Season 4, Episode 2: A Naturopathic Approach to Common Skin Issues with Dr. DeJarra Sims

Evelyne: Absolutely. DJ, what is lighting you up this week?

Dr. DeJarra Sims: What is lighting me up this week? Well, to be honest, it is the month of both my parents’ birthday. My mom and dad both share birthdays this month, so it’s really good to be in Texas celebrating with them. They’re in their 70s. And they were my inspiration to go into medicine because they’re both nurses. My dad is a CRNA, which is a certified registered nurse anesthetist, and my mom was an RN. And they actually convinced me to go into naturopathic medicine instead of conventional medicine. Yeah, I’m celebrating them this month.

Evelyne: I love that. I always love just learning more about people. And I definitely want to talk about your background and how you ended up then specializing in naturopathic dermatology. Dr. DeJarra Sims, affectionately known as Dr. DJ, is a distinguished naturopathic doctor and published author. She holds a bachelor’s degree in biology from Prairie View A&M University in Texas, and a doctorate from Sonoran University of Health Sciences in Phoenix, which you may know by its former name, Southwest College of Naturopathic Medicine. Dr. DJ has a rich academic background having served as an assistant professor and core faculty at Bastyr University, California here in San Diego where she taught dermatology and business practices. Very important. And she was also an adjunct clinical professor at Sonoran University.

She’s the founder of the virtual clinic, Superhero Skincare, where she’s dedicated to empowering women to embrace their inner strength and beauty. DJ specializes in treating acne and other skin conditions and is a leader in naturopathic dermatology. She’s a renowned keynote speaker at medical conferences and diverse events, including Comic-Con. She has trained in improvisational comedy at the Finest City Improv in San Diego and the Second City in Hollywood. You’ll notice today DJ has a way of making complex medical information accessible and entertaining. DJ, I remember when you did that Comic-Con presentation. You talked about lotions and potions in popular movies, right?

Dr. DeJarra Sims: Yeah, it was actually potions and magic in TV. It was beautiful. It was so fun because I got to break down potions and different herbal remedies that we use when we see in Harry Potter or the Witcher, any kind of potion. Anything basically that’s on TV and movies that had herbs in it, if I watch it, I’m like, “Oh my gosh, would that potion actually work in real life?” I broke down those different herbs and told them, “Will this potion make you sleepy? Will this potion make you fall in love? What made this author or this director use that?” It was really fun. And people love it.

Evelyne: That’s so cool.

Dr. DeJarra Sims: They love that. Yeah, it was hilarious to be a doctor at Comic-Con talking about natural medicine.

Evelyne: Very unique. I love it. I’d love to hear a little bit more. You just mentioned your parents and how they got you into medicine. Why did they tell you to go to naturopathic medicine? And then how did you get so interested in the skin and hair piece?

Dr. DeJarra Sims: Oh, those are two great stories. My parents, they were in conventional medicine, and they’re just like, “We’re missing something.” My dad had started reading about natural medicine. I had some things like reading about Andrew Weil and different natural MDs who were going into integrative medicine, Deepak Chopra, all these people that were around, they’ve been around a long time talking about, “Hey, there’s a piece of this that we’re missing in medicine.” And most of these were MDs, and so they were talking about this natural medicine, integrative medicine piece. And my dad was reading all these books. And he had, back in the day, tapes and CDs. And he’s like, “This is what you need to go into. You can do what you want to do.”

My parents have always been supportive. They’re like, “Do what you want to do.” And I know, because I wanted to be an anesthesiologist and do like my dad and join him in medicine. And he’s like, “Yeah, but that’s not where medicine is heading. With medicine is heading is into this natural field.” And mind you, this is in the ’90s. This is in the early nineties, and he is like, “Medicine is heading this way, and you need to be there because this is what we’re missing. We’re missing this natural piece.” And even though there’s a long stint in there where I went to DO school for a while and then I ended up landing in naturopathic medicine, that’s a whole other story. And if you’ve listened to some other podcasts I’ve on, I’ve talked about that.

But I ended up in naturopathic medical school in Arizona. And then from there, the piece where I went directly into skincare, it wasn’t very instant. I actually was working in pain management. I did a lot of injection therapy. I worked in the inpatient drug rehab on the weekends, and it was there where I saw patients where they were doing these therapies in naturopathic medicine. It was an integrated drug rehab program. And we were doing sauna and acupuncture. And we’re trained in acupuncture at SCNM, or Sonoran, and we were doing that and diet. And in 30, 60, 90 days, you saw people that had track marks from heroin use and skin picking marks from meth use and just ruddy, dark skin, wrinkles from drinking too much alcohol, and all of this happened, but in 30, 60, 90 days, their skin was turning over. They would have a glow, they would have more energy, and they would feel better with these detoxification protocols we were using.

And so when I had my very first serious acne patient who had large cyst all over their face and nothing was working in dermatology, they came to me. And I was like, “You know what? I’m going to try something, if you don’t mind. You’re going to be my miracle patient. I’m going to put these detoxification protocols that I learned in drug rehab. I’m going to use them on you and see what happens.” And in four months, her skin was completely clear with no medication, no steroid use, no birth control, nothing. And on top of that, this person had a hysterectomy, so they had zero hormones working with. And I didn’t use any bioidentical hormones. And we completely cleared her skin. That was my first serious cystic acne case.

And because people saw her coming in to see me… And actually, it was like an experiment so she saw me weekly for four months. And everyone in the university clinic saw her and they saw the change. And then doctors start sending patients to me with serious acne that they couldn’t fix. And I was like, “Okay, here we go. This is it.” Because seeing her come in feeling so defeated, not being able to go outside, not being able to do anything but go to work, go home, not even stopping for gas, not liking to go to the grocery store because of her face, and just seeing her change and go from this person who’s timid and shy and quiet but living her life as strongly as she can with huge acne cysts on her face to blooming into this wonderful person who’s full of joy and light and speaking, I wanted to have that feeling forever so I was like, “Okay, I’m helping people with skin disorders.” And that’s the story.

Evelyne: That’s amazing. I love that. Thank you so much for sharing. That’s just really, really incredible. Today, we’re talking about naturopathic solutions for acne, eczema, psoriasis, and hair loss; and we’ll go through all of those. From a high level overview, how would you describe your approach? You just mentioned the detoxification part.

Dr. DeJarra Sims: Well, my approach is really looking at the root cause. And I know everyone says that now; it’s like a buzzword. But when we look at the root cause, what we’re doing is saying, “Okay, it’s not just about C acnes on the face,” it’s about what causes this overgrowth of bacteria, what causes inflammation in the body and in the skin, and looking at the real root causes, which are hormonal imbalance, gut dysbiosis, and food sensitivities, digestive issues, liver congestion. And to me, that’s the high level. It’s like what internally is going wrong that is manifesting on the skin?

Because people ask me all the time, they’re like, “Oh, you treat skin. Do I need to see another naturopathic doctor for my food sensitivities?” And I’m like, “Oh, no, no, I’m sorry. Let me rewind. I treat food sensitivities, food allergies, gut dysbiosis, hormonal imbalance, liver congestion, and everything that leads to skin disorders.” When you have a skin issue, it’s usually one of those things that have gone so awry, they’re so out of balance that it’s now manifesting on the skin. And I also do that without flaring the skin. To me, what makes skin so intriguing to me is that I have to fix everything on the inside and also not flare the skin while I’m doing it. Because you can easily flare a skin disorder while treating any of those things that you’re treating on the inside.

Evelyne: Absolutely. And I love that you use that inside out approach. Let’s get it a little deeper into acne. What would you say are the top root causes of acne? A little more detailed than-

Dr. DeJarra Sims: A little more detail.

Evelyne: … what you just said, the hormonal imbalances. Yeah.

Dr. DeJarra Sims: It’s looking at those things, so hormonal imbalance. But specifically acne, to me, I see mostly excess androgens in that hormonal imbalance. But I also see other things. And we can talk about that in more detail later. But when I look at the top things when I look at acne, there’s like what’s within the top of the categories? Within hormonal imbalance, I see mostly androgen excess. That’s testosterone, DHEA, cortisol. Any type of excess, you’re going to see acne.

And then in dysbiosis, I see a lot of loss of good bacteria. It’s not necessarily always a bad bacteria that’s overgrown in the gut. I’m going to see someone who has low lactobacillus, low bifidobacteria in their gut. Then there’s a dysbiosis there. And then of course you have food sensitivities, and it’s across the board, but I hate to blame it all on gluten and dairy, but at the end of the day, the highest that I see is gluten and dairy sensitivities, but not all the time.

Evelyne: And then what about the liver aspect? What are you looking for there with testing?

Dr. DeJarra Sims: Well, with liver, you’re not going to necessarily see high liver enzymes in everyone. There are definitely people that come to me and I run basic CBC CMP and they have high liver enzymes, but that’s not always the case. Usually, it’s like a sluggish liver. And you’ll generally just support the liver in all cases of acne and eczema and psoriasis. They need liver support.

Now, you can do testing. I like to do hormone testing. You can look at genetic testing to see if they have any snips or if they have some type of detoxification problem. And that happens a lot, but not all the time. A lot of times people just need liver support because their liver is working 24/7, 365, and people eat bad, people just eat bad and they don’t rest their liver. They’re not doing those supportive liver things. I like to support everyone’s liver regardless of if there are high liver enzymes.

Evelyne: I want to talk through some of the categories that you mentioned a little more detail just with some specific questions. For hormones, do you use a DUTCH test? Do you use serum testing? What’s your preferred method for assessing that?

Dr. DeJarra Sims: My preferred method is DUTCH testing. I will get serum tests just to have a baseline understanding of where they are. But generally the values are so wide that they’re not useful. And you have to do the testing at certain times of the month, and people generally just go into their MD and then ask for tests, and they’re just random. I’ll ask them where they are in their period if they were remember, and we can see if it’s helpful. But a lot of times, it’s normal. When someone finds me as a naturopathic doctor, the problem is that everyone is telling them that their labs are normal. They’re like, “You’re normal, you’re fine. Your hormones are fine.” And so by the time they come to me, they’re like, “I know that I’m not normal. I’m overweight. I can’t lose weight. My skin is bumpy. I’m hot flashing, or I don’t have a sex drive.” They have all of these symptoms of hormonal imbalance and their serum isn’t showing that. Using a DUTCH test to me gives me a little bit more control over what’s happening. I can see that there are very obvious changes and there’s imbalances in their hormones. And it shows all the hormones, and it shows where they are in the process of the metabolic processes, so I can see where the problem is.

Evelyne: Right. And then when you’re seeing excess androgens, what are some of the treatment methods that you use in diet, lifestyle, supplementation?

Dr. DeJarra Sims: Oh, yes, there’s so much. Now, when I look at the diet, I am their food sensitivity panels and I’m using the gut microbiome test to come up with their diet. I also look at the hormones and see what is the level in relation to your estrogen and progesterone? It’s not just about do you have high androgens? It’s are your androgens normal and your progesterone too low or your estrogen too low? Because we see different manifestations of hormonal imbalance because it’s not just about high androgens, sometimes it’s relative to what the other hormones look like in your body. People can have this acne that concentrates on the jawline and neck, but their androgens are completely normal. But then I look at the estrogen and progesterone. Does that make sense? And see where are they?

Evelyne: Absolutely. Yeah.

Dr. DeJarra Sims: And so in relation to the estrogen and progesterone, you’re going to have a response. It’s not just about getting a random total testosterone in a person or a random DHEAS. That’s why I have to look at a DUTCH test, because it’s going to give me everything.

Evelyne: Right. And it’s also going to tell you how the liver is working or not, how well it’s working or not working. Yeah.

Dr. DeJarra Sims: I had a patient actually recently say, “Oh, I love the DUTCH test. It’s like a screening test because it shows you so much.” And I’m like, “Actually, yeah, it’s like a screening test,” because I can give a Dutch test and I’m going to see what’s going on with the cortisol levels, progesterone, estrogen, all of your androgens, DHEA, and I’m going to have an OAT test, like a mini OAT in the back. And so it’s going to look at nutrient levels as well as the detoxification pathways. And then I can see if I need to further test.

Evelyne: Absolutely. Yeah, those organic acid tests are important too. And when it comes to the next portion, the microbiome and the food sensitivities, you’re doing a stool test on everybody. And then tell me a little bit more about your treatment diet wise and supplement wise.

Dr. DeJarra Sims: Oh, that’s going to be so in depth.

Evelyne: Okay, broad overview. And of course, it’s individualized to each patient, right?

Dr. DeJarra Sims: Absolutely. It’s absolutely individualized to each patient. I’m always going to do a food sensitivity. And I love doing the stool test. And the reason I do both together and I start there is because with the foods, I always tell my patients, “It’s like pouring gasoline on a fire. You have a fire burning inside of you, and the foods can either put out the fire or it can be like pouring gasoline on the fire.” Food sensitivity is very like, what’s going on right now? It’s not forever. And I want to see what’s inflaming you in the moment so I can remove it temporarily. They’re not removing foods forever. These are not food allergies.

When I’m removing the food sensitivities, I want to heal the gut because now we’ve decreased some of the inflammation going on in the gut and those supplements can get in and do the work. I’m going to then treat the gut based off of what’s going on in the stool test. And that’s going to look at the lining, it’s going to look at the short chain fatty acids, it’s going to look at if there’s any overt inflammation, actual inflammation of the lining, or if it’s just dysbiosis causing this disruption in the microbiome. I love using both of those together. And I can get a lot of skin issues cleared just with food sensitivity testing and gut microbiome testing and stool testing. Does that make sense?

Evelyne: Yeah. What are some of the most surprising foods you’ve seen on a food sensitivity panel related to skin health?

Dr. DeJarra Sims: Spinach, carrots, curcumin, glycyrrhiza, things that actually treat inflammation of the gut. Those are the worst because I’m just like, “Oh my gosh.” It’s the main reason I do food sensitivity testing first, because it helps inform me on what supplements I cannot give a patient because it’s awful to give your patient glycyrrhiza for six to 12 months and they’re actually having a IgG reaction to it. And you don’t know that if you’re not testing the foods.

And I’ve done that before. It was a costly mistake that cost me some months because I pride myself on patients clearing their skin in four to six months. And I’m just like, “I wonder.” Because I used to blindly treat because I was just like, “I know this works. This is a great product. Here you go. This is a great product. Here you go.” And then I’m like, “Well, why isn’t this patient getting better when everybody, 90%, 99% of the patients are getting better except for this 1%?” And then you do a food sensitivity panel and you’re like, “Oh, it’s the supplement I’m giving them.” Because they’re in an allergic state where they’re reacting to things. And who knows what supplements they were taking before. But they’ve developed some type of chronic sensitivity to something, and so I want to remove that. And that informs, well, that’s the difference between doing a combination of herbs for healing the gut versus one amino acid like L-glutamine. Right?

Evelyne: Right.

Dr. DeJarra Sims: And so in those people where they’re sensitive to everything, I can go to L-glutamine versus doing a combination.

Evelyne: I know that you’re a big fan of the combination products because you and I have had this conversation before, and I love to ask people on our podcast, especially when we’re talking about treating the gut where you start. Do you start with the gut healing or do you start with killing the bad bacteria, populating the good bacteria? I’m curious on your timeline that you use to approach gut health gut treatment.

Dr. DeJarra Sims: That’s a great question. I used to go right in killing. And I think in most situations, I do a combination of healing and killing at the same time. Here’s something that’s going to support your gut lining, and this is going to kill down the bacteria. The only time I switch that and go in straight to just giving them great probiotics is they’re really low and they’re really sensitive. People that are very sensitive… And a lot of skin patients are. I always tell people, “My skin patients are my sensitive flowers.” They’re like my delicate little flowers, and they’re going to react to a lot of things. And so I will go in with probiotics first in those people who have very low of their beneficial bacteria because I can kill off everything all day long, but they’re not making beneficial bacteria that they need to make the short chain fatty acids, that they need to have the gut lining to be intact. A lot of times, it is more gentle to go in with the good probiotics and the ones they’re missing, which is usually lactose and bifido.

Evelyne: Yeah, thank you for sharing that. And on this podcast, we try not to talk about specific products, but I really want to ask you this question.

Dr. DeJarra Sims: It’s fine.

Evelyne: I just have to because you gave me such great insight.

Dr. DeJarra Sims: Can I?

Evelyne: Well, I’m going to make the decision that, yes, we’re going to talk about GI Revive for a second because I know you love it, and I love it. And you gave me such a good clinical pearl that I’ve shared with other practitioners that you use with people. Could you share that?

Dr. DeJarra Sims: With GI Revive very specifically, I like to give patients. Depending on what’s going on. In most cases, I’ll give them one scoop twice a day. And I tell them until the canister is gone, and then they do a second canister. It helps them visualize. They’re like, “Okay, when this canister’s done, I need to do one more canister.” I keep everything very simple for people. I’m like, “You’re not on there for two or three months, six month,” I’m like, “Listen, you’re going to use this till it’s done, and then I want you to get one more canister, and then we’re going to switch to L-glutamine.”

And this is what’s cool about GI Revive is some people say, “But can I stay on it? I feel so good when I’m on it. Can I just stay on it?” And I’m like, “Yeah, you can.” I almost switched them to L-glutamine because it’s a simpler way to continue to feed the gut, healing the L-glutamine without necessarily it being as expensive.

As a person of color, as someone who treats patients from all different lifestyles, we have to think of the cost of care. And this is about equity and inclusion in medicine because naturopathic medicine is seen as a more elite medicine a lot of times, so the cost of the prescription is important to me. A lot of times, I’ll have people do two canisters of GI Revive and then switch them to L-glutamine because it’s a little bit more affordable. But because healing is so important to people, they will find a way if it feels good. And if they can afford it, they will. And I want them to make that decision, but I also want them to know that I’m not going to let the cost of a supplement stop them from being healed. I’m not going to be the doctor that says, “Well, if you don’t do GI Revive, I can’t work with you, because I’m a great doctor and I know how to heal you on a zero budget and I know how to heal you when you have a unlimited budget.” And to me, I feel like that’s important to let people know, “This is the top. I want you to do this one, but don’t worry because we got options, we got options. And we have L-glutamine as well.”

Evelyne: Thank you so much for sharing that. And I feel like there were some great clinical pearls in there about setting expectations as well for patients. I think that’s so important. Thank you for sharing that.

I’d love to talk about a few other supplements for acne. I’d love to talk about vitamin A specifically and zinc, talking about amounts because I actually had acne in high school and in college, and we should talk about the mental emotional impact of it too, because even now when I start to break out even a little bit, it’s like I freak out. It triggers all those memories of just feeling so uncomfortable, not wanting to go to school and just feeling so incredibly self-conscious. And so I actually did do Accutane, two rounds of it in my life. And so I know that high dose Vitamin A works for me so even now it’s something that I take. And of course I wish I’d maybe just taken the high dose supplemental vitamin A and all of these other things instead of the Accutane. But yeah, I just wanted to bring that up to lead to the vitamin A. Can we talk about that a little more?

Dr. DeJarra Sims: Yeah. I love Vitamin A. I’ve actually will preemptively give people vitamin A and zinc when they’re dealing with acne while we wait for tests to come back because if everyone knows, these functional medicine tests are going to take three to four weeks to come back. And that doesn’t mean you just sit on your fingers twirling your thumbs like, “Well, I guess you’ll get better soon. See you in a month.” I give them vitamin A, and a lot of times their skin will clear immediately using Vitamin A. Retinols work.

It’s not that I’m anti-retinols, I’m anti-side effects. And I love to use least invasive to most invasive. And so when I talk about healing acne, we do need vitamin A. And many people are deficient in vitamin A, they’re deficient in zinc. And most of it is because of the dysbiosis that’s going on in their gut. A lot of it has to do with not eating vegetables and fruits. And mostly vegetables because people love fruits, but they don’t eat a lot of vegetables, and then they have this dysbiosis going on so they’re not absorbing. You’re already not getting in the amount of nutrients you need, then you’re not absorbing it properly because there’s dysbiosis going on in your gut, and so you will lack of nutrients that you need to actually make skin.

Vitamin A helps with skin turnover, so doing it in high dose is going to help you turn over the skin. That’s why when you see people using retinols and Retin A and Accutane, their skin is really, really glassy and red and angry because they’re turning the skin over very fast and that skin is coming up way faster than it naturally should come up, and it’s just a little bit more sensitive. You’re sensitive to the sun.

And so if we use a natural vitamin A, we can get that same effect without all the side effects. However, I still tell people if I’m doing a high dose vitamin A, whether it’s natural or not, they’re still having to, “Hey, you need to not get pregnant during this time. You need to do two forms of birth control. I hope you understand. You need to understand. You need to verbally tell me you understand that this can cause birth defects even though it’s natural.” And so this is something that I’ve been very diligent about because I don’t want to be the doctor that’s just like, “Natural medicine is better than drugs,” and then still have the same side effects. Any natural medicine can have side effects to it. And like I said, I want the least invasive to the most invasive.

It just so happens that using herbs and in the least invasive method works for me. I don’t have to go to the retinols, I don’t have to use Accutane because if any moment I tell patients, “You can always go on Accutane. I’m not going to stand in your way. I’m not going to lay down my life in front of you. That’s not the hill I want to die on. I want your skin to clear, and you can use whatever you want. However, if you want to work with me, this is the way I do it.”

And that zinc, same way, it helps with bacteria, it helps to heal the skin. You need zinc for all different kinds of things in your body, so using zinc and vitamin A together along with a few other things. But that zinc and vitamin A combination, amazing for acne, amazing for eczema, amazing for psoriasis. And that can get it right up front. And you don’t have to high dose it all the time; a high dose vitamin A and acne, but not necessarily in the other skin disorders.

Evelyne: When you say a high dose of vitamin A, what are you talking about? What do you recommend to people?

Dr. DeJarra Sims: The highest is 200,000 IUs. Now, mind you, most vitamin A you’ll see is like 5,000, 10,000 IUs. When you see a vitamin A capsule, they’re 10,000 and they’re like, that’s all you need to give. And I’m doing 200,000 IUs. And so that’s a lot of vitamin A.

Evelyne: For how long?

Dr. DeJarra Sims: Two weeks. Personally, I have my own protocol, but I do it for two weeks, and then I’m monitoring. But I also message my patients. When patients work with me, they direct message me because of the way I set up my virtual practice. If I put somebody on high dose vitamin A, I’m like, “We’re going to be on high dose vitamin A for two weeks.”

However, I will say this. Because I learned this high dose vitamin A, what I’ve been doing is because people are so deficient, I’ve actually started them on lower doses and get great results doing 10,000. When I first started my practice, everybody was getting 200,000 IUs a day for two weeks. That was a basic protocol. Easy peasy, your acne’s clear. And now people are so deficient, I’m giving them an a ADEK supplement or I’m just giving them regular vitamin A that just a 10,000 IUs, and they’re just like, “Oh my God, my skin looks amazing.” I’m like, “You’re that deficient? You’re not eating any vegetables? No proteins, nothing? No fats?” People are not eating well and people’s guts are unhealthy.

If you’re afraid of doing high dose vitamin A, don’t worry. Start them on any vitamin A. Get them on vitamin A, get them on zinc and let them be on a low dose daily until you… You have four weeks until the test come back. Put them on A and zinc at a very normal level. Then you don’t have to worry about signing consent forms and checking in every day to make sure they don’t have brain swelling. Don’t put yourself in a position that you’re uncomfortable with as a physician. Do what you’re comfortable with because at the end of the day, they’re going to get better because they’re deficient.

Evelyne: Yeah, I definitely don’t use that high of a dose. I’ve done nutrient testing to know that I don’t have toxic amounts of vitamin A in my blood. I think that’s important to test as well. And then with the zinc, I think one word of caution when you take those higher amounts is to make sure that you take it with food, otherwise you will feel pretty nauseated. And I’m curious, what’s the amount of zinc that you recommend generally?

Dr. DeJarra Sims: I don’t usually go over 50 milligrams. Usually people are at 20, 15, 30. Not very high. Ever since 2020, people are coming in on super high doses of zinc. They’re still been taking them for the past four years. I’m like, “Why are you taking so much zinc? Have you checked your copper? You know there’s zinc to copper ratio we have to pay attention to.” And they’re like, “What?”

And so it’s just one of those things where I don’t really see a lot of people that aren’t taking zinc nowadays, so I’m adding mostly vitamin A and lowering their zinc because people are taking zinc every day because they don’t want to get sick. It’s a little bit of expectation there of, “Hey, it’s okay to not use this every day. You’re fine. I’ll take care of you. If something goes wrong, just let me know.”

I take a lot of people off of supplements that have skin issues, because that can congest your liver. Because everything we take the liver has to break down, and so that liver piece, when we talk about it’s not just supporting the liver, it’s actually looking at their supplements. And patients come to me from doctors all over the world, and they are sometimes on 20 supplements, 15 given by the doctor, five they’ve added themselves. And they’re like, “What’s wrong?” And then I take them and say, “Stay on this fish oil and this vitamin A and zinc.” And they are on those three things and they get better. And they’re like, “Why did my skin clear?” I’m like, “Because your liver’s not burdened by the 20 supplements you’ve been taking.” There’s a piece of that that has to do with med management as well with skin.

Evelyne: Right. And let’s talk a little bit about the skin microbiome. We talked about the gut microbiome. What are you doing to address the skin microbiome in acne? Or do you find that it just regulates due to all the other things that you’re doing?

Dr. DeJarra Sims: Absolute I find both happening. With the skin microbiome, I generally don’t change people’s skin products right away. Because skin grows from the inside out, most of the time I’m not seeing a lot of disruption with their skin. Because mind you, when people come to find me, they’ve already changed a lot of things. They’re just like, “I’ve been gluten free and dairy free for six months free. I’ve changed all my skincare products and they’re all clean.” I’m seeing people who’ve whittled down and they’re the cleanest of the clean, and they’re just like, “What am I doing wrong?” And so I don’t necessarily have patients that I have to just completely be like, “Do you know you need to not use perfumes in your skincare?” They’re so well versed by the time they come to me.

Now, when I do meet those patients that I need to clean up their skincare products, it’s sometimes a lot of the eczema patients because they’re reacting to the dyes and the perfumes and all the different things that are in skincare products. And so when you’re looking at the skin microbiome, you’re not just looking at, well, how do we hold in moisture? It’s just depending on what disease you’re dealing with.

With eczema, that’s a barrier issue. They’re losing water. How can we keep the water in? How can we make sure they’re getting enough moisture without irritating their damaged skin barrier already?

With acne, we’re like, how can we moisturize the skin, decrease inflammation, and not clog the pores? Then you’re going to use different products for that. And then maintaining the skin’s pH, which is 4.5. It’s very acidic, 4.5 to 5.5, something like that. And so we want to make sure we maintain the skin’s pH.

When we are looking at products, I’m looking at products from a naturopathic point of view of what are you sensitive to? Let’s remove that. And that’s going to be different for every person. You’re going to say, “Well, use clean products,” but what does clean mean? There’s some big categories of clean, we don’t want glyphosates in it, we don’t want forever chemicals in your products. But at the same time, there is a… What is this person in front of me sensitive to? And how can I remove that? That’s going to be on an individual basis.

Because it’s going to be so varied, I always defer to estheticians a lot of times. I love me some estheticians. I love me a natural esthetician. I’m like, “Girl, you need to see an esthetician and let her pick some products for your skin that are clean, and then I’m going to evaluate them to make sure that they’re not having any other adverse effects based on the food sensitivities, based off the stool testing, based off of the tests that I run to make sure that it also is aligned with what I need you to have.”

Evelyne: Yeah, thank you for that. I want to talk about the food sensitivities one more time just to wrap up the acne piece. I feel like dairy has been somewhat controversial in maybe the conventional medicine world as related to skin health, though it does seem like even in conventional medicine, practitioners are increasingly recognizing the importance of lowering inflammation and that maybe diet does play a role. Can you talk a little bit about the research around acne and dairy?

Dr. DeJarra Sims: Yeah, it’s been varied. And they’ve gone from being like, “Dairy has nothing to do with it,” to, “Oh my god, dairy and sugar; don’t do it.” In this profession for almost 20 years, it’s interesting to see it come full circle to, “Oh, you naturopaths actually did know what you’re talking about when you said that it matters what people eat and that probiotics help,” because dairy is inflammatory. It’s going to increase IGF, one. There’s issues with dairy disrupting the microbiome, there’s issues with dairy spiking like blood sugar levels. It’s not just about dairy being bad. And that’s why I look at food sensitivities because, yes, dairy is inflammatory, but so are other foods in the case of each individual person. But broadly, when you look at gluten, when you look at dairy, when you look at the major players in food sensitivities and food allergies, it’s like gluten, dairy, eggs, soy. And most people, if they remove those, can clear up the majority of skin issues.

The problem comes in with all the people who don’t have issues with dairy, eat cheese every day, and their skin is amazing. And then my patients are looking like, “Well, my mom drinks milk every morning and she has beautiful skin. What’s wrong with me?” And then that’s when it goes back to the microbiome. And so I think what’s going to happen is the pendulum swung from dairy doesn’t matter to dairy is the devil to, oh, it’s all about the microbiome. I think that we’re going to start seeing more and more research that specifically will show us that everyone’s microbiome is different and how we handle food is different.

For every person that doesn’t do well on dairy, I could find three people that do great eating cheese, and then they have a green drink with nothing in it, and it’s spinach and carrots and they completely have an outbreak. I’m just like, “What is happening?” That’s what I have to explain to patients. I have to explain to patients why their friends eat dairy every day and don’t have acne, and they have a dairy-free, gluten-free diet, and they do have acne. And that’s when you have to understand that it’s not always dairy, but it probably is dairy. It probably is, but not all the time.

Evelyne: Yeah, that’s the beauty of individualized treatment and care.

Dr. DeJarra Sims: And that’s why I love naturopathic medicine.

Evelyne: Yes, absolutely. Let’s move on to eczema. Obviously you’re looking at the same underlying causes. You’re looking at food sensitivities, you’re looking at liver, you’re looking at the microbiome, and you’re looking at hormones. What is different about eczema? You mentioned barrier function just a little bit ago.

Dr. DeJarra Sims: Yeah. When you look at the skin barrier, there’s a topical barrier dysfunction. When I am treating someone with eczema, I have to look at the products because I’m going to have to hold that water in on their skin while we treat the inside because they’re losing water and they have inflammation and their skin is dry, and so I can’t ignore the products. With acne, I can say, “Hey, whatever you’re using, if it’s not causing you to have worse acne, keep it, keep using it while we heal the gut.” With eczema, I’m like, “Show me your products. Let’s go through those products. Let’s clean those up. Let’s get you something that you’re not going to flare every time you use it.” Because patients with eczema can get out the shower and have nothing on their skin and they’re flaring from the hot water of the shower, or they put the most basic nothing on their skin, and they’re just like, “I’m itching everywhere.” We have to look at the products. We use the food sensitivities to help guide with the products.

But at the same time, eczema is really gut dysbiosis, and so if we’re looking at these big major players, and I’m like, “Okay, how do you treat acne?” I’m going to always go hormones, food sensitivities, gut probably in that order. When I’m treating eczema, I’m like, dysbiosis number one, food sensitivities number two, because most of the time they’re sensitive to everything, but it’s because of the dysbiosis. If I have one test, if they’re just like, “Dr. DJ, I just need one test,” I’m like, “You’re going to do a stool test,” because I got to figure out what’s going on. And we’re going to look at those bugs that are overgrowing, and guarantee there’s usually one that’s related to autoimmune dysfunction that is higher than it should be in someone with eczema.

Evelyne: Interesting. With eczema, I don’t think as much of autoimmune as psoriasis. Tell me more about that.

Dr. DeJarra Sims: I see in both. With psoriasis, I will see an autoimmune. You’re definitely going to see a bug that’s autoimmune related in psoriasis. But I see that also in eczema. But they also, in eczema, they’re going to have some bug that’s super overgrown. It’s ridiculous. And it could be campylobacter. A lot of them will have parasites. A lot of parasites in eczema, especially eczema that hasn’t been able to be treated or controlled with steroids because most eczema, even mild cases of eczema, people like, “Well, I had some steroids from a dermatologist, and then it went away for eight to 10 years. And then I had this stressful moment, and then now it’s back.”

Stress. I forgot to mention that, stress. Let me restate that. I will probably say stress and eczema. Because the dysbiosis is going to cause it, but a lot of people with eczema, they have a lot of stress in their life because you’ll see when they argue with their wife, their eczema flares. It’s like a cortisol dysfunction, so you’ll see that hand in hand. I’ll probably put those together, that cortisol, that adrenal dysfunction. HPA axis dysfunction, and dysbiosis probably run hand in hand and with eczema. And I definitely will see the autoimmune issue more so in psoriasis, but a lot of times with really severe eczema, you’ll see some autoimmune bugs that are there too. And that’s a correlation that we see.

I can’t say that there’s a specific bug with each eczema patient, but I’m definitely seeing a lot of the correlation with bugs being… Whether even if it’s streptococcus or something very normal, it’s just extremely high and it’s been high for a really long time, and they’re having diarrhea or constipation. There’s always some digestive issues that people don’t talk about in skin issues. I used to say 99% of patients that come to me with skin issues have dysbiosis, they have some form of either constipation or diarrhea. And so that’s one of my screening questions, “How are your bowel movements?” And they’re just like, “Really?” A lot of people don’t even connect that. I’m just like, “How are your bowel movements?” They’re just like, “Oh, soft serve all the time.” It took you while. It’s like soft serve. I just realized that soft serve is a very normal thing to say to describe to me stool. No one the Bristol, they’re just like, “It’s more soft serve.” And I’m like, “Oh. Got it.”

Evelyne: There’s DJ, the comedian, coming out. I love it. Yes, I think that that stress part is so important, that gut, brain, skin connection. And it goes both ways, right?

Dr. DeJarra Sims: Yes.

Evelyne: The dysbiosis causes the physical stress, which adds to the total stress toll, but then the psychological and emotional stress also leads to additional dysbiosis, so it’s just such a vicious cycle. Yeah.

Dr. DeJarra Sims: It is. There’s so many people that come off of all kinds. And I never professed to do this, and I actually don’t take people off any type of psych meds. I don’t take people off medication in general, I tell to see their doctors. But their doctors will take them off of things because their mental health gets so much better when you heal their gut; people’s anxieties going away, the depression’s going away.

Because when you deal with people with chronic skin disorder, it’s not just the skin, you’re dealing with people who have something on their face and on their body that they cannot hide. And they have to go through their life every day. And you talk about it where you have having acne as a kid. Middle school is awful, high school is awful. People always talk about you. And they’re like, “Look at pizza face.” I remember back in the ’90s, they would call people pizza face. People are dealing with an emotional toil that they’re taking because of what the American Academy of Dermatology… Depression, anxiety, low self-esteem, loss of self-worth, all of this are symptoms of having acne. It’s not just the skin issues.

And then can you imagine someone with a head to toe eczema or even steroid withdrawal syndrome? There are people that come to see me that have this. And so when I say with Superhero Skincare I’m releasing that inner superhero that’s inside of them, it’s because they’ve shrunk down to lesser than who they are because of their skin. And their skin is holding them back from being this bubbly, outgoing person because they’ve shrunk inside of themselves. It’s so much more than just treating the skin, it’s about unleashing this inner superhero. Just like in the drug rehab, 30, 60, 90 days, at the end of four months, four to six months, this person is bubbly, and they’re just like, “Oh, Dr. DJ.” And they’re going out with their friends because they had stopped having a social life, they’re hanging out with their family more, they’re laughing where they used to cry in the shower every morning, and they’re getting on social media and they’re taking pictures and they’re doing before and afters and they’re helping other people. And so it continuously helps people to understand that skin is so much more than just take this drug and remove this food, it’s about healing from the inside out.

Evelyne: Absolutely. I love that you’ve been able to bring your love of superheroes to your business. I think it’s amazing. Let’s talk about psoriasis a little bit more. We’ve talked so much about the acne piece specifically. Can you maybe share what’s a little bit different with psoriasis in terms of treatments?

Dr. DeJarra Sims: I touched on that a little bit. I think that with psoriasis, it is a little bit of a grab bag of different things because some people with psoriasis, it acts and behaves much like eczema, sometimes so much that I’m like, “Have you been diagnosed properly? Why don’t you go get a biopsy? Why don’t you make sure? Go get your dermatologist. Let me see that biopsy result.” Because it acts a lot like eczema in some cases. But I’m looking at the microbiome and I’m looking at the foods.

And what I’ve seen though, what I’ve seen with psoriasis personally, and this is just in my clinical practice, is that a lot of the food sensitivities are more like an intolerance to the food that they cannot ever bring back in versus most food sensitivities I heal. I’ll say, “Okay, you need to remove this one food for four to eight weeks.” I’ve never removed a food longer than 12 weeks. And then we’re going to add it back in. And I know you’re better because you can eat this food now and it doesn’t cause you to have acne or it doesn’t cause you to have eczema.

Psoriasis is like a grab bag of, oh, you can never eat that food again. Because they’ll bring it back in, and they’re just like, “Yep, got another patch. Oh, got…” I’m like, “Oh, no. Okay, well, you can’t eat eggs.” And I’ve seen eggs be one of the main culprits in psoriasis, people having a rando egg allergy that was undiagnosed. And so a lot of times in psoriasis, I’ll need to do an actual food allergy test because I don’t know if they’re developing these because of liver toxicity or what, but there’s a lot of food allergies. And the number one food implicated that I’ve seen is psoriasis by research and by clinical validation is eggs, and so many people have this egg sensitivity that they cannot get rid of. Even if it doesn’t pop on their food allergy test, they will eat an egg and they will have a psoriasis lesion, so we will remove that indefinitely.

Evelyne: Let’s talk about hair loss. I know we’re running out of time here. I know this could be another whole episode. Let’s dive into some of the causes of hair loss and then your nutritional and lifestyle approaches. And I know you also have done scalp analysis, but I don’t know if you still do that now that you’re virtual. Tell me more about that.

Dr. DeJarra Sims: Yeah, with hair loss, I’m going to say the majority of women that I see with hair loss, because I see some men with hair loss, but the majority of people I see with hair loss are women, and they’re coming in with hair loss secondary to iron deficiency, anemia that is undiagnosed because people think it’s super normal for you to bleed seven days, and it’s not, on your period. I feel like that’s a hill I’m going to die on. It is not normal for you to bleed five to seven days on your period.

And I test. I just test. I do a CBD, a CMP, and I do an iron panel and people have low iron and I fix it and their hair loss goes away. We do have tillage effluvium, so we do have some people that have hair loss because of stress, but that’s going to come back in three to four months. It’s six months at the most. And we saw a lot of that during 2020 where people were stressed out and they lost hair and then it came back.

But when you’re dealing with hair loss, the number one is usually iron deficiency. And then other forms of hair loss would be stress, and then high androgens. High DHEA can cause it. High DHT also. When you look at cortisol, high cortisol levels can cause hair loss. There’s several things. It’s going to be a hormonal imbalance. Once again, why do DUTCH tests? Because we can look at all the hormones and figure out which hormone is out of balance.

Same thing with why are you bleeding too much? Why are you bleeding not enough? Why are you spotting on your period? When you look at women’s medicine and the abnormalities in the period, the DUTCH test is going to give you the most bang for your buck, and also with hair loss as well. I am looking at the hormones to balance them as well as looking at the gut, looking at the food sensitivities, but mostly hormones. I will run a DUTCH test first on anyone with hair loss, and then we’re going to have to start doing…

And adrenal testing as well. Because there are so many people that deal with stress and they think that they’re fine. People are really running around with 10 out of 10 stress, and they’re just like, “But, yeah, for me it’s like it probably would be…” This is what they say, this is what they say. “It probably would be 10 out of 10 for most people, but for me it’s like a five or a six.” And I’m like, “Yeah, but your body still feels a 10 out of 10. Yeah, you’ve mentally changed that in your mind. You’re telling yourself that’s what it is, but I’m seeing your hair in this bag that you just gave me and it’s all your…” The thumbs up. “I see your hair in this bag and it’s telling me a different story. Your body feels 10 out of 10.”

I feel like with hair loss, we have to look at all the different things. I am virtual now, so I’m not doing this anymore, but when you look at a scalp, you can actually tell by how the hair strand looks like. Is it too thin? Is there dimpling or pitting around the hair follicle? There are signs of inflammation that can let you know if it’s DHT, if there’s inflammation there, and what type of hair loss you’re dealing with. When you train in microscopy of the scalp, you’ll be able to look at the hair and say, “Okay, this is because excess androgens versus this is stress related versus this is another reason. This is just inflammation or autoimmune inflammation,” which you can see in autoimmune hair disorders as well. You can see that. And that will correlate with their gut stool test. You’ll see an autoimmune bug.

Evelyne: Very interesting regarding the scalp analysis. And what you said about stress reminds me of that cartoon, the dog where everything’s on fire and the dog’s like, “Everything’s fine.”

Dr. DeJarra Sims: Everything’s-

Evelyne: You know what I’m talking about.

Dr. DeJarra Sims: That’s what most patients with hair loss say. They’re like, “Everything’s fine.” They’re like, “I deal with some stress, but it’s probably what the average person deal with.” And then they tell me about the dumpster fire that is their life, and I’m like, “Do you realize that you’re dealing with a lot?”

And then a lot of times, people have this aha moment when I tell them that it’s a lot and it’s okay to acknowledge that it’s a lot where they even release in that moment. Because once again, skin, hair, nails, it’s very stressful and it’s a very emotional thing. When people come to me, the one thing that they’re going to say is that, “I’m so happy you’re listening to me. No one believed me. I knew there was more to this,” or, “Oh my gosh, thank you for saying that. I didn’t realize that I was so stressed, and I thought I was supposed to just push through.” And they have this aha moment where they’re just like, “Oh, I’m pushing through. I’m okay. Everything’s fine, everything’s fine.” And then when they see their labs and they’re all out of whack, and that they actually look at pictures of themselves, they’re just like, “Oh, everything’s not okay. I am not fine.” And then I tell them it’s okay and that we’re going to get you better in the four to six months. With hair, it’s going to be like 12 months because hair grows slowly. But at the end of the day, that hope is what I try to give them. I’m a hope dealer. I’m a hope dealer.

Evelyne: Sure (laughs)

Dr. DeJarra Sims: I give them hope. Actually, that’s one of my packages. It’s called A New Hope, but it’s also after the Star Wars because I’m a big nerd. It’s like a new hope. It’s like giving them a new hope that they can be better.

Evelyne: I love that. And with the stress too, again, sometimes it’s not just that mental, emotional stress, but because you mentioned 2020, getting a viral infection is a huge stressor to the body. And it’s not just COVID, it can be any kind of crazy stressor to the body-

Dr. DeJarra Sims: Any virus.

Evelyne: … in terms of an infection, whether it’s a GI infection or a respiratory infection, right?

Dr. DeJarra Sims: Yes, all of the stress. It was the stress of the time because people were just not used to being isolated, but it also is the stress of the virus, it’s also stress of any virus. Because I have patients that deal with EBV, HSV. Any type of virus that lives in the body that can cause your body to be stressed can cause you to have hair loss, immune dysfunction, hormonal imbalance. It goes back to what is the root cause? We’re still going back to the root cause. Why are you having these problems? And it’s any type of overgrowth of virus, it’s any type of bug that’s in your system that’s not supposed to be there in large amounts.

Evelyne: DJ, I just have one more question for you on hair loss. While you are addressing all of those things, do you also use biotin to help with hair growth?

Dr. DeJarra Sims: Yes, I do use biotin, I do use collagen, I do use zinc, I do use amino acids because you need amino acids to have hair. I love me some amino acids. There’s all kind of things that you can use for hair. But with hair loss, you also need to look at micronutrient panels. I do run those. I know I talk a lot about stool, food sensitivity, and hormone imbalance, but that’s because that’s the foundational stuff.

And then once I heal… Because you have to be able to absorb nutrients, and so I want to correct what I can by letting you eat food. Heal your gut, eat good food. But then at the end of the day, we do have to look at a micronutrient panel to see what you have, whether it’s a NutrEval or some type of Metabol mix. I love those by Genova. But there’s other nutrient panels out there that exist. Any micronutrient panel, just I need to know what’s low because most of the time, if you don’t have hair, it’s because you can’t make hair. It’s not always something, sometimes you’re just not able to make hair because you don’t have the nutrients you need to make hair, and so I need to figure out what that is missing and give it to you.

And then there’s probably some type of dysfunction in how you absorb that nutrient to make hair. Just that high level picture of it is like, can you make hair? Is there something stopping you from making hair? Are you making hair and then you’re just losing it? It’s not hard. Naturopathic medicine isn’t hard, it’s just very intricate details about how the body works.

And I tell my patients all the time, “You’re the person that is going to tell me what’s happening in your body. I’m going to translate what your body’s telling me. You just take good notes and tell me everything. I need to know what’s going on with your poop, I need to know how you feel when you wake up in the morning, I need to know if you had a fight with your spouse or loved one. I need to know all of that, and then I will figure out what to give you to fix it.”

Evelyne: I love it, I love it. And I think something I’ve noticed based on what you just said about the building blocks of collagen and amino acids is there’s now this shift in people are talking more about the importance of protein. We really see that on social media, so that’s important. But also, are we properly absorbing that protein? Those are all things that we can find out with stool testing, metabolomics testing. Just want to throw that out there. That’s important.

DJ, thank you so much. This has been so informative. I just have three rapid fire questions for you that I ask everybody on the show. But before we go to those, where can people learn more about you?

Dr. DeJarra Sims: Well, I am at www.superheroskincare.com, all one word, superheroskincare.com. And at Instagram, it’s @doctordjsims, so D-O-C-T-O-R-D-J-S-I-M-S, doctordjsims. That’s only one M in Sims. People still mix. It’s one M, and then you can find me. And if you actually just put in Dr. DJ naturopath, I should pop up because I don’t think there’s a lot of Dr. DJs.

Evelyne: Great. DJ, what is something that you’ve changed your mind about through your years in practice?

Dr. DeJarra Sims: Ooh, that’s a good question. I used to detox everybody immediately. Everybody went on a detox. All of my old students back at SCNM, or Sonoran and all my students at Bastyr, Dr. DJ, detox, double detox, everybody. And I stopped doing that because I had a month of people just reacting to the detox over and over because skin patients are sensitive. I don’t detox anyone until I get the food sensitivity back, and that’s the main thing.

Evelyne: What are your three favorite supplements just for yourself that you take?

Dr. DeJarra Sims: Oh, for myself, collagen. I do take collagen with biotin every day. That’s one of your products. Oh, what else? I love a SPM. I like fish oils, but I love SPMs now. SPMs are the new fad for me because I’m just like, “Oh, I feel so good when I take SPM.” And there’s so many. I love GI Revive, but can I also say that I also love GI Microb X?

Evelyne: Sure.

Dr. DeJarra Sims: I thought you said three, but I like GI Microb X. And this is not an everyday thing, but I did my stool test and the GI Microb X went in, took care of it, so I was like, how can I not… Physician healed thyself. And I love GI Microb X and GI Revive. That combination is like chef’s kiss.

Evelyne: I love it. I love it. And final question for you, what are your favorite health practices that keep you healthy and resilient and balanced and ready to show up for your patients every day?

Dr. DeJarra Sims: Oh, I need to do HIIT. I like HIIT classes because I’m super aggressive. I used to run track, so I need to do something that’s three days a week it’s going to get me all hyped for the day. That is my caffeine, because if not, I have to artificially have caffeine. And I love me some face mask and facial… I’m not a product girl, which to be in skin, it’s really weird not be a product girl because I love supplements and internal products. But I do love me a face mask and I love me a light peel once a month, like some type of mandelic acid peel, and then all kinds of face masks. I’m a face mask girl, so I got to do my face care routines.

Evelyne: Amazing. I love it. DJ, thank you so very much. This has been such an enlightening conversation. And I so appreciate your wisdom and your humor and just sharing so generously with me today. Thank you.

Dr. DeJarra Sims: Thank you so much for having me. This is really fun.

Evelyne: Thank you, DJ. Thank you for tuning in to Conversations for Health. Check out the show notes for any resources from our conversation today. Please share this podcast with your colleagues. Follow, rate, early review, wherever you listen or watch. And thank you for designing a well world with us.

Voiceover: This is Conversations for Health with Evelyne Lambrecht, dedicated to engaging discussions with industry experts exploring evidence-based, cutting edge research and practical tips.