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Pamela : Hi, this is Pamela Wirth from the Encourage Your Wellness podcast, and today I have Dr. Heather Tallman Ruhm. Thank you so much for being with us.
Dr. Heather Tallman Ruhm : Thanks for having me, pleasure to be here.
Pamela : All right, so doctor, you're a board-certified family physician. You focus on whole body health and patient education. You have worked with a number of ages and diagnoses, and I'd love to hear more about your journey and some of the things that you're really focused on right now.
Dr. Heather Tallman Ruhm : Okay, wonderful. Yes, I'm a family physician by training. I was trained in a conventional Western style of medicine. I went to the University of New Mexico School of Medicine and always had an interest in the whole person and in nutrition, exercise, and how to optimize health for anybody of any age. When I got through medical school, I loved it. It was a wonderful experience learning about how the body works, the incredible magnitude of what our body can do at a cellular level, at a biochemical level, physiology, anatomy. It was amazing to learn about how the body worked.
Then transitioning into residency or into the clinical phase, it felt like we got a little bit more away from some of that, from what made the body so amazing and wonderful, and a little more in the direction of finding diagnoses and using codes for those diagnoses and using kind of a prescription for those diagnoses or a more regimented approach to prevention that didn't leave a lot of room for bio-individuality. It kind of strayed away from my original passion for nutrition and whole body health in a way. That longing for that part of medicine, even before I got into medicine, some will ask why my journey took me to a master's in public policy before I went into medicine. It’s because I was interested in health, kind of global health.
But that path kind of away from those roots of interest left a longing. That longing started to be fulfilled early on when I went to work at the Whitaker Wellness Institute in California. There, it was full immersion, working in an environment where there was not an emphasis on drugs or surgery. In fact, there was an emphasis on helping bodies heal from whatever ailments without the heavy use of drugs and surgery to get there, really much more in line with the natural capability of the human body to resolve issues with the right supports and by removing the obstacles from healing.
Fast forward, I've worked in quite a few different environments of integrative, holistic, bioregulatory, integrative, functional, whatever the popular word is today for looking at the whole person, looking through the lens of bio-individuality, collaborating with practitioners from a very broad range of perspectives and modalities. I've worked with very transdisciplinary teams of individuals, be they teams in one environment like they were at the Whitaker Wellness Institute, or across a region or throughout town. I've both been in my own private practice where I hung my shingle, and right now I work at the New Hampshire Health and Wellness Center. That's almost like a co-op collection of practitioners that work in that same space of healing using lots of different modalities but working both independently and then cross-referring.
Pamela : Yeah, so what does that mean? What types of people come to you? What are they trying to look for? What kind of tests do you like to run? What are you thinking as you're meeting with people?
Dr. Heather Tallman Ruhm : All right, so that's a good question. I don't really follow a particular protocol. I see patients as fairly young. I don't typically do primary care in the sense that I consider myself more adjunctive to somebody's primary care. I'm no longer delivering babies or doing newborn checks and that kind of thing, or working on the other end like in hospice or in the hospital setting. It's more people coming to me and coming to this practice who have all types of conditions but are looking for a means of nurturing their health in some way.
They may be getting conventional treatment someplace and then want to look at their nutrition and lifestyle or what might be underlying their condition that they haven't looked at yet. So, they've gotten the idea of root cause or what you think of as functional medicine. If you look at our clinic in particular, it is primarily adult medicine, but I see children and all ages, and so do most of my colleagues, maybe not all. They are naturopaths, acupuncturists, hands-on reiki, massage, cranial sacral, doing sound therapy, a whole range of things.
As far as navigating what's best for a patient that walks through my office, it's really a lot of history, looking for patterns in presentation, in illness, in interventions, and starting to sort out what comes up as the priorities. So that might look like somebody has a heavy amount of inflammation, I may suspect a hidden infection, or I may suspect that they could use something much more nuanced for their genetic makeup. If I see certain things in a family, and that isn't to say looking for a gross genetic anomaly, that is looking across what your listeners probably know of as SNPs, which are single nucleotide polymorphisms or genomics to see where they vary slightly from other people in society and where they might biohack their health based on their individuality.
The type of testing I do, I don't usually rely on a lot of heavy testing upfront. There are practitioners who do, and I respect that, and they're very good at the nuanced interpretation of those tests. Even if you take a standard lab test, which I will not infrequently order, maybe a CBC, a complete blood count, a complete metabolic panel, thyroid tests, maybe certain vitamins, and knowing just enough to perhaps test it slightly differently. Like I might not look at magnesium, I wouldn't write on my requisition "magnesium," I would write "red blood cell magnesium" because to me that's more clinically appropriate or explains to me what's happening in the tissue with magnesium, not just what's in the serum or the plasma. So that's helpful to fine-tune standard labs. Sometimes that's what's accessible for patients if it's an insurance issue or if it's a small child, you know, sometimes collecting a lot of labs is very inconvenient. That isn't to say it can't be helpful.
This probably gets me into describing more of the kind of work I'm doing with another organization that you're probably very familiar with, which is Epidemic Answers. So my one hat is that I work in a clinic, which I have for many years, various clinics, and that's my own private practice. It's part-time. For the rest of the time, I am working with an organization called Epidemic Answers. It's a nonprofit that serves parents and practitioners with resources to help navigate chronic illness or to keep their already healthy children healthy or make them healthier.
That drew my attention many years ago when the director of that organization, Beth Lambert, wrote her first book, which was "A Compromised Generation," looking into what is happening with our children today. As I read her book, I said, "Oh, this is right in keeping with everything I've learned from a holistic functional approach and the various individuals I've been listening to over time," whether it was from A4M, which was one of the early medical communities that looked at what was happening from a physiologic standpoint, from a total load standpoint, you know, what's weighing on people's health today, to the more modern practitioners that really moved the biological approach to autism forward. She was speaking about our children in the same way I was learning about what's helpful, what seems to be harmful, and really looking at that total load perspective now.
Her book, I think she wrote about 10 years ago, and I was always kind of an advisor in the wings waiting for this kind of project to take place where they were developing the research capacity to study scientifically, you know, what is it that's burdening our children globally. What are all the things if we looked at the total load on our children today, what things are most impactful, what things are most impactful under certain conditions, what things are most impactful for children being healthy? So they created a research project around that, and I was there to advise when time was appropriate, as well as a prospective study. There are two studies. Do you mind me telling about it?
Pamela : Oh no, please, and I mean, frankly, the work done at Epidemic Answers has been life-changing in my family because it's not just one thing that you have a symptom from. There are a bunch of things that pissed off your body, for lack of a better word, and now you've got to figure out how to calm it down, and you can't just calm it down with one thing. That's really the interesting thing about the work being done at Epidemic Answers and the insight that has been done in the written works and the research, really explaining in layman's terms how this can impact this, this can impact this, and how all of it together then creates these massive diagnoses.
Dr. Heather Tallman Ruhm : Yes, the perfect storm as it were, right? For your child, when you look at that kind of tip of the iceberg which often comes to a parent in the form of a diagnosis that's completely overwhelming, but sometimes comes forth in different symptomatology, then under that iceberg is a lot of other things that maybe the body, the physiology, is trying to navigate under the sea of total load. So, it is extremely appealing to me that we're not looking at a smoking gun as the source of all evil. It's like, what are all the things that are contributing today to the health of our children?
That has manifested in two research studies, two IRB-approved research studies, one being a broad survey with over a thousand questions for parents to fill out if they have a child between the ages of one and fifteen. It takes a deep dive into everything that they've either been exposed to or that's a current part of their life, their diet, their family, their history, and takes all of that into account. Then it generates a report that shows from the literature what things, whether they had a C-section, whether they were breastfed and for how long, just every detail about their house and where it's located, every detail you can imagine, and then starts to sort out which things rise to the top in different conditions.
So, that's been a really interesting part of the research. The other research is a prospective study working with live children, not that the children aren't live for the survey study, but children in real time, to take them from or follow their journey from the onset or early stages of a chronic illness to an 18-month course of time wherein someone or a multidisciplinary team of individuals are working with that child to see progress toward recovery. I came into play in a more active way a few years ago when the research moved into that dimension, and they needed a medical director. In the context of that, working as research facilitators, we're not acting as the clinicians but facilitating the work of a multidisciplinary team of clinicians supporting this child, and then the family's input and contribution to the narrative about what's happening with their child, both from lab standpoints, various assessments, written assessments, and assessments from specialists.
For example, someone who understands reflexes, someone who understands neuro-optometry, that the brain and the eyeball are one and the same, and that you can study the innards of the brain through the eyeball. You can also work on healing that body through the eye or correcting vision in certain ways. Different groups use their skill at understanding how something is functioning to see what's happening internally with that child as well, and then navigating that and improving it. In a summary, simplified way, I kind of think of it like Goldilocks, looking for just right. So, as you look at the total load, you're saying what kind of things are weighing heavily, what kind of things are contributing to that stuck place of an individual or dysfunction, and then where is there not enough support. How can we lower the load on the child and raise the supports, maybe very uniquely specific to them?
Sometimes that requires some testing or a facility with interpreting body language. For example, you may look at someone's fingernails and see lots of white spots and think they probably have a zinc deficiency. You can use that and employ things that are not offensive to the child or use something more subtle like homeopathy or energy work of some sort to give you feedback and then to offer some kind of guidance as to what might lower the load, what might raise the supports, and then where you see that something has been really derailed. Let's say someone moves out of a moldy house, that's a real lowering of a load that could have been contributing to their health. We give lots of nutritional supports, but maybe something got derailed, maybe their reflexes were thrown back into more of a primitive state, just like they might with a stroke. Then you work with someone who helps those reflexes move along so that they get brought back up to speed or helps that joint get realigned, in a way a chiropractor might realign the spine.
So, there may be some skilled people that I would refer out to, especially in my practice, or also as we would with the Documenting Hope, which is the overarching name for the two studies because we're documenting everything that we research. That should culminate in a film documentary and case reports along the way. But really, as I see the role of the functional, integrative, holistic type practitioner, it's doing what we know how to do to help the family or the individual lower the barriers to healing, raise the supports, and then find, if we aren't the ones that provide that particular technique or tool, someone who we know is skilled at doing that particular piece that we aren't skilled in.
Pamela : Yeah, I mean, you know, the example of moving out of the moldy house is certainly a good one. Have you found other things that make a big difference? In our experience, removing gluten and sugar made a huge difference in terms of overall health and wellness. Do you have things that you have found to make a big difference or some themes that you have found over the years that you say, "Hey, if you want to test this or try removing this or try anything in the lifestyle, anything in particular?"
Dr. Heather Tallman Ruhm : I think there are numerous factors, some of which are coming out of recent studies. For example, the high amount of antibiotic use. Finding alternatives to antibiotics when possible or teaching our doctors about interventions that are effective but don't involve antibiotics can make a difference. For instance, in early stages of infection, we can minimize the use of antibiotics, preventing the infection from escalating to the point where antibiotics are necessary.
I'll give an example. I remember a young child, close to three, with very limited speech. The family was working hard with speech therapy to get the child to say recognizable words like "Mama" and "Dada." By taking an extensive history and learning about the child's likes, dislikes, dietary practices, and physical manifestations (such as ear infections or skin issues), I suspected the child might not be doing well with dairy. Dairy isn't wrong for everyone, but for this child, the patterns indicated it might be a problem. I suggested they reduce dairy, even though the child loved milk. Often, people crave things that may not be good for them, like gluten or dairy.
A few weeks later, the mother brought the child back to show me the progress. The child, who previously needed milk to calm down, had begun speaking more clearly after reducing dairy. This isn't a solution for every non-verbal child, but for this particular case, it made a significant difference. Sometimes, the issue isn't a complex genetic disorder but something simpler like a dietary intolerance.
I've also seen examples of using an "energy mind" to determine what might help a child. For instance, with homeopathics or products made from plant buds (like gemmos), just having the product in the child's presence can show effects. One child with congenital Lyme, who didn't communicate well, held a vial of fig (known for calming the nervous system). He wandered around the room but calmed down significantly when he held the fig vial, even lying down on the clinic table. This indicated that the fig might help him, and it did.
There are many examples of people experiencing significant health improvements by eliminating foods like gluten, dairy, or soy, or avoiding genetically modified foods sprayed with harmful chemicals. Modern agriculture often uses chemicals similarly to antibiotics, which can disrupt our microbiome—the ecosystem in our gut. Our microbiome is crucial for manufacturing neurotransmitters, vitamins, and supporting our immune system. If we disrupt it with antibiotics or chemicals, we lose these essential functions.
Research has shown that animals stripped of their gut ecosystem lose the ability to produce immune cells and neurotransmitters like serotonin and dopamine. Our gut is often referred to as the second brain due to its extensive nervous system and its role in overall health. Removing harmful substances from our diet and focusing on gut health can lead to profound health improvements.
Dietary changes can have dramatic effects, and this is often where I start due to my passion for nutrition. Many children suffer from hunger, not due to a lack of food but because of poor nutrition or anti-nutrition—foods that harm their ability to absorb nutrients. Trauma also plays a significant role in health outcomes. My medical school thesis focused on trauma and comorbidity, showing that exposure to trauma can impact health significantly.
Overall, the body, mind, and spirit work to protect themselves. When lacking resources, the body will use whatever it can to stay alive, based on available resources and past experiences. Addressing dietary issues, trauma, and gut health can lead to significant health improvements.
Pamela : That's a good point. Is there anything you want to make sure people take away from today? Any place you want them to visit to learn more about health and wellness?
Dr. Heather Tallman Ruhm : I'll put a plug in for Epidemic Answers because they have spent 10 years collecting a library of resources for parents and practitioners to navigate all forms of modern chronic illness and symptomatology. They have a checklist of things to look at for different diagnoses, from ADHD to Alzheimer's. This can provide insights. We will have the CHIRP survey available for people soon. We're switching platforms right now because the platform we had is no longer available. It was based on the Living Matrix, a functional medicine approach to capturing total load and chronological history.
You can become part of the science and learn from it, as you will get a report back about your children. We invite people to join in, and there's no cost for taking the survey. You get a report back that can help you think differently about your child's illness or navigate it differently. There is also a library of resources, webinars from specialists, and various categories of information collected over 10 years. You can explore things you might not know much about yet or that might help you in a continuum of actions, from free options to more costly ones like moving out of a moldy house.
The platform provides mental resources and encouragement, reminding us that we are not alone. We also have a program called Healing Together for parents navigating difficult situations with their children. Parents can come together in a community membership to discuss and share support and encouragement with practitioners and among themselves. It's a lonely journey, especially at the outset when encountering fears that something might be seriously wrong with your child.
We have resources for parents and children, and even though it's child-centric, it pertains to everyone. When I first researched autism to understand what it meant for my patients, I found that the biomedical approach to autism provided a model to understand all illnesses. It's like a petri dish for understanding any age or diagnosis because there's so much overlap. It's about looking at the total load and identifying what creates the perfect storm today.
Pamela : Well, thank you so much. We really appreciate having you on today.
Dr. Heather Tallman Ruhm : Thank you for your time.