A Broader Definition of Health Through Ancestral Learning, Diet and Better Understanding of the Human Body

Ticktective Podcast Transcript

 

In this podcast episode, host Lia Gaertner interviews Chris Kresser, a renowned expert in functional medicine and ancestral health. Kresser shares his personal health journey, which involved struggling with chronic illness and eventually finding his way to functional medicine. He discusses the importance of zooming in and zooming out in managing chronic illness, as well as the broader definition of health as human flourishing. Kresser also talks about his approach to diet, which involves giving himself permission to eat a variety of foods while prioritizing those that make him feel good. He emphasizes the importance of the ecosystem in managing chronic illness, focusing on factors such as gut health, lifestyle, stress management, and finding joy and fulfillment in life. Kresser concludes by offering advice to individuals with Lyme disease and chronic illness, highlighting the significance of addressing the entire ecosystem rather than solely focusing on the pathogen.

 

Lia Gaertner: Welcome to the Ticktective podcast and video series, a program of the Bay Area Lyme Foundation, where our mission is to make Lyme disease easy to diagnose and simple to cure. I’m your host, Lia Gaertner, director of Education and outreach. Lyme disease is the most common vector-borne disease in the USA and is a global issue. This show includes interviews with the researchers we fund, as well as other interesting people in the Lyme scientific community. We are a nonprofit foundation based in Silicon Valley. Thanks to a generous grant that covers all of our overhead, 100% of all donations go directly to support, research and prevention programs. You can find out more or donate@bayarealyme.org.

Lia Gaertner: Thank you, Chris Kresser, for joining me on the Ticktective™ video and podcast series.

Chris Kresser: Thanks for having me, Lia. It’s a pleasure.

Lia Gaertner: Chris Kresser is a renowned expert leading clinician and top educator in the fields of functional medicine and ancestral health. He is the author of the New York Times bestselling book, The Paleo Cure, as well as the book Unconventional Medicine. Chris is the co-founder and educational director of the California Center for Functional Medicine and the founder of the Kresser Institute. Chris regularly shares his evidence-based insights from trusted sources and world-renowned health practitioners and coaches through his blogs, webcast interviews, and his own podcast, Revolution Health Radio. So, Chris, during your decade-long struggle with chronic illness, you learned firsthand where healthcare mattered most and where it came up short. After seeking the help of more than 30 healthcare practitioners and ultimately having to learn and implement behavior changes on your own with limited support, you emerged with your health and a vision and drive for changing and improving the practice and education of functional medicine. Can you please tell us about your health journey?

Chris Kresser: I’ll be brief because it was long and arduous, but I took off to travel around the world for a couple of years in my early twenties, and I was doing a lot of surfing. I was in a little village on Sumbawa, which is an island in Indonesia, and a bunch of the people there who were surfing at that break got exposed to a waterborne pathogen, actually several pathogens. There was a stagnant pool of water near the river mouth there, and locals dug a trench to drain that pool into the river mouth. And all of that water where cows had been defecating went out into the surf break, which are often located right at the river mouth. And unbeknownst to a lot of us who were there surfing, we were exposed to it and I would say 70-80% of the people there got quite sick.

I took some antibiotics that I had in my medical kit and the acute phase of it passed relatively quickly. But as I continued to travel after that, I went to the Maldives and was there for a few months and I was in South Africa and Reunion Island, Mauritius, and Madagascar. After about six, seven months, I started feeling really sick and it became clear to me that it wasn’t something that was just temporary that was going to go away. So, I made my way back to Australia and that was where I started to seek medical care. And then when I didn’t make much progress, I decided to go back home to the US and although most of the doctors and other practitioners I saw meant very well and did their best to help me, it was pretty clear that the medical system was not set up to deal with those kinds of problems.

I think conventional medicine’s phenomenal if you break your leg or get in a car accident, but it’s not very good at dealing with complex chronic illnesses. I just kind of struggled for the first few years trying to even get an idea of what I was dealing with and how to approach it. And then once I figured out that it was multiple parasite infections as well as AIC dysentery that I had had, there was the effort of treating those infections and then dealing with the after-effects of the treatment of those infections. And that went on for a long time. And during the course of that, I experimented with a lot of different dietary approaches from being macrobiotic vegan to eating raw food to eventually stumbling upon what we would now call a paleo diet. But at that time, that was not a term that was in use really except for a small handful of people that I didn’t know or wasn’t exposed to. And that was what worked best for me. And then I was also doing a whole bunch of other stuff throughout that whole period to try to restore my energy levels and rebuild resilience and find my way through. And as I did that at the time that this all happened, I had no intention of becoming a healthcare practitioner. I wasn’t the kid who, when you asked me what I wanted to be when I grew up, I said, “doctor.” That wasn’t on my list.

“I think conventional medicine’s phenomenal if you break your leg or get in a car accident, but it’s not very good at dealing with complex chronic illnesses.”

—Chris Kresser

But over time, as I started to recover and as I got deeper into my own research into all of the things that did help me recover, people started to ask me questions. At some point I realized that even though that wasn’t necessarily the career choice that I would’ve made five years ago or 10 years ago, that it was in some way choosing me and that I felt like I could translate—or transmute—some of my own experiences in a way that could help other people. It was kind of a slow burn, but I then over time got very passionate about that path. One thing led to another, and I started a functional medicine practice. After a few years of doing that, I realized that there just weren’t enough of us. There was such a high demand and there just weren’t enough providers to satisfy that demand.

I started a practitioner training program in functional medicine —a 12 month program—did that for a few years and then realized that although functional medicine is a key part of the puzzle, diet, lifestyle and behavior change is extremely important. And for a lot of people, they may not even necessarily need functional medicine. They just need that to shift their diet, lifestyle, and behavior. And there’ll never be enough doctors or medical providers to do that with people. And arguably they’re not the best providers to do that anyways because it’s better to reserve them for “doctory” type of stuff like ordering labs and interpreting them and prescribing treatment, et cetera. And they’re not really trained in behavior change. So that’s when I got really interested in coaching as a profession and as a way of addressing the healthcare epidemic that we are facing right now. We launched a health coach training program in 2018. We just enrolled our sixth cohort for that. So that’s been my kind of general trajectory over the past 15, 20 years.

Lia Gaertner: It’s funny because you and I were at UC Berkeley at the same time. We didn’t know each other, but I also traveled to South America and Polynesia, and I ended up with parasites and I ended up going through a health journey. And then I went to grad school at Cornell, and I got Lyme disease and Babesia. And so I also was thrown onto this path. I was already interested in ethnobotany, which is why I started those journeys, but medicine was part of what I was interested in, but I then thought, “Oh, I should write a book on gluten and Lyme and all this stuff” a decade ago, more than two decades ago, but I didn’t do it. And you did. And the thing that I find remarkable about you is not only do you get it done, but you research so thoroughly so well. And I hold a pretty high bar for the people that I’m willing to listen to in terms of how they’re going to summarize the medical information out there and how they’re going to translate research. And you continuously impress me with your perceptive and critical thinking that you apply to some pretty rigorous scientific studies and that you can really have a big picture view of things that very few people take the time and energy to formulate because it takes so much research and so many studies that you must be reading to come up with your ideas. What do you think gives you that special gift that many of us really admire?

Chris Kresser: Well, thank you for that. I appreciate those kind words. I don’t know, my parents always used to say I was like a dog with a bone growing up, and they even had a nickname for me, the Hound of Baskerville, I guess, which wasn’t meant to be flattering. So, I think that trait can cut both ways. When I get interested in something, I can be a little bit obsessed and my wife Ellan can confirm this, so I’m—for better and for worse—the type of person that just enjoys doing really deep dives into things that I get interested in. And I’ve always been that way for as long as I can remember. I don’t know if I can take any credit for it. And I have, again, for whatever reason, an ability to process and synthesize information quickly. I can read, I generally read three-four books a week and also lots and lots of studies.

And I think that’s a capacity that I’ve intentionally cultivated over time, but that also maybe came fairly naturally to me as well. Then I think the other thing is that I’ve always had a lot of different interests, and I’ve always given myself permission to pursue those even if I didn’t know how they were going to relate to one another. I think that’s helpful in allowing me to make connections that might be otherwise difficult to make. And I think our educational system doesn’t emphasize that enough. It has gotten really narrow and specialized, and if someone goes into a really specialized field of study that tends to be all that they are exposed to in school. I had the benefit of what I would call a true liberal arts education. And I think that has really supported me in being able to make those connections and do that kind of synthesis. But it mostly comes from my own interest and having had some really great mentors and people who encourage me to follow them.

Lia Gaertner: So, one of the things that I also share with you and have since my days at Berkeley is an interest in evolutionary health and ancestral health. I used to always just say, how would your ancestors be living? How would they be eating? Then you became actively involved with ancestral health, and I was wondering if you could talk to our listeners and viewers about that.

Chris Kresser: To me, it’s just a no-brainer. I am always surprised when people push back against the concept because it’s almost kind of as self-evident to me as, “Hey, the sky is blue, and we breathe oxygen and we need it to survive.” If you look at evolutionary biology, there’s really no controversy that all organisms are adapted to survive and thrive in a particular environment. If you change the environment quickly, then that particular organism is going to struggle to adapt fast enough to thrive in that new environment. So a simple example would be a type of bacteria that lives deep in the ocean near hydrothermal vents and has adapted survival mechanisms to be able to live in that environment. And then if you take that bacteria and put it in a shallow tide pool, things are not going to go well. That’s a fundamental concept in biology, and it’s not controversial at all.

Yet when we apply that same thinking to human beings, it all of a sudden somehow becomes controversial. I mean, the reality is that human beings evolve. For the vast majority of our evolutionary history in a particular environment, we lived outdoors. We were exposed to sunlight, we ate primarily meat, fish, nuts and seeds, wild fruits and vegetables and some starchy tubers. We were active most of the day for a lot of the day because we had to be in order to gather food or hunt food or build shelter or fight or whatever it was; we lived in sync with the natural rhythms of light and dark. When it got dark, we didn’t flip on the lights and pull out our iPads. We were maybe around a fire for a little bit. And we went to bed shortly thereafter, and we woke up when it got light, and we lived in tribal tight-knit groups with maybe no more than a hundred to 150 people.

That was essentially the story of humanity and our hominid ancestors for two to two and a half million years. If you consider human history or hominid history is a football field, you could start walking in one end of that football field and go all the way, even in the end zone, you go all the way to the last half yard on the other end of the football field, and that entire time would be humans and hominids living in the paleolithic kind of circumstances. And it’s only in the last half yard that we developed agriculture, and it’s only in the last few inches that the industrial revolution occurred. It’s only really in the last few centimeters that our modern life as we know it now, with all the processed and refined food and smartphones and social media and all of the pesticides and herbicides and toxins and everything that we’re exposed to now, which we consider to be normal, is just a tiny, tiny blip in human evolutionary history. So, I think it makes sense to start with the hypothesis that there is a mismatch between what our biology and our genes evolved for and then the modern environment that we’re living in now. And it may not be as extreme as the example I used of the geothermal bacteria that gets moved to the tide pool, but it’s that to some degree, and our health has really suffered from that—both our physical health and also our mental emotional psychological health as well.

“There is a mismatch between what our biology and our genes evolved for and the modern environment that we’re living in.”

—Chris Kresser

Lia Gaertner: How would you describe the broader definition of health?

Chris Kresser: I think over time that’s changed for me. Earlier on, in my own personal journey of recovering my health, my fundamental burning desire was to be symptom-free. It was to get back to a previous experience of health or idea of health that I was still holding onto, which was being free of disease and free of symptoms and free of pain. That was my concept of health over time, both in terms of my own experience and then also having now worked with thousands of patients and having trained hundreds of doctors who in turn have worked with hundreds of thousands of patients. The way I think about health has evolved. It’s not that I don’t think that aiming to be symptom-free or pain-free or disease-free is a worthy goal. And it’s not that I don’t think that those could be considered aspects of health, but I think that health is more than just the absence of disease or symptoms and pain.

We really have to think about it in a broader context of maybe what we might call human flourishing. The Greeks use this term eudemonia, which can be roughly translated into human flourishing or living a good life is a simpler way of putting it, and it could be possible to flourish and live a good life, even when you still have pain and symptoms and even if you have an incurable disease. On the flip side, it’s possible to be profoundly unhealthy in many ways, even if you have no physical symptoms or no sign of disease. And we probably all know people who are at both ends of that spectrum, people who have a chronic illness, maybe even a very serious chronic illness, and they’re constantly struggling with pain and symptoms and yet might be some of the most joyful, loving, kind, productive people that we know who just really kind of embody the notion of health. And then on the other hand, you might have someone who is functioning at a very high level physically, but they’re kind of a wreck in every other part of their life. The word health does not come to mind when you think of them, even though they’re physically in really great shape. I’ve become more and more interested in this broader definition of health and what health is and how we define it and how we can work toward it no matter what the circumstances of our lives are.

Lia Gaertner: I know that you have talked about zooming in and zooming out, and I’m wondering for someone who’s suffering from a chronic illness, how you use zooming in and zooming out in your life.

Chris Kresser: I think it’s a critical concept for anybody who’s experiencing anything chronic—not just chronic illness—but chronic pain, chronic stress, for example. I think of someone like a caregiver for an Alzheimer’s patient. We know that’s one of the most stressful experiences that you can have any long-term challenge that you’re facing. So, this concept of zooming in and zooming out refers to the ebb and flow that I think needs to happen in terms of our efforts to deal directly with those symptoms, whether they’re pain or illness. As a personal example, I was dealing with pretty intense symptoms for probably a decade, and there were periods of time during that decade where I was intensely focused on trying to resolve the symptoms directly. For example, I was doing a new dietary approach, or I was taking a new supplement regimen or taking medication, or I was trying some new treatment that I was working on with a doctor, or I was spending a lot of time researching something that I hoped might give me relief or pursuing a new avenue of investigation.

And that’s zooming in. So, that’s really narrowly focusing my attention on things that I imagine will have a direct impact on the pain and the symptoms in the way that we typically understand that meaning. So I take this supplement, it has this immediate effect. It works based on this mechanism, but what I found is that if I stayed zoomed in like that for too long, I would become exhausted and depressed and even helpless and hopeless, especially if I wasn’t making the progress that I wanted to make because the quality of that experience is not really that great and it’s not sustainable. It can amount to a lot of time on the internet researching stuff. It can amount to a kind of white knuckling and holding on tight and regimented type of life where you’re following a very strict diet and you’re taking different pills six times a day and you’re working really hard at this health project idea.

I think for me, the way I discovered this and learned was not through any kind of graceful, premeditated process. It was just through collapse. There were a few points in time where I just collapsed, and I couldn’t do it anymore. And I’m pretty tenacious by nature. As I mentioned. I tend to get pretty obsessed. So, it took a lot to get me to that point. I’m a slow learner in that respect. Other people might have reached this conclusion sooner, but it took a lot to bring me to my knees. But when that did happen, I realized, “Okay, so there’s a role here for zooming out.” And one of my first experiences of that, I still remember very clearly, I made an intentional choice to not think too much about diet. It didn’t mean I was going to eat donuts and pizza and I’d just never eat that way or not for any significant length of time.

I was still eating probably what most people would say was a relatively healthy diet. But I also didn’t limit or restrict myself if I was out with friends and they were having pizza, I had pizza. Or if I had a favorite meal, that reminded me of my childhood favorite food occasionally. And I explicitly said, “I’m not going to pursue any new treatments. I’m not going to get on the internet and start researching stuff. I’m just going to focus on things that bring me pleasure, things that make me happy on rest, on relationships, connecting with other people, feeling like I’m part of, I’m not alone. I’m not completely isolated in this experience.” And interestingly enough, not only did I enjoy that experience, I mean that’s the predictable outcome that was much more pleasurable of an experience, but my symptoms got better. And this was a light bulb moment for me because in my mind, I was holding it as either I do this intense focus of trying to eliminate my symptoms and use supplements and diet and all the things that we typically talk about, or I focus on just having a good time and enjoying my life and my symptoms.

“I’m a fan of things that build resilience and that improve our ability to tolerate the inevitable challenges that we’re going to face in life.”

—Chris Kresser

Nothing’s going to happen with my symptoms, but it actually was not what happened at all. By doing those other things and channeling energies into those different parts of my life that had been neglected for so long, I actually started feeling better in all of the different ways. And now I have a framework for understanding. I understand, for example, that pleasure releases endorphins, and endorphins actually play a really important role in the immune system. I didn’t know that before. Endorphins are important for stress management and stress relief. They have an impact on the nervous system. Rest of course can play an important role in tissue regeneration and repair and all of this stuff. I understand a lot more now the mechanisms of why that strategy would be effective. But at the time, it was not a choice that I made strategically. It was a kind of choice that came out of just not being able to do anything else.

But now at this point, I think about it in those terms of zooming in and zooming out. And I think with my patients that I work with that have complex chronic illnesses is something we often discuss because so many patients who come to me are in that “zoomed in” place, and I totally get that. I’ve been there myself, so there’s no judgment, but it’s really important not to live there all of the time because life frankly, in many cases can just become not worth living. And I’ve seen that in people who have Lyme and other tick-borne illnesses and mold related illnesses and these really intense, mysterious, and difficult to treat conditions that I think it’s even more important in those cases to zoom out periodically.

Lia Gaertner: To be clear, it’s zooming in and zooming out at the same time. You’re still staying on your supplements and you’re doing all that work, but you’re also making sure that you can see outside of that and look out the window and see what’s going on.

Chris Kresser: It’s not the same for everybody. Some people actually may get more benefit from zooming in. Other people may find that zooming out is something that leads to more transformation and change than zooming in. It doesn’t mean there’s never a time to zoom in for those people, but if we think of a ratio, use the photography analogy. Some people really like that wide angle view, and some people really like that telephoto, zoomed in view, and it might change over time too. That’s part of, I think, the importance of listening and getting to know ourselves. For me, I got to the point where it was clear when I needed to zoom out and clear when I needed to zoom in, and it wasn’t on a perfect schedule. It wasn’t like, “Okay, three months’ time to zoom out, three months more time to zoom in.” We just have to listen for those signs and signals and having a guide or someone that we trust in our life that can help with that is helpful.

My wife was that person for me among other people, but it can change throughout the course of one’s life. For example, right now, I’ve been pretty zoomed out for quite a while and I’m not in the same place that I was back then either. And I don’t have the level of symptoms anywhere near what I had at that point, but I’m not symptom free. And it’s not that I don’t deal with symptoms anymore, it’s just that I tend to deal with them in a more zoomed out way at this point, which often surprises people given my profession and given what I do, but that’s actually what works best for me now.

Lia Gaertner: What kind of diet are you on? I think everyone wants to know what Coach Kresser is doing these days.

Chris Kresser: I’m not on a diet. That’s part of being zoomed out—and I don’t mean that to be flippant. I really don’t conceive of myself as being on any kind of diet. And that’s one thing I learned about myself over time is that I don’t do well when I place strict limits around what I can and can’t eat. Again, my parents will attest to my relationship with limits and boundaries. I push back against them. Essentially, I give myself full permission to eat whatever I want. It just so happens that 90% of the time I want to eat just healthy food because that’s what makes me feel good. It’s fairly close to a paleo-ish type of diet, but I eat white rice. I eat dairy products, not fluid milk, but fermented dairy and full fat dairy, like cream and butter.

I’ll eat grains here and there. I don’t really eat gluten. My wife is severely gluten intolerant. My daughter is as well. I’m not, but just given that environment, it works for me not to eat gluten. I eat lots of fruits and vegetables, but I have my things that really, I get a lot of pleasure from eating and that I’ll eat periodically because they make me happy. Chips and salsa is a great example. I spent a lot of time in Mexico over the years, and it’s a visceral experience to eat chips and salsa and have Mexican food. It brings me joy. And on Saturday nights we have a family movie night, and we’ll typically watch a movie together and have some ice cream, and that’s fun. We cook homemade pizza on a grain-free crust, this Italian crust from Whole Foods. And we have fun making different kinds of pizza.

So, we have this really fun pizza ice cream movie night on Saturdays. I think those kinds of rituals are really important. Again, it’s just about including pleasure and even things that we associate with good feelings and good times from childhood with food is an important part of the experience, and I think that’s also important for kids as well. That’s pretty much it. It will shift and vary too. If I’m on a backpacking trip, I’m probably going to be a little more flexible in what I eat just because of the circumstances or if I’m traveling or with friends. I’m not going to be the person who brings their brown bag lunch into the restaurant because I refuse to eat industrial seed oils that the foods are cooked in—not knocking that again. That level of rigor and limit doesn’t work for me. It doesn’t make me happy. So, I don’t do that.

Lia Gaertner: Which is so funny. I was just on your website, and I saw your big article on seed oils. So, everyone who reads that is going to be the person who goes into the restaurant with their brown bag.

Chris Kresser: I don’t think so. Everything in moderation, including moderation goes the Buddhist saying, right? So, it’s like I do feel like I have to atone a little bit. Some people will read that article and come to that conclusion. That’s not the intention. The intention is, “Hey, we probably shouldn’t be eating processed and refined chips, crackers, or whatever with seed oils all day long every day,” which is what a lot of people do. And we probably shouldn’t be eating at restaurants every day, which is what a lot of people do, because these oils are not good. But we are also resilient, and we have in most cases the ability to handle some level of non-optimal input, whether that’s food, whether that’s technology to screen time, whether that’s toxins that we encounter in the environment, whether that’s difficult relationships or emotions.

We shouldn’t be so fragile that we can’t tolerate anything. And this reminds me of a story that one of my professors in school used to tell. One of the students came up to him and said—and was kind of boasting about how he had become so pure—that he couldn’t even eat in a restaurant anymore because when he did, he would just feel terrible. And my professor’s perspective on that was terrible. That’s nothing to boast about. That’s actually a sign that your health is declining because you’re not resilient enough to encounter something that’s not optimal, and to be able to just handle that with ease. And that’s a movement in the wrong direction. And actually, I see this happening to people who go on really restricted diets for a long period of time. And it’s a reason that I don’t tend to recommend those diets in my practice except for short periods of time when necessary is because I rarely find that more and more restriction eventually leads to less restriction.

I find that more restriction tends to lead to even more restriction over time. And I think part of it is that the body is not being stimulated to develop that resilience. And so, I often will encourage people to start adding foods back into their diet that they’ve taken away, assuming they’re healthful foods when they’re able to do that. Now again, we recognize that if someone who is following AIP autoimmune protocol and they need to do that to get their symptoms under control, of course, but at some point, I would suggest they start adding some of those foods they remove back in because it can be easy to develop nutrient deficiencies on a really restricted diet.  I do think the body loses some resilience when it doesn’t have those different inputs. That’s something that I came to over many, many years. I found it to be largely true.

Lia Gaertner: I’ve seen that with gluten, people go off and then if they eat it again, they feel way worse than they ever did the first time. But that feels different. I feel like people who are really gluten sensitive probably just need to stay off of it for life.

Chris Kresser: That might be a little different because of the mechanism there. But there are studies in the literature that suggest that people who are dairy intolerant, and this is mostly lactose, not so much CIN intolerance, the protein, they can essentially train themselves to tolerate lactose by consuming fermented dairy, starting in very small amounts and then gradually increasing over time. Because what happens is the microorganisms in the fermented dairy probably engage in some horizontal gene transfer with the microorganisms in the gut, which then provides the enzymes that are needed to break down lactose in the gut. At least that’s how, that’s the theory. So that’s interesting to me. And I think that may apply to other foods as well. We know people in Japan, for example, have a particular enzyme to break down the complex polysaccharides in seaweed, and that if people eat seaweed enough that they can develop that capacity over time as well. I think in general, what I would say is I’m a fan of things that build resilience and that improve our ability to tolerate the inevitable challenges that we’re going to face in life. And that doesn’t mean donuts and soda because those things don’t confer any benefit to us other than maybe if people really like to eat them once in a blue moon, but foods that are beneficial, I think we should try to add them back in if we can without too much distress or any exacerbation of symptoms.

Lia Gaertner: Well, I thought when you were talking about the dairy, I thought you were going to talk about how people go gluten-free for a long time, and then their intestinal villi  build back up, and then they have the little crypts where they produce the lactase enzymes and then all of a sudden they’re able to eat dairy for the first time in their lives. They’ve healed their gut from being off of gluten. It’s complex, right?

Chris Kresser: That’s true too.

Lia Gaertner: And would you say maybe the 80/20 rule is what you would recommend?

Chris Kresser: It might be sometimes more like 90/10 or even 95/5. Other times it might even be 70/30 if I’m on vacation. It just varies with what’s going on in my life rather than getting fixated on a particular ratio. I think the concept is still sound where most of the time we’re eating the foods that we know are healthy and beneficial to us and nutritious and support our body and our mind. And then there’s some other period of time, whatever that number ends up being, where we’re eating foods that bring us pleasure and joy and help us connect with others socially. If I’m traveling, for example, and somebody invites me to their house and they serve me something that I wouldn’t otherwise eat, I’ll almost always choose to eat that thing because I want to show gratitude and appreciation to the host. I feel like the experience that comes out of that is more important than me sticking to a rigid diet course. If I was celiac, had celiac and they serve gluten, I wouldn’t do that. The calculation is different in that situation. You always have to evaluate based on your own circumstances.

Lia Gaertner: I got you talking about nutrition for a long time. It wasn’t part of my plan.

Chris Kresser: It’s a popular topic.

Lia Gaertner: I can’t help it because you’re Chris Kresser. You co-founded the California Center for Functional Medicine with Dr. Sunjya Schweig. And I know that you don’t really treat a lot of Lyme patients, but I know that he does. Do you have any theories on evolutionary health and any potential symbiotic evolution with Lyme Borrelia spirochetes?

Chris Kresser: That’s a fascinating topic. And I, many years ago encountered the work of Moises Velasquez Madoff who wrote about the hygiene hypothesis, and then the old friends hypothesis, which is very similar, which is the idea that human beings co-evolved with a number of different organisms, which we now typically see as pathogenic. So nematodes like whipworm or hookworm are a good example of that. Helicobacter pylori, which is the bacterium that causes ulcers, is another example of that. And it’s very possible that Borrelia may be included in that group of organisms. And one of the examples, similar examples is we’ve been eating gluten for a long time as humans, and certainly there were people who were gluten intolerant in the past and we just didn’t understand celiac or gluten intolerance, and they were very sick, and some kids even died from malnutrition. But I don’t think anybody is out there arguing that the level of gluten intolerance has always been the same now versus the past, or that it’s somehow increased because we’re eating a lot more wheat and gluten.

We’re not. So how do you explain the fact that gluten intolerance is so much more prevalent now than it was before? It’s not just because of testing and detection. There must be something else going on. And that’s something else, in my opinion, is a change in our internal ecosystem that took something that made us very susceptible to an antigen that we have been exposed to for a very long time, and typically only cause problems for maybe a very small minority of people, but now is a widespread problem because there changes to our gut flora, changes in nutrient status, maybe exposure to other environmental toxins that dysregulates our immune system. We could go on and on with the list of threats in the modern world. And so, I don’t know that this is what’s happening with Lyme and Borrelia and other tick-borne pathogens, but I suspect that it plays that there’s something here. I don’t know to what extent, but I suspect that there is definitely something that has shifted in our own physiology that’s making us more susceptible to these pathogens.

“With Lyme and Borrelia and other tick-borne pathogens, I suspect something has shifted in our own physiology that’s making us more susceptible to these pathogens.” 

—Chris Kresser

Lia Gaertner: Do you have any advice for people with Lyme disease and chronic illness who might be listening to this podcast, things that they can do that you haven’t already discussed so far, this podcast?

Chris Kresser: Lyme is just so challenging. I don’t need to tell you that. I mean, you’re so deeply immersed in that world and Sunjya as well, and I’ve treated a number of people with Lyme. I probably had Lyme myself. Even the fact that I have to say probably is indicative of the challenge that we faced with Lyme and tick-borne disease, right? It’s like in so many cases it’s like horseshoes and hand grenades. You’re trying to get close. You’re not sure if you’re going to be right on the money, but sometimes close enough is close enough. And my feeling over many years with my own experience and treating a number of patients, and I think you would agree, and I’m pretty sure Sunjya agrees as well, is that the ecosystem is very important. There’s often, in the case of infectious disease, a myopic focus on the pathogen.

This again, is I think, a consequence of our conventional approach to treating disease. Way back in the 19th century, there were  Koch’s Postulates, and that was a major advance in medicine, which he was responsible essentially for recognizing that bacteria were the cause of infectious disease. What I think came out of that really important realization is a hyper focus. Too much focus on the pathogen itself and not enough focus on the environment that that pathogen is in. And if there was one insight that I could offer from my time recognizing that I’m not nearly as experienced with tick-borne diseases as many other practitioners are, that the ecosystem deserves attention. By that I mean everything other than the pathogen. So the gut microbiome, our diet, our lifestyle, how much rest are we getting? How are we managing our stress? How are the relationships in our life?

Are we doing things that bring us joy and pleasure, even if they’re small things, if we’re really sick, like going to sit outside and read a book and feeling the sun on your skin or the wind on your skin, and are we taking the time to play with our kids and are we working on something in our lives where we can experience a sense of mastery or fulfillment, which I think is really important when you’re sick, those things we tend to forget about when we’re really sick and dealing with a chronic health struggle, we either don’t feel like we can do them because of our energy levels, or we’re spending a lot of our time seeing doctors or researching cures. Again, that’s necessary in many cases to some extent. And it’s important, but not to the total exclusion of everything else in my experience. Even small steps in each of those areas can make a big difference in my experience and can provide sustenance both physically, emotionally, even spiritually, that helps us to endure the challenge of living with chronic pain or illness.

Lia Gaertner: That makes a lot of sense. I think that’ll resonate with a lot of people. Okay. Well, thank you so much for joining me, the detective video and podcast series, Chris Kresser.

Chris Kresser: Thanks, Lia. It’s a pleasure to talk to you.

Lia Gaertner: Thank you for joining us for this episode of the Ticktective podcast and video series, a program of the Bay Area Lyme Foundation. You can find out more or donate at bayarealyme.org.