Ep. 94: Navigating Health: Transforming Autoimmune Conditions with Nutrition and Self-Care - A Midlife Conversation with Andrea Nakayama

When midlife and autoimmune disease collide, it can feel like navigating an uncharted wilderness. Yet, Andrea Nakayama's personal triumphs and profound expertise in functional medicine nutrition light up the path to wellbeing. This episode is a treasure trove of insights, as Andrea shares her own journey with Hashimoto's disease and how she's turned adversity into advocacy for those wrestling with chronic illnesses. We also talk about an ingenious life hack—a medical planner—that could revolutionize how you keep tabs on your health, and Ellen's enchanting mason jar fairy lights to add a sprinkle of magic to your evenings.

Tackling autoimmune diseases requires more than just medication—it's about understanding the symphony of factors that play together in our bodies. In this heartfelt conversation, we unravel how diet, lifestyle, and even our mindset shape our health landscape. Andrea eloquently describes the 'tree of symptoms,' urging us to look beyond the branches and explore the roots, diving into the worlds of genetics, digestion, and inflammation. We also dive into the practicalities of managing conditions like lupus amidst the challenges of medical gaslighting, emphasizing the importance of self-trust and the art of narrative medicine.

In our quest for optimal health, Andrea reminds us of the three pillars of nutrition: fat, fiber, and protein. She guides us on how to balance our meals for our gut's sake, harmonize our hormones, and fortify our overall health. The conversation culminates with actionable steps—simple yet transformative dietary and lifestyle adjustments that can have outsized impacts on autoimmune disease management. As we share Andrea's wisdom, we illuminate the path for anyone seeking to reclaim their health, one mindful bite at a time.

Obsessions:
Tish: Medical Planner
Ellen: Colored Mason Jars outdoor lights

By listening to this podcast you agree not to use this podcast as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. The  Positively Midlife Podcast is presented solely for general informational, educational, and entertainment purposes only. 

Transcript

Ellen: 0:21

Welcome back to the Positively Midlife Podcast. Today we're going to talk with Andrea Nakayama, a functional medicine nutritionist, all about dealing with autoimmune disease and the impact that menopause in midlife may have on these conditions.

Tish: 0:39

You know, over two decades ago, our guest Andrea, husband, was diagnosed with a brain tumor and given only six months to live. This news came while she was pregnant with her first and only child, and then Andrea herself was diagnosed with Hashimoto's disease.

Ellen: 1:00

I mean, it's hard to fathom what that situation must have been like and she turned her passion for nutrition to provide the longest and healthiest life for her husband, herself and her child, and that is what led her to where she is now.

Tish: 1:18

You know, I've always admired when someone can turn such tragedies into a life passion that affects change, not just for themselves but for others around them.

Ellen: 1:29

So true, tish, and as someone with an autoimmune condition I have Hashimoto's I am really looking forward to talking to her today. But before we welcome her to the show to share her personal story and what she's learned along the way, and some things for our midlife listeners, let's get to our obsessions. You know I love this part. What do you got for me this week?

Tish: 1:51

Well, this one I have is a medical planner. It's called the Clever Fox Compact and what I have found is because I have like several long going issues and stuff like that, and when I see a new doctor and try to especially when it's not in my network and try to like remember dates and times and places and symptoms and all that, it becomes overwhelming. So I've decided that I'm going to start recording everything in my medical planner. I can take it with me If I'm having issues. It allows you to chart those things. It's really it's really meant for like a year plan. So say, you are somebody who is affected by ongoing condition. This might be a great way to condense all that information to one place that you can also bring with you to your doctors.

Ellen: 2:45

So is it digital or is it a physical thing?

Tish: 2:48

No, it's a physical thing. It's a physical thing, so we'll put a link for that.

Ellen: 2:54

I'd like that. You know I have still a paper day planner that's very small that I use pencil on. So I think some of us that aren't digital native the paper things feel better. Tish, I like that.

Tish: 3:07

Yeah, backup, you know. So, yeah, and I think you know, putting everything down because you're going to have to, you know, condense this information from several places. So, yeah, that is my obsession this week. What about you, Ellen? What's yours?

Ellen: 3:23

Well, I always love how different our obsessions are, but you know I am so into spring and I know we're going to have an episode on spring cleaning here coming up. But I'm getting my back patio ready and I have this love of mason jar lights and you know what I did last year is I got a couple and I left them out and they got rusty. But this year I found a multi-color six pack and they can hang also in the trees. I have this beautiful Magnolia tree I'm going to hang them in. So I just think that these are the number one way you can freshen up your outdoor space. So I'm going with mason jar fairy lights again, but a different kind.

Tish: 4:08

Yeah, yeah, I like those because it brings you outside at night. You know Again, anytime we can get ourselves out into nature. I think it's just going to make us feel better.

Ellen: 4:21

I agree Again. We'll have the links in our show notes, but let's get to it. I am so excited to speak with our guest. Andrea is the host of the 15 minute matrix podcast and she founded the functional nutrition alliance. That leads a revolution to offer better solutions to the growing chronic illness epidemic, and this is so common for midlife women.

Tish: 4:46

You know, Andrea's work really highlights the importance of systems biology, root cause methodology and therapeutic partnerships. She's helped historically underserved individuals reclaim ownership of their own house.

Ellen: 5:06

Welcome to the podcast today. We are so glad to have you with us because it seems like at least half of the women I know have an autoimmune condition. Andrea, can you share a little bit more about yourself and your background with our listeners?

Andrea: 5:20

Yeah, thank you for having me. I feel like I'm sitting down for tea. It's very nourishing.

Ellen: 5:26

Thank you for having me.

Andrea: 5:29

As you mentioned, my journey into the healthcare realm really came from a family health crisis when my late husband, Isamu, was diagnosed with a very aggressive brain tumor. I was seven weeks pregnant at the time of his diagnosis and he was given about six months to live, and it really came out of nowhere. There were not any signs that we could see, and this is a worst case scenario. When you go to the emergency room with a headache, it is very rare that it's a brain tumor and so this came out of nowhere for us. So I had already had a kind of obsession of my own with good quality food and cooking. I lived in the Bay Area at the time. We'd have these elaborate dinner parties and shop at the farmers market.

Andrea: 6:22

So I really turned my attention to food, and not food to fight the cancer, but food to support his body in all it was going through, so that it could influence the cancer but also help him mitigate any of the interventions that he had to go through and there were many. So that became sort of my boot camp. Meanwhile I'm pregnant, so I'm having to nourish my own body through extreme stress to really manage all of the whole family to be as healthy as we could be. So this is a long time ago. Isama was diagnosed in April of 2020. He died in the summer of 2022, so about two and a half years later, when our son, who's now 23, was 19 months old. So this is some time ago, but that really fueled my passion for the powers of dietary and lifestyle modifications for those who are sick and not getting better, and recognizing where there were many gaps in our healthcare system in working with those who are chronically ill. So there's a long story.

Ellen: 7:37

There's a lot of you.

Andrea: 7:38

So thank you for allowing me to tell it.

Tish: 7:41

Were his doctors at the time talking about nutrition, or was this something that was just kind of born out of where your passions were and your attempts to keep him as healthy as possible?

Andrea: 7:54

Yeah, I mean, if you can imagine the world of oncology period and then we get to neuro oncology, you're working with people who see the brain not connected to the body. We can now well know that the brain doesn't exist in a vacuum. We know the gut brain connection. That conversation wasn't happening in 2020. So his oncologist brilliant oncologist at UCSF in San Francisco was very open to anything else we were doing, but wasn't the one talking about it and part of I think, like we see in breast cancer, because women kind of take the charge, it's much more integrative. Oncology as a practice isn't very integrative in most of the other areas, if that makes sense.

Ellen: 8:43

I definitely think it does make sense. And did you feel being in the Bay Area at that time kind of opened you up to more of these types of you know the kind of lifestyle?

Andrea: 8:57

Yeah, I mean I think that there's definitely. We were part of a foodie culture. I worked in publishing, I worked with a lot of cookbook authors, so that culture of eating good food, not necessarily healthy in the way that we came to see it and I'm putting healthy in quotation marks because that's changed for me over time but we learned a lot. I started reading about the impacts that different foods could make on the body and on the body's ability to reproduce cells that we don't want it to reproduce, to tame inflammation, which we do want it to do. So one of the first things we did was to remove sugar because of some reading I was doing.

Andrea: 9:44

Now, isamu was a very intelligent, very headstrong person, so he was doing all the medical research. What trials? He was like a, you know, a desirable test case, so all the people around the country were contacting him with their clinical trials because he was a 32 year old man with a tumor at that point that we didn't usually see in younger populations. Now we are seeing it in younger populations, but it was a tumor typically seen in an aging population and so he was very desirable for everybody's clinical trials because he would understandably do better on their trials. So he was having to do that research, which is the right thing, and that's where I started to do a different body of research and bring information to him. Look, sugar feeds growth, cell growth in the body. The fastest growing cells in our body are cancer cells. What do you think of removing sugar? And he had a sweet tooth but he automatically was like no sugar.

Andrea: 10:52

So we went for a long time, and then I started to understand more about glycemic levels and lower glycemic sweeteners, so I could feed our sweet tooth or his tooth and not have the same negative effect that refined sugar could have on the growing cells and also on the inflammatory cascade in the body.

Ellen: 11:21

You know, it sounds to me like you were really passionate about this side of supporting your husband's illness and, coming from that foodie culture, I know you two were diagnosed with an autoimmune condition. Can you tell us a little bit more about that?

Andrea: 11:40

Yeah. So when we think about autoimmunity, it's definitely a case where we're understanding that the body's defense mechanism has turned on itself. And when we think about autoimmunity, I always think about three roots, and this is my current thinking, looking back at the past. So those three roots are our genes, our digestion and our inflammation. There are key triggers that are going to set all of those roots into motion and lead to our own body's immune system attacking certain cells or tissues in our body, and one of those big triggers is stress.

Andrea: 12:21

Another big trigger is pregnancy, because our bodies are going through a lot of hormonal changes at one time. So here I was going through both of those things in a heightened fashion at the same time. So that cascade that was already kind of blueprinted for me, but that does not tell me it's going to happen, was triggered into a state where, after Esamu died a couple years after, I really started to experience some symptoms that I couldn't figure out. I didn't know what was going on. Again, in those days Hashimoto's was not as prevalent or well understood as it is today.

Andrea: 13:03

So, there was a lot of searching for me to understand why my body wasn't quote unquote performing or responding the way I was accustomed to it. Having done before that and that's where I stumbled upon my own research I was first able to identify my mom's Hashimoto's and then recognize this is what's going on for me as well.

Tish: 13:31

Now, do you think that the reason that, like 80% of the people that are diagnosed with autoimmune disease are women is because of our hormonal changes?

Andrea: 13:41

There's a lot more going on in our bodies for sure. So, yes, there is a much higher prevalence of autoimmunity among women, and the hormones definitely play a role in that, and the changing hormones and also you know a lot of. I think the hormones are the biggest difference in our body internally, but then there's cultural and other things that we're managing externally that also put on extra stressors, especially in today's day and age. I'm seeing women just have different challenges than they ever have in the past.

Ellen: 14:17

I'm 57.

Andrea: 14:18

I look at my friends and my peers and I think like, wow, we're dealing with things that our mothers did not deal with in terms of life stressors. So it's a combination of the external environment and the internal environment and where those two things meet and that's what makes it functional.

Ellen: 14:38

You know. I just want to share that I was diagnosed with Hashimoto's when I went to seek some hormone treatment here in menopause and they did a very full blood panel. I have probably had this for a long time with absolutely no idea of what it was, and so I also think that women, the way we react is like let's power through something, let's go. I might be fatigued, I may have swollen hands or like, but we're like, that's it. I got to, got to, you know, run the home, got to do the business, and maybe you could speak a little bit to that.

Andrea: 15:18

Yeah, I think that that's absolutely true. We're taking on more and more. We are experiencing, I think, more, like I said, challenges in later life and I also think to your point, Ellen, we are looking for either we're either powering through or we want to fix. So we also live in an age where there's a lot of noise out there on the many highways that we go through and work through that, tell us that there is one way to do something that it worked for so and so.

Andrea: 15:53

It'll work for us. Do I need that supplement? Oh, that's what's going on for me. There's a lot of self-diagnosing. I love what you're doing, Tish, with your obsession, your medical diary.

Andrea: 16:05

I'd love to talk about time-lining and functional nutrition, because that's so critical and we're so reliant these days on quantitative data. We're looking for those lab tests. If we don't get them, we're angry. We're angry that our doctor won't run the right tests. We're experiencing menopausal symptoms. We want to know what's the fix, what's the diet, what's the supplement? Should I go on bioidenticals? And the truth is, we are just much more complicated creatures than that, and so I feel like it's kind of a confluence of added stressors that we're experiencing as we age Complicated internal responses and then this desire to suppress.

Andrea: 16:50

Ellen, as you were talking about power through and then, only, when it gets to a tipping point, raising our hands and going what's the thing? What's the thing that I'm supposed to do?

Ellen: 17:01

Yes, and it's not one thing. Like you said, and it may not be fast, and I have heard that right, it's definitely not that fast fix. Go ahead, tish. I know you have a question, sorry.

Tish: 17:14

No, I was saying like I. When researching this, I was shocked when I realized there's over a hundred different autoimmune diseases and I'd like for you to kind of address some of the more common ones. But can you explain, for those that don't really understand, what is an autoimmune disease and how are they diagnosed?

Andrea: 17:35

Yeah, so they're all different. So it's there are some autoimmune diseases that don't have a standard diagnosis. Quote unquote. Luckily for Ellen and I, hashimoto's is actually somewhat easier to diagnose if the right tests are run in a serum labs, which our doctors will do. There is a number of other autoimmune conditions, like MS, for example. That is a cluster of things that lead us to a hypothesis that it's a diagnosis. So really, when I think about autoimmunity from a functional nutrition perspective, I'm looking at the diagnosis as a branch and I'm going back to those three roots. So let me just explain what I'm talking about there, because I'm not somebody who has the the it's not within my scope of practice to diagnose.

Tish: 18:31

Right.

Andrea: 18:31

Contrary to what my mother believes, it's not. I can look at labs and be able to suggest it looks like you have antibodies to your thyroid. Let's get a diagnosis.

Andrea: 18:45

But even that diagnosis doesn't lead us to the fix. And this is the problem with chronic health challenges that just because we get a label doesn't mean we have the answer. There is no fix in classic what we modern medicine for anything chronic. It is designed to deal with acute situations and thank goodness because there are a lot of those, but we do need to think differently about chronic issues. So when I say branches, if we think about Ellen's garden and that Magnolia tree and we think about the spring blossoms on the Magnolia tree, it was a Magnolia right.

Ellen: 19:25

It was, you got it.

Andrea: 19:27

Think about those blossoms. And we're looking at this tree and it is just sitting in so much magnificence and we're astounded by the magnificence of the Magnolia tree. And then we get closer to it and we realize that there are some leaves that are turning brown, that some of the flowers are dying sooner than they should, that some of the branches are starting to turn, the bark is not looking healthy, and we're really struck by the impulse to do something to help this tree.

Andrea: 20:02

So we can get a ladder and pick off leaves and flowers. We can get a ladder and a saw and saw off branches. Or we can take a different approach, and anybody who cares for trees likely knows we have to get down to the trunk, deeper, down to the roots, and even deeper than the roots, to the soil.

Andrea: 20:23

So in functional nutrition, no matter what the sign, the symptom or the diagnosis and I'm sure we can list many- related to community autoimmunity and hormone imbalances, we still need to come back to those roots and that soil, and so for me, the three roots are always the genes, digestion and inflammation. And then I've identified the circle of influence or the soil around each of those roots, which helps direct our attention as patients, because when our attention is on the branch, we're not going to find results when we shift our attention to the roots and the soil, we start to be better partners in our health care.

Ellen: 21:10

I mean this is amazing just for the kind of the mind shift, the pivot that I'm experiencing right here in this conversation. I'm sure you are too Tish and I think about looking at the genes, looking at digestion which is something totally new, that around your gut health, I think for a lot of us and inflammation. Would you suggest that women go back and look genetically in their history? Does your mom have an autoimmune condition? Or would you say that gut health is one the place to start?

Andrea: 21:49

Yeah, so the place to start is also really individual, because we have different relationships with our bodies, with our family histories, with diet or making dietary change, and I really like to take a moment to honor that. I've worked with populations of people who can't talk about food for a long time because any conversation about food removing, adding is triggering, and so I like to really honor the individual in all aspects. But when I talk about genes, yes, I love if we can know our familial history. I've worked with adopted folks who maybe don't know their familial history, and that's okay. I also don't think we have to run out and get genetic testing.

Andrea: 22:42

The information that we know from genetic testing these days is it's not so helpful, it's not predictive.

Andrea: 22:49

It may be helping us to see what's possible, but certain genes cancel each other out.

Andrea: 22:55

There's something called polygenomics that's getting a lot more attention. That helps us understand that if you have this gene and this gene, then this gene A isn't activated, if gene B is there, but we wouldn't know that, and so people are going around thinking you know, I'll just throw out the common genes. They may not be popular to your audience, but I have an MTHFR or I have a calmed gene. We don't know if that's turned on or off, up or down, and so I prefer to think about the soil around that gene root, which is what we call the epigenetics, and that's food, movement, environment and mindset, and those things are the factors that are going to influence the expression of our genes, and that's where we have more influence versus control, overlooking at our genetic blueprint and going man, I'm screwed or I didn't win the lottery with my genes. Well, we all have the opportunity to influence our genes, and food isn't one thing, movement isn't one thing, environment isn't one thing, mindset isn't one thing.

Andrea: 24:08

It reminds us to constantly be kind of massaging the areas that influence our genes.

Tish: 24:16

It kind of goes back to what you were saying. It's not a single solution, this isn't a vaccine, it's not a one pill and it's done and each person's gonna be different and, like I was saying, there's so many. I was shocked when I learned that type one diabetes is considered an autoimmune. I was surprised that MS is considered when rheumatoid arthritis, I mean lupus. Those are, I think they're more in my mindset, but there are so many. There are so many.

Andrea: 24:50

And what they have in common is that our immune system, which is designed to protect us, has turned on us. Autoimmune just means that our immune system is attacking part of our own body, our tissues for Ellen and I, the tissues in our thyroid are being attacked when instigated to do so, and the immune system has memory cells, and so we've trained our body to remember to attack itself by mistake. If you think about somebody who has a severe allergy, they're hyper reactive to something outside the body and with autoimmunity in its simplest way of thinking about it, we are hyper reactive to attacking inside the body, and once the body has that mechanism turned on, it's more likely to do it elsewhere. So if we attack our thyroid, if we don't kind of manage that, unfortunately the immune system will have more of a propensity to exercise that over reactivity elsewhere. I like to think of it as like when you're surprised, like when you go right, that's what our immune system is doing to ourselves, like it's constantly in this hyper vigilant state where it's going well.

Andrea: 26:16

That's not a good thing. That's not a good thing. But that thing is us. We want our immune system. So for me, on that third route of immune, we have genes, digestion and inflammation. Inflammation is an immune response and the circle of influences clear, calm, enhance and modulate. So that's pretty broad. But we just think about clear and calm. Calm is really critical because that's not a calm state and the body can't heal in that state. That's called a sympathetic, dominant, fight or flight state. We need to come in to rest and digest, to heal.

Ellen: 27:05

And do you find that there is a difference now in your 50s, from in your 30s, when you were first diagnosed with an autoimmune condition?

Andrea: 27:17

Yeah, I'm going to knock on wood and say for me it's better because I understand myself more and because I understand my non-negotiables, my personal non-negotiables, more, and so I can recognize when something is off for me. And this again, tish, is where that medical planner like understanding, knowing, time-lining, recognizing what are the things that are triggers for me, not the big life triggers but the daily triggers I can recognize them better. So I'm post-menopausal. I was able to get through menopause without too much challenge.

Ellen: 28:04

Again, knock on wood wherever I was.

Andrea: 28:08

I think that's because of all that I was doing I have experimented with bioidenticals I can tune in really easily and be like not working. I know I need that, but really really fine tune that, what I call interoception, that understanding of listening in as opposed to all the noise. So different because I'm different and I've had the opportunity to work with thousands of women and kind of get this mirrored back to me what works and what doesn't.

Tish: 28:46

But before we get too much further, I know there are a lot of challenges of getting diagnosed. I think back to a good friend of mine years ago who went to doctor after doctor after doctor and finally she was given a diagnosis of lupus. But people were trying to put her on medications, saying basically she was crazy and I know that's probably a little better, but I know there's still a lot of challenges. And especially when, as we're getting older, into midlife, how do you know that it's not just a common symptom of getting older, but rather that you do have a medical condition?

Andrea: 29:28

Yeah, I mean this is where a lot of the evolution of my work is going in terms of understanding that piece of interoception, how we tune in what gaslighting is when we experience it.

Andrea: 29:42

What you're talking about is not being heard, and that's a form of medical gaslighting. Right, when you're saying and I had the same experience something isn't right, something isn't right, and I would go into the most well-meaning doctors, naturopathic doctors, and they would say, well, it must be adrenal issues because you lost your husband. That's like an external story. You lost your husband. It must be that you have stress, hormone dysregulation, so we'll treat it like that. Well, that didn't feel good. I knew something wasn't right, and so finding a provider who will listen to you sometimes these are not our medical providers. We might need other people to affirm, and that's why I'm treating an army of people who can understand. This is what I'm seeing. Let's find the person who can recognize this and put a label on it. The truth is, the label, like I said, doesn't come with a solution, and so the label might be a relief that we finally know we are not crazy.

Andrea: 30:51

And if we're feeling something we're not crazy, but it doesn't come with the solution. It might come with a piece of the solution, but more of the solution. Unfortunately, when we're diagnosed with an autoimmune condition, is going to come back to the risk and reward decisions we make every single day. So, Tish, I think it's a matter of trusting yourself. Now something isn't right. Where do I need to go.

Andrea: 31:19

I think it's also how you show up with the information that you are expressing and how you are a better partner in your own health care, and we do that with medical journaling, we do that with time-lining. I like to ask people if you understand a sign or a symptom? When was the first time it happened? What do you know makes it feel better or worse? When you go in more informed, you're going to be met with a better listening ear. The other thing I just want to point out is that we tend, as patients, to conflate signs and symptoms. The doctor doesn't hear those two things in the same regard. So a symptom is something we're feeling that they can't measure.

Andrea: 32:08

A sign is something they can measure. So they can measure a sign if you're unconscious, but they don't know if you're fatigued and have a headache.

Tish: 32:17

Right.

Andrea: 32:18

When we separate. I'm experiencing these signs and these symptoms. This is what I notice makes a difference. I've been trying to figure it out. When we show up with the expertise that we have, which is in ourselves Nobody else has that expertise that's when we're met with a better listening ear from our partner, ideally who? Is our provider, who has the powers, quote unquote to give something a diagnosis, which unfortunately isn't the end game.

Ellen: 32:51

Right. I feel like, as women, hearing this is so empowering because I know Tish and I have both had medical gas lighting. I mean, I don't think there's any midlife woman out there that hasn't been gas lit at some point in our 50-something years. But I think that idea of awareness, of time lining, of journaling, going in informed to a meeting like this is maybe new information for some of our listeners and for some of us. I happen to be in Marin County where this kind of mindset is much more familiar than, say, some of my family that's maybe on the East Coast or in the Midwest. So I have to say that being able to really dig deep and understand yourself, not being disconnected from your body, really going deep, is one of the key things I've heard you say in this conversation.

Andrea: 33:56

I love that, ellen, that reflection, and, like I said, this is where my work is taking me more into the overlap between what's called narrative medicine, which is a newer practice, and functional medicine. I worry that nobody wants to hear it.

Andrea: 34:13

This is work right, like we want the quick fix, and so I just want to point that out, because there is a desire and a chronic noise that everything can be better if we're intermittent fasting, go into ketosis, take bioidenticals. And I'm not saying that there aren't benefits to different things, they're just true but partial.

Andrea: 34:41

I don't agree with those earlier things that I stated, but there's no easy answer here. I don't know one person who's opted for bioidentical hormones and had an easy time of it. It's often a back. You have to be working with somebody who's willing to find your unique cocktail, and that's not how medicine is set up. So I just want to put it out there that it's a journey and it's actually a lovely journey because it's about us. But it's interesting.

Andrea: 35:17

going back to what you were saying, ellen, how much we want to run away from ourselves, mask what's really happening, and that's true in the healing journey as well.

Tish: 35:31

You know, I do have one question what if you think you have an autoimmune disease? Are you starting at your primary? Are you going to a specialist? Because in healthcare right now, doctors are outlawing smaller and smaller bits of time for your appointment and to go into all these symptoms. And you know, I see a lot of pushback. I would see a lot of pushback that they're going to just say, hey, take this antidepressant, Everything will be better.

Andrea: 36:06

Absolutely so again, I'm going to give us, as patients, a little more work. So this is where I think we can show up and best utilize that time. If we are able to collect information, we have the data to bring in to have a quicker, faster conversation. So when we're prepared for that dialogue, we're going to be able to get through it more quickly instead of being in the emotion of it.

Andrea: 36:38

And unfortunately, our medical appointments are not a time for a lot of emotion. Like you said, if there's seven, 12 minutes, there's not a lot of time. We can get our emotional support elsewhere, but we have to really be strategic about that time. So the more we're prepared and we've gathered the information, we can also call in a advance and say I'm having some talk to the front desk or whoever is there and say I'm having some challenges I need to talk through with the doctor. Is there some way I should schedule more time? Can we alert the doctor to the fact that I'm struggling with some of these symptoms? What do you recommend? So you've given them a heads up.

Andrea: 37:18

But here's an even harder thing I'm going to ask people to do, and this is to get your information from your portal, which exists these days your past labs and start to make your own charts. So we have a lab tracker at the Functional Nutrition Alliance. You can do that on an Excel sheet or a Google sheet. Just put in the numbers. You don't need to know what they mean. But what I want you to do is see where there's a number that looks drastically different than the time it was run before. Get your labs run the regular old serum labs that your primary care doctor is going to run every single year at a minimum, and just go back five years and start tracking. Then you're coming in going. I don't know what this is, but why did this change so much? Could this be related to? Their job is to do no harm, and if we put the information in front of them, their job is to do no harm. If we don't, they are not being asked to step up in the same way.

Ellen: 38:25

Yeah.

Andrea: 38:26

I see that preparation.

Ellen: 38:28

I do too, and I think we have to be curious about ourselves, about these numbers, about the changes, and I hear that advocating for ourselves. I love this functional tracker. I think we should put a link to it in our show notes and I do think it's this connection with our life on a bigger level Right, I mean, the blood work could be one part of it but really understanding what's going on and connecting it. I want to just pivot just a little bit here and talk about these four things you mentioned food, movement, environment and mindset. Maybe we can chat a little bit about food, because I think the role of nutrition in managing an autoimmune disease is huge. Where would someone start?

Andrea: 39:24

Yeah, so I like to make this broad. So I have three primary principles that I like us to apply in nutrition, as opposed to rules or theories. I don't believe in dietary theories because they're one size fits all and we get trapped in them and then we do them for short time. So those three principles and I do speak in a lot of threes, so that's kind of one of my ways of putting things into system.

Andrea: 39:52

The first of the three is fat fiber protein. Now, eating fat fiber protein at every single meal is going to be good for our gut. It's going to be good for our hormones. When I think about the hormones and we're talking about menopause, I'm making a little pyramid with my hands here. Our sex hormones, our estrogen, progesterone, testosterone is at the top of the pyramid. But that pyramid has ways to get to the top. We can't start at the top. The bottom is blood sugar balance, and then our insulin, and then our cortisol, and then our thyroid and then our sex hormones. If we're trying to address our sex hormones top down, we're never going to find resolution.

Andrea: 40:39

So again, fat fiber protein helps with our hormones, it helps with our immune system, it helps with our gut, where most of our immune system lives, and nobody should be talking about nutrition without talking about digestion, because it's where the two shall meet.

Andrea: 40:54

So again, fat, fiber, protein, every single meal. Principle number two is to eat the rainbow. Not only do we get more of that fiber, but we get a lot of different nutrients that the immune system needs, that our aging bodies need, that really help us to find the balance within. The third principle is what I call a yes, no, maybe list. This is where it becomes really bio individual, meaning that, alan Tish, you may have different foods where you're like oh my gosh, when I eat that food I'm in the bathroom all day or I get an immediate migraine or I bloat like I'm pregnant. So this is where we get to knowing that interoception what are my yes foods, what are my no foods and what are my maybe foods, where maybe I'm not sure. Sometimes it happens, sometimes it doesn't.

Andrea: 42:00

And again, that place of collection allows us to be in discussion with anybody who does understand nutrition. That could be helping us through what we're trying to figure out there. And I just want to talk into the two extremes there. I'll either see people who say I don't know anything. That makes me feel bad, but they never feel good, so they're always in pain, but they're like that's not my food. So there's some denial.

Andrea: 42:34

Yeah tracking and understanding connections.

Tish: 42:38

I've been in denial about how bad sugar is for me.

Andrea: 42:41

That's my denial. You're not alone, I promise you. And the other end of the spectrum are people who are so tuned in that they're not healing on the inside and they're attributing every sign or symptom to food. And then they develop a conditioned food hypersensitivity where they're reactive to everything. And that's because they haven't done the inside healing. They're just looking for food to be the only self.

Ellen: 43:12

Right, the only answer. I really love these three, and I think we need to put these in our show notes too. I think, though, sometimes we find women who feel like they're doing all the right things, but they're still talking about lack of energy, brain fog, chronic pain. I mean, what would you say to somebody who feels like they're living a balanced life, they're minimizing stress, all of these things? Where would you go with that kind of person?

Andrea: 43:48

I mean, this is my favorite person because I call them the big bigs. They have maybe a big diagnosis, but they're doing all the things, so they're already taking all the steps. So the first thing I really like to do is go a little bit deeper to see. Is that true? Is that the truth? I'm going to bring in one person that I was working with in my case study group recently and she comes from a health coaching background. She has two autoimmune diseases, hashimoto's and alopecia. She does CrossFit, she climbs mountains, she eats a paleo diet. But when we took a look and just did a little food mood poop tracking which she was willing to do not everybody is I could see she was eating more of the kind of paleo fast foods, like a lot of the almond flour tortillas and the cereals, and so, without saying that to her, I was like let's try some different breakfasts, let's get some fat fiber protein into some breakfast and see how that supports you.

Andrea: 44:55

Through the work together, she was also able to identify where her work situation was really really stressful. She felt really unmet, really unseen, under chronic stress, and she started to think differently about what was possible for her, even at this stage in life, which I'm seeing more of changing careers or changing the location of her career. She did a lot of work on her digestion because she was like I'm fine, I'm doing all the things, but you know what? I'm still a little constipated. I don't have a good poop every single day. So we focus on some of the things that we may be kind of glossing over in favor of what we might think is the answer. Do I need more new tropics or am I taking the right fish oil? I mean, I have friends who will text me. I saw this on Instagram. Should I be taking this? I asked why do you want to take that?

Andrea: 45:58

And they say you know they pull in all the benefits that are from the Instagram ad. And I'm like but aren't you already taking an X? And they're like yes, and I'm like same thing.

Tish: 46:10

Right.

Andrea: 46:10

You're a little different, like what do you think you're looking for and do you need more rest? I've worked with people who have chronic fatigue and we talk about hydration and going to bed a half hour earlier and they're like wait what Nobody ever talks to me about those.

Andrea: 46:31

And, physiologically, when we're dehydrated, our blood doesn't flow the same. That impacts a lot of things related to our heart, our brain, our ability to rest, our iron markers, and so sometimes I like to call it the simplicity on the other side of complexity. I understand the physiological function, but yet we can't overlook some of the things that we think. I'm doing. All the things and yet wait a minute, yeah, I don't hydrate really well because I'm nervous about going to the bathroom all the time.

Tish: 47:10

Right, or I think. I think midlife also brings a lot of. It's like going through another adolescence. Your body is changing, so so fast. So what worked for you premenopause is not going to work for you. So how much of an impact does menopause have?

Andrea: 47:31

Well, aging has a big impact on the immune system, and I think that's something we have to recognize. And then the hormones have a big impact on the immune system. So immunosynescence is a term that speaks to the immune system, and senescence, which is aging cells and organs, boom. It's true, our organs and cells have been through more quote unquote trauma or more impacts as we age more influences and they don't perform as well as when we're young.

Andrea: 48:09

Plus you have the drop in estrogen and progesterone. Both play a really critical role in our immune function, so it does have a role. That doesn't mean we have to throw in the towel and make it like it's well this is happening.

Tish: 48:26

I mean we'd all like to reverse aging Right, all like to, not the fountain of you, the secret of the fountain of you.

Andrea: 48:34

Exactly, and there are things that we can do to slow the aging process in the brain with our energy at the cellular level. It's not about being perfect. We're going to. We have to live our lives. We get to live our lives like we're in our fifties. We're going to live our lives Right.

Ellen: 48:55

Yeah, we always say, if not now, when right? It is the time to start if you haven't been living your life on that.

Andrea: 49:05

Exactly, Exactly. So I don't think it needs to be this highly restrictive. I just ask us to tune in at a different level and recognize we are aging, like having lost a husband at the age of 34. And I have a mom who just turned 85. I'm like this is lucky. This is not something that we have to deny, Like how do we embrace this opportunity to know more about ourselves?

Tish: 49:39

to tune in more deeply what are some holistic approaches that midlife women can look into to dealing with these autoimmune diseases?

Andrea: 49:51

Yeah, I mean for me the hormones and the immune diagnoses. They're all branches, like the hormone symptoms are branches too, in our Magnolia Tree model. They're just branches, so it doesn't mean they're not going to happen. But how do we influence them? And again, those three principles around food. I have another three, which I call the three tiers of nutrition mastery. Tier one are the non-negotiables. Tier two is deficiency to sufficiency. Tier three is dismantling dysfunction. What the doctor does is tier three work. What we've gotten trapped in is tier three work, and so do I Fixed, dismantled this dysfunction for me now and what I'm saying is no, you're non-negotiables.

Andrea: 50:37

I call a non-negotiable trifecta sleep, poop and blood sugar balance. So those are key. Leading back, you can see how all the systems kind of overlap each other, and I know you had a great conversation about sleep on the podcast. So sleep poop, blood sugar balance tune in. Where do you need some help? Get that specific help instead of looking for the help that is at a higher level.

Andrea: 51:03

That isn't addressing that underlying piece, because pooping is the most homistic way to manage our hormones. Blood sugar balance the most. Sleep poop, blood sugar balance. If those aren't in place, again you're on quicksand, because poop is where we detoxify our dirty estrogens, the estrogens that are in excess as we age. So estrogen isn't bad. There are different kinds of estrogens and our body metabolizes them differently, but one of the ways we get rid of the stuff we don't need that circulates and leads to more symptoms is pooping. So when we think holistically, to me it's like it's not a supplement and not saying that the supplements aren't in the picture. That's the deficiency to sufficiency, the tier two in the arena, but non-negotiables sleep poop, blood sugar balance.

Andrea: 52:02

And then each of us have our own non-negotiables. I need to be out in nature, I need to walk every day, I need to make sure my brain is engaged and I like to listen to a lot of podcasts and put information together. So I have Andrea non-negotiables, ellen has her non-negotiables. Those are the holistic approaches. We do us yeah, and we do us better.

Ellen: 52:34

And I think that's every woman's responsibility and to really look inward and to own their own life and how they do it, to tune in, as you said. You said tune in and I think that is really important. I know so many women who have gotten to midlife without tuning in to themselves. It's like waking up and tuning in, so important. We like to ask each guest to share what their superpower is with our listeners, and I know Tish and I are curious about yours.

Andrea: 53:10

Well, that's a great question and I was like what's my superpower? I think my superpower is synthesizing information. I really liked I think of myself as a renaissance thinker so taking information from different fields and understanding how they help us to understand complexity in a better way. So I'm going to say I'm a super synthesizer.

Tish: 53:36

Albumist, just this little time knowing you. I absolutely would have to agree with that, because I love this message that you've been giving the whole podcast through of there's no one single answer, and I think there's so many practitioners and so many people out there. I've got the answers. This is the only formula, and I like your approach that that's not the case. We're all so different, so I would say that is your superpower.

Ellen: 54:04

I agree, I agree. And if there's one piece of advice or one thing, one point that you'd like our listeners to take away from our conversation today, what is it?

Andrea: 54:17

That's a rough one because there's so many little pieces, but I think it really is this piece of agency tuning in. When you find yourself looking for an answer, take a pause. I think that our answer is in the pause and in the ability to say what do I really need in this moment? And so I'm going to offer that, as it's not as sexy as Take Magnesium. I think it is really where we each tap into what it is that will drive us forward.

Tish: 54:59

I love that. I love that, that's great.

Ellen: 55:05

Is there a way that we can share how our listeners could work with you if they're interested?

Andrea: 55:11

Well, I have the website andrianapyamacom, and that's where I have current writing that's more geared towards the patient. That will also lead you back to the Functional Nutrition Alliance where I train practitioners. I have a team of nutritionists that work with the patients. I personally don't work with patients anymore, but I am doing more workshops through Andrea Nakayama. So andrianakayamacom will lead you to all the different places that tap into the opportunities and lots to read in both places as well.

Tish: 55:48

Awesome. Yeah, that's great. Well, I want to go ahead, oh no.

Ellen: 55:53

I was just going to say thank you. So much I learned. I mean this has just been really opening for me. It's really opened me to be so much more curious and, as you said, to take that agency for myself and really tune in.

Tish: 56:12

Yes, and I want to just thank all of our listeners for tuning in and until next time, I want you to keep finding the positives in midlife.

Ellen: 56:24

That's right. Until next week, midlifers.