Episode Transcript
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Ellen (00:02):
Welcome back to the
Positively Midlife Podcast.
Today we're going to talk withAndrea Nakayama, a functional
medicine nutritionist, all aboutdealing with autoimmune disease
and the impact that menopausein midlife may have on these
conditions.
Tish (00:20):
You know, over two decades
ago, our guest Andrea, husband,
was diagnosed with a braintumor and given only six months
to live.
This news came while she waspregnant with her first and only
child, and then Andrea herselfwas diagnosed with Hashimoto's
disease.
Ellen (00:41):
I mean, it's hard to
fathom what that situation must
have been like and she turnedher passion for nutrition to
provide the longest andhealthiest life for her husband,
herself and her child, and thatis what led her to where she is
now.
Tish (00:59):
You know, I've always
admired when someone can turn
such tragedies into a lifepassion that affects change, not
just for themselves but forothers around them.
Ellen (01:10):
So true, tish, and as
someone with an autoimmune
condition I have Hashimoto's Iam really looking forward to
talking to her today.
But before we welcome her tothe show to share her personal
story and what she's learnedalong the way, and some things
for our midlife listeners, let'sget to our obsessions.
You know I love this part.
What do you got for me thisweek?
Tish (01:32):
Well, this one I have is a
medical planner.
It's called the Clever FoxCompact and what I have found is
because I have like severallong going issues and stuff like
that, and when I see a newdoctor and try to especially
when it's not in my network andtry to like remember dates and
(01:53):
times and places and symptomsand all that, it becomes
overwhelming.
So I've decided that I'm goingto start recording everything in
my medical planner.
I can take it with me If I'mhaving issues.
It allows you to chart thosethings.
It's really it's really meantfor like a year plan.
So say, you are somebody who isaffected by ongoing condition.
(02:18):
This might be a great way tocondense all that information to
one place that you can alsobring with you to your doctors.
Ellen (02:26):
So is it digital or is it
a physical thing?
Tish (02:29):
No, it's a physical thing.
It's a physical thing, so we'llput a link for that.
Ellen (02:35):
I'd like that.
You know I have still a paperday planner that's very small
that I use pencil on.
So I think some of us thataren't digital native the paper
things feel better.
Tish, I like that.
Tish (02:48):
Yeah, backup, you know.
So, yeah, and I think you know,putting everything down because
you're going to have to, youknow, condense this information
from several places.
So, yeah, that is my obsessionthis week.
What about you, Ellen?
What's yours?
Ellen (03:05):
Well, I always love how
different our obsessions are,
but you know I am so into springand I know we're going to have
an episode on spring cleaninghere coming up.
But I'm getting my back patioready and I have this love of
mason jar lights and you knowwhat I did last year is I got a
couple and I left them out andthey got rusty.
(03:26):
But this year I found amulti-color six pack and they
can hang also in the trees.
I have this beautiful Magnoliatree I'm going to hang them in.
So I just think that these arethe number one way you can
freshen up your outdoor space.
So I'm going with mason jarfairy lights again, but a
(03:49):
different kind.
Tish (03:50):
Yeah, yeah, I like those
because it brings you outside at
night.
You know Again, anytime we canget ourselves out into nature.
I think it's just going to makeus feel better.
Ellen (04:02):
I agree Again.
We'll have the links in ourshow notes, but let's get to it.
I am so excited to speak withour guest.
Andrea is the host of the 15minute matrix podcast and she
founded the functional nutritionalliance.
That leads a revolution tooffer better solutions to the
growing chronic illness epidemic, and this is so common for
(04:25):
midlife women.
Tish (04:27):
You know, Andrea's work
really highlights the importance
of systems biology, root causemethodology and therapeutic
partnerships.
She's helped historicallyunderserved individuals reclaim
ownership of their own house.
Ellen (04:48):
Welcome to the podcast
today.
We are so glad to have you withus because it seems like at
least half of the women I knowhave an autoimmune condition.
Andrea, can you share a littlebit more about yourself and your
background with our listeners?
Andrea (05:02):
Yeah, thank you for
having me.
I feel like I'm sitting downfor tea.
It's very nourishing.
Ellen (05:07):
Thank you for having me.
Andrea (05:10):
As you mentioned, my
journey into the healthcare
realm really came from a familyhealth crisis when my late
husband, Isamu, was diagnosedwith a very aggressive brain
tumor.
I was seven weeks pregnant atthe time of his diagnosis and he
was given about six months tolive, and it really came out of
(05:32):
nowhere.
There were not any signs thatwe could see, and this is a
worst case scenario.
When you go to the emergencyroom with a headache, it is very
rare that it's a brain tumorand so this came out of nowhere
for us.
So I had already had a kind ofobsession of my own with good
(05:54):
quality food and cooking.
I lived in the Bay Area at thetime.
We'd have these elaboratedinner parties and shop at the
farmers market.
So I really turned my attentionto food, and not food to fight
the cancer, but food to supporthis body in all it was going
through, so that it couldinfluence the cancer but also
(06:18):
help him mitigate any of theinterventions that he had to go
through and there were many.
So that became sort of my bootcamp.
Meanwhile I'm pregnant, so I'mhaving to nourish my own body
through extreme stress to reallymanage all of the whole family
to be as healthy as we could be.
(06:40):
So this is a long time ago.
Isama was diagnosed in April of2020.
He died in the summer of 2022,so about two and a half years
later, when our son, who's now23, was 19 months old.
So this is some time ago, butthat really fueled my passion
(07:00):
for the powers of dietary andlifestyle modifications for
those who are sick and notgetting better, and recognizing
where there were many gaps inour healthcare system in working
with those who are chronicallyill.
So there's a long story.
Ellen (07:18):
There's a lot of you.
Andrea (07:20):
So thank you for
allowing me to tell it.
Tish (07:23):
Were his doctors at the
time talking about nutrition, or
was this something that wasjust kind of born out of where
your passions were and yourattempts to keep him as healthy
as possible?
Andrea (07:35):
Yeah, I mean, if you can
imagine the world of oncology
period and then we get to neurooncology, you're working with
people who see the brain notconnected to the body.
We can now well know that thebrain doesn't exist in a vacuum.
We know the gut brainconnection.
That conversation wasn'thappening in 2020.
(07:56):
So his oncologist brilliantoncologist at UCSF in San
Francisco was very open toanything else we were doing, but
wasn't the one talking about itand part of I think, like we
see in breast cancer, becausewomen kind of take the charge,
it's much more integrative.
Oncology as a practice isn'tvery integrative in most of the
(08:21):
other areas, if that makes sense.
Ellen (08:25):
I definitely think it
does make sense.
And did you feel being in theBay Area at that time kind of
opened you up to more of thesetypes of you know the kind of
lifestyle?
Andrea (08:39):
Yeah, I mean I think
that there's definitely.
We were part of a foodieculture.
I worked in publishing, Iworked with a lot of cookbook
authors, so that culture ofeating good food, not
necessarily healthy in the waythat we came to see it and I'm
putting healthy in quotationmarks because that's changed for
(09:01):
me over time but we learned alot.
I started reading about theimpacts that different foods
could make on the body and onthe body's ability to reproduce
cells that we don't want it toreproduce, to tame inflammation,
which we do want it to do.
So one of the first things wedid was to remove sugar because
(09:24):
of some reading I was doing.
Now, isamu was a veryintelligent, very headstrong
person, so he was doing all themedical research.
What trials?
He was like a, you know, adesirable test case, so all the
people around the country werecontacting him with their
clinical trials because he was a32 year old man with a tumor at
(09:47):
that point that we didn'tusually see in younger
populations.
Now we are seeing it in youngerpopulations, but it was a tumor
typically seen in an agingpopulation and so he was very
desirable for everybody'sclinical trials because he would
understandably do better ontheir trials.
So he was having to do thatresearch, which is the right
(10:10):
thing, and that's where Istarted to do a different body
of research and bringinformation to him.
Look, sugar feeds growth, cellgrowth in the body.
The fastest growing cells inour body are cancer cells.
What do you think of removingsugar?
And he had a sweet tooth but heautomatically was like no sugar
(10:33):
.
So we went for a long time, andthen I started to understand
more about glycemic levels andlower glycemic sweeteners, so I
could feed our sweet tooth orhis tooth and not have the same
negative effect that refinedsugar could have on the growing
(10:56):
cells and also on theinflammatory cascade in the body
.
Ellen (11:02):
You know, it sounds to me
like you were really passionate
about this side of supportingyour husband's illness and,
coming from that foodie culture,I know you two were diagnosed
with an autoimmune condition.
Can you tell us a little bitmore about that?
Andrea (11:21):
Yeah.
So when we think aboutautoimmunity, it's definitely a
case where we're understandingthat the body's defense
mechanism has turned on itself.
And when we think aboutautoimmunity, I always think
about three roots, and this ismy current thinking, looking
back at the past.
So those three roots are ourgenes, our digestion and our
(11:44):
inflammation.
There are key triggers that aregoing to set all of those roots
into motion and lead to our ownbody's immune system attacking
certain cells or tissues in ourbody, and one of those big
triggers is stress.
Another big trigger is pregnancy, because our bodies are going
(12:07):
through a lot of hormonalchanges at one time.
So here I was going throughboth of those things in a
heightened fashion at the sametime.
So that cascade that wasalready kind of blueprinted for
me, but that does not tell meit's going to happen, was
triggered into a state where,after Esamu died a couple years
(12:30):
after, I really started toexperience some symptoms that I
couldn't figure out.
I didn't know what was going on.
Again, in those daysHashimoto's was not as prevalent
or well understood as it istoday.
So, there was a lot of searchingfor me to understand why my
body wasn't quote unquoteperforming or responding the way
(12:54):
I was accustomed to it.
Having done before that andthat's where I stumbled upon my
own research I was first able toidentify my mom's Hashimoto's
and then recognize this iswhat's going on for me as well.
Tish (13:12):
Now, do you think that the
reason that, like 80% of the
people that are diagnosed withautoimmune disease are women is
because of our hormonal changes?
Andrea (13:23):
There's a lot more going
on in our bodies for sure.
So, yes, there is a much higherprevalence of autoimmunity
among women, and the hormonesdefinitely play a role in that,
and the changing hormones andalso you know a lot of.
I think the hormones are thebiggest difference in our body
internally, but then there'scultural and other things that
(13:46):
we're managing externally thatalso put on extra stressors,
especially in today's day andage.
I'm seeing women just havedifferent challenges than they
ever have in the past.
Ellen (13:58):
I'm 57.
Andrea (14:00):
I look at my friends and
my peers and I think like, wow,
we're dealing with things thatour mothers did not deal with in
terms of life stressors.
So it's a combination of theexternal environment and the
internal environment and wherethose two things meet and that's
what makes it functional.
Ellen (14:20):
You know.
I just want to share that I wasdiagnosed with Hashimoto's when
I went to seek some hormonetreatment here in menopause and
they did a very full blood panel.
I have probably had this for along time with absolutely no
idea of what it was, and so Ialso think that women, the way
(14:43):
we react is like let's powerthrough something, let's go.
I might be fatigued, I may haveswollen hands or like, but
we're like, that's it.
I got to, got to, you know, runthe home, got to do the
business, and maybe you couldspeak a little bit to that.
Andrea (14:59):
Yeah, I think that
that's absolutely true.
We're taking on more and more.
We are experiencing, I think,more, like I said, challenges in
later life and I also think toyour point, Ellen, we are
looking for either we're eitherpowering through or we want to
fix.
So we also live in an age wherethere's a lot of noise out
(15:24):
there on the many highways thatwe go through and work through
that, tell us that there is oneway to do something that it
worked for so and so.
It'll work for us.
Do I need that supplement?
Oh, that's what's going on forme.
There's a lot ofself-diagnosing.
I love what you're doing, Tish,with your obsession, your
(15:45):
medical diary.
I'd love to talk abouttime-lining and functional
nutrition, because that's socritical and we're so reliant
these days on quantitative data.
We're looking for those labtests.
If we don't get them, we'reangry.
We're angry that our doctorwon't run the right tests.
We're experiencing menopausalsymptoms.
(16:05):
We want to know what's the fix,what's the diet, what's the
supplement?
Should I go on bioidenticals?
And the truth is, we are justmuch more complicated creatures
than that, and so I feel likeit's kind of a confluence of
added stressors that we'reexperiencing as we age
(16:27):
Complicated internal responsesand then this desire to suppress
.
Ellen, as you were talking aboutpower through and then, only,
when it gets to a tipping point,raising our hands and going
what's the thing?
What's the thing that I'msupposed to do?
Ellen (16:42):
Yes, and it's not one
thing.
Like you said, and it may notbe fast, and I have heard that
right, it's definitely not thatfast fix.
Go ahead, tish.
I know you have a question,sorry.
Tish (16:56):
No, I was saying like I.
When researching this, I wasshocked when I realized there's
over a hundred differentautoimmune diseases and I'd like
for you to kind of address someof the more common ones.
But can you explain, for thosethat don't really understand,
what is an autoimmune diseaseand how are they diagnosed?
Andrea (17:16):
Yeah, so they're all
different.
So it's there are someautoimmune diseases that don't
have a standard diagnosis.
Quote unquote.
Luckily for Ellen and I,hashimoto's is actually somewhat
easier to diagnose if the righttests are run in a serum labs,
which our doctors will do.
(17:37):
There is a number of otherautoimmune conditions, like MS,
for example.
That is a cluster of thingsthat lead us to a hypothesis
that it's a diagnosis.
So really, when I think aboutautoimmunity from a functional
nutrition perspective, I'mlooking at the diagnosis as a
(17:58):
branch and I'm going back tothose three roots.
So let me just explain what I'mtalking about there, because
I'm not somebody who has the theit's not within my scope of
practice to diagnose.
Tish (18:12):
Right.
Andrea (18:12):
Contrary to what my
mother believes, it's not.
I can look at labs and be ableto suggest it looks like you
have antibodies to your thyroid.
Let's get a diagnosis.
But even that diagnosis doesn'tlead us to the fix.
And this is the problem withchronic health challenges that
(18:33):
just because we get a labeldoesn't mean we have the answer.
There is no fix in classic whatwe modern medicine for anything
chronic.
It is designed to deal withacute situations and thank
goodness because there are a lotof those, but we do need to
think differently about chronicissues.
(18:53):
So when I say branches, if wethink about Ellen's garden and
that Magnolia tree and we thinkabout the spring blossoms on the
Magnolia tree, it was aMagnolia right.
Ellen (19:07):
It was, you got it.
Andrea (19:09):
Think about those
blossoms.
And we're looking at this treeand it is just sitting in so
much magnificence and we'reastounded by the magnificence of
the Magnolia tree.
And then we get closer to itand we realize that there are
some leaves that are turningbrown, that some of the flowers
(19:29):
are dying sooner than theyshould, that some of the
branches are starting to turn,the bark is not looking healthy,
and we're really struck by theimpulse to do something to help
this tree.
So we can get a ladder and pickoff leaves and flowers.
We can get a ladder and a sawand saw off branches.
(19:50):
Or we can take a differentapproach, and anybody who cares
for trees likely knows we haveto get down to the trunk, deeper
, down to the roots, and evendeeper than the roots, to the
soil.
So in functional nutrition, nomatter what the sign, the
symptom or the diagnosis and I'msure we can list many- related
(20:12):
to community autoimmunity andhormone imbalances, we still
need to come back to those rootsand that soil, and so for me,
the three roots are always thegenes, digestion and
inflammation.
And then I've identified thecircle of influence or the soil
around each of those roots,which helps direct our attention
(20:36):
as patients, because when ourattention is on the branch,
we're not going to find resultswhen we shift our attention to
the roots and the soil, we startto be better partners in our
health care.
Ellen (20:51):
I mean this is amazing
just for the kind of the mind
shift, the pivot that I'mexperiencing right here in this
conversation.
I'm sure you are too Tish and Ithink about looking at the
genes, looking at digestionwhich is something totally new,
that around your gut health, Ithink for a lot of us and
(21:13):
inflammation.
Would you suggest that women goback and look genetically in
their history?
Does your mom have anautoimmune condition?
Or would you say that guthealth is one the place to start
?
Andrea (21:31):
Yeah, so the place to
start is also really individual,
because we have differentrelationships with our bodies,
with our family histories, withdiet or making dietary change,
and I really like to take amoment to honor that.
I've worked with populations ofpeople who can't talk about
(21:54):
food for a long time because anyconversation about food
removing, adding is triggering,and so I like to really honor
the individual in all aspects.
But when I talk about genes,yes, I love if we can know our
familial history.
I've worked with adopted folkswho maybe don't know their
(22:17):
familial history, and that'sokay.
I also don't think we have torun out and get genetic testing.
The information that we knowfrom genetic testing these days
is it's not so helpful, it's notpredictive.
It may be helping us to seewhat's possible, but certain
genes cancel each other out.
There's something calledpolygenomics that's getting a
(22:40):
lot more attention.
That helps us understand thatif you have this gene and this
gene, then this gene A isn'tactivated, if gene B is there,
but we wouldn't know that, andso people are going around
thinking you know, I'll justthrow out the common genes.
They may not be popular to youraudience, but I have an MTHFR
(23:00):
or I have a calmed gene.
We don't know if that's turnedon or off, up or down, and so I
prefer to think about the soilaround that gene root, which is
what we call the epigenetics,and that's food, movement,
environment and mindset, andthose things are the factors
that are going to influence theexpression of our genes, and
(23:25):
that's where we have moreinfluence versus control,
overlooking at our geneticblueprint and going man, I'm
screwed or I didn't win thelottery with my genes.
Well, we all have theopportunity to influence our
genes, and food isn't one thing,movement isn't one thing,
(23:45):
environment isn't one thing,mindset isn't one thing.
It reminds us to constantly bekind of massaging the areas that
influence our genes.
Tish (23:58):
It kind of goes back to
what you were saying.
It's not a single solution,this isn't a vaccine, it's not a
one pill and it's done and eachperson's gonna be different and
, like I was saying, there's somany.
I was shocked when I learnedthat type one diabetes is
considered an autoimmune.
I was surprised that MS isconsidered when rheumatoid
(24:23):
arthritis, I mean lupus.
Those are, I think they're morein my mindset, but there are so
many.
There are so many.
Andrea (24:32):
And what they have in
common is that our immune system
, which is designed to protectus, has turned on us.
Autoimmune just means that ourimmune system is attacking part
of our own body, our tissues forEllen and I, the tissues in our
thyroid are being attacked wheninstigated to do so, and the
(24:56):
immune system has memory cells,and so we've trained our body to
remember to attack itself bymistake.
If you think about somebody whohas a severe allergy, they're
hyper reactive to somethingoutside the body and with
autoimmunity in its simplest wayof thinking about it, we are
(25:18):
hyper reactive to attackinginside the body, and once the
body has that mechanism turnedon, it's more likely to do it
elsewhere.
So if we attack our thyroid, ifwe don't kind of manage that,
unfortunately the immune systemwill have more of a propensity
(25:39):
to exercise that over reactivityelsewhere.
I like to think of it as likewhen you're surprised, like when
you go right, that's what ourimmune system is doing to
ourselves, like it's constantlyin this hyper vigilant state
where it's going well.
That's not a good thing.
That's not a good thing.
But that thing is us.
(26:01):
We want our immune system.
So for me, on that third routeof immune, we have genes,
digestion and inflammation.
Inflammation is an immuneresponse and the circle of
influences clear, calm, enhanceand modulate.
So that's pretty broad.
(26:23):
But we just think about clearand calm.
Calm is really critical becausethat's not a calm state and the
body can't heal in that state.
That's called a sympathetic,dominant, fight or flight state.
We need to come in to rest anddigest, to heal.
Ellen (26:47):
And do you find that
there is a difference now in
your 50s, from in your 30s, whenyou were first diagnosed with
an autoimmune condition?
Andrea (26:59):
Yeah, I'm going to knock
on wood and say for me it's
better because I understandmyself more and because I
understand my non-negotiables,my personal non-negotiables,
more, and so I can recognizewhen something is off for me.
And this again, tish, is wherethat medical planner like
(27:22):
understanding, knowing,time-lining, recognizing what
are the things that are triggersfor me, not the big life
triggers but the daily triggersI can recognize them better.
So I'm post-menopausal.
I was able to get throughmenopause without too much
(27:45):
challenge.
Ellen (27:46):
Again, knock on wood
wherever I was.
Andrea (27:49):
I think that's because
of all that I was doing I have
experimented with bioidenticalsI can tune in really easily and
be like not working.
I know I need that, but reallyreally fine tune that, what I
call interoception, thatunderstanding of listening in as
(28:12):
opposed to all the noise.
So different because I'mdifferent and I've had the
opportunity to work withthousands of women and kind of
get this mirrored back to mewhat works and what doesn't.
Tish (28:28):
But before we get too much
further, I know there are a lot
of challenges of gettingdiagnosed.
I think back to a good friendof mine years ago who went to
doctor after doctor after doctorand finally she was given a
diagnosis of lupus.
But people were trying to puther on medications, saying
(28:49):
basically she was crazy and Iknow that's probably a little
better, but I know there's stilla lot of challenges.
And especially when, as we'regetting older, into midlife, how
do you know that it's not justa common symptom of getting
older, but rather that you dohave a medical condition?
Andrea (29:09):
Yeah, I mean this is
where a lot of the evolution of
my work is going in terms ofunderstanding that piece of
interoception, how we tune inwhat gaslighting is when we
experience it.
What you're talking about is notbeing heard, and that's a form
of medical gaslighting.
(29:30):
Right, when you're saying and Ihad the same experience
something isn't right, somethingisn't right, and I would go
into the most well-meaningdoctors, naturopathic doctors,
and they would say, well, itmust be adrenal issues because
you lost your husband.
That's like an external story.
You lost your husband.
It must be that you have stress, hormone dysregulation, so
(29:54):
we'll treat it like that.
Well, that didn't feel good.
I knew something wasn't right,and so finding a provider who
will listen to you sometimesthese are not our medical
providers.
We might need other people toaffirm, and that's why I'm
treating an army of people whocan understand.
(30:15):
This is what I'm seeing.
Let's find the person who canrecognize this and put a label
on it.
The truth is, the label, like Isaid, doesn't come with a
solution, and so the label mightbe a relief that we finally
know we are not crazy.
And if we're feeling somethingwe're not crazy, but it doesn't
(30:37):
come with the solution.
It might come with a piece ofthe solution, but more of the
solution.
Unfortunately, when we'rediagnosed with an autoimmune
condition, is going to come backto the risk and reward
decisions we make every singleday.
So, Tish, I think it's a matterof trusting yourself.
Now something isn't right.
(30:58):
Where do I need to go.
I think it's also how you showup with the information that you
are expressing and how you area better partner in your own
health care, and we do that withmedical journaling, we do that
with time-lining.
I like to ask people if youunderstand a sign or a symptom?
(31:20):
When was the first time ithappened?
What do you know makes it feelbetter or worse?
When you go in more informed,you're going to be met with a
better listening ear.
The other thing I just want topoint out is that we tend, as
patients, to conflate signs andsymptoms.
The doctor doesn't hear thosetwo things in the same regard.
(31:45):
So a symptom is something we'refeeling that they can't measure
.
A sign is something they canmeasure.
So they can measure a sign ifyou're unconscious, but they
don't know if you're fatiguedand have a headache.
Tish (31:58):
Right.
Andrea (31:59):
When we separate.
I'm experiencing these signsand these symptoms.
This is what I notice makes adifference.
I've been trying to figure itout.
When we show up with theexpertise that we have, which is
in ourselves Nobody else hasthat expertise that's when we're
met with a better listening earfrom our partner, ideally who?
(32:23):
Is our provider, who has thepowers, quote unquote to give
something a diagnosis, whichunfortunately isn't the end game
.
Ellen (32:33):
Right.
I feel like, as women, hearingthis is so empowering because I
know Tish and I have both hadmedical gas lighting.
I mean, I don't think there'sany midlife woman out there that
hasn't been gas lit at somepoint in our 50-something years.
But I think that idea ofawareness, of time lining, of
(32:56):
journaling, going in informed toa meeting like this is maybe
new information for some of ourlisteners and for some of us.
I happen to be in Marin Countywhere this kind of mindset is
much more familiar than, say,some of my family that's maybe
(33:19):
on the East Coast or in theMidwest.
So I have to say that beingable to really dig deep and
understand yourself, not beingdisconnected from your body,
really going deep, is one of thekey things I've heard you say
in this conversation.
Andrea (33:38):
I love that, ellen, that
reflection, and, like I said,
this is where my work is takingme more into the overlap between
what's called narrativemedicine, which is a newer
practice, and functionalmedicine.
I worry that nobody wants tohear it.
This is work right, like we wantthe quick fix, and so I just
(34:00):
want to point that out, becausethere is a desire and a chronic
noise that everything can bebetter if we're intermittent
fasting, go into ketosis, takebioidenticals.
And I'm not saying that therearen't benefits to different
(34:20):
things, they're just true butpartial.
I don't agree with those earlierthings that I stated, but
there's no easy answer here.
I don't know one person who'sopted for bioidentical hormones
and had an easy time of it.
It's often a back.
You have to be working withsomebody who's willing to find
(34:43):
your unique cocktail, and that'snot how medicine is set up.
So I just want to put it outthere that it's a journey and
it's actually a lovely journeybecause it's about us.
But it's interesting.
going back to what you weresaying, ellen, how much we want
to run away from ourselves, maskwhat's really happening, and
(35:08):
that's true in the healingjourney as well.
Tish (35:13):
You know, I do have one
question what if you think you
have an autoimmune disease?
Are you starting at yourprimary?
Are you going to a specialist?
Because in healthcare right now, doctors are outlawing smaller
and smaller bits of time foryour appointment and to go into
(35:34):
all these symptoms.
And you know, I see a lot ofpushback.
I would see a lot of pushbackthat they're going to just say,
hey, take this antidepressant,Everything will be better.
Andrea (35:47):
Absolutely so again, I'm
going to give us, as patients,
a little more work.
So this is where I think we canshow up and best utilize that
time.
If we are able to collectinformation, we have the data to
bring in to have a quicker,faster conversation.
(36:10):
So when we're prepared for thatdialogue, we're going to be
able to get through it morequickly instead of being in the
emotion of it.
And unfortunately, our medicalappointments are not a time for
a lot of emotion.
Like you said, if there's seven, 12 minutes, there's not a lot
of time.
We can get our emotionalsupport elsewhere, but we have
(36:31):
to really be strategic aboutthat time.
So the more we're prepared andwe've gathered the information,
we can also call in a advanceand say I'm having some talk to
the front desk or whoever isthere and say I'm having some
challenges I need to talkthrough with the doctor.
Is there some way I shouldschedule more time?
(36:52):
Can we alert the doctor to thefact that I'm struggling with
some of these symptoms?
What do you recommend?
So you've given them a heads up.
But here's an even harder thingI'm going to ask people to do,
and this is to get yourinformation from your portal,
which exists these days yourpast labs and start to make your
(37:12):
own charts.
So we have a lab tracker at theFunctional Nutrition Alliance.
You can do that on an Excelsheet or a Google sheet.
Just put in the numbers.
You don't need to know whatthey mean.
But what I want you to do issee where there's a number that
looks drastically different thanthe time it was run before.
Get your labs run the regularold serum labs that your primary
(37:36):
care doctor is going to runevery single year at a minimum,
and just go back five years andstart tracking.
Then you're coming in going.
I don't know what this is, butwhy did this change so much?
Could this be related to?
Their job is to do no harm, andif we put the information in
(37:56):
front of them, their job is todo no harm.
If we don't, they are not beingasked to step up in the same
way.
Ellen (38:07):
Yeah.
Andrea (38:07):
I see that preparation.
Ellen (38:10):
I do too, and I think we
have to be curious about
ourselves, about these numbers,about the changes, and I hear
that advocating for ourselves.
I love this functional tracker.
I think we should put a link toit in our show notes and I do
(38:30):
think it's this connection withour life on a bigger level Right
, I mean, the blood work couldbe one part of it but really
understanding what's going onand connecting it.
I want to just pivot just alittle bit here and talk about
these four things you mentionedfood, movement, environment and
(38:52):
mindset.
Maybe we can chat a little bitabout food, because I think the
role of nutrition in managing anautoimmune disease is huge.
Where would someone start?
Andrea (39:05):
Yeah, so I like to make
this broad.
So I have three primaryprinciples that I like us to
apply in nutrition, as opposedto rules or theories.
I don't believe in dietarytheories because they're one
size fits all and we get trappedin them and then we do them for
short time.
So those three principles and Ido speak in a lot of threes, so
(39:29):
that's kind of one of my waysof putting things into system.
The first of the three is fatfiber protein.
Now, eating fat fiber proteinat every single meal is going to
be good for our gut.
It's going to be good for ourhormones.
When I think about the hormonesand we're talking about
(39:49):
menopause, I'm making a littlepyramid with my hands here.
Our sex hormones, our estrogen,progesterone, testosterone is
at the top of the pyramid.
But that pyramid has ways toget to the top.
We can't start at the top.
The bottom is blood sugarbalance, and then our insulin,
and then our cortisol, and thenour thyroid and then our sex
(40:13):
hormones.
If we're trying to address oursex hormones top down, we're
never going to find resolution.
So again, fat fiber proteinhelps with our hormones, it
helps with our immune system, ithelps with our gut, where most
of our immune system lives, andnobody should be talking about
nutrition without talking aboutdigestion, because it's where
(40:35):
the two shall meet.
So again, fat, fiber, protein,every single meal.
Principle number two is to eatthe rainbow.
Not only do we get more of thatfiber, but we get a lot of
different nutrients that theimmune system needs, that our
aging bodies need, that reallyhelp us to find the balance
(40:59):
within.
The third principle is what Icall a yes, no, maybe list.
This is where it becomes reallybio individual, meaning that,
alan Tish, you may havedifferent foods where you're
like oh my gosh, when I eat thatfood I'm in the bathroom all
(41:19):
day or I get an immediatemigraine or I bloat like I'm
pregnant.
So this is where we get toknowing that interoception what
are my yes foods, what are my nofoods and what are my maybe
foods, where maybe I'm not sure.
Sometimes it happens, sometimesit doesn't.
(41:42):
And again, that place ofcollection allows us to be in
discussion with anybody who doesunderstand nutrition.
That could be helping usthrough what we're trying to
figure out there.
And I just want to talk intothe two extremes there.
I'll either see people who sayI don't know anything.
(42:02):
That makes me feel bad, butthey never feel good, so they're
always in pain, but they'relike that's not my food.
So there's some denial.
Yeah tracking and understandingconnections.
Tish (42:19):
I've been in denial about
how bad sugar is for me.
Andrea (42:22):
That's my denial.
You're not alone, I promise you.
And the other end of thespectrum are people who are so
tuned in that they're nothealing on the inside and
they're attributing every signor symptom to food.
And then they develop aconditioned food
(42:42):
hypersensitivity where they'rereactive to everything.
And that's because they haven'tdone the inside healing.
They're just looking for foodto be the only self.
Ellen (42:53):
Right, the only answer.
I really love these three, andI think we need to put these in
our show notes too.
I think, though, sometimes wefind women who feel like they're
doing all the right things, butthey're still talking about
lack of energy, brain fog,chronic pain.
(43:17):
I mean, what would you say tosomebody who feels like they're
living a balanced life, they'reminimizing stress, all of these
things?
Where would you go with thatkind of person?
Andrea (43:30):
I mean, this is my
favorite person because I call
them the big bigs.
They have maybe a big diagnosis, but they're doing all the
things, so they're alreadytaking all the steps.
So the first thing I reallylike to do is go a little bit
deeper to see.
Is that true?
Is that the truth?
(43:50):
I'm going to bring in oneperson that I was working with
in my case study group recentlyand she comes from a health
coaching background.
She has two autoimmune diseases, hashimoto's and alopecia.
She does CrossFit, she climbsmountains, she eats a paleo diet
.
But when we took a look andjust did a little food mood poop
(44:12):
tracking which she was willingto do not everybody is I could
see she was eating more of thekind of paleo fast foods, like a
lot of the almond flourtortillas and the cereals, and
so, without saying that to her,I was like let's try some
different breakfasts, let's getsome fat fiber protein into some
(44:33):
breakfast and see how thatsupports you.
Through the work together, shewas also able to identify where
her work situation was reallyreally stressful.
She felt really unmet, reallyunseen, under chronic stress,
and she started to thinkdifferently about what was
(44:54):
possible for her, even at thisstage in life, which I'm seeing
more of changing careers orchanging the location of her
career.
She did a lot of work on herdigestion because she was like
I'm fine, I'm doing all thethings, but you know what?
I'm still a little constipated.
I don't have a good poop everysingle day.
(45:15):
So we focus on some of thethings that we may be kind of
glossing over in favor of whatwe might think is the answer.
Do I need more new tropics oram I taking the right fish oil?
I mean, I have friends who willtext me.
I saw this on Instagram.
(45:35):
Should I be taking this?
I asked why do you want to takethat?
And they say you know they pullin all the benefits that are
from the Instagram ad.
And I'm like but aren't youalready taking an X?
And they're like yes, and I'mlike same thing.
Tish (45:51):
Right.
Andrea (45:52):
You're a little
different, like what do you
think you're looking for and doyou need more rest?
I've worked with people whohave chronic fatigue and we talk
about hydration and going tobed a half hour earlier and
they're like wait what Nobodyever talks to me about those.
(46:13):
And, physiologically, when we'redehydrated, our blood doesn't
flow the same.
That impacts a lot of thingsrelated to our heart, our brain,
our ability to rest, our ironmarkers, and so sometimes I like
to call it the simplicity onthe other side of complexity.
(46:33):
I understand the physiologicalfunction, but yet we can't
overlook some of the things thatwe think.
I'm doing.
All the things and yet wait aminute, yeah, I don't hydrate
really well because I'm nervousabout going to the bathroom all
the time.
Tish (46:51):
Right, or I think.
I think midlife also brings alot of.
It's like going through anotheradolescence.
Your body is changing, so sofast.
So what worked for youpremenopause is not going to
work for you.
So how much of an impact doesmenopause have?
Andrea (47:12):
Well, aging has a big
impact on the immune system, and
I think that's something wehave to recognize.
And then the hormones have abig impact on the immune system.
So immunosynescence is a termthat speaks to the immune system
, and senescence, which is agingcells and organs, boom.
(47:35):
It's true, our organs and cellshave been through more quote
unquote trauma or more impactsas we age more influences and
they don't perform as well aswhen we're young.
Plus you have the drop inestrogen and progesterone.
Both play a really criticalrole in our immune function, so
(48:00):
it does have a role.
That doesn't mean we have tothrow in the towel and make it
like it's well this is happening.
Tish (48:08):
I mean we'd all like to
reverse aging Right, all like to
, not the fountain of you, thesecret of the fountain of you.
Andrea (48:16):
Exactly, and there are
things that we can do to slow
the aging process in the brainwith our energy at the cellular
level.
It's not about being perfect.
We're going to.
We have to live our lives.
We get to live our lives likewe're in our fifties.
We're going to live our livesRight.
Ellen (48:37):
Yeah, we always say, if
not now, when right?
It is the time to start if youhaven't been living your life on
that.
Andrea (48:46):
Exactly, Exactly.
So I don't think it needs to bethis highly restrictive.
I just ask us to tune in at adifferent level and recognize we
are aging, like having lost ahusband at the age of 34.
And I have a mom who justturned 85.
I'm like this is lucky.
(49:09):
This is not something that wehave to deny, Like how do we
embrace this opportunity to knowmore about ourselves?
Tish (49:20):
to tune in more deeply
what are some holistic
approaches that midlife womencan look into to dealing with
these autoimmune diseases?
Andrea (49:32):
Yeah, I mean for me the
hormones and the immune
diagnoses.
They're all branches, like thehormone symptoms are branches
too, in our Magnolia Tree model.
They're just branches, so itdoesn't mean they're not going
to happen.
But how do we influence them?
And again, those threeprinciples around food.
I have another three, which Icall the three tiers of
(49:55):
nutrition mastery.
Tier one are thenon-negotiables.
Tier two is deficiency tosufficiency.
Tier three is dismantlingdysfunction.
What the doctor does is tierthree work.
What we've gotten trapped in istier three work, and so do I
Fixed, dismantled thisdysfunction for me now and what
I'm saying is no, you'renon-negotiables.
(50:18):
I call a non-negotiable trifectasleep, poop and blood sugar
balance.
So those are key.
Leading back, you can see howall the systems kind of overlap
each other, and I know you had agreat conversation about sleep
on the podcast.
So sleep poop, blood sugarbalance tune in.
Where do you need some help?
Get that specific help insteadof looking for the help that is
(50:43):
at a higher level.
That isn't addressing thatunderlying piece, because
pooping is the most homistic wayto manage our hormones.
Blood sugar balance the most.
Sleep poop, blood sugar balance.
If those aren't in place, againyou're on quicksand, because
poop is where we detoxify ourdirty estrogens, the estrogens
(51:08):
that are in excess as we age.
So estrogen isn't bad.
There are different kinds ofestrogens and our body
metabolizes them differently,but one of the ways we get rid
of the stuff we don't need thatcirculates and leads to more
symptoms is pooping.
So when we think holistically,to me it's like it's not a
(51:33):
supplement and not saying thatthe supplements aren't in the
picture.
That's the deficiency tosufficiency, the tier two in the
arena, but non-negotiablessleep poop, blood sugar balance.
And then each of us have our ownnon-negotiables.
I need to be out in nature, Ineed to walk every day, I need
(51:54):
to make sure my brain is engagedand I like to listen to a lot
of podcasts and put informationtogether.
So I have Andreanon-negotiables, ellen has her
non-negotiables.
Those are the holisticapproaches.
We do us yeah, and we do usbetter.
Ellen (52:16):
And I think that's every
woman's responsibility and to
really look inward and to owntheir own life and how they do
it, to tune in, as you said.
You said tune in and I thinkthat is really important.
I know so many women who havegotten to midlife without tuning
(52:37):
in to themselves.
It's like waking up and tuningin, so important.
We like to ask each guest toshare what their superpower is
with our listeners, and I knowTish and I are curious about
yours.
Andrea (52:52):
Well, that's a great
question and I was like what's
my superpower?
I think my superpower issynthesizing information.
I really liked I think ofmyself as a renaissance thinker
so taking information fromdifferent fields and
understanding how they help usto understand complexity in a
(53:12):
better way.
So I'm going to say I'm a supersynthesizer.
Tish (53:18):
Albumist, just this little
time knowing you.
I absolutely would have toagree with that, because I love
this message that you've beengiving the whole podcast through
of there's no one single answer, and I think there's so many
practitioners and so many peopleout there.
I've got the answers.
This is the only formula, and Ilike your approach that that's
(53:39):
not the case.
We're all so different, so Iwould say that is your
superpower.
Ellen (53:46):
I agree, I agree.
And if there's one piece ofadvice or one thing, one point
that you'd like our listeners totake away from our conversation
today, what is it?
Andrea (53:58):
That's a rough one
because there's so many little
pieces, but I think it really isthis piece of agency tuning in.
When you find yourself lookingfor an answer, take a pause.
I think that our answer is inthe pause and in the ability to
(54:19):
say what do I really need inthis moment?
And so I'm going to offer that,as it's not as sexy as Take
Magnesium.
I think it is really where weeach tap into what it is that
will drive us forward.
Tish (54:40):
I love that.
I love that, that's great.
Ellen (54:46):
Is there a way that we
can share how our listeners
could work with you if they'reinterested?
Andrea (54:53):
Well, I have the website
andrianapyamacom, and that's
where I have current writingthat's more geared towards the
patient.
That will also lead you back tothe Functional Nutrition
Alliance where I trainpractitioners.
I have a team of nutritioniststhat work with the patients.
I personally don't work withpatients anymore, but I am doing
(55:16):
more workshops through AndreaNakayama.
So andrianakayamacom will leadyou to all the different places
that tap into the opportunitiesand lots to read in both places
as well.
Tish (55:30):
Awesome.
Yeah, that's great.
Well, I want to go ahead, oh no.
Ellen (55:34):
I was just going to say
thank you.
So much I learned.
I mean this has just beenreally opening for me.
It's really opened me to be somuch more curious and, as you
said, to take that agency formyself and really tune in.
Tish (55:53):
Yes, and I want to just
thank all of our listeners for
tuning in and until next time, Iwant you to keep finding the
positives in midlife.
Ellen (56:06):
That's right.
Until next week, midlifers.