Brave New Medicine With Cynthia Li, MD

Yeah. I would say it's not enlightenment. It was really a breakdown, complete breakdown of my body. And I was about three years out from my residency training. So sort of at this place in my career where I felt a strong sense of mastery. You know, I knew all the research, the latest protocols, and I was feeling just a great sense of pride, but also the sense of mastery. And it was at that time that my husband and I had our first child. And when she was about four months old, I developed postpartum thyroiditis, which is the postpartum form of Hashimoto's thyroiditis, an autoimmune condition of the thyroid gland. It affects things like blood pressure control, heart rate, digestion, breathing, body temperature. And so I felt I was on the verge of passing out. I have profound exhaustion, literally cannot get off the couch. So it took about two years. I mean, as I trained, as an internist, as an expert in chronic conditions and these sets of conditions were not only ones I didn't know how to treat or that Western medicine had really no good remedies for, but I hadn't quite believed them to be real. You know, I thought that there was a huge psychosomatic component to it. We had no way of measuring it. So I got off and was pretty much on my own. I did not know about. I knew vaguely about integrative medicine, just some lifestyle changes. But I was too exhausted, too debilitated to do that. And I had two young kids. I did not know about functional medicine at the time, and I was very skeptical of anything alternative. So I really went back to my pathology, went to one textbook and went back to fundamentals and began to really dig deeper into how chronic diseases begin and how did they progress. So it was really going back to fundamentals that opened me to new ways of seeing and new questions to be asked.

I would say that no doctor outright called me a difficult patient, but I knew from my training that I had become one of those. And you know, it can really be anything from somebody with a really challenging and abrasive personality to someone who like me and like millions don't fit into the paradigm. Whereas as you just said, it's actually a difficult case. And patients like me are coming back again and again because we are deeply suffering. The last place I wanted to be in a doctor's office. So I remember that moment when I saw it was in my endocrinologist's eyes. You know, we were there was a little bit of tension in the visit. And I was actually presenting research that I had found about potentially foods that might be exacerbating my symptoms. And he just looked at me and said, you know, your thyroid numbers look great. You know, it's fine. So it was I myself who diagnosed chronic fatigue syndrome and decided, no, me. I remember I was in the bathroom and I was barely able to stand up after a shower. And I basically took my vital signs and realized that from simply just standing, I had taken a shower, rested because I was exhausted and then got up and was taking my vital signs. I was just standing there for about five minutes. My heart rate went way up to about 140 as if I had just done a good run. My blood pressure was tanking. And so I realized, oh my God, you know, and that's one of the telltale signs of disorder. It's out of sync with what it is that your body's actually doing. So I thought, oh, my God, I've got ME and chronic fatigue syndrome because it's been going on now more than six months. It makes it feel like there's something tangible to work with. And the way that I've been trained, everything did hinge on the diagnosis. Right. If you get a diagnosis of diabetes and you meet a certain lab criteria or a certain set of symptom criteria for other conditions, then we know what the treatment plans are. And all the studies are organized that way in terms of treatment arms. Right. And how people do with this particular treatment versus that with a particular name. And the diagnosis of chronic fatigue syndrome and decided no me were quite the opposite. It was basically naming the symptoms that I had with no further answers. I was so brittle that there was no way I would be able to even follow through or undergo any more diagnostic testing. So it took me quite a while to get to the place of seeing an acupuncturist. But in my doctor's mind, the way that I approached it was what can I do that is low risk, something that is not going to set me back even further with a potential gain. I wasn't even going for high potential gain. I was just going for any kind of gain with low risk. And so it was a friend who really urged me to go into acupuncture because it was seemingly low risk. And my response to that was really profound. And it got me to the place where chronic vertigo was another one of my symptoms. And that, along with exhaustion, was really what kept me housebound for a couple of years. And it got me to the place where the vertigo was good enough to where I could actually read books and I could go online without having worsening vertigo. So I began also at that time my own research into what was out there and what science was there.

Yeah. And you know, the other thing, my thyroid levels were normal. You know, I still had all of my hyper and hypo overactive and under-active thyroid symptoms like sort of all bundled together. And also my screening labs were normal. You know, the kind of standard complete blood count, the liver screen, the chemistry, their analysis. You know what most people get if they go to the doctor, whether for regular checkup, all of those were within a normal range. And so the disconnect was very profound for me. And I thought, God, you know, as a doctor, when I look at these labs, I would certainly not correlate with someone who is debilitated. So it was humbling because, you know, so often I rely on diagnostics. Well, when I was working at the time, had relied on diagnostics to reassure me about how patients were doing. And what's more important is really what they're experiencing and the quality of their life. So the challenge with lab tests is that, first of all, they're taking a snapshot just at the time that you had it drawn, which is limiting. The second piece is that a lot of patients and this goes back to your earlier question about what patients who have these mystery symptoms, approach the body really as a whole ecosystem and not just the body as an ecosystem, but there's an ecosystem within and on us, right, with the gut flora and the viruses and the parasites and the yeast and the bacteria. And then also we're living within ecosystems around us. So, you know, our zip code, there's that saying that. Right, the zip code matters more than genetic code. So what kind of environmental exposures am I getting to? Chemicals and pollutants? What kind of access to fresh food do I have? Am I getting enough movement in my day to day life? And just to say nothing of stress? What is the day to day minute by minute of my existence? So an example would be my thyroid was out of whack in the beginning. It's not just my thyroid gland. It's actually my entire hormonal system that was out of balance. And then it was manifesting largely in my thyroid gland and that's connected to my immune system. Right. This is an autoimmune condition. And then the immune system and the hormone system are connected to the neurological system, to our digestive systems. So all of these systems are a little bit or sometimes a lot out of balance and they're pulling on each other. And so with the Western medicine approach, we tend to isolate and want to treat one thing. But you've got all these other systems that are needing support and needing tweaking as well. If I, for example, prescribe a particular diet for a patient or a particular mind body practice for a patient. They're focused on what they're doing, but it's addressing and sort of writing multiple systems at once. So the healing becomes much deeper and much more comprehensive. To say nothing of the fact that these modalities really encourage the patient to get much more in touch with themselves. I think that's the most healing of all is to get back into your body, reconnect with it, you know, in a compassionate way, which is really the root of healing.

Yeah. You know, trauma is a really big factor. And it's a delicate topic to broach because of this notion of psychosomatic. People often say, oh, you just said that. You know, it's not in your head. But now you're saying that there's a lot of trauma that happens, you know. And so when we say, oh, God, it's not real. And there's a lot of data now. I mean, it's been around for decades, but it's really kind of coming to the forefront now about childhood trauma and how within these formative years, it doesn't even have to be overt violence per se, but perceived trauma. And so there are children, for example, who are just very sensitive, are more sensitive to negative influences or to an authoritarian parent than their sibling. And what it does is it sets up patterns in the stress system, in the hormone system and the neurological system. And then in the immune system, it sort of gets primed, you know, and then they learn how to cope. So then later in life, let's say there's multiple tours and oftentimes there's multiple, multiple triggers. And, you know, and I remember when I was writing my book and living back into the timeline of my illness and healing journey, the third idea seemed to come out of nowhere. I mean, I was like really healthy, quote, unquote. And then the chronic fatigue syndrome and the disorder, me, I hit very abruptly on a trip to Beijing. And what I know now is that while the manifestations of those diseases were abrupt for me, that these and there were imbalances going on for a long, long time. You know, it's a trauma, as you say, it's a trauma of sorts. You're going through medical boot camp. I also had a relationship then a man that I was engaged to. And a big tragedy happened and it was incredibly stressful. And so that can be aggravations on top of an immune system and a hormone system that's already been sort of primed by stress, you know, and then you add that to genetic susceptibility to autoimmunity and then you kind of get the perfect storm. And I think so many of us go through traumas and through stress.

Yeah. So the first place always to start is food. And food is actually it's hard to change your diet. It's hard to do any lifestyle changes, but it's easier than, for example, going right in and dealing with your trauma or trauma, for sure. So, yes, it's just like a baby. Exactly. And so, you know, one of the ways is really how do we fortify the physical body to get to a place where then we can begin to what I call detox the soul. Oh, I can do mind body practices that literally release and change the way that my DNA is folded so that it's physically kind of at the cellular level releasing trauma. So you sort of bypass, you know, years of talking about diet. Let's talk about this. So what are some of these practices then to release the trauma that you found effective?

Yeah. So for me and it's going to be different for everyone, but for me was really going into a mind body practice called Qigong. And again, I didn't enter it thinking I was going to do trauma work. I was doing it because, oh, OK, I need to rehabilitate my inner workings. And the only way to do that right is by doing my body practices. It's from traditional Chinese medicine. But there's three components. There's the movement part. There's the meditation and consciousness work. And then there's sound vibrations. So sort of like, you know, the way chanting is, you know, people do it in different traditions and the vibrations actually, together with the movements, they begin to just they rewire the way that my brain was wired. So changing the neuronal connections to a healthier pattern, or I would say out of the chronic illness pattern, chronic inflammatory pattern. And, you know, there's no data on this right now. But I felt like through the chanting and the movements that I was releasing trauma that actually wasn't even mine. I had kind of inherited it. Right. My parents survived wars. My grandparents, you know, they were parents during the wars. And there was tremendous trauma and sort of this fight or flight mode of living. And then the other thing that helped me was great for it was actually was not processing mentally the grief, but I went to a grief ritual. And again, it's a somatic it's a visceral response, you know, of. It doesn't matter what I thought I was going there for, which was actually my health will break down of my body and the years that I lost. But, you know, all this stuff from even my childhood came up when I was there. So I just felt like it was like a detox. I felt like, oh, you know, I just did a massive detox. And in the spaciousness that opened up empathy, you know, confidence, compassion, peacefulness. These qualities that we associate with resilience. They filled up that spaciousness. You know, as a side effect. So I did not know. It wasn't like, oh, I suddenly decided I was going to get self agency and then become resilient. I was really there was no room in me. So it was about how do I let go.

Yeah, it's really powerful. It's through something that's going to engage the body. Well, even think this will be. Yeah. They even talk about dancing. How dancing is very soothing. Yeah. And dancing is another. Yeah. And I have a lot of patients who do that or even like laughter yoga. You know, I mean, it's not it seems almost opposite of going to a grief ritual after yoga, but it's a visceral response. And going to grief ritual is not going to be for everybody. So, you know, you can opt for laughter yoga, but it has to be something that's where you're inhabiting your body. Yeah. So there's lots of avenues. And, you know, in another way, going back to your other question, is healing the gut.

Yeah. Let's get back to the diet. Like what causes leaky gut? And then what steps do we take to heal that? Yeah. I mean, there are a lot of factors that can cause leaky. Leaky gut is basically, you know, the epithelium, the barrier in the gut where we're absorbing nutrients and, you know, we're colonized right. Where we've got this rich micro ecosystem of microorganisms that are helping us digest and metabolize and absorb. But they're also the keepers of the gut lining. So when this micro ecosystem is out of balance, we can almost look at it almost like a monoculture. And that's really what confers resilience to a system. Is this diversity? So multiple factors can cause the gut flora to go out of balance. Emotional stress is one big one. Chemicals, you know, pesticides, medications, processed foods, again, monoculture foods. So for sort of eating a lot of things that are processed wheat and corn derivatives, it can all contribute to it. You know, I don't know anybody who is not exposed to things and their own hormones. Hormones can contribute to. So there's a lot of factors. Infections. But we usually have a reserve and we can it's just like having another acute stress. We can get over it. So then the keepers of the gut lining are out of balance. And what happens is then lots of particles that are food or non-food are then crossing that barrier. And flooding right outside that barrier is the vast majority of our immune system are sitting there in lymph nodes sort of waiting and they're learning actually what their duties are going to school. They're learning what is self, what is myself and what is a foreign or not even just a foreign protein, but what is a harmful foreign protein. Right. I mean, the immune system is so sophisticated where they actually know which microorganisms are beneficial and which ones are not. And that's really what auto immunity is, is an immune system that's gotten hyped up and then is now starting to get confused. Right. Certain sequences in the protein and gluten, for example, are very, very closely linked to certain sequences in the thyroid gland. So oftentimes they write. It's called molecular mimicry. The immune system gets confused. And now they're actually meaning to attack the gluten. Now they're attacking the thyroid gland. So the leaky gut or intestinal hyper permeability is a really big target. The first target for healing of autoimmunity and actually any other chronic disease. And this is not a it's a new concept sort of scientifically.

Yeah, intuition. That was one that completely came out of left field for me. Intuition has been used and misused, I would say this many times. But the definition I like the best came from the Heart Math Institute of Silicon Valley. And they do really cool experiments on things like the electromagnetic field of heart. And how does that affect someone in your own? That is beyond the standard cognitive processes. And that is more based on sensations in the body that then guide this knowing. So again, it kind of goes back to this visceral experience in tuning back into the body. And the reason why I even went into intuition was because a friend of ours had come to stay with us. She was psychic. She was clairvoyant. We knew this about her, but had never gone there. Just, you know, I was skeptical. And, you know, who needs to hear those kinds of stories? And I was also a little bit freaked out. I was just freaked out because it was so outside of my world view. And my daughter's night terrors, which go on for months, stopped in an instant. So I had asked her I didn't know, first of all, that intuition was something you could develop. I didn't know it was something like art or music, where some people are born gifted. But the vast majority of us are kind of under this bell curve and we can learn no matter where we begin on that bell curve. I was more asking her, hey, you know, if you could kind of clear that energy, can you help sort of clear the energy that's in my body? I had no clue, but I thought I would just take a stab at it because again, it was low risk. Right. So she said, well, it doesn't quite work that way in the body. But what I can do is I can teach you how to develop your intuition. So that's really how that journey began. I was horrible at sitting meditation and my mind was just way too active. And that's actually how I got into Qigong. Oh, there's actually meditation that's moving where I can focus my mind on movements. And it gave my mind something to get something to do. But my impetus for developing my intuition was that I had suddenly gone from conventional medicine, which had no answers for my conditions to integrative and functional medicine, which was incredible. But I had an infinite number of possibilities of things to try, which supplements to do, which vitamins, God forbid, which diet. Right. So the intuition, I felt like was helping me to hone in a little bit more efficiently on which path to take. But oh, lo and behold, six months later, you know what? You really need vitamin C and you can do it at higher doses. So the longer I develop, learn to practice and develop my intuition. And I pair it always with my analytical mind. Right. So I think of it just as we have two eyes to see deeper and broader. And that intuition is just that other is my right brain. Then pairs with my left brain and can I see more deeply and more accurately into what's going on, not just for myself, but with my patients as well.

New World is this dystopia of what is modern healthcare. So it was a negative connotation as much as I love Aldous. So but then the other piece that I was cautious about was that it sounded so certain. And I said, you know, there's so much uncertainty, even with functional medicine. There's a lot of uncertainty. So when I began to bring in the intuition piece and going into this whole new world, that was yeah, it was new and scary for me. And it sort of embraced the uncertainty. Body And how do we go in there? How do we learn to listen? And how do we find out things about ourselves that are kind of scary, that are parts of ourselves that we don't want to see. So that's where that name came from.

You'd have to go back to inhabiting your body, reconnecting. And, you know, along with that is, you know, one of the threads I really explored in my book and which is why I decided to write a memoir. It's about belief and how beliefs can either trap us or we can really liberate us. And, you know, the hardest part of healing, I think there's also the simplest, which is believing that it's possible. And again, if we go into the body, our left brains can remain skeptical. I'm still skeptical. But going into the body sort of bypasses that skepticism and allows the healing to happen.