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Episode 27: The Autoimmune Impact of Endometriosis

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This week on Supplementing Health, Dr. Michelle Dowker, MSc, ND presents a discussion on the link between endometriosis and autoimmune diseases. Learn more about treatment options and coping strategies. 

Free masterclass 6-step roadmap to finding relief from endometriosis:  



The content of this podcast has not been evaluated by Health Canada or the FDA. It is educational in nature and should not be taken as medical advice. Always consult a qualified medical professional to see if a diet, lifestyle change, or supplement is right for you. Any supplements mentioned are not intended to diagnose, treat, cure, or prevent any disease. Please note that the opinions of the guests or hosts are their own and may not reflect those of Advanced Orthomolecular Research, Inc.


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[1:36] Cassy Price: Hello, and welcome back to Supplementing Health. We are excited to be chatting with Michelle Dowker. She is a wellness strategist, as well as a Dietary and Life Coach with an educational background as a Naturopathic doctor. She helps people to better understand their own bodies and help them overcome health challenges. Today we will be discussing endometriosis and immune dysfunction. Welcome, Michelle.


[1:54] Dr. Michelle Dowker: Hi, Cassy. Thank you for having me.


[1:58] Cassy Price: Thank you for joining me. I would love to know how did you first make the transition into focusing on immune dysfunction and the role it plays in endometriosis?


[2:07] Dr. Michelle Dowker: That’s a good question. I’ve been a naturopathic doctor now for just over ten years. It wasn’t until about four years ago that I actually realized that I myself have an autoimmune condition and endometriosis. They appeared, or I ended up with a really bad flare up after some major stressors in my life. 


[2:36] Everything that I knew about endometriosis and autoimmune and making the dietary, lifestyle, and supplement changes from what I knew from my studies wasn’t working. So I dove into some research to try to get some answers. That’s what helped me, first of all, put the pieces of the puzzle together for me so that I could get control over my conditions and recover. But then, it opened my eyes to the fact that there are some pieces of the puzzle that are missing in terms of mainstream information about these conditions, especially about endometriosis.


[3:24] Cassy Price: Can you share with our listeners exactly what endometriosis is?


[3:28] Dr. Michelle Dowker: Yeah. Endometriosis is a condition where tissue that’s similar to the tissue that normally lines the inside of the uterus, which is called the endometrium, ends up growing outside of the uterus. There are several different theories as to why that is, and I’m not going to go into that today.


[3:48] This tissue can grow in many different places, most commonly on the ovaries, in the tissue lining of the inside of your pelvis, and on your intestines. This tissue can also grow in places like lungs and even the brain.


[4:05] Cassy Price: Oh, wow. Really? Can you share some of the common signs and symptoms of endometriosis that your patients present with?


[4:14] Dr. Michelle Dowker: The most commonly known symptoms that most people tend to know about are things like painful periods and pain during ovulation. You can have irregular periods and heavy bleeding, pain during or after sexual activity, but you can also end up with pain or difficulty with bowel movements and urination, oftentimes, because endometriosis is growing on the intestines or the bladder. Oftentimes, it’s like a knife-like or searing pain. 


[4:48] There can also be general pelvic pain, pain in the lower back, and legs. Then, some symptoms that aren’t usually and may not be considered associated with endometriosis are things like nausea and bloating – which is often termed as endo belly, fatigue, tiredness, exhaustion, brain fog. Then, oftentimes, there could be digestive issues, including diarrhea or constipation. 


[5:17] A lot of times, women are also struggling with infertility if they have endometriosis. Sometimes, some women will just experience these symptoms during their period and during potential ovulation, but some women experience this all the time regardless of their menstrual cycle.


[5:38] Cassy Price: Okay. That’s interesting to note. Many people talk about this condition in terms of the hormonal imbalances and PMS symptoms like the painful periods that you mentioned. However, you have a unique perspective. Can you speak to that?


[5:52] Dr. Michelle Dowker: One of the things that I put together in terms of looking at the research is that a root cause of endometriosis is something called immune dysfunction. What that means is that the immune system isn’t functioning as it should. As a result, immune cells can trigger the production of messengers that cause inflammation. These are called inflammatory mediators.


[6:25] These are what are a root cause of a lot of the symptoms that are associated with endometriosis, especially things like pain and fatigue. A lot of times, like in the medical system, they’re going to look at endometriosis as an estrogen-dominant condition. This is because estrogen can fuel endometriosis.


[6:49] But, the thing is that what’s actually happening here is that the actual cause of this estrogen-dominance and this estrogen fueling the endometriosis actually lies in the immune system. I don’t want to go into too many technical things here, but this explanation will also be important later on. 


[7:47] There’s one particular inflammatory cell or inflammatory mediator that’s important here. This inflammatory mediator is called prostaglandin and E2. This compound, when it is activated, activates a particular enzyme called aromatase. Aromatase is responsible for estrogen production, which happens right at the endometriosis lesion site. 


[7:47] As estrogen is being produced at the endometriosis lesion, estrogen actually feeds back to stimulate the production of even more prostaglandin and E2. It creates this vicious cycle of more and more estrogen being produced at the endometriosis legion site. In the medical system, what they’re going to do is, they’ll typically provide exogenous hormones to stop your own body’s natural production of estrogen.


[8:21] However, it’s not getting to the root of why that estrogen is being produced in the first place, which is rooted in the immune system. This is why, as well, one of the other treatments in the medical system is surgery to remove endometriosis lesions. But, unfortunately, a lot of people end up with symptoms returning after surgery. It may be right way; it might be months or years down the road. The reason for that is because the immune dysfunction hasn’t been addressed. If the immune dysfunction is left to continue, symptoms can return.


[9:00] Cassy Price: You mentioned some people experience pain in their legs or other areas that aren’t localized to the main cause, so the uterus and the endometrium there. Would that be due to the widespread inflammation that comes with the immune dysfunction?


[9:18] Dr. Michelle Dowker: Exactly. Endometriosis is not just a reproductive issue. It doesn’t just affect the reproductive tract. It’s an issue of the entire immune system. That’s why you can get symptoms that affect you elsewhere: pain in other parts of the body, fatigue, digestive issues, nausea, and those types of things because it is a systemic issue, which means it’s a whole-body response.


[9:50] Cassy Price: If the lesion sites are producing excess estrogen, does it help to support the methylation and the disposal or removal of the excess estrogen as part of the treatment protocol, or do you tend to leave that and focus first on the immune system in getting that working correctly?


[10:12] Dr. Michelle Dowker: Yeah. My approach is multifactorial. It’s never just one thing that caused the issue, so it’s never going to be just one thing that resolves it either. Detoxification or removal of estrogen is also an important factor here. Say, for example, there are certain single nucleotide polymorphisms, which, if they’re imbalanced, can cause us to not be able to eliminate estrogen adequately or as quickly as we would like. So, obviously, supporting these processes is going to be part of the process as well. 


[10:51] Of course, in terms of, for example, methylation and COMT is a big one in terms of estrogen elimination. What’s really important here, as well, is supporting the other things that are causing the problem. Part of that explanation ties in a little bit later, so I’m going to leave the rest of that response to something that I want to mention later that’s really important in terms of addressing the multifactorial piece of endometriosis and immune dysfunction.


[11:36] Cassy Price: Awesome. Are there certain autoimmune conditions that increase the risk of endometriosis, or if you’ve been diagnosed with endometriosis, are there certain autoimmune conditions that you are more likely to suffer from?


[11:49] Dr. Michelle Dowker: Yeah. Having endometriosis does increase the chance of developing a variety of other conditions that are associated with immune dysfunction. Studies do show this. The conditions that are associated with immune dysfunction do include autoimmune diseases, but there are other conditions associated with immune dysfunction. Those include allergies, asthma, chronic fatigue, and fibromyalgia.


[12:18] Women with endometriosis do have a higher tendency than the general population to have any of these conditions that I just listed. But in terms of the specific autoimmune diseases, there is no hard and fast rule. But, I do see a lot of Hashimoto’s thyroiditis, which is an autoimmune condition of the thyroid gland along with endometriosis.


[12:45] In many cases, Hashimoto’s tends to be triggered by hormone changes, particularly pregnancy and childbirth, as well as perimenopause and menopause. But studies do show that some of the other commonly-associated autoimmune conditions that are often seen with endometriosis include Lupus and Multiple Sclerosis. Then some other ones that I tend to see would be Sjögren’s, ulcerative colitis, and Crohn’s disease. The thing is that once you have one autoimmune disease, it increases the risk of actually developing others because of this root of immune dysfunction. 


[13:30] Cassy Price: Okay. This might be a bit of a which comes first? The chicken or the egg kind of situation, but does endometriosis cause autoimmune conditions, or do the autoimmune conditions cause endometriosis?


[13:44] Dr. Michelle Dowker: This is the thing. One doesn’t necessarily cause the other. It’s that they’re both rooted in immune dysfunction, and that’s where the link comes from. It’s not necessarily that endometriosis causes autoimmune or autoimmune causes endometriosis. The actual question of the day is, what causes immune dysfunction? There is typically a genetic predisposition when it comes to immune dysfunction. This genetic predisposition may be why one person develops endometriosis over a particular autoimmune condition or one autoimmune condition over another one. 


[14:26] But the key with immune dysfunction is, you may have a genetic predisposition, but that doesn’t necessarily mean that you’re going to actually express the condition. What’s required for immune dysfunction to actually express is a trigger. Oftentimes, it’s either a really big trigger, or it’s multiple triggers.


[14:52] Common triggers that are associated that can trigger the immune dysfunction: diet is a big one, so inflammatory in immune-triggering foods. I’ll talk more about diet a little bit later. Stress, both physical and emotional stress. Physical stresses can be things like injuries, surgeries, inadequate sleep, over-training, and emotional stress.


[15:17] One study actually found that 86% of individuals who had adult-onset autoimmune conditions could recount an extreme stressor in their life just before the symptoms started. It’s also known that stress is a huge trigger for endometriosis as well. Other triggers include toxins like glyphosate, which is the herbicide, mold, scents like body care products, household cleaning products, scented candles, those types of things, and mothballs.


[15:54] Hormone changes can be a trigger. So during adolescence, pregnancy, childbirth, and menopause can be times where there can be a triggering of these conditions – and infections, especially mononucleosis and Lyme, but other infections can be triggers.


[16:13] Cassy Price: Can parasites ever be a trigger, or is it more bacterial or viral infections that tend to be the triggers?


[16:21] Dr. Michelle Dowker: Yeah. I don’t know the exact answer to that question, but I could imagine that it could probably pose as a trigger as well, especially the fact that some studies that I’ve looked over actually indicate when the immune dysfunction is triggered, the trigger actually starts at what’s called the intestinal barrier function.


[16:44] Typically, the intestine and the intestinal barrier functions are like the first line of defense of our immune system. It needs to be in a balanced or a homeostatic state. When it’s in a homeostatic state, it is in an intolerant state, which means that it doesn’t react to things that it shouldn’t. So it doesn’t react to the food that you’re eating. It’s not reacting to the good bacteria in your gut.


[17:12] If it’s activated, it can start to react to the foods that you’re eating, and it can even react to the good bacteria in your gut and cause inflammation. That’s why there’s a lot of food sensitivities that we see associated with someone who has immune dysfunction. So it wouldn’t surprise me, your question about parasites because it’s going to be affecting the lining of your intestine, and that’s the first line of defense in terms of that intestinal barrier function.


[17:49] Cassy Price: Are there specific ways to treat the inflammation that happens in other parts of the body as part of this condition?


[17:56] Dr. Michelle Dowker: This is the key – kind of what I mentioned before. This is a systemic or whole-body issue. It’s not just about treating the reproductive tract. What’s really important to support immune dysfunction is to address and support the immune system and to address and support the gut because it’s the first line of defense of your whole immune system. Two big factors to help to support controlling inflammation are through diet and through stress management. Diet is one way that we can absolutely control a lot of these inflammatory processes that are happening. 


[18:45] I mentioned before about that prostaglandin E2, which is that inflammatory mediator that can stimulate that estrogen production at the endometriosis site. Here is something interesting about prostaglandin E2. The precursor for prostaglandin E2 is something called arachidonic acid, which is a fatty acid. The higher levels of arachidonic acid that you have can lead to higher levels of prostaglandin E2 formation.


[19:22] We can control, to an extent, the levels of arachidonic acid through our dietary choices. There are two ways that you can do this. One of them is through your ratio of Omega-6 to Omega-3 fatty acids. Omega-3 fatty acids are found particularly in fish. You’re going to find your highest level in the acronym SMASH: salmon, mackerel, anchovies, sardines, and herring, which are going to give you the highest levels of Omega-3.


[19:56] Omega-6 to Omega-3 should be a ratio of 1:1 to 4:1. The problem is if we start to take in more Omega-6 to Omega-3 than this 4:1 ratio, that excess Omega-6 goes down a pathway to actually produce arachidonic acid, and that’s going to be the precursor for prostaglandin E2. Omega-6 fatty acids are found in lots of places. We need some. We can find Omega-6 fatty acids in nuts and seeds, chicken, pork, and eggs.


[20:45] The problem lies in, especially the standard American diet now, there are a lot of highly processes forms of Omega-6 fatty acids where we’re getting highly concentrated forms of Omega-6, which is driving this ratio up to 16:1 and up to 30:1. That drives excess arachidonic acid production. 


[21:13] You can find this excess highly concentrated form of Omega-6. The biggest culprit is seed oils: vegetable oils like safflower oil, sunflower oil, corn oil, soy oil, as well as you’re going to find Omega-6 in things like wheat, corn, and soy. When you process them into a flour, it becomes highly processed. That’s going to give us a lot of excess Omega-6 fatty acids.


[21:44] Cassy Price: So do you suggest that people supplement with Omega-3 then?


[21:51] Dr. Michelle Dowker: I’ll get to that in a minute. One of the things that I’ll mention, though, is that this ratio of 1:1 to 4:1, studies actually show that if you have a high Omega-6 fatty acid, and then you supplement by taking extra Omega-3 to offset this excess Omega-6, that’s not going to be helpful. So just taking extra Omega-3 to try and offset the excess Omega-6 is not helpful in this situation. That’s where controlling how much Omega-6 that you’re getting by controlling processed foods like seed oils and flours. 


[22:32] A lot of people are going to flour alternatives, and they’re choosing, say, for example, almond flour. That’s also a highly concentrated form of Omega-6. Almonds have a ratio of 2,000:1 of Omega-6 to Omega-3. Then you grind that down, and you make a flour out of it, so you’re going to be eating a lot more than just a small handful that way. So that’s another way that you can end up driving Omega-6.


[23:03] The other thing that can cause this excess arachidonic acid is through an enzyme called phospholipase a2. Phospholipase a2 is the enzyme that cleaves or cuts larger fatty acids to produce the arachidonic acid in our body. I’ve mentioned how taking in excess Omega-6 will lead down this pathway, and then phospholipase a2 will cleave it to become arachidonic acid. 


[23:38] But phospholipase a2 is also found in your diet, particularly in wheat, corn, and soy. These foods will not only give you excess arachidonic acid or, sorry, excess Omega-6 fatty acids, but they’re also going to give you extra phospholipase a2 to help the whole process of producing the arachidonic acid, and then the prostaglandin E2. So that’s another piece to consider, especially for endometriosis is that wheat, corn, and soy can be for many reasons problematic, and this is one of those reasons.


[24:20] In terms of reducing inflammation, avoiding processed seed and vegetable oils and avoiding wheat, corn, and soy can be particularly helpful here to control overall body inflammation, which is going to help to support better improvement and managing of endometriosis symptoms.


[24:43] Cassy Price: Those are all good things to be aware of. Do you have other suggestions for our listeners on how they can support the immune system to help reduce their symptoms?


[24:52] Dr. Michelle Dowker: Yeah. First of all, you know how I mentioned that there are triggers that can trigger immune dysfunction?


[25:00] Cassy Price: Yeah.


[25:01] Dr. Michelle Dowker: What’s important here is to address the triggers. Obviously, there are triggers that you need to manage or minimize. First things first – look around at your exposure to toxins: things like herbicide, glyphosate, looking at how much-scented care products are in your life in terms of scented body care products and household cleaning products because these chemicals can be endocrine disruptors, and they can be known triggers for immune dysfunction.


[25:42] As well as your exposure to plastics – the BPA, mothballs, taking a look, and doing an inventory of your exposure to all of these toxins and minimizing them as much as possible is a really important step. 


[25:59] Diet: I’ve already explained a couple of things here. The first step is looking at ultra-processed foods, especially those filled with wheat, corn, and soy, in terms of flours, as well as vegetable oils. And then, sugar. Sugar can also be inflammatory, and the elevated insulin that can happen when you consume sugar may actually also stimulate endometriosis growth.


[26:31] So that’s important to know. Say, for example, wheat – for the phospholipase a2 and also because it contains gluten. Gluten can be aggravating for the immune system. It can definitely be a trigger for the intestinal barrier function. And for many other reasons, gluten can be problematic for endometriosis.


[26:57] Oftentimes, women do benefit from going gluten-free. But I want to point out here that a lot of people will end up going gluten-free, and then they’ll opt for all the gluten-free alternatives that are filled with lots of starches and sugars. Those starches and sugars can also be inflammatory, so it’s important to be mindful of that, that it’s not just the gluten, but that starches and sugars can also be problematic for endometriosis. 


[27:28] So reducing sugar, definitely, and keeping in mind your starch intake as well because those breakdown into sugar in the bloodstream as well. Then, dairy is another one that I find can be problematic for endometriosis and immune dysfunction. So trying dairy-free can also be helpful here.


[27:51] Cassy Price: Have you ever found that small intestinal bacterial overgrowth or candida overgrowth has come hand-in-hand with endometriosis or could be a trigger for it?


[28:01] Dr. Michelle Dowker: Yes. That’s a really good question because a lot of women with endometriosis often experience something called endo belly, which is bloating of the abdomen. A lot of women can’t seem to get control over that. It’s a very frustrating, painful, and difficult situation.


[28:24] In one study, they tested women with endometriosis and found that a large percentage of these women had small intestine bacterial overgrowth, which is, of course, growth of bacteria in the small intestine, where it shouldn’t be. The question is, is why? There are a few different reasons for this. 


[28:48] What I’m piecing together from the research is, is that the intestines don’t tend to move properly in endometriosis for a variety of reasons. It could be the inflammatory mediators produced from the immune system that are affecting intestinal motility. So this can set up the terrain for developing the small intestine bacterial overgrowth. There can be other reasons, as well.


[29:18] Endometriosis lesions can cause something that is called adhesions, which can cause things to stick together, especially intestines. Those adhesions can also affect intestinal motility, which can set up a terrain for developing small intestine bacterial overgrowth.


[29:39] Cassy Price: Very interesting. Conventional medicine, as you mentioned, often offers up birth control and/or surgery as treatments or other hormone therapies, but that wouldn’t address triggers or root causes like placebo or candida overgrowth or some of the other things you’ve mentioned such as Chrone’s and those sorts of things. What alternative therapies have been shown to be effective for treating those root causes?


[30:08] Dr. Michelle Dowker: When I work with somebody, I’m using what’s called a Triad Method Approach, which means that I’m attacking it from all angles because endometriosis and immune dysfunction are what are called multifactorial conditions. There’s never just one thing that’s causing all the symptoms. There are hundreds of biochemical and immune reactions going on that are contributing to the symptoms.


[30:35] That means there’s never going to be just one thing that resolves it either. The other piece of the puzzle is getting to the root cause of what are the causes of the symptoms? This can be different for different people. That’s where it’s important to get personalized support from a knowledgeable practitioner to do a deep dive and understand what the causes are in your situation.


[31:03] The causes for one person can be different than the causes for another. For example, that list of triggers that I mentioned, one person can be triggered one way, and another person can be triggered by something else. In my Triad Method, I use diet, first of all. I usually start with a reset, called An Elimination Diet, to determine what foods are problematic. 


[31:31] We cut out common immune-triggering foods, usually for around four weeks, and then we reintroduce them one at a time to see how the body responds because each person is unique. What one person reacts to might be okay for another person, and the other person might react to something that somebody else might be okay with because everybody is unique.


[31:55] But what I do find is that once we do the other pieces in the Triad Method to heal the immune system and heal the gut and intestinal barrier function tolerance to foods tends to improve. That’s why it’s not just about diet. I see a lot of people say, “I’m following this diet. I cut out gluten,” and they think that’s going to be the be-all and end-all. But there are other factors that need to be taken into consideration.


[32:25] The next step in my Triad Method is supplements. This can help to support getting that immune system under better control and support the gut-barrier function in the gut, as well as supporting better hormone balance. I’m not going to go into a lot of detail here because it is a personalized approach. So one supplement might work really well for one person, but it actually might be detrimental for another. This is where getting personalized help can be very helpful here. 


[32:59] But one thing that can be helpful here is – I’ve mentioned about Omega-3 fatty acids. Omega-3 fatty acids are found in fish. As I mentioned earlier, supplementing with a whole lot of extra Omega-3 fatty acids to offset a whole lot of extra Omega-6 fatty acids in your diet isn’t going to be helpful. But on the other side of the token or the other side of the coin, a lot of us don’t tend to get enough Omega-3 fatty acids in our diet. 


[33:35] The active ingredient that’s especially helpful here is something called eicosapentaenoic acid, which the short form is EPA. That’s what’s going to be helpful here in terms of the anti-inflammatory function. Studies show that when they looked at women, and they were looking at their fatty acid profiles, they found that a higher EPA compared to arachidonic acid, those women had less intense endometriosis symptoms.


[34:06] The women who had higher arachidonic acid compared to the EPA, which is found in Omega-3 fatty acids from fish, those women with the higher arachidonic acid levels had worse and more intense endometriosis symptoms. So you can get this EPA from your diet. Again, the SMASH acronym of fish: salmon, mackerel, anchovies, sardines, and herring, and getting them at least three times a week can be helpful, but not everybody enjoys those fish. 


[34:44] That’s where a fish oil supplement can be helpful and making sure that it has a higher level of that EPA or eicosapentaenoic acid. Some studies have shown that fish oil supplementation can help reduce the tendency of development of adhesions in endometriosis as well. So this is a really great general supplement that could be helpful for most people.


[35:13] Cassy Price: On that note of the Omega supplement, most of them have a combination of DHA and EPA in the Omega-3 makeup. Is there a certain ratio of the two that you should be looking for when you’re picking a supplement?


[35:30] Dr. Michelle Dowker: Yeah. You’re always going to find some level of DHA with your EPA in a fish oil supplement. DHA is more important, especially for developing children and pregnant women, because DHA is really important for developing nerves and brain health in a developing child. 


[35:56] Each company is going to have a different ratio, but you want to have one that has a higher concentration of the EPA than the DHA. I usually look for one where I can get somewhere between 300 to 800 milligrams of EPA in the dosage that you’re going to get. Those are the first two steps in the Triad Method.


[36:31] The first step, we look at diet, and then we’re looking at the other step in the Triad Method is looking at supplements to support your immune system, to support your gut health, and to balance your hormones. But then the third, and what I actually find is the most important step is stress management and mindset work, and this is the thing that’s often ignored, and it’s especially ignored in the medical system. You usually have five-minute appointments with your medical doctor. They don’t have the time to address and deal with this. 


[37:07] But if you’re doing all the things to change your diet and heal your gut, but you don’t do anything to fix your stress, you’re not going to see optimal results because studies show that chronic and ongoing stress is actually going to negatively impact your immune function and it makes endometriosis symptoms worse. So, if that’s not addressed, you’re never going to get on top of this condition.


[37:34] How you respond to stress makes a difference because it affects every aspect of your body physiology, including stress affects your intestinal barrier function. It affects your immune system, and it affects how your hormones are being produced and released. It really is important.


[37:56] It can start with training your nervous system to relax, activating what’s called the parasympathetic nervous system or that rest and digest response that can help you calm down even if life around you is stressful, and it can also help to improve your digestion, which could help with the bloating, and the endo belly, and all of those other digestive issues that can come along with endometriosis.


[38:25] I have a step-by-step process for this. The first step is deep breathing because it does stretch your diaphragm. When you stretch your diaphragm, it activates your vagus nerve, which can activate that parasympathetic nervous system response. Usually, when we’re stressed, we’re doing short, shallow breathing, and that can affect the stress response.


[38:54] Once you start to calm the nervous system down, it can be helpful to learn how to redirect your focus. Focusing on the present can be helpful. This is called mindfulness. There are many different ways you can practice mindfulness. It doesn’t necessarily need to be meditation. I actually don’t start with meditation because I find that people have a really hard time with this if they’re not used to it.


[39:18] Learning how to focus on the now instead of focusing on all of our worries, and our to-do lists, and our what-ifs. That’s what keeps your mind constantly stuck in that stress response. If you can get yourself out of that thought-loop and focus on the only moment you can control with your actions, which is right now, people notice a significant improvement in their feeling of control over life in general, over stress, and their symptoms.


[39:56] Then, my secret sauce ingredient when I work with somebody, I do mindset-shifting things. We’re looking at how you see and think about challenges in life determines how you respond to them. That’s what determines your stress response and how your body physiology responds in stressful situations.


[40:17] This is usually set up in your developmental years, depending on your life experiences, to manage whatever stressors or difficult events that we went through; this is called your coping mechanisms. They usually become habits. We don’t even realize that this is happening in the background.


[40:37] The problem is that oftentimes, these coping mechanisms aren’t the most productive way of looking at or thinking about challenges or life situations. Over time, this can actually be detrimental because sometimes our responses keep us locked in stress response, so if you can start to learn what’s actually going on underneath in terms of how you’re seeing and thinking about life challenges. 


[41:04] Then, you start to learn new and more productive ways to see and think about the world. This is what transforms everything. This is what’s going to transform your stress responses and your whole-body physiology, and it’s going to last a lifetime because you’re getting to the root of what’s underneath it all if that makes sense.


[41:25] Cassy Price: Yeah. Absolutely. That makes total sense. I think mindset plays such a huge role in so many aspects of our life, such as goals and overcoming challenges. And not just health and wellness goals, but all forms of goals. So it makes complete sense that a mindset shift would help with a condition like this as well, in my opinion.


[41:46] Unfortunately, we’ve reached the end of our time today. However, if our listeners wanted to get a hold of you to continue the conversation or work with you on their own health challenges, how could they go about doing that?


[41:59] Dr. Michelle Dowker: I do have a website: You can find me on social media, where I share a lot of this type of information more with lots of tips, tricks, and education. I’m on Instagram and Twitter. My handle is @wellbalancend (nd for naturopathic doctor). You can also follow or friend me on Facebook. My name is Michelle Dowker. 


[42:37] I talk a lot about my own personal experience and how I overcame it on my Facebook profile. Instagram is more talking about specific facts and tips and tricks for immune dysfunction, in general. Twitter is where I post a lot of the research. I’m continuing to do research constantly, so I post a lot of the papers and the findings that I get from there on my Twitter account.


[43:07] Cassy Price: Fantastic. I look forward to checking out your pages and thank you again for joining me. It’s been an absolute pleasure.


[43:14] Dr. Michelle Dowker: My pleasure. Thank you so much.


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