Thyroid Dysfunction, Cellular Stress & Autophagy

Doesn't matter what you talk about, it gets back to the same places. That's a lot more simple than you might imagine. You would think it's this huge list of things, but it's really only 5 categories of things. Could that be what Hashimoto's is? And I can't prove that, but there are some suggestions in the science that that is a possibility. I think of thyroid dysfunction as a symptom of chronic illness, not a cause.

Okay.

We are running from the tiger 24/7.

On today's episode, we are chatting and having a fascinating conversation with Dr. Bill Rawls. He is a physician whose own health journey led him down a serious rabbit hole, looking at cellular health, cellular repair, autophagy, microinfections. Fascinating conversations. We talk about thyroid and we really look at symptoms, signals of our body in a completely different way, even for me. But it aligns so much too with my approach. Anyway, it's a fascinating conversation. Let's dig in.

So thank you so much for taking the time to chat with me today, Dr. Rawls. I am so excited to have you here, and I think we're going to have such a unique conversation and take, take listeners on a little adventure and an enlightening experience. So thank you so much for taking the time.

My pleasure. Thank you for inviting me.

Absolutely. So I would like to start just by asking the question. You're involved and interested and invested in kind of unique areas and aspects of medicine. I would love for you to share, even for me, for my own curiosity, how you ended up practicing and looking at medicine in the way that you do now, and kind of describe a little bit about how you got to to where you are in terms of your interests?

Yeah, yeah, it was all by accident, truly. Where I am today is not where I expected to be 40 years ago when I started doing this. Medicine was in my family. I'm a 4th-generation physician, and I went into it, you know, when I was a kid, I used to go on house calls with my grandfather, who was just a country doctor. But by the time I got into medicine, again, to medical school, things were starting to change. A lot was happening. I mean, it was a very volatile time in the medical field. But I went with obstetrics and gynecology because I enjoyed working with a healthier population and people who were interested in keeping their health and the interventions that were done, whether it was someone in labor or a gynecologic problem like a tubal pregnancy or heavy bleeding, the interventions fixed the problem and it was very satisfying. And so it was very interventional and the interventions were acute and they worked and people got better. I wasn't attracted to the chronic illness side of medicine because those people never seemed to really get well. And so, I kind of steered away from that. And oddly enough, though, the chosen profession, OB-GYN, in a small town with 2 partners meant that I was on call every second, two-third night, every second, two-third weekend. And I was one of those people who, if somebody was in labor, I just didn't sleep. I mean, I just— You know, my partners could go to sleep, but I was just very attuned to the person. And I thought in my 30s, you know, what do I really need to sleep for? I can just push through this. And I did for years. But by my late 40s, that caught up with me and my body crashed. And I ended up having to stop practicing obstetrics thinking, yeah, my sleep will come back and I'll be fine. I can figure out something else to do. I opened a primary care practice office that didn't require the obstetrics. But I didn't get better. My body kept falling apart, and I couldn't figure it out. My colleagues couldn't figure it out. I started looking at alternative medicine, became certified in holistic medicine, and just was getting some better with diet and you know nutrients and various kinds of things. But still, my life wasn't good, and my future was not good, and I was very, very worried. I mean, I had. cardiac manifestations, brain, my joints were falling apart. I felt like I had the flu most of the time. My energy level was half normal virtually every day. And I just struggled to get through every day of my life and kept coming back to what I was hearing about, could it be Lyme disease? You know?

Mm-hmm.

And I was bitten by lots of ticks when I was a kid all through the mountains of North Carolina and beyond. It's like, could it be that? But the test was negative, so I kind of blew it off and kind of settled with a diagnosis of fibromyalgia because even though I had a lot of neurological symptoms, it wasn't quite enough to be MS. And I had a lot of cardiac manifestations, had a cardiac cath, but even though my heart was skipping beats, they said, well, your vessels are clear, we can give you a beta blocker. Yeah, don't really know what else is going on there. Really frustrating, and a lot of people go through that sort of thing.

Yeah.

Long story short, I did eventually find I was carrying that bacteria and thought, yeah, antibiotics, get that, I'll be fine, things are going to be great. Took antibiotics, several different rounds of antibiotics, and just got sicker instead of better, and it wrecked my gut. And out of desperation, ended up doing an herbal protocol that gradually gave me my life back over a 5-year period. all of the symptoms went away.

Wow.

And that's been 20 years ago, around 2005. And now I'm looking at it and recognizing that microbes play a role in a lot of different kinds of chronic illnesses. Chronic Lyme disease isn't really what people think it is. And the herbs that I used, adaptogenic botanical extracts with antimicrobial properties, They're real powerhouses that can influence virtually every kind of chronic illness out there and the process of aging better than anything else. And I've devoted the past 20 years of studying that. The past decade of my life, my health has been great. I've enjoyed some of the best health in my entire life over the past 10 years. And I've been taking these adaptogenic botanical extracts that whole time.

Wow. It's funny, I talk about so often because my people are a lot like you in different variation, but I think a lot of it is at the core the same. And it's, you know, I think what so many people miss is in your life when you're stuck trying to just get through every day, survive, you don't feel well, you're tired, you're foggy. Your life suffers, like your productivity at work, your ability to show up as a spouse and a parent and a partner is compromised. But I think what so many people don't take account of is we, we lose so much joy. Like, you're robbed of joy in your life when you don't have the energy to almost experience it. It's like the hierarchy of needs, and it comes kind of last. Like, joy and creativity are reserved for people who function well and It is sad that so much, so many people in our midlife, you know, like in some of the best years of our life, are stuck in that survival and we miss so much of the joy.

Yeah. Yeah. You know, I was there. I mean, I had a lot of anger, you know, why is this happening to me? I didn't deserve any of this. And there was a point and it was a turning point in the whole thing. By then I was taking the botanical botanical extracts and doing other things. And I was starting to see some improvement, but I switched from being, why is this happening to me, and anger, to what am I supposed to be learning here? How can I— not only me benefit from figuring this out, but how can I benefit my patients and other people? And that turning point— and that— so I recovered a lot of that I don't know if I would call it joy, but satisfaction in learning and writing, which I've been doing ever since, to help people understand this thing. And, you know, when I look at chronic illness, I don't look at it the same way as other people. I don't really put a lot of weight in specific diagnoses. So when you talk about a diagnosis, a diagnosis defines therapy, and it's very important when you have targeted intervention. And our whole system is based on targeted intervention. So somebody breaks their leg or has an acute pneumonia, you know, you need to know where the leg's broken or which bacteria, which artery is blocked. So that's how that concept of diagnosis came to be. It was, let's— Define the problem in very specific terms so we match the proper intervention.

Mm-hmm.

But when you look at chronic illness, it's not one thing. Everything in the body is breaking down all at once. And so it's— so there are a lot of different stress factors that are driving the dysfunction. So there's a lot of things going on, and you end up just putting out fires all over everywhere because, you know, we're Where the testing that we do and defining the diagnosis, you know, I mean, look at chronic illness diagnoses. I mean, we've got Parkinson's named for people and Lyme named for a place and MS that's just kind of this weird description of what it is. And it's all over the map and none of them are specific. You know, it's like MS, multiple sclerosis. It's not a test, it's a clinician reading a variety of things and defining. So, you might go to one practitioner that says, oh, you have multiple sclerosis, and another that says, eh, you don't really fit the guidelines for this, not quite. So, it's a mismatch and we end up treating it with all of these drug interventions which block the dysfunction, but they don't get at what's driving the dysfunction. So where I am is, let's get to the root causes. Let's get to what's driving the dysfunction so we understand the person. And that puts you in a whole different place. And that's what I've based my practice on in the past 2 decades.

I love it. And from your perspective and your vantage point, when we think about all these different chronic conditions, do you think that the underlying cause is quite similar in many of them, like where we could intervene if we wanted to take a few steps back and intervene at the core.

Doesn't matter what you talk about, it gets back to the same places.

So tell me some of those.

All right. Um, so we tend to think about the body as a whole made up of parts. We have our liver, we have our heart, we have our brain, we have all these parts, and that— and dividing it up into systems Almost makes it more complicated because then we have providers that specialize in each of the different systems and subspecialists that specialize in specific diseases in those systems. But it all gets back to this one thing: your body is made of cells. Everything in your body. So a heart isn't a unit, it's a composite of billions of heart cells. And the same with your liver and your brain and your skin and everything. So, the smallest functional unit in your body and the smallest functional unit of living organisms is a cell. And each one of our cells are independently functioning units. So, everything in the body, everything that happens is doing— due to cellular functions. So, thyroid hormone, it's cells that are producing the thyroid.

Mm-hmm.

Your heart beats because of cells functioning, you know, coordinated functions of heart cells causing your heart to beat. So, when you look at dysfunction, it's all rooted to cellular stress. So, every symptom, every manifestation of illness, every aspect of every illness can be traced to cellular stress. So, when you start getting to the roots of the cellular stress, that's where you start getting answers.

Fascinating. I just— I'm so excited about this conversation. Tell me some of the most common causes that you see create cellular stress. All right.

So, that's simple. That's a lot more simple than you might imagine. You know, you would think it's this huge list of things. But it's really only five categories of things. So think about your cells this way: your cells are like little biological machines, and you know we have a lot of cells, and we have hormones that are coordinating all of our cellular functions. We have to have that to function as a unit, but every cell is independent, and every cell you you know if you think about it as a little operating as a little machine, it has an operating system. So built into our genetic program is an operating system that defines how that cell should work, what its job is, where it should be in relation to other cells. Everything about that cell's function is built into that operating system. But cells also have very specific operating requirements and Things that affect their functions. So first, nutrients. Cells need specific nutrients, and that varies depending on different cells in the body. It's like thyroid cells, of course, need iodine. Heart cells tend to burn more fat. Brain cells like quick energy of glucose. So our cells need specific nutrients, vitamins, minerals, carbohydrates, fats, amino acids to rebuild, to do their jobs, to keep functioning. So, if you're not giving yourselves the right nutrients and they're programmed— our cells are programmed from our ancient past, what our foraging ancestors did for hundreds of thousands of years. So, that programming defines what we should eat to help ourselves functioning best. And we're way off the program with a processed food diet. We just couldn't be any more off the program. So that's one thing. Toxic substances. We are loaded with toxic substances. There are more environmental toxins, over 200,000 different chemicals that exist in the environment that didn't exist in, in the planet before 100 years ago. So we have all these things, and most of them can be sourced from coal and petroleum. Or excessive use of making plastic chemicals, powering cars, everything. So these chemicals are organic compounds. They're from plants and algae. But that distortion of being pressed into the earth for millions of years created chemicals that are not compatible with life any longer. So they are like the common chemicals that started out that, you know, if you went back couple of million years and ate the plants that became coal, it'd actually be good for you. But it changed and it embedded heavy metals into it. So it has all these other inorganic chemicals embedded into it. So, but these things enter our body and they enter our cells and they get stuck. They disrupt cellular function. So toxic substances. And, you know, you can add to that natural toxins. Like mold in our houses that are tight and sealed and have a lot of moisture inside. So toxic substances, that's number 2. Number 3 is our cells need downtime. So we work, they work all day, they need rest at night. And, you know, most people are getting 6.5 hours. So that's not enough time for cells to recover. So people are working all day, not sleeping enough, and then starting their day with a cellular deficit. And trying to compensate that with a big dose of caffeine, which pushes their stress cells even harder. So, it's— so, getting rest during the day, episodes of rest. So, you know, our body is built on stress and recovery, stress, recovery, stress, recovery. And if you're not getting that recovery, things start breaking down. Physical stresses, obviously, Excessive exercise, too much hot, which we're all having, too much cold, that's damaging to your cells. But being sedentary, we need blood flow. Our cells need to be continually flushed with fluid that comes out of our capillaries and washes away toxic substances. And if we're not moving, we don't get that. We're way too sedentary. And finally, and the big one, the wild card, Is microbes and this idea that we get an infection and we get symptoms like a cold or a flu and we clear that virus or bacteria, whatever it was, or we get antibiotics if we're not getting better and it clears, then it's gone. And what the evidence is showing is that's not true of all microbes. So tick-borne pathogens are an example, but we're exposed to a lot of different things. things. Top of the list is pretty much everybody has Epstein-Barr virus and other herpesviruses. There are various different viruses. There's mycoplasmas, chlamydias, and the list just goes on and on. These things have the ability to persist in our body, and they end up in our tissues, inside our cells, and they can just hang out there in a dormant state. And wait until we're stressed, and then they reactivate. And different microbes invade different cells in the body, so wherever they reactivate is where we have symptoms.

Fascinating.

That's pretty much all of chronic illness. So when you look at that, it's all cellular stress, and which microbes you pick up in your lifetime may be a big differentiating factor Along with your genetic profile and that sort of thing, of what illnesses you might end up with.

And in terms— I kind of want to go back, I have so many questions about all of these, I took some notes— but in terms of microbes, is it like they show up when our cells are stressed later, like we become weakened and then it manifests?

Yeah, you know, that's— that was the interesting thing that has been the research that I've really been working with over the past decade, is looking at Borrelia, the Lyme bacteria, Bartonella, which is often listed as a Lyme coinfection, but lots of people pick it up from pets, from fleas, from bites of pets, various kinds of things, cat scratches. Bartonella is present in every mammal species, including whales and dolphins. And these pathogens that we call stealth pathogens have the ability to invade the body, And invade cells in our tissues, and different ones invade different cells, and they have the capacity to go dormant inside the cells. So that's one big mechanism of how they persist, along with others, and they can persist without causing symptoms for years or decades, for all we know. So then when our cells are stressed, That's the signal. You know, they're, you know, when that cell is drying down its mitochondria and its repair mechanisms called autophagy are starting to be disrupted, that's a signal for these microbes to reactivate. And then they, you know, they start breaking down tissues because what they want to do at that point is release nutrients to grow more microbes.

I got it. Fascinating. Okay, I, I understand why one of your podcasts lasted 3 hours. Like, I could talk about this for a very, very long time.

Yeah, yeah, it is, uh, a fascinating topic. You know, I'm giving you the kind of high level, and we're still learning a lot of things, but, you know, that's what my past 2 decades has been, is connecting, you know, finding the little pieces of evidence that support this and putting pieces together and going Yeah, well, is this a possibility? And finding evidence to support that. So, you know, when— so it's a different way of understanding chronic illness, and it's like a big 1,000-piece puzzle that you don't have the picture to look at. And so at this point, my picture is probably about 90 to 95% complete. So we don't have all the answers, but we are at a point where you can make some logical conclusions, and that really makes sense, and it helps understand why people aren't getting, uh, overcoming chronic illness and why they're continuing to struggle. But we can apply it to virtually anything. We can apply it to thyroid illness, everything.

Okay, I want to talk thyroid too. I want to ask a few other questions. So when you think about food and you think about rest, I'm curious if Those 2 concepts kind of collide in the form of intermittent fasting and intermittent fasting giving your body rest from food, but also, you know, rest from all the work that's involved in food and therefore triggering autophagy, which I would love for you to share with listeners what that means because I think maybe not everybody knows. I'm curious your perspective on that.

Yeah, I think that you have to think about it slightly differently. So, you're thinking of intermittent fasting as rest, but it's actually stress. It is. And that's how they discovered autophagy is, you know, back about 40 years ago, they happened upon this process that they saw when they, you know, when they were looking, working with laboratory animals, when they were starved, then the body became, the cells in the body became Mm-hmm. ...frugal and started recycling nutrients. You know, they were pulling worn-out parts, misfolding proteins, etc., and they were digesting that. So, if you can— so, if, you know, I think about autophagy like if you had a little alien inside your cell and it's constantly looking around and going, okay, that protein's not working anymore, and that piece isn't working anymore, and pulls these parts and throws them into a garbage can that we call lysosome. And that digests the parts down to their component amino acids, fats, et cetera, so they can be used by the cell. So, it was really— looked like a frugal thing. And it wasn't until 20 years later into the '90s that they were starting to understand, no, this is a process that's going on all the time. And in fact, it's really a critical process. So, when you look at ourselves as little microscopic machines, one of the most exciting and interesting things is this process called autophagy, that cells are continually recycling and rebuilding. And that includes restructuring mitochondria, getting rid of old mitochondria, so repairing DNA so that The autophagy process is cellular maintenance and resilience. Without it, if it stopped right now, your body would last a few days. That's it. You'd be gone. So, it turns out that stress is really important for stimulating autophagy. So, when our cells are a little bit stressed, when they have natural Stresses, it's like okay, we've got to get work and really rebuild again and make things work again. So not getting nutrients is a stress. So when you're fasting, your body is going okay, time to rebuild. That's you know we we got to get on the ball here and and be frugal and and make sure everything is good. But it's only good up you know they what where we get that intermittent fasting is. At about a 16-hour point, you start taking out the good stuff just to keep the cell surviving to burn. So, I use this analogy. If you think about an old steam locomotive, right, and you're trying to get from point A to point B, and you're going along and you run out of coal, what do you do? Well, you start Burning the furniture and the things that aren't essential. You know, anything with wood that's going to burn, you start throwing that to get enough power to get to your destination. But, if you go too long, you start pulling off all the boards on the train and you'd get it down to the fact that it's kind of nothing and it's barely functional by the time you get there. So, after 16 hours, you're starting to break down good stuff in the cell that you really don't to break down. Now, every now and then, doing a 3 or 4-day fast, it's kind of good. It's good housekeeping. It cleans everything out really well, but not as an everyday practice. So that 16-hour window of allowing 8 hours for eating is a pretty good number. So what suppresses autophagy is lots of carbohydrates and fats, you know. So So, you eat a fat carbohydrate-rich diet and your body's going, we don't need any nutrients, we're getting plenty of things and we don't really need to do autophagy. We'll just kind of sit here. And that's what happens to your cells. So, yeah, so that fasting, so it applies to all of these parameters. I've actually studied this. So, when you look at toxic substances, a lot of the chemicals that we get from natural vegetables are Mild stress, your body has to process them. That's enough to stimulate autophagy. What breaks autophagy— so if you, you know, all the petrochemicals that we're exposed to, man, do they stimulate autophagy like crazy, but they break the machinery. So that's why they're damaging. So a certain amount of toxic stress is actually good.

Exercise.

Boy, just get out and go for a walk or a jog or something. Boy, is that great stress to stimulate autophagy. But if you overdo it, you break the machinery.

Right.

And you set yourself back. So, even so, that day stress during the day, sleep at night recovery, it's part of optimizing autophagy. And there's even some evidence that some Possibly even some microbes that end up in our tissues are actually good for us, that they actually stimulate autophagy. That normal balance of our microbiome with our whole system may be good. So yeah, that's kind of autophagy in a nutshell.

I love that. And that's honestly a different way than I think I was thinking about it, especially in perspective of intermittent fasting. And I loved that you added in the caveat that, hey, every once in a while, maybe a prolonged fast I view it as like a deep clean, right?

Mm-hmm.

Like, I have 6 kids. If they're all here all the time, I'm just barely keeping my head above water trying to maintain our house not looking like a frat house. But if they all go somewhere, hey, then we have time to actually do a deep clean, not just like pick up the dirty dishes from everywhere, but do a deep clean of the floors, the carpet, dusting, windows, etc. And I kind of view, you know, I view more prolonged fasts— I don't recommend them for the vast majority of people, but for some people in my own life especially, it's been incredibly powerful for the— in those eras where I need a deep clean.

Yeah. Well, you know, it gets back to that steam locomotive. You show up in the, uh, in the station and you're just barely hanging on, but the engine's still running. You rebuild the train, right? It's stripped down to nothing. You rebuild the whole train. You don't want to do that every time you make a run, but Hey, every now and then it's kind of good.

Absolutely. Talk with me too about what cellular repair or lack thereof, how that intersects in the world of thyroid with specifically, I would probably say Hashimoto's more than hypothyroidism, but I'm curious on your take.

You know, when you look at thyroid, you have to ask, well, what is the thyroid doing? And it's regulating metabolism. So, when you produce thyroid hormone, it's producing T4. The cells are regulating the conversion of T4 to T3, and that's really important because if your cells are overstressed, then they shut down that conversion and shunt it into something called reverse T3 so they don't get overstimulated. So, it's really important that that happens. But what thyroid is doing is basically turning on the machinery. It's revving up our mitochondria. It's giving cells energy. So as we're going through our day, we need thyroid to kind of keep that engine going. It's the signal for our cells to go, yeah, you know, it's daytime. We gotta work hard. Let's get going. So it's the metabolism.

Yeah.

Metabolism signal to make that happen. So what happens though, say you're, you know, eating a bad diet, you're stressed, you've got reactivated microbes, you're— again, that's exaggerating that fight-or-flight response, and you're not sleeping. So you're burning both ends of the candle and you're really running autophagy into the ground. Your cells are stressed, You know, your cell, your brain is going, okay, we got to push ourselves harder. So thyroid pushes the cells harder. But you have to understand that all those stress factors are also affecting the thyroid cells too. So they become stressed and they become overworked, so they start to burn out.

Mm-hmm.

So those thyroid cells become very, very stressed. And just the work of doing that. So producing thyroid hormone is a very toxic process. I'm sure you know that just taking an amino acid and plucking thyroid— I mean, iodine molecules onto it to make thyroid hormone, they use— their cells use hydrogen peroxide, and it's a really toxic free radical process. So if you're really pushing metabolism, your cells are stressed, you're driving them to go harder, you're really— it's a toxic process in the thyroid. So here's something to think about. I talked about buried intracellular microbes. So one thing, and I've been trying to research, and there, you know, not any absolute evidence, but suggestions that microbes, Epstein-Barr virus, other herpes virus, mycoplasmas, have the ability to invade thyroid cells. And if those thyroid cells are stressed, are they reactivating? You know, are we having reactivation of microbes? And you think about that, you know, the cell has microbe antigens on the cell and the body starts attacking that to get rid of these microbes. Could that be what Hashimoto's is? And I can't prove that, but there are some suggestions in the science that that is a possibility. So, so no matter what you look at, looking at the disease process, cellular stress, microbe reactivation, that, that all can be part of it.

I'm curious too, and I love how you kind of touched on this, how cellular stress can lead to thyroid dysfunction, but also how thyroid dysfunction can lead to cellular stress, which I think is—

Wrapped up together.

Right. It's so true. I'm curious. One of my biggest passions that I love to think about, talk about, look at literature on is how thyroid dysfunction, even mildly, Right. Like before potentially medicine would intervene, especially, you know, medicine advocates now more and more for waiting to treat things like subclinical hypothyroidism until TSH is over 10, like really, really late in the game. I'm curious how you feel like this bidirectional relationship between cells, thyroid, thyroid cells, when that is dysfunctional, what would you anticipate as being some potential sequelae of that? Like, what disease process could happen because of that dysfunction?

Well, not surprisingly, you see thyroid dysfunction with a lot of chronic illnesses, right? Here's another different way of thinking about it. I think of thyroid dysfunction as a symptom of chronic illness, not a cause. And I think that's where we go wrong, that practitioners are treating the thyroid dysfunction with thyroid hormones or whatever and thinking they're solving the problem. The problem is always rooted in cellular stress. So, if you're starting to have thyroid dysfunction, it means you've got a lot of cellular stress going on in your body, and that may not have manifested, you know, or, you know, we've When we look at thyroid dysfunction, you think, well, it's the fatigue that is, you know, that's the symptom of hypothyroidism is fatigue. But is it? Maybe that's part of it. That is when the thyroid hormones, you know, when the thyroid cells start getting burned out and just can't keep up with demand. Yeah, that can be part of it, but— Is the root of it instead the cellular stress? So if your cells are stressed and they're burned down their mitochondria, they don't have as much energy, the result is gonna be fatigue. So I always look at fatigue as being an overriding symptom of widespread cellular stress. So I think when we look at thyroid dysfunction, We're doing a disservice to look at it as an isolated problem. We should be looking at it and going on, going, okay, this person has significant cellular stress throughout their body, and we should be addressing that. And if we can address that before we actually just address the thyroid alone, they may not even need thyroid hormone.

Mm-hmm.

And I— so I think that's important to really put that in perspective.

Yeah, it's an interesting concept for sure. Talk with me about ways of intervening with cellular stress. Like, what are some— one, I'd love to know, hey, what are some things that we can easily do, like easily accessible things, whether it's supplements, activities? And I know you can kind of reverse engineer From what we spoke about earlier with sleep and things of that nature. But I'd love your top tips that are accessible to everyone. And then I'd also love to know, just for my own curiosity, if you have any weird, esoteric, or know of any also ways, like think biohacking, which isn't what I normally do. I'm just more curious than anything if there's biohacking tools that also address this same thing.

Yeah. Yeah. Well, it gets back to the basics of just, let's create an environment inside the body that allows cells to recover. Let's give cells an environment of what they need. So, top of that list is a healthy diet. And on my list, what a healthy diet is, is predominantly whole foods, more vegetables, than anything else, not fruit and vegetables, vegetables. I think it's really important. I think that's where most people miss out. And then all the rest of the food kind of divided up with healthy proteins, some grains, etc., but all whole. And then the deciding factor is I try to keep my carbohydrate load below 150 grams a day. Now, that's not ketogenic. Ketogenic is hard to do and it makes life uncomfortable, but that's enough carbohydrate to live comfortably. And then that 8-hour eating window, I think, is really important to let your cells recover, you know, let them, let them do the autophagy.

So do you drink anything that raises your blood sugar outside of that 8-hour window? Is it more digestive rest or is it insulin blood sugar rest as well? Sorry to interrupt you. I was so curious.

Well, the 8-hour window is when you eat. The 16-hour window is when you don't. So, you know, you might start eating around 9 and cut it off around 5 or 6, you know, roughly that sort of thing. But yeah, I think, you know, drinking water or beverages without a lot of sugar. And I always tell people, don't overthink it and make it uncomfortable. as a guideline and try to fit it into your life to do better than what you're doing now, which probably isn't anywhere close to that. And so, I think it's important to keep it in perspective. But so, diet is important, but we could do a whole podcast just on diet alone.

Yeah.

But those are my kind of basic guidelines that I try to live under. And if everybody did that, we wouldn't have as many health problems as we do.

I agree.

Um, yeah, um, toxic environment. Um, organic food, it's easier now to get than ever before. Filter your water and, and whatever you drink. Um, and air is a big one. Um, I'm fortunate, I mean, we, we, you know, filter the air in our home, but I'm also surrounded by trees. And so, you know, the air around me where I live is healthy. Not everybody has that advantage, but, you know, the more you can get out in natural places with healthy air, breathing healthy air, and just being really careful about what you put on your skin— that's— those are pretty simple things. Um, sleep— just prioritizing sleep. You really do need 8 And you're gonna feel better if you get 8 hours. And sometimes you have to work to get that, and, you know, you have to kind of set your life to do that, but you're gonna feel better. Um, and, and then moving. Um, you know, you don't necessarily have to go to gym— to a gym and bulk up, but you need to move all day.

Yeah.

And, you know, Walk. And I mean, I get a lot of different kinds of exercise. I actually don't go to a gym except to do yoga routines, which I do 2 or 3 times a week. But I get movement in throughout the day. I mean, you know, when I get up from here, I'm going to go take a nice long walk or go out for a paddle out on the water or something just to get some movement in to go, you know, get Flush those toxic substances, and then the microbes. We're all going to pick stuff up if we keep a healthy body. That's our best defense. But one thing we're not getting in our diet any longer is phytochemicals from plants. And when we talk about herbs or botanical medicines, basically we're borrowing another organism's defense and regulatory.

Mm-hmm.

So plants solve problems with chemicals. They don't have a cellular immune system, they have a chemical immune system. So plants are producing this tremendous range of, of what we call phytochemicals to, uh, to neutralize viruses, protozoa, yeast, all these different things, free radicals. So, uh, you know, the, the Things that herbs offer us is just extraordinary. So it's affecting every one of those stress factors. So it's giving us a whole extra level, especially if we're using herbs that we would define as adaptogens or adaptogenic. And so that's just tremendous support.

Tell me a couple questions. One, are there any foods that are your favorite, like your top three foods that you would recommend that I assume vegetables that people eat? in terms of helping their cellular repair system? And I'm also secondary to that, I would love for you to talk with us about some of maybe your favorite supplements to target this in particular. And I'm curious if there's overlap between that and what I use for thyroid, et cetera.

Yeah, when you look at diet, I mean, I try to eat a— the big deal is diversity. I mean, again, we are programmed by what our ancient ancestors did. And for several hundred thousand years, our ancient ancestors foraged food. And it wasn't until human populations started to outstrip nature, which took a long time, that we started farming. And what we farmed first was wheat. And that was about 10,000 years ago. Once we did that, we had to stop roaming around to where the food was, and it kept us in place. So once we made the choice to farm, We were stuck with that, and we very quickly adapted to that lifestyle. And it wasn't that it was better than foraging, it was just because people, once they started doing that, it, you know, that was kind of the only way to do it. But humans ate enormous diversity of food. There's evidence that an average human Foraging might eat 500 different plants in a year. And most of the evidence suggests that they ate about 2/3 vegetable matter from stems, leaves, berries, roots, and about 1/3 animal. So they were eating a lot of vegetable matter, they were getting an enormous amount of fiber and phytochemicals that from, from these plants that they were eating. And when we switched to grains, we lost all that. But humans still retained it by medicinal and culinary herbs. And about 100 years ago, we traded all that for drugs, and it hadn't quite been the same ever since.

Yeah.

So, so, you know, it's, uh, so it's not— so I, I, you know, I have a lot of foods that I like, but I try to eat as much diversity as I can. I eat whatever's spectrum of vegetables are fresh. Um, I eat a lot of different protein sources. I do eat some red meat. I eat some poultry. My favorite is fish. Um, I went to a Japanese restaurant and had grilled squid the other night, which I really love. Um, so diversity is really important.

Yeah, it is. I think we're supposed to have 30 different vegetables a week.

Yeah, it's good.

I bet we— I bet 1% of us get that.

Yeah, no, really small percentage. I mean, it's, it's, it's harder to find in restaurants too. I mean, it's all, it's all grain and meat now.

And, you know, that's the recipe for cellular stress, right? The carbs and the fat.

Yeah. But too, too much, too much protein is really not very good for you. So.

And tell me some of your favorite supplements, your favorite, you know, adaptogens. Is it ashwagandha? There's so much back and forth about ashwagandha and its usefulness.

We can definitely talk about ashwagandha and thyroid function, but all of the, you know, there, when you talk about herbs, there's a pretty wide range all the way from food plants and culinary herbs, which do have medicinal benefits, to plants that have very strong drug-like almost poisonous effects. Um, and yeah, interestingly, that's where a lot of our drugs come from, is the poisonous plants.

Oh, wow.

Because things that affect or stop or poison some reaction in the body. But here, when we come back, um, to the kind of the middle, there are herbs that we call adaptogens or adaptogenic. And what an adaptogen is, is a plant that increases resilience and stamina. And they do that by protecting our cells. They don't have drug-like effects, which means you can take them a long time. The incidence of side effects is very, very low. And a true adaptogen affects our central stress hormones. So there are a lot of herbs that are adaptogenic that aren't true adaptogens. Adaptogens like turmeric, which is a great anti-inflammatory. Ashwagandha is a true adaptogen. Rhodiola is a nice adaptogen. There we also have medicinal mushrooms that act very much like our plants, like reishi and cordyceps, that are adaptogens. But I found a whole new class that I discovered just in, in my journey with chronic disease of adaptogenic herbs with stronger antimicrobial properties. Japanese knotweed, which is an excellent source of resveratrol, the age-defying substance that, that you, that you find in wine. Japanese knotweed is a better source. Chinese skullcap, fantastic antimicrobial herb. All these are immune modulating, increase stamina, And they actually do reduce our stress because we are— if our body is less stressed, then we produce less stress hormones.

Right.

So, I fit them as adaptogens, but they have stronger antimicrobial properties. But there's so many out there. I discovered a new one the other day, one that I formulated into a product years ago. I have a gut product that I put dandelion in. I put it in there because it protects liver cells and it has this really nice effect of stimulating bile flow, which helps us digest food and get toxic substances out of our body. New paper, a review paper, 2025, I just read it this week, that showed that it has good antimicrobial properties. It's great for balancing the gut. It actually stimulates repair of our intestinal cells. It is calming, so it's a true adaptogenic effect. It protects cells throughout our body. It protects the liver. It stimulates bowel. We just go on and on and on about all these wonderful properties. And it's because whenever you're looking at any herb, you're— what you're getting is the cell protection system of that the plant is producing. So it's protecting cells from free radicals and toxic substances, and it may be a little better for certain cells in the body. But another, like milk thistle— you probably have heard of milk thistle, great herb for a liver. I do take it every single day. I think it's a really important one. Because there was a study that showed that by protecting liver cells, it actually allowed regeneration. It stimulated regeneration of liver cells.

Wow.

In our very toxic world, that's really important. Everybody's doing these 10-day detoxes and they're not doing anything because the problem is that as we go through life, we lose processing capacity because we burn out our liver cells and replace them with inert fat cells. So, Your liver becomes fatty, your processing power goes down, toxic substances become more toxic. Milk thistle protects that. Well, I found a study that showed that milk thistle is really good in postmenopausal women for stimulating bone reconstruction in the bones.

Wow.

So yeah, so these things, it was like, okay, it's just for that, but turns out, no, it's good for a lot of other things too. So, but the cool thing about the antimicrobial properties of these herbs is they're selective for pathogens. And that's really important because dandelion, berberine, some of these other herbs that I've mentioned kill pathogens, kill, suppress things that we don't like that are, that are in our gut, but they don't affect our normal flora like an antibiotic. And resistance doesn't occur in the same way as antibiotics, so we can take them for a long time. But they— but, but the really interesting thing is all of these herbs that I've mentioned, these adaptogenic antimicrobial herbs, have the effect of supporting autophagy. So they're actually helping our cells rebuild. How do they do that? Well, they take the stress off so the cell can do what it's normally supposed to do. So a lot of things, all of our drugs, or most of our drugs disrupt autophagy. A lot of therapies that people do disrupt autophagy. So herbs are the one thing that doesn't do that. They actually promote or support normal autophagy, which is Really important.

Right. Absolutely. It's so fascinating. I mean, it is, and it kind of goes back to what you started with, that everything is thought about in these silos in medicine, but the interconnectedness of some of these therapies to hit on so many aspects of our physiology is incredibly, incredibly powerful and obviously synergistic.

Yeah, it's really cool.

Yeah.

It is. Yeah. But all these properties, you know, we ashwagandha, You mentioned that's a great adaptogen. A lot of people are very familiar with it. It is known to stimulate thyroid function. It has a mild stimulating effect, so it can, but it's not the same as like if your body is stressed that it's just pouring the juice on the thyroid. It's actually helping the thyroid gland work better.

Mm-hmm.

It's protecting thyroid cells, which is really important. And all of these adaptogens, that really toxic process of creating thyroid hormone. It's helping to protect the thyroid cells. It's suppressing any microbe activity that might be a factor in thyroid. It's reducing— so all of these adaptogens are immune modulating. They help reduce autoimmune and other aspects of a dysregulated immune system.

Mm-hmm. So yeah.

Yeah, they're, they're helping us in a lot of different ways.

I love that you clarified all of that because on social media, one of the most common comments that I'll get if I even mention ashwagandha is, well, everyone says it's contraindicated in thyroid. And I'm like, absolutely not. Pretty much 100% of our patients at Modern Thyroid Clinic are put on ashwagandha at some point in time. I've never had it trigger a worsening of Hashimoto's or autoimmune disease. In fact, I think it's Yep, absolutely. I'm curious too, we haven't gotten into this topic. We've danced a little bit around it, but it is my kryptonite for sure. So I love that you hit on the concept of, hey, physical stress is stress to our body, because I think so many people interpret stress as psychological or emotional stress, but physical stress is stress. I also wanted you to touch on If psychological emotional stress also plays into the cellular repair system or its inability to effectively and efficiently do its job, autophagy, all of that.

Oh, absolutely. You know, when, when it, you know, it is that stress relief, stress recovery cycle, which is really important, but any unnatural stress is going to disrupt autophagy. You know, it's physical stresses. I'm reading about more and more athletes that are pushing themselves to the limits and their bodies are breaking down. They're exceeding their capacity of their cells to recover. So it's really a bad idea. And I think we're going to see a lot more of that as we kind of go, well, we're superhuman. You know, we can just train and keep doing this. No, you can't. can't. It's really important to stay within those parameters. But when you look at psychological stress, it's not necessarily something that is directly harming us, but it's the perception that gets us. So it goes way back. You know, what our fight-or-flight response is for is if you're collecting berries in the bushes and you come out from the bushes and, oh my God, there's a saber-toothed saber-toothed tiger, you know, you need to change your physiology to either fight that threat or, more likely, run away from that threat. So it's changing everything. You have adrenaline, you have cortisol, all of these things are changing cellular functions to give you a better chance of surviving.

Mm-hmm.

But it's a short-term effect, you know, and So, when you look at our ancient ancestors, they didn't have watches or clocks. They didn't have cell phones. They didn't have schedules. I mean, it was like, get up in the morning when the sun comes up, go forage and get as much food as we can, hang around by the campfire, eat the food, wait till it's dark, go to sleep, sleep all night, get up and do it again tomorrow morning. There was no schedules. There was no— way to anticipate how bad the next day or the next hour might be. Now, we have schedules, we have deadlines, we have all of these stresses coming at us all the time. So we are running from the tiger 24/7.

Mm-hmm.

And what that does is it messes up our fight-or-flight response. So instead of that occasional thing that we kick in when we really need it, Mm-hmm. It's on all the time. And so cortisol follows adrenaline. If you're— if you're amped up all the time, your cortisol goes high. So what cortisol does is it primes your cells to work and be active. That's what it does. So cortisol comes up in the morning and stays active, and then toward the afternoon, it starts going down. So what cortisol What cortisol is doing is priming your cells. It's the message to say, it's daytime, it's time to work, we're gonna be active, keep at it. But if your cortisol is high, it's driving your cells harder than they need to be, and if it doesn't go down in the evening when it should, then it's disrupting this— our abilities, our cells' abilities to recover. ability to relax. So, if you pick the number one autophagy disruptor of anything out there, it's high cortisol.

Oh, no.

Cortisol shuts autophagy down.

Damn it.

For sure.

Yeah.

So, you know, just those episodes. And, you know, you don't have to be an expert in meditation. All it takes is to go out and walk for a mile, and that starts bringing your cortisol down and normalizing your stress hormones.

Yes.

So, yeah, it's really important. And what the adaptogens like ashwagandha, rhodiola, others are doing is they're chemicals that are feeding back to the hypothalamus, which is where your cortisol— you know, that's the, that's the place in your brain that's driving your adrenal glands or regulating your adrenal glands. And these chemicals are basically feeding back and saying, yeah, it's not so bad. You can just chill out a little bit, tone it down a bit. And, and that's how they work. So it can be really valuable.

Oh, absolutely. And I love— this conversation has been so enlightening for me even because what I think about happening on a larger physiological scale This has been such an eye-opening conversation to remind me that it's not just the big organs that are impacted. Those same things are impacting us on a cellular level.

Yeah.

Fascinating. Thank you so much for this conversation. I would love for you to tell listeners where they can find more about you, about your work, because this truly is— it's enlightening.

Okay, um, I've written a couple of books, one on Lyme disease called Unlocking Lyme. A few years ago, I kind of built everything that I could think of that I knew into a book called The Cellular Wellness Solution, and that's available on Amazon. I have a website, RawlsMD.com, that I just place kind of whatever's current, whatever's going on. A lot of it is for folks struggling with chronic Lyme disease, and I'm trying to help them understand their condition differently because people are getting so much misinformation. And then I have a company with my daughter that we produce high-quality botanical supplements and programs called Vital Plan. And so vitalplan.com. There's a lot of great information and great stuff there too.

I would love for you to tell us a little bit maybe about your top couple programs or supplements on Vital Plan.

I just started a new program about a year and a half ago called Restore 180. So we had putting— been putting together packages of herbal products for people struggling with chronic Lyme, but just the supplements alone, I just always have felt like I needed to do more. For— so for years, I built this email series to accompany it, to give people education. I wrote books. But about a year and a half ago, we went all in and created a program within a community network called Mighty Network. So it's the Vital Plan Network that people can come, and it's kind of a safe place to learn, to talk with other people at your same level, mostly people struggling with complex chronic illnesses like fibromyalgia and chronic Lyme. So a place that they can learn, but also I built a lot of instruction in it. There's videos, there's a resource library that's just got lots and lots and lots of information. So it It took us about a year to build the whole thing. And it's a 6-month protocol that people go through that starts with calming sympathetic overactivity and cortisol. We do that for a month, and then we start into detoxification and, and, and, and getting the gut back the way it— the way it's supposed to.

Mm-hmm.

And then finally, we get into the more concentrated herbal extracts with antimicrobial properties. So we kind of stage people to prepare their body for what they need to get well.

I love that. Thank you for that work. It is so needed. Well, it has been an absolute pleasure meeting you, chatting with you. Thank you so much for the time that you poured into my, my people today.

You know, thank you for the opportunity because Again, you know, I wouldn't be here if I hadn't gone through this experience. But now that I've had this experience and accumulated that knowledge, it's just really important for me to share it with other people because it's so critical to how we should be looking at chronic illness and how we should be doing healthcare in this country. So every opportunity is very much appreciated.

Of course, absolutely. Well, thank you so much.