ILADS 2012 - Boston Conference Takeaways

This blog entry summarizes some of the notes I took at the ILADS conference in Boston in November 2012. As there were many concurrent sessions, the below does not reflect the overall nature of the ILADS event, but rather the specific interest in topics that most resonated with me. Thus, this may be a more integrative or alternative view of the event that others may have experienced. Nonetheless, it was a superb weekend with many great practitioners and healers to learn from. It was my 7th ILADS conference. The full event is available for purchase as videos or DVDs at the ILADS site at http://www.ilads.org.

Additionally, some of the event was replayed after the conference and I took notes on a couple of those lectures which can be found here.

Disclaimer:Nothing in this text is intended to serve as medical advice. All medical decisions should be made only with the guidance of your own personal medical authority.

Disclaimer: This information was taken as notes during the conference and may not represent the exact statements of the speakers. Errors and/or omissions may be present.

The highlight for me was seeing Alan MacDonald back in action after having been away for a couple of years. He is a true hero in my mind, and I appreciate all that he has done for us and for everyone struggling with Lyme disease.

• There were over 675 registrants for this event. It was so hopeful to see how big this event is becoming and to see that people are starting to listen and understand that this is a real disease.
• ILADS is working on a revised set of guidelines as an update to their 2006 recommendations.

Andrea Gaito made the following points in her discussion on Lyme Arthritis and autoimmunity:

• Lyme arthritis is present in 60% of patients with untreated Lyme.
• Spirochetes make the joints more permeable which promotes inflammatory cytokines.
• Persistence of infection stimulates inflammation and autoimmune responses.
• Synovitis, or inflammation of the synovial membrane, is a hallmark of Lyme disease and Rheumatoid Arthritis.
• A SED rate over 50-80 is important to evaluate further.
• Anti-dsDNA is a test specific for Lupus.
• Anti-CCP antibody is an indicator for Rheumatoid Arthritis and is rarely positive in Lyme. It is rarely elevated with infections except tuberculosis.
• SSA and SSB antibodies are an indicator for Sjogren's syndrome.
• IL-6 plays a role in inflammation.
• Statins are involved in muscle weakness.
• Lipoproteins on the spirochetes promote inflammation. TNF-alpha, IL-6, and IL-10.
• Treatment may include NSAIDs and Plaquenil.
• Biologics that may be used include TNF-alpha inhibitors, IL-6 inhibitors.
• Methotrexate may be used. Imuran may be used.
• Enbrel is least likely to suppress the immune system.

Ken Bock made the following comments on transfer factors:

• Spoke about Transfer Factor – Immunology and Clinical Applications.
• They can be very useful immune modulators.
• Immunology is like a pyramid. At the base is the skin and mucous membranes which serve as barriers.
• The innate immune system consists of the phagocytes. They are non-specific and include macrophages, NK cells, and granulocytes.
• Antibodies are created by lymphocytes which may be B cells or T cells.
• The gastrointestinal system is the key to the immune system. We need to maintain the health of the GI system.
• There are "tight junctions" which prevent toxins and larger immunogenic molecules from crossing the gastrointestinal wall and into the bloodstream.
• When these tight junctions become loose, intestinal hyperpermeability results; commonly referred to as Leaky Gut Syndrome.
• The GALT (gut-associated lymphoid tissue) is immune tissue and differentiates friend from foe.
• The surface area of the gut is about the size of a tennis court.
• 75% of the immune cells of the body are in the GI tract.
• We need immune tolerance to things we eat and need to react appropriately to pathogenic microbes.
• Macrophages come from monocytes and act as phagocytes in the innate immune system.
• Dendritic cells orchestrate innate and adaptive immunity. They induce protective immunity to infections. Have to be smart and differentiate what is what and send messages to other immune cells.
• Dendritic cells stimulate Th1 or Th17.
• NK cells play a major role in innate immunity. Cytotoxic granular lymphocytes, non-specific NK cells, cruise around looking for virally infected cells, cancer cells, etc. and attack and release perforin and granzyme to cause the target cells to die.
• More learned, specific immunity – lymphocytes – B and T cells. B cells can create antibodies. Humoral immunity. T cells are specific – more learned – more regulatory.
• Cellular immunity – T and B cells. Humoral immunity - antibodies.
• Key is balance and modulation; not boosting. Autoimmunity is not good.
• Hyperactive is just as bad as underactive. Allergies and autoimmunity result.
• Th0 become Th1 (cell mediated immunity) and Th2 (humoral or antibody immunity).
• Cytokines are peptides secreted by a variety of cells. They are messenger molecules. Regulate both initiation and maintenance of the immune response through a complex network. They are information-carrying cells.
• The neurological and immune systems are the most complex in body.
• IFN-y is associated with TH1. IL-4 associated with Th2.
• TReg cells regulate the balance of Th1 and Th2. Allergic responses result from too much Th2.
• Anti-inflammatory and regulatory IL-10.
• Th17 - secretes IL17 which is involved in inflammation. It causes and sustains tissue damage.
• Th17 is involved in regulating inflammation. Important in Lyme disease. Will get more appreciation over time.
• Inflammation is generally thought of as a negative. Some inflammation is good. It is a response to infection.
• Chronic inflammation is another beast. It can result in tissue destruction.
• Glia and neurons – immune cells in nervous system – can be neuroprotective or neuroreparative. If infection is prolonged or overwhelming, neuroinflammation and neurodegeneration can result.
• Overwhelming or prolonged toxicity lead to chronic inflammation.
• Transfer factors are small molecules.
• They are messenger peptides, oligoribonucleotide peptides, contains more than 200 molecules (1000-20000 daltons).
• They are not immunogenic. They are not species-specific. They are below the level of antigenicity.
• Produced by activated T lymphocytes as part of cellular immunity.
• There could be a contraindication for transfer factors if someone has a serious anaphylactic response to dairy.
• Derived from leukocytes originally then bovine colostrum then egg yolks.
• Doctor took products of lymphocytes from a person with cellular immunity to TB and the person developed a positive skin test (cellular immunity).
• Have not gained the acceptance they should have today.
• Chicken pox takes time for the body to learn immune response. If you could give them the recognition and tell immune system what to do to address Varicella and may allow primary response to become a secondary response. Inducer and suppressor properties.
• Can see a Herxheimer if stimulating immune system. Rare case of allergy.
• Transfer factors promote Th1 cytokines resulting in an antiviral/anti-cancer profile.
• Clinical benefit seen with virus, fungi, parasites, mycobacterium, cancer, autoimmune disease/allergy.
• Transfer factor may reconstitute immune function.
• Cell-mediated immunity enhancement may be needed in those with herpes viruses even if they have antibodies and antibodies may then go down.
• Pediatric experience with transfer factors – 74% reduction in illness and 84% reduction in antibiotic use.
• Transfer factors work orally. The response is dose dependent.
• Editor note: I have used the Transfer Factors from Researched Nutritionals. Specifically, I feel that I benefited from the LymPlus and PlasMyc formulations and was on them for many months at various steps of my recovery.

William Padula spoke on eye issues in people with complex health conditions:

• Visual processing issues are often an issue with the brain; not the eye. It is how the brain processes the visual input.
• The eyes are relatively unaffected by Lyme but processing centers in the brain are impacted.
• Lyme causes visual processing problems.
• Binocular difficulties lead to sensory motor and cognitive dysfunction.
• Uses lenses and prisms to affect processing balance in the brain.
• Impacts performance, attention, cognitive function, balance, spacial orientation, headaches, diplopia, blurred vision, photophobia, asthenopia, posture and balance difficulties.
• Midline shifts with the vision can lead to posture issues.

Richard Longland spoke about biofilms:

• He was on the Marshall Protocol and then went to naturopaths.
• Created a documentary film about biofilms. "Why Am I Still Sick?"
• RD Wolcott studied the impact of biofilms in chronic wounds.
• Numerous videos from Bill Costerton and others at http://www.youtube.com/user/ADRSupport
• Biofilms are the basis for chronic infections, and the main reason that antibiotics fail
• Tens of millions of people are impacted by a biofilm-related illness.
• Arthropatient.org
• Biofilmcommunity.org
• http://www.whyamistillsick.com/

Kenny de Meirleir spoke about GcMAF in the treatment of Chronic Fatigue:

• Lack of macrophages leads to immune suppression.
• Gc protein is Vitamin D binding protein.
• The body puts small protein Gc around it as fat cannot be dissolved in blood.
• GcMAF is a natural activator of macrophages.
• When the immune system cannot convert Gc Protein (when nagalase is elevated), we get deglycosylated Gc Protein and not GcMAF.
• Nagalase is part of envelope of HIV and is found in cancers, viruses, and HERVs.
• Intestinal bacterial also produce nagalase – 120 different ones.
• Intestinal flora can increase or decrease nagalase production.
• GcMAF is the most potent macrophage activator.
• People with CFS have many different infections.
• Healthy people have low nagalase.
• CFS patients average 1.72 and some up to 4.0.
• Controls range from .35 to .68.
• Cheney finds an average of 3.0 (0.8 to 6.7).
• Origin or nagalase – retrovirus, Herpes viruses, intestinal bacteria, HERVs, intracellular bacteria like Bartonella. Borrelia.
• Increases plasma LPS (lipopolysaccharide) in sick people (leaky gut) – activating macrophages in pathological way.
• VDR genetics are involved in GcMAF responsiveness – Bsm1 and Fok1.
• High responder – FF bb; Moderate Ff Bb; low responder Ff/BB.
• 920 patient study – 50% with zoonosis of Borrelia or Bartonella.
• GcMAF will not generally have a bad IL1 or TNF-a response like LPS. LPS and GcMAF cannot both stimulate macrophages at the same time. GcMAF has preferential activation.
• 25-100 ng per week. Lowered doses later to 25-50 ng per week. 60—70% were responders.
• GcMAF risk – could develop autoimmune disorders. Has not seen it. 3 people with autoimmune thyroid have been treated and has not increased.
• In people with TGF-b1 or IL-6 elevation, you have to be more careful.
• IRIS (Immune reconstitution inflammatory syndrome) – is a cytokine storm – immune system produces an exaggerated response.
• < 20% experienced IRIS with treatment and even less now due to lower dosing and excluding some patients from the treatment.
• IRIS is more common when more co-infections or activated T cells or low T cells are present.
• Monitor treatment with cytokines, C4a, activated T cells (CD25, HLA-DR).
• Prevention of IRIS - all microbes addressed as much as possible beforehand.
• Does IV GcMAF when they can or SC/SQ injections.
• Patients with very damaged immune systems like leukopenia, low CD4, etc. may not be candidates for GcMAF.
• If toxic levels of 1,25 Vitamin D, should not give more vitamin D.
• If GcMAF works, 1,25 Vitamin D goes down and 25 Vitamin D goes up.
• Viruses, bacteria, etc. and inflammation lead to Vitamin D 1,25 production.
• Prostaglandin inhibitors may be used for IRIS like aspirin or 100mg indomethacin suppositories.
• The process is driven by IL-8 when having an IRIS reaction.
• When nagalase is normalized and GcMAF therapy stopped, does nagalase rise? Depends on whether the other infections are treated as well. Need to handle the ongoing immune support.
• MAF yogurt may not be effective unless intestinal bacteria are the driver of the nagalase. It is a large protein destroyed in the gut.
• Treating Borrelia will lower nagalase.
• With Bartonella, he sees mostly psychiatric symptoms.
• Bacteria produce more nagalase than viruses.
• High IL-8 or high IL-6 are used to rule out GcMAF treatment.
• TGF-b1 is related to Th17 and autoimmunity.
• LPS from gram negative bacteria activate macrophages.
• His specific GcMAF comes in small vials and can be frozen.
• Headaches and sleep problems are their main IRIS symptoms.
• He allows re-freezing. 50% loss in 2 weeks if kept in the fridge.
• Keeps on once a month GcMAF after nagalase normalizes.
• 6 days activation of macrophages from the GcMAF treatment.
• They do gut biopsies to look for microbes and see Parvovirus and others in tissues.

Bill Rea presented on environmental toxicity:

• Many Lyme patients that cannot tolerate antibiotic treatment work with Bill Rea.
• They often cannot tolerate food, water, or other common exposures.
• The barrel is overflowing and sensory and autonomic nerves are damaged.
• Some develop electrical sensitivity – the next "chemical" around the block.
• Electrical sensitivity is a bigger wave than chemical sensitivity – will be a big problem.
• They have a Marriott wing near their office with environmentally-friendly rooms for patients to stay at.
• The goal is to decrease total pollutant load and restore nervous and immune systems.
• Use less polluted water – spring or distilled. Spring water can be a problem due to fracking.
• Mountain Valley Spring Water from hot springs Arkansas best in bottled glass. Evian is the second cleanest.
• Whole house water filtration should be first and then sink top filters.
• Organic food is more nutritional.
• Organic cotton bedding and non-toxic metals since they conduct EMFs.
• Intradermal injection therapy for Lyme patients.
• Nutritional supplementation – oral, injection, or IV.
• Alkalinization to keep detox system alkaline. Potassium bicarbonate, calcium carbonate, or sodium bicarbonate can neutralize the pH. TriSalts is a good product that may help here.
• Rotation diets are used to reduce food stress.
• Oxygen therapy. Experience dramatic fatigue and brain fog when low oxygen conditions are present.
• Immune modulators for T & B cell deficiency and gamma globulin.
• CD8 immune cells (suppressors) are often down.
• Autogenous Lymphocyte Factor - draw and incubate for 6 weeks.
• Use GammaGard in some patients. If GG is normal, it doesn't help.
• Physical therapy.
• When running near highway, toxicity goes up 8 times.
• Sauna – glass or ceramic – not plastic.
• Of 40 Lyme patients, 35 had molds/foods/chemicals sensitivities. 38 lost EMF sensitivity. 10 needed antibiotics but could tolerate them now. 30 needed no antibiotics. Sporadic oxygen and bicarb treatments at home. 2 got worse.
• Environmental treatment for Lyme appears promising.

Lisa Nagy spoke on mold and mycotoxins:

• Chemicals are in the air, food, and water and are all increasing.
• Toxicity of general daily living has gone up.
• Mold damages immune system.
• Most Lyme patients have a damaged immune system from mold or pesticides.
• It could be that focus on co-infections, etc. is not the right focus.
• Development of MCS is what often gets people to her practice.
• Does your basement smell a little musty?
• Dysautonomia can be made worse with chemicals.
• Women that are cold in grocery store may need to look at adrenals and thyroid.
• POTS – heart rate goes up when standing. Orthostatic hypotension results in lower blood pressure when standing.
• Dysautonomia can be made worse with standing up, eating a big meal, heat, and exercise.
• With lower barometric pressure, on rainy days, dysautonomia can be worse.
• EMFs can be a factor from computers, phones, etc. Suggests the Envi Air Tube headset.
• In some, she uses Midodrine which raises blood pressure.
• RealTime Labs tests for aflatoxin, ochratoxin, and tricothecenes. Testing runs about $699.
• If patients do a sauna and then follow with the urine collection for mycotoxins, she has observed increases in the mycotoxins found.
• IgG for molds at Alletess Lab – each mold runs about 6 dollars. Nagy Mold panel for 90 dollars.
• Mold exposure leads to food allergy and chemical sensitivity.
• Wants Coq10 levels of 3000 and uses 600-1200mg per day
• Ndrf.org has good information on POTS. POTS can be mold-induced.
• Mold exposure in rats leads to adrenal death primarily in females (unless they were injected with Testosterone).
• Stop exposure. If still in moldy clothing, one is still getting exposed. Fresh clothes, washed in clean washer/dryer. In 4 days, the person will become sick by being around the old clothes.
• Trichothecenes can be measured using Pure Air Controls if one needs a lower cost option than doing the full testing from Real Time Labs.
• For toxicity, IV vitamins, Alpha Lipoic Acid, Phosphatidyl Choline, Glutathione, and oxygen are often used.
• Useful oral supplements may include Calcium D Glucarate (for trichothecenes), alpha lipoic acid, NAC, glutathione, vitamin C, Tri-Salts, vitamin E, and selenium.
• Cholestyramine, bentonite, charcoal, sauna with a target of 30 minutes a day, and coffee enemas may be helpful.
• One should treat adrenals and POTS before attempting sauna therapy.
• One should use glass water bottles, not plastic.
• Seventh Generation home cleaning products and detergents are cleaner options.
• An approach of provocation and neutralization are needed for most.
• Metformin and Berberine can be useful for insulin resistance.
• She does not treat fungal growth in the body but does address mycotoxins that are stored in the fat.
• Sauna therapy may lead to increased mycotoxins in urine mycotoxin testing after 30 minute sauna. This sounded like a great option for anyone to consider prior to collecting urine for a mold mycotoxin test.
• Sauna is very useful for detoxification.
• Metametrix has a number of useful tests for chemicals, solvents, etc.
• Dr. Rea suggested that you could compensate for CCSVI with appropriate hypercoagulation treatment.
• Dr. Kinderlehrer suggested 6 cups of epsom salt with 6 cups of baking soda as a useful detoxification bath.
• A normal adrenal gland puts out 40mg of hydrocortisone. 2.5-20mg is used when supporting the adrenals. This is not a problem in terms of impacting the immune system.
• Coffee enemas can reduce mycotoxin levels.

Sam Shor talked about Chronic Fatigue in Lyme:

• Fatigue - Depletion in energy, post exertional malaise (CFS/ME hallmark), hypersomnia (excessive daytime sleepiness), emotional inertia/apathy, muscle strength, cognitive impairment.
• Elevated IL-1b, IFN-y, TNF-a, IL-6 associated with fatigue.
• In CFS, there is often a decrease in NK (natural killer) cells. Lyme decrease CD57 NK cells.
• CoQ10 is often used for mitochondrial dysfunction.
• Generally targets a TSH of around 1.0 with supplementation.
• For sleep issues, consider ways to address IL-1b, IL-6, and TNF-a. Could also be related to growth hormone or iron levels.

Sam Donta shared the following comments:

• Recovered people do not see reversal of T2 signals in MRIs, but SPECT scans do show progress.
• What if there is a toxin with Borrelia that is so minute that it is not seen by the immune system but causing significant ongoing symptoms?
• If there is autoimmunity, if you get the core cause (infection), the autoimmunity should resolve.
• Borrelia exists under the skin and in neuronal cells in spinal sensory nerve roots which are protected from immune response.
• Shingles can be found in the sensory nerve root neurons and may be why Shingles often reactivates.
• Rocephin is anti-neurotoxic by reducing glutamate accumulation. Ceftriaxone does not get into the cells (intracellular).
• You cannot supplement vitamin C with Plaquenil. Plaquenil is intended to make the environment more alkaline and vitamin C is making it more acid.
• We may be helping the microbes by taking supplemental vitamins.

Wayne Anderson lectured on the many of the genetic factors such as HLA and methylation:

• A subset of patients are different and have different treatment needs.
• Some cannot tolerate a 1/2 a normal dose and feel worse or have an unusual response.
• Genetic and metabolic issues create narrow places like 2-lane highways that are backing people up in terms of being able to detoxify and get things out of the body.
• Food allergy may be just a trigger with underlying factors predisposing one to the response.
• One can have a hyperimmune response to mold, a colonizing effect, or a toxic effect which is adding to the overall load.
• The genetically predisposed may have more likely colonization.
• With a physical examination, the gut evaluation is important.
• HLA relates to genetic predisposing factors to family of neurotoxins. It is like our hard drive.
• When there is an inefficiency of the immune system in trying to overcome something that it cannot, symptoms result.
• The 1-5 HLA type is related to low MSH and to the hypothalamus.
• Multi-susceptible HLAs can be highly toxic with chemicals as they hold onto chemicals.
• When looking at multi-susceptible and mold-susceptible types, you can often treat a multi-susceptible for mold and the issue often clears. Attempting to treat a mold HLA-type for mold is often more difficult than a multi-susceptible.
• There are tools to address people that have the "dreaded" genotypes as Dr. Shoemaker refers to them. It is not a hopeless situation by any means.
• With Lyme HLA types, the response to treatment is often not smooth and the practitioner needs to do more immune-modulation and support.
• If a person has two mold HLA types, mold may colonize in the mucous membranes. Candida is part of what he considers when someone has a mold HLA type.
• When there are 2 multi-susceptible types, the major focus is on detoxification and the patient is often very sensitive.
• Someone with two 15-6-51 types can be vulnerable but with knowledge of these types and how to approach them, these are very treatable.
• Methylation is the backbone of the waste processing system and an important part of the immune system. It is also important for cell regeneration, creating of neurotransmitters, and many other bodily processes
• Standard drug dosages are made for people with no methylation defects.
• Methylation supplements are taken together to synergize the effect.
• BH4 may be helpful in reducing ammonia.
• Sulfites are more of an issue then sulfates.
• There are two ways to evaluate methylation. One approach is to look at all of the SNPs as can be done with the Yasko testing. Another is to do the panel from Health Diagnostics and Research Institute.
• Glutathione is a backup system for methylation. The more depleted we are in glutathione, the worse our methylation is working. Improving methylation improves levels of glutathione.
• Folic Acid RBC testing can show the last two months whereas folic acid testing is at the present time.
• If SAMe/SAH are low, energy is going downward and not to the left (from the right) to the next cycle.
• Chronic infections are more common when methylation is not working correctly.
• Transsulfuration pathway is associated with KPU.
• When people have ammonia, start with methylation support, yucca with meals, RNA Ammonia, charcoal, or BH4.
• The worst thing for an ammonia patient is constipation.
• High ammonia is often related to low homocysteine. Homocysteine of 5 and below are methylation issues. Transsulfuration pathway is likely a problem.
• BH4 may not be helpful until you start methylation moving forward. Ecological Formulas TetrahydroBiopterin is BH4.
• When glutamine is used for leaky gut syndrome, it may not be converted to GABA but instead may become undesirable glutamate.
• P5P keeps zinc and copper balanced in KPU.
• Mast cells hold histamine molecules. Some people's mast cells break very easily. Ketotifen can be helpful here. Ketotifen causes initial sedation which subsides later.

Neil Nathan spoke on the Shoemaker Protocol:

• Lyme and mold are both biotoxin illnesses.
• There is a massive outpouring of cytokines that the immune system cannot control.
• We need to separate allergy from infection from toxin when thinking about mold. One can be allergic to mold. It can be toxic. One can have an allergy and not be toxic. The toxic effects of mold are the main focus of what he was discussing in this lecture.
• The main toxic molds are aspergillus, stachybotrys, penicillium, and chaetomium.
• A mold plate is the cheapest way to test. It takes about 2 hours and then you see what grows. These are helpful as once a person sees what grows on the plate, there is an indicator to look deeper. You need to validate the type of mold that shows up on the plate.
• Mold toxins are intended for the molds to carve out their own ecological niche. It is their protective mechanism.
• The problem begins when it grows without opposition and does not have to compete with other organisms in nature.
• Sheet rock is basically paper and is very easy for mold to start to grow on.
• Mold toxicity is very different from mold allergy.
• "Mold" means fungi, actinomycetes, mycobacteria, VOCs, beta glucans, hemolysins, mannans, and proteinases.
• Mold is a sensitizer; as is Lyme.
• Mold can cause MCS. It can also lead to electromagnetic dysthymia, food allergies, and autoimmunity. Everything else gets much worse when mold is present.
• Static shocks are common in people with biotoxin illnesses.
• When one fails the VCS (Visual Contrast Sensitivity) testing, mold, Lyme, and mercury toxicity are all on the table as potential factors.
• Ionophores are lipophilic.
• MSH is the kingpin to the entire biotoxin illness pathway.
• VIP helps shut down the inflammatory process.
• HLA-DR can be inhibited by IL-10.
• TFGb1 and C4a are indicators of inflammation in biotoxin illness.
• MMP9 may be correlated with a high toxin load. Should be 350 or below.
• VEGF may be related to post-exertional malaise.
• With aerobic respiration, 38 ATP are produced. With anaerobic respiration, only 2 ATP are produced.
• High VEGF may be seen in Bartonella.
• MSH is involved in gliadin allergy.
• MARCoNS is a "colonization" not an "infection". It does not itself cause symptoms.
• Low MSH leads to MARCoNS which further lowers MSH.
• Air hunger and shortness of breath may be a VIP deficiency.
• There is not a good test for VIP that is accurate. They used to always come back low and later seemed to not be helpful at all.
• Phosphatidylcholine and Glutathione can be helpful for reducing biotoxins.
• Cholestyramine should be taken 30 minutes before eating and then eat and then take supplements 90 minutes later.
• Actos is not used if leptin levels are low. Actos is used with a high protein, low carb diet. It can cause hypoglycemia or swelling of the face, hands, and feet (stop treatment).
• DHEA is the substance that helps sick patients the fastest in his practice as 99% of sick patients are low in DHEA.
• Zithromax once weekly may help to treat biofilms. Pulmonologists have used it in the treatment of cystic fibrosis.
• Remediation is very expensive and may not work.
• It is often best to treat mold first in people with several factors in their illness.
• MSH would be a superb treatment but it is not available to us. Some are using subcutaneous HCG as a way to increase MSH.
• Lactulose would be a last resort for constipation and ammonia.
• Large parasites often lead to constipation whereas smaller parasites often lead to diarrhea.

Some additional comments after the talks from Lisa Nagy, Wayne Anderson, and Neil Nathan:

• NeuroScience does cytokine related testing which may be useful though whether or not it helps clinically given that everyone is inflamed is still unclear. TGFb1 may be the best marker at present.
• Some doctors are using Voriconazole along with mycotoxin testing from Real Time Labs, but this is a separate population of patients from those with a Shoemaker-like biotoxin illness.
• Sinus Dynamics is a company that has options for the treatment of mold in the sinuses.
• With Lisa Nagy's patients, she has seen people with positive urine tests for mycotoxins 25 years after their last known exposure.
• Rich Van Konynenburg's Simplified Methylation Protocol has demonstrated significant improvement in the majority of patients that have utilized it.
• One can correlate genetics to functional tests results, but methylation treatment often reverses the functional test abnormalities. There is genetic potential and the "real and now" function.

Armin Schwarzbach shared the following:

• Chlamydia pneumoniae can be airborne.
• Mycoplasma fermentans and Mycoplasma pneumoniae can be found in ticks.
• Chlamydia is intracellular and develops biofilms.
• Antibodies are produced from B cells.
• IgA for Chlamydia pneumoniae has a half-life of about one week. Thus, a positive test represents current infection.
• For Borrelia and Chlamydia, a reasonable treatment combination may be a macrolide, Doxycycline or Minocycline, and metronidazole.
• For intracellular organisms, Plaquenil and artemisinin can be helpful.
• In their works, 86% of Borrelia patients were co-infected with Chlamydia pneumoniae.
• http://www.infectolab.com/

Alan MacDonald talked about Borrelia and biofilms:

• Bill Costerton was a researcher of biofilm science.
• Borrelia cyst form is real and a reason for persistence in part; Borson research.
• He believes that transplacental transmission is very real.
• Blebs have DNA of Borrelia.
• Cyst forms shed blebs.
• Blebs are weapons that the microbes throw off to confuse the immune system.
• Blebs produce an autoimmune reaction.
• Does not take 24 hours to get infected by a tick.
• If you have Babesia without Lyme, it would be unusual as they travel together.
• 1 million new cases of Lyme were reported in Germany last year.
• He is working to prove that Alzheimer's is Borrelia producing biofilms that others consider plaques.
• He urged people to not have a narrow point of view.
• Blebs are very small and cannot be seen by the naked eye, granules are bigger, and cyst are much bigger

Ginger Savely talked about CD57:

• CD57 could be impacted by Bartonella, Babesia, mold, viruses, PANDAS/PANS, Mycoplasma, and Chlamydia.
• Mentioned a low CD57 in one case with Chlamydia pneumoniae with no Borrelia infection.
• Does not appear to be reliable in monitoring progress in the short-term.
• Should never be ordered more than every 6 months.
• Dr. Jones does not use for children.

Norton Fishman commented:

• The goal of the organisms is to rule the world. They are very intelligent.
• Persister cells sleep and are an insurance policy for the microbes.

Miscellaneous Tips and Tidbits

• Curcumin can be anti-inflammatory, anti-yeast, increases glutathione. 600mg per day initially may be a good starting point and then 600mg twice per day after 5 days and then finally 600mg three times per day after another 5 days.
• When an IND band is received several times on band 31 only on an IGeneX Western Blot, one may want to consider testing for Chlamydia pneumoniae.
• NutraMedix products use potato alcohol.

Disclaimer: While I attempted to accurately represent the statements of the various speakers, it is possible that the above contains errors or inaccuracies. If you have any corrections to the content listed above, please Contact Me.