Podcasts about sjogren

In this episode of 'Masks Off,' host Kim Gross addresses the strong correlation between autoimmune diseases and people-pleasing tendencies, especially among women. She cites Dr. Gabor Mate's observations about trauma being at the root of people-pleasing behaviors. Drawing from her own battle with Sjogren's syndrome, Kim shares her personal struggles of overextending herself to meet the needs of others at the expense of her own health and well-being. She recounts how her upbringing and family dynamics reinforced these tendencies and led to severe health issues. Kim eventually learned to prioritize self-care as a way to improve her condition and her relationships. She outlines practical steps and resources for listeners to start recognizing and transforming these harmful patterns, emphasizing the importance of awareness, ownership, and the arduous but rewarding journey of inner healing. The episode aims to inspire listeners to put themselves first and remove their people-pleaser masks in order to lead a more joyful and connected life.

This is a continuing session from the last Episode

Autoimmune diseases like lupus and Sjogren's disease are often associated with joint pain, fatigue, and organ involvement, but their impact on the nervous system is less commonly discussed. In this episode, Dr. Julius Birnbaum, a leading expert in neuro-rheumatology, joins us to explore the neurological manifestations of these conditions and what patients need to know. From brain fog and memory issues to more severe complications like neuropathy, Dr. Birnbaum explains how these diseases affect the brain and nerves, why symptoms can be challenging to diagnose, and the latest advancements in treatment. If you or a loved one live with lupus or Sjogren's and have experienced unexplained neurological symptoms, this episode provides clarity, validation, and expert insights on what to look for and how to advocate for proper care.   Donate to Support the Show: www.aiarthritis.org/donate   Episode Highlights: Understanding the link between autoimmune diseases and the nervous system. Common neurological symptoms in lupus and Sjogren's Why neurological symptoms are often overlooked or misdiagnosed. The latest research and treatment approaches for managing neurological complications. How to advocate for proper testing and care if you suspect neurological involvement.   Links & Resources Volunteer with AiArthritis : https://bit.ly/AiArthritisVolunteerApp   Follow AiArthritis on all social media platforms @IFAiArthritis Sign up for our Monthly AiArthritis Voices 360 Talk Show newsletter! HERE   Connect with our Cohost & Guest: Dr. Julius Birnbaum is a distinguished rheumatologist with 20 years of experience and the only physician in the U.S. trained as an internist, neurologist, and rheumatologist. He completed his medical training at Columbia, Mount Sinai, Jacobi Medical Center, and Johns Hopkins, where he later pioneered a Neuro-Rheumatology Clinic to treat complex neurological complications of autoimmune diseases. Dr. Birnbaum has authored over 30 publications in prestigious medical journals and has been a featured speaker at national and international rheumatology conferences. Currently, he serves as Associate Professor of Rheumatology at the University of Pittsburgh Medical Center (UPMC) and Division Chief of Rheumatology at UPMC Mercy Hospital, where he continues to teach and mentor medical trainees. Outside of medicine, he enjoys sports like basketball, swimming, and running, which he shares with his wife and three children in Wexford, Pennsylvania.   Connect with Dr. Birnbaum: Book: Living Well With Autoimmune Diseases: A Rheumatologist's Guide to Taking Charge of Your Health - https://bit.ly/41XrpZR Website: https://www.juliusbirnbaum.com/   Leila is the Health Education Manager at the International Foundation for AiArthritis. She is a person living with Lupus and Sjögren's disease. She is passionate about inclusion and diversity in health education and meeting individuals where they are at in order to learn in a way that resonates with them.    Connect with Leila: Tiktok: @Lupuslifestyle.lei  

Learn about an autoimmune disease affecting millions with dry eyes, dry mouth, and other symptoms.

Together, they break down the latest research from the 2024 American College of Rheumatology conference, unpacking the science behind the gut microbiome and the Mediterranean diet. Cristina explains how these can impact inflammatory diseases like RA and Sjogren's—and why it's about more than just what's on your plate.They also tackle the big questions: Should you go gluten-free? Is the carnivore diet a miracle cure or just another fad? Is it worth having a restrictive diet if I'm stressed about food all the time? Cheryl and Cristina separate fact from fiction, debunking common diet myths so you can make informed choices without the confusion.But this conversation isn't just about food—it's about the bigger picture. Cristina shares her “Five C's” framework—Commitment, Consistency, Compassion, Courage, and Credibility—helping you stay on track while giving yourself grace. Plus, they dive into the importance of finding the right healthcare team and support system, so you never have to navigate RA alone.If you're looking for real talk, expert insights, and actionable tips to feel your best, this episode is a must-listen!*Content warning: discussion of disordered eating from minute 10:40-14:40Episode at a glance:Cristina's Journey: How dietitian Cristina was diagnosed with arthritis and Sjorgen's DiseaseBalanced Approach to Arthritis: Combine medication with smart lifestyle changes like diet and exercise for the best results.Gut Microbiome Matters: The health of your gut microbiome plays a key role in managing inflammation and supporting overall health.Cristina's Five C's Framework: Commitment, Consistency, Compassion, Courage, & CredibilityBuild Your Healthcare Dream Team: Collaborate with trusted specialists (rheumatologists, dietitians, occupational therapists) for comprehensive care.Avoid Quick Fixes: Don't fall for miracle cures; rely on evidence-based practices for long-term success.Specific Aspects of the Mediterranean Diet and Mediterranean Lifestyle: What makes it so helpful for inflammatory arthritis patients?Medical disclaimer: All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.Episode SponsorsRheum to THRIVE, an online course and support program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. See all the details and join the program or waitlist now! 

This session was recorded during a Zoom training session.

Send us a textEpisode Summary:In this episode of Midlife with Courage, Kim welcomes Emily Black, founder of a menopause-focused gummy supplement business. Emily shares her personal journey of being diagnosed with an autoimmune disorder, navigating perimenopause symptoms, and discovering alternative solutions for relief. She discusses the challenges of receiving proper medical support, the role of cannabis in symptom management, and how she developed her business to help other women.Key Topics:Emily's courageous decision to leave an 18-year marriageHer struggle with an autoimmune disorder (Sjogren's Syndrome) and menopause symptomsHow traditional medicine often dismisses women's health concernsThe benefits of cannabis (THC & CBD) for menopause symptoms like sleep and anxietyThe process of formulating and launching her gummy supplement businessConnect with Emily Black:WEBSITE-Still For Her***Midlife with Courage listeners will get a 20% discount on their first order by using the code "Courage"***DISCLAIMER-the information contained in this episode should not be considered medical advice. Always consult with your healthcare provider before taking any supplements. Get your free ebook called Daily Habits for Hormonal Harmony by going to my website. This free guide will help you balance your hormones through some easy daily activities. Just add your email to the popup and your guide will be on its way to your inbox.From morning until bedtime, you can help yourself feel better! Support the showKim Benoy is a retired RN, Certified Aromatherapist, wife and mom who is passionate about inspiring and encouraging women over 40. She wants you to see your own beauty, value and worth through sharing stories of other women just like you.Would you like to get a "sneak" listen to each podcast? Subscribe to my website to get my weekly inspirational message and a link to that week's podcast a day ahead of everyone else! Just click the link below to get on the list! SUBSCRIBE WEBSITEFACEBOOK

Let's get to know our hosts a bit more. Dr. Kara Wada, MD is a board certified Allergy Immunologist. She also has Sjogren's disease. Did you know that Sjogren's affects about 1 in 100 people? Many of them are undiagnosed and suffer with chronic symptoms. 30-40% of the time, lab tests are normal. Listen here as Kara teaches us lessons about both a doctor and patient living with the disease. 

In this episode of the Bendy Bodies Podcast, Dr. Linda Bluestein welcomes Dr. Kara Wada, an allergy and immunology expert, to explore Sjogren's disease and its connection to hypermobility, dysautonomia, and Mast Cell Activation Syndrome (MCAS). They discuss why Sjogren's is one of the most underdiagnosed autoimmune conditions, its symptoms beyond dryness, and how it intertwines with POTS (postural orthostatic tachycardia syndrome) and EDS (Ehlers-Danlos Syndromes). Dr. Wada also dives into Sjogren's diagnostic challenges, emerging treatments, nutrition strategies, and the role of inflammation in fatigue and pain. Whether you're navigating autoimmune symptoms or looking for practical tools to manage them, this episode is filled with expert insights and actionable advice. Takeaways: Sjogren's is Massively Underdiagnosed – Up to 75% of people with Sjogren's remain undiagnosed, in part because its symptoms extend far beyond dryness and don't always present in a textbook way. Autoimmune Conditions & EDS Are Connected – Sjogren's, POTS, and MCAS frequently overlap due to their shared impact on the immune and nervous systems, making diagnosis and treatment complex. Dryness is Just the Beginning – Sjogren's can cause neuropathy, fatigue, dysautonomia, gastrointestinal issues, and even a higher risk of lymphoma, making it more than just an inconvenience. Current Treatments Are Limited but Improving – There are no FDA-approved medications specifically for Sjogren's, but promising treatments are currently in phase 3 trials, offering hope for better management Nutrition & Lifestyle Matter – Avoiding ultra-processed foods, prioritizing hydration, and incorporating anti-inflammatory nutrients can help manage symptoms and support immune function. Connect with YOUR Hypermobility Specialist, Dr. Linda Bluestein, MD at https://www.hypermobilitymd.com/. Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Past Episodes: https://www.bendybodiespodcast.com/linking-mast-cell-activation-autoimmunity-and-eds/ https://www.drkarawada.com/podcasts/becoming-immune-confident/episodes/2148563154 Join YOUR Bendy Bodies community at https://www.bendybodiespodcast.com/. Learn more about Human Content at http://www.human-content.com Podcast Advertising/Business Inquiries: sales@human-content.com YOUR bendy body is our highest priority! Learn about  Dr. Karen Wada Twitter: @CrunchyAllergy Instagram: @immuneconfidentmd TikTok: @immuneconfidentmd FB: @KaraWadaMD YT: @drkarawada Keep up to date with the HypermobilityMD: YouTube: youtube.com/@bendybodiespodcast Twitter: twitter.com/BluesteinLinda LinkedIn: linkedin.com/in/hypermobilitymd Facebook: facebook.com/BendyBodiesPodcast Blog: hypermobilitymd.com/blog Part of the Human Content Podcast Network Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of the Bendy Bodies Podcast, Dr. Linda Bluestein welcomes Dr. Kara Wada, an allergy and immunology expert, to explore Sjogren's disease and its connection to hypermobility, dysautonomia, and Mast Cell Activation Syndrome (MCAS). They discuss why Sjogren's is one of the most underdiagnosed autoimmune conditions, its symptoms beyond dryness, and how it intertwines with POTS (postural orthostatic tachycardia syndrome) and EDS (Ehlers-Danlos Syndromes). Dr. Wada also dives into Sjogren's diagnostic challenges, emerging treatments, nutrition strategies, and the role of inflammation in fatigue and pain. Whether you're navigating autoimmune symptoms or looking for practical tools to manage them, this episode is filled with expert insights and actionable advice. Find this episode's transcript here: https://www.bendybodiespodcast.com/sjogrens-misdiagnosis-dr-kara-wada/ Takeaways: Sjogren's is Massively Underdiagnosed – Up to 75% of people with Sjogren's remain undiagnosed, in part because its symptoms extend far beyond dryness and don't always present in a textbook way. Autoimmune Conditions & EDS Are Connected – Sjogren's, POTS, and MCAS frequently overlap due to their shared impact on the immune and nervous systems, making diagnosis and treatment complex. Dryness is Just the Beginning – Sjogren's can cause neuropathy, fatigue, dysautonomia, gastrointestinal issues, and even a higher risk of lymphoma, making it more than just an inconvenience. Current Treatments Are Limited but Improving – There are no FDA-approved medications specifically for Sjogren's, but promising treatments are currently in phase 3 trials, offering hope for better management Nutrition & Lifestyle Matter – Avoiding ultra-processed foods, prioritizing hydration, and incorporating anti-inflammatory nutrients can help manage symptoms and support immune function. Connect with YOUR Hypermobility Specialist, Dr. Linda Bluestein, MD at https://www.hypermobilitymd.com/. Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Past Episodes: https://www.bendybodiespodcast.com/linking-mast-cell-activation-autoimmunity-and-eds/ https://www.drkarawada.com/podcasts/becoming-immune-confident/episodes/2148563154 Join YOUR Bendy Bodies community at https://www.bendybodiespodcast.com/. Learn more about Human Content at http://www.human-content.com Podcast Advertising/Business Inquiries: sales@human-content.com YOUR bendy body is our highest priority! Learn about  Dr. Karen Wada Twitter: @CrunchyAllergy Instagram: @immuneconfidentmd TikTok: @immuneconfidentmd FB: @KaraWadaMD YT: @drkarawada Keep up to date with the HypermobilityMD: YouTube: youtube.com/@bendybodiespodcast Twitter: twitter.com/BluesteinLinda LinkedIn: linkedin.com/in/hypermobilitymd Facebook: facebook.com/BendyBodiesPodcast Blog: hypermobilitymd.com/blog Part of the Human Content Podcast Network Learn more about your ad choices. Visit megaphone.fm/adchoices

Today we celebrate 40 years of God's faithfulness at Vineyard Cincinnati!We honor the journey that brought us here and look ahead to what's next. Clay teaches from stage, and we'll also hear from our Founding Pastor, Steve Sjogren!Support the show

Clay Harrington sits down with Steve Sjogren, Vineyard Cincinnati' Church's former Lead Pastor, talking about the 40-Year History of Vineyard Cincinnati Church!Support the show

In this episode of the Vacation Rental Revolution podcast, host Shawn Moore interviews Michael Sjogren, a successful short-term rental investor and coach. Michael shares his inspiring backstory, detailing how a life-altering event with his son motivated him to pursue financial freedom through real estate. He discusses the importance of clarity in goals, the challenges of co-hosting, and the necessity of treating it as a business rather than a job. The conversation emphasizes the need for systems, processes, and a strong team to achieve success in the competitive short-term rental market. In this conversation, Shawn Moore and Michael Sjogren delve into the intricacies of short-term rentals, co-hosting, and the boutique hotel market. They discuss strategic investment approaches, the differences between co-hosting and property management, and the potential of commercial properties for wealth building. The conversation emphasizes the importance of understanding market dynamics, avoiding bad deals, and the value of mentorship in navigating the real estate landscape.If you would like to learn more about Vodyssey or submit a question for us to answer on an upcoming episode send us an email at:support@vodyssey.com Get In Contact With Michael:https://www.strsecrets.com/https://www.instagram.com/mike.sjogren/?hl=enhttps://www.youtube.com/@mikesjogrenhttps://www.linkedin.com/in/mikesjogren/https://www.facebook.com/mikesjogrenofficial/JOIN HIS WEBINAR:https://hotels.strsecrets.com/boutique-hotel-webinar-registrationFollow Us:https://www.instagram.com/vodysseyshawnmoorehttps://www.facebook.com/vodysseyshawnmoore/https://www.linkedin.com/company/str-financial-freedomhttps://www.tiktok.com/@UCSOqHabG-uj_8Sq3r8QgoEgChapters00:00:00 Intro00:00:30 The Show Begins 00:01:51 The Life-Changing Event00:07:12 Turning Adversity into Opportunity00:14:44 Understanding Co-Hosting as a Business00:21:17 Strategic Investment in Short-Term Rentals00:23:33 Understanding Co-Hosting vs Property Management00:26:36 Navigating the Boutique Hotel Landscape00:32:58 The Value of Commercial Properties00:40:04 Avoiding Bad Deals in Real Estate00:41:23 Wrap Up

In this episode of the Vacation Rental Revolution podcast, host Shawn Moore interviews @strsecret a successful short-term rental investor and coach. Michael shares his inspiring backstory, detailing how a life-altering event with his son motivated him to pursue financial freedom through real estate. He discusses the importance of clarity in goals, the challenges of co-hosting, and the necessity of treating it as a business rather than a job. The conversation emphasizes the need for systems, processes, and a strong team to achieve success in the competitive short-term rental market. In this conversation, Shawn Moore and Michael Sjogren delve into the intricacies of short-term rentals, co-hosting, and the boutique hotel market. They discuss strategic investment approaches, the differences between co-hosting and property management, and the potential of commercial properties for wealth building. The conversation emphasizes the importance of understanding market dynamics, avoiding bad deals, and the value of mentorship in navigating the real estate landscape.If you would like to learn more about Vodyssey or submit a question for us to answer on an upcoming episode send us an email at:support@vodyssey.com Get In Contact With Michael:https://www.strsecrets.com/https://www.instagram.com/mike.sjogren/?hl=en @strsecret https://www.linkedin.com/in/mikesjogren/https://www.facebook.com/mikesjogrenofficial/JOIN HIS WEBINAR:https://hotels.strsecrets.com/boutique-hotel-webinar-registrationFollow Us:https://www.instagram.com/vodysseyshawnmoorehttps://www.facebook.com/vodysseyshawnmoore/https://www.linkedin.com/company/str-financial-freedomhttps://www.tiktok.com/@UCSOqHabG-uj_8Sq3r8QgoEgChapters00:00:00 Intro00:00:30 The Show Begins 00:01:51 The Life-Changing Event00:07:12 Turning Adversity into Opportunity00:14:44 Understanding Co-Hosting as a Business00:21:17 Strategic Investment in Short-Term Rentals00:23:33 Understanding Co-Hosting vs Property Management00:26:36 Navigating the Boutique Hotel Landscape00:32:58 The Value of Commercial Properties00:40:04 Avoiding Bad Deals in Real Estate00:41:23 Wrap Up

Join us for a compelling episode as we highlight key insights from our recent webinar, featuring a fascinating complex case of a 75-year-old female patient with a history of Sjogren's syndrome, breast cancer, and chronic thromboembolic disease. Our expert panelists discuss the complexities of diagnosis, the role of advanced imaging techniques, and the lessons learned from this challenging case. Whether you missed the webinar or want to revisit the discussion, this episode is packed with valuable takeaways for healthcare professionals. Tune in now and expand your knowledge with insights from leading experts in the field!

In this episode, we present the second part of our conversation with the authors of the scouting reports for the teams in the T'd Up T-cells region of RheumMadness 2025: the Innovation Invitational.  Plus, we highlight Q&As from theMednet.org about the T'd Up T-Cells teams AND record an interview with Dr. Bill St. Clair, the first author of the phase 2 dazodalibep study.  It's a long episode because there's so much content!Links to the Q&As from theMednet.org discussed in this episode:What is your approach to managing sicca symptoms in patients not responding or not tolerating conservative measures, pilocarpine, and cevimeline?What is your approach to immunomodulatory treatment in patients with Sjogren's syndrome who have active serologies (i.e. elevated ESR, hypergammaglobulinemia, hypocomplementemia) but minimal symptoms?What is your approach to monitoring patients referred for high titer +RF and +CCP but without active symptoms of inflammatory arthritis?What factors drive you to prioritize T vs B cell inhibition when choosing therapies for patients with refractory SLE?To learn more about RheumMadness:https://sites.duke.edu/rheummadness/Subscribe to our newsletter:https://lists.duke.edu/sympa/subscribe/rheummadnessFind us on social media:Bluesky: @rheummadness.bsky.socialInstagram: https://www.instagram.com/rheummadness/X: Follow #RheumMadnessIntro/outro music: Cheery Monday by Kevin MacLeodLink: https://incompetech.filmmusic.io/song/3495-cheery-mondayLicense: http://creativecommons.org/licenses/by/4.0/

To have your question featured in a future video, please email: questions@drmdc.health Please include at least: Age, Weight and as much history as possible.

In this episode of the Know Your Shit podcast, Josh Cadillac sits down with Michael Sjogren, a seasoned real estate investor and short-term rental expert, to discuss strategies for achieving financial freedom and building wealth through thoughtful decision-making. Michael shares his journey, the risks he took, and the disciplined approach he uses to evaluate opportunities. They delve into leveraging empathy, mitigating risks, and staying focused on long-term goals while balancing personal growth with professional success.

Do you ever feel like something's missing in healthcare? Like there are important conversations we should be having, but aren't? Get ready for a sneak peek into a brand-new podcast, "Lessons We Didn't Learn in Medical School," hosted by Dr. Kara Wada and Dr. Beth Vukin. In this special bonus episode of "Becoming Immune Confident," Dr. Kara shares what inspired this exciting project, a taste of the powerful conversations to come, and how YOU can be a part of the movement by joining their Launch Team. It's all about bringing together patients and physicians, sharing stories, and creating a healthcare system that truly works for us. Join the "Lessons We Didn't Learn In Medical School" Launch Team for exclusive early access, bonus content, and a chance to win some amazing giveaways! → https://www.drkarawada.com/lessons-we-didnt-learn-launch-team EPISODE IN A GLANCE00:00 Intro00:39 Introducing Lessons We Didn't Learn In Medical School and Hosts01:12 Challenges in Healthcare01:50 The Importance of Community02:33 Sneak Peek with Dr. Beth Vukin04:01 Complexities of Chronic Illness05:00 Navigating the Healthcare System06:44 The Power of Shared Experiences10:22 Lessons and Stories ABOUT DR. BETH VUKINDr. Beth Vukin is a board-certified pediatrician and hospitalist, bringing over 20 years of experience to her insightful conversations about healthcare. As both a physician and a patient with scleroderma, she understands the importance of bridging the gap between medical knowledge and lived experience. CONNECT WITH DR. BETH VUKINInstagram → https://www.instagram.com/realtalkwithkiddocs YouTube → https://www.youtube.com/@RealTalkWithKidDocs ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfidentmd/ Podcast Instagram → https://www.instagram.com/becomingimmuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@immuneconfident SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health. Calling all my healthcare sisters! Looking for scrubs that are both comfy and stylish (because we deserve both!)? Check out GreenCloud Apparel and use code LWDLMS for $10 off!→ https://www.greencloudapparel.com/discount/LWDLMS

ACR 24: What I learned in Sjogren's, Takayasu's and CAR-T:Dr. Janet Pope Anti IL-17 on Entheseal Biopsy in PsA:Dr. Eric Dein  axSpA: Impact of TNF and IL-17 in Patients with Prior TNF Exposure:Dr. Brian Jaros Can We Make Clinical Trials Better?:Dr. Janet Pope Cumulative Steroid Use and Cardiovascular Events:Dr. Mrinalini Dey  IL 6 Inhibitors, Frailty and Polymyalgia Rheumatica:Drs. Trish Harkins and Sebastian Sattui IVIG Treatment in Immune-mediated Necrotizing Myopathy:Drs. Caoilfhionn Connolly interviews Dr. Asim Mohamed  Machine Learning for Predicting Flares in axSpA:Dr. Sheila Reyes So really, are JAKs Safe?:Dr. Janet Pope Tackling the Workforce Crisis: A shared dilemma:Drs. Mrinalini Dey,  Louise Pollard and Bharat Kumar The 2024 ACR Guidelines for Lupus Nephritis:Dr. Sheila Reyes  The Real Value of JAKi is Beyond RA:Dr. David Liew  Vaccine Responses:The DMARD Counts:Dr. David Liew

Best Things I Saw Today in PsA:Dr. Catherine Bakewell  Do TNFis and JAKis Prevent Cancer!?:Dr. Richard Conway Efficacy and Safety of Nipocalimab for Sjogren's Syndrome:Dr. Mike Putman Evaluating ANA Patterns and Titers with AI:Dr. Bella Mehta Improvements in Pain and Fatigue in Bimekizumab:Dr. Philip Mease  Long Term Follow up from APIPPRA:Dr. Antoni Chan talks with Dr. Andrew Cope Race Neutral PFTs in Scleroderma Improves Equity:Dr. Caoilfhionn Connolly talks with Dr. Kamini Kuchinad  Summary of JAKi Studies:Dr. Peter Nash The Psoriatic March: PsA before PsO:DR. Antoni Chan Use of AI in Hand Ultrasound Scoring:Dr. Bella Mehta  What is MCTD? The Great Debate:Drs. Caoilfhionn Connolly & Lisa Christopher-Stine What's The State of Biosimilars?:Drs. Eric Dein and Jonathan Kay Pred Softly: Steroids:Dr. Jiha Lee talks with Dr. Beth Wallace

We've been creating content to help viewers make wiser decisions about their food choices. Many of today's food sources are contaminated with toxic chemicals or created with inflammatory ingredients. Over time, these foods can promote long-term inflammation that can result in a variety of health conditions, including autoimmune disease, obesity, anxiety, and more. Today's chat is going to be a very interesting one, as we will discuss the anti-inflammatory food pyramid with our guest Dr. Kara Wada, the Crunchy Allergist. Dr. Wada specializes in allergies, Sjogren's Syndrome, immunology, and autoimmunity. We're going to discuss how we should reimagine the food pyramid, how toxins can impact our immunity, and more. Learn more about Dr. Wada's services: https://www.drkarawada.com/link-in-bio Get tested for BPA, phthalates, parabens, and other hormone-disrupting chemicals with Million Marker's Detect & Detox Test Kit: https://www.millionmarker.com/

Listen as Elizabeth Kircher, DNP, and R. Hal Scofield, MD, discuss best practice approaches for the treatment of Sjögren's syndrome and what's on the horizon for future therapeutic options.Topics include:Challenges in Sjogren's Syndrome Diagnosis and Patient Understanding: Difficulties in explaining Sjogren's syndrome diagnosis to patients unfamiliar with it and challenges in addressing the disease's varied symptomsPatient Education and Communication: Strategies to prevent overwhelming patients during early visits and effective ways to address misconceptionsDiagnostic Challenges and Misunderstandings: Differences between clinical and research criteria for diagnosis and the importance of understanding eachUse of Ultrasound and Biopsy in Diagnosis: Benefits and limitations of ultrasound and biopsies in diagnosing Sjogren's syndromeMultidisciplinary Care Barriers: Challenges in coordinating care among specialists such as ophthalmologists, dentists, and rheumatologistsSymptomatic vs Disease-Modifying Treatments: Strategies for managing symptoms vs addressing the underlying disease with medicationsLong-term Medication and Risks: Considerations when prescribing long-term medications and immunosuppressive therapiesResearch and Emerging Therapies: Developments in Sjogren's syndrome research, including promising medications in clinical trialsGuideline Development and Patient Reassurance: The role of professional guidelines in shaping care and providing patients with reassurancePolypharmacy and Medication Reconciliation: The importance of pharmacist involvement in managing complex medication regimens for older patients Faculty:Elizabeth Kircher, DNPR. Hal Scofield, MDMember/Professor, Arthritis & Clinical ImmunologyOklahoma Medical Research FoundationProfessor, Department of Medicine, College of MedicineUniversity of Oklahoma Health Sciences CenterAssociate Chief of Staff for ResearchOklahoma City US Department of Veterans Affairs Medical CenterOklahoma City, OklahomaLink to full program:https://bit.ly/3YKpsOE

Este 17, 18, 19 y 20 de noviembre de 2024 estaremos publicando los resúmenes de cubrimiento del congreso del colegio americano de reumatología (ACR Convergence) 2024.Te invitamos a que visites www.reumatimes.com, te inscribas gratis y revises el contenido que día a día estarán revisando nuestros expertos para que de una forma práctica y concisa estés al día en la reumatología.Te invitamos a que participes en la sección de comentarios. ¿Qué quieres escuchar? ¿Cuáles son tus temas de interés?Síguenos en www.reumatimes.com, donde podrás encontrar cubrimientos de congresos de reumatología y resúmenes de actualidad en la especialidad.Encuéntranos en YouTube como ReumaTimes Y Facebook como Reumatologia.Online o ReumaTimes, en Instagram como dr.sebastianherrera o ReumaTimes, y en X (antes Twitter) como @Reuma_Online_ o @ReumaTimes. Estamos también en TikTok como @Reuma_Times.Síguenos en www.reumatimes.comTambién puedes encontrarnos en:Twitter: https://twitter.com/Reuma_Online_Facebook: https://www.facebook.com/reumatologiaonline/Instagram: https://www.instagram.com/dr.sebastianherrera/Spreaker: https://www.spreaker.com/user/11390404Spotify: https://spoti.fi/3DILwLP

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Send us a textJack Lu, Director of Corporate Development, of Ainos joins us on this week's WTR Small-Cap Spotlight to discuss the therapeutic platform and Veldona clinical development. He reviews the effects of Veldona on the immune system and benefit seen in prior clinical trials. Jack focuses on the recently announced studies being conducted in Taiwan for the three priority indications of oral warts in HIV+ patients, Sjogren's syndrome, and cat FCGS in animal health. We get a sense of timelines for potential data catalysts and outcome goals.

Mike "C-Roc", guest Michael Sjogren shares his journey of resilience and success in the world of real estate, specifically short-term rentals. Michael, a CPA turned entrepreneur and investor, opens up about the life-changing event that propelled him into business ownership. After facing the challenges of his newborn son's rare lung disease and the struggle of balancing hospital bills with limited vacation days, Michael made a vow to never trade time for money again. His relentless drive led him to build a thriving short-term rental empire, amassing over 80 properties across three states, including two boutique hotels. Throughout the conversation, Michael discusses how he turned adversity into fuel, the importance of mentorship, and his passion for helping others achieve financial freedom through real estate. He emphasizes the power of pushing beyond comfort zones, finding growth in challenges, and constantly leveling up to live a life without regrets. This episode is packed with inspiration for anyone seeking motivation to overcome obstacles and unlock their potential. Tune in to learn Michael's secrets to success and the mindset that keeps him moving forward. Website- www.STRsecrets.com Social Media Links/Handles: Facebook.com/groups/STRentalsecrets https://www.instagram.com/mike.sjogren/?hl=en https://www.youtube.com/channel/UC3j2uYbWOLdbreNQ9aq19ZA Podcast: Short Term Rental Secrets

Have you ever wondered if there's a connection between mast cell activation syndrome (MCAS) and Sjogren's?

Tuesday, October 1st, 2024Today, Donald Trump lies about the federal response to the devastation caused by Hurricane Helene while tapping local resources for a political visit to Valdosta Georgia; CBS News says it will not be responsible to fact check the candidates in tonight's Vice Presidential Debate; the DNC and Georgia Dems have sued the Georgia State Election Board for their hand count rule on the eve of the bench trial for other potential election violations which is set to begin today; Fulton  County Judge McBurney has overturned Georgia's six week abortion ban; the Federal Reserve Chair Jerome Powell says the US Economy is in solid shape as he plans to cut interest rates again; Kamala Harris' economic plan is more popular than Trump's; and Allison and Dana deliver your Good News. Go to drinkAG1.com/dailybeans to try AG1 and get a FREE 1-year supply of Vitamin D3K2 AND 5 FREE AG1 Travel Packs with your first purchase.Harris Campaign Social Media Toolkit (kamalaharris.com)Give to the Kamala Harris Presidential CampaignKamala Harris — Donate via ActBlue (MSW Media's Donation Link)See What's On Your Ballot, Check Your Voter Registration, Find Your Polling Place, Discover Upcoming Debates In Your Area, And Much More! vote411.orgStoriesHarris cuts West Coast swing short for Hurricane Helene briefings (CNN)Kamala Harris's economic policy slate more popular than Trump's – poll (The Guardian)The Incredible Ruling Striking Down Georgia's Anti-Choice Law (MuellerSheWrote.com)Fed Chair Powell says the US economy is in ‘solid shape' with gradual rate cuts coming (AP News) Check out other MSW Media podcastshttps://mswmedia.com/shows/Subscribe for free to MuellerSheWrote on Substackhttps://muellershewrote.substack.comHave some good news; a confession; or a correction to share?Good News & Confessions - The Daily Beanshttps://www.dailybeanspod.com/confessional/From The Good NewsList: Ways to donate and help flood victims in Western North Carolina after Hurricane Helene (BPR.org)BeLoved Asheville (belovedasheville.com)CatsOnACouch (Instagram)Online Passport Renewal (state.gov)VA Eastern Colorado health care (va.gov)Sjogren's syndrome Information (mayoclinic.org)Kris Kristofferson - "Sunday Mornin' Comin' Down" [Live from Austin, TX] (YouTube)Tony and Olivier Award Winner Gavin Creel Passes Away at 48 (broadwayworld.com)Check out the first 2 episodes of Trump's Project 2025: Up Close and Personal.https://trumpsproject2025pod.com/A Special Excel Training From Generation Data for Daily Beans Listeners!Saturday, October 12 · 10am - 1pm PDTgenerationdata.org/daily-beansCheck Your Voter Registration!vote.orgThere is a new “Harris For President” Patreon tier:https://www.patreon.com/muellershewrote/membership Check out other MSW Media podcastshttps://mswmedia.com/shows/Subscribe for free to MuellerSheWrote on Substackhttps://muellershewrote.substack.com Follow AG and Dana on Social MediaDr. Allison Gill https://muellershewrote.substack.comhttps://twitter.com/MuellerSheWrotehttps://www.threads.net/@muellershewrotehttps://www.tiktok.com/@muellershewrotehttps://instagram.com/muellershewroteDana Goldberghttps://twitter.com/DGComedyhttps://www.instagram.com/dgcomedyhttps://www.facebook.com/dgcomedyhttps://danagoldberg.comHave some good news; a confession; or a correction to share?Good News & Confessions - The Daily Beanshttps://www.dailybeanspod.com/confessional/ Listener Survey:http://survey.podtrac.com/start-survey.aspx?pubid=BffJOlI7qQcF&ver=shortFollow the Podcast on Apple:The Daily Beans on Apple PodcastsWant to support the show and get it ad-free and early?Supercasthttps://dailybeans.supercast.com/OrPatreon https://patreon.com/thedailybeansOr subscribe on Apple Podcasts with our affiliate linkThe Daily Beans on Apple Podcasts

Have you ever been told your pain is "just medical student anxiety?" Or faced a diagnosis during a stressful time like medical school? This week, we're diving into the experience of medical student and advocate, Stephanie Moss, and how she navigated chronic illness, medical gaslighting, and even a leave of absence from her medical education. In this episode, Dr. Kara Wada sits down with Stephanie Moss, a fourth-year medical student and advocate, to discuss her journey with chronic illness, navigating medical school with a diagnosis, and how she found strength and confidence in her resilience. Stephanie shares her experience with medical gaslighting, the importance of finding support and advocating for yourself, and how her leave of absence from medical school, while challenging, ultimately empowered her to develop valuable tools and strategies for managing chronic pain. EPISODE IN A GLANCE00:39 Meet Stephanie Moss: Trauma-informed Advocate and Activist03:01 Stephanie's Chronic Illness Diagnosis and Perspective Shift04:55 Medical Gaslighting and Power Dynamics in Healthcare08:20 The Power of the Placebo Effect and Human Connection09:20 Failing a Major Exam and Advocating for Accommodations13:30 Taking a Leave of Absence and Overcoming Challenges18:29 Tools for Managing Chronic Pain20:42 Reframing Exercise as a Practice of Love and Kindness22:56 Advice for Students Facing Similar Challenges25:00 Becoming Immune Confident: Building Confidence in Body and Resilience26:59 Connect with Stephanie Moss ABOUT STEPHANIE MOSS, MDStephanie Moss is a trauma-informed advocate, health disparities activist, Endometriosis and Infertility warrior, and a 4th year Medical Student pursuing her Medical Doctorate (M.D.) at Rush Medical College in Chicago. Through her lifelong dedication to diversity, health equity, inclusion, and accessibility (DEIA) she has striven to be a voice for marginalized communities. She is a part of the Family Medicine Leadership Program (FMLP), TightLipped medical team, is on the Infertility Committee at American Medical Women's association (AMWA), and serves on the International Society of Study of Women's Sexual Medicine (ISSWSM) Advocacy committee. During COVID she co-founded the Chicago Homelessness and Health Response Group for Equity (CHHRGE). Stephanie shares her experiences through her narrative medicine writing and public speaking, with her work being featured on notable platforms such as MedPageTody, The Endometriosis Foundation, KevinMD, Doximity, and American Medical Women's Association (AMWA). CONNECT WITH STEPHANIE MOSS, MDWebsite → https://medpsycmoss.com/ LinkedIn → https://www.linkedin.com/in/stephanie-e-moss/ Instagram → https://www.instagram.com/medpsycmoss YouTube → https://www.youtube.com/channel/UC_Ypzlapvju3XZ-8rgjF8Vw Twitter → https://x.com/medpsycmoss ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfidentmd/ Podcast Instagram → https://www.instagram.com/becomingimmuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@immuneconfident SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health.

Basic knowledge of the common CNS manifestations of rheumatologic diseases and sarcoidosis is important. In the context of many systemic inflammatory diseases, CNS disease may be a presenting feature or occur without systemic manifestations of the disease, making familiarity with these diseases even more important. In this episode, Kait Nevel, MD speaks with Jennifer A. McCombe, MD, author of the article “Neurologic Manifestations of Rheumatologic Disorders,” in the Continuum® August 2024 Autoimmune Neurology issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. McCombe is an associate professor in the Division of Neurology, Department of Medicine at the University of Alberta, Edmonton in Alberta, Canada. Additional Resources Read the article: Neurologic Manifestations of Rheumatologic Disorders Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Guest: @Div_Dubey Transcript Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology.  Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME.   Dr Nevel: Hello. This is Dr Kait Nevel. Today, I'm interviewing Dr Jennifer McCombe about her article on neurosarcoidosis and neurologic involvement of rheumatological disorders, which appears in the August 2024 Continuum issue on autoimmune neurology. Welcome to the podcast, and I would love to have you introduce yourself to the audience.   Dr McCombe: Well, thank you, and thank you for having me. As you said, my name is Jen McCombe. I'm a neurologist in Edmonton, Alberta, Canada, where I spend kind of a third of my time in teaching roles (I coordinate the undergraduate block for our medical school there), I spend about a third of my time in a neuroinflammatory clinic in Edmonton, Alberta, and then about a third of my time doing clinical research.   Dr Nevel: Wonderful. Well, thank you so much for being here today and for chatting with me about your article on this topic.   Dr McCombe: Thank you for having me.   Dr Nevel: To start off, can you share with the listeners a little bit about your career path?   Dr McCombe: Absolutely. Yeah. So, I've had, uh, a bit of a circuitous career path. I did my medical school in Queens (which is in Eastern Canada, in Kingston, Ontario) and then went back to Edmonton, Alberta, for my residency (in Canada, we have a five-year residency program, so a little bit different than the US), but finished my residency and then did a master's degree in Public Health at Johns Hopkins while completing clinical research in HIV, actually, and did this thing we call the Clinical Scholar Training Program – so, kind of like a fellowship, but a little bit more, you know, research and academic-based. So, when I first started, I was focused more on neuroinfectious diseases, and that's kind of what my career path looked like at the time - but, actually, shortly after I finished my residency program, I also had my first child, and he, unfortunately, developed opsoclonus-myoclonus syndrome, and at the time (this was in 2010), it was a rather rare condition, so, I ended up finding myself having to become a bit of a neuroinflammatory disease specialist at the same time. So, at that point, I transitioned into working in the neuroinflammatory clinic with some mentorship but was getting all of the kind of weird and wonderful referrals and diagnostic dilemmas from my colleagues who recognized I kind of developed some expertise, and so decided (actually, mid-career) to take a sabbatical, and in 2021, completed a fellowship in autoimmune neurology at the Mayo Clinic. So, I finished that quite recently and then went back, and now I'm feeling much more, I guess, confident, too. Sometimes, you wonder about, you know, the choices you're making. I recognize most of the conditions I'm dealing with don't have, in fact, any evidence for their treatment, and that was confirmed when I went to the Mayo Clinic and found that, really, it was just trying to gain an understanding of the disease process to make a rational choice to medications and treatments. So, now, I'm back and kind of trying to focus a little bit more on some clinical research in that area since I've kind of solidified that expertise.   Dr Nevel: Wow. Well, thank you for sharing with us your career path and how, you know, unexpected life events kind of changed your interests or molded your interests (changed kind of the things that you became expert in, you know), and being fluid in your career path and willing to kind of take a break and reassess and get additional training. That's really inspiring to, I think, to me, and probably to a lot of listeners, that you can always, you know, develop more expertise in the more niche area or additional area no matter where you are in your stage of life or career path.   Dr McCombe: Yeah.   Dr Nevel: So, can you tell us a little bit more about - you know, you shared with us kind of autoimmune inflammatory disorders and how you became interested in that, neurosarcoidosis, specifically (you know the article focuses on that), and what's your background in neurosarcoidosis, how you became interested in that specifically and in neurologic manifestations of rheumatologic disorders?   Dr McCombe: I started in our neuroinflammatory clinic over a decade ago, and, you know, at the time, a lot of the expertise in any of these neuroinflammatory disorders was quite spread out over the country, and so, as I kind to alluded to before, often some of the more complicated patients where there wasn't necessarily clear-cut evidence or even, you know, a fellowship path to get there, I would end up getting referrals for - and so, I developed quite a cohort of patients with central nervous system primarily, but other types of neuroinflammatory and autoimmune neurologic diseases, and part of that cohort was a rather large (and still growing) group of patients with neurosarcoidosis. And so, I kind of developed some practical expertise, although, as you can see in the article (and as I'm sure you all know), the approach to the treatment is extremely variable. One of the most telling things is when we were at the Mayo Clinic, one of my co-fellows actually pulled all of the neurologists in neuroinflammation at all of the Mayo Clinic sites and asked them, you know, what is your treatment approach to a patient with neurosarcoidosis, and I think got twelve completely different responses as to the medications chosen and the length of time for the tapers and things like that. So, you know, it is very much a part of neurologic disease treatment that we still really don't have great evidence for, and although we do have some kind of rational choices that we can make based on other types of evidence, so -   Dr Nevel: Yeah.   Dr McCombe: And I enjoy working with patients with these types of diseases where we can kind of work together to come up with a treatment plan that makes sense for them and also makes sense based on whatever evidence we do have at this time.   Dr Nevel: Yeah. So, moving on to the article a little bit, knowing that this is a area of neurology where there's a lot of, you know, maybe personal expertise and experience but not a ton of data or evidence to necessarily guide our standardization to our treatments and approach, what do you think is the most important clinical takeaway from your article for our listeners?   Dr McCombe: Well, I mentioned before I coordinate the neuro block for our undergraduate program here, so I've developed over the years (I've been doing that for a number of years) a curriculum that's all based on, kind of, that approach to - and I like to do it that way because it's very practical. I like the students to be able to basically take their class notes and then go to the emergency department on their first shift as a clerk and, you know, use their approach to headache that I've developed for them to kind of take a clinical history and examine a patient with that sort of problem. And so, similar to that, I tried to do an approach to, you know, a couple of the more common presentations that would make you think of a rheumatologic condition or neurosarcoidosis in looking at the approach to CNS vasculitis and the approach to, uh, pachymeningitis - and these are difficult differentials for lots of neurologists, because it really relies on a lot of medicine knowledge, and we graduate from our residencies slightly more confident in our medicine knowledge, because we get a lot of that in our residencies. But as neurologists, as we go through our careers, we get much more confident in our areas of specialty, and at least for myself and many of my colleagues, much less confident in other things like general medicine. And so, it's difficult, because you have to face your areas of potentially less confident knowledge and really think about that in the differential - and so, I think, you know, I put those two big “approach to” sections in there, because they're the most relevant for the conditions that I was covering. But, I think also what I would say to a learner or a more experienced neurologist who might be reading the article, kind of pick out the little things that you might add to your own kind of approach to - you know, when you see that person with an ataxia, remember that Sjogren syndrome is one of the things you might consider that could be a treatable cause, or you want to see a sensory neuronopathy, don't just think paraneoplastic – again, Sjogren syndrome. So, kind of pick out those little pearls and add them to your approach to that patient that we all see, and I think that would be my biggest takeaway.   Dr Nevel: Yeah. Thank you. So, kind of like, keep this information from the article in mind so that you keep rheumatologic disorders in mind as a possibility when you're approaching a patient with whatever neurologic symptoms they're presenting with. So, what do you think is challenging? You kind of already mentioned a little bit, you know, just that it stretches us maybe into the medicine arena and so maybe stretches our medical knowledge, especially as we become more subspecialized or focused in neurology - but what is challenging about identifying, diagnosing neurologic symptoms as being related or due to an underlying rheumatologic disorder?   Dr McCombe: Absolutely. Yeah. Well, as you said, you know, it forces us to kind of face that medicine stuff that we might not be as comfortable with, but I think what else is challenging is that, sometimes, those medical clues aren't there. For the rheumatologic disorders for the most part, they are. Sjogren's is potentially a little bit different in that, potentially, the symptoms are less obvious or a little bit more subtle. But, in particular, with neurosarcoidosis, there's a distinct proportion of the patients that won't, in fact, have any systemic complications of their underlying disease, and so, you have to think about it even when the clues aren't there. That's why you have to add it to those kind of differential diagnoses where it might be considered, because those systemic clues that we all rely on when we do our review of systems and we ask about rashes and joint pain and lung issues, and these sorts of things may not be there - and so, you still have to think about it even when it might be completely isolated to the central nervous system.   Dr Nevel: What is our understanding of why some patients with rheumatologic disorders develop neurologic involvement? Do we have an understanding? Do we know why some patients do and some patients don't? I know that's, you know, kind of, uh - that's a tough question, but that was something that I thought of as I was reading your article, like, why does this happen to some people?   Dr McCombe: Absolutely. I mean, I think, potentially, it's a little bit more clear for some of them, like rheumatoid arthritis, because, typically, if you develop a CNS complication of this, it's, in fact, just because you've had the disease for a very long time, and often, it's uncontrolled, and so you think about the disease “spreading” now to the central nervous system - but for other conditions, like neurosarcoidosis, it is much less clear, and even if you look at the epidemiologic patterns for that, it makes it even more muddied in that in some populations, it appears that they develop more central nervous system disease, whereas in others, less. And so, why that is the case and why certain individuals might develop this complication of these diseases I think is yet to be seen.   Dr Nevel: Yeah, that's always the crux of things if we can figure out the why, then maybe we could prevent it, right?   Dr McCombe: Million-dollar question always.   Dr Nevel: Always. So, what do you find the most intriguing about neurologic involvement of rheumatologic disorders?   Dr McCombe: Well, I think one of the things that, really, I mean, for neurosarcoidosis in particular, so many patients do so well, and that's what I really like about it. You know, you see patients who present with an incredible burden of disease radiologically, and yet, don't look nearly as sick as they should when they're sitting in front of you. And then, you start them on therapies and some of them do so well, and even those with relatively devastating deficits, or moderate disease who do have neurologic symptoms, have a remarkable improvement in their neurologic symptoms with treatment. And so, that's always something that's quite rewarding when you get to see these patients in follow-up, and they're generally quite thankful because they're doing so well. And it's different from many of the neurologic diseases that we treat. I mean, in autoimmune neurology, we're lucky because we do have a number of diseases that are quite treatable and patients can have wonderful outcomes. But, you know, it's always scary when we see patients with devastating neurologic signs and it's great to see improvement with treatment. And so, that really draws me to it.   Dr Nevel: Yeah, absolutely. That's really rewarding when you're able to help somebody get better in such a profound way.   Dr McCombe: Mm hmm.   Dr Nevel: What is one common misconception about neurologic manifestations of rheumatologic disorders? Or what do you think is not well understood by treating clinicians?   Dr McCombe: I think probably one of the things I see the most is, sometimes, an undertreatment of the patient. And so, I see patients who, you know, other clinicians may have seen and have made the diagnosis, and perhaps it's a lack of confidence in the diagnosis and so they kind of want somebody else with a subspecialty to kind of confirm the diagnosis, but that treatment hasn't been initiated despite pathological confirmation on biopsy of another tissue. And these patients, like I alluded to before, they do well, but you need to treat them and you need to treat them adequately, and when their symptoms are quite impairing, you need to treat them adequately now. And so I think, sometimes, that delay in starting a second-line therapy and relying on steroids for too long - those sorts of things can really expose a patient to a lot of different side effects and to a lot of different complications that they may not have had, too. So, that's why I spent some time focusing on the treatment, because I think just gaining a little bit of comfort with some of these more common second-line medications is a good thing, because starting those early, I think, makes sense because you can really save the patient a lot. And then, the other thing, too, is that when you're using steroids, think about all of the systemic things that you're causing - think about the increased risk of infection and the fact that you need to prophylax for certain infections, think about bone health, think about protecting the lining of someone's stomach - so not only kind of thinking about your disease in isolation and what you need to do for treatment, but that you need to ensure that you're appropriately prescribing the patient all of the things they need to do to protect themselves during these times.   Dr Nevel: Yeah. I think that's so important. And I'm glad that you brought that up, because I think, unfortunately, many of us have seen a patient who ended up having PJP pneumonia (or something like that) because they weren't put on antibiotic coverage for prolonged steroid use or, you know, bone health - all of that is really important to think about. So, this may be entering a territory where there's no, you know, great evidence, but you mentioned, you know, starting kind of that maintenance or second-line agent - when do you decide to do that in patients? And maybe we can focus (since it gets a little broad), but, you know, in a patient with neurosarcoidosis, let's say - when you're starting the steroids, when do you decide, okay, this person is also going to need a maintenance therapy? Is that something that you do at the beginning when you're starting the steroids, or is that something that you think about later on depending on how their course goes?   Dr McCombe: Yeah. In my practice, I do it at the outset - again, because I'm quite focused on, you know, as soon as I get them on it, getting people off steroids - and so I start essentially almost all of my patients on it unless there's some other contraindication or complication to their disease. And because I deal with central nervous system complications in the vast majority of my patients, I'm starting a TNF-a inhibitor as well as methotrexate, and that's because I see a lot of patients with cord disease and significant brain disease, and so I want to treat them kind of more aggressively from the outset. And so, typically, they'll be on steroids, um, a TNF-a inhibitor, as well as methotrexate, and then I just back off, actually, as they do well. And so, I try to taper the steroids quite quickly over the course of just a number of weeks, or kind of two to three months at most. I maintain the TNF-a inhibitor, and then in some patients, depending on how they're doing, I might eventually stop the methotrexate. Some patients tolerate it so well that we don't for a number of months - other patients want to try to minimize their medications as quick as they can. So, that's my personal practice. In the province where I live, we don't have to worry about access to these medications, and so I understand that that might be an issue in some centers where people practice and have different access and different funding. Of course, I live in a country where we have universal healthcare, and in our province, I have very good access to these medications and they're funded from my patients regardless of socioeconomic status, and so I have the luxury of making these choices and I understand that other people might not, but that's my personal practice and I find it works quite well in the vast majority of patients.   Dr Nevel: Yeah. And you bring up a really good point that, you know, access to some of these medications for patients with CNS manifestations of sarcoidosis, neurosarcoidosis, sometimes can be challenging to treating the patient with medications that you feel like would be best for them. But that's wonderful that you don't have those access issues where you live. How long do you typically continue the TNF-a inhibitor in patients, since you mentioned, you know, tapering off the steroids, tapering off the methotrexate, potentially depending on patient tolerance and course. What's your approach to the TNF-a inhibitor?   Dr McCombe: Yeah, so, of course I follow them clinically, and then radiologically as well, and it's really satisfying if you can see the resolution of their symptoms as well as resolution of the abnormalities and the MRI, so I let that guide me a little bit. But, in most patients, I keep them on therapy for about one to two years, and then at that point, see if I can cease it in some patients. And I, again, continue to follow them radiologically and clinically after I cease it so that I can ensure that I'm catching their disease more quickly if it does come back and then can just reinitiate therapy, but in lots of patients you're able to stop the medication and they have persisting, kind of, disease freedom after that, and so they don't need to be on anything.   Dr Nevel: Yeah, great. And I'm almost hesitant to focus so much on neurosarcoidosis. (It was the rheumatologic manifestation that you talked about the most in your article.) I'm going to put in a plug for everybody to read your article so that they can read about neurologic manifestations of rheumatoid arthritis, Sjogren's, lupus, Behcet's - many more things. But focusing on neurosarcoidosis, it can be difficult in my experience to definitively diagnose, and people who have neurosarcoidosis particularly, and people who don't seem to have any systemic manifestations or, you know, imaging findings consistent with sarcoidosis - can you share your approach with us? And you outlined this in your article nicely, too, but your personal approach to patients with suspected neurosarcoidosis, and how you make that clinical decision to treat somebody with possible neurosarcoidosis, somebody who maybe you're not able to get pathologic evidence on?   Dr McCombe: Absolutely. Yeah, those ones are difficult. And, you know, whenever possible (as I mentioned in my article), I think pathological evidence of a diagnosis is important, because then when you find yourself a year down the road and a treatment path and you have uncertainty, it's much more difficult to consider continuing medications that can have quite a number of side effects when you're not absolutely certain about that diagnosis. But, in some patients, you know, I've had patients who might have nondiagnostic biopsies (if you attempt to do a biopsy), or they have disease in a site that really just isn't amenable to biopsy, or they have some other reason they can't have a biopsy. So, how I approach that is that, you know, if you think about possible neurosarcoidosis similar to any other nondiagnosed, you know, blow out-like lesion (for lack of a better term) in the CNS, if it's steroid-responsive, I think that kind of going down a path of treating it as a steroid-responsive lesion is kind of the approach that I take - so the diagnosis in the chart might be possible neurosarcoidosis, but in the back of my mind, I'm just thinking of kind of a steroid-responsive nondiagnostic or idiopathic lesion. So, I then follow that up typically with something like methotrexate (so, a more broader- spectrum immunosuppressant-type medication), and if the methotrexate is able to maintain the response that the steroids initiated, then eventually get them off the steroids. And so, you know, if I think about my patients that I've treated in the past, if they have a diagnosis of possible neurosarcoidosis, I probably don't start a TNF-a inhibitor as quickly in them, because in the back of my mind, I'm always wondering what type of inflammatory lesion this is, but that steroid responsiveness really helps me decide to start a second-line or maintenance therapy and then, typically, in those patients, as I mentioned, I'll start something like methotrexate a little bit more soon.   Dr Nevel: Yeah, great. Thanks for sharing that with us. So, what do you think comes next in this field? What excites you? Where do you think our next kind of development or understanding or breakthrough, whether it's diagnostic or treatment-wise?   Dr McCombe: I think, in the field, you know, any immunologic diseases, we've been really gaining a much better understanding of pathophysiology, and that's honestly what excites me the most, when you can know precisely what part of the immune system is at play here (whether it's, you know, complement-mediated or antibody-mediated) and then being able to then rationally choose medications based on a really clear understanding of the disease is something that I think is kind of novel in a way. For so many years, we would use kind of big broad-spectrum immunosuppression - even in multiple sclerosis, still, we use medications that, historically, we've found to be helpful - but we don't have a great understanding sometimes of why the medicines work. So, kind of going at it from the other way, where we're actually determining what is the exact pathophysiology of disease and then making a rational approach to a therapy, or choosing a therapy based on that, I think is what excites me the most, and I think we'll gain a better understanding of even a broader swath of diseases and be able to make those choices more often. That's what I like about this field.   Dr Nevel: Great. Well, thank you so much for sharing that - and looking forward to the future in this area of neurology. And thanks so much for talking with me today and sharing your story and your expertise and knowledge.   Dr McCombe: Well, thank you for having me. It's been fun.   Dr Nevel: And I encourage all the listeners to read your article. Again, today, I've been interviewing Dr Jennifer McCombe, whose article on neurosarcoidosis and neurologic involvement of rheumatologic disorders appears in the most recent issue of Continuum on autoimmune neurology. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today.   Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at Continpub.com/AudioCME. Thank you for listening to Continuum Audio.

Did you know that air pollution can increase the effects of allergies threefold? Imagine a world where you could paint your way to cleaner air. Dr. Kara Wada sits down with Dr. Tanya Rogers, a NASA engineer with a passion for sustainability, to discuss her journey from space exploration to launching a company dedicated to carbon capture. Dr. Rogers shares her story of navigating a demanding career path while also facing chronic health challenges, inspiring listeners to embrace acceptance and prioritize self-care. We explore the link between climate change and our immune health, highlighting the critical role of individual action in creating a healthier future. EPISODE IN A GLANCE00:00 Introduction to Dr. Tanya Rogers, NASA engineer and CEO of The People's CO202:52 The connection between climate change and immune health04:11 Balancing the demands of entrepreneurship with chronic illness06:56 The unexpected ways Dr. Rogers' health journey has impacted her leadership09:43 Staying motivated through challenging work12:54 The long-term goals for The People's CO213:55 The power of starting small and making safer swaps16:20 The importance of collective action and finding your genius zone21:05 How to connect with Dr. Rogers and support her work22:00 Dr. Rogers' perspective on becoming immune confident ABOUT DR. TANYA ROGERSDr. Tanya Rogers is a NASA engineer and co-founder of The People's CO2, a woman-led started focused on fighting climate change through citizen empowerment. CONNECT WITH DR. TANYA ROGERS & THE PEOPLE'S CO2Website → https://www.thepeoplesco2.com/ Instagram → https://www.instagram.com/peoplesco2 Facebook → https://www.facebook.com/profile.php?id=61565170804108 ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfident/ Podcast Instagram → https://www.instagram.com/becomingimmuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@immuneconfident SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health.

One of the hardest part of trusting God is leaving room for the mystery of God.How can we continue to faithfully follow Him when we are struggling to see evidence of His goodness in our story?In this episode, Lysa TerKeurst discusses the truths inside her new book, I Want to Trust You, but I Don't, with her friend Brittany Sjogren.Related Resources:We don't have to let the one who broke our trust break us. Sign up to receive “When the Person Who Hurt You Got Away With It: 3 Days to Moving Forward,” a FREE resource by Lysa TerKeurst, today!Get your copy of Lysa TerKeurst's new book, I Want to Trust You, but I Don't: Moving Forward When You're Skeptical of Others, Afraid of What God Will Allow, and Doubtful of Your Own Discernment, from the P31 Bookstore.You can stay connected with Lysa TerKeurst on Instagram at @LysaTerKeurst and Brittany Sjogren at @LoverlyGrey.Click here to download a transcript of this episode. Proverbs 31 Ministries is a nonprofit organization, and this podcast is funded thanks to the generous support of our one-time and monthly donors. To learn more about how to partner with us, click here!We want to hear how this podcast has impacted you! Share your story with us here.

Nearly 300,000 breast augmentations are performed annually in the United States, and  25% of these women will go on to develop Breast Implant Illness. My next guest is Penny Treese, an extraordinary woman, mom, wife, artist, and workshop facilitator.  Penny spent two decades suffering from breast implant illness. During today's episode of THLZ, she shares her unimaginable story. Breast Implant Illness (BII) is a syndrome that includes a constellation of symptoms driven by a systemic inflammatory immune response occurring in women who have had breast augmentation.  Common Breast Implant Illness Symptoms that can manifest within weeks, months, or years after receiving breast implants:  Joint & Muscle Pain • Fatigue • Brain Fog • Rashes & Skin Issues • Anxiety • Depression •  Mood Swings • Food Sensitivity • Allergies • Autoimmune Disorders • Cancer Dr Lillian Schapiro, gynecologist and dear colleague, referred Penny to my clinical practice.  It took her nearly 6 months to finally contact me.  That one phone call changed her life forever, as well as mine.  Every aspect of Penny's health was in rapid decline, and in her own words, "Meg, I would have died in a few months if I didn't make that call and start working with you."  During our first session, I referred her to Dr David Brothers, an amazing explant surgeon located here in Atlanta.   Penny suffered for over 20 years with Breast Implant Illness (BII). Her symptoms of fatigue and Raynaud's syndrome developed within months of her breast augmentation. By the time Penny came to see me, she had depilating joint and muscle pain, a diagnosis of connective tissue disease that included Sjogren's syndrome, brain fog, and cognitive decline– so severe that she couldn't remember how she drove to our appointment.  I am honored to have Penny share her BII journey. She displays tremendous honesty, and vulnerability  coupled with immense grace and courage as she tells her story. This journey also includes our 9 months of working together and peeling back the onion that has helped her recover and reclaim her life.   Sweet Lovelies, If you haven't already, please subscribe on SPOTIFY OR ITUNES. You can also watch episodes on MY YOUTUBE CHANNEL.

In this episode, our co-hosts bring you an exclusive look into the AiArthritis “Go With Us!” to Conferences program. We dive deep into EULAR 2024, the European Rheumatology Research Conference, where patients and co-hosts reveal groundbreaking advancements in AiArthritis research. Discover the latest on CAR-T therapy, innovative pain management tailored for patients, the role of opioids in addressing pain and fatigue, and practical strategies for battling brain fog. Gain valuable insights and practical advice from fellow patients and experts. Don't miss this episode packed with cutting-edge information!   If you're eager for more, join us for our next journey to the ACR conference in November. Visit AiArthritis.org/conferences for more details and to sign up! Episode Highlights Overview of the Go With Us to Conferences program, which allows patients to virtually join and learn from major rheumatology conferences like EULAR and ACR.  Tiffany, CEO and person living with non-radiographic axial spondyloarthritis, discusses CAR-T therapy and its potential to achieve remission in autoimmune diseases, particularly in lupus patients. Deb, AiArthritis volunteer and person living with rheumatoid arthritis, presents on patient-tailored pain management, emphasizing multi-dimensional approaches to address different types of pain. Becky, AiArthritis volunteer and person living with Sjogren's Disease, explores the relationship between fatigue, pain, and opioids, highlighting the challenges of treating these symptoms in autoimmune patients. Leila, AiArthritis Health Education Manager and person living with Lupus Nephritis and Sjogren's Disease, covers cognitive dysfunction (brain fog), offering strategies for managing this common but under-discussed symptom in autoimmune diseases. Volunteer with AiArthritis : https://bit.ly/AiArthritisVolunteerApp Donate to Support the Show: https://www.aiarthritis.org/donate  Follow AiArthritis on all social media platforms @IFAiArthritis Sign up for our Monthly AiArthritis Voices 360 Talk Show newsletter! HERE   Resources & Links: Join the Go With Us Program for ACR in November: https://aiarthritis.org/conferences Connect with our Co-Hosts: Tiffany is the CEO at AiArthritis (International Foundation for Autoimmune & Autoinflammatory Arthritis) and uses her professional expertise in mind-mapping and problem solving to help others, like her, who live with AiArthritis diseases work in unison to identify and solve unresolved community issues.   Leila is the Health Education Manager at the International Foundation for AiArthritis. She is a person living with Lupus Nephritis and Sjögren's Syndrome. She is passionate about inclusion and diversity in health education and meeting individuals where they are at in order to learn in a way that resonates with them.    Deb Constien is a medically retired Registered Dietitian and a Representative for AiArthritis with Rheumatoid Arthritis. Deb is also on the Advisory Council for WREN- Wisconsin Research Education Network and a Patient Family Advisor- PFA on an International PCORI research study for ACP- Advanced Care Planning.   Becky Hosey is an AiArthritis volunteer, a healthcare professional, and also a person living with Sjogren's disease.

In this conversation, Dr. Isabelle Amigues discusses the treatment of Sjogren's syndrome. She shares several patient cases to illustrate different treatment approaches. The goal of the episode is to provide insights into how rheumatologists think when treating Sjogren's syndrome. Dr. Amigues emphasizes the importance of achieving remission and preventing further damage. She discusses the use of immunosuppressive agents, such as Plaquenil and Rituxan, based on the severity of symptoms. She also provides recommendations for managing dry eyes and dry mouth, as well as addressing fatigue and fibromyalgia symptoms. Dr. Amigues concludes by highlighting the importance of regular dental, ophthalmologist, and neurologist visits for Sjogren's syndrome patients.This episode comes from Dr. Amigues' educational YouTube channel,  Rheumatology101! Check it out and subscribe so you don't miss a new live stream every Tuesday at 11AM.________________________________________________________________________________________________Join the community and follow UnabridgedMD on social media!Instagram: @unabridgedmdFacebook: @UnabridgedMDTiktok: @unabridgedmdIf you live in Colorado and are looking for a rheumatologist to help you achieve disease remission, email or contact us at UnabridgedMD.com. We are the first direct care rheumatology in Colorado and can see you within a week!Click here to get in touch: https://www.unabridgedmd.comOr give us a call: 303-731-4006

We all know that movement is essential for health, but what if you're dealing with chronic pain? Many people feel limited, even discouraged, from embracing movement because of fear or past experiences.But what if that even with chronic pain, movement can be a source of joy and empowerment? In this week's podcast episode of the Becoming Immune Confident Podcast, Dr. Kara Wada had the pleasure of speaking with DK Ciccone, a certified Pilates instructor and author of "You're Meant to Move," who shares her personal journey of navigating chronic back pain and reclaiming her love of movement.DK emphasizes that our bodies are designed to move, and even with pain, we can find ways to engage in activities that bring us joy and support our well-being. She encourages us to shift our perspective on pain, exploring the role of the nervous system and how we can foster a deeper connection with our bodies.DK's inspiring message reminds us that movement is not just about achieving a certain aesthetic, but about cultivating a deeper sense of agency, self-compassion, and resilience. EPISODE IN A GLANCE01:40 DK Ciccone's Personal Journey with Chronic Pain04:35 The role of body image and diet culture in shaping our relationship with pain07:36 Unhelpful Messages and Misconceptions About Pain10:38 The Impact of Dismissive Medical Advice12:58 Holistic Approach to Pain Management17:53 Building Resilience and Managing Pain Flares24:45 Pain Reprocessing Therapy and Somatic Tracking28:39 Finding Joy in Movement30:49 Core Message of the book 'You're Meant to Move'33:07 Conclusion and How to Connect with DK Ciccone ABOUT DANA KAREN (“DK”) CICCONEDana Karen (“DK”) Ciccone is a certified Pilates instructor who helps people in pain improve strength, mobility, and well-being in a weight-neutral environment. She's also trained in pain reprocessing therapy through the Pain Psychology Center. Having begun her own journey with chronic back pain as a young teen, she has been exploring ways to help herself and others regain joy of movement for decades. After twenty years in the health sector, DK left a corporate career to follow her passion, later launching Movement Remedies, a chronic pain–focused Pilates studio in Boston, Massachusetts. Her first book, You're Meant to Move: A Guide to Conquering Chronic Pain, Increasing Stress Resilience, and Reclaiming an Active Life, was released December 2023. CONNECT WITH DANA KAREN (“DK”) CICCONEWebsite → https://movementremedies.org LinkedIn → https://www.linkedin.com/in/dana-karen-ciccone Instagram → https://www.instagram.com/movement_remedies/ Facebook → https://www.facebook.com/movement.remedies.llc/ YouTube → https://www.youtube.com/@movementremediesllc Pick up a copy of DK Ciccone's book, "You're Meant to Move: A Guide to Conquering Chronic Pain, Increasing Stress Resilience, and Reclaiming an Active Life," available on Amazon. ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfident/ Podcast Instagram → https://www.instagram.com/becomingimmuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@immuneconfident SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health. JOIN THE 28-DAY Sjogren's Superpowers Activated Challenge: A Journey to Better Health and Unshakeable Confidence → https://www.drkarawada.com/sjogrens-28day-challenge

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Joanna: Hi Dr. Cabral, I hope this message finds you well and you're enjoying a beautiful summer! I've got two totally unrelated questions that I would love to get your take on: 1. Could you quickly explain what Sjorgren's syndrome is in your words, what could be causing it or what tests would help to find that out and what you would recommend if someone in your family suffered from that? 2. Could you see the drug industry investing more research into things like myostatin-inhibitors again to counteract the risks of muscle loss for people using GLP-1 agonists? Thanks for everything you do! Johann      Michael: Hey Steven, I haven't messaged in a long time I still have primary Addisons disease and take the regular hydrocortisone and fludrocortisone daily. I'm just after having an emergency shot of hydrocortisone because I have a gastro bug and I want to recover quickly. Have you any tips on this please? Just so tired of being scared to get sick with this illness.     Lisa: Does meat cause cancer specially like prostate cancer or any other cancer? Can you use diet to stop it without treatment? WIll a whole food plant base diet help it? Is it possible to get colon cancer within 2 years of having colonoscopy? Will a ct scan show it or pet scan?     Mindy: Hi! I enjoy listening to your podcast each day and really trust your advice. I was wondering if you've heard of or looked into the Jaspr air filter? It's more expensive than the air doctor and I'm wondering if it is really effective and worth the price. Thanks for all you do!     Pip: Hi Dr Cabral. I'm 35 and have been diagnosed with idiopathic cervical dystonia tremor. I've had it on and off for about ten years however this year it has got considerably worse and affects me daily in activities. The neurologist has referred me to another neurologist specialising in dystonia who will inject Botox into my neck muscle to relax it and stop the tremor. This is a three monthly treatment for the rest of my life. Apparently there is no cure but I'd like to think there is SOMETHING natural / alternative I can do to stop or reduce the tremor. I'd love to hear your suggestions? Thank you. Pip   Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right!   - - - Show Notes and Resources: StephenCabral.com/3124 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

We all know the importance of a strong immune system, but what if the key to unlocking your immune confidence lies within your gut? That's right, the health of your digestive system plays a crucial role in bolstering your immune defenses. In this episode, Dr. Kara Wada welcomes the brilliant Dr. Vivian Asamoah, a board-certified gastroenterologist specializing in functional medicine, to discuss the powerful connection between the gut and the immune system. Together, they talk about the science behind the gut-immune axis, explore common signs of an unhealthy gut, and discuss strategies for supporting gut health and overall well-being. Dr. Asamoah shares valuable insights from her practice, including a fascinating success story about a patient who overcame debilitating digestive issues through targeted treatment of a yeast overgrowth. Listen now and join us as we explore the fascinating world of gut health and its profound impact on our immune system! EPISODE IN A GLANCE-Gut Health Secrets for a Stronger Immune System-Dr. Asamoah's Journey from Conventional Medicine to Functional Medicine-The Gut-Immune System Connection Explained-Common Signs of an Unhealthy Gut-Navigating Food Sensitivities and Restrictive Diets-Understanding Food Intolerances and Elimination Diets-Exploring Additional Gut Health Challenges like SIBO, LIBO, and Yeast Overgrowth-The Importance of Integrating Traditional Medicine into Modern Healthcare-A Successful Case Study Involving a Patient with Severe Food Sensitivity and Candida Overgrowth-Building Immune Confidence through Diet, Lifestyle, and Stress Management-How to Connect with Dr. Asamoah on Social Media ABOUT DR VIVIAN ASAMOAH Dr. Vivian Asamoah is a board-certified gastroenterologist, hepatologist, and nutritionist with a passion for functional medicine. She completed her fellowship at Johns Hopkins University Hospital and is CEO of Houston Gastro Institute, where she has served the West Houston community for over a decade. Dr. Asamoah is a renowned speaker, educator, and patient advocate, sharing her expertise on the impact of diet and lifestyle on gut health through her popular "Natural Gut Relief" Facebook community and YouTube channel. She is also the host of the weekly Facebook show "Back to Basics," featuring prominent guest interviews. Dr. Asamoah's commitment to personalized, integrated care is evident in her practice, which focuses on addressing the root causes of digestive issues through a combination of conventional and functional medicine approaches. She is actively involved in clinical trials exploring cutting-edge therapies for gastrointestinal conditions. CONNECT WITH DR VIVIAN ASAMOAHLinkedIn → https://www.linkedin.com/in/vivian-asamoah-md-6258b694/ Instagram → https://www.instagram.com/drvivianasamoah/ Facebook → https://www.facebook.com/drvivianasamoah YouTube → https://www.youtube.com/channel/UCbmhQMF6VJyKrmCxFJyKIHA ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfident/ Podcast Instagram → https://www.instagram.com/becomingimmuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@immuneconfidentmd SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health.

In today's episode I'm joined by Dr. Kara Wada, a quadruple board-certified physician specializing in allergy, immunology, and lifestyle medicine. Dr. Wada shares her personal journey with Sjogren's syndrome and how it transformed her approach to patient care and understanding of autoimmune conditions.For the complete show notes and links visit inspiredliving.show/152

Today, we have a special guest, Jen Patenaude, a dedicated Sleep Wellness Advocate. In this episode, we delve into the critical role of sleep in achieving peak performance and overall wellness. Jen shares her insights on how busy executives and entrepreneurs can transform their sleep habits from a mere afterthought to a cornerstone of their success. About the Guest Jen Patenaude is the founder of Jennifer Eve Wellness. With a passion for guiding entrepreneurs and busy executives to their best selves, she specializes in transforming sleep from a mere afterthought to the cornerstone of peak performance and wellness. As a sleep and wellness coach, Jen has seen firsthand the power of restorative sleep in unlocking one's full potential. Her mission is to help driven individuals harness that power. Through personalized sleep strategies that slide seamlessly into a packed schedule. Beyond the coach, she's a mom, a wife, and your biggest cheerleader. When she's not decoding the mysteries of the circadian rhythm, you can find Jen snuggled up with her dogs, cheering on her kids at their sports games, or losing herself in a good book. Key Takeaways:-Understanding why sleep is a foundational aspect of health and wellness.-Jen's story of becoming a sleep and wellness coach after being diagnosed with Sjogren's syndrome and facing health challenges.-How sleep affects weight loss, brain health, and reproductive health.-Tips for creating an optimal sleep environment, include the importance of darkness, quiet, and a comfortable temperature.-How pets can impact sleep quality and what to consider for a restful night.-Get outside into natural sunlight within 10-15 minutes of waking up. This helps signal your body to start ramping up cortisol production, which is crucial for alertness.-Maintain a consistent bedtime and wake time to regulate your circadian rhythm, which might be more important than sleep duration for long-term health.-If you can't fall back asleep within 20 minutes, get out of bed to avoid associating the bed with stress.-Engage in a calming activity until you feel sleepy again.-Try the 4-7-8 breathing technique to calm your mind.-Set aside time in the evening to write down your worries, which can prevent them from disrupting your sleep.-Avoid heavy meals 2-3 hours before bed. If blood sugar issues cause you to wake up, try a small snack with protein and healthy fats before bed.-Mouth breathing during sleep can cause dehydration. Ensure you are well-hydrated throughout the day.-For those who mouth-breathe, taping your mouth can help improve nasal breathing and sleep quality. Connect with Jennifer-Learn more about sleep wellness on Jen's website:  https://jenniferevewellness.com/-Follow on Instagram: (@jenniferevewellness)- Connect on Linkedin:  https://www.linkedin.com/in/jennifer-eve-patenaude-276ba020/ Book a consultation today:I am always here to help answer any question and schedule a 15 minute call with me. If I can not help, I can get you to a provider that can.https://shereewertz.com/15-min

Have you ever felt like your body was working against you? Like your heart was racing, your brain was foggy, and you just couldn't seem to catch your breath? In this episode, Dr. Kara Wada welcomes back her friend and guest, Lauren Stiles, JD, President of Dysautonomia International and a research assistant professor of neurology at Stony Brook University School of Medicine. Lauren shares her personal journey with POTS, a form of dysautonomia, and discusses the challenges of diagnosis and treatment. She explains the complexities of the autonomic nervous system and why our current testing methods are limited in diagnosing dysautonomia. Dr. Kara and Lauren delve into the need for holistic approaches to manage these conditions, emphasizing the importance of anti-inflammatory diets and lifestyle changes. Lauren highlights the crucial role of patient advocacy and research in advancing understanding and treatment options for dysautonomia. They discuss the obstacles faced by researchers and clinicians in studying and treating these conditions and emphasize the need for more funding and support. EPISODE IN A GLANCE00:53 Lauren's Journey with Dysautonomia and POTS03:06 Understanding Dysautonomia and its different forms05:03 Common dysautonomia types like neurocardiogenic syncope (vasovagal) and POTS07:08 Limitations in diagnostic testing and the need for better biomarkers08:47 The missing pieces of autonomic nervous system testing13:29 The role of patient empowerment and holistic approaches to managing dysautonomia20:24 Dysautonomia International's mission and initiatives: education, research, and advocacy26:44 The challenges faced by researchers and clinicians in studying and treating dysautonomia30:57 Changing Minds and Confronting Medical Gaslighting37:07 How to Get Involved and Support Dysautonomia International ABOUT LAUREN STILES, JDLauren Stiles is a passionate advocate for individuals living with autonomic disorders. She serves as President of Dysautonomia International, a leading organization dedicated to supporting and empowering patients, while also holding a position as Research Assistant Professor of Neurology at Stony Brook University School of Medicine. Lauren's personal journey with POTS began at age 31, sparking a relentless pursuit of answers and ultimately leading her to a diagnosis of autonomic neuropathy caused by Sjogren's Syndrome. This experience ignited her commitment to raising awareness, improving research, and advocating for better healthcare for those impacted by autonomic disorders. A graduate of Stony Brook University and Pace University School of Law, Lauren brings a wealth of experience in both science and law to her work. She has served in leadership positions on numerous government councils, non-profit boards, and professional associations, utilizing her expertise to drive positive change. Lauren finds joy in her life on Long Island with her husband, her beloved Jack Russell Terrier, and a flock of six amusing chickens. CONNECT WITH LAUREN STILES, JD & Dysautonomia InternationalWebsite → https://dysautonomiainternational.org/ LinkedIn → https://www.linkedin.com/in/lauren-stiles-33810411/ Instagram → https://instagram.com/DysautonomiaIntl X/Twitter → https://x.com/Dysautonomia Facebook → https://www.facebook.com/DysautonomiaInternational/ ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfidentMD/ Podcast Instagram → https://www.instagram.com/becomingimmuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@immuneconfident SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health. The Virtual Sjogren's Summit: Gut Instincts for Sjogren's was a HUGE success! We had over 1,100 amazing people join us from all over the world. Didn't get a chance to join us live? It's not too late! You can still access all the recordings, transcripts, audio podcasts, and speaker bonuses with our $25 Full Access Ticket → https://www.drkarawada.com/offers/fhvzsDpx

In this episode, Dr. Linda Bluestein, the Hypermobility MD, delves into the intricate connections between the immune system and hypermobility disorders with Dr. Kara Wada. A quadruple board-certified physician and Sjogren's patient, Dr. Wada shares her expertise on mast cell activation syndrome, autoimmunity, and the role of inflammation. Discover holistic approaches to managing these conditions and gain valuable insights into the latest research and treatments. Don't miss the special hypermobility hacks at the end! Takeaways: Interplay Between Immune System and EDS: The immune system plays a significant role in hypermobility disorders, with conditions like mast cell activation syndrome and autoimmunity frequently seen in patients with EDS. Differences in Allergy and Mast Cell Activation: Allergy involves the immune system's memory of proteins, whereas mast cell activation syndrome can be triggered by various factors, often without the presence of traditional allergies. Inflammation's Role in Chronic Conditions: Chronic inflammation is a core issue in many modern diseases, including EDS and autoimmune disorders. It's the body's prolonged response to injury or infection that can lead to various health issues. Impact of Hormones: Hormones, particularly estrogen and progesterone, significantly influence immune system functioning and can affect conditions like POTS, often seen in EDS patients. Holistic and Lifestyle Approaches: Managing EDS and related conditions can benefit from holistic approaches, including anti-inflammatory diets, regular movement, adequate sleep, and stress management techniques such as meditation and journaling. Connect with YOUR Bendy Specialist, Dr. Linda Bluestein, MD at https://www.hypermobilitymd.com/.   This episode is sponsored by EDS Guardians. If you want to learn more, check them out here: https://www.edsguardians.org/    Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them.

Tired of your Sjogren's symptoms controlling your life, especially when it comes to gut issues? In this episode, Dr. Kara Wada continues her conversation with registered dietitian Cristina Montoya, who lives with both Sjogren's and rheumatoid arthritis. Together, they dive deep into actionable strategies for nourishing your gut and reclaiming your health when living with Sjogren's. Learn how the gut-Sjogren's connection goes beyond dryness, how to tailor your diet for optimal digestion, and lifestyle tips for managing symptoms and feeling your best. Plus, don't miss the exciting announcement about the 3rd Annual Virtual Sjogren's Summit! EPISODE IN A GLANCE-Understanding Sjogren's Impact on the Body: Beyond Dry Eyes and Mouth-Neurological Manifestations and Gut Health: The Gut-Brain Connection-Gastrointestinal Manifestations and Research: The Latest on Sjogren's and the Gut-Challenges in the Medical Field and Nutrition: Navigating Misinformation-Dietary Adjustments for Sjogren's: Gastroparesis and Beyond-Practical Tips for Gut Health: Plant-Based Foods, Hydration, and Meal Timing-Upcoming Events and Resources: Cristina's Blog, Webinars, and the Virtual Sjogren's SummitABOUT CRISTINA MONTOYALiving with both Sjogren's and RA, Cristina is a registered dietitian dedicated to helping you create a fulfilling life free from restrictive diets. She specializes in gut-healing strategies and making anti-inflammatory living both effective and enjoyable. CONNECT WITH CRISTINA MONTOYAWebsite → https://www.arthritisdietitian.com/ LinkedIn → https://www.linkedin.com/in/cristinamontoya/ Instagram → https://www.instagram.com/arthritisdietitian/ Facebook → https://www.facebook.com/arthritisdietitian/ X/Twitter → https://x.com/ArthrDietitian TikTok → https://www.tiktok.com/@arthritisdietitian ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfidentmd/ Podcast Instagram → https://www.instagram.com/becomingimmuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@immuneconfident SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health. JOIN THE 3RD ANNUAL VIRTUAL SJOGREN'S SUMMIT! REGISTER NOW AND GET YOUR FREE TICKET → https://www.sjogrenssummit.com/ A two-day online event dedicated to providing you with the knowledge, tools, and community you need to thrive with Sjogren's.

Dr. Armando Hernandez-Rey is Conceptions Florida's medical director and triple-board certified in Reproductive Endocrinology and Infertility; Obstetrics and Gynecology; and Surgery. Dr. Armando Hernandez-Rey has over 24 years of experience in the medical field. He graduated from Universidad Autonoma de Ciencias Médicas de Centro America in 1998. He attended medical school at the University of Miami Miller School of Medicine for his specialization in Obstetrics and Gynecology. He specializes in treating patients with polycystic ovary syndrome (PCOS), recurrent pregnancy loss (miscarriage), and severe endometriosis. He is especially interested in fertility preservation (eggfreezing) for patients who must delay childbearing for personal or medical reasons, including cancer and systemic lupus erythematosus. Dr. Hernandez-Rey is an assistant clinical professor at the Herbert Wertheim College of Medicine at Florida International University and serves as an ad-hoc reviewer for the prestigious peer-reviewed journal, Fertility and Sterility. He has also published several articles and chapters in medical literature.   Website https://www.conceptionsflorida.com Instagram https://www.instagram.com/conceptionsflorida/ Facebook https://www.facebook.com/conceptionsfl Tiktok https://www.tiktok.com/@conceptionsflorida     For more information about Michelle, visit: www.michelleoravitz.com   The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/   Instagram: @thewholesomelotusfertility   Facebook:https://www.facebook.com/thewholesomelotus/     Transcript:   Michelle (00:00) Welcome to the podcast, Dr. Hernandez -Ray.   Armando Hernandez-Rey MD (00:04) Thank you, Michelle. Thanks for the invitation. It's really an honor and a privilege to be on your show, on your podcast.   Michelle (00:09) Yes, well, I've heard a lot about you over the years because I've had a lot of patients go to you. And one of the things that I've heard is that you do really well with surgeries and fibroids and you're able to in and   but in a way that still preserves fertility. So that was one of the things that I've learned.   Armando Hernandez-Rey MD (00:32) Well, reproductive endocrinology and infertility as a subspecialty is a surgical subspecialty as is OB -GYN, which is a mandatory path to get to the infertility route. Unfortunately, a lot of the newer generation is not operating because they're not taught, not through no fault of their own, they're not taught. The reality is that it is...   Michelle (00:47) Mm -hmm.   Armando Hernandez-Rey MD (00:55) for a myriad of reasons this phenomenon has happened. Number one, the minimally invasive surgery tract has been developed where you have the person who's really just really perfected their obstetrical skills. And then you have the gynecologic oncology route and the pelvic urogynecology or pelvic reconstruction route and the minimally invasive surgical route. And a lot of the reproductive endocrinologists,   have said, you know what, I'm going to forego surgery and I'm going to refer it out. My personal philosophy, and this is in no way critical to absolutely anybody, it's just my own, is that I went into medicine to be a surgeon, I actually wanted to be an orthopedic surgeon. I ended up not liking it, I had a very bad fracture when I was in my teens playing competitive soccer, and I really had some PTSD from that fracture, so I just couldn't see myself doing   orthopedic surgery, but I somehow found my way towards OBGYN, absolutely loved it. And eventually towards the reproductive endocrinology route, which encompasses a lot of surgery, should you allow it. And so yes, like you said, fibroids are an important part of fertility. you, tubal reconstruction used to be much more important than it is now. People are more, are bypassing that route and going directly to in vitro fertilization.   Endometriosis, as I said, I was running a little bit late today. I was in a very, very complex endometriosis case with a patient with bilateral endometriomas and complete frozen pelvis and scar tissue. And, you know, just a little bit longer, I had to work with the colorectal surgeons to do some resection of the colon because it was, you know, endometriosis is such an awful, awful disease. So yes, to answer your question, I...   Michelle (02:41) Yeah.   Armando Hernandez-Rey MD (02:44) Absolutely love surgery. I think it's an integral part of the infertility journey to get a patient from being infertile to getting them to a high level of success with any sort of treatment. And hopefully it's more conservative than having to resort to artificial insemination or in vitro and with just surgery and corrective surgery, we can help the couple achieve a pregnancy.   Michelle (03:07) Yeah, and I think it's important because I think that a lot of people might not realize that there are certain people that specialize in this or have experience doing that, doing surgery and really getting in there because it is important to find somebody who's specialized if you have a complicated case.   Armando Hernandez-Rey MD (03:23) I think it's important. I think people feel well taken care of. Again, my perception, people feel well taken care of when everything is done in house. Meaning, you know, there's no messages that get lost as you refer a patient out who may have the minimally invasive surgery knowledge, but not necessarily the focus on infertility, reproductive endocrinology.   Michelle (03:33) Mm -hmm.   Armando Hernandez-Rey MD (03:50) specialist has and I think people feel comfortable with that.   Michelle (03:52) Yeah, absolutely. Because there's some people that will take out fibroids, but they're not doing it with fertility in mind. You know, for many women, it could just be just taking out fibroids, but you're doing these things with fertility in mind.   Armando Hernandez-Rey MD (04:07) There are many great surgeons out there that are not infertility specialists. You know, I want to make sure that I'm clear. I just think that I was, I always love surgery. I happen to do surgery and I feel my patients feel very comfortable with me doing the surgery and not being referred out. It's what I think. You know, the journey, the infertility journey is very complex. It requires a lot of a woman in particular more than the male and to be   Michelle (04:25) Yeah.   Armando Hernandez-Rey MD (04:36) you know, passed around, it gets complicated. And I think it's nice to be able to offer that service to patients.   Michelle (04:44) Yeah, for sure. And then you do specialize in miscarriages.   Armando Hernandez-Rey MD (04:49) Sure, I mean, I think we all really have a focus on on as you know, we're all specialized in miscarriages and and PCOS and all that there's some people that tend to see More miscarriage patients or they people will refer miscarriage patients to us We have a particular kind of focus on that, you know, I think a lot of it is   genetic, a lot of it is immunologic, a lot of it is just taking a holistic approach to things and not just focusing on one or the more common causes of infertility. And even now, I think that, you know, the use of supplements, which maybe 15 years ago was maybe considered some snake oil. Now, I think there's a lot of provocative data that has shown that supplements do work, in particular in   Michelle (05:18) Mm -hmm.   Armando Hernandez-Rey MD (05:44) cases with recurrent miscarriage. And now we have the ability to measure those levels and we are now ability to supplement those levels and they have tremendous impact positively on these patients.   Michelle (05:57) And what supplements have you seen help with miscarriages?   Armando Hernandez-Rey MD (06:02) Well, I think a lot of it has to do with what the cause of the miscarriages is. Oftentimes, believe it or not, miscarriages can alluded to fibroids, it could be anatomical, sub -mucosal myoma. Well, there's not gonna be any supplement that's gonna help with that. It's just purely the surgical route or the diminished ovarian reserve,   Michelle (06:07) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (06:29) cause for recurrent miscarriages, which is older women or ovaries that are behaving or eggs that are behaving older than what their chronological age would dictate, you have a higher chance for aneuploidy. And in those cases, there's a variable cocktail of supplements that we use, including ubiquinol, including N -acetylcysteine, including vitamin E, even melatonin has been shown to be very, very effective. And I can go on and on, even alpha lipoic acid.   Michelle (06:50) Mm -hmm.   Armando Hernandez-Rey MD (06:57) as well. There's some very nice studies coming out of Mayo Clinic that have shown that aflalipoic acid is very, very good for recurrent miscarriages. So again, things that we thought were, well, they can't hurt, now we know that they absolutely help.   Michelle (06:57) Yeah.   Right. Yeah. I mean, that's great because it just helps to know that there's something that people can do that really does make a difference. And it's not just like in theory with miscarriages when it comes to immunology. I'd love to talk about that because I know that that's a big one. Actually, I did see a study that showed that women who have are more sexually active, that their immune system calms down. It behaves differently in the luteal phase.   Armando Hernandez-Rey MD (07:31) Mm -hmm.   Michelle (07:44) so that it's able to receive life so that it's not seeing like the sperm as an invader the, yeah.   Armando Hernandez-Rey MD (07:50) So women that are more sexually active than others, it's probably a function of repeated antigen exposure, which is the more the woman is exposed to the antigens of the sperm, more there becomes an acquiescence by the immune system to be more receptive of that embryo. Because remember, the embryo is   Michelle (08:06) Mm -hmm.   Armando Hernandez-Rey MD (08:19) a haplotype, meaning it's half female, half the woman, half the mother, and half the male. And the only genes that the immune system of the mother has got to harbor the pregnancy are her own. And so oftentimes the immunologic processes are heightened because it does not recognize the male antigens that are formed part of the embryo in general. But as a whole, I mean, recurrent pregnancy loss,   Michelle (08:33) Mm -hmm. Right.   Armando Hernandez-Rey MD (08:47) is, is a small portion of the general population and, it's skewed towards advanced maternal age and advanced paternal age. so the immunologic component, while absolutely important, I think it's the one where we're still not a hundred percent sure how to absolutely treat it. Although supplementation and.   immune suppression definitely are known to work. It's the testing that I think we still need a lot more work in doing because you know people talk about NK cells and you know that was part of my thesis when I was a fellow. So we talk about NK cells and ANA and antiphospholipids and all of that and the reality is that these tests have very very   poor sensitivity in the realm of immunologic infertility or reproductive immunology. And so you may have COVID and then you can test positive or lightly positive for NK cells. And so I think that the overwhelming response by the treating physician is, well, they're positive, they must be immunologically incapable of handling a pregnancy. So therefore we should treat.   Michelle (09:40) Mm -hmm.   Armando Hernandez-Rey MD (10:04) with nowadays what we use as intralipids. Back in the day, we used to use IVIG that has kind of fallen by the wayside a little bit. I think it's better to treat empirically than to have someone treat or test for all of these different immune markers that really, really in the presence of immunology and reproductive immunology,   They have very low sensitivity. Now if you're treating or you're looking for lupus or rheumatoid arthritis or mixed collagen disorder or Sjogren's for sure, they are your go -tos every single time.   Michelle (10:44) And what about a PRP for ovaries? What has do you do offer that?   Armando Hernandez-Rey MD (10:50) ovaries. American study of reproductive medicine came out with a black box warning that they do not recommend PRP for ovaries. Now, PRP for recurrent implantation failure, poor lining development, there is some very robust data that there may be some room or benefit for this.   Michelle (10:57) okay.   Mm -hmm.   Armando Hernandez-Rey MD (11:14) And we do do offer that. We do not offer intra ovarian PRP because ASRM has a huge black box warning on this. It's a liability. The potential for infection is there. Tubo ovarian abscess have been reported, adhesions, periovarian adhesions, and with very little to no benefit whatsoever. I mean, the whole premise for it is that we are...   Michelle (11:16) Okay.   wow, okay, I didn't know that.   Mm -hmm.   Okay, got it.   Armando Hernandez-Rey MD (11:42) regenerating the follicle complex and therefore improving egg quality and that definitively has not been shown to be the case. Although anybody who suffers from that as I would be would be like, slide me up. But unfortunately, you know, it's very easy for us to fall prey to things that we desperately want without having the medical literature to corroborate it or back it up.   Michelle (11:49) Got it.   Right.   Got it. So that's actually showing to not necessarily be what a lot of people originally thought, but for the uterus, it has been shown to help.   Armando Hernandez-Rey MD (12:15) Yes, we are doing PRP installations and very select group of women with those diagnoses in particular. And.   Michelle (12:25) So who would be a good candidate? Somebody who's had failed transfers, inflammation.   Armando Hernandez-Rey MD (12:30) Yes, someone with very high quality embryos, high quality embryos that are not getting pregnant. Also patients, for example, patients who have adenomyosis that do not develop a nice lining, a thickened lining. Those have been shown. Our numbers are very small, you know, by no means.   Michelle (12:42) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (12:53) they are in the realm of what a randomized controlled trial should be. We're following the data from the randomized controlled trials and from the literature that's out there. So patients with adenomyosis who have poor lining development, recurrent implantation failure, so patients with euploid embryos, that means a normal embryo that's tested that looks to be high quality. Also, after a second implantation failure, we'll...   offer that to the patient as a possibility.   Michelle (13:19) Mm hmm. Got it. Awesome. And then also we were talking about Ozempic pre -talk. So I'd love to get your... Yes. Yeah. Ozempic babies.   Armando Hernandez-Rey MD (13:24) the topic du jour these days, right?   It's right. So as we were discussing, I mean, this, this phenomena is not really a phenomenon that's surprising at all. It is just a, a byproduct, a side effect of, of how the medication works and the effects that positive effects that I have on women with in particular, and ambulatory disorders, specifically polycystic ovarian syndrome, which is often tied to or associated with insulin resistance, obesity, sometimes even overt.   type 2 diabetes and the elevated levels of insulin, the elevated testosterone levels, they all work together to create this sort of environment within the ovary and the system of the female which creates an ovulatory disorder or dysfunction. And as a woman loses weight by virtue of the way that these GLP1s or glucocortes   Michelle (13:58) Mm -hmm.   Armando Hernandez-Rey MD (14:22) Glucagon like peptides work They're very successful. They're very good at number one slowing gastric emptying which in turn slows down the release of sugar into the blood system to the Number one number two it stops the the release of glucose produced by the liver and Number three increases insulin levels so increase insulin levels helps get the the   the sugar into the muscles out of the circulation and out of stimulating the ovaries and the theca cells to produce more androgens which then get produced produce more estrogen which then stops the hypothalamic pituitary ovarian axis from functioning correctly and as these levels drop patients automatically begin to have spontaneous ovulation if the system is working and the male has normal sperm and they're sexually active.   this is how the ozempic baby phenomena occurs. And what we discussed also is that the concern is of the downstream consequences of ozempic babies given that the current recommendations are to have at least a two month washout period before anybody starts to try to conceive.   Michelle (15:32) So two month washout means like really not trying anything. Yeah. And then also, I know like naturally, myonocytol is really helpful as well for insulin resistance. It might take a little longer. And then also metformin has been used as well.   Armando Hernandez-Rey MD (15:37) No exposure, right? No exposure.   Yeah. Yes. So, my own hospital is, is a, is a great product. my own hospital alone, although you will find oftentimes my, my own hospital with a D chimeric, hospital and really the literature shows that my own hospital by itself is the one that truly has the most benefit might be hard to find.   Michelle (16:06) Right, yeah.   Right because for a little while they said my own hospital and dechiro, but now they're going back to saying just my own ocital, correct?   Armando Hernandez-Rey MD (16:23) Yeah, well the way that it's normally found in the body is at a ratio of 20 to 1. And that's what those supplements show, 20 to 1. Although we know now that in the ovary it's almost 40 to 1 ratio of myoinocytol to D -chimeric, inocytol.   Michelle (16:30) Mm -hmm.   Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (16:49) Myo Inositol is actually not an essential vitamin, but it's considered like a vitamin, but it's in the category of B8 It's a glucose like peptide that basically helps to Help the system function by processing the circulating blood sugar in a way that's more physiologic and there by lowering insulin levels and thereby also helping tremendously with   Michelle (16:56) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (17:16) regularity of cycles and even spontaneous ovulation as well. And metformin obviously is medication that's been around for many, many years. It is somewhat of a controversial drug. It is an anti -aging drug even these days because we know that insulin levels are so profoundly toxic for aging for the muscle and for the system in general.   Michelle (17:29) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (17:45) And so we know it works, we know that it helps with the efficiency of insulin. And so it's certainly been used for many, many, many years in the presence of patients with polycystic ovarian syndrome. I would challenge people to be a little bit more meticulous about using it in patients who are the lean PCOS.   Michelle (18:11) Right.   Armando Hernandez-Rey MD (18:11) or the skinny PCOS or the ovulatory PCOS even though insulin levels have been shown to be higher, slightly higher in...   Michelle (18:19) So you're talking about being cautious with metformin, not necessarily myonositol. Yeah, yeah.   Armando Hernandez-Rey MD (18:22) Metformin, you also don't want very high levels of myelonostetal because they can be, you know, there is some quote unquote toxicity. I think the recommendations are up to four grams per day. I think all the recommendations are four grams per day in two divided doses, two grams in the morning and two grams at night. I've seen patients be on eight grams and 10 grams and toxicity really starts happening around the greater than 10 gram dose.   Michelle (18:29) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (18:52) I in our office we only use it, you know, what's recommended which is the four gram total per day two grams in the morning two grams at night and I don't think it's the end -all be -all I don't think it's you know treating anything in life is multi -pronged. It's not just one single thing perhaps but I definitely believe very wholeheartedly that it does assist in in adjunct treatment, although we certainly have patients put patients on on myocytil and combined with   Michelle (19:06) Yeah. Right.   Armando Hernandez-Rey MD (19:20) diet and exercise and have been able to achieve pregnancies on their own, which is obviously what we want instead of having to go through treatments.   Michelle (19:27) That's great. I mean, I will say that I was very surprised this past year. two different patients came from different, different places, not yours, it was other doctors, but I think the nutritionist there suggested metformin when they did not have insulin resistance or PCOS for egg quality.   Armando Hernandez-Rey MD (19:47) Yeah, I'm not familiar with any studies that have shown that have improved that. In fact, when I was a fellow, we were, just as I was coming into fellowship, where I trained, Rutgers was involved with a very well known and publicized study, it's called the PP COAS study, which looked at patients on placebo versus metformin alone versus metformin with Clomid, sorry.   placebo versus clomid versus clomid with metformin and there was no difference in pregnancy rates or anything else. I'll go one step further with them going back to the myonocytol. It has even been shown to decrease the rates of gestational diabetes and so in our patients with PCOS with who are you know   Michelle (20:18) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (20:39) Stage one, type one obesity, type two, we'll continue them on the myonostetal throughout the pregnancy and when they leave us and go to their OB -GYN, in our referral letter back, we'll say that we're recommending for her to continue on myonostetal because there have been improvements in sugar levels and glycemic control and reduction in gestational diabetes overall.   Michelle (20:54) Yeah, that's good to know.   another big one is vitamin D. A lot of people, even though we're in Florida here, we have a lot of sun. A lot of people are very deficient in vitamin D.   Armando Hernandez-Rey MD (21:11) Yeah, What it is is a combination of things. Number one, we're not as sun exposed as you think we are. You know, we're always in a car, we're always indoors, it's very hot. And yes, we go out to the beach and there is a lot of sun, but we become very, very sensitive to the sun and to the untoward effects of the sun.   Michelle (21:17) Mm -hmm.   Armando Hernandez-Rey MD (21:35) So we protect ourselves tremendously. That's number one. Number two is that I think the levels are set higher than what the average person can sustain with just diet and sun exposure. And actually the recommendations now in the infertility world that when you order a vitamin D from Quest, they'll tell you that the levels are, you want them at   Michelle (21:38) Mm -hmm.   Armando Hernandez-Rey MD (22:04) definitively above 20 Certainly above 30 and now recently now the recommendations are that for them to go above 40 and and and Yeah, I'm not yeah, so I heard I've read 40 I it was a Paper that came out of Either the Lancet or   Michelle (22:11) Yes, yep, I've been hearing that or even 50. Yeah.   Armando Hernandez-Rey MD (22:27) or fertility necessarily, anyone, one of, that they recommend now for vitamin D levels to be above 40. So that's really hard. I mean, I work really hard. I take a lot of vitamin D and I'm just barely scraping like 50. You know, I take about 5 ,000 units a day, which is what we're recommending nowadays, 5 ,000 units of vitamin D. And I take that every single day and I barely scratch,   Michelle (22:38) Mm -hmm.   Yeah.   Armando Hernandez-Rey MD (22:56) you know, 45, 50 every time I get an average check. So I'm not getting as much sun as I think I am, number one. I am out fairly often. I do play some golf, not enough. And yet it's not enough. So definitely supplementation's important.   Michelle (23:03) Mm -hmm.   Yeah, magnesium is also important. That's another thing. It's to not be deficient in magnesium because magnesium plays an important role of our absorption of D, which, you know, obviously doing this, I learned, I was like, that's might be deficient magnesium and be taking a lot of D and then their body's not processing, which is why it's important sometimes even in foods, foods have everything. So like,   even beef liver, you know, from Chinese medicine perspective is so beneficial because it has iron, but it has it in a combination of nutrients that helps the body absorb it.   Armando Hernandez-Rey MD (23:46) Yeah, B6, B12 are incredibly important for iron absorption as well. So all of these things are extremely important. Everything is all intertwined and we're just learning about this. And for us, I've really gotten grabbed hold of this whole longevity thing, hence my aura ring and all of this. And...   Michelle (23:57) It is.   Yeah.   Armando Hernandez-Rey MD (24:09) I'm just trying to apply a lot of the things that we know today work for longevity medicine and anti -aging principles to the infertility world because it's all intertwined. It's all intertwined.   Michelle (24:16) Yeah.   without a doubt. It's funny because that you say that because I always say it's pretty much anti aging. Yeah.   Armando Hernandez-Rey MD (24:26) Yeah, totally, totally. They're even coming up with a way to stop menopause.   Michelle (24:36) wow. How?   Armando Hernandez-Rey MD (24:37) which is extremely interesting. Believe it or not, recombinant antimullerian hormones.   Michelle (24:42) How is that? Explain that.   Armando Hernandez-Rey MD (24:46) So the way that antimullerine, the function of antimullerine hormone at the level of the ovary is that it stops follicular recruitment. That's why women with PCOS have higher AMHs and therefore they have higher egg counts and higher, they tend to go into menopause later on, et cetera. That's because they have high levels of antimullerine hormone. So by reproducing or creating it in the laboratory and then from an early stage,   This is in its infancy, by the way, okay? So this is, yeah, this company, I believe she's a Harvard scientist, biochemist or something, who's coming up. My point is that, listen, that it's all intertwined, aging and even in menopause, for God sakes. Now I've been doing this for so long that I now,   Michelle (25:18) It's new.   Mm -hmm.   Armando Hernandez-Rey MD (25:39) seeing menopausal patients who were like, you know, listen, you took care of my baby, you're a reproductive metachronologist, you understand the science, will you treat me? And, you know, like, and I realized, like, somewhere, some women got like, they got a some bad luck thrown their way because, you know, with the WHI results and the way they were interpreted, they made hormones bad. And somewhere along the way, someone said,   It's okay for women to suffer from menopause, just suck it up. Like it's not okay. That's not okay. That's not okay. And so if you start from very early on and, you know, and, and really practice what you preach, which is healthcare and not sick care, which is what we practice in the United States, you know, we're just very, we, we're not proactive. We're reactive to when a patient is sick instead of early intervention, early screening and all of that.   Michelle (26:25) Yeah, absolutely.   Armando Hernandez-Rey MD (26:30) And that goes for the infertility world and that goes for a woman's long reproductive life extending past menopause. I think we still have a lot of challenges to overcome, but I think that we're heading in the right direction. Sorry to digress a little bit. I went off on a tangent there for a second.   Michelle (26:43) Yeah, for sure. no, it's okay. But you know what? I love the passion and I love that, that, you know, ultimately is great. It's important, very important, because it's true. And I agree a lot with what you just said, that we should be proactive when it comes to healthcare. I mean, really when it comes to so many things and something else that I...   that I read, it was an animal study. It was a study on, I believe it was like, I don't remember which kind of animal it was. I think it was like either sheep or cows or some form of those where they actually gave them oxytocin right before IUI. And that improved the chances of the conception rates, which I thought was very interesting because I think that that's one of the things with IUI that's missing because obviously you're taking away the connection.   that is usually there when you're just under natural circumstance. And I thought it was interesting because I was looking into it for something else to understand from a Chinese medicine perspective, because they have this heart -uterusconnection, that connection, the bonding. And so what I found was interesting too is that oxytocin increases around ovulation and after intercourse. And usually what they look at it as its role is usually for labor.   not so much conception. So I was just going to kind of like pick your brain on that. Any thoughts on that?   Armando Hernandez-Rey MD (28:13) Well, I mean, oxytocin is secreted at the time of... I'm not sure of ovulation, I didn't know that. But definitely at the time of...   Michelle (28:21) or it increases around that time, like right before ovulation in the cycle, a woman cycle.   Armando Hernandez-Rey MD (28:27) What we know that it's involved is at the time of orgasm. And so this may promote uterine contractility, which is what is used for intrapartum, to promote contractility of the uterus, to promote descent and eventual delivery. And we know that it's intimately involved in orgasm, we're seeing.   Michelle (28:33) Mm -hmm.   Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (28:55) during intercourse and orgasm and so with you know the projection of with the secretion of oxytocin and it causing uterine contractility obviously not at the same level that it does during labor but at smaller amounts then I can see how there could be a role for oxytocin in artificial insemination.   Michelle (29:18) even in fertility in general and because it's got to be there for a reason why would the body produce it around that time?   Armando Hernandez-Rey MD (29:25) Well, yeah, I guess, but it's either IUI or IVF and we definitely don't want oxytocin during the IVF cycle.   Michelle (29:33) Right, because you don't want to contract, right?   Armando Hernandez-Rey MD (29:35) Right, because we're transferring an embryo where there should not be any oxytocin. And you can have the most beautiful embryo, but if you screw up the embryo transfer, through no fault, just because it's a difficult transfer for a myriad of reasons, and you cause uterine contractility, then there's a high likelihood of pregnancy not occurring during that time.   Michelle (29:57) Right. I think it would be an interesting thing to look into for IUI. There might be something to it, because if it works with animals, and the animals obviously have similar certain functions that we do, mammals, that seems like an interesting thing.   Armando Hernandez-Rey MD (30:10) Yeah.   I think there's not going to be a lot of resources put into improving IUI, to be honest with you. IUI, I think it is what it is. And I mean, I think the majority of research is going to go to improving even more IVF rates, because I think ultimately patients are going to want to go more.   Michelle (30:22) Mm -hmm. Yeah.   Armando Hernandez-Rey MD (30:40) towards IBF, no matter how hard we try to say, hey, listen, there's this option or this option or this option. It's more become a more of an instant gratification society. Number one, number two, people are waiting longer. So therefore they're more pressed for time, if you will. And I think there will be less of a motivation to go down a treatment option that frankly,   Michelle (30:48) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (31:07) You know, has a low pregnancy rate.   Michelle (31:09) Right. And then my other question is, what are your, thoughts about a lower intensity cycle?   like lower amounts of hormones for older women. In some cases I've heard it might be a little better. you do? Yeah, yeah.   Armando Hernandez-Rey MD (31:24) We use it all the time. Yeah, we use it all the time. I think it's...   a very successful option in cases with severely diminished ovarian reserve. I think that the senescent ovary does not do well with high impact medication or high doses of medication separately, but you know, jointly the medication costs are exorbitant and you end up having the same number of eggs that are mature, that get fertilized with a mini stent protocol as you do with   Michelle (31:38) Okay.   Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (31:59) a high dose regimen.   Michelle (32:02) Okay, so you've seen good success with that.   Armando Hernandez-Rey MD (32:06) Well, I mean, not good success because generally these cases are, we've seen success. Let's call it that. Because the patients that you're treating with these medics, with this protocol are patients who are POI, you know, premature ovarian insufficiency, diminished ovarian reserve, poor egg quality, high rate maniploidy. So these are your poor responders essentially. And they're very...   Michelle (32:12) Yeah, okay.   Mm -hmm. Mm -hmm.   Armando Hernandez-Rey MD (32:34) specific factors that propel a woman to have success with this protocol compared to her twin sister with almost the same testing who doesn't do as well.   Michelle (32:47) Got it. And then lastly, we talked about this in the pre -talk, let's talk about marijuana and sperm, data is showing. Yeah.   Armando Hernandez-Rey MD (32:55) I don't do it myself, but I have no problem with people that do. What the data has shown that we're just becoming more and more familiar because the overwhelming number of people who are using cannabis and open about it, which is the second part, which was very difficult to conduct studies because it was so people were ostracized. They were looked at.   not the wrong way and seen as in the fringe. And now it's, you know, it's so mainstream. but so now we're, we're keenly aware, of patients were able to analyze them and what we know without a shadow of a doubt that the potency of the cannabis that's being produced these days is anywhere between eight to 12 times more potent than I think I use the joke of the guys at Woodstock back in the sixties, right?   Michelle (33:21) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (33:46) where everybody was getting pregnant and everybody was high on life, all of those things. And then what we've also known, which I did mention, is that using the vape pens, whatever types of inhalers as opposed to the traditional joint, if you will, increase the potency of that by a factor of two to three. The cannabis that was already potent to begin with.   Michelle (34:08) Yeah.   Right.   Armando Hernandez-Rey MD (34:14) So what you're seeing in males in particular, and I'm not sure that the literature is so complete on the female aspects, are that we're seeing a high levels of fragmentation. And what fragmentation is, is imagine that sperm is like an Amazon box. And inside that box, there's a porcelain doll that's wrapped in these packing cubes. They're held very, very tight. And under...   Michelle (34:26) Mm -hmm.   Armando Hernandez-Rey MD (34:40) The best of circumstances, those packing cubes are wound so tight, packed so tight that nothing, if I kick the box off the Amazon truck, nothing is gonna happen to the porcelain doll. Well, as fragmentation occurs and it happens under natural conditions and old guys like me, you know, patients who, occupational hazards, firefighters, exposed to toxins, a lot of people who use fertilizers, et cetera, et cetera.   you see high levels of fragmentation. I'm talking about DNA fragmentation. And so what we're seeing is high levels of fragmentation at the level of the DNA of the sperm, which has significant effects on embryo quality, embryo development, and pregnancy rates, and high levels of aneuploidy, which is abnormal embryos. So,   Michelle (35:10) So you're talking about DNA fragmentation. Yeah. Yeah.   Mm -hmm.   Armando Hernandez-Rey MD (35:33) You know, I'm not here to like, you know, slap you on the wrist and say don't smoke weed, but really that's what you're facing. And we know that this happens in women with cigarette smoking. Like this is a well -known cause of an accelerated transition to perimenopause. You know, 65 % of women who smoked a pack a day for greater than 15 years will go into menopause before the age of 40, assuming they started before their 20s. That's a pretty...   Michelle (35:40) Bye.   Mm -hmm.   Armando Hernandez-Rey MD (36:03) ominous number, actually. Thankfully, not many women smoke these days, cigarettes anyway. So I guess the results of cannabis on females is yet to be elucidated, but we definitely have some pretty compelling evidence in terms of the male data that show that it can have detrimental or deleterious effects on sperm quality and not necessarily on numbers.   Michelle (36:04) Yeah.   Mm -hmm.   right, which is what people look at usually when I mean, that's like the, the analysis is always on numbers shape and, numbers shape it. Yeah. And morphology and they won't necessarily look at the DNA fragmentation. That's actually not something that REIs usually initially look at.   Armando Hernandez-Rey MD (36:33) Exactly.   the thesis in morphology.   is done in a well not initially unless there's comorbid situations or things that raise your red flags. For example, advanced paternal age, we always do it. Particularly in egg donor cycles, right? Because patients will be like, well, I'm using an egg donor and why don't I have bad energy? Well, because your husband could be 70 or 60 and   Michelle (37:11) Yeah.   Armando Hernandez-Rey MD (37:14) And then their fragmentation is completely elevated and through the roof. So yeah. So, you know, firefighters, occupational hazards.   Michelle (37:18) Right. So, yeah, it's important. It's important for people to hear this because they can go in and say, the semen analysis was perfect. But that, like what you just said, is not really checked. So they may not, in a healthy, like, younger guy.   Armando Hernandez-Rey MD (37:35) It's not as nuanced as we once thought it was.   Michelle (37:38) Yeah. Yeah. Interesting. It's, it's fun. It's always fun for me to talk to our, our ease, you know, just to get, to pick your brain and get your thoughts. and you're my neighbors. So it's pretty cool.   Armando Hernandez-Rey MD (37:50) That's right. Thank you very much for the invitation. This was really fun. We spoke about a wide array of different topics here. So this was really nice to connect this way.   Michelle (37:53) Yeah.   Yeah.   Yeah, for sure. And I know that a lot of people are going to be like, this is interesting information. Cause I know that what you just mentioned, a lot of it is not common knowledge. people don't know automatically hear about this or really know to think about asking about it. So, so I appreciate all your information, all your good, good data. And, for people who would like to work with you or in town, how can they find more about you?   Armando Hernandez-Rey MD (38:27) Well, we are at Conceptions Florida. We have two offices in Merritt Park, Coral Gables and one in Miramar and hopefully soon also in Boca. And I'm there Armando Hernandez -Ray, MD I'm sure. Easy to find these days on Google, but I'm happy to help in any way that we can. We've been doing this for a long time, quite successfully, thankfully. And we take a lot of pride, humbly speaking, but probably also.   in having a good footprint in South Florida and the infertility world and trying to offer the best care possible.   Michelle (39:01) Awesome. Well, this was such a pleasure and thank you so much for coming on today.   Armando Hernandez-Rey MD (39:05) Thank you, Michelle.    

Have you ever wondered how Sjogren's Disease affects your gut health? Join us as we delve into the gut-Sjogren's connection and discover practical strategies for managing both. In this episode of the Becoming Immune Confident Podcast, Dr. Kara Wada welcomes fellow Sjogie Cristina Montoya, a registered dietitian and the founder of Arthritis Dietitian, to discuss the intricate relationship between Sjogren's disease and gut health. Cristina shares her personal journey of living with Sjogren's and rheumatoid arthritis for over 20 years, highlighting the challenges and triumphs she's experienced along the way. She reveals how Sjogren's can significantly impact the gut and provides insights into how dietary changes and lifestyle modifications can support overall well-being for individuals living with these conditions. EPISODE IN A GLANCE-Cristina Montoya's Personal Journey with Sjogren's and Rheumatoid Arthritis-Discussion on the importance of nourishment and the role of nutrition in managing autoimmune diseases-Exploring the connection between Sjogren's Disease and gut health-Invitation the 3rd Annual Virtual Sjogren's Summit ABOUT CRISTINA MONTOYALiving with both Sjogren's and RA, Cristina is a registered dietitian dedicated to helping you create a fulfilling life free from restrictive diets. She specializes in gut-healing strategies and making anti-inflammatory living both effective and enjoyable. CONNECT WITH CRISTINA MONTOYAWebsite → https://www.arthritisdietitian.com/ LinkedIn → https://www.linkedin.com/in/cristinamontoya/ Instagram → https://www.instagram.com/arthritisdietitian/ Facebook → https://www.facebook.com/arthritisdietitian/ X/Twitter → https://x.com/ArthrDietitian TikTok → https://www.tiktok.com/@arthritisdietitian ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/karawadamd/ Instagram → https://www.instagram.com/immuneconfidentmd/ Podcast Instagram → https://www.instagram.com/becomingimmuneconfident/ Facebook → https://www.facebook.com/KaraWadaMD Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@immuneconfident SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health. JOIN THE 3RD ANNUAL VIRTUAL SJOGREN'S SUMMIT! REGISTER NOW → https://www.sjogrenssummit.com/ A two-day online event dedicated to providing you with the knowledge, tools, and community you need to thrive with Sjogren's.

Join us for a conversation with Kara Wada, an adult and pediatric allergy, immunology, and lifestyle medicine physician, as she shares her personal journey with Sjogren's. Discover how her experience as both doctor and patient has shaped her perspective on patient care, the challenges of diagnosing non-specific symptoms, and the systemic implications of Sjogren's. Kara discusses the importance of empathy in medical training, the impact of health care disparities, and the urgent need to break outdated stereotypes about invisible illnesses. Kara Wada is an adult and pediatric allergy, immunology, and lifestyle medicine physician. She discusses the KevinMD article, "From doctor to patient: my Sjogren's journey and a challenge to colleagues." Our presenting sponsor is Nuance, a Microsoft company. Do you spend more time on administrative tasks like clinical documentation than you do with patients? You're not alone. Clinicians report spending up to two hours on administrative tasks for each hour of care provided. Nuance, a Microsoft company, is committed to helping clinicians restore the balance with Dragon Ambient eXperience – or DAX for short. DAX is an AI-powered, voice-enabled solution that helps physicians cut documentation time in half. DAX Copilot combines proven conversational and ambient AI with the most advanced generative AI in a mobile application that integrates directly with your existing workflows. DAX Copilot can be easily enabled within the workflow of the Dragon Medical application to bring the power of ambient technology to more clinicians faster while leveraging the proven and powerful capabilities used by over 550,000 physicians. Explore DAX Copilot today. Visit https://nuance.com/daxinaction to see a 12-minute DAX Copilot demo. Discover clinical documentation that writes itself and reclaim your work-life balance. VISIT SPONSOR → https://nuance.com/daxinaction SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme I'm partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus

You probably already know my dear friend, Brittany Sjogren— the beautiful face and heart behind the Instagram, @loverlygrey. In this episode, we talk about how different perception is from reality, how boundaries are necessary to protect our peace, and how to find true fulfillment in an industry that can easily leave you chasing the next thing. Brittany is honest, wise, and authentic; her willingness to go against the grain is so refreshing and I can't wait for you to hear her heart in this episode. It will encourage you, remind you of the power of hard work, and inspire you to trust the Holy Spirit with whatever you put your hands to. The there is, we all have influence exactly where we are; the difference will be whether we realize that influence and what we choose to do with it.

Have you heard these myths about personal growth and forgiveness? Myth #1: Forgiveness is a sign of weakness. Myth #2: Forgiveness means forgetting the past. Myth #3: Forgiving means letting the other person off the hook. But the truth about forgiveness is powerful and transformative. Want to know the truth? Then you won't want to miss this episode.   My special guest is Amy Lacey! Meet Amy Lacey, the visionary behind Cali'flour Foods and a remarkable example of turning adversity into triumph. Amy's battle with health challenges, including lupus and Sjogren's, inspired her to create the first cauliflower pizza crust, defying industry norms and transforming the health food landscape. She went on to create Soursop Nutrition. A supplement line featuring the "superfood with super powers, Soursop." Her journey embodies the profound impact of forgiveness and personal growth, showcasing the resilience that comes from embracing forgiveness. Amy's story not only reflects her unwavering determination but also offers invaluable insights into the transformative power of forgiveness. Her experiences and wisdom are sure to resonate deeply with those seeking emotional freedom and personal growth.    In this episode of Kathryn for Real, Amy shares her journey as it serves as a beacon of hope, reminding us of the incredible strength that emerges from forgiveness and resilience. Go to Soursopnutrition.com and enter KATHRYNFORREAL20 for 20% off About Amy: Amy Lacey is a serial entrepreneur, innovator, best-selling author, keynote speaker and business mentor. In 2016, after being diagnosed with Lupus, Amy launched Cali'flour Foods and introduced the first cauliflower pizza crust to the market when only a head of cauliflower could be found in grocery stores. The brand took the food industry by storm, going from farmers markets to grocery stores across America, and spearheading what would become a billion dollar industry category. Cali'flour was the number 1 pizza crust sold on Amazon for 16 months straight from 2018-2019. The product won several awards including KeHE Best New Product in 2018 and was featured in Food and Beverage Magazine, OK! Magazine, GQ, Good Housekeeping, as well as one of “Whoopi's Favorite Things” on The View. The products were also seen at the ESPY, Teen Choice, the Emmys, NY Food Show, as well as many other traditional food shows. Amy sold the majority of Cali'Flour in late 2019 and became one of the top 1% of women business owners to exit a company with an 8 figure deal. Amy is now trailblazing the path towards a brand new innovative health and wellness product with her new company, Beyond Medicine, founded in 2023. This new company is on a mission to highlight one of the world's greatest superfoods that most people don't even know exists yet. She is introducing a new category of superfood to the market and paving the way for a new era of self-care and wellbeing that prioritizes the body's natural ability to be and stay healthy while enhancing the immune system's armor against disease and illness. Up next alongside Beyond Medicine, Amy continues to collect her vast knowledge and experience in entrepreneurship into courses and programmes that make e-commerce easy for entrepreneurs. Her philanthropic mission includes supporting women founders, and she continues to be incredibly passionate about being involved in non-profit organizations that support children with cancer and fighting against the sex trade. When she's not innovating the next industry shaking product, you'll find Amy at her home in Melbourne, Florida with her husband, her 3 children and their new puppy.

Join Dr. Kiltz and Cecilia Berlim as she details her transformative healing journey from a vegan diet to full-blown carnivore.   Cecilia Berlim is a 5 year carnivore who credits eating a high fat meat-based diet for reversing her fibromyalgia, arthritis, Sjogren, asthma, and several other health conditions while controlling her Hashimoto's. Cecilia believes many of health ailments were caused by eating a vegan diet.   As a result of her personal healing journey, Cecilia is now dedicated to sharing her story with the world in an effort inspire as many people as possible.     In this episode you will discover:   Cecilia's personal healing journey   Trials with vegetarian and veganism   The healing power of going carnivore   Deciding if carnivore is right for you  Connect with Cecilia:   Instagram    Connect more with Dr. Kiltz:  Website  Kiltz Mighty Tribe - Free membership and 30-Day Course   Doctor Kiltz Nutritional Solutions  Instagram  Tiktok  Facebook  Amazon