The Biology of Trauma® With Dr. Aimie

Your labs keep coming back acceptable. Your symptoms keep getting harder to hold. And you have probably landed on one of two conclusions: either something is wrong with you that nobody has found yet, or something is wrong with how you are handling it.
I want to offer a third.
Full show notes
Three things change at the same time in this decade, and each one is invisible on its own.
Your immune baseline was set decades before perimenopause. Estrogen, which your immune system has been reading as an instruction every day for years, stops declining in a straight line and starts swinging. And cortisol, which is one of the most powerful anti-inflammatory signals your body makes, stops being received even while your body is producing more of it.
That third one is why a normal lab result can be a false negative. The all clear is being sent. It is not landing.
In this episode I walk through all three, and I translate the research into language you can use with your own provider. I also tell you why I stopped calculating ACE scores, what a hazard ratio actually means when you read one about your own health, and what has to be stabilized before anything else will hold.
Perimenopause does not create the autoimmunity. It does not create the pattern either. It removes the margin that had been holding that pattern quietly, which is why it feels like it arrived out of nowhere.
In this episode:
Why a cortisol test can read normal while inflammation gets worse
The four immune control points estrogen sits at
Why unpredictable estrogen costs more than declining estrogen
What "seventy percent increased risk" really means
Why I stopped calculating ACE scores
What has to come first, and why most people start at the wrong end
Resources:
Take the free 2-Minute Assessment for Stored Trauma: https://biologyoftrauma.scoreapp.com/?utm_source=podcast&utm_medium=podcast_audio&utm_campaign=ep195-autoimmunity-perimenopause&utm_content=show-notes
The Biology of Trauma by Dr. Aimie Apigian: https://www.amazon.com/dp/1637746237?tag=draimie-20
Full show notes: https://www.biologyoftrauma.com/post/episode-195-why-autoimmune-symptoms-get-worse-in-perimenopause
Full show notes

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I do not ask about your past. I do not get out the checklist of adverse childhood experiences. I am not calculating your ACE score. And I know how strange that sounds coming from a physician who works with stored trauma.
Full show notes
What I look at is the impact of your past on your today, because that is where it is still leaving its footprint.
In this episode I walk you through the assessment I teach practitioners, so you can run it on yourself. Three domains, one repeating pattern, and the equation that decides whether a stressor stays a stress or tips you into overwhelm.
Then I take you to the part that surprises people most. Trauma work runs on energy. If your body does not have the capacity, the work cannot integrate no matter how willing you are. Which means the most useful place to start is sometimes sleep, or brain inflammation, rather than the trauma itself. That is still trauma work.
I also tell you about the pattern I carried for thirty years, and how it changed without me ever going looking for the reason.
In this episode:
Why the word trauma gets in the way of finding trauma
The three domains I ask about, and the one pattern that runs through all of them
Your capacity against your stress load, and what happens when capacity is small
Where stress ends and overwhelm begins
Why perimenopause costs more capacity than most women expect
The nervous system dashboard, and the three things that feed it
Why I sometimes tell someone not to do the trauma work yet
How to find your biggest block without handing yourself the whole list
Find your pattern: Take the free 2-Minute Assessment for Stored Trauma
The book: The Biology of Trauma by Dr. Aimie Apigian
Full show notes
This podcast is educational and is not medical advice. Consult your own physician about your health.



Grab your copy of The Biology of Trauma

Your labs confirmed the autoimmune diagnosis. The hardest symptom turned out to be the one nobody prepared you for.

Dr. Aimie goes solo on depression and autoimmunity, and which one actually comes first. The answer is less orderly than the one most people are given, and it changes what to do about it.

➡️ Full show notes and research: CLICK HERE

Most people are told depression is a reasonable response to being ill. Dr. Aimie interrupts that conclusion with what the research shows: each condition carries close to double the risk of the other, depression turns up in the two years before a diagnosis is made, and roughly a quarter of the link between early adversity and autoimmune disease appears to travel through mental health on the way.

She also walks through why this depression rarely feels like sadness, and why the medication may have underperformed. She was on two of them herself, and the hardest part was not the depression.

WHAT YOU'LL LEARN:

0:00 The hardest symptom of an autoimmune diagnosis

02:41 — Why is depression treated as the reasonable response to a diagnosis?

04:49 — What does double the risk actually mean for you?

07:58 — What is a dose-response pattern and why does it matter?

09:45 — Where does the childhood adversity evidence stop?

12:19 — What does it mean that depression mediates part of the link?

13:54 — What happens when your cells stop responding to cortisol?

15:55 — Why does this feel like the flu rather than sadness?

20:48 — Why has working on your thoughts not moved it?

22:55 — Why do antidepressants underperform here?

24:54 — What does the infliximab trial actually prove?

28:48 — Where do you start when both are running?

"Depression is part of the road from I was healthy to I now have an autoimmune diagnosis." — Dr. Aimie Apigian

If the antidepressant did not do much and you quietly concluded something was wrong with you, this episode is for you.

RESOURCES:

Take the FREE 2-Minute Assessment for Discovering Your Pattern of Stored Trauma: You cannot change a pattern you cannot see. Find your primary pattern of responding when life becomes too much, then see how the other four show up.

Get The Biology of Trauma: Disease is one of the five patterns of stored trauma.

Nothing in this episode is a recommendation to change or stop a medication. Talk to the prescriber who knows your history.

This episode is educational and is not medical advice. Please work with your own qualified healthcare provider for decisions about your care.

Grab your copy of The Biology of Trauma

You have been doing the work. The therapy, the somatic practices, the self-care. And your body still will not come online.

You have also been doing the gut protocol. Months of it. And the exhaustion has not lifted.

Here is what almost nobody tells you. The thyroid governs gut motility. When it runs low and slow, the bloating and the constipation you have been treating from the gut end may have been downstream of the thyroid the whole time. So you can do everything right, in the right order, and still be working the wrong end of the problem.

This is Part 2 with Dr. Amie Hornaman, known as the Thyroid Fixer. She was misdiagnosed six different times in her twenties before anyone found it.

In this episode she gets practical about selenium, about which system to start with, and about why she thinks adrenal fatigue is overdiagnosed. She also gives a number for how long before your energy and stress resilience actually shift, with the caveat that belongs beside it.

WHAT YOU'LL LEARN:

Which to treat first when your gut and thyroid are both struggling

How a slow thyroid produces constipation, bloating and SIBO

The foundational nutrients she starts everyone on, and why selenium leads

Why one morning cortisol reading cannot tell you what you think it does

How long before energy, mood and stress resilience begin to move

The full show notes have the research behind the SIBO connection, every quote from the episode, the chapter list, and the optimal lab ranges to ask about.

Read the full show notes: https://www.biologyoftrauma.com/post/gut-or-thyroid-first-when-you-are-in-chronic-freeze

RESOURCES:
Get the Stress or Trauma Guide
Part 1 of this conversation

By listening to this podcast, you agree not to use it as medical, psychological, or mental health advice to treat any condition in yourself or others. This podcast is for informational and educational purposes only. Always consult your own qualified health provider.

Grab your copy of The Biology of Trauma

You have been doing the work. You understand your patterns. And you are still waking up unable to face the day.

When the body decides survival is the priority, it stops converting thyroid hormone into the form your cells can use. It produces an inactive version instead, called reverse T3, and that version blocks the active hormone at the cell door. The result is a body running low and slow. It is the same physiology I call chronic functional freeze.

Dr. Amie Hornaman ranks reverse T3 as the single most important thyroid marker, ahead of free T3, and it is a marker almost nobody orders. She also holds that stress and trauma on their own can raise it.

This is Part 1 of a two part conversation.

➡️ Full show notes, research and timestamps: https://www.biologyoftrauma.com/post/can-a-thyroid-problem-keep-me-in-chronic-freeze

WHAT YOU'LL LEARN:

Why a normal TSH does not settle the question of whether your thyroid is involved

What reverse T3 is, and why Dr. Hornaman ranks it above free T3

How stress and trauma can shift thyroid function directly

Why the hibernation state and chronic functional freeze are the same physiology

What happens to the thyroid in the year after an injury or accident

Why you cannot think your way out of a decision the body made below thought

RESOURCES:

Take the free 2-Minute Assessment for Stored Trauma: https://biologyoftrauma.com/quiz

Stress or Trauma Guide

The Biology of Trauma: https://www.biologyoftrauma.com/book

The Thyroid Fix by Dr. Amie Hornaman

Part 2 releases August 20, 2026.

Grab your copy of The Biology of Trauma