If you have any signs of joint hyper-mobility, joint laxity, or lack of integrity in the joints, maybe your joints hyperextend, and it doesn't have to be every joint in the body. It can move around and be transient, and you have an autoimmune condition, maybe you have Hashimotos. This episode is for you!

Today I have on Jessica Drummond. She is the founder and CEO of Integrative Women's Health Institute and is passionate about caring for and empowering women who struggle with women's health conditions, specifically endometriosis, but through her own journey. With long-haul covid, she has experienced joint issues and dysautonomia, which we will discuss in this episode.

I talk about joint laxity and how we must train resistance, especially with Hashimotos. I have clinically found joint hyper-mobility, tissue laxity, and autoimmune conditions to go hand in hand in my clinical practice. And I sit down with Jessica Drummond to talk about different strategies to reign in that hyper-mobility.

Jessica also comes at it from a functional medicine perspective by addressing root cause issues like leaky gut, mast cell activation syndrome, and other things that can relate to feeling lightheaded, especially related to POTS.

Quotes:

" I think the best research we have is on the Levine Protocol or Children's Hospital of Philadelphia. Similar protocol, which is essentially an exercise protocol for dysautonomia that's very basic."

"Joint stability and strength first in the lower quarter in the core. In collaboration with that, we can use nutritional strategies to lower inflammation, and build myofascial stability."

"Even if you're literally in bed almost all the time. If you're still alive, you're somewhere on the continuum of health. Even if you have a terminal illness, you can be living in a way that's, I think, deeply beautiful and human right."

Where you can find Jessica Drummond:

http://integrativewomenshealthinstitute.com/

https://www.instagram.com/integrativewomenshealth/

Dr Emily Kiberd and where to find Thyroid Strong:

If you’re looking to lose weight with Hashimoto’s: https://www.dremilykiberd.com/weight/

If you’re looking to beat the Hashimoto’s fatigue:

https://www.dremilykiberd.com/fatigue/

If you want to learn more about 3 things NOT TO DO in your workout if you have Hashimoto’s and WHAT TO DO instead:

https://www.dremilykiberd.com/strong

If you want to dive right into Thyroid Strong online workout program: https://www.dremilykiberd.com/thyroid-strong/

If you have any signs of joint hypermobility, joint laxity, lack of

integrity in the joints, maybe your joints hyperextend, and it doesn't

have to be every joint in the body.

It can move around and it can be transient, and you

have an autoimmune condition.

Maybe you have Hashimotos.

This episode is for you.

Today I have on Jessica Drummond.

She is the founder and c e o of Integrative Women's Health Institute,

and is passionate about caring for and empowering women who struggle

with women's health conditions, specifically endometriosis,

but through her own journey.

With long haul covid, she has experienced some joint issues and disautonomia, which

we're gonna talk about in this episode.

I talk about joint laxity all the time and how we need to resistance

train, especially with Hashimotos and how I have clinically found.

Joint hypermobility, tissue laxity and having an autoimmune condition to go

hand in hand in my clinical practice.

And I sit down with Jessica Drummond to talk about different strategies on

how to reign in that hypermobility.

Also coming at it from a functional medicine perspective with.

Addressing some root cause issues like leaky gut, muscle activation syndrome, and

other things that can relate to feeling lightheaded, especially related to pots.

Dive on in.

If you enjoy the episode, go to iTunes, leave a review.

I read every single one.

And if you're interested in joining Thyroid Strong, jump right in.

You can go to my website, dremilykiberd.com/thyroid-strong.

Alright, let's dive in.

Yeah, and I think, you know, so I work with many women with endometriosis,

and endometriosis is a complex disease, which in and of itself is not super

well defined, but it's certainly.

, it has, uh, you know, it has an underlying genetic underpinning.

Uh, we do see roughly the same number of fetuses with, uh, endometriosis as

adults, teenagers in the same population.

So we know it, it's not a sort of period disease.

It's a systemic, uh, disease with a genetic under, uh, underpinning.

And it's also though, in inflammatory and.

While the research is controversial on this, I believe from my 20, almost

25 years of clinical experience, that autoimmunity certainly plays

a role and it's very common to have other autoimmune comorbidities.

Everything from Hashimotos to um, uh, celiac to autoimmune infertility,

challenges related to endo.

With my endometriosis population.

Um, we also see lots and lots of comorbid ELOs, danlos, sometimes really directly

clear diagnosed, you know, and sometimes fairly severe impacting gut motility.

Impacting vascular stability, um, you know, requiring,

um, cervical spinal fusions.

Uh, I have several patients that have had more than one of

those things being required.

. Um, and so I think when we were thinking about an a pa population of

people with autoimmunity, is there some underlying common genetics

between both of those things?

Possibly.

Or is it just a common comorbidity and I think at this point we don't know yet.

Um, But I do think clinically you're very often gonna see people that have both,

and the other key issue is that they're not all clearcut cases of ELOs Danlos

at any particular level of severity.

Some people don't have systemic joint laxity.

They may have it in just, or, or laxity of the tissues.

It, it may be just in one area, it may.

Sort of be transient, which is even more complicated, . So, and I think finally,

as we were talking about earlier, the, there's also this integration with

Disautonomia and or postviral syndromes, which again, also coexist commonly with

people with autoimmunity because their immune systems are not super targeted.

So they're more at, you know, they're, their immune systems are.

Sometimes hyper responding in a sense of an inflammatory response, but not

in a really perfectly coordinated way.

So they can end up being more at risk for kind of chronically, you know,

dealing with, whether it's, uh, viral activations or viral exposures or getting

viruses or, you know, diso, I mean, dis uh, dysbiosis, you know, me microbial.

Issues as well.

So that's kind of a checklist of the vague things that people can present with.

Yeah.

Yeah.

So dysautonomia again, can be.

Less or more severe.

It's about a hundred different things.

But the root of it is that, um, one of the things that's most commonly understood

in terms of dysautonomia is postural orthostatic hypertension syndrome.

So that's where the.

The crux of it, and the way it's diagnosed is through tilt table

testing, where basically you stand up your blood pressure drops, which is

the opposite of what should happen.

Because what should happen is the vessels in the feet, the legs, you

know, in the bottom part of the body.

Tense automatically.

And then you stand up and your blood pressure, you know, is maintained.

But people with pots, the opposite.

Things happens.

They, they stand up and the blood pressure tanks and so you can feel dizzy.

So, But that's not the only thing that happens like visually, because again, the

muscles and the vessels around the eye can be lax and not super quickly responsive.

So there's transient blurred vision.

There's transient.

Dizziness.

Um, there's pain in various places because again, sometimes blood flow is changed

or it's difficult to exercise and really get oxygenation to the areas that you're.

Exercising potentially because of disautonomia, potentially

because of other reasons.

Um, and so there are lots of different kinds of disautonomia.

Most are not life-threatening.

A few rarely are, but what it is really, and having experienced this,

it, it is basically, it's like.

Stuff that you don't usually have to think about.

Your body just automatically does.

Like an auto transmission car.

You have to really like think about like, How much water have I had?

How tense are my vessels?

How quickly can I move?

You know, why is my heart rate kind of crazy all over the place?

Um, how, you know, what kind of clothing are you wearing to sort of gently

compress things for either the actual compression or for proprioception?

So it's this sense of the stuff that's normally autonomic, like

blood pressure variability.

I, uh, you know, kind of like if you think about your camera having to

like adjust the um, Yeah, the focus that should be auto , those things

are not auto, so you end up ha or they or they're slower to catch up.

So every little thing is something you have to kind of think about.

Like if you walk downstairs, are you a little dizzy?

You know, can you stand up and take a shower?

Cuz getting hot.

Your temperature regulation is.

Optimal.

So it's all these little things that most people just move through,

walking and, you know, go outside to a different temperature.

It's, there's not, you don't think about the adaptation of that, whereas

with just, you have to think about it.

Mm-hmm.

Probably yes.

Although I don't have the checklist of that memorized.

There are some, because there are some related to ELO Danlos.

Um, . And again, there's a, there's about three kind of particular

levels of severity of Ellis analysts.

You know, some people just have more joint stability, whereas other people

have even cardiac instability, which is more problematic and more dangerous.

Um, I don't know those genetic stems off the top of my head,

but I do think there is some awareness of that in hypermobility.

Yes.

Mm.

right?

Because to some extent the, the symptoms overlap.

So it can be very complicated to go go through a checklist

of what you're diagnosing.

So similarly, when you have mast cell activation, Everything can get hot.

. You know, it's, it's difficult to tolerate heat.

Your skin can flush or like break out in hives.

And again, if you think about it, if your autonomic nervous system

is not in a, is not coordinated.

Think about how, why things like neuro reeducation, autonomic

nervous system reeducation helps.

It's because when your, when your nervous system is not, is not, is

stressed by any of these kind of.

Discomforts, it actually triggers an immune response.

So, you know, people with um, histamine intolerance for example, may be more

symptomatic, the more distressing that is to the conscious or subconscious

nervous system because there's never a sense of feeling safe in the.

. And so the faster or so strategies that help people kind of feel comfortable

in this chronic state of being wobbly, , um, can help settle the nervous system

because settle the immune system.

And so the mast cells aren't chronically activated related

to the fact that it feels.

Scary at some level to not be at rest in your body.

And a lot of times there's some degree of predisposition to this because even people

who don't have severe cases don't have like the clear signs of hypermobility.

Like you can't touch your thumb to your wrist, or you don't

have those locked out knees.

You know, you didn't live like, Until you started becoming more symptomatic,

you were probably always a person who is trying to sit more comfortably.

Like you couldn't sit still in class, or you were always kind of like

laying on the floor or, or propping your legs up, or kind of holding

yourself in a way that physically.

Create some stability signaling into the nervous system, which I also think is why

things like Kinesio tape can be helpful.

I mean, we know for sure there's tons of data that Kinesio tape doesn't like

stabilize joints, but it pro provides a really valuable, um, bit of feedback

to the nervous system that things are a little more stable, provides

a sense of proprioceptive stability.

So I think that's why we have such an integration between potentially, um,

you know, hypermobility syndromes, um, disautonomia, and then actual immune

reactivity, which is where the mast cell activation you literally breaking out in

hives or becoming more and more intolerant to foods or chemical smells or mold.

You know, anything else that under healthy circumstances people

can tolerate to some extent.

This is why kind of getting to the root of that is an integration between

creating stability in the body and then settling the nervous system.

And that might mean really slowing people down, which is not.

, what's rewarded in this society.

So it's a big shift for a lot of people.

Yeah, so this is exactly right, and I think the best research we

have is on the Levine Protocol or Children's Hospital of Philadelphia.

Similar protocol, which is essentially a, an exercise protocol

for dysautonomia that's very basic.

It's like the sup, most super boring physical therapy

exercises you could imagine,

Yeah, bridges, straight leg raises, you know, lateral raises.

Um, but what you're doing is you're strengthening and, and things like planks,

you're strengthening one core stability and two lower extremity strength first.

Um, in a pa, a horizontal.

Kind of position.

So as you were talking about, like closer to the ground, um, which does two things.

One, having better tone in your legs is going to help tone that, you

know, the, the, the vascular tone.

Um, but two, it starts to retrain your autonomic nervous system to

adapt as you change positions.

But that part that you're talking about in between where you're

taking rest breaks, and this is why.

Things like yin yoga are really helpful or sort of integrating yin

yoga or restorative yoga with or breath work, restorative breath work.

Con vagus nerve toning strategies, which is the humming, the

slow breathing, any sense of grounding, compression in between.

Teaches the nervous system yet again that this movement is safe and.

Can be progressed.

Um, and so similarly with cardiovascular exercise, rowing, swimming, um, You

know, stationary, recombinant stationary, biking is much, much more effective to

retrain cardiovascular health without kind of having these dumps of like

stress every time someone would walk.

Um, and it's really challenging cuz again, it's kind of boring, slow progression

of like, Five minutes of rowing three times a week, or four, four times a week

for a month, then six minutes of row.

You know, four times a week for a month, and, um, yeah, really slow.

It's totally fine.

Um, and that works best.

And whereas upright exercise takes a while to get to, it's not that you

don't get there, it's that it's slow more slowly over time because you're

essentially retraining the integration between the nervous system and the

cardiovascular system while building.

Joint stability and strength first in the lower quarter in the core.

And you know, in, in collaboration with that, we can use, um, nutritional

strategies to lower inflammation, to build myofascial stability.

So, Collagen, although increasingly because of the integration with Postviral

syndrome, sometimes I'm considering, and I haven't really done a lot of this

clinically yet, but I'm looking into using peptide therapy instead, um, to

kind of help people rebuild their own collagen versus taking too much argenine.

Um, What else?

So, uh, oh, S P M, mediators, fish oil, um, all of the anti-inflammatory

tools that we have, because again, just starting this exercise because

there's such instability at the.

Core, both vascularly and in the fascia can trigger pain really easily.

So that's why when you do the exercise right after that, if someone's in your

clinic, ideally you would also be doing like a little bit of myofascial release

or tiny, tiny muscle stability, but the littlest movements would feel totally

fine and great when you're doing them can knock people down for a week.

Yeah.

Yeah.

And then slowly but surely progressing to things like Pilates has been really,

really helpful for many of my clients.

Um, You know, resisted laying down exercises and in, and so much so, in

fact, you know, we all know how Pilates was invented by just Pilates, literally

doing stuff in his hospital bed.

And it leaves me to wonder, you know, did he have Dyson?

Like, why would you start doing like pulley exercises when you could just

stand up and, you know, lift stuff?

, but if you can't stand up and lift stuff, you can get longer, stronger, laying

down and, and lifting things to the point where that's actually beneficial.

So there is a little bit of a tipping point.

Uh, you know, I've lived with Dysautonomia for some time now, and

it's been in, in learning experience.

And I would say the most frustrating thing is like I can row, you know, a long

time, not a long time, but like slowly but surely more and more and more with no.

Like my, if you're checking on a watch or something like that, the,

it doesn't even pick up that I'm exercising, like it's just, it's fine.

My heart rate's totally basically the same, but half a mile of walking

could knock me down for a while.

Yeah.

Yes.

Well, I think both and right?

Like so.

You know, like you, in my practice, I work with a lot of super complicated

people, , that have all the things, right?

You've got one kind of core diagnosis.

For us, it's mostly endo endometriosis, but other things too, Hashimoto's,

other autoimmune diseases, you know, increasingly things like long C.

You know, perimenopausal symptoms, like there's a lot of things

going on at the same time.

And so when you think about what, what I always say to my patients, and I got

this, um, term from a book called Cured by a guy named Jeffrey Reiger, but this

is how I've thought of my work for, you know, my entire career, almost 25 years.

With any kind of complex chronic illness, first of all, there's a lot of

the same things going on, like people with a lot of, whatever the diagno, you

know, the, the leading diagnosis is.

Have all of these, any, any, you know, random, uh, number of cards.

. You know, if you're thinking about like the cards that you're dealt here

with your complex illness, you could have any number of these things.

You might have hypermobility but not dysautonomia.

You might have dysautonomia and not so much hypermobility.

You may have Postviral syndrome, you may not.

You may have gut dysbiosis, leaky gut.

That's kind of core to almost all of this.

I think most people have some degree.

digestive function issues and or gut dysbiosis.

And also I think most people, even people who are relatively healthy

have, um, nervous system dysregulation.

So that's often at the core of everything, but it's, it's not the only thing.

So this term is called the upward spiral of healing, and I feel like.

Wherever you can get in, right?

It's not an upward straight line of healing.

It's not an upward ladder of healing.

So there are some days where you don't feel where we're like, I think

we can't be tracking day by day.

Like, how do you feel?

How do you feel this moment?

Zero outta 10.

What's your pain?

I think we need to be thinking differently that you're healthy right now.

and how can we move a lot of these different levers.

Even if you're literally in bed like almost all the time.

If you're still alive, you're somewhere on the continuum of health.

Even if you have a tournament terminal illness, you can be

living in a way that's, I think, Deeply beautiful and human right.

So if we take that, that there's no like perfect place that we're all trying to

get to in terms of health, we're just, everyone's trying to live more fully.

All you do wanna address all of these things somewhat simultaneously.

And so the term we use in our clinic is don't chase symptoms.

Optimize systems.

. So we just, you're gonna have symptoms, like even if you're quote unquote

healthy, some mornings you're hungover, some days you have a headache, , you

know, sometimes your knee hurts.

You have no idea why.

Right?

And you know, This increases as you age.

Even if again, you're, you're doing N dvs and you're, you're, you know,

triathlon training and whatever.

You might have a bad night of sleep because your dog was throwing up.

Like, who knows,

all the things.

So like, no one is health, no one is like, perfectly healthy.

Like what does that even mean?

So, A very different way to look at this is my goal is to help my clients

get really clear on how they wanna live and feel less uncomfortable doing it.

Yeah, I do think it's all of those things.

So as I mentioned before, like the sense that you're always a little wobbly.

Feels steadily unstable for the nervous system.

And again, it's not just your joints, it's your vascular system, it's

your digestion, it's your vision.

So it's challenging to move through the world when like

everything's a little, always like.

Unbalanced.

Yeah, and like things like your heart rate, you know, if you just aren't

quite right with your salt, magnesium, potassium, hydration balance, your

heart rate can be like 1 20, 60, 12.

You know, it doesn't go to 12, but one of the, you know, it's

like it bounces or it stays high.

For kind of no reason, even with just sort of mild stress, um, because then

the vagus nerve gets sort of clicked into the wrong gear, if you will, so

that there's an integration in the kind of gut-brain, heart axis of this that I

think helps people feel more grounded.

So what I do is have people have a lot of strategies for.

Feeling more grounded.

So this is gonna get a slightly esoteric, but I'm a Taurus and so I'm in like

an earth sign . And so, yeah, and so like I literally have like rocks on my

desk, like, you know, just from like walking around in the neighborhood

or in on the beach near my town.

And just kind of like there's this sense of like natural grounding.

That you can utilize tools like that, or like earthy sense, like cinnamon tea,

warmth, compression, things that kind of in a more spiritual way, keep people

grounded or even like routines, things like this is when I do my meditation

practice, and this is one, you know, if you have a prayer practice or whatever,

this is when I sit outside, this is what time I go to bed, like keeping.

St stabilizing routines, certain kinds of music might be more calming.

Um, but, and, and I also think this is more important to some people than others.

Some people feel okay, they kind of like a little bit of airy fairness.

Like , there's a, there's a sort.

Spiritual joy in that for some people.

And then I think on a very practical level for people with justo and

hypermobility, there's an even more importance to grounding nutrition.

So, um, you know, really.

More protein, more beneficial fats, probably animal proteins for most people.

Um, bone broth soups, you know, or like if it's summer, like hardier

salads, you know, things that I would never start the day of.

Someone with this degree of kind of instability.

Also making their blood sugar insecure ins unstable.

So being mindful of.

Don't start your day with like coffee and a donut cuz you're just already wobbly.

Like don't make it more shaky.

, right?

Yeah.

. So I think it depends, start with what's most bothersome to them.

Um, because sometimes just understanding what's going on that the fact that

many of your tissues are a little wobbly and the things that for many

people, and even for you in the past were just kind of automatic.

We gotta slow down and let the nervous system catch up.

Like it just doesn't go as fast.

that can be helpful because then you don't panic every time your heart

races or you know, you feel dizzy.

Understanding the condition is helpful because it's just like,

oh, this is just the dysautonomia.

And then I have a couple tools so that that upward spiral starts

with the moment where you're like, okay, what feels easiest to me?

Is it a certain breakfast?

Is it a, is it a coherence breathing practice, which is just simply.

Six seconds.

In six seconds out through the nose if you can.

, um, you know, is it a cup of tea?

Is it lying down and doing some bridges?

So you start like just getting more stable in the kind of mid-section of the body.

Um, is it how you set up your desk?

Is it the kind of clothes you wear?

Is it a taping routine?

So there's sort of that.

We can do it from the inside and we can do it from the outside.

And when we talk about like the myofascial structure, so.

I start with if people are very anxious, which is very common, and

then depression can fall behind that because it's like, ugh, I used to be so

productive, , and I just active and I just can't move at that pace anymore.

You know?

I mean, and I, I get this for to under to go from you.

Three or four high intensity hit classes, you know, dead lifting 120 pounds to

walking a half mile is a little bit of a struggle, is a big emotional shift.

It's a big identity shift.

So we have to see like, what, where is this person in terms of acceptance and

understanding of their journey first?

Then the checklist of tools.

. The good news is we have a ton.

We can use the nervous system regulation tools, we can use nutritional tools,

we can use movement tools, we can use grounding and spirituality kinds of tools.

And a lot of that just depends from a, you know, I always lead everything

with a coaching perspective on what's most feels best to the client.

Where, where are they ready to start?

What feels easiest?

Mm.

Mm-hmm.

Mm.

Well, I'll answer that question before I answer that really quickly.

For me, a postviral experience has been, I also can't lie down.

Now I, I have to exercise lying down, which is weird.

But I can't, I wasn't able to breathe lying down for a long time.

So sitting is better, standing is better, but exercising,

lying down is the only thing.

So it's, it's weird there.

There's no like one size fits all of this.

It's, it's very inconsistent, although it tends to be consistent for that person.

Cuz I've seen the same kind of thing.

Like I feel better in this position.

I feel worse in that position.

I can move in this position, I can't.

And.

You're right.

Like whatever you feel it's correct , it's correct.

Um, yeah, so it is, I think the hard part is that this is kind of like

pre and post having children, right?

You literally can't know what it's like unless you're, you are there.

and, uh, there is post.

The other thing to, to discuss that we haven't really talked about there

is exercise tolerance, pe p e m, uh, post exertional malaise, which is

also a little different from this.

It's not just the how of exercise, but like the how much

and how often and things like.

and it's, it's tricky because especially if they're post-viral,

you really can't push that.

It, it can kind of break, if you will, the mitochondria and it makes it worse.

So you have to think differently about exercise.

Exercise isn't to strengthen and build endurance.

You rest to strengthen and build an endurance, which allows you to exercise.

, which is opposite of what we kind of know, you know, we generally know.

So that's super confusing.

So there are also people in that boat do need to be doing a lot of work

to strengthen their mitochondria.

And most of that, like the most important thing is to sleep a ton.

But there are also supplemental supports, things like Kcu 10 and N

M N, and lyin A and stuff like that.

So back to the.

As, as we're always doing.

Um, but I think we have to shift our expectations.

People aren't going to understand how you feel, and also it's not

really something they can focus on, like they have their own stuff on.

and now you're the people very closest to you.

I think there's a level of, I am a different kind of person now because

I do have different capabilities.

May they improve someday at a whole level, like on that upward spiral?

Like may I get to level two from level one?

Yep.

I might.

Um, but also in, in.

along the way, there are gonna be some rougher days,

which you have too, you know?

So let's say you're talking to like your spouse or your best friend,

someone who wants to try to help understand even your children.

I think depending on how old they are, you know, Some moms are

athletes, some moms aren't, you know, and, and I love moving and I

loved being able to do this with you.

And I also love cheering you on from the side.

Um, and some things you get to do with your sister and some things you get to

do with your dad, and some things you get to do with your aunt and some things

you get to do with me and you change.

your re you'll, you do have to kind of change your relationship with people

a little bit, especially if it's way different from what they're used to.

Um, and, but I do think it's, there's an important level of acceptance

around even your closest friends.

Like there's only so much if they can't do anything about it, they just

don't wanna hear it after a while.

. And so you have to, and while this is super ableist and unfortunate that

you have to do this, it's helpful if you instead just invite people

to do things you can do, um, you know, and, and it might be much, much

smaller and it might be less often.

And it also was helpful to connect with people who were in the same.

. Um, but it's tricky because it's, it's inconsistent.

I think that's the hardest part about any chronic illness.

And again, I've been working with people with endometriosis for 25 years.

The hardest part is that you just never really know when

you're gonna be able to show up.

And you have to get comfortable with showing up 50% when you really

wanna be there a hundred percent, or canceling at the last minute.

and looking flaky, which you're not, right, but also there's so much.

The reality is, and I think this is what's really up to me, this happens in general.

We just think it happens more.

It maybe in a, maybe it does, happens more to us now than it used to.

So it's a new sensation for us.

But life is by definition, uncertain.

So people cancel stuff all the time for any number of reasons.

They got a flat tire, you know, again, there was a pet issue,

like anything could happen.

. Yeah.

So, but it is challenging when you become like this and people

knew you in a different way.

And if your social network.

And your identity is very wrapped up in that it requires literally

changing how you see yourself.

And that may take therapy coaching, tons of journaling.

It's a process.

Um, if they're people physically wanting to get help for themselves,

uh, outsmart endo.com And for our professional trainings, it's integrative

women's health institute.com.

Yes, Instagram Integrative Integrative Women's Health.

Is kind of more mostly post thing.

So that's the best place.

Yeah.

Yeah, yeah,

yeah.