Learn True Health with Ashley James

On Learn True Health, Ashley James interviews today's most successful natural healers each week. Learn True Health was created for YOU, the health enthusiast. If you are passionate about organic living or struggling with health issues and are looking to gain your health naturally, our holistic podcast is what you have been looking for! Ashley James interviews Naturopathic Doctors and expert holistic health care practitioners to bring you key holistic health information, results based advice and new natural steps you can take to achieve true health, starting NOW! If you are sick and tired of being sick and tired, if you are fed up with prescription drug side effects, if you want to live in optimal health but you don't know where to start, this podcast is for you! If you are looking for ACTIONABLE advice from holistic doctors to get you on your path to healing, you will enjoy the wisdom each episode brings. Each practitioner will leave you with a challenge, something that you can do now, and each day, to measurably improve your health, energy, and vitality. Learn about new healing diet strategies, how to boost your immune system, balance your hormones, increase your energy, what supplements to take and why and how to experience your health and stamina in a new way. Ashley James from Learn True Health interviews doctors like Dr. Joel Wallach, Dr. Andrew Weil, Dr. Deepak Chopra, Dr. Oz, Dr. Joseph Mercola and Dr. Molly Niedermeyer on Naturopathic Medicine, Homeopathy, Supplements, Meditation, Holistic Health and Alternative Health Strategies for Gaining Optimal Health.
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Now displaying: May, 2019
May 31, 2019 and use coupon code LTH for 20% off!

"We sell two types of algae: spirulina (ENERGYbits) that provides energy, focus and satisfies hunger and chlorella (RECOVERYbits) which builds the immune system, removes toxins, strengthens the liver and helps prevent chronic illness like heart disease, cancer, and osteoporosis."

May 25, 2019


Become A Health Coach-Learn More About The Institute for Integrative Nutrition's Health Coaching Certification Program by checking out these four resources:

1) Integrative Nutrition's Curriculum Guide:

2) The IIN Curriculum Syllabus:

3) Module One of the IIN curriculum:

4) Get three free chapters of Joshua Rosenthal's book:

Watch my little video on how to become a Certified Health Coach!


Learn How To Achieve Optimal Health From Naturopathic Doctors!

Get Learn True Health's Seven-Day Course For FREE! Visit


Do You Have Anxiety? End Anxiety Now! Learn Two Powerful Mind Tricks for Removing Anxiety, Ending Worry, & Controlling Fear So It Stops Controlling You! Attend my FREE Webinar that Will Teach You How! Click Here!

Need Help Ordering The Right Supplements For You?

Visit, and a FREE health coach will help you!

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Visit for your free 30min coaching call with Ashley James!

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Thank you!
Ashley James

Enjoyed this podcast episode? Visit my website Learn True Health with Ashley James so you can gain access to all of my episodes and more!

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Music used Aurora by Jonny Easton
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May 17, 2019

"It's not about the strep, it is about susceptibility. You have to ask why your child gets a common illness and ends up looking like a mental patient instead of getting a fever and a sore throat like other kids. Killing the bugs that caused it won't prevent it from happening again. Nothing will unless you treat the susceptibility."

 FB Group:


Become A Health Coach-Learn More About The Institute for Integrative Nutrition's Health Coaching Certification Program by checking out these four resources:

1) Integrative Nutrition's Curriculum Guide:

2) The IIN Curriculum Syllabus:

3) Module One of the IIN curriculum:

4) Get three free chapters of Joshua Rosenthal's book:

Watch my little video on how to become a Certified Health Coach!


Learn How To Achieve Optimal Health From Naturopathic Doctors!

Get Learn True Health's Seven-Day Course For FREE! Visit


Do You Have Anxiety? End Anxiety Now! Learn Two Powerful Mind Tricks for Removing Anxiety, Ending Worry, & Controlling Fear So It Stops Controlling You! Attend my FREE Webinar that Will Teach You How! Click Here!

Need Help Ordering The Right Supplements For You?

Visit, and a FREE health coach will help you!

Do you have a blood sugar issue? I can help you achieve healthy, normal and balanced blood sugar naturally!

Visit for your free 30min coaching call with Ashley James!

Join Learn True Health's Facebook community group!
or search Learn True Health on Facebook!


If this episode made a difference in your life, please leave me a tip in the virtual tip jar by giving my podcast a great rating and review in iTunes!

Thank you!
Ashley James

Enjoyed this podcast episode? Visit my website Learn True Health with Ashley James so you can gain access to all of my episodes and more!

Follow the Learn True Health podcast on social media! Share with your friends and spread the word! Let's all get healthier & happier together!

Learn True Health - Facebook:
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Learn True Health - Medium:
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May 14, 2019

Info From Dr. Katie Tredo:

Here is a link to find a pelvic PT near you:
Contact info for my clinic for local patients: (262) 241-2131 11725 N Port Washington Rd, Mequon WI 
beautycounter website:

Instagram- @katie.tredo
Facebook- Katie Dickelman Tredo


Do You Pee When You Laugh?

We hear "pelvic rehabilitation," and we think "women giving birth." Hold that thought. Katie Tredo, a physical therapist specializing in pelvic health, explains how pelvic rehab can benefit men and women, adults and kids alike.


[00:00:03] Ashley James: Welcome to the Learn True Health podcast. I'm your host, Ashley James. This is Episode 353.

Hello, true health seeker, and welcome to another exciting episode of Learn True Health podcast. I'm excited to bring you today's interview because the information is so life-changing for those who need it.

Even if you don't have pelvic floor issues, you'll want to listen to today's episode because she also teaches preventive measures to help us sustain a healthy pelvic floor. Every woman knows someone who has pelvic issues. This is a big deal, and a lot of people don't know that there is help.

Today you're going to learn about the natural and effective ways to create a healthy pelvic floor. For some people, it will be life-changing information, so I'm very excited to bring this to you today.

Please visit because in the show notes of today's podcast, there are some free resources that have been provided for us. Also, while you're at, I want to let you know about a few other resources I have created for you. We have a 7-day workshop that's delivered by naturopathic physicians to teach you the foundations of health. You should apply for that. It's free.

Just go to and put in your email, and every day you'll be given a video by one of the naturopaths that I've worked with. Also, on the website, in the menu bar in the upper right-hand corner, if you're on a desktop, or click on the little menu bar if you're on your phone, there's 'Ashley Recommends.' That takes you to a part of Amazon where I have picked out all the things that either past guests have talked about being helpful or I have in my home that is helpful for me--kitchen gadgets, and all kinds of wonderful health goodies, including my absolute favorite replacement for the microwave, if you are like me and you don't use the microwave because you know of the unhealthy effects that microwaves can create. If you've never heard of that and you're going, "Oh, my gosh, wait! I use the microwave every day. What’s going on? I put my plastic container in the microwave. What do you mean that that’s unsafe?”

Yes, absolutely. We've talked about it in past episodes. I wouldn't get into details here, but there's a replacement for the microwave that is safe and healthy. I have it in the kitchen section. Just go to and click on 'Ashley Recommends.' From there, you will see my absolute favorite health gadgets and wonderful goodies.

There are lots of resources on Learn True Health website, including most recently we’ve started to transcribe all of the interviews that we're posting. You can go to the most recent interviews at You can read what the guest has said, which is so helpful. The feedback listeners have given me is that they listen to episodes sometimes two or three times while taking notes because of how valuable the information is that's been delivered by the experts I have on the show. Now, it’s going to be a lot easier for you to be able to go through that information because we're transcribing the interviews!

Thank you so much for being a listener. I know you’re going to share this episode with those you love because, ladies, if we pee when we laugh, that means we have pelvic floor dysfunction. We can correct it. Men can have pelvic floor issues as well.

If we have a pelvic floor issue, we can have pain, incontinence, pain during intercourse. For children, they can have problems potty training or wetting the bed. This is not just a female issue, but it’s very common for women after giving birth to have a pelvic floor dysfunction. The most common thing we hear from women after we have had a few children is that we pee when we laugh. Guess what? There's a way to correct that. You're going to learn it right now.

We are in for such a treat today. We have with us Katie Tredo. She’s an amazing physical therapist who specializes in pelvic health.

Is it only for women--the pelvic rehabilitation?


[00:04:45] Katie Tredo: No. I treat men, women, and children.


[00:04:48] Ashley James: This is cool. I know before we record, we were talking about postpartum health. When I think of pelvic rehabilitation, I think of women after giving birth, and how messed up we are in that area. That's interesting that what you do can help everyone.


[00:05:09] Katie Tredo: I see a lot of women who have never given birth, too.


[00:05:12] Ashley James: Interesting. Just yesterday morning, I was with a girlfriend. I said something funny, and we both keeled over laughing. She said, “Stop it. You're going to make me pee.” Of course, I was already peeing. I didn't know that this was such a common problem that women can develop after having children. I was told that I should see a pelvic rehabilitation practitioner because there are exercises and things we can do to restore a pelvic floor, so we don’t have these accidents every time we sneeze, cough or laugh. That piqued my interest in hearing what you have to do, but you do so much more than that.

We’re going to get into your story, and what is pelvic rehabilitation, how do you know that you need a pelvic rehabilitation. But before we get into all that, I want to let listeners know that Katie is actively in our listener Facebook group, the Learn True Health Facebook group. She’s going to do a giveaway for the listeners.

After you hear this episode, please come into the Facebook group and join the giveaway. It's a little bit unrelated to pelvic health. However, it is linked to Katie's story.

She sells a healthy sunscreen. We're coming into summer here in the northern hemisphere. I keep seeing articles about how sunscreen enters the bloodstream. It’s scary that this toxic sunscreen sold in the stores have carcinogens, endocrine disruptors, and they enter our bloodstream. We think that they’re protecting us from skin cancer, but they end up damaging us in a different way.

Katie, can you talk a little bit about the natural sunscreen that you sell and that you’re going to be giving away to a listener in the Facebook group.


[00:07:23] Katie Tredo: Yes. I partnered with a company about a year and a half ago called, Beautycounter, that’s based on Santa Monica, California. Years back, my husband and I were dealing with unexplained infertility. At the time, we started researching what we are eating, what was in the products we were using, and I was blown away when I learned how many hormone disruptors are in our products that we were using.

At that time, I switched to things I thought were safer, but later learned, as I joined Beautycounter, about different things, that there’s a loophole in the United States, that a company can claim to be paraben-free or phthalate-free and have fragrance on their label. That allows them to put any number of chemicals without disclosing what they are. It kind of undoes the claim on their label. It’s something that exists in the US.

Of course, I’m so curious, going back and looking at what I’m using. Everything in my bathroom had fragrance in it, so that’s a little bit disheartening. I started using Beautycounter with my family and getting more passionate about educating people on what I have learned because, in the U.S., there are only 30 ingredients banned from our personal care products. FDA has virtually no control or regulation over the industry.

By joining Beautycounter, I’ve been able to educate people, as well as advocate at the government level for change in the regulation. It’s been so much fun. Like pelvic health, it’s kind of once you know it, you can’t unknow it.

One of my favorite products with Beautycounter is the Beautycounter Countersun Face Stick. It’s a safe mineral-based sunscreen that I love for both myself and my kids. One of your listeners will get that. It uses non-nano zinc oxide, so it doesn’t absorb through the bloodstream. It’s unlike those chemical sunscreens that are getting a lot of press right now for showing up in the bloodstream. This is not absorbed.

Besides our health, sunscreen also impacts our environment quite a bit. This year, Key West joined Hawaii in banning chemical sunscreen. They do not sell chemical sunscreens anymore because it was killing the coral reef in those areas.


[00:09:40] Ashley James: Yeah. I heard that. I heard somewhere in Australia that they also ban it because it was killing coral reefs.


[00:09:47] Katie Tredo: Yeah, that could be. I’m not sure.


[00:09:50] Ashley James: You mentioned 30 chemicals are banned from our products. Do you know how many are banned in Europe? I’ve heard the number is way higher.


[00:09:59] Katie Tredo: Canada has 600 ingredients banned. They’re slightly ahead of us. Beautycounter is in the United States and Canada. Some of our leaders in Canada were just up there lobbying for better regulation in Canada in Parliament this past week. I saw the pictures.

Europe bans over 1400 ingredients. There are 1400 things in Europe that have been found to cause adverse health reactions, and in the US, we only recognize 30 of these. We still have formaldehyde in our products.


[00:10:30] Ashley James: No. Not in the products that you sell, but in America.


[00:10:35] Katie Tredo: No, not in ours. Beautycounter goes above and beyond. It has over 1500 that they have found that can either absorb in the bloodstream or cause an adverse health effect. They go by the theory that something has to be proven innocent before it’s used in a product.

We don’t wait to find out bad research about the ingredients we’re using. We make sure they’re safe before putting them in. They partnered with Tufts Medical School this year to provide medical research on all the ingredients we’re using.


[00:11:08] Ashley James: Cool. Early this morning, I was at Home Depot. I was like, “I ran out of my all-natural household cleaner.” I’m looking through other cleaners. Can I find a safe one? Then there’s this one. It’s called “green" something--I don’t remember the name, but it has the word green in it, so you think, "This must be their biodegradable, non-toxic, all natural one."?

I flipped over the other side. It has that big warning: “In California, ingredients have been known to cause cancer.” I don’t trust this entire company because they call themselves green in the name. It’s frustrating that company’s try to be "green," and then they’re using things that are known carcinogens. They’re poisoning their customers because it probably profits them to do so.

So just a recap, in Europe, 1400 chemicals are banned from their products versus our 30.


[00:12:13] Katie Tredo: Correct. What’s even more alarming is the last time we had a major law passed on the personal care industry was in 1938.

There is one right now on the Senate floor, The Personal Care Product Safety Act. Beautycounter was largely involved in getting that introduced in the Senate, and now we’re asking people to support that. I like to talk about this because it makes people understand why there is a need for better regulation.


[00:12:49] Ashley James: It reminds me of the Wild West where I could start a company tomorrow that sold some face cream or some cosmetic. I can put almost whatever I want in there as long as it didn’t have those 30 chemicals that are banned here, but I can put whatever I want in it.


[00:13:10] Katie Tredo: You can take it to another level. The FDA can’t even inspect where you’re making this product. It never has to be tested for safety before it’s sold.


[00:13:22] Ashley James: Wow.


[00:13:23] Katie Tredo: Right? Alarming.


[00:13:24] Ashley James: It is alarming. Learning about our clothing, when we buy new clothing, you always try to buy organic cotton as much as possible. When we buy clothing, the clothing is infused with formaldehyde because otherwise the clothing, when it’s a textile before it’s made into a garment, it could get moldy. They spray it with all kinds of chemicals. People don’t know to wash their clothing after they buy it, and it’s in direct contact with our skin.

My husband got a pair of jeans once from a well-known jeans manufacturer. He just put them on right away. I always wash stuff, but he’s like, “Oh, whatever! I’m in a rush.” He got a full rash from his belt down to his ankles. Our naturopath said, "Absolutely, it’s the chemicals they’re putting in our clothing now. It’s just getting worse and worse."

We are the ones that advocate. This is me and my soapbox. The Learn True Health podcast helps us all to understand through wonderful guests like you that we need to be the experts in a sense that we need to do a little bit of research before we buy things.


[00:14:43] Katie Tredo: Right. Every dollar you spend is putting a vote towards what you believe in.


[00:14:48] Ashley James: Absolutely. I love that you advocate for a healthy sunscreen. We’re coming into summer. We all should have a healthy one. There’s nothing wrong with getting sun every day on bare skin. That’s great. But if you do buy sunscreen, buy a non-toxic one, obviously, one that doesn’t have the 1400 chemicals that are banned in Europe in our sunscreen.

All right. That has nothing to do directly with pelvic health, but it does have to do with health in general. It does have to do with your story. Let’s dive into your story, Katie. Please share with us, what had you want to become a doctor of physical therapy and specialize in pelvic health and pelvic rehabilitation?


[00:15:36] Katie Tredo: I can admit right now that when I was in PT school, I remember someone coming in. At the time I was in school, we didn’t talk about pelvic health that much, but someone introduced the topic to us. I remember specifically saying in my head, “Who would ever specialize in that?” Here I am. But it’s been a model for everything. Whenever I say I’m not into something, it happens.

I was one of those people who knew what they want to do from a very young age. When I was in eighth grade, I had met a family in my hometown that had a child with cerebral palsy, and I began babysitting. They were such an awesome family. I had an interest in working with children with special needs. They let me go to all the PT appointments. I traveled with them for a surgery their child had. It piqued my interest.

I know from that point on, I wanted to go into physical therapy. I was 100% certain that I would end up in Pediatrics. My first job was a cross between pediatrics and spinal cord injury. I was very fortunate in one of my internships to work with a physician that was working with Christopher Reeves in St. Louis at that time with spinal cord injury.

At the time, he had been asked by John Hopkins to come out to Kennedy Krieger Institute in Maryland and start this international spinal cord center. I happened to be graduating at that time. I was able to jump on and be part of that process, which was an amazing opportunity.


[00:17:12] Ashley James: That’s so cool.


[00:17:13] Katie Tredo: After about two years, I felt between pediatrics and spinal cord injury, that I was becoming so specialized in an area that if I have to leave Baltimore, which I plan to do someday, where would I ever find a job that would compare to this clinic? We had patients from all over the world flying in.

I met my husband. He had been doing travel physical therapy and was hoping to stop doing that, but I was very convincing. We left Baltimore and started traveling around the country doing different contract jobs. I got a taste of what working in different environments was like. Maybe 15 weeks, I did an outpatient orthopedic practice. Maybe another three months at a nursing home. Seeing the different areas that you could work in as a PT.

I found that I missed working with these major quality-of-life issues. The thing that drew me to pediatrics and spinal cord injury was that you weren't only treating someone for something like an ankle sprain or an injury that might impact their life, but also you were changing their world. You were helping them to change their world and providing this education to get them beyond that point in their life.

That’s what I’m passionate about within PT. It’s not that I don’t think these small injuries need rehabilitation. Of course, they do. I like working on these big issues.

We were living in Hawaii for a year. I don’t know what it was about pelvic health, but I kept reading more and more about it. I found a pelvic health practitioner in Hawaii. I met with her and made her gave me a list of what classes do I need to do; where do you think I should start; how do I do this.

My husband and I were getting ready to move back from Hawaii, and when I have something in my head, I have to do it right away. On our transition to moving to Boulder, Colorado, I had a four-day layover in Seattle and took my first pelvic health class. I then landed in Denver to interview for a job to start a pelvic health clinic, which was courageous at that time. I wanted to learn as much as I could, so the next several years, I spent flying around taking different seminars and courses, learning as much about the topic as I could.

The type of people that come in my clinic, I know you’ve said like postpartum is what you think of. That is definitely a part of my practice, but the kind of issues that I’m dealing with patients are a few have come in that have such severe pain that’s preventing them from having intercourse with their partner. They can’t tolerate sitting at a meal with their family, sitting at an airplane or a bus to travel. They can’t engage in social activities. Patients have leaked urine and feces, and it can be anywhere from laughing with a friend and having a little bit of leakage to people who feel so isolated that they are afraid to leave their house because they are embarrassed to leak.

And then I work with children. Some of these kids are kids that don’t go to sleepovers because they’re scared they’re going to have bedwetting. They’re nervous about playing sports or be involved in things at school because they’re scared they’re going to wet their pants, and they are beyond the age that that should be happening.


[00:20:50] Ashley James: Very interesting. So, it can be anyone. You are saying either it’s a pain or discomfort or that they’re having incontinence in some way. Are there any other symptoms?


[00:21:03] Katie Tredo: Yes. I treat people with prolapse. I treat a lot of men as well. My patients with pain can be both male and female. I do see a lot of men who have had prostate cancer and are having incontinence after surgery.


[00:21:21] Ashley James: Any other male issues, like erectile dysfunction, or any other issues that are common for men to see you?


[00:21:30] Katie Tredo: Sure. Usually, they present with either incontinence or pelvic pain. But along with the pain especially or with incontinence actually, they can have erectile dysfunction as an issue with that. I’m working closely with urologists, so sometimes they’re testing different medications, those kinds of things. But when there is a dysfunction in the pelvic floor, it can impact the blood flow to the area and those sorts of things, so a lot of times men report that their erections improve after doing pelvic floor therapy.


[00:22:03] Ashley James: What about women’s sexual issues? Do women find that they have an improvement in sensation with their partner?


[00:22:18] Katie Tredo: 100%.


[00:22:19] Ashley James: very interesting.


[00:22:21] Katie Tredo: I advocate taking a holistic approach with these things. I do work with a lot of patients with sexual dysfunction. While the physical part is part of my job, I like to be in a network of whether it’s a sex therapist or psychotherapist. They can also help these individuals or couples work through some of these issues from more the emotional aspect as well.


[00:22:46] Ashley James: Right. Because we beat ourselves up and we feel anxious about it. Maybe we’ve had trauma in our past. We often have emotional issues either around not being able to perform in that area or not feeling good about ourselves in that area. I can see that there are emotions that can come up.

But if someone doesn’t have any emotional issues and then they end up not realizing that there’s not optimal health in their pelvic floor that can lead to sexual dysfunctions, like incontinence and pain and these other things. You can develop emotional issues because you have something physical.


[00:23:39] Katie Tredo: 100%. I was looking up some stuff recently about incontinence in particular which surprise me because I thought I’d see more of these with pain which is very isolating and there’s a lot of psychosocial stuff that comes about after realizing that you’re in pain. But for bowel and bladder, which when you maybe leak a little when you laugh, you don’t think this could be that serious, but bowel and bladder incontinence are highly linked to suicidal tendencies.

In one study I read, 70% of people interviewed felt that experiencing incontinence would be worse than death. In the United States, it is one of the top reasons for nursing home admissions. Fecal incontinence is the second reason why a person would put an elderly family member in a nursing home.


[00:24:27] Ashley James: Wow! Our society is so different from other cultures. Some cultures would never dream of putting their parents in a home. They take care of them no matter what. But in our society, we want to be very clean and sanitized, kill 99.9% of bacteria with hand soap. We want to be clean. We want everything sterile.

Tell me about this pain that people experience. What is causing pelvic pain?


[00:25:07] Katie Tredo: Pelvic pain is a huge area. There are so many different causes and different pain conditions that it’s hard to see in the research what the true incidence of this is because there are so many different names. As a medical community, it hasn’t been standardized.

There can be very different reasons people have pain. There can be nerve pain in the area from the pudendal nerve. Sometimes a hormone disruption will cause pelvic pain or changes in the pelvic floor or the vestibule area, which is like the entrance to the vaginal canal. Another fairly common thing is vaginismus, which is a condition where the pelvic floor is spasmodic. It’s painful. It’s the contraction of the vagina in response to physical contact or pressure and often intercourse.

This is one condition I see a lot of. Often, patients if they have primary vaginismus, maybe as a teenager they tried to use a tampon, and it was very painful, so they just stopped doing it. They avoided medical exams there. Then they go on later, and they’re in a relationship. They have sex for the first time, and they feel like there’s a wall blocking them. Someone descri bed to me that it feels like knives are stabbing them. They think they’re broken. It can destroy relationships. This is truly a problem of the pelvic floor.

Through physical therapy, they can learn relaxation techniques and be educated on their pelvic floor. We do a lot of in-clinic techniques and a lot of education between sessions, the patient working either by themselves or with a partner to relax these muscles.

It’s a terrible condition to have, so I hate when someone walks in and have this. But it’s one of my favorite conditions to treat because someone comes in scared to tell anyone that they have this problem, and they haven’t admitted it to most people in their lives. They feel like their husband has married someone defective. I hear all these horrible self-deprecating stories.

You can sit down with someone and say, "I see people with these all the time, and there are things we can do to get you past this." One of my favorite success stories was a patient in Maryland. At that time, I had a cash-based practice. For her and her husband, their insurance didn't have good reimbursement, and it wasn’t feasible to come often. They were both dedicated. I would teach them ways they could work on this at home.

I’d see her kind of spaced out, and then she was getting a litter better–more and more spaced out. Then I stopped seeing her. You always wonder what happens to these people that you’re not seeing. I got an email months later from her, and she said, “Things have been crazy. I never got time to thank you, but I also wanted to let you know that because I was never able to have intercourse or even a pelvic exam, I never in my life thought about preventing pregnancy, and I want you to know that we’re happily expecting our daughter in September.”

It made my day, because here is a couple who had never been able to have intercourse, and they’re growing a family and having pain-free intercourse.


[00:28:38] Ashley James: Oh, my gosh! I love it. That’s amazing. One of my midwives or my doula told me, because I was doing Kegel exercise to correct the peeing after laughing from birth, and one of them said, “Wait, don’t do Kegels because sometimes the problem is having the wrong muscles too tight and other muscles too loose.” She’s trying to explain that pelvic floor health is so much more than doing Kegels. Can you talk a bit about that?


[00:29:16] Katie Tredo: Yes, 100%. I want to make a side comment too that I love these people you’re talking to because your friend that you’re talking to that recommended pelvic floor therapy and this doula you’re talking to, it’s not common. I can’t tell you how many times I’m in a conversation with women and they laugh that they are leaking urine. Their doctors have told them, “Oh, it’s just part of having kids.” I sound like a broken record in my clinic because I’m constantly telling people, “This is common, but not normal.” It is something you need to work on. It’s something that goes beyond just that little bit of leakage. It’s part of your anticipatory core muscles. It changes the way you move, being injury prone, and all that. I am very excited that you’re having these conversations.

As far as your question, that’s 100% accurate. That is probably the thing I get most--people calling, friends that live in different areas that can’t come in, asking me, "Should I do Kegels?" It is very hard to answer that question because if someone has pelvic floor weakness which is very common, especially after having a child, they can present with incontinence, prolapse, musculoskeletal dysfunctions, back pain. They indeed need to strengthen their pelvic floor, making sure they’re contracting the correct muscles is important, and making sure they’re able to relax their muscles.

I have, on the other side, patients that maybe are experiencing frequent urination and overactive bladder symptoms. They may think that they need to do Kegels as well, but they might have a hypertonic pelvic floor, so the muscles are incapable of relaxing. On those patients, the last thing I’d want to tell them to do is to go home and do 20 Kegels.

It depends on an exam. Whenever I see someone for the first time, I explain that it can be anywhere on that spectrum. Through examination, we can determine where’s a good place to start and an appropriate plan of care.


[00:31:29] Ashley James: How do you examine the pelvic floor? I’m imagining it’s like getting a pap smear. In my mind, how else would you examine the pelvic floor?


[00:31:40] Katie Tredo: It’s less scary than a pap smear, in my opinion. It’s an internal pelvic exam. There are no stirrups involved. You are lying with your knees bent on the table. I don’t use a speculum or a device like that. It’s using a lubricated, gloved finger palpating the muscle starting very external working through the three layers of pelvic floor muscles. I’m looking for things like tight trigger points or painful spots that may cause pain there or referred pain. Sometimes, they’ll tell me it gives them an urge to urinate, or I might find laxity in the pelvic floor.

Different muscles can be tight, and different ones that can be lax. Then I’ll have someone do a contraction and try to do a Kegel. I see all sorts of things from squeezing just their glutes to squeezing their inner thighs. Sometimes you see one half of the pelvic floor, the right side or the left side, contract better than the other side, and that could be a recruitment issue. Sometimes women tear their pelvic floor muscles, and it's left undiagnosed. A lot of times we picked up on that when we see you actually cannot elicit a contraction on those muscles.


[00:32:50] Ashley James: You’re saying 'see,' but what you mean is 'feel' because you’re not looking.


[00:32:54] Katie Tredo: We need to look at the skin quality and all that, but yes, 'feel.'


[00:32:59] Ashley James: That’s how you would do with an adult female. How would you do it for a male? How would you do it for children?


[00:33:09] Katie Tredo: Good question. For a male patient, I usually have them lying in the same position. I start with an external exam, starting right at the groin and sinking into the pelvic floor muscles. I always check externally with the female as well because you get different information.

For a male, you can feel if the muscles are tight and painful there. Are they lax? I’ll have someone contract and relax. Sometimes you can barely clearly feel, and sometimes you can. Depending on the case, we may do a rectal exam, having someone contract that way and relax and feeling. If a male is coming in with pelvic pain, a rectal exam is the best way to relieve these trigger points and teach them how to do self-trigger point release at home.


[00:33:59] Ashley James: Interesting. I went to massage therapy college in Canada, which is very different from the States. It’s like a 3,000-hour program. What I learned about trigger points is that--correct me if this is the same thing or something different--it’s a small taut band of muscles that usually where the point of innervation is by the nerve, and that it is cutting off circulation which is creating referred pain. Is that what you mean by trigger point?


[00:34:43] Katie Tredo: Yes, 100%.



[00:34:44] Ashley James: Okay. You can teach people to release their trigger points from the pelvic muscles at home.


[00:34:50] Katie Tredo: Yeah. We do a lot of that work in the clinic. I do use a technique called trigger point dry needling in some cases as well, but a lot of people can use devices called vaginal dilators, or there are devices specifically made for the rectum that can be inserted. They’re kind of curved plastic devices that can help you target these trigger points.

They have massage tools like that, too. You’re putting pressure on different points. I have people think of their pelvic floor as a clock, and they go around that clock, and find where are their trigger points, and do these trigger point releases on them.


[00:35:32] Ashley James: So interesting. In Canada, in some of our provinces, you can be licensed. We call them registered massage therapist, not licensed. But we can be registered or licensed to do a vaginal massage, and you have to go for more training for it, but there’s so much stigma around it. Yet getting that right before or during labor prevents tearing. What I was so amazed by is that while I was in labor, my OB did vaginal massage. She’s like, “Hey, I’m here. We’ve got time. Can I do it for you?” I am like, “Yes!” I was so excited.

It’s not like sitting down in the spa to get a massage, but I’m so excited that she had the extra training and that she was knowledgeable. Our OB happened to be on vacation when the baby finally came, so I got a different one, and I have not met her before, but she was perfect. She was perfect. She sat down and said, “Can I do vaginal massage on you?” It was awesome.

I think we have a lot of stigma in our society. We’re afraid still. In some ways, as women, we look at how we’re dressing and how we’re acting in society, and we’re not prude in some ways.

But then, in others, what is going on? We’re still stuck in 1930 when it comes to talking about our pelvic floor health. We’re so closeted. The idea of having a vaginal massage for health or vaginal PT for health--this is not sexual. This is health. It’s done by a practitioner who’s trained and safe. Releasing that stigma, I think, is important.


[00:37:50] Katie Tredo: 100%. It’s sad to me that this stigma exists within the female culture. Some of it is just historical. Pelvic floor PT is becoming more popular because women are finally talking about these things. You’ll see more things on the news. Cosmopolitan last year had a big article on childbirth injuries bringing awareness that this stuff happens.

This isn’t to throw any physician under the bus, but unfortunately, pelvic PT wasn’t taught, or a lot of doula stuff was never taught in medical school for a lot of the doctors practicing now.

For me, and later on I’ll talk a little bit about the postpartum culture in our society, but I was blown away because here I had been practicing pelvic health for years before I had my children. I moved to Wisconsin. I was pregnant with my twins when I was here. I was going from doctor’s office to doctor’s office introducing myself, marketing what I do and getting very discouraged when OBs weren’t sending their patients into me. I thought maybe they don’t have faith in what I’m doing or whatever.

Then I had my kids. I had a twin pregnancy and twin vaginal delivery. I also was heavily trying to market to my physician. I went to my postpartum eval showing ready to tell her, “I’ve done a self-exam. This is what I think is going on with myself. I don’t have a diastasis. I think I have this.” We never even got to that part in the conversation. I was blown away. I realized doctors are not recommending pelvic PT because they don’t believe in it.

They’re not even checking for the things that we see people for. Again that’s not their training, so I shifted in my focus with marketing to educating physicians and why they should consider sending patients to us saying, “Not only you have to examine them for this, but if a patient mention this, that’s a reason to send them to our office.”

They’re checking for things at the postpartum visits like, “Are you still bleeding? Do you have any signs of infection?” They’re looking for major medical things.

More often if you have incontinence, which by six weeks postpartum is not normal--that should resolve before four weeks postpartum-- they’re not necessarily checking if you have a prolapse or if you have a painful scar. I left feeling, “Wow! I’ve been practicing for years in this specialty, and I know what I have, and I know who to see for it. What if I didn’t know that and for years wondered what is going on with me?"

That’s what I see. Often, people that I’m treating for postpartum issues aren’t coming in six weeks or six months after having a baby, sometimes its years or decades after they’ve had a child.


[00:41:04] Ashley James: I have a friend who’s had five. She’s probably listening to this. Hello! Can a woman who has given birth to multiple children even years later go to a pelvic rehabilitation practitioner and see success?


[00:41:24] Katie Tredo: 100%. Sometimes I’ve had patients that have big problems for their first baby, no problems after their second or third. It varies, and there are always things you can work on. Something with moms, and I recently did an Instagram post about this, is our postures and our muscles change while we’re pregnant. Often, we have these compensatory movements or different movement strategies because our transabdominals are stretched out, our pelvic floor has gone through trauma, our diaphragm is not able to descend as it’s supposed to.

All of a sudden we’re not pregnant anymore, but our bodies are stuck in these positions, and we keep on reinforcing those movement patterns, and we never take the time to rehab those muscles that need to be part of the pelvic floor, diaphragm, and the transabdominals. These are anticipatory muscles that before we move, they fire.

They’ve shown these in healthy subjects that helps stabilize us, that helps keep us continent. It helps keep our breathing normal. A lot of time I do see people years later, and they can do great. I always advocate for earlier intervention, but I think it’s never too late. I’ve had people in their 80s and 90s even come in with incontinence that has gotten completely better.


[00:42:50] Ashley James: That’s exciting. To complete our conversation about the exams and sort of what to expect when someone comes in to see you or another pelvic rehabilitation practitioner. For children, how do you do that examination?


[00:43:10] Katie Tredo: With children, it is not invasive at all. Honestly, with children, education is the biggest thing. It’s a lot of education for their parents. A lot of these things someone could work on.

Anyone listening who has a child who's having problems with bed wetting or incontinence, start paying attention if your child is constipated. It makes everything, and when I say everything like my adults with constipation have worse bladder leakage. They have worse pelvic pain. All of these conditions are compounded with constipation.

The biggest piece of advice to parents is to make sure your child has a regular bowel movement, having enough water, having enough fiber, having enough physical activity. That’s the biggest things for parents.

A lot of these kids go to school, and they dehydrate themselves all day long. They never want to take a drink of water because they’re afraid that they are going to leak, or they’re so distracted and busy at school that they are not doing that.

One thing I see, a lot of teachers and a lot of students are not allowed to go to the bathroom at a lot of schools during their class which can cause some problems for kids that really need to go.

A lot of it are basic things as far as making sure your hydrated and not constipated. When children come in, I have some children’s books that have pictures of how the body works, and how food and urine go through your body.

We do things like toileting positions. The child can be fully clothed, but we’re working on, “Can you contract your muscles to stop pee?” Then things to get the pelvic floor to relax so that they can void or have a bowel movement. We’ll do a lot of things like blowing bubbles with it or learning these breathing patterns, doing it through play.


[00:45:05] Ashley James: I love it.


[00:45:07] Katie Tredo: Sometimes we’ll check the perineum and the skin because we do need to check that the child isn’t having this red, irritated-- physical therapists at most states now have direct access, and so if I see something that potentially could be an infection, I need to send them out to a physician who can treat that.

Then I’ll press along the groin, if I have the child’s and the parent’s permission, as the child contracts and relaxes, to see if any spots on their body are painful.


[00:45:41] Ashley James: That is very interesting. Do you have any advice? I know it’s hard because we don’t know what’s going on. You don’t tell everyone to Kegels because that could be the exact opposite of what they might need. So we can’t tell all children that are having incontinence, “Imagine you’re pulling everything up into you,” or try to give them some imagery because we don’t know if those are the right muscle groups for them to be exercising.


[00:46:18] Katie Tredo: We are very far from this in our culture. Nobody knows about the pelvic floor, that it exists until there’s a problem or until they’re having a baby. I think it would be great if we could teach children that there are muscles in their pelvis, and that if they have to go to the bathroom, and they have to hold it, to squeeze those muscles that are holding that urine and feel what that feels like, and then for these muscles also to be able to relax for them to be able to void or to have a bowel movement.

The good thing with the child knowing that they have muscles that control this is when there is a problem, they know it. I see a lot of adults who never know it was an issue or that it was something they could help.

When girls get to puberty too, they’re more prone to musculoskeletal injuries and different things just because of our development and hormonal factors and structural factors in our body, but we’re never taught that.


[00:47:22] Ashley James: Between the ages of 15 and 18, once every three months, I was twisting my ankle, falling down. I didn’t understand, and now I understand what was going on. My body was changing so fast that I didn’t know where the center of my gravity was. I just thought I was a klutz. Thinking back, I haven’t tripped or had any of those problems in years and years. It was only because our body is changing so much during our teenage years that we can be prone to accidents because everything is changing, and we don’t know where we are in gravity.


[00:48:05] Katie Tredo: This happens again in menopause actually, so be prepared. I think what happens is there are often changes on the pelvic floor whether because of hormonal changes and things. Sometimes people can develop secondary va ginismus, like that pain I’ve described before, but its due maybe to hormonal changes or menopause, or they can develop incontinence as part of that as well that they get vaginal atrophy.

At the same time, you see people losing their balance and having morefalls. One thing that I try to talk to other PTs about that treat orthopedics and want nothing to do with the pelvic floor is that those are not separate issues.

Back pain—it’s not a separate issue. If there’s a problem with the pelvic floor muscles, you’re going to present with another problem. So I encourage PTs on their screening form and probably any practitioner to have, “Do you leak urine?”—just a very simple question.

If someone’s coming back and they’ve had back pain over and over, or hip pain, neck pain, jaw pain, and you’re not getting anywhere with the techniques you know, and you noticed that they have written that they’re also leaking urine. There is a problem in those anticipatory muscles, and their core is not intact. That needs to be treated as part of the problem.


[00:49:32] Ashley James: In someone who’s walking, can you see in their gait that they have issues on their pelvic floor? Does it affect the body so overtly?


[00:49:40] Katie Tredo: That’s an interesting question. You can definitely in their posture. People move differently when they have a problem with their pelvic floor. You can sometimes tell from how someone is standing. I always look at posture when I’m looking at a patient because oftentimes someone stands in that posture, a pelvic tilt, with their tail bone kind of tucked under.

If anyone listening right now goes into that position and they try to contract their pelvic floor, what you’ll feel is maybe a little bit of a contraction on the anus, but a lot of gluteal muscles contracting.

If you come to a better seated or standing posture with more of a neutral spine, restoring that lumbar curve, you try to contract, and you can feel that that contraction moves anteriorly. You’re getting your pelvic floor muscles. Often, positionally, even with gait or just static standing or sitting, we can change the body’s ability to recruit these muscles.


[00:50:36] Ashley James: That’s so cool. I had a question pop on my mind. I’m not quite sure how to form it. More people than we are aware of have suffered from sexual assault. It’s one of those topics that is still not completely open. Unfortunately, the victims are left to feel that it’s their fault, and they’re ashamed of it. Some victims even have it in childhood.

Have you ever had patients who’ve come to you with pelvic issues, and in the discovery, you found out that they were sexually assaulted? Does the sexual assault injure the pelvic floor, or the emotions around it cause them to use their muscles in a different way, so it creates an injury?


[00:51:43] Katie Tredo: Yes, 100%. Traumatic events like that can cause people to develop these holding patterns, that clenching on the pelvic floor. People clench their jaws or those upper trapezius muscles. Trigger points on the pelvic floor are no different. Often, if someone has been sexually assaulted, they have been holding that pelvic floor tight and trying to protect themselves. They do develop pain. They also have a lot of psychological damage done from that. I have seen this in my clinic probably more often than you know. I’m glad they come in, but it’s sad.

What I do with these patients is I always tell them that you do not have to do internal work if you’re not comfortable with it. I say that to anyone whether they are traumatized or not. I explained that for me to get the most information from this exam, an internal exam is what is best, but if someone is not comfortable, that’s not best for them then.

A lot of these patients, I explain to them, “Let’s start with working on diaphragmatic breathing because you probably had never breath into your belly ever” or “Let’s work on some of the stretches.” Happy baby pose in yoga is one of my favorite for opening the pelvic floor. Sometimes having their feelings validated, someone willing to work at their comfort level. I make sure that they have seen a psychologist or know of one or get a referral for one. I explain to them that that is not my specialty. I am there to walk them through this and to work with them, but it will be beneficial for them also to see someone.

These patients do great because you can give them the tool they need. If it’s something like, “You need to work on this on your own at home,” if that’s what they’re most comfortable, sure they come back less frequently, you progress their exercise program, and you answer their questions. Often these patients end up becoming more comfortable in allowing an internal exam and internal work.

What I work out in those exams, we don’t do it for very long. It will be a very limited treatment there. I make sure the patient stays present with me. One thing I’ve noticed in my patients, and I’ve one that’s particular in my mind, always I see her eyes go up, and it was like she wasn’t paying attention anymore. I could tell when she’s dissociating from what is happening in her body.

It had been a technique that she had learned because she had to. She had been abused for so long. I try to keep people present with me. “Is this painful if I move your leg this way or if you contract or relax?” or “If we add pressure here, does that decrease the pain?” I keep this conversation going up. “What makes the pain better?” “What makes it worse?” “Let’s find a technique together and try to breathe into that spot.”

Sometimes you can only do that for a couple of minutes before the person is gone, but they continue to improve in that. I think getting back in their bodies and working with the psychologist on that is important as well. That can be beneficial for them because they’ve spent so long just tightening up and blocking people and blocking themselves from feeling anything.


[00:54:59] Ashley James: Have any of those patients shared with you that they were surprised that the pelvic physical therapy was cathartic, was a healing process for them emotionally?


[00:55:13] Katie Tredo: Yes. I have had several patients that I don’t even think they were even sad. It’s just like these tears would just come out. More so like, “I can’t believe I don’t have pain right there.” Do you what I mean as they were getting better and doing that?

I’ve had experience in a patient who didn’t know that she had been sexually traumatized until very recently. She had been by a priest. She blocked that out of her head, and she thought because it wasn’t sex, that she hadn’t been molested. When recent news had come out, and people were talking about it, “All of a sudden, she had this breakdown because she had been molested in her childhood, but had made excuses for it and blocked it out of her head.

She happened to be seeing me at that time. We took a break from physical therapy completely for her to do more talk therapy, working with her body, and ways with a psychotherapist. Then, she came back and did fantastically, but she was coming in for bowel and bladder symptoms, and it wasn’t what she was expecting was related to it.


[00:56:26] Ashley James: So were the problems because she was holding herself tight for so long?


[00:56:30] Katie Tredo: I think so. I think that played into it. She has also had a couple of children at the time. I think for her, it was a lot of urinary frequency and difficulty fully emptying her bladder — a lot of things that go along with having a tight pelvic floor.


[00:56:46] Ashley James: You see these commercials, like the Depends, the adult diaper commercials. They make it sound like this is something to expect, especially for women when they’re in their golden years.

You’ve said that you’ve had even women in their 80s come in, but the marketing is making it sound like when women are older, they’re supposed to pee themselves.

What you are saying is that it's common, but it’s not normal or healthy. If 50% of the people walk with a limp, we would say it’s common, but that doesn’t mean it’s normal. It’s not supposed to be that way. It’s like people are walking around with an injury, and we’re being told by all the marketing that this is normal. It’s just part of aging, or it's just part of having kids, or it’s just part of life. But it’s an injury, an imbalance we’re walking around with. It is not optimal health.


[00:57:52] Katie Tredo: Yes. We see this in every industry, but people are making billions of dollars off of these, so why would they want you to know that you could get better? But 100%, it is common, but not normal. We kind of put in our heads, it’s either after a baby or as we’re getting older, and that’s when it’s normal to experience this. It’s not normal in either of those cases.


[00:58:19] Ashley James: I haven’t yet gone to a pelvic rehabilitation practitioner. As I’m thinking about it, I’ve been putting it off, because it’s not that big of a deal. “So what? I pee a little when I laugh — no big deal. I’m busy. I’m a mom. I’m an entrepreneur. I’m putting my business and everything else.”

I’m just seeing this. I’m looking at my thinking. I’m thinking like how many women do this? We’re putting everyone else first, and we’re putting our health on the back burner. I keep saying myself, “I’m going to one eventually. In the future, when I have some free time, I’ll make time for my health.” How many of us do that? Now that my listeners know about pelvic rehabilitation, don’t be like me and put it off for years.

What you are saying is that the incontinence is a symptom and that the problem can be far greater, even though that’s the only thing you’re seeing. Maybe you’re not having discomfort or pain, but maybe you’re just seeing that you pee a little when you laugh, but that is actually causing more damage. Can you talk more about that? What’s the damage of continuing life with this imbalance?


[00:59:39] Katie Tredo: It can vary. Obviously, incontinence can become worse. I like to describe the course as a soda can. If you imagine you’ve had the respiratory diaphragm on top, the pelvic floor on the bottom, and the transverse abdominals coming around, and the multifidus on the back—those four muscles make up your canister, your core. These muscles should contract first, and they should stabilize and allow you to move from there to prevent injury anywhere in your body. They keep us continent. They keep us breathing well.

Like a soda can, if you imagine, pop open that can—whether its diastasis recti and you have lost your abdominal tone, you have this bulging herniation at your abdominals or pelvic floor weakness—how easy is that can to crash? You have no stability there anymore. It’s a balance of pressures on our body that’s there.

There was an article in the Medical Research, and I’m just going to read the title of it because it’s my best article to bring to a physician’s office and say, “Look at this. It changes what you think.” They found that disorders of breathing and continence, the diaphragm and the pelvic floor, have a stronger association with back pain than obesity and physical activity.

So what do we tell people when they have pain in their body? “You need to lose weight. You need to exercise.” But these disorders of the diaphragm and the pelvic floor are more associated with back pain than any of those things which are important as well. So it’s a huge problem.

One other thing, as far as how you said you don’t get help for it and how our culture feeds into this, it’s a little off that path, but I think with postpartum women, we are constantly marketed to how fast you can lose your baby weight and how great you can look right after you have a baby. If you’re on Facebook or Instagram or any of those, how many times a day are you marketed, “Join me and lose all this weight.” They’re these hard exercises that people are doing, and a lot of these women have never rehab their pelvic floor or their transverse abdominals.

I’m someone that believes that people can get back to everything after having a baby. I think after most of these that if you rehab correctly and you improve your movement patterns, the goal is to get back to all these. I would never want to tell one of my patients that they have to stop running or they have to stop doing anything.

When I was working in Maryland, I was asked to talk at a CrossFit gym, and I was a little taken back because at first, I didn’t know how this would go. I would see some of these women in these CrossFit gyms doing exercises that I knew they probably shouldn’t be doing.

One thing I was asked in Maryland was from an owner of a CrossFit gym to come in and talked about peeing while you exercise. I don’t know how to approach it exactly because I knew a lot of these women were peeing while they’re exercising because they have never rehab themselves properly to be able to do the type of activities they were doing.

I said, “That’s not normal. I’d love to talk about it.” She said, “Really, it’s not normal? You’ve got to see this YouTube videos,” and she sent them to me.

It was these interviews of someone at these CrossFit competitions going up to people and going, “Do you have the workout pees?” or “Do you pee while you exercise?” All these women like, “Yeah, I lift all these weights. I do all these hard exercises. I pee in my pants. I’m wearing a diaper right now.” I’m thinking, “What are we promoting in our culture that makes this seem like it’s a good thing or normal?”

It took a lot to get these women to step back. I said, “This isn’t that you’re never going to do these exercises, but you need to step back and learn how to move better before you can get back into these exercises.” There were people that came up to me and said, “I’m not going to see you if you tell me I have to take a break from this.” Of course, they never came to see me.

I do challenge people to think about it. We think about the pelvic floor so different than other parts of our bodies. If you strained your hamstring and you were playing a sport, you would rest. You’d work n stretches and strengthening. You’d ice. You’d do all of these things to rehab. You’d gradually get back into your exercise or your sport as you could tolerate because your hamstring was your weakest link. You wouldn’t push past and further injure yourself.

If we think of the pelvic floor as the weakest link in these situations, exercise to your weakest link. Maybe you can do a certain amount of reps or a certain amount of weight and stay continent, and you gradually increase that. But the second you train your body, “I’m going to keep jumping 800 times in a row,” or “I need to lift these weight that’s so heavy, and I completely lose bladder control,” you’re not training your body to move better.

They do want to help people. We have to look at the system. It was 1910, around there, the Flexner Report was created.

People can go on Wiki and see this but Carnegie—maybe he was the richest, I don’t know—who was one of the richest people in the United States at the time owned a pharmaceutical company. He wanted to influence the marketplace. He had a man go throughout the United States and create the Flexner report, which is, at that time, a list of all the doctors who are practicing allopathic medicine, which is a pharmaceutical-based medicine. At that time in history, we have to imagine what we know is not what the world was like back then.

Back then, you could see a chiropractor, osteopath, you could go to an herbalist or a homeopathy practitioner, and everything was an even playing field. You could become any of these different types of therapists. You could become a student of them at any of these universities or these colleges. Everything was an even playing field.

Then Carnegie invested millions of dollars. He put colleges out of business. He told the colleges and universities that he gave his money to that they had to stop teaching anything that had to do with types of therapy that competed against pharmaceutical medicine. He was able to change, and he created what we know now.

Everyone goes to an M.D., and everyone is put on a drug. Seventy percent of adults in America are on at least one prescription medication. We grow up in a system, and we didn’t realize that we think it’s normal. You go to an M.D.; you get a drug.

But back in 1910, right around then, it’s when Carnegie was influencing all the schools. The schools were influenced to teach a certain curriculum that he agreed to, which would then teach doctors to push the drugs and not natural therapies. So, if you have a bunch of people who are peeing themselves when they get older, then you can sell them a drug that might prevent peeing or sell them diapers or whatever.


[01:04:47] Ashley James: Interesting. I’ve worked with trainers before, and they always start with the core. Before we do anything, we’re going to strengthen your core because there is no point in having you do deadlifts or whatever when you have a weak core.

Everyone thinks when you say core muscles—what are your core muscles? My abs and my back. Everyone thinks abs. Let’s work on your core—your abs and your back or maybe your butt. But no one thinks about the pelvic floor as being part of their core.

That’s interesting because when it was described to me by Jennifer Saltzman who’s been on the show before. She’s a 20+ years’ Pilates instructor. She says that the pelvic floor, imagine it’s a big salad bowl that’s sitting in your pelvis holding everything up. It’s holding your bladder and your bowels. It’s holding your uterus for women. It’s holding everything up, and it’s a big salad bowl.

She helps people to understand that they’re walking around with their salad bowl spilling out because their salad bowl is tipped forward or tipped to the side. Looking at and respecting the pelvic muscles are just as important as a part of our core. It’s there a bit subtler. You’re not going to do crunches.


[01:06:19] Katie Tredo: Right. The thing that people don’t realize is that the rectus abdominals are not part of our core. They’re very external muscles, and yet everyone wants them because it can do a six pack, but that’s not part of our core. If you just work on your rectus abdominals, you’re not strengthening your core.


[01:06:36] Ashley James: Your core is needed for stability, and so you’re saying that those with weak core end up injuring themselves more. As they get older though, they’re more prone to falling and injuring themselves.


[01:06:49] Katie Tredo: It can go the opposite way, too. We talked about fixation or immobility. We need our pelvic floors to be mobile and stable. It is this constant kind of balance because we need our muscles to be very mobile. We need them to expand to have babies and to have bowel movements, urination, and all of that. We need its stability to move and do all those things.

We end up at one side of the spectrum or the other, whether it is a very weak, stretched pelvic floor or if it’s a very hypertonic and painful pelvic floor. We’re going to have problems involved in those situations.


[01:07:31] Ashley James: Is this kind of physical therapy fairly new, or can you see when looking back in history that there are types of therapy, or there are cultures that focus on pelvic floor health throughout time?


[01:07:52] Katie Tredo: I don’t know when pelvic floor therapy started in the U.S. I know I’ve been doing it for ten years, and there have been therapists doing it way longer than that here.

There are definitely techniques taken from other cultures that we’ve learned about. I think some midwives in other cultures have been doing some rehab for the pelvic floor.

This isn’t really to speak to the historical aspect of it, but one thing I’m blown away by is I used to work outside of Washington D.C., and I had the luxury of working with people from all over the world because their jobs took them there or their partner’s jobs or whatever. It was eye-opening to me because I had a lot of patients from places like France and Germany that would come right after their postpartum check-up.

I’d say, “What brings you in today? What’s the problem?” They say, “You tell me. I’m here for my postpartum check-up.” It was refreshing. Some of these patients needed ongoing PT for a little while. Some of them, I gave them tips. We worked on their posture, made sure things were moving well, and I said, “Call me if you’re having any of these problems in eight weeks or whatever.” It was ingrained to them that having a baby is a physical event, and you need rehabilitation after. You’re going to go because why wouldn’t you take care of yourself after an event like that.

It’s just not the way it works in the U.S. We don’t support preventative medicine. We don’t necessarily take care of our moms after they have a child. We’re looking at getting people back into the workforce as soon as possible, losing your baby weight as soon as possible.

I think that’s damaging to women. I think more and more people are talking about it now, and there’s a huge demand for this type of therapy.

I encourage any physical therapist who is at all interested in working on this to take some training, even a course or two under your belt. It’s enough to help the most basic things and know enough to refer someone to someone more specialized later because there are just so many people not getting help.


[01:10:04] Ashley James: Absolutely. I’ve talked about this before on the show with other practitioners. Looking at the history of modern medicine—I wouldn’t get into it too deep, but it’s a very interesting topic to dive into to understand what’s influencing our modern-day practitioners.

We go to an M.D. or your OB, and we’re expecting them to know about other resources. If we tell them we’re peeing when we laugh, they should know to tell us to go for pelvic rehabilitation.

I’m not vilifying M.D.’s or any doctor. I think there are individuals who get into medicine because they do want to help people. We have to look at the system. It was 1910, around there, the Flexner Report was created.

People can go on Wiki and see this but Carnegie—maybe he was the richest, I don’t know—who was one of the richest people in the United States at the time owned a pharmaceutical company. He wanted to influence the marketplace. He had a man go throughout the United States and create the Flexner report, which is, at that time, a list of all the doctors who are practicing allopathic medicine, which is a pharmaceutical-based medicine. At that time in history, we have to imagine what we know is not what the world was like back then.

Back then, you could see a chiropractor, osteopath, you could go to an herbalist or a homeopathy practitioner, and everything was an even playing field. You could become any of these different types of therapists. You could become a student of them at any of these universities or these colleges. Everything was an even playing field.

Then Carnegie invested millions of dollars. He put colleges out of business. He told the colleges and universities that he gave his money to that they had to stop teaching anything that had to do with types of therapy that competed against pharmaceutical medicine. He was able to change, and he created what we know now.

Everyone goes to an M.D., and everyone is put on a drug. Seventy percent of adults in America are on at least one prescription medication. We grow up in a system, and we didn’t realize that we think it’s normal. You go to an M.D.; you get a drug.

But back in 1910, right around then, it’s when Carnegie was influencing all the schools. The schools were influenced to teach a certain curriculum that he agreed to, which would then teach doctors to push the drugs and not natural therapies. So, if you have a bunch of people who are peeing themselves when they get older, then you can sell them a drug that might prevent peeing or sell them diapers or whatever.


[01:13:32] Katie Tredo: Or surgery,


[01:13:35] Ashley James: Thank you. I’m getting to that. Surgery is another thing that they can sell you. Again, I’m not vilifying any individual doctor. Maybe listeners have gone to their doctor and told them that they pee themselves. The doctor said, “We have a drug or have diapers,” or “This is just normal,” or “Here’s a surgery.”

This is what medical schools teach because it would harm profits. Think about it--if doctors learned how to cure people, so they no longer needed drugs or surgery, then it would put industries out of business. The whole system is set up in a way to keep people stuck.

I think there are a lot of good people in the system. I think a lot of people are breaking out. I’ve interviewed a lot of M.D.’s that have broken out of the system and gone, “Wait a second. There’s way more than just drugs and surgery. What am I doing?”

At the same time, I love that drugs and surgeries are available should I need them. We want it, but it’s only one tool. It’s not “the” only tool. It’s one tool in our tool belt, and there are a hundred other tools, like what you do, which is get to the root cause and help people heal at the root level.

I want all the doctors listening, and all the patients listening. Let’s educate our doctors and let them know that there is a better way; that we don’t have to get on a drug or get surgery for peeing ourselves. If we have pelvic pain, there’s a viable therapy that gets to the root cause.


[01:15:13] Katie Tredo: I have had experience of working with absolutely fantastic doctors and learning from them too, and being able to observe some of their surgeries, and coming in for their exams, and having these discussions. I think more and more doctors are learning about this. To their credit, as you said, they did not learn about a lot of these in medical school.

My entire practice up until this past August was in private practice. For the first time, I’m working as a pelvic floor therapist in a hospital system. It has been wonderful to work with physicians, to start programs, and talk to doctors about how we may able to help each other.

One thing with surgery, for a long time with prolapse, for patients that was their option. That’s it—do a surgery. Depending on the doctor you go to, a lot more are saying, “Try physical therapy first.” A couple of my favorite surgeons in this area are huge supporters of pelvic floor therapists. It makes sense because if you only do surgery in the people that need that surgery, you’ll going to have better outcomes yourself as well.

One thing I’m working on educating both patients and physicians right now is the idea of pre-op surgery. Prolapse, for instance, I’m not going to say that everyone that walks in my door, I cure their prolapse. I don’t even take credit like that. I teach them to do things. I have some patients whose symptoms are 100% resolved, and they never need to have surgery. I have some patients who are borderline—"We’ll see how you do in therapy.”

I’ve had patients coming off the street into my clinic. I have them bear down, and their bladder is physically coming out of their vagina. I say, “I have a name of a great surgeon I’m going to send you to, and I think you should strengthen your pelvic floor as part of your rehab.”

It’s knowing each other’s specialties, who you can help and who you can’t help. I tried to educate my patients that if you go to somebody—my favorite thing is when a doctor says, “I don’t know. Let me find someone that does,” or “I don’t know. Let me look that up.”

Whether you’re going to a PT or a chiropractor or a doctor, if they think they know everything, that’s frightening to me. I’d much rather have a doctor say, “You know what, that’s not my specialty. Let me give you the name of somebody who it is.” I would much rather hear that.
Unfortunately, a lot of doctors still when they don’t know something, they dismiss the patient’s complaint. One thing that breaks my heart that I hear over and over still is a patient will go into her OB or her primary care doctor and say, “I’m having painful intercourse.”

When you say that, you’ve become vulnerable. You’re opening up to a very private part of your life. I can’t tell you how many times a patient comes in my door, either recently or years earlier their doctor’s advice to them was, “You just need to have a glass of wine and relax before you have sex with your husband.” It’s 2019. If someone’s willing to open up with that, find someone that can help them. Even if you think it is in their head, send them to a psychologist. But there are physical reasons for this pain.

I’m never under the belief that everyone will get better with what I do. I do need to refer out to other practitioners a lot. I think that working together is something that our medical field needs to do more of.


[01:18:57] Ashley James: As a patient, we should have the idea in mind that we are creating a team of holistic experts or a team of experts to surround us -- hopefully, a lot of them holistic, but a team of experts. We want them to talk to each other. We want this team to inform us and help us to make the best choices, and we ultimately are the final deciders in the therapies that we’re going to participate in.

A doctor is not to put up in a pedestal. If your doctor has hubris or an ego, then fire him and get one that can step down from their ego and say, “You know what, I don’t know the answer. Let’s get the information. Let’s go find out.”


[01:19:42] Katie Tredo: Right. There is a lot of dangerous stuff by Googling stuff. One positive thing is if you can’t find the doctors, then get a physical therapy evaluation. A lot of times, most states don’t require a physician’s referral. If your particular insurance does, call your primary care doctor, any doctor you know, any nurse practitioner, and have them write a script for physical therapy. It’s rare that someone would say no. When you go to that specialist, whether it’s a pelvic PT or whoever you’re working with, and you have a problem, they probably have a physician to recommend for you because there are a lot of fantastic doctors out there.


[01:20:19] Ashley James: Absolutely. You’re just reminding me of Kristen Bowen. I don’t know if you’ve listened to her episodes. She’s the magnesium soak lady.


[01:20:27] Katie Tredo: Yeah, I’ve heard a little bit of it.


[01:20:32] Ashley James: She told her sisters—she had given birth to, I think, three children at that point—she started peeing after laughing, that kind of thing. Her sister went, “It’s time for you to go get the surgery.” She went to the doctor, and the doctor was like, “No problem. Let’s do the surgery.” They took a tissue from a cadaver, made a little hammock, put her bladder in it, and then use titanium screws to screw that little dead tissue hammock to the bones on her pelvis.

When she woke, she started having 30 seizures a day for two or three years, and she got down to 70 pounds. Then they finally convince the doctor/surgeon to take it out, to remove it. Most of her seizure went away. She got down to three seizures a day. She thinks she had an autoimmune response to the titanium, and also the tissue that was used. It turns out that they think that it was black market tissue because it was not tattooed with the code on it which it was supposed to.

She was not given any choices. She wasn’t told, “Let’s get examined by a physical therapist that specializes in pelvic rehabilitation,” or “Let’s give it a few months of exercises and see if that improves.” It was just immediate, “Oh yeah, you’re peeing when you laugh. It’s time to get the surgery.”

I understand that prolapse, if the bladder is coming through the vagina, then maybe it’s so far gone that PT wouldn’t help that person get back to where they need to be, but that they can use the physical therapy as rehabilitation.

Surgery should always be, unless its life-threatening surgery, should always be a choice you make after we’ve tried other options, like try a few months of physical therapy. It should be mandatory—if it’s a surgery that isn’t life-threatening, it should be mandatory that we at least try a few months of physical therapy first to see if we could make headway or see if we could prevent the surgeries because surgery is dangerous and life-altering, life-changing.


[01:23:10] Katie Tredo: That whole idea of having physical therapy first—I try to tell my patients, and that’s something I’m working on that I didn’t get to do much. When you tell someone that this might be able to prevent you from having surgery, I always tell my patients worst case scenario, you still need the surgery, but you’re rehabbing your pelvic floor, and you’re learning new movement patterns. You are learning how to properly void and not strain when you have a bowel movement.

All of these things you’re doing are going to optimize the results of your surgery. You’re changing the things that are contributing to you prolapse in the first place, so when you have that surgery, you’re not going to need it redone right after because you’re going to know how to move.

It just gets me when I get someone that’s post-surgical, and they have been straining their entire life. How did someone have surgery for prolapse and had not been taught how to toilet without straining? That’s just contributing to the issues.

I feel like pre-operative physical therapy cannot only do that but in men with prostate surgery, if these men came in for one visit pre-operatively, I think we could cut back the number of PT sessions they have after. By the time they come to me, they’ve developed very poor bladder habits.

It’s things a lot of people do anyway, but if they know not to do these things, and they know how to do a proper Kegel, when that catheter is pulled, they can start strengthening right away. They would be less frustrated, more educated, and prevent the secondary problems that they can cause with their habits.


[01:24:50] Ashley James: What about hernias? Can pelvic rehabilitation help with preventing or healing hernias?


[01:25:02] Katie Tredo: I treat a lot of patients for diastasis recti. If someone has a true hernia or umbilical hernia, they’re also seeing a surgeon depending on how severe it is. I’m not sure the answer to that question actually.


[01:25:19] Ashley James: For those who don’t know and I know because I have it, can you explain what diastasis recti is?


[01:25:27] Katie Tredo: Diastasis recti is a split in the rectus abdominal muscles. Sometimes during pregnancy or men with beer bellies or women with beer bellies, it’s not just pregnancy that can cause tearing in the linea alba or that white fascia when you see a picture of the muscular system between the abdominal muscles. When that splits, you see a bulge there, or you can usually sink a few fingers in between. That’s how it's measured actually, so it can disrupt how you’re moving and how load transfers through your body.


[01:26:04] Ashley James: You can help people to heal it?


[01:26:07] Katie Tredo: Yeah.


[01:26:08] Ashley James: Very cool. How about inguinal hernias?


[01:26:11] Katie Tredo: The patients I see with hernias, either had a hernia repair, or they were sent to me with a questionable hernia. By working on the pelvic floor and the core, their symptoms went away. I’m not sure that they ever had a hernia.


[01:26:26] Ashley James: Thank you. That’s what I was getting at.


[01:26:28] Katie Tredo: I think it’s more of a misdiagnosis.


[01:26:30] Ashley James: Yes, I was misdiagnosed with a hernia, and it was diastasis. How do you say it?


[01:26:38] Katie Tredo: Diastasis recti.


[01:26:40] Ashley James: Thank you. Diastasis recti which is common for people to have or having some symptoms in their pelvic floor because it’s out of balance and its appearing like it’s a hernia. You do the work, and then the symptoms go away. So, we don’t need to know if it was a hernia or not because you’ve strengthened whatever was weak.


[01:26:58] Katie Tredo: Right.


[01:26:58] Ashley James: Very cool. This has been wonderful. I like it when practitioners share tips or exercises, but I’m getting the feeling that it’s personalized. You can’t tell us all to do Kegels because that could be making it worse for some people, but making it better for others. Is there any kind of advice, very general, applying to 100% of the population—exercises or advice that you can give us?


[01:27:25] Katie Tredo: First thing I keep talking about how with constipation that people strain and can’t have a bowel movement, so if anyone listening is sitting, I’m a huge fan of those squatty potties. Have you seen those?


[01:27:44] Ashley James: Yes. Every toilet in my house has a squatty potty.


[01:27:46] Katie Tredo: Same with mine. That’s great. You want your knees above your hips. You want your pelvic floor to be able to relax.

If everyone listening tries to do a Valsalva or pushing or bearing down motion, try doing that, and you’re probably holding your breath. As you do that, you’re holding your breath, what is your pelvic floor doing? When you’re doing that, you should feel like the pelvic floor is contracting and lifting up.

That’s not allowing for a bowel movement. Now if you sit and you let your abdominal relax, your pelvic floor relaxed, and I want you to blow out as you bear down like you’re blowing bubbles. Not a forceful air but just [blows].

Do you feel your pelvic floor dropping down and widening? How simple is that? I mean that is something I work with patients coming in from GI doctors, surgeons, and different people.

You’re an adult, and I had you pretend to blow bubbles, and we’ve just fixed your constipation problem. That’s a big thing—this breath holding pattern—that reflexive tightening of the pelvic floor. That’s one thing I like to tell people.

Another thing is—because it’s such a common issue—bladder issues. Some very simple things that a lot of us have been taught wrong when we were children is stay hydrated. The general recommendation is drinking half your body weight in ounces. I think this varies a little bit between people but in that fluid. That doesn’t mean drink half your body weight in soda. It means you want at least two-thirds of your fluids to be plain, flat water, so no carbonation.

Then you can have some things that have bladder irritants, but if you’re having a problem watching those bladder irritants--everything good like caffeine, carbonation, sweeteners, acidic foods, tomato products, some spicy foods. Some of these things can irritate our bladder and want the bladder to contract sooner and empty.

Pay attention. Some people don’t have a problem with that, but if it is contributing to your issues, make sure you’re at least diluting those irritants by having a good amount of water.

A big thing I hear—I had just someone come into my clinic, and I was like, “Oh, no. Go home and tell your daughter you didn’t mean that.” She was like, “I always teach my daughter never to sit on a public toilet.”

What we’re training to do, it’s very different than in third world countries where they have this deep squat that relaxes the pelvic floor. When you’re hovering over a toilet seat, you are in a contraction, and you're teaching your bladder that it’s okay to contract or relax.

She said, “But she could get all those diseases on the toilet seat.” I laugh because I’ve never heard of anyone catching a disease from a toilet seat. I want to make a public service announcement that the toilets will be a lot cleaner if everyone just sat down and stop peeing on the seat. Maybe that could be the takeaway.

Then no going just in case. I have to catch myself saying this to my children, but every time you leave the house going, maybe you’ll be going half an hour, you’re going to go just in case because you’d hate to have to void half an hour into your shopping trip.

What you’re training your bladder what’s normal is that the bladder fills to a certain capacity. It's only half full, but you’re letting it empty every time it gets to that point or way sooner than you’re even getting that first initial signal that you need to go, you’re now training your bladder that when it’s at that capacity, it needs to contract and empty.

People come in saying, “I’ve always had a small bladder. I’ve always known all the time.” They’ve trained their bladder to do this. What’s normal is three to four hours, so if you’re getting it within that time, you need to go and void. If half an hour, you’re getting this message, see if you can distract yourself. Do a few quick pelvic floor contractions. Give yourself positive affirmation. See if you can even stretch it 15 more minutes. You’re gradually training your bladder to get back to that normal bladder interval that can hugely prevent a ton of problems with urinary frequency.

Those are my everybody could learn from those. Moms and dads, stop telling your children to keep going just in case and never sit on toilet seats.


[01:32:29] Ashley James: I laugh there because in my mind you just made the bladder like a lithium-ion battery, where you want to wait till it’s fully empty and then fully recharge it, not just plug it in every time it is 75%. You don’t go pee when you have 25% full bladder. You should wait till the bladder is full, and then pee because it helps tonify and stretch the bladder.


[01:32:55] Katie Tredo: Right.


[01:32:56] Ashley James: That’s some pretty good advice right there. I have been doing a little bit with our son who’s four because I don’t know when he was going to need to go pee. Sometimes he goes like hours without needing to go. I’m like, “It’s been all afternoon, and you haven’t needed to go. You should go right now.” He’s like, “I don’t need to.” And I’m like, “You should. You haven’t gone enough.”


[01:33:14] Katie Tredo: Kids sometimes have a holding pattern. That’s important, too. It is tough with kids. I have three kids. I’m not going to lie. When we have to stop, and one of them has to go potty, it is extremely inconvenient and very challenging to have all three of them in a stall. Sometimes, I don’t follow my advice, but I feel like the best we can.


[01:33:34] Ashley James: Do the best you can. Excellent. I like it. Wow! Thank you so much, Katie, for coming here.


[01:33:42] Katie Tredo: You’re welcome. Thank you.


[01:33:43] Ashley James: Absolutely. You shared a lot of great information. Did we get to everything that you wanted to share? Was there anything else that you wanted to make sure that you covered?


[01:33:51] Katie Tredo: I think I covered everything I was thinking of. The one thing maybe I’ll mention just for people who like numbers or someone out there who’s just learning that this is common is some of the recent statistics in the research, just as far as after childbirth what women are experiencing. Twenty-four percent of women have pain with intercourse a year and a half after childbirth; 77% have persistent back pain a year after childbirth; 49% experience urinary incontinence one year after childbirth.

That’s half of the women are experiencing what you said. They’re talking with their friends. They’re laughing. You have a baby, you go home, you pick up this heavy car seat carrier, and you’re doing all of this stuff. It’ s not that surprising, but these are all reasons.

Twenty-nine percent of people have undiagnosed pelvic fractures after having a baby, and 41% of undiagnosed tears on their pelvic floor muscles. If you’re pregnant out there or having children or have them ten years ago, if you’re having any of these problems, get yourself looked at and evaluated.

I am happy, to the best of my knowledge, to give you resources, and how to find someone who’s trained in pelvic floor therapy, and be available. As Ashley said, I’m on her Facebook page, so if you have any follow-up questions or anything like that, I’m happy to try to help you find someone near you.


[01:35:18] Ashley James: Yes, please join the Learn True Health Facebook group. You can go, which will redirect you to the group or just search Learn True Health on Facebook.

Katie, we’re going to make sure your information is in the show notes of the podcast on Learn True Health so those who want to connect with you can. I know mainly you work with people one on one. You want to see them physically, but I know that you have also worked with some people over Skype as more of a consultation to help them to find the right practitioners for them.

For those who want to reach out and talk to you, we’re going to make sure that your information is on the show notes of the podcast of


[01:36:04] Katie Tredo: Perfect.


[01:36:05] Ashley James: Excellent. It’s been a real pleasure having you here today. I want to implore the listeners to please share this episode with your girlfriends or the female family members of yours who are pregnant or have had kids because the more we spread this information, the more we can finally get this to be—

As you said, 50% of women are having pelvic floor issues even a year after birth. Half the population should be seeing a pelvic floor specialist for one thing or another even if we can do some corrections. It’s like going to the gym for our pelvis, and do some corrections, strengthen and stretch the right muscles, and hopefully, prevent a lot of things from going wrong in the future.


[01:36:58] Katie Tredo: Yeah, and we’ve talked a lot about how behind our culture is in treating these conditions we’re talking about. If we think women have it bad, men are like in the Dark Ages still because now doctors finally recognize these things in women, but these poor men are—I can’t tell you how many times I see someone for pelvic pain.

When a man has pelvic pain, 95% of the time, they do not have an infection, and 5% they have actual bacterial prostatitis. These men are given round after round of antibiotics and told that this is prostatitis.

I want to make that last mention because I probably see 70-80% is female and 20-30% male. I do focus a lot of my education on females, but these men need help too. I feel like there are not enough people talking about the problems that men have.


[01:37:52] Ashley James: Right. Because there’s shame in having pain in that area. Then you go to a doctor, and they’re like, “It’s probably an infection. Let’s treat it.”

Like you’re saying, most of the time it’s not an infection. It’s a pelvic floor issue. This is just eye-opening. Getting on round and round of antibiotics that aren’t needed is so damaging.


[01:38:14] Katie Tredo: It is, and discouraging. Not to mention if you keep seeing someone and you’re not getting better, it’s depressing.


[01:38:21] Ashley James: Right. You said that there’s an increased chance of depression and suicide in people who suffer from this pain.

You’re doing some really important work. I’m excited I had you on the show today. We allowed everyone to know and shed some light on this very important topic. I’m excited to continue this conversation in the Facebook group, the Learn True Health Facebook group, because I know we have a lot of great listeners wanting to thank you and also wanting to share their own experiences. So, thank you, Katie. This has been great having you on the show.


[01:38:53] Katie Tredo: Thank you. Thank you for allowing me to talk about this. It’s actually Pelvic Pain Awareness Month. My passion for this lies in educating people and teaching them about this. Thank you for giving me that platform.


[01:39:04] Ashley James: Happy Pelvic Pain Awareness Month.


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Ending Female Pain - Isa Herrera


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May 9, 2019

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How To Create Amazing Sleep 

From a diagnosis of narcolepsy to 10 years of sleep deprivation--this 180-shift in sleep quality led integrative health coach Cathy Cooke to  "go down the rabbit hole of studying everything [she] could possibly learn about sleep." She's back on the show to share what she has discovered and done and how that benefited her sleep. Listen and learn, and if you're lucky, win a free one-hour health coaching consult with Cathy.


[00:00:01] Ashley James: Hello, true health seeker and welcome to another exciting episode of the Learn True Health podcast. Today's episode is all about sleep—deep, restful, restorative, glorious sleep.

After listening to this episode, we will have empowered you with all the tools that you need to shift the quality of your sleep so that you sleep deeply through the night, and you wake up feeling so refreshed. Even if you think you have good sleep now, there's always room for improvement. I know you're going to get some amazing pointers today.

Cathy Cooke comes back on the show to share with us all the things that she's done with herself and with her clients to gain exceptional asleep. I myself have gone through quite a transformation in my sleep back when we recorded this interview in March. I was hunting for an organic bed. I've been hunting for it for months, and finally I came upon a company that I thought was very interesting because they had the most third-party studies and science related to a mattress. I didn't realize how much science could go into a mattress. And so I talked to some of the experts that I refer to, my mentors that I go to, and they all have the same mattress. I thought, “Wow, what am I missing? Everyone I talked to seems to have this mattress.”

So I called up the company. I started talking to them. They sent me many emails filled with the research and the studies and all the science. In fact, they even gave me the ingredient list because some people want to make sure that anything that goes into making it is 100% organic, non-toxic, doesn't off gas.

I learned through the literature they gave me that memory foam has nine carcinogenic chemicals linked to sudden infant death syndrome. My mind was blown. It kept expanding. It was like coming out of the Matrix when it came to mattresses. I knew that you could have a good mattress and get better sleep, but I had no idea.

So I jumped in, I got this brand new mattress. I've been sleeping on it for 34 nights now. So I can definitely say, I definitely have some experience. I'm really shocked that a mattress could have this much of a difference in my sleep quality. Everything we talk about in this interview, I've already incorporated in my life and seen some really great results. So I didn't know that I could get better sleep. Even though with all the good things I was doing, I was still turning and tossing through the night because my old mattress created pressure points. So I'd wake up a few times in the night to roll over. That would disrupt the depth of my sleep.

With this new mattress, I sleep solid through the night without moving because it creates no pressure points. If you sleep on your side, you'll wake up on your side. You feel totally refreshed. If I fall asleep on my back, I'll wake up on my back. I don't roll around in the night. I sleep solid. I’m now waking up an hour earlier than I usually do with way more energy because instead of disrupted sleep, I have solid sleep, and that's really cool. Considering I have a four-year-old that sleeps in the same bedroom as us, that is saying something.

Between having a husband, a kid, and a cat and everything, you'd think I'd be waking up all night, which I was, and I kept blaming my family thinking that I was waking up all night long because I have a cat and a four-year-old and a husband. But we changed our mattress and I sleep solidly through the night, and we all do, which is really exciting.

I wanted to wait to have a significant amount of time experiencing this mattress before I introduced it to you. It's been 34 days sleeping on the mattress. I've invited the founder of this company. He's going to be coming on the show in about a month. He put together an educational webinar. I said, “I feel that what you offer is the best of the best for my listeners. I want you guys to give my listeners a discount.”

It’s like a group buy, and I've seen some other holistic experts do this for their followers. They're going to give us a discount. Should you happen to be shopping for a new mattress or want an organic mattress that is the best sleep you'll ever have, they're going to give you a discount. They're going to give you a free mattress protector, and they're going to give you these pillows that are outstanding. They're hypoallergenic. They're my favorite. I said, “I love your pillows. Can you also give my listeners free pillows?” I think they’re like $100 each these pillows, so they're going to throw in two of their pillows, which is the biggest difference I've seen.

I used to go to my chiropractor every week, sometimes twice or three times a week because I'd wake up in pain. You ever had that where you’re like, “How did I injure myself while sleeping?” I'm not getting that old and that's exactly what kept happening to me. I have not seen my chiropractor in over a month. I'd have not needed to see my chiropractor, and I love him. I love visiting him. He's great. I have not needed to see him once since getting this new mattress. That's how powerful this technology is.

It also, for me, solidifies how damaging my old mattress was, and it was a newer mattress. We'd gotten it in 2011, so it wasn't that old. It was kind of middle of the line, like $2,200. I thought it would last us 10 years, and it started falling apart within two years, which I was really upset about. This new company that I got, the new mattress that I've had for the last just over a month, they have a 10-year or 20-year warranty—some crazy warranty that they absolutely guarantee if the mattress becomes warped in any way, they replace it immediately.

Really cool stuff. But I want you to check out the webinar they created. The founder of the company created this educational webinar—really blew my mind, lots of great information. There are two videos that he created, and they've put it on a website with the discount for my listeners—for you guys.

You can go to, go watch the video, go get the information. Their staff is amazing. I have asked them so many questions about everything they put into making the bed. It is 100% nontoxic. It doesn't off-gas. In fact, when we received delivery, we immediately slept on it. You don't have to air it out like memory foam where it creates a toxic gas. It does not. This bed is amazing—the most enjoyable sleep I've ever had.

So go to and check it out. Watch their videos. I am so thrilled to bring this information to you. It’s life-changing because if you've tried everything and you still toss and turn, if you're in pain, if you wake up with an injury of the neck or lower back and you're like, “What's going on?” It's your mattress.

Our mattresses can damage us. They can prevent us from healing, from fully going into a deep healing sleep, so that we stay inflamed, so that we sustain pain longer, create stiffness and pain. That affects our hormones because if we don't get deep, restful sleep, it affects everything. It affects our brain health, our immune health—everything. Even blood sugar and weight loss can be impacted by poor sleep. Every system of the body needs deep, restful sleep.

That's why I'm really excited for you to check this out. Go watch that webinar on that page:, look into it, and see what you think. Take in the information, see what you think because I am so excited to bring this to you.

If you have any friends or family, they're looking for a good bed, please send them to because this information is wonderful, and the bed is absolutely amazing. I'm so impressed with this company. I actually tried a few other “organic mattresses” before coming upon this one. So I took advantage of the other companies’ return policies. All these companies now have return policies. and this one has a 90-day one. I’m 34 days in, you cannot take this mattress away from me. I will not give it back. This is the mattress I will be sleeping on for the rest of my life. That's how good it is.

I'm really glad that I could share this with you. I know it's going to make a big difference in everyone's lives. Enjoy today's interview. It’s wonderful information about everything we can do to improve sleep, and of course, your mattress is very important. Go to to check out all that great information.


[00:09:59] Ashley James: Welcome to the Learn True Health podcast. I'm your host, Ashley James. This is Episode 352.

I am very excited to have back on the show, Cathy Cooke. She's a building biologist and a health coach. She was on our show, Episode 323. It was very interesting. I highly recommend going back and listening to that episode. Today is a continuation because we decided in that first episode we wanted to talk about the importance of sleep and how to create a lifestyle that allows you to have the deepest and restorative healing sleep possible.

So welcome, Cathy, back to the show. It is fantastic to have you here again.


[00:10:51] Cathy Cooke: Thanks so much, Ashley. I had so much fun the first time. I'm super excited to be back.


[00:10:56] Ashley James: Absolutely. I know a lot of listeners reached out. They had questions for you after our first interview. Listeners can go to your website, which is Of course, the links to everything that Cathy Cooke does is going to be in the show notes of today's podcast at

Cathy has also very graciously offered to give to one lucky listener a free one-hour health coaching consult. We're going to do that in the Facebook group. After this episode goes live, please join the Learn True Health Facebook group, and we're going to have a post there for about a week, and everyone can comment what they love learning about today from Cathy in today's show. And then, we'll do a random draw, Learn True Health Facebook group and roll the dice, and a lucky listener will get a hook-up with health coach Cathy Cooke.

Let's dive right in. Since the last episode, the first episode, episode 323, you went into your story and you shared about everything that led to you becoming an expert in not only helping people heal their bodies, but also organizing their environment in a way that's optimally supportive of their health. We're going to dive right into this concept of sleep. Did something happen to you in your life that made you want to go down this rabbit hole and learn more about how to correct your sleep or how to help others sleep? What happened that made you want to become an expert in this subject?


[00:12:34] Cathy Cooke: Great question. For the first 30 years of my life, I slept like a champ. I slept actually way too much. At one point, I was actually diagnosed as being narcoleptic. That diagnosis was since rescinded, but I could sleep anywhere, anytime so much. I was falling asleep in class, pretty much every single class from high school and college. It was pretty severe.

And then something happened around the age of 30, and there was a complete shift. It went from this severe narcoleptic-like symptoms to insomnia, and it kind of fascinated me. It was super frustrating, but it was like, “Why would I have this 180 shift from one extreme to the other?” And then for many years, I struggled to sleep through the night and to get restful sound, sleep—the kind of sleep that we need every night.

And so I just went down the rabbit hole of studying everything I could possibly learn about sleep to identify what I was doing wrong, what the underlying issues might be for why I was having these sleeping issues. Fourteen years later, I've just learned so much about sleep that I had to put this out there for other people because I know so many people suffer from sleeping issues.


[00:14:19] Ashley James: Absolutely. You just jogged my memory . In high school and college, I really had a hard time staying awake. Even though in college I found every class fascinating—neurology, biology, pathology, anatomy—ugh! I love that stuff. But I could not stay awake, especially later in the day. It didn't matter how much sleep I got at night, and it took me years to realize that that was because I had an underlying blood sugar problem. I had prediabetes, and it was gearing up to become full-blown type 2 diabetes. But that was my problem. I had no idea that is an early symptom of the blood sugar problems.


[00:15:06] Cathy Cooke: Yeah, that's a great story. Blood sugar is hugely impactful on sleep, and most people do not ever make that connection. For me, I think that was a very large issue in my first 30 years with sleeping excessively because I was not aware of how to balance your blood sugar. In hindsight looking back, this was in the era of everything needs to be low fat. I was hardly eating any protein. If it said low fat on the box, I was going to eat it.

Clearly, it was getting a lot of sugar because that's how the low-fat products taste good. They just pump them up with sugar, and I was getting very little nutrients. I wasn't getting vitamins and minerals and phytonutrients from whole foods, so my body was just exhausted, which sounds was probably a lot like what you experienced.


[00:16:07] Ashley James: Did you fall asleep while you're driving or talking to people?


[00:16:12] Cathy Cooke: Oh, my gosh. Yes, I hate to admit that. Not necessarily while I was conversing with people, but I had a little system down, and I can't believe I'm going to admit this to you and your listeners, but I would be at a red light, and I would press my foot really hard on the brake, and I would literally pass out for 20-30 seconds, and then cars would start moving, and I would wake up and drive. It was insane.


[00:16:38] Ashley James: Oh, my Gosh.


[00:16:39] Cathy Cooke: I know. It was horrible.


[00:16:42] Ashley James: Did you ever figure out what caused the narcolepsy? Was it blood sugar? Do you know why you had it?


[00:16:50] Cathy Cooke: It's interesting because when we talked last time, I had mentioned that I had been bit by a tick when I was 12, and then I had never been the same since. It was probably about a year after. Looking back, I've done a lot of hindsight investigating into when all of these symptoms began, and it was about a year after that tick bite that this hypersomnia started.

Looking back, I feel like that bacterial infection that we get from tick bites triggered something in me. I don't know if it was something along the lines of gene expression or if it was just the bacteria itself or how that happened, but it all started from there. I hear that a lot from people when they've had some of these infections that you might get acute symptoms for a little bit, and then nothing happens for several months to a year, and then the chronic symptoms really kick in. And so I think it stemmed from there, but additionally, my diet played a huge role.


[00:18:07] Ashley James: Right. I've had several people in the show who have reversed Lyme disease, and they all say that the environment of the body creates this perfect space for the spirochete, that infection from the Lyme, plus the co-infections that tend to come with it. Those co-infections will settle. It's like a garden that is perfect for weeds, and it’s like the perfect environment that’s set up. You start with one weed, and there's 10 different varieties of weeds. It's like the perfect environment for the body to then have all these co-infections. And so like you said, you even though you were bitten by the tick, the environment to your body was undernourished—too much junk food, too much sugar, too much processed food. It was creating a perfect environment for the other parasites to thrive.


[00:19:17] Cathy Cooke: That's very well said, and I would completely agree. You often have to question why some people get bit by ticks all summer long, and they never have a symptom. Why does one person become affected with all of these symptoms and another person doesn't? I think you bring up a great point. It's all about the terrain inside the body. I think that we also want to give consideration to our emotional environment, how is our mental health, because those ACES or adverse childhood events and emotional trauma that we have can really wreck havoc on our internal terrain, and a lot of us don't make that connection either.


[00:20:08] Ashley James: So all of a sudden it flipped. You went from too much sleep to no sleep or very little sleep. Were you having problems falling asleep or staying asleep or both?


[00:20:21] Cathy Cooke: It was definitely both. It was not consistent. It was kind of all over the place.


[00:20:29] Ashley James: How long were you having sleep deprivation for?


[00:20:33] Cathy Cooke: I'd say that this went on pretty severely for about 10 years.


[00:20:42] Ashley James: Wow.


[00:20:43] Cathy Cooke: Yes, it was a very long time. I'll just backtrack a little bit. This happened around the time, one, I had just spent a month in Siberia and did some traveling in some underdeveloped countries, so the idea of microbes was heavy in my mind. And two, I started to really jump on some of these health fad, and I started to detox aggressively. I started to juice a lot, and I went on a raw diet. I was actually living in Alaska at the time, which is the silliest thing to do—a raw diet in a cold place like that. So I created the perfect storm of being really aggressive and saying, “I'm going to be the healthiest person in the world and I'm going raw, and I'm going to start juicing.” And then I had horrible, horrible, horrible symptoms of this.

A few months after a lot of these symptoms started, I had a naturopathic doctor look in my mouth, and he was like, “We need to run a heavy metals test on you,” because I had a number of amalgam fillings in my mouth from when I was a child. We ran a heavy metals test and my mercury levels, in his words, they're the highest he’d ever seen. They were so off the charts. What I believe had happened is I was aggressively trying to clean up my body, and I liberated all of these heavy metals and probably some microbes, and it was too overwhelming for my body to be able to process.

So this is the reason why I always caution people when they want to jump into these colon cleanses or these fasts or whatever aggressive “detoxes” are, you really need to be very cautious and know what you're doing because if you're somebody like me who didn't have any idea what I was doing at the time, and you liberate all of this stuff that the body can't handle, you can have severe health symptoms like I did, which manifested in 10 years of insomnia, feeling hung over a lot, muscle weakness, and a number of other issues.

But the benefit of this is what I learned, and over the years was able to piece together and I worked with some excellent practitioners who helped me to understand the big picture, and then we could peel the onion back one layer at a time and address all of the underlying issues until I got to the point where I am today, which is significantly better and almost symptom free.


[00:23:50] Ashley James: Right. And this struggle has led you to become a holistic nutritionist and integrative health coach and building biologist. You dedicated your life not only to healing your body, but to healing other people. It's such a common theme—the best healers in the world suffered for years. That's what led them down that path.

I would rather see a healer who has been sick than one who cannot relate to me—who's never been sick. So you have learned so much. You have to put on that detective cap. You have to advocate for yourself and listen to your intuition. There's so many tools that you need to hone in order to not only heal your body, but then to go on to help others heal

So there you are, 10 years have gone by, what happened? Was there an aha moment? Was there a light bulb? Did you make some changes and noticed that you could sleep perfectly or was there a bunch of things that you had to have fall into place to start to slowly get better sleep?


[00:25:08] Cathy Cooke: Yeah, it was really a process. It was one thing at a time. There are multiple issues that I had to address, including the heavy metals, lyme and addressing or managing the microbial infections, and of course the EMS and the blood sugar balancing and blue light exposure. It was just kind of one thing helped a little bit. And then I learned about another thing, and then I added that in, so it was very cumulative, and it was multiple pieces put together.


[00:25:48] Ashley James: Did you have an Aha moment? Was there any one time when you went, “Oh, my gosh. It's working. There's hope.”


[00:25:57] Cathy Cooke: Well, yeah, I would say with each of these issues that I identified, it gave me more and more hope each time. For example, once I learned about blood sugar balancing—oh my gosh—it was dramatically impactful when I started to add in more healthy proteins, and cut back on the processed foods. That was a huge shift, and that piece of it really helped me with the sleep maintenance, with sleeping through the night.

But I still had a lot of issues with falling asleep. I kept hearing about these blue light blocking glasses and this exposure to artificial light at night. I really didn't understand it, but I bought just a cheap pair of orange safety glasses off of Amazon for $10, and the first night I wore those, I put them on and about five minutes later I was a little dizzy and out of it. And I was like, “Whoa, what's that about?” I went to bed shortly after, maybe 30 minutes after because I just kind of got tired all of a sudden, and I fell asleep right away. It was like, “Oh, my gosh. That was incredibly impactful.”

There were still times when I wasn't falling asleep right away. Then I got into the EMS and then I realized, “I'm sitting here watching a show at the end of the day on this couch and my router is plugged in right behind me. That's probably not a good idea.” And so I unplugged the router, and then I saw even more improvement. My sleep was so bad in the beginning that I made huge improvements with each of these. Each time was like, “Wow, that's intense. That was so impactful.” And just with each mitigation that I made, the better everything became.


[00:28:05] Ashley James: Very cool. How is your sleep now?


[00:28:08] Cathy Cooke: It's great. It's so much better than it's been before. I do have to take a lot of precautions. Everything with my sleep, it starts the moment I get up till the time that I lay my head down at the end of the day. All of the decisions I'm making through the day in some respect are helping me to optimize my sleep at the end of the day. I have to work hard at it, but it's fine because those things that I do to ensure that I get better sleep are very important for overall health in a variety of ways. Light exposure first thing in the morning, the blood sugar balancing, stress management, inflammatory foods—everything.


[00:28:57] Ashley James: Can you walk us through your day? Let's say we just woke up. Do you wake up to an alarm clock or do you let your body wake up naturally? Walk us through your day and explain each thing you do throughout the day to optimize your circadian rhythm and your sleep at night.


[00:29:15] Cathy Cooke: Sure. I wake up naturally, which is definitely what I prefer. There are certainly times when you have to use an alarm clock if you've got an early morning meeting or early morning flight or something like that. But I definitely prefer to wake up naturally because when we're waking up with an alarm clock, if we're in a certain deep sleep or REM sleep or a certain stage that we’re jolted out of, that can really start our day off on the wrong foot. So I prefer to wake up without an alarm clock, and I usually get up between say 7 and 8 A.M., which is kind of late for some people, but I've always been a person that needs about 9-10 hours of sleep, which I wish I didn't, but that's just the way my body has always been, and I have to respect that.

So I wake up between seven and eight, and the very first thing I do is drink a lot of water, drink some lemon water. If I'm taking supplements at the time, I take my supplements, and then I put my shoes on and head outside.


[00:30:28] Ashley James: So let's back it up. Why drink lemon water first thing in the morning?


[00:30:32] Cathy Cooke: Great question. I like the lemon water first thing in the morning, one reason is it can stimulate the liver a little bit so it can help to detoxify some of what's happened in the middle of the night because your liver is very active in the middle of the night. That's where it does a lot of its detoxification. And then the lemon water also helps to stimulate stomach acid and prepares you for digestion for the rest of the day. And it's a little bit alkalinizing as well, which can be helpful for some of us.


[00:31:04] Ashley James: Some people can't tolerate lemon water first thing in the morning. Would you suggest that they try sipping vinegar or like an apple cider vinegar instead mixed with a little water?


[00:31:15] Cathy Cooke: Sure. That would be fine. I have to be honest, there's not a plethora of science backing up that lemon water or apple cider vinegar is the best thing in the world for us. There's a little bit, but I do it mostly because I like the flavor, and I like stimulating that digestion. It's not something that everybody necessarily has to do, but if you want a little extra of a boost, apple cider vinegar could be fine. Even a bit of orange essence from an orange peelm I find to be really nice. You can infuse your water with lemon rinds or orange rinds, basil, mint—that kind of thing. That can be really helpful. Sometimes the flavor of those things will encourage you to drink more water, which is important in the morning because we haven't had any liquids for eight hours, so we can tend to be a little bit dehydrated in the morning.


[00:32:22] Ashley James: The number one thing is to get some hydration. I have heard that some people really resonate with a pinch of Himalayan sea salt in their water. Some people prefer room temperature or even slightly warm water as opposed to drinking cold water first thing in the morning.

So we have to play with it, dial it in. But the most important thing is that we're getting that hydration first thing in the morning, so getting 8-16 ounces. I drink about 20 ounces first thing in the morning, so depending on your needs. I notice I'm definitely thirsty first thing in the morning.

It's priming the pump. When we drink water first thing in the morning, we tend to drink more throughout the day and continue the hydration. Especially a lot of people go for the caffeine in the morning, which dehydrate us. We want to get on top of the hydration before we start pumping ourselves full of coffee.


[00:33:24] Cathy Cooke: Yeah, absolutely. I think that's a great tip about the salt, too. I actually do that exact thing. I use Celtic Sea salt for the minerals, and put a little of that in my water for a variety of reasons, and the electrolyte balances great.


[00:33:40] Ashley James: There's a big fad right now with juicing celery first thing in the morning. That contains some electrolytes. People could use some celery if they want it, but the whole point is get the water in, and you’ll get the hydration.

So you get some water and some lemon water in you, you throw on your sneakers, and you go outside. Why are you doing that first thing in the morning especially if it's cold?


[00:34:03] Cathy Cooke: A number of reasons. The most important for me is that sunlight exposure first thing in the morning. When we get sunlight on our eyeballs and on our skin, our circadian rhythm is taking a really important cue that it's morning. That helps to train our circadian rhythm over the course of the day of what time it is—"My cortisol should be high right now. I should be circulating my blood. I should be moving. I'm getting energetic to prepare for the day.” It's just a important cue to our body to set our circadian rhythm for the rest of the day. So getting that sunlight exposure, even if it's cloudy, the sunlight that you're getting even through the clouds is still very impactful.

Even when it's cold, even when it's raining, snowing, I go out pretty much no matter what. If it's a torrential downpour, I might not, but even if it's very cold, that cold weather exposure is actually really good for us. Humans aren't supposed to be in 72 degrees, 24 hours a day for 365 days a year. We're not meant to be comfortable all the time. Our body actually wants these cues that it's really hot or it's really cold because that's information for us about what time of day it is, about what time of year it is. Our DNA really thrives on having this information so that it knows where it's at in space, and where it's at in the time of day and the time of year.

So that cold exposure—because we're in March, it's still pretty cold here in Idaho—it's actually very invigorating to me in the morning. And then the movement that I'm getting just from walking, that circulation, the lymph flow, just getting energetic and I'm prepared for the day, it's all very important.


[00:36:17] Ashley James: I've also heard that when direct sunlight—I mean not staring at the sun, but sunlight and you're outside. You can't get this if you're just looking out your window, if you're in your car looking out the window. You actually have to be outside with sunlight and it can be through clouds. But when you're outside in the sunlight in the morning, it burns off the melatonin through the circulation in your eyeballs. I've heard that's how the body is burning off the rest of the melatonin. That's why we feel so awake and perky after a few minutes outside first thing in the morning.


[00:37:06] Cathy Cooke: Interesting. I don't know specifically what the mechanism is there. But it definitely makes a lot of sense because as our hormones shift through the night, melatonin is highest at night of course, and then we see it decline, and so it should be very low in the morning. Where's the opposite curve with our cortisol? It should be very low at night, and then it rises first thing in the morning. So that makes a lot of sense, and the cortisol, of course, is very energizing.


[00:37:39] Ashley James: So there you are, you spend a few minutes outside after your hydration. Now what do you do?


[00:37:47] Cathy Cooke: After that, it depends on my schedule for the day. Generally, I like to block out between 30 minutes to an hour after a brief morning walk to do some kind of movement. That's usually yoga. It could be some kind of cardiovascular or weightlifting, but yoga is my preferred method because you can get a big cardiovascular workout from yoga as well as strength training.

But I like the mindfulness piece of yoga, and I like that, while I'm getting a good workout often with the yoga routine that I choose, I'm also getting the mindfulness piece. So that helps me to set my day off with good intentions and in a good mental health capacity.

Sometimes it's not vigorous. Sometimes it's like, “Ugh, I'm exhausted today.” It just turns out to be more of a relaxing, stretching routine and that's just fine. But anything that I can do to move my body and prepare my mind for the workday. Sometimes I don't have time for that, but that's preferred. And then after I get some movement in, I jump right into the workday.


[00:39:10] Ashley James: What about breakfast? How important is your breakfast for your sleep?


[00:39:14] Cathy Cooke: It's interesting. We've talked a lot about blood sugar balancing already, and what I have found is that if I have to get out of the house, go to work right away, or I've got a really intensive day as far as my mental capacity—I have to use a lot of brain power—that eating first thing in the morning is helpful for me. But when I'm working from home and I don't need quite as much energy in that regard, I find that intermittent fasting works much better.

And so it's something that I've played with over the years, and certain times of the year might be different than other times, so it's not a hard and fast rule for me. But I would say over the last six months, I probably don't eat breakfast. I have maybe some warm herbal teas, or I'll have more lemon water. But I'm usually eating about 12 or 1:00 PM for my first meal of the day. And that works really well for me right now. It changes. Sometimes it doesn't. But that seems to be where my blood sugar really likes that.


[00:40:27] Ashley James: So you're listening to your body. I think a lot of people do intermittent fasting without really listening to their body, and the one pitfall that people can get tripped up by is that if they skip breakfast, they'll eat a second dinner late at night. We have to remember that intermittent fasting is not just skipping breakfast, it's also narrowing the eating window.

If we’re going to eat our first meal around 11 or noon, then we need to make sure that we eat our last meal around six or seven and eight at the very latest, but that's getting too late because we want to be on an empty stomach going to bed, and a lot of people overeat before going to bed, and so they're not sleeping and healing throughout the night. They're digesting throughout the night.


[00:41:22] Cathy Cooke: Yeah, that's a good point.


[00:41:23] Ashley James: I thought it was really fascinating to find out that 30% of our energy goes towards digesting. So if we're doing that in our sleep, we're not restoring. We're not healing, and we're not going to feel revitalized the next day. Also, we don't really need calories at night. Our body can use up the stores in the liver and in the muscles or the energy stores. We don't really need to consume calories. So the calories that we consume late at night will end up getting processed and stored as fat cause we're not exercising in our sleep.

So that's a big problem that we have is that people will skip breakfast because they've heard intermittent fasting is good, or they just drink a coffee and they skip breakfast because they have created a bad habit. But then they'll eat most of their calories after the sun has set.


[00:42:14] Cathy Cooke: That's a really good consideration. I'm glad you brought that up. That's one of the reasons why I mentioned it, that this is what's working for me right now. It doesn't always work for me, and it's definitely not for everybody. I would say in my experience, the more thyroid and adrenal issues that you might have, the harder it is for someone to be effective with intermittent fasting. And you're absolutely right—I see that exact thing happening where somebody skips breakfast and then they just overdo it the rest of the day.

You really got to pay attention to, is this something that seems manageable and seems intuitively okay for the habits that come out the rest of the day for you? So yeah, it's really important to monitor what's happening in your body.


[00:43:10] Ashley James: Because you have found that creating healthy blood sugar, optimizing healthy blood sugar is so important for sleep. Can you give some examples of what you eat for lunch?


[00:43:23] Cathy Cooke: Sure. I like to consider Ayurvedic and traditional Chinese medicine principles, which means that I try to eat with the seasons. So what I eat for my first meal of the day or any meal will often vary by the seasons. So right now it's March, and pretty soon we're going to start having things like sprouts and young vegetables and real bitter foods that are going to prepare us for springtime and kind of that shedding of the extra weight or the heaviness that we've carried through the winter, which provided warmth and installation for us.

We're coming into the time where we're going to start shutting that. So I've been adding a little bit of greens and a little bit of sprouts into my meals. But I don't go real heavy on the raw vegetables because I find that my digestion isn't really strong enough for a lot of raw foods. Like today, I had a couple of pasture-based eggs, which are excellent, and I had a little bit of pasture-based bacon, which I understand is not for everybody, and I don't do that often, but that just happened to be what I had today. And then I had some big squash with that and a little bit of some of these micro greens and sprouts that I had mentioned. So that was my meal for today.


[00:45:02] Ashley James: Yummy. Since we're sharing our meals, I had a quinoa with a vegetable stew that I made with my husband. We took every vegetable known to man and we put it through our veggie bullet food processor to basically make it shaved. So make little shavings of carrot, beet, zucchini, onion, mushrooms, celery, kale and red peppers. So we just basically picked every vegetable, everything we had in the fridge, and we made a big pot of it, and just a little bit of water because so much water gets released from the vegetables as we simmered it. And then we added a bunch of different kinds of beans, and we added some chili spices. We made a huge batch of it, and it's been feeding us for days, but we recently added a bunch of quinoa to it, so it came out like a delicious stew, and it's plant based and affordable. It's all organic, and it tastes amazing.

It's really funny. When we get into the kitchen, my husband and I, we make some recipes together. We always say, “Why do we ever eat out?” We're always disappointed. We overpay. We’re disappointed because of the food contamination because we have so many allergies in our house that it's like a Russian roulette. Our son is allergic to garlic. Try to go to a restaurant and not have garlic on something. My husband is vegan. We're allergic to dairy, wheat and eggs.

And so when we do go out, it is definitely Russian roulette, but we're always disappointed. We ended up more and more and more cooking at home, but doing these large batches of food, so that we can eat it for days. People say, “Isn't that boring, eating the same thing?” And I tell you, it tastes different every day because it's marinating. And so every time we heat it up, sometimes we'll add other stuff to it, but we've just made this giant pot, and it's lasted almost a week. We even brought over a bunch to a friend's house yesterday cause she's feeling sick.

It's just one of those things where you can eat super healthy on a budget and save a lot of time. You just have to find the right recipes. But what I love about what we ate, even though there wasn't any meat in it, it was still very high in plant-based protein because of the beans and the quinoa, and all the carbs that were in it were low-glycemic, and so it doesn't create a blood sugar spike. So those are two examples—your example and my example of some blood sugar responsible meals that we can have for lunch.

So what happens the rest of the day? What other habits have you created to support healthy sleep?


[00:48:16] Cathy Cooke: I'm working the rest of the day usually. So my EMF environment is a big piece of this. I'm fortunate in that I work from home, so I don't have to have WiFi or other people's cell phones or Bluetooth or whatever it is out in thec world that is going to impact me. My computer is plugged in via an ethernet. My phone is off. And it's a very low EMF environment in my home.

I do notice that, in the past, when I've been working for people and I'm working in an office environment or in a building, that my sleep does suffer because you can't go anywhere without the building having WiFi and multiple people having their phones. It's everywhere.

The choice for me to work on my own has been partly because of that, so that I can avoid all of that EMF exposure that I would get working for somebody else in a group setting. So I'm at home and my EMF environment is very low. While I am working, I make sure to move often. I mentioned that I do exercise earlier in the day, but I also try to make sure that I get little spurts of exercise during the rest of the day, and that's usually between 5-10 minutes. Keeping the circulation going, keeping the lymph moving because people don't realize that our lymph has no pump. If we don't move, our lymph doesn't move.

So keeping the circulation and the lymph movement going throughout the day is really important, and also getting outside. So even though I get sun exposure first thing in the morning, really human beings are meant to be outside 24 hours a day. So I try to go outside at least three times a day, preferably more. But just so I get the different intensity of sunlight because again, the bright light in the morning versus the light at noon versus the light in the evening, they're all different. They're different intensities. They're different colors. And those are all cues, again, to our circadian rhythm about where we are in the day. So getting outside throughout the workday, moving throughout the workday is also very important to me.


[00:51:03] Ashley James: I want to go back to the low EMF discussion. For those who didn't listen to your Episode 323, why does EMF impact sleep?


[00:51:18] Cathy Cooke: Great question. What we know about EMF—that stands for electromagnetic fields. So this is the radiation that we're getting from our wireless devices, as well as the wiring in our walls, as well as our electronics that have motors, and all of this stuff is putting off electricity in a certain form.

So what we know from the science is that the EMF affect our voltage gated calcium channels. So that means that our body is electric, our body works off of electric signaling, and that's why we have electrolytes. Hence the name--e electrolytes. It helps signals within our cells communicate with each other. So our voltage gated calcium channels, this means that our cells are not supposed to have a lot of calcium inside the cell. It's supposed to be on the outside.

And when we get exposure to these frequencies from EMFs that are different than our bodies— our bodies usually run on 60 hertz—and all these other frequencies are just all over the place, way different magnitudes than our own bodies. So this electrical interference is very confusing to the body. We have found through a lot of scientific research that the calcium channels are opened because they work on voltage. They’re opened and calcium can flood into the cell. And when calcium floods into the cell, we get reactive oxygen species, which you can consider as oxidative stress. And that oxidative stress, as you probably know, Ashley, is the beginning of any chronic health symptom or a health condition that you can name. I mean all of our modern health conditions can stem from this kind of oxidative stress because it can manifest in many, many different ways.

So what symptoms do we see from that? All of the symptoms that I mentioned earlier, and then we've got this whole nervous system disruption happening. And when you think about the body being compromised on the nervous system, clearly that's not setting up a stage for rest for our body. Our nervous system is overburdened, the communication is all confused, neurotransmitters are affected. The brain doesn't know—is it day? Is it night, what's going on? And it just doesn't set an environment for the body to be able to rest and to calm down.


[00:54:12] Ashley James: Very interesting, and interesting that you noticed a difference between when you're in office buildings versus in your own home, which you being a building biologist, that's a service you offer. You teach people in their offices and in their homes, how to lower exposure to things that are harming them such as EMFs.

Ty Bollinger, the creator of the Truth About Cancer and the Truth About Vaccines, he was on my show and he said that he was in New York City to be on—I can't remember what TV show—CNN or something big like that. He couldn't sleep that night, and it was almost painful. He’s used to living out like you—low EMF. He’s not surrounded by it. And when you are in a major city and you turn on the WiFi and your cell phone or your laptop and you see all the routers that you're be exposed to, you're being exposed to sometimes 200 different WiFi signals.

And he said he could feel it. He couldn't sleep that night. It just bombarded his cells. He really, really could tell the difference. And then there's a specialist here, a doctor local to me, I’ve had him on the show, Dr. Dietrich Klinghardt, he's world renowned for helping people to reverse these mystery diseases, and he's really good at helping to reverse autism.

The first thing he does with children of autism is he has the parents completely remove the child from all WiFi because he sees that it damages their brains because he sees that the those with autism have trouble detoxing. There's heavy metal accumulation in their nervous tissue, and the heavy metals inside the brain will vibrate at the 60 hertz from the exposure to the WiFi signal, for example, and to other EMFs.

And so he has them immediately changed their environment to be incredibly low EMF and then start them on a very gentle detox. He gets incredible results. He's had people go from nonverbal to be able to go to college. That level of shift because we're just supporting the body's ability to heal itself, to detox correctly, safely, efficiently again, nutrify the body again, nitrify the cells.

Now you brought up lymph, and this is I think a really important topic. I don't want to pass up an opportunity for those to learn about it. So you mentioned that the lymph system doesn't have a pump, but people may not know what the lymph system is. So can you explain the absolute importance of what is lymph, why is it really important to move your body in order to make lymph flow through the body?


[00:57:29] Cathy Cooke: Good question. The lymph system is essentially the network of tissues in the body that help rid the body of toxins and waste or unwanted materials. We've got lymph everywhere, all throughout the body. Think of the blood vessels throughout your body, and it's everywhere, and so is the lymph.

Oftentimes people think of lympth being kind of in their neck because when you get sick and you've got a sore throat, your lymph nodes in your neck will kind of get swollen. And that's a really tangible way to think about what's happening there because the immune system is being activated there to help the lymph get rid of what it doesn't want, which is in this case, the microbes or whatever it is that's making you sick.

So that lymph system, the importance there, we want to remove the accumulated waste. Unlike the heart, which pumps and pumps blood all throughout the body, that lymph will essentially just sit there unless we contract our muscles throughout the day. So muscle movement and circulation are what helps the lymph to actually move, and we can actually do this manually too. You can go to a massage therapist who specializes in lymph drainage or lymph massage, and it's basically gentle touches throughout the body to encourage the lymph to move. Exercise, of course, is going to be the most accessible way that we get lymph movement throughout the day.

But it's really important because people who are not moving a lot or not exercising, or even if they exercise once in the morning and then they sit for the rest of the day, while you may have exercise in the morning, but that sitting for the next 10 hours that you do is not good. You're not getting lymph movement and you're not getting circulation, so things just kind of become stagnant. Of course, that's not what we want. We want movement, circulation and drainage happening.


[00:59:55] Ashley James: I like to illustrate the lymph system as I think about the individual cell as a water balloon. So individual cells are enclosed and they have their own system going on, and they have all these amazing processes happening inside the cell, and they're making waste like a car. It’s making exhaust. It has all this waste it needs to get rid of, and we need to get rid of the waste in order to bring in more nutrition, so the cell can continue being healthy.

And so the cell poops out the waste, and some waste is pooped out into the lymph fluid that bathes each cell. Some of our waste does get carried away by the venous blood flow. But a lot of this waste is pooped out from the cell into the lymph, and it'll just sit there. All this waste, this junk, this material, possible pathogens like mold and bacteria and viruses is just sitting there and stagnating around, surrounding our swamp water, surrounding our 37.2 trillion cells in our body.

And the only thing that's going to make that lymph fluid move back into the liver, because it all collects and come back up and flows back into the liver for the liver to process, for the body to filter and process, it will only move when we move or deep breathe. Deep breathing is really good for moving lymph as well because it creates this negative cavity in the chest and that pulls it up.

But like you said, someone who's sick could just do range of motion exercises where they're just bending their ankles, bending their toes, bending their knees. Because every time we bend any appendage, any joint, the second we bend it to its full extent, then bend it back, you are pumping the lymph because all the lymph nodes are surrounding each joint.

It’s really amazing. When you start to study how the body was created, there's such intelligence behind it. It really fascinates me that they have the religious people on one sidem and we have the scientists on the other. One says there's no god. The other one says there is God.

When you start to study the body, it is so complex and so brilliant, and it makes so much sense when you start to understand how the body works. You start to see there's this world that we don't understand where we came from. We have ideas. We can all argue about where we came from, but we can all agree that the body is amazing and brilliant, and there's so much intelligence.

And so if we can just support the body by coming back to nature, like when you said, “Get up and move your body. We were never meant to sit at a chair.” In fact, we really didn't have chairs growing up as cavemen or whatever. We would squat. We used to be able to squat all the time, and we would move. Our bodies are just meant to move often. The more that we sit at our desks, the more we're developing problems with our neck like stenosis. We're having these chronic conditions come up from lack of movement, which is really interesting that we're developing. It's purely from lifestyle.

So you're saying, “Get up, maybe set a timer or have a routine.” If you drink enough water, you'll need to pee throughout the day. So there's get up and do some movement. But do you have any suggestions? Let's say someone has a desk job, but they have the freedom to get up. They're not chained to their desks like a factory where they have to stay there, but they can get up and move around. Do you have any suggestions for how do we create this habit or when we do get up to go pee and grab a glass of water, do you have some suggestions where we can do for a few minutes just to maximize that movement before we clear the cobwebs and then go back to work?


[01:04:26] Cathy Cooke: Sure. I think that the motivation is going to be different for everyone. I find that for some people, setting an alarm works well. There are several apps that you can download, and there are numerous ones. I don't have a favorite one to recommend, but they’d be worth looking into and playing with, but different apps that will remind you to get up every 45 minutes or every hour or 20 minutes or whatever it is that works for you. And then they can prompt you to do a different exercise. Say you have to get up and do 10 push-ups or 20 squats or 20 jumping jacks or whatever it is.

I find that people find that really helpful or it's just, “Okay, I've been sitting for an hour, I have to go outside for 10 minutes.” There's a number of different ways to do this. I found that there's not one recommendation that works for everybody because some people don't want to go outside, or they don't want to do push-ups, or they're better off with, “At 10 o'clock, I get up and go visit my co-worker who's down the hall or on the second floor.”

I think people just have to be creative and identify what works best for them and then stick to it, of course. That's where I find that the apps help a lot because the apps are an outside influence to say, “Hey, you got to stop. You got to do this now.” We just have to take accountability for our actions and actually do it.


[01:06:10] Ashley James: For those who say, “Oh, I just don't have time to take all this free time out of my work,” my counter to that is that we find that when people do take breaks, even just five minutes every hour to stretch, breathe, move, drink more water, and then get back to it, that break cleared the cobwebs, and now you're even more efficient at work for the next hour. You’re moral alert, more awake.

Because when we're in stress mode, our body shunts blood away from logic centers of the brain, and we really end up in this brain fog where we don't have the full access to our cognitive abilities. Taking those breaks throughout the day are going to re-energize us, restore us, boost our immune system, help us with sleep at night, help us to move the sludge out of our body and detoxify, and then come back empowered to be more efficient at work.


[01:07:10] Cathy Cooke: Great point. I find that you make less mistakes too, so you spend less time in the future going back and fixing your mistakes. I also wanted to mention another one that I just thought of. Have you ever heard of the website called Fitness Blender?


[01:07:26] Ashley James: No, I don't think I have.


[01:07:29] Cathy Cooke: It's fantastic. This is something that I recommend to almost all the clients I work with. Fitness Blender is a website by a younger, married couple that it's just all about fitness, and they've got something like over 400 exercise videos and they're totally free. You can choose anywhere from like four minutes to over an hour. You can narrow down your search. So you say, I've got four minutes, I want to do cardio, or I want to do strength training or I want to do stretching. You plug that in, and all the videos come up that meet that criteria.


[01:08:07] Ashley James: Very cool.


[01:08:09] Cathy Cooke: It's really cool. I find that it's really effective for that person that's like, “I don't have time to work out. I can't do it.” It's like, “Okay, got four minutes to do this exercise, and you can do it right in your office.” They don't take up a lot of space. They are designed just for this purpose—for somebody that's busy and just needs to get something really quick. I have found huge benefits for people doing this throughout the day because again, everything we just talked about, that lymph movement, that oxygenation, moving your joints around, becoming more productive. So that's another great tip for people.


[01:08:46] Ashley James: Awesome. So you work in a low EMF environment, and you move your body throughout the day. Now it is getting close to when you go outside throughout the day, at least a few times during the day, so that your eyeballs get sunlight filtering through, so you get that signal to your brain, hey, it's now later in the day, so the brain starts lowering the cortisol, getting ready to make some melatonin. So now you're coming up towards dinner. What health habits do you have in the late afternoon/evening for improving sleep?


[01:09:22] Cathy Cooke: Late afternoon/evening, I start to consider toning back the liquids a little bit. One, I don't like to have a lot of fluids in me when I'm eating my meals because I find that it really dilutes your stomach acid quite a bit. I noticed that significantly, so I try to not eat or not drink anything at least about a half an hour before I'm going to eat, especially dinner, because it just really affects my digestion.

As well as we're starting to get to the time where if you're drinking liquids later in the evening, you could get up in the middle of the night to have to pee, and we don't want that to happen either. Of course, I don't actually drink any caffeine. My body just does not like it. It does not metabolize it well. But for people that do drink caffeine, be it coffee or tea or, God forbid, sodas or whatever it is. We're hoping that you stop that before noon or at least earlier in the day, especially if you're someone that has sleeping issues. You really need to be careful about the caffeine intake, and you also need to consider things like cocoa that have naturally occurring caffeine.

So having chocolate later in the day, I try not to do because that little bit of caffeine can keep me up. And then when I'm making the choice of what to eat for dinner—we've talked a lot about blood sugar, and I have found over the past year, so I've really been toying with if I reduce my protein intake in the evening and increase some of my complex carbohydrates, how does that impact my sleep? I have found that it improves my sleep, that if I keep the protein, specifically if I'm doing things like animal products, if I keep them to the earlier meal of the day and focus more on a plant based meal or plant based protein in the evening, that actually helps me. I found that to actually be the case for a lot of people.

All of the amino acids in the protein can actually be a little bit too stimulating for us at night, and the carbohydrates for that serotonin is effective and important for sleep. It's not going to be for everybody, but I found a significant amount of people actually do benefit from being a bit cognizant of that. Choosing what I have for my dinner is going to impact that quite a bit. So if I was going to go out and have a big steak for dinner, it's almost always that I'm not going to have good deep sleep that night. So that's a consideration.

Of course, keeping in mind foods that are inflammatory in and of themselves. As a nutritionist, I'm not eating a lot of processed foods. I'm sure you're not either. But some of your listeners might be saying, “Oh, well, if I have a little pasta, what's that going to hurt, or if I throw a little cheese on that pasta? It's just a little bit, it's not going to be that big of a deal.”

But if you're somebody that has an inflammatory response to wheat or to dairy or whatever the food is, you got to be cognizant of that, and be kind to your body. You got to remember that that bite of cheese or that pasta lasts about 20 seconds, and then you're up the rest of the night. Is that really worth it? It wouldn't be worth it to me.

So keeping in your mind about what those trigger foods are for you or what those foods that are inflammatory are for you—all processed, packaged foods are going to be inflammatory for everybody, so we need to reduce that. We need to consider a whole food diet especially in the evening. Keep in mind what those trigger foods are for you, and keep it a whole food based approach. That's kind of what dinner and late evening looks like.


[01:13:56] Ashley James: Very cool. My husband, when I met him and he's originally from Seattle, which is like the caffeine capitol of the world, and he would brag that he could drink a venti coffee and fall asleep. Now I have always been sensitive to caffeine, so if I drink caffeine past 1:00 PM, I am up all night. It just wrecks me.

And so it really surprised me that he would opt to drink coffee at night, or do you know if you watch those TV shows where they're getting together for coffee, and I'm like, “What are you doing? Who does that? Who drinks coffee at night?” Or someone's like, “Let's have some tea,” and you know, it's black tea, and you're just like,”What's going on? In what world do people caffeinate at night? This is crazy.”

But, yeah, sure enough he can drink a venti and fall asleep. Now we're coming up on our 11 years together, and we've discovered in the last year through playing with cutting out coffee, which was something very big for someone from Seattle to do, that he used to wake up about four or five in the morning, very early in the morning, regardless of whether he went to bed at 10 or one in the morning. He would always wake up, and he rarely could go back to sleep. And so he would just start his day that way with some more coffee.

But when he took coffee out of his life, he was sleeping in. For him, sleeping in is like, “Oh, my gosh!” The sun has risen, it’s seven in the morning, and he would roll over and be well rested—he couldn't believe it. I did some digging and discovered that caffeine has a half-life that lasts about 18 hours. It'll stay in our body for that long. And for some people it doesn't affect them falling asleep. Like he said, he never really felt energized from coffee, whereas I get very jittery and very energized. He didn't really feel like a lot of energy from it.

But what it does for some people is it disrupts them on the other end of sleep. So it disrupts them from falling into the second wave of deep sleep, and it disrupts them late at night or really early in the morning, and so they'll wake up. Some people can fall asleep with caffeine in their system, but it will make them have a lot later sleep that's less restorative, and then they'll wake up earlier feeling not 100% restored.

It was bad. It took him over a week. It felt like about two weeks to be able to get coffee out of his system. He had caffeine headaches for days because if you've been on caffeine for many years and then you get off of it, suddenly it actually inflames the blood vessels in the brain. So you feel almost like a migraine. Caffeine headaches are pretty severe, and so it's best to slowly reduce the coffee down over time, and then wean yourself off of it.

But he was hardcore. He just said, “Okay, that's it. Let's try it without.” And so that was very interesting that he now can get very deep, healing, restorative sleep because he doesn't drink coffee throughout the day. For me, that chocolate thing, if I had even one piece of chocolate at night, I would notice that my sleep was disrupted. That's really frustrating because I eat organic vegan Stevia sweetened, no sugar added chocolate. It seems to be the healthiest dark chocolate in the world, but it's still very stimulating.

Alcohol is another thing. I've had an HPATH on the show share that there's a way in which you can monitor your body's stress levels called heart rate variability, and they find that when you even drink one serving of alcohol, for 24 hours, our stress levels are heightened. Our body is in a state of stress for 24 hours after even consuming just one alcoholic beverage. Some people think that they need to unwind and drink alcohol to help them sleep, but it in fact severely disrupts their sleep.

So alcohol, chocolate, sugar, caffeine. Another thing which I found really interesting—an old school naturopath taught me that white rice consumed after noon or in the evenings can cause nightmares.


[01:18:55] Cathy Cooke: Interesting.


[01:18:57] Ashley James: Yeah. So really being responsible for choosing the glycemic-friendly foods. If you're going to eat starches, like if you're going to eat rice, make sure it's brown rice, for example. It has more fiber. It breaks down slower in the body. Choosing the least amount of processed things possible because the second you process something into a flour to make pasta, for example, you're removing fiber and thus it converts quickly to sugar.

I like that you talked about eating those complex carbs in the evening to help with the serotonin. Some people find that if they eat some sweet potato, for example, in the evening it helps them sleep. And some people find that if they eat some scrambled eggs as an evening snack, like one or two scrambled eggs, that the fat and the protein helped them sleep. So you have to play around and figure out which one is going to be more supportive for you.

[01:20:03] Cathy Cooke: Right. That's why it's really hard to make blanket recommendations across the board because everybody responds differently. For me, adding protein into my diet when I was a hypersomniac back in the day was very, very helpful to help me be more energized. But I also went to the extreme end and was just eating protein all the time and found that that wasn't helpful either.

It's going take a lot of trial and error for everybody individually to find out what the best macro nutrient balance is. I often do suggest that people get a blood sugar monitor for themselves, and oftentimes your doctor will give you one for free because the strips are actually what's so expensive, as you probably know. That's where they get you. But you can get a blood sugar monitor, and then use it for a couple of weeks just to get a sense of how your body is responding to different foods in different macronutrient combinations. It can be really insightful. Something that you've been doing forever, like a piece of chicken and some broccoli and some rice at dinner, checking your blood sugar 30 minutes, an hour, two hours afterwards to see what kind of fluctuations you get will really help you dial in the certain foods that work for you and the certain macronutrient combinations that are going to be the best for you regarding sleep and everything else, too.


[01:21:42] Ashley James: And that's why hiring a health coach like yourself or like me helps people. Because sometimes this is too much. Like, “Oh, my gosh. You want me to figure out the way food combinations are going to support my sleep and my blood sugar?” If you talk to a health coach, especially if it's so overwhelming, they help you to bring it back down into something that's manageable and fun and easy to make these little adjustments over time, so that you can really see big results.

I interviewed Dr. William Davis, the author of Wheat Belly—that was Episode 167, highly recommend listening to it. He's a cardiologist that reverses heart disease naturally with diet and some supplementation and lifestyle, and that's his suggestion as well, exactly what you said. He said 100% of the population should own a glucometer, we should take this out of this idea that only diabetics need one—everyone needs one because if we could monitor ourselves like an hour or two hours after eating each meal, we could see how our body is responding to that meal. “Oh, wow. I really am not responding well to that gluten-free pizza. Maybe that shouldn't be something that I eat on a regular basis,” or “Oh, wow. I can't believe how well I'm responding to those sweet potatoes and baked beans.”

So you play around with it, but it's in addition to how you're feeling. That's why we want to create a food mood journal and see “How was my sleep? How am I feeling?” But then getting some tests and something that you can do at home that allows you outside of yourself to go, “Wow, this is really affirming how I'm feeling about these meals.” I think that sometimes we talk ourselves or we stop listening to our bodies if we really want to keep the caffeine or alcohol or sugar. Like, “I really like that chocolate fudge sundae.” And we justify it like you said—“Oh, it's just a little bit of cheese and pasta. It doesn't really matter.”

But then our sleep keeps suffering. And if we use a glucometer to see how we're doing, then it'll really be that great reality check that allows us to go, “You know what, I'm not going to make excuses anymore because my sleep is more important than that 30 seconds of the food in my mouth.”

And then another great thing you can do with the glucometer is if you have a disrupted sleep in the middle of the night, take your blood sugar in the middle night and see what's going on because some people have really low blood sugar or really high blood sugar, which on both ends can wake us up in the middle of the night.

Taking blood sugar right before bed, in the middle night if we do wake up, and first thing in the morning really allows us to get that great picture of what's going on beause we might discover we have an underlying blood sugar problem that we can catch really early on and then correct before it manifests as a disease.


[01:24:48] Cathy Cooke: Great points. I totally agree. And I oftentimes, with somebody who's got some really severe sleeping problems and they're waking up in the middle of the night, I suggest that they often will have a snack right by their bed so that they can eat that in the middle of the night. Of course that sounds maybe counter intuitive. We shouldn't be eating in the middle of the night, and we shouldn't have to eat in the middle of the night. But until we can, peel back all those layers of the onion and address each underlying issue. You might just need some band-aids right now, and that's okay. We want you to sleep through the night.

In my work, what I do with clients, sleep is number one. You can have hormonal issues. You can have diabetes. You can have lupus. You can have whatever it is. But we have to get you sleeping before anything else can happen, before anything else can start to repair in the body, because if you're not sleeping, the body is going to be unable to address everything else that's happening.

So in the meantime, when somebody is having some chronic sleep issues, they might have to have a little bit of snack in the middle of the night. That might mean a little bit of collagen and a tiny bit of diluted orange juice or a handful of nuts—there's many different options. To have that available so that somebody can fall back asleep when they're having that blood sugar crash, and then over time, we are addressing all the rest of the issues, so that we don't need that anymore.


[01:26:31] Ashley James: Brilliant. I love it. During my pregnancy, my naturopath said I needed to eat some protein in the middle of the night, and that did seem to help, so I like it. We need to figure out what's going on right now and then address it, and know that in the long term, we're going to get ourselves back to a place where we won't need it anymore.

That's the thing with these broad health statements—never go to bed on a full stomach, or never eat food before bed. I know a naturopath that says people with blood sugar issues should eat some scrambled eggs right before bed. That really helps some people, but some people, it doesn't. So we have to experiment. That's where working with someone like you comes in, where we can experiment, but at the same time bring the science and the experience.

So it's the evening time for you. You've eaten a meal that's more plant-based, more complex carbohydrates, that you choose not to have the animal protein because you find that that works best for you. When do you put on your blue blocking glasses?


[01:27:46] Cathy Cooke: Great question. Perfect segue. When the sun goes down, they're usually on, but of course, that's going to depend on where you live. I used to live in Alaska and that wouldn't work because it's 24 hours of daylight during the summer, and the sun goes down at about 4:00 PM in the winter.

So typically, if we live in more southern latitudes, it's a good rule of thumb to have the bluelight blocking glasses on when the sun goes down. Otherwise we say about two hours before you want to be asleep is a good rule of thumb. There are more research happening out there about just filtering the bluelight from any of our artificial lighting, any of our light bulbs whatsoever, or our screens because this is what we call junk light.

It's just like junk food. It's junk light. It's predominantly blue. It's not the full spectrum that we get from the sun. This does have a lot of impact on our mitochondria, which can result in a number of health symptoms. Are you familiar with the work of Dr. Jack Kruse?


[01:29:01] Ashley James: I am not.  


[01:29:02] Cathy Cooke: Fascinating individual. He's a neurosurgeon. He's heavily into light, bluelight, and EMF exposure. That could be a good resource for your listeners to check out. He can be very overwhelming because, of course, he's a neurosurgeon, and some of the terminology he uses can be really daunting and over your head. But he's done a significant amount of research into the topic of the mitochondria and how the mitochondria is affected by our light, bluelight and EMF exposure. When you see interviews with him, for example, anytime he's on a computer or a screen or under artificial light, he's at least wearing glasses that filter out the blue component even if it's in the middle of the day.

I have actually found that to be pretty effective. Dr. Mercola does a similar thing. When you're working on the computer and having not full on bluelight blocking glasses , but some tent to block out the blue light no matter what time of day it is. And then in the evening, we put on the darker ones that are going to filter much more of that light. If you want to go outside, of course, you can go outside anytime of the day and not have any glasses whatsoever because, of course, you're getting that natural light, and you're getting the full spectrum—all of the colors that are in sun.

So even though the sun does have blue, it's got green and yellow and violet and red and orange, and those are all excellent. So you can be outside any time of day and you don't need the glasses, but pretty much any time you're inside, the lights are on, the computers are on, having some kind of protection for your eyes, and then the darker glasses about two hours before you want it to be asleep is what I've found to be the most effective thing for most people.


[01:30:57] Ashley James: I had an interview with a guy, James Swanwick. He produces blue blocking glasses that look really cool. Of course, you could buy them, like you said, for $10 or $20 on Amazon, but they look like safety goggles and no one wants to look goofy when they're in downtown L.A. He was living in downtown L.A., and he would basically wear ski goggles. He’s like, “I need a better solution than ski goggles,” so he invented Swanwick’s blue blocking glasses, and they just look really cool.

He sent me a pair and I thought, “This is complete rubbish. You're telling me that I'm going to wear some yellow glasses, and it's going to help me with my sleep.” I just thought this was such poopoo. I put them on about 9:00 PM, and by 9:30, I couldn't keep my eyes open. I went to bed at 9:30. I was like, “I am done.” They're more effective than some sleep aid. I was really impressed. I think it's going to be a few more years then we're going to see everyone wearing them. It's going to really catch on because they work.


[01:32:11] Cathy Cooke: They do work. I'll tell you a quick story. My sister got married back in December, and so I was at home in Kansas City for her wedding, and it was an evening wedding. And then, we had the reception afterwards, and I was at the reception, and thankfully I was a bridesmaid and my dress was red, so I pulled out my red glasses at the reception. I was like, “I don't care. I want to sleep tonight. We're going to have fun. I can still have fun with my red glasses on.” So I put them on and everyone's like, “You're such a dork. What are you doing?” And I was like, “I don't care. My sleep is more important.” And then, I was able to educate everybody about it, and they're like, “Oh, interesting.”

We sometimes do look like big dorks when we're doing this stuff, but I don't care. I want to feel good the next day, so I'm okay with it.


[01:33:03] Ashley James: How was your sleep that night?


[01:33:05] Cathy Cooke: Oh, it was great. Well, I was out a little bit later than I normally would be, so it wasn't perfect, but it was definitely considerably better than had I not been wearing the glasses.


[01:33:16] Ashley James: That's actually something really important to bring up. I learned this from Dr. Molly Niedermeyer. She's a naturopathic physician here in Seattle. She used to be the dean of the Naturopathic College in Bastyr, and she's been a naturopath for over 30 years. She's delivered over a thousand babies, and she told me that if you're awake after 10:00 P.M., somewhere between 9:30 and 10:30, our body hits a second wind.

So if you're awake, you're cleaning the kitchen or watching TV on your computer, whatever you're doing, if you're awake at 10:00 PM and the lights are on and you're staring at screens, you're telling your body that it is noon. You're getting basically noonday sunlight being mimicked from the lights being on, and your body will reset and go, “Okay, you're getting a whole bunch of cortisol right now. We are stopping the production of melatonin.”

And so people noticed that if they stay up late, “I'm just going to watch one more episode,” and so now it's 10:30 and now they're wide awake. “Geez, I don't even feel tired. I'm not going to go to bed. I'm going to watch another episode and watch another episode and watch another episode.” Now it's two in the morning, and we wonder why we can't fall asleep.

I really did notice a big correlation between being on my computer in the evening—I tried not to go. I often do not go into the office after dinner because if I do even a little bit of computer work, I am up to like two in the morning. So that's the blue blocking glasses aspect. But also if it's like 10:00 PM, and I'm still getting some laundry done or just doing some late-night stuff, if I'm not winding down in bed reading and just starting that descent down into sleep then I’m awake till one or two because it hit that second wind.

That's another reason why we all need to shift our biological or [inaudible 01:35:15] our biological clocks back a few hours and say to ourselves, “We need to be in bed with lights off by 10,” and really we need to be in bed at 9:30, winding it down, reading a book or something with low lights, so that we prevent getting that second wind, that second spike of cortisol where the brain goes, “We're not going to produce melatonin right now. We're just going to produce more energy,” which is really disruptive for healing. It increases inflammation in the body. It makes us exhausted the next day. It makes us cranky. And it can just be this downward spiral where it takes sometimes days to recover. 


[01:35:59] Cathy Cooke: Yeah, I agree completely. I always tell everybody, it comes back to that circadian rhythm and you need to be in bed by 10—exactly what you're saying. In traditional Chinese medicine, they say every hour of sleep that you get before midnight is worth two hours more than the hours that you get after midnight. So that sleep before midnight between 10 and 12 is really important.

I've worked with a lot of people that are like, “There's no way. I can't do it. I go to bed at 2:00 AM,” and I'm like, “Yeah, that's why you're here working with me because you feel like crap. You got to get this dialed in.” Part of it is, we've extended our days to be infinite with the advent of the light bulb. And now we've got social media 24 hours a day, and all of these things that are stimulating to us at the end of the day.

But I really liked what you said about the winding down. It's not just, “Oh, it's 10, turn the lights of, go to bed.” You need to take a lot of time for the body to mentally prepare to wind down. That's why I also talk a lot about sleep hygiene and winding down is part of that. So going through a nightly routine that you do every day, because again, we're getting those signals—"Oh, I'm brushing my teeth. Oh, I'm washing my face. Oh, I'm preparing a hot water bottle for my bed. Oh, I'm closing the blinds.” All of those little routines that we go through each night are more signals to “Oh, it's bedtime. I need to be calming down. I need to be producing more melatonin.” It's really helpful for us to wind down, so that when we do lie down, that we can fall asleep quicker rather than lying awake for another hour.


[01:38:09] Ashley James: I had a really hard time getting our son to sleep as a baby and as a toddler. It was pretty ridiculous how much he would fight us. It took us sometimes two hours to get him to fall asleep, and he would just be fighting us, and then there will be times that we just let him stay awake. We're like, “Okay, let's just see. Maybe his body will tell us when he wants to fall asleep.” He'd be two years old, midnight, totally awake, and we're like, “Okay, that experiment did not work. This kid will not go to sleep.”

And then I discovered this magnesium soak. I'm sure you've heard of it—the Living the Good Life Naturally Magnesium Soak. Kristen Bowen, who I'm going to have on the show again soon, I discovered her through a friend of mine who invited me to go to her health lecture when she was here in Seattle. And so I brought home a jug and you can put kids in it in the bathtub and it was a miracle. Our son doesn't eat sugar. We don't feed him processed food. We don't feed him stimulants like chocolate or caffeine. He already had everything set up in his life that should give him—and he gets plenty of exercise throughout the day. So he should fall asleep at night, but why is he fighting us?

But for us, I believe it was a mineral deficiency. He was deficient in magnesium, and so he started to soak every night in nice warm bath with magnesium and he wouldn't fight us. He would actually tell us, “Okay, it's time to go to sleep. Can I go to bed now?” We’re like, “Oh, my gosh. He wouldn’t even say because we had this routine where we'd read five books before going to bed because it took us about five books to get him—


[01:40:01] Cathy Cooke: Oh, my gosh. That’s a lot.


[01:40:01] Ashley James: It was a two-hour bedtime routine to get him to go to sleep. It would take us five books before he was even willing to lie in bed. And lying in bed, he would fight us and fight us and fight us. It went from five books down to he would say, “Okay, I only want one book tonight.” We were just like, “Oh, my gosh, this is a miracle.”

So this magnesium soak is really great. There's a bunch out there in the market, but my understanding is that this one is very specifically is highly absorbed by the body, highly bioavailable. I noticed that I felt really relaxed and calm after starting to use it. So we use it in our baths, our foot soaks, or we put it in his bath. It's, their magnesium foot soak, and then she gives the listeners a discount. The coupon code is LTH, as in Learn True Health. That was life-changing for our son, and it was great for our whole family because we all just noticed we're calmer. But for him, it went from fighting us to sleep to actually just being really cool about winding it down, going to bed. He falls asleep fast now. That was the missing link for us.

Sometimes it could be a mineral deficiency or nutrient deficiency. I've heard that even B vitamins, sometimes it's hormonal. So there's some kind of a biochemistry aspect going on that if there's one thing missing, it could be that missing link that when you find it, everything falls into place. But you have to have everything else, like you said, sleep hygiene. We have to have the environment. We have to have all the habits set up throughout the day to support that amazing restful healing sleep.

So can you unpack what sleep hygiene is and that checklist of things that we should make sure we have to create good sleep hygiene in our bedroom?


[01:42:14] Cathy Cooke: The routine is great, like I mentioned. And then also just having a really conducive sleeping sanctuary as we like to say, and building biology. But your bedroom should be a place free of distractions. Don't have your bedroom and your office be in the same room because that association with, “Ugh, I got to do this and this and this, and seeing your file cabinet and seeing your notepad, and seeing your computer or whatever it is, that's stimulating, that's thinking work.

The bedroom should not be used for anything besides sleep and sex and that's it. We should not bring other work-related things into the bedroom or computers, or even your phone, or your computer or iPads like I mentioned. People love to bring their phones into their bedroom and get on Facebook as they're falling asleep, which is about the worst thing you can do because, for one, for the blue light; two, for the EMS; and 3, the mental stimulation from whatever it is that you're viewing on Facebook, those are all very stimulating.

So the bedroom should be completely free of electronics. Even, I'm an alarm clock, I do not recommend because alarm clocks give off significant magnetic fields, which can disrupt your sleep. If you have to use an alarm clock to wake up, you at least want to put the alarm clock on the other side of the room. Some people use their phones for an alarm clock, and that's okay. But keep the phone in airplane mode. Do not have it sending out a radio frequency signal throughout the night. Keep an airplane mode and make sure that you turn off the Bluetooth and the Wifi so everything is off. But your alarm will still work when it's an airplane mode like that. So if that is your alarm clock and you have to have it, then that's okay. But I would also recommend to put the screen in a night mode.

Different phones have different settings where you can dim the blue light on the phone. So I mean, I would recommend just don't look at it at night or you can look at it if you're wearing bluelight blocking glasses . But otherwise, you can install free software like Iris or iflux. I'm not sure if iflux is available for phones, but I believe Iris is, and that will automatically dim the blueness of the screen at night. So that's a good idea.

And then we want the bedroom to be very comfortable and cozy. Of course you have a mattress that works for you—not too firm, not too soft. You have comfortable bedding. I can't believe sometimes when I am visiting family or friends and I'm sleeping in a bed with really stiff, scratchy sheets or uncomfortable comforters. I'm like, “How do you guys sleep like this? This is so uncomfortable for me.” And it sounds simple, but they're important factors because if you're not really comfortable in your bed, you're going to wake up in the middle of the night, and we don't want that.

Whatever that looks like for you, silk sheets or satin sheets, or down comforters or whatever, you just want to make it as pleasing and as comfortable for you as possible. You also want to keep the bedroom nice and cool. Plenty of research out there is showing that we sleep better when the body is just slightly cool. Any excess heat will cause disruptions in sleep. Anybody who lives in a hot climate or has summer has experienced this. When it's blazing hot outside, our sleep really suffers, so do your best to keep the bedroom cool.

Again, I don't have a set temperature to recommend because everybody's tolerance is a little bit different on that. I like to make sure that there is a window open always all year round. It doesn't have to be wide open, but you do want just a little bit of circulation of fresh air coming in through the window. You're going to have to play with your preferences on that, but that fresh air is critical to keep ventilation happening. Even just the smells of the environment, it's another little connection to nature, which is an important signal again for our DNA. We really like to be in nature, so that can be very calming to our nervous system.

There's even some science showing that some of the scents from pine trees can reduce cortisol. So having that little bit of fresh air can be very helpful. And then, of course, some of the basics like the light, having blackout curtains if you need it, depending on where you're at. If you're in the city, you may need blackout curtains. If you're in the country, it might not be necessary. You could maybe just have regular blinds or whatever it is. But you don't want any light coming in through the windows at all.

I wear an eye mask because even sometimes the moonlight can be a little bit too much for me just because I'm that sensitive. So I wear an eye mask and I also wear earplugs. We're in an environment in the middle of the city. We're in a suburb. There are dogs, and dogs bark at night, and cars drive past. Little noises like that can actually interrupt my sleep, so earplugs and an ear mask are essential for me. Took me a little bit of time to get used to doing that, but now I am in a total panic if I find myself somewhere, and I don't have earplugs because I know my sleep is going to suffer.

Paying attention to all of those things in the environment and creating a conducive bedroom for your sleep, focusing on that sleeping sanctuary, and of course, we've already talked about the EMF, so making sure that there are no EMFs penetrating into the bedroom, and you can get a lot of tips from the previous episode that I was on about that, like turning off the breakers and not having your Internet on and those kinds of things. Those are pretty much the basics.

There are other things you can do like taking a warm shower before bed or a warm bath, which can be really nice, doing a magnesium foot soak like you mentioned, having that as part of your nightly routine can be really helpful. There are a few other things, but those are the basics, I would say.


[01:49:19] Ashley James: Wonderful. I started learning about sleep hygiene and implementing one thing at a time, and it really does make a difference. We got blackout curtains for our bedroom, and we have an Austin Air filter, so it creates that white noise, and so we don't hear cars going by or the coyotes that we have in our neighborhood because they all get together and howl. We're out there in the country a little bit, so we have bears, coyotes, woodpeckers, owls, and all kinds of things that could keep us up.

Before the air filter, we would hear everything. I'd hear the coyotes, I'd hear the owls, and I would stay awake. But yeah, we turn the air filter on, and it has a nice little white noise that blocks everything out. The curtains that block out most of the light—it's pretty dark in the bedroom now. So we have to watch out about the tripping hazards and make sure it's a comfortable bed. Like you said, bamboo sheets are amazing. They're antimicrobial, they breathe, and they also are a wonderful for feeling soft.

And then also considering the vacuuming—if you have carpet, vacuum daily. Get out the vacuum and vacuum your bedroom every day to minimize the dust mites because the dust mites, we basically are constantly breathing in their poop. When we're breathing that in, it will lower our immune system. What we can do is take our pillows and put them in the freezer because that kills the dust mites as well. Wash your sheets often, wash your comforter, put stuffed animals and put pillows in the freezer for as long as you can, 12-24 hours, to kill the dust mites and do that on a regular basis.

But I noticed that the noise from the Austin Air filter helps us sleep now. When it's not on, I really now notice how every little noise can wake me up or disrupt my sleep.

In terms of the EMFs—I've shared this before on the podcast—think back to the last time you had a blackout in your neighborhood. If you don't remember, keep it in mind for the next time. The sleep you get when there's a power outage is the most deep restful sleep. Unless of course you're worried that you won't hear your alarm clock in the morning because worry can keep you awake.

But no EMFs, like I cannot believe—I first noticed it. We were living in an apartment building, and we were surrounded by over 30 different WiFi signals all the time, and all the EMFs from everyone else's apartment.

When there were power outages, it was amazing—the sleep I'd get, the depth of that sleep. I feel so restored in the morning. That was the only difference. You can't see it. You can't hear it. You can't smell it. You can't taste it. You can't touch it. It's invisible to us, but the EMF really does disrupt sleep.

Since learning about that and now living in our house, we're fortunate enough that we cannot see anyone else's WiFi signal. We're that far away from neighbors, and we only turn our modem on when we absolutely need it. Other than that, we don't have any WiFi in the house. We have almost nothing plugged in the entire bedroom, so that we lower the EMF as much as possible, and it really made a difference.

In fact, recently I plugged something in, and then I forgot to unplug it, and it was near our bed. That night, that was a few nights ago, I had really bad sleep. I woke up in the morning going, “Oh, my gosh. I can't believe I forgot to unplug that thing.” It really does make a difference.


[01:53:30] Cathy Cooke: Yeah, you'd be so surprised. I was doing an EMF assessment in a home just a couple of days ago, and they had their phone charger in the outlet right next to their bed. And they're like, “Well, the phone is not plugged in, so it's not that big of a deal.” I put my meter on there, and the electric field was off the charts. And so I'm like, “This is right by your head, and this is voltage. This is all the voltage that you're sleeping right next to your head.” You've got to consider those little things because clearly you're not going to sleep really well with voltage running right next to your head, right?


[01:54:08] Ashley James: Absolutely. It's just amazing. You've given us so many points today that we can implement immediately and run with. Is there anything left unsaid about your evening routine or your bedtime routine, or going to sleep at night? Do you take any supplements? Do you recommend melatonin?


[01:54:33] Cathy Cooke: I just wanted to touch real quickly on the dust mites that you mentioned. I'm really glad you brought that up because allergies play a big role in sleep. If you're inflamed from allergies, you're not going to sleep that well. So another tip is to have your ducts cleaned. A lot of people are like, “Oh, right. I've been living here for seven years and I've never had the ducts cleaned.” They're just not thinking about it, but that's an important consideration.

I like to recommend people have their ducts cleaned every two years. I think the EPA recommends maybe every two to three, but just think about all the air that's circulating through those ducts, and all the dust that settles in there, and all of the microbes, and the bacteria, and the mold. Having your ducts cleaned is a really important piece.

And then I've also got a post on my website about not making your bed—that's what we recommend from a building biology standpoint because of the dust and the dust mites that you just mentioned. When you think about the fact that you're sleeping at night and a lot of us will perspire in the middle of the night, we're creating this really nice warm, moist environment, and then we get out of bed and we pull the covers over that and we're creating just the perfect little nest for microbes for dust and bacteria to flourish. You actually want to leave your bed unmade or the covers off the bed so that you can air it out, and that will actually help to cut back a little bit on the dust, the dust mites and the microbes.

But I do want to address your comment about the supplements. I think that's a really important topic because so many people are taking supplements and melatonin, and all of these sleeping aids. Of course, none of your listeners will be surprised to hear that I'm not a fan of pharmaceutical sleep aids. I'm sure you're not either. Insomnia is not an immunodeficiency, so we don't need to be taking sleeping pills to sleep at night.

But along those same lines, people want to take Valerian or Hops or all of these different formulas or combination of sleeping herbs. While those can be helpful for some people sometimes, they're not something that you want to depend on for the rest of your life. So if you say, “I just can't sleep without Valerian,” then I say, “There's an underlying issue that still has not been addressed.”

You shouldn't need to take Valerian in order to sleep. Even though it's natural, even though it's an herb, we still want to identify what the underlying issue is. Along those same lines, you mentioned magnesium. So magnesium is a great sleep aid, and when you take magnesium and it helps you to sleep, that's probably indicative of a mineral deficiency like you mentioned.

Some supplements like a magnesium or different minerals can be very important, and that is something that we want to pay attention to. We want to get our minerals in balance. Of course, we want to start with food, maybe eat some magnesium-rich foods. If that's not quite cutting it, we can go to a mineral supplement.

But when it comes to things like herbs, maybe passion flower or so many different sleeping aids, we need to be careful about that because we don't want to become dependent on them in the same fashion that we can become dependent on a pharmaceutical sleep aid. We still need to identify what the underlying issue is. They can be helpful in certain times. You're traveling, you're in a very stressful circumstance—fine, it's okay once in a while. But we still want to address all of these other lifestyle habits.

And then as far as the melatonin goes, melatonin is not something that we want to take long term. Melatonin is a hormone, and when we take a hormone like that exogenously, we can disrupt the body's own production of melatonin. So if we take it every day and we've been taking it every day for a year, the body is not going to do a good job in making it on its own because it's like, “You're giving it to me in a pill, so why do I need to create it?”

So I caution people with melatonin. It can be helpful in certain circumstances, like if you're traveling over a number of time zones, it can kind of help you to reset your circadian rhythm. But I don't generally recommend that people take it for longer than two weeks. The shorter amount of time, the better. And if you absolutely can't sleep without melatonin, then again, there's an underlying issue that we need to address. I have found that those bluelight blocking glasses are what's the most impactful for that melatonin release at the end of the day.

And then lastly, we can put all of these pieces into place and yet there are some people that are still going to have some issues. When that happens, we need to consider a more advanced or more complicated situations. That would be an area where you would work with someone like yourself or someone like me to identify, “Maybe I've got hormonal imbalance, maybe I have an infection, maybe I have SIBOs—small intestinal bacterial overgrowth, maybe I have a parasite, maybe I have heavy metals.” Those are a little bit more complicated, and where functional lab testing can shed a significant amount of light on the piece that we're missing.

So for people that are putting all these steps into place and just not quite getting it, sometimes we have to dig a bit deeper. Of course, I mentioned the emotional piece of it prior. Sometimes people really need to work with a trained professional, a mental health professional to address some of their emotional issues, their emotional traumas that are still left undealt with. That's an important consideration as well.

And then lastly, I have actually a pretty comprehensive e-book on my website and it’s all about sleep. It's called “Sleep Like You Mean It.” It's about 30 pages, and it covers a lot of what we talked about today, but it goes into a little bit more depth, and it's got resources and the science behind a lot of this.

That's totally free. If anybody wants to go to my website and download that, please do. I got over 10 years of information packed into there that I've learned over the years and I've uncovered from some of the best researchers across the country. So yes, download that. If you need a little bit more help and, of course, always reach out to someone like Ashley or someone like myself that can help you if you're just still struggling because nobody should be struggling. We all deserve to feel really well.


[02:01:59] Ashley James: Absolutely. Your website is


[02:02:03] Cathy Cooke: Yep, that's right.


[02:02:05] Ashley James: Awesome. Thank you so much for coming on the show today and sharing your wonderful health tips. This has been enlightening. Is there anything that you'd like to say to the listeners to wrap up today's show?


[02:02:16] Cathy Cooke: Oh, gosh, we covered a lot. I guess I would just say to somebody that has listened, and they do have sleeping issues or other health challenges, don't get overwhelmed. We presented a ton of information today. It's all about baby steps. It's all about picking out that one thing that's manageable for you and doing one thing at a time. You don't have to do all of this immediately. Sit with it, think about what resonates for you, try to tackle one little piece at a time, and over time you will start to see big benefits. Don't get overwhelmed, and again, we are here to support you, so reach out to one of us if you need a little bit more guidance and help.


[02:03:06] Ashley James: Beautiful. So great having you back on the show.


[02:03:09] Cathy Cooke: Thanks Ashley. I'm so happy that we were able to do it again, and this has been really fun.


[02:03:14] Ashley James: Are you going to optimize your health? Are you looking to get the best supplements at the lowest price for high quality supplements? And to talk to someone about what supplements are best for you? Go to take your and one of our fantastic true health coaches will help you pick out the right supplements for you that are the highest quality and the best price that's takeyour that's takeyour be sure to ask about free shipping and our awesome referral program.

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May 4, 2019

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Safe Remedies For Kids

Her personal experience with postpartum depression led Dr. Erica Krumbeck to focus on postpartum depression (PPD) and maternal mental health. Listen on and find out true health gems about PPD, how to deal with it, her recommended supplementation, how she works (or not work) with vaccines, what to do with flu, ear infections, nutrition, sleep, and other big pieces of advice one can only get from a naturopathic pediatrician.


[00:00:03] Ashley James: Welcome to the Learn True Health podcast. I’m your host, Ashley James. This is Episode 351.

I am so excited about today’s guest. In fact, I announced in our Facebook group, the Learn True Heath Facebook group, that we’re having a naturopathic pediatrician on the show, and it exploded with comments. Within minutes, we got over 30 people commenting. It was just a huge explosion of questions.

I know you guys are really interested in learning from a holistic doctor when it comes to supporting the health and development of our children. Dr. Erica Krumbeck, welcome to the show.


[00:00:46] Dr. Erica Krumbeck: Thanks for having me. I’m happy to be here.


[00:00:47] Ashley James: We’ve had some fun scheduling issues trying to get you on the show. I’ve been excited to have you on. Finally, the timing is right. I believe in divine intervention. I believe the universe brings forth the right interviews at the right time, so I know everyone listening, this is the information they are here to receive right now.

I’d love to start by learning a bit about you. Before we get into all the questions that the listeners have, I’d love to understand what had you want to, first of all, become a naturopath as opposed to becoming an M.D.? And then what had you wanted to specialize in pediatrics?


[00:01:24] Dr. Erica Krumbeck: That’s a great one. I’ll try to make it short. I’m sure everyone’s story is a very long story, but I started in undergrad as being a double art and biology major, and strangely enough, I wanted to do medical illustration. That was my goal in undergrad. Part way through undergrad, I realized that most medical illustrators spend their life in a cadaver lab, and that was not super exciting.

So I thought about nursing and medical school. I studied all through undergrad with all my buddies in OCAM and everything. We’re going to med school, and they were all taking their tests and everything. I took a little break. I thought that  I was going to eventually apply in med school, and I ended up doing an AmeriCorps program in the health care field in National Tennessee, and I hated it with a passion. It was painful to see the conventional medical approach. I was not happy with any aspect of it. And if we talked about divine intervention, that was probably completely divine intervention, too.

I spent two years in Nashville doing crazy, silly things like playing music and doing this AmeriCorps program and a bunch of other stuff with my soon-to-be, now husband. While I was there, my dad had a stroke back in Seattle, Washington, or Kirkland, Washington, right by Bastier. My childhood home is right behind Bastier University, where I ended up going to naturopathic school.

The long and the short of it with him is he did the whole conventional medical route for stroke treatment. At some point, he plateaued in therapy, basically physical therapy, and didn’t progress any further. At that point, you get kicked off insurance for future therapies, and my family ended up spending quite a lot of money out of pocket doing all these alternative therapies. He was doing acupuncture, [inaudible 00:03:36] therapy, anything in the alternative world, although interestingly not naturopathic medicine.

My dad wanted me to move home, so he wanted me to enroll in Bastier because his acupuncturist was a teacher there. It’s just funny the way the world works. I went and took a tour of the university before I knew anything about naturopathic medicine. I fell in love with the school. The thought process behind naturopathic medicine, before I knew what I was getting into and applied and got in, which I highly recommend not doing the approach that I did for future students because I didn’t know what I was getting into until I was multiple years through school.

I’d tell people in the future, be sure. It’s a huge investment of time and money. It’s a life-long career choice. But for me, it just happened to work out. For me, every day I was in school, I fell more and more in love with this medicine that I stumbled into, which was providential.

And then out of the same process, my husband ended up going to physical therapy school. From my dad having a stroke, it ended up with both of us being in medicine. It’s an interesting thing.

I thought I was going to work way more in mental health when I was in school than pediatrics. I had no focus on pediatrics. I just fell into it. I’m not sure how I fell into it. Somehow I fell into it and started doing a couple of well-child checks and remembering that “I love this. This is great.” You get to play when you’re with kids, and it’s super fun.

I ended up falling into peds, and then when I had my daughter, who’s now seven, I had a severe experience with postpartum depression. She had severe colic, too. That changed the whole course of my career to focus on postpartum depression and maternal mental health, which is so important. I feel like the circle came all the way around for me that I could treat mom’s postpartum and work in mental health even though it wasn’t the field that I thought was going to be in.


[00:06:07] Ashley James: Interesting. Is there a link between postpartum depression and colic?


[00:06:12] Dr. Erica Krumbeck: I don’t know that that that’s been studied, but it makes sense. I mean, for her there’s obviously sleep deprivation as a pretty strong trigger for PPD. In her case, she was waking 10-12 times a night, screaming uncontrollably, could not be calmed in any circumstance. It’s stressful to have a child who’s suffering uncontrollably and to feel powerless in your ability to help your child. I don’t even know the best word—it’s a disempowering feeling and a terrifying feeling. I feel like I can relate to parents now going through something very scary because you can’t help the person that you are meant to help in your life. It sort of makes sense when you have your cortisol levels off the charts for nine months to a year. I don’t know how you could not end up having severe anxiety or depression.


[00:07:16] Ashley James: Absolutely. My son had some colic. He only woke us up six times a night, not 12 times.


[00:07:23] Dr. Erica Krumbeck: But at that point, what’s the difference between 12 and 6?


[00:07:26] Ashley James: Right. I definitely saw that sleep deprivation impacted me. I felt so grateful to have built a team of holistic practitioners around me during the pregnancy, so we had cranio. We had lots of homeopathy and pediatric acupuncture. I even had practitioners who became friends. They came to the house. All of it helped a little—diet and making these little fennel teas, rubbing his belly with essential oils—everything.

Homeopathy for me was the one that had the fastest and the best results, which I was constantly stunned by. But it wasn’t curative, so he still woke us up six times a night. But what a difference between my experience and a typical going to an M.D. experience, where the parents go to an M.D., and the child is possibly put on over-the-counter medication for gas and not guided to shift diet or other modalities that might help with the colic.

Even to this day, there’s not a very strong support structure for women who are suffering from post-partum depression. What do you do now when you work with families, and you see that there might be postpartum depression? What kind of advice do you have for those women?


[00:08:59] Dr. Erica Krumbeck: I’m very vigilant about screening very quickly. I’m checking in with parents very often in that first couple of months of life and even beyond. I started using the Edinburgh Postnatal Depression Screening Questionnaire early on before that become standard of care. Now, I find most OBs, at least in Montana where I’m at, are using that regularly and having moms fill it out regularly. When I first started, no one had even thought about that.

I quickly got involved in the postpartum depression group here of providers and therapists, some of whom had their postpartum depression issues, and so they’re active in creating this group. It just exploded in terms of awareness, so now they’ve done everything.

One of my colleagues became a licensed clinical social worker and had her job at an OB’s office. She created this entire position for herself, and it’s only counseling for moms who have lost babies, who have postpartum depression, who’ve been working with infertility. It’s incredible. It’s been great.

For me, in my office, I’m often screening, but if there are any signs, I strongly recommend the women to schedule with me immediately. I always find room for them in my schedule. I tell them that. I just told a mom this morning that it’s newborns and them that take priority, and I tell women all the time that when mama goes down, the ship goes down. I’m more worried about the health and impact of the parent’s than I am the kid’s most of the time. I also strongly believe now that the purpose of the well child check is not so much to make sure that the child is healthy--I think that’s number two. It’s important, of course. That’s why we’re here. We’re going to weigh the baby, make sure they’re okay. But number one is to encourage the bond between the parents and the child, and that cannot happen without parents having good mental health. I screened quickly, and one of the first things that I’ll do with a woman who has postpartum depression is to get some basic blood work done.

Postpartum thyroiditis occurs in 5% of women. Postpartum depression occurs in about 20% of women, and there’s a really strong overlap there. I don’t think I’ve known any woman with postpartum thyroiditis that hasn’t had postpartum depression. It’s really important to find that and correct that early because it can make a world of difference.

And then we have so many tools as naturopathic doctors, anything from homeopathy to herbs, to nutrients. Basic nutrients, like a good quality prenatal and high-dose fish oil in about half of my patients—just those two alone will be enough to pull them out of postpartum depression or anxiety state. I could talk about that for a whole hour, too.


[00:12:10] Ashley James: I already told Dr. Erica that I would be having her on the show for multiple sessions because we’ve decided that we have so much that we could talk about.


[00:12:20] Dr. Erica Krumbeck: Yeah, I can’t stop. [laughs]


[00:12:22] Ashley James: Please don’t.


[00:12:23] Dr. Erica Krumbeck: I stop in place, but it’s hard to.


[00:12:26] Ashley James: If someone is listening to this currently with postpartum depression, what actionable steps should she take today to help her get on the path? Should she schedule some sessions? She has a newborn, so it’s hard to leave the house and go for counseling. What are some critical things that she should do today to help herself get on the path to feeling better?


[00:12:54] Dr. Erica Krumbeck: I’m going to take a step back and explain something super important first, and that’s the difference between baby blues and postpartum depression. Just as a warning, I might lose my train of thought and forget the question you asked. I want to go through this first because some women think that they have postpartum depression, and they don’t.

Eighty percent of women have what they call baby blues. I don’t like that name because it connotates something negative. What most women describe is the sensation of having every emotion simultaneously. They’re so happy they have their baby, “So why am I crying?” They’re crying, happy, joyful, exhausted, and it’s everything mixed. It feels completely overwhelming. They are just wondering, “What the world is going on?”

That classically happens shortly after birth. Usually, it peaks right around the same day that milk comes in, which is a good way to figure this out. That’s because of the hormone levels that have dramatically shifted. In pregnancy, we have high progesterone levels. We have estrogen levels.

Postpartum, those plummet quickly because the placenta holds that progesterone, and so the placenta comes out. We have less progesterone circulating. And then prolactin inhibits the production of all these hormones as well. Prolactin will peak right when milk comes in, and it’s just overwhelming. Plus we have fluid and blood pressure changes, and you’re usually sleep-deprived—it’s overwhelming.

Baby blues happen to 80% of women. It usually peaks on the day that milk comes in, and it’s typically gone by two weeks. If the symptoms are either not gone by two weeks or starting after two weeks or just continuing to go down, then we’re talking about more like a slide into postpartum depression, postpartum anxiety, postpartum OCD, or something like that. Does that make sense?


[00:14:54] Ashley James: Absolutely. Someone who has postpartum depression might not have a newborn still. It might be a baby that’s three months old.


[00:15:02] Dr. Erica Krumbeck: Exactly. The lowest the progesterone levels get is somewhere around three to four months postpartum. Usually, postpartum depression is at it’s worst at four months, and then slowly, slowly, slowly they start to come out of it.

Sometimes moms feel like they’re in the clear because maybe the baby is sleeping a little better, and then they can’t figure out what’s going on, and their progesterone levels are super low. It’s important to understand that progesterone act on our GABA receptors in our brain. It acts on the same receptors as Valium, so the postpartum state is like a Valium withdrawal state. Sometimes it helps women to understand that.

This isn’t the case for all women, but for a lot who tend to be anxious, they might feel better in pregnancy and then all of a sudden, the anxiety comes back, and it’s very severe postpartum, and that’s just from that progesterone state. So there are some women postpartum, the thyroid is looking good, but postpartum is pretty severe, we will do a trial of oral micronized progesterone to see if it works. It doesn’t work in all women, but the women it does work for, it’s very fast, and it’s very dramatic.

You might have seen that postpartum depression medication was recently approved by the FDA, like within the last couple of weeks. It’s 32,000 dollars, I believe, and it’s like a 72-hour infusion or something insane like that. It’s a pregnenolone or a progesterone analog. It binds on the same receptors.

It’s really silly because you have a 32,000 dollar medication, or you could give progesterone and pregnenolone, which are bio-identical and have the same effect.


[00:17:03] Ashley James: People can go to the health food store and buy topical progesterone cream. Is that the same?


[00:17:09] Dr. Erica Krumbeck: No, I would not recommend that. One, for some reason, oral micronized progesterone seems to have a better happy brain effect. I haven’t been able to figure out why exactly, but that was a trick taught to me when I was in school, and so I’ve been sticking with that. I would never recommend over-the-counter progesterone for a nursing mom. So you’d be careful about progesterone levels, and so I would want to get it either compounded by a pharmacy.

Even if for some reason you did do cream, I don’t think I’ve ever done cream for postpartum depression. I’ve always prescribed oral, and it’s covered by insurance usually, so if you can at least code creatively for it. It hasn’t been FDA-approved for postpartum depression, but if the progesterone levels are documented to be really low, you can code for that.

Most women do not have any inhibition of lactation with oral micronized progesterone. But I always recommend that it’s given under the supervision of a physician just in case that did happen. I’ve warned every woman I’ve ever put it on that it can, and I’ve never seen it happen. We know for sure that estrogen will inhibit lactation, which is why women are put on the mini pill postpartum, and not a combined oral birth control pill.

The mini pill is a progestin, and this is something that is not well known in conventional medicine. I had an argument with a woman who was teaching the postpartum course that I attended last year at St. Pat’s hospital here. She was talking about supplementing women with the mini pill. She couldn’t quite figure out why that wouldn’t help women with postpartum depression. A synthetic progestin that is in either birth control or the mini pill, so either a combined birth control pill or the mini pill inhibits our bodies’ progesterone but does not act on our happy brain receptors.

So it is actually worse, and that’s why Dr. Julian Brayton has this whole book called Beyond the Pills. Breast control pill has been around for decades now. Many women have complained about the side effects of depression. It was only up to a couple of years ago that they finally studied it and found that yes, sure enough, women who are on long-term oral contraceptives have higher rates of depression, and that could be two-fold.

One, they’re not making progesterone, so they don’t have the happy brain effect, and two, now we know of course that birth control pills deplete vitamin B6, which is a super important co-factor in making all our happy brain chemicals. It’s a double whammy. For that reason, I would ask women who are postpartum taking the mini pill that they be cautious about that. If they feel their mood is sleepy, they might want to stop the pill and do oral progesterone, but it is not good for birth control. It is not as reliable as a birth control method. You got to be a little careful.


[00:20:23] Ashley James: That’s interesting. I’ve had a few different interviews about birth control and all the nutrients it depletes from the body is pretty crazy. When you see the cons versus the pros, the cons are just way outnumbered that it affects our mental and emotional health, and of course, our physical health in the long term. Really scary.

Getting back to my question, if someone is listening to this, and they’ve heard you talk about baby blues versus postpartum, and they suspect they have some postpartum, or maybe they even have a diagnosis, what steps should they take right now? Should they go to their doctor and talk about getting on progesterone?


[00:21:09] Dr. Erica Krumbeck: Number one, if you’ve got a naturopathic doctor near you, go to them first. Don’t go to your OB because half of the OBs are a loss. Five or six years ago, I didn't feel like our professionals were doing a great job with this at all. I don’t think that we were talking about it nearly enough. I don’t think we had enough options. Now, I feel like most of us who’ve done anything in women’s health feel pretty darn confident treating postpartum depression. If I have a colleague who doesn’t feel that way, you’re welcome to email me directly. But I feel like most of us feel pretty confident.

So go there first. If you don’t have a naturopathic doctor near you, you can go to your OB. I would request to have your thyroid checked, to get a complete blood count done and check on your iron levels. A lot of women do hemorrhage postpartum. Iron is yet another co-factor in making happy brain chemicals, and so if you feel exhausted, it could be anemia as well. And then I would request anti-TPO antibodies. Those are thyroid antibodies that are elevated in Hashimoto’s thyroiditis, and the postpartum onset of Hashimoto’s is super common, so I would definitely do that.

If you end up having elevated anti-TPO antibodies, your OB is not going to know what to do with you other than give you thyroid medications, so you need to go back to a naturopathic doctor anyway or read a lot. But I think that’s a smart place to start. I don’t know that many OBs truthfully that prescribed progesterone. The midwives in town here at least definitely do, so you might also want to contact the midwife who is much more familiar with this, and then be careful about self-prescribing supplements. It’s easy to get a good quality prenatal multi and high-dose fish oil on board, but a lot of the herbs and certain nutrients that we commonly use for depression are not necessarily safe in lactation. There are a lot of things that are not safe in pregnancy, and in lactation, we have a lot more options for treatment. But even things like St. John’s where I only use basically at the last case and usually not till babies are much bigger, so there is definitely some research that St. John’s can either cause colic in babies, or they can become sleepy, and so that’s not a great choice for a lot of women. 5HTP is a common depression supplement, and that has not been studied for safety even though I know a lot of midwives prescribe it. I’m not comfortable with that if that hasn’t been prescribed. There is just a lot that maybe is not super safe. I will often prescribe a basic B complex for a lot of women though, and one of the good professional brands. You don’t want an over-the-counter one for those, but that can help if you get a little extra – methyl B12 and metafolate. That can perk women up right away.

I would also wait until the baby is a little bit bigger, and so in those first couple of weeks, that’s not going to be appropriate. The baby is going to get stimulated and agitated by that. It’s usually at least a month but often when the baby is two or three months old.


[00:24:32] Ashley James: You mentioned fish oil. I’m such a believer in omegas. What is a good dose for an adult—6 grams a day, 9 grams a day? What are your thoughts on that?


[00:24:56] Dr. Erica Krumbeck: There has been a couple of studies. One, women who have better omega-3 levels in pregnancy have lower rates of postpartum depression. That’s awesome.

Two, women who supplement with fish oil in pregnancy, their babies have a 50% decreased risk of asthma. That’s cool, isn’t it?


[00:25:16] Ashley James: Very cool.


[00:25:18] Dr. Erica Krumbeck: That was on a really high dose of fish oil, and some of those babies ended up being much chunkier than their non-supplemented counterparts. We might not want to supplement that high. I usually recommend a gram in pregnancy. Again, you do need to talk to an OB though because this is a podcast—don’t take medical advice over the internet. That should be the motto for everybody and especially for us.

And then postpartum, yes, I dose high, high. It won’t work if you don’t dose high—at least 6 grams, and yeah, 9 is a good aim. It must be a high-quality brand because what you don’t want to do is get that cheap over-the-counter fish oil, have it contaminated with mercury, and then have mercury toxicity for you and your baby. Please don’t do that. So get a good professional brand on that, and yeah, I dose really high. Moms are losing so many fatty acids because they’re all going to the milk. So you need way more than someone who is not nursing.


[00:26:30] Ashley James: Absolutely. You brought up something—you said certain herbs are not safe in pregnancy or during lactation. Ironically, one of our listeners, just this morning, she wants to be a surrogate, and she really likes the family. She’s passionate about it, and now she has hit a wall with the surrogate family because they’re insisting that she do the flu shot during the pregnancy and the whooping cough vaccine, and she’s never had those vaccines. She isn’t someone that participates in the vaccine in her body, and she’s concerned about this, so a very lively discussion was formed in the Learn True Health Facebook group in support of her, but she wanted everyone’s opinion on it. In doing so, I googled some interesting studies that show there hasn’t been anything definite because you can’t ethically test. You can’t do a study on women that are pregnant. There is no ability to test whether flu shots are safe.


[00:27:48] Dr. Erica Krumbeck: Actually, there are quite a few studies though, and they have been studying vaccinated versus unvaccinated women in pregnancy for both Tdap and influenza. Are you sure you want to start with this one?


[00:28:01] Ashley James: Yeah, I would love to hear. You’re a holistic doctor. I would love to know what are your thoughts if a woman comes to you, and she’s healthy—eats healthy, not deficient in any nutrients at all. Is it healthy to get a flu shot and other vaccines during pregnancy, or is it healthier to not?


[00:28:29] Dr. Erica Krumbeck: Listeners, please don’t send me hate mail. My general approach to vaccinations is to support families wherever they’re at. This is important.

In my practice, I basically lay out the evidence for and against vaccines and allows families to choose. I’m a very strong advocate of that. I might have my own opinions, but I want to keep my opinions out as much as possible and just present what we know.

Now, that’s why I asked if you’re sure that you wanted to start there because the pregnancy topics, they’re almost harder to go over, but at least, we do have some data.

So let’s start with the flu vaccine first because they have been studying vaccinated versus unvaccinated women. They do not do double-blind placebo-controlled trials because that’s considered unethical. But they have been studying the vaccinated versus unvaccinated populations.

The other hard thing is, depending on where we’re at in the research cycle, this is my knowledge to date. If you’ve given me any warning, I will look up probably 87 studies because that’s what I do. I can’t tell you that I’ve read every study up to May 2nd of 2019.

For the influenza vaccine, the last data that I saw showed that women who get the flu vaccine in the first trimester of pregnancy have slightly increased rates of miscarriage. That’s not the case for the second trimester and beyond. There is data that women who do get the flu have significantly increased poor outcomes.


[00:30:34] Ashley James: If they’ve had the flu shots


[00:30:36] Dr. Erica Krumbeck: No. if you get the flu in pregnancy, the rates of the baby having autism, birth defects, or having early labor—if you get the virus while you’re pregnant, it’s bad.

There is that piece of research that shows that the flu vaccine in the early pregnancy increases the risk of miscarriage, but that doesn’t seem to be the case for the second and third trimester. I don’t know what to say about that.

The really hard part about the flu vaccine is that we never know if it’s going to match from year to year, and so it makes it hard for me to counsel my patients on it because on years that it matches well, that’s awesome. It feels like we can be like, “Hey, look. It matches,” and at least we can have some evidence of efficacy. On years that it doesn’t match, then it’s like, “What’s the point?” There’s always the risk of side effects on all vaccines.

I do want to be clear on that—to be clear and to be unclear at the same time that it’s hard to capture data on a vaccine that changes every year. We never know whether it’s going to match usually well into the flu season, at least until January of that year. Does that make sense?


[00:32:04] Ashley James: Uh-huh.


[00:32:05] Dr. Erica Krumbeck: So at least that’s like an answer/non-answer for that.

For Tdap, this is a little different. Tdap is the pertussis vaccine. It’s tetanus, diphtheria, and acellular pertussis. It does not come as a non-combo shot. Whooping cough is pertussis. Whooping in very tiny babies is extremely dangerous. I have people argue with me on that one, but it really is. It’s very dangerous.

The idea of vaccinating women in pregnancy is—and it must be vaccinated in pregnancy. It doesn’t count if you get it before becoming pregnant. The reason is if you get that Tdap in pregnancy, the woman’s body creates maternal antibodies which cross the placenta and reach the baby so that when the baby is born, they already have antibodies for the first 2 to 6 months of life. Basically, the baby has antibodies against whooping cough before they’re even eligible for their first round of vaccines at two months of age.

This could be another hour-long conversation. They have studied vaccinated versus unvaccinated mothers. They found no difference in neonatal outcomes from vaccinated versus unvaccinated babies. They have found an increase in antibodies in newborns whose moms were vaccinated, which is the point, so that part does work. I don’t know that we have enough long-term data to show differences in whooping cough rates in babies whose moms have had that versus not because there is usually not large enough outbreaks to compare the two populations. They’re trying to keep away.

There is a little bit of question about whether babies whose moms are vaccinated if they’re developing the same immunity from their primary vaccination series as babies whose moms were not vaccinated. That’s a future conversation. But right now, at least the data does support that there is no difference in outcomes. And they have studies tens of thousands of women in multiple countries at this point. They’re not small studies right now.


[00:34:32] Ashley James: What about the concern that the thimerosal crosses the—


[00:34:37] Dr. Erica Krumbeck: Can we talk about the thimerosal?


[00:34:38] Ashley James: Yes. It’s mercury. It’s an adjuvant.


[00:34:45] Dr. Erica Krumbeck: No. Let’s be very clear. I’m excited to talk about this because I want to clear this up, and I get frustrated even by our colleagues who see this wrong all the time. Thimerosal is not an adjuvant. Thimerosal is a mercury-containing preservative that was found in a number of vaccines, primarily the hepatitis B vaccine, up until right around the late 1990s that they switched.

At this point in time, please listen to me: There is no more thimerosal in vaccines. The only vaccines that contain thimerosal in any amount are the seasonal flu vaccines in multi-use vials only and tetanus only vaccine, which I can’t even find anymore, so it’s a moot point. It’s only seasonal influenza vaccines and multi-use vials that we could possibly be exposed to thimerosal.


[00:35:48] Ashley James: So heavy metals are in vaccines then?


[00:35:51] Dr. Erica Krumbeck: Yes. Let’s talk about that. That is aluminum, and aluminum is considered an adjuvant. It is not a preservative. I often hear people say, “They just replaced mercury with aluminum,” and that’s completely not true. It does totally different things.

Again, thimerosal was a preservative. Now, aluminum is an adjuvant, and adjuvate means something that makes the immune system reacts. Let’s say for Tdap, the whole point of the Tdap vaccine is so the body can make antibodies to tetanus, diphtheria, and pertussis. The little ‘a’ stands for ‘acecullar’ in the Tdap vaccine.

If you injected Tdap without aluminum, the immune system would basically wave at it and say “hi” and just let it go because it’s not exciting to the immune system at all. Those vaccines are not live virus vaccines or bacteria because those are bacterial products.

Let’s say MMR and chicken pox vaccines are viruses. They are a live virus, which is why you usually only need one dose to become fully immune from both of those vaccines. There is no need for an adjuvant. The immune system sees the actual virus itself develops antibodies to it and then most, 90-95% of people, are functionally immune.

When we’re talking about bacterial products, let’s say [HEB 00:37:22] pneumococcal, which is a pneumococcal bacteria, tetanus, diphtheria, pertussis—these are all bacteria. There’s no way to inject a live bacteria into us. That would be bad. It would cause sepsis. They take a component of the bacteria and then add aluminum as an adjuvant. When it’s injected, it creates inflammation, specifically designed to create inflammation, so that the body recognizes a vaccine component and creates antibodies to it.

It is hard to have this conversation in a short period of time. That’s why I go over all these details in my Vaccines Demystified course, which I try to set up and be as neutral as humanly possible. But it’s really important to me that everybody understands the difference between thimerosal and aluminum and which vaccines contain thimerosal and aluminum and why.

You can completely avoid mercury. You don’t have to worry about that. Aluminum is a totally different story. It’s in a ton of vaccines. That is something to talk about in addition, but I do want everybody to be clear on that.


[00:38:43] Ashley James: You’d mention your course, and I want to let listeners know the links to all of your websites are going to be in the show notes of today’s podcast at They can go to, click on ‘Shop’ and they’ll see right there that you have an online course, a webinar that they can take where you go through and explain in a neutral way the pros and cons of vaccines and inform consent fully, inform parents and parents-to-be, so that they can make fully informed choices.

This is a very polarizing topic. We’re not shaming people. I have my very passionate and firm beliefs about vaccines, but I do not impose them on others, and I’m getting the feeling that you are the same. I believe in freedom, and I believe in information, and I do not support an idea that we should ever be forced into any medical procedure. We should use and share information to make knowledgeable decisions.

Your online course, you are offering 20% off to the listeners. They can use coupon code LTH, and all that information is going to be in the show notes of the podcast. I am very interested in having listeners who are passionate about learning more about vaccines to take your course because we want as much information as possible from that neutral standpoint so we can see the pros and cons clearly.

It is when we polarize this, argue for argument’s sake and take a stand because we have a belief, that is where we lose the ability to see the science for what it is. We need to come to the science from a place of non-judgment. I’m glad that you are clearing up these misconceptions.

We’re not saying that anything from a pharmaceutical company is perfect. There’s not one pharmaceutical in the world that doesn’t have a list of side effects.


[00:40:57] Dr. Erica Krumbeck: Absolutely. Let’s talk about all of them. It’s really important. I hear people say that vaccines are not regulated as pharmaceuticals. That’s true—they’re not. They’re regulated as biologics, so they’re regulated under a different type of category. But they are regulated.

What do I want people to understand? So many things. One, I am happy to support families in my office regardless of what they decide. Whether you pick all vaccines, no vaccines, some vaccines, I will support you. This is not about me; this is about you. That’s why I lay out what we know.

The other thing is that all I lay out is the evidence that has been studied. There are things that haven’t been studied. There are questions. There are thoughts. There are concerns in some places. I actually lay those out, too.

This is not about me at all, which hopefully spares me a little bit of hate mail because being neutral or somewhere in the middle means that I’ve gotten hate mail saying that I’m killing babies from both sides. Let’s stop that.

If you have very strong feelings about vaccines, it probably doesn’t help anybody to go to the other side and tell them that they’re killing babies. I want to be very clear about this. The reason we’re also passionate about this subject is that we all care about children very much. That’s why it becomes such a polarizing topic because some people have had experiences, which might not line up with what literature says, which doesn’t make sense, which is so confusing to people.

So we’re comparing, sometimes oranges to apples to bananas. It can be so confusing. I urge everybody to take a step back, take a breath. Let’s examine what we know. We can add life experience in with that. We can talk about it in a way that doesn’t shame or guilt, and talk about how to support our bodies and our kids, and come back together and not make this so heated because it’s not helping anybody.


[00:43:29] Ashley James: I knew we were going to get into the topic of vaccines, having a naturopathic pediatrician on the show. You mentioned some of the concerns that maybe haven’t been studied, but there are concerns nonetheless. I have had some doctors in the show talk about the concern that at least the current vaccine schedule where they feel that it is too aggressive. It’s causing a rise in autoimmune disease by overstimulating the immune response. Have you seen this, or seen any evidence to support that the current vaccine schedule is increasing autoimmune disease?


[00:44:12] Dr. Erica Krumbeck: There is no hard evidence of that right now. They have studied that in multiple places. There are a couple know autoimmune conditions like idiopathic thrombocytopenic purpura in MMR vaccine, and that is a direct link. There are a few other things, particularly with the MMR vaccine. It’s such an old vaccine that we have decades of research now, but most of the autoimmune diseases that a lot of people talk about with MMR, either like Crohn’s or ulcerative colitisAutism isn’t an autoimmune disease, but that’s a whole another discussion topic.

A lot of the ones that parents have reported, they’ve specifically studied and have not shown to be associated. There is a lot of discussion in the literature right now, and there are some unknowns, particularly about aluminum as an adjuvant and a possible trigger for autoimmunity. It seems like, every time the researchers try to study one vaccine and break it out to see if kids have an increased risk of X, Y, and Z against that vaccine, it’s very rare that they find any direct correlation. Truthfully, it could be due to just variance in the population.

There are so many different things to think about, but for some people getting a virus is a trigger for their autoimmune condition. In that case, it makes sense that if you got a vaccine, it could be a possible trigger for an autoimmune condition. It’s also possible that if you get the disease, that the vaccine is designed to prevent, it could also trigger an autoimmune condition. So remember with autoimmunity, there is always a genetic predisposition and an environmental trigger. Vaccines could be an environmental trigger. There is also a huge number of other things that could be environmental triggers as well. How many environmental things do you think we are exposed to nowadays? It’s a lot.

That was a total non-answer. I’m sorry. We have to be through each vaccine individually, and I do in most cases and in my webinar. Again, most of the research we have is in MMR. I’m breaking my brain trying to think of all the other ones that could be potentials, but I would watch each section individually because I do talk about well-reported adverse events in each section.


[00:47:06] Ashley James: You’re saying that having a virus could trigger autoimmune disease, which could be from the vaccine, but it also could be from getting it naturally.


[00:47:22] Dr. Erica Krumbeck: Right.


[00:47:24] Ashley James: Got it. Measles is quite a hot topic right now. I live just down the street from where you grew up. I’m in Snohomish, in between Woodinville and Monroe, so I know Kirkland. And here in Washington, I believe our passing a bill to take away the ability to opt out of the MMR vaccine, and there are talks of going after religious exemptions as well.

There is definitely fear and concern around an outbreak. I believe 700 cases have been reported in the United States in the last year. What would you like to say regarding measles? Before the measles vaccine, we would get the measles. They’re even showing that people who have had measles naturally and survived and went on to have natural immunity have lower rates of cancer. They see that in some ways, it stimulates and helps the immune system. You have to survive it though.


[00:48:40] Dr. Erica Krumbeck: Yeah. Measles has about a 0.01% chance of death. Again, only the people that have survived—oh, man. I don’t know how much I can do justice to this topic because I think that MMR topic in my course is 25 minutes long. But there’s a couple of things that I want to mention.

We can’t interview the people that died from it. Of all our “vaccine-preventable” diseases, measles probably has the highest permanent complication rate and permanent death rate. It can be just a fever and a rash, but it does seem to have much higher rates of encephalitis. It particularly attacks the neurological system, so permanent deafness and/or encephalitis. Obviously, not in everybody. It never happens to everybody.

The question is—yes, the weak ones—people who are genetically susceptible or have weak immune systems, historically probably would not have survived the measles outbreak. The question now is, “Are you willing for that to be your kid?” because I don’t want my kid to be the one who has the weak immune system and didn’t make it?

There are a couple of other things too. Actually getting measles significantly causes almost a year-long immunosuppression. Folks who get wild-type measles have a doubled risk of all-cause mortality the year following natural infection. That’s pretty significant.

Wow, I don’t like having the conversation this way because I don’t like to present it like, “Hey, here’s a fear tactic,” you know? That’s not what I’m about at all. This is a weird way to have this conversation and be like, “Ah, measles. We’re all going to die.”

That’s the problem with the media, too. We have not had a death this year, but there are, I’m sure, children who are going to have permanent neurological complications from measles.


[00:51:28] Ashley James: I just saw an interview with two doctors about this. I think they were citing some studies that those who have vitamin A deficiency have a much greater chance of having complications or not surviving measles.


[00:51:45] Dr. Erica Krumbeck: Oh, yeah. That’s in a developing world. That has been cited amongst naturopathic doctors and the holistic medical world prominently, so a lot of people have been saying, “Just give vitamin A.” But that only seems to hold true for developing nations.

So if you give a child in a developing nation vitamin A and they get the measles, their survival rate goes way up. That has not been documented to be true in Western nations, but we also have really low rates of mortality in Western nations with measles because we have access to excellent healthcare. The rate of vitamin A deficiency, like natural vitamin A deficiency in Western nations is really low.


[00:52:31] Ashley James: So we’re not diving too deep into this. As you said, you have a 25-minute talk in your—


[00:52:37] Dr. Erica Krumbeck: I kind of feel bad. Again, this is not how I like to present this information. I know we’re in the midst of a measles outbreak right now, and I was thinking about recording an extra add-on piece to my MMR lecture about a couple of these things like measles causing immunosuppression and all sorts of things. I apologized to our listeners because this is not the way that I like to present this in an unbiased format and not a fear-based format.

But I think that we should talk about the actual consequences of measles. It can either be way played up in the media or way played down in conventional and alternative medicine where people say, “It’s just measles. It’s not a big deal.” The reality is somewhere in between. It’s not like, “We’re all going to die” but some kids statistically speaking will, and some kids who get measles infection, even if they have the best treatment, probably are going to have serious neurological complications. I do know of a case of a child with measles who is now partially deaf in the US and Canada. Just be aware of that. There’s somewhere in between, and let’s talk about it. It’s not Shmeasle Measles like I’ve seen Mama Blog talked about. At the same time, it’s not like the world is ending either.


[00:54:07] Ashley James: So you’ve brought up some good points about it—somewhere in between like you said. So measles, if you contract it a year afterward, your immune system is compromised. You can, therefore, develop other complications. You have a percentage of a chance. There’s a chance that you can develop long-term permanent neurological complications and a very small percentage, there is death.

A good chunk of people though go through measles. Like you said it’s a rash, a fever, your body fights it and mounts a response, and you’re done. But even so, even the healthiest of those who survive measles with no complications, still have a year ahead of them. Like getting mono, where they have a year ahead of them being depleted.


[00:54:59] Dr. Erica Krumbeck: That’s a good way of describing it.


[00:55:00] Ashley James: People can go through any virus and end up feeling crappy for a whole year. I’ve heard of even chronic fatigue being a long-term consequence of being exposed to a virus.


[00:55:15] Dr. Erica Krumbeck: That’s specifically those human herpes viruses, and I don’t mean to herpes simplex, like the cold sore virus. It’s a strain of the virus that’s called human herpes virus. Sort of like HHB6, EBV, CMV—these are all not family, and yes, they’re going to cause long-term immune suppression. So yeah, that’s a great way of characterizing actually.


[00:55:35] Ashley James: You painted one side of the picture. Let’s paint the other side of the picture coming from a very wonderful neutral stand. I don’t feel like you’re fear-mongering. You want us to know the truth.

The truth is life is messy, and we could get exposed to anything. You can cut your finger and die of an infection. Not to be morbid, but we are surrounded by unseen bacteria and viruses all the time. The best thing we can do is build up our bodies. Make our bodies as healthy as possible. Make our bodies just as healthy as we can because we’re always going to be exposed to germs, and that’s at least in our control. We can choose to eat at McDonald’s, or we can choose to eat at the organic salad bar? One choice is going to lower our overall health, and the other choice is going to help support our overall health. We do have daily choices. We make 50 choices a day that could build our health or destroy our health.

We have the ability to make choices to build ourselves up. Let’s talk about the other side. I bring up choices because the fear-mongering make us feel helpless. These viruses are unseen, and it leads us to feel like we’re helpless. Therefore, we can’t do anything about it.

And the marketing that is used to make us want to go up and get a flu vaccine, for example, is all the fear-mongering like you said. So no—don’t give in to fear mongering. Let’s listen to Dr. Erica. Let’s listen to the reality of it that there are consequences. There are pros. Let’s look up both of them. So having outlined what would happen if you got measles, this could be someone who’s vaccinated but is a non-responder, or someone who has chosen not to vaccinate.


[00:57:30] Dr. Erica Krumbeck: Right. It’s about 5%.


[00:57:32] Ashley James: So even if you’ve been vaccinated, you have a 5% chance of getting the measles anyway. Here’s the information. Now, let’s look at the other side. What are the known cons of getting the MRR vaccine?


[00:57:46] Dr. Erica Krumbeck: I keep answering a different question. Can I take one step back?


[00:57:53] Ashley James: Please do.


[00:57:55] Dr. Erica Krumbeck: This goes back to our autoimmune piece. Maybe this will help put it together. One of my absolute no-no’s around the time of vaccination or illness is suppressing the fever. This point is totally opinion, so this may not be medical fact at all. This is completely Dr. Erica opinion.

I think that autoimmunity has been triggered by suppressing a normal, natural immune response to either a vaccine or an illness. This is what I’ve been telling my patients not to do. In times of fever, if we suppress the immune system, then I think the immune system gets confused and starts attacking itself. That’s why absolutely, no Tylenol—anywhere around the time of vaccines, and I also want to be clear on this—the MMR vaccine has been studied up, down, backward, sideways. They’ve done studies of 20 million children at this point and have not found an association with autism.

Now, I know you’re going to have a listener who’s going to tell me that their child had a reaction to MMR, and I’m not discounting that. There’s quite a bit of discussion of whether things have been under-reported or not reported. But I do think at least some of those cases were from Tylenol exposure and not from the MMR vaccine itself. There is more evidence now that Tylenol is triggering autism than there is the MMR vaccine, and probably particularly the combination of the two is dangerous. So talking about an event where you’re putting a live virus into the subcu tissue, the immune system is acting upon it and trying to create antibodies against what you have just injected into subcu. You suppressed the immune system. Where does it have to go? It doesn’t know what to do. And so, I think, that’s when we’re causing problems is when we’re starting to suppress fevers.

And you’re right. I hadn’t seen measles, but for sure from having high fevers from a strep infection reduces the rates of cancers. And so I think we’ve suppressed so many fevers. We’re so afraid of fevers now. It’s dangerous. I think that many more people would do better if we just let them have their fever because it runs its course on its own. Does that make sense?


[01:00:26] Ashley James: Absolutely. I love that you brought this up. I had an anesthesiologist who’s turned holistic doctor. She left anesthesiology after her son—her son is autistic, and she saw this world of holistic medicine, and he went from not being able to function in a “normal” school to completely able to function in a “normal school.” He goes to a Waldorf or something, but not having to go to very specialized autistic schools for those in the spectrum

He’s not highly functioning, and she did it with him using holistic medicine. She says that the most important thing in development is a fever. She sees a neurological leap in development after a child has had a healthy fever that wasn’t suppressed.


[01:01:26] Dr. Erica Krumbeck: I’ve never heard of that before, but I completely would believe it. It’s so important to have an immune system that does something. That’s what our immune system is supposed to do. When you don’t, then you’re going to get eczema, asthma, chronic illness.

That’s what our immune system was designed for. Why are we so afraid of that? That is one of the things that I hammer into parents. I wish we would throw out our thermometers. A 105-degree fever can be normal. A fever is not intrinsically dangerous until at 108. It’s shocking to parents.

If you don’t believe me, go to Seattle Children’s hospital and type in [A Fever Mess], and they’ll back me up. For some reason, I put that all over Naturopathic Pediatrics, and again I have people telling me that I’m killing babies. It was just not true.

It’s so pervasive in parenting culture that you must treat a fever, and it’s completely not based on any evidence in any way. It drives me absolutely crazy. There is no degree of fever other than 108, which kids never get to, that is dangerous at all. Kids who do get high fevers often will get febrile seizures. They are super scary. But the studies are really clear that febrile seizures are not dangerous. They are probably dangerous to the parents’ blood pressure. They are really scary, and so I get it. I have total empathy with parents that it’s absolutely so scary, but the kids are okay. It’s just a really scary process.

The warning signs—one, fevers in newborns are not normal. So please don’t [mishear 01:03:13] me that. Any fever from newborn to 28 days is worked up incredibly aggressively in the hospital, and I mean lumbar puncture, IV antibiotics, IV antivirals. They’re aggressive. So that’s anything over 100.4 on a [inaudible 01:03:31] thermometer which is I usually recommend. It needs to be worked up immediately. Even babies who are up to three months of age, a fever is not considered normal, and they need a workup by their doctor within 24 hours, unless they’re looking sick and then they need to go to the ER right away. Anything that children at three months and above, they could get any degree of fever, and I’m not worried about it as long as, A, they’re hydrating, and B, they look okay. They’re going to be fussy. They’re going to be probably sleeping more than usual, but they should not be listless, non-responsive, lethargic—all of those would be warning signs that something is more dangerous. Don’t touch it. Just let it go.


[01:04:12] Ashley James: I love it.


[01:04:13] Dr. Erica Krumbeck: And then I can come back to MMR if you want me to.


[01:04:15] Ashley James: At this point, someone might consider you to be pro-vaccine in your sharing. You’re not pushing vaccines at all. You’re just giving the information. But the information you’ve presented makes them sound safe and a really good choice. Am I wrong? Is there anything you’d like to say to add to this conversation? Do you have any concerns about the safety of vaccines?


[01:04:48] Dr. Erica Krumbeck: Of course. When I’m in a group of alternative medicine providers, I always sound like a crazy pro-vaccine, and when I am in a group of conventional medical providers, I sound like so crazy antivaccine. That’s part of the nature of good old-fashioned Jesuit education, where you’re just like our contrarian no matter what. That’s part of examining the evidence.

So again, I like to present both sides very clearly, and again it’s more because you’re interviewing me and asking these questions that are coming from listeners who, I think, in alternative medicine, tend to be biased against vaccines. It makes me seem like I'm really skewed for vaccines, and part of that also is because I’m discussing things that have become such a part of the culture, and they’re just factually untrue like the thiomersal piece. It’s just not true.

And so we need to talk about that. It’s not true that thiomersal is in vaccines. It’s not there, but aluminum is. There is no aluminum in the MMR vaccine. I do go through a section of aluminum in my webinar as well. I don’t think there’s truthfully great evidence on either side in terms of aluminum itself. There is one large safety study on aluminum exposure and why at least conventional medicine in public health considers aluminum safe in kids, and it’s based on a safety study done in two New Zealand white rabbits. I don't love that. How can anybody make inferences of safety in humans based on white rabbits? That’s just so frustrating.

And so I have a few things in MMR that are incredibly frustrating, too, in terms of immunity. I have a section in my webinar where I say—this is the actual quote from the CDC. It says, “Measles antibodies develop among approximately 95% of children vaccinated at the age of 12 months, and 98% of children vaccinated at 15 months. That’s based on unpublished data. We don’t even have—when I try to find the actual research citation for that, it’s published in a pink book, which is like cites itself in the CDC, which cites itself again. There is no data for that. It’s absolutely freaking up the wall.

So what I’m trying to do is give families evidence, and how can you give them evidence if there’s no data? It’s just like, “Ugh!” I wish I had something. There are no guarantees in life. I wish I could tell you it’s safe to give your child an MMR, and I also which I could tell you, it’s totally safe to let them have the measles. I just can’t. There are no guarantees. Statistically speaking, there is always going to be a child who reacts poorly to the MMR vaccine. We’ve reached the tipping point. At this point, we’re up until this year probably there are more kids having adverse reactions to the MMR vaccine than there were kids getting measles. And then it skews because then people don’t want to vaccinate then it skews to not having coverage to the point where then the measles can come back and spread. I will be very honest about me. I am not comfortable with my children having a wild type measles infection. I don’t love the MMR vaccine at all, but I feel like the odds are kind of in favor of actually getting MMR, so it would be great if no one had to have the MMR vaccine and there’s no measles. That would be ideal right? Wouldn’t it be great? But we don’t live in that world.


[01:08:55] Ashley James: So then it sounds like you did vaccinate your children?


[01:09:00] Dr. Erica Krumbeck: Oh, boy. I usually don’t tell people what I did. [laughs]


[01:09:04] Ashley James: Well, no. My next question then is a relevant question. For those who have vaccinated, how do we support our child in being healthy in the face of all those chemicals? Read the full insert. It’s pretty bizarre—the carcinogens.


[01:09:21] Dr. Erica Krumbeck: I go through all of those though. It’s great because I go through each individual ingredient in my webinar. Some of them look scarier than they are. Some of them are not great at all. Some are more kind of terrible. But some of them are like nowhere [inaudible 01:09:38] People like to publish all sorts of weird things about—I don’t know. The things that some people on the internet have gotten all hung up about on the vaccine ingredients, I’m like, “What?” That’s sodium phosphate. That’s salt. Let’s talk about the ones that we need to be talking about.


[01:09:57] Ashley James: Well, they’re scary. The scary ingredients—like we’re talking about aluminum in your brain or your bloodstream. It’s not healthy in high doses. What do you do to support a child in detoxing and being healthy after a vaccine?


[01:10:18] Dr. Erica Krumbeck: I always feel like legally this is a risky place to talk about all these without having the time for it. In my office, almost all families who come to me who want to vaccinate are vaccinating on an alternate schedule because they come into my office. Why else would they be in my office if they want to get all of them at the same time? They go to a pediatrician down the road.

Almost all of my patients, if they’re vaccinating, they are vaccinating on an alternate schedule. I have an alternate vaccine schedule that only gives one aluminum-containing vaccine at a time. I also go way out of my way to find the vaccines that either has no aluminum, or low aluminum or are preservative-free. I do my absolute best. In some cases, that’s available. In some cases, it’s not available. In my office, I typically only give two vaccines at a time.

The nice part about that, with only giving two at a time, is that you can identify quickly which vaccine is causing the problem and which isn’t. So that makes it much easier. It’s very rare for families in my office to have vaccine reactions. I mean anything other than—I don’t even have any fevers truthfully. I’ve had one child ever show any signs of developmental regression, and we immediately stopped vaccinating and gave them glutathione, and he came back on track.

Interestingly enough, he was an IVF baby, and I don’t know if that was some part of it, but that’s the very first one I’ve ever seen in my office. I am extremely cautious about vaccinating babies. One, and this is probably the other thing that’s happening in conventional practices, is babies/toddlers, whatever age you’re vaccinating, whatever age you choose to start vaccinating, they must be well.

Why are we vaccinating? Not me—I’m not vaccinating when they’re sick. But in conventional physicians’ offices, they’re routinely vaccinating kids who are sick. That’s another guaranteed way to get a vaccine reaction. When your immune system is already doing something, and then you throw in all—of course, they’re throwing in six to ten antigens at once, I guess research says that that’s okay, but that—yeah. That’s why I’m a naturopathic doctor, but it’s probably not the antigens maybe that are even the problem because in some ways the antigenic load is slightly lower than it was in the 80s because DTP, now it’s DTaP and the DTP vaccine, was highly antigenic.

Just so listeners are aware, the DTP vaccine we had in the 80s is different than the DTaP. The DTaP now seems to be well tolerated. DTP then was not well tolerated. The downside of DTaP now is it's not as effective as it was as the DTP vaccine back then.

One, kids must be well. Two, if they're showing absolutely any signs of anything other than fussiness, I'm giving liposomal glutathione immediately. I probably would give it to every child across the board except its expensive, and probably most kids don't need it. Remember, only kids who are genetically susceptible to glutathione depletion are going to have glutathione depletion. But you can supplement lipo glutathione around the time of vaccination, and it works great.

Probiotics have good research for both improving the immune response to vaccines and reducing side effects, which is great. It helps our immune stimulation in our gut, and it makes a big difference there, too. Kids should be supplementing vitamin D to help immune systems, but the two biggies are kids are well, and they do not have fever-suppressing medications.


[01:14:38] Ashley James: When it comes to flu season, when there are large outbreaks, have you ever talked to other clinics and seen that your patients statistically, because they're following your instructions and choosing a healthy lifestyle as possible, that statistically your clinic has fewer cases of flu than others?


[01:15:04] Dr. Erica Krumbeck: I don't know. I have had cases of flu in my office. There hasn't been anybody who was needed to be sent to the hospital. Flu spreads. You might get flu whether or not you're perfect on your supplements, and I want to reduce the guilt for moms a little bit, too. Having your child have a perfect diet and supplementing perfectly doesn't mean that they're never going to get sick. And if they get sick, it doesn't mean you did anything wrong. Sometimes they get sick, you know? They do. Whether they eat the perfect diet, they have the world's best supplements on board, whether you vaccinate or not vaccinate, whether you think you did everything right or you didn't think you did everything right, the most important thing you can do for your child is to be there for them.

It's so important. We have to lay aside the guilt. We are not going to do it perfectly with our kids, but you got to be there for them. I don't want you to go to McDonald's. I think it's terrible. If you do it and you're in their life, you did it. You made it.


[01:16:35] Ashley James: I love it. That's very well said. A lot of mothers look back and regret making some choices around medical things, and then they learn something, and they realize that it might not have been the right choice. But we can't change the past, and feeling guilty about it is not going to help us in the now. We're in our child's life. We're filling them with love, and they're going to have a good outcome in life because we're there for them and just beaming love at them and really caring. Regardless of where we stand on the vaccine—I don’t want to say issue, but—


[01:17:14] Dr. Erica Krumbeck: Conversation.


[01:17:16] Ashley James: Yeah, it's a conversation. It's not a fight. I like that you advocate for an altered schedule because you're doing it in a way that's respectful of the child's immune system, and you're watching. Every time they get one vaccine, you watch to see if there are any issues.

I had Dr. Paul Thompson [Dr. Paul Thomas] on the show, and he also discussed this. That's why I asked you about the flu thing because when I interviewed him, it was last February. His practice is in Portland, and he has four or five other pediatricians in his practice—a nice-sized practice. Thousands and thousands of patients on a Friday where all the local hospitals had four- or five-hour wait times because the flu was prevalent in the community, the entire clinic closed early because they got not one phone call for the flu.

Again, you can be the healthiest person in the world but still catch the flu. It's more about how quickly you bounce back, how healthy your immune response.” I remember when I was a kid, and I had a naturopath that my mom took me to. When I was sick, it was just very quick. I get a fever, I'd go to sleep, I'd wake up, and I was better. It was just, boom, the immune system kicks in, does its job. We don't impede it, and I've seen this in my son. If he gets sick, it's just a big fever, and he sleeps and then he’s better.

It can drag on really long. If someone is diminished, depleted, if their body is toxic, like you said, the person can't produce enough glutathione. Dr. Paul Thompson [Dr. Paul Thomas] was saying he recommends the same thing you've recommended that the family supplement, eat healthily and avoid bad food, get out in the sunshine and move around and do the basic, what we think is common sense. But it's not taught by every pediatrician unfortunately or emphasized as standard.
In his clinic, he's had what seems to be fewer cases of flu because of that advice. So I was curious to know if you'd possibly seen that.

You've already talked a bit about vitamin D, vitamin E, good clean multivitamin, fish oil. Can you recommend what would you want to be in every single family’s medicine cabinet, some go-to either homeopathics or essential oils? What's great for babies and children for us to use when dealing with the common things that come up?


[01:20:24] Dr. Erica Krumbeck: I've got lots, way too many. One thing quickly about that, seeing differences in flu cases—Maybe I just don't know because I'm not comparing directly to other urgent care clinics. They're probably slammed, and I get busy with cold and flu season, but I don't know how to compare the relationship between the two. I did want to say one other thing too about vaccines in my office and that's that in Montana where I am, if kids want to be in daycare or preschool, they must be not completely fully vaccinated but close and on schedule. That's another reason why families have to have their vaccines basically on time if both parents are returning to work.

And so that's different. Just to put that in context for the listeners in case they feel like, “Whoa, she gives a lot of vaccines early.” We're stuck to that based on the vaccine requirements.

So to go to your actual question, hopefully, all kids are being supplemented with vitamin D. All breastfed babies should be supplemented with vitamin D, at least 400 IU daily. I recommend up to a 1000 IU daily way up here in Missoula, Montana, because I've been testing babies’ levels and they're all low—super low.

So I was doing maybe like 3000-4000 IU a week, and I've just upped it to 1000 IU a day because they've never seen one normal. They're super low. But I mean that's up here, too. We're in a different spot than a lot of people in the country.


[01:22:02] Ashley James: What is a normal level for a child?


[01:22:05] Dr. Erica Krumbeck: Still above 30 is like a bare minimum. I see them in the teens, below teens, in babies, and that's worrying.

The theory was that if you give mom a certain amount of IU, 10% pass to the babies. So we used to supplement mom with 5,000 IU and hope that the baby gets, 500 but if mom is deficient, that does not work, and so I stopped doing that. I do not recommend that as a reliable method of supplementing the baby with vitamin D because we don't know how much mom is putting in breast milk. She might be just taking all of it for herself. I do recommend supplementing babies directly with Vitamin D.

My absolute favorite thing to have in our herbal medicine cabinet is lemon balm glycerides. I love it. I have a series of well child guides on the naturopathic shop. They only go from newborn to 12 months. Right now, I'm working hard on getting the 15 months to 4 years age range, and they correspond with all the well child visits for each age group.

My thought behind this was this—they call them anticipatory guidance handouts that you get at a pediatric visit. All they tell you to do is how not to kill your baby. “Don't smoke around your baby. Always buckle them up in a car seat.” And I'm like, “Really? That's the best you can do. I pretty well could figure that one out.”

What I wanted to do was give families extra information, not just about how to not kill their baby, but how to support them, what's normal sleep times, what's the normal amount of time for babies to fall asleep, what's normal development at that age, what's not normal development, and when is it concerning. I do have a little list of vaccines, and right at the top, it says what is typically recommended at each age. And right at the top, we say we want to support families regardless of how they vaccinate. I still wanted to put that there because I still think it's important for families to know what's typically given at certain ages, whether or not you choose to vaccinate your child.

At the end of each one is an herb guide, and it includes dosages based on weight. I mean babies under four months are too young really to supplement with any significant, meaningful amount. I think I have a little bit in there for fennel at the two-month visit, but at the four-month one, I have an herb guide for lemon balm, which is my favorite ever.

You can make a tea out of lemon balm. It grows like a weed here in Montana, which is great because we have an overabundant supply. But in a glycerate form, it's like a tincture, only they use glycerin instead of alcohol to make the liquid, and you can give it to babies. It's a great substitute for Tylenol. It will not artificially suppress a fever. It will help break a fever that's already ready to come down on its own. It's an anti-inflammatory if that fever is ready to come down on its own.

Another pro tip for parents, dehydrated babies have a really hard time breaking their fevers. It can be helpful to give them even spoonfuls of tea or liquid or something. Nursing them is ideal, but if you can't get something into them, camomile tea, just a spoonful at a time can help hydrate them.

Lemon balm is great for pain relief, too. The same thing—it doesn't block the pain like Tylenol does, which by the way, Tylenol works by an unknown mechanism in the brain. It's centrally acting. It works at the brain itself—a little disturbing because we don't know what's happening. We don't know whether the negative effects of Tylenol are from glutathione reduction or from actually working directly on our endocannabinoid system, which is super disturbing. We don't know what it's doing.

Lemon balm is fantastic. It would be my number one. I would always have a source of vitamin C. I use vitamin C orally for ear infections to help reduce inflammation in the eustachian tube. That's another great one. I have a course of 10 vitamin C mix, which has a little extra antimicrobial and flavonoids support and it tastes delicious, mixed in applesauce for babies six months and up.

Passionflower glycerin is another nice one for a little bit older babies and toddlers and all the way through elementary school children. It's a fantastic herb. I'm an herb lover. I love and adore herbs. Mullein tincture is one of my faves too for coughs. It's super gentle, and it helps both wet and dry coughs, kind of. It's relaxing. It's a gentle mucolytic. I also use it orally for ear infections to help drain mucus and help the eustachian tube to open up.


[01:27:34] Ashley James: What is passionflower for?


[01:27:37] Dr. Erica Krumbeck: It's an anxiolytic. It's mild happy herbs.


[01:27:43] Ashley James: When would you give it to a child—when they're going through an illness?


[01:27:48] Dr. Erica Krumbeck: Teething is great. It's very gentle. It's safe. It's great for nursing moms too. Oh, gosh. I have so many more, but maybe we should stop there so that we can stop at some point.


[01:28:10] Ashley James: Do you have this information that people can purchase as your e-books on your website? Is that correct?


[01:28:17] Dr. Erica Krumbeck: Yes. Right now, there's a couple of different options. One, each of these is available for each well-child guide, so say for two months there's information that's relevant to the two-month timeframe, and then at the end there is an herb guide that I thought is relevant for that age. So herbs that are safe for that age group is what I put and attached to each of the well-child guides.

You can also get all of them from newborn to 12 months as part of the My Infant Health Binder, and my idea behind that—this is what I do for families in my office. The first visit they have with me, they get a three-ring binder as a place to store both growth charts, but also these well-child guides that are about six pages of information, places to write down questions for the doctor, a place to track milestones and development. I have a little section on what to expect.

In the two-month well child guide it says what to expect between two months and four months, which is your next scheduled well child check, and then the herb guide that goes with each of them. My Infant Health Binder has all of them in it plus extra places to store information, particularly for families who have a child with a complex medical health issue.

That could be a full provider list, a full supplement list, and a start and stop date for all the supplements that have been tried—just a way to organize everything. I am big about this because there's so much information. There's more information than I can go over in a well child check. There's more information I want to give than I could possibly talk about in a well child check. For families who do have complex medical health issues, they need a way to organize all that information.


[01:30:11] Ashley James: Absolutely. Anything you want to add before we move on to the next question?


[01:30:16] Dr. Erica Krumbeck: Oh, geez. I’ll say no.


[01:30:19] Ashley James: For those parents who have young children, they can go to, click on “Shop” and then choose the guides that support them during that developmental stage and use the coupon code LTH to get 20% off, and you're going to be coming out with more guides in the future, which is exciting.


[01:30:38] Dr. Erica Krumbeck: Yes.


[01:30:41] Ashley James: Clone yourself.


[01:30:42] Dr. Erica Krumbeck: Yes, I actually am. This is what I'm working on. This is my new endeavor with It is literally how to clone myself because I get emails from people all the time, “Where can I find a doctor like you?”

My practice is closed to new patients. I have 40 people on my waiting list. I can't keep up with demand. There are tons of you guys who are listening who are like, “Whoa, there's so much information. This is so cool,” and I don't have time for all of you.

What I'm trying to do is put more information up on I seem never to have time. I'm trying to run a practice, and I have two kids that are 7 and 3, and I'm trying to be a mom at the same time. It's a little bit crazy.

The long-term goal of is to provide providers, naturopathic doctors or functional docs with trustworthy pediatric resources and references so that I can clone myself so that we can all do this because there's no reason that we can't. Clearly, there's a huge demand for it.


[01:31:56] Ashley James: Great. So then, those who are listening who aren't in your area and you're not taking new patients right now anyway, although I know that you are expanding your practice as well. But for those around the world, they could ask their pediatrician to check out your resources on your website.


[01:32:12] Dr. Erica Krumbeck: Yes. Just started it, but right now it's at, and there's only a very small chunk of things up on that section. But my goal—I was hoping by the end of the summer, but it's probably not going to happen—is to have a hundred hand-outs on that page. I'm working on that, and I'm also working on finishing all these well child guides up until age 10 and develop templates for all of us too, so there's one place to look for information rather than just the conventional options for everything.


[01:32:58] Ashley James: I love it. I love the work you're doing. I love your website, and I love your mission. Naturopathic medicine saved my life. I was very sick, and I'd exhausted all the resources in conventional medicine. It was like spring air. It was like a light bulb turning on to go from an MD allopathic medical system back to naturopathy.

I grew up with a naturopath, and then I kind of lost my way, and then I came back to it. I had type 2 diabetes, chronic adrenal fatigue, chronic infections. I was on courses and courses of antibiotics. I was miserable and sick all the time. I couldn't even process human language in the morning. My brain was so shot, and I was just in so much brain fog. I felt like a prisoner trapped in my own body. I was going through yoyos of hormone issues. I also had a polycystic ovarian syndrome. I was told I'd never have kids, and I was infertile.

Naturopathic medicine—I had conceived naturally. I have a four-year-old now that I conceived naturally. I look at how big he is. I'm like, “Oh, my God, I can't believe.” He grows so fast. It was all naturopathic medicine in the last eight years that saved my life and got me to where I am now.

That's why I do this podcast because I want everyone else who is going through what they're going through to learn that there are alternatives that can support their body in coming back into balance. Of course, we want to respect science as well. That's why I love the type of work you do.

For me, it was a natural step to bring our newborn to a naturopath pediatrician, and it is much like seeing one as an adult. They spend an ample amount between 30-60 minutes every appointment. I've never seen that with an MD. There are couches, and we sit down, and it is a good long hour, sometimes 40-45 minutes, whatever our needs are, and then we've emptied out, and then the naturopath or our pediatrician is like, “Anything else? What about this?” And we're like, “Wow! We can really empty out.”

Our son had some asthma attacks, and I was concerned. I love Children's Hospital in Seattle. Just always, they've taken such good care of us. Our naturopathic pediatrician said, “We need to do some allergy testing.” It turns out he's allergic to about five different foods and dust mites. We did all the dust mite mitigation. It didn't make a difference.

That's when we turned to the food testing, and we have removed the foods that he was allergic to, the foods he ate every day like avocado, salmon, eggs. I was really surprised that these are foods that he had been eating since he was six months old. No wonder he had been having these problems. We removed the foods he was allergic to or sensitive to, and immediately overnight, the sniffles went away. The wheezing went away.

Unbelievable. I can't imagine how many children have asthma out there with inhalers, steroids, and trips to the emergency room, and it's because they're exposed to foods that are perceived as healthy, but their immune system can’t handle it. If he goes to someone's house that is not vacuumed very well, he'll get wheezy just a little bit. But no more rushing him to the emergency room. Since removing those foods, it has cut down all the problems by 70%, and then the dust mites are the other 30%. But this is the care I don't think I would ever have gotten going to an allopathic practitioner.

What you do as a naturopath, you look at the family unit as a whole. You look at mental health, emotional health. You look at food. You're looking at the whole picture, and I respect that.

A lot of my listeners had questions about ear infections. Can we get into that a little bit?


[01:37:29] Dr. Erica Krumbeck: Yeah, for sure. Remember that ear infections in babies is primarily because the eustachian tube doesn't drain. It's horizontal rather than at a semi-vertical angle like it is in adults. The main reason that kids get ear infections is that anytime they get a cold, the eustachian tube backs up, and rather than draining into the throat, it just stays there behind the ear.

Ear infections are a fluid management problem. They're not an infection problem per se. It's that the fluid persists behind the eardrum. That's what creates a breeding ground for bacteria. It doesn't matter that it's like the bacteria per se. If you can drain it, you don't have to worry about it. It's pretty rare in my office that I have a child that we can't “cure.” I don't know about cure but treat naturopathically. I think I've had two or maybe three kids over the last three years that we finally sent for ear tubes. I think in all three cases, their parents also had a history of needing to have ear tubes placed.

Now Missoula, Montana, also has terrible air quality, and so this is contributing to like a massive tonsillar enlargement all the time here. And so that's also kind of an obstacle to cure that I cannot cure because we have wildfire smoke for at least two months in the summer. There's nothing I can do about that even in the best case.

In the winter when there's not smoke, we sit in a bowl, and so we get all of this air pollution. It’s terrible. Most of the time, kids can be treated naturopathically. There's a sweet little easy eustachian tube massage you can do by putting your thumbs underneath your lobes, putting some gentle traction, and then gently dragging down the neck. It helps pop open the eustachian tube behind your thumb there. It’s hard to describe. I should video that. I might put that up on the nat ped site at some point.

And then using things like vitamin C to help reduce the swelling of the eustachian tube. I'm doing some gentle mucolytic is important. And then I do treat topically with garlic mullein ear drops as well. The eardrum must be intact. It has to be fully there. If the eardrum is ruptured, then it's dangerous to put anything actually into the ear canal. We used to say that those garlic mullein eardrops were antimicrobial. I don't know that the garlic penetrates the eardrum well enough to kill the infection, but they feel amazing. They're awesome. Have you ever tried them?


[01:40:12] Ashley James: Oh, yeah.


[01:40:13] Dr. Erica Krumbeck: People criticize naturopathic doctors like, “That onion ear muff is so pseudosciencey.” Have you ever tried it? It's awesome. The onion earmuff is the other one. You take a half an onion, you either microwave it for 20 seconds or simmer it in a little bit of water, like a half an inch of water until it's soft, wrap a towel around it, hold it against the ear. It is amazing. It feels so good. Why would you criticize us for that? It's so cheap. It's so easy. It feels amazing.

Lots of little tiny ones won't hold still long enough to put the onion over there. But the garlic mullein drops, if you warm them—they must be warmed to body temperature. Stick the whole bottle in a little cup of warm water. The reason for that is if you put anything into the ear canal that's either too hot or too cold, it'll trigger nystagmus in the kids. The eyes will beat, the eyes will go sideways, and it's dizzy. You never want to put something cold in the ear canal, warm it up to body temperature, and it feels great. It's fantastic for pain relief. Maybe there's some antimicrobial benefit. I don't care. It works fantastic.


[01:41:22] Ashley James: It has to be anti-inflammatory. The calendula at least is a very nice pain reliever. I went through a series of ear infections in the last few years, and I figured out I wear studio headphones all day long, and they were trapping all the moisture, and then I was sleeping on a latex pillow, which I think I'm allergic to.

I chucked the pillow, and the infections cut down, and so I would start to feel it coming on, and I used the garlic mullein we have for our son. Oh, my gosh. It feels so good. You're right. It feels so good.

I've done the onion ear muffs. I put them in the oven and then cut it. I just put the whole onion in the oven, warm it up, then cut it in half and stuck it right on my ear. That felt good too, but nothing feels as good if you have an earache as the garlic mullein oil. I'd wait until my son fell asleep and then put it in his ear because he will not sit around for putting something in it. A toddler does not like that.

My understanding is that when a child has ear infections, we look to the diet to make sure that cow's milk, for example, it can cause or contribute. Can you talk a bit about how we can prevent ear infections beyond the fact that it's not draining? As you said, it might be physiological. It's not draining. But beyond that, what can we do to prevent them?


[01:42:54] Dr. Erica Krumbeck: Yeah, so it's still swelling to the eustachian tube. Usually, it's triggered by some cold, so any virus, then there’s mucus from the nose, and it's draining back into the throat. [inaudible 01:43:07] elimination works a certain percentage of the time. I don't know that the kids that have severe or chronic ear infections; I have not seen it be that helpful for it. But again, that may be one because I don't have a ton of recurrent ear infection patients.

It seems like usually once we treat it for most kids, it's gone. Some kids get unlucky and have recurrent ear infections, and we will remove cow's dairy. Maybe I see that help in 30-50%. It could be a confounder though because again I think our air quality is pretty poor here in Missoula.

I think that's contributing to extra inflammation. So yes, cow's dairy products and citrus fruits can be mucus-forming. And so if kids are getting recurrent ear infections, then eliminate those foods, at least around the time that they have the ear infection. If there are kids that have more than two ear infections, then we cut out dairy for the long term.


[01:44:11] Ashley James: Would you say that they could get on lemon balm, mullein, passion fruit, these things you mentioned?


[01:44:17] Dr. Erica Krumbeck: Passionflower. Passion fruit wouldn't work—totally different. Tastes delicious, but it would not work. Yeah, for pain control, if they want to.


[01:44:29] Ashley James: I've heard from my chiropractor friends that often a good adjustment will clear it up.


[01:44:37] Dr. Erica Krumbeck: Yes, that's a great one. I have referred to pediatric chiropractors all the time, and there are different ways of doing it. Some are manipulated in the cervical bones. Some are just doing an endonasal kind of treatment. You can also reach in and gently massage. It's uncomfortable— the opening of the eustachian tube into the pharynx itself.

There are lots of different ways to do it, but yes, for a couple of the kids. I have one family who we finally did send them to the ENT to at least get the consult for ear tubes because here's the deal—for a lot of these kids, they have ended up on recurrent antibiotics. It's very rare for me to prescribe antibiotics for an ear infection. I've hardly ever done it. But when you've got kids who are having bursting eardrums, then we're at the point where we're like, “You know what, what else are we going to do?” In those cases, basically by the time naturopathic therapies have failed, almost all the time I see antibiotics fail, too.

It doesn't seem like the antibiotics are doing anything. Either the eustachian tube is so swollen, or genetically they have such a twisted eustachian tube, it's not going to make a difference. So that's when I refer to the ENT because then our only other option is drainage out of the ear into the ear canal itself because there's no other way to do it. I'm not going to keep having kids be on recurrent antibiotics forever and ever. I'd rather have them put a tube in. But this one family did go to the chiropractor and cleared it in that amount of time. I was thrilled. I was really happy.


[01:46:12] Ashley James: That’s very cool. Do you have other big pieces of advice that someone would have never gotten if they went to an MD and are very happy to get from you?


[01:46:28] Dr. Erica Krumbeck: That's really broad.


[01:46:30] Ashley James: I know it's broad, but like, “Go see a pediatric chiropractor is really effective.” Is there any other kind of effective forms of therapy? Do you have like these big, “I recommend all children only get two hours of screen time”? Do you have any one of those big powerful recommendations that help most children?


[01:46:59] Dr. Erica Krumbeck: So many. One, any child with ADHD, autism, or neurological issues, I strongly recommend turning off Wi-Fi at least at night. It makes a difference. A huge percentage of kids don’t notice the difference, but why do we have Wi-Fi on at night anyway? And then I have a certain number of kids that actually can tell their parents when Wi-Fi is on. That’s so freaky. Turn off that Wi-Fi. That's one.

For constipated kids, dairy protein intolerance is really common in constipation. Oftentimes, a dairy elimination diet will completely cure constipation. Speaking of constipation, because I have a constipation guide in the shop as well because that's a really common complaint. I can't remember how many millions of children statistically we're affected every year—tons and tons and tons.

Probiotics are super helpful for constipation, but I know families do not like laxatives. I hate Miralax. It's never been approved for use in children at all, not to mention long-term use, and it's the absolute standard of care for pediatricians.

I prefer other types of laxatives. Magnesium citrate is a great laxative. There are other ones as well, but I want to explain the point of that quickly. That's when kids are chronically constipated. Their rectum or colon expands, and it makes it so that the colon can no longer squeeze effectively. There is a vicious cycle and chronic constipation where then they become so impacted, and the muscle is stretched out, and the nerves are stretched out, so it can't even squeeze anymore.

The point of long-term laxative therapy, and I mean like 6-12 months is so the stools stay at a mashed potato consistency so that the rectum can shrink back down and kids can regain the control of their bowel. That's important.

Kids with chronic constipation can be allergic or sensitive to all sorts of other things—gluten, eggs. I could go on forever. There are so many other little tidbits. There are about a hundred of them, and there are so many different things.


[01:49:26] Ashley James: Tell us about all the guides you have created so far.


[01:49:30] Dr. Erica Krumbeck: I wish I had time to make so many more.


[01:49:32] Ashley James: I know you will. I mean this podcast evergreen. I've been doing this show for just over three years, and I still get people downloading the first 20 episodes. You'll have people listen to this for years to come. I know that when we all go to your website, Naturopathic Pediatrics a few years from now, you'll have many more, and I love what you've already created. Let's talk about what you've already created. When people go to your website, and they click on 'Shop,' you have wonderful guides. Just tell us what you're proud of and what you think all parents can benefit from.


[01:50:09] Dr. Erica Krumbeck: One is if there are questions about vaccines, that's the main one. That's my Vaccines Demystified webinar for anyone who has any questions about vaccines. My only caveat with that is if you already have very strong opinions one way or the other, please do not buy it. It's not for you. You won't be happy. But if you're somewhere in between, go for it. You're laughing at me.


[01:50:34] Ashley James: No, I'm laughing because I'm very strongly on one side, but I'm also the biggest open-minded skeptic. I love it when I can be pulled back towards neutral from my radical views because I want balance and I want the science. I would love it. I think people are like me will upload your webinar.


[01:50:58] Dr. Erica Krumbeck: Good. I hope so. Just don't send me hate mail. I gave you the warning. That's the funny part about being in the middle. I said that then I literally get hate mail from both sides, and I just got tired of it after a while. I stopped promoting my vaccine webinar because I got so tired of the hate mail. It's just unbelievable, and it’s seriously from both sides. I've had entire blog posts on the internet about how terrible I am from both sides, which is like phenomenal to me because I do support all families in my office, and I'm happy to support all families in my office.

So the other stuff I've got up in the shop, I have the well child guides from aged newborn to 12 months. Again, I'll be expanding that soon. I have a constipation e-book. I have an ADHD e-book. I am working probably within the next 12-ish months or so. We're probably going to expand that constipation e-book into a whole webinar series that I'm going to do with a pediatric physical therapist who specializes in the pelvic floor for children. So that's going to be exciting, too.

Again, I am such a dreamer, and I have so many more ideas than I ever have time for, and we'll be working hard on developing practice and resource guides for providers as well. So stay tuned, there's so much more. If only I had time to implement all of my dreams.


[01:52:23] Ashley James: Absolutely. When it comes to just making sure that kids are fully nutrified, what advice do you have? For every question I've asked, we could do an entire interview, and I know I'm just not doing this topic any justice by skimming over that. We usually dive deep into one topic for an episode. But I love the tidbits you're providing. I think they're valuable.

Anything you could leave us with in terms of nutrition? Are there some things to look for that you want to let us know about? What tidbits do you have to support us in making sure that we're giving our kids the best nutritional support possible, from diet or supplements and both?

I love the idea of leaving the vegetables out while you're preparing dinner as an appetizer kids can snack on. I love that, and I read once you have to expose a child—I'm talking about like a toddler—you have to expose a child to avenge the new vegetable like eight times, and they're going to reject it like the first eight times before they're going to say yes to it. And some parents get to see the rejection once like broccoli, and they go, “Oh, no. My kid doesn't like broccoli,” and then they never offer it again.

The best psychology is just don't put any emotion on it. Don't shame them or yell at them or whatever. Just keep putting it in their field of vision. Like my son, if I give him a vegetable, he will not eat it. But as he's sitting in the grocery cart, he will eat an entire head of kale, or he'll start peeling a cabbage, or he'll grab asparagus, or bean, or peas, and he'll start munching them.

We have a kitchen garden, and he'll sit there and eat right out of the ground. But it's because it's his will. It's his choice. He's very strong-willed. So if I'm offering it to him, absolutely not. But if he's choosing, it's gangbusters. Do you have any advice like that that can help us to fill our kids with nutrition?


[01:54:27] Dr. Erica Krumbeck: Yes. First, most babies, when they're being introduced to solid foods, are open to everything. Even at 12 months is usually pretty good, somewhere between the first year and the second and a half year of life. So somewhere between age 1 and I'd say 2-1/2, often kids start to restrict their palate and then not like veggies in particular, but sometimes other foods.

Now I got unlucky, and I have, of course, the naturopath’s kid doesn’t like veggies or fruit. He's like the [inaudible 01:55:06] syndrome kid that I talk about on the website. Thank goodness, all I serve is whole grains because that's all he ever wants to eat. This is another key one. He's three and a half, and we're just figuring out he's got sensory issues. He's terrified, shaking uncontrollably if we make him taste fruit. So that's counterproductive. We've gotten to the point for fruit where all I'm doing is having him hold the orange.

It sounds so silly. I know some of your parents, they're watching, listening to this are going to judge me for this. This is legit. But I also know, and this is what the research shows us that exposure to foods, but in my opinion it's, it's well beyond eight times for some kids.

I saw this with my daughter, who was not afraid of fruit. She'd be a fruitarian if she could. It did take her almost four years to eat lettuce, and it was repeat exposure again and again and actually eat it. There's no problem.

Strangely enough now Leopold, my little guy, he'll eat lettuce and spinach, but he's still afraid of fruit. So we're thinking there is some kind of sensory thing. It must be the smell that's too strong.


[01:56:25] Ashley James: I’m really curious. What if you put it in a smoothie, and he doesn't see that it’s fruit? Is it once it's touched his palate and then he's afraid?


[01:56:32] Dr. Erica Krumbeck: No, he will not have a smoothie.


[01:56:35] Ashley James: Is it the color of the fruit? Can he eat fruit if it's hidden, or is it the taste or the color?


[01:56:46] Dr. Erica Krumbeck: I think it's the smell. I think there's a sensory processing issue going on with him, which we're going to get evaluated by OT here really soon. I'm quite positive there. I think that there's like sensory stuff in our family basically, so that's what I'm working on. That's another story.


[01:57:10] Ashley James: He could be a super smeller. There's one woman, I think she's in the UK, she can actually smell Parkinson's. People who are going to get Parkinson's smell different, and she can detect it.


[01:57:26] Dr. Erica Krumbeck: I think that that that's him. The only flavor of anything that he will have is chocolate or vanilla. Anything like Halloween candy, forget it. He's scared of it. Early on, he was afraid of huckleberries, and my husband almost disowned him—Montana man. A lot of huckleberry picking.

We were like, “No, you're going to like this. Of course, you're going to. Who doesn't like huckleberries? Are you kidding me?” So we put some in his mouth, and he started crying, and we're like, “Aw, I'm so sorry.” He does not go huckleberry picking anymore.


[01:58:07] Ashley James: No kidding. Next time, he has a cold, and his nasal passage is stuffy.


[01:58:11] Dr. Erica Krumbeck: It does not work. We've tried that.


[01:58:14] Ashley James: Darn it. I was going to be like, “I fixed it.” Just plug his nose.


[01:58:19] Dr. Erica Krumbeck: Tastes and textures. He will have applesauce and not apples. We've got a lot of sensory things going on with that guy. So we'll be doing some other stuff, which makes supplementing him impossible. He's the kid that I haven't figured out how to supplement because I'm not going to hide stuff in chocolate every day. I feel like that's a no go.

The long and short of it, going way back, what research has shown now is that repeated exposure is helpful. That's what we're doing with Leopold, saying, “You have to experience this vegetable.” At least, we started with the vegetables. The fruits we're still going to work on for a while. They have to try.

So now I tell all families, we talk about my plate guidelines. The food pyramid that they used to do when we were kids, they no longer do, thank goodness, because it was pretty much like all carbs and then a few other things. It was crazy. They've developed the My Plate guidelines, and it's a quarter protein, a quarter starch or grain, a quarter veggie, a quarter fruit.

The long and the short of it is, for families, I don't even care as much what's on the half of the plate that's the protein and green side. I don't really like mac and cheese, but if you are coming from that's all you eat, then okay, let's stick mac and cheese on that one side, the other half of the plate must be fruits and veggies.

What I'll often tell parents hopefully it will progress beyond mac and cheese at some point. Some parents get there; some don't. I don't even care if kids eat all of their fruit and veggie sides. I want them to know it's there because when they see it on their plate, the studies have shown that kids then at least by the time they're in late elementary school or adolescence, they know that that is what a healthy plate looks like and they will eat it eventually. It can take years of exposure.

The other thing is that kids must try, so I often tell the kids in my practice, “Dr. K says you don't have to like your veggies, but Dr. K says you have to try your veggies.” So that means every day they're trying at least two bites of everything on their plate. And then the research has also shown that kids will try veggies if they also have something on their plate that they already like to eat. Hopefully, that's not something junky.

In the case of Leo, it's an organic sweet potato cracker with flaxseeds, which thank goodness he likes. He's got lots of fiber that he has on his plate. Then it is encouraging them to try something else on their plate.


[02:01:02] Ashley James: Coming back to this idea that the universe sets us up for success, by giving you these challenges, you have become so much more knowledgeable in these areas, and thus you can help so many more people. If you had children that had absolutely no issues, you wouldn't need to be diving into learning, about learning deeper beyond helping your clients and your patients. You’re learning for your children, and you have a deeper level of compassion and connection that someone who's the pediatrician who's never had to deal with this and their family could ever have.


[02:01:44] Dr. Erica Krumbeck: Oh, man. I see so many parents judging each other too, and we've got to knock that off. I have so many parents that they buoy themselves up like, “My kid eats all their veggies,” and they're so great and then their next kid doesn't. We got to stop that. I don't want to serve my kid mac and cheese. There's no nutritional value of it. I turn around, and my hubby does it anyway, and it drives me crazy.


[02:02:11] Ashley James: That's what I'm telling. My husband has a younger brother. That happened in his family. I'm an only child, but my parents still managed to do it. They compared me to one of my friends who seemed perfect, “Why aren't you more like Jane?” Every chance they got—“Jane says please and thank you. Jane eats her broccoli.” They could do vegetable shaming with other friends, and it's not productive. It does not help with self-esteem. It doesn't make the kid want to eat the vegetables. It's not helpful at all.


[02:02:45] Dr. Erica Krumbeck: But at the same time, you can't cave. Just because Leopold got fed an Oreo by Grandpa, it does not mean I’m going to feed him Oreos. I'm not going to put an Oreo on his plate. He’s going to have a protein, he's going to have a green, and those grains are going to be whole grains, and he's going to have a fruit, and he's going to have a veggie, even if he cries about having orange on his plate. But it's still going to be there. I'm not going to force him to the point where he's crying because that's counterproductive. So we're just going to work, moving step by step, and we've got to let go of the guilt, and then we’ve got to let go of the shame.

If you have a fantastic eater, that's awesome, and I'm so happy for you. If you have a friend whose kid doesn't eat that, let's get them help because some of the kids—like my guy does need to go to occupational therapy. That's what OTs do—help desensitize kids.


[02:03:38] Ashley James: Yes, I love pediatric occupational therapy. Maybe you could tell us some other reasons that would be good for going to one. I don't think that parents know enough about that resource. What other issues come up commonly that are great to go to a pediatric occupational therapist for?


[02:04:02] Dr. Erica Krumbeck: Any kid who is actually on the autism spectrum should be fully evaluated and should probably go to an OT. It depends on your state. In my state, we have an organization that does all of these screenings. Often, they're called like a 0-3 program. It's different from state to state. If the child is actually on the autism spectrum, most of the time they'll qualify for services, it'll be covered by the state or federal government. If they're not. But a lot of kids do still have some sensory processing disorder, and that's when they’re dysregulated.

There's a lot of symptoms involved in that. It might be sensitivity to noise, sound, taste, texture, touch, inattention, things like that would be an appropriate referral. There are sensory processing questionnaires that you can fill out if you're kind of curious about that.

Sometimes kids are dysregulated, so they're having explosive meltdowns for no reason. They might have a sensory processing disorder. It is not just being completely dysregulated. That's a little hard to tell because toddlers are dysregulated anyways. That's sort of their job is--to be constantly dysregulated.



[02:05:19] Ashley James: When in doubt, you can get evaluated and see if that's going to be beneficial.


[02:05:26] Dr. Erica Krumbeck: Yes.


[02:05:29] Ashley James: We could go on and on for hours. I'm going to ask one last question. We're going to wrap it up and definitely going to have you back on the show because we've got plenty of more topics to explore.


[02:05:40] Dr. Erica Krumbeck: Sure.


[02:05:40] Ashley James: Sleep.


[02:05:42] Dr. Erica Krumbeck: [laughs] You threw that one as last! Oh, boy!


[02:05:49] Ashley James: I'll share what happened with us. Our son, he's an Aries. He’s very typical Aries. He is full of energy. You can't stop this kid. He’s going places. We don't feed him sugar. We feed him fruits and vegetables. He's going to get sugar naturally. I would hate to see this kid on a standard American diet. We had a problem. He had always fought sleep. He wants to be awake. He wants to go. Ever since he was born, he wants to go, go, go.

We discovered this magnesium soak--really effective, very easy to absorb through soaking in it. I interviewed the founder of it, and you can even do blood tests, and you can see that your magnesium or red blood cell count or the magnesium goes up in the bloodstream from soaking in this. We started adding it to his bath, and he started to calm down the evenings and tell us he was ready to go to sleep, which I thought was cool. We have this routine no screen time. We avoid screen time as much as possible.

We're reading books. There's a routine, and that helps. But for those who they feel like they've done everything, and their children still fight sleep, we also noticed that we had to start sleep routine around 5 PM. People think that their kids can go to bed at nine. It's like, no, Kids should be asleep by like six or seven, so maybe talk a little bit about like how long children should sleep and what are the most beneficial sleep routines, especially for children who fight sleep?


[02:07:41] Dr. Erica Krumbeck: Yeah. I have no way of figuring out how to do this quickly. Kids usually need more sleep than we think. The rooms really should be dark, although lots of kids are scared of the dark in developing nations. We are in Western nations. We're one of the very few cultures that do not sleep in the same room or same bed as our children. If you're going to bed share with a baby, you got to do it carefully.

But a lot of other cultures consider us to be barbarians for putting our kids to sleep in a different room than us. For some kids, it can be normal for them to sleep in the same room as mom and dad up until five or six. It's biologically advantageous to be in the same room as mom and dad.

Some of those kids have this heightened awareness, and they would have been great in tribal society because they're thinking like maybe the tiger is going to come and get me, so I better be alert and be vigilant. That would be great if we're going to try, but we're not in a tribe anymore. We should go to sleep, but we don't. It's okay if you still need to sleep with their kids. That doesn't mean you're a bad person.

Magnesium is great. I think it's a great idea to do it in the bath. There are also magnesium topicals. There are tons of magnesium chewies. There are all sorts of magnesium—very safe. If you dose magnesium orally and you dose it too high, you're just going to get diarrhea. So back up the dose. We call that dosing to bowel tolerance. I do think that’s short term, or at least a low dose of melatonin is pretty safe. It's been studied and is pretty safe. There aren't long-term studies on safety in melatonin, but I do think that now we have a lot of melatonin inhibition of our body making its melatonin because we're just too exposed to light, noise, sound, Wi-Fi and everything. In some ways, we might be replacing melatonin to where it's supposed to be. That's just scratching the surface. Yeah, we could do a whole sleep episode if you want.


[02:09:48] Ashley James: I'd love that. That'd be cool. What dosage is a generally good dose for melatonin for children?


[02:09:59] Dr. Erica Krumbeck: I start low at half a milligram or less. Sometimes kids who are dosed too high of melatonin can get nightmares. Don't do that. I'm never dosing melatonin in toddlers. I don't think that there's usually a need for that. It's very rare that I am.


[02:10:24] Ashley James: So you try everything else first.

Anything else first? I love talking to you, and we're going to have so much fun. You're going to come back on this show. We're just going to keep diving into these wonderful topics. I encourage parents and grandparents to go to your website in and explore all the free resources that are there.

And if you do choose to buy something, use the coupon code LTH, get 20% off. Only write Dr. Erica love mail and none of this hate mail. Dr. Erica is on our side. She's supporting us and getting good information out there. You’re probably going to get some love mail. My listeners are the most loving and passionate individuals. We have a great Facebook group. I'd love for you to join it. It is Learn True Health on Facebook. People can go to Facebook and search Learn True Health, or they can go to They'll redirect them to the Facebook group, a very lively and active community of passionate, caring individuals who all want to learn holistic health to improve their health and their family's health.

We've got a lot of parents there, too, so I know that you'll be welcome. There's zero hate speech in our Facebook group.


[02:11:47] Dr. Erica Krumbeck: Yay! Thank you for supporting each other.


[02:11:50] Ashley James: I've been so thrilled that my Facebook group has never attracted bullies or negative people. It's just been grounded down to earth people who want to be healthy and support other people in being healthy. So we've got that great support system there.

I can't wait to have you back on the show. It's going to be so wonderful. Is there anything you'd like to say to wrap up today's interview? Just anything you felt has been left unsaid?


[02:12:18] Dr. Erica Krumbeck: The only thing I would tell parents is don't Dr. Google and trust yourself, but don't trust Dr. Google. It will always convince you that you have cancer.


[02:12:28] Ashley James: It's kind of scary. It’s a big bag of worms we can open. But you can go to


[02:12:37] Dr. Erica Krumbeck: Yeah.


[02:12:39] Ashley James: Thank you so much, Dr. Erica Krumbeck. It's been such a pleasure having you on the show. Can't wait to have you back.


[02:12:46] Dr. Erica Krumbeck: Thank you so much. I appreciate it.


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