A Holistic Approach to Autoimmune

There are more than 80 different types of autoimmune diseases, making this area of medicine complex and in need of attention from a holistic standpoint. Rheumatology expert Anastasia Stocker, ND, LAc, has expertise in working with patients who have various autoimmune conditions. She is also well-versed in helping patients navigate prescription medications while using an integrative approach to their care. If you or someone you love has an autoimmune condition, you won't want to miss this show!

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Episode Transcript

(00:00):
Any health related information on the followingshow provides general information only. Content presented
on any show by any host orguest should not be substituted for a doctor's
advice. Always consult your physician beforebeginning any new diet, exercise, or
treatment programs. Hello everyone, andwelcome to Five to Thrive Live. I'm

(00:44):
Carolyn Gazella and I co host thisshow with my good friend, doctor Lisaul
Schuler. Today I have a rheumatologyexpert with me to talk about autoimmune conditions.
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(02:16):
is doctor Anastasia Stocker, who isa naturopathic physician and acupuncturist who specializes in
treating autoimmune conditions. She is aphysician with the Aria Integrative Medicine Clinic in
Seattle, Washington. Doctor Stoker,Welcome to the show. Hi, Thank
you so much for having me,I'm so excited to be here today.

(02:37):
Yeah, I mean it's a bigtopic, but it's an important topic.
I think the last time I reada statistic, there were like over eighty
different types of autoimmune conditions. Andif you know, doctor Stalker, some
of those autoimmune conditions can be prettychallenging to treat. Why is that.
Yeah, they can be very challengingto treat because they can affect every single

(03:00):
body system. Right, So anywherethat your immune system goes, which is
everywhere in your body, you canhave those places be affected by autoimmune disease.
So it's challenging to treat them becausewe have troubles diagnosing them. So
sometimes we don't know that there's certainautoimmune diseases happening until it's farther down the

(03:22):
line. We also have to figureout what is triggering your immune system,
and this can be very difficult todo, right. So identifying your environmental
triggers, which I know we'll talkabout a little bit later, is a
big part of treating autoimmune disease.And this can be tricky because for every
person it's different and sometimes it's amoving target, and so it can be

(03:43):
frustrating and it's a journey to helptreat autoimmune conditions. Yeah, it is.
And I know I've talked about myalopecia universalis on the show, which
is an autoimmune condition that causes completebaldness, and they did have difficulty diagnosing
it and it was a very scaryprocess. Who was very frustrating, and
then treatment options for me are arepretty limited. So there is a level

(04:06):
of complexity and that's why i thinkyour holistic approach is so important. But
before we talk about a holistic approach, tell us how conventional medicine typically treats
autoimmune conditions. Yeah, so conventionaltreatment is usually just aimed at targeting symptoms,

(04:28):
right, so inflammation, pain,and they're also aimed at stopping disease
progression. So conventional medicines are oftenusing anti inflammatory medications so things like insets,
ibuprofen, leave, that sort ofthings, or they're using suppressive medications
like steroids, and they're using diseasemodifying rheumatic anti rheumatic drugs, so things

(04:53):
like methotrexate and biologic medications, whichI'm sure everyone is familiar with. They're
all over the TV. Right there'adds for them because they're so prevalent and
they're used so much in conventional medicine. Yeah, so some people who want
to use a holistic approach still haveto be on prescription medications. Just as
you mentioned, it helps control theirsymptoms, it reduces disease progression, it

(05:16):
even enhances their quality of life.Some of these same individuals may feel bad
that they have to take a medication, and some of these medications are pretty
potent. So what advice do youhave for those people who are needing to
stay on their medication. Yeah.I always ask my patients that have to

(05:38):
be on medication to stop disease progression, right, to prevent organ or joint
damage, to give them themselves alittle bit of grace. I always try
to help educate them about why we'reusing medications. And I think that is
a piece that a lot of conventionaldoctors just don't have time for. Is
that education piece on helping people understandthe mechanism behind the medication, why we're

(06:03):
using them, and if there's anend goal? Right? Is there an
end goal? Is there an endin sight? How can we get off
these medications? So I just reallyalways try to educate my patients, like
why are you on these medications,What symptoms are going to be improved?
What are we preventing? So,because the ultimate thing for health is preventing

(06:25):
worsening disease, And so I alwaysask patients to give themselves grace. It's
it's understandable, it's frustrating, butwe sometimes need these medications to allow the
space to bring in the integrative piece. Right, if you're in a ton
of pain because you have joint pain, because you have something like rheumatat arthritis,
asking you to make lifestyle changes isnot realistic, So we use,

(06:46):
you know, medications that are goingto help with the pain, so then
we can get the other pieces onboard. Absolutely, and that's really a
truly integrative approach. You're really usingthe best of both worlds. And I
think the disease progression aspect is prettyimportant. Like you mentioned rheumatite arthritis,
and even with soriatic arthritis, whichis what my sister has. Now,

(07:11):
if that disease progresses, it cancause permanent joint damage for example. Isn't
that correct? Exactly exactly? Soif they're if we don't treat the disease
with these medications, we have thethere's the risk right of permanent joint damage.
And once that joint damage occurs,we can't reverse it. There's a

(07:33):
lot of things in medicine that wecan help reverse, but if there's damage
to organs or if there's damage tothe joints, it's it's irreversible. So
that is really what we're trying toprevent. Right, So for those people
who are concerned where they still haveto be on their conventional medication, there's
no shame in that, right,absolutely not. And if you have a

(07:56):
doctor that's shaming you, I inviteyou to seek other care, right,
Yeah, exactly. Yeah. Sowell, now let's talk about creating a
holistic treatment plan. So I realizethat we're going to talk in general terms
today. I realized that your approachis hugely individualized. But for the purpose

(08:16):
of the show, I want totalk in general terms. So, when
you begin creating a holistic treatment planfor your patients, where do you even
begin. Yeah, that's a greatquestion. It is a huge topic.
So I always begin by trying toidentify their individual triggers. So what is

(08:37):
triggering their immune system to be overactive? So these are things like microbial triggers,
So things like imbalance in the gut, in the microbiome. This is
diet and lifestyle, stress levels,hormones and other toxic exposures, so other

(08:58):
things they're exposed to in their environment. And once we're able to identify their
individual triggers, then we can workon reducing them and then we can help
the immune system relax. Okay,So I want to talk about some of
these triggers. So because obviously withautoimmune conditions, triggers cause flares and they

(09:22):
worship the condition. They cause symptoms. You mentioned some big ones. Now
you mentioned stress, and I wastold when I was diagnosed that it was
a stressful life event that kicked inmy autoimmune condition. Now, the way
it was explained to me is Iprobably had a predisposition for this autoimmune condition

(09:48):
to begin with that was lying dormantand then the stressful event caused it to
kick into action. Is that theconnection between stress in autoimmune Yeah, it
definitely can be. And I wishwe were like in person. I could
draw you a graph because I reallyenjoyed drawing this graph. For people.

(10:09):
There's a line and it's a symptomthreshold line, and you do have to
have the genetic predisposition, but thatdoesn't mean you're going to have an autoimmune
disease. But these triggers, includingstress, push you over the symptom threshold
and that's when you see the autoimmunedisease manifest So our goal is to pull

(10:30):
you back under the line so you'renot getting symptoms of autoimmune disease. So
stress is a really interesting one becauseit's we think about cortisol, right,
Cortisols are stress hormone, but cortisolis actually anti inflammatory. It's our natural
prednisone. Right, It's a steroid, so it's inhibiting our immune system.

(10:52):
So for a while, having highstress, high cortisol is beneficial in preventing
immune system autoimmune disease symptoms. Right. But it's after a period of long
stress or acute stressors that are buildingon each other, that the cortisol levels
become dysregulated and that's when we cansee autoimmune disease symptoms. And then the

(11:18):
gut as a trigger makes sense.I mean, we know that the gut
and the immune system are intimately created, intimately connected. So if there's how
do you work on the gut,then if you're if that's if you feel
like that could be the trigger.Right, These are I'm always on first

(11:39):
visits. I'm always looking for thelowest hanging fruit on where we can make
the most improvement the quickest, andthe gut is often that piece. And
like you said, right, seventypercent of our immune system is in our
gut, so it's often the rootcause of a lot of these environmental triggers.
So we're working on improving or yourfunction, so that's your your digestive

(12:01):
system lining. Right, So ifthere's any this is the leaky gut,
which I'm sure people are very familiarwith, right, improving that we're looking
for signs of dyspiosis or the imbalancebetween the bacteria and the yeast and the
viruses that live in our gut.And if there's symptoms of that, we

(12:22):
can do more in depth, moreintegrative type testing to look for what exactly
is in the gut that could betriggering the immune system, because we do
know certain microbes trigger autoimmune diseases.Right, Yeah, give me an example
of a dietary trigger of a dietarytrigger yea, yeah. I think the

(12:45):
most obvious and well known example isgluten. Right, So we know that
gluten is a very large protein.It's very hard for our body to digest
and break down gluten just because ofhow big it is and when in the
immune system and the gut really doesnot like big pieces of things. So
if there's a large piece of foodthat is being exposed to your immune system,

(13:07):
it's going to activate it. Andthen what gluten or any sort of
dietary trigger, and each person canbe different, It activates the immune system
and it causes confusion, and thenthe immune system will inadvertently target your own
cells. And that is the basisof autoimmune disease with a dietary trigger.

(13:28):
So gluten, dairy, citrus,soy eggs, those are kind of the
big ones that are always on theforefront of our mind. There can always
be some weird foods that some personis eating that can also be triggering their
immune system. Okay, so let'sstay on diet for a bit. So
if in fact my trigger is notdietary, do you have general phone in

(13:54):
shield dietary advice that you give toyour auto immune patients? So what type
of diet is a good diet forautoimmune people? Eat not when that there's
a dietary trigger. Yeah, soI think eating a wide variety of fruits

(14:16):
and vegetables, So eating different colors, eating a more diverse variety of foods,
Trying to reduce the amount of processedfoods is always better trying to eat
at least, you know, wehave to eat more servings of fruits and
vegetables, we have to increase fiber. We're looking for nutrient dense foods.

(14:41):
I always advocate if you're eating meats, to eat grass fed, wild caught
meat. We're looking for the amountof like the toxicant levels in those foods,
right, and so there's bioaccumulation.So if you can't, we're always
looking for ways we can decrease costwith diet also, right, So if
you have to put money somewhere,put it on the meats and then add

(15:03):
in the variety of fruits and vegetables. And I always try to ask patients
to try something new every week,something you wouldn't normally pick out. Pick
a new color, try to eata rainbow. Right, that's kind of
the general advice. Yeah, greatadvice, and that really matches with doctor

(15:24):
Alschuler and I promote on the show. So from a lifestyle standpoint, what
general lifestyle advice do you give yourpatients with an autoimmune condition, Yeah,
so including in that nutrient rich diet. I always ask them to engage in
regular movement, whatever feels good inyour body. So, if you have

(15:48):
an autoimmune disease that is affecting yourjoints, it can sometimes be painful to
start using those joints, but generally, if you start moving, it's going
to move the immune cells and theinflammatory cells out of the joint spaces and
you're going to feel better. SoI don't need you to go out and
like start a whole new exercise routine, but doing something that you like to
do, whether it's going on awalk with a loved one or taking a

(16:11):
class, doing some sort of physicalregular physical activity, doing those stress reducing
techniques you know, yoga, meditation, and prioritizing sleep. And this is
a big one, and I thinkit's a big one for a lot of
us. I think we're chronically notgetting enough sleep. So we're always working
on how we can get better sleepwith our patients. Right, how can

(16:34):
you get the number of hours thatmake you feel best so you can fall
asleep, stay asleep, wake upand have energy. Yeah, I'm glad
that you brought up sleep because weknow, based on the research, that
lack of sleep puts our body intoan inflamed state, It reduces immunity,
it puts weight on, and thereare a lot of negative ramifications associated with

(16:56):
lack of sleep. So what aresome of your sleep tips or do you
do you rely on some dietary supplementswhen it comes to sleep sometimes right,
It depends on the picture and alot and this goes back to the stress
piece. So cortisols are stress hormone. It's also a hormone that is really
important in our sleep wake cycle.So what I see a lot of the

(17:18):
time is this disregulated cortisol patterning whereif cortisol is too high at night,
you're not going to be able tofall asleep or stay asleep, and if
it is too low during the day, you're going to feel really tired.
That's like that afternoon crash that alot of people get and you just have
to go take a nap. It'soften because our cortisol is not being released
in a pattern. So that's whenI utilize supplements if I think that's the

(17:41):
case. And you know sleep hygiene, so you know turning off devices,
not looking at blue screens at night, doing some wind down techniques. All
of that good stuff isn't working.Then that's when I utilize dietary supplements to
help reregulate the cortisol patterns to helpimprove people sleep. So using supplements that

(18:02):
help turn off cortisol at night sothey can fall asleep stay asleep, and
then using herbs and nutrients to supportcortisol during the day. Can you give
me some examples or an example,yes, sure, yeah. So one
of my favorite things to use atnight is phosphatidal cyane, which is,
I know, a mouthful, butphosphital cyrriane is a phospholipid and it helps

(18:23):
your body break down cortisol. Soif I think your cortisol levels are too
high at night, I often givethis and we often have to ty trate
the dosage just depending on a person'sresponse to it. But this oftentimes helps
people fall asleep and if they're wakingup in the middle of the night,
if we take it late enough,it helps with cortisol not waking them up

(18:44):
in the middle of the night.Okay, perfect, Let's stick with stress
management for a bit. Do youever use dietary supplements to help with stress
relief. Yeah, so that goeshand in hand with this cortisol patterning.
So definitely I love adaptogenic herbs.I think they're very useful for helping manage

(19:06):
stress. So one of my favoritesis tulsi or holy basal. That's like
things like Rhodiola Oshogonda's one that peopleare very familiar that that one's a little
bit more tricky in my experience.It can make people really sleepy, which
is not necessarily what you want todo in the middle of the day.

(19:26):
But yeah, finding I really liketo get to know my patients and get
to know their constitution before I pickout an adaptogen for them, because they
are all so different. We havelike cooling adaptagens, more heating, and
it really depends on each person's personalityand type that like what they will actually
need and benefit from. Yeah,We've done entire shows on these adaptogenic herbs

(19:48):
and they're just really really powerful.Now, for because we are talking about
dietary supplements and herbs and nutrients,for a person who is on a medication,
wouldn't it behoove them to work withsomebody like you versus I mean I
don't think it's good if you're automedication to just willing really start taking herbs.

(20:10):
Am I right with that? Yes, very yes, definitely. And
I also amount to make like thisis a perfect off opportunity to make a
point that certain herbs, so immunostimulatingherbs are really not recommended, strongly not
recommended with people that have autoimmune disease. So these are things like echinaesia,

(20:30):
And I think echineesia's everywhere, especiallyright now because it's cold and flu season.
Echinacias and every single supplement it's everywhere, right, But it's very immuno
stimulating, and it can make anautoimmune disease worse. It stimulates a flare,
and I always ask people to avoidit if they have autoimmune disease.
So that's just my PSA. Avoidechinasia if you have an autoimmune disease.

(20:52):
Yeah, it's such a good point. And there are so many things that
stimulate the immune system. It's logical, I mean, right now and with
autoimmune the immune system is overactive,so you don't want to keep that,
you know, going by immune stimulation. Are there any other immune stimulating herbs

(21:17):
or nutrients in addition to echinaesia,or is this a case where the person
should really be working with a naturopathicphysician who's well versed. I think definitely
working with someone that is well versedin in herbs and has a really good
and deep understanding of herbs in howthey affect the body. I will say

(21:40):
that a strag list, which weknow to be really good for certain autoimmune
diseases, can be too stimulating forothers. So it's really interesting to me
because I'm also you know, Iam an acupuncturist. I studied traditional Chinese
medicine and Chinese herbs, and weuse a strag list a lot. But
what I found in clinical practice isa straggler can be too stimulating, and

(22:02):
so I do use that one alsowith a lot of caution. I use
the echination example just because it's soprevalent and it's on all the shelves,
Like you can go to any grocerystore and you see acinaesia everywhere. Yeah,
yeah, that's a great, greatexample. I'd love to talk about
acupuncture a little bit because I'm ahuge fan. I've used acupuncture for a
number of conditions over the years.When we're looking at acupuncture and autoimmune are

(22:26):
we primarily primarily looking at symptom reliefor are we actually looking at having it
be something that can help reverse thecondition. What role does acupuncture play?
So both? So both right,Like, it can definitely help with symptoms.
So if you're in a lot ofpain, acupuncture is great for pain,

(22:49):
but it's also any acupunctures that yousee if as long as they're not
just doing like trigger point therapy ordry nealing type techniques, if they are
actually trained in Chinese medicine, they'retaking your constitution. And what I mean
about constitution is this myriad of symptomsthat you present with. And oftentimes in

(23:12):
autoimmune disease, we see a deficiency, but deficiency with fire, so like
that's hot, right, Autoimmune diseaseis kind of a hot symptoms, right,
swollen joints, the immune system isturned on. There's a lot of
heat when the immune system is turnedon, but it also wears you out,
so you see these deficiency. Soif you're seeing an acupuncturist and you're

(23:33):
getting acupuncture, they're more than likelydoing constitutional or systemic points to help with
that underlying cause of why an autoimmunedisease manifested. That makes a lot of
sense, which is it's good toknow. So what final advice do you
have for listeners who may be strugglingwith an autoimmune condition right now? Yeah,

(24:00):
I think my final advice is oneof hopefully empowerment and resilience, which
I think you need to have ifyou have an autoimmune disease, and that
just that understanding that managing an autoimmunedisease condition is a journey and it's okay
to seek a combination of providers thatare going to listen to you, hear
you address your concerns, and youcan use both conventional and holistic approaches in

(24:26):
your management of your condition. Yeah. Absolutely, And I like the fact
that you encourage resilience and empowerment becausethere's no question that depending on the type
of condition, it can kind ofget you down, and it can kind
of be frustrating, and it cankind of, you know, really put

(24:48):
you at your wits end at times. It definitely can, And that's why
I think having a strong support network, including your healthcare team, right but
also your friends, your loved ones, and remembering to prioritize your self care
because what I find so often isthat, especially with people with autoimmune disease,

(25:08):
they're so busy, they're doing otherthings for every other person except for
themselves. And you need to takea little time prioritize yourself to help you
feel better and to help treat yourautoimmune disease. So then you can go
and help the ones that you're tryingto help, all your loved ones.
Right, Yeah, yeah, good, good advice. Prioritize self care for

(25:30):
sure. So where can people findmore information about you and your work?
Do you have a website that you'dlike to share? Yeah, so I
practice in Seattle at Aria at GradeiveMedicine. You can find us at Aria
Integrative dot com. We're also onsocial media, so Aria and Agraative on
Instagram or Facebook. You can findme on Instagram as well. It's just

(25:56):
my name, so Anastasia doctor,Anastagia's soccer and yeah, I would love
to connect with people. Yeah,and does Aria Integrative do you do virtual
medicine or is it all in person? We do both, so you know,
I'd love to see people in person, but we do do telehealth if

(26:17):
that's not available to some folks.Okay, cool, that's Aria Integrative dot
com Well, thanks again, doctorStocker for this important conversation about a holistic
approach to autoimmune Yeah, thank youso much. It was a pleasure.
Well that wraps up this episode offive to Thrive Live once again. I'd

(26:37):
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(27:00):
made you experience joy, laughter andlove. It's time to thrive everyone,
have a good night. Scotty lotof got a lot of excuse me,
good the Jays, the city isfun. Love love, love