Ditching the Dirty
with
Wendie Trubow,MD

Adam Rinde:             

[00:00] Wendie, thank you so much for joining us today on the One Thing Podcast.

 

Wendie Trubow:        

My pleasure, Adam. It's so great to be here.

 

Adam:                        

It is great to share time with you. I've enjoyed catching up with you offline a bit.

 

00:16] I would love to just start off – you have a really interesting background. I'd love to hear a little bit what led you from the classic medical training, coming out of Tufts University and being in the obstetric world and gynecology world and getting into functional medicine. How did that happen?

 

Wendie:                     

I was always kind of a maverick. I vividly remember irking my – I think it was my biochem

teacher at one point in med school, when I was like, "Why is that happening?" It is not for us to ask why, was basically the response. I've always been a little bit of a maverick and thinking a little differently and always wondering what's the root cause of something.

 

There was no accessibility to functional medicine, or even knowledge of it in my med school. I went into OBGYN because it appealed to my brain from the standpoint of I love doing multiple different things, I love learning new things. I loved the idea of caring for women, because I absolutely adore women. I loved the idea of being both in the hospital and delivering babies and doing surgery and doing office care. It was the best of everything.

 

The only issue with being an OBGYN is that I'm not constitutionally set up or prepared to be up all night and be high stressed. I was basically a quivering puddle on the floor. It was great for my brain, horrible for my body. In residency I got – I went from being unknowingly gluten-sensitive to being full-blown celiac in residency, but didn't even get diagnosed until five years later.

 

Adam:                        

Wow.

 

Wendie:                     

It was pretty crazy, because I just was like, this is just the way it is. I never complained. I was a very bad patient. Of course I think it always comes down to it's personal. I got diagnosed with celiac when I was 35. It was by my husband's mentor who was doing – he's one of the old-style function medicine docs in Boston. He's been around for, I don't know, 40, 50 years doing this. I knew about functional medicine at that point because my husband was training in it, but it really got personal, like, whoa, that's what people do, huh? I want to do that.

 

That paralleled pretty nicely that I was recognizing that constitutionally OBGYN was the worst possible career choice I could've made, maybe second only to trauma surgery, where it's high stress and you're up all the – in surgery for 20 hours. Maybe that would've been worse, but basically OB was pretty high up there. When I got diagnosed with celiac and it opened my eyes to functional medicine, and I recognized I was not constitutionally in the right field, then we all put it together. In 2009, which was nine years after graduating med school, and I'd been in OB for almost five years, I said, "Okay, I need to make the transition." I still only care for women. I love women. I love taking care of them. I think our needs are uniquely set up and I'm uniquely positioned to take care of them, but I don't do any of the hospital work or surgery or delivery. It's really exclusively functional medicine in the office.

 

Adam:                        

Wow.

 

Wendie:                     

It was personal. It was like, I want to do for others what happened for me.

 

Adam:                        

I've always been curious, going from the classic training into functional medicine, is it something that it's building on to what you know or was there any kind of unlearning that you had to do with the way your clinical process and thinking went?

 

Wendie:                     

That's a great question, Adam. I think that there's two steps to getting into being a provider of functional medicine. The first step is to recognizing that not every issue requires a medicine. Really what every issue needs is to understand the root cause of it. That's step one. Understanding that you need to get to the root cause is the philosophical flip. That's this flip switch. Then the second part is, okay, now I need all this data to back up that philosophy.

 

I will say I've been in functional medicine for 13 years. I'm still learning. I'm actually studying for my functional medicine boards now. I'm like, whoa, there's so many things that either I forgot or I never learned in the first place. It's just broadening and deepening that information. That's I would say lifelong, especially because technologically we're advancing so rapidly, so there's this huge amount of information to cover, always.

 

Adam:                        

I love that, the pausing and saying, wait, I don't have to think about what drug is right for this situation. I have this whole other tool chest to tap into. Also, I love that what is really needed is the understanding of what's going on versus the medication. That's fascinating. I've never really heard that put that way. That makes a lot of sense to me.

 

 The last couple years have been quite interesting, and we're shaking out some of it now and figuring out what this is going to mean not only from a global perspective and socioeconomics perspective, but also just from a health care perspective. How has the last two years changed your life? I'm referring to from the onset of COVID or around the COVID times and how that's changed things for you.

 

Wendie:                     

It's really interesting. I always say to people, we never left the office. We continued to come to the office every day, even – I have four children. Even as my kids were at home doing their homeschool, I was in the office. COVID made it a lot harder to get food, and it made it a lot harder to take care of my life. I was a little bit more isolated because we weren't seeing our friends. Other than that it was like, this is just business as usual. Wrote a book during COVID, because –

 

 

 At one point, I think it was March and April of 2020, our revenues were down 30%. My husband hates to be bored. I'm like, oh you're bored, you got that look in your eye. He's up to no good. We had already decided we were going to write this book, because we already knew about – we were just entering this thing. COVID hits, and I was like, "Why don't we write our book?" He's like, "Yeah, let's write our book," because we were a little bit bored.

​

  We were looking for a project. Then quite quickly, the revenues came back and all the patients came back and we were still writing a book. We really made it hard on ourselves, because it was writing a book and doing full-time practice.

 

Adam:                        

 I'm sure what was going on in the world really was part of the impetus for the book as far as seeing how many people were getting affected by this virus and your understanding of the role that toxins might play in overall health. Was that part of it?

 

Wendie:                     

It was less about COVID and more really about the impact of toxins. Let's back up for the listeners. My use of the word toxins is anything that acts in an unpleasant way on the body. Bread could be a toxin. If you're eating a lot of sugar, that can be a toxin. We're also referring to heavy metals, mycotoxins, which are the toxins that molds put out, environmental toxins, beauty products, cleaning products, gasoline fumes, pesticides, herbicides, all that stuff. That's the bucket of toxins that we're talking about.

 

It wasn't so much about COVID. It was really about it's everywhere and we are all feeling the impact of it and it is impacting our experience of life, our hair, our energy, our sex drives, our weight, our fertility. It's impacting everything. If you said to me, oh, it's not… I'm like, it is. It's impacting everything.

 

When we started writing the book, we didn't really know anything about COVID. We didn't understand that it's an inflammatory process and impacts every system. We didn't really know that at the time. I can't claim to say, oh yeah, it was about toxins and COVID. I can't. It's not true. It was really just how impactful toxins are on our health, and we need to deal with it, because it's killing us. It's not killing us; it's torturing us. It's a slow death by a thousand cuts.

 

Adam:                        

[I do like in your book that you make the distinctions between toxins and toxicants. Maybe just also could you clarify that for us?

 

Wendie:                     

Think about toxicants as these true heavy metals, like lead, mercury, VOC paint fumes. It's just a lot easier to think of it like toxins. It's easier not to always have to qualify, okay, we're talking about this, not that, just put it in a bucket and move on, because it's easier for people when they think about.

 

Adam:                        

It's like the combination of all these environmental exposures that our body somehow has to figure out a way to deal with.

 

Wendie:                     

Either way, your liver has to deal with it – your kidneys. It's an artificial distinction.

 

Adam:                        

Makes sense.

Your journey also is very personal through this process. You talk a lot about how you were a person who really took care of themselves fairly well. You knew the right things to do and you – diet, lifestyle. Then your health was impacted, even though you were doing a lot for prevention. Can you talk about that and what led to you discovering the role of toxins in your health?

 

Wendie:                     

Sure. I really was the poster child, Adam. I was so boring on paper. I didn't eat gluten. I didn't eat dairy. I don't drink alcohol. I don't stay up all night. I'm super boring. I try to get eight hours of sleep. I exercise. Now I'm working with a trainer. I'm doing everything right, and yet we – the linchpin.

 

In between 2018 to 2019 I had two lead exposures. I knew clearly about one off them, and I blew it off, because I was like – my neighbor took his postwar house down, and those houses are almost universally filled with paint that has lead in it, because it was built before 1978. I blew it off. I closed the windows. I turned on the air. Then I didn't even think much of it. Even when my hair started falling out, I didn't think of it. I blew it off.

 

Then about eight months after that exposure, we went to France, right after Notre Dame burned. This time I didn't know that I had a lead exposure, but I did know that as soon as we came back from France, within a month I gained nine pounds, I had a rash on my face that would not quit, and my hair was just – droves falling out. That really got my attention. I didn't blow it off, but I didn't know that I had gotten a lead exposure until about three months later. I'm going crazy, like, what's the problem here? Then I heard on NPR that when Notre Dame burned it released 500 tons of lead into the atmosphere. The closer you were to Notre Dame, the more exposure you got. We were right there for almost a week. I was like, "Oh," expletive, four-letter word, "I got an effing – I got an effing lead exposure." It's like, oh my god, that's what it is.

 

I redid my testing. I had done it before and was mildly positive, and blew off the mildly positive, because I was like, oh how bad is it really? It's only a point over the cutoff. The only problem is that what we've come to see is that that testing is often just the tip of the iceberg. That one point over positive was really actually 13 points over positive, but because I had such terrible detox ability, and mechanisms and pathways were shut down, I couldn't even release it from my system. It was only after multiple rounds of pulling it out that I started to see, wow, okay, my mercury went up to 41. It started at seven. My lead went up to 21. It started at nine. It's a huge amount difference. Those exposures were what had me get into it. Then I finally figured out I had an exposure and did the testing. I was much higher before. I just didn't know it. That's the problem. I didn't know.

 

Adam:                        

I think it's so true with the testing that you really have to understand how these toxins can be hidden on tests and how to actually interpret tests to come up with an accurate diagnosis. Having lead in your system, there's a multiple degree of things it could be doing as far as harm.

 

  Where do you start your thinking process as far as what is a toxin doing to the body if your body's overburdened with toxins? Of course the body can handle some day-to-day exposures, but then when it becomes overloaded and excessive, where do you think about that in the body? What's the most harm being done, or a couple things related to it?

 

Wendie:                     

 

Let me say two things about that. One is the clinical stories that I say to people, oh, you've got some kind of probably heavy metal or major toxin exposure – would be any autoimmune disease. I don't care what autoimmune disease it is. Autoimmune disease – loss of hair. When people say that they – we've had a couple patients with full loss of hair on their bodies, complete alopecia. They've gone to 20 doctors, of course, because when you lose your hair, women freak, obviously. We freak out. Guys are like, I don't want to go bald, but it's just what I do. Women, when they go bald, they freak, so they've gone to 10 doctors. Someone who has a complete loss of hair on their body, that's a clear toxins, likely metals issue. Then anyone with osteoporosis, because lead loves to sit in the bones. Those are the three that catch my attention like that.

 

Adam, pretty much anything you say to me, I'm going to say to you, we need to work you up. We do the foundational things first, your food, your minerals, nutrients, hormones, your digestion, of course the gut – we start with the gut – your adrenals. That's the foundational approach. If you're not better after doing the foundational approach, you have an issue with toxins, because if you're doing everything right and you're not a million bucks, there's something.

 

Also, the fourth category would be people who can't lose weight. I'm trying to lose weight. I'm doing everything right. I'm intermittent fasting. I don't eat sugar, blah blah blah. Can't lose weight, that's another category where I'm like, oh, you got toxins, because they sit in your fat, and your body knows. If you don't get rid of the toxin, it's not getting rid of the fat, because you would be toxic. You'd have nowhere to put it. We always take a foundational approach to look at what's happening, fix it, fix your hormones, replace your nutrients and minerals, fix the gut, fix the adrenals, and if you're still not a million bucks, then we go, okay, we're going to work up toxins next.

 

Adam:                        

I like that. I've always heard it described as like a door that's – it's there and you have to do the foundational stuff there. You don't want to just dive into that world, unless it's obvious, unless...

 

Wendie:                     

Yeah. There are some patients who I say to them, I've totally going out of order, I'm violating my own rules, but you're so sick that we need to deal with your toxins first. Just a caveat here, if you go to your regular normal doctor and ask for a workup on toxins, they're going to look at you like, I don't know what I'm – I don't know. They can do a blood test for mercury. They can do a blood test for lead. Here's the thing. Those only indicate that you've had an exposure that's in your blood right then. The kids in Flint, Michigan are positive for lead. No one else is positive when you do those tests, because the body quickly recognizes, oh, this is a major problem here. You hide it away in the fat, in the bones, in the organs. You sequester it away. You're not going to see it in the blood. It's a useless test, as far as I'm concerned. The only one that's pretty good is the tri-test to look and see if your mercury fillings are making an impact. That's useful. Otherwise a blood test isn't going to make a big difference.

 

Adam:                        

Good point.  With all those – the aftermath of having a toxin burden, it seems like there's – obviously if you see a strong connection between toxins and autoimmunity, obviously they disrupt or are a driver of inflammation in the immune system and alter the immune system's normal patterns, if you can share a little bit more about that.

 

Wendie:                     

Think of it like it's – every person has – I always say to my patients, find your line and stay behind it. The body has its set point that works for the body. Then because we're humans, we like to push the envelope, so we live. We sometimes live hard. We may not have had the best role models for food or how to take care of ourselves, so we start to pile on stressors.

 

Think of it like a rain barrel. You're this empty rain barrel at birth, and then you pile on standard American diet eating, with lots of processed carbs. For me it was gluten. Then it was microwaved food that was microwaved in plastic. I'm a child of the '70s. We were freewheeling back then. Pile all that stuff on. Personally I had to go to med school, and then I chose to do a really hard specialty and had this predisposition for an autoimmune disease and didn't eat the best and had all these triggers and then had four kids. Pile it on.

 

What happens is the body has a difficult time compensating for all these exposures. You start to essentially chip away at what the body can do, because it's just getting overloaded. If you go back to that rain barrel, I filled my rain barrel. I was overflowing. My cup overfloweth. It was everywhere. For autoimmune disease, it's a state of inflammation. If you have inflammation, you're going to manifest it in some way that your body – that's the pathway your body is going down. For some it's Sjogren's. For some it's celiac. Others get diabetes or rheumatoid arthritis. Whatever that is, it's basically saying you have inflammation that's at a state that your body cannot cope with it.

 

Let's sleuth backwards, do the foundational stuff, fix the food, the sleep, the minerals, nutrients, hormones, and then make sure there's no toxins that we need to get rid of, that are causing inflammation for you. It's all about what's causing your inflammation. Sometimes I will have a rheumatoid arthritis patient who just by transforming their food, they get better. That's pretty rare. Usually they've got a lot of toxins.

 

Adam:                        

I agree. I think this concept of finding the driver and removing as much of the driver as you can is like a – it's such a quest in the autoimmune world to find what it is that's crossing the line, as you would say, because it's like – I love that term, because it's so true. We can get away – if you have predisposition, if you have genetics that are setting you up for certain problems, you really do have to figure a way to get away with as much as you can. Then there's a certain point where something might tip it off. I don't say that to be fearful. It's just the patterns we see.

 

Wendie:                     

There's always something. I'll say to someone, hey, in the year before you went off the cliff, what happened? I got divorced. I had two or three moves. I started college. I graduated college. I looked for a job. I lost a job. I got in a car accident. In the moment those things don't seem like they're life-altering, but they are considered major life events. For you it was the straw. People will say to me, my friend can – I'm like, I don't care about your friend, because you're not in your friend's body. You're in your body.

 

Adam:                        

Exactly.

 

Wendie:                     

For your body, that was too much.

 

Adam:                        

You have an experience having celiac disease that I think really puts you in a place where your optics are really clearer in this world as to the impact of environment on health. Can you share a little bit about your journey with celiac and how you've seen your management of celiac change over the years?

 

Wendie:                     

Sure. I will make this joke, Adam, that I am a pedigreed celiac. My dad has celiac. I think my grandmother had celiac. I think my uncle has celiac, but he hasn't been tested. My brothers have celiac. My kids we took off gluten before they got celiac. Two of them are sensitive, and two of them are not, yet. We have very powerful genes – terrible genes, but powerful – powerfully terrible genes.

 

My celiac story really starts from before birth, because epigenetics is the study of what happens to your ancestors that causes your genes to express themselves or not. My ancestors had sufficiently stressful events that caused me to easily, quickly, rapidly, and hugely express the celiac genes. 40% of the population has one or both of the celiac genes. I have both. Having the gene doesn't mean you're going to get celiac. It just means you're at risk. Then if you get gluten-sensitive, I call you a celiac in training, a CIT. We have CITs at camp, and there's a celiac in training at my practice.

 

My story starts before birth, because I inherited the genes that were not only for celiac, but turned on, ready to go. Even in my teens I had mineral and nutrient deficiency and iron deficiency that did not respond to supplementation, when I was 15. I had the early warning signs at that point. We're talking 35 years ago. It just wasn't a thing. Celiac was not a thing.

 

Then you fast-forward to I decide to go to med school. Remember the rain barrel. Pile on the stress. I had brain fog. This is a hallmark of celiac. Your brain doesn't work well. I struggled to do all the testing. I was like, they're just younger than me. I was four years older. It wasn't like I was 50 years older. I started to pile on all these things that made me more sensitive to gluten. I had an irritable bowel. I didn't think anything of it. Then I started residency, went off the cliff, but finally got diagnosed when I was 35. I know that I had been sick for 10, 15 years.

 

Unfortunately, celiac is genetic. If there's one person in your family who has celiac, the entire family needs to be tested, periodically too. Essentially if someone has the genes for celiac, then I would test them every couple years, and maybe minimize gluten so you're not at risk, because it's a clear line between if you don't eat gluten, you cannot get celiac, because it's based on exposure to gluten.

 

Back to my story, I got diagnosed when I was 35 and immediately eliminated gluten and also eliminated a number of foods that I was very sensitive to and had found out at the same time. That was dairy, banana of all things, tomatoes – had a whole list of things. I did a candida control protocol at the same time, because I had a lot of candida in my system. They often go together, gut irritation, inflammation. Candida has a field day when the microbiome gets thrown off. It's happy. Nothing inhibits it. It was happy and growing away in my gut. I also did that.

 

I felt pretty good for a number of years, but I was extremely sensitive to cross-contamination, like the canary in the coalmine sensitive. I used to joke that I could be the tester for programs to see whether their foods contained gluten above parts per million, except I wasn't reacting at 20 parts per million. I was reacting at eight. I could say, yeah, there's gluten.

 

My worst exposure occurred – let me think about this – about eight years ago. The kids were all at camp. All the kids were somewhere else, so my husband took me out for this really romantic dinner in the North End, which is the Italian section in Boston. We had an amazing dinner, and within a half hour I was sick and proceeded to be sick for the next three months, because what had happened is I had a cracked tooth, and it was right into my bloodstream and I was sick as a dog. That's the worst gluten exposure I ever had. It was from nothing. It was eating from a cast iron pan that had been used for gluten. We're really talking about parts per million here.

 

What I will say, just – you haven't asked me this, but I'll bring it up, that the impact of having recognized and then addressed my toxins is that my worst gluten exposure lasted three months. Now when I get a gluten exposure, within 12 hours I'm better. That's really transformed my life, because I couldn't even eat out. My gut was so jacked up and almost always on alert and ready. I don't eat at my friends' houses, and I can't eat out, and so I cook everything. Traveling's awful. That's been really impactful, because now I can start to go out in the world again and eat in certain restaurants that I know are safe, which is not something I could ever even do before.

 

Adam:                        

That's really inspiring, because people who are recently diagnosed with celiac, some can't even walk into a bakery. Just walking into a bakery with the aerosols of – being around gluten or having it contact their skin can set people off.

 

Wendie:                     

I don't spend a lot of time in bakeries, because I don't eat the food. I'm thinking back to – we have a bakery near us that has gluten-free and gluten-containing foods. I do go in there periodically to get these little mini cupcakes for my kids for birthday parties. I'm trying to think. I don't react after walking in there. Also, they're not baking. I wouldn't walk in if they were baking. I would not go in, because I don't want to inhale it, touch. I don't want anything to do with that.

 

Adam:                        

Just to be clear, I usually see that in people who have just been recently diagnosed where they're still really dealing with an intestine that's been damaged for years, and they're just getting into the world of being gluten-free. They're very sensitive and reactive at that state. That's really inspiring. I think someday, and I think it's not too far in the future, there's going to be more options coming out of Dr. Fasano's work with helping through medication so that people can once again eat gluten if they choose to.

 

Wendie:                     

Isn't that funny, Adam? I was thinking about that. It's been really challenging to have celiac. People say to me, "How do you live?" I'm like, I live pretty well actually. I don't think I would go back to eating gluten.

 

Adam:                         

Yeah, I hear you.

 

Wendie:                     

I'd like to eat out, and not eat gluten, but eat out without fear of being sick. That would be a huge motivator, but gluten and honestly its replacement foods are not good for you, because later on it's processed. Nobody eats the wheat berries. They eat bread. The flour's been processed down, so that's inflammatory. It was made with glyphosate sprayed on it, so that's messing up your microbiome. I don't think I really want to eat gluten, but I do want the freedom to go and stay in an all-inclusive resort and not eat gluten, just that sort of nuanced thing.

 

Adam:                        

That's a good point.

 

Wendie:                     

I'm a wicked groupie of Dr. Fasano. I'm convinced he's going to get the Nobel Prize. My husband always teases me, I'm the groupie and he's my boyfriend, because I love him, love him to death.

 

Adam:                        

He's amazing. It's been really fun to watch and learn from him. [30:36] With your process of addressing toxins, the evaluation, the questionnaires, the testing – and then you have a patient who you have taken through various changes and they've arrived at a point where you think that this is happening – you even take it a step further in your philosophy by saying that, until we get your stress under control, we should really proceed in a major detoxification process. Can you talk about that, the importance of addressing stress?

 

It's funny, because on the East Coast the word stress comes with a lot of eye rolls. It's like, what are you going to do about it? It's like, everybody has stress. It was interesting coming from an East Coast doctor, hearing that. You must really have to educate your patients about that this is a thing to really pay attention to, because West Coast, the surfers, and this, that, the other, it's in your face, but on the East Coast – can you talk about that? I think it was really refreshing to hear you talk about the importance of addressing stress and cortisol and those types of things.

 

Wendie:                     

Yeah, definitely. Think of stress as one of the platform foundational behaviors. What you put in your body, the food you're eating, the stress you're under, the way you're moving your body or frequency of moving your body, the relationships you have with others, your purpose in life, your ability to replace your minerals and nutrients, these are foundational.

 

Think about, okay, you're driving in a car, and you see from the corner of your eye that there is a car who is about the run the light that you have a green light for. You have this thought, I'm going to get in a car accident. You slam on the brakes. The other car notices and you don't hit each other. Doesn't matter. You've already set off the cascade of events in your body, just by having a thought, no event, just a thought, I'm going to get in an accident.

 

What happens downstream, so think – I'm pointing to my midsection. If you're listening, I'm like, right here. What happens is your adrenals, which are your fight, flight, or freeze organs, they kick in. They have got to be on point at this point. They are putting out adrenaline and cortisol because your body needs to respond. You also shut down digestion, because if you're about to get in an accident – your body is primitive. It doesn't realize accident. It thinks lion. It thinks, a lion's about to chase me; I really need to get away and run. You direct glucose towards your leg muscles. You shut down digestion. You shut down toxin removal, because that is not a priority. You focus on survival.

 

Now, if you do this every day, or if you have some kind of stressful event or chronic – death by a thousand cuts, again. It's just never-ending. You're in a relationship that doesn't work for you. You have a sick child. You hate your job or your boss – something that's constantly ticking away at you. You switch from going into the immediate fight, flight, or freeze, and you go into a more chronic state.

 

You do do your digestion, but your body starts to deposit fat around the midsection. This is when people say, I look at food and I gain weight. That's because your body is now in this chronic state of stress. It is thinking that it really needs to stockpile, because you really need all these calories in order to run from that lion. Again, we're super primitive. We haven't caught up with technology. Our bodies are still back 10,000 years ago. Even though we've had all these amazing strides, we haven't. We really haven't done that. Technology has; we have not.

 

Even your thoughts can trigger a whole cascade of things that will shut down digestion, shut off detox, mess up your sleep long-term, have you gain weight around the belly. That's angry fat, by the way. That's not happy fat. That's fat that's making cytokines and pro-inflammatory substances that are making your body unhappy, autoimmune disease. You see this rat wheel that we start to walk on. Stress is extremely impactful, interrupting the process. Focusing on telling your body it's safe, focusing on telling the body that it can digest, it can relax, it's okay, it's not about to be eaten by a lion, it's okay...

 

Patients will say to me – I see all these women, and I always say to them, I know it's always about your weight. I know that. Your weight, your hair, your skin – we care how we look. However, it's never about your weight, even though it always is about your weight. It's about what's causing your weight to be that way.

 

Women will say to me, oh – I had a patient, she took care of her husband who had a stroke. She drove two hours each way to work, each way every day. She had two young children who she needed to take care of. Her job was very challenging. She said to me, "I've gained 15 pounds. I can't take it off." I was like, "I love you." We've been together for a million years. I said, "I love you to pieces, and you're asking how to decorate your bedroom when the house is burning down."

 

Even though for women it's always about the weight, you have to figure out what are those things that are causing the weight to deposit. A lot of times it is stress at the root cause. Toxins play a role. Minerals and nutrients play a role. Hormones play a role. If you can't get a handle on the stress, you cannot lose any weight, period – toxins too. They all go together.

 

Adam:                        

 I love that because you can think about just from a behavioral model all the behaviors that when you're under stress you just default to.

 

Wendie:                     

Let me say something about that, Adam, because you just brought up such a great point, that often when you're in a state of stress, that's the point where you're playing 52 pickup. Who has time to eat well and get enough sleep and move your body? When you have a stressful event, you also stop doing your foundational behaviors. That makes it even worse, because now you have to recover from not sleeping, eating poorly, and being a stress ball. It's not in your favor.

 

I always say to people, double down. When you have a stressor double down, because that's the time you need to be particularly careful about your food, your sleeping, your exercise, instead of letting it – being like, oh, forget it. People will say to me, what do I do? I'm like, just carry a shake with you. Carry a powdered shake that you throw in some liquid, at least so you're not hungry, so you don't make bad choices around food.

 

Adam:                        

There's this chronic underlying problem of not being okay with making yourself a priority in those situations. We're very good in general at stepping up for other people in those situations or being there for the loved one that is demanding attention or the crisis that's demanding attention. Then it's like for ourselves it takes the backseat. I hear that over and over in my practice, is just like, I just don't make myself a priority.

 

Wendie:                     

It's funny, I always – I only see women, because I'm a gynecologist. I always say to these women – a lot of them have children or are thinking they might want to have children. I pull out the – it's like dirty pool. I pull out the dirty card. The dirty card is, if not for you, then for the role model you're teaching your children to be, because you might not do it for yourself, but if you have children, you want them to be people who take care of themselves and who honor their health and who recognize what they need and who eat well, take care of themselves, sleep enough, eat well. For their children, women will often do it, or for their future children, that they're being the role model they want to be for their children, because kids – I say to them, kids are going to do what you're teaching them to do, so if you don't take care of yourself, your kids are going to do that, because that is what you're teaching them. It's a dirty pool card, but I pull it a lot.

 

Adam:                        

Because it works.

 

Wendie:                     

It works.

 

Adam:                        

It's important and it's right.

 

Wendie:                     

I will say that as a mom, I didn't learn that lesson until about five years ago. I had a meditation coach who said to me, "I can't actually coach you on meditation. You are too tired to meditate. I can't coach you. Go spend a couple years taking care of yourself, and then we can revisit that, but right now, I've got nothing to work with." I was like, oh, I was fired by a meditation coach? Things must be really bad. I have spent the last five years prioritizing sleep, rest, exercise, taking care of myself. I just so regret that I didn't learn that earlier, because my oldest is someone who has a hard time prioritizing her health. I was like, bad mommy moment, that moment. I didn't win at teaching that to my oldest. I failed. Now I'm hopeful that the other ones I can maybe do, because I had the transformation early enough that maybe they get it. Really people will do it for their kids, but not necessarily for themselves.

 

Adam:                        

Very true. [40:45] In your book you really do a good job of looking at the broad spectrum of things that could be considered toxicants, and you do talk about this emerging topic in our field, mycotoxins. Do you feel like this is really a new problem or we just know more about it?

 

Wendie:                     

Such a great question. No, I don't think it's a new problem. However, I think that it's gotten worse, because it doesn't exist in a vacuum. You have this bucket or – I'm not sure how to language this. You have this simultaneous occurrence of more mycotoxins – we're a lot more mobile – and things that disrupt the microbiome, and more exposure to toxins and toxicants. We can't get rid of them, because we're being deluged. Then you layer this on, and people have a lot more reactivity to it, because of the underlying state of inflammation, challenge, stress, disbalance. I think it's been around for forever.

 

Adam:                        

How could it not be?

 

Wendie:                     

I think it's worse. I do think it's worse, especially because when you eat grains, anything that comes from a package with flour, it's got mycotoxins in it. If you say to someone, what are you eating? I have cereal or a bagel for breakfast. What do you eat for lunch? Oh, a sandwich or a wrap. It's a healthy one. It has lettuce and tomatoes. I'm like, okay, cool. What do you have for dinner? Chicken and pasta and a vegetable. Great, you have now exposed yourself three times a day to mycotoxins, because it's in all the processed grain.

 

I think it's a number of things that are coming all together, like a perfect storm, that we're eating it more, there's more sources of it, there's other ways that we're challenging our immune system, we have other things the body's trying to deal with, and then there's the mycotoxins. It's a perfect storm, but it's a bad one.

 

Adam:                        

I'll throw in there also eating lots of leftovers more and more, that the longer food sits in your fridge with these massive once-a-week meal preps and stuff like that, that's another source of mycotoxin.

 

Wendie:                     

I will say my mom always says to me, "Why don't you do your food prep for the week on Sunday?" I was like, "Ma, we have eight people eating with us every night." I have four kids, one husband, a live-in nanny, and my mother-in-law eats with us. My mom eats with us once in a while, so eight or nine people every night. Do you have any idea how much food that is?

 

Adam:                        

A restaurant.

 

Wendie:                     

We are like a little mini restaurant. I'm like, I'm just grateful to get food on the table every night. There's no way I could do that ahead of time, because prepping for one is manageable, but prepping for eight, forget it. It happens the day of. You're 100% right, leftovers are a tremendous source of mycotoxins, because the minute you put it in the fridge, it starts to grow.

 

Adam:                        

You can get away with a couple days here, but it's –

 

Wendie:                     

I would say 24 hours or less. I do have people who need to prep for the week. I say prep your whole meal, cool it, put it in glass containers and stick it in the freezer. The day you're going to eat it, pull it out and let it defrost on your way to work. Hopefully you have a toaster, but if not, microwave it or eat it room temperature.

 

Adam:                        

Definitely ways around it, different strategies. [44:35] This has been really a fascinating discussion. I would love to hear where you're going next in your career and what you're up to now that you have your book out in the public and people are learning more about how to help their bodies with inflammation and detoxification and stress reduction. What's next for you?

 

Wendie:                     

World domination, of course. I look at it like a one-three-five-year plan. Within the next year our goal – we've already signed to write our next book, which is all about menopause. I'm perimenopausal. My husband talked to me when I was having a hot flash. I looked at him, I'm like, "Dude, do you value your life? Seriously, do you value your life? You are asking me an inane question and I'm having a hot flash." Then I was like, "Oh, we got to write a book about that." Later in the year we'll write our second book, which is all about how to not be an evil witch in menopause, and then a companion guide for their partners on how not to get your head cut off when you're talking to your partner who's going through menopause.

 

We're going to do a summit on toxins and overall health. Really I think at this stage in my career, I love my patients. I'm continuing to see patients. The next stage is really about how do we take what we do and make it accessible to many more people, so that it's accessible to the broader population, who may not either have the resources, time, energy, or geolocation to be able to be a patient, to bring it from one-to-one into one-to-many so that we can make that impact on people, because it's everywhere, and people are literally dying for this information, for lack of the information.

 

Adam:                        

There's a lot that people can do. I encourage people to pick up your book and learn things you can do without even having seen a doctor to help you reduce this bucket load and help decrease inflammation.

 

Wendie:                     

There's so many things you can do. There's so many ways. Without ever seeing a doctor, getting the data, doing testing, there's a million things you can do on your own. Our book really walks through that.

[ We also have a program that's all about the food, because that's foundational. You have to start with your food. We have a program that helps people go from two diet sodas a day and lots of processed food into leveling up. We have that program.

 

Adam:                        

I bet you're good at convincing people to eat broccoli sprouts.

 

Wendie:                     

I really feel like – there's this great book called French Kids Eat Everything. It talks about how you can't try something once. You're never going to – you're not programmed to like it after once, especially if it's not sweet. Sweet you're going to like after one, but not sweet, you're probably not going to like it after one. You have to try things in all the different forms, 15, 20 times, in every form, so cooked, raw, steamed, sauteed, whatever. I always say to people, experiment. Hey, if you hate broccoli sprouts, go for micro greens. Micro greens are a great source of high nutrient density foods, and you don't have to eat that much of it.

 

Adam:                        

French Kids Eat Everything, is that a bedtime book or is it –

 

Wendie:                     

 No, it was a book written by a woman who moved to France and had American kids who then went into the French food eating system. French eat very differently than we do. They have smaller portions. They have a very broad pallet. Her entry into going from standard American food into French cuisine culture cooking was a very – she wrote a book about it. It was just a great book. I always say to my kids, "You haven't tried it 15 times. Try it another time."

 

Adam:                        

That's good. I'm working on the one-time try first.

 Any closing thoughts or closing messages that you want to leave us with? Also, if you could just leave us with how you want people to reach out to or get in touch with you if they...

 

Wendie:                     

My closing thought is, toxins and toxicants are everywhere. It can feel really overwhelming. Start with one thing. If that one thing that you're looking at – I would say start with food, because it's extremely impactful to just level up. Explore, learn new things, try new things, but don't feel overwhelmed, because it's a journey. It's not a destination; it's a journey. You're never going to be free of toxins. You're only ever going to be less. Don't get overwhelmed. Just chip away at it. That's that.

 

Adam:                        

Great advice.

 

Wendie:                     

 I'd love to have people come find me. The book is on Amazon. My suggestion is don't type in Dirty Girl when you go to Amazon. Type in Dirty Girl Detox. That'll get you to the book, or type in Dirty Girl Trubow, which is my name. That'll get you to the book. It's also on our website, which is fivejourneys.com. Then my Instagram, Facebook, LinkedIn, and Twitter are all the same name. It's Wendie Trubow MD. You can find me there. Then our website is fivejourneys.com. We have a podcast also called the Five Journeys Podcast: Live Like You Matter. That's also live. People can get to that on any platform that they're looking for – that they listen to on.

 

[50:01] Then lastly, we have a free gift for your listeners, because often as people are starting the journey of how do you clean up your life, it's super overwhelming. Since we did it ourselves, we put it all into writing. We have a companion guide to the book on how to detox your life, what pans do you use if you want to level up, and what beauty products and what cleaning products, all of the things that you use every day, what are those. That's at fivejourneys.com/promo. 

 

Adam:                        

Thank you. That's really valuable. It saves a lot of time.

 

Wendie:                     

It really does. We normally sell it actually, but for the listeners we give it out for free.

 

Adam:                        

Thank you. I'll put that up in the show notes if that's okay with you.

 

Wendie:                     

Sure.

 

Adam:                       

  Make sure people have all the information and all your contact information and social media links.

 

Wendie:                    

  Awesome. Thank you.

 

Adam:                        

 

[50:58] Thank you so much for spending the time with me. I've learned a lot. Your story is very inspirational, and just the health care world is really lucky to have you as part of the health care world, leading us and seeing patients. I'm sure your patients just love you.

 

Wendie:                      Thank you. You, you're part of it too, so in this together.

 

Adam:                         Exactly. Thanks for your time. Please come back when you're ready to talk about the menopause world, perimenopause.

 

Wendie:                      The evil witch comes back. That would be great, Adam. Thank you.

 

Adam:                         Thanks for your time.