Episode 33: Dr. Heather Moday, MD on Inflammation, Autoimmunity, and the Four Immunotypes

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SPEAKERS: Dr. Andrew Wong, Dr. Heather Moday

Didthat there’s a superhero inside you. It’s called your immune system. Is your immune system strong. Is your immune system balanced or ideally is it both. We’re going to be talking about these topics today with Dr. Heather Moday.

Dr. Moday is a functional medicine doctor who specializes in immunology and has a new book about the four immunotypes called The Immunotype Breakthrough. This is a personalized plan for how to balance your immune system optimize health and build lifelong resilience.

I am Dr Andrew Wong, co-founder of Capital Integrative Health. This is a podcast dedicated to transforming the consciousness around what it means to be healthy and understanding the root causes of both disease and wellness. And in this Podcast we’re going to really focus today and take a deep dive into the immune system. Join us for a conversation about how supporting your immunity using sleep, stress reduction, nutrition, and much more can help to strengthen and balance your immune system.

Dr. Wong

Welcome heather to our Podcast. Thanks so much for being on today

Dr. Moday

Thank you Andrew. It’s really fun to be here

Dr. Wong

And of course it’s so nice to reconnect with you after our fellowship days. This was actually like eight years ago now I think which seems like a long time

Dr. Moday

I know! It seems like not long ago but at the same time it seems a long. I feel like a lot has gone on

Dr. Wong

Yes absolutely not the least of which is the pandemic and I don’t want to get too heavy right away but I know we’re talking today about the immune system. I want to give you and congratulations first of all this amazing book, new book that you have written called The Immunotype Breakthrough, which is basically and basically the subtitle I want to read this out because I think it’s really great for listeners to hear this your personalized plan to balance your immune system. Optimize health and build lifelong resilience. I just love that that title and just kind of going through the book and reading it myself. It’s an amazing book so everyone needs to check that out we’ll. Have more about that at the end here but I wanted to also say that Mark Hyman who I know is one of the functional gurus that we learn from and follow in IFM ( Institute for Functional Medicine) said that this is the most important guide available today to understanding and optimizing your immune function. So that’s really high praise from Dr. Hyman, so that’s congrats.

Dr. Moday

Yeah, I was really I mean I was really humbled to get that. Quite honestly it was pretty amazing. I’m glad that he liked it and I hope that other people get a lot out of it when they read it.

Dr. Wong

Yes definitely. Let’s talk first about the immune system. I think let’s take a deep dive in a little bit but starting broad first generally speaking what is our immune system. We’ve all heard about it over the last couple years. We’re all concerned about how to get the immune system sort of up to speed. To speak but what is their immune system and why is it so important

Dr. Moday

Our immune system is a system of cells and organs. Also I would say chemicals right. The immune system really is present in all parts of the body. Tt’s not like other organ systems where like the heart of the lungs that you might just have like one organ system in one place. The immune system really is everywhere and that’s because we need immune activity everywhere and so there’s a whole series of different kinds of cells that have very

specialized jobs. There are organ systems or organs that play a very big role in providing places for these cells to develop and then also to hang out and sort of be ready but also a lot of the tissues of our body have immune function. We don’t really think about this but like our skin, the lining of our intestinal tract, the lining of our respiratory tract. Our stomach acid, a lot of enzymes. They actually play a role in our in our innate immunity. It’s a system that is in place to protect us from harm that can be everything. From microbes and things that we would typically think of like bacteria viruses, but also even chemical toxins. Things are going to damage our cells and the other thing too is that it’s part of our repair system. It’s what helps us repair from injury. It helps us recover from illness. It helps us with basically the onslaught of things that we’re exposed to during our life so like all of the toxins and free radicals. It’s there to help us to repair all of our organs and cells so that we can live to a nice hearty age versus dying when we’re very young . It actually has a lot of different roles in terms of a system. That’s why I think it can be a little perplexing and a little overwhelming for people to understand, because you can’t really put it in a box you know.

Dr. Wong

Let’s talk and this is what will be a little bit of a preface towards the four different immunotypes that you talk about in your book. Let’s talk about self versus non-self. What is the role of the immune system and differentiating that between those two aspects?

Dr. Moday

Yeah! This is a really important sort of like tenet of immunity. Is that our immune cells need to differentiate between self-tissue or like our own human cells and non-human cells. The reason is obviously if it can’t do that, then it could be attacking our own tissues and of course that does happen in the case of autoimmune disease. But when we develop certain cells for example, a certain a type of cell called lymphocytes or T cells. When these T cells are born or developed, they go through like almost like a test that they have to prove that they can ignore or what we call tolerate our own self-tissue and it’s almost like if you’re training a dog right.

Dr. Wong

It’s an immune academy yeah right

Dr. Moday

It’s the immune academy and the dog you put the treat down and the dog wants. If the dog is able to look at the treat and look away then it’s past the test right. We sort of have the same thing but instead these T cells, if they’re like oh that’s a cell I’m going to attack and it turns out to be a skin human skin cell or a human thyroid cell or whatever that

T cell literally gets destroyed. Okay so it gets annihilated.

Dr. Wong

The consequences are pretty severe then for the pretty severe

Dr. Moday

Yes they are killed now. Granted there are a few that make it through and circulate and a lot of times don’t cause a lot of problems but you know that if that does get out of control or if we lose this tolerance over time you can develop autoimmune issues and other problems.

Dr. Wong

Yeah so it sounds like the immune system has many many different roles. Just to recap, what you said defending and protecting repairing also kind of differentiating cell from non-self and this immune tolerance after going through that immune academy. It sounds like I love this question. I wanted to bring this up to you because during this pandemic time we’ve all been sort of focusing on I think certainly in the popular media about boosting the immune system. How do we get the immune system stronger. How do we make that higher faster, bigger stronger kind of thing and I think it sounds like from reading your book that The Immunotype Breakthrough that there are certain people that depend. Depending on their type of immune system that they have they would benefit from a boost of the immune system but then there’s other people that maybe have a different immunotype that maybe the boosting would not be helpful.

Dr. Moday

Right! So when we talk about boosting at least my interpretation is we want a stronger

immune response okay. So and and this sort of brings up the idea of inflammation. Inflammation is a cornerstone central aspect of how our immune system works or at least how some of the cells work and inflammation is it’s a whole. It’s a whole sort of pathway that occurs that you know something comes into the body or something needs to be repaired in the body. It initiates different cells that come in at different time periods . They actually create an inflammatory response but that inflammatory response may be to kill something or to repair something, but then it has to be resolved. That’s inflammation is super super important and some people may have actually a very good ability to recognize pathogens and to kill them. Those people may not need an excessive amount of boosting, especially if they also have say some issues we call a misguided immune response. That would be an a autoimmune response. They’re already misguided so they’re attacking their own tissue. You wouldn’t want to really boost that then there’s some people that are already sort of very inflamed. They’re putting out fires all over their bodies so they might be dealing with obesity. They’re already dealing with heart disease or elevated blood sugar. These are things that might be causing inflammation throughout the body. They may not need really more of an increase in inflammation which when we talk about boosting. We’re really talking about aiding cells that create inflammatory cytokines. Which are these chemical messengers. Which if they go too far, it’s like the goldilocks effect right you know. You want it to be perfect because if it gets too high, if the fire gets too high that’s not a good thing either. The people who really need and we all probably need immune boosting at certain times in our life because we change obviously throughout our life. There are people who maybe aren’t having a very quick or robust response to pathogens. This can occur in the very young. This can occur in the elderly. This can occur in people who are extremely stressed or who have nutritional deficiencies or even people who might have lowered immune responses. Because of medication or chronic disease. People with cancer, things like that there’s definitely people who need a boost, but not everybody does.

Dr. Wong

Got it and let’s go through the four primary immunotypes that you talk about in your book The Immunotype Breakthrough. Then maybe you could kind of provide an outline for how you would approach them differently as a clinician?

Dr. Moday

Sure so the first one which I think is the one that I think a lot of people in the United States fall into is what I call the Smoldering Immunotype. Because just to give a background when I was thinking about writing this book and it really was because I felt like most people had this very black and white idea of how the immune system works. It’s on, it’s off, it’s on, it’s off and it’s that’s just not how it works right and many of us are walking around with chronic inflammation. That isn’t really showing up on the surface necessarily as a disease. We might have things like hypertension or smoldering heart disease that people don’t find out about until they have a heart attack. Where maybe their blood sugar is a little high but they haven’t been diagnosed. With diabetes maybe they have some arthritis. That’s not autoimmune in nature. So these people are the Smoldering Type. They have oftentimes have slight elevations in certain cytokines. They might have tests that show that they have a little bit more inflammation and then they have some of these sort of lifestyle diseases that are driven by these fires that they’re putting out in the body. This is sometimes very quiet. This inflammation until it’s not sort of the smoldering type and the reason why it’s really important to to look at this is that a all of our most of our chronic diseases are coming out of this. Everything from Alzheimer’s disease to heart disease, Diabetes etc. But also when over time if we are very sort of distracted and we are trying to deal with chronic inflammation. We may not respond so well. To say a novel virus and this is sort of what we saw in the beginning of COVID is not in everybody but especially people who did have say overt diabetes. People who were very obese and people who would say lung disease inflammation. There they weren’t able to have a really good rapid response to this novel virus because there was no memory of it and by the time it sort of spread enough in the cells as viruses, do we were sort of making these hail mary passes in the end. Unfortunately people ended up dying from sepsis and cytokine storms and things like that. That can happen, so that’s the Smoldering Type. Those people you really want to double down on looking at lifestyle. Looking at diets. Looking at things that can be driving chronic inflammation and there’s obviously many of those things.

The next I would say on the list would be the Weak which is sort of the opposite right. This is probably I would say the least common in a way. Because we live in a western world where most people have access to good food, for the most part I mean maybe junky food. But we don’t have a lot of malnutrition. We are dealing with most people have some access to care. People are growing up for the most part with a okay immune reaction. There are people obviously who are born with congenital issues that cause immune

weakening people. Who develop cancer. Who might get on immune suppressive drugs, HIV obviously and then but we do have some people who just through chronic stress or GI issues or really poor nutrition. Their immune system is going to be weakened and so they’re going to have a hard time clearing things like viruses. Clearing things like bacteria I say. These are the people who get sick all the time. They say “oh I everything comes around, I get it . I get bronchitis for weeks . I get chronic illness for weeks. I can’t always recover. I’m exhausted etc.” That’s sort of the weak immunotype and then the misguided is probably the most complicated those are people literally with autoimmune disease. It sort of covers a very large swath of people but with autoimmune disease there has to be some sort of inflammation first. It’s driven by an underlying trigger now. That trigger can be lots of different things as we’re seeing sometimes. it’s a cult virus so we see that with Epstein-Barr Virus things like that Lyme Disease, Mold toxin, stress, other toxins GUT leakiness. Lots of things can cause the immune system to become misguided and start reacting towards self tissue.

Last is the Hyperactive. So hyperactive is also inflamed but inflamed in a different way. These are people who actually make a very specific type of immune response. It’s an allergic response and it’s a totally different kind sort of want to say corner of the immune

system. They tend to make antibodies of a certain type. What you call IgE type. They stimulate cells that release histamine. These are people who tend to have allergies, eczema, chronic sinusitis, asthma. All of these we call atopic or allergic type of issues. Food issues, obviously food sensitivities and allergies but it’s still inflammatory. It’s working a different way. So it’s really important to sort of look at these differently. They’re not all the same.

Dr. Wong

Thank you for that brilliant overview of the immune system. I feel like I just went to medical school all over again subspecialty. I have a couple of sub questions that were generated from that but one of the things is that it kind of reminds me of something we learned in fellowship which is the Ayurvedic Doshas right. There’s Kapha-Vata and I wonder if like you said, as the body changes over time maybe nutritional uses change over time.Do people’s immunotypes, could they also change over time and then the other sort of sub question if you don’t mind answering them together. Can they be combined, can someone have a weak and misguided or something like that.

Dr. Moday

Absolutely we are not static creatures and it’s really the things that we encounter through life and the way that we live our life that changes our immune system. We’re very adaptable creatures and that’s another thing that we can change. This which is of course why I wrote the book. Just like the Doshas right, you might have a primary Dosha-bata pizza Kapha, but it can become imbalanced. You know with this a lot of times, it’s okay when you were born right. Were you breastfed? Where you vaginally delivered? That might put you in a different category, like if you didn’t have those benefits you might have a slightly more weak immunotype or you might develop a lot of childhood

allergies. But then there’s people who they were very healthy and you probably see this with a lot of your clients. They didn’t have any childhood illness. Everything was great but then they went to college and they don’t know they went to let’s just say they went to Southeast Asia or Africa. They picked up a parasite or something happened. They came back, they started having diarrhea and then they started having GI issues. Then all of a sudden they develop food allergies and then they started getting asthma or maybe they got Epstein-Barr Virus as a teenager. Then they went to college and then their father died and they went through a period of stress which was a tremendous. Then they were diagnosed with rheumatoid arthritis or something so you know. it’s how the environment

works on our genes. Turning things on and off and our immune system is going to change based on that but you can absolutely have people when they take the quiz. Some people take the immunotype prison they’ll say well I’m sort of a little bit of the smoldering and I’m a little bit of the misguided and I said absolutely you can be that. You should be that I mean so you look at sort of where you score the highest. That would be sort of the predominant one. So yeah absolutely!

Dr. Wong

Where to focus the attention on the most. Got it yes that makes sense well I know we had talked about and the beginning of this conversation about self and non-self and immune tolerance. I’m wondering how the GUT is connected to the immune system specifically the GUT microbiome and are there specific GUT microbes that the immune system recognizes as “self-friends” Where they wouldn’t react as much as say the ones that are considered more inflammatory etc.

Dr. Moday

Yeah and so that’s one of the reasons too. It’s really important as a infant child to have exposure to microbes early. I talk a lot about the idea of the hygiene hypothesis and how. Because that’s actually when I was doing my allergy fellowship. That’s what we talked about the hygiene hypothesis right. They had done this study showing that kids who grew up in I think it was East Germany versus West Germany when the wall was up. We’re talking in the 70s 80s that children who grew up in East Germany who hadf arm animals and cows and not quite access to the modern conveniences of west germany. Actually had less allergies and the people the kids who grew up in West Germany had a lot more allergies. They said it’s probably because these children were exposed in West Germany to antibiotics and highly sanitized water. They didn’t had pasteurized milk etc. That might be part of it but really it’s probably that they were exposed. It’s not the issue that they weren’t exposed to pathogens, is that they may not have been exposed to friendly bacteria. So our intestinal microbiome which is mostly in the colon which is trillions of bacteria and viruses and all sorts of things yeast forms. They are there for a reason, because they act as teachers and so we learned very early that certain species are supposed to be there. Our immune system the cells that you know because a lot of our immune cells are hanging out just beyond the surface of the colon. They’re just right outside sort of right before the bloodstream. There’s all these lymphatic areas where they hang out and they’re able to communicate literally with the interior of the colon. So many of these lactobacilli and bifidobacteri but either even other ones even. Even other species that we consider to be sort of inert or not necessarily beneficial are still important teachers and so we do learn to sort of tolerate them and they are beneficial to

us over time. When we lose them we know that there are problems with increased inflammation, loss of tolerance, loss of tolerance to foods . It is really important to keep our GUT microbes very varied and very healthy in terms of number.

Dr. Wong

Got it in terms of healthy GUT bacteria being some of our greatest teachers to the immune system is there research on the age at which an average person would have an immune system that matured you. know to in other words when is it sort of too late to say okay I’m going to dig my hands in the soil now but in my 40s is that actually going to help me if my immune system wasn’t exposed as much as a child.

Dr. Moday

So I don’t know if they’ve ever done studies, proving that I know, that we know even based on say fecal transplants right. In a which usually occurring in adults who have c diff or something like that. Radically changes their health outcomes by literally transplanting a new microbiome. So whether you can get that from I don’t think they’ve ever done long-term studies but we obviously know that increasing your natural prebiotic intake and fiber intake will often bring alive a lot of these dormant bacteria that just aren’t being fed by having more fermented foods. You can significantly improve it whether they’ve done human studies like before and after like doing year long that would be a great study if you can take people and control them for say 12 months with their diet. Use of fermented foods and sort of do before and after that would be a great study but we do know that they that you can resurrect quite a bit of your microbiome and improve your immunity over time. We’ve seen that really just with how people’s inflammation changes over time. Just like you I I think we we do a lot of these stool tests to look at the microbiome. I’m not sure which one’s your favorite but there’s different ones right and we even see over over a six-month period you do a repeat a lot of times they’ve got microbiomes better. It sort of correlates with how they’re feeling oh yeah and I’ve seen and I know you probably use a lot of the tests that do the DNA probes and so a lot of times there will be no the probe won’t be sensitive enough to pick up certain bacteria so it’ll say it’s less than a detectable limit and it’ll look like they have none of this. This normal resident bacteria there and six months later it’s not like you’re giving them that bacteria.

You’re just they’re feeding differently they may be taking in some probiotic species but all of a sudden you’ll see this other species completely bloom. So it’s there, it’s just not getting like the love and support that it needs so you really can resurrect your microbiome

Dr. Wong

Yeah! Bringing it out of hibernation

Dr. Moday

Yeah! exactly yeah

Dr. Wong

Well let’s get into what I feel like listeners may want to know about we’re in 2022 and we’re taping this. It’s still during the pandemic, hopefully it’s receding a bit but there’s variance always on the horizon and things like that so how does the immune terrain impact viral prevalence. I think we’re talking generally about viruses but we can also talk about COVID if you’d like and also severity of viruses.

Dr. Moday

So COVID obviously, I should say SARS COVID too yeah this is a virus that has been

hanging out in a animal population probably for who god knows decades right. Just like most of the the viruses that we see that we call novel but they’re novel to humans they’re

spilling over from these animal populations because of unfortunately how we are, how we destroy their ecology and bring them into our environment. We have no exposure to them like humans have been dealing with coronaviruses for you know millennia right and that’s just a big family but these particular strains we don’t have any experience with. That’s why it’s so devastating because we have no natural immunity to the although that was debatable in the beginning they thought some people did but I think that’s why it’s scary for people because they’re like oh my gosh we’ve never seen this before. The other thing is that as we know viruses in order to live they have to exist in animal or human cells in order to replicate and when they do that of course they can mutate and mutation is very scary because they’re usually figuring out ways to become more invasive or to hide themselves better or to basically become stronger. That’sa scary thing so when I think of how can we protect ourselves from so-called novel viruses, we don’t have a way of knowing which ones are coming next. I mean maybe epidemiologists too do but we can work on our innate immune system. So our innate immune system is sort of our first line of defense when it comes to allowing things into the body. There’s barriers to that, there’s everything from enzymes in our in our saliva and tears to enzymes in our stomach and acid in our stomach. That kind of thing and so that’s important but we have a bunch of cells that circulate throughout the body which really are looking for the first thing to come in and these are natural killer cells. There are macrophages there’s this whole family they’re called, phagocytes which basically either swallow whole things or take them back to the adaptive immune cells. We really want to have a very active and strong innate immune response and that’s where a lot of the things that you can take right so you can make sure you’re taking things that can help. That’s where a lot of the medicinal mushrooms come in. That’s where certain antioxidants come in because they can actually make natural killer cells stronger and more active. They can improve cytokine function

and so I would say like really working on the innate immune system is very important There’s other things with that too, for example sleep we know that if you don’t sleep right you sort of drop the hammer on your ability to actually mount a really good immune response and then also to mount a response against things like vaccines. Once you do have vaccine you can actually improve your response to vaccines through some lifestyle

things too.

Dr. Wong

Yes and I believe you talked in the book also about Autophagy and how intermittent fasting can be helpful. Can you speak to your experience on that or either clinically or personally.

Dr. Moday

Yeah. So Autophagy it’s something that and obviously there’s many people that see specialized talking about autophagy. It’s really a recycling in a way of our cells we can turn over cells relatively quickly but we can also sort of improve them. It’s almost like we take some of the used up parts and we take them to the central organelle on the cell .We almost like melt them down right get rid of them to make the cell stronger and allow it to live longer and we know that improved autophagy is helpful for immune cell function. It’s important for aging and brain function. Autophagy happens I would say if you want to improve autophagy one of the best ways to do it is to to do some intermittent fasting because we know that this happens in a state that we are not taking in extra fuel. It’s almost like a way for our body when it doesn’t see other fuel coming in. It goes okay how can we how can we create energy how can we improve our function when we don’t have

the resources. We can we can work with what we have and so even just overnight fasting some people don’t even fast for 12 hours which is sort of crazy. If you think about it like evolutionarily we were meant to probably fast a lot more than that but we have food everywhere now so a lot of people don’t even get their 12 hours overnight. So I tell people first of all start with 12 hours make sure you can do that you’re not snacking at night and then try to incrementally move that up to 13 – 14 hours. Some people obviously do much longer than that there’s certain disease states that people it benefits them to do longer fasts or maybe fast once a week or a couple times a month so.

Dr. Wong

And if someone had a weak immune system or maybe they have an eating disorder they’re malnourished then that would maybe not be the time to do.

Dr. Moday

That would be correct and the other actually people although it’s funny I know some people may disagree with this but I’m a big fan of getting people into normal glucose tolerance before they start doing intermittent fasting, because I think there’s just too much dysregulation of people’s energy and their adrenal function. Obviously many people they’re stuck on sugar right. They’re on this like sugar roller coaster all day long so they don’t know how really to go for periods of time fasting. They don’t they use fat very well. They’re not fat adapted they just need a constant flow of sugar and so if they start to fast all of a sudden they usually crash. This is the hangriness and things like that so first get to a point that you’re changing your intake of sugar right so you’re getting so that your glycemic balance is good and that might mean actually snacking a little bit during the day but doing higher fiber foods and low sugar foods to the point that you’re like okay my blood sugar is pretty good. I feel pretty stable during the day let’s see now if I can start fasting yeah so that might take a few weeks.

Dr. Wong

Yes and being hungry is is not productive for for ourselves or the people that we love or the people we’re around you know.

Dr. Moday

Definitely not!

Dr. Wong

Now have you been to this is a little bit of an off topic but this happened sometimes on the podcast. Have you been to Busch Gardens or Kings Dominion I’m not a big fan of roller coasters they have a lot of roller coasters there.

Dr. Moday

I haven’t no! I haven’t ridden a roller coaster in many years but I know that it’s not too far from where I live.

Dr. Wong

Yes. Definitely check it out it’s fun but the park is fun in general but the roller coasters. I’m not a big fan. Sugar is a huge roller coaster for the immune system andI think you’ve read in the book how sugar’s really the public enemy number one right for the immune system. Let’s kind of take a dive into that a bit more why are people so addicted to sugar maybe and is it not their fault. Is it kind of the food system the marketing what’s kind of going on with sugar I I think.

Dr. Moday

I think it is because of the food system and the only reason I say that is if you look back and there’s actually some good statistics. I don’t have them at the tip of my tongue but the amount of sugar that we ate even 50 years ago. I mean even when I was growing up right people just didn’t eat that much sugar like it was not in all even if you had like cereal back then or even if you had so-called junk food. It wasn’t even in that as much as it is now and I think it’s something like I don’t know we’ll just say like now it’s like 17 teaspoons extra sugar and back then it was like seven or something. It’s a huge difference between what was found in in food and then we also just didn’t have as much packaged food and as much fast food. Kids for dessert, you would have likefruit things like that we just didn’t have the same amount and so that’s really bad for lots of different reasons. I mean obviously it’s when we have so much sugar in the system our cells, I mean we can’t have high blood sugar it’s very very dangerous to our vessels and so we want to try to get that blood sugar into the cells as quickly as possible. It doesn’t do damage and the hormone responsible for that is insulin and so but there’s a limit to that right. One’s insulin and starts increasing it gets to a point, it gets tapped out and we literally cannot fit any more blood sugar in to the cells we end up having high blood sugar. insulin can also convert blood sugar to triglycerides. it can cause fatty liver disease which is extremely damaging and dangerous. We end up in this very inflamed state, very high insulin . Insulin is a growth hormone makes it very difficult to lose weight so we get in this this horrible state of obesity. High blood sugar high insulin and high inflammation people are like well how do I get out of it the first thing you do is literally take the sugar out.

Dr. Wong

Yeah! it seems so simple and profound but I’m surethat that rat study with cocaine versus sugar right. The sugar one over the cocaine it was more addictive and 88 of the population has metabolic syndrome. They have at least some sort of smoldering immunotype. Is that correct? Yes and it is true, I mean it is an addictive thing.

Dr. Moday

Like we, it triggers dopamine in the brain. It’s a reward right because we evolutionarily sort of move towards award.

Dr. Wong

Who doesn’t want to feel pleasure?

Dr. Moday

Yeah right and there’s nothing wrong with that but over time I think our food has been become so so high in sugar. With so much extra sugar and a lot of times also these false sugars that we just don’t metabolize the same so if you have let’s say sucrose in a cookie or a piece of cake or something very different than having like high fructose corn syrup which you can take in tons and tons and tons and not have the same sort of satiation that you would from a regular molecule of sucrose. You have it, you have to go quite honestly through the withdrawal and that might take weeks. It’s very difficult sometimes but it’s like anything else. It’s in the end, it’s so important.

Dr. Wong

Yeah so in your book you talk about sleep and stress management movement. Let’s touch on movement for a second,because I know that a lot of us are sitting around zoom which during the pandemic and trying to move more take little work breaks or you know breaks around your house or what not what are your top tips for movement and how does movement really impact the immune system.

Dr. Moday

So lots like many different ways so for example and I thought this was really interesting because obviously I’d love to exercise . Sorry that I love to exercise however probably the most important thing for metabolism is just daily movement. They’ve looked at this and if you just say walk throughout the day and this is why doing the 10 000 steps for 15 000 steps is actually really foundational or even standing versus sitting that that really impacts your metabolism more than you getting up and doing say a half an hour 45 minutes of exercise that is beneficial no doubt but you also want to be moving throughout the day just doing functional movement so that’s number one that actually makes a bigger dent into your basal metabolic rate right which is I mean your basal metabolic rate is doing nothing but just thejust daily movement right is really really important but on top of that doing different forms of exercise can be very helpful for the immune system, because we know that it can increase certain cell types. They’ve looked at this in runners and cyclists that you can have bursts of certain cells from natural killer cells T cells, the cytokines actually the pro-inflammatory cytokines but that’s good if you’re trying to fight infection right the most important thing though is that if you’re doing say hit workouts or even endurance exercise. You need to recover and a lot of people don’t get adequate recovery time and recovery time is actually a really important time for growth. In fact if you talk to people, athletes that are trained a lot of coaches will say well yes the working out the big workouts are really really important but the recovery days are just as important because that’s actually when your muscles get stronger when your cardiovascular system gets stronger because it’s during that sort of repair cycle right so that’s great and the other thing too is that it’s very over time doing exercises that you enjoy lowers your stress level or actually sort of makes you more resilient or more tolerant of stress that sort of idea about hormesis or or creating a resilience and so daily exercise is really good for that too just making us stronger in that category.

Dr. Wong

Yes one one more question about lifestyle. How do you feel gratitude or mindset play a role in immune immune balance or immune health.

Dr. Moday

I would say it’s huge and there’s I didn’t go really into the science of this in the book. This is probably another book right.

Dr. Wong

Yeah!

Dr. Moday

But we do know that for example let’s just talk about stress and cortisol right. So cortisol is very important for our immune system and when if it’s too high for long periods of time it’s very damaging, but when it’s normal when it’s you know we get some exposure it can be really really good. Let’s just say someone who’s chronically stressed if you’re doing a gratitude practice on a daily basis you can literally just with your mind and this has been shown inmeditation studies. Yoga studies some of the Buddhist monks you can really really control and lower your basal cortisol so that it’s in that nice sweet spot right it’s not

going to cause damage but I think also mindsets. I don’t know if they have markers for this but if you look at the blue zones the studies of the blue zones which is the areas of the world where people live the longest now people live the longest usually because they have very resilient immune systems. Like the people who live in Sardinia off the coast of Italy they’re living to a hundred years old and they’re walking and they’re doing everything one of the core tenets outside of nutrition and exercise is spirituality and community and purpose life purpose right so waking up every day and having that feeling of I’m here for a reason I’m glad to be here I amm grateful that’s gratitude right. We know that those inputs are so important for longevity and that translates to me to it’s important for immune system.

Dr. Wong

Yes well Heather, Dr. Moday thank you so much for being on today we have some closing questions for you with all of our guests I’m gonna get do a little shake and bake here and mix it up a bit one of the one of the questions is on since we just talked about joy and purpose and meaning what do you do every day yourself to cultivate as a physician as a leader and author as someone who it sounds like enjoys a lot of different things but what do you do every day to cultivate joy yourself?

Dr. Moday

One thing is that I have animals they bring me a lot of joy. Yes so I really would say that they’re big ones for me and then recently I’ve been doing more sort of just creative venturesI think for a long time I had shut that out because I I just got busy right and I found that decreased my joy so it could be something simple, it can be drawing it could be hand lettering which I do sometimes things like that just really bring me joy just it could be gardening. I try to do something like that that I’m using my hands or using like a different part of my brain.

Dr. Wong

Yeah functional medicine is very cognitive. I think having some creative sideis good.

Dr. Moday

Some sort of creative outlet even tactical.

Dr. Wong

Yeah and do you have any morning routine that is that you do yourself or you know something that’s good for the immune system.

Dr. Moday

Yeah well the biggest thing for me is movement in the morning because I like many people find that as the day goes on I get distracted and busy and when I start my day out with doing exercise I get to be by myself. I get to think about my day I also get a lot of energy from that and I also make sure that I get it in. For me basically I wake up I have my lemon water I have I make my delicious little cup of coffee which I like to have and then I do my exercise and whether that’s running walking, peloton, yoga, I just do something that gets me moving for 30 to 45 minutes or so and that’s really how I start my day.

Dr. Wong

That’s the best way to wake up is start moving. Let life is dynami, get outside if you can I’m going to give a shout out to mike Mutzel, who is a podcaster. He does a podcast called high intensity health so I’m gonna actually borrow this question from him but if you were stuck on a desert island or beach let’s say since you’re close to the beach what would be the and if you had to choose like three supplements to pack in your bag with you, kind of

long-term what would they be and you’re sitting under that palm tree with some of your amazing food and supplements what would they be for you.

Dr. Moday

Well I would say Vitamin D, but if I’m on the beach maybe not.But yeah Vitamin D would be one an overcast day you might know overcast yeah vitamin D would be one I would say. The other would probably be some sort of omega-3 fatty acid so some sort of fish oil and lastly would probably be that’s a tough one. I figure I can eat my fermented food so it wouldn’t be a probiotic I would say probably curcumin, because it’s hard to get a lot of curcumin in your food and it’s such a great multifaceted in terms of what it can do for you. So yeah so a turmeric curcumin supplement.

Dr. Wong

Great! thank you so much and thank you so much Dr. Moday for being on today again. For all the listeners out there, book is amazing the Immunotype Breakthrough just released very recently it’s doing very well and I think it’s such a worthwhile read i’ve learned so much from it myself, so thank you for for writing this book and being of service in that way and explaining the immune system to all of us and I love especially the the different breakdowns of the immunotypes because it can really focus people. If people have chronic issues or even if they’re trying to prevent illness and optimize wellness it’s really nice to have a personalized plan for the immune system. This is the book that really does that so heather how can listeners learn more about you and work with you.

Dr. Moday

They can find me at my website which is www.modaycenter.com an I actually work individually with people in certain states. If they’re in Virginia, Pennsylvania, New Jersey, we do have some other programs that people can join through our nutritionist and that can be across the united states and then also they can follow me at the Immunity MD on Instagram. That’s where Iprobably hang out the most on social media and where we post so.

Dr. Wong

I love that Immunity MD. Well thank you Heather so much for being on today and thank you all for listening and we’ll talk soon

Dr. Moday

Yes thank you so much it was great.