written by Team Liberty Road

It's a jarring issue for too many people today. Something feels off, so we go to our doctor only to be told "you're fine" after all the boxes—blood test, quick conversation—are checked. But deep down, we know something's not right. 

Efrat LaMandre, FNP-C, PhD, lived this story, from the medical side. As she tells us, she went to medical school and started a primary care practice. "So many patients would come in and say, 'Hey, I don't feel so well,' and I would say, 'you're in the right place," she says. "I would do the blood test, and the blood test will come back fine. I would say, 'You're good. See you next year.' There was no malice. I did everything I learned in conventional medicine." 

Things turned when Efrat, widely known as Dr. E, faced a major medical scare in her family. "My wife got sick, and we just hit a wall," she recalls. "All we were offered were heavy-duty medications. And we just knew that there was a better way." 

There was. Efrat and her wife took a functional medicine approach, free of conventional medication (Efrat says she's not against medications, but that wasn't the path for her wife at the time) that ultimately healed her wife. Since then, Efrat has returned to school, earned a PhD in integrative medicine, and started her practice today, which she calls The KNEW Method. "It's called this because my patients know. They either know something's wrong with them, and no one's listening. Or they know there's a different way to approach it, and they can't get access."

We spoke with Efrat about that access. She tells us about her approach to her patients' care, three tips for getting healthier, and how we can better understand our health by knowing one critical fact.

Chatting with Efrat LaMandre FNP-C, PhD

Your book has a great image of a matchstick burning to nothing. Is that relative to what you've seen patients deal with?

I used that image because if you're someone who's not feeling well, and you're consistently dismissed—not from malice, your doctor is not malicious— this is just the wheelhouse that you have, eventually you will become very sick. The underlying assumption under every chronic illness is that there's inflammation. And if you don't feel good, you're inflamed. So if you go to the doctor and all your tests are negative, that inflammation is not going anywhere because it's not being treated. So it will keep going and going until, eventually, you will become sick enough for something in your blood work to show up or something in your images to show up. So, it's constant, low-level chronic inflammation that is just going to burn you out.

We've been hearing more and more about inflammation. Why is traditional Western medicine dismissing it even with all the new information?

It's not that they mean to dismiss, and this is really important. It's about the tools we have in conventional medicine—I still practice conventional medicine once a week in my other practice—are designed to find a sickness. Do you have anemia? Do you have a thyroid issue? Are you diabetic? Do you have cancer? Do you have pneumonia? So, if you are positive and you find those things, then you're in the right place. But if you're just not feeling well or optimal, that will not show up with the tools they have. So, they can't address it because they can't test for it. And then they can't treat it. It's kind of going to an electrician and asking for plumbing. It's just not designed for it.

You talk about empowering the patient. When you empower them and say, 'I know that your symptoms are not in your head, ' what does that open up in terms of dialogue between the patient-doctor relationship?

First of all, it opens a lot of tears. I give lectures a lot, and people always ask, how do you test for inflammation? There's one surefire way to know if your patient is inflamed: just to listen to their story. If you're coming to me, and you're telling me, 'Hey, ever since whatever, I have not been the same, I'm not as focused at work, my joints hurt, I can't do the thing, my life is just not the same,' that's enough. Why do I need more? And then I have to say to them, 'This is real, this is not in your head.' So, I listen to the story. Then I go back in time; I try to get their story from birth. Because it's all connected. We get one body, and the things that happen throughout the years matter. And then I say, 'Hey, look, this is where we are, this is why we're here.'

The relief patients feel when they're finally validated— Your story is real. You're not crazy—sometimes that in and of itself is healing. Not everyone who consults with me continues, but the consultation itself is healing. Because you walk away saying, 'Okay, all right, this is making sense now.' I put the puzzle pieces together for people. And for some people, that is just what they need, just to know they're not crazy. So, it opens up a huge dialogue. There's so much that happens to people when they're heard.

It can also give you agency. What misconceptions do patients grapple with that you hear most regularly?

There are two parts. First of all, anything that you're dealing with is already a disease process; let's say it's high blood pressure or an autoimmune issue, but that is not the thing. That is the tip of the iceberg that you are seeing. If you have Hashimotos, for example, that's not actually the problem. That's the expression of the problem. So the first part is what you have is the expression of the underlying problem.

The other thing that some people really have a hard time understanding is how much lifestyle choices can create disease and can prevent and reverse disease. People can't imagine that when we heal their belly, their joint pain or psoriasis goes away. They cannot imagine how their food has anything to do with psoriasis. They think, I went to 20 dermatologists in New York City. No one said if I come off gluten, my psoriasis will go away. So, it's about understanding that things are connected. We're so used to going to specialists, we go to the GI doctor, we go to the skin doctor, and the two never talk, and so we start thinking that these parts don't interact with each other. So, starting to understand that it's all connected is a process, because we’re never taught this.

You got to see that firsthand with your wife. What are the biggest changes we can make today to start seeing a difference?

I'll tell you my wife's story to start, and then I'll tell you the three things.

My wife had something called PMLE, polymorphous light eruption, which is basically an allergy to the sun. I always say when I met my wife, she was a vampire. We could not go outside. And then, but we accommodated. We thought, you'll get through this, you'll be fine. Then, she developed severe psoriasis. It was so bad that she couldn't put on her shoes. She did not have gut issues, no bloating, or anything like that. So again, we discovered functional medicine. She was, at the time, a strict vegan. Her staples were corn, soy, and bread. We had to change all of that— we had to get off gluten, corn, or soy. The rash disappeared. We were taking pictures, and we couldn't believe what we were seeing. She was able to be outside. We never thought of a life when we could go outside like normal humans. And all of that happened with nutrition. We were never taught this in med school. We were never taught there was a connection between psoriasis and food. It's not discussed. Seventy percent of your immune system—seven zero—is in your belly. So, if your belly is not happy, for whatever reason, or the things you're putting in are sensitive, it's going to wack out your immune system.

If you're suffering, don't run for the testing; you've got to do the basics first. You have to go on an elimination diet. At the very least, remove the gluten and dairy. That is the most basic. If you're still eating gluten and dairy, and you're dealing with autoimmune issues, and you're not even in the game. More can be done, but at the very least, start there. Then you must prioritize sleep. I say this all the time: I don't care how much gluten-free ice you're eating; if you're not sleeping, you are not healthy. And then, you must prioritize some sort of movement. I never say the word exercise, because movement for some people just means going outside to their driveway. Wherever your movement spectrum is, go a little bit more the next day. If you can start with those three things, you're already 90 percent there; the rest is tweaking and layering on top of that.

What is the best way to advocate for ourselves with our primary care physicians or outside of them?

Firstly, I see people nationally. With functional medicine, I'm not prescribing; I'm coaching. So there's so much we could do. That said, I want to tell everyone: Don't get frustrated with the system. Understand its limitations and use it to its max. You may get frustrated and feel that the system is failing you. It's not failing you. It's not designed for this. So you go to your primary care physician and get every test under the sun that your insurance covers. Don't skip that step. Get the endoscopy, get the colonoscopy, make sure there's no cancer, make sure there's no anemia, make sure there's no thyroid. If anything is positive, you want to make sure to address it. But if all of that is negative, thank goodness. That's a state of gratitude. And from there, find a functional medicine person to take you to that next level. You can't find this thinking in conventional medicine. It just doesn't exist.

__________________________________________________________________________________

Efrat LaMandre, FNP-C, PhD is a nurse practitioner and functional medicine practitioner. We pulled this conversation from our original conversation with her. To listen to it in its entirety and to glean more of Dr E’s tips, visit ‘The Liberty Road Podcast.’

YOU MAY ALSO LIKE