The Autoimmune Answer with Dr. John Bartemus and Pamela Wirth

The Autoimmune Answer with Dr. John Bartemus and Pamela Wirth

 

 


Bio: 

Husband and father of 5.

Crossfit enthusiast

Practicing Functional Medicine for 15 years.

International #1 Best Selling Author of The Autoimmune Answer

Doctor of Chiropractic

Certified Functional Medicine Practitioner

Board Certified Integrative Medicine

Member, North Carolina Physicians for Freedom (NCPFF)

Member, PANDAS Physicians Network (PPN)

Member, International College of Human Nutrition and Functional Medicine (ICHNFM)

Graduate, American Functional Neurology Institute (AFNI)


www.FunctionalMedicineCharlotte.com

https://www.youtube.com/c/drjohnbartemus Dr. Bartemus’ YT channel

https://a.co/d/0fcbvNio Dr. Bartemus’ book

 

Pamela:  hi this is Pamela worth with the encourager Wellness podcast and today I have Dr John bamus uh fantastic uh background and so many things that he's doing to help so many others international number one bestseller author of The autoimmune answer member of Panda's physician Network international human nutrition and functional medicine uh the list goes on and on and father of five CrossFit Enthusiast um so thank you and uh for being here.

 

 Dr. John Bartemus: yeah thank you for having me I'm uh happy to share with your audience.

Pamela:  you know um touching on autoimmune they're saying now that one in every five people is being diagnosed with an autoimmune disorder um so many Physicians and practitioners believe that you know those are merely just names for inflammatory responses of a certain um part of the body you know what do you suggest or what do you like to do in terms of a protocol for people that have been or have a loved one that's diagnosed with an autoimmune disorder

 Dr. John Bartemus: uh yeah so I had a consultation with the lady yesterday who um called and she said I have uh it was some acronym like six or seven letters long and she's like have you ever heard of it and I said no and she said it's a rare autoimmune disease uh that attacks the kidney and I've been to Mayo Clinic and they have no answers for me I've been to wake force and they have no answers for me can you help me and I said you know I've never heard of it but because it's autoimmune um you know I can't guarantee any patient anything but because it's autoimmune I think we have a good shot because we're Mayo Clinic and wake for start looking at her as a kidney issue it's actually an immune issue right so there's over a hundred autoimmune diseases they all have fancy names and everything but the Crux of it is that they're all the same and that it's an immune dysfunction they're just named by what tissue or organ the immune system is attacking right so I told her I've never seen it before um but I've worked with tons of autoimmune patients so I feel like I can help you absence a GU because if we can figure out what's going on immunologically and address that then teaching your immune system to say that's Pam don't shoot at that that's not Pam shoot at that if we can do that or promote that that discernment then we can win where other clinicians maybe haven't helped her and so that's what I'm looking at with patients whether it's you know Hashimoto or pandas or rheumatoid arthritis or some acronym that I've never heard of.

Pamela:  are there particular types of tests you like athlete but you know um what kind of process do you like to take people through in terms of how to attack an autoimmune diagnosis like this because it's really um it's really scary for most people it sounds uh permanent it sounds awful and um but there's so many things that can be done to kind of unravel this.

Dr. John Bartemus: absolutely it it is permanent technically from where we sit today scientifically because to technically cure an autoimmune disease we need need to know how to delete the memory cells in the immune system that are recognizing that tissue is enemy so technically it is longterm but you don't have to be symptomatic long term you don't have to be progressing over time right and so the way to at least the way that I practice to help a patient reach optimal is I want to honor them as the individual they are so Pam with Hashimoto's disease is different than Joan with Hashimoto's disease we're in a system where conventional medicine looks at ham and Joan is the same they both get Synthroid neither of their immune systems are addressed and they're both sent out the door okay but uh you and I realize that 10 women with or men with Hashimoto's disease lined up outside my door have 10 different puzzles that are influencing that autoimmune disease in them so the beginning for me or the process for me is to start with a history birth to now it all potentially matters you know going back to Mom's Health going into conception Dad's health going into conception because epigenetics influence the health of the baby you know was it vaginal was there antibiotics did they breastfeed blah blah blah vaccine schedule all that stuff up to today uh and and then in addition to that I request the last seven years of medical records because I want to understand what's been done what hasn't been done what have doctors called normal that to me isn't what have lab Trends been What treatments have worked and not worked and going through all that I can sit down with you and say Pam I know you as they as possible to the minute and based on your history and Records to this point here are the five things waving their hands saying look deeper over here right those are my informed guesses at that point based on knowing you up to now I want to prove or disprove those guesses with these tests okay so what are those tests well those vary based on your workup so I don't do the same testing on everyone I do what's relevant for you so that we can be um you know good stewards of your resources we don't need to run tests that aren't necessary right and so that workup leads  to the testing we want to run we run that and get the results back and we can say Pam remember those five things well these three are not involved in your case Hallelujah these two things are real Based On A B and C right here on paper and so at that point we've got the objective clinical targets specific to you that you and I can be accountable to we can say this is what we're seeking to change and so then I can create an individual ized in specific plan for you to say hey go do this stuff we're going to retest at these intervals and observe for objective change on your labs and at the same time you'll fill out progress questionnaires at testing intervals to say hey my fatigue 0 to 100% better and my anxiety zero to 100 better and my gut and my sleep and my pain and my hair skin nails and my whatever and so when the labs are changing and you're feeling better we know we're winning and the goal is to ultimately say pay high five great job your wings The Only Magical is discipline we figured out what works for you now stay disciplined.

 

Pamela:  um when when people are listening and and they want to talk to doctors and understand a little bit more are there certain classifications of tests that you typically will look at whether it's nutritional genetic the presence of any infection anything like that.

Dr. John Bartemus: yeah so all those things potentially can drive an autoimmune development and so again that history and and medical record review helps us understand in Pam it looks like it's been Foods more for her or it looks like it maybe is a chronic Epstein bar or CMV or something or maybe um she's lived in a water damaged building and it's an environmental mold or atino or some bacterial endotoxin right and so that that's why that history of medical record review is so important whereas you go in another office you fill out the paper they never look at it they have it in case they were audited or something but it's like the the gold starts there like that's that first the first striking of gold that leads you on the trail to like I want to follow this
vein and hopefully we've got a line right here and so to answer your question more specifically.

Pamela:  no I understand I mean it it does need to be personalized for sure I'm just trying to

Dr. John Bartemus: fundamentally yeah yeah fundamentally we want to understand the immune system right so so um this the CBC which is short for complete blood count with differential is run by every doctor in the country at your yearly Labs it should be R anytime you have Labs because it's inexpensive and it's really that that that test is gold for understanding the immune system if you know how to interpret it so that would be a uh if you have no money I mean that's a $5 test depending on are you insurance or cash or whatever right but that that's a starting point but then there's if you look at my book um in the introduction I talk about the immune system and this is going to be nerdy for a minute for listeners but there's two sides to the immune system there's the innate immune system which is the First Responders kind of the the uh more primitive side you could say or the older side and then there's the Adaptive immune system which is your B cells and antibodies and te- cells and killers and things and so the way things should work normally is you're exposed to a foreign thing that's infection that's allergen that's toxin that's something an a immune system recognizes the foreign thing and grabs it goes to the lymph node is trying to hand it off to the Adaptive immune system okay if the Adaptive immune system if the handoff is clean then when that handoff is made at the same time the anate immune system is releasing chemicals called cyto kindes that are influencing the development of the te- cells along a certain path and so as lay people you know Co was a good example you'd say well we just want to take immune boosting supplements right what should I take to boost immunity but the immune system is much more nuanced than let's raise it or let's lower it okay and so one of the reason we have to be nuanced with patients is because once that handoff is made and and we're turning naive te- cells which you could think of as a baby okay it's it's immature it's chubby it's cute but it's pretty useless okay it has has to mature into one of seven careers an adult being say a doctor a lawyer a carpenter a teacher or whatever okay and what career it picks depends on what is being presented and what this inate immune cell is releasing into the environment to influence it a certain way and so to answer well what supplement should I take to boost my immune system it's like well are we trying to go antiviral are we trying to go more of a mucosal gut lung sinus bladder thing are we trying to actually resolve and calm down inflammation that answer helps us know what you know what supplement to do or what lifestyle strategy to implement or what test we want to look at to observe are they already immunologically biased that way and so in in the introduction of the book I have a Graphic for you that shows you that stuff um and so understanding that is really the secret sauce immunologically and that that that the nerd term is the immune phenotype so whatever immune phenotype you have might be different than Jones and that's why your Hashimoto would respond differently um so so the CBC is a baseline test for that then running th inflammatory markers like CRP or C reactive protein the arthrite sedimentation rate or ESR uh human transforming growth factor beta 1 or TGF beta 1 uh uric acid lactate dehydrogenase understanding blood sugar and Insulin because that's a fundamental thing getting an iron panel because if you can't deliver oxygen you're going to be inflamed and fatigued and you know brain's not going to work well no tissue will work well uh so those are um and there's many more but those are Baseline things to help understand inflammation and the actual type of inflammation and knowing that helps us know how do we push back for this person.

Pamela:  yeah and then are there certain things that you really encourage people to do from a food standpoint from a uh environmental and your home standpoint I mean inflammation is is frankly everywhere and you can never really get rid of all of it but um are there certain things that you believe more than others that you help people try and work through real life

Dr. John Bartemus: so um remind me of that question if I get lost here for a second course just just to finish the first question so there's some blood stuff right but then you could if if we're saying okay we think it's more gut in a patient well then a stool test helps us understand the gut right and up to 80% of the immune system is in the gut so often we want to understand the gut for that reason you know you read these Health blogs and it's like start with that gut and it's like you're really only starting with the gut because that's where 80% of the immune system is okay if 80% of the immune system was in your pinky I'd say it'd be like leaky pinky would be all the blogs right so um a stool test helps you understand the immune system by understanding the gut and is the gut hyperpermeable and are there you know food reactions and are there bad bacteria virus worms yeast parasites there do you have healthy probotics which are the Allied Forces to your immune system you know so the stool test can help us understand that autoimmune case differently and further than just the blood um you could look at a urine test and or saliva test that are looking at cortisol and your cortisol circadian rhythm and the stress response and impacts on your sleep and your sex hormones and your stress levels because all of that influences the immune system positively or negatively um you could do genetic testing to understand is this person uh does this person have a genetic makeup that makes them more prone to being inflamed than Pam right so Pam has normal genes she was dealt the best handic cards you could have genetically so that c reactive protein normal range of you know zero to three for her we would expect her to always be within normal range if she's not inflamed someone that's got a a a snip I don't know if your audience knows that term but single nucleotide polymorphism a sniff a gene variant in the CRP gene or in the il6 gene they're going to be more prone to having a higher Baseline CRP than normal and if that higher Baseline is lab High okay say uh so normal would be three or less medically we'd want you optimal is less than one okay but anything above three would be lab high so say we test say I'm G to flip it on you now but say Pam has the bad bad genes or the gene variance in CRP so now we're testing you and you've got an autoimmune disease and what's going on here so then we might think okay is there a gene variant here we test it you've got a positive CRP variant now that changes our clinical expectation for for you you might not ever make sub three okay but because you were eight and it moved to 6.8 we at least know you can do 6.8 right so then moving forward in the future if it ever goes lower say say five is the best you could be we've seen a five eventually well then we know five is the best Pam can be CRP wise so if you think you're flaring we could run a CRP and be like hey it's eight again so we know five's her best we know she's flaring right so we can genetic testing is helpful in that we can't change your genes but it can help us understand what's realistic for your test results so that you don't move forward not knowing that and you're always like thinking you're failing because your CRP won't go down and all it's like that's not a realistic goal in that case um so th those are those are tests um other examples of tests we could use now remind me of your question you asked last time again.

Pamela:  so you've you've you've got the the person in front of you you've you've um chatted with them on the test um in my experience it's a long process you know kind of talking people through the fact that you know you're going to have to be pay patient as we're working through this and in our case it was over a year I don't know if you've found um I mean obviously there were incremental improvements but before we were back where we wanted to be it was it was a good year or so um do you find that you know you have to kind of talk people through certain things and then is there maybe particular things around food or in their environment that you really recommend um to reduce potential inflammatory things that can happen to the body which might make it flare more than otherwise or

Dr. John Bartemus: um yeah I at least in my practice we're just fire hosing you um because a lot of times you've seen 10 12 doctors you're getting no butter it's been years and and and the family's out what's going on with you we're tailoring that plan to to hammer it from every angle so it's like hey nutritionally eat this don't eat this time it like this physical activity do this type of movement this time a day this many days a week um at this intensity stress reduction strategies do these things toxin avoidance do these things sleep hygiene do these things supplementation weeks one to three with food without food this many times a day ramp up like this weeks four through six full these in week seven through whatever full these in so you know you could think of it metaphorically as you've got the Pam for dummies on your fridge and it's like what week am I in what am I doing you know and because if if it for the patients I see if it were just diet or just a supplement I would I wouldn't see them because Google would have let them there right and so our society's very very um very bought into uh just tell me what diet to eat and I'll be good or just tell me what supplement I need and I'll be good it's like if that was going to work for you you wouldn't be here so um I look at it as again Pam as a puzzle and will your care some some 100% of the care you need will have some percent nutrient nutrition tweaking or necessity in it it will have some percent supplementation but if that's all we do you're leaving all the percentage of physical activity stress sleep toxin EMF exposure blah blah blah that that no one else is addressed and so you don't get optimal if you're only addressing you know two of the pie right

Pamela:   yeah a lot of people don't talk about EMF um so like with with my kids I I asked them to keep their phones away from their bed um you know yeah what do you what do you what do you seeing what do you suggest uh this is still fairly new I think for a lot of people to understand U that it does cause inflammation um

Dr. John Bartemus: oh yeah there's there's no doubt that it causes inflammation um it's just who's funding the thing that you're reading because obviously the the people who own the towers don't want it from you as possible when you're talking and absolutely don't sleep with it near you adults shouldn't either like my I unplug my Wi-Fi router at night I leave my phone on off or Airplane Mode down in the kitchen like if you call me at 4:00 A.M what am I really going to do for you you know like I'll see you in the morning so um you have to realize that we are electromagnetic beings and that external um non-natural EMF field impacts the fields that we put off that we live in that the Earth puts off and from you as possible when you're talking and absolutely don't sleep with it near you adults shouldn't either like my I unplug my Wi-Fi router at night I leave my phone on off or Airplane Mode down in the kitchen like if you call me at 4:00 A.M what am I really going to do for you you know like I'll see you in the morning so um you have to realize that we are electromagnetic beings and that external um non-natural EMF field impacts the fields that we put off that we live in that the Earth puts off and so um you know we're we're basically a walking experiment because you know we're the first generation with this you know so so um my bias is to you know always be conservative and natural and so the uh the less we can be exposed the better and so to your point I don't know if you know this I was just turned on to it recently by a patient but there's a company called Lambs it's get lamps.com and they have EMF blocking clothes and so I've purchased a t-shirt a hat and a beanie and they block 99% of all the G's um and they and it blocks the sun too so if you're worried about UV um and it's done it's done by the silver is embedded into the clothes kind of like space suits are for astronauts and they've got videos on their site where they're doing eegs and they put you know a phone near their head and then they put the beanie on and put the phone near the head and the brain waves are different like it's it's pretty cool so I don't get any money from them they don't know me I've just been a a h you know a buyer myself but it's it's comfortable and nice uh it's not inexpensive but it's you know for people who are I don't have electr hypersensitivity syndrome but that's an actual diagnosis so for people who are you know this might be a way for you to be out in the world

Pamela:   you know do you find right now that you're seeing you know kids kids versus adults do you find that you're seeing more one than another or do you kind of start with one and then you work through the whole family eventually or how does that kind of work

Dr. John Bartemus: uh  it's um I mean it's more adult just because adults are making the healthcare choices but there's there's more and more kids as parents know that we work with kids you know it's like we'll get inquiries do you work with kids and it's like yeah you know absolutely don't wait till they're 20 or 30 um so so it's usually the mom's making the health care choices so if they find us and ask them yeah we work with them um the men are are dumb typically they don't want to come in until they physically can't work and then they want to be better yesterday you know so uh the women are more likely to to be on it and be making those choices so um my practice it's more adult than kids but I think only because you know the adults haven't thought about it

Pamela:   do you find that you're seeing um a certain type of diagnosis more than another lately or anything that's just

Dr. John Bartemus: I don't I mean I don't I don't no I don't think so I mean I guess maybe anxiety Panic you know heart rate Rhythm stuff which we could um conjecture about recent novel influences to that um so that might that might be

Pamela:   yeah it's um one of the things I you know my my my kids are older and so one of them is is anxious and so I keep trying to explain to him that it's possible to influence that more through other things besides medication but he doesn't seem to want to

Dr. John Bartemus: oh yeah on that one but um actually I I uh posted a testimonial video last week on a lady that was um she had depersonalization severe social anxiety so she couldn't leave the house and she was dependent on Adavan to sleep and just exist and so we started working together and she just had her six week followup and she's uh and it didn't even take six weeks she she emailed me after two weeks but but she's taken the kids on play dates out in the world again the depersonalization is gone and she hasn't had adavance since she started um care and so she's obviously a whole different person and you know she had seen multiple conventional doctors and tried all the ssris and all that and nothing helped her and and I had a conversation briefly on uh social media recently where said this this was framed by conventional medicine as mental illness and the problem with that and and today everything's mental illness which is you know unfortunate because most of it's not and so she was failed because they're looking at her through the wrong pair of glasses rather than looking at her individually and so her her deal was metabolic and there were multiple contributions but once we figure those out and address them again quickly she can have her life back and so anxiety um depression fatigue you know migraine all these are non-specific symptoms meaning just because I'm anxious doesn't mean it's here okay anxiety could be your sleep deprived anxiety could be blood sugar issues thyroid issues hormone issues gut issues you know you might be anxious because you have a board exam coming up which is normal anxiety maybe that's a signal of of your body trying to tell you study more you know like like um we can't just hear anxiety and go to Z we should say anxiety why what factors matter you know and then address those and then observe um does your anxiety reduce and he talked about genetics earlier there are people who are more anxious at Baseline due to their constitutional makeup which genetics contribute to and so again should they be on drugs their whole life no because drugs aren't going to change their their genetic physiologic level of anxiety right so if we had a Pam that's you know if my Baseline anxiety's here and Pam's is here she's more anxious than me but if that's her physiological level we're cool if Pam's level goes up here then our goal is to get it back to this and if we do that then hey this this is Pam right so then it's first know thyself and you have strategies to help you know literally rubber band snap yourself out of it if if you start going that way um you know you do a lot better than just being dependent on a on a medication that by definition is T

Pamela:   I feel like it's still fairly new and people are still trying to grasp that the physical body and the Brain you know really do work hand in hand but you know I feel like we're we're finally getting there is there anything else that I have not asked you about um you want to touch on um you have done and continue to do so much

Dr. John Bartemus: um I mean we could talk for a long time about stuff so I I would I would throw it back on you I mean you know your audience better than I do so what is a question you know they might have or what what's the what's the most common say ailment um that you're that you are corresponding with and then maybe I can give you some targeted stuff

Pamela:   I mean it's it's um autoimmune autism anxiety depression Ed

Dr. John Bartemus: it's okay so what would be what would be considered autoimmune right um at least the autism uh pandas that sort of thing so um you know again it's we want to be individualized and specific because those might I mean there's going to be a a neuro component because pandas for example is neuro autoimmune like you're targeting brain targets but again the blood sugar and the sleep and the the foods and all that and the g got all that play in so Panda's conventional treatment is here's some psychiatric meds for the behavior maybe you go to IVIG or plasmapheresis but they don't do they never run a stool test right so that that kid's gut could be a mess since birth never addressed and and if that's true their immune system was compromised since birth and now they don't handle strep the way it sibling did that wasn't as compromised and we're like why is Johnny so messed up and why aren't these drugs help them and it's like well no one's ever addressed a driver so you know the brain gut gut brain Loop if we just take a medication to kind of pinch this end of the clothes pin right of the brain end but we leave the gut open this drug might help for two weeks right and then the physiology is like and here we go again because we never pinched off this end so again that's why we have to understand the whole puzzle and say okay there's a time in place for meds and if we need them cool take them so that buys us time to win here but then if we win here can we phase these out and not need them and maybe use natural strategies to win here and stay that way

Pamela:   yeah that's why we never IVIG I mean I I looked into it obviously um but it didn't seem permanent it didn't seem to really get to the root of the problem um and I'm not saying it's it's not a valid treatment it's just I go that route

Dr. John Bartemus: um there's a time in place but I've seen many patients who did that first and it's expensive and invasive and you know not as successful as finding the cause and I'm biased obviously towards finding the cause but um you can have success doing that

Pamela:   um you can have success doing that yeah I agree I was very lucky to found a a doctor that was originally from Asia educated in in in the states um and said we have to fix his gut and uh I had no idea what that meant and you know she L led me down this deep dive on on certain probiotics and prebiotics and removing gluten and sugar and how to get this you know ship writed and um yeah it's it's super interesting um what what the be doing

Dr. John Bartemus: look at all the look at all the people that you've helped because of it

Pamela:   oh gosh yeah thank you yeah yeah

Dr. John Bartemus: so um you know maybe you could Point them to that vibrant presentation I did for the ones who like all the science stuff because I'll put that there's three patients in that presentation that I took through one was Ms one was pandas one was autism and so you can see kind of how I worked them up and their their trajectories of their cases but then in there science of like for the autism case here's why the gut matters you know if you're lacking this in the gut that's not providing anti-inflammatory stimulus for the brain so you're now more inflamed more Behavior Etc so um maybe that's useful for people some people to see and and then in my book each each chapter is a different autoimmune disease with a different case from my office uh pandas is chapter 4 um you know so I did Crohn's is chapter three as an example of a GI autoimmune pandas is chapter four for neuro and then chapter five is brain gut connecting the two uh and looking at concussion traumatic brain injury and things that way so um that can be found on Amazon paperback hard cover ebook audible any way you can consume it it's there um so and then my YouTube channel has over 1100 videos

Pamela:   That's awesome well thank you so much really appreciate your time today

Pamela:   yeah thank you for the opportunity

 

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