 Welcome to Ancestral Health Today. Evolutionary insights into modern health. Welcome everyone to today's episode of Ancestral Health Today. Thank you for being with us. I am your host, Isabel Burnett. And today I am doing a solo episode. I am a board certified health coach and also an autoimmune protocol certified coach. I'm doing an episode today because I wanted to speak about the intersection of chronic conditions and health optimization within the framework of Ancestral Health and Evolutionary Medicine. First, I'm going to go a little bit into my history because this has a very personal framework for me. And I will put in the show notes when you can skip that history if you want to go straight into the actual content. So a little bit about myself. I was born in the Dominican Republic and I got shingles at the age of seven. And subsequently developed a condition called ME-CFS, which is myelgic, and so follow my lightest in chronic fatigue syndrome, which at that time was undiagnosed. But looking back, I had all of the symptoms. My diagnosis came way, way later at the age of 25, somewhere around there. So how do I know that I had this condition growing up? Well, I knew that I wasn't the same as my peer. I didn't have the same stamina. I didn't have the same amount of energy. Every time I tried to do something that my peers would do, I would pay for it for days, weeks, and sometimes even months, whether that was playing basketball at school or going for a long walk to visit a friend and just doing things that everybody would do on a normal basis. I also experienced pain as a child, although the pain was not as significant at this stage as the fatigue was. There were food intolerances. The only pain that was consistent was leg pain. The leg pain would also come as a consequence of doing exertion, such as a long walk or trying to ride the bike or things of that nature. And I would have to be in bed for hours with the leg pain. I would be given medication, massage, and other interventions in order to relieve the pain, which was excruciating. But fortunately, that wasn't an everyday thing. It was occasionally. So fast forward to the age of 12. At the age of 12, I got measles and I was very sick for about a month. I was hospitalized. And then when I came home from the hospital, there was this one time when I was on my bed and my voice would just simply not come out. And I needed water. I was starting to feel dizzy, but I got up and fell down the stairs. And after that is when the pain that was a constant, or that has been a constant in my life, really started. There was a lot of neck pain. There was a lot of back pain, hips, you name it, muscle soreness, everything, which at the age of 12 is very, very difficult to understand. I was taken to a lot of doctors, and there was really no explanation for what I was going through. And I was just given comfort measures, medication from time to time, and things of that nature. I grew up with my grandmother, who was very knowledgeable about herbal medicine and supplementation. So she did everything that she could in order to alleviate that in other ways, also provide comfort and hopefully fill some nutritional gaps. It's worth saying that eating junk food and things of that nature was not a factor. It was not an issue for me growing up. The diet that we had growing up was extremely healthy and there were still food intolerances that happened during this time, although not as severe as they went on to be later on. Then something very interesting that's very relevant to the story that happened after I had the measles and everything got worse was that I would get throat infections from time to time that were severe and also very painful. We had a local doctor who would give me rosephan injections and I almost looked forward to getting the tonsillitis because I knew that after getting the antibiotics I would feel much better than my normal levels for weeks and sometimes for months. Then as time went by, the need for those antibiotics decreased and by the time I went to college it wasn't as significant as it had been for the past four years. I wanted to go to college to be a doctor but every time I went to visit a cadaver lab I would pass out or nearly pass out and I didn't know why. Now I understand why and how that is part of my condition and the activity of mast cells and so forth and so on but back then I just thought that I just wasn't built to be a doctor because if I couldn't even go into the cadaver lab then I wouldn't be able to do the required work in a hospital. I do have hyperosmia which is more severe the worst I feel and that also played a significant part. I went into engineering instead and getting through college was extremely difficult but I had a really great support system between my family and my friends in school who would carry me down from the third floor when my leg pain flare up would give me massages and kind of set me straight in terms of my structure in between classes. So that was what allowed me to really get through that. After that I got married and had my first child and my pregnancy was incredibly difficult. I had to spend it in bed the majority of the time. I had nausea and vomiting up until the day I gave birth and again mystery as to why a pregnancy is so difficult but also not a big of a mystery in terms of how I had been prior to those four years when I had some improvement. So fast forward and my husband is from the United States he grew up in Rhode Island so after my son was about a year old we moved to the US and I had somewhat gone back to my pre-pregnancy baseline in terms of how I was feeling. So definitely excessive fatigue compared to healthy people pain and whatnot but not to a level where I couldn't function but upon moving to the US things deteriorated rather quickly. I was able to have a couple of months where that wasn't the case but after that I had multiple infections and it got to a level where going to work I had to pull over several times in a random parking lot and take five to ten minute naps in order to be able to continue. I was later diagnosed with narcolepsy which is another potentially post-infectious condition that affects quality of life significantly. So things deteriorated for me. I felt like hell all the time there is really no other explanation for that and after that I went into years of a roller coaster of feeling absolutely terrible, not being able to work and then being home, being able to do a lot of things to improve myself including resting and then being able to go back to work and try to do it all over again and that roller coaster lasted for a lot of years and of course it impacted severely my ability to mother my children, my relationships everything that we have to do in life is effective by chronic illness. I was diagnosed with ME-CFS in around 1998 I was very fortunate to find a doctor that understood this condition and had some knowledge about it and was empathetic didn't dismiss my symptoms because when you look at me now or ever I don't look sick there's no indication that anything is going on in my body my levels of fatigue are not shown on my face and fatigue in itself is a very inadequate word to describe what we go through so I was diagnosed but that diagnosis at that time really didn't mean much because what we were told is there's really nothing that we can do we can give you pain medication, muscle relaxers and again comfort measures which I had bad reactions to a lot of the things that I tried but that's what set me on the road of really trying to understand and more than understand experiment with the things that I could do in order to get at least some relief that wasn't necessarily medication related I was successful at times for short periods but there were pieces of this puzzle that were missing that I didn't yet understand that have had a big impact on what I'm able to do my level of function and therefore my quality of life so fast forward to 2015 I had had great improvement in 2010 and then I fell and I started having headaches that were constant and when I mean constant I mean constant I don't mean that they are very frequent I mean that they are constant do not go away at times they intensified and it felt like more like a migraine where you can't stand light and have to be in bed and other times it was a lower level of pain where you can do certain things but it's definitely a big task to get anything done when you have that lower level headache that is in the back of my head so at this point I was able to be diagnosed with Chiari malformation cranioservical instability and hypermobile EDS so the cranioservical instability stems from the hypermobility and now we understand that there's a big overlap with ME-CFS and hypermobility and now we also understand that we have that overlap with long COVID and hypermobility in fact there's an article that was published recently that explained that people with hypermobility are at a higher risk of getting long COVID so with those diagnosis in hand and also after that I was when I was finally diagnosed with narcolepsy I was able to put the pieces of the puzzle together and explore more adequate treatments as well as better understand myself what I could do to sustain improvements that I had but also what brought those improvements down and why so why did I just give you all that history I'm giving you that history because my story is unfortunately not unique and the development of these conditions can happen at any age it happened unfortunately very early for me but it's very common for it to happen in your 20s in your 30s and there doesn't seem to be a reason that is obvious to us so in terms of who can develop these conditions we see people who are formerly athletes we see people who are generally very healthy we see people who have other various conditions so the mix is really really big and in the last four years we have seen an explosion of this with long COVID patients with long COVID 50% of them meet the criteria for ME CFS and others who don't meet the criteria have some of those elements and other issues that are also complex and chronic that affect the quality of life and affect their function and we need to really understand this and the intersection of complex chronic illnesses and health optimization in the context of ancestral health and evolutionary medicine so we can better communicate with each other so we can better serve people if we are in a coaching position and that we can also understand what risk we are at whether we have an incredible level of health or we have other factors already going into it so with long COVID we all know that the last four years have affected people not just with the acute infection which many people have a very mild level of acute infection that's why a lot of people refer to it as just another flu but the just another flu in terms of the acute infection is an accurate picture but in terms of the long term consequences is incredibly inadequate and the reason why it is inadequate is because people go on to develop long COVID people go on to lose their function, lose their jobs because of this and it is something that needs to be acknowledged, understood and also addressed what happens with long COVID is that one it is the risk goes up with each infection that you have and I will put the references in the show notes for this as well and people with hypermobility which may not be diagnosed because it may not be a symptomatic hypermobility people are also at higher risk of developing long COVID and then there's another series of factors that are that have an effect on the development of long COVID these are not the only complex conditions that require a lot of nuance when discussing recovery and interventions and treatment there are others as well but for the purpose of this I'll continue to focus on this too where do we intersect there's, anecdotically of course there is a lot of discussion in the ancestral health movement about lifestyle in general but a big focus on diet and exercise which stems from the fact that we have or we live rather in an era of over-processed food and that is very different than how our ancestors whether immediate ancestors at this point or ancestors long time ago lived their lives food was not the commodity that it is considered today food was nourishment food was a way of sharing our lives everyday in a lot of cases food procurement was part of the lifestyle of our ancestors and in that procurement you have built in movement and what we call exercise today which is a prescriptive amount of movement for a period of time and the micro level encompasses so much more than that and happens at the micro and the micro level but we know that these are things that our ancestors enjoyed and that has decreased more and more over time and with that decrease we have seen an increase in chronic conditions and we have new ones discussions about how those things intersect how they are affected how it affects us and what are the differences in our approaches when we come to this from a an already modern world where we are at we all live in the modern world and we all have to deal with the consequences that this has brought into our health and the modifications in our lifestyle that occur as a result of that but we all need to deal with that in a very different way based on what we have already taken place in our bodies our genetics, our predispositions and very importantly the resources that we have to work with. We know that sleep is incredibly important yet the disturbances in sleep that are not just repaired or improved sleep hygiene are a big factor in chronic illnesses and in infection associated chronic conditions like long COVID and ME-CFS they are a big point of or a big source rather of further issues and deterioration but the way to correct those and the way to improve that doesn't come from just sleep hygiene and again the conversation is incredibly nuanced and that's what we we need to all understand whether we are trying to improve our own outcomes and continue to get frustrated that we're not seeing the results that we want to see even though we are putting in the work or whether you are in a coach or even a peer capacity and you're having these discussions with someone else who is having these struggles and it's helpful to have the ability to understand that it's not all the same so as a healthy individual you may come to the world of ancestral health and understanding about the impact of the modern world you may be someone who is getting into your 40s or you're working a lot of hours you're not sleeping well you're not eating the best that you know you can and you're starting to have some consequences maybe some aches and pains maybe again you're sleeping for hours or you're having difficulty falling asleep because the stress that you're going through or maybe you're somebody who has gained some weight and you want to be able to have more energy and be able to do the things that you used to do in the past so those are all very valid reasons why people discover ancestral health and start to understand that we have lost the connection with our food, with nature with each other the relationship with community that used to exist because we live in very separate very individualistic units and it is a big burden to have to do everything on your own there's limited time and there's limited energy even for the healthiest of us so people come with that understanding and try to implement the available lifestyle changes that are used to align more with the way that our ancestors used to live life so whether that is improving your exercise by going hiking or by even doing runs or long walks or training or things of that nature that utilize the muscles and mimic the activities that our ancestors used to do because they needed to do it whether that was for food procurement or that was to move from one landscape to another or to build their own houses all of those things were built into the fabric of society in the small societies that used to exist and that's something that we don't have anymore that is readily available we don't have to construct it we have to make it happen in order to as we say have our environment better match our biological needs we need sleep and we have lights going on 24 hours a day which affect the signals that our body gets and affect our circadian rhythm we need to take care of maybe aging parents or children and that takes a lot of time and a lot of effort and a lot of energy and it draws away from the things that we may want to do in order to take care of our own bodies so when we come to ancestral health from that perspective we need to understand how we can make modifications to better align our lifestyles with the things that we need biologically the things that our ancestors were able to do naturally and with that the majority of us have seen an improvement from that perspective the perception is that all that it takes is some discipline and some adjustments and some integration of certain things in order to be able to achieve that lifestyle and therefore achieve that outcome which is what we all want better health and that is that one, not everybody has access to the same resources not everybody is able to buy a chili pad and be able to have colder temperatures at night and even if you are even if you have those resources a lot of the times you may live with a partner or other family members and you may be able to do some of the things that you want to do whether it is in the preparation of the food or the going hiking or things of that nature so there's a lot of points of friction in this transition in wanting to adopt an ancestral lifestyle and be able to improve your health but the friction is greater and greater for certain people because of different factors whether that is resources or as we are talking about in this intersection that is due to somebody having a complex chronic illness where the factors are not just going to be having discipline and being able to modify your environment in a certain way there are a lot of complex issues that go into that have to be taken into account and that we also have to understand that even with the integration of all of the modifications and the lifestyle changes as one possibly can to an ancestrally inspired lifestyle that is still not a solution for a lot of people and there's this perspective that if you are not getting better is because you're not doing enough which is a very inaccurate or very harmful perspective and one that further separates us from each other that further contributes to a divide that exists that doesn't allow for a very important aspect of ancestral health and that is community that is being able to rely on each other being able to share in each other's burdens and triumphs and being able to coexist together in a manner that is beneficial for everyone involved so what makes the difference between somebody who is coming to the ancestral health world and using this framework to improve their health and optimize it but may not have any quote-unquote major issues affecting them at the moment and someone who is coming into the ancestral health world looking at the factors that compose this framework and how our ancestor live and want to also be able to implement what we have to offer in order to improve their condition but they come from a complex chronic condition where no amount of discipline necessarily is going to have a big impact into the disease development in terms of the level of function etc. The difference is big and we need to acknowledge that so I'll start with the factors that affect ME-CFS and as I said before now long COVID and 50% of long COVID suffers meet the criteria for ME-CFS and the other factors of ME-CFS is post-exertional malaise. If you hear me talking elsewhere you'll understand that I have big qualms with a lot of the terminology that is used scientifically and the naming conventions that are used when explaining the symptoms end up being very inadequate and end up being misinterpreted by people who are outside of the scientific community so the public at large ends up not understanding the reality of the symptoms and the lack of function that these conditions bring so for example if you have a long day at work you exercise in a way that you haven't exercised before you had too much activity with the kids over the weekend and then you have to go to work on Monday and you have to go to work on Monday and you have to go to work on Monday and you have to go to work on Monday and you have to go to work on Monday and you're fatigued. Everybody experiences that. The level of fatigue that is experienced in ME-CFS and it's shared with some other conditions as well but this is a primary indicator is it's not fatigue where you can push through and rest a little bit and overcome it. It is a level of fatigue that feels like your muscles are emptied it feels like you have a battery inside of you and it doesn't matter how long you charge it it just does not charge. It is a level of fatigue that keeps you sometimes going to the bathroom and if you do you pay for it by that getting even worse and by exacerbating other symptoms which is what I was going to say before post-exertional malaise. Post-exertional malaise is also not very descriptive because the word malaise is something that you're starting to get a cold when you're starting to get the flu when you have even some indigestion you feel a certain level of malaise but the post-exertional malaise that is felt in these complex conditions is very disproportionate to the amount of exertion that happened. There is a spectrum from mild to very severe and again the word mild is inappropriate because even though the function of the person may be close to or equal to that of a healthy person that level of function does not exist without an incredible amount of symptoms which are not always coupled so the complexity of the conditions and the complexity of the naming conventions and how that does not match the reality of the conditions are things that are generally not well known and not understood so there's been stigma associated with ME-CFS for a long time and now with long COVID stigma very often shows itself as not being believed or people simply thinking that you're not trying hard enough that it must be nice to be able to stay in bed all day or not to leave your house and things of that nature which if you think about it deeply is just preposterous because who wants to lose their income and if you understand how difficult it is to get disability and how low those wages are not wages but that income is you understand that really choice is not a factor in here but I digress let's go back to post-exertional malays post-exertional malays is the symptoms and lack of function the consequences that happen after a particular activity and those the consequences are very disproportionate to the activity and that those consequences depend on the level of severity that the person is at so someone who is severe who is bed bound or house bound is going to have those consequences from activities that are daily activities of life so go into the bathroom go into the kitchen brush in their teeth having to speak to someone else for more than a few minutes and so forth someone who is moderate may see those consequences with going to doctor's appointment someone may be able to work part time but the rest of the time they have to spend it recuperating from doing that work because of the post-exertional malays and someone who is at the mild end of the range of having to have a full-time job and have many of the activities that or the functional level that other people do have but again with an incredible amount of symptoms attached to that and also knowing that at any moment that can change either because of an infection or because of the scope of energy that your body is able to generate and the difficult part is that that level of energy is also variable within the same person for reasons that we don't we're not always aware of and that we can not always detect or predict so for somebody with a chronic condition that has a higher level of function go in let's say for a mile walk it's within their energy envelope and they do that whether it is consistent or occasionally but that energy envelope can change for multiple factors for multiple reasons and all of a sudden someone's mile walk has detrimental effects and causes post exertional malays because that energy envelope narrowed and it could be that that was spent in other activities and we are not realizing that these are utilizing that energy or it could simply be because someone had a recent infection that set them back or something that we need to have new ones conversations and acknowledge too is maybe because a vaccine you know set somebody back which happens and we do see reactions from vaccines that are detrimental and either have the onset of these conditions or have made people with these conditions worse we've seen the opposite too which is really paradoxical but we do know that the effect on the immune system whether it is from a virus or the vaccine is the effect in the disease process so while it is poorly understood it is not unacknowledged that this also happens and that we need to be able to have the conversations between what are the risks and what are the benefits and who is at more risk than those effects from a vaccine rather than you know from the virus itself we do see it we do see the development of long COVID at much greater rates resulting from the virus itself than the vaccine but we also see it in the vaccine and that has been coined as long backs and you know it is something we need to be able to discuss in order to be able to research it and someone doesn't get labeled as anti-vax because of you know because they are acknowledging this fact and people are able to have these discussions and express this and acknowledge the benefits of the vaccines while also acknowledging the risks of it but I'm digressing from the topic at hand what I wanted to discuss in this portion was we went into the approach from a person who comes to ancestor health and modifying and aligning that lifestyle with our ancestors or as close to it as we do in the modern world right but what is the difference when somebody already has the process of a chronic and complex chronic conditions the premise is that we can all benefit from having a lifestyle that is biologically compatible with our needs right that we are not affecting our circadian rhythm by being blasted by lights all day that we are able to maintain the tensile strength of our connective tissue with movement that we are able to do the things that maintain that health based on where we are at but that approach is incredibly different when we are dealing with complex chronic illnesses and the best example is post-exertional malaise so we know from data that exercise is beneficial for many aspects of health but if you have a condition where exercise is detrimental we need to take that into account how is it detrimental if you exceed that energy envelope which is very small for many many people even those with high function in terms of exercise then you are setting back the function of that person which is very harmful and in many instances have landed people in worse permanent or long term condition than they were prior to exercising so in long COVID for example anecdotally there are so many athletes and so many people who value exercise the acute infection and I didn't feel well for months afterwards it was difficult to do what I needed to do but my understanding is that exercise is beneficial so I wanted to continue to do it and one day I went for a run or I was doing a workout and by the time I came home I felt like a truck had run over me and I have never been the same and I have worsened to the point where I can barely leave my house the amount of stories like that are incredible and there's been a long long-standing history of damage for people with ME-CFS where practitioners and health coaches and other people are telling us you just need to eat right and exercise and if you do that consistently you will be able to get better and you are not able to do this things because you're deconditioned and there is so much literature to the contrary and there is so much from patients if you listen to the stories you will realize that not wanting to do this things is not at all a factor and I would say all of us because we want to be able to live our lives to work to be productive to be able to enjoy outdoors to exercise and it's not a matter of wanting to but a matter of not being able to sleep disturbances that happened in these conditions are very prevalent whether it is a diagnosed sleep disorder like narcolepsy or severe insomnia these are factors that are not able to be corrected with sleep hygiene so there are other interventions and other things that need to be addressed first or at the same time in order to have any measured improvement when it comes to sleep and then sleep itself or the lack of quality of sleep and other symptoms so it becomes a vicious cycle and then we have food right, eat right, ancestral diets we know that the quality of our food and the type of food that we eat has an impact on our health but when you have a complex condition with food intolerances and sometimes those are very severe and those modifications are not possible or need to be done in a very careful, very strategic very layered approach in order to be able to work on the intolerances the autoimmune reactions the dysbiosis in the microbiome while being able to to hopefully reintroduce foods that we know are beneficial so the approach is a lot more complex it's not that we don't all have the same biological needs right, we all are humans and we are potentially benefiting from instituting what we call the basics right, we all need good nutrition we all need movement we all need good sleep we all need community all of those things that are the pillars of ancestral health are also needed for everybody whether you have a complex chronic illness or not but in the process of a diseased body and where there is metabolic dysfunction not just at a regulation of calories in, calories out level but a metabolic at the cellular level dysfunction where there is lack of ability to convert those nutrients there are so many factors that affect those pathways that are not the same in one chronic ill person to another which is why sometimes you make a modification or you take something and it has an effect but many other times it doesn't so we need to let go of the dogma that all medication is harmful because we do live in the modern world and there are many things that have had a great impact in the quality of life and the ability to modify disease so it is not an either or approach it is a both understanding that the complexity of these conditions are not just a do not get modified or do not see benefit from the simplistic approach of just do this or just do that or if you do this and that and don't see any results it is because you're not doing it hard enough or well enough or sufficiently enough we need to understand that although we do benefit in the terms of we all have the same biological needs the approach to being able to implement these things and the level of quote-unquote relief that they may have with people for complex chronic illnesses are not immediate many times are not sufficient many times and are detrimental in many instances because other parts of the body are not functioning in a way that can withstand those introductions those modifications and those interventions so if we understand each other if we understand what we're coming from we can not only have better communication and we can approach our individual situations with new ones but more importantly with compassion then we can at least have the part of ancestral health that is incredibly important and that is going to get us to to the next level which is community and that is what's being fragmented and it's being dissolved by the way of dogma and by the way of lack of understanding of the different situations that we each face I encourage you to research more if you're a healthy person about how they feel or how they function that you understand that there is a deeper more complex situation and I encourage you to understand if somebody is telling you that they have made these modifications and it hasn't made a difference in how they feel or how they function in a more complex situation and on why that happens we need to be able to come together and we need to be able to know that although there are a lot of benefits to this lifestyle there are also a lot of challenges for a lot of people and by doing so we can build community, we can help each other, we can have productive conversations and we can help each other thrive Thanks for joining us on this episode of Ancestral Health Today We hope you enjoyed our discussion on how evolutionary insights can inform modern health practices Be sure to subscribe to our podcast to catch future episodes