10. Understanding Your Symptoms: The Critical Role of Differential Diagnosis with Mihaela

Hey friends. This is one of those foundational conversations that quietly shapes everything we do in healthcare, yet it’s rarely talked about outside medical training.

In this episode, I walk you through the concept of differential diagnosis, what it is, why it matters, and how overlooking it can delay healing or, in some cases, cause real harm.

Differential diagnosis simply means creating a thoughtful list of all the possible causes of a symptom before jumping to conclusions. It’s not about being overly technical. It’s about being thorough, humble, and clinically responsible.

Using real-world examples like chronic abdominal pain, I explain how symptoms that sound familiar can have very different meanings depending on context:

• How long has it been going on?
• Is it changing?
• Is it associated with food, movement, stress, or time of day?

In functional medicine, we’re trained to think broadly. Lyme, mold, parasites, gut infections, inflammation, and toxicity all matter. That perspective is incredibly valuable. But here’s the nuance: we can’t skip over the conventional “big and bad” possibilities, especially acute or dangerous conditions like infection, obstruction, or cancer.

This episode is especially important for:

• Prescribing clinicians practicing functional or integrative medicine
• Patients with long-standing, complex, or unexplained symptoms
• Anyone who has felt dismissed, or alternatively, overwhelmed by diagnoses

I also talk candidly about a real risk in our space. We can become so focused on chronic, root-cause explanations that we miss something urgent or conventional that still needs to be ruled out first.

The takeaway isn’t fear. It’s balance.

Good medicine, whether functional or conventional, requires:

• Pattern recognition and vigilance
• Curiosity and restraint
• Innovation and respect for fundamentals

If you’ve been on a long health journey, this conversation may help you better understand how your symptoms are being interpreted and how to advocate for yourself more clearly. And if you’re a clinician, my hope is that this serves as a grounding reminder: breadth without prioritization can be just as risky as narrow thinking.

As always, let’s get real and let’s get results.

Ready to stop guessing and finally get a clear plan?

Join Dr. Su for the Ask Dr. Mark Clinical Q&A Call, a small-group call limited to about five people each month where you can bring your real questions and get real direction.

Book your spot: https://go.rootseekhealth.com/askdrmark

Or download the free Lab Results Guide if you have ever been told your labs are normal while still feeling terrible:

 https://labsoptin.rootseekhealth.com/labs/

Connect with Dr. Su: IG | @rootseekhealth

Disclaimer: This podcast is for educational purposes only.  Information discussed is not intended for diagnosis, curing, or prevention of any disease and is not intended to replace advice given by a licensed healthcare practitioner. This podcast and its guests may have direct or indirect financial interests associated with products mentioned.

Transcript

Setting The Stage: Why Weight

Dr. Mark Su 0:00

All right. Uh hi everyone. Welcome again to the Functional Medicine Reality Podcast. I'm your host, Dr. Mark Sue. I'm here with a patient guest. Her name is Mihela. We're gonna introduce everyone to her in just a second. So, just as a reminder, this podcast is about helping the public, patients, not only become more aware and familiar with functional medicine and the tools around it, but to also talk about not just the good, but also sometimes the bad, sometimes the ugly of functional medicine. And ultimately, we're trying to be truth tellers and help people create more clarity so that they can make better decisions around all the stuff that's all things functional medicine related, right? And a lot of that has to do with how to make better choices so that we're reducing our cost in time, money, and effort with the plethora of options and the stuff we hear about with all the noise from various sources in our uh self-care and even our practitioner-patient uh working relationships to get either healthier or to live healthier in a wellness pursuit. So, with that being said, Mahela, thanks for joining us today. Um If I can just briefly introduce you just on a high level, and then we can kind of jump right into things. I think today's conversation is going to be very commonly experienced by a lot of people. It's a really broadly applicable topic. I have conversations around this with people all the time. But just to kind of put in context, you and I knew of each other, had never, I don't think we'd ever talked live time in the past, but we knew each other through uh knew of each other through a professional practitioner type email forum, uh, a functional medicine email forum for that matter. And you are a pharmacist by training, you're working in a pharmacy environment, but through a conventional pharmacy. Um but you have a lot of experience with the healthcare world, no doubt, and not just the conventional side, but um you have a lot of interest in the functional medicine side as well. But um anything you wanna share or kind of introduce about yourself otherwise, or shall we just like dig

Mihela’s Lifelong Weight Struggle

Dr. Mark Su 2:10

in?

SPEAKER_02 2:10

Let's dig in.

Dr. Mark Su 2:11

Okay. There we go. All right. Well then, so why don't we just go ahead and get started and say, um, why don't you um revisit or share with us briefly? I had thrown out to the email list, hey, we're we're doing this podcasting every four weeks. It's a free patient consult, you know, in exchange for consent that we're kind of sharing this experience for other people's learning experience uh learning opportunities through your case. So what do you have in mind that you want to um bring to the table and talk about?

SPEAKER_02 2:37

Well, thank you for having me, first of all. Second of all, um yeah, I I've uh had pretty much like a almost like a lifelong problem with weight. And um every time I I see a doctor, they tell me lose weight. And um I've tried everything. I've tried everything from running marathons and um like at the end of a full marathon after training for five months and running 30-some miles a week, I lost a whole one pound, which may be like a baby. Um just hear that right.

Dr. Mark Su 3:13

After training for the whole marathon and then finishing the marathon, it was only one pound difference from before training.

SPEAKER_02 3:18

One pound.

Dr. Mark Su 3:19

That's incredible, all right?

SPEAKER_02 3:20

Yeah, so I I and and even before I decided to run, I um I actually used to have personal trainers. I would go to the gym a couple two, three times a week. Um, so I was uh training quite intensely, and people would be like, you need to train, you need to work out. Like as if you're fat constantly, consequently, you must not be working out. And and I was like, Well, but I am working out. So then one day I was like, I and I remember it was like January 1st, January 2nd, you know, when we all take all these big decisions, and I was like, darn it, I'm gonna train for a marathon. And when I started running, uh training for the marathon, I could not run from here to the end of the street. And um, and then by the end of five months, I actually completed the uh San Diego Rock and Roll Marathon. And um, and as I said, like I I got on the scale after five months, and I I was like one pound lighter. And I all I wanted to do was just cry. So I knew that. I want to just validate you.

Dr. Mark Su 4:28

I I just want to validate you on that experience because first of all, I can't I can't run just to run. So I can't even imagine doing a a five-miler just to do it, much less a freaking marathon. And if I were in your shoe, I'd be completely deflated and defeated and deflated as well. I mean, I I'm I think I would cry. Yeah. That's that's really disheartening.

SPEAKER_02 4:48

Yeah. Then after I had my my second baby, um, I had the you know, the regular women checkup and I had a mammogram, and they're like, you

Marathon Effort, One Pound Lost

SPEAKER_02 5:00

need to come back. We think it's possible cancer. I'm like, great. So then they did a biopsy, and in the meanwhile, before they even had the results, they sent me to visit the surgeon. And the surgeon sat there and she was like lecturing me that don't you know when fat women are the biggest risk of getting cancer? And I'm like, wonderful, tell me how to lose this weight. I'll do anything. Honestly, I ran a marathon, I'll do anything. Literally, I'll do anything. And um so it turned out it wasn't cancer, it was just a lymph node that they uh had they thought is uh something. So, you know, 14 years later now I'm I'm fine, I'm good, but um, I still am struggling with weight. And then um about 10 years ago or so, I um I was actually introduced to functional medicine world, and they um my my doctor was like, Well, you know, just try to to eliminate gluten. Um, and that was for different reasons. It had nothing to do with the weight. And I uh at that time I actually really um tested myself for food sensitivities, and I followed that, and I did lose 32 pounds without any other um. You lost 32 pounds going off gluten? Gluten and other, like I I cut out gluten dairy, okay, um, some other little things that I was allergic to, broccoli and asparagus.

Dr. Mark Su 6:34

Okay. So yeah, you you basically followed a food sense. You took action in response to food allergy testing.

SPEAKER_02 6:40

Yeah.

Dr. Mark Su 6:41

Again, a functional food allergy testing, which is IgG based, not conventional.

SPEAKER_02 6:44

Correct.

Dr. Mark Su 6:45

And then you lost 32 pounds.

SPEAKER_02 6:46

Yes. And then but then about three, four years into it, um, I started gaining weight and didn't matter what I did. And I retested the food sensitivities, which of course they changed because that's the the name of the game. And um I started like following that um and being very mindful about what I was eating.

Dr. Mark Su 7:09

And okay, just for clarity, were you when you regained weight, were you still following that sort of food elimination or not so much? Yeah. Yeah.

SPEAKER_02 7:16

No, I was.

Dr. Mark Su 7:18

You were still eating the same way as when you lost 32 pounds, but then you started gaining weight.

SPEAKER_02 7:22

Yes.

Dr. Mark Su 7:23

And then you did a repeat food allergy test. Yes. Do you rec do you recall if it was the same lab?

SPEAKER_02 7:27

Yeah, it was the same lab.

Dr. Mark Su 7:28

Same lab. Okay.

SPEAKER_02 7:29

Yeah.

Dr. Mark Su 7:29

And then you come up with different results.

SPEAKER_02 7:31

Different results, different foods. Um, and I I, you know, as sad as I was to uh eliminate garlic, I think that's the hardest allergy to have, to not be able to have garlic. Wow. Um, because with that, you're done with any other food from outside world, unless you cook it yourself. There's nothing there. Everything has garlic. And not to mention I I think it's healthy and it's tasty. So I I was I was quite sad.

Dr. Mark Su 8:05

But and then what what came of your what came of this um attempt to follow this?

SPEAKER_02 8:10

Nothing. I just kept gaining weight. And so I ended up by now um back to probably like 20 pounds.

unknown 8:19

Okay.

Dr. Mark Su 8:19

From the time when I was. In the last uh you're saying as of like four years ago, I think you said or something like that?

SPEAKER_02 8:27

Um, this was probably about seven years ago, six, seven years ago, and then and then constantly just keeps going up. Um and then I went through a phase where so about two years ago,

Food Sensitivities And Big Results

SPEAKER_02 8:40

maybe actually by now it's almost three years. It was three years, it was because it was a March. And I um I remember I just went to play some pickleball. I mean, how much activities in the pickleball?

SPEAKER_01 8:52

Yeah.

SPEAKER_02 8:53

And I played um, I used to play tennis, and my husband is like, well, why don't we go? Because they have a couple's tournament. Let's go do pickleball. I'm like, let's go do pickleball. And um it was very um weird because we kept not losing. And my legs started hurting so badly. And uh, yeah, true, we play for two hours, but how again, it's not a marathon, it's not even tennis, it's pickleball.

Dr. Mark Su 9:20

So um and But it was weird too that your legs were sore.

SPEAKER_02 9:24

I was so sore that at some point like my brain would be like the ball is there, and my body could not even bend to do that. And so like we literally um got out of the tournament because I could not function anymore.

Dr. Mark Su 9:38

Oh wow, you had to you had to sort of like disqualify yourself, withdrawal?

SPEAKER_02 9:42

Uh-huh.

Dr. Mark Su 9:42

Oh, that's sad.

SPEAKER_02 9:44

And we and that pain didn't go away for like three months. I mean, it was the kind of pain that I recall having at the end of a full marathon. That's how painful it was. And I couldn't even sit down on a couch. I would just have to kind of throw myself on the couch.

Dr. Mark Su 10:02

And just for curiosity, were you already physically active on some level before this pickleball tournament?

SPEAKER_02 10:07

I would I would do walks and um uh no, I wasn't that intensely working out. No. Okay.

Dr. Mark Su 10:13

Um certainly it was nothing like training for the marathon, but also not um not more aggressive intensely exercising, but you weren't a completely sedentary either.

SPEAKER_02 10:22

Correct. Yeah.

Dr. Mark Su 10:24

Sure.

SPEAKER_02 10:24

And so that happened then, I don't know, maybe six, seven months later, we went oh it it improved, but I was constantly in pain to a s a moderate or maybe even mild amount of pain. But like the moment I would just do a walk, like I if I would just walk from here to the clubhouse, which is less than a mile, I would just feel like I ran a marathon and I would uh recover for like two weeks. So it was very abnormal. And then by July, I remember we went to California to visit family, and the kids were playing in the waves, and I was just like standing where the waves are breaking, just chatting with with my uh friends, and I remember so we we were there probably a couple of hours. So yeah, you do use the muscles to kind of anchor yourself in the sand, but give me a break. I mean, what kind of workout is that?

Dr. Mark Su 11:20

You're saying you're saying your legs felt sore from standing in the waves of the ocean?

SPEAKER_02 11:25

And it wasn't that they were sore. I was in so much pain that I could barely make it to the car. Oh, wow. And then the next day my brother saw me, and my brother's a doctor, and when he saw me, he's like, Why are you walking like that? I'm like, I don't know. I and he I'm I got him thinking, he's like, I don't know what's wrong with you. I'm like, I know, I that's how I feel. This is not normal. I mean, it so so between this two, and now I feel better. Um I I and so that pain is gone. I I now can go, I do hikes, I um I do walks, I'm I'm much better.

Dr. Mark Su 12:04

But um you you have more tolerance now? You can do more without having those layers the muscle fatigue kind of thing going on. Yeah. Huh.

SPEAKER_02 12:11

Yeah. So like for example, in And you don't know why. No, and I I mean I've maybe I know why. I did for the la like in the spring,

Weight Regain Despite Same Diet

SPEAKER_02 12:20

I tried some peptides. I did the BPC.

Dr. Mark Su 12:24

Yeah, in your intake form, yeah.

SPEAKER_02 12:25

Yeah. And then um, so that kind of really improved a lot, my condition. And then um in the summer we've got to be.

Dr. Mark Su 12:34

By the way, just for everyone's clarity, we're talking about BPC 157. Most anyone who's dug into peptides knows what that is, but just to clarify, yeah.

SPEAKER_02 12:40

Yeah. So then we went hiking uh uh in Mount Rainier, so that's not an easy mountain. I I did not do the go to the top and back, no. So it's not that kind of hiking, but but still for for considering my my couple of years of history, that was I was like, Yeah, well, you can't walk to the clubhouse one mile down and back without being tired.

Dr. Mark Su 13:03

Yeah, that's big difference.

SPEAKER_02 13:04

So I think it's a big uh I still think I was much more sore compared to my husband or my boys, of course, but they're like you know, 14, so they should not be sore from that, right? Sure, sure. So um, but um so but it's the it's the weight that is just like it doesn't matter what I do. My husband, every time I try to do something, he's like, okay, let me do it with you. And he loses like 30 pounds and I gain five.

Dr. Mark Su 13:34

And I'm like, you know, I mean, I know it's easier to I won't ask you how frustrated you get about that because we might I might go down, I might be gaslighting you.

SPEAKER_02 13:43

I told him I'm like, you know, you're not allowed to join any of my effort. Right, right. Because everything you lose I find, so please.

Dr. Mark Su 13:51

Um That's unfortunately such a common story between the men and the women. It's it's uh I don't I you know, I'm speaking on the guy's side, but I'm saying it it it is unfair. It happens a lot for reasons we won't get into right now, but yeah, it happens a lot, unfortunately.

SPEAKER_02 14:05

Yeah.

Dr. Mark Su 14:05

Okay. Yeah, more or should we can I jump in a little bit?

SPEAKER_02 14:08

No, go ahead. Yeah, I think that's kind of I give you I painted my s my sorry picture, but yeah, that's that's been my uh my uh struggle for years.

Dr. Mark Su 14:19

Yeah, first of all, you know, first of all, um thank you for being willing to share this, you know, um, on a podcast. Again, our goal is to not just help more people be aware of the how we might approach things through functional medicine, not that as a cookie cutter, not that the next ten of my colleagues or our colleagues are gonna do things the same way, right? But just to give it a a real life example, right? Because you and I both know we could be referred by our closest friends to an awesome practitioner, but when we go there, like it's not so awesome, right? We just we just don't know it's behind the wall, if you will, and and everyone's different. A lot of this is to uh just give people an opportunity to sort of like see behind the curtain, if you will. And then of course, on on our side with the the virtual practice root seek, we are trying to demonstrate for people how we think things through. Okay. Um again, we're not all the same, but we are very similar and we work together and we think alike and et cetera. So um thank you for sharing your story. And um no doubt you and I both know this is a struggle that a lot of people have experienced or are experiencing real time now in some way or another, right? Um so let me jump into, let me just let me just go ahead and jump into because um, you know, these are run unscripted, you know, you've provided an intake form just like we see, just like how we process new patients through RootSeek or our office, et cetera. And so we haven't had a a a conversation to date, but I've without going into more detail about your intake information, it it's not a complicated story otherwise with all kinds of other issues that we've talked about in other podcasts with, at least on paper, known, you know, Lyme, mold, long COVID, autoimmunity, et cetera, et cetera. But let me just ask a couple things just to clarify. Especially when you talk about those muscle symptoms and experiences you had, do you is it fair to assume to s to assume that I understood from your intake, you've not had any known autoimmune diagnoses to date, is that right? Correct. Okay. Do you have any family history of autoimmune conditions?

SPEAKER_02 16:25

No. Unless uh we count type 2 diabetes as uh

Mysterious Leg Pain And Fatigue

SPEAKER_02 16:30

as autoimmune, then yes. Otherwise, no. Not over.

Dr. Mark Su 16:35

Okay. So then how about um so uh well let me just if it's actually let me go ahead and ask one more question, then I'll jump in with a couple of thoughts. Um, you know, again, not to be overly sort of impulsive or or rash, but th being that we're doing this kind of like in a podcast setting, then we're just gonna kind of jump into things a little bit more quickly than we might otherwise in a total real-time setting. But so you you you alluded to on the intake form and right before we jumped on the recording that you were on a low dose semaglutide or osempic before, and I think you said you're still on it now. Can you give me a little more detail around your experiences with that?

SPEAKER_02 17:14

Yeah, so um, you know, considering uh I so I actually even gave a talk on on um Osempic and Munjaro and uh GLP wants, and so I knew that there is an anti-inflammatory side effect or good effect of them. Um and so and I do have insulin resistance. I've my blood sugar has been in the 90s, probably since I was like 20.

Dr. Mark Su 17:41

Your blood sugar or your insulin?

SPEAKER_02 17:43

My blood sugar. And my insulin has climbed up to 27 last year. Okay. Um I don't know how it's doing to date, but um so that's partly why I was mentioning in my intake form that I'm trying uh I was trying a lot and intensely to avoid sugary foods, um, like carbs of any kind, and so I ate more proteins and fats.

Dr. Mark Su 18:14

So trying to help myself, but um so um so with the with those semaglutides specifically, what kind of doses were you on and for how long?

SPEAKER_02 18:26

Yeah, so at first I did like 10 units, which is so I I I'm using a compounded form. So 10 units was 0.25 um milligrams. So that's actually the entry dose.

Dr. Mark Su 18:39

Yeah, the lowest starting dose of correctempic, yeah.

SPEAKER_02 18:42

Yeah, so I did that for uh like maybe six months or so, and I did not lose any weight, which maybe it's expected because of that dose is more like designed to kind of acclimatise your gut versus um you know trying to lose weight. So then eventually I was like, okay, fine. Although I've heard a lot of um uh people talk about low dose and how not everybody needs higher dose, so I was like hopeful, okay, well maybe, maybe I'll help myself. So we'll see. And then I increased to 20 units, is which is 0.5, and then so for the last couple of months, I'm now doing 0.75. So I'm approaching, but other than the fact that I don't gain weight, I did not lose any weight.

Dr. Mark Su 19:33

And so we by six months of the lowest dose, and then you did um at least a month or more of the second dose, and now you're at um not the third dose because the by standard dosing it goes up double, but you are halfway between the second and third dose, and that's been for two months, and you've not lost any weight on those doses.

SPEAKER_02 19:52

No.

Dr. Mark Su 19:53

Okay.

SPEAKER_02 19:54

I I do feel that like the pain is much milder, so it could be the peptides.

SPEAKER_01 20:02

Sure.

SPEAKER_02 20:03

Uh, or it could be this peptide, because uh this one is also peptide, right? The GLP one. So or it's a combination of both. Um so I do feel much better um with the muscle pain.

Dr. Mark Su 20:18

But so can I then also back up and ask you, um when you had the muscle pains with your legs you talked about, was it just your legs, or did you ever have experience with muscle fatigue or pains with your upper body in any way?

SPEAKER_02 20:30

Just my legs and it's probably my thighs and to the knees, not even like the upper leg. Like it's kind of like it almost it stops. Um, it does go up the leg a little bit, but most of my pain is around the knee and the thighs.

Dr. Mark Su 20:51

Okay.

SPEAKER_02 20:51

Um I mean, not die.

Dr. Mark Su 20:54

Did you ever um inquire about that with any practitioners, primary person, primary care,

Peptides, GLP‑1s, And Partial Relief

Dr. Mark Su 21:00

orthopedics at all?

SPEAKER_02 21:01

I I did discuss that with my primary.

Dr. Mark Su 21:03

Did you end up doing any kind of testing around your low back? To be sure it wasn't like a a kind of like an atypical sciatica kind of phenomenon.

SPEAKER_02 21:12

It felt so for example, this past year, um my insurance was quite good to me. And so they paid. So I've done physical therapy with chiropractic for a full year, um, and they paid for it, and they they did um trigger point injections.

Dr. Mark Su 21:31

So no one really had concerns about it coming from your back as a nerve issue, it sounds like Yeah.

SPEAKER_02 21:37

No.

Dr. Mark Su 21:37

No one had concerns about that.

SPEAKER_02 21:39

No.

Dr. Mark Su 21:40

Okay. And quite honestly, the fact that, you know, you've I don't know. I mean, it's not impossible, but since you've gotten better, then there's less reason to go looking, so that's fine. But okay.

SPEAKER_01 21:48

Yeah.

Dr. Mark Su 21:49

Uh one last question. So you did say that in your intake form that you've had um Lyme disease at some point in the past. Can you like really snapshot describe was it a Short-term thing was a a longer time journey and or what not, or did you and specifically did you have aches and pains with that experience?

SPEAKER_02 22:08

Yeah, so I've so I used Cyrex labs, if you're familiar with them. So there it showed that I I was positive for antibodies. I've never had a ticket. I've never so and then uh a few years later I was muscle tested and um during the muscle testing they told me the same thing that must um that Lyme disease is coming up. Um and historically, um I would so I would always have all kinds of pains. And the weird thing, and that also lines up with Lyme, it would be I would have a pain here without any reason it would go away, and then the pain would move elsewhere, and then I would deal with that pain, and then that would go away for no particular reason. I think and then it would move elsewhere. So that was um when I realized that that kind of may present is is a presentation of Lyme. That's when I did uh the cyrux test to just like yeah.

Dr. Mark Su 23:17

So you weren't clinically diagnosed with Lyme, you just had markers on lab testing, and then you also had somebody talk about it with muscle testing that may have been, may or may not have been connected with any particular symptoms. All right. So um bear with me. All right, this is just this is kind of off-the-cuff thinking here, but you know, just on this initial information, um I I had like three sort of diagnostic thoughts up front, but they're they're not sort of treatment-directed diagnostic thoughts, they're more just um validating but also uh your struggle, but also thinking about what might be going on here at the root cause, right? I mean, if we if we start with the question of, you know, because that's what people talk about that all the time. What's the root cause? What's the root cause? What's the root cause? And so in this case, we're starting out with what's the root cause of such stubborn weight? Okay. And then we've got the second topic about your muscle aches and pains, but um, they're not, I would I would say they might be related, they may not, you know, but let's just look at them kind of separately for, you know, just to keep it kind of clean. So the first um the first thought I have on root cause of weight, um, you already know this, but I'm just gonna state it out there, you know, for anybody else also. God help us, who knows?

unknown 24:26

All right.

Dr. Mark Su 24:27

Like it there's no cookie cutter answer. All right. You, you, your story, I think, I think, as I said, I expect a lot of people. I don't think most people are gonna say, like, yeah, I've run a marathon too and only lost one pound. Okay. I don't think that's a common story, but I think there's gonna be a lot of people who hear that and say, Yeah, I hear that, and that's me, because I also did this or this or this or this and didn't lose any weight, effectively. Okay. And and I think um the take-home message I have for that is that in America, most of the most all the discussion about weight comes down to eating and exercise, right? And I still believe that for most of America, it's true. Okay. Most of us in America, by our experience, if we were to do it or we've done it before, if we clean up our eating, we exercise more, there's a caloric in, caloric out kind of phenomenon, and we're going to see changes in our weight. But it's not everybody by any means. Okay. The question then for me becomes on a pragmatic level with patients, since we can't predict who's going to happen for or not happen for, then how far and how long are we going to

Ruling Out Nerves And Autoimmunity

Dr. Mark Su 25:30

continue down that journey? You know, because there's always more you can do, right? I mean, in your case, having run a marathon, I'm not sure how much more you can do. Okay. But most people, there's always more. Like everybody will say, I could eating, I could be eating better, I could be eating better, I could exercise more, I could exercise exercise more. People who are exercising two hours a day will still still say to me, I could exercise more. But come on, like the margin of change, the margin of benefit is getting it's lesser and lesser return, right? So um, I'm not trying to enable or minimize eating and exercise, but I do have conviction, um, you know, at this point, 23 years into practice, that there's a lot more people in America who there's issues with um weight that are not related to eating exercise than we speak to, okay, or give it credit for. And your your story's gotta be one of those cases, okay? I think it's safe to say, without going into another more detailed information and journal about your eating habits and all that kind of thing, um, you know, you've you've taken great efforts. You've freaking ran a marathon, trained and ran a freaking marathon, didn't lose any weight. You've done elimination diets, right, and did have benefit and then didn't. So that's another interesting piece, but you have made meaningful efforts, right? Now, the other part of that, so so like one A that's really inform inter interesting about your story is you have one of those, because this doesn't always happen either, okay? First of all, let me back up a second. When we talk about that eating and exercise thing, I th it's not just mainstream America. I I am, I will say I think that you can tell me if you disagree, that a lot of functional medicine, right? And non-mainstream medicine, I don't care if it's a nutritionist, a health coach, or practitioners, whatever, we also still put a lot of emphasis on eating and exercise, because we can always do better. And it's not wrong, but for me, it's gonna come down to, well, how far are we gonna how far are we gonna keep pushing that button and knowing that we can't predict for certainty that it's gonna lead to outcome? And if someone like yourself tells your story, okay, even if I am hellbent on eating and exercise as the main approach, I'm gonna argue from a third person perspective that I I think the margin of likelihood of benefit, the uh the confidence is low. Do we really do you really want to waste her time and effort? Okay. And and I I could be wrong, but that's that's how I would approach that. So it's not just mainstream medicine. I would argue a lot of times in functional medicine, how much are we uh maybe putting uh uh stress on um emphasis on the eating and exercise when it doesn't end up happening for the person. Okay, like we're we're a little bit overfocused on it at times. I'm gonna get a lot of flack for people saying, I'm gonna get a lot of flack, no doubt for saying that. Okay, there's gonna be people who are like, flame me for that, but um your story is an example of what I mean. And there and the thing is I'm I'm saying there's no right answer. I don't know how you in the patient perspective or me from a p uh provider POV, I don't know how we make those decisions as to, well, that person has shown that they've made enough effort and the likelihood, the confidence of getting benefit with the eating exercise is not high. Let's turn a different direction. I don't know how we make that decision. Okay. But your case is a little more straightforward, so we're gonna leave that to the side. Okay, the next piece. So topic number two here is you have given a great example of what can happen when we actually do that whole food allergy piece. All right. And we say food allergy again, we're not gonna go down that rabbit hole, but we're not talking about the food allergy testing by conventional medicine with the skin prickling prick testing or the allergist or the ENT, the immunologist. Those are different kinds of tests, different forms of mechanism. But uh putting that aside, you did the IgG food allergy testing. I'm 100% sure it's 90, 98, 95 plus percent sure it's IgG testing. Yes. And so then when you when you do the gluten and other foods, right, effectively what you are what you did was you took an anti-inflammatory approach and you freaking lost 32 pounds, right? Now, have I seen people lose weight doing the sort of anti-inflammatory approach,

Three Lenses: Calories, Inflammation, Stress

Dr. Mark Su 29:30

whether it's foods or whether it's Lyme disease or whether it's autoimmunity or whatever? Have I seen that? Yeah, I've seen that. Am I gonna predict that for anybody? No. I cannot predict who is gonna lose weight from not just the eating exercise, but also similarly, the taking an anti-inflammatory approach. I I can't predict that up front. Okay, and I and I'll I'm totally open to learning if anybody can actually tell me like this is how we can predict choosing which path is gonna be your best effic your your highest bang for your buck. Okay. So but you you but you prove that. Like you you stink and lost 32 pounds. That's that's on the high, that's on the really high side from my experience on taking that kind of approach, much less just with food allergies. Okay. So kudos, okay, kudos. But then you get the you get the wild card, right? You get the um the um what what do the kids call it? The um um the plot twist. The plot twist, right? You now gain more weight again, and you're despite doing the same things as before, something's not adding up. And then you do a repeat test and you follow the same approach of like, okay, now I'm gonna change what I'm not eating or restricting to avoid to reduce inflammation, and nothing happens, right? So for me, diagnostically, that means the root cause or root causes of your weight at that time have shifted. Okay. You got a lot of bang for your buck from inflammation. You didn't get bang for your buck from exercising. It's not a calories in, calories, calories out topic. You got benefit from anti-inflammatory diet. Yes, inflammation was your key. Now you've had yet another shift. At least I'd say, not just anti-inflammation in general, but inflammation from foods anyway. Okay, so there's some other shift that's happened now. And that's where, okay, we don't know where that is right now. If we just stop there for a second, the way I'm thinking about it right now, off the top, off the cuff, God help us start and figure out what the cause or cause is. It's it's very unlikely it's just one thing. So causes of inflammation are that are if assuming your main cause is still inflammation, okay, God help us trying to figure out what it is. And I'll just dare say, and we're not going to go into the rabbit hole here on podcast or and we can talk about it offline, but this is where for me that kinesiology and muscle testing comes really into play. And that's not like 100% guaranteed either, but yes, um, I that's that's easily where I s I incorporate that information at least to try to decide instead of just total guesswork as to which direction we go, right? That, well, what's the like what are some how do we narrow our choices? Okay. So hey, right off the bat from your intake form with inflammation, we could talk about is it the Lyme disease topics? Now we're pulling in topic number two with the muscle pains, right? Because when you talk about those muscle pains, like that is not that does not make sense, right? I can't walk a mile down the street without being out for the next two weeks. And then suddenly without re-explanation, now I can hike Mount Rainier, right? That doesn't make any sense. There's something else. So that's why I'm thinking, okay, conventional thinking, let's rule out the common things, right? Atypical sciatica, some kind of what we call ridiculopathy. It's a nerve issue from the from the spinal column. Didn't make a lot of sense. You didn't describe nerve symptoms, but nonetheless, I'm thinking about it. But okay, well, don't know, but not obvious. Um, I did start to think about fibromyalgia, which is why I was asking you, was it only in your legs or did you have pains elsewhere? Like, no, at the time it was just my legs. But then you back up and say, no, but I've had migrating aches and pains, whether joints, muscles, not sure, but I've had migrating pains in the past. And that's much more suggestive of a Lyme disease story. Okay. Um so there might be some of that underlying there. And then we could sort of translate that topic of Lyme disease, not just to chronic Lyme disease, by the way, clearly here. We're not just talking about that affecting your muscles, but could that be one of your root causes driving inflammation that's affecting your weight, right? It it very well could be. But I'm not gonna tell you after all these years that I've had a meaningful number. I don't even know if I've had five. I don't even know, okay. People who we treated Lyme disease specifically and they lost meaningful weight. And now when I say meaningful, I'm talking more like five or six pounds, more than five or six pounds. And it's not side effects from treatments or whatever, like legitimate concomitant with treating Lyme, they lost weight. It's not a common story for me. Okay. But it's just to say there's a lot of possibilities that there's other inflammatory drivers for you because you've already shown back then that it's not a caloric issue with just exercising. Could it be on a devil's advocate here? Could it be that something's changed and now it is a caloric issue? Maybe, maybe not. But we don't have to entertain that point right now because let's bring in those empic topics. Okay. So I'm also gonna say it is rather unusual. I don't I haven't had anybody go on the GLP ones for as long as you have at such low doses, consist constantly, you know, persistently. So I can't compare from that. But first of all, I'm just gonna say um I'm not against GLP ones, right? A lot of people in functional medicine are. I'm not saying just like it's a blind thing and uh everybody go uh go hog wild with it and don't care about whatever else and don't care about how you eat or exercise and don't care about protein and muscles. I'm not saying that. But uh but I'm a fan. There's a lot of benefits, and you you know it as much more than I do, I'm sure. Okay. But putting all that aside, um ever it's um it's very predictable people are gonna lose weight. I'll I'll bet every single time and win 90 plus percent of the time people are gonna lose weight in a meaningful way. I've had I can only think of one person off the top of my head who, after six, maybe eight weeks, they

When Anti‑Inflammatory Stops Working

Dr. Mark Su 35:00

didn't lose more than three pounds, and it becomes questionable whether it's, you know, random or related to those empig or the the GLP one at all. Who knows? But um they didn't go beyond that because they got frustrated with the experience to date. I don't remember how far they went up on the dosing. But I would predict even anybody who stayed on even the lowest dose like you did for six months, much less went to the second dose, the th the second and a half dose now, a total of it sounds like um 10 plus months, I would still expect that you would have lost some weight. Okay. So I'm gonna just bookmark that as that seems meaningfully unusual. Okay. So again, something is something's amiss. Something doesn't quite add up, okay? But I certainly would um fully support you continuing if you're, you know, since you're on it and you've um, you know, you you don't have any it doesn't sound like you're having downsides and side effects. I certainly would advocate continuing, you know, to push up the dosing as as you are currently doing, okay? If you get to a point where you're on, you know, the highest or next to highest dosing and you still haven't lost weight, then unfortunately you've won that prize too, where like it doesn't add up. Okay, like you're the only person. Like that doesn't make sense. Oh, I take that back. I have two guys, I uh I'm sorry. Uh because I'm thinking about people who are just trying to lose weight. I have two guys who um who I see who are diabetics and after a year and and on meaningful doses of the terzepatite even, they've not lost. And again, I say, y this is a a a zebra situation. This is a very unusual situation because everybody else loses weight. Okay, so there's something else weird. Okay, so um I know I'm being wordy here, so um, let me move on. So there's that there's that osempic piece that then f we're talking about second root cause inflammator inflammation as a uh category. And um, of course, the GLP one, we could put in that that scenario, that uh umbrella, that category that, you know, because it does have anti-inflammatory effects, it's not just a calorie in, calorie out topic. Okay, most of the people I talk to, they assume that they're like, well, of course, I've I I don't I'm not hungry as much, I don't eat as much, I've lost weight. But as I've as I've said, I've had people like that person who after six, eight weeks only lost three pounds, like they said, it it feels to me like I'm only eating 30% of what I used to eat. That's how drastic my appetite has curved, and yet I'm not losing weight. That's the opposite reflection of like it's not just about calories. Okay, so in the inflammation scenario, right, we have some options and we can take it offline, but we have some options on the um digging for root causes of inflammation because you actually have, which is highly unusual for me, you have a track record to prove that you have an inflammatory driver of weight. Okay. So then um third and lastly, uh for me, I guess I'm thinking um about autoimmunity. And I I asked you about that. Um it's a very broad topic. It doesn't mean a whole lot necessarily with weight per se, but um it's I guess it's a kind of variation on a theme from the topic of inflammation, because autoimmunity is inflammation, of course. But um, you know, I've had a few. Oh, I'm sorry. I had a different third topic. So I'll make that 2B, okay, or 2A or 2B. Autoimmune as another variation of inflammation here. Um, but we don't need to go down that road. It's just to say I have had, finishing that thought, I have had a few patients when we did um what I call drainage. A lot of people might call it detox. Some practitioners call it pre-tox. Commonly, when we're talking about treating people with chronic complex conditions like combinations of fibromyalgia, IBS, long COVID, brain fog, chronic fatigue, and the whole thing, right? They're they're in a real mess. A lot of those folks we will more adamantly recommend a pretox slash drainage slash detox before we go treating the problems. Okay. Again, you're you have you are you familiar with what I'm talking about?

SPEAKER_02 38:49

Um like cell core type of um cell core likes to use the word drainage.

Dr. Mark Su 38:54

Yep. So great, yeah, yes. Cell core kind of thinking, or it doesn't have to be cell core specifically. But

Drainage, Detox, And Unexpected Loss

Dr. Mark Su 39:00

the idea is just to kind of clear the field of inflamm of um toxins and inflammation so that because when we start to treat problems, a lot of times people get even more inflamed, and so we don't want to add to their symptoms.

SPEAKER_01 39:12

Yeah.

Dr. Mark Su 39:12

So um I have had a few people who lost weight doing drainage pre-tox. Okay. It was not expected, it wasn't our goal, it just happened, right? And the in the first the first couple times I was just I was kind of eyes wide open, right? Because I had no expectation of it. That wasn't the plan. But um one person in particular I remember was like, uh, I gave up on losing weight to like 10 years ago. I never lose weight. It just nothing. Everything that you said, you know, they could probably say the same, except they may not have run a marathon. Okay. I tried everything. I tried everything, didn't lose weight. And then um, after just one month of this three-part stack, it in this case we use a lot of cell core stuff. So three-part cell core stack that we personalized to them, and they said, My friends said I looked like I lose what lost weight. I was like, there's no way. I weighed myself just out of for fun. Holy crap, I lost like eight to ten pounds and I had no idea, right? So I've seen that before too. And so my point here is that functional practitioners as a community, if you go talking to a number of different practitioners, you're gonna get some people like, yeah, eating exercise. And you're gonna be like, uh, I ran a marathon and I did that. Like I redid those things.

SPEAKER_02 40:14

And for the record, I've run two marathons and six half marathons. So I need to stop just that one marathon.

Dr. Mark Su 40:23

Holy crap.

SPEAKER_02 40:24

Yes.

Dr. Mark Su 40:25

Honor to you. I cannot do that. I cannot even think about doing that. I might get nauseated if you make me think about too long. I cannot run the run. Honor to you. Right? If that if that practitioner then is like, okay, fair enough. I believe you, let's move on. Okay. Inflammation, right? They could move on to that topic. They'll say, hey, my go-to is um whatever, the food allergies, whatever. Yes, I did that, and that worked for one time, but not the second time. Okay, I believe you. Let's move on. Next topic, right? People are gonna commonly have their familiarities, their biases, um, and they're gonna push that because there's always room for more. Um, the question is, at what point can we stop and say, you know what, I know that's how I usually think, I know that works for most people, but I can't we don't want to waste this person's time. Like they really have given it a good effort. We need to look elsewhere. Like, right, instead of digging deeper on that topic, look wider. Okay, so now we're into the third and last topic that's crossed my mind. And and you kind of alluded to this either on the intake or our communications before just now about fight or flight, stress, all that stuff, right? Because you've talked about that a little bit. And you and I are definitely going to come across other practitioners who that's a big focus for them for weight too. Like we gotta get meditation and um, you know, calming the nervous system, the the cortisol topic that a lot of people read about, hear about social media and otherwise, right? And practitioners. It's an understandable topic, of course, it's justified. But um, again, I don't have any way, and I don't know, I'm I don't know how I would believe anybody else to tell me I know exactly how to predict who's gonna lose weight on the first pass attempt from cortisol slash fight or flight reduction versus inflammation versus caloric, you know, eating and exercise behaviors, right? Like as three broad topics, and there's plenty of others, but just on those three big ones, I I don't know how we we um can predict that with confidence. Okay. And that's again, muscle testing, that's where I go with that, but we'll put that aside for a second. So I'm I'm rambling here. Uh I mean, I'm not rambling, I'm I'm being um verbose. Uh I'm being I sort of taking the mic here, not intentionally, but just to kind of overview for you a structural way of thinking about where do we go next, right? And if you're staying on those EMPIC, I I certainly I still would expect, you know, until proven otherwise, that it will help. And of course, you are mindful, as you said, about protein and exercise and not letting the muscles, you know, get too degen atrophied and degenerated, gener degenerated as part of that weight loss. You're being mindful about the usage of such, and and I'm fully supportive of the GOP ones. And so it'd be easy for me to say, hey, you're on a path there with the GLP one, right? And you're taking care of yourself peripherally to support that. If I were to uh you know, go to a next step, I'm thinking about, well, in the case that it doesn't go far enough for you, and even if you go to trosepita and it still doesn't, um, you know, which is commonly more effective as you know, then where do we go next? Yeah, that's how I'm thinking is inflammation is the likely topic, and then it's a matter of deciding which subtopic within the inflammation category as root causes to you know to target as a next step. Any thoughts on that so far?

SPEAKER_02 43:34

Yeah, I know I agree. Um I totally agree. I I think the food um sensitivities I in the last year, um again because the insurance paid, I was like, okay, fine, let's just check the IGE. And um last maybe a year and a half ago when I did my blood test, oh, I made

Liver Health And Thyroid Conversion

SPEAKER_02 44:00

measured the IgE amount. So it wasn't specific, but it was highly elevated. Oh the total IgE. Yeah. So I'm like, I'm t I'm totally dealing with the allergies like the in the true sense of the word, right? Um but I I I knew that I do have environmental allergies, so I wasn't sure is it food, is it what is it? So I did test um for a full year, then I did um injections, the immunosuppression, the immunotherapy injections.

Dr. Mark Su 44:33

Oh which one?

SPEAKER_02 44:35

Um just I don't know.

unknown 44:37

Okay.

Dr. Mark Su 44:38

We're talking about prescriptions, right?

SPEAKER_02 44:40

Yeah. So yes. I actually had to go in office for a whole year I went and I got injections and and so after a year I was I gave up because I did not physically wait a second.

Dr. Mark Su 44:52

You're talking about um immunotherapy not you don't mean like dupixin or zole or something like that. You mean allergy like allergy allergy correct okay like with the with the allergens.

SPEAKER_02 45:02

Yeah. So so I've done that and I just got my results back and my IgE level isn't now normal. So maybe it did help. But again, so as you said like maybe the food is not gonna uh it's we are past that cause and probably something else is causing the inflammation.

Dr. Mark Su 45:26

Yeah it's right I mean this is again I'm just thinking it through the the exercise of how do we think through the purpose of what my my verbosity or you know explanation um was to demonstrate for you and this is what what I do with patients, what our our team does with patients also is this is how we think this through. In your case, you have such, you know, I didn't know prior to this jumping on with you here, I didn't know it was that extreme, but your story is so much more obvious so it actually kind of makes the case a little easier you know that um between the calorie thing, the the food aller inflammation topic and then it didn't work the second time so something else has changed. It's a little clearer that um in decision making here than the average person by far. But um when we think through the mechanisms, if you will, like categorically and then break it down into the subtopics, right? Um then then it gives us more at least a method and a rationale for what we're doing because otherwise it's it can feel like we're just shooting in the dark and just kind of guesswork in some way. And that's unfortunate that's just unfortunately it's the reality of functional medicine because we have so many more tools than conventional medicine as you know, right? I I like to say conventional medicine our tools are much more narrow and limited but they're much more predictable, right? Because there's so much time and money spent on the the the mechan the the research, the medicines, et cetera, you know, and putting aside the whole a lot of people are anti-pharma as you and I both know, which, you know, you're in the pharmacy world and you understand that. But the functional medicine world, we have so many more tools. It's just the the breadth and spectrum are you know um are are it's a plethora of tools, but the predictable outcome is not so great. Right? We have some tools that are much more predictable, others not so much, whether diagnostically or treatment, you know, and therapy so so we have to just line up our expectations. And I think again your situation with Wade is it's a you know equally applicable or fantastic example where where do we go next beyond Ozempic if we need to so I think that the inflammation is is very I I would have a lot of confidence going down that road. It's a matter of just deciding which sources or sources of inflammation and you commenting on the IgE antibodies and the conventional food allergy testing. So you tried you crossed that off your list also. Personally I don't know that I would have thought that to be a driver of um of weight anyway. I could be wrong but I don't know if I've ever seen that myself and I don't know that anybody in conventional medicine talks about that either.

SPEAKER_02 48:02

Yeah. I was just thinking like the immune system is made of Ig A, Ig G Ig G Ig M complex um um so it's it's kind of like I was thinking oh yeah I looked at three parts of immune system let me look at the fourth one um and so it's you you've done your due diligence right yeah you know enough to know hey we don't understand everything so if I got benefit from reducing foods from IgG testing that were inflammatory then there could be something similar in a different realm that's just slightly different.

Dr. Mark Su 48:39

So let me go down the IgE food testing route, right? So kudos to you, right? I mean you're working at it you're working it yeah which unfortunately you haven't had more benefit yet.

SPEAKER_02 48:48

Exactly that's the disappointing part and um so I'm sure it has consequences because probably that does make the cortisol go up.

Dr. Mark Su 48:58

So but then

Practical Next Steps And Mindset

Dr. Mark Su 49:00

um yeah so yeah and I'll I'll I'll end with the if it's okay. Sure. I'll end with I'll end this one other thought and then we can kind of like we might bring this to a close not that we've come to some definitive decision making, okay, because I think this is where it gets a little bit more personalized and I'll do that with you offline. Okay. So we might we might say hey what we've accomplished in this session is it's sort of like the exercise and thought process behind how do we decide when we don't have better tools that on paper can direct us in the right direction more definitively and more confidently, how do we decide which way to go? Okay, that's that's kind of like what I'm gathering is this is the primary take-home message. But the other topic I do want to throw out is um liver health. All right and I again this is going to sound at the risk of sounding not very definitive. Okay. You know, a lot of people who struggle with weight have fatty liver. A lot of people perceive it both as patients and practitioners as I have fatty liver because I have kind of like fat tissue, adipose tissue everywhere, including my liver. But we also know there's plenty of people who are thin looking outside who are thin. Their BMI is like even under 25, but they've got fatty liver, right? So the question for me is well how many people and we don't have a way to know the fatty liver actually is more of the origin and then it's led to dismetabolism or metabolic imbalances and dysfunction that then manifest also as weight and obesity, right? And it that's that's not a stretch. I mean we can find all kinds of concern um conventional medicine research around that, okay, but it just doesn't get like talked about in an applicable way in in the actual care of a patient in front of us. So um I do have some patients who we have or are taking a different route so I'll this could be like a fourth category of liver health. Commonly more commonly for me that's in the realm of addressing sugar and um sugar issues, glucose, prediabetes, diabetes and the cholesterol topics as a as a lead um target more so than weight itself. Okay, and um for me I'm I'm kind of currently exploring a different form of glutathione to see it to be determined, okay, but I'm exploring different glutathione and then there's different there's a lot of different ways we could talk about liver health, no doubt. Okay, a lot of different ways. And a lot of that kind of crosses over with that whole pre-tox, drainage, detox approach. But um again our blood tests that we have available to us are not sensitive enough to assess um you know more cellular level um liver health matters. I can say that with confidence at this point um after a lot of years. So that might be something we kind of bring into the mix for you directly but broadly applicable to some people. So with all that being said, I don't want to leave it as um too many loose ends here today, but um is some of this does some of this helpful to you in terms of just directions for next steps?

SPEAKER_02 52:04

Yeah.

Dr. Mark Su 52:04

Or consideration for at least some people they just want to some people just want to feel more grounded as to like I just need an I need to have something to hang my hat on as why? Why did this happen? Why, you know, what can I do to move forward or just I just need some semblance of something makes sense at least in my life because life is so much of life is a little out of our control and then you know we just need to have a sense of like something at least makes sense. Whether it's totally true or not or it's the reality we don't know but at least it makes sense.

SPEAKER_02 52:34

Yeah. Yeah I know for sure and the liver it's definitely something that I looked at and so I've I've tried to help it along the years. Um historically I also had a problem where my T3 level was always low. My T4 TSH were normal but T3 was always low. And over the years I remember I was in my 20s I would go to the doctor and I would describe my symptoms. I was the poster child of hypothyroidism on paper. And um it was just like I would just think of food and gain five pounds and and and I would have all the symptoms that that are um associated with hypothyroidism. So and the doctors would be like oh let me check your thyroid and then they would check TSH and T4 and they would be like you're completely normal there's nothing wrong with your thyroid um I now I agree with that but my T3 was always low so that's why I had my symptoms which we know that the liver is what does the basically turns T4 into T3 which is the active hormone. So that's why I felt the way I did so we it was really liver disease it wasn't thyroid disease but it manifested as um a thyroid issue and so I I I have been babysitting my liver for many years now but if somehow I'm not really probably getting to what's really bothering it's again it's it's probably that's the same the same unknown that's causing everything else um that so I don't know.

Dr. Mark Su 54:14

Yeah so um I think that's where if it's okay with you I'll um take this we'll we can stop this here I'll kind of help you out um offline on the next step to be more specific and concrete to you. Um but you know that part is um can open itself up to way too many questions on a sort of podcast recording because it's uh it's a it's a whole nother animal so we'll if that we'll defer that next step but um yeah it look again um I really appreciate you just sharing your story and giving us the opportunity you know collectively you and I in on behalf of the function medicine world and arena and the practitioner community and the um the health enthusiasts etc you know the chance to just um think this through and and talk it out loud and because I I know a lot of people are going

Closing Thoughts And Where To Get Help

Dr. Mark Su 55:00

to relate with this. Um it's just the decision making is very individual um you know person person. So um that part we'll kind of say for off camera if that's okay.

SPEAKER_01 55:09

Yeah, of course.

Dr. Mark Su 55:10

Okay. So that's um so thanks. Yeah. Uh so I guess to close this down so again um yeah for those who are um not familiar with functional medicine uh yeah we we encourage it, right? Just it's just about expectations and if you to to to explore that road for whatever your condition may be, whether it's weight related or if it's fibromyalgia or um chronic Lyme or a number of other possibilities, uh if you haven't worked with somebody and you could use some help, you can certainly reach us at um rootseekhealth.com. If you are working with somebody but it just um has kind of stalled you're not finding further progress and you are looking for any kind of second opinion, we're more than happy to provide that also would be privileged to work with you. And uh this is this is what it looks like. This is what functional medicine's about and just being real about the parts that are predictable, the parts that are less predictable, but exercising the thought process and understanding uh physiology and health enough to be able to help patients in the point of care right in front of us to make rational decisions in the midst of a lot of the noise and um such that aren't well explained or just sometimes even conflicting or contradicting online, much less between practitioners. So um thanks for joining us and um thanks again, Mahila for your willingness to to share.

SPEAKER_02 56:25

Glad to to help and basically show the world that there's more to medicine than just the lap tests and um the root cause I think ultimately it boils down to that and um sometimes we cannot find it, but it's still better than to not even know about it that it there is something out there. So Amen.

Dr. Mark Su 56:52

I didn't want to complicate it. I was thinking the same thing I didn't want to say it to complicate things but you said it so amen. It's it's not always identifiable but it more we can often find benefit to some degree one way or the other. And so it's just a decision of d do we want to explore are we going to kinda like be victim or just be passive and just accept what we don't necessarily have to accept.

SPEAKER_02 57:14

Yeah. Yeah, exactly.

Dr. Mark Su 57:16

I love it. I I appreciate I appreciate you. And so thanks for your continued work in your you know in your own professional world and your and in your own community in life. So thank you.