The Dr. Hyman Show - 5 Steps To Prevent And Treat Autoimmune Disease Today

Episode Date: December 24, 2021

This episode is sponsored by Rupa Health and Athletic Greens. Millions of individuals worldwide are affected by autoimmune diseases including rheumatoid arthritis, lupus, multiple sclerosis, inflammatory bowel disease, type-1 diabetes, hypothyroidism, psoriasis, and many others. Simply put, autoimmune diseases are conditions where the body’s immune system attacks its own tissues rather than a foreign molecule like bacteria. This happens when something confuses the immune system.  In this compilation episode, I talk to Dr. Cynthia Li, Dr. George Papanicolaou, Dr. Todd LePine, Dr. Steven Phillips, and Dana Parish about out-of-the-box ways to treat autoimmune disease. We also discuss the importance of healing your gut and optimizing your diet, treating hidden infections, and more. Dr. Cynthia Li received her medical degree from the University of Texas Southwestern Medical Center in Dallas. She currently has a private practice in Berkeley, CA and is the author of Brave New Medicine: A Doctor’s Unconventional Path to Healing Her Autoimmune Illness. Dr. George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital. In 2015, he established Cornerstone Personal Health—a practice dedicated entirely to Functional Medicine. He joined The UltraWellness Center in 2017. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine’s focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body.  Dr. Steven Phillips is a renowned Yale-trained physician, international lecturer, and media go-to expert. Well-published in the medical literature, he has treated over 20,000 patients with complex, chronic illness from nearly 20 countries. Dr. Phillips experienced firsthand the nightmare of an undiagnosed, serious infection after nearly dying from his own mystery illness. He figured out how to save his own life when 25 doctors could not. Dana Parish developed Lyme-induced heart failure as a result of being improperly diagnosed by some of the “top” doctors in the country—and had her life saved by Dr. Steven Phillips. A chart-topping Sony/ATV singer/songwriter who has written songs for artists like Celine Dion and Idina Menzel, she has become a major voice in the world of chronic illness. Her popular column on Huffington Post has been read by more than one million people globally.   This episode is brought to you by Rupa Health and Athletic Greens.   Rupa Health is a place for Functional Medicine practitioners to access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, Great Plains, and more. Check out a free live demo with a Q&A or create an account here.    Athletic Greens is offering my listeners 10 free travel packs of AG1 when you make your first purchase here.

Coming up on this episode of The Doctor's Pharmacy. If you are suffering, there is a road for most people to recover. Stress is probably the start of all disease. Your doctor says your labs are fine, you don't have Lyme, but actually if you look deeper, you can actually find it. I always tell my patients that's like when the check engine light comes on in your car. Exactly. If you ignore that, you're going to get, going to get smoke coming out of the hood soon. Hey everyone, it's Dr. Mark. I know a lot of you out there are practitioners like me helping

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Just go to athleticgreens.com forward slash hymen. That's A-T-H-L-E-T-I-C-G-R-E-E-N-S dot com slash hymen. Now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Feehan, one of the producers of The Doctor's Pharmacy podcast. Millions of Americans are affected by autoimmune diseases, including type 1 diabetes, lupus, rheumatoid arthritis, multiple sclerosis, Crohn's disease, colitis, and dozens of others. On today's compilation episode, Dr. Hyman talks to Dr. Cynthia Lee, Dr. George Papanikolaou, Dr. Todd Lepine, Dr. Stephen Phillips, and Dana Parrish

about out-of-the-box ways to treat autoimmune disease. They get into the importance of healing your gut, optimizing your diet, and treating hidden infections. Let's dive in. so um the first thing i did was uh i went back to basics and so i did you know i i did not suddenly just start seeing an acupuncturist or start you know trying energy medicine or anything that's really alternative i was like okay no i'm a doctor off with crystals no i didn't i didn't uh and oh god meditation was like it was like pulling teeth so um no i went back to basics and i i took out my um pathology 101 textbook yeah right pathologic basis of disease robbins and cotran exactly that's the we all take it first second year medical school right and kumar kumar was my pathology teacher. Oh, wow. So I took it out. I still had it.

It was highlighted, dog-eared. I mean, and it actually was good for me. Like if I know neuroplasticity, right, it kind of brought me back to this time where I had more of a sense of agency over my life. So in that sense, it was also healing. I didn't recognize it at the time but I started reading about how diseases how chronic disease develops and you know about cellular repair and cellular injury and I was like wait a minute and and they actually talk about this was you know this

was published I don't even know which edition but 20 years ago yeah where they say the one cause, one effect paradigm does not work anymore. Yeah. Right. We're in this, this complex living environment where nutrition matters, where environmental toxins, I mean, this is 20 years ago and they probably wrote that several years before that was published. Right. So I started reading that and I thought, well, wait a minute. And then that diseases are not defined by a set of criteria. Yeah. This continuum, this process. Right.

And that. Yeah, that's right. I remember going back and reading chapter one and it said, any pathologic change is always preceded by a biochemical change yes which means that anything you see like on a microscope there's got to be a lot of years of stuff going wrong with your biochemistry and physiology before that happens yes and we years and we don't we don't know how to look at that in western medicine we just wait till you have something wrong and then we go yeah now i don't know what it is right right because in the

way that we've been trained inflammation which is what i had right widespread inflammation in my nerves inflammation in my gut inflammation in your brain in my thyroid exactly um it doesn't qualify as a treatable disease inflammation right no that's what i was joking say functional medicine doctors are inflammologists you know yes I love that. I remember that. From the first functional medicine conference I went to. Yeah. I gave a talk on that, right? Right.

Right. So that was a really big aha moment for me was, wait a minute. Okay. I understand this sudden disturbance, what I call it in Beijing, but then I had the thyroiditis before that, which was sort of the preceding trigger. And then before that, okay, wait a minute, you know what, when I was in residency, post-call, 36-hour shifts,

my muscles would feel really crampy. Like I felt like I'd run a marathon and I was dizzy. And I just assumed, well, of course everyone feels this way because they're exhausted. After not sleeping, right. Right. And so I started going backwards and realizing, okay, this has been going on for a long time. And for some people that can be really, know sort of disheartening but for me at where i was it was a little ounce of hope because it meant that i could sort of stepwise piecemeal

address inflammation in a way that i could tolerate what i was really afraid of because i was so brittle was having any kind of setback that would push me down further. And so if I could do it in a way that was more controlled and gentle, then it felt like something I could move forward with. So what did you do? What were the things that helped you recover? So one of the things was, yeah, was identifying- Because by the way, chronic fatigue syndrome was not something most people recover from, right? Right.

Fibromyalgia is not something people recover from. Absolutely. Unless you see a functional medicine doctor. Right, right. Or have some one of those spontaneous remissions, which is one in a million, probably. Yeah. Right? a million. Yeah. So what I ended up doing also was distancing myself from the diagnosis and the prognosis because it was more despairing. My marriage was held together by a single thread.

You know, I had two young kids. I had everything to lose. So I was like, if I don't get my act together and start trying differently, then I'm going to lose whatever, you know, what little I have left. So I was really motivated. And, you know, the first thing I did was really, I started reading about, well, I knew I had to get sleep. If I can't get sleep, I'm going to not have enough energy. So really looking, understanding the circadian clock. And, you know, I learned things that I was surprised I didn't know already. You know, I knew about the pineal gland and the hypothalamus and we have this master clock and we have jet lag and that's why, but I didn't know about every organ having its own clock, its own rhythm. And that's-

And even a whole field of chronobiology where the different kinds of chemo is better given at different times of the day to work better. Yes, I know. This is in conventional medicine. Right, and it makes, I mean, it makes complete rational sense, right? So I started, first of all, being more regimented

about just, okay, you know what, I'm gonna wake up, you know, and get up out of bed, even if I feel kind of all, being more regimented about just, okay, you know, I'm going to wake up, you know, and get up out of bed. Um, even if I feel kind of miserable, but I'm going to, my body needs to know that it's awake and that it's alive. So really basic fundamental, um, steps. And, um, and I learned that when we deviate, I mean, particularly when you're brittle like that i mean of course when we're more resilient like now i have much more flexibility but when when i was brittle you know any uh when you stray away so often from a routine it causes stress on the body so i was like oh okay this is maybe an easier way where i can reduce stress on my body yeah rhythm yeah we all live myrhythmic lives.

I feed my dog at the same times every day. Why don't I do that for myself? And he gets walks now at the same time. Why don't I do that for myself? So I started syncing myself also with my kids. Like, okay, I'm going to take care of my kids. I can take care of myself at the same time. So I think that also in that caretaker mentality you know as a mother or a partner or a doctor is we we tend to put ourselves last and so it was kind of time to put myself first you

know as my first patient that's good and so you did the rhythm and what else? Change your diet? And then yeah and you know a lot of it was just asking new questions. The diet piece I thought I was eating quote healthy you know which was largely vegetarian. I was cooking meals but also doing a lot of pre-packaged meals, but not a lot of processed stuff. And it wasn't until I saw an acupuncturist. So the acupuncturist that I saw, Robert Levine, who's in Berkeley, California, he was brilliant, really brilliant. And he's still practicing, and he's a dear friend of mine, a mentor of mine. I learned a ton from him about understanding the body in terms of systems.

So when my thyroid was out of whack, it wasn't just my thyroid. It was my whole hormone system, which is tied then to the digestive system, which is tied to the immune system. Like it suddenly started making sense. The knee bone is connected to the thigh bone, right? Yeah, exactly. And the body is connected to the brain. Which is actually amazing in medicine that our entire training teaches us the opposite. That there's all these organ systems, right? We take the GI system and the liver and the lungs and the brain and the heart and the

hormone. And you go to specialists for every different part of you and nobody connects the dots. Right, right. And traditional Chinese medicine is actually a system thinking of the body as a system, and that's what functional medicine is. It's a systems thinking approach. Yes, absolutely. And so we can extrapolate that to any size system, right?

We look at our communities and our world, right? And one of the things I feel like that drives almost every everything if not everything that we do as individuals and that we do as societies is how do i get more energy yeah right my qigong teacher was talking about that how do we get more energy you know whether it's through you know qi means energy yeah whether it's through solar energy you know fossil fuels whether it's yeah i mean it's food nature movement um so you know i began to shift my thinking in relationship to health and disease in a much more living sort of embodied way so the but diet thing, he was the first one. He was like, you know, you're so deficient right now.

Like, I think you need more meat, you know, and you need more of these heavier foods. Like you're doing lots of salads and you're doing, which are great, but not for you right now. So I hadn't even thought about a personalized diet. And I was like, more meats, what are you talking about? You know, and this is before paleo days and all that. Meat was the enemy.

So I began researching ancestral diets and the work of dentist Weston A. Price. Price and Melvin Connors. Right, and it suddenly made sense. Like, oh yeah, okay, I'm gonna eat like my ancestors ate. I'm gonna prepare food the way my ancestors prepared so I can maximize nutrient density.

Nutrient density equals more energy. And then the gluten issue came up. I was really skeptical of it. It's one of the biggest drivers of thyroid disease, Hashimoto's. Yes, yes. And the celiac experts know that, but the endocrinologists don't right so there's no crosstalk there either and this is in conventional medicine right um so and i do

remember asking my endocrinologist like what can i do what can i do and he said nothing you know it's genetic oh gosh no it's not right right it's a genetic predisposition, but not predetermination. And so, but the gluten thing didn't actually arise. I think I was partly in denial about it. You know, there were lots of rabbit holes that I knew about, and I just didn't want to go down. As long as I was steadily getting better. It was my older daughter, who she was five at the time.

I was taking her to her first dentist visit. And, I felt like as a family ate pretty well shouldn't do a lot of sweets and but she had not just one cavity at her visit she had six cavities Wow yeah and I was floored so you know and the dentist kept saying well don't feel guilty don't feel guilty you know and I the dentist kept saying, well, don't feel guilty. Don't feel guilty. You know, and I was like, wait a minute. I wasn't feeling guilty until you just said that. But it made me investigate like something else is going on. Like I know how we eat. I know how she brushes.

And I know cavities happen. But like six, it just it didn't compute. So I started researching and that's when I came across Weston A. Price's work around the condition of teeth tied directly to diet. But then going deeper and then in my research, I came across gluten and gluten causing enamel defects, gluten, you know, causing inflammation in the gut, which therefore could translate into poor oral hygiene and or just conditioning of the gums and the teeth and um so that was just kind of another step in that process when i realized oh i got to go back and again this is not unconventional this is just traditional properties said all diseases begin in the gut so we're just kind of going back and I realized I have to learn I have to learn how to

heal my gut as another step did you still have digestive symptoms after that initial gastroenteritis in China or did it get better it was they were largely quiescent until I removed gluten. I removed gluten and I had massive withdrawal, diarrhea, irritable bowel. And again, this was kind of before the time that I realized I understood about detox and how healing happens is that often it gets a lot worse before it gets better and that it could be a good sign. So I was really frightened by how severe my my reaction was when i stopped gluten so i was thinking it was a bad thing um but then you know what i stuck with it and a week later it calmed down and then my health improved a notch so and not only that but you know

we changed the way that our whole family ate and um my younger daughter so my my older daughter's teeth like you know really basically resolved i mean they became really strong some of her cavities even filled like they recalcified and uh didn't have to get filled my younger daughter um who didn't really have any thing that, you know, was alarming, but she had like this perioral eczema, which is this dermatitis, which is very difficult to treat with. It's often dairy. With steroids, I mean, which is how we treat most dermatitis. And leaving red on the skin, they put steroids on it.

Exactly. Why is the skin irritated? Right, right. Coming from the inside, not the outside. So she had that and she had, she would get asthma when she got colds and both of those are totally, totally resolved. Off of gluten. Well, off of gluten, but also doing the ancestral diet. So off of dairy. Yes. Yes. Yeah. And, um, you know, so it was just one of those things i was like you know you can't make

this stuff up and um this stuff isn't written up um and it's very individualized so but if you look in the literature you know doctors say where's the evidence where's the evidence well there's 900 000 papers published every year most doctors haven't read that many of them and the truth is that most of the ones that are on these subjects are completely ignored. And when you put all the dots together, there's a pattern there in the data that suggests that these things are real, that there is something called leaky gut, that there is inflammation that comes from the microbiome, that foods do cause reactions in the body that lead to all these diseases, that heavy metals and toxins are an issue that cause

disease. I mean, there's no lack of data. It's just not data that doctors pay attention to in literature. Right. And, you know, and it takes on average 14 years. 17. Oh, 17. Oh, God.

That's not a good day. For information. That's not a good day. For information and research to translate over to clinical care. Yeah. I think that's not a good day. The guy who discovered that we should wash our hands before giving any surgery or childbirth was basically ridiculed for suggesting that doctors could be causing their patients to

get sick by not washing their hands. And he was basically exiled and ended up dying in sort of disgrace with no money and excommunicated from the medical community, Semmelweis. And it took 50 years for them to go, oh yeah, maybe we should wash their hands. Oh my God. Where's the science on that, right? Yeah, right, well, it was an anathema to doctors that, oh, you could suggest that a doctor

would be causing their patients to die from childbirth fever because they didn't wash their hands. That's nonsense. So it is tough to change medical paradigms. Right, right, but I mean, some of it is common sense. Yeah. We don't need science to show us that, right? Well, I mean, when they didn't know about bacteria,

common sense was, you know. Yeah, that's true. That's true. Yeah. So yeah, I mean, I kind of just did this stepwise progression to get to the point where I was much more able to get out of the house. Yeah. And then, and one of the the things i also

explored which i would say maybe is down the unconventional path was um i began to i began to shadow integrative doctors on just different um different paths in integrative medicine or sort of you know i didn't actually know about functional medicine at the time. So I was shadowing a, um, uh, an anthroposophical medicine doc, you know, someone doing like sort of anti-aging hormone therapies. Um, and then it was when I was shadowing a, um, integrative pediatrician who said, well, you know, what are you, this was, I i mean i was still unwell i was had taken off work for a couple of years and but i was starting to think like oh how does it how would

it look if i were to return to work like what are the different ways i could practice yeah and um it was the pediatrician who said what are you interested in i said well you know i really i love the traditional chinese medicine paradigm makes so much sense to me, the systems thinking, you know, about the gut, you know, sort of being the foundation of healing and I'm really, you know, ancestral health, you know, figures into it. And she said, it sounds like you, you know, you're interested in functional medicine. I was like, what is that? What's that? What is that? So, and she really strongly recommended that I go see the, take this course with Institute for Functional Medicine. So I, it was sort of a bone for me, right?

Like I could, I was aiming to get healthy enough to be able to travel, to go attend a conference. And so, and it came to Santa Monica and I and i live in in the bay area so it was it felt doable it wasn't yeah cross country and um and i went and it was i think i had that aha moment like you did when you you know listened to jeff bland i was like oh my god oh my god and like this is this is like this is something that's been developed and developing and there's a framework. I don't have to make this up. No. So it was a, it was a really important turning point for me. It gave me hope both in, you know, as a, as a patient, but also as a doctor. You know, the microbiome is one of those areas that is blowing

apart our traditional concepts, right? So the microbiome is this ecosystem of bugs in our gut. It's trillions of bacteria. It outnumbers our cells by 10 to 1 and outnumbers our DNA by 100 to 1. And it has been linked to everything from autoimmune disease, to cancer, to heart disease, to diabetes, to obesity, to autism, to Alzheimer's. I mean, the list goes on and on. So when you go to the rheumatologist, they don't go, how's your poop? But we do, right? So let's talk about the gut in connection to some of these diseases. We treat something a lot that's called SIBO. Now, when I went to medical school, this wasn't even a thing, but essentially it means small intestinal bacterial overgrowth, which means bad bugs growing in the small intestine where they should be sterile that have an impact on our health. So what are the

symptoms? How would people know they have it? And what kinds of problems are they connected to? And let's kind of get deeper into what our approach to diagnosing and treating is going to be. Sure. So you know I just want to be a little cautious here because we're jumping right into talking about a disease. Yeah. Well, it's not a disease. It's a phenomenon. It's a phenomenon. That actually causes all sorts of other problems. Right. We do have to give things labels, but it is a phenomenon that's connected to many different parts of our body and getting somebody better involves the whole lifestyle spectrum and it involves us using something

in the functional medicine realm that we call the matrix. And the matrix is looking at not diagnoses, but conditions. Yeah, let's talk about the matrix. Tell us more about them. What is the matrix? How does it differ from traditional diagnosis and why do we use it? For me to tell you about the matrix, you have to swallow the red pill or the blue pill.

Which one do you want to swallow? I think I'll take the red pill. Okay, take the red pill. That's the right pill. Okay. So anyhow, now I can tell you about the matrix. So the matrix is basically a construct that we have in our minds where when you start telling me, I have headaches, I have fatigue, I have belching, telling me i have headaches i have fatigue i have belching i have bloating um i have uh i have a diagnosis of hashimoto's thyroiditis migraines migraines we they don't become the end point they become part of the narrative of your of your disease and we we put together into a story we call the matrix. And so we look at assimilation, which is the gut. We look at energy that takes us from, you know, an idea of fatigue.

We rattle it down on our brain to what are the things in the body that control energy, right? And so we think about mitochondria. When we think about energy, we think about toxins. How do toxins influence the rest of your well-being? We think about our transport system our blood vessels our lymph drainage and the connection between lymph drainage in the brain and your gut leaky gut leaky brain things that we'll talk about and we we think about the hormonal

system neurotransmitters to adrenals to thyroids and we we place this all in our mind in this in this matrix this paradigm of thinking and then we make the connections we say okay what's SIBO okay well it's going to be symptoms bloating distension I feel like I've used the term food baby there's something always in my gut yeah when you have a food baby you something and you feel your belly blowed up that's called SIBO right that is SIBO you don't feel like you fully evacuate when you have a food baby, you have something and you feel your belly blowed up, that's called SIBO. Right, that is SIBO. You don't feel like you fully evacuate when you have a bowel movement,

you're fatigued, you get depressed, and you can actually feel your depression and it's related to how your gut feels. I had that food baby, I'm anxious, I feel depressed. It impacts my ability. And it can link to all sorts of other diseases, right? Yeah, fatigue. And then when we think about fibromyalgia,

we need to think about the gut and what's been impacted there. And we think about Parkinson's. 50% of people with Parkinson's actually have SIBO. Yeah. Now- Asthma. Right? And we don't know-

Autoimmune diseases. We know there's an observational connection there. We don't know anything about causality, but it's something you have to consider when you're thinking about other diseases. So the fatigue, the brain fog, the potential inflammation and joint pain, all of the gut issues, that's SIBO. And a lot of SIBO, we don't know all the causes. There used to be some standard ideas what the causes were,

but now we know that it's hard to determine. So the use of proton pump inhibitors and other- It's acid blockers, like Prolocec, Prevacid, all that stuff. hard to determine. So the use of proton pump inhibitors and other acid blockers. That's acid blockers, like Prolocec, Prevacid, all that stuff. All that stuff. And then we have stress plays a major role. And so that's some of the cause that's what SIBO can look like. And now how do we address it?

How do we get people back? I'm going to back up for a second. You mentioned these acid blockers because they're given out like candy. You can buy them in the drugstore. They're over over the counter now and people think they're safe and fine i remember when i went to medical school uh they just came out and we were told by the drug reps these are very strong drugs they completely shut down acid in the stomach you never want to give them more than six weeks and now people are on them for six decades you know and and what they do is pretty frightening literally they will help your heart

burn but the side effects which are not really side effects their effects we just don't like them so we call them side effects are bloating and diarrhea and distension all the SIBO symptoms and by the way they cause osteoporosis and pneumonia and prevent b12 absorption and zinc absorption and mineral magnesium absorption so they're not exactly so i just have to say this mark and i you know is that this is my this is the concern we all have for medicine when we we've been unplugged and this is the issue is that we have pharmaceutical companies that provide medications to our patients support sick lifestyle that perpetuates disease. Yeah, I love those advertisements on TV where they're like, don't worry, eat your like sausage and peppers and don't worry, just take this Prevacet or Vrilosac, take the purple pill.

It's ridiculous. It is. But on the functional medicine side, here's where the hard work is, changing the lifestyle to make it a healthy lifestyle. So people can, you know, be healthy, prevent disease. If they do get sick, then we help them change lifestyle because that can impact disease more than anything else. And then for people who are well or have gotten better, we can use lifestyle to optimize their aging. And again, using a term I've heard you use, age young. And that's part of what we do

here at the Ultra Wellness Center, the whole spectrum, prevent, treat, and then help people optimize and age young. Yeah, my goal is to die young as late as possible. So back to the SIBO thing, right? So once we make that, now, how do we make the diagnosis? So I always tell people, tests are good, but there's no perfect test. And, you know, your cognition, your doctor's ability to think through problems is the most important thing that they can do for you. Well, that's what we do at Functional Medicine, right? We think. We are thinking differently.

Thinking all the time. My mentor, Sid Baker, who's one of the leading, I think, medical minds of the last century, who's really pioneered a lot of the leading, I think, medical minds of the last century, who's really pioneered a lot of the visionary concepts of functional medicine. He says, we're in the name it, blame it, and tame it game. You know, we name and blame. We name the disease, then we blame the name for the problem, and then we tame it with the drug. So we say, oh, you're sad and hopeless and helpless. You have depression. That's what's wrong with you. No, it's just the name of what's wrong with you. It's not the cause. Then we go, oh, I know what you need. You need an antidepressant. And that's like, it just

doesn't make sense. Instead of what we do in functional medicine, it's called thinking and linking. Right. Think and link constantly. Everybody thinks you treat the same disease with the same treatment. And in functional medicine, you can have 10 people with migraines or 10- Treat everyone differently. Everybody's different, right? Absolutely.

10 people with lupus and everybody's treated differently because you're looking at what the root cause for them is. And I think that's really profound. Yeah. And I want to get back to the SIBO thing, but I just want to come back to the matrix because that's such a key concept. And you described all these biological networks, assimilation, which is the gut, defense and repair of the immune system, energy, how we make energy, detoxification, our transport system, our circulation, our communication systems, hormones,

our transmitters, our structural system. And all those are influenced by our lifestyle, by our thoughts, our feelings, our relationships, our diet, our exercise, our sleep, all those things. Intrinsic relationships. Yeah. And then they're also influenced by external factors like toxins, allergens, bad bugs, stress, poor diet. And those impact our genes to change the expression. And so we have basically our inputs that are a problem and then our lifestyle, and that causes disturbances in these systems. And no matter what disease you have, we use this model and every single chronic disease and even acute many acute disease are caused by disturbances in our biological systems and that is what functional medicine so unique at diagnosing and treating in a totally new way absolutely and so it's it's that constant

work around the matrix and one of the things that i said earlier is functional medicine is is hard medicine it's hard for the doctor it's hard for the patient yeah because you think you have to think right and you're constantly thinking and as you treat the environment of the patient changes so you treat you you begin the treatment plan and the patient comes back with a particular response and that response will be based on what is their lifestyle? What part of the lifestyle have they been able to change? Because it's a real struggle for people to change lifestyle. That's hard work. And then, you know, what are their genetics? You know, and how are their genetics? Because we, you know, use a lot of genetic testing here that help us

identify that. And so once they come back and they've responded to our first step of treatment, then we go around the matrix again. And we rebalance and we look, okay, okay. It's like tailoring, you adjust every time they come in. It's like a fine watch and you're just constantly working the gears, asking questions, having them tell their story again, retell their story.

I can't tell you how many times I have sat an hour and a half initial visit only to have the patient come back over a Zoom or a physical visit to the office. And I ask them the same questions. And all of a sudden they're in a different place. And I get a different answer that opens up a whole new realm of thinking about their disease, their health, and even their goals for their life. So every time I go around the matrix, I get that person better and better and better. So we don't treat 155,000 diseases. We just work with optimizing our biological systems in the matrix. That is the key to functional medicine. So that in a way it's very simple, but it's also very unique because each patient's

different. And for the patient, some of the changes are hard because we're asking people to change their diet or take different supplements. But the truth is that it actually ends so much suffering and helps them so much that people are so excited about it and they do it. And so it's actually many times very easy for patients to change because they see the results so quickly.

So let's talk about the SIBO. Let's get back to SIBO and talk about these cases. I think we should share some cases. Give an example of what we're talking about. Because it's sort of abstract. I would say that very rarely do I see SIBO by itself. And why is that? Because Mark, you've already talked about it.

It's the microbiome. When the microbiome is disordered as it is in SIBO and you have these bacteria growing or they shouldn't grow. And so you're now changing how food is processed, you're changing where it's processed, and you're changing the body's ability to absorb it. And what we know about the microbiome is those bacteria actually train our immune system. They're very closely related to our immune system. And our immune system identifies antigenic material from the bacteria,

and the bacteria is able to tell the immune system, here's what you need to be worried about, here's what you don't need to be worried about. Right? And so when we alter that gut immunity, we can create inflammation. And when we create inflammation, we begin to break down that that that membrane that's responsible for opening and closing and letting

good compounds and and and good nutrients in and keeping the bad guys out yeah when that breaks down we have leaky gut and now all of a sudden our immune system starts to see proteins and that have not been completely processed down to the peptide level that they're accustomed to and they start making antibodies against commonly eaten foods yeah so now this person with SIBO is sensitive to a plethora of foods that they eat every day which might not they might not be allergic to those foods, but they're sensitive to them. So now they're not eating. So they're coming with all these symptoms.

It gets exacerbated by almost everything they eat in their diet. And because now the disease process- Or they're eating and they don't know what to do, not eat, because everything bothers them. Right, right. And so now they can come in that sick. Now that their immune system is triggered, they have muscle aches.

They have joint pains. They have brain fog. Because now they're having- Fatigue. They have fatigue. Their mitochondria are being affected. Their brains are inflamed. They're being affected.

So now this person comes in and they may say to me, I have brain fog. I have this, I have that. I get the whole story and I hear the gut. Always start in the gut, right? So now what do we do? When they tell me there's symptoms, we order a test. It's called a small intestine.

Before you do the test, I just want to recap because what you said was so profound, which is that- I like being profound, thank you. No, I mean, it's a total frame shift. So most doctors don't think much about the gut unless you have direct digestive symptoms. And even when you do, they treat it kind of in a very linear way. But what you're saying is when those bugs that should be in our large intestine migrate up to the small intestine for various reasons, it causes an imbalance in there. And

that leads to a breakdown in the barrier which causes this leaky gut and then all these foreign proteins and bacterial components leak into the system your immune system goes ah that's not me and it starts creating a response and then you get systemic inflammation which is why you get brain fog and muscle aches and fatigue and joint pain all these things skin rashes acne whatever and and and people think these are all not connected, but they're all connected. That's why SIBO is such a great topic to start with. Yeah.

Because it connects the entire matrix. So tell us how we test for it. Now let's get into a case. Okay. So testing will be with a breath test. It's called a SIBO breath test. And we starve you for a day. Basically, we want to starve out those bacteria

that are living in the small intestine so they become metabolically inactive. And then you wake up in the morning and you take some lactulose which is like a non-absorbed sugar not absorbed sugar but before you do that you breathe into a little balloon and then we put that aside as your baseline um test then you drink the sugar drink and now the bacteria are like we we got some food we're excited we're starving out thought we're we're doomed and then they get metabolically active. And then within 30 minutes or 60 minutes, when they're metabolically active, they start producing the exhaust of their metabolism, hydrogen, and then sometimes methane, and even sometimes sulfur gases.

So it's not just the cows that are burping methane? Nope. Humans? Nope. Yeah, Uncle Art's been belching methane. So if you have SIBO, you're contributing to climate change is that it yep that was going to be when you when we get to the magic wand question i'll talk about my wife anyhow so there's also other tests like urine tests you can look at metabolites right yep you can look at yeah so yeah we can look at where it metabolites that will show us markers for

dysbiosis in the gut using an organics test. So an organics test is when we look at all the organic acids that are products of your metabolism. And so we're able to tell, we know what should be in the metabolism appropriately, and we can look at organic acids. And we do that as a part of our GI work. Which is a test that traditional doctors don't do. They'll do the traditional breath test, but they're not going to do an organic acid test. Organic acid test or something even more advanced called an ion profile that looks at all of your amino acids. And that's important when I do a SIBO workup because if I look at your amino acids and you're depleted,

then I know you're really in trouble with your SIBO because you're not getting good nutrition. You're not absorbing. And then I can see markers of inflammation on the ion test. I can also see the organic acids are really critical because there are things that the bacteria produce that will end up in our urine that indicate to us that, wow, those things are in the urine because you have bacteria overgrowing or don't belong in your gut. And now we find out- I think you're right. I'm going to jump in with a case that just reminded me of a little girl I saw years ago

who was nine years old. And she's a pretty little sweet looking girl who was a monster, like a terror. She would constantly get kicked out of class. She literally couldn't make it home on the bus without the bus driver having to stop 10 times to settle her down. She was violent. She would rip you know her pictures of a part of her family at home she would terrorize her sister and i'm like what's going on

with this girl right and we did a whole workup and we found her organic acid test and we found she had massive levels of overgrowth of bacteria yep she had overgrowth of yeast, which is not called SIBO, but SIFO or small intestinal fungal overgrowth. And what I did was I gave her an antibiotic and an antifungal and literally the girl completely transformed. So you think you're treating a psychiatric disorder with antibiotics and antifungals. How does that make sense? Well, it makes sense when you understand the connections between the gut and the brain i mean this was over 10 years ago and i remember writing about it in the ultra mind solution like wow you know the gut is so connected another one with ocd the same thing she had high levels of ammonia and she had

severe ocd she wouldn't put anything off the floor i gave her an antibiotic and literally she became like neat freak it was the weirdest thing. Oh, yeah. Now, so I would. So in those cases, in the cases I've seen, SIBO is very commonly related to neuropsychiatric disorders. So when I have people with memory loss, brain fog, ADHD, just as you said, I've had I've had multiple patients of mine. Autism. Right. Autism. The first thing we do is treat their SIBO, change their diet.

And within the first six weeks, we're starting to see significant change in their behaviors with ADHD and in their verbal abilities with autism kids. Tell us the case. So I was going to talk about a fibromyalgia case, but I will talk about ADHD. I had actually an anxiety depression case talk about both of them yeah talk about them why there's so many cases i could choose from um uh there is um a recent case um from a patient from a different part of the world actually came in and they were having lots of difficulties with their child very bright siblings but this particular they were having lots of difficulties with their child, very bright siblings, but this particular child was having lots of issues with impulsive behavior,

tension in the classroom, moodiness, to the point where the child would speak of not wanting to live anymore. And so I went through all of their symptoms and the biggest thing that this child had a difficulty with was the bloating and the distention. That was constant. Mom noticed it from almost day one of life. So we did not only the SIBO breath test, but we did something called a GI map test, which we'll look at. It will, using DNA and PCR technology,

look at all of the bacteria in your gut the major colonies major species look for candida and then also look for markers of inflammation those two tests on this patient indicated severe disruption of the balance of the microbiome the patient was the patient was put on a brief elemental diet, which is a diet that takes out most foods. All the foreign proteins. All the foreign proteins. And then was put on a autoimmune paleo diet. And very difficult to put a kid on, a diet like this.

Which basically starves a lot of the bad bacteria. Absolutely. So instead of feeding them with all the starch and sugar and carbs, which they love, you're giving them less of that. And we combined it with a low FODMAP diet to make sure that the child got all the nutrition they needed. And FODMAP is like what?

It's like... So those are long chain sugars that get fermented very quickly by bacteria. And when you eat them and you have small intestinal bacterial overgrowth... You get a very big food baby, like nine months pregnant. Right. And the food baby is this basically, you're fermenting food where you shouldn't be. Food's meant to be fermented in the large intestine,

and that's like Florida, right? But you know, what's happening with small intestinal bacterial overgrowth, bacteria are up in Maine, and the food's coming into Maine, Maine's not ready for gas. So now all of a sudden you've got this gas where it doesn't belong geographically, you feel very uncomfortable, and it starts to impact everything we talked about. Your nutrition, your inflammation, and that translate to that gut brain connection, the

brain gets affected. That's why we see so much benefit when we treat diseases like SIBO and dysbiosis in our patients with neuropsychiatric disorders from ADHD to OCD to anxiety and depression. And you've noticed it. I know we've talked about even like Parkinson's and other disease processes that will stabilize once we start addressing gut issues. So what happened to this kid then? So we had the six-week follow-up and we had started, no, it was actually not the six-week follow-up, but the six-week follow-up, we went over all the testing and we started the second part of the nutrition

plan. Once we started the nutrition plan and I used some natural herbs to get rid of some of that overgrowth. So sort of antibacterial herbs. Antibacterial herbs that come in different compounds that we use. At the eight weeks later, that child's behavior, the mood swings were completely gone. Completely gone, the impulsivity was drastically reduced

and the teachers were saying he was now paying attention in class. And that was just with food. No stimulants. No stimulants. It's just herbs like oregano and berberine and thyme and things like that. Powerful stuff.

Yeah, and so that's the SIBO story. It's that gut brain connection, it's so powerful. Brought back some bad memories because we talked about the food baby. When I got sick from mercury poisoning almost 30 years ago, one of the things mercury does is it interrupts all your enzymes and your function. So my gut became very dysfunctional.

And I remember literally having food babies all the time. I literally almost couldn't eat anything without my stomach blowing up and feeling like someone just pumped my intestines up like a bicycle tire. And at that point in time, we didn't really think about SIBO, we didn't really name it, and we weren't really aggressively treating it. I was trying things that I thought would work, but it was really tough.

Until I got rid of the mercury, I couldn't get rid of the SIBO. So often there's something underlying it. There's often a root cause. I've seen people with gut issues that maybe were caused by Babesia, for example, which is a tick infection, which can paralyze the gut. Right. So if I have a SIBO patient that's not getting better, I think two things. One is I think about Lyme disease, if one of the one of the symptoms of lyme disease and is a

trigger to test somebody for lyme is when they get bell's palsy lyme disease can affect the nervous system yeah and so bell's palsy is when you have your facial nerve is paralyzed and it can be caused by lyme the same thing can happen in the gut you can get a paralysis and a dysfunction of the migrating motor complexes, and now the peristalsis of the intestine is declining. The intestine won't move. Now these bacteria can stay there and populate. So again, it's all these things that can impact it.

And that's the thing, you know, when you go to a traditional gastroenterologist, you might say, okay, we do the breath test, you have SIBO, take these antibiotics, forget about the yeast stuff, and like I'll see and help cause things. And there's so many times it fails because they're not getting the root cause. So the root cause may not be SIBO.

It might be something that's causing the SIBO, like Lyme or like mercury or something else. And there's something else too, going back to lifestyle. When I can't get a person better with SIBO, and I start going around the matrix again, are you sleeping? Are you exercising? How's your marriage how

your relationship do you have a toxic relationship because the people that i've done everything for i've given them the bone broth and colostrum and um and and uh you know elemental diets they're not getting better it's the fifth r R. We use the five R's, right? We use remove, repair, restore, and I can't remember four. It's remove, replace, re-inoculate, repair. Rebalance. Rebalance. And the rebalance piece, the fifth R, I call it fifth R.

It's the fifth R. It's getting people to rebalance their lives. And that is basically, are you dealing with your stress? The people that aren't dealing with their stress, aren't getting their sleep, aren't exercising. And how would a stress have to do with your intestines? That's another podcast. Come on. Give us a nugget here. Okay. So stress. So stress is probably the start of all disease. It impacts everything from your hormones in your own body. But stress actually creates some neurochemical changes in your brain.

And there's a communication between your brain and your gut microbiome. And your gut, it's called the second brain. It's the second brain. Some people think the gut was the first brain. Maybe. Right? And that our brain only developed once mitochondria were starting to make energy force and then we're able to convert, use that energy to make a second brain that allowed us to reason

and so forth. However, once you have that gut brainbrain connection, stress can actually, you know, we have this vagus nerve. It's a superhighway from the gut to the brain. And more, there's actually- It's the relaxation nerve. It's the relaxation nerve. And your brain can communicate anxiety and stress to your gut microbiome and actually change the makeup of your gut microbiome. Yeah, and your nervous system. Right, and your nervous system.

And it literally paralyzes, stress hormones literally paralyze your gut, your sympathetic nervous system and your fight or flight. You don't want to be digesting your food when you're running from a tiger. Right. You want your gut to shut down so you don't have to poop or do anything else. Right. So your gut shuts down. And that's what happens.

We live in a state of chronic stress and our gut's not working. It's not working and then you end up with, you know, now you create that environment for SIBO to develop. Yeah. I just, you know, talking about SIBO, I just remember this patient I had a few weeks ago was, was what a striking case. She came in with what we call vestibular migraines, which is essentially a migraine from hell where your room is spinning around, you're in bed, you're nauseous, you can't get up. And she had it like 25 days a month. And she was a really smart young woman who you know wanted to go to graduate school and was basically in bed and so i started not just asking

about her headaches and she was she'd seen like 45 doctors and you know seen neurologists and everybody and she was on this medication nothing was working so i'm like what else is going on well i bloated all the time and my belly's distended i you know and i could see she was puffy and swollen she gained a bunch of weight she was severely depressed she was anxious and i'm like this is not a messed up person this is a person whose biology is messed up and i said well let's just try to put you on a clean diet, eliminate all the allergic foods. I gave her a non-absorbed antibiotic and an antifungal, basic nutrients, very simple. And I waited for a test to come back.

And she came back in. On the first time she came in, she had to leave the door open. She was so anxious. Her system was so in fight or flight. She couldn't even be in the room. She stood up. She's pacing around. I'd never had a fight or flight. She couldn't even be in the room. She stood up. She's pacing around. I'd never had a patient like that.

She came back six weeks later. She looked like a different person. I mean, not only was all the inflammation gone out of her body, all the fluid. Not only did she lose 20 pounds, but her gut was normal. And she hadn't had a migraine. Right. She was completely better. She maybe had one or two very mild headaches.

And when I got her test back, yes, she had SIBO. And I sort of could anticipate, based her history what was going on. But that's a case where she had been seen doctor after doctor after doctor. And these are the kinds of patients we see here where I often joke, because we've been here for about 15 years. Before that, I worked at Kenya Ranch, was the medical director. And I always joke I was a resort doctor, the doctor of last resort. And that's the kind of patients we see here. Or I joke I'm a resort doctor, the doctor of last resort. And that's the kind of patients we see here. Or I joke I'm a holistic doctor because they take care of people with a holistic patients.

A holistic problems. So, and the treatment for this is all the things you mentioned. It's diet. Right, we start with diet. You know, it's really diet lifestyle. And by the time patients get to me, as I said before, SIBO is just part of the whole complex.

Because once you've affected diet, then you're affecting how your hormones are working, your autoimmunity, and so forth. So we always start with diet because we can impact all the systems with a good diet. We had a visit from some friends of ours who ended up staying with us. And we had known them for years, but they'd never stayed with us. And we've always known them through sort of the sustainability work, right? So I had been doing environmental health. My husband is in public policy around renewable energy. So we knew them through work circles. And anyways, we were hosting them for a weekend and they come. We knew that the wife, Pia,

was also clairvoyant. So she was a sustainable architect and her husband was one of the leading climate physicists. So there was this very- That's a handy skill to have. Exactly. So they're a very dynamic couple. We knew about her clairvoyance through sort of hearsay, but we'd never experienced it up front and kind of never really were curious enough to go there. It's kind of woo-woo. Oh, yeah, exactly.

That's how I felt. So they ended up staying in our house. And one of the things was that my younger daughter was having night terrors for four months, which did not bode well for my insomnia. And we had tried everything. And actually gone out kind of on an alternative limb, too. She was doing chamomile drops and some homeopathy. But nothing really touched her.

And so Pia walks into her house and she starts coughing, coughing, coughing. And she said, there's something going on. The energy in this house is really heavy. Do you guys feel it? And we're all looking at each other like, okay, woo-hoo. Right, right. And she said, well, but it's really heavy. And so she said, do you mind if I just walk around?

So she's walking around, and she said it's heaviest in the girls' room. And so, you know, nothing opens your mind like desperation, right? Sure, right. So I just said. People only change when they don't have any P syndrome anymore. Absolutely. You know, anyEP syndrome is not enough pain. Yes. When people have enough pain, they're going to do whatever.

Right, right. And you hit that dead end, right? So I just said, I said, you know what? Maybe it's heavy because Sonia, my daughter, has been crying every single night, right? And she said, wait a minute. She said, no, no, no. It's the other way around. Sonia's crying because she feels the heaviness too. And I'm like, wait a minute. She said, no, no, no. It's the other way around. Sonia's crying because she feels the heaviness too.

And I'm like, okay, whatever. So she goes off to Whole Foods of all places, gets a sage wand, right? With a smudge stick, which I had never heard of before. It's a Native American way of creating energy. Exactly. So she just goes around. She said, well, it's really important that you come with me.

You're the lady of the house and your intention really matters. And I'm like, but my intention is I don't actually believe what you're doing. She said, no, no, just, just say whatever doesn't belong here needs to leave. And the thing that really convinced me to do it with her was, well, first of all, it's low risk. I mean, there was, right. I'm always looking for high potential gain, low risk. A little sage around the room.

Exactly, never hurt anyone. But she- Bad stuff, get out. She said that she had a vision and she described this vision of this man, you know, tall, slender, reddish brown hair, balding right here, wearing a plaid shirt. And it sent chills down my my just threw out my body because this was the seller of the house who we'd met three times like to a t and so she said died

he had not died he had moved out but he had not wanted to move out and she said that's just what keeps coming to me when i look at the energy and i was like okay whoa weird but okay like that's just what keeps coming to me when I look at the energy. And I was like, okay, whoa, weird, but okay. Like, that's really spot on. Yeah. So we just walked around. And, you know, and I was kind of just being very sympathetic, too. I sympathized with the seller, right, that he had to leave his home. Yeah.

So, you know, but I wasn't holding my breath. And from that night on sonia slept soundly amazing i mean you know to this day she's an incredible sleeper so you know and then there was still part of me who was like well you know there's no control you know how do we really know maybe it was coincidental but before pia left what she did was she said um i actually approached her and i said well if you can lift the heaviness in a house can you what's wrong with me can you lift the heaviness in my body you know i mean i'm much smaller than this house and uh she said oh you know it doesn't work quite like that um and she said but i can do one thing i can teach you how to develop

intuition which i had never heard of. I did not know that intuition was something like music or art, like you can develop it. Practice it. Yeah, you can practice it. And she was very pragmatic about it. And she said, no, no, this doesn't mean you're going to be clairvoyant, right?

But it just means that you can learn to open this other side of your brain that has probably been closed off for a long time because of your training and your upbringing. So she taught me how to do that. Well, she taught me what I needed to do to begin to practice to open up to that. And a lot of it was, it was so basic. A lot of it was just silencing my analytical mind and being in my body. And that second part was the hard, well, actually they were both really hard. They were both really hard.

Silence, analytical mind, being in my body because my body was so uncomfortable. And so she said, you know, you can only heal something that you are connected to. You can't heal something you're detached from. So that was healing on multiple levels, both that I had to inhabit my body, which was probably one of the biggest steps

in terms of healing, not being afraid of it, but going into it, and then also learning how to read sensations as messages, and not just symptoms that were making me miserable. Yeah. I always say the smartest doctor in the room is your own body if you listen to it. Absolutely. Absolutely.

So the intuition piece came in incredibly handy when I was introduced to functional medicine. I wasn't really practicing it because I was doing steadily better. Were you trying some of it on yourself? I was trying some of it on myself, but it was, you know, I mean, you know how it is when you're, it's like someone wants you to play a piano piece, you can't even read the notes yet, and it's laborious.

So I wasn't motivated. But then I go to the intro to Functional Medicine Conference and saw all these tools, but then felt overwhelmed. And then I was motivated to practice intuition. And I really learned to use intuition to guide me. Like, how do I choose what to do next? Is this the right diet for me? Is gluten really, you know, is it something that I choose what to do next? Is this the right diet for me? Is gluten really, you know, is it something that I can return to

or is it something that I really need to stay off of strictly? So it began to, it made that navigation much easier for me. And it's something that I encourage my patients to, you know, to develop if they're interested. It's simple, it just takes a lot of repetition and quiet listening. So you found one of the causes was gluten, right?

Mm-hmm, mm-hmm. And toxins you got from China that you worked on getting rid of. Right. Was there anything else? Yeah, so I did a lot of detoxes. So I learned how to balance my hormones. I think my hormones were really out of whack after that incident.

What does that mean? Well, my estrogen and progesterone levels were really low. So I, you know, for a while I actually took bioidentical hormones to just support my system so I could get strong enough, just to help balance out the immune system. And then as my whole system got stronger, I was able to really wean off of those. And just last year, even like 14 years later, I actually completely tapered off my thyroid medicine as

well. So I didn't know that was possible. Yeah. Amazing what happens when you learn how to take care of your body. Amazing. Yeah. Yeah. I mean, functional medicine is an incredible roadmap. It's really about thinking differently about disease. And it's what you said, it's about understanding the body as a system where everything's connected, where there are root causes of things that we can get to, where there's things your body needs like rhythm or the right food to help it restore balance and when you do that for yourself it works and often you know it's not something you even have to do in a doctor's office a lot of things that actually work to create balance are things that everybody can do whether it's eating well moving right sleeping absolutely meditating connecting you know being

the social support system and then sometimes you do need help to get rid of some of the drivers things like heavy metals or infections like lime which you said you had or mold if you're which i had and almost died from a couple years ago um allergens those those are the things that actually you know you might need a little help with but But if you're suffering out there, if you're listening and you're wondering, you know, what's the road? How do I get better? You know, I've been told that this is just something I have to live with, that I have to manage, that I have to take medications for. I encourage you to just have hope because if you are suffering, there is a road for most people to recover. And functional medicine is the GPS system

to figure out how to navigate that road. And it really is a powerful model. It's not the answer to everything, but it is a far better mousetrap than we were trained with in conventional medicine. And it's what I've done for the last 25 years. It clearly is what helped you recover. It helped me recover. And I wouldn't be able to do what I'm doing if I didn't actually understand the body in that way. And every day, you know, I remember first practicing functional medicine. I wasn't like for you, but I was like, I would tell people to do this stuff that was sort of outside the box of what I learned in medical school. They'd have severe migraines, you know, 25 times a month, or they'd be having severe irritable bowel, or they'd have, you know, an autoimmune disease and

and i would tell them to do you know change your diet do this do that and they'd call me back six weeks later whatever and they're like i'm better and i'm like you are really i'm like what that worked okay fine you know i was like i i really took me years and years to expect yes that people would get better because i was like well i, I don't know what I'm doing. I'm just going to try this stuff. And it seems to make sense and it's not going to hurt them. Right. And people just recovered.

And it just was amazing to me. I mean, I had a woman the other day who came in with vestibular migraines, which is a terrible kind of migraine where your head is spinning. You're in vertigo. It's like you were saying you experienced. She had severe migraines 25 is a terrible kind of migraine where your head is spinning you're in vertigo it's like you were saying you experienced she had severe migraines 25 times a month she had severe other quote other symptoms so she was seeing the neurologist for that but they weren't worrying about her gut and she was having severe bloating fluid retention you know digestive issues she had anxiety I mean she couldn't even come in my office without the

door being open wow and she was really smart young woman who wanted to go to be a nurse practitioner she was a nurse and it wasn't in her head and she was on all these antidepressants and psychiatric medications and any anxiety medications and uh vertigo medications and migraine medications you know the drill and i'm like well And then medications to counter those side effects of those medications. Right, and so, you know, I just followed the basic map of how do you help people restore health and function? And for her, I was like, well, you know,

she's got a lot of inflammation going on. I could see her, she was swollen, she had fluid retention, she had gained a bunch of weight. And, you know, I wasn't treating her migraine. I was helping restore her gut function. Yes. And I was helping her, you know, I wasn't treating her migraine. I was helping restore her gut function. Yes. And I was helping her, you know, eat a diet that was anti-inflammatory. And I was helping her with certain nutrients she was low in. And, you know, I never really had a patient like this

before, you know, that was that severe that had vestibular migraines. And in functional medicine, it doesn't matter if you've never seen the disease before because if you follow the principles of removing the stuff that's causing a problem and adding in the stuff that creates health, the body knows what to do. It's super smart. Right, the body figures it out. Yeah.

We don't have to. No. And so I just fixed her gut. She had really bad, I gave her stuff to clear out SIBO. She had bacterial overgrowth. She had fungal overgrowth in her gut. So I bad i gave her stuff to clear out you know SIBO she had bacterial overgrowth i should like fungal overgrowth in her gut so i cleared all that out i restored her gut with a gut health shake which contained you know polyphenols and cranberry and pomegranate green

tea and gave her probiotics and prebiotics and you know just fiber and things to help her gut few basic nutrients got her you know an anti-inflammatory gluten dairy-free diet came back six weeks later i didn't recognize her i mean she all the flu went out of her body she was bright and alert she was funny and had not had a migraine and was you know symptom-free her gut was completely better and she was off the medication that's amazing but i don't want to discount also the fact that you acknowledged her and validated her, right? I mean, which is a huge piece of healing.

I'm like, you're not crazy. You saw her. Yeah, I saw her, right? I mean, she was in bed and she, I mean, I could tell she wasn't a malingerer, she wasn't a whiner. Right, right. But it's easy to dismiss these patients and go, well, it's just, you know, they're just psychological or whatever.

Just give them some meds and kick them out of the way. Right, but then they're psychological because they feel miserable, right? Well, that's very important. I mean, right, right. I'm like, wait a minute, like, okay, we call these things. If your body isn't working, your brain isn't gonna work. The difficult patients are the ones

who are really suffering, right? That's why they keep coming back. That's why they're irritable. That's why. And your doctors called you a difficult patient. Yeah, I mean, I call myself a difficult patient. You wanna be a difficult patient. But it's the difficult relationships that force us to grow.

I mean, we have to start asking the question, like, wait a minute. And I would say it's like any other relationship, right? Even if one person is the one who's sort of being dismissed and is kind of miserable, I mean, both people in the relationship know something's not working. Yeah, that's right. So even before I got sick, I knew that the tools that I had in my doctor's bag were really limited. I already knew that. But that's kind of the best I could do.

But you didn't know what else was out there. I mean, you and I both have the experience of being knocked to our knees in order to figure out a different way. I don't wish that on all our medical colleagues. No. But I do wish they would understand that the paradigm that we learned is only part of the story. And that, yeah, everything I learned in medical school is useful and I use it and I rely on it, but there's another meta layer of understanding how the body is organized. Because those are just the piece parts. Like what does the puzzle look like when you put it together?

That's what functional medicine is. And it's such a powerful model. It's what we do at the Ultra Wellness Center in Lenox. You know, I have three other doctors, two PAs, five nutritionists. And we work with people from all over the world. We've like, you know, probably over 70 years of clinical experience together. And it's just amazing the kinds of things

that people can recover from. And now you're doing that in your own practice. You've written this great book, Brave New Medicine, which is a really fabulous story about how you as a physician understood that there's a different way to heal your illnesses and your autoimmune disease and all this weird nonsense that we don't know how to deal with in medicine.

Right, and sort of just what does it look like, the lived experience? You know, to your point, though, I mean, I write at the end of my book about this essay, this famous essay called Arrogance back in, I think it was 1980, in the New England Journal of Medicine editor at that time, or he had been retired, Engelfinger. He was dying from cancer and had written this very provocative essay where, I mean, he was talking about arrogance at the time, and I would say arrogance is probably not the vice of today.

I think it's more just not seeing, right? Not seeing or denial. It's a little bit of hubris, a little bit of denial. A little bit, right. And he had posed the question, what would medicine look like if one of the prerequisites for all doctors entering medical school was that they had a serious illness? Yeah. Like, what would it look like, right? Yeah.

And so, yeah, would there be more empathy? Would there be more belief? I mean, like this, this, one of the central questions in my life has always been around belief, right? Like what is true and what is not true? How do we make ourselves believe things if we don't? Um, and yeah. And like, how do, how do we start with that? Like as a doctor, like just believing all patients. That's really important because, you know, as physicians, we were subliminally trained to have a dismissive attitude

to many categories of patients. You know, if you had irritable bowel, well, that was in your head. Or if you had chronic fatigue or fibromyalgia, or if you had, you know, even more serious illnesses like Crohn's or colitis, well, that was psychological. Yeah, it manifested physically. But these were troubled patients. Right, right.

I mean, which is so ironic and unfortunate for everyone. I mean, like I know for myself and many of my colleagues and friends that I know went into medicine to alleviate suffering. And, you know, how much of it are we perpetuating? And, you know, one of the themes also that comes up over and over again with chronic illness, and I know for myself too, is, you know, reaching that point of hopelessness or helplessness. And there becomes a learned helplessness on top of that when you get punted from doctor to doctor to doctor so are we perpetuating illness as well through this system and you know i so yeah would i want doctors to go through this i mean hell no but

you know so i sort of turn that question on its head. What would medicine look like if doctors, nurses, healthcare practitioners had an immersion in wellness? Yeah. What if doctors were taught to sleep well? What if doctors were fed well in their training? What if doctors, you know? No, I'm serious. Oh my God, it's so terrible.

What would it look like what would medicine look like if we could experience or consider weaknesses in residency training i know that i know that and uh but would we would we have that experience then to be able to translate to our patients right i mean we're ultimately Well, that's what functional medicine is. It's a science of creating health. Yes. And when you do that, disease goes away as a side effect. Yes.

And you're right. I think if you look at most healing traditions, a lot of shamans or healers went through some crisis, some health crisis, some trauma, something. Some initiatory illness, yes. It was sort of help, you know, sort of select them to be healers. We don't do that anymore. We just have the hazing of medical school.

But that makes us all kind of unwell in a way, and we sort of then normalize that. Absolutely. Yeah. And then we sort of pass it on, right? It's a kind of trauma. It is. It's a kind of trauma, and then we pass it on to our patients inadvert kind of trauma it is it's a kind of trauma and we pass it on to

our patients inadvertently so how do we break that cycle and you know i would say one thing though just to um to bring up related to that in terms of my healing was it was hard for me i mean even when i found functional medicine um i just it was i just had such little energy that it was easy still for me to have uh hope i called it hope fatigue yeah right to try another thing to try again and what i ended up um discovering that was easier was to release so instead of sort of going you know trying to think positively trying to be optimistic, which were things that- You kind of have to surrender to it. Absolutely.

I mean, because those qualities feel like sunlight to someone who's suffering from a migraine, right? Like, I know I need that sunlight, but it is killing me right now. You know, my husband was this sort of embodiment of resilience and confidence and optimism. I couldn't stand to be around him. It was stressful from where I was.

And so what I ended up stumbling across was, oh, my God, I'm carrying around a lot of grief. Okay, yes, I've got my lost identities and time lost and all the suffering, but all this stuff came out, right? I went to a grief ritual. I didn't know those things existed, but you know, back generations ago in cultures, those like soul detoxes, right? Like how do we do that?

That's right. It's not a body, I love that, soul detox. How much are we carrying that is subconsciously programmed into the way our dna folds you know into the way our our neurons are wired and so you know and grief is in is non-discriminate so like i thought i was going for my health you know just the loss of the function of my body yeah and all this stuff came out cobwewebs, right? From childhood, from residency, relationships in the past. And then the shame, the shame of having this mysterious illness.

The shame of being a doctor who cannot figure it out. And that was really, really healing. So then, as you say, as a side effect, what ends up filling up that space is health. It is, oh, I suddenly become more optimistic. I have more hope because there's space for it. It's not something that I have to will myself in order to get because I couldn't do that. That's amazing. And so you've taken all you've learned.

You've been through so many different cycles of struggle. And you've recovered and come back on top. And so you've taken all you've learned. You've been through, you know, so many different cycles of struggle. And you've recovered and come back on top. And you've written this book. And, you know, what's beautiful is, you know, it's really your story. But it's an inspiring story. And it's sort of a window into both sort of how in traditional medicine we kind of miss the boat a lot of times. And how you can, on your own, become boat a lot of times and how you can on your own become empowered to sort of find a brave new medicine. But you also share at the end of the

book, you know, 15 steps that are about healing, about how to care for your body and how to heal. So in a way you sort of make it really simple for people in how to actually create health for themselves. Can you take us through those? Yeah. So, I mean, a lot of the steps were ones that we covered. And so the way that I sort of live through the experience of my healing journey is, you know, it was really through the journal that I kept. And the journal was something that I had kept since I was a little girl. And so when I began, when I sort of made

that shift, like, I've got to try differently, go back to pathology 101, review inflammation. Okay, what's my first step? Like, this is going to be my experiment. I'm an N of one. I'm my own doctor. I'm my own patient. Life is experiment. Step number one, ask new questions. And so then, you know, number two, I think was the resetting my inner clock, right? Number three. So I kind of, yeah, I just build it stepwise as I'm living through my healing journey. So it's a how-to, but it's sort of an organic. But it's really detailed.

I mean, it's really beautiful. It's simple. Like how do you set your rhythm how do you sleep yes how do you give yourself permission to receive and have people help you right right right which was yeah it was really challenging yeah um because you know i stopped driving for quite a while and yeah most people were just like oh my god that's just horrible you know like how do you get, you know, you can't even get around. And you know what? I started thinking about like, who can I carpool with? Who can get a ride?

It ended up being a strange community building experience. We can do it ourselves. I can do it myself. Right. And then I realized also, I don't have to live my life so fast, right? I can slow things down. I can wait for a carpool. So there's a lot of things I think that happen with healing. Like for instance, a diet, I might prescribe a diet

that's healing for myself or my family or my patients. And maybe it's less about the diet per se than just getting them to connect to their food, right? Getting them to connect to their bodies and they're paying attention, and they're treating themselves with love. So how much is that? Right. Beautiful. You get a daily dose of nature,

detoxify your house and yourself. And it's really well laid out and very simple. It's almost like you've taken all the concepts of functional medicine and traditional Chinese medicine and everything you know about healing and integrated medicine put into really very practical, simple things. And some of them are kind of strange,

like let your intuition tell your thinking mind where to look next, right? So it's not- Now that's a quote that I took from Jonas Salk, right? The inventor of one of the polio vaccines. And that was another thing that was sort of reassuring to me when sometimes I thought, well, I'm getting too woo-woo out there. But really looking at scientists, forefathers of modern medicine,

who were, they let their intuition sort of guide their discoveries. So I was like, oh, again, it's not woo-woo. Why are we calling it woo-woo? they let their intuition sort of guide their discoveries. So I was like, oh, again, it's not woo-woo. Why are we calling it woo-woo? It's actually very human. We've just forgotten it in our culture. And there's so many other great things here, like heal your gut and the basics of a 30-day diet reset, which is super important because diet drives so much disease,

as people know, and breaking old habits and just having pleasure and looking for root causes. I mean, surviving love and loss, really, really fantastic. Claiming your purpose. Finding your story. I mean, these are just real nuggets of wisdom

around healing that you've really come to the hard way. And- Practicing pleasure is my favorite prescription. Yeah, that's a good one. I like that. It's amazing how many patients won't do that unless a doctor prescribes it to them. Yeah, it's really true. I think we don't prioritize fun and play and joy.

Right. It's so great. Well, you just have shared such a wonderful story about how sick you could be, how sick we get and how much illness there is and your own road out of it. I think it was inspiring for so many people. And I think I really feel like that's really why you do what you do. It's why I do what I do. It's why we spend time teaching and sharing because there are so many people

who suffer unnecessarily, who suffered needlessly, and there is a way forward. Well, let's talk about stress for a minute because, you know, my thinking about stress is it sort of sets the table for other things to sort of take over. So it doesn't cause not in and of itself. It may cause it may cause some illness for some people, but for the most time it exacerbates whatever's going on. So if you're stressed, your immune system suppressed, you're going to get more inflammation. And then if you have underlying issues like this woman did, they're going to come out.

Absolutely. So tell us how you approach this from a functional medicine perspective. How do we think about autoimmune disease in general, from a functional medicine perspective and lupus in particular? Well, when I see a patient who has lupus, and I go down sort of the checklist, so I look at, okay, do they have sensitivity to gluten? The other thing which I find in a lot of lupus patients is Epstein-Barr virus. So, Epstein-Barr virus is the virus that causes mono. And mono stands for mononucleosis because the virus infects your white blood cells. And the thing about Epstein-Barr virus is it's very common, about 70, 80% of the population has it. And most of the time, the immune system will clear it. And it's a herpes class virus, just like a cold sore. And once you get a herpes cold sore that virus stays in your body all

the time most of time the immune system keeps it in check but there are certain individuals where the virus will reactivate and the herpes virus will come out or the mono can actually reactivate so cold sore in your lip is basically a herpes virus herpes and it doesn't come out all the time it comes out under stress under stress weather is that emotional stress much sunlight getting a cold sunlight so it's sort of a latent virus that we all live with hundreds of viruses in us when we're stressed it allows those viruses to emerge exactly and so this is what happened with this patient yeah and and and and so I've I always like to go down

and ask the question so so why is this? Why do women have lupus more than men? Well, that's functional medicine. Why, why, why? And then, interestingly, when you go into the medical literature in autoimmunity related to lupus, the Epstein-Barr virus is associated with seven different autoimmune conditions. Multiple sclerosis, rheumatoid arthritis, lupus, type 1 diabetes, ulcerative colitis. So what happens is the virus, in some cases, patients will reactivate, and it causes

the stimulation of the immune system, and the immune system will then start reacting to it. And then interestingly, I've always been curious about photosensitivity. Like why does photosensitivity happen in patients who have lupus? What's going on there? Why is it when they get sunlight, is it affecting them? And what I found out in the literature is that the virus causes the body to produce more interferon gamma. And interferon gamma is one of the cytokines that help our bodies to fight off viruses. And when we have high levels of this interferon gamma, it sensitizes the body to sunlight. So that's why you get that sort of lupus-like photosensitivity, especially with exposure to sunlight.

And interferon is one of the treatments we're looking at for fighting COVID-19. Yes, so what they do is they have an overabundance, and it may be a genetic predisposition. There may be some single-duclide polymorphisms that certain lupus patients have, and they produce lots of interferon gamma, and that actually gets involved in the skin cells and can make them more photosensitive.

So it's an interesting phenomenon. And then the other thing about, you know, and I've seen this with a lot of regular mainstream doctors, they'll say, well, you can't really check for Epstein-Barr virus because everybody's, you know, if the antibodies are positive, it just means that you've been exposed to it. Well, that's true. But if you actually do specific testing for Epstein-Barr virus. So there's a panel that we do which checks for antibodies to the nuclear antigen and the cytoplasmic antigen, and then also the early antigen. And then I'll also throw in the Epstein-Barr virus by PCR. So PCR is checking for the DNA of the virus. You're actually seeing if there's live virus around circulating in your blood,

not just your immune response. Exactly. So typically in the panel that we use, if you have the three out of four antibodies that are positive, especially with the early antigen and or with the PCR of the Epstein-Barr virus, you know, prove positive that the Epstein-Barr virus is reactive. Exactly. Reactive. And that's where then you have to ask yourself, well, what do I do to calm down that particular virus? So there's a lot of things that you have to look at. Yeah, I mean, that's true. Functional medicine really has a different perspective, and that's why we see so many patients here at the Ultra Wellness Center who have tried so many things,

and then they get better because we look at all the factors. So when I think of an autoimmune patient or just any disease in general, there are really only five main triggers. It's a toxin. So I've had patients with lupus who have autoimmune disease triggered by heavy metals, for example. Could be an infection like lupus, or it could be the microbiome changes. It could be an allergen, something they're eating, like gluten. And it could be poor diet, which something they're eating, like gluten. And it could be poor

diet, which is inflammatory and has, for example, a lot of the emulsifiers in our food, like carrageenan and all these gums. They cause leaky gut, driving inflammation. And it also can be stress, like you said. And often it's many of those things together. So for her, it was a few of those things. For her, it was stress and the virus, and also her gut was a mess too. Yes, her gut was a mess, yeah. So the other thing that she noticed is that if she ate foods that were high in lectins, things like the nightshade family, that her symptoms actually got worse. And there's interesting, some of the work by Peter Dodamo,

who was the author of The Blood Type Diet, he's the guru of lectins. And what we find is that in certain individuals, when you have high lectins in your diet, and these are compounds that are found in plants, which actually act as a defense mechanism for the plant, so that animals and insects are less likely to eat them. Lectins, there's, in the medical literature, a case study of a hospital that thought they would have a healthy eating day. So they served everybody red kidney beans in some type of a casserole or a soup.

And then everybody got sick from it because it was very high in lectins. And it actually caused transient leaky gut. They had an immune response to the lectins in the plants. And I've had a number of patients, it's not everybody will have that response to lectins. I mean, there's a lot of promotion out there of lectin-free diets as the cure for everything. Or low lectins, low lectins. It's impossible to get- A low lectin diet. And I think it can be helpful for some specific patients. I think the thing is everybody finds the latest fad and think it's the cure for everything.

It's really not. And when you're in functional medicine, you get humbled by understanding how complex things are, how everybody's really different, how one person may tolerate gluten and another person may not. One person may be fine with lectins, another person may not. But if you have an autoimmune or inflammatory condition, it's something worth trying. Absolutely. It is. And I'll interject here because this is an interesting finding.

I stumbled upon this. And again, this was actually by Peter Dodamo, who got me down this rabbit hole. I just recently had a patient who had five autoimmune conditions, including lupus. And I checked for a lab test called Manos binding lectin. Have you ever checked for it? Actually, no, but I know about it. It's one of those things, and he's the one who got me to understand this. Manos Binding Lectin is a compound that our body makes to bind Manos.

It's a sugar. Manos is a sugar. What you find out is that people who have Manos Binding Lectin deficiency are at higher risk for lupus. And hers was undetected. Yeah, and I think the other thing I want to just point out is that, you know, you're talking about this patient with lupus, and she had gluten, she had gut issues, she had stress, she had this virus, she had lectin sensitivity.

But that was her. If you take 10 other patients with lupus, the problem with traditional thinking is that everybody with lupus gets the same treatment. Once you make the diagnosis, you stop thinking. And in functional medicine, when you have the diagnosis, that's when you start thinking. It's just the first step on solving the problem. It's like, okay, this is what your picture looks like. Okay, what are the potential factors that we need to think about to get to the root cause? And then we have to treat the cause, not the symptom.

Yes. And that's the beauty of functional medicine. So for her, how did you treat the cause, not the symptom. Yes, exactly. And that's the beauty of functional medicine. So for her, how did you treat the causes of her lupus, and what happened? Well, for her, it was really focusing on—she already actually was doing very well. I actually tested her. Even though she said that she was eating a clean diet, I made sure. So she said she was avoiding gluten, avoiding dairy, avoiding lectins.

And her testing was negative for any reactions to gluten. So I said, you're doing a good job. Keep it up. It was negative for leaky gut. You're doing a great job. Let's do that. But what I did do, and she had never had done, is she did tell me that she had a bad case of mono when she was a teenager.

And my theory with her is that she probably went under this very stressful time period that the Epstein-Barr virus reactivated for whatever reason and hers was she had a positive PCR so the DNA of the virus was floating around in her blood and also she had positive antibodies three out of four of her antibodies were positive that was to me a smoking gun that her Epstein-Barr virus was really driving her lupus symptoms. So initially, what I did is I treated her with some medicinal mushrooms, things like turkey tail. I used also lysine, which is an amino acid, which can help. And I combined that also with some monolaurin. Yeah, lysine is often something people take to prevent herpes outbreaks on their lip.

It works. And it works incredibly well. It works quite well. Because it helps inactivate the virus. And other foods that contain arginine like nuts which are good for you but in this case they act have high arginine levels that actually can activate yeah this virus yes and that's an interesting uh observation but um that was so that was one of the ways in which i initially uh treated her and um she did get some improvement with that. And then another thing which I added to her regimen is low-dose naltrexone.

And I'm sure you used that yourself. And I've been really amazed at low-dose. What is naltrexone? So naltrexone, this is an interesting thing. So naltrexone is an opiate blocker. And I'm not sure how they actually stumbled upon this, but if somebody takes too much opiates and they overdose, you can give naltrexone to block the effect of the opiate.

When someone has an overdose of heroin or narcotic, they give them Narcan, which is naltrexone, and that stops them from dying. Exactly. It's theorized that when you give naltrexone at very low doses, what you do is you block the body's own opioid receptors and the body senses that and it starts producing more natural feel-good molecules, endorphins. These are our own body's pharmacy for the pain molecules, which in turn modulates the immune system. So when you upregulate opioids, you're actually modulating the immune system.

And I used to use it primarily in patients with ulcerative colitis and multiple sclerosis, but now I'm using it in a lot more patients. And I find that it works really quite well in a whole host of autoimmune conditions. So I used it in her. And it's very low toxic. It's probably the safest thing. It's very safe to use. Yeah, you can have a couple of side effects in a few people, but it's probably one of the safest medications that I prescribe.

Absolutely. Very, very. It has to be compounded and you slowly work your way up on it. What I experienced with it is that it can help, but unless you deal with the root cause, again, it's a symptom manager. So it can help mitigate the symptoms but it's not going to address the underlying biology. Exactly, you're actually true it's not going to reverse the condition but it's one of those things where the risk benefit is so good that it's worth doing in a lot of patients. So I actually added that to her and then we went to the next level, which is that she, you know, we tried the natural route, and then she got some benefit, but it wasn't really where she wanted to. So I said, well, let's go ahead and we'll give her an antiviral.

So I actually gave her some Valtrex at high dose. I gave it to her, I think, three times a day. I think you probably have done that yourself. High dose Valtrex for Epstein-Barr virus. There is no simple one-size-fits-all treatment for Epstein-Barr virus. There is no simple one-size-fits-all treatment for Epstein-Barr virus. I've learned that. There really isn't. And she actually responded remarkably well to that. Within a couple of months, she was like 80% better using the Valtrex. And I've had a few patients that that was very, very... Yeah, I think that's right. I think,

you know, it's interesting. The more you do this, you more realize, you know, what works with one person may not work with another person. It's not the person I have Epstein-Barr. You give them Valtrex, it may not do anything. And I think I've had the same experience. There's some patients, you know, you give them this relatively benign antiviral like Valtrex and it works well. Others don't respond to that. I've had other patients use something called Valcyte, which is very expensive, has higher levels of toxicity, but it actually can be effective in select patients but i think there's other therapies that she used which are also important to mention because you know as i've gotten more experience in this i'm more interested in how do i activate the body's own healing systems how do i use therapies

that are regenerative how do i use therapies that are regenerative? How do I use therapies that are facilitating the body's own ability to fight things? And she ended up using one of these therapies. So can you talk about that? Sure. Yeah. Well, before I actually talk about that, the other thing that also I've used in patients is intravenous vitamin C, and that's actually in the medical literature. High B vitamin C at fairly high doses, about 25 to 50 grams has been shown to be be very effective also for Epstein-Barr virus. That's another thing. In her particular case... By the way, how does that work?

How does that work? Well, at high levels, it actually works as a pro-oxidant. We think of vitamin C as an antioxidant, but actually it's working as a pro-oxidant. Which goes into the next therapy, which is the therapy that she... How does it do that? Do you want to explain how it becomes... Well, it's a yin and a yang because there's reduction, which is the adding of electrons, and oxidation, which is the removing of electrons. And it has to do with coupling, coupling of the oxidative forces versus the reductive forces.

So it's a little bit like a magnetic pull. And at high doses, vitamin C increases the release of hydrogen peroxide from the white blood cells. So people don't understand this, but how does our white blood cell kill bugs? We bleach them. It produces bleach, hydrogen peroxide, and ozone, which are all oxidants. Yes. So that's exactly how our bodies kill things.

And it sometimes can't do the job. And using these other therapies like high dose vitamin C can help actually increase the body's ability to kill infections. And they've actually studied it in ICUs, they're using it in COVID-19. Yeah, you bring up a really interesting point, which is that actually there's a term in medicine called redox signaling molecules. And when you have these redox signaling molecules, which of ozone will be one, it actually upregulates your body's own reparative forces. So talk about what she did with, with ozone. Yeah. Ozone was a game changer for her. She ended up using ozone and she said it was,

it was like a game changer for her, which is really interesting because it was the first time I had a patient who had lupus who who uh responded to ozone uh in that way and was really quite quite amazing it was i was so how did she get the ozone she got it she um she got it um uh actually she got it uh she it was administered by a local uh physician who she was seeing because she was seeing me in consultation and she actually got it rectally and intravaginally. So not even intravenously. She didn't even get it intravenously. Yeah. And she had that response. It was really quite- You can give it intravenously. You can give it in the muscle. You can give it rectally, vaginally. It gets absorbed and it can be very, very effective in rectal and vaginal

treatments you can do at home and you don't even need a doctor to order it. Yeah. I mean, it's basically, it's oxygen on steroids. That's really what it is. Yeah. High dose of oxygen and a little bit of ozone. Right, so if you ever go out after a thunderstorm and you get that nice clean smell afterwards, that's ozone in the air. That's the lightning-producing ozone. It's a special reactive species of oxygen.

And it's one of those oxidative therapies, just like vitamin C, that gives you a little bit of a stress, but it also activates your body's own anti-inflammatory mechanisms, antioxidant mechanisms. Dr. Absolutely. Dr. Yeah. It can be antiviral and kill bugs, which is powerful. I think it sounds like a wacky therapy, but it's something we do here at the Ultra Wellness Center.

It's something that is... We were talking about earlier that when we both heard our patients talking about this, and I often heard this, Dr. Hyman, I tried everything and I did ozone therapy and it was the thing that made me better. And I was like, oh, that's interesting. And I had a little footnote in my head, but I was like, that's a little weird. I don't know about that. And when I got sick with mold toxicity and autoimmune and colitis, it was the thing that actually flipped my body into a healing response.

And it doesn't treat any disease it just activates your body's own healing mechanisms yeah and that's very powerfully very powerfully and very quickly i mean i i had uh you know autoimmune disease brain fog and within a few days it was it wasn't like a took weeks it was in a few days i really turned around dramatically absolutely yeah the other thing which I'll mention as it relates to lupus in women, and I've found this, and actually, again, whenever I see something that's sort of out-of-the-box thinking, I'll go into the medical literature to see if it's substantiated. And what I found is a pattern in patients who have lupus is their estrogen

detoxification pathway. And when we check estrogen levels and hormone levels in patients, we don't just check your estrogen and maybe your progesterone. We check all of the hormones, and then we also check the metabolites of the hormones. And I found this pattern in not all lupus patients, but some lupus patients, is they have an increased pathway for metabolism to what's called the 4-hydroxyestrogen. And 4-hydroxyestrogen is not, you're not going to go to your regular doctor, you're open to it.

They won't check that. They're not going to check that. It comes out in the urine. It comes out in the urine, exactly. It comes out in the urine. And I learned about this through Jeffrey Bland. And it's one of the things we test here at the Ultra Wellness Center. Exactly.

And Jeffrey Bland, he basically called this, you know, like the dancing Shiva. And Jeffrey Bland, he basically called this, you know, like the dancing Shiva. And in some individuals, because women's hormones go up and down and they have to be detoxified throughout the monthly cycle. And you oftentimes will see patients who have lupus, they'll flare with their cycles. And when you measure their 4-hydroxyestrogen, they're very high. And the 4-hydroxyestrogen is what's called a quinone adduct. So it damages DNA. And when you have a high level to this over time, it actually increases your risk for breast cancer. This is why you think women might have a higher risk of lupus.

Absolutely. Absolutely. And I've got, I've got, actually I have a literature paper that cites this and I've been doing it in my own little cohorts of patients and I oftentimes check it. And in a lot of patients, they have that. And then the other thing that's then the other thing that's so wait wait before you I just want to unpack that because that was very powerful what you just said what you said is that is that there are some women who have trouble metabolizing estrogen and it goes down a pathway that produces a toxic estrogen that damages DNA which is what we see in lupus and that by fixing that and we know how to fix that with functional medicine using food and various nutrients and herbs that actually help upregulate or fix those pathways, these

patients can get better. Absolutely. Yes, absolutely. And the other thing that- So by the way, most traditional doctors would not be looking at your hormones if you have lupus. Right. And then the other thing that we then do is we then look at the genetics. So we look at your genetic pathways. So there's a specific polymorphism called the 1B1 pathway. And when that has a variation, you are more prone towards producing the 4-hydroxyestrogen. So typically you start, you know, looking up- And how would you fix that? Well, what you do, and interestingly, the particular SNP that's involved in that particular

pathway, that gets actually upregulated by polycyclic aromatic hydrocarbons. Basically, if you eat a lot of charcoal-boiled food and barbecue, you're going to be upregulating that pathway. So a patient who's got lupus, you don't want them eating- Whether you're grilling your vegetables or grilling your steak, it's going to cause the same problem. Exactly. It's the ash. It's those compounds. The blackened stuff. Blackened stuff, exactly. That upregulates that enzyme. The other thing which you can do is by adding through your diet, cruciferous vegetables, supplements like DIM helps to shift that pathway in a different direction. You know, they published a study in 2015 where they looked at people with this type of condition,

this type of heart failure, went in and did heart muscle biopsies on all of them and found that 20% had Lyme DNA. They made a point in the study to say that almost two-thirds of them had negative Lyme tests. So if you don't really have a big suspicion about what these infections can do, you're going to miss it. And I've treated about 50 cases. See, what you just said is really important. I don't want to, I want to emphasize it. You say

that, you know, 20% of the biopsies in the heart muscle were positive, but two thirds of the people who had the positive test had a negative blood test. So in other words, you can get a blood test, it can look fine. Your doctor says your labs are fine. You don't have Lyme. But actually, if you look deeper, you can actually find it because it may not always show up in the regular lab test. It's an important point. Yeah. You have to ask yourself, who goes and gets a heart biopsy to diagnose Lyme?

Like, it's the silliest thing. Like, you know, the tests are antiquated. They're like 40 years old. I would say I won't get on a 40-year-old app plan. I'm not going to trust my health to outdated technology with blood testing. But long story short, he wouldn't evaluate him because my dad never had arthritis and he didn't have Bell's palsy. He said, you're a doctor now, do it. I was just, you know, fresh out of school basically. And I basically treated him and his heart function completely normalized. He's 88 years old now. He never needed a heart transplant. He's not in heart failure at all.

And that's the story. That's incredible. So what you're saying is essentially you cured an incurable condition, according to traditional medicine, with treatment of his Lyme disease, which was causing his heart failure. And I think this is important to underscore because so much of what we see in my world, in your world, people who are suffering from chronic illnesses who just don't get better bounce from doctor to doctor and are often misdiagnosed because doctors often don't have a framework for looking at root

causes. And functional medicine is this framework for looking whether it's heavy metals, which I've had, or Lyme disease, which I've had, or Babesia, which I've had, or mercury, which I've had, or mold, which I've had. You know, these are things which are typically ignored by traditional doctors. Even diet, for God's sake, which is more obvious, is often also ignored as the root cause of so many chronic illnesses. And I think what you're talking about is that there is hope for people who suffer and who struggled if they can figure out how to get to the right person, which is not always easy, but to even advocate for yourself and say, look, I've got this problem, but I'm not giving up. And I'm going to kind of dig until I find what's going on. And yeah, it could be a number of different things from a perspective of causes

that can cause the same syndrome. So you can have rheumatoid arthritis, but it could be heavy metals. It could be gluten. It could be Lyme. it could be Bartonella, it could be all kinds of things. But we basically just lump everybody into the same category. Oh, you've got rheumatoid arthritis, or you've got this or that disease. We know what to do. We give you the drug for that disease, but it doesn't really speak to the cause. And that's really what you guys have been talking about. It's so refreshing to hear you talking about that.

So Dana, I want to jump to you for a minute. You got sick sick and you also developed a Lyme-induced heart failure and you're a pretty young woman. And you sort of talk about how you got a tick bite and a rash and everything kind of went downhill from there. And you went to doctor to doctor until you kind of found Dr. Phillips and got treated. So tell us about your story and how you ended up being treated by Dr. Phillips and what happened to you and how you got better. Sure. So it was the summer of 2014.

I was truly at the prime of my life. I just signed a brand new deal with Sony and just wrote their songs for Celine. And I was supposed to be traveling all over the place. And I was incredibly happy. So I say that because when doctors start saying like, it's in your head, or you're making it up, or you want, you know, you just want attention, like those kinds of things are absolutely insane to me, because so many people are like me, where they get really derailed at the prime of their lives, and nobody would make this stuff up. It's absolutely

devastating. So I got a tick bite, I saw the rash. I got it within five days. I caught it because I knew when I got back from New Jersey and got back to Manhattan where I lived and I saw it. I was lucky that I was in the minority that saw the bite and the rash on my shoulder. Most people never see it. And many strains of Lyme do not produce a rash and many other tick-borne infections produce no rash. So that's an important

thing for people to know. So I went right over to urgent care. I knew it was Lyme. They knew it was Lyme. They gave me three weeks of doxycycline, an antibiotic, and said, you'll be fine. Go on with your life. They also told me not to Google Lyme and that I would get scared and that I don't want to be a crazy Lyme person. That was a clue that something really weird was going on. I had no idea that this very common, ubiquitous infectious disease that drives a pandemic of illness was a political hotbed. Like I had no clue. So I do take the doxycycline. I try to move on with my life. And three months later, I wake up, all hell broke loose. The first symptom was that my breast had swollen overnight.

I had all these fibrocystic changes and extreme pain. Went to the internist. She sent me, she panicked. She sent me to an oncologist that day at Mount Sinai. He ruled out cancer. He agreed my breast was swollen. He agreed this was weird. Didn't know why.

Just knew it wasn't cancer. Sent me on. I went to go on to have fibromyalgia, you know, exercise-induced incredible weakness. I was a little gym in my building. I did my same lame workout that I do all the time. And just one day, my arm stopped working in the midst of all of this. Literally couldn't lift a fork. Couldn't feed myself, couldn't walk my 29-pound dog. And I went on to have incredible body pain, brain fog, visual disturbances, anxiety, depression, intrusive suicidal ideation, where I literally couldn't stop thinking about jumping

out my window, but I didn't want to, but I couldn't stop. It was something, it was like a monster took over my brain and my body. I went on to see three infectious disease doctors, tons of internal medicine and the oncologist and sports medicine, and nobody had any answers. And what the, you know, I would ask them, especially the ID guys, you know, could this be related to the tick bite? No. Why not? Because you took the three weeks of doxy and it's cured 100% of the time and the test tube with doxy.

Okay. That's actually totally not true. The other reason that one of them gave me, this is my favorite, you know, this well-known doctor at NYU said to me, because I went to medical school. So I'm like, well, ticks carry other infections too. You know, is there anything else? I was pushing them at some point. I said, do you want to test me for inflammatory markers? Like anything? He goes, that's a pretty good idea. Okay. Well, this is my third visit with you. You know, are you kidding

me? So I went on to have this horrible experience until December when I went into heart failure. And then everybody like really got serious, really believed me. I mean, I do think some of them thought it was in my head because I had so many weird, disparate migrating symptoms that doctors are when they don't understand something, they put you in the psychiatric bucket. You know, that's, that's a theme. I think, of course, you know that very well. So and when you when you have these things, you do feel crazy, because nobody can give you any help. And also the fact that it's changing all the time. And every day, it really feels crazy.

So then, in December, I went into heart failure, my ejection fraction was 40%. Under 50 is considered heart failure for people don't know and yeah yeah and it was no I mean I was so healthy before all this so then thank god I had a friend who knew about Dr. Phillips and seen him testify at some hearing and like knocked it out of the park and said you know you got to go see him he's brilliant and he's the only person I would see if I was in your position. So I went to him and he saved my life. And, you know, within like two months of seeing him, my heart failure totally resolved. And he did talk to the Mount Sinai cardiologist who had been very concerned about it did take my heart failure seriously, just didn't know the cause. And Steve really educated him about, you know,

Lyme carditis. He didn't really even know very deeply about it. He was interested and he was educable. He was the only one, but he was, and I really appreciate that. But I was treated with a rotating course of antibiotics, antimicrobials, Chinese, I did a Chinese herbal protocol as well called the Zhang protocol. There are plenty of them of different Chinese medicines you can take. That was the choice I made because I lived in Manhattan and it was in the city and I could see them. And anyway, Dr. Phillips really came in and got me better. It was a miracle. Yeah. Well, I hear this story so much that people, you know, often suffer and they really struggle with trying to figure out how to get the right treatment. But you know, I think what you're speaking to is, is the need to think deeply about rethinking medicine.

One of the things I want us to jump into with both of you, and it's, and you talk a lot about these kinds of things in your book chronic, which is great. It's called the hidden cause of autoimmune pandemic and how to get healthy again. Um, and it's available now on Amazon everywhere and people should get a copy. If it's available now on Amazon everywhere. And people should get a copy if you've been struggling. This is going to help you understand what's going on and maybe guide you to the right resources. What really is going on is that, you know, there's these chronic latent infections with clearly the tick infections, which is Lyme, Bartonella, Babesia, Ehrlichia. and there are lots of varieties of each one of these. So

they're often hard to detect. The testing is sort of a little bit outdated, as you mentioned, Stephen. And I just wondered if you could speak a little bit about the testing, and then I want to sort of jump into talking about COVID and COVID and latent infections and autoimmune disease, because I think it's a topic that people are talking about a lot, and I think people don't understand what that means, the long-haul COVID. So the many infections do have an unfortunate commonality is that they're fastidious. It's a term that microbiologists use to describe infections that we can't isolate from animals and people that have the infection. So Lyme is probably the best studied of all of them. If you inject Lyme bacteria into a dog and then let the dog get sick and then take the dog's blood sample a month later

and you know the dog has Lyme, you can't find the actual bacteria in the blood. And it's the same for all the animals studied and same for people. And with the animal studies, they can cut them up and find that there's still Lyme bacteria alive after the same treatments that are supposed to cure it in humans. And in humans, they don't cut us up thankfully and um and that's the main difference in terms of the animal data and the human data but they've isolated this bacteria even though it's so hard to isolate they've still isolated from about 75 patients um human patients after up to two years of antibiotics so it could be a really really stubborn bacteria but believe it or not it's easier to treat in my experience than some of the other infections, particularly Bartonella. Tularemia is really rough sometimes. And so concoxiala, Q fever is very, very difficult.

And then the parasitic infections that people never talk about because we're told to ignore them in med school. But I do a broad range of a panel, a blood test panel for antibodies against, you know, nine different parasites whenever people come in. It's shockingly common. And the interaction between parasitic infections and bacterial ones is such that the parasitic infections facilitate and perpetuate the bacterial ones because they're a bit immune suppressive. And so you're getting also viral infections that underlie some of these chronic things too. And right now we're seeing this viral infection of COVID. And what we're seeing, even more scary to me than the actual COVID, because most people recover from that, is the long hauler COVID syndrome, which we've talked about on the podcast before. Essentially, it's a chronic fatigue-like syndrome. And with the first SARS infection, you know, decades ago,

about 40% of people who survived, and it was a much more lethal infection, 40% of people who survived got chronic fatigue at three years. And we're seeing this now. We're seeing people who've not even been that sick, people who are young and healthy who got it and recovered and just never get better. So can you talk about what this long hauler COVID syndrome is, how it relates to the underlying potential other factors that are going on with people like chronic infections? What do we know? What do we not know? And what's your experience in treating some of these patients? So my experience in treating just regular COVID, acute COVID has been overall very, very good. And patients have responded to things like doxycycline, ivermectin, and a bunch of herbals like vitamin D, vitamin C, zinc, quercetin, and bromelain. However, my experience with long COVID is a little bit different. I only have one true long

COVID patient. She's a person who didn't call the office for her acute COVID situation. She called a primary care doctor who said, just take Tylenol. And then three months later, she called 11 doctors in desperation. I was doctor number 11 and actually gave her ivermectin and she turned around in 24 hours. I do have one patient I actually just spoke to today who had a mild case of COVID. And after that, her Bartonella symptoms are very much flared up. And we're trying to figure out, is this still virus persistent in her body? Is that what's driving things? Or is it like the apple cart was just upset immunologically and her prior Bartonella is flared up? It seems to be actually the latter in her because she's

responding to the antimicrobial therapies she did before with Herxheimer reactions, which are these die-off reactions, and all these things that all got worse since her COVID are responding to, you know, the same antibiotics that I would treat somebody with Bartonella. So I'm wondering if some of these long COVID patients that have, people don't understand that, you know, we think about these infections that they always cause illness, but the majority of these chronic infections that we're talking about today don't make people sick. Or if they make them sick, they make them mildly sick and they never really get a diagnosis. What happens when you come with a long, you know, a bad viral insult? So before COVID came along, I would have people who had a really bad flu and then they were never

the same. And then they develop a chronic fatigue-like picture. And we do an evaluation for chronic infections, find some, treat some, and get them better. I don't think it's that dissimilar. I think COVID is a terrible, terrible virus, but I think it has the same common features with other viruses that I could just, like I said, be a big shock to the immune system. And it's ridiculously common how many of us are walking around with chronic infections we just don't know about that never get diagnosed. So how do we then attack this long-haul COVID? Because I think people are curious about, okay, well, I'm not feeling well. I've had COVID.

I want to get better. I don't know what to do. And what are the kinds of things you're seeing as, one, any diagnostic information you're getting on these people? And two, what are you finding works clinically to treat these people and help them get better? Well, it's hard to find the virus. In the studies, the people that have had persistent active virus, it's been basically GI tract biopsies and biopsies of the olfactory bulb near the brain. So it's not just, your listeners should know, it's not just go for a nasal swab and when

it's PCR negative, that rules it out. So the virus can persist in hard to, you know, biopsy places. And these tests are not available at like routine drive-through centers. It's really like a research test. So doctors don't have the ability to do that outside of a research setting. In terms of looking for these other infections, any doctor that's educated about these can look for them. You know, I do 99% of my blood tests for patients at chain labs like Quest and LabCorp, and it's a long litany. It's like 17 tubes of blood, but we cast a broad net and we try to find targets that are treatable.

And in terms of the clinical symptoms people are having and the treatments that are working, can you tell us more what you're thinking about how we should be approaching this? So there's a subset of long COVID patients that, you know, have some common features. The breadth of symptoms is really, really, it's incredibly broad. Like, and there are some things that I'm hearing about in long COVID patients that I see in my chronic illness patients, and they're very weird symptoms, like a sense of internal vibrations. I don't know if you've had patients that ever complained of that to you, but this is a common, you know, common complaint

among my patients. It's something long COVIDs are complaining about, long COVID patients. So, as soon as I heard that, I started getting very, very suspicious that, wait a second, is this really flaring up underlying infections that we see? And in my one clear, you know, long COVID patient that I've seen, she responded to Ivermectin, like I said, overnight. And she basically had chest pressure and pain with breathing. And that was her persistent manifestation of COVID. It's not something she ever had with her prior illness. She was a patient who was treated, you know, over a year or so before, you know, she'd been fine, you know, since I treated her, got COVID and had this chest pain.

So she developed a new symptom and very quickly responsive to ivermectin. So ivermectin, I don't know if you've talked about ivermectin on your shows before or no. Yeah. But ivermectin is an antiparasitic. It's a really safe drug yeah so it's um i've been i've had experience with it uh way before covid came around because i used it because i do like i said evaluate and treat parasitic infections and i've also used it as an immune modulator so ivermectin has this really cool

many effects in the body it um it gets rid of abnormal inflammation and it gets rid of abnormal immune suppression at the same time. So it has immunologic benefits for people with inflammatory illness, but also in the case of COVID, it has direct antiviral effect. So if I have a long COVID patient, I mean, I'm going to offer them something that's going to cover the virus and I'm going to evaluate them for the other chronic infections that COVID could have stirred up and what we find will offer treatment for those as well. I would take a dual approach. Yeah. And are people getting better, you think? Because I think a lot of people are worried about the long haul COVID syndrome and people not actually

recovering fully from it. Well, I've been booked out for so long, I mean, you know, that we haven't even, long COVID patients are calling the office. And I'm just gathering data among my patients now who have had COVID, like I said, limited experience in treating long COVID patients. So I'm going to start accepting long COVID patients and evaluating them the way that I said, using this dual approach to cover the possibility of persistent viral, you know, viral stuff going on, and also the possibility of flared up other chronic infections like Lyme and Bartonella and other chronic infections that people may never have heard about. And, you know, I do think that I can help patients, but I don't have a big well,

you know, of experience to draw from. I don't know how many long COVID doctors are that have a big well of experience on what's working because from what I'm hearing from the long COVID community, because we're partnered with Survivor Corps, which is a large group with long COVID patients. And so far, there's very limited trials of stuff to get these patients better. Like none of the doctors are really taking it by the horns, so to speak, and really helping these patients. Well,

we've got a clinic at Cleveland clinic called the recover, RECOV, R-E-C-O-V, right? Like for COVID recover clinic. It's a multidisciplinary clinic around how to recover from COVID from the long hauler syndrome. So I think that there's some interesting things happening around the academic centers. We're looking at all kinds of options.

And I do think functional medicine approach is really powerful. I think for people listening, you know, there's a lot of approaches to chronic infections, antibiotics, herbs, lifestyle, and more. Some of the other things that we've talked about in the show, like ozone and hyperbaric oxygen therapy, hyperthermia, and other approaches can be actually also very effective. And clinically, I find some of those really helpful in kind of resetting the immune system and resetting the way in which your body handles infections, even directly killing infections. So I think there's a lot of tools out there and options. We did a podcast from Santa Viva where I went and I, you know, personally had Bartonella. I was really persistent. I was having night sweats, still fatigued. I was functioning pretty well, but I

still really, you know, struggled. And people who do kind of well, they're walking wounded are often the ones who have good lifestyles, but they still have this low grade stuff. If you have a crappy lifestyle and you get this, you're in trouble. It's really bad. But I got the chance to do hyperthermia, which was an interesting treatment that's not available in the United States. It's in Europe and in Mexico. And I was able to put my body to 107 degrees. And after that and getting the antibiotics during that time, during the peak of the fever, allowed my system to start to respond and shift and recover. And I just talked to another patient who had Parkinson's disease who also had Babesia and Lyme and many other co-infections and, you know, really found the

same thing. We treated him with lots of antibiotics and herbs and things over the years, but finally we got him to do treatments of ozone or hyperbaric oxygen and hyperthermia and he went to Sanib even. It was really quite remarkable. So it's not available to everybody. It's expensive, but for people who are really struggling, there is often a way out. So, um, Dana, tell us, tell us about, um, your, um, perspective in terms of interacting with your own, you know, health and the medical community and the struggles you've had and, um, and, and what you're, what you're doing to kind of change how people are, are, are, you know, shifting the perspective of how we can get better? Well, one thing that I should have mentioned is that, which speaks to

this, is that when Steve worked me up, he found another infection, Bartonella, that was also driving my symptoms. So my Lyme was definitely undertreated. There's no question three weeks of antibiotics is definitely not enough for many, many, many people. The data is clear. So I should say that. But the fact that nobody looked for anything else is crazy to me. And when he treated both of those infections, all my symptoms went away, my psych stuff too. So I think that that point needs to be made. I think a lot of people suffer from anxiety and depression, along with their quote, autoimmune diseases. And people tell them, well, you're anxious because you have fibromyalgia or because you have RA. No, you're not anxious because you have those things necessarily. I mean, yes, they suck. It's depressing. But there's a brain

component here. There's a neurologic component, just like we're seeing with COVID. And I think it's a lot easier for doctors now. Well, not all of them. Okay, so they're coming around to the fact that infections can cause a humongous, multisystemic illness that lasts and lingers, and that is driven by a stealth chronic infection. So there's so much for them to learn. If they'd been paying attention to Lyme for the last 30 years, we wouldn't be in this horrible mess with COVID, in my opinion, with long haulers, because I think it would be very obvious that there are chronic infections driving some percentage of these people's symptoms. So, you know, it's a bit crazy making to me to watch this all being, you know, predictably played out the way it is where

we're talking about immune suppressants already, and they're not talking about antivirals, where, you know, these things need to be put on the table. But in terms of my interactions with the medical community, and my advice is just, you know, if I didn't advocate for myself, and if I didn't trust my intuition, I knew they were all wrong. Yeah, it did. It made me feel badly that I wasn't being taken as seriously as I felt I should have been. It made me feel badly to have the sense that people thought it was in my head. But I kind of didn't care that much because I knew they were wrong. And I think everybody has this inner voice that tells

them, this is the wrong path. This doesn't make sense. But most people don't follow it. They need the confidence. So if I can be, you know, a guiding light in that regard, and just tell people to keep going, and go move on from doctors that aren't believing you, and they won't look at data or won't listen to other stories that are similar to yours, stories like mine where people recovered. I say move on. But I also feel very strongly that you need to bring somebody to an appointment with you because when you're really sick like this, you need somebody to advocate, ask questions, write down information because you forget a lot of stuff when you're in this state. And yeah, I mean, I just say, as you just said, like, don't give up. There's a lot of ways to skin a cat. And this is my journey, but there are many, many other

people I know that got better in various ways. Just look for the root though. Demand, demand the root cause answer. Demand it. If you don't find it, that's what you got to keep going for. That's my opinion. Yeah. And the challenge a lot of times, Dana and Stephen, you know, is that, um, the traditional medicine, we're not really trained to look at root causes most of the time. Sometimes we do, but most of the time we don't really have a framework for thinking about chronic complex illnesses. We're good at acute illness. You had acute infection. Okay. We'll say this bacteria will treat you. We'll figure out the cause and that's fine. But for these latent infections or chronic infections or blatant issues, whether it's mercury or mold or Lyme or whatever, people are often struggling

for decades. And there really is a method of figuring this out. And really, that's what we do at Cleveland Clinic at the Center for Functional Medicine at my practice, Delta Wellness Center. It's what you do, Stephen. And a lot of doctors around the country are moving towards this kind of medicine. And people call it functional medicine or my practice, the Delta Wellness Center. It's what you do, Stephen. And a lot of doctors around the country are moving towards this kind of medicine and people call it functional medicine or whatever you want to call it. But it's essentially, it's a new framework for thinking about disease based on treating the body as a system, about getting through a cause, about understanding the interconnections between these things and thinking out of the box. I mean, just the idea that you could cure heart failure by treating infection, you know, that's a kind

of interesting idea. We know that viral effects, viral infections affect the heart and cause heart failure, but we never really, and we even know from the literature that Lyme does too, but it's just sort of a blank spot that doctors don't pay much attention to. So really grateful for both of you for taking this on, writing this book, Chronic, The Hidden Cause of Autoimmune Pandemic and How to Get Healthy Again. There's a great chapter in there on COVID and how we need to think differently about COVID and autoimmune disease and chronic long hauler syndrome and some of the stuff we're really struggling with.

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