Following Your Gut Podcast #15, Beyond Quick Fixes with Dr. Eric Balcavage

In this enlightening episode of the “Following Your Gut” podcast, host Roland Pankewich welcomes back Dr. Eric Balcavage for a deep dive into the digestive system. Titled as a masterclass in gut physiology, the episode intricately explores topics such as fungal overgrowth, the role of the immune system, and the consequences of lifestyle factors on gut health. Dr. Balcavage articulates the nuanced interplay between gastrointestinal issues and thyroid conditions, emphasizing the importance of viewing the body holistically.

The conversation sheds light on the often-overlooked aspects of immune dysregulation caused by lifestyle choices and environmental factors. Dr. Balcavage introduces listeners to cutting-edge testing methods like Cyrex Labs’ lymphocyte map and biome burden test, which provide detailed insights into the immune system’s interaction with microbial factors. The podcast emphasizes a shift from conventional symptom management to addressing root causes, offering listeners a comprehensive understanding of both immunological and lifestyle-driven digestive disorders.

About the Guest:

Dr. Eric Balcavage is a renowned specialist in the field of functional medicine, focusing extensively on thyroid dysfunction and related metabolic conditions. With years of experience, Dr. Balcavage is an advocate for understanding thyroid disorders not as isolated issues but as interconnected systemic imbalances. He is the co-author of “The Thyroid Debacle” and hosts the Thyroid Answers Podcast. Dr. Balcavage is committed to educating both patients and clinicians on adaptive immune responses and physiology to improve methods of diagnosis and treatment.

Key Takeaways:

• The digestive system’s health is pivotal to overall well-being, influenced by lifestyle habits, stress, and environmental factors.

• Conventional testing may not adequately reflect immune reactivity to gut organisms; advanced tests like those from Cyrex Labs can offer deeper insights.

• There’s a critical need to focus not just on eradicating pathogens like those seen in SIBO, but to understand and correct the reasons behind microbial imbalances.

• True recovery from gut-related disorders requires examining factors beyond digestion, such as mindset, habits, and sleep, to restore equilibrium.

• Avoidance of labeling and identity association with disorders encourages a more comprehensive approach to wellness, focusing on change and adaptation rather than a singular diagnosis.

“The microbiome of our digestive tract is like the soil of our body." 

Transcript

0:00:02 Roland Pankewich: Welcome back to the following your gut podcast, where health science meets clinical wisdom. Have you ever wanted a masterclass in the digestive system in about 30, 35 minutes? Most people cannot pull that off, but if there’s one person I know that can, he is our guest today. He also has the distinguished honor of being the person I’ve probably interviewed the most. So that’s probably saying one of two things. Either he and I really like to talk to each other or he has a lot of amazing things to say.

0:00:30 Roland Pankewich: So I want to welcome back. Well, welcome to the first time for the podcast, but welcome back to the master supplements us enzymes world of interviews. Dr. Eric Balcavic. Eric, how you doing today?

0:00:40 Eric Balcavage: Doing fantastic. Thanks for having me on the new podcast. Exciting. We’ve got a bunch of other ones, but this is the official follow your gut podcast interview. So my first it is, yes.

0:00:52 Roland Pankewich: And I’m so excited for our listeners to get access to your insights, your wisdom, your knowledge base, because you are essentially, if an encyclopedia could sprout arms, legs and a head, it would be you. In the terms of health and wellness.

0:01:05 Eric Balcavage: It’s a high honor that it’s nice to say. I’m not sure if it’s accurate, but it is nice. It’s a nice compliment. But, you know, I think where we are, we work with the best knowledge we have, and I think we’re still in the infancy of what we actually know about human physiology. So we just work with the best information we have at the moment.

0:01:23 Roland Pankewich: I agree with that. The older you get and the more you learn, the more you realize you don’t know. You stop collecting the things you know and adding them up. The more you start to realize, oh, what don’t I understand here? And I think that’s a great segue into today’s conversation because we have a multitude of things to cover. But we’re going to start with kind of like a deep dive into physiology of the digestive system, various things that influence it negatively.

0:01:45 Roland Pankewich: And you want to talk about something that people possibly know about, which is fungal overgrowth in the gut and how it impacts the immune system. Most people are familiar with bacterial overgrowth, but I do want to dive into some fungal stuff and bring that back to practical outcomes, takeaways, and maybe some supplemental strategies, understandings. But where would you like to start in terms of this, this masterclass deep dive? What, what’s piquing your interest the most right now about the. The digestive system?

0:02:12 Eric Balcavage: Well, I think one of the biggest things that we often have to Think about is why the GI tract is so important and why maybe functional and integrative medicine. We oftentimes look at the GI track and people are like, I don’t have a GI problem. Like I don’t have any. They don’t realize they have a GI problem. But the vast, for the vast majority of the population who have immune inflammatory, chronic health issues, inflammatory issues, thyroid issues, blood sugar regulation issues, obesity issues, they have, whether they know it or not, underlying GI issues.

0:02:52 Eric Balcavage: And that is oftentimes the result of habits, behaviors, diet, lifestyle, toxins and environmental stressors, disrupted sleep patterns. And too often people just the signs and symptoms they experience are so common and they’ve had them for so long that they just don’t even think of them as actual problems. Yeah, I’ve always had reflux, I’ve always had gas, I’ve always had a little bit of bloat, but it doesn’t bug me. It’s all just who I am.

0:03:25 Eric Balcavage: And they don’t realize that that two or three decade mild dysfunction that they’ve gotten used to is maybe at the root of their chronic health issues.

0:03:39 Roland Pankewich: That’s such an important perspective because a, it’s not a good measure to be conditioned to dysfunctional normalcy, meaning if you have those symptoms, one should never write them off as just you, because that’s not optimal from a physiologic perspective. The other thing that you said there that I think is such an important takeaway, and I’ve been thinking about this myself lately, is the body only throws off symptoms once things have been there so long that they can no longer be suppressed.

0:04:08 Roland Pankewich: And I think most people don’t factor that in to the context of how a long it may take to actually intervene successfully and remediate a problem. But number two, think of how many things can layer themselves in terms of development when things go awry in the gut and then the person’s going, well, oh my God, how do I fix this? How did this happen? It is the two decades of things that brew insidiously under the surface and then they only finally show themselves when the body’s ready to no longer keep a lid on it. I don’t know if that perspective resonates with you.

0:04:40 Eric Balcavage: I mean, there’s, you know, we’ve all experienced health issues, infections as we kind of grew up. Probably everybody has experienced some level of antibiotic use. And based on the literature, we think, oh, you know, I think decades ago we thought there’s no bacteria in the gut. Anything that’s there is probably A problem. So we just. Antibiotics is the answer and the solution. And what the literature is now making more clear is that even one round of antibiotics can disrupt the microbiome.

0:05:15 Eric Balcavage: And the results of that antibiotic use may not be detected for five, ten years down the line. So it may take, you might have something, some type of infection, you got an antibiotic, general antibiotic. It seemed to address the issue. And what might have happened for some people is that that antibiotic went into, into the system, disrupted the overall microbiome. And it took this slow change over years with all the other things that go on in life for them to now start to have dysfunction that they may or may not realize as abnormal as symptoms and abnormal dysfunction. I just have reflux.

0:06:13 Eric Balcavage: You know, my dad had it, I have it. So it’s a disorder. I take something for it. I just get some gas or bloating, but it’s not a big deal. But we know that diet, lifestyle, and especially that early antibiotic use can really have a disruptive effect on physiology for some people. Yeah, you take an antibiotic and it wipes out bacteria in the GI tract and maybe it’s a reset. If you have a healthy diet, healthy lifestyle, maybe that it does knock out some dysbiotic bacteria and all of a sudden you’re in much better shape. But for a large percentage of people, it may not do that. And it might be the reason they develop digestive issues, immune inflammatory issues a decade later.

0:07:02 Eric Balcavage: But nobody’s going back and tying it to one round of antibiotics, let alone maybe multiple rounds of antibiotics through their early part of their life and maybe into their adult life.

0:07:17 Roland Pankewich: That’s absolutely true. And, and I grew up in the 80s where antibiotics were kind of given out like Pez candy because we didn’t know then what we know now. And I didn’t even resonate with a personal experience that ties into what you said because I was given a course of doxycycline because I was bitten by a tick. And I don’t know what was worse. The tick bite and the outcome of that or the aftermath have taken pop probably the most weapons grade, powerful antibiotic that exists. Again, it’s you pick your poison.

0:07:46 Roland Pankewich: The hard part for the average person in terms of the general knowledge here and then taking that and making it personalized is what you said there is very much individualistic. It is a individual person’s journey. How one antibiotic may affect one person will be totally different. Then you layer in all the lifestyle aspects of that and it brings the person to where they are symptomatically typically why they’re reaching out to a professional to help them.

0:08:14 Roland Pankewich: Where do you start with someone if they’ve come in to see you and this is the background that you’ve teased out in terms of an intake session and putting some pieces together of reverse engineering their experiences?

0:08:26 Eric Balcavage: Well, the vast majority of people come to see me, typically come to see me because they have some level of a thyroid problem, because I talk through that lens of thyroid physiology. And I often look at problem or changes in thyroid physiology as an adaptive response to some type of stress or threat. But because we know that a large percentage of the immune system surrounds the GI tract more as a protective mechanism because the organisms in the GI tract, while they belong in the GI tract, we don’t want them or their toxins coming into the body proper and triggering chronic issues.

0:09:03 Eric Balcavage: So when I initially look at somebody who’s got immune based conditions, I think about the gut and I think about the immune system and how. Where I go with potentially testing really depends on what they’ve done to date. If they’ve already done multiple stool tests with other providers and it’s worked temporarily, but it continues to be an issue. I’m less likely to continue to run another GI test because I’m probably going to see pretty much the same things.

0:09:36 Eric Balcavage: And I may instead go directly to looking at immune panels. And we can look at, there’s a lab called Cyrex Labs that has a lymphocyte map test that looks like at the immune system directly, it looks at the T cells, the B cells, and then it breaks down the T cells into Th1 versus Th2, Th17 versus Treg. It looks at the natural killer cells and we can get an idea of what’s happening with their immune system and potentially what’s driving it.

0:10:09 Eric Balcavage: Recently they’ve also developed another test which has really become helpful for some of these people with chronic GI issues who’ve had functional GI tests done but still have something driving it despite constantly doing that. And it’s a test called their biome burden test where they actually look at the immune system along with looking at immunogenicity or reactivity to Candida and food based molds.

0:10:38 Eric Balcavage: And the challenge with traditional functional GI test is they measure the quantity but not the immune reactivity necessarily. So you could have, somebody could have a normal amount of Candida in their, in their biome. So when they do a stool test and they say, okay, it’s within the normal level, normal numbers. So it’s not it. We make an asset. We could make an assumption that it’s not an issue, but they may have a normal level of organisms or an appropriate in the lab reference range, but they may have significant, significant immune reaction to those fungi.

0:11:18 Eric Balcavage: And when there’s dysbiosis and when there’s, especially when there’s antibiotic use, some of these fungi, which can be normally present or what we call commensal can actually become more virulent and start to create more consistent problems. And we might not see that on a functional GI test because it’s not really measuring the ne directly, the im immunogenicity to the fungi or mold, mold based foods, it’s only measuring the quantity. So I depending on what somebody’s coming in with and almost everybody that comes to see me has got a thyroid conditions. The vast majority of thyroid gland conditions are caused by immune activation.

0:12:07 Eric Balcavage: So I always want to take a look at the immune system because that’s usually the thing that nobody else has looked at is the immune system.

0:12:15 Roland Pankewich: Well, the immune system is a rather complex body system that takes a lot of points of connection to really understand. Because, you know, there’s an old saying that says, what is it? One data point is a piece of information, two data points makes a trend. So you have to put the pieces together to get the entire picture. What were the names of those Cyrex labs again? Just in case people were curious about following through, either looking at them for themselves or maybe even reaching out to you to run one.

0:12:44 Eric Balcavage: The Cyrex lymphocyte map was the original immune panel that Cyrex really came out with to look at the T cell populations and the natural killer cells. And that came out, maybe it came out like during COVID We learned a lot during COVID good and bad, about what goes on in the physiology. And Dr. Vujdani developed that test during COVID And so that was the original test that once I saw that test come out, I’m like, this is what I want to know, right? I want to know what’s going on. And we can get into why that’s important later.

0:13:24 Eric Balcavage: But then recently they came out with what they call their biome burden tests. And there’s three different levels to the test. One includes part of the immune. The T cell population piece doesn’t have the natural killer cells, but it has the T cell population breakdown. And then it looks at immune reactivity to different types of candidal species, molds, different types of food based molds like Saccharomyces cervaceae and Saccharomyces boulardii. Reactivity.

0:13:57 Eric Balcavage: It looks at reactivity to the mold toxins or these fungal toxins. And it looks at immune reactivity to both anaerobic and aerobic bacteria that are typically in the GI tract. So it’s kind of the next level test and I think it’s really good. A lot of times when as clinicians we might, based on a history and inter, you know, listening to what their signs and their symptoms are and looking at certain aspects of labs, we may get a feel for that’s what’s going on.

0:14:30 Eric Balcavage: But this gives more clarity sometimes and especially even for the people. Cyrex Labs also has a test called their array 12. And there’s lots of different ways to look at molds and mold reactivity and different types of tests. But they have their array 12 that looks at all the different organisms or the most common organisms that trigger immune and inflammatory processes. And on that test many times you would see Aspergillus, Penicillium, Stachybotrys, elevated.

0:15:03 Eric Balcavage: You would say, okay, these are many times airborne and water damage, building type molds and be looking at the home and the environment for the mold and the person didn’t have it. But why did they have these positive antibodies? Now we know through more testing and looking at some of these other fungi that a lot of these things cross react and there’s Aspergillus and Penicillium and in from the foods we consume that may create those positive antibodies that may cause somebody to think they have a mold issue going on from their environment. But it really just may be gut based.

0:15:37 Eric Balcavage: So really neat test that’s come out.

0:15:40 Roland Pankewich: And what I took away there was the person’s immune system essentially is dysregulated to the point where it can’t parse out reality from assumed reality, if that makes sense. If there’s cross reactivity, even though it’s not present, what you’re seeing is someone who’s had a burden for quite some time negatively influencing their immune system. So your job is really to restore tolerance and regulation so that can that person can get out of that crisis.

0:16:07 Eric Balcavage: Yeah. And that’s where the, the looking at the immune mar. The T cell breakdown is really helpful. Once you run a bunch of these tests and really start to understand what the patterns are. When we take a look, we can kind of understand why somebody might have a lot of mucosal barrier problems and, and chronic fungal overgrowth. If they do, we oftentimes take a look at the TH17T cells as they’re many times they’re upregulated when there is an active in fungal infection.

0:16:40 Eric Balcavage: They go after extracellular organisms, but they’re typically elevated when there’s fungal issues or mucosal barrier threats. And that’s, that’s what they should do. They should go up. So if we look at somebody who’s got carbohydrate sensitivity, alcohol sensitivity, sensitivities to more mold laden foods, and we see an elevation of Th17 on an immune panel, we could say, okay, yeah, that TH17 is elevated. There’s a good chance that may be a fungal component. But we can also look at it the opposite way. If somebody does test and they know they have chronic fungal issues and reactivity to these things and TH17 is really low, then we can say, hey, there’s immune dysregulation. You don’t have the muco protection here to fight these things off. And this is why you’re more susceptible to a chronic mold or candidal infection because you just can’t fight it off.

0:17:40 Roland Pankewich: And that’s very powerful because I’m sure a lot of people are in that camp and they’re scrambling for answers as to why their body’s doing a certain thing. And being able to distinguish elevation of reactivity versus deficiency of reactivity and understanding why the body’s presenting symptoms that way is huge. You mentioned mold and fungus. Oftentimes in this space we talk sibo, bacterial overgrowth.

0:18:08 Roland Pankewich: But it sounds like you’re saying although connected because it’s a biome disturbance. Is there a distinguishable characteristic to C FO or. I don’t. Even if cmo, mold overgrowth. Mold and fungus are sometimes used interchangeably one and the same. Sometimes they’re looked at differently. But do you have any insights or perspectives about FIFO and C mo? I might have just made that up. That might be interesting for people to take away or understand in a greater context.

0:18:41 Eric Balcavage: Well, I say SEMO too. And I just cause small intestinal microbial overgrowth. Like something. Right. It’s just easier.

0:18:48 Roland Pankewich: Right? You go right to the core.

0:18:50 Eric Balcavage: So it doesn’t, I mean we sometimes we make a big deal of, oh, I have sibo, that’s what’s wrong with me versus I have dysbiosis or I have low stomach. Like we, I think we hang on to these titles and, and that becomes I have, I have sibo. That’s what’s different. It doesn’t matter to me if you have colonic dysbiosis or SIBO or SIBO or whatever. You want to call it, there’s immune dysregulation and gut dysfunction going on.

0:19:22 Eric Balcavage: And so any of those issues is highly possible or probable. So anybody who’s got GI symptoms, gas bloating, constipation, loose stools, diarrhea, sensitivity to carbohydrates or proteins or fats, has a GI related issue. And when that terrain is disturbed and there’s chronic inflammation, you could have an imbalance of the bacterial flora anywhere along that chain. So I almost assume for most people that if they have low stomach acid production, poor biophysiology, reduced pancreatic enzymes, of course, they likely have simo of some.

0:20:06 Eric Balcavage: Some of some form, along with the dysbiosis that we might see on a functional GI test. So while some people, that is their thing that they totally focus on their SIBO specialist. I hate the labels. I hate the idea that we’re treating, oh, well, I have Crohn’s or I have colitis or I have celiac or I have sibo. Look, there’s dysfunction there. It’s. It, you. It’s unique to you based on your habits, your behaviors, your genetics, your epigenetics.

0:20:39 Eric Balcavage: It’s how your experience, how your body is experiencing this altered terrain and altered immune response. But I don’t, I don’t like to spend too much time saying, oh, it’s sibo or it’s this or it’s that. A lot of people, they’re like, oh, my doctor said it’s not dysbiosis, it’s just sibo. To me, it doesn’t really change the overall strategy of how we have to help them. What’s creating the stress on the gut physiology that’s altering the terrain? What’s led to this, and what do we need to do long term to restore appropriate digestive acids and enzyme production and restore balance to the immune system so it can restore homeostasis within that intestinal terrain, regardless of where it is.

0:21:36 Roland Pankewich: You know, there’s something that I would like to add to that too, because a lot of the work I do with people beyond the physical is what I call psychological and emotional worldview. And I do believe that I have compassion in the understanding that people want an explanation of a why they want to know something that gives them a label so they can hang their hat on something that makes them understand their experience.

0:22:01 Roland Pankewich: But to your point, I’m with you in the whole idea that labels can be a trap. And why I say they can be a trap is when we psychologically identify with an externalized label. Or a diagnosis, our entire worldview bends to move around that new addition. And in a certain context, it can be an insidious way of actually furthering the problem. When you give power to something, either being part of your identity or you give power to something, taking ownership over an aspect of your life, and then when you have to give it up, it, it kind of challenges the conventional notion of who you may think you are and it impedes the healing process potentially. I think it’s a really important point that you made that regardless of whatever the label is, that’s a mentalized, compartmentalized way of understanding a concept.

0:22:51 Roland Pankewich: The individual is the individual is the individual. It’s always going to be a slightly different presentation, even if some carryover or crossover is common among multiple people. So you know, from that I take away, understand that there’s dysfunction, don’t claim ownership over it. Same ownership over finding the solution to it and then let it go once it’s gone.

0:23:12 Eric Balcavage: Yeah, I mean I, I get it. People like labels. You know, I talk about this in the book. You know, when people have come to see me many times, they go, I have an adrenal issue, I have a thyroid issue, I have a, I have a blood sugar issue, I’ve got fatty liver, I’ve got this, I got that. I’m like, look, here’s what you have. You have an excessive level of stress on your physiology that your bodies can’t adapt to it and maintain what we call homeostasis anymore. So your body’s in this adaptive mode.

0:23:41 Eric Balcavage: Every system is going to be altered under that excessive stress because it’s a give and take at this point. Under homeostatic regulation, I make enough energy from the food I take in and the food stores. I have to run all of the systems of the body appropriately and efficiently. But when there’s excessive stress on the physiology due to limited resources or excessive threats from infections or emotional stress, the body has to make adaptations and it has to say, okay, what’s most in what systems are most important now and what systems can I downregulate? And in those situations, we shouldn’t be surprised that we have multiple systems that are dysfunctional.

0:24:23 Eric Balcavage: We should assume multi, multiple systems are going to be start to become compromised. So if somebody asked me what do I have, I, you know, I, I call it, I say you have a multi system adaptive disorder. You’re not broken, you’re adapting. And it’s the reason why, you know, to go to your point, like we label somebody as maybe having sibo and now Instead of saying, okay, what is my immune system trying to protect me from?

0:24:53 Eric Balcavage: They shift to, I’ve got this organism that’s overgrowing that I gotta kill, and I got to keep trying to kill it. And the focus is on killing the bacteria versus, wait a minute. Why do I have this imbalance of bacteria or fungus in that GI tract to begin with? Is it the food I’m eating? Is it the lifestyle I lead? Is it the alcohol I consume? Is it the medications I’m taking? Is it the. The worry about politics and finances and relationships?

0:25:26 Eric Balcavage: And so we never address the real root issues because we’ve shifted from life and lifestyle to, oh, this bad organism that I got to get rid of. And if we really think about it, you have an immune system in the GI tract that’s constantly managing the bacterial and fungal balance within the whole GI tract. So the oral cavity, you have already in place everything you need. When we’re in homeostasis to prevent overgrowth of bacteria that can be problematic, or fungi or organism, other organisms.

0:26:09 Eric Balcavage: It is when the excessive stress on our physiology starts down, regulating an appropriate or dysregulating the immune system to some degree that we start to see these things start to occur. But they aren’t the starting point. But I think most people think that the diagnosis is the starting point when the diagnosis is the outcome, not the root cause. And it’s worse sometimes in our industry because we say we’re root cause practitioners, and yet we practice allopathically. Oh, you have sibo. I gotta treat Sibo. But I don’t care if you have SIBO or dysbiosis. If you have low stomach acid production, of course you’re going to have problems with digestion all the way through the GI tract. But even though I might give you some betaine HCL to start supporting stomach acid production as a. Okay, right now thing that we can start to do, my job is not. That is not done by doing that. My job is just. That’s a management strategy while I actually address the root cause issues.

0:27:17 Eric Balcavage: Hey, you have. You have these stressors. These stressors are up regulating your sympathetic nervous system. That’s down, regulating your parasympathetic nervous system. So if we change the things that are creating the excessive stress on your physiology, then we can more easily support the recovery of normal gut immune response and physiology. And now we don’t have to treat Sibo every 90 to 120, 20 days because we’ve actually addressed the true root cause issues.

0:27:51 Roland Pankewich: I just feel like saying, can I Get an amen because that was a really nice way of explaining practitioners should not be high priced dispensaries of band aid solutions. It really is a root causative thing, providing you’re getting to the root of what’s pushing someone out of balance. And I agree so often we’re starting at the result and we’re trying to treat the result. And in some cases if someone’s result is requiring you to intervene at an organismic level, then the killing of said organisms and the die off reaction, for example, can actually be a stress that their physiology isn’t necessarily ready to adapt to.

0:28:34 Roland Pankewich: And I think that’s why so many people cycle through the various parasite cleanses on the market that these things that, and they kind of end up, rather than scrubbing the dirt off of the floor, they kind of just push it around in different corners of the room, but the dirt never gets resolved. It just takes on a different shape, a different pile, a different identity. So I, I really hope that everyone resonates with the core understanding of what Eric just said there.

0:29:01 Roland Pankewich: The true holistic approach is to factor in the result and work backwards to figure out as many clues as you can as to where this thing may have started. And sometimes, actually I’m going to say this all the time, the body is the last place where things show up. My philosophy is what’s non physical is still physical. The body is what has to process all these things. So if you can look at a vantage point of multiple lenses of perspective, I think your insights are going to be far more correct, useful and insightful so the person can understand what brought them to this point in their journey.

0:29:38 Roland Pankewich: Because it really is a journey, it’s a moment in time, it’s never an end destination. And to round this out full circle, I think that’s where the labels actually create a block to freedom rather than an entrapment of a perpetuation of their reality. Meaning the label keeps you stuck if you’re not careful. Knowing that there’s some multi system dysfunction is a beautiful way to put it. So I want to shift gears and ask question that I’m going to preface when I ask it. We just said that there is no single start at the end result and figure it out.

0:30:12 Roland Pankewich: But you did say that sometimes you’re supporting things along the way. You’re giving BTNHCL for those who can’t produce stomach acid. You’re maybe giving a probiotic, giving a lifestyle strategy. Where are some places that people can start examining in their world if they want to Start looking at support that’s going to drive resolution.

0:30:35 Eric Balcavage: Well, I, I talk about this in, in, in my book, the Thyroid Debacle, that to me, foundationally we have there, there’s these things I call fitness factors. Dietary fitness, physical fitness, sleep fitness, respiratory fitness. I think in the book I started with 10. Now I’ve got 18 different categories. Right. So that is really the foundation of what we need to start to work on. And right off the bat with everybody, the key things I want to talk to them about foundationally is their, what’s their sleep habits and behavior and their sleep fitness, what’s their dietary fitness, what’s their physical fitness, what’s their mindset fitness and what’s their habit fitness? Because those things to me are foundational. If you have a mindset that I’m sick, my body is attacking me, my immune system’s attacking me, you’re in big trouble because you believe your body’s attacking you. And how are you going to get better if your body has now decided that your own tissues are no longer self tissue and your immune system’s just destroying them, the best, the only hope is then to manage. Right, because you have an immune system out of control.

0:31:44 Eric Balcavage: So that’s a terrible mindset. I have a disease, I have a disorder. You do. But we need to shift that mindset to my body’s protecting me from something. Something my cells are trying to protect me from. Something my immune system’s trying to protect me from something. And while there are negative consequences to some degree from that protective response, the protective response is rarely the inappropriate thing.

0:32:10 Eric Balcavage: It is usually the right thing. And we have to just shift the mindset. Like, oh, my body’s protecting me from something. Now I just need to figure out what the thing or things are that’s causing my cells to perceive danger. When we do that, life gets better. So those foundational things and mindset’s important, the habits is the second one is critical to me because when you start to look at what somebody’s habits are and have them start to kind of list out what they do from the start of the day to the end of the day and say, is that helping me improve my health or wellbeing or is that contributing to my demise?

0:32:46 Eric Balcavage: It now becomes clearer. Like, hey, I get up in the morning, I spend an hour on social media and then I go to work and I drink a couple cups of coffee, I grab a cup of Danish and then I eat some, you know, I run out to the local restaurant, get some something quick to eat, then I come home, crash on the couch for a little bit, have dinner and a glass of wine to wind down, and then sit and watch TV for the rest of the day.

0:33:15 Eric Balcavage: Okay, that’s your habit. If you do that every day, day in, day out, what did you do? What in there was helping you improve your health and wellbeing? Right. Probably not much. But if you said, if you looked at your, you know, three days of your life and said, okay, I get up in the morning and I spend that first, you know, 30 minutes doing physical training, whether it’s cardio or strength training or yoga or meditation, is that going to be beneficial? Yeah. Okay. Could I have done that instead of spending an hour on social media looking at how wonderful somebody else’s pretend life is?

0:33:52 Eric Balcavage: Sure, but that wasn’t helpful. But when they people actually start to look at, they, you can start to see these are the things. I do these things day in, day out and that isn’t healthy. And I don’t have as many healthy habits as I once thought I did. And they can make some of these easy changes to improve their habits. It doesn’t cost them anything, it doesn’t require supplementation. It’s just making small changes to say that habit, not health, it’s not going to improve my health, it’s actually probably detrimental. What can I exchange that for?

0:34:29 Eric Balcavage: So habits to me are foundational and we just don’t realize we have them. We just don’t realize we have as many potentially health reducing habits as we do physical fitness. I think there’s two categories there, there’s the p. There’s three categories. The person who does very little physical activity for whatever reason in their mind, they think they can’t do it. I don’t have time. Okay, well wait a second. We just looked at you spend on your social, on your phone.

0:34:58 Eric Balcavage: We can see that you spend five hours a day on your phone. Could you give back 30 minutes that you didn’t look at social media or your phone and use that to do a healthy habit? Yeah. Okay. And we can do that. Right. So we have the people that don’t have time for exercise or think that they can’t do anything because they have an ache, a pain or they’re tired or fatigued, but they don’t realize that even small amounts of physical activity and exercise slowly building up has massive impact on our overall health and well being, from gut physiology to sleep physiology to emotional well being.

0:35:35 Eric Balcavage: You have the people that do a fair amount, which is good, and then you have the people that do Excessive levels of exercise. Thinking that excessive extreme exercise done day in, day out is going to get them the thing they want. It’s going to get me my six pack of abs, it’s going to get me to lose the weight I have. And they don’t realize that it’s probably more detrimental to their well being. Then we have people who disregard healthy sleep habits. They spend too, they’re up too late at night, they don’t, they get up too early in the morning.

0:36:08 Eric Balcavage: They had, you know, they pump their chest because maybe they only need to sleep five hours a day and don’t realize the detrimental effect that has on their sleep. And when they start to realize, oh, I’m only getting like 5 hours of sleep a night and they realize how important sleep is to recovery and calming the immune inflammatory processes down and detoxing the body, it’s like, oh, maybe I should make that a priority. But I got so many things to do. You’re never done.

0:36:33 Eric Balcavage: I tell people all the time, you’re never done. You’ll be done when you’re dead. Right.

0:36:37 Roland Pankewich: I was going to wait for you to bring that one in. Done is for the dead.

0:36:41 Eric Balcavage: Yeah, I mean I’m never done work, right. And I, you know, I work for myself, but I am never done. So you have to plan. This is my work time. These are the three things I, I that are non negotiable. I have to get done for the day. But then when my work time is over, I’m done work for the day and I’m going on to my social things I need to do or lifestyle things I need to do. And, and then the last piece of that was diet and diet and what we consume has a massive impact on our health and our physiology and even the microbiome.

0:37:18 Eric Balcavage: Like we talk about eating for to nourish us, but really when we’re eating, we’re eating to also feed the organisms in our g, in our GI tract. And if we feed us trash, we get overweight and obese. But if we feed our, the organisms within our GI stuff trash, they don’t develop appropriately. Or things that flourish in that chaotic inflammatory, toxic nutrition become the challenge and the problem.

0:37:48 Roland Pankewich: I always liken the gut to a New York sewer. You know, if you litter crap around the streets, you’re going to have giant, you know, morphogenic rats that rewrite the Darwinian perception of evolution. And the reality is what we’re doing to our systems, the more we affect the terrain, the more the negative outcome is perceived through the microbes. In the ecology. And I just want to bring a little bit of awareness as we round this out to the fact that I love that we spoke about digestive issues and your first resolution or all of your resolutions or everything outside of the digestive system first.

0:38:28 Roland Pankewich: Because funny enough, and this is where I agree with you, if people were to want to get out of the quick fix mentality, the antacid tums relationship kind of practice, they would realize that every single gut issue is a nervous system issue. That’s my perspective. You can’t have a gut issue without a sympathetic nervous system or a parasympathetic nervous system dysregulation because the body has lost its ability to find homeostasis for that person unique.

0:38:59 Roland Pankewich: If you throw everything and anything into the gut without looking at what controls the gut, you’re never going to see the whole picture. If you harmonize all of the inputs, the lifestyle factors, the fitness, the sleep, the recovery, the stress management things that allow your system to take the energy that are dispersed externally in stress driven manners and to direct that energy internally. You might be surprised at how easily and effortlessly some of your gut symptoms magically vanish because they’re a symptom of your physiology’s experiences of reality more than they are a symptom of a digestive system that’s trying to destroy you from the inside out.

0:39:41 Eric Balcavage: Oh yeah. The challenge for all of us as practitioners is that we have to find that balance, right? Because we have the patient who’s coming because I have gas or bloating or constipation or whatever their diagnosis is and they want something to treat it. And if you start just talking about diet and lifestyle issues, they may already tune out and they want something more, more quick and immediate. So we really have to do a blend of things and say, okay, what do we need right now from a management strategy to help with digestive capacity while we work on all these fitness because they’ll take a while to make life and lifestyle changes and dietary changes and people want that immediate change. So it is a blend of things that we need to do.

0:40:30 Eric Balcavage: But, but ultimately it is, it’s not sexy, but it is all those fitness factor things that definitely, ultimately have an impact on the physiology. And I’ve had lots of clients who I, you know, I’m rarely anybody’s in first stop and I’m usually got the person that I’ve been on this gut protocol for, for on and off for the last three years and I still have problems, I’ve changed my diet and I still have problems. I’ve tried different strategies to fix my gut. And it’s like your gut, the reason you can’t get long term resolve. All those things can manage signs and symptoms just like medications can.

0:41:19 Eric Balcavage: But you have to really address the root issue. And when you start to really talk to them, it is their perception of many times of their environment. I hate my job, I hate my job. I go to work, I fight with my people, I hate what I’m doing. And that creates fear perception or danger perception in the mind. And when you create that danger perception in the mind, whether it’s conscious or subconscious, that changes your physiologic state. It up regulates the sympathetic nervous system. It downregulates the parasympathetic system.

0:41:51 Eric Balcavage: And it’s not like an on off switch. You’re either on or off. It’s just, it starts as a gentle decline. You know, mildly upregulate the sympathetic nervous system, mildly downregulate the parasympathetics. But that becomes not a temporary shift, but for many people, a chronic persistent shift. And the longer you’re in that mode and the more things you perceive as threatening or danger, the worse it gets and the greater the dysregulation between sympathetic and parasympathetic.

0:42:22 Eric Balcavage: And so that becomes the thing. But somebody might say, but I have, I’ve got a spouse who drives me crazy. Okay, do they drive you crazy or do you just internalize what’s going on with the relationship that way? And is there other ways you can think about what’s going on? Well, they’re not nice to me. Well, okay, is it truly that they’re not nice to you? Is it something that you’re perceiving as the problem?

0:42:48 Eric Balcavage: Right? Because every stress that we perceive could be used as a tool to make us more threatened or more fearful or more perception perceiving of danger. Or we could look at that as an opportunity to flourish, right? Look what happened during COVID right? Some people lock themselves in their houses and worried about everything. And they worried about the finances, they drank more, they ate worse because they were worried about everything going on. And other people, especially in business, were like, this is awesome. Look at all the opportunities that are coming out and thrived in that same environment because they saw that what was going on, which may have been a crazy situation. Well, it was a crazy situation, but it’s a matter of, a matter of perception, right? If I fail in my business, I can look at that as failure and danger and that can change my physiology. Or I could look at that failure in the business as a.

0:43:53 Eric Balcavage: As a stepping stone to rebuild a business or a different business or improve my lot in life and say, okay, that strategy didn’t work. Why didn’t it work? How can I use that to become successful if I restart the business or try a different business?

0:44:08 Roland Pankewich: Right.

0:44:08 Eric Balcavage: It’s all. It’s all perception. People don’t like to hear that, but it’s a reality. I had somebody who’d been to a number of people, chronic health issues, chronic thyroid issues, chronic gut issues, but they were stressed out about Trump being in office. They were stressed out about the changes that were going to be made in government and they might lose their job. And then they had life issues going on where a family member was dying and they needed to spend time with them and just this constant perseveration of all these negative things in their mind.

0:44:46 Eric Balcavage: And we had multiple conversations, and I’m like, no wonder you don’t react well to any type of support strategy is because your physiology isn’t one that any of that stuff is going to work. You’re in threat mode. Why is your. You’re putting things in to say, oh, I want to heal my GI tract, I want to heal these things. But your body is still in threat mode. Cells aren’t communicating. You’re still dumping out inflammatory chemicals.

0:45:10 Eric Balcavage: These things are abandoned at best under that chronic stress perception. I said, what we need to do is change what’s going on in your mind and how you think about things. And then you can start the ability to shift from danger physiology back through allostatic regulation to homeostatic regulation. But you can’t fix something when you’re in danger mode. It just doesn’t work very long. And so I know she and I had a conversation. I’m like, look, this is the best of both worlds. You hate the fact that your new potential boss is going to be Donald Trump. You don’t like him and what he stands for, and you don’t want to have to work from. But you like your job. Well, that job’s going to go away.

0:45:52 Eric Balcavage: But you. That now gives you two things. You can take the buyout that they’re willing to give you. You can sit at home for 13 months or whatever it is. You can look for another job that you might enjoy much more, and you might be able to still work from home instead of having to go into the office. And that gives you the time you didn’t think you had to spend with your dying family member. Or you can feel satisfied that, hey, at least I got the change.

0:46:21 Eric Balcavage: I don’t understand how you can look at that way. I’m like, because I chose to look at it that way. And when you look at it that way, like, okay, I get to leave the job, I still get paid and I can spend time with my family member. I said that this is the best. If you really look at this objectively, this is the best thing that could happen to you because you get the best of everything. You’re getting paid for doing nothing. You’re getting paid to look for a new job and you’re getting paid to spend time with your family member who’s dying. What could be better?

0:46:59 Roland Pankewich: Perspective is a powerful thing.

0:47:01 Eric Balcavage: Yeah. So we have to deal with the stressors and much of it is what’s going on in our mind. And unfortunately, and you know, same thing with finances. So I’ve got a terrible financial situation. I can’t save money. I da da da da. I don’t make enough money. Okay, that’s the problem. You’re problem focused. What’s the, what are the solutions? What could you do? Could you save some money? I don’t have a lot of money to save.

0:47:25 Eric Balcavage: Okay, well, could you save some money? Yeah. Okay, how much could you save? I don’t have much. Could you save $10 a month? Yeah, good. Spend $10 a month. Now you know you’re saving money. That’s going to make you feel a little bit better about it. What else could you do? Well, I’m so busy, I’m like, okay, well could you find another way to generate income either in the same business or by picking up a side hustle?

0:47:51 Eric Balcavage: I could if I, you know, I could, but then I’ll take away from my time. But if finances are the primary objective, instead of focusing on what you don’t have, start focusing on solving the problem. But we often get caught up in the problem and never in this, in addressing the solution.

0:48:09 Roland Pankewich: I think that’s a very wise conclusion to a perspective that fits all aspects of someone trying to get healthy, whether it be physiologic, psychologic, emotionally. It’s easy to focus on the problem because the problem gives us something to focus on. The solution is the thing that has to be figured out by understanding, examining the problem than stepping away from it to understand all the inputs that have created that. Because there’s a saying in life that I abide by.

0:48:39 Roland Pankewich: You’re never given a problem without the gift that comes along with that problem. Like there is no thing. In the world of polarity, the third dimension that is purely negative or positive. It’s a perpetual shade of a spectrum. You’re given equal opposites in the same category all the time. And it’s really a matter of perspective or as you said, course. So, Eric, I want to thank you for that because I love when you go on your Vince Vaughn style monologues and I just sit back and I just kind of nod and no one can see me nodding and smiling, but that’s what’s happening on my end.

0:49:08 Roland Pankewich: So I wanted to ask you two things. Number one, if people would like to get in touch with you or can they find you? Number two, if there is more out there that you’ve done as education resources, I would love for you to mention your book or anything else that you’re working on. Please share, because I believe the information that you have should get to as many people as possible because if they didn’t know they were looking for it, they probably do now.

0:49:34 Eric Balcavage: Well, yeah, anybody can find me at my website and it’s. Doctorericbalkavage.com is my website and they can find me there and a lot of my information there. If somebody’s interested in potentially scheduling an appointment with me, there’s a link there for a complimentary discovery call. We could talk about what’s going on and how my strategy probably differs from a lot of what they’ve experienced in allopathic and even in functional medicine.

0:50:04 Eric Balcavage: Two, I’ve got a, a podcast called Thyroid Answers Podcast, which you’ve been a guest on. And we talk about everything. It’s not just related to thyroid physiology, but, you know, overall physiology and talking through this lens of the cell danger response. I’ve got the book the Thyroid Debacle that I wrote with our mutual friend Dr. Kelly Halderman, that’s been out for a number of years now. And then I’m, I’m on social media. You know, I, I post a lot of educational things on social media, especially Instagram, and I’ve developed two, two things.

0:50:39 Eric Balcavage: One is what I call the Thyroid Recovery Blueprint. And this is for people who, you know, for financial reasons or just not an interest in wanting to work with a practitioner at this point. And the Thyroid Recovery Blueprint is essentially assessing these 18 fitness factors, saying, okay, let’s look at each one of these big broad categories. Score yourself on a scale of 0 to 10. 0, really bad. 10 is I’m very fit in this category.

0:51:06 Eric Balcavage: Once you score those, then you, then I provide a individual questionnaire on each individual fitness factor. And then based on Your responses there. There’s strategies for every question. So if you say oh, for this question I scored a 4 out of 10. That’s something you probably need to start working on. So then you can go to the support process part of the thyroid recovery blueprint and say okay, on this mindset questionnaire, on question 4 I scored a 4 out of 10.

0:51:41 Eric Balcavage: What are the support strategies to improve that area? And so we give those things and these are the things I work with my clients but this is something any person could get a hold of to improve their health and their wellbeing. Doesn’t require any clinician to help you. It’s all kind of written there. And then my new focus is really on building out a new clinician course in how to look at addressing our clients from a different perspective.

0:52:11 Eric Balcavage: I I call it especially because most people come to see me from a thyroid perspective. It’s called the adaptive thyroid model. Instead of looking at what goes on with thyroid physiology is broken. Like your body can’t convert T4 to T3 anymore. That’s why T3 is low and reverse T3 is high or that your immune system is destroying your gland. I I want practitioners to understand that what we often see is adaptive physiology.

0:52:39 Eric Balcavage: Here’s how to evaluate it, here’s how to interpret it. Here’s the science that that kind of backs up this model and that’s the. The clinician course is really coming but it’s in process. But that’ll be the next piece for clinicians.

0:52:56 Roland Pankewich: That’s a 20, 26 release likely probably yeah.

0:52:59 Eric Balcavage: I’m about halfway through it. In the meantime, every. Every month, every other month I’m doing if a lab interpretation for. For patients, people that can sign up to be on that lab Q and A will I’ll interpret their thyroid panels the way I would interpret them which might is probably different than their clinicians are interpreting it and give not tell them. Here’s what you, you know, here’s the support or strategy but just so they can see a different interpretation and then the other, the other. Every other month I’m doing the same thing for clinicians where they can upload their patients labs and say okay, this is a patient I’m struggling with. How would you interpret it? And I give them my interpretation. This is how I see it. These are the things that I would be thinking and the strategies that I might be. Here’s the test I would consider consider. Here’s strategies I would consider and here’s my interpretation. So patients can clinicians or patients if they follow me on Instagram, Dr. Eric Balkavage.

0:54:05 Eric Balcavage: They’ll see when those things are coming and they can sign up for them and it’s free.

0:54:11 Roland Pankewich: Amazing. And that’s both for clinicians and for people on their own journey. I encourage you all to find a way to connect with Eric. Follow what he does, listen to the things he shares. He’s not dogmatic about anything. He’s just open and he’s always evolving, which I love. And Eric, I mean it’s once every three to six months. So at some point I’m going to tap you on the shoulder, be like dude, you got to get back on here. So we’ll look forward to when that data does come.

0:54:36 Roland Pankewich: But I want to thank you for everything that you shared today. It felt so genuine and authentic and as always, I want to thank everyone for supporting the podcast. We’ll see you next time on the following your gut podcast. Until then, take care of.