I’m really excited about this blog post, because I’m interviewing Margaret Romero and we are talking about the autoimmune disease process. My guest today specializes in lupus. She has her own personal story of being diagnosed with lupus, overcoming it, and getting control. But essentially, autoimmune diseases all have the same disease process.

For instance, I have Hashimotos, which is an autoimmune disease of my thyroid. Many people have celiac disease, rheumatoid arthritis, psoriasis, or other autoimmune conditions. If you have an autoimmune disease, I want you to understand, you have the genetic propensity for certain genes to be activated or triggered that set autoimmune disease in motion.

Typically this is exacerbated by leaky gut or increased intestinal permeability. Many people develop that. Our endothelial lining in our gut (which is one cell layer thick, it’s what’s separating the food we’re digesting from our bloodstream. There’s only one cell layer, and those are easily destroyed.) The junctions in between them are easily broken by…

  • steroids

  • antibiotics

  • pesticides in our food

  • too much cortisol production from chronic stress

  • hormonal shifts, like pregnancy and menopause

  • steroid use

All of these things can damage those gap junctions and create microscopic holes for things to get into our bloodstream that shouldn’t. This activates our immune system. Sometimes it gets confused and starts attacking our own tissue. That’s the autoimmune process. 

For me, my autoimmune disease was activated from having a pregnancy at 17 years old. Talk about stress, right? The hormonal shifts, the stress of being a teen mom, and dropping out of high school.

Once those genes are activated and turned on, it’s really hard to turn them off. However, you can control it. There’s so much evidence coming out that autoimmune disease processes are partly reversible, if not completely. You can get them under control without nasty medications that have major side effects. 

The key is going back to where it originated. I’m really excited to talk to my guest today because she understands that you have to evaluate and treat gut dysbiosis and gut dysfunction and get to the root cause of autoimmune disease. 

If you or someone you know has an autoimmune issue, or a chronic condition that they really haven’t figured out or been able to get control of, they are suffering needlessly. They could feel better and reclaim their health. Share this blog post with everyone you know, because we need to help each other, feel better, and live the amazing lives that God put us on this earth to do. 

About Margaret Romero

My guest today is Margaret Romero. She’s a nurse practitioner. She received her Bachelor’s and Masters Degree in Nursing from Columbia University. She utilizes functional medicine to treat chronic illness, autoimmunity, and women’s health issues. She’s been a clinical instructor and taught functional Integrative Medicine at Columbia University. She is the host of the Sacred Medicine Podcast and author of  “From Flare to Fabulous 25 Things You Must Do to Avoid Your Next Lupus Flare.” 

On this blog post, we are going to talk about…

  • Why you should stop worrying about getting a diagnosis and start getting to the root of the problem.

  • What it’s like to work with Margaret

  • What two foods are essential to leave out of your diet if you suspect or know that you have autoimmune conditions.

  • The secret hidden puzzle piece that might be affecting your health and keeping you from feeling better.

  • Why the suggested ranges on tests might not mean that you are in the normal range for your body.

  • The Vitamin that Margaret tests for and starts patients on right away if she suspects autoimmune disease

Welcome Margaret, to The Functional Gynecologist blog.

Margaret: Thank you so much for having me. Tabitha,

Tabatha: I am really excited about this conversation, because I feel like so many women are either diagnosed with autoimmune way more than when I was in medical school, or they are showing up with an autoimmune type presentation. Are you seeing the same thing?

Margaret: I don’t know if it’s because it’s my specialty, but it just seems to be this growing epidemic in women.

Why Do You Think We are Seeing a Growing Autoimmunity Epidemic in Women?

Tabatha: Why do you think this is?

Margaret: There are so many contributing factors. Everything from gluten, glyphosate, toxins, environmental toxins, everything from Lysol to fragrances to all of these things. I think it just sort of breaks your body down. Then throw in genes, bad diet, fast foods, and things. Things just tend to easily go off the rails.

Tabatha: I’d like to get into that, but first, why don’t you tell us your story?

Tell Us Your Autoimmune Story

Way back in 2006 I had your typical lupus symptoms. Initially, it started with just a sore wrist joint. Then it would go away and then it would go to a different joint. This is way before I was into autoimmune or any of that stuff. It progressed pretty quickly. I was in the hospital and I had multi organ involvement lupus nephritis. It affected my liver function. I had pleurisy and muscles and joint pain so severe it was so hard for me to walk. I just ached from head to toe. Even my scalp would hurt. It was a very difficult period of my life.

One day, I noticed that after almost every meal, my knee joints would get really red and swollen. So I went to see the rheumatologist and I said, listen, I really think that we need to check for celiac disease. Every time I eat, I don’t feel well, there’s something going on. I want to get a gene test, and I want to test for intolerance. I think it’s really important. She said, no, just save your money, you’re not going to need any of that stuff. Just take your medicine, which by the way was 20 pills each day.

I took my medicine. I was a hot mess, my hair was falling out. I gained 30 pounds of water weight from all the steroids and I wasn’t feeling any better. I found a way to get gene tested. The test came back. I found out that I have two non celiac gluten sensitive genes. Almost immediately, I became gluten free. I bought cookbooks, I attended cooking classes, I went online and researched things. At the time, gluten free was not as big as it as it is now. I did everything on my own. I just was determined to feel better.

Within one week of being off gluten, the redness was gone from my joints. There was no more no more pain. I was just floored. I thought why didn’t she want to test me? Then I realized, even if she tested me for celiac disease, it wouldn’t have showed up. Thank God, I had this gene test that allowed me to see that I have these two non celiac genes. That changed everything for me. After that, it took me a couple years to really figure it out because I would eat a certain way or take supplements. Then have labs drawn to see if anything changed. I would draw my blood four or fives times a year. Aside from that. I was doing all of the functional tests as well.

The First Thing I Discovered Was…

The very first thing I discovered was that my body did not like gluten. It was the tipping point, though if I’m honest, symptoms began a few years before the pain started. I was having GI issues. I was severely constipated. I would have to go to get a colonic in order to have a bowel movement. It was so bad. At the time, I did not know that this was connected. I do now.

I learned so much more once I did my stool testing and all kinds of other labs my regular doctor that had never done for me. I have no idea where I would be now if I just continued on their regimen.

Dr. Tabatha: It’s tough to predict. You could be in kidney failure at this point on dialysis. It’s really scary. When I think of autoimmune diseases like lupus, Hashimotos, celiac, rheumatoid. I think of them almost as the same disease process just affecting different parts of our body. Would you agree?

Lupus and Other Autoimmune Diseases Are the Same Process, They Just Affect Different Parts of the Body.

So many patients, get caught up, figuring out their diagnosis so that they can get the appropriate treatment, because that’s what conventional medicine has trained everyone to think, right? Until you have that diagnosis, we can’t give you the correct medication. I encourage patients not to wait until they get the diagnosis of Lupus. If your AMA Test (Antimitochondrial antibodies test) is positive and nothing else is showing up. Let’s intervene and take action to start reversing this.

Tabatha: I talk about this so much. I do not sit on a positive AMA test result. The majority of my patients are being told if they don’t have symptoms, there’s nothing your doctor can do, but that isn’t the way I look at it.

Margaret: Right. Come back when you have a diagnosis.

Tell Us About the Process of Working with You

Tabatha: Could you explain to my readers what it looks like when women are first starting to work with you?

The first thing I do is get lab testing done. A lot of people tell me they had all of their blood tests done with their rheumatologist. I tell them that was to diagnose you, but not to really find out what else is going on and what else is involved here. I check for various things depending on the age, symptoms etc. I always check for vitamin deficiencies, sometimes I’ll do a heavy metal panel and check for chronic infections. I’ll check insulin just to cover all of my bases. Basically I’m just checking to see where there’s deficiency, because typically, people with chronic illnesses are very deficient in several places. They’re rundown, and their bodies are depleted. They have very little nutrient stores. So I start with blood work. Then the second thing is comprehensive stool test.

Tabatha: Yeah, I couldn’t agree more. We know autoimmune disease is activated through our gut. Right? Can you talk about that a little bit?

Autoimmune Disease is Activated Through the Gut

Oh, my gosh, yes. If you want to worry about anything, worry about the condition of your gut because that will determine how well you are and if you develop any chronic issues or not. I think it’s so critical. I really wish that stool testing was just part of mainstream medical testing. It would be so amazing if everyone got it done once a year. Do you know how many people would not be so sick?

The thing is that you need to know how to read the test. If you don’t know about how to read it, it’s not useful. I hear that all the time from patients. I had the stool tests, but what they had was a fecal occult test for blood or maybe calprotectin level, but they did not have their microbiome and digestive function evaluated. Those are all key processes that control autoimmune disease.

Tabatha: Absolutely! Or they’ll do a stool ova and parasite test, but that’s someone looking through a microscope to see if they can find anything. You’re really not going to get much because they are reviewing tons of samples every day.

Margaret: Right and with one little sample, you could miss a parasite or a worm.Tabatha: Absolutely and it doesn’t tell you the health of your gut microbiome, or anything else, honestly.

You have to beg the gastroenterologist to order that kind of stuff. It’s very sad, how stuck in their ways they are, but it’s a broken system. It’s driven by insurance, if it’s not covered by insurance, they don’t want to order it, they don’t want to deal with the rejection and explaining to the patient. It’s just easier not even to address it at all. We need more people like us to break out of the system and help fix it because it’s, it’s not serving our patients.

Margaret: Definitely not. I mean, going back to what you were asking me, for, I’d say about 90% -98% of my patients that have gas and bloating, or have had IBS or IBD. No one’s ever asking, why do I have this?

What is Leaky Gut?

Tabatha: Okay, so you are looking for all of those different systems, thyroid, adrenals, blood sugar, you’re looking for vitamin and mineral deficiencies. You’re evaluating the stool for gut function and balance.

How is Your Approach Different than a Conventional Practitioner?

First, I don’t look at reference ranges. You can have someone with a B 12, level of 300. That’s normal range, but that is not optimal range. As functional medicine providers, we look at optimal ranges, this is where you need to be. I don’t care that the reference ranges is. I think that’s the biggest difference. But thyroid, someone comes in, they say, oh, no, I’m 4.0 that’s within the reference range. I’m like, that’s not good.

Dr. Tabatha: Where I live, it’s up to five. I say, Do you feel good? Do you think you’re in the good range right now? And the answer is no.

Margaret:

Right. So that’s one big difference, I look at optimal ranges not reference ranges. I also don’t write prescriptions as my go to. I can. I want to if I need to, but that’s not where I start. I want to figure out what’s going on. Almost everyone is vitamin deficient. So that’s one of the things that I look at, because how can you heal if you are depleted? It just doesn’t work that way. First I try to figure out all of the deficiencies, and get my patients on the supplements that are needed to fix the deficiencies.

Is There a One Size Fits All Diet for Autoimmune Disease?

Tabatha; Tell me? Is there one diet that fits everyone who has autoimmune, especially lupus? Are there diet changes that work for all patients?

Margaret: Well, for me, and from what I have seen in my patient population, almost everybody is gluten sensitive. I test for it, but I usually have them take gluten and dairy out for at least nine months. There is the Autoimmune Paleo Diet, which is also out there. I think that’s pretty good. There are some key foods that I tell them to try not to do like peppers, or potatoes, but sometimes people are very thin and depleted. I don’t want to take out too many things from their diet. Gluten and dairy are definitely the two big ones. If after a while, they start to feel better, they can slowly introduce it and see how they feel. I will tell you, though, that the majority of them do not feel good after they consume it after being off it for a while.

Tabatha: Without a doubt. So they remove the food triggers and they’re trying to eat to nourish themselves. What else are you having them do to really get this autoimmunity under control?

Margaret: I also look at food allergies. If I noticed indications in the blood work. For example, if I noticed really low cholesterol levels, and they’re not on a statin. That tells me they have leaky gut. Anything less than, like 150. You probably have leaky gut. Typically, a lot of people have leaky gut syndrome and permeability issues. They’ve probably had it for a long time, because they’ve been sick for many, many years. If that’s the case, what I also see is a long list of food sensitivities. I try not to start food allergy testing, right in the beginning when we start working together, because they’re just going to be a reacting to almost everything. I find that if they see something like a long list of foods to avoid they feel really defeated in the very beginning.

Tabatha: What do you think is the biggest game changer? Is it the diet? Is it the supplements? Is it something else? What really gets women feeling better?

What is the Biggest Game Changer in Healing Autoimmune Disease?

That’s a good question. It depends. Let’s say they come to me with fatigue. I try to get them on supplements that will start giving them some energy. So they’re starting to feel better. At the same time, we’re removing gluten and dairy. Most people tend to be vitamin D deficient if they have an autoimmune condition. I’m putting them on some really good supplements and changing their diet. Once people start to remove gluten and dairy, it doesn’t really take them that long to start feeling a lot better in their body. Once they started seeing and noticing some nice changes, and their body getting the nutrients it needs, it doesn’t it really doesn’t take that long, but it is a combination of things.

Tabatha: Definitely! I know personally for myself getting rid of gluten was life changing, but I really made traction when I worked to heal my gut and discovered through genetic testing that I have three different mutations responsible for my inability to make vitamin D from the sun. I think understanding ourselves as individuals is key, because I realized I need a lot more vitamin D in a different form to be able to even absorb it. However, I needed to heal my gut first. I love your approach to this, because I think that is the only way that you can really get control of an autoimmune process, you know?

Margaret: How much Vitamin D Did you Need to Take?

Tabatha: I did 50,000 IU for a week. Then I did 10,000 IU and you know, for a couple months. I fluctuate, I’m not the best supplement taker, I’ll admit that. I go in waves. I do my best. When I stop taking it, I don’t feel well.Then I start taking them again. I’m usually in the 5000 to 10,000 a day range living up in Michigan. I rarely see the sun, and when I do you’re supposed to wear sunscreen.

I think it’s important for women to talk about their autoimmune journey, because it can have so many different pictures and so many variations, right?

Autoimmune Journeys Can Look Different for Everyone

Yes, there’s such a variety of different autoimmune conditions. With that, there are so many symptoms, but I also see a combination of things. A lot of times, I see celiac and Hashimotos. I see lupus and Hashimotos. I see lupus and celiac.

What Do You Recommend That Women Do First if They Think They Might Have an Autoimmune Condition?

Say someone hasn’t been diagnosed with any of these actual diseases yet, but they feel like they must have an autoimmune issue going on because they’re having chronic fatigue, unexplained joint pain, muscle weakness, things like that. What do you recommend they do first? Should they go after testing and try to figure out that diagnosis? What should they do? Well, first I would probably do an AMA test and an anti-dsDNA test to see if they actually have an autoimmune condition.

I have a lot of women who come to me who say, I don’t feel right. There’s something wrong, something’s off. They haven’t had blood work, or they have just had a CBC, a CMP and a urine test. They are told “we found nothing, you’re fine”. Which is not true because nobody is actually looking, in the right places, or doing very in depth lab work to really know what’s going on. Most women when they come to me feel like they have not had any testing. I test for everything that I initially talked about, because I need to figure out, well, why is she so tired? Then the test results give me clues as to what’s going on and what the next step should be.

Tabatha: Awesome! Say they go through all of this process, they’re making all of the changes. Do you ever see women who just aren’t getting better? There’s something deeper that you haven’t really uncovered yet?

Common Symptoms of Autoimmune Disease

Have You Discovered Anything That is a Commonly Overlooked Trigger for Autoimmune Conditions?

Yes, one of the things that I have discovered in the past year and a half is mold. I think that that can sometimes be the missing piece, when people aren’t getting any better. It’s a good idea to check for mold. I’ve actually started testing for mold as a part of my routine testing. Now, you can just check it in the blood or you can get a urine test as well. Even if you can’t see or smell mold, it could still be in your environment and making you sick.

Dr. Tabatha: Right? Exactly. I see that as well. You can get the majority of the patients feeling better with the diet changes, supplements and balancing out their other systems, but there’s always maybe 10% of women who need more investigation. Maybe they need to get rid of their heavy metals, their toxic burden, their mold exposure, or chronic Epstein Barr Virus, things like that. I see a lot of chronic viral infections, ecurrent shingles outbreaks, etc. Do you see that as well?

Margaret: I’ve been seeing that so much, and young in young women too. Chronic infections are pretty normal. Those are things that are also never checked.

Tabatha: That’s why I encourage women to step away from conventional medicine and find a functional practitioner, integrative medicine doctor, someone who is thinking outside the box, who’s doing testing that isn’t covered by insurance. I just don’t want women not to get evaluated and properly treated, because it’s not covered. I don’t want them to be stuck in that mindset that they can’t take care of themselves, because the doctor isn’t, ordering it. I see that quite a bit. We just have to take ownership of our health and what’s happening to us, right?

Margaret: Oh, my gosh, so much. What is the deal with doctors refusing bloodwork that patients are asking for. What is that? Why? Why are you ignoring what they want?

Dr. Tabatha: Yeah, I’ve worked alongside doctors like that. From my best understanding, it’s because they don’t know what to do with those results. They are held liable and responsible and they wouldn’t know what to say to the patient when the tests came back. I think that’s a huge frustrating piece for some women. They haven’t had other options, but now you and I, we both work virtually, so really, that barrier is gone. You can see anybody anywhere and get the help that you need.

I would love for you to tell my readers, where to find you, how to work with you. All of that good stuff.

How Can My Readers Connect With You?

My website is margaretromero.com and I am on Instagram every single day and because food is like my obsession and gluten free food in particular. Those are my two biggest places where where I hang out.

To Wrap it Up

Wasn’t that an awesome interview? I told you there would be some amazing information in this one. I just love her approach to healing Lupus and other autoimmune diseases. I’m telling you ladies, if you feel like you aren’t being heard and you aren’t feeling well, you HAVE other options. Look for a new doctor who specializes in functional or integrative medicine and start getting the answers and healing that you deserve.

What was your biggest aha moment in this post? Send me an email at info@drtabatha.com or leave me a comment below and let me know what your biggest takeaway was. I’d love to hear from you.