Season 3 Episode 12 of Quiet the Diet Podcast with Michelle Shapiro, RD and Taylor Goldberg

A New Perspective on Chiropractic Care, Hypermobility, Dysautonomia, and MCAS with Taylor Goldberg

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In this week’s episode of Quiet the Diet, Michelle sits down with Taylor Goldberg, a chiropractor turned hypermobility coach. After finishing chiropractic school, Taylor’s career began when she started working as an associate at a traditional chiropractic practice. However, she quickly realized that conventional chiropractic teachings and methods didn’t align with the way she hoped to help people. Michelle and Taylor unpack the dangers of cookie-cutter chiropractic practices and the importance of an evidence-based approach in treatment and self-care.

Discover why adjustments are not a one-size-fits-all and how hypermobility calls for a tailored strategy that embraces your own set of unique needs.

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They discuss:

Taylor’s approach to chiropractic and evidence-based care. [8:09]
Challenging the notion that there is “good” and “bad” posture [12:59]
The misunderstandings surrounding chiropractic care and hypermobility [18:34]
Hypermobility, dizziness, and mast cell activation syndrome. [23:30]
Hypermobility, Ehlers-Danlos syndrome, and joint pain. [34:07]
The importance of understanding the autonomic nervous system in managing hypermobility, mast cell activation syndrome, and dysautonomia [1:01:07]
Managing hypermobility symptoms through strength training and other methods. [1:16:59]
Resources for learning more about hypermobility and musculoskeletal health as a practitioner [1:22:19]

Listen to the Episode

Episode Transcript

A New Perspective on Chiropractic Care, Hypermobility, Dysautonomia, and MCAS with Taylor Goldberg

Michelle [00:00:01]:

All right, guys, ladies and gents and everyone all identifying folks. I am so excited for my guest today. This is my personal trainer. This is one of my healthcare professionals who’s helped me through so much. I’ve had one other on the podcast before, but Taylor, I am so freaking excited to have you here today.

Taylor Goldberg [00:00:22]:

I’m so excited to be here. Thank you for having me.

Please share your journey from a conventional chiropractor to a functional chiropractor.

Michelle [00:00:25]:

Oh, my goodness. Taylor. So you are a chiropractor by trade, but very much how I consider myself a functional dietitian. I consider you a very root cause functional chiropractor. And although many the degree of chiropractice is intended to be a functional and root cause degree, can you just tell us about how you kind of came from a conventional chiropractic understanding to what I would call you? I would label you as like a functional chiropractor. Honestly.

Taylor Goldberg [00:00:53]:

Yeah. We call it evidence based chiropractors in our world, but same. So basically, I went to Cairo’s. Let’s fast forward undergrad I was pre med. I always wanted to be a doctor. I always knew I wanted to be a doctor. And then I studied abroad in Spain and realized the medical system in America is not something I wanted to be a part of. I did not understand at the time where chiropractic fit into that at all or really understand what I meant when I said I don’t like the medical system back then.

Michelle [00:01:25]:

It has a bad taste, but I don’t know what it means.

Taylor Goldberg [00:01:27]:

Yeah, I don’t know. I just had this feeling in my body. I was like, this is just not right. And so this was my senior year. I took the MCAT, I applied to med school, the whole nine yards. And I got home hysterically, crying, telling my mom, I don’t want to go to med school. I don’t know what I want to do, but I do not want to go to med school. And that was my existential crisis moment.

Taylor Goldberg [00:01:49]:

And sitting in my sorority house at the time, one of my friends was like, why don’t you look into chiropractic? I feel like that really aligns with you, who you are. And I was like, I don’t know anything about it, but there’s a school in Oregon. I’ve always wanted to live in Oregon. I’m going to go there. So go to school in Oregon. And it was very eye opening. I did not know a lot about chiropractic at the time. I didn’t know what it entailed.

Taylor Goldberg [00:02:15]:

I was very much the black sheep at school. I was not into adjusting that much, never was going to be. And so that forced me to find other chiropractors who we call evidence based chiropractors on the Internet through social media, network with them. And that has allowed me to create an evidence based practice and teach others to create an evidence based practice, which is super, super exciting. But when I graduated chiro school, I took an associate position at a practice in Colorado Springs where I was a very much traditional brackham and crackham chiropractor. And that’s really where I learned who I don’t want to be as a.

Michelle [00:02:56]:

You know, you’re probably scaring people with a sentence which is you’re saying that you are an evidence based chiropractor but that not all chiropractors you would consider to be non evidence based chiropractors. What are other chiropractors? Because they’re educated, right? They have lengthy degrees. You have a very lengthy degree. It’s a very serious degree. Is it more that people are practicing with intuition? They’re practicing with tropes about what they know chiropractors do, what other chiropractors are doing? What’s the deal? What is that?

Taylor Goldberg [00:03:25]:

It’s more about outdated research and certain schools teach very outdated practices and it’s more of an educational system problem when it comes to chiropractic because our board exams are still very outdated. And so when I say chiropractors that aren’t treating evidence based, what I mean is that they’re really doing the same thing on every single patient, and all they’re doing is adjusting. And maybe they’re taking false pine X rays and trying to create urgency so that you will buy a very expensive care plan and so that you will stay in care forever. And I can say this from personal experience because that was exactly what I was taught to do at my old associate practice and it never sat right with me. We weren’t taught that at my school, but there are a lot of schools that teach that. I actually just went to my continuing education for chiropractic that I have to and it was very much how can we adjust more people? And it was all about adjustments and nothing else. And chiropractic is so much more than adjustments.

Michelle [00:04:25]:

It certainly is. Let’s talk about adjustments for a second. Let’s say someone’s never been to a chiropractor. What can you expect at a conventional chiropractic visit? What is an adjustment? Tell me that much.

What can you expect at a conventional chiropractic visit? What is an adjustment?

Taylor Goldberg [00:04:39]:

Yeah, so what an adjustment actually is, is every joint in your body has what we call synovial fluid. So it’s this fluid surrounding your joint. When you get an adjustment, that noise you hear is bubbles forming in that joint fluid. It feels nice. It sounds really cool ASMR it’s super trending on TikTok right now and it feels really good for some people sometimes. And that has immense, immense value. I think there is a huge value if it is safe for you and if you get short term relief from it, that is valuable because there’s not a lot of things that have low risk that can give you that type of relief. With that being said, they are not safe for everybody.

Taylor Goldberg [00:05:25]:

But we’ll get into that in a second. But prior conversation, prior to that, for the general population, the biggest issue I have with the adjustment only chiropractor is the dependency. If you feel dependent on your chiropractor, if you feel like you are not going to be healthy or that you are not in line unless you see your chiropractor and your chiropractor is the only person that can give you relief, that’s a problem. We don’t want to be dependent on anybody. We want to have that power ourselves. With that being said, virals, don’t move your bones. There is no such thing as proper alignment. There’s no such thing as getting an adjustment.

Taylor Goldberg [00:06:06]:

Makes your immune system healthier. That has all been debunked. That has all been 100% debunked. And it’s just not how it works.

Michelle [00:06:17]:

Removing the fluid is what is happening in the adjustment. So if you were to get an adjustment, quantify this for me. What percentage of that adjustment lasts after the first day or so?

Taylor Goldberg [00:06:31]:

None. It’s short term. So it’s a short term increase of range of motion and short term relief for some people. Sometimes what you do with that short term relief, what you do with that short term can last long term. And that’s why having a Cairo that gives you exercise and also can walk you through lifestyle management and how to maybe use this new relief to benefit you, that’s an evidence based chiro using passive modalities like adjustments when it’s safe and when it feels good for the patient in front of you without creating dependency.

Michelle [00:07:08]:

Okay, this is really important and really fascinating. Chiropractors take a lot of X rays generally, right? So is the assumption in the practice that the adjustments will alter the X rays if you’re saying you don’t move bones? I’m seeing a face of validation here for my confusion. Right?

Taylor Goldberg [00:07:29]:

Yeah. And you’re totally valid and being confused. And so there is different techniques in chiropractic, and there are certain techniques in chiropractic that rely on X rays to sell that technique, to get you to buy into that technique and for the practitioner to believe in what they’re doing. I honestly was not taught to take X rays before adjustments. I was taught very much so that X rays, we don’t move bones with adjustments. We know that X rays are used for red flags. If there is a red flag, that’s when we want imaging. Or if you haven’t been responding well to care for a while, that is when we want imaging.

Taylor Goldberg [00:08:12]:

We don’t want imaging because we’re going to be able to change your structure. We’re not capable of that. It takes a lot of force to change the structure of your bones. You need a knife. And if you’ve ever seen those orthopedic surgeon videos, you’ll see how hard it is to truly change your structure. You can’t do that through a chiropractor.

Michelle [00:08:32]:

About posture and things like that, too. Oh, my God, Taylor, I’m freaking out. I have so much to ask you.

Taylor Goldberg [00:08:37]:

Okay, it’s going to be a long.

Michelle [00:08:39]:

Podcast, just something that you’ve talked to me about. Like, again, I think people go to chiropractors or do things at home to change their posture. How able are we to change our posture through you roll your shoulders back or you do adjustments. Are we able to do that? What is the deal with posture?

How able are we to change our posture through you roll your shoulders back or you do adjustments. Are we able to do that?

Taylor Goldberg [00:09:01]:

So to answer your question, in the short term yes, in the long term no. But the real question here is do we want to? So is there such thing as good and bad posture? And this actually leads to a conversation I wanted to talk about. Is there such thing as good or bad food? We can parallel this very same thing when it comes to posture, there’s no such thing as good or bad posture. Posture is dynamic. The best posture is the next posture. Our body likes movement and there’s nothing wrong with slouching as long as you’re not slouching the entire day, as long as you’re not slouching for hours on end. The same thing. If you sat up perfectly for 6 hours without moving, I guarantee you’d be in pain.

Taylor Goldberg [00:09:42]:

I guarantee you would feel like just as bad if you were slouching for 6 hours. It’s more about staying in one position for too long. That’s really the problem. But when it comes to this whole posture myth and good posture versus bad posture, you want to be able to get in and out of different postures and that is important. And if you are not able to hold yourself up, then we have a strength and musculature issue and we can address that via exercise, via different things. But sometimes chiropractic adjustments can give you that relief in order to be able to work on sitting up straight. So there is some benefits to that, if it is helpful for you. But if your chiropractor is telling you you look like a shrimp and you have the worst posture I’ve ever seen and that’s the reason for all of your pain and all of your issues, it’s not.

Taylor Goldberg [00:10:34]:

Pain is always multifactorial. There’s always more than one factor. It’s not as simple as you need to fix your posture. I wish it was. I wish we could just say fix your posture, you’re never going to be in pain again. It’d be a lot easier.

Michelle [00:10:46]:

It would. 100%. And I think what you’re really saying is it matters much less what happens in that 15 minutes chiropractic session than what happens in the week in between the sessions or the days in between the sessions. And I want people to hear you saying that changing position and being able to change position is so important. And that’s really more a tale of nervous system, of strength, of mobility than it is of just posture. So the posture might be a reflection of a lack of strength, blood flow, something like that, but it is not necessarily the posture is not the root cause. And that’s the most kind of important thing that’s key.

Taylor Goldberg [00:11:29]:

Yeah, 100%. And also our posture doesn’t come from our structure. Our ability to stay in one posture is very musculature or your muscles allow you to stay in that posture. It’s not putting you into the right alignment to stay in that posture. And again, you want to be able to change postures, and there’s no such thing as good or bad.

Michelle [00:11:52]:

Yeah. All right. Okay.

Taylor Goldberg [00:11:54]:

I’ve never felt like this on a podcast.

Let’s talk about our similarity of hypermobility and why adjustments aren’t suited for the two of us.

Michelle [00:11:56]:

I’m getting upset with us because I’m like, oh, we already didn’t talk about this. It’s just starting. Michelle, calm down. We’re going to get I’m like, oh. Taylor okay, so you talked before about there’s people who adjustments might not be suited for, people whose bodies adjustments might not be suited for, who are adjustments not suited for. And if you also want to regale us with a little bit of a personal tale of yourself, I will also regale my personal tale of myself, too, because we have a huge similarity. So I’m asking a leading question, but you know where I’m going.

Taylor Goldberg [00:12:29]:

Perfect.

Michelle [00:12:29]:

Yes.

Taylor Goldberg [00:12:30]:

So I work with hypermobility. I’m hypermobile. Michelle is hypermobile. That’s what we have in common. And hypermobility is a contraindication to cervical adjustments. So adjustments in your neck. The reason for this is because there’s a lot of really important stuff in your neck, like your brain stem, like your vertebral arteries, blood flow to your brain. There’s a lot of risk factors in your neck when it comes to neck adjustments.

Taylor Goldberg [00:12:56]:

When you’re hypermobile, you already have enough range of motion. We know that chiropractic adjustments do two things short term relief and increase your range of motion. In the short term, you probably don’t need short term increased range of motion. When you already have too much motion, you probably don’t need any more, probably need less or learn to control it. With that being said, there’s also some very common comorbidities that we see in the hypermobile population that are extreme contraindications for cervical adjustments. Those are CSF leaks, which I see way too commonly.

Michelle [00:13:33]:

How do you measure them, by the way? How do you know if someone’s CF?

Taylor Goldberg [00:13:37]:

It’s hard. A lumbar puncture is the gold standard. A brain MRI can sometimes be helpful. I have a friend, dr. Brianna from Healed and Empowered. She specializes in reading images to see if there is CSF leak. So if anybody it might be a.

Michelle [00:13:54]:

Little bit challenging to see unless you’re.

Taylor Goldberg [00:13:56]:

In very, very, very hard. Not something I’m capable of doing. But if you do need somebody, Dr. Brianna is the best. And so the other risk factor is upper cervical instability, which we’re going to talk about. And obviously, stroke is still a risk factor for anybody when it comes to getting a cervical neck adjustment. Now, it is very small, but it is still not zero. With that being said, if you have not got genetic testing and you are hypermobile, you don’t know that you don’t have vEDS yet.

Taylor Goldberg [00:14:31]:

And that is an extreme risk factor when it comes to cervical neck adjustments.

Michelle [00:14:35]:

What would you see in genetic testing?

Taylor Goldberg [00:14:37]:

Taylor so genetic testing can test for all the other types of Eds besides HEDS. We have the genetic markers, which is.

Michelle [00:14:47]:

Hypermobile Eds, and Eds is Eller’s Danlow syndrome. Just for people who might not be.

Taylor Goldberg [00:14:52]:

So let’s, let’s back up a little bit. Hypermobility is a symptom of a lot of different things. Majority of the time it is a connective tissue disorder of some sort. There’s a lot of different connective tissue disorders. The most common are Eds, which there are 13 types, and then Marfans, which usually is more male dominant, whereas Eds is more female dominant. We’re going to be talking about Eds in general for all twelve types of Eds besides HEDS, which is hypermobile Eller’s Danlow syndrome, we have the genetic marker for. So you can get a genetic connective tissue panel and it will tell you you’ve got it or you don’t. It’s very black and white.

Taylor Goldberg [00:15:35]:

You either got it or you don’t. If you don’t have any of those twelve and you meet the rest of the diagnostic criteria for HEDS, that’s how you get an HEDS diagnosis.

What do hypermobility and connected tissue disorders look like in the body?

Michelle [00:15:44]:

Perfect. Thank you. That’s really helpful. When you say these are connected tissue disorders, or you say even the word hypermobility. Taylor, draw me a visual of what that looks like in the body. When your joints are hypermobile, you have ligament laxity. Give us a visual for that so people can understand.

Taylor Goldberg [00:15:58]:

Yeah. So what hypermobility means is it’s very different than flexibility. And those two can get very confusing. So hypermobility is when your joints move beyond their normal range of motion. So your elbows, if they hyperextend, they’re.

Michelle [00:16:15]:

Going to go, stand up and show my knees.

Taylor Goldberg [00:16:16]:

If people want yeah, they’ll go past its range of motion. This can happen in any joint of your body. And there is actually four different types of hypermobility classifications depending on how many joints in your body are hypermobile. This is different than flexibility. Flexibility is more your muscles being able to lengthen easily without creating a sensation. And you do not have to be flexible to be hypermobile. That is a huge common misconception. At the same time, most people who are hypermobile also do have some flexibility, but it is not a requirement.

Are you able to notice you are hypermobile yourself?

Michelle [00:16:51]:

I’m very inflexible and quite hypermobile, according to Taylor, who laughed at me when I said I wasn’t. So apparently, yes, that is entirely possible. Would you be able to notice this if you did not notice it, if you didn’t know about this definition of it? Is it something that people would notice about themselves that they’re hypermobile?

Taylor Goldberg [00:17:14]:

Most people, like when I was a kid, I was always told I was double jointed. Most people, if you were told you were double jointed at any point in your life, you are probably hypermobile. That is like the easiest way. There is no such thing as double jointed. Double jointed by nature means you have more than one joint. You don’t have more than one joint. You just have too much motion in your joints if you are, quote unquote, double jointed. If you have been told you’re double jointed, you have hypermobility in that joint.

Michelle [00:17:39]:

Exactly. Okay, I’m going to tell my story, Taylor, because I’m going to lay the foundation for this conversation from a scientific perspective, but you are going to correct me on anything because you are the master of this, and you are going to add in things as we go along. Okay?

Taylor Goldberg [00:17:56]:

Perfect.

Michelle’s history and experience with a chiropractor:

Michelle [00:17:59]:

As people have now heard on other episodes of the season, I had a mold exposure, and then I had COVID, and then I had some long COVID like symptoms that I eventually found out were Mass Activation Syndrome, which I’ve been a dietitian for almost ten years. And in the beginning part of my career, I was working with anxiety, gut issues, and body neutral weight loss, which I still work with majoritatively. And I was always very grateful for these conditions because I was like, I now know what someone’s experiencing. Like, I used to have 15 panic attacks a day. I would be vomiting from them all day. I’m like, I can get in there with you. I know exactly what it feels like, and I know what’s going to help from clinical experience as well as personal experience. When I started having Mass Cell Activation Syndrome symptoms, high histamine intolerant symptoms, I was floored by the new level of discomfort I was at that I hadn’t experienced in many years.

Michelle [00:18:50]:

Right. I was quite well for a very long time. And then once I had this really bad mold exposure plus COVID, it created this inflammatory cascade that ultimately resulted in these brand new symptoms. So one of those symptoms was Dizziness. And I had Dizziness about like, ten years ago, and it actually was just anxiety, the Dizziness. Like, when my anxiety resolved, the Dizziness really came down. I don’t really have anxiety anymore, so not conscious anxiety, although my nervous system can be obviously activated, but I don’t experience anxiety anymore. So this time I was like, that’s weird that I’m having Dizziness.

Michelle [00:19:24]:

So I went to a chiropractor myself. Not you yet. Thank goodness you later. And as you know, and now people are going to know, I went and got a really intense neck adjustment repeatedly, because what was happening was I think I started doing certain movements that my body wasn’t used to. When I started a new training routine, I went to a chiropractor and they said, I’ve never felt muscles this tight in my life. So they took this kind of like, metal rod scalpel thing, and we’re just digging into my neck. I left there and I was holding the walls. I was so dizzy, and they are lovely.

Michelle [00:20:03]:

So I was the one person they should not have done this to, and they didn’t know that, and they didn’t recognize the hypermobility. But what had happened was all the joints in my neck got we’ll call them looser, they activated the hypermobility of those joints, which can be really challenging. So from that point, then the Dizziness really was pretty constant. And I really don’t like dizziness. I’m so used to symptoms now. Like, you could give me basically any symptom in this life and I would not care anymore because I’ve experienced them.

Taylor Goldberg [00:20:36]:

All, and I was like, I really don’t like Dizziness.

Michelle [00:20:38]:

It’s very annoying for me. And then just like, anytime I would move my neck even like an inch, I would get really bad activation of this Dizziness, and I really couldn’t. Like Taylor was saying, I couldn’t hold myself off, and this was extremely abnormal for me. It then started turning into these crazy heart rate fluctuations and issues. And obviously all my friends are functional medicine doctors. They’re all like, I don’t really know what the heck is going on with you. And then it really took working with you and really doing my own research to understand the relationship between the mass cell activation syndrome and the hypermobility and what ultimately became Pots Dysautonomia heart rate issues. All right, so let’s roll together, everyone together on this.

Michelle [00:21:23]:

Okay, I’m going to do the whole science of what the heck happened. And I just want to say as a disclaimer, that because of Taylor’s working with me and because of the work I’ve done with my other Naturopathic physician, I have zero heart rate issues. Like, still working on all the strength and all these other things and regaining but it is entirely possible to turn around, especially Dizziness for me again, which is one of the scariest symptoms. I feel more confident than ever in our ability to do this work and to help people with this. So I just want to disclaimer before we go into all the juicy science and everything, that I was in a neck brace a couple of months ago in my client sessions, and I was just like, guys, you got to take me like this. And they’re like, it’s fine for a couple of weeks, and now I have full range of motion back in my neck again. So. Thank God for you, Taylor.

Michelle [00:22:09]:

But yes. Okay, so before we even do the science interject, talk to me.

Are chiropractors trained in hypermobility? How should you feel after a chiropractic appointment?

Taylor Goldberg [00:22:13]:

So I want to start at the beginning of your story because your story is a perfect example of what a lot of hypermobile people experience. And so you go to the Chiropractor because you have neck pain. You go to the Chiropractor because maybe.

Michelle [00:22:25]:

You’Re feeling a little bit off.

Taylor Goldberg [00:22:27]:

And the chiropractor, unfortunately, we were not taught about hypermobility in school, and it is a huge issue. It is not the chiropractor’s fault. It is not even the physical therapist’s fault, too, because this happens in physical therapy offices as well. It is the educational system’s fault, and it is the fact that HEDS is still considered a rare disorder, meaning we don’t get funded or grants for research. So it’s really hard to do research when there is no money. That’s a side story, but we can get into that regardless. When you went to the Chiropractor, they did not screen you for hypermobility. It is so easy to screen for hypermobility.

Taylor Goldberg [00:23:08]:

It takes literally 1 minute. And I have a whole course about this. So if any Chiropractors, Pts or OTS are watching, definitely check that out. But you can do the bait and scale in quite literally 5 seconds. If the bait and scale is negative and you still think your patient is hypermobile, do the five PQ, which is a questionnaire on hypermobility, because hypermobility is dynamic and it may not always show up. With that being said, there are some other red flags that I believe a chiropractor should have noted to not adjust you. Those red flags are if you experience any ringing in your ears, that is a contraindication for neck adjustments. That should always be a question.

Michelle [00:23:49]:

They were doing because of the ring in my ear and because of vertigo, they were doing that maneuver. What’s it called when they dixon yeah. Dix Hallpike. Yeah. Flipping me on my head. It’s just so crazy to think about now, but, like, literally flipping me on one side of my head and yanking my neck all over to try to readjust my inner ear balance, basically. The crystals in the inner ear. Yeah.

Michelle [00:24:12]:

Which that is valid. That’s a valid maneuver.

Taylor Goldberg [00:24:17]:

100%. That is going to help. You did not have BPPV.

Michelle [00:24:21]:

You had wrong tool for the wrong client. However, that is an extremely valid maneuver, and I’m very aware, and I have clients who have tremendously benefited from it. Okay, keep going. Yes, sir.

Taylor Goldberg [00:24:34]:

And so with that being said, if you’ve had an experience at the Chiropractor and you’ve left dizzy, that means something did not go well. And you should address that in that moment. You should never feel worse after an adjustment. If an adjustment causes pain, if an adjustment causes dizziness, if an adjustment causes an increase in symptoms that lasts longer than an hour, one, don’t get adjusted after that, but two, that something went wrong in that moment. It did. They missed something. They didn’t screen for something.

Michelle [00:25:09]:

1 million%. And this is something, and I know we’re going to have a larger conversation about, and I promise we’ll go through the science of this, too. But the larger conversation is we know in a lot of times functional medicine, even functional medicine, detoxing and fitness culture, chiropractic culture. What’s the name of the game? Taylor. No. Pain. No. And you’re like you could not be more the opposite.

Michelle [00:25:33]:

You’re like pain reflection. If there’s pain, no game. If there’s any pain, no game. Exactly. So I think that’s really important and something that it sounds like you really have gone very far away from your traditional learning in this no pain, no game model. Yeah.

Taylor Goldberg [00:25:52]:

100%. And that when it comes to chiropractic. Yes. 100%. When it comes to movement, not necessarily, but tolerable pain. There’s a difference between debilitating pain and tolerable pain and learning when pain is dangerous and when pain is just a sensation and something that we want to work through can be so valuable, especially in an exercise setting. But let’s backtrack a little bit. So moral of this story.

Taylor Goldberg [00:26:24]:

When it comes to hypermobility or HEDS, there is usually what we call the triad. And what that triad is, is mast cell activation syndrome, some sort of Dysautonomia. Usually Pots or orthostatic hypotension, but there’s like 30 types of Dysautenomia. So if you don’t have one of those two, that does not mean you don’t have dysautonomia. And then hypermobility, which usually comes along with joint pain and fatigue and a bunch of other symptoms. Usually there is a trigger, like Michelle experienced when it was COVID, when it was mold. There’s usually a trigger of some sort that’s going to make your mast cells very angry and produce too much histamine. That increase in histamine, we now know, can actually increase the laxity in our ligaments.

Taylor Goldberg [00:27:11]:

So if you’re already bendy and now you have too much histamine laxity, meaning like looseness. Yes. So if you think of a rubber band, usually a rubber band, it’ll bounce back. If you pull it too far, it doesn’t bounce back. That’s usually what happens to ligaments in the HEDS population. And anybody who has ligament laxity. You do not have to have ligament laxity in order to be hypermobile, though. But they usually 99% of the time, go together, I would say.

Michelle [00:27:39]:

Got it. So hypermobility, the hypermobility of your joints is not only ligament laxity, it’s really that, like you said, that if you’re able to extend past the point of what is considered normal range of motion, essentially.

Taylor Goldberg [00:27:53]:

Yeah, exactly. So ligament laxity is actually going to be more in the instability conversation. Whereas hypermobility is a symptom. It is not a diagnosis. Hypermobility is a symptom of a lot of things, but in this conversation, we’re talking about Eds specifically.

Michelle [00:28:10]:

Okay. All right. I’ve never, by the way, had a guest on where I’m like, seething with interest. Okay. I don’t even have the word.

Taylor Goldberg [00:28:20]:

Taylor I love it.

Michelle [00:28:22]:

There’s no editing that will be necessary because I want people to understand how intense I feel right now. Taylor. Okay. He doesn’t need to cut that line out. All right.

Taylor, please share your hypermobility story.

Taylor Goldberg [00:28:31]:

Yeah. So obviously I was in chiropractic school and a little bit of my backstory. I’ve actually always known I was hypermobile. I knew I was hypermobile since second grade, which is super rare, hopefully will be more common now. But back then, that was unheard of. And I have my mom to thank for that. My mom is literally a rock star. Most amazing human being ever.

Taylor Goldberg [00:28:52]:

Regardless, I’ve always known I was hypermobile. I also didn’t really take it that seriously. It didn’t really mean much to me. I wasn’t that symptomatic as a kid.

Michelle [00:29:01]:

It.

Taylor Goldberg [00:29:01]:

Really only affected me in school because I wasn’t able to hold a pencil. But then I got into occupational therapy, and I was able to hold a pencil again. And so I didn’t really think, oh.

Michelle [00:29:11]:

That actually you weren’t able to hold a pencil because you were so hypermobile. That’s so interesting. Taylor and sorry about that experience.

Taylor Goldberg [00:29:18]:

Couldn’t write until second very to me.

Michelle [00:29:24]:

It’S so obviously like this muscular joint issue because you’re such a verbal person and able to express yourself through writing and things like that. So it obviously was not like any sort of cognition. It was just like physically, literally, I.

Taylor Goldberg [00:29:37]:

Couldn’T hold the no, we can talk.

Michelle [00:29:39]:

About neurodivergence and how it ties into all of this, too. But anyway, go ahead.

Taylor Goldberg [00:29:42]:

Which I also have that. Yeah. So now fast forward. Go through my whole life really not feeling much. I get to college. I get to college. And I actually was in an Orange Theory class. Not calling out Orange Theory at all, but I was in an Orange Theory class, and I was lifting weights how I normally do, and a trainer told me if I continue to lift with my bad form, I will never be able to lift my arms overhead again.

Taylor Goldberg [00:30:09]:

And I took that for what it is and stopped lifting. And that’s when a lot of my symptoms started to come on. That’s when I started to get really bad neck pain. And that’s actually when I started going to a chiropractor more regularly, actually, was during that time period of my life. Now fast forward, I’m in Cairo school. I still do have neck pain at this time. I am back to lifting weights, though. And now I am getting adjusted pretty much every single day because that’s what you do in chiropractic school.

Taylor Goldberg [00:30:41]:

And I didn’t really think anything of it. I didn’t think it was that dangerous. I didn’t know enough at the time.

Michelle [00:30:46]:

And again, it was the more the better. You’re like free adjustments. This is amazing.

Taylor Goldberg [00:30:50]:

Yeah, exactly. And also, I didn’t want to be that girl. Everybody wants to practice on each other. We’re all helping each other out. I just didn’t want to do that. And then I didn’t have a choice because I got an adjustment and.

Michelle [00:31:06]:

Things.

Taylor Goldberg [00:31:07]:

Were not good after that. I started losing feeling in my upper body, and I wasn’t able to swallow. And that was a big red flag, obviously. I went to the hospital. It only lasted 24 hours, luckily went away. I was fine. But I knew after that, adjustments are not okay for my body. And that’s when I actually got diagnosed with upper cervical instability and went through an upper cervical instability protocol made by my roommate at the time.

Taylor Goldberg [00:31:38]:

And now I literally have no neck pain, which is really cool.

Michelle [00:31:42]:

That’s freaking sick. And you also swallow, as far as I’m concerned.

Taylor Goldberg [00:31:47]:

Exactly. That was truly 24 hours. I’m very lucky that it was not a long term issue. It was a very short term nervous system issue in that moment.

Why isn’t there evidence based research about hypermobility and upper cervical adjustments?

Michelle [00:32:00]:

It seems like the gold standard for hypermobility diagnoses should just be, go get an upper cervical adjustment and see what happens to you.

Taylor Goldberg [00:32:08]:

I think you say that because I was having a conversation about this on TikTok, actually, and they’re like, Why is there no research on adjustments and upper cervical instability and adjustments and hypermobility? And I was like, well, it would be really unethical to put hypermobile bodies into adjustments to see if they’re safe when we have all of this anecdotal evidence that it hasn’t been safe. So it just would not be ethical to ever run that study. So it’s never going to happen. And so that’s a big thing in the evidence based Cairo world. And the evidence based PT world is.

Michelle [00:32:41]:

Like, we’re not evidence based, too. What are you going to do? Yeah, you don’t have it.

Taylor Goldberg [00:32:45]:

It doesn’t exist, and it’s not going to exist. And that’s okay. And so here’s the thing about being an evidence based practitioner, is you use what evidence you have to guide you, but you also use your clinical experience as well as your patient’s experience, the person in front of you, and you put it all together. So are there hypermobile people who have had neck adjustments and are totally fine? Yes, 100%. But are there ones that aren’t? Yes. Ask those questions. If there’s chiropractors listening to this, ask those questions and screen for hypermobility before you.

What impacts people who are hypermobile or who experience Mass Activation Syndrome?

Michelle [00:33:19]:

Two minutes from what you described. I mean, it literally takes two minutes. Every single patient should be screened for this. It would have saved me and you a lot of heartache. Although I will say I am quite grateful that this happens, that I can understand my clients better, too. And I believe functional nutrition is quite holistic, and we need to understand all these different things. And I just want to say, for people who are hypermobile or who experience Mass Activation Syndrome, what often the experiences in functional nutrition and medicine, and certainly in functional movement, evidence based chiropractic medicine, is that these people almost react to everything opposite from how other people will. Right? So it’s like someone who has Mass Activation Syndrome, they really need B vitamins to help their liver to function properly, right? And that will really help with the mass cell signaling, with the histamine receptors, everything, the release of histamines.

Michelle [00:34:08]:

But when they take B vitamins, their body absolutely goes into this threat response and absolutely flares up. It’s the same thing with movement. Like, the things that we need the most can actually flare us the most. So a massage, if your muscles are tight feels very intuitive and like, an amazing thing. But there is some non intuitive things about these conditions and syndromes because although I of course, believe that all of these syndromes we think of as being more temporary, like Pots, but mass cell activation. Well, mass cell activation syndrome is a syndrome too, but versus Mass Cell activation disease, right. We think of things. I don’t want to think of them as totally binary.

Michelle [00:34:47]:

I don’t want that people think of them, I am this now and I have this forever. But there’s always ways to move through it. Although there is some acceptance that maybe you can’t do things the same exact way you used to.

Taylor Goldberg [00:35:01]:

I like to call it as it is. Like, you do have a genetic connective tissue disorder that’s going to make certain parts of your life, one, harder, but two, also you’re going to have to do things a little bit differently than maybe you were taught or maybe that your friends and family have to do. And so instead of looking at this genetic connective tissue disorder diagnosis as like a life sentence of doom, I like to look at it through a different lens of, oh, now I know things that are going to help me. Now I’m able to learn how to help future me not be in debilitating pain all of the time. There is so much we can do to increase our quality of life when it comes to all three of these diagnosis that we’re talking about. And we just have to learn what is going to work for you because it’s going to be different for every single person, even if you have all three of these diagnosis, it’s a spectrum, so it’s going to be different for every single person. But regardless, it is okay to say like, I know I’m never 100% going to be flare free, but I also know I can decrease my intensity of my flares, I can decrease my frequency of my flares and I have the power to give myself relief. I don’t have to rely on anybody else.

Taylor Goldberg [00:36:12]:

I don’t have to rely and spend thousands of dollars on a chiropractic adjustment, on a massage, on whatever, every single week just to feel functional. I can do that myself. That is power.

Michelle [00:36:24]:

It is power. And there’s a real wisdom in all of these conditions in that you really have to learn how to take care of yourself again for what feels like the first time for many of us and really no one else can do it for you. Listen, if you have a little IBS, maybe a couple of supplements down the hatchet will help a little bit, right? It’s definitely for me, the learning curve of this for each individual client is very large and it’s like the biggest call home, the biggest call into taking care of yourself. And that is the news. I’m sad to impart from this podcast is you have no way out but through, which is like you have to rely on you eventually. But when you do that, man, the power from that is just like unbelievable. The power you can get from being your own best friend and your own person. Okay, we have to go to the science of this for a second.

Could people be hypermobile and have no symptoms and it’s not a problem for them?

Michelle [00:37:20]:

Why? I was dizzy in the first place. What the heck this mast cell activation syndrome has to do with all this other crap? All right, one question I’m going to ask you before I roll us through the science is Taylor, could people be hypermobile and have no symptoms and it’s not a problem for them?

Taylor Goldberg [00:37:33]:

Yes. So hypermobility asymptomatic hypermobility exists, and I’m extremely passionate about this because a lot of the times, especially in athletes, like gymnasts, cheerleaders, dancers, I have coaches all the time reach out to me. I have this athlete that’s hypermobile. I’m really nervous that it’s going to cause issues in the future. And we have to ask, are they symptomatic? Are they experiencing any symptoms? Now? With that being said, we have to know what symptoms to ask for. We can’t just decide someone’s asymptomatic because they’re not in, because that’s not the only symptom that is going to come along with hypermobility. When we think of secondary musculoskeletal manifestations, which is how you would diagnose something like HSD or hypermobile spectrum disorder, pain is one of them, but other things are decreased proprioception. So maybe you’re really clumsy and you walk into things a lot or you roll your ankles constantly.

Taylor Goldberg [00:38:31]:

That is a secondary muscular manifestation. That is a symptom subluxations. Painful or not, if you’re able to.

Michelle [00:38:38]:

Find subluxation for people, something popping out.

Taylor Goldberg [00:38:40]:

Of place, basically a subluxation is a partial dislocation, whereas a dislocation is a.

Michelle [00:38:46]:

Full dislocation, versus sub is the meaning partial. Got it? Yeah.

Taylor Goldberg [00:38:50]:

And so for a partial dislocation, they’re not always painful. A lot of hypermobile people do them on purpose. If you ever see the dancers who take their arms out of their socket when they’re dancing on stage, beyonce’s. Dancers do it all the time. That was my talent show trick since I was little. Don’t do those if you’re hypermobile, by the way. No party tricks. We don’t do party tricks anymore.

Michelle [00:39:11]:

Human beings, not party freaks.

Taylor Goldberg [00:39:13]:

Okay, yes, but that is also sign of symptomatic hypermobility. So pain is not the only symptom when it comes to looking for hypermobility. But if you are truly not experiencing any symptoms asymptomatic hypermobility does exist, it is rarer, it’s definitely less, but it does exist.

Michelle [00:39:37]:

Sure. I was hypermobile probably my whole life without realizing it really did not cause me any problems that I noted. And it only became a problem once I had this is what’s going to be like, what the heck to most people, these immune activations that were constant. Okay, so I had these events, and many of my clients have experienced this. I had mold exposure, I had COVID a couple of times. The combination of those immune episodes left my body in a place that was primed for me to feel the symptoms of existing hypermobility. Okay, so one thing that histamines do, which is again, this chemical messenger that we associate generally with allergies. But there’s actually receptors on every cell of your body.

Michelle [00:40:30]:

There’s mass cell receptors on every cell of your body. So we can have a plethora of symptoms from them. One of the things that’s really important in this conversation is that histamines can cause when you have excess histamines or your body’s not clearing them or your body’s not recognizing they’re there, and then more are pumped out. In the case of histamine intolerance is you have something called vasodilation. So when we think of high blood pressure, we often think, like, vasoconstriction is not good. So I’m making my hands into a fist. If you think of like, blood pumping right. We think of those vessels constricting.

What is POTS: Postural Orthostatic Tachycardia Syndrome?

Michelle [00:41:00]:

Right. Vasodilation is when your vessels are basically wide open and you’re not getting good blood flow. So what ends up happening is if people have consistent histamine intolerance or consistent histamines and they’re constantly vasodilating is they’re not getting a pump of blood to different areas Taylor pull us into. And that can lead to conditions of blood pressure and getting low blood pressure. We think of Pots postural orthostatic Tachycardia syndrome. We get that again because we’re not getting proper blood flow because something is signaling to our blood vessels to relax. Right. So what ends up happening is the areas do not get proper blood flow.

Michelle [00:41:44]:

And then eventually your heart is going to be like, hello, I need blood flow here. And we’ll try to do things to bring that heart rate up. So what Pots is characterized by is low heart rate or blood pressure that then there’s a result of high blood pressure or heart rate.

Taylor Goldberg [00:41:59]:

Wait, I’m going to stop you there for a second. So Pots is a type of Dysautenomia.

Michelle [00:42:05]:

And let’s do the nervous system yet.

Taylor Goldberg [00:42:08]:

Sorry.

Michelle [00:42:08]:

Go ahead.

What is Dysautenomia?

Taylor Goldberg [00:42:08]:

So Dysautenomia is our umbrella term for about 30 different conditions. The two we’re going to discuss are Pots, which is postural orthostatic Tachycardia syndrome, and oh, which is orthostatic hypotension. Both of those symptomatically have exactly what Michelle is talking about. That blood volume blood pooling issue where we don’t get enough blood pumping to our heart or to our brain, which can lead to a slur of symptoms, which we’re about to get into. But the overlying cause of these conditions is our autonomic nervous system, which is basically who’s in charge of the things we don’t think about. Breathing, swallowing, eating, digesting, all the stuff we don’t think about it’s in charge of. When we have an autonomic nervous system dysfunction or disorder, our autonomic nervous system is all out of whack. Maybe we’re in fight or flight too much.

Taylor Goldberg [00:43:03]:

Maybe we’re not in flight or flight enough and we’re in parasympathetic too much. I do see that sometimes, too. Usually it’s fight or flight constantly, constantly, constantly.

Michelle [00:43:11]:

But sometimes I’ve never met anyone who’s too calm. By the way.

Taylor Goldberg [00:43:16]:

You live in New York. Okay. Move to Oregon. You’ll meet a lot of people.

Michelle [00:43:21]:

Exactly. You’re like, let’s get it together. Be more anxious.

Taylor Goldberg [00:43:25]:

That’s how I felt when I got there. I was like, Why is everybody so calm? What is happening, Taylor?

Michelle [00:43:31]:

We have to mention really quick that Taylor’s family owns Utopia Bagels, which is a literal, like, this is Queen’s Legacy, like, serious action. I just need to say that. And Taylor lives in Colorado. But it was very funny because I grew up five minutes from Utopia Bagels. So shout out to Taylor’s family who owns Utopia Bagels.

Taylor Goldberg [00:43:50]:

Iconic. Iconic. Yeah. They also have a podcast if you want to listen to theirs. So dysautonomia the umbrella term. Your autonomic nervous system has some sort of dysfunction. This will lead to symptoms that Michelle is talking about. Now take it away.

Michelle [00:44:05]:

Okay. The reason why what you just said is so important is I went down one pathway of histamines that possibly interfaces with what can lead to Pots. That’s one. There’s a bunch of them. I can’t tell you how confusing it is for people, Taylor, for people to understand this. And I want listeners to zone in on what I’m saying. This is the most important sentence of the podcast. This heart rate characteristic condition, which we go to cardiologist to diagnose for us, is a form of disautenomia.

Michelle [00:44:43]:

It’s a form of dysfunction of our autonomic nervous system, which means that nervous system work has to be at the core of what we do with Mass Activation Syndrome, Pots and all these, because mass Activation syndrome is highly influenced by our nervous system and our autonomic nervous system specifically, too. But it took so long for my brain, honestly, to get to a point where I was like, what do you mean? My knees being weird and bendy is making me dizzy in some way or making my heart rate funky. What are you talking right, so in knowing that it’s dysfunction of the nervous system, I want you guys to come back to my story and Taylor’s story for a second and understand that things that are done on your neck taylor, why does our neck matter so much when it comes to our nervous system? What nerves are in our neck? That might be important.

Why does our neck matter so much when it comes to our nervous system? What nerves are in our neck?

Taylor Goldberg [00:45:35]:

Yeah. So I’m going to back up a little bit farther. First, I’m going to take you down the ladder of importance. So our first big thing here is connective tissue, connective tissue lines, every single thing in our body. When we dissect cadavers, it is so crazy to truly see literally this very little film on everything on your organs, on your muscles, everything in your body. When you have a connective tissue disorder, which is what HEDS is, which is what we’re talking about, that means it potentially can affect every area of your body. When we then sometimes have a trigger of some sort, like Michelle is talking about, that can be that cascade event that creates this histamine issue, which then in turn, can lead to autonomic dysfunction issues. And this is just one of the very many ways a connective tissue disorder can become symptomatic or can become triggered.

Taylor Goldberg [00:46:37]:

There is a lot of other ways, but this is one and it’s probably the most common right now. And we’re seeing that with the long COVID research that is coming out and they have now detected and shown that mass cell activation syndrome high histamine 100% can lead to autonomic dysfunction. So we do know that this is one of the ways, but again, it is just one of the ways.

Michelle [00:47:01]:

And you’re saying autonomic dysfunction and connective tissue are directly related as well?

Taylor Goldberg [00:47:05]:

Yeah. So your connective tissue is the headmaster, he’s the one that is in charge. If you did not have a connective tissue disorder and you got COVID, most likely it probably would not have led to a lot of the autonomic dysfunction.

Michelle [00:47:22]:

And a lot of long COVID. Is there studies now that show that long COVID and people with connective tissue disorders, it’s very interrelated. There’s a lot of other mechanisms of when COVID can smash you too honestly. But I would be interested if you knew of studies about that. That’s fascinating.

Taylor Goldberg [00:47:37]:

I wish there was like I said in the specific I get it.

Michelle [00:47:41]:

Yeah.

Taylor Goldberg [00:47:41]:

The connective tissue also just happened. I understand in the connective tissue disorder world we don’t have a lot of research and a lot of that has to do with because we are still categorized as a rare disease or rare disorder and we don’t have a lot of true studies done on any of this stuff. We just have anecdotal evidence and using our kind of critical thinking skills. But we are starting to make a lot of connections with the research being done in the long COVID population to the hypermobile population as well, which is really follow if you want to learn more about this, especially the research side of things. Courtney, I’m sorry if I pronounced your last name wrong. Jessmer, she works at the Norris Lab and she is in charge of finding the gene for HEDS, but she also has a subscription on her Instagram that will send you any research article with a summary about all of these topics. So highly, highly recommend.

Michelle [00:48:40]:

She’s awesome.

Taylor Goldberg [00:48:40]:

That’s awesome.

Michelle [00:48:41]:

We’ll definitely have that resource in the show Notes too. That’s fantastic.

Taylor Goldberg [00:48:43]:

She’s great. Also my resource page on my website has a lot of papers that we do have, but again, we don’t have that much yet. But I think it should be coming soon. So backing up now we have this latter effect. And now with Dysautonomia, it’s really important to note that Dysautonomia, so Pots is going to create a heart rate change of 30 beats per minute or more when you go from laying to standing, whereas orthostatic Hypotension is going to go from a blood pressure drop when you go from laying down to standing. They are two separate conditions but they merge a lot.

Michelle [00:49:19]:

Thank you. Yeah.

Taylor Goldberg [00:49:21]:

Now when you go to a cardiologist and you tell them, I’m having heart palpitations, my heart rate is so, so high it’s beating out of my chest. And then they do a heart rate monitor or they do an echo or they do an EKG, and your heart is normal, there’s nothing wrong with your heart. That’s because there is nothing wrong with your heart. You have an autonomic disorder. There’s something wrong with your nervous system that is causing your heart to have these symptoms of tachycardia, to have these symptoms of palpitations. And a lot of the times you’ll be told by your cardiologist, it’s just anxiety, when what you really need to be seeing is a neurologist or somebody that specializes in Dysautonomia, because unfortunately, not all cardiologists are up to speed on Dysautinomia yet. I do think it’s changing, and I have seen it changed a lot in this past year alone, but it’s still not where it needs to be.

Michelle [00:50:10]:

Yeah. When I had this one really bad flare after the chiropractor, the day after that chiropractor, my heart rate, I was like laying it was like 80. It went up to like 170 or something went standing. Very abnormal for me. I’ve always had extremely normal heart rate, extremely normal blood pressure, both and my blood pressure was very high, too. I have all the monitors here and I went to the Er and I walked in and I knew, I was like, hey, I have no history of heart issues. You’re going to do an AKG. It’s going to look gorgeous, I promise.

Michelle [00:50:37]:

I was like, I am suspecting I have Dysautonomia of some kind, and that changed the whole experience. So just something to keep in mind in the conversation. By the way, my heart rate is 170 and I’m having this conversation with the woman and I’m like, I can’t really see straight right now, and I can’t really see you right now. My blood pressure was insanely high and she was like, to be honest with you, you’re the most calm I’ve ever seen a person with this heart rate and blood pressure. And I was like, you know what? I work with clients with anxiety. I’m very used to keeping my brain calm, despite my body being totally uncom and totally raging right now. But that really set the pace because otherwise it may have been like, you have high blood pressure conversation, I’m going to refer you to a cardiologist who doesn’t specialize in it. And it was so foreign to me.

Michelle [00:51:19]:

I mean, I’ve literally never had any issues like that very and to have that happen again, it’s really hard, Taylor, for people who are not in our space. And it was hard for me to understand how someone touching my neck is going to make my heart rate erratic. And that is literally because, of course, our vagus nerve is you have nerves running down your body. And if you’re doing things that are going to activate you from a mental or physical perspective, you can have those consequences. And when we think of our nervous system, we do think of, like, you get a jumping heart, right? When you’re nervous. Even we think of the word like nervous, anxious. You get, like, a jumping heart. But this is, like, a very extreme example of how your body is communicating with you, where it needs resources and supplies of blood flow and things like that, too.

Michelle [00:52:08]:

So to get from there to there was hard even for my brain, because I’m like, why did this chiropractic adjustment just make my heart rate go wild? It’s hard for people to understand that. Yeah.

Taylor Goldberg [00:52:17]:

And so going back to the neck conversation, it’s more than just the Dysautonomia when it comes to your neck. So remember, your brain stem is right there. And when you have upper cervical instability, which is ligament laxity between your first vertebrae and your skull, or your second vertebrae and your first vertebrae, or all three, that can cause your vertebrae to hit your brainstem, which is really scary and really not fun. And that can lead to significant neurosymptoms, like dizziness, like heart palpitations. And that can be really confusing when we’re also dealing with Pots, because it’s hard to differentiate the two. It’s also hard to differentiate when anxiety comes into play as well, because, let’s be honest, anxiety does coexist with Pots, with oh, with Dysautonomia, with upper cervical instability, with all of this. And so the real question and how to distinguish within yourself, is this anxiety? Is this something else? Is it positional? Is it happening when you’re going from laying to standing? Because anxiety isn’t going to just happen every time you stand up. Is it happening when you’re moving your head really fast? Is it happening after an adjustment?

Michelle [00:53:33]:

By the way, don’t do that again.

Taylor Goldberg [00:53:36]:

Is it was I was talking to John about this the other day. I was like, sometimes I explain things to patients, and I do things that I know I should not be like.

Michelle [00:53:47]:

Hey, don’t do this. I’m like, you also are hypermobile. Taylor, protect your neck for me, please. I’m like, do not do that again. Thank you.

Taylor Goldberg [00:53:53]:

Okay. And so does it happen when you move your neck too fast? Does it happen after a jolty movement on your neck, like a cervical neck adjustment? Those are signs that it’s probably not anxiety. It’s probably something deeper. Is it happening when you’re just living your life normally? And is there anxiety that’s going to be a part of this? And do we have to manage that anxiety, too? Yes, 100%. But the two are not mutually exclusive. You can have both. Two can be true at the same time. And doctors can be extremely dismissive when they see anxiety on your chart.

Where can people find a professional to help them?

Taylor Goldberg [00:54:31]:

Find a new doctor. We live in a for profit healthcare system in America. You get to choose find a new doctor. If your doctor looks at your chart says, oh, that’s just anxiety, and is not asking deeper questions, if you feel like this is something bigger than anxiety or that this is positional by nature, find a specialist. The Ellers Analyst Society is a great place to look. Disautenomia International is a great place to look. They both have practitioner.

Michelle [00:54:56]:

Like your functional movement perspective. Is anxiety could the root cause of anxiety? Because everyone who’s at this point in my podcast, I’m sure, knows that I believe that anxiety is very not only mental, it’s quite physical as well. One of mine would be is it quite cyclical positionally, right? So that would be like is it every time you lay down at night your heart starts pounding like crazy? I would also be asking my clients who have been dealing with mass cell activation syndrome for a long time, they know the difference between body anxiety and brain anxiety, but you can get to know that too. And also I feel like if it’s mental anxiety and you use any of the tips that we have for anxiety that don’t really influence it, and you feel like it’s just if you can separate the physical symptom from the mental symptom, like if it’s racing thoughts or something like that, I still feel like racing thoughts is physical. I actually think every symptom anxiety is actually I don’t think any of them come from they’re all coming from a physical place. But I think tapping into the body is really important and I think pattern tracking is essential here too. Taylor because if people like my client, I have one client who every time it’s the 6th day of her cycle, she gets a histamine hike and she gets the same anxiety symptoms. I have another client who on day six gets the same ligament laxity symptoms.

Michelle [00:56:13]:

It really depends on the client. And you get to know your patterns. It’s something you do incredibly well with your client.

Taylor Goldberg [00:56:19]:

Really familiar. Exactly.

Michelle [00:56:21]:

You have them keep a flare journal, very similar to the work I do too, where we’re always looking for those patterns. But you are militant about your flare journal and you’re like, you better give me that flare journal.

Taylor Goldberg [00:56:30]:

I’m going to call you out here. It took me a while to get Michelle to know I’m not like a tracker.

Michelle [00:56:34]:

It’s so nikki. Nikki has like food journals. I’m like, we’re just like talking. I’m like we’re feeling a lot in our sessions. We’re not like recording. And a lot of my clients, by the time they come to me, they are so symptomatic, so uncomfortable that it’s too triggering to start a flare journal. And it’s just not my bag to be like a symptom tracker. But yes, I’ve been very good.

Taylor Goldberg [00:56:58]:

Taylor because you’ve been very I’m very proud of you.

Michelle [00:57:03]:

So on the scientific level, again, you have this autonomic nervous system dysfunction which can. Be kicking something off. Now, this is the interesting thing. If you’re having a combination of these symptoms, the Hypermobility Mass Cell Activation Syndrome and Dysautonomia, that triad you talked about, those can be happening from any one of those symptoms. So you can actually have a triggering event. You believe, and I’m sure for very valid reason, that a lot of it will come from a connective tissue triggering event. Of course I might believe that a lot of it will come from an emotional event or a viral event or an immune event, but it can basically be this cycle. And we are very aware of the cycle and what happens and those changes that happens and that cascade.

Michelle [00:57:42]:

But at the very heart of it and core of it is literally nervous system dysfunction. And I can’t even overstress how important this is because people think like, oh, what are you, Michelle, like meditate and then I’m going to not have hypermobility. It’s like not at all. But there’s no way out of the nervous system dysfunction through cardiac you can’t fix your heart because your heart’s fine. So it’s like these things that are categorized as other conditions are really nervous system leading to immune dysfunction, leading to connective tissue dysfunction. The question I want to ask you too is you said before, if you are hypermobile, don’t get a huge neck adjustment or move your head crazy. What is the response from the body onto the nervous system? Also, if you actually move something out of place, is your body like, hey, I really don’t like that, and kind of create a response. A leading question again, but tell us about that.

What is the response from the body onto the nervous system when you move something out of place?

Taylor Goldberg [00:58:35]:

So like I said at the beginning of this podcast, chiropractors can’t move bones. But if you have ligament laxity and you have an unstable neck or if you have an unstable joint, that becomes a whole different story because your bones are actually moving in and out, partially subluxing on their own. Now we add extra pressure to an already too loose system that is a recipe for especially in your neck, those vertebra possibly hitting your brain stem, possibly causing some upper cervical instability, symptomatic flares, possibly causing something like a CSF leak. Like I said at the beginning of this podcast, this is not for the general population. This is purely for people with hypermobility. And I want to make that very clear. The general population, you do not have to worry about this. I’m speaking to my hypermobile humans right now.

Taylor Goldberg [00:59:36]:

We do, we unfortunately do have to worry about this and we do have to take this into consideration when we get a neck adjustment. And we already have too much laxity in those ligaments. Our Vertebra, our first Vertebra and our second Vertebra can move too much and it can hit important structures leading to catastrophic disabling symptoms, unfortunately, and that’s also.

Michelle [00:59:58]:

Especially the brain stem, we obviously know your nervous system is going to be related to your brain stem. If you pop a hip out, does your body create an immune response or a nervous system response against that as well?

Taylor Goldberg [01:00:08]:

Of course. Yeah. And also think about anytime, any joint, if it’s a full dislocation, partial dislocation, regardless, there’s going to be inflammation in that area. And also your muscles go into spasm anytime you get a full dislocation or a partial dislocation, that is going to require some white blood cells to go towards that area. That’s also going to require some blood flow. And guess what? Most of us don’t have enough blood flow because it’s all stuck at our feet, and we got to get it pumping back up. So it’s this kind of big symptom train, if you will, of this loop of one hitting the other over and over, and they’re all impacting at a time. And going back to the whole mindset thing and mental component of everything, I do truly, truly believe that physical and mental go together.

Taylor Goldberg [01:00:58]:

And just because something is not coming from your head doesn’t mean that working through your mindset, working through your nervous system, can’t be helpful. That being said, it’s not the only thing. It’s not always the only thing. And there’s a huge difference between saying, this is all in your head. This is just anxiety versus anxiety is a part of your story. It’s a puzzle piece in your puzzle that we have to work on. But we also have a lot of other things. Because pain and symptoms are multifactorial.

Taylor Goldberg [01:01:26]:

They’re always more than one.

Michelle [01:01:29]:

You know, it’s very surprising to people when they are coming to me with Mass Activation Syndrome. And another amazing guest we had on this podcast this season is Ashok Gupta, the creator of the Gupta program. And of course, I know your clients have probably been through the Gupta Program. People are like, Why are you telling me to do a mindset program? I should be eating a low histamine diet. What are you talking about? And that’s because our nervous system interfaces with our immune system. And this piece that Taylor’s bringing in so beautifully, also our musculature, too, right. I’m assuming that our nervous system also directs which muscles we should be using during different times, right? Talk a little bit about that. Yeah.

Does our nervous system direct which muscles we should be using during different times?

Taylor Goldberg [01:02:04]:

So our brain controls everything. Our brain controls literally everything. It’s where our pain comes from. It’s where nociceptive comes from. That does not mean pain is in your head. And there are biomechanical causes of pain, of course, but tissue damage doesn’t always equal pain. Pain doesn’t always equal tissue damage. Regardless, tissue damage does sometimes equal pain, and we can’t ignore that either.

Taylor Goldberg [01:02:30]:

But when it comes to our muscles in general, they function only if our brain tells them to. If our brain doesn’t tell our body what to do, our body doesn’t do anything. It’s not capable. It is controlled purely by our nervous system, and each of our muscles have nerve innervation, so they’re innervated by nerves. And when there are injuries towards that area, when our nervous system isn’t doing what we needed to do, when you haven’t used something in a really long time, your body forgets how to use it, move it or lose it’s a real thing and it’s all affected. I forget your initial question though.

Michelle [01:03:06]:

No, you did it. Don’t worry, you did it. I think when people think of our muscles, we’re thinking, oh, my brain is not involved in this. I’m making my arm move, right? But if you think about something as daunting as like paralysis or something like that, we know that any spinal cord issue or brain issues can cause paralysis, right? So we have to understand that. And our bodies are very smart. And there’s not one episode in this podcast I’ve not mentioned evolutionary biology and I will not let it pass without me mentioning it. But if we think about again how our brains would work in that fight flight or freeze response, which is a massive activation of our nervous system, our body is going to divert resources, as in blood flow and blood supply to our legs so we can run, let’s say in that instance away from our digestion. Because it’s like we don’t need to digest things right now.

Michelle [01:03:49]:

It’ll want things to go there. And then the problem is there’s no venous return, right? Like we can’t get the blood back up after. So it’s really like this. All these conditions are the perpetual state of survival, the perpetual state of what it would look like if your body was constantly fighting a battle. That’s what it would look like, essentially. And of course that has to come from the brain, right? If you see a bear and then you get blood pooling in your legs, it’s starting in your brain. And that is what is the central theme of this conversation is that we think that our body is in different parts and is not connected. But if I get a neck adjustment that’s going to affect my immune system, that’s going to affect my nervous system, that’s going to affect my musculature, and that’s going to affect my joints, that’s going to affect every part of my that could affect my digestion, right? Because of your vagus nerve too, it affects every single other part of your health.

Michelle [01:04:40]:

So when you are a person who’s in a hypermobile body or you are a person who has special considerations, we have to understand too that anything that affects any of these areas is going to affect all of your organ systems. And the kind of safest bet in all of these situations for everyone where you will never fail is treating your nervous system with respect and love. There’s no way to fail doing that at all.

Taylor Goldberg [01:05:02]:

You can’t go wrong doing and it’s funny that you talk about when clients are like a low histamine diet that’s going to be my solution. Right? I get the same thing with exercise. I mean, I do a lot of nervous system retraining and a lot of nervous system stuff within my program and with my clients. And a lot of the time, when I ask clients what was the most surprising thing working with me is all the mindset stuff, all the nervous system stuff. I didn’t realize how important it was to regulate my nervous system in order to be able to exercise again, in order to be able to work again or to be able to do insert goal again. And we can’t ignore our nervous system. We just can’t.

Michelle [01:05:39]:

Yeah. I want to, though, a lot of the time, and we all want to, right? So I had this amazing colleague, client, and friend who had me on her podcast to talk about. I had worked with her on she had a spontaneous garlic allergy that happened, and it really wasn’t so spontaneous. She had a long dose of antibiotics that then disrupted her gut and disrupted her liver function and then led to mass Altivation syndrome and histamine intolerance. And she’s an incredible therapist. Molly Carmel I’m actually doing an incredible program with her coming up, but she was so surprised and angry when I sent her a plan for her histamine intolerance that did not involve food. Really? I didn’t say anything about food. I was like, we have to do nervous system work.

Michelle [01:06:19]:

She’s like, I’m a therapist here, okay? What do you mean? Like, I have to do nervous system work? What are you talking about? And it was, like, the last thing on my list for her. It was a lot of nutrient repair that had to be done, a lot of gut repair, and a lot of nervous system work. So it’s always surprising to people, and I think we answered the question of why, when it’s mass cell activation syndrome, why, when it’s Pots, do these damn people keep talking about stupid nervous system work? I want to fix the blood flow issue. I want to fix I feel dizzy. What do you mean, nervous system work? And it’s really just because that is, like, kind of the rootiest root cause when it comes to Dysautonomia or mast cell activation syndrome.

Why is nervous system work so important?

Taylor Goldberg [01:06:51]:

It’s not even the root cause. It is what it is. Like, Dysautonomia is what the condition is. It is literally what it is. It is a dysfunction of your autonomic nervous system. It’s not the root cause or anything. We can use whatever word you want to use. It’s just what it is.

Michelle [01:07:07]:

It is literally and it’s so, again, you can understand why people are like, what the heck are you talking about? Why does your heart rate have to do with this? And I think we answered that Triad question, which is what you work with day in and day out. And so, Taylor, I’m assuming the work that you do with clients on Dizziness or we didn’t even talk about diziness. It’s hilarious that I thought that was going to be the topic of the episode because we had too much foundation. I’m going to have to have you back, not jokingly and just do a full episode on diziness too, because it’s really important. But we had to lay a really strong foundation of very misunderstood, dismissed and invalidated conditions that people are experiencing and very dismissed and invalidated people. So I just deeply thank you for laying that context for us too. When it comes to these symptoms like Dizziness, these things, let’s say people aren’t working with a practitioner yet. Let’s say they suspect they have hypermobility.

Where should people start to even look or start to even help themselves?

Michelle [01:07:54]:

Where do people start to even look or start to even help themselves? What would you say?

Taylor Goldberg [01:07:59]:

Yeah, so there’s a lot of information on the internet right now, good and bad. Like any stay away from Reddit would be my number one recommendation. But my resource page is honestly a really good first place to start. The Ellers Danlo Society is an amazing place to start. They have a lot of resources there and then Disautenomia International would be my next place. But in general, if you are concerned that you are dealing with hypermobility of any sort, one, you can always reach out to me. But asking your PCP and saying print out the HEDS diagnostic checklist, bring it to them and say, I saw this online somewhere. I heard about this on a podcast.

Taylor Goldberg [01:08:40]:

I think I might be dealing with this. Do you think you could help me figure that out? If they are completely unwilling, find another one. But most of the time they will say, I don’t really know that much about this. Who can I refer you to? Say a geneticist. A geneticist is the one who’s going to kind of be able to put all the pieces together for you and look on the Ellers Danlo Society practitioner list, if there is a practitioner that specializes in this and ask for your PCP to refer you to them specifically.

Michelle [01:09:11]:

Beautiful. Okay, that’s really helpful. Also, Taylor, you work with clients one on one. I think we’ll definitely talk about how you work with people too. I think in all of these different I just these are for me like the conditions I’m working with with people or have experienced myself again the most what feels like scary, sudden, misunderstood, mysterious, totally non conventional medical knowledge, non conventional dietitian knowledge, non conventional chiropractic knowledge. I want to ask you, Taylor, how much hope do you have for this population of people that you are and that you work?

How do you work with people? How much hope do you have for this population?

Taylor Goldberg [01:09:46]:

Lot. A lot. And I can genuinely say because I have been in this world for a very long time, we are at the kind of peak and it’s getting there. Two years ago we would not be having this conversation because three, please. Yeah, no one was talking about this. When I told professors I had HEDS, they didn’t even think twice. They didn’t even say like, hey, you probably shouldn’t get adjusted. Like nothing.

Taylor Goldberg [01:10:12]:

It was just such like it was just something I knew, something that my mom had, something that I knew about. But I did not really understand anything about it or how it was affecting me or how common it was. We had no idea how common it was until the past three years. The past three years have changed so much. But when it comes to hope for this population, I see it day in and out. I see people improve. I see people get their quality of life back. I have my quality of life back again.

Taylor Goldberg [01:10:41]:

I’ve seen it with my own eyes so many times. But regardless, we know we can do so much to manage these conditions and to increase our quality of life. And if a doctor tells you there is no point in getting a diagnosis, there is no point in looking into this because there’s nothing that we can do for it. Run. That is a lie. That is not true. There is so much we can do to increase our quality of life. It’s not easy.

Taylor Goldberg [01:11:09]:

It’s going to take time, it takes work. I’m not going to sugarcoat it. But it is so possible.

Michelle [01:11:17]:

It’s like the most of conditions. That is not a one size fits all, a one fix. But the beauty is there’s so many tools available. And again, you work on your nervous system, you get some points. You work on your strength, you get some points. You work on your daily rhythms, your circadian rhythm, you get some points. You work on your food in every single area. I think you get those points.

Michelle [01:11:39]:

One thing we didn’t talk about that I just want to mention for 1 second, even though this is going to be one of them, I will absolutely be having you back because I didn’t even start with you, Miss okay. When it comes to strength and protein, I just think it’s really important to mention and just strength, really in all of this, tell me how important is strength and conditioning in all three of these conditions? In the triad?

How important is strength and conditioning in all three of these conditions that are inthe triad?

Taylor Goldberg [01:12:03]:

Yeah. So I’m going to back up because there was a really good point. You just talked about how you get points for doing this, you get points for doing that and talking about all the systems of our body. The reason that it affects all the systems of our body is because of the connective tissue lining everything in our body. So that was an AHA moment for a lot of people is why does this affect so many things? Because connective tissue literally lines every single thing inside of your body. Now, when it comes to strength, so when we’ve talked about our ligaments and when we have ligament laxity, we cannot change our ligaments. The only thing that can change our ligaments is a scaffold. We don’t have power over our ligaments.

Taylor Goldberg [01:12:40]:

Unfortunately. So our bodies are super smart and super adaptable and what do they do? They say, I need stability and our muscles get really tight and our muscles hold on for dear life and provide that stability that our ligaments can’t. Now what if our muscles aren’t ready or don’t have the capacity to handle that amount of being on all the time or of holding on for dear life all the time to create that stability? They get really tired and then they get sometimes very agitated or irritated or what most people will describe as knots in their upper traps or knots in their system, or feeling really your body.

Michelle [01:13:16]:

Trying to create the stability, it’s your.

Taylor Goldberg [01:13:17]:

Body trying to create the stability. And it’s confusing because it’s like I’m hypermobile, but I feel so tight. I’m so, so tight. That’s the number one symptom I hear all the time, I’m so tight. How can I be hypermobile and tight? This is why. And so why is strength training so important in this population is actually for a couple of reasons. One, we now know that it takes longer for hypermobile bodies to increase their muscle mass. And we know that we naturally have less muscle mass than the general population.

Taylor Goldberg [01:13:47]:

We also know that we need our muscles to be nice and strong so that they can handle the load that our ligaments can’t. That is the number one reason that strength training will usually help symptomatically in the exercise world. We don’t usually say that exercise is going to help with pain or help with symptoms, but it will help with overall health. And that is a good reason to do something like strength training in the hypermobile population. I don’t know that there is a true study that shows exactly what I’m about to say, so take it with a grain of salt. But I have seen a huge improvement in that tightness feeling, that symptom of tightness all of the time when we add strength training into our mix.

Michelle [01:14:32]:

Absolutely. And also we know that our muscle is an endocrine organ too. So it’s interfacing again, that endocrine. Then ultimately that immune system, we release cytokines, right, which are also going to be like admyokines and all these different signals from our muscle that also interface with the rest of our body too. So it’s extremely important. And again, if you can’t change the ligaments, you at least have to change the muscle. Basically. I’ve had you here for hours at this point.

Michelle [01:14:59]:

Okay, Taylor, you will be back because I want to do a full episode on Dizziness. So this is my commitment to everyone listening to this, that we will do this. I’m going to have all of your resources in the show notes, all the places people can find you, how can people work with you and find you? But I will have links obviously available for them as well.

How can people work with you and find you?

Taylor Goldberg [01:15:15]:

Yeah, so I do one on one hypermobility coaching for anybody in the world that is dealing with hypermobility symptomatically, you can reach out on my website. Michelle is going to provide the link. I also now created a course for muscular MSK practitioners. So physical therapists, occupational therapists, chiropractors who want to learn how to work with this population or already working with this population and want to learn how to better help their patients. And I’m really excited about that because it is so, so needed. Like I said, we don’t get taught this in school. We don’t get taught about hypermobility in school at all. And if you feel like you see a lot of hypermobility and you have no idea what to do with it and it can feel really defeating, look into my course.

Taylor Goldberg [01:16:01]:

I think it would be really helpful. And then any chiropractors, new chiropractors, if you’re a student, chiropractic student or new grad. I also run a mentorship with clinical concepts where we teach you how to be an evidence based chiropractor. So, yeah, that’s pretty much how you can work with me.

Michelle [01:16:18]:

You are all going to follow Taylor because you need to. I don’t care if you’re hyper mode or not. And Taylor, I have to tell you, I’ve never found another practitioner who does this thing that I do. And it’s not from an ego standpoint that either of us do this. It’s a quite loving thing that you do that I just want to commend you on, which is like, I send you a bunch of clients and you’re literally not hypermobile, I’m going to find you a different person. People do discovery calls with me and they will say, I’ll do the discovery call because I might be able to just send them to someone else. We’re deeply connected in these communities too. So I really thank you for taking the time even to talk to my clients and say, here’s the right fit for you, here’s not, here’s what you need, and for not just taking people’s money just because you know that they aren’t feeling well.

Michelle [01:17:06]:

It’s one of the million reasons why I think you’re an extremely special practitioner and you really are this kind of referral space, just like I feel like I hope to always be for people, the safe referral space, and I just want to commend you for that too. But if you are suspecting again you have hypermobility, if you’re noticing, like you’re going to chiropractors and trainers and you always feel worse and you never feel better, that might be a hint also that you might want to book a discovery call with Taylor. I cannot recommend this pathway of working with you any stronger. You have been formative in changing my life, and I really mean that. I’ve done a lot of episodes of this podcast. This was one of the most important I’ll ever do and I will certainly have you back on and I just adore you and thank you so much for being on today.

Taylor Goldberg [01:17:51]:

Right back at you. And I don’t think it should be complimented that we don’t take people’s money. I think that is what all of us got into healthcare for. I wish it didn’t have to be that way, but unfortunately it is that way, especially right now. But if you feel like you are being taken advantage of by your practitioner or your chiropractor and I see it all the time in chiropractic a lot. I see it all the time in really, any MSK setting, find a new one. I’m always open to a conversation. Even if you don’t think you’re dealing with hypermobility, but you’re having a rough time with pain in general.

Taylor Goldberg [01:18:27]:

I have a huge network of amazing providers that I 100% would love to see if any of them can help you. If I can’t, I will find you somebody that does.

Michelle [01:18:37]:

I’m going to start calling myself the tailor of nutrition. That’s what I want to be. That’s what I want to be. I feel so you’re the Michelle of the body. I think you’re really of everything and really those hypermobility people. Thank you so much, Taylor.

Taylor Goldberg [01:18:51]:

Thank you.

QTD: A New Perspective on Chiropractic Care and Hypermobility

Season 3 Episode 12 of Quiet the Diet Podcast with Michelle Shapiro, RD and Taylor Goldberg

A New Perspective on Chiropractic Care, Hypermobility, Dysautonomia, and MCAS with Taylor Goldberg

Taylor’s Resources:

Podcast Links:

Work with Michelle:

Free Resources:

Connect with Michelle:

Episode Transcript

A New Perspective on Chiropractic Care, Hypermobility, Dysautonomia, and MCAS with Taylor Goldberg

Please share your journey from a conventional chiropractor to a functional chiropractor.

What can you expect at a conventional chiropractic visit? What is an adjustment?

How able are we to change our posture through you roll your shoulders back or you do adjustments. Are we able to do that?

Let’s talk about our similarity of hypermobility and why adjustments aren’t suited for the two of us.

What do hypermobility and connected tissue disorders look like in the body?

Are you able to notice you are hypermobile yourself?

Michelle’s history and experience with a chiropractor:

Are chiropractors trained in hypermobility? How should you feel after a chiropractic appointment?

Taylor, please share your hypermobility story.

Why isn’t there evidence based research about hypermobility and upper cervical adjustments?

What impacts people who are hypermobile or who experience Mass Activation Syndrome?

Could people be hypermobile and have no symptoms and it’s not a problem for them?

What is POTS: Postural Orthostatic Tachycardia Syndrome?

What is Dysautenomia?

Why does our neck matter so much when it comes to our nervous system? What nerves are in our neck?

Where can people find a professional to help them?

What is the response from the body onto the nervous system when you move something out of place?

Does our nervous system direct which muscles we should be using during different times?

Why is nervous system work so important?

Where should people start to even look or start to even help themselves?

How do you work with people? How much hope do you have for this population?

How important is strength and conditioning in all three of these conditions that are inthe triad?

How can people work with you and find you?

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