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In this episode, you will learn about a healing guide to support sensitive patients in restoring health.

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About My Guest

My guest for this episode is Dr. Neil Nathan.  Neil Nathan, MD has been practicing medicine for 50 years.  He has written several books including: "Healing is Possible: New Hope for Chronic Fatigue, Fibromyalgia, Persistent Pain, and Other Chronic Illnesses" and "On Hope and Healing: For Those Who Have Fallen Through the Medical Cracks".   He has been working to bring an awareness that mold toxicity is a major contributing factor for patients with chronic illness and lectures internationally on this subject which led to the publication of his eBook "Mold and Mycotoxins: Current Evaluation and Treatment", and then to his best-selling book "Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness".   His 2021 book "Energetic Diagnosis" is a discussion of the value of intuition and energetic devices as an aid to both diagnosis and treatment of medical illness. His new book "The Sensitive Patient's Healing Guide" was released in early 2024.  He is currently providing mentorship in the treatment of chronic inflammatory illness to approximately 150 physicians, with Jill Crista, ND. 

Key Takeaways

  • What is the difference between sensitivity and toxicity?
  • What is the limbic, vagal, mast cell triad?
  • What tools can be used to support the limbic system and vagus nerve?
  • How might structure be supported without exogenous collagen supplementation?
  • What are the many roles of Epsom Salt baths in working with sensitive patients?
  • What are some potential triggers of Spiky-Leaky Syndrome?
  • What is a Homeostasis Associated Molecular Pattern (HAMP)?
  • Is urine mycotoxin testing a clinically helpful tool?
  • Are there any tests for exploring fungal colonization?
  • What tools have emerged in the treatment of Lyme disease?
  • Is 5G really a problem when it comes to EMF sensitivity?
  • Does working in the mental/emotional, limbic, and vagal realm support detoxification?
  • Is the concern about oxalates more about dietary exposure or fungal colonization?
  • How might salicylate intolerance be approached?
  • What role do structural issues play in sensitive patients?
  • Can benzodiazepine withdrawal be another contributor in sensitization?
  • What are some of the factors that may impact thiamine?
  • What is the role of RANTES as a marker of inflammation?
  • Can people be allergic to their own hormones?
  • Is carbon monoxide a sensitizing agent?
  • Does treating Bartonella potentially serve as a trigger for secondary porphyria?
  • What interventions may support those dealing with spikeopathies?
  • What are some of the many beneficial properties of ketamine in working with sensitive patients?

Connect With My Guest


Related Resources

Book: The Sensitive Patient's Healing Guide

Interview Date

April 25, 2024


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.  


[00:00:02] ANNOUNCER: Welcome to BetterHealthGuy Blogcasts, empowering your better health. And now, here's Scott, your BetterHealthGuy.

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] SCOTT: Hello, everyone. And welcome to episode 200 of the BetterHealthGuy Blogcasts series. Today's guest is Dr. Neil Nathan. And the topic of the show is the Sensitive Patient's Healing Guide.

Dr. Neil Nathan has been practicing medicine for over 50 years. He's written several books, including Healing is Possible: New Hope for Chronic Fatigue, Fibromyalgia, Persistent Pain, and Other Chronic Illnesses and On Hope and Healing: For Those Who Have Fallen Through the Medical Cracks.

He's been working to bring an awareness that mold toxicity is a major contributing factor for patients with chronic illness and lectures internationally on this topic, which led to the publication of his eBook Mold and Mycotoxins: Current Evaluation and Treatment. And then to his best-selling book Toxic: Heal Your Body From Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness.

His 2021 book Energetic Diagnosis is a discussion of the value of intuition and energetic devices as an aid to both diagnosis and treatment of medical illness. His new book, The Sensitive Patient's Healing Guide, was just released.

He is currently providing mentorship in the treatment of chronic inflammatory illness to over 200 physicians with Dr. Jill Crista.

And now, my interview with Dr. Neil Nathan.


[00:01:58] SCOTT: I am super excited today to have Dr. Neil Nathan with us as our special guest for episode 200 of the podcast. This is his sixth appearance on the show. And each of them has been such a gift. Today we're going to talk about his new 466-page book, The Sensitive Patient's Healing Guide: Top Experts Offer New Insights and Treatments for Environmental Toxins, Lyme Disease, and EMFs.

It is so dense with information that literally each chapter could be a book or a podcast episode of its own. He's been of my top heroes and mentors in the chronic illness arena for many years. Thank you so much for being here today, Dr. Nathan.

[00:02:36] DR. NATHAN: Thanks, Scott, for having me. And I want you to know, it is an honor to be your 200th podcast. I mean, kudos to you for the effort, and discipline, and continuous way that you have provided some of the most up-to-date, interesting, cutting-edge information out there.

And I really appreciate the balanced view you've always taken to doing this. You've never picked sides about they're right or they're right. Because we're all evolving this whole information as we go. And there isn't a, "Oh, yes. This is the absolute truth. We've now nailed it," kind of concept here. It's we're learning as we go. And we keep expanding how we view things. I appreciate you're staying on the cutting-edge here. Kudos to you.

[00:03:35] SCOTT: Thank you. That means a lot coming from you. And with that, we are going to learn a lot in this conversation.

In the book, you differentiate sensitivity from toxicity both being types of reactivity. You say that sensitivity is a hyperactive, hyper-sensitive nervous system that is not convinced something is "safe". And, thus, is doing its best job to protect us in that moment. Where toxicity more is a direct action of a toxicant or toxin on a body tissue. The more toxic we become, the more sensitivity may develop as well.

And I want to talk about the importance of feeling safe as a prerequisite for healing. This is really an area that I've had to work on personally a lot over the years. Again, recently, as a result of the pandemic. Probably will still have more work to be done in that arena.

How do we create safety signals for the body such that we resonate with feeling safe in our bodies, in our world? What are some of the tools we can use? And why might traditional talk therapy not be the best tool for creating safety signals?

[00:04:47] DR. NATHAN: I just so love your questions, which are so multi-layered that we can talk on the whole podcast for just that one. But, safety, that's what it's all about. It's all about how do we as an entity or a being flow through this world that we're living in and do so in a safe way? Because we know that there's tons of things that aren't safe in this world. If we drive a car. If we simply are in the world, which is fairly toxic. The chemicals were exposed to, it's amazing. The EMFs were exposed to; increasingly electrical signals that human beings have never been exposed to in the history of humankind. We live in a sea of danger. And from the time we're in our mother's womb, we have to begin the process of dealing with that, which is am I safe right now?

There are three major – I'll call them organs, or tissues, or cell lines, or neurological processes, which are the key to how we notice that we're safe. And they are – very simply, I call them the trifecta of limbic, vagal, mast cell. The mast cells are a cellular line that helps to establish safety. The limbic system is a part of the brain, which is neurologically wired to notice whether the stimuli that are coming into us are safe. And then we have what's called the vagal nerve system, which is different part of the brain, which again does the same thing. It is analyzing the stimuli that are coming into us. Light, sound, touch, food, chemicals, EMFs. It's analyzing it for potential danger. And then its job, and it does it really well, is to warn us about, "Okay, this particular incoming stimulus may not be safe for you. So I'm going to warn you of that and shut you down so that we don't get into any trouble here." It's all about safety. That's it.

Now our nervous system has been wiring itself for safety since the moment of our conception. None of us have had perfect childhoods. Whether we had multiple ear infections, or throat infections and took a lot of antibiotics, or required surgery, or we lived in a family situation in which there was abuse, verbal, emotional, or sexual. Whether we grew up in a family system in which we just didn't get much attention. Didn't get our needs met. And eventually evolved through our teenage years. And, again, were exposed to infections, or surgery, or disappointments, or – you name it.

Every single experience that we've had shapes our nervous system's perception of safety. So that, for some people, they grew up in an environment which was so unsafe that they basically went on high alert. We'll call it hyper-vigilance. They go on high alert about, "Okay, I've got to just stay totally wired because I don't know when the next threat's coming in. And I got to protect myself."

And so, this process of wiring our nervous system to protect ourselves goes from the time we're born throughout our entire lives. And with each subsequent insult would become even more hypervigilant. And that hypervigilance is what really triggers this whole sensitivity process. We're combining the effects of the limbic, vagal, and mast cells, which connect to each other profoundly.

The bottom line here, as you're saying, is safety. And as we know from Dr. Naviaux's Cell Danger Response concept, you can't heal if you don't feel safe. I'll say it again because it's so important. Cannot heal if you don't feel safe. This means that you could be doing the right things. You might be deficient in zinc, or magnesium, or some vitamin. And you may take those. But your body may not be able to use what you're putting into your body because it's basically going, "Can't deal with that now. I'm on survival mode. Come back when I'm ready to be able to handle you and benefit from you."

This is, as you well know, a complicated issue. And I think it's one of the most underestimated, minimized concepts of healing that we have. Because I think people just take their state of hypervigilance for granted, which is, yeah, it's a dangerous world. I'm just going to stay hypervigilant. Without realizing that that has a profound effect on your health.

No matter what you have, whatever illness you have, if you are not taking into consideration these things, you may have trouble healing if we don't honor them and work on them. Simply put, these are not psychological issues. These are neurological and cellular.

You can't really override a neurological issue properly or optimally with talk therapy. You could forever talk about I had a terrible childhood. And this wasn't done right by me. And you could go over that over and over and over again. But unless you change your neurology, unless you change the way your nervous system responds to that, you're going to stay stuck there for a very long time.

[00:10:55] SCOTT: Does the presence of sensitivity or sensitization by definition mean that there is limbic system impairment? Do you see people that are sensitive to foods? To their environment? To light? To sound? To sense? Where those sensitivities are not largely driven by the limbic system?

[00:11:15] DR. NATHAN: Simple answer is no. You can't get sensitive unless the part of your nervous system that controls sensitivity, which is the limbic system, is involved. That's the job of the limbic system. It does a number of things. But its main function is to monitor your environment for safety. And if it doesn't think you're safe, the main ways that it will give you symptoms are either emotionally or from a sensitization process.

Anyone experiencing from a patient perspective, if you have sensitivity to light, sound, touch, chemicals, smells, EMF, food, that's limbic. If you have an emotional experience, anxiety, panic, hopelessness, despair, depression, mood swings, OCD, you name it, if it is new, it means there's new involvement of your limbic system. And if you've had it for a long time, it means your limbic system has been trying to tell you for a long time, "Hey, you've got some threats in your system." It's unavoidable. If you have those things, you have limbic involvement.

[00:12:38] SCOTT: Talk to us then a little bit about the timing of doing limbic system work. I used to be more of the opinion and probably still largely am that the limbic system work is best done to reboot. That term borrowed from you. To reboot the system after you have addressed the tiger, so to speak. If you're living in a moldy house, we want to be environmentally aware. Address the exposure. Move. Remediate. And then do that re-calibration or rebooting to re-calibrate the perception of threat to the actual threat.

That said, in cases where the patient can't tolerate any of the treatments that you attempt to give them, might there be a place earlier for limbic and vagal work to increase the options in your toolbox that you then can use with that patient? And if you do that recalibrating earlier, you start one of these programs early on, maybe they're still living in a moldy house, what do you say to those that are concerned that telling the body that their moldy house is okay may have detrimental consequences later in that their immune system may no longer appropriately respond? Or they may not be able to sense that they're in an environment where there is mold? When do you introduce limbic system retraining in your healing process?

[00:13:53] DR. NATHAN: This might be one of the few areas in which you and I don't completely agree. Because, in my world, we do it first thing. Okay. Now, if someone is living in a moldy environment, it isn't going to work as well as if they get out of that moldy environment and get the mold out.

Ultimately, the cure is getting the direct root cause of what's triggering all of this fixed. Whether it is mold toxicity, or a Lyme disease, or another infection, or viruses, or environmental toxins of different types, whatever the root cause is, ultimately, they will not get well if that doesn't get identified and fixed. That's true.

But for sensitive patients, they often can't begin to address that. Again, we just talked about safety. Until the body feels safer, it cannot respond to what we're trying to do. Again, my practice has evolved over years into working with some of the most sensitive people around. And that's most of what I see at this point. It's skewed. I will readily admit that I see more sensitive folks than some people do.

But for anybody who works in the field of Lyme, or mold toxicity, or environmental toxicity, you're going to see a lot of sensitive patients. It's unavoidable. Because those things trigger limbic, and vagal, and mast cell issues. It comes with the territory. It's absolutely unavoidable.

With my most sensitive patients, what I'd say categorically is that if they don't do the limbic, vagal, mast cell work first, they're not going anywhere. They just will not respond. My bias is that that is work that should be done first. Or if nothing else early on in the course of treatment, to optimize their body's ability to respond.

[00:16:02] SCOTT: And any thoughts then on people's concern that doing limbic system retraining when they're still in their moldy home might then mean that their immune system isn't going to respond? Or that they may lose the ability to sense that an environment is not safe for them?

[00:16:19] DR. NATHAN: You know, I don't think I've seen that. I will readily admit that they may not be able to respond as well. But I've had so – I mean, I've had a couple thousand people do this. And the vast majority of them who have been unable to move from their moldy environment have had noticeable benefit to varying extents from doing this work. Now it's going to be a little bit like treading water until they really get the cause fixed. Get out of the moldy environment and get the mold treated properly.

But there is a school of people who work with mold who say, "I don't even want to treat you until you get out of your moldy environment. To me, that's condemning those folks to misery while we kind of sit on a high horse and say, "Well, when you get into the proper way, then I will treat you." To me, that's borders on unethical, which is most patients that I work with can get a bit better to varying degrees if I start treating them even when they're in a moldy environment. Is that optimal? No. But is it necessary or helpful? Yes.

It also – and this is really important. It also communicates hope, which is I can start treatment now. I'm not condemned to getting more and more miserable and sick until I figure out how I can move or remediate my home environment. Because if they are in the latter condition, which is okay, now you're telling me you're my hope and salvation. And you're saying you're not even going to treat me until I get out of this moldy environment? Think of what that does to the limbic system. It's like, "Whoa. Slap me around the head. And now I'm even more hopeless." For me, it's a distinct negative. And although it's not optimal, I don't think that we're going to mess with treatment by providing the beginning of what people need early on.

[00:18:33] SCOTT: Survival is the body's number one priority. And our physical, our emotional well-being really comes second. The brain can, in that process, make mistakes that can result in overprotecting us. Ultimately, leading to us becoming a more sensitive patient. Let's touch a little bit on the limbic system retraining, and the Cell Danger Response, and the potential for tools like DNRS, like the Gupta Program that you have chapters on in the book. Using those systems to send the all-clear signal to our cells to move out of a Cell Danger Response and back to the health cycle. Given that there was an original trigger for that Cell Danger Response, and that may still be present in some people, when we're thinking really about Cell Danger Response and moving beyond it, how much of a focus should we place on using limbic system retraining to reset that evolutionary, protective mechanism to move out of a Cell Danger Response versus treating the original trigger of the Cell Danger Response? Or do we almost always need to do both?

[00:19:37] DR. NATHAN: Both. To me, it's very clear. The original trigger may be gone. And the vast majority of people I work with who've had mold toxicity or Lyme disease, they still have those things. And, usually, not always, when you remove the original cause, when you cure the Lyme disease, the Bartonella, or the Babesia – and we can use the word cure in a light manner here because we could argue that. But if you get it to the point that the immune system has got those infections contained again and they're not affecting people, if you get the mold toxin out of the body, and we can measure that, we know when that happens because the urine test will be clear. In that state, the body may reboot itself.

When I first started doing this work and didn't know what I now know about the limbic, and vagal, and mast cell issues, I found that a lot of my patients who had chemical sensitivities and other sensitivities, once I got the mold out of their body, many of them got well on their own without doing limbic retraining. I didn't know anything at the time.

When I learned about those things, I realized that I could help them much faster. It often took them a year to really let that chemical sensitivity work out of their system when the mold was gone. But when we treat it first, it's already gone by the time the mold has gone. So that it's a complete boon to treatment to restore safety.

And let's not talk about complete safety. I don't know a single human being who is completely safe in their own body in this world. But we can get safer. And that's the key, which is we can make those patients safer and have them more able to tolerate the treatments they're going to need to get the cause out of their body. I think that if we phrase it that way, I think that becomes more understandable. It's probably a good time to talk about safety in the world that we live in.

COVID profoundly changed our perceptions of safety. And I mean profoundly. Yes, there were threats in this world. There's war going on in Russia. And there's wars going on in the Middle East. And there's all kinds of shootings in the United States and other countries. And you name it. There are all kinds of threats out there to our existence as we know it.

But COVID was in our face, which was – and the way it was handled by the media, which I believe was somewhat irresponsible, was that it began the process by scaring us so badly that we accepted without thinking about it. Without using critical thinking skills, we accepted the statement that, "Okay, we're going to be isolated. We're going to wear masks. We're going to be six feet apart. And we're going to pray that the pharmaceutical community will make vaccines soon enough that it will protect us and that we will live through this horrific experience."

And, indeed, the first round of COVID was horrific. Our emergency rooms in the big cities of New York, and Boston, and San Francisco were so overloaded that the media, again, I believe with consciousness, deluged us with this film footage of all of these people in emergency rooms stuck there unable to get out. Films of nurses and physicians who' been at work for days on end without any rest or any break. This is frightening. Super frightening.

And the entire message was we're now in a pandemic that is so frightening that all of the governments of the world, except Sweden, are going to agree that we are all going to do this. Now never in the history of humankind has the entire government of the entire world agreed that this is the right approach, which is, forgive me, bizarre from the beginning.

And so, we were all placed in a position of isolation, wearing masks. And when we talk about the polyvagal system, we relate to each other by our facial expressions in terms of safety. What are the things our nervous system – as a mammal. Not just as a human being. But all mammals have this where we will look at the facial expression of any being or any critter that we're looking at for safety. Are they smiling? Does the smile reach their eyes? Or is it just kind of – well, I mean, there's that. And then if you have someone wearing sunglasses and wearing a mask, I have no idea what their facial expressions are.

And so, we're going through this horrific pandemic experience unable to know who is safe because our normal way of determining safety is gone. It's been taken away from us. This has profoundly affected everyone on this planet whether we admit it or not to varying degrees, which we have all been frightened in a way that I'm not aware that human beings have ever been this frightened about our neighbors, our friends, our – is it safe to be in public? Can I leave my home? Can I get on an airplane? I mean, what can I do? Can I go to the store to buy the food that I need? Or do I need to have it – I mean, these were considerations that we all went through. And we're not done yet. We still have it.

This has taken our normal state of hypervigilance and thrown it into hyperdrive, so that there isn't a man, woman, and child on this planet that hasn't been affected this way. I'm going to come back to one of the first questions you asked, which is how do we deal with this? And the answer is we all need to understand what has happened to us. And we all need to be doing rebooting for both the limbic and vagal systems. And that means everyone.

And no one – we may think we're coping well. But I can absolutely promise you that, to some extent, our nervous systems have been jacked up in terms of our perception of hypervigilance. This is super important. Because what this means is the increasing awareness that sensitization has occurred has escalated profoundly. It's an epidemic now.

When I first started medical practice, I don't know that I ever saw a sensitive patient. Maybe one once a year. By the early 90s, I started to see a few patients who were unusually sensitive. And now it's got to the point that virtually every patient I treat is hypersensitive.

Just for the audience, there's some studies that have been done in England, which showed that 1% of the population is so sensitive that they are legally disabled 1%. And then to some extent, 35% of the population has some degree of sensitization that is messing with their life.

We're not talking about something rare here. Or, "Oh, no. This poor, unfortunate person, I don't know what happened to them. But they got sensitive.' We're talking about canaries in a coal mine. We are all susceptible to this right now because of the threats to our body that we're all experiencing.

[00:27:53] SCOTT: I used to think of limbic system impairment as more binary. You had it or you didn't. And now I think, really, it is a spectrum. It's how much limbic system and nervous system impairment or dysregulation do we have? And I really feel now like almost everyone has some degree of limbic system impairment.

[00:28:13] DR. NATHAN: That's pretty much what I'm saying. I think that that's true. Now some people who have a stronger constitution or wired a little bit differently can shrug it off and go, "You know, but I'm functioning at a pretty high level right now." No problem. But for everyone else, we're a country that takes anti-depressants, SSRIs, at a rate that is extraordinary. We drink alcohol and use CBD and THC, which is legal in most states. This is normal, ordinary. Everybody does that. But we don't realize that that's because our nervous systems are – forgive me. I'll get poetic. A shadow of their former selves.

[00:28:59] SCOTT: Dr. Stephen Porges says in the book that the sensitive patient is “locked into a chronic state of defense with a predictable autonomic profile that fosters constant detection of danger on every level of their experience”.

In his polyvagal theory chapter, he talks about the more primitive dorsal branch, which is more about freeze. And then we have the ventral vagal branch, which is more about safety, about social engagement. Is the aim of interventions to tonify or support the vagus nerve? Focus more on the ventral vagal branch? And what are some of the favorite tools in your toolbox for vagal tonification?

[00:29:42] DR. NATHAN: Excellent question. And the good news is there's a lot. One of the newer tools that I'm liking a lot is there's a whole bunch of devices that have emerged on the market in the last few years called vagal nerve stimulators, which literally can stimulate the vagus nerve to rebalance it is probably the best way to say it. So that the hyper-sympathetic part that most of us live in, we can gain a little bit more parasympathetic balance, so that we're in more balance.

And so, there's a bunch of these devices out there. A lot of our colleagues have their favorites. The one that I – again, I work with really sensitive patients. And some of the better devices aren't well-tolerated by my sensitive patient because they're too strong for them.

GammaCore, which has been really studied well by Peter Staats, who's from Johns Hopkins, has been shown to be extremely helpful in treating migraines and a whole bunch of other materials. He's got dozens of papers out proving that great device. I find that it's a little strong for my sensitive patients.

Now, that device uses a process of stimulating the vagus nerve in the neck directly, which is where we have immediate access to it. The vagus nerve runs right down through here. There is a number of devices that do that. One that I like a lot, which is called Apollo Neuro. And it's a band that you wear on your wrist that vibrates at different frequencies that doesn't as directly stimulated but it's a lot more gentle.

And you can set that device. The specific settings that we use for it that my patients like the best are calm and unwind. And there's a nice setting for sleep that they have. But the instructions that come with the device are to wear it for 5 to 8 hours a day. That would throw almost all my patients under the bus, which is you can't overstimulate the vagus nerve. And people who have that are not happy campers.

I urge my sensitive patients to start by wearing it for 3 minutes once a day. And if you're handling that comfortably, bump it up to five minutes once a day, 10 minutes once a day, 10 minutes twice a day. And if you're loving it, and a lot of my patients do, okay, increase your usage at a weight that's comfortable with you. But please don't start at thinking you're going to do a complete reboot by really walloping your vagus nerve. All of this is about balance. And be careful with that. That's one method.

Another method that I really like a lot is osteopathic cranial work, which is a method of very gently physicians who are trained to do this work can put their hands on the patient's head or other body areas and feel the neurological disturbance and use the body's own systems very gently to reboot it. I know that sounds a little bit odd. But having done that myself for 40 years, I've been trained by osteopaths to do the work, you can learn to feel – I want to call it the disturbance and the force, Luke. But you can feel the energies in the body not being in balance. And you can guide them to be back in balance. You can directly feel and treat the vagus nerve. It's a very powerful, very gentle way to about that.

For those who want to access people who are trained, there is a website called The Osteopathic Cranial Academy. And this is a branch of the osteopathic profession that certifies and trains physicians to do it. There's another group of physicians which is called Biodynamic Osteopathy, which from my experience is even more profound. You can go on that website and find practitioners trained to do that.

Another device that I love is Frequency-Specific Microcurrent. It's an extremely flexible device that can do a whole lot of things to help heal the body. And they've put together some terrific programs. Now, this is an electrical device that operates at such a light amount of electricity that you can virtually not feel what's going on. But it can profoundly reboot parts of the system.

The program that they have developed, which I love, the best is called the Vagus Nerve. And it includes both limbic and vagal rebooting processes. There's another one that they've recently put together for mast cell activation as well. You can reboot other components of the brain if it's inflamed and fired up as well. You can use it to help improve detoxification from mold. You can detoxify from mold specifically from the organs of detoxification. Improving the function of the gut liver, gallbladder, lymphatic system, kidneys, and skin. It's a great device.

But, again, with sensitive patients, they need to start with one program. Work with it at a very light level until it really can set in and begin the process of making them safer. Then you can add some of the other programs to it.

Another device that I like, which I think you turned me on to – you did an interview with Patrick Porter who developed a device called BrainTap. And a lot of my patients like that device as well. Simply, it's a virtual reality headset that visually takes stimuli in and earplugs where you're getting sound as well. You're using light and sound stimuli in different patterns to literally reboot some of the inflamed parts of the brain, particularly the vagus. I found that to be a very effective tool.

Another tool that I like is called the LENS, which stands for Low Energy Neurofeedback Systems. And it measures brain waves. These little ear clips that allow you to measure brain waves in 21 different parts of the brain. Looking for areas of the brain that are electrically under-profused. And you can literally put a homeopathic electrical signal in by feedback to literally reboot parts of the brain that have been kind of shut down. It's a great tool for children who not only have some of these issues. But for those who have autism, traumatic brain injury, a variety of neurological issues like seizures, or pseudoseizures, or dyskinesias. It's a really great way to very safely and gently reboot some of the neurological processes we're talking about. There's more. But you asked me for my favorites.

[00:37:09] SCOTT: That's amazing. It's interesting you talk about using some of these tools and potentially people wanting to kind of overuse them. And that just brought the thought for me that my observation has been many people with these chronic health challenges, myself included, are very much type-A personalities. And I think part of that type-A personality is what leads us to develop these conditions. And that we can't then use that same type-A approach to find our path to healing.

[00:37:38] DR. NATHAN: That is profound. And I agree with you completely. For whatever reason, maybe because it's type-A people who are prone to it, my practice has always been filled with type-A patients. And their basic attitude towards healing is I have to do more. You're asking me to come at this very slowly and gently, Neil. That's not my approach. And so, they do their approach and they overdo and they hurt themselves. And they come back a little bit with their tail between their legs. And they do that repeatedly.

And part of their healing process is getting it into their system that the tools that I use to be a successful person to succeed at my work, to be creative, to do everything really well in my life, I need another gear. I've sometimes accused my patients of having two gears, which is overdrive and burnout. And I basically say, "How about we get a couple more gears in there so we don't have to fluctuate between those two extremes? How about we –" and so, the patients who've done the best are the ones that get that message soonest and go, "Okay, I think the thing is I'm not going to listen to my head about how fast I want to heal. I'm going to listen to my body. Because it is trying to tell me how fast I should move. And I think it's been trying to tell me that for a while. And I'm not sure I've been listening properly." It's about listening to what your body is saying. And it's hard for some people.

[00:39:22] SCOTT: Guilty as charged.

[00:39:25] DR. NATHAN: I was not throwing any stones in this glass house.

[00:39:31] SCOTT: In the book and in our conversation today, you talked about the foundation of healing for complex chronic illnesses being really to focus on the limbic system, the vagus nerve, and on mast cell activation syndrome. Many people understand the value of working on the limbic system and then kind of separately working on the vagus nerve.

And I think one of the concepts that I got from you was we really need to work on both simultaneously to optimize that foundation for healing. There's lots of tools we've talked about for the limbic system and separately for the vagus nerve. Are there some tools that you believe really cross over into both limbic and vagal? Essentially, feeding two birds with one seed, as Dr. Crista likes to say. How do we get the biggest benefit with the least effort? And, finally, are yoga and meditation tools that support the limbic and vagus nerve in a similar manner?

[00:40:24] DR. NATHAN: The bad news is that they're really two different systems and they respond differently to treatment. The only system that even begins to address both is Frequency-Specific Microcurrent. It's the only one I know that does both. For everything else, there's limbic retraining. There's vagal retraining. And as you're saying, and I completely agree, they need to be done concurrently.

If you're looking at a hypervigilant nervous system, limbic and vagal, and you treat the limbic system only, there's a good chance that it's not going to work if we're not also treating the vagal system and vice versa. Both systems have to get safer at the same time to make progress. And I'm going to throw a third in there. Not everyone with limbic and vagal dysfunction has mast cell activation. Most do.

When patients are ready, they need to do mast cell treatment also. Because all three are interwoven. I've had a lot of patients do take the correct supplements for mast cell activation and not get very far. Because they're not treating limbic and vagal issues as well. And you've got to treat all three systems because they are completely interwoven in terms of how they affect each other. That's a hard one for patients.

Because, well, some will say, "Well, let me just do my vagal stuff first." Or, "Let me just do my limbic training first." That's great. Go ahead. But please add other components as soon as you feel capable of doing that. Don't just think that one is going to fix you. You have to do several.

Now the back half of your question was, "Well, what about basic relaxation strategies?" Almost all of which involve some form of breathing. Yoga, tai chi, meditation of every type. They're great, all of them. In my experience, they're not as specific for limbic and vagal retraining as we want. I totally encourage people to do that.

I mean, I've personally done Vipassana-type meditation for almost 30 years. And it's a part of my life. But what I have seen is I have many patients who will say, "Well, I don't need to do that. Because I meditate an hour a day." And I'll go, "Well, your limbic and vagal system are still messed up and you're doing it an hour a day." That's great. But you're not getting to the specificity of rebooting the system the way you need to.

And to be honest, some patients are so attached to their meditation practice that they're reluctant to add these other things. When they do, they'll usually go, "I should have listened to you six months ago when you told me to do it six months ago." Okay. My style of practice, as you know, Scott, is I don't beat people up with I told you so. I use shaming and guilt as my primary methods of very just gently reminding people that, "Okay. Now you know this. Now let's get on the horse and let's do this properly. "I don't feel that beating people up about what you didn't do helps them very much. They already know they didn't do it. So, okay.

[00:44:03] SCOTT: I want to take just a very quick sidetrack on the topic of Frequency-Specific Microcurrent. We know that attempts to support mitochondria can backfire when people are still stuck in Cell Danger Response. We also know that FSM increases ATP significantly with any program that you run. I'm wondering if some sensitive patients aren't going to tolerate FSM even when we're doing limbic, and vagal, and concussion, and mast cell, and those kinds of things because the effect that it might have on mitochondria, on ATP. Or do you generally find that it is well-tolerated?

[00:44:42] DR. NATHAN: It's a good question. It depends on how the FSM is done and with what intensity. What I mean by that is if there's ever a problem with FSM practitioners – and I love FSM. I have been involved in teaching the advanced course. And I've done FSM in my office for many, many years. I love it. But many FSM practitioners are really gung-ho. Patient comes in. They're really sensitive. They're really behind the 8 ball and they go, "Oh, yeah. We can do the vagus nerve. And we can do concussion. And we can help your organs to detoxify better. Come on down on the table." And they overtreat those patients and they take weeks to recover. Can you do too much FSM? Yes, you can. True of anything that I talk about. You can overdo anything. And it depends on the sensitivity of the person involved.

My super sensitive patients, I'll tell them to start with the vagus nerve at the lowest amount of current possible. And to be specific, most treatments are given at 100 milliamps. Thousands of an amp. Tiny amount of electric. But for my really sensitive patients, I'll have them start at the lowest the device will go, which is 20 milliamps. And for a shorter period of time, don't run the whole half-hour program. Run it for 10, 20 minutes and then low dose. And easing people into it helps. Maybe they could have gone faster. That's type-A. But by going slower, I can ease most people into a treatment that will be effective for them.

Now, I don't know that I can say that it's the ATP stimulation that is doing that. I don't know that we have the research or science to know is that the issue? Or why is that the issue? I'm more inclined to look at it from a more practical view, which is what is my patient going to tolerate and then benefit from. And then we can build on that and move them forward from that. It's pretty rare for FSM to throw someone off unless you majorly overdo it. And I've had people do that.

[00:47:11] SCOTT: We covered the first two components of the foundation for healing, which is the limbic, the vagal. Now let's talk a little bit about mast cell activation syndrome, which could be and really is a book in and of itself. Many books on mast cell activation. Really, every single chapter in this new book could be its own book.

And so, let's talk a little bit about mast cell activation. And does mast cell activation itself also cause inflammation, which further impairs the limbic system? And does treating mast cell activation then also assist in calming the limbic system or reducing limbic inflammation? And then the opposite, does treating the limbic system and the vagus nerve assist in calming the mast cells? Is this relationship really bidirectional?

[00:48:01] DR. NATHAN: Yes. Yes. And yes. It is truly by directional. Tri-directional would probably be more correct in this particular case. Mast Cell Activation involves the release of hundreds of biochemical mediators into the body from the release of mass cells when they're overstimulated. And many of those substances, I venture most, are inflammatory in nature. So that there is a direct, clear inflammatory component to mast cell activation, which exacerbates the inflammation that is triggered by mold toxicity, or Lyme, or coinfections, or whatever we're talking about here. And it directly affects the limbic and vagal systems making them more dysfunctional. The answer to that is a resounding yes.

And I think I had mentioned before that if we're going to treat mast cell activation, it's really important to treat limbic and vagal pieces. And if there's one caveat here, I don't think that people realize that. So that since mast cell activation came into our consciousness maybe 2016 when Larry Afrin's book, Never Bet Against Occam, came out, it was a profound game changer in terms of, "Whoa. I thought mast cell activation was rare. This actually explains a lot of what I'm seeing."

And we went from believing incorrectly that mast cell activation was rare, and genetic, and only a few people had it. To we now know that 17% of the population has a propensity to mast cell activation. That if we do the wrong things, we're going to get mast cell activation. That's a lot of people. We're talking millions of people.

And, indeed, the whole subject of mast cell activation has blossomed in the last eight years, so that we have summits on it and whole meetings devoted to it. And it's this whole new topic in medicine. But people are taking it as a subject unto itself, which is, "Okay, you have mast cell activation patient? You're going to take these supplements and you're going to feel better." There's a couple of things wrong with that. Number one, mast cell activation isn't a standalone diagnosis. It is triggered by a variety of things that we need to discover and treat.

It's triggered by mold. 80% of my patients with mold toxicity have mast cell activation. It's triggered by Lyme. A high percentage of patients with Lyme disease and coinfections have it. It can be triggered by viral infections, other environmental toxins. It's triggered.

And if you want to treat it as if it's this own thing with its own name, that's fine. But you're going to treat it for the rest of that patient's earthly life. Unless you get to the red cause of what's triggering it. And so, I have an axe to grind, if you will. With a lot of the clinics that have been set up to treat it is that they seem to be unaware of that. And they're missing the forest for the trees.

The second big caveat there is that what we've been talking about. If you're trying to treat mast cell activation and you're not looking at limbic and vagal issues, you're not going to help that patient optimally. Because we have these three interwoven systems. Treating only one of them is not sufficient for most people.

[00:51:41] SCOTT: Yeah. It's kind of interesting with the mast cell activation and the triggers. I mean, the way I think about it is that Rich Horowitz talks about the nails in the foot. And then I think about the mast cell activation more as the redness and swelling around the nail. And we can either put arnica cream all around the nail to address the swelling and redness. Or we can pull out the nail and then put on the arnica cream, right? And so, if we're really just focused on the mast cell activation, I agree with you. I don't think we – well, we never would get to resolution, right? We would be doing that for the rest of our life essentially.

[00:52:15] DR. NATHAN: Right. That's correct. To me, those are really take-home messages, which is, is it common? Yes. Can we treat it? Yes. But what caused it and what's it connected to? And then we have a much more comprehensive way of looking at it.

[00:52:31] SCOTT: One mast cell activation syndrome intervention that Beth O'Hara talks about in the book is the use of bicarbonates to support mast cells. There's a number of products in this realm that provide sodium or potassium bicarbonate. What about just plain baking soda as a potential tool for calming mast cells? And then want to extend on that just a little bit. One of the tools that people commonly use is collagen. And so, do you find that collagen might actually make the histamine situation worse? And are there better ways to support collagen to support structural integrity without adding to our histamine bucket? And maybe even using something like collagen creating more histamine and then that having a negative implication in terms of structural integrity. Love to hear your thoughts on baking soda. And then, also, on collagen.

[00:53:23] DR. NATHAN: This is an area that's not my specialty. I have not used this form of treatment very much. Beth has extensive use of it much more than I have. I can't really comment on how effective it is or how it would be. I just don't have much experience with it.

In terms of collagen, it could trigger a histamine issue for some patients. And I think when I think about collagen, I think about supporting it by supporting sulfate and sulfur metabolism more than anything. And again, we have a chapter in the book by Greg Nigh, who I know you did a podcast with. Greg's extremely knowledgeable about this.

And the use of, for example, Epsom salts, which is simply magnesium sulfate and is absorbed directly through the skin, many of my patients love Epsom salt baths. And it's very benign. It's very safe. You can overdo it like everything else. You would start with a little bit of Epsom salt and then slowly increase the amount that you use.

For many of my sensitive patients, they might use a half a cup. And Greg recommends four cups ultimately to really get maximum benefit from that. But by adding sulfur into our system, our body can make the sulfate that we need to make collagen from. And I think that makes the most sense to me in terms of supporting a way of understanding the metabolism and giving the body the raw materials it needs to make something from.

[00:55:01] SCOTT: Let's talk now about Dr. Andrew Maxwell's work with Spiky-Leaky Syndrome. This is a really complex condition that involves hypermobility, Ehlers-Danlos Syndrome, structural instability, musculoskeletal, vascular, and lymphatic injury in the upper neck, disordered breathing, and essentially a sympathetic overdrive. Some patients also have CCI or craniocervical instability where the ligaments can become weakened or tenderized. Intracranial pressure rises or spikes. And that can lead then to drainage or leakage of cerebral spinal fluid. What have you observed in patients with these types of conditions both in terms of common triggers as well as your top therapeutic interventions? And why are so many people today dealing with significant structural integrity issues?

[00:55:53] DR. NATHAN: Again, it's a very good question. I mean, again, Ehlers-Danlos Syndrome was thought to be a rare inherited condition many years ago. And now we're seeing people not born with it, which was often the case before. But developing these loose ligaments all over their body.

Classically, someone with Ehlers-Danlos would be able to take their thumb and put it on their wrist, which I can't even vaguely come close to. But they could just put it there. That's a sign of the ligaments in their body becoming looser. We could use the word weaker. But I think looser is may be more accurate.

And one of the things that Andy Maxwell has put together is that what is causing this looseness is some of the mast cell activation materials that are released are having a direct effect on the ligaments causing them to be looser. And so, this is not intrinsic Ehlers-Danlos Syndrome. But it's created by the underlying medical conditions that we're looking at.

Again, for this condition, if we treat the cause, again, we can make huge inroads. And a lot of my patients who've had loose ligaments, once they get the Lyme and mold out of their system, don't anymore. This is treatable from that perspective.

And, again, what we're talking about here is pretty complicated. I'd encourage people to look at the chapter that Andy – and I helped write that as well. There's a diagram in that chapter which I think says it all, which shows – it's a detailed diagram of the anatomy at the base of the neck, at the base of the skull.

And what you can see is if the ligaments that are holding the first cervical vertebrae up against the skull get loose, that it collapses on itself. And in doing so, the blood flow the lymph flow to the head is compromised. It creates that buildup of cerebral spinal fluid, which creates that leaky process, which for some people creates a very odd facial puffy perception.

And until I heard Andy speak, I had never put it together. I thought that the facial puffiness that I was seeing was caused exclusively by mast cell activation. Because that's the thing that did it most. You can get it for people taking Prednisone as a side effect. But that's a separate issue. But I would often treat my patients with the things that help mast cells. It would help some of their symptoms. But their facial puffiness did not improve.

I think their Spiky-Leaky theory has great validity. I'm not sure how common it is. I think some degree of CCI of cervical cranial instability is present in more patients than we realize. It can get better when we fix the underlying issue. It is also something that responds really well to osteopathic cranial work, for example. And if you get the structure right with osteopathic treatment using prolotherapy to strengthen the ligaments, is a treatment that can be helpful.

Now, one of the things that Andy has suggested is, one way to tell whether you're having this or not, is to get a soft cervical collar, which sort of lifts your neck up from that collapsed position. Or if you can get an over-the-door traction device. Very simple. Put a little bit of water in a container and then traction goes over the door. That, again, will lift up the neck structure. And if you are getting better from that, then that's a tip-off. You have that condition.

This is very hard to pick up on MRI or a CT scan. But some people don't understand is that the limit of resolution of MRIs is 2 millimeters. Meaning, if you have a very subtle structural imbalance and it's of 2 millimeters or less, that's not a lot, but it won't be picked up by scan. You can actually have a condition and it's just not within the resolution of the device to pick it up. It's a very tricky diagnosis to make. I suspect it's more common than people realize.

[01:00:31] SCOTT: In the biochemistry of sensitivity chapter, we learned from Dr. Woeller about PAMPs, or pathogen-associated molecular patterns. We learn about DAMPs, or danger-associated molecular patterns. He also talks about HAMPs, which was new to me. homeostasis-associated molecular pattern.

That HAMPs concept is newer. All three can be involved in sensitivity and people with chronic illness. Talk to us a bit about HAMPs. Their role. What triggers HAMPs in the body in sensitive patients?

[01:01:03] DR. NATHAN: I think HAMPs is just another way of describing the healing process from an immunological perspective. It's what the immune system does to undo the PAMPs and DAMPs? Meaning, okay, we have pathological inflammatory processes. And this is a good time to mention that almost all chronic illness, you name it, has at its root inflammation of some type.

And so, we've learned in the last 10 years that this inflammatory underlying process is what we have to be looking for in any worse person who has any chronic illness, whatsoever. Because that's what's triggering it.

For example, in Alzheimer's disease, Dale Bredesen has done some pioneering work showing that it's inflammation that is triggering the laying down of tau proteins and amyloid in the brain. And that if we get at the inflammatory process early, it can be reversed. This is profound. This is for the first time. And Dale has found that, shock, Lyme and mold toxicity are two of the main inflammatory processes that are triggering Alzheimer's disease.

When he first started, Dale found that about 60% of his patients with Alzheimer's had mold toxicity. He's now finding it's closer to 90%. Again, this is a phenomenally important process that people have not recognized how pathogenic it is and how pervasive it is. And if we get on top of this early, we can really help a lot of people.

In the cardiovascular system we've recognized that cardiovascular health is profoundly caused by inflammation of the blood vessels, which are laying down cholesterol, not to block them, but kind of like a poultice, to kind of protect it from the inflammatory process.

In fact, Jack Wolfson at a medical meeting, a well-known cardiologist, went so far as to say that every patient with cardiovascular disease should be checked for mold toxicity. Because that is an underlying informational process. I think that's a bit much, personally. But I think it makes a terrific point, which is we should be looking for the causes of inflammation for whatever underlying chronic illness we have. And that's not been basic medical practice yet. But, hopefully, it will become so.

[01:03:58] SCOTT: Maybe we need to stop testing our cholesterol every year and test our house and test our urine mycotoxins. Maybe we actually would shift things in a much more efficient manner.

[01:04:10] DR. NATHAN: It could make a profound difference. I don't know that we have the scientific information to be able to say that categorically. But it seems like a pretty reasonable thing to check.

[01:04:24] SCOTT: You've talked about another potential roadblock in returning to health being that the body habituates to illness. And that attempts to move it back to health are also then perceived as unsafe and are resisted. How often do you see this clinically? And is there anything unique about approaching this safety in becoming healthy again from what we've already discussed with limbic, vagal, mast cell? How do we approach this being able to feel safe with becoming healthy?

[01:04:57] DR. NATHAN: That is a very good question. My learning about that came from Bob Naviaux's work where he talked about, on a cellular level, the cell gets so used to being in a hypometabolic or disturbed metabolic environment where its chemistry is messed up. It gets so used to that, that if you improve it, the cell literally freaks out and goes, "What am I going to do with that? I'm used to this. What's happening now?" Now, that seems odd. But I am certain that it is true.

The way that I perceive that most often in a clinical way is with what we call Herx reaction or detox reactions. We're giving our mold patients binders or antifungals and they may have a die-off reaction, in which taking a substance appears to make them worse. So we go, "Oops. That's not a good thing. Let's back off from that." Or with Lyme disease, we're giving someone an antibiotic. They have a Herx reaction. They get worse. Oops. Maybe I gave you too much. Maybe that was too strong.

What this concept is telling us is maybe that's not a Herx. Maybe that's not a detox. Maybe this is the body's reaction to, "Oh, this is a change. And I'm not sure what to do with it." I think what it is telling us is that we have to have another gear, if you will, to look at negative reactions that people are having from treatment and may be willing to hold on a little longer with a negative reaction. Because it may just be a reaction to healing.

And that if you can stay with it long enough, the patient will get, "Oh, okay. This is okay. I know it was freaking me out at first. But now, oh, this is good. This is good. My tissues are really getting better."

Let me give you the same thing in a completely different context. One of the things that I've seen over many years is that when you get to a certain point in healing, patients are faced with the possibility of being well when they're getting better. And many of them really freak out at that point.

Now, there are many, many reasons for that. Some of them perfectly reasonable, which is, "Oh, my God. I've been using my illness for years to not do these things or to avoid certain family situations." Or, "I'm getting disability. My whole family income depends on being disabled. What if I got well? Would I have to go to work again?"

I mean, there's a whole bunch of very important, reasonable reasons why that might happen. But the bottom line is bodies – and this is a shock. Came to me as a shock as a physician. Is that when people were on the verge of being well, they did not always embrace that. They often went backwards at that point and, "Whoa. I'm not sure I'm ready to be well. That would mean I'd have to step up to the plate in a variety of ways that I don't know if I can. I don't know if I should."

As my patients got better for my entire practice career, I would begin to introduce that subject early on in the course of treatment. Because it's an important one, which is, "Okay, you're starting to get better." And, often, I wouldn't introduce it until my perception was that they were at least halfway through the process that they were very definitely getting better. Said, "Okay, so what's your life – I'd like you to start visualizing or imagining what's your life going to be like when you're really well. How's that going to be different? How can you embrace it?"

A major concept that I would ask people to look at that point is what I call what gives your life meaning and purpose? And how can you find new meaning and purpose in a healthy body, in a healthy mind, in a healthy spirit that can now go on and do more?"

And I found that we had to have those discussions repeatedly as people got better so that they weren't shocked by the concept of, "Oh, my God. How am I going to deal with this now that I'm well?" But rather, "Okay, how can I embrace this? How can I welcome it in a different way?" And I think that those discussions were very helpful for a lot of people in making the transition from illness behavior, illness consciousness, into being healthy and ready to live a vibrant life again. And I think this is a very important subject.

[01:09:56] SCOTT: You wrote the chapter in the book on mold toxicity, which we've covered in detail in another podcast. But I want to touch on urine mycotoxin testing, which you've said has been the most accurate method for diagnosing mold illness. Some will argue that mycotoxins coming out in the urine is normal, is healthy, and is not an indication of disease or of any health problem. I personally have found these tools very helpful as well. How do you respond to that criticism?

[01:10:22] DR. NATHAN: Well, everyone can have their own opinion about whatever. There's a couple of well-known people in the mold world who specifically don't think that urine testing is accurate. Because it doesn't reflect what's really going on in the body. That has not been the experience of the vast majority of people that I work with.

For example, I have a mentorship program for healthcare providers with Jill Crista that we've done for a long time. And we now have a little bit over – I've hit my 200 number as well. We have a little bit over 200 practitioners in the group. The vast majority of them have found that measuring urine mycotoxins is very accurate, very helpful, and has revolutionized our ability to work with mold toxicity as an issue.

Now, as to whether or not everybody has mold toxin in their urine, there was a study done by Great Plains Lab, which is now Mosaic, several years ago. It wasn't published in a medical journal. It was published in the Townsend Letter. But it was a very well-done study. They took 80-plus patientscontrols. People who did not have mold toxicity. And they took 100 patients who had known mold toxicity and they just measured what was in their urine.

When they looked at the controls, there were no mold toxins except for a little bit of ochratoxin. And what I mean by a little bit of ochratoxin – and in fairness, 50% of the patients had a little bit of ochratoxin. Now we quantitate those numbers. The average amount of toxicity of ochratoxin in those patients was 1.8. In the patients who had mold toxicity, the average amount was 18. It's obvious that you can differentiate a trace amount of mold from a massive amount of mold by this test. No other mycotoxins that they measured were present in controls to any appreciable degree. If you're seeing mycotoxin is in the urine, they're there and they're meaningful.

In fact, that's one of the reasons that Great Plains at the time, they made their cut off for an amount that meant something as 7.5. That meant that for the vast majority of people who had a little bit of ochratoxin, that would have read by their test negative. My comment is I believe that using mycotoxin testing is a godsend and allows us to measure what people have in their body and know what is there so I know how to treat it more specifically. And when we're done, when that test reads not present in every category, we're done. It's really helpful. I know there are people who don't agree.

[01:13:22] SCOTT: Your mold treatment approach is to get out of mold. To use precision binders for their specific mycotoxins and then to address colonization. Are we getting any closer to better testing options for colonization? And for those that prefer to use natural options, are there some tools that we can really work with to address fungal colonization naturally? Or do we need to bring the pharmaceutical guns in here?

[01:13:49] DR. NATHAN: The tools we have are really minimal and not adequate to tell us what's going on in the body. The main way we can know that colonization has occurred is that when we're treating with binders and we get people out of a mold environment, if they're not improving and their mold toxin numbers are not changing no matter what we do, then we can be pretty sure that they're colonized. And, honestly, Scott, the vast majority of people that I treat have colonized.

Now, Great Plains/Mosaic does have a test in which the first part of their OAT test measures a number of things which give a hint as to whether colonization could have occurred. It's not a really accurate test. You can't base what's going on clinically because of it. But if it is positive, it gives us added evidence that, yes, we've colonized and we're going to need to treat with antifungals.

Okay. As to the natural treatments, here we might have a little disagreement which is rare between me and my teaching partner, Jill Crista, who I adore and who is a fabulous practitioner. From my perspective, treating mold and candida has changed profoundly in the 50 years that I've been doing it. So that 30 years ago, I would be using herbs to treat candida and mold very successfully. There was a whole bunch of herbs which worked really well to do that with.

As time went on, I found that the mold and candida had become less and less sensitive to that and required – I'll call them bigger guns. They required more medication in order to do that.

In my world, I think that using actual antifungals by prescription is necessary for many patients. But I would also suggest that Dr. Crista's experience is profound. And she's had excellent results with her treatments, which involve more natural things. And her book, Break the Mold, is filled with that information, which I encourage listeners to check that out.

[01:16:14] SCOTT: Does extreme avoidance or extreme mold avoidance potentially work against the limbic system and lead to further limbic system impairment? Potentially reinforcing danger signals. Essentially, really the opposite of our goal and what we've talked about so far. While I absolutely would agree that a less toxic environment is certainly best, how often have you found the need to use more extreme avoidance methods clinically?

[01:16:43] DR. NATHAN: Your point is very well taken. When patients become so frightened about the possibility that there's mold in their environment that they go to extremes, and that can include moving to a tent in the desert, or moving to New Mexico, or Arizona, or getting rid of every possession they've ever had, somewhere along the line, sometimes that works.

Many folks who are in the camp that extreme avoidance works. Put it this way, it can't hurt. However, it is very expensive and not necessary most of the time having successfully treated over 4,000 people with mold toxicity in my career. But your point is very important, which is it isn't what you're doing as much as why you're doing it that matters. And if the why is from fear, panic, then the limbic system is involved and it is very contraproductive in order to do it that way. And I see that a lot.

I mean, there's many chat rooms out there and some of them are devoted to extreme avoidance. And many of the folks on those chat rooms are literally hurting their limbic systems unwittingly because they don't realize that your fear is hurting you – is hurting your whole body and illness as much as the benefits you might be getting from extreme avoidance. It varies very much.

I put it this way, there's two components to being sensitized by mold. One is mold toxin is directly sensitizing to both the limbic and vagal system. But the other is, as the limbic system becomes more sensitized, our sense of smell becomes more and more sensitive as we go.

For some people, when they get into an environment where they smell a little bit of mold, some of that is the direct effect of the mold. And some of it is a direct effect of the limbic system picking up the smell of that mold and scaring them. And that isn't always appreciative.

For many people, when they do their limbic retraining, they become less sensitive to the smell of mold and much less sensitive to being going into buildings that they couldn't go into before. And now that's not because their mold has been cured. It's because their limbic system has been improved and made much safer. And I'm not sure that that is appreciated to the extent that it needs to be.

[01:19:34] SCOTT: Dr. Richard Horowitz shares a chapter on Lyme and co-infections. He says that 18 of over 30 species of Bartonella can cause illness. And that in some states, up to 20% of ticks carry Bartonella. Whether or not ticks carry Bartonella has long been a topic of debate. And it sounds like that is now put to rest. What are some of the latest treatment options in the Lyme and co-infection landscape that are moving the field forward and really helping patients to regain their lives in your clinical experience?

[01:20:04] DR. NATHAN: Well, the biggest is Dr. Horowitz's own research and work. We've fairly recently learned that one of the reasons that Lyme and Bartonella have not been able to be cured or treated successfully for many patients is the existence of what are called persister cells. These are certain bacteria in the Bartonella and Lyme strain that become more and more resistant to the antibiotics being used.

And recent research by Dr. Zhang at Johns Hopkins has shown us that we can now treat these persister cells. Based on Dr. Zhang’s research, Dr. Horowitz has slowly put together and evolved a treatment that he called the dapsone protocol, the double dapsone protocol, and now the triple dapsone protocol in which combining the antibiotic dapsone with methylene blue with the other antibiotics that we typically use has profoundly changed our ability to help these patients.

When I first heard about this from Dr. Horowitz when I was still in practice, I was able to help quite a few of my patients with Lyme and Bartonella who were treading water. We were able – if they took antibiotics, they were able to get 80% better so that they were much more functional. But they just couldn't get well. And with the use of these protocols, many of them were able to make that jump from being water treading to well. And so, his work is profoundly important. And anyone with Lyme or Bartonella should be looking at his research. All of which, he's got published papers and his protocol on his website. I would really encourage people to look there.

[01:22:03] SCOTT: And that is cangetbetter.com for people listening.

Riina Bray and Magda Havas, they share their thoughts in the book on EMFs. Wondering if you feel that the exponentially increasing effects of EMFs are a factor in the increase that we see in mold in our buildings, potentially in some of these organisms within our bodies as well. And then how much of a threat is 5G itself? Is it the 5G that's the problem? Or is it that we now have so many towers that are closer to us that are also broadcasting 3G and 4G? And then any thoughts on what's working in your patients that are EMF sensitive?

[01:22:43] DR. NATHAN: The answer is both. What many people don't realize is that the difference between 4G and 5G isn't one. It's a thousandfold increase in the amount of EMF exposure between 5G in 4G. What we've seen is an exponential rise in EMF sensitivity. And for listeners who are not sure what that means is, for those of you who work at a computer or work a lot with a cell phone, after any period of usage, if you begin to get brain fog, fatigue, headaches, for some people, neurological symptoms like seizures or dyskinesia, these are a direct effect of EMF sensitivity.

Again, many of the folks who get this have had their symptoms dismissed or disparaged, "Oh, nobody's that sensitive. I'm not that sensitive." We have a very bad habit in this world of thinking that if I don't experience something in a certain environment, other people in the same environment shouldn't either. It doesn't work that way. We're all biochemically and genetically unique. There is very definitely a real EMF sensitivity.

One of the chapters in the book by Marty Pall talks about voltage-gated channels as now being discovered as there's a very specific biochemical aberration in our patients with EMF sensitivity that it's real. It's not in their head. It's in their tissues. We can protect ourselves.

The main and first thing that people need to do is to measure the EMF exposure that they have right in their body. And that's not hard to do. I recommend a book by Nicolas Pineault. He's a French-Canadian with a snarky sense of humor. And he calls his book The Non-Tinfoil Guide to EMFs.

And in it, he not only talks about the devices and how to measure them. But how to block the effects of those devices by things you can buy readily. For example, the EMF meter that he recommends is called a Cornet Electrosmog Meter, which you can get for less than $200 on Amazon. And it has three different settings for three different kinds of EMF that you get exposed to.

EMF is not one thing. There's EMF from cell towers. And then there's EMF that you can get from electrical devices in your vicinity, which put out both a magnetic and an electrical field. There's different settings for the device. You can click on them. And by holding it up against your body, you can see what you're getting exposed to. Exposed to with the computer that I'm in front of right now. Or put it up right by my cell phone. Put it up against my laptop or my Kindle that I read with.

As an example, I had used that. But I had never looked at my Kindle in the past. And I was shocked that, right up against my body, I had a fairly high amount of EMF coming into my body. And so, I bought a shielding device, which you can get easily on Amazon. And with that in place, I don't get any. We can protect ourselves to a certain extent.

For those people – and I've lived rurally. I've had personally less exposure than some people. But if you live in a city and you have smart meters in an apartment building and is right below you and you have everyone else's using 5G and it's coming into your existence, you may be in trouble. And many people are because they can't control what their neighbors are doing. They can't control what the cell towers are doing.

There's a variety of devices that you can get. Most of them I don't think work very well. Things like lockets, and pendants, and things that are supposed to protect you. But there is a device that was brought to this country by Roger Billica, who's a wonderful physician that I've known for many years.

Roger was the Chief Medical Officer for NASA for 10 years. He's particularly knowledgeable about electromagnetic radiation and its effect on bodies. And he has a device from Spain called PRANAN. You can get from his clinic. That is about the size of a cell phone which you can hold on your body and it will shield you for a radius of about 3 or 4 feet. So that even when you're wandering around or in your home, you can be somewhat or better protected from the EMF onslaught than you were before.

There are also environmental engineers that you can hire to come in. You can put certain paints in your body or put up certain screens that will keep some of the EMFs out of your existence. There's a bed canopy you can use at night in order to protect yourself from that. And Dietrich Klinghardt has talked about that for years.

There are ways of protecting yourself. And I want to emphasize here, EMF sensitivity is also a result of limbic dysfunction. So that if you do limbic retraining, that will help profoundly in decreasing your EMF sensitivity.

[01:28:14] SCOTT: The chapter that Dr. Marty Pall wrote that you talked about a moment ago, which really looks at the impact of the voltage-gated calcium channels from EMFs and then the influx of calcium into our cells was also another interesting lens on this whole topic. And I really enjoyed some of the ideas that he had for how we can support the body from that perspective using things like magnesium, or vitamin D, or melatonin. Some medications that he discusses as well. Upregulating NRF2. Things of that nature. Lots of fantastic practical tools.

Then we get into looking a little bit in the book about environmental toxicants with Dr. Lyn Patrick. The idea that we have so many exposures these days that our bucket literally becomes full and is overflowing. She mentions that there's over 350,000 chemicals. 50,000, she says, are confidential. 70,000, she says, are not described well enough to even understand what they are. And very, very few of these have been tested for human safety. Really important chapter.

I started making sure after reading that chapter that I have my vent hood running over my gas stove anytime that I'm using stove. That's an important thing that she talks about.

But let's tie this back into the limbic system, to the vagus nerve, to the mental-emotional realm, to the nervous system, to the Cell Danger Response. Talk to us a bit about how we can support our body's ability to detoxify by working on those foundational levels. And why maybe jumping in with aggressive detoxification protocols early on is going to be resisted by the body or at least have a less than optimal outcome?

[01:30:03] DR. NATHAN: Again, each person is genetically and biochemically unique. There are some people who can handle almost anything I can give them in terms of either treatment or improving detoxification. And for quite a few people who are sensitive, if I give them things that would improve their ability to detoxify, they will simply get more toxic.

I mean, huge examples of this would be, first, glutathione. Glutathione is a super important natural component of our bodies to deal with all of the toxins and free radicals we have in our world super important. But when if I give glutathione to my sensitive patients, at least 50% of them will get worse. Because it will mobilize the toxins in them faster than they can process it and they will get worse. Okay?

The same is true of doing a sauna. Saunas are great. Sweating is a wonderful way to get toxins out of the body. But if you take a sauna at too higher temperature or for too longer period of time, again, you're going to mobilize toxins faster than that person can deal with it and you're going to get worse.

Each person has to be treated uniquely in terms of their capacity for detoxification. Meaning that if we improve the functioning of their liver, their gallbladder, their kidneys, their gut, all of which are important in detoxification, we have to go slowly at it. We have to ease them into it in order to be sure that we're not overloading their system.

As people's ability to detoxify improves, what we normally see is an increase in their urine mycotoxin levels on their second test. And then in subsequent tests, it drops down. And that is what we are seeing in our patients whose limbic, vagal, and mast cell systems are improving. That we have evidence that they are mobilizing toxin better and healthier. Now they're getting the toxins out of their body and it's not making them worse.

[01:32:11] SCOTT: Next in the book, we have Emily Giver talking about oxalates. We know that mold can make oxalates. Or fungi can make oxalates in us. As well as consuming foods that contain oxalates. Would you say that the majority of your patients dealing with oxalate burdens, that it's coming from external food consumption? Or is it more likely coming from internal fungal colonization?

[01:32:38] DR. NATHAN: I think in the majority of our patients, it's internal fungal colonization. We know that certain mold species make oxalates. And it's extremely common. When my patients get OAT tests, almost all of them have elevated oxalates. And so, I'm pretty sure that that's from the mold that they have in their bodies.  

There's other components of the test that shows that if you have a history of having had kidney stones, most of which are oxalate in nature, you will get often an exacerbation of that. Yes, you can get an exacerbation of that.

There is a subpopulation of sensitive patients who needs to take this very seriously. For most of my patients who have an excess amount of oxalate in their body, they don't really need to do anything step continue with their mold treatment. Get the treatment and they'll get well.

But there's a percentage. I would put it at maybe 10%, and Emily and Beth might put it a little bit higher than that, of patients where these oxalates are adding to their symptoms and making them worse and making them more sensitive. And we have to treat them more aggressively. Which means either giving them some type of citrate, sodium potassium citrate, or calcium magnesium citrate to bind oxalates in their gut to help them get it out of their body. Or put them on a low oxalate diet.

And having said that, oxalates are made by kale, spinach, rhubarb, and many things that people eat a lot of. For example, many of our patients are unaware that these healthy smoothies filled with spinach and kale that they drink every morning may be actually exacerbating their illness. And for them, they need to wean off. Because there is a phenomenon called oxalate dumping, in which if you suddenly deprive the body of oxalates and you've been giving it for a long time, the body starts dumping the load that it has and can make you much worse. You need to very slowly ease off that amount of oxalates that you're eating. You don't just suddenly go on a low oxalate diet. And Emily Givler is very expert on that. Has a great chapter in the book. And I know that you've interviewed Sally Norton who has a wonderful book on the same subject, which really goes into detail about how to do this very slow weaning dietarily.

[01:35:17] SCOTT: One of the things that I took out of that chapter that was a good reminder that I had not thought of for a while was kind of the balance between sulfate and oxalate as well. And, again, how we can also use Epsom salt baths and magnesium sulfate as another tool to help mitigate oxalates. And so, kind of Epsom salt baths came through in two or three chapters as a tool that could be very helpful that I think we probably don't use as much as we potentially could.

[01:35:47] DR. NATHAN: I agree. And a lot of my patients who do it love it. They'll just go, "Oh, I do that every night. I don't know how I get by without it."

[01:35:57] SCOTT: I've interviewed Dr. Greg Nigh on his book, The Devil in the Garlic. In your book, he talks about the importance of sulfur for detoxification, for supporting the immune system, for connective tissue health. We want dietary sulfur to become sulfate and not become sulfite or hydrogen sulfide, which can also be a component of SIBO. He suggests looking at things like nutrient deficiencies, our environmental exposures, our genetics. Molybdenum is one of the common tools that can help. It's actually one that I take every day to support these sulfation pathways. Epsom salt baths, again, mentioned here as a source of sulfate from the magnesium sulfate.

And my question for you is: Might replenishing sulfate with the use of Epsom salt baths reduce the body's need to allow these compensatory bacteria to grow in our GI tract? And, thus, potentially also be a helpful intervention in SIBO?

[01:37:00] DR. NATHAN: Yeah. Potentially, yes. Let me expand on that particular subject. One of the hallmarks of functional medicine has always been to fix the gut first and then everything else will follow. The exception to that is mold toxicity. If you have mold toxicity, the usual things that effectively treat SIBO do not work anywhere near as well until you get the candida and mold out of the gut. I just wanted to emphasize that for folks.

I've had way too many patients spend several years working on their gut, taking course after course of rifaximin, which helps a little bit at first. And then the effect wears off. Because they're not getting at root cause.

[01:37:49] SCOTT: Yeah. I liked the concept that he brought out. If I understood it correctly, that some of the hydrogen sulfide and the SIBO may be the body's attempt to address the sulfate deficiency. And so, if we're then providing sulfate through the Epsom salt baths, maybe then the body doesn't need to create those or to let those overgrow.

[01:38:12] DR. NATHAN: And I think that that's a fascinating concept.

[01:38:14] SCOTT: He also talked about spiking coffee enemas with butyrate and bifido bacteria. I actually reached out to him after reading that in the book. And I am now doing a personal experiment that is underway. And we'll see how that plays out.

Beth O'Hara talks about salicylates, which can lead to sensitivities, even to things that could help us. Like, quercetin, for example. They can come from foods, from supplements, or even be created in our own microbiome. Beth suggests that about 20% of her clients are salicylate intolerant. Epsom salt baths, again, can be potentially helpful in this population. Wondering how often in your clinical work do you find salicylate sensitivity? And do you ever see it in someone who doesn't also have mast cell activation syndrome?

[01:39:03] DR. NATHAN: Good question. I would say I see salicylates issues maybe 5% of my patients. And, again, I often say that I have some really sensitive patients. But I would say that Beth also has really sensitive patients that her particular interest in that group of people brings to her a higher percentage than maybe I do.

But the key is to take a look at what people are taking. Again, as you said, we're using quercetin to treat mast cell activation. If you have a salicylate toxicity, you may be inadvertently making yourself even more sensitive and sick by taking quercetin. It's more of an openness to looking at the whole picture and going, "This isn't seem to be working." And then asking why. Because that's where the answer can come from.

With salicylates, you need to look at what you're taking. And if you go to that chapter, you can see a whole list of foods, and substances, and materials that contain salicylates that a lot of people are going to be surprised about. And, also, you have to improve the body's ability to detoxify from them.

Now, the good news is improving the body's ability to detoxify or remove salicylates are the same ones that we use in treating mold toxicity. Improving glucuronidation. Improving the cytochrome panel. Those things that I put in my table in toxic in which Beth, and Emily, and I put together a list of the ways we can improve the specific liver detoxification phase pathways to get rid of mold. The same thing applies to salicylates.

[01:41:03] SCOTT: Dr. Tasha Turzo talks about dental and facial components of sensitivity. And a compromised cranial structure can impact the vagus nerve. Can impact our ability to detoxify. May activate the limbic system and can lead to a constant feeling of disease and ongoing relentless stimulation of the sympathetic nervous system. Brain fog, which many people have, can be the result of toxic cellular debris in the brain that cannot get out of the brain. What are some of the tools that are at the top of your list for those dealing with these types of structural contributors to chronic complex conditions?

[01:41:41] DR. NATHAN: This is very important. Because I don't think that it is appreciated how important the body believes that dental occlusion is. We have to have our teeth fit just so in order for us to be comfortable. And the body puts a tremendous emphasis on this. More than you might realize. So that if our teeth don't occlude properly, if the bite isn't right, if you've got TMJ, and you've got some other facial and dental areas, this can literally throw the body into a tizzy. So that it just wants to move heaven and earth to get back into proper alignment.

We've had a number of patients who couldn't even do limbic, vagal, and mast cell work until they got their jaw aligned properly. It's that important. It's not common. But I've seen at least a dozen patients where their sensitivity was focused on getting that jaw to get back in alignment.

And so, Dr. Turzo has a great book that she has recently written that she alludes to in the book on exactly what this is and how it works. Again, as you say, we can have a book on almost every chapter of this that we covered here. But seeing a dentist who can get you into proper alignment, along with an osteopath who can get the facial structure into the proper alignment, is critical for those patients. And it has to be done very slowly and carefully. You can't just get someone to put bands in the mouth and jam on the jaw. You've got to ease them in or each of those little perturbations are going to be taken by the body very badly.

[01:43:35] SCOTT: Kind of dovetailing on that chapter, you have Dr. Carmine Van Deven talking about the structural components of sensitization. He says the body is a symphony of motion. He talks about how shock can prevent healing. He says that sensitive patients have an internal tension with resistance to motion. My question is, when we have stress and trauma that leads to compensation or to constriction patterns in the body, do we then want to treat the stress, treat the body, or do we again need to do both simultaneously?

[01:44:10] DR. NATHAN: Again, it's both. A huge percentage of our patients unknowingly have structural issues that are preventing their body from healing. And by that, I mean, in order for the body to heal, you need a good blood flow. Arteries have to bring the blood to the body. The veins need to bring it back. Lymph needs to flow unimpeded through the body so waste material can be taken care of. There's flow in the nervous system. There are energetic flows in the body.

The basic tenant of osteopathy is called the rule of the artery is supreme. Now this is a metaphor for. If there is a blockage of arterial flow, you cannot heal. And so, it's not just the rule of the arteries. The rule of every tissue in the body requires flow.

Now there's a – in almost all of our mold, and Lyme patients, and almost all chronic illness, flow is poor, especially lymphatic flow, which is not always appreciated. There's very few patients who can't be improved or helped by getting some structural work on a regular basis to improve those flows through the body.

The better things flow in the body, the better oxygen is delivered to the tissue, the better waste materials removed from the body. It's kind of basic and overlooked in medical care. I think Carmine's chapter is very appropriate here.

[01:45:39] SCOTT: Another very interesting topic in the book is benzodiazepines and SSRI withdrawals as contributors to sensitization. Dr. James Greenblatt talks about core nutritional deficiencies that can lead to withdrawal. How neurotransmitter support may needed, such as supporting GABA, for example. How important it is to explore gut health. How anti-inflammatory polyphenols can provide relief to these patients. My question to you is do you find that patients need to occasionally stop these medications to optimize or support their healing journey? Can they be roadblocks to healing for some people? Where might working with a professional to taper off of these medications come into a healing timeline? Or might it be better for some people to stay on these medications rather than to experience the process of withdrawal?

[01:46:34] DR. NATHAN: Okay. These are very good questions. The vast majority of my patients, be it mold, or Lyme, or Bartonella have been told by previous practitioners that they have anxiety and depression. And many of them have been placed on SSRIs or benzodiazepines as treatment. Many have been placed on it for sleep. What is not always appreciated is withdrawing from these things has become increasingly difficult. And I think this is another thing that has changed over time.

I mean, earlier in my career, I would occasionally use benzodiazepines like Klonopin and things like that for either sleep or for muscle relaxation purposes. And when I took people off, and I did so very slowly and carefully, I rarely remember anybody getting a reaction to that or going through withdrawal. A couple. But rare.

In the last 10 years of my practice, it became much more common. We're seeing an increase in sensitization in this form also, so that patients are much more prone to withdrawal symptoms coming off of benzodiazepines. And I think even in the psychiatric profession, I don't think they're aware of how slowly you have to bring people off SSRIs in order to get them to not have that reaction.

In my patients, if I were to take people off of what they're on, I would be adding a withdrawal reaction to a messed up limbic system, vagal, and mast cell system to people who are already cognitively impaired, and anxious, and really struggling with their life. It would be horrific.

My view is if you are already on those things, it's best to come off after we get your body healthier. Now that may mean after the mold is gone or the Lyme is gone. It could mean during. Once you're more stable. Once you're safer and better. Each patient would be different.

But I think it's been my experience that if you try to take people off those medications and they're in the throes of being really sick from these illnesses, you're going to make them worse. They're going to have a very tough time. And it's infinitely easier and safer to do that withdrawal process once they are in better shape.

[01:48:58] SCOTT: I learned something new from you in every conversation. Thank you for that perspective.

We then get into another important topic, which is Dr. Chandler Marrs's chapter on thiamine. Many medications can lead to thiamine deficiency, including antibiotics, SSRIs, PPIs, alcohol, high carbohydrates, even coffee and tea can impact thiamine as well. Thiamine can really support the mitochondria and help to increase energy production.

Coming back to similar question that I had earlier on FSM, are there some people where bringing thiamine in too early might then support mitochondria kind of working against the Cell Danger Response? Or do you generally find thiamine supplementation is well-tolerated if you do it slow, low, and methodically?

[01:49:47] DR. NATHAN: Generally, well-tolerated. But not for everyone. I've had a number of very sensitive patients who could not handle anything but the tiniest amount of thiamine to start and then could slowly build that up over time. Now one of the things where this becomes important is that we've learned that, in mold toxic patients, they are unable to absorb or utilize thiamine properly.

And I would add to the list of medications that you covered metformin, which is currently being taken by 4 million diabetics in this country, interferes with the body's ability to absorb and utilize thiamine correctly. I think thiamine is a very important piece of the puzzle. But we have to start slowly. For that, I typically start with simple thiamine hydrochloride, which is a very gentle, probably easiest way to take it in. Most of my patients can start by taking 100 milligrams once or twice a day. I've got a few where they could not take 50 or 25 and they had to just ease in.

When I then try to use a better absorbed form of thiamine, which theoretically would work better, like benfotiamine, or by TTFD, many of my patients who are sensitive couldn't do it. That was just too strong for them. Whether that's because of the way thiamine works with the Krebs cycle and our ability to make energy and ATP, I don't know. But I just clinically observed, like everything else, we have to be careful about it. And then, again, Dr Marrs has observed that, with a number of patients, you have to jack that dose up to 1000 milligrams or 1200 milligrams a day to get benefit of it. We see a huge range of spectrum of need.

[01:51:45] SCOTT: In that chapter, there is some discussion around Vitamin Diagnostics now having their erythrocyte transketolase testing to look for thiamine deficiency. Wondering if you've used that clinically. And is it a helpful tool for exploring thiamine deficiency?

[01:52:01] DR. NATHAN: I've not used it myself yet. It's not easy to get. You have to special order it from Health Diagnostics. And I've not had occasion to do that generally because for cost reasons. It's a somewhat expensive test. And for practical reasons, it's always been easier to assume that someone is thiamine deficient and give it to them. It's a very safe thing to give patients. It's a water-soluble vitamin. You can't get toxic by taking too much of it.

[01:52:31] SCOTT: Bob Miller talks about the genetics of sensitivity. He also covers the topic of RANTES and seeing very high levels in patients with long COVID, with chronic Lyme, mold, autism. Sustained high levels of RANTES can lead to things like atherosclerosis, liver disease. What are some of the tools that can reduce RANTES? And what do you generally attribute RANTES elevation to in your patients?

[01:52:59] DR. NATHAN: Well, I think the observation is a very profound one, which is we are learning that, in all of our inflamed patients, the testing for inflammation that we used to do isn't work at all. For example, doing sedimentation rates or doing CRP testing, highly sensitive CRP, which is a measure of inflammation that we've used in medicine for decades, it doesn't show up in our patients. It comes back normal.

Dr. Shoemaker pioneered the use of TGF Beta-1 and C4a as another way to measure inflammation, which showed to be positive in some of our mold patients. Great. But now we had a much more specific biomarker to tell us when they were inflamed.

Now, proving that you're inflamed is extremely important to a lot of our patients more than you might realize. Because a lot of our patients have been told this is in your head. You do not have a medical problem. This is in your head. And when you can look and go, "Well, if it's in my head, how come my biochemistry shows that I'm inflamed?" Well, now, we can measure RANTES. We can measure other new biochemical markers.

The Radiance Laboratory put together by Dr. Bruce Patterson, has given us a new tool to measure inflammation at a much more profound level and much more depth. And, ultimately, I think that tool will help us to help us make diagnoses as well.

For example, he's using his tool primarily to measure 14 different cytokines. And with that, he can tell that patients have long COVID and can distinguish that from patients who have Lyme disease who have a different cytokine panel. We don't yet have such a panel for mold. And I'm hoping that we can get that put together fairly soon. But being able to have a blood test that will tell us what category the inflammation is coming from will not only be reassuring to patients, which is, "I knew this was real. I know this is not in my head. I know that I'm sick." It's a very important consideration. But, also, begin the process of telling us, "Okay, where should we be looking for that inflammation?"

[01:55:19] SCOTT: You authored the chapter on hormonal dysfunction and sensitivity. Maybe a different lens than the chapter talks about. But since we're talking about sensitivity, my question to you is, is it possible that people become allergic or sensitive to their own hormones? Thus, making them less beneficial or even creating sensitivity. Meaning the body then isn't using the hormones that we have because it has a sensitivity type reaction to them. And maybe doing something in the realm of desensitization. Whether that's NAET, or BioSET, or Ellen Cutler's Method, or even Low-Dose Immunotherapy from Ty Vincent's work. Could that have some potential in helping us to better utilize the hormones that we do have?

[01:56:05] DR. NATHAN: They could. One of my earliest learning frustrations was a patient of mine early 90s who was a solid citizen, a teacher, hard worker. We measured her hormones, and they were so low that she needed to take estrogen and progesterone if she was going to get well. And she couldn't. No matter how low I made the dose, she couldn't do it. It made her sick. She was one of my first sensitive patients where I was realizing this is not psychological. But I did not know then what I know now, and I didn't have the tools to help her the way I needed to, which we always wish I knew then what I knew now. But that's unfortunately not possible. That was the first example I had of that. And I think there are several different issues.

One, there is allergy to your own hormones. I believe that does exist. And a number of practitioners have used neutralization potentiation as a way of literally desensitizing that. LDI could be used as a tool in that regard. NAET might be used in that same regard so that patients could be able to handle their own hormones better. Because they can become allergic to it.

Some of those same tools can help reduce the sensitization process so that you would be able to take bioidentical hormones in tiny doses and then increase. And my experience has been, when we cure the mold and we cure the Lyme, patients who couldn't do much of that before now are able to – they're just less sensitive. Now they can take better doses and be better helped by those doses.

The point I kind of want to make here is that mold and Lyme affect the pituitary's ability to make hormones. And so, almost all of our patients with these underlying conditions will have somewhere along the line adrenal thyroid and sex hormone issues. Looking for them early on and providing them with that will help balance their system and make them more able to deal with it.

Example, both progesterone and estrogen are necessary when patients are feeling anxious. Both of them have some anxiolytic properties to them and help them function better. For estrogen, for example, if they need it, it might help them sleep better. It might have decreased mood swings. Might have not only less hot flashes. It So that taking them will make them more functional and less reactive if they can. And that was I think the purpose of that chapter.

[01:58:55] SCOTT: You discussed the importance of emotional, energetic, and spiritual considerations for sensitive patients. How emotions are held tightly in our cells, in our muscles. That that can impact blood flow and lymphatic flow. You share some of the tools such as  Reichian Therapy and Voice Dialogue in the chapter. I want to talk a little bit about energetic cords and even external parasites. If you can talk a little bit about what those are? And how do we cleanse ourself of these potential negative external influences that are also potentially negatively impacting health?

[01:59:30] DR. NATHAN: This is probably deserving a whole book. And, in fact, I wrote one.

[01:59:36] SCOTT: Energetic Diagnosis.

[01:59:37] DR. NATHAN: Energetic Diagnosis. But, again, this is a super important topic. Because sometimes the blockage to healing is old emotional or spiritual wounds that patients have that have never been healed. And for some patients, they are motivated, they do everything we ask them to do and they're not going anywhere. They maybe even getting worse that their test results are not improving.

And then we begin to ask the question, "Is there something else that is preventing you from healing?" And when we have that conversation, the vast majority of people are already aware of something in their history that happened or multiple things that happened that they think maybe they worked on it. A lot of people will say, "Oh, I worked on that in therapy for 10 years." And the question is, "Well, was that enough? Or did you do it in the right way?" But many impediments to people's healing also involve current relationships and connections to people in their lives.

And you refer to something, which I call energy cords. There are literally chords of energy that connect us to everybody in our life. Some cords are trivial and small, like the person who takes my credit card at the checkout counter at the grocery store. I don't have a particular cord with that person. But with all of the people who are important in my life, my mother, my father, my brother, my wife, my in-laws, my colleagues.

Particularly people who have given us trouble in our lives, people who have not respected us or hurt us in different ways, we often still have residual energy cords connecting us to those people. Now one way you can tell that is, every time you bring that person's name up, you get red in the face and you start, "Ugh." That cord's still there. If you're still reacting, that may have been 10 years ago, the cord's still there.

And so, sometimes you need to literally pull the energy cords out, whether metaphorically or physically, to be disconnected to the people who have hurt you. Because they're still hurting you. And for many people, the difficulty in healing is present in that particular way.

A similar discussion would be about people who I call toxic, where when you are around them, either they're an energy vampire. Meaning they suck your energy out instantly. And then like you talk to them for five minutes and, "God, I just have to go home and take a nap. Where did my energy go?" Well, they took it.

But maybe even more important than people who are talking, people who either consciously or unconsciously are hurting you by their presence. Meaning that their energy just is not right for you. And you exit those experiences with having to talk to somebody about it. Like, "I don't understand. I was just with them for a few minutes. And now I got to spend three days talking about it." Those people are toxic to us.

And, unfortunately, for quite a few of our patients, some of their illness is in these toxic relationships. A spouse, a parent, a child, a friend, a relative who the constant presence of that person is so toxic that is preventing you from healing. And at some point, you may have to take a look at that relationship or do something about it if you're going to get well.

[02:03:22] SCOTT: You author a chapter on carbon monoxide as a sensitizing agent and the potential treatment with oxygen. Secondary porphyrias are discussed as another sensitizing factor. I've generally thought of these secondary porphyrias being triggered from the treatment of Chlamydia. You mentioned Bartonella in this chapter as well. And so, I'm wondering is that to suggest that Bartonella treatment itself can trigger porphyria? Or is that to suggest that the agents or antimicrobial materials that we might use to treat Bartonella may also be impacting Chlamydia? And that then is triggering secondary porphyria?

[02:04:03] DR. NATHAN: Well, I think the answer to the question is we use very similar antibiotics to treat Bartonella that we do for chlamydia. So that there's no surprise to me that there would be a crossover.

And when I was working with Lyme, although I did see it with chlamydia, I saw it more often with Bartonella because I treated that a whole lot more, that some of the patients, as I'm treating them, would have these severe reactions of intense overwhelming, anxiety, and panic, and nausea, and vomiting, which looked like a Herx.

Okay. You give this person antibiotic and they have this reaction. Now Herxes go away in two or three days. These did not. These would be lingering for a week, or two, or three. And so, what we learned is that a prolonged Herx may be actually a secondary porphyria, which needs to be treated differently. And, typically, if it's available, the use of intravenous glucose is the ideal way to treat it.

[02:05:12] SCOTT: Dr. Greg Nigh contributed a chapter on long-haul COVID and COVID vaccination as potential sensitizing factors as well. The spike protein can be both toxic and inflammatory. And how long it persists is still not known. It can potentially lead to microglia inflammation and the activation of the sympathetic nervous system. Wondering what you're seeing clinically in terms of the health of your patients before as compared to after having either COVID or COVID vaccination? And what tools have emerged for you as top interventions for addressing spikeopathies?

[02:05:49] DR. NATHAN: Earlier in our talk, we did talk about how profound COVID was at changing the consciousness of the whole world that we live in. The inflammation triggered by COVID is the same process involving some of the similar cytokines to mold and Lyme. It would not be a shock that COVID would do that. And, in fact, it has. There's been a huge increase in uptick in sensitive patients since COVID arrived both from the vaccine and actually getting COVID. Both are responsible for that.

A comment that I would like to make is that what some people are calling long-haul COVID is actually unmasking Lyme disease and mold toxicity. Meaning, you get COVID and then these symptoms emerge. And so, people go, "Oh, okay. That's long-haul COVID."

Now as we mentioned, you can do Bruce Patterson's test and find out is that really long-haul COVID or not. Because it's not. A large percentage of those folks have had unmasked, if you will. Meaning the inflammation that had triggered overwhelmed the immune system. No longer in containment. And now, mold and Lyme issues are surfacing.

And so, what we found is a lot of people who were diagnosed as having long-haul COVID actually have treatable mold or Lyme and got well when we did that. I just think that's an important point for us to cover.

The two specific treatments that I find helpful for getting rid of spike protein, if it's the instigator, is nattokinase. Taking one capsule three times a day. And Ivermectin, which is increasingly hard to get hold of. Those two things are known to help dissolve or get rid of spike protein.

[02:07:42] SCOTT: Coming near the end of the book, we have Dr. Ty Vincent talking about LDI or low-dose immunotherapy. That has been a tremendous help in my personal recovery journey. He says that tolerance is an active process. Not a passive one. He says that many illnesses believed to be infection are really immune dysfunction and hypersensitivity reactions. Very interesting chapter. And his work has been incredible for many.

There's a chapter from Dr. Andreas Grossgold on ketamine, which was very interesting in terms of its numerous properties. Being helpful for depression, anxiety, OCD, many conditions. Including helping to reset sensitivity. It may help with reducing pain and inflammation. Supports neuroplasticity. Can be helpful in those with POTS and seizures.

What was new to me is I didn't realize that ketamine had antimicrobial properties, including against Borrelia, some fungi, some parasites. Also knew that it may have some mast cell inhibition properties. What has your clinical experience been with ketamine?

[02:08:48] DR. NATHAN: I love ketamine. It's a game changer for some of our sickest patients. Now it's available in a bunch of different forms. You can take it as a nasal spray, orally, topically. But I find that it really works absolutely best if you get it intravenously in low dosage.

Especially for people who are having trouble getting rebooted, they're having trouble getting the response we need from doing their limbic retraining, their vagal retraining and mast cell activation. And I found quite a few of them, if they get a few treatments with low dose, 25 milligrams of IV ketamine, it reboots it. That, all of a sudden, they can tolerate this stuff and do much better. I found it to be, as Dr. Grossgold has, a major player probably underutilized in helping our patients get well faster.

[02:09:47] SCOTT: Finally, you beautifully wrap up the book with a chapter that puts all the pieces together from a more clinical lens. How to approach healing in the sensitive and chronic illness community. Now, to wrap up our discussion, the last question I have is the same for every guest, and that is what are some of the key things that you're doing on a daily basis to support your own health?

[02:10:08] DR. NATHAN: Well, I've answered this five times.

[02:10:12] SCOTT: That's true.

[02:10:14] DR. NATHAN: I suspect that my answer is going to be a little different this time but some of the same. First of all, what I believe is the underpinning of a life well lived is love. I have the unconditional love of my fabulous wife, Cheryl, and my two puppies, and the rest of my family. But I live in a house of love. To me, that is as good as it gets.

But to get a little better, I also moved, as you know Scott, to the southern coast of Oregon. A little town called Bandon. And I'm looking at – right in front of me is this beautiful wild park. And to my side here is the Pacific Ocean. I can see the waves crashing over here.

What my wife and I and the puppies do is we have this love seat in our second story which has an even better ocean view. And towards sunset, we just crowd in together and we just take it in. It's a form of both meditation and being part of the natural world.

We take a walk on the beach almost every day just to be a part of it. And then I have more named things. I do a fair amount of tai chi and Pilates. And I walk a couple of miles a day. And I eat organic. And la-la-la-la. But I think the most profound things that I do that really quiet my limbic system, my vagal system, is I take in this natural world that I live in, I take in the love of my family, and I just am grateful. And I don't think it gets any better than this.

[02:12:04] SCOTT: Sounds pretty amazing. I want to remind people to get your new book, The Sensitive Patient's Healing Guide. It is incredibly empowering. It is so rich with information. It will not disappoint. And then as a reminder for practitioners listening, check out Dr. Nathan and Dr. Crista's mentorship. You can learn more about that on his website at neilnathanmd.com.

I just want to thank Dr. Nathan for spending so much time with us today. For sharing your wisdom. For putting this incredible book together. I learned a ton. And I know others will really benefit from it also. But more importantly, I want to thank you for being the light in the world that you are. I am personally so honored and blessed that our paths have crossed in this lifetime. And I just appreciate you beyond words for all that you do. You are just incredible.

[02:13:00] DR. NATHAN: Thanks, Scott. And I appreciate you just as much. Thank you for all you do.


[02:13:05] SCOTT: To learn more about today's guest, visit NeilNathanMD.com. That's NeilNathanMD.com. NeilNathanMD.com.

Thanks so much for listening to today's episode. If you're enjoying this show, please leave a positive rating or review, as doing so will help the show reach a broader audience. To follow me on Facebook, Instagram, Twitter, or TikTok, you can find me there as BetterHealthGuy. If you'd like to support the show, please visit BetterHealthGuy.com/donate. To be added to my newsletter, visit BetterHealthGuy.com/newsletters. This and other episodes can be found on YouTube, Apple Podcasts, Spotify, Google Podcasts, and Amazon Music.

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