The Dr. Hyman Show - Chronic Lyme Disease: Symptoms You Shouldn't Ignore

Episode Date: August 12, 2024

So many people suffer from chronic Lyme disease without even knowing they have it. Why? Because it can mimic over 300 different medical conditions. On this episode of “The Doctor’s Farmacy,” I revisit my conversations with Dr. Steven Phillips, Dana Parish, and Dr. Todd LePine to unravel the complexities of Lyme disease and other tick-borne illnesses. We dive into the diagnostic and treatment challenges, and explore how functional medicine can offer solutions to your suffering.  View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal Full-length episodes of these interviews can be found here: Answering Your Questions About Lyme Disease, Detoxing, And More The Link Between Autoimmune Disease, Chronic Fatigue, And Hidden Infections How To Recover From Chronic Lyme And Tick Diseases with Dr. Todd LePine This episode is brought to you by Pique, AG1, and Happy Egg. Enjoy Pique's Sun Goddess Matcha. Just head over to piquelife.com/hyman with code HYMAN for 15% off + Right now, get up to 15% off + a complimentary beaker and rechargeable frother. Get your daily serving of vitamins, minerals, adaptogens, and more with AG1. Head to DrinkAG1.com/Hyman and get a year's worth of D3 and five Travel Packs for FREE with your first order. Shopping for better eggs shouldn’t be confusing. Look for the yellow carton at your local grocery store or visit happyegg.com/farmacy to find Happy Egg near you.

Coming up on this episode of The Doctor's Pharmacy. I first got Lyme, just regular garden variety Lyme. There was real discordance among the medical community on how they approached chronic illness, and no one seemed to know what was going on. I gradually got better, and I had many relapses, and it wasn't a three-course of doxycycline that got me better.

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Hyman Hive. And if you're looking for curated and trusted supplements and health products for your routine, visit my website, Supplement Store, for a summary of my favorite and tested products. Hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine, a framework to help you understand the why or the root cause of your symptoms. Welcome to The Doctor's Pharmacy. Every week, I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field.

So let's just trump right in. If I could literally eliminate one condition from the planet Earth, it would be tick-borne illnesses. They are awful. I've had them. I've had Lyme disease. I've had Babesia. I've been sick from them.

I get it. I promise you. And I've seen patient after patient who struggled not only for years, but often decades with a chronic Lyme. And when I say chronic Lyme, I'm including every single tick-borne disease, Babesia, Ehrlichia, Babesiosis, Rocky Mountain spotted fever, all the tick-borne diseases. And there's even with Lyme disease, there's multiple strains of Lyme disease. And I spent a lot of my life studying it, both from a personal interest,

because I was really sick from it, and from trying to help my patients and figure out what works and what doesn't work. And if you go online, if you listen to, read books, you're going to get a thousand different ideas. And I'm just going to share with you what I've come to understand is probably the best approach, but just with a caveat that you're going to hear a lot of other different opinions that it might

be different from mine. I'm just going to share with you what I found really works for me and my patients and what I've been able to call from working with this disease for a long time, looking at the scientific literature, looking at actually often things that aren't in the scientific literature that people are using that can work. what is what is lyme disease lyme disease and again it's all the rubric of all these different conditions they're all manifest a little bit differently but but essentially it's a illness that you get from a tick bite and the ticks carry these little spirochetes these little nasty things almost kind of like syphilis and you know syphilis used to be the great masquerader we called the great masquerader because it would cause all these problems. And the same thing with chronic Lyme,

autoimmune diseases, memory issues. I mean, Chris Christopherson had, quote, dementia, but it was Lyme disease. It can cause heart disease, arthritis. It can cause all sorts of gut issues. It can cause skin problems. It can cause cognitive issues. It's just a huge problem. And essentially, it can also manifest as chronic fatigue syndrome, and people can't figure it out. Now, let's just talk a little bit about, I'm going to go kind of down the rabbit hole here because you asked, and I'm going to say it because I don't really get a chance to talk about this much, but I think it's an important thing to talk about. Diagnostics is challenging. You know, we have antibody tests. You've heard of coronavirus

antibodies. They tell you if you have the infection. They don't necessarily tell you that you have the infection. They tell you that you've had the infection. And that's important to know for sure. But the question is, do you have an active infection? So a lot of our tests on antibody tests, you go to the regular doctor, they test you, they go, oh, you're fine. You don't have Lyme disease. They're really not that sensitive. Sensitive test means if you have it, it'll pick it up. In other words, if you have a bladder infection, you pee in a cup and you look under a microscope, it's like 100%. You're going to find it, right? But this kind of test, you may not. And it's hidden because they hide. These little sneaky ticks hide inside your cells and they're hard to detect there's

another level of testing called pcr testing which is often helpful to look at fragments of the dna you know about coronavirus pcr testing same thing and so we can detect these tick infections through pcr testing now i had a positive pcr and and i had you know i definitely had it and when you have that you have it for sure it's active active, floating around your blood. But sometimes you don't have that. It's like looking for a needle in a haystack. And then you can look at your immune response to Lyme. And that's more what I look at because these are tests that were developed in Germany and Europe.

We now have labs in the United States that do them. And essentially, it looks at how do your white blood cells respond in real time to some tick that they give in the laboratory and and that is called lymphocyte response assay and that's very helpful and it's we call it an le spot test and we use that a lot and i find that really helpful to detect how your immune system is reacting we look at your interferons we look at all kinds of cytokines you know about cytokines from the cytokine storm we can tell like example, natural killer cells go down. CD57 is one of the immune cells goes down.

So we have, like, ways of looking at this indirectly. Sometimes you can't really tell for sure, even with all these tests. So you have to kind of go on a clinical diagnosis. And Dr. Horowitz, Richard Horowitz is one of the Lyme experts. He's written a lot of books on this. A friend of mine, he's really quite brilliant about this. And he developed a Lyme questionnaire, which I encourage you to check it out. It's called MSIDS, M-S-I-D-S.

And you can download it. It's free. And you can see, you know, if you score high on this, it's likely you might have Lyme. Now, you might never know you got a tick bite. I don't remember ever getting a tick bite. I don't remember pulling a tick off me. I don't remember having a rash. I don't remember having anything, but I had full-blown Lyme disease. And it's like that for a lot of patients.

They might not know. Now, if you live in the desert somewhere in Australia, probably you don't have Lyme disease, but pretty much everywhere in America, there's some degree of tick-borne illness. So then you got the diagnosis. Let's say we find you have it, but most doctors just look for Lyme. They don't look for Babesia or Ehrlichia or Bartonella or many of the other infectious agents that come with ticks or they don't look for different strains. So it's really important to cast a wide net when you suspect it.

So let's say you have it, then what do you do? Well traditionally you give three weeks of antibiotics and you're done. But that doesn't work unless you really have acute Lyme. If you have acute Lyme, for sure, you get a tick bite, you notice it, you have a rash, you go in the emergency room, you get a doxycycline for three weeks. That usually knocks it out for most people. But when you have chronic Lyme, it doesn't. And I'm just going to take you through a number of different frameworks that people are using. One, which I'm going to sort of tell you what they are, and then I'll tell you what I generally do, what I think is the most effective and the least harmful. One is long-term chronic antibiotics.

Some doctors put people on antibiotics for three months, for three years. That's a problem because those antibiotics are not benign. They cause gut issues and many other problems. You get a lot of secondary issues. They may control the symptoms somewhat, but they're not no magic bullet and it's just a rough road. So I'm not a big fan of that. I'm okay sometimes with a short course, six weeks, hit them hard, you know, and hit the different forms because there's a lot of different forms of lung. There's a cyst form, intracellular form. So you've got to hit all the forms of different drugs to get them to go away. And different ticks need different drugs. So it's not like one size fits all. Sometimes you usually have not one infection.

You might have two or three. Like I had Lyme and Babesia. Some people have Lyme and Bartonella. So you kind of have to go through all of the right treatments for each one. We use a lot of herbs. That's another category. There's a lot of people who use herbs.

Dr. Jang herbs, Byron White herbs. There's the Cowden protocol. So there's a lot of protocols and herbal, Dr. Jiang herbs, Byron White herbs, there's the Cowden protocol. So there's a lot of protocols and herbal protocols that often can be very effective. I had a patient, for example, who had chronic Lyme and used the Jiang herbs, which are from Dr. Jiang, who's a Chinese physician, Chinese medicine physician. And one of the herbs there is garlic. Now garlic, we know is a very powerful antimicrobial. It works, but you smell pretty bad and you won't have any friends while you're taking the drug i'm taking the herb so herbal protocols can be helpful i use it often as as an adjunct and then we go down a different rabbit hole um so there's a long-term antibiotics there's

short-term antibiotics there's the herbs uh and then there's all the stuff that i think actually works which is way off the grid unfortunately it's not easily found for most people. It's not accessible to a lot of people and it can be expensive, but I think these are some of the most effective treatments. One is ozone therapy. And ozone therapy doesn't have to be that expensive. You can actually do rectal ozone. You can buy a machine for $800. You can do it at home. You can do it every day. And that's kind of a very inexpensive way to get ozone on your own every day. And for people who have Lyme, I do recommend that. And it can help, but it takes a little longer than doing the IV version. And then there's intravenous ozone, we call it multi-pass or 10-pass ozone. I think that is one of the most important foundations of

tick-borne illness treatment and many other illnesses. The second thing I think that can be very helpful are peptides. And peptides are these small molecular weight proteins that are like little mini proteins and that your body uses to regulate all kinds of things, including your immune system. So thymus and alpha-1, thymus and beta-4 fragments and others can be really helpful, LL-37.

I'm just kind of rattling them off. But there's a number of peptides out there that are antimicrobial peptides, that are immune-boosting peptides, and that can be really helpful in helping people have their own immune system start to fight this. It's a lot like immunotherapy. Think about cancer and immunotherapy, where these treatments actually use your own immune system to kill the cancer. And then there's some things that seem maybe a little far out like hyperbaric oxygen therapy that's essentially where you go in a like a decompression chamber which they use for scuba diving and you go down under two atmospheres of pressure or more under 100 oxygen and guess what bugs don't like oxygen right uh what what what did one of the famous

chief justice or in the United States Supreme Court years ago said, the best disinfectant is sunlight, right? So we need to, you know, oxygen is a great therapy. In fact, if you just go to PubMed, which is the National Library of Medicine research studies, you should have an oxygen, intravenous oxygen, and you'll see it's actually been used in medical treatments for all kinds of things, including infections. So hyperbaric oxygen therapy can also be helpful, and that's an adjunct. I'll usually use herbs, I'll use antibiotics with that, and ozone, sometimes combinations of these therapies help. And then there's kind of a last resort therapy, which we use in patients who just don't get better, and this has often been a miracle for people who've been sick for 20 years.

It's called hyperthermia, and essentially what it is, is it gives you a fever. You, under medical supervision with intravenous lines, under anesthesia, they heat up your body to about 107 degrees. Now that sounds crazy, and I've had it done twice, and I'm still alive. And I've sent my patients down to Mexico, to Europe to do this.

And often it's one of those treatments that they go, my God, Dr. Hyman, this stopped it. This is the thing that worked. After 20 years of struggling, I got a little better from this, this, and this, but this is what knocked it out. So I think there's all kinds of therapies out there. And of course, you have to also fix your gut and get rid of heavy metals and deal with mold and balance your hormones and get your mitochondria working and get your nutritional levels right and optimized. So it's a comprehensive functional medicine approach that has to be used to treat chronic Lyme, but it is treatable, and I'm a perfect example. If you're a longtime listener, you might know that I've been drinking AG1 for a while now.

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standards coupled with the humane treatment of their hens lead to superior tasting eggs so choose happy with happy egg visit happy egg.com pharmacy to get 50 off your next dozen and look for the yellow carton at a store near you that's happy egg h-a-p-p-y-e-g-g.com pharmacy f-a-r-m-a-c-y my first has got lime just regular garden variety, like so many people do that live in Connecticut. And it was a moderate case. It wasn't dramatic. It didn't disable me.

But I realized by going to many infectious disease doctors and ultimately ending up in the office of doctors like myself, Lyme doctors, that there was real discordance among the medical community on how they approach chronic illness. And no one seemed to know what was going on. I gradually got better and I had many relapses. And it wasn't a three-course of doxycycline that got me better. And then I was really fine. I still had occasional relapses, but I was a healthy guy. I could run like five miles. I could play tennis all day and work six days a week, which I did for many, many years. Then in 2010, while I was sleeping, I got spider bites and I didn't think anything of it. And with those spider bites, a couple months later, my body exploded with arthritis all over,

rapidly progressive to literally every joint in my body, especially my spine. And I went to 25 doctors that couldn't help me. I went to other doctors like myself who thought it was maybe prior Lyme, but I was the only one that's saying it wasn't. And none of the antibiotics that helped me previously helped me for this case. And I went to a rheumatologist who diagnosed me with rheumatoid arthritis and spondylitis, which is arthritis of the spine. And it progressed very rapidly within six months, despite treatment with

different medications, including many antibiotics. I couldn't walk. And I ended up not walking for almost two years. I had to give up my practice for two and a half years. I was completely bed bound for about a year and a half. And I almost died on many occasions. I lost 50 pounds. I couldn't turn over in bed. I couldn't sit up on my own. I needed 24-hour home care. I got severely anemic. And I have fevers, 102 every night. It was a dire situation. And I figured it out in the last minute and put it all together. And I saved my own life. And it's not just saved my life. I'm back to a full life. And I, back in practice since 2013, you know, I lecture all over the place before COVID traveling around the world and, you know, not limited in any way. And when I went back to my three top rheumatologists, when I recovered

and I told them, you know, this is how I got better. Will it change how you practice? Like, no, I'm glad you got better, but we're not got better but we're not gonna not gonna change tell us more what what actually got you better what you did to recover what was the root of cause because functional medicine is really about looking at the root causes of disease and this is really what you're doing you're looking at not just a label that people get like rheumatoid arthritis but what's underneath it and how do we fix that i went to regular doctors and i went to functional medicine doctors as well like i said I went to every specialist I can find. And I did the elimination diets.

I didn't find any heavy metals or anything like this. She wasn't able to help me, to be perfectly honest. And I took lots of antibiotics that flared me up but didn't get me better. And really it came down to that my infection was Bartonella, which is an antibiotic refractory infection. And it needed really just specific antibiotics. And that's what got me better.

I took lots and lots of herbs that didn't help. And at first, I wasn't a believer that herbals were helpful. And then I took my first herb to rock my world. And it caused this huge heart summer and massive improvement. And that was liposomal artemisinin. And I was like, oh, so that's how an herb's supposed to work and um and then i ended up getting tremendous benefit from liposomal oil of oregano and my second herbal and then monolaurin so there were a few supplements and herbals that were found

really really beneficial but primarily for me it was uh antibiotics it was things like doxycycline and rifampin and bactrim and Yeah, so those antibiotics are strong antibiotics, but Bartonello is really one of those tough infections. It's one of those tough infections that's often hard to find and hard to treat. And so, you know, people suffer for years from things like this. And I've seen people literally for decades have problems, and then you treat them and they get better. It's pretty miraculous. No, I went back to a rheumatologist and they looked like I was a Martian. I mean, one was delighted that I got better. One treated me like it can't be like in disbelief. And I did a little dance in front of him to try and convince him.

I mean, cause he saw me not walking and I was like, look, I'm dancing. I'm not a good dancer, but, and then, uh, one was just looking like I was a one-off, like I'm a one in a million case. And she's like, look, one in a million things happen. I'm like like I'm a one in a million case and she's like look one in a million things happen I'm like I'm not one in a million I mean I always my mommy told me I'm special when I'm a kid but I don't think I'm one in a million and I think there are other people that have very similar things yeah yeah that's funny I remember giving a talk at Harvard and I was presenting about a case of autism that had dramatically turned around and um one of the pediatricians there was like well you know this might just be a case of spontaneous remission and um one of the pediatricians there was like well you know this might just be a case of spontaneous remission and then one of the other doctors well dr hyman said like five

cases of spontaneous remission his practice is here so far yeah if you if you understand what what the roots are um and you also talk about in the book your dad who had um pretty bad heart failure um and needed a heart transplant. No, he did not need a heart transplant. He was going to need one, right? So what was sort of the discovery there? Tell us about your dad. That's what galvanized my interest in doing what I do.

It wasn't my own case. Like I said, my case of Lyme was pretty moderate, and I wasn't planning on doing this as a career. But when I started learning about this, my heart, my father had had a case of what they thought was a viral meningitis in 1975. And then shortly after that became a nonspecific heart palpitations and it got just worse and worse. Then he turned to atrial fibrillation, a specific type of arrhythmia. And then he went into heart failure and we took him to all the best doctors in New York City and all the top teaching hospitals. And we don't skimp. We went to the best. And they all couldn't save him. And he got worse and worse. He had ejection fraction

between 10 and 20. They said that his lifespan would be measured in months without a heart transplant. And I was just finishing up my residency at Yale. I was doing Lyme research. I'd already had some experience with Lyme personally. And I was like, looked it up and I was like, holy crap, Lyme can do this. So I went to the cardiologist. I said, you know, Lyme can do this condition, dilated cardiomyopathy. Can we evaluate him? And he rolled his eyes and discounted the whole thing. And, you know, they published a study in 2015 where they looked at people with his type of condition, his 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, your labs are fine, you don't have line but actually if you look deeper you can actually find it because it may not always show up in the regular lab test that's an important point yeah you have to ask yourself who goes and gets a heart biopsy

to diagnose line 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 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. These areme 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 a 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 go 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, 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. And we go, 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 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 um so it was the summer of 2014 I was truly at the prime of my life you know 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 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 and 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, exercise-induced incredible weakness. There was a little gym in my building. I did my same lame workout that I do all the time. And just one day, my arms 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 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. I would ask them, especially the ID guys, 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 in 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, they, you know, Dr. Phillips, like really came in and got me better. It was a miracle. Yeah. Well, you know, 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 they need to think deeply about rethinking medicine and rethinking how we approach disease based on root causes 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 you've been struggling this is going to help you understand what's going on maybe guide

you to the right the right resources um what really is going on is that you know there's these chronic late infections with clearly um the tick infections which is lyme bartonella babesia um or lichiahrlichia, 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. So the many infections do have an unfortunate commonality is that they're fastidious.

It's a term that microbiologists use to describe, you know, 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. 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 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 it from about 75 patients, 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. People think, you know, Lyme disease, you get the bullseye rash,

maybe you get arthritis, Lyme arthritis or Lyme heart disease. It's acute illness. If you get neurologic Lyme, it's a thing. They diagnose it and they give people IV antibiotics. But there's very little appreciation that if someone comes with Parkinson's disease or MS, that you should be thinking about a tick infection. It's not even on the radar for most doctors. But in functional medicine, we do think differently. Yeah. And if you actually, going back into the history of understanding syphilis, there used to be primary syphilis, which is the acute infection. Then you would have secondary and tertiary syphilis. It would appear years down the road as dementia and tabes dorsalis and problems with balance and all different kinds of things. So you've got to have a broad understanding

of how these things affect the body and then the immune system. So maybe it's not chronic and acute, maybe it's primary and secondary Lyme. Exactly, that's another way, right, it's how you want to word it, exactly. So what is a typical approach to thinking about Lyme disease

and how do traditional doctors diagnose it and treat it and what is the the general perspective? The general perspective and I think this is the CDC criteria is basically you go to your doctor and you get a what's called a two-tiered testing. First is what's the ELISA screen test and the ELISA is just a screening. It's the antibody test. It's the antibody test. Enzyme-linked immunoabsorbent antibody. And if that's positive, then you then reflexively go to a Western blot test, which is supposed to be more sensitive, and also it's more expensive. And this standard of how you diagnose Lyme disease is this two-tiered approach.

And the unfortunate thing is if that's negative, which 50% of the time it is, you are going to be missing Lyme disease in a lot of your patients. So you might as well flip a coin. So I almost don't even do that. If it's positive and you have a clinical history, then it's helpful. But 50% of the time, it's not going to be helpful. Most of all, acute disease. I mean, I remember working in Nantucket in the ER and I remember seeing so many patients coming with Lyme disease, but they had acute Lyme. They had a fever, they had joint pain, they had a rash. You give them antibiotics, three weeks, they're fine. And the truth is a lot of people will get Lyme disease and get treated and they're fine or they get it and it's not an issue. And I think that there's a subset of

patients that are uniquely susceptible to the adverse consequences of these tick infections, whereas others are more resilient. Do you find that too? Absolutely. And you bring up a really good point in fact I just had a paper about people who have mannose binding lectin deficiency I'm familiar with that mark that's a mouthful yeah I heard about it right so I'm actually it's relatively new to me and there's a condition which is mannose binding lectin deficiency which you can draw on a routine lab thing test and people who have this are more susceptible to developing infections like

urinary tract infections and upper respiratory infections and lo and behold chronic Lyme disease so now I'm starting to actually check for this in my patients other patients are finding it yeah absolutely yes absolutely the other thing that is also and I don't exactly sure of the mechanism for it, but patients who have hypermobility, sort of a form of Ehlers-Danlos syndrome. And for whatever reason, those patients tend to have it a little bit more difficult to eradicate. And that may be related to the fact that Lyme is predisposed towards going towards connective tissue, and they have a connective tissue disease or a mild form of it.

So what's the typical like approach, traditional medicine? They just give them three weeks antibiotics and you're done? Yeah, I mean, the traditional approach is anywhere between one week to a month of antibiotics and then you're done and it's the end of discussion. I can't tell you the number of times that I've gone to. And if you're still sick afterwards, doctor goes well it can't be lime exactly and then and then they they call that post Lyme syndrome there's a there's a whole diagnosis called post Lyme syndrome where your your testing may be

negative you still have symptoms despite the standard of care treatment and you fall into this nebulous category is it a ongoing immune reaction is it the the body's still trying to fight the infection and you're not seeing it on the lab testing, et cetera? Yeah, and so what is the approach to post Lyme syndrome in traditional medicine? There is none. There is none. There is none.

There really is no treatment. I mean, that's sort of where, you know, if patients are fatigued, they may get provigil. If they're having problems sleeping, they're going to throw Ambien at them. If they're depressed, they'll get some Prozac. Polypharmacy. Polypharmacy, yeah. And that's iatrogenica imperfecta. One of my favorite terms. So most of the time when... What does that mean, Todd? Yeah, that is... Basically, iatrogenica is the doctor does it. So a lot of times... Caused by a doctor. Right. So a lot of times, I mean, Mark, you and I have seen it with patients come into us and the problem is the doctors were treating them.

Yeah. So, the number one thing is stay away from doctors. Oh, yeah. It's true. Some of them. Yeah, for some of them. Exactly. Yeah.

So, it's really, you know, a very problematic issue. And I would say if there was one condition that I could erase from the planet, yeah, it would be tick-borne illness Yeah, it is one of the biggest scourges on humanity ever absolutely causes so much suffering Needless so needless suffering. It's so underdiagnosed. It's not a well appreciated by traditional medicine No, and it's really real and it does masquerade as all these other problems So you mentioned a few of them, but it can cause all sorts of autoimmune diseases It can cause all sorts of gut issues it can cause all sorts of neurologic issues and mood issues It can cause like you said neurodegenerative diseases. It can cause chronic fatigue syndrome

fibromyalgia depression Dementia, I mean I had a guy come in with Capgras syndrome was he kind of mistake your you know everybody for everybody for somebody else. You'd go know who your wife is and you just have these weird. He had like neuro Lyme. Neuro Lyme, yeah. And about three other co-infections and we treat them with antibiotics and he got better. Yeah. I had another patient who had all these MS symptoms and she saw the best doctors at Cleveland

Clinic and they're like, no, you have MS. And she ended up having Ehrlichia. Yeah. Which is a tick, one of those tick-borne infections. I gave her doxycycline for six weeks, and like, all her symptoms went away. And I don't love antibiotics, but... Sometimes you have to use them. Sometimes you have to use them. And I think having an open mind to who are those patients who are just not getting better?

There's a whole subclass of them who really struggle with these chronic issues that are undiagnosed, that nobody can figure out. And there's a lot of approaches to this. So we do different kinds of diagnostics here, and functional medicine has a very different approach. How would you define the approach for functional medicine? The approach for functional medicine is actually listen to the patient. I think the best thing you can do is take the time, and you can't do this in five or 10 minutes. As you well know, Mark, you have to really be astute, you have to listen really well,

and you also have to have the clinical experience where you've seen a lot of patients and you can sort of put the pieces of the puzzle together. Because this is like, this is not a 50-piece jigsaw puzzle, this is a 1,000-piece jigsaw puzzle. Yeah, often, right? And you're not gonna do a 1,000-piece jigsaw puzzle in five minutes, it takes a while.piece jigsaw puzzle in five minutes.

It takes a while. My wife can do it in like half an hour. Yeah, right. She's good. So you've got to really listen well. And then a lot of the confirmation of the Lyme is, in my opinion, done by advanced testing. Like the test that I really like and that we use here is the Eli spot testing, which basically is checking for the immune system's response to the bacterium. How is that different than an antibody test, which is what traditional medicine uses? Exactly. So an antibody test is, say for example, you get a polio vaccination,

you are going to develop polio antibodies. Okay, if I test you right now for polio antibodies, you have polio antibodies. Does that mean that you have polio, the disease? No. Okay, in chronic Lyme, some patients don't develop antibodies. So those antibodies actually go away over time. So the antibody test is negative, especially in chronic Lyme. And if somebody has had the disease and the antibodies are positive, does that still mean that they still have the disease or is the disease gone away? So you're sort of up in the air. You're in this nebulous area. And that's why I think combining the clinical history with some of the more advanced testing, like the Eli spot test, where you actually take the person's blood, expose it to the antigens, the proteins that the tick has,

or the other co-infections that are there, and see the live cell's immune response to it. So this is based upon memory T cells and the production of compounds like interferon gamma. Is your innate immune system. Your innate immune system, your primary. So there's like two kinds of immune system, right? There's one that's like the old ancient immune system,

which is called the innate. And you're born with it. You're born with it. And that just like reacts to everything in a sort of like carpet bombing. And that's why maybe the symptoms are so bad with this. And then there's the antibody, which is more like the smart missile or called adaptive immunity

that actually targets specific bugs. So it's a memory cell. So like you get a memory cell to measles when you get the measles vaccine, so you don't get measles. This is different. This is just more of like a widespread immune response. And you can't measure through typical tests.

That's why this Eli spot is so unusual and helps us to determine what's going on. Exactly. And then when the other test, which I also use it again, it's not really this test, but by itself is not diagnostic of Lyme, but the CD57, which is the natural killer cell. And we measure the overall level of the natural killer cells in patients. There are many conditions that can cause low natural killer cell. And we measure the overall level of the natural killer cells in patients. There are many conditions that can cause low natural killer cell function. So things like chronic Epstein-Barr virus may do it, HIV virus, cancer, et cetera. But Lyme is also one of those.

So if a patient comes in with symptoms consistent with chronic Lyme and they have a low CD57 count, that ups the threshold for their probability of having chronic Lyme, and they have a low CD57 count, that ups the threshold for their probability of having chronic Lyme clinically. And then we also do the natural killer cell function test, which is not only the level of the natural killer cells, but are these cells actually able to do their thing? Are they able to kill pathogens? That's really important. I think, you know, I have this theory after seeing so many hundreds and hundreds of these patients is that Lyme and these chronic tick infections are kind of like AIDS in a way. They suppress the immune system. Absolutely. And they're sort of, they sort of hijack it and it

makes your body unable to fight it. So what I've been finding, I don't know if you see this Todd, but so many of these patients don't just have chronic Lyme, but they have a whole host of other things that destabilize their system. And it may be things that the body could handle when they're normally everything else okay. There's heavy metals. There's gut issues. There may be mold issues. There may be nutritional factors.

So there are all these things that are complex web of causative factors that don't get untangled with traditional medicine. And sometimes you need to treat all these things to get people back to normal. Absolutely. And you bring up a really good thing. So that patients who have chronic mold, so anybody who's out there, and if they have the diagnosis of mast cell activation syndrome, if they have the diagnosis of POTS, postural orthostatic tachycardia syndrome, where when you get up, your heart rate goes up high.

If you have other symptoms like dysautonomia, which is part of POTS, if you have these types of things go along with someone who's got chronic Lyme, they sort of go together. The other one, which we see a lot of, is also small intestinal bacterial overgrowth. I actually went to a talk given by a gastroenterologist, and all of a sudden, he was seeing all these patients with SIBO. Okay, when you and I went in our training, I never used to see SIBO. I mean, you had somebody with irritable bowel, but SIBO is now rampant. Yeah, it's true. It's really true. Exactly. Interestingly, in patients who have chronic Lyme disease, because Lyme bacteria is

neurotrophic, in other words, it heads towards nervous tissue and affects nervous tissue, also connective tissue, that you get what is termed Bell's palsy of the gut. Bell's palsy is when your face gets paralyzed. That's one of the symptoms of acute Lyme is you'll get a paralysis in your face and your face will go limp. In fact, one of my first cases of a severe case of Lyme disease when I had a private practice was a patient who I'd met to the hospital with acute Bell's palsy that was caused from Lyme disease. And the term Bell's palsy of the gut. So any patients who are out there, anybody who has refractory bad small intestinal bacterial overgrowth,

think of Lyme because this gastroenterologist, he got it on his radar. So he started checking all of his patients for Ly and lo and behold they had it yeah i had a patient who had a little different syndrome but she had severe constipation she could only go with colonics and heavy duty medication and turned out she had babesia which is another tick infection and that is known to cause a autonomic dysfunction of the gut, a paralysis of the gut essentially. Which is what she was suffering from. Wow. Which is fascinating, right?

Wow, yeah it is. So we see all these variable presentations and we do have a questionnaire we use called the MSIDS questionnaire which is the multiple immune whatever deficiency whatever questionnaire, symptom questionnaire and it helps us to sort of make track of all these very weird symptoms that people have. You know, I've got tingling, I get palpitations, I get headaches, I'm anky, I'm this and that. And you get this whole list of symptoms. And if people have a high score, it's likely that they have some issue. Now, it may not be 100%, but your odds are higher and and often people won't remember having a tick

bite they won't remember having a bullseye rash they won't remember an acute infection and you can live in hawaii and have it yeah it's everywhere i live in i live in arizona i can't get it exactly exactly it's everywhere just like you know with global and exactly and just just like you know with the covid virus we see that the vector for the spread of the code virus is the airplane it's not it's not a mosquito it's an airplane all? And how many of us travel and fly in planes? We go all over the place. There's also a theory. So that's why it's good that the airlines have checked it? Yeah, exactly. So also there's a theory that Lyme may also be sexually transmitted. And I've had some privy to some people have done some small studies on checking for the DNA of Lyme in sperm.

And it's been identified. So just like syphilis was actually sexually transmitted, I think there are in some cases Lyme may actually be sexually transmitted. So there can be transmission from the mother to the baby also. Yeah, maternal fetal transmission. Maternal fetal transmission. So you really have to think about it. And just because somebody doesn't live in an area like the Northeast of America, because Lyme, Connecticut was where it all started. And the interesting thing about that is that it was an astute clinician

who said, all of a sudden, I've got all these kids with juvenile rheumatoid arthritis, which is a rare condition. You never see that. And he had a whole clustering of it. Then he said, well, why is this happening? We just label it as juvenile rheumatoid arthritis. That's an autoimmune disease, but it's also infectious, right? Well, most autoimmune diseases, I think, probably have some type of infectious origin. Because of microbes, for example, in your gut. Yeah. So leaky gut and all that. Yeah. The ones that you probably see the most, or at least in my experience, I've seen the most, are Lyme with Bartonella and Babesia. Yeah. Those are probably the bigger co-infections.

Bartonella as one is, I think you probably have experienced this, that can cause neuropsychiatric illnesses. So we had a patient in the clinic. At the Ultra Wellness Center. At the Ultra Wellness Center, exactly, who was admitted to a psych hospital for psychosis and had Lyme and co-infections as a trigger for that. Just like, you know, it's like syphilis can cause madness, well Lyme can cause madness too.

Neuropsychiatry. Exactly, and it's not on the radar of neurologists, it's not on the radar of psychiatrists. Everybody's in their silos, and that's what's so different about functional medicine is that we look at the whole picture. We look at, I joke that we're holistic doctors because we take care of people with a whole list of problems.

Exactly. And I think that that is what's unique about functional medicine and about the Ultra Wellness Center is that we don't just take things at face value. We dig deep into figuring out the why and why people are suffering. Thanks for listening today. If you love this podcast,

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