Uncover the Root of Inflammatory Bowel Disease

Introduction and Dr. Stangau2019s Background 0:00

This is Doctor Talks, real talk from real doctors on the issues that matter to you most. Welcome back. We're continuing our conversation on reversing Crohn's and colitis. I'm your host, Sinclair Canale, and today I am joined by the wonderful Dr. Megan Stanga. She is an IBD expert. She's a DC, a dedicated functional medicine expert and a passionate advocate for immune system modulation to address chronic illness. And as the founder of a successful practice in San Antonio and the host of the Functional Medicine Unfiltered podcast, Dr.

Stanga is committed to empowering both patients and practitioners. Her personal journey from severe illness triggered by reactivated infections to wellness has deeply informed her practice and her approach to functional medicine. This experience fuels her determination to help others uncover and address the root causes of their chronic symptoms. Dr. Stonga was first offered or honored to be a finalist for San Antonio women business owner of the year in 2023. She has played a pivotal role in developing a Lyme certification program for practitioners.

And today she's here to help us unpack. All things strep and immune dysregulation uncovering the root of inflammatory bowel disease. So this is really interesting. And one of the reasons why we want to make sure we did this, of course, is you and I have a shared history, right? When you had to go through your own severe chronic illness, like, there's a certain passion that you bring to this work to deign by it, right? And I'm so glad that you're spreading the word. Yes. I mean, I feel like that's really most of the doctors in this space, I find that is their story is that we had to heal our own chronic illness.

And, you know, lots of times hit roadblocks and how to figure things out on ourselves. And I know that's what I did. And it really helped me to uncover some pivotal pieces to help my patients. Yeah, absolutely agreed. And when you wanted to, when you proposed this topic to me, I was really excited about it because this was actually a big part of my health journey. It took me forever to connect the dots between the infections and then later on in life, getting down to just three foods and having to, you know, slowly get myself.

Yes. Yeah, so talk to us about, first of all, the immune system itself. We talk about modulation and dysregulation, but the immune system imbalance, how can that lead to chronic inflammation in the GI tract? Yes. So when we're thinking about something like Crohn's and colitis, it's two factors. It's autoimmune, it's inflammation, and both of those are immune dysregulation. And I feel like that's so often overlooked when we're working with patients or trying to heal our own chronic illness is the immune system is really what's at play here.

And so a simplified version of it to keep it simple is there's really two major sides to the immune system.

Immune Dysregulation and IBD Basics 3:00

And it's not this one thing that is weak or strong, there's two sides to it and they each play a pivotal role. one side is the killing r what's fighting off all t viruses and bacteria. It p The antibody response and its job is to identify enemies in our environment. It produces pro-inflammatory cytokines. And so when you think about autoimmunity and inflammation, when we see an imbalance occurring between the two sides of the immune system, that's really what's driving both of those things. And so understanding those deep level root causes is how to get the patient better.

Yeah, I think that's really well said. So help us unpack this and understand like the connections here. When it comes to colitis and Crohn's specifically, what do you want the audience to understand about those two sides of the immune system or the two like a weakened immune response and what we want to or how we want to think about that in a productive way? Yeah. So when you think about the two sides, when the killing response weekends, what happens is it allows pathogen reactivation, which is not typically always something that people are aware of.

But the example I always use is chicken pox and shingles because everybody knows what that looks like. But it's a classic example of a virus we had when we were a kid. It's been dormant in our body and then it reactivates later in life, typically due to a stressor or a trigger. But not everybody who had chickenpox ends up getting shingles. It's the person whose immune system isn't regulating it. Right. So when we're dealing with a weakened or dysregulated immune system, it can allow other pathogens to reactivate.

And when we think about something like GI issues, there are specific pathogens that are really connected to these issues. Streptococcus being, I would say, the main culprit behind many GI issues is what I find. Tons of studies, and that's what I see clinically as well. So maybe you want to explain to the audience about that, because when we think about strep, you know, for kids, we're often thinking like, oh, sore throat. And then, you know, it takes a week or two and we get through it. So what are you looking at when you see it showing up in the GI like that?

That's exactly what people think about is strep throat, but strep isn't just in our throat. That's what I always explain. Strep is everywhere. It's all over the body. So it's all through the ear, nose and throat. So oftentimes people with reactivated strep also could have sinus issues or ear issues. It's all over our skin. So we can see skin issues and it is in the intestines. And so. If it reactivates in the intestines, then it can lead to inflammation and cause a number of different issues. When we think about actually the term SIBO, SIBO is small intestinal bacterial overgrowth.

But when we think about what the actual bacteria is, it does tend to be streptococcus and strep co-infections. But again, it just tends to get overlooked what the specific actual pathogen is, because I think most people don't really have pathogen-specific treatments for it so they don't really care what the specific pathogen is. Yeah, that's a really good point. So when we think about specifically strep reactivating, contributing to chronic gastrointestinal symptoms, you also mentioned like maybe some co-infections.

What are some of those other ones that often get overlooked? Yes, I do want to mention too that there are studies done showing that streptococcus is a trigger for Crohn's. So a study was published in 2020 and it showed that those with new onset of Crohn's had really, really high anti streptolysin O positive titers. And so the assumption that was made was that streptococcus was a trigger for new onset Crohn's.

Strep, Co-Infections, and GI Triggers 7:00

And so it was nice to see that come out in a study because that's, again, what I see clinically as well, but it does, it's one of the tests that I often run for my patient base is the anti streptomycin titer. And I do see it often coming back in high, you know, for Crohn's and colitis. But other co-infections certainly can be, I see H. pylori a lot. I can see Candida, C. diff, parasites. I would say these are some of the top infections that we also find. Yeah, that's a really great point. I mean, parasites are so interesting to me because they're a huge part of our practice and I think they are for you as well.

And, and yet for most, you know, chronic digestive illness focused practices, I see them still overlooking them like crazy, not just in traditional medicine, but also in the natural health world as well. It's kind of interesting, isn't it? It is. And I think that, you know, really from my perspective and my approach, I always look at the immune system because the TH2 side of the immune system is what regulates parasites. And so if we'd have a parasite problem, I always try to educate the patient that it's really parasites aren't the issue.

The immune system is the issue because our immune system is designed to regulate these pathogens. And so if you don't focus on the immune system, then you just get stuck in a killing strategy. where you're always relying on killing protocols to fight the pathogen when really what you want to do is get the immune system back on track to take care of the pathogen the way that it was supposed to do in the first place. I totally agree. We always say we want to get the immune system running the show again.

It's not about killing every last parasite. Yeah. Yes. OK. So let's get nerdy here. What are some key mechanisms by which pathogens actually disrupt that immune tolerance in the gastrointestinal tract or immune strength also? Yeah. I find that I always like to talk about triggering events when it comes to how pathogens reactivate in the intestines and what that looks like. When it comes to disrupting the immune system, most of my patients do find that something occurred prior to them being told that they had a new autoimmune disorder, a new set of symptoms.

And so there are four, four to five triggers that I find in practice frequently. that triggered the immune system into a dysregulated state. And those are pregnancy is one of them. The immune system shifts by design in pregnancy. So I feel like hormones get all the blame here, but it's really the immune system shifting into this dysregulated state. And for some women, we just can't recover from it. And yes, that was me too. I had that experience as well. The second one is stressors. And most people get this.

They don't ever have to convince people that stress affects the immune system. That's why we see cold sores popping up and shingles popping up when we're stressed out because it's weakening that killing response. But it can be also physical stressors and it can be environmental stressors, things like mold or even, you know, toxic foods. You know, this can stress and overwhelm our immune system. But whereas sometimes people focus on these as root causes, I really look at them more as a trigger to the immune system, dysregulating.

So my focus is always going to be on the immune system. And then the last two things that can do it are vaccines, which I know can be a hairy topic sometimes, but you know, the mechanism of a vaccination is to up-regulate one side and decrease the other side. So that can oftentimes be a trigger. And then acute infections. So getting about a strep throat or getting COVID. These are things that can also disrupt the immune system and cause pathogens to reactivate. Yeah, that's a great point. So when we think about like, what is the straw that broke the camel's back?

Like this is, this is obviously building for a long time, the conditions with which, you know, a triggering event would actually become a triggering event. There's so many small micro factors building up in the background along the way. What are some of those that you pay attention to? Yeah. So the straw that breaks the camel's back for people. I mean, like what, what makes that triggering event a triggering event for some person, one person versus somebody else that can survive that type of triggering event.

It's typically that body burden, right? So what are you paying attention to as a clinician in that regard? You know? Yeah. So when we look at, actually what's happening with the immune system. I've talked a little bit about TH1 and TH2. When those become dysregulated for long periods of time or severely dysregulated, then it will trigger TH17 cells. And that's what actually causes tissue destruction. And that's what's actually behind autoimmunity is TH17. And then T9 cells are behind inflammation in the intestinal lining.

So essentially what I see happening is people will have been in a state of dysregulation. And then all of a sudden, one of these triggers just throws them into full blown autoimmunity or inflammatory conditions. Right? Yeah, that's a great way to say it. really nice concise way to explain it to it's so hard for people that wrap their minds around the immune system especially because you know a lot of people get told like oh let's suppress it because it's making a mistake right now and that's how they get on these long-term immune suppressive drugs for things like Crohn's and colitis so can you talk about your do you want to comment on that before talking about current strategies and therapies Yeah, essentially it's really only addressing one side of the immune system, one part of the immune system and just the one that's causing the biggest issue for people, right?

We're just going to dampen that down without looking holistically at the entire immune system and bringing balance back to it. We're just going to knock down one side. So that's essentially what that is doing. Yeah, totally. So what about your favorite current strategies and therapies really aiming at restoring that immune balance in patients with IBD?

Triggering Events and Immune Shifts 13:00

Yeah. So one of the biggest things that made a difference with my health, what I've seen made a huge difference in my practice with my patients is I use homeopathy for chronic infections and it's really an immune therapy. because it's directing and guiding the immune system to build innate tolerance towards the pathogen. And that's such a different strategy than killing, because you don't want to kill. These pathogens are in our body. Most people have pathogens. We've been exposed to them. The problem isn't that they're there.

The problem is the immune system not regulating them. So this therapy, homeopathy, which has been around for a couple hundred years, It basically triggers the immune system to bring the pathogen dormant by microdosing the pathogen in small amounts. It's kind of like allergy shots. If you get allergy shots, you'll get injections of what you're actually allergic to in small amounts, and it builds tolerance to whatever you've lost tolerance to. Well, this uses that same concept to build tolerance to the pathogens in our body.

It's incredibly effective, and it allows us to get really specific with pathogens, right? really broad antimicrobial or antibacterial, we can actually go and treat things like strep and candida and H. pylori and Epstein bar. And we can be really, really specific with it. Yeah. Okay. So tell us more, like, what are some of your favorite like products out there or, you know, where would you start as like a standard protocol for somebody coming in the door? Like very textbook IBD. Yeah. So I always begin my protocols with addressing drainage.

Drainage is huge because if our natural pathways are not open and flowing properly, we certainly don't want to start stirring things up and going after infections until that happens. And the way that I describe it to my patients is like, it's kind of like if you had this raging but controlled fire in your home with the fire being representative of inflammation, the first thing you would want to do is come in and open up all the doors and windows and let all, you know, 20 years of smoke out because You can't really address the fire until you do that.

So that's really what drainage is for me and for my patients. It's making sure those natural pathways of elimination are open. And then from there, we can effectively start to address the inflammation by addressing the pathogens in the immune system. And then the last thing that we do after that is the cleanup and restoration, where we're restoring all the damage that's been done from years of this chronic fire being in your house or your body. And that's where we're doing gentle detox and we're up regulating nutrients and supporting those downstream systems that have been affected.

Yeah. Yeah. Those are great. That's a great three stage phase or three phases to go through. I'm also drainage obsessed. What are some of your favorite drainage tools, especially for those sensitive folks that are down to like just a few foods, like where do you start them? Yeah. So for my sensitive patients, I do find that they tend to be really low with acid in their stomach. And so I tend to start there by giving them HCL, or if they can't tolerate that, we begin with some lemon juice or some apple cider vinegar.

But I do find that for sensitive people, that H. pylori and a lack of stomach acid a lot of times is a factor. And then from there, they can tend to start to tolerate some more of the supplements. My favorite drainage supplements are by a company called DoesBio. They're amazing. It's homeopathy. So it's really different than herbals, right? It's homeopathy, generally speaking, is directing your body's own ability to make something happen. So it's a different approach to drainage. And so it's very gentle, but very effective.

So even with sensitive patients, they can tolerate it, and we can always alter the dosing accordingly. So definitely want to focus on GI drainage, liver drainage. We like to address lymphatic and systemic drainage. All of those areas, in my opinion, need to be addressed before we can start moving forward. Yeah, that's a great point. And for what about folks who are really, really depleted, maybe not super reactive, but just you're concerned about adding things into the system. Like homeopathy is so perfect for them.

Do you have any special tips or tricks that you think like, Oh, I wish more practitioners knew for really depleted people who've had IBD for just years, if not decades, but you know, think about homeopathy in this way with them. Yeah. So I feel like homeopathy is a perfect solution for people who are really sensitive because it meets your body where it's at essentially. And so the way that it works is like, if you're taking the dilutions of strep, it's not going to do anything unless strep is in the body.

And so that's where it is really, really effective. Um, but there are ways that you can work with a patient to, to reduce the dosing and make it tolerable for them.

Homeopathy and Immune Modulation 18:00

So obviously everybody will be different with what they can tolerate with homeopathy. You really can alter the dosing. You can also spread out how often you take the doses. Some of my patients can't tolerate it to take it at the normal dosage that I tend to recommend. So we have to spread it out over a longer period of time. Sometimes we can address multiple pathogens at once. We can only do one at a time. So there's definitely many ways that you can use homeopathy for the sensitive patient. Yeah, absolutely.

Is there anything that you want to tell practitioners listening about homeopathy or even a specific desk bioproduct? I really love to give really savvy seasoned practitioners the chance to myth bust or be like, please, pay more attention to this one. Yeah. I mean, it's streptococcus. That's why I'm talking about it. I feel like it's just not looked at. as much as it should be. I feel like Epstein-Barr, you know, people talk about Epstein-Barr and I feel like people talk about Lyme a lot, but streptococcus is at the root of so many issues, from chronic skin issues to sinus issues, ear, nose and throat problems, GI issues, many mood disorders, anxiety in particular.

It's at the root of so many conditions. You know, of course, pandas, people are familiar with pandas, pediatric autoimmune neuropsychiatric disorder associated with streptococcus. You know, you think about all of the symptoms that occur with pandas. Well, this can occur in adults too, right? It's not just a pediatric problem. It can be seen in adults as well. And so strep is multifaceted. It's all over the body and therefore can show up in all kinds of different ways. Yeah, you know, the thing that I wish back when we were both sick was that Pans, Pandas and Strep was more deeply understood because I feel very strongly that me going undiagnosed with that for years was a big, big issue for me.

You know, like temperament change, like all the things and it's really scary when it's happening to you. And you just chuck it up to like mental, emotional stuff, but it's actually has a physical route. It has a physical route. Exactly. And it's interesting when you start working with these pathogens, especially when you're doing them one at a time on yourself or with a patient, you can see the actual symptoms associated with each pathogen. And it really is interesting that all the things that we tend to blame on outsize sources, you know, we think that it's hormones or it's this or it's that.

Most chronic symptoms really can be tied back to chronic infections. That would be the one thing that I would want people to know. Yeah, I'm really glad you're, you're setting a light on that. And you're right. Like EBV gets a ton of airtime, but EBV is just an opportunist. It's always present when there's other stuff going on. So maybe, maybe we widen the lens a little bit here. There's, there's other pathogens out there. What else? So we talked about drainage for phase one for and using some despire remedies to really open up the pathways for folks and why homeopathy is good for that.

What about phase two when you're actually directly addressing the parasites and infections? What are some of your favorite tools there? Yeah, so I like to also use other herbs and nutraceuticals to help with modulation of the immune system. So when TH2 is really up-regulated, things like quercetin and NAC are really helpful. And when TH1 is really down-regulated, sulforaphane is amazing and zinc, berberine, these things really help to boost up the TH1 response. to just help the immune system in building that innate immune tolerance, but also kind of just up regulating the nutrient status and down regulating inflammation.

So those are some key nutrients that I use when I'm trying to help shift the immune response a little more when I'm walking patients through the homeopathy immune therapy. Yeah, that makes sense. So for the people in the audience who are DIYing it and trying to understand how to support themselves at home, how would they know If TH1 is down regulated and TH2 is up regulated, what for each of us just slow down and do each one of those at a time symptoms and signs. So TH1 downregulation is the killer response.

So when people are severely TH1 downregulated, they're going to be the patient that gets sick all the time. So they're going to be the person that's like, I'm constantly sick. I can never get over this. And then TH2, this is going to be the patient that's allergic to everything. They over-respond to their environment. They have lots of food sensitivities, lots of allergic responses, rashes. those sorts of things.

Drainage and Sensitive Patient Support 23:00

So that's essentially in a nutshell what TH2 is allergic response. TH1 is just incredibly weak immune system, which is what allows pathogens to reactivate. So patients end up experiencing symptoms from the actual immune system shifting, but then they're also experiencing the symptoms from the pathogens reactivating. Yeah, absolutely. Any other clinical advice for the practitioners in the audience about this phase two where we're actually going after pathogens and doing all the fun stuff? Yeah. So I like to start by looking at GI pathogens first.

I mean, there's so many pathogens that can be at play with with a patient, there's systemic pathogens, there's the mono pathogens, the Lyme pathogens. And I really do like to start in the gut with the GI pathogens. I find that a lot of times it clears up a lot of things. Like you, if you can just address those, it gets the immune system on track enough that sometimes we don't even have to address the other pathogens. Um, so I really feel like GI is the best place to start when addressing pathogens versus going directly after Lyme or something like that, that can be a little harsh on people.

It's so harsh, it's financially devastating. When you're trying to go after Lyme first and Lyme co-infections, there's so much drama about the ups and downs and the herxing and you can't tolerate anything and you're crashing. And I wish people understood this. You're one of the very first practitioners I've ever talked to that agrees with me about this. This is huge. You can shrink Lyme down from a life-ruining problem down to something you can gently target with precision, or you may not even need to at all if you do an FGI cleanup.

That's the insane thing. Yeah. And it's, you know, it's, the immune system is like a seesaw, right? The more you build the side up, the side modulates too. And so sometimes just gently building the side up is enough where the immune system is incapable of taking care of the rest. So, especially in the really sick patients, in my opinion, that's, it makes the most sense to start with the GI pathogens and gently start building up the immune system and, and For a lot of people, we don't even have to do the bigger stuff.

So yeah. Right. What about for mast cell folks who have Crohn's or colitis? We see that more and more, that convergence in our practice. How about you? Yeah. So yes. And again, so mast cell is going to be that Th2 upregulation, right? That allergic response. And so with those patients, for sure, we are addressing Th2 downregulation. in all the ways that we can, we are gently building up that TH1 immune response. A lot of times with these patients, homeopathy, it's alcohol-based. And so they can't always tolerate alcohol.

And so we have to dilute it in water and evaporate it with boiling water so that they can tolerate it. Those are some kind of clinical nuggets with mast cell. Yeah, that's such a great point. Absolutely. Okay, so really fun stuff. I mean, you and I think this is really fun. The audience is enjoying it too. We have so many summit junkies that follow along because they know, first of all, that I'll tell them the truth. And, you know, because I've been where they are and they're just looking for that one thing they haven't heard before.

Yeah, because they know it's their job to heal themselves. They're not waiting for their doctors anymore. What insights do you have for those guys that are really far along in their healing journey? What do you think has been overlooked by them or what's a great clinical nugget for them? I really find that it's it's very rare. Many of my patients come to me after having done all the other things. And, but they've never done this, right? Where it's, it's using these homeopathic products to address the pathogens.

Pathogen-Focused Treatment Strategies 27:00

And I really feel like that is the missing piece. It's, it's very rare that, um, and I would say to somebody who maybe he's already tried that you may have missed the wrong pathogen, right? You may not have gotten the right pathogen that because that's crucial too. If you are using these products, but you haven't narrowed, narrowed it down to the right pathogen. Well, then you're not going to get a very good result. And so, you know, made that mistake a few times in, in my history of like, you have to know what the pathogen is behind the problem.

And if you don't, then you may not get a very good result. So when it comes to GI, just generally speaking, you can kind of not go wrong typically. That is a big root cause of GI issues. But again, there can be other pathogens at play too. So it's important that we're narrowing down them all. And so a good comprehensive stool test is helpful. I don't fully rely on testing. That's another thing I feel like is worth noting is Testing to me, it's, it's a tool, but it's, I know that it's, um, it's not perfect.

And so I'm always taking that into account along with the person's health history, along with their symptoms, your health history can really tell you a lot. You know, if you're somebody who's like, yeah, I have strep throat every year. I used to have ear infections when I was a kid, I got my tonsils removed. I had the staph infection when I was 20. I mean, you can look back at a person's health history too, and you can see a lot of times a pathogen that's prevalent in their past health history. And so paying attention to all of those signs kind of leads you to what your pathogen is.

Again, strep is very often at the root of GI issues, but it's important to take all the information in so that you are narrowing it down to the right pathogen. Yeah, I think it's a great point. And I appreciate you acknowledging the limitations, too, of the lab tests because stool tests aren't perfect. No, no lab tech is perfect, guys. A skilled practitioner will be looking at it as a window into you at best. It's a layer of information. Yes. I appreciate you emphasizing the health history and the symptomology pieces.

Like, we want to treat the human, not the lab, right? I always say that. I treat people, not paper. You have to take it all into account. Yeah. And so you factor it in. If, if you've had this huge health history of strep and maybe strep doesn't show up as high, but it's showing up. Like I'm, I'm probably still going to, to go after that pathogen, but that's where you, you take it all into account. You're not just relying on the testing result. Yeah. That's a great way to say it. Cool. So, um, I know that we've been talking about immune modulation the whole time, but is there anything else you want to make sure the audience knows about managing and treating these chronic symptoms when it comes specifically to IBD and immune modulation?

Like how important is it or any, any clinical insights there? How important it is crucial. And I feel like it's the missing link. It really is when we're thinking about what, what is, It's inflammation and it's autoimmunity, and that is immune dysregulation. And where I see people going wrong is with killing strategies. They're relying on killing strategies, and a killing strategy is never going to fix your immune system. That's why, you know, when people get on antibiotics, they have to stay on antibiotics or, you know, H.

pylori keeps coming back or they're taking antimicrobial herbs, which is a killing strategy, but they're continuing to have to take them because they can never clear the parasites or they can never completely clear the pathogen. And in those scenarios, the missing piece is that the immune system isn't working properly. And until you get that on track, you'll always be band-aiding with natural remedies.

Clinical Takeaways and Where to Find Dr. Stanga 31:00

And so again, what is so amazing about, about the immune therapy protocols and about the homeopathics is that it has the ability to regulate the immune system and build up that innate immune response to get it back on track, to work and fight for you the way that it was supposed to all along. So definitely a huge missing piece for people. Yeah, I agree. We spent a lot of time clearing out parasites as well, and it has to be done after drainage pathways are open. Let's step away from the drama of it.

I also find that people don't give themselves enough time in this stage. They're like, okay, 10-day parasite cleanse, right? And we're like, what? Where did you get that idea? Was that on TikTok or something? Like, don't, no, no, no, no. Yeah, no, I see patients clearing parasites without actually ever treating the parasites. just by a lot of times with H. pylori, doing the H. pylori treatment because it is, you know, when you don't have enough acid in your stomach, that's a line of defense against parasites.

And so a lot of times patients on the H. pylori treatment will pass tons and tons of parasites. And it's like, we're not even doing anything with parasites. We're just getting the immune system back on track and the immune system's doing its job. Right. Yeah, I love that. It's so true. It's like finally giving it the energy it needs. Like, oh yeah, now I have the bandwidth. Let's get rid of these guys. Yes. Like, oh yeah, these shouldn't be here. They've been on the list, the to-do list. Your body knows these guys are in there.

It's so brilliant. It's not stupid. It's just not in a position to do anything about it at this time, but that can shift very quickly. Yes. Yeah. It's like, it's, it's handcuffed. We have to help it out. Yeah, totally. So where can people find you and your work? Um, so you can go to my website, which is drstanga.com. I'm on Instagram under Dr. Megan Stanga have a podcast called the functional medicine unfiltered podcast. So those are all good places where you can find me. That's great. And for desk bioproducts that you mentioned, where can folks find those?

Um, so you can go to, actually you can't buy it directly from Desbio. You can go to my store. Yeah. So I have a strong on my website and you can go there and you can purchase the supplements from drstanga.com. Thank you so much for your work and for your advocacy. It was great talking to you. It was good talking to you too. 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 wellbeing.

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