Autoimmune Cure with Dr. Sara Szal Gottfried

This week on The Less Stressed Life Podcast, I am so excited to be joined by Dr. Sara Szal Gottfried! In this episode, Sara tells us about her healing journey after learning she was suffering from pre-autoimmune disease. Through her experience, she learned there weren't many resources to help people with their autoimmunity, so she wrote a book called The Autoimmune Cure. We dig into the tests she recommends, using psychedelics, diet, breathwork and other modalities that helped her heal her body.

KEY TAKEAWAYS:

• How do you bring awareness to overwhelming emotional events?
• What are immunomodulators?
• What labs determine an autoimmunity?
• 80% of patients with autoimmune disease experienced significant emotional distress before getting sick
• Why is autoimmune disease on the rise?
• What psychedelics help autoimmunity?

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ABOUT GUEST:
Sara Szal Gottfried MD is a physician, researcher, author, and educator. She graduated from Harvard Medical School and MIT, but is more likely to prescribe a CGM and personalized nutrition plan than the latest pharmaceutical. Dr. Szal Gottfried is a global keynote speaker and the author of four New York Times bestselling books about hormones, nutrition, and health. Her latest book is called THE AUTOIMMUNE CURE was released March 2024. 

WHERE TO FIND:
Website: https://www.saragottfriedmd.com/
Instagram: https://www.instagram.com/saragottfriedmd/

WORK WITH CHRISTA: https://www.christabiegler.com/fss

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Podcast Instagram: @lessstressedlife
YouTube: https://www.youtube.com/@lessstressedlife
Leave a review, submit a questions for the podcast or take one of my quizzes here: https://www.christabiegler.com/links

NUTRITION PHILOSOPHY OF LESS STRESSED LIFE: 

• Over restriction is dead; if your practitioner is recommending this, they are stuck in 2010 and not evolving
• Whole food is soul food and fed is best
• Sustainable, synergistic nutrition is in (the opposite of whack-a-mole supplementation & supplement graveyards)
• You don’t have to figure it out alone
• Do your best and leave the rest

EPISODE SPONSOR:
A special thanks to Jigsaw Health for sponsoring this episode. Get a discount on any of their products, including my favorite, Pickleball Cocktail. Use the code lessstressed10. 

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TRANSCRIPT:

[00:00:00] Dr. Sara Szal Gottfried: I'm listening for what the trigger or triggers might be in somebody and addressing those triggers I think is really critical because those triggers, there's this line that you hear in spiritual work, never waste a good trigger. Really understanding what your triggers are and using those as part of your map what to address.

[00:01:10] Christa Biegler, RD: All right. Today on the less stressed life, I have Sarah and I forgot to ask her the new pronunciation of her maiden name. So she'll tell us in a moment. I'm going to take a stab at Cezal Godfried is a physician, researcher, author, and educator. She graduated from Harvard medical school and MIT, but she's more likely to prescribe a CGM and personalized nutrition than the latest pharmaceutical.

[00:01:30] Christa Biegler, RD: She's a global keynote speaker, author of four New York times, bestselling books about hormones, nutrition, and health. And her latest book is called the autoimmune cure, which. Today, as we're recording, this was released yesterday. So it's released March, 2024. She's currently a professor in the department of integrative medicine and traditional sciences at Thomas Jefferson university and her professional focus and extra interests include wearable technology and how to use these tools for improving health outcomes and N of one trial design.

[00:01:58] Christa Biegler, RD: So this is, you're super nerding shows in this last sentence, which I appreciate so much. This is exactly like how my brain thinks. So welcome to the show. 

[00:02:08] Dr. Sara Szal Gottfried: Thank you, Christa. So happy to be with you. 

[00:02:11] Christa Biegler, RD: Yeah, I'm happy to have you. And in our brains and, we all have our stereotypes. When I see your name, I think of as the hormone doctor.

[00:02:19] Christa Biegler, RD: And today there is a shift. We're talking about immunity, which is everyone knows someone touched by autoimmunity. It's almost hard to even define the entire umbrella. There's skin conditions, that I work with that are almost questionable right around the autoimmunity. So I'd love to hear a little bit about how I feel like if you're going to birth a book, and I know this book took longer to write than the other books.

[00:02:46] Christa Biegler, RD: I feel like if you're going to birth a baby like this. There's some new passion. And here's the thing you have covered huge, like big topics, right? Like these are big topics to swing from, and it's not good or bad. It's just, it's an undertaking I feel. So if you're going to birth a baby like this, tell me why.

[00:03:04] Christa Biegler, RD: This happened. Why did you feel after the time and hormones that you felt called to the autoimmune space or so more so to, to write a book with, and we didn't talk about this, but it's got a really good tagline or subtitle, right? So we'll, I'll let you talk about that too, a little bit. 

[00:03:24] Dr. Sara Szal Gottfried: It may seem like switching from hormones to autoimmunity is a big shift.

[00:03:30] Dr. Sara Szal Gottfried: It's not really they're so interdependent and yes, I started with hormone imbalances because that's what I was faced with when I was in my thirties. I had one baby and I went to my doctor, just super frustrated with how I felt. I felt way too young to feel so old. I had no energy, no libido couldn't lose the baby weight.

[00:03:53] Dr. Sara Szal Gottfried: And that, sitting in his office when he said to me, why don't you take a birth control pill? How about an antidepressant for your and, that math Sarah, it's exercise more and eat less that's how you lose weight. And so it was at that moment that I went to the lab and I started studying hormones.

[00:04:15] Dr. Sara Szal Gottfried: And then about six years ago, I tested my blood. I ran an autoimmune panel, which I do in all of my clients and patients, and I was positive for anti nuclear antibodies. So not just a little bit, but a pretty high level of anti nuclear antibodies, meaning that my immune system was attacking my cells. The nucleus of my cells are really core and fundamental really existential crisis in some ways from body perspective.

[00:04:46] Dr. Sara Szal Gottfried: And so that kicked off what I think of as a divine process where these things are not happening to me, my hormonal balance, my thirties, my auto. Immunity in my fifties, they're happening for me, they're happening through me as a way of going deeper, especially with some of these conditions that mainstream medicine can fail.

[00:05:11] Dr. Sara Szal Gottfried: As I started to look at it, I called my friend Mark Hyman, and he told me about this new lab that he launched and he's had a hundred thousand people give their blood mostly pretty healthy people like you and me. And he's found that 30%. Have positive anti nuclear antibodies so we think that there's.

[00:05:33] Dr. Sara Szal Gottfried: We're at a moment in time where the rate of autoimmunity is so much higher than we ever expected. And we know over the past 25 to 30 years that the rate of the body getting confused about what's normal tissue. That needs to be protected by the immune system versus pathogens that need to be attacked that confusion is rapidly increasing.

[00:05:57] Dr. Sara Szal Gottfried: So the reason why I focused on this book is because. I saw this link, this exponential rise in autoimmunity. I saw it in myself. And so I set about trying to understand what are the root causes, what are the triggers in my case, what are some of the things that I could fix nutritionally? Is there something beyond a nutrition and supplement protocol?

[00:06:22] Dr. Sara Szal Gottfried: That's called for here, and in fact, that is the case. 

[00:06:28] Christa Biegler, RD: I often think with autoimmune stuff, there's a lot of opportunity. There's a lot of Tangents or arms or avenues that 1 could go down. And to be honest, I feel that also an auto immunity that can feel overwhelming instead of an opportunity, much like when your antibodies were positive, which you were not really.

[00:06:55] Christa Biegler, RD: Much of a minority, it sounds right? It's a huge thing. If he's finding it positive and 30 percent of the lab is being run. By generally healthy people, right? Finding that functional lab work. I hear you speak optimistically and with curiosity, right? In this good nervous system state of, instead of with alarm and reaction, as we often are faced with when we face.

[00:07:22] Christa Biegler, RD: Maybe a touch of adversity, and I wonder if it was that was your initial reaction to your antibodies being elevated or not, or if that came later, 

[00:07:31] Dr. Sara Szal Gottfried: That's really the key question. I'm so glad you asked it because. Yeah, there's a way that I feel like things are happening to me. When they first occur, and that's not when I share about them, I feel like I know enough about this process of a health crisis and what it might be trying to show you that you have to.

[00:07:54] Dr. Sara Szal Gottfried: Work through it 1st, before you really talk about it and share it. Yeah, my initial reaction was. Are you kidding just when I thought that I got my cortisol into a manageable place and I'm, making my way through perimenopause and I'm happy with my body composition and my muscle mass now my immune system is overactive and attacking my nucleus.

[00:08:18] Dr. Sara Szal Gottfried: Yeah, that was my initial reaction and I would say that's the reaction from my childhood. It's a well worn groove. That evolved out of significant childhood adverse experiences, which we talk about in the book, how adverse childhood experiences or aces can set you up to have a dysregulated nervous system, a dysregulated psyche.

[00:08:47] Dr. Sara Szal Gottfried: A dysregulated immune system and dysregulated hormones. I did that out of order, but we're talking about the pine network here. So psycho and, neuro endocrine network. And for me, I spent a lot of time in my thirties and overwhelm. If I think back to my younger self sitting on that exam table at my doctor's office with my list of woes.

[00:09:18] Dr. Sara Szal Gottfried: Shivering and a thin little gown, my main diagnosis was overwhelmed. My main diagnosis was nervous system dysregulation that then later started to affect my immune system. That was certainly affecting my hormones then. So it's a really good point because it's taken a lot of work, with food first, with some supplements that can help with leaky gut or increased intestinal permeability, with Embodiment so that I wasn't doing my childhood pattern of a cognitive approach to problems and not spending a lot of time integrated, below the neck as well as above the neck and it took healing states of consciousness, breath, work, yoga, psychedelic medicine to really get to a place of having a more regulated approach to the diagnosis of autoimmunity.

[00:10:19] Dr. Sara Szal Gottfried: And the good news is. I'll just give the punch line going through this process. Led to now having negative anti nuclear antibodies, so I no longer have positive anti nuclear antibodies and I really credit this protocol that I wrote about not immune cure to helping me get there. 

[00:10:41] Christa Biegler, RD: Ooh. There's so much to unpack here.

[00:10:42] Christa Biegler, RD: That's really good stuff. Got it highlighted here. Let's talk about. Defining before I get into some nuance around boosting and immune system homeostasis, which is the massaging of the conversation that's happening in functional medicine.

[00:10:57] Christa Biegler, RD: If you're paying attention, I hope. But so often people want to boost their immune system and it's really about. Modulation. Resilience, maybe management, essentially. And so what do you want to say about that? And then I think that's going to relate to the difference of autoimmunity and autoimmune disease.

[00:11:14] Christa Biegler, RD: And maybe we want to make that distinction too, while we're out here laying groundwork on what this all is. Immune system boosting versus homeostasis and or autoimmunity and autoimmune disease. 

[00:11:26] Dr. Sara Szal Gottfried: Yeah, I appreciate the conversation that's happening in functional medicine. I've practiced functional medicine for about 25 years.

[00:11:33] Dr. Sara Szal Gottfried: So I've got a lot of experience with it and a lot of colleagues who, some of whom were in that boosting conversation for me, boosting the immune system feels really masculine. It's, crank it up, get it where you need it to be instead of a more collaborative, feminine approach.

[00:11:51] Dr. Sara Szal Gottfried: Which is really the way the immune system is meant to work. So you mentioned homeostasis when I first started practicing, I realized, there's something wrong here in conventional medicine. It's so disease centered. It's not centered around health. And even when you ask thought leaders back then about what is health, they would say it's the absence of disease.

[00:12:15] Dr. Sara Szal Gottfried: And that's such a circuitous way of describing it. And so now I understand health. As a state, a very dynamic state of homeostasis where homeostasis, as, is defined as. A sense of inner equilibrium and balance between all of these pathways that you have in the body biochemical. Psychological spiritual pathways.

[00:12:45] Dr. Sara Szal Gottfried: So a sense of homeostasis and balance, regardless of what's going on externally, regardless of what you hear based on your latest lab result. So that homeostasis I think is really key and I agree what we want is homeostasis in the immune system and part of what's challenging here is that once again, it is a health hazard to be female.

[00:13:14] Dr. Sara Szal Gottfried: When you look at people with autoimmune disease, 4 out of 5 are women. Why is that we know that women have a more robust immune response that's been documented for decades, especially in response to vaccines. And we know that response, that immune system response becomes more dysregulated at certain times of hormonal shift, such as pregnancy, postpartum, when a lot of people get diagnosed with Hashimoto's thyroiditis, such as perimenopause.

[00:13:45] Dr. Sara Szal Gottfried: I saw a huge spike in my perimenopausal women who got vaccinated against covet and so it's just an example of how homeostasis can be somewhat tenuous. Women have this more robust immune response, which helps us. It led to a lower mortality rate during the height of the pandemic among women compared to men, but it can backfire and it can lead to a greater problem with tolerance.

[00:14:16] Dr. Sara Szal Gottfried: And here I'm talking about fiscal tolerance, but I think there's a way that women tolerate. Way too much, not just physically, but emotionally and spiritually too, can be our downfall. Yes, I agree. Homeostasis is the key here. There's a chapter in my book on immunomodulators, things that support the immune system.

[00:14:39] Dr. Sara Szal Gottfried: Things like getting five to seven colors of fresh fruits and vegetables in your food every day. Vitamin D, curcumin, low dose naltrexone. And I would also add certain psychedelics as being immune modulators. 

[00:14:56] Christa Biegler, RD: I want to talk about psychedelics. So I hear that through this book writing process through what year did you have the initial ANA antibodies that were elevated?

[00:15:06] Christa Biegler, RD: Was that six years ago? 

[00:15:08] Dr. Sara Szal Gottfried: So it was 2017. So that's 

[00:15:12] Christa Biegler, RD: seven years ago. And then two years into that, you started formulating the concepts for the book. Is that right? 

[00:15:20] Dr. Sara Szal Gottfried: I did. I found this positive ANA and then I started to really look among my patient population to see, okay, are there a lot of people who don't have an autoimmune disease yet who might have some of these blood biomarkers?

[00:15:36] Dr. Sara Szal Gottfried: And I started to see them in about a third of my patients. This includes people who've got a relatively normal thyroid function test. So their TSH is good. Their free T3 is good, but they've got antibodies against their thyroid and that's in about 13 percent of the same. A patient population that I mentioned earlier with Mark Hyman.

[00:16:00] Dr. Sara Szal Gottfried: So I started to see it in my practice and I also noticed, there's a particular pattern with people with autoimmunity where they often have a flat diurnal. Curve, so their cortisol 1st thing in the morning around noon around 4 and before they go to bed is relatively flat.

[00:16:21] Dr. Sara Szal Gottfried: Maybe a little high before they go to bed. That is the most immunogenic cortisol pattern that you can find and it's just part of this dysregulation. As I started to work with people, I saw these hormone changes. I saw these immune changes. I started asking more about trauma and about the triggers for autoimmunity and I really started to see them everywhere.

[00:16:46] Dr. Sara Szal Gottfried: I'm not seeing everyone with. Autoimmunity has a history of trauma, and I'm not saying that, everyone with trauma develops autoimmune disease, but there's a very high correlation between the two, and it was true for me. 

[00:16:59] Christa Biegler, RD: Yeah, trauma's been talked about for sure.

[00:17:02] Christa Biegler, RD: I hope I think for over 5 years, I think more and more. Sometimes I'm not sure how skewed my perception of this. However, not everyone. I think that there's a huge population. And this is where my heart goes out to is the people who don't resonate with the word trauma, right? Which is what you're referencing a little bit.

[00:17:20] Christa Biegler, RD: We don't resonate with the word trauma. With our non communicative husband being traumatic, for example, right? That may be a trauma response from his own parenting as he grew up. I'm just thinking about things that have come up in conversation just recently. There's so much. About our realization, and I guess it is all boiled down to it's not the stress that kills you.

[00:17:44] Christa Biegler, RD: It's the perception of the stress and it's not necessarily what you think. You logically think of the stress is what you're 95 percent subconscious and what's being stored as the stress. So. We know this, but making this tangible for those of us, because, I see 2 sides of this all the time, right?

[00:18:01] Christa Biegler, RD: I see the people and probably you too, when you have this kind of a practice, people come in and they want to do functional medicine treatments and take supplements and right. You understand that. And then you're trying to, then you start to, not be able to avoid or ignore all of these emotional pieces or emotional regulation pieces.

[00:18:20] Christa Biegler, RD: And you think how are we going to bring that to the surface and in conversation and truly an awareness? And you talked a little bit earlier about going from the brain to the heart. The other day, I was interviewing gay Hendricks, who I really appreciated his work. It was very, it really called me out when I was reading some of his books.

[00:18:36] Christa Biegler, RD: And so we had the conversation about how do you bring about consciousness? How do you bring about awareness? How do you bring about my favorite term is unrealized stress, right? How do you shine a light on something that's low grade? Always been there to where you think it's normal.

[00:18:50] Christa Biegler, RD: And you can say that about any kind of symptom too, right? You have this, Whatever you have if you have a stuffy nose and you've always had it, it's so normally, you don't think about it today. Earlier, someone was talking about little sores around the edge of your nose. She said, Oh, I never even thought about it.

[00:19:02] Christa Biegler, RD: Cause it was so normal. Yeah. Little signs and symptoms. That's nice when there's a tangible exterior sign, right? But how do you start to draw that connection and how do you help people realize their unrealized stress? This is a hard question. 

[00:19:17] Dr. Sara Szal Gottfried: It's the key question. So I really. Love that you post it, what I want people to understand is what I had to learn, which is.

[00:19:30] Dr. Sara Szal Gottfried: We think of overwhelming emotional experiences, which is the definition of trauma. We think of those as being associated with mental health effects. We think of. Depression, anxiety, post traumatic stress disorder, disordered eating attention deficit disorder. And yet the physical body is also affected by these experiences of overwhelming and distressful events and as you described, 

[00:20:02] Dr. Sara Szal Gottfried: there's a way that trauma has become a buzzword, and I think it's maybe losing its meaning for some people. So we could just insert overwhelming emotional events here. 

[00:20:12] Christa Biegler, RD: The 

[00:20:13] Christa Biegler, RD: great new term, I'm gonna start using that all the time. 

[00:20:17] Dr. Sara Szal Gottfried: I like unrealized stress, so we might have to use that too.

[00:20:20] Dr. Sara Szal Gottfried: There's the capital T drama or overwhelming stressful events that we could all agree are traumatic you lose someone you love suddenly, or you survive a genocide. And then there's these other events that maybe you're speaking into being in a marriage where. You just don't feel emotionally attuned.

[00:20:42] Dr. Sara Szal Gottfried: You don't feel seen. Maybe you're even sacrificing your authenticity to securely attach or to have some sort of level of attachment. Maybe it's a toxic job, a toxic work culture. So there's these other events that can also get under the skin. And, 1 of the things that Gabor Monte talks about in the myth of normal is that it's not so much.

[00:21:12] Dr. Sara Szal Gottfried: The event that happened to you, it's the way it lives on in your body. It's the way it lives on in your pine network, especially because that's the forward facing part of your body. That is dealing with these unrealized stressors. My work is. Initially, I went through the portal of hormones and so dealing with cortisol issues, estrogen, progesterone, testosterone, insulin with my clients has been a big part of my career, but it's really just the tip of the iceberg because as you dig deeper and deeper, you find that there's all these other signs of dysregulation.

[00:21:54] Dr. Sara Szal Gottfried: I think part of what you were asking is. How do you know, and I think the way, is that you've got some kind of condition, usually a chronic condition. That's not getting better or what I see commonly. My practice is that people take 2 to 3 steps forward and then they backslide, that's especially true with.

[00:22:15] Dr. Sara Szal Gottfried: Autoimmune conditions and so looking for some of these signs of dysregulation looking for when it comes to the immune system, there's some basic tests that you can do to look for this, such as a complete blood cell count and a differential and looking at the neutral filter look.

[00:22:33] Dr. Sara Szal Gottfried: Lymphocyte ratio, the NLR, you can also look at inflammation. Inflammatory tone level of high sensitivity C, reactive protein segmentation rate, a measure of how sticky the blood is. And then you can do more advanced blood testing at the immune system. You can do a lymphocyte map.

[00:22:52] Dr. Sara Szal Gottfried: You can do an antibody panel. I run in all of my executives, some professional athletes that I see at Thomas Jefferson. And then, when it comes to the nervous system, I think 1 of the best measures is heart rate variability. And I know you spoke to someone recently about that. I'm not going to get into the details of it and while your guest.

[00:23:15] Dr. Sara Szal Gottfried: Was totally accurate and talked about how you can't compare yourself to other people because some of it's genetically determined. Some of it's based on your fitness and your endurance space. It's also true that there are some low levels that are associated with being incredibly dysregulated, significantly dysregulated such that, I imagine if I measured my heart rate variability when I was sitting in that doctor's office in my 30s, I imagine it was really low.

[00:23:45] Dr. Sara Szal Gottfried: And so there are these outer measures and certainly wearables can help you track these things because 1 of the things we know for people who have experienced significant toxic stress. Is that many of us become or historians. And we become disembodied, I even write in the book about how I was functionally dissociated.

[00:24:15] Christa Biegler, RD: I get it. 

[00:24:15] Christa Biegler, RD: Me too. 

[00:24:17] Dr. Sara Szal Gottfried: Yeah. And, I think being a clinician, Hey, that is revered to be function associated to be up here solving problems all day long. And oh, no, I don't want to go down into the rest of my body and have to deal with the stress response. That's too much work. 

[00:24:33] Christa Biegler, RD: Yeah. 

[00:24:34] Dr. Sara Szal Gottfried: So when you're a poor historian, you need some of these more objective measures to just see is dysregulation true for me?

[00:24:43] Dr. Sara Szal Gottfried: Because I think we're more dysregulated now than I've ever seen in my entire life. 

[00:24:49] Christa Biegler, RD: I think that's a really good question. To take to underline to put in our toolbox is dysregulation true for me. I think another 1. I think what I hear from you is you've been on a little bit of this journey and I think we have some similarities based on some of the things you are into because I remember.

[00:25:10] Christa Biegler, RD: At least four years ago, I was like, I could see that stress was the problem, but I just needed to unravel my own history and my own healing journey that I didn't know I needed, right? So I just started trying modalities, right? I ended up seeing a big Psychic, I didn't know was a psychic. I did psychedelic, right?

[00:25:31] Christa Biegler, RD: Cause I had friends, colleagues I really respected that were saying this changed my life. This healed my relationship with my mother, right? Didn't even know these were issues. And I often think, and it's so good to have all of these experiences. It's a lovely thing. And in short, there's no shortage of opportunities, but, it just some things don't work for certain people.

[00:25:51] Christa Biegler, RD: To me, I prefer breathwork over psychedelics, based on some experiences, right? I could change my mind about that in a few years. Who knows? We have lots of research and I think about this and I think for people who are really up in their head It totally on a really tangible visceral level, I feel just completely changes how you're experiencing your body.

[00:26:10] Christa Biegler, RD: So it gives people this opportunity to have new sensations that they have been ignoring, suppressing, whatever. That's, this is just my feelings. At the moment, and I feel like you have also experimented with a lot of things as you went through this, your own healing journey. We'll call it a healing journey, whatever.

[00:26:30] Christa Biegler, RD: I don't know how you want to call it, but I feel like you have sampled a lot of things. So I'd love to hear a little bit more about some of the things that you have sampled, or if you want to take a moment to talk about psychedelics here, because I know you're passionate about this topic. 

[00:26:43] Christa Biegler, RD: I think,

[00:26:43] Dr. Sara Szal Gottfried: yes, very passionate.

[00:26:46] Dr. Sara Szal Gottfried: So I feel like I have to start by saying I was total square. I didn't pot I didn't take mushrooms in college. I was in the library. 

[00:26:55] Christa Biegler, RD: Yeah, for sure. 

[00:26:56] Dr. Sara Szal Gottfried: And that was also in some ways. A response to my childhood, I had a somewhat volatile childhood. I've got a nice score of 6. my parents got divorced. I grew up without my father in the picture.

[00:27:10] Dr. Sara Szal Gottfried: And so I learned that academic achievement was a way to get the love and attention that I wanted. And so I never experimented until I had an experience. In my fifties where I had a falling out with someone that I love and we became a strange, this person that I was really close to. And as I started to look at my side of the street, I felt like.

[00:27:40] Dr. Sara Szal Gottfried: I'm reactive and if I'm not going to clear up this way that trauma is still living on in my system and leading to conflict and estrangement with someone that I love, if not now, when so that really got me to open to the possibility of taking some of these medications that I've always stayed away from plant medicines.

[00:28:08] Dr. Sara Szal Gottfried: I'd always done. Yoga. I've practiced yoga since I was five years old and I learned meditation when I was a teenager. So I had those things, but I would say even those things, yoga and meditation weren't enough. They weren't enough to shift some of that unrealized stress out of my system. So the first thing I tried was holotropic breath work.

[00:28:38] Dr. Sara Szal Gottfried: And I've been doing that for about three years. And it's it's something that I write about quite a bit in the book and I review all the latest literature on it. And I found that to be really powerful. It was a way to create a healing state of consciousness. Some would call it even psychedelic without taking any medication.

[00:28:58] Dr. Sara Szal Gottfried: And so the way that you breathe with holotropic breath work, I would do it for 20 minutes, and I would feel so regulated as a result. So I practiced that 4 times a week for a couple of years, found it to be really helpful, but this was right around the time that MDMA assisted therapy was being studied in clinical trials.

[00:29:23] Dr. Sara Szal Gottfried: And we were starting to see that, the gold standard of how we treat trauma post traumatic stress disorder, or what I see more commonly is partial PTSD or sub threshold PTSD. That's what I see hyper vigilance, nightmares, fear response exaggerated startle response, cortisol issues. Those are some of the things that I see in my practice.

[00:29:48] Dr. Sara Szal Gottfried: And the gold standard is. Usually talk therapy, sometimes trauma informed, but not always and then that sometimes is combined with selective serotonin reuptake inhibitors. And there's three that are FDA approved for PTSD, and yet the efficacy of those two things talk therapy and SSRIs is around 30%. 30%.

[00:30:16] Dr. Sara Szal Gottfried: So when I started talk therapy at my twenties for my first round of depression, if they told me that going to weekly psychotherapy at, quite a bit of. An expense and a big time commitment that my chances of resolving my drama were 30%. I don't think I would have done it. Fortunately, we've got more options now for dealing with that might be more effective, but not a lot of long term studies, but when you look at assisted therapy, so here, we're talking about 2 to 3 journeys.

[00:30:51] Dr. Sara Szal Gottfried: With MDMA combined with therapy, so use a therapeutic, not a recreational context. The efficacy is somewhere around 67 to 71%. That's how many people no longer meet criteria for PTSD. After 2 to 3 sessions, so it's pretty dramatic. It's more than double as effective as the gold standard and that's what got me.

[00:31:15] Dr. Sara Szal Gottfried: That was my gateway. So I started and therapy and it really made a difference. I went through certification. With maps, I've done the level 1 training level 2 is not open until they get FDA approved right now. And then I've also gone through 3 certifications with ketamine and with and 1 with psilocybin.

[00:31:39] Dr. Sara Szal Gottfried: These medicines are really interesting because they allow you to go back to some of that unrealized stress, those events that have occurred to you, but to approach it with fresh eyes to approach it without the usual fear response without the amygdala going. Oh, there's the threat. And when you're able to do that, especially inside of a really solid therapeutic container, it can make a big difference.

[00:32:05] Dr. Sara Szal Gottfried: It doesn't have to be a psychedelic medicine. There's lots of ways to create a healing state of consciousness, but I found nothing more effective for the dysregulation that I felt in my nervous system. But I also think many of us need, especially if we had trauma before age 3, we need daily nervous system regulation.

[00:32:27] Christa Biegler, RD: I think we all need daily nervous system regulation. If you want your immune system to be homeostatic, it's at least 50 percent in my very humble opinion. Okay. So what I'm hearing from you, and I want to just lay this out because part of the complaint with healing as it's like a little ambiguous.

[00:32:47] Christa Biegler, RD: So I'm just going to lay a little bit of a map here for us to follow along with. I think, This is also a bias. I think the first step is always awareness. And you can go so far with your cognitive awareness, right? You talked about, and I am right here with you, that certain types of breathwork can be a little bit like a psychedelic.

[00:33:08] Christa Biegler, RD: Now, that said, now I also would like to use you As an inspiration to go dig into all of the literature related to breathwork in this, because there is literature and you're very interested in the literature on psychedelics now. So when that is, then not enough. And I understand what happens in the brain there.

[00:33:25] Christa Biegler, RD: I understand that you may access data state waves that allow you to access.

[00:33:31] Christa Biegler, RD: Memory, memory, healing, creativity, right? Ancient memories when people are on these healing journeys. Now this is a interesting topic, not that many years ago. I just gave up on recommending CBD years ago because of. Rules and regulations at the time. Now, it's not really a big deal at all.

[00:33:52] Christa Biegler, RD: But in a similar, but different way, these journeys have drugs. They're drug assisted journeys in theory, right? That's how we classify them now. That have regulations, as you said, that are waiting to be passed. And so I think there's a little bit of, I don't know if this is the right or privilege around being able to use this, like how do people access someone, right?

[00:34:12] Christa Biegler, RD: It's still a small niche of people. And so what's happening here is it's a psilocybin or mushroom journey. It's a MDMA or Molly or ecstasy. Journey and I don't know if there was another, was there, oh, ketamine can you tell me a little bit about ketamine? Isn't that a little bit easier to access?

[00:34:29] Christa Biegler, RD: I feel like where I live in the middle of nowhere, you can get ketamine. 

[00:34:34] Dr. Sara Szal Gottfried: Yes. Ketamine is widely available because it's a anesthetic. So I've used it for 30 years. I started it, my medical training in 1994 at UCSF, it's, The number 1 anesthetic that we use for children in the emergency room.

[00:34:51] Dr. Sara Szal Gottfried: And so we've learned that, there's the anesthetic doses. And then at about 1 10th of that, you can see psychedelic effects. So ketamine is being used sublingually as a lozenge. Intravenously and also intramuscularly. It's also FDA approved as an intranasal spray for treatment resistant depression.

[00:35:16] Dr. Sara Szal Gottfried: So it's interesting, ketamine at low doses can be em pathogenic heart opening, and at the higher doses within the. Range that we're talking about therapeutically, not as an anesthetic. It can be more in theogenic. So ketamine is very interesting. It's really versatile. It's legal. It's used off label, but it's something that you can access pretty readily.

[00:35:42] Dr. Sara Szal Gottfried: So I live in Northern California, where we've got a ketamine clinic. It seems like on every street corner. And I don't totally agree with the medicalization of it. I don't think you should, be in an IV chair getting ketamine without any therapy. I don't think that's the right. And I appreciate the point that you made about privilege and niche.

[00:36:04] Dr. Sara Szal Gottfried: What we're now seeing as we're on the cusp of this revolution with psychedelic medicine is that trauma is such a common part of our experience. And if you take more of a public health view, we're going to shift away from that one on one kind of privilege situation with psychedelic medicine toward more of a group and peer process.

[00:36:30] Dr. Sara Szal Gottfried: So that's a trend that I see. It's something that we're studying in a nonprofit that I'm part of. And that feels really helpful to me that, group process with these healing states of consciousness. Has the promise to be much more accessible, affordable, and to treat, some of the systemic problems that we have.

[00:36:51] Christa Biegler, RD: And what about healing and community? Do we have research and evidence around healing happens in community because you feel seen, heard that you're not the only person going through that issue or pain? 

Woof, woof, woof, woof, woof!

[00:37:05] Christa Biegler, RD: If you're urinating a lot when you're drinking water, maybe you're not actually hydrating that much. Or, in other words, getting the fluid and nutrients into the cell. Electrolytes are minerals that help fluid and nutrients get into the cell. I recommend all of my clients start by drinking electrolytes when we begin our work together, so to improve energy.

[00:37:24] Christa Biegler, RD: And then we get even more strategic with our electrolyte recommendations as test results come in. Now, generally electrolytes are potassium, sodium, and chloride. One of my favorite electrolyte products is pickleball cocktail from jigsaw health, because it's one of the only products you can get with an adequate dose of potassium to meet my recommendations, which is critical for blood sugar, which everyone should care about hormone health.

[00:37:47] Christa Biegler, RD: And digestion huge thing for relapsing digestive issues. Jigsaw health is also maker of the famous adrenal cocktail made popular by the pro metabolic corner of the internet and root cause protocol, as well as a multi mineral electrolyte for recovery called electrolyte supreme. You can get a discount on all of jigsaw's amazing products, including pickleball, electrolyte, supreme, and adrenal cocktail at jigsawhealth.

[00:38:11] Christa Biegler, RD: com with the code less stressed 10. That's three S's less stressed. Ten. 

[00:38:18] Dr. Sara Szal Gottfried: Yeah, it makes me slow down a little bit to answer this question, because I think it's so critical and it's something that I never learned in medical school.

[00:38:26] Dr. Sara Szal Gottfried: When I went through my medical training, I got almost no nutrition. I don't think anyone said a word about trauma and we never talked about healing and community and what I've learned is that. If you look at a group of people going through some sort of process together. So 1 of the things I used to do is to lead detoxes.

[00:38:47] Dr. Sara Szal Gottfried: We call them detoxes, but they're really, functional medicine approaches to healing the gut. That's just harder to market than detox and what we found was that the people who had accountability partners, the people who paired up with someone else and they had more of a community engagement, they had more than double the benefit in terms of tracking things like MSQ, medical symptom questionnaires.

[00:39:17] Dr. Sara Szal Gottfried: Community definitely makes a huge difference and I would say, from the perspective of trauma, we're still learning, how do we. Yes, we think community is important. Yes, we think oxytocin is a big part of that healing. We think that reaching across the issues of loneliness and isolation that we have so much in our culture right now.

[00:39:38] Dr. Sara Szal Gottfried: And we certainly had during the pandemic. Really important in terms of healing and this isn't, I take your point about the vagueness, the ambiguity of the way that sometimes we talk about healing and there is hard science behind this. If you just, we think of you and me as these 2 stable human beings who don't change that much.

[00:39:59] Dr. Sara Szal Gottfried: Maybe we improve a little bit with some of these healing states of consciousness, but we are. We've got these social genomics even on zoom that are changing constantly, right? The way that your DNA is being expressed, the way that you methylate, the amount of oxidative stress that you make, your immune cells, all of those are changing as we talk.

[00:40:22] Dr. Sara Szal Gottfried: Same thing on my end. So there's a way that. There's something that happens in dyads and in communities related to social genomics related to the pine network. That's very different than what happens in isolation. 

[00:40:39] Christa Biegler, RD: I think when I say that the healing is there's some ambiguity is because. We're not exactly the same, but we have more in common than we think.

[00:40:48] Christa Biegler, RD: And so what it boils down to is what is the aha moment for this person versus this person that kind of makes them click and head down a path to heal their different parts. And I think a lot of, as I researched this area that I had no education around either attachment theory and other things, these things, when you are, it's just like in functional medicine.

[00:41:08] Christa Biegler, RD: So when you have a test that's positive. You feel and you don't feel well, you feel validated. And so in a similar way, when you're able to self diagnosis, the word I'm just going to choose here an attachment issue, you can either live in that space or maybe you just feel like, Oh, I am not the only person like this.

[00:41:25] Christa Biegler, RD: And that there's a series of steps maybe after this part in a similar way, I think. Even though maybe clinicians see this, we see these pieces, there are many options, modalities, et cetera, for nervous system healing. When we bake this together and bring it back to autoimmune, and in the word, the book is called Autoimmune Cure, which is a spicy word for a medical professional, right?

[00:41:51] Christa Biegler, RD: But your other books were also called Cure, right? Any of you want to comment on that comment? I welcome it too, because it's, I think we were always like, feel when I see that word, I almost feel like my hand just got slapped, right? Cause it was like, we don't talk about there is no curing anything.

[00:42:06] Christa Biegler, RD: You now have this thing. And so even just the choice of our words so often, actually, I'm going to stop there and let you talk about the word cure and then let's weave around and talk a little bit about the healing map with auto immunity, you've piecemealed it here and there, but I just want to make sure we wrap it in a bow for sure, before we finish up.

[00:42:23] Christa Biegler, RD: So cure 

[00:42:25] Christa Biegler, RD: why that word? 

[00:42:26] Dr. Sara Szal Gottfried: Yeah. There's a lot of things I was taught in my medical training. I was taught, and I think patriarchy is alive and well in mainstream medicine. I was taught that you never talk about yourself. You only talk about cases. You never share your personal story and you certainly never talk about cure, but once I turned toward functional and integrative medicine, I found that cure happened all the time that the idea that, say, an autoimmune disease can go into remission.

[00:43:06] Dr. Sara Szal Gottfried: I don't think that quite captures the process that someone can go through and the transformation that they can experience. And I think the word cure does. It captures the transformation. So that's why I very intentionally use it. And this idea that you don't use cure in your language as a medical profession, we need a new model.

[00:43:34] Christa Biegler, RD: On that note, let's talk about a model for autoimmune healing, because I feel like there's several pieces. And so I'd like to. I'd like to come up with steps, pieces, whatever. I'd like us to, for sure, discuss let's say, do you ever hear this statement? I've tried everything. I'm like, that might be the most broken record thing I've ever heard in practice.

[00:43:57] Christa Biegler, RD: I've tried everything and I'm like, Oh, it sounds like you've just tried a few pieces of a certain section. So tell me how you itemize categorize how you the steps you might go through if you were looking at the opportunities in the autoimmune situation. 

[00:44:14] Dr. Sara Szal Gottfried: I'm an engineer, so I'm systems based thinking.

[00:44:18] Dr. Sara Szal Gottfried: And when you look at what's required to develop autoimmune disease, Alessio Fasano at Massachusetts General Hospital, pediatric gastroenterologist described a triad, and that triad is genetic predisposition together with increased intestinal permeability, and then a trigger. And so we've talked about some triggers.

[00:44:40] Dr. Sara Szal Gottfried: That can occur the issue with that triad is that you can't do much about your genetic predisposition, although you might be able to make some changes with your genetics. That's another conversation, but with leaky gut and with your response to triggers. You have a lot of power to change those things.

[00:45:00] Dr. Sara Szal Gottfried: So if you start with leaky gut, what we know is that an elimination diet that's well designed that goes through a rigorous process of eliminating the most immunogenic foods, the foods that really trigger your immune system potentially, and then adding them back one at a time, very carefully and methodically, that's been shown to improve leaky gut.

[00:45:25] Dr. Sara Szal Gottfried: And here I'm using leaky gut as a proxy for increased intestinal permeability. We also know that addressing gut health, especially the dysbiosis that we see that's associated with increased intestinal permeability can make a big difference. So. Part of my path with this is paying keen attention to my patients.

[00:45:49] Dr. Sara Szal Gottfried: And I had a patient with Crohn's disease who had a segment of his colon. He had colonic chromes removed about a nine centimeter segment. He's a case in the book. And when he recovered from the surgery, his high sensitivity, c reactive protein was like 27 the day that he had surgery. And now it's less than one.

[00:46:13] Dr. Sara Szal Gottfried: And a big part of our work was. Microbiome restoration working on his gut health and, there's never just 1 thing that really moves the needle for people. But 1 of the things that really worked for him was that he would have a smoothie every day. He would go to the farmer's market, and he would get 50 plus fresh fruits and vegetables and season, and he would make a smoothie out of it.

[00:46:46] Dr. Sara Szal Gottfried: And he would use that to feed the benevolent. Microbes in his gut, and he would make a big batch, freeze it, and then drink about 6 ounces a day. And inside of a few months, he dramatically changed his microbiome and I would say he has a cure. He's. A very rigorous scientist, so he would say that he's in remission with his disease.

[00:47:12] Dr. Sara Szal Gottfried: That's leaky gut and there's also supplements that can be helpful. I'll glutamine, some more proven than others, but that brings us to the triggers. The map with triggers is to really understand what they are and what I'm listening for when I'm taking a patient's history. When I'm listening to their story, I'm listening for I was fine until and then there was a moment, my mother died or I got a divorce or I had my baby.

[00:47:45] Dr. Sara Szal Gottfried: And it was traumatic, so I'm listening for what the trigger or triggers might be in somebody and addressing those triggers, I think is really critical because those triggers, there's this line that you hear in spiritual work, never waste a good trigger. Really understanding what your triggers are.

[00:48:06] Dr. Sara Szal Gottfried: And using those as part of your map for what to address, for me, one of my triggers was this falling out. I had with a person. I loved. That was an important trigger related to relationship that I needed to pay attention to. 

[00:48:23] Christa Biegler, RD: It's really normal for us to want to not feel that stuff. And when you say triggers, I think about other ways to make it relate to someone.

[00:48:32] Christa Biegler, RD: And I think it's what you're thinking about all day. You're distracted by, it's like the monkey on your back or just like what's taking up rent free space in your brain. I feel like that might be a trigger. Just saying. It's like what you can't, what pops in your mind when you try to have stillness, right?

[00:48:48] Christa Biegler, RD: What's stressing you out? 

[00:48:50] Dr. Sara Szal Gottfried: Yeah. John Donahue, the poet from Ireland also talks about this. He talks about how we all have seven ideas that we just think about over and over again. And you're married to them. Did you consent? Are they really the seven thoughts that you want to keep having that red free space?

[00:49:11] Dr. Sara Szal Gottfried: Like maybe we want to be more intentional about those seven thoughts? 

[00:49:17] Christa Biegler, RD: I have never. I've never personally taken an autoimmune intake or history without that stressful trigger, that strong trigger. And to your point, when you said earlier hormones and autoimmunity aren't really separate, I take a very, I'm sure like you do, root cause approach to hormones.

[00:49:36] Christa Biegler, RD: I think about here's all the things that make hormones function well. As an aside, when I see a very low testosterone, I've started to just recognize. Yes. What trauma trigger did you have here? I'm not sure there's a ton of other reasons I've seen this such depleted, unless you have a genetic reason for this,

[00:49:56] Christa Biegler, RD: so triggers are vast and broad. And I even think just to expand on the microbiome piece, that there's sometimes things affecting microbiome. I would put it in that umbrella, like fungal toxic toxicity and that kind of burden, just so we're not accidentally pigeonholed and I don't know, you can disagree with me, but I just want to say that there's some other things that might fit in that bucket that would be stressing to the gut.

[00:50:19] Christa Biegler, RD: Overall, which stresses the immune system. Tell 

[00:50:23] Christa Biegler, RD: me where. 

[00:50:24] Dr. Sara Szal Gottfried: Yeah, for sure fungal overgrowth parasites. There's lots of things that can cause a dysregulation in the gut. 

[00:50:33] Christa Biegler, RD: Tell me where you are now in your 7. Of this healing journey. I know you now have the book out, but there was a lot of processes and I'm stumbling over your name change a little bit.

[00:50:49] Christa Biegler, RD: Do you want to talk about that at all? 

[00:50:52] Dr. Sara Szal Gottfried: Sure. I want to be respectful of my ex husband. Let me tread carefully. I went through a divorce last year and that was after 20 years of marriage. Okay. So I've got two daughters, the youngest one went off to college and as we looked at our empty nest, there were ways that I felt like this relationship just wasn't the sanctuary that I believe a marriage should be.

[00:51:21] Dr. Sara Szal Gottfried: And I recently heard Nicola para talking about bare minimum fathers and bare minimum mothers. And that really struck a chord for me because there's a way that, what you experienced growing up, what you witnessed, you then accept, unless you do a lot of work around it. And I had done that. So I had a trauma bond with my ex husband, and there was a way that our trauma kind of interlocked.

[00:51:52] Dr. Sara Szal Gottfried: My abandonment, his. Need for more independence and not to be engulfed. And yeah, a big part of my process of realizing that I grew up as someone who sacrificed authenticity for attachment and realized that I was doing it in my marriage, we tried for half the marriage to address this. We were in couples therapy for half of it and we just realized.

[00:52:20] Dr. Sara Szal Gottfried: We're still dysregulating each other, and it's not a little bit. It's significant. It's high blood sugar elevations. It's high resting heart rate. It's high cortisol levels. It's a low heart rate variability. It's a low level of resilience. And once you get to a point in a marriage where you've got that kind of bi directional dysregulation,

[00:52:48] Dr. Sara Szal Gottfried: that's a problem. That's harder to fix. So I completed my divorce and there's a way that, the second half of life for me. So I'm in my fifties. I'm just really excited. And I want to work on transformation. I want to help other people who struggle similarly with some of these things that we've been talking about.

[00:53:10] Dr. Sara Szal Gottfried: I'm excellent at functional medicine. I can help people, recalibrate their gut. I can help people get their hormones to a much better place. I can talk about genomics and how those interact with biomarkers, but in some ways that's less interesting to me than this more core work of transformation and regulation.

[00:53:32] Dr. Sara Szal Gottfried: And also, if there are things I can do to regulate someone else to be of service in that way, like if our podcast today could co regulate our listeners. That's 

[00:53:47] Dr. Sara Szal Gottfried: what it was. 

[00:53:49] Christa Biegler, RD: I hear you have lived in your zone of excellence for a long time. And now you're really wanting to step into your zone of genius of transformation and regulation is what I hear you saying.

[00:54:00] Christa Biegler, RD: So I understand. I have all of these similar wavelengths and on a positive note, when we think about family structures, being a huge piece of our Sensitive on not safety and dysregulation. I had a bit of a look at my own life. I haven't talked about this a lot on the podcast yet, although I intend to, because I think it's important and it's just to your point.

[00:54:23] Christa Biegler, RD: I think if it can help someone realize their own accidental stress faster, then that's great. Life is achieved, I guess I've achieved fulfillment, but, in a similar way, long story short, I was observing my family system with my children, et cetera. And I just had all of these feelings like, oh, okay.

[00:54:43] Christa Biegler, RD: Everything is a reflection of where I am, much to where you said what you witness is what you accept. And I heard you talk about your divorced parents. And so sometimes those treatments of those things show up there. That's talked about, right? We seek that in our mates and whatnot, but. The point of my story, the brief comment here is just that I started to observe that, oh, my 10 year old is reactive and angry.

[00:55:06] Christa Biegler, RD: Where am I being reactive and angry? And I just started really being very curious. And very witnessing of everything I could be doing, and I made, I just very quickly it was, I had already been on a healing journey, right? So I had nervous system tools. I just, I became almost vigilant, right?

[00:55:30] Christa Biegler, RD: About just tending to the nervous system and being a witness of that. And within a a maximum of three weeks, I started to just see the changes positively ripple, right? And so I share that just because. It's, I think, an important piece. So often, and just this morning in my, I have a call with clients if they want to show up and ask like a group call questions.

[00:55:52] Christa Biegler, RD: And someone asked me today about their baby's microbiome. And so often it's it depends on yours. You are the mirror of all these things. And so that would be an invitation I would extend as we go forth and start to finish up our conversation here is look at where you are mirroring all those things.

[00:56:09] Christa Biegler, RD: And this is talked about, right? This is not a new concept, but look at where these things are mirroring and just get really curious about life. And for you, what advice do you want to give the listener and then where can people find you online? 

[00:56:22] Dr. Sara Szal Gottfried: I love this point about mirroring. I feel like our biggest job as mothers.

[00:56:28] Dr. Sara Szal Gottfried: Whether that's to a child or to an adult or a mission is to be a clean mirror. I really want to honor you for that particular story and it's similar to, when you have a new baby, when you've got an infant, we're meant to co regulate that infant. Just to hold the baby close and soothe the baby because the baby hasn't learned with their nervous system, how to do that for themselves yet.

[00:56:56] Dr. Sara Szal Gottfried: And so they look to parents, mostly the mother to do that. So I so appreciate that point that you made. So I would say a takeaway that I really want people to understand is that while you may feel dysregulated while you might feel. Maybe like a bit of a victim and overwhelmed by. A recent diagnosis, or even having mysterious symptoms that no one can seem to get to a cause for, or, put a label on or diagnose once you experience regulation.

[00:57:36] Dr. Sara Szal Gottfried: Once you experience that sense of peace and equilibrium in your system, and it feels enduring, there's no going back. There's no going back and it's easier to get into this place of regulation than it is to live with the misery of that dysregulation. 

[00:57:55] Dr. Sara Szal Gottfried: So I hope people understand that and hear it as an invitation to learn, what's the a la carte menu of what you want to try to regulate yourself.

[00:58:05] Christa Biegler, RD: Yeah. 

[00:58:06] Dr. Sara Szal Gottfried: Everyone to have like their top three. What's your top three, Krista? 

[00:58:10] Christa Biegler, RD: To regulate my nervous system. So I have two top for sure. I have. breathwork if I don't do a longer breathwork of 20 to 30 minutes every week. If I go more than two weeks, I am not a good person anymore. So at least weekly is my bare minimum for that.

[00:58:28] Christa Biegler, RD: The second thing is some version of coaching. And so coaching is, it's a little bit of an ambiguous model, but it's essentially a little bit of it's, I think about it as math problem solving and it's like oversimplifying problems, right? By using a structure, right? Like circumstances, thoughts, feelings, result actions, results, basically.

[00:58:49] Christa Biegler, RD: And so I love. tools in that realm that helped me plug things in. And then from there, I don't know, I'm just really, I'm really adamant about sleep to be honest, right? I see a lot of really brilliant, smart people doing revenge bedtime stuff and just not getting sleep because they're like, I must achieve and achieve.

[00:59:08] Christa Biegler, RD: And that's, our, that's just an extension of our desire to just do, and not be able to sit and rest and feel like you deserve rest. So I'm just going to. Play an easy card, like a wild card here and say I'm really just adamant about getting proper sleep. I'll go with it works for me.

[00:59:27] Christa Biegler, RD: And you, what are yours and also I saw a scrolling your Instagram before we got on this and I saw you asking people what their word of the year was and I didn't get to bring this up yet. I want to ask you your word of the year. Mine is I haven't talked about this either. Mine is embodiment, which just means I'm just so open to all of these different modalities.

[00:59:44] Christa Biegler, RD: Right? And actually, doing the thing. It's like the feelings of fraud we have as medical providers. I feel when we end up in this health crisis ourselves, right? It's Oh, I have not embodied, this stuff. And I think you said it in different words earlier.

[01:00:00] Christa Biegler, RD: It's if you haven't healed your thing maybe don't teach other people how to heal it yet. And so you have to really step into that embodiment piece. And that's what I'm hanging out in is the embodiment of the less stress life. And I'll tell you where this comes up. This podcast has been called the less stress life since 2017 as an synonym for inflammation.

[01:00:17] Christa Biegler, RD: And I really think we need to just be calling it in pursuit of the last stress life. Like it's not a mountain that you get to necessarily. It's we're pursuing that. We believe it's accessible and an option for everyone. So embodiment for me. I'd love to hear about your word and your top three.

[01:00:32] Dr. Sara Szal Gottfried: My word of the month is regulation. So this is my 6th book. And my hope was to not be on a plane every single week and be doing to not be saying yes to everything, but to be much more selective about congruence and alignment with what I say yes to. And. My word of the year for I've been doing this for 19 years with my best friend, and there were a few years, I think like 2020 until about 2022, where my word was embodiment 

[01:01:07] Dr. Sara Szal Gottfried: and, 

[01:01:08] Dr. Sara Szal Gottfried: My best friend and I go hiking on New Year's day and we come up with our word and her point was in 2022, she's wait, that was your word last year and the year before that.

[01:01:18] Dr. Sara Szal Gottfried: Like, how long is this going to take? 

[01:01:21] Christa Biegler, RD: Yeah, it's reasonable. Okay. Good. Thanks for letting me know. I might be working on that for a couple of years. I appreciate it. 

[01:01:27] Dr. Sara Szal Gottfried: It's a 

[01:01:27] Dr. Sara Szal Gottfried: good project and it was, it's not a destination. So the things that I find are the most regulating are certainly breath work. And I've experimented with a lot of things over the years.

[01:01:40] Dr. Sara Szal Gottfried: I heard you talking about Joe Dispenza and I'm really enjoying some of his work right now. And I'm using a new app that does some data activation. So working with that right now. The second is. Psychedelic medicine, as I've said, I just think it's a, it's an accelerator and the right. Patient population with the right people with the right support and container.

[01:02:05] Dr. Sara Szal Gottfried: 3rd, orgasm I think the female body, especially as designed for pleasure and orgasm is just 1 of our ways of regulating, especially when it's done correctly. And then. I'm going to say a fourth, which has been such a surprise to me, heavyweight lifting. So I've really embraced this over the past year.

[01:02:28] Dr. Sara Szal Gottfried: And it's just shocking to me how much it regulates my nervous system when I'm doing it, when I'm noticing, I'm doing like a deep squat and I'm noticing the difference, right? Left. I'm noticing what I'm storing in my pelvis. So regulating. And so it's that embodiment that I really was So those are my top 4.

[01:02:50] Christa Biegler, RD: Yeah. And I think what I hear is also proper structure is involved in your heavy lifting, right? Because there's all that conversation about what are you storing in your pelvis also. And I am now going to add another 1 also which is really. And a new hobby to enjoy, right? I started, I'm very slowly plucking my way through a guitar because I love these stories of learning things as you get older.

[01:03:14] Christa Biegler, RD: And so I've been plucking around on a guitar for a couple of months and going to lessons. So funny to one, learn something as an adult, right? Showing up, doing lessons and sitting down and realizing, wow, this is feels so good with my nervous system to just enjoy this thing, like some creative expression.

[01:03:31] Christa Biegler, RD: So I just wanted to share that also. Where can people find you online? 

[01:03:36] Dr. Sara Szal Gottfried: So the best place is to go to my website saragoffriedmd.com and I hang out mostly on Instagram. So that's a good place to interact with me. And that's also at sara goffriedmd. 

[01:03:50] Christa Biegler, RD: Perfect. 

[01:03:50] Christa Biegler, RD: I thank you so much for coming on today.

[01:03:52] Christa Biegler, RD: And I am going to insert one last question for the audience because we were talking about psychedelics. And I just wanted to know if you had any knowledge about, I feel that I see studies happening in the VAs for psychedelics. And this is just, like I have a little heart strings for this. And so this is some of the places I watched trauma playing out in front of my eyes right now is with my dad starting to Maybe become a little more aware of his Vietnam trauma.

[01:04:19] Christa Biegler, RD: And and then also seeing it with my sister was an Iraqi war veteran. And so anyway, since you are, have this training, is this happening in VAs and how do people find out about it? 

[01:04:30] Dr. Sara Szal Gottfried: It's really exciting. The VA is going through such a process right now. They're switching where they're embracing whole health and the map studies that have been published, the two randomized trials of phase three with MDMA assisted therapy for post traumatic stress disorder, the VA very wisely said.

[01:04:51] Dr. Sara Szal Gottfried: That's different patient population than the veterans that we take care of. So they want to do their own studies and veterans with therapy. So that is being done right now. And I would really encourage people who are veterans to look into that research, especially before is FDA approved. You really want to be in a research setting.

[01:05:13] Dr. Sara Szal Gottfried: You want to be what we call above ground with how you're doing some of these psychedelic medicines. So I would say, look into the research that's being done at the VA where they're trying to replicate what's been done in a severe PTSD population, which was the first phase three MDMA assisted therapy trial.

[01:05:34] Dr. Sara Szal Gottfried: And then the second trial was with moderate to severe PTSD. The first trial had mostly white participants. So there was a real bias. The second trial was 50 percent non white. And so we need to know in a VA population, do you see the same efficacy of 67 to 71%? 

[01:05:54] Christa Biegler, RD: Cool. Thank you so much for indulging in that 

[01:05:56] Christa Biegler, RD: last question.

[01:05:56] Christa Biegler, RD: And thank you so much. 

[01:05:57] Dr. Sara Szal Gottfried: Of course. It was 

[01:05:58] Dr. Sara Szal Gottfried: a good one.

[01:05:59] Christa Biegler, RD: Just keep breaking. Gotta get myself.