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Jenny Hsu 2/5/24 Jenny Hsu 2/5/24

Healing eczema and your gut

Living with eczema was more than painful; it was physically and emotionally exhausting. Tired, agitated, and withdrawn from social life, my emotional state, already strained by a demanding and stressful career, was further exacerbated by eczema. The condition seemed to amplify everything. Coping with the pain and discomfort day in and out drained my energy and emotional bandwidth, leaving little room for much else. Above all, there's an overpowering sense of shame and embarrassment associated with skin that appears unhealthy and repulsive to some—an emotional burden that can be a lot for any human to endure. Determined to find relief, I embarked on a quest to heal my skin.

My tryst with eczema began during my university years around 2011, emerging on the thumb and index finger of my dominant hand. The demands of a hands-on Product Design degree amplified the struggle, with patches of skin incessantly itching, opening up lesions that refused to stop bleeding. Every touch hurt; every graze burned. The second episode unfolded in Shanghai as a small patch on my face while I hustled through the techscape as an entrepreneur and then a large corporate employee. Then, in 2018, I went to war with my skin. Eczema launched a full-scale assault on my right hand (and occasionally the left) for two relentless years.

Living with eczema was more than painful; it was physically and emotionally exhausting. Tired, agitated, and withdrawn from social life, my emotional state, already strained by a demanding and stressful career in—ironically—health and consumer genetics, was further exacerbated by eczema. The condition seemed to amplify everything. Coping with the pain and discomfort day in and out drained my energy and emotional bandwidth, leaving little room for much else. Above all, there's an overpowering sense of shame and embarrassment associated with skin that appears unhealthy and repulsive to some—an emotional burden that can be a lot for any human to endure.

Determined to find relief, I embarked on a quest to heal my skin. I explored various remedies, from Traditional Chinese Medicine to unconventional practices like dunking my hands in petroleum jelly and sleeping with them in cotton gloves. I experimented with topical steroid creams and, as a last resort, dabbled in pharmaceutical drugs. Despite my initial resistance, desperation compelled me to embrace conventional medicine for a brief period until it became evident how unsustainable it was.

At that time, Topical Steroid Withdrawal (TSW) wasn't in my vocabulary. However, with each attempt to discontinue steroid creams, my eczema flared with an insistent itch and burning sensation, aligning with the symptoms of TSW. High school memories echoed caution, as my teacher's battle with Redbull addiction led to hospitalisation due to severe withdrawal symptoms. Aware that reliance on Western medicine could cause withdrawal symptoms and compromise our immune response, I was determined to adopt a 'natural' approach and explore holistic solutions.

Deep within, I had a gut feeling that conventional approaches overlooked the root cause of eczema. I was very fortunate to live in New York City at a time when the study of the human microbiome was exploding mainstream. Exposure to this emerging science provided me with a foundational understanding of the crucial role of gut health. It wasn't until later, during my quest for holistic solutions to eczema, that I stumbled upon research articles linking the condition to a leaky gut (intestinal permeability). It was a no-brainer what I needed to do next: fix my gut barrier.

I feel compelled to share my journey after several individuals reached out for help, ever since I began to speak publicly about my eczema journey. Before diving into the specifics of my healing journey, let's establish a scientific foundation behind the eczema detox.

Forget genetics

It’s easy to blame bad genes for our problems, but the science is clear: genetics only accounts for approximately 20~30% of our overall health outcomes. Moreover, recent studies suggest an even lower percentage, often less than 10%, with an increased understanding of genetics and epigenetics. For the majority of diseases, including many cancers, diabetes, and Alzheimer's, the genetic contribution is limited to around 5~10% at best. The belief that our genetics are the primary determinant suggests that our fate is written into the stars and denies us a world of opportunities for a better and healthier future. Factually, we have much more control than we think.

The role of our microbiome

We are less human than we think—there are more bacterial cells in our body than there are human cells. According to a 2016 study, the total count of bacterial cells to human cells is approximately in a ratio of 1.3:1. This means there is more bacterial DNA than human DNA. What does DNA do? It contains the instructions needed for an organism to survive, function and reproduce. Every single cell in our body influences human physiology, metabolism, nutrition and immune function. With around 30~50 trillion microbial cells in a human, from as many as 1,000 different species, the microbes in our body are essentially running the show. The microbiome influences not only gut health but also whole-body health through its connections to immunity, inflammation, blood pressure, obesity, brain function and longevity. Everything is interconnected; there is nothing that our microbiome does not touch and control. The good news is that, similar to training our muscles, we can actually train our gut.

Healthy gut vs leaky gut

The mucous lining of our gut serves as a crucial barrier between our gastrointestinal tract and the rest of our body. A healthy gut barrier is designed to efficiently absorb and transfer nutrients—such as water, vitamins, and minerals—from our food to the rest of our body through the bloodstream. However, a compromised gut, often referred to as a 'leaky gut,' allows more than what is needed to 'leak' into the bloodstream. In this condition, the usually tightly knit cells of the intestines become porous, allowing undigested food particles, toxins and harmful microorganisms to pass through. Consequently, the body initiates an inflammatory response to combat these foreign invaders. As a result, the body's immunity becomes chronically weakened having to engage in a constant battle with itself 24/7, diminishing its ability to effectively respond to real threats, such as viruses and increasing risks that impact long-term health issues.

Source: Microbiome Labs

The role of a healthy gut

A healthy gut refers to the integrity of a digestive system that functions optimally where the microorganisms coexist in a balanced ecosystem that is essential to optimal well-being. It plays a crucial role in several key jobs:

Immune system modulation
Metabolism
Colonisation resistance (i.e. protects against infections)
Gastrointestinal motility
Gut integrity
Mitochondrial function
Nutrient absorption
Xenobiotic/drug metabolism
Production of short-chain fatty acids
Inflammatory response regulation
Blood glucose control
Mood regulation
Brain function
Ageing

Gut dysbiosis

Gut microorganisms, collectively known as the microbiota or gut flora, consist predominantly of bacteria, viruses, fungi and other microbes. Gut dysbiosis means there is an imbalance of microorganisms in the gastrointestinal tract where typically there is an overgrowth of pathogenic microorganisms (the bad) and pathbionts (the ugly) over their beneficial counterparts (the good). An imbalance of microbiota can alter immune function and speed up disease. Given that our microbiome is a complex ecosystem with a multitude of drivers that impact its physiology, some of the key factors that contribute to dysbiosis are:

Antibiotics: Antibiotics disturb the balance of gut bacteria by indiscriminately targeting both harmful and beneficial microbes.
Pharmaceutical Drugs: Certain drugs can disrupt the environment of the gastrointestinal (GI) tract.
Dietary Factors: A diet high in sugar and processed foods, low in fibre, or lacking in diversity can negatively impact the gut flora.
Stress: Chronic stress influences the gut-brain axis, affecting the composition of the gut microbiota.
Lifestyle Factors: Inadequate physical activity and other lifestyle factors contribute to the development of gut dysbiosis.
Age: The composition of the microbiota can change with age.

There is a growing list of diseases strongly associated with gut dysbiosis including alcoholic liver disease, antibiotic-associated diarrhoea, coeliac disease, Chron’s disease, ulcerative colitis, irritable bowel syndrome, SIBO, liver diseases, and non-alcoholic fatty liver disease. Other non-gut conditions associated with dysbiosis include Alzheimer’s, Parkinson’s, anxiety and depression, asthma, eczema, autism, Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), kidney disease, kidney stones, metabolic syndrome, multiple sclerosis, obesity, Rheumatoid arthritis, Type I diabetes and Type II diabetes.

The key takeaway is that cultivating a healthy and well-balanced microbiota is crucial for optimal health and longevity. This understanding provides a compelling motivation to take actionable steps and train our gut towards improved health outcomes. This principle forms the foundation of The Eczema Diet, the transformative approach that played a pivotal role in my complete recovery from a two-year battle with eczema.

I express my deep gratitude to Karen Fischer for the carefully crafted detox program as a result of her meticulous research on nutrition and eczema. The world of microbiome research and all those who have contributed towards this field are all heroes guiding us towards a healthier future. While we have never met, thank you for helping me eradicate eczema from my life.

The Eczema Diet

This is a three-stage detox program focused on enhancing gut health by reducing the body’s chemical load, facilitating liver detoxification, restoring pH balance and optimizing the ratio of essential fatty acids. Here is a diagram from the book 'The Eczema Diet,' illustrating how the programme works:

The ultimate goal is to enhance your intestinal barrier, allowing you to function—and feel—like a normal human again. The Eczema Diet, like most dietary plans, is not intended for long-term adherence but rather as a short-term aid in the restoration of your gut barrier. Following the Eczema Diet takes a lot of disciplinary action, but I was able to store my gut barrier through this three-stage process:

Stage 1: Implementing a restricted diet limited to eczema-healthy foods only (e.g., low to negligible levels of salicylates).
Stage 2: Gradually reintroducing foods into the diet as symptoms start to disappear.
Stage 3: Establishing and maintaining a new, healthy, acid-alkaline balanced diet.

I skipped the recommended 3-day liver cleanse and jumped directly to Stage 1, adhering strictly to a consistent diet for one month. Looking back, considering more knowledge around how our body works, I would recommend starting with a liver detox to flush toxins and waste products to promote improved liver function. My initial diet primarily consisted of (many) pears, leeks, Brussels sprouts, white potatoes and chicken thighs—just because it’s tastier than chicken breast. Throughout this initial month, I focused exclusively on the mentioned foods, deliberately avoiding other items even if categorised as Stage 1. The goal was to introduce a limited number of compounds, providing my gut with the best chance of healing. Only in the second month, after seeing tangible improvements in my skin, did I begin incorporating additional foods that are still within the confines of Stage 1. Despite the constraints of using only rice bran oil and Celtic salt, I found the meals to taste rather delicious—particularly when baking the veggies! The challenge with adhering to this diet is when you're out and socialising with friends so I was always meal-prepping and bringing out my food, even to restaurants (call them in advance as a courtesy).

Within the first month, tangible improvements became evident. Despite occasional attempts to introduce foods beyond the Stage 1 list, I found myself reverting to Stage 1 for roughly three months due to worsened symptoms when deviating. By the third month, I was able to reintroduce Stage 2 foods (while maintaining most of Stage 1 elements) without any major flare-ups. Around the sixth month, my gut was confident enough to return to a normal diet. Although you might see progressive improvements during Stage 2, occasional flare-ups may occur. In such instances, I suggest returning to Stage 1 for a brief period to help lower the chemical load and facilitate gut repair. It's also important to understand the triggers behind flare-ups so you can minimise exposure and prevent future episodes until you have recovered completely.

For anyone genuinely seeking improvement in their condition, strict adherence to the diet is imperative. I've witnessed cases where individuals experiment with foods containing moderate to high levels of salicylates, thinking 'just a little bit' will be okay, only to find that their conditions never fully resolve. I liken this to the healing of a physical wound. Imagine having a scab that gets rubbed and jabbed while it's still recovering; each time you impact the wound, you interfere with the healing process and potentially risk infection and further damage.

Knowing countless friends struggling with skin diseases like eczema, and having personally endured it for two years, with intermittent battles over nine years, I hope this offers a clear, science-based path towards healing.

To a healed you,
Jenny

PS: I'm not a medical professional, so please don't take what I'm sharing as medical advice. This is a personal story, with a few references to support the science behind the detox process and how our bodies can thrive or struggle depending on the health of our microbiome.

Above left to right: hand from two years of eczema to a happy recovered hand :)

Jenny Hsu 6/24/23 Jenny Hsu 6/24/23

Ego vs Soul: listen to your gut

Our intuition gives us the capacity to pick up energies and cues, to feel what our gut tells us, and to trust our inner compass. Compared to the other five senses, our intuition is a highly refined sixth sense that is not easily recognised unless we are in touch with our embodied self. When we are in situations that don’t work for us, our body sends the flight or flight response and our nervous system starts to send distress signals to help us understand when something is in misalignment.

I dedicate this post to my little sister.

It’s easy to follow the path most travelled and conform to the prescripted template of modern society. But if we walk the unconscious path ignoring our intuition, we inflict self-harm and sabotage our own happiness. Burnout manifests, as a result, in our negligence for ourselves and our health (physical, social, mental, emotional and spiritual). It’s a global phenomenon that needs no introduction - burnout is at an all-time high.

There are many reasons why people suffer from burnout. Whether the stress is due to unrealistic expectations, being in a toxic environment, a lack of boundaries or not having tools to manage negative emotions, burnout boils down to one single culprit: the work we’re doing doesn’t lead us to the path of self-actualisation. It manifests when we’re not in alignment with our mind, body and soul. That’s why passion can also lead to burnout. The idea of choosing a job you love so you never have to work a day in your life encourages the dysfunctional idea that you should do more of what you love, even if it kills you.

When we are in situations that don’t work for us, our body sends the fight or flight response and our nervous system triggers distress signals to help us understand when something is in misalignment. Unlike the five senses focused on the visceral experience of the physical plane, our intuition gives us the capacity to pick up on energies and cues, to feel what our gut tells us, and to trust our inner compass. Our intuition is a subtle yet highly refined sixth sense that we can easily tap into and recognise when we are in touch with the embodied self, but to ignore it is to betray and deny our own existence.

I’ve been foolish many times when I ignored all the signs. Even though I knew something was wrong, I pushed on with my ego. I feel compelled to share my story after learning about someone close to my heart living with chronic depression, and a few days later, learning about a friend who was at the hospital for a potentially life-threatening condition that is linked to eczema.

I have battled three episodes of eczema during the past 10 years. Every single episode has been linked to stress and a poor lifestyle. While we all have certain genetic predispositions, they only contribute to roughly 20~30% of your overall makeup. There’s a saying that genes load the gun and the environment pulls the trigger because our genetic characteristics aren’t written in stone. Genes can be turned on or off based on our lifestyle choices.

I took my health for granted because I’ve always been pretty invincible growing up—or at least, I felt invincible—thanks to a healthy Asian diet and an active upbringing. It wasn’t until my first career burnout in 2016 that led me down a pursuit of health. I returned to yoga, and through a friend, was introduced to the world of martial arts. I left my first startup and went corporate.

Corporate life at the Chinese conglomerate crushed my soul. I developed my second case of eczema and went through a brief episode of depression. My first case of eczema appeared during my university days - I was extremely passionate and dedicated at the time. I thought I was happy, but I was exhausted from working three part-time jobs while studying for two different degrees (and design school is extremely demanding).

In 2017, I quit corporate to pursue personal interests and enrolled in the Precision Nutrition certification course. Not long after, I dove into a new role at another startup and never finished the programme. I thought having a job with a guaranteed income meant stability and success. A year later, I was utterly miserable despite having a great team and believing passionately in our mission to empower behavioural change through micro-learning.

I quit that job and contemplated becoming a monk or working on a farm. Instead, I asked myself what I was most passionate about. I desperately wanted to get into health and sustainability because I wanted to make the world a better place. At that time, there weren’t many options in Hong Kong but one biotech company stood out - it was a growth startup in genomics and diagnostic health, and they were expanding at the time. I tracked down the hiring manager and wrote him a long letter after going through his blog - I felt inspired. I had called the letter “my mission to the world” where I wanted to join the team and empower people to make healthier choices, and in turn, I believed those choices would positively impact our planet and society as a whole.

I was fortunate to land a role that propelled me into the healthcare industry. I had an incredible but hard and honestly painful journey. Although I learned a tremendous amount and evolved as a person, a manager and a leader, I was suffering on the inside. My ego was on overdrive. Not only did I want to make an impact on the world, but I also wanted to prove that I was worthy. I focused so much on pleasing everyone else that I neglected myself. My eczema returned and it lasted for two years. Leaving the company was one of the hardest decisions of my life. I was on a fast-track path to success and I was extremely passionate about my work, but I was unhappy. I lost my energy and thrill for life. I was mentally and physically sick.

The brain has a direct effect on our stomach and intestines. Our gastrointestinal health is largely influenced by stress and chronic stress can inflame the gut. My gut was destroyed. I ignored my gut for two years until one day I just couldn’t carry on anymore. For me, severe burnout manifests in the form of eczema but it can show up differently for each individual. It took me 3 months on a strict eczema detox (i.e. low salicylate diet) to see the symptoms fade away and another 3 months for my gut to properly heal.

It’s easy to fall into the passion trap and convince ourselves that there’s no gain without pain. While growth and happiness stem from challenges, there’s also only so much that we can take. When we ignore our gut intuition, we are essentially betraying ourselves, and our gut is usually always right. Somatic awareness allows us to tune into our body and inner compass. When we can break away from our conditioned mind and tap into our true selves, we’re able to listen more closely to our gut intuition and notice what makes us feel alive. Follow the loving and all that is within you. Walk that path wherever it leads you.

Three takeaways:

The power of letting go: it’s better to let go than to hold on to something that’s killing you.
The passion trap: no matter how much you love something (or someone), if it’s killing you then something needs to change, and you might need to let go.
Live smarter: there are other ways to do what you love without experiencing burnout - everyone is different so discover the tools that work for your unique being.