SIBO Made Simple | EP 21 | East vs. West: Using Acupuncture, Gua Sha and Other Tenets of Chinese Medicine to Treat Thyroid and Gut Issues with Dr. Heidi Lovie

By | July 10, 2019


A lot of integrative medicine these days blends practices from Western science and ancient cultures. But rarely do we get to fully understand the principles of the Eastern approach and how we can apply them to our healing journey.

In today’s episode, I have one of my personal practitioners, Dr. Heidi Lovie, discussing the tenets of Chinese Medicine, including modalities like acupuncture, herbs, moxabustion and gua sha, and what they teach us about thyroid and gut disorders. Heidi is a member of the HashiPosse herself, so we go deep on how acupuncture, manual therapy and dietary changes can make up the secret sauce for Hashimoto’s healing.

If you’ve be wanting to try acupuncture, or are curious why it works so well for chronic conditions like Hashimoto’s and SIBO, this episode includes so much wisdom.

A quick taste of what we’ll cover:

  • How Chinese Medicine teaches us to live in harmony with nature and what this means in our modern world
  • What changes our bodies have undergone between 2019 BC and 2019 today
  • Why gua sha and manual work is so essential for thyroid therapy – all you need is a ceramic soup spoon!
  • The best diet for Hashimoto’s and why keto + a low carb approach isn’t the best fit
  • SIBO, parasites, and opportunistic viruses – the category they all fit into and how to treat them
  • When to use herbs and when to use acupuncture to treat a gut issue
  • How to detox properly according to Chinese Medicine and what the seasons mean for our diet
  • And so much more…

Resources, mentions and notes:

This episode is brought to you by my new e-book program, The Low FODMAP Summer Reset, a 4-week elimination diet meal plan with mouthwatering SIBO-friendly recipes using the best of the season’s produce. All the dishes are not only free of high FODMAP foods, but also gluten, dairy, soy, corn and refined sugar. This will help not only quiet symptoms of bloating and IBS, but identify the food triggers that might be lighting up your immune system and creating a cycle of inflammation in the gut. Plus, there’s a step by step guide for reintroducing these ingredients one at a time so you can design your best path forward. As a member of the SIBO Made Simple listener family, you can take $20 off by using the code SIBO20 at checkout. Just click here to learn more.  


WHAT IS CHINESE MEDICINE?


PHOEBE: Heidi Lovie, since you’re one of my favorite people in the world in addition to being a very smart and talented practitioner, I would love to start by hearing a little bit of your health story. You’re a member of the Hashi posse. All five die-hard fans of the wellness project book may remember you as acu Heidi and probably are just dying to hear more about who you are and where you came from and how you became an acupuncturist and such.

HEIDI: Phoebe, you’re the best. Thanks. I was thinking about this over the past couple of days preparing for this discussion. One of the questions that I always ask patients when they come in, and you may remember this, is when did you feel your healthiest? It gives us a baseline and it gives us something to aim for. If they’re coming to me, they’re not feeling good. It’s kind of like what do you remember in your system when you felt amazing? When I ask that question of myself, it’s an incredibly hard one to answer.

PHOEBE: I was going to say, I can’t remember what I answered for you, but it was a really long time ago. I’m not sure I can quite remember myself.

HEIDI: A lot of us with Hashi, they call it the catalyst event. That’s a time or something where it happened and it’s like I’ve never felt the same since X, Y, Z. That could be I’ve never felt the same since I had food poisoning in 2011 or I’ve never felt the same since my divorce or I’ve never felt the same since … fill in the blank. With most autoimmune, there’s a trigger that sets it off, but there’s a backlog of things behind that. It could be I’ve never felt the same since I had that sushi explosion that happened Christmas of 2017, whatever it is.

Before that a lot of people will probably notice that they weren’t feeling so well. A lot of the symptoms were things that could just be easily written off. I’m getting a little bit older. My joints hurt because I’m the ripe old age of 28, whatever these things are that we tell ourselves is. When I asked that of myself, I’ve never felt healthy. That’s not something I’m sure a lot of people expect to hear from their healthcare practitioner.

When I made my cameo on planet earth in the middle of a Minnesota snowstorm, my family still talks about my legendary colic. Then as I got older, the health problems didn’t clear up. Anything weird that would come into the neighborhood, be it pityriasis rosea, be it Lyme’s disease, I got it as a kid. All through high school I was sick. Then when I went to go get my college physical when I was 18, I can’t really tell you much about that appointment. I don’t remember the appointment, but I do remember the panicked phone calls from the GP.

I’m 18. I’m a kid, but technically old enough to be an adult. The college GP called, and all I remember from that conversation – this is 1995. The doctor called and all I remember is Synthroid. I remember thyroid disease, and I remember lifelong medication. Those were the three takeaways I had from that conversation.

Being 18, we came from a lower middle class family. I started working at 14, 15. I was already working, going to high school. I was on the ski team. For a lot of Hashi’s people, this is going to sound familiar. There’s a psychological profile that shows up that I call plate spinners that we seem to do everything in the world, and we do it in spades, and we do it well, often at a consequence of our own health. I was already doing this kind of behavior as a teenager.

You’re 18, and I had no idea what that was. It was one more thing to forget about because I already felt like shit most of the time. I wasn’t connecting that to thyroid. When I’ve gone back in retrospect and looked at my pediatric records, I probably had thyroid disease since 12 or 13. I’m now 42, so I’ve been dealing with it for a good 30 years, a good portion of that undiagnosed. I wasn’t formally diagnosed until I was 26.

PHOEBE: What does that mean, formally diagnosed? Do you mean that you got an ultrasound?

HEIDI: Yup. What happened was I had lived in Japan in this interim. That was when I first had acupuncture. I just had acupuncture on a fluke because a friend of mine was going, and I was like it’s a bigger part of this Japanese experience. It’s just weird voodoo. I have no idea what this is.

The acupuncturist I really liked. He was this tiny guy that you could put in your pocket. He was the cutest, most humble, to this day the most gentle soul I feel like I’ve ever come across. There are some of us that we would take the last appointments of the day and the practice was in the front part of his house. We would just go have dinner with him and hang out until midnight and do whatever.

I was really going more because I liked this guy. I like his wife. I liked the social scene. Acupuncture was a side piece to that. All of a sudden my cramps went away. At this point I had gained an additional 50 pounds from what I was in high school. My weight started to stabilize. My mood started to stabilize.

My whole health profile completely changed. If I have to think about my healthiest, it was when I was regularly getting acupuncture and living on the healthier side in Japan. I moved back to New York afterwards, and my health just crashed. It went back to when I was in high school and it was just awful. I was telling a colleague about it, and she goes this sounds familiar. Go see my endocrinologist.

I go to see the endocrinologist, and I walk in and the guy just does a sonogram on my throat. He goes, “That’s classic [00:06:30]. You have Hashimoto’s.” I started crying. I started balling. He was like, “Oh, my God. Why are you crying?” I finally have a name to this. I finally have a name.

When I was first diagnosed, this was pre-internet. There was no Doctor Google or WebMD or anything like that. You just kind of had to lean into people if you could find them that had the experience. I was diagnosed in 2004, 2005, something like that. I got on Synthroid. Then with all of this you would think I started feeling better. I started feeling worse.

They put me on Cytomel. I’m sure this is going to sound really familiar to a lot of people. They put me on Synthroid and they put me on Cytomel. They were just like your blood work is fine. I’m like great. Why am I 210 pounds and I’m eating 1,200 calories a day and I’m going to booty boot camp class and I’m not losing weight? I can’t get up in the morning, and my hair is falling out.

They said, “Go see a nutritionist.” I go see a nutritionist. I give the guy my food journal for the week, and the dude literally flips it back at me and said, “If this is how you’re actually eating, I have nothing to teach you.” I was like, “Yes, you have nothing to teach me. Screw you.” I walked out.

It took a couple years to get my ducks in a row, but I went back to an acupuncturist, and all of the sudden my health profile started changing again. I couldn’t explain it. I didn’t understand why. I just knew that I felt better when I did it. I decided to go to Chinese medicine school, thinking it was going to be all unicorns and intuition. I really didn’t know what I was getting into.

I was like I’ll take classes here and there. It’s actually a four-year full-time degree where you go through 4,500 hours of both Eastern and Western medical training. I wound up doing rotations at St. Vincent’s HIV Center. I was at St. Vincent’s Cancer Care Center. I did the VA Manhattan Veteran’s Affairs Hospital. I went right into private practice after that thinking I was going to be the HIV queen of New York.

I loved treating HIV. I loved treating the LGBTQIA community. I loved being an ally, but you treat what you know. What started coming in was a lot of Hashi’s patients. Since then I can’t even tell you how many Hashi’s patients have been on my table; a couple thousand easily. You sit with that many of us and start hearing the same stories over and over again.

My story is really not that unique. It’s part of a bigger conversation. I do consider thyroid disease to be a feminist issue 100% because 8 times more women than men suffer with it. It’s not just that men don’t have Hashi’s, but I can count on two hands the number of male patients with Hashi’s that have come to the table. The treatment strategy from a Western standpoint has not changed in over 50 years. The treatment strategy is mostly just hormone replacement therapy, meaning your body is attacking your thyroid. Your thyroid is not producing hormones. Therefore, we’re just going to replace it with either something synthetic or more natural cousins like Armour or [00:09:57]or something.

That doesn’t actually resolve the issue. Through my work in Chinese medicine, I’m working with a lot of functional medicine practitioners. I’m convinced it’s an antibody game. You start to get the antibodies down, you start to bring the attack down. I’m also convinced that it’s a scar tissue issue.

Those of us who our thyroids have been under attack for that long, the thyroid gland itself starts to swell, starts to adhere to tissue next to it. She just can’t breathe. When I work with patients, there’s a lot of manual work. There’s a lot of soft tissue work we do. Diet is the number one thing, and I have gotten into pissing matches with MDs over this. Diet is the number one thing. That’s one of the things that I pulled from Chinese medicine.

PHOEBE: I actually thought you were in Japan studying medicine when you were there. I didn’t realize that was earlier on in your story. I would love to know the Chinese medicine side of your training. I think it’s now a buzzword that comes up a lot in the “wellness space.” I don’t think a lot of people really understand it, myself included, being a patient of yours of Chinese medicine for many years. I don’t know that I really understand what makes it different from other ancient healing and other cultures and what the classic central tenants of it is.

HEIDI: That’s a beautiful question. My time in Japan, I was just teaching English, drinking a lot, just generally causing mayhem.

PHOEBE: Important life skills that led you to where you are today.

HEIDI: Thank God. We all need that experience. I actually had an opportunity to go back and study in Japan, but I decided to do my studies here in New York for a couple reasons. One, at the time we had St. Vincent’s. This is before integrative medicine was this huge buzzword. The college was able to get us into rotations next to MDs and Western practitioners.

I really wanted that experience because I think that’s where we shine. I think when we’re in crisis, we need a team onboard to help us with things. That was one reason. Another reason was that the program I chose was a California-based program, and in California we’re licensed as general practitioners. We’re GPs. The training was very different. It was a very higher caliber of training than I would have gotten abroad. That’s one reason I chose to stay in the US to do that.

I was at this integrative medical conference about a year ago. I sat through three days of lectures. There were mostly MDs, but some nurse practitioners and other people speaking. Every single person referenced acupuncture, but they didn’t have a Chinese medical person who came up to speak for the medicine itself. I wound up talking with the organizers of the conference afterwards. I was like this hurts because I think there’s so much cultural appropriation around it and myths around it. There’s a little bit of racism tinged with it as well.

Even the word Oriental medicine is not good these days. The tenants of the medicine, we can go back about 4,000 years for sure. There’s talks that it goes back 10,000 years, but that has yet to be verified by medical anthropologists. The beauty of the medicine is we have this long tradition of historical writings and case studies that go back. Our tenant book is called The Yellow Emperor’s Classic, the Huangdi Neijing.

The book is actually a conversation between a student and the teacher. The teacher’s name is Qibo, and the student’s name is Huangdi. Huangdi starts off the conversation by saying, “Oh, teacher, teacher, teacher, why is it in the olden days people lived to be 100 and they were so much healthier?” Even 4,000 years ago they’re like why is it that a couple generations ago we were doing better? Qibo, the teacher, answers, “Because the sages of yore were able to live in concert and harmoniously with nature.” The rest of the book is a conversation how to do that.

There’s addendum books that have been written over time to be like when you don’t live in accordance with nature, when you don’t rise and set with the sun, when you don’t eat seasonally, all these things that we’re talking about now, this was codified in the Huangdi Neijing. It talks about where the breakdown in the system happened and what the intervention to that is. When I introduce myself, I very rarely introduce myself as an acupuncturist because that’s not really what we do. As a Chinese medicine practitioner, we actually have eight pillars to the medicine, five that we talk about and three that we don’t talk about because we sound fucking crazy when we talk about the other three.

These are all interventions that we can do with people. The five main ones are acupuncture. I think that would be one of the number one things. Because it’s so weird, that’s the one that gets the most attention out of everything we do. It’s the one that’s the least understood as well.

PHOEBE: Acupuncture is Chinese medicine. It originated there as a concept and practice.

HEIDI: It’s a branch of Chinese medicine. We have acupuncture. Out of these five pillars, acupuncture is number one. What falls under that, 1A, 1B, 1C are things like cupping, moxa, gua sha, all these other weird things that we do with our hands, the modality of it. Acupuncture is number one.

Number two would be dietary intervention. We know how or when to intervene in the diet, so it’s right diet, right person. I love the keto thing. It’s right diet, right person. You’ll find that even though keto is the big new thing, I know plenty of people that have had tons of issues resolved on keto. I find very few Hashimoto’s patients can tolerate it just because the way our bodies need carbs a little bit differently.

We do acupuncture. We do diet. We do herbal therapy. That’s basically prescription intervention. We do something called tuina, which is medical massage. We’re doing hands on work in addition to the acupuncture. That’s hands on work in addition to the acupuncture. That’s our hands and not using other tools.

Then the fifth branch would be movement. I do a very specific type of yoga. I do Kundalini yoga because it’s basically Indian qigong. A lot of practitioners will do qigong. They’ll do tai chi. They do these things. Again, these are different levels of intervention that we are able to offer to people.

The three that we don’t talk about, the secret ones are meditation, feng shui, and astrology. It’s how you move in meditation. It’s how you move internally. Feng shui is how you move locally. Astrology is how you move globally.

Those are ones that I like to refer out. I know where I’m strong. My feng shui, I’m good enough to be dangerous, but I’m no master any stretch of the imagination. A lot of people will say I’m an acupuncturist, but that’s really a misnomer because we’re doing all kinds of other things.


HOW TO FIND AN ACUPUNCTURIST WITH PROPER CREDENTIALS


PHOEB E: Do you think that today in America most acupuncturists are just trained in acupuncture and not Chinese medicine? What should someone look for in terms of letters or title that they say when looking for a practitioner who actually understands Chinese medicine and was trained the way that you are as a general practitioner?

HEIDI: Me as a licensed practitioner, the California based school, I had 4,500 hours of training. Up until recently we were one of the few healthcare degrees that had that many hours without having a doctorate title. The field is now changing a little bit. I went on to get my doctorate. I’m a DACM, so that’s a doctor of Asian and Chinese medicine. I just did a little bit of extra training to upgrade the title with that.

What you need to look for is the letters at the end of anyone’s name. You have to see LAC. That stands for licensed acupuncturist. That’s somebody that did go to school. They trained in Chinese medicine. They have the license. We’re the only license to move qi. We have a very unique license to us.

You want someone who’s licensed. You’ll see sometimes a certified acupuncturist. What a certified acupuncturist is, that’s an MD who did 200 hours of additional training. You can already see 200 hours versus 4,500 hours is something completely different.

The other thing that we’re seeing in the field, and there has been a lot of fights over this, is something called dry needling. There’s a lot of chiropractors and PTs that are not trained in acupuncture. If I were to offer as an acupuncturist, a licensed healthcare practitioner, as a non chiropractor adjustments to people, I would lose my license. However, the chiropractors and the PTs have taken on this “dry needling.” Wet needling would be hypodermic where it draws blood. The name dry needling comes from the type of needles that they’re using, which are just acupuncture needles. They’re going in with one-eighth the amount of training and trying to do muscle releases on people.

We’re seeing really egregious and harmful treatments. I’ve seen everything from pneumothorax, which is a collapsed lung. We’ve seen infections. We’ve seen all kinds of things coming from this practice. You know this. I’ve said this before. If a PT or a chiropractor wants to do it, run like hell. I refer out. You know this.

When in doubt, refer out. I refer out all the time. I have no problem referring to a chiropractor or a PT or a functional medicine doctor or a parasitologist. I have no problem with that, but the acupuncture is something that other professions have started to pick up without the training with deleterious effects that just aren’t good.

PHOEBE: I’m so glad you gave us a good primer on what actually to look for. Do you want to use that as a segue? First of all, I want to understand why acupuncture allowed you to feel the best that you’ve felt and how it can potentially allow our listeners to feel the best that they’ve ever felt. I also know that you do work in conjunction with body workers sometimes. There is something to that if you have the license to do the acupuncture segment of it. Just take us from the beginning about the power of acupuncture and how it works in improving movement in the body alongside someone who does more traditional manual work.


HOW DOES ACUPUNCTURE WORK FOR HASHIMOTOS AND THYROID ISSUES


HEIDI: We don’t know why the hell it works. Let’s be very clear about that. Unfortunately, acupuncture doesn’t lend itself very well to the Western scientific method. Another fun cocktail party argument I get into with MDs, they’re like how does it work? I’m like explain anesthesia. That usually shuts them up pretty quick because we can’t explain anesthesia.

There are certain things we just don’t know why they work, but they work. Acupuncture does fall into the category of what we say is EIP, so evidence informed practice. A lot of times when people hear EIP or they hear evidence informed practice, that’s the kind of thing that you find in PubMed or things that are well researched. Another category of EIP is clinical experience. Because in this grand tradition of Chinese medicine they’ve had written tones of this in case studies in teachings going back thousands of years, we actually do fall into EIP.

The kind of bodies that we’re inhabiting in 2019 versus the type of bodies we were inhabiting in 2019 B.C. are a little bit different. They weren’t being exposed to the same environmental damage that we’re getting exposed to. If somebody can please for the love of God give me a different word for needles, I will take it. What we use in acupuncture is not what most people think. It’s hair thin. It’s filiform. It’s super fine.

The tools that we use specifically for acupuncture are very different than what they were using even 50 years ago. When we look at the historical antique texts around this, we don’t actually have any examples of what they were using once upon a time. We do have pictures and drawings of them. They looked more like scalpels. They were doing a lot of bloodletting. They had the nine needles.

You look at these pictures of these “nine needles,” and I wouldn’t let anyone near me with one of those things. It was absolutely a completely different game. The way that we’re practicing acupuncture today is drawn from the classical texts, but the technology around the instruments that we’re using is very different. How I think it works, and we’re still breaking some of this down, is when you insert one of these needles into a specific place in the body, one of the better descriptions I’ve heard of this is when you turn off the light, you don’t unscrew the light bulb. You flip the switch.

We happen to know that if I needle you at the top of the foot versus at the top of the leg versus in your shoulder versus at your belly button that your body is going to react in a very different way at each of these places. We’ve been able to figure this out with time in this evidence informed practice. How I think it works is we go in and create a [00:25:20]. We’re creating an injury to the system. Both your immune system and your endocrine system are going to respond in a very specific way to go defend itself.

That’s why we do really well with endocrine disorders. That’s why we do really well with women’s health because our ovarian, pituitary, gonad access is all hormonal. It’s all hormonal in how we cycle through that. I kind of think of it like defragging a computer. It’s defragging the system and it just allows the system to run a little bit more efficiently.

At the same time we do really well with certain musculoskeletal stuff. I think it has to do with how the needles are interacting with the fascia layer. If people don’t know what fascia is, if you’ve ever cooked a chicken and you peel the skin back and there’s that weird clear, thin layer around the actual meat to itself, that’s fascia. Fascia is this thin membranous tissue that comes in really long sheets in the body. It wraps the muscles and allows the muscles to rub up against each other without getting caught. We are still understanding it.

When they’ve done these studies by sticking a needle into the muscle area passing through the fascia, the fascia starts to wrap itself around the needle and it looks like a little tornado. It expands out and the entire collagen structure shifts. There’s something happening at that level that we haven’t fully grasped yet. I like referring out to body workers all the time.

One of my favorite referrals is to a very specific chiropractor who does soft tissue manipulation. I’ll allow him to adjust my thyroid. I’ll allow him to adjust the glandular tissue. Like I said, in autoimmune in a case like this with Hashi’s in particular, when the body is attacking the thyroid like that and the thyroid is taking a hit, it’s going to change the cellular structure from the inflammation. The thyroid is going to start to get sticky and it’s not going to move as much.

One of the things I do now today besides private practice is I teach over at Pacific College of Oriental Medicine, and I teach the women’s gynecology class. I’m a supervisor in the clinic. It’s kind of cool because I get to really interact with the students, and I get to see the studies. The students are always so excited about this stuff. One of my Korean students approached me with a study that had come out of Korea where they were looking at antibody levels, specifically TPO levels, in concert with gua sha. The chiropractors do something like gua sha called Graston where they’re actually scraping tissue and scraping out the fascia layer.

The study that came out of Korea showed that antibody levels dropped when the subjects scraped the back of their necks on a daily basis with gua sha. I read the study, and the study was absolute complete garbage. It was a really poorly done study. That’s why you have to read these studies. It was a really poorly done study, but it was fascinating because we have a teaching in Chinese medicine that says the wise or the sage acupuncturist uses the left to treat the right, the top to treat the bottom, the front to treat the back, the yin to treat the yang. The fact that they were scraping the back of somebody’s neck and it was affecting the front of the thyroid I thought was fascinating.

Of course, I have to go do this on myself. I’m doing gua sha every night before I go to bed on the back of my neck and getting this chiropractor that I refer to to actually work on the soft tissue in my thyroid. I go and get my thyroid checked, and my antibodies halved. I was like there’s something to this. The study might be garbage, but clinically this is pretty cool. Then of course, you adjust practice.

One of the things that I do with almost all thyroid patients is I work on their necks; not aggressively. You’ve seen me. I’ve never totally torn you up. I really do go in and teach them to gua sha. I make sure that their neck is articulating. It’s very rare that I’ve met a Hashi patient that doesn’t have neck pain.

It’s one of the first things that we address, even if it is a third or fourth complaint. It’s not their main complaint. It’s one that I go after because I have seen it working with patients over and over again. It’s something that I’ve seen shift antibody numbers. I think it’s just because we’re giving the thyroid space to breathe. When she can breathe, she can start to defend herself against the attack, and it will calm the immune system down. Again, Chinese medicine, immune system was not a word that they were using, and so we have to be very careful in the language, the vernacular around this, that we’re not making one-to-one correlations. I think that’s a danger we see in the field with a lot of practitioners. They’ll say Hashimoto’s is kidney [yong] deficiency Maybe; maybe not. There’s so much bio-individuality that you really have to sit down with the person because we’ve talked about this extensively, that your presentation, experience of Hashi’s, is so incredibly different than mine. How we went through the world and how our body reacts to it, and it’s so incredibly different than the next person and the next person and the next person and the next person.

I think that’s why when people get on Dr. Google and they start going into these chat rooms and they start reading these different books, they’re just like – they get even more confused. Then it’s like oh, my God, am I supposed to do A? Am I supposed to do B? Am I supposed to do C? I don’t know what I’m supposed to do. This is crazy. It’s just because the one thing we all have in common is antibodies, but then the experience of the antibodies is so unique that I really do think you need to sit down with someone who’s been through the weeds, and you have to advocate for yourself. You have to advocate, and part of that is patient education, which is so incredibly important.

PHOEBE:  Totally. Well, we have a lot of listeners who have reached the point of confusion and overwhelm for sure. I get tons of messages myself just email and Instagram that I’m not at all qualified to answer. To these people, I’m always saying you have to find your team. That’s, of course, easier said than done, but I like that you brought up Quasha, because we’re seeing it a lot now, I feel like, in the [0:31:49]around green beauty and draining the lymphatic system, de-puffing your face, but it’s actually just a really easy, accessible technique, as you said, for just working out some of that tension in the neck without needing a body worker to go in there for you. Is there any kind of danger or things to look out for? What is the basic technique there?

LOVE:  Well, one thing you can get on Amazon or you can get on any of these websites. They’re just jade, crystal quartz, blah, blah, blah. What I use in the office, I use one of two things. I either use baby food lid jars, which are about, what – or the jar and lid, the actual aluminum lid. We use those in the college because they’re disposable, but what I use in the office, I just use a soup spoon, the miso soup spoon, the ceramic one. I think I paid like a buck-fifty for it at Pearl River. You do – at one point, you and I do a little YouTube video on how to do it so people can see because there’s – if you’re being pretty superficial with it and you’re not pressing super hard, there’s little to no consequence. You’re not going to do a lot of damage there. The neck, it’s a very sensitive area. You have your carotid. You have your jugular. You have your trachea. There’s a lot of anatomy packed into a little space, so I think people can sometimes get intimidated by that. If you’re staying pretty superficial and you’re not pushing into anything uncomfortably, then you’re fine. It’s not about doing it once or twice and you’re set. It’s more about this is part of your winding down routine at night. You wash your face. You get your nice, greasy night cream on there. I’m of a certain vintage now; I get a little dry, so I need some extra oil on my face. That just goes down into my neck, and you really gently scrape it down. Yeah, I think that would be fun to do, just a little primer at some point.

PHOEBE:  Oh, we’re going to do it. Everyone, look in the show notes. There’ll be a link there to this video, which will exist by the time this podcast is published. Get excited. To switch gears for a second to the subject at hand, obviously there’s a lot of connection between the endocrine system and the gut, but people are here for the gut. Which of these one A through D – I can’t remember how many listed – of the Chinese medicine sub-acupuncture modalities work best for the gut and how do they work. I know you mentioned Moxa. Then of course, there’s actual acupuncture Tell us a little bit more about your strategies there.


ACUPUNCTURE FOR SIBO AND GUT ISSUES


LOVIE:  So again, like I said, we have this book, “The [0:34:48],” this Yellow Empress classic. It goes back however far it goes back. Since then through the years, there have been scholars, mostly in China throughout the centuries who have added to that base of knowledge. A lot of us practice different schools of either herbology or we practice the principles of acupuncture You might’ve heard about Five Element acupuncture, TCM, which is traditional Chinese medicine. There’s little asterisk to that; it’s a trademark to the Communist party in the ’50s. There’s the [Hoshempi], which is the fire school. With my thinking and where I’ve really fallen in treatment strategies over the last decade is I come from a school of thought called the Pe Wei Lun, which is a classic Chinese book that came from Lee Dong Wang, who was a Chinese physician that passed away in 1251. The theory has been around for a while.

Lee Dong Wang’s theory and the Pe Wei Lun was you treat the earth first. You always treat the earth first, which means you treat the spleen/stomach. Any sort of patient – his theory was that anybody who walks in, regardless of the chief complaint, if the stomach and spleen – what they meant by spleen was really most likely the pancreas but it refers to the digestive system, so if the stomach and spleen were off, it didn’t matter what else you did, that nothing else was going to work. All his treatment strategies came back to the gut over and over and over again. That’s why I’ve been harping for a number of years, and we’ve seen it proven out, so yay, me for thinking this, self-high five, that the next research is going to be on gut biome and  gut health. We’re now seeing that.

When people come in and we sit down, they could have a myriad of complaints. It just feels like a constellation I think that’s one of the things with Hashi or SIBO. You can be all over the board with this stuff, but me as a Chinese medicine practitioner, I’m looking for patterns and I’m looking for patterns that’ve been established even in the 1100s. First thing we do is we look at gut health and gut integrity. You know two of my favorite things to talk about all day every day is poop and periods. I can talk about poop anywhere, any time, no problem whatsoever. First thing we do is we talk about gut health. If you want a fun little google, just google gut and brain or gut and Hashi’s, and we see it over, and over, and over again.

First thing we do is we look at are – your poop, is it meatballs? Does it break the bowl? Is it the 50-wipe shit? Is it the color of a brown paper bag, lighter or darker? We go through all of that. Do you see undigested food? I have to say usually the first at least two months in working with people, first thing we do is we shift the diet. Now, you can be a little crazy about diet, and I tend to think we are in a culture of disordered eating that goes beyond the traditional anorexia,  bulimia, that kind of thing. My only nonnegotiable with Hashi’s, the only nonnegotiable I ever have is gluten. That’s it, and I hate to break people’s hearts with that. Listen, gluten is delicious. It’s glorious thing. There’s a reason why they called it the Fertile Crescent. It’s a fantastic protein. Gluten, in and of itself, is not evil. In fact, gluten is really pretty magic. There’s nothing wrong with it. It’s just if you have Hashi’s, the way that Hashi’s reads gluten is it reads is similar to the way it reads thyroid. When we eat gluten, it increases our antibodies.

Whether it’s SIBO or gut, whatever, the first thing you have to do is reduce insult, is what I call it. Whatever kind of infection you have there, you have to stop feeding the infection. If you have some sort of antibody issue, you have to stop feeding the antibodies. Then after that, it’s right diet, right person. The reason I like functional medicine – I just brought this up a little while ago – is I like the way that functional medicine tests. I don’t necessary like the way that it treats. I tend to think that there’s a lot of over-supplementation when you start getting into IV drips three times a week or whatever. It’s just like, you’re not on chemo! This isn’t dialysis The body – when the body has the right resources, it can hit homeostasis.

Now, sometimes we need a little extra help with those resources, and I think some genetic testing we have now available to us, like MTHFR testing and other things, can help us decide if maybe supplements are the right intervention. A lot of times, I think herbs are the right intervention, or maybe a little bit of both. You always start with the gut.

The other thing that I do is I send people out for parasite testing daily because in – we tend to think of ourselves as, as controversial as this statement is, like a first world nation. In the US, who gets parasites? How does this happen? Not everybody has worms. I think that’s – people think pinworms or whatever. Parasites includes certain amoebas other – like gerea, stuff like that. There is a thought in Chinese medicine. We call it Gu syndrome, and you can Google this, G-U syndrome. Gu syndrome is parasites, but how the Chinese are defining it – and it’s not something that shows up in modern texts. It was actually Heiner Fruhauf who is my mentor’s mentor, and he’s doing a lot of translations of these Chinese texts, bringing them into English, into the forefront, but Gu syndrome – Gu refers to anything that’s smart. SIBO, candida, any of these guys, they’re smart – Lyme disease, syphilis, things that are bacteria that are spirochetes are smart. They know how to hide form the antibiotics.

I consider herpes smart. Herpes is a totally smart little critter. It hides out in the dorsal ganglia root. It hides out in the nervous system. HIV falls into this. That’s why HIV has been such a tough nut to crack. It falls into Gu syndrome. It’s something that goes into a host that it’s really hard to get it out. It’s like mixing milk into coffee. Once it’s there, it’s there.

PHOEBE: There’s a precedent for all of these things in Chinese medicine. They’re just lumped into this category of Gu.

LOVIE: They’re lumped into the category of Gu, so we have to then figure out as a Chinese medicine practitioner how do you get the milk out of the coffee It’s a pretty hard task. It’s a pretty big task, and I think that’s why SIBO falls into this category of Gu. A lot of people that’ve had SIBO really struggle with it and seems to keep coming back or they can’t quite clear it. I think where – so how, from a Chinese medicine perspective, how we try and treat SIBO is we try and reduce insult. We try and start to heal the actual gut lining, and then we prime the immune system. We try and get your immune system to fight it if it’s able to.

PHOEBE: How does that work with needles versus herbs, or is it a multi-pronged approach that you use?


CHINESE HERBS FOR SIBO 


LOVIE: It’s almost always a multi-pronged approach. When we’re diagnosing and we’re looking at someone, whether we’re doing it tongue or pulse, we’ll do these incredibly long intakes. Patients that come in know the first time that we hang out, I’m with them at least an hour just talking and trying to troubleshoot. Every single one of us has a different experience of being human, so me as a practitioner, I kind of got to get into their experience of being human. I don’t live in the patient’s body. I’m not the expert on them. They’re the expert on them. You as the only one, I hope, inhabiting your system, you have to get in there and know what’s right for you and what’s not right for you. Me as a practitioner, I’m looking at someone saying do they have too much of something of them, or do they have too little of something in them. We say is it excess or deficiency? If it’s excess, acupuncture works great for that. If there’s a deficiency, that’s more diet, herbs, and supplements, if we have to.

Sometimes patients come to me and they’re like well, my last acupuncturist, I needed to see once a week every week. I’ll be like cool, I don’t need to see you for six weeks. I just need you to go do your homework, upgrade the diet where we talked about the doable upgrades. Get on your supplements, and then come back and see me and we’ll have a conversation. I think any time that we put something in our mouth, any time we take a supplement, any time that we take a medication, we have to ask yourself one of two things. Is this objectively making me feel better? Is it qualitatively improving my life, or is it qualitatively shifting the blood numbers? Sometimes we’ll show up with vitamin D deficiency. We’ll take a vitamin D and it’s like nah, I don’t feel too different. The next time you run your blood, you’re like oh, I went from a vitamin D blood serum of like 8 to 80. That’s a significant change.

If you’re taking supplements and you’re given this huge regimen but you’re not feeling better on the regimen, you have to question that regimen You have to question it. Whether you’re taking even B vitamins – people are like oh, I take my Bs because it’s good for me. It’s like great, but do you notice if there’s a shift in the blood numbers where you’re follette or your B-12 is showing up in the blood work differently, or do you notice that you have a little bit more energy, you have a little bit clearer thinking, and if that’s not the case, you might not be taking the right B vitamin. Oh, I’m taking this herb because I read in Timemagazine it’s good. I’m like, maybe not.

A lot of times, people are like, oh, well, it’s natural. I’m like yeah, so is arsenic and plutonium. Those are not things that we want to be ingesting on any sort of basis whatsoever. These are things where whether it’s a gut issue or it’s an autoimmune issue or any sort of basic health issue and we’re taking corrective measures, if they’re not correcting, it’s not the right measure. That’s another reason I do like to see people regularly, because I like to see how they’re reacting to the treatments. I like to see how they’re reacting to the herbs or the diet shift or the [45:48]or the manual therapy or the referral or whatever it is. I do have a responsibility to my patient to move the needle forward, and that means that I have to be checking in with them.

PHOEBE: Yeah, I’m glad that you mention the fact that herbs are incredibly powerful because I do see people going just willy-nilly with some of these herbal protocols for SIBO without even getting at test, per se. I know that you like the metagenics combo of herbs. Are there any Chinese-specific herbal protocols or combinations that work particularly well for SIBO or other types of Gu syndromes?

LOVIE: So I do like the candibactin. What is that, candibactin AR and BR, do the combo, but one reason I liked that combo is it’s been studied. The studies around that show that that has a significant impact. They studied it in relationship to antibiotics and medication. I tend to like stuff coming back to this guy Heiner Fruhauf, H-E-I-N-E-R F-R-U-H-A-U-F, so Heiner started a company. He’s actually based in the northwest. He’s based out of the Portland area. He started a – he helped found a school out there. This guy is an absolute force of nature. He has a line called Classical Chinese Medicine Pearls, P-E-A-R-L-S, and it’s a whole line of Chinese formulas. The only kicker with these formulas, though, Phoebe, is in order to buy them, you have to have a license. They have to be prescribed by a licensed healthcare practitioner. I get it. Getting healthy and seeing healthcare practitioners, it’s expensive. Unfortunately with the American healthcare system in terms of insurance, some policies cover these kind of medical interventions. Some don’t, and I think that’s a lot of times why people go online to do research or they’re reaching out and asking questions, because it’s not that they’re cheap by any stretch of the imagination, and it’s not that – I don’t know. They’re trying to get better, and they don’t always necessarily have the resources, the financial resources, to do it.

When I was about 25, I went to go see a nutritionist who is different from the other nutritionists that I was just complaining about. This nutritionist, she prescribed me a supplement regimen that was going to cost me about $400 a month. I was just like, first of all, I put all my savings into coming to see you and second of all, there is no way that $400 a month is going to be sustainable for me with the job that I had and all of the time. I do understand the financial impact of a lot of these intervention and why people choose to reach out and really kind of ask a lot of these questions and self-treat. But I do think it is important to at least get somebody on board with you who can have an eye on it who knows how to navigate a lot of that.

That’s why Heiner’s Chinese medicine line for a lot of these gut infections, one that I like – that’s why he requires in order to purchase it, you have to have a license or it has to be prescribed by someone who knows what they’re doing. Even though it’s “natural” you can’t really mess someone up with acupuncture too badly unless there’s malintent or you’re just stupid. You can really mess somebody up with herbs though. I mean, you can do some serious damage.

PHOEBE: What is the damage? Just killing things that you don’t want to kill?

LOVIE: Killing things you don’t want to kill or another story – when I was a student, I went to go see a practitioner that diagnosed me through this machine where he had me hold two metal bars in my hand and then it was connected to a plate that was connected to it – it almost looked like a Geiger counter where it’d be like, [Geiger noise]. He would put herbs down on this plate and then how the Geiger counter, this noise reacted, was how he decided to prescribe herbs to me. You know what? You did the wellness project. You go do kooky things. I went and did kooky things, too. Yeah, this is totally normal. Let’s do this.

The guy prescribed me herbs, and at that point, I’d been in Chinese medicine school a couple years and how he – the diagnosis he gave me, I was like, that’s interesting. That’s not a diagnosis I’ve heard for myself before, but okay, cool. I take these herbs, and I quit pooping for ten days. One of my friends looked over at me and it was just like, are you pregnant? I was like, no, I have a shit baby in there. I haven’t pooped. It was awful.

Then, of course, I go see another Chinese medicine practitioner that a friend brought me into, and the guy took one look at me, took one look at the herbs that I was prescribed, and went, “Who the hell prescribed you this?” I was like, I didn’t even want to name names. He was like, “This is absolutely completely the wrong formula for you.” I’m like, “I kind of figured.” It took me four months to get pooping regularly.

PHOEBE: A good cautionary tale. I want to end by talking a little bit about the seasons because I know that’s an important aspect of Chinese medicine. I know there’s also important distinctions about times of day in various organs. Since this is coming out in April-ish, spring, can you tell us a little bit about what that means for our digestive system today, SIBO or otherwise, and any little things that we can apply today to our routine?

LOVIE: Oh, this – Phoebe, we got to be careful because I could talk about this for the next three hours.

PHOEBE: I know!


CHINESE MEDICINE AND THE SEASONS: DIET AND TREATMENT


LOVIE: This is in my top five, so what did I say? I said poop, periods, I think Five Elements, which we’re leaning into, and STDs, STIs. I got to figure out what my fifth favorite thing thing to talk about is. Yeah, definitely like the Five Elements. So let’s really get back to basics. There’s yin and there’s yang. What yin and yang refer to in the Chinese characters refers to the light side and the dark side of a hill, that tai chi symbol that we see that’s entered into mainstream as something from the ’60s or ’70s. That tai chi symbol is encoded with so much information it’s breathtaking. It’s absolutely breathtaking.

If we just look at a spectrum, there’s light and there’s dark, but the world is not black and white. There’s a lot of shades in between those two things. There’s a lot of colors in between those two things. Once upon a time as they were trying to make sense in this medicine of the world that we inhabit, there’s the light and the dark, and those are just frequencies. Everything vibrates. You vibrate; I vibrate; the table vibrates; atoms vibrate; the universe vibrates. Everything really is about frequencies. What they saw was that if you put light on one end and dark on the other that you have this whole rainbow spectrum of frequencies that run all the way in between the two ends. I looked around and said okay, what are the five biggest, loudest, baddest frequencies that are out there, and for shorthand, they coded them against what they were seeing in nature. Remember, Chinese medicine, it came from a Confucian, Agrarian society. This is Farmer society. This is people who are living and breathing earth. They were farmers and gatherers and whatnot.

They saw what they saw in nature, and they divided the five elements, these five big frequencies that exist between light and dark, as fire, earth, metal, water, and wood. Each of these shorthand elements are buckets that we put things that vibrate similar to that frequency to. For example, if you think about fire, you sit here and think about fire for a second and you think about the nature of fire. We have forest fires, or we have slow-burning embers, or we have candles, or we have a cooking fire, or we have a fire that we put over a teapot over or a house fire. There’s so much to that, but fire’s also for us in Chinese medicine, it’s the color red. It refers to the heart and the small intestine, that stomach fire, that metabolic fire that we look at. It refers to joy; it refers to sex, and relationships, and it’s all of that.

When we move through the seasons – water – we associate water with winter. It’s icy, it’s cold, that kind of thing. Wood, that’s spring, so that really starts around May, somewhere, 20th, 22nd, or the equinox. Fire is summer, and then earth – there’s that weird time of summer. Right after the dog days but before it gets cold where the harvest comes in, when you go down to the farmer’s market and you could drop $800 at the farmer’s market because there’s just so much abundance. That’s earth; that’s late summer. Then fall is metal, so right before we – metal’s about death, and dying, and reflection.

There’s appropriate behaviors and appropriate ways of eating and appropriate ways of moving through the world that are in accordance with the vibratory frequency of the season we’re residing in. For example, if you’re doing a detox and you’re really looking to clear out the liver, you’re not going to want to do that in winter. Winter is the season of the kidneys, and it’s the season of going in and hibernating. You don’t want to activate that system like that. That’s not the time to do it. The fact that we put February 14th– it’s kind of nice to put Valentine’s Day in the mid-ass dead of winter when nothing else is happening,  but how sexy are you feeling on Valentine’s Day as you put on that extra winter weight? Not really the appropriate season for that. Valentine’s Day belongs in June because that’s the season of fire, and connection, and meeting people, and going out and having a good time.

PHOEBE: Well, don’t even get us started on January 1stresolutions. Every year, I’m like, this is the worst time to be telling me to eat a salad because you shouldn’t.

LOVIE: No, you know why you shouldn’t, right? It’s because that’s cold. That’s the season of cold. Salads and stuff, if your body’s metabolically having to fight a polar vortex, your body metabolically – because it’s a closed system – is not going to have the energetics to actually pull any nutrients out of that fucking Caesar salad you just ate. That salad you just ate is not as bioavailable to you as it is in spring. In winter, because our systems, again, are trying to fight the cold and what have you. We need to be eating warm, nourishing foods. We need to be eating spices, any spice you put in a pumpkin pie. That’s what you need to be eating on January 1st. If you want to make that kind of commitment to salads, eat it when it grows Again, it comes right back to the Wang Lee Majing. We eat seasonally and we eat appropriate. Maybe in fall, you do want to like Thanksgiving in the terms of the foods that we eat at Thanksgiving. They’re highly fat, highly sugar, highly choloric. I think of my mom’s baked corn recipe That’s just cardiac arrest in a plate. You need to fatten up for winter, so it’s appropriate to do that.

When we’re looking at detoxes and we’re looking at really trying to clear out the liver and the gall bladder, the best time to do that and the most efficient time, again, according to Chinese medicine, is to do that in the spring, one hundred percent. So winter, January 1st, that’s the time to go deep, and journal, and reflect, and start to gestate the seeds that will come up, so that’s the time that you actually maybe want to plan but not commit to anything.

PHOEBE: So what do we need to do this spring to help our liver along, and how will that affect our gut and general digestive system?


EASTERN APPROACH TO DETOX


LOVIE: Liver, again, we’re coming back into this elemental world of vibratory frequencies and things that kind of gel well together at the right time of year. The liver falls into the category – the color of the liver in Chinese medicine in this category that we’re looking at is green. What you want to do is as part of your detox is you do want to eat anything – any of the dark, leafy greens. That’s fiber that’s going to start helping you clear things out a little bit from a poop standpoint.

The other thing you can do is dark, leafy greens that smell. That’s anything like your rosemary. That’s your cilantro, if you like cilantro. That’s your parsley. Any part of that produce section you go to and you can smell it before you even hit that produce section, that’s what you want to be eating because the volatile oils that are producing those smells are highly anti-inflammatory and they help with phase two detox in the liver.

PHOEBE: Do we want to eat them raw or cook them? Are we ready yet for raw food?

LOVIE: You are not ready yet for raw food.

PHOEBE: Okay.

LOVIE: Especially those of us with autoimmune and SIBO. If your gut is compromised, one of the issues with that is, again, you as a closed system, there’s only so much metabolic energy in that system. If you don’t have the digestive strength to be pulling all these good things out of that salad or whatever it is you’re making, then you’re just throwing it in the toilet, and you’ll see it being thrown in the toilet. You always check your poop. If you go to the bathroom and it’s borderline diarrhea, if you’re seeing undigested food in there – corn does not count; everybody poops corn, so corn gets put to the side. This is more like tomato peels. This is more like kale. If you’re seeing any leafy things come out in full form, then you don’t belong eating raw food, and you want to steam or blanch the food at least a little tiny bit at possible.

Other thing we do too is we look at the diurnal clock. Even though we have this elemental season thing going on that I was just talking about, the diurnal clock in Chinese medicine breaks it down into two-hour chunks during the day, and for us the clock starts at 3 a.m. from 3 to 5, that’s the hour of the lung because that’s when you wake up and take your first breath. From 5 to 7, that’s large intestine because that’s when you’re supposed to go poo. Then from 7 to 9, that’s the hour of the stomach when you should be going and eating and having a good breakfast. Your breakfast, you eat like a king. Then from 9 to 11, that’s the spleen where you digest. 11 to 1, that’s the hour of the heart where you should go commune the outdoors. You can see we have this clock.

From 11 to 1 – 11 p.m. to 1 a.m. for us is the hour of the gallbladder. This is when these specific organs become most active. 11 to 1 is the gallbladder, which is the paired organ to the liver in the wintertime goes from 1 a.m. To 3 a.m. Ideally, what we do is when we’re trying to detox and really give our liver space to do what she’s supposed to do, you want to be flat in bed by 11 p.m. What starts to happen is the liver, from even Western medicine standpoint, it’s the garbage disposal of the system. Her job is to really clean the blood and start pulling out whether it’s hormones or producing good steroids, all these synthesizers, all the things that liver’s supposed to do. What happens is when you go flat at 11 a.m., it literally helps gravity start to pull your blood down and makes it more accessible in terms of circulation to the liver. The liver, by the time that you hit 1 a.m. And you’ve been flat this whole time, that’s whne she’s most active, really doing a good job.

What a real detox looks like is reducing insult because what that does – and when I say reduce insult, that means no sugar or go light on the sugar, no alcohol or go light on the alcohol, things that are easy to digest. You want to reduce any sort of strain on that organ system because she knows what to do. The liver absolutely knows how to do her job. She just needs space to do it. A detox is about giving her that space, and it means not overloading her on things that are going to make her work harder. It means giving her the dark, leafy greens and good foods that she’s going to use to synthesize phase two detox in the liver and it also means going to bed at an appropriate time just so she can work better.

PHOEBE: I love that. I feel like we need to do a whole episode just on sleep and how our body works and how it can help our digestive system. This has been so informative. I’m so happy to share your wisdom and just general wisdom from Chinese medicine with our listeners. Is there anything else you want to leave people with before we go in terms of acupuncture, in terms of SIBO, in terms of Hashi’s, really any of these many prongs that we’ve discussed today.

LOVIE: You know, I think the one thing that I want to leave people with is you don’t have to do it alone and that it can be an incredibly isolating experience and that to seek out help and to give the space to allow people to contribute to you. I think that’s something that we don’t do enough of and I guess the other thing I want to leave people with is the ability to say no to certain things, meaning saying no to something means you’re giving space to say yes to something else. If something doesn’t feel right in terms of your health journey and you as the individual is going to be the only person who can actually judge that, it’s absolutely completely fine to make an informed no but then look out and discover where your yes resides.

PHOEBE: I love that. It’s something that I have definitely had to learn the hard way over the years. Still learning it a little bit every day.

LOVIE: Oh, I’m still learning it, too. Easier said than done.

PHOEBE: A little. But I always say yes to coming in to see you because it feels amazing. You’ve been such an important part of my team and just a central lesson to everyone else of why it’s so important to have a team around you but then also one essential touchstone like you.

LOVIE: Absolutely.

PHOEBE: Thank you, AccuHeidi, Heidi Lovie, for coming on.


Disclaimer: The information shared in this podcast is not meant to provide medical advice, professional diagnosis, or treatment. The information discussed is for educational purposes only and is not a substitute for medical or professional care.



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