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In this episode, you will learn about diagnosing and treating Morgellons.

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About My Guest

My guest for this episode is Dr. Eboni Cornish. Eboni Cornish, MD graduated from Brown University undergraduate and Brown University Medical School. She completed her family medicine residency at Georgetown University.  During her training there, she volunteered her time by serving as a medical consultant on a DC Human Rights Committee for Individuals with Disabilities.  In 2003, as a Howard Hughes Medical Fellow, Dr. Cornish conducted translational research at the National Human Genome Research Institute of NIH. She was an apprentice in the laboratory of Francis Collins, MD, PhD., the current Director of NIH and leader of the Human Genome Project. Under his leadership, she analyzed genetic associations of chronic illnesses.  She is currently a member of the American College for Advancement in Medicine (ACAM), the Institute of Functional Medicine (IFM), and A4M . She is on the physician advisory board of the Charles E. Holman Foundation for Morgellons Disease.  She is a board member of the International Lyme and Associated Diseases Society Educational Foundation.  One of her roles is the ILADS physician training program which trains hundreds of doctors in the management of chronic tick-borne illness.  She is an expert in the treatment of Lyme Disease, Chronic Fatigue, PANDAS/PANS, Biotoxin Illness, Fibromyalgia, among other chronic conditions.  In 2019, Dr. Cornish merged her private Lyme practice with the national Amen Clinics. There, she serves as functional medicine provider and treats neuropsychiatric manifestations of disease from a holistic perspective.  Dr. Cornish’s approach to the treatment of chronic disease is to find the root cause of a person’s health problems by performing a comprehensive evaluation of the body’s various biological systems. She understands that all of these symptoms are interconnected and contribute to the emergence of disease as well as its resolution.  Not only is she an amazing doctor, but she's also a mom of triplets.

Key Takeaways

  • How long has Morgellons been identified, and where did the name come from?
  • What are the main symptoms and common themes in Morgellons?
  • Is Morgellons contagious?
  • What is the connection between chronic Lyme disease and Morgellons?
  • Which organisms play a role in Morgellons?
  • What are the diagnostic criteria for Morgellons?
  • What are Morgellons fibers or filaments made of?
  • What role does environmental toxicity play in Morgellons?
  • Does mold illness from water-damaged buildings play a role in Morgellons?
  • What role does Mast Cell Activation Syndrome play in Morgellons?
  • Does dental health issues contribute to Morgellons?
  • How is Morgellons treated?
  • Why are sleeping, pooping, and GI health so key to recovery?
  • Is there a place for Disulfiram in the treatment of Morgellons?
  • What order should vector-borne infections be treated in?
  • Why are anti-parasitics helpful?
  • Do biofilms need to be treated to optimize Morgellons treatment outcome?
  • What needs to be done to further legitimize Morgellons?

Connect With My Guest

http://AmenClinic.com
http://ILADEF.org

Related Resources

http://TheCEHF.org
http://MorgellonsMovie.org

Interview Date

January 24, 2020

Transcript

Transcript Disclaimer: Transcripts are intended to provide optimized access to information contained in the podcast.  They are not a full replacement for the discussion.  Timestamps are provided to facilitate finding portions of the conversation.  Errors and omissions may be present as the transcript is not created by someone familiar with the topics being discussed.  Please Contact Me with any corrections. 

[00:00:01.18] Welcome to BetterHealthGuy Blogcasts, empowering your better health. And now, here's Scott, your Better Health Guy.

[00:00:13.26] The content of this show is for informational purposes only and is not intended to diagnose treat or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice, or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority.

[00:00:34.20] Scott: Hello everyone, and welcome to episode number 112 of the BetterHealthGuy Blogcast series. Today's guest is Dr. Eboni Cornish, and the topic of the show is Morgellons. Dr. Eboni Cornish graduated from Brown University undergraduate, and Brown University Medical School. She completed her family medicine residency at Georgetown University; during her training there, she volunteered her time by serving as a medical consultant on a DC Human Rights Committee for individuals with disabilities.

In 2003, as a Howard Hughes Medical fellow, Dr. Cornish conducted translational research at the National Human Genome Research Institute of NIH. She was an apprentice in the laboratory of Francis Collins, the current director of NIH and the leader of the Human Genome Project. Under his leadership, she analyzed genetic associations of chronic illnesses. She is currently a member of the American College for the Advancement in Medicine, the Institute of Functional Medicine, and A4M. She is on the physician advisory board of the Charles E. Holman Foundation for Morgellons disease.

She is a board member of the International Lyme and Associated Diseases Society Educational Foundation. One of her roles is the ILADS physician training program, which trains hundreds of doctors in the management of chronic tick-borne illness. She is an expert in the treatment of Lyme disease, Chronic Fatigue, PANDAS/PANS, biotoxin illness, Fibromyalgia, among many other chronic conditions. In 2019, Dr. Cornish merged her private Lyme practice with the national Amen clinics.

There she serves as a functional medicine provider and treats neuropsychiatric manifestations of disease from a holistic perspective. Dr. Cornish’s approach to the treatment of chronic disease is to find the root cause of a person's health problems by performing a comprehensive evaluation of the body's various biological systems. She understands that all of these symptoms are interconnected and contribute to the emergence of disease as well as its resolution. Not only is she an amazing doctor, but she's also a mom of triplets. And now, my interview with Dr. Eboni Cornish.

[00:03:00.04] Scott: It is an honor for me today to have Dr. Eboni Cornish on the show. We have met several times in the past through ILADS and through The Forum for Integrative Medicine. Not only is she a bright doctor, but she truly and deeply cares about making a difference for her patients. I've been really looking forward to this conversation for some time now, and thank you so much for being here today, Dr. Cornish.

[00:03:20.21] Dr. Cornish: Thank you for inviting me. I've been looking forward to this as well. I listen to your podcast for the last two years, and I learned a lot every time I listen to you. And I've kind of been honored that you chose me to be on your show, so thank you.

[00:03:33.00] Scott: Thank you so much, that means a lot. First, let's talk a little bit about how you were led to doing the work you're doing today. What made you choose these challenging, complex conditions that most of medicine doesn't even believe are real conditions such as chronic Lyme disease and Morgellons. Did you have some kind of personal health journey that played a role in doing what you do today?

[00:03:53.07] Dr. Cornish: That's an excellent question. One thing that happened to me early on when I first transitioned into functional medicine, I was kind of bored with family practice. And my boyfriend at the time, who is now my husband, I told him finally on my third date my profession, and I was waiting for him to be impressed, and yes I'm dating a doctor. And he looked at me, and he said, wow, you use quite a bit of pharmaceuticals, don't you? I don't think that should be the answer to your patients; there's more. And as we were early in our relationship, he gave me a lot of books on a functional healing and just challenged me to think outside the box.

And honestly, that was the title of my first job opportunity in functional medicine and chronic Lyme, was for doctors that think outside the box, so everything was kind of aligned there. And with personal journeys, when I started doing functional medicine, it made me reflect on my own life because I had been diagnosed with what they call idiopathic condition. Meaning they didn't know why it was presenting. So when I was in training in med school at Brown at about age 23, 24, I started to have seizures for the first time.

I didn't have childhood epilepsy, and they couldn't determine what the cause was all my imaging was always normal, EEGs were normal, and it made me realize that okay this is stress and that was the conclusion by numerous neurologists. And my first seizure did take place as I was preparing for a board exam. And so I really kind of didn't think about it, and then over the years, I've noticed that when I am stressed or when I don't take care of myself, or when I eat poor or make poor choices in food and lifestyle, it can trigger a seizure.

And luckily when it's in control now, but when I have those onsets of downward spirals because we're all human and we have our moments where we might stay up too late, and not get the rest we need. I realized that I need to become more centered and focused. And then the second one was when we got pregnant with unexpected triplets, and that was a shocker. I mean, I cried when they told me, I just didn't believe it. And throughout the pregnancy, my family, especially my husband and I, every day we were nervous. We we're bringing in the world three humans.

And I'll never forget my first doctor; he wasn't my OBGYN. He came in the room, and he said to me - Oh, only animals breed litters, you're going to have to reduce one of them, right? That was my shock, and it's a colleague I'm like whoa. And the entire pregnancy, my husband and I who had been practicing the vegetarian lifestyle, he'd been vegetarian for years we were strict about the diet. We were vegan, gluten-free, fresh fruits and vegetables, green smoothies every morning all throughout my 32 and a half weeks of pregnancy.

And I was told by doctors oh you can't do that, you must have this, you can't have such a restricted diet. Oh what are you doing? I was supposed to be on bed rest; I'm walking because I felt great and that morning sickness, and then they just kept telling me oh you need to do more, you need to eat more, you need to eat differently. And surprisingly enough, I now have three three-year-old triplets who are completely healthy and are almost bilingual; they're learning Spanish now, so something worked. So that's kind of how I apply my lifestyle in my practice, that's one entity, and I learn a lot for myself, and I'm able to use myself as an example for my patients.

[00:07:58.01] Scott: Beautiful. So let's talk a little bit about Morgellons; how long has Morgellons been identified as a medical condition, and where did the name actually come from?

[00:08:09.14] Dr. Cornish: Okay. So, in 1674, there was a person Sir Thomas Browne who actually visited a former French province called Logandale. And at that time he saw this outbreak of children who had horse hairs on their backs, and he didn't know what the name is so he called it Morgellons, and Morgellons itself is a derivative of the word Mouscouloun which means hooks or that are attached to small spindles. And then, in 1682, Dr. Michael Ettmuller, he drew these pictures of what he saw in children what he described as worm. Very similar to kind to part of this kind of collagenous fibers we see under microscopy today.

Later on at 2002, the Morgellons Research Foundation started to open up to accept patients and stories of people who were suffering from symptoms consistent with the disease. And the first paper that I was exposed to was in 2006 when a colleague of mine, Virginia Savely, she started to describe what it was she was seeing in her patient population. These non-healing wounds, these fibers, and these Morgellons syndrome. But it's been around for years, and it was described in 1674; people think it's something new, but it really isn't.

[00:09:58.11] Scott: Yes. Ginger Savely, she's definitely one of my heroes and doing all of the work, and I know she's been a mentor and colleague of yours as well. What are the common symptoms that you see in your patients with Morgellons?

[00:10:11.16] Dr. Cornish: So typically, I'll find patients who complain of kind of nebulous symptoms. Crawling, itching, non-healing wounds sometimes they'll get numbness and tingling at nighttime. The common presentation is always they see fibers that are being shed from their skin, but then you also have other systemic symptoms of fatigue and cognitive impairment that are also associated. But you definitely get a lot of the dermatologic manifestations; joint/muscle pain can also be associated with this illness. So it's pretty broad spectrum about the different etiologies and presentations.

[00:11:03.06] Scott: Are there any common themes in terms of patients' stories in terms of what might have led to the development of or presentation of the Morgellons itself?

[00:11:14.09] Dr. Cornish: That's an excellent question. A lot of times, I might see some patterns. Tpically, I'll find patients have had exposures to some sort of infectious process, okay that's one of the big trends. I'll also find patients who are exposed to very toxic environments report this condition.

And a lot of patients believe it or not just present with terrible lifestyle choices. Obesity, poor dieting, lack of sleep, all the things I mentioned earlier. So it's definitely consistent among the Morgellons population that people who suffer from this chronic debilitating process to have those different causes. I see that constantly in my practice.

[00:12:09.17] Scott: And I've heard that in some cases people will have a history of some type of skin puncture or maybe they were gardeners or something soil-based prior to the presentation of Morgellons. Is that a common theme or not?

[00:12:23.26] Dr. Cornish: I have seen that in some cases, not in all of them. Actually, I was treating Morgellons when I was treating chronic Lyme before I knew what it was. And my first Morgellons patient actually had surgery, and she saw the Morgellons fibers from her wound. She had been researching; she's the one who got me very involved in Morgellons in the Charles E. Holman Foundation and really educated me because I've ever heard of this condition. And after starting her care, I realized I was treating a lot of other Morgellons patients, and so were some of my associates.

And I would think about this one story of a patient of mine who had terrible had sores all over her legs, arms, but she would get better as she went through her treatment for tick-borne disease and then when she had changes in her lifestyle or stress or other infections, those sores would present again. And years later when I started to study more about Morgellons, I told her I said let's look under the microscope; you have it, and she was like well I'm so happy because I didn't want to tell you about these fibers, I thought you would think I was crazy. So that's kind of some of the stories that stick out to me.

[00:13:46.03] Scott: One of the common questions when talking about Morgellons is, is it contagious? And so I'm curious, what are your thoughts on the possibility of it being contagious? We know in some cases several people in the same household may present with Morgellons. When you're working in your medical practice, do you take any special precautions considering that possibility, or do you feel like it's likely not contagious?

[00:14:09.06] Dr. Cornish: So that's another great question.  A lot of my patients, that's one of the first things they asked me. Right now, we don't have evidence, either published evidence or anecdotal, that I could be comfortable with saying that this is definitely a contagious illness. I think that just like with a lot of other chronic illnesses and infections that families may have the same exposure which could potentially lead to similar clinical presentations.

Because we think at this time that Morgellons and some of the etiologies could be infectious organisms, I don't actually think one infection is going to jump to another. However, those trends are, like I said earlier, usually due to those exposures. And when you're taking precautions, I think you should take the same precautions you would take with all of your patients, okay? Good hygiene, cleaning, those are things we were all trained to do. But I don't necessarily think you need masks or anything that's the more severe to take care of these cases. You should use the same on sterility that you would use with anyone.

[00:15:27.28] Scott: Are there are any patterns that you observe either in laboratory testing if we look at either immunological testing or inflammatory markers, toxicity markers. Do you run any of the CIRS or Chronic Inflammatory Response Syndrome markers like C4A or TGF-beta one or MMP-9? Do any of these seem to correlate to symptom presentation or severity in Morgellons?

[00:15:53.24] Dr. Cornish: So with my Morgellons patient population, and right now, I would say it's over the number of 200 through the last four or five years. I have seen typically high inflammatory markers. Some of the nonspecific inflammatory markers C4A, ANA, C-reactive protein, TGF-beta 1, which is also C4A, TGF-beta seen quite often in patients who suffer from biotoxin illness. I also see that they also have those exposures to mold when we do our due diligence.

A lot of patients will also have IgG subclasses, which this represents for your listeners, your immunoglobulins. Your amount of immune cells in your body and they'll have deficiencies, and the one pattern I see most often is IgG2. Another colleague of ours on Kristine Gedroic a few years ago at an ILADS conference stated that IgG2 deficiency is seen a lot of times in parasitic infections.

So I definitely see that trend among patients. And I'll see positivities for different chronic infections. Like I'll see chronic viral infections, a lot of patients have on systemic candidiasis or yeast. Also, I'll see, in some cases, positive tick-borne disease or other chronic bacteria, but there definitely is some abnormalities that I see consistently among our patients.

[00:17:37.09] Scott: What is the connection between Lyme disease and Morgellons? Is it your experience that patients with Morgellons also tend to have underlying chronic Lyme disease?

[00:17:48.13] Dr. Cornish: That's an excellent question. We are just on the brink of discovery for understanding this connection. In about 2009, Ray Stricker and Ginger Savely, they published a study on the newly emerging disease at that time, which was called bovine dermatitis digitalis. And what they saw was that there were cattle who had decreased milk production, weight loss, and they had these fibers that were coming from there hoof. And when they did staining, immunofluorescent staining and genotyping, they found Borrelia.

Well taking it a step further, in 2013, Marianne Middelveen and other colleagues they published a study where they looked at patients and the samples and found that Borrelia burgdorferi specifically was noted in PCR, which for your listeners is polymerase chain reaction, the way you amplify DNA. They also saw Borrelia burgdorferi in FISH, which stands for fluorescent in situ hybridization. And under the microscope, it was reproduced to show Borrelia burgdorferi.

So they published that, and it was evidenced that these wounds weren't self-inflicted. And then taking it a step further in 2018, they published another study, where they looked at about 30 patients who had Morgellons symptoms; I actually had patients that were a part of that study. And they were found to have Borrelia burgdorferi, relapsing fever Borrelia, which is another subspecies of this organism as well as Bartonella also using the same technical methodology that we use in our previous studies.

So there's definitely been a published association between these underlying tick-borne diseases and Morgellons. However, like I said it's still early, I think that there are most likely just from anecdotal data, nothing published but just my own experience. Yeast contributing to symptoms, biotoxin illness, or mold toxicity are contributing to these symptoms, and a lot of patients also have heavy metals.

I also see a lot of my Morgellons patients who have the tick-borne disease Babesiosis which is also a parasite. And I have about four patients who have the parasite Toxoplasma gondii. So there are quite a few different infections that have not only been studied or evidence-based, but also I've seen in my practice. But we still have a lot more to do.

[00:21:05.08] Scott: So if we look at the approximate 200 patients that you've worked with Morgellons, about how many of those had some indication of chronic Lyme disease?

[00:21:15.03] Dr. Cornish: Out of my patient population, when you say indication, you look at it two ways, both clinically and from the testing. I would say about 70% of my patients have clinical symptoms that are consistent with vector-borne illness. And I would say from serology; there are about half the patients who are seropositive for vector-borne illness.

But some of them are positive for the clinical signs, symptoms, and may not necessarily have positive testing. And as we know that's one of the controversies with chronic vector-borne disease is that the serology aren't sensitive. So I typically based it on the clinical presentation of our patients.

[00:22:04.03] Scott: So if we look at a population of people with chronic Lyme disease that may also then present with Morgellons and those that may not have Morgellons symptoms. What do you think is the difference between those two populations? Is it a genetic link? Is it a toxicity issue? Or there are some other factors that lead some in the chronic Lyme disease population to then present with Morgellons?

[00:22:26.01] Dr. Cornish: That's an excellent question, and we don't like have that answer yet. From personal experience, I have seen my patients who have chronic Lyme disease have similar trends, where it be this is exacerbated from biotoxins or from lifestyle issues or from heavy metals and other environmental causes.

And I also see a lot of patients who do have what we call methylation imbalances, which are genetic problems that cause you to have problems/issues with detoxification. But I can't necessarily say at this point in time; I can come up with the differential diagnosis of the causes of one presentation versus another. I think it's multifactorial, but we're going to find it one day.

[00:23:23.28] Scott: What are the diagnostic criteria for Morgellons? And this came from a listener who had a question of could you have Morgellons without having filaments externally and skin lesions, but maybe have some internal presentation of Morgellons?

[00:23:39.00] Dr. Cornish: That's an excellent question. As we are going forward with trying to legitimize this disease, it's important that we kind of come up with this standard classification and qualifications for diagnosis. Personally and when I find among other doctors who do treat this condition, one of the requirements is that there are those microscopic filaments seen under microscopy. I actually use an electronic microscope in my office, which is 400x, and I typically find fibers under the skin. There is question if someone has non-healing wounds and fiber presentations; does that definitely mean Morgellons? The verdict is still out.

But when I actually trying to justify that diagnosis and classify those patients, they have to have some of those symptoms I reported earlier. The stinging, the crawling, the non-healing wounds, typically some patients may have exposure to chronic infections, and then the microscopic exam is very important. Now can I say a hundred percent that everyone has those filaments that suffer from Morgellons? I can't. But as I said earlier, we're working hard to legitimize this disease to the general public and among our colleagues. So I do think it's important that we do utilize those skin exams and have some concrete data to present to others in our community.

[00:25:31.24] Scott: Let's talk a little bit more about the fibers, others refer to them as filaments, I think filaments is technically the more correct as I understand. What are they made of? Why is the body producing them? What do we think are maybe the underlying triggers for the production specifically of these fibers or filaments?

[00:25:50.19] Dr. Cornish: So the way I typically describe it, because these terms are used interchangeably. The filaments as you alluded to that is the more technical term. And the filaments are keratin and collagen in their composition. The filaments are what we see under electronic microscopy. The fibers are the way I look at it, what you see with the naked eye, what's shedding from the patient, what they typically report because those filaments are typically not seen with the naked eye, that's why you utilize the electronic microscope for that.

Clinically, I think that one of the reasons why my patients may present with this condition, one of the associations can be the chronic vector-borne untreated disease complex. Because we know Borrelia and its preference for collagen, okay. I also think that there is a component of environmental illness that compounds this condition. So chronic infections, as well as environmental exposures. And then as we earlier discussed, there definitely seems to be a subset of patients who have had surgery or scars of certain locations that tend to convert to this dermatological manifestation of disease.

[00:27:37.13] Scott: Given that the fibers are made of in part collagen, we also know Borrelia negatively impacts our collagen. But given that the fibers are made of collagen, does supplemental exogenous collagen in Morgellons patients make things better or worse?

[00:27:55.27] Dr. Cornish: That's an excellent question. And I have not found any direct correlation; I mean it's been consistencies with the patients. I have a lot of patients you have no response to collagen; I have some patients who may have had reported response.

But I think there are other potential causes for their symptoms, and it's not just that one thing. I haven't met a patient with Morgellons who simply used collagen as their only therapeutic intervention. So it's hard for me to have kind of a case and a control to that treatment option.

[00:28:37.13] Scott: You talked a little bit earlier about some of the organisms that are associated with Morgellons in some of the research Borrelia burgdorferi, relapsing fever Borrelias, you mentioned Bartonella, I've also heard H. pylori in some cases. And so one of the things that I wondered relative to H. pylori, it's so common in the general population.

So if H. pylori is seen in cases of Morgellons, is that more of a causal role, or does it just happen to be present there because it's high in the general population anyway? Do we know if there was any testing done in control patients versus Morgellons patients?

[00:29:16.28] Dr. Cornish: That's a great question. And I think just like with the other infectious organisms we mentioned earlier, there are some that believe, and I do believe that H. pylori could be a contributing factor to Morgellons presentation.

That bacteria itself was actually cultured in some of the Morgellons fibers. So while it is, just like tick-borne disease is a very popular kind of common in presentation among the general population, I think that this infection is the causative component of this disease. There has not been a study that I'm aware of, and I learn something new every day. But not that I'm aware of currently that looks at case controls for Morgellons with H. pylori.

[00:30:13.29] Scott: Given that many people have Borrelia and Bartonella and H. pylori but don't develop Morgellons, do we think Morgellons is caused by the bug or this community or mix of bugs? Or do we think it's the immune response or host response that really makes the disease? In other words, is it the immunological response that leads to Morgellons in some patients with Lyme disease?

[00:30:40.09] Dr. Cornish: Well, as we know, tick-borne diseases are able to evade the immune system, and Borrelia burgdorferi specifically has the ability to do what we call molecular mimicry. Where it integrates its DNA in the host DNA, and what that can lead to is a predisposition of autoimmunity. So in a lot of patients who suffer from vector-borne illnesses and other chronic bacteria tend to have an immunocompromised state already as one kind of predisposition, they're already immuno- compromised.

Then if you tackle on kind of the environmental toxins that they are expose to and also some of the genetic mutations inability to process histamine or glutathione and ability to process it, those are also confounding factors. So I tend to find that my Morgellons patients versus the patients with chronic tick-bore disease that don't have Morgellons have a huge amount of other compounding variables that contribute to their situation.

[00:32:03.26] Scott: Let's talk a little bit about some of the mental, emotional, psychiatric symptoms that often are present in Morgellons. Is your thought that those symptoms are of mental, emotional, psychiatric origin? Or are they the result of underlying infections?

[00:32:20.25] Dr. Cornish: That's an excellent question. I get that all the time. The majority of my Morgellons patients who present to my office, I'm never really their first doctor, it's rare. They tend to have been to a psychiatrist, dermatologists, other primary care doctors. And a lot of times they are misunderstood, and even labeled delusional. There's a term delusions of parasitosis, whereby patients are told that they have psychosis due to self-inflicting wounds and textile fibers.

So if you could imagine if you've been on this journey whereby this disease complex, which in some patients can be mutilating. I've seen it look like leprosy in some cases when it affects the face and extremities. And they're giving these, they're provided these terms and diagnoses of exclusions, and more importantly, told that they do have psychiatric conditions because they have something that they can't quite explain that would affect the mood; I call it the life component.

But then when we think about vector-borne illness or the live component that organism Borrelia burgdorferi has been shown to decrease the production of something called quinolinic acid, which helps your body produce serotonin. I work here at the Amen Clinic, so I deal with a lot of patients who have neuropsychiatric manifestations of tick-borne disease, and their mood improves as you treat the underlying infectious process.

So it is my thought that there are quite a few of my patients that not only have that Lyme perspective because they have a disease complex that people can't understand and they've been judged and dismissed. But also there is an actual scientific component leading to the decrease in the amount of that needed neurotransmitter serotonin that makes us happy. So, I think it's multifactorial.

[00:34:49.11] Scott: Yes. And I think in Morgellons, and unfortunately, it's a condition where people are so commonly invalidated and told that it's all psychological. And so I think what I'm hearing you say and my understanding as well is there may be psychiatric symptoms in those with Morgellons, but that does not mean that it's a psychiatric illness or condition.

[00:35:09.17] Dr. Cornish: Correct, that's absolutely right, and it's important to differentiate the two. And that's why I go back to the need to have some set criteria for diagnosis.

[00:35:24.12] Scott: Yes. It's almost like Morgellons and PANS or PANDAS are both kinds of at a similar place where there's still not a lot of acceptance, kind of where we were with chronic Lyme disease 15 years ago. But hopefully from people doing the work like you're doing and really getting the message out there, hopefully, people will start to understand that this is a very real condition.

We all live in a very toxic soup in our environment, something like we've never seen before; to what extent do we think Morgellons is an environmental illness? And when you're evaluating patients, what are the kind of key toxins that concern you in potentially being contributors to Morgellons?

[00:36:09.14] Dr. Cornish: I don't think that Morgellons is necessarily only an environmental issue. I do believe, however, that there are environmental triggers that contribute to this clinical presentation. Some of the most common things that I find mercury and lead toxicity, a lot of my patients, have dental amalgams that are rich in mercury or have had them removed not by a biological or holistic dentist, by a traditional dentist and they tend to tell me, oh yes I started to feel a lot worse after that. I have patients who are exposed to water-damaged buildings and moldy environments.

And also those who suffer from something we call MARCoNS, which is a methicillin-resistant form of staph aureus. And definitely, when I do some testing, one specific test is testing I'll find a lot of oxalates, pesticides, so other environmental components that are contributing to this presentation.

But I definitely call it one of the M&M's I think about this Morgellons and mold, there's a close connection. And if any providers listening are treating patients who have these chronic illnesses or infections, skin not quite healing and they don't quite understand it, look at their environment, and that's even with any chronic illness.

[00:37:51.16] Scott: What is the role of mold exposure, of mycotoxins and the development of Morgellons? Is it that they may potentially be dysregulating the immune system that kind of opens the door for Morgellons? And I'm curious do you find a correlation between Morgellons and any specific molds or mycotoxins that are present in higher amounts in your Morgellons population.

[00:38:13.16] Dr. Cornish: That's an excellent question. I definitely think when patients suffer from the Chronic Inflammatory Response Syndrome or CIRS that they have this chronic constant inflammatory process. And the way I view treating mold illness it's a battle between the inflammation and your immune system. So typically I'll have patients who have Morgellons who do have mold illness and when I do, some of the urine mold testing one specifically great plane, they look for a mold Chaetomium globosum that has been shown to be popular in or found in skin lesions.

So I was like, oh wow, and the more I tested patient I found like, I have about 50 to 60 patients who have that specific mold. But I also see quite a few patients who have Aspergillus. Ochratoxin is very common among all of us just from food, but I definitely see that toxin that mold toxin in my patients. And surprisingly enough, Scott, I see quite a bit of systemic candidiasis. I've actually had some of my patients who I found who have Morgellons who have had very high candida markers, immune markers on blood tests, and I just couldn't get them to go down. We tried antifungals and the like, and when they culture their homes with petri dishes, they found Candida in their homes or Candida on their pets, and it's like wow, maybe that could also be contributing to this presentation.

[00:40:03.28] Scott: Yes, that's very interesting, and I've seen that in some of the Immunolytics testing, for example, with Candida showing up. And I've heard people suggest that that could be a source of re-exposure, so that's interesting that you're exploring that possibility as well. You talk about the 3 M&M's: mold, Morgellons, and mast cells. What's the role of mast cell activation syndrome in the Morgellons population?

[00:40:28.14] Dr. Cornish: For those who are not aware of what the mast cell activation syndrome is, these mast cells are a normal part of our immune system. So when they have some sort of aggravator, an allergen, a virus, a toxin, peptides, they start to do what's called degranulate, which is the breakdown. I got to look at it like popcorn popping; they're breaking down uncontrollably. And during that process, they're releasing numerous different mediators from those cells, and one of which that's seen the most often is histamine. Now let's think about histamine just simply; histamine is usually associated with allergies.

Some people who have allergies what do they present with skin rashes, itching, they can also have symptoms of insomnia. There's also a common association with this mast cell or histamine intolerance with joint pain, muscle pain, cognitive impairment, malaise. So what I find is that some of my patients with Morgellons who have this numbness, tingling, itching they tend to do well when I provide them compound and antihistamines like Ketotifen or even when I put them on histamine blockers like combinations that block both receptors H1 and H2.

And then natural agents that lower histamine like quercetin and bromelain, because I mean it just makes sense, right? You have these patients with these skin symptoms, this itching, these rashes, these non-healing wounds, and they also have these triggers. So when I started to find that it worked before I even knew about histamine intolerance, I'm like wow my Morgellons patients feel better, when I give them Ketotifen way to go. But then I'm like oh yes, and now I understand my Morgellons a lot of them are suffering from histamine intolerance and mast cell activation syndrome. 

[00:42:44.10] Scott: Some time ago, Dr. Omar Amin, who is a parasitologist, came to an interesting and for me unexpected conclusion around Morgellons. He called it a Neuro-Cutaneous Syndrome, suggesting that Morgellons is connected with dental material toxicity. I'm curious if you've observed any connections with your Morgellons patients and dental health past dental work or specific dental materials that might have been previously placed in their mouths?

[00:43:14.03] Dr. Cornish: I am so happy that you asked that question because I would say a large percentage of my patients with Morgellons have dental complications. And I see what they report some of the biological dentist reports as cavitations. We know Borrelia can also make cavitations in the mouth. I see a lot of neurological nonspecific gum pain. I've even seen patients who've had fibers actually come out of their gums. And I think a lot of patients of mine have the heavy metals; they have the old-school mercury amalgams.

So I do think there's something to be said about there being some sort of metal-dental association with this illness because it's definitely a very, very common pattern. In fact, most of my patients I tell them to use good toothpaste that are binders like Dentalcidin by Bio-Research is a great toothpaste that can help some patients alleviate those symptoms. I see a lot of yeast overgrowth or thrush in the mouths of my patients with a very white tongues contributed to by Candida. So there's definitely an oral component to this illness.

[00:44:43.13] Scott: Some have suggested that there's a correlation between Morgellons and genetically modified foods, Morgellons and chemtrails, Morgellons and microplastics in our environment. Do you feel that any of these plays a role in Morgellons, in your opinion?

[00:45:00.05] Dr. Cornish: Well, the way I look at it, Scott, is this, as you alluded to earlier, we live in this toxic soup. But I also do my due diligence of trying as hard as I can with the limited evidence that we have available at finding something that is tangible, that is researched, and who's to say that some of those other conditions don't cause this. Like you said earlier, Lyme 15 years ago was kind of an unknown illness, and I think Morgellons is where Lyme was 15 years ago.

So you may interview me 15 years from now, and I will have more confidence in saying yes, those are definitely contributing factors. But right now, what I can say confidently is that those are toxins that we're all exposed to, that can compromise our health. But I don't have any kind of tangible, concrete answers that they're associated with Morgellons at this time. But like I said, who knows down the road.

[00:46:17.23] Scott: We'll come back and do this again in 15 years and see.

[00:46:20.23] Dr. Cornish: I can't wait.

[00:46:22.01] Scott: Let's move into treatment a little bit. So is the treatment of Morgellons any different from the treatment of chronic Lyme disease? Is it generally treated systemically as well as topically or locally where there's filaments or lesions present? And what are some of the tools that you found the most helpful from a treatment perspective in your Morgellons population?

[00:46:41.26] Dr. Cornish: And that's a great question because I tend to look at all infections from a functional medicine perspective because a lot of patients first thing they do, especially Morgellons patients they want me to eliminate the causative factor. Get me the drug, get me better right away. But I call it kind of the preparatory phase, where we're stabilizing hormones. We're testing the gut, we're testing their toxic burden, and we're starting them on typically start people on agents that help bind like charcoal and clay, things like GI Detox or Takesumi charcoal and the list goes on.

So I start them on that process because I understand that typically there is some sort of toxic exposure in most cases, and I also focus on cleaning up lifestyle. It's one patient that I presented on recently, a patient of long-standing of mine, she's now married, ready to have children. But when she presented, she had very terrible sores on her face, and she was very succumb to much scrutiny and was suicidal in a sense. And she wanted me to give her drugs day one. So I gave her some agents, but there things you can use over the counter like Nizoral or antifungal shampoo or there certain topical antibiotics that are helpful. But for her, I said look, I'm not going to treat you quite yet because she was an uncontrolled diabetic; she had a terrible sleeping pattern. She was a home inspector; she was exposed to mold day in and day out.

And so I just made her initially some supportive methods for sensations, and I gave her a great nutritional plan. Started her on a binder, other agents to help detox are like NAC, started her on probiotics, we did some work with her gut and got her hemoglobin A1C for diabetes and better control and changed her to a strict diabetic diet. She came to visit me six weeks without any antimicrobial treatment, and 40% of her lesions had started to heal.

And so that's what I tell patients because once they enter my doorstep, they're waiting for the answer, they want the treatment. What they may have read on the internet, what their friend might have, what they think should work they want it right away. But I tell them Morgellons is multifactorial, and there is a functional component. So just like when I used to treat chronic Lyme disease, and I used to jump the first day at just giving antibiotics, you know that was my initial treatment.

I now treat my patients who suffer from chronic tick-borne disease from a functional medicine perspective. So after we get some stability, and I tell them you're committed to boot camp, you're committed to this process. Then I transition to more of a treatment of the underlying disease process. So at that point, depending on what the cause is, we start either antibiotics; with some patients, we start anti-malarials, some patients we may start anti-parasitics, and some patients may just use natural remedies as well. But there's no protocol for this; it's all individually tailored.

So, one Morgellons patient may have a completely different presentation than someone else by just tweaking certain antimicrobials. So I wish we had a textbook that works for every patient, we do have some agents that have been shown to be successful among multiple cases. So a lot of the antibiotics we've seen Cipro, doxycycline, I'm starting to use in my case some Disulfiram and some of the anti-parasitics like Ivermectin, Albendazole and even in some patients antimalarials that treats the tick-borne disease Babesia. But it has to be individually tailored for that individual patient.

[00:51:31.01] Scott: At your talk at ILADS, you said that treatment must start with sleeping and pooping. And so I'm curious how commonly are these issues in your patients, why are they important, and what are some of the recommendations that you have for improving sleep and going with the flow?

[00:51:47.14] Dr. Cornish: So that's great, that's how I start every visit, is with what I call neuro-endocrine support. Your brain and your hormone, your stress response, your mindfulness because we have to think about it. If we're not sleeping, our brains and our bodies aren't healing. When I find that I don't sleep, as I said in the beginning, that's when I had seizures or other illnesses that plagued me, I'm like, wow I didn't sleep well, it's that simple.

You have to sleep, and you have to get into a deep REM sleep in order for your immune cells to turn over, your gut cells to turn over to decrease inflammation and improve cognition. I was so surprised at how many patients I see who think they have all these debilitating illnesses, and I say go get a sleep study because you snore and they say oh wow, I'm much better, thank you didn't quite need your assistance. But that is the pillar to health: quality sleep, mindfulness, and relaxation, and poop. Now poop is actually a Brown University Medical School word, and I use it constantly, or maybe it's just a triplet mom word I don't know because I see a lot of that regulary.

[00:53:16.21] Scott: I bet you do.

[00:53:18.03] Dr. Cornish: But even here, I get magic wands, my patients give me gifts, they call me the poop queen because that's an area people are uncomfortable talking about, bowel movements. But once again we have to think about this very simply, everything that we're exposed to and we eat it goes through our digestive tract. And that's the number one way we detox, so we talked a lot about detoxification strategies, well if a person is constipated then that's going to impair their major detox pathway, you have to get it out.

And I explained it to my patients that if I don't encourage you to successfully have one bowel movement a day, then I've created a septic tank. And once people see that visual, even children they're like oh I don't want to be a septic tank, help me, please. And the gut is our second brain, Scott. And so you've had a lot of experts here who speak on leaky gut and things like a gut dysbiosis, but even if you take a step further, just look at TV. Everything you watch, every other commercial is nausea, vomiting, diarrhea, irritable bowel. You know people can't make it to bathrooms, and they're really pushing medication to help improve gut stability.

Now granted, I do that more from an integrative and functional perspective, whereby I give them dietary changes, actually do a lot of stool testing to evaluate their gut microbiome and give them herbals as well natural remedies. They feel better; it's just very black-and-white medicine. If you don't sleep and you don't have bowel movements, nothing will work for you pretty much, or you're going to have to work four times as hard at getting the right treatment protocol just because you missed the basics.

For sleep, I always encourage patients to make sure they're having a good sleep hygiene; that they are also not sleeping in front of the television. That they're decreasing their risk of exposure to electronic magnetic frequencies, so turn that phone to airplane mode, turn those devices to airplane mode, and a matter of fact get them out of the room because you're sleeping you're supposed to be resting. And I even have some of my patients participate in sleep courses that are online that get them in that regular pattern.

I also encourage those who have severe insomnia to do more mindfulness activities throughout the day. Because sometimes, we'll find that a patient has a lot of cortisol or stress hormone when I do testing while they're supposed to be resting. So that's leading to a non-restorative sleep. Even though they think hey, I'm sleeping all night, but you're really not getting into that deep REM sleep. So good sleep hygiene, mindfulness, sometimes even taking baths, Epsom Salt baths, which are great at detoxing right before bedtime and turning off those devices. Those are key as far as stabilizing your sleep pattern, it's imperative.

[00:57:10.21] Scott: So let's broaden the poop discussion to a gastrointestinal health discussion. You talked a little bit about leaky gut, what are some of the tests that you like to perform to look at the health of the gut? Do you use the GI MAP? Do you have other tools that you like? And what are some of the top interventions that you often recommend to patients when you kind of implement your gut protocol or what's called a 5R protocol?

[00:57:34.18] Dr. Cornish: So, some of the tests that I use, a lot of times I'll use KBMO, which looks at food sensitivities. Not necessarily allergies, but those foods that are causing what we call complement system to respond and to be inflamed because that's a part of your gut health. What foods are we eating that are damaging you, but that's kind of the removal phase. I also utilize tests like CDSA test, GI Effects as you alluded to, and GI MAP because it's easy for us to say hey, you know your gut is impaired. But we have to understand the reason for that imbalance.

A lot of times, we'll find the imbalance is with bad and good bacteria and imbalance between the two, and we call that dysbiosis. We may also see that there's an imbalance because of too much yeast or other infectious organisms. We find that patients may not have the proper amount of enzymes needed to get the gut working or process their foods, but they need to. They can also be deficient and things like butyrate, which feeds a small chain fatty acid that feeds good bacteria. Or they could just have a lot of inflammation in the gut.

So, all of these tests screen for those different markers. And as you alluded to earlier, you have that functional medicine approach to the gut, the Rs which I say remove, replace, rebalance, repair, re-inoculate. So you want to kind of remove the junk, right? Remove the things that can potentially cause damage to your gut like the stress, like the foods. I mean a lot of patients we talked a lot about treating with antimicrobial or antibiotics, but those also damage the gut.

So I have to work three times as hard to help stabilize the gut in a patient that I'm using potentially toxic medications to treat Morgellons or any other debilitating chronic illness that requires that drug. And you also have to make sure you replace kind of that good cell layer, so I use things that are soothing to the gut; things like glutamine that help stabilize that gut wall, which becomes impaired with gut dysbiosis. I use a lot of immunoglobulin things like MegaMucosa, SBI Protect, I use a lot of Enteragam, and that gives you some of those immune cells, those immunoglobulins, and it works wonderfully in helping to heal the gut.

And you also want to repair it, so replacing with the enzyme or preparing that gut lining and soothing it. And Re-inoculate, that's when you start giving the good bacteria those good probiotics. Because if you try to give the probiotics too early in a patient's gut healing journey, they may have an adverse reaction to them because probiotics are still living organisms. So at times when you have that gut border impaired, and that causes that leaky gut, well sometimes things like good and bad bacteria leak out to the environment and also probiotics. And since the majority of your immune cells are located in your gut, impaired gut or dysbiosis can cause your immune system to be compromised. So also, the next are re-balance you got to relax, because as I said, stress is a huge component of this leaky gut as well as gut dysbiosis, alright. So that's the approach I take, but it starts with the foods and the diet and removing the toxins.

[01:01:59.28] Scott: You mentioned how important it is to address inflammation in the gut. We talked about mast cell activation earlier. Do you find that removing or reducing high histamine foods is an important part of getting the gut health back on track?

[01:02:13.00] Dr. Cornish: I definitely think it is. The histamine foods are some of our beloved foods like avocado and spinach, but I typically have patients of whom I think are suffering from mast cell activation syndrome or histamine intolerance; and especially with my Morgellons patients, I have them do a two-month challenge lowering the histamine foods in their diet to assess if there is a clinical response. I definitely have patients and educate them a lot of importance of removing gluten because we know that our wheat is just not the wheat that our ancestors had, and it's very toxic.

And being cautious with the dairy as well, and the sugars. But I definitely make those dietary restrictions and do elimination diets in all of my patients. But specifically with the Morgellons, the removal of the histamine-rich foods, the sugar, the gluten, and the dairy and trying to focus on good grains, fruits and vegetables, and lean meats. I mean, that makes a huge difference.

[01:03:26.06] Scott: And sometimes it's surprising the things that we used to think were healthy like kombucha or bone broth that now in the realm of histamine and glutamate and some of these other things, we now kind of think they may be not be so healthy for some people that are dealing with mast cell issues for example.

[01:03:42.15] Dr. Cornish: And that's unfortunate because all of those things were recommendations if you would interview me two years ago; I would have said oh that's across the board. But we know that fermented foods can possibly cause adverse reactions in patients who have mold illness. And other things that you mentioned, it's just that yes they may have been healthy at one time, but just due to the environment we live in right now and these toxicity levels, the production is just not as clean as it once was.

So with the bone and mineral, bone broth specifically was a great recommendation that I would provide patients to heal the gut, and then I realized oh it might stimulate histamine release. So I've kind of withdrew that recommendation from my patients due to that. And the same thing with spinach, spinach is great, every patient needs spinach. But if you have histamine overload, it can be provoking. And avocado, who doesn't love avocado? It's the same thing.

So one of my patients told me, do you want me to eat rocks and paper, Dr. Cornish, like what are you telling me? And I said no, there are numerous different cookbooks; you can look at institutions like the Institute of Functional Medicine. I just want to fix the gut, I just want to get you moving, and that same patient came back six weeks later and said oh thank you, I feel much better now, you really changed my life. But having that idea, and that's something that early on in my marriage, you know committing to that whole foods lifestyle.

Having every meal with something that's a vegetable, eating green maybe kale and other cruciferous things they help, and they help your immune system, and they help you fight off infections. So I tell patients look I can treat you, we can get better, but you have to meet me halfway, and you have to remove the junk, that's the first step, you got to remove it.

[01:05:54.04] Scott: Let's talk a little about pharmaceutical interventions versus natural interventions. Do you find that Morgellons can be treated entirely naturally in some patients, or are the pharmaceutical interventions fairly commonly a necessity?

[01:06:09.06] Dr. Cornish: That's an excellent question. I have found that it's a combination of both, there are some patients who have come to my office who may have used things they saw online like silver and said that they were instantly treated, but then they kind of had relapses. So typically, with Morgellons cases, as I stated earlier, I work really hard, I clean up the toxins and stabilizing our gut as we set that foundation. But I tend to utilize pharmaceutical interventions like antibiotics, antiparasitics, things that treat resistant forms of Borrelia, biofilm treating agents, and antihistamine and other supportive agents to help treat this underlying process, because these patients are suffering, and they're suffering from many nebulous symptoms, and they need that support.

However, I do simultaneously incorporate quite a few both herbal and even in some cases, homeopathic strategies to healing because I don't think you can do one without the other for these patients. I have some of my PANS or tick-borne patients who may benefit more from our herbal approach as their primary approach, but I found in this population there has been, for me, a requirement of using both herbal and pharmaceutical.

[01:07:49.17] Scott: Let's talk a little bit about Disulfiram. You mentioned it earlier; I know that for Borrelia and Babesia, there's a lot of excitement around Disulfiram in the chronic Lyme population at this point. There is some indication that it seems to be helpful for Bartonella, though maybe not as helpful as for Borrelia and Babesia.

And so historically in the Morgellons realm, my understanding has been that the things that work the best are generally those things that address Bartonella. And so I'm curious in your experience with Morgellons and Disulfiram; what do you seen clinically so far?

[01:08:26.19] Dr. Cornish: So I recently introduced Disulfiram in my practice after the ILADS conference meeting the authors, Ken Liegner, and we had training because I was one of those doctors she was quite frightened because I was reading a lot of the alarming side effects. So I had some colleagues who had been using it much earlier and having a lot of success with their patients who suffered from chronic tick-borne disease, some of those resistant patients. And so since I've started to incorporate Disulfiram in my practice, I have been very impressed.

Now I've only seen a handful of patients thus far with positive reactions that follow up because I just started to incorporate it. But I will tell you, my one Morgellons patient of whom he had stabilized her gut; she had moved from her moldy environment, we made sure she didn't have yeast. And most of her wounds had resolved, but she still had some that were on her scalp that for two years that was the only one that remained. They started Disulfiram, and she was at a very low dose of 37.5 twice a day of liposomal Disulfiram, and the lesion healed.

So I definitely look forward to using this more aggressively with my patients, I just want to make sure that when I do incorporate it, that I've done my due diligence of evaluating the environment, the mold, the gut, the yeast, and that they're committed to that process and also the copper and the zinc. Because sometimes, you can have those adverse reactions if you just have a knee-jerk response, and you haven't taken the time to evaluate the patient's entire clinical picture, but I'm very impressed.

[01:10:30.06] Scott: Beautiful, that's really exciting. When you treat chronic Lyme, co-infections is there a particular order that you find works best in Morgellons? Is treating one particular co-infection what often leads to higher ground, what do you see around treating Lyme and co-infections for your Morgellons population?

[01:10:49.10] Dr. Cornish: So when I first started treating chronic tick-borne disease about almost ten years ago now, I was always taught treat Babesia first if a person has Babesia, because that is the parasite, that's the organism that lives within the red blood cell, that's the one that doesn't really respond as well to antibiotics. So if you think a person has Babesiosis, has those night sweats, Bell's neuropsychiatric symptoms, that air hunger, any of those cognitive impairment, inappropriate changes in their blood pressure from lying to standing; that’s dysautonomia.

So anything that presented in that Babesia realm or even positive serology, but that was the first thing to target. And I still do that in my practice, and I transition them to more of a Bartonella stage because that is very common. And it also it's very debilitating due to the neurological manifestations of this organism. And it also lives in what we call intraerythrocytic or lives within the red blood cell as well.

So that to me is another dominant player, so I'm very aggressive with the treatment of Bartonella as well, and then I'll transition more into the Borrelia phase. But I always make sure I'm having patients do yeast prevention methods. So we might be using things like Nystatin or Diflucan or other garlic, monolaurin things that help to decrease the yeast load, because if they are on antibiotics as I said that does increase that risk. But definitely, I'll always look at the Babesia as far as the co-infections first then the Bartonella, but they sometimes look very similar.

[01:12:57.10] Scott: We've talked a lot about the toxic soup, the importance of detoxification. What are some of your top detoxification tools? Do you like sauna therapy, for example? Do you like coffee enemas? Or there are some really big detoxification support options that you find helpful.

[01:13:14.02] Dr. Cornish: So, in my practice, I use quite a bit of Myers Cocktail, which is a combination of different vitamins that helps with what we call phase 2 of the liver detoxification. So kind of like clearing those toxins out the body. I use a lot of IV vitamin C, which is great at immune-boosting and also treatment of pain. NAC, N-acetyl cysteine, which is a precursor to glutathione, I used that pretty much regularly.

I use a lot of clays and binders things like chlorella, bentonite clay, charcoal, zeolite, things that help bind and things that also can help chelate; I use agents like EDTA and DMSA, things that help to chelate and remove metals.

So I have a broad arsenal, and I also think that things like low pressure hyperbaric like very low pressure just at sea level, as well as infrared saunas are excellent forms of detox. But also remember Scott I told you already, the first phase of detox it gut. So I make sure that gut health that's imperative and regular bowel movements and sweating, Epson salt baths are all crucial and very important components of my clinical paradigm.

[01:14:46.27] Dr. Cornish: I'm curious, can people with Morgellons when they have skin lesions, do they tolerate Epsom salt baths pretty well or is it ever irritating?

[01:14:55.14] Dr. Cornish: And I've seen both, I've seen it become extremely irritating in patients due to the open lesions, and I see patients who may prefer baking soda. But I've also seen them help, so I've seen a mix.

[01:15:11.09] Scott: There are some that suggest that anti-helminthics or antiparasitics can be helpful in Morgellons you've mentioned them as well. If the filaments are not living, there not parasites which we know at this point that they aren't, do we know why these medications are helpful in Morgellons? Are they possibly hitting Bartonella or some other organism that maybe is triggering that filament production?

[01:15:36.04] Dr. Cornish: And that's another, you always give great questions. So, regarding the anti-helminthics and antiparasitics, I think that they are treating other parasitic infections like Babesia, like Toxoplasma, like Blastocystis hominis, which I see quite often on CDSA results for patients with Morgellons syndrome. So some of the common ones I use Alinia, Albendazole, Ivermectin, and we think that they could also have some benefit for some of the other co-infections as well.

I definitely think there are more parasites that contribute to this disease complex that we know at this time because there's such a positive response these patients have to the anti-parasitic medications, I see that daily. I have probably eighty percent of my patients on some, probably more, on some sort of anti-parasitic, maybe herbal like PARAZOMON or oregano oil or Artemisinin to more of the prescription agents. So I think it's to be determined what all species contribute to this.

[01:16:54.00] Scott: Let's talk a little about biofilms, you mentioned NAC, which can have some effect on biofilms. But what role do biofilms play in Morgellons patients, and how do you address them in a treatment protocol, or do you even find that that's necessary?

[01:17:08.03] Dr. Cornish: I think that it's a requirement because the biofilm is so common in this patient population. And you can shrink the biofilm with systemic enzymes. I use a lot of things like Lumbrokinase, which breaks up fibrin, so it's a derivative of earthworm, so it's like a natural blood thinner. I use quite often Serrapeptase and Nattokinase, which are both enzymes that help break down proteins, which are critical components of this biofilm niche that protects this infectious process.

But also I use stevia, there was work that was published by Eva Sapi a couple of years ago about the benefits of stevia on the biofilm, as well as lactoferrin which binds ferritin, and ferritin has also been shown to be a component of the biofilms as well. So I think it's critical that if you have a patient who you think has chronic, resistant infections that you incorporate those biofilm strategies that I've discussed, and there are others. But definitely an important component of my health care plan with patients.

[01:18:35.24] Scott: Have you found in your patient population any relief in the realm of light, frequency, sound, vibration? Is there a role for some of these physics-based treatment solutions in Morgellons?

[01:18:48.14] Dr. Cornish: I think there is definitely a role in that my treatment. I've had a patient of mine who uses PEMF for pain, and he sees the benefit, which is pulse electronic magnetic frequencies. So it's a machine that kind of you use different parts of your body to decrease pain. I've also had patients who've used Rife machines to treat tick-borne diseases.

Those are things that I use regularly, but I'm sure they are extremely helpful not only in Morgellons patients but in all patients who suffer from chronic infections. I don't have a lot of experience personally with using those tools in my practice. However, I can't say that I have seen positive results and quite a few patients from that treatment.

[01:19:44.24] Scott: And in some skin conditions like psoriasis and eczema and vitiligo and things of that nature, some people will use ultraviolet light therapies. Does that help in any way with the skin presentations of Morgellons?

[01:19:57.26] Dr. Cornish: I have not, and I actually had quite a few patients when I first started treating Morgellons who had started, that was one of the initial because you have to remember Scott, they've tried numerous treatments out of desperation prior to seeing a physician who actually understands the disease process and can validate them.

But they use the light therapy and didn't have benefit. So I don't have enough experience to say how helpful it is, but the limited amount of patients that I have used it, I haven't been impressed with the results.

[01:20:37.16] Scott: Let's talk a little bit about treatment outcomes, does the condition generally entirely resolve with treatment? Or does it need some longer-term management or maintenance type therapies?

[01:20:49.17] Dr. Cornish: I have found that most patients can get to some sort of improvement with treatment. Now that might lead to scarring where the lesions were, or there could also be some because I think has a biofilm component when their bodies are under stress, you might have severe relapses if they know what those stressors are.

But the goal and the treatment of any chronic vector-borne disease is to get a patient in remission, and that means to the point where your immune system that was compromised is now able to coexist with that infectious organism to cause you to not be symptomatic, right? So with Morgellons, I think they do require my patient’s longer treatment intervals and the maintenance for their treatment, and they also have to really be strict with the dietary components. I have patients who present in one visit their lesions are completely healed and closed and just look scarring.

The next visit maybe after the holiday or after a lot of sugar or alcohol or just kind of what I say falling off the wagon a bit; things flare up again. So I think that's the nature of chronic illness in general, is you want to get these diseases in remission and boost immunity. And patients can get into remission and become stable, but it takes a lot of work.

[01:22:35.01] Scott: What do you see on the horizon in terms of Morgellons research, better testing, better treatments. What are some of the things that are maybe around the corner that are exciting you that hopefully will improve the quality of life in those people dealing with Morgellons? 

[01:22:50.14] Dr. Cornish: I think all of the above. You know at the Charles E. Holman Foundation their website you'll be able to find numerous different research articles. And as I alluded to in 2018 just a year ago, basically two years ago now it's 2020. We had new research that confirmed that there were infectious organisms contributing to this illness. I hope to find more research on new organisms that are being studied, definitely better testing.

I hope to find studies where we're culturing and looking under electron microscopy of this biofilm for other conditions, that's something I look forward to. And I think that that's all coming down the pipeline, we have some excellent researchers in this field that every day are beating the pavement because we want to find a cure for this, we want to find an end to this. And so one day we'll get there, but there are things coming down the pipeline every day, which is very exciting.

[01:23:59.02] Scott: We've talked about the fact that Morgellons seems to be where chronic Lyme disease was 15 years ago in terms of understanding, acceptance, even research. What do you think it'll take for Morgellons patients to gain more validation? To not be told by conventional medicine doctors that they have delusional parasitosis. What will it take to further legitimize this disease?

[01:24:23.16] Dr. Cornish: The first thing is that we have to make a concrete definition for criteria, all right? Diagnostic criteria and that's what I alluded to earlier, and we have to train other physicians. I tell doctors who are even chronic Lyme specialists in ILADS; I said you're probably treating Morgellons, and you have no idea because the treatment is the same treatment you would possibly used to treat vector-borne disease because we know in some cases it is caused by it. So you're definitely treating, but it's just having more training. I love it when I get referrals from other docs. I'm like, yes, you know I do this Morgellons, so thank you.

Having more things like these educational sessions, where we educate the general population more research, okay. And just kind of guiding the patients to places where they can get the proper and more evidence-based solution and ideas. Because there's so much on the internet, and there's so much we just don't know. And just like with chronic Lyme disease, we did our due diligence of developing guidelines that were peer-review and published.

We had numerous physicians who published articles over the years to legitimize this disease, and we have an excellent training program where we train other doctors on how to treat it. And that's what it's going to take, it's going to take research, it's going to take classification of illness, and it's just going to take awareness and training.

[01:26:13.22] Scott: I loved in your talk on Morgellons at ILADS, I think you asked how many doctors in the room treated chronic Lyme, lots of hands went up, how many treated Morgellons lots of hands went down. And you said something to the effect of all of you that just put your hands down are treating it, you just don't know it, right?

[01:26:32.10] Dr. Cornish: Exactly.

[01:26:33.09] Scott: There is so much overlap.

[01:26:34.20] Dr. Cornish: There is so much overlap. It was embarrassing when I went back to my patient who I have been treating for three years and didn't know what Morgellons was prior to my other patient educating me on the topic. I'm like, oh. Sorry, I never asked you about that, you were so ashamed to tell me that had fibers. I just thought your wounds were improving because we were treating your Bartonella better, I didn't think of ever looking under the microscope. And it happens all the time, you get these patients, and you must do a thorough skin exam for all patients with vector-borne illness, that's mandatory.

And you'll be surprised at what you find; I don't think that every let's clarify not every tick-borne disease patient has Morgellons or vice-versa, but it's more common than you would think. And sometimes doctors are like I don't want to deal with that, but that's how doctors are with chronic Lyme disease 15 years ago and look where we are now. So I think awareness is happening, I'm so excited about it, I love it when my colleagues want to learn more, want to get trained on how to treat this, and it's looking differently now, it's becoming legitimize now, I'm very excited about what's going to happen in the future.

[01:28:00.20] Scott: For those people dealing with Morgellons, it can be a very difficult journey. Unfortunately, we know that suicide is not uncommon. So, I'm wondering what message of hope can you offer to those people that are currently dealing with Morgellons?

[01:28:17.11] Dr. Cornish: I would tell them you will get better, that's the one thing you have to always remember, you will get better. And I also will let you know you're not alone; there are other people who are dealing with this, they may be dealing with this in being silent about it, they may be dealing with this and getting help for it. But you aren't alone, and people get better, and that's what's so reassuring and just makes me so excited about treating this condition, and keep the faith.

These diseases, not just Morgellons, but chronic tick-borne disease, in general, can cause neuropsychiatric manifestations. It can take such a toll on you because you may have people who don't believe you, family members who aren't supportive, doctors who aren't supportive, and you just don't have any place to turn, but you really do. We have organizations out here to help people like you, but the first step is trying to consolidate all the other impairments in your life.

So it really starts with you doing the hard work, changing your lifestyle, trying things differently, getting the rest you need, and seeking help from professionals and from organizations who are familiar with this and don't take it personally. As we keep saying, your listeners are familiar with chronic Lyme, and fifteen years ago, they weren't, this is no different. Just keep the faith and keep trying, and you will get better.

[01:30:04.25] Scott: Beautiful, thank you. How do people find a doctor that knows how to treat Morgellons, and how do they find resources that they can really explore to figure out their next step?

[01:30:14.21] Dr. Cornish: The best place is the Charles E. Holman Foundation website. It has listed I'm a board physician or board member for that organization, and it just has tons of research. You can also email the people at the foundation, and they will link you up with others in your area that either can treat you or may have more information about local sources of treatment for you. They also have my mentor; we mentioned Ginger Savely; she has an amazing book legitimization of the disease Morgellons, which is amazing.

It gives you not only of the science but from her experience of treating thousands of Morgellons patients over the years and getting them better; it gives you that treatment journey. And then we have a documentary soon to come out by Pi Wei on Morgellons; Skin Deep, which will also give you an overview of physicians' and patients' experiences with this disease complex. So there are definitely places to go, there are places not to go because sometimes it's overwhelming. But if you find those set resources to get you started on your journey, I think you'll be successful in getting help.

[01:31:44.11] Scott: I will put the links to the Charles E. Holman Foundation and also to the Skin Deep documentary in the show notes for people listening so that you have access to those. Tell us a little about your experience being involved in the documentary Skin Deep: The Battle Over Morgellons. How can people find it and watch that film? 

[01:32:02.19] Dr. Cornish: Yes. I mean that film is groundbreaking, it reminds me of Under Our Skin when we filmed the other film for Lyme disease that's available on Netflix. And it just gives you that overall holistic experience, because you not only understand the physicians who are fighting to get the treatment for these patients, but you hear these stories of people who may be similar to you and see them get better.

So it's just a great movie Pi Ware and his team did an amazing job of capturing this disease process and all the multifactorial issues that affected and the social injustice behind it, the politics, the research, the clinical evidence, and specifically those patient stories which are so passionate. So, you'll be able to soon find us on Netflix, it's great; I'll recommend all of you to look into it because it's so educational, and it may change your perspective.

[01:33:26.06] Scott: Yes. And I have seen it, and I do urge people to watch it, it will certainly open your mind and provide lots of new information and insights. The last question that I have is the same for every guest, and that is what are some of the key things that you do on a daily basis in support of your own health?

[01:33:43.26] Dr. Cornish: I was not looking forward to this question, because all your interviewees they leave all these elaborate and wonderful methods. I go hike mountains and all these wonderful exotic things they do, and then I thought about this. I said if he interviews me, he's going to ask me that. And the honest answer is I run after three-year-old triplets, and I eat well, and I try to get the rest I need, but it's a challenge.

So I do apply a those different things we talked about earlier to my own life. And I do try to find that work-life balance. But I'm so happy in that peace with my family that is reassuring to me, and even though if you could imagine life with toddlers is insane, it's a joy. So that's kind of what I do.

[01:34:50.21] Scott: And I think you also are in your work life living in your purpose and passion which also feeds us at a very deep level as well right when you can help somebody, especially in this realm with the condition that so many others have invalidated them in having. I think that has to be highly rewarding for you as well.

[01:35:11.08] Dr. Cornish: It is. And it's just the fact that patients have hope. I did research for years even an undergrad, and my mom even says at a young age I always questioned why, why so I've always looked for answers, and I've always tried to solve problems, and I've transitioned now to be a physician that treats complex illnesses that aren't well understood, but more importantly I treat a patient population that is not well-understood, that's dismissed quite often, and it is very rewarding when you can be a part of their health care journey.

And not only just listen to them, because I take a lot of time at least an hour, an hour and a half on my initial visits listening to a patient. But come up with some solutions as a team and let someone know that you have their back; we're going to get through this together. And in most of my discharge handouts is I tell patients the best is yet to come, you can't give in to these diseases, you can't let them take over. You have to continue to have that fighting spirit, especially when you have a doctor or someone in your life who's fighting to make you better. You just have to commit, no matter how hard it is, and the best is yet to come.

[01:36:52.05] Scott: Beautiful, that's such a great way to wrap things up. I have really enjoyed our conversation. You are a passionate practitioner, you are a hero in my mind, and I'm sure in the minds of many others. And so I just appreciate all that you do to be there for a population of people that often find that there aren't a lot of practitioners and people to be there and be supportive. And so I think the work that you do is amazing.

I'm looking forward to our follow-up in 2035 when we do another interview, and see what we learned in the next 15 years. Just thank you so much for your time today, I appreciate it very much.

[01:37:33.22] Dr. Cornish: Oh, thank you for always doing great interviews. You have some amazing guests, and just being dedicated to our mission, I appreciate you; I appreciate the journey you've been through and how you share that with other patients. So, I thank you as well, Scott, you're doing a great job, you're doing some great work.

[01:37:53.01] Scott: Thanks so much, Dr. Cornish, thank you.

[01:37:55.15] To learn more about today's guests, visit Amen Clinics at Amenclinic.com or visit the International Lyme and Associated Diseases Educational Foundation ILADEF at ILADEF.org.

[01:38:16.10] Thanks for your interest in today's show. If you'd like to follow me on Facebook or Twitter, you can find me there as better health guy. To support the show, please visit Betterhealthguy.com/donate. If you'd like to be added to my newsletter, visit Betterhealthguy.com/newsletters, and this and other shows can be found on YouTube, iTunes, Google Play, Stitcher, and Spotify. 

[01:38:41.11] Thanks for listening to this BetterHealthGuy Blogcast, with Scott, your better health guy. To check out additional shows and learn more about Scott's personal journey to better health, please visit Betterhealthguy.com.

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  BetterHealthGuy.com is intended to share my personal experience in recovering from my own chronic illness.  Information presented is based on my journey working with my doctors and other practitioners as well as things I have learned from conferences and other helpful resources.  As always, any medical decisions should be made only with the guidance of your own personal medical authority.  Everyone is unique and what may be right for me may not be right for others.