Episode #229: Supportive Oligonucleotide Therapy (SOT) with Dr. Clayton Bell, MD

Why You Should Listen

In this episode, you will learn about the role of Supportive Oligonucleotide Therapy, or SOT, in the treatment of Lyme disease and vector-borne infections.

Watch The Show

Listen To The Show

Find The Show

Support The Show

About My Guest

My guest for this episode is Dr. Clayton Bell.  Clayton Bell, MD is a leading integrative and functional medicine physician dedicated to helping patients achieve deep, lasting wellness.  Dr. Bell works with Lyme and vector-borne infections, integrative cancer support, environmental medicine including mold, mycotoxins, heavy metals, and detoxification; hormones, cardiometabolic and GI health, and mind-body balance.  Combining his Western medical training with functional, integrative, environmental, and Ayurvedic approaches, he focuses on uncovering the root causes of health concerns.  Patients benefit from personalized, whole-person treatment plans that empower the body’s natural healing ability and support sustainable wellness from the inside out.  Dr. Bell provides online consultations that offer accessible, holistic care tailored to each individual’s needs.

Key Takeaways

• What place does SOT have in the treatment arsenal for chronic Lyme disease?
• What is AOT or Antisense Oligonucleotide Therapy?
• What testing is acceptable for a practitioner to request an SOT for a patient?
• What testing is offered by Biocentaur?
• How does SOT work in the body?
• How does the practitioner determine which SOT to request when many infections may be positive?
• What SOTs are available for vector-borne infections and viruses?
• What are the foundational steps to prepare a patient for an SOT?
• Do certain therapies need to be stopped before testing and while doing SOT?
• How important is immune modulation or creating immune tolerance to the microbes?
• What is the SOT administration process?
• How are Herxheimer's mitigated with SOT?
• Can the SOT push back one infection and then lead to another becoming the dominant focus of the immune system and symptom presentation?
• How long should there be between SOTs?  Is there a maximum number of SOTs that can be done?
• Can SOT reach all potential reservoirs of infection in the body?
• What role do biofilms play in the context of SOT?
• Have any specific SOTs been helpful in the contents of EDS, PANS/PANDAS, or Long COVID?
• What role might SOT play in neurodegenerative conditions?
• Can SOT resolve autoimmunity, inflammation, or oxidative stress?
• When SOT does not appear to work, how does the practitioner troubleshoot potential reasons?
• What is the cost of SOT?

Connect With My Guest

MetaMedical.life
DrClaytonBell.com

Related Resources

RGCC North America
RGCC International 
RGCC Vector-Borne and Virus SOTs available
RGCC Provider Map

Interview Date

February 24, 2026

Transcript

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

[INTRODUCTION]

[0:00:01] 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.

[0:00:35] SCOTT: Hello, everyone, and welcome to episode 229 of the BetterHealthGuy Blogcasts series. Today's guest is Dr. Clayton Bell, and the topic of the show is Supportive Oligonucleotide Therapy or SOT. Dr. Clayton Bell is a leading integrative and functional medicine physician dedicated to helping patients achieve deep, lasting wellness.

Dr. Bell works with Lyme and vector-borne infections, integrative cancer support, environmental medicine, including mold, mycotoxins, heavy metals, and detoxification, hormones, cardiometabolic and GI health, and mind-body balance. Combining his western medical training with functional, integrative, environmental, and ayurvedic approaches, he focuses on uncovering the root causes of health concerns.

Patients benefit from personalized whole-person treatment plans that empower the body's natural healing ability and support sustainable wellness from the inside out. Dr. Bell provides online consultations that offer accessible, holistic care tailored to each individual's needs.

And now my interview with Dr. Clayton Bell.

[INTERVIEW]

[0:01:45] SCOTT: I am very excited today to have Dr. Clayton Bell on the podcast to talk with us about Supportive Oligonucleotide Therapy, also known as SOT, recently renamed to Q-REstrain. This is really a therapy for the last several years that I've kind of had questions about where it fits into the landscape of healing. And so, as I had the opportunity to dig a little deeper for this conversation, I became more excited to learn about this as another potentially valuable tool in our toolbox. Thanks so much for being here, Dr. Bell.

[0:02:15] DR. BELL: I'm so happy to be here. Yeah, thank you for having me.

[0:02:17] SCOTT: So, tell us a little bit about your personal journey. What drives your passion for the work you do today? Was it a personal health experience that led you to becoming a more complex chronic illness doctor, or that led you to making SOT a focus of your clinical work?

[0:02:34] DR. BELL: Yeah, that's a great question. So, kind of twofold for that. I think that the functional medicine landscape has always been more aligned with my philosophical and kind of medical value system, per se. So, I was always even in medical school looking for deeper root cause analysis and deeper forms of healing, whatever those may be.

And as far as getting into the SOT therapies or Q-REstrain, as you mentioned, they are now called by RGCC, really, for me, honestly, it was getting Lyme disease myself to be just totally honest about it. I had been highly functional. I was through medical school. I went through a fellowship integrated medicine at University of Kansas. I was working at an academic center, University of Tennessee Medical Center, and doing all the functional medicine consultations for the cancer institute as well. And so, I mean, I was performing at a very high level, but I had internal health things happening. I had a lot of adrenal hyperactivity dysfunction, a lot of excess cortisol, had extremely low testosterone, in the 100s, lower than most 80-year-old men that I test. I also had rather borderline osteoporosis by the time I was 30. And I was a pretty savvy, well-accomplished mountain biker. So, it's like it doesn't make sense. I'm so athletic, and I'm having these things.

And then I had hypothyroid. I had lost 40 pounds one year during – I guess it was my first year of residency, and I thought it was from stress and just not getting enough sleep. And I had gone vegetarian that year. So, I thought maybe I lost so much weight from that. Looking back, I was like, "Oh, wow." I got Lyme that year when I was in Maine. It made sense. And then it made sense why I had all the HPA axis and the adrenal dysfunction, the low testosterone, and nothing I could do could really help that no matter how much I meditated, or ate clean, or took care of myself. It's like there was still this internal challenge, stressor in my body, and I was just totally clueless that it was not only Borrelia burgdorferi Lyme. But when I ran the first Vibrant Tick Panel on myself, it lit up like a Christmas tree. I had like at least six different forms of Borrelia, and I had multiple forms of Bartonella and Babesia as well.

And so, when I actually started treating it, I did some antibiotics, I did some herbals, and then what really helped get me over the hump was the SOTs. And I remember I was somewhere, probably about 8 months into my therapy, and things just finally started to click. I remember I put on 10 pounds of muscle, and then I put on another 10 pounds. And my thyroid regulated. I wasn't cold all the time anymore. And my testosterone autoregulated without being on TRT or any hormone replacement therapy. And my stress levels went down, and I just felt more embodied and just healthier. And I didn't realize that I had been sick for a decade. It was so slow, and it was so continuous that I just thought that was normal.

And then when I started to get healthy, I was like, "Oh my god. Wow." I've been having a lot of brain fog. And I haven't had as much energy, and my mood has not been as good. And so, it was really getting healthier to that new plane of awareness, and consciousness, and just vitality. And then it was like, "Wow. I want to help other people, too." And what I realized is I'm over in western North Carolina in Asheville. But when I started testing people, now I'm not saying that every single person has an active flare or infection. But that being said, every single person I've ever tested, the exception of one or two people, and I've tested well over 300 people, they all have immune signatures of exposure to whether it's Lyme, Bartonella, Babesia, maybe Ehrlichia, Anaplasma, Rickettsia, and mold mycotoxins, which we'll get into too.

What I found is these things are just totally ubiquitous in our environment. We all carry some of them around, some much more than others, and some of us are more sick than others at different times. And so really for me it became a personal passion, because they say the best research is me-search. And so, I had to figure it out for myself. And then I figured out – we tested my wife, she has it. We tested my mom and dad, they have it. It's like, "Wow." My daughter's unfortunately – she had a bullseye rash pop-up last summer, which is pretty scary. She's only six. It's like everybody in my family's had it. And I have hundreds of patients that I'm actively taking care of that have it. I really just shifted my entire focus to really Lyme and then the mold by proxy because so many patients with Lyme have mold. And then I do personalized cancer testing and therapies as well. But, really, that's 90 plus% of my practice now.

[0:06:46] SCOTT: Definitely a pain to passion story and journey that you've had as well. As we mentioned, what we used to call SOT, and that's probably what I'm going to refer to it as in a lot of this conversation. They now call it Q-REstrain. That is the technology from RGCC in Cyprus, Greece. And much of their earlier work, they're really kind of known, I think, initially in the cancer realm. That's not going to be the focus of our conversation today. So, we're going to talk more about the newer tools in the realm of Lyme, and co-infections, and viruses, and things of that nature.

Talk to us a little about why you saw a need for SOT in your toolbox. Where it fits into the tools that you use for vector-borne illness patients? How long have you used SOT? About how many patients? And then talk a little bit about the clinical success. I've seen numbers put out there knowing myself, I've been in the Lyme, co-infection, mold realm now for more than two decades. When I hear really high success percentages, I kind of go, "Huh, wonder if that's marketing or reality." Give us some landscape there.

[0:07:45] DR. BELL: Yeah, I'd be happy to. Yeah, multiple great questions there. So, I'll just try to kind of answer it, break them down piece by piece. As far as how does it fit into my treatment modality, when someone comes in, the first thing is diagnosis, right? Because you need the proper diagnosis, so you know how to treat them. But let's say you get that, okay? And we're specifically talking about vector-borne illnesses here. So Lyme, Bart, Babesia, co-infections.

And so, let's say somebody has one of those, or usually, as you well know, it's usually several of those, right? It's very rarely ever just one. And so when people have those, and they present with that, then we really kind of break it down and we can stratify it based on essentially what condition they have, what their desires are, what's in alignment with their belief system, and then also what's in alignment with resources, right? I mean, because I hate to say that, but it's just the truth of it.

For instance, let's say someone comes in and they're adamantly opposed to antibiotics. They've had really bad experiences in the past with antibiotics. They always have a lot of GI dysfunction thereafter, or they've had a lot of allergies to various antibiotics, and they're just like, "That's a no for me." Fair. Okay. Because if I give them antibiotics for, let's say, Bartonella, I'm going to be putting them on Bactrim, or rifampin for a good three months, right? Same way with Babesia. They're going to be on a Malarone and Azithro for like a three-month period. And then with Lyme, if they just got it recently, that's awesome, and maybe we can give them a couple months of Doxy and knock it out with some herbs. But maybe they've had it for years, and that's really tough because you really need about three different types of antibiotics to cover all the different forms of Lyme, between the spirochete and then the cell-wall deficient form and the cyst form. And so that's tough because I don't really want to put people on three antibiotics for multiple months. I'd prefer to do other things. But antibiotics are obviously an option, and they can be super effective. And I found them to be really effective and life-rejuvenating for a lot of people.

Second realm, though, is like the herbals, right? So, you have everything from like the Buhner protocol. There's lots of other programs out there now. And they're typically going to be sent around a lot of the same herbs, right? Things like Cryptolepis, Japanese knotweed, Skullcap. And there's a host of other ones as well. And those can be great. And I use those pretty much across the board with every patient, whether we're doing SOTs or antibiotics, just because there's so much additional support adjunctively as well. Sometimes that's all patients will do because they don't want antibiotics and they can't afford the SOT, but I like to use them in combination with. I feel like it's a lot more effective to use the herbals in combination with the other treatments.

SOTs. If SOTs were free, I would give them to all my patients. There's no question about that. I mean, they're very, very safe from a safety standpoint. Really, the only thing you have to worry about is Herx reactions. Now, this is specifically for the vector-borne infections and viral infections, okay?

In cancer, it's a little different. So, I do cancer SOTs as well. And in cancer we have some really specific contraindications, if it's a larger tumor mass, 5 centimeters cumulatively or more. Or if it's in the brain, or the lungs, or the liver, I'm very cautious because the SOTs can kill the cancer, and it's why they do that. They can create some edema there. And so there can be kind of a mass effect. And you can get things like pulmonary edema or liver issues. We definitely don't want any expansion in the brain, right? There's no room to grow there. And you can get tumor lysis syndrome. Those patients that have really advanced cancers, it's not even on the table. It's not an option. It's clearly a contraindication from RGCC.

Back to the Lyme, though, and the viruses, they're very, very safe. What you might get though, what a lot of patients experience is a Herx reaction. Very similar to what they're going to get with antibiotics, or herbals for that matter, or sometimes biofilm busters. We give them biofilm busters, and they're exposed now to all the bacteria floating around. That's what you get.

With the SOT, it is very important. We'll get more into this later about how to mitigate the Herx reactions to maximize success as well. But from just a purely safety perspective, I mean, they're very safe. And relatively speaking, compared to what I've seen with herbals and antibiotics, they're very effective. Now, they're not 100% effective. They're not a panacea. I tell patients, they're not going to wipe out every spirochete, Borrelia in your body. Nothing's going to do that.

My philosophy is that once we get Borrelia burgdorferi, or Bartonella henselae, or Babesia duncani, what have you, we're always going to have those organisms in our body forever. And that's okay. The goal is not to eradicate all of them. That would be trying to eradicate every single speck of dust out of your home. You'll have to destroy the house in the process, right? That's not the goal. The goal is to knock down the pathogenic and the allostatic load that your immune system is stronger. It can just keep things at bay. And you have it, but it's basically like a weed in the garden, and there's flowers everywhere, and there's an occasional weed, and it's not a big deal. That's really as far as how I would use them. Like I said, if I could use them for every patient, I most certainly would.

There is a couple of nuances to that, and I think we'll probably touch on this later. People with really advanced neurodegenerative conditions I'm more cautious about just because I feel like their advanced disease process doesn't lend to much resiliency with increased potential die-off that might include some neuroinflammation while it's killing the pathogens. And I've actually seen some of the neurogenerative conditions temporarily get worse for a couple of months before they round back and level out. And that's kind of scary. I just don't get into people that are that advanced.

But by and large, 95% of your patients, I would totally give them SOTs for anything that's definitely an active infection. I mean, that's what just kind of context to. I use it personally. As an RGCC provider, I'm actually in a really blessed position to actually get the medicine from RGCC for myself and my immediate family members. And the company is extremely generous, and they just provide it for providers, which is amazing. Because I guess the idea is that, well, if you do it yourself and you have felt the benefit of it in your own body, you're more likely to advocate it for your patients too. It makes sense.

But I've personally done 12 SOTs. I've given my wife five. I actually have another SOT being made right now. I just came back positive for Borrelia mayonii. My wife just came back PCR positive for Borrelia mayonii and Borrelia afzelii. I've had afzelii. So, we're probably swapping it back and forth sexually as well.

Anyway, and then I've given SOT to my mom every six months for her cancer just to keep it from ever recurring because she's done with her allopathic cancer treatment. She has no evidence of the disease, but she still has 10,000 circulating tumor cells. And we test her CTCs and give her an SOT to help just kind of mop those up to prevent recurrence because we don't want to have to deal with all that again. I use them for myself. And I would like to use them for more patients. It's just really just a resource game, just to be totally honest about why everybody doesn't get them.

[0:14:16] SCOTT: Maybe touch on how many patients approximately you've used them with and what your success rate, your observations clinically have been.

[0:14:23] DR. BELL: That's a great question. I actually took a peek at this just the other day kind of in preparation, and I know I started Meta Medical in November of 2024. So, we're one, two, 16 months in. And at that point in time, I had had about 110 patients get SOTs in that, say, 16 months. And then I was previously at Forum Health in Asheville. And I was there for about four years. And I've been using SOTs for about four years collectively. I guess I was there maybe for three and a half years.

Anyway, in that period, I'd say we probably did at least another 200 there. I've probably done 300-plus SOTs. A combination. Probably, if I was just going to guess, I'd say maybe 100, 110, 120 for cancer, and then probably closer to 200. Maybe more, honestly. Mainly for Lyme, Bartonella, Babesia, but some for viral infections as well.

Success rates. If you look at the only – really, there's two papers published specifically on SOTs. There's a lot of papers on antisense technology. I mean, thousands of papers on that. There's a lot of papers on gene silencing therapies. There's multiple different – there's at least 10 different FDA-approved drugs that utilize gene silencing therapy, mechanisms of action. This is just the only clinical application that's used in pathogens or cancer.

But as far as specifically looking at Lyme and viral infections, there's one paper published. It's an internal paper. Obviously, you have to interpret it with that. As you well know, large studies cost millions and millions of dollars and are essentially only able to be done if pharmaceutical companies are paying for them because they're the only people that really have that much money unless you get a really specific NIH grant or what have you.

I'm not surprised there's not more. I know the lab's trying to collect data. Especially the owner, Dr. Ioannis, is really, really big on being data-driven. So, he's really trying to collect as much data as possible. There's a lot of confounding variables, as you very much know. So, it makes it harder to like – it's not just like a stage 2A breast cancer, intraductal carcinoma. You give this chemo, and you assess. There's so many variables with Lyme. How many co- infections? They do antibiotics, not antibiotics, herbals, not herbals. Are they in mold? They even know they have mold in their – there's a thousand variables, right?

Anyway, that being said, just if I was going to pull all that information, what's in my neurological system as far as like numbers that come up for me, I would say that we probably get somewhere between – I would say around an 85% clinically success rate. And that's not a 85% improvement in symptoms. That's not like an MSQ or like a Horowitz/MSIDS score of like a 100 dropping down to 15, but that's where 85 out of a 100 people. And some people get multiples, right? But sometimes it's a week or two. Most likely it's going to be within 2, 3 months.

But they're saying, "Hey, I noticed a significant difference with that SOT infusion." About 15% of the time, it's flat. And so why is it flat? Well, maybe we picked the wrong pathogen. Maybe the pathogen is an infection, but it's not having as many active symptoms in their body, right? There's something else going on. Maybe we didn't diagnose the mold, which we pretty much test all Lyme patients for now. That's a huge one, right? Why SOTs don't work. Usually, it's because they have mold, or MCAS, or CIRS, or something else, right?

I mean, with those, as you know too, if someone has Chronic Inflammatory Response Syndrome, or MCAS, it's possible you could even clean out the bacteria. But if there's not a software update and a resetting of their neurological and immune system, their symptoms might not actually improve even if the bacteria is not necessarily present. There's probably a component of that as well.

But I would say, have I ever had anyone get worse? I've had a few people with the really advanced Parkinson's disease and ALS get worse for a few months, and then they all rounded back to baseline. I've had a few people get better, but that deters me from giving in those populations. But for the vast majority, like I said, in the rare occasions, maybe 10% or 15%, it's flat. And then for, say, 80%, 85% of the people, there's a clinical benefit. Some is life-changing, like, "Oh my god. My pain in my shoulders went away. And I don't have headaches anymore. I don't have night sweats anymore. I can function again. I can work again," and those things.

And then sometimes it's more subtle in nature. And it really depends, too, on how many pathogens they have. What are all the therapies they're doing? Essentially, kind of how primed they are for success. And a lot of what we do is not just the SOT. The SOT is amazing. It's a great therapy, but you have to do all the other things to make it effective. That's like checking for the mold, detoxification, supporting all the other pathways like methylation. Are they deficient in vitamin D? Or do they have a history of trauma that's never been fully addressed? Do they have autoimmune conditions as well? There's a lot to it.

I think that's why you see the dramatic variance if you look on Facebook groups, or you look on social media threads, or people's blogs. That's why I feel like some people are very strong either advocates or detractors from the therapy. I think a lot of it is the nuances and the intangibles around the SOT. I feel like the SOT technology itself is sound, but there's a lot that goes into making it effective.

[0:19:30] SCOTT: I already love the way you think about these complex chronic illnesses, this patient community, the fact that you're very holistic in your way of thinking.

Let's just touch very briefly since we've mentioned or you mentioned AOT, or Antisense Oligonucleotide Therapy. Is that more the underlying technology, the framework? And then SOT is kind of how it was brought out to the patient population. What is AOT and antisense?

[0:19:55] DR. BELL: Yeah, that's exactly – that's a great, great question. Even for people that are watching, it's actually not even a bad idea, just literally to pull up. There's some even two-minute cartoon videos on the way transcription and translation works between DNA and RNA, and then creating proteins. And it's nice to get a visual of that. I know we're on a podcast, you can't see it, but I would encourage you to do that. And there's lots of images that you can see about that, too. And just make it simple. I mean, look for someone that's a scientist that created it so that everybody can understand it easily.

But for all intents and purposes, basically, the way these antisense technologies work is they work as a messenger RNA silencing therapies. A good metaphor is everybody's familiar with COVID vaccines, right? With mRNA vaccines for COVID. The way those worked was they would actually insert a messenger RNA, and it would create a spike protein. And then the spike protein was supposed to create an immunological response. I'm not going to get into all that. And that's a whole another podcast times 20. But people are familiar with that mechanism action.

The way SOTs work is the exact opposite. Instead of introducing an mRNA to create a protein, you introduce a silencing mRNA to block a protein from being produced. Instead of creating a spike protein in the body, you actually prevent the spike protein from ever being created. And that's actually the way they work. But instead of doing COVID, they're geared towards very specific genus and species orientation.

And by that, I mean, they're not – for instance, let's say you get a positive test from IGeneX, or Vibrant, or LabCorp request for Borrelia burgdorferi, okay? Whether it's ImmunoBlot, or Western blot, or PCR, what have you. You send your blood, you get your blood drawn, you send it to the lab in Greece, right? And then they're actually going to isolate the organism via PCR. So, Polymerase Chain Reaction.

And when they do that, they're actually using their PaldiSpot testing technology from their sister company, Biocentaur. And I know we'll come back to this later, Scott, but it seems practical right now to mention that. When they actually isolate that organism, they're not just going to be like, "Okay, great. You have a positive test result. Or we found DNA that matches Borrelia burgdorferi. So, here's the shelf. Let me get the Borrelia burgdorferi SOT off the shelf and send it to you." No, they're actually going to break it down and essentially sequence that genome.

And I was looking up today, and there's like 32 different plasmids that are genetic interchanges that basically Borrelia burgdorferi. My Lyme is not the same as your Lyme even if they're both Borrelia burgdorferi. And honestly, my Lyme today is not going to be the same as my Lyme in two years from now, or my wife's Lyme. It's all going to be changing based on its environment constantly with genetic expression. They're actually looking at it at the genetic level, at the DNA level, at the messenger RNA level to create essentially a nucleotide sequence, which you mentioned is really the essence and the backbone of the antisense technology.

With that, if everybody thinks about it, you have like a double-stranded double helix, two snakes cooling DNA, and then you basically have an RNA polymerase that comes in, it splits that. And then an RNA can attach to the DNA. And then basically RNA will replicate itself. And so, it'll look like a DNA but just be a couple base changes on there.

And then from that, that'll basically separate, and you have a messenger RNA. And the messenger RNA will attach the ribosomes. And that'll either be in the endoplasmic reticulum, or it'll be essentially like just floating around in the cytoplasm of the cell. And then what it'll do is it'll basically start to make amino acids. And the amino acids are going to be your building blocks. And those building blocks are going to make proteins. And proteins are actually going to create function in the body. Metabolism, reproduction, replication, so on and so forth.

Essentially, what the silencing mRNA is doing is going in there. It's trying to find that very specific sequence. Kind of like a glove on a hand or like a jigsaw puzzle piece of that mRNA sequence, and it's just going to attach to it. So, you can almost think about it. I use the reference like birth control. It's going to float around. It's going to attach to it. It's basically just going to make it inept or unable to basically reproduce itself or carry on its function. So, it's essentially going to degrade that messenger RNA strand.

Then when you do that, basically, it's almost like a knockout gene. You're knocking out function. And so it's very, very specific. And they actually test it. They actually test it like in silica to make sure. And then they'll test it, actually, in a dish too. It's not in the body, but it's – and then they'll send it back to you and put in the body, and they'll change it actually. They'll actually reconfigure it if it's not effective. They put a lot of time and energy on these, which is really, really interesting.

And they test for it themselves. And one reason they do that is they say that so many people don't know what they really have, if that makes sense. And then they'll think they have one thing. But then, when they test for it, the pathogen might be significantly more in a different species of the same genus, or what have you, differently. It's very specific. And that's kind of the way it works.

Another really easy way to think about it is like Pac-Man. It's just like going around, and it's not like gobbling. It's not like a phagocyte. But it's going to basically attach. And then when it does, it's going to stick to it. It's not going to attach anything else in the body because you're not going to have that, say, specific mRNA sequence. And so it'd be totally inert if you didn't have that specific pathogen and that specific sequence. And so, yeah, it's very specific. It's not going to damage your cells at all. It's really just targeted towards the pathogen of choice. It's kind of like a Pac-Man birth control and just a really overly simplistic terminology. But it's balancing mRNA is the way it works.

[0:25:10] SCOTT: So, birth control for bugs essentially.

[0:25:13] DR. BELL: Pretty much. Yeah, pretty much.

[0:25:15] SCOTT: Before one can do SOT, they have to get a positive test for the specific organism at the genus and species level that there is an SOT available for. So let's talk a little about what testing RGCC will accept. If we think about things like IGeneX, Vibrant, DNA Connections, ArminLabs, ILabs, TLabs, maybe even LabCorp, or Quest. Are there certain ones they will accept, won't accept? Does it have to be a serum-based test versus a urine test potentially? And then if RGCC has to then find that organism again using PCR to then create the SOT, sounds like their testing is pretty advanced. So why do we use any of this testing? Why aren't we just using their testing?

[0:26:01] DR. BELL: Those are great questions. So testing, what will they take? They'll take blood tests, blood serum tests. They won't take the urine test. They used to take like the urine test, like the DNA connections. They used to be able to take that, and you could look at the urine PCR. But they don't accept that anymore. I'm not privy to the exact reason why.

From a practitioner standpoint, if I was going to hypothesize, I could only presume that they were getting positive test results and then not finding it in the blood of the patient and they were having to basically do all that work and then refund the patient. Because if you have a positive test and you send it in and they can't find it, they send your money back. And so, they're out labor and technology expenses for that. So, that's my guess, but I don't know that. I do consulting for RGCC to basically educate other physicians and advanced practitioners, but I don't work for the company directly. So, I'm not privy to some of those decisions obviously.

But as far as blood test, yes, if you get a positive blood test within 6 months of the blood draw date, then yes, you're eligible to get a SOT. That can be as simple as a Quest or LabCorp Western blot. I've used those before when patients just literally could not afford to get, say, proper testing or better testing, right? But then also – so that counts, right? That's an antibody test.

You can use direct or indirect test. If you get a PCR positive, well, that's phenomenal. They shouldn't have any trouble finding that, right? But even if you get like an IgM positive test or an IgG positive test, now that can be an overall immunoblot or Western blot considered positive. But that can even be – let's say you get a Vibrant panel. And on Vibrant, everybody's going to have some bands positive, right?

Well, literally, even if you just get one IgG moderately positive band, you can send it in and request an SOT to be made from that, and they'll search for it and see if they can find it. Now obviously, let's say if your direct test, your FISH analysis on IGeneX for Barb or Babesia is positive, or if your PCR is positive, and if you have multiple IgM bands, or whether that's like IGeneX criteria or like CDC criteria, or even like multiple IgG bands, they're typically going to be able to find it. Literally, only had them not be able to find it two or three times. Then one of them was for me. And they just said, "Sorry, I see a positive result, but we can't find it. Here's your money back."

And so, to me that actually created additional trust in the company because it would be to their benefit to hand me something off the shelf because I would never know, and they don't. They're like, "No, we can't find it. We did the work on it. Here's your money. Refund your patient." And so I was like, "Okay, cool." That's good. I trust things when it's not to someone's advantage and they do what would be considered the right thing. That meant a lot to me just from like a trust perspective because this is very like kind of space age technology. You know what I mean? It's hard to wrap your brain around all the way it works.

And so, I wanted to – and that's the reason I went to the international conference the first time in Zurich, Switzerland was I wanted to meet the people. I wanted to meet the lead scientist myself personally and then really have that relationship where it's like, "I know that person. I see where their heart's at. I see their intentions." It's not like a financial gain. It's like they're totally invested in this as their life work. And so that was really important component for me if I was going to recommend these therapies to people because they're not inexpensive as you know. And so that's the testing aspect.

Now, a couple nuances to that too. When you order, you go into the RGCC portal under therapies, and then you would choose a specific genus and a specific species. It's not just Lyme disease, right? It's Borrelia burgdorferi, or Borrelia afzelii, or miyamotoi, or mayonii, or what have you. Californiensis, right? Same way with Bartonella. It's Bartonella henselae, or quintana, what have you. Same with Babesia duncani, or microti, what have you.

And so now there is a nuance to that. Let's say you get a – I run a lot of IGeneX testing for patients that can either afford it or if their Medicare, because Medicare covers IGeneX for free. So that is by far my favorite test for anyone 65 or older. I just order that TBD 6IBL panel from them, which normally costs about 2,700 bucks. But it's a phenomenal panel. It's the best thing I've ever seen by far.

And so anyway, if I get a Bartonella or Babesia FISH positive, oftentimes the immunoblot will be negative. Sometimes it'll be positive, or it'll be like Bartonella henselae indeterminate Bartonella FISH positive. So, if I get that, then I'm like, "Okay, great. It's probably the Bartonella henselae. And so let me order that one." But if it's just the Bart's positive on FISH and the ImmunoBlot is negative – and the same way, I actually kind of cross-order between labs now to help patients save some money and try to get the best of both worlds.

So, the patient comes in, they're our age, they're under 65, they're paying cash. I'll actually typically order a Vibrant Tick 1.0 Panel for them. And then I'll order the Bartonella FISH and Babesia panels if I feel like that is a higher risk for them. Because a lot of times, the Vibrant test, in my opinion, is great picking up antibody titers for all the different Borrelia species. But I feel like it misses or undersells sometimes the Bartonella and the Babesia.

And there's a lot of times where I have a Bart Babesia negative test on Vibrant, and I'll get a FISH positive on IGeneX. And then patients ask me, "Well, how does that happen?" Well, those are usually kind of – I don't say worst case scenario, but more severe cases. It's like body's ability to pick up the bug, the pathogen, is so suppressed, they're not even making antibody titers to it. So, it's basically just running amok in the system. And it's so prevalent that it's basically free floating around, and you can do a fluorescent in situ hybridization assay and catch it in the blood.

So, to me, that would be the worst infection, right? FISH positive, antibodies negative. And then I'm looking for things. Well, let me finish that thought. If you get a FISH positive but you don't know the speciation, you can actually order a Bartonella species or Babesia species to be done. And then they'll actually go in, and they'll PCR it, and they'll find it. They don't tell you which species it winds up being. But I mean, ultimately, it doesn't really matter. You're getting treated for it clinically. So that's an option. Yeah. I run that.

And then, as far as the Vibrant testing, I think, a lot of times that PCR is going to be negative. And I've run 200, 300 panels on Vibrant, and I've seen less than five PCRs positive. It's just a really low sensitivity. I always tell people, if it's positive, take it home, slam dunk, treat it. If it's negative, it means nothing. It's kind of like going to your PCP and getting an ELISA and a Western blot. If it's positive, great. You have Lyme. If it's negative, it's worthless. Doesn't mean anything. It's a really low sensitivity. That's kind of the way that I use those tests.

Now you mentioned too, why don't we just go straight to the RGCC testing or their sister company, Biocentaur? Great question. I think it's a nuanced answer. Number one is, once again, it can be expensive. If you order the PaldiSpot test, that's going to be over $1,000 in and of itself. And it's going to cover fewer pathogens than are going to be found on like a Vibrant panel, if that makes sense.

And then if you order the PrimeSpot test, which is by Biocentaur, which is going to be the viral infections, too, that combination testing is probably going to cost you at least 2500 bucks. So, it could be cost-inhibiting to people, especially if they were going to put that money towards the SOT.

Now I have some patients that I do order that, and that's what I order on myself. Actually, that's the test I just got back positive. Every six months or year, that's the test I get on myself because it's like if it shows up PCR positive, I know it needs to be treated. If I get a Vibrant panel and I get eight things back that have positive bands, I really have to be discerning about what's actually really relevant, and what's more like kind of static immunological memory. And so you just have to interpret it all.

And so, basically, what they will do, though is – another nuance to it is when they're doing testing on their PaldiSpot or PrimeSpot, doing a PCR analysis, they'll do this methodology, and they go by spin cycles. And so the fewer the spin cycles, the more positive you had it. So basically it means they had to spin it down. You can almost think about would you go exponential, like 10 to the 10 to the 10 to the 10, right? When they're spinning it down, if they find it at like 20 spins, that's a lot worse than if they find it at 25 spins, or 30 spins, or 35 spins.

And so, essentially, what'll happen is we'll go to 35 spins. And the kind of the idea is that if we don't find it at that, yeah, it's maybe there, but it's probably not clinically that relevant. So we're not going to go further. And so if you send it in, you might have a really low-grade Borrelia burgdorferi, or afzelii, or Babesia microti, or Bartonella henselae, what have you. And maybe it's like sub-threshold to their testing parameters.

So, it doesn't mean it's not there. It just means it's not enough. It's kind of back when I was a teenager, right? Thinking about like a THC urine test, right? You had to have a threshold of THC in your urine to be positive. And even if you smoke marijuana a day or two before, the test could still be negative if you dilute your urine out and so on so forth. So, it could still be there in the system, right? It doesn't mean you don't have it. It just means it's not enough to meet threshold.

So, if you're highly suspicious that, "I have Bartonella. I know I got Bartonella, I know I got Babesia. Or I have Lyme. Maybe I want to get a Vibrant test so I can get a band that's positive, or even an IGeneX potentially." But Vibrant, I feel like, is the most sensitive perhaps, not as specific, right? There might be more of an overshoot with Vibrant versus IGeneX, I feel like. And like I said, I use both those labs. I like the labs very much. Love the reps at both companies. They're great. It's apples and oranges, right? They both have strengths.

And so, with that, it's like if I feel really determined that I want to get this SOT for this patient and I'm kind of like looking, I'm fishing for antibody titers to make the SOT, then I would go with the Vibrant because I get a band positive. And when I send that positive test – and they'll spin it down to 40 cycles. And so even though it wouldn't meet their threshold on screening, they might find it if they spin harder, if that makes sense.

And so, it's kind of a game about what are the resources? What do you need? How aggressive do we want to be? How hard are we going to look for this? And get the SOT done. So, there's a lot of multi-tiered nuances to it, if that makes sense.

[0:35:59] SCOTT: My observation with Vibrant is very similar, that they tend to find a lot, that then you sometimes have to question which ones are clinically relevant. And that I generally see far fewer Bartonellas or Babesias than I do many other things. So, it's interesting that you've had that same observation.

If you do do a LabCorp or a Quest Western blot, I'm not sure if they have immunoblots now or not, but are we just assuming then that it's Borrelia burgdorferi and there's not the potential for some kind of mimicry or cross-reactivity between Borrelia organisms?

[0:36:32] DR. BELL: Yeah, I honestly don't ever order those tests. The only time I've ever ordered it is, honestly, when I had a patient whose Vibrant test was like past 6 months, and they basically just needed a band positive. So, it was like, "Hey, instead of spending 1500 bucks and get the Vibrant test, just spend 20 bucks at LabCorp. Go get your Western blot, get a positive band, and we'll send it in for your test results." That's really all. It's just not a good test. You know what I mean? And so it's just so low sensitivity, less than 50%.

And then I don't have confidence that it tests for any of the other. With Vibrant, at least we get 20-plus different species of Borrelia that we're testing for with the Western blot. I mean, my impression, I could be wrong. Someone might come and correct me, but I believe it's literally only for Borrelia burgdorferi. I don't think it's covering any of the bands.

When you're testing with IGeneX, you're getting multiple different species. Vibrant's a lot of different species. All these other labs, too. I'm speaking more about the IGeneX and Vibrant because those are the two tests that I use. But I do have patients that come in with ArminLabs and occasionally TLabs, and things like that. And I'm sure those are wonderful laboratories as well. I just haven't personally used them as much, so I can't provide as much clinical expertise on those.

[0:37:38] SCOTT: So, let's talk a little bit more then about Biocentaur. You talked about the PrimeSpot, which looks for viruses and Lyme-associated infections. There's 14 viruses, 16 cytokines and interleukins, and then one marker for Lyme. So that's not a deep Lyme and co-infection test. But then they do have their more detailed Lyme and co-infection testing, the PaldiSpot, which looks to me like it has 19 Borrelias, three Bartonellas, and two Babesias. So, I'm kind of curious that that's not really deep coverage for Bartonellas and Babesias. If that's the test they're using to confirm the presence of a specific genus and species from a test that looks for more Bartonellas and Babesias, how are they confirming that with the PaldiSpot? Or is what they're using internally something broader than what they use commercially?

[0:38:27] DR. BELL: That's a great question, Scott. I would actually just have to ask. I'd have to like refer that one over to Dr. Terry Bauman or someone else on the clinical support team regarding that. Yeah, that's a great question. I'm really not exactly sure with that. Because, yeah, I totally agree with you. I've ordered different pathogens that are not specifically on the PaldiSpot. And they're breaking it down. I'm not sure. I would have to just honestly ask that question explicitly.

[0:38:52] SCOTT: They don't even have Bartonella quintana on that test. So, I was like, "That's interesting." Yeah.

[0:38:56] DR. BELL: Yeah. That's a great question, actually. I would have to just defer that to the scientist and get back to you on that one.

[0:39:01] SCOTT: One of the limitations from my perspective with SOT is this genus and species combination. If you've got four different Bartonellas potentially, then you've got to do four different SOTs. You've got to get positive tests for all of those. We don't have the ability to do an SOT for all Bartonella. So, I'm wondering, is it possible in the future that this technology could evolve to the point that you can do a genus-level SOT, or that you could maybe do multiple organisms like Bartonella, and Borrelia, and Babesia? Is that a limitation of the technology, or is that that it might just be too much for the body to process?

[0:39:40] DR. BELL: Good questions. I think both. I think one is that it is extremely specific, right? I mean, you're talking about nucleotide sequences 10 to 15 base pairs long. So, you need to have basically combinations of nucleotide sequences or have multiple different nucleotide sequences from each genus, species, orientation, and then basically dehydrate it and then package it into a vial and reconstitute, which would essentially be two or three SOTs in one. And I would not do that. That would be contraindicated for me.

When they send us those little nucleotide sequences, they're somewhere in the multi-hundred-thousand range. Somewhere between 500,000 and a million sequences. And so if you had, say, 500,000 Borrelia burgdorferi, and Bartonella henselae, and, say, Babesia duncani, that load, I think, would be way too much on the system for the vast majority of people to handle.

RGCC used to say you have to spread them out by a week. But some people got pretty aggressive, and they were given like back-to-back-to-back several weeks in a row. And I think a few people had some adverse reactions, understandably so. Probably Herx on top of Herx on top of Herx. And so now they say, "Hey, spread them out at least three weeks."

In my clinical practice, if somebody gets multiple SOTs, I split them out by a month apart. If they're still in the woods as far as having any Herx reactions, we slow it down. You know what I mean? Okay, you're still having some Herxing? No problem. Let's wait two more weeks. We can wait another month. They're shelf-stable for 6 months. And so, it's no rush to get them in the body. Most of my patients are getting one, maybe two, maybe three at a time. If something comes up, there's a vacation, there's travel, what have you. It's like, "No problem. We can do it next week or next month." There's no rush on that.

[0:41:15] SCOTT: So, when you then send the sample to the lab, and you're requesting a specific target organism, how are you as the practitioner determining which organism to create the SOT for? If we think about Vibrant as an example, particularly if you – which I think most practitioners in the Lyme literate realm would consider IgGs relevant if there are symptoms to match. So, we might see 10 or 12 of those on a Tickborne2.0 panel. Would you prioritize IgM responses over IgG? Even though we know with vector-borne infections, IgM and IgG, doesn't really mean what it means with other infections.

As you mentioned, you've seen five positive PCRs with Vibrant. I've seen zero. You've probably seen many more than I have, but they don't seem to be very sensitive with their direct testing. But if you do have a direct test that you've done, maybe from another lab, would you then prioritize direct test positives over antibodies like IgM or IgG? And does the intensity of the response on an indirect test also matter?

If you're looking at Vibrant, then they kind of categorize yellows and reds and give you numerical quantification, does that come into your thought process about where to start and where to go next? How do you create that roadmap for the patient when someone might need several SOTs over a period of time?

[0:42:37] DR. BELL: I love that question. That's great. And the answer to your question essentially is like yes, yes, and yes. So, basically, if I get a direct test positive, that's going to be more preferential for me. So, let's say I get a FISH positive or a PCR positive. Well, that's going to kind of be usually like, "Okay, obviously, you need an SOT for this one." Right?

Because some people might have four or five things that are positive, and they can't get four or five SOTs. They have to pick one, or two, or three, right? And so, we have to pick. Okay, we're not going to treat everything, but we'll treat the ones that are most important. And so if I get a FISH or PCR positive, that would be number one. Number two would essentially be like the number of bands, and then the magnitude of the bands, and IgM, IGG. I just have to take all that into consideration.

If all things were equal, I would typically take IgM over IgG, even though so many people just have chronic IgG infections. But if everything was equal, I would take IgM over IGG. And then after that, if it was the same number of bands, I would look at amplitude, right? Let's say Borrelia afzelii on Vibrant has an IgG or an IgM of 25, and then Borrelia californiensis has an IgG or IgM of 13. Well, I'm going to choose the afzelli over the californiensis, right?

And then on the Vibrant test, sometimes with like Lyme, you have like a dozen-plus different bands. Of course, you're likely going to have three, or four, or five, or six, seven bands light up. Afzelii, I think you get three or four bands. And then some of them, like maritima and californiensis, you get one band. And so, if I have multiple different bands that are also positive that's also leading me towards choosing that pathogen, other things that will help me choose it is obviously symptom clusters. Kind of high-level step backup view. It's symptoms, right?

Even if I get a patient, comes in, they're like, "Hey, I had this tick bite, or what have you. And all of a sudden, out of nowhere, I started getting panic attacks and shortness of breath. And I just can't catch my breath every time I walk up the steps. I'm night sweats now." Well, I'm going to get a Babesia SOT, even if they barely have anything positive. Because it's obvious that that's Babesia as well.

So, if I get a really clear constellation like that, I would choose that one. But most of the time, it's smudgy. Sometimes it's clear, but most of the time it's like there's several infections going on and mold. And so it's hard to tease it all out with the history. Sometimes it is. But with those nuances, what I would do is let's say there's five different Borrelia that have positive bands, and there's two Barts and two Babesias have positive bands. And the patient's going to get three SOTs. Well, then what I'm going to do is I'm going to pick one from each genus. Because what happens – you mentioned earlier, you said, "Oh, well, do you have to do four, say, SOTs for Lyme or Bart?" And like, you really don't, honestly.

I mean, I very rarely will get two Bart SOTs at a time or two Babesia SOTs at a time. Sometimes Lyme. I've had a few patients recently who had a lot of Lyme infections, they were clear on the other ones. And they actually got three SOTs for the different Borrelia species. And, really, both of them had tremendous clinical responses. One gentleman had a complete Bell's palsy on the right side of his face, and it's pretty much essentially resolved now, which is amazing. We also did ceftriaxone for him for 30 days and doxy for two months. But we did the three SOTs too. And he's just doing great now. Love it.

But what I found is, let's say you have two Barts that pop up positive, if you treat the Bart that's what you think is most prevalent based on the lab testing, right? Then, typically, when you go back and look at the titers again or the FISH analysis, whatever, in six months, you'll see that both of them are improved. And I think what it is, it's really because you've reduced the immunological burden on the body, and then the immune system can start to attack the other ones.

Kind of like Lyme. If you have five Lyme, and if I go after Borrelia burgdorferi, and that's the biggest one, well, your immune system can start to really work on the other four. Or EBV. So, that's kind of the same thing. You definitely can do them for the viruses. And I have some patients that have had really good success doing things like HHV6, and EBV, what have you.

I do some for EBV. But honestly, I find that if I go out for the tick infections in the mold, typically the person's immune system can clear out the EBV. Whereas, if I'm doing SOTs, it's almost kind of like doing continual symptom management to keep – you know what I mean? But the EBV is just an opportunistic viral infection, and it's always going to be there. I need to work on the other things that are allowing it to continue in the body.

[0:46:41] SCOTT: I wonder too if you address one Bartonella with SOT, and you essentially now have these Bartonella dead body parts that are working their way out of the system. And there is some overlap between different species within the same genus. I wonder if that then wakes the immune system up to something that was a little more sequestered or hidden before. And so then it can start working on those, like you were saying, because the immune system is also going to be more able to respond at that point less burdened.

If we're thinking about someone with Borrelia, Bartonella, and Babesia historically in the smudgy Lyme realm, we've heard practitioners treating the organism that they think is the most significant and driving symptoms for that person. Commonly, Bartonella. I've seen other people that will start unlayering things with the organism that they think is not as significant, maybe Borrelia for a certain person. So, do you tend to go after the kingpin first? Do you like to start unlayering those microbes that might lead to less Herxheimer response when they're doing a therapeutic intervention? Maybe SOT? Bring some regulation, vitality back to the system, and then go after their bigger issues. Or is the order always the same when it comes to Borrelia, Bartonella, and Babesia if they have a confirmed positive for all of those?

[0:47:58] DR. BELL: Really good question. I mean, I've talked to different providers that do a combination of all of those. I know some people that have very specific Bart, Babesia, Lyme protocols. Myself personally, what I do is I typically go after the biggest infection first. Now, I try to prep the body on the front end. Checking for mold, making sure that we've got that down. Because I found that even if you give the SOTs, if people have a lot of mold, they just don't really get better like you want them to and like they want to. And so you more likely to need to repeat the SOTs or continue other therapies.

But a lot of the prep work that I'm thinking about, whether it's mitochondrial support, and detoxification support, and all those things, I want to get started even before they do the first SOT. And then I honestly go after the first one, and I tell people, "Hey, you might not know that you got this at all." And that's the way the cancer SOTs are. People are like, "Oh, I didn't know I got anything." It's like, "Nobody ever does, unless they have a really big cancer burden," relatively speaking.

But with the Lyme ones, you talk about, "Hey, you might not feel anything." And that's great. And if you don't feel anything, then it's probably going to be a month, two months, 3 months later, you're going to just be noticing you're doing things you weren't doing before, or you're going to be in less pain, or whatever your symptoms are going to be lower.

But, really, I tell people, "Hey, you might Herx on this." And I kind of prep them for that. And we've actually started using a lot of Herxheimer support by Allergy Research Group. It's got a couple different bicarb salts in there. Nothing like what Alka-Seltzer Gold used to have. But it's also got like a little curcumin and Boswellia.

It's a very common-sensical formula, but I've been shocked how clinically helpful it's been for patients, not only with SOTs. But when we're doing like Malarone, or tafenoquine, or other antibiotics. So, that's been really helpful for people. And then we also do – typically, I'll get people – especially if they're sensitive on things like liposomal glutathione, or a binder as well. If they're prone to histamine reactions or mast cell, then something like Quercetin or just like straight up Zyrtec. Another H1 blocker, things like that. Sometimes we have people like on Ketotifen, and Cromolyn, and some of the more advanced therapies. Yeah, those are kind of the big ones.

And then being on good anti-inflammatories. If people are prone to hsCRPs, or sed rates, or they have a lot of inflammation in their body and joint pain, just making sure they're like on a good dose of whether it's curcumin, or some of the resolvins, or omegas, or Boswellia. And there's a whole host of anti-inflammatory herbals.

But yeah, I honestly go after the big one first, and I'm like, "Hey, get a coffee enema kit on standby, and know how to use it." Because when I did my first SOT, I literally turned white as a ghost. Just like, "Hell, that day, actually." And my partner and my wife, she's like, "What's wrong with you?" And I was like, "What? I feel fine." But I literally had no color in my face. And I wasn't detoxifying very well. I had a lot of GI issues and some peristalsis issues, which I think could be related to all the tick infections, too. Anyway, I was literally constipated, and I wasn't getting out all the toxins. And so I started to get really toxic. And I felt really bad.

And then I started doing coffee enemas, and it literally kind of saved my life. And I was doing them at one point every other day or even every other day for a few weeks. And then at a certain point, I just kind of tapered it down. And now I'm not doing as needed. But I mean, I tell people, "If you start to have a major Herxing, or if you're getting just kind of toxy or toxic, that coffee enema is the cheapest, most effective thing that you can possibly do." It works immediately. It's really incredible.

[0:51:09] SCOTT: It's so funny how much overlap there is in our ways of thinking about this. So, Tuesdays, Thursdays, and Saturdays are coffee enema days for me. And anyone listening to this podcast knows that, literally, I think of them as lifesaving interventions, that they have been tremendous.

[0:51:24] DR. BELL: Beautiful.

[0:51:25] SCOTT: Less so as I've become healthier. But back in the day, when I had significant pain, they were really, really critical. I think that Herxheimer support product that you mentioned, if I'm not mistaken, I think that was created by Dr. Darin Ingels. And that is probably a nice replacement. Because we used to use Alka-Seltzer Gold, and it was a tremendous tool in this realm, but you can't get it anymore because they don't make it unless there's still some laying around somewhere. That's a good tip with that Herxheimer support product that you mentioned from allergy research.

You mentioned earlier that the gene sequence that's used to make the SOT to be that birth control for the bug is different for each person, even if it's the same genus and species, that that's very personalized. Does every species of a given genus have a different SOT target region? Or are there any scenarios where there's overlaps within the same genus? Meaning that maybe the target for one specific Bartonella henselae, for example, might also have an effect on another lesser common Bartonella at the same time.

[0:52:33] DR. BELL: That's a good question. And just to be totally transparent, I'm not exactly sure. I know we talked about earlier with some of the bacteria, like the Lyme, especially, it has a lot of plasma exchange that it can do. With things like Babesia, not so much. And apparently, Bartonella can just have horizontal plasmid sharing with other Bartonella, which is really interesting. They're literally sharing these genome structures back and forth. I guess it's possible, right? It's possible, but I just don't know that. I haven't done that bench research or been in a lab to be able to tell you that.

[0:53:05] SCOTT: And is it possible that a Borrelia, Bartonella, or Babesia have mutated somewhat within a person? I generally don't know that they mutate that much within a single person. But I think maybe over time. And many people, there are certainly mutations in these organisms. Is that where the fact that they're looking very specifically for that target site for that person would also be then addressing any potential mutations in that organism?

[0:53:33] DR. BELL: Correct. Correct. Yeah. And I think that's why it's more effective than if it was just like on the shelf stack of Lyme or Borrelia burgdorferi, because it's literally like that person-specific.

[0:53:42] SCOTT: In the Lyme co-infection and viral realm, talk to us a little about the SOTs that are available. I think I can put a link in the show notes that has the full list because I know it's pretty extensive. But are there any missing in the Borrelia, Bartonella, Babesia, or viral realm that you think are clinically relevant where you would be hoping for or advocating for new SOTs in the future?

[0:54:07] DR. BELL: I actually just pulled it up this morning, so I could look, and I was like, "How many are there for Borrelia?" And I think it's good. I know you put them in our show notes, too. But yeah, I would encourage people to take a peek at those. But I want to say I think there was like 18 or 19 for Borrelia. There's six for Bartonella, six for Babesia. And I know you can get them for Anaplasma, Ehrlichia, and Rickettsia as well. And then there's a host for the different virus infections like HSV 1 and 2, HHV6, EBV, CMV, Varicella Zoster, HIV, and then a host of other viral infections, too. I mean, in a perfect world, I'd love to see if they had one for COVID. That'd be amazing.

[0:54:48] SCOTT: That question is coming up.

[0:54:50] DR. BELL: Yeah. Okay. I don't know if there's just so much variance in COVID. And it mutates so much that you can't keep up with it. I'm not really sure.

[0:54:57] SCOTT: Or maybe it wasn't completely naturally occurring and thus has a unique way of replicating. Who knows?

[0:55:04] DR. BELL: I don't know. Yeah, it's just beyond me. It's really interesting. So, when COVID first came out, not to like derail too much, but I was at University of Tennessee Medical Center. And we were seeing some really serious cases. And I did some IFM trainings about COVID and those kind of things. And then at a certain point, probably within about a year, I couldn't make heads or tails. I'm looking at two peer-reviewed journals, and they're telling me two exact opposite things. And it was so polarized. I was like, "You know what? I got to focus on cancer and other things that there's at least like –" I don't know. I can't figure out what the truth is on this. I have no idea. You know what I mean?

Yeah, COVID is honestly just beyond me. It's a very complex issue. I know it's very politicized, but no doubt about it. A lot of people have suffered from whether it was COVID itself or vaccine injury. There's no question about that. Yeah, I wish they did have something for COVID. That'd be amazing. I know there was kind of more of a COVID preventative. Not a vaccine, but kind of a therapy that they had a few years ago. But I haven't really seen that. So, I'm not really sure if that kind of fell by the wayside or what have you.

Now I know that the scientists have been working on Toxoplasmosis for a while now, and it's just I guess not quite ready for prime time. It hasn't been released yet. But I've had a few patients that pop up positive on their Vibrant Tick 2.0 panels with Toxo. And it's not available. There are other Borrelia species. From my understanding, I think there's at least 50 brilliant species that cause either Lyme or tick-borne relapsing fever. And there's not 50 SOTs. Once again, I don't think you really need to do an SOT for every single infection you have. You could. But I mean, I think that would be a little over the top. I think you really just need to continue to target the big ones and help bring the immune system into balance as well.

[0:56:39] SCOTT: The other one that shows up almost always on Vibrant, and I don't know that they go down. Maybe they do go down to the species level. But Strep comes up in almost every Vibrant panel that I've seen, right? That would be an interesting one too if they could get into coming up with some strep SOTs, particularly for the kids with PANS and PANDAS.

[0:56:57] DR. BELL: I was just thinking that. When you said that, I was just thinking that.

[0:57:00] SCOTT: Oh, it's a question coming up.

[0:57:03] DR. BELL: Yeah. No. Perfect.

[0:57:06] SCOTT: And I will try to link to this list in the show notes as well, but I'm sure some people will be interested. We've had a lot of debate the last few years about Babesia odocoilei. Some labs, in fact, I think, IGeneX, has found it in ticks if I remember correctly, but has never found it in a human sample. TLabs, on the other hand, finds it regularly in people. So, it is interesting that there is a Babesia odocoilei SOT available. Yeah, I think it looks like they're definitely keeping up with the vector-borne infection realm.

Let's talk a little more about kind of the foundational steps you might take for a patient before they do their first SOT administration. You talked about some of these, but would you already start the process of detoxification and drainage? Are you generally doing lifestyle things like stress, nutrition, sleep, getting them exercising? Does that even matter in the context of SOT? And then kind of building on that, do they need to be out of their moldy home first and address their mold illness first before getting into infection SOTs? What are the steps to set the stage for success with SOT?

[0:58:15] DR. BELL: That's great. Yeah, you and I think very similarly, very much alike. So, answer your second question first. Yes, ideally. Ideally, I would always treat the mold or at least get it under control to a baseline before I would do the SOTs. And like I said, we pretty much test every single patient with tick-borne infections. We give them screening questionnaires, too, right? Like the MSIDS form. And then a mold questionnaire from Dr. Jill Crista. And so that gives us a better indicator, "Hey, this person's probably also dealing with this as well."

And there's a lot of overlap of symptoms, especially the strange neurological symptoms. Between Bartonella and mold, there's a lot of crossover there, so it's kind of hard to tease out. Yeah, if I can, for sure. I want to like get them under control with the mold first. They don't have to be totally eradicated because a lot of patients are colonized, and they might be on itraconazole 6 months, even after we have them on, say, liposomal glutathione, and calcium D-Glucarate, binder, herbal combinations, maybe prescription herbals, depending on the patient, so on so forth.

But yeah, what I try to do is get that load down, where they're like less symptomatic from the mold. And they're in a stable place, essentially. And then I think getting the SOTs on board. But completely concurrently with that, in all my – I do one-hour new patient consultations. And we are definitely talking about even on my – I literally have a treatment plan that breaks it down, like bullet-pointed, and I have it into different basically subgroups. And nutrition is the very first one. Then it's physical activity. Then it's stress resiliency. Then it's sleep. Then it's relationships. Then it's environment.

And environment, we talk about, "Hey, if you have mold, you need to get your house checked." And if your house is clean and you still have mold when I retest you in 4 months, then I'm going to treat you systemically. It's living inside your sinus cavities, or your GI tract." But that's a big thing.

And I've had patients who literally just had an evaluation on their house, sometimes their mediation's dramatic, and that's obviously very stressful financially. And then they might leave their house temporarily. So, a lot of times it's fairly simple fixes. And people's health has radically improved when they've been able to identify water leaks and mold in their home, and then either get out of that home environment or get it fixed.

Yeah, if you want this to be effective, you got to tackle the mold first. At least make sure screen for it, make sure people are addressing that. And then at the same time, too, if someone's in a constant state of fight or flight, they're just complex PTSD, still highly traumatized, that might not be the most appropriate time to introduce a medication that might induce Herxing that we can't stop. You know what I mean?

We might need to like help them find a safe place mentally, emotionally, spiritually, psychologically as well before they go into a really – because SOTs, I mean, they come in a little vial, but they are literally the most powerful therapy that I've ever experienced in my body, outside of, say, natural medicines, such as some of the more like kind in the psychedelic realm per se. But as far as – I'll say more like truly physiological therapies, SOT to me is the strongest medicine I've ever taken. And I try things that I give my patients too because I don't want to give someone something that I'm not willing to do myself.

[1:01:16] SCOTT: If we think about SOT working by blocking the replication of organisms, it seems then that we want them to be replicating. We don't want them to be threatened by an antibiotic or an antimicrobial herb. Talk to us a little bit about do you have people stop their antimicrobials before testing as part of the SOT process itself? Does stopping the antimicrobials then lead to a higher probability that RGCC can find the organism in the sample to then create the SOT?

And then once someone's had the SOT, should they stay off of antimicrobials for that entire four to six-month duration where the SOT is working? What are some of the things that should be stopped? And then just taking that concept further, if you are doing SOT and you then are doing antimicrobials that could also be affecting, and let's say killing organisms and leading to even more dead body parts in the system, is that potentially going to use up those Pac-Man on dead or dying organisms that can already not replicate and essentially waste your SOT?

[1:02:31] DR. BELL: Yes. All the same as the last. Yes, absolutely. And so that's one reason RGCC actually has pretty explicit protocol. Two weeks before the blood draw for the SOT, you want to be off all your pathogen-specific or viral-specific antivirals, antimicrobials, herbs, IV vitamin C, methylene blue, IV ozone, ozone insufflation. Anything like that, right? So you want to be off of those. And that's so they can find it with their PCR analysis. That's pretty straightforward.

And then also they want you to be off of all those same therapies for two weeks before the SOT and for at least one week after the SOT. To make it simple, though, I just tell people two weeks before and two weeks after the SOT. And that also gives them a little more leeway, so they can have some Herxing and get over it. Because if we blast them with methylene blue, or Cryptolepis, or doxy, or whatever else immediately after the SOT, too, it's like their body might just, "Aaah." It's like too much, too much stuff.

And so, yeah, I give people a two-week window on both sides of the SOT. And then two weeks before the blood draw. And then I start – if they're feeling well, right? Because also, Scott, you got to temper it with, "Okay, you have X, Y, and Z. And I want to get rid of X, Y, and Z." But also, what can a person handle? And I find that especially with people that have mold, because, yeah, they might have mold, and they might want to get rid of it. But yeah, you might be at a quarter dose of the binder, and you can't even tolerate glutathione. So, we might need to find something else that's more gentle on you.

If you pull out the mold too fast, people don't feel well. They get really sick. Same way with killing the bacteria or the protozoa. We have to titrate it based on where they're at. While at the same time, I want to try to be aggressive because I have a six-month window, per se. And so, I want to really try to beat it while it's down. So, I want to round back with herbals and methylene blue because that's an antibiotic. It has a lot of broad coverage. It does have coverage against Borrelia, Bartonella, Babesia, viral infections. Clears COVID spike protein, helps to regenerate their mitochondrial complex 4. You can photosynthesize it with red light therapies. That's like an antibiotic that I feel good about them being on for say six months.

So, a lot of times, I'll do the SOT or sequence SOTs. And then when they're like back to running again or feeling well enough, I'll get them with, say, the Cryptolepis, Japanese knotweed combo, maybe some other herbs, like a Phytocidal mix with Orthomolecular or some other – like Cryptolepis synergy or something. And then I'll also get the methylene blue on board, treat them for six months, and retest them after that.

[1:04:56] SCOTT: So, would you generally stop the antimicrobials for the specific target organism that you're working on? Or let's say you were working on SOT for Borrelia, Bartonella, and Babesia, but that person also has a history of chronic viral activation and is on acyclovir long term, do you need to stop those antivirals or other things as well?

[1:05:17] DR. BELL: No, you can let it roll. You just let the antivirals roll. Anything that is giving them overall immune support, like their vitamin D, or their vitamin C, or what have you, as long as it's not directly killing the Lyme. Low-dose naltrexone. I have a lot of patients on LDN. And it's probably a good thing. I should probably have them all on LDN for the most part, right? Just for immune regulation, and T-cell upregulation, so on, so forth. But they are totally cool to roll with LDN. They do not need to stop that before the blood draw, before or after the SOT.

If anything, it's kind of like them being on curcumin or the bicarb salts. We talked about with Alka-Seltzer Gold. It's probably it's going to make their experience a lot better, but it's not going to kill the pathogen. So, it's not going to cause any interference there. Like you said, if you kill that pathogen, then you basically just have a bunch of like DNA or mRNA fragments floating around. And it's kind of like shooting a laser through a muddy puddle. You're going to get a lot of refraction. You're not going to get the best benefit out of that. So, yes, I just wait on those.

And then as far as like biofilm busters, because that's a big topic, too. I typically don't do a biofilm buster immediately post SOT. And that's just to basically prevent an overload of pathogens in the system. I want to wait several weeks, maybe even a month or two. I want to get the other antimicrobials on board before we start to blow open the biofilms as well.

[1:06:30] SCOTT: So, let's build on the LDN conversation and talk about immune modulation or creating immune tolerance to the microbe that you're doing the SOT for, so that when the body then sees that dead microbe and has to clear it out of the system, that it doesn't overrespond, trigger mast cell activation, trigger more inflammation. Could we potentially use something like Low Dose Immunotherapy from Ty Vincent's work before the SOT to create more immune tolerance and discernment to keep the immune system from potentially then overreacting and amplifying those Herxheimer reactions? So, how do we minimize a negative response to the Lyme funerals that are happening throughout the body after SOT?

[1:07:15] DR. BELL: Yeah, that's a great question. I think LDI could be really great for that. I have a colleague, Dr. Andrew Petersen, who actually worked with me when I was at Forum Health. And he is also been a past president of ILADS. And he's done how many probably thousands of SOTs. But he uses a lot of LDI, and he's had a lot of good success with that. He would actually be a better person to ask how he dovetails it into the SOT therapies.

I'm not trained in LDI. Although, I did – interestingly enough, when I was in my medical school, I really wanted to go to Alaska, to Anchorage, to my family medicine residency. And when I was up there, I happened to hang out, meet, and be friends with Dr. Ty Vincent. I actually spent some time with one of his good friends who was one of the – I guess the people in the faculty at there. And I remember hanging out in a sauna with Ty one time, and I was –

[1:07:56] SCOTT: I was going to say, it was probably at the gym.

[1:07:58] DR. BELL: Yeah. We were at a ski resort. But he was just such a cool guy. Just so smart. It's funny because I think about him from time to time. I should really get trained in that therapy. But he was genius, and he's brilliant.

[1:08:08] SCOTT: He's incredible. My own Lyme recovery journey has been significantly better because of his Varicella-zoster LDI. It made a tremendous difference.

Let's talk then a little bit about the administration of the SOT. Is there anything the patient takes or does before the SOT is given to minimize potential reactions? Anything that's done to kind of keep that SOT in the bloodstream when you're administering it to maximize the effect? How long is the administration? Is it an IV drip? Is it a push? And then is this a relatively easy process for the patient to go through in terms of the delivery of the SOT into the body?

[1:08:48] DR. BELL: Very easy process. The whole process takes less an hour, and that's with running like a little – let's say, a 250cc bag after the SOT. Basically, the process, though, is we have somebody come in. And basically, it's like pop into the IV suite for an hour. We actually give them a gift certificate to go to the local breakfast place, Biscuit Head, next door. If they want to go grab some lunch with their family, they can do that. Make it a fun trip. So, I told people, "Hey, you're coming to Asheville, make it a fun trip. Spend the night. Bring your partner. Bring your kids. Go hiking. Go to Biltmore. Have fun here while you're here."

People don't ever feel bad after the SOT. If anything, honestly, they feel better because one of the premeds is dexamethasone. It's not a high dose. It's like four milligrams. But a lot of people that are chronically inflamed and adrenal fatigue syndrome, they get a little bump from that dexamethasone. They're the people that are like, "I felt so good after my SOT. The next day, I felt so great." And I'm like, "Yeah, that's the dexamethasone. That's not the SOT." But, hey, no worries. If you're feeling that good, that's awesome that you had that resonance point with it. That's one med.

The dexamethasone is essentially just to keep the vein tight. Because when you put the SOT in, you want to make sure it gets into systemic circulation and you don't lose anything. Nothing essentially that leaks out. And so that's what the dexamethasone for, really. It's not even to prevent any kind of allergic reaction or anything like that. It's really just keep the vein tight.

The other medicine is basically we do like an IV famotidine. It's essentially like Pepcid. And you can take Pepcid orally 6 hours before. Or we just give it to people IV right before. It's easy. They don't have to worry about it. And that just prevents any kind of like histamine reactions. I've never had anybody have anything. Literally, I had one lady get nauseous, I think, and this is out of like 300 SOTs. She got a little nauseous, and she got some crackers, and had some water, and she was fine.

Nobody ever has any reactions after the SOT. It's super simple. When my parents come in town, we all go to the IV suite and get our blood drawn to get SOTs together. And my daughter hangs out and colors. It's super laid-back, super chill. It's fun because my daughter's six, and my partner and I really want to introduce her to different forms of medicine. And so it's neat that she gets to see these things, and she's already familiar with, "Oh, you're getting SOT. You have Lyme? What is that? Do I have Lyme?" And I'm like, "Everybody has Lyme, honey. But that doesn't mean you're sick from it."

It's really interesting. And it's cool to show her that people can get better. Because, as you know, it's like you have a really personal story that's driven where you are right now, and so do I. But a lot of people are still in a really, we'll say, a dark place, and they're still in the middle of their disease process. And it's really hard sometimes to see the other side of that. And so it's one thing that I love that really just turns me on and lights me up is that I get to see people get better every day.

Now, not everybody's getting better every time, right? But it's like you're at least going to catch a couple people a day that have just had like life-changing recoveries. And that gives me a lot of encouragement to help provide hope to the other people that are still going through the process. Because for most people with significant Lyme, mold, it's a multi-month, maybe a several-year process, you know?

[1:11:42] SCOTT: Or decade.

[1:11:43] DR. BELL: Or decade. Yeah. I have people that show up several decades in.

[1:11:47] SCOTT: A family that SOTs together stays together, it sounds like.

[1:11:51] DR. BELL: I guess so. I never thought about that. That's pretty funny. Yeah.

[1:11:53] SCOTT: Let's talk a little more about these Herxheimer reactions after SOT. So maybe someone's having headaches, or fatigue, or flu-like feelings, kind of the normal Herxheimer reactions. Are you keeping people then on binders, on detox, on drainage, maybe things to alkalize the system while they're weeks and a few months after the SOT?

And then I'd like to hear a little bit about what portion of your patients have no negative reaction, no Herxheimer reaction, versus something mild, very tolerable, they're still functional, versus a more significant reaction where they need to kind of slow their life down, pull back, take a little bit more care of themselves. And how long does that last? Are there any people where their Herxheimer reactions after many months or SOT after many months led them or left them in a place that was worse than their original baseline?

And then one of the things building on that that kind of made me wonder was if someone was having a really strong Herxheimer reaction, and this SOT is still kind of there, it seems like RGCC could make something that could then be injected into the body to bind all of that remaining SOT to kind of render it inert. But it sounds like we don't have that currently.

[1:13:12] DR. BELL: Not that I'm aware of. I have not heard that. Yeah, that kind of a blocker, per se. Yeah, I think once it's in, it's in him. You want to be discerning on your patient population. There's some people that are just like super, super fragile. Let's say 80-lbs, 90-year-old woman. Yeah, I might not give it to her. You know what I mean? She might need it, she might do better, but I might just not take a chance. Because some people do get her reactions.

Now, how do we prevent that? The Herxheimer Support I found to be extremely beneficial. We already talked about like getting coffee enemas set up just in case things get intense. So, I really like people to get their kit set up, train. And when I'm teaching people about coffee enemas, I'm like, "Hey, don't just make it one at a time." That's a pain in the butt, no pun intended. You don't want to be hanging out over the stove top for 30 minutes, let it cool off. Make it and like – make five or six at a time. And then it's almost like a cold brew concentrate, right? Then you just dilute it and heat it up to body temperature when you want to actually use it. And so, just so it's stockpiled. If you feel bad enough, typically, to do a coffee. You just want to make it as easy as possible, you know what I mean, to do it. And then when you feel better, just do them for prophylaxis, whatever. That's a different story.

But anyway, Herxheimer Support is a great one. If you have any Alka-Seltzer Gold lying around, that's a great one. The coffee enema as backup. And then as far as things that people should probably all be on, either something like liposomal glutathione, which I found to be really helpful. Whether it's the antioxidant support and the detoxification support, what have you.

If price point's a big deal for people, you could put them on NAC. Although NAC is a pretty potent biofilm buster. And so that's probably not the best thing to be doing right at the time of SOT. I like glutathione. I also like a binder. Now, I don't have many patients on prescription binders. I honestly find that sometimes we have trouble with insurance. But practically speaking, it easily hurts people's stomachs. They get constipated. They don't like them.

I typically use some herbal combination. I use a lot of Quicksilver Ultra Binder, because I get that in a capsule form or a powder form. And there's a sensitive formulation too for people that are really sensitive. They can titrate the dosing really easy based on the powder. I use MycoPul sometimes, sometimes Z-Binder. There's a lot of other good ones out there. Your charcoals, your clays, your fulvic humic acids. Shilajit would actually be a really good one. Any of those those things are really beneficial.

If people have MCAS, then I think quercetin is really good. Get them on a good quercetin. I use a lot of Thorne, the Quercetin Phytosome two times a day. But whatever your favorite quercetin formulation is great. And that'll be a good mast cell stabilizer for people. And if you want to do something, Researched Nutritionals has HistaQuel, which is nice, because you have some histamine-blocking benefits. And then you have the mast cell. Because you got quercetin, you get black cumin, you get nettles, you get some other things in there.

Besides that, that's kind of the big ones. Anti-inflammatory herbs. Whatever your favorite combination of anti-inflammatories is. I use a lot curcumin, turmeric. But we use some resolvins. And people have great success with resolvins, like the SPM Actives and such. Some people like omega. Some people like Boswellia. It's really just kind of user preference with those.

People sometimes have to try different variations of herbs and even within the same class. They might really like Gaia, but they didn't like the other one as much. Or they might like Thorne, or they might like Pure Encapsulations. You got to try different ones. So those are kind of the main things that I do for people to keep them from having reactions.

And then who has reactions? I like to think about it, it's kind of like a third, a third, a third. A third of the people will feel better like pretty immediately. Not like within six hours, like post-dexamethasone immediately. But, I mean, within the next couple days, they're like, "Wow. I feel better. Oh my god. Wow." You're like, "Boom." And you're like, "Yes, thank you." It feels good, right? Because it's like slam dunk. They feel great. They're stoked about it. That happens I'd say 25% to 33% of the time.

About a third of the people, like I said, initially it's totally flat. And those are actually some of the harder patients because they're like, "I just spent you know X-amount of dollars you know on this SOT and I don't feel anything. Is it working in my body?" And that's one reason I tell providers. I coach SOT providers and everything, too, with RGCC. But I tell them make sure you're using some kind of like objective data to track their symptoms. Because I can't tell you how many people I've had that I see them two months later, three months later, and they're like, "I feel about the same. Can't really tell a difference."

And then I go back and I look at their medical symptom questionnaire. I look at their Horowitz MSIDS questionnaire, I'm like, "You're 34% better." You know what I mean? And they're like, "Oh, you know what? I forgot. I used to have that symptom. I used to have those headaches. I used to have that back pain. Oh, yeah. My stomach hasn't hurt in two weeks. I forgot about that." People just forget that they were sick because they're no longer hurting.

And so, I think it's really important you track their symptoms. And I'm kind of a stickler for that. Just on my EMR, it just automatically sends them those basically forms every two days for every single appointment because I want to make sure it's working.

And what's interesting, a lot of times, I got people, they get a SOT, let's say, for Borrelia burgdorferi, Bartonella, whatever, and we'll see 40%, 50%, 60%, 70%, whatever, drop in their scores. Well, at around that six-month mark, we'll see the score start to go up again sometimes, and it's interesting. I'm like, "What did you do different?" They're like, "I don't know. It just almost wore off." And we might give them a second dose, and it'll drop again, but lower this time. And so it's one and done. It's kind of like everything you do, detoxification, meditation, physical activity, draining support, SOTs, mold. You're all working together to bring the body into a new equilibrium and homeostasis.

And then about a third of the people feel worse temporarily. And that can last for a couple days, sometimes a week or two. I've had a few people recently had big reactions that lasted for almost a month, and they're better now. And they're like, "Oh, I feel a lot better. But that month was tough."

And I've only had a few people who got really severe that lasted for a couple months, but those were all like advanced neurogenerative condition patients. And they did all round back to baseline, but I didn't like that feeling of them having worse Parkinson symptoms for a couple of months. I just don't give them in advanced cases.

[1:19:03] SCOTT: So, one of the things in the Herxheimer realm with SOT that I heard was that one of the more significant ones can be Borrelia afzelii. Wondering if we know why that's the case. Could it be that the replication region for Borrelia afzelii overlaps with something else and we're really hitting several things beyond just Borrelia afzelii? Talk to us a little about that specific Borrelia and why you think some people may have strong Herxheimer reactions with Borrelia afzelii SOT.

[1:19:33] DR. BELL: Yeah, it's a good hypothesis. I'm not really sure, but I have noticed that clinically for sure. That's one of the nastier ones. It's a European strain. But I have people, they're like, "Well, I've never been to Europe." Or I have miyamotoi, but I've never been to Japan. So, it doesn't matter. It's all cross-contamination. People fly, you trade it around. It's everywhere. It doesn't matter. But anyway, yeah, it's kind of a nasty bug. It's hard to get rid of.

I have honestly found, if people have high titers, Borrelia afzelii, they do tend to Herx more with the SOTs. Borrelia afzelii. The first Borrelia afzelli I got, it hit me pretty hard. I locked up my GI tract. I couldn't eat for two or three days. Had a lot of gas and bloating. And then after that, my GI tract was better than it had been in years. Really weird. I guess I just had some belly infection in my intestines or GI tract, what have you. But I do see more Herxing with that one. Sometimes with the some of the Barts and the Babesia, sometimes with Borrelia burgdorferi. But afzelii is one of the more prominent ones I do see more Herxing with.

[1:20:29] SCOTT: Is there a concept of pushing back one infection and then another infection becoming the dominant issue? Wayne Anderson, Dr. Wayne Anderson, Dr. Eric Gordon, they talked about this years ago. If you're doing let's say something for Bartonella, like SOT, do you then see the symptom picture shift to maybe Babesia, where the immune system now is focused on the thing that you're not treating? Maybe there's also some real estate that you've cleared up in the body by addressing Bartonella, and now another infection moves in. We see that, I think, sometimes when we're dealing with fungal colonization from mold, and then suddenly there's a big yeast issue that kind of comes back in. Wondering if that applies to SOT, where maybe a flare after SOT is not related to the organism that you're targeting, but to something else then that's kind of become the more dominant infection or the focus of the immune system.

[1:21:20] DR. BELL: Yeah. And I feel like I've seen that clinically, and I'm familiar with that line of thinking, too. When I first started getting trained on SOTs, to do these, you had to get accredited by RGCC. You can't just do SOTs because you want to do them. You need to formally be trained and everything. But my teacher, who's a phenomenal naturopathic physician, Dr. Terry Bomb, she really echoed this to me, and she's like, "Hey, just be aware that these people have viral infections, too. You might treat Borrelia burgdorferi, and they might get a EVV flare afterwards, or something else that might pop up."

And so, I have seen that. I feel like when we're kind of like approaching the person from a whole system constellation, we're able to manage that with people. But I think it definitely happens to some degree for sure. And that's why, like I said, if we could do SOTs for everybody, it would be great. If you get at least a Bart, a Babesia, and a Borrelia, and then throw on the EBV, or if you have some other viral infections that are pertinent, that would be awesome just so we can kind of tamper the whole load down.

But for all intents and purposes, I'd say yes. And sometimes it's hard to tease out what's a Herx reaction to that specific pathogen. And then what's like a different kind of a flare, per se, from a different co-infection. And there's probably honestly overlap there. It's probably more of a blend than a binary, one or the other.

[1:22:39] SCOTT: I've heard it said that SOT can last four to six months. Some will say that maybe there are shorter duration in certain people. Do we know what factors lead SOT to work for a shorter or longer duration? Is it that scenario where other antimicrobials potentially lead to dead organisms that are then the SOT is then being used up essentially in that scenario? Is it related to maybe the quantitative amount of a given organism, where if they really have more, that the SOT is going to be used up faster? And are there scenarios where the body attempts to clear the SOT molecule as part of detoxification even if it hasn't been used to block the replication of an organism? Can the body make an antibody to the SOT molecule itself?

[1:23:31] DR. BELL: Those are good questions. I would say yes to the first two. And I think that's why RGCC says, "Hey, don't give antimicrobials for two weeks before and at least a week after the SOT," just because like we talked about earlier, you're going to blow apart the organism. There'll be free-floating DNA and messenger RNA, and you'll basically waste some of your SOT. It'll bind to that, and you can't use it for other active infections.

And then the second one, if you have a huge load, yes. I mean, it makes sense to me. At some point, you're going to reach saturation with your SOT even let's say you have half a million nucleotide gene silencing particles in there. If there's – I don't know. I'm just making up numbers. If there was like 2 million bugs versus 200,000, you're going to super saturate at some point as far as you'll run out. You're just going to run out of medicine basically. So, I think that could be a variable as well.

And then with the third one, I am not familiar with the body detoxifying these illegal nucleotide sequences. And that's a great question. I know I read a couple years ago as I was like getting into this, and I'm like, "What is this? Is this real? What is this stuff?" And I started looking at some of the basic science research on oligonucleotide therapy, or antisense therapy is what a lot of it was called previously, and these ASOs, these antisense oligonucleotide nucleotides. If someone wants to nerd out like I do, and I know you do sometimes, Scott, and you want to do a deep dive. If you want to look up research on SOT, you're not going to find much. You're going to find two articles. One with Lyme and viruses and one on cancer. But if you want to do like antisense oligonucleotide nucleotides, you're going to find a ton of articles on that.

And then RGCC, I believe, on their website, at least for providers. I know they even have reference pages with a lot of different articles. A lot of them have been published by them kind of bench to bedside research. But then there's thousands of other articles out there. Like I said, there's at least 10 FDA approved drugs using this technology. There's a couple different ways to keep that oligonucleotide nucleotide basically from getting metabolized in the body. And I read an article on it a couple years ago. It's out there.

Let's see. What method using to stabilize the nucleotides? It's called a phosphonotheonate is the type of modification that they're making. And there's another ASO modification as well. Like I said, there's research of papers if you just want to like totally nerd out on it. I understood the gist of it. But honestly, I'm a physician scientist, but I'm not like a bench side scientist. Some of the technology, honestly, was above my pay grade in that regard.

[1:25:53] SCOTT: Are there any places in the body where SOT just cannot access? So, can it pass the blood-brain barrier? Can it get to an organism in the skin? We think about maybe Bartonella or Borrelia. Can it get to organisms that are living within the inner tube of the gastrointestinal tract? What about areas that have lower blood perfusion? And thus, the SOT maybe isn't delivered there? Can it get to intracellular compartments where there's intracellular infections? Does it have any impact on persister cells? What about abscesses or localized infections, or maybe vector-borne infections in dental cavitations? And then you touched briefly on biofilms. Can SOT get to organisms that are sequestered in biofilms?

[1:26:41] DR. BELL: That is an awesome question, and I do not know the answer as far as how much it actually penetrates. I'm not sure if there have been any studies on that specifically with SOTs. I'd probably have to reference back to some more like antisense oligonucleotide nucleotides therapies. And look, I'm sure that information is out there.

I can say that, clinically, what I have seen, I hypothesize. Anywhere basically blood goes, those SOTs go. And I say that because, in my own body, I felt it like in my GI tract after I got that Borrelia afzelii. I told you. I've seen a lot of patients have neurological symptoms that either was a Herx temporarily or neuro symptoms significantly got better thereafter.

I don't know if that's because it knocked down the inflammatory cytokines that were crossing the blood-brain barrier and creating neuroinflammation, or if in fact it actually did cross the blood-brain barrier itself and started to clear out some of the – because if you look at McDonald's work, the pathologist out of Texas, when he was looking at patients with neurogenerative conditions, every single one of them had spirochetes in their brain, right?

And syphilis gets into the brain, tertiary syphilis. It's very common. And so I hypothesize it likely does penetrate there or potentially joint spaces. Biofilms, abscesses, I don't 100% know to be completely honest. I would be interested if someone has done research on that. It'd be great to see that. I don't really don't even know how you would test that. Maybe you'd have to just do it outside the body. But it's a good question.

[1:28:06] SCOTT: And what about biofilms? Where do you then find that there's benefit in bringing in the biofilm interventions to then maybe allow access for the SOT to get to the microbes that are sequestered within the biofilm?

[1:28:19] DR. BELL: If I was just going to give like a really broad simplistic answer to that, I would say I'd wait like a month after the SOT or until the person quit Herxing, if they were having a longer Herx, which is rare. Most people are going to Herx for like a week, three or four days, a week, two weeks. Very rare someone Herx for a month. But I would wait till they're over that Herx before I go to biofilm busters just because we're going to reintroduce or introduce for the first time in a long time a lot of those bacteria into the system. And then we're likely to see more inflammatory cytokines release, maybe histamine reactions, so on and so forth. But I would definitely not do it during the SOT. I would wait a good month thereafter.

[1:28:54] SCOTT: Building then on the biofilm conversation, many of us view hypercoagulation and the accumulation of fibrin as kind of the earlier part of a spectrum that eventually includes biofilms. We know that coagulopathies and clotting are certainly more common now in the era of COVID and spike protein. Is it important to assess the patient's coagulation status and to optimize their blood flow for nutrient delivery, oxygen delivery, waste removal, but also then as a way to optimize the delivery of the SOT within the body?

Could being on something like lumbrokinase or nattokinase for hypercoagulation before SOT set the stage for a better response given the greater access then of the SOT to the organisms that maybe otherwise were hidden in biofilms?

[1:29:44] DR. BELL: Yeah, I think that's a great idea. I might actually have to start using that, Scott. I really like the way you're thinking about that, like proactively on the frontend versus like retroactively on the backend to open things up. But you're setting the stage. So, I actually really like that philosophy.

I do use quite a bit of lumbrokinase. From my understanding, it's by far the strongest of the proteolytic enzymes. And so that'll help out with the fibrin clots and so forth as well. And the other thing is it'll bust open the biofilms, and it'll open any kind of microcapillary circulation issues, too. So that's all a big benefit for people.

Yeah, I think actually prepping with that. But I would stop it at least, like I said, that two-week window before potentially just to – I guess you could do it before the blood draw. It probably be good to do before the blood draw, just to release organisms that catch it. But yeah, I might slow down on it for a week or two before the actual SOT infusion just so there's not so much of an overwhelming amount of the bacteria in the system, per se.

And the one thing that I think about that's like we don't often check for and catch, but if I'm having people that are having hypoxia systemically, they're not getting good blood flow. And I think the people that jump out my mind are obstructive sleep apnea, undiagnosed. I can't tell you how many people. And their chronic fatigue. Sure, maybe they have adrenal dysfunction, or low B12, or thyroid, whatever. But it's like, "Oh, you're snoring. You're tired all the time." Then you do like a STOP-Bang questionnaire, and they're four or five questions positive on that. And you're like, "Oh, I think you have sleep apnea."

And people ask me sometimes, "Oh, should I be doing HBOT?" And I'm like, "Well, why don't you get your sleep apnea assessed first and get on a CPAP. And then HBOT could be like your icing on the cake." But you're not getting proper oxygenation. And as you know, Lyme, they thrive in a low-oxygen environment, too. That's another really key area that if you can get someone auctioning well, then their body will heal a lot better.

[1:31:30] SCOTT: The other one I wondered about is maybe doing Pulsed Electromagnetic Field, mat-type therapy, to also increase the microcirculation and help with the delivery of the SOT.

Kind of on a similar idea, Dr. Dietrich Klinghardt, who's been a mentor of mine for many years, he had a strategy of using hyaluronic acid before antimicrobials to get Borelia to come out of the tissues and into the blood where they were more accessible by the antimicrobial therapy. Wondering if using something like hyaluronic acid in the context of SOT to bring some of those organisms out of the tissues and into the bloodstream could also maximize the potential benefit of the SOT.

[1:32:08] DR. BELL: Yeah, it definitely could. I wasn't familiar with that mechanism action. But Dr. Klinghardt's obviously a mastermind in the field. So that makes total sense to me. That could definitely be a practical strategy to employ.

[1:32:20] SCOTT: Are there organisms that you've observed that are one-and-done with SOT versus others that maybe are more persistent, maybe related to the length of their replication cycle, where it's harder to get real progress with one SOT? Certain patterns where you needed to do multiple for a given genus species combination. And what's the maximum number of SOTs you've done for the same genus and species combination in a person?

[1:32:46] DR. BELL: So, let me give you two extreme examples, because it's a bell curve, and most people are in the middle. So, one end of the bell curve as far as like a one-and-done best case scenario. 8-year-old boy comes in, swollen knee, go see me, gets Lyme checked. Turns out he has Lyme disease, right? He comes back and sees me like a year later, he's in another flare. And so given SOT, and then no symptoms anymore. Totally asymptomatic. He's still got Lyme in the system, but we're just letting him rock out with like a Crypto Co-Max, which is basically Japanese knotweed and Cryptolepis. And he's just on maintenance for that, right? No symptoms. One-and-done. Hopefully, he'll never get a flare again. But we're just kind of keeping some good herbal support kind of on board for that. And that's one extreme.

The other extreme where like it hasn't worked. I've seen people that had like recurrent EBV flares or like EBV early antigens stay positive. And they got an EBV SOT. Didn't really make a huge difference. But at the time, we didn't know they were like working in a moldy building either.

And so, yeah, the SOT is trying to do its thing, but it's like, yeah, the immune system is still too suppressed. It's just not going to hold up. So that person would probably just continue to get EBV SOTs indefinitely, and it would probably never knock it down just because the underlying factor that was really predisposing that was never fully addressed. And that was a coworker in the past. I'm thinking we never fully checked all of her tick panel either. She wasn't my patient. She was a colleague. Anyway, those are kind of two extremes of ineffectuality and like super effective.

Now, most people are in the middle. My mom, for instance, she's had a really sticky Babesia microti, and has been PCR positive for a couple years now. And I've given her – she's going to get, I think, her second Babesia SOT coming up. But I've given her Arakoda. A 13-week run of that, pulse run of that. She just finished up Malarone. I've had her on different combinations of artemisinin and Cryptolepis. And she takes the artemisinin the Artemis Plus by Natural Health. It's really effective on her tubular tumor cells as well. And so, it's kind of a win-win. Artemisinin is killing the Babesia and it's knocking out the CTC's, which is great.

But last time I checked her was in December and she was still positive in her cells. And so I've been treating that really aggressively. It's still there. Antimicrobials, herbs, SOTs. I'm doing it all, and it's still there. But for all we know, she could have had it for 20 years, and that might have one of the reasons she got cancer because she was immunosuppressed from Babesia. We don't know. That's kind of a different one.

But for most people, it's going to be a spectrum. How many infections they have? How many co-infections? How severe is it? How long have they had it? Obviously, if they only have one infection and it's newly diagnosed, well then the SOT is going to be way more effective than we've had it for 30 years, and they have 10 infections, and you only treat one of them.

[1:35:26] SCOTT: I want to do some rapid fire through some conditions where SOT could potentially be helpful. So, have you seen patients that were dealing with hypermobility or Ehlers-Danlos syndrome that had a notable improvement in their hypermobility when doing SOT for Bartonella or maybe another organism?

[1:35:45] DR. BELL: Good question. Most of my people with EDS, or essentially like the hypermobility syndrome, they don't genetic package for EDS, they haven't done SOTs yet. And that's really more just from a like a resource perspective. That'd be cool if they did. But the people that I have seen do better with that are the people that you clear the mold up. I feel like they get the mold taken care of, and maybe they have less histamine. I've seen some research indicating that maybe like that histamine hyper responsiveness is leading to some of that laxity. I have seen it with that same way.

Now, what I have seen though is autoimmunity reverse back to negative. And so it's really common. I see people that come to me with, let's say, these autoimmune diseases, or even things – I've actually seen multiple sclerosis as well, or atypical multiple sclerosis, right? But then you diagnose them and they have like Lyme and mold, and they have ANA positive. 1 to 40 ratio, 1 to 80, 1 to 160, whatever. But they don't have like straight up lupus. They don't have like Sjögren’s syndrome or like Mixed Connective Tissue Disease. But their ANA is positive. Maybe no one's ever checked them. Or it's been positive for years.

What I have found with them is if you give them an SOT, or antibiotics, or herbals, whatever, and you treat that infection, and if you get the mold cleaned out of them, I have seen their ANA reverse back and people be able to get off a biologic drugs as well. But a lot of it was just kind of – I don't want to say misdiagnosis. But it was a symptom cluster, and they just got thrown on biologics. And then we tested what was likely causing it. And then we basically allowed the body to reverse itself, and then ANA goes back to negative, which is super cool.

[1:37:12] SCOTT: In the mold illness realm then, we talk about the potential for fungal colonization. You mentioned the sinuses and the gut. We know that where there's mold, there's usually also candida, yeast. They tend to kind of come together. So, is there a scenario where an SOT could be made to change the mold illness landscape and deal with fungal colonization and overgrowth of yeast?

[1:37:34] DR. BELL: Good question. I would say, indirectly, it's helping. It's kind of like if you lower the mold, it's automatically easier to treat the Lyme. If you lower the Lyme, which is also immunosuppressant, it's easier for the immune system to work on the mold, right? I think indirectly. But as far as directly, to my knowledge, there's no candida, there's no specific mold, or like mycotoxin SOT protocols out there. It would be those indirect benefits, not direct.

[1:37:59] SCOTT: So, when we're thinking about Lyme and co-infections, it seems that almost every person with Lyme also has Mycoplasma. And it seems like many people with Lyme and many people without Lyme also have Chlamydia. So, do we anticipate that RGCC may be working on additional bacterial SOTs for Mycoplasmas and Chlamydias?

[1:38:20] DR. BELL: Good question. The one that I've heard about is the Toxoplasma. I know that's been in the works for a while now. I imagine that they'll get that one finalized before they move on to other ones. I'm not sure what all is in the works. Yeah, they're always brewing something up over there. They're pretty innovative. So, the North American conference will be in November. And so, those are fun because you get together with all the different practitioners, and all the scientists, and everything. I'll actually ask him that in November so I can report back to you in the future on that.

[1:38:44] SCOTT: Awesome. So, we talked a little bit about PANS and PANDAS and the potential for strep. There is no SOT for that. I do see a lot of people though where Bartonella is the trigger for their PANS. And wondering, have you used SOT in any children with PANS? Is there an age limit for when you can use SOT in children?

[1:39:03] DR. BELL: Yeah. Actually, I was checking that this morning just to confirm I gave you the right age. But there's a contraindication, at least a strong recommendation not to use it in kids under five just according to the comprehensive guide for practitioners. So, under that. But I'll be honest with you, okay? That is potentially cautionary in nature. Same way with pregnancy. It's contraindicated in pregnancy. I mean, honestly, just biologically, hypothetically, if a woman's pregnant, she probably should get an SOT. I'm not saying I would not give it –

[1:39:32] SCOTT: Yeah, to stop congenital transmission to the child, right?

[1:39:35] DR. BELL: Yeah. Yeah. Exactly. Exactly. Yeah. If my wife got it, and she was pregnant, would I give it to her? Probably. I would think about it. I would like talk to the scientist and get more information. But I mean, theoretically, it makes sense. Same way, my daughter got Lyme. I guess it was about a year ago. And I actually tried to get her blood draw to get her an SOT because I know she has Borrelia burgdorferi in her body. I saw the bullseye rash. I gave her I gave her doxy. I gave her a moxi. Her symptoms got better. Thank God. She's not sick at all. But I know she's got it in her body.

But I tried to get her blood draw, she has little bitty arms, little bitty veins, couldn't get the draw. I didn't want to traumatize her. So, it's like maybe this year, I'll try to get it again. But I would treat her with an SOT even if she's totally asymptomatic. Because a lot of times with SOTs, I'm counseling a lot of people that are 50s, 60-years-old. And I'm like, "Hey, you're asymptomatic with Lyme right now. You think you came in for something else. You just have brain fog and fatigue. And then I ran an IGeneX test on you, then I found you have Lyme, Bart, Babesia, whatever." Yes, I want to clean that infection out.

And for my parents, too. I told them this two nights ago. I want to make sure you don't get Alzheimer's. I want to make sure you don't get a neurogenerative condition. So it's like why don't we just do SOTs every six months or year for you and then keep you from getting something that we can't reverse? Because once you get it, I don't know how to help you fix it and reverse it. But I can help you not ever get that.

And so, for me, when my daughter gets – when I get the blood drawn or get the SOT, and she get the abusing, I'll just give her one for the rest of her life. Same way for me. I've got lots of Lyme, Bart, Babesia. I've got bit about thousands of ticks. I've spent countless days in the woods. And I'm not going to stop doing that, but I'm going to take care of myself, too, so that I don't ever get sick.

[1:41:12] SCOTT: So, I want to touch then a little bit on the viruses. So, viruses, they don't really replicate on their own. They need our cellular machinery to multiply or replicate. So they're using our own cells to replicate. Some viruses are embedding themselves into our own DNA. So what happens to the cell or to the DNA when the virus that's within it has its replication region blocked by the SOT? Does the cell survive? Is that embedded virus then removed from the cell, or does the cell then have to die and be cleaned up through autophagy?

[1:41:46] DR. BELL: That's a great question, Scott. You should be a scientist, I feel like, for the lab. I don't honestly know that. If I was just going to venture a hypothesis, I would imagine, if you silence the gene and it can't undergo its either metabolic process, replication process, and it dies, I would assume maybe it would be similar to if you're immune clearance via other methods that the body's already utilizing. I doubt if there's a unique specific method for that one. It's probably more perhaps like an autophagy, or phagocytosis, or what have you. But I don't know that. I've never been privy to that information or seen that testing.

[1:42:20] SCOTT: So, in the era of long COVID, we know there is not yet an SOT for SARS-Cov-2. But we also know that long COVID in many people is an unmasking of their Epstein-Barr, of their Bartonella, of their mycoplasma. And things are no longer contained by the immune system. So, have you seen people with long COVID, where dealing with some of the organisms that were unmasked and then using SOT has helped resolve or improve their long COVID?

[1:42:51] DR. BELL: Indirectly, yes. Because we can't treat, right? But a lot of times, the things that I'm giving them for like their tick infections per se, whether it's like the LDN or the methylene blue, that's also giving them benefit for their long COVID, too. And if they happen to have long COVID, but we happen to also catch a Bartonella infection or a Lyme infection, we treat that. Of course, their long COVID is likely going to get better as well. I have seen like that indirect benefit in those patients even though I'm not specifically targeting that, the COVID, per se.

[1:43:21] SCOTT: You talked earlier about the resolution that you've seen of some people's autoimmune conditions by dealing with the microbe. Have you also seen shifts in people's either inflammatory markers or their mast cell activation? If you're looking at, let's say, labs for inflammation or even oxidative stress, what are some of the other things that you've seen improve that maybe you didn't necessarily expect?

[1:43:45] DR. BELL: Yeah. So, massive improvements in inflammatory markers. Even during my initial workup, I'll get a hsCRP on everybody across the board. It's very common that a lot of my patients have elevated numbers there. But yeah, when we treat the microbes, that tends to drop dramatically. They just have less inflammation in their body, less inflammatory cytokines floating around causing problems.

Other ones that I've seen, you I've seen the ANA flip back to negative, which is great. Another one that I wasn't really familiar with. I never thought about it and it kind of just made the connection when I was testing people was ferritin levels. So, it's extremely common for folks with these tick-borne infections as well as like the mold to have really low ferritin levels. And that's interesting.

And I was kind of looking that up yesterday. The Borrelia doesn't so much like use iron as a fuel source. It uses manganese, which is really unique in the bacterial population. But Bartonella does. And then with Babesia, it lives in red blood cells. So it can hemolyze red blood cells as well.

But I'll see low ferritin especially in my old patients. When I'm seeing people with ferritins of 15, or sometimes even single digits, or 20s, I'm like, "Oh, you got mold. Yeah, I'm going to check you for mold. I know you got mold." And they always do essentially. And so what I have seen, too, is, yeah, I can give them – I don't give like iron, per se, if someone has a tick-borne infection. But I'll use lactoferrin. Lactoferrin can actually sequester the iron actually be beneficial as well and a lot of other immunological benefits. I can give them lactoferrin, and it helps some. It gets it up a little bit. But really, when we clean the mold out of the system, that's when I've seen the biggest benefit, and some of the tick infections. But that ferritin level shoots up quite a bit.

[1:45:18] SCOTT: What have you seen clinically in terms of patterns with SOTs helping move the needle in patients? Is it more the Bartonella SOT, or maybe Borrelia, or something else? Is it really individual based on the person? So, what are your top desert island SOTs? What are the ones that you really see making a difference?

[1:45:39] DR. BELL: Yeah, great question. So, I would say it totally is individual orientation there. I have a lady the other day I saw, and she got a Babesia. I can't remember if it was done duncani or microti. I have to go back and look. Anyway, she got it back in the fall, and she's just like night and day different. And I have other people that have had that responsive Bartonella and different ones with Lyme. It really depends on a person. I take whatever their biggest infection is, that's the one that's going to be the most effective for them, really.

If I was on a desert island and I could only take one SOT with me forever, I'd say Borrelia burgdorferi. Because for me and for a lot of patients, it is kind of the kingpin. Yeah, even if you just treat that one, everything else tends to get better. I've literally done Vibrant panels where I only gave them one SOT for Lyme, and then all the Babesia scores dropped, all the Bartonella scores dropped, too. But it makes sense. It's like we opened up their immune system.

Now, one caveat to that. I have actually seen people that were so immunosuppressed. They only had very small elevations in their scores on the bands, low-moderate on the Vibrant. And I gave them an SOT or two. And then the next time I tested them six months later, their score shot up dramatically. And that's also a good thing because their immune system is actually able to pick it up now.

[1:46:51] SCOTT: One of the things that I've heard Dr. Andrew Petersen talk about was his surprise at how some of the viral SOTs impacted systemic symptoms. We think of HSV1, let's say, as just being lesions on the lips or cold sores. But we also know that it's been correlated to Alzheimer's. What have you observed in terms of the benefit of some of the viral SOTs? And have you seen the effects be more systemic than you might have suspected?

[1:47:18] DR. BELL: I would actually defer more to Dr. Andrew Petersen. He's done a lot more of the viral ones than I have. I would say that 95% of the SOTs that I've done either been tick-borne or cancer, and less than 5% have been viral. Honestly, I don't have the same breadth of patient experience with viral ones that somebody like Dr. Petersen has.

[1:47:37] SCOTT: How long after doing an SOT would you retest to see if that infection has been addressed? And if you're retesting, would you use the same lab you used initially, or would it be better to use a direct test to look for the presence of that organism to see if in fact it has resolved?

[1:47:52] DR. BELL: Typically, I'll wait 6 months after the last SOT. If I'm getting a series of three SOTs today, end of March, end of April, then I would wait till October to get the blood test. I typically will use the same blood test just so I get apples to apples. That being said, there's nuances to that. Let's say someone turns 65, and I can get a free IGeneX test for Medicare, versus they had to pay cash for Vibrant. Well, then obviously I think the IGeneX testing is superior and it's free, so I'm going to transition to that. But for all intents and purposes, I'm going to use the same test they did last time. Unless, let's say, that they did maybe like a full IGeneX panel, they had to pay out of pocket for it. The Bartonella FISH came back positive, everything else was negative. Well, then I might subscale and be like, "Okay, we're just going to get a Bartonella panel for you." If you're totally asymptomatic. Right? Because you just have to got to meet people where they're at.

[1:48:43] SCOTT: Let's touch a little more on contraindications. So, you mentioned pregnancy. I think breastfeeding is also a contraindication. Recent blood transfusion. And you mentioned the age in children as well. Are there any other contraindications or even incompatibilities? I've seen people in some of the SOT groups say, "Oh my goodness, I took a steroid injection for something, and I had done an SOT, and I didn't think. And maybe that's going to cause a problem for the SOT." Or if someone's on IVIG. To me, it seems like it's somewhat independent of the immune system. But are there other therapies that would be then not ideal to be doing besides antimicrobials if we're thinking about SOT compatibility?

[1:49:24] DR. BELL: Yeah, great question. One thing that you might have mentioned this, but it's like blood transfusions. They really want you to wait like 120 days from blood transfusions as well. And then the other contraindications are things that I kind of talked about that are more on the cancer side, like size of the tumor mass, location of the tumor. If it's in the brain, you don't do it. Or lungs and liver.

But as far as contraindications go, they're barely not too many of them. It's the pregnancy or breastfeeding, it's the recent blood transfusion, the age for the kid. Advanced neurodegenerative conditions for me is a relative contraindication as well. If I feel like a patient is just too tenuous, just their health is just so fragile anyway, that might be a relative contraindication.

Another one would be if a patient – this is more of a social issue, but if a patient is like just totally isolated and has a lot – because I'm all telemedicine. I see people in seven different states, from Texas, to Colorado, to Florida, to North Carolina, Tennessee, South Carolina, Georgia. Anyway, if I have a patient who's living kind of on an island, they have no social support. They have trouble utilizing technology to communicate, like the patient portal, email. Most people can talk on the phone. But I might not give them an SOT. Because if they get in a bad place, and they can't reach out to me, and they can't come see me, you know what I mean? It's maybe not the best fit. Maybe we should just try something else that's a little less, I don't know, aggressive or effective, you know what I mean? But it's going to be like they can handle it if they have trouble at all, like a Herx. That's social. But that's really about it. It's pretty clean, pretty easy therapy.

[1:51:01] SCOTT: I think we've touched on this somewhat. But in patients that do multiple SOTs and are non-responders, how do you troubleshoot those SOT non-responders? What are the things or patterns that you see that are maybe preventing SOT from being a needle mover for that patient?

[1:51:19] DR. BELL: What did we miss? What did I miss? I kind of own my responsibility of things. Did I check you for mold? Did I do the proper testing? Did I try to save you money and not do the right testing? And I am guilty of that. I lived in Haiti for two years. I'm still transitioning from that scarcity mentality to one of abundance. And I have a lot of people that I'm probably overly paternalistic about them not using all their financial resources on testing and therapies.

I probably hurt my patients more by not having them do like, "Yeah, spend the $2,000 to get the right test from IGeneX. It's going to save you a lot of money in the long run. Your return on investment is phenomenal." And then what'll happen is maybe I'll get the Vibrant instead because it's only, say, 550 or six, but I missed the infection that's causing the problems. And I'm like that's that's on me, right? Because I'm projecting, you know what I mean? What they should – and so I'm missing something. Or there's something we're not aware of. There's mold in the house, so on and so forth.

Or the other big piece, though, that even if you give them all the right therapies, are people that are just like – and we all have traumas, like little T traumas and big T traumas. But the people that are like in a perpetual state of sympathetic charge and overdrive. Sometimes no matter what I give those people, they're just in a place that they're not in a place conducive to healing. And so it probably doesn't matter what I give them or what I don't give them. There needs to be some type of deep internal shift on a consciousness, soul, esoteric level for them to be able to move into a place of healing. And I've been there myself. I've been depressed before. I get it. But yeah, that's a thing. That's a real thing. It holds people back.

[1:52:58] SCOTT: Yeah, for sure. One more question before my wrap-up question, and that is where in the world is SOT available? Is it United States only? What about other countries? Does it require FDA approval? And then what is the general cost people can expect to pay for SOT therapy?

[1:53:16] DR. BELL: It's available throughout the United States. You just have to find an RGCC provider. There is like an RGCC provider map that you can look at, and then you can pick, "I want SOT, or I want cancer testing," what have you. And then you can look in your area. It should be available in all 50 states. I'm sure there's providers in Alaska. And so that's a good reference for people.

It is available in most European countries. Last year, there was some political issues that happened with like some of the European Union and some of the countries. I can't remember if it was Poland or which country it was. Then they did temporarily withhold SOT. And so the patients had to go to different countries to get them done. And I don't know if that's been fully resolved or not. I'm not sure. I think that was more of a political issue than a safety issue. But like I said, I'm not privy to everything that happens in European sanctions and politics and such.

And then as far as is it FDA approved? And the answer to that is no. It is covered by the European Medicines Union. And it's basically considered advanced biological molecular product there. And so it's individualized. So, it cannot and will never be FDA approved. It's not like losartan, simvastatin, or propranolol. It's not like you have a condition, you take this med. It's personalized to you. It just can't be.

It really falls more in with like autologous products, like stem cell, or PRP as well. With that, it's plus-minus. It bypasses the FDA entirely. It's not regulable, if that makes sense. But it is overseen. And RGCC is like GMP, CLIA certified, all the credentialing, all the safety checks.

And I can tell you what we do and I can give you kind of a range. The least expensive that I have seen is about $2,000 per SOT. The more expensive that I've seen is somewhere around 3500 per SOT. There's a wide range based on different models and what people's overheads are. We don't have brick and mortar. I do all telemedicine in seven states. And I have some advanced practitioners work with me. And then I basically have a nurse that I work with and essentially kind of pay her to do the infusions.

We have a really streamlined setup. I don't have near the overhead that most patients do. So when I tell you our price, I don't want you to think that anyone else is overcharging you. It's just that we have less overhead so we can give a lot better deal to patients. But we charge $2,200. And that's probably underselling it, honestly, just because it's a lot of work on our end logistically. It takes a lot of time to prep patients, and educate them, and everything else, too. We're definitely kind of on the lower end of the spectrum as far as price goes. But I think you should expect it to cost – I'd say 2,500 would be a fair – and if it's 3,000 in your area, that's not necessarily wrong. It might just be the overhead cost of the provider and the clinic that you're seeing.

[1:55:58] SCOTT: And that's not including testing. And then I'm assuming there are some appointments with you that are not part of that cost as well. Correct?

[1:56:05] DR. BELL: Right. Yeah. The appointments with me are independent of that. And then during the appointment, we choose whether SOT is appropriate for you or not. And then testing is not included. That's independent. You have to have the testing positive to send in. But for us, that would include like blood draw, and then infusion, and then paying RGCC obviously to get the SOT made.

[1:56:23] SCOTT: My last question is the same for every guest, and that is what are some of the key things you do on a daily basis besides coffee enemas in support of your own health?

[1:56:31] DR. BELL: Yeah, I think the biggest things for me are exercise and nature, because I'm so cerebral. I'm a Gemini. I'm like in the medicine all the time. Always thinking. I'm always doing very complex problem solving for like hours a day with patients. And so for me, it's just like turning my phone off and going on my mountain bike and getting in the woods, getting in the forest. So, I try to do that at least once a week. I try to work out every day. That keeps depression at bay for me. If I don't move my body, I get pretty sick mentally. Moving my body a lot is really helpful for me to just move that energy and keep it out of getting stuck in my cerebral cortex.

And then I think also just the thing that I'd encourage everybody to do, providers especially, that we don't do enough of is just self-care. And I'm not good at it either. It's a constant practice my partner and I are always working on. And then when you have kids, it's even harder sometimes because you always feel you're responsible for everybody else. And that's one of the problems I see my patients, too, and fellow providers is they're taking care everybody else and not themselves. So why would their body heal, you know?

[1:57:29] SCOTT: I want to thank you for your time, your generosity, your knowledge, sharing all of your wisdom with us. I definitely love your approach. And you have a very clear passion for helping your patients. It's really helpful to know that there are practitioners like you out there to help those of us that have dealt with Lyme and co-infections, and those that are still dealing with it. So very impressed by the conversation that we had with you. I hope more people will reach out and just want to honor you for all that you're doing. So, thank you, Dr. Bell.

[1:57:56] DR. BELL: Yeah, thank you so much, Scott. It was an honor being here. And if anyone wants to reach out and find us, we're at www.metamedical.life, and we'd love to help serve you. So, enjoy. And thank you, Scott. It was obvious that you have a passion for this, too. And I love that we have similar life stories. So, thank you for what you're doing.

[1:58:13] SCOTT: To learn more about today's guest, visit MetaMedical.life. That's MetaMedical.life. MetaMedical.life.

Thanks so much for listening to today's episode. If you're enjoying the podcast, please leave a positive rating or review, as doing so will help the show reach a broader audience. To support the show, visit BetterHealthGuy.com/donate. To get my newsletter, visit BetterHealthGuy.com/newsletters.

To follow me on Facebook, Instagram, X, or TikTok, you can find me there as BetterHealthGuy. This and other episodes can be found on Apple Podcasts, Spotify, Amazon Music, YouTube, and Odysee.

[1:58:56] ANNOUNCER: Thanks for listening to this BetterHealthGuy Blogcast with Scott, your BetterHealthGuy. To check out additional shows and learn more about Scott's personal journey to better health, please visit BetterHealthGuy.com.

[END]

Disclaimer

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.