EP#16- Holistic Medicine and Gut Health with Dr. Jaclyn Tolentino, Senior Physician at Parsley Health

[MUSIC] Holistic medicine is really medicine that looks at the health of a whole person to help maintain their wellness or even diagnose her treat disease. That was Dr. Jacqueline Tolentino. Dr. Tolentino is a board-certified family physician with a collaborative, holistic approach to practicing medicine. She holds a sub-specialty certification and hormone optimization, has received extensive training in functional medicine through the Institute of Functional Medicine and additional training and oncology nutrition. Dr. Tolentino is one of the senior doctors at Parsley Health, which is the leading national provider of holistic personalized medicine designed to reverse chronic illness and optimize health. They offer telehealth options and also in-person services. In this episode, Dr. Tolentino and I talk a lot about what holistic medicine is and how that differs from traditional models of medicine that we might be aware of in America. We also spoke a little bit about the relationship between our gut health and our brain health and ways we can engage in preventative wellness so that we can make better decisions that will optimize our health in the long run. Before we get into the interview, this episode is sponsored by Inker. [MUSIC] Thank you so much, Dr. Tolentino, for coming on to the podcast today. >> Hi, I'm so glad to be here. I'd love for us to just start off by introducing who you are and what you do. >> Sure, I'm Dr. I'm a senior doctor at Parsley Health. I work in the virtual team, so I see patients virtually in California and Florida. Are you familiar with Parsley Health Stella? >> I know that it's a telemedicine company and I'd love for you to talk a little bit more about telemedicine and Parsley's unique approach to holistic medicine. >> Yeah, so Parsley Health is the largest holistic wellness company in the country. We see patients virtually in almost all 50 states. And what I love about our approach is that it's not just a doctor that the patient is seeing, but it's really the doctor, a health coach, and we really establish a good relationship over time. And I think what's missing in medicine today, especially when it comes to the kinds of issues that people see us for, whether it's hormonal issues, autoimmune disease, gut issues, stress, you name it. It's really having a holistic approach and that means not just seeing your doctor, but having a health coach to support you along the way. So all of our patients, they really get the added benefit of seeing health coach and also seeing their doctor and having some time in between and to access us if they have questions about our care. And it's not usually just this one visit one time a year thing where you just go in for your 15 minutes and then that's it as part of an annual physical. No, it's an entirely new dynamic where you're really spending a lot of time with your doctor and your health coach and you develop this relationship over time throughout the year. So I think that's so important because things change between one annual checkup and the next year. And if you're missing that crucial space and time between one year and the next, so much can happen. And I love with Parsley Health, there's just this commitment to being with the patient and really being committed to understanding what's happening in their life and seeing these changes that occur not even day to day, but maybe month to month if you're really showing that persistent commitment to the patient. Yeah, but that's what I love about it too. I feel like the preventive philosophy behind how we practice is really getting to meet a patient where they're at. It doesn't matter what part of their wellness platform, what kind of disease state they're in. It's really just where are you at currently walking through your health story. So that way I really understand how you became to be at this point. And then it helping you move forward and really educating our patients, helping them learn about their bodies so they can become more intuitive about different things that they have going on and then establishing a really good relationship with us so that we can help move the needle forward. What are some kinds of questions that you ask to better understand like what the patient's health story is or to really understand certain moments in their life that might impact their current state of health and well-being? Great question. I think it depends on what they're coming to see us for. So we don't just go over like the top goals of that moment. It's really like what are your goals throughout the year, what you're trying to accomplish. And then we have our patients fill out an extensive questionnaire. So that process usually does take a little bit of time to really understand a full health story, talking about your own personal medical history, social history that really goes into depth. And then also pass medical history that goes down all the way from birth. So we do ask a lot of questions like when you're referring to your backstory about how things have became to be, like where you grew up geographically where that was, taking a look at what types of health conditions that you had as a child. If you had any traumatic issues, were there any sort of specific hospitalizations and things like that that have happened throughout your life? Have you had anything from a severe illness to persistent daily headaches to where you the kind of kid who was sick all the time and ended up having to see a doctor frequently where you a child who had any issues with nutrition? Were there any sort of gaps in the way that you were eating or were you a picky eater? Were you happy, healthy, thriving baby? Were you a baby who ended up having to need specific dietary needs? Did you take a lot of antibiotics growing up? Maybe you were a woman who had been on birth control for many years. So we kind of ask the kinds of questions that help us build the stories so that we understand exactly what's going on and it depends on what the goals are or the patient because everybody has different goals for their health and it depends on what they're trying to accomplish and that's really where we start and then of course we peel the layers back from there so that we know exactly what kinds of questions are going to be good to ask. Right. And I think the term holistic medicine or holistic wellness has become even more popular recently and to me, it seems kind of like a buzzword. I don't really necessarily know what it means to be a part of a practice that engages in holistic wellness. How would you define what it means to be treated in a holistic approach? Yeah. I feel like, and you're so right, it was funny because my husband and I were listening to a podcast earlier where they just used that term very loosely. So for you and for the readers, let's like make sure that we define it clearly. When it comes to medicine, holistic medicine is really medicine that looks at the health of a whole person to help maintain their wellness or even diagnose or treat disease. So what that means is that we're looking at their physical health, their emotional health, spiritual health, what are their social factors, what is their environment like and all of these factors do influence the health of an individual. And what we do is we help look at how we can tweak or optimize these factors to restore, preserve exactly where they're at. So the holistic approach is really the overall, like almost like an umbrella type picture. So we're not really just treating like a collection of symptoms or one specific disease, or treating and supporting all of the things that may actually play a role in this individual's health. And you are right. Like a lot of this is really, like we had talked about briefly, some of this is really lifestyle based. And that we have to make sure that that's addressed. So teaching you how to maintain your health, even if you're juggling a really busy work schedule or lots of day to day things that you're trying to do. And all of these things can really add up. So we're trying to prioritize how your health is, but we're also taking a look at all of these other factors that may really be contributing to the status of your health. Yeah. And I think maybe in more Western or like traditional medicine or the way we see doctors function in America, there can be this very narrow-minded approach just looking to find the symptoms, diagnose the patient, and there, like the problem solved. But it seems as in like holistic medicine, and in this really integrative approach, you're approaching the patient and all of their symptoms and issues from a really, your painting is very broad picture so that you can really gather all of like, quote, the evidence or specific factors that may or may not have influenced the person's health and well-being in that moment. So taking, looking at it from really since their inception to present day to really understand the underlying issues that have contributed to their current health status. Yes. And that may, that may actually be changing up some of the daily like habits that individuals have, right? So focusing on sleep, stress, movement, seeing what their nutrition is like and really delving into how an individual is living so that you can move the needle there and make some changes in healthy habits that may make an improvement on exactly where they're at. And I think the biggest issues that some patients have is they may not be able to see that the way that they're living is really impacting their health. And so our job as clinicians, not just myself, but also the patient's health coach, is to really walk through that and help them understand that if we say, if we stay up until two a.m. and we're sleeping from two a.m. to 10, that's not quite the same as getting really great quality sleep at proper times to help support the best for your immune system, the best restorative physiologic properties. How can your hormones restore? How can you get your body in the best optimal shape? And maybe an individual might not understand that's even impacting the way that they live and have their energy and mental clarity. And so really talking about it and getting down to it and helping to educate them on physiologically what's happening at specific times, even specific times of day night can really help them see and help them make healthier habits to move on. I love how you brought up the point about the importance of decision-making and getting into a healthier routine and really just making small changes on a day-to-day basis that will really aggregate into a larger impact and having like a health coach and a physician there to kind of guide you and help you make more informed and better choices that otherwise you may not have been made aware of and I think this is a great segue into discussing what preventative wellness is tying into this concept of making better choices and a lot of my listeners are in their early to mid-20s young adults and I mean come in college we make a lot of I don't want to say dumb decisions but decisions that probably aren't the best for our health in the long-term so I'm curious to learn a bit more about what preventative wellness is and what are some steps we can take to improve our health in the present and in the future. Yeah now that's such a great term because I feel like preventative wellness is it can actually be utilized at any age and every age but specifically teens 20s and 30s are so much that can be done now that will really lay down a great foundation for your future and it always starts back with the basics. How are we eating? Are we moving? Are we getting good exercise in? How are we learning to manage and handle our stress and whether or not we're really focusing on optimizing your sleep and sleep is so important I feel like a big key there because it's really where all of the restorative processes happen in the body to help set you up not just for the next day but for the following days after that and these are things that sometimes like diet, sleep, exercise these are things that most people take for granted especially when we're young because you know you don't I feel like when your body and where you are you feel like you could eat horribly, horribly or get four hours of sleep and you can still push through the next day. I feel like we've all done that we've been able to like bounce back super resilient after a really really tough night when we were younger so just some of these things are so so important and laying that good foundation now and creating these healthy habits really does have so much impact on how somebody does in the future. Yeah for sure I mean there there's so many times in college where I've stayed up late and then I felt so horrible and groggy the next day and then it impacts my focus and it's hard to pay attention and it can be really this like dangerous cyclical loop where you make one poor choice and then it kind of backfires into another poor choice and you can it can start to feel really horrible and hard to get out of as well. Yeah and you know the younger bodies we tend to be a lot more resilient regardless of how you treat them so when we're younger there's there's less of these negative consequences that we seem to like get when we're older and especially in your 20s you may be able to push through without having too many negative consequences from like a bad night's sleep or drinking too late or having way too much to drink or eating horribly 2am without too many negative consequences the following day or even a couple days later if it just keep on like like you said in the cyclical rhythm of doing it I'm with I feel like that's really the time to develop good healthy habits because we don't stay that way for so long and some of those negative consequences really do start to creep up on you. Bad habits they're really tough to break especially when it comes to think like things like nutrition so if we can really lay down the foundation for better health earlier I know it sounds kind of like a cliche but these are like the fundamentals here like how we're eating whether or not we're getting in good consistent movement in are we giving our bodies enough rest and are we creating really great resilience when it comes to stress and the impacts of different kinds of stressors that happen throughout your 20s or 30s. I love that you brought up stressors and their impact on like your physical and mental well-being. I want to touch a little bit more on the relationship between stress and our gut health. I've read a lot about the relationship between our like head brain and our gut brain and the connection between gut and digestion and our mind so I'm curious to learn a little bit more about how stress impacts our gut health and how that then impacts like our own mental health. And I know this is kind of an open-ended question but maybe if you have any like tips on how to reduce stress and how that might also impact our gut health as well. Yeah so are your readers familiar with gut health? I actually'm not sure so maybe because we're by defining what gut health is. So when we talk about gut health we're really talking about our gut, our digestive tractability to do. It's very very important job as effectively as possible helping your brought by your body digest things and break things down. So our gut is really responsible for all of the heavy lifting that we associate with digestion, breaking things down, beginning the absorption process so that we get we can get a new transfer from the foods that we're eating, those kinds of things. And in order for our gut and our digestive tract to really work effectively it needs to have great balance and balance meaning the microbes that are in our gut, the collection of different bacteria and so forth and other types of pathogens that those are in balance when it comes to good and bad bacteria that are flourishing and thriving within our digestive tract. And we're made up of hundreds that there's hundreds and thousands of different types of bacteria that reside in our gut in our digestive tract and they're helping and hurting that process. So when it comes to how is our body breaking down food and nutrients, are we able to get things in, is it impacting the way that our body responds to stress, does it impact our immune system? Absolutely, there is a collection of different bacteria there that do create or cannot create that sense of balance. And I think it's important to recognize that we're made up of all of these different bacteria that are also residing in our digestive tract as well. So when things are not balanced within our digestive tract and that's when things like inflammation can come into play, our immune system can be affected, stress can be a big part here because it can also really exacerbate more of the bad bacteria to overgrow. It can create other problems. And I think that that transition or when we think about it, the gut and the brain, there is a connection there and it's really connected through the vagus nerve. So the vagus nerve really comes from the brain and innovates the top of the diaphragm and it actually does innovate parts of the digestive tract as well. So think about as a great example when people have a nervous belly, when they're super nervous or they're stressed out about something that's about to happen, sometimes people can feel like their stomach is a nuts or they can have an upset stomach or they could feel nauseous all of a sudden or maybe they have to run to the bathroom or something like that. So it really does tie in through the brain and the gut. There are messengers that go from the brain to the gut and the digestive tract and also from the digestive tract back to the brain and it can impact one another. So which one is it? Is it the brain impacting the gut or is it the gut impacting the brain? I feel like it's the right. It's like, is it the chicken or the egg come first? Like how do we know where maybe that that originates? And I think I actually read something for a class. I took a class called Body Mind Balance and we've learned about the gut brain, the heart brain and the head brain and how for everything to be in balance, your gut brain needs to be truly aligned and in balance and taken care of so that everything can fall into place. Like your heart brain, which I guess has to do with like compassion and like spirituality maybe and gratitude and then your head brain, which is what we think of when we think of our brain like in our head. So there's really this like strong connection between the three or at least we know between our head and our gut and even you know physiologically that vagus nerve that connects the two is really fascinating. So I mean when I think of gut health, we hear about having probiotics and fermented foods in kombucha and you know I don't really know like kombucha for example is that like a fat or does that actually help balance the microbes that are in our gut and produce better overall health and well-being? Well I mean I feel like kombucha does have some great properties to it. So if you think about the actual like the good bacteria that's there and also the fact that it's fermented, there's some great things that are part of that but also one thing I often see with kombucha is there's a lot of sugar. Right. So then we might have another issue of is that way too much sugar for that specific individual or not. I would say that one of the the first things that we can do to optimize our gut health is really take a look at when and if and where you're at like where do we have issues? Are you noticing that you're having specific symptoms? And sometimes I'll ask patients about specific symptoms whether gut health and they might not have an idea and they want to pay closer attention to it. So even just bringing up how do you feel after your meals? Are you super energized from eating? Are you feeling incredibly tired after eating? Do you have issues with bloating? Are you having excessive gas all throughout the day and you're really just not not sure exactly why? Or are you somebody who is having a lot of burping or acid reflux or upper chest type symptoms or clearing your throat all the time? So paying attention to if your body is giving you any sort of signs or symptoms that your digestive health is in great shape. And then when you were talking about the gut and the brain and whether or not like stress is a really big factor here, are you an individual who does get stressed out and notice that their digestive tract is really one of the first things to go, like somebody who is super stressed out that they can't eat or super stressed out and they feel super nauseous or maybe their bowel starts to go or maybe they're having issues like that. To pay closer attention to how your body feels and what impact you have when you drink fluids, when you're eating certain foods, I feel like that's the first step to understanding your gut health. You were featured in this wonderful article on pop sugar about meditation and its effect on our gut health and I think it really ties into this idea of just bringing a greater awareness internally to our body and how it makes us physically feel and mentally feel. What emotions we derive from certain physiological experiences. So I also love how meditation, we know it benefits on stress and anxiety or something that we can do to just calm the mind a bit. But I'd never really heard of meditation as this tool we can use to enhance our own gut health and decrease our stress. So I think that's a really interesting connection as well. Yeah, and I feel like going back to holistic health, one of the things that we think is really vital is to really support breath work. So maybe an early part or even one step of getting into a meditation type practice is really just to focus on your breath and by decreasing stress and by focusing on really great breath work or even having a five to ten minute practice. Maybe that's a couple times throughout the day. People will really see the type of impact it can also happen their digestion because oftentimes digestion is this really active process and so you're really eating frequently or maybe you're drinking a lot of fluids throughout the day or even having some snacks in between really understanding is that the great digestive processor, the great rhythm of the way that you should be eating for yourself. And if that's the case, once you talk with your health coach or you're really trying to work through nutrient timing and the way that somebody should be eating and when they should be eating, should they incorporate some sort of fast. A lot of times will incorporate meditation and breath work as well because it does impact the way that somebody's digestive process is calming down and relaxing from this consistent active process all the time. That's very fascinating and I am a huge advocate for mindfulness and meditation and so to hear about its effects in this way also from a doctor's perspective I think is really fascinating and I would love to kind of wrap up on this note because I think it just comes back to the importance of breath work and calming your mind and in this podcast I talk a lot about the mind body connection and I think that's very connected to the whole concept of holistic medicine and an integrative approach. Before I let you go, I do have two final questions. What are some actionable steps young adults can take to really put their health and well-being into their own hands, you know, having as much control over that as possible? I think one of the biggest things is, you know, what can you do to limit your stress and how can you work on, you know, your coping mechanisms to help deal with what types of stressors that you have in your life? Most people don't think about stress and it's impact on your health or even, you know, your hormonal health when we talk about cortisol or adrenaline as some of these stress hormones but it can really stress can ultimately lead to elevations of different hormones that can impact the quality of life because of the way that impacts you physiologically. So this could be how it impacts your immune system, how it does impact the way that you sleep, how does it impact the way that your body just naturally works in order for it to work best? So it does have a really big impact on quality of life and sometimes just even understanding what is stressing you out, what kinds of coping mechanisms that you do have to really help support that. I feel like that's a big one. Becoming more intuitive and self-aware of how these things may impact the way that you're working and functioning, feel like that's an important thing to understand and learn about yourself. Absolutely. Thank you for sharing that and I think that will be really helpful for my listeners, especially young adults who are listening right now. And my final question, this is something that I ask all my guests on the podcast, is what is something that brings you endorphins? Oh, I love that question. Going on adventures, especially during COVID, we've been exploring a lot more. So I've been spending time with my husband, Charles and our little Chihuahua Cali doing a lot more hikes and we've been mountain biking a lot more. Spending time with my family brings me endorphins. I think with COVID, this has really been so, so difficult because a lot of my family members do live outside the state of California. But I feel like that's what's also created more meaningful time when I do get to spend with them, whether it's the phone calls or the Zoom conversations or the group family chats and things like that. So I feel like that's really, really important to my endorphins and overall happiness from a work perspective, practicing the kind of medicine that I really believe is going to be the future of healthcare. And it feels amazing to be part of a company that's really forward thinking and has the potential to change and impact so many patients lives across the US. And I think the last thing that does bring me a lot of endorphins is appreciating all the little things, whether that's taking my dog for a walk or breathing in the fresh air in the beach or really diving into a good book or making the perfect cup of matcha, which I do love oftentimes in the morning. Life is really about a lot of little things and these perfect moments and taking the time to really save for them. So I think that is the last thing that I'll leave you with is just make sure that we really pay attention and really savor the little things in life. Thank you. I wholeheartedly agree and it's been such a pleasure to have you on the podcast. Where can people find you on social media and your website? Any links I can direct people to. Yeah, you can find me at Dr. Jacqueline Tolentino on Instagram and I pop up from time to time on Parsley Health. So at Parsley Health, you can check out our website at ParsleyHealth.com if you're interested in becoming a member, if you want to learn more about our approach to medicine and our philosophy and what kinds of things that we treat and how we support preventative wellness and health, be sure to check out all those platforms.