MTHFR Myths, Psoriasis, Panic Attacks & Poop Shoes | Ask Me Anything

WATCH THE FULL-LENGTH EPISODE HERE ON YOUTUBE! 

Before we even got into questions this episode, the team spent a good five minutes debating whether a shirt was linen or Zara, whether a certain gray hoodie was actually from H&M's old "Divided" line, and whether I count as a "fall Scrooge" for hating pumpkin spice candles. Andrea's already fully in her "Bermons" era. I'm just saying a pumpkin doesn't smell like that. Anyway - onto the actual questions, because we had three good ones.

Heal Your Cells is officially out in the world as of this episode, which still feels surreal after two years of quietly writing it with Josh Axe. So this AMA comes with extra giveaways: a signed copy of Heal Your Cells, Gut Feelings, Intuitive Fasting, The Inflammation Spectrum, or Ketotarian, plus a free supplement protocol stack or a clinical case review with our telehealth team. Rate and review the show on Apple Podcasts and screenshot it to us on Instagram at @theartofbeingwell_ for a shot at winning.

Our first question came from a listener whose husband has dealt with chronic, itchy psoriasis for years - worse in the summer, mostly on his ankles and waistband, and he's noticed the same pattern in coworkers who also do concrete work. I think this is such an important question because it gets at something people miss constantly: psoriasis isn't just a skin problem, it's a case of molecular mimicry, where the immune system loses recognition of self and attacks the skin the same way it attacks the thyroid in Hashimoto's or the gut lining in Crohn's. Job exposures absolutely matter here - heat, sweat, dirt, and debris trapped against skin all day can be exactly the kind of chronic irritant that keeps a flare going, on top of whatever genetic and epigenetic factors set the stage in the first place. We talked through the gut-immune-skin axis, an elimination diet approach, gut-repair tools like marshmallow root and DGL, and even skin-healing peptides like BPC-157 and GHK-Cu. My favorite way I've ever described this on the show: it's like a scratched record. The DNA - the code - is all there. It's just not playing cleanly. Our job is to help that cell find its way back to reading the code correctly.

Our second question was from a listener named Lydia, an incoming freshman heading into functional medicine herself (which genuinely made my week), asking about her mom, whose heart-racing episodes escalated into full panic attacks a few weeks after she started taking methylfolate to prepare for another pregnancy. This is a great one to talk through because methylation gets treated like genetic astrology online - people find out they have an MTHFR variant and suddenly that's their whole personality. It's not that simple. A gene variant just means a gene is working at reduced capacity, not that it's broken, and the right response is almost never "avoid this vitamin forever." It's dose, form, and pace. We talked through the specific MTHFR variants and their real impact on gene function, why L-methylfolate or L-5-MTHF is the form to look for, how niacin and electrolytes can help take the edge off an over-methylated system, and why starting low and slow - sometimes literally one capsule — matters more than most people realize.

And then we closed the episode with something I genuinely didn't see coming: a listener asking whether wellness culture has officially gone off the rails with "poop shoes" - yes, that's a real seven-inch platform heel designed for squatting on the toilet. Here's the part I actually want people to take seriously underneath the jokes: the biomechanics behind squatting to have a bowel movement are real, and we've recommended the Squatty Potty for fifteen years for exactly that reason. Would I recommend seven-inch heels to my telehealth patients? No. But I respect that somewhere in this very online, very online-shopping culture, someone took a legitimate piece of physiology and ran way too far with it in the most extremely online way possible. That's sort of the whole story of health consumerism right now, and I think it's worth naming out loud, even while we're laughing about it.

A few of my favorite things we cover in this episode: 

• Ask Me Anything: three listener questions this episode
• Heal Your Cells is officially out, with new giveaways to match
• A listener's husband and his chronic psoriasis from concrete work
• Psoriasis as autoimmune molecular mimicry, not just a skin issue
• Why trapped heat and sweat on the job can trigger flare-ups
• Childhood stress and ACE scores as an overlooked root cause
• The gut-immune-skin axis and an elimination diet approach
• Gut repair tools: marshmallow root, DGL, and skin-healing peptides
• A teenager's question about her mom's sudden panic attacks
• MTHFR gene variants and the trap of "genetic astrology"
• How methylfolate dosing and form can overwhelm a sensitive system
• Simple ways to calm an over-methylated system: niacin, electrolytes
• The viral "poop shoes" trend and the real science behind squatting
• Dr. Cole's honest verdict on wellness gimmicks vs. real tools

Products Mentioned:

• Heal Your Cells by Dr. Josh Axe and Dr. Will Cole
• Gut Feelings by Dr. Will Cole
• Ketotarian by Dr. Will Cole
• Intuitive Fasting by Dr. Will Cole
• The Inflammation Spectrum by Dr. Will Cole 
• The plants & protocol that clear eczema and acne, with Dr. Barbara Paldus (episode referenced for the psoriasis question)
• Squatty Potty
• Additional Protocols/Products Mentioned:
  • The Methylator (methylation support)
  • MitoMultiply from Longevity Rx (whole-food mitochondrial/methylation support)
  • B-Better (broad-spectrum B complex)
  • Marshmallow root, slippery elm, DGL (deglycyrrhizinated licorice), digestive enzymes, spore-based probiotic, Boswellia, and aloe for gut-skin repair
  • Skin-healing peptides: BPC-157, TB-500, KPV, and GHK-Cu
  • Niacin (nicotinic acid) and electrolytes (sodium, potassium, magnesium) for over-methylation support
  • Folinic acid as a gentler alternative to methylfolate
  • Red light therapy and colloidal oatmeal baths for calming irritated skin

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Happy listening, and we hope you learned a little bit more on the art of being well!

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In Health,

Dr. Will Cole