ISEAI 2020: One People, One Planet, One Health

Details: Created: October 05, 2020; Last Updated: October 06, 2020

I had the opportunity to attend ISEAI's "One People, One Planet, One Health" conference. The event was held online on October 2-4, 2020. I loved ISEAI's first in-person event last year in Arizona, and am very pleased that this year's event was made available virtually.

This society (S in ISEAI) is one that every practitioner that works with environmental illnesses such as Lyme disease and mold illness should join. There is a strong desire within the group to truly find solutions for patients. ISEAI is doing excellent work, and I urge you to become a part of it. They also have membership options for patients.

There was so much more discussed than I could cover below, and I highly urge you to check out get the recordings of this event. My notes below are a small subset of the information covered at the event.

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 licensed medical authority.

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

Note: As this information may be updated as any errors are found, I kindly request that you link to this single source of information rather than copying the content below. If any updates or corrections are made, this will help to ensure that anyone reading this is getting the most current and accurate information available.

The event kicked off with Mary Ackerley, MD and Kelly McCann, MD sharing:

The purpose of ISEAI is to provide training and foster a community to support the best possible treatment options for patients with complex, chronic illness.
As many as 1 in 3 COVID survivors may have long-term challenges and persistence of symptoms.

Jill Carnahan, MD spoke on "Mold, Mycotoxins, and Management: Tips and Tricks for Managing Complex Cases" and shared:

We get through by looking right in front of us and taking one step at a time.
When the bucket gets full with toxins, it overflows as disease. The goal is to lower total toxic body burden to allow for detoxification and healing; need to give them back enough margin.
Mold depletes glutathione; which depletes our ability to detoxify in the most toxic environment of our lives.
Both exotoxins (outside) and endotoxins (inside) play a role in contributing to total toxic load.
10-15% of population are HSPs (highly sensitive persons); gift and curse; more intuitive but also more sensitive to the environment and smaller toxic exposures.
Avoidance is key.
Genetics is the gun; environment is the trigger.
Average age of diagnosis of celiac is 55 years old.
Uses CIRS labs but they are not specific; can be helpful to follow the course of recovery.
Cannot talk about mold without talking about infectious burden which adds to the toxic load.
Many mycotoxins are known immunosuppressants.
Consider Lyme and co-infections as well as parasites, viruses, and mold.
Mycotoxins are ionophoric and not easily detectable in the blood.
In genetically-susceptible individuals, the toxins are not tagged and lead to chronic stimulation of the immune system.
The innate immune system going awry and creating persistent inflammation (cytokines) is a big problem in chronic illness.
It is a toxic soup in a water-damaged building; not just mold and mycotoxins.
ERMI or plate testing will give patient's the power to make a decision to go further in their exploration.
Uses urine mycotoxin testing as a tool; is an excretion test; can look good and have a huge load or can be treating and releasing massive amounts which may actually be a good thing as the patient is detoxifying.
RealTime (ELISA), Great Plains (LC/MS), Vibrant (ELISA).
RealTime less likely to be food contamination.
May combine the Great Plains OAT and MycoTOX.
IgG antibody levels to mycotoxins can be correlated to clinical presentation.
Bovine immune globulins can be very helpful for intestinal hyperpermeability.
Mold creates a PTSD response; part of getting patients well is addressing the limbic system response.
Accessing the Healing Power of the Vagus Nerve (Porges), The Brain That Changes Itself (Doidge), Safe and Sound Protocol (Porges)
Uses BrainTap, DNRS, Gupta, Heart Math, Binaural Beats, cranial sacral, FSM, neurofeedback, breathwork, neurolinguistic programming.
Avoiding high histamine foods can be helpful in those with MCAS and histamine issues.
Many immune suppressed are colonized with fungus or mold and may benefit from a low mold diet.
Treating colonization, if necessary, is important; controversial but clinically makes a difference.
Furans in OAT test can be an indication for colonization.
Patients with food list getting smaller and smaller often have fungal or mold colonization.
Can look at stool culture, OAT, or serum Candida as potential markers of fungal dysbiosis.
Treatment for fungal dysbiosis: RX antifungals, undecylenic acid, caprylic acid, garlic, berberine, oregano, Pau D'Arco, olive leaf
Clean air, clean water, clean food.
Home air quality meters can be highly informative.
Basic detox: optimize elimination, gut microbiome, support mitochondria and liver
Fast phase 1 and slow phase 2 can make things worse.
Detox nutrients: organic parsley, cilantro, chlorophyll, NAC, green tea, quercetin, B complex, Sulforaphane, milk thistle, R-ALA, Calcium D Glucarate, Trans-Resveratrol, Curcumin, SAMe, probiotics, glutamine, glycine
NAD precursors help recycling of glutathione. NAD is depleted by exposure to mold and mycotoxins.
Does glutathione with NADPH and methyl donor support to improve tolerance.
Mold Detox Box: Glutathione, Liver Support, Binder, Electrolytes, NAD+; "Happy Meal" for mold.
Phase 3 is the gut; if MSH is low and leaky gut is present, need to support. Consider spore probiotics, IonBiome, humic and fulvic acids
Phase 3: elimination diet, 5R program, coffee enemas, colon hydrotherapy, fibers, probiotics, cholagogue herbs.
Coffee enemas increase glutathione production.
Lymphatic support: gentle exercise, castor oil, hydrotherapy, lymph drainage, lymph massage, dry brushing, rebounding, rhubarb, calendula, burdock, echinacea, astragalus
UNDA or Pekana drainage remedies can be very helpful.

JW Biava spoke about ImmunoLytics:

In some cases, an IEP is not available or cost-prohibitive.
Plates are as inexpensive as 3 dollars a plate.
Patient compliance increases with visually seeing the mold growth.
They provide consultations after testing to provide additional guidance.
The mold plates are the best bang for the buck.
Aspergillus, Penicillium, Alternaria (major health effects), Candida, Nocardia, and others.
To be statistically significant, need sampling programs that increase statistical significance.

Larry Schwartz BSME, MBA, CIEC spoke on "Creating an Environmental Sanctuary in the Existing Home" and shared:

Has done over 10,000 investigations
Creating a sanctuary is a process of steps
1. Assessment: Mold Propensity Index Assessment, exterior and interior visual evaluation, sampling/lab testing
2. Critical Thinking and Report Creation: evaluation of the lab reports and inspection
3. Tailoring a solution plan: Ventilation, Air Purification, Small Particle Cleaning
4. Performance of the solutions
5. Post testing and verification
Pre and post VCS testing can be a measure of improvement in a home after cleanup
May make sense to do a GENIE test to determine if small particle cleaning is needed
Want relative humidity 40-60%
Virtual consults started emerging 3-4 years ago. The use a questionnaire, Zoom visit, guidance on measuring instruments, and help connect with a local person that can help with collection and inspection.
SafeStartIAQ.com

Dr. Carnahan likes the single red light from SaunaSpace for collagen support or local injury. She also shared a Hydrogen Gas Inhaler from High Tech Health. Dr. Mary Ackerley mentioned the Lifepro vibrational plate as one of her favorite self-care tools. Has been promoted by Terry Wahls for her MS patients and discount code "TERRYWAHLS" for 15% off.

Lyn Patrick, ND spoke on "Environmental Exposures & Immune Toxicity" and shared:

Why are toxicants more important now than ever? Less monitoring of hazardous emissions due to COVID outbreak; immune vulnerability and systemic inflammation in COVID.
Organophosphate pesticides are neurotoxic, respiratory toxicants, endocrine disruptors, and immune toxicants.
Solvents are neurotoxic and carcinogenic.
BPA/Phthalates disrupt testosterone and immunity.
Can test for Pesticide metabolites, flame retardants, Phthalates, Bisphenols, Mycotoxins, Glyphosate, Metals, PFAS, MTBE.
Upregulation of Th2 leads to autoimmunity, allergy, inflammation; downregulation of Th1 leads to cancer.
Many toxicants lead to Th2 upregulation.
Organophosphate exposure can play a significant role on patient's illness; higher levels are seen with conventional diet as compared to organic.
Those with PON-1 under-functioning may have a more difficult time clearing these pesticides.
Pesticides like malathion can lead to mast cell degranulation.
97% of breast milk samples show triclosan.
Glyphosate increases risk of non-Hodgkin's lymphoma; changes in microbiome are seen in animals.
Pesticides are found in fish.
Mothballs are a source of exposure to pesticides.
Permethrin used as a tick-repellent is not benign and impacts many systems of the body negatively.
As air quality index worsens, the risk for COVID-19 increases significantly.
Solvents include benzene, xylene, styrene, toluene and many others.
Fracking can be a source of exposure to solvents.
TCE exposure is the poster child for solvent toxicity.
Living under a flight path can be a significant source of solvent exposure.
Memory foam mattresses can lead to solvent toxicity.
PCBs can be found in our diet from fish (including fish oil), beef, dairy, butter (including organic), cheese, mother's milk.
PCBs can stay in the body for up to 6 decades; half-life 30 year or more.
PCBs are eliminated in stool, sweat, breast milk.
PCBs can play a role in Hashimoto's.
Dioxin is one of the most immunosuppressive chemicals known to human beings.
Phthalates and BPA have a 24 hour half-life; avoidance is the treatment.
BPF and BPS are probably MORE toxic than BPA which is being phased out.
Canned coconut milk is the highest source of BPA in food.
Most important thing to treat is glutathione.
Presence of a mycotoxin prevents the body from making glutathione even with all the right materials.
The enzymes that help recycle glutathione are poisoned by the toxicants.
Need to use exogenous glutathione.
NAC and ALA can be helpful but will not be enough.
Medical sauna is very important for toxicant removal.
Magnesium deficiency is assumed in the general population; toxicants further induce deficiency.
Magnesium deficiency leads to reduction of ATP production and mitochondrial function.
Magnesium sulfate IV or IM may be necessary.
Magnesium taurate, glycinate, citrate, threonate can be good oral options.
Solvents: NAC, Sulforaphane
Glass grown chlorella can be very helpful for toxicant reduction; increases fecal excretion.
Buffered ascorbate acts as an electron donor, restores ATP capacity, is antioxidant, and supports glutathione.
PCB damage: resveratrol, Sulforaphane, EGCG
Dietary fibers very useful if tolerated.
Organophosphate pesticides: melatonin may be helpful.
Allergenicity and immunotoxicity that we experience in additional to mold exposure and infections is related to pesticides.
Permethrin often sprayed directly on people in flights; leading to allergic and histamine reactions.
EHQ Questionnaire

Joseph Pizzorno, ND spoke on "Environmental Exposures and Immune Toxicity: Metals and Meta-Metals" and shared:

Metals impair both innate and humoral immune response
Correlation with autoimmunity via increase in oxidative stress and inflammation
Metals and chemicals bind to normal tissue and lead to immune triggering
Competition with trace minerals disrupt metabolism in many ways
Inflammation setpoint increases and body reacts too easily
We are way sicker as a society than ever before
1/3 of the population suffers disease due to arsenic
Over 50% of cases of gout are due to arsenic, 18% of diabetes.
Primary sources of arsenic: water, chicken, rice.
Half-life is 2-4 days; ongoing exposure is the problem
Can look in urine or can look at toenails (for historic exposure)
More problematic if methylation impairments are present
B vitamin supplements if homocysteine > 8, NAC/Glutathione, treat water
Cadmium elevation leads to more infections such as H. Pylori, Toxoplasma, and Hepatitis B.
As mom's cadmium levels goes up, child's immune function becomes depressed
20% of osteoporosis may be attributed to cadmium
Smokers have twice the cadmium levels
Primary sources: smoking, products made with soy grown in high-phosphate fertilizers
Cadmium bioaccumulates in the kidneys and poisons renal mitochondria
GGT increases with lead and cadmium levels
Sweating is a good way to reduce cadmium
Lead impairs immunity, shifts to Th1 dominance, leads to more infections, increases hypersensitivity reactions, and autoantibodies against neural proteins
Lead, cadmium, and arsenic toxicity way worse than cholesterol in terms of health implications
Lead sources: water, dust, maternal/fetal exchange, lead dishes, bone loss
Lead detox: calcium, C, NAC, EDTA, DMSA, maintain bone, test water supply
Mercury leads to immune dysfunction, autoimmunity, inflammation, and leads to neurological dysfunction
Mercury sources: fish, shellfish, dental amalgams
50% of the population is at the toxicity threshold
Most of the mercury release in the environment comes from China
The larger the fish, the more the downsides outweigh the benefits of the omegas
Some Chinese herbal medicines are toxic with metals; same with Ayurvedic herbal medicines
Mercury detox: Fiber, NAC, trace minerals, DMSA, Curcumin (protect damage)
Should remove amalgams but ONLY with a biological dentist
Tattoo inks can be a source of heavy metals

Stephanie Seneff, PhD spoke on "Glyphosate, Biofuels, and COVID-19" and shared:

Vaping uses glycerol which contains glyphosate and creates a lung disease very much like COVID-19.
26% of COVID deaths worldwide were US; only 4.2% of the world's population are in the US
Biofuel turns waste from food processing into usable fuels; major by-product is glycerin
Correlation between air pollution and bad outcomes in COVID-19
Blacks are twice as likely to die from COVID-19
Biofuel production sources such as waste cooking oil, cow manure, municipal solid waste, crop residues, crops for biofuel production, waste from meat processing, forestry residues from paper industry; all contaminated with glyphosate
Diesel may make glyphosate more toxic to the lungs
Is the biofuel industry a smoking gun?
High biofuel consumptions overlaps with COVID deaths
Obesity is directly linked to glyphosate
Taiwan has low biofuel, low glyphosate, and almost zero deaths from COVID.
Nigeria has high air pollution but low COVID deaths
Humans exposed to pollution have disturbances in blood cholesterol
SARS-CoV-2 found in nanoparticles in the air; may trap the virus for longer periods
Biodigesters on cruise ships may release glyphosate and make people more sensitive to COVID
Glyphosate displaces glycine in protein synthesis
Glyphosate correlated to hypertension, diabetes, hyperlipidemia, end-stage renal disease, dementia, liver cancer, obesity; she feels it causes all of these
Symptoms of EVALI from vaping remarkably similar to COVID.
Fatty lung disease and fatty liver disease associated with glyphosate
PEPCK enzyme key for gluconeogenesis and associated with fatty liver, neonatal hypoglycemia, Type 1 diabetes, SIDS, fungal overgrowth, high oxalates and kidney stones.
Glyphosate may disrupt PEPCK.
Wuhan epidemic of COVID subsided when traffic went down
Statin drugs and ACE inhibitors upregulate ACE2 receptor which opens the door to COVID
Cyanide poisoning leads to hypoxia and intravascular coagulation
Modification of gasoline vehicle engines release cyanide
Endothelial cell disruption may be a key in COVID disease
Heme oxygenase activity is insufficient to overcome inflammation in those who die from COVID
Collagen and gelatin are likely glyphosate-contaminated.
Glyphosate leads to mold growth as it reduces competing bacteria.
Correlation between reduced COVID and fermented food consumption leading her to an interest in vitamin K2
Ozone and chlorine dioxide breakdown glyphosate

Georgina Hale, MD spoke on "Mold Infection and Colonization in Mycotoxin Illness" and shared:

Infectious disease doctor in Queensland, Australia
Molds such as Aspergillus, Histoplasmosis, Fusarium
Yeasts such as Candida and Cryptococcus
Yeasts are unicellular, round/oval, reproduce by budding or binary fission, monochromatic, can grow well anywhere
Molds are multicellular, like moist, humid environments, reproduce by sexual or asexual spores; wide variety of colors
Aspergillus, Chaetomium, Fusarium, Penicillium, Stachybotrys, Cladosporium, Alternaria, Aureobasidium, Serpula, Ulocladium are environmental molds related to chronic illness
In non-immune compromised, mold spores may lead to infection and allergy and illness via mycotoxins including CIRS, cytokines, CDR, MCAS, collagen disorders such as EDS, detox system overloading, mitochondrial toxin.
Mycotoxins are a systemic problem with widespread inflammation; 2-20 nanometers.
Molds can get into the sinus; gut, brain, elsewhere unclear; 2-20 microns.
Mold in sinuses could explain ongoing symptoms
It is not an invasive infection but could produce mycotoxins and serve as effective biofilm producers
Everyone may have mold in the sinuses, but not mycotoxin-producing mold
Aspergillus: Voriconazole, Posaconazole, Ampho B
Fusarium: Voriconazole, Posaconazole, Ampho B
Penicillium: Echinocandins (Caspofungin), Ampho B
Mucormycosis: Voriconazole, Ampho B
Candida: Echinocandins (Caspofungin), Fluconazole, Ampho B
Probable sinus colonization: Dr. Dennis finds endoscopic wash and suck critical to success; Ampho B or Voriconazole irrigations with biofilm busters
If no sinus symptoms, could there be mold/mycotoxins in the gut? Or could it be MCAS, SIBO/SIFO, autoimmunity, neuroinflammation, fatigue?
Why might we not want to use antifungals? May be impacting the mycobiome negatively.
Some fungi are becoming resistant to antifungals; Candida auris, glabrata, krusei becoming resistant; emerging azole resistance in Aspergillus
Judicious use in non-sinus CIRS

Lauren Tessier, ND spoke on "Thoughtful Use of Antifungals: A Naturopathic Approach" and shared:

Stachybotrys and Chaetomium grew on drywall places in sterile water
First formulation of Ampho B led to renal/hepatic toxicity.
Fluconazole is ineffective for Fusarium, Mucorales, Aspergillus
Microbiomes exist across the body
Fungi create biofilms and can be persisters
Many bacteria can help combat overgrowth of fungi and formation of biofilm
Similar organisms exist in both healthy and diseased systems; is the body reacting to normal flora?
Need low carb diet, boosting saturated fatty acids, boosting SCFAs, beneficial bacteria, beneficial fungi (some may cross-react), avoidance of problematic inoculation (low mold diet), immune rebalancing, herbs, nutraceuticals (caprylic, monolaurin), non-RX antifungals
Many types of essential oils have antifungal action.
Numerous herbs may be anti-fungal; including Holy Basil.
Plant extracts can enhance the efficacy of RX antifungals.
Start with non-pharmaceuticals to shift the terrain -> attempt to identify and get more specific with the natural options.
If that does not work, continues the terrain and bringing on antigen-specific antifungal.
If that does not work, continue the terrain, maintain the specific medications, and consider additional medication or adjunct herbal options.
Attempt the lowest intervention first.

Steven Sandberg-Lewis, ND presented on "Next Steps in the Treatment of SIBO and IMO" and shared:

IMO = Intestinal Methanogen Overgrowth
Elemental Diet can help with SIBO and IMO
Starts with breath test using lactulose.
May use antibiotics, herbals, elemental diet, diet; then follow with prokinetics.
If better, moves to prevention phase with diet, prokinetic.
If not better, redo breath testing and either consider other diagnosis or re-treat based on the results.
SIBO/IBS Look-a-likes: Fructose intolerance, brush border enzyme deficiency, pancreatic insufficiency, Celiac, Crohn's, yeast overgrowth, hypermobility syndromes, peritoneal neoplasms
SIBO is a complication of an underlying small intestinal dysmotility disorder.
Treat the underlying cause to prevent inevitable relapse.
Not abnormal or pathogenic bacteria; just more bacteria in the wrong place than should be present
Bloating, gas, pain, cramps, constipation, diarrhea, heartburn, nausea, systemic symptoms, malabsorption
Location, location, location
Rosacea gets better with treatment of hydrogen SIBO but worse with treatment of methane SIBO
SIBO clue when people take an antibiotic for another issue and see GI symptoms improve; worsening of GI symptoms with probiotics/prebiotics; fiber worsens constipation; celiac patient reports limited progress with strict gluten free diet; started when taking proton pump inhibitors as acid is a defense; development of GI symptoms after opiates (slow motility); develops chronic GI symptoms after long term, broad spectrum antibiotics; chronic low ferritin or iron with no other cause (bacteria consume the iron); post-infectious IBS
Increase risk: PPI, opiates, prolonged antibiotics, immunosuppressive medications
Most commonly overgrown: Bacteroides, Lactobacillus, Clostridium, Strep, E. coli, Enterococcus, Staph, Klebsiella, Proteus
Cytolethal distending toxin B and anti-viniculin antibody testing can reveal autoimmune IBS
Food poisoning -> bacterial toxin -> autoimmunity -> GI nerve damage -> SIBO -> PI-IBS (post-infectious)
Migrating Motor Complex sweeps undigested food and organisms; likely the main etiologic factor
Adhesions decrease clearance and can lead to SIBO
Motility in small and large intestine are very different; prokinetics are essential in both diarrhea and constipation SIBO and IMO.
MMC most active during fasting
Need functional ileocecal value
Blood sugars can contribute to overgrowth
Stool culture tells nothing about SIBO
3 breath tests: H. Pylori, sugar intolerance, SIBO (lactulose or glucose)
"Trio" breath tests measures hydrogen, methane, and hydrogen sulfide; new in last month
Avoid laxatives for 4 days before the test; no high dose magnesium or C, no herbal or RX laxatives
Have to check that the prep diet was adequate; no carbs that the bacteria could be fermenting at the start of the test
Treatment
- Hydrogen - Berberine, Candibactin AR/BR, FC-cidal/Dysbiocide; RX Rifaximin
- Methane: Allicin, Oregano, Atrantil; RX Rifaximin + Neomycin or Metronidazole
- Elemental diet: drink that replaces food to start the bacteria; useful when other treatments fail to work
Prevention: Prokinetics: Iberogast, Ginger, Motility Activator, Motilpro; RX Erythromycin, LDN, Prucalopride/Motegrity (first choice if significant constipation)
Hydrogen is used by methanogens to create methane
Etiologies: Adhesions, blind loops, bowel wall thickening/loss of motility, hypermobility, ICV dysfunction, overtraining/adrenals, TBI, hypothyroid, diabetes, enzyme deficiency, food poisoning, autoimmunity
Hypermobility Syndrome - consider bone marrow broth or collagen, vitamin C, MSM
Fish oil can be helpful for TBIs; magnesium, K, C, folate
For post-infectious IBS, has used: prokinetic (3-5 years), LDN, high dose fish oil, D, rosemary
Treat cause: ICV, enzyme or acid deficiency, overtraining/adrenals, hypothyroid, diabetes
Resistant cases may need rotation of treatments that worked previously long-term

Carsten Nicolaus, MD spoke on "Update on Lyme Disease and Co-Infections, Associated Diseases and Accompanying Health Conditions" and shared:

Borrelia afzelii thought of as European but recent study suggests it is in North America as well.
Babesia, Bartonella, Ehrlichia, Anaplasma, Rickettsia are the most common co-infections in US and Europe
Common to see Chlamydia, Mycoplasma, EBV, CMV, HSV1, HSV2, HHV6, Coxsackie
Borrelia: 11 species; North America andersonii, bissettii, burgdorferi sensu stricto; Europe: burgdorferi sensu stricto, garinii, afzelii, valasiana, lusitaniae; Asia: garinii, afzelii, valasiana, japonica, tanukii, turdi, sinica; miyamotoi and hermsii discovered in 1992 and now found more frequently worldwide, including Europe.
Finding the root cause: history, physical exam, diagnostic testing
Multiple Infectious Diseases Prediction Tool
Acrodermatitis may include redness and swelling on the hands and upper side of the feet.
Borrelia can impact the nerves and lead to Bell's Palsy.
Bartonella: striae more common on the back side of the body, heat rash, mottling, bruises (vasculitis) on arms and legs, lymphadenitis
Borrelia tests: most are indirect such as IgG and IgM ELISA (50% accurate) and Blot, C6 Peptide, Elispot, CD57. Direct tests: DNA-PCR, culture
EliSpot can be used to gauge the success of treatment.
5 of 6 patients with Lyme had re-activated Chlamydia
Mycoplasma re-activated in 30-40%
Yersinia may be an opportunistic infection leading to reactive arthritis
Parasites such as Babesia, Piroplasma, Toxoplasma tested with blood smear, ELISA/IFT, PCR, FISH, EliSpot
Harder to test for intestinal parasites
Toxocara and Ascaris larvae may be observed
Vector-borne viruses: Tick-Borne Encephalitis, Crimean-Congo-Hemorrhagic Fever, Heartland Virus, Bourbon Virus
Airborne viruses: EBV, CMV, HHV-6, HSV-1, HSV-2, VZV, Coxsackie, Parvo B19
Differentials: Rheumatic diseases, autoimmune diseases, inflammation, toxicity, genetic predisposition, endocrine dysfunction
Treatment: no "one-size fits all"
Most common obstacles to healing: bacterial escape and survival strategies (pleomorphism, intracellular infections, persister cells)
Borrelia and Bartonella have persister cells
Addressing biofilms is essential for a good treatment outcome; NAC, Serrapeptase, APP+/TBB+/DTC+ herbs, oregano oil, stevia, Biocidin
8 Pillars of treatment: Antibiotics, Lifestyle/Diet, Supplements and Detox, Supportive Medication, Pain Management, Physio/Exercise, Stress Management, Mental Coaching/Social Support
Optimal treatment needs to consider agents for Cell Wall, Round Body/Cyst, Intracellular, Persister forms
Alternative treatment approaches: herbal antimicrobials can eliminate spirochete, pleomorphic forms, coinfections, and biofilm formation; need to regulate the immune response, decrease inflammation, and promote repair of damaged tissue
US: Buhner, Beyond Balance, Cowden, Byron White, Zhang
Europe: "Lyme Plus Protocol" and "M1-M6 Protocol" both developed by Dr. Nicolaus

Robert Mozayeni, MD spoke on "Bartonella: Diagnosis, Mechanisms of Disease & Strategies for Therapy" and shared:

Protocols have to have good measurement of milestones
Neurological manifestations include: cerebrovascular, hemodynamic, white matter blood flow, subcortical, and involves biofilms
In Europe, transcranial dopplers are used to explore the cerebral vasculature
If patients are not getting better with Borrelia treatment, you may not need IVs and PICC lines, there may be other infections such as Bartonella (fleas, cats, lice, dust mites)
A lot of IgM on Western Blot for chronic Lyme with clean IgG could be cross-reaction due to other infections like Bartonella.
Bartonella testing: IFA can not rule out, children more likely to be positive, shift toward molecular testing; hard to miss a case of Bartonella if you do the right test.
Lyme rage could be the result of small vessel disease.
No single method is capable of being sensitive enough to pick up Bartonella
Skin biopsy might have higher sensitivity; easier to find in the skin
Specificity of their Bartonella testing is high
IFAs can cross react with other Bartonellas so it may not be that they have multiple Bartonella strains
Bartonella injures collagen and can lead to cutaneous lesions
Bartonella is very common in Lyme cases resistant to treatment
These are host-response diseases, not infectious diseases alone
Many symptoms we attribute to Lyme may be Bartonella
Bartonella can infect every cell; slow dividing time
Damage and host response over a long period of time is the problem
After infection, there is a local and systemic spread. Those with symptoms on one side of the body may be infection spreading along tissue planes.
Infection leads to inflammation which leads to fibrin deposits and biofilms which leads to flow impairment and resulting symptoms.
In sick kids with PANDAS and Bartonella, sees significant blood flow and biofilm issues
Has not seen antibiotic resistance being an issue
IV Glutathione has been the fastest approach to dissolving biofilms
Serrapeptase, Lumbrokinase, Nattokinase may be helpful.
Collagen can unzipper in locations with Bartonella; not just striae.
Lymphatics are profoundly abnormal in Bartonella
Bartonella has been found in mites and can lead to rosacea
No good diagnostic test for small vessel disease; working memory impacted; anywhere in the vascular system including the brain
Nerves are like trip wires; impacts lower extremities before upper; CIDP could be due to vascular inflammation from Bartonella
Small vessel disease can lead to mild cognitive impairment, executive dysfunction; not a dementia
non-CNS symptoms: dysautonomia/POTS, peripheral migrating neuropathy, joint and muscle pain, headaches, fatigue, decreased stamina
VEGF levels may drop at altitude; endothelial injury can lead to fluctuating levels
Hypermobility/EDS may develop as a result of Bartonella
Testing: IFA can be false negative at presentation; positive titer is likely real; culture with molecular ID is highly specific.
Many patients have mixed infections with "Lymeonella".
Parents with PANS/PANDAS are in a horrifying situation; we do not do enough as a society for them
Traditional treatment includes Azithromycin, Doxycycline, or Rifampin
Doxycycline barely touches Bartonella in dogs (and thus likely humans)
Need multiple agents and likely longer than even treatment for TB
Emerging treatments: Clarithromycin/Rifampin -> Rifabutin with low dose hydrocortisone to avoid induction of adrenal crisis
Others to soon to have a sense: Disulfiram (probably not), Dapsone (some clear failures), Essential oils, methylene blue (MAO inhibitor and oxidative stressor)
Dr. Zhang found Azithromycin/Rifampin, Clarithromycin/Rifabutin (not tested), Methylene Blue, Daptomycin, essential oils
Has seen clinical results with Allicin using microscope methods; encouraging
Likes to intensify the treatment as the patient gets better
Bartonella is present in all tissues; including eyes
Uveitis may be a Herxheimer of the eye
Patients need an ophthalmologist plugged into the treatment team
Liver enzymes and neutropenia during treatment are normal and expected; does not generally result in a need to stop treatment
Labs: GalaxyDx.com, TLabDx.com, IGeneX
Bartonella can be found in non-lesional skin
He got into Bartonella from cerebrovascular medicine; not Lyme
Bartonella can create any symptom depending on where the inflammation is and where the blood flow compromise may be
Beginning to appreciate how confusing serology for Bartonella can be; advocates for molecular testing
Dr. Carnahan mentioned inflammatory breast cancer and Crohn's could be associated with Bartonella.
Variety of skin lesions with Bartonella; eczema and hyperpigmentation on low extremities seen during treatment; possibly original portals of entry
When they test biopsy of lesional skin, they test non-lesional skin an inch away and find Bartonella in both.
Important to manage adrenals while on Rifampin and Rifabutin; he will not treat if they are not on hydrocortisone

Bob Miller, CTN did a talk which I could not attend (but was similar to his conference here). After his talk, some notes from the live Q&A:

23andme v3 and 4 had about 600K SNPs; v5 dropped a third of the SNPs.
His chip has 200K+ SNPs and new ones added as they become clinically relevant.
The DNA is stored so that they can upgrade the SNPs as they have new ones available.
They can now create a custom supplement that is personalized to each client.
Many clients are in Cell Danger Response; methylation support often backfires.
English, Irish, or German decent often have over-absorption of iron leading to hydroxyl radicals.
Italian/Native American may have G6PD issues and not produce enough NADPH.
Looking at the genome gives you clues as to where to intervene.
Some of the greatest benefits come from taking people off things; not putting them on more things.
COVID hijacks mTOR and uses it to its advantage

Ashok Gupta, MA(Cantab), MSc shared "A Neuroplasticity 'Brain Retraining' Approach to treating 'Neuro-Immune Conditioned Syndromes (NICS)'" and shared:

He suffered from ME/CFS in university and recovered 100%; was bedbound/housebound.
Setup a clinic to treat people with ME, CFS, and Fibromyalgia; got a lot of people with mold illness.
Conditions arise in the brain itself
Spectrum of conditions where symptoms are based on genetic or physiologic vulnerabilities
Brains and nervous systems and bodies have evolved over millions of years to get to the refined system of survival we have today
System is designed to ensure survival so we pass on our genes to the next generation
Ensuring survival is the primary goal
Brain's response to environmentally-acquired illness is the logical thing to do
In the past, we were not exposed to so many factors leading to an inflammatory bias
Now, food has toxins, we get less sleep, more emotional stress, more pollution and chemicals.
Many of us have continuous, background stimulation of the immune system primed toward over-reactions.
Modern world leads to more likelihood for increasing environmental illness
How EAI May Begin: 1) chemical/mold/toxin (or infection) exposure, 2) Genetic vulnerability (may limit detox capacity), and, 3) Chronic/Acute Stress; these factors lead to conditioning in the brain.
Chronic/acute stress leads to the immune system being compromised.
Brain interprets chemical signals from exposures in a magnified way; brain and body feel vulnerable.
Initial trigger + stress creates a PTSD-like reaction leading to a traumatic response
Exposure to one chemical leads to systemic generalization to more chemicals - leading to a viscous cycle that keeps the illness going.
These lead to amygdala/insula trauma and hippocampus dysfunction.
Anything that reminds the brain of a similar exposure leads to the brain coordinating a chronic sympathetic arousal and triggering of the immune system.
Chronic Sympathetic Arousal, Immune Dysfunction, HPA abnormalities, Oxidative Stress follow and create the symptoms of environmental illness.
Symptoms feedback to chronic brain sensitization.
Secondary illness cycles may present such as adrenal exhaustion, mitochondrial dysfunction, nitric oxide increase, latent viral reactivation, allergies, sensitivities.
The symptoms feedback to the brain creating a viscous cycle.
Brain just sees threats that it needs to address to ensure survival; becomes over-protective.
Brain generalizes stimuli that indicate the presence of the dangerous chemical
Detoxification systems shutdown during severe sympathetic responses
Peripheral Sensitization (brain, nerves) vs. Centralized Sensitization (limbic system and insula); more likely both
Local and global inflammation
Amygdala - two almond shape structures behind the eyes; protection responses; each emotion is also a protective response; both emotional and immunological and pain responses; inhibitory responses to stop pain signals if desired
Insula - between limbic system and cortex
Thalamus, prefrontal cortex, anterior cingulate, hypothalamus, hippocampus are all involved
Do not differentiate between emotional, physical, chemical, biological.
Insula produces an emotionally relevant context for sensory experience
Magnified presence of mold, chemicals, foods
Brain structures stimulate a threat response
When the brain is aroused, it feels vulnerable to milder threats; errs on the side of caution and over-protects
We live in a more chemically-triggering environment, but the responses are over-reactions resulting from the original triggering event.
Not opposed to supplements; many angles can be helpful
Until the conditioning of the brain is treated, it is tricky for other things to fully support healing
Evidence in these conditions points toward brain dysfunction
Gave rats sweet water with immunosuppressants; later gave just sweet water without immunosuppressants but led to same result
Burnt toast smoke moves toward the smoke detector, but it is an inappropriate response of the alarm
Brain cares more about survival than well-being
5-10% of patients with COVID experience symptoms for months; similar level as with EBV; secondary wave of Chronic Post-COVID-19 Syndrome follows a similar pattern; heightened awareness and fear from the media leads to more severe illness
Several patients with post-COVID syndrome using their retraining program
Amygdala and Insula Retraining: the brain is conditioned to react to chemicals but is re-wireable; brain is not fixed; it is neuroplastic.
Essentially software problems
Brain retraining can bring the system back to homeostasis
We will see more and more of these illnesses due to the pro-inflammatory environment, more chemical exposures, more stress
3Rs: Retraining, Relaxing the Nervous System, Re-Engaging with Joy
40% reduction in Fibromyalgia FIQ scores with their program in a recent study
Minimum 6 month program with 12 month money-back guarantee
Chemical and mold sensitivities seem to reduce dramatically in 2-3 months
Neurons that fire together wire together
If the brain is reminded of the original event while also under stress, the brain may trigger the protective response
In a vulnerable state, any chemical exposure can push the body over the edge
Amygdala in those with ACEs are more reactive
Unconscious retraining may occur in some people that have not been through the formal program; the brain may identify something they are doing at the solution and subdue the danger signals; not a placebo effect but a self-healing effect
EMDR is a deconditioning process with eye movements; attempts to do what they are doing; it is one tool; they have a similar tool as a part of their toolbox
A more holistic approach that is more than retraining; deep relaxation techniques are part of the Gupta program as well as diet and pacing components; focus on joy
guptaprogram.com

Lori Allen, RPh spoke on "Pharmaceutical Issues in Caring for the Chronically Ill" and shared:

Compounded medications can allow for adjustment of dosage strengths and forms
Use fillers that don't add to MCAS issues
Naltrexone (oral or topical; vivid dreams decrease over time)
Ketotifen (capsule, troche, solution; dizziness and drowsiness when starting; 8-12 weeks to get full effect; mast cell stabilizer)
Cromolyn Sodium (nasal, inhalation, oral solution, eye solution; mast cell stabilizer and histamine blocker)
Cholestyramine pure powder (constipation most common side effect; ox bile in addition to CSM a good option in those without a gallbladder)
Disulfiram (capsule; small amounts of alcohol can be very unpleasant; neuropoathy, garlic smell, avoid green tea)
Methylene blue (capsules; green urine; MAOI with SSRI can lead to serotonin syndrome)
EDTA (IV, nasal spray; biofilm disruptor; anti-fungal)
BEG spray (decreased in use)
Itraconazole/Ketoconazole
VIP (nasal spray)
Peptides (special FDA license required)

Mark Filidei, DO presented on "CBD and Related Cannabinoids in Neuropsychiatry" and shared:

When he started to explore CBD as a doctor, he could not find a good brand to carry.
Need to know where it is from, how it is extracted, what is in it/not in it.
Marijuana and hemp are both Cannabis sativa; THC level in the plant is the differentiator.
THC is the intoxicating component; CBD is non-intoxicating.
Gelcap may be 25-50mg when many studies are on 400-800mg; safe at high doses
CBD reduces anxiety and has effects on the limbic system
CB1 receptor is highly expressed in the limbic system, basal ganglia, and cerebellum; affects relax, eat, sleep, forget, and protect.
Strong neuroprotective effects of CBD.
Kids on the autism spectrum tend to have lower endocannabinoid levels
Hemp is <0.3% THC; Marijuana greater than 0.3%.
Entourage effect - the whole is greater than the sum of the parts

Ken Liegner, MD spoke on "'Repurposing' Disulfiram in the Treatment of Lyme Disease and Babesiosis: Retrospective Review of First 3 Years' Experience in One Medical Practice" and shared:

Interest in Disulfiram started after a talk from Kim Lewis, PhD in 2016
Dr. Rajadas and Dr. Pothineni found Disulfiram to have effects on Borrelia.
A patient brought this work to Dr. Liegner with an interest in trying it himself
Unclear if it is the Disulfiram or the metabolites that have the beneficial effects
His patient was kept well with several antibiotics for years; open-ended. When he would stop, he would relapse.
Asked Dr. Liegner if he could try Disulfiram.
Based on his experience and past failures, he was ready to try something different.
Disulfiram had been around for decades, but he had no experience with it. He educated himself and then authorized the patient use.
Gave a 3 month supply; canceled follow-up and declaring he was cured. He was, however, hospitalized for a psychiatric event.
This can be a side effect of Disulfiram, but the patient did not feel it was the drug and that even if it were, the patient said it was worth it.
Later mentioned to a couple of other patients that also had a dramatic positive response.
71 patients were treated with DSF; 4 lost to follow-up leaving 67; 62 of 67 endorsed a net benefit; 12 of 33 that completed one or two courses of high dose therapy enjoyed enduring remission of 6 more months; unable to determine if low dose achieved enduring remission.
Fatigue, psychiatric symptoms, neuroapthy, and liver enzyme elevations were observed.
Treated 6 weeks to 16 months.
Started early on with 500mg/day dosing but individualized dosing later evolved.
One patient has been well for 3 years; 9 more for 1 year after cessation of therapy.
15 patients were co-infected with Babesia; all reported improvement; 5 had enduring remission.
12 of 67 had Bartonella; 3 of 67 were positive for Bartonella and Babesia; 10 of 12 had some improvement.
May need concurrent Bartonella treatment
Some patients that have not responded to traditional antibiotics have responded to Disulfiram
EGCG is contraindicated; many herbs contain polyphenols and may need caution; he advises against using herbs with Disulfiram
Clinical follow-up at least monthly with regular testing to monitor treatment course
62.5mg every 3rd day and titrate upwards every 2 weeks with a max goal of 4-5mg/kg/day; lower doses still convey benefit. At target dose for 6-12 weeks then taper off over 2-4 weeks.
More data is needed on the utility of Disulfiram in Bartonella.
Dr. Sapi has shown that biofilms exist not just in test tubes but in patients with Lyme disease.
Organisms in biofilms are 1000 fold more resistant to antibiotics.
In a patient that had died, biofilms were seen in liver, brain, and other locations.
The mechanism of Disulfiram in Lyme remains unknown
Breakdown of Disulfiram is carbon disulfide which is potentially toxic and antimicrobial.
Carbon dioxide and carbon disulfide are close in size; carbon disulfide may be better able to penetrate biofilms than traditional antibiotics
Can react to hand sanitizers with alcohol.
Has seen some nausea; often related to alcohol that was not obvious
Vinegar often has traces of alcohol
Polyphenol concern is from a mouse model; has not been seen in humans; best to be cautious
Had a patient with skin eruptions on Disulfiram that did fine with a compounded, clean version; may have triggered mast cell activation.
Half life is about 2 weeks
Tapers off now to minimize chances of psychiatric event when stopping too quickly; may be the result of a dramatic drop in dopamine leading to anxiety and depression
May not be obvious what improvement the patient is having until after they have been off Disfulfiram for 1-3 months
Copper can damage the myelin in Disulfiram use
Had a patient that developed severe neuropathy and required Gabapentin; neuropathy resolved after several months; ultimately did very well.
His article has been downloaded more than 20,000 times since it was published; indicates the thirst for better tools
Not a miracle or panacea but another tool in the toolbox

Dietrich Klinghardt, MD, PhD spoke on "Lyme Treatment Options":

Causes of neuroinflammation: neurotoxins (mercury, aluminum, glyphosate, fluoride), pathogens, head trauma, autoimmunity, aging (more toxins/infections; decline in melatonin and B12), vascular, exposure to microwave
Autoimmunity does not exist without the presence of microbes or toxins inside the cells
Chronic COVID affects the vasculature
Alzheimer's disease is a neuro-spirochetosis; treating Lyme to preserve the brain is a huge task for all of us
Half of us will die with or of Alzheimer's.
EM rash is second strike; were already infected previously; observed in 10% of patients
If we have a pandemic, it is a pandemic of Lyme disease; not of anything else
Estimated genes in Borrelia over 1,000
Cysts survive hydrochloric acid; survive 400 degrees; indestructible; once you have Lyme, you have to find a truce with the bugs and find peace and a normal life
When Lyme is undertreated with Doxycycline, you developer permanent round bodies and biofilms with later autoimmune disease
Ideal treatment should include immune modulation like LDI which keeping the microbes in check
Looks for and find Lyme in autism; treating it is a big breakthrough
Differentials: heavy metals, environmental illness, mold exposure; usually all of these are concurrent with Lyme
At least half of mold patients improve when Lyme disease is treated properly
Treats mold more lightly; metals more heavily
When you look carefully, everyone has Mycoplasma; may use EVOO or ozonated plant oils
Once immune suppressed, you get parasites, mold colonization, and viruses.
Mosquitos - 15-20% carry Lyme, spiders, flees, lice; these may not be as bad as the presentation after a tick bite or it may taken longer to decline
EliSpot is more sensitive than the traditional blot testing.
Best test: ultrasound provoked co-infection urine (6 hour collection) PCR test (DNA Connexions)
DNA Connexions lifted the bar up and the detection rate has gone down; no longer uses
Helpful lab tips: moderate LDL elevation, elevated triglycerides, insulin resistance, borderline low WBC, low MSH, high TGFb1, high MMP9, high C4a, low normal thyroid, phase 2 adrenal failure, low normal alk phos (low zinc/KPU), decreased urine concentration
Normal WBC of 6000-7000 is not active Lyme disease
Deficiency of ADH is an issue in his Lyme patients
Yersinia can lead to joint problems
Patients with Bartonella often have cats
Most common cause of Lyme disease in Seattle is from spider bites; more common than tick-bite West of the Mississippi
Disulfiram has led to some major miracles; starts with lower doses liposomally prepared; often starting with 10mg once per week and working up to 50mg twice a day; may take months to get there; can have serious side effects
Should always be used with Benfotiamine or B1.
Likes to use LDI/LDA when neuropathy occurs
Bartonella may lead to joint problems, dental problems, cavitations, anxiety, OCD
Methylene blue and Zithromax may be helpful in Bartonella; starts with low dose 10mg daily and working up; have seen some unpleasant side effects that led to stopping treatment
Aluminum is a growth factor for the growth of Lyme; use ionic footbath
2020 study showing Cryptolepis, Black Walnut, Japanese Knotweed, Artemisia, Cat's Claw, Cistus incanus, Scutellaria baicalensis for Borrelia
Main treatment: Cistus tea powerful antimicrobial, Zeolite or Chlorella, KiVita or Cocktail
The herbs often lead to higher ground in antibiotic treatment failures
Cistus tea is the foundation of his protocol
For mold colonization, uses O3 Gamma and uses propolis vaporizer to treat the home
Use sauna, acupuncture, neural therapy, microcurrent, sound, light, magnetic fields, ultrasound as tools in the physics realm.
Artesunate, Ozone, cavitation surgery, hyperthermia with IV antibiotics, Hypothermia, Desferal, DMPS, liposomal cocktail, high dose melatonin, bee venom are helpful tools.

Theoharis C. Theoharides, MD spoke on "The Role of Mast Cells on Brain Syndromes Involving Inflammation" and shared:

Inflammation is a defense mechanism of the body that is a response to both real and perceived dangers; can become destructive if not controlled
Systemic cytokine storm is called sepsis
EMFs can contribute to brain inflammation
Cachexins, EMFs, metals, herbicides, inflammatory cytokines, mitochondrial DNA, mycotoxins, neuroendocrine disruptors, neuropeptides, ROX, toxins, venoms, viruses, xenobiotics all contribute
COVID-19 may trigger a CIRS-like condition
Long-haulers survive COVID-19 and months later have numerous complications; has several names in the research; impacts lungs and vascular system
MMP-9 is pro-inflammatory; TGFb1 is anti-inflammatory.
Mast cells increase blood-brain barrier permeability and permit focal inflammation of the brain; specifically in the hypothalamus and amygdala
Mast cells may play a role in POTS, Fibromyalgia, IBS, CIRS, vasculitis, CFS, anxiety, depression, autism, MS, and many more.
Multiple chemical sensitivity involves mast cells
We only know how to address a few of the many substances that are released from the mast cells
Degranulation releases Chondroitin sulfate, Hemokinin-1, Heparin, Histamine, Leukotrienes, Prostaglandins, TNF, Tryptase, and more.
Can also create many interleukins and chemokines; as well as VEGF.
Mast cells respond to heavy metals including mercury and aluminum; as well as atrazine and glyphosate
Mast cells respond to pretty much anything you can imagine
Mast cells respond to Borrelia, fungi, and mycotoxins.
Mycotoxins are very high on the list of triggers for many individuals
"Mastopsychosis" is a term coined for psychological symptoms following mast cell activation
Some patients may not have a mast cell problem but may still have an inability to breakdown biogenic amines (missing DAO); histamine intolerance
Dark circles or allergic shiners under the eyes in children is an allergy or intolerance
Testing: IgE, IgG (1 and 4), Anti-IgE receptor antibody (chronic itching can be autoimmune), Food Intolerance, IgE RAST for alpha-gal, casein, gluten, dust mites, fungi, grass, pollens), IL4, 6, 31, TNF, PGD2, Tryptase; can all be negative; then 24 hour urine or first morning Methylhistamine or MIA (methyl imidazole acetic acid), 23BPG.
Food testing: rice and chicken only for a few days before testing to avoid foods commonly consumed
Histamine is necessary for motivation and learning; you can take too much anti-histamine; too much can lead to brain fog
Antihistamines: Cetirizine, Cyproheptadine (migraine prevention), Diphenhydramine (dye free), Hydroxyzine (good for sleep), Ketotifen (anti-eosinophilic), Loratadine, Rupatadine, Amitriptyline, Doxepin, Promethazine, Prochlorperazine
Mastocytosis occurs in 1 in 2000 people
More correctly mast cell mediator syndrome, not mast cell activation syndrome
Cromolyn sodium does not inhibit mast cells; blocks in rat but not in humans; less than 5% absorbed; if it works, it is largely in the gut
Montelukast and Omalizumab may be used in Mastocytosis. Omalizumab is anti-IgE but seems to reduce reactivity of mast cells as well.
Mast cells play a role in interstitial cystitis, Fibromyalgia, CFS.
Mast cells can selectively release different mediators to different triggers
Prenatal stress impacts the child's potential for atopic conditions
The mast cells are the canary in the coal mine
Stress can be a major trigger for mast cells
Prenatal stress increases the risk of autism; autism may be an allergy of the brain
Mast cells lead to microglial activation
Fungi and mycotoxins stimulate mast cells and microglia
Mast cells impact the amygdala and lead to a lower fear threshold
Avoid allergens, colorings, deodorants, perfumes, EMFs, flame retardants, heat, histamine foods, plastics, preservatives, stress
Histamine-rich foods: avocado, ripe tomatoes, cheese, nectarines, sardines, spinach, spices, tuna
IL-37 and IL-38 are new anti-inflammatory molecules
Luteolin reduces ROS, inhibits inflammation, inhibits mast cell activation, inhibits microglial activation, inhibits neurotoxicity, weak metal chelator, improves memory.
20% of people are phenol-intolerant and may not tolerate.
Methoxyluteolin is not a phenolic; inhibits mTOR, mast cells, and microglia
G6PD present in 20% of Mediterranean people; cannot tolerate fava beans which is where quercetin and luteolin are derived
Treatment in children: Hyperactivity (Hydroxyzine, Propranolol, Clonidine, NAC), Inflammation (Luteolin, D3), Neuronal fatigue (Folinic or methylfolate, selenium, SAMe), OCD (Aripiprazole, Risperidone)
Mast cells exist in the lungs; luteolin and Rupatadine may be helpful prophylaxis in COVID
Most focus on quercetin due to lack of knowledge of luteolin
Less than 10% of polyphenols are absorbed in the gut; GI accumulation can inhibit gut microbiota; need to make liposomal
Rutin is cheap and not very useful
Methoxyluteolin is not available orally as it is expensive to purify
Rupatadine may be a better option than Ketotifen.
Mast cells secrete approximately 100 different molecules.
People may adapt quickly to CBD and need more and more; at higher levels may have some negative neuro-psych effects; are receptors in the mast cells; not against trying it; can be helpful in seizures.

Dale Bredesen, MD spoke on "Precision Medicine for Neurodegenerative Diseases" and shared:

Dementogens are a huge issue in Northern California from the recent fires.
By 2015, 13% of first responders at 9/11 developed cognitive decline
Toxins and toxicants play a major role in neurodegeneration
Parkinson's, Alzheimer's, ALS all associated with various environmental toxins
Master Switch of Alzheimer's is APP; can be synaptoblastic or synaptoclastic
Type 1: inflammatory
Type 2: atrophic
Type 1.5: glycotoxinc
Type 3: toxic
Type 4: vascular
Type 5: traumatic
25% have a dominant Type 3; over 60% have association with toxicity
Goals of treatment:
- Energetics: ketosis, cerebral blood flow, oxygenation
- Insulin Sensitivity
- Trophic Support: growth factors, hormones, nutrients
- Resolution of inflammation
- Alzheimer's is like COVID-19 with innate immune activation over many years
- Treatment of pathogens: optimizing various microbiomes including GI, oral, sinus
- Detoxification
- Stimulation: light, magnetic, brain training
- Improve adaptive immune system and reduce innate immunity
- Reducing amyloid-beta (after the fire is out!)
- Large loads of amyloid are not particularly toxic
- Regeneration: synaptogenesis
Developed a ReCODE Mobile App to track the various factors involved
Achieving the biochemical goals
- Energetics
  - Endogenous or exogenous ketosis, KetoFLEX 12/3, exercise (Kaatsu, EWOT, strength training), sleep, stress reduction
  - Want 1.0-4.0 mM Bhb or > 7 ACEs for ketosis
  - 2/3 of people with Alzheimer's are apoE 4 positive
  - KE1 combination of ketone salts and esters
  - EWOT turning out to be helpful in increasing oxygen and induces nervous system to create more trophic support
- Cerebral blood flow: EWOT, optimizing vascularity, minimize inflammation, nitric oxide, ginkgo, vinpocetine; if thrombotic tendency, pycnogenol or nattokinase
- Oxygenation: want nocturnal SpO2 to be 96-98; explore sleep apnea, EWOT
- Mitochondria: ubiquinol, nicotinamide riboside, PQQ, ketones, methylene blue
- Insulin resistance
  - Virtually universal; KetoFLEX, plant-rich, high fiber, grass fed meat, wild caught fish, high choline, high good fat, intermediate protein, low carb
  - Strength training
  - Insulin Support: Magnesium, zinc, D, chromium, Ceylon cinnamon, R-ALA, berberine, NAC, bitter melon
  - Continuous glucose monitor insights very helpful
  - RX Januvia or Victoza
- Trophic Support
  - BDNF, NGF, whole coffee fruit extract, ALCAR, Lion's mane, exercise, TB4, Cerebrolysin, VIP, insulin
  - Optimize hormones
  - Estradiol, progesterone, testosterone, pregnenolone, DHEA, thyroid, cortisol
  - Nutrients: B12, D, choline, omega 3
  - Need 550 mg per day of choline
- Resolution of inflammation: pro-resolving mediators, omega 3, curcumin, ginger
- Remove causes: leaky gut, periodontitis, sinusitis, mycotoxins, pathogens, lack of sleep
- Treat the pathogens
  - Oral DNA; Dentalcidin/Revitin
  - Identify chronic pathogens such as Lyme and co-infections and mold spores
  - Heal the gut (DGL, bone broth), Sacc B, pre/pro biotics
- Detoxification
  - Most difficult part; metals, inorganics, organics, biotoxins
  - High fiber, filtered water, sauna/sweating, non-toxic soap, NAC, liposomal glutathione, Sulforaphane, ascorbate
  - Targeted detox for mercury, copper
  - Shoemaker or Nathan Protocol for biotoxins
  - Most common reason for failure to improve other than lack of compliance
Reasons for failure: not identifying contributors, reduced SpO2, not achieving ketosis, not improving vascular flow, not resolving inflammation, stress, biotoxins/toxins, not healing the innate immune response, not including BHRT, not using a health coach, doctor shopping, not continuing to optimize
Toxins play a major role in neurodegenerative diseases; now the third leading cause of death
Alzheimer's shall become a former scourge

Dietrich Klinghardt, MD, PhD responded to questions and shared:

Trees have their own detox system: the pine needles or leaves; inhale toxins in the air; 100 times more mercury in California air than 200 years ago; trees outgas mercury and aluminum and even glyphosate
Dr. Mary Ackerley has seen highest TGFb1 recently; found that particulate can increase; the smokes from the fires may be triggering elevations of TGFb1
He uses DMPS, Desferal, propolis, glutathione, selenium, Enula (lung support), sauna, colonics
Toxicants may be in the blood for six weeks and then are deposited more deeply; need to focus urgently on detox
Bartonella is not easy to treat
Has not used antibiotics for treatment of Lyme and co-infections in many years; uses the "Cocktail" which is a liposomal herbal preparation
Japanese Knotweed better than triple antibiotic therapy
Bartonella: propolis and calendula
Likes to use Heparin for a few months; phenomenal addition in the treatment of Bartonella
Dr. Ackerley mentioned 100% of feral cats have Bartonella; probability of flees without Bartonella is low
In early COVID, sprays throat with propolis and eyes/nose with HOCL.
COVID found in various tap water, food delivery packaging
Anything inflammatory or autoimmune is triggered by something that is really there; an infection or toxin
There is no antibiotic that treats spirochetes inside the nerves where they are
In Alzheimer's, do not overlook the spirochetes in the brain; we may not get to the places in the body that are leading to triggering of the immune response
Wonderful success in half of those on Disulfiram, but not all of them
Had a pandemic of Lyme disease for 30 years that no one in academia ever paid attention to

Bruce Hoffman, MD spoke on "Integration of Complex Systems into a Structured and Staged Diagnostic and Treatment Approach - 7 Stages to Health and Transformation - From Illness to Illumination" and shared:

Everyone desires to be the best they can be
Patients may have sickness and disease; where do practitioners enter into the system / what is their responsibility?
Can't treat patients on a physical level only
Can't treat the body as a machine
When something cannot be named, it is dismissed as being "all in your head"; a great tragedy of medicine
Types of medicine: regulation, substitution, and suppressive
The wounded healer sees the sick and healthy part of the patient
How much inner-work has the physician done on themselves?
Not all healing is from a remedy; an internal journey is required
Five Koshas, 5 Levels of Healing, and the 7 Stages to Health and Transformation
Stage 1 - Environmental Toxins
Stage 2 - Physical-Biochemical/Structural
Stage 3 - Energy/ANS/Mitochondria
Stage 4 - Emotional/Trauma
Stage 5 - Intellectual/Ego/Defenses
Stage 6 - Soul/Authentic Self/Personal; Family Soul
Stage 7 - Spirit/Unified Field/God
Health is more than the absence of disease; a harmonious relationship between all levels
People may be more outward focused in the first half of life and more inner-focused in the second half of life
Often need a new image, story, or internal dialog to heal

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.

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