Beyond the Basics: Calming the System, with Heidi Turner
The patients that Heidi Turner typically sees in her practice have done the basics of diet, probiotics, antimicrobials. They have often been through many doctors, elimination diets, supplements, and more, yet inflammatory symptoms persist and are resistant to treatment. They often have some degree of histamine intolerance or mast cell activation. For this highly sensitive population, managing symptoms alone is a challenge. But recently, many of Heidi’s patients have seen significant healing results from an unexpected natural therapy. In this episode, Heidi shares her experience treating this unique group of patients, and explains why targeting the limbic system has been effective.
Dr. Michael Ruscio, DC: Hi, everyone. Welcome back to Dr. Ruscio Radio. This is Dr. Ruscio. Today, back with us is Heidi Turner. I just want to quickly qualify that this podcast episode will be more for people with fairly progressed symptoms, highly sensitive patients, patients who feel like nothing works for them, or they’re reactive to many of the therapies that they have tried.
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Dr. R’s Fast Facts Summary
MCAS and histamine intolerance
- Underlying causes are usually gut dysbiosis, mold/CIRS, Lyme and/or chronic viral reactivation
- Patients with a history of trauma/abuse will often times need limbic retraining therapy
Alternative therapies for MCAS and severe histamine dysregulation
Where to learn more:
We’re going to be discussing histamine intolerance, mast cell activation, and how we can use some other therapies that are maybe not so much the frontline therapies to help in this highly sensitive subgroup of patients. So if you don’t feel like you fit that category, you may not necessarily listen to this episode. But of course, you’re more than welcome to listen to every episode!
Heidi, welcome back to the show.
Heidi Turner: Thanks for having me.
DrMR: It’s always a pleasure chatting with you, because I can tell that you are an experienced clinician. And while everyone I interview, I think, is trying to do the best that they can, you can really tell the difference between an experienced clinician and people who might be more theoretical. So not to disparage anyone, I just want to prop you up and say, I appreciate the tenured and level-headed approach that you bring to nutrition and functional medicine nutrition.
HT: Thank you, I appreciate the feedback. Haha, I try!
Less Testing for Sensitized Patients
DrMR: I think this is a great conversation for us to be having. Because when not handled appropriately, the subset of patients or clients that are very sensitive, I think, really run the risk of being very disserved by a community that can sometimes be overzealous about things like gluten or dietary restrictions or supplement popping.
And unfortunately, a motivated patient—where that motivation is utilized in a somewhat irresponsible way—can really lead to, as I’m sure you’ve seen, patients coming in, having just been through the wringer of superfluous, meaningless testing. Just popping bottles and bottles of supplements and being afraid of food. That’s why, again, I really appreciate your approach because it doesn’t subject someone to all that craziness.
HT: Yeah, I think when I start seeing someone, they’ve usually been through all of that craziness. So I don’t have to subject them to any more! And then it’s interesting that, in that population—I’m not saying for everybody, but in this population—they’ve been through so much and they’ve had so much tested. And things come up. We might see issues related to adrenal or issues related to the stool or what have you. And yet, none of the treatments have really been beneficial.
HT: So I find… We have to stop the tests, especially in this population. Step back a little bit further. And I think that’s what we’ll talk about today. Just, how do we step back a little bit more?
DrMR: Yeah, I think that’s a really good way of interpreting it. That’s one of the ways that I’ve come to rely on testing less. Maybe we could term it this way: in a patient that has some sort of lab test aberrancy (who’s a strong responder), they’re going to respond to almost any therapy.
So if you think you’re treating the lab tests and that’s the reason why you’re attributing their response, if you’re treating a fairly healthy population that’s prone to respond favorably, you could very easily bias your way into thinking that treating the lab result is a reason why you’re such a good clinician. When, in actuality, you might just be seeing a really responsive group of patients. And if you just treat it based upon signs and symptoms, you might see similar outcomes.
But my theorizing aside, can you give just your brief background, in case they didn’t catch the first episode? Then we’ll launch in.
HT: Yeah, sure. I’m a functional dietician/nutritionist. The majority of my career has been at The Seattle Arthritis Clinic in Seattle, Washington. I was a provider there working with seven, sometimes eight, rheumatologists and seeing a fairly complex population of patients with autoimmune and inflammatory conditions. So I spent the last 12 years there. I actually just left my position there in December.
For the last seven, eight months now, I have just been doing my own private practice and working remotely, via Skype and such, with this more complex population that I got to know during my 12 years at the Arthritis Clinic. And I’m specializing more with mast cell activation and histamine intolerance issues.
That seems to be a place where I’ve settled after having worked with autoimmunity, SIBO, digestive issues and such. I still work with all of those things, absolutely. I’ve just found myself swimming a lot with this more complex population and really observing and trying to see commonalities, trying to find patterns.
Where can we go just beyond medicating and alleviating symptoms, whether that’s with medication or supplementation or even diet, for that matter? What more can we do to step back and really help a more complex and sensitive population calm some of that sensitivity?
That’s really what I’ve been doing here for the last seven or eight months, beyond the 12 years at The Seattle Arthritis Clinic.
Complex Conditions & Managing Symptoms
DrMR: So your current focus indirectly posits that the reason you feel many of the sensitive patients to be sensitive is because it’s underlaid by a degree of histamine intolerance and/or mast cell activation. Is that an accurate representation?
HT: Yeah… Maybe. Let me think about that.
DrMR: There’s a lot of nuance. I get that.
HT: There is, yeah. That’s the label I think we can put on whenever we’re seeing a constellation of symptoms, right? So that can be hiving, or most of my patients have severe digestive issues. But that could be hiving, migraine, or autonomic nervous system issues. That could be eczema. That could be any number of symptoms that fit within a histamine modulation, where histamine might be active in that particular inflammatory process.
So then when we see this, when histamine is at play, then yeah, we can say there is either a histamine intolerance or histamine dysregulation, as I like to call it. And when there’s a higher level of severity, where we really can’t calm things down and the body is just in this constant activated state, that’s where it veers more into that mast cell activation syndrome place.
DrMR: Yup, which makes sense. Okay, so I definitely want to get into the facets of the therapeutic protocol (for lack of a better term) that you’re using here. But you were mentioning—before we started the recording—how you look at the evolution of this, or the mechanisms, or what’s going on underneath the hood. Do you want to give us just your big picture thoughts there?
HT: Yeah. Well, I’ll give you a little bit of my history with it, and take you through to that. My history with this is, again, working with the autoimmune population. I’m seeing the subset of people with inflammatory conditions that didn’t quite fit within the standard model of autoimmunity or neuro issues or gastrointestinal issues.
So again, just very hypersensitive individuals that have very low food tolerance, very low supplemental tolerance. Anything that I would try to do to help the individual was just met with severe reactivity. And it’s this head-scratching thing. Well, what’s going on? Sometimes, I was able to get in there with a certain supplement or we were able to find a particular diet that really helped them to reduce their symptoms significantly.
But we were really just doing symptom management, I would say. Just helping them to feel better, but never really resolving what was going on. The frustrating part was that everybody was different. You could have a mast cell activation situation, but everybody was coming in with different symptoms, all under the same idea of histamine mediation. So it became very frustrating. You would find kind of the “in” with one patient and get them feeling better. Then you tried the exact same thing, and the next patient was never the same. Their symptoms were always a little bit different.
So it’s been like this for 12 years, working with this population. Was introduced to mast cell cytosis, and then we finally got the diagnostic criteria of mast cell activation syndrome. And then, what do you do about it?
I know that you’ve had Dr. Afrin on the program before, working more with symptom management. That’s what these conditions have always really worked around, what do we do to calm these symptoms down? That’s really important because the quality of life for people who are extremely hypersensitive is really poor. So you want to help them manage their daily life.
You might need to medicate either with H1 or H2 blockers or leukotriene inhibitors, mast cell stabilizers, quercetin, vitamin C, or DAO, or all of those things. So really, it’s been a lot around symptom management for a long time. And then also trying to figure out the dietary piece for a long time as well. Is it low histamine, low sulfur, low fermentable? Everybody was really different in terms of how they reacted to any of those changes that we made. So that’s what I’ve been doing, always trying to find the in, for a long time and with varying success.
Why Is the Body Being Protective?
But still with this question of, “What’s the problem?” Why is the body in such a state of fear? Why does it just reject everything that is asked of it, or everything that’s being given to it, or any kind of sensory inputs? And that’s what I would find in this population, that they were highly sensitive, not just to supplements and food but to everything. To emotions, to smells, to any little itch of the skin. So just this really highly sensitized population.
I step back from it and think, “Well, why does the body think it needs to be so protective? What is it protecting? What is it fearful of?” So this is my perspective as I’ve worked with this population, always trying to find the key to each person.
I keep coming back to that idea of, “What’s the fear?” What do we need to be doing that is going to turn the volume down on that level of hypersensitivity and hyperreactivity, and identify what the fear is in each of these people? That’s the idea.
DrMR: And you’re using the term fear broadly, not meaning necessarily psychological fear, but immune system being overzealous…
HT: Exactly. Yeah, like, why does it feel like it has to protect? Because every time we give them something, it’s this hyperreactive thing that could take weeks to clear.
So as a practitioner who becomes very sensitive to this level of sensitivity, you become very judicious in what you recommend to the patient. You really step back and go, “Okay, wait a minute.” You’re looking for certain things. “Oh, that person tolerated that. Maybe the next person will.” And you’re looking for some pattern of, “Ah, there’s better tolerance to this particular thing. Great. Let’s start with this.” But never able to really find the key, like, “Here it is.”
Sometimes, we can calm the histamine response. And that does calm things enough for us to be able to get in there and treat. When I say treat, most of these patients have a certain level of something, whether it’s bacterial overgrowth or mycotoxicity or Lyme disease, or some sort of significant dysbiosis or viral infection that needs to be managed. So I’d say that that’s a very common thing in this population. And we are looking for these kind of coinfections.
The question is, how do we get in there to manage it? So again, “fear,” no. That’s not an actual psychological fear, that’s an immune system protective. Why so protective, and how do we get in there?
DrMR: Okay. So a lot there to pick into.
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Make Sure Basics Are Addressed First
DrMR: I should restate for the audience that there’s definitely a foundation we’re assuming is in place, as you implied, addressing things like gut dysbiosis. That can be massively helpful for someone who thinks they have either mast cell activation syndrome or histamine intolerance. It’s something that I’ve noticed myself when I get too liberal with histamine foods. If I’m literally eating a high histamine food or a couple of them at every meal, after a few days, I start to feel it.
When you’re not feeling well, you can think that things are far worse than they are. I just want to make sure we pull people out of the black hole of despair and remind them that the foundational factors will get you very far. So, the appropriate addressing of gut dysbiosis, using a general term, and all the things that could fall underneath that, including SIBO, H. pylori, fungus, or even just dietary intolerances that you need to pin down.
The same may hold true for viral reactivation or mold. I do want to get your thoughts on mold a little bit later. But I think for right now, we’re going to assume that those have all been addressed fairly well.
Now, the question is, what else do we do besides that to move the patient forward? Is that where you want to take us?
HT: Yeah, I would absolutely agree with that. Again, the patients that I work with are those who have already gone through most of these hoops, and have already been through the months. They have SIBO. They’ve been through the antibiotics. They’ve been through the antimicrobials and yet, they’re still symptomatic. They’re very hypersensitive to those treatments. They become more hypersensitive the more the body is treated. That’s what I’m looking for. That’s the population that we’re really talking about.
Not necessarily, like, if you have histamine intolerance, you still want to go through the same hoops you want to go through. Because in most cases, going through and treating the SIBO or treating the mycotoxin or what have you is going to be what you need to do.
It’s when we get into the situation where the body just says, “Nope. I’m not going to let you in. Yes, I’ve got mold. Yes, I’ve got Lyme, I’ve got SIBO, but I’m going to react to everything you give to me. We’re done.” That’s the population that I work with.
The Limbic System: One Key to Treatment
DrMR: Right. So for this population, just starting from a high level here, what are the main facets that you found to be helpful (that might differ from person to person)? What do the core pillars look like here?
HT: Let’s see, given that there’s very little I can give them supplementally, I’ve been working a lot with meditation with my patients, for a long time. What do we do to turn the volume down? I’m always working with that metaphor. So if there’s a lot of stress in someone’s life, most people are very resistant to stress. And stress typically will trigger a lot of their symptoms.
So what do we need to shift that around? What do we need to do to look at the relationships in their life? Work meditation in, yoga, deep breathing. What is it we need to do to calm that down? So, different physical therapies. Craniosacral therapy, acupressure, acupuncture. I wouldn’t recommend really heavy duty massage, or anything really that is too hard on the system.
Just very light, light touch things that can at least help to calm the system down a little bit more. So these are things that I’ve been working with for quite a while with some level of benefit. But again, not really able to fully open the diet up, let’s say, or really calm things down and reset what’s going on.
So about a year ago, I was working with a patient and we had just had our initial session. I sent them away to do some things. And they had been bedridden for the last year. And when I got back on the call with them, they had just gotten back from a mile walk. And I said, “What? Was it because of what we did?”
She’s like, “Oh, no, no. I started doing this limbic system retraining program.” And I didn’t know what this was and I asked her to explain, which we’ll talk about here. She said, “I’m really noticing that I’m much less sensitive to my environment, much less sensitive to my food, and really feeling in a better place.” So I thought that was interesting. And sometimes, I’ll see things that work for some people. But I put it on the backburner and moved on.
Then about a week or two later, another one of my patients came to me and said, “I’m doing this limbic system retraining stuff and I’m starting to notice a shift.” So in my line of work, if I have more than a couple of people come and give me similar feedback from anything that they’re doing, I’m starting to get interested.
HT: Like, “Okay, what is this?”
DrMR: You’ve got to see it more than once, because there are all sorts of things one person can randomly try. You’ll get a shining recommendation, and sometimes that’s placebo, sometimes that’s legitimate. But you have to have some filter. And that filter is usually, “Okay, if I hear this a few more times, then I’m really going to start looking at this.” So yeah, exact same process goes for my practice.
HT: Yeah, absolutely. I think it might have even happened one or two more times after that. And this was all within a short period of time. I’m like, “Okay, limbic system. That’s the brain. Interesting.” Because, again, as I work more with this, I’m stepping back. I’m not getting in there and treating so much with supplements, diet, and things, I’m really stepping back and doing more of the meditative strategies. I’m like, “Oh, the brain? Okay.”
Well, is this the missing piece that I haven’t really been considering, because I’m not a neuroscientist? So I start looking into the limbic system piece. I’ll just give you an overview of the limbic system and how it works. The limbic system is part of our brain that assimilates incoming information and it determines how the body is going to respond to something.
So one of the things it does is it’s involved in the fight-or-flight response of the body. There are four areas to the brain, the hypothalamus, amygdala, cingulate cortex, and the hippocampus. So when there’s some kind of trauma coming at someone, each of these areas of the brain will come together to help you through that trauma, from the perception of what’s going on, to the survival, getting into the fight-or-flight, getting you out of it, to the recovery, and then to the memory of it as well, so that if that situation happens again, you’ll be more adept at surviving it.
So the limbic system is really this lovely thing. We’re always assessing information every day and it’s determining how our body responds. There’s something called limbic system injury or damage. And when we’re working with this issue, the brain is being activated in that same way as it would in any kind of trauma, by any number of toxins or injuries.
This can be physical injury, chemical exposure to, say, pesticides, chemicals, cleaners, air, water, cosmetics, lotions, anything that the body is having a reaction to. Electromagnetic radiation, bacteria or viruses, molds or fungus, and psychological stressors or trauma. I would also add in, actually, dysbiosis, from medications and multiple rounds of antibiotics.
So when we’re working with some level of limbic system injury or damage, the idea of this dysfunction is that when one experiences a level of toxic overload—and the brain continues to trigger these cells’ protective mechanisms to manage these traumas, because the brain is plastic—it can get stuck in a state of chronic emergency. And multiple systems will be chronically activated. Our digestive process, cardiovascular system, respiratory, immune system, endocrine system.
As this continues, we’re being exposed continuously to any one or more of these stressors, we’re going to continue to have this reaction in the brain. What this continued elevation of stress hormone can do is create this feedback loop in the brain, and this keeps this process activated. And over the course of time, the wiring changes in such a way that it just continues and continues and continues, even if those stressors are not present anymore.
DrMR: How I think this can manifest for some people, just to try to give this an avatar of presentation is—and I’m sure clinicians have seen this before many a time—someone who seems to have gotten physically healthier, yet they’re stuck in this pattern as if they were still ill.
I think any clinician who’s got a degree of empathic ability will get this intuitive sense that this person is physically healthier, yet the lesion, so to speak, is moreso in the mind.
And those historically have been some of the most challenging cases to work with. It’s easy for me to say, “Okay, low FODMAP, then we’ll use elemental dieting…”
HT: Haha. Which is fine. It might work!
DrMR: Right. It’s much harder for me to say, “Well, stop thinking the wrong way.” And just to get you up to speed—sorry, I should have mentioned this before—we’ve already had Annie Hopper and Ashok Gupta on the podcast. So we’ve had a chance to elaborate on this. And this is terrific, I think, giving people another clinician’s perspective on how this can be really helpful.
Typically, a History of Trauma
HT: Yeah, absolutely. Even before I knew all of this, I could see a pattern in this hypersensitive population. Usually, not always, there’s a history of early childhood trauma. I would say, like, 80% to 90%. There’s that 10% where they had a great life and everything was fine. But I’d say that’s setting us up for a higher peak level, right? The brain is already wired to a point of trauma. So we’re already there.
Then, later, what I might see is a perfect storm scenario. The perfect storm that I always observe is prolonged stress. And that’s more an emotional stressor, that could be divorce, death, grad school, medical school. Or deprived sleep, or whatever. But prolonged stress. They get a virus, they get sick in some way, whether that’s bacterial or viral, and then antibiotics are often involved in that.
I would also say that it’s pretty common for my patients who have been through a significant amount of antibiotics in their life. That’s where I feel like the immune system of the gut is really important in all of this as well, and where I think the dysbiosis plays in too, to this whole limbic system piece. I’d love to see the research on how those two things are playing off of each other.
So those are the three things that I’ve seen. Then, what I will see is… it could just be that that gets things going. And once we’re off, we have that constant, consistent exposure over the course of time. And it just takes something to really kick it over. That’s where we’re going to see that cascade of symptoms start to come on, that are going to be digestive and immune. They might stop sleeping. All the things that I might see as histamine-mediated.
Then, coming back to your mold question, you might layer in moving into a moldy environment, or excessive exposure to EMRs (electromagnetic radiation), which I am seeing. I question whether that might be a player in at least some of the hyperstimulation that we’re all exposing ourselves to. Or they start a new job and there are chemicals in the building that they’re reactive to. So that’s where going into the history becomes really important as well.
You can kind of see what’s happening though. There’s this layering effect that’s occurring, right? We’re starting early, and then we’re already starting at a heightened sense of the brain. And that memory is there. It’s always judging its experience based on that memory of trauma, and then we build from there. Depending upon what’s the right recipe that gets us there, at a certain point… and I think that that’s related to again, the history, our bacterial balance and genes. If you put all of that together, that’s where I think one person might have this kind of reaction versus the next.
So we might put a whole family into a house with mold, and only one person is going to be symptomatic and the rest are perfectly fine. That’s when you look at that history of that person and see, what were the predisposing factors that led to their level of hypersensitivity versus everybody else’s? That’s the general grounding or baseline of all of this.
Programs for Limbic System Retraining
There are a number of limbic system retraining things out there. You had Dr. Gupta and Annie Hopper on. Those are the two primary ones. The one that I usually recommend is Annie Hopper, just because she’s working more from a place of chemical sensitivity.
And it’s a program, it’s a thing, it’s not just something that you’re just going to do. You’re like, six months, hour a day, 14-hour training, you’re committing to this whole process! But what I am seeing in every single one of my patients—and I have never said that before—is improvement in some way. It is the first time I’ve ever been able to actually get in there. And it’s allowing us some space for the system to calm, to be less protective and less fearful.
And in engaging in this program, we’re starting to be able to actually get in there. First of all, strengthening the immune system. Doing this kind of work strengthens your immune system. So that is giving us a leg up, in terms of allowing your body to deal with any kind of coexisting infections that are going on, whether that’s mold or Lyme or Bartonella or EDD or SIBO.
But it also gives us an opportunity to be able to get in and treat anything, without a level of hypersensitivity and reactivity. I have to say, it’s been a game changer in my practice. Having worked with this for so long and looking for the key, I’m always hesitant to put something too much onto the pedestal. But it makes sense to me, having stepped back from it further and further. Looking at this piece, how the brain works, how the brain directs the body, how the hypothalamus directs how our immune system works and our endocrine function works, and all those things that we see are in distress in this hypersensitive population. You manipulate that particular area in a way that is noninvasive.
There’s no prescription, there’s no medication, there’s no supplementation, there’s no diet to it. But in doing that, in employing that, the immune system, the digestive system, the neurology, everything, starts to just calm down. It’s remarkable. It’s really remarkable.
Hyper-attentiveness & Sensitivity
DrMR: It’s almost as if there’s a law of diminishing returns with being attentive to oneself. So if you’re totally disconnected, then you might have this raging dairy intolerance: “I can’t figure out why I’m bloated all the time!” Well, if you had any ability to read your body, eventually you’d piece that together.
Now, at the other end of the spectrum, if you’re hyperattentive, that can start to be a problem. While you’ll probably be able to pick out all these associations, there is this cliff over which you can fall and you start seeing associations that may not even be there. That might be someone who is just experiencing a tiny amount of bloating where most people would say, “Eh, yeah, that’s normal, maybe.”
Maybe there was something in this food that wasn’t a quality oil, maybe it was because you were up last night, or maybe this is just a little thing that comes up like every once in a while, you’ve got a weird sensation of an itch you have to scratch. It doesn’t mean that you have a herpes zoster breakout or anything like that.
But with enough attentiveness, you can really start to, I guess, assign a pathological level of meaning to otherwise normal events (as just one example of what can set the groundwork for this). But you’re absolutely right that for some people, if there’s any indication that they may be having a reaction, they really start with this cascade of fear.
HT: That’s right.
DrMR: And that might be one of the limiting factors allowing people to respond and move forward.
HT: That’s right, absolutely. And that hyper-attentiveness is part of the treatment protocol when we’re working with MCAS, unfortunately. I think it’s because it’s not only H1, H2 and things like that to control the response, if they even tolerate that. But it’s also avoid the triggers. Make sure you avoid the triggers. All of a sudden, “Well, I can’t go there because I can’t breathe that scent. And if I go there, I’m breathing that in. And if I eat that… I can’t.”
And all of a sudden, you’re just building yourself into this corner where you really can’t live your life at all. And that’s perpetuating the fear. Which is then perpetuating the issue from the limbic system perspective.
DrMR: And there’s also this kind of placebo expectation when you go to any kind of unknown building, let’s say for chemical sensitivity, or any kind of unknown restaurant, let’s say it’s food intolerances, that you’re almost expecting to have a reaction.
And I think that’s one of the things that this limbic system retraining really benefits the patient regarding. It gets them over that hump of expecting, or at least, being suspicious that there’s going to be a negative reaction with everything they eat and everywhere they go.
I’ve noticed that with some patients, when I’ve told them, “You can eat X, Y or Z food,” they can eat X, Y or Z food and not have the reaction they thought they were going to have, just because someone told them that they probably could!
HT: It’s true, yeah. Sometimes that’s true, and sometimes it’s not. Sometimes there is still that level of hypersensitivity around food. Or there still is that level of hypersensitivity that is present, until they can basically train the brain in such a way so that it becomes less sensitive to that. So there is sort of the subconscious piece and then there’s the conscious piece, right? There’s a balance of that.
These people that have this don’t have allergies. They don’t have food allergies. They don’t have allergies to the environment. It’s very unusual to see any kind of allergy. You do a skin prick test, there’s no IgE response at all. So this is not an allergic situation, this is a hypersensitive situation. And it’s not in your head. I think that that’s a really important thing to differentiate as well. We don’t want it to be construed as that. You don’t want to say, “Well, this is just a psychological issue that you’re experiencing,” because they’ve heard that from all of their doctors at this point, right?
Typically, if the medical doctor can’t figure it out, the next thing is, “Here are your anti-anxiety medications. Here are your antidepressants, because obviously this is a psychological issue.” I think the psychological issue can be perpetuated from this, like, it can really mess with your brain. Just how you were saying, it can really mess with your mind. All of a sudden, the fear becomes so palpable that even just the fear itself can start to trigger that response. And I think that’s what you’re saying, right, that that’s going to lead to that?
But this is not necessarily a psychological issue.
DrMR: Well, it sounds like it’s almost more neurological, there’s neurological facilitation of certain pathways in the brain, but wrapped into that whole scenario is a degree of psychology. And the good news is that they both improve with the appropriate limbic system retraining.
HT: Absolutely, yeah.
Comparison of Limbic System Retraining Programs
And it can take some time. I’m not sure around Dr. Gupta’s program. Some of my patients are doing them both, I’ll say. They’re layering everything into it! They’re doing both Dr. Gupta and Annie Hopper.
DrMR: Here’s what I’ve heard. I had one patient who actually did both, and he was telling me, “If you’re type A and you just want to get in, get it done and get out,” the Gupta Program was his preferred choice.
DrMR: If you’re looking for more support, more of a verbose explanation, maybe a bit more handholding, then the Annie Hopper DNRS program was a little bit better. So I’ve been recommending as such. If someone seems like they’re needing a lot of emotional support and maybe that more all-encompassing sort of feeling to the therapy, then I’ll steer them toward Annie Hopper’s DNRS. If it’s someone who’s busy and you can tell there’s like, “Boom, boom, I want to get this done,” then I steer them more toward the Ashok Gupta program.
HT: Interesting. That’s good to know and I’m glad to hear that. I know he does a little bit more meditation, and some of my patients just really like that. They like to bring more the meditation quality into it, instead of the rounds and POPs and things like that that she does. But yeah, I would say if one program doesn’t work for your patient, then to direct them to another. Some of my patients are also bringing tapping (Emotional Freedom Technique) into it.
That also was a form of limbic system retrain, just from a different perspective. And some people bring a lot of different limbic system modalities into this and find that they work in different situations. Like if they’re in a restaurant and they’re having a reaction, starting with tapping will actually help to abate that reaction, so that they don’t have to jump up and start doing rounds or whatever.
They can use each of these different tools in different situations. And they found that to be really beneficial, for the really hypersensitive who’s just reacting to everything.
DrMR: And that’s the Emotional Freedom Technique that you’re referring to, with the tapping?
HT: Yeah, exactly. So there are lots of different ways to do it, but I think it’s getting to the same place. What I’ll say is that, typically, the more common thing that I will see—at least with the DNRS—is benefits to the patient usually within the first one to three weeks. So even though she’s asking for a six-month minimum, I will typically start to see a reduction in anxiety and improvement in sleep and an improvement in energy. Those are the three things that I’ll typically start to see as our initial feedback.
And that’s not with everybody, so you can’t judge on what I’m saying. Everybody is very different, but that’s most common. Then it’s also common to see some reversal in the progress that you make. And she will talk about this as well. Sometimes, you might hit a wall and not feel like it’s working anymore. And you have to keep up with it. It has to be a regular and daily commitment. And it’s an hour a day, so it’s a thing, right?
So you have to make sure that you’re sticking with it. Then you reassess at six months. If you still need it at that point, you continue. If you feel like, “I’m good, I’m feeling pretty stable and everything is good,” then you stop it at that point. The rewiring has occurred. But you have to give it a certain period of time. So six months is the absolute minimum. I have some patients who are eight months, 12 months who are in a much better place, but are still working some of their reactivity. And some are still in their molding environment.
DrMR: Also, Heidi, I think, important just to underscore what you said, which is, you have a good probability of seeing improvements before that six months.
DrMR: So I don’t want people to misconstrue this as, “My God, I’ve got to go through six months to see anything.” You’ll likely be having positive feedback, which will invigorate your motivation between one and three weeks.
HT: Soon. Yeah.
DrMR: I look at this almost like gym for your brain, right?
DrMR: Maybe now, you focus more on this and your exercise sessions are a little bit shorter… well, I would assume many in this situation are probably fairly minimal in their exercise anyway.
HT: Yes, it’s true. They can typically expand on that.
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The Potential Impact of Screens & EMFs
DrMR: Right. The other thing I want to get your take on is screens. You had mentioned that one of the things you’re finding to be beneficial incorporating, along with the limbic system retraining, is some limitations on screen use. And maybe EMFs. I’m just curious what you’re doing there.
HT: Yeah, I did notice after we started the limbic system retraining… a lot of it is done on screen, whether it’s DVDs or whether you’re doing the online program. And the majority of my patients are working eight hours a day on the screen and aren’t sleeping at night, so they’re on their devices. So I started doing “screen diets.” What can we do to reduce that? Looking at the environmental exposure.
First of all, when we’re on the screen, we’re assessing. We’re always in this assessment mode. So really trying, again, to turn the volume down on what the brain has to do. Depending on what we’re reading, social media, or something like a movie, the violence or anything that can stress the system, there’s a level of stress that we’re putting the brain through.
There’s a difference between sitting there and going through our phone, sitting and reading a book, or listening to music, right? The brain is active in a very different way. I’m trying to reduce the activity so that we can calm the situation down.
Basically, whatever we can do to shift… I’m especially seeing more reactivity to wireless. That’s where I’m seeing the most reactivity. So to the pads, the phones, or to the wiring in the house. I’ve actually seen some remarkable reduction in symptoms by going from wireless to just cable modem kind of things, or whatever you call it these days. Wiring the house differently. So going off of a wireless system.
And also, just being more on the screen. Like if you’re going to be on your computer, be on your computer. Be less on the phone and less on the iPad. Going into airplane mode. Turning off your wireless at night, and whenever you can afford to keep it off. So I have seen shifting in numbness and tingling in the extremities by making these changes.
I’ve seen shifting in headaches, I’ve seen shifting in digestive issues, all the stuff that we’re looking to calm, I’ve seen a remarkable shift in that. I don’t know if it’s a causal factor. I certainly don’t think it’s helping us, in terms of how hypersensitized we’re becoming to our environments. We’ve got a lot coming at us. And I do question whether just our exposure to the EMFs, EMR are a contributing factor to that.
So wherever we can turn that volume down as well, I’m finding to be really beneficial, in most who I recommend that to.
DrMR: Yeah, and I’ll second that. I got an EMF-sensing device and did an experiment where I live with the WiFi on and the WiFi off. There was clearly a difference. I went down a full category of EMF on the meter when I would turn my WiFi router on or off. And I retested a multiple times to make sure that the association was true. So now, I have switched my home office over to wired.
DrMR: And I pretty much don’t ever use my WiFi at home. I’m fully wired. My cellphone is pulling. But when I’m not using my cell phone, especially if I’m carrying it on me, I always have it on WiFi. I can’t say I feel any differently, but I am planning on running an experiment with an EMF canopy. And I’m going to test EMF inside the canopy. This canopy would be where I sleep.
I’m first going to test to make sure it’s EMF-free and then do some Oura Ring sleep tracking. And I’m going to look at my historical data and then do a few weeks in this kind of EMF cocoon/canopy and see if there’s any appreciable difference, because I am curious. I’m open to it. I’m a bit skeptical, but also curious to see what kind of benefit one may garner from limitation. Certainly, with what you’re saying there that makes me lean a little bit more… I’m suspicious of its ill effects.
HT: Yeah. And I’ve been doing my own experimentation, because I started working remotely via Skype and FaceTime and all of that. So I’m on the computer quite a bit. And just really started to notice my own anxiety levels going up, just by being on the computer so much in a wireless environment. And visually, a lot of headaches and just feeling absolutely awful at the end of the day. I’m like, “This is not a sustainable situation.”
So just by making these revisions—I did get computer glasses—different kinds of ergonomics, but also, “What can I do to block out the blue light?” seems to be a major piece in terms of my nervous system stimulation. All of these invisible things that are impacting us, that we’re just taking for granted, that are just a part of what we do at this point, we do need to question, to what extent are they impacting us?
We’re dealing with a lot these days. I don’t know if anyone has noticed this, that we’re dealing with a lot of stressors these days. I think that our visual stressors are high, our global stressors are high, our environmental stressors are high. There’s a lot that we’re taking on and all of that is invisible, that we’re not really taking into consideration. Those are the things that I really look at.
What are the things that we might not consider, that aren’t just the diet? That aren’t just the supplements, aren’t just the SIBO, aren’t just the things that are in front of us? What are the invisible things that we’re not considering? I think that those are really important things for us to take assessment of in our own homes and in our own environment.
DrMR: I think that’s a great note to move us into a close. Just to reiterate, the two main thrusts of this are reducing your screen time and WiFi exposure, combined with some type of limbic system retraining. Those might not be as easy as popping some pills, but certainly for the right population, seem to be pretty impactful.
And Heidi, you’re not the first person to say this whose opinion I respect, I would say that I have now seen a number of patients who reported that same thing. So I think there is a “there” there. Which is great because we can offer that subset of highly reactive people a way to get out of that position. And this is something that I think is a message that needs to be championed more and more, so more and more people are aware of it and can take the appropriate steps toward resolution.
DrMR: So there was one item I know you wanted to sneak in, which was how you’re incorporating immunoglobulin therapy, like our Intestinal Support Formula (formerly known as Intestinal Repair Formula) but also ImmunoLin. It has a few other trade names going on the market.
I thought this was really interesting for someone who’s getting some initial response from this limbic retraining and now they can start expanding their diet. You’re incorporating immunoglobulins at this time, and really finding this potentiation effect. Why don’t we go over that in brief here?
HT: Yeah, sure. So if we bring in the ImmunoLin therapy too early, I don’t typically find good tolerance there. So we need that limbic system retraining happening first. Then, as soon as we start to see the diet being able to expand—that’s where I’m getting in there and saying, “Okay, what’s the next best place to expand the diet out?”—or once we start to see the immune system start to rest and accept more foods, that’s when I will often add in that ImmunoLin. Hopefully it’s tolerated and accepted at that point, when I’m starting to see a really significant expansion of dietary tolerance. So you have to put it in at the right time. You can’t put it in too early.
But once you start to get better food tolerance, adding tiny bits in and going to full dosage on that, that’s when I will start to see improvement overall. And modulation of the immune system, and calming of that basic visceral hypersensitivity and reactivity in the gut.
DrMR: So for the audience, there are two ways I’d recommend using ImmunoLin or Intestinal Support Formula. This would be, I guess, a bit of trial and error. What I’ve noticed with some patients, clearly, is when we’ve used many of the other therapies, and someone has improved but has not improved fully, that’s when the immunoglobulins can really help them get over that hump, dampen some of the immune reactivity, and allow them to expand their diet. That would be one way this could manifest or play out.
There could be an alternative situation. I have seen this. There are a small number of cases who do negatively respond to immunoglobulins. I guess it all depends on the patient population that you’re treating. In this case, this would be more the way Heidi’s using it. So if you had a negative reaction to immunoglobulins, that’s when you may be a prime candidate for limbic system retraining. Then once you’re making some headway and a little bit less sensitive, that’s when you can add the immunoglobulins in and really see a potentiation of those improvements you’re now starting to establish. It’s brilliant.
HT: All right!
DrMR: Cool, anything else there?
HT: No, that’s it. You said it really well. That’s exactly when I would use it. I love that stuff, so if you can get it in, and get it in early, terrific. But again, if you can’t, then do the work, and then bring it in. It’s lovely stuff. It can really help to set the immune system right in the gut.
Heidi, do you have any closing thoughts you want to leave people with? And then, also remind people where they can track you down on the internet.
HT: Yeah, sure. Well, you can find me at foodlogic.org. I do work with those who have MCAS, as I said, and more sensitive individuals. I also just work with those who would like to eat better, because I am a dietician. And I think that one thing we didn’t get to is the diet does make a difference. I do work that angle as well. Certainly, from a symptom management perspective, I do help to guide the patient into working into the diet that’s going to be the least reactive, while doing all of these things to help strengthen that immune system and strengthen that nervous system.
So I still think that there are things that you can do with diet, maybe with supplementation if your body is going to take it. Once we actually do calm things down, again, that’s when we want to enter in and do what we can to help to guide the body back to a place of homeostasis and balance. And I think this type of protocol is really the way for us to move ourselves, at least move ourselves in that direction.
Yeah, so that’s where I’d leave it.
DrMR: Awesome. Well, thank you, Heidi.
DrMR: And for everyone listening, if you want to hear a deeper conversation between me and Heidi regarding diet, just look up her last appearance on the show and we’ll also link that in the transcript for everybody.
And Heidi, thank you again. Really appreciate it.
HT: Yeah, thanks for having me.
What do you think? I would like to hear your thoughts or experience with this.
Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.