Recently I interviewed Dr. Julie Greenberg, as we chatted about skin conditions and thyroid health. If you would prefer to listen the interview you can access it by Clicking Here [1].
With me, I have Dr. Julie Greenberg. Dr. Greenberg is a licensed naturopathic doctor and registered herbalist who specializes in integrative dermatology. She is the founder of the Center for Integrative and Naturopathic Dermatology, which is a holistic clinic that approaches skin and hair problems by finding and treating the root cause. Dr. Greenberg holds degrees from Northwestern University, Stanford University, and Bastyr University. She lectures at naturopathic medical schools and is sought after to speak at conferences across the United States on the topics of hair, skin, and nails. Thank you so much for joining us, Dr. Greenberg. Appreciate you agreeing to do this.
Dr. Julie Greenberg: Thank you so much for having me.
Dr. Eric: I’m excited just because this is really the first time we are diving into the skin, which is relevant with any chronic health condition, but I do see it a lot with both my Graves’ and Hashimoto’s patients.
Can you start out by giving a little bit more of your background? How did you start to focus on dermatology?
Dr. Julie: Yes. It is actually apropos for this podcast because I got to dermatology through my thyroid. If your listeners don’t know, I am a naturopathic doctor. Naturopathic doctors say, “Treat the whole person,” which means we look at how the organ systems interconnect with one another. It was a very naturopathic way for me to get to dermatology.
I went to business school in my 20s. I graduated and started having symptoms that will sound very familiar to you. I was very tired. I was gaining weight. I was having some hair growth, some brittle hair, some dry skin. It turns out I had developed Hashimoto’s thyroiditis. When I finally got diagnosed, it was a very jarring experience. It was my first real experience with a chronic health issue. The doctor who diagnosed me was like, “Well, you have this autoimmune disease. We don’t know why it’s happening. We don’t know how to fix it. Here is some thyroid hormone. You will be on this for the rest of your life. You will probably have trouble with fatigue and weight the rest of your life.” Out the door I went shell-shocked.
I really had no interest in being a doctor or anything medical before that. I started researching. That just doesn’t feel right, that that’s the answer I’m getting from my doctor. How could that be the end of the story?
The more research I did, the more I found that other things in the system affect the thyroid. A lot of the chemicals that we use on our body everyday for personal care products—women use around 125 different chemicals on their bodies a day—can impact the thyroid. We have endocrine disruptors. I started making that connection between the skin and the thyroid. I started trying to make my own skincare products. I got the chemicals out and saw I could make myself healthier. That was my first foray into health and dermatology.
I became so passionate about the skin and dermatology and what we were putting on our skin. That was the impetus that ended up in me going back to naturopathic medical school to become a naturopathic doctor and specialize in dermatology.
Dr. Eric: Maybe I misheard you, but did you say that the average woman puts 125 different chemicals on their skin every day?
Dr. Julie: Yeah, you did not mishear me. When you think about the number of products that a woman puts on her skin. You wake up in the morning and are putting on deodorant. You wash your hair with shampoo and conditioner. We are applying all sorts of makeup, gels to the hair, lotions to the body. If you pick one personal care product, turn it over, and look at the ingredients list, you will see a very long list of multisyllabic chemicals that are only made in a lab. Add those up. You get to about 125 for one day.
Dr. Eric: Wow. I knew it was a lot, but if I were to guess, I would say maybe a few dozen, not over 100. That’s crazy. And that’s the average. Some people apply more than 125 chemicals on their body.
Why do so many people have skin issues? I think I know the reason. The gut plays a big role, which I know you will talk about. If you could dive into why it is so common in people with not only autoimmune conditions, but other health conditions as well.
Dr. Julie: Great question. Our skin is a very complex organ. It is enormous; it is our largest organ. Obviously, it is covering our body. Its job is so complex because it is outward-facing at all times, and it has to keep out most things but let some things in. It has to keep in most things, being our blood and water, but it has to let some things out. We have to sweat. You think about something like a turtle shell. That is much easier. They build a hard exoskeleton. Nothing gets in; nothing gets out. That’s it. It’s a much simpler job. Skin has to be soft and supple, but it has to be tough because it’s outward-facing. It’s really a very complex organ.
We’re going to get to the gut as you said, but when we think about how did we evolve? How are we supposed to be taking care of our skin? If we lived out in caves still, we probably weren’t showering all that often. We weren’t using detergents and soaps.
I talk to my patients about this: pH is really important when it comes to skin. Let’s take a scientific detour, and we will come back to the skin. Most of us maybe got introduced to the concept of pH, which is a scale of acids to bases, in junior high school. One day, your science teacher handed us these litmus paper strips, and we were dunking it into different solutions, trying to see what color it would turn up. If it was something yellow or orange, it was an acid. If it was purple or blue, it was alkaline or base. That scale of pH runs from 0-14. 0 is acid, and up high are basic or alkaline. Right in the middle at 7 is neutral. Things like water are neutral, for example.
Our body has evolved to operate efficiently at a different pH, depending on where you’re at. Our stomach is the most acidic. That can be down at a 2. That is because our stomach needs to digest food and kill organisms that we bring in through our mouth. Our blood is about a 7, so fairly neutral.
Every single patient gets educated on this. I always ask patients, “If you had to guess, where do you think skin would be? Nobody knows because we don’t get user manuals. If you need a clue, I’ll give you one.” If they don’t take a clue, everyone guesses neutral. If they do take a clue, I say, “Covering your skin is something called a fatty acid mantle. Let’s break it down. What word did we just hear? We heard the word ‘acid.’” That’s our clue. Our skin is surprisingly acidic. It needs to be acidic to be healthy.
Down at a 4 or a 5 is where we want our skin to be. Let’s pause and look at our Western hygiene protocol. We are obsessed with cleanliness. For a lot of reasons, that’s good. We tend to use soap and water multiple times throughout a day, especially on our hands. Most people shower maybe about once a day, and we’re soaping up. If we look at soap, soap is made with a substance called lye. We combine that with fat, and there is a chemical reaction that makes soap. Lye is super alkaline. It’s at a 12. All soap or cleansers by nature are alkaline.
Now we look at the fact that we want skin to be acidic, yet we are using water, which is a 7, and soaps, which are quite alkaline. Some soaps can be as high as 12 in pH. Every time we wash our skin, we are stripping off the fatty acid mantle, and we are raising the pH of our skin. We are compromising our skin. Most people then are putting on lotions and moisturizers with chemicals that are more easily absorbed through the skin now. Our whole Western hygiene protocol is compromising our skin because it keeps stripping off the fatty acid mantle and throwing off the pH by pulling it up.
I have never treated as much hand eczema as I did during the start of COVID. People were hysterically washing their hands with hot water and soap 10-20 times a day. If you want a recipe for hand eczema, that’s a great one. All you have to do is stop, and the hand eczema will go away. Unfortunately, this kind of hypersensitivity to cleanliness and all the chemicals we’re using is compromising our skin barrier and putting us at risk for skin issues. There is a lot of gut/skin relation as well that is driving the bus on this.
Dr. Eric: I’m guessing it probably depends on the person, but as far as how frequent do you recommend showering? Is it not a matter of don’t shower daily, but maybe be cautious about the soap that you use when you shower?
Dr. Julie: it’s a combination of those things. I definitely counsel patients to use more natural soaps. I counsel patients to read your skincare products the same way you would read food. Most of us now are wise to the fact that they can sneak stuff in food, and we should look at labels if it’s packaged and see what we are putting in our mouths and eating.
Same thing with skin care. If it’s a long list of multisyllabic chemical names that you don’t understand, probably shouldn’t be putting it on your skin. There is no need for products like that. With soap, you just need basic five ingredients: some plant oils, sodium hydroxide (that lye that has to happen for the chemical reaction). I don’t like fragrances, but maybe some natural essential oils. A couple of items in your soap with names that you recognize. That is the start.
The second is I tell patients unless you really get out and get dirty, pits and palms. We need to wash our armpits and our groin; those are areas that could probably use soaping once a day. Palms, so hands and feet.
Our hands, there is a very good reason to wash our hands several times a day. If we use the restroom, if there is COVID exposure, moms who are changing dirty diapers, anyone who is preparing raw meat. We are going to wash our hands, but we are going to try to do it when appropriate. I have patients follow up that soap with natural products that help reacidify the skin. As soon as we’re done washing, we can do things to help pull that pH back down again and restore where the skin was meant to be.
Dr. Eric: You’re hopefully not using chemicals. The products you use can definitely impact the skin. Let’s talk about the gut. How about that gut/skin connection?
Dr. Julie: As a naturopathic doctor, I think naturopathic doctors have been talking about the gut for upwards of 30 years. The gut microbiome. In case that is a new term to your listeners, the microbiome is the collection of organisms. A gut microbiome is the collection of organisms living in our gut. We definitely have them. The average adult human has about 3-5 pounds of microorganisms living in their gut. The vast majority are bacteria. There is a whole host of different types of organisms, including fungal, like candida and yeast; viruses; protozoa; worms; archaea; and other things.
The reason why we have those pounds of organisms is we have coevolved with them. They are really there to help keep us healthy. We can’t survive without them, and they can’t survive without us. As long as we know we have them and we need them. When it is the right organisms, they keep us healthy. When there is dysbiosis, which is a disruption of the gut microbiome with what’s supposed to be there, they put us at risk for illness.
As a naturopathic doctor who specializes in dermatology, I only treat patients with dermatological complaints. I see a lot of the spectrum of what’s in the population: a lot of eczema; acne; psoriasis; rosacea; alopecia areata, which is an autoimmune attack on the hair follicle, vitiligo, an autoimmune attack on the melanin sites and the skin. What I have found is I have to go in and treat the gut in order to treat the hair, skin, and nails. 100% of my patients have that gut dysbiosis.
Not only that, after doing hundreds and hundreds of these tests, I started seeing patterns by disease of different types of dysbiosis. My patients with acne tend to have a set of at least three problems that keep showing up. I call that the acne gut. As opposed to my eczema patients, who have a different set of problems that show up again and again. It’s not just that there is gut microbiome dysfunction or dysbiosis. It really interestingly falls into patterns by disease. It’s intrinsically related. The root cause of a lot of the skin illness is the problems in the gut. I can do some things topically to help the situation. If I can’t get in and test and treat the gut, I’m not going to be able to get to the root cause of their skin issues.
Dr. Eric: What type of testing do you do? Do you do a comprehensive stool test or a microbiome testing for the gut, or both?
Dr. Julie: There is two main tests that I do on just about every patient. One is a comprehensive stool test. One is a urine test called an organic acids test, OAT. The stool test does an excellent job at showing me the specific bacterial organisms that are living in the gut as well as agood overview of digestive function and protozoa. Those are single celled animal organisms that can exist in the gut. For example, I see those in about half of my acne patients.
I don’t find the stool test does a great job on fungal organisms in the gut. For that reason, I also use the OAT. That does a much better job on showing me things like candida overgrowth or molds, like aspergillus or fusarium. Maybe if there are indicators of some toxic exposure or methylation issues, which is related to the MTHFR gene. It gives me some B vitamin status and other information as well.
I use those two labs together to try to paint a comprehensive picture of all the things I need to fix in the gut.
Dr. Eric: Can you talk about the importance of diet when it comes to skin? Is there any specific diet that you recommend? Does it depend if someone is autoimmune or not?
Dr. Julie: There are some overarching principles to follow. Then there can be some specific ones by various diseases. Overarching, for all my adult patients, we are working up to 35g of fiber a day. I can go in and fix the dysbiosis that I see with herbs and supplements to correct it; I don’t use pharmaceuticals 99% of the time. I can’t keep things healthy if the fiber isn’t there. Most of the healthy organisms in our gut, their food is fiber. We want nice big colonies of these healthy ones. Just like any organism, if you don’t feed them, then they die. Most Americans eat the SAD; it’s pretty low in fiber. Most people are not ever going to eat 35g of fiber a day. We really work on that because ultimately, I want people to get off my schedule, and I want to keep their gut healthy. The fiber is that path forward for them.
Dr. Eric: I was going to ask if you mainly accomplish that through vegetables.
Dr. Julie: It depends. If we are working with teens and kids, and fruit is the only plant they are willing to eat, I call that my gateway fiber drug. We will start with anything we can get. But for adults who have more self-control, vegetables are the key.
I know there is a lot of debate over legumes for various reasons. I like beans and legumes. They are very high in fiber. All of the blue zone populations in the world, which means populations who have centenarians or people who live to the age of 100, more than other populations, they all tend to have beans and legumes in their diet. I do think they are beneficial.
We really work on a variety as well. Variety is not just the spice of life. It is crafting a healthy gut microbiome. The two targets are 35g a day and 30 different plants a week. That includes spices, herbs, teas, nuts, seeds. We don’t want people just eating the same thing day in and day out. Those are the two elements I work on.
Yes, definitely. Low sugar, which is vegetables. That brings me to the next point. For skin, sugar ages you. It ages skin. There is something called glycation. If anyone has ever had a hemoglobin A1C test, then you have been testing glycation. Hemoglobin A1C tests basically how much sugar is attaching to your red blood cells.
When it’s very high, people have diabetes. They are eating too much sugar, so there is too much sugar in the blood. The sugar has nowhere to go, so it starts attaching to things like our red blood cells. It also attaches to skin cells. When you have glycation or sugar attaching to skin, think of it like a crispy, crunchy caramelization. It literally makes for crunchy skin. The more sugar someone eats, the more they will age their skin. I really recommend low sugar if you want healthy, naturally younger-looking skin.
All of the vegetables that we talked about, all of those nutrients will feed skin. Fruits and vegetables that are rich in bright colors, they contain things called polyphenols, which are fantastic for both the gut microbiome and skin health.
The things that we are doing for gut health and overall health are the things that are going to build healthy skin. Sometimes, I will supplement patients with collagen. There are very good studies at this point that show at least 3-4 months of supplementation with a high-quality collagen will help reduce wrinkles and improve elasticity and suppleness of skin.
Dr. Eric: You just add a scoop of collage powder to a smoothie or water per day?
Dr. Julie: Exactly. People can also drink high quality bone broth, and that will get you a lot of collagen as well.
Dr. Eric: 30 different types of plant-based foods per week to get your fiber. That is not just vegetables, but you mentioned other plant-based foods like legumes, nuts, and seeds.
Dr. Julie: Yes. Herbs and spices. The more people cook with herbs and spices, they are just so rich in things. If you look at the ORAC scale, which is an antioxidant scale, something like cloves is one of the highest. Cooking with herbs and spices makes our food taste great, and it’s really good for us. It’s really easy to get to 30 different plants a week when you are cooking with herbs and spices.
Dr. Eric: When it comes to vegetables, do you recommend specific vegetables? Maybe more cruciferous vegetables compared to green, leafy vegetables.
Dr. Julie: It comes down to diversity. All of them. People want to say, “I eat a lot of kale.” That is fantastic. Kale gives you a lot of nutrients. We don’t want just to eat kale.
What I instruct patients to do is eat the rainbow. By that, I tell them when you go to the market or farmers’ market, if you have kids, you can play this rainbow game with them. Go to the produce section. Do your normal shop. Get the stuff into your basket. Then go through the colors of the rainbow: red, orange, yellow, green, blue, violet. Look in the basket and see which of those colors are missing. You will go back out, and you or your kid will pick a vegetable from that color group and get it in the basket.
Worlds of color will start to open up. There is no purple; look around, and then this world of purple will bloom before your eyes. You will see purple onions, purple carrots, purple broccoli, purple sweet potatoes, purple regular potatoes. You can try different things. That way, you will build in the diversity.
It’s really about having different things in the diet and all the different groups. We definitely want cruciferous vegetables. We want green, leafy vegetables. We want orange things, like carrots or squash. We want diversity.
Dr. Eric: I agree. I don’t know if you have heard of Dr. Jason Hawrelak. He is also a naturopath. When I went through my Masters in nutrition, he was talking about eating 40 different types of vegetables, not just plant-based foods. 30 different types, including nuts, seeds, legumes, is attainable. 40 vegetables is very difficult. To get 40 different types of vegetables per week… I do what you say. I try to eat green, leafy vegetables and cruciferous vegetables. I could probably do an even better job than I’m doing now, like most people.
How about probiotics? Do you recommend for people to get more through the food they eat, through fermented foods, or supplements, or a combination of both?
Dr. Julie: You mentioned Jason. He is a probiotic guy. When it comes to probiotics, people can overestimate. I have a lot of eczema patients or eczema infants whose moms come to see me, and they’re like, “I have them on a probiotic, but it’s not working,” thinking somehow the probiotic will be magical and fix everything. That is not the way it’s going to work.
Eating fermented foods and getting probiotics naturally in your diet is always the best. But I do think there is a role for probiotics in helping, and I do prescribe a lot of probiotics. There are different types, and I use different ones in different people. I am always recommending those fermented foods, things like sauerkraut or natto or small amounts of kombucha, so we are not getting too much sugar.
For probiotics, for kids and breastfeeding moms and infants, the most common strains are the ones you get in the refrigerator section. There is strains of lactobacillus and bifidobacteria. Those I find work best in kids. That’s not usually going to magically clean up the eczema. As part of a comprehensive protocol, it can be helpful.
For adults, I like bacillus strains. Those are known as spore or soil-based probiotics. Those are a little bit different. I don’t use those in kids and breastfeeding moms because I’ve found that those species don’t work well in the guts of little ones.
There are more specialty strains. There is a bacteria called akkermansia muciniphila, which is- Its name tells us it’s a muciniphile; it loves mucin. It helps prevent leaky gut. There is a company that makes akkermansia. Sometimes I prescribe that as well.
I use a variety of probiotics. It will just never be the only thing I recommend. It’s part of a comprehensive plan where I am treating the issues I saw in the stool and OAT, using herbs and supplements to kill unwanted organisms and trying to regrow and rebalance the gut more toward the back end.
Dr. Eric: With the akkermansia, I assume if you recommend it, it’s based on it being low on a comprehensive stool test?
Dr. Julie: Exactly. If it’s either low or missing. A lot of patients show up with low detectable limits, which basically means it wasn’t found. We don’t think there is a single spore or something of akkermansia, but it’s just so low that it’s not coming out on the stool test. Akkermansiais a delicate bacteria. It can get to that point where it’s low or not found with antibiotic use. There is collateral damage in the gut. Antibiotics can be life-saving and amazing and wonderful, but at the same time, they can kill off beneficial organisms like akkermansia. A lot of patients who aren’t eating enough fiber, or if they are doing for a long time a low-FODMAP diet or a keto/paleo diet, and there is no fiber, that also can lead to low or no akkermansia.
Dr. Eric: You mentioned dysbiosis, imbalance in the gut flora. That doesn’t just pertain to low good bacteria. You mentioned candida overgrowth. How about gut infections like H-pylori or parasites? Do you see those leading to skin issues in your patients?
Dr. Julie: Yes. Just so your listeners know, H-pylori is a bacteria that lives in the stomach. I find H-pylori in almost 100% of my acne patients. I mentioned there is an acne-gut connection. The acne gut, almost all of them have H-pylori. It doesn’t even need to be massive amounts. It can be just low levels that are present. They also have candida overgrowth.
Half of my acne patients have something called protozoa. They are a type of parasite. Protozoa is Latin for “first animal.” These are eukaryotes, which is in the animal kingdom, single-celled organisms. Definitely my acne patients, I am expecting to see H-pylori in them.
Rosacea has a pretty strong connection with H-pylori and SIBO (small intestinal bacterial overgrowth). I see a lot of H-pylori in psoriasis patients. It can show up in my eczema patients as well.
The stool test that I use to test H-pylori standard, there is a lot of different bacteria that are tested for. I see everything from pathogens like C-difficile or even enterohemorrhagic e-coli can show up. Even things like pseudomonas comes up a lot. Or morganella or klebsiella. Those are high histamine producers. In my eczema patients, that high histamine level being cranked out in their gut is driving that allergic response and itch. I see a lot of different things. I don’t usually see worms, but protozoa can show up in patients in terms of parasites.
I feel like a lot of people have this idea that they need to do a parasite cleanse. That’s not really what I see in my experience with skin. It’s much more that there is dysbiosis. There is overgrowth of these unwanted organisms and not enough or lacking of the good guys. We need to switch that around and heal up the gut.
Dr. Eric: I think you did say there are times where you use herbal antimicrobials.
Dr. Julie: Every time I do, yeah.
Dr. Eric: You do. Protozoa or H-pylori, you mentioned pseudomonas or these other bacteria. Protozoa are not bacteria, but these micro-organisms. You do use every time some herbal antimicrobials.
Dr. Julie: I do, yes. Types of herbs vary by the organism I am trying to address. I usually see patients every 2-3 months for follow-up visits. The plan changes every time. We are working through different things. That’s why at first, when I sit down and am assessing the stool and OAT, I am making a list in my mind of all the issues. I am sorting them in terms of order of importance. What do I need to go after first? That will be addressed in the first protocol. I want to address massive candida overgrowth, so I will use a lot of antifungal herbs to start. Now for the second plan, I really want to go after that H-pylori, so it’s a different set of herbs and supplements. Maybe the third visit is more going after the protozoa and some bacteria.
The nice thing about using herbs is they are what’s known as broad spectrum. They address a lot of different issues. Even though we have herbs that are really good at addressing fungal organisms or things like protozoa, parasites, they are still going to cast a wider net and work with bacteria or other things.
That is not true with pharmaceuticals. Pharmaceuticals are in classes. If you use an antibiotic, it is only capable of killing bacteria and only certain types of bacteria. You can get problems. A lot of women who take antibiotics will then get vaginal yeast infections. The problem is that the pharmaceutical has killed off the beneficial bacteria in the vagina that was keeping the microbiome normal. We have a microbiome everywhere, including in the vagina. You can get fungal overgrowth. Then you need to use an antifungal. Antifungals will only kill off fungal elements, not bacteria or viruses. If you have viral, you need an antiviral.
The beautiful thing about herbs is they are broad spectrum. Plants need to exist out in nature and fight bacteria, viruses, fungal elements, parasitic elements. We don’t tend to get those kinds of symptoms and overgrowth when we are using herbs. Even though I am like, this is maybe a protocol that is focusing on the protozoa, It’s not that I am completely ignoring the fungal or bacterial overgrowth, and I won’t be driving problems with these other types of organisms. Obviously, I am an herbalist and naturopath and am using herbs for that reason.
Dr. Eric: Are there any supplements that you give directly for the skin? You spoke about probiotics for the gut. We just spoke about herbal antimicrobials. It doesn’t even have to be directly for the skin. If there are, that’s great. Do you recommend things to reduce toxic load, which might relate to the skin issues? I’m sure you recommend many of the supplements depending on the situation. Maybe a few common ones that you recommend that you find to be helpful. Or, like I said, silica as far as skin health, anything like that. You mentioned collagen.
Dr. Julie: Aside from supplementing with collagen powder, my goal as a naturopathic doctor is to restore function to the body. Most of the time, if I can clean up the gut and make their system healthy again, their skin is going to be healthy. I don’t usually give skin supplements.
That being said, I’m looking at labs. If it looks like they need liver support, the liver is the main organ of detoxification, and it relates to skin health. If they need liver support, I might give supplements like burdock, dandelion, artichoke, something like glutathione or NAC, n-acetyl cysteine. That can support the liver and thereby support the skin.
I tend not to give hair, skin, and nail supplements because I don’t really need to. If people are getting proper nutrition, their organs are functioning properly, and we are doing things topically on the skin like we talked about, not really messing with the pH and restoring the pH with things like aloe vera gel or hydrosols or water-based plant extractions. It’s part of the essential oil making process. It’s kind of like a tea. Diluted apple cider vinegar, teas, and using plant-based moisturizers to moisturize the skin. That is all you need.
We talked about not eating a lot of sugar, not eating a lot of junk. A healthy diet. Your skin is going to look and feel great naturally as long as we are supporting all the systems. We don’t need to throw a lot of vitamins and stuff like that at it.
Dr. Eric: I’m glad you said that just because there are times when my patients will ask me, “Can I have a supplement?” not so much for the skin, but especially for the hair. I say the same thing. Trying to address what is causing the hair loss. Is it a thyroid hormone imbalance? Is it a nutrient deficiency, which might be tied to the gut?
The last question I have is when it comes to skincare products, how do you recommend people find- There are databases like the Skin Deep database. Do you recommend people use databases like that to look at ingredients as far as finding clean products?
Dr. Julie: For my patients, I am giving very specific recommendations on very specific products for their condition. In general, I do think that the Environmental Working Group Skin Deep database is helpful. I don’t agree with every single thing that’s in there. But it’s a good guideline.
Reading the ingredients and getting up to speed on things, there is no substitute for it. Even sometimes within a brand, there will be one specific product which I will use, and another specific product I won’t use. I’ve read the labels, and this one is totally fine, and this one has stuff I do not want my patients putting on their skin.
What is difficult about the product market is it is not really well-regulated in the United States. It is buyer beware. A lot of chemicals that we can have in our products here in the United States are banned from Europe and other countries. The same product that you might buy by the same manufacturer, if you buy it in Europe, it’s actually a better, healthier product than if you buy it here. Europe has banned a specific substance, so it’s not in the European product. But it’s cheaper, so they will put it in the American product.
Things like fragrance, I don’t recommend patients use anything with fragrance in it. Fragrance is a catch-all for over 2,000 chemicals that are untested, and a lot of them are quite toxic.
I have a site called RootCauseDermatology. For free, your listeners can sign up for a video on this exact topic. What kind of skin care products should they be using? What should they be looking out for? If they put their email address in there, they will get this free 15-minute video of me talking about this exact topic and how to look out for themselves and get healthy skincare products.
Education, reading the labels, and I would say only buy products that you know what those ingredients are. The only exception is natural products have to have the common name and the Latin name. For example, something may list rosemary and then Rosmarinus officinalis next to it in italics. That’s fine. That’s just the Latin name.
If it’s a lot of multisyllabic chemical-sounding names, and you don’t know what it is, it’s probably things like parabens, emulsifiers, and preservatives. A lot of those are endocrine disruptors. They are things you want to get out of your products, particularly if you have thyroid issues.
If you know what all the ingredients are, and you see things that has lavender essential oil and aloe vera gel and shea butter and coconut oil, you know what those things are. Your body knows what those things are. Those will not contain endocrine disruptors. Those are not going to mess with your thyroid.
Dr. Eric: Anything else that I didn’t ask you that you wanted to chat about? I know we covered a lot, but I wanted to make sure there wasn’t anything else you wanted to cover specifically.
Dr. Julie: When I was talking about food, I didn’t really talk about gluten. The stool test that I use does have a gluten sensitivity test. This is different than testing for Celiac or a food allergy. A sensitivity is that you have issues with it. I bring it up because a lot of thyroid patients and Hashimoto’s patients have issues with gluten. If that marker comes up in my patients, I do have them eliminate gluten. Gluten can trigger something called zonulin. Zonulin contributes to a leaky gut.
Gluten is an issue for some of my patients, especially if they have thyroid disease. Thyroid is the #1 autoimmune disease. A lot of my patients have skin issues + thyroid. Autoimmune diseases go together. Especially if it’s something like an alopecia areata or vitiligo, they are more likely to have something like an autoimmune thyroid disease.
I think we eat too much gluten in our diet. I don’t think everyone needs to completely eliminate it, but I do think it’s helpful to know if you do have a gluten sensitivity, and if so, really cut it out completely. There are so many other grains and options. Some people are eating gluten morning, noon, and night. It’s really not great for their gut, thyroid, or skin at the end of the day.
Dr. Eric: How about dairy? Does that depend on the person? Do you usually let people eat dairy?
Dr. Julie: It depends. About 100% of my eczema patients should not be eating dairy. I have never met an eczema patient where dairy does them any favors. Unfortunately, we are not baby cows. That is not an appropriate food source.
I kind of tongue and cheek ask my adult eczema patients, “Do you still breast feed from your mom?” Of course, they look at me like I’m completely insane. The reason is if we were meant to drink dairy as adults, we would still be breast feeding. No mammal on the planet breast feeds past infancy. Every mammal mama cuts off the baby at a certain point. That mammal will never have milk again and will never drink the milk from another species.
We like milk because it’s delicious, and it makes things like cream and cheese. It releases endorphins, so there is an addictive nature. None of my eczema patients and none of my acne patients should be drinking milk.
Some people can get away with it, but it’s really not an appropriate food source. We weren’t meant to drink dairy as adults. We weren’t meant to drink dairy of other species.
Dairy and gluten are not my favorites. Some people can get away with it, but they are not great food sources.
Dr. Eric: I definitely agree with that. Can you take a minute to wrap this up? Maybe some action steps if someone with Hashimoto’s or Graves’ is listening to this, or another health condition or non-autoimmune thyroid condition listening to this. Working with a practitioner such as yourself is an option. What are some initial steps even before that that they should do?
Dr. Julie: We can break it up to topically and internally. Topically, the best thing you can do is turn those personal care products over. Start reading labels. Ask yourself if you understand what is in it. If you don’t, think twice about whether you should be using it. There is lots of good options. You can start with my course or the Environmental Working Group Skin Deep database to educate yourself. That’s for topicals.
For internals, if you can get 35g of fiber a day and 30 different plants a week, a lot is going to change. Your thyroid symptoms will improve. Your gut is going to improve. Your skin will improve. It is the way we were meant to eat. There is nothing we can do to get around that.
Topically read your labels. Focus on 35g and 30 different plants a week. You will see big changes in your skin health and your thyroid health.
Dr. Eric: Thank you, Dr. Greenberg. Where can people find out more about you? You said your website is RootCauseDermatology.com. I know you have some courses, besides the free video, that you offer.
Dr. Julie: Yes. I have a course on eczema, acne, rosacea, hair loss, and something called seborrheic dermatitis and dandruff. If you live in California, Oregon, or Washington, those are states where I’m licensed and where I can legally see patients. My clinic site is IntegrativeDermatologyCenter.com. If you’re interested in potentially seeing me as a patient, you can go there and sign up for a free 15-minute consult. I can talk to you about your condition and how I treat it.
Dr. Eric: Wonderful. Thank you so much again for doing this. Appreciate it. I learned a lot. I’m sure the listeners did, too.
Dr. Julie: Thanks so much for having me. It was a pleasure.