Unexpected Health Challenges with Dr. Jill Carnahan: Rational Wellness Podcast 332
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Dr. Jill Carnahan discusses her Unexpected Health Challenges with Dr. Ben Weitz.
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Podcast Highlights
1:40 Breast cancer. Dr. Carnahan has faced a number of personal health challenges in her life, including a battle with breast cancer while she was in medical school. During her third year of medical school she was taught how to do a breast exam and she performed one on herself and she found a lump. At first she didn’t think it was serious, but she had a mammogram and an ultrasound and she was getting suspicious looking at the images, but the radiologist blew her off and told her that since she was 24 years old that it was no big deal. Jill went on to have surgery and the surgeon told her that it was very aggressive ductal carcinoma and that she was in the fight for her life.
6:41 Dr. Carnahan then went through a very aggressive, very toxic, 3 drug chemotherapy regimen. One of the drugs she was given is very toxic for the heart and she was given a dosage just slightly less than that amount. She lost all of her hair, affected her skin, and she had massive gut symptoms. Dr. Carnahan admits that she did go against the recommendations of her oncologist not to take any antioxidants, but she knew intuitively that taking a few antioxidants was better for her body. After the chemo she had radiation and then multiple surgeries. Eventually she was considered cured of cancer. Then nine months later she started having cyclical fevers, diarrhea, abdominal pain and she was not allowed to call in sick, even working at the hospital. She passed out one day while working in the emergency room and was taken to emergency surgery for a cyst in her intestines and she was diagnosed as having Crohn’s disease.
Dr. Jill Carnahan is an MD who runs the Flatiron Functional Medicine clinic in Louisville, Colorado. Dr. Carnahan is one of the first 100 doctors certified by the Institute of Functional Medicine. Dr. Carnahan is a popular inspirational speaker and writer and she often teaches other health care practitioners the Functional Medicine approach. Dr. Carnahan has written a new book, Unexpected, Finding Resilience through Functional Medicine, Science, and Faith. She can be contacted through her website, JillCarnahan.com.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
Podcast Transcript
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field, to bring you the latest in cutting-edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, DrWeitz.com.
Thanks for joining me, and let’s jump into the podcast. Hello, Rational Wellness Podcasters. Today, we’ll be having another discussion with Dr. Jill Carnahan, one of the most important voices in the functional medicine world, who has a wonderful new book, Unexpected: Finding Resilience Through Functional Medicine, Science and Faith. This book documents Jill’s personal and professional journey through life and how she’s been able to overcome the most severe health challenges, as well as her professional and personal journey. Dr. Jill is a survivor of breast cancer, Crohn’s disease, and mold toxicity. Dr. Carnahan also has a documentary coming out called Doctor/Patient based on her life story.
Dr. Jill Carnahan is an MD who runs the Flatiron Functional Medicine Clinic in Louisville, Colorado. Dr. Carnahan is one of the first 100 doctors certified by the Institute of Functional Medicine. Dr. Carnahan is a popular, inspirational speaker and writer, and she often teaches other healthcare practitioners the functional medicine approach. Jill, thank you so much for joining us.
Dr. Carnahan: You’re welcome. I’m excited to be here.
Dr. Weitz: Excellent. I am too. Please tell us a bit about your life journey and some of the challenges you have faced, starting with perhaps overcoming breast cancer while you were in medical school.
Dr. Carnahan: Yeah, so it’s interesting because we know the healer’s journey. I think I was born a healer and I didn’t really know it. I do remember very young wanting to go into some kind of helping space. I never in a million years thought I could be a doctor, that was not even in the vocabulary. I grew up on a farm with farmers. Now, my brothers are engineers, so definitely educated, but medicine was not in my family, so it was accidental. Interestingly, I grew up with a chiropractor as my primary doctor. My mother was a retired nurse. She retired to be on the farm and raise the five of us children. She actually was told that she wouldn’t have any children, and then all of a sudden, she has five over 10 years of a period. As a retired nurse, she definitely would, before we’d go to the doctor, she’d try maybe an herbal remedy or she’d take us to the chiropractor and we went to doctors. But we definitely had an idea growing up that food was medicine. That there were ways to start to maybe soothe the fever versus just run to the doctor, so I had that built into my genetics and DNA.
I literally looked at acupuncture school, chiropractic school, all the other traditions. Then right around that same time, I realized, “You know what? Maybe I should go into medicine.” It was literally my childhood chiropractor who said, “Jill, I think you should go into medicine because you could actually make more of a difference.” As we know, I have the greatest respect for my friends who are chiropractors and naturopaths because I learn so much from them. With this mindset, I literally was like, “Well, maybe I can go into medicine and infiltrate and learn the system that right now is just the best reimbursed.” It’s not better, and then actually make some changes from the inside out.
I’m so glad that I did because I really got to look at this system from a very objective view and say, “What’s good?” Yeah. If you have a heart attack or a stroke or a car accident, you want to be in a major medical center. But if you are really in a chronic illness, some of these complex, chronic things that you and I see all the time.
Mold-related illness, chronic infections like Lyme, autoimmunity, brain inflammation, dementia, diabetes, obesity, there’s no drug that cures that, and there’s usually no surgery that cures that, this bigger perspective. And so back even in the midst of medical school, I was making changes. I went to Loyola University, and it was the first group that I created for medical students for integrative medicine.
We started actually bringing in other practitioners in getting exposure to that in medical school, so that’s the foundation. Then during medical school, all of a sudden in my third year during my surgical rotation, we’re taught about breast exams and I do a breast exam, and I find a lump. Now actually I was 24 at that time, I wasn’t even yet 25. I thought, “No big deal. I don’t even have time for this.”
I did not think it was serious, but my husband at the time was insistent that I get it checked out. I had a mammogram and an ultrasound, and I started realizing by sitting with that radiologist to see the actual images, he was very concerned, but he blew it off. He said, “You’re 24. 24-year-olds don’t get cancer, but the findings here look very suspicious.”
There’s calcifications, there’s things that are changing that if you were 55, I’d be highly suspicious. I knew at that point there might be something going on. Went on to have surgery, and I get a call from the oncologist just a few days after surgery and she said, “Jill, I don’t know how to tell you this. You have invasive ductal carcinoma, which is breast cancer, very aggressive.”
The cells are some of the most aggressive I’ve seen, which is classic in a younger person. You’re in for the fight of your life. You know those times in your life when you’re like the World Trade Centers, or a death of your father or mother, or someone you love? There’s those times in your life, where you’re sitting somewhere or you’re in a place and you never ever forget.
That moment is totally etched in your memory. The chair you’re sitting on, the color of the wallpaper, maybe a song that was playing. That was one of those times for me that looking back, it was an absolute transformation in my life and it was for my good, but at the moment, it sure didn’t feel like it. I got this diagnosis of cancer. You hear the word cancer and your life just stops in a way, as far as what does this mean?
I didn’t know at that moment. Now I’m 20 plus years out, and doing well and free of cancer, but at that moment you don’t know. I say this because I know a lot of your listeners probably have dealt with those kinds of conditions or diagnoses. Or it might be something for your child or your parents or someone you love, and you hear these words, whether it’s cancer or some autoimmune disease or incurable dementia, or whatever those things are. It really does shift and change our perspective. What happened all of a sudden for me, was I went into a whole different realm of education. It was the most scary, but the most profound education, and far greater on the impact of my career and my practice than any medical textbook.
Dr. Weitz: Great. Then you had another really significant health challenge that may have been partially related to the treatments you had for your breast cancer, which was Crohn’s disease.
Dr. Carnahan: Yeah. I get through, so ended up having three-drug chemotherapy, some of the most aggressive drugs on the planet because I was young and they wanted me to survive. Literally, one of the drugs was I went right to the toxic dose for your heart, that if I would’ve gotten 10 MLs more of that, it would’ve stopped my heart from beating. Very, very toxic chemotherapy, lost all my hair. Had massive, massive issues. Of course, in my gut, every rapidly dividing cell in my body was affected. This is where the Crohn’s comes in.
Dr. Weitz: By the way, were you using some integrative approaches at the same time as well?
Dr. Carnahan: I was. My oncologist said, “Don’t even take vitamin C.” I was like, “Screw that, I’m going to.” Now, I don’t advise patients to go against their oncologist. I’m always very, very careful. You need to be talk to them and decide. But I always do encourage people to trust their intuition because sometimes we know. I knew taking a few antioxidants, even though it’s not recommended, was better for my body and I did. I saw a naturopath, I had a prayer group praying for me. I had lots of friends and family. I had all kinds of things that were not traditional medicine, and they were really powerful. This three-drug chemotherapy really destroyed my gut, my skin, a lot of things. I had radiation after that and then multiple surgeries. I get through all this and I’m considered cured of cancer.
It was about nine months later, and all of a sudden, I started having cyclical fevers, diarrhea, abdominal pain. I just literally, I had been out of school for nine months, was back in rotations, and I didn’t want to complain. I grew up on a farm where you’re tough, you don’t complain. I don’t know if your training was like this, but for us in medical school, unless you were dead or hospitalized with a fever, you reported to work. Now post-COVID, we don’t do that anymore, but back in the day when you were sick, you didn’t call in sick. You weren’t allowed to have, it just wasn’t acceptable. I went to work with these fevers. I didn’t tell anyone until one day, about three or four months into it, I literally passed out in the ER. I was taking a patient’s blood pressure. I was rushed into the hospital that night and they found an abscess. Went to surgery, emergency surgery overnight. I never forget getting out of the surgery, waking up from anesthesia. The surgeon came to talk to me and he said, “Jill, there’s no doubt in my mind this is Crohn’s disease.” Here I am in the hospital bed just working the day before. I’m like, “What in the world? I just got through cancer.” But as you mentioned, it makes so much sense because toxic chemo drugs, again, I have no regrets.
I want to state that clearly. I think it saved my life and I chose very deliberately. I think when we make those choices, the worst thing we can do is go back and say, “Well, what if I wouldn’t have done that?” I never do that. It was toxic, but I chose that and I accepted that. But that toxicity damaged rapidly dividing cells, including those on the lining of my gut. What happened was it created more intestinal permeability. This leakage of the contents of your gut go into the bloodstream and create an inflammatory effect. I have a genetic predisposition towards Crohn’s. That means that if I get those little lipopolysaccharides, the bacterial coatings going into my immune system, my body reacts more aggressively. This was how I developed Crohn’s because my body’s like, “Wait, what are these things doing in the blood?” Started an inflammatory reaction that actually innocent bystander attack the gut lining, causes granulomas, abscesses and damage, and then there’s Crohn’s disease.
Dr. Weitz: What was that genetic difference that made you more prone to Crohn’s?
Dr. Carnahan: It’s called NOD2.
Dr. Weitz: Okay.
Dr. Carnahan: It’s a SNP, of course, that’s higher risk for Crohn’s. Later, I was like, “Oh, no wonder.” The literal description is abnormally robust response to a normal microbiome, so that makes sense. My response, my immune response, my TNF-alpha, my IL-6, my IL-2, was probably 2, 3, 4, 10 times the average for normal microbial interloper, that got through the barrier and then developed Crohn’s.
Dr. Weitz: Did you treat the Crohn’s?
Dr. Carnahan: Yeah. Part of my story is I go to the gastroenterologist, I’m like, “What do I have? What do I do about this?” He says, “This is lifelong. It’s incurable.” He’s very depressing. You’re going to need steroids right now. You probably should be on steroids. You’re going to need immune-modulating drugs. You’re probably going to need surgery to take out part of your colon over your lifetime.
This is permanent and very depressing. I remember leaving that office and saying one thing. I said, “You know what? I want to do whatever I can, and I know that there’s other things that might help. Does diet have anything to do with this?” He did not even pause, he said, “Jill, that has nothing to do with this.” That was again, where I had to trust my intuition, because I was just a mere third-year medical student.
I didn’t really know a lot. I knew my limitations, but I’m like, “That doesn’t feel right. How couldn’t diet not have anything to do with this?” Then my Swiss German stubbornness kicked in. I was like, “Screw that. I’m going to figure this out.” I went to the library and started looking. I came across this specific carbohydrate diet, which Elaine Gottschall made famous in her book, Breaking the Vicious Cycle.
I was like, “Gosh, what do I have to lose? I might as well try this.” Well, I think there was a couple of things. I think that diet really does work. It’s one of the first things I do for patients with Crohn’s and colitis, because it takes out certain disaccharides and monosaccharides that feed SIBO. Now we know, “Okay, there’s an underlying piece here.”
You’re clearing out the excess bacteria that’s triggering that abnormal immune response by the dietary changes. Within two weeks of changing my diet, I had no more fevers. I had no more pain. Now, it took me years to really feel cured from Crohn’s, because I worked on the microbiome over the next several years, but I knew within two weeks that this was powerful in the healing process.
Dr. Weitz: Well, the gastrointestinal field hasn’t really changed that much. For the most part, gastroenterologists don’t often prescribe changes in diet for most gastrointestinal conditions even in 2023.
Dr. Carnahan: Yes, sadly. I just literally, as I’m teaching this in lectures and stuff, pulled, I think it was 2022, an article where they started to say, “Well, maybe there’s something to do.” But it was still like there’s not enough evidence. The thing is, as you and I know, there’s interventions that can be really dangerous. Some of these really, really toxic drugs like to say, “This has benefit.” You really need to have the evidence. But for things like changing your diet and getting rid of sugar or processed foods or adding a little vitamin C, if the benefit has great potential, even if we don’t have great data and the risk is very low, there’s no reason we shouldn’t move forward.
Dr. Weitz: Absolutely. On the other hand, traditional or the current, state-of-the-art treatments for Crohn’s disease, is to give you drugs that block your immune system. We obviously learned the last few years how significant that can be, not having a healthy, functioning immune system.
Dr. Carnahan: Yeah, so critical. Like you said, people don’t think about those side effects. It’s literally, if you look at the drug warnings of HUMIRA and all the new TNF-alpha blockers and other meds directed towards blocking certain cytokines that contribute to Crohn’s. First of all, I will say there’s some people that are so sick, that those do really save their lives. I have a lot of people who come in on those drugs and I never say, “Stop the drug.” I go to the root cause and give them time, even up to years, to reverse that. I want to mention that if you’re on the drugs, don’t stop the drugs. They might be saving your life, but like you said, what happens is that’s not the root cause. The literally warning label in the medical literature is don’t take if you have TB.
Don’t take if you have fungal infections, don’t take if you have any opportunistic viral infections. Guess what I’ve found? In Crohn’s disease, one of the markers they do in Labcorp that’s a predictive panel for the aggressiveness of Crohn’s, is a panel of anti-carbohydrate, anti-Candida, anti-Saccharomyces antibodies. I found one of the biggest things that changes the progression of Crohn’s and colitis, is seeing if there’s a fungal burden. I would guess in my clinical practice, 80% of the patients that come in with Crohn’s or colitis have a fungal burden. Why would you put them on something that blocks their ability to take care of that fungus?
Dr. Weitz: Interesting. That’s fascinating. How do you test for fungus? Because fungus is tricky. It doesn’t always come up on stool tests and a lot of us are using organic acids.
Dr. Carnahan: I’m so glad you asked that. I love teaching about this because I think this is actually you’re getting to the heart of my Crohn’s. My remission was absolutely maybe 80% based on me clearing S-I-F-O, small intestinal fungal overgrowth. I think from a child, I had a more weakened immune system, and I have some other mitochondria defects that caused me to have more trouble fighting yeast. I think for me, that was a huge player in the development of Crohn’s. Me treating, over the last 20 years that fungal burden, has been the absolute number one thing that has brought me into not only remission but cure. How do you test? This is really important because a lot of functional docs, they start with a stool test and they don’t see it. They’re like, “Okay, no fungus.”
Just like you said, it’s very low sensitivity. If you have fungus in the colon, which is actually, usually in the small bowel, not the colon. It might even be in the stomach or duodenum, and even in the mouth, esophagus, it may be way up high in the gut. On the stool test, you may not see it. If you do see it, you might see it as one plus Candida, and it says green. The testing company will be like, “Oh, it’s no big deal.” I treat anyone who has yeast in the stool, even if it’s one plus small levels, and they have symptoms, so symptoms plus. You mentioned organic acids. That’s one of my favorite ways to test. Raffinose is really, really common on all organic acids, and a lot of our test companies have a lot more. The one I use has, I think, nine markers of yeast and fungus so I look at that very carefully.
Dr. Weitz: Which test is that?
Dr. Carnahan: Yeah, I like the Mosaic OAT. It’s the Great Plains formerly.
Dr. Weitz: Oh, okay.
Dr. Carnahan: Yeah. Very, very detailed for these yeast markers. You can also see if you see oxalates elevated in the urine. Oxalates are made by mold and yeast, so they’re coming from that source unless you just have a massive oxalate load in your diet. So often if you see both a raffinose and oxalates, you’re like, “Oh, there’s a fungal burden here.” Now, a third test you can do that is also sensitive and specific, is Candida IgG, IgM and IgA. You can do that on Labcorp or Quest or any standard lab. A lot of docs are like, “Oh well, that’s like IgG for Candida. That just means past exposure.” The truth is this, IgG develops when something crosses over from the gut lumen to the bloodstream. Unless you have exposure in the blood to Candida, you’re not going to develop an IgG antibody. The only way you can get that is through a permeable gut and a load of Candida. I do see those markers go down as we treat. Again, this is my clinical experience, but I am treating if I have elevated IgG or IgA levels. IgM is less common because that’s an acute one, but that’s real important as well.
Dr. Weitz: Interesting. Yeah. Ilana Guervich, she was talking about using that test as well.
Dr. Carnahan: Yeah, it’s wonderful. One of my favorites.
Dr. Weitz: I’m going to have to add that. Your third major health challenge was your experience with mold toxicity.
Dr. Carnahan: Yeah. Okay, I get through cancer and Crohn’s. I graduated from medical school a year late because I took time for medical treatment, and I’m out and practicing. Now, it took me a while and the chemo was hard on my body. I started growing my hair back. By the time, maybe six, seven years out, I was running marathons, hiking, skiing, very healthy and robust, and I felt like I had recovered. Interesting, I don’t always talk a lot about this. The chemo actually caused me to be amenorrheic, almost menopausal for two years. For a while, I thought I was going to be permanently menopausal. At 25, my cycles came back and everything was working. I moved out to Colorado and started my practice here as a functional medicine consultant, and was doing fine. Then 2013, there was a massive flood in Boulder. Now sadly, we’re hearing this all over the world, and I think about the mold effects of these floods and hurricanes, but we have this massive flood. My office already had some issues. It was an older building and the basement flooded. Now I look back and it makes so much sense. Sorry, I was on the second floor over an unfinished crawlspace that was a standing water. My actual office itself, we had had a contractor come in and make it really beautiful, and they just decided to put beautiful, new bamboo flooring over old 20-year-old carpet, like duh.
Dr. Weitz: Horrible.
Dr. Carnahan: Then under my office was this unfinished crawlspace. In the basement, two stories down, was like bulk Stachybotrys black mold. When we had that water damage come in, it just accentuated all of that stuff that was already happening in that building. What I started feeling was exhaustion, red, irritated eyes, I had rashes from the histamine, I had brain fog.
I had frequent infections, so a weakened immune system. I got really, really sick. It’s funny because back then I knew mold could be a cause, but this is where I have a lot of compassion for patients because I was in denial. I did not want to know that mold was an issue because that meant my workplace, my car, my home, something would be affected.
Finally though, I got so sick I had to do something about it. I checked urinary mycotoxins and then I also did an inspection in the basement. I found that the match there was I had trichothecenes, which are black Stachybotrys toxins in the urine. Then I also saw the bulk sample came back. Dr. Weitz, when I found that out, I literally never again set foot in that office. I left, I started over. It took a while to heal, but I had to become the expert just so that I could heal myself.
Dr. Weitz: Wow, that’s a lot to go through.
Dr. Carnahan: Yeah, I guess that’s why I said now I look back, I’m like, “Oh duh, the healer. That’s the soul’s journey as a healer is to learn.” Now it’s funny because looking back, these were hard things. Anyone who’s going through cancer or Crohn’s or any of those things can be difficult, but what happens during it is the development of deep compassion is unparalleled.
For me to be able to sit in that patient’s shoes and really understand where they’ve been, I have a deepest, deepest compassion. I also, there’s little, tiny things like cancer and Crohn’s connection, and even in the chemo treatment. Then the connection between Candida and Crohn’s and all these things, I would’ve never, there’s no medical textbook that’s teaching that. Putting together the pieces of the puzzle to take patients to another level on this journey with functional integrated medicine, there were so many things I learned through my own experience, that I could have never gotten in a book.
Dr. Weitz: The connection between fungal overgrowth and mold, I treat a lot of patients for mold toxicity and mycotoxins. We often see that they also have fungal overgrowth, which seems to go hand in hand with the mold toxicity.
Dr. Carnahan: Now I look back, I’ll tell you something I’ve just been talking about very recently, it’s not even in the book, is I grew up on a farm, lots of corn and soybeans. Corn is known to be contaminated with a mold called Fusarium. Fusarium, I just read the research just this year, massively correlated with cancers and development. I look back, and again, I think the pesticides and lots of other things on the farm were contributory to my development of cancer at a early age. Many of them are endocrine disruptors. But this new bit of data on Fusarium made me go, “Oh, I wonder if mold was at the root all along, or at least one of the players?”
Dr. Weitz: Well, when you think about all the toxic chemicals, now you’re talking about mold, it’s surprising that anybody who lives on a farm, lives very long.
Dr. Carnahan: Honestly, you’re right. I look back and I look at my mother, she was so resilient and lovely and a great mother, but she was tired a lot. If I look back, she probably would’ve had chronic fatigue, fibromyalgia, migraines. I think, as I tell my story, I think that in utero, she probably had a massive toxic load, but I even got some of that in utero through my mother’s placenta.
Dr. Weitz: Fascinating. In the book, one of the things you mentioned is this philosophy of believe, act, wait. Maybe you can explain what that is.
Dr. Carnahan: Sure. It’s so interesting that when we write or journal or do these inner work things, for me, it’s funny, the book ended up being a beautiful therapy I never expected. Because what happens is as we start to really put together, this is what I went through, this is maybe more meaning and purpose of the suffering and difficulties. What happens is patterns start to emerge.
This was one of those things that literally did not, I never went in saying, “I’m going to write a chapter called Believe, Act, Wait.” What I did is I started to tell stories, and as I told stories, I thought, “Oh my goodness, there’s a theme emerging.” This theme is chapter four, Believe, Act, Wait. It literally came to me as I’m writing this stuff, and what believe, act, wait is for me, it’s my formula for life.
I wanted to share it because I do think it’s powerful. What it is, is if we believe in possibilities, this could be I can be a doctor, I can go to medical school, or I can overcome cancer. Or I can leave a job that I’m stuck in and it’s so miserable, and find a new career or a new job at 55 years old. These things that we maybe think are difficult or impossible.
The first step to achieving your dreams or where your soul wants to go or grow, or learn or transform, is believing that something is possible. Now I come from a faith perspective, but I’m very open to the people who have no faith perspective. It still works because you can still manifest by believing. For me, I do believe in God and I believe in a higher power, and I have that as part of who I am.
But again, I’m very open to the fact that you don’t have to believe in anything religious to have this actually work. You can believe that something else is possible. When you have that belief, that’s what starts the action of the next step. The next is to act. Act just means we do what we can. For me, it’s maybe going to medical school, I’m going to be a doctor, or maybe applying, doing the application.
The first application that you put off. For cancer, it’s like, “Okay, let me talk to a naturopath. Let me talk to an oncologist. Let me get some options.” Let me go to the library and spend hours and hours reading the literature on what works and what doesn’t work for breast cancer, for ductal carcinoma.
You act and you do what is possible within your realm of your life and health, and sleep and family, and you do those things that will take you towards your goal. Then the wait part is where the divine or the manifesting power, the whatever you have belief in. For me, it is very divine. It’s a prayer and meditation. I wait for the unexpected, the things that I can’t do on my own to happen. For example, I found a phenomenal doctor that helped me with a very special type of radiation during my therapy, and I felt like it partially saved my life. That was such a coincidental meeting of how I got to know him, how I found out what he was doing. That was nothing in my own accord. It was literally the waiting and that came to me.
Dr. Weitz: That’s something I hadn’t heard about. Can you describe that type of radiation? Is that something that’s still being done for breast cancer?
Dr. Carnahan: Yeah. This was 20 plus years ago, and at that time, it was called brachytherapy. There’s this doctor that was doing this. This was very experimental, and what they would do is, so first of all, lumpectomy almost always is followed by external beam radiation. What they do is they take out the tumor and the section of the breast that’s affected, and they give a large margin like two centimeters or greater around the tumor. They get all that tumor out, and then they go back in and they externally beam hit radiation. They still do this 20 years later, but the external beam, it was on my left. Guess what organ is right under the breast? It’s the heart.
Dr. Weitz: The heart, yeah.
Dr. Carnahan: The external beam radiation, number one, it damages the skin. People have terrible radiation burns on the skin because this beam goes right through the skin. Number two, even if they’re really careful with the physics of that beam, it gets to the heart and to the lungs. A lot of people have permanent heart damage or lung damage to those tissues, because it goes right through and splays onto the heart or the lungs.
I knew that so I thought, “How in the world could I get this safety of treating any remaining cells, but not hurt my heart and lungs and my skin?” This guy, what he did was back in the day when I got it, they literally implanted tubes, these little, hollow tubes where over my treatment of five days, twice a day, they would put radium beads through that. The physics of the machine would calculate exactly where the area of that breast was.
It was basically radiating from the inside out. In that pocket where the tumor was taken, there’s these tubes where the radiation would go inside and it would calculate, just seconds it would pass through. It would pass through just in that internal section, so it literally was like a microwave cooking from the inside out, as crazy as that sounds. But with that, I had no heart and no lung damage.
My skin was fine except for those tubes that went in and out and had to heal, no big deal. That was profound. Now it’s called MammoSite. There’s a couple other devices where they literally do a surgery, and they’ll implant a little thing, like a little pocket inside the tumor region. They’ll put radiation in that pocket. That’s another way to do it.
For prostate cancer, brachytherapy has become very, very common. The same thing, they’ll do those tubes into the prostate and radiate from the inside out, so that you don’t have damage to the rectum or anything else when you’re treating the prostate.
Dr. Weitz: Yeah. I think I heard some discussion about it. I think this one doctor was saying that the reimbursement for that procedure is not very good, so they don’t do it that often.
Dr. Carnahan: Isn’t that crazy? I’ll tell you, I believe it was the best thing I could have ever done because my heart and lungs are great. My skin was great and it treated me and I’m fine. But what happened was I had to go to this doctor, all he was doing was experimental. There was no standard at all, so he had a study. The only way I could get in was to be in a study, and his study was all these 55, 65, 75-year-old women, very low risk. I literally had to beg him to say, “Can I please be in your study? I know I might ruin it if I die,” but he took me.
Dr. Weitz: To talk a little bit about some clinical things. In your book, you have these gray sections that are like pearls of wisdom about health, so I thought maybe we could talk about a few of these.
Dr. Carnahan: Sure, sure, sure.
Dr. Weitz: The first one you discuss is lab tests everyone should consider by age 30. Maybe you want to could talk about some of those tests that you think are important screens for overall health, above and beyond the normal lab tests that patients get. It’s interesting. I often talk to patients and they go, “Well, I went to my primary care doctor and I had all the tests done.” They think they had every test that could possibly be run because they had a CBC and a chem screen, and maybe a basic lipid profile.
Dr. Carnahan: I literally grabbed the book so I can make sure that I give you the right information because it’s all here.
Dr. Weitz: Right, yeah.
Dr. Carnahan: Yeah, so this was important. Like you said, what happened was, and I’ll just tell you the background on that. I wanted this book to be something you could curl up with a good cup of tea at night and you’ll be engrossed in the story. All the books that I love are great stories first, and the teaching is second. I wanted it to be like you’re sitting with me and I’m telling you a story about my life or about a patient, but I also wanted to include these really practical tips. I thought, “How in the world? It took me months to figure out with a publisher, how do we do this?” That’s what you mentioned with the gray bars. Those are actually just really practical takeaways. Here’s how you treat mold, here’s how you deal with lab issues or whatever. But then you can stay in the story in between those boxes, so that’s what you’re talking about there.
Dr. Weitz: Exactly.
Dr. Carnahan: Basic things like CMP, CBC, which are standard, are going to check liver, kidney, all that. That’s pretty standard. But some of the other things you might want to do are advanced inflammatory markers for the heart. Things like CRP, TMAO, PLAC, which is plaque, MPO, myeloperoxidase oxidation. These are all markers of more detailed inflammatory processes.
If that’s going on, you can look backwards and say, “Is there an infection or something else going on?” The gut disturbance, complete thyroid panel, this is huge. Not only TSH, which is the standard, but free T3, free T4, TPO antibodies, thyroglobulin antibodies, and even reverse free T3. Those are all going to be comprehensive.
You can see where the thyroid is, where it’s going, complete hormone. You can do this through blood work like estradiol, progesterone, free and total testosterone, DHEAS and cortisol, morning cortisol. You can also do it through a lab like say, DUTCH Complete or ZRT. There’s a couple out there where they literally will test the cortisol through the day.
That’s super helpful to see adrenal function. You’re missing the boat if you don’t get the hormones because those are playing so much into our lives and our aging, and our feeling well and all those good things. Autoimmune markers, I always feel like checking ANA. Then the ENA panel, which includes Sjogren’s antibodies, anti-double-stranded DNA, and those, great screening to see if there’s any autoimmunity.
Since the pandemic, I’ve been adding on anticardiolipin antibodies, which are really crucial for antiphospholipid syndromes, which are more the blood clotting disorders. I’m checking people for that now. You would be shocked at how many people have an elevated D-dimer, which means they’re breaking down fibrin, making clot, and they need to be treated so really, really important.
Vitamin D, really basic. A lot of docs don’t test this. Medicare doesn’t even cover it, and it’s crucial for our immune system. I like to see that between 50 and 80, it can go up to 100, but that’s an ideal range. Fatty acid testing, you can get on a routine lab panel fatty acid, so you can see your Omega-3-6-9, your EPA, your DHA. Those are crucial to brain health, to detox, to inflammation.
Iron study’s really important, and we often think about anemia or low iron, but high iron, hemochromatosis, is also an issue. It’s real important to make sure you’re not too high or too low. Just a quick antidote here. I have a patient who had hair loss at 14, total alopecia totalis, which means poor 14-year-old had no hair. She had lost it, and underlying part of her issue was gluten intolerance, but also undiagnosed hemochromatosis.
Now, normally that girl would’ve gone until 56 years old. She would’ve started to have liver failure, and the doc would’ve been like, “Why are you having liver failure?” They would’ve found this high iron and it would be too late. She’d probably have to have a liver transplant. Fortunately for me, because I’m checking this all the time, I found the hemochromatosis at 14 years old.
I guarantee that girl’s going to have a totally different life, because we’re treating her right now for that disease that at 50 could have actually killed her.
Dr. Weitz: That’s great.
Dr. Carnahan: That’s important.
Dr. Weitz: How are you treating her?
Dr. Carnahan: We do therapeutic phlebotomy, just like if you were to give blood that’s ordered and usually every eight to 12 weeks. Now, I think she’s on every maybe four months, and that will literally decrease the hemoglobin. It’s interesting, another little caveat here. Post-menopausal women, they actually increase the risk of heart disease, stroke, heart attack, above that of men as soon as they hit menopause.
Dr. Carnahan: One of my theories, and this is backed by science, is that all of a sudden women who are no longer menstruating, have a higher accumulation of iron. Iron is very inflammatory, and then with the hormone levels changing after menopause, they’re also at higher risk of clot. These things actually play into all ages of women with iron too much or too little.
Dr. Weitz: Interesting.
Dr. Carnahan: Yeah, those are the main. I guess fasting insulin, fasting glucose, making sure metabolically, those are a few of the others, but that’s most of the ones that are there in my list.
Dr. Weitz: Right. Great. Another one of your sections, maybe I should have written down the page numbers for you.
Dr. Carnahan: I’ll find it. We’ll see how quick I am.
Dr. Weitz: It’s the one on neuroplasticity and how to enhance it. We’re talking about essentially brain health, and how to reduce our risk of these chronic, neurological diseases like Alzheimer’s.
Dr. Carnahan: Yeah. First of all, what is neuroplasticity? Neuroplasticity is how our ability of our brain to rewire. I see all the time, people with Lyme or mold, or chronic HSV infection or things that could long-term cause a decline in cognitive performance. Or for example, someone who has microvascular issues where they’re having little, baby clots in their brain.
All of these things will actually cause damage to the brain, but our brain is so amazing. If we have a little, it’s almost like the heart, you can have a heart attack and your body will rewire around there. The same with the brain. If we have one chemical pathway that’s not working, one neural pathway that’s not working, our body can actually go around. It’s like a rerouted stream.
That’s what happens with neuroplasticity. Now, how do we increase that? Increasing neuroplasticity is very simple and usually pretty fun, so things like games or puzzles are great. Driving a new way to work. Going to a new country where you hear different language, or you try even speaking a different language. Doing things differently, maybe just changing up your routine in your day.
Especially, like I said, driving a new way to work, puzzles, words, word kinds of crossword things. All those new games in The New York Times. Some of my friends do those every single day, and reading. Reading is probably the number one thing that’s related to neuroplasticity.
Dr. Weitz: Yeah. Novel stresses to the brain to cause the brain to improve its various capacities. Okay. The next one is living well in a toxic world by promoting clean air, clean water, clean food, clean mind and a clean body.
Dr. Carnahan: Yeah. I love this because it just happened one day. I don’t know when I said it first, but it’s one of those things that you and I do a lot of integrated functional medicine and principles. There’s lots of complex things like we’re looking at does the patient do better on glutathione or NAC or whatever? We can get lost in the minutia or we can get lost in these expensive IV medications, hepatitis therapies. These things are wonderful or buying a PEMF mat. But the truth is sometimes very simple moves the needle more. I love this because clean air, clean water, clean food. When I say that, most patients are like, “Oh wait, it doesn’t have to be overwhelming or hard or expensive. I can do this.” It gives the patient, the people we’re dealing with, even your listeners, the permission to do something that’s doable and affordable that’s actually going to move the needle.
I really believe this foundation is so crucial because if you can have clean air, so making sure you have air filters or open your windows, or getting air exchanged. I’m a huge fan of a HEPA and a VOC filter. Things like IQAir, Austin Air, AirDoctor, and there’s many more, in your house would be great. But even if you can’t afford an air filter, you can open your windows, you can exchange air.
Now, that would be in the case that you don’t have tons of exhaust right outside your door, or a wildfire or something because certainly sometimes the outdoor air is a lot more contaminated. But clean air is crucial, and we have so many studies that show that nanoparticulate from exhaust and diesel fuels, actually can contribute to autoimmunity and Alzheimer’s, and the many chronic issues that we see. Really, really crucial.
Clean air, clean water, making sure that the sources of water that you get, ideally a whole house reverse osmosis system would be great. But you can literally, right now, I have a pitcher in my fridge from Clearly Filtered, that works. I have a condo, so it’s harder to do their reverse osmosis system system. Someday I may have that, but I don’t right now.
I have a $30 water pitcher in my fridge and it filters out 200 of the top chemicals so that can work, but you want to make sure you’re not drinking tap water, you’re not drinking bottled water. Last summer, this became even more evident as the test from the Colorado water supply where I live came out publicly. It showed that every single water source they tested was contaminated with PFAs.
These are polyfluorinated compounds like Teflon and GORE-TEX, and they’re forever chemicals. In 50 years, they probably will still be the same levels. They’re not going to go away anytime soon, so filtering your water [inaudible 00:39:29].
Dr. Weitz: Yeah. Those are all across the country, either in southern California where we are, they’re really everywhere.
Dr. Carnahan: Yeah, yeah. It’s literally, and again, it’s sad because there’s no way to get rid of them. We can filter them out of our drinking water for sure and our bathing water. But they’re in the water supply and they’re not going anywhere. Because of that clean air, clean water, clean food, this is making choices every day within your [inaudible 00:39:51].
Dr. Weitz: They’re still being added to our water supply. They’re in these flame-retardant chemicals that they use to put out fires, so they’re proliferating even more.
Dr. Carnahan: Yeah. I think this is the secret of our chronic illness and our exponential rise in autoimmunity is the toxic load in our environment is just so increasing quicker than we can possibly handle. Our bodies are designed to detox, and if you give the right tools, we can really get well. But I think what’s happening is we’re all drowning in the bucket of toxicity.
Dr. Weitz: Yeah, it’s crazy. We spray flame-retardant chemicals on our mattress, and it’s like a big deal to try to get a mattress that doesn’t have flame-retardant chemicals in it. It’s insane.
Dr. Carnahan: You’re so right. Even like baby, the outfits they wear and things, clothing. All of it is mandated to have flame retardants because they don’t want the babies to get, but it’s so toxic.
Dr. Weitz: It’s ridiculous. Yeah.
Dr. Carnahan: Yeah. Clean food, this can be as basic as choosing like the dirty dozen on our environmental working group, tells you the top 12 foods that are most contaminated with pesticides every year, so choosing to buy organic for those. Ideally, all organic if you can, locally grown, sustainable, all those kinds of things. Good example is salmon. Farm salmon is one of the most toxic foods you can consume. It has PCBs and mercury. Wild salmon is one of the most healthy foods you can consume. Choosing to pay a little bit more for wild salmon is going to be worth it in the long run.
Dr. Weitz: By the way, here’s a hint. A lot of the restaurants around here and in stores sell wild Scottish salmon. It’s not wild. It’s grown in pens in the ocean, and they’re saying because it’s grown in these big pens that it’s actually wild, but it’s not.
Dr. Carnahan: Yes, I’ve seen that. It’s funny with restaurants too, they love to put wild or they’ve Scottish or whatever. You’re right. The studies that show those pens and those farm salmon, first of all, there’s massive amounts of fish viral diseases, so there’s infections. Second of all, the PCB levels are off the charts so just that alone, if there’s no mercury, is an issue. Really, really sadly, is people think they’re eating healthy. I had a guy the other day just come in and mercury off the charts. I said, “What are you even doing?” He said, “Well, just two years ago I started changing. I wanted to lose weight and for lunches at work, I found this place that had these bowls and they had salmon.” I thought, “I’m eating healthy, so I would have that every single day.” It’s like, “Oh my goodness, how sad.” He’s eating this lettuce and beautiful, but it’s like the source doesn’t matter.
Dr. Weitz: Most salmon at sushi bars is farmed as well.
Dr. Carnahan: Yes, exactly. If you’re eating in restaurants and you’re getting your fish from restaurants, unless you know that restaurateur is an organic sourcing, which is rare, extremely rare, you’re getting not good source.
Dr. Weitz: Very few restaurants serve wild fish.
Dr. Carnahan: Yeah, yeah.
Dr. Weitz: Yeah, that’s too bad. Okay, let’s see. One more, steps to prevent mold growth.
Dr. Carnahan: Okay. It’s interesting because I always, if I suspect mold in a patient from testing or from their history, if I just go out and say, “Do you have mold in your house?” 99% of people will say no because they’re like, “Oh, I don’t see mold.” You have to be creative in how you ask, and this is partially for preventing mold growth too. Things like first, a simple example. Last summer, I’m in a condo so multi-level.
My neighbor above me had a fridge leak that went down into my wall and down into my floor, and I had Chaetomium growing in my kitchen from that leak. I learned from that, and I just was like because it wasn’t my fridge, but because the fridge waterline, I’ve seen so many cases of fridge waterlines leaking from improper installation. I’m like, “Disconnect my line. I can make my own ice cubes. This is not worth it.”
I tell patients who have mold, don’t connect your fridge. It’s not worth that risk of that leaking into the wall. I’ve seen so many problems. Simple thing is just disconnect your fridge waterline, turn it off, make your own ice cubes. It’s so easy. It’s not a big deal. Under your sinks and things, you should have those, you can buy them at Home Depot and Lowe’s.
They’re rubber mats that will protect your wood from if there is an accidental leak, because how many of you out there have had a leak under your sink? I would say 90% of people. That literally can cause enough mold growth to cause an issue. Putting the pads, and they often come with a little water sensor. Under all of my sinks, I have pads to protect from water damage accidental with a water sensor. Things like attics and crawlspaces.
You need to know, literally, I went to Australia a few weeks ago and a building biologist there was one of the best lectures I’d ever heard. She talked about moisture is the problem, not mold. I love that framework because if we think about it as intrusion of moisture, condensation, leakage of windows. Making sure your windows are sealed, making sure your crawlspace is sealed, especially if you pull air.
A lot of houses pull air from the crawlspace. If there’s mold in there, you’re pulling air from a moldy area. So often attics or crawlspaces aren’t properly maintained. They get condensation, they get water damage, they get leaks from hurricanes or roof damage, or the crawlspace isn’t finished. If you have air exchange from either the attic or the crawlspace, you’re pulling air into your system from a moldy environment.
Like I said, windows, condensation, improperly sealed siding. Your foundation, if you’re below grade and your foundation isn’t stable and sealed, a lot of people will get water intrusion through their foundation. Sump pumps or places in your basement that are pulling out water, they’re just sitting water. I’ve looked once in a while for new homes and done some walking through them.
Most of the time, if I’m looking at the homes, the places I find issues are basements, crawlspaces or the sump pumps. These are all just little practical things, but home maintenance and your gutters. If your gutters are full of leaves, you should be 2, 3, 4 times a year cleaning out those gutters. If you’re not doing that, are not hiring someone to do that, then what happens is they get full and that water will leak past the gutters right into the wall of your home. Those are some of the bigger issues, the foundations, the walls of the home, the attics, the crawlspaces, and they really, really affect the mold in the home.
Dr. Weitz: A lot of the newer homes or the newer construction is being designed to make sure the homes are airtight. This is partially to be energy efficient, and that means that if there is moisture, it can’t get out. It’s more likely to create mold inside the walls.
Dr. Carnahan: You’re absolutely right. Two little things here, because this new energy efficiency and solar power and all these things, wonderful for environment, I’m all for it. But you have to understand what it could be doing. The energy efficiency, like you said, is very, very tightly constructed. If there is a difference in the moisture in the home, the humidity in the home versus outside, you’re going to have condensation. If your home’s more humid and just like this building biologist from Australia was saying, if you do a shower, if you breathe out literally all the time, I think she said each person in a house produces 40 liters of vapor a day. Don’t quote me on that because I might have it wrong. But it was such an astronomical number of like, “You’re kidding me.” She goes, “Your college kid’s in there for 30 minutes, the steam’s going up and they don’t install a fan.” You are guaranteed to have mold growth on that particleboard, because it’s just getting wet and damp. You have to have the fans, you have to have them properly installed, and that moisture in the house is actually the issue.
Dr. Weitz: Yeah. Great. Any final thoughts for our listeners and viewers?
Dr. Carnahan: Well, thanks for taking me on the journey through my [inaudible 00:47:23], I really enjoyed talking to you about that.
Dr. Weitz: Thank you for taking me and the other readers on the journey through your book about through your whole life’s journey.
Dr. Carnahan: Yeah. I think the biggest takeaway is I’m not unique. People have read the book like, “Oh my gosh, I can’t believe you’ve been through all that.” The truth is everyone out there has the same potential. When we change, that’s why the believe, act, wait or some way of reframing your story is so powerful. I just tell my story because I’ve learned through the difficulties and the good and how to do that. My takeaway would be, if you’re facing difficulty or disaster, or financial issues or health issues, or a child or a parent who’s sick or all these many things that can go wrong in our lives, first of all, difficulties and suffering are going to happen. When we know that we’re not caught off guard. Like my book title, Unexpected, unexpected things are going to happen.
If we have that frame of like, “How are we going to deal with something when the curveball gets thrown our way?” Instead of being shocked and being like, “Why me?” We change that frame and we say, “Why not me? How can I take this and turn it into something that actually helps me transform into a better person, a better human, and all those things?” I think when we have that framework, it’s still hard. It’s still suffering. It can still be so painful, and I don’t deny any of that. But when we have a framework, we can literally transform suffering into something that turns out to be a really beautiful thing.
Dr. Weitz: Do you want to provide contacts for your office or your book or both?
Dr. Carnahan: Oh, thank you. My regular website is just my name, JillCarnahan.com. Everything you ever want to know about mold and everything, it’s articles and blogs. It’s all free. I have a podcast you can get on iTunes, YouTube, Stitcher, whatever. If you want more about the book, go to readunexpected.com. Lots of free resources there as well.
Dr. Weitz: That’s great. Thank you so much, Jill.
Dr. Carnahan: You are so welcome.
Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify, and give us a five-star ratings and review. That way, more people will discover the Rational Wellness Podcast. I wanted to let everybody know that I do have some openings for new patients, so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions. Or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. That usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing. We’re going to look at a lot more details to get a better picture of your overall health from a preventative, functional medicine perspective. If you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111. We can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.
