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>> Dr. Terry Simpson: Hey, welcome back to Fork U Fork University, where

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we make sense of the badness, bust a few myths and show

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you how food may not be medicine, but it is

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important. I am your chief medical

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explanationist and host, doctor Terry Simpson.

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Today we're going to tackle the topic that is both timely

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and critical. We're going to talk about why

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chiropractors and other functional medicine practitioners

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take stool samples and recommend rather

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restrictive diets for autoimmune disease like Hashimoto's

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thyroiditis, rheumatoid arthritis and

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others. Let's start with the simple truth.

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Autoimmune diseases are complex,

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chronic conditions that require careful

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management. Conditions like Hashimoto's

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thyroiditis, where the immune system attacks the thyroid

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gland leading to hypothyroidism, are

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not easily fixed by dietary changes

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or gut health gimmicks. Yet there are people

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out there, often without a medical degree,

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claiming they can diagnose and treat these

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serious conditions by analyzing your

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stool or putting you on a restrictive

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diet. Let me be clear, these

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folks are quacks.

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Now don't get me wrong. Diet does

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play a role in your health, and there's growing

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evidence that our gut microbiome is important to

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overall well being. But when it comes to autoimmune

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disease, the science is far more

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nuanced than what these so called experts would have

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you believe. Let's break it down.

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First, let's talk about the chiropractors and other

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alternative health practitioners who claim they

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can diagnose autoimmune diseases

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and their treatments by analyzing stool

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samples. The idea here is by looking at the

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bacteria in your gut, they can identify

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imbalances or what we call

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dysbiosis, which claims to be the root

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cause of your autoimmune disease.

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They will tell you by adjusting your gut bacteria,

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usually with expensive probiotics, supplements

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and restrictive diets, you can cure or

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manage your disease. Heres the problem.

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While its true that our gut microbiome influences

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many aspects of our health, the science

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of specific gut bacteria to

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autoimmune disease is in its

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infancy. We do not yet have a

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clear understanding of how to manipulate the gut

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microbiome and treat autoimmune

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diseases effectively. The studies

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that do exist are often preliminary,

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done with mice or rats, or based

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on small sample sizes of human beings,

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and to extrapolate that limited amount of

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data into broad claims that gut health

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can cure or significantly

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change autoimmune disease is just

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not only premature, it's

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irresponsible. I'll give you an example.

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A study published in Nature Reviews Immunology in

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2015, highlighted the complexity

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of gut immune interaction and noted

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that the gut microbiome likely plays a role

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in the development of autoimmune disease, but we are far

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from understanding how to target it for treatment.

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More recent research, such as that from the Journal of

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Autoimmunology in 2021

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supports that view, acknowledging that

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while gut dysbiosis is associated with

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autoimmune conditions, there is no one size fits

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all pattern, no one solution to fixing it

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through diets or gut probiotics.

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Furthermore, recent

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studies show that stool samples

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may not be helpful in termining the

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gut microbiome, especially in the context of

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determining autoimmune disease. A study by Lew

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et al found that fecal bacteria

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significantly different from the swab and tissue

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microbiota in patients with irritable bowel

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syndrome versus if we lavage the

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gut with like a colonoscopy so we can get

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truer to where anatomically

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the gut microbiome is. Let's be clear,

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the chiris factors will have you take a stool sample.

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However, the microbacteria which are in your

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gut that might be affecting it are going to be

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completely different if you go up further into the colon,

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as if you use a colonoscopy.

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Leviathan et al demonstrated stool samples

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are a poor proxy for what we call

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the inner colonic microbiome, or the bacteria of your

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gut. Their study showed that those samples that were

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taken very carefully significantly

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differ from those in a stool sample.

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It's just not the same

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thing. So in summary, stool samples may not be

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helpful for determining gut microbiome, as if gut

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microbiome could actually fix autoimmune

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diseases. So when someone takes

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your stool sample and say they can cure your

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hashimoto's or your lupus or your rheumatoid

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arthritis by tweaking your diet and selling you rather

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expensive stuff, theyre selling you

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snake oil. The truth is, managing

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autoimmune diseases requires a

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multifaceted approach and typically involves

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medications such as synthetic thyroid hormone. In the case of

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Hashimoto's and close monitoring by

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healthcare professionals, this is something that these

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people have no clinical idea about. They weren't

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trained clinically. Let's be clear, a

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chiropractor doesn't have the extensive

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clinical training that

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a physician does. Consider this. Your average medical

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student not only spends two years studying basic clinical

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medicine in a textbook, they then go on to the wards

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of hospitals where they see the most complex

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patients on the planet treated by the most

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well known physicians on the wards, then they

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go out and do a three year internal

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medicine internship in some of the brightest

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hospitals in the nation, taught by some of the best scientists.

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Then they go on to do a fellowship in rheumatology.

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Compare that to a chiropractor who has two years

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of neck cracking. Let's move on.

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Let's talk about the restrictive diets that are pushed by these

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practitioners. You've probably heard of the autoimmune protocol,

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or the AIP diet, which eliminates a wide

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range of foods, from grains and legumes to

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nightshades, dairy, eggs, nuts and seeds.

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The idea is that these foods could trigger some

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immune response, and by eliminating them, you can reduce

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inflammation and manage your autoimmune disease. Sounds

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promising, right? The problem is that the AIP

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diet is based on very, very weak

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science. While some people report

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feeling better on these diets, we have to ask,

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why? Is it limited by their eliminating

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food groups? Or is it simply

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that their disease comes and

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goes, relapses, returns,

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goes into remission, which is the nature of

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autoimmune disease. Let's look at a study published

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in nutrients in 2017. They looked at the

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AIP diet in the context of inflammatory bowel

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disease, another autoimmune disease, and found that while

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some patients experienced symptomatic

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relief, the study was small, lacked the control.

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Group, couldn't possibly say it was the AIP diethouse,

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etcetera. There are other

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diets that are used for this. Typically what they will do is, let's

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eliminate dairy. I can tell you, based on

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what we have seen and has been told to us, that

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their formula comes down to this. Besides selling you the

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really expensive supplements, the really expensive

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probiotics for which there is zero, and I

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mean zero evidence, they will tell you to

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eliminate dairy, eliminate gluten, and

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go on one of these highly restrictive diets, like, oh,

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the whole 30 diet or the AIP diet, and

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then they'll say, look, you're cured.

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Let's be very clear.

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When you have a relapsing disease like

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rheumatoid arthritis, you are going to

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have times when it's going to relapse for unknown reasons. It's not your

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gut microbiome. it will just does it over

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time. And if you have rheumatoid arthritis aren't

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getting appropriate clinical medicine,

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you will end up with more joint destruction and more

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problems. And let's put it this way, once the

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chiropractors have you out of their office, they're not going to

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be able to follow your inflammation. They're not going to be able to

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follow your joint destruction. They

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don't care. They just want to sell you

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their exceedingly expensive tests, which cost up to

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dollar 500 for a stool sample, and their supplements,

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which are like $90 a point at each.

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So what's the bottom line? When it comes to

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autoimmune diseases? Beware of anyone who promises a

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cure or significant management from

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diet and supplements alone. The science

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simply doesn't support these claims.

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Instead, focus on working with a

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qualified healthcare provider. If you have a

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rheumatologic disease, see a board certified

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rheumatologist. If you have a problem with your

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thyroid, see a board certified

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endocrinologist. Because these non qualified

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nurses, dentists and chiropractors who get their

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little functional medicine degree, which by the way, they focus

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on thyroid disease and they focus poorly on

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it, they simply don't lack the clinical

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experience, the comprehensive literature knowledge,

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and they end up keeping people from

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having support, the support you need

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for an exceedingly complex medical

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problem. Alright,

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managing autoimmune diseases is a

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marathon. It's not a sprint. It

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requires thoughtful, multifaceted

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approach, not a quick fix. Don't let

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those quacks steer you off courses with

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promises far too good to be

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true. I hope today's episode has shed a

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little light on the dangers of these so called miracle cures with

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miracle diets and the quackery. That

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sounds too good. This reminds me of one thing

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else. Do you remember when chiropractors

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used to say the cure of all their diseases is in

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sublaxations of the spine, which they could never

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see, could never demonstrate, and spent years telling you to come back

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every week? Now they're going to the gut. They can't

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see it. They have sort of a science y test, and they are trying to

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convince you they alone have the answer to the root cause

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of disease, as opposed to all of the

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people who seriously study this and follow their

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patients intently and publish in the

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literature, the only root cause of

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disease that these functional medicine practitioners have

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found is your wallet. I would be

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careful of them. See board certified people to make

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sure thanks for joining me on this episode of

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fork you where we try to make sense of the madness.

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I'm your host, doctor Terry Simpson. This has been written and

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researched by me and you can find references for

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this to for those of you who like it on the blog

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associated with this, which is called

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yourdoctorsorders.com or four

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q.com dot. I want to thank the people who are

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distributing this, our friends at Simpler media, the pod God, Mister

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Evotera. And of course, I couldn't

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produce this without my favorite producer in the world,

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from producer girl Productions. Thanks for listening. We'll

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see you later.

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Hey, Ivo, did you ever find some sort of

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thing that we could use to, cure everything in that herb garden of

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yours?

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>> Emily: Ivo is on vacation in Portugal. Terry, this is

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Emily filling in for him on the podcasting front, but he

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didn't mention anything about watering his plants.