Healing Your Gut For Hashimoto's Disease With Dr. Jill Carnahan

Healing Your Gut For Hashimoto’s & Autoimmune Disease | Dr. Jill Carnahan & Dr. Westin Childs

How to Reverse Gut Problems for Hashimoto’s & Autoimmune Disease with Dr. Jill Carnahan Podcast Interview

YouTube video

Show Notes & Links From the Video/Podcast

Today I am joined with Dr. Jill Carnahan for a discussion on gut health and its role in Hashimoto’s and autoimmune disease in general. 

Dr. Jill Carnahan MD is trained in both Family Medicine as well as Functional Medicine and has been helping patients for over a decade. She is a survivor of both breast cancer and Crohn’s disease and is currently in remission from both conditions. She’s been through the gauntlet when it comes to treating both autoimmune disease and gut problems and her expertise in this area comes through in this interview. 

You can learn more about Dr. Jill Carnahan Below:

Topics discussed in today’s video:

  • How genes impact your susceptibility to disease states and autoimmune disease. 
  • Why it’s so important to treat the gut if you want to improve your health and immune system. 
  • The concept of molecular mimicry. 
  • What happens to food particles and bacteria when you have a damaged gut lining. 
  • How to repair your gut lining. 
  • The role that testosterone plays in autoimmune disease. 
  • Why women are more susceptible to autoimmune disease. 
  • Reasons you should consider using testosterone replacement therapy as a woman. 
  • The difference between Celiac disease and NCGIS. 
  • The importance of detoxification in overall health and autoimmune disease. 
  • How to detox gently and more aggressively (therapies you can use). 
  • Why it’s becoming more difficult to treat patients. 
  • The benefits of coffee enemas, how they increase your glutathione levels, and how they work in the liver. 
  • The importance of improving glutathione levels in those with autoimmune disease. 
  • Which tests can be used to test for gut-related issues. 
  • The connection between gut health and SIBO and SIFO. 
  • Why thyroid conditions lead to persistent gut problems. 
  • The importance of physical treatments for improving gut health and treating gut conditions.

Audio Transcript

Dr. Childs:

Hey, guys. It’s Dr. Childs here. Today, I am joined with Dr. Jill Carnahan. Dr. Jill Carnahan is your functional medicine expert. She uses nutrition, supplements, lifestyle changes, or medication to treat your illness, and always seeks the gentlest and least invasive way to help you find hope, restore health, and optimize healing. Dr. Jill was dually board certified in family medicine from 2006 to 2016, and in integrative holistic medicine since 2005. Now, Dr. Jill also has a personal history with breast cancer and Crohn’s disease, so she has a pretty significant history with gut health, which is really what I want to be focusing on today. So Dr. Jill, welcome to the show.

Dr. Jill:

Thank you so much. I am delighted to be here with you.

Dr. Childs:

It’s awesome to have you. And so I’m going a little off-script here, but… You probably don’t know this, but ever since about 2014, when I was in residency, I looked to your blog post and to your website, and I’m like, “I want to be like her when I grow up.” So you’ve been actually a really good source of information for me throughout my professional life. So like I said, you’re not aware of that, but I’m very grateful for all that you do. And for those listening, she has a wealth of knowledge on her website in the form of blog posts, videos, podcasts, and so on. So Dr. Jill, what I’d like to do is maybe… Could you tell us a little bit about your own personal history? Because I know you’ve faced some challenges, and then that will kind of springboard us into a discussion, I think, on gut health and chronic infections.

Dr. Jill:

You got it. I do love the story, because it makes it all worthwhile. I’ve been through a lot, and I’ve learned so much. It’s like I’m the guinea pig for so many of these. Basically, it comes down to… I was a third-year medical student at Loyola doing what I dreamed of, becoming a doctor, and all of a sudden I discovered a lump in my breast. I was 25 years old. So as you well know, the statistics of me actually getting breast cancer at 25 are like winning the lottery. And I won the lottery and was told a few weeks later after a biopsy that I did indeed have a very aggressive form of ductal carcinoma, or breast cancer, the most common type. Now, the interesting thing which is relevant to some of our discussion is I grew up on a farm in Illinois, and looking back, I had exposure to all kinds of endocrine-disrupting chemicals that probably led to that early cancer.

Dr. Jill:

And then my genetics were really poor for detoxification, so it was kind of the perfect storm. And at 25, diagnosed with aggressive breast cancer, and then I proceeded to kind of fight the battle of my life. And I was always… Even though I was in traditional medical school, I was very holistic-minded. And if it would’ve been my choice and I thought that it would’ve worked, I would’ve maybe not done any conventional therapy, but what I did was choose to do the best of both worlds. And I had three drug chemotherapy, which was so toxic to the gut, but also maybe saved my life. And then I also did radiation and surgery, and so I did all of that. But while I did that, I consulted with a naturopath. I did meditation and prayer. I had all kinds of other things, and so I feel like I really pulled in both worlds in my own care and I really created my own treatment protocol.

Dr. Jill:

And here I am 20 years later and doing great, living, vibrant health, totally free of cancer, and have been for 19 years. So it worked. But I often say I don’t regret any of my choices. I remember when I chose to do the chemotherapy. I said, “You know what? I’m going to do the best I can right now, and never regret it.” But the truth is those toxic chemotherapy drugs, which kill rapidly-dividing cells all over the body, including the gut, have had a detrimental effect my entire life. And a lot of the things I’ve had to do in the last 20 years have been recovering not from the cancer, but from the treatment I chose to do for the cancer.

Dr. Childs:

Yeah. And you hit a couple things that I definitely want to jump into a discussion on here, but first of all, that’s an impressive story. And I’m sorry to hear about that, but also at the same time, it sounds like it really kind of led you to where you are now. So in a way, there’s that silver lining there. But one thing that I wanted to touch on that you mentioned was this concept of your genetics and then also how that manifests as disease in your body. So maybe, could you talk a little bit about per perhaps what that meant for you, but also what that means for other patients? Because the way I’m kind of thinking about it is, and the way I kind of try to explain it to people, is that you may have this underlying susceptibility to developing certain conditions or diseases, but it doesn’t necessarily guarantee that you will get there. So you can kind of have this manifestation or potential manifestation. So could you talk a little bit about genetics and the role that it plays in gut dysfunction and immune problems, and just health issues in general?

Dr. Jill:

You got it, because I just have so much respect for every woman out there who’s making decisions about breast cancer risk and history. Because of this, if someone comes back with genetics that are high risk for breast cancer, I don’t always recommend they have a bilateral prophylactic mastectomy. Because again, we have choices in our environmental exposures that change the expression of genes. Now, I had the perfect storm, because I have all kinds of detoxification problems with my genetics. And so I had that, plus a toxic load very early in life, probably even, I say, in utero from my mother’s exposures. So it probably started even before birth, and led me to a very early diagnosis of cancer. But just because I had those genetics doesn’t mean that you can’t do things to change that. And now, I feel like I’m living my best life. I’m actually probably healthier in my forties than I was in my twenties and thirties.

Dr. Childs:

Awesome.

Dr. Jill:

One thing I didn’t mention about the story but goes right into the gut things was just six months after I finished all my treatment for breast cancer, got through, I was bald from the chemotherapy, but I was doing well. I was diagnosed with Crohn’s disease. In that as well, genetics and environment play such a role. I had the NOD2 gene, which is a high risk for Crohn’s. And then, as we talked about, the chemotherapy causes damage to rapidly-dividing cells, which are some of the cells that line your gut. And so I had this perfect storm of basically a high risk… And what that means is with Crohn’s or colitis or any of these inflammatory bowels, it’s really just an abnormally aggressive response to a normal microbiome.

Dr. Jill:

So it kind of was a perfect storm, because I had the aggressiveness of my immune system, and then I had an insult from the chemotherapy that caused massive permeability or dumping of the bacterial contents into the immune system. And then it was the perfect storm to create Crohn’s, which is these damage to the lining of the gut based on that immune reaction. And I recovered from that too, and fully cured of Crohn’s disease. So that was another experience, but that all… It’s interesting, because the gut relates to everything, doesn’t it?

Dr. Childs:

It sure does. And honestly, I think that’s so important. And such a great story that you could go and have a diagnosis of Crohn’s disease, but also put it into remission. Because there’s a lot of people listening to this… I talk specifically to a lot of people who have thyroid conditions, and so a lot of people with Hashimoto’s, hypothyroidism, even Graves’, post-thyroidectomy, and post-RAI, they end up with a lot of gut issues. And I think it’s helpful to hear from other people that you can actually do something about these things. Because when I talk about it, I’ll say, “You got to treat your gut, treat your gut.” I’m sure everyone’s heard that. “Treat your gut, treat your gut.”

Dr. Jill:

Yes.

Dr. Childs:

Okay. We know it’s important, but can you kind of explain a little bit about how important and what the gut is doing inside of the body? Why is it so important to treat the gut? And then we’ll talk a little bit about how to do that, but you talk a little bit about why it’s so important.

Dr. Jill:

You got it. I love talking about this, because it really relates, whether you have lupus, or MS, or Hashimoto’s thyroiditis, or Crohn’s, or colitis, or rheumatoid arthritis, or I could name a slew of other autoimmune conditions. We know that autoimmunity, based on Dr. Fasano’s research, is a triad, which means there’s a genetic component. We can’t always change that, but we can change the expression of the genes. Then there’s an environmental trigger. That could be gluten in the case of celiac, or sometimes rheumatoid arthritis, or it could be some infectious trigger or some sort of environmental toxic trigger. Like in me, I think the chemotherapy and all of those kinds of things in the toxic chemicals from the farm were all environmental triggers. But the third thing is what you just mentioned, and that is the gut immune interface. So our tube that lines from our mouth to our anus is our basically external environment connection.

Dr. Jill:

That’s how we are connected to the external environment where the food goes down, where the bacteria resides. And whenever we have an impairment to those cells that line the gut, and we have permeability, which is also called leaky gut, all of a sudden we get antigens like bacterial coatings or fungal coatings or other bugs, or just inflammatory food molecules that aren’t properly digested that leak into the bloodstream. It’s only one cell layer thick between the gut lumen and the bloodstream, and if there’s a barrier issue, like the chemotherapy caused in my case, all of a sudden we have pouring into these bacterial antigens and things. And these in the bloodstream… Our body’s meant to respond to dangerous strangers. So all of a sudden the blood is like…

Dr. Jill:

The immune system says, “What the heck is here? We have corn antigens, we have bacterial coatings. This must be an alarm.” So the immune system does what it’s supposed to do, which is react to foreign invaders that shouldn’t be there, and then it creates this inflammatory cascade that in some cases can cross-react to self tissue and create autoimmunity. So I love that you frame that, because to me, it all makes sense. And how we fix that is look at what environmental triggers led to this. Is there any bacterial overgrowth, fungal overgrowth, parasite infections, or things that are going wrong in that gut lumen? And what cause that permeability of the gut? And how do we shore up that gut integrity so that we aren’t leaking loads and loads of antigens into the bloodstream, creating more of a risk for autoimmunity?

Dr. Childs:

You hit a lot of good things, so I want to talk about a lot of these things as we go. One thing though that I wanted to mention before we jump in there is when you’re talking about these particles of food or bacteria, these things that are being broken down by the gut which normally should stay in the gut, and they’re getting inside of the body, you’re referring to molecular mimicry. Is that kind of what we’re talking about here, or are you talking about something a little bit different? Maybe go into a little bit detail about that.

Dr. Jill:

You got it. So molecular mimicry we typically talk about with bacteria or parasites or other sort of infectious antigens, where the body sees this salmonella, or it sees a lipopolysaccharide coating of a bacteria from your gut, and it starts to attack like it should, because it thinks it’s a foreign invader. It creates an antibody to that, but then that antibody cross-reacts to your joint or to your brain or to your thyroid and starts to attack self, even though it was meant to attack a foreign invader. Typically, that’s with the infection. The food antigens are a little different. I suppose you could have molecular mimicry, but typically what happens there is, say, a corn that’s not completely digested or a gluten molecule gets into the bloodstream, body creates antibody, and those just create inflammation. And so when we decrease those foods while we’re healing the body, then we decrease the inflammatory load of the cytokines and all the reactive molecules that are trying to attack that food instead of the bad guys.

Dr. Childs:

Right, okay. I appreciate that clarification. So it sounds like if somebody’s listening to this, then one of the things that they really want to focus on is shoring up the integrity of that gut lining, because you want it to maintain that protective sort of function that it’s supposed to do. So we talked a little bit about what happens when there’s inflammation and the disruption of that lining. So what kind of things can somebody do if they really want to protect that gut lining, or to restore it if it’s been damaged? Is that even possible? What does that look like from the perspective of the patient?

Dr. Jill:

Yeah. Well, one of the things I find in clinical practice, I’m sure you do too, is we know… Like glutamine. Glutamine is a fuel for enterocytes. It’s something you can buy over the counter in pills or powders, and it’s a good thing for leaky gut. However, if you have an infection or bacterial overgrowth or a parasite, or you’re eating gluten all day long, there’s no amount of glutamine that you can take to restore the leaky gut. So while I will talk about nutrients that can help restore the integrity of those enterocytes, there’s no way you can think just taking glutamine’s going to fix a leaky gut until you get to the root cause of what’s creating inflammation. And so what’s creating inflammation could fall into the category of things like… Gluten’s a big one. And the reason gluten’s so problematic is because it’s a very long…

Dr. Jill:

I talk about pearl necklace, like polypeptide. That often our bodies should have the scissors to snip it into little one or two pearl pieces, but many people don’t have that DPP4 enzyme, so you can’t break it down properly and it becomes more inflammatory. And a lot of people have more issues now that wheat is grown with glyphosate, and we produce a much more high-gluten type of yield product. So the US types of wheat that we grow are typically way worse for celiacs or non-celiac gluten sensitivity than they were 100 years ago. So gluten’s one, but then other things like infection, if there’s a SIBO or SIFO, the bacterial or fungal overgrowth in the small bowel.

Dr. Jill:

If there’s a parasitic infection, which is hard to find but can be present, and can be present for decades if people don’t know about it… And then just other kinds of overgrowth in the colon or inflammation, like inflammatory bowel disease. So you have to find out what’s… Or for me, chemotherapy or drugs can do it too, so there’s definitely drugs that can increase permeability. And if any of those things are happening, you can’t really use the nutrients to restore until you fix that root problem.

Dr. Childs:

For sure. Whenever we talk about supplements, I always need to be… What you said is perfect, because we need to say they’re supplements to the other things that you’re doing. And probably first and foremost, in many cases, is what you’re putting into your body in the form of your diet. And I do want to talk about diet and kind of the types of diet that we might use to heal the gut and so on, but before, I want to touch a little bit about celiac and NCGIS, as you mentioned previously. So in the case of Hashimoto’s and other autoimmune diseases, I found, and maybe this is the case with you and I’d love to hear your opinion, is that a lot of these patients do better when they remove gluten from their diet, even if they don’t have an official diagnosis of celiac disease. So is this something that you’re seeing as well? Where do you stand on this sort of gluten with autoimmune disease, maybe in the setting of Hashimoto’s, but also maybe in the setting of just improving gut health in general?

Dr. Jill:

I love that you’re talking about this, because so many patients go to their gastroenterologist, and they’re like, “You don’t have celiac.” So the patient’s like, “Okay, well then I can eat gluten.” And there is a spectrum or different variations of this. The true celiac, which I am one of those, absolutely can’t have even a molecule of gluten because it definitely creates inflammation. But there’s a lot of other people on that spectrum that react to gluten, and one of those is the non-celiac gluten sensitivity. Here’s how I tell patients in my clinical practice. First of all, I’ll check for a tTG IgA and IgG, which typically… I just posted about this recently. If that is five times normal, you don’t even need a biopsy now. It is so highly correlated with celiac. So that, if you have a high tTG IgA or tTG IgG, it is very likely that you have celiac without even getting an intestinal biopsy.

Dr. Jill:

But you can have anti-gliadin or an anti-non-deamidated gliadin. Either one of those can be non-celiac, meaning you don’t have complete villous atrophy. The shag carpet that lines your gut isn’t completely destroyed, and you can still have significant sensitivity or creation of more risk of autoimmunity. And how I tell patients is I check the genes too, and there’s a DQ2 and a DQ8 that we can test in blood. And if you have one of those, you’re at higher risk for celiac, but here’s how I explain it. It’s like the two genes are like the center of a wagon wheel, and all the spokes that come off that wagon wheel are autoimmune diseases. One spoke is celiac, but many of the other spokes are what we just said: Hashimoto’s, rheumatoid arthritis, lupus, multiple sclerosis, and any number of other autoimmune disease that we could name. So when you have that gene in the middle of the wagon wheel, you may never ever get the spoke that’s called celiac, but you’re still going to have a greater risk of developing any autoimmune disease if you have that genetic risk.

Dr. Jill:

Because we know by nature that if someone has that gene, their HLA types, in their gut, which are basically sensing, “Is this good or bad?” When they see gluten, they get angry. It’s like angry wolves. And so even if they don’t have celiac or never develop villous atrophy, they’re going to be at higher risk for irritating their immune system when they consume gluten. So then I give them a choice and said, “If you knew that getting gluten out of your diet could be reduce your mortality by 30%, would you do it, even if you didn’t have celiac or didn’t have autoimmunity?” And most people get it, and they start to go gluten free or understand that that does decrease risk of all autoimmunity. And the statistics say that all cause mortality: cancer, heart disease, you name it, causes of death are decreased by 70% in someone who has the genetics that goes on a gluten-free diet.

Dr. Childs:

That’s huge. Those numbers are astounding, really. And I tend to run into this problem sometimes with patients, or at least had in the past, and we’re trying to get people to go gluten free. And so it seems to be something that maybe was in, let’s say, in vogue probably, I don’t know, maybe… Gosh, seven, eight years ago. It seemed like everyone was going gluten free. Then that’s sort of replaced with the keto diet and carnivore diet, even now maybe a little bit. So these things kind of come up and down, but there’s still a lot of relevance to going gluten free, and I think there’s a lot of benefit as well. And so I actually really like the analogy that you mentioned with the spokes, because even if it’s not specifically celiac disease that you’re preventing or trying to stop, it could be something else.

Dr. Childs:

In this case, maybe the people listening to this, maybe Hashimoto’s, maybe some other type of autoimmune disease. Something that you brought up as well that I wanted to talk about just for a second, see if you have an opinion on it, is just sort of the luck of the draw that a lot of women get when it comes to autoimmune disease, because they tend to get it more frequently than men do. Do you have any insight as to why that may be? Sometimes I’ve heard maybe testosterone is playing a role. Maybe it has to do with the genes. I don’t know if you had any input on that or insight on that.

Dr. Jill:

I do.

Dr. Childs:

Okay.

Dr. Jill:

One thing I didn’t mention, another part of my story, is I had mold toxicity. One of my offices flooded before I moved. Massive issues with mold. I’ve recovered from that, but mold is a massive trigger of autoimmunity, of leaky gut, et cetera. I’m mentioning that because many people don’t know. This is a part of my story I don’t always talk about. Right after the mold exposure, I was diagnosed with type 1 diabetes-

Dr. Childs:

Oh, wow.

Dr. Jill:

… which is latent adult. I was about 40 years old. Type 1, latent adult onset. I had all the antibodies for that, and I literally had an A1C that was high. It was abnormal. Now, once again, this maybe will surprise you, maybe won’t. I no longer… I have a normal A1C. I’m not on insulin.

Dr. Childs:

That’s amazing.

Dr. Jill:

I feel like I’ve completely reversed that. Here’s the secret. I did the studies and I looked, and one of the biggest factors for women being four times the amount of men in autoimmunity was the testosterone levels, just like you mentioned. And I replaced my testosterone to normal levels, maybe just a little bit higher than normal, but pretty normal for women, and that was one of the factors for me in reversing my type 1 diabetes.

Dr. Childs:

Awesome. I’m so glad you mentioned that, because I feel like maybe I’m alone in that. But I have recommended testosterone replacement therapy if it’s low.

Dr. Jill:

Yes.

Dr. Childs:

I don’t give it if it’s high.

Dr. Jill:

Absolutely.

Dr. Childs:

But as a potential treatment for really any autoimmune disease, but I use it in the setting of Hashimoto’s. Now, I tend to find that a lot of women, just probably across the board… Some women have low testosterone, and some have high, especially if they’re on that sort of PCOS spectrum. But at least my experience has been most women with autoimmune disease tend to have those lower levels, and so there’s a lot of benefit, I think, to using the testosterone. And I’ve even dabbled with a little bit of DHEA and other lighter androgens as well. Have you tried those therapies as well, either personally or on patients?

Dr. Jill:

Absolutely. And again, I’m speaking as a breast cancer survivor that has done her research. That could be risky, but I monitor the levels. I take both DHEA and testosterone to normalize. And interesting, as you well know, mold itself for men and women often lowers testosterone. So when I was diagnosed, I had almost zero testosterone, so it was definitely in need of getting back to physiological levels. And that’s kind of the key is you get… Like you said, when you replace it, checking levels, make sure you’re normal physiologic. You don’t need to be super physiological, but it absolutely makes a huge difference in women with autoimmunity.

Dr. Childs:

Yeah, I agree completely. That’s funny that the conversation kind of went there. But just one more question on the topic of testosterone, but especially in women, because I really feel like testosterone has kind of, at least marketing-wise, has been dominated or directed towards men. But I do think that women also outside of the realm of autoimmunity, they also have some additional benefits that they can get from testosterone replacement therapy. Maybe can you speak to a little bit of the additional benefits, or maybe why women might consider using testosterone replacement therapy, and why it’s not just solely for men?

Dr. Jill:

Sure. Well, of course women have libido issues too, and testosterone’s a great solution for that. But not only that, but bone loss and bone integrity. It’s huge for maintaining bone and muscle. And as we age, we lose muscle, we get sarcopenic, and we actually gain body fat. And that doesn’t do anything for metabolic syndrome, risk of diabetes, or even bone loss. So for many reasons, it’s much more of an anabolic type of thing, which builds muscle, builds tissues. Hair, skin, nails benefits, so all across the board, and especially just drive, ambition, follow-through, some of the cognitive benefits too. We see that with dementia, low estrogens and testosterone in women. So there’s a myriad of effects in women as well as men.

Dr. Childs:

Now, are you using any bioidentical hormones for, let’s say, for treating menopausal-type symptoms as well in your practice? Are you doing other types of hormone replacement therapy?

Dr. Jill:

Yes. So absolutely, I use all the hormones for women who need it, and men too.

Dr. Childs:

Okay, awesome. I know that kind of shifted off topic a little bit.

Dr. Jill:

That’s okay.

Dr. Childs:

So one thing I wanted to get back to, which you mentioned before, was this concept of toxic load. So could you expand a little bit on this idea of toxic load, how that impacts perhaps gut health and even detoxification? Or maybe just define it, and then sort of explain it in layman’s terms for those perhaps listening.

Dr. Jill:

Sure. And I love that you brought it back to that, because it’s very relevant for the thyroid patients that you treat, Hashimoto’s or any type of thyroid symptom. Our thyroid tends to be like the canary in the coal mine that is one of the most sensitive organs to toxic load. So what is toxic load? I always describe it as like a bucket, and all of us are born with a different bucket capacity. Our bodies are actually created to detox. We’re made as detox machines, so this isn’t something that we don’t do or don’t know how to do. We’re actually created to do that. But the problem is when that bucket becomes full with various toxins, like for me pesticides, organophosphates, parabens, metals, et cetera, it starts to decrease the… I think of the water level starts to go up. And when that water level reaches the top, it spills over into symptoms or diseases like autoimmunity, gut integrity, et cetera. And even cognitive issues, energy issues, whatever we want to talk about could probably be affected by that toxic load.

Dr. Jill:

So as clinicians, one of the most exciting things is… It’s great to know what’s in that bucket, but you don’t necessarily need to identify all 1,000, 10,000 things that are in the bucket. All you have to do is start detoxifying and decrease that margin, decrease that water level so that all of a sudden the patients have a little bit of space or margin left. Because once you create more margin, the body will do what it needs to do anyway, so all you have to do is begin some basic detox. It’s great to test to know what the toxins are, but even if you don’t, or even if you’re out there listening and you don’t have a functional-minded doctor, you can still basic detox protocols and things and decrease that load, and buy yourself some margin, and then your body will come back to a more baseline normal place when that toxic load is decreased.

Dr. Childs:

Yeah. And when it comes to detoxification, these sort of simple things, do you have any sort of tips that you might give somebody on how to decrease that toxic load to help improve just the overall function of the body, but also gut health?

Dr. Jill:

Yeah. So we can go with supplement stuff, and I’ll talk about that in one second, but I love simplicity, and I often say clean air, clean water, clean food. It can go that simple. And often, people are real excited about a 21-day detox, or this supplement protocol. I am all for that, but it starts with what we put in our body, so it actually starts way simpler than that: clean air. 80% of our toxic load is the air that we breathe, so having an air filter in your home… I recommend a HEPA filtration with a high MERV rating on your furnace or a standalone filter. And if you get a standalone filter, you can get VOC filters that contain zeolite or charcoal and decrease the VOCs in the air. So that’d be like mycotoxins or formaldehydes that are off-gassing from materials, et cetera.

Dr. Jill:

I think we should all, nowadays, and especially… I’m in Colorado. We just had all kinds of wildfires. I know California, everybody’s had a lot more lately. Those have massive effects on our air quality, and so does a myriad of other things. So we cannot assume that our air quality is okay. I think we should, probably in offices and homes, have air filters in place. Clean water, we take that for granted, but whether you are drinking… If you’re drinking tap water, think again, because our tap water is so contaminated nowadays. Ideally, a whole house reverse osmosis filter is great, but not everybody can afford that. You can get pitchers that are like… Clearly Filtered has some, and there’s some other. Berkey has a great one that are countertop or in your fridge that are affordable. But you want to drink filtered water nowadays. It’s almost essential. So clean water.

Dr. Jill:

Clean food, the things we put in our diet. Avoiding fast food, avoiding processed foods, avoiding wheat for many people, avoiding pesticides and chemicals, so eating organic local when possible, in season when possible, all of those things really make a difference, and they don’t cost all that much. You can start with simple things and do 80% of the good without a lot of supplements.

Dr. Childs:

So it sounds like preventative is a pretty big source of there. And then I think as you mentioned, you do have supplements that you can use. Maybe even far infrared sauna, sweating, ensuring you have proper stooling habits and things like that. Is that kind of in line with what comes downstream for you?

Dr. Jill:

Yeah. So then the next phase would be sweating is huge. So whether you do infrared sauna or workouts… Or if you’re not sweating, there’s a problem. That’s an issue. So sweating and infrared sauna can be huge. Epsom salt baths. Castor oil packs over your liver can be helpful. Even coffee enemas, which I learned in Switzerland. People don’t like to talk about it, but it’s a powerful way to increase glutathione. Basic supplements I think about with detox are: How do we raise glutathione? You can take it. You can do precursors like N-acetyl cysteine, glycine, glutamine, back to the gut, alpha-lipoic acid, milk thistle. Those are all kind of liver and detox-supportive things. Broccoli sprouts, or leafy greens, which are sources of sulforaphanes. And then binders. I’m a huge fan of binders, because many toxins that we have go into the bile and accumulate there, and then our bile is just reabsorbed with about 95% efficacy. And if we don’t kind of stop that and pull it out through the stool with a binder… That could be clay, charcoal, zeolite, glucomannan. Then sometimes we just reabsorb those toxins.

Dr. Childs:

That’s awesome. In your practice, are you seeing a lot of patients who suffer from issues with the inability to detoxify inside of their body? Is that a big thing for a lot of people? Does it play a smaller role for most people? Where are you seeing that in terms of its importance of all the things that people sort of have to think about their health? Where does that fall for you?

Dr. Jill:

I think it’s huge. I think it’s the elephant in the room. And the reason for that is not that we don’t detox better, that we detoxify worse than we used to. It’s that our toxic environmental load, the amount of chemicals… Literally hundreds of thousands of new chemicals are being put into the environment every year without proper testing, and they certainly aren’t testing them synergistically in combinations. So we’re having these new-to-nature molecules and chemicals in our air, in our water, and our food supplies that are overloading our capacity. I think we saw that really well in the pandemic, because all of a sudden… Granted, this was a really nasty virus that was highly contagious, but we saw a lot more people getting sick because our loads in our immune systems were way overloaded than they might have been 50 or 100 years ago. So that’s why I said that things that we eat and do, basic clean air, clean water, clean food really matter more than ever, because that toxic environment is weakening our immune systems. And then we have a hard time fighting infections or detoxifying, like we should be.

Dr. Childs:

And I think I see that a lot in patients, especially like you said, during the pandemic. But even before, where you have people… They’re riding on sort of the edge where they’re just barely getting by, and one little thing can tip them over, whether it’s the pandemic, staying inside, the toxic loads goes a little bit high. Maybe it’s stress from taking care of somebody. Whatever it is, dietary changes all of a sudden, then they get tipped in and now they start developing gut issues. And it just sort of spirals down into autoimmune disease and so on, and bad health. And so I do see a lot of that, and it sounds like you might be seeing some of that as well in your practice. Is that correct?

Dr. Jill:

Yeah. And again, I’ve been doing this about 20 years. Years ago, it was like a Hashimoto’s or a menopause issue. Three months later, they were better. They didn’t need to see me anymore. Nowadays, the people that come see me, probably like you, they’re really sick. The level of sickness and toxic overload is way greater than it used to be, and it’s way more complex. There’s more layers. There’s more infection. So I think it is just part of that environmental toxicity that’s increasing complexity of the people now that are getting sick.

Dr. Childs:

Yeah. I’ve seen a little bit of that, I would say. I haven’t seen a lot of it, just because I don’t think I’ve been in practice long enough to really see trends necessarily. But I have from other people who have been around, and they’ve said that exact same thing. They’re like, “Look, back in the day, used be totally different.” I do want to get back to the gut health, but I do think this kind of ties in with it. And you mentioned the coffee enemas, going to Switzerland, kind of doing… It sounded like doing detoxification there, if I’m understood what you mentioned previously. But maybe, could you talk a little bit about coffee enema? And if somebody who never has heard about this, maybe they’re kind of like, “What is going on,” maybe explain a little bit about that, how it’s maybe supporting detoxification in the liver, or kind of how it’s working inside of the body and its benefits.

Dr. Jill:

I love it. And I’ve got a big smile, because MDs, we don’t talk about coffee enemas.

Dr. Childs:

Yeah, right.

Dr. Jill:

So it’s so funny I’ve gotten real comfortable. And I’ll tell you my little story. Two years, I went for a two-week retreat in the Swiss Mountain Clinic in the Southern Alps of Switzerland with this amazing German team of physicians that did basically liver, gallbladder cleanse for the week. And they had amazing therapies, a lot of the stuff we do here, but also other colon hydrotherapy and coffee enemas, and then lots of amazing foods, auricular acupuncture, and then herbs and treatments and protocols. So that week or two that you were there, you’d get this incredible protocol. You’d come home detoxed and feeling great, eating great food, hiking in the Swiss Alps.

Dr. Childs:

That’s amazing, yeah.

Dr. Jill:

One of the things, though… Here’s why I talk about coffee enemas. I went my first year, and I was by far the youngest person. The average age was like 95.

Dr. Childs:

Oh, wow.

Dr. Jill:

I’m exaggerating, but a lot of people in their eighties or in their late seventies, and these were healthy people overall. But generally back here, when I would treat those kinds of people, I would go more carefully, more slowly-

Dr. Childs:

Absolutely.

Dr. Jill:

advanced age. And I saw these people flying through with no problem these intense detox protocols, and I’m like, “Why in the world? How in the world are these elderly people doing so well at this massively intense detox?” And I realized one of the things they were doing every day was if the patients wanted to, they could do coffee enemas in their room. They had all the kits and everything there. And then they also did colon hydrotherapy once per week with a professional.

Dr. Jill:

And I realized that because our liver, gallbladder, biotransformation access is all about gut and stool, and part of it, we don’t really assist that as much here in the US, and like I said, especially not in allopathic medicine. And I realized that was one of the things that was allowing them to do so well with such an intense protocol. And I said, “Why are we not talking about this here?” And then I came back here and I looked online, and all I could find was this, “Brew the coffee, cool the coffee.” It was a mess and an incredible half-a-day ordeal. I’m like, “Who’s going to do that?”

Dr. Childs:

Yeah, too complicated.

Dr. Jill:

Right. So I started importing the kits from Switzerland, and all they are is this wonderful BPA-free bottle that has a tube. And you just fill it in with this instant, clean, organic with charcoal coffee mixture, shake it up and squeeze it, and you’re done. It’s like the easiest thing in the world. So I started number one and made it easy, because that’s what they did there. And number two, I found for my patients with mold and severe toxicity… It was one of those, like you mentioned, Epsom salt baths, or infrared sauna, or coffee enemas. Those are all in the same class. We think about mobilization of toxins. That’s easy. We take supplements, we do the protocols. But we can mobilize, and if we’re not excreting, we get stuck. We feel horrible. So what I learned is the mobilization, that’s what we have down. We don’t have the excretion down as well. And those excretion things I think are harder, because they involve dry brushing, lymphatic drainage, lymphatic massage, castor oil packs, coffee enemas. But by adding those into the protocol, people tolerated the detox a lot better.

Dr. Childs:

That’s awesome, and I definitely agree with you. I kind of had this internal threshold of age where it was like above 65 got a lot more difficult, or I had to be a lot more careful. And 65 is not that old. It really isn’t. And if you’re treating patients in the hospital, like you said, the average age is easily in the eighties. But you’ve got to be pretty careful with them, at least here, so that’s really interesting to hear. And whenever I have personal experiences like that, it really sort of changes the way I think about things and what is possible. I sometimes get limited in terms of what is possible, just because of my world and what I’m seeing visually.

Dr. Childs:

But if you go somewhere else and you’re like… Suddenly, it’s like a light bulb goes off. You’re like, “Well, it could be like this. Why does it have-“

Dr. Jill:

Exactly.

Dr. Childs:

“… to be this way? It doesn’t have to be this way. It could be so much better.” And when it comes to coffee enemas, I’ve never actually done one myself. I’ve heard a lot about it. I think it was from Dr. Gonzalez, who is deceased now. He talked a lot about it in the treatment of cancer. My understanding was through the venous network that’s in the area, it comes back up to the liver and supports probably phase two detoxification. I’m not exactly sure. I don’t know if you know the physiology in terms of how it’s working.

Dr. Jill:

Oh, yeah. And that’s what helped me too to understand why in the world would this be-

Dr. Childs:

Yeah, how is it helpful?

Dr. Jill:

Or why haven’t we heard about it? And again, I think it’s because just medicine hasn’t really talked about that, but bottom line is this. When you get that enterohepatic circulation stimulated, your body goes back. It’s connected to the liver, and your production of glutathione goes up by 600%. So you’re basically inducing your body to dump bile and produce more glutathione. So you’re kind of inducing that pathway to be more active. And usually, in rare cases, if someone has electrolyte disturbances, that would be a reason not to do it. And if patients are in a really, really weakened state, or there’s an issue, maybe I do it once a week or once a month versus multiple times. But generally, it’s quite well-tolerated too, which is nice. It’s safe.

Dr. Childs:

Now, do you see… My ears are perking up here, especially in the setting of treating something like Hashimoto’s, because they tend to have problems with free radicals and the thyroid, and the glutathione is potentially helpful there. So the glutathione production from the liver is… Do you see any benefit in systemic autoimmune diseases? In other words, is that glutathione staying localized, or does it go throughout the body? Do you think there would be any benefit from the treatment of an autoimmune disease aside from, let’s say, gut health and detoxification in using something like a coffee enema regularly?

Dr. Jill:

Absolutely. Because again, that glutathione production is definitely total body. It’s where the liver produces it, but it’s going to… It’s basically like just gently tapping the whole detox pathway and getting a good response. But also, like I said, mobilizing and excretion, you’re doing both parts of that, not-

Dr. Jill:

… just the mobilization. Yeah.

Dr. Childs:

Awesome, okay. And you did mention that you have those available. Did I hear that correctly?

Dr. Jill:

Yeah, we do. And it’s so funny, because I didn’t do this for profit, because literally we barely make anything because I have to import them, but it’s because there’s none of them like it. So yeah, at drjillhealth.com we sell them, and certainly people can buy them. And all I do is just try to get them here.

Dr. Childs:

Awesome.

Dr. Jill:

But it’s easy to… And they’re easy to use.

Dr. Childs:

So if you’re listening to this and you have autoimmune disease, especially Hashimoto’s, since a lot of people will, that’s a potential, I think, a big potential game changer for these people. And of course, combined with everything else that we’ve talked about, diet, supplements, healthy sleep, and so on. But that’s definitely an interesting thing. I’m going to have to look into that a lot more, do a lot of research. So I’m really grateful you brought that up, because I’ve heard about it before but didn’t really completely understand it, just sort of was peripherally aware of it. So I wanted to kind of go back to the gut health just while we’re kind of closing up here, and talk a little bit about gut health testing.

Dr. Childs:

And so I see a lot of patients who they know something’s up in their gut. Maybe they have constipation, acid reflux. Maybe they just have chronic pain, things like that. What is somebody going to do in that situation to really figure out what is wrong? Because we know in order to feel better, we kind of have to direct treatment. You can do some shotgun approaches to gut health with diet and things like that potentially, even if you don’t know exactly what’s wrong, but what type of tests are you using to help identify the main problem in those people who have these gut problems?

Dr. Jill:

Yeah. So I usually do a pretty good battery of tests, because people have been other places and tried other things. So the typical patient who comes in with any gut symptoms will have a stool test, and I’ll tell you about some of the main markers that we want to see there, and then also organic acids, which will do some metabolites of both yeast and bacteria, neurotransmitters and vitamins. And then I also do blood work. So with the stool test, some of the things I’m looking at are obviously the bacterial contents and any overgrowth. And that’s typically colon bacteria, because we’re testing from the colon and not the small bowel, so you can’t really diagnose the SIBO or bacterial overgrowth in the small bowel. Other things I look at there are protein in the stool. If people are low hydrochloric acid, they may be spilling protein. Or if they have low pancreatic elastase, their pancreas isn’t secreting enzymes properly.

Dr. Jill:

And both of those things are upstream things that need to be dealt with with digestion and breaking down food, or you increase that same antigenic load. Other things are short-chain fatty acids, which if are very low, important to improve with things like butyrate. And also inflammatory markers like calprotectin and eosinophilic protein X, sometimes lactoferrin, because that’ll kind of differentiate is this a typical IBS or inflammatory bowel person. And those are very different. So Crohn’s and colitis are a whole different ballgame than just your typical IBS. So that stool will give us that information, and then you can of course treat with drugs or medications or herbs if there’s overgrowth or problems with the enzyme production or the hydrochloric acid. The organic acids will tell me a little bit more detail about the whole body, especially maybe up in the small bowel, and you can look for fungal markers or bacterial markers that you may not see in the stool that can be really helpful.

Dr. Jill:

And then the blood work, I often test for H. pylori, either breath, stool, or IgG, IgM, IgA, and those can all be done in a routine blood work. I often check for Candida IgG, IgA, IgM as well to see if there’s antigens to those. And you can do some of the basic CBC, CMP, make sure absorption liver enzymes are okay, pancreatic enzymes like lipase and amylase to make sure the pancreas isn’t inflamed. So that whole slew usually gives me a good idea. And then if they do have symptoms of IBS and they’ve never been diagnosed or treated, we can do a breath test to rule out SIBO. And that’s key, because SIBO is a really common thing with autoimmunity, and treating that will make a big difference in symptoms that look like IBS.

Dr. Childs:

And I do want to talk a little bit about SIBO and SIFO just here for a second, just because in the thyroid population, just due to the decreased kinetics of the bowel that low thyroid function can cause, and also low stomach acid, I see a ton of patients with SIBO and SIFO, and I think it’s more common, kind of more accepted nowadays. But I’d say go back five years, it was sort of like a less-known diagnosis. So maybe, could you discuss a little bit about what these conditions are and sort of how they manifest, and maybe how they’re a little bit different from other gut conditions that most people might be aware of?

Dr. Jill:

Yes. I’m so glad you mentioned that, because it’s super common. So we have SIBO, small intestinal bacterial overgrowth. There’s a couple types. There’s a hydrogen predominant type. There’s a methane predominant type that they are now calling IMO, intestinal methanogen overgrowth, because methanogens are technically not bacteria. And that type typically causes more constipation than diarrhea, whereas these hydrogen predominant type causes a diarrhea. And there’s a new kid on the block that we’ve had around for a while, but we’ve never been able to test it, now we can, and it’s hydrogen sulfide SIBO. So there’s three different types. Ask your doctor to get a three-hour and three-gas breath test, because you’re going to get more of a comprehensive diagnosis if you do the three gases that I just mentioned, and also the three-hour test and see. And that’s the basic way to diagnose it.

Dr. Jill:

Now we know from Dr. [Pimentel’s 00:38:32] research that 60% of IBS has an underlying cause of SIBO. So it’s really common if you’ve been diagnosed with IBS. The second thing is many of those cases are post-infectious, which means you go to Hawaii or you go to Costa Rica and you get a bug, you get a gastroenteritis, and then ever since then, you’re not the same. You have symptoms. And what can happen is your body cross-reacts to that salmonella or shigella or bacteria and then cross-reacts to the migrating motor complex, which is a thing that has motility in your small bowel and keeps you from having stagnation and overgrowth of bacteria. So often after an infection, people will develop this IBS, and it turns into SIBO. Now, SIFO is a cousin. It’s fungal overgrowth, not bacteria, and these two can coexist.

Dr. Jill:

And you mentioned thyroid. Thyroid, even if we decrease our body temperature and are mildly hypothyroid, we call it subclinical, by about a half a degree, it can cause massive proliferation of yeast. Take advantage of that slightly decreased body temperature. So it’s super common to have, because of lack of motility due to thyroid issues or to the body temperature, to have both SIBO and SIFO. And the treatments involve medications for SIBO or herbs, and then for SIFO, the same thing. If you have both, antibiotics may make your SIFO worse, so you kind of got to know which one you’re dealing with and either use meds to cover both or herbs that would cover both.

Dr. Childs:

And in my experience, it’s been a little bit difficult to treat these conditions, especially if you don’t treat the underlying problem which led to it. So in the case of thyroid, what I’ll tell them is, “You’ve got to optimize your thyroid medication, because if you leave your motility decreased, then the problem’s just going to keep coming back.” It’s going to keep coming back. And so I see a lot of recurrence of SIBO and SIFO. Is that something you’re seeing? Do you see difficulty in treating it? Or what’s been your experience there?

Dr. Jill:

100%. And I always think of upstream… We have digestion absorption, so basically pancreatic enzyme protein malabsorption. If you’re not digesting food, you’re going to have it recur. And then the motility issue, so migrating motor complex, if you’re not having good motility, you’re going to have it recur. And things like low-dose naltrexone, low-dose erythromycin, prucalopride, or even herbals like ginger or Iberogast, those are all things that can help with that motility. But all of those things must be addressed, or you will frequently have recurrence. And then you mentioned something that not a lot of docs are aware of, but clearly you are, and that’s the thyroid. Absolutely, 100%. If someone has subclinical untreated hypothyroid, they will not get better until you treat the thyroid.

Dr. Childs:

Yeah. And obviously we see a lot of that, just with the people that are listening to this. When we close up here, I got one more question I want to ask you about, since you kind of have a pretty broad experience. I’m really impressed by the different types of therapies that you’ve been exposed to in your life, even the things that you’re doing on yourself, and so maybe you’re familiar with this sort of thing. But sometimes when I think about treating gut health, I also think about the vagus nerve, and maybe even physical therapy or physical manipulation to try and improve the conduction of nerves and so on to get things kind of moving. So do you think there’s any place for, let’s say, even massage therapy or chiropractic work or osteopathic therapy in treating these sort of gut dysfunctions or gut issues?

Dr. Jill:

100%. One of the things we didn’t mention is obstruction can happen or lack of motility with adhesions. So I’m frequently recommending visceral physical therapy, which can be done with a chiropractor or a physical therapist that’s trained. And they’ll actually do abdominal massage for adhesions, because… And especially that ileocecal region, if you’ve ever had abdominal surgery, hysterectomy for women, other groin-like hernia surgery for men, that can absolutely impair motility, so that’s huge. And then acupuncture can treat vagal nerve. Did you know… There’s this interesting thing I found in the last several years, that some of the tick-borne infections can actually infect the vagal nerve and cause chronic dysfunction like Ehrlichia and Anaplasma. So there’s a whole nother set of infections that can affect the vagus nerve as well, but you’re right on. I think whatever way we treat that vagus nerve, it could be really, really critical.

Dr. Childs:

Yeah. And the vagus nerve, for those people maybe not accustomed to anatomy, it’s really important for motility and just sort of the innervation to that gut. And so I see a lot of people, at least in my experience, who have had issues, maybe even just tight muscles or whatever it is. They just aren’t getting the movement that they should. Maybe lymphatics are being slowed down, all these sort of physical problems that can occur. Like Dr. Jill said, they can get visceral motility, or they can have adhesions, other types of physical problems inside of the gut. And so I do think it’s beneficial. At least I’ve seen that.

Dr. Childs:

And it sounds like, based off what I’m hearing from you, is that treating the gut is very comprehensive. You’ve got diet, supplements, potentially prescription medications, antifungals, supplements, botanicals, and so on, physical therapy even, to some degree. So I definitely think it’s possible to get there, but it can be difficult in some cases, especially if you have underlying things that aren’t being treated. So before we wrap up, do you have any last things? Then we’ll talk about how people can kind of find or get ahold of you. Do you have any last words of wisdom when treating gut health or gut problems that you might share with the audience?

Dr. Jill:

Sure. Well, I just think I want to leave you with… 20 years ago I had Crohn’s, and I have for every day of my life since then been very, very proactive in treating my gut. I feel like it’s in great shape, but I still eat a very, very clean diet. I take a ton of supplements. So I don’t want you to lose hope or feel like you do an eight-week course and it goes away but then comes back, that you haven’t… Just know, for people who have issues like my history, you might have to be pretty persistent, but you can get to a place where you’re functioning well, you feel great, your gut functions amazing, even despite some very significant setbacks. So don’t give up, is the bottom line.

Dr. Childs:

I love that, and thank you so much. And your story is so inspiring, because like you said, you’ve gone through quite a bit. And to be where you’re at now, that’s amazing. You look awesome, so that’s really good. Now, Dr. Jill, where can people get… Where can they reach you? If someone’s interested in being treated by you, can they get ahold of your clinic? Or what about your website, podcast, anything like that?

Dr. Jill:

Thank you, and thanks for mentioning. I’ve been working for 10 years on content, so my website’s loaded with free stuff for all-

Dr. Childs:

It is, yeah.

Dr. Jill:

Yeah, just loaded, and you can search the blog. So jillcarnahan.com is the blog and the clinic site, tons of free information there. I have a new YouTube channel for the last two years. We have 100 episodes or more of professionals. If you just search my name with YouTube, you’ll find the channel. We’d love for you to subscribe. It’s all free. And then lastly, I mentioned Dr. Jill Health is actually our retail store, and we do have the coffee enema kits and things there as well. And thank you for asking.

Dr. Childs:

No problem. I’m going to include the link to the coffee enemas, so hopefully they don’t blow them all up. But I think that-

Dr. Jill:

I have to tell you a really quick, funny story. Again, nobody knows.

Dr. Childs:

Yeah, go ahead.

Dr. Jill:

So I know a lady who flew back and forth. She’s got a private jet. She has the funds. Switzerland with me and met her. She sent me a picture about maybe six weeks ago, and she had the director of the Swiss Mountain Clinic. They were coming here to visit in her private jet. She said, “Hey, Jill, we’re flying here on my private jet, and guess what’s in the cargo. We brought dozens and dozens of coffee enema kits for you by private jet.” I’m like, “Yay!”

Dr. Childs:

Yeah, that’s awesome.

Dr. Jill:

Just got a shipment in by private jet.

Dr. Childs:

Ah, that’s so cool. All right, good. Well, if anyone needs to get them, they know where to get them. It’s at your website. All right. Well, that’s kind of all we have for you guys today. Thank you so much, Dr. Jill, for coming, and otherwise we’ll see you guys in the next one.

Dr. Jill:

You’re welcome. Thank you.

Dr. Childs:

No problem.

reversing gut problems and improving gut health with dr. jill carnahan

Dr westin childs photo

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 70,000+ people have used them over the last 6 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

P.S. Need more help? Check out my free thyroid downloads and resources.

Leave a Comment

0
Your Cart
Your cart is emptyReturn to Shop
Calculate Shipping