s6 e05: MCAS, POTS, & Hypermobility Part 1 with Michelle Shapiro, RD

MCAS, POTS, & Hypermobility Part 1 with Michelle Shapiro, RD

MCAS, POTS, & Hypermobility Part 1 with Michelle Shapiro, RD

Today, Michelle Shapiro joins me again for another episode! Michelle is an integrative and functional registered dietitian who has helped over 1,000 clients reverse their anxiety, heal longstanding gut issues and immune issues, and approach their weight in a loving way. Together, we discuss the complex world of long Covid, mast cell activation syndrome (MCAS), and histamine issues and Michelle shares her personal journey and insights on how chronic stress, gut health, and hypermobility intersect with these conditions. This episode not only provides practical strategies for managing these conditions but also emphasizes the importance of understanding your body’s unique needs. Michelle and I address how excessive mast cell activation can affect day-to-day life and pregnancy, offering a hopeful perspective on achieving full recovery through both conventional and non-conventional treatments.

This episode covers:

  • Understanding your unique body requirements and creating a specific system for introducing necessary nutrients
  • The critical role a hopeful and proactive mindset plays in managing and overcoming health challenges
  • Complexities of treating conditions like MCAS and POTS
  • Relation of hypermobility, nervous system, and connective tissue issues with MCAS and POTS
  • Importance to see the interconnectedness of symptoms
  • Function of mast cells and how COVID-19 can trigger MCAS

Mineral Quiz


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Reflux episode with Michelle
Compression socks
The Chop Levine Protocol (exercise protocol for POTS)
The Hypermobility Chiropractor we constantly mentioned
Gupta program
Study link for long covid

Connect with Michelle:

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Free Resources:

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Amanda Montalvo [00:00:01]:

Welcome to the Are You Menstrual podcast, where we dive deep into all things women’s health to support you on your healing journey. I’m Amanda Montalvo, functional and integrative dietitian, also known as the Hormone healing Rd. If you enjoyed this podcast and you want to keep learning, check out the podcast Patreon, where I share a bonus episode with additional downloadable resources. Each week you can go to patreon.com, hormonehealingrd or check out the link in the show notes. All right. In this episode, I am interviewing Michelle Shapiro. She’s been here before. If you don’t know her, that I would be shocked.

Amanda Montalvo [00:00:39]:

One of our most popular episodes on reflux. I feel like everyone knows who you are now, but we are going to be talking about Histamines today. So we did a whole episode on Reflux. Extremely popular. We got so many questions from it. A lot of them are histamine related. So we’re doing a whole two part series on histamine issues. Mast cell activation, pots, long Covid, hypermobility, all of the things.

Amanda Montalvo [00:01:03]:

And if you don’t know Michelle, she is an integrative and functional registered dietitian in New York City. She’s helped over 1000 clients reverse their anxiety, heal, longstanding gut issues and immune issues, and approach their weight in a loving way. She now has five nutritionists that work on her team as well, and they all work one on one towards these goals with clients. And she has her own podcast, quiet the diet. It’s really good. She has a lot of really good guests. I know you and Nikki do a lot of the episodes together now, and Nikki’s amazing. And really they’re focusing on bridging the gap between body positivity and functional nutrition.

Amanda Montalvo [00:01:43]:

And then her latest, like, big project, it’s a very big project that she has finally wrapped up is the highly sensitive body hub. And I’m actually in it. I have some lessons in there, but it’s this amazing, like, I can’t even describe. It’s not a course, it’s much more than a course. It’s just like this beautiful, organized resource hub for people in highly sensitive bodies. And it covers like all the different areas that you could be concerned with. Food, supplements, herbs, how to like start incorporating these things, things to consider. I have mineral lessons in there and how that impacts histamine issues, mcas, all that kind of stuff.

Amanda Montalvo [00:02:23]:

But Michelle does a lot. She’s the best. She’s also one of my best friends. And yeah, she’s here to teach us about Histamines and mast cell activation today. So thank you for being here, Michelle.

Michelle Shapiro [00:02:35]:

Any time that we get to spend a minute together is very joyous. And us doing it about a topic that you and I have been talking about for maybe five years is even more exciting. So I am so excited to be here. And I’m so excited to be here with all of you.

Amanda Montalvo [00:02:49]:

I know it’s something that, it’s like, we’ve talked about it so much about different clients and stuff, and then now all of a sudden, I’m like, it’s everywhere. Everyone, a lot of people have his pain issues. Mass activation has become much more, like, mainstream, I guess you would say. And I think we have a lot of theories on how this has happened post Covid, which we’ll talk about. But can we just start with, like, what is mast cell activation syndrome? Talk to us about histamines, and then we’ll kind of dig into the different areas.

Michelle Shapiro [00:03:22]:

Absolutely. So there are these immune cells, white blood cell, a type of white blood cells in our body called mast cells. And these cells are highly intelligent. They live in our connective tissue of our body, and they have many different roles. Some of our immune cells live in one place, and some of them travel to other places to communicate things with us. Mast cells are interesting because they can communicate with other cells and other parts of the body through these mediators that we send out, essentially. So what happens is something will attach to the outside of the mast cell, and they have these pockets inside of them with these different chemicals. And when the mast cell gets activated, it starts releasing a lot of those chemicals.

Michelle Shapiro [00:04:04]:

Mast cells are fascinating because they can be stimulated from fascinating and frustrating. They can be stimulated from immune reasons, they can be stimulated from nervous system reasons. Anything that feels like a transition, anything that feels like stress, anything that feels concerning, like, dangerous to these mast cells, will cause them to dump these chemicals into the bloodstream and through our tissues, and they will do many different tasks. One of the main mediators that we hear about is histamine. And the reason that histamines comes up so much and why we are all talking about histamines so much is because they tend to be one of the mediators that shows symptoms kind of the most directly they’re on our skin or in many other symptoms that we’re going to talk about. And essentially what happens is either those histamines can build up too much in the tissues in our bloodstream and can wreak havoc based on their, what their intended use is. So really quickly, I’ll tell you that histamines, they open up your blood vessels, essentially. And the goal of that is that you can kind of get nutrients to a place really quick.

Michelle Shapiro [00:05:11]:

You can get immune cells to somewhere really quick. This is a process called vasodilation, literally dilation of those blood vessels. So also because of this constant vasodilation, we can have other symptoms. Like, for instance, we could have blood flow issues that can create dizziness. There’s so many different symptoms just from that one action of histamine, let alone the many other actions that histamine has. And really, the goal of any of these mediators is to either alert the body that something is going on or to help to defend against an immune situation. So much like in autoimmunity, what this looks like in mast cell activation syndrome is a constant and chronic over activation of our immune system, which does very, very differently from someone being immune compromised in some ways. So this is really why we’ve been talking about histamine so specifically.

Michelle Shapiro [00:06:04]:

But we can definitely talk about other mediators that mast cells release. And also like, what these cells even are, I think we can talk about from a philosophy perspective, because they’re really so intelligent and intricate. They almost always release the exact thing that they know is going to get your attention the most or is going to give them the most bang for your buck. And they are very selective in what they release. And that can look like, again, if we have too much histamines, let’s use histamines as an example, again, floating around in our blood. Well, then we get those symptoms. In addition to that, it can be that we just are people who feel, in the case of histamine intolerance, reactions to having a normal amount of histamines floating around. So we can either be overreactive to existing histamines, we can be overproducing histamines, or we can have an inability to get rid of them.

Michelle Shapiro [00:06:53]:

And all of those can cause symptoms. And that’s true for all mediators, not just histamines.

Amanda Montalvo [00:06:59]:

It’s creating this inflammatory response in the body. And I think it’s important to say, like, we need some, like, mast cells are important, we need them to function. It’s interesting, when I was working on the pregnancy lesson for the highly sensitive body hub, I was looking at some specifics, because histamines are important in pregnancy, but obviously, if you have too many, you have a lot of unwanted symptoms. But mast cell activation is important too, and it’s actually important for implantation and everything. And I was like, oh, that’s really interesting. But if we have too much, then, of course, it kind of tips over. So it’s not that we never want any histamines or mast cell activation. We need this.

Amanda Montalvo [00:07:37]:

It’s an important part of our immune system function. It’s when it gets out, out of control and it’s happening at, like, every turn. Right? Like we were talking about, like, every transition, every, like, hard little, like, weather change. Yeah. Like, literally anything, like, hot. Like, temperature changes. Yeah. It’s just like, when that’s happening, that’s when we know, like, okay, this is a red flag, and it’s going to impact your day to day life a lot.

Amanda Montalvo [00:08:01]:

So let’s talk about what it’s going to. What could possibly look like for someone.

Michelle Shapiro [00:08:07]:

Yeah. I’m going to tell you honestly my story because I think it helps to lay the groundwork for what people might be experiencing. So I had mold exposure in my apartment, and then I had Covid. And I think of anything with mass salvation syndrome, as we call it, like the bucket theory, which I’m sure all of your listeners have heard of when it comes to autoimmunity or when it comes to stress that there’s kind of, like, this finite amount of tolerable inflammation, stress that our body can encounter before it starts being a little bit dramatic and a little bit overreactive, which is what kind of, you know, I have no problem calling myself and my body highly sensitive or dramatic, whatever we want to call it, but it gets that state of being basically in constant defense. And I think of also mast cells as being these, like, guards on a watchtower. And when something like Covid happens, and Covid specifically going to talk about more. I know, but it has our mast cells have receptors on the outside of them. One receptor, specifically, the ACE, two receptors that Covid just attaches directly to.

Michelle Shapiro [00:09:11]:

So a lot of what we see as long Covid is actually mast cell activation syndrome, which is really important and not in every case, but mostly. And that’s because our body not only has a problem from the initial immune response. So let’s say Covid happens, we have damage to some of our organs, maybe because of COVID but it’s that the body is so freaked out, Amanda, that this just happened that it starts defending you excessively. It’s like, is this Covid? Is this going to get me? And it basically has its guns drawn all the time to make sure that nothing’s going to hurt you. So in my case, the thing that scared the crap out of my body was having mold exposure going through a mold detox. And then having Covid, for me, fascinatingly, it was actually the mold detox, not the mold itself, that caused a huge histamine and mast cell issue for me. I started doing a mold detox within a day. I had a ten pound weight gain overnight.

Michelle Shapiro [00:10:09]:

And what it looked like for me, really, was tremors, dizziness, extreme dizziness, extreme tremors, severe insomnia. And this experience that, it was like, there was almost like, a black cloud covering my eyes, both, like, physically and mentally. And it put me into a state of anxious arousal all the time. I’ve been working with anxiety with clients for so long that I identified it as, like, this and myself. But I was like, this is a body anxiety thing. This is not a brain anxiety thing. And I remember literally on the night of my bachelorette, my friend Dan was sleeping over, and he was coming from out of town, and we were having, like, we were always the night before the bachelorette, I don’t drink or anything, so it’s not like we had to do any, like, physical prep here. Like, I wasn’t, you know, I don’t drink, and it was just my friends doing karaoke and being, like, weird, honestly.

Michelle Shapiro [00:11:00]:

So you were invited, obviously, but you had, like, babies, you know, it’s the whole thing. So I. When Dan was sleeping over and I was having these violent tremors all night, and what felt like, I just. I couldn’t explain this feeling of absolute dread, like, severe gut issues. It can show up for people as either constipation or diarrhea and extreme bloating. And it was just like, a man. The only way I can explain it is I thought I was going to die. I was like, this is.

Michelle Shapiro [00:11:27]:

I’m just going to die. I don’t know. This is the worst feeling. Your temperature is raised because histamine can alter temperature regulation, so you have all these changes in your vital signs. And that’s so scary for people, because when we have changes in our vital signs, like our temperature, our heart rate, our blood pressure, it leads us to immediately think something very, very serious is going on. That’s how strong histamine reactions can be, is that they can hit your vital signs. So that’s what it looks like for me. And I remember Dan Saying, michelle, are you having a panic attack? And I’m like, oh, no, I know what a panic attack is.

Michelle Shapiro [00:12:00]:

I promise you, I know what a panic attack is. This is not a panic atTack. And so I started somehow figured out that this was potentially a HIstamIne Thing, which was a very very, very hard road. Because the only thing we ever hear about histamines is that they cause skin rashes. And because they can show up differently in every person, it’s hard to know. Like, is this the thing? You know? So I basically did with doing so much research and honestly, to, in total transparency to all of you, I was looking on Reddit for answers because you can’t go into PuBMed and type, why am I dizzy in supermarkets? Why, why do I feel so bad on Day nine of my cycle? Even a resource like yours, Amanda, which I consider to be the most comprehensive, comprehensive resource in anything for women’s health, that is, that’s my true and honest opinion. It still doesn’t lead people to one direct question like that because that’s not how information exists. Right.

Michelle Shapiro [00:12:55]:

So the only place that it exists is, like, somewhere like Reddit. So the point being that the symptoms can be so huge, they can feel so scary and so severe, like these insomnia symptoms. I’ve had clients with mcas. I mean, they didn’t sleep for three weeks straight. And I’m not exaggerating when I say.

Amanda Montalvo [00:13:11]:

That, yeah, it’s serious. Like, it’s, it can be life altering. Yeah.

Michelle Shapiro [00:13:16]:

And especially quality of life. I think the bark is a lot worse than the bite for a lot of histamine stuff. Although I always want people to check in with their doctors anytime they’re having symptoms. And, you know, this is not suitable replacement for medical care or anything like that. But, um, the other thing about this is that when you go to, like, functional medicine doctors, a lot of the protocols that they’re going to give you are going to make Histamine issues worse because a lot of when that Mast Cell is on guard, when it’s ready to attack anything that comes at it, you give a little vitamin C that feels really threatening to the body. That’s high in histamine as a food. If you do a mold protocol, you start poking around, forcing and pushing detox. What that results in is, again, this body’s response.

Michelle Shapiro [00:13:59]:

The problem is you can’t really treat the root cause of things without causing a histamine response first. So it’s really important if you have felt a lot worse doing those things that everyone seems to feel amazing, you know, doing these things. Amanda, you even post about, like, low histamine adrenal cocktails because vitamin C from orange juice can cause these weird reactions in people. And you’re so sensitive to that, which is why, like, your audience is so freaking lucky to have you, because a lot of people aren’t talking about it because we are, like, the group of people, highly sensitive people who react the opposite to things that other people do.

Amanda Montalvo [00:14:33]:

It’s so true. And honestly, it’s the reason why so much, like, I’ve included it more in so much of my content is because it’s everywhere. I mean, and I was thinking about this when I was planning the episode. I’m like, okay, like, when did I really start diving in histamine stuff? I mean, I think it’s literally been since COVID and a lot, because a lot of it was like, okay, you might get, like, a small portion of your clients that, okay, well, this is definitely likely related. Histamines. They’re more sensitive, right. They don’t tolerate a lot of supplements. It’s not usually.

Amanda Montalvo [00:15:03]:

It’s like, a handful of people now. It’s like, I mean, I’m. I think at least, like, 60% to 70% of our clients were like, oh, you’re a histamine MCAs case. Like, everyone is being affected by this. And that’s why I’m like, okay, well, we have to have more resources because it’s an issue, and not everyone can work one on one with someone, unfortunately.

Michelle Shapiro [00:15:24]:

Absolutely. And. And it is such a self discovery journey because your body, when you have mcas, operates in a way that makes no sense sometimes, to be honest with you. And you have to learn the game of your own body. For instance, if I go into a room that has a bunch of bleach in it, I have no chemical sensitivities until last week. And then I was like, oh, my God, is this a thing now? I didn’t even know. I’ve never had that problem before. Everyone reacts completely differently to different things, like Amanda mind.

Michelle Shapiro [00:15:55]:

And your bodies are always a perfect example because we all have, like, opposite sensitive bodies where, like, the things that your body take in, like nothing, are very hard for me, but the things that are very, like, hard for you are easy for me. It’s just so interesting because there’s no roadmap that’s perfect. But when you understand the mechanisms of this, it’s so liberating and empowering, and I think that’s what’s so important. Even someone hearing me say before, why do I get dizzy? In supermarkets, people are like, what? That’s a thing that not everyone experiences. And I’ve been doing so many polls recently and finding that it’s about 50% of people. If I do a poll and I say, do you feel dizzy? In supermarkets, I will get 300 responses, no. And 300 responses, yes. It’s really, it’s coming down to that, though.

Michelle Shapiro [00:16:38]:

And there’s. There’s one study that I’m going to give you the link for that showed that about, in each state, about 20% to 35% of people are experiencing long Covid symptoms. And. And remember, like, long Covid means not the immediate reaction, but the response to the reaction. So we’re talking about potentially 100 million Americans who are experiencing this, and. Or I’m sure that didn’t capture every single person. I’m seeing the same thing, because, again, there’s that relationship between Covid and our mast cells that really, if we had any vulnerabilities in ways of having an overactive nervous system, if we had an overactive immune system, if our body was not properly nutrients dense, like, we didn’t have that density of nutrients within our cells that we needed to protect us, everything was exposed in the past few years, and it was like a level of illness that we were so unprepared for. And these symptoms, Amanda, they come on so strong, and they’re so extreme at times.

Michelle Shapiro [00:17:39]:

Sometimes people have smaller reactions. But in the case of COVID the vaccines, everything like that, it was like a bum rush for people who, some of them weren’t even chronically ill before. And they’re like, what the heck do I do with this?

Amanda Montalvo [00:17:50]:

It’s interesting, too, because, like, we have a. It’s like a different level of awareness depending on the person. So, like, we have some people that are like, you know, I’ve really thought about this. I’ve traced it back. This all started after I got Covid. Whereas we’ll have other people where they’re like, I definitely have. They think it’s definitely mast cell activation syndrome. And they’re like, it’s just constant histamine symptoms.

Amanda Montalvo [00:18:12]:

They jump around every day because we have histamine receptors all over the body, so they can look super differently for even not just person to person, like, but for you every single day, like, how sudden. You’re, like, sensitive to bleach and stuff, so. But they don’t. And then we go back on their timeline and we realize, oh, well, you had Covid, like, right before all this happened. And they didn’t even, like, necessarily make the connection because maybe they didn’t feel that bad.

Michelle Shapiro [00:18:37]:

We don’t feel that bad during COVID I felt fine during COVID by the way. I had a fever for three days. I don’t know, like, it was. It was. It’s much more because this is the trickiest part of this, the nervous system is so involved with mast cells, and there you even release histamines from your hypothalamus in your brain. So, I mean, it literally kicks off that HPA axis right at the beginning. I mean, yeah, and it’s absolutely true. So I think that, you know, people were not getting how dysregulated they were before and that their bucket was 99% full, because maybe you don’t feel symptoms until 100%.

Michelle Shapiro [00:19:10]:

And it seems like something so silly like this. How could it cause these debilitating symptoms in the long term? And it’s really just like our bodies threat signals are on so high, and in a way that it just hasn’t. I don’t think there’s been anything as impactful as the COVID vaccine and Covid itself to push us into that. And I’ll tell you when it comes to Covid, that my fascination with mcas and histamine started for myself, obviously, because I was like, I need to not be having tremors all night. Please. It was awful. Because I started looking up studies of long Covid, and this one study I found, because I don’t know why, I just started realizing maybe this is, like, a Covid thing, because it was a couple months after Covid, and the studies that I found were really surrounding pepcid, and I was like, pepcid, the acid drug?

Amanda Montalvo [00:19:57]:


Michelle Shapiro [00:19:57]:

I don’t even understand what this is about. And realizing that pepcid is actually an h two antihistamine drug, because it’s like, anytime you see a drug that has ine, it’s usually, like a famotidine. It’s like an antihistamine drug. And that’s where I was like, is this whole thing a histamine thing? What is going on with this? Because the study showed that of the people, I think, who had long Covid symptoms, they gave them 80 milligrams of Pepsi, which is a very, very high dose, and, like, not what is usually medically advised. And they had resolution of symptoms they had for months prior. And so I started taking pepcid. This is not an ad for pepcid, by the way, but really, this is true to my story. I started taking pepcid for my tremors, and, like, my tremors went away.

Michelle Shapiro [00:20:40]:

And this is not, like a hypo, like, psychosomatic thing where you, like, the tremors went away because I believed, you know, it was, like, within ten minutes, my tremors went away. And that’s because histamine is also one of these, it acts kind of like a neurotransmitter, but one of these chemicals that’s extremely arising arousing. So it makes you up, up that like zinginess, essentially. So oftentimes if I’m looking at like h two support, which actually, like ginger works in a similar way to pep, that pepcid does too. It’s, it’s actually because it’s working on the gut. The h two receptors are in the gut and it’s actually working on the vagus nerve too, which is so wild. So now Pepsin’s being studied for like depression and really interesting things.

Amanda Montalvo [00:21:23]:

That is really, and I will say, like, you couldn’t take anything. I mean, you, the, you were taking the lowest, like micro, micro doses of even just like b vitamins. Like any supplement you could not take. So, like, to be able to take that much pepcid is a big deal.

Michelle Shapiro [00:21:41]:


Amanda Montalvo [00:21:41]:

And it definitely was not a fluke.

Michelle Shapiro [00:21:43]:

No, exactly. And you also, I mean, I’m glad you brought that up too, because you and Jillian. Jillian grieves are their bestie, were the two people who I went to and I went to the best functional medicine doctors, the best naturopathic physicians you could ever find, who are my closest friends. No one knew what to do. It was you guys having this intuition around this stuff. And honestly, Amanda, I think about your pregnancy with eliana, and I’m like, you were histamine. Duh. And we didn’t know exactly.

Amanda Montalvo [00:22:09]:

I was a histamine. I was a histamine.

Michelle Shapiro [00:22:10]:

You were a histamine. You were. I know. And it was, I think back to it, where again, we, like, knew it was reflux. We knew, like, these connections, reflexes also.

Amanda Montalvo [00:22:19]:

Seen as very normal during pregnancy. And as your belly grows, it can be from multiple things, like, literally, like pressure. So it wasn’t for me, though. So it’s like. But like, I think that’s where it can be tricky to deciphering stuff in pregnancy, but 100%.

Michelle Shapiro [00:22:36]:

Yeah, I mean, and that’s like the, again, this complicated part. You know, we even Amanda, like, where Amanda’s fire is. Amanda, you’re not going to get tremors at some point, but you’re going to get, like, bright red. You know, like, it’s like we, we have such different bodies and it makes it so I did a whole episode on Olivia of Organic Olivia’s podcast, what’s the juice? And, like, Olivia’s symptoms that she spoke about on the podcast were like, she pees 15 times a night. And that’s the tricky part of mast cells and mast cell activation syndrome is they’re in all of the connective tissue of our body. So they’re in every single organ system, every single tissue. Like, they’re. They’re in everything.

Michelle Shapiro [00:23:15]:

So the symptoms can show up in so many funky ways. And those symptoms can be very extreme because the body’s like, I am going to get your attention, and I am going to defend you at all costs, essentially, yeah.

Amanda Montalvo [00:23:27]:

So if you are someone that has experienced, like, weird symptoms, you’re not sure where they’re coming from. They feel like they’re all over the place. They could possibly be concerning, like, things like with your heart rate, things like that, dizziness. I mean, those are scary symptoms. Then it could possibly be related to mass cell activation, histamine issues. And that’s an area that we would recommend exploring more. We’re now we have to talk about pots. I’m like, we have to, like, stand up everything.

Amanda Montalvo [00:23:54]:

So we have so much to cover. If you’re listening to this episode and wondering if you may have a mineral imbalance, you can head to the description of this podcast or my website, hormonehealingrd.com, and take my mineral imbalance quiz. It will give you a rating of low, moderate, or high risk based on your answers to questions mostly related to symptoms that you may be having. And from there, you can take my free mineral training. That is really where I recommend everyone start with supporting their minerals. It’s going to walk you through three ways you can start doing this at home today. So let’s talk. Everyone has pots now.

Amanda Montalvo [00:24:32]:

I mean, so many of our clients, it’s like something that, again, like, you see it, you know, every once in a while before, but now it’s like, oh, half of our client applications are pots and mast cell activation cases. So can you talk more about what is pots? How the heck does it have to do with mast cell activation syndrome? And then we’ll go into, like, what it looks like.

Michelle Shapiro [00:24:53]:

There’s nothing I’d rather do than have this discussion, honestly. I’m so excited. So pOTS is postural orthostatic tachycardia syndrome, which means when you make positional changes, you have heart rate changes or quick heart rate. What this looks like is someone kind of standing up too quickly, and then either having that blackout sensation, which is more, we see an orthostatic hypotension, or, oh, or you stand up and then your heart rate starts pounding, even when you’re not, like, exerting that much effort. And the, the other kind of symptoms that pots has that I think aren’t talked about as much are like, vision changes, having visual snow. I have a lot of clients who describe it as having, like, um, a brick in your head or something like that. Like, it feels like if you move your head to the left clunk, you move your head to the right clunk. Like, and a lot of blood flow issues.

Michelle Shapiro [00:25:45]:

I mean, that’s, that’s really what’s characteristic. Here’s the craziest thing about pots in the entire world. POtS is a dysautonomia condition. It means dysfunction of your autonomic nervous system. When people hear pots, what do they think? Amanda? They think this is a cardiac condition, right. This is where you would go to a cardiologist. Your heart isn’t working well. It’s not actually that your heart isn’t functioning properly.

Michelle Shapiro [00:26:09]:

It’s that your nervous system directs. Where does blood flow go? Our nervous system, everything starts in the brain, right? So it’s, it’ll say, our brain will detect this area needs blood flow. This is how things should function. It will send the blood flow to the area. So when your nervous system is off, when the nerves from your brain are sending that signal to the rest of your body to go here, pump here, do this, and which muscles should activate. Also, what ends up happening is you get funky heart rate issues. Here’s what makes mcas and pots so challenging to diagnose is that you can’t really go to most cardiologists with this because they’re going to do an ekg, and they’re going to say your heart looks fantastic. But it’s not actually a heart condition.

Michelle Shapiro [00:26:52]:

It’s actually, and by the way, there is actually people who are hypermobile and have pots and do have heart conditions. So I’m not saying to not go to a cardiologist. I’m definitely saying still go to the cardiologist. And there are actually interventional cardiologists who diagnose pots. The way they would diagnose it is they would put you on a table and they would do something called a tilt table test, and they would see what happens when your heart rate’s at rest versus when you stand up and start walking around. Now, if you want, if you want to let me keep rambling, I’ll talk about why that heart rate thing happens. So a lot of times, people with pots will also be in a shower, like a hot shower, and get incredibly dizzy and their heart’s pounding. I definitely experienced this and another part of my story.

Michelle Shapiro [00:27:31]:

I can talk about is that a neck injury actually kicked a lot of this off for me, which was extremely odd. So basically, what’s happening when you go into the shower is there’s more of this, what we would call, again, vasodilation action. That happens. So I’ll start you back from mcas to talk about the shower thing. Histamines cause vasodilation. Your blood vessels are wide open. When you’re standing in a shower and it’s hot, there’s a double vasodilation issue, and you have histamines. Histamines make your blood vessels open.

Michelle Shapiro [00:28:00]:

You’re standing in the shower and you don’t have a good constriction. We need vasoconstriction. We need our blood to pump. Right. It has to get to us somehow. So what happens when you’re standing up for a long period of time and or in the shower? A lot of people with pots will experience this. Also, when they’re standing at a supermarket, they’re standing at an amusement park. Anytime they’re just standing in one position, all the blood drops to your feet.

Michelle Shapiro [00:28:23]:

Not all the blood. A lot of the blood in your body drops to your feet. That’s when they’ll start seeing that redness in their feet, because that’s actually blood at that area. And then your heart goes, oh, my God, please give me some blood up here. We need some blood for the brain and heart, so it forces your heart to pound really quickly and vasoconstrict to get the blood flow back up. So what’s really helpful for people with pots is, like, doing things like putting their feet up on the wall when they’re laying flat, so that the blood flow is directed back towards their heart. Doing things like, you know, anything that it’s like wearing compression socks, because the compression socks creates. I’m wearing them right now.

Michelle Shapiro [00:28:58]:

It creates that vasoconstriction. A huge recommendation for pots also is sodium, which is like, I can’t even talk about sodium on the re menstrual podcast. I have to let Amanda talk about it. Like, please. But really, the whole deal with pots is that, in my opinion, people are missing that. The precursor to pots is often mass saltivation syndrome, because your blood vessels are constantly vasodilated and you’re not getting that juicy blood flow back. So if you are treating pots without treating mcas, you have to start looking at mcas too. Oftentimes, they go hand in hand.

Michelle Shapiro [00:29:30]:

And I do not think this is talked about enough.

Amanda Montalvo [00:29:33]:

I agree. I 100% agree. I will say a lot of our clients come to us with pots as a diagnosis and a concern, amongst other typically hormone issues, wanting to conceive, which can be really scary if you’re like, I’m struggling with all these really terrifying symptoms, and what am I going to do if I have a baby as well? I’m, like, holding my baby and stuff. I’m like, I totally get that. And a lot of it comes back to, we’re talking about their gut health and then chronic stress, and then we can go through their health timeline, and it’s like, okay, well, your body’s incredibly inflamed right now. And this is definitely mast cell activation syndrome. It’s not just pots, but it’s really hard. Like, I think there’s typically, like, one blood test that most people will have, like, a functional medicine doctor run to see if they have.

Amanda Montalvo [00:30:23]:

Yeah, to see if they have mast cell activation syndrome. And then from there, it’s like, if it’s not positive, then they’re like, oh, I don’t have that. I already, like, looked into that. I’m like, that’s not quite how it works. We need to look at it.

Michelle Shapiro [00:30:36]:

So can we talk about the testing for testing? So the testing, again, we talked about the testing for pots. The testing for MCATs is what they can do is they can run, like, a urinary histamine, right? So you can look and see, are there histamines floating around your urine? Are you excreting them? They can run a blood histamine. They can run a blood tryptase, like a serum tryptase, not blood. And the serum tryptase is another one of those mediators that’s released. So basically what they’re doing in testing for MCAs in this way is they’re looking to see, do you have extra mediators floating around? Essentially, there could be days where you don’t. That’s the problem. And also, they don’t live there necessarily. They live in your connective tissue.

Michelle Shapiro [00:31:15]:

So it’s not that it’s going to be at that exact moment. So I really feel the gold standard for MCAs is actually having a biopsy of the skin or of the GI tract, and they can see the activity of mast cells there and the presence of mast cells there. So that’s always a route to go. And I wouldn’t have people be discouraged if you’re like, I feel a million times better when I do things that work with histamines, but it’s not showing up in my blood or serum. They’re not reliable tests, and I think any functional medicine doctor will tell you that, and they’ll appease you in running the test, but it certainly wouldn’t discourage me. I was one of those people who did have, like, high histamine in my. I remember sending it to you too, Amanda. And I was like, it just, it still doesn’t tell you enough of the story.

Michelle Shapiro [00:32:02]:

Anyway, you kind of have to work with your symptoms because you’re not going to get resolution from knowing that you still have to do stuff. You know what I mean?

Amanda Montalvo [00:32:10]:

So basically, what we’re thinking is that people have mass untreated mass cell activation syndrome, and that is what’s leading to the pots diagnosis down the road.

Michelle Shapiro [00:32:24]:

Yeah. And I think that there’s a triad, which we’ll, we’ll talk about. The third member of the triad, which is hypermobility, is another member of this triad, too. So I think that where people can be, I think about 50% of the population has some level of hypermobility. I think people can have asymptomatic hypermobility, which is just basically when you’re. It’s actually in its genetic form, it’s a. It’s a connective tissue disorder. And connect.

Michelle Shapiro [00:32:50]:

We can’t really talk about, like, all these conditions without talking about connective tissue. Connective tissue is. Is present in the lining of your blood vessels and the lining of your joints. It’s a specific type of tissue that is essential to many different forms and functions within the body. In hypermobility, you have an inability to create or maintain connective tissue. And what that looks like is you have loosey goosey joints, you have loosey goosey blood vessels, potentially, and that can tie into other issues. You’ll have heard me say in the beginning of the episode that mast cells reside in your connective tissue. So what’s characteristic of these three conditions is they’re related to your nervous system, and they’re related to your connective tissue.

Michelle Shapiro [00:33:36]:

So anything that impacts either of those and your immune system, I would say as well, anything that impacts any of them is going to impact all of them. Now, here’s where I think pots not only ties into mcas, but where it ties into that hypermobility too. I think that a couple things happened that made the picture for pots so much worse is a, we had this mass cell activation syndrome, which caused the constant basal dilation, which then caused leaky blood vessels, and that led to pots like symptoms. And then if you have hypermobility already, your likelihood of having those leaky blood vessels is already higher. And there’s also this part about pots, which is this deconditioning, Amanda, which is that people during COVID were not moving as much. They were very deconditioned. And when you’re deconditioned and you don’t have proper connective tissue blood vessel function, you’re not making your blood vessels in your heart work for you. Basically, this kind of cascade of things can happen.

Michelle Shapiro [00:34:34]:

So we had this huge storm of immune and nervous system issues, and then we had severe deconditioning. We’re not getting our blood pumping. Our blood’s just sitting there. And then we. If someone had hypermobility, it kind of became this, like, huge cluster of horrible symptoms for people.

Amanda Montalvo [00:34:53]:

I also think that hypermobility is just not easily diagnosed. Like, it’s just not. We don’t have an incredible, like, awareness of it in, like, the medical community, and so. But now I know, like, a lot of our clients have used, like, genetic testing in order to, like, get the proper diagnosis and have. But it’s like, I would say I don’t have any clients that have had this, like, come up after Covid. The only the clients that we’ve had with hypermobility, they do have the triad, so they have hypermobility. They have mass activation syndrome and pots, but they’re like, oh, I’ve been struggling with the hypermobility my whole life. I just couldn’t get anyone to listen to me, which I find very interesting.

Amanda Montalvo [00:35:36]:

But it’s, I think because of all, everything coming from COVID and it’s like, hypermobility has definitely more come to the forefront in the last few years. More people are talking about it. We actually have testing for it that you can ask your doctor for. I think social media helps, too, because there’s a lot more people online talking about it. So, like, the awareness has just. I think TikTok helped.

Michelle Shapiro [00:35:58]:

TikTok helped with pots and hypermobility, I think.

Amanda Montalvo [00:36:01]:

Yeah, I don’t know, but I’m.

Michelle Shapiro [00:36:03]:

I have no doubt been on Instagram. I’m also not on TikTok because I was too scared of the people on TikTok, so I deleted my TikTok too. I’m too scared.

Amanda Montalvo [00:36:10]:

I’m just like. I’m like, I don’t have time for another thing. I just will enjoy myself on Instagram. But I just think the awareness has increased a lot. And so it’s like, yes, I think it has for sure come from post Covid and all that. It totally makes sense. It’s just interesting to me because I’m like, man. Also, all these people have had hypermobility their whole lives, but they haven’t had the pot symptoms or the mouse activation.

Michelle Shapiro [00:36:33]:

Or the hypermobility symptoms. They haven’t necessarily. You can absolutely be asymptomatic with hypermobility. I want to make another, like, another discriminating comment about this so that people understand hypermobility doesn’t mean flexibility.

Amanda Montalvo [00:36:47]:

Yeah, it doesn’t.

Michelle Shapiro [00:36:48]:

It doesn’t mean that you’re flexible. There are people who are double jointed because of it. I’m like, I’m like, you know, my dad said the other day in a text to me, he said, I am a stiff, schlubby slug. That’s what he described himself as. And I was like, that sounds like me too. I understand. It’s not. You can be very stiff, and I’ll tell you why that happens in hypermobility.

Michelle Shapiro [00:37:07]:

So there’s something characteristic to both pots, and I see in hypermobility something called coat hanger pain, which is basically like the back of your head going into your shoulders. Like, it makes a triangle like that. And I think people experience it as, like, pulling down, because the nervous system is involved with hypermobility as well. Basically, our nervous system will tell us not only where blood flow should go, but what muscles should operate. Now, what happens with hypermobility is basically, we will kind of sublaxate or, like, dislocate a joint, because we have very. We’re like bobbleheads, basically. So we’ll have especially in, like, severe. I’m very.

Michelle Shapiro [00:37:43]:

I have a lot of upper cervical instability, which is hugely related to pots, also hugely important to talk about. And what will happen is if there’s something that goes, like, a little bit out of place, or is a little bit. A little, the joint is not in the right place, essentially, it will kick off your muscle and your nervous system to say, go directly and make that muscle tighten up to hold your body together, basically, because your joints are loose, but your body needs to be stabilized. So when we feel that tightness, what it is is essentially you’ve probably moved. We also have often an inability to build muscle, but you probably move something out of place, and then the nervous system freaks out and tells that muscle tighten up. Please stabilize us. Because if you had a bobblehead and you kind of put, like, two bricks on the side, right, to really stiffen and tighten, it would hold you together. So all of these things happen.

Michelle Shapiro [00:38:35]:

And again, what I noticed with mcas, pots and hypermobility is people go into what I would call flares. And those are systemic. Those happen throughout the entire body. So they might, like. You can hear. I’m, like, coming out of a little bit of a flare because I was flying, but you can hear my voice. Like, I’ll get some swallowing issues. I’ll get some, like, weird eye stuff going on, and then I’ll also get muscle pain, basically, which happens.

Michelle Shapiro [00:39:00]:

And characteristically, often in people with hypermobility. Knees, lower back, coat hanger, which will happen in pots, too, because your body can’t get that blood flow up. So anything that triggers the joints out of place is going to trigger mass cells, and this. It’s going to trigger the pot symptoms. And sometimes when people have the triad, they can have symptoms from just hypermobility. One day. They can have symptoms from mcaTs. But I can tell you there’s characteristic things like extreme stress, over exercising, not having enough minerals that are going to affect all three.

Michelle Shapiro [00:39:33]:

And they kind of go in this cycle. So you have to kind of crack into the cycle wherever you can to help with symptoms.

Amanda Montalvo [00:39:39]:

And I thought it’s interesting that you mentioned, like, the inability to put on muscle. So what. Why. Why do you think that is with hypermobility?

Michelle Shapiro [00:39:50]:

I think it’s just because it’s a connective tissue issue. So it’s just they’re. They’re less likely and less able to build muscle as a result. Yeah. Like, I. You’re not hypermobile, by the way, Amanda. And you don’t have pots, either. You’re just mcats, if anything.

Michelle Shapiro [00:40:05]:

Like, you’re a hit. You’re maybe a histamine intolerance person, but our bodies are, like, the exact difference. And also, like, growing up, I always. My knees. You know, I was joking with Taylor Goldberg, who’s on Instagram, is the hypermobile Cairo. She’s, like, in the highly sensitive body hub. She’s our hypermobility person. I don’t even feel equipped to talk about hypermobility.

Michelle Shapiro [00:40:23]:

I’m basically repeating what Taylor’s taught me.

Amanda Montalvo [00:40:27]:

I’ll have her on the podcast for sure.

Michelle Shapiro [00:40:28]:

Yeah, you guys will be obsessed with each other, by the way. But, you know, I did my. I did an assessment with Taylor for hypermobility when we first. Cause she’s my trainer, too. Yeah, she’s a chiropractor by trade, but she trains. And I was like, do you think I’m hypermobile? And I literally stood back from the camera, and she said, your knees are in the back of the room, Michelle. She said, I. She’s like, literally, your knees.

Michelle Shapiro [00:40:47]:

My knees always go backwards, which is like, you can see my hands, too. Yep, I have extremity hypermobility, she’s told me, and I’ve run the genetic testing and stuff. So it’s Ehlers Danlos, she’ll tell you. There’s 13 different types of Ehlers Danlos, by the way, on the podcast. She’ll tell you a lot more than.

Amanda Montalvo [00:41:02]:

I will, but, gosh, I can’t wait for that episode. Yeah, she’s.

Michelle Shapiro [00:41:06]:

Oh, she’s a wiz. Oh, my. Taylor’s amazing. I could just talk about how much I love Taylor as an episode and then you too. We could just do that for now. But Taylor, really, again, what the goal is in any work with hypermobility and pots is restabilizing the body through building muscle and really through redirecting the nervous system. Because if you’re also, your ability to build muscle is going to be reliant on the nervous system as well, and obviously on synthesis of longer chain amino acids and building those proteins and building that up in your body. It’s really, really important.

Michelle Shapiro [00:41:39]:

So it’s interesting because half of the work Taylor will do with people with hypermobility is actually on their nervous system. And then with cost, clients come to me and they’re pissed because they think they’re getting a cool little meal plan. And I’m like, we need to do so much work on your nervous system that I’m giving you a ten page plan, and seven pages of it is going to be, how are we working on your nervous system? And I don’t mean go breathe. That’s not what I mean by nervous system work. It’s how do we make your environment and your body feel safe again? That’s really what it’s about. And whatever that looks like is what it looks like. But it’s not just go do some breath work. That’s not really what most people.

Michelle Shapiro [00:42:15]:

It’s going to give them the most bang for their buck.

Amanda Montalvo [00:42:17]:

So. And one thing I just want to highlight, because I don’t think a lot of people realize this is like, when you’re having a histamine response to something, it is an alert, like a stress response in the body. So I think that’s why, too, with that mast cell activation syndrome, it’s like driving this really strong, and it’s a chronic stressor, chronic stress contributes to it, and then it further drains you. Because all of my clients that have mast cell activation syndrome pots hypermobility, most of them are either a fast four metabolic type on a hair test, which is like we’ve driven into the ground. We no longer have any mineral resources. The body is, like, beyond exhausted, but it’s still stressed. Or they’re like a slow one with really low minerals. But either way, it’s like, they have very low mineral levels.

Amanda Montalvo [00:43:04]:

You can see that they’re chronically stressed in that. And then that is another stressor, like, for your body. So that’s why it’s such a. It’s like such a dance to get out of this state, and it is. So it just takes time. It takes experimentation, and, like, there’s no perfect roadmap for doing it. That’s why, like, you’re talking about, like, what makes someone feel safe. And that’s what’s gonna help their nervous system, which is gonna look totally different for two different people.

Amanda Montalvo [00:43:33]:

But it is. It’s like, you have to ease the nervous system. You have to really slowly replenish, because once you start replenishing minerals and different nutrients in the body, it’s like your. If your body’s still stressed, it’s like, oh, sweet, I’m going to use all these up so I can respond to this stress now. So it’s a very, like, intentional, like, you can’t ignore the nervous system piece. You can try to just, like, throw nutrients and supplements at it. You will probably feel worse. And I’m sure people listening to this that have struggled with this have already tried that.

Amanda Montalvo [00:44:01]:

So it’s like, it’s so important to recognize, like, how important that nervous system piece is. There’s a lot of talk about the nervous system out there. Irene line is my personal favorite resource for this. I will link the podcast episode I did with her. She has so many nervous system exercises, and they’re not breath work. It is like paying attention, noticing your. It’s a lot about your environment starting to not be as afraid to, like, pay attention to how you feel in your body, because that can be really hard if you’ve been struggling with these symptoms. But it’s, like, orienting to yourself, and it’s learning your nervous system.

Amanda Montalvo [00:44:37]:

Not like watching someone on Instagram talk about, like, oh, how do you support your nervous system with, like, here’s five tips to support your nervous system. It’s like that, like, half of those could send someone probably into a flare, you know? So it’s like, I know it.

Michelle Shapiro [00:44:50]:

I know. It certainly sends me into a flare to hear you even talking about it.

Amanda Montalvo [00:44:53]:

I know, I know. So don’t, like, don’t feel if you’ve tried those types of things for nervous system support. Don’t let that discourage you or, like, deter you from wanting to dig into it more. And do we want to talk a little bit about mass activation nervous system a little bit more? And then we’re going to talk about, this will be the end of the first episode and we’re going to get into, like, what the heck can we actually do about this?

Michelle Shapiro [00:45:16]:

Absolutely. Yeah, I absolutely want to talk about that because I think we, the piece of it that is most important in all this is not only our nervous system, but our limbic system. And our limbic system is a different connection of brain structures and how they interact. And our nervous systems like them connecting through the rest of the body. Right. But the limbic systems within our brain. And basically what is happening in these conditions and what I think makes them so scary. And I mean, that I wasn’t experiencing anxiety when this was happening.

Michelle Shapiro [00:45:47]:

But, Amanda, I was in a moment where I was like, am I never gonna get better? And I never said that before. I was messaging you that too. I was like, what is the, like, what is gonna happen here? And then once I started saying that, and I said it out loud once to myself, talking to myself, and I was like, hey, Michelle, you cannot afford to ever say that again. Do not say that again. Because our nervous systems are listening to us and our limbic systems listening to us. So it’s not only that we have to basically have these symptoms, but we have to be, like, really non reactive to them. I just want to say this to everyone listening. I don’t think any of this is fair.

Michelle Shapiro [00:46:22]:

I just want to tell you, I don’t think the fact that we have to have these symptoms to, like, learn the wisdom of them and non react to them, I don’t think what I’m asking of people is fair to say that, but it is. What I am asking of people is to become non reactive. And I know in part two that’s going to be a big premise of it also. But it’s really about if in the throes of symptomatic versions of these conditions, syndromes, syndromes means they can come in different ways at different times. They may go away, they may come back. Right. It’s a cluster of these symptoms, essentially, and this body reaction. But in the throes of it, it’s so important that we do what we can to tell the body that we’re safe.

Michelle Shapiro [00:47:04]:

That is the only way out. If you talk to one person who’s in kind of like, remission from these conditions, they will tell you the whole game is the nervous system in ways of safety. The whole game is safety. There’s just not any other pathway out and forward without your body believing it. And I think that it’s really corny to say this, but the second you start believing you’re not going to heal, you will stop healing. So it is true, though.

Amanda Montalvo [00:47:28]:

I mean, it’s, it’s, and this is like, not woo woo. This is like scientifically proven. How our mindset and thoughts impact our immune system is a big one. There’s some really cool studies on, like, negative thoughts versus positive thoughts and the different immune system reactions they cause. So it’s like, there’s, it’s out there. I think it’s just, it’s not just like quite like displayed or like laid out for people that way. I did a really cool episode on Healing Mindset with Teresa. She’s got like tapping with tea, she’s got like this tapping membership and stuff.

Amanda Montalvo [00:48:03]:

But she talks about like, this limbic feedback system and like, so you get a symptom and then what is your, your body or even like a thought, like you have, say you have a thought like trigger. You’re nervous that you’re, you’re like about to go do something in the past, it’s caused flare and you’re nervous and then you start to have these thoughts and then your brain recognizes that and you, it will go through that same process that it’s been to a million times because you’ve had these symptoms a million times and it’ll just continue that. Or I always think of like supplements is like a big one for this population. Like, oh, I’m going to try to take this supplement because of x, y, z. But it’s like every time they try a new supplement, they have an awful experience. And so even before they’ve tried the supplement, their body has already decided what’s going to happen as a result of taking it. So it really is this. And it’s like, and the whole point is that it’s supposed to like protect you, you know? So it’s not something to be frustrated about with our bodies.

Amanda Montalvo [00:49:04]:

Like, they’re trying to protect us. They’re trying to keep us safe. It’s more just like, okay, this is dysfunctional at this point, so how are we gonna stop this? We’re gonna take control. We’re actually gonna stop it and show it another path and that it can heal and that this is how we’re gonna do it. So it’s not impossible to heal. I think listening to this episode, you can you hear all the connections? And you’re like, oh, my gosh, this makes so much sense. Like, oh, I have this symptom too. Or maybe you have pots and you’re like, you know, I’m gonna look into this hypermobility piece.

Amanda Montalvo [00:49:36]:

Maybe that’s a piece of it for me. It doesn’t mean it’s not just another diagnosis. It’s a piece of the puzzle, and it’s gonna help you understand what resources are actually gonna help you heal and make progress versus just, like, spinning your wheels. So try not to take this information as, like, a, oh, my gosh, it’s like doomsday. No, this is to empower you and to make it so that you know, okay, this is what I’m going to research next. It’s also why Michelle made the highly sensitive body hub, because of. It’s really hard to find this information all in one place and covering all the different conditions and how they relate to each other. So the resource is there.

Amanda Montalvo [00:50:13]:

But even if you’re going to go off and do your own research, like, look at them together and try to, like, make sense of, like, okay, well, if that’s being recommended for that, but that might flare my mast cell activation, maybe I won’t do it. Maybe this isn’t a good fit for me because I think that’s, like, where a lot of the confusion comes in is like, should I do this? This person said to do this for that condition, but I have, like, all these other things going on, so no one knows your body like you do.

Michelle Shapiro [00:50:36]:

It’s there. Even these. All these conditions. Like, for instance, we really need vitamin C in order to, like, build connective tissue, to build collagen. But when we take vitamin C and we have mass altitude syndrome, we get, like, a flare from it. So it’s really just about knowing what your body needs and then making a system for introducing it. That’s very specific, which I know we’re about to talk about, that’s gonna be released next week. I also will tell you that this mindset piece of things, we almost have to find a version of us that we don’t even believe exists.

Michelle Shapiro [00:51:14]:

And, like, I had to find, like, this part of me that was, like, recklessly hopeful and was just like, oh, we’re doing this. And, like, I don’t have voices like that. I’m a New Yorker. We don’t have voices like that. You know what I mean? Like, we’re not. We’re not recklessly hopeful. We’re recklessly not hopeful, you know? And I think that that’s what we have to find within ourselves, too. And I just want anyone listening to know, like, wherever you are right now, there’s always a tomorrow.

Michelle Shapiro [00:51:39]:

Like, there’s always, always something you can do. And I will tell you, and I promise this. I have never been more hopeful about these conditions or about understanding the human body as I am today. And I. The more that I’ve experienced, the more than I’ve learned. I know. And, Amanda, what the people we’re talking to have been to, like, every conventional medicine doctor. When you and I started our careers, Amanda, we were dietitians and then quickly became functional dietitians.

Michelle Shapiro [00:52:04]:

And when we first started, the whole thing in functional medicine was, this is the place for people who have failed out of conventional medicine, who conventional medicine has failed, I’d rather say. And then now, Amanda, who we’re talking to is the people who functional medicine has failed. I know now that’s our clients now. And you and I were always the people where, like, we were always the last stop on the train, where, like, people have gone to every conventional doctor, and now we’re at a place where it’s the people who have gone, they’ve done mold detoxes, they’ve done parasite protocols, and they got worse because the way that the game is played in the body with mcats and pots and hypermobility, it’s like all these practitioners are playing, I don’t know, darts and, like, it’s a game of chess. So once you learn the game, you really have the power to fix it. And I fix symptoms or you can’t fix hypermobility. It’s a genetic condition. But fix as much as you can and fix the experience of your quality of life so much.

Amanda Montalvo [00:53:01]:

Yes. And that’s. And that’s really our goal. So that’s going to wrap up part one. Next week. We are going to talk about. We’re going to go through, like, what is the conventional treatment for the different conditions that we’ve gone through today, and then what they’re missing, because it doesn’t mean we don’t do any of the conventional. I think that’s important to mention, like, you definitely do.

Amanda Montalvo [00:53:22]:

It’s just that they don’t get you to. They might get you, like, maybe 20% better, and you’re like, okay, well, it helped a little bit. We’re going to talk about how to get you to that 100% better. So we’ll talk about that next week. So make sure you tune in and just thank you so much, Michelle, for being here. I appreciate it more than you know, and we’ll see you guys next week. Thank you for listening to this episode of the Ru Menstrual podcast. If you want to support my work, please leave a review and let me know how you like the episode.

Amanda Montalvo [00:53:53]:

This lets me know, like, what you guys want more of, less of. I read every single one and I appreciate them more than you know. If you want to keep learning, you can get access to the bonus episode and additional resources on patreon.com hormonehealingrd. I’d love to have you in there. Thanks again, and I will see you in the next episode.

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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