The Mel Robbins PodcastWhy 80% of Autoimmune Diseases Happen to Women & Solutions From a Renowned MD
EVERY SPOKEN WORD
125 min read · 25,161 words- 0:00 – 0:59
Introduction
- MRMel Robbins
I posted this video and it featured Dr. Gabor Mate, a world-renowned expert in trauma, and he was talking about how 80% of autoimmune diseases happen to women. Holy cow, this topic exploded online. And you know what that tells me? That tells me that you wanna learn more about the topic of autoimmune disease, why they are impacting you or impacting the women in your life at alarming rates. So here's what I did, I called in a world-renowned expert, and she is gonna give you and me a masterclass and a private consultation on all things autoimmune disease. What is an autoimmune disease? What are the three causes of autoimmune diseases? Why exactly are rates of MS, Hashimoto's, and all kinds of other autoimmune diseases rising at alarming rates, especially for women over the past 20 years? And most of the things that you're going to learn and that she's gonna recommend cost you nothing.
- 0:59 – 6:25
Your Autoimmune Breakthrough: Regain Control Now
- MRMel Robbins
Hey, it's your friend Mel, and I just wanna take a moment and welcome you to the Mel Robbins podcast. First of all, I am so excited that you're here. I'm excited for our topic today. It is always such an honor to be able to spend time with you, to be together. And if you're brand new, welcome to the Mel Robbins podcast family. Because you hit play on this episode and you made the time to listen when I know you don't have a lot of time, but you found the time and you made the time to listen to this episode, here's what I know about you. First of all, you value your time and you're spending it because you wanna learn more about your health and improving the quality of your life. And today's conversation, it's gonna blow your mind and it will improve the quality of your life. See, I recently posted a very short video clip that was just a short moment from this podcast, and the video featured the renowned trauma expert and medical doctor, Dr. Gabor Mate. And in the video clip, he was explaining the four reasons why 80% of autoimmune diseases impact women. Now, this video exploded online. The only other topic I've ever seen resonate that immediately and globally was when I first shared the Let Them Theory. Based on my inbox crashing, the DMs, and your comments, I'm like, "We have got to go deep on the topic of autoimmune disease, and in particular, why is it impacting women at higher rates than men?" What do you need to know? What are the symptoms that you may have that indicate that you have an autoimmune issue but you don't even know about it? And most importantly, what can you do about it if you're concerned about your health or the health of someone you love? Well, today we're gonna talk about all of that and we're gonna leave you feeling informed and empowered. I cannot wait to introduce you to Dr. Sarah Saul. Now, Dr. Saul is a physician, a researcher, a renowned speaker on all things health. She graduated from Harvard Medical School as part of their joint medical program with MIT. She completed her residency at UCSF, one of the top hospitals in the world. Dr. Saul is the New York Times bestselling author of nine books about health. She's also a clinical assistant professor in the Department of Integrative Medicine and Nutritional Sciences at Thomas Jefferson University, and the director of precision medicine at the Marcus Institute of Integrative Health at Jefferson. Dr. Saul has over 25 years of clinical experience seeing patients, and she hopped on a plane, she flew across country for one reason: she did it for you. She's here to provide you with the information, resources, and the step-by-step treatment plan for anyone in your life who may be struggling with an autoimmune issue or just with some symptoms and they don't know what's going on. Today's conversation is a free life-changing resource for anyone in your life who is struggling with an autoimmune disease or is just chronically tired, or who has a lot of health symptoms and can't quite get to the bottom of what's going on. Well, today we're gonna do our best to do that for you. And I wanna thank you in advance for taking a moment right now to share this episode with someone you care about, because there's no doubt in my mind everything that we are about to learn is gonna improve your health and your life. Dr. Saul, thank you so much for being here.
- SSDr. Sarah Szal
Thank you.
- MRMel Robbins
I am so looking forward to our conversation today.
- SSDr. Sarah Szal
Mel, I'm so happy to be with you.
- MRMel Robbins
Oh my gosh. We've got so much to talk about, and where I wanna start is could you tell the person who's listening what they might experience or how their life might change if they take everything to heart that you're about to share with us today?
- SSDr. Sarah Szal
A few things. First, energy. Right now we know that 30% of Americans have antibodies against the nucleus of their cells, anti-nuclear antibodies. That is causing a civil war in the body and it is keeping you from having the energy that you need to live your best life. Number two is regulation. That sense of safety that I think women especially desperately need right now. And then number three is empowerment, so having the tools and the insights that you need to make the changes and to make them stick.
- MRMel Robbins
That's a lot.
- SSDr. Sarah Szal
That's the promise of lifestyle medicine and a different approach to taking care of the body.
- MRMel Robbins
I've never heard the term lifestyle medicine. What does that mean?
- SSDr. Sarah Szal
It means that rather than deciding that you've got a diagnosis and giving you a pill, we wanna think about, okay, how did you get to this place with this diagnosis? What are the lifestyle factors? Your sleep, the way that you eat, move, think, and feel, and love.... how do we address those? How do we address those first?
- MRMel Robbins
Mm.
- SSDr. Sarah Szal
Because that, that provides about 80% of the prevention and reversal of chronic disease.
- MRMel Robbins
And that's what we're gonna talk about, is chronic disease and in particular, autoimmune
- 6:25 – 14:39
Is Your Immune System Attacking You?
- MRMel Robbins
diseases. So I wanna start at the very just top, most basic level. What exactly is an autoimmune disease?
- SSDr. Sarah Szal
Autoimmune disease is when you've got a problem with your immune system. It becomes imbalanced and it starts to attack your normal tissues. You can think of it like a case of mistaken identity. So your immune system is kinda like your private security.
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
It's supposed to identify what's healthy and normal in your body and then also find the invaders, like a pathogen, like a virus, and attack it. But if your immune system becomes confused and it can't separate those two, you can have this problem where your immune system is attacking normal tissue. So that's what happens with autoimmune disease. And in that situation, your immune system is making a weapon called an antibody. You're making autoantibodies, antibodies against your own normal tissues, and you can measure it. So with autoimmune disease, you've got this imbalanced immune system, you've got autoantibodies, and then you've got symptoms that fit with a particular diagnosis.
- MRMel Robbins
I love the word that you used, confused, that your body is just confused as to what is the enemy versus what it's supposed to be protecting. And b- as we kind of dig in deeper and deeper and deeper around what an autoimmune disease is, I have a couple just basic questions. Is there a difference between autoimmune disease and an autoimmune disorder? 'Cause I've heard people refer to both.
- SSDr. Sarah Szal
The way I think of it, Mel, is that there's, there's a continuum.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
So there's a state of health.
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
Your immune system is working perfectly. It can separate the invaders from your normal tissue. And then at the other extreme is autoimmune disease, and that's, that can be well established, and we'll talk about some of those conditions, type 1 diabetes, rheumatoid arthritis, Hashimoto's thyroiditis.
- MRMel Robbins
Wait a minute. Diabetes is an autoimmune disease?
- SSDr. Sarah Szal
Type 1 diabetes is. Yeah, you attack the pancreas. Your immune system attacks the pancreas.
- MRMel Robbins
I, I, I mean, I'm pro- I probably sound like an idiot that I didn't know that, but I never even thought that there're probably a long list of things that we talk about that people struggle with that a lot of us don't even know it's an autoimmune disease.
- SSDr. Sarah Szal
That's true. It tends to fly below the radar, and what troubles me so much about this is that these are the people who are often failed-
- MRMel Robbins
Mm.
- SSDr. Sarah Szal
... by the medical system. They struggle for seven to 14 years before they get a diagnosis. So they could be somewhere along that spectrum, from normal, healthy to autoimmune disease. There's a pretty broad middle section where you've got antibodies that you can measure in the blood, when you've got early signs and symptoms, the fatigue, the joint pain, the other problems, and yet doctors often aren't putting it together until you cross that threshold into a disease.
- MRMel Robbins
Can you just list what some common ailments or diseases or things that people have that actually are a autoimmune disease?
- SSDr. Sarah Szal
There's two different categories.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
So there's classic autoimmune disease.
- MRMel Robbins
Uh-huh.
- SSDr. Sarah Szal
There's more than 100 of them.
- MRMel Robbins
100?
- SSDr. Sarah Szal
100. And there's-
- MRMel Robbins
What?
- SSDr. Sarah Szal
Yeah. So exponential rise in the number of autoimmune diseases, but it's things like rheumatoid arthritis, where your immune system is attacking your joints. There's Hashimoto's thyroiditis, where your immune system is attacking the thyroid gland in your neck. There's multiple sclerosis. There's type 1 diabetes, as we talked about. Psoriasis.
- MRMel Robbins
Psoriasis?
- SSDr. Sarah Szal
Psoriasis.
- MRMel Robbins
What?
- SSDr. Sarah Szal
So-
- 14:39 – 27:48
The Hidden Triggers of Autoimmune Disease
- SSDr. Sarah Szal
- MRMel Robbins
Dr. Stahl, what are the root causes of an autoimmune condition or disease?
- SSDr. Sarah Szal
The root causes have been identified for years. There's a local pediatric gastroenterologist at Massachusetts General Hospital who found that there are three requirements. These are the root causes.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
Number one, genetic predisposition. Number two, leaky gut. So that's when you lose the barrier in your gut. You have increased intestinal permeability, and we can talk about what that is.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
And then number three, a trigger. So the trigger is where things get interesting. The trigger's often trauma or toxic stress, but it can also be big hormonal changes like pregnancy, post-partum, perimenopause, menopause. There's lots of different triggers that we wanna consider.
- MRMel Robbins
So just, again, to make sure that I'm tracking because since this impacts so many of us, and now I'm realizing I need to share this episode immediately with my daughter and with my husband as soon as I'm done talking to you. Number one, genetic predisposition. Number two, you may have a leaky gut which can contribute to, I guess, the balance in your body. And number three, there is something that happened, whether it's hormonal changes or some traumatic situation or unresolved trauma or stress in your life that then triggers confusion in your body and you start attacking yourself.
- SSDr. Sarah Szal
That's right, it starts the civil war.
- MRMel Robbins
Wow. Okay, well let's take them one by one. How do you even know if you're genetically predisposed to this?
- SSDr. Sarah Szal
You can do a genetic test. So the genetics are pretty well-defined. They all sound like license plates, so I won't list them here, but a genetic test is a way to identify them.
- MRMel Robbins
And let's talk about leaky gut. Why does a leaky gut... First of all, what the heck is a leaky gut? And secondly, why does that contribute to your body starting to attack itself?
- SSDr. Sarah Szal
Leaky gut is fascinating. Physically, but also more poetically. It's a loss of a boundary in your body.
- MRMel Robbins
Oh, whoa. Hold on.
- SSDr. Sarah Szal
(laughs)
- MRMel Robbins
I wanna make sure everybody, I wanna make sure the person that's driving the car or taking you and I on a walk with them hears it. I've never heard anybody say that before. Leaky gut is a loss of a boundary in your body. What- what- what does that mean, that it's a boundary? And what's the implications that leaky gut is now a loss of that boundary?
- SSDr. Sarah Szal
When you think about the gut-
- MRMel Robbins
Uh-huh.
- SSDr. Sarah Szal
... at its simplest, it's a tube from your mouth to your anus.
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
The part of the tube where your intestines are requires these things called tight junctions between the cells. So the cells are supposed to be lined up like an army. And what happens is that if you've got leaky gut, those tight junctions don't work. And so things that are supposed to be on the outside of you-
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
... that you take in through your mouth-
- MRMel Robbins
Yeah.
- SSDr. Sarah Szal
... bacteria, viruses, um, maybe foods that you're reacting to like gluten or dairy, those can start to come through the tight junctions, through the boundary that you're supposed to have, and start to trigger the cells underneath. Now here's where things get interesting because-70% to 80% of your immune system is right there in the tube. And so, when you're passing these, these foreign particles through the tube, through the boundary-
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
... you're triggering the immune system in a way that it's not meant to be triggered.
- MRMel Robbins
The third thing that you talked about was triggers, that there are lifestyle triggers and there are all kinds of triggers, I would imagine, that can also cause this civil war in your body. What are some of the top triggers that you've seen in your research?
- SSDr. Sarah Szal
The number one trigger is trauma. So I, I started to notice this. I didn't learn a lot about trauma when I went through medical school 30 years ago. But I had to teach myself, because I saw this rise of autoimmune disease in my patients.
- MRMel Robbins
Mm-hmm.
- 27:48 – 35:46
Autoimmune Disease for Women, Explained
- SSDr. Sarah Szal
don't work to the same degree.
- MRMel Robbins
Dr. Saul, do autoimmune diseases impact women more than men?
- SSDr. Sarah Szal
Absolutely. Four times more women than men-
- MRMel Robbins
Why?
- SSDr. Sarah Szal
... have autoimmune diseases. There's a number of reasons. There's sex differences, which are biology, things like X chromosome versus Y chromosome. But then more concerning are the gender differences, and those are socially constructed. That's the fact, for instance, that women experience more stress than men. They experience more trauma than men. They experience trauma earlier. When men and women are exposed to the same trauma, women have higher rates of post-traumatic stress disorder. We've got huge hormonal differences. We go through pregnancy and postpartum, perimenopause and menopause. So this idea that a lot of people have, that it's just a biological difference, it's just an X chromosome, that's an oversimplification. It's necessary, but it's not sufficient for this dramatic rise that we're seeing in autoimmune disease, especially among women.
- MRMel Robbins
Well, I think it's shocking that in the last 25 years, based on the research, MS for example, women are experiencing it four times more than men. And when I think about the number of female friends of mine that are the primary caregivers, or they are the breadwinner in the household and the caregiver, or the chronic levels of stress that women feel, the rise in anxiety, the rise in depression, are these all factors too?
- SSDr. Sarah Szal
They're all factors. What's important to realize is we can measure these things.
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
We can measure the cost of not being able to say no. We can measure the cost of caregiving, and overfunctioning, and giving until you're depleted. We know that women are at greater risk of burnout. I think it's important to take it out of the purview of women just aren't measuring up in some way-
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
... and to say that there's something wrong with our environment. It's a health hazard to be female in our culture. It makes me sad to say that because I was here in Boston in 1989 learning about how it was a health hazard to be a woman in our culture. And if anything, it's gotten worse, Mel. So we've got double the rates of depression, double the rates of insomnia, four times the rate of autoimmune disease, twice the rate of Alzheimer's disease, more regional and chronic pain.We've got so many differences, gender differences, research gaps. Most of the research is done in men and assumed to apply to women.
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
There's a knowledge gap. There's a gender bias in the way that doctors take care of patients, females versus males. There's a treatment gap. If you have perimenopause or menopause and you go to your doctor for some help, 73% of women don't get the treatment they need. So that's the situation in which autoimmune disease is increasing.
- MRMel Robbins
I think it's important to say it because it validates the experience of a person listening, or as you're listening you're thinking about somebody in your life who's struggling and you're gonna share all of Dr. Saul's wisdom and research with that person in your life to go, "Oh, it's not that you're damaged. There are things that have happened to you that are creating this confusion and this civil war in your body." And one of the encouraging things about all the depressing news is that if it's environmental and if there are things that were done to you, it means that there are corresponding things that you can do once you understand all this to help your body go back into a state of healing itself and getting the boundaries back up and removing the confusion so that your body is not at war with itself.
- SSDr. Sarah Szal
Perfectly stated. What happens for a lot of women is that they go to their doctor and they're trained to turn over their power.
- MRMel Robbins
Mm.
- SSDr. Sarah Szal
They're trained to just go along with what the doctor says, whether that's being dismissed or being told, "Okay, you've got rheumatoid arthritis. We're gonna start this pharmaceutical." And so what's hopeful here is that you can step into action.
- MRMel Robbins
Mm.
- SSDr. Sarah Szal
You can start to make these changes about leaky gut, about the triggers that you've experienced, and you can take back the wheel of your health.
- MRMel Robbins
I love that. I love that. And your book, The Autoimmune Cure, is basically a roadmap for doing that. You know, when I posted this clip, Dr. Gabor Mate was on the show, and he had this moment where he talked about autoimmune diseases in women. And it's one of the single most viral things that I've ever posted online, and it was all about what you're talking about, these environmental factors that contribute to the documented rise in automi- autoimmune diseases in women. I want you to hear this clip, and I wanna play it in particular in case the person that's with us right now hasn't had a chance to hear it, and then I would love to hear your reaction to it.
- NANarrator
80% of autoimmune disease, which are diseases where the immune system attacks the body that it's supposed to protect, 80% of them happen to women.
- MRMel Robbins
Why?
- NANarrator
I knew people before they got sick, and I knew them in the context of their families of origin, and these people had four significant characteristics. One is, they tended to put other people's emotional needs ahead of their own. Number two, they tended to identify with duty, role, and responsibility rather than the needs of their self. Number three, they tended to be very nice, which means they repressed healthy anger. And number four, these people tended to believe that they're responsible for how other people feel, which is a point that you address in your book Let Them, and that the- th- they had this belief that they must never disappoint anybody. Now, those beliefs lead you into not saying no to the demands of the world, and you're constantly taking on stuff and stress and other people's stress. You get stressed. That stress undermines the immune system, which then turns against you. Why is it women? 'Cause who in this culture is programmed to always looking after everybody else's emotional needs, taking everybody's stresses, um, identify with their duties and their role, uh, be nice all the time, not be angry in a healthy way, and to take responsibility for other people's feelings? It's women. It's not a gender issue. It's a- a cultural issue.
- MRMel Robbins
Why do you think this topic triggers so many people, positive or negative? 'Cause people had very strong reactions to what he was saying when he was saying chronic stress, they're the caregivers, there's a lot of sexism. Why do you think this topic triggers so many people?
- SSDr. Sarah Szal
I think that clip nailed the experience of women.
- MRMel Robbins
Mm.
- SSDr. Sarah Szal
And as I listened to it, I felt like I was nailed to the wall, not in a good way. I was nailed to the wall because there are cultural norms that make us sick and keep us sick. And Dr. Mate talked about how we over-function, we prioritize other people's needs over our own, we get caught up in over- over-providing, over-caring, and there's a cost to it.
- MRMel Robbins
And the cost is our health.
- SSDr. Sarah Szal
Yes.
- 35:46 – 44:52
Childhood Trauma and Your Health
- MRMel Robbins
And you also talked about trauma as a big trigger. And in the book actually, if I turn to page 48 and 49 in your book, you go through a bunch of questions that are part of something called ACE, which is your adverse childhood experiences score, and this helps us understand experiences from the past that may have created stored trauma in your body. Is that what this is?
- SSDr. Sarah Szal
That's right. This questionnaire, Mel, was developed in the 1990s-
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
... with the Centers for Disease Control and also Kaiser Permanente, and they did this really interesting thing where they took midlife people, people like you and me-
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
... and they looked at how many childhood experiences they had that were adverse, things like abuse, neglect, having a mother that was beaten.... physical violence in the home, having a parent with an alcohol or other substance use disorder, and they found that women and men, if they had a, an elevated adverse childhood experience score, they had a greater risk in midlife of 45 different chronic diseases.
- MRMel Robbins
Really?
- SSDr. Sarah Szal
Including autoimmune disease.
- MRMel Robbins
Wow. Could you read through some of these questions just so that the person that's with us right now can just be kind of really thinking about what this adverse childhood experiences score is? And I think when you start to hear these questions, it makes sense that it would connect to something-
- SSDr. Sarah Szal
Yeah.
- MRMel Robbins
... in terms of your health.
- SSDr. Sarah Szal
Before your 18th birthday, did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you? Did a parent or other adult in the household often or very often act in a way that made you feel afraid that you might be physically hurt? What about push, grab, slap, or throw something at you? Did a parent or adult in the household often or very often hit you so hard that you had marks or were injured? Did an adult or a person at least five years older than you ever touch or fondle you, or have you touch their body, in a sexual way? Did an adult or a person at least five years older than you ever attempt or actually have oral, anal, or vaginal intercourse with you? Did you often or very often feel that no one in your family loved you or thought you were important or special? Did you often or very often feel that your family didn't look out for one another, feel close to one another, or support one another? Did you often or very often feel that you didn't have enough to eat, had to wear dirty clothes, or had no one to protect you? Did you often or very often feel that your parents were too drunk or high to take care of you or take you to the doctor if you needed it? Were your parents ever separated or divorced? Was your mother or stepmother sometimes, often, or very often pushed, grabbed, or slapped, or had something thrown at her? Was your mother or stepmother sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? Was your mother or stepmother sometimes, often, or very often repeatedly hit over at least a few minutes or threatened with a gun or knife? Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs? Was a household member depressed or mentally ill, or did a household member attempt suicide? Did a household member go to prison?"
- MRMel Robbins
You know, you hear those questions and it's a wonder anybody makes it to adulthood.
- SSDr. Sarah Szal
It's true. It's very true. And what was so fascinating about this particular questionnaire is that we never connected the dots before between these kind of adverse experiences and physical problems later in life.
- MRMel Robbins
Dr. Salt, can you connect the dots for us? So let's take something that I think most of us could probably answer yes to, which is, did you often feel that no one in your family loved you or thought you were important or special? Like that feeling of not being seen. So something that feels not as, quote, "serious" as being punched with a fist or sexually abused. How does even that type of traumatic experience of not feeling seen or important to the adults and caregivers around you connect to physical issues with your health later in life?
- SSDr. Sarah Szal
This is where things get interesting. So if you imagine being a child, and I certainly had experiences when I was a kid where I didn't feel special or loved, that then changes the stress response in the body. And the way I think of it at its simplest is the PINE Network.
- MRMel Robbins
What's a PINE Network?
- SSDr. Sarah Szal
PINE Network stands for your psychology, I is your immune system, N is your neurological system, and E is your endocrine system. So the PINE Network, when you're that kid with an adverse childhood experience, it becomes dysregulated.
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
And for some people it's the immune system that becomes most dysregulated, and those are the people who have a greater risk of autoimmunity. For some people it's the endocrine system. They produce a lot of cortisol when they're experiencing that ACE, that adverse childhood experience-
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
... and then they have problems with cortisol for the rest of their life, unless they address it. Other people have nervous system dysregulation and they don't understand why their heart rate variability, you know, with maybe a wearable, why they're so stressed all the time and their HRV is so low.
- MRMel Robbins
Or why they have chronic anxiety. Hi, Mel Robbins. (laughs)
- SSDr. Sarah Szal
(laughs)
- MRMel Robbins
Right? No serious.
- SSDr. Sarah Szal
Yeah.
- MRMel Robbins
That makes a lot of... I've never heard anybody talk about the PINE Network, but it makes a lot of sense because when you're little that entire network is developing.
- SSDr. Sarah Szal
That's right.
- MRMel Robbins
And it's developing and learning and changing in real time based on what you're exposed to, and if you don't feel safe or you feel under threat, then your entire system from hormones to immune to nervous system to your psychology adapts because of these adverse childhood experiences.
- SSDr. Sarah Szal
That's right. And you just used the word safety.... which is so critical. Safety is the fundamental part of childhood that we want our kids to experience, and too many of them don't.
- 44:52 – 51:16
Recognizing Autoimmune Disease Symptoms
- MRMel Robbins
- SSDr. Sarah Szal
That's right.
- MRMel Robbins
How would you know if you're dealing with an autoimmune disease or condition if nobody's ever told you? Like, what are the symptoms that you may be dealing with an autoimmune disease?
- SSDr. Sarah Szal
There's a long list of symptoms, and part of what makes people search for a diagnosis and a doctor who will take them seriously for years-
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
... is that the symptoms are what we call non-specific. That's a medical term. But-
- MRMel Robbins
That's a medical term?
- SSDr. Sarah Szal
(laughs)
- MRMel Robbins
Non-specific?
- SSDr. Sarah Szal
(laughs)
- MRMel Robbins
If my doctor said, "Well, those are non-specific symptoms," I'd be like, "Well, let me put some verys and really hurts in front of that."
- SSDr. Sarah Szal
(laughs)
- MRMel Robbins
"Very specific, Doc."
- SSDr. Sarah Szal
So, it depends on which part of the body is being attacked by the immune system. So the most common things that we see across all 100 autoimmune diseases are things like fatigue, exhaustion, swelling, signs of inflammation, joint pain, and aches.
- MRMel Robbins
Huh.
- SSDr. Sarah Szal
The other symptoms depend on what's being attacked. So with Hashimoto's thyroiditis-
- MRMel Robbins
Yep.
- SSDr. Sarah Szal
... we know right now 13% of relatively healthy people have positive antibodies against their thyroid.
- MRMel Robbins
13%?
- SSDr. Sarah Szal
13%. So with Hashimoto's thyroiditis, it's the fatigue, it's the joint aches, but it's also that you just can't put your foot on the gas like you once did.
- MRMel Robbins
Mm.
- SSDr. Sarah Szal
You find that you're gaining weight, seemingly out of nowhere. Intermittent low grade fevers or night sweats, and that's where perimenopause, menopause can make things confusing.
- MRMel Robbins
Hmm.
- SSDr. Sarah Szal
Neuropathy, so an autoimmune attack of the nerves in the legs and the arms. It can cause tingling or, um, even difficulty with your gut function, like diarrhea or constipation, difficulty swallowing. Loss of appetite, gut issues like acid reflux, bloating, cramping, skin reactions. We talked about psoriasis, rashes, swollen glands, anxiety and depression, visual changes, especially important with, uh, people with multiple sclerosis, weight gain or loss, irregular or rapid heartbeat.
- MRMel Robbins
And you write in the book, and I think this is important for everyone to hear, that given that there's usually clustering of symptoms, that you recommend going to your primary care practitioner if you have three or more, and if you've got additional symptoms, you definitely wanna see a specialist, whether it's a rheumatologist or a gastroenterologist, or somebody that is really a specialist in that part of the body that has the most acute symptoms. Well, what's interesting about you connecting the dots between the symptoms of autoimmune disease and menopause is that, if I go back to the original words that you used, which is your body is confused, and your boundaries that were there to protect you are now no longer there, if you look at the drop of estrogen production in a woman's body, of course your body's confused if it runs on it.
- SSDr. Sarah Szal
Mm-hmm.
- MRMel Robbins
So if you take the exact same approach of, "My body is designed to function properly, my body is designed to heal itself," if I look at this condition, whether it's menopause or an autoimmune disease, as me needing to recognize that I'm at war with myself, and if I really embrace that, I can also activate the healing properties in my body and reestablish the boundaries internally, whether it's nervous system or my hormones or it is my psychology or it is my gut, and that that's gonna make a huge difference.
- SSDr. Sarah Szal
Amen.
- MRMel Robbins
Wow.
- SSDr. Sarah Szal
So I would say I love the point that you're making, because I think a lot of women don't understand this.
- 51:16 – 1:12:26
Simple Steps to Reverse Autoimmune Symptoms
- MRMel Robbins
What are the three things that I need to do or that the person that I love needs to do immediately, regardless of if I have a diagnosis or if I'm just tired and achy and just feeling like something's off and I'm in that age range of 40 and up?
- SSDr. Sarah Szal
Number one, get tested.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
Number two, elimination diet.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
Number three, track those triggers. Address them. Hunt them.
- MRMel Robbins
Stress, adverse childhood experiences.
- SSDr. Sarah Szal
And adult trauma too.
- MRMel Robbins
And adult trauma. When you say test, give me the list. What is the succinct thing as I'm walking into my doctor's office or I'm doing one of the tests online that you can now do to measure all this stuff? What exactly am I testing for?
- SSDr. Sarah Szal
You wanna test your immune system.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
So complete blood count with a differential. You wanna test your level of inflammation, high sensitivity to C-reactive protein, erythrocyte sedimentation rate, something called the neutrophil-to-lymphocyte ratio.
- MRMel Robbins
Neutrophil-a-slim-po-site-a-lay, wait, what the? (laughs)
- SSDr. Sarah Szal
(laughs)
- MRMel Robbins
What was that?
- SSDr. Sarah Szal
NLR, so it's the neutrophil, these are white blood cells.
- MRMel Robbins
Okay. Neutrophil.
- SSDr. Sarah Szal
Neutrophil.
- MRMel Robbins
White blood cells I can remember.
- SSDr. Sarah Szal
Neutrophil-to-lymphocyte ratio.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
Then you wanna look at your metabolism. And a lot of people don't connect these dots with autoimmunity, but what we know is that when you look at your white blood cell count, when you look at your T cells, which are part of the army in your immune system-
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
... the T cells, the mitochondria that are working in- inside your T cells, they start to become impaired, and it seems to lead to this confusion, or at least it's associated with the immune system confusion that occurs. So you wanna look at things like your glucose and your insulin levels. How are you turning your food into fuel? Is that working properly? And then you wanna look at your hormones, estrogen, progesterone, testosterone, vitamin D, which is really important for leaky gut.
- MRMel Robbins
If you're someone who's listening, and you know, you're halfway around the world, and you don't have access or the money to be able to pay for these tests, without getting a test, is there something that you should be doing right now in order to activate the healing properties in your body and to start to heal the leaky gut for sure?
- SSDr. Sarah Szal
The thing you can do right away if you can't test is an elimination diet.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
It's free. So, what we know is that gluten, dairy, alcohol, sugar, all of these tend to trigger problems with leaky gut.
- MRMel Robbins
Okay.
- SSDr. Sarah Szal
So you gotta give those up. An elimination diet itself helps to reverse leaky gut. Uh, we think that addressing your stress, addressing your cortisol levels, if that's driving the leaky gut, that also helps. So give up gluten, dairy, sugar, and alcohol.
- 1:12:26 – 1:18:53
Healing Trauma to Heal Your Body
- SSDr. Sarah Szal
- MRMel Robbins
If you could speak directly to the person that is with us right now, if they were to just take one action based on absolutely everything that you have so generously shared with us today, what is the most important thing for them to do?
- SSDr. Sarah Szal
Deal with your trauma. Assess your trauma, deal with it, resolve it. A lot of people think they're stuck with their trauma, and I would say, "You're not. Make the choice to resolve it."
- MRMel Robbins
And how do you resolve it? Like, if you're someone who always thought, "Oh, trauma is just something that happens to people that are at war," and you're starting to embrace the truth that I don't think anybody gets to adulthood without experiencing some level of trauma that is stored in your body and your nervous system-How do you begin to address it? Because it does feel very overwhelming when you embrace that this may be something from your past that is actually impacting your day-to-day life still today.
- SSDr. Sarah Szal
It starts with creating safety in your body.
- MRMel Robbins
Hmm.
- SSDr. Sarah Szal
And this is especially important for those of us who had adverse childhood experiences before age three. So creating safety in your body, using the breath that we practiced together, meditation, yoga, ways of being in your body, creating safety, that's where you start. There's lots of different ways that you can create regulation in your body, nervous system regulation, immune system regulation. I would say it starts with being fully embodied.
- MRMel Robbins
That's a big word. I don't even know what the hell that means.
- SSDr. Sarah Szal
(laughs)
- MRMel Robbins
You know what I mean? Like I know what it means kinda, but if I were to hear that I'd be like, "But Dr. Saul, I don't know what the hell that means." If you are the kind of person that has ever gone to a yoga class or you've tried a guided meditation on YouTube or, you know, iTunes or Spotify and at the end of it you have this experience of feeling at peace and you almost never feel that way, to me that's a sign that there are stored experiences in your body that are driving how you live your life as an adult, and there's a different way for you to be able to go through life, that that sort of moment of calmness in your body and that safety, the word that you just used, Dr. Saul, that that could be the majority of how you feel.
- SSDr. Sarah Szal
That's right. And it's entirely within reach, and yet, you won't be told that by most doctors.
- MRMel Robbins
Hmm.
- SSDr. Sarah Szal
What I was taught to do with people with trauma when I went through my medical training here in Boston was that you do talk therapy with or without a selective serotonin reuptake inhibitor, and there are three medications that are approved for post-traumatic stress disorder. The effectiveness of that approach, which is the gold standard right now, is about 30% because you can't think your way out of trauma. You had a beautiful quote about this.
- MRMel Robbins
Yeah, I don't remember whose quote this is, that if you didn't talk yourself into it, how are you gonna talk yourself out of it? And for me personally, talking about adverse childhood experiences or traumatic experiences or just periods of my life where I was so out of control and a walking red flag that I have a lot of shame and regret about who I was 'cause I didn't know any better, and I didn't know that trauma and adverse childhood experiences were driving behaviors I couldn't get control of. But talking about it helps legitimize what you're feeling and validate what you're feeling, and it helps you kind of architect the story of what happened, but it didn't do anything to settle the programming from the neck down. I had to take physical approaches of cold plunging, meditation, yoga, being outside in nature more, uh, guided therapeutic psychedelic modalities that were all done with the intention of trying to settle my body to that point where I would go to a yoga class 20 years ago, I'd spend 90 minutes on the mat, if I could find 90 minutes. The entire time I'd be, in my brain, thinking about the grocery list or how much better somebody else was at yoga or how hot it was or how I hated the song or blabbity, blabbity, blah, blah, blah, di-de, di-de, di-de. And it wasn't until it was over and I laid down that my body just felt safe.
- SSDr. Sarah Szal
Yes.
- MRMel Robbins
And I am here to tell you that if you take... if you first recognize that your childhood is impacting you in ways today that you may not realize, but you actually accept that as true, and then you realize that talking about it is gonna help you validate what happened and some of the patterns that you can't get control of, but really, your body is designed to heal. Your body does want to be at rest. And if you truly take that on and you follow the recommendations that Dr. Saul just gave you and you also... even just following the breath and doing the 5.5 breath whenever you feel yourself go up in your head or get triggered, that right there is you activating the healing response, and it's possible. It truly is. What I love so much is that the body's designed to do this.
- SSDr. Sarah Szal
Yes.
- MRMel Robbins
That's-
- SSDr. Sarah Szal
And we keep getting in the way.
- MRMel Robbins
Uh, eh, well, after today we're not going to because-
- SSDr. Sarah Szal
(laughs) .
- MRMel Robbins
... you've taught us, Dr. Saul, how to get out of the way and how to validate what we're feeling and to grab the wheel and to turn our relationship to our own health in an entirely new and empowering
- 1:18:53 – 1:23:20
Take Back Control of Your Health
- MRMel Robbins
direction. What are your parting words, Dr. Saul?
- SSDr. Sarah Szal
I know we talked today about things that are scary and threatening and, for some people, shameful. What I want you to remember is that it is so much easier to live in a state of regulation-
- MRMel Robbins
Mm-hmm.
- SSDr. Sarah Szal
... to live in that place of safety inside of your body, and it sends these cues everywhere in your body. It sends the cues to your immune system.... to the sweet private security force that you have working on your behalf. It sends the cues to your nervous system. It sends the cues to your hormones and how they're produced in your body. It's so much easier to get into a state of regulation than it is to live with the misery of being dysregulated.
- MRMel Robbins
Dr. Saul, I know I speak not only for myself, but for the person who found the time and took the time to be with you and me and learn from you, and what's so exciting about everything that you shared is that... You know, I think when you're really struggling with your health and you feel dismissed by your doctors or your family that you feel disempowered, and everything that you talked about today puts the power back in our hands and our bodies and being reminded that your body is this magical, amazing thing that is designed to heal, and you just taught us how to activate that within ourselves. So thank you, thank you, thank you for taking time out of your extraordinarily busy practice to get on a plane and fly here and spend this time and be so generous with us. I just loved being with you and cannot thank you enough. I cannot wait to see how many people's lives change, because this is life-altering, what you just shared.
- SSDr. Sarah Szal
Thank you so much, Mel. I mean, I love the service that you provide in the world. You're such a deep listener and a critical messenger in this time in our lives. Thank you.
- MRMel Robbins
Thank you. And I also want to take a moment and thank you. Thank you for finding the time and making the time to listen to something that could truly change your life. It could improve your health. Thank you for sharing this with the people that you care about. There's no doubt in my mind that if you take everything to heart that Dr. Saul just shared with us, all the research, all the recommendations, all the wisdom, your life and the health of people that you care about, it will get better, and I think it's really cool that you're taking the time to learn this stuff and to invest in your health and in your life. That's absolutely why I'm here, and I just love that you're doing that too. And in case no one else tells you, I wanted to be sure to tell you that I love you, I believe in you, I believe in your ability to change your life, and there's no doubt that by taking the time that you took today, you will. All righty. I'll see you in a few days, and I'll be waiting for you in the very next episode to welcome you in the moment you hit play. I'll see you there. And thank you for being here with me on YouTube and watching all the way to the end. And thank you for sharing this with anybody in your life that's struggling with their health that you know could really use the wisdom and all of the advice that Dr. Saul just shared with us. And one more thing, because you're the kind of person that is always supporting people that support you, please hit subscribe. It's my goal that 50% of the people that watch this channel are subscribers. It's free, it costs you nothing, and it's really important to me and here's why. It tells me that you really love the videos that we post here every single day, it tells me that you love the world-renowned experts that we bring to our studios here in Boston, and it tells me that you love these free resources that you can share with the people that you care about. So thank you, thank you, thank you for hitting subscribe, and I know you're thinking, "Mel, shut up. Tell me what I should watch next." You got it. Check out this video. You're gonna love this. It's the perfect thing to watch now, and I'm gonna be waiting for you in it the moment you hit play. I'll see you there.
Episode duration: 1:23:20
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