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Podcast, Provider Interviews

Autoimmune Nutrition Made Easier: Practical Tips from Dr. Saimun Singla

3 days ago
60 min read
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Summary:

In this episode, Cheryl sits down with Dr. Saimun Singla to talk about one of the most important and often misunderstood topics in autoimmune health: nutrition and diet. Together, they unpack common myths surrounding food and autoimmune conditions and share practical, real-life strategies for self-management. It’s a conversation packed with practical advice and empowering insights for anyone looking to make nutrition more manageable while living with an autoimmune condition.

Episode at a glance:

  • Common misconceptions about diet and autoimmune diseases: Cheryl and Dr. Singla discuss common myths about diet and nutrition for autoimmune diseases.
  • How Dr. Singla adapts her kitchen for comfort and efficiency: Organizing items to avoid reaching or bending, using pre-chopped ingredients to reduce strain, utilizing assistive kitchen tools (many available on Amazon)
  • Creative, real-life kitchen strategies: Wearing weightlifting gloves for cutting tough vegetables, prepping water ahead of time to avoid lifting heavy pots

Medical disclaimer: 

All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Episode Sponsors

Rheum to THRIVE, an online course and support program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. See all the details and join the program or waitlist now! 

Speaker Bios:

Guest Speaker bio

Dr. Saimun Singla is a triple board-certified physician specializing in pediatric rheumatology and integrative medicine. Her story is unique because she was diagnosed with rheumatoid arthritis after becoming an attending rheumatologist—a backwards journey that led to a shift in how she treats chronic diseases and a few career pivots along the way. She is especially interested in the intersection of managing autoimmune disease with both traditional medications and lifestyle interventions, and how this comprehensive approach influences disease progression and co-morbid outcomes.

Cheryl Crow

Cheryl is an occupational therapist who has lived with rheumatoid arthritis for over twenty years. Her life passion is helping others with rheumatoid arthritis figure out how to live a full life despite arthritis, by developing tools to navigate physical, emotional and social challenges. She formed the educational company Arthritis Life in 2019 after seeing a huge need for more engaging, accessible, and (dare I say) FUN patient education and self-management resources.

Episode links:

Full Episode Transcript:

[00:00:00] 

[00:00:05] Cheryl Crow: Hi. I am so excited today to have Dr. Saimun Singla back on the Arthritis Life Podcast for the second time, but the first time in the last three years. So welcome. 

[00:00:21] Dr. Singla: Thank you. Thank you for having me again. 

[00:00:24] Cheryl Crow: Yeah. It’s so great to be able to catch up. A lot has changed in both of our lives since we last talked.

[00:00:30] Cheryl Crow: But first, for those who maybe didn’t hear your earlier episode 72 can you let the listeners know, where do you live and what is your relationship to arthritis? 

[00:00:40] Dr. Singla: Yes. So, I’m, my name is Dr. Saimun Singla and I am a pediatric rheumatologist and then became a patient with rheumatoid arthritis and then became, again, board certified in something called integrative medicine.

[00:00:55] Dr. Singla: So in that order. And so my journey with arthritis is not [00:01:00] because I see patients with arthritis or autoimmune conditions, it’s because I have RA myself or got RA after becoming a full fledged rheumatologist. So when you become kind of the patient, everything turns and flips and your perspective of the disease changes, obviously.

[00:01:17] Dr. Singla: So through that journey, obviously I had the medical knowledge going in, but from the patient standpoint, I realized there were so many gaps in care or knowledge that was evidence-based. Which is kind of why I ended up doing the integrative medicine fellowship to figure out, okay, well, what do arthritis patients or patients with autoimmune conditions, what are they supposed to eat?

[00:01:36] Dr. Singla: How, why is sleep even important? Are there things that we can do for pain control other than just medication? So all these real life questions started popping up, and now I’ve kind of pivoted my career. I went from full blown academia to now full blown private practice where I blend kind of the clinical world, the evidence-based stuff that I’ve done day in and day out with more complimentary things to kind of help [00:02:00] your symptoms and as you know, just manage the overall illness for the long haul.

[00:02:05] Cheryl Crow: Yeah, that’s just, I mean, your story is very unique. For people who don’t know, there’s only about 350 board certified pediatric rheumatologists in the entire United States to begin with. So you’re like a unicorn just to start off and then to get diagnosed after already becoming one, it’s just a such a rare mixture, and I think it’s such a powerful story that, and a testament to the fact that you can have all the medical knowledge in the world, but when it happens to you, it’s a whole different thing. Right? 

[00:02:38] Dr. Singla: Absolutely. Absolutely. It’s as if all the medical knowledge goes out the window, actually. 

[00:02:43] Cheryl Crow: Yeah. Yeah.

[00:02:44] Cheryl Crow: And I know a lot of people have had that experience, if they’re, you know a healthcare provider and then maybe someone in their family gets sick or they get sick, you suddenly see things through a new lens. And I just wanna quickly state or review the fact that you got diagnosed [00:03:00] postpartum, right?

[00:03:00] Cheryl Crow: After the birth of your second child? ‘Cause that’s a, there’s a lot of people who contact me through social media and I’m sure you too and, you know, wanna know like how do I manage having small kids? Now you have three kids? 

[00:03:13] Dr. Singla: Yes. 

[00:03:14] Cheryl Crow: What are some, sorry, this wasn’t one I prepared you for, but it’s okay.

[00:03:17] Cheryl Crow: Before we go onto, the topic of the day is really gonna be, we’re gonna dive more into dietary changes and how people can do diet. You know, what are some myths versus fact about how to nutrition and RA. But just to something unique about your story that I would love to hear, honestly as a mom myself too, or is, what are some of the things that have helped you?

[00:03:35] Cheryl Crow: Balance being a mom and with managing your rheumatoid arthritis? 

[00:03:40] Dr. Singla: Yeah, that, that is a tricky question and I think that’s been a learning curve for me. Because the stages and ages of the children is kind of what dictates how active you need to be, how much they understand about your diagnosis. So for me it’s really.

[00:03:56] Dr. Singla: They all know I have arthritis. They see me take my medications. [00:04:00] My daughter did like a juvenile arthritis awareness thing at school once for one of her projects. I think it’s a family affair for us. So my husband is very involved. I think it was a learning curve for us too, of okay, well we’re starting this medication.

[00:04:13] Dr. Singla: All the symptoms should go away, right? Everything’s gonna be fixed. And then you very quickly realize that like this diagnosis is at is like an attachment to you. It’s not going anywhere. So we have got to nurture it. We’ve got to include it as part of our family. So sometimes that means not going out when everybody else is going out to eat or going for family events or birthday parties and or me taking a step back and being like, I just wanna rest.

[00:04:35] Dr. Singla: And the kids are okay with that. They’re like, okay, mommy needs to rest so that when we come back we can hang out with her. So it’s been a, never once have they been like, well , why is mommy always saying no? Or Why is mommy ? It’s always been us educating them at whatever stage of life they’re in and then me trying to be present when they actually are with me.

[00:04:53] Cheryl Crow: I love that and I think that I relate to that as well. I’ve really had to learn to advocate for my need to rest and, which [00:05:00] is hard for me because I’m at baseline, the kind of person that wants to say yes to everything. I think you can relate to that too, just ’cause I know you a little bit and Yeah.

[00:05:07] Cheryl Crow: You know, we’re multi-passionate and, but there really is a point where you have to just recognize that your basic needs matter, right? I don’t know if you’ve ever met her, Dr. Christine Stato. She’s a nurse practitioner who has her own like fibromyalgia clinic.

[00:05:24] Cheryl Crow: She was a past association of rheumatology professionals president, but she’s a great advocate for patients. And she said, I tell my patients, think of your bed as your recharging station, like for yourself. like you don’t just, it’s not just a nice to have to recharge it, like you have to charge it, you know?

[00:05:39] Dr. Singla: Yes. 

[00:05:39] Cheryl Crow: So, because 

[00:05:40] Dr. Singla: otherwise you’re gonna find out very quickly that you are not full of endless energy. Yeah. 

[00:05:45] Cheryl Crow: Yes. Nothing like becoming a mom or parent to humble you. And I think it’s so good for kids to learn. I have the same thing. My child has learned that, you know, mom needs rest. Yeah. And that’s just.

[00:05:57] Cheryl Crow: It’s, we think we have a lot of, we tend to have a lot [00:06:00] of like emotional loading around that. Or like guilt and the kid for kids, they just kind of take it, if you present it to them as like a fact of life, 

[00:06:08] Dr. Singla: it’s like it is what it is. Yeah. For them we do a lot of stuff that doesn’t require a lot of running around.

[00:06:13] Dr. Singla: So like puzzles, Jenga, board games, you know, we’re drawing, painting together. We’ll do stuff where I’m like still spending quality time with them, but i’m not running around all the time.

[00:06:24] Cheryl Crow: Yes. Yeah. And I mean, a lot of kids, there’s so many arts and crafts and things that kids love to do and 

[00:06:29] Both: Right.

[00:06:30] Cheryl Crow: Yeah. It’s, that’s a great, those are some great pro tips. Advocate for your need to rest, find fun activities that you can do that are not expending a lot of physical energy. And as you said Yeah. Pivoting as your kids go through different stages and ages. ’cause you’re right.

[00:06:45] Cheryl Crow: Like the fine motor demands are so high when the kids have a baby or toddler and it’s, as they get older, like my son’s 11, it’s a lot less fine motor now. But it’s almost more like emotional, you know? Right. Getting ready for the pre-teen years and, right. Yeah. Yeah. [00:07:00] But thank you for on this for the moment, talking about that.

[00:07:02] Cheryl Crow: Yeah. But yeah, you recently created a really great course for people to learn more about one of what the most complicated topics, I think in all of what, what’s called self-management. Self-management is like the skills you need on a daily basis to manage your condition. Whether that’s exercise, you know, pain management tools, lifestyle, nutrition, we’re gonna talk about nutrition because that’s, yes. That’s the one that tends to be complex and confusing. So I guess first, yeah. Why did you create this course? 

[00:07:36] Dr. Singla: Yeah. No, it’s a great question. I had zero intention prior to this of creating any courses. I’m like, I have enough on my plate.

[00:07:43] Dr. Singla: I don’t wanna figure out how to upload a video onto a teaching platform. 

[00:07:47] Cheryl Crow: Right, right. 

[00:07:48] Dr. Singla: But the reason that I switched my mind is because now that I’ve been doing my private practice for three years, the most common question that I get when it comes to not just arthritis, but [00:08:00] any autoimmune condition, is, what am I supposed to be eating?

[00:08:03] Dr. Singla: Is there anything that I’m supposed to be eating that can help me get rid of the disease? Can it help me reverse the disease? Can it help me control my symptoms? So many different questions. All the same version of the question and I ended up kind of finding myself repeating the same stuff over and over again.

[00:08:19] Dr. Singla: And mind you, I have training in integrative medicine, so there was like a whole three months dedicated to just diet, learning about the different types of diet for different types of conditions. And so. What I was thinking is you know what? Instead of repeating myself and also so people don’t have to come here to see me just for the a visit, one-on-one visit, this is knowledge that anyone with arthritis that’s interested in learning about this can have access to so.

[00:08:45] Dr. Singla: That was kind of the driving factor behind it because I, what I’ve realized is there’s tons of myths out there, just from anecdotal experience, meaning people’s own experience of well, I ate this and this is what happened to me. Now everybody [00:09:00] should do it. And I’m like, that’s not true ’cause sometimes I’ll, I’m like cringing on the other side of the camera, you know, of the screen.

[00:09:06] Dr. Singla: And I’m like that’s not true. Or I’ve tried that and that did not happen to me. You know, and it’s but they say it so matter of factly that you’re very compelled to be like, well, I’m gonna do it too. So that was kind of the birth of the course. 

[00:09:18] Cheryl Crow: I totally, I’m just, I’m grateful that anyone who tackles this topic I did in my, I do have a self-paced course that’s really like a overall, I call it like the orientation manual for having rheumatic disease or inflammatory arthritis. And when I first made the course in 2020, I actually said, I’m not gonna touch diet ’cause it’s too complicated. And to summarize, and I feel strongly that people should work with an expert, like a registered dietician or get the highest quality guidance from somebody who specializes in this. But then I realized because I was doing a disservice by not including it, because it is so many people’s first question, right? And there are some general rules of thumb. So anyway, I’m always [00:10:00] like so grateful to people who really do dig deep. Mine’s more of a overview, right?

[00:10:04] Cheryl Crow: A basic beginners, true beginners guide. But you’re giving in this course more depth of detail, right? And more truly like deeper understanding of why do some of these myths persist? You know? Because yeah, there’s oftentimes a tiny kernel of truth, but it’s taken like 20 steps far 

[00:10:24] Dr. Singla: Right. And I think at the end of the day, if you think about it, what we eat, we make that decision three times a day, times 365, you know, days a year, it’s over a thousand times that you’re having to think about the same darn question over and over again. So it’s the medication part is almost easy.

[00:10:41] Dr. Singla: It’s oh yeah, I take this medicine on this day, or I take it daily, but then the food part is still lingering. You’re like, well, no one’s told me what I should be doing about that. And the reality is there’s not one right answer. We know that. Otherwise, we’d all be doing it. We’d all be eating the same stuff to get the, to get rid of the disease, but the reality is it needs to make sense [00:11:00] for your life, your taste buds, your culture . You might not enjoy the same types of sandwiches or curries that other people enjoy. So it really needs to be fine tuned. And I think because there is so many moving parts to it, and that’s where that analysis paralysis comes in, you’re like, oh, it almost feels better to get keep reading about it than actually taking action on it and doing it. 

[00:11:24] Cheryl Crow: So true. That’s why everyone ends up with like 30 tabs open. Now with chat GPT, you can use that. But then that can confuse you even more. So yeah, let’s like, let’s go through some of the maybe myths versus facts. Yeah. I think a lot of these come down to, or a lot of these involve amorphous or an unclearly defined terms.

[00:11:44] Cheryl Crow: So maybe what do people mean when they say inflammatory foods or anti-inflammatory? Can you help unpack that?

[00:11:53] Dr. Singla: Yes. Because when a rheumatologist hears the word in inflammation, it’s your immune system doing something [00:12:00] specific to either get rid of an infection, right?

[00:12:02] Dr. Singla: Fight off something. Or in the case of an autoimmune disease, it’s your immune system has gone rogue and now it’s inappropriately causing too much inflammation and attacking a certain area when it shouldn’t be. Some of that is measurable through lab work. Some of it is not measurable, so you see where the confusion lies.

[00:12:19] Dr. Singla: It’s well, how do you know I don’t have inflammation even if my labs are normal? 

[00:12:22] Dr. Singla: Because it’s not. It’s not something we say, oh, you have inflammation, you don’t. We define inflammation as you have this diagnosis. The underlying cause of it is because your immune system is doing inappropriate things like creating too much inflammation at the level of the joint or the organ or whatever.

[00:12:40] Dr. Singla: And so when someone says inflammatory foods, is it really that you’re eating certain foods and it’s kind of making that process a whole lot worse? Or is it that there is some component of the food that maybe might not be serving you in the long run if you’re eating it for prolonged amounts of time? [00:13:00] I think that’s where the switch needs to happen of what’s actually happening versus what you think is happening because we have all eaten inflammatory foods, right? Processed foods, sugary foods, all those things that we are not good for us that we know, right? 

[00:13:16] Cheryl Crow: Right. 

[00:13:16] Dr. Singla: But is that really gonna be the reason why I can’t get off my medication? Or is that why I am having to start a medication or why I have arthritis to begin with?

[00:13:24] Dr. Singla: Not necessarily. I think the way I think about it is your diet is going to do two things. Yes, it can definitely kind of simmer that help calm that inflammation down some more for some people than others. Okay. But the bigger kind of game plan here is that it’s gonna decrease your risk of things that are going to kill you, your mortality, risks of heart disease, strokes, heart failure, all those things.

[00:13:51] Dr. Singla: ’cause your heart is your main organ, right? Like your number one reason for dying is gonna be cardiovascular disease, right? And so if what you’re putting in [00:14:00] your mouth can decrease the risk of those bad things happening, then that’s my number one takeaways. Hey, let’s at least focus on that part. Now, as you know, when you have an inflammatory condition, like an autoimmune condition, your risk of heart disease is higher.

[00:14:13] Cheryl Crow: Most people don’t know that. I never was taught that. I just learned it Googling.

[00:14:18] Dr. Singla: Yes. 

[00:14:18] Dr. Singla: No, it’s true. And I learned that in the integrative medicine fellowship and I was like, oh my God. I was so scared when I read that. I was like, I have all the check marks to get to lead up to heart disease and I don’t want that in my fifties.

[00:14:29] Dr. Singla: I wanna see my kids graduate, I wanna see them get married and have grandchildren. You know, so for me, I’m like, okay, that’s my motivation. What do I need to do to decrease that risk? Part of it is making sure your inflammation is under control, and that can be with the traditional medications.

[00:14:44] Dr. Singla: And there’s nothing wrong in having to take your Orencia or CIM Z or methotrexate, whatever it is that you need to keep that inflammation under control. The second layer, now we’re getting more sophisticated, is the lifestyle stuff is if you really wanna nourish your [00:15:00] body, you really need to focus on certain groups of food.

[00:15:02] Dr. Singla: What I like to do is focusing on what you’re supposed to be putting in your mouth, not what you’re supposed to be kind of supposedly getting rid of. Right. And so there’s a, that’s where the myth is eat this, not this, eat this, not this. It’s

[00:15:13] Cheryl Crow: well, and I was just gonna add I follow a really great, he has, he’s not, I guess not necessarily a registered dietician.

[00:15:18] Cheryl Crow: He has a PhD in nutrition and he said there’s no such thing as an inflammatory food. That’s across the board always gonna be completely inflammatory to everyone. There’s just different people’s, right? I don’t know if you agree with that, but he was, I think he might’ve been saying it to the extreme.

[00:15:35] Cheryl Crow: I mean like I think there are things like additives, like there’s not like some person out there who’s wow, highly processed food is just not inflammatory at all. To me, why I see least what you say is like dairy is a great example. If you are sensitive to dairy, eating, dairy is going to be inflammatory, potentially. Whereas if you’re not dairy’s great, like you can’t, there’s no one size fit all. So, sorry, that just reminded me of that when you were saying that.

[00:15:57] Dr. Singla: These are like tomatoes potatoes, like in, call it what [00:16:00] you want. But in long run, in the long run, we know it’s not serving us to eat certain types of foods.

[00:16:05] Dr. Singla: And those are very specific foods that are like no-brainers. I’m not talking about like the gluten, the dairy, the, you know, the stuff that pops up on your allergy sensitivity testing. I’m talking about processed foods. You know, high sugar content stuff that’s not gonna serve anybody regardless of what condition you have.

[00:16:22] Dr. Singla: So those foods, I wouldn’t necessarily say they’re inflammatory. I think, let’s just say they’re not good for us. 

[00:16:28] Cheryl Crow: I’m sorry, I’m like. I really love this reframe because I think the reason I’ve had this sometimes complicated relationship with this topic of nutrition is that i’ve seen so many people get led astray down like a path of unnecessary, restricted diets, or I think the worst is when they withhold medication because they’re putting all their hopes on diet . and I think, yes, but I don’t wanna throw the baby out with the bath water. Right, right. Just because diet for the severity of my RA when I was diagnosed, it was like, you’re not this, we need medication.

[00:16:57] Cheryl Crow: This is not this is not a optional [00:17:00] thing. And I also am going to be benefit, even if I’m never getting, gonna get off of my biologics or methotrexate or even titrate down, this is gonna help my overall health to have good heart health. There’s no downside of that. So it’s keep it simple, like whether or not it affects my RA on any measurable, like I don’t feel. My joints maybe don’t feel like I get sore. They get sore when I have a certain food, but I’m going to eat it because I’m investing in my health. And that’s like a beautiful thing 

[00:17:27] Dr. Singla: And that’s where the mindset needs to happen.

[00:17:29] Dr. Singla: It’s I don’t need to have the perfect foods in front of me. I don’t need to have the perfect plate. You have kind of a combo of things that you know are gonna serve you in the long run, regardless of if you’re on medicine or not. ’cause I have seen the extreme come into my clinic where they have been on a diet for way too long.

[00:17:47] Dr. Singla: So if it’s in the case of a child, they are not growing properly, right? They’re skinny, they’re a failure to thrive at a certain age is what we call it. Their joints are contracted, flexed like it is hard [00:18:00] to look at that and say, I could have helped you. It’s, we’re in 20 something, right?

[00:18:04] Dr. Singla: Beyond. We have medications to, to help you get through this, and I wish someone had not given you so much false hope in being able to put all your eggs in one basket and say, Hey, I’m gonna eliminate this, and this, and only eat this and see what happens. Maybe for some people they’re allergic to certain foods, they need to be removing certain things from the diet, but that’s where it gets, that’s like the gray area where really you need to be working with a professional one-on-one to figure out what that is.

[00:18:31] Dr. Singla: But for the majority of people, what I notice is that food is not gonna move the needle in your big RA picture or juvenile arthritis picture. Yeah. It’s just an added component where it’s, Hey, do this now, so your future self will look back and be like, thank you. I don’t have to worry about high calcium score on my CT of my heart.

[00:18:50] Dr. Singla: You know, like these are things that we don’t think about now, but we should start to talk about. I also don’t want people to have fear of foods because it’s like someone told me on [00:19:00] the internet that potatoes were so bad for you, so I’m not eating it. You know? We don’t want that mentality going in as well.

[00:19:08] Cheryl Crow: Yeah. And when I had, sorry. When I had, initially I chimed in on my idea of no food being a hundred percent inflammatory versus noninflammatory anti-inflammatory. You were saying about nourishing, which I just wanna ask. I wanna underline that point because I say the same thing to my support groups is that, you know, if you’re not sure where to start, starting with, when you’re looking at making different choices around diet and nutrition, thinking about what can I add?

[00:19:32] Cheryl Crow: If I could can I add in some blueberries, right? Can I add something in to nourish my body versus what are all the bad, horrible foods that I’m gonna be a, I’m gonna be a failure of a patient if I eat these fruits, right? 

[00:19:43] Dr. Singla: Yeah, exactly. Anytime you go to the extreme, it’s almost like you’re setting yourself up for failure or if not right away, at least in the next couple of months, because it’s not sustainable to be super restrictive.

[00:19:55] Dr. Singla: If you have celiac and you need to be off of gluten, completely different story like that [00:20:00] is a part of the acceptance game of knowing like I can’t eat gluten, so we’re gonna have to, you know, figure that out. But if you don’t have celiac or some sort of sensitivity to gluten, it don’t feel bad for eating bread or having pasta.

[00:20:13] Dr. Singla: You know, it’s like you, you have to be able to enjoy your life. And it comes down to portions as well. Like how much of it are you eating on a week to week basis? Is it actually doing any harm or is it hurting you? What, where are we with this? 

[00:20:27] Cheryl Crow: I love that. And so we’ve talked about inflammation and you know, anti-inflammatory versus inflammatory potentially, you know, clarifying that distinction.

[00:20:36] Cheryl Crow: What about trigger foods? What does it mean to have a trigger food and why can that be helpful? 

[00:20:42] Dr. Singla: Trigger food. So. A trigger in general, when you have RA is gonna be something that makes you, if not, you have a flare, but at least make you, maybe make your joints feel a little bit achier the next day, or you feel more tired the next day or your stomach is hurting or you’re having diarrhea, something more obvious related to a food.[00:21:00] 

[00:21:00] Dr. Singla: But sometimes at the beginning when you don’t know what to look for or what you’re supposed to be looking for, you’re like, I think I’m okay eating this. So it’s a matter of knowing do your joints feel different when you eat this food. Now, when we’re talking about tracking down a trigger, that’s where it gets tricky because obviously we’re eating multiple types of foods in a day.

[00:21:19] Dr. Singla: We’re doing multiple things, taking different medications, right? So that’s when I track kind of specific triggers, I break it down into the four pillars, which is gonna be, what did I eat the day before? Was I overexerting myself? What type of physical activity was I doing? How was my sleep?

[00:21:35] Dr. Singla: What was my stress like? What’s my current milieu of stress right now? You know, so when you’re like, okay this variable, or still the only thing that’s changed is this. It’s almost like an experiment. You were able to figure out like, ah, okay, I think I was triggered by this food. So keep it going.

[00:21:50] Dr. Singla: So if you eat that again, the next time you eat, do you notice that same trend? Now, if you wanna be extra sophisticated, you’ll say, okay, if bread, let’s say [00:22:00] gluten is a thing. Let me eliminate it for two weeks and then reintroduce it on week three. What are my joints doing? Well, how am I feeling?

[00:22:07] Dr. Singla: That’s the only way we’re gonna know. It’s not gonna be a lab test that tells you that, oh my gosh, Cheryl, you need to, why? How dare you eat sweet potatoes? Or you know, this or that? Like you, it needs to be fine tuned to what’s happening in real time in your joints.

[00:22:23] Cheryl Crow: I love that. And I think, you know, it’s like really what you learn in high school, right?

[00:22:28] Cheryl Crow: Of like the scientific method, right? It’s just, well, I think where the overwhelm comes in, if you’re listening to this be like, it’s not that simple in your head. Right? Because it’s so hard sometimes to hold variables steady and only change one thing. I will say if it’s a strong trigger, you will figure it out.

[00:22:46] Cheryl Crow: Like for me, one of the biggest triggers I’ve discovered, I mean first is lack of sleep. That one’s a little easier because it’s like you’re either sleep or you’re right. And then I don’t know, maybe I have lupus too. I don’t know but I have it’s sun [00:23:00] sensitivity and light sensitivity. Or sorry, heat sensitivity and sun sensitivity, separate and together. So my fatigue flares up horribly if I am in the sun or heat for too long. But worse together. So when you figure those things out, you’re like, oh yeah. It’s so extreme. That I’m making this, you know, A to B connection.

[00:23:20] Cheryl Crow: Right. With some of the smaller triggers, it just will take a little longer. I’m just trying to, giving some words of encouragement. 

[00:23:25] Dr. Singla: Absolutely. I’ve, we’ve all been there. I had no idea for me like red wine was a trigger. I’m like, you know, you don’t put two and two together until you’re like, on year two of diagnosis.

[00:23:33] Dr. Singla: You’re like, huh. Every time I drink this, I. I just wake up feeling achy or hurting and then you’re like, oh my gosh, I think it’s what I drink. And so unless someone teaches you to blatantly look for this pattern, how do you know? You don’t know what you don’t know. So for anyone who’s newly diagnosed, do not feel bad if you don’t know your triggers.

[00:23:52] Dr. Singla: I’m sure there’s tons of triggers I don’t know of yet as well because I don’t know about them. 

[00:23:57] Cheryl Crow: Right. Or they can change over time too. 

[00:23:59] Dr. Singla: Or they can change over [00:24:00] time. Exactly. So if I’m having, the biggest thing is looking in hindsight and saying, okay, if I’m feeling like this today. What did I do?

[00:24:06] Dr. Singla: What did I eat? What? Who was I around that may have added to this? And you might not know the answer right away. This is why everything in rheumatology land is sometimes trial and error. It’s did the medicine work? Okay, great, we’ll continue. If it didn’t, we pivot. You know? So you have to have.

[00:24:20] Dr. Singla: That’s a one part of medicine that’s the hardest to deal with is the gray area. or what you call the art of medicine. Right. Where you can do it in 10, 10 different ways to tackle one problem. And so it can be overwhelming for the doctor, it can be overwhelming for the patient to figure out what’s up, what’s down.

[00:24:35] Dr. Singla: But as long as, you know, going in i’m gonna try to figure out a trigger. I’m gonna try to figure out if this food is what I, what my body needs or should be eating. That’s all that matters. Is that effort? 

[00:24:46] Cheryl Crow: Yeah, a hundred percent. And the other kind of I’m thinking like, let’s see, defining terms here.

[00:24:53] Cheryl Crow: I wrote down a few other things other than, you know, inflammatory, anti-inflammatory trigger foods, and then gut health. That seems to be [00:25:00] such a buzzword. And even just more in the three years since we last chatted. Why is everyone talking about gut health these days?

[00:25:09] Dr. Singla: Yeah. First of all, the gut is in, in the medical world, it’s not just your stomach. It’s everything from your mouth all the way. So track it down. It’s gonna be your esophagus, your stomach, your small intestine, your large intestine, all of it, because all of it needs to work together for you to be able to absorb food properly.

[00:25:27] Dr. Singla: The things that are going to be harmful for your gut, right? In this setting from what I just defined, is processed food, sugar foods, things that we know are no-nos are not gonna help us. They’re not gonna help those cells be optimized and work the way they’re supposed to work. And so a lot of this comes from research, looking at the gut microbiome.

[00:25:46] Dr. Singla: That’s like the newest sexiest term, right? Is what is the gut microbiome doing? Because in reality, if you look at it, we are more bacterial cells, viral cells, yeast, and we are human cells. And that’s evolution. 

[00:25:58] Cheryl Crow: That freaks me out. 

[00:25:59] Dr. Singla: I know. 

[00:25:59] Cheryl Crow: [00:26:00] Sorry. 

[00:26:00] Dr. Singla: It’s just knowledge is power. 

[00:26:01] Cheryl Crow: It’s also sometimes scary. 

[00:26:04] Dr. Singla: But it’s evolution, right?

[00:26:05] Dr. Singla: Like we are obviously as human cells more sophisticated than the bacterial cells, but they were here before us and they, we have what we call a symbiotic relationship with them. So if we keep them happy, it’s you scratch my back, I scratch your back type of relationship with them, right? So if we can optimize the gut and keep that gut microbiome happy and have the systems performing as they’re as they should, then that’s another outlet to feel better. That’s another avenue for us to feel better. And so all that is summarized in the term gut health. Yeah. But a lot of people fixate on one part of the gut, unfortunately. Instead of looking at it as a whole of okay, well how can I optimize all parts of it from brushing my teeth properly, drinking enough water?

[00:26:46] Dr. Singla: Right. Even, and like water is important for the large intestine as well. Eating fiber, things like that is we’re talking about all these things together, not just, you should only eat fiber and forget about the rest of the picture. 

[00:26:59] Cheryl Crow: Yeah, [00:27:00] I think, you know, one of the visuals, I I imagine, let me know if this is correct.

[00:27:04] Cheryl Crow: ’cause I, my brain’s very visual. Yeah. I’m not, but I’m not really wanting to visualize exactly what’s happening in my colon. No. But I think about the, kinda like when you go to the dentist when you’re a kid or.\ When you take your kid to the dentist and they say, oh, you have to like brush like the sugar bugs off of your teeth.

[00:27:19] Cheryl Crow: I think about that, like that, the sugar or the highly processed food, which again, I have those things in moderation every day because I just know moderation works for me. But but I’m not having them in excess. Because my, what I imagine is that’s feeding the quote unquote bad. There’s the gut microbiome, the microbiome stuff, the whatever we call it. The whatever you just call it the good bugs and there’s the not so helpful bugs and we want that. As far as my dietician, I feel like I’m not doing her good. Not I’m doing her disservice by explaining this wrong.

[00:27:49] Cheryl Crow: I think maybe, but you let me know if this is right, that it’s like you wanna be feeding the most helpful ones that are in the right spot and not feeding the ones that are on. 

[00:27:58] Dr. Singla: Right. Right. You wanna kind drown [00:28:00] those people out. Because what happens is if the ratio flips where the bad is over the good, then you have what we call dysbiosis.

[00:28:05] Dr. Singla: Yes. 

[00:28:06] Cheryl Crow: Which I’ve had

[00:28:06] Dr. Singla: Yeah. Some people take it to the extreme and say, everybody has dysbiosis, or You should be on this type of cleanse to get rid of your dysbiosis. It takes time for good things to grow and bad things to go away. It’s not gonna be an overnight, you know, sensation.

[00:28:22] Dr. Singla: I think the biggest thing that moves the needle for most people when it comes to dysbiosis and gut health is getting rid of the crap that’s probably not helping you. And then as that’s step one, right? And then the second part is adding in more of the things that’s nourishing you. So, fruits, veggies, think fiber for the gut.

[00:28:42] Dr. Singla: Because we as humans cannot break down fiber, we rely on those little bacteria to break it down. When they break down those, the fiber, they release metabolites that then go on to be helpful to us. So obviously we wanna keep them happy, keeps us our body happy. Keeps us feeling good. When [00:29:00] you’ll notice probably when you eat too much of a not great thing, right? Like you’re constantly eating out, eating fast food. You might feel sluggish or you might feel like, gosh, the food is just sitting there. It’s not moving like the way, it’s like a vegetable or a smoothie would kind of move through you for a reason. Your metabolism’s gonna change.

[00:29:17] Dr. Singla: Peristalsis, which is like the rate the stomach kind of moves. Food is gonna change. There’s subtle things happening, and just because you can’t see it doesn’t mean it’s not happening. Right. And so what we do know is that when you nourish your body with more anti-inflammatory type foods, meaning the not processed stuff, the stuff that will help us flourish from a system standpoint, like stuff happening at a microscopic level, then we know that all systems are go at least we have that part optimized.

[00:29:47] Dr. Singla: You’re doing what you can in your power without having to take medications to, to do what you need to do now. For some people that might not be enough. You might be doing, you might be maxed out in eating healthy and trying to get rid of [00:30:00] processed food or, you know, for the most part you’re doing well, but you might still need to be on medication even if you are doing everything you can.

[00:30:07] Dr. Singla: And that’s, I think, that’s where people get stuck is well, I’m doing everything I can. I’m not going out to eat. That’s the reality for the majority of us with an autoimmune condition is that unfortunately we have to do every single little box checkbox there is to live our best life.

[00:30:23] Cheryl Crow: Yeah and I think I wanna unpack that more if that’s okay with you. Because you have such a unique perspective. ’cause you’re treating such a variety of patients. Fair enough that you get people, I mean, it is a little bit of a sec, self-selected population that comes through your door and that they’re looking from like an integrative or you know, but you’re also like, you have experience in other settings. And I think the thing that people are missing when they’re like in this echo chamber on social media is they keep hearing the same kinds of stories over and oh, this person reversed their ra, they cured it, they healed it. When those are typically represent, this is my understanding obviously I can’t prove it because we can’t, there aren’t any studies I’m aware of on [00:31:00] this, but from a lot of experts I’ve talked to, I’m curious to your opinion, a lot of experts I’ve asked why are there some people, I don’t think they’re not all lying. Right? Some people are snake oil salesman. Right. But there are genuinely like patients who are like I really made this dietary change and it was very quick that I had this relief. Like some, the experts I’ve talked to have said either that person potentially could have been misdiagnosed and they had reactive arthritis, which is like a short term condition anyway, and it was destined to go away.

[00:31:29] Cheryl Crow: They were just destined to go into spontaneous remission and it remission, happen to have changed their diet, or they had more mild disease.

[00:31:36] Cheryl Crow: What do you, okay. Are you agreeing with all that? 

[00:31:38] Dr. Singla: I a hundred percent agree, and that’s been my experience in clinic. I haven’t written this up or there are no randomized, you know, double-blinded placebo controlled trials on this.

[00:31:47] Dr. Singla: But what I’ve noticed and observed from years of doing this is that there is a small subset of patients where if they control diet, things somehow go into remission. And I’m not gonna be the one to [00:32:00] say, no way, no how, that’s not true. I have witnessed that. But I will say that is a minority of cases where the disease was already kind of minor to begin with.

[00:32:09] Dr. Singla: So when I say when, not as severe, let’s say. So you don’t have diffuse joint involvement. Your inflammatory markers aren’t through the roof. Your rheumatoid factor CCP are negative, you know? So you have a milder course. Yes. It could be reactive, definitely. Or you might just see that lucky person who went into remission from getting rid of stuff that wasn’t serving your body.

[00:32:28] Dr. Singla: That and I’m not gonna say no, that’s not possible. I’ve seen it. I’ve seen it. But the majority, when I say majority, I’m talking 70, 80%. So out of every 10 people that come in, maybe two at most will have the remission just with diet control. 

[00:32:43] Dr. Singla: Majority of everybody else is gonna have to do a little bit of everything to keep it under control.

[00:32:49] Cheryl Crow: Yeah. And there should not be any, I hope I’m preaching to the choir, but you know. If you know 10 people who have an RA diagnosis try their best, and eight of [00:33:00] them end up needing medication and two of them don’t. That’s not like those eight failed. That’s just like what their body responded to. It’s not your fault.

[00:33:08] Cheryl Crow: Like I don’t feel guilty at all. I just, I. I didn’t, but I didn’t know until I started sharing my story on social media, how many people feel like they’re like a failure for taking medicine. And I’m like, what? 

[00:33:16] Dr. Singla: Not true at all. 

[00:33:17] Dr. Singla: It’s oh, you’re a failure for being born into the world with black hair for, you know, being a brunette.

[00:33:21] Dr. Singla: It’s okay, well I really had no, I promise you I had no input into this. 

[00:33:26] Cheryl Crow: Or wearing glasses, you know? It’s well, I just need glasses. I just need glasses. I just need my meds. I get, I think with children it is, you know, more emotionally loaded potentially, because you’re like you’re making a decision.

[00:33:36] Cheryl Crow: The parent has the decision making power in some ways for their child, and then you’re like feeling guilty do I need this medication or whatnot. 

[00:33:44] Dr. Singla: But yeah and sometimes it is hard to have to explain that to a parent that your child needs this medication, but at the end of the day, it’s like I’m laying out all the cards for you.

[00:33:53] Dr. Singla: This is what’s what I’m seeing. This is what your labs are showing. This is what could happen. This is the [00:34:00] badness that can happen if we don’t treat it. So we need to fall on some middle ground here. And I think it helps that I have been on these medications myself. So you can’t say well you haven’t had to make this decision.

[00:34:12] Dr. Singla: Or it’s poison. No, I’m on it. This is what helps me show up in front of you today. Like otherwise I’d be sitting in bed in pain. 

[00:34:20] Cheryl Crow: Right. It is so important to share like success stories in like a real down to earth way. Like I know a lot of people see those commercials. They’re like, thanks to this medication, I’m running through a field of sunflowers and they, it feels fake, right?

[00:34:34] Cheryl Crow: Actually like. Literally, like I’ll post a video on myself, swing dancing like on a good day, and I’m like, no, these medications did enable me to do that. Given at least the objective and subjective markers at my diagnosis in 2003 my doctor was like, yeah, without these meds you would’ve been, we would have a. Expected you to be in a wheelchair within two years. Yeah. Like it was that bad. . And now here I am 22 years later, you know, so again, I’m just, [00:35:00] I know there’s so much fear around the medicine and they do legitimately have potential side effects for people, which you should consider. But I it’s to remember the disease 

[00:35:09] Cheryl Crow: has effects too, if not controlled. 

[00:35:11] Dr. Singla: It’s a risk benefit ratio, right? So the risk of using it has to be lower than the benefit of what you’re gonna get out of it. And part of that equation of balancing it is figuring out, okay, well what if we don’t treat, what would be the risks? You don’t wanna know what those risks like I we just said, like ongoing inflammation, you know, also increases your risk for heart disease.

[00:35:30] Dr. Singla: We don’t wanna add to that fire. So this is part of the process of having to decrease that risk. 

[00:35:36] Cheryl Crow: And it’s very complicated for each individual. I feel like I got a little bit further from the topic of I wanted to highlight a couple other things from your course. 

[00:35:44] Dr. Singla: Oh, sure. 

[00:35:45] Cheryl Crow: And one of the little, the bullet points I thought was really great how you worded it. It was navigating, one of the things you cover is navigating your anti-inflammatory kitchen, from stocking up to dining out. So I think that listeners might wanna hear, this is hard. What are some of the things in your [00:36:00] kitchen? What are some things that you recommend others have?

[00:36:03] Dr. Singla: Yeah, so I, for me, ’cause my arthritis is in my hands and my wrist, so I like to keep everything kind of where I don’t need to go digging. I don’t need to reach up high. I don’t need to go down low to be like, where did I put the crock pott? So most everything is in high, like eyesight or like maybe a little bit above of it on a counter.

[00:36:20] Dr. Singla: So that in itself helps if I know I’m gonna be like chopping, cutting, or like meal prepping a, if I can, I’ll buy it pre-chopped. That’s my number one hack. 

[00:36:30] Cheryl Crow: Yeah, me too. 

[00:36:30] Dr. Singla: If I can’t, because it’s like too expensive or it’s gonna go bad, there’s too much of it that they sell, then I will put on my gloves.

[00:36:36] Dr. Singla: Like I have special gloves that I use to actually lift weights. And then use that to kind of cut and you chop up stuff. So I have to be very strategic in not only like where stuff is placed in the kitchen, but also how intense is it to chopping carrots is different than chopping cucumbers.

[00:36:53] Dr. Singla: So for the carrots, I’m gonna be using gloves. Obviously there’s lots of assisted devices on Amazon galore. I know you are all [00:37:00] about that. So anything that will make your life easier, put it out, have it in front of you right there. If I’m using like a lot of water. I’ll just have I’ll tell my husband to like, fill up a pot of water and put it right next to the stove.

[00:37:13] Dr. Singla: So then if I can just dump from there, grab a glass, dip it in there, and put it into the pot so I’m not going back and forth filling up a heavy pan and, you know, doing that whole thing. So things that reduce weight off my hand I enlist everyone. This is where kids can help as well. Devices help.

[00:37:27] Dr. Singla: Placement helps. Planning helps all these things. Yes, it is work, but the flip side is if you don’t wanna do any of the work, then you’re either eating out or going out to eat and then we’re left to our own devices in terms of making a decision of, yeah, you know, when you don’t plan things, you’re probably not gonna make the best decision for food.

[00:37:47] Dr. Singla: And so I have to deliberately plan my meals and where things are in the kitchen, who I need help from. I mean, sometimes it’s not perfect obviously, but whatever I can do to control the unknowns I control. 

[00:37:59] Cheryl Crow: I love that. [00:38:00] You’re music to my ears as a, as an OT. And another one, another bullet point, I just last one I’ll highlight, but is the 15 best foods, spices, and beverages to fight RA pain. So what are some of those, I don’t want you to give away the whole course now, but what are some of the ones that you most enjoy or that you find that your clients.

[00:38:19] Dr. Singla: What I outline in the course is kind of taken from what I learned in my integrative medicine fellowship on what helps, what at least has some data, even if it’s not robust.

[00:38:30] Dr. Singla: But if someone has thought about this, looked at it, tested it, and saying, Hey, maybe it affects inflammatory outcomes. So what I mean by that is someone has eaten foods and test it to see does it increase your cytokines or inflammatory markers. So we know those are the culprits that cause kind of inflammation.

[00:38:47] Dr. Singla: And if it has some data, I know it’s not gonna be the best data ’cause again, we’d all be eating the same foods. But I, those are the ones that I tend to put on the list because I know at least there’s evidence backing it. Things like [00:39:00] antioxidant rich foods, your strawberries, your family of berries in general are wonderful to fight inflammation, we need antioxidants to kind of clean up damaged DNA, basically those cells. Because those cells, when they’re damaged, create free radicals that can go on to kind of create a ripple effect of inflammation. So that helps kind of bind those free radicals. So blueberries, I’m sure you’ve heard are great.

[00:39:22] Cheryl Crow: That’s one of my favorites. Yeah. I have a history of, I have gastroparesis and history of SIBO. So I have certain of the berries I have to, or I tend to avoid because they’re irritants, but blueberries, my stomach is awesome.

[00:39:33] Dr. Singla: Yeah. And it’s full of fiber. It’s great.

[00:39:35] Dr. Singla: Like the more colorful of fruit is the more rich it’s gonna be an antioxidants that are good for, right? Those are called the phytochemicals or the chemicals that come from plants that are helpful for us. So though that the berries family is great, I also put herbs in drinks in there because a lot of times we fixate on food, but we forget about the ingredients of cooking like ginger, garlic, you know, all those things are so [00:40:00] good. A lot of times, and I come from like a South Asian background where it was very heavy in turmeric, ginger, garlic. So a lot of the curries are so good for you and also drinks. So when we’re thinking about drinks, what are some of the water is number one, right?

[00:40:13] Dr. Singla: That’s not on my 15 list, by the way. Like obviously hydration, but if you can do like green tea and if you can’t handle the caffeinated part, then there’s non-caffeinated forms of it as well. But there’s components in these foods that have been shown to help decrease inflammation. So when I say decrease inflammation, probably not enough for you to get off your medication or not have to be on a medication, but enough for you to be able to kind of decrease that fire of inflammation. And obviously the long, again, the bigger thing is the long-term risk that comes with having ongoing inflammation or too much cholesterol. Things that we know aren’t directly related to food, diabetes metabolic disorders. That’s what we wanna decrease the risk of.

[00:40:58] Cheryl Crow: Yeah. And I think, you know, for me, [00:41:00] i’m not one that’s interested in making like super elaborate meals all the time. I do have a huge sweet tooth, so I like to bake. I like to bake cupcakes or cakes and stuff like for people’s birthdays.

[00:41:10] Cheryl Crow: But for daily eating like more healthy eating, helpful eating, I love smoothies. Because it’s just such a fast way to get some of the stuff. You can grate some fresh ginger into a smoothie. But the throw the blueberries and they throw some spinach in there.

[00:41:25] Dr. Singla: You know, chia seeds, flax seeds, all these things help fight inflammation. And know constipation too with the flax seeds. You know, we need fiber. So that smoothie is a great way not only is it easy, so my blender is like an eyesight in my kitchen. Like it’s right there. Yeah. So I don’t have to go grabbing it.

[00:41:41] Dr. Singla: But also it’s helpful for like gastric motility if you have issues, right? With constipation. But it’s also easy on the go, like you just put it in your car or you don’t need to sit there and eat breakfast before heading off to work for those that need to get to work early time. It’s just easier to do that.

[00:41:57] Dr. Singla: So. Smoothies might not always [00:42:00] hit everybody, but if you can do it even once a week, twice a week, that’s, yeah. And you can put protein powder in there. There’s great plant based proteins. There’s whey based proteins add a little bit of flavor. But the other thing is, when you have RA you need to realize that your protein intake matters, especially after you hit a certain age.

[00:42:17] Dr. Singla: Because that strength, you know, muscle is what anchors the bone and the tendons. So you wanna, we’ve, we talk about like building muscle, like biceps, but also the large muscle groups like your core, your back, your quads. We wanna focus on that. And in order to maintain slash grow it, you do need a certain amount of protein.

[00:42:35] Dr. Singla: So I kind of go into that in the course as well. 

[00:42:38] Cheryl Crow: Yeah. And I’ll put a link to the episode with and we had a kinesiologist on. And I knew people with rheumatoid arthritis are more prone to like muscle wasting. But I didn’t know it was so severe. She said it was, you are you are 16 times more likely to have muscle wasting.

[00:42:55] Cheryl Crow: If you have. Rheumatoid arthritis, which ever since she said that, it’s yes. 

[00:42:59] Dr. Singla: You know, it’s [00:43:00] eyeopening, right? 

[00:43:00] Cheryl Crow: Yeah. I’ve been, well, I’ve, you have to come. In my case, I’ve been combining strength training with with eating protein, you know? ‘Cause you have to. Yeah, you have to actually, you can’t just eat, the protein doesn’t look like, as far as I know, it doesn’t just like magically turn into muscle when you eat it.

[00:43:15] Cheryl Crow: That would be amazing. Yeah. 

[00:43:17] Dr. Singla: Right. We’d all be eating it. There is actually, there’s a d there’s a specific mechanism when you have too much inflammation where you have faster degradation of the muscle and slow muscle building process, so it’s like you’re losing than you are building. You’re, it’s, that process is happening faster and so you have to be mindful of that.

[00:43:36] Dr. Singla: Yes. You need to control the big game inflammation, right? But then also from a microscopic level, you need to give the body what it needs to be able to build the muscle and give it the nutrient. So you have to focus on what you’re eating. 

[00:43:48] Cheryl Crow: Yeah. This has been so great. Was there anything else that we didn’t touch on that you wanted to share?

[00:43:55] Dr. Singla: No, I just think that if you are confused about food with, most of us [00:44:00] are, even me when I was first diagnosed, it’s like this is more of , . It has a very strong educational component to the course. But also practical component with recipes. Symptom tracking one-on-one questions with the RD, with the dietician.

[00:44:13] Dr. Singla: Specifically one who deals with autoimmune conditions like women with autoimmune conditions. So I think if you’re looking for more info, check it out. I hope it helps. So you’re not confused every time you go on instagram or TikTok. 

[00:44:25] Cheryl Crow: Yes. And I mean, I can’t emphasize enough the importance of not overgeneralizing from anecdotes because someone else’s experience may not apply to yours at all. They may have a, especially if they catch, if they got their disease caught early, like you said with low, you know, low inflammation markers and low like other, you know, objective disease activity. Yeah. Then that’s not gonna be the same prognosis as you, so .

[00:44:53] Cheryl Crow: Yeah. Yeah. And I, you know, I just for people listening, you know, I get caught approached all the time with people who want to come on the podcast and [00:45:00] talk about like their program that’s guaranteed to make people never have pain again. And like that I only have people on the podcast that I know are legit evidence-based.

[00:45:09] Cheryl Crow: In your case, you obviously get it from the inside out ’cause you’re a patient and a rheumatologist, you know, you get your rheumatologist, integrative rheumatologist. So it’s so great to be able to chat. I cannot believe it’s been three years. 

[00:45:19] Dr. Singla: I know. And now I have a better idea of what people are asking for now and you know, what are the things sitting on people’s minds and diet is number one.

[00:45:27] Dr. Singla: It’s like right up there. It’s right up there. There’s a lot of confusion. Obviously we make that decision day to day, but, and some people might say oh, diet has nothing to do with your disease course. And I don’t think that’s true either, because there’s a lot of comorbidities, like I mentioned, the heart disease factor that sits with RA.

[00:45:43] Dr. Singla: So all of it needs to be addressed maybe in not one visit but certainly over the lifespan of someone with RA These things need to be addressed. 

[00:45:51] Cheryl Crow: Right. I think, yeah, just because people make outsized claims about diet, that doesn’t mean that diet has no impact on anything. I [00:46:00] think we made years ago, actually I should link to this too.

[00:46:02] Cheryl Crow: I wanted to try to find a way to visualize the fact that different lifestyle variables in a group approaches move the needle stronger for certain people. For me, the dietary changes, I think because I have such strong other comorbidities like the gastroparesis. It’s been harder for me to make those direct links between my subjective like symptoms or even I don’t feel a lot of moving of the needle of my symptoms when I make dietary changes. However, I’ve feel a lot of improvement. A, I make the dietary changes ’cause they’re good for me overall . they’re good for my other conditions, but and they’re good for mitigating the risk of heart disease and stuff like that. And in my body, things like sleep and exercise and stress management really have moved the needle more. So knowing that, you know, it’s not an all or nothing, 

[00:46:50] Dr. Singla: no 

[00:46:51] Cheryl Crow: one or the other’s, 

[00:46:51] Dr. Singla: It’s not all or nothing, and a lot of it is you doing the weightlifting and a lot of it is the medicine doing the weightlifting.

[00:46:57] Dr. Singla: It’s just a ratio for everybody’s gonna be different. [00:47:00] 

[00:47:00] Cheryl Crow: Yes. Yeah. So I’ll put those pie charts. My, the pie chart. 

[00:47:03] Dr. Singla: That’s what it was our pie charts. 

[00:47:05] Cheryl Crow: Yeah. Well thank you so much. Last question if you have time. I always like to ask people this question. I think it’s it might be interesting to see your answer now compared to three years ago, but it’s probably similar, but you know what what does it mean to you to live a good life and thrive with rheumatoid arthritis? 

[00:47:23] Dr. Singla: Ooh, that is a good, I don’t know what I said three years ago. 

[00:47:25] Cheryl Crow: That’s like a what is the meaning of life kind of question. 

[00:47:29] Dr. Singla: I would say for anyone newly diagnosed or even gone through the journey, I think this is gonna be marathon and not a sprint. Along those lines, that thought process. Because so many times I’ve thought oh my gosh, this is the medicine, this is it. This is gonna fix everything for me. And then you realize, shoot, it wasn’t, or man, I need to adjust this, or I need to not eat that. ’cause I feel a certain way. And so that newness of that learning curve is gonna pop up. From time to time, [00:48:00] and it’s easy to feel like, Ugh, I thought I had it figured out.

[00:48:03] Dr. Singla: Now we’re back to square one. But it’s part of the game. It’s part of the game. It’s part of we are all creatures of habit. We don’t want, we don’t like change, but be cognitively flexible to know that like you might have to tweak different parts of your life at different times. 

[00:48:18] Cheryl Crow: I love that. And oh, it looks like from my, I’m looking very quickly at the transcript. And I don’t think I asked that. I started asking that question at the end of the episodes, but I don’t think I asked it back then. So yeah, I’m looking at this, so we’ll never know. 

[00:48:31] Dr. Singla: I don’t know if I would’ve said the same thing. 

[00:48:34] Cheryl Crow: Yeah. Yeah. I think it, I love that. And I think it sounds like you’re living, like I know you did a TED Talk that was really great about, you know, this kind of like idea of or maybe I’m gonna put, I don’t wanna put words in your mouth, but you’re living in congruently with your ra and you’re not fighting it like, you’re not like at odds with it, you know? 

[00:48:51] Cheryl Crow: And that’s, to me, that’s like an essential element. 

[00:48:54] Dr. Singla: Yes. It’s part of you. And so what do you do with any part of you?

[00:48:58] Dr. Singla: Is that you live with it. [00:49:00] Right? You live with it. Yes. You embrace it and sometimes you hate it and that’s okay. It’s part of it. You can’t always just love one thing. Yeah. And it’s, especially when it changes, you have to change in reaction to it as well. 

[00:49:12] Cheryl Crow: I was reviewing a training, I had taken a while ago on like acceptance and commitment therapy, and it made the analogy of the weather, like we kind of have we don’t have to like the weather, but we understand that we cannot influence the weather. Like it’s just there. 

[00:49:24] Dr. Singla: Correct. 

[00:49:24] Cheryl Crow: In effect, it impacts our life, but no amount of doing anything is gonna change it, you know? So sometimes that’s like the diagnosis is like that we can influence it is. And it’s very, 

[00:49:34] Dr. Singla: yeah.

[00:49:34] Dr. Singla: I just had a woman in clinic earlier today who was like, you know, I’m having such a hard time accepting the diagnosis, and I’m like that’s okay. That’s part of the process is not if you were to also accept everything on day one, day two, I’d be like, oh, okay. There was no grieving of your old self there or like you kind of, 

[00:49:53] Cheryl Crow: that’s how I was.

[00:49:53] Dr. Singla: Yeah. Right.

[00:49:54] Cheryl Crow: I didn’t grieve it for a long time and it was, it still hurt. Like it hurt. It hurts whether you do it quickly or [00:50:00] whether you do it like delayed by years. 

[00:50:03] Dr. Singla: Remember when I used to go rock climbing? Yeah. That’s not gonna be my current picture a weekend. I’m not gonna go rock climbing for fun unless someone else is going like forcing me to go.

[00:50:12] Dr. Singla: But that’s okay. Yeah, that’s okay. Like life changes, circumstances, changes, and the more you can let go of that control, the better it is. 

[00:50:21] Cheryl Crow: It’s just, it’s hard. But you’re, I agree with you a hundred percent. Oh, and very last question. Where can people find you online? 

[00:50:29] Dr. Singla: Oh, okay. I am in a couple places.

[00:50:31] Dr. Singla: I am on Instagram @rheum.to.grow.tx. I’m on TikTok with the same handle rheum.to.grow.tx. Facebook as well. I think I’m rheum to grow there. 

[00:50:41] Cheryl Crow: R-H-E-U-M? 

[00:50:42] Dr. Singla: Correct. Not ROOM. Yeah.

[00:50:46] Dr. Singla: Yeah. Yeah. And then if you’re interested in the course, hopefully you’ll have the link for that as well.

[00:50:51] Dr. Singla: Yes. So, yeah, from an educational standpoint, hopefully that helps. And you’re part of a private Facebook group for people who, when they you enroll in the course, you get [00:51:00] to be part of our community. That’s so you can bounce ideas off each other. That recipe sucked, that wasn’t great.

[00:51:04] Dr. Singla: Or I’m struggling with this, can you help me? So you have a brain trust of people who get it. 

[00:51:10] Cheryl Crow: That’s really nice. I think I’m a big fan of small curated Facebook groups. Right. Kind of versus the huge ones that are very overwhelming. Even for me as an extrovert, I’m like, this is too much even for me.

[00:51:19] Cheryl Crow: So yeah, I love it. Yeah. And I always have, you know, for those listening, I always have links in on the Arthritis Life website, which is arthritis dot the enthusiastic life.com. That’s the long URL. Or you can just see a link to it in the show notes or in the initial show notes if you’re on like your podcast platform, you can click there and then I’ll also have a link to the video of the conversation in a transcript.

[00:51:42] Cheryl Crow: ’cause I try to make it as accessible as possible. So thank you so much for your time. It’s so great to catch up. 

[00:51:49] Dr. Singla: Yeah, likewise. Thank you for having me. 

[00:51:51] Cheryl Crow: Alright, we’ll let it be quicker than three years next time you come out. Alright. Alright. Bye-Bye for now.

[00:51:56] Dr. Singla: Bye

[00:51:57] 

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