Meet Dr Amy

13 March 22

Dr Amy Carmichael
MBChB, MRCP, Functional Medical Doctor
Author of Be Unumbered
Gut health expert

Dr Amy Carmichael might just be the answer to all the worlds problems. If we could all manage to spend even just one minute with this medical wonder woman I’m sure we would all be the best version of ourselves, living our best lives in our healthiest state.

I would like to be able to tell you what kind of a day it was to help set the stage for our amazing interview, but honestly, all i can remember is a golden orb of energy greeting me with the kind of hug you get from your best friend after 3 years of separation, and an overwhelming feeling of happiness and calm. She can only be described as the kind of doctor the world needs more of, the kind that genuinely has an interest is breaking norms and digging deeper in order to ensure her life here on earth leaves everlasting positive change, not just for herself but for everyone around her. She embodies the very essence of her medical philosophy: Health, happiness and harmony and her extensive knowledge as medical professional is second to none. We couldn't be prouder to call her our COYO ambassador....Meet Dr Amy Carmichael.

Let’s start from the beginning. We would love to know how you began your journey into the health world and how it has led you to where you are.

As a young girl I was fascinated with health and my grandfather was the village GP, he was very well respected and was also fascinated by different tools and modalities in health. I remember picking up books as a child on iridology and I also remember my dad telling me how people would knock on their home door anytime of the day to see my grandfather, not just for physical ailments, but also for their struggles in their day to day life .

At school I always got A grades in biology it was just second nature to me, and I always made friends quickly, I just seemed to connect with people.

When I started medicine I truly felt like I was going to be making an impact, I knew I wanted to make a difference.

As a junior doctor, I was often told off for chatting too long with patients and also showing my emotions in their times of distress, yet the patients always found it comforting to know that a doctor cared.

I would really go out of my way to explain complicated medical language to people so that they could not only understand it for themselves but also so they could be in the driver's seat and do more research when at home.

Now what I do is combine evidence based medicine on lifestyle interventions, which allows patients to have the greatest choice, have time for education and reflection as well as a symbiotic relationship between doctor and patient. I'm not there to heal them but to guide.

Dr Amy, you have an extensive background in the medical field, working as a Doctor for over 10 years. What sparked your interest in Lifestyle therapies?

My own health is the honest answer. I always had a fascination with wellbeing so I never limited myself to the physical body or the physiology. I always knew there was more, but it was my own health that had the biggest impact on me.

Whilst I was studying acute medicine, I became disenchanted by the reality that I could only do so much and I often felt I wasn't doing my best despite long hours and giving it my all. I saw so much chronic disease that's so multifaceted yet my colleagues and I just didn't have the time to go over their lifestyle even if we heard about it.

The cumulative effect of my work meant terrible sleep patterns, poor food choices, high stress and a feeling of emptiness. In the end I became a victim to the same social norm and I was burnt out. I was the heaviest I had ever been, had adult acne, I was constantly anxious and my gut was horrendous, with bloating and diarrhoea, not to mention the addiction to alcohol to escape it all. I wasn't practicing what I preached and so I came to a halt.

Something had to change. So I invested in my curiosity and my true calling to see what health really is, how all encompassing it is. I not only did further studies in Integrative or Functional Medicine, I also became a life coach, NIP practitioner, a yoga teacher, a personal instructor and am now finishing a Nutrition and Aromatherapy diploma. Now i'm working on collating all that I have learnt into my new book being released later this year.

I now feel aligned to my core values and have learnt many different aspects of health so that I can see the person as a whole not just the disease. I’m teaching what I’ve learnt which is empowering people in their journeys, listening to people's concerns and running my own online lifestyle clinic. This involves creating more time for my patients and looking at the biochemistry rather than just the set of symptoms.

The medical world and mainstream media has placed a lot of focus on the importance of gut health in recent years, why do you think gut health is so prevalent in today’s society?

There are more microbes on a person's hand than there are people in the world. We have finally started to see that our gut health plays a significant role. Just think about it, in our lifetime we consume between 30-50 tons of food. We interact with it daily, we eat, digest, absorb, excrete and 80% of our immune system is located in our guts! What this means is the single biggest demand on our immune system isn’t from environmental factors like germs or bugs. It’s actually from our food.

These microbes have been here long before us, millions of years ago and science has shown that over the last 60 years despite advances in medicine , our chronic disease numbers are ever increasing. Over time due to our everyday practices our biodiversity (the variety of these organisms) has been lost and this loss of microbes drives chronic disease.

What happens in the gut does not stay in the gut.

This imbalance is called dysbiosis and is undeniably far-reaching. This has been linked to stress, obesity, asthma, eczema, dermatitis, obesity, type 2 diabetes, autoimmune conditions, heart disease and autoimmune disorders

So as research enlightens us we are now driven to look at our individual gut health and honestly, have a reality check. Bloating, diarrhoea, gas these signs aren't normal and now we are seeing how food and lifestyle have such an impact and how people can get healthier when they address their gut.

What are your top tips for making sure we all keep our gut health in peak form?

Firstly water water water, we need water to help break down food but also allow us to have 1-2 bowel movements a day. This means we are eliminating and detoxifying appropriately. Nowadays so many people are constipated and in order to eliminate this you need to eat fibre and drink lots of water to create a smooth consistency of your poo!

Then it's all about remove, replenish, re-establish and repair which is the Four R 4 step system.
Remove - foods that trigger you or are high in sugar, processed foods and preservatives. Replenish - with a variety of vegetables and fruits. Re-establish - with high fibre foods and pre and probiotics. Repair - with micro nutrient dense vegetables and fruits that are high in phyto-nutrients

Some of my favourite foods are apples they are high in pectin a soluble fibre which helps with constipation. Fennel in my smoothies as it's an antispasmodic (relieves gut discomfort) Chia seeds as a prebiotic, great mixed with coconut yoghurt , tempeh as a probiotic and ginger which improves gastric emptying (going to the toilet), I have ginger daily in a tea.

Working so closely with clients, what are some of the most common diets and foods that you have seen as detrimental to our gut health and how can we all as a community break these habits for a better, healthier us?

Well we are certainly marketed too well and many of these foods that are not so healthy for us. The first part to changing this, is informing and educating ourselves and that means looking at the labels on the back, not just the tick as a stamp of approval or the words “healthy” in bold.

Let's start with everyone's favorite - sugar, it seems obvious but why is it an issue for our gut, well there are several types of sugars and not all are bad. However studies on the consumption of non-nutritive artificial sweeteners are shown to alter metabolism linked to glucose sensitivity and increase gut dysbiosis (imbalance of good and bad bacteria) in humans.

What's even more fascinating is that scientists took the microbiome of a diabteic mouse and implanted it into a healthy mouse. Without changing the diet of the mouse the mouse became diabetic. I think that's a significant link to deter me from heading to the sweet aisle.

But furthermore many people are unknowingly eating inflammatory foods like dairy and gluten, which causes microscopic effects that we don’t tend to notice day to day.

You see gluten is a two-part “sticky” protein found in grains, most notably wheat, barley, and a few others. It's what holds together foods like bread. Whenever you innocently eat a sandwich or pasta for lunch, the gluten goes down your intestines and an enzyme called transglutaminase (tTG) is produced, this breaks down the gluten into its building blocks, gliadin and glutenin.

In our digestive system we have gut-associated lymphoid tissue (GALT), which reviews the food you eat for dangerous substances. If you are gluten sensitive, the GALT identifies gliadin as a harmful substance and produces antibodies to attack it. This can lead to eroding of the microvilli (hair like projections from the cells), decreasing your ability to absorb nutrients. Sustained inflammation leads to gut permeability or what we call leaky gut.

So the best way to tell if you are sensitive is to do a food diary and assess how you feel on gluten and then how you feel not eating it.

Then to dairy firstly about 75 percent of the world’s population is genetically unable to properly digest the sugar in milk, a problem called lactose intolerance. So this can present with symptoms of bloating and diarrhoea. But also milk contains casein which acts similar to the inflammatory gluten we talked about. In The Journal of Nutrition they showed eating dairy foods increased low-grade inflammation. Another aspect to consider is the majority of dairy products contain low levels of antibiotics which decrease our diversity of the good and bad bacteria.

Lastly eating red meat is well known to increase incidences in cancer but now a study has shown it enhances gut bacteria production of TMAO, (trimethylamine N-oxide ) a by product which is associated with heart disease. Some studies have found that people who consume a vegan diet have lower levels of TMAO.

Decisions at the dinner table really do matter.

Your approach rests on three fundamental pillars: Health, Happiness and Harmony. When did you discover these pillars and how do you work them into your practice?

I have always known these principles but I honestly didn't make the time to live by them until I got ill. Now my definition of health extends far beyond just being the right weight and being free from disease. Good health means being energised, loving life and feeling great in your body. It’s about living your best life, that aligns with your true values.

The first pillar is Health - ultimately I want you to see the things like tiredness, bloating, gas and stress as not normal, but instead alarm bells from our body. It seems we have just accepted these things as normal.
Lifestyle medicine combines evidence-based medical practice with an understanding of biochemical, environmental, social and behavioural factors. It’s about looking at the patient as a whole person, not just a set of symptoms.

The second pillar is Happiness - Research clearly shows that our bodies are healthier when we are happier. Our muscles are more relaxed; we produce greater amounts of our anti-aging hormone (DHEA) and our happiness hormone (serotonin). We also produce less stress hormones like adrenaline and cortisol, which can have damaging impacts on our bodies, and affect our moods.

I work with clients to rewire their brains and start to live in a way that’s open, honest and authentic. When people are happy they have lower blood pressure, improved immunity, less pain and actually live longer! So happiness is the cornerstone of great health.

The third pillar is Harmony - I believe we should create healthy boundaries and limit the amount of processed foods, chemicals in our homes and reactive activity like phones and tv. We work so hard and have limited time to prepare homemade food, spend quality time with loved ones and even simply relax. Instead we are in constant stress where our hypothalamic - pituitary-adrenal (HPA) axis spits out cortisol and puts us in a fight or flight mode. The issue is we don't ever give ourselves the time to reset and recalibrate. This long term chronic stress has an impact on our gut too, damaging our microbiome and as we know 90% of our serotonin is produced here. So teaching people to create non-negotiable time out and putting us into our Parasympathetic nervous state where we can rejuvenate - reducing inflammation and improving gut barrier function.

Your extensive knowledge as a doctor and in lifestyle therapies seem like the perfect combination to help people live their best and healthiest life, have you found both of these practices to be complimentary when working with clients?

Yes, people are ecstatic that someone has listened for longer than 7 minutes, they feel heard and seen. They also feel supported to share their views openly which means that whatever choices they are making they are making them in alignment with their values and are guided about the evidence in the literature. Lifestyle medicine is the revolution people have been asking for. I am truly grateful for being able to share what I have learnt and to continue learning from the people who are in front of me.