自身免疫疾病的五大根源（以及如何开始康复）

如果脑雾和情绪波动根本不是单纯的心理问题呢？

What if brain fog, and mood swings aren't simply all in your head?

如果你的心理健康其实源于更深层的身体因素——比如肠道、荷尔蒙、新陈代谢和免疫系统呢？

What if the health of your mind actually starts deeper in your body, in your gut, in your hormones, metabolism, and your immune system?

我可以告诉你，这种联系是真实存在的，它每天都在影响你的思维和感受。

Well, let me tell you, the connection is real and it affects how you think and you feel every single day.

正因如此，我创建了‘大脑塑形学院’，一个为期六周的课程，教你如何通过调理身体来修复心智。

And that's why I created Brain Shaping Academy, a six week program that shows you how healing your body can help you heal your mind.

大脑塑形学院所采用的营养和生活方式方案，是我三十年来帮助患者改善心理、情绪和认知健康所依赖的核心方法。

Brain Shaping Academy relies on the same target nutrition and lifestyle strategies that I've used for thirty years to help my patients improve their mental, emotional, and cognitive health.

如果你希望更平静、更清醒、更有掌控感，保持思维敏锐，并在 aging 过程中保护大脑，欢迎访问 drhyman.com/brainshaping 了解大脑塑形学院。

So if you want to feel calmer, clear, and more in control and stay sharp and protect your brain as you age, check out Brain Shaping Academy at drhyman.com/brainshaping.

网址是 drhyman.com/brainshaping。

That's drhyman.com/brainshaping.

欢迎来到办公时间。

Welcome to Office Hours.

这里是专属于你们的一对一空间，让我们深入探讨，理清思路，找到真正能改善你健康的关键所在。

This is our dedicated one on one space to go deeper, get clear, and explore what truly moves the needle for your health.

我是医生。

I'm Doctor.

马克·海曼。

Mark Hyman.

每周我们都会揭开幕后，分享那些在与嘉宾对话中通常不会提到的见解、研究和心得。

And each week we're going to pull back the curtain and share the insights, the research, the lessons that don't always make it into our conversations with guests.

归根结底，你才是自己健康的第一责任人。

Because at the end of the day, you are the CEO of your own health.

对很多人来说，你也是全家健康的掌舵者。

And for many of you, your family's health too.

也许你平时感觉不到，但你实际拥有的掌控力，远比你想象的要大得多。

And you might not feel it all the time, but you have far more power and agency than you realize.

很高兴你来到这里。

I'm glad you're here.

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This episode is brought to you by Function Health, empowering you to live a 100 healthy years with over 160 lab tests for just $365 a year and use the code MARK2026 to get $50 off your membership.

自身免疫性疾病是美国主要的疾病原因之一，也带来了大量痛苦。

Autoimmune diseases are a leading cause of disease and a lot of suffering in The United States.

大约百分之八十的自身免疫性疾病患者是女性。

Roughly eighty percent of people who have autoimmune disease are women.

对于15到65岁的女性来说，这是导致死亡的主要原因之一。

And they're a leading cause of death for women between 15 and 65.

但尽管这些疾病如此普遍，大多数人却常被灌输两种说法。

And yet despite how common they are, most people are told two things.

第一，说这是随机发生的，其实根本不是。

One, that it's random, which it ain't.

第二，说一旦得了，就一辈子甩不掉了。

And two, that once you got it, you have it forever.

这会伴随你整个人生。

It's your whole life.

自身免疫疾病是治不好的。

You can't cure autoimmune disease.

那你怎么看这种说法？

And you know what I say to that?

胡说八道。

Nonsense.

你从医生那儿听到的，根本不是真相。

What you're hearing from your doctor ain't the good news.

我会告诉你真正需要知道的事，让你彻底理解这种病——它怎么来的，该怎么应对，甚至有没有可能彻底治愈。

And I'm going to tell you what you need to know so you can actually understand this condition, causes it, and how to handle it and how potentially even to cure it.

得了自身免疫疾病，意味着你的免疫系统在攻击你自己的身体。

When you're having autoimmune disease, your immune system essentially attacks yourself.

这就相当于你在自残。

It's like you're attacking yourself.

你身体明明是自己的，免疫系统却误以为它是外来入侵者，开始疯狂攻击。

You're you're think your body is some foreign invader and your immune system starts to attack it.

大多数医生认为，你只能抑制免疫系统，因为它太活跃了。

And most doctors think, well, all you can do is suppress the immune system because it's just overactive.

它发炎了。

It's inflamed.

它在攻击你的身体。

It's attacking your body.

但说实话，我并不只想控制这种自身免疫疾病。

But the truth is, I don't really want to manage autoimmune disease.

我想找到根本原因，真正帮人们解决它。

I want to find the root cause and actually resolve it for people.

那如果医生们一直认为的——一旦得了就终身患病——这个观念是错的呢？

So what if the, the old concept that doctors have that once you have it, you've got it for life.

如果这根本不是真的呢？

Isn't true.

如果问题不在你的身体出错，而在于你的免疫系统其实只是在按它本来的方式做出反应呢？

What if it isn't your body malfunctioning, but your immune system's actually responding the way it's designed to.

它是在回应某种威胁，但这种威胁通常被传统医生完全忽略。

And it's responding to some threat, but that threat is usually never picked up by traditional doctors.

这些威胁并不是随机出现的。

Now those threats aren't random.

它们都是我们早已了解的因素。

They're things we know about.

比如你每天接触的食物、生活环境，还有压力。

They're things you're exposed to every day, the food you eat, the environment you live in, stress.

当你从病因的角度来看待自身免疫疾病时，整个讨论的方向就变了。

And when you start to look at autoimmune disease through the lens of causes, you can shift the whole conversation.

它不再是什么神秘的偶然事件，而变成了一件你能理解、并且可以去改变的事情。

It stops being a mystery in some random event and starts becoming something you actually understand and begin to change.

今天我们就来一一拆解这些关键点。

And that's what we're going to break down today.

导致自身免疫疾病的一个关键因素，就是你每天多次重复的行为——饮食。

One of the key drivers behind autoimmune disease is something you're doing every single day, multiple times a day, eating.

自身免疫疾病并不意味着你的身体坏了。

Now autoimmune disease doesn't mean your body's broken.

而是你的免疫系统在对某些东西做出反应。

It's your immune system reacting to something.

对吧？

Right?

你的免疫系统很生气，你得弄清楚原因。

Your immune system's pissed off and you got to find out why.

一旦你明白了诱因或根源，就会明白为什么你的身体会对某些东西过度反应，为什么你会发炎。

And when you understand the triggers or the causes, everything starts to make sense about why your body's overreacting to something and why you're inflamed.

很多人在面对自身免疫疾病时一直卡住，主要是因为三个常见错误。

Now the reason so many people stay stuck when it comes to autoimmune disease is because of three major mistakes.

第一个错误是认为药物是唯一的解决办法。

The first is thinking that medication is the only solution.

当然，药物确实可能有帮助。

And to be clear, medication can be helpful.

它可能救人性命。

It can be lifesaving.

它可能是必需的。

It can be necessary.

但大多数这类药物是通过抑制免疫系统来起作用，而不是解决让免疫系统失常的根本原因。

But most of these medications work by suppressing the immune system, not by addressing what's actually causing it to go out of whack.

所以虽然症状可能会缓解，但根本问题依然存在。

So while symptoms could improve, the root cause is still there.

在功能医学里有句话：如果你踩在钉子上，吃再多止痛药也难真正缓解。

There's a saying in functional medicine, if you're standing on a tac, it takes a lot of aspirin to make it feel better.

把钉子拔出来，你就根本不需要止痛药了。

Take out the tac, then you won't need the aspirin.

在功能医学里看待自身免疫疾病，道理也是一样的。

And that's the same as as we think about it in functional medicine with autoimmune disease.

第二个错误是认为自身免疫疾病无法治愈。

The second mistake is that believing that autoimmune disease is incurable.

一旦得了，就觉得这辈子都得带着它过日子。

That once you have it, it's something you're have to live with forever.

光是这种想法，就让人根本不想去寻找答案。

And that belief alone can stop people from even looking for answers.

但我们一再看到，只要找到并消除诱因和根源，免疫系统就能慢慢恢复平衡，健康也能逐步回来。

And, but what we see over and over again is that when you identify and remove the triggers, the causes, the immune system can actually begin to rebalance and you can start to regain your health.

这就说到第三个误区了，也是最大的一个：没找到根本原因。

Which brings us to the third mistake, and this is the biggest one, not identifying the root cause.

因为自身免疫疾病不是单一的问题。

Because autoimmune disease isn't just one thing.

它是一种反应。

It's a response.

如果你不去追问免疫系统为什么会这样反应，最后只能控制症状，而改变不了疾病的走向。

If you don't ask why the immune system is reacting in the first place, you end up managing the symptoms instead of actually changing the trajectory of the disease.

从功能医学的角度来看，根本原因有五个。

So from a functional medicine perspective, there are five root causes.

这些因素往往是一起作用的。

There's some combination of these things.

通常不是单一原因，而是多个因素共同导致的。

And it's often multiple things, not just one.

可能是饮食问题，比如吃得太不健康，引发炎症。

It could be food and that could be just an inflammatory poor diet.

也可能是食物不耐受、过敏原，像麸质这类物质，对自身免疫疾病的影响特别大，可以说是最重要的诱因之一。

It can be food sensitivities or allergens or things like gluten, which are more of a significant trigger for autoimmune disease and probably one of the most important triggers out there.

微生物，也就是感染。

Microbes, and that's infections.

比如莱姆病、蜱虫、病毒，也可能是肠道菌群，它同样起着关键作用。

So it could be Lyme disease, ticks, viruses, or it could be the microbiome, which also plays a big role.

饮食和肠道健康对理解自身免疫疾病至关重要，因为人体60%的免疫系统都在肠道里。

So food and the gut are pretty central to understanding autoimmune disease because 60% of your immune system is in your gut.

另一个导致自身免疫疾病的重要因素是毒素。

Another big category that causes autoimmune disease are toxins.

这些可能是环境中的毒素，比如农药、除草剂、重金属、阻燃剂、邻苯二甲酸盐、多氯联苯，等等，你能想到的都算。

And this can be environmental toxins, pesticides, herbicides, heavy metals, flame retardants, phthalates, PCBs, whatever you name it.

这些被称为自身触发物。

These are called autogens.

它们是会引发自身免疫反应的毒素。

They are toxins that create an autoimmune reaction.

最后一个是压力。

And then lastly, there's stress.

比如童年时期的创伤，可能在日后引发免疫系统失调，最终导致自身免疫疾病。

And that can be childhood traumas that trigger immune dysregulation later on in life and lead to autoimmune disease.

也可能是长期的压力。

It can be chronic stress.

压力本身通常不会直接引发自身免疫病，但往往会加重病情，或者阻碍康复。

So stress in itself usually doesn't cause an autoimmune disease, but it certainly often usually makes it worse or prevents you from getting better.

咱们先从最重要的一点开始——饮食。

Let's start with the big big one first, food.

饮食往往是最快也最有效的切入点。

Food is often the fastest and most powerful place to start.

你每天要吃好几顿，每顿都在加剧炎症，或者反过来，减轻炎症。

You're eating multiple times a day, means you're either triggering inflammation and causing it or turning it down every single day.

现在的饮食和我们身体原本适应的模式完全不同了。

Today's diet looks nothing like what our biology was designed for.

我们吃的东西大多经过高度加工，糖分高、营养低、纤维少，还塞满了身体根本没法处理的化学物质。

We're eating foods that are highly processed, high in sugar, low in nutrients, low in fiber, filled with toxic chemicals our bodies were never meant to handle.

长此以往，就为炎症创造了理想的温床。

And over time, that creates the perfect environment for inflammation.

但更让人意外的是，就连我们日常主食的本身也变了。

But what's kind of even more surprising is that even our staple foods have changed.

拿小麦来说吧。

Take wheat for example.

现代小麦经过杂交改良，为了提高产量、增加淀粉含量、延长保质期，还要抗旱，好处是不少。

Modern wheat has been hybridized to increase the yield, much more starch in it and the shelf life and also to be drought resistant and have all these benefits, which is great.

但在改造过程中，它变得更容易引发炎症，原因有两个。

But in the process, it became way more inflammatory for two reasons.

第一，它含有更多会引发炎症的麦醇溶蛋白或麸质蛋白。

One, because it has way more gliadin or gluten proteins that are inflammatory.

第二，它的淀粉含量极高，糖分也多得多，而糖正是导致炎症和肠道紊乱的诱因。

And two, because it's super starch and has so much more sugar, and sugar can be a driver of inflammation and gut disruption.

因此，它更可能激发免疫反应。

So it's far more likely to trigger an immune response.

所以问题不只是我们吃了什么，更是像小麦这样的食物本身已经发生了根本性的改变。

So it's not just what we're eating, it's it's how those foods have fundamentally changed like wheat.

那么，饮食中最常见的诱因有哪些呢？

So what are the most common triggers in food that we see?

麸质，麸质，还是麸质。

Gluten, gluten, gluten.

如果一个人患有自身免疫疾病，不检查乳糜泻指标，简直可以说是医疗疏忽。

Someone has an autoimmune disease, it's almost malpractice not to get a celiac panel.

前几天我接诊了一位患者，她被医生诊断为桥本甲状腺炎，这是一种非常常见的甲状腺自身免疫疾病。

I just saw a patient the other day who had been diagnosed by her doctor with Hashimoto's, a very common autoimmune disease of the thyroid.

她正在接受医生开的甲状腺药物治疗，这本身没问题，但医生从未深入探究她为什么会得这个病。

And she was being treated by her doctor with thyroid medication, which was fine, but he never went down the rabbit hole to figure out why she has this problem.

结果发现，她其实已经得了严重的乳糜泻，却一直没被确诊。

And turned out she had full blown celiac disease and was never diagnosed.

只要戒掉麸质，她的甲状腺问题很可能会改善，甚至完全恢复。

And getting off the gluten, it's very possible her thyroid problem could get better or even correct entirely.

接下来是糖和精制淀粉。

Next is sugar and refined starches.

这些食物正在全身范围内引发炎症。

These are driving inflammation throughout the body.

它们导致肠道菌群失衡。

They foster dysbiosis or imbalances in the gut flora.

它们还会造成肠漏。

They create a leaky gut.

干了很多伤害肠道免疫系统、引发自身免疫反应的事。

I mean, do all sorts of things that damage the gut immune system and trigger autoimmunity.

乳制品是另一个大问题。

Dairy is another big one.

我们现在喝的牛奶，来自经过杂交的奶牛。

Our modern dairy is hybridized cows.

里面的酪蛋白非常容易引发炎症。

The casein is very inflammatory in there.

是A1型酪蛋白。

It's A1 casein.

对很多人来说，这会带来不少麻烦。

And it it it can be quite problematic for many people.

所以在我眼里，麸质和乳制品绝对是头号两大诱因。

And so I always gluten and dairy are the top two in my mind.

当然，还有各种高度加工食品，以及不同的食物不耐受。

Obviously, any kind of ultra processed foods, various food sensitivities.

如果你有肠漏或者肠道受损，就很容易对很多食物产生反应，这些食物会趁机添乱，引发问题。

You know, if you have a leaky gut or damaged gut, you just tend to react to many different foods so they can kind of jump on the bandwagon and create issues.

所以搞清楚这些食物是什么很重要。

So it's important to find out what those are.

但大多数人不知道的是，

Now, here's what most people don't realize.

就算是一些所谓的健康食品，一旦肠道受损，也可能成为诱因。

Even a so called healthy food can become a trigger if your gut's compromised.

肠道和免疫系统的关联非常关键。

The gut connection is critical.

我们后面会更深入讲微生物组，但眼下这可是自身免疫疾病的一大诱因。

Now we're going to go deeper on the microbiome later, but this is a huge driver of autoimmune disease.

很多人其实都有这个问题，这叫肠漏综合征。

Many of us have it, and it's called leaky gut.

意思是，肠道内壁破损了，导致肠道里的内容物——比如食物残渣和粪便——和血液之间失去了屏障。

And what that means is that the lining breaks down in your gut between basically your intestinal contents, poop and food, and your bloodstream.

于是，粪便和食物真的会从这道屏障中渗漏过去。

And then poop and food literally leak across that barrier.

而就在屏障的另一侧，分布着你体内60%的免疫系统。

And right across that barrier is 60% of your immune system.

你的免疫系统本该抵御外来入侵者，结果却开始过度反应。

And your immune system is there to protect you against foreign invaders and it starts to overreact.

久而久之，这种误判可能演变成身体攻击自身。

And over time, that confusion can turn into your body attacking itself.

所以如果你正受自身免疫疾病困扰，该重点关注什么呢？

So if you're struggling with autoimmune disease, what should you focus on?

吃天然、真实、未加工的食物，多吃水果蔬菜，补充优质脂肪比如橄榄油、牛油果、坚果和种子，摄取高质量蛋白质，选择对肠道有益的食物。

Whole, real, unprocessed food, lots of fruits and veggies, lots of good fats like olive oil, avocados, nuts and seeds, high quality protein, foods that help your gut.

富含纤维、含有益生元的食物，发酵食品，多酚类物质，这些对滋养有益肠道菌群、调节肠道免疫都至关重要。

Fiber rich foods with prebiotics in them, fermented foods, polyphenols, all these are critical for feeding the healthy gut bacteria and help with regulating immunity in the gut.

因为食物不只是提供热量，它更是给免疫系统传递信息的信号。

Because food isn't just calories, right, it's information for your immune system.

如果你有自身免疫问题，一顿特别好的餐食可以是野生三文鱼配绿叶菜，蛋白质就选烤或烤制的三文鱼，蔬菜要选富含纤维和抗氧化物的，比如混合绿叶菜、芝麻菜、菠菜、羽衣甘蓝、西兰花和抱子甘蓝。

So an example of a really great meal if you're having autoimmunity would be something like wild salmon, greens, protein could be like grilled, baked like a pro like a salmon, vegetables, which have lots of fiber and antioxidants, mixed leafy greens, arugula, spinach, kale, broccoli, brussels sprouts.

还可以加点胡萝卜、甜菜根、牛油果片，再淋点橄榄油。

You can have carrots, beets, avocado slices, olive oil.

这顿饭很简单，但抗炎效果特别强。

It's a really simple meal, but it's super anti inflammatory.

如果想加点柠檬汁和新鲜香草，比如欧芹、香菜，再撒点黑胡椒、大蒜、姜黄，这些都会很有帮助。

If you wanna have lemon juice and fresh herbs, like parsley, cilantro, maybe black pepper, garlic, turmeric, all these things can be very helpful.

甚至红薯，也会很有帮助。

Even, sweet potatoes can be really helpful.

在过去三十年当功能性医学医生的过程中，我学到的最重要的饮食干预方法，就是排除饮食法。

So the single most important dietary intervention that I've learned to use in the last thirty years of being a functional medicine doctor is an elimination diet.

我更愿意叫它‘增加饮食法’，因为我们其实是在大量增加有益的食物，同时去掉那些可能引发炎症的坏东西。

I like to call it an addition diet because we're actually adding in all the good foods, we're taking out the bad foods or things that are potentially inflammatory.

在我的临床实践中，我设计了一套抗炎效果极强的饮食方案，能改善肠道菌群、稳定血糖，对自身免疫疾病特别有效。

And as part of my practice, I created a a diet that was super anti inflammatory, that helped the microbiome, that helped balance blood sugar, and was great for autoimmune disease.

我把它整理出来，后来写成了一本书，叫《十日排毒饮食》。

And I developed it, and then I turned it into a book called the ten Day Detox Diet.

这其实是一个我们称为《十日排毒饮食》的计划。

And it's essentially a program we have called the ten Day Detox Diet.

你可以访问 tendaydetox.com，了解更多详情。

And you go to ten day detox dot com, and you can learn more about it.

它主要剔除最常见的致炎食物：麸质、乳制品、高度加工食品、糖和酒精。

But essentially removes the most common inflammatory foods, gluten, dairy, ultra processed foods, sugar, alcohol.

同时也会去掉谷物和豆类。

But it also removes grains and beans.

并不是说它们本身不好，只是对某些人来说可能不太合适。

Not that they're inherently bad, but they can be problematic for certain people.

还有一种更严格的版本，叫自身免疫性生酮饮食，除了上面那些，还要去掉坚果、种子、鸡蛋和茄科植物。

There's also a more extreme version, which is the autoimmune paleo diet, which eliminates all those things I just mentioned, plus gets rid of nuts and seeds and eggs and nightshades.

但并不是每个人都需要做到这一步。

Now not everybody has to do that.

我觉得大多数人可以从十日排毒开始，看看效果如何。

I think most people can start with the ten day detox and see how they do.

但我发现，这对缓解、控制甚至减轻多种自身免疫疾病的症状特别有效。

But I found that extraordinarily effective for for resting or stopping or reducing the symptoms from so many autoimmune diseases.

有一次我在克利夫兰诊所做讲座时，有个人走过来对我说，医生。

Had a person come up to me at a lecture once when I was at Cleveland Clinic, and he said, Doctor.

海曼，我做了您的十日排毒饮食，我有类风湿性关节炎，十天内症状就消失了。

Hyman, I did your ten day detox diet, I have rheumatoid arthritis, and it went away in ten days.

这可能吗？

Is that possible?

我说，当然可能。

I'm like, yeah, it's possible.

它确实发生在你身上了。

It happened for you.

我觉得很多人还没意识到食物作为药物的强大力量。

So I think that's kind of thing people don't understand the power of food as medicine.

食物里有成千上万种具有抗炎作用的植物化合物。

There's there's tens of thousands of of, molecules that are in anti inflammatory in food that are phytochemicals.

它们能调节炎症，帮助增强免疫力。

They have regular inflammation, they support the immune system.

这些成分本质上就是药物。

They literally are medicine.

不过你得选对那些对的食材，对吧？

And you have to choose the right ones though, right?

所以，饮食可能是最值得优先入手的方向。

So food is probably the most important place to start.

任何人都能做到。

It's something anybody can do.

而且不花一分钱。

It's free.

建议你试试更严格的排除饮食，比如十日排毒饮食。

It's important to try a more strict elimination diet like the ten day detox diet.

而且不只是十天，你可以坚持三周、三个月，甚至三年。

And not just for ten days, can do it for three weeks, three months, three years.

长期这样吃完全没有问题。

It's fine to eat long term.

关键在于，它真的能帮你重置免疫系统和肠道环境。

But the point is that it's really going to reset your immune system and reset your gut.

这才是最重要的。

And that's the key.

不过，饮食只是其中一部分。

Now food is just one piece of the puzzle.

还有许多其他诱因，你得全面排查。

There are many other triggers, you have to look at all of them.

接下来我们要谈的是毒素。

The next one we're going to talk about are toxins.

毒素是下一个主要的诱因。

Now toxin is the next major trigger.

很多人根本忽略了这一点，因为医生也不知道该怎么检测这些物质。

It's one that's most people actually overlook it because doctors don't know how to test for them.

他们根本想不到要去查这些。

They don't know to look at them.

但他们知道该怎么治疗。

They know how to treat them.

我们日常环境中接触到的化学物质多达数万种，比如农药、塑料、空气污染和重金属。

We're exposed to tens of thousands of chemicals in our environment, pesticides, plastics, air pollution, heavy metals.

事实上，很多这类化学物质一百年前根本不存在。

And in fact, many of these chemicals didn't even exist a hundred years ago.

它们都是近现代才被发明出来的化合物，自工业革命以来，环境中就新增了八万种化学物质。

They're sort of newly invented compounds, 80,000 new chemicals in the environment since the industrial revolution.

你的免疫系统得判断：这东西安全吗？

And your immune system has to decide, is it safe?

这会不会构成威胁？

Is this a threat?

这东西我该怎么处理呢？

Like, what do I do with this thing?

对有些人来说，长期接触这些物质会让身体不堪重负。

And for some people, the constant exposure starts to overwhelm the system.

这些化合物被称为自身免疫诱导毒素。

And these compounds are called autogens, autoimmune inducing toxins.

这时候，免疫系统通常就会失去平衡。

And that's when the immune system usually becomes dysregulated.

它不再只对真正的威胁做出反应，而是对一切东西都起反应，包括你自己的组织。

Instead of just reacting to real threat, it starts reacting to everything, including your own tissues.

举个简单的例子，就是汞。

So a simple example of this is mercury.

汞是一种重金属，会在体内逐渐积累。

Mercury is a heavy metal that accumulates over time in the body.

来源可能是鱼类、牙科填充物、环境接触，或者燃煤电厂。

It can be from fish, from dental fillings, environmental exposures, coal plants.

有些人，它会直接激活免疫系统。

And some people, it can directly activate the immune system.

它会引起炎症。

It can cause inflammation.

它会导致肠漏。

It can cause leaky gut.

它会制造出过度活跃的免疫系统，最终引发自身免疫疾病。

It can create this overactive immune system that leads to an autoimmune disease.

听好了。

Listen up.

如果你是三十多岁或四十出头的女性，感觉身体一夜之间变了样，那不是你的错觉。

If you're a woman in your late thirties or forties, and it feels like your body changed overnight, you're not imagining it.

睡眠紊乱、情绪波动、体重增加、精力不足。

The disrupted sleep, the mood swings, the weight gain, low energy.

这可不是你不够坚强。

It's not weakness.

这不仅仅是压力的问题，更是生理变化。

And it's not just stress, it's biology.

围绝经期是女性一生中最重要的代谢转折之一，而且它从不会悄然而至。

Perimenopause is one of the most significant metabolic transitions of a woman's life, and it doesn't arrive politely.

雌二醇的下降并不是一条平滑的线。

Estradiol doesn't decline in a straight line.

它会突然飙升，然后急剧下滑。

It surges and crashes.

孕酮水平则持续下降。

Progesterone drops.

皮质醇的干扰作用变得更强。

Cortisol becomes more disruptive.

胰岛素敏感性也开始发生变化。

And insulin sensitivity shifts.

突然间，二十年前还管用的那些方法，现在全都不灵了。

Suddenly, the rules that worked twenty years ago stop working.

但很多女性只做了几项基础化验，就被告诉一切正常。

Yet many women get a handful of basic lab tests and are told everything looks normal.

正常并不等于你感觉良好。

And normal doesn't mean you feel good.

这可不是情绪问题。

This isn't a mood.

这是可以测量出来的。

It's measurable.

Function 提供一年超过 160 项化验，包括更深入的激素和代谢指标。

Function gives you access to over a 160 lab tests a year, including deeper hormone and metabolic markers.

让你清楚更年期期间身体到底发生了哪些变化。

So you can see what's actually shifting during menopause.

你不是反应过度。

You're not overreacting.

你正处于一个转变的过程中。

You're in transition.

前往 functionhealth.com/mark

Go to functionhealth.com/mark.

如果你是本周前一千位用户，使用代码 mark twenty twenty six，可获得50美元抵扣，用于支付每年365美元的会员费

And if you're one of the first 1,000 people this week, use the code mark twenty twenty six for a $50 credit toward your $365 a year membership.

就是 functionhealth.com/mark，今天就用代码 mark twenty twenty six

That's functionhealth.com/mark and use the code mark twenty twenty six today.

但关键在于，并不是每个人都会有相同的反应

But the key is not everybody reacts the same way.

对吧

Right?

这一点很重要，你要明白

It's important to understand that.

有人能耐受某种程度的接触，而另一个人的免疫系统却会高度敏感，这就是为什么毒素并不总是直接原因

One person can tolerate a certain level of exposure while another person's immune system becomes highly reactive, which is why toxins aren't always a cause.

但对某些人来说，它们确实是关键因素

But for some people, they're a really critical piece of the puzzle.

如果你不去找这些原因，就会错过影响健康的关键因素。

And if you don't look for them, you're gonna miss a major driver of what's going on.

我记得有个病人，患了严重的溃疡性结肠炎。

I had a I remember I just remember a patient offhand who had terrible ulcerative colitis.

真的特别严重。

I mean, bad.

我们试遍了所有功能医学的方法——饮食调整、补充剂，能想到的都用了。

And we tried everything in functional medicine, dietary changes, supplements, everything we could think of.

但就是不见效。

And it wasn't working.

他一直在掉体重，整天拉血便，情况真的很危急。

And he was losing weight, and he was having bloody diarrhea all the time, and really it was quite serious.

要不是及时发现，他可能就得用上强效药物了。

And, you know, he would have had to go on some pretty heavy duty medication.

后来我就跟他说，你猜怎么着？

But I said, you know what?

我们可能漏掉了什么。

We might be missing something.

咱们查一查你体内有没有毒素吧。

Let's kinda look and see if there's any toxins in your system.

结果发现他的汞含量非常高。

And we found very high levels of mercury.

我们就给他做了排汞治疗。

And we chelated him.

把汞降下来之后，他的溃疡性结肠炎就完全好了。

We got his mercury down, and his ulcerative colitis completely went away.

这种情况其实在我很多病人身上都挺常见的。

So that's that's something that actually is not that uncommon in many of my patients.

明白了。

Alright.

第三个主要诱因是肠道、肠道菌群和微生物组。

The third major trigger is the gut and your gut bacteria and your microbiome.

这是整个拼图中最重要的部分之一，因为你的免疫系统有很大一部分其实就住在肠道里。

This is one of the most important pieces of the entire puzzle because a huge part of your immune system actually lives in your gut.

你的肠道菌群一直在和免疫系统沟通。

Your gut bacteria are constantly communicating with your immune system.

它们帮你分辨哪些东西是安全的，哪些是威胁。

They're helping you understand what's safe, what's a threat.

当这个系统保持平衡时，你的免疫系统就能保持平静、稳定，并对各种情况做出恰当的反应。

And when that system is balanced, your immune system can stay calm, can stay regulated and make appropriate responses to things.

但一旦失衡，一切就都变了。

But when it's disrupted, everything changes.

而今天，这种失衡已经非常普遍了。

And today that disruption is so common.

抗生素、饮食差、长期压力、膳食纤维不足、加工食品——这些都会打乱你肠道菌群的平衡。

Things like antibiotics, poor diet, chronic stress, lack of fiber, processed food, all these things shift the balance of your gut bacteria.

一旦平衡被打破，那些原本约束免疫系统的信号也就跟着消失了。

And when that balances off, lose the signals that keep your immune system in check.

所以免疫系统不再精准，反而变得过度敏感，更容易被激活。

So instead of being precise, your immune system becomes reactive and starts over responding and gets triggered more easily.

在某些情况下，它甚至会攻击自己的身体。

And in some cases, it turns against your own body.

而这一切最终都可能与食物有关，因为影响微生物组最快、最有效的方式就是饮食。

And that's where it all can expect to food Because the fastest, most powerful way to influence your microbiome is through what you eat.

每一餐要么在滋养那些调节免疫系统的有益菌群，要么就是在喂养引发炎症的有害菌群。

Every meal is either feeding the good bugs and the good bacteria that regulate the immune system, or it's feeding the bad bugs that drive inflammation.

这就是为什么饮食不仅仅是拼图中的一块。

Which is why diet isn't just one piece of the puzzle.

它是我们恢复身体平衡最有效的手段之一。

It's one of the most effective tools we have to start restoring balance in the body.

对于许多自身免疫疾病患者，我会把调理肠道作为治疗的关键。

And for many people with autoimmune disease, I focus on their gut as a way to treat them.

我跟你说个我在克利夫兰诊所遇到的病人，他患有银屑病关节炎，是一种很严重的自身免疫病。

I'll just tell you a quick story of a patient I had at Cleveland Clinic who had psoriatic arthritis, terrible autoimmune disease.

她当时在用一种抑制免疫系统的药，每年花费五万美元。

She was on a drug that suppressed her immune system that cost $50,000 a year.

她还经常偏头痛，血糖也快要达到糖尿病标准了。

She also had migraines, pre diabetes.

她有抑郁症，同时还饱受肠易激综合征和胃食管反流的折磨。

She also had depression, and she also had irritable bowel and reflux.

她一直在克利夫兰诊所看最好的医生——最顶尖的胃肠科医生、治疗偏头痛的神经科专家、处理抑郁的精神科医生、风湿科权威等等。

And she was seeing all the best doctors at Cleveland Clinic, the best gastroenterologist, the best neurologist for migraines, the best psychiatrist for depression, the best rheumatologist and so on.

但她的生活还是勉强维持着，根本没好转。

And she was just barely getting by.

可没人问一句：这些症状之间，到底有什么共同联系？

And no one said, gee, what's connecting all these things?

为什么她的身体会这么发炎？

Why is her body so inflamed?

这些问题本质上都是炎症引起的。

All these are inflammatory problems.

她的肠道一团糟。

Her gut was a mess.

我说，咱们先从肠道开始调理。

I said, let's start with the gut.

于是我给她做了一整套肠道修复方案。

So I gave her a whole gut reset.

我们给她安排了一个五小时的调理计划。

We call the five hour program for her.

她需要抗生素和抗真菌药，把有害菌清除掉。

She needed an antibiotic and any fungal to clear out the bad bugs.

我们给她补充了益生菌、维生素D和一些鱼油。

We gave her probiotics, vitamin D, some fish oil.

其实也没用多少东西。

Not that much really.

我们让她做了十天的排毒饮食。

We put her on the ten day detox diet.

六周后她回来了，说：医生。

And in six weeks she came back and she said, Doctor.

海曼，我好多了。

Hyman, I'm all better.

我已经停掉所有药了。

I stopped my medications.

我说：我没让你停药啊。

I said, I didn't tell you to do that.

她说：哦，不是的。

She said, oh, no.

我只是感觉特别好。

I just felt so good.

我一点症状都没有了。

I don't have any symptoms.

我的银屑病完全消失了。

My psoriasis is gone.

我的关节炎也好了。

My arthritis is gone.

我的偏头痛也消失了。

My migraines are gone.

我的抑郁症状也没了。

My depression is gone.

我的肠易激综合征也缓解了。

My irritable bowel is gone.

我的胃食管反流也好了。

My reflux is gone.

我还瘦了二十磅。

And I've lost 20 pounds.

这就是恢复健康肠道菌群的力量。

So that's the power of of helping restore a healthy microbiome.

有时候需要特定的方法，不只是调整饮食，但这些都可以在专业的功能医学医生指导下完成。

And sometimes it's a very specific method that you have to use, not just changing your diet, but that can be done with a good functional medicine practitioner.

下一个诱因是感染。

The next trigger are infections.

比如莱姆病、病毒、寄生虫，甚至细菌都可能引发。

And this can be things like Lyme disease, viruses, parasites, even bacteria.

这时候，自身免疫病就容易让人困惑了。

And this is where autoimmune disease gets confusing.

免疫系统本来在攻击病原体，却意外地攻击了你自身的组织。

And in this case, what happens is the immune system's trying to attack the bug, but it also cross reacts with your body's tissues.

它可能本想对付莱姆病，结果反而对你自己的身体发动了攻击。

So it might be trying to fight Lyme disease, but then it creates an autoimmune response to you.

新冠、莱姆病、某些病毒都会出现这种情况。

And this happens with COVID, with Lyme disease, with certain viruses.

比如EB病毒可能和多发性硬化有关，而类风湿关节炎则可能和莱姆病相关。

And, like, Epstein Barr virus can be linked to, for example, MS and rheumatoid arthritis can be linked to things like Lyme.

这些感染往往处于潜伏状态。

And and these infections often are latent.

它们不像急性感染那样。

They're not like an acute infection.

而是长期低水平地存在。

They're they're lingering at a low level.

让免疫系统一直处于激活状态。

They keep the immune system in a constant state of activation.

久而久之，免疫反应的分子就开始出错。

And over time, that immune response molecules start to misfire.

失去精准性，转而攻击自身的组织。

It loses its precision and it begins reacting to your own tissues and attacking your own tissues.

有点像认错了人。

Kind of like a mistaken identity.

这种情况其实并不少见。

And and this is this is this is not uncommon.

这在传统医学里也有类似说法，叫分子模拟。

This is sort of a a common framework for even traditional medicine that understands that the body it's called molecular mimicry.

身体会对细菌里的某种外来蛋白产生反应，但这种蛋白长得跟你自身的组织很像，结果身体就误以为是自己人，开始攻击自己的组织。

The body reacts to something that's a foreign protein in a bacteria, but it it kind of mimics your body's own tissues, and then your body starts to attack your own tissues.

所以，寻找潜在的感染源非常重要。

So looking for hidden infections is really important.

每个人的病史都不一样。

And, nobody has the same history.

每个人的潜在病因也都不相同。

No one has the same, underlying causes.

就算是同一种自身免疫疾病，也可能有十种不同的原因。

Even with the same autoimmune disease, you can have 10 different causes.

这一点一定要搞清楚。

So it's important to really understand that.

拿类风湿性关节炎来说，一个人可能是对麸质过敏，另一个人可能是寄生虫感染，还有人是重金属中毒，或者肠道菌群失衡、肠漏问题。

You have to look at, let's say rheumatoid arthritis, one person could be gluten, one person could be a parasite, one person could be heavy metals, one person could be the microbiome, leaky gut.

所以这些因素都得一一排查。

So you've got to look at all those things.

有人是慢性压力引发或加重了类风湿性关节炎。

One person could be a treatment chronic stress can trigger and exacerbate, rheumatoid arthritis.

所以你得看看自己的具体情况和经历，弄清楚自己到底对什么有反应。

So you kind of have to look at your particular story and your history, what you're reacting to.

有人是食物引起的，有人是毒素，也有人是潜伏的感染。

One person, it might be food, another might be toxins, another could be a hidden infection.

所以那种一刀切的治疗方法是行不通的。

And so one size fits all medicine doesn't work.

这是因为触发因素各不相同。

And that's because the triggers aren't the same.

根本原因也不一样。

The causes aren't the same.

我们得根据病因来治疗，而不是只看症状或疾病名称。

We have to treat by cause, not by symptom or disease.

这正是功能医学的核心原则。

And this is such a fundamental principle of functional medicine.