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The Clay Travis and Buck Sexton Show
Wellness Unmasked: Exploring Autoimmune Diseases with Dr. Alexander Torres
00:51:36
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- [00:00]
Clay Travis
Hey, Clay Travis here to tell you about a brand new podcast in the Clay and Buck Podcast Network. That's right, Buck Sexton here and we're excited to welcome our good friend Dr. Nicole Safire to the mix. Her podcast is called Wellness Unmasked and it's a must listen. Check it out here and subscribe, download and listen on the iHeartRadio app, Apple Podcasts, or wherever you get your podcast.
- [00:27]
Dr. Nicole Safire
Welcome to wellness unmasked. I'm Dr. Nicole Safire, board certified doctor. I'm the a woman and I'm just one of those forever truth seekers. As we embark on this podcast journey together. It is our first episode, I thought it's going to be important to talk about why I am so into wellness. Sure, I'm a doctor and I'm supposed to care about health and all of that medical stuff, but it really wasn't until I found myself on the other side of the exam table as the patient that I decided to dig a little bit deeper. And let me tell you, when they say doctors make the worst patients, we absolutely do. So now I find myself living my life, a combination of traditional western medicine, but I have also done a deep dive into more eastern techniques, wellness, natural remedies. I'm all about it. And let me tell you a little bit about why. So I would say for the last 10 years of my life, I had some very obvious symptoms. And if it was written in like an exam format, like if I was sitting down taking my medical boards and they listed out the symptoms slam dunk, I would have known exactly what it was. It's so classic. Looking back, living it was an entirely different experience. I would complain a little bit, oh, this hurts a little bit. My eye. I would wake up one morning and it'd be beet red and incredibly painful. And you know what? I'd give it some time. Give it some time. Year after year after year, I would just kind of deal with it, tell my husband a little bit about it. And then finally, when symptoms kind of got pretty unbearable, I had to have that big sigh and say, something's going on. And while I love that I'm trying to manage myself being the doctor and the patient, it's not working. I'm failing as my own doctor and the patient, also me, is suffering because of it. So, so I decided to go see a rheumatologist. And one of the hardest things for me going to see a doctor is I walk into the room and I automatically think I know more than them, which is ridiculous because by no stress of the imagination. Do I know anything about rheumatology and autoimmune diseases other than what I learned in medical school? And let me tell you, at this point, just about everything I learned in medical school is pretty outdated. It's quite antiquated. So I'm going to remind myself that I am an expert in one thing and that's cancer. So it wasn't cancer that was causing my symptoms. So I had to take a backseat real fast and realize I don't even. I don't know anything about me and I really needed some help. That's really hard for people is to recognize when you need help. For me specifically, I find it very hard to admit that I'm not running at 100%, that I don't know what's going on, and even more, I don't know how to fix it. But thankfully, I was able to find a doctor who did. I had to go to a couple of rheumatologists. You always, you know, if you don't have that bond with your doctor, if you don't feel like it's clicking, they're not the right one for you. They may be brilliant, they may be at the biggest name institutions, but it's a feeling, it's a relationship. You have to have a relationship with your doctor. You have to trust them and you have to trust that they are going to give you honest advice and respect your decisions. It shouldn't be a paternalistic relationship. It has to be a conversation. So I am very grateful that I have found someone who calls me out on my bad behavior when I have bad behavior. But she's also led me on a path to feeling better. We started out with kind of the very mildest of the medications. I had terrible side effects of it. One being when I used the restroom, it looked like there was coffee from my urine. It was no longer yellow, it was brown. And it was all because of the medication. So we have to remember, sometimes the treatments can be worse than the disease. So I certainly had some side effects from the medications. Over the years, I've gotten onto injections, biologicals, which is something I tried to put off for so long because the thought of being on a weekly injection was just something that I didn't want to relinquish myself to. It also makes you somewhat immunocompromised, and I just didn't want that. I didn't want to be wedded to a weekly injection and I didn't want to live my life being immunocompromised. It sounds. It's awful. I was convinced to finally do it, and I'm glad I did because my quality of life has gotten significantly better in terms of my disease flares and my symptoms and just my ability to actually live my life. And so I was really dependent just on the medications in the beginning. That's what I was doing. That was my treatment plan. It was all about the meds, which is fine because it's one of those illnesses where, you know, you do need some of the Western medicines to help you sometimes. But then Covid hit. And while I continued to work full time during COVID as a physician, I had three kids. I also found myself playing with some natural stuff a little bit more. One of my favorite things is a glass of champagne. Yes, yes, yes, I know, I know. I'm a doctor. I have an autoimmune disease. I shouldn't be saying I enjoy alcohol, but you know what? I've always said everything in moderation. And I enjoy champagne. That's the reality. But I also know that champagne has a pretty high sugar content. Maybe not as high as, like, some of the wines, certainly not as high as some of your sodas or your fruity, sweetened other beverages, but it definitely has a higher sugar content. And so I wanted to do what I can to decrease my sugar consumption. Because sugar in the body, obviously it raises your blood sugar and. And having an elevated blood sugar causes inflammation. Well, an autoimmune disease is exactly that is inflammation in your body. And your body's going crazy because it's so inflamed. So you have to decrease that inflammation to help control that disease. So I decided I wanted to decrease my champagne intake. And one of the things that I did was I actually switched to drinking a blanco tequila, which I know that sounds funny, like you don't go from champagne to tequila for health reasons, but the reality is you don't have the sugar boost the same way. So that was the first thing that I did, was I really tried to decrease my sugar consumption by switching to a very clean, smooth, blanco tequila. Now, I didn't add anything to it. I don't add anything that raises the blood sugar, but that was one thing that I did. But in addition to that, I also started to dabble with some natural herbs and. Which I'm not talking about natural herbs that you go and you get in the back alley anywhere. I'm talking about the herbs that you buy, like rosemary, lavender, turmeric, ginger, garlic and all of those. And I started growing them fresh, making Them into liquid tinctures. And then I started taking them. And I found that by putting certain herbs together and using them for various different things, you know, you can use herbs to decrease your bodily inflammation. You can use herbs to boost your immune system, grow your hair, your nails, pain relief, perimenopausal symptoms. Who knew natural herbs could actually help you with all of this? And some people say, you know, natural stuff, it's a little bit, you know, it's snake oil and all that stuff, and it's not real. Well, let me tell you, there's centuries of reports and data showing, yeah, some of that may be real. And you know what? They don't have nearly the same side effects as some of our western medications. Nothing's affected my urine like that first round of medications that I took for my autoimmune disease. So for me, it's been about decreasing my sugar consumption, Whether it be through my foods, the alcohol, but also really incorporating natural herbs into my life that has helped keep my disease in check. Yes, I'm still on. I'm still on injections. I have to be. When I go off the injections, and believe me, I've tried, I like to do this little test. My rheumatologist hates me for it, But I'm like, what if I just stop doing an injection for a couple of weeks? Let's just see. Let's just see what happens. Well, without fail, every time I flare. So I have relinquished myself to accept that it is a combination between traditional western techniques as well as some of my natural techniques that gives me the best harmony when it comes to my autoimmune disease. But one of the things that I have been increasingly concerned about is the rise in autoimmune disease. Now, for the last several decades, it's been reported that autoimmune disease is on the rise. I mean, we hear. We're talking about it all the time. Cancer's on the rise, Being overweight's on the rise. And all of a sudden, all of this illness is on the rise. And the question is why? Obviously, our lifestyle has a lot to do with it. We sit too much, we eat too much, and we stare at our phones way too much. All of that affects the inflammation going on in our body. And the more inflammation we have in our body, the more likely things are to go awry, Whether that is an autoimmune disease, whether that is cancer or something else. So certainly the way that we are living is contributing to this. When Covid happened, having an autoimmune disease. I was concerned because going into Covid, I was relatively immunocompromised. I'm not the same. Being on this injection doesn't make me as immunocompromised as, say, someone who's had a bone marrow transplant. Not even close. But there is still the notion that if I were to get infected with this virus, that I could potentially have a more severe course, because I quote, unquote, was one of those in the immunocompromised camps. So I was nervous. My husband is a brain surgeon. His specialty is strokes and brain aneurysms. It's not like he could just say, sorry, guys, I can't come in because I can't risk getting infected and then bringing it home. My husband went to the hospital every single day. He didn't skip a beat during COVID I too, also was in the hospital and it was a little bit of a scary time. And I ended up getting Covid like everyone else did. It wasn't until, like, November 2020 that I got Covid and I got pretty sick. I certainly got more sick than anybody else in the house. But it was. It was equivalent to, like, a flu for me. My doctors were all very nervous about it, trying to get me to take certain medications, and I was confident that being hydrated, keeping my body moving, my lungs moving, that I would. I didn't need to take those medications and I didn't. So I got through it just fine. And then the vaccine came out. About six weeks later, it became available for healthcare workers. I obviously just recovered from COVID I saw no utility to get the vaccine on my own account because, well, I just had it and I know how the immune system works. Therefore, I have antibodies to this virus. It's a coronavirus. And of course, it was mandated from the hospitals. The hospital said, you have to get it, you have to get it. And I tried to reason with people saying, you know, I'm not sure why we would vaccinate someone so recent after an infection, especially if they have, like, an autoimmune disease, because at that point their immune system's already been activated by the virus. And like mine, I was sick with COVID My immune system was. It was quite active during that time. Let me tell you. I had all the feelings, all of the symptoms. So why did I want to go and get the vaccine right then? Had my body even quieted down yet from the infection? Let's let it recover a little bit more. I delayed it. I delayed getting the vaccine as long as I possibly Could I tried appealing to say, you know, I don't really want it Right now, I am very concerned that there's going to be negative implications when it comes to having an autoimmune disease. I'm nervous that it's going to. That it is going to activate my autoimmune disease and it's going to give me a flare. There had already been reports of inflammatory responses following the vaccine. And in fact, that was one of the things that they were touting about the vaccine was, wow, you have such an amazing inflammatory response to the vaccine, which is actually what you want. You do, you want your body to react to a vaccine. It produces the antibodies, and that's how vaccines work. My concern was, but what about people who have autoimmune diseases? Are we going to trigger their inflammation? Are we going to trigger their autoimmune disease? And obviously, it wasn't a novel thought. Other people had it as well. I, off the record, reached out to someone on the Pfizer scientific Advisory committee early on, only a few months after the vaccine had been out. And I said, question, this is a personal question. What about people with autoimmune diseases? Are you seeing a flare in their symptoms? Do you think that there's going to be a change in recommendations for them? And the unofficial response that I was told was, it is a concern considered getting half the dose, if possible. And I was just taken aback, like, whoa, hold on a second. Off record, you're telling me as an acquaintance I should try to get a lesser dose? Which, by the way, you couldn't do that. We had random pharmacists at all these pharmacies giving us the vaccine. You think I'm going to say, I just want half the dose, please. And then they're gonna be like, oh, yeah, sure, I'll do that. No, that's not how it's going to work. But the fact that there was even a suggestion to decrease the dose to avoid an autoimmune flare told me there must be some safety signal somewhere that this could potentially flare the autoimmune disease. And I actually wrote about my concerns. I wrote about it in the Wall Street Journal. I wrote about it@foxdigital.com I said that I was concerned that the vaccine was going to cause too much inflammation in the body. And I specifically mentioned it for the children because there was talk about kids getting MIS C, which is essentially an inflammatory response, almost like an autoimmune response. They were getting that from COVID Well, now we're going to Recommend giving them a vaccine that's causing an even higher inflammatory response. What's that going to do to kids? Are kids going to now get inflammation from the vaccine? Are they going to get an autoimmune disease from the vaccine? I had a lot of concerns about this and I was very vocal about it, especially when it came to kids. And I was really turned off on a lot of things from COVID Obviously, I think we all were. But when it came to the autoimmune diseases, I just, I was very concerned. We were already seeing a rise in autoimmune disease pre Covid. COVID infections was causing a flare of autoimmune disease. And now several years later, it's well documented that the COVID vaccine also flared autoimmune diseases and actually caused some new autoimmune symptoms and disease in patients. So part of me thinks that a lot of it caused a lot more harm than good. And it's a little disconcerting moving into the future with this rising autoimmune disease. And while I, I like to fancy myself as someone who knows a lot about autoimmune diseases and I do because I've had to read a lot about them. I've lived with them now for over a decade. I am not an expert and that is why I have my own rheumatologist. That's why I listen to my rheumatologists most of the time. But I wanted to bring on someone who I've known now for almost two decades. His name is Dr. Alexander Torres. He is a board certified rheumatologist, studied at Cleveland Clinic. He, he opened up a private practice in central Florida. And not only does he focus on autoimmune diseases, all things rheumatology and nephritis, but he also is interested in the health and the lifestyle component. And I'm excited to have him here with us today. And I'm sure you're going to learn something too. You're listening to Wellness en Masse. We'll be right back with more. All right. While I know a little bit about rheumatology and all things autoimmune disease, just essentially because, well, I've kind. I had to learn about it in my own journey, but I am far from an expert, which is why I am so excited to have not only my friend, but a very important rheumatologist in the Autoimmune World, Dr. Alexander Torres. He is the owner of Highlands Advanced Rheumatology and Arthritis center in central Florida. I know Dr. Torres because we did a part of our residency in the same hospital way back when, very long time ago. I don't want to say how long ago because that's going to age me, but it was a long time ago. But then he went off. He went off to the Cleveland Clinic to one of the world renowned arthritis and autoimmune centers. And he has just continued to just flourish ever since then. So, Alex, thank you so much for joining us today.
- [18:39]
Dr. Alexander Torres
Thanks for having me, Nicole.
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Dr. Nicole Safire
So, Alex, I'm going to call you Dr. Torres or Alex, I don't know. You're my friend. All right. So, Alex, when it comes to autoimmune disease, first of all, from a very basic level, can you just explain a little bit what it is?
- [18:54]
Dr. Alexander Torres
So the immune complex in a human being, right, in all of us, basically its own, own self or autonomous body of functioning, right? In this case, this is the main system in your body that it's active and main responsible to make sure that it fights different type of infections, different type of, you know, malignant cells. It kind of recognize whatever is going on in your body that is not, you know, that is a foreign, for example. And it's basically what drives us on a daily basis. Now, you know, we have talked to this in some detail now we are seeing a lot of chronic illnesses that we are noticing that is actually from an autoimmune standpoint. So the immune system is as important as the cardiovascular system, as your pulmonary system, that's your brain system as well, too, or neurological system. So it is extremely important now that we have better research in the last 25 years, we're understanding how it works in a better way. And we're understanding that it's one of the main culprits reasons as to why we're having this new incidence of new conditions right now.
- [20:16]
Dr. Nicole Safire
So our immune system, essentially, it's kind of there to protect us. I like to think of it as our home alarm system. And if there's any foreign invaders or anything of the sorts, like allergens or anything else, you know, it's there to protect us. But in autoimmune diseases, it's like the wiring got wrong and all of a sudden your home alarm system is starting to attack you itself. Is that about right?
- [20:39]
Dr. Alexander Torres
Well, yes, that's what we understood before. But now we, you know, imagine your system completely different new type of wiring in your system. This is your immunological system. This is your immuno immunoprite. But now we have external, you know, causes that actually they're rewiring our immune system that is causing this new alarm in, in. In. In us, you know, around the world. You know, things are changing immune wise. You know, we, you know, for example, we used to have certain type of diseases back in the 60s and the 70s, in the 80s, that now it's completely different now. So things are getting rewiring right now. Even though we have that immunoprint or initial immune printing, things are getting rewired right now as we go.
- [21:28]
Dr. Nicole Safire
So that's interesting. So that's kind of something similar to what we're seeing in cancer. Like there is, you know, there's an intrinsic risk to developing cancer in our lifetime, whether it's because of the genetics or the DNA that we're born with, kind of the environment that we're raised in. But we're also seeing a lot of external factors that are all of a sudden changing our cancer risk. So you think that is very similar for autoimmune diseases? That some of our like environment and toxins are what's causing the rise in autoimmune disease? Is that what you're saying?
- [21:59]
Dr. Alexander Torres
You're extremely right. I think that in the last, for example, I have been a rheumatologist for almost 16 years, going on 17 years.
- [22:06]
Dr. Nicole Safire
Already I said we're not supposed to age us. No.
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Dr. Alexander Torres
So I am seeing things that I never used to see. Right now, for example, our American diet I think has been one of the main culprits of how things are changing in America. We are seeing immune mediated conditions that we were not able to see before. For example, right now the incidence and the prevalence of diabetes is much more, the insulin resistance much more. We see that this as a factor and how to work on the immune system. We're seeing patients that having more rheumatoid arthritis right now. Before used to be a 2 to 1 ration female. Now we're seeing a much more prevalent amount of patients with rheumatoid arthritis. Connective tissue diseases. So I think our diet has changed dramatically since the 60s, 70s, 80s and 90s. And now we're seeing a much more complex diagnosis. And it's not what we used to see in medical books. We used to read this Nicole, like, oh, you have bilateral symmetric joint disease. This must be rheumatoid arthritis. Now it's complex. It's just not just black or white. You know, it has different type of, of. Of. Of character, different autoimmune conditions. In one, for example, you know, not only with, with diet, but we have Seen a lot lately with. In your field as well. We're seeing, we've seen a lot of patients with certain type of checkpoint inhibitors that we use for a certain type of cancer. So we're seeing a lot of immune regulation that we've seen some rheumatic adverse events. Not only that, we're seeing also post Covid, a lot of patients with post Covid and not more than that post vaccinations. We're seeing a dramatic increase of very random, most of autoimmune rheumatological characteristics that we're seeing. These patients in younger populations, such as early Raynaud's, early paretic or very generalized, you know, rash in this, you know, kids, teenagers, more inflammatory arthritis in this, you know, population as well, too. So I think there's multiple variables that have changed throughout, you know, decades. And not only now we're working with that immune system, especially in cancer. We've seen some adverse events from those, you know, immunotherapies because they're not chemotherapies, as you know, they're more, you know, they're like immunotherapy. So we're seeing more of that. And also we're becoming smarter. We're able to understand how the immune system works where you understand how really what triggers things. And we're able to see what kind of flags we're able to identify they are main. The main culprits in certain kind of conditions. We understand more interleukins as, you know, certain type of inflammatory signals or chemokines and we call it. We're able to identify, we're now able to go to inside the cell and know exactly what triggers what, what turns on that intracellular signal that basically explode that inflammatory response in an individual. And now we understand too, that what causes, you know, we understand that certain type of, you know, immunotherapies can do that. Certain type of insulin resistance. We know that we can do that. Certain age, gender can do that as well too. You know, we're getting, you know, we're being much more, you know, like, you know, smarter, I guess. And we're able to identify this kind of new pathologies and obviously treatment based on that.
- [26:01]
Dr. Nicole Safire
Well, it's interesting because you're right, we're smarter. We're able to identify illness a little bit earlier. And so that's, you know, one of the criticisms of medicine is that, oh, diseases aren't on the rise. We're just diagnosing more. And so it's really important to acknowledge the fact that yes, it's true. We are able to diagnose more. We have expanded diagnostic criterias which also allow for this increased prevalence. But there's no denying that we have more disease. I mean, you said something very interesting about COVID I know, I want to talk more about it and I know everyone listening wants to, but pre Covid, we were already seeing a rise in autoantibodies and the markers and autoimmune disease in younger people. There was like a 2020 NIH study that kind of said that and that before COVID type 1 diabetes, like you mentioned, celiac, rheumatoid, hashimotoes, thyroiditis, all have been increasing for the past few decades. So, you know, we have a lot of theories as to why that is.
- [27:04]
Dr. Alexander Torres
Pollutants as well too, we believe like this kind of microplastics, they play a big role as well too. But I firmly believe not only on the diet, on that part of, you know, the chemo exposures, you know, fertilizer, etc. You know, American society have trended to a much more sedentary lifestyle, much more, much more overweight. Our BMI have been going up. You know, we have become extremely insulin resistant. And that has been the key, which I believe it's the main problem is the insulin resistance that has driven us to this kind of pendantry autoimmune issues. Right now we're just in a constant.
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Dr. Nicole Safire
State of inflammation because the blood sugar's up and sugar causes inflammation. And that state of inflammation is not good.
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Dr. Alexander Torres
Correct enough. And this is just on my own, you know, my own practice that I see many patients that are, for example, in this new medications and GLP1s etc, they're actually, they're becoming much more, you know, they're losing weight and I've seen a lot of them just improving.
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Dr. Nicole Safire
GLP1s being like the Wegovies and the Manjaro and the Ozempic, quote unquote, is everyone's taking.
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Dr. Alexander Torres
Yeah, correct. And not only that, we also believe that the medications response as well to work on this, you know, different in this population as well too. We saw that the recent medications that we had, it had a certain type of effect. But now that we've seen, you know, a certain type of patients using this kind of treatment, they are actually, they're becoming less insulin resistance. We are actually seeing a much more better response in this as well.
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Dr. Nicole Safire
That's interesting. You know, heading into Covid, one of my big concerns was what are we doing by shielding the kids so much from all the pathogens like, we couldn't. They didn't. We didn't have anything. Flu wasn't circulating, colds weren't circulating. Everyone was so afraid of COVID that putting us in the state of isolation. I mean, don't get me started. Obviously the mental health component was. That's a whole nother episode. But this, this whole hygiene phenomenon is one of those things that the hygiene hypothesis has to do with autoimmune diseases too. And do you think that maybe that. Can you explain what that is and like maybe how that also played a.
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Dr. Alexander Torres
Role, you know, if you over the world. Like. I think one of the reasons too is it has even contest is not, you know, nowadays. You know, back in the days we used to have the. The chickenpox, you know, get together times. You know, if you happen that, you know, Jimmy, you know, your neighbor used to get chickenpox. I want to make sure that Alex go with Jimmy so he can get some chicken.
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Dr. Nicole Safire
So, yeah, we do not recommend chickenpox parties. FYI.
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Dr. Alexander Torres
That's how it used to do. That's how it used to be. The smart way back then in how the immune system recognizes, right.
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Dr. Nicole Safire
We.
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Dr. Alexander Torres
We stopped doing that. You know, we are into a state of, you know, aseptic, you know, areas that we have to. We clean it, you know, hands everyone, you know, kids and table and please don't do that. Please don't go on. Make sure that you wear a mask. Please, please make sure you don't.
- [30:22]
Dr. Nicole Safire
And what about the hand sanitizer that you see everyone putting on constantly? I'm like that rubbing. Rubbing alcohol. That can't be good for you. Like get some germs around you. Yeah.
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Dr. Alexander Torres
I will tell you this. And again, you know, there's many smart people out there. There are, you know, working your immune system and infectious disease people and you know, look, I. My heart goes to them. But when you are in the trenches, in my office or my practice is basically in the trenches, we serve underserved population here in central Florida. I was able to see something that I was not able to see. And I think that once this virus came through, the way that we handled ourselves, it was not consonant of what they were telling us. I was not seeing. You know, most of our patient population, they were wearing masks. And I noticed. I was noticing right away that they were not, you know, they were still contracting, you know, Covid as well. Then vaccine came through and. And we had some of our issues. You know, we thought it would work, but then I noticed in my patients that it didn't work. And I noticed that right away. Like.
- [31:36]
Dr. Nicole Safire
Well, do you think, do you think so? Well, first of all, it's well documented people with autoimmune diseases who got infected had the COVID infection that could cause a flare. That makes sense. Obviously, being infected with the coronavirus causes inflammation and you could get a flare. But do you think, you know, then come the vaccine? I mean, it's kind of twofold. One, the vaccine itself was kind of causing more of an inflammatory response than the actual infection. So people with autoimmune diseases, did you see that they were having more flares from the vaccine than the actual infection? And then did you also see that maybe the vaccine didn't work as well because maybe the medications they were on or what do you think it was?
- [32:18]
Dr. Alexander Torres
It was both ways. First and foremost, most of these patients are immunosuppressed in a way. Right. They're also immunocompetent in a way. So I didn't think they had a good immune response, but also activated a very, you know, erratic immune system to start having symptoms I didn't have before.
- [32:38]
Dr. Nicole Safire
And it was from the vaccine, they had new symptoms as well, too.
- [32:41]
Dr. Alexander Torres
It was non consonant of what they usually have. So if you, for a patient, for example, if a patient only always had inflammatory arthritis, now they're starting having Raynaud, they're starting having some rash, they're starting some dry, dry mouth, dry eye, which is secondary symptoms of this. Rheumatic conditions as well, too.
- [33:01]
Dr. Nicole Safire
It's like they're picking little. They're picking symptoms from various other diseases.
- [33:06]
Dr. Alexander Torres
For example, this is my own experience. I was completely healthy before, and I remember I received my second short shot of the COVID vaccine.
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Dr. Nicole Safire
You had MRNA like Pfizer Moderna.
- [33:19]
Dr. Alexander Torres
And two weeks after, I'm a, I'm a runner. So I like to, you know, train for, you know, half marathons and marathons. And I was running. I remember it was around December that the vaccine came around, that and I started developing Raynaud's myself.
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Dr. Nicole Safire
Raynaud's being where your blood vessels and your fingers, when it's cold, you have poor blood flow. Yeah, extremely.
- [33:41]
Dr. Alexander Torres
It was just nothing. It was just simple. It was very, very extreme. Very quite evident. It was a triphasic discoloration of my hands turning completely white, then bluish, and then, then red. And I didn't have that before. Another observation that I noticed that those symptoms that I was having, they're waning off as well. So it seems like a way how my immune system is somehow resettling to what it used to be before. So that's another observation that I have seen the same way with my patients. Those patients that I have here, well documented post vaccination, they develop some sort of an erratic immune system. Then novo or new onset or subsequent, you know, symptoms. Those symptoms are somehow, you know, start getting somehow more quiet right now, which is pretty quite interesting.
- [34:38]
Dr. Nicole Safire
Yeah. So were you recommending then for these patients? Because, I mean, a lot of the colleges, I think even rheumatology, recommended obviously full vaccination, but then boosters. But we have so many documented, published papers now showing that the vaccine itself could potentially worsen existing autoimmune disease. But also, as you're mentioning, they could start fresh. Like, how do you have that conversation with your patients about the formal recommendation of getting all these boosters, but when it could potentially be causing a problem?
- [35:13]
Dr. Alexander Torres
It was extremely challenging because the trenches, it was not consonant of what the main source. They were telling us. They were telling us that this is what you need to do. You need to do these vaccinations, and then you have to boost yourself every so quite often. And I was. I was not seeing that you needed that first and foremost. And two, it was causing a lot of problems. I was seeing that on my patients, in my patients, that I had to make a medical decision and say, look, Doc, but they're telling me to do this in tv. And I had to actually sit down with our patients completely frustrated about it. That this is something that is between the patient and the doctor. It's extreme. It's like going to a confession. You know, it's something that is between you and the priest, that you have to create that bond with the patient, and you have to, you know, you have to create that. That bond and confidence with the patient. And I used to tell them what I used to see with my patient and what they were going through. And I had to dealt with that because they were all lost. You know, they were confused on what they were telling them on one end and what I was seeing on one end. And for me, I continued my practice the way I thought it was the best way, because that's the way that I was seen on a daily basis. So in my case, I stopped recommending the vaccine on my rheumatic patients way before it was announced, because I was seeing something that it was not. It was not nice. A lot of patients, they were very upset because, for example, we had a lot of patients with, you know, rheumatic issues that they developed it. Then. Then they have the. The immunotherapy after or immunoglobulins after and that somehow neutralize the monoclonal antibodies that were given to them. So they came not only with, you know, post covet vaccination symptoms, but also they came with major flares because they were treated in the hospital for Covid and immunotherapy or immunoglobulins in order to kind of counteract that. And that was a problem also too. Look at this, Nicole. The beauty of this, how things we were able to identify that this vaccinations that were causing some post traumatic conditions or some post traumatic adverse events is that we eventually decided to use Tazing usumab, which is an interleukin 6 blocker for Covid cytokine release, you know, which is a medication that we give for our patients in rheumatoid arthritis. And that's when we kind of figured out, I said, look, something is wrong here and this vaccination must be completely carefully decided between a doctor and the patient. Could. It's something that you just couldn't be just thrown out there. Hey, everyone needs to do this. Kids, especially kids. Kids that have the best immune system ever. Let them be what they have to be. You know, like we talked about the hypothesis, you know, the hygiene hypothesis. You know, we saw the kids, kids that were not, you know, the mortality rate in kids, it was extremely, extremely low. And we kept vaccinating these kids, start seeing patients. And I don't see pediatric patients that I had to do it because again, I see, you know, patients, they are underserved. So they were coming to me, patients that were 9, 13 years old, 15 years old, with rheumatic conditions that they never had before post vaccination.
- [38:40]
Dr. Nicole Safire
Yeah, I mean, it's really upsetting kind of post Covid to kind of learn all about that. But I certainly think that while again, there's been a rise in autoimmune diseases pre Covid, certainly the COVID infections as well as the vaccines have contributed to that rise. So we've touched on the hygiene hypothesis, the fact that we don't let our kids eat dirt anymore that could potentially have increased their risk of autoimmune diseases and infections. We you've touched upon the fact that we live in a world of microplastics, and microplastics are inserting themselves into all parts of our bodies. But what about gut health and the microbiome? What is your take on that? And it's linked to autoimmune disease.
- [39:22]
Dr. Alexander Torres
So microbiome is a very Hot topic the same way as, you know, microplastics as well too and post COVID vaccinations, et cetera, microbiome. It's very, very interesting and complex to the fact that we're, we're altering our own normal flora based on the recent or basically the last 25 years diet. We're becoming much more insulin resistance. We're seeing a lot of patients with a certain type of what we call gluten, you know, sensitivities or some real full blown celiac disease. We're seeing a lot of patients with inflammatory arthritis that they're coming through, you know, problems that they have that they start of overgrowth, we believe is some sort of a growth overgrowth of bacteria and that kind of like genetical code is kind of changing and creating this kind of cascade of inflammatory response. So the microbiome or the gut health is extremely important also in rheumatic conditions. So we're learning that more often now.
- [40:24]
Dr. Nicole Safire
So for people who are listening, who maybe they have an autoimmune disease or they think that they might have one, you know, what are some early indicators or what should they do if they're kind of having some symptoms and they're not really sure what they are?
- [40:37]
Dr. Alexander Torres
I think that we always look, you know, if, if I would be their physicians. Right. Of this population that comes to you as a doc. You know, I used to feel pretty good. I didn't have any gut issues. But lately I am feeling this way. I'm feeling a little bloated. I cannot tolerate any specific type of, of food. But every time I, I eat this kind of food or whatever, I'm getting this xyz. Symptoms are getting more fatigue. We're seeing a lot more chronic fatigue, you know, population insomnia, more inflammatory arthritis based on processed food as well too. So my recommendations is that we still don't have the technology to really identify this kind of triggers in terms of what triggers an inflammatory arthritis or in autoimmune conditions on, based on what they, they eat, we tear. What I tell to my patients is that look, you know your body more than anyone else. So if you happen that you eat, you know, for example, I had a patient that doctor, every time I eat white rice, I get my knuckles, I get completely inflamed. And for me I'm trying to figure it out exactly what is the main, you know, pathophysiology on. This was like a white rice. What really happens over here. I basically tailored that to them. I, I consult nutritionist, obviously I do the whole, you know, panel in terms of thyroid issues and, and other gut autoimmune blood work as well too. And then refer to the gastroenterologist as well.
- [42:09]
Dr. Nicole Safire
So if, if someone's starting out kind of having some symptoms, they're vague, they don't really know what's going on. Do you recommend putting together like a food diary for like a few weeks or a month just to see if it's triggered by anything?
- [42:22]
Dr. Alexander Torres
I do, I do. I am actually a fan of fasting. So I do a little bit of fasting usually, you know, 18, six on occasion. And tell the patients to identify exactly what. What are they eating? What are they eating differently this time? What are they doing that they were not doing before and when did they notice those symptoms? So history is extremely important in this population to identify those kind of, you know, trigger factors.
- [42:49]
Dr. Nicole Safire
Yeah. Rarely when autoimmune patients present, I imagine is it very text white, textbook black and white. It's kind of like an enigma. And you get to be the little puzzle, puzzle put together person trying to figure it all out.
- [43:02]
Dr. Alexander Torres
It's not that anymore. It's impressive. Like, I have my residents and my medical students with me. And my medical students are always, you know, expecting, oh, doctor, Right. You know, you have that positive with a positive ana, ssa, ssb. This is short grade. But the reality is not the reality. They may have is subtle ANA test, you know, and they may have some sticker manifestations from dry and dry mouth and they still could have some short ones. So we're seeing a lot of inflammatory arthritis and not necessarily will give you positive blood work. Yeah, we're getting smarter. Like, like, like, like I just mentioned. And we're able to identify certain type of, you know, auto antibodies that we're able to recognize. And you know, through different, you know, labs, they're, you know, providing us, you know, to help these patients. But I will say 6 out of 10 patients, you may have a negative blood work. We've seen a lot of spondyloarthritis patients, a lot of what we call seronegative.
- [44:02]
Dr. Nicole Safire
Hi, I'm one of those, those Seronegative. Seronegative spondyloarthropathy wastebasket term patients. We don't fit in a box. But it's real.
- [44:13]
Dr. Alexander Torres
It's real. You know, I'm doing, I'm doing some clinical trials over here with spondyloarthritis. We're working on a lot of signals, interleukins, you know, 23. We're actually, we're having possibly we're going through the process right now getting a phase one. We're working with the CAR T therapy, so. Or natural killer and Carta.
- [44:38]
Dr. Nicole Safire
CAR T just for anybody listening is a. It's an amazing therapy that we've used in pediatric cancers. But I mean, it certainly is a good starting point for a lot of things. Yes.
- [44:47]
Dr. Alexander Torres
So we're seeing some evidence already that they work incredibly on type of arthritis, such as, you know, lupus, lupus nephritis or certain type of vasculitis. So that's going to be. We're going to be conducting those studies pretty soon over here in phase one.
- [45:01]
Dr. Nicole Safire
Well, I mean, we've come a long way in terms of treatment for these patients and thankfully there's still people like you doing a lot of research. Alex, some takeaway for those who either have an autoimmune disease or who don't, but they want to do everything they can to try and prevent it. If you have just, you know, like three what you should do, how you should live your life, what your, what's your advice for people?
- [45:24]
Dr. Alexander Torres
I think the number one, you know, advice for me is lifestyle changes. If you think that, you know, you're sedentary. I think it's important for anyone that may feel that they need to kind of reset everything, lifestyle changes, such as a certain type, much more healthy diet. It is extremely important. Low sugar, basically and aerobic exercises. We're experiment. You know, I basically advising every, every one of my patients to do a lot of aerobic or low aerobic exercises and want to try to implement like.
- [46:01]
Dr. Nicole Safire
What, give an example, what's an aerobic exercise?
- [46:04]
Dr. Alexander Torres
So what, what I try to explain to my patients is that in order for us to decrease the insulin resistance, not only just the diet, but we have to improve what we call the low aerobic or zone two exercises. And basically what that means is that low aerobic exercise or zone 2 exercises induces your mitochondrial replication and mitochondrial replications, most of the energy is fatty acids or fatty oxidation. And what happens when you do that? When you do that cardiovascular, you. You decrease your metabolically to improve dramatically and you decrease insulin resistance. And I strongly believe by decreasing insulin resistance those general symptoms of inflammatory response or autoimmune response, if we want to call it that way. Any, anything that is inflammatory, it's an autoimmune. So I encourage that from our patients. So I set up, I set them certain type of workouts that we lead to that kind of like low or zone two or low aerobic exercise, about 20 to 35 minutes, at least four times or five times a day.
- [47:13]
Dr. Nicole Safire
I mean, I think we wait four or five times a day or a week. Wow.
- [47:22]
Dr. Alexander Torres
Twice a day. That's me. I'm like, oh, my God. Oh.
- [47:25]
Dr. Nicole Safire
I mean, I think you're right. I mean, you don't have to be a gym rat. You don't have to be like the most fitness person, but you do have to get your body moving a little bit more. And as you're saying, we have to keep our sugars down because sugar causes inflammation and inflammation causes autoimmune disease.
- [47:42]
Dr. Alexander Torres
Incredible. And that's, I think people, they don't, they haven't realized yet, but autoimmune and systemic inflammatory process is the main, you know, you know, culprit of almost every condition nowadays.
- [47:55]
Dr. Nicole Safire
Everything. Well, isn't it true? So by what we eat, by if we take in less sugar or, you know, less ultra processed foods and like the processed breads and sugar, sugary sweet drinks, that decreases the sugar intake. But the exercise actually upregulates some of the receptors on our cells so that we are able to use our insulin more efficiently. Right.
- [48:20]
Dr. Alexander Torres
Well, you know, obviously insulin, Insulin resistance is a main issue. And how did we actually help that insulin resistance to become, you know, or resensitize? There's a lot of studies out there, like, if we do a little bit of a insulin pulse, therapy can resensitize those receptors again. And we've seen a lot of study on that. It seems to be good. But you have to reset that body by a doing, you know, lifestyle changes like fasting. It could be a great form of resensitation as well, too, as well as zone 2 aerobic or lower aerobic exercises.
- [48:57]
Dr. Nicole Safire
Right. Well, you heard it here, folks. If you want to resensitize your body to insulin, you have to start your fasting and you got to get exercising. All right, thank you so much. Dr. Alexander Torres, rheumatologist, colleague, and friend of mine. We really appreciate you coming on Wellness Unmasked and giving us all of your expertise, expert advice. It's great seeing you.
- [49:19]
Dr. Alexander Torres
Thank you very much.
- [49:20]
Dr. Nicole Safire
More coming up on Wellness unmasked with Dr. Nicole Safire. Well, that was a lot to unpack from Dr. Alexander Torres, my friend and colleague. I certainly learned a lot from him. And it is validating to hear an expert say, yes. It is not just intrinsic to us. It's not that we're just diagnosing more autoimmune disease. We are seeing more autoimmune disease and we can point fingers. All we want. And there are a lot of finger pointing to do, but it boils down to our lifestyle, the sedentary way we're living. We're not moving our body enough. We're eating loads of crap. You know, I wrote all about it in my book Make America healthy again from 2020. I talked about the foods we're eating and the fact we're not moving our body. And as Dr. Torres just told us, insulin is not working in our body because of this, and therefore we have baseline higher blood sugars than we should. And when you have too much sugar in the blood, it's going to cause inflammation. And inflammation leads to bad things, one of which are autoimmune diseases. And autoimmune diseases, while they may be manageable and you may be able to live with them, they can also be deadly. And so we have to do everything we possibly can to decrease the inflammation in our body. You know, for me, it is getting my body moving, trying to reduce the all of the crap that we're eating, the processed foods. As we know. I love to incorporate natural herbs into my diet. I use ginger and turmeric on a daily basis to get that inflammation down in my body. And I also use lavender to relax me. And I do everything I can to get a good night's sleep because your sleep is so important. And that's a wrap on this episode of Wellness on Mass. I wanted you to learn a little bit about myself so you know why I'm on this wellness journey with you. Just remember, your health isn't a trend. It's our foundation. If today's conversation is something that resonated with you, I ask you, please share it with someone you care about. Thanks for listening to Wellness Unmass on America's number one podcast network, I Heart. Follow Wellness Unmass with Dr. Nicole Safire and start listening on the free I Heart Radio app, Apple Podcasts, or wherever you get your podcasts and we'll catch you next time.