From Medications to Lifestyle: A New Approach to Autoimmune Healing

In this powerful episode of Hormones and Hope, Dr. Chhaya Makhija sits down with quadruple board-certified rheumatologist Dr. Micah Yu to explore a topic many patients are curious (and confused) about: Can autoimmune diseases be managed beyond medications?

This conversation bridges the gap between conventional medicine and integrative approaches, offering a realistic, evidence-based look at supplements, lifestyle changes, and personalized care for autoimmune conditions like arthritis.

Dr. Yu shares his personal journey with autoimmune disease, how it shaped his approach to medicine, and why true healing often requires looking beyond prescriptions alone.

From debunking common myths to breaking down the science behind turmeric, omega-3s, and vitamin D, this episode is packed with clarity, nuance, and practical insights.

If you’ve ever wondered whether lifestyle changes actually make a difference, or how to safely integrate supplements into your care plan, this episode is for you.

Micah Yu, MD is a quadruple board-certified integrative rheumatologist specializing in Rheumatology, Internal Medicine, Integrative Medicine and Functional Medicine. Trained at Loma Linda University and the Andrew Weil Integrative Medicine Fellowship at the University of Arizona, he is the co-founder of Dr. Lifestyle and founder of MYAutoimmuneMD, where he helps patients address autoimmune disease through evidence-based integrative care. As both a physician and a patient with arthritis, Dr. Yu brings a rare, deeply personal perspective to autoimmunity, arthritis, and whole-person healing.

Follow Dr. Chhaya Makhija here:
https://www.instagram.com/chhayamakhijamd/
https://www.facebook.com/unifiedendocrine
https://unifiedendocrinecare.com/
https://www.youtube.com/@chhayamakhijamd
https://www.linkedin.com/in/chhayamakhijamd/

Email: connect@unifiedendocrinecare.com

 Download Free Guides/ Resources here:
https://linktr.ee/chhayamakhijamd

Follow Dr. Micah Yu here:

 https://drlifestyle.org/dr-micah-yu/
https://www-fallback.instagram.com/myautoimmunemd/
https://www.youtube.com/@MYAutoimmuneMD
https://podcasts.apple.com/us/podcast/autoimmune-alchemy/id1834049652
https://www.linkedin.com/in/micah-yu/

Disclaimer: This podcast is for educational, informational, and entertainment purposes only. It’s not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personalized guidance.

🔔 Don’t forget to like, subscribe, and hit the bell icon!

Transcript

SPEAKER_01 0:00

If someone with autoimmune arthritis starts medication, they will need to stay on it forever.

SPEAKER_00 0:06

False. So if a patient goes on a rheumatology medication, they do not need to be on it forever. It depends on the situation.

SPEAKER_01 0:12

If someone has autoimmune arthritis, inflammation is only happening in the joints.

SPEAKER_00 0:18

That's a myth. So rheumatology autumn diseases are systemic, so it can attack from head to toe and it can attack different organs as well.

SPEAKER_01 0:26

Myth or fact, people with autoimmune arthritis should avoid exercise because it will worsen joint damage.

SPEAKER_00 0:34

People with arthritis should continue exercising because it is anti-inflammatory and it can help the joints.

SPEAKER_01 0:41

All supplements labeled anti-inflammatory are actually helpful for autoimmune conditions.

SPEAKER_00 0:48

All the different anti-inflammatory supplements have the potential to be helpful, but not all of them are helpful.

SPEAKER_01 0:55

Last one, what is an underestimated lifestyle factor that worsens inflammation in autoimmune arthritis? Welcome to Hormones and Hope, a podcast where we bridge science and wellness to help transform your health. Or you can call me Dr. Chaya, a triple board certified endocrinologist and lifestyle medicine physician and founder of Unified Endocrine and Diabetes Care. Each week we dive into the powerful intersection of clinical medicine and real-life lifestyle strategies to help you feel stronger, live longer, and show up as your most vibrant self inside and out. So let's get empowered. Hello and welcome everyone. Happy Thursday if you are tuning in for our episode today with uh Dr. McHeijah, that's me, your host and endocrinologist on hormones and hope. Today is a very exciting day because what you're going to learn is not just about medicine or just about westernization of pharmaceutical drugs, but also a very important topic that many of you have asked me about complementary medicine, but which can also be evidence-based, which can be a discussion with your physician in terms of pros and cons and the benefits that you can accomplish. So for that, we have one of the nation's leading experts, Dr. Micah Yu, who resides in California, but he's a quadruple board certified. You heard me right, quadruple, that is for board certifications in the United States of America and diversified. That is his specialty is rheumatology, but it complements so well with integrative medicine and functional medicine as well, where he's also board certified. It's my honor to introduce Dr. Yu to you. And today, other than you as our listeners and viewers who are going to learn the thoraf knowledge coming from Dr. Yu, I myself am going to learn a lot, which I'm pretty sure about by the end of the episode. So welcome, Dr. Yu.

SPEAKER_00 3:02

Thank you so much for having me, Dr. Makija.

SPEAKER_01 3:04

Absolutely. Dr. Yu, before we get into the nuances and actual topic of what we're going to discuss today, which could range from different types of herbs or supplements, take them, don't take them, what's appropriate, what's not. And in the realm of this autoimmune world, inflammation, as well as your feedback and insights on certain questions that I have, can you tell us more about yourself? What does quadruple board certification mean? How long has that education taken for you? And uh your passion, like why are you doing what you're doing?

SPEAKER_00 3:38

Yeah, great, great question. So I am board certified in internal medicine and rheumatology. And also I'm certified in lifestyle medicine, and I got my board certification in integrated medicine as well. So after three years of internal medicine, I did two years of rheumatology fellowship, and then I did another two years of integrated medicine fellowship. And during that time, I got my lifestyle medicine certification, and then also I got training. I went through the Institute of Functional Medicine and got their certification as well. So I'm certified through functional medicine, but that's not a board certification. So I don't count that as one. So it's taken me, I don't know, how long? So three plus two, that's five years, and then two years of integrated medicine. So seven years of training total to get to this point, and I'm still studying and learning to this day.

SPEAKER_01 4:24

Yeah, that's so true. You know, you just uh reminded me of my 10th grade math teacher, and she had written this down in my in my book, like as a send-off, that if you become a master in one topic, become a pupil in another. And that's the way to never have to remain uh humble. So you're being very, very humble right now.

SPEAKER_00 4:45

Yeah, yeah. So yeah, that's what I learned. The well, that's what I noticed. The more I learned, the more that, the more learning I need to do. It never stops. And to answer your other question, the reason why I got into integrated medicine with rheumatology is because of my own autoimmune disease. I have arthritis myself, I have spondylal arthritis, which is an autoimmune disease of the joints. And I was able to heal and help myself naturally, even though I was offered medications. Being a doctor myself, I'm not the greatest patient, uh, easiest to work with. So I felt that there was another way besides medications, and luckily it didn't work for me.

SPEAKER_01 5:24

Wow. And this was before you became a rheumatologist or after?

SPEAKER_00 5:29

Right before. Well, I got into rheumatology fellowship already. So I went on a plant-based diet prior to starting my rheumatology fellowship. So it was maybe two months away from starting fellowship. I went on a plant-based diet, and then I noticed that one month, two months, three months, no flares at all. So that was a game changer and and it changed the trajectory of my career.

SPEAKER_01 5:52

Yeah, that's impressive. That's impressive. You know, having that story as a clinician, physician, but also being in the shoes of patients, but actually experiencing that's a different sense of empathy that one can experience. Yeah, so neat. I had one more question for you before we get into the details, is also about your certifications and your qualifications, is integrative medicine, that there is lifestyle medicine, and like you explained that those are all our board certifications. And then we have this new field functional medicine in the last decade or so, which ended more awareness in the last five years. What is the difference between the three? And uh, if you can just break it down or simplify it for us, for me as well as for our audience.

SPEAKER_00 6:35

Sure. Well, let's start with lifestyle medicine first. So, lifestyle medicine is just learning about the different lifestyle factors that can affect you, whether it's diet, sleep, stress, having community, and also exercise. Those are the main pillars of um lifestyle medicine. So that's the most basic one. Integrated medicine, there's an actual fellowship for, and that's more comprehensive. So not only do you learn about things in lifestyle medicine, but you also learn about environmental toxins. You learn about different herbs and supplements along with that. Functional medicine is very similar to integrated medicine, except for several things. Number one is in functional medicine, there's a lot more testing. So there's a lot more, they focus more on biochemistry, a lot more testing. So you have gut testing, looking at different pathways of the mitochondria. There's all these tests out there that functional medicine likes to test. So functional medicine is very heavy on testing. And another difference between integrated medicine and functional medicine is that integrated medicine actually has an actual fellowship. You can actually be board certified in it. Functional medicine, you can't. And with functional medicine, anyone can call themselves functional medicine these days. They take a one-day course, a weekend course, and they say they do functional medicine. Of course, you can throw that term around for integrated medicine as well. But at least with integrated medicine, you can see that someone's actually board certified, or they actually went through an actual fellowship to get to that point.

SPEAKER_01 8:02

Yeah, thank you for educating us. You know, this is so important, especially for us as physicians, and you just walked us through the number of decades, the decades that you've done this impressive specialization over time and how that can contribute to patients' well-being and also our nation's well-being. But uh, there is so much out there in, again, today's era and 21st century influencers versus the actual professionals. And uh that's why I love our physicians who are on the guest to explain their journey and also for our audience that there should be a public awareness of uh how do you seek the right medical expertise so that you can cut the noise off and really work on true health transformation. So thank you for what you're serving and you know what you're providing in terms of all these specialties. Love it. All right, Dr. Yu. So today, autoimmunity, arthritis, inflammation, and also, you know, what you're very passionate about is the whole person healing based on you know what I have watched, your podcast, your YouTube videos, which are very impressive. You're gonna start with rapid fire. That's uh basically a myth busting rounds, few questions, five to seven, one liner, one word, and then we get into the deep dive. You ready?

SPEAKER_00 9:18

Yes, let's do it.

SPEAKER_01 9:20

Okay. Number one, it's regarding turmeric and inflammation. Turmeric or curcumin alone can cure autoimmune arthritis.

SPEAKER_00 9:28

Curcumin or turmeric alone can help with arthritis, but it can't cure it. Autoimmune disease in general is not curable, but you can't put it to remission. So it really depends. Can someone take turmeric and their auto arthritis go away? It's not only possible, but it depends on the severity of the arthritis. So if a patient's more mild case, yes, taking some turmeric can definitely help. And I've seen the arthritis go away, but not in severe cases.

SPEAKER_01 9:55

Number two, autoimmune arthritis medications. Myth or fact, if someone with autoimmune arthritis starts medication, they will need to stay on it forever.

SPEAKER_00 10:05

False. So if a patient goes on a rheumatology medication, they do not need to be on it forever. It depends on the situation.

SPEAKER_01 10:11

Number three, inflammation misconceptions. Myth or fact, if someone has autoimmune arthritis, inflammation is only happening in the joints.

SPEAKER_00 10:21

That's a myth. So rheumatology autumn diseases are systemic, so it can attack from head to toe and it can attack different organs as well.

SPEAKER_01 10:30

Lifestyle changes like nutrition, sleep, stress management don't make a meaningful difference once someone has autoimmune arthritis.

SPEAKER_00 10:38

Lifestyle changes do make a meaningful difference, but whether it fixes a patient really depends on the patient's genetics and physiology.

SPEAKER_01 10:46

In regards to exercise and arthritis, myth or fact, people with autoimmune arthritis should avoid exercise because it will worsen joint damage.

SPEAKER_00 10:57

People with arthritis should continue exercising because it is anti-inflammatory and it can help the joints.

SPEAKER_01 11:04

Thank you. Now regarding supplements and autoimmune diseases, all supplements labeled anti-inflammatory are actually helpful for autoimmune conditions.

SPEAKER_00 11:13

All the different anti-inflammatory supplements have the potential to be helpful, but not all of them are helpful.

SPEAKER_01 11:21

Okay, thank you. We'll really need a deep dive for all of these. Last one, what is an underestimated lifestyle factor that worsens inflammation in autoimmune arthritis?

SPEAKER_00 11:33

We always talk about diet, so that is not underestimated. So I would say stress is underestimated, especially if there's a big event like a divorce, toxic relationships, that can worsen flares.

SPEAKER_01 11:45

Thank you. I really love this. And now we're going to get into the deep dive. You know, most of the guests that I've had on the podcast, they're mostly integrating lifestyle or, you know, the aspect of combination of Eastern and Western medicine, but again with evidence-based and also uh individualizing it, personalizing it for patients. And whenever we ask them about that one particular lifestyle factor, which is either, you know, worth or top number in terms of how to address it or what is the most important ones for inflammation, or in your case, you mentioned about autoimmune. The answer is usually either the stress or a sleep aspect of that pillar that you just mentioned, rather than a nutrition and exercise. Thank you. You know, it's like overlapping every time we have a physician as yourself who's really reflecting on it and then pinpointing towards stress and sleep. So thank you so much. So now you were in our rapid fire. You mentioned about turmeric, curcumin, and uh, I would really love for you to start with your experience as a rheumatologist and uh in the world of autoimmune arthritis. What is exactly triggering the autoimmunity or the inflammation? Because you touched on, you know, certain things, environmental and uh the genetics. And then following that, we can get into our other questions in relevance to all the rapid fire explanations that we will need from you.

SPEAKER_00 13:18

Sure. There are so many factors as to root causes and triggers of autoimmune onset and flares as well. Everyone's a little bit different. So we have to talk about the lifestyle factors first. Some people have very pro-inflammatory diet. They're eating a lot of cookies, chips, sodas. That can contribute to flares. Some patients, they have very poor sleep. They sleep three hours, they sleep at 4 a.m., their whole circadian rhythm is off. That will contribute to more inflammation. We talked about stress already with trauma. They've been abused in the past, parents divorcing early, they've been bullied. That's another risk factor. And also current stress as well, whether it's work or whether it's toxic relationships, that can also contribute to autoimmunity. And I would say lack of exercise does not cause autoimmunity, but it can definitely contribute to inflammation. If you have lack of movement, and then also that is a lifestyle piece. But we also have to talk about the other factors in integrated medicine. So patients can be triggered by infections, whether that's Lyme disease, viruses, or bacteria, that can trigger autoimmunity. So there's something called molecular mimicry, where if a patient gets attacked with a virus or bacteria, that virus or bacteria looks like the body's own cells and the immune system gets confused and it starts attacking not only the virus or bacteria, but your own body cells. And something that's how autoimmune disease gets triggered. So we have to think about infections and also environmental toxins as well.

SPEAKER_01 14:53

And what about the genetics that you had uh commented about earlier?

SPEAKER_00 14:57

Yeah, so genetics definitely does play a role in getting the onset of autoimmunity. However, the strength of the genetics really depends on the patient. Some patients they get lupus or rheumatoid arthritis at the age of one. So I would say that genetics is much stronger in those patients that are getting autoimmune disease. Whereas other people, if they get at a later age, the genetics is not as strong. Maybe it's more environmentally induced. But you have to have some component of genetics for autoimmunity to get auto disease, or else all of us will have autoimmune disease.

SPEAKER_01 15:28

So before we get into the supplement world and how you're integrating integrative medicine and all your education and knowledge into clinical care, we have this subset of autoimmune conditions and endocrinology, you know, type 1 diabetes, thyroid disorders, which is hyperthyroidism. We are screening these individuals for other autoimmune conditions like celiac disease. Say if someone has that personal history or they have the genetics or the family history, are there certain proven preventive strategies in those individuals? Early screening measures that you would recommend?

SPEAKER_00 16:06

There are. The lifestyle piece is the most important. Avoiding ultra-processed foods, we know that is bad for all diseases across the board. So avoidance of ultra-processed food and really watching the stress levels. Because that I've seen patients, they flare after a big event, whether that's um divorces or um something happening in their life with work. I've seen that trigger automy diseases. So those are the biggest measures. It's working on the lifestyle piece and minimizing environmental toxins as well.

SPEAKER_01 16:39

And is there a list of the environmental toxins that you discuss with your patients about? Like specific ones?

SPEAKER_00 16:46

I do. So I talk about having a water filter, getting an air filter as well. I talk about plastics, these forever chemicals, volatile organic compounds, some of these things, they can contribute to immune toxicity. We know they're around toxins already, endocrine disruptors already, but they're also immune disruptors as well. So these such as bisphenols from in plastics, there are other chemicals out there that you don't really want to have a lot of on a daily basis. Of course, we're going to be exposed to them, but you want to minimize the amount of exposure you get. So there are ways to prevent that. For example, don't drink plastic water bottles, uh switch to a stainless steel, get a water filter, air filter. We already have data to show that pollution worsens autoimmunity. We already have data to show that pesticides and insecticides can increase the risk of autoimmune disease as well with RA and lupus. So there are things that we can do that's under our control, but we don't also want to stress over it as well. So there's comes a point where you don't want to stress over this stuff. You want to do the best you can, but not make it the focus every day where you're actually stressed about the toxins you're encountering, because that is will just worsen autoimmune disease because you're now it's doing the opposite effect.

SPEAKER_01 18:11

Yes, you're so right. Yeah. So this is the dilemma that we uh encounter as clinicians, but I would love to know also your clinical approach because the one of the top number ones that you mentioned and you repeated it a couple of times was the stress, right? Or learning how to manage that. So, what are a few tips or strategies that you talk to your patients about? If either they're coming in for preventive strategies or they're actually coming in for treatment, so you're helping them to prevent these relapses in the future. So, what is uh certain techniques or strategies for stress management or stress response?

SPEAKER_00 18:49

Yeah. One of the first things we learn in integrated medicine at University of Arizona is the box breathing technique. So that is focusing on your breath only, so you can't think of anything else in the world that is distracting you. So box breathing could be breathing in for three seconds, holding your breath for three seconds, and then breathing out for three seconds. So you're focusing your breath the whole time. So mindful breathing, mindful eating as well. So when you eat, don't think about anything else in the world. Just try to focus on the food, focus on where the food came from and what it's doing for your body. And also meditation is very helpful. Mind stress-based reduction and also prayer. If you're religious, prayer can be very powerful as well. And just having a community of people around you that build you up and don't break you down.

SPEAKER_01 19:41

Mm-hmm. Yeah, yeah. Very beautifully put. And this is applicable for anything, like for all of us in general, like as a life's mantra to learn because we can't move stress out of life because that's life, but how he responds. So thank you for sharing that. Uh, this was also part of the integrative medicine training, which is lovely to know because you know, I have a lot of medical students who listen to the podcast, and it's just nice for them to know what's out there in the world in terms of how we can really approach care 360 degrees. So I love this uh box breathing. There's one more aspect in the stress response in terms of how do we help them get the resources, right? So it's very easy for one person to tell that, okay, go meditate or just be quiet or you know, focus on your breathing. And the second thing is where are my resources? Like how can I build that muscle, right? In terms of uh practicing it or implementing it. Any patient stories that you have, or anything that rings a bell, or how do you approach it in terms of teaching your patients? That one is introducing them to this concept, the second is actually teaching them to implement.

SPEAKER_00 20:52

Yeah, I do have a couple of patient stories. There's a patient story of a patient who with rheumatoid arthritis actually got offered biologics and has been remission for two years now. So this patient came to me. She was eating pretty healthy already, but she had some stress as well. And she was on a medication at the time. She was on um a biologic and or a strong rheumatology medication. So I tweaked her diet a little bit, made it less processed. And at the same time, I taught her about the vagus nerve, how to stimulate the vagus nerve to bring down inflammation. And she implemented some of these techniques that I taught her, change up her diet a little bit, and also added some supplements to help her inflammation, a combination of these factors over time. She went from flaring on a biologic to coming off a biologic and being pain-free for now two years. So there are ways to get better with this. There's ways to implement it. And it does take some discipline and practice. It doesn't happen overnight.

SPEAKER_01 21:53

Wow. So why don't you shared your personal story? And now you're also sharing how it's being implemented. In your patients, you know, I would love people to know that such care exists. So thank you for showing that this is possible. And you're combining both of those aspects of science. So, in uh in regards to now, you know, you talk about biologics. Is there a simple protocol on how you would approach any patient with specific autoimmune arthritic condition and they're seeking care and they're like, I just want to, you know, I wanted this to be treated naturally. So, are there any evidence-based supplements? You talked to us about evidence-based lifestyle strategies. So, evidence-based supplements that you would consider in your discussion during that visit or during that patient clinical approach care.

SPEAKER_00 22:48

Yeah, so we mentioned turmeric at the very beginning of this podcast. So, turmeric, I did a clinical trial on turmeric during COVID. Unfortunately, it was cut short. We were doing a study on turmeric and lupus, and uh we never published it because COVID cut our uh study. But when I was doing my research on turmeric back then, there were over 6,000 studies on turmeric, from lab studies to human studies on multiple diseases across all different systems, on cancer, on automing diseases, on endocrine diseases as well. And there were some studies on arthritis, there are some studies on lupus, and so turmeric can potentially work. Another evidence-based supplement is omega-3 fatty acids, whether you use fish oil or algae oil. Studies have shown that three grams can help clinically with inflammation and arthritis. That's number two. Another evidence-based supplement is NAC and acetylcysteine. It's an antioxidant. We were trained in medical school that we use it for patients that come to the ER with liver toxicity from overdosing on talentol. But we do have some evidence that it can work with autoimmune diseases as well. So there was a study done two years ago in the Journal of Lupus where they took patients with lupus, they kept them on their regular rheumatology drugs, but they also added either NAC or placebo. And the patients that took the NAC at 1800 milligrams did better than placebo. So NAC is another evidence-based supplement. And one supplement that we can never forget is vitamin D. Vitamin D affects all autoimmune diseases. There's vitamin D receptors in all our cells, there's vitamin D receptors in our gut cells, in our immune cells. And studies have shown that when vitamin D is low, then it can lead to more flares, it can lead to more upper restorative infections and more illnesses. So you definitely want to keep your vitamin D normal. You don't want it to be low.

SPEAKER_01 24:53

And the fifth one? Did we cover all that?

SPEAKER_00 24:55

A fifth one. Let me think here. There's boswellia as well. So baswellia is an Indian herb. So it's now also known as frankincense for those of you that like essential oils. So there's studies with boswellia with arthritis, osteoarthritis, or some with rheumatoid arthritis, and it's been shown to be helpful as well.

SPEAKER_01 25:15

When we are looking at these at least the five supplements, any pros and cons, or is it anyone can start taking these supplements?

SPEAKER_00 25:26

Yeah, I would say mostly everyone can take it. I mean, there's, of course, you have to talk to your doctor. Just because I say it's good for you doesn't mean that there's no side effects. So turmeric, there are some case studies that it can cause liver injury in some individuals. That's very, very uncommon. They've done studies of turmeric up to 12 grams on patients that had no disease. And I think one or two patients had liver injury. The other patients just had some orange stool. One patient had diarrhea. So most patients tolerate even 12 grams was okay for these individuals. Of course, I don't give my patients 12 grams. That's way too much. Each, usually each pill is 500 milligrams to 750 milligrams at most. So I would say turmeric overall is pretty safe, except you might see higher doses, you might see some orange stool. Some patients just genetically cannot process turmeric supplements for whatever reason. And then they might have liver injury even at a lower dose. Okay. Same thing with Bonsvolia, there can be liver injury as well. With omega-3 fatty acids, at a higher dose, you can see more bleeding risk. So I tell my patients if you are taking omega-3 fatty acids at a higher dose, just be careful of bruising. That can be a sign that you're bleeding easier. With NAC, the only side effect I've seen is acid reflux on it. So NAC is really low risk. And with vitamin D, it's very low risk. Also, some patients just overdose on vitamin D way too much. I think we've seen patients do vitamin D on their own, like 40,000 units a day before. We did not tell them to do that. And then we told them you have to go to ER. You're having some confusion now. So I have higher, super high doses is not safe.

SPEAKER_01 27:04

Yes. Yeah. Thank you for sharing that. I know every year, maybe two or three cases I'll get with vitamin D toxicity because of hypercalcemia that we are noticing. And yeah, you're right. Yeah. Thank you. This was very, very insightful, especially, you know, when you talked about all five of them and just the studies, because that that uh really helps in terms of what is the evidence-based. In terms of prescriptions now, right, you uh which are mostly like the biologics or steroids, right? When do you initiate? Because say if uh most of the individuals who are either dealing with autoimmune arthritis or are having symptoms and you're getting the workup done, they all wish that, you know, if I could just get a non-prescription way of treating it, managing it, and also, you know, likely being in remission. But I'm pretty sure you as a specialist encounter where there needs to be a balance or there needs to be a support of both of these, right? The pharmacological interventions along with the lifestyle supplements as well as integrative medicine. So, how do you bring about that discussion in terms of complementing both of these rather than just one way in uh in your approach?

SPEAKER_00 28:16

Yeah, so it really depends on the type of patient that's coming through the door. Some patients are very sick when they come in and say, yes, we can use lifestyle as supportive, but you really need to go on medications today and possibly even biologics next week because they're on the verge of ending up in the ER. So I don't mess around when I see that situation. There are some patients who have more mild symptoms. I'm like, because I get a lot of patients who don't want to be on medications when they see me. So I tell them, okay, we can hold off on medications. It's always going to be an option for you. We can try supplements and lifestyle measures and see if that helps you. If it helps you, then great. Then we don't need to go on medications. But if it doesn't help you, here are some of the other options for medications we can add on and combine it with the supplements and lifestyle changes that you're doing already to minimize the amount of medicines that you need to be on so that we can just lower the amount of disease activity of your on disease while limiting the number of medications as much as possible. So really it depends on the patient. So when I am analyzing my patient, it really comes down to how active the disease is when they see me. What is their philosophy? Some patients absolutely do not want to be on medications. So for some patients, I have to nudge them a little bit harder or give us some time in order for them to finally take Western medications.

SPEAKER_01 29:39

You know, when you're seeing it, it needs more visits or more education because yes, they can read the resources, they're listening to you, and uh it's also the time that they have to make that decision. Yeah, yeah. You know, one more thing I wanted to ask you, this comes about as you're sharing your insights, is the testing part of it, right? In our science, or whenever we are getting our fellowship, in your case, rheumatology, there's like a structured list of uh guidelines or what what antibody testing or certain parameters makes it rule in or rule out, or there's a gray zone. But initially you talked about there are certain testings that or functional medicine is testing, heavy on testing. What are certain tests that actually you utilize from the functional medicine world that has been clinically beneficial uh for you when you're approaching again your patient care?

SPEAKER_00 30:35

Yeah, great question. So, of course, we have the regular rheumatology labs. I do test for infections to see what patients have been exposed to, to see whether there's an active infection also, because sometimes that can be driving the autoimmune disease. I like to test for Lyme disease as well, because that could be a driver of autoimmunity. One thing I really didn't mention is mold. I do check for mold in my patients because mold, if patients are exposed to they're very sick, I have some sick mold patients in my clinic. It can trigger and contribute to flares as well. Um, I have patients who tell me I've never been exposed to mold. I check it, they have high mold levels, and then they find out there's all this black mold in there behind the drywall. And so I have patients with that. Other, there's tests like gut microbiome testing. There is also gut microbiome, I mentioned gut microbiome. There's organic acids testing, which looks like the mitochondria and different factors and the biochemical pathways. So those are just some examples of tests I use. I don't, I know the food sensitivity testing is very popular, but I don't use that because it's not that accurate.

SPEAKER_01 31:38

But all of these that you mentioned, you're actually interpreting it, and then you're able to provide them a right approach or a treatment, right? Uh based on that. Yes. Because I do have a lot of patients who will get this online functional testing and it's difficult in terms of interpreting it, and then, okay, now what do we do in terms of either alleviating it or correlating with specific symptoms? But you have the expertise in that because you're you know what you're ordering and you know what to expect, as well as if you're expecting something different, you know how to treat it.

SPEAKER_00 32:11

Right. I I normally don't order all these functional medicine tests. Um I usually go through a local lab first, and then if we need to, then I order the other tests because they're out of pocket and we can avoid it, then uh, I try to limit it.

SPEAKER_01 32:25

Yes, yeah, that's why it's so important to see the right medical expertise, such as yourself. Yesterday I had a patient, Thursdays are my long days, and the patient was on 27 supplements. She had 27 bottles. Yes, and the same thing that, you know, very expensive and just random testing, no correlation between what she's taking in terms of and what the labs reflect. And it was all a hormonal chaos because of, you know, uh wrong prescriptions and wrong supplements. Thank you. So people here, Dr. U out, if you have to see the right medical expertise, here is someone who knows all of these aspects of complementary medicine. One last question I had before we get to know about how to get to you in terms of someone seeking a medical expertise is just one another clinical story, which I would love from you. You talked about the rheumatoid arthritis patient, you talked about yourself. But when we are looking at lifestyle interventions or even complementing it with pharmacological interventions, what's more crucial? Because everyone, I feel, thinks that, okay, I've started something new or I've made lifestyle intervention change. I should expect dramatic change or resolution in a week, in a few weeks, or a month. But what is the realistic expectations that you talk to your patients about?

SPEAKER_00 33:43

Yeah, everyone's a little bit different. So some patients, I would say at least a couple months. So lifestyle changes can happen quickly. I've seen patients change their lifestyle into your diet and they get fixed or they get better in a month. But that's not always the case. So it depends. So I would say at least three months. Well, when you start medications, you always tell patients at least three or six months to wait three to six months of trying it to know that it does or doesn't work. So I would give my patients three or six months to see changes usually.

SPEAKER_01 34:12

Yeah, yeah. That that's very helpful. But yes, if someone's you know suddenly avoiding gluten or completely eliminated processed sugar, yes, boom, they'll see a magical difference uh in a shorter period of time. But yeah, three to six months feels right, even what I see in the clinical world from the endocrine standpoint, like in terms of autoimmune conditions or hyperglycemia. Thank you. Now, Dr. Yu, you have a limited amount of time with us. I was just getting to learn about you. I would love to have you on another podcast on very specifics on uh certain dermatology, you know, diseases or specific conditions and how you are approaching the care. But I know that you have an amazing YouTube channel where you have all these topics laid out. And of course, you're out there speaking and teaching and also seeing patients. So please tell us more about how individuals can reach. And I just learned uh from you today that you see patients in multiple states in our United States. So please let us know. So, how can someone who's really seeking this type of care uh knows how to connect with you?

SPEAKER_00 35:18

Yeah, so you can, I'm located in Newport Beach, California. I share a clinic with my wife, Dr. Mandala. And we're our website is drlifestyle.org. That's drlifestyle.org. That's my clinic website. I am on social media under the handle my autoimmune md. And you can find me at my autoimmune md.com where I have blogs and newsletters and other information that's free for the public. And so you can find me on YouTube, TikTok, LinkedIn, Instagram, and Facebook and Twitter or X now. So I'm I'm there, but if you want to see me at my clinic, you can see me through telemedicine. You don't have to drive to Newport Beach. I'm licensed in 16 states. You can go to the website and my clinic to see what those states are.

SPEAKER_01 36:03

Impressive. Yeah, you're all over. Like you mentioned, all the major social media platforms. That's impressive. So people go out, tune in to Dr. Yu's podcast or even the YouTube channel because you know you'll find almost every supplement, lots of other conditions, and how he really breaks down the evidence-based science and also how he integrates it. So I love it. I usually share those with our patients, Dr. Hughes. So thank you so much for this short and sweet episode, but filled with insights. And I will see you again.

SPEAKER_00 36:35

Thank you.

SPEAKER_01 36:37

Thanks for hanging out with me on hormones and hope. If you've loved this episode, do me a favor, hit subscribe, share it with someone you care about, and drop a review if you're feeling generous. Want more tools to support your hormones and health? Head over to UnifiedEndocrine Care.com. We've got free guides, resources, and more waiting for you. Until next time, stay curious, stay kind to your body, and keep your hormones happy.