxification. There's the influencer that says, the only way to detox is you have to take all of these supplements. And then there's the doctor that says, your liver just detoxes on its own. There's no reason for you to do anything special. Where does the truth live? In the middle. so let's talk about that because you know whenever i hear that that extreme argument of like there's nothing you need to do your liver detox is on its own i'm like and so do your kidneys but they don't do it without water like there are inputs that are required there's a reason why we eat and so let's talk a little bit about how people can nutritionally lifestyle wise set up their liver for successful detoxification and so we've talked a little bit about like you know avoiding alcohol I think that's definitely number one.

33:41I mean, it's interesting because when you drink alcohol, if you have it with a meal, which is great so you don't absorb so much, but your body actually prioritize processing the alcohol over actually processing your nutrients that are coming in. And of course, that's problematic. But let's talk a little bit about how people can support their liver's detox capacity. Yes. I think, first of all, we have to understand, like, the liver doesn't have, like, an output. Like, it has to go through the kidneys, sorry, or through your gut. So, first of all, it's not, as we talked at the beginning, it's not isolated.

34:18The liver has connection. It has to be, for example, you can have a very good liver, like phase one working perfectly. But if you have constipation, you're not going to eliminate all the things. And it could be even worse because you have intermediate forms, for example, like estrogens. It's going to be there and it's going to be even worse. So I think, first of all, we go back again to the gut. To have a nice working gut, it will help the process of getting rid of the things that you don't need. Also, as you told, like in the kidneys, that's the main thing. that sometimes it's not very, because you just go right to the liver.

35:04I also saw that they were like selling some castor oil or something that you put in the packs. I personally don't think it works too much because you have to know that the liver is not like that. It has a connection with a lot of things. And I think nice gut working and also like the liver. And going back specifically to how to help your liver to work, there's a lot of things we already talk about, like avoiding toxins. And then we have to understand how it works, the two phases of how it works our liver. So the phase one is the CPY. There's some enzymes that work. And the phase two is the conjugation part.

35:50In the phase two, I think we can have more range to work and to help with it. We can use, for example, this kind of milk thistle, sammy. Also, the methionine, it also works very good. But as I said, we have to be very – it depends on every patient. I think that is – yeah. But I think we could agree, cruciferous vegetables. Wow, broccoli sprouts, yeah. Broccoli sprouts especially because that's going to give you the sulforaphane with the phase two liver detoxification. As we're recording this right now, it is Ostera this weekend, which is the first day of spring. And that's whenever people are like, oh, New Year's resolution, I want to do a detox.

36:36I'm like, follow nature's rhythm. When you see the dandelions, that's nature's sign because dandelion roots help with liver detoxification and dandelion leaves help with the kidneys detoxifying. And so you can, if you have a yard that's sprayed with glyphosate, do not harvest your dandelions. But if you, you know, I keep a chemical-free yard, I have dandelions, I let them grow. And before they flower, I take their leaves, I make a tea out of it. I'll dig up the roots, I'll dry them out, and I'll make teas out of that as well. And it's because so many people want to focus on the liver because it is an amazing organ, but you're absolutely right.

37:15The process of elimination, the bowels and the kidneys also have to be cared for, and that should be the first step. Wow, it's amazing what you talk about, like how nature is speaking to us. Like, wow, that's a very good point that you say about that. dandelion. I haven't think about it. But now that you say like, it's a very, very, very good one. Yeah. Now we're like, wow, there's kohlrabi and Jerusalem artichoke and kale and chard and all of these things that you're like, wow. And I think that's fantastic. But I also think it's removed us from that rhythm of nature. And of course, I'm not saying like, don't eat a banana because you don't live like in the tropics.

37:55But it's more of like just paying attention that Like you're in rhythm with the entire Earth. Like our health is dependent on the Earth's health. And like all animals, we're in rhythm with nature. Wow, Jolene, it's amazing what you're saying. I always had that idea. That's it. Why New Year's Eve if it's on January? Why when it's cold? Why when everybody just want to lay down, hibernate? So that exposed like how as humanity we live like totally separate from the nature's rhythm. So that's amazing. Yeah. Spring is really the start. It's the rebirth. We're starting anew. I want to shift the conversation into talking more about Hashimoto's, since it is like the top autoimmune condition that affects women.

38:43We know a huge portion of women here, your TSH is normal, therefore everything's fine. Why is that not correct? Because it's not like that. We have to understand, as we were talking about before, like everything is connected. So also the thyroid gland is connected also to your mood is also connected to how you're eating. So TSH, it's a good parameter. We have to look at it in our patients. But it's not the only one. It's not the only one because the thyroid needs a lot of things to work. It's not just like the creating of the hormones. It also, we have to understand that we have, when the thyroid gland releases the hormone, it's T4.

39:33So that is not very active. But biologically, it's almost non-active. It has to lose one yodum. So be active. And in order to happen that, we need minerals, We need nutrients like selenium, like zinc. So if you just look at TSH, it's a good parameter, but it's not going to tell you everything, how it's working. Because you have to, as we said, you have to match the laboratories with your patient. So I think one of the things that we share, Jolene, it's about not just going to tap the symptom, not to avoid, to get rid of the symptom. You have to take this for a symptom. You have to understand where the symptom is coming.

40:22And when you understand this patient with the TSH normal, but they say, I'm tired, I'm losing hair, I have constipation, you have to realize it's not enough just to see TSH. So you have to continue to talk with your patient, habits, how he's sleeping, if they have the good supplementation, If they're eating a lot of nuts, also seeds, that's why you have to be like an integral view of your patient. But of course, it's important TSH, but it's not the only thing. There are many women who get diagnosed as hypothyroid. They're told antibodies don't matter. Take levothyroxine, so synthetic T4, and yet they don't feel better.

41:07What's going on in those cases and what are doctors missing? because the the t4 it needs to it needs to lose like the the onidase enzyme which works and make this t4 active in your body so if you just take the t4 you're gonna have like good levels but then you're you're gonna don't have like a good systemic impact because your body doesn't have the nutrients to make this T4 into T3 to be active. So that's why you just can't just give T4 and stay calm. You have to give T4, see how patient is eating, see how the patient is feeling. And that's going to be the proper way that you can realize if it's working your therapy or is not working.

41:59You need to do more for him. Yeah. In the cases of autoimmunity, is it enough just to replace thyroid hormone and do nothing else? No, no, no, no. It would be like very simple. It would be simple. And in my clinical practice, for example, my recipes for the patients is like two pages, two pages. And when I see of my colleagues' recipes is like levotiroxin 20 minutes before breakfast. That's it. By recipes, you mean prescriptions. Yeah, prescriptions. Yeah, sorry. I kind of like recipes better, though. Like, here's our recipe to a fantastic life. Yeah, the prescription. Sorry. So, yes, you have to see like all the other things like in the patient, not just like giving the medication.

42:49You have to dig in a little bit more. Can you take us through your framework for approaching Hashimoto's with a patient? Okay. Yeah. First, what I want to know is how the patient is feeling. For me, that's the right thing, the first thing that I see in my patient. And after that, you have always to see, not just a thyroid gland, because most of the patients with Hashimoto, they're very tired. I think that's one of the main symptoms that they, why they come to me. Of course, then you see, have bloating and inflammation. Also see like mood swings. And then you start to realize like, okay, it's our immune disease.

43:34It's Hashimoto, but where does it come? And again, the first thing that you have to look is the gut. That we were talking about the molecular mimicry and the inflammation. So for me, the first approach is repair the gut. To avoid those stressors that make your body inflammation. So get rid of them. That's the first thing you have to do. After that, of course, you can use levotoraxin, like T4, sorry. And then you have to see how the patient is feeling. Not just like, because sometimes in medicine, we think it's jeopardy. No, we're playing jeopardy. Like Hashimoto, like this medication, like this one and this one.

44:18No, you have to see where the symptom is coming from. So my approach, first, heal the gut. After that, of course, if you need medication, supplementation, you just do it. But always looking how your patient is feeling, how it's feeling, how their habits. And that's why you make kind of a partnership with your patient in functional medicine. because it's not like you just go and in one consultation, you're going to give them like all the answers. And no, no, it's a process. It's a process. As I always say, it's a self-knowledge process. Yeah, that's the way I approach it. How often are you seeing small intestinal bacterial overgrowth or SIBO with your Hashimoto's patients?

45:05SIBO, well, in my practice, to be honest, a lot of patients that I treat, they don't have their resources. So to diagnose SIBO, it's a little bit expensive. So sometimes I have that, how can I say it? Barrier. Yeah, that barrier that doesn't allow me to go deeper in SIBO. That's the truth. Yeah. We have to prioritize those things and be realistic of like, here's our ideal, and then here's what the patient can actually do. And that sounds like that's what you're doing. Yes, yeah, that's true. Because, you know, also with social media, like, it's very easy for patients, also for doctors to, okay, I read this, and this is the thing that we have to do.

45:48But when you see patients, things change. Like, you have to know the status of your patient, the economic possibilities. is also there are some cultural barriers that you just have to get to be aware that they exist. And you have to have to modulate your clinical practice also for your patients in each individual case. Cultural competency is one of the biggest glaring issues, I think, is just non-existent in a lot of medical practices and that people don't recognize you. You will never have someone's trust if you don't respect their culture. I want to ask about rheumatoid arthritis because that's another autoimmune condition that you commonly treat.

46:32For people who don't know what that is, I feel like Hashimoto's is a lot more common and we've talked about the thyroid, but what is rheumatoid arthritis for people listening? Well, it's an autoimmune disease, which means your body attacks itself, and it attacks your joints. It starts by a process of molecular mimicry. It gets confused, and it attacks your joints. And it's going to be progressive, degenerative. So that's why it's a very, very disabilitating autoimmune disease. What I saw, and it's something that for me is very, very important, this thing, that I saw people with arthritis, with RA, maybe, I don't know, how can I say, like 70 % when they came in and I see their faces, because as a doctor, you have to see how your patient get in, how it works, how it behaves.

47:37I saw with these specific autoimmunities, there are people who want to have control in everything, in mental part. Yeah, they try. With an A-type personality, I giggle because literally everybody says this about autoimmunity, but I'm sorry, continue. Yeah, so that's the first thing. The other thing is also their habits. There are people who never sleep well. They have this problem. And you don't know what happened first, if they can't sleep and they develop MRI or it was like vice versa. But there are people who their mental state is always like this. It's always like they're feeling like they're not safe.

48:21So I think this also accelerates the autoimmune disease, not in a direct way, but in a way that they can't sleep. So if you can't sleep, your inflammation is going to go up and also your disease is going to get worse. But what I try, I also, as I told you, I don't have like a protocol to say you have this disease, you need this. I try to see each patient, but what I see, they have a lot of relief and it could sound paradoxically. They don't move enough because all the doctors said you can't exercise, you have to don't do anything. And I saw that not moving get the disease worse. and I'm not saying that they have to go and lift heavy weights.

49:08No, no, no. But slow, gentle move works marvelous, marvelous, sorry, for this kind of patience. Also with the foods, with also going back to the gut again. I saw when I take off some specific foods that we already talked before, like breath, dairy, those two main, they get better, they get better. but it's a dance for me to treat a patient because they come with a lot of medication. So you have to equilibrate them. Like, okay, I take this food, you're getting better on your inflammation, the joints are less swollen, so let's get a little bit down the medication that you're taking. And then you have to go like step by step.

49:56Okay, you start to move in yourself, you start going to walk three times a week, You're feeling better. Okay, let's go down this other medication. Because the average of the patient that I saw with this disease, they have at least five medications at least. So then you have, for example, they have like the SSRIs. They have like a lot of things. And then you, for example, of course, if you are in pain, it's going to affect your mood. So then you have some options and you say like, okay, 5-HTP to get a little bit slower the SSRI. So it's kind of a dance. It's kind of, how can I say, like a move with a patient, like have patient with them and ask them to have patient with themselves.

50:48And it works marbles. Yeah. I'm curious, you know, there's been some compelling evidence showing that oral pathogens and rheumatoid arthritis are connected. How are you integrating that into your clinical approach? Or like oral pathogens, like when, well, I don't have like a specific thing that I do of that. I'm very aware of that things. And also, because we think for probiotics, I remember right now a case that she also had like a lot of gum disease. Gingivitis. Yeah, gingivitis and things like that. So the approach, also these patients have always a dry mouth also. So what I... Do you think there's a concomitant Sjogren's maybe?

51:36Yes, I think almost in every autoimmune disease, there's concomitant Sjogren. And these patients, because, you know, also the specialists agree that when you have autoimmune disease, a process is not just one. You have like a little piece of chagrin. You have a little piece of lupus. You have a little piece of psoriasis. So for me, and going back to that question, I use two things. Like the probiotics, there are some oral probiotics that works good. But for the people who have this dryness, it maybe sounds like it's something like, it doesn't happen anything, but it do because they have a lot, a lot of problems with their teeth.

52:25So one of the things that I saw that works marbles is the coconut oil, a little bit of coconut oil and passing through your teeth. So like oil pulling? Yeah. Okay. Yeah, like the coconut oil. And it helps you to have more saliva. Also, you have, and going back to the nervous system regulation, these people, when you have a relaxed nervous system, you secrete saliva. And also, as I told you, I saw this character in this kind of patients that are very stressed. They try to control everything. And when they slow down, first, they have to recognize it because you have to be very careful also with this kind of processes.

53:12You just can't say like, hey, I saw you come and you want control. No, no, no. You have to be very soft with them. I'm like, yeah, that's always like when someone's stressed and then someone says, like, just stop stressing. And you're like, that's not the way. But when you start to like giving them, for example, for me, one of the things that I said to them, OK, I'm going to get you two things you have to do in your house. When you get a bath, you're going to feel the hot water on your body. You're just going to try to be aware how it suits you, how it relaxes you. That's your homework. your homework.

53:50And the other one is before going to sleep, you're just going to have six deep breaths to activate the vagus nerve. And with those two things, really, there's some patients that told me like, doctor, this is mind blowing. It doesn't cure me like that. But right now, when I'm in the third breathing in the night, I'm already asleep. And it doesn't happen the first time. They have to do it like continuously. And after, for example, with being aware of the shower, of the hot shower, they say, after that, right now, I'm more aware when I'm, for example, at the gym, or I'm more aware when I'm driving.

54:32So that small things really makes them like relax the nervous system. And it's also helped for the pain and the swollen in these patients. You had mentioned that not exercising actually makes symptoms worse. And I think people automatically will think, well, of course, movement helps and, you know, moving the lymphatic system. But I'm curious in terms of insulin resistance and adipokines, what role you think they're playing in the progression of autoimmunity? In the progression? Yeah, because if we saw the muscle, we have to see it like as an organ. like myokines, also reduce inflammation, also help to regulate the glucose in our body.

55:19But if we don't use the muscles, they're not going to secrete those substances. So I think that's the biochemical explanation of it. But I think in your mental part, when you're moving, you start feeling that you're alive. movement, it's very connected with being alive. So they restrict your movement. They say like a lot of physicians tell them, you can't exercise. You get disconnected from life. And when you restart moving, it's like an uphill process because they start walking. Then they say, okay, I feel nice walking. Then I go to the water to walk maybe in the pool. And then I start to talk with all the people.

56:07And then it comes another thing that is community, that it also works marvel for them. But movement for me, it's basic in these patients. That's the key, key thing for people with everybody, but more with people without immune disease who can share their experiences, their pain, what works for them, what doesn't work for them. And I think that's, as you said, that's medicine. For me, that's medicine also. I want to ask about fibromyalgia because this is something that has a big overlap with autoimmune disease, with gut dysfunction. So let's talk about what are some of the underlying mechanisms you see with fibromyalgia.

56:50Fibromyalgia. I think it's one of my favorite pathologies. And still, there's a lot of people, physicians, that doesn't think it's real. I know it's real. And the thing in fibromyalgia, for me, what I have experienced and for what I saw in my patients, because we try to think that all the emotions go to our brain and all the emotions are stored in our brain. But that's not true. All our body, it's, how can I say, something that is connected. All the emotions is not just here in your mind. It's in all your body. So what I saw with people with fibromyalgia is that they have a lot of things, a lot of pain, mentally things that they can't express or they don't know how to express it.

57:41So the body says it's this accumulative stress of emotions that you don't say that you keep to yourself, that at the end, your body, the only way it has to tell you something's wrong is about symptoms. And for me, fibromyalgia is that thing. And of course, if you give them like an SSRI that is going to be like the standard treatment for this, it's not going to heal. It's just going to be a block. It works a little bit, but it's not just the thing that you have to do. For example, my approach with this kind of patients is, okay, I'm going to give you the SSRI for this time, but you have to do something.

58:19And specific things that they have to do. And one of the things that I have realized with these patients, it's when I ask them, what do you like to do? Like, do you like the cinema? Do you like to, I don't know, hiking or something? Maybe 95 % of my patients, they don't know what they enjoy doing. They don't know. So one of the homeworks that I send to them, the next time that we're going to see, you're going to take your SSRIs, but you're going to bring me a list of 10 things that you really enjoy. So I think that that combination, it works and it works very, very good. Then I take off the SSRI and they have already their things that they enjoy.

59:05They start having moving and they get better and better. Yes. What is going on with fibromyalgia? And for people who are not familiar with it, what are the signs and symptoms? First of all, it's pain. It's pain. It depends on, We have like the trigger points that as a physician we know and we touch them. So in a normal person, you touch, for example, one of them is here. You touch them in a normal person and nobody's going to feel pain. You have to do it with your thumbs and pressure it until it gets like a little bit white. It's a gentle pressure. It's not like this. And they have, you see that the patient, it's hurting me.

59:48And so it's that hypersensibility to pain. And when you get some of those points like positive, you diagnose fibromyalgia because there's not lab tests or some x-ray or something that can tell you this is fibromyalgia. And that's why it's a little bit hard to diagnose. And that's why I understand some physicians don't believe in it. So, but to resume, like, to synthesize, like, everything, it's hypersensibility for pain. In your opinion, how much do you think fibromyalgia is central sensitization of the nervous system versus, like, peripheral inflammation that's going on? Or is it both? I think it's both, but I think it's more peripheral because we always tend, as we saw in physiology, in med school, all the pain is right here.

1:00:48The brain is what I tell you, but we need to understand that the whole body is connected and the whole body is always speaking to us. It's not just the brain. We try to mentalize everything. So, yes, of course, it's a part. maybe will be like some mechanisms in the central nervous system that makes you feel like the pain more, but it's also in the peripheral, which means that your body is also telling you something. What role do you think the mitochondria is playing in this? Yeah, I think mitochondria plays like almost in every chronic condition. They're like everything? Everything, yeah. Yeah, for sure, a lot.

1:01:26Yeah, but for people listening, as much as they know about the mitochondria, it's probably what they got in sixth grade biology which is the powerhouse of the cell. It makes energy. Why should people know about mitochondrial dysfunction in the same conversation that we're having about systemic inflammation, chronic inflammation, and then pain amplification? Well, it's a very nice question. And I think it's very extensive what mitochondria, because it's, as you said, like it's a powerhouse of every cell. So going back a little bit without immune disease, you always see, like, of course, there's sometimes pain, but you almost always have, like, no energy.

1:02:08They don't want to do anything. They don't want to go out. They don't want to do anything. So it's a challenge also. It's a challenge because, as I told you, I told them, like, go and move, but they don't have the energy. So it's a vicious cycle. And when you help the mitochondria, that there's, of course, you can do like various lab tests to see the mitochondria and whatever. But like normal things, for example, coenzyme Q10 and things like that, that you know that they're going to help. Almost going back a little bit, remember when I told you like vitamin D, also the omega-3 fatty acids in autoimmune disease, coenzyme Q10 is going to also work.

1:02:53to start supporting the mitochondria. But then you have a lot of things. You can do like sauna. You can do a lot of things to that. But for starting, I think the easiest way to help this kind of patient with fatigue is that. It will be like that supplementation. Yeah. And going back to what you were saying about exercise, we know that exercise is one of the most effective ways to help modulate the immune system, but also to start to build efficient mitochondria and more mitochondria. Yes, that's true. Yeah, totally, totally agree. And that's the role we play as physicians also because we have to encourage our patients to move.

1:03:36Because if you just say, like, move and eat vegetables and fruits, it's not going to work. You have to explain them a little bit about, for example, this mitochondria. And this supplement is going to help you to do that. It makes a world of difference if you just take this, take this, take that. It works a lot. Well, I have seen that. Yeah, I appreciate what you're saying. SSRIs can be life-changing for some women. And then we can work on the other therapies and bring those up so that we can get them off that medication so they're not on it long term. I always say, like, unless the medication is necessary for you to stay alive and avoid chronic disease, like in the case of Hashimoto's, we don't want you developing heart disease because you didn't have enough thyroid hormone.

1:04:22I think we need to have a plan to not be on that for life because nobody wants to have to take a pill every day. No, no, nobody. Nobody. And yes, I think that's the smartest approach to chronic disease. Also, for example, going back a little bit with SSRIs. as sometimes there's a time that we thought that they were like, nothing happens. They just bring you joy and that's it. That's the way they sell to us. But there's not that easy. Everything that changes your chemicals in your brain, you have to be a little bit aware of it. So I use the analogy of a cane. When you broke your leg, you... No, we've both had knee surgeries.

1:05:03We've both been on canes. We both know what it is. We know what it is. So SSRIs is a cane. When you have like this mood, like going back, you need to know it's going to help you to get better, to get strong bones, to get back your muscle. And that's what I told to them. Okay, I know you feel with no energy. You're feeling depressed. You're going to take this SRI. You're going to feel the boost. But then you're going to use it to create a different lifestyle. because eventually you're going to get rid of it. Yeah. And we know with SSRIs, there's a lot of people that are like, the research was never great for depression.

1:05:41And I definitely agree. Before they came out, the research wasn't great. But now we're understanding that serotonin is actually playing a role in neuroplasticity and changing the brain. And I think it's important for people to understand where they might be like, wait, you're telling me SSRI and fibromyalgia, chronic pain. Yes, because chronic pain changes your brain. But if we can use something that helps change your brain, like an SSRI, so that you are upregulating neuroplasticity, and then you put the lifestyle factors in place, like that's a way that we can get your body to adapt and to adapt out of the dysfunction that it found itself in.

1:06:20Because as you were saying, it's all about homeostasis, and that's all your body was trying to find, and it became dysfunctional in trying to find that. And so now we have to walk you back out of that. I want to ask you, why do so many patients with fibromyalgia fail the standard interventions that doctors are providing them? Because it's centered in medication. And there's no, for example, like it would be like saying like depression is a Prozac deficiency. It's not a deficiency of something you have to give to the patient. It's something because a patient, we as people, as humans, we are complex living things.

1:07:02It's not a deficiency of appeal or of a certain thing. Also with patients with fibromyalgia, I always suggest them to go to a therapist, like a psychological therapy, in order to express the emotions that are trapped in their body. So SSRIs, yes, I use them. I'm not going to say they're bad because I use them often with this kind of patients. But as I told you, like not a prescription, like just take this one and see you in three months. It doesn't work. It doesn't work. It may feel them like a little bit better. But if you encourage your patient and you explain to them what is happening, they feel like your companionship.

1:07:45They feel that they have trust in yourself and in their self, things changes. And I think that's the beautiful part that we share about our view, our clinical approach of the patient. It's not just like giving the pill. It's like something different. When you chose to pursue functional medicine, why is it that you decided to go that route? Well, it was because of a personal medical condition. All my family, my father is infectious disease specialist. I have the aunts that are dermatologists, cousins that are urologists. All my family are like traditional medicine. But then I start to have a lot of some personal health problems, chronic pain, a lot of surgeries.

1:08:39And I was desperate to do something to make me feel better. And I wasn't getting all the answers from the traditional medicine. So that thing forced me to look up on something different. And it starts with homeopathy. And I went with this doctor with homeopathy. He treated me. Before that, I thought homeopathy was just placebo, to be honest. And I, of course, when I was studying, I was maybe sometimes I will laugh about homeopathy. That's the truth. But then I go with this doctor. He treated me. I start feeling better. But I go with him because maybe he was giving me steroids or something that is not good for my health.

1:09:23So I asked him to allow me to see his clinical practice and to understand why it's homeopathy. So you thought maybe he was drugging you and not telling you? Yes, yeah, yeah. He was giving me like some medication like steroids or something that is getting me better that is not good. So, I realized and when I started to understanding the philosophy of medicine, for me, it was like opening my eyes. Like, wow, this is amazing because you take in consideration the mental things, the emotional things, of course, the physical things. And the basic thing of homeopathy is that you stimulate your body, work like a vaccine, like stimulates your body to make him like with his own processes.

1:10:14its own process heal. So then I say, okay, I like this. I start practicing. But you have like your Bible in homeopathy, which is a book that is named Organon. And the first thing that I told you in homeopathy is you need to know nutrition and you need to know your patient habits. Because no matter how good a physician you are and you choose the best medicine, if your patient is doing something that is getting him sick, it's not going to work. And it sounds right now very logical, no? But after I graduated from medicine, it's not logical because the mind that I had in that time, it's a mind that, as I told you, like kind of a jeopardy, like this medicine, this disease, this medicine, this, this.

1:11:07I wasn't able to think the way I was looking at medicine right now. So I said, okay, I need to know about nutrition. I need to know about sleep. And where do I go? Because I don't know anything about it. In faculty, they didn't show me anything, anything. So I said, okay, I remember I went in Australia to do a passenger in neuroscience. So somebody talked about functional medicine, somebody. I just recalled it. And I said, okay, I thought it was like something small, but I go to the IFM, I start my certification, and then I realized it was something much, much bigger than I thought. But that was the path that I followed to get into functional medicine, homeopathy.

1:11:56But still, I very respect the traditional medicine. As we were talking before, we use medications. patients they're like very helpful like tools that we have and i think you can integrate like different models and right now it's working for me it's working for the patients uh of course you have to be like the because you can lose yourself a little bit you have to be uh scientific you have to you have to see that the things that you're using uh is working and also of course the safe and the well-being of the patient. If you have those two things, you can see different models without getting lost.

1:12:38It's always interesting to me because it's usually when people have had a homeopathy experience that they're usually like, maybe there's something more to this. And as I was saying, when I was in Paris and my son had got sick, you go to the pharmacy and homeopathy is like the first thing they use in France. The pharmacists are like, this is where we need to start. and there's I think as a science it's very easy to criticize but it's something that has always been a a gap for me that I can't explain it's like why does it work on animals and this is something that you know my dog I had a dog that was afraid of uh fireworks and I would use homeopathy because what what else can you give a dog right I don't want to sedate my dog and it would work every time and i'm like okay like i can see that like there is absence of evidence here i can hear all the criticisms but i can't explain this actual piece or why it works on babies because yeah we were like oh it's just placebo but a pet doesn't know that i'm and then sometimes i'm like i'm having to hold her down and put it in her mouth like that's not a like positive experience It has to be something.

1:13:46It works. Yeah. They also use them with plants. Agro homeopathy. Oh, really? It's a branch of homeopathy. Oh, I've never even heard that. Yes. And it's amazing. One of my cousins is doing that. And yes, of course, I understand why is the resistance of the physicians about homeopathy. I understand it pretty well. But as you said, I see it every day, how it works with the patients. So really, I say, okay, this is working. This is working. Yeah. I want to ask you just as a final question in what you see happening online in the wellness space. Do you feel like there's oversimplification of what patients are dealing with and that's actually causing harm?

1:14:29Yes, for sure. For sure. And we need to understand it like in an economic perspective. For example, for me, it's very funny to see in the TV like you have back pain, take the magic pill and everything is going to solve. but you don't even change the way they sit, the way they move. So I think it's due to selling strategies. I think it's because of that. And before studying medicine, I was two years in finance. So that's where I understand it's not that because some other people can go to the other side and say, like pharma, they're the evil. Of course not. They have very, very interesting things.

1:15:16For example, for me, I got a horrible infection. And if there were no pharma, I wouldn't be here talking to you. So they have very nice things. But we need to understand we're immersed in economy that they want to sell us. And if they sell you, who's going to sell, for example, go exercise? Well, nobody, because nobody's going to win. But if they sell you - Go to track equipment. They'll do it. Yeah, that's true. That's true. Or the bow flex, right? Yeah, but, you know, like they simplify things for you as a consumer, not as a patient. So I think that's a misconception. And we have to be aware that pharma and all the companies are to sell.

1:16:06Of course, they have like very interesting tools, but the main thing is to sell. That's why they simplify things to sell them better. What would you say to people listening right now to avoid being a consumer of people, of these companies that just want to sell you and actually taking actionable steps to heal themselves? I love that question. And I have you bring me. I'm not, and I told, for example, to my patients when they have pain because they have to take something, before swallowing the pill, just make a little bit of the space to listen, to feel the pain that your body's telling you. Because in that moment, a very small moment, you're going to realize a lot of things.

1:16:54Just take a little bit, feel your body, and then take the pill. I think that's the first thing to start making awareness of our body. And for me, that's the first step. And I have saw like a lot of people that say, doctor, sometimes I was about to take the pill. Then I listened to my body and then I didn't feel the pain. So I let the pill. So I think that's the first step. Yeah. Well, thank you so much for sitting down with me today. I appreciate this conversation. It's a pleasure. It's a pleasure. Thank you.