Julie Buckley, MD, IFMCP, was one of the first pediatricians to successfully complete the IFM certification program in 2016. She was inspired to study functional medicine when her daughter began showing signs of autism at age 4; years later Dr. Buckley herself was diagnosed with breast cancer. These two diagnoses propelled her to learn new ways to approach chronic and acute diseases and ultimately, to improve the health outcomes within her own family. Dr. Buckley has a thriving practice in Ponte Vedra Beach, Florida, combining neurotypical primary care pediatrics and an integrative medicine approach to autism spectrum disorders. She developed a patented antioxidant formula for peri-vaccination and peri-oxidative stress use and is the founder of HealthyUNow, a nonprofit foundation that provides treatment and residential facilities for individuals and their families impacted by autism.
Kalea Wattles, ND:
On this episode of Pathways to Well-Being, our guest Dr. Julie Buckley will discuss the connection between early development, the atopic triad of eczema, allergies and asthma, and how these might influence autoimmune development later in life.
Dr. Julie Buckley was one of the first pediatricians to successfully complete the IFM Certification Program in 2016. She was inspired to study functional medicine when her daughter began showing signs of autism at age four. Years later, Dr. Buckley herself was diagnosed with breast cancer. These two diagnoses propelled her to learn new ways to approach chronic and acute diseases and ultimately to improve the health outcomes within her own family.
Dr. Buckley has a thriving practice in Florida, combining neurotypical primary care pediatrics and an integrative medicine approach to autism spectrum disorders. She’s also the founder of HealthyUNow, a nonprofit foundation that provides treatment and residential facilities to individuals and their families impacted by autism.
Atopic conditions clearly have a genetic predisposition; environmental exposures may also trigger disease onset or influence disease progression. Research suggests that the presence of atopy itself may even be considered a risk factor for the development of autoimmune disease in adulthood. Welcome, Dr. Buckley, we’re so honored to have you today.
Julie Buckley, MD:
Thanks for having me.
This immune disruption—including things like eczema, atopy, allergy, asthma—those things are all inflammatory in nature. And where there’s inflammation, it’s just inextricably linked with these immune dysregulation issues. Autoimmunity is just an extension of that immune dysregulation and that chronic inflammatory response. If we can quiet one, we’ll quiet all of those things.
Inevitably, you get very, very focused on the gut when you start talking about immune dysregulation. You can’t help it; you have to talk about the gut. I am very well known in my little world for being that person who talks about food endlessly, and talks about probiotics endlessly, and talks about how if you want to heal yourself of an autoimmune problem, if you want to correct an atopic, an asthma, an allergy kind of problem, you have to fix your gut. And you really do have to make food your most important medicine.
Well, this is a very relevant topic. And on this podcast, we often start talking about the timeline, just because it’s such an important foundational tool in our functional medicine approach. My first question is somewhat centered on this early part of the timeline, because we know that early life experiences during the pre- and neonatal stages may shape an individual’s health trajectory and predispose to certain conditions. Genetics certainly play a role, like we mentioned, but I’d love to hear, from your perspective, how do environmental exposures set the stage for the development of atopic conditions?
Well, whenever I talk about these things, I try to remember that most of us are trying to find ways to teach our patients as well as learning things ourselves. So I’m trying to make it as simple as possible. And I think that the environmental exposure pieces are a huge part of what happens, especially in children. We know that in utero kids are getting exposed to extraordinary numbers of chemicals and toxins and things that are difficult to get rid of.
Most of us in pediatrics just love to get a hold of somebody before they even get pregnant so that we can try to optimize the living environment for that child before they’re ever even born. And that’s one of the focuses that I’d like to drill down on and really try to get women to pay careful attention to what they’re eating. You’re not eating for two, and you don’t get to have a caloric intake with impunity. Every calorie has to count—it has to be as dense as possible.
We really like for women to focus on avoiding inflammatory foods, really staying away from gluten—and often staying away from dairy—especially toward the end of the pregnancy. And we’re big proponents of using probiotics in mommies when they’re pregnant. And then hopefully getting that passed through the vaginal canal so that there’s all of the environmental exposure to the bacteria through birth.
Then the trick becomes trying to avoid the toxins and avoiding the things that are difficult to excrete early on. One of my big concerns is that in babies that are formula fed, the primary ingredient in almost all commercially available formulas is corn syrup. And corn syrup in the United States of America is made with corn that’s grown with a tremendous exposure to Roundup, and that’s just really a huge issue for our children. Never mind the other things that they get exposed to as they’re just living everyday life.
One of the things that I think is really intriguing, because I deal primarily with children with autism in my practice, is that these children are grossly overrepresented in terms of their genetic vulnerability to not being able to excrete toxins. So we have—where 40% or so of the population may have MTHFR, which is this genetic vulnerability—about 95% to 99% of the kids that I work with, who have autism, have that genetic vulnerability. And they are set up for not being able to excrete toxins.
When you can’t excrete your toxins, then one of the things that happens is your immune system gets dysregulated. We know that. It has been well studied. I think this then sets us up for this atopic march—the progression from a patch of atopy, a little bit of eczema, on toward asthma and the allergies, and then, ultimately, autoimmunity.
I’d love to dive a little bit deeper into this gut health perspective. You mentioned how you’re giving probiotics to pregnant mothers, which I think is so important. Would you just give us a little bit of insight into, when mothers do have a cesarean section (I think that there’s so much anxiety about that), is this going to really impact the baby’s gut? What advice do you have for moms with newborns who might want to repopulate a little bit?
It just really depends on what the situation is in terms of c-sections. There are physicians out there now who are willing to take a vaginal swab and swab the babies. So that’s ideal. That would be a fantastic thing to have happen. Some people are willing to do that, some people are not. And then sometimes, in the heat of the moment, it gets forgotten. So that’s an unfortunate reality, but there are lots and lots of probiotics out there that are good for babies and that are designed for babies. We will oftentimes have mommies just get an infant probiotic—and they’re designed for infants—and just dip their little pinky into it, and then once or twice a day let the baby suck the probiotics off their fingers and use that right out of the chute. That’s one of the things that I like to do frequently, especially if a baby’s going to be formula fed.
Well, thank you for giving us some comfort that there’s actually actionable things that we can do. I think that’s so helpful and empowering. I’d like to jump to a little bit of research, because our research team found a cross-sectional study of hospitalized adults and children in the US are patients with atopic dermatitis. And they were found to have higher rates of really a variety of autoimmune disorders. Things affecting the skin, the endocrine system, gastrointestinal hematologic, really a variety. More so than patients without atopic dermatitis. Can you speak to this connection and help shed some light on what you’re seeing in your pediatric patients?
Yeah, so there’s definitely a cross linkage, if you will. When I talk to patients about this, I explain to them that these immune disruption sorts of things like eczema, atopy, allergy, asthma—those things are all inflammatory in nature. Where there’s inflammation, it’s just inextricably linked with these immune dysregulation issues. By extension, it’s just to me…autoimmunity is just an extension of that immune dysregulation and that chronic inflammatory response.
So if we can quiet one, we’ll quiet all of those things. Inevitably, you get very, very focused on the gut when you start talking about immune dysregulation. You can’t help it; you have to talk about the gut. I am very well known in my little world for being that person who talks about food endlessly. And talks about probiotics endlessly. And talks about how if you want to heal yourself of an autoimmune problem, if you want to correct an atopic, an asthma, an allergy kind of problem, you have to fix your gut. And you really do have to make food your most important medicine. Every medicine in the world, every supplement in the world is great, but there is nothing that compares to doing it right with food.
I think you’ve beautifully highlighted, when we look at the functional medicine matrix and looking at all of the body systems and the different nodes of the matrix, defense and repair, right? These things go together because information in our immune function are tied together. I think that was a beautiful point. And then also, if we think about all of our body systems as a web, [we see] how that defense and repair node interacts with our assimilation and digestion. I think that was a really nice connection to make. You also talked a little bit about you have a food first approach, and I think that’s so important.
Would you mind sharing a little bit more about the impact of lifestyle factors on the evolution of autoimmune disease? Because we always talk in our programs about [the fact that] we maybe have a genetic predisposition, but then it’s all the stuff that comes after that that can really drive that forward.
Right, absolutely. I love to use examples. And there was a young man that I’ve taken care of for many years now who I told his parents years before he got sick that I was most worried about him. He had a sister who lived her life on the outside. If there was something wrong, everybody saw it, everybody knew. She externalized everything that went on. Her father—much the same way. His mother, this young man’s mother, was quieter but was willing to talk to people, and she would take care of her stressors externally. And interestingly, we started with this young man’s sister first and changed her diet. And we worked with the dad and we changed his diet. So mom was sort of on board, and this young man, who was very quiet and never expressed it… “I’m fine, I’m fine.” He was always fine. And never, ever, ever externalized any of the stressors that were going on in that family. And steadfastly refused, steadfastly refused to change his diet while everybody else was doing it in the household.
A couple of years later, he manifested with Crohn’s, and it was Crohn’s for that… In the presentation, he had a massive abscess, there was a fistula, there was supposed to be surgery, there was supposed to be the… Wow, I don’t even, I don’t like to use those things or talk about them, so the biologics, the immunosuppressive agents. And his mother was saying, “Can we do this differently?” And we were all taking a little bit of a risk because he was a pediatric patient. And I was lucky enough to have the ear of one of the GI docs in our town. And his mother brought him home, and he was tube fed initially, but she made all of his tube feedings. And they were organic, and it was a specific carbohydrate diet oriented. It was so carefully made, and we started with that, and we started with supplementation. We started with tons of probiotics, and then we progressed to where he was allowed to eat. But he ate soups for another probably six months.
She was scared to death to take him off of it, but we documented him going into remission. And we got him there and kept him there while his gut healed. He never had surgery. He never got put on a biologic, and we’ve moved forward. So when I presented him, he was in very classic, just very classic supplementation probiotics and those sorts of things. And in the last phase of treatment, what we did was to add the HDCs, and we added CBD, which are two things that are a little further down the line and not commonly used necessarily right out of the chute. But he looked at me last Sunday, because I see him in church every Sunday, we sing together, and he said, “I’m at an all-time high for my weight.”
The kid looks robust and healthy, and it’s extraordinary. So all by way of saying the food is the most important thing. Sid Baker, who we all know and love, is just one of my favorite mentors of all time. Sid has said many times over that people would rather die than change their diet. And so spending time talking about food endlessly and having the approach ready at hand to be able to speak about it, I think, is critically important for us as practitioners. And we live that life in my house, and so I can talk about recipes. I can talk about the way we did it. And I can also speak as a pediatrician to the fact that it cannot be a diet. It cannot be something that one person does, it really can’t.
When we’re talking about pediatrics and we’re talking about children and needing to change how children eat, it becomes critically important that the whole house eat that way. And I just don’t want to hear that there’s one kid eating this and that mom’s running a restaurant and there are eight…or the kid’s eating eight other things. And dad, by the way, will not. He refuses to eat this kind of thing. For me, it’s look, if I’ve got a male patient, you as a father are teaching him how to be a man. So if I’m asking him to eat a certain way and you’re eating differently, then that’s not “manly.” And if you’re his role model on how to grow up and be a good guy and do it right… If it’s a girl and mom is teaching her how to be a good woman, then it’s incumbent on us as the adults in the household to lead the way and to do as I say, and also really do as I do.
I think that’s actually a really unique component of having a pediatric practice as you do, is it really needs to be kind of “all hands on deck,” and all family members need to get involved.
Right. I’m so worried about our kids having another toxic exposure with all of their screens all of the time. And I want everybody to put those things down. I want there to be a place at the front door where all the phones get parked, all the screens get parked. And IFM has done that study and looked at how different it is to prepare food and then to prepare food for each other with the intention of consuming it. Everybody get into the kitchen together. Everybody has a role to play, to prepare the food with the intention of nourishing each other. And you will increase exponentially truly the nutritive value of what you’re doing if everybody is doing it together. This is speaking from a pediatric standpoint. The other thing that happens is, if the kids are involved in preparing it, they’re much more willing to try it.
Just a couple of weeks ago…I have this nonprofit, we have a campus where eventually young people with autism are going to live, and we’re going to have all kinds of wellness and therapeutic… Well, the garden is already there, and the garden is already hard at work, and the garden is already teaching and learning. And we’ve got kids in the campus. Last weekend, we went down there and we harvested and literally washed, prepped, grilled, and ate. Because the kids had harvested their greens, there was a big huge pot of greens. And those had been cooking for a couple of days, so they really were incredibly flavored. They were willing to try them, and it’s, “Well, no, no, no.” I said, “No, no, no, no, no, no.” I was serving, and I said, “You already had some.” They all came back for seconds. They had been a part of harvesting it, and so they were willing to try it. So everybody got their greens that day.
Well, as the mother of a three and six-year-old, I can confirm they’re very much more likely to eat their veggies when they participate in the preparation. And I think you’ve also really highlighted the beautiful part of those modifiable personal lifestyle factors that we always talk about in functional medicine and the community aspect, that community is medicine. That remains true for children and getting the whole family on board. I think there’s a healing component to just having the support of your family.
Yeah, I couldn’t agree more. It’s a big deal. It’s really, really important.
What you shared with the patient example that you just gave us was a pretty complex case for a pediatric patient. How is the functional medicine model and just the comprehensive nature of our functional medicine approach? How does that help you to map out and solve these really complex cases?
It’s critical. It’s such an honor and a privilege to be able to spend quality time with my patients. And that’s part of the IFM approach, really. It’s a big deal. When this young man, especially, presented, I already knew his family. I already knew their story. And his mom came into me about a week or so before he ended up in the hospital, and she said, “I’m so afraid this is Crohn’s.” And I said, “So if it is, we’ll fix it.” And she looked at me and she goes, “You going to fix that?” I was, “Well, of course. The functional medicine model says the human body wants to heal. And if it doesn’t heal, it’s because it has too much of something it needs to get rid of, or not enough of something it needs to get. Then we’ll just figure those things out. I don’t care what you label it. We’ll just figure those things out and fix those.”
So she left with a lot of hope. The delving into it becomes critically important. So I knew that this family already had a leg up on food. I knew that we had a fighting chance in terms of food for him. And I knew that she was a good cook. I think that’s just the kind of stuff that at IFM, that we really have to probe and we really have to get a feel for. You can’t make the assumption that everybody knows how to cook. If they don’t know how to cook, we’ve got to make sure that we get them taught and they know how to prepare things.
In pediatrics, we like to keep it super, super simple. So when I focus on food, I like to say things Stew Friedman says like “eat what grew.” And eat what grew a day or two ago at most. Make sure it roots. If it grew, it doesn’t have a label, you don’t have to read the ingredients. So that’s a really simple approach for people; prepare what grew.
I like to tell people that if your immune system is practicing its competence…and this kind of goes to that whole immune dysregulation. And then how do I restore the immune system to its proper function? And getting it to behave correctly. Well, the immune system lies in the gut wall, and it’s there for a reason. It’s there to protect us from the outside world, which is the contents of our gut, right? I love to look at people and go, “Well, your gut’s not actually inside you.” And they all give me this puppy dog look, right? Where the dog turns their head and they look at you funny and then they get the squinty face, “What do you mean?”
But our gut is not inside us. Our gut is a tube filled with the outside world running through us. We’re donuts, not the…don’t go eat a donut to prove the point, but we’re donuts. And so the immune system’s there, with these gorgeous finger-like projections, looking through the gut wall as a way of practicing its competence. And what we have to remember is that if the immune system is charged, its job is to look through the gut wall all day long and say “friend or foe, friend or foe, friend or foe” at what swims by.
Then if you’re those immune cells, would you rather look at one goldfish in a goldfish bowl? Which is pretty boring pretty quickly. Or would you rather look at the great barrier reef with thousands of cool fishies and all this coral right there, and there’s so many colors and it’s really, really exciting and the immune system is never bored, and it stops doing inappropriate behavior and instead watches what’s going by. When you talk to people like that and you say, “Look, we just need to build a great barrier reef. It needs to be colorful and with lots of things living on it. Then your immune system will behave properly.” It all makes it a lot easier to figure out how to fix it.
Well, I am really appreciating this language that you’re giving us for talking. Especially to pediatric patients and their families, because just these colorful and vivid descriptions. I think just having these soundbites for how we’re going to talk about these really complex subjects is very easy. So I can tell you’ve been having these conversations and you know what you’re doing.
I have a lot of fun with it. And you know what’s amazing? There’s a train table out in my lobby, and the dads come in and they sit there and they look at my train table. And they just look at my train table, and I’ll say to them, “It’s all right if you play. Nobody’s going to call you out on it. You’re allowed to play.” And they all start playing with the train table. My professional athletes that I take care of will come in, and they’ll start playing with the train people. And so as much as these sort of things that we think of as being for pediatrics, the reality I think is there for everyone. If you have a really good visual, if you have something that’s very elemental and easy to understand, it’s a lot easier to drive right past the fast food and go, “There’s not a great barrier reef there for me to choose from, let me go home and prepare something.”
Well, I will definitely be returning to this concept as I speak to patients personally. I want to dive in a little bit too… You’ve really illustrated for us how all of these different body systems are connected and how that can influence the development of autoimmune conditions. And one thing that’s been really, I think, a hot topic in the research is this psychoneuroimmunology. That’s something that’s come up at our annual conference and something that continues to come up in research. And it seems research around the psychoneuroimmunology, it continues to find new connections between our different body systems and new treatment pathways for diseases like atopic dermatitis. I’m hoping you can speak a little bit about the link between the central nervous system and the immune system and how autoimmune conditions like atopic dermatitis might have a connection to things like stress.
Yeah. There’s no question about that link. And for me, when I think about the link between the brain and the gut and the psychology, that sort of thing, to me a lot of times it comes to PANS and PANDAS in our children and in young people. And it’s interesting, because you can measure these pediatric disease processes and measure these titers in adults and find them in adults who are anxious, hot messes too.
There’s just very little question—again, I go back to when we talk about atopy, the asthma allergy—of those kinds of things, and then by extension autoimmunity. When we talk about those things, we’re talking about inflammation. There’s no way they’re not one and the same thing, they’re like this. And then what we have to also understand is that there’s no question… I just had a thought. There’s no question that there is a link between inflammation and anxiety and depression. That’s actually really well published in the medical literature, this point. When we’re talking about pediatric autoimmune neuropsychiatric syndromes and PANDAS, which is the one that’s associated with strep, as much as it’s associated with strep and it was initiated by some sort of an infection. The whole thing is propagated forward as an autoimmune process that is absolutely neuropsychiatric. Our kids have very dark thoughts. They’re very, very anxious, and it’s a very difficult situation. And that is absolutely an inflammatory response, right?
And what I’ve learned is that the very standard approach uses endless amounts of antibiotics, which of course is the worst thing you could possibly do for a gut that you’re trying to heal and when you’re trying to get inflammation under control. So I spend a lot of time talking about anti-inflammatory diets, which ended up being a lot like all the other diets I talk about. If we can get inflammation under control, if we can get rid of sugar—I just talk about sugar and how addictive it is and how rats will choose sugar over cocaine. And I get really graphic about those kinds of things in the office when I’m talking to kids and when I’m talking to their families.
There’s no question about there being an inflammatory component and that there is a gut-brain connection. I started chuckling because a few years ago, I had a patient who actually went up to Harvard and got seen at Harvard by the GI guys. And apparently, one of them said, “I don’t believe in the gut-brain connection.” And my head just swiveled. It’s like, “They said what?” And she said this, I said, “Wait a second. What’s this guy’s phone number?” And I literally right there in that moment called that guy up. And I said, because I’m kind of an irreverent girl sometimes, “Dude, I hear that you don’t believe in the gut-brain connection. So what I’m going to do is I’m getting on the next plane up to Boston, and we’re going to go out to Cheers. And we’re going to have a couple of brews, and then we’re going to decide whether or not there’s a gut-brain connection.”
So hopefully that changed his way of thinking, but there’s no question that you really have to focus in on the gut. You have to focus in on inflammation. If you’re going to get control of the inflammatory responses that include everything from atopy to depression and anxiety. When we’re talking, especially about so many of these autoimmune diseases that are in play and are impacting our children’s brains, especially in young people’s brains, it becomes really critically important to focus in on food and to make sure that we’ve got inflammation under control.
Well, I’m hopeful that we have since established that there is a bi-directional communication between our gut and our brain. I think the science continues to emerge, and I hope we’re all staying up to date on that. But I want to ask a follow up question. I’m just thinking about my personal practice, and I don’t care for pediatric patients so much, but I see lots of postpartum mamas. And I know that, for example, when a baby has atopic dermatitis, it can be so emotionally draining for the mother. Do you have any suggestions? Or how do you counsel moms in your practice who are just so worried and stressed out about watching their child feel so uncomfortable, and how do you kind of support them through that process?
In terms of how do I help with managing the atopy or the mom or both?
I guess both. If you’d share with us some advice that you give to parents. How do you offer some comfort as you’re doing all of that work to support kiddos’ health?
Let me use an example. I have a woman who has two children on the autism spectrum. She is trained as an attorney, and her husband is a physician, and she is frantically helping him to open a massive practice that is very, very, very busy, and she pops up pregnant. She calls me in a panic because she already has two boys with autism, “And now what are we going to do? And how am I going to make sure this doesn’t happen to me again? And what do I need to do differently?” And that type of thing. So we worked very, very hard on a very clean, very organic pregnancy. She did a fantastic job, managed to have the dream home birth that she wanted to have and all the rest of it.
And then the baby was born with a tongue tie. Which we know is highly associated with MTHFR genetic abnormalities. And both of her boys have that genetic abnormality. I had very little doubt that it was going to happen in this baby as well. Some of the things that we do, and I did an anticipation of MTHFR, is going to be not as much glutathione. The immune balance in this baby is going to be a set up for some struggles. Some of the things that we did were those probiotics right out of the chute. We made sure that she had methylfolate on board through her pregnancy rather than just a folic acid supplement of some type. We were aggressive with methylfolate. I made sure that she took lithium through her pregnancy, and we made sure that it was a good quality one and made sure that she was not getting new toxins.
It was not something that I did with [haste], or just slap somebody on glutathione who might be very, very toxic and we might make things worse. She was already in pretty good shape. I knew what I was doing with her was going to be something safe. Then when the baby was born, the baby had to have the tongue clipped, and she is not a good milk producer. We had to use some supplementation to try to augment her breast milk, but it’s just not enough. What she did was to find a goat’s milk formula that did not have corn syrup as its lead ingredient and that was organic. We started with that as her supplementation, and she was using baby probiotics, and sure enough if that baby didn’t come up with a patch of eczema.
What I’ve counseled her most recently is, “Okay, dairy may be a problem here because it’s a problem for both of your other boys. Let’s look at making sure there’s no dairy in your diet,” which she already was doing. Her breast milk is very anti-inflammatory. But what we did is I said, “Let’s see if we can find an organic soy formula, because the organic soy does not have the same kind of estrogenic effect that the non-organics do. See if we can find one that doesn’t have corn syrup as its lead ingredient and see if he does a little better with that.” And then I offered her a couple of other supplements and things to see if we could get a little more breast milk.
The other thing that I did was say, “Let’s try to manage your anxiety a little bit with some supplements that are safe for the baby and see if I can get you to relax if your breast milk flows a little better. Because this being your third baby, there should be plenty of breast milk now.” But I think she’s just so anxious about the whole thing and trying to do it right. That may be making things worse rather than better for that poor little baby.
I think that that will help her tremendously. And again, I suspect that people are deeply interested in CBD. I would love for us to talk more about that somewhere. I think some other podcast, but I put her on CBD because I feel very strongly that a pure, isolated CBD is very, very safe for the baby, and it’s going to definitely help her anxiety. It’s going to help that baby’s immune system, and it will help her immune system. I really like that for her and for him and to see how we do with our eczema patch.
Well, just as you mentioned, getting the whole family involved with diet and lifestyle changes, it makes perfect sense that we would also support the stress response of multiple family members who are caring for children. When we look at the IFM Matrix, that mental, emotional, spiritual component definitely needs to be supported across the board as well.
I really appreciate all of these insights you’ve given us today about how we conceptualize the development of autoimmune disorders by looking at the whole map of our body systems and identifying areas that are strong so that we can leverage those to support the areas that really need some extra support. You’ve certainly given us some speaking points that those of us who are clinicians can use with patients. Thank you so much for your time and for sharing your experience with us today.
My pleasure, thanks for having me.
Dr. Julie Buckley developed a patented antioxidant formula for peri-vaccination and peri-oxidative stress use and is the founder of HealthyUNow, a nonprofit foundation that provides treatment and residential facilities for individuals and their families impacted by autism.
In a cross-sectional study of hospitalized adults and children in the United States, patients with atopic dermatitis were found to have higher rates of various autoimmune disorders, including those affecting the skin, endocrine, gastrointestinal, hematologic, and musculoskeletal systems, than patients without atopic dermatitis.