Natural Treatments for Eczema That Actually Work: Creams, Moisturisers & More | Jen Fugo

Jen Fugo: [00:00:00] Food fear is very real. It's a huge problem in 18 to 24 year olds. The price to good health to good skin doesn't have to be, I can't eat anything. 

Dr. Brighten: There are particular nutrients that not everybody's getting or not getting enough of to actually support that. It's actually crucial for skin health. 

Jen Fugo: It was belief for a long time to only be something that impacted kids.

Now we have a lot of adult onset eczema. I had adult onset eczema. 

Dr. Brighten: Even though people are having dysfunction, they don't see it as dysfunction because it's become something that says such a constant that they're like, it must. Be normal. Jennifer Fuo 

Narrator: is a certified nutrition specialist dedicated to helping people who feel failed by conventional medicine, finally find relief from chronic skin and gut issues.

Narrator 2: Through her virtual practice, she works with clients worldwide to tackle conditions like eczema, psoriasis, rosacea, and hives, offering real solutions beyond just symptom management. 

Narrator: As the founder of Quell Shop, a skincare and supplement line designed for chronic skin [00:01:00] sufferers and the host of the Healthy Skin Show podcast, with over 1.1 million downloads, Jennifer is on a mission to empower people with the knowledge and tools to heal from the inside out.

Dr. Brighten: You'll have three-year-olds, five-year-olds, wear the doctors. Doctors like just put steroids, just put steroids, but they come off. It comes back and you see that things get worse over time. Why are topical steroids destroying people's skin? The truth 

Jen Fugo: is that the issue can be so bad that there's no amount of diet and herbs that are going to fix it, but 

Dr. Brighten: there are.

Welcome back to the Dr. Brighten Show. I'm your host, Dr. Jolene Brighten. I'm board certified in naturopathic endocrinology, a nutrition scientist, a certified sex counselor, and a certified menopause specialist. As always, I'm bringing you the latest, most UpToDate information to help you take charge of your health and take back your hormones.

If you enjoy this kind of information, I invite you to visit my website, dr Brighten.com, where I [00:02:00] have a ton of free resources for you, including a newsletter that brings you some of the best information, including updates on this podcast. Now, as always, this information is brought to you cost free, and because of that, I have to say thank you to my sponsors for making this.

Possible. It's my aim to make sure that you can have all the tools and resources in your hands and that we end the gatekeeping. And in order to do that, I do have to get support for this podcast. Thank you so much for being here. I know your time is so valuable and so important, and it's not lost on me and you're sharing it with me right now.

Don't forget to subscribe, leave a comment, or share this with a friend because it helps this podcast Get out to everyone who needs it. Alright, let's dive in. Why are topical steroids destroying people's skin? Unfortunately, 

Jen Fugo: the answer is not fully clear yet, but there are doctors who are starting to do research around this.

And what's [00:03:00] been fascinating, because I've had the honor and pleasure to be able to talk to a lot of dermatologists that are, are concerned about the overuse. And also not only just the overuse, but the increasing potency that is prescribed to patients is a little concerning in that they've been, it's been kind of assumed for a long time that if you have any type of rash, oh, just put some topical steroid on it.

Mm-hmm. And what has happened is that there's this. Dependency, I don't know of a better word at this point in time, but a dependency that can form it does not happen in every single individual. So I wanna be very cautious and not fear mongering and making everyone think that they're the worst thing in the world.

There's a time and a place and. What happens is someone can depend, someone can develop a dependency upon them, which we're not fully sure how or [00:04:00] why, and even who will develop this. That's kind of the unfortunate place that we're in. But what will happen is, let's pretend for example, that you have hand eczema.

You use topical steroids on your hands. Maybe it starts with hydrocortisone and eventually your doctor's like, Hey, you know, it's just not working enough. Or maybe you tell the doctor it's not working enough. It's starting to spread, and eventually you're given beam Me Methasone. Mm-hmm. I think is the other one.

And then Clobetasol sometimes is prescribed, which is a much more potent steroid. Um. And you'll notice your rash starts to spread. Mm-hmm. And it starts to go places that it, you never had it before and you can't go off of it. So let's pretend that the doctor said, oh, we'll take it for two weeks and then stop.

Well, the rash just keeps on going. And your skin all over your body starts to look like you're developing a full body eczema rash, where you'll even notice that individuals will develop [00:05:00] like sleeves, like the rash will stop. Mm-hmm. The redness will stop at their wrists. The tip of your nose will be white, or, you know, a normal color.

And I, I wanna be careful here because obviously people who have different skin co tones, inflammation looks different. Totally. Yeah. So in darker skin tones, somebody who may have more like brownish tone skin, it could look gray. Mm-hmm. It could look purple, it could just look darker. And in white individuals or more fairer complected individuals, that's where we see the pink and red tone.

So inflammation shows up in these kind of really interesting ways. The skin becomes extremely dried out. Uh, you'll start developing what's known as elephant skin. Hmm. So it's sort of where like at the joints, especially the skin becomes very wrinkly. Yeah. And it starts to look like, like literally elephant skin.

Um, and. You can't sleep, your hair sometimes can start falling out. Wow. You can obviously, uh, because you're being exposed to hydrocortisone and, and [00:06:00] steroids, you can sometimes develop cataracts mm-hmm. Which you need cataract surgery to remove, and you end up becoming extremely sensitive to things. Um, I, I think I mentioned insomnia is one problem.

Um, another issue is what they call zingers. So you'll feel like your body is being jolted full of like an electric current. Mm-hmm. And also swollen lymph nodes are an issue. Um, and like I said, I mean, you just can't sleep, you can't function, you can't regulate your body temperature. And so that's sort of like the worst case scenario.

Mm-hmm. But again, you don't have to go on clobetasol, which is a more potent steroid to have this happen to you. So. There's obviously adrenal issues that I think are, are, are a part of this, but also mitochondrial issues. Mm. So that's where I get concerned. I, I use topical steroids and I understand the concern that a lot of people have.

They don't know what to [00:07:00] do because doctors don't generally believe that this is a problem. It's not recognized. And so topical steroid withdrawal and it, that's now being, uh, we're trying a whole group of physicians, really smart physicians are trying to get it renamed as topical steroid withdrawal syndrome.

Mm-hmm. But getting even the diagnostic criteria passed has been, uh, uh, quite a hurdle. So, um. I think we have to consider that perhaps this medication, which I've had, uh, dermatologists on my podcast, the Healthy Skin Show, admit that if it had been, if it had gone through the FDA today, might not have actually passed and, and be used like it is now.

Um, it's just been kind of grandfathered in. Mm-hmm. And unfortunately now there's no, there's no warning Yeah. On these steroids about how to use them, how long to use them for, how much to use them for. 

Dr. Brighten: So, yeah. And when you consider, these are also over the counter, and so oftentimes people think if it's over the counter, [00:08:00] it must be safe.

Jen Fugo: Mm-hmm. 

Dr. Brighten: We know the same is true with like acetaminophen. There's, we, we wouldn't see that approved today. No. If it went by the FDA standards today. And the sad reality in the United States is that once something gets FDA approval, it is so hard to take it back off the market. Mm-hmm. Why? There's really no good answer for that.

It's just the way the bureaucracy actually works. So a lot of people are using these topical steroids for various skin conditions. Mm-hmm. Can you walk us through what are some of the top skin conditions that might make someone reach for a steroid? The first I would say is just having 

Jen Fugo: a rash. Mm. Um, typically eczema or atopic dermatitis.

Then psoriasis, I've seen it be prescribed for seborrheic dermatitis. It can, if used on the face can cause peri oral dermatitis. Mm. So that's not always advisable, at least. Look, I'm not a doctor, but the, these are things that I have learned from, uh, [00:09:00] interviewing physicians and, uh, working with clients who've ended up with problems.

So that's where, you know, I'm coming from with this. 

Dr. Brighten: Well, also, I think it's important for the audience to know that you lecture at dermatology conferences, so I have You do teach doctors on other ways and other methods to manage these skin rashes Yeah. Without having to rely on steroids. Mm-hmm. And so that's why we're gonna get there.

But that's why we're having this conversation today is I wanna talk about some of these issues because. It often isn't until things get bad. Mm-hmm. That people are then made aware the, the risks that come with topical steroids. But you were saying seic dermatitis, what other skin conditions? Um, 

Jen Fugo: well the other thing too, if it's used on the face, it can thin so it can thin your skin, but the skin on our face is very thin.

Mm-hmm. And that thinning can make your skin extremely aged because it'll destroy the matrix of collagen underneath the skin. And then in like your eyelid area, some individuals will develop these. Like cracks [00:10:00] that will not heal up. So, wow. It, it's, you have to be very careful on the face. Yeah. Um, it's also used for lichen sclerosis.

Mm-hmm. Um, I'm trying to think what else. Chronic hives and urticaria, I mean, they're used, there's people who use it for mosquito bites and it's in skincare products that are marketed, like I've seen them marketed on Instagram and Facebook. Mm-hmm. And it's. An ingredient in the formulation, but it's never really disclosed why it's so great with like making your skin clear up and you have this like, sensitive skin and you might be prone to rashes and Oh, it has a steroid in it.

Yeah. Um, the other like big red flag are, um, creams that come from China, like Chinese medicine creams, A lot of times they have steroids hidden in them. Oh, wow. And you can't read the directions and the ingredients on them because obviously it's written in a language like most of us, I mean, there are certainly people I'm sure who can read it, but most of us who do not read Chinese have no idea what's in this.

And so unfortunately that is, you have to be [00:11:00] very careful with those creams as well. 

Dr. Brighten: Mm-hmm. That's, uh, that's actually something that's, I'm like, oh my gosh, check your skincare. Mm-hmm. Because I never considered that they were gonna be hiding steroids within there. Mm-hmm. 

Jen Fugo: There's very famous.

Dermatologists who have huge followings mm-hmm. Who put steroids in their creams that they recommend, oh, you can use on your face, you can use everywhere. And it has has hydrocortisone in it. 

Dr. Brighten: Wow. Wow. Mm-hmm. That's shocking. And this is something that you should always read your labels, but I think, mm-hmm.

As much as we've taught the public about reading food labels, there hasn't been a lot about skincare literacy and actually understanding what's going in there. I think also when a doctor is recommending it, you tend to trust that and not always question it. So what should people be asking their doctor about if their doctor recommends steroids as first line?

What other things might be considered or should be investigated? 

Jen Fugo: Well, I can say one thing that's [00:12:00] a challenge is insurance companies and what they'll pee for because the more, the higher potency, bigger kind of gun drugs. Yeah, like biologics, JAK inhibitors, um, immunosuppressants. A lot of times you have to fail with steroids or you have to have such bad recurrent skin infections that they won't cover it until you fail certain things like methotrexate, cyclosporin.

So a lot of times the first line of defense is literally. Topical steroids. Mm-hmm. Or if it's so bad, they'll do like a prednisone shot. 'cause they're like, we just gotta get the inflammation down. The challenge is that what we don't ask enough questions, I think just generally is patients. And a lot of patients also don't know that pharmacists are so knowledgeable.

Oh yes. They're amazing. So yeah. So start asking. Your pharmacist about guidelines and recommendations about how to use the cream, what do they suggest? Ask your doctor or [00:13:00] provider, how long should I be on this? Mm-hmm. And then when should I stop? How much of my body surface should I apply this to? How many times a day is too much?

Because if you are given, and I'm not even joking, sometimes a ginormous tub that does not give any kind of like boundaries. Mm-hmm. How are you the patient supposed to know that you were supposed to stop it after two weeks when it doesn't actually say that? Yeah. So you know, my worry is that. Uh, yes, steroids can be helpful.

They have a time and a place, so I don't want anyone to walk away listening to this and being like, oh, I'm throwing this all out in the trash. That's probably not a good idea because it, it could be possible, you know, if your doctor prescribed that and you've been taking it readily and you just. Cold Turkey, stop it.

There may be some TSW symptoms that will pop [00:14:00] out. Um, what's ts w Ts W is topical steroid withdrawal. Okay. So, um, again, that's just like this condition that's triggered as a secondary condition by the medication. So whatever condition you had prior or condition. So if you had eczema and that's what drove you to use the cream mm-hmm.

You still have eczema, you just have now this other problem, which is quite significant on top of it. If you're a mom, for example, who's. You know, rubbing your child with the creams at night, you can develop TSW as well because you are exposed to it. So it's just really interesting and, and again, I feel sad that like I can't go in this study.

We don't have a whole lot right now at the moment. There's been a ca there's been a couple of case studies I believe that are like right in, they've either been published, um, or are going to be published. And we had one doctor from the NIH who published a study that believes that the redness, the extreme redness that people experience in their skin [00:15:00] from this is actually the result of excess NAD.

Okay. So then the, um, flushing form of niacin mm-hmm. That is overproduced by your mitochondria. Um, and also. In the Urin pathway so that eventually in the urin pathway we end up generating NAD and steroids, specifically hydrocortisone, upregulate, that pathway. Okay. So it's really fascinating, like all the things, but we're just in the, the infancy of it.

So I like to say what could possibly be driving the inflammation under the surface, so maybe we can get off of these medications, we could look for other alternatives to try to get back to normal skin. 

Dr. Brighten: Mm-hmm. Eczema is a condition a lot of people are struggling with. Roughly, like how many people struggle with eczema?

Jen Fugo: I think the last time I look at the stats, at least in the United States, it was. Oh, I think it was something like 30 million people. Oh, wow. Yeah. It was believed for a long time to only be [00:16:00] something that impacted kids. Now we have a lot of adult onset eczema. I had adult e uh, onset eczema. Mm-hmm. I had retic eczema on my hands, so I was told to use steroids and Vaseline.

Yeah. I mean, I don't know about you, but Vaseline on your palm, the palms of your hands, where you touch things is not exactly the most practical su suggestion. 

Dr. Brighten: Totally. It's also like the texture wise, like not great, and it's a petroleum based product. Yeah. And we have to use caution when using a petroleum based product that, especially on skin that is broken and we've lost the barrier, but you know, Vaseline gloves for example, putting those on at night can be tremendously beneficial for someone.

And so again, it's, it's, it's always weighing the risk versus benefit. Now when it comes to eczema, that's one primary condition. We often see steroids, I mean, children. You'll have three year olds, five year olds. Mm-hmm. Where the doctor's like just put steroids, just put [00:17:00] steroids. They come off, it comes back and you see that things get worse over time.

There's also, you know, I get that we wanna get them out of discomfort and we wanna get relief, but there's not a lot of thought for that aging skin over time. Mm-hmm. What is going on at the root of eczema as far as we, our current understanding, 

Jen Fugo: our current understanding from a conventional standpoint is there's inflammation under the surface.

You might have gotten bad genes, you might have, uh, you might be in an environment that you're allergic to. There could be some food allergies. And then they don't know the rest. Mm-hmm. That's pretty much where it's left. The more recent research, which I have found super fascinating, which was actually to be fair, done by pharmaceutical companies.

'cause they had the budget to do it. Yeah. Was looking at specific cytokines. So specific, uh, cytokines are, for those who don't know, they are inflammatory messengers. They're sort of like, I think Dr. Carrie [00:18:00] Jones described them as like emails that keep getting like sent out into the system. She's like so great at analogies.

Yeah. And um, your body is trying to recruit help to a specific location so the inflammation doesn't necessarily begin on the skin that you see on, that's on the skin. Mm-hmm. It could literally be a sign of something else happening someplace else. Mm-hmm. And it just so happens that for me it was on the palms of my hands that it showed up.

And so. What the more current research showed us that then has contributed to the development of these newer medications like biologic drugs and JAK inhibitors, is that there are specific types of messengers or cytokines that are probably, I would say more predominant in specific conditions. Like, for example, with eczema, there's um, IL four, IL 13.

Mm-hmm. [00:19:00] Um, with psoriasis, it's like IL 17, IL 23. And they're looking at other, um, interleukins and whatnot, and then there's like tumor necrosis factor alpha. But the fascinating thing about all of this research is that they're, they know what can trigger these potential cytokines. They actually do know, which I think is really interesting.

And one of, so, so this happened to me a couple years ago. I got an email, I don't know, do you ever get drug company emails? Mm-hmm. No. I, I don't know 

Dr. Brighten: how I got on this drug companies list. They leave me alone. They're like, she wrote this book called Beyond the Pill. She's not our friend. 

Jen Fugo: I don't know why they, they thought I was their friend.

So they were, they were asking for money, for funding, for like a phase three drug trial for a oral, I think it was an IL 17 blocker. And at first I was like, I don't know what this is. And I threw it in my trash. And then I was like, I wonder what that says. Why did I get that? And as I'm reading through about halfway down, they acknowledged in the email that [00:20:00] IL 17 is an inflammatory cytokine that's triggered by pathogens mm-hmm.

In the body. And I'm like, they know. Yeah. They know. They actually know what is causing these cytokines. So why are we just using a drug to block the signal and not going after the thing that caused it in the first place? So what are the pathogens? So. H pylori, which is a, a stomach infection. And what is it, like 60% of the population, something like that is infected.

Yeah. And um, I actually presented information on this at gastro a MPI think it was 2023, about the relationship between h pylori and all of the different cytokines that it can potentially trigger and how that can then play into different skin conditions. Because historically, even in like functional and integrative and even naturopathic medicine, if you don't have symptoms of like [00:21:00] gerd, heartburn, um, a stomach ulcer, they don't do anything.

Even if it showed up on, uh, like a stool test, they're like, well, you're asymptomatic. We're not gonna do anything. And some people actually think it's a commensal. So it's like a good thing that it's there. It's not a problem. But what if you show symptoms in a different way? Mm-hmm. I have had clients, like we talked about, um, histamine intolerance.

So I've had some clients where they had h pylori, but they had no traditional symptoms of it. They did have other GI issues like gas, bloating, maybe some occasional diarrhea, but really it was mostly skin issues, especially itchiness. Mm-hmm. And h pylori can contribute to histamine release because it destabilizes mast cells.

I was like, well, let's try dealing with it. Let's see what happens. And through a bunch of trial and errors with clients, I started to see that people began to actually feel better. Yeah. And then it was showing up in their skin as well as if they had [00:22:00] GI issues, it would start to improve GI symptoms. So that can do it.

We can have, um, different bacteria that we're exposed to one medication that is commonly used in eczema. There are IL 13 blockers. Mm-hmm. So Dupixent, Abri, there's a few others, but those are the two most notable ones. And they actually have a warning on them that you should not use them if you have a helmet infection.

Well, most people don't know what a helmuth is. Yeah, I was just gonna say, go find that it's a worm. It's a type of parasitic worm. Um, and. I don't know about you, but most doctors rarely check for parasites unless you have such severe GI distress and probably either had food poisoning or came from like a third world country.

Mm-hmm. From vacation. They don't check. So I've asked drug reps and I've asked [00:23:00] doctors, well, if there's a warning on this, you're not supposed to be on this medication. Be if you, you have a helmet infection because it's an IL 13 blocker. I. W who's supposed to sort that out? Yeah. And the response is doing the testing response.

The patient would tell their 

Dr. Brighten: doctor, I think I have a worm, sir. Actually, you know, if we actually said that they would probably think we had a psych condition. If we said we, I think I have a worm inside me. 

Jen Fugo: I have provided, uh, clients with stool testing proof that they have what is called larval nematodes.

So they're like baby worms. And I'm like, uh, you need to bring this to your dermatologist and ask them to treat you for this, or you have to come off the medication. And I have countless times been told, I don't know how to, I don't treat GI issues. I don't treat parasites. Yeah, it's probably fine. And I'm like, yeah, but it, so the reason I'll just specify 'cause I'm, I don't want your listeners to go, but why should you not, why, [00:24:00] what's the deal with this?

Mm-hmm. So people think that cytokines are bad and um, actually I think you know her, Dr. Heather Zwicky. Yeah. Um, she was my immunology teacher actually in med school. Yeah. So she's super brilliant. She's been on the Healthy Skin Show a bunch, and what she shared with me, it's similar to like histamine and all of these things.

It's never this black and white. Sometimes it's black and white, but a lot of times there's shades of gray when it comes to these issues. And cytokines are not necessarily bad. They're a part of our immune system. It's your body trying to help tell you there's a problem. And the symptoms that result like eczema or hives or whatever.

Admittedly, yes, they are super annoying and very, in some instances very debilitating. But IL 13 is there to help you clear out worms. Mm-hmm. So when you block it, your body can't do what it's supposed to do. Yeah. Which is a problem. And so that's why the warning is on the medication. So [00:25:00] I just, I find the research that's being done about these medications and whatnot, really interesting.

And it's, I don't know why I have colleagues that are also in this space and, and a lot of people are like, why are you looking at this research? It was made, it was from drug companies. And I'm like, but it offers us insight into how these medications work. And if we can then take that and say, well, okay, if we know then that these medications are blocking cytokines caused by, you know, X number of pathogens that in the GI tract that cause this whole inflammation cascade.

Why don't we deal with that? Mm-hmm. So it's not, I don't want anyone to think, oh, it's just a gut issue. There's plenty of other issues that can happen with, with eczema. Um, you can certainly have environmental allergies, you can mold exposure, um, you can have genetic SNPs. That one specifically in, um, are you familiar with rin?

Mm-hmm. So, um, for your listeners who don't know, [00:26:00] RIN is sort of like the mortar mix of your skin barrier. And it also, when it breaks down, helps produce something called natural moisturizing factor that helps keep your skin nice and moisturized. And when you think of eczema, psoriasis, and many of these skin conditions, your skin gets like.

Super dried out. Yeah. And flaky. And you can't hold moisture in. And so you can have a snip in the gene that produces the protein called rin. And um, I like to think of it as like the mortar mix in between the skin cells. So it helps to keep the skin barrier nice and tight, but internal inflammation will also dysregulate the enzyme or that, or the, the enzy, the resulting.

So there's a gene that makes an enzyme that then makes the protein phin. Mm-hmm. And that enzyme is susceptible to creating like kind of a cruddy version of RIN when there's a lot of internal inflammation. 

Dr. Brighten: Yeah. [00:27:00] So you mentioned, we talked about histamine, not this episode, friends. Yeah. We actually have an entire episode about histamine that I'm gonna link to in the show notes.

That way people can go back and listen to that. Um, and if you've heard that. Then I'm glad that you're here because bringing up the h pylori, we didn't get to talk about that. I think another important thing to understand about h pylori, so I actually had h pylori as a kid, super sick for a very long time.

The h pori pylori hadn't been discovered yet. That's how old I am. Um, and then they discovered it and this doctor was like, I just wonder, let's do, let's scope you and let's see. And sure enough, there was h pylori. So the chronic acid throwing up what people thought was an eating disorder, uh, was actually h pylori.

That's something important to know about h pylori is if your partner hasn't, and you guys make out mm-hmm. You have it and vice versa. And it's not like an STI okay. But like an STI, if we treat one person, we generally wanna treat the other person. And so that [00:28:00] is something that I know you've seen with clients as like a missing piece of like, they are having skin symptoms and as it turns out, their partner had passed them the h pylori.

Mm-hmm. 

Jen Fugo: Well, and also. H Pylori Hijacks gut function. Mm-hmm. So again, it's not all gut. I know we're talking a lot about that, and this applies to many different skin conditions, but our gut. In terms of the gut. So gut function is a one way street. So if you, it better hijack be, I know when it goes the other way, nobody's happy.

No, no, no, no, no, no, no. But it's a one way street. So that means that every stop, essentially along the way is unfortunately there's no backup for it. So in our stomach, which is where h pylori infects mm-hmm. You're supposed to have one of the most, uh, acidic environments in the body so that we can break apart these chemical bonds that hold proteins together.

Mm-hmm. It also, we have protein and [00:29:00] B12 linked together protein and iron, and we need stomach acid in order to break those links. And the other thing is it's a chemical barrier. Mm-hmm. So that every time you swallow your mouth microbiome and so you don't get worms. You don't get worms. Yeah. You don't, you know, and even food poisoning, a lot of these things, we forget when we swallow things, it's supposed to die in the stomach.

Mm-hmm. So h pylori produces an enzyme called urease. That deactivates stomach acid. And when that happens, it's like leaving the front door of your house wide open. You wouldn't do that and go on vacation. Yeah. It's not even just unlocked. It's wide open. And so people can end up developing sibo. Right. So a lot of times they're like, how did SIBO happen?

Well, if you keep swallowing literally everything in your, your saliva mm-hmm. Which is a microbiome in and of itself, it's also your mouth is a gateway microbiome, as is your nasal microbiome, by the way. And you swallow that too, [00:30:00] what's in your water. Right. Even though our water here looks clear, there's things living in it that we can't see.

Mm-hmm. We're inhaling organisms every time we inhale in that again, you're swallowing. We have to kill those organisms to protect our gut further down, that will not happen. So every time you swallow, you are swallowing, maybe some Klebsiella, you're swallowing, some ciro backer. You're swallowing even fungal organisms and parasites.

Yeah. And so. When we don't have sufficient stomach acid, it hijacks our ability to acquire enough iron, B12 protein, and other nutrients. Uh, it also populates potentially our whole gut from the small intestine all the way down to the large intestine with organisms that, again, the pathogens that can trigger inflammatory cascades.

Mm-hmm. And. When your stomach doesn't break food down appropriately, it cannot [00:31:00] like that one step, there's no backup. So now your gallbladder doesn't squeeze out bile appropriately, your, uh, pancreas. While yes, it might squeeze out, uh, or secrete a bunch of enzymes into the small intestine. Those enzymes can only do so much.

They're, they're like the little tiny, they just do a little smaller job of cutting up the amino acids. Yeah. They're not meant to do the whole work. So we start to see a ton of gut dysfunction. We start to lose nutrients that impacts your thyroid. Mm-hmm. It impacts, I was hoping you were gonna talk about thyroid.

Oh, a hundred and, and, and thyroid issues also impact skin heavily, but your thyroid needs nutrients. Your brain obviously needs nutrients. Your liver detox, which we talked a ton about on the histamine episode, also needs nutrients. And we start to see this cascade of problems where more and more nutrients aren't being absorbed.

You have a ton of GI symptoms. I will say this. I don't know [00:32:00] why this is, maybe, you know, I don't know. I have seen cases where people have really messed up GI tracts. Mm-hmm. Like lots of dysbiosis and these imbalances and no gut symptoms. So I don't think that you can assume, oh, my gut's good. Yeah. But I have skin problems.

I don't have a gut problem. I don't think you can assume that because my experience has shown me otherwise. If you know, know why, I would love to know. Well, there's also 

Dr. Brighten: the part of normalizing what has existed for a long period of time. Yeah. So even though people are having dysfunction, they don't see it as dysfunction.

That's true. Because it's become something that says such a constant that they're like, it must be normal. And so, you know, I've even had patients where I've been like, do you ever see undigested food in your stool? After they've told me, I have no gut issues, I have nothing going on. And they're like, yeah, sure.

If I eat lettuce, that always comes through and I'm like. Lettuce. How long has that been going on? And they're like, for years. Isn't that normal? Mm-hmm. We don't talk about poop. Just like we don't talk about periods and we don't talk about hormones. Very true. Like enough. And so we [00:33:00] don't have people who are bouncing off mm-hmm To know what's normal.

I think there's also the way that people express, so when you have gut symptoms, maybe you're having joint pain, maybe you're having brain fog, maybe you're having other endocrine issues. So hormonal issues going on. But skin is also a way that we know when the gut is not adequately detoxifying. 'cause that's one of its jobs, digest, just all these things.

But. And it's not moving. Waste out, waste has to get out somehow. And so sometimes we see that present in the skin as well. Mm-hmm. So with that being said, I brought up that we don't always talk about what's normal, what's not. Let's go through what's not normal when it comes to digestive health. So people know.

I 

Jen Fugo: would say that if you, I would say the first thing is it's not normal to just swallow your food, but Yeah. I do have to like tell everyone in the military, I, I know one of my best friends ins in college was, uh, I know a lot of 

Dr. Brighten: moms. Yeah. Um, one of my best friends in college was, [00:34:00] uh, in the, um, military.

He's the Coast Guard. And he literally, we, we would, we would have breakfast, like we'd work out together and then we'd have breakfast together and he would sit down and by the time I sat down, his food would already be gone. Mm-hmm. And he's like. This is how we operate. But I feel like military and moms, these are the two that are like, inhale or never see the food again.

Jen Fugo: Yes. And if you are, if somebody was to describe you as that, that is like, we got a problem. We don't have teeth anywhere else. Yeah. This is true. They true of a purpose more. They're not just for smiling. So, um, we do need to chew our food appropriately mm-hmm. To make right. We're setting the stage for what's gonna happen in the stomach.

If you then get to the stomach and you start having reflux or any type of pain, or you feel like the food is really heavy, it won't move like you've gotta. Stone in your stomach. Mm-hmm. That's definitely a concern if you have discomfort anywhere in the GI tract. So the stomach, just so everyone knows, 'cause people are like, oh, my stomach hurts.

I'm like, where does it hurt? 'cause your stomach is [00:35:00] on the left side under your rib cage on the right side is your gallbladder in your liver. Mm-hmm. So if it's on the right side, now we have to wonder, is something going on with the gallbladder or the liver? Right? So the pain, where the pain is, is important.

Your stomach is not by your belly button, but this is all of your abdomen, your small intestine, and your large intestines. So if there's any pain or discomfort or like, I don't know how to describe this other than just like, it feels like your insides are sore. Mm-hmm. That's not normal. Um, any type of gas or bloating, um, constipation is not normal.

So if you're not having at least one bowel movement every day, that's. I would say well-formed. That's a problem as is on the flip side, diarrhea, which is also nutrients and everything are moving so quickly through you. It's very, very disruptive. So if you're the type of person that's like, oh yeah, food just goes right through me, that's not normal.

Belching, bloating, or belching, especially like that's gas coming up usually from the small intestine or the [00:36:00] stomach. Whereas flatulence or our lovely farts are usually from lower down in the large intestine. And obviously if you have anal itching, I know nobody wants to talk about a itchy butt. Mm-hmm.

But like that's not normal. Yeah. So what can that be? Let people know? Well, it can be, so it can be fungal overgrowth. Mm-hmm. But it also can be parasites as well. Yeah. Pin like moms know a lot about pin worms, I feel like. Mm-hmm. Because that's a thing kids pass around. I don't. See that ever in adults. But I, I think like for kids, we don't put everything in our mouth.

That's true. Good point. Good point. 

Dr. Brighten: But the other thing too is if your food is passing through too quickly, the anus can become irritated. Yeah. And that can also cause itching as well. Yep. You brought up reflux and I think a lot of people often miss the signs, which could be clearing your throat excessively after you eat or coughing after you eat or coughing when you go to bed at night.

And so when their doctor asks them, are you having reflux? They think [00:37:00] No. And that can actually be a sign of h pylori. Like bringing it back to that. Um, you brought up passing gas farting. Yep. PE people fart. So what's everybody farts, Melissa? Because people are gonna be like, wait, should I never fart? 

Jen Fugo: No, I mean, you're supposed to fart.

I mean, we have a whole microbiome in our GI tract. They're farting by the way. They're farting. 

Dr. Brighten: It's not you, you're just the vehicle in which it exits and you're fleshy. Exactly. So it makes noise, but it's actually the bacteria making that gas. Yeah. 

Jen Fugo: So I think, you know, if it's. If you're not having a whole lot, it's, it's different where it's all day.

It's after you eat. And especially if it's got a really distinct odor. Like if you're like sitting in meetings and being like, oh my God, I, I really need to, like, people would Clear room. Yeah. Yeah. Like that you've got a problem, something's going on there. It can be purification of the proteins mm-hmm.

That weren't broken down in the stomach and thus couldn't be absorbed. Um, you know, we, again, our gut function is equally as important as the gut [00:38:00] microbiome and they both contribute to this whole concept of leaky gut. And I just wanna say this right here and now. Leaky gut's not the problem. That's not the thing you should focus on.

If you have these conditions, yes, you likely have leaky gut. You could just easily assume that you don't need to do a test. You don't need to buy products to heal your leaky gut. You have to deal with the actual issue that's driving that. Mm-hmm. And so we have these barriers. And what's fascinating about the skin is it's also a barrier.

You can have leaky skin. That's what it results in. Things like eczema, it's a leaky skin barrier. And we have a skin microbiome, right, that people will develop. Skin infections to things like staph aria, which produces all of these like, ugh, very caustic toxins and whatnot, and makes it difficult for our skin to heal.

Um, there's other, uh, imbalances that can happen on the skin as well. Mm-hmm. Like malasia overgrowth. I mean, you can certainly have candida infections on the skin, but [00:39:00] Malthe is a type of fungal organism that predominantly lives in the sebaceous areas. So anywhere that. You have kind of hair, that's where they love to hang out.

They eat the lipids. Mm-hmm. Um, and when you have things like sic dermatitis or dandruff, there's usually some sort of overgrowth of malasia. Um, but we can also develop, um, skin infections, strep infections, pseudomonas infections. Uh, the other interesting one is demodex overgrowth, specifically on the face.

I don't know if you can get that on the rest of your body. Yeah. But definitely on the face. I have seen that in a few cases of eczema. But with rosacea, you should definitely get checked if you've got a, I learned, oh my gosh. From, from, we both know her, Dr. Carly Rose. Oh yeah. She came on and told me all about how demodex mites, when they overgrow on your eyelashes, like all the crusting and everything is like their poop.

Dr. Brighten: Mm-hmm. Yeah. Well explain what people [00:40:00] are, uh, what these are, because I think this might be totally new to people what they are. 

Jen Fugo: It's, it's a commensal organism. I do wanna say that, but it's a, you do have bugs. You do have bugs that live on your face and they of all different varieties, um, these happen to be more parasitic in nature.

Mm-hmm. And so in rosacea specifically, they tend to be something that may overgrow and contribute to worsening rosacea. They can also show up, um, as like a kind of a form of blepharitis. Mm-hmm. And so it's, you're, which is where you're gonna get inflammation and swelling. Inflammation. Yep. And like a lot of like dry eye issues and irritation.

And you might get like the crusting and uh, mucus and all sorts of stuff. So your ophthalmologist or optometrist can. Like pretty quickly, see if that's what's going on and help you figure out how to like resolve it. Um, but if it's on the face, usually they use [00:41:00] topical ivermectin. Mm-hmm. To deal with it.

There is a new product that Dr. Rose told me about that's for the eyes that actually was discovered because of a pet medication used to treat mange that actually works and it's now been FDA approved. Um, I don't have any experience with that, but like that it was, I have these episodes so if anybody's interested we can certainly share them.

Um, but again, we have this interesting interplay between the gut microbiome. Gut function that contributes to creating these inflammatory messengers and then how it communicates to the skin and the inflammation that shows up on the skin and disregulates our skin, whether mm-hmm. You know, in psoriasis, whether you end up with this excess, um, production of skin cells that creates the plaques.

It's just, to me, it's so fascinating, um, and obviously too. Because I know you know so much about thyroid and hormone health, the [00:42:00] thyroid is a crucial piece to this. Mm-hmm. And some skin conditions can put you at greater risk for having thyroid dysfunction. Um, psoriasis, I, I don't know what the increase, what the actual percentage is or rate, it's increased, but those who have psoriasis are at much greater rate.

Uh, or in, uh, much greater risk for developing Hashimoto's thyroiditis. Mm-hmm. And if you have a thyroid that's really dysregulated and in a hypo state, I don't know about a hyper 'cause I don't see, um, many clients that have hyperthyroidism is 

Dr. Brighten: much more rare. And I appreciate you bringing it up. 'cause people and I will link to, uh, web article on dr Brighten.com all about Graves disease.

'cause people are always like, well, what about graves? And that's like one out of like 3000 people who have Hashimoto's talking about it because it's just disproportionately much more rare. 

Jen Fugo: Yeah. But the, the, the higher your TSH goes, the more your thyroid gets [00:43:00] kind of. Low. One of the symptoms is an eczema esque type rash.

Mm-hmm. You can end up with a lot of skin dryness, itchiness. 

Dr. Brighten: So you think it's scaling. So when I was diagnosed with hypothyroidism, I had scaling on my knees, like they were so dry and we called it dragon Skin Sales scales. Mm. And just to clarify for people, you said as the TSH gets higher and your thyroid gets low, TSH will be going high, high, high.

'cause it's your brain screaming at your thyroid, but the actual thyroid hormone is low. And that's why you're getting that response. 

Jen Fugo: Yeah. And it can have, you might not think that it's a big deal. I, I really recommend clients get their full thyroid panel checked. Mm-hmm. Uh, one individual I worked with, um, and actually I interviewed her on the show, her TSH came back at 33, which was the highest I had ever seen, A TSH.

And she was so physically miserable with her skin, but also mentally she was like, she was ready to kind of like. Not be here [00:44:00] anymore. Mm-hmm. She was so depressed, she was so overwhelmed and couldn't she just, and so I'm so glad and grateful that we looked deeper because then she was able to get on medication and not drastically improved so many things.

Gave her more runway so that she could work on a lot of those other underlying root causes. And you know, actually get back to like getting outside and going in the garden and doing normal things. 

Dr. Brighten: Well and for context for people to understand, you said TSH is above 30. We don't like to see it consistently above 2.5, so that is grossly hypothyroid.

Yeah. Some doctors won't actually treat until it's 10. Mm-hmm. 15. And I feel like that's because this is predominantly a condition that affects women and telling women you're just tired because you're a mom. You're just tired because of this and gaslighting them about their symptoms just to still in trend.

We need to like boot that like call Cosmo up and be like, can you like issue gaslighting women is out. [00:45:00] 2025, it's out. Uh, that would be really nice. Yeah. Um, you've brought up psoriasis. So we've talked a little bit about like the root cause of eczema. Mm-hmm. Some things that can contribute. How is it similar or maybe different with psoriasis?

Jen Fugo: With psoriasis? There's definitely gut function, gut microbiome issues for sure. Mm-hmm. I, um, have also found with a lot of psoriasis that I, and I don't fully know the reason why, but it looks like there's a tendency or propensity towards a lot more fungal overgrowth. Mm-hmm. Within the GI tract. I wanna be really clear, 'cause a lot of times people think what I talk about an overgrowth or an organism, they're like, on the skin.

Yeah. No, no, no. It's in the gut. And then that inflammation as your body is sending out those cytokines or those messengers trying to recruit for help ends up on your skin and you end up with these symptoms. So that's one concern also. The specific type of strep, it's not all strep. Mm-hmm. Because we have a lot of strep [00:46:00] species that live in our mouth microbiome.

But strep pyro genes can be a trigger for gut ate psoriasis. Mm-hmm. So the kind of spots, so if you got strep throat as a kid and then all of a sudden you're covered head to toe in a bunch of spots, that can be an inflammatory trigger towards it. And. So there's some interesting research showing that some folks with psoriasis have actually seen a, an improvement by having their tonsils removed.

Mm-hmm. Which it can be a reservoir for strep. Yeah. It can be a reservoir for strep. Um, you can have strep hiding in the system. But yes, I, I think in general it's like we're looking at the thyroid, we're looking at the gut microbiome, we're looking at gut function. We're looking at the environment that you live in because mold plays a huge factor for people with psoriasis and for whatever reason will make it absolutely worse.

It might not show up as a histamine response. Mm-hmm. I don't know why. I've only had a handful of psoriasis clients that have histamine issues, it just send, it shows up differently. [00:47:00] Um, also looking at nutrient depletions, folks with psoriasis tend to have certain key nutrient depletions that you don't, it's not that you don't see them in other conditions, but it's.

Like vitamin D, vitamin A. Mm-hmm. Um, omega threes protein, um, those are kind of the big ones. Yeah. And there's actual research to back that up. Um, and so one of the things that I love when it comes to looking at psoriasis is looking at the nutrients, but also what's happening with their liver. So for, for those who are in the know, psoriasis has a lot of comorbidities, basically like connections to other conditions associated with like metabolic function.

And your liver is one where. I've had, I, and I'm, I'm sure you've, you have seen this where someone has psoriasis and they start developing fatty liver. Mm-hmm. And the doctor's like, how much, how much alcohol are you drinking? It's always Right, right. You must be drinking. You must be drinking. It's like 

Dr. Brighten: [00:48:00] same thing, you get pancreatitis, they're like, you're an alcoholic.

And it's like, 

Jen Fugo: what? You could be something else. Get curious. Right, right, right. It could be. So instead, what did we call it? Non-alcoholic fatty liver disease. And they're like, we don't know. We don't know. It's just we, it's you didn't drink alcohol, but for somehow you have this fatty liver. We don't, we just don't know.

And so it was my kind of theory for a long while thinking like, well, these organisms, right, we were talking about how organisms fart, they mm-hmm. They also poop too. Not the type of poop we poop, but they have waste products. Yeah. And those waste products have to be metabolized in some way. Either they are excreted out by us directly or they go through phase two liver detox.

Mm-hmm. What happens if you have a lot of organisms that also produce alcohol? Mm-hmm. So maybe it's not that you're consuming alcohol, but it's that you are literally a little bit like an alcohol, uh, production factory. You don't mean mean it to be an 

Dr. Brighten: alcoholic, but only because they're producing beer in your [00:49:00] gut.

Sorry. Yeah. And it's like, you don't even get a buzz. It's kind of lame. No. 

Jen Fugo: So, um, so I've seen so many lectures from a four M and from IFM now mm-hmm. Of this. Integral, um, relationship of the, what's produced in the GI tract goes through the portal liver to the vein, and now you're or portal vein to the liver and your, now your liver has to deal with it through, we talked about on, so if you wanna know about the histamine stuff and all the liver detox, we did talk about the liver detox stuff extensively there.

But basically it goes through phase two liver detox. 

Dr. Brighten: Mm-hmm. And, and what do we need for phase two liver detox? Because there are particular nutrients that not everybody's getting or not getting enough of to actually support that. Yeah. It's, it's actually crucial for skin health. 

Jen Fugo: It is. And I would say if anybody is interested in doing all this gut work, please start with the liver first.

Mm-hmm. Because the liver's gonna deal with the brunt and increase of toxins when you start addressing the GI tract. So the liver and phase two detox needs [00:50:00] a number of crucial minerals. Um, also specific. Amino acids and I, we talked about this, um, many times, but vitamin B six is really important for your liver.

I was on your show talking about 

Dr. Brighten: vitamin B six. I know. So, healthy skin show, I'm gonna link to it. I was talking all about PMD, DADH, adhd, autism, histamine issues, and vitamin B six was definitely one that came up. Yeah. So 

Jen Fugo: I also love vitamin B six, and so I think the first easiest step is to increase your glycine consumption, but you can't do it through diet.

I don't know why I have tried to figure this out. It just does not work. I think your body goes, oh, it's food based. Let me put it where I wanna put it. If it's supplemental. So you actually go and you get like the capsules or the powder. Um, it seems to work better to refill this well that you need in order to process things through the gly.

It's actually called the glycine cleavage system. Mm-hmm. So it's part, it's [00:51:00] one of the, it sounds sexy too. I know. Cleavage system. It just means 

Dr. Brighten: like cutting something off, which is kinda lame, but I'm like, we can just try to make it look glycine spicy. 

Jen Fugo: It does, it does sound spicy. I like that. Um, we also have the glutathione pathway, sulfation methylation.

So we've got a lot of things happening in the liver that require nutrients, so. I think the easiest thing to do is look at glycine and B six is like your first step. Mm-hmm. If you've had long standing skin issues and or they're really severe, that's where we really need to add in a more full spectrum support of these different amino acids.

Because at the end of the day now it's like we need to make sure that your liver's got what it needs in order to do this work. 'cause if it doesn't, it's just not gonna happen. Mm-hmm. And now you're like. Kind of slowing the conveyor belt down. And it, for those of you that remember the I Love Lucy, uh, episode with Ethylene Lucy at the chocolate factory, [00:52:00] like, you're gonna have a problem.

You need those nutrients in order for this to work. And so, um, like one of the, uh, products that I created called, um, P two, D two, P two detox balance mm-hmm. Has this full scope of amino acids that help support the liver without triggering a flare up because it doesn't have certain herbs in it. That, and b vitamins as well that sometimes make people feel worse.

Yeah. And skin people are funny. We sort of react in different ways than somebody who has like, just gut problems because the skin is so temperamental from one moment to another. You're not always sure what. Was the trigger. And that's one of the reasons why we wanna make sure that we're giving the liver what it needs, get it up, get it humming, and then you start dealing with the gut microbiome.

You can do gut function. Mm-hmm. Before gut microbiome, but do not start working on the gut microbiome before you've got the liver humming. It's really important. 

Dr. Brighten: Mm-hmm. You had said [00:53:00] that diet doesn't necessarily work for glycine. I think some people are gonna walk away being like, oh, so she's saying don't bother with the diet, just take a supplement.

No. Okay. Diet matters. I do 

Jen Fugo: think diet matters. I think one of the big frustrations I have with integrative medicine is that most people are like, oh, just go on this diet or just do a IP or just think, think you, you said psoriasis is connected 

Dr. Brighten: to candida? 

Jen Fugo: Yes. Candida 

Dr. Brighten: diet. No. Thumbs up or down? 

Jen Fugo: No thumbs down.

Okay. Um. So part of the problem is we've created this world where people think that be, the more foods they take out, the healthier they are. Yes. Much and perhaps. There's a likelihood that maybe you take out one of the inputs, things change, and all of a sudden your skin does start to get better. But long term, is that really sustainable?

Mm-hmm. If it's maybe just like DI dairy or gluten, it might not be that hard. Yeah. But what happens? It might be sad, but not that hard. Right. [00:54:00] But what happens in like six months when now all of a sudden you've gotta take out more food? Yeah. And then another six months. Now it's more food and your diet is getting smaller and smaller.

I wanna know why you're becoming so reactive to those foods. Mm-hmm. Now, in the case of psoriasis, there is a risk that you could have celiac disease. There is again, all of these comorbidities, and that is one of them. So some individuals actually do really well on a gluten-free diet who have psoriasis.

That being said, I think try to add into your diet as many whole foods as humanly possible. But these other diets, like if you struggle with salicylates, which is a phytonutrient and a phytochemical essentially, that comes from plant foods that some people start to react to, that's actually a sign that you have an issue with glycine.

Mm-hmm. Because it's, that's where salicylic acid is processed. We need glycine to repackage it to get it out of the body. So it's a sign of deficiency. Mm-hmm. Not that you have to avoid all of these foods. [00:55:00] Um, you know, you asked about the candida diet. Well, I don't like it because number one, it's miserable.

Yeah. Like I like food. You like food, you know, I like food. You have foodies. And when you have spent years, like I spent 13 years not eating eggs and gluten. I, listen, I got used to it, I accepted it. But to be able to just travel and eat eggs, like actually have some food for breakfast mm-hmm. When you travel made such an, uh, like it gave me such an ease.

And so that's what a lot of clients report when they're able to add back these foods because it wasn't the foods causing the problem. It wasn't the foods causing all of this inflammation. It was all of the other factors, the gut dysfunction, the gut microbiome, and then how that, how the, when we eat things weren't processed correctly.

It then intermingled with [00:56:00] the gut microbiome and boom, you've got all these, but it's not the food's fault. Mm-hmm. So let's fix the actual problem so that you can eat the most well-rounded nutrient-dense diet possible and enjoy food. Mm-hmm. Right. It doesn't mean going to McDonald's, it's not what I'm talking about, but like.

I love chocolate. I enjoy cheese. I enjoy for the first time in my life, the last few months I've been able to enjoy sourdough bread since 2008. Mm-hmm. Like the joy of being able to just eat something that tasted like what I remembered from what feels like eons ago was amazing. Yeah. And so I love to give that back to clients.

And I think that that's an important message that people feel that they don't, and they hear that they don't have to just keep cutting more and more things out in order to get healthier. That the issues with the food could be a sign of. Something else. So let's ask questions. Let's [00:57:00] dig into that. And yes, there are plenty of people who have eczema that can eat eggs and dairy and all this other stuff.

There's plenty of people who have rosacea that can go back and start eating some of the rosacea foods that you're not supposed to eat, like, um, ginger or cinnamon. Mm-hmm. And spicy foods, right? They're able to reintroduce those things. There's people who have hives that are able to reintroduce high histamine foods and there are people who have psoriasis that are able to eat red meat.

And, uh, a lot of those. Like potatoes and ni other nightshades that everyone's like, oh, you can't have those. But they're able to tolerate 

Dr. Brighten: them. I, I have psoriasis and uh, when people were like, that means you can't eat nightshades. I'm like, I'm a Latina. I live on salsa. I don't think you understand. I literally drink salsa.

Like I can't, I can't even, and it, it's never made a difference. Yeah. Um, I wanna talk about like, what foods can people eat that will nourish their skin? 'cause you're talking about a lot of adding in, so I think people are gonna be curious like. [00:58:00] What can I be eating that's gonna be great for my skin? The first 

Jen Fugo: thing I would say is if you took dairy out, I love ghee.

Mm-hmm. I think GH is a worthwhile try. One of the reasons why is it has butyrate in it, and butyrate is really good for your GI tract. It's one of those short chain fatty acids that our gut bugs naturally produce when they munch on the fibers that we eat and it helps to provide fuel for our colon cells, it helps to seal up those junctions and the leaky gut.

It helps to improve that. Mm-hmm. So I love ghee. I also love cold water, fish, grass fed beef, and if you can afford it, things like free range chicken and whatnot. While yes, I do think that like we, I know everybody's on a different budget and you do you, but I think all of the fear mongering that makes people afraid to eat real food.

Yeah. Is a. Is it does a really grave disservice to those who maybe are in a tighter budget. [00:59:00] I would much prefer you be able to add in, listen, I get it. There's some people who like to go vegan and more plant-based. That's fine. You do you. That's not my jam. Um, you know, I work with clients who do eat a more plant-based diet, and that's fine, but if that was what helped your skin heal up and you have to stay on a plant-based diet in order to have your skin stay clear, I wanna know why.

Mm-hmm. Because if you can't tolerate animal proteins, there's a problem. It could be a sign of h pylori. Yeah. On the flip side, if you do carnivore where you're only eating animal products and that's what cleared your skin up, I wanna know why. Mm-hmm. To me, that could be a SIBO issue, it could be a fungal overgrowth issue, but there's usually some type of underlying issue where you aren't able to tolerate all of the fiber.

So I always like to ask why. So another, uh, group of foods that I love are berries. I know you love berries. Anything that's like bright in color, you know, I do. [01:00:00] 

Dr. Brighten: I mean, I love berries. They're so, I mean, they look like ovaries. They're good for your ovaries. Like mama nature against signaling. Yeah. She's like, I got you.

Jen Fugo: And antioxidants, they're also, you know, there's something sweet that I feel like we can enjoy and appreciate without necessarily, I don't know, like I have berries with breakfast. Mm-hmm. That to me, I would much rather that than like a muffin I don't have any interest in, in, in like a pastry. So to me, I slowly with times switched my diets.

Like, oh, berries are like my dessert. Mm-hmm. And I really enjoy them. Mm-hmm. Um, I also love things like asparagus. I love carrots. I love apples and all different colors of apples as well. Granny Smith apples are great, but I think other apples are also wonderful 'cause they contain really great fiber and pectin and uh, quercetin and all sorts of things.

Mm-hmm. Um, and then also, I'm just trying to think some other favorites. I mean, we definitely wanna see clients have some fiber into their diet. Mm-hmm. So it could be through chia seeds, could be [01:01:00] hemp seeds. Um, I love pepitas and pumpkin seeds. Those are really great. I know, like you talked a lot about how they have magnesium and zinc and they're a great source of minerals.

Um, and from there, I mean. I like a well-rounded plate where about like a two, two thirds of the plate is some sort of green, colorful veggie type situation. Maybe we have a little bit of starch in there and the amount of starch that you'll have. Like for me earlier in the day, I like to do lower starch later in the day.

I like to do like, and that's where I'll do potatoes. Mm-hmm. Um, and then that other third is really gonna be like a good amount of protein. Usually somewhere between 20, I even sometimes go up to 40 grams. But I think in general with skin, when you're trying to address skin issues, I think we should be closer to 80 to a hundred grams of protein a day, partly because.

A, we need it for all of these different processes and a lot of [01:02:00] times people are nutrient deprived because of h pylori and low stomach acid and all the, all of this. But also we're healing tissue. We have to rebuild our skin tissue and not take protein in order to do it. Mm-hmm. Um, and we need it for liver detox, we need it for thyroid, we need it for all sorts of things.

So, um, I think that's another good kind of avenue to go down. 

Dr. Brighten: Yeah. And when you're talking budget, I think often people hear cold water, fish, they think salmon, they think that's expensive. Mm-hmm. Sardines are incredibly, absolutely economical. Such a great place to like get your Omega-3 fatty acids. And you brought up the fearmongering, the fearmongering of Whole Foods.

I cannot, for the life of me understand how people are out there. And they'll, they'll nitpick things like sometimes it's oats, sometimes it's a nut, sometimes it's a seed, sometimes it's this, you know, leafy green vegetable. And I'm like, you really think. In the current paradigm of the US' chronic health crisis, that [01:03:00] kale is the biggest problem.

Right. That, that, you know, eating a cashew is the biggest problem. And yet you will see people out there in the grocery store usually doing a video where they're telling you this, this is full of poison. Mm-hmm. And in reality, we know that ultra processed foods, these are, these are filled with omega six fatty acids.

Mm-hmm. And they're not filled with nutrients. These are things that are going to sabotage your skin. Mm-hmm. And we're not talking about that. We're seeing people talk about and vilify whole foods. Mm-hmm. And I think it's so refreshing to hear you say this because people get so confused. Yeah. So confused about what to even eat.

Because of this Basically clickbait that happens on social media. Yeah. 

Jen Fugo: Like if you can tolerate dairy. If, if you literally can do, if you have your coffee in the morning and you like coffee, drink coffee. I like, this is another one. Oh, coffee's bad for you. It's bad for your skin. You should stop that. Like, it's like take or [01:04:00] because you're a woman, 

Dr. Brighten: no woman can drink coffee.

I'm like, watch me. Watch me. I'm also a rapid detoxer. So it's something too where people are like, no, women don't metabolize it like men do. And I'm like. You should see me wake up in surgery, uh, drink espresso at 10 o'clock at night. I go to bed. I also like have horrible drug reactions because I metabolize things so quick.

Yeah. But I'm like, you can't just make blatant statements No. About this. Whereas, like we were talking, my husband, if he has a cup of coffee at 12 in the afternoon, he will not sleep at all. But me, I can have espresso at 10:00 PM Yeah. And I'm like, fall asleep, like 10 minutes later. I'm not having a problem with it.

Jen Fugo: And, and that speaks to the differences in individuals. And that's what, when we're just going online looking at these reels, right. A ten second reel with a caption. Through that person has a particular agenda and perspective. Mm-hmm. I would much rather you figure out your, like [01:05:00] you eat the Jolene diet. I eat the Jen diet.

Yeah. Your husband eats his diet. Understand my husband, eat his understand, and that's it. Understand 

Dr. Brighten: it changes. Yeah. Over time. So as you were saying, you know, you and I were both talking about, um, that this week you were saying how you couldn't eat eggs. Yeah. I was telling my son for my twenties, I couldn't eat eggs because I ate eggs and I had horrible, horrible stomach pain.

Mm-hmm. Um, I, you know, I had the same thing with avocado. Like, I couldn't eat avocado for like 10 years. As it turns out I had small intestinal bacterial overgrowth and I addressed that and then all these foods were able to come back in. Mm-hmm. And I feel like, um, I've always been, I've been seen sometimes as like a heretic in like the functional medicine space because I've always had the same perspective as you, is that you should be able to eat just about everything.

That's a whole food. And if you can't, then we have to ask why. Right. There are intolerances. There are sensitivities and there are allergies. Mm-hmm. And there are medical conditions Yeah. That say you can't eat that. Okay. We know that. But when we start getting to the place where it's [01:06:00] like, well, I just can't eat this.

Mm-hmm. Because, you know, I'm eliminating everything outta my diet or because my doctor said you have candida, therefore you can never eat this food again. I've always called BS on that. Like, that is not how, that is not how you were designed. And also that is not how you would actually survive. Right. If we weren't living in such an artificial environment.

Right. Where we can procure food at, like, I mean. We go to the like, I'm sure you remember like kale was never even a thing when we were kids. No. There was one apple you could get in the store. There wasn't all these apple varieties like. We would've died. Okay. We would die if we had the same dietary practices that we see sensationalized now.

Mm-hmm. When we were on the planes. Right. Or living in caves like we would've never survived. 

Jen Fugo: Yeah. And I can tell you just from clinical, plenty of clinical experience, you're not gonna starve yeast if it's pretty bad and you have pretty significant candida overgrowth. Those, those little nuts buggers are good, they're smart, they're the cockroaches of the gut.

They're gonna be long around. But [01:07:00] what we're. Kind of on our way out, they're still hanging out. They're like, yeah, we're partying. Okay, but like, 

Dr. Brighten: let's talk about what actually works for treating yeast well. 'cause that's right. People are gonna be like, okay, if it's not the diet, then what? 

Jen Fugo: So I think the important thing to know, and this is kind of like to go back to eczema and some of these skin issues, is that yeast, 'cause we didn't even mention that really, is that you can have overgrowth within the small intestine of candida or other fungal organisms as well as in the large intestine.

Again, that can trigger cytokines, the inflammatory messengers that show up on our skin triggering these issues. And so I've gotten to a place for a long time, I, I thought it was diet and herb, like different antifungal herbs. The truth is that. Sometimes we need medication. The, the issue can be so bad that there's no amount of diet and um, and herbs that are going to fix it.

I think that's why a lot of people have gravitated towards carnivore because they've seen such. Yeah. [01:08:00] Such improvements. The problem is when you ask somebody if they try to go off of carnivore, all the yeast issues come back. That's why they're like the cockroaches. When you go off of the, uh, anti candida diet, all the symptoms come back after a period of time.

Mm-hmm. And it's because they are very resilient. They hide behind biofilms like they're, they're not going away. So we have to address the overgrowth. We have to use the tools that are appropriate and antifungal. Herbs are not like antibiotics. They don't devastate the gut microbiome. They don't wreck your gut bacteria.

And most people are shocked to learn that. They can be hard on your liver, though they can. They absolutely can, but that's why it's a time and a place to figure out the right way. I personally like to assess the situation and then I make a suggestion to the client like, Hey, in this particular instance I think you would do best, especially if they have thrush where they have the infection in their mouth and down their throat, or they have tinia [01:09:00] versa color.

So it's an actual fungal infection on the skin. Go get meds, your doctor will, even if it's just one or two tablets, that will help knock it down and it makes everything else work better. Mm-hmm. So why don't we be more open and flexible to the process? Like, I used to be very hard lined when I first developed Retic eczema.

That was like, oh gosh, that was a long time ago. Back in 2014, if I could go back and tell myself like, you made this harder on yourself. You drew the process out. Mm-hmm. Because you only thought that if you healed naturally, that was the only way and the right way to do it. I wish I could say, Hey, I, I see and hear what you're trying to do.

I hear all the good intentions. At the same time, think about your body is in this kind of pole of inflammation, and if we could get that down faster and get you feeling better faster, that improves your quality of life. Mm-hmm. So that's kind of like where I stand with, [01:10:00] with, uh, the candida and obviously.

Listen, we're not gonna go have ice cream every night. We're gonna be a little mindful of our sugar intake at, at the least. Yeah. Um, but I do think that there's other ways to deal with it. Um, but in general, um, the other thing that I, I also wanted to share, I. Um, was that it's okay if you're on this journey and you need to use medications mm-hmm.

As part of it. Because if you are really suffering and you really wanna do natural things, you may not have the energy and the bandwidth to be able to do it. It's a longer road and you can mix the two. Most people don't know that. Mm-hmm. So you can use. Certain medications like there, and I'm talking about biologic drugs, JAK inhibitors, immunosuppressants at the same time while doing the diet stuff, the lifestyle stuff, working on the gut microbiome at the same time.

And then slowly as the inflammation [01:11:00] subsides, you can wean off of those medications with the help of your doctor. Mm-hmm. Without having a huge flare up. So I think there's a lot out there that people can do. They're just, they think it has to be one camp or the other. Yeah. And I love to show them that there's a way to do that, to get back to eating real food and to enjoy their life again.

Mm-hmm. 

Dr. Brighten: Because that's what's really important. Well, and I think it's important for people to understand that a lot of the side effects they wanna avoid or that they even fear with medications can be mitigated through nutrition and lifestyle. And that's always the stuff that if you lay that foundation.

That's really your ticket towards long-term health. And so just because you use a medication doesn't mean that you failed in some way. Mm-hmm. Or you weren't working hard enough. Mm-hmm. It's that sometimes we need a medication. Yeah. And if you do use a medication, that doesn't mean just forego everything else.

Mm-hmm. 'cause it doesn't matter. It actually can help you immensely. We know, [01:12:00] you know, there's a lot of medications that have nutrient depletions. Mm-hmm. And so that's something most doctors don't even talk about. Mm-hmm. That, you know, these medications can actually deplete you of nutrients. So, and then people get side effects and it's like if we work on your diet, like we don't have to have those side effects.

Jen Fugo: I can add to this one reason why you have to be very careful with elimination, uh, diets and eliminating too much food. It's not all foods, but the top nine allergens. So that includes things like dairy and eggs. You run the risk if you take them out for, and I don't know the, we, there's not a lot of great research in adults on this.

There's more in kids. Mm-hmm. But after somewhere around a year, your body, when you try to reintroduce them, may see them as an actual allergen and you can develop an IgE allergy. Mm-hmm. So I have now, unfortunately, clients who had eczema, who read online, oh, take out dairy. Mm-hmm. [01:13:00] That individual now has an anaphylactic dairy allergy.

Can't do cow's milk. Can't do goats milk. I have another client who took out eggs, now has an egg allergy so severe, she can't even have an unbaked goods and has to have an EpiPen. Wow. So. We have to be cautious if your provider is constantly pushing on you, these elimination diets with no end in sight and does not say, oh, by the way, here's a side effect.

Right. We have to, I, I feel I'm not a prescriber, right? As a clinical nutritionist, I can't prescribe medication, but I want my doctor hopefully, at least my pharmacist, to tell me if there's a side effect. Mm-hmm. To taking that. And there are side effects to doing elimination diets that we are not being told.

And yes, food fear is very real. It's a huge problem In 18 to 24 year olds, it is about 80% of people. Who are obviously really impressionable at that age. Yeah. Who [01:14:00] developed food fear from doing elimination diets to help their skin. Mm. Um, and I worked with a research team out of uc, Davis, and we surveyed over 600 people who all had chronic skin problems and how they used elimination diets and food.

I mean, that's huge. Over 80%. Yeah. And even when you got to like, I think it was the 55 to 64-year-old bracket, it was still about 50% of people. Wow. And it was. It didn't matter whether you had a previous eating disorder, you could have no issues with food prior. And using elimination diets caused so much stress in people that they now associate had a real negative association with food.

Mm-hmm. Plus the issue of potentially developing food allergies. Yeah. So I think this is, this is why this is so important to say, hey, is there another way? Is there a better way where we don't have to wreck our relationship? The price to good health to good skin doesn't have to be, I can't eat anything.

Mm-hmm. It shouldn't be that. Yeah. That to me is [01:15:00] not 

Dr. Brighten: a fair trade. I wanna go full circle back to the conversation that we started with. So we talked about corticosteroids, um, as topical. Mm-hmm. So using steroids for topical treatment of rashes, what are the alternatives? 'cause we've talked a lot about like the root cause, what you should investigate, what you should be eating, what are like topical alternatives that people could be using to get symptom relief with their skin issues.

Mm-hmm. 

Jen Fugo: I will say it does vary from skin issue to skin issue, but generally with eczema, um, one of the things that I find really helpful is zinc. Mm-hmm. So topical zinc is really nice. It cannot penetrate through the skin. So if you are supplementing with zinc, you're not going to increase your your, so you don't have to worry about zinc.

Yeah. Issues. Um, but. I, I, so one thing that I decided at a certain point was like, I wasn't super happy with a lot of skincare products because while they might look natural and there's a ton of greenwashing that goes on in the skincare industry, what is 

Dr. Brighten: greenwashing for people who don't know? 

Jen Fugo: Yeah.

Greenwashing is where the product [01:16:00] looks natural and organic, but when you actually flip it over, you're like, what the heck? It's all these chemical names. Now chemical names aren't necessarily bad and there are plenty of, uh, websites like, um, made Safe for example, where you can go and look up the ingredients.

Mm-hmm. But they're loaded with things like sulfates, parabens, phthalates, um, xeno hormones and whatnot, and endocrine disrupting hormones, and it's. Uh, that is really alarming. And some of the products, especially like bigger brands, they intentionally create products like moisturizers mm-hmm. Where it will, you apply within two hours, your skin is dried out again and you reapply.

So it's not meant to saboteur. I know. Oh my gosh. I know. So they know that the, they're gonna encourage you if you, if the one bottle worked. You, right? Like if the one bottle worked, you wouldn't need the product. You wouldn't have the problem. Mm-hmm. Management, unfortunately, is where the money [01:17:00] is in pharma and many of these big skincare companies that are in big box stores at the pharmacies and et cetera are, and by 

Dr. Brighten: management you mean 

Jen Fugo: just 

Dr. Brighten: maintenance products?

Maintenance. They're not actually solving the problem. No. They're just making you a forever customer. Right. 

Jen Fugo: Correct. And so, um, I just made this decision. I was like, you know, I wanna try and create something that has like, the benefit of certain herbs without, like, we're not put using any essential oils.

We're not using any like, crummy ingredients. Mm-hmm. And really knowing where things came from that we can nourish, we can have, add these nourishing ingredients to the skin and help support it. So, um, one of the products that I created is called Z plus Rebuild, which has enough zinc in it to be helpful, but it doesn't give any whitish cast and it's not drying.

'cause if you've ever used like a butt paste cream, it's super drying. So we figured out how to blend the oils and the herbs and the zing together so that it actually has a synergistic effect. Mm-hmm. And you can wear it during the day and no one knows it won't get all over [01:18:00] your clothes. It's wonderful.

So that is really helpful, I would say for itch, which Hazel, um, uh, a hydrosol is really helpful for that. Mm-hmm. Um, I also love. If you're really sensitive, start with single oils. So things like hemp, seed, oil, avocado, uh, oil. I would avoid olive oil because malasia, that commensal yeast organism. The little fat muncher.

Yeah, the little yes, the little fat muncher. He loves, uh, olive oil. So you might wanna be beware of that. Um, but there's a lot of different, you know, shea butter, see what your skin tolerates. Mm-hmm. What your skin likes. Sometimes you may have to layer things on. So if you get out of the shower, do your lighter things like maybe some ae vera and then your hydrosols or hypochlorous acid spray.

I don't know if your listeners are familiar with that, but it's probably not. So break it down. So hypochlorous acid is produced in our neutrophils, so it's part of the DEF [01:19:00] defense, our immune system's defense to kind of like kill other organisms. And so, I don't know who figured this out, but they did. And they, they have put it into bottles, it looks and feels like water.

Mm-hmm. So there's no like. Stinging or anything weird and it can help with what's going on in our skin microbiome. So you can spray that on your skin up to five times a day. If you're kind of prone to infectious issues, it's not gonna help. If you're in an infection, it's too late. But if you're kind of prone to it, it can help kind of, you know, we wanna keep the skin barrier happy as long as we can.

So is that 

Dr. Brighten: helping with the leaky skin that you were talking about? Yes. Okay. 

Jen Fugo: Because like staph aria produces alpha and beta toxins, which are both really inflammatory to the skin. Yeah. So, um. So anyway, hypochlorous acid spray and there's a bunch of different companies out there that make that, now that's a really great option.

Um, yeah, I, I mean like, I think the key is to find sim simple [01:20:00] formulas that your skin likes and you use that as a way to help keep the skin happy on the outside while working on the internal stuff. 'cause the inflammation is most likely, unless you have an infection on the skin. It's not, that's not where the inflammation starts.

Mm-hmm. It's internal and that's what we wanna try to shut off, essentially rebalance. So your body and its immune system can do what it's supposed to do and handle it. But right now it's, it's on the struggle bus and it needs help. And it's a clue. It's an annoying and aggravating and awfully inconvenient clue that something's going on under the surface.

And I apologize to everybody out there if you're going to your dermatologist and expecting them to look at your case from that perspective, and you're not. Mm-hmm. You know, feeling heard. It's not their modality right now. It's not the in their toolbox unless they are personally [01:21:00] interested in looking at your case from that perspective.

So, yes, it may be you diving into research, listening to different podcasts and such. Um. And that's why, or consulting licensed nutrition professionals like yourself. I know we have a, we have a worldwide clinic that we see clients world all over the world virtually, which is 

Dr. Brighten: so cool. Yeah. And you only like your big specialty like focus is a psoriasis, eczema, chronic skin conditions.

Yeah. That's why I was like, I have to have you on the show to talk about this. We've had listeners who have said like, are you gonna talk about like more skin issues? Because we've had, you know, we've had our friend Tony Yung, Dr. Tony Yung, about you, the beauty aspect. I had dermatologists and this has been a requested episode, so it had to be you.

 

And I'm so grateful that you came on and you shared so many actionable tips with everybody. I will link to you and your clinic so that people can find you very easily in our show notes. But thank you so much for joining us. Thank you for having me. I hope you enjoyed this [01:22:00] episode. If this is the kind of content you're into, then I highly recommend checking out this.