Dr. Tim Gerstmar And Ashley James
- Recognize the help of health professionals around you not juts MDs
- Pharmaceuticals can only manage the symptoms we have to go to the root cause of the illness
- food is either causing disease or it’s healing our body
- Food and stress are triggers of our health
Considered as a “taboo” when it comes to conversations, one may never know how important gut health is. Listen to today’s interview to learn more about how to take good care of your gut health besides treating it as a simple digestive system which simply has to function.
[00:00] Ashley James: Hello, true health seeker and welcome to another exciting episode of Learn True Health podcast. Today Dr. Tim Gerstmar shares some excellent advice for those who have gut health issues and autoimmune issues and who wish to no longer have them. He talks about the foundations of health that when disrupted lead to exacerbating those issues, inflaming them and creating acute symptoms and how to get them under control. He works with people that within a year most of them are in remission which is really exciting. He gets such great results. There’s three key things. We talked a little bit about the importance of sleep and stress reduction and some ways to do that. I mentioned that my absolute favorite mattress that a few months ago I got. My husband and I love it. It completely changed how we sleep. We sleep deep. We get such great quality sleep. You can go to learntruehealth.com/bed to learn more about my favorite mattress. There’s a really great special that they’re providing for my listeners. There’s 2 educational videos on that site talking about the science behind the mattresses. They’re non-toxic. They have I believe it’s a 20-year guarantee, a 20-year warranty. What I mostly love about it is that the science behind it allows you to no matter what you’re a side sleeper, whether you sleep on your stomach, whether you sleep on your back, any direction. It relieves pressure and allows your spine to be straight the entire time. It’s the most luxurious deepest restful sleep you’ll ever have. I highly recommend going to learntruehealth.com/bed to check that out. I also mentioned that I absolutely loved using my Sunlighten Sauna both for detoxification and to decrease stress. You can go to learntruehealth.com and search sauna or search Sunlighten to listen to the two episodes I’ve done on sunlighten sauna and why it’s my favorite. I had the co-founder Connie Zack on the show and she shares some great information about their low EMF non-toxic saunas. I have one in my house and I’ve been using them for over a year. Getting some really great results with detoxification. Like I said, it’s also wonderful for stress reduction and that’s really important in today’s interview. My third thing that I absolutely love that I have to mention especially about autoimmune and decreasing inflammation, are grounding mats. I recently had Clint over on the show. I highly recommend listening into that episode. You can join the Learn True Health Facebook group. Check out the pinned post right now which is the movie. The documentary that Clint created so you can learn more about why people are going into remission. Going into remission from autoimmune condition when doing grounding or earthing. They explain the science of it in that video which is in the Learn True Health Facebook group. Excellent. If you want to learn more about the grounding, you can go to learntruehealth.com/grounding. That’s learntruehealth.com/grounding. Thank you so much for being a listener. I know you’re going to love today’s episode. Please share it with those you love who have gut issues and who have autoimmune issues so we can help them to learn true health.
[03:44] Ashley James: Welcome to the Learn True Health podcast. I’m your host, Ashley James. This is episode 372. I am so excited for today’s interview. We have with us Dr. Tim Gerstmar who is an expert in autoimmune and gut health. He’s actually a local naturopathic here, just south of me in Redmond, Washington but he can also consult people all around the world through the magic of Skype or the magic of the internet. Tim, I’m really excited to have you here today because I actually know your office manager, Lorelie. She’s the one that introduced us and she became an avid listener. She raves about you. She says that people around the world come to your clinic who are just the most complex cases of gut health and people with autoimmune conditions that – she see miracles performed in the clinic. You must have holy water on your office desk or something that people come in and you help them to dial in their diet, their herbs, their supplements, their lifestyle and that you’re really helping them to gain a foundation of health especially after they have seen so many other specialists and they feel like the medical system has failed them. So really excited to have you here today, welcome to the show.
[05:11] Dr. Tim Gerstmar: Thanks, Ashley. I really appreciate it. I’m very grateful to get in front of your audience and share some nuggets of wisdom here. See if we can help people. I really want to thank you. You’ve created something magical. I’ve seen your podcast, your Facebook group. To everyone listening, you’ve done a good thing for yourself by being part of this community and thank you for the kinds words. I also don’t want to take too much credit. One of the things, the good thing and the bad thing about integrative or holistic medicine is compared to conventional medicine is it’s not like the doctor as the mechanic. I’m taking out your muffler and putting in a new one and it solves all your problems. Certainly, a lot of our great results come from people who are really engaged in the process. They’re really willing to dive in there and get into their own diet and lifestyle. Work on their mindset and make some of these changes and do some of these things. I owe so much of my results to the hard work and the willingness to change that the people who come to work with us are willing to do because without that the people who come to us and they’re just like, “Hey, give me the magic herb that will fix my problems.” They invariably walk away disappointed and in fact over the years I’ve been practicing, I’ve been doing this for over 10 years now. We actually have a screening process to turn those people away not because there’s anything wrong with them but we just know that they’re not going to get the results. They’re going to be disappointed and it’s just a waste of their time, their money, their energy. Nothing’s are going to happen unless people are engaged in and that is probably the single biggest reason not to engage with holistic medicine is because some people just start in a place where they’re already willing and able to make those changes. We understand and we’re grateful. We’re going to talk about a different approach to autoimmunity but I also want to be clear, I’m not anti-drug. There is a time and a place for those drugs. They saved people’s lives they continue to be valuable tools. We don’t believe that they address the root causes and the issues that are going on but they’re a helpful tool that can have their place and some people even with the best holistic medicine that we have available find that they still do need some of those medications. A lot of people are able to get off them. A lot of people are able to reduce their medicine or move from stronger ones to less potent ones but it is important to know one of the very first things that we talked about. For anyone who’s interested to come and see us is understanding what the goals are. A lot of people their goal is to get off medicine. We always say, “Look it is really easy to get off the medicine, just stop taking the medicine.” but of course, that can be a very, very bad thing for the person to do. Their quality of life can be very poor. Their pain or disability or other issues can be quite serious. So our goal first and foremost is that people have a great quality of life. Not only do they feel good but they’re thriving in all the aspects of their life. If we can get a person to that place without the need for prescription medicine and immune suppressant or anti-inflammatory or other medications then awesome. That is our goal. But if we do need those medicines for people to achieve that quality of life, that safety of life and limb now we’re going to make us the medicine. I’m bringing this off right of the bat because there may be a few people who hear that message and are like, “I don’t know if I want to continue in this conversation if this guy is saying that medicines are useful.” and that’s okay but we do believe medicines aren’t bad. They’re tools. A lot of times they’re misused or they’re used to just put a band-aid on top of things instead of really going in and addressing it but they are valuable tools nonetheless.
[09:20] Ashley James: With naturopathic medicine, you learn how to use other tools. Whereas MDs are taught how to use pharmaceutical medicine. They’re not taught how to use herbs or how to use supplements even how to use diet. They’re not taught anything about therapeutic diets or foods or herbs so you have bigger tool belt than MDs. For those who don’t know much about naturopaths, there’s a lot of listeners that would know a lot about naturopaths because I have them on the show all the time but for those who don’t know about naturopaths, I urge listeners to get yourself a naturopathic physician. They are the best. Because of naturopathic medicine I’m no longer a diabetic, no longer have polycystic ovarian syndrome, I no longer have chronic adrenal fatigue. The things that plagued me. I was so sick in my 20’s and 30’s. I was so sick. I was bedridden. When I was 19, I was told by an endocrinologist I’d never have kids. I was infertile my entire adult life until naturopathic medicine and we conceived naturally and our son is 4 years old. Whereas MDs that I saw through my 20’s and 30’s said, every time I came to them it’s like, “Okay, here’s another drug, here’s another drug.” They had no tools in their tool belt for help me heal anything in my chronic illness. Could you just let people know what’s the difference between a naturopath and a medical doctor in terms of your education and your ability to help people.
[10:58] Dr. Tim Gerstmar: Totally. Absolutely. Listen it’s important to recognize, I’m happy to answer that. This is just quickly on what you said. MDs in the conventional medical system there’s no one better to treat serious illnesses life-threatening disease, injuries, surgeries. Nobody does it better than the conventional system and regular MDs. That is where they absolutely shine. If I get in a car accident, I’m not going to go see a Naturopathic doctor if I’m bleeding. I’m going to get myself to a hospital. I’m going to get the surgery that I need. I’m going to take the medications to protect my life and limb. Exactly what you said in this chronic health issues like PCOS like chronic digestive issues like irritable bowel syndrome or heartburn or autoimmune disease. The best that MDs can do is manage those things for you. Use prescription medications to manage those things. Diabetes, for example, is considered as incurable, progressive, meaning it will just continue to get worse and worse over time disease. Basically any Naturopath work the result will tell you that type II diabetes, we’re not talking about type 1 the autoimmune type of diabetes. But type II diabetes is incredibly manageable. The vast majority of the time it’s completely reversible and can disappear and it does not have to be a chronic progressive disease. Of course, you have to go far beyond just taking medications to try and manage it. You actually have to get into diet and lifestyle and all of these factors. Like you said, MDs just don’t have the training. People express frustration all the time. “Why won’t my MD talk about these things with me? Why won’t they prescribe this type of treatments for me? Why did they look at me like I have two heads when I bring these things up?” There are a lot of reasons but fundamentally most MDs out there are dedicated, diligent, very intelligent, hardworking people. They’re trying to make a difference in people’s lives. They just don’t have the education to understand that these thing are possible or to know what to do about them. Again, use an MD for their expertise and the things they’re good at. My hope with integrative medicine is that instead of each side saying, so again if you break a leg, don’t come and see me I’d be a terrible doctor to help treat those. If you need to have surgery, you do not want me to be wielding the knife and doing the surgery. You probably not going to make it out there. At the same time, what I want is, when someone like you Ashley goes and says, “Hey, I have PCOS. Hey, I have diabetes. Hey, I have these other issues.” In my dream world that MD says, “You know what, this is not my wheelhouse. This is not my expertise. You need to go see someone like a naturopath to get those issues resolved. We’d all worked together and be friends.” In some ways it’s starting to happen a little bit, in other ways it’s a long way off. One of the deep frustrations of basically everyone that comes to see us “Why isn’t this stuff more commonplace. If I’d only known 2, 3, 5, 10” – was just talking to a lady on the phone the other day who’s had chronic digestive issues for 40 years and has tried to seek out help many different places and just hasn’t found it. There’s a very good chance within the next six months we can have these things majorly improved for this person. So why don’t people know about it? To answer your other question quickly. Naturopathic Medicine for many people maybe not the listeners of this show, for many people it’s something they’ve never heard about before. People may think, “Does that mean a herbalist? Does that mean a nutritionist? A homeopath is that what you’re talking about?” and the answer is No, that’s not what we’re talking about. We are talking about the profession of Naturopathic medicine, which is to attend a rigorous medical school education. I went to 4 years of intensive medical school. All of the sciences that MDS have. Anatomy, biochemistry, we were in the labs dissecting the bodies, we were doing rotations, we were doing all of these things. The major most critical difference is after we get that education in basic science, instead of going on to exclusively focus on drugs and surgery, our focus is on lifestyle, nutrition, therapeutic diets, the use of herbal medicines and on and on and on. A whole host of different therapy. We know prescription drugs but we also know and favor the use of non-prescription drugs. That would be the single biggest difference. You get the same level of medical education with a completely different focus for therapies and that’s what is many people are looking for.
[16:25] Ashley James: I love it. Thank you so much for just laying the groundwork. Moving forward to the interview, everyone knows you’re a naturopathic physician. It’s like the best of both worlds. You can diagnose. You have drugs to treat if you want them but you also have the herb supplements, diet like all the other things out there. Naturopaths love to help people by doing the least amount of harm. And so you’re going to find the tool that does the least amount of harm and helps the person the most.
[16:57] Dr. Tim Gerstmar: Well, we always talk about, you can imagine a pyramid. In your mind, you imagine pyramid or a triangle with four different levels on it. The lowest level to the ground, we talk about is diet and lifestyle. That is the foundation of what we’re working with. You go one step up to the second level of the pyramid and that’s things like herbs, vitamins, minerals, and other nutrients go in that second level. The third level up is going to be prescription medications and the fourth level up is going to be things like surgeries and other very aggressive type of therapies for people. We always start at the bottom and work our way upwards. Again, it’s not that no one ever needs prescription medicine or no one needs surgeries, that’s definitely not the case but were saying to the MDs like, “Look, you’re starting to the third level up. How about we back up and make sure that those two bottom levels are taken care of first and a good trunk of the time we find out if those base levels are taken care off. We don’t even need to get to the third and fourth levels.” Again, it’s not that one is good ant the other is bad. It’s saying we need a bigger picture of what’s going on. Again, I find that MDs are stuck at the top of the pyramid and I find some natural practitioners are stuck at the bottom of the pyramid and refused to acknowledge that just the bigger picture all around. If our goal is the well-being, the health and the well-being of everyone or at least the people we come in contact with and are able to help. We need to use every tool that’s available. Again, some people need drugs, a lot of people don’t. We want to have all those tools available and thank you for tuning the horn for naturopaths here. We are one of the few professions that really has the training and the understanding to make use of all of it. That is the reason I evaluated many different types of medicine before I chose to become a naturopath and it was that blending together. Getting the best of all worlds. That’s the reason that I chose this profession and I pursued it all these years. Because it gives me the flexibility to deploy a whole range of tools for people.
[19:25] Ashley James: I definitely want to get into how to help people. Later in this interview, we’re going to give some really great actionable advice and help people have a clear path to health. The name of your book, The Clear Path to Health. I want to first learn a bit more about your story. What happened in your life that made you want to become a doctor specifically a naturopathic physician?
[19:50] Dr. Tim Gerstmar: Yes. If you ask most the majority of doctors or other health practitioners, you’re going to hear one of two stories. Either their own personal health struggles and their journey led them into healing and medicine. Then they pursued that down a particular path. Or that a loved one their struggles brought someone into medicine and that second one is me. I was on college at that time about to graduate and finish college. My dad went into surgery, it all went perfectly fine. I can remember very vividly, I was at work. I came home late. Full disclosure here, I was popping a microwave meal into the microwave to have some dinner after a long day of school and then work. The phone rang and I picked it up and my mom was just sobbing on the other end of the phone. Long story short, after the surgery, while my dad was in recovery, he’d have a massive stroke. No one had known or paid attention because he was unconscious from the sedatives. It was only when my mom said, “Shouldn’t he be waking up?” And they were like, “Well, maybe but it’s okay.” And then she finally said put her foot down and said, “No. Listen, it’s been hours and hours and hours now. He should be awake. Wake him up.” and suddenly it was, he’s had a severe stroke. They rushed him off. So she called me and said they were taking him to intensive care. He might not live through the night. I scarfed down my microwave meal and that began my health journey. The short version is. I moved home. Along with my mom, his caretaker for a little over a year. Taking him to all his appointments. I’ve been grateful and lucky to be a healthy young man. I never really had too much experience with medicine or the medical system but I was in and out of doctor’s offices and physical therapists and other therapists near constantly so I got to see everything from the inside. All the good stuff that was awesome and all the bad stuff. Like so many other people, I was asking “What else can we do? What else can help him?” You know, the conventional answer was nothing. There are no other options. No, his diet doesn’t make any difference. No herbs or nutrients can possibly help. No other therapies beyond physical therapy speech and occupational therapy could make any difference on him. Like so many other people, I refused to accept that answer. In those days, the internet was not such a big thing. Google and Facebook didn’t exist at that time. It was a little harder to find information. I started going to libraries during the day and bookstores. I started calling practitioners and talking to them, trying to understand what other options. I found out for example in China, if you have stroke while you’re there in the hospital, they will start acupuncture right away and find that the combination again of conventional medicine and a more holistic approach is more effective than one or either alone. After that year and a half or so, I was aimless. I didn’t quite know what I needed to do. Short version is, medicine sounded really interesting to me. I spent so many hours studying and talking to people but I was trying to figure out which one was right for me. I thought at first, I would go the conventional route. Get an MD and maybe like Andrew Weil who was just kind of becoming popular around this time. Maybe I would be a more integrative. I had a fortune of talking to a few good MDs who very quickly stirred me away from that path and said, “You’re setting yourself up for a very unpleasant number of years if that’s what you’re really hope to do. You’re not going to find it within the conventional system.” I explored many other options from chiropractic to acupuncture and just could not find the right fit for me until I heard about this little profession. It was headquartered in the Pacific North West in Washington, in Oregon. Really where it’s home was called naturopathic medicine. I explored it and knew immediately that that was the right choice for me and that’s been my path ever since.
[24:24] Ashley James: I love it. As you were going to school, were you able to help your dad further? Did you start to see that natural medicine could help him?
[24:37] Dr. Tim Gerstmar: That year plus that I was caretaking him, we engaged in quite a bit of holistic medicine. From acupuncture to something called neurofeedback. To some vitamins and minerals and such and we found that they were all helpful. One of the greatest tragedies of anyone who learns this stuff either as a professional practitioner or just as a layperson listening to a podcast like this and educating themselves, one of the greatest tragedies is that the people closest to us so often don’t listen to us. My mom who since passed on was more than pleased to tell everyone that I was a doctor. Her son the doctor but when it came to listening to me about making changes or trying this, they very rarely happen. Unfortunately, despite all my expertise, I like to believe I was able to help a little bit but that was not the be my calling but instead, help with other people locally here and all over the place, all over the States and all over the world to help them.
[25:53] Ashley James: When did you decide in autoimmune and in healing the gut?
[25:56] Dr. Tim Gerstmar: That’s a great question. The gut had become trendy now. You look on the internet, you listen to shows and you hear a lot about the gut and were having more and more research every day coming out telling us about how the gut and what’s going on in it affects basically every single part of our bodies. One of the beautiful things about naturopathic medicine which is about a hundred years old now, the profession from the very beginning focused on the importance of the gut. It’s always said from the earlier part of our schooling was always, “Look, disease begins in the gut.” That old Hippocrates, that ancient great physician Hippocrates quote, “Disease begins at the gut.” And so we always took that to heart. When I graduated, no matter else I was doing what other symptoms someone had going on. I was always coming back to the digestion as an important part of healing that. The gut is not a very glamorous thing. It’s not something most of us want to talk about. Our digestive function, what’s happening in in the bathroom. I found as I was working with people that I just grew more and more interested in the gut. I was very grateful that I got into the earlier research on the microbiome or the bacteria that live inside our digestive tract and began to see the influence that it had on health. I was just able to make such an impact on people’s lives that I very quickly transitioned to sort of just being a general naturopath to working on the gut. What I found over the years was that many people came to me with autoimmune issues both digestive and autoimmune issues and as we worked on their digestive issues, we saw a lot of improvement in their autoimmune issues. It wasn’t the primary focus but we saw so much improving. Coupled with more research and the increasing prevalence of autoimmune disease it became a segway for me moving from exclusively working on the gut to working with people with autoimmune disease as well. Thankfully, now there are many practitioners who are queued into the importance of the gut and are helping people. There are still far and away not enough people taking a holistic approach to autoimmune disease and helping people with that.
[28:33] Ashley James: Since you decide to focus specifically on those two, what kind of results have you seen? Can you share some stories of success or some kind of results that you’ve gotten through the years of helping people to recover from autoimmune and heal their gut?
[28:51] Dr. Tim Gerstmar: Yes. Absolutely. It’s a joy to see people go from the bad place that they’re in to go to feeling great and many even thriving. One recent for example, I had a gentleman in something called inflammatory bowel disease. This is one of our specialties because it is at the inner section between the digestive system and autoimmunity. Inflammatory bowel disease is a type of autoimmunity specifically affecting the digestion. This gentleman had a version of it known as ulcerative colitis. It causes a lot of pain in the gut, diarrhea, and blood. It’s a very scary disease because you can imagine you go to the bathroom, your guts are hurting, you pass some diarrhea which is unpleasant enough to start with but you happen to look down into the toilet bowl and there’s just blood everywhere. It’s a very scary experience for people to go through. So this gentleman had been dealing with ulcerative colitis for a number of years now. He’d been on and off medication with ups and downs going on. Finally, like many people, he said, ”Is there something more that can be done rather than having to keep running back to the doctor and getting a prescription for steroid or prednisone every time something flares up?” He came to see us. We worked with him over the course of about 9 months. Made dietary changes for him. Recommended some different herbs and nutrients. He has done exceptionally well. We’ve been monitoring him now, his ulcerative colitis is in complete remission. It’s absolutely dormant and quiet for him. He’s not taking any medications. Actually in his case been able to wean off many of the supplements, the herbs and nutrient as well. There’s a few that he takes. Does definitely pays attention to his diet. He finds it’s a major factor. We help him identify specific foods that are problematic for him. Others that don’t have any issue whatsoever. It was such joy at his last visit, which was a few weeks back to see, not only was the UC not bothering him. He had no digestive issues whatsoever. He had no other complaints of autoimmunity that were going on. He was actually thriving. He was happy. Speaking to going just beyond the symptoms. Of course, when people come to us they’re hyper-focused, “I’m going to the bathroom 5-10 times a day. It’s diarrhea, there’s blood in it. It’s scary. I don’t feel good.” All these issues are going on. One of the things that we found in his case was that stress was a big factor for him. Stress at home. Stress at work. By his willingness to dive in and start addressing those factors. He’s made some fundamental changes at work. He’s made some changes at home. He’s made some changes in some of the relationships in his life. Again, not only is the UC quiet, but his quality of life, his ability to thrive has skyrocketed. That’s just one example. We’re so incredibly proud of all the work that he’s done and the progress. In contrast, what would have happened if he had just gone down the conventional routes is there would have been an escalation of medications possibly up to the biologic medications, which if insurance covers them that’s good. There’s often major out of pocket cost. Most of the medications run $20,000 or more a year as their base price. These are very expensive medications for people. They either have to give themselves injections or they have to go into the facility and have IVs put in every once in a while to get these medications. There would’ve been no discussion of diet, no discussion of stress, no discussion of these other factors. If everything worked right and we hope it would. His UC would’ve been quiet and not bothering him. We wouldn’t have moved to simply being symptom-free to thriving having a better quality of life than before.
[33:18] Ashley James: Awesome. I love it. I love that story. Do you get people who have an autoimmune and gut issue all the time? Is that your main focus or do you find that you get people with just the autoimmune or do all autoimmune people have some gut-level issues?
[33:35] Dr. Tim Gerstmar: I shy away from all, every and none. Those big categorical words. Does every person who has autoimmune disease have a gut dysfunction? I don’t believe the answer is yes. Do the vast majority of people with autoimmunity have gut dysfunction? Yes, they do. We found our experience has been that 80-90% of people find that making dietary changes result in from major to at least minor improvement in their autoimmunity. Do there seem to be some people maybe 10% of people out there from our experiences where diet seems to play little to no role in what’s going on for them? Yes. I’m cautious when we say every person but our experience the people that we worked with, almost all of them. They may not recognize they have gut problems. In fact, it’s very common when you come in they say, “I have rheumatoid arthritis” “Okay, let’s talk about your digestion.” “Oh, it’s fine.” “Okay, no worries but let’s talk about it a little bit more what’s going on.” “Oh yes, I have this issue. Oh yes, I guess I have that as well. Oh, doesn’t everybody have that?” It’s just like, “Okay. There is a dysfunction.” Now a gut dysfunction seems to be at the root of many cases of autoimmunity and again, we routinely find that by improving the gut function that we’re able to make a real positive difference in people’s autoimmunity. Again, if everybody remembers the pyramid, at the bottom of it. Diet and lifestyle and we would also put gut function right down there at the base. is just treating the gut going to cure all autoimmune disease and deal with everything? No. It’s not, unfortunately. I wish it was a simple answer that we could say like that. Is it fundamental that many, many people are going to find significant benefit by treating their gut? Yes. Again, what would you say to people, look if diet and lifestyle and treating the gut are not enough to take care of your problems on their own, it’s good to start at a lower level where the side effects, the issues there are very minimal. Again if you clean up your diet and lifestyle and even if it makes absolutely zero impact on your autoimmune disease, it’s going to make a significant impact on the rest of you as a human being. Who has a body who has all the systems functioning? The worst we can say, for example, another case were still going, we have a person come to us with autoimmune thyroid disease, Hashimoto’s, hoping to get off their medication. Again, one of the things we tell people, we cannot guarantee that you’re going to get off your medicine. I just want to put this out there. If people have seen other practitioner or other courses or other people saying, “Absolutely, positively, I guarantee you can get off your thyroid medication if you do this thing” either they have some magic that I’m not aware of or my experience says that’s a false spell of goods. There is no guarantee that everyone everywhere will be able to get off medication. We found through some dietary changes that have been ongoing thus far, we have not been able to make a big impact on her thyroid function or the hashimotos. But at a minimum, she lost some weight, her skin is better, her energy has improved. She feels better. Her stress levels are down. That’s what we always tell people is look, by starting with these fundamentals even if it’s not able to make a big impact on the autoimmunity or the other disease or issue that you have going on. It’s able to improve the general quality of your life and your overall well-being and reducing your long term risk for things like heart disease or cancer. The big E’s that cut people’s life short and destroy their quality of life. I personally believe it’s always worthwhile to address this. Most of the time it’s going to improve a persons’ autoimmunity and in those instances where it doesn’t. I have yet to see someone who doesn’t feel that it’s improved their quality of life or their overall health.
[38:27] Ashley James: Got it. There’s this theory that autoimmune issues are caused by leaky gut syndrome which has been exacerbated by or caused by gluten and grains among other things. Can you talk about that? Do you get everyone off of grains or every one off of gluten? How effective have you found that? I’ve heard from other practitioners that they cannot get results with an autoimmune client if they don’t go gluten-free. Is that your experience?
[39:07] Dr. Tim Gerstmar: Sure. Gluten is one of the more common problematic foods. Again, I am not an every and all. So generally, if we have our way, we start people on a gluten-free diet. We often will use a paleo diet or an autoimmune paleo diet as a starting place to put people on. I want to say a lot of people with autoimmunity definitely do have problems with gluten. It is a very problematic food for people as is dairy. Probably the two biggest problematic foods that are really unfortunate because so many foods that we all love to eat have gluten and dairy in them but they are very problematic foods for people. Having said that, does every person with autoimmunity must be gluten-free or cannot heal if they eat gluten? That has not been my experience. Again, many people have problems with gluten but not everyone does. I’ve seen people with a variety of autoimmune diseases, again, we usually cut it out in the beginning as we get to work and as we’re trying to identify the problematic foods for people but in a later time, we almost always recommend that people re-introduce gluten and see if it’s a problematic food for them. There are percentage of people they find that gluten is just not an issue. They’re able to eat it and be perfectly fine.
[40:37] Ashley James: I know you’re not always person when it comes to advise. What are the most common things though that you found are really helpful?
[40:50] Dr. Tim Gerstmar: Definitely diet. We always recommend unless people come to us already have done a lot of experimentation with diet, already identified a lot of the triggers and issues that are going on but virtually everyone who comes to see us. Again, we kind of consider this low hanging fruit. We go through to an elimination diet. There are a lot of different ways to do it but again, something like a paleo diet or an autoimmune paleo diet is a nice segway into it. A paleo diet remove grains and dairy at its base. There are a few different tweaks to it. An autoimmune paleo diet goes one step further taking out all of the big problematic foods to include things like eggs and nightshade and nuts and some other foods as well. It can be quite a restrictive diet. Certainly, if no one has ever done that before this idea for you that food could possibly impact what’s going on. The number of people that have been told by their gastroenterologist, that’s a conventional gut doctor, or rheumatologist, kind of conventional autoimmune doctor that food has zero impact what’s going on. I’ve wanted to bang my head against the wall so many times for that bad advice for people. Food absolutely for the majority of people plays at least a modest role in their autoimmunity. The majority of people by finding their dietary triggers and removing them can make a significant impact in their autoimmunity and in their health in general. Kind of a low hanging fruit for everyone is I do recommend if you’ve never done it before. Do an elimination diet. In fact, not quite autoimmunity. Just yesterday I spoke with someone and they found they were healing with eczema. Very common immune conditions. Eczema is not autoimmune. In fact, Ashley do you think you would help just briefly to talk about the different between inflammatory or an autoimmune issues. I find there’s a lot of confusion about that.
[43:07] Ashley James: Absolutely. Go ahead.
[43:08] Dr. Tim Gerstmar: Inflammation a lot of people specially the educated people who are listening to a podcast like this have heard the word inflammation before. They know that information is at the root of many different conditions and problems and diseases that are going on. I find that a lot of people who come to see me don’t actually know what inflammation is. Inflammation at its heart just means an active immune system. When the immune system gears up and activates itself a whole bunch of things happen. Chemicals are released and things happen but globally we call that those changes inflammation. Now we come to think of inflammation as a bad thing. Somethings that’s a problem and it absolutely can be. Inflammation can also be a very good thing. If we are able to magically reach in and shut down inflammation in your body, you would not be able to fight off infections. We need inflammation to happen. Again, inflammation active immune system when we’re fighting off a virus or bacteria. It’s one of the reasons that these immune-suppressing drugs whether they’re steroids or whether they’re the more aggressive immune suppressors make people more vulnerable to things like infection and possibly cancer as well. It’s because by shutting down the immune system or reducing it’s effectiveness, it can’t fight off those things in the same way as if it didn’t have those drugs pulling down immune functions. Inflammation in and of itself is not bad. The problem is inflammation and active immune system is supposed to be there to fight off an infection. To help heal an injury or wound. Again, if anybody’s taken steroids or immune suppressants, you can see that cuts and scratches and other wounds just basically can stop healing or take forever to heal because the necessary inflammation that the body needs to generate to cause that healing just isn’t happening. Again, that inflammation continuing on unshackled or too much of it or for too long is where we see all of these problems occurring. Something like eczema which his very common is an inflammatory condition. The immune system is flaring up, it’s causing the skin to react to become red or itchy. In contrast, an autoimmune issue is when the immune system has decided that part of your body is a problem. It is treating your joints for example as if they were a foreign bacteria that invading you. It’s attacking those joints and causing damage and pain and destruction to those joints. Something like eczema is inflammatory but not autoimmune. The body is not attacking or trying to destroy or damage the skin or other tissues but it is immune-inflammatory. Psoriasis, on the other hand, is an autoimmune disease. Now we have the immune system targeting the skin and causing issues for people. I just find a lot of confusion for people so I hope it helps to clarify and give people a little bit better understanding of the difference between inflammation and autoimmunity. If you have autoimmunity, you’re going to have inflammation but if you have an inflammatory issue it doesn’t necessarily mean that it’s an autoimmune one.
[46:40] Ashley James: Got it. As someone who has an autoimmune condition, you want to make sure that you’re not doing things that increase inflammation in your life. You want to decrease inflammation. I learned from an old school naturopath, I think he’s in ’80s now. He said that this issue with autoimmune which is it feels new to me. It doesn’t sound like something that we had hundred years ago that was as big of a deal. I don’t know if that’s because diagnosing has become so much more advanced or is it that we are really seeing this like huge leap in auto immune conditions in the last 50 years through just the toxic environment and those standard American diet and the chemicals that we’re exposed to. The body is just way more toxic now than it is ever been so more agitated and inflamed. He says that – he also before he became a naturopath was a pathologist so he has that unique relationship to tissue and on a cellular level and he says that when someone has inflation cell damage at the tissue at the cellular level that the immune system comes along to clean it up. That autoimmune is where there’s inflammation on and damage like let’s say to the thyroid. A healthy thyroid but there’s inflammation in the body and the immune system keeps going keeps trying to clean it up and in doing so, it’s digesting the thyroid. The MDs will say, “Okay, the body’s attacking itself we need to suppress the immune system.” He says, “No, the immune system’s trying to clean up the damaged tissue. But the damages from the inflammation so something about the immune system of people with autoimmune is a little either hyperactive or what’s going on that some people can have inflammation and that their body doesn’t continue to clean it up and clean it up like an autoimmune response whereas others do. What is the difference? Can we see through genetics? Can we see through like toxicology reports? What can we see that is the difference between those with autoimmune and those without?
[49:11] Dr. Tim Gerstmar: Right. That’s the million-dollar question. If I have that exact answer for you, I would be trumpeting it to the world because all these we’re doing, all doctors were doing the best that we can. There’s a lot that we do know and frankly, there’s still so much that we don’t know and we’re hoping to continue to uncover. Now for most autoimmune disease there seem to be some genetic pre-dispositions, I argue that there are. Like for example why does one person get rheumatoid arthritis where the other gets ulcerative colitis where the other gets multiple sclerosis. I think there are some genetic predispositions. Now there’s no smoking gun that’s been identified oh if you have this gene you are going to get multiple sclerosis. I think the way I look at it is in autoimmune disease the immune system loses its way. Our immune systems have a very difficult job. Their job is to be constantly be patrolling around our body looking for things that don’t belong. Now when everything works properly even if the immune cells that are a little too aggressive or that want to target the body’s tissues get weeded out. They don’t exist. Where we‘re seeing autoimmunity occur is because something has gone wrong there. Cells that can target the body are now doing so and that process gets laid down and gets locked into the body. I think from my perspective again, my focus is to try and keep zoomed out and keep a holistic picture on someone. You name a number of factors. I think both detection of autoimmune disease is greater. There are more treatments we can argue about how much we like the different prescription drugs but there are many more treatments available for people than they were in the past. Hundred years ago someone with rheumatoid arthritis was just sort of doomed. They were stuck in their home or they were stuck in a wheelchair. They were just going to live a shorter more miserable life because there were really no, from a conventional side, there were really no available treatments for them. When steroid first become available, they were hailed as a miracle drug because these people that are crippled with pain, their joints and finger were all deformed from damage suddenly could leap out of their chairs and they could move around and they could be pain-free and they could have energy again. Certainly, part of it is that we’re able to detect these things now. The treatments are available. People come forward and they’re diagnosed and they’re brought out into the light if you will some of them were kind of captive in a way in the past. Yes, absolutely we’re seeing a dramatic uptake in autoimmune disease and other issues. One of my mentors begin practicing in the 1970’s he said to me that in his experience diseases all from the 70’s to the present day. He’s seeing diseases happen 20-30 years earlier in people than they used to. Something used to effect to people in their 60s we’re seeing it now affecting people in their 30’s. If something only affecting adults before we’re seeing it now affecting children and teens as well. Definitely many, many factors from our environment. Things we put out there to the way that people are living their lives now. I think all combined together. Whether on autoimmune disease begins as a healing process like you said, it is true when tissue is damaged or needs to be broken down or gotten rid of, it’s the immune system’s job to be a little janitor or a little garbage person and take out that trash and help that tissue rebuild and be healthy again. Whether it’s a genetic predisposition. The immune cells are little faulty in that regard. They’re a little too aggressive now and they’ll go after things they should be restrained from. Think about like we have guard dog on a leash if that leash is a little bit too long or the guard dog is a little bit too aggressive, it can end up biting things that you don’t want to when you want to protect other things. Whether there’s a genetic predisposition or whether the balance that’s going on with that person’s life. If your listeners can imagine those old scales where they have a pan on one side and a pan on the other, you put weights on one side it goes up or down and the things are balanced out. The level with one the other sides heavier it’ll be down lower than the lower one. We can imagine having a balance like that. One side of the scale you can imagine one of those pans being all the anti-inflammatory factors in a person’s life. A good nutritious diet, getting enough rest, reasonable level of exercise, managing their stress correctly that can be again certain supplements or nutrients, all of those different factors that serve to calm the immune system and reduce inflammation go on one side. All the factors that increase or raise inflammation go on the other side. The fact is that the modern lifestyles tilt heavily towards a pro-inflammatory state. My opinion is whether it’s a damage or other issues that kick things off for people, whether you throw in a dash of genetic predisposition towards it and then you tilt those scales heavily in terms of inflammatory factors, it’s no wonder that so many of us are suffering in health conditions in general and autoimmunity here in specific that we’re talking about.
[55:26] Ashley James: It’s really scary and interesting to see that what we used to suffer in our 60‘s and 70s’ with, we now suffer in our 30’s or 40’s or even earlier. I know Dr. Caldwell Esselstyn, the cardiologist I’ve had on the show. He’s in his 80’s and still practicing. He’s the man that wrote the book, How To Prevent and Reverse Heart Disease. He said that when they would open people up and they would see this sort of the beginnings of heart disease that they see beginnings of heart disease people like 40 or 50, these are autopsies from people who died in accidents. Like car accidents. They do those autopsies and they’d find sort of the baseline of the population in terms of heart disease that they could see a 50-year-old beginning to have maybe some blockages or some calcification build up. They’re seeing that in teenagers now. As a population as a whole, we are dying sooner of preventable lifestyle-based diseases and we are as an entire population going down the wrong path. You said the lowest hanging fruit is fixing diet. We definitely all need to be responsible for our diet and I want to talk a bit more about that. What about the toxins that people are exposed to? Do you look into chelation or detoxing or sweating in a sauna. Have you find that helping autoimmune patients to detoxify? Has that also benefited their condition?
[57:26] Dr. Tim Gerstmar: Yes, because we know there are many different toxic compounds. I define a toxin. My personal definitely is going to be any substance that interferes with the normal functioning of the body symptom. The most basic level is you hold your breath the carbon dioxide, it builds up in your body becomes a toxin and then things your metabolism things start not working correctly so you desperately breathe out to get rid some of that carbon dioxide and get more oxygen into your body. Anything that interferes with that normal functioning there are normal body process that are going to produced toxins and sort of unfortunately we are the inheritors we’ve done a really great job of putting out a lot. The estimates range about a hundred thousand man-made chemicals into the environment that were not there before and are new to the environment. We either dug them of the ground or we synthesized and created them in a laboratory. The sad thing and I wish it weren’t true is that many of these compounds have undergone very minimal testing. It’s usually been around how much you have to give to someone to kill them or to cause them to have cancer. The newest research that has been accumulating shows that lower levels of these toxins of these compounds that won’t kill you can still have a chronic long term impact. We know many of these chemicals are endocrine disruptors. Endocrine’s another word for hormones. We have these compounds that act as hormone disruptors. Whether that’s in causing obesity, diabetes, whether that’s being a carcinogen or chemical that causes cancer. Immune disruptors. So we know many of these chemicals have these issues. Now when it comes to treatment, again, there’s kind of a low hanging fruit and then there’s the more complex stuff. Everything at the simplest level for your listeners reducing as many of these compounds and chemicals in their life as possible. We can break them down into a couple. We have beauty products, I’m sure you’ve probably had experts on before to talk about in particular women’s make-up as a very unregulated field. All the big cosmetic companies, there is no big oversight of them. They voluntarily are supposed to keep an eye on the stuff that they put into their make-up and their beauty products. We know many of them are full of some really nasty products so if people haven’t seen it, the environmental working group has a nice website. A section of it is called skin deep and they talk about a number of different studies and analysis of various cosmetics and beauty products and they make recommendations for some cleaner more organic, less toxic compounds. We always think about beauty products things, people are putting in their skin is being one factor. Household cleaners would be another and then the yard or the office would be another place. We’ve seen many people they move into a new building or a new workplace and their health took a big downturn. Obviously, there could be a variety of factors. One that I just want to bring up because it is so often ignored when we focus on diet, we focus on things like toxins are is mindset as well. That stress factor we find this is such a big deal. We’ve seen people eating good clean diets. Let me back up for just one second Ashley, we talked about the health triad. The three most critical health factors for autoimmunity. It’s not saying that there are other factors that aren’t important or that need to be addressed. The three most critical factors that we see are one, diet. Two, stress and three, sleep. We see it all the time. If one of these factors get a little off, people go out to eat or they go on vacation or they’re on traveling of for some reason their diet gets a little off track. If the other two factors sleep and stress are really under control, they’ll see either just a minor shift in symptoms or they may not notice much of anything. If two of these factors get out of control, we often see a flare and if all three of these factors are out of control, look out this person is set up for some pain unfortunately in a not too distant future. So diet is one critical piece we’ve kind of talked about that to some degree. Sleep is critically important. When people sleep well that is the signal to repair and rebuild their body. We see a lot of improvement from that. Stress is a factor that is just very often overlooked. We were talking earlier about doctors saying if they don’t get gluten out of the diet, we found in addition, that if people don’t or unwilling to look at their stress or unwilling to make changes in their life to help manage and deal with stress then we are unable to get long-lasting significant improvement for people. That if they just changed their diet, that they will see improvement in their autoimmune disease but if they don’t get some of these other factors and stress is probably the elephant in the room if they don’t get that addressed then they’re not going to see really significant results and they’re not going to see really long-lasting results.
[01:03:19] Ashley James: I really like that you pointed this out. I had a client who was she was transiting into type 1 diabetes. The doctors were calling it type 1.5. I’ve never heard of that but she was basically pre-diabetic and then they could see that her even though she was, this was like adult onset type 1 coming on as an autoimmune response. I was helping her as a health coach with her diet and her supplements and I kept addressing stress. I just intuitively felt this was probably the biggest piece of the puzzle and she kept fighting me on it. At one point she said, “I don’t feel stressed.” I said, ”Thank you. Thank you for pointing this out because stress isn’t an emotion like anger and I think we’re all sort of waiting to feel stressed but it’s not an emotion” Right? Can you tell us what is stress and how do we know we have it?
[01:04:19] Dr. Tim Gerstmar: The short answer, there’s a few pieces to answer here. We don’t ask people anymore if they are stressed. We ask them how they’re managing their stress because almost everyone with the exception of a few retirees or Microsoft millionaires who are independently wealthy and no longer working and can structure their life however they want. With the exception of few people, the vast majority of us are stressed. Now when we ask people or think about stress what they imagine is that inner sensation of pressure. That could be a psychological feeling like, “Oh my gosh, I’ve got so much to do today. So many things going on.” It can be that physical sensation of pressure or tightness. The classic shoulders-up-in-your-ears tension in your body that people are feeling but at a fundamental level there are two kinds of stress. There’s the mental-emotional stress, so this is everything from deadlines to children to bosses to traffic. All of those mental-emotional feelings that we have going on. Then their physical stresses as well. Those can range from inflammation is a kind of stress on our body that can go from poor fueling strategies, blood sugar crashes are going to be a source of stress on the body. It’s important to realize that no matter whether it’s a mental stress whether it’s a physical stress the reaction that happens in the body is the same. From a primitive physiological or body-based perspective, stress is gearing us up to deal with a life or death situation. The gazelle on the grasslands, they don’t have too much mental or emotional stress. They’re not thinking about jobs or deadlines, planning for retirement, or dealing so much with the kids or any of those things. Their life is mostly built around the physical stress which is a lion wants to eat me. When that stress responds kicks in we call the fight or flight response is really what stress is. That causes changes within a person’s body. It changes within that animal’s body. Changes within our bodies. Based around that response which is to fight off something that wants to hurt us or run away from something that wants to hurts us. Now human beings we have the blessing and the curse. For most other animals out there, their stresses are mostly physical. For human beings who are fortunate enough like we are to live in the modern world most of us were not dealing with starvation, work or physical harm as real ever-present issues that are going on for us. Most of us modern humans are lucky enough not to deal with those and most of our issues are psychological. Traffic that I had to wave trough, my kids bugging me, my boss is nagging me. All those kinds of issues. It’s important to realize those mental stressors trigger the same physical reactions to occur in a person’s body. Now the other big piece that you said is most of us are dealing with a load of chronic stress but like the story of the frog in the pot of water. If people haven’t heard, I don’t think this story is actually true but you hear it repeated everywhere so it’s good to use as an example. You put a frog in a pot of water if you suddenly pour boiling water on there, it will hurt and the frog will leap out of the pot. The story goes if you just slowly heat up the water the frog gets used to that hot water and doesn’t leap out of the pot. For most of us, we’re in the same situation as the frog in a pot of hot water that’s been turned up and turned up and turned up. That hot water feels normal to us. The chronic stress that we’re under is what we call normalized. We don’t even know it because most of the time it’s there. It’s become background and baseline but still affecting us but we don’t notice it. It’s only when there’s big changes in our lives. When we go away on a extended vacation, for example, we’re able to get out from under all that stress and then we suddenly go, “Oh my god. I didn’t even realized how much this was affecting me.” It’s very common. We see it all the time with people. For example with food, there are food that they really need to stay away from. They see flares of those food when they eat those foods. They go away on vacation and they suddenly go, “Oh my god. I was able to eat that food. I thought –“ I accidentally got it for example. “I was so worried that thing were going to flare up” And you know what? They didn’t. Maybe I felt the twinge or maybe I actually felt nothing. It’s very common for people to do a celebratory dance and say, “My gosh, I no longer have problem with gluten. I no longer have a problem with the foods that are an issue for me.” They get back home and they climb back into the pot of hot water that stress level and all of a sudden they go, “Why can I not eat that food? When I was on vacation I was able to eat that food and now I can’t do it anymore?” If you remember back to the scale the one side is anti-inflammatory, the other side being pro-inflammatory. If you’re on vacation, your stress level goes way down. There’s other factors you’re’ loading at the anti-inflammatory side of the scale. Now it’s hanging down low. You put a little bit of inflammatory food on the other side it’s not enough to tip the balance into big active inflammation. It’s not a problem. You get back home. You load up the pro-inflammatory side of the scale and so now, you drop that inflammatory food on and it and it shift things over and brings up a flare of symptoms for people. I’m so glad you’ve recognized it. Oftentimes it can feel like talking to brick wall. People either say,” I’m not stressed.” When majority of the time we find when we dig into it, there’s a lot of normalized stress going on for the person. They’re stressed. They just don’t pay attention to it anymore. For some people they just refuse to acknowledge and work on it because on some level, it’s much easier to change your diet that something external to you than to dig into the issues that are stressful. It can be work, it can be family life, they can be priorities, they can be issue patterns that you have, it can go back into all the way into childhood. They can be challenging to deal with it. It feels more internal and it feels more personal. If people are willing fundamentally we’ve seen if they are not willing to address this they’re going to limit their healing and what positive things that can happen for them.
[01:11:38] Ashley James: I interviewed a naturopath actually local one here as well. She made a funny joke. She goes, “You know every time – “she just had another client come back from Hawaii. She says, “Every time a patient of mine comes back from Hawaii, all their symptoms go away. I think I’m going to start prescribing vacations to Hawaii.” It’s just, it’s amazing how you’re painting this picture. This correlation of my condition gets better when I’m on vacation and then I come home and it gets worst. Hello, this is the soup we live in. The stress soup. We want to do things like see mental health counselors to learn healthy coping strategies and mechanisms for helping us on a daily basis. Deal with the daily stressors like you said even from childhood. I know that I run programs that I learn from my parents who are both entrepreneurs. There are things from my childhood that I need to examine and re-program. What can we immediately do or implement on a daily basis to significantly reduce stress? What do you see works really well in your clinic?
[01:12:56] Dr. Tim Gerstmar: This is one of the more personal approaches because again, there is no one perfect things that one person finds stress relieving can be stress-inducing for another person. Right?
[01:13:13] Ashley James: Like meditation?
[01:13:14] Dr. Tim Gerstmar: Meditation. You totally read my mind there. Meditation works beautifully for some people. Such a magical tool. For other people, it makes them insane with rage. It’s like the worst possible thing that we can do. I’m happy here to give you a few suggestions. It is important for anyone listening to know while we can roughly come to some generics like, “Hey, from our perspective try something like a paleo diet or that autoimmune paleo diet or the whole 30 diet. Those are all specific carbohydrate diets. These are all reasonable starting places to work with diet. When it comes to stress, there are few basics. As always it’s figuring out what works for you. Doing this “stress-relieving thing” leaves you feeling more stressed out. It’s not working, right?
[01:14:13] Ashley James: If they’re not in touch with their body and in touch with their stress levels, how do they now whether if it’s working or not? We know of heart rate variability. It’s difficult to find an affordable and effective heart rate variability monitor so how would they know that they’re actually lowering their stress when they’re doing something new?
[01:14:34] Dr. Tim Gerstmar: Again if stress is triggering the fight or flight response then de-stressing should trigger the relax and digest response going on. Certainly, we can conjure back to those times in our lives when we were not stressed. We can watch what little kids look like when they play. Kids, of course, can get stressed out and have their own issues but by enlarge most kids thankfully aren’t dealing with all the chronic stressors that we have. So there’s smiles, there’s enjoyment, there’s play going on. From a big-picture perspective, this takes most adults totally aback when we ask it. What do you do for play? What do you do for just pleasure and enjoyment? For example, a lot of people have come to us understandably have been doing a lot of research on the internet, reading books, listening to podcasts, watching blogs or vlogs and videos. All of these things to try and better understand what’s going on for them. One of the challenges that will put to people is “What was the last book you read for enjoyment?” Not self-help. Not health related but purely for enjoyment. A lot of times they sit there and stare at us, trying to think up the last thing they did that was purely for joy. Purely for pleasure and have a hard time and often we need to put people, I’m all for people being educated it’s great but often times we have to put people on little bit of a fast of information that’s purely help their self-improvement, make it a homework piece to read something fun or something enjoyable. An activity that people can get lost in by its nature, that flow state is a state of not being stressed. Right? So what do you enjoy doing? This time of year in the pacific northwest, is it getting out for a walk with your dog? Not a power walk, not an “I need to walk for 30 minutes and get my heart rate to 85 % of my cardiovascular maximum” but “Can I actually get outside and enjoy the view? Can I just get some time to de-stress and to bring my creativity out?” One of the things that we see that disappears when people are stressed is creativity. Because we’re on fight or flight. There’s no need to be creative when a tiger’s trying to eat you. Creativity by its nature is a more relaxed flow state. We can’t be worried about the next thing trying to be too creative when you’re driving to work and bumper to bumper traffic. It’s not going to happen. But when we’re talking a nice hot shower. We’re relaxing, our mind is pacing out and all of a sudden the ideas come flooding out. We know we’ve switched off from that sympathetic fight or flight response into a more parasympathetic one.
[01:17:40] Ashley James: I love it. My husband has the best ideas when he’s in the shower. He always comes to the shower and tells me something really cool. He’s really creative. I love my time in the sauna. I got my sunlighten sauna, which I absolutely love. Decrease stress and sweating out the toxins which is so great. I have my grounding mat. I really feel relaxed on it and it’s funny because I have it on my bed and I also have it on my desk and now whenever I’m on it, I don’t want to get off of it. I’m lying there going, “I have so much energy, I’m so awake, I’m so ready to get up out of bed but I’m so happy and relaxed right now.” I know that’s working for me. I have a newer mattress. I got a few months ago which I adore. I’ve talked about it before on the show. It’s completely changed how I sleep. That in and of itself decreases stress because when I don’t get sleep, I worry about not getting sleep and I worry about not getting sleep increases stress. Just like about worrying about diets can increase stress. Worrying about stress is going to increase your stress. Worrying about your sleep so it’s that vicious cycle of “Oh, I didn’t get enough sleep. I’m not going to be able to function today.” That worry exacerbates it. That exacerbation of worry it means the next night you won’t be able to sleep well. We’ve got to have that break state. Before we hit record you were talking about the studies they’ve done around getting out in nature and how effective that is in decreasing stress in general. You obviously mentioned, “Let’s go for a walk with our dog.” What about just being in nature? Why is that so important? Why is that rather than walking down a busy city street. Why is so nature so relaxing?
[01:19:37] Dr. Tim Gerstmar: Right. We can dissect it a million and one ways but anyone who’s interested amongst to look at any of the research there out of Japan in particular and some of the Asian societies there is a long-standing ritual that is very poetic sounding it’s called forest bathing. It has nothing to do with taking a bath or slipping into a bathtub in the middle of a forest that sounds like a drug commercial that we see sometimes. Forest bathing merely means to get outside and be surrounded by nature. Whether that’s sitting and spending time in a natural surrounding or walking through a forest or being around a natural scene. There’s a lot of theories. Now we could talk about and I think this is so very cool. We know the plants breathe themselves. Opposite of us they breathe out oxygen and they breathe in carbon dioxide and we actually know that for example, if you go for a walk in a pine forest and we’re blessed to have many pines and evergreens here in the Pacific Northwest but we actually know that in that exhalation those trees there are essential oils. We know that when we breathe in these exhalations of the trees we’re breathing in trace amounts of these essential oils and other compounds and it’s been theorized that they’re one factor that’s having a positive influence on our immune system. On our nervous systems or stress levels as well. I think most of us have the experience partly it’s noise, I don’t know about you but I know for me going out in a natural scene where there’s some stillness and some quiet and you can hear the wind moving through and you’re not hearing cars and airplane sand jackhammers and all sorts of people yelling and screaming and doing all the stuff that people do. I feel personally if I spend time there I can feel my nervous system ratcheting down whereas for me if I’m walking downtown there’s people everywhere. There’s car buzzing here to and all over the place and there’s all of that. There’s lights, there’s sounds, there’s all these things going on it is profoundly non-relaxing experience for me. Evidence bears that out. There was an interesting study done in Europe as well that asked about people living in downtown areas with constant noise and the constant activity and again to our idea of normalized stress Ashley. When they’re asked these to self-report like, do they feel stressed, do they notice the noise anymore, does it bother them? They basically say no. They don’t notice the noise. It does not bother them. But when they measured their body and what was going on with their body they found that their body was indeed still reacting to those stressors from the noise and the activity and everything else that was going on. Even for people who would live there for a very long time. Again, I don’t believe – you’ll find many people out there and I hope I can caution your audience. Human beings love simple answers. The reason that we have autoimmunity, more autoimmunity and they’re suffering from it is gluten. That’s the answer or maybe it’s glyphosate or maybe it’s whatever like X, Y, and Z. It’s a traumatic childhood. You’re seeing people say The Answer, again, I caution people, there is no The Answer. There’s been a lot of changes. We live very, very different lifestyles from those of our ancestors. Our ancestors of a hundred years ago, a thousand years ago or 25 thousand years ago. We live very different lifestyles. Those changes while there are many very positive changes, I personally don’t want to go back 25 thousand years ago and live that lifestyle that our tough as nails ancestors lived back then. Along with the positives, not having to starve and not worry about a tiger eating me, there are a whole host of negatives. I think what we’ve seen in the past 50-year or so we sort of tipped over the line where those negatives have really compounded in so many ways. That’s why we’re seeing more autoimmunity, why we’re seeing more diseases in general and why we’re seeing diseases younger. I’m sure you know that type II diabetes used to be called adult-onset diabetes because it basically only ever happened in adults and they had to take away it’s not called that anymore because we see unfortunately so many kids and teens with type II diabetes these days.
[01:25:45] Ashley James: Yes, it’s just so sad. It’s so sad but luckily the listener here is enlightened and doesn’t go eat fast-food, basically do the basic American diet which causes disease. We have to think about this way that food is either causing disease or it’s healing our body. It’s either destructive or restorative. There is no neutral. It’s either building us up or tearing us down. It’s a fuel. People feel in general have disconnected from food and beverages that they look at this one little pill. We could get a pharmaceutical one tiny pill the size of a pea could give us side effects that could potentially kill us. That’s how powerful this tiny thing is the size of a pea. And yet we eat cups and cups ad cups of food and drink everyday not aware of their side effects. They’re molecules as well. That can either harm us or help us. So food, stress. I love that you point out that stress is so vastly important. That those people who lived in the cities that were studied. They became habituated. I think we become habituated to the diet reading as well. A lot of people say, “I’m not allergic to gluten or grains.” But you spent a month cutting them out, oh my gosh. I’m not allergic to them. I don’t have an autoimmune condition that I know of. My husband and I cut out gluten 8 years ago. We cut out barley, wheat, rye, and oats. What happened to us was miraculous. I lost 25 pounds of water weight and my husband, he lost something like 11 or something but what’s interesting is that our rings started to fly off our fingers. We had them actually made for our wedding. We have them made by a jeweler. We knew our wedding bands were properly fitted when we got married years before and they started flying off our finger so we waited a few months because I was worried that it would, this was temporary, right? This decrease in inflammation was temporary. After six months, we were still having our rings fly off our fingers. We went it to get resized reluctantly because my engagement ring is actually a hundred years old. It’s been passed down to my family. So I really didn’t want it to have it changed in size if not needed. So we went in and I went down two ring sizes and my husband went down one and a half, no sorry. I went down one and a half, my husband went down to two. Now I’m getting them mixed up. Either way, it went down significantly. I think I went down two because I lost more water weight. What’s funny is that we have our pictures taken for our driver’s licenses right before we went gluten free. We have this before and after. We hold it up to people when we meet them and they’re like don’t believe gluten makes a big difference. I’m like “Look we’re not celiac.” This is just pro inflammatory grains. We showed them the pictures and its like I look like the difference between Bert and Ernie. My face is round and puffy. I’m just so surprised when people go “I don’t have any problems with that. It doesn’t cause any damage.” Just try it. Try cutting out gluten for a month, try to cut dairy for a month. Then you go back to it. I had a friend call me up so angry at me because she’s Jewish and she goes, “I can’t eat bagels anymore.” She was so angry because she was habituated to gluten then she went off it for a month. She felt amazing. She got on some supplements and I gave her some health coaching. She got off foods that were pro-inflammatory. A month later her migraines had stopped but she went back to eating a bagel and she felt so sick she goes, “I can’t believe you’ve taken bagels away from me.” She’s in all just she’s very happy to continue to be gluten-free. Almost seven years later, she’s still doing it because we become habituated. We become habituated to stress. Even become habituated to sleep. I can’t tell you how many people have to told me “I only need 4 hours of sleep.” What’s up with that? Do you find that people that come to you, they just have poor sleep in general because that’s sort of one of the biggest factors that helps to set the groundwork for having autoimmune? Do most people tell you they can function on four to six hours of sleep just fine?
[01:29:34] Dr. Tim Gerstmar: It’s a mix. We get people saying things like they do definitely are people who say like “Oh yes, I sleep four to six hours and I feel great.” and you’re like, “Okay. Unfortunately, it’s design for if you will but that part of our brain, that monitors our state like our wakefulness and how we feel is one of the first to go down from lack of sleep. In the same way and this is very difficult. Again, sleep and stress we often find more difficult for more people than dietary changes. Diet is tough. Listen no doubt about it. Some people took it very easily some people don’t. Sleep and stress can be even more difficult and will often challenge people to do a two to four week challenge of getting more sleep. Whether that’s adding an hour or whatever is appropriate for their situation of getting more sleep. When they do it almost uniformly people go, “Oh my god, I have no idea how much better I could feel getting more sleep than I was.” Again, “I thought I was okay because I was used to it but I really wasn’t. I don’t have those crashes. My mood is so much better. My energy is improved, my inflammation is down.” So many of these pieces improve for people with, two things, better quality sleep is important. Like you mentioned, for example, having an old uncomfortable mattress can impair people’s quality of sleep. So you can sleep a lot quantity-wise but quality is bad, you’re not going to be getting the benefit out of it. You can simply for a lot of people, just not getting enough. A lot of people who come to see us reality admit that. “I’m sleeping six and a half hours a night. How’s that going? Well, I’m tired. I know I should sleep more. I don’t. Okay, we’re going to have to talk about that and see what we need to do to make some changes for you.” This reminds me of a point often when we’re taking someone’s history and we’re looking back through it, autoimmunity can feel like it came on overnight for people. One day I was fine. The next day I wasn’t. Sometimes things do happen. Type 1 diabetes, for example, is typically now not in the example you gave up the adult-onset, that is a little bit into type 1 diabetes but your classic type 1 diabetes, what is thought to happen is the child gets sick with a cold or a stomach bug or the immune system reacts to that stomach bug and there’s a cross-reaction that occurs. That the cells of the pancreas that produce insulin so we could control our blood sugar would close enough like that the gut bug that the immune reaction against the gut bug pivots and a start attacking the pancreas. Often that onset can be within a few weeks. The kid was sick and sort of never really recovers well and gets into the symptoms of having type 1 diabetes. But for most the majority of people, most autoimmune diseases they may say to us “Well, it felt like it just came on overnight” when we track their health back to their history often what we see are the roots and the stirrings of that autoimmunity years or decades before hand. Usually culminates what we call the straw that broke the camel’s back. That’s often a hugely stressful event. That can be a divorce, job change, going to school, some big event travel or something else that was just kind of the last straw that tipped people over into a full-blown autoimmune disease. We often see that and they’ll say, “Well, it was this trip that gave me autoimmunity or whatever the case might be and almost never is that actually the case. That was just the final straw that kicked off the autoimmunity in earnest but often will see it going on for years or decades beforehand.
[01:33:50] Ashley James: Got it. Very interesting. You talked about the paleo or the paleo autoimmune protocol. What about the GAPS diet? Have you had success with that? The GAPS diet being really about helping to restore the gut.
[01:34:07] Dr. Tim Gerstmar: Yes. Again, not an all or nothing guide. I’ve seen the GAPS diet worked wonderfully of people it’s a little more of in my experience a little bit more of logistics kind of a complicated diet with different stages in it. I find a lot of people have a lot of trouble understanding how to do the diet. How to follow it. I’ve certainly used it. I was certified by the creator of the diet to work with it. I found it be quiet helpful for people. Again, just because of the logistic I often found that people do a little bit better with paleo diets or autoimmune paleo diets. It’s just a little bit more straightforward. Yes, found that gaps diets worked well. We’ve mentioned one called the specific carbohydrate diet. It’s been around for quite a long time. Had worked nicely for people before. My biggest thing is, not that anyone diet, in particular, is the right one and all the others are wrong. The question for me is several fold. Does the diet take away foods that are problematic for a person? If it does so then they’re good to be seeing improvement in what’s going on. Secondly, we have to say, along with that diet is a gut dysfunction. You know, a very common story. I’m sure some of the listeners have heard it before is that they remove some food from their diet. Say, for example, gluten. “Oh my gosh, everything got so much better when I took gluten out of my diet. But now it’s been a while and kind of seen some symptoms have been creeping back and things are a problem so now I need to eliminate more foods from my diet. Maybe that’s okay for a while. Everything got better again great. Then it came back again now this is a problem. Now that’s a problem.” So we’ve seen people get down to this three or four foods that they feel like they can eat safely. It’s a very bad, hard place to be in. That’s fundamental because diet is one component of healing a person’s gut. But it’s not the only. For some people when they take the food out, their gut is able to heal itself. Everything rebalances and they’re in a good place but for other people taking the food out can merely be a band-aid. One of the places without actually addressing the underlying causes of the leaky gut and the sensitivity in the first place, one of the areas that I found that a number of more holistically minded practitioners really let their patients down. They run some sort of test to identify sensitivities to food or they put them on an elimination diet and they go, “Great Ashley, gluten is problem for you. Maybe whatever nuts are a problems, eggs are a problem whatever the food is that’s an issue for you. Great, don’t eat those foods. You’re all good. See you later.” It’s like we haven’t actually address the underlying factor. You have to get those inflammatory foods out to get the system to calm down. Some of those removed foods may be permanent. They may be foods you really need to stay away from or you should stay away from them. Many of those foods can be temporary. While the gut is dysfunctional and disorder the immune system is activated and inflamed, a lot of foods can be problematic. We commonly see that in the beginning, you need to take out quite a few different foods but over time as we heal the gut as things get to a better place for many people, many those foods can start to make their appearance back in a person’s diet and not be problematic for them anymore.
[01:37:58] Ashley James: I love that you brought that up. That we can go down that road of eliminating things from our diet but people can get very restrictive and that’s a level of stress.
[01:38:12] Dr. Tim Gerstmar: Absolutely. Yes, it is.
[01:38:14] Ashley James: Right, so we have to find that balance. We have to address stress. We do have to help the person figure to what diet is, the most healing way to eat for their body at that time and then help them address sleep. When you help the patient to dial in this trifecta, how long do people get results? Is it immediate? Is it within a few months? I know you can’t say like a hundred percent of people everyone always. I know you can’t say that. Let’s just say that the people who are listening right now have autoimmune maybe also have some gut issues, if they work with you, in six months from now, could majority of them be in remission? Is there that much hope?
[01:39:11] Dr. Tim Gerstmar: Again, please I know Ashley just did a good job with it, it does depend. Some people get very huge results very quickly. Sometimes, 80% of their symptoms can be improved within a month. That does happen. Is it common? No. Depends on what’s going on and all the rest. But can it make that big of a difference for people very, very quickly? It can. Often it doesn’t. Generally, here’s the timeline that we generally use for people. When we think autoimmune disease, we typically think a year of treatment. We’re confident that within 12 months we could’ve made substantial and long-lasting changes for those persons. Again, some people move faster, some people move a little bit slower but we’re generally looking at that. Often by 3 months, again ballpark figure, we’ll often see 30-40% improvement in symptoms. People would be feeling noticeably better, digestion working better, pain levels down, skin improved, thinks feeling better. By six months we’ll often see somewhere around 70-80% improvement so massive. Big changes people are feeling very different than they were six months ago. Then that final six months as often what we’re getting at last 10-20% and also critically important is when we’re cementing habits for sustainability and the long-term. We used to aim for six months of working with people knowing that we can make really major changes. In those six months what we found where we really let people down is that we would say, “Okay, great. You’re good to go. You know what to do. You’ve addressed many of those factors. Keep up the good work. Follow up for your check-up and make sure everything’s on track.” We found there are still a significant percentage of people who would backslide, their habits would come loose with life stressors and things happening in their lives. Yes, diet was in really good shape. Then things got busy and the kids went back to school and this happened. Job changes or moved. Whatever happened and the diet kind of came undone and that trifecta we’ve talked about, the sleep, stress, and diet came apart and then people started to backslide and symptoms returned. What we found is by talking that additional six months of really making sure that all those changes are really cemented, the fundamentals have all been addressed, lifestyle changes have become permanent for people. We found that after 12 months the chance of recurrence of backsliding and having things come back drops really dramatically. So our recommendation for most people with autoimmunity is going to be a plan that encompasses 12 months or a full year.
[01:42:21] Ashley James: I love it. I love that you get such great results and that you help people to sustain at themselves.
[01:42:29] Dr. Tim Gerstmar: Right. That’s the goal, right? There is a place and obviously, I’m biased as a medical professional who does this for a living but there’s a place for medical professionals. I know many people out there who have horror stories. Really terrible experiences with doctors or the medical system. I hear them every week people tell me about those stories and I understand why some people just give the whole medical system a middle finger and say that they’re just going to manage their own health. Again, we come back to that pyramid there’s a place for self-management. Your doctor , your health professional, your health coach. All of these they don’t go home with you. They don’t cook unless you can have a professional chef preparing all your meals for you which some people are very fortunate to be in that place but vast majority of us we have to get our own meals. We have to eat our own meals. We don’t have a personal trainer to be there to force us to do the exercise we need to do. We don’t have someone mom or dad telling us to go to bed and make sure these things happens. We have to be responsible for our own lives and for our own health habits. By doing that we can take our health into our own hands and we can make big changes. But there’s absolutely a place for health professionals for people who do this, who’ve gone through the training, who’ve done the work, who do this on a day to day basis. We need both of those. We need a practitioner who will work with the person and we need the person to do their side of things as well. That’s how we get optimal results. Again, it’s not an either-or, it’s an and both type of situation.
[01:44:15] Ashley James: I love it. You told me that you have some advice for those who have been maybe they like you said, have felt as though the medical system has failed them and they’re quite upset about it so they go to google and they try to get advice from great podcasts like this one, from blogs and from wiki, from all kinds of medical websites to try to help themselves. There are a million websites out there to tell you what to do. Many of them contradict each other when it comes to gut healing and autoimmune and then forms, Facebook groups. We could just go on and on. We are at a wonderful age of information and it’s up to us to dial it in and figure out what’s best for us. Unfortunately, if we are in a state of stress and we have autoimmune, we probably have brain fog because being in the sympathetic nervous response shunts blood away to logic centers of the brain so we’re not thinking straight so now we’re being overwhelmed with too much information and we don’t know what actionable steps to take. Can you tell us how can we figure out what’s best for us and what sources of good information versus maybe non information will best serve us?
[01:45:39] Dr. Tim Gerstmar: Unfortunately, there is no super easy answer and just shameless plug here, my book called The Clear Path To Health was in large part me trying to lay that out this extremely common situation. Where someone’s gone to their doctor looking for help. They’ve got one of two different things that happened. They were either diagnosed with an issue, given some sort of treatment for it. If they asked, “Is there anything else that could be done beyond taking this medication or doing this thing?” They were told “No there are no other options.” Type II diabetes again, right, you have to take your drugs it’s a progressive disease it’s just going to get worse over the course of our life. “Is there anything else that could be done? Nope. Nothing else that could be done.” A lot of people wisely go, “Hold on. That doesn’t sound right. There’s got to be something else that I could do to help.” Of course, they go to doctor google to try to look for answers or unfortunately, we hear this very often people are feeling bad. They go to their doctor. They get some tests run and they’re told that, “Everything looks fine. Nothing’s going on” or maybe there’s something going on but it’s unclear what it is. What can we do about it? Nothing. Please get out of here. You’re clogging up the office.” and people are just thrown out left on their own and don’t know what to do. Again, completely understandable they turn to Doctor Google looking for some answers.
The key piece that I think is important to keep in mind is always start with the fundamentals. To make it easy, we’ve honed in on three starting places. Three fundamentals and we’ve talked about them. Diet, sleep and stress. Does that mean that just addressing those three things will take care of everything that’s going on for you and there aren’t other issues or things that need to be taken care of? No. It does not mean that. Like what we talked about before with the pyramid. These three are the foundation. If you aren’t eating well, you’re stressed out of your mind and you’re not sleeping well. You can be taking all the supplements in the world, you could be doing all the practices, all the mediations, all the other you-name-it-you-can-be-doing-it. Will they give you some benefit? Yes. But will they give you the benefit that you’re really looking for? No, they will not. To go back to diabetes, why do MDs say that diabetes is an incurable progressive disease? Type II diabetes again, just to be clear it’s because when you slap medications on it but you don’t address the fundamentals, the medications will help but hey cannot get the root of what’s going on and they won’t fundamentally stop diabetes. Similarly, with autoimmune disease. You can read all about the latest herbs, potions, pills, patches, therapeutics, all these different things. Is there some benefit in many of them? There are. But if you don’t have the fundamentals in play, you’re chasing shiny objects. One of the things we humans are cursed with is shiny objects syndrome. Like Kosar, we like things that are shiny, interesting, sexy and the problem with me banging in the drum about food, sleep and stress is people go, “Yes, yes, yes. I got that. I know that I already sleep fine. I already eat a healthy diet. I’m not stressed out.”
The majority of people that we work with when we analyzed those factors they may or may not done a lot of great work in their diet. Often there’s a lot of various that still need to be addressed and worked with. They almost always have not properly addressed stress. Again, I want to be really clear I don’t believe in shame or blame. This isn’t about telling people they’re wrong or bad or anything else. It’s just these are things that are not taught. They’re not reinforced in our society. We don’t recognize them and some of the cures for things like stress and sleep go against the varied values that we’re taught about. Always working hard and trying to get ahead and trying to do the things in our life sometimes that we need to be doing. These factors are important and if they’re not addressed first then we can get caught up in all the shiny objects and all the new supplements and all the latest greatest testing. It comes back to making sure that your foundation is solid. The base of that pyramid is there before we jump on to other factors. Then again, shameless plug finding a good holistic practitioner who can work with you. Again, I spent years and years researching and working with these materials. It’s fairly straight forward for me to look up something going to the internet and go, “That sounds reasonable” or maybe that sounds like maybe it’ll work for a few people but it isn’t going to be useful for the vast majority of people. Can be difficult for people out there struggling through on their own. So really finding a practitioner to work with who can guide you, can really shortcut and save you a lot of time, a lot of effort, a lot of years of your life. Finding a good one. Again, in the back of my book, The Clear Path to Health, I lay out the 11 questions that you need to think about and ask a practitioner that you’re considering working with to help you understand if this is someone who might be a good fit for you. Might give you the help that you need or unfortunately might be a waste of your time money and energy and you should keep on looking to find someone different.
[01:51:14] Ashley James: I love it. Thank you so much and I know you’re doing a giveaway. It’s in our Facebook group. Listeners who would like to potentially win a copy of your book. They can go to the learn true health Facebook group. After I publish the show, we’ll do the giveaway and they can comment to enter into the giveaway. Thank you for that. I love that you have simplified things. It is very complex. There are I believe there’s over 200 different kinds of autoimmune conditions. Is that correct?
[01:51:50] Dr. Tim Gerstmar: I’ve heard varying numbers. The number I’ve most commonly heard thrown around is about a 150 but listen, we’re in a ballpark. There are many, many types of autoimmunity. Some of them are very common. They have common names. We know about them. Some others are much more uncommon or rare or even discovering that some conditions we thought that no autoimmune kind of basis are now being shown that there is autoimmunity involved in them as well. Unfortunately, for us, autoimmune disease is one of the curses of modern life. Thankfully we’re not getting chased by tigers, most of us are not striving to death anymore but we traded that for autoimmunity. Among many other things. The good news is that many of the things that are within our control that we can do can make a really big impact. For a lot of people, they need for immune-suppressing drugs, they may to need them. We’ve seen many people with a whole host of different autoimmune conditions either not need to get on drugs or be able to get off of them. Some people definitely do need them and we recommend that they use them. But again, use the whole pyramid. Don’t just start at level three the drugs ignoring steps 1 and 2. By layering in steps 1 and 2, we often need less drugs if we need them and we minimize or reduce the side effects that can happen with those drugs. There’s a lot that can be done and I hope people are taking this as the hopeful message that I’m intending it to be.
[01:53:33] Ashley James: Absolutely. It was very positive. It was wonderful having you on the show. Is there anything left unsaid? Is there anything you wanted to make sure that you cover before we wrap up today’s interview?
[01:53:46] Dr. Tim Gerstmar: Well, I think we’ve gone to a lot of really good stuff. I hope people have taken some notes or if they feel like it’s gone by in a whirlwind I hope they come back and give it a listen too. There’s a lot of good stuff here. Be aware that all of us we have the shiny object syndrome as an issue. It can be fun to research the newest latest greatest stuff but make sure before you waste your time, money and energy chasing over those shiny things that your fundamentals are being taken care of. Know that there are qualified, caring practitioners out there who can help you. We’re not anti-MD but recognize the strengths and the weaknesses of anyone you work with. No one will be able to do everything. So recognize what the health professionals in your life are skilled at and if they can’t meet a need that you have, then it’s time to get someone involved who does have that expertise who can help you make those changes.
[01:54:58] Ashley James: Dr. Tim Gerstmar, it’s been such a pleasure having you on the show today. Dr. Tim’s website is aspirenaturalhealth.com. Of course, the links to everything that he does is going to be on the show notes of today’s’ podcast at learntruehealth.com. It’s been wonderful. Thank you so much for coming today and sharing with our listeners. I hope that it fills them with hope and it gives them the clear direction for them to know that they can take step by step. In a matter of months to a year, they can see great changes in their health.
[01:55:34] Dr. Tim Gerstmar: Yes, profound changes for sure. If this has been helpful for people, please feel welcome, drop us a line on our Facebook page or send us a message. Just saying that you’ve found the podcast helpful. It always warms my heart, makes my day to know that this has made a difference in people’s lives. If you’re looking for a practitioner if you’re local in the Seattle, the greater Seattle area. Feel welcome to give us a call or drop us a line or if you’re listening from somewhere else know that through the miracles of modern technology, we can do virtual consults with people all over the States and really all over the world. There is hope and please feel welcome to reach out and contact us. You can find all of our information at our website as Ashley said, aspirenaturalhealth.com and I hope you’ll check it out.
[01:56:24] Ashley James: Awesome. Thanks so much.
[01:56:25] Dr. Tim Gerstmar: Thank you.
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