Let me introduce Jill, this is Dr. Jill Carnahan. She's your functional medicine expert. She uses functional medicine to help patients find the root cause of their illness and identify nutritional and biochemical imbalances that may be contributing to your symptoms. Dr. Jill will search for underlying triggers that contribute to your illness through cutting edge lab testing and tailor the intervention to your specific individual needs. She uses nutrition supplements, lifestyle changes, or medication to treat your illness and always seeks the gentlest and least invasive way to help find hope and restore health and optimize healing. She completed a residency at the University of Illinois in family medicine at Methodist Medical Center and received her medical degree from Loyola University Stritch School of Medicine in Chicago. She received her bachelor of science degree and bioengineering at the University of Illinois at Champaign-Urbana. Dr. Jill was duly board certified in family medicine in 2006-2016 and in integrative medicine since 2005. She founded the Methodist Center for Integrative Medicine in Peoria, Illinois in 2009 and worked there as medical director. In 2010, she moved to Boulder, Colorado and opened the Flat Iron Functional Medicine Center, where she is widely sought after medical practice with a broad range of clinical service, including nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy. Dr. Jill is a survivor of both breast cancer and Crohn's disease and passionate about teaching patients how to live well and thrive in the midst of complex and chronic illness. She's also a widely sought after inspirational speaker and travels around the world to teach physicians the principles of personalized functional medicine. She's a prolific writer, speaker, and loves to infuse others with her passion for hope, health, and healing. She's been featured in Shape Magazine, Parade, Forbes, Mind Body Green, First for Women, Towns and Letter, and The Huffington Post, as well as seen on NBC News and Health Segments with Joan London. She recently co-authored the Personalized and Precision Integrative Cardiovascular Medicine textbook and her prescriptive memoir will be released by Harper Collins in the fall of 2021. Please welcome Dr. Jill Carnahan. Hi, Jill. Hey, Tom. Thank you so much for inviting me. I am just delighted to be here with you guys. We're so happy to have you and appreciate your insights always. So just so everybody knows, we're going to do a little bit different here. Jill doesn't really have a PowerPoint to go off of. We're just going to kind of sit here and chat and talk to each other and ask questions and see if there's anything you guys want to ask Jill that's important to you. So I'll just kind of guide us through conversation here and we'll see where this takes us. So I know, you know, in conversations with you and in reading about you and you're very open about your past and some of the difficulties that you've had in your lifetime, could you share some of your stories with us that would kind of enlighten us about the path that you've been on? Oh, I would love to. Tom, thank you so much for asking and thank you guys for asking me here. I have such great respect for both you and Karan and the company you've built and just the support that you give us as clinicians. So I just want to shout out to you. It is an honor to be here with you guys and support you. And I think this time is a time of reflection for all of us. It's a time for us to really decide what is no longer serving us and what is, where are we headed into 2021? So when you guys asked me to be on this, I was just absolutely thrilled because I loved to inspire and I love to. Many people have been out who are on here. I'm sure I've heard my story, but even when I do interviews, I always like to start with people's story because it really gives you a glimpse into where they've been, what motivates them and what drives them. So I would love to tell a little bit of my story. And then I do have just like five slides in a few minutes of another story that we can get to in a few minutes, but we'll start really quickly with my background. So again, many of you have heard this, but in 2001 when I was 25 in medical school, my third year, I had a brush with death in my own mortality. So I was going along pursuing my dream of becoming a physician at Loyola University and I was in my surgical rotation and suddenly found a lump in my left breast. So the irony of being in surgery rotation, learning about breast cancer and finding a lump in my own breast. But I'll tell you what, as we all know, whether it's children or friends or whatever in their 20s, we tend to not think about our own mortality at that age. We don't really think about life or death. And I was no different. I was absolutely gung-ho about becoming a physician. And for our audience's sake, it's very interesting. I actually had, I always say, I have the heart of a naturopath. I had a much more holistic healing. I grew up on a farm, one of five children. We had a one acre garden with fresh corn and raspberries and strawberries and potatoes and sweet corn. And so I grew up with a really health conscious family and a health conscious lifestyle. And I knew that food was medicine and that medicine starts with what we put into our bodies and our gut microbiome. So I grew up understanding that the soil is kind of a microcosm of our guts and really the health of our soils reflects the health of our gut. And so what you guys have done and developed in sport probiotics is so game changing because our soils are depleted and our soils are lacking nutrients. And there's been fungicides and all kinds of things that actually disrupt the microbiome of the soils. And so then that actually reflects in our gut health. And I love talking to my older brother, who's a businessman entrepreneur. And I kind of call him like the functional soil guy because we have this, when we talk about the depletions in the soil of nutrients, it totally reflects the depletions that we're seeing in our patients. So that's just a little backstory because I grew up with this heart of wanting basically the heart of a healer and I didn't know it. I actually applied to chiropractic school, to naturopathic school, to traditional Chinese acupuncture school, and to osteopathic school, and as an afterthought to allopathic MD school. And what happened was I got accepted to multiple allopathic schools and I was kind of surprised like, oh my, I guess maybe I should consider this. And what I did, I always joke, I kind of tried to infiltrate the system because I knew that our traditional system in the US is still predominantly allopathic, whether that's good or bad is, you know, who's to say, but it is good with trauma. And I thought if everyone to go overseas and do mission work or anything, I would still probably within the system be able to do the most good. And I knew that if I wanted to be a changemaker, which is my heart a healer and changemaker that I wanted to go into that system, learn it well, because there's something to be learned there, and then take and transform medicine. And I know many of you listening are physicians, and so you have that heart, you wouldn't be here if you didn't, because you're using these kinds of principles in your patients and starting to transform your own practice. And as patients ask you questions, you're going deeper. I remember in medical school, I was such an outlier, I was kind of the weirdo, I'd started a integrative medicine club, the first of its kind at Leola, we brought in chiropractors and massage therapists, and we kind of introduced these fields to the medical school. And I love doing that and breaking the mold, but everybody thought I was kind of weird. And then what happened is a decade later, I get calls all the time from my old colleagues in medical school, because their son, or their daughter, or their husband, or someone they love has gotten ill, and they don't have the answers. And so they say, Jill, you know, I remember you way back then were questioning, you were questioning, were asking the questions, and they'll say, do you know if there's anything that could help my husband's seizures?  And so I love now that I'm, it's validation in a way, because I've always known I followed my own heart and my own path, knowing that this was right and true. I remember when I got diagnosed with Crohn's disease in medical school, and my gastroenterologist said, Jill, diet has nothing to do with this. And I just, I felt so like I didn't know much, I didn't have confidence in myself. But there was a little voice inside of me that even though I didn't know the answers, I thought that can't be true. And I fired him and I went on my journey to heal myself from Crohn's and I realized diet does have something to do with it. So back to the story where I left off at 25, lump in my breast, I asked my husband at the time, and he said, Jill, this is, I don't feel good about this, you need to get it checked out. So of course, I went in, I always joked I didn't even have time at that time with surgical rotation working 36 hour shifts. But I went ahead and got a mammogram and ultrasound and the full workup. And again, you've probably heard me tell this before, but I remember sitting next to my colleagues and teachers, one was a radiologist, looking at the films with him, and seeing the look the flash of fear across his face and knowing that moment, my life was about to change. I knew deep in my soul, even though I didn't have a diagnosis yet. And he said, Jill, if you were 55, this is highly suspicious for carcinoma or cancer. But you're 25 and get it checked out and get a biopsy and probably nothing to worry about. He was trying to reassure me, but I knew, I already knew. I went in and got a biopsy. And two days later, my oncologist, again, a teacher and a friend called me. If you've ever had news like that, you remember the place where you were, the place where you were sitting, you remember the texture of the chair, the color of the walls. And I remember all the details of that day when she called me. And she said, Jill, I don't know how to tell you this, you have cancer. And not only cancer, but you're 25. And this disease, breast cancer in a 25 year woman has a high fatality rate. You're in for the battle of your life. The cells that we found in your breasts are extremely aggressive. They have the highest grade, the fastest growing, the most aggressive, awful cells that we could have find in cancer. These are yours. You're going to need to do chemo, radiation, surgery, everything you have. And I had to choose at that point, because I believed in natural healing and food as medicine. But I also knew that I had a purpose in life to inspire and to heal and to bring change to medicine. And I knew that wasn't going to be the end of my life. I just, I knew I had to survive. And so with everything I had, I went diving into the literature and I looked at all the studies and tried to make best decisions. And I have such compassion for those people who are trying to make decisions about their health, especially as laypersons. I had the medical background because that amount of data was astronomical and nothing was black and white. We think that decisions in medicine are like black and white and it's all gray. And the positions use the best information they can to pull this together and to make decisions. But I realized right then in my third year that what we think is black and white science is so far from it. And you guys as researchers, Tom and Kieran know this. And so as we in functional medicine dive into the cutting edge research and we find these things about nutrition that are true, just because they're not published in JAMA does not mean they're not true. So I made decisions and what I decided to do was go with the most aggressive conventional therapy possible because I wanted to live. I had a purpose in my life to live and to continue. And it's funny. This is relevant, I promise. But the facing my own death immortality at that time, there couldn't have been a more horrible thing to happen. I mean, I didn't know if I was going to live six weeks or six months or six years. But that will to survive has always been my signature. And what I learned now in my 40s is I was born number one to overcome adversity so that I can teach and inspire others. But number two, to actually experience some of these things, experience of suffering, experience illness, because the experiential learning in me gives this fire and passion and understanding that cannot be bought with a textbook, cannot be learned at a lecture.  And now I can look back and I think, oh my goodness, the platform that I have, the understanding that I have, it came from great suffering. It came from great trials. It came from looking in the mirror, bald and scarred and down to the lowest weight since I'd been like 12 years old and not knowing if I was going to even live. My gut was destroyed by chemotherapy. I had three drug chemotherapy. And we know now one of the drugs, cytoxins, it's very nature is to increase permeability of the gut. And part of its activity against the cancer cells is to trigger leaky gut so that you have LPS-induced endotoxemia, which of course, Tom and Karen are the leaders on some of the teaching here. And this triggers that immune reactivation of all the cytokines, IL-6, IL-2, et cetera. And that actually activates your system to fight the cancer. But of course, as you can imagine coming out of that treatment, my gut was destroyed. And unbeknownst to me, I also had undiagnosed celiac disease. I had a high-risk gene NOD2 for Crohn's. And all of this led to six months later, I had cyclical fevers. I had granulomas and fistulas and pain and bleeding. And as you can imagine, you've heard this before too, from me. I was diagnosed Crohn's disease just six months after I completed all the treatment. So here I am bald. I am malnourished. I'm down to the lowest weight. And I wasn't discouraged because I've never given up hope. I've never in my life lost hope. And I hope today, that's one of the gifts I can give you is how to hang on to hope in the most dark times because it isn't always easy. But at that time, I got hit with another diagnosis. And as I mentioned, I sat with my gastroenterologist and we had this talk. And I just could not believe that food couldn't have anything to do with this. Now, funny thing was I had been a vegetarian from the age of 14. And if I look back, it makes perfect sense. I was probably hypochlorhydric from very young. I was celiac undiagnosed. I had malabsorption. And I had become a vegetarian because meat was hard to digest. And I had low zinc levels, which also make you have a lack of taste for meat. So all of these things, if you have a young woman or young man that has all of a sudden a big change in diet like they become vegetarian at 12 years old, you better look at their nutritional status and you better look at their microvilla and their absorption because I look back and it wasn't really a choice so much to stop eating meat for ethical sake. It was a choice because it didn't feel good, but I didn't understand it at the time. So that zinc deficiency, that hypochlorhydria, probably malabsorption already happening from the celiac led to this manifestation. And I was even diagnosed in high school with bulimia. And I have no signs or symptoms of that or any sort of behavioral eating disorder. Now what it was was I felt so awful with the foods that I was eating that I felt like I felt puffy and swollen and bloated with gluten and with, you know, flowers and sugars and things. And once I ate a clean diet, that went away. So look at these things in your patients because sometimes those manifestations of an early young woman becoming vegetarian or eating disorder can be actually malabsorptive syndromes or nutrient deficiencies or other things. And that definitely was the case for me. So all that to say, I found Elaine got to a specific carbohydrate diet and I had read all the, I thought, what do I have to lose? I remember my doc before I fired him. He said, Jill, you're going to need lifelong surgeries. This is, there's no cure for this. You're going to forever have Crohn's and you will probably be on biologics. And for now, let's start steroids. I said, oh, give me some time to think. Never went back to him, found this diet. And I changed my diet. And within two weeks, the fevers were gone and almost 80 to 90% of my symptoms were gone. I knew that moment, the diet does and your gut has everything to do with health. And it took me several years to really, I had SIBO and SIFO and I had all kinds of parasites, I had Giardia at one point, Celiac undiagnosed. So it took me a while to really heal the microbiome of my gut, but I have no evidence of Crohn's. I am cured. It's not in remission. And some of my patients or fans, if I've actually tweeted or said that out loud, they get mad because they've been told by their doctors, Crohn's is incurable. So if I have Crohn's, there's no cure. And I just, I get so excited talking about it because for me, I, I lived that and I proved the difference. So that was all of my early history in a nutshell of cancer and Crohn's and understanding soil and microbiome and the passion for this. So I'll, I'll stop for a moment, Tom. That's great. I mean, that's what we brought you here is truly inspirational. Did you say you wanted to share some slides? Is that something? I would love to. Yeah, if you don't mind, I can go on to the next part, two of the story. I'll tell you just a little bit about the next phase, and then I'll share a couple slides, and then we can do some Q&A. And thank you for your patience listening to my monologue here. So I was doing well after Crohn's. I cured myself from Crohn's. I did have, like I said, I went to Honduras for a mission trip and brought back Giardia. And that's when I actually found out the diagnosis of celiac, because that Giardia triggered that in a full blown celiac. And what I found this would be clinically interesting is both candida antigen can look like gluten to the body. So if you have a latent or silent celiac, and you have the genetics for celiac, and you get a candida or a fungal overgrowth, a lot of times that is one of the triggers that triggers you into full blown celiac or latent celiac or non celiac gluten sensitivity, because that candida antigen, it's in the literature looks like gluten to the body. So it's like molecular mimicry. So I'll tell you what, as a clinician, if you find a patient with celiac newly diagnosed, you better look for fungal dysbiosis. Same with Crohn's, because I would say 80% of Crohn's and colitis patients have some form of fungal dysbiosis, and it's kind of hard to detect on the lab testing. So you have to have a high index of suspicion. In my own healing, not only did the diet change me, but treating the fungal dysbiosis was a game changer for me. And it's very hard. Like I said, you can check antibodies in the blood, you can check stool, which rarely shows it because it's in the small bowel, and you can check organic acids and sometimes even with all those, you won't find it. So have a high index of suspicion for that. So got well, I moved to Boulder in 2010, I was doing great. So I had been, you know, six years in remission from cancer and Crohn's and doing well, actually about a decade at that time, and running and active and skiing and hiking. And we had a massive flood in Boulder, epidemic proportions, they said a thousand-year flood and flooded the whole town, washed out literally entire zip codes, billions of dollars of damage. And what happened was, of course, water and there were lots of remediators came in, tried to fix the problems, and it was quick and fast and furious. And every since then we've had mold problems in this town. And I didn't know anything about mold. I always say I would have never chose to be the mold expert, but mold chose me. Just like cancer and just like Crohn's. And so what happened was there was a basement and then a regular level and then an upper level where my office was, and in that basement it had flooded. There had already probably been a little bit of mold growth and it just went crazy. And then right directly under my office was an unsealed cross space that had standing water. And then in my office was I put down brand new, I painted the walls, redid the office, put down bamboo flooring. And I had no clue about construction or these kinds of things. And my contractor put beautiful new bamboo flooring on like 30 year old carpet. Can you imagine?  So I was just in this Petri dish for mold unbeknownst to me. And the year after the flood I started having rashes and my eyes would be all red. I'd have like trouble word finding and difficulty with like a type and type in a wrong word or names, different things like that. And then shortness of breath. And I developed a new onset asthma, which I'd never had asthma in my life. So trouble breathing and albuterol did nothing. It wasn't that kind of an asthma. So it was basically an interstitial inflammation from the mold. And I kind of knew a little bit about mold knew that might be the case, but I was in denial for quite a while. And when I finally realized I had to figure this out, I was kind of going downhill pretty quickly. I went down and got bulk samples with an inspector without even any protective gear. I remember like scraping it off the wall. And this is black stackie batteries. Now I would never do anything like that. And we took send the sample in. And then what I did at that time, which was very new and very, you know, controversy is urine mycotoxin testing. And my mycotoxins in my urine were super high for T two, which is trichocethenes. So these are basically, you know, really bad toxic, these are used in chemical warfare. So they're toxic, they're nephrotoxic, they're pulmonary toxic, they're neurological toxins and skin toxins, etc. They affect all the systems. So I knew at that point. And I had to I literally found the day after Christmas 2014. And I never set foot back in my office after that moment. I got rid of everything, all my library, all my books, I took the charts and it took me a couple months to get a new location. And actually, my labs continue to remain abnormal until I got rid of the paper charts and scan them in. So it was a really big deal. But then just like everything else, I was born to overcome an experience adversity so that I can teach and inspire others and help my patients. So I had to figure this out. So it was just like a necessity that I dove into what is mold, why is it totally taking me down and how do we heal from this? And of course, Dr. Shoemaker was a leader at that time and worked with some of his stuff. And then as we've developed ICI group and some of the other physicians, many, many other professionals that are more educated than I am, we really, really, I feel have transformed. And it's perfect timing because as people go with COVID back into their homes, and they're more inside, we are seeing epidemic proportions of mold related illness. So over that next 18 months, I healed from mold. And it's just been my passion every since the gut and the mold and all of these things. So that's the mold story. And I've got one more, I'll go ahead and share just a recent experience. And then we can go into some questions, Tom. And I think if you if I can share my screen, I'll share these slides. Okay, so this is recent. And I thought it would be fun to share because it's my own little adventure that I did last fall. So can you see the photo there? Okay, so let me tell you about this guys. Last October, a writing coach that I have who's working on the book with me, who's an expert rock climber, he's been a guide for years. He said, Hey, Jill, let's why don't we go climbing? Because as we do the story, I'm writing my prescriptive memoir, and it's very personal, as you can imagine. And so there needs to be this trust between the coach and myself. And he I think in his mind that well, there's no greater trust than to take someone climbing.  So this is quite funny, because I am someone who likes adventure. And I just said, Sure, that sounds great. Let's do it. And I had no clue, like I had clueless. The day before I the day before this is with a Saturday, the Friday night I had done an interview was like a formal dress from the interview. I went into REI because I thought, I better get some climbing shoes that fit me. So I'm in a dress, like pull off my heels, I'm trying on climbing shoes and I grabbed a pair. And what's funny about climbing shoes, they're really tight. So I bought a pair that was like tight enough to work, but like didn't totally squeeze my circulation that hopefully these will work. And they were red. So I kind of felt like, you know, in the Wizard of Oz, my magical red shoes. So I left came the next day. I didn't even know to wear. I mean, I'm wearing like glue, lemon and a jacket. And most of the climbers have a little bit more tough material. So, but my writing friend was very patient. And he said, Okay, here's the rules.  He said, All you need is these eighth of an inch holds for your feet. You don't need a lot. And as long as you can get a little edge, you can support yourself. And he said, You're going to, you're going to think you need a lot of upper body strength, which I I have a decent amount of upper body strength, but he said it's actually pretty equally distributed. So don't worry if you feel like you're not real strong on the upper body. And then he said this, he said, Jill, with the equipment, the way climbing is once we're about a third of the way up, if you have problems, if you're afraid, if you want to turn back, let me know. But once we're a third of the way up, we're committed, or we cannot turn back, because we lose too much equipment. It's too dangerous. There's this piece. So part of the danger and the fear was knowing, I had to kind of make a decision as I got up there of if I could continue or not. So I get on the rock right at the base, you know, just a few feet above my very first experience. And I slip and fall, I scraped my hand and starts bleeding. I thought, Okay, this is great. I'm like literally at the base and I'm bleeding and like wounded.  And then I started, and I was literally shaking.  Well, there is a point I promise. The lessons on that rock are so important for all of us, because what I had to do to get up that three and a half hour climb on the third flat iron was number one, I had to believe that I could do it. I had to believe in myself. Number two, I had to look right in front of me and know I was on solid rock, because I had grips and I had a rock in front of me and it was solid as can be. And number three, I didn't look back. So the presence that I had to practice, it was like, if you think about meditation or some of these meditative presence practices, rock climbing is probably the best experience of that in any form of sport, because you absolutely probably the same as surfing or any of these things, you have to be in a flow state in presence, because if you look back, for me, if I would have looked back, I actually didn't take in the view because I was afraid that if I would look back, I would completely lose it. And I know I look brave. I was terrified. And the whole time I just kept thinking, okay, rock and just one foot for the other, one hand for the other, I can do this. And I literally, you guys, I sang songs to myself on that rock. I just sang, I sang to myself and grabbed a rock and sang and people were around, you know, but I was far enough away that I thought, who cares what they think of me. I'm going to do this and I'm going to get up and get through it. And here's a couple more pictures. Here's me, you know, looking down, but I didn't look back. I stayed present and I looked forward to what was possible. And when you ask yourself what else is possible, it opens up your subconscious and allows you your body to creatively think of solutions. And what's funny is I did it. And when I was towards the top, I started getting shaky, just I think from hunger and adrenaline, after three and a half hours, but it was the most fantastic experience of my life so far. Here's on the side looking out. And what's funny, you have ropes to protect you, right, if you fall, but you could still fall and get gravely injured hundreds of feet because there's only, you know, I don't even know the terms for rock climbing, but there's only these attachments every hundreds of feet or whatever. So if I were to fall, I was still going to plummet for many, many thousands of hundreds of feet and potentially die. But so it was definitely, this is looking to the side on the second flat iron. So the views were amazing. And I didn't really get to take in the view until I got to the very top because I told myself I can't look back. But once I did, you know, I was able to enjoy that at the top, I was kind of a little bit adrenalineized and shaking, but I was like, I did it, I did it. And I just again, I share this not to bring any glory to me, but I hope you can see yourself in this type of experience, because this year has been a rock climb for all of us, we have to look straight ahead, we have to hold on to what we know to be secure family or friends, the things that resource us and know that this too shall pass. And then when we get through it, we're going to look back and say, look what we did, look what we accomplished as a group, as physicians, how we took care of people, because we all have these experiences and it's no different than mine. This was at the very top I repelled off, that was the funnest part, I just jumped and slid down the rope off the rock at the top to the next base and then climbed down. And that was easy. And the last thing in this story, I just want to leave you with, this is a scary year. When you think about stressors, we know from Han Selie, he talked about novelty, unpredictability, threat to ego, which is like threat to our health and sense of control. That's the nuts acronym for stress induced cortisol response. Every one of those four this year has been at an all time high novelty. It's all new. We've never done this before. Unpredictability, we don't know what's going to happen tomorrow. A lockdown, no lockdown, school, no school, no work, whatever, no patients or many patients, threat to ego or threat to self or threat to health. We have this threat that's kind of invisible and a little scary if you don't know what to do with your mean stuff. And then sense of control. We don't have a lot of control over this virus. So I just want to encourage you, it's okay to be scared. It's okay to have rough days, but being scared means you're about to do something really, really brave. Love it. That's awesome.  So really, when you look at yourself and the idea of the rock climbing and motorcycle riding, and you know, this is you expressing the resilience and strength that life has made for you, that you've become through your experiences. Yeah, you know, it is Tom. And what's funny is this year, so I grew up on a farm sandwiched by brothers, and I have three brothers two right next to me. So I had to be tough, like there was no other option on a farm with the boys. I had to keep up, I had to, you know, and what I found in this year and maybe a couple years, but my own self discovery is the truth is I'm actually a really sensitive, intuitive being. And I for many years, I joke with Sarah Gottfried on our last call. We both when we first stepped into speaking, we were these black pants suits, and we laugh now because that's so not me. I now wear flowing dresses because I want to embrace my femininity.  And what's happened now is I've swung the other way. I still love my motorcycle. I'll probably climb again. But what I've done is actually embrace that more intuitive because we have the left brain, which is how we survive medicine and medical school, very analytical, very problem solving, very driven. And what's happened now is I've embraced this other side, which is intuitive, which is more gentle, which is a little bit more soft and feminine. And that makes me a much, much better clinician, friend, partner in all of these ways. So it's funny because I do have a badass side. But I also have this other side.  And it doesn't mean I'm not tough. There have been a couple of people that have come on and they've shared a little bit of their own difficulties also, just very quickly, just kind of explaining their their issues too. Do you have any tools or resources that you've used to overcome adversity that you maybe be beneficial to some of the people in our audience? Yeah. So the first thing was I wanted to share that climbing story because when you can be present in your journey and know that this too shall pass and that there is a greater purpose, it's really hard. And I'm no different when we're in the midst of a struggle, it is hard to see past it to see outside of it to even believe there's a future. But if you can know that this is transient, this too shall pass. I remember in my head just repeating this too shall pass at my darkest hours because there is a light at the end of the tunnel. There is 2021 after this crazy year. And all of the lessons that we learned are going to make us into stronger, better, more resilient people. So thinking about the transientness of your suffering as such, because when you're in it, it doesn't feel like it's transient. It feels like it'll be forever. That's that's a big thing. For me personally, I have a very strong faith and a higher power. And so bringing that into knowing that there's purpose and meaning and suffering and that he only gives us what we can handle, he or she. Those things have been really powerful for me. And I know everybody's different. I love meeting people where they are because you don't have to have the same beliefs as I do. But if you can hang on to something that's bigger than yourself, it expands your awareness. And it also allows you to see greater purpose because if it's just us, and all we do is die, that's kind of hopeless. But if we can think about leaving a legacy or making a difference in your lifetime or inspiring others, it gives us a bigger, more expansive purpose in being. Did you ever lose your faith or lose your way since you brought that up? Yeah, no, that's a great question, Tom. You know, I have had some dark times and sometimes where I'm scared and I feel hopeless, or I feel afraid or I'm not sure if I'm going to make it. Because even though I sound, I say I was born to overcome, there's been scary times. But I will say that is one thing that has never been shaken for me. And there's no shame if it has been for you and you're listening, it's okay. But grab onto that again, because I do feel like that's been my rock is like I always believe there's something better coming and that there is purpose and meaning. And so through prayer meditation, and that's often sometimes all my prayer is just help me, help me.  Right, that's awesome. I've got a quick question for Joe. We have time. Hi, Joe. I love hearing your story, of course. Your passion, your compassion, your intelligence and empathy all comes out when you speak about your own personal story and your personal why as to why you do what you do and who you are. So it's always inspirational and awesome to hear that. We're calling this event hindsight 2020. So looking back at the very beginning of this year and everything kind of going upside down, wanted to get your thoughts on a couple of things. One is how do you see the role of functional natural medicine in a health crisis like we're having, especially considering what we understand to be the vulnerabilities of our population. And so that's part of it. And then the second part is you've built and run a very successful practice. A lot of the people in this audience right now are practicing and have likely had struggles in practicing throughout this year. Some offices have had to be shut for a period of time. Patients aren't coming in the way they used to. What are some pivots that you may have done this year with your practice that has helped you through this year? And then are there anything, any of those things that you will maintain moving forward? Because it just seems to make sense. You've had to do it because of COVID and this health crisis, but these might continue to be beneficial down the road. Oh, I love this question. It's so practical and so many functional practitioners are struggling. So this is a really common thing to probably many of you. How do we kind of pivot? How do we meet that? So a couple things. I heard from Edith Eager recently, and I want to say this right, but I love this quote.  So one thing that I think is important, I joke. I'm like Switzerland. So I've always liked whether it's a vaccine issue or some of these controversial issues. I've been able to release right the fence and say, oh, if you know about Enneagram, I'm a nine, which means I get everybody, I understand everybody's perspective. I really can actually sometimes I lose my own perspective because I can hear your perspective and say, oh my gosh, I understand what you mean. This other perspective, oh my goodness, I understand what you mean. But this is relevant because I think what we're going to be called to do is be standing more firm in our position, moving forward and to take a stand for what's right and good and health. Because what we're seeing is we're seeing things that are just blatantly untrue. And for me, I've been called to be more bold about what really do we do for immune system, how do we prevent disease and take a stand for some of these things. Because as we all know, some of the stuff that's being put out there is just not even true. And the money is on these very expensive pharmaceuticals when there's repurposed old drugs that actually work. So these are dichotomies that I have to face. And I have to say, am I willing to take a stand for what I know to be right and true, even if it puts me into a controversy position?  So that half-assed statement, I was like, I like that because I got to sit on one chair and really stay in my lane and I encourage you guys to do the same. I think as a group, we're getting strength and we do have a voice and we do have an important message. So and even though I hate politics, I think that I'm going to be called more than ever to really take a stand and to speak on what's right and good and true. So that's one thing. The practical aspect of your practice is patients can feel your energy and your motivation to do what you do. And I always joke, I have a secret weapon in my clinic and I really believe it with two things that are the secret to my success. And it's not a great business plan. I've never had one. It's not a great office manager. It's not a beautiful space. It's two things. One is the belief in a higher power and the trusting that when I show up, the how will come. So I always have this vision of where I want to go. So I do have a plan, but I don't know how it's going to manifest. And I just step forward taking steps toward that and I wait for the answers, the people, the resources, the patients. So I don't always have a specific plan. I trust that the universe or God, wherever you are at with that is going to bring the how. But I know my why. And the second thing, which is my why is loving people. People can tell whether it's your patients, my fellow clinicians or my friends and family.  People can tell that. And I always find that's the magic because it's it comes from a true, genuine place. And that just draws people in because people are hungry. People are hungry now more than ever. And you might think this is all like fluffy. And it's like, well, Jill, what about your business plan? What about your bottom line? I have people that I hire for that. But would I stay? It's like the if you ever read Rocketfuel Walt Disney and a lot of these great companies, they have two people. One is the inspirational leader that stays in this place of inspiration and vision. And they know the why, but they don't know the how. And then they hire someone to take care of the business plan and the accounting. And I don't do that, because that pulls me down. I have smart people who do that. But what I do is stay in the vision and inspire the team to come together for a common goal. And we do that through loving people first. That's amazing. Yeah, thank you. And you know, there's some, we mirror some of that at microbiome labs, because I know, you know, even from the beginning, both for Tom and I, we were, I would say, I would speak for him as well, that we're both much better at the why than we are the how, you know, we've got a good general idea of the how, but but we're not great at executing that part of it, you know, and the company really started to take off when we brought in really capable people to do the how. So I'm so glad you mentioned that because, you know, for a lot of practitioners right now who have taken a hit this year and maybe are struggling, you know, they are in this, in this space because of their passion, because they know the why so well. And maybe one of the things is to bring in somebody that can really help them with the how, right? So and it actually is counterintuitive. Because when you're small, you think I can't afford that. I have often spent money on things I didn't think I could afford, but they panned out really well. And one of the things in that, and you guys do this so well, this event is a perfect example. You're generously giving just freely because you love serving. And you do that, you guys both do that so well. So I love working with you. You give generously of information of knowledge, you know, product information, and people can see that and so you build goodwill. So I don't do that because I get something back. But what's happened is as I give freely of information and my knowledge, it just comes back to you. So what I would encourage you as a practitioner is, is give away information, you know, educate people and show that love and generosity because it will always come back. And then hire, even if you think you can't afford it, hire those people that will help you support you to be the visionary. Yeah, absolutely. And I think one of the things you've done really successfully is you've built a voice out there in the marketplace, right? And that affords people good practical objective information on health and wellness and so on. And I think more of the people in this audience need to be out there expressing their voice because there's a lot of nonsense out there. Like you expressed and the more people with this background of functional holistic health, the more that are speaking out there, I think the better off our population will be in general. I think imagine if most of the medical community was based on holistic health and integrative health, we wouldn't have as vulnerable of a population dealing with COVID. Our population is especially vulnerable because of the way this pathogen targets the body, right? And with metabolic dysfunctions, obesity, and so on. So yeah, very powerful message. Congratulations on everything that you've done. And I think you've got a book coming out next year. So, right? I think Tom mentioned that in the intro. Yes, yes. I'm working diligently now between writing a book is hard work. You all know that who've done it. Especially when you have a couple of their full-time jobs. When is that slated? What would be the best case scenario? Well, it's funny the timeline shift a little because of COVID. So as I was planning and having manuscript in it by February, it may be six months after. So it might actually be the early 2022, but we shall see. Within the next year is my hope for that. Well, awesome. Well, it would be our commitment now, we'll say it on recording that when it is ready, when it comes up, we would love to have you back on for a session like this to talk about the book itself. We would of course love to give away, you know, we would buy and give away copies to several hundred people that come on. Because of course, we are committed to spreading good information and education. So we're very excited that you're putting that together. Thank you. If it's a fraction that is the value of your talks and all that, it's going to be amazing. So we're excited about it. How are we doing on the schedule, Tom? No, we're good. We've got about, we can dig into some of these questions. Yeah, okay. I would love that. Yeah. So one of the themes that seems to be coming through on the Q&A is, you know, what do you do with your, how do you start with somebody who comes in with chronic disease? They've been to lots of other doctors. They've come to you because you're this beacon of hope.  But what's your, what are the first few things?  Yeah. So that's a great question. So that first thing is kind of, and again, everyone listening, I'm sure you guys are pros at this. I'm not teaching you anything new, but really being present, it's so funny because that rock claiming is actually very relevant to all of this. Even as you build your clinic, just being present and not looking back, not looking too far ahead and staying in your lane. But as far as with the patient, really being present and allowing them to tell their story, listening carefully for details, I usually get the diagnosis and the story and the history. And that's come from 20 years of experience.  It might take a little bit more experience. But what I found is medical school taught us how to use our analytical science-based left brain. And it's beautiful because you can take, I actually was bioengineering background, so very left brain analytical. And is really at the core of what we all do is problem solving. And we also look for pattern recognition. So we're looking at lots of data points and trying to find patterns that we see that look familiar and then how that leads to a diagnosis. That's all left brain. And it's beautiful. And then we take the science behind it to, to, you know, make sure that we have the right, whether it's lab testing or looking of articles on the topic. But what I've learned in the last five to seven years that's been so much more powerful is melding that with our intuitive creative side. Because our intuitive subconscious, if we listen and listen while we're present. So we basically really, instead of thinking about the next patient or the next lunch break or the other things outside of that, we're there, we're present with the patient engaged and listening. What happens is, as I've learned to reconnect and trust my intuitive nature inside, which we all have, you can take millions of pieces of data in a split second instead of thousands or hundreds of pieces of data with the analytical mind. So you can actually take in a lot more information. And the truth is, this is actually scientifically proven, you can come to a much more accurate diagnosis with that right intuitive side. So now I really trust my intuition, trust my intuition about how to ask the questions about how to engage and about where to go. And then I prove it with the science with the testing with that. But I'm never, the joke in my clinic was when Dr. Jill, my staff, when Dr. Jill thinks there's mold, she's 100% right. So far I'm batting 100% because if I have that suspicion, it's so far been right. And that's part of that intuition because I see the pattern. I remember the clues of what I experienced. And, and even I remember right after my mold experience, I thought, gosh, this has to be kind of unique. You know, not that many people experience it. But as we all know, the more you hear the stories, it's very, very common. And it'll present with auto immunity or other issues. So that being present with the patient is absolutely huge. And then again, using the science to back up what you're, and really being open to, if you listen to the patients, they usually know what they need and they know their diagnosis, they might not have the answer like the word for it. But if you listen carefully, they will give you almost all the tools that you need in the direction you need to go. That's amazing how far a little bit of compassion can go, a little bit of listening, a little bit of compassion can go. Just kind of opens people up for the possibility of healing, you know, versus. And I mentioned this in my, but this is actually huge for all of us and for our patients. A patient the other day was like, she was so in her like belief of like, I'm not going to get well. And you know, she kept saying, well, can you prove that this kind of so, you know, this condition you've, you've helped, she was very angry, had a lot of issues, it wasn't about me. I didn't take it personally. But I told her this, and you could do this for yourself or for your patients, I said, let's reframe that. And let's ask, I put this on her summary, let's ask the question, what else is possible? Because when you do that, your subconscious lights up and it's like, oh, yay, we get to find an answer. When you ask, what else is possible, your subconscious goes to work, it will be in your dream, it'll be in your subconscious or wherever you're at. And it's just brewing and chewing on a solution. And it will come to you. But if you never ask that question, your subconscious doesn't have the opportunity to get the answer. And as I already said, our subconscious is analyzing the light, the sound, the temperature, thousands and maybe even millions of pieces of data, whereas our conscious mind can't even see all those pieces. So it can actually gather a lot more information for you if you harness that power. That's awesome. So I have to open up this box, because you're here and everybody always asks the question when you're here. Mold, we're going to talk about mold. So a lot of questions are coming in around the diagnostics of mold toxicity. And so can you speak a little bit on your experience? Obviously, you're trusting your intuition and your own experience with it too. But from a diagnostic side, what do you like to use to validate your intuition? Okay. So let's go from the right brain back to the left brain. This is perfect. So yeah, I love it. So first of all, clues to the diagnosis. This is a multi-symptom, multi-system disease. We see that with like Horowitz's model. We see that with Richie Shoemaker's model. We see that with the cell danger response with Naboo's model. These are all ways of explaining the elephant in the room by different language. It's all the same thing. It's our chronic complex conditions. Mold is no different. Lyme disease is no different. But these things that we're seeing at the root of functional medicine, let me give you a couple framework things that I think are super helpful. Number one is at the root of almost every case that I see is toxic load and infectious burden. So if you think about it in those frames, you're going to have some sort of a toxic load. You're going to have some sort of infectious burden in how the center play they create inflammatory responses, they create cell danger responses, they create cytokine responses, and you're going to see the manifestations of an autoimmune disease like MS or Hashimoto's thyroiditis or rheumatoid arthritis or gut dysbiosis or SIBO. But at the root there is this toxic load, infectious burden. And when I really got my hat around that, it made functional medicine simple because I just have to go down and try to find out how those are interplaying and how to go backwards and treat some of the infections or help the immune system to overcome those and decrease the toxic load. And I think whether it's mold or anything else, the toxic load in our environment is increasing exponentially every year. And this is the elephant in the room that's creating the immune deficiencies and the toxic burden and the obesity and the gut dysbiosis and all of these things that we're seeing manifest. So at that level, we have to teach people very basic things about how to live a clean life. I always say clean air, clean water, clean food. Super simple. It sounds like, well, how could that possibly help someone? But if you really go back to that, that's 80% of the battle, clean air, clean water, clean food. And then we add on supplements and all these other things that we do. So understanding toxic load infectious burden is the start. And that's relevant to mold because what happens with mold is years ago, there was a lot more interplay with the external air in our homes and now they're airtight. So whatever happens in there becomes more toxic because there's no way for the airflow to breathe. So our lead certified building might be way worse than an old log cabin built in 1900 because there's circulation of air. Then we went through fungicides in the paint and we killed off all the very non-aggressive molds. So what happens now is in these interior environments when there's mold, we're getting growth of more toxic species. Here's another thing. Dr. Klinghart put Petri dishes under a household router and then under a protected router so there was no EMFs. And that Petri dish that was under a regular household router with the EMFs that we all get exposed to every day grew 600 times the mycotoxins. So it was a very much more aggressive form because it felt that electromagnetic frequency. So as we put more EMFs in our environment, we put more cell towers and things, even if our human bodies don't notice, which a lot of us are sensitive, the toxins and infections, especially mold that is colonies in our bodies or in our home, they can sense that dangerous signal and they produce more toxic effects. So in our homes, we're getting more aggressive molds and we're getting more mycotoxins being produced. So that's a big part of it and that's why we're seeing more of this. So what to do?  So sometimes we see the whole slew of mast cell activation, which could include POTS, postural orthostatic tachycardia. It could include rashes or hives or permeability is increased by histamines. So guess what? If you have mast cell issues, if you have mold, you're going to have a leaky gut. We know in my studies that low MSH, which is a marker we use in mold and chronic inflammatory response, indicates that there is, excuse me, massive permeability. So low MSH by nature is going to increase permeability. And in my studies, by lowering MSH and knocking out MSH, they created a Crohn's and Colitis situation in mice. So it could even lead to inflammatory bowel disease. So the gut is massively affected. And one thing I love about your company, Microbiome and Megaspore and some of your products is I feel like they are the best. The spores needed and asked me to say this to say it on my own for you. Well, they are the best thing we can do for leaky gut, because number one, the evidence points to increased diversity with the spore probiotics. The IgG and bovine immunoglobulins are some of the really powerful things we can do to stop up those LPS endotoxins and actually seal that permeability. So with mold, you have to deal with the gut. And then we see things like lung damage, lung inflammation, chronic sinusitis or aspergillus or biofilms in the sinuses. So mold has all these different effects on the body. And then what do we do to diagnose it? So I still do some of the chronic inflammatory labs on lab core quest or your hospital lab. And those could be TGF beta, MMP9, MSH, ADHD and osmolality. I don't usually check VIP anymore. And the HLA genetics can be tested, but the original data was proven to be not well done. So we do know that there is a percentage of people genetically that can't tag the antigens of mold and clear them easily from the body.  And those people need assistance in the liver gallbladder access and in pulling out those toxins with some of the things like glutathione, NAC, lipoic acid, liver support and binders. So the diagnosis can be done with those inflammatory markers. It can be done with urinary mycotoxins, which I'm a big believer in. There's a lot of controversy. Now you have to know what you're testing. You're testing excretion. So what you need to know is if you start a detox protocol and you get higher levels of excretion in the urine, that's good because you're excreting the toxins. So what I typically do is test it at the beginning and see what they might be excreting, see if it correlates with what we find in their environment. And often it does. So say they have stachybacteris in the environment and T2 rodent or one of those stachybacteris T2 toxins in the urine that correlates. And then as I'm treating, I usually won't repeat urinary mycotoxins for about six months or more because if we do it quickly, they're going to have higher levels and then the patient's confused and the doctor if they don't know what they're doing is confused. So I don't always repeat that real quickly. You can also do a visual contrast test either online. I do them in the clinic and if that's abnormal, that's testing retinal acuity for black and white lines and ability to distinguish. And that can be abnormal because of the blood flow and the cytokines that affect the blood flow in those small vessels in the retina. So you can actually detect biotoxin exposure. That was used in the 1940s in soldiers that had had biotoxin exposure. So it's actually a well validated tool and it's free. So it's nice to use that. So screening questions, visual contrast, urinary mycotoxins, the test in the blood that I mentioned, and then a great history. That's kind of how we make the diagnosis. And typically I'll do some form of either an inspection or an early test or petri dishes, some form of testing their environment as well. That's awesome. Can you give everybody a little bit more information about you've got a couple people that are asking where your clinics at and how can they become a patient and all that stuff. So could you just give a little recap of where you are and what your information is for everybody? Sure. And I'll try to include a link in the chat. So my website, jillcarnahan.com, I have tons of free stuff. So free blogs, every week we have blogs out. So MCAS, mold, you know, any of these kinds of things we're talking about, environmental toxicity, you can just search on the search bar in the blogs and I have 10 years of blogs, lots and lots of content all free. If you get a chance, you can click on the top there and sign up for my newsletter that just comes out every week with free information as well. And I would love to have you sign up for that. And then the brand new thing I've been doing this year during COVID is I have a new YouTube channel and podcast where I've interviewed people like you guys and I'd love to have you too on soon. So we'll have to make that happen. About just topics, you know, mold toxicity, environmental toxicity, autoimmune disease, Sarah Gottfried and I talk about bad boyfriends so you can even get personal. But that's on just YouTube under Jill Carnahan and I'd love for you to subscribe there again. It's all free. But those are kind of the main outlets that I have. Jill, so awesome. We could nerd out like this for hours on end, but we've got to put a stop to this at the top of the hour. But thank you so much for coming and offering us your time and your expertise. It's always great listening to you whether you're speaking at a lecture, whether we're just sitting around catching up and talking shop. So thank you again. And microbiome labs is very excited to be working with you. And we appreciate all the hard efforts that you've done with us and look forward to working with you into the future. Thank you. And again, I just want to say publicly I love and appreciate you guys so much. I don't know if there's another company I like working with more because of your integrity, your commitment to great science and great products. I really, really believe in what you're doing and I support you 100%. So I'm always honored to be part of your programs and your company. And I appreciate it very much. Thank you so much, Jill. It's no kind of way to say thank you. You're welcome.