how the food can really affect our mood. Even within a couple days of changing what we eat, that can affect our gut health and we can start producing more neurotransmitters, reduce inflammation and improve our mood.

So food, gut health and mood, that connection there is really profound. And just by doing a few simple things like cutting down on the sugar, getting more fiber, Couple basic tweaks to work with your doctor or whoever you're working with on diet can improve that inflammation and help with our mood, whether it's depression, anxiety, sometimes even sleep issues.

This is Doctor Talks, real talk from real doctors on the issues that matter to you most. Hello, I'm Dr. Monica Harigee. You are listening to Truly Healthy MD podcast.

Today I have Dr. Nelsa Anderson-Chiponi She is a medical doctor, IFMCP, very good credentials to have, because those are the same credentials I have. So Dr.

Nelsa, she's board certified in both family medicine and functional medicine. She's a graduate of Duke University and completed medical school at the Medical College of Pennsylvania, now called Drexel University.

She completed her residency in family medicine at the University of Connecticut in Hartford, Connecticut. Having practiced family medicine for over 30 years, She has a special interest in preventative and functional medicine, which is full-person approach to addressing the underlying and root causes of illness instead of just treating symptoms.

Her other areas of interest are chronic fatigue, GI issues, and holistic weight loss. I bet your practice is full, because who doesn't have fatigue, GI issues, and needs a little bit of weight loss?

She combines evidence-based traditional and integrative functional medicine to help people achieve lasting wellness and improve quality of life. Dr. Nelsa is committed and passionate and a passionate advocate for preventative and integrative functional medicine.

She continues advanced studies in these areas as well as providing community education. She's fluent in Spanish, An animal lover and lives in Charlotte with her husband and has two grown children and a grandson.

How old is your grandson, Dr. Nelson? About a year and a half. Aw, that's amazing. So cool. So welcome. Welcome to Truly Healthy MD, our podcast. I'm really excited to talk to you today.

We're going to be talking about mood and food. I love this. How we can boost our mood by enhancing gut health today. This is such an important topic because we're obviously all needing to eat every day and mental health is like, it's just dismal in our country.

It's, it's so bad. It's so bad. And so if we can put those two things together, right, if we can use our food to get better mental health, just imagine what we could achieve.

So I really love this topic that, that we're going to talk about today. So welcome. First of all, I wanted to ask you the, what's the relationship? People think of, you know, they go and eat their food and then they're in a bad mood and they don't put two and two together.

So how can we help people understand the relationship between gut health, what they're eating, their mood, this whole gut brain access that is a really interesting thing.

How do you explain that to your patients so that they can get to better mental health and more well-being? Well, thank you so much, Dr. Monica. I just want to say thanks for having me, and it's a pleasure to be here.

And I agree, I'm on the same page with you. We're not really taught this much in conventional medicine, right? You know, when I, of course, when we went to med school, I don't think things have changed all that much.

It's, it's pretty much if you've got depression and somebody may need a prescription, correct. But it was pretty much, that was the only treatment. It was either an SSRI or a prescription plus counseling.

And it really never entered my mind. The idea of food affecting mood until we get into functional medicine and we learn about more of the relation between the whole body as a whole.

And then more specifically, I think what really opened my eyes and mind to this was reading a study on the Mediterranean diet, lowering the risk of depression and anxiety.

And that really kind of opened the floodgates of food and diet can affect your mood. And of course, we know as we get into it that food is affecting the gut health.

One of the major things that affects gut health and that in turn is going to have an effect as you mentioned that gut brain access in a way that we're starting to understand more and more.

There's now hundreds of studies on food and mood and this concept of neuroinflammation and how that is all relating. Yeah, yeah. It is cool to see all the new scientific studies that are coming out.

And I love that we're being able to implement them. It's a little bit sad to me to see that where we have all the scientific evidence and a lot of our colleagues who aren't adopting these are not, you know, really helping their patients understand that connection.

So it's, it's so, so, so important to bring more awareness to this topic. I'm so glad that we're talking about it today. So, so what, what is, how, how do you explain it to your patients, that relationship between the gut health and our mood?

Well, we come at it as, as you and I kind of deal with the, with functional medicine, we're often dealing with inflammation in whatever the issue is, right?

So when somebody comes in, it's often, as we know, it's not just depression. They may not be sleeping well. They often have gut issues when we dig into it a little bit more, but if they are coming in for depression, then we can use this concept of inflammation, you know, chronic systemic inflammation.

And that's where I start talking about how the gut health is really important because if there's inflammation going on in the gut, then that can erode the lining.

We can get to some gut permeability or leaky gut situations. And then as we say, what happens in the gut doesn't stay in the gut. So chemicals and cytokines, et cetera, can travel to the brain.

causing some inflammation in the brain and this is how it can affect mood. So this is kind of what I explained to them that if we're eating something unbeknownst to us, a diet that is creating some inflammation, then that inflammation in the gut and those maybe small IBS symptoms that they might not even think of could actually be causing some inflammation and worsening their depression, which is the number one mental health disorder in the whole world.

Absolutely. I think it's, yeah, that's, that's, it's probably very validating to your patients to understand it that way, because I think mental health is so stigmatized in our society and our medical system that people think something's intrinsically wrong with them when they're depressed.

If we explained it to them from a more biochemical standpoint, that this is, this is inflammation, it's cytokines. These are things that it's not something that's wrong with you, there is something biochemically going on that we can't absolutely fix.

So I'm sure that people are very happy to hear this explanation, right? Yes, yes. I mean, of course it's always, you know, in addition to, right? I mean, if someone has had significant traumas and they may need to see a trauma-informed therapist and be working through that.

But, you know, the concept that this could be an adjunct or if it's mild depression or mild anxiety and people don't want to get on medicines, then maybe we can use this alone.

So it's kind of part of that armamentarium that we talk about or tools in the toolbox, but it's a bigger piece than I was ever taught or realized. And I think most people don't realize that the symptoms are mild or moderate, that this can make a big difference on how they feel with depression, anxiety, and even sleep, because it's all related in there.

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Yeah, absolutely. And I think it's, it is important to make clear to our public that you and I are both medical doctors. We both have been certified through IFM and we do integrative medicine, which doesn't mean that we just, instead of giving people an SSRI, we instead ask them to meditate and just do food.

All of that's great. We integrate all of that. We just have a wider toolbox than we used to have before we got our integrative functional medicine training.

Um, and we, we continue to, and when it's needed, we absolutely prescribe medications. I, sometimes people accuse me of being against medications, against Big Pharma, I think Big Pharma has brought a lot of good things to modern medicine, and I use it appropriately, but I try very hard not to overuse it.

Yeah, or you and I tend to see some of those people that say that they're sensitive to numerous medications, and they've tried, by the time they come to us, many people have already tried numerous meds, and either they don't work or they have side effects or they're looking for something else.

And previously, I really had nothing much else to offer. So that now that we have some other tools, it's exciting to be able to pull from this toolbox, as you said, and say, well, have you tried this?

Let's look at this so that we can really personalize it and see what's going to work for that person. Absolutely. It's a much more empowering way to practice medicine, both for the physician and for patients.

I like to say that I used to really dislike treating anything that had to do with mental health when I didn't know about integrative medicine, because I just felt like it was, you know, people have a symptom that is their diagnosis and they have a pill for that.

Right. It just, I didn't feel like I was really helping people. And now that I've learned so much about integrative medicine, I understand there's so much more to that.

They have a symptom. That symptom is not really their diagnosis. They have that symptom because of a root cause and we need to figure out what that root cause is.

And then the root cause, we can obviously treat the symptoms at the same time. That's totally valid, but we don't stay at that superficial level of just treating the symptoms.

We try to get to the root cause, treat the root cause. It has so many more layers and we actually help heal people instead of just telling them, take this pill.

It's going to make you feel better, but not really healing them. So it's very, very empowering. So, so yeah, I love this topic. What are the. common inflammatory tr problems in their mental health?

What are those common triggers that you normally see? Yeah, that's a good question. Sometimes we're not even aware. We're eating with so many health foods now and so many sources out there.

Oh, this is a superfood, right? It seems like there's a new one each week. It's like all these superfoods and things that are supposed to be healthy for you, which you never know in a certain person, right?

What may be like eggs or dairy may be great for some person, but for someone else that may be causing inflammation. So I try to find out what is causing their inflammation and either they can do an elimination diet or sometimes we'll do a food sensitivity test so that we can say, okay, oh, we've got some evidence that these are some inflammatory foods.

But even before we do that, I should back up and say there are certain foods that that we're aware of that cause inflammation, that I would tell somebody if they don't want to do further testing, if they want to keep it real simple, if they were just to cut down on the added sugar, because we know sugar is like major inflammatory thing number one, sugar and chronic stress, but they were just to cut down on the sugar and perhaps gluten and maybe dairy.

But if they were to start one place, take a look at their diet and see if there's any sugar they could reduce. And then those two other things so we can keep it really simple.

And then if somebody really doesn't want to you know change things or they really want more evidence sometimes someone kind of wants to do a test and see then we can certainly do a test to get some further information not that they're perfect by any sense but it is another piece of the puzzle and I have found that to be one of the most helpful tests that I can do and if we can lower the inflammation in the gut then oftentimes that can lower the inflammation in the brain.

And then depression and anxiety and mood disorders are improved by doing that. So we look at sugar and the liquid sugar is something that we don't always think of.

If it's the ice cream or if it's something that is in a food, but if we're drinking in a liquid form, sometimes we're not as aware of that. Oh, well, that's just as much sugar, even though it's not a candy, a pastry, something like that.

It may not be as obvious. It's sneaky. It's sneaky. It is. It's so much easier to consume a lot more dense calories when we're drinking something than when we're eating something.

So it's something to be aware of. I know that there's a lot of parents out there that are thinking that they're doing the best for their kids by giving them fruit juices.

But some of these fruit juices are just not really that healthy, especially some that in addition to just being fruit juices, they might even have, you know, they might have some dyes in them or some high fructose corn syrup.

So as much as they kind of do the best thing for their kids, it's just, it's really not the healthiest thing. Yeah. So reading labels can be really helpful because, you know, yogurt is one of those, you know, healthy for you if you can tolerate dairy, but so much of the yogurt even has, you know, the Greek yogurts are loaded with sugar.

So that's what we're talking about. It's sneaky. Sugar is in just about everything. Even, you know, pasta sauce you want to, or, you know, tomato sauce.

So not that we are gonna drive ourselves crazy, but if you just quickly look at a label and it's got a bunch of sugar in there, it's listed as an ingredient and compared to one that doesn't, it's like it may be a simple swap or something you eat a lot of.

I might tell people, if it's something you eat a lot of, let's see if we can find one that has less sugar and start eliminating or cutting that down and get your sugar from the natural sources, the fruits, even carrots will have some sugar in them, right?

So it's not like we're not getting sugar. Yeah, we definitely can get plenty of calories and energy sources in ways that are not as inflammatory as the high fructose corn syrup and all the processed things that have all these labels.

I love it when patients read labels, but what I love more is when people eat products that don't come with a label. That's even the best. Right. It's like salmon, broccoli, beans.

We don't really need a label. Right. Yeah. And I do like the fact that you touched on yogurt. That is something that a lot of patients come to me saying that They want to eat yogurt because of the probiotics.

It's really hard to find yogurt out there that's not full of sugar. I try to tell people there's multiple reasons that yogurt may not be the best choice.

Yes, I want food to be medicine. you have to choose the right foods. Maybe if you want a probiotic food, let's talk about doing a, maybe a coconut kefir that doesn't have as much potentially, you know, some, for some people, dairy's inflammatory, maybe less sugar in it, or the best really would be to eat something like a sauerkraut or a kimchi that's really vegetables with, that are giving us that probiotic food and not the yogurt, but you know, it's, it's, it's really hard to educate people about this.

It's such a huge, huge, huge topic. Right. You got to start where they are, right? And if they love yogurt, then I like that you're working with them instead of like taking it all away, kind of trying to find a swap, something that might be healthier.

Yeah, absolutely. I do think that's something that we run into a lot with nutritional advice. If we only focus on the things they can't have, then people are really confused or like, well, then what can't I have?

So maybe starting with where they are, what they like, what those healthy swaps are. And that's much more empowering than just taking away all the food that they love and then they won't know what to eat, right?

Yeah, that is a great point. And I think sometimes by just mentioning what I'm learning to do now is just talk about maybe adding something instead of taking away for certain people.

Just saying, well, okay, that's good what you're doing there. Pretty good. Let's see if we can add a serving of, if we're talking about anti-inflammatory food, apparently I just read recently about 90% of us fall short on the vegetable.

You know, nine to 13 servings a day is like, I'm short on that. It's like, it's really hard to get that much vegetable with all those phytonutrients and anti-inflammatory, antioxidants, et cetera.

So I might start with someone, can you add an extra serving or two a day? Instead of talking about taking away, let's see what we can add. Even if you're doing an egg scramble, can you add some spinach in there?

Or if you're doing a smoothie, can you add a handful of spinach? That way we're just trying to add something in there rather than take away. They may not need to take away much, but just by adding.

So that's, we're reducing the inflammation with antioxidants. Cause we're talking about food being inflammatory or anti-inflammatory, which to me was kind of a new concept in functional medicine.

It wasn't talking about that. It was just a calories a calorie, right? It's like, no, not. It's not. Yeah. Yeah. Yeah. That, that concept of a calories, a calories, a calorie is, is so false.

And getting people to understand that is a huge basis for them to make better food choices, for sure, for sure. What are like the main strategies that you find are the most effective for people to reduce inflammation?

So if we can talk about food that they may be eating that's inflammatory and just reduce that a little bit and add more of the anti-inflammatory foods, which as we say are going to be more of the fruits, the vegetables, the whole grains, the legumes, slowly if they can, omega-3s, so we see what we can do in that area, which kind of falls under the, you know, like a modified Mediterranean type without kind of putting a label on it.

I just, you know, kind of those categories of keeping it simple, fruits, vegetables, and omega-3s. So we see what we can do to add some of those in there.

Most of us are short on omega-3s, and that's really important for brain health too. So if somebody has depression, anxiety, almost always if I do a nutrient test on somebody, I'm sure you've seen this too, that omega-3 index is low.

So if they can eat some more fatty fish, if they don't eat fish, if they're plant-based, then we've got flax and walnuts, there's other ways to increase the omega-3s.

maybe some turmeric. So reducing the, the inflammatory foods and adding some of those anti-inflammatory foods to help rebalance the gut. And if we do have some testing that we can put in place to help guide us with that, you know, we'll use that.

If not, we give six weeks or so a try of, of kind of a, of a gut reset by doing some of those things. Yeah, absolutely. Definitely using food as medicine is, is, is so powerful.

Do you introduce supplements at this time when you're doing that with patients or just work solely with food during that period? Yeah, that's a really good question because so many people, just about every seems like most people are taking some form of supplement, right?

So if we're talking about, you know, probiotic food, I'm sure you get that question all the time, right? What probiotic do I take? What is the right one?

And that's one of the reasons I went into this because I had no idea how to educate people on supplements. And when I would be walking down the supplement aisle, it would just be like an instant migraine.

I had no idea what to do. You know what to recommend. It's so confusing. How can I recommend it to somebody? So of course, when it comes to probiotics, we're kind of in our infancy, right?

Which strains might, might help with this or that. It's exciting that we're getting so much better. Certain probiotics are really being targeted for certain things now.

But I, usually my approach is to say, yes, we're going to start with food. Cause as you said, food is our first and best medicine. That's the functional medicine approach.

That's our foundation. So that's like the, uh, the horse before the cart. So that's the main thing. And then. Yes, adding some targeted nutrients or certain supplements can make the healing process go quicker.

Because oftentimes if we're dealing with mood issues, there are other things going on as well. So I will talk about adding a probiotic, if they can, a probiotic and perhaps a digestive enzyme, if there's some bloating, that's where we kind of really get personalized what else might be going on.

So if they're not sleeping and they're having depression and anxiety, well, then we may be working on that, doing a supplement for sleep or maybe some magnesium.

but those sorts of things. But yes, usually I'll recommend a couple of supplements that can help the healing process go a little bit quicker for the first couple of months or so.

And then, then we see what we need to get people kind of on a minimum amount that they're, they're comfortable with. Cause what I find is that most people will start things and then if they're feeling better and you see them again, they don't want to be on these things or do they need to be necessarily.

And that's always a question, what should I keep taking? But to get started, yeah, to your point, adding a few targeted supplements, I think is a good idea.

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Visit trulyhealthymd.com and book a consultation today. It's time to feel like your real self again. Absolutely. And like you said, this is always personalized.

It's not like we have a protocol that everybody follows. It has to be extremely, we have to understand who the patient is in front of us before we start recommending these supplements.

I'm never a protocol doctor. I'm always like, okay, I'm treating the patient. And based on that, I will make recommendations. And it's kind of ironic that I do follow what's called like the five R protocol.

But it's, you know, it's a framework. I would call it the five-hour framework would be a better. I like that. Yeah. Exactly. It's not edged in stone. Right.

Yeah. And it's kind of what we're talking about, right? The first step is kind of rid or remove. If something is obvious, like sometimes you may see someone who's drinking three sodas a day.

Oh, but it's a diet soda. So that's, oh, that's another thing. When you would ask which things would be eliminated, we added sugar. You mentioned sugar, but also artificial sweeteners we would add in there too, right?

So unbeknownst to us that we had no idea when I first came out how disruptive they could be to the gut microbiome and create that imbalance or dysbiosis, sometimes even more than just having a regular sugar.

Not that that's great to have every day either, but so if there's some low hanging fruit there that someone's either doing soda or a lot of sugar in some added form or artificial sweeteners, then that would be kind of things to remove, kind of start right there.

Or if someone's doing a lot of processed food, they're eating three bars, you know, energy bars a day of some sort, or something with that process. So those would be the things, the ultra processed foods, which I know that's kind of a topic in itself, what's an ultra processed food, and sugars and artificial sweeteners, those might be things to start taking away first.

Yeah, absolutely. So like, so the first just to help our patients or listeners, sorry, what we're talking about the five hour protocol is the way that we are taught when we're in functional medicine training as far as how to help gut healing.

And so, yeah, the first thing is remove, what do we need to take out, right? And then the second one I think is replace, correct? Yeah. Yeah, so we replace digestive enzymes, we replace things that need to be in the gut that maybe are not there right away.

Sometimes our body is not making enough digestive enzymes because it takes a lot of energy, right, to make digestive enzymes So, and you had mentioned, right, that that's some of the supplements that you recommend sometimes.

Number three is re-inoculate, which it means putting, helping balance out the gut bacteria, re-inoculation. Number four, repair is repairing the gut lining.

There's a lot of foods out there that help repair the gut lining, like bone broth or aloe vera. And there's lots of supplements, obviously too. There's supplements for everything, right?

But we're always trying to like do the foods first and then we'll add the supplements if food's not enough. And finally, rebalance, making sure that we rebalance patients sleep, movement, stress management.

And these are like the five R's that we have as a framework to help our patients heal their gut and have that gut brain access work a ton better. So just Just I threw out that five bar and I was like, wait, maybe not everybody knows what the five bar is.

Good point. Thanks for reviewing that. Exactly. That's kind of what our minds go through internally when, when we're working on that. Yeah. Yeah. Yeah.

I think, I think you and I like just go through it like so automatically every, every day with, with our patients that we're just, it's just kind of like, it's, it's something that we do so automatically.

I was like, Oh wait, I might need to explain that to our listeners. They might not, they might not be our patients and they might not have been through like the whole training of what we teach them to, to, to do all this.

But yeah, we use that framework to try to, or not just try to, it's a very successful framework, let's say, to heal the gut. And once the gut is healthier, typically the rest of the body starts getting a lot healthier.

Specifically what we're talking about today, mental health gets better once the gut is healthier. So that our process is a very powerful tool that we use in integrated medicine to help people heal.

When we heal the gut, so much, everything else starts getting better. I'd love to hear some cases. Do you have any specific cases that you could tell me about where a patient's gut health led to improvements in their mental health, how that happened?

I think that's how we learn best, right? Humans learn best by stories. Telling stories is how we understand things better. So if you could tell us one of your cases, I think that would really help our listeners understand kind of a real life scenario of how this works.

Sure. I just want to mention one more thing that I thought was important kind of before, before I get to that. That is the neurotransmitters that are produced in the gut.

So that is something that I will often explain to them when they're saying, why are we focusing there? When is my mood? And then I will often explain that, wow, well, you know, neurotransmitters like our serotonin and, and GABA and dopamine are produced in the gut as well as other places, but like 90% of our serotonin, you know, that happy hormone that Prozac, Zoloft effect are 90% of it is produced in the gut.

So the healthier, so explain to them the healthier their gut is, then maybe they need less medications or don't have to go on one. And then all of a sudden it's like, oh yeah, cause that to me was pretty amazing.

I was never taught that, wow, we have neurotransmitters actually produced in our gut. So if that's healthier, then we can produce our own serotonin, GABA, kind of the calming hormone, which can help with anxiety.

So that's just another reason to help reduce inflammation and help with the gut permeability and just help the gut in general. Yeah, absolutely. That's such a cornerstone concept that's so important to understand as far as like how the gut-brain access works and why there's such a relationship.

I think another cornerstone concept that we haven't talked about yet is the vagus nerve. Would you like to talk about that or you want me to Talk about go ahead.

That's great. Yeah, that's huge. Yeah. Yeah. Yeah. The vagus nerve. So the vagus nerve is the nerve that comes out of our brainstem. It goes through our throat, our lungs or diaphragm and ends in our gut.

And we always think of it as something that controls our gut. So when people are trying to, let's say, have better gut motility. We have them do vagal exercises, vagus nerve exercises to strengthen that vagal tone.

So that's a huge part of the mind-gut connection. But what's really interesting is that it's not just a superhighway from the mind to the gut. It's also superhighway from all the bug bacteria and fungi and viruses and our gut.

talk to the vagus nerve and it's a super high with information going back up to our brain. So that's another reason that yeah, there's such an important gut brain connection.

There's a super highway that goes both ways. Our brain can really affect our gut. People with IBS, if they learn to cope with their stressors better, if they're sleeping better, their IBS is going to get better.

but also people with mental health disorders, if they pay attention to their gut, they feed it the right food, they make their gut bacteria happy, all of that's gonna communicate directly, directly to the brain via the vagus nerve, and in many indirect ways too, right?

Because in addition to the vagus nerve, we have the neurotransmitters you were talking about, obviously all the nutrients that our body needs, all the building blocks are gonna come through our gut, and if we don't have good nutrition, There's no building blocks.

There's no building blocks for neurotransmitters, right? So there's just like so many ways that how our gut affects our mood. And it's also something that's growing every day.

The science behind it is growing. It's like the amount of research behind it is just phenomenal. I love that we live in the age of information where people can just Google this stuff.

They can look it up, use Google or another. search engine out there at the research there. Anybody can find the research nowadays. It's just that we have to understand it and implement it.

And I love what I do. And I love talking to my colleagues like you that practice integrative medicine because we're doing our best to read the research.

That's the latest research. Whereas when doctors are just in the conventional setting, they're doing an amazing job. They, excuse me. they're doing the best they can, but they're not always staying up to date with all those things.

Yeah, I think they said it takes like 20 years or so or more for the studies to get into the clinical practices. There's just that huge lag time. So yeah, I love what you said about the vagus nerve and that bi-directional.

You know, the brain affects the gut and the gut affects the brain. So, Leslie, you were mentioning, thanks for going over that. You could do a whole thing just on that.

Yeah. Well, I didn't want to put you on the spot and be like, explain this. But like, oh yeah, we didn't talk about that too. We didn't. Yeah, we got to put that in there.

Our notes as far as like what we wanted to cover. I was like, wait, we're not talking about that yet. That's so important. Yeah. So it's like, if it's one thing people want to know, it's probably, you probably teach them like your breath, right?

It's like, what do I do? What's one thing I can do to activate the vagus nerve? That's usually where I start with people. because most of us don't breathe correctly or optimally, myself included.

I find myself doing this chesty breathing and not doing the belly breathing a lot. Absolutely. By altering the breath, paying attention, we can activate the vagus nerve.

So they can, your patients can ask you about that. But let's see, you were asking about, oh, a case study. Yeah. Absolutely. One recently that comes to mind, I will call her Amy.

You know, a young lady really came in for some abdominal pain and GI issues, but she was also having anxiety and she did not want to go on medications.

It was not like severe where we really needed to prescribe medications, but her anxiety was worse lately. So we did a, cause she was having some GI symptoms as well.

We did some testing on her. because she wanted to dig a little bit deeper. So we did some nutrient tests and a food sensitivity test. And once we get those results and put a little, some basic anti-inflammatory foods in place, after about six weeks, when the results came back, we reviewed the results.

She had some food sensitivity. So we decided to take those foods out and replace some of the nutrients that were lacking. She was low in omega-3, some B vitamins and magnesium.

So helped correct those imbalances. And when she came back six weeks or so later, her GI issues were improved and her anxiety was much better as well.

So kind of fits into what you were saying about that, what we're talking about, that gut brain connection. And so that was really great to see that, as you said, once you kind of improve gut health and reduce inflammation, then a number of things improve.

And she had acne, some skin issues, and she also noticed some improvements in acne. So that's just a case of some depression, anxiety, or some mental health issues going on that have improved with some gut health and some basic nutrients.

And how long did this take? Sorry, if you say that. About six weeks or so, I would say. Wow, that's so fast. Cause you know, you think of people struggling with mental health, it takes, you don't think of such quick improvements, right?

You think of people being chronically ill with these things. So yeah, six weeks. It certainly could take a lot longer. I guess what I should say is that she started to notice improvement.

So by the time we like that, by the time we gave something a little time to. affect her body and a treatment plan in place, I usually like to give it four to six weeks.

And I'm sure you've noted too that sometimes even within two weeks, people can notice that they're sleeping better or getting some improvements. But yeah, so that that can encourage us to kind of stay on the path.

Okay, we're getting improvements here. Let's let's keep going. Yeah, like you said, we don't have to do, you know, like, six months of treatment before patients improve.

Yeah, yeah, people just may need that. It's nice when you can They can see results sooner. Awesome. Yeah, that's, that's, that's so great. And I also like what you mentioned about the acne and the sleep so many times when we address root causes.

People don't realize how sick they were. They're like, all these other things start getting better and they're like, oh, and now I'm able to walk farther and play with my kids more and do all these other things.

Uh, I didn't come to you for that, but you're actually helping my entire body heal and not only heal that one person. I also love seeing the ripple effects when you teach one person in a household to eat better.

They typically will start teaching the people around them, their spouse, their parents, their kids to eat better. And that ripple effect that we have in the community is just something that I love.

I love seeing. I love hearing from the space, you know, six months later, they're like, Oh, actually my doctor took me off my blood pressure medicine.

Once you taught my wife how to eat better. Cause she was feeding me better. Wow. That is awesome. Yeah. Yeah. Those, those stories of healing are really what.

Makes it worthwhile to me to continue down this path. It's not, it's not always easy. You know, we, we talk about all the winds that we have as integrative physicians, but it's actually, I find it a lot harder to practice integrative medicine than I found it before when I was just doing straight up conventional medicine because when I was doing conventional medicine, there were, there were protocols and things were by the book.

And it was really easy just to. look things up in the book, if they didn't fit in the book, then it was maybe in the patient's head, right? That's how, unfortunately, sometimes we just different, every person is unique, we have to personalize the plan.

So we have to read a lot more, we have to stay on top of our knowledge. And sometimes solutions don't come fast. I mean, I was happy to hear that your patient got better in six weeks, but sometimes, yeah, people take months before they see any improvement and it's frustrating.

So we absolutely have to really focus in on the good parts because it's hard. It's very hard to be an integrated doctor every year that I practice integrated medicine.

It does become a little bit easier, but it's still hard every day. So I have to really focus in on those wins to keep me going sometimes. What do you feel is, I want to talk about you a little bit.

What's your biggest struggle that you find as a person who chooses to practice integrative medicine? Because we're here, we're doing a lot to help our patients, but we're humans too.

And so I think having them see us as humans is important. What's your experience? Well, what comes to mind, one of the challenges is kind of being their last resort.

I mean, I went into this because I hope to be proactive and help people get well. But as I found out, it's like, people don't want to see a doctor unless they're sick.

And then they want to, we all want to use insurance. And there's a lot of reasons for that. It costs a lot. So by the time that I see them, they've been through the normal realms and they're regular doctors and the specialists.

And it's kind of like a last resort. So they're pretty sick. They've tried lots of things. And that wasn't what I thought it was going to be. I thought it was going to be kind of preventive.

So I've had to do a mind shift around that. And then sometimes it's more challenging. You know, like you said, we get very challenging cases that don't have the quick fix that we could, otherwise their good conventional doc would have found something and the pill would have worked or the treatment plan that they had in place.

So it can be a lot more challenging, as you say. And it can be a little lonely out there, right? I mean, I really enjoyed kind of being with my my group in conventional practice and going down the hall and finding someone.

But thank goodness that we've got groups. We can chat and ask each other questions and help each other out. So that has been a real blessing and a good thing to have others around us there.

Yeah, absolutely. Yeah. I also find that experience that it's more of a lonely path when I'm in my integrative role. I still have a conventional role and I still work for the hospital sometimes.

it's, it's sometimes easier on that different hat. Yeah. You put on that hat and it's, it's just easier. You feel like you're part of a bigger group and you feel accepted.

I feel like a big part of my professional desires are to help more conventional doctors understand what we do so that they don't think that what we do is not evidence-based and it's, it's, it's a, it's all or nothing.

Like, yes, many of our patients are already on prescriptions. This is not in All I'm not thinking is just giving them other tools. Yeah, absolutely. And the more that we can educate the public, I'm hoping the message will get to the ears of our conventional colleagues and they'll understand what we're doing better because I want to work with everybody.

I want everybody to be on the same page on the same team. And not least sometimes a conventional colleague may not understand what we're doing. And I've had, for example, I had a rheumatologist mad at me because the rheumatologist thought that I was trying to.

Uh, just put people on some vitamins and trying to take them off their, the medications that the rheumatologist was prescribing. I was like, I'm sorry, you are not understanding my role here.

I'm trying to help the person be healthier. I am going to continue to tell the person to see you to be on all their medications that you prescribed. But if this person's healthier than maybe in the future, you can deescalate your treatment.

And so when I first started practicing integrative medicine, it was hard for me to understand how to explain it to my, my friends, my, the people that had worked with for many years as, as conventional doctors.

And I think the patients that seek us out are also lonely too, because they, they don't feel heard. They've been to many doctors. They feel like. Doctors tell them that maybe things are in their head.

I mean, especially the type of conditions they come to us with, with irritable bowel syndrome. Like, what is that? No, the gut, it's not that your gut is irritable.

There's, it's, there's a lot of root causes for irritable bowel syndrome or you know, fibromyalgia. It's kind of like blaming the patient for the, for the disease.

There's root causes and it's, it's lonely. It's lonely to be a patient that's that sick and has had to struggle until they find us. So. I think it's a very loving community too, even though there's a lot less of us doctors that practice integrative medicine.

I feel that those of us that practice it, we kind of find each other and we support each other wholeheartedly. It's a great experience too. Yeah, you did touch on another important part, kind of integrating with our peers can be a challenge as well, that we're trying to be another piece to the team and work together for the good of the patient.

Absolutely. Neither you nor I, nor any of the people who have MD or DO after their names, who started as a conventional doctor and then went on to adopt integrative medicine.

We all consider ourselves physicians first and foremost, and then, you know, uh, integrative practitioners. And so we want to continue to be part of the medical system.

We want our patients to trust the medical system. I know it's hard. It's hard to trust the medical system when you've had a chronic illness and you don't feel heard and you feel mistrust.

but we can do better as a community. We can do better as, as patients and as doctors to, to make it, to, you know, to grow stronger each day and try to help patients, no matter if you call yourself integrative or not.

I was just interviewing an MD recently and she doesn't consider herself integrative. She, but she's a lifestyle medicine doctor. And so I'm like, you know, telling her it's, yeah, I understand that you're a lifestyle doctor, but you're integrating other things in your practice, right?

So she was kind of caught maybe off guard with what I was saying. Like I wasn't calling her an integrated doctor. She's like, no, no, I'm not an integrated doctor.

I'm like, but you are integrated in other therapies. That's what integrated medicine is. She's like, Oh, okay. So conversation to have. And yeah, absolutely.

I do think it's, it's important for me to, to say it over and over again, that doctors always want to help patients if they haven't been able to. If you haven't found the right doctor in the past, it's not that they didn't want to help you.

They just didn't have the right toolbox. And you just need until you find the doctor with the right toolbox to help you. Yeah. Well, I love that you're trying to kind of be a resource for your colleagues there and, and, and just, and, and be a part of the team to help them in the same mission of helping the patient.

That's what I'd like to be able to do as well. Yeah, yeah, definitely. Yeah. The best way I think we can help patients is by extending that olive branch to our conventional colleagues, because we are conventional.

We're also integrative. And the more that everybody understands that, I think the better off we are. And I think patients need to understand it too. I think patients come to me and they see that I'm a holistic doctor and they think that I just don't do any pharma.

And I'm like, I definitely will use pharma when it's needed. I just feel like I balance the risks and the benefits more than I used to before I understood more of integrative medicine.

So. So yeah, all of those are concepts that I, I, you know, say often. And if this is not the first podcast you've listened of mine, you might have heard me say it more times than you wanted to, but it, they're just like very basic concepts that I feel like need to be said and repeated and the message.

Yes, I love that. Anyway, thank you so much for being on the podcast. And I feel like we talked about a ton of things. So I never want our listeners to go away being like, wow, that was a lot of information, but I just don't know what I listened to.

So if you could give our listeners maybe like some top three tips, top three packs when it comes to the gut brain connection, what would those top three tips be?

Well, I think my first tip would be even just kind of more general that are amazing or brilliantly designed bodies were designed to heal. So if someone is still struggling and not feeling well, just to keep looking, keep finding, like you said, find a practitioner who will work with you because you and I have just seen some amazing things, I'm sure, in both of our careers where people just get better or great improvements anyway.

So I've been amazed at how the body can heal from things, even if it's been years of issues going on. So that's the first one. The second one is how the food can really affect our mood.

Even within a couple of days of changing what we eat, that can affect our gut health, and we can start producing more neurotransmitters, reduce inflammation, and improve our mood.

So food, gut health, and mood, that connection there is really profound. And just by doing a few simple things like cutting down on the sugar, getting more fiber, Couple basic tweaks to work with your doctor or whoever you're working with on diet can improve that inflammation and help with our mood, whether it's depression, anxiety, sometimes even sleep issues.

Very valuable. That's amazing how you wrapped all that in like less than two minutes. Wow. Thank you so much for being here, Dr. Nelsa, and I am so glad to call you my colleague, my friend, and thank you for being on the podcast.

I'm sure our listeners are very grateful to have you too, and we'll talk soon. Thank you for having me. Appreciate it. Have a great day, Dr. Monica. Bye-bye.

Thank you for tuning into Dr. Talks. We hope today's episode has enlightened and inspired you on your path to optimal health. Each day is a new opportunity to make choices that empower your well-being.

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Nelsa Andersson Ciapponi, MD

What If It’s Not Just in Your Head? How Gut Health Shapes Your Mood