Episode 8 - Autoimmunity Shouldn't Be This Hard

🎓 This episode was inspired by something happening next week. On Thursday 29 October, Dr Andie Siggers and Robyn Puglia are collaborating on Clinical Principles for Autoimmunity Management, a full-day CPD event in central London headlined by Dr Datis Kharrazian. This conversation is a taster of the thinking behind it: what autoimmunity really is, and what we wish more people understood. Practitioners can find details and tickets in the "For practitioners" section below. Autoimmunity is usually described as the immune system making a mistake and attacking the body. In this episode, Mosaic Medical co-founder Dr Andie Siggers is joined by Robyn Puglia, who has spent two decades working in autoimmunity and educating clinicians, to explain why that framing doesn't hold up, and why it matters. Robyn walks through what she calls the "tolerance algorithm": the immune system's constant decision-making about what is self, what is a friendly stranger (food, gut bacteria) and what is genuine stranger danger. Autoimmunity is a loss of tolerance, and because the body doesn't do anything for no reason, the real question is what upstream communication led to that decision. They discuss why science that is now well established, including the discovery of regulatory T cells, took so long to reach everyday practice, and why diagnosis still takes 10 to 15 years for many people, with a long run of vague symptoms before a diagnosable disease appears. They also cover the three things that need to be in place for autoimmunity to develop (genetics, an environmental trigger and barrier permeability), why toxins are such an under-recognised trigger, how detoxification genetics vary enormously between people, and why hormonal transitions such as puberty, pregnancy and perimenopause are periods of higher risk for women. Finally, they get practical about what to do after a diagnosis, why "normal" bloods aren't always the end of the story, and why feeling heard and feeling safe are part of the biology, not just a nicety. If you enjoyed Episode 6, where Dr Camilla Stokholm spoke with Andie about what you didn't know about autoimmunity, this is a natural next listen. ABOUT OUR GUEST Robyn Puglia, IFMCP is a Clinical Nutritionist, IFM Certified Functional Medicine Practitioner and educator with over 20 years of experience in autoimmunity and complex chronic illness. She has worked with thousands of patients, mentored hundreds of practitioners through the clinical grey areas where protocols fall short, and taught autoimmune modules at leading UK nutrition colleges. Robyn has served as UK Head of Education for Cyrex Labs, specialising in functional immunology and testing interpretation, and has led practitioner training for labs including Genova Diagnostics, Doctor's Data and Regenerus. She works with complex and treatment-resistant autoimmune and coeliac cases, and runs the Autoimmune Academy, a mentoring programme for practitioners. Website: https://robynpuglia.com/ Instagram:   / robynpuglia   TAKE THE NEXT STEP 📞 Book a free discovery call with Mosaic Medical to holistically investigate and manage your autoimmune risk: https://mosaic-medical.com/ FOR PRACTITIONERS 🎓 Clinical Principles for Autoimmunity Management: a CPD study day with Dr Datis Kharrazian, Thursday 29 October 2026, Cavendish Venues, 22 Duchess Mews, London W1G 9DT. Dr Andie Siggers and Robyn Puglia are both involved in hosting and supporting the day and will be on the closing panel. Tickets: https://www.eventbrite.co.uk/e/clinic... 👩‍⚕️ Mosaic Medical Mentoring Scheme: group-based teaching and support for clinicians training in functional medicine: https://mosaic-medical.com/healthcare... 🧩 Robyn's Autoimmune Academy and practitioner newsletter: https://robynpuglia.com/autoimmune-me... DISCLAIMER This podcast is for educational purposes only and is not a substitute for personalised medical advice. Please don't start, stop or change any medication, diet or supplement without discussing it with your own doctor first.