Functional Medicine Approach to Autoimmune Disease

Maya Nahra, RD: Welcome, Dr. Parke. Thanks for being here.

Dr. Emily Parke: Yeah, thanks for meeting me this morning so early.

 Maya Nahra, RD: Absolutely, yep, I think it’s a great time. Hopefully we’ll have some people tuned in for the Facebook Live, too. Welcome, everybody. We’re live on the Nuuaria page. My name is Maya. I’m the founder of Nuuaria and the Habit and Behavior Change Curriculum and program and of Heart Training.

We’re here with Dr. Emily Parke. Many of you actually know her. We work outside of Arizona, or inside Arizona Wellness Medicine right now, as Kristen is one of her health coaches, as well. We’re here to chat about autoimmune diseases today. It’s a term that Dr. Parke specializes in, but it’s a term that gets thrown around a lot, so can we dive in and dissect this, Dr. Emily? What is autoimmune diseases? What are they?

Dr. Emily Parke: Sure, yeah, sure. The term autoimmune disease is a broad category, and it’s like an umbrella for a lot of different diagnoses. The general term, autoimmune disease, means your body’s own immune system sees something in your body that’s normally normal, like an organ or a tissue, and it starts attacking it. Your body’s immune system creates antibodies against a foreign invader normally. That’s how it works when you get sick. Your immune system gets called to action, and it creates antibodies, and then it cures your infection or allergy or whatever it is that your immune system’s responding to. In the case of autoimmune disease, the signaling gets a little bit messed up, and what happens is your body’s own immune system starts attacking itself. That’s the general description.

 Maya Nahra, RD: Got it, so I guess the next natural question that just wants to flow out of me at this point is, now, of course, that’s why you exist, but why? Why does that even happen?

Dr. Emily Parke: Right, so there are multiple different reasons why someone would get an autoimmune disease. There are some genetic predispositions, and there are some actual genes associated with some of the autoimmune diseases. For example, celiac disease is an autoimmune disease of the small intestine that occurs from eating gluten. Well, we know there are definite celiac genes, HLA-DQ2, HLA-DQ8. Not every autoimmune disease has an exact gene, but sometimes we know it runs in families. That’s one thing, is to have the genetic predisposition for an autoimmune disease.

A lot of people have the genes and have pre-genetic disposition to autoimmune diseases, but they don’t ever get the autoimmune disease. The big point here is that there’s got to be a trigger or, more commonly, triggers that turn on the autoimmune disease being expressed, meaning turn it on in your body. These are all … There’s many different factors that lead up to that. This is how the environment interacts with your genes to then create a disease process itself. To give you an example of those triggers … That’s probably what you’re going to ask me next, right?

 Maya Nahra, RD: Yeah, yeah, my brain’s going straight to stress.

Dr. Emily Parke: Yes, yes! Okay, so exactly, okay, so that’s one of the big triggers. I have seen, in my patient population, just stress by itself–

 Maya Nahra, RD: Wow.

Dr. Emily Parke: Yeah, create an autoimmune disease flare. Basically, if everything is going really well, just stress, by itself, can create a flare. Now, other huge factors are nutrition, and this is one of the reasons why I’m such a big supporter and proponent of doing a paleo nutrition, and that’s because it’s an anti-inflammatory, nutrient dense food plan that takes out most of the common food triggers, too. Then, there’s something even a little bit more in-depth that takes out more foods, when you have severe autoimmune disease, called paleo-autoimmune protocol. You’ve got stress. You’ve got nutrition. You’ve got nutrient deficiencies. You’ve got toxins. You’ve got chronic infections. Those are big, broad categories, as far as things that can turn on or trigger autoimmune disease from happening. The term, stress, is a big, general term, right?

 Maya Nahra, RD: Mm-hmm (affirmative).

Dr. Emily Parke: To me, stress … Well, everyone thinks of stress as mental/emotional stresses, which is 100% true, but the term, stress, is really a term for all the things coming at your body: mental, emotional, physical. Just like I said, that there is no … It means you’re not sleeping well, if you’ve got toxin overload, chronic infection, if you’re working out too much. There are so many different factors that create the total load of stress on the body, that then can flip on and trigger an autoimmune disease.

 Maya Nahra, RD: Okay, perfect. This is good. What … I’m going to recap. For everybody who just tuned in, by the way … I see a bunch of people starting to watch, so this is Dr. Emily Parke. We’re talking about autoimmune diseases today. What are they? What triggers them? Then, obviously, how they’re impacting your life, and how to start moving forward. If you have any questions on anything, please just put them in the comments section, and we’ll be sure to answer them.

Okay, Dr. Parke, what … We talked about the triggers there for a minute, but back up for just a second. We say autoimmune diseases, and what are types of autoimmune diseases?

Dr. Emily Parke: Cool, okay, yeah. I mentioned one earlier, celiac disease is an autoimmune disease of the small intestine that gets triggered by eating gluten, if you have a certain genetic predisposition. Generally, there’s autoimmune diseases of the gut, so there’s celiac disease. Then there’s also Crohn’s disease and ulcerative colitis, right? Those are the three autoimmune gut disorders, the top ones that you think of.

Then there’s other autoimmune diseases, like rheumatoid arthritis. That’s related to the joints, and the joint deformations and joint pains and muscle aches. Then there’s a category of other musculoskeletal disorders, like lupus, mixed connective tissue disorder, scleroderma. There’s a bit list of autoimmune diseases in that category. I’m not going to name them all.

Then, there’s other central neurological autoimmune diseases, like multiple sclerosis is a big one, of course. Then, the one I see the most, which is the most common autoimmune disease in my practice and probably in most people’s practices, is Hashimoto’s thyroiditis. That is … You and I did a good video session, interview session, about thyroid disorders and Hashimoto’s before, but that’s a very, very common cause of hypothyroidism. You can also have the opposite. You can have Graves disease, which causes hyperthyroidism and overactive thyroid. I didn’t name every single autoimmune disease under the sun, but those are the most common ones that are out there.

 Maya Nahra, RD: Yeah, yeah, yes. Autoimmune tends to be this … You work with this every day. I tend to be more on the outside, just from the habit, behavior change, nutrition perspective, but it’s a wide open space, it seems as though. It seems as though that patients that we’ve seen with autoimmune diseases and disorders, it’s almost … There’s a level of — what’s the word I’m looking for? — it’s almost helplessness, like I’ve tried every route, and I don’t know what to do. In your opinion, of course, and I have my own opinion that it is actually healable, so to speak. Talk to me about the trajectory. People don’t actually have to live with this, right?

Dr. Emily Parke: Yeah, totally. On the traditional side of medicine, and again, I’m doing functional medicine, so I’m not … I’m getting a lot of the patients that went the traditional route and either didn’t get any better or want to get off the medications or had side effects from medications and can’t take them anymore. I’m getting the patient population that wants, is looking for, something different. Of course, functional medicine’s all about finding and treating the root causes of whatever signs and symptoms are going on.

In the case of autoimmune disease, this is no different. Just like I talked about at the beginning, our job in functional medicine is to really figure out what all of those triggers are, so that we can start reversing each of those things that turned on the autoimmune disease in the first place. Autoimmune disease is largely reversible. I say the term reversible because … Well, there’s two things. One, reversible means that if you … We can make you feel a lot better, and we can reverse a lot of the changes that have happened, but the term reversible and not curable is on purpose, because if you go back to doing what you were doing to trigger your autoimmune disease, it will come back, right?

 Maya Nahra, RD: I see. I see. Okay, that makes sense. There’s the triggers, of course, with the genetic predisposition. If the triggers are turned on, so to speak … As we mentioned the triggers, stress, nutrition, nutrient deficiency, toxins, chronic infections, that kind of stuff, so if we go back to any of those triggers, so this is something that, potentially, it’s in the background, but a life cleanup is required.

Dr. Emily Parke: Absolutely, absolutely. Now, in certain autoimmune diseases, if they’ve been going on a long time … For example, if someone’s had rheumatoid arthritis for 20 years, they’re going to come to me with joint deformities that aren’t going to really be reversible, because the joints have already been destroyed. If someone’s had Hashimoto’s thyroiditis for 30 years, they might not have much of a thyroid gland left, because it’s been destroyed, but we certainly can still get people feeling a whole heck of a lot better, because, by decreasing those circulating antibodies … When those antibodies are floating around, it’s not just about the thyroid or the joints. There’s symptoms of all kinds all over the body, and so people really do feel a whole heck of a lot better, once you find and treat all of those root causes.

 Maya Nahra, RD: Back to the root causes, completely agree. I’m getting the full picture here. For those of you, who just tuned in and are watching, this is Dr. Emily Parke of Arizona Wellness Medicine. We work very closely with Dr. Parke, because there’s in habit behavior change, of course. As you know, we have to have a plan to move forward, and then there’s the implementation of that plan, and the long-term habit and behavior change, because most of us know what to do. It’s just a matter of actually doing it.

When we’re in the face of chronic disease, when we’re in the face of autoimmune diseases, these things, quite literally, have to be followed, and if we’re met with any resistance in our lives to actually following it, we’re not going to get the health that we’re looking for. The point of that question was, Dr. Parke, tell us what is the difference … You touched on this, of course, but what’s the difference then between, say, a regular medical doctor versus you practicing functional medicine?

Dr. Emily Parke: Sure, so I did go to traditional medical school, internship, residency, fellowship, so I’m fully trained on the traditional side. Then, of course, I got trained and certified in functional medicine. The difference is in traditional training, and again, I did it all, so I very well know it, they really teach us what drug do we have? What procedure do we have to treat the signs and symptoms that patients have? Really, the thought process on finding and treating all of the root causes, getting to the bottom of the why, is unfortunately largely missing from our medical education, like the importance of nutrition, sleep, exercise and movement, stress management, is really missing from traditional medical school.

Of course, there’s a mention of nutrition, like, “Oh, if you’re overweight, hey, you should probably cut your calories,” or, “Oh, if you have type 2 diabetes, cut down on your sugars and carbs.” It’s almost like a side note, instead of the main event, which it should be, because nutrition, sleep, exercise and movement, stress management are the foundations to health. That’s key and central in functional medicine.

Then, other concepts that make us a little bit different in functional medicine are that we tend to have a lot longer visits. A new patient appointment is 90 minutes with me. We care about, not just your health history in a vacuum. We care about your whole life history, because, as we’ve talked about already, there is such a huge mind-body connection, and so we really do get to know people really well in the process of functional medicine.

Then, of course, there’s the advanced laboratory testing that, again, is missing from traditional medical school. We also look at things through the lens of wanting to get to optimal health or optimal ranges, not normal. If you do a traditional blood work panel from your primary care doctor, first of all, they’re only going to check probably a handful of things. Again, it’s not their fault. I went to regular medical school, too. It’s how we were trained. If everything looks normal, you’ll be told exactly that, everything looks normal. Well, in functional medicine, we look at normal versus optimal, where you are in that range, how it’s affecting your health, and what we’re going to do about it.

 Maya Nahra, RD: Yes, yes, absolutely. I want to … Which, by the way, for those of you watching, just stay tuned. Hold on, for just a second, because I want to go into Dr. Parke’s generalized recommendations for autoimmune diseases, but there’s something that I want to mention first, and it’s very important. I want you to think about this differently.

Here’s how I want you to think about this kind of medicine, is that it’s not supplemental, and it is not — I don’t know — woo-woo, so to speak. It’s not like … This is the next era of medicine, and this is how we must think about it, is that functional medicine is moving into a place where we are looking at the root causes. I’d go as far as to say, us, here at Nuuaria we’re the next era of nutrition, because we know what to do. It’s going to be very important that, if autoimmune disease is something that you’ve lived with for a long time, that you don’t have to live with it. This is one of the reasons that we’ve partnered with Dr. Parke on a really exclusive level.

Kristen, our dietitian … You know Kristen. She is inside Arizona Wellness Medicine as the health coach there, as well. What happens is, when you go see Dr. Parke, she’s going to give you that recommendation, and you combine health coaching sessions with functional medicine. That’s your first step. Then you can go through the protocols and get done what needs to get done. We help you through that with food suggestions and meal suggestions. Then you move into habit and behavior change naturally, because we need that piece where it says, “I know what to do, and I’m feeling better. I’ve reduced these autoimmune triggers in my life. Now, how do I actually maintain it?” meaning that something important will happen, and that’s called life. It’s called stress, anxiety, falling off the wagon, mother-in-law, Saturday nights.

These things are just going to happen, and if we don’t learn how to think differently, change the all or nothing thinking, perfectionist thinking, trying to control things in a future that we can’t control, that ultimately drives behavior. That’s what we do at habit and behavior change. That’s why this whole combination is not … It is the next era of medicine, because this is what’s going to get you back to that happy and healthy and whole you that’s truly the truth of who you are.

All right, Dr. Parke, let’s talk about, so, autoimmune diseases. We talked about what they are and the triggers and what types. We know that it is reversible, and we have to reduce those triggers, so kind of like a blanket statement with autoimmune, and I know that this is a big one, but what would some generalized recommendations be?

Dr. Emily Parke: Sure, so I want to actually back up to something you mentioned.

 Maya Nahra, RD: Okay.

Dr. Emily Parke: Okay, so yeah. For those of you who’ve never heard the term functional medicine, I have my training and certification through the Institute for Functional Medicine, and back in 2014, the Institute for Functional Medicine paired with the Cleveland Clinic, and there’s been the Cleveland Clinic Center for Functional Medicine since 2014. The Institute of Functional Medicine is there, comparing traditional healthcare costs and outcomes to functional medicine healthcare costs and outcomes. The preliminary data on it, so far, has been really amazing.

To your point of this is the next era of medicine in that center at the Cleveland Clinic, the Cleveland Clinic Center for Functional Medicine, it just keeps booming and growing. They keep having to grow out of their space and get a new, bigger one. There’s an over 2000 patient wait list there now. Then, in the functional medicine training, everything was very evidence based, very research based. There is a reference for their research virtually behind everything they are saying on every single slide of every lecture. To your point, it is …

It’s two things. It’s the modern medicine, but it really actually … It’s the modern medicine in the fact that we’re ahead of the research curve a little bit. It takes, on average, 15 to 20 years from the time something comes out in research before it’s truly implemented as standard of peers. That’s one thing. Then, I also feel like functional medicine’s the old medicine. It’s what medicine used to be. Your doctor used to know you. They used to come to your house. They knew your whole life, everything about you. It’s that combination of the two things there. I hope that helps.

 Maya Nahra, RD: I love that. It’s traditional medicine, and then ahead of the curb to create that new standard of care. I think you and I are on the same page with this, and we’ve had discussions.

Dr. Emily Parke: Totally, yeah.

 Maya Nahra, RD: In order for our world to move forward, because we’ve got more obesity, heart disease, and diabetes than we’ve ever had before, more stress-related, habit-related diseases than we’ve ever had before, and something new is needed. We need to change the trajectory of medicine. It’s happening now, but it’s extremely important that we start seeing it that way.

Dr. Emily Parke: Yes, and so, and then the other thing I wanted to talk about briefly is habit and behavior change.   Well, I see exactly what you described in my practice all the time. I have my autoimmune disease patients. There’s a category of people that I can give them their entire roadmap to health, their plan with nutrition, sleep, exercise, stress management, their nutritional supplements, what they’re supposed to do. Everything’s very personalized.  There are a small percentage of people that can take that and go with it, and they’re good, but that’s the smaller percentage.

 Maya Nahra, RD: Yeah.

Dr. Emily Parke: I would say the larger percentage are in two categories. They’re in either the category of they really never are able to fully implement the plan, or, what I see a lot is people implement their plan, and they’re feeling better for a few weeks, a few months, a few years, and then, just exactly what you said, life happens, stress happens. Then, X-Y-Z part of their plan starts falling apart, and then their disease starts to regress. Depending on what kind of autoimmune disease you have.

I’m going to give you a perfect example. One of my MS patients describes it beautifully. It’s like whether she sticks to her nutrition plan or not makes the difference to whether she needs a wheelchair or not. I mean, it’s that profound.

 Maya Nahra, RD: Wow, wow.

Dr. Emily Parke: Yeah, so this is a big deal. One of the reasons I love working with you guys at Nuuaria, with having behavior changes.  People also have to learn that they don’t have to be 100% perfect 100% of the time, right? It doesn’t have to be stressful. One thing you guys do beautifully is you get patients’ health habits on the same level as other habits that people do on a daily basis, like brushing their teeth or tying their shoes, as you’ve mentioned as examples before. It’s getting those health habits onto a level where it’s not a stress. It’s not like, “Oh, my God, I’ve got to meditate today.” It’s just happening.

 Maya Nahra, RD: Right, right.

Dr. Emily Parke: That’s just so important for the longevity, especially of an autoimmune disease patient, but lots of other diseases apply to that category, too.

 Maya Nahra, RD: Huge, completely agree. Yeah, it’s really a matter of a life change for sure, and so we work with just in the beginning basic habit loops, when we want to change the physical habits and behaviors. There’s cues, routines, and rewards. The human mind, the human brain, is wired to always choose pleasure over pain, and simply that means we choose the less painful option at all times, and so it’s not right off the bat that someone says…I mean, even in that wheelchair example, sometimes we choose the food if it is some kind of form of pleasure or more pleasure than the wheelchair, so we quite literally have to start shifting, and it shifts to become this effortless choice.

It’s easy and effortless for me to not reach for sugar, because I feel better and have found more pleasure in the not having of it than the having of it. That shift has to happen, but in the beginning we tend to fight ourselves. That’s one key point in habit and behavior changes. We help you to just reduce your resistance until you get to that threshold and move over, where it is easy and effortless, but only first because you’ve reduced your resistance. Most of us tend to use willpower un-strategically and force ourselves to the other side in the beginning.

Dr. Emily Parke: Right, yep, yep. Then, the beauty of combining it with functional medicine is then we’ve got all this wonderful data from the advanced laboratory tests. I think patients also find it really motivating when you’re like, “Look, your thyroid antibodies came down. Your thyroid function is better,” or things that are very like, “Oh, look, I’m reaping the benefits and I know I feel better, but look, my labs are better.” They’re reaping the rewards of their hard work. I think that is a good, nice, positive reinforcement, as well, not just, “Oh, hey, these are things I should do, because my doctor said I need to do them to feel better.” It’s like, “Look, no, you’re actually getting better.”

 Maya Nahra, RD: I love it. I completely agree. It just popped into my head. I think it’s appropriate time to ask, but you have the same amount of passion that I do, but why do you do functional medicine? Why do you do this?

Dr. Emily Parke: Yeah, yeah! I did traditional medicine for years, right? This type of medicine is really all about true healing and changing someone’s long-term trajectory in life. I mean, I think your answer’s exactly the same, right?

 Maya Nahra, RD: Mm-hmm (affirmative), yes, definitely.

Dr. Emily Parke: You were in the traditional side of being a registered dietitian also. I think both of us loved our careers and everything, but there was just something missing. It really wasn’t as rewarding. I think, obviously, both of us have our own stories as patients on the other side, too-

 Maya Nahra, RD: Totally.

Dr. Emily Parke: And frustrations with the traditional side. Really, that’s why I’m sitting in the chair I am now, instead of on the traditional side. I had my own frustrations as a patient, and I had my own frustrations as a doctor taking care of patients in the past, also. I just knew there was something better, more permanent, so to speak, out there, to really help people heal, instead of just giving out a pill for a Band-Aid, or instead of you giving out, “Here’s your food portions and here’s your calendar,” right? There’s a way bigger picture out there for permanent habit and behavior change, and for optimal health and healing really. That’s the gist of the why for me.

 Maya Nahra, RD: That’s amazing and perfect. Yes, I love it. I wanted you to share that. Cool, for those of you who are just joining and watching, we’re talking about autoimmune diseases. My next question for Dr. Parke, and then I’m going to stay tuned, because I’m not sure with just where you want to go with it. If this plagues any of you, in terms of celiac, gut health, Crohn’s, ulcerative colitis, rheumatoid arthritis, lupus, multiple sclerosis, Hashimoto’s, Graves, these are all types of autoimmune diseases. Dr. Parke, tell us what are generalized recommendations that you would have?

Dr. Emily Parke: Oh, perfect. Yes, you did ask that earlier.

 Maya Nahra, RD: That’s fine.

Dr. Emily Parke: There’s the big categories of nutrition, sleep, exercise and movement, stress management. On the nutrition part, the very first recommendation is going to be to get yourself moving towards more of a paleo type food plan. Again, it’s because it’s anti-inflammatory, nutrient dense. It stays away from processed and packaged food items. It really just gets back to eating whole food, real food, that’s very healing to the body, number one, and number two, takes away the most common food triggers that can contribute to flipping the autoimmune disease’s switches on.

Nutrition is paleo. Then, of course, if you have more significant autoimmune disease and/or if regular paleo is not enough, you can go to the next level, which is paleo autoimmune protocol. That is a little bit more restrictive than traditional paleo. Then there’s actually even a third level that was designed actually specifically for neurological autoimmune disease, like multiple sclerosis, called the Wahl’s protocol, that gets even more restrictive. About 80% of the time, traditional paleo works really well, so I don’t have to really use any other further restrictive food plan very often, but it definitely is out there, and I do have some patients that they needed to do a paleo AIP, autoimmune protocol, in order to really get better.

 Maya Nahra, RD: I was just going to mention that. When you see recipes that say AIP, that’s what that is.

Dr. Emily Parke: Yes, exactly, autoimmune protocol. Traditional paleo takes out the grain family, so gluten, of course, but it takes out grains of all kinds. It takes out dairy, soy, legumes. Peanuts are a legume. They’re the only nut that’s really not a nut. Corn is a grain. Then, of course, it takes out sugar. As I mentioned, too, it takes out all the processed and packaged food items. A paleo plate is just real food. Half the plate should be non-starchy vegetables of some kind. Then there’s a serving of lean protein, a serving of healthy fats, and then, especially at dinner, a serving of either starchy veggies and/or some fruit. It’s nothing weird or odd. It’s just getting back to eating regular food.

 Maya Nahra, RD: Right.

Dr. Emily Parke: Nutritionally, that’s the top recommendation. There are other factors that are huge, too, for instance, getting enough sleep. Not getting enough good quality sleep is a huge stress on the body. In my patient visits, we talk about all these factors every single time, because it’s so important. If someone has a situation, where they’re not getting enough good quality sleep on a regular basis, that’s a big stress on the body. That’ll affect the adrenals and the thyroid and the sex hormones and the immune system. Then, as you know, on the food side, it’s like food cravings, and you’re not making great choices, and it has a huge waterfall effect.

There’s nutrition, sleep, and enough good quality sleep really means, on average, somewhere between seven and nine hours of sleep at night, but that number varies from person to person, so you have to figure it out yourself. How you do that is it’s the number of hours of sleep that you wake up and you feel pretty refreshed, like, “Oh, okay.” You could just pop out of bed and do anything.

 Maya Nahra, RD: “I feel human again, yes.”

Dr. Emily Parke: “I feel human again,” exactly. There’s nutrition, sleep, and then, of course, there’s the exercise and movement part. They are two separate categories. The movement piece really refers to that magical 10,000 steps a day that’s been pretty well steady. Of course, if there’s limitations in actually walking the 10,000 steps a day, there are substitutes, of course, swimming or biking, things like that. It’s getting your daily movement in. This is just less sitting, more standing, more walking around. That’s important.

Then there’s the exercise piece. The current recommendation is at least 150 minutes a week of moderate intensity exercise. That’s for optimal cardio-metabolic health. Then, with each patient, we can get even more specific on exercise recommendations if we need to. For brain health, it may be more high intensity interval training. For diabetes, it might be more lifting heavy weights, with some high intensity interval training, and so on. Honestly, the details are less important. I always tell people, the best kind of exercise is the kind you’ll do.

 Maya Nahra, RD: Yep, we say the same thing, yep.

Dr. Emily Parke: Right? It’s like whatever is motivating to you, whatever you like … If it’s a Zumba class, go for it. If it’s a spin class, if it … Whatever, because doing the exercise is more important than the details on the what. I can prescribe you the details. For people that are at that level and can do it, great, but just doing it is most important.

 Maya Nahra, RD: Yep, when you have least amount of resistance to face.

Dr. Emily Parke: Yep, and then, of course, there’s the big stress category that we were talking about earlier. This is why I really emphasize a daily relaxation practice to my patients. The biggest, most well-studied one, is really meditation. Meditation works better than medications for many things, but it doesn’t have to be meditation. It can be meditation, deep breathing, yoga, Tai chi, Qigong, whatever it means … taking an Epsom salt bath with lavender oil, great. I’m very interested in people having a daily relaxation practice, because it’s super important to keep your nervous system balanced.

Here’s why. It’s because the sympathetic nervous system is this fight or flight, stressful side of the nervous system. This is being overstressed. Then there’s the parasympathetic nervous system, which is the rest, relax, digest side of the nervous system. Things like meditation help lower the sympathetic nervous system, and they raise the parasympathetic nervous system. It very much decreases your stress hormones, which are the things that float around. Cortisol, for example, is one of your body’s main stress hormones and can have so many damaging effects on the body.

We know that high cortisol does affect the immune system. It lowers your immunity. It then has effects on, like I was mentioning earlier, on other things like your thyroid hormones, your sex hormones. It can affect blood sugar balance. It can affect body composition directly, as high levels will store fat and waste muscle, at the expense of storing fat.

It’s not just, “Yeah, yeah, yeah, I know I should relax more. I know I should meditate more.” There’s like true, true and true, medical research and medical benefit behind the daily relaxation practice.

 Maya Nahra, RD: Huge, huge. I’ve seen it and experienced it firsthand, which I think we both have.

Dr. Emily Parke: Yep.

 Maya Nahra, RD: Excellent. Thanks for that.

Dr. Emily Parke: Nutrition, sleep, exercise and movement, stress management, those are the big foundations to health. That’s where anyone with an autoimmune disease should start. They should start their journey there. Then, of course, if they want to get more specific, more in-depth, then they’re going to want to find a practitioner that can do some advanced laboratory testing on them, so that they can really dig out all of those root causes.

 Maya Nahra, RD: Yes, yes, perfect. Perfect segue to exactly what I wanted to mention. The reason that we, at Nuuaria, have partnered with Dr. Emily Parke, at Arizona Wellness Medicine and Functional Medicine, as well, is … Here’s your trajectory. Here’s your 10,000 foot overview, because there was a lot of information in this, so we’ll be sure to recap it all. We’ll put … I’ll make sure around this video someplace is both Dr. Parke’s information and our information.

Here is the trajectory in what you’d want to do. Of course, at Nuuaria, we do health coaching and habit-behavior change program, a curriculum. A lot of habit-driven diseases: diabetes, obesity, heart disease, that kind of stuff … You want to be health, in general. We’ve partnered with Dr. Parke. Of course, if you have any of these autoimmune diseases that we spoke about and wish to get healthy and reverse them, yes, it is possible. We’re looking here at the first thing that you’d want to do, of course, is schedule an appointment with Dr. Emily Parke.

We’ve partnered with Arizona Wellness Medicine. We can include functional medicine visits with Dr. Parke and health coaching together. That’s the first thing you’re going to want to do, just basic health coaching, because you’re going to get this plan, and we’ve got to start implementing your plan. We can harness the power of our all or nothing, so to speak, for a little while, get us on the ball. Then you want to move into, with Arizona Medicine, with our habit-behavior change. You want to move in a habit-behavior change program with us. That’s going to help you stay on track for the long-term. Something that’s also incredibly important to stay on track for the long-term, and I just gave a lecture at Arizona Wellness Medicine on Thought and Emotional Habits, is that in habit-behavior change, our thoughts drive our emotions, drive our behaviors.

In order for the behaviors to stay permanent, when we work the path of least resistance and our steppingstones to create habits, we want to make sure that we’re actually changing the perfectionism thinking, the all or nothing thinking, catastrophic thinking, trying to control things in the future you can’t control. There’s something important that happens, and I say this from experience and having coached for 12 years, is that oftentimes when we feel physically bad in the body, and I’m sure you’ve seen this, too, Dr. Parke, we can become our disease in a way that is not preferential, so to speak. When you wake up every day and-

Dr. Emily Parke: Yeah, identity, becomes your identity, and right.

 Maya Nahra, RD: Bingo. If we’re waking up every day and saying, “Am I sick today? Yes, I’m sick today. Am I sick today? Yes, I’m sick today,” you rode in that cycle, and you can feed … It’s the equivalent of feeding your body Brussels sprouts, but feeding your mind and emotion candy bars, and we expect to get healthy that way. We’ve got to get a zero wobble in all of these areas. When it becomes your identity, that’s a very dangerous place to be. That’s another reason that you’d want to tack on habit and behavior change to your functional medicine. Yeah, I love it. Anything to add here, Dr. Parke? Anything you want to add?

Dr. Emily Parke: No, I think we covered quite a bit.

 Maya Nahra, RD: Yeah.

Dr. Emily Parke: Yeah, as Maya mentioned, the reason that we paired together, that I’ve got her in the practice, integrated, is because I can create all these awesome plans, but the long-term follow-through, or for some people even just getting start, is a bit overwhelming, and so health coaching, and then especially the Habit and Behavior Change Curriculum really helps patients implement long-term. I tell people this at their visits all the time. I’m like, “It’s the long game. Here are your long-term goals.” I don’t expect you to start doing everything 100% perfectly by the time you come for your first follow-up visit, for example. Really implementing the long-term health changes are what are going to really help people to stay. Get healthier to begin with, and then stay healthier, because as people progress in functional medicine, the goal is to get you to a point where you don’t need me. You’re coming in once or twice a year, and we’re checking your labs, and we’re staying ahead of the curve.

Same thing with you guys, right? It’s to get you to a point where your clients aren’t going to be ingrained in a hardcore program, because eventually they’ve got it. Now, there’s going to be ways to stay plugged in of course.

 Maya Nahra, RD: Mm-hmm (affirmative).

Dr. Emily Parke: There’s ways to stay plugged in once or twice a year, or people can stay connected with you, but the goal is to get people to the point where they don’t really need to see me often.  We’ve taught them, and they know how to do it themselves, basically.

 Maya Nahra, RD: Absolutely, absolutely, and knowing that this autoimmune disease is just anything that has been the, the … What’s the word I’m looking for? The diagnosis, thank you. The diagnosis is not who you are. It’s not an identity, and it certainly is reversible. I’ve found, in my own life experience, it’s the difference between wanting and deciding that we’re going to make a change.

Dr. Emily Parke: Love that.

 Maya Nahra, RD: I’ll make sure we put all of the information here. This was such good stuff. If you just joined us, make sure that you stop this video and go watch the whole thing, because we talked about what are autoimmune diseases? We talked about the triggers that turn the on, the types of different autoimmune diseases, how it is indeed reversible, and then Dr. Parke’s general recommendations. You’re going to want to go through the whole video, because it’s super informative.

Call Dr. Parke’s office, Arizona Wellness Medicine, to find out more information and schedule with Dr. Parke. Of course, there is always a complimentary 15-minutes consult with me at Nuuaria, to learn more about habit and behavior change, as well. We’re here to help. That’s the intention for both of us. Thanks, everybody for watching today. We hope that this was helpful for you. Dr. Parke, thanks for your time today.

 Maya Nahra, RD: We totally appreciate it. It was perfect.

Dr. Emily Parke: Thank you, as well. Have a great day.

 Maya Nahra, RD: You, too. Have a good weekend.