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ISEAI 2022: Cultivating Resilience: The Environmentally Acquired Illness Framework Part 2

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I had the honor of attending the ISEAI 2022 event "Cultivating Resilience: The Environmentally Acquired Illness Framework" on September 16-18, 2022.  

It has long been my opinion that many of the complex conditions we face today are the result of our external environment.  ISEAI is a leading organization sharing this message; as well as fostering collaboration and sharing solutions to improve the quality of our lives.

I strongly encourage practitioners working with complex, chronic illnesses to join ISEAI; become part of the conversation and ultimately the solution.

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.

Mark Su, MD spoke on "Introduction to ISEAI Framework Pt II: Interfaces, Self, Systems" and shared:

  • Exposome, self, and interfaces between the exposome and the self
  • We are all reservoirs of bugs and toxins
  • Exposome includes: subclinical pathogens, biotoxins, synthetic toxins, food reactants, environmental allergens; these can impact the immune system depending on the health of the interfaces
  • Internal self includes: immune system, hormones, mitochondria, micronutrients, neurotransmitters, blood-brain barrier, genetics, and autoimmunity
  • Interfaces include: gut, respiratory tract, skin
  • "Back 9" are MCAS, SIBO, hEDS, hypercoagulation, dysautonomia, ECM dysfunction, sleep disorders, malnutrition, mental health/limbic dysfunction; not generally the causes 

Jill Carnahan, MD spoke on "The Gut-Lung Axis:  Where the Microbiome Meets the Immune System" and shared:

  • Environmental toxic load is increasing day by day; impairing immunity
  • Fatigue, memory issues, sleep issues, headaches; cancer, autoimmunity, neurodegenerative diseases
  • Internal/endotoxins contribute to total toxic load as well; particularly from the gut and the lungs
  • How full is your bucket?  The goal is to create margin in your bucket.
  • Dr. Jill grew up on a farm and had severe allergies, asthma; later developed breast cancer which she believes was contributed to by environmental toxicants
  • Atrazine usage was high in the areas where she grew up; still used today in the US
  • Mycotoxins have wide-ranging, health-negating effects; avoidance is key
  • Mycotoxins recirculate without binder and cholagogue interventions
  • Chemical exposures can lead to inflammation and autoimmunity
  • Water-damaged buildings have a toxic soup that goes far being just mold
  • Bioactivation of mycotoxins into toxic compounds depends on the microbiome
  • Mycotoxin exposure can negatively impact the microbiome and the gut barrier
  • LPS antibody testing can be done through Cyrex; zonulin testing can also be helpful for testing permeability
  • Trichothecenes are probably the worst; can contribute to food reactions, allergies, histamine/MCAS
  • Inhalation is the primary exposure, but food can be a source of mold/mycotoxins; can lead to blunted villi that appear similar to results of Celiac
  • Zinc, D, A, probiotics, glutamine, bovine immunoglobulins can help with intestinal permeability and LPS
  • Mold exposed patients may be immune compromised; mycophenolic acid impacts immunity
  • Fungal colonization may be present on tongue, in sinuses, lungs, gut
  • Fungal dysbiosis leads to more and more sensitivity to foods and more leaky gut
  • Stool culture, organic acids (arabinose, citramalic acid, beta-keto glutaric acid), immune response to Candida IgG, IgA, IgM and Candida antigen
  • Treatment for fungal dysbiosis: Fluconazole, Nystatin, Amphotericin B; undecylenic acid, caprylic acid, garlic, berberine, oregano, Pau d 'Arco, olive leaf
  • Inhaled, nasal, and oral options may be used 
  • IL-17 regulates antifungal immunity
  • Colonization was lower in mice using coconut oil
  • Majority of our exposure is from the air we breathe; clean air is the most important thing we can do for health
  • 2.5 micron or smaller particulates can go through alveoli and into bloodstream; more toxic than items consumed through the digestive system
  • Reactions to the detergent aisle at the store can be a clue for MCAS
  • Has 5 air filters in her office and 3 in her condo; invest in air filters; particularly in the bedroom
  • Butyrate has become a favorite in long COVID and as an anti-inflammatory
  • Bacillus subtilis increases the production of SCFAs
  • SCFAs will likely be a key player in the post-COVID world; can modulate inflammation and immunity
  • Taught that autoimmunity not treatable; now calls it "reversible autoimmunity"
  • Intestinal permeability: NSAIDS, SIBO, celiac, protozoa, mold, toxins, food allergies, and other contributors; intensive exercise training makes it difficult to resolve intestinal hyperpermeability
  • Uses fecal calprotectin and fecal zonulin regularly
  • Metabolic endotoxemia is when innate immune response and inflammation persist due to LPS and increase in endotoxins; gram-negative bacteria outer cell wall leaking from gut into bloodstream
  • Can have increase in first 3-5 hours following a meal; can reduce load with intermittent fasting
  • Toxicity depends on the type of fat in the diet; saturated fats create a more toxic effect; coconut oil leads to the most increase in LPS; cod and fish oil reduce endotoxins
  • Still uses keto and saturated fats; but thoughtfully in specific patients
  • Sites far away from the gut can be impacted by LPS endotoxemia
  • Insulin-resistance underlies many conditions and can be developed due to prolonged exposure to endotoxins
  • Metabolic endotoxemia is underlying many different conditions and diseases; leptin resistance, constipation, mood/appetite disorders, depression, cognitive decline, memory loss, anorexia, anxiety, chronic pain, Parkinson's, hypogonadism, autoimmunity, psoriasis, Scleroderma, atopic dermatitis, acne, vitiligo, rosacea, and more
  • Has found Bartonella underlying chronic, severe, scarring acne cases
  • You name the disease and you can find a connection to endotoxemia
  • Increase fish consumption, dietary fiber and prebiotics, whole plant food
  • Soluble and insoluble fibers leads to SCFA production
  • Reduce LPS inflammation: exercise, quercetin, curcumin, sulforaphane, resveratrol, EPA/DHA, Bifidobacteria, MegaSporeBiotic
  • Bifidobacteria may mitigate the potential downside of a high-fat diet
  • Bovine immunoglobulins bind many pathogens
  • Bacillus subtilis and bacillus coagulans are two of her favorites
  • Support detox: elimination diet, 5R program, coffee enemas/colonics, stool bulking, fibers, spores, fish oil, SPMs, cholagogues, bovine immunoglobulins
  • Limit fibers until dysbiosis, SIBO, SIFO treated
  • SCFAs are key mediators for the immune system and inflammatory reactions
  • Metabolic endotoxemia is a leading cause of mortality and morbidity worldwide
  • Bacillus can increase butyrate production by 38%
  • Some probiotics can increase histamine; Lactobacillus casei for example
  • Often starts with one spore Bacillus subtilis or coagulans; or Bifido probiotics only which tend to lower histamine
  • Prebiotics are great and help diversity but can make people worse when they have microbial overgrowths
  • Post-COVID -> T-cells going down; less ability to recognize self vs. danger; confused immune systems
  • Sees improvement with butyric acid of all sorts; butter, ghee, supplements
  • There is no evidence that larger numbers or strains of probiotics increase diversity
  • Coffee, cocoa, chocolate are often contaminated with mold and mycotoxins; grains are most contaminated food group
  • Urine mycotoxin testing is helpful; but never uses as the single piece of information
  • Stachybotrys and Chaetomium are rarely found in foods

Tom Moorcroft, DO was interviewed on "Sinus and Blood-Brain Barrier Impacts" and shared:

  • Information comes from the nose to the limbic system
  • Bartonella likes to go intracellular into microglia
  • People with Lyme and Bartonella often have issues with mold toxicity and MCAS
  • Mold and Bartonella both impact the microglia; need to bring down inflammation
  • Breathing such as Buteyko, saline, and other approaches can open up the sinuses; can be a starting place to open the drains before using antimicrobials; improves detoxification
  • Sees a lot of insomnia; stuffy nose, dental problems; mouth breathing
  • Need to look at the full drainage of the glymphatics for getting out the dirty water which requires good posture
  • Head forward postures slows drainage
  • The more you breath through your mouth, the more the brain will be inflamed and the more poorly you will sleep 
  • COVID inflames the olfactory tissue
  • Best way to support the sinuses is to close your mouth
  • The best way to open the nose is to breath through the nose
  • Significant congestion often resolves with Buteyko breathing
  • Become aware of your breath 5 minutes before bedtime
  • A little bit of saline can be helpful; then moving to herbal or medical approaches if needed
  • 30% of the drainage of the brain happens through the sinus area
  • Killing sinus organisms too early can lead to more inflammation and more sinus issues

Ann Marie Fine, NMD spoke on "Dermatological Considerations and Environmentally Acquired Illness" and shared":

  • Skin is also an immune organ
  • Pollution is a factor in skin aging
  • Airborne particle exposure plays a role in skin aging; can lead to age spots
  • Phthalates are ubiquitous toxicants found in vinyl floors, shower curtains, rain coats, wall coverings, food containers, personal care products, air fresheners, medical device, IV tubing, new car smell
  • Phthalate exposure via oral, dermal, inhalation, dust
  • 75-100% have daily phthalate exposures
  • Face masks may be a source of phthalates; sanitary napkins, paper diapers, toys
  • Face masks lead to exposure through dermal absorption, ingestion, and inhalation
  • Twelve phthalates were found in 56 mask samples taken from different countries
  • 89.3% of masks exhibited potential carcinogenic effects to humans
  • Can find microplastics in the lungs from mask wearing
  • Phthalates may play a role in breast cancer
  • Some medications ay contain phthalates as a coating
  • Nail polish, fragrances, and hair spray may contain phthalates
  • Become educated on personal care products, fragrances, laundry products
  • BPA is not a persistent pollutant but is ubiquitous
  • Formula-fed babies had higher BPA than breast fed
  • Thermal paper receipts an increase exposure to BPA
  • BPA found in 96% of pantyhose
  • BPA involved in fertility issues, cardiovascular, breast/prostate/colon cancers, endometrial hyperplasia, PCOS, immune issues, insulin sensitivity, obesity, diabetes, decreased sperm, autoimmunity
  • Rice cakes and rice are sources of arsenic
  • Aluminum exposure can be dermal; drinking water, vaccines, drugs, antiperspirants, cosmetics, pesticides, food
  • https://madesafe.org
  • https://millionmarker.com
  • https://emeiglobal.com 

Rachaele Caver Morin, DMD spoke on "Interaction between Interfaces & Immune System" and shared:

  • Conventionally trained
  • Developed a chronic skin condition/eczema; was prescribed a cancer drug to shut down her immune system
  • Took wheat out of her diet for 4 weeks which notably cleared up her skin
  • Next level was emotional and trauma work
  • Body knows how to heal itself
  • Two months on parasite products from CellCore which resolved her eczema; has not come back in two years
  • Dentistry is one of the most toxic professions
  • Plaque in arteries contains oral bacteria
  • Chronic disease is a result of toxins and their downstream effects on the systems of the body; biotoxins, emotional toxins, chemicals
  • All disease begins in the gut; which begins in the mouth
  • Cavitations are breeding grounds for bacteria and parasites
  • 80% have some degree of gum disease
  • Teeth marks on a tongue can be hypothyroid or liver/gallbladder issues
  • Oral bacteria are linked to health challenges throughout the body
  • The terrain is what matters; not the germ
  • Fungus is a big player in the oral cavity and the sinuses
  • Leaky mouth is a similar concept to leaky gut or leaky brain
  • Each tooth is its own organ; own nerve, own blood supply, own lymph system
  • Vagus nerve innervates every part of the digestive organs; oral toxicity can impact the vagus nerve and thus digestion
  • Should spend 80% of our time in a parasympathetic response; probably more like 80% sympathetic/dorsal parasympathetic
  • Infection of vagus leads to lower stomach acid and bile release -> no absorption of fat soluble vitamins -> weakened enamel and bones
  • Perio patients: lacking C, D, CoQ10, folic acid, mineral cofactors trace elements, NO precursors; imbalance of acid/base; periodontal disease is autoimmunity: Leaky gut, inflammation, dysbiosis
  • Cavity patients: lacking minerals, iodine, selenium, irone, copper, manganese, D3/K2, A
  • Treats gum disease patients just like autoimmune patients
  • Weston Price found 10x fat soluble vitamins and 4x calcium and other minerals in healthy populations compared to modern American diet
  • Caries are the #1 chronic disease in children; declined from 70s-90s and then rapid increase
  • Teeth are circuit breakers; 90% of cancers have an infected tooth on the same meridian
  • Root canal teeth can lower voltage along the circuit by 60%
  • Tooth meridian chart
  • Can you re-mineralize and regrow teeth?
  • No biological function for fluoride; WWII waste product
  • Fluoride works topically by poisoning the bacteria; but also poisons the good bacteria; linked to lower IQ
  • Pure titanium should not lead to an immune response, but there are other metals on implants that lead to cytokines/RANTES elevations
  • 2% lidocaine can lead to mitochondrial injury
  • Does not use epinephrine as it cuts off the blood supply
  • Lower wisdom tooth sites are common sites for cavitations; dry sockets mean that the blood clot came out and the bone did not heal
  • Sees elevation of CCL5/RANTES in many chronic conditions
  • Dentistry is the only profession that leaves a dead organ in the body
  • Ari Whitten has concluded that adrenal fatigue doesn't exist; mitochondrial dysfunction does
  • Biological dentists use different diagnostics, SMART/Protect certified, least toxic materials, no lidocaine or epinephrine, nutritional support, detox protocols, homeopathy, Ayurveda, energy medicine, lasers and light
  • Are patients pooping? Are they hydrated?  What is the diet?  Are they committed to health?  What about emotional health?
  • https://iaomt.org  
  • https://iabdm.org 

Mark Su, MD spoke on the "Interaction Between Interfaces and the Immune System" and shared:

  • The weaker our interfaces and the greater the bug and toxin burden, the more impact on the immune system; chronic inflammation; chronic, complex illness
  • What aspect of the immune system is reactive?
  • Could there be insufficient Th1 response to deal with infection due to Th2 dominance
  • Is Th2 dominance due to Th1 burnout or to extracellular parasites, asthma, and allergy
  • Th17 response could be extracellular bacteria or fungi (including Candida)
  • Mucosal immunology work of Alessio Fasano, MD; put leaky gut on the map; discovered zonulin as a primary regulator of leaky gut
  • Communication can exist between nasal and genital mucosa
  • Presenting antigen in the nasal tract can lead to induction of immunity within the vaginal tract
  • Gut/brain axis is a two-way street
  • Health of gut microbiome correlates to COVID-19 severity
  • There is a respiratory microbiota just like there is a GI microbiota
  • Three part framework is a framework for learning, awareness, understanding

Samuel Yanuck, DC was interviewed on "Functional Immunology of Environmental Exposures" and shared:

  • He works to build a map of what he thinks are the components of an individual's biology
  • Then overlays blood work/lab work on top of that
  • Every cycle of working with a patient is diagnostic and therapeutic
  • There are too many variables to know for sure what is going on
  • M1 macrophages run on glycolysis
  • Th1 system is essential for antibacterial, antiviral, cancer
  • If M1 macrophages are unfueled, cannot get NK cells and Th1 cells working; metabolic issues are enormously important
  • Tick-borne illnesses, mold illness also dysregulate metabolically and tank the Th1 system
  • Don't need there to still be Lyme or mold for the persistence of this loop to continue
  • Adaptive immunity is T/B cells
  • Normal housekeeping of the immune system is important
  • Normal immune response can lead to inflammation and can be appropriate
  • The resolution phase of the inflammatory process is an actively signaled event; fish oil essential
  • NFkb co-activated STAT3 which causes naïve T-cells to become Th17; primary players in tissue destruction component of autoimmunity
  • Once autoimmune disease is present, it is not about the initiator of the mistake
  • Infection is often an initiator of autoimmunity
  • An infection may have been the trigger, but the autoimmunity may be more about Th17 than about then re-treating the infection
  • Anything that turns on NFkb will activate STAT3 and lead to more Th17 and more autoimmunity
  • Inflammation upregulates TNFa and IL-6 which lead to naïve T-cells becoming Th2 cells and glycosylated antibodies
  • Glycosylated antibodies are more aggressive in their attack of their target
  • Goldilocks zone in terms of how much tolerance you want vs. how aggressive to attack pathogens
  • Don't always want to start by reducing inflammation; promotion of greater tolerance may give less surveillance of pathogens
  • Th9 comes from curcumin, D, and fish oil; but TGFb1 goes up and Th2 dominance goes up
  • T-cell polarization issues are enormously important
  • Chronic inflammation is a driver of sympathetic activation and stress chemistry leading to programmed cell death of NK cells and Th1 cells
  • Mast cells is a reflection of Th2 dominance
  • Pesticides and xenoestrogens depleted glutathione
  • Cannot have Th1 without glutathione
  • Many with chronic illness are Th2 dominant
  • We are all reservoirs of bugs and toxins
  • Th1 cells are not the drivers of autoimmunity
  • Th1 and Th17 were grouped previously, but they are different; Th17 is the driver of autoimmunity
  • IFN-y from Th1 inhibits Th17 cells from doing damage; loss of Th1 leads to Th2 dominance and lack of inhibition of Th17
  • Th1 Support, Th2 Modulator, Innate Immune Support (NK Support) products from Pure Encapsulations
  • Immune system is not one thing that goes up and down; more like a football team; looks identical but all play different positions and do different things
  • COVID may reveal a defect in immune choreography
  • Some may have a genetic SNP that leads to a higher baseline level of inflammation
  • Baseline background of viral and bacterial burden; should not be trying to sterilize people
  • No one has chronic Ebola; some pathogens will not be symbiotic; others are
  • May have EBV and not matter; as one gets older, chronic viruses may lead to more heart disease due to immune grinding leading to inflammation over time
  • Bacteria and viruses are "tolerated"
  • Pesticides and xenoestrogens are predisposing variables that create vulnerability
  • Causal pie theory: triggers, sustainers, amplifiers, hinderers
  • Golf courses are pesticide clouds; uses up glutathione; cannot sustain a Th1 response
  • Loss of Th1 is a loss of anti-cancer surveillance 
  • Acute illness like tick-borne illness or mold exposure create a bigger shift
  • Mold is a massive Th2 promoter; Th1 tries to kill but hollow spaces are lined with epithelial cells; when they get inflamed, Th2 is promoted; mast cell degranulation is promoted
  • Pre-frontal cortex inflammation leads to fatigue and brain fog
  • Vagal nerve inflammation will diminish migrating motor complex, peristalsis and lead to SIBO
  • Mold exposure can be enormously important, but the exposure does not have to persist for the cycle of immune dysregulation to persist
  • Need to break up enough loops so that the sustainability of the dysfunction falls apart
  • If a baseball breaks a window, is it cold and wet in the room because of the baseball or because you need to fix the window?  In the vast majority of people, it is not the baseball anymore?
  • Need to ensure there is not too much or too little TGFb1
  • Chronic illness is not about the original target, but about the resulting biological destruction 
  • Plastics, pesticides lead to tipping away from adequacy of Th1 response and tipped towards Th2
  • Blue light is a diminisher of Th1
  • Average patient has dysbiosis and inflamed intestinal epithelial leading to Th2 dominance and MCAS
  • Stress leads to inflammation and Th2 dominance
  • Population is inflamed and Th2 dominant at baseline
  • Want to downregulate Th2, support Th1 first; then inhibit inflammation
  • Overlap between MCAS and POTS
  • Aldehyde dehydrogenase gets rid of histamine and aldehydes; perfume intolerance may be ALDH and over-burden of histamine leading to intolerance to aldehydes
  • Molds offgases aldehydes as well; using up ALDH leads to more intolerance to molds
  • Should only have ATP inside the cell; if a cell dies, ATP is released as a danger signal
  • Should never take a supplement that has "ATP" in it; gigantic inflammatory signal
  • What if there was a pathogen for which there was no pathogen recognition receptor?  Have a fallback system but creates a huge amount of inflammation.
  • M1 and M2 are macrophage polarization; Th1 is the M1 macrophage; kills things
  • M2 macrophage is a cleanup macrophage; can oscillate between M1 and M2 state
  • Being hypoglycemic will wind down M1 macrophages and Th1
  • Autophagy is inhibited by IL-4 of the Th2 response; shifting back to Th1 leads to autophagy repairing brain cells
  • Macrophage polarization is done by influencing Th1/Th2
  • In terms of biologics, tools are tools; can be amazing; none of the T-cell polarizations are inherently wrong; chronicity is where things become inappropriate
  • Humans cannot live without fire; a forest fire is not a good idea
  • There are IL-4 biologics; biologics are a decisive inhibition rather than a Goldilocks zone; should be a "tried everything" option
  • May still have a place to rescue/shutdown a process to then do more work
  • Natural is not always better; natural is good if you are not in a position of rescue

Nafysa Parpia, ND spoke on "Complexities of Tick Borne Disease Through the Lens of the Cell Danger Response" and shared:

  • Generally finds that antibiotics don't work for her patients
  • Killing infections leads to increase in cytokines and toxins; as well as inflammation
  • Everyone benefits from detox, but in her patients, it is mandatory
  • Detoxify prior to killing infections to improve tolerance
  • Treating the cause is typically not the resolution of a complex, chronic illness patient
  • The body gets stuck; the problem may no longer be the inciting factor
  • CDR1, CDR2, CDR3 phases of Cell Danger Response
  • Mitochondria are sensors of danger for the system
  • Mitochondria change form and function during different phases
  • CDR1 - mitochondria are pro-inflammatory; anaerobic glycolysis; M1 polarized
  • CDR2 - M0 mitochondria; proliferation; aerobic glycolysis 
  • CDR3 - mitochondria are anti-inflammatory; cells communicating; M2 polarized/healthy
  • We need oxidative stress to protect cells from invaders/toxins; persistence is the defect
  • Giving mitochondrial repair and antioxidants typically don't work; putting out the fire when it is needed
  • Oxidative stress is intentional and protective
  • Typically, in all three stages of the CDR simultaneously 
  • Neither oxidative or reductive stress is dangerous; abnormal persistence is the issue
  • Each stage extinguishes an earlier stage and prepares the way for the next; must be entered and exited in sequence
  • CDR1 disorders: innate immune system: HPA axis, allergies, asthma, chronic infections (often underneath wastebasket terms like CFS and Fibromyalgia)
  • CDR2 is about biomass replacement and rebuilding of tissue; mitochondria producing less extracellular ATP and more intracellular ATP
  • CDR2 disorders: cancer, hypertension, heart disease
  • CDR3 is about cell communication and restoration; adaptive immunity, sleep architecture, pain modulation
  • CDR3 disorders: CFS, autism, PTSD, Fibromyalgia, anxiety, depression, autoimmunity 
  • Salugenesis is not the reverse of pathogenesis
  • Removing the triggers is not going to get the patient back; remove the triggers but that's not the full solution
  • Those with Lyme that fail simple antibiotic therapy often have MCAS, ligament laxity, detox problems, inappropriate T-cell modulation; may also be risk factors for COVID severity
  • Perpetuating factors: numerous infections, mycotoxins, environmental toxicants, MCAS, structural issues, intestinal permeability, hypercoagulation, psychological defenses, ACEs, jaw/dental infections, sinus colonization (more than just MARCoNS)
  • Before detox and infection killing, remove from the toxic environment, use binders, support organs of elimination; some may need to treat MCAS to start detox; generally starts MCAS treatment first before detoxification
  • Modulates immune system with LDN or peptides
  • If dealing with CCI, treatments will not work until stabilized; they move their neck and all symptoms flare
  • If limbic system is sensitized, changes in the internal milieu may upregulate the CDR; system overreacts
  • Does limbic system retraining, MCAS, CCI work before detox and infection treatment
  • Mast cells are the guards of the immune system with over 1000 mediators
  • Can have bone pain, brain fog, interstitial cystitis, headaches, and more with mast cell activation
  • MCAS has an inciting event, but you generally cannot treat the inciting event until you treat the MCAS
  • Mycotoxins and MCAS may contribute to neuropsych symptoms
  • Treatment for MCAS for symptom relief and to prepare for detox and antimicrobials
  • Highly sensitive patients may react poorly to herbs
  • Low histamine diet is important
  • MCAS treatment: Neuroprotek, quercetin, Chinese skullcap, Perilla, DAO, Vitamin A as Retinyl Acetate or Beta Carotene, luteoline, D3/K2, SPMs, baking soda, Adrenal Cortex; Allegra, Singulair, Pepcid, Cromolyn, Ketotifen
  • KPV and Amlexanox can often be helpful
  • Suspect CCI with hypermobility or family history of hypermobility or EDS
  • Onset coincides with neck injury or strain
  • Ligaments get more lax when there is more inflammation
  • Lax ligaments and MCAS genetic tendencies exacerbate each other
  • Viruses insert into our DNA but are not replicating; immune system can be triggered leading to immune priming; elevated IgG
  • Immune system can be priming itself to fight an infection that does not exist any longer
  • Diagnosis is supine cervical MRI
  • Treatments: neural therapy with BPC-157 or GHK, topical peptides, traction, brace, lower inflammation; surgical stabilization as last resort
  • Lowering inflammation is with MCAS treatment, detox, infection treatment, anti-inflammatories
  • Mast cells tenderize lax ligaments
  • Dysregulated nervous system can activate the immune system
  • Nervous system dysregulation and immune dysregulation: Fibromyalgia, CFS, EDS, CCI, POTS, CRPS, autoimmunity, neuropathy, tinnitus, IBS, gastroparesis, MCAS; almost everyone with chronic, longstanding Lyme has several or all of these
  • Treating nervous system dysregulation is with limbic system (DNRS, Gupta) and vagal nerve structure (neuro chiro, upper cervical chiro, osteopathic manipulation, FSM, singing/chanting/humming, cold exposure) and signaling work (neuro chiro, neuro-biofeedback, neural therapy, acupuncture, FSM, Safe and Sound, Tai Chi, Qi Gong, Yoga, meditation, breathing
  • Toxicants that hinder the healing cycle: mycotoxins, biotoxins, neurotoxins, metals, EMF, chemicals, pesticides
  • The immune system can be simultaneously overactive and underactive
  • TGFb1 is an attempt to downregulate the innate immune response; indicates a misguided immune system

Joseph Smith, DC spoke on "Brain Dysfunction as an Initiator of Immunopathology" and shared:

  • Gut, Lyme, mold all cause brain issues; as does environmental toxicity
  • Neurogenic inflammation is the interface between histamine and brain inflammation
  • Central Nervous System Injury-Induced Immune Deficiency Syndrome
  • Parasympathetic and sympathetic discharge at the same time
  • Dysautonomias such as POTS can have a vagal component, but some dysautonomias can be exacerbated by vagal stimulation
  • Some have too little sympathetic tone
  • Acetylcholine effects the vagus nerve
  • ANS regulates inflammation
  • Dysautonomia can lead to autoimmunity; sympathetics interact with thymus, spleen, bone marrow, and lymph nodes
  • Norepinephrine inhibits TNF-a, IL-b, IL-6, and LPS in the short term, but long-term, the opposite occurs
  • Activation of the sympathetic nervous system attenuates innate immunity
  • Inhaled biotoxins/mycotoxins and mold spores cause mast cells to release tryptase, TGFb1, VEGF, histamine
  • Fungal spores growing in the body trigger mast cells directly or via mycotoxin productions
  • Black mold can breakdown blood-brain barrier within 6 hours
  • Mold can cause neurogenic inflammation
  • Mold is nasty; very nasty
  • Tips the body toward Th2; increased sympathetic tone suppresses NK cells and increases Th2
  • Patients have cognitive issues; Cambridge Brain Sciences testing; anxiety/depression
  • Parasympathetic is bi-directional
  • SNS and PNS are not a teeter/totter; they act synergistically
  • Outcomes can be pain, brain fog, loss of cognitive function, anxiety, depression, insomnia, hypersomnia, SIBO, reflux, IBD
  • PNS and SNS both have amplifying and inhibiting aspects on bott he innate and adaptive immune systems
  • PNS and SNS act more synergistically than against each other
  • If the SNS is elevated, vagal stimulation can be helpful; if PNS is elevated, it may be detrimental
  • Disruption of the HPA axis leads to autoimmunity
  • Cytokines cross-talk with the PNS and SNS
  • Upregulation of sympathetic tone can lead to MCAS/histamine; mast cell issue causes more sensory nervous system issues
  • Being awake and alive and not regulating your PNS/SNS; tipping to SNS high tone leads to neurogenic inflammation and mast cell degranulation
  • Working with the brain directly can amplify treatment response
  • Increased sympathetic tone leads to decreased Th1, increased Th2, increased Th17, and increased Treg; autoimmunity, allergy, cancer
  • Some do not meet diagnostic criteria for dysautonomia but still have dysregulated ANS
  • The brain issue can be causing the downstream issues; downstream issues can be causing brain issues
  • Pulse oximeter - heart rate; stand up; heart rate should not go up > 20 beats per minute; should go up and come down; abnormal would be that heart rate does not go up at all; heart rate should go up if blood pressure goes down
  • Blood pressure cuff - seated/stand; take at 1 minute and then 3 minutes; get a mixed signal on left side vs. right side
  •  Person with a balance issue might have a chronic infection due to inability to integrate the HPA and sympathetic pathways
  • Traumatic brain injuries or children with autism may end up with these downstream issues
  • Clear indication of issues with fastigial nucelli could be a head tilt; adjusting out of a head tilt can be the wrong thing; may need a different therapy; can be a neurological issue creating a downstream issue
  • Head trauma can lead to asymmetry and a difference in how a child might develop over a lifetime; impacts the HPA axis that may make one more vulnerable to future infections
  • 1 out of 4 boys born in California today will be diagnosed with ADHD
  • Can have "chemical concussion" from neuroinflammation resulting from infections
  • Can do a Romberg test and then do an intervention (herbs, IVs, HBOT, etc.) and re-test Romberg; if it gets worse, the treatment may not be appropriate at that time; did the brain come online?

Chad Prusmack, MD spoke on "Environmental Sub-Concussion: The Potential Role of Toxicity in Chronic Traumatic Encephalopathy" and shared:

  • Traumatic brain injury is the most complicated disease of the most complex organ of the body persisting in an environment full of invisible toxins
  • Concussion is a clinical syndrome with acute or subacute transient alteration in brain function, including alteration of mental status or level of consciousness, that results from mechanical force or trauma
  • MMA fighters have a concussion every time they get knocked out
  • Lack effective means of prognosis, treatment, and recovery; remain reliant on symptom resolution which may not be the best way to determine "back to normal"
  • 35 pharmaceutical trials have all failed
  • Estimated cost 1.1 billion dollars
  • Diagnosis is a clinical diagnosis; no screening test, biomarker, or imaging study that is diagnostic
  • Symptoms, history, physical are most important
  • Tests: SCAT 5, VOMS, Impact, King Devic
  • MRI, MRA, CT important to rule out hematoma or stroke
  • Evaluation
    • History (migraines, ADD, learning disabilities; number of concussions, symptoms, recovery, assess sub-concussive burden (head hit without obvious concussion), PCSS, MSQ, CT/MRI
    • Exam: Orthostatic/dysautonomia (biggest cause of post-concussive symptoms), people with POTS have differential of 30 beats per minute; drop of 20 point systolic
    • Many different types of tests used to establish a baseline
  • Subtyping
    • Vestibulo-ocular: dizziness, fogginess, lightheaded, nausea, vertigo, photophobia, and others
    • Somatic: headaches, migraines, cervicogenic
    • Cognitive: memory, calculation, attention, reaction time
    • Limbic: nervousness, hypervigilance, ruminative thoughts
    • Dysautonomic: orthostatic intolerance, brain fog, anxiety, panic, flushing, palpitations, fatigue, constipation, bloating, POTS, neurocardiogenic syncope
    • Neuromechanical responsiveness: coordinated symphony of the various systems; impaired performance in the context of higher demands; symptom improved by not optimal
  • Brain fog is a common symptom of post-concussive syndrome
  • For orthostatic measurements, look for a drop of > 20 systolic blood pressure and/or a heart rate increase of > 20 beats per minute
  • Treatments vary depending on the subtype(s)
  • Best RX sleep medication is Trazadone
  • Propranolol, Midodrine, Florinef for dysautonomia; compression ware; salt, VNS, HRV biofeedback
  • Primary injury is the initial injury/trauma, shearing and tearing of blood vessels, neurons, and glia; secondary injury includes mitochondrial dysfunction, inflammation, ecotoxicity, calcium overload, oxidative stress
  • 100% of his patients have vestibular dysfunction; any head injury impacts the mid-brain due to rotational forces
  • NAC after injury can be helpful
  • Recommends ketogenic diet
  • Microglial priming can play a role in ongoing neurological impairment
  • Blood-brain barrier may be broken down
  • Environmental sub-concussion is the environmental toxicants impacting the brain due to a broken down blood-brain barrier
  • Asymmetries after a concussion can lead to musculoskeletal pain 
  • Need a systems approach to treatment
  • Secondary effects of concussion are second impact syndrome (calcium and potassium influx create a setup for a second hit), post-concussive syndrome (symptoms longer than 3 weeks; chronic after 1 year), neurodegenerative disease such as Parkinson's and CTE
  • Post-concussion syndrome is persistence of physical, cognitive, emotional, and sleep symptoms
  • CTE is a neurodegenerative disease associated with TBI; pathological diagnosis discovered post-mortem
  • Patients with no history of concussion have been found to have CTE on autopsy
  • CTE appears years after TBI, early neuropsych more than cognitive complaints, progresses to motor impairments and cognitive decline
  • CTE consists of hyperphosphorylated tau, neurofibrillary tangles, perivascular; amyloid may or may not be present; not as consistent as in Alzheimer's
  • Look at concussions with a complex system's approach; social, experiential, network, and cellular
  • Brain is like a highway; bumps, blocked roads; new roads need to be taken
  • Concussive burden considers concussion, sub-concussion, environmental sub-concussion
  • CTE appears to be total lifetime brain trauma
  • Environmental toxicants, chronic infections, gut dysfunction, systemic imbalances may stimulation chronic neuroimmune activation; may be the missing link to neurodegenerative diseases
  • Altered microbiome, endotoxins, LPS in a setting of blood-brain barrier dysfunction leads to a neurochemical toxicity reaction
  • His approach looks at genes, toxins, inflammation, imbalances, symptoms
  • They look at many functional medicine tests including infections, organic acids, heavy metals, mycotoxins, food allergens, inflammation, leaky gut, dysbiosis, HPA axis, hormones, nutrients
  • Dysautonomia can cause gastroparesis
  • Gargling water until eyes tear can help with GI motility
  • 39% had mold toxicity; 33% tick-borne infections; 19% dysbiosis; 11% heavy metals
  • High gliotoxin and aflatoxin in post-concussion vs. citrinin in non-concussed; Aspergillus and Fusarium higher in concussed
  • May be a sick-building syndrome/mold toxicity in post-concussive syndrome
  • Study on tick-borne disease found an association between post-concussive syndrome and tick-borne disease
  • Combined history of tick-borne disease and mild traumatic brain injury were lower in D and magnesium; higher T3 and free T3; lower levels of LH and FSH, low SHBG, higher IL-6, reduced CD57, low CD3 and CD4
  • Combination of tick-borne disease and traumatic brain injury leads to worst outcomes
  • Environmental sub-concussion needs to be evaluated and treated

Mary Ackerley, MD spoke on "Brains on Fire: Epidemiology of Mental Health Disorders in the COVID Era & State of Psychiatry including SSRIs" and shared:

  • Worked with mold, Lyme, CFS for over a decade
  • Excessive pharmacological treatment of depression and anxiety can be harmful
  • By 2030, depression will be the leading cause of disability
  • SSRIs no better than placebo or exercise for mild to moderate depression; get 50% of patients 50% better
  • 337 million SSRI prescriptions written in 2021
  • Why are we using drugs that barely work?
  • Diagnosis is over-simplified
  • The Serotonin Hypothesis was debunked in 2022
  • Drug companies know that branding depression as a chemical imbalance is good for business
  • Use of SSRIs increased 3000% from 1991 to 2018; the conditions for which SSRIs were provided was greatly expanded
  • Suicide rate in teens dropped from 1995 but began a steady increase in 2008; social media may be a contributor
  • 42% of Americans reported mental health issues in December 2021; up from 11% in prior years
  • For every 2 COVID deaths in 2020, 1 death from drug overdose, alcohol, or suicide
  • 337 million anti-depressant prescriptions written in 2021
  • Suicidal ideation is a known side effect of SSRIs
  • Allowing active metabolites of SSRIs to circulate in water and soil is bad for the environment
  • Activated carbon appears to remove 99.9% of SSRI metabolites; use for showering, bathing, and drinking
  • Work with diet, exercise, Lyme, mold, and other root causes
  • She explored neurotransmitter testing and found it not to be helpful; no longer uses urinary neurotransmitter testing
  • An attendee suggested SSRI may have antifungal and anti-biofilm activity; Dr. Ackerley has found some on Fluconazole that were unable to get off without return of psychiatric symptoms; "azoles" have side effects when long-term as well

Mary Ackerley, MD spoke on "Root Causes in Neuropsychiatric Syndromes: Biotoxins, Infections, and Neuroinflammation" and shared:

  • Chronic inflammation causes neuropsych symptoms
  • Depression is an inflammatory illness
  • Where does the inflammation come from?
  • Not a single RX pill that works better than diet, exercise, and fish oil
  • Causes of chronic inflammation: psychosocial stress, leaky gut, T-cell dysfunction, obesity, diet, early life stress, EMFs?, CIRS; result in: diabetes, cancer, depression, cardiovascular disease
  • Most of her patients have 1-2+ neuropsych symptoms; generalized anxiety and panic attacks most common
  • CIRS symptoms are often explained away as neuropsych
  • "Nothing wrong with you that psychiatry can't cure"
  • Sickness behavior is based on high cytokines; Cell-Danger Response is conserving biological resources in adversity for evolutionary survival
  • Inflammation promotes obesity, cardiac illness, neurodegeneration, depression
  • Psych illness: biotoxins, NeuroLyme, coinfections, Strep, COVID, Spanish Flu, RMSF, Toxo, glyphosate
  • Exposure to water-damaged buildings correlated to depression and cognitive dysfunction
  • Study of 277 Polish children showed 10 points lower IQ if living in homes with mold
  • MMP9 and TGFb1 are inflammatory cytokines and increase blood-brain barrier permeability and activation of glial excitotoxicity 
  • OCD is fairly common in CIRS
  • Bipolar illness is also associated with inflammation
  • Microglia activation present in bipolar; has treated underlying causes and seen a loss of the diagnosis
  • TGFb1 elevation has been seeing in CSF in Alzheimer's
  • Low VEGF has been associated with completed suicide

Mary Ackerley, MD spoke on "Practical Interventions for Depression, Anxiety & Insomnia in Environmentally Acquired Illness" and shared:

  • Depression treatment: fish oil, NAC, diet (low carb, Autoimmune Paleo, Keto), gut repair, exercise, micronutrient replacement with Equilib or Empower Plus, lithium orotate, curcumin, BHRT, MitoCore or ATP 360, LDN, Pregnenolone, DHEA, Mucuna, methylene blue; and removal of mold exposure
  • Researched Nutritionals CytoQuel and ATP 360 has been a good combination
  • LDN is one of her favorite treatments; can calm activated microglia; helpful for anxiety, depression, insomnia, and MCAS
  • Methylene blue can be helpful for Bartonella and Alzheimer's 
  • Tapering off SSRIs may require 6-12 months
  • KPU is more common than most think it is; looks at low zinc (<1000 RBC)
  • Can use algae-derived omegas; SPMs can be helpful
  • Will use Bupropion for dopamine support and low dose Remeron; hard to get people off Effexor; Paxil even harder to wean off of
  • Lithium orotate is helpful in bipolar but is not enough; helps to grow gray matter
  • 70-90% prevalence of anxiety/depression in her patient population
  • Works with anxiety and insomnia very quickly; sleep is critical for detoxing the brain; reducing anxiety helps with sleep
  • Restoring hormones is important; measures pregnenolone on everybody
  • Older white males have highest rates of suicide
  • Suicidal ideation in children often warrants hospitalization; don't have an appreciation of the finality of death
  • Trauma is the root of all of these
  • Blood brain barrier is real and can be impacted by EMF exposure; reduce EMFs, get more nature
  • Electronics and social media are major contributors to why teenagers commit suicide
  • Pregnenolone used for pain and RA; birth control pills drop; works to get to 150 if possible
  • Anxiety treatment: inositol (anxiety, OCD, PCOS), progesterone, magnesium threonate/glycinate, passion flower, theanine, CDP choline, PC, CBD, LDN, niacinamide (decreases glutamate and over-methylation), Seriphos (lowers cortisol), Gelsemium 30C (social anxiety, public speaking)
  • CBD a better alternative than benzos for anxiety and sleep; no withdrawal issues
  • Choline can cause depression in some people; anxiety and depression are activation and inactivation
  • LDN may be used from .25 to 8mg; depression can be seen in higher doses and may have to drop back to 4.5; Lyme population may become agitated with even .5; LDN fairly good for COVID post-vaccine injury or post-COVID
  • CBD for anxiety and neuroinflammation; THC can cause psychosis
  • Most doctor don't want to prescribe opiates and Clonazepam
  • Gabapentin can be hard to get off of and some now consider it a drug of abuse
  • Insomnia treatment: sleep hygiene, progesterone, magnesium citrate, melatonin, Chinese skullcap, CBD, LDN, Lidtke Slumber EZ, Orthomolecular Botanicalm, lavender oil/Lavelle, apigenin. CALMS FORTE homeopathic
  • Chinese skullcap a favorite for COVID and other viruses; helpful for sleep and anxiety
  • High homocysteine (> 7) implies excess histamine; may use Thorne Methyl-Guard
  • COVID and Long COVID may lead to higher levels of homocysteine
  • Likes VEGF from 40-100; most CIRS below 30
  • Low ADH can lead to frequent urination; leads to interpersonal dysfunction
  • Oxytocin better tolerated and safer than DDAVP/Vasopressin for ADH
  • Increase gray matter: VIP, exercise, antidepressants, mediation, diet, curcumin, zinc, taurine; helps depression and cognition; likely anxiety; ECT may also increase gray matter
  • A focus on methylation without a focus on mold and tick-borne illness is probably not optimal
  • Anxiety with methylation support could be a sign of over-methylation
  • Sees higher homocysteine levels as people get older

Mary Ackerley, MD spoke on "Mast Cell Activation & Trauma in Neuropsychiatric Syndromes" and shared:

  • Common MCAS patient symptoms: MCAS, hypermobility/EDS, dysautonomia/POTS/small fiber neuropathy, autoimmunity, gastroparesis, sensitive to smell/sound/EMF/light/most allopathic meds, adverse childhood experiences
  • EDS, POTS, MCAS are common top explorations when people she sees have seen more than 10 doctors and still have no answers
  • Histamine supports regulation of normal cognition, sleep/wake cycle
  • Mast cells are found in the brain; including in the limbic system
  • Fibromyalgia, migraines, neuropathic pain, CRPS, vulvodynia, autism, MS, Alzheimer's, Parkinson's, Neurofibromatosis, and many others associated with mast cells
  • Mast cells an important root cause of depression and anxiety
  • Stress destabilizes mast cells
  • Trauma occurs when our ability to cope with an event is overwhelmed
  • Larger pupils with sympathetic activation; smaller with parasympathetic
  • Fight or flight vs. feed and breed
  • Oura ring can be helpful to measure heart rate and HRV
  • Most humans get stuck in fight/flight or freeze
  • Fight = bully, narcissist, sociopath
  • Flight = panic disorder, mood disorder, ADHD, OCD
  • Freeze = depression, disassociation, chronic fatigue
  • Fawn = codependent, victim
  • Xyzal and Pepcid at bedtime to start; Cromolyn, Ketotifen, CBD, LDN, PEA (best with luteolin or CBD), PC
  • Luteolin, quercetin, C, red sage, baikal skullcap, boswellia, bromelain, stinging nettle, NAC, spirulina, bee pollen, moringa (72% histamine inhibition)
  • Lactobacillus rhamnosus, spore based probiotics, arabinogalactan
  • BPC-157, Thymosin, KPV
  • Antihistaminergic psych meds in severe weight loss, insomnia, or pain: Mirtazapine, Seroquel, Nortriptyline, Trazadone
  • Uses Fluvoxamine for OCD and adult PANS; helpful in COVID; antiviral, improves blood flow, stabilizes mast cells
  • Bodywork: osteopathic, craniosacral, lymph drainage, vibration plates, coffee enemas, colonics, Qigong, Tai Chi, Somatic Experiencing, Organic Intelligence, visual therapy, functional neurology, network chiro (no forceful adjustments)
  • Yoga can worsen hypermobility if done incorrectly

Ann Corson, MD presented on "What's the Fuss About Fibrin?" and shared:

  • David Berg study showed 87.3% with Lyme had low level activation of coagulation; 89.7% had one or more hereditary defects; 1.9% had normal results
  • Hypercoagulation results with abundance of molecules encouraging clotting over those encouraging blood thinning
  • Soluble fibrin is the result of the coagulation cascade
  • If soluble fibrin outpaces fibrinolysis, accumulation acts like a sludge-layer; trapping toxins, infections
  • Precipitated by: aging, pregnancy, genetics, infections, cancer, toxins including metals and mold, allergens, physical trauma, vaccinations, EMF/EMR, biological warfare agents such as trichothecenes
  • Exacerbated by acute and chronic infections, acute trauma, chronic inflammation/chronic infections (GI, dental, vasculitis, toxic load), cytokine flares (Herx, mold hit), detox (mold, metals), glyphosate induced sulfate deficiency
  • Coagulation depends on platelet activation and fibrin production
  • Controlled by:
    • Platelet behavior - acute or low level activation of aggregation, adhesion, secretion -> clots
    • Fibrin formation or thrombophilia - low level activation of coagulation -> excess soluble fibrin
    • Fibrin degradation or fibrinolysis - hypofribrinolysis - genetic tendencies to create weakness in breaking down fibrin
  • Platelets become sticky in response to trauma to blood vessels; immune system activation by toxins and infections, junk food and sedentary lifestyle; platelets supply clotting factors to product fibrin; low level activation is an indictor of cardiovascular disease
  • Fibrin formation - thrombin (Factor IIa), tissue factors, platelet factors are pro-coagulant
  • Fibrin degradation - anti-thrombin, Protein S, Protein C, Heparans, GAGs are anti-coagulant
  • Anti-fibrinolytic - PAI-1, Lipoprotein(a), a-2 antiplasmin, TAF-1
  • Fibrinolysis - Plasmin, uPA, tPA, Streptokinase, Lumbrokinase, Nattokinase
  • Fibrinogen is precursor to fibrin; elevated in acute or chronic inflammatory disorders, cancer, estrogen therapy, normal pregnancy
  • PT/PTT measures two pathways; extrinsic and intrinsic
  • Antithrombin is amplified 1000x by Heparin
  • Can measure Prothrombic Fragment 1 and 2, Thrombin/Antithrombin, Protein S, Protein C, Fibrinogen
  • Lipoprotein(a) binds to Plasminogen bindings site and decreases function of Plasminogen; PAI-1 blocks tPA action; A2-Antiplasmin blocks Plasmin breakdown of soluble fibrin; all leads to a sludge layer in lining of endothelial cells in vascular space
  • Exogenous kinases breakdown soluble fibrin; Lumbrokinase, Nattokinase
  • Delivery of nutrients, growth factors, hormones as well as removal of toxins significantly impacted
  • 20% of population is genetically prone to hypercoagulation
  • One micron of soluble fibrin in endothelial cell reduces oxygen diffusion by 500%; 2 seconds to 5.3 minutes
  • Can lead to fatigue, brain fog, and pain after exercise
  • Cytokines, pathogens, toxins in soluble fibrin; can be released when breaking down; start low and go slow
  • Testing
    • Pro-coagulant: Prothrombin fragments 1 and 2, Fibrinogen, Factor II activity, T/AT complex, Activated protein C resistance, homocysteine, PT/PTT
    • Anti-fibrinolytic - PAI-1, lipoprotein(a), alpha-2 antiplasmin
    • Anticoagulant - antithrombin III, Protein S, Protein C
    • Fibrinolysis - D-Dimer
  • D-Dimer = too much fibrin
  • Low SED rate can be hypercoagulation
  • Cholesterol and LDL often elevated with inflammation
  • Prothrombin Fragment 1+2 elevated with increases thrombin formation and cancer
  • T/AT Complexes are elevated with increased thrombin breakdown
  • Fibrinogen activity is elevated in acute and/or chronic inflammation with infection, cancer, pregnancy, and ongoing clotting
  • Confirming thrombin formation and fibrin deposition: F 1+2, T/AT, Fibrinogen activity
  • When F 1+2 is elevated, T/ATs should also be elevated
  • Activated Protein C resistance most often Factor V Leiden
  • Factor II Activity shows making too much thrombin when elevated
  • Lipoprotein(a) elevated with inflammation or genetic weakness, breast cancer, prostate cancer
  • Alpha 2 Antiplasmin protects fibrin by blocking fibrinolysis
  • PAI-1 blocks fibrinolysis
  • Homocysteine based between 6-9; when < 5, can indicate a hypercoagulable state
  • Anti-thrombin, Protein C, Protein S activity should be 1:1:1; within 10 points of each other
  • An upset balance is stress, inflammation, trauma, genetic weakness
  • Low protein S can be a chronic hypercoagulable state
  • Up to 95% of chronically ill patients are hypercoagulable
  • SARS-CoV-2 and spike protein itself contribute to hypercoagulable states; moreso from vaccination than infection
  • Spike protein damages endothelial cells; spike protein itself is toxic and dangerous to humans
  • Hypercoagulation symptoms: generalized pain, limbs falling asleep, painful numbness, sharp/stabbing pains, brain fog, stiff upon waking or when sedentary, painful teeth of sensation of loose teeth, post-exertional malaise after exercise, insomnia, cold extremities but warm centrally, and more
  • Treatment
    • Reduce systemic inflammation
    • Reduce insulin resistance
    • Decrease platelet activation: Omega 3, E, Gingko, treat triggers
    • Dissolve excess soluble fibrin: Heparin/Lovenox, fibrinolytic or proteolytic enzyme combinations
    • Herbs, nutraceuticals, homeopathic immune modulators
    • Eliminate causes such as infections and toxins
    • Buffer genetic weaknesses
  • Nattokinase and lumbrokinase fibrinolytic
  • Natto works best in a gelcap; not a capsule
  • Natto and Lumbrokinase need to be taken away from food
  • Boluoke is the best Lumbrokinase; others don't seem to work
  • Lumbrokinase is active only when fibrin is around; very low risk of hemorrhage; useful in breaking up biofilms
  • People with ongoing infections and mold exposure will continue to be hypercoagulable
  • Movement of heavy metals and mold toxins worsen hypercoagulation
  • Herxheimer's and mold exposures increase soluble fibrin production
  • Natto is more intravascular; Lumbrokinase is intravascular and extravascular
  • Fibrinolytics can rarely worsen hypercoagulation and symptoms; due to release of trapped thrombin in the sludge layer; addressed by increasing enzymes or using Heparin

Christina Laukaitis, MD, PhD spoke on "Ehlers-Danlos Syndrome: Genetics Plus Environment" and shared:

  • Genetic and environmental components to EDS
  • Can be primarily genetic or have a very strong environmental component that can be affected
  • Has a focus on the genetics involved in EDS and other genetic syndromes
  • Genes + environment = disease
  • It is rare that disease is entirely genetic or entirely environmental
  • Even lead poisoning has a genetic component
  • PKU is a genetic disease, but environment is important and how the condition is treated; phenylalanine free diet
  • Diseases that are extremely genetic; diseases with more common genetic components but less of a role in the disease; EDS is in the middle
  • Several types of EDS where genetic play the primary role; more rare
  • hEDS has a genetic and environmental contributor
  • Multiple genes interact to create a given disease
  • Environment can change the threshold of how genes impact the resulting disease
  • Alzheimer's and heart disease have both genetic and environmental factors
  • Estimate what is genes
    • Height 95%
    • Autism 78%
    • RA 67%
    • Depression 42%
    • Metabolic Syndrome 40%
    • IQ 40%
  • Hypermobility is about 70% genetic; 30% environmental
  • Beighton score is one measure of hypermobility
  • Hypermobility is very common in EDS and other disorders
  • EDS is a group of connective tissue disorders named after 2 dermatologists
  • Abnormalities in collagen structures
  • 13 subtypes of EDS; classical, vascular, and others
  • Many types of EDS are associated with genetic mutations in collagen; many inherited in autosomal dominant fashion (50% chance)
  • The gene for hEDS is unknown
  • Parents can be carriers with no manifestations and children can inherit the disease
  • Pathogenic variant of COL3A1 associated with vascular EDS (vEDS)
  • Vascular EDS is < 1:5000 people; rare; should not exist in family with hEDS; types do not change
  • vEDS: thin vermillion of lips, micrognathia, narrow nose, prominent eyes, distal joint hypermobility, easy bruising, thin skin with acrogeria, clubfeet
  • vEDS can have more severe manifestations than other type of EDS; aneurysms and dissections; avoid colonoscopies; pregnancy has 5% mortality risk; 50% de novo mutations; 50% familial
  • vEDS managed with blood pressure treatment and avoidance
  • 1 in 5000 people have EDS; not including hEDS
  • hEDS is reasonably common; 1 in 500
  • Hypermobility syndromes 1 in 100
  • Hypermobility without syndromes 1 in 4
  • Key findings: dizziness, alternating constipation/diarrhea, rashes/flushing, Raynaud's, multiple migraines each month, jaw pain with popping, myopia
  • Different EDS types impact different collagen types
  • EDSIII, Joint Hypermobility Syndrome, HT-EDS all earlier names for hEDS or hypermobility spectrum disorder
  • One ICD code for all 14 EDS types
  • Barriers to diagnosis: lack of awareness, lack of diagnostic experts, complex diagnostic criteria
  • Hypermobility, 2 of 3 other criteria, rule out other conditions
  • 2 of 3 includes family history, pain or joint instability, and 5 out of 12 signs of connective tissue
  • Unexplained stretch marks are interestingly one of the 12 signs
  • 5% longer arm span-to-height ratio
  • Classical EDS has specific skin findings; atrophic scars in hEDS; stretchy, molluscoid pseudotumor, suture tearing in Classical EDS
  • Hereditary Disorders of Connective Tissue genetic panels to help differentiate types
  • Variants of uncertain significance is an unclear finding; don't know what they mean; most eventually become likely benign
  • Talk about pathogenic variants and benign variants; can vary but not be pathogenic
  • Some "break the gene" and others are benign
  • Co-diagnoses of hEDS: joint pain, headaches, POTS, dysmotility, fatigue, brain fog, easy bleeding/bruising, MCAS, Chiari malformation, Interstitial cystitis 
  • Very few differences in symptoms of hEDS or hypermobility spectrum disorders; same symptoms
  • Joint hypermobility and anxiety associated; not to suggest anxiety is a cause, more likely a result
  • Odds ratio of co-diagnosis with joint hypermobility and significant mental illness is 7.4
  • Hypermobility may have an association with autism or neurodevelopmental disorders
  • 18% of hEDS in a study reported ACEs
  • Pathogenesis of hEDS: ECM remodeling and disarray shared between hEDS and vEDS
  • Could be related to glial overload, central hypersensitivity; more to be explored
  • One hypothesis is multiple genes and multiple sub-syndromes

Andrew Maxwell, MD presented on "Dysautonomia & The Pentad: Environmental Connections" and shared:

  • Has been seeing many patients with MCAS, POTS, EDS
  • Dysautonomia is a dysfunction of the ANS
  • Parasympathetic is usually dysfunctional in dysautonomia; vagus nerve
  • Racing heart, palpitations, shortness of breath, chest pain, dizziness, light-headedness, near-fainting, fainting, fatigue, exhaustion, exercise intolerance, intolerance to upright position
  • Symptoms of dysautonomia involve every system of the body; many relate to blood flow
  • When standing, blood pools downward; should be redistributed in the body but may not be; lower extremity pooling
  • Cardiovascular system delivers blood and oxygen to tissue; deoxygenated venous blood goes back to centra venous pool; should create preload for next heartbeat
  • Pool of blood pools away from the heart and there is a loss of preload; the blood is not there; drop in stroke volume
  • Has to increase heart rate to compensate when SV is not present; compensation usually fails; cardiac output falls and perfusion to the head suffers most
  • When standing, heart rate increases a little and blood pressure maintained; normal
  • With dysautonomia, heart rate rise is more exaggerated; 30 point rise over 18 or 40 point under 18; called POTS
  • Shortness of breath with minor exertion can be painful
  • With exercise testing, oxygen is a surrogate measure for stroke volume; should go up in healthy person; 3-12ml oxygen/kg/minute increase; can be trained even higher; on POTS SV does not increase; remains flat
  • Sympathetic overdrive due to parasympathetics not working well; leads to palpitations, heart racing, anxiety, insomnia, subtle hyperventilation (lower CO2; leads to edge of panic attack, migraines, brain fog)
  • CO2 can be measured with exercise testing; often show lower levels in low 30s
  • Can look at sympathetic overdrive with HRV
  • Pentad of MCAS, Dysautonomia, hEDS + GI Dysmotility + Autoimmunity; some develop CCI
  • Many symptoms and signs of dysautonomia overlap with other components of the pentad
  • Patients present differently depending on their age
  • In pediatrics, dysautonomia is significant
  • In adults, MCAS, autoimmunity are significant; dysautonomia is less significant
  • There are many sub-syndromes associated with each of the 5 elements of the pentad
  • Vagus nerve becomes injured by brainstem compression, pseudo-Eagle Syndrome compression, nerve/body/axonal inflammation, enteric afferent inflammation, carotid body compression
  • Sensory portion of vagus nerve can lead to putting a break on the heart, dilating blood vessels, leading to nausea and GI dysmotility
  • Mast cells impact dysautonomia via enteric connection
  • Vagus nerve dysfunction -> efferent vagal nerve dysfunction -> elevated gut pH dysmotility -> SIBO -> MCAS -> leaky gut -> more MCAS -< histamine/cytokines -> afferent vagal nerve dysfunction
  • Elastase secreted by MCAS lead to leaky blood-brain barrier
  • Mast cell mediators may create a hypermobility
  • Craniocervical instability is a slipping forward of the atlas; causes problems with CSF drainage; brain fog; compression of arterial inflow and venous outflow; 3 important cranial nerves can be injured in the pharyngeal plexus (cranial nerve 9, 10 (vagus), 11)
  • Can gently lift head with 10-20 pounds of upward traction; may feel sudden relief
  • Spiky-Leaky Syndrome: unstable ligaments in cranial region (TMJ, floppy airway, CCI) setup for losing airway when sleeping; retain CO2; poor drainage of CSF at night; blood rushes into the skull and displaces CSF but cannot be drained from the jugular; CSF leaks into olfactory nerve; can have fluid in nose and ears
  • 206 patients with dysautonomia; 2/3 had MCAS; 1/3 has hypermobility; Spiky-Leaky Syndrome in 13% when they have MCAS, hypermobility, and dysautonomia
  • Alternating intracranial hypertension/hypotension
  • Symptoms of dysautonomia are often symptoms of the overlapping conditions of the pentad
  • Did geographic mapping of patients DQ score, where they came from, where they became ill; found a corridor of high prevalence including neighborhoods or streets with several people
  • Environmental toxins or geographical issues impact disease; mold and mold toxins are the top of the list; cyanobacteria/cyanotoxins given many patients live close to water; blue-green algae; industrial toxins from farmlands; stealth infections like Lyme and co-infections; EMFs; spike protein from COVID or vaccine
  • Environmental exposures in a genetically susceptible host
  • Mast cells secrete substances that breakdown connective tissues
  • Many show genetic variants with TNXB and COL genes and fibrinogen genes
  • Auto-inflammatory genetic variants also seen
  • Samples water to look for blue-green algae/cyanobacteria
  • As water temperature rises at 19C, algae blooms; becoming longer and stronger
  • Not all toxins can be removed before water is fed to the population
  • Some of these toxins can lead to dysautonomia and can bind to the vagus nerve leading to gastroparesis
  • Fountains in water can aerosolize toxins in water; can create an airshed near an algae bloom; 
  • Cyanobacteria may colonize the GI tract and create a SIBO-like condition
  • Genetic variants may lead to increased susceptibility to how close you can live to an algae bloom
  • Many patients recently where their pentad is arising from Long COVID
  • Sleep study is not a sleep study without CO2 measurement
  • Getting away from ponds and outdoor water can be helpful when it is otherwise difficult to identify what may be impacting patients
  • He has a chapter in the book Disjointed that discusses the pentad
  • Has not found glyphosate to play a role; same with environmental toxins; most are high, but not a specific pattern associated with the pentad

Paolo Bolognese, MD spoke on "Craniocervical Instability: Diagnosis & Neurosurgical Perspectives" and shared:

  • Chiari EDS center has seen over 12K patients for Chiari, EDS, and related disorders
  • Has done over 1400 Chiari surgeries; over 1100 CCI fusions; over 1000 tethered cord surgeries
  • Cranio Cervical Junction is the container; Cervico-Medullary Junction is the content; CSF is the lubricant/padding/milieu/capacitor); Vertebral Arteries are the feeders
  • Ligaments in this area are very complex and work in many different directions
  • Everything in the nervous system passes through the medulla oblongata
  • Cervico-Medullary Syndrome: headache, neck pain, lower brainstem, lower cranial nerves, sensory/pain, motor and coordination, vision and oculomotion, hearing and equilibrium, cerebellar function, behavior, cognition 
  • Mechanical compression or distortion of the regional nervous tissue, vascular compression, CSF disturbances
  • Pathologies causing Cervico-Medullary Syndrome: trauma, tumors, inflammation, infections, congenital malformations, vascular, metabolic
  • Pathologies like trauma and vascular events are harsh and fast
  • Tumors are slower but progressive
  • Some pathologies will keep going on simmer
  • Craniocervial Junction: can be congenital malformations, can be static and/or dynamic, dynamic problems are linked to Craniocervical Instability (CCI)
  • Trauma, infections, inflammation, tumors, degermation impact both structure and biomechanics of CCJ
  • Dynamic problems can be caused by ligament laxity at the CCJ
  • Trauma and EDS are frequent offenders
  • EDS is being born with "sloppy" "stretchy" ligaments
  • Joint can become unstable like a twisted ankle
  • Down Syndrome population presents with these issues over time; instability between first and second vertebrae; have to be screened and cleared of this condition before going to Special Olympics
  • Applying some traction to the head/neck can lead to symptom improvement in some
  • EDS: soft/stretchy  skin, loose ligaments, hypermobile joints, poor wound healing, cardiac valve insufficiency, aortic aneurysms
  • Can be other connective tissue disorders
  • MCAS can cause ligamentous softening
  • EDS Companions: tethered cord, intracranial hyper/hypotension, MCAS, POTS/dysautonomia, compromised immunity, median arcuate ligament syndrome, superior mesenteric artery syndrome, Nutcracker syndrome, hormonal dysfunction, fluid imbalance, styloid hypertrophy, sensory integration disorder
  • Do not confuse hypermobility with instability
  • Instability = hypermobility + symptoms from CCJ
  • Radiological criteria are not enough
  • EDS/hypermobility may be an evolutionary advantage
  • Some with EDS fall off the cliff due to trauma or to MCAS
  • A subset of patients did not have EDS or a congenital problem
  • Diagnostic criteria: history, Cevico-Medullary Syndrome, underlying pathology (EDS, tumor, RA), radiological evidence/morphometrics
  • Morphometrics is measuring angles; more than 20 measurements
  • Invasive cervical traction: confirm the diagnosis, check if CCI is responsible for the symptoms, clinical and morphometric scores, dress rehearsal for fusion, create a map for the surgery
  • Surgical criteria: severe compromise in quality of life or severe neurological deficits secondary to CCI and strongly positive ICT results plus one of more morphometric criteria; the bar for surgery is high
  • Surgery fuses the CCJ with hardware and bone
  • In some people, the joint below will become an issue after surgery
  • Has changed the type of fusion done over time to improve the outcomes for the patient
  • He did 600 classical fusions before starting to work with CCI
  • Collects many types of tissues during the surgery to look for infections
  • Diagnosis of CCI is complex
  • The prevalence of these pathologies within the ME/CFS community is larger than initially expected
  • Classical chiropractic manipulations are a no-no for this population
  • Has not seem stem cell therapies work in those that were surgical grade; may be helpful for less severe cases; same for PRP and prolotherapy
  • Should not use a collar more than 3 hours a day; will leave to weakening
  • Incidence of psychiatric disorders may be up to 75%
  • Takes a lot of work on the part of the patient after the surgery
  • Trauma of surgery of other traumas may stress the adrenals
  • Patients with best results have not been in heavy duty narcotics for more than 2-3 years; pain receptors will change and may lead to more complications
  • NSAIDs can be good before surgery but not after as they interfere with ossification
  • To start, would like MRI of cervical spine in neutral position supine
  • 1/3 of patients that have fusion surgery develop signs of tethered cord (had before but was secondary)
  • Tethered cord - spinal cord to tailbone connected by a cord/rubber band; not needed after age 1 but if too tense, creates dysfunction
  • Recovery and reconditioning can take 18 months after the surgery; many go home for recovery; some may need to stay in the hospital for 6-8 months and may need additional surgeries; some may need intense physical therapy / rehab for months
  • Jury is still out on the use of peptides in CCI cases
  • Try everything before you consider surgery which is a drastic decision; you cannot reverse a fusion; even if you remove the hardware, the effect remains

Suzanne Gazda, MD  spoke on "Long Covid: The Pandemic Upon the Pandemic" and shared:

  • Long COVID is the pandemic upon the pandemic
  • Long COVID and post-vaccine injuries are a catastrophic health crisis
  • Long COVID is a mass disabling event
  • Will we see a rise in neurodegenerative disease?  Yes
  • She has worked in neurology for over 30 years; already seeing it
  • Seeing more MS; more brain tumors
  • Potential integration of spike into DNA
  • Prion spreading, amyloidogenic, viral reactivation, vascular disease, decrease in innate immunity, autoantibodies, neuroinflammation, advanced senescence, mitochondrial damage, alteration of GI microbiome
  • Recent study suggested 1 in 8 have Long COVID; another suggests 45%
  • 200-300 new referrals per month
  • 4.5 percent of older people developed dementia two years after infection; compared with 3.3 percent of controls
  • The brain is being taken down so hard by SARS-CoV2 and spike protein
  • The more times you get COVID, the higher risk of adverse outcome
  • Vaccines do not prevent long COVID; may increase the risk
  • PCNS: Post-COVID Neurological Syndrome
  • Multiple mechanisms: cytokines, rogue antibodies, molecular mimicry, alteration of immunity, oxidative stress, vascular inflammation, advanced senescence, mitochondrial damage, exosomes, microbiome, MCAS, DNA damage, viral reactivation, altered neurotransmitters, amyloid/prions 
  • Spike crosses BBB; virus does not readily cross 
  • Messenger RNA is shielded from the immune system by a lipid nanoparticle
  • VAERS data is underreported by a factor of 30+
  • German insurer reported 1 in 25 pursued medical care for vaccine side effects
  • Rise in cancer up 143,000%; strokes up
  • Advising students and military to get boosted with a vaccine that is no longer effective and has potential for serious harm needs to stop
  • Vaccines do not reduce mortality; 4 fold increase in mortality
  • Life expectancy around the world is dropping
  • Why are so many athletes collapsing?  
  • SADS - Sudden Adult Death Syndrome
  • 25% increase in cardiac events age 16-39 after vaccine rollouts
  • 40% increase in deaths in 18-64 group
  • Spike protein is a biomarker for PASC; can linger after infection or vaccination
  • Spike protein alone is toxic
  • Molecular mimicry with the brain
  • Majority of people with Long COVID have spike protein lingering; mRNA has been found lingering as well
  • Long COVID is more common in women, serious cases of COVID
  • The Five Horsemen: A Looming Apocalypse 
    • Immune Dysregulation: high cytokines, MCAS, monocyte shifts, toll like receptors, activation of viruses, neuroinflammation (downfall of the brain), NeuroQuant "sea of red"
    • Had patients that got worse after vaccine if they had an MRI; many non-biological components in the vaccine
    • Autoimmune: tremendous rise during COVID, imbalance of Th17 and Treg, molecular mimicry, 28 out of 55 human tissues react to viral fragments, Zebra fish showed high mortality with spike protein injection, CSF shows high inflammatory markers, similar damage seen as in "chemo brain", new onset or worsening MS after COVID vaccination, exosomes play a role in the development of neurodegenerative disease, spike protein carried by exosomes for up to 4 months, mitochondrial damage, boosts production of tau, shedding is a real phenomenon
    • Spike proteins are carried by exosomes which are found in every bodily fluid
    • Prions: will increase Alzheimer's, childhood dementia is coming, amyloid deposits in many organ systems, found in Long COVID micro-clots, amyloid and tau are prions, spike protein impacts cingulate cortex, sees high inflammation in cingulate in post-vaccine patients, spike blocks ACE2 which is neuroprotective, spike binds heparin leading to more prions, long COVID brain fog may be a form of Alzheimer's, spike in cell culture transformed into amyloid fibrins, Lewy bodies included by COVID, prions are mis-folded proteins, cause normal proteins to misform, only Coronavirus that has a prion arm, rise in prion diseases/CJD in VAERS data, prions found in all vaccines and variants except for Omicron, internal tremor/vibration reported, neurotoxin similar to snake venom, spike inhibits DNA repair 
    • Casey Hodgkinson Interview on YouTube 
    • Vascular: microclots, spike drives senescence  
  • Lockdowns detrimental to mental health
  • Challenges we face are vast
  • Not finding the virus lingering but do find lingering viral fragments
  • Synthetic spike protein appears to last longer in the body than from infection
  • Bruce Patterson finds spike in non-classical monocytes for 24+ months
  • More important than ever to follow healthy routines
  • Ivermectin can be an immune modulator and enhance spike protein elimination
  • 12.6 billion vaccinations given globally; shedding is a new environmental threat
  • Patients are spending their entire life savings
  • Patients with symptoms from shedding are real; have to get out of day to day exposures
  • Most patients likely have vascular inflammation

Peter McCullough, MD spoke on "Five Pandemic Truths: Testing, Treatment, Vaccines, Censorship and Reprisal from the Academic Biopharmaceutical Complex" and shared:

  • Wrote book "The Courage to Face: COVID-19"
  • Five COID truths
    • Negligible asymptomatic spread
      • Assumed it is the first respiratory disease in history that spreads with no symptoms
      • Less than 1%; 85% of spread occurs in the home
      • Putting masks on people with no symptoms is not supported
    • Asymptomatic testing not supported
      • If it can't be spread asymptomatically, why do we need to test?
      • FDA has not cleared tests for asymptomatic spread
      • When rapid test positive, 62% chance of false positives in asymptomatic people
    • Natural immunity protects against severe disease
      • Omicron broke through natural immunity
      • Denial of natural immunity is incorrect; vaccines should not have been mandated in those with natural immunity
      • Any prior infection confers 97% protection against next infection
    • COVID-19 is treatable
      • Has always been a treatable illness
      • Many were working on protocols to treat early on
      • Duty to treat; not let the virus slaughter people around the world
      • Community standard of care is not determined by the government or hospitals; determined by doctors
      • Patients hospitalized that died were the result of a lack of early treatment
      • Did not have time for large, randomized trials; 3-5 years
      • Two bad outcomes: hospitalization and deaths
      • Two Presidents and task forces; none stated the problem
      • Global failure of critical thinking
      • Alpha through Omicron lasted 30 days or more; mortality started climbing after 14 days
      • 3 phases: Viral Proliferation, Cytokine Injury, Thrombosis
      • Remdesivir only helps in the viral proliferation phase; was used at the wrong time
      • Should be doing nasal washes six times a day
      • Symptomatic people should wear a mask
      • Zinc, D3, C, quercetin, Famotidine
      • Monoclonal antibodies have been safe and effective
      • Hydroxychloroquine, Ivermectin, Paxlovid + Doxy
      • May use inhaled or oral steroids
      • May use anticoagulants such as Heparin
      • Very few patients would ever have needed to go to a hospital
      • Other protocols: FLCCC, Zelenko
      • First 3 days are the golden window of treatment
      • Nasal washes with povidone iodine; should not sting; takes very little iodine; 30 second gargles
      • Best way to reduce spreading the virus is nasal washes and gargles; not hand-sanitizers
      • Every house should have povidone iodine or hydrogen peroxide or CoFixRX or colloidal silver
      • A Guide to Home-Based COVID Treatment Guide
    • Vaccines are not sufficiently safe or effective
      • Overreach by government agencies and schools
      • Single greatest concern is the vaccines
      • Over 95% of seniors have taken a vaccine
      • Overall, 65% took the vaccines
      • Current rates of vaccination are as low as they have ever been
      • Companies did not report safety data
      • Injuries and deaths were concealed
      • Documents showed tremendous disability and death
      • World Council for Health confirmed evidence for vaccine recall

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.   

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