In this insightful episode of Resiliency Radio, Dr. Jill Carnahan welcomes Christa Biegler, functional nutritionist, author, and host of The Less Stressed Life Podcast, for an empowering conversation about food sensitivities, eczema, and gut health. 🌱

Together, they uncover how skin conditions and digestive health are deeply connected — and why the answer isn’t always eliminating more foods. Christa shares her expertise on creating balance through nervous system regulation, gut repair, and nutritional rebalancing, helping listeners move from restriction to resilience.

💡 What You’ll Learn in This Episode:
• How food sensitivities, eczema, and gut health are interconnected.
• The hidden dangers of overly restrictive diets and how to avoid them.
• Real-life case studies, including Shelley’s story of transformation.
• How to identify and address root causes like stress, biotoxins, and thyroid dysfunction.
• Why education, empowerment, and professional guidance are key to lasting healing.

Key Topics You'll Discover with Christa Biegler

① Introduction to Food Sensitivities and Skin Health: The episode opens with a discussion on the surprising connection between food sensitivities and skin issues, emphasizing the role of gut health in this relationship.

② Personal Journey and Professional Insights: The guest shares their personal journey into the field of food sensitivities, highlighting how personal experiences often drive professional passion and purpose.

③ Challenges with Food Sensitivity Protocols: The conversation touches on the challenges and pitfalls of food sensitivity protocols, including the creation of new sensitivities and the importance of planning dietary changes.

④ Nuanced Conversations on Food and Health: The guest emphasizes the importance of nuanced conversations about food, advocating for a balanced approach to diet and health.

💬 Case Studies and Success Stories: A compelling case study is shared, illustrating the journey of a client named Shelley who achieved significant health improvements through a supportive and gradual approach.

🔑 KEY TAKEAWAYS:

📌 Interconnectedness of Health Issues: Skin issues and food sensitivities are often linked, with gut health playing a central role in managing both.
📌 Balanced Approach to Diet: Overly restrictive diets can lead to more health issues; a balanced and informed approach is crucial.
📌 Empowerment Through Knowledge: Listeners are encouraged to become informed and empowered, learning to ask the right questions and seek effective solutions.
📌 Importance of Professional Guidance: The episode underscores the value of professional guidance in navigating complex health issues, ensuring that interventions are tailored to individual needs

🔑 CONCLUSION: This episode offers valuable insights into the complex world of food sensitivities and skin health, providing listeners with practical advice and inspiring stories of transformation. Whether you're dealing with these issues personally or professionally, the episode is a rich resource for understanding and improving health outcomes.

About Christa Biegler

Christa Biegler is a licensed nutritionist, author, and host of The Less Stressed Life Podcast. She helps health-savvy women overcome eczema, food sensitivities, and fatigue without endless elimination diets or excessive supplements. Passionate about thyroid health, nervous system balance, and detox pathways, Christa brings a practical, science-based, and compassionate approach to wellness. She lives in the Midwest with her unicycling husband and kids.

🌐 Connect with Christa Biegler: Website: https://www.christabiegler.com/about and https://www.instagram.com/anti.inflammatory.nutritionist/

Dr. Jill Carnahan, MD – Leading Functional Medicine Doctor

Dr. Jill Carnahan, MD, ABIHM, ABoIM, IFMCP is internationally recognized as one of the most respected leaders in functional and integrative medicine. She is dually board-certified in Family Medicine and Integrative Holistic Medicine, and the founder and medical director of Flatiron Functional Medicine in Louisville, Colorado.

Widely known as a pioneer in environmental toxicity, mold-related illness, autoimmune disease, and resilience medicine, Dr. Carnahan combines cutting-edge science with compassionate, root-cause care. Her clinical approach integrates precision genomics, epigenetics, microbiome research, peptide therapy, and lifestyle interventions to transform health outcomes for patients worldwide.

She is the author of the best-selling memoir Unexpected, which weaves her personal journey through cancer, Crohn’s disease, and mold-related illness with her professional expertise. Dr. Carnahan is also the executive producer of the award-winning documentary Doctor/Patient and the host of the popular podcast Resiliency Radio, which reaches over 500,000 global subscribers.

As an international keynote speaker, Dr. Carnahan has been featured at leading medical conferences including A4M, IFM, EPIC, and IPM Congress, and her work is frequently highlighted in major media outlets such as NBC, CBS, Fox News, Forbes, Parade, People, and MindBodyGreen.

With a reputation as both a scientist and a healer, Dr. Jill Carnahan is regarded as one of the top functional medicine doctors in the world, offering a unique blend of evidence-based research, innovation, and deeply personalized care.

The Podcast with Christa Biegler

The Video with Christa Biegler

The Transcript – Overview

Skin Health and Immune System Interactions

The discussion clarified that eczema and related skin conditions stem largely from internal immune and microbial imbalances rather than surface issues alone.

• Krista Bigler emphasized the role of low-grade infections like staphylococcus aureus overgrowth in skin inflammation and noted that around 80% of fungal infections clinically do not show positive cultures due to testing limitations (08:05).
  • This means many patients suffer from microbial imbalances that go undetected, requiring high clinical suspicion.
  • Skin inflammation often worsens with common colds or stress, showing a dynamic immune response.
  • Topical infections must be addressed first to allow healing; otherwise, internal treatment alone won’t succeed.
  • Dermatologists often recommend bleach baths to control bacterial overgrowth on skin, highlighting microbial control as key.
• The immune system’s imbalance between TH1 and TH2 responses drives atopic conditions like eczema, asthma, and allergies, which are tightly linked to gut health as well (11:21).
  • Stress chemistry and detoxification pathways also fill the metaphorical “inflammatory bucket,” triggering immune flare-ups.
  • The skin acts as a drainage organ, so dysfunction in liver detox and gut microbiome imbalance often manifest visibly on skin.
  • Mold exposure suppresses immunity, worsening skin infections and triggering recurrent fungal issues especially in lymphatic areas like armpits and scalp.
• Krista described three layers of eczema causes: gut-immune mediated, drainage/detox related, and stress hormone driven, each requiring distinct treatment approaches (16:59).
  • The gut-immune layer presents as red, angry rash worsening through the day, often in classic areas like behind knees and inside elbows.
  • Detox-related eczema tends to be dry and flaky, worsens in winter, and links to sluggish bile and lipid metabolism affecting cell membranes.
  • Stress-related eczema commonly appears on hands, worsened since 2020 by sanitizer overuse and heightened stress hormones.

Treatment Approaches and Patient Triage

Treatment strategy depends on patient stability, focusing either on calming hypersensitivity or addressing gut-immune imbalance without extreme restriction.

• Krista triages patients into two categories: those in “total chaos” needing calming and nutrient support first, and more stable patients who can start gut-immune system repair without heavy food restriction (34:06).
  • For hypersensitive patients, calming inflammation and addressing any skin infections are priorities before gut work.
  • Stable patients begin with reducing inflammation and immune activation without removing many foods long term.
  • Krista and Dr. Jill agree that long-term severe food restriction worsens outcomes by increasing food sensitivities and prolonging healing (37:19).
  • Temporary reduction of gluten, dairy, sugar, and alcohol for 60 to 90 days can help reduce antigen load but should not become permanent.
• Krista stressed that restriction-based diets reduce microbiome diversity and impair long-term recovery, making reintroduction of foods slower and more challenging (38:41).
  • Patients often present with orthorexic tendencies due to fear and frustration, requiring supportive coaching to regain dietary freedom.
  • Autoimmune patients (Crohn’s, celiac) often require more sustained restrictions, but gradual expansion is still possible.
  • Quality of foods impacts inflammation; for example, US wheat sprayed with glyphosate causes more reactions than European wheat (45:29).
• Both speakers highlighted the importance of patient empowerment and setting realistic expectations, aiming for patients to stand on their own feet without lifelong dependence on practitioners (56:00).
  • One client improved 63% in 4 to 6 weeks just by adding supportive nutrients and calming inflammation before more complex treatments (55:51).
  • Krista uses a variety of communication methods, including written check-ins, to support busy patients toward steady progress.

Nutritional and Supplement Support for Skin and Detox

Optimal skin healing requires targeted nutrients that support cell membranes and detox pathways, balanced carefully with patient tolerance.

• Krista recommends therapeutic doses of omega-3 fatty acids, around 4000 mg total daily, to improve systemic dryness and support cell membrane integrity (50:15).
  • Omega-3s are consumed through fish like black cod or sable fish, especially for those with poor conversion of plant-based ALA.
  • Inflammation depletes omega-3s, so cycling supplementation during stressful or inflammatory periods is beneficial.
• Additional key nutrients include tocotrienol form of vitamin E (e.g., Quicksilver’s Membrane Mend) and phosphatidylcholine, which supports membranes and detox but should be introduced cautiously to avoid bile overload (52:15).
  • Phosphatidylcholine is avoided early in treatment due to its bile-moving effects that can trigger symptom flare.
  • Cod liver oil may be used but requires higher doses to match omega-3 content.
  • Supplement timing and stacking are critical to prevent overwhelming detox pathways and skin reactions.
• Krista avoids commonly used bile-support supplements like TEDCA early on due to adverse reactions in her patient population (53:25).
  • She advocates a layered approach to gut-immune and detox support, waiting until patients are stable before advancing to bile-moving interventions.
  • This staged strategy reduces flares and improves tolerance, accelerating skin and immune recovery.

Stress, Detox, and Environmental Factors

Stress and environmental toxins, especially mold, play a critical role in skin and immune dysfunction, requiring integrated management.

• The stress-driven eczema layer became more prominent after the 2020 pandemic, with increased hypersensitivity and mast cell activation from viral impact and sanitizer overuse (30:36).
  • Hand eczema surged due to disrupted skin microbiome from alcohol-based sanitizers and increased stress hormones.
  • Stress hormones interfere with skin barrier repair, making hands particularly vulnerable.
• Mold exposure suppresses immunity and complicates detoxification by mobilizing toxins faster than the body can eliminate them, leading to skin flares (21:32).
  • Mold-related skin symptoms often show in lymphatic-rich areas such as armpits, groin, and scalp.
  • Mold history delays bile-moving treatments to avoid worsening symptoms.
  • Mold also predisposes to opportunistic infections like staph and recurrent yeast infections, which require vigilance.
• The liver’s role in detox and fatty acid metabolism links environmental toxin burden to skin dryness and immune imbalance (19:13).
  • Supporting liver detox and bile flow improves cell membrane health and reduces systemic inflammation.
  • Nutrient support for detox pathways is essential to prevent toxin buildup and symptom flare.

Patient Experience and Long-Term Vision

The conversation highlighted the emotional burden of skin conditions and the importance of hope, realistic pacing, and joy in recovery.

• Both speakers shared personal stories illustrating the deep impact of visible skin disease on confidence and daily life (26:12).
  • Krista described the shame and isolation patients feel, especially mothers with children who have eczema.
  • She emphasized the need to support patients’ nervous systems to avoid absorbing their distress and to provide empathetic care.
• Recovery is often non-linear and slow, especially for long-term sufferers; patients with over 5 years of skin issues typically have more layered and complex cases (19:13).
  • The goal is not just symptom suppression but restoring balance across gut, immune, detox, and stress systems with sustainable lifestyle changes.
  • Krista’s approach includes educating patients to ask their own questions and regain control, reducing dependence on practitioners (56:00).
• Joy and freedom around food and life are central goals; Krista encourages patients to enjoy foods like birthday cake and not fear reintroduction when possible (06:59).
  • She works against orthorexia and food fear, emphasizing that restriction is usually counterproductive long term.
  • The European cultural example was cited where less stress around food and more joy correlates with fewer inflammatory conditions (46:42).

Resource and Engagement Opportunities

Krista offers multiple ways for patients to engage with her work, combining clinical care, education, and ongoing support.

• Krista runs a podcast called Less Stressed Life that explores inflammation and stress topics broadly, reflecting her holistic philosophy (59:15).
• Patients can access her work and resources at kristabigler.com for education and support.
• She offers personalized care with options for Q&A and written communication to fit busy lifestyles, focusing on steady progress and empowerment (57:00).

Transcript

00:00
Dr. Jill Carnahan, MD
Hey everybody. Welcome to Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine. I'm your host, Dr. Jill and with each episode we dive into the heart of healing and personal transformation. Join me as we interview thought leaders, medical experts and people of all types and backgrounds with interesting tidbits to help you on your journey for optimal performance and longevity. Today's no Difference have you been told to restrict foods because of a food allergy test? Or have you been restricting foods and you just find the box is getting smaller and smaller so that you're down to four or five or ten foods that you feel like you can eat without reacting? Today we're going to bust the myth that you have to continue restricting foods in order to get well. 

00:45
Dr. Jill Carnahan, MD
And we're going to talk about skin conditions like eczema and atopic illnesses. And you will not want to miss this incredible interview with Krista Bigler. So stay tuned. Before we jump into the interview, I just want to share with you. We have lots of products and services that are specially curated and today's episode in particularly. You may want to check out my antihistamine products, my mast cell bundle and you can find all of that@drjillhealth.com again drjillhealth.com you can also find natural beauty products that are incredible for skin health and anti aging. And one thing I want to be sure and mention today is our beauty collagen. This product is one of my very favorites for hair, skin and nails. I take a scoop and put it into my coffee every single morning. 

01:29
Dr. Jill Carnahan, MD
It is one of our best sellers and I just feel like I cannot go a day without it. It's loaded with peptides and collagen and silica and the things that your skin needs to be optimal glowing and your nails need to be strong. I have the strongest nails I've ever had in my life since I've been taking this. So find this@doctor Jill health.com Now I also want to mention, I don't know if you know, but I actually have a clinical practice near Boulder, Colorado and we are accepting new patients. So if you're out there struggling with mast cell activation with chronic complex illness of any type, we are taking new patients. I have a nurse practitioner and a PA that are mentored by me and work together with me on cases and we are accepting clients. 

02:09
Dr. Jill Carnahan, MD
So if you are interested in becoming a patient, feel free to call the office at 303-993-7910 or send an email to ask flatiron functional medicine.com okay, let me introduce our guest. Christa Bigler is an author, podcast host and private practice owner helping with health savvy women overcome eczema, food sensitivities and fatigue without unnecessarily restricting endless testing and supplements. She has a passion for subclinical thyroid issues, nervous system and stealth biotoxins. And she lives in the Midwest with her unicycling husband and children. Going to love this episode with Christa. And let's get to the show. Christa. I am so excited to be here one of my favorite topics. We're going to talk about food sensitivities and I want to also talk about skin, which many people may be like, what are those two doing in the same conversation? 

03:00
Dr. Jill Carnahan, MD
But all of it relates to our gut, so we're going to dive deep. If you're listening and want to know more, please stay tuned. Listen till the end because you're going to get some real good pearls for yourself or someone you know who is suffering. But let's start with your journey because it sounds like you've had some of your own experiences with this and that often drives our passion and purpose. Tell me a little bit more about how you got into this field. 

03:20
Christa Biegler
Yeah, accidentally as usual. Right. And as a dietitian by trade, I thought it was pretty cool to change your diet and to get to see different things happen. And so I got into food sensitivity work, kind of a certification and that kind of work about 10ish years ago when it was, I feel very popular at the height everyone was talking about that. And my journey was a little bit different. It was interesting. When I first started doing that work with clients, it was all going quite well. But for me, I had a different experience, a lot like some clients have, where the food sensitivity results showed that I was reacting to everything that I was eating, which sent me into an emotional spiral of I'll just stick that on the fridge and deal with it later. 

04:01
Christa Biegler
Shortly after that, around, I mean, it's a bit of a blur, but around that same time I ended up with a I would what I would call my first big health crisis, which I woke up one morning. It's funny because it's like, did I really wake up one morning? And that's exactly how it went down. So I woke up one morning and my face and my neck were covered in a rash. Now the trigger, there's always a triggering event, very often. Right. And so the trigger was five Days straight at the swimming pool with my kids. Unusual for me because I used to think I had genetic, quote, unquote, dry skin that only presented in the winter. And I never really had a problem, right? It wasn't causing enough issue for me to think it was abnormal at that time. 

04:39
Christa Biegler
And it wasn't causing enough stress. But I woke up that morning, I was dealing with a career change, a couple of kids, right? Like, all those stresses that sort of let things happen. And so to kind of tie it all into a bow. I was looking for help with skin stuff, struggling. And at the time I was like, okay, I guess I'm gonna go do this food sensitivity protocol. It was a month after I did the results, which is a terrible idea in the first place. And now I'm not even into this at all. So we'll talk about how this all comes 360 or 180. But essentially what happened was I went under the food sensitivity protoc. I didn't see a massive difference a little bit. But what was really striking to me was actually kind of created food sensitivities that weren't there before. 

05:18
Christa Biegler
So specifically, I was at the end of a couple week period. And, you know, if you don't plan, when you change your diet, you're going to be hungry. And when you're hungry, nothing is good, right? And so these are just real things. Like everyone is a human. These are real human experiences that we live through. And I remember sticking my hand in a bag of pecans because I was going through the pantry like a raccoon looking for something I could eat. And I remember my eyes swelling from eating these pecans. And I'd never had any kind of reaction to that, like that to anything before. And so, you know, this is not such an unusual story. You've seen this many times where it's like, okay, everything is dysregulated. The immune system was literally having a freak out. 

05:57
Christa Biegler
And I created more problems by going into restriction mode. So that was kind of the beginning of that story. And the, you know, the bridge in the middle is it was really hard to find people who knew much about skin stuff. And so as much as I tried not to work with skin issues for a number of years, people just kept coming to me for it. Because when you have a personal experience around it, you're pretty. You know, it's just different. It hits different, right? And so. And I could talk about this topic endlessly and I have lots of opinions about it. What actually works well and what does not work well, and I love to be as generous as possible with it, because we are in a. It's just. It's an underserved area. Right. And it's a really common issue. 

06:35
Christa Biegler
And so if we can try to help people get results faster around these. These are so. I love people to have a free life and enjoy food and enjoy birthday cake. Like, that's. Those are real things that I'm really in love with. But people always came for skin issues, and these things are just tied together. Right. So usually if you're having skin stuff, you think or you might be having or whatever, you might be having some type of food reaction, it's part of the entire conversation. It's even part of the atopic march. Right. Like allergies versus sensitivity. So allergies, asthma, eczema, all part of the. They go together. All immune issues in general. And so, of course, not surprisingly, that was my first health journey 10 years ago. Of course, we all have our. 

07:15
Christa Biegler
We have a cascade of health journeys in our overall journey in general. 

07:19
Dr. Jill Carnahan, MD
What next? Right. 

07:20
Christa Biegler
Yeah, Right. Stress hormones. Broke myself with fasting, but that's a different story for a different day. 

07:25
Dr. Jill Carnahan, MD
And again, we can. We'll tie all this together. If you're listening, like, okay, how'd that all connect? I really love this personally, because I grew up on a farm, and unbeknownst to me, I had incredible toxicity, leaky gut, and severe eczema, as you can imagine. I literally would scratch myself at night, so my sheets would be bloody in the morning because I'd scratch so hard and so bad and the dryness and all that. So I also unbeknownst. And this was, like, at 5, 8, 10, 12, like, young, not knowing, that was just. To me, it was just normal. And then, of course, my mom tried to help, and we go to the doctor and I get steroid creams, which didn't have really helped the root cause. So I have lived that. 

08:00
Dr. Jill Carnahan, MD
And then with my Crohn's and celiac and all that, I know a lot of how this is all connected. But let's hear from you. I think you have been such a voice in this area and so important. And the truth is, people out there listening are struggling, and they maybe don't know it's related to the gut. But let's kind of frame this deeper in balance. Like, how could the gut, the immune system, the liver, these things that are underlying. Maybe you start to kind of frame the underlying root causes of how someone could present with atopic issues or rashes. 

08:30
Christa Biegler
Or eczema there's multiple ways we can go about it. And if you don't mind in a bit, I'd love to share kind of something I've come up with for categorizing it, because I generally think that we try to treat it all the same first. So I'm going to answer your question first. I want to bridge something you said. One of the issues is that unfortunately for this specific issue, our toolbox is so shallow. It's just steroids and then biologics. And people say that's it, right? What? Right. And then, and then we generally do not agree about the other root causes, but actually something we do agree about universally, conventionally and holistically, functionally, whatever is a presence of low grade infection. And I think this is important because one of the areas of relapse is the common cold. 

09:14
Christa Biegler
So sometimes you'll be clear and then you'll have a cold, then you'll be like, where did these symptoms come from? Low grade infection. And so we universally agree that there's a staphylococcus aureus overgrowth with skin issues. And so the skin grows from the inside out. And so when we're trying to treat it, and that makes sense to people if you really think about it, right. It's like, oh, of course. And so very commonly, if you go to a dermatologist, one of the treatments, I guess we have a few more treatments that they recommend. They might recommend a bleach bath, right. Which is antimicrobial dunk, essentially. There's other ways you could do that without bleach, but they'll recommend that because they're trying to control the overall bacterial overgrowth on the skin in general. Right. 

09:54
Christa Biegler
And so when we have this kind of low grade infection, when we kind of go to the more of the functional or holistic version of this, we kind of look at an overall terrain and overall microbiome. Right. So it could be bacterial overgrowth, it could be fungal overgrowth. As you are very aware, mold is a huge driver just because it's a more aggressive fungus, the more aggressive toxin. And then also you can have parasitical things driving. I mean, it's sort of the gamut, in my opinion. And whether we like it, like, we like testing, but not every test is going to show anything. So, you know, we arrive at lots of opinions about that would be, we all want a quick, easy button for everything. And what I would say is, in general, the terrain is out of balance. 

10:35
Christa Biegler
So your question was, how does that affect the gut and the Immune system, essentially. I like to think about it. There's an image I have in my head from immunologist Dr. Samuel Yanik. And when I first saw this image, I thought, oh, this is exactly how I'm practicing. Thank you for putting it into an image for me. I appreciate this. And so there's a circle in the middle that says inflammation and then there's all these little circles that are filling the inflammatory bucket. And so one of them is overall dysbiosis or imbalance that we just talked about those microbial overgrowth. So we generally agree about it. We don't agree about it completely. And if you go and try to get a topical culture for fungus, apparently, according to dermatologists I've interviewed, they say not always accurate. 

11:15
Christa Biegler
So we can talk about some of that too, because these pieces, it's the nuance that's important, right? Because we'll get stuck on. Well, I had a swab and they said there was no problem, like, well, let's discuss. Okay, so there's the image of the inflammation. Inflammation is just an umbrella term, right? It's a full bucket, as you have probably described here. And so we've got our overgrowth of bacteria, organisms, et cetera. And then the other big circle, which I think is really important is we've got stress chemistry. And so we've got what's going on in the nervous system also talks to the overall immune system. And then there's a bunch of other inputs, detox issues, et cetera, what is going on in the environment, other things. They're kind of like little line items. We can make them all the same circle. 

11:56
Christa Biegler
But all of this are filling that inflammatory bucket. That inflammation is talking to the immune system. It's throwing the immune system out of balance. TH1, TH2 dominant balance. It's triggering other inflammatory mediators. And then you're going to start to see essentially exacerbation of immune stuff. And different immune exacerbations look differently. But the one I most commonly see is this atopic look list like asthma, allergy, sinus eczema, et cetera. More so than. There's some different presentations, but that's the one I more commonly see. So that's how I, I like to think about it. So yes, the gut is a huge part of it. And so there's so much to unwrap with the gut. And then automatically, because the skin is a drainage organ, what's going on with drainage as a whole is a huge conversation as well. So those are the two. 

12:43
Christa Biegler
Those are two of the systems. But there's another system as well that's involved. 

12:46
Dr. Jill Carnahan, MD
I love it. Well, let's dive into that next. But I think it's so critical for people to understand that often at the root is, you'd be surprised, but your gut drains into the liver, and the liver, when it's overloaded, presents on the skin. And so this is all connected, as you so well eloquently talked about. And all often, like you said, doctors, for example, you mentioned mold or yeast cultures. When we do that for sinuses or gut, it takes about 30 days in the right culture to grow these things out. And even then, often that mold or yeast or fungi will not grow. So it's extremely common. I would guess clinically, this is not evidence based, just my clinical experience. Maybe 80% of those people who really have fungal issues will not have a positive culture. 

13:28
Dr. Jill Carnahan, MD
So again, I love that you say that because there's other ways that we can look at possible fungus. But your doctor or your clinician or your nutritionist has to have a pretty high index of suspicion. And just like you said, we often find bacteria or fungus or parasites or some other thing, the infectious burden contributing to that. Do you want to walk us through a little bit about, like, why something in the gut would affect the skin? 

13:51
Christa Biegler
Yeah, I think just backing up to finish up what you said. So just to comment on that, I actually think your clinical experience is incredibly valuable. And I love that you brought up that 80% because that's what I was. I had not heard a number that high from the dermatologist. They just said it's not very accurate swab of fungus. Right. And so I share that because so often we kind of get stuck with these roadblocks of like, well, I tested that. There's so many things I hate even saying out loud sometimes. Or I want to give a full caveat on a podcast because, you know, for example, if I use the words H. Pylori, I'm like, my goodness, I better give a, you know, two or three minute caveat here type thing. 

14:31
Christa Biegler
But I will say you can go in and get swabbed, right, for staff. And that's a little more accurate. But at the same time, even if it shows up negative and it's pretty inflamed, supporting micro balance on the surface is a really good first step. And actually, I should mention that really quickly because there's so many things that happen when people come in and present and in. In a minute, if you don't mind, I'll probably talk about how it looks when it's more gut mediated versus other forms. And that's where unfortunately, sometimes we get lost. And we could probably be a little bit more efficient in helping our clients and give them a little bit more of a realistic outlook on like how long it's going to take to resolve things. 

15:09
Christa Biegler
But what I was going to say is a lot of times sometimes people come in and there's a couple scenarios. They're either ready to come in and get to work and get started or they're like in total chaos. And I would call it like everything's on fire. They're reacting to everything. Like all kinds of stuff is happening. And so there's two things I want to look at right away. I want to sort of fake it, calm down the immune system, which is in the gut. Right. Or I want to support that topical skin. And sorry, I got stuck up on this one, but it's important because if you have an infection, it's sort of like the house burning down and you're going to be trying to drywall. It just doesn't work. So don't even try to go about it from a holistic perspective. 

15:47
Christa Biegler
If you have a topical infection, it just does not work. Yeah, it just does not work. So you've got to, if you've got, you got to kind of assess for infection. And the simple version is if it looks terrible, it might be infected, if it looks oozing, if it's broken open, if it is weeping at all of those are much more significant. And you know, I use all these subjective terms. Tricky. This is why people submit photos. I'm like, oh, you should go in and get this swabbed or you should go in and just treat the microbes on the skin. Right. Because otherwise you're not gonna be able to heal that skin barrier. And then what we want, of course we want my skin. We want it to be simple, we want it to be external and it's like twice as hard. 

16:25
Dr. Jill Carnahan, MD
Yes. 

16:25
Christa Biegler
Because you're dealing with the topical microbiome and you're dealing with the internal. Right. So if you don't mind, you asked how the gut could be related to skin issues and when I was talking about how overgrowth in the gut grows from the inside out. Right. We have this tissue on the inside and we have tissue on the outside and it grows from the inside out. But if you don't mind, I'll frame it in a way that I think is really helpful for people to kind of categorizing their own eczema so one of the problems I think with this industry is that we sort of treat it the same, right? And there's pros and cons, but usually I'm talking to people because it's a con, right? Like they're like, I don't really get why X, Y, Z isn't working for me type thing. 

17:03
Christa Biegler
And so I will say that there's three to four underlying systems. We're trying to bring in a balance. We've already kind of given some lip service to all of them. We talked about gut immune system, right. Those two kind of are our partners. We talked about drainage and detox. Right. So detoxification, there's multiple detoxification organs. Drainage is a little bit bigger of a conversation. We can dive into that if we want to. And then the other system to me is stress hormones. And I kind of mentioned it a little bit because that's communicating with the immune system and the gut in general. So just like there's those three systems to me those are the dominant areas. The dominant areas that need support, depending how the skin is looking. So the first layer, and I think about this as like layers of a cake. 

17:42
Christa Biegler
And sometimes you have all three layers of the cake and sometimes you just have one. And it's actually pretty straightforward. I would say the majority of pediatrics, not maybe the majority is an overstatement, but a lot of pediatrics, they're going to fall in kind of this first layer, which I would call gut immune mediated eczema. And that's going to look red. Unless you have darker melanated skin, it might look more gray. So that's, it'll just change based on skin color a little bit. But for lighter toned people it's going to be red angry. Usually some characteristics is that it's going to be worse in the afternoon and not in the morning. This is pretty like histamine driven overall. Right. So you might relate with reacting to different histamine foods. That might mean like broth or strawberries or bananas or avocados are sort of flaring. 

18:24
Christa Biegler
Again, those are not super root cause. Those are kind of like surface level symptoms. What else would be really common here? So waking up looking clearer than you go to bed, hot water being really irritating to you, getting worse, like just generally having trouble regulating temperature, but just kind of red, rashy. And then I would say if it's presenting in circles for sure this is also part of the conversation. It's going to be in those really typical places as well. The inside of the Elbows behind the knees, those are the classical initial places. That is just basic eczema inflammatory 101, the most introductory level, and I would argue the simplest. So. And I would generally say also, if you've had skin stuff for less than five years, it would probably clear up a little bit faster. 

19:13
Christa Biegler
Like, it may clear up a little bit faster than someone who's had it for more than a decade. The longer you've had it, the more layered it gets. And so a very common story that you'll hear is, I had it as a child and I grew out of it, and then it came back in college or as an adult or something, and then it becomes more layered. So the next layer, I kind of call it environmental, but it can also be like detox or drainage driven. And so this looks like more dryness overall. So it's more like dry and flaky. It might be worse in the winter versus the summer. It's not a requirement in general. Yeah, dry, flaky, I would say more reactive to chemicals. You might say, like, I have more sensitivity. Like, you might. These are. 

19:56
Christa Biegler
There's so much nuance here where it's like sometimes you might not say, I have sensitive skin, but you've adjusted all your products. 

20:01
Dr. Jill Carnahan, MD
Yes, yes, exactly. 

20:03
Christa Biegler
Or you. Or you have a sensitivity to smells. And so in general, why would it be dry? Because the liver is a big. This organ helps with fatty acid metabolism. Right. We have bile and it breaks down our fats. And then those lipids make up these nice cell membranes. And if you have all these, if that process is working well and efficiently, there's all kinds of great things that happen. But one thing is that each cell membrane is going to be very nice and it's not going to be dry, dried out and whatnot. And so if just physiologically makes sense that at that point, okay, now we've got another system involved. And that dryness does take probably a little bit longer to resolve because we're trying to support two major systems and generally we're probably going to support both of them anyway. 

20:46
Christa Biegler
But now when you've added this layer, that becomes even more of a priority. You need to do additional loving on of those systems in order to, like, get to where you want to go. Right. May take a little bit longer, a little extra love. And you probably got both. Both. Now you have both things. And like we already talked about, when the gut has over. I love using the lawn as an example. When the gut is overgrown in weeds, you have a lot more. Like there's a Lot more trash to pick up. Right. Overall, like there's more dandelions giving off more seeds. And so all that toxic, those endotoxins from the bacteria, you know, your liver, like your detoxification systems have to take that out too. 

21:24
Christa Biegler
So as you reduce, it's sort of like a, you know, a little bit of one, half a dozen of another where it's like you start to reduce those microbes and it reduces the toxic. Birch. 

21:33
Dr. Jill Carnahan, MD
Right. 

21:33
Christa Biegler
So those two things go together. Probably one of the more. Probably something I like to try to correct, how people start to think about it is the way we talk about detox is a little. Probably not your audience, probably not the people listening to this necessarily, but we can talk about detox a little bit superficially. We might say things like, oh, I tried to detox by eating some. Someone wrote this to me recently. I tried to detox by eating meat and vegetables. And I was like, that's not the word I would use for that. You know, I suppose you're removing toxins from coming in if you simplify to a whole foods diet. But I just think that's foundational and fundamental. 

22:11
Christa Biegler
When I think about detoxification, I'm sure, just like you, I think about it being this machine that requires all these nutrients and all these things to work. And one of the reasons I have a job is that it's not quite as simple. And you know this from working with lots of mold people and from having your own symptoms and your own mold stuff. If you go too hard, too fast. 

22:30
Dr. Jill Carnahan, MD
Yeah. 

22:31
Christa Biegler
Where do you. It's all going to show up on the skin. 

22:33
Dr. Jill Carnahan, MD
And then people are like, you alluded to this. Exactly. And may say it slightly different, but I always say it's mobilization and excretion. Right? 

22:39
Christa Biegler
Yeah. 

22:40
Dr. Jill Carnahan, MD
Mobilizing them out of the tissues. But if your excretion pathways are blocked, then it shows up in somewhere, whether it's brain or skin issues or whatever. So. And you can mobilize too quickly where your excretion can't keep up with it. 

22:51
Christa Biegler
Right? No, I love that. I love those terms. And sometimes different terms work better for different people. I think sometimes drainage is confusing. 

22:57
Dr. Jill Carnahan, MD
Yeah, I love that too. Exactly. 

23:00
Christa Biegler
No, I love. I love that. And so very specifically, what happens. Right. Is if we get into things that really push on bile, typically it's a nightmare and it shows up on the skin. And especially if there's mold history. If there's mold history, it's always showing off throughout the process. Usually people will. It's more common. There's such a gamut. Right. It just depends on how significant it was. And I would say my jam is mild to moderate. I'm not looking for like this severe unstable situation. Right. But there's a lot of education where it's like, yeah, your college house is still affecting you as an adult 10 years later. It's inside your body and it's just kind of hanging out there thriving. Right. Making you look reactive to gluten and dairy. 

23:42
Dr. Jill Carnahan, MD
Hey guys, just a quick pause to remind you that you can find all kinds of great products and services@drjillhealth.com related today's episode. If you're struggling with skin rashes or histamine issues, some of our favorite bestsellers are the Omega Plus 1300, which is a high potency EPA DHA, which is incredible for the skin. You can also find one of my favorite Dr. Jo beauty products. It's called. It's kind of hard to read this Dr. Jill Beauty Collagen. And it is a phenomenal. There we go. Beauty collagen. Really, really powerful improver of skin integrity, of hair, nails, all of that. So it's got the biotin that we need, but it also in there has collagen peptides, the inositol stabilized silicate and silicone, which is incredible for powerful hair, skin, nails. And I have literally, I won't go a day without this stuff. 

24:35
Dr. Jill Carnahan, MD
I put it in my coffee. So you can find that and other things@drjillhealth.com and back to our show. Totally. And Krista, just as I said, I, you know, had this childhood eczema which resolved. But then when I got the mold and the detox there, I have photos that look so horrific of my skin. And so it was. And now that I look at patients, I'm like, oh my gosh, that's mold. Just like you. Right? You can see it. And I mean, my eyes would swell shut, they were crusting my arms completely covered with rash and itching, all that. And it was fine because it had like a decade or two of almost no eczema. And then when that mold started detoxing from my body and my bile was sluggish, just like you said. 

25:11
Christa Biegler
Socks. 

25:12
Dr. Jill Carnahan, MD
Yeah. And sometimes I'll show those pictures of lectures and people like what? Like that's you. It's pretty grat. It's pretty awful when it happens. And again, I'm sure you've seen people. 

25:20
Christa Biegler
Totally, totally. It is. So there's a few things that are really common that happen that I'm sure you see all the time as well. One is, as you're working through this, it's easy to get a staph infection because mold, once you mobilize it into the tissue, it suppresses the immune system. So you can get sick in all kinds of ways. Right. So, so cold source viruses, opportunistic staph infections, more common. So you have to be really careful around that. And then third, vaginal infections, super common, recurrent, like yeast infection, bv, et cetera. All those are really common. So those are common. And then just to talk about how it's not only dry and flaky, but if it's mold, it's usually showing up in lymphatic areas. So it's in the armpits, it's in the groin. And then you're going to see other fungal type symptoms. 

26:07
Christa Biegler
And I'm really suspicious of anything on the scalp as well. Right. Because there's more fungal stuff from, like the scalp up. Malassezia. There's also just more lymph nodes from the shoulders up. Like, I think it's a third of them in our body or from our shoulders up. It's like bonkers. Right. So it's. I always, you know, the hard part. No one feels this way when they're going through it initially. But the hard part is like, well, at least it's skin and not like cancer or a neurological issue. Right. Because that's actually the other thing that could be triggered by mold. Like, all of those things can be triggered by it as well. So I attempt to, like, sit in gratitude as much as possible around that. Right. Which is easier to do when you've gotten farther into it. 

26:46
Christa Biegler
It's like, okay, well, at least my body's giving it to me this way in a vocal place. And I will say the tricky thing about skin is it moves us to action. Right? 

26:54
Dr. Jill Carnahan, MD
Yes. Right. Because it's like, oh, I remember, like sitting in a car one day when I was at my worst. Worst, worst. And I'm practicing seen in Boulder, Colorado, and I literally was crying and I'm like, I can't go in. My face is a walking billboard of how sick I am right now. And it was like, how can people trust that I can help them if I'm like. And of course I knew I was in the process, I was okay with it. But I just remember being at a really low point one day where it's like, this is the billboard. I want to be healthy. And I'm working through it. But right now, this moment, I look horrible. People would, like, be like, what kind of thing do you have? And it was so. It was so depressing and discouraging. 

27:27
Dr. Jill Carnahan, MD
So now, when I'm sure you as well have these patients or clients, I just want to be like, oh, sweetheart, you'll get through this. And. And it's really hard when it's on your face or your body. 

27:36
Christa Biegler
I know, right? I know. 

27:37
Dr. Jill Carnahan, MD
Yep. 

27:38
Christa Biegler
Been there. And, you know, there's just certain things, like that image of you in your car that you remember. I remember being. Going through that journey and having trouble finding. There's so many other parts of it. Right. We're having trouble finding someone who could help me at that time, doing multiple stool tests and being told, like, there's nothing wrong here. 

27:56
Dr. Jill Carnahan, MD
Right. 

27:56
Christa Biegler
Well, there clearly is something going on. Right. There's obviously something going on. Anyway, so many. So many learning experiences which were good. I attempted to be grateful. But I remember, you know, quite a few months in my brother saying at Christmas, like, what is on your neck? Right. And I imagine that this is the pain that mothers and the guilt and the shame that they go through with their babies, because so often they're are out with their babies and people will come. I mean, there's like. 

28:21
Dr. Jill Carnahan, MD
Like, what are you doing? Naturopathic friends that had very severe issues with their child in the first year of life, and they were so ashamed because, again, just like me going in there as a doctor and my face is a mess. It's like this shame around, like, oh, my gosh, I'm supposed to know what to do. And even. Even a. Just a normal, healthy mother who's trying to do the best for her baby. It's sad that it's that way because clearly it's not the mom's fault. Although, you know, the microbiome and all that can be played into it. But it is. There's a lot of shame around that. 

28:49
Christa Biegler
Totally. And those are. I think that's always the stuff that I wasn't prepared for as a practitioner for the first however long. 

28:57
Dr. Jill Carnahan, MD
Right. 

28:58
Christa Biegler
It's just like the stuff that you start to realize that you need to support people with and you've got to work on your own nervous system so you're not absorbing it, and then you can be a good mirror for them as well. So there's so much. Yeah, it's. Working with humans is a trip. Right. And also being a human, I always say we don't blame ourselves for being in humans. Right. And so we're like, oh, of course I have this experience. 

29:17
Dr. Jill Carnahan, MD
Yeah, of course. It's all good. 

29:20
Christa Biegler
Yeah. So having that layers. 

29:22
Dr. Jill Carnahan, MD
I keep interrupting. 

29:23
Christa Biegler
Yeah, no, it's perfect. That's exactly how I would be. So we got that first layer, right. I consider it the most straightforward, which is a good thing, which is exciting. We could talk certainly about like mistakes and common pitfalls that happen there as well. The next one, right, is that drainage detox or as you said, even excretion. And just sort of, you know, it's all of those pieces. So what's kind of coming into the top of the funnel? How well is the machine working in general and how are we going to eliminate it? And it's a little bit of an art and a science, I would say. 

29:52
Christa Biegler
And I don't mean that in some weird way, but this is where I feel like more of the issues kind of the more layered it gets, like the more there's certain things that are going to work better. Right. And so when you're doing detoxification support, I always like to start with things that clean up after themselves, as I like to call them, like amino acids with calcium, D glucorate. Right. Like things that clean up and then the last layer. And I think that this one is really important as we, you know, are five years in now to like pandemic time there. That was a shift that happened where people were more broken after that time. Right. And so essentially, you know, even before that time, but especially after that time, were seeing more hypersensitivity in general. Right. 

30:37
Dr. Jill Carnahan, MD
Mast cells got triggered massively by this virus and the immune system got suppressed. And I now say that it's an immunosuppressive virus. We see it for almost anyone, even a mild case for a period of time. And those two things, of course, when we're talking about skin and immune system make all the difference, Right? 

30:53
Christa Biegler
Such a difference. So I call this layer kind of the stress driven layer. But it can, and I would characterize it by things got worse, you know, after a really stressful event, which could be anyone, right. Or you're hypersensitive or reacting to lots of things. Like everything feels like it's on fire. And the clinical presentation I feel is hand eczema. Now that can be mold also very commonly. And in general, mold will generally like drive you into like, yeah, challenged adrenal. So it's sort of like all matters. Right. But in general as well, like there's a couple things that happened in 2020. I think that our overuse of alcohol based sanitizers really disrupted our topical skin microbiome on the hands alone. Like hand eczema literally exploded. And so it allowed for different pathogens to grow. 

31:46
Christa Biegler
And then second, usually I just see, usually I see hand eczema when there is a lot of stress hormones, activity happening as well. So like I said, it can be mold as well. But that's kind of that top layer and that one's tough because you use your hands a lot, right? Like, where are the worst places to have eczema? Well, there's multiple places that are terrible to have it, but your face and your hands are pretty rough, right. And you're trying to use your hands. So it's really hard to get that topical skin barrier to heal overall. So one of the things I try to do there is like give the as many nourishing nutrients to heal that skin barrier as fast as possible. Because that's kind of the worst thing and it just makes you really susceptible to more infections. 

32:24
Christa Biegler
So those are kind of the layers overall, the things that all need to be addressed and supported and they all look slightly different. And so what that looks like if someone comes in, and I'm sure you do this too, right? They're kind of in a couple of places, as I mentioned before, they're either kind of, okay, I have this problem, I want to address all the things, or I'm literally reacting to everything. And if they're literally reacting to everything, we might have to start at the top layer of the cake, right? You might have to start with like calming things down, giving back nourishment to the. So what happens in those scenarios is often there's like been a lot of restriction sometimes that has been there as well. 

32:58
Christa Biegler
So when we're over restricting for a long, especially a very long period of time, like more than a few months, our body initially it's like, okay. And then after that it's like, hey, I already was nutrient depleted. Like I already wasn't digesting well and getting nutrients and now you want me to do all this with nothing. And so it really, it kind of, it cannot keep up. And so things get more severe. And another example of this, and this is kind of just one of those clinical things that I'm sure you've seen too, a very common presentation I see is especially with this mold thing is people might be kind of getting by, like things are okay, things are not falling apart, and then they go through a chronic period of stress, one plus month of stress, and then everything falls apart. 

33:43
Christa Biegler
They're in the same Environment, actually the environment hasn't changed. But because their stress is increased and their nutrient I would call the workers of their systems have gone down. They're not able to handle the. They're not able to handle it as they were before because they have reduced. They're understaffed and overworked. Right. And so that's essentially what happens. And so everything kind of starts to. That was barely keeping up before just sort of falls apart. And so that's an extremely common presentation that is wonderful to recognize. Like, yeah, thank God for being able to recognize clinical presentations because then you can see people, right. And you can help. It's like, oh, you actually need to put some workers back before you can do anything else. 

34:21
Dr. Jill Carnahan, MD
Well, I love it, Krista, because I really feel like what you've just described to us is so clear, maybe more clear than I've ever heard anyone talk about, because there's all these things interplay and understanding kind of how. And even giving us the clinical pearls of like, it looks like this when you have this. Looks like this when you have this. I really appreciate your clarification. So let's talk about. You have the client present with one of these and you're kind of figuring out where we go with the level one, level two, level three. How are you going to approach the treatments and how would that be different among the levels? 

34:50
Christa Biegler
Yeah, and that's a great question. I actually just triage into one of two places. And so the one of two places is if you are kind of falling apart and hypersensitive, let's go in and like make sure that you've got enough workers to do the processes and let's calm down. Let's kind of, I call it, fake it till you make it. Let's either cut out in a topical infection and maybe calm down some things like give you some anti inflammatories even from the inside to try to, like to just try to calm it down so we can like move forward essentially. Right. And generally again, the hypersensitivity, it's either like a lot of nervous system dysregulation or a mold situation or whatnot. And again, and it's not this horrendous thing, it's mild to moderate. So that's one. 

35:32
Christa Biegler
So we're coming in, we're answering a few questions. We're like, hey, did I have this, this and this? Okay, well, I maybe should start over here. But if I am pretty stable, right? Like I'm not falling apart, then I can probably come over Here and just get started with what's going on in my gut and immune system and reducing inflammation without. By correcting that kind of stuff. I call it reducing inflammation without restricting. Yeah, right. So not, you know, removing every single food from your diet, like, that's not part of anything I do anymore. Which is fun. It's exciting because we don't want. I. A healthy diet is a foundation, and digesting that food is a foundation. But to restrict long term and to cause more stress is contraindicated in my opinion. Right. 

36:12
Christa Biegler
So anytime we're really inducing stress around somebody or people come to me and they're like, I'm literally milling my own flour. And I don't want to be. 

36:19
Dr. Jill Carnahan, MD
Oh, yeah. Well, let me clarify because I want to know what you think. And see, I bet we're very much aligned. Frequently I have people just like you who come in there on four foods. I'm like, oh my goodness, this is not sustainable. Right. But once in a while, in the very beginning, when someone is eating whatever they want, you know, fast food ever, I find gluten, maybe dairy, sugar, alcohol, like are. You have to get out. Because gluten, you know, in even healthy individuals increases permeability. And I kind of want to clarify for people out there, it's like, well, does that mean I can eat whatever I want? Because I do find for 60 to 90 days, often just temporarily, because once again, that's creating more inflammation. 

36:55
Dr. Jill Carnahan, MD
Now, I'm not talking on restricting 100 foods and what to your point, and I'll let you talk about your experience in just a second here, but we do these food allergy tests. I used to do them, I don't anymore. I think we align with that and it lights up like a Christmas tree. Right. And all that shows me is there's a very high degree of intestinal permeability because I always say the guts like Swiss cheese. And so you're having reactions of everything you eat, right? Duh. 

37:18
Christa Biegler
Yeah, absolutely. 

37:19
Dr. Jill Carnahan, MD
On the same token, sugar, alcohol, processed foods, and usually gluten, sometimes dairy, and sometimes corn or another random thing for a period of time really does help because you're decreasing the antigenic load till you can shore up the gut. So now tell me your. Your input on that, because I think that's important for you to understand. Sometimes a very typical temporarily, not huge restriction is important. Is that true? Okay, yes. 

37:43
Christa Biegler
So I'll go either way. It kind of depends on what they're coming in with. And people come in with a lot of emotions around food. 

37:48
Dr. Jill Carnahan, MD
Yes, right. 

37:49
Christa Biegler
My end goal is if you can tolerate gluten and dairy, I want you to live your life and enjoy those and to know that they can be more inflammatory and you're going to need a support thing. Like I try to set people up for the long term of being supportive long term. So usually people are coming in on a pretty clearly awesome diet already. Right. But if I see alcohol, if I'm seeing other things, I may point at that what happens most of the time. So I will share that the more restrictive someone has been, the more difficult it is for them to find a middle ground. To be perfectly honest, it's usually the guys who come in on Carnivore. 

38:28
Christa Biegler
They're literally so much farther behind someone who like, if you could have come in almost on a standard American diet and we could have cleaned things up, I honestly think you would have gotten faster success than if we came in on and I mean people might be kind of frustrated about that. People are really obsessed with things that are helpful. And I understand it's like you cut out all the carbs, you cut out all the food for these microbes and whatever. Like if you're happy, be happy. That's all I want for you. I just want you to be joyful. 

38:53
Dr. Jill Carnahan, MD
But let's Krista, clarify. I love this and I want to just clarify too. When you restrict plant based foods and you create these micro diets of just a very small, you lose diversity in the microbiome. So it goes against everything you and I are trying to do and to increase this results long term. Right. 

39:10
Christa Biegler
It literally takes twice as long to get the same distance as someone who's not doing that. Like I, I, I wish that wasn't true. Yeah, it's a unfortunate, it's a bummer. So it's always good to have these conversations like this is what I'm seeing clinically. It just takes longer to come back from that. There's a lot more food fear. I, we're finally at a stability place with the, I'm thinking of this one guy, he's like, I think I'm reacting this and this and it's all, it's unfortunately like it's, it was initially in a, like it had good intentions and it becomes disordered orthorexic sometimes after a while. Right. And I don't mean it in a negative way. It's like I really just want you to have joy. 

39:51
Dr. Jill Carnahan, MD
Truly get stuck in a box. And again, I know from experience because 20 years ago when I got it, I was in A small little box. And I'm like, I never. And now I travel and eat out and I do things that I would have never done before and I'm fine and it's so much healthier for my body. 

40:04
Christa Biegler
Right, right. Yeah, exactly. So I think when people come in, they are always asking me if they've been restricting gluten and dairy, can I bring that back now? I was like, I have no idea if you can bring it back yet because you just. You haven't done anything yet. Yeah. So I don't really know how it's going to go. So I think that mental. It's kind of cute. Right. Because it's like, mentally I made this decision that I wanted to be able tolerate as much food as possible. So I want to know, because I made that decision, if it happens now. Right. And logically we know it doesn't. But, like, our emotions get caught up and that's totally fine. We do not blame ourselves for being human. 

40:37
Christa Biegler
But that's kind of the, you know, it sort of depends on the conversation I'm having with someone and, like, how much stress is oozing out between the cracks and what might be in best service to them in general. Right. If I see that someone, like, all they're eating is super high histamine, and I know that is, like, probably the most common driver. And again, both food and histamine are secondary exacerbations of a root cause going on inside of the immune system generally. Right. Like in simplicity. And so if you're reacting to histamine, there's different levels and spectrums of that. Right. But generally you're not processing, breaking down, making the enzymes to break down the histamine or clear it out in general. However, those are, you know, and dairy fits in that category. Right. 

41:18
Christa Biegler
That's going to be like the biggest area that's going to make the biggest impact short term. If people wanted to adjust their diet in general, because most of people are coming in already with a clean diet, I'm not making too many adjustments. And that's a nice exhale as well. So there's room for nuanced conversation. And the cool part is I can have whatever nuanced conversation they need to have about food. Like, I'm. I speak it very fluently. 

41:45
Dr. Jill Carnahan, MD
Yeah. 

41:45
Christa Biegler
I just want you to enjoy it. 

41:47
Dr. Jill Carnahan, MD
And again, I really. That's one thing I loved about having you on is I'm like, I want to be bringing this to the forefront where people. Because I see more often than not people overly restrictive orthorexic and being stuck. And it's not even that they want to be there. But like you mentioned, man, you're treating or. I've had many patients like that. You kind of get feeling stuck because as you restrict, then your body reacts to more things. It's like, it ha. It needs a target. So the more you restrict, it's going to find another target until you heal the gut. Now, I will also do a little caveat here, because again, I have Crohn's and celiac, and I've been through this myself. Yeah, I need a really clean diet. 

42:19
Dr. Jill Carnahan, MD
I still personally restrict dairy, gluten, and certain things, but I feel like I can eat a ton of stuff and I'm so much less restrictive. But I will just say, just recently, my gut is in great shape, and I was like, I think I can do some hard cheese again. I'm going to try some Parmesan. And I did it. Two days, no problem. I'm like, oh, my gosh, I can have a little bit of Parmesan again. Third day, I started getting a rash, really bad right around here. I'm like, okay, not yet. But I kind of want to just say that because you still might have a little reaction. And I'm like, I don't need Parmesan. I'm fine without it. Right. And so that's one thing, that it's not worth a little rash on my face. 

42:50
Christa Biegler
Right. 

42:51
Dr. Jill Carnahan, MD
And so for me, it's just one of those things. But it's not like I'm so restricted anymore. And to me, that's no big deal. I don't miss it. I don't mind it. It was just fun to experiment. But there might still be people out there who still notice gluten or. Or Parmesan or high histamine food. 

43:06
Christa Biegler
Yeah. And I will also say, I think this is an important caveat because those diagnoses do usually come with a little more gravity. And often I would say that one very large bucket of humans. Anyone with an autoimmune condition, usually food makes a bigger difference than an autoimmune condition. Right. 

43:27
Dr. Jill Carnahan, MD
So that would be the exception because we have, like, just simple eczema. And that is something that. That doesn't necessarily go with celiac or Crohn's or colitis or. So actually, that's a real important point medically. Obviously, if you're dealing with Crohn's or ulcerative colitis or any sort of inflammatory bowel issue or a severe autoimmune disease, these Things may make a bigger difference than Kristen I talked about versus just skin. So clarified there because, yeah, my situation has been much more restrictive long term. But now, again, after 20 years of working on the gut, I can eat so much more than I used to. 

44:00
Christa Biegler
Right. And I can offer. Also offer my own story there a little bit because I did much better with grass fed cheese and butter before I could do anything conventional. And I did better with, you know, butter or cheese before any kind of yogurt or milk or anything like that. So that's, there's all these layers. Yeah. And then as far as gluten, it's such a wide topic. It's like we want to be able tolerate grains as much as possible, but yeah, your own symptoms are helpful. It's like for the person who doesn't have autoimmune conditions, if they're having some skin breakups from dairy, it's like, okay, is there any opportunities here? Is there anything I want to do with this or is this just mean, like, this is a thing and it's all fine. 

44:43
Christa Biegler
I'm a natural questioner, so I'm sort of like, what could I do? Yeah, like, what are my options? And I'm still aware of the research around gluten and permeability at the same time. Right. And so it's sort of like balancing life and figuring out what works best. But to that point, I'm glad. 

45:02
Dr. Jill Carnahan, MD
You know, when I'm testing patients, like I'm testing, number one, I test every patient with autoimmune. Do you have the genetics for celiac? And to me, that's the buckets. If you have a high risk DQ2 or DQ8 gene, you probably are going to be at more risk of inflammatory and autoimmune conditions if you eat gluten, if you choose to even clean gluten. And then if you don't, I'm like, you're another category. If you do have an issue non celiac gluten sensitivity, you have a lot more broad, you know, bandwidth to do this. And the last thing that you mentioned, I think is so crucial quality matters. 

45:34
Christa Biegler
Yeah. 

45:34
Dr. Jill Carnahan, MD
Because for example, in the US the wheat here is usually sprayed with glyphosate. There's a lot of residues. It's a much higher gluten product. So there are tons of people who can eat gluten as much in the US as if they go to Europe or another country, which is sad, but. And grass fed, you know, sources of dairy or meat also, like you said, these things actually the quality does make a little difference too. 

45:56
Christa Biegler
Totally. It does make a difference. I know we could go have a tangent about glyphosate in general because I, I have lots of, I'd like have lots of questioner tendencies around that as well. It's like, well, why aren't we reacting to oranges and the other things we splay spray with glyphosate in the same way. So anyway, so many things and we're all just trying to like live our. And the thing about going to Europe, I love going to Europe and being like, why are you guys, why do you guys have less health issues? And I've arrived on that they're having more fun than us because they're out till like 3am drinking and smoking and eating late and they are very joyful and they're dancing and so. And I have a colleague, another, you might know her too. 

46:39
Christa Biegler
I have a colleague who just got back from Europe from Colorado also. And she's like, I swear they're just having more fun than us. That must be it. Because it doesn't make sense to us. And of course there's other things too. 

46:49
Dr. Jill Carnahan, MD
They have for 20 years. They have. It's illegal to use like some of the chemicals that are in our food supply right in there either. But agreed. They are enjoying a two hour meal with no phone and no, exactly like relaxing. 

47:04
Christa Biegler
They are digesting what they're eating. 

47:07
Dr. Jill Carnahan, MD
You started. I keep interrupting, but this is so perfect conversation. So we started talking about like what interventions. So let's go back to kind of wrap it up with like what are we doing for these clients that are, you know that you said kind of level one and level two and you kind of differentiate them. Immune system. 

47:20
Christa Biegler
Yeah, right. So I always like to oversimplify a complicated topic. And so that's why I'm coming in and triaging like, what are your op like, do we really need to overcomplicate it into three? And I said no, because the gut, immune system and drainage and excretion are, they're both major systems, but they tie together so much. They interplay so darn much. I mean everything interplays so much. But usually you can come in and start to work on because again, the skin is a drainage organ. So even if you have like the first layer, right, the most basic eczema going on, you might still need a little bit of drainage support. It's just that when you have that second layer, you're probably going to need more of it for longer. Is the is the bottom line. 

48:06
Christa Biegler
And so what when they come in and go to like step one, which is like, we'll come in and let's work on gut immune system and drainage detox as the first line therapy, instead of going over here to make sure that you literally have enough to even function and calm down the freak out, other stuff, right? Because that's really essentially when someone's in front of you, it's like, and if people come to me from other practices, that's sometimes what's not being necessarily addressed, right? This other like, hey, I'm reacting to everything. This isn't working. I can't do this. It's like, oh, yes, that's because we have to calm everything down first before we can do anything else. So one of two places. So if you're coming into that first. And by the way, if they start in like, hey, I gotta calm everything down. 

48:43
Christa Biegler
It's just slightly more scenic. They're gonna come back to the step one as well, like, no problem. And so then they're gonna come in and support what's going on. Gut immune system drainage detox, kind of in a layered order as well. Like each of those has at least three layers overall of how you're going to support that in general. So that way we're not dumping too much on the skin, et cetera. And if they're the person who has that drier stuff, as I just mentioned, there's more opportunities to lean into what's going to really support that cell membrane. What is going to work first, second, third. I don't usually do anything that's bile moving until month three with an eczema client. Because I see so much, even mild mold history that I'm not interested in hearing that your skin got worse. 

49:24
Christa Biegler
I just want it to get better as much as possible. So if you move bile too much, it's like this soapy stuff that like cleans things out and it's going to move. It's like sweeping it out. I always describe it as, you know, it's like cleaning under the stove, in the fridge, but the rest of the kitchen floor isn't really clean enough yet. So it's like it's just overflowing the dustpan. And so we want to wait until we've gotten farther along and then we can kind of get under there and get more out. And the more of that we do, the better we feel, right? The more we wake up with, like, better energy. We don't have creaky joints. Maybe we start tolerate Dairy sands and autoimmune stuff. Right. Those are the things that can happen. 

49:59
Christa Biegler
As we start to clear that up more and more we have better periods. Right. We have less cramping, all of those things, less heavy bleeding, et cetera. 

50:06
Dr. Jill Carnahan, MD
Cell membrane support. Give us your top three things that you'd want to include as nutrients or maybe top five. 

50:11
Christa Biegler
Yeah. So I have a whole kind of handout on this and there's like an interplay. So I'm just thinking about overall nutrients that help support cell membrane. So you can do high dose omegas and I think that I like to be at very therapeutic dosages of this. And so one of the conversations around omegas in general is we're just sort of, kind of sort of trialing this. So I love to trial 4000 and this is nice because it's like generally going to work as long as there's no fish allergy, it's usually not a big issue. So 4000 total omegas for an adult for at least 2 to 3 weeks. 

50:43
Christa Biegler
To see a slight difference in dryness, I would say you're going to see a difference in more systemic dryness versus like if I had a little patch and it was kind of dry, that might actually be the healing process happening in that small place. So more systemic how my brain thinks about this. I have like a slow fads gene, so I don't convert plant based ALA into animal based EPA and dha. And so I just generally suck at having a good quality like these omega 3 fatty acids unless I'm taking them in from salmon or cod. My favorite fish is black cod or sable fish. And so if I'm not taking those in, I might be a person who's like a little more dry in the winter. I. This is kind of funny. This like will tell you my personality. 

51:28
Christa Biegler
I'm too lazy to use lotion, so I'm like, hey, my skin's dry. I better be hitting my cell membrane support, my Omega 3. But that's how my brain works is like, oh, my skin is drier, I need to go in and like cycle in some support in general. Another little thing to keep in mind is that inflammation naturally uses up omegas and so it's going to compromise that cell membrane structure. And so in general, like it makes sense that you would have to cycle that in at different times of life in general. So like if you're working out and like breaking out muscle and inducing inflammation. So I just want to make those caveats because I think those are important details. That are kind of good pearls for all of us in life. So I'm going to consider that. 

52:05
Christa Biegler
But I don't automatically do that all the time. And I'd like to be considerate of the fact that like that's expensive. So I like to go in, see if it's making a difference and then move on and try something different as well. I like vitamin E, I like tocotrienol form of vitamin E, A natto E. But most of the literature around that is kind of long term. So there's a product from Quicksilver called membrane mend. That's kind of awesome. That's like a little phospholine and vitamin E. It's a lower, little lower dose. I wouldn't give it if I know there's a bunch of mold right away. But I do that. I am obsessed with phospholine, probably because I have a PEMT genetic variation as well. So I do great with choline. 

52:47
Christa Biegler
I think this is an interesting topic my brain likes to play with as well. My mom has an autoimmune condition where she doesn't like acetylcholine receptors don't work very well. So I just think it's like interesting, right. Overall. So anyway, I love choline. I think it's like the best thing ever. And then from there it's going to be kind of combinations of those different things. Like I'll use, I'll maybe use cod liver oil, but you've got to take a lot more cod liver oil to get those types of omegas. So those are going to be the things that I find work best for people. But the tricky thing about phosphatidylcholine is because it's a bile mover, it's not an initial thing to be using. If you add that too soon, people are going to freak out and it's going to be an issue. 

53:25
Christa Biegler
I don't even get into stuff like TEDCA typically. I know it's really commonplace, but like it causes too many issues in my kinds of clients. And so I go from a much smaller, like a bile support. So when I talk about cell membranes, I'm like, okay, there's a bunch of nutrients here. And these different nutrients like also flirt with other topics. They also wear other hats is what I'm saying. And so, you know, what supports the cell membrane can also support detoxification. And that's the beauty of nutrients or herbs or other things is like they don't just do one thing, they actually do multiple things. And it's a. It's a magic of stacking it and layering at the right time so it's handled by the client best, so they get the best results the most efficiently. 

54:03
Christa Biegler
I mean, that's like kind of the magic that takes time to figure out. Right. 

54:07
Dr. Jill Carnahan, MD
Overall, no, Very well put, because I could not agree more. PC at the wrong time is terrible at the right time. It's. It's magical. It's like, it's really amazing. So. Oh, my goodness, I can't believe we're almost at the hour, because we could talk for. No, another hour. You are such a wealth of knowledge and I really appreciate your balanced approach because I do believe a lot of people are just getting into these boxes and getting stuck and then feeling so hopeless and so restricted and so depressed, and they're not getting omegas for their brain function and everything. 

54:38
Christa Biegler
Right. 

54:39
Dr. Jill Carnahan, MD
So I actually love that you're bringing this. This model and this view to the world of skin health. What. Maybe we'll just end with, like, maybe a client's story or a situation where you felt like there was like, wow, this is really severe, and there was success. Any thoughts on maybe sharing with us a little vignette of someone who really did a good job of. Of improving in a. In a case where they were just hopeless or felt like there was no way they could get out of it? 

55:05
Christa Biegler
Yeah, I actually was just writing case studies last week, so there is this client, I'm going to call her Shelley. And she. What I love about this is that she told me not very long ago, she said, oh, I didn't tell my husband about working with you, which I thought was. I had no problem with, but it was just like, she's a really beautiful soul. Sandwiching. And I like. I love the human perspective. Like, I actually like to know the people. Right. And so she's like, literally caring for her aging parents and her kids are, you know, growing, but she's kind of sandwiched between them. 

55:39
Christa Biegler
And she's had stuff going on for 20 years, and she had tried to see different people for different things, and I can't exactly remember the result, but essentially she came out and was like, I'm reacting to all these things. I'm, like, hypersensitive. And so the reason I like this story is because I call. I always say, like, if you're in that place, usually the route is going to take just a little bit longer. It's going to be slightly more scenic. You're going to need to go support yourself before we can go back and get some of the other work done. But what I loved was she went in to just give herself the supportive stuff to calm inflammation down, to put nutrients or workers back in so the systems could work well on their own. 

56:18
Christa Biegler
And she improved, like, 63% in, like, four to six weeks before she even got back to that first phase. And she went really slow. But I was like, it's so fun to see that and to see how her brain was processing through the information as well. I can really tell, like, when I'm looking at people's data and having conversations with them, how well it's all driving for them and how my goal now. There's so much nuance in how I'm working now because I got, like, converse. A different conversation for another day is, like, things that aren't working in functional medicine for me anymore. And so I started to want to solve for that. Like, yeah, people feeling dependent on you forever was feeling not good to me. 

56:56
Christa Biegler
And so I was like, how can we get you through this and feel really empowered and, like, you know how to stand on your own two feet at the end of it, like, and how. You know how to ask your own questions to get your own really good answers, right? Like, that's what I want for you, because I don't want to be your yes man forever, right? Like, but I want for you this freedom. And then it's. It's sort of. There's a lot all tied into this. And so anyway, I can see that she's synthesizing it so beautifully. And so I. That was like, you know, between four and six weeks, she was 63% better. And then she had something that happened to. She was just 50% better. But, like, her skin was like. 

57:29
Christa Biegler
And she wrote recently, she said, I really feel like this is gonna work, right? And it's like, she's dealing with so damn much at home, right? She's dealing. Like, there was so many other layers and, like, things and crazy things that have happened. But what I love is, like, she had. I'm always so impressed with how even the supportive angle can make such a big difference for somebody before we get back to the other things that we're so good at in functional medicine, right? But it's like, what if I just gave her the nutrients to make her systems work well in the right order for someone with her context? And, like, what kind of magic will happen at the beginning, right? 

58:03
Dr. Jill Carnahan, MD
That's a great case because often it really is. Like, clearly, when you sit with a client, just listening, understanding, and Giving them the support for them to believe that something else is possible. That right there is the power of the beginning of the healing process, isn't it? Yeah. 

58:20
Christa Biegler
I love her so much. And it's like we have our. How we communicate is kind of funny and interesting. Like, it's a lot of written communication just because she's too busy for whatever. But it's like I give people the option to do multiple things one one. Seeing me for Q and A, it's like all of these options to, like, do what works best for you. I'm gonna proactively check on you no matter what. Right. And. Because I don't want you to fall off the wagon. Right. Like, ideally. And so. And it's just beautiful when, like I said, see her synthesizing this stuff, even though life is hard and she's like, oh, I see it. Like, I'm getting these little things. It's like work and just. It's really. She's inspiring to me. I'm like, yeah, I mean, you're like my hero. Like, you're the best. 

59:01
Christa Biegler
Right? And that's kind of. That's the stuff that I think, you know, we love as providers is like getting to know the real human is actually the fun part. Like, I do love quality over quantity. Still. 

59:13
Dr. Jill Carnahan, MD
I could not agree more. Krista, you have been a incredible source of knowledge today, and I know people will be inspired and they'll probably want to find you. Where can they find you? Where can they find your work if they want to work with you? Where do we go? 

59:25
Christa Biegler
If you're listening to this podcast, you listen to podcasts. And I have a nerdy podcast as well. It's called the Less Stressed Life, which was a very accidental title. I was looking for a synonym for inflammation in 2017. That was the best I could come up with, but it's been a wonderful umbrella. It's like stress is literally the go. Like, it's like the umbrella of inflammation. But it lets. Lets me talk about lots of topics, so I'm happy for that. And then you can always find me over@kristabigler.com awesome. 

59:49
Dr. Jill Carnahan, MD
Thank you so much for your time today and the work you're doing in the world. It was such a pleasure to interview you. Hey, everybody. Wasn't that a great interview with Krista Bigler? I hope whether you have inflammation on the skin or in your body or you know someone who does, I hope it was helpful and informative. I really enjoyed getting to know Christa better and talking with her, as always, we have new episodes out every week, so be sure and stay tuned. If you're on YouTube, hit the subscribe button and join the over 700,000 subscribers that have already subscribed to our podcast. If you're out on any of the audio platforms, Spotify, itunes, or wherever you listen to podcasts, would you stop by and leave us a review? It really helps us to reach more people. 

01:00:30
Dr. Jill Carnahan, MD
And as always, you can find anti inflammatory, anti histamine products and services@drjillhealth.com and I will see you again next week for a new episode of Resiliency Radio.