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Wow, such a good piece. I appreciate how you present everything in a digestible way (pun originally not intended, but kept on purpose).

My grandmother was a “hippie doctor” in the 1970s before it was cool to be one. I have clear memories of playing at her house while she sat in her chair, reading medical research journals. She had wheels of vitamins she took every day; protein shakes; her house was cleaned with organic cleaners; her air purifiers ran constantly. She was insistent that everyone take vitamins and that we know about the health of our poop. (Very fun when you’re 8.)

An (in)famous family story centers on her bringing out her “Poop Book” at a dinner party to ask a four-star general which of the pictures he most closely related to. 💩 She was serious about gut health, she wanted people to be healthy, and she lived an active life until age 90.

This presented an interesting experience for me growing up as a child. My parents leaned away from modern medicine to a degree that definitely harmed me and my brother (both physiologically and mentally). As a 20-something I had to learn how to go to the doctor, ask questions and evaluate medication, but eventually realized that I needed both sides of the medicine aisle in my life. I want a medical doctor to be able to catch the big stuff. And it’s not lost on me that fertility doctors helped figure out how to help me deliver a healthy baby girl after two consecutive, unexplained second trimester miscarriages. (I also did some acupuncture and active body trauma therapy, so I know those were in the mix, but for me, modern western medicine came in clutch here.)

I’ve likened Functional Medicine vs Western Medicine as two warring kingdoms. They’re (often, not always) insistent on discrediting the other in order to be the top dog. Because being the top dog is what the fight is all about? When, as your piece highlights, the top dog would’ve had you living in misery, insisting nothing can be done about how your body was basically at war with you.

Most of my extended family sees functional medicine doctors (or some who lean more toward witch doctor status if I’m being honest), and I’ve noticed the most common reason they’re hesitant to listen to medical doctors is because they’re so often full of dead ends and prescription pads. Whereas FM doctors tend to have this tireless, keep searching posture -- they keep fighting to help you find a way to feel better. And I can’t blame anyone for wanting someone who doesn’t give up on them.

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Wow, that story about your grandmother and her poop book is AMAZING!

I'm totally with you about needing the full spectrum of care, medical and...other. It's so difficult as a patient to walk the line, and as someone who also has had a long infertility journey, I think that's a place where the worlds collide for many women, each, as you say, discrediting the other. It is so hard to figure out what to do when multiple highly-educated people are telling you exactly opposite things.

My great wish is for the integration of the two approaches. Certain Functional Medicine practitioners (the non-witch doctor kind) have come the closest I've seen, espousing a view that the combination of western medical approaches and lifestyle changes together are most powerful. (Though I still do feel highly judged at times for choosing to conceive through IVF, which enabled me to have a baby and for which I'm extremely grateful).

Anyways, thanks for sharing your story!

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The closest I’ve come to finding some neutral ground in both “kingdoms” (damn this terminology might stick) is the American Board for Lifestyle Medicine. https://ablm.org/

Andrew Weil’s Center for Integrative Medicine (in Arizona) is the source of that certification. You can read through their resources and note their “non violent” language toward additional modalities like acupuncture, testing allergies with food elimination diets, etc. But they do have some clear places they stop where FM would keep pursuing.

Write on.

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Ooo thanks for the rec. I hand't heard of the ABLM. I'm always shocked when I feel I have gone so deep on something and then there is still a whole totally new universe that I don't know about.

I think it speaks volumes that they feel they need to specify non-violent language towards other modalities 😶

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lol ... well those air quotes are on me. It was the best description I could come up with after reading some of their stuff. 🙃 They aren’t saying acupuncture is bogus voodoo buuuuut they do list its limitations and the scope in which they would consider it useful. Which... I do think is fair.

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Your grandmother sounds truly amazing!

I also love your perspective on Functional Medicine and Western Medicine being two warring kingdoms. I think you could apply that to all “Alternative Medicine” and Western Medicine. I’ve read a bit about the history of traditional medicine and alt, and Western or allopathic and the fight seems to have been there from the beginning sadly. There’d be so much good to come from collaboration!

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I also have autoimmune thyroid. I discovered it when I was pregnant at 40, and not soon enough because I had a monster case of preclampsia which, it turns out, are linked. I had been battling weight, fatigue etc for years. I went to an MD that was also into a lot of alternative medicine because I never felt good when my labs said I should. Went through tons of tests. Lots of supplements etc.. but by that time, my thyroid was pretty much burned out. I needed so much supplementation that I didn't really consider any other option. And I chose a doctor who was willing to over medicate me.

I think there are a lot of theories, and anecdotal evidence but in the end, no one really knows. I think it feels good to take action (do something!), and making an effort outside of taking a pill gives you some semblance of control. But at the end of the day, my grandmother grew up and lived in rural Wisconsin. Less pollution. Low stress. Diet quality debatable (with all that white flour). But theoretically less allostatic load than me. But pretty much the same result, a funky thyroid as she wound up with Graves disease in her 40s.

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Mar 21, 2023·edited Mar 21, 2023Author

I’m so so sorry to hear about your struggles to get diagnosed, and the resulting preeclampsia. That is such an awful condition, and the connection between the two is under-recognized.

I totally agree with you that much of this is out of our control, and that is always a good reminder. I do think so much of my activity over the years, with autoimmunity and with infertility, has been primarily out of the urge to do something, anything. Like you, my family on my dad’s side has tons of thyroid and other types of autoimmunity. It’s estimated that autoimmune conditions are 2/3 genetic and 1/3 environmental - in other words, a genetic predisposition is the majority of the cause, and then environmental factors can trigger it and make it more or less severe.

I should have mentioned this in my post, but I also take levothyroxine for my Hashimoto’s. I am convinced it’s a critical part of managing the disease, because low thyroid hormones bring their own host of problems. I originally didn’t want to take it because I was compelled by a "natural" approach, but after further research my opinion flipped. My TSH has stabilized under the medication, and I am doing my best to take a “best of both worlds” approach, though it can be a big struggle. It totally makes sense that you would supplement - it helps us to finally feel better!

I agree that there is tons of anecdotal evidence out there, including my story, but I have a different perspective than you on the evidence: I actually think we are starting to have a some clear scientific research showing that lifestyle affects thyroid autoimmunity. Although the research is still early, the mounting evidence linking lifestyle, diet and autoimmunity is becoming formidable. Most of what I know about Hashimoto’s I learned from Dr. Datis Kharrazian's online materials. He is meticulously detailed and highly evidence-based. He has many free resources and paid courses here: https://drknews.com/. Not sure if this is up your alley, but I wanted to share here for anyone interested in going deep on Hashimoto’s 😊

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congratulations! that's major progress!

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Thank you for cheering me on! I'm definitely encouraged by it.

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Congrats on getting down those TPO's so quickly!!! It is crazy that endocrinologists don't think thyroid antibodies worth focusing on, even though they're clearly a sign that something is off. I'm glad you proved them wrong by moving the needle with a gluten/dairy-free diet.

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Thanks :). It feels good, although it's less satisfying when I know that all over the country millions of women are being given incorrect information by their specialists 😠

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A fantastic piece. Functional medicine gives me hope and I appreciate you sharing about it. And yet also…I saw a functional medicine practitioner and things did not go well. He diagnosed me with conditions that it turned out I did not have, he put me on needlessly restrictive diets whilst knowing I had a history of disordered eating, and—to be frank—he ought to have given more consideration to my poop. It turned out I didn’t have Mast Cell Activation Syndrome. I had microbiome dysbiosis to the point that I had zero lactobasillus bacteria in my gut and candida. That’ll do ya. I had an increase of chronic health symptoms after seeing this functional medicine doctor (and spent a lot of money I did not have), though he did recommend an herb that was vital to my healing. When I started to truly improve it was with the help of two completely allopathic doctors who listened to me and let me direct my own care. My allopathic gastroenterologist ordered the stool test that changed my life, but then he was ok with me picking the probiotics and candida treatment that ended up being the game changers.

My understanding has been that a major part of functional medicine is establishing the root cause of symptoms. Perhaps this is more exceptional than I thought, because that’s not what the functional medicine doctor I saw practiced. But that’s what guided me as I worked with the two allopathic doctors: let’s get to the root. I suppose what happened was I employed the perspective of functional medicine myself and self directed the care I received from those two practitioners. My husband and I did research, requested specific labs, refused some things, tried new modalities, etc. This isn’t something I could have done when I became chronically ill at nineteen—it took eight years of learning and experience. Which is bollocks, really. It shouldn’t take that.

Also poop is awesome and needs to be talked about more. Thank you for that! That’s massive that your thyroid antibodies improved and that you’ve seen changes in your body. Every increment of more energy, less symptoms should be celebrated. Also your reconsideration of stress—spot on!

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Ugh, Ema, it sounds like you had a really bad FM experience! I think this is still a huge problem with the field--every practitioner is so different. I've seen two, and while I think the were both good in their own ways, their approaches were really different, and I feel totally unqualified to assess them. But what you're describing sounds awful and really sad...I'm so sorry it set you back the way it did.

Kudos on being so determined, it sounds like you have truly charted your own destiny through a ton of learning and hard work. It is indeed totally BS that you required essentially and eight-year self-directed degree in order to make progress.

No pressure to share, but I am curious - what did you land on for increasing your lacto? I also have a stubbornly low number there. If it's too complicated to write in a comment, I understand :).

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It wasn’t a fun experience, to be sure. I feel like this is sadly how it goes right now, in this medical system. It takes courage to keep going—which is what I see in your story. Kudos to *you* for being determined, and writing about it too!

For increasing my lacto, taking Biokult (a probiotic) was the bulk of it. I’ve tried so many probiotics, including one recommended by the functional medicine dr and an allopathic gastro, and this is the only thing that made a difference. My understanding is that while eating ferments is great, to re-establish a colony of good bacteria one needs to take a good quality probiotic for an extended period. So it took about three months to see a shift with the Biokult; at a year things were amazingly improved. Doing a microbiome diet protocol for six weeks and an L-glutamine powder (for the gut lining) were important too.

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Oh goodness... this is so deep and resonates hugely to my current condition. I have on-off symptoms in my gut and heart that the GP and cardiologists can't really connect the dots, although my heart bills are clear after extensive tests. I should plan seeing an FM doctor next year. This kind of writing is what motivates me to share my story as well in my publication because we women are often misunderstood (talk about me going to A&E a couple of times of chest pain, getting dismissed because non-cardiac related, yes but why? I had to research it myself). Cheers and prayers for your management and let's keep sharing the word and grow the community.

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Seventy percent of the immune system resides in the gut, and ninety percent of serotonin is produced in the gut.!!!

i knew it i knew it i knew it

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You knew this?!? Why didn't you tell me?!?

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my tummy was prolly hurting that day

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I'm so glad that it was helpful! Thanks for reading :)

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