The Forum for Integrative Medicine: Exploring Practical Solutions for Complex Conditions

I had the opportunity to attend and moderate "Exploring Practical Solutions for Complex Conditions" hosted by The Forum for Integrative Medicine on March 7-9, 2019.  This was the fourth annual TFIM event, and it was another top-notch conference.  The speakers, attendees, and exhibitors made this a powerful few days full of learning and collaboration.  

The goal of TFIM is to share practical solutions with practitioners such that they in turn can help their patients.  From the TFIM website, "The forum was born by practitioners for practitioners to identify the best integrative tools available in support of detoxification, the treatment of stubborn infections, and overall balance and well-being. The primary focus of the forum is to share practical solutions to enhance the treatment options available to our patients."

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 conference 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.  

Carolyn McMakin, DC spoke on "Frequency Specific Microcurrent: A Powerful Tool For Resolution of Complex Chronic Cases" and shared:

• Frequency-Specific Microcurrent (FSM) is another tool in the toolbox.
• People may use various interventions to recover from an infection, but can still be left with problems.
• Central sensitization is when someone may feel more pain than is actually present.
• FSM uses frequencies and microcurrent.
• Allopathic medicine may not view frequencies as a valid therapy; focus is on pharmaceutical medications.
• Nutrition, herbs, homeopathics, and frequency-based therapies were outlawed by 1924. Practitioners were persecuted and lost licenses.
• Harry Van Gelder, ND, DO bought a practice in 1946 that had a device and a list of frequencies from 1922.
• Carolyn McMakin graduated in 1993 and started her clinic in Oregon; found a two-channel microcurrent device and used frequencies from another list.
• She has let go of trying to fully understand how all of the frequencies were derived; either they work or they don't.
• The full mechanism of action of FSM is not known, but the results are evident and repeatable.
• In toxicity, FSM changes function and pain levels but does not lead to detox reactions.
• With kidney stones, FSM may take the pain from an 8 to a 0 and allow the stone to pass.
• With FSM, there is 1000 times less current than with TENS; it is approved by the FDA for the treatment of pain.
• Healing takes time and energy and is limited by ATP, vascularity, collagen, and elastin.
• ATP may be increased by 500%, protein synthesis by 70%, amino acids by 40%. These may accelerate healing in conditions such as leaky gut and SIBO. What happens to healing if ATP is increased by 500%?
• In rabbits, have seen increases of 39% in vascularity, 14% in collagen, 48% in elastin.
• Genes turned on by injury determine the rate of healing; genes determine what the cells do.
• Frequencies change the genes and speed healing.
• She treated Terrell Owens with FSM after surgery from a fracture to get ready for a SuperBowl six weeks later. He had no swelling, bruising, or pain after 24 hours of FSM therapy. Surgeon indicated it would take 18 or more weeks to heal; was fully healed in 4 weeks.
• For an acute injury, treatment is needed within 4 hours.
• Curcumin lands on the receptor of a cell that leads to reduced inflammation.
• Frequencies change membrane receptor configuration electromagnetically.
• Living tissue is made of biochemicals such as molecules, atoms, subatomic particles held by electromagnetic bonds; every bond has a resonant frequency.
• Water lines the gel inside the cells; gel makes a cell like a gummy bear; water and gel form a semiconductor. Cells function as a semiconductor network.
• Frequencies open cellular locks with electromagnetic signals.
• Anti-inflammatory drugs and nutrients often take too long and may have side effects.
• Lyme, mold, etc. can be gone but we may need to turn off the body's unnecessary response to them.
• Can have Sickness Syndrome where the body needs to be rebooted.
• With Shingles, there are two frequencies to address; the pain can be gone in four hours.
• Frequency changes the membrane's protein configuration and cell function electromagnetically.
• If you resolve the infection, you may still need a new tool for cell signaling.
• Inflammation may be reduced with FSM; LOX-mediated by 62%, COX-mediated by 30%. Inflammation is easy.
• The body uses inflammation to fight infection; frequency can override inflammation even if infection is still present. While inflammation is gone, the infection can proliferate for the next 4-6 hours and make the infection worse.
• If you treat the gallbladder and the pain goes from a 4 to a 7, there is likely a pathogen issue.
• You want to reverse the immune system activation only after the infection is gone.
• In one example, FSM patients pain went from 7.4 to 1.3 in a single 90 minute treatment.
• Significant reductions have been found in IL-1, IL-6, and other inflammatory mediators.
• Cytokines are created by changes in cell signaling. Leads to changes in IL-1, IL-6, TNFα, CGRP, IFNγ. May drop 10-20 times in 90 minutes.
• When you are on immune suppressants, you get infections and cancer. Yo do not want to overshoot the normal range.
• Substance P went from 132 to 10. Endorphins go up; side effect is people can feel stoned.
• Cortisol goes up but not as a stress response.
• In one group, 58% had complete resolution of their issues in 4 months of FSM; all experienced pain relief.
• Can reduce sympathetic stress and modify autonomic dysfunction.
• Functional medicine often costs too much and takes too long.
• FSM works to reduce pain and increase energy, but needs an integrative approach to create lasting, stable improvements.
• May be helpful for nerve pain, muscle pain, low back pain, and other types of pain.

Tony Smith, DC spoke on "Keeping it Simple: Using Biomagnetic Points to Quickly Eliminate Infections and Allergies" and shared:

• Dr. Smith's workshop showed attendees how to energetically support specific microbial overgrowths. This is not something that can be shared in written form, but he does train practitioners on his systems for those practitioners interested.
• In his Lyme patients, he commonly sees an infected liver and viral infections are a key player.
• AllerTouch, one of the systems he created, is similar to NAET; may be simpler.
• Autoimmune issues are often undiagnosed pathogens or allergens.
• His work builds on Contact Reflex Analysis from Dr. Richard Versendaal, DC using various points on the body.
• LymeStop uses the brain in conjunction with the points to get the brain to lock on to the infection and get rid of it.
• He does not use antimicrobial nutritional support or "killers".
• It is unusual for him not to find a virus in the liver in those with Lyme.
• Many sensitivities are the result of a sick liver. The sick liver cannot phagocytize and leads to a Herxheimer reaction when you start killing modalities.
• EBV is easily transmitted between partners.
• Aspergillus is often energetically found in the sinuses.
• When someone has Borrelia, it is very uncommon not to have Bartonella, Babesia, and several viruses; people generally have the "whole Lyme package". When you get bit, it is a package deal.
• Borrelia is not generally the bad boy.
• Lyme carditis is often viral.

Kristine Gedroic, MD spoke on "Unraveling the Herx Reaction: Treating the Hard to Treat" and shared:

• A classic Herx reaction is uncommon.
• Resolvins are anti-inflammatory.
• Candida is a lead producer of resolvins in a balanced state.
• Cytokines - Th1 and Th2 (IL-4, IL-5; allergic)
• Toxins and microbiome changes inhibit the body's ability to create anti-inflammatory signals.
• Pituitary adenoma is IL-6 based and may resolve with treatment for mold exposure.
• CD57 is tightly linked to mold and immune suppression; treating mold leads to increase in CD57.
• If one is not sick in years and then starts getting sick, that's an indication of a more normal immune response.
• The "toxic patient" is most patients until detoxified. People will Herx like mad until detoxifying.
• Toxicity impacts the matrix and cell membranes.
• Extracellular Matrix (ECM) is involved in transport, storage, and communication.
• We are 99% energy and frequency and 1% matter. The autonomic nervous system is linked through the matrix; matrix congestion limits cellular communication.
• In support of membrane stabilization, supplements are generally needed; food is not enough.
• Cell wall fats, very long chain fatty acids (VLCFA), are associated with viruses and fungi; best way to burn these up is fever.
• Demyelination is a nerve stripping and can be from mold exposure.
• Too much fish oil can block the omega 6 pathway; want a 4:1 ratio of healthy omega 6:omega 3. We need non-oxidized omega 6 oils.
• Butyrate has far reaching inflammation-modulating properties.  
• Phos Choline (PC) works as a TNFa inhibitor; can even stop bleeding in Ulcerative Colitis.
• Lipid rafts form with Borrelia; addressing them is helpful in resolving Borrelia.
• Prometol may be used for myelin support; no one reacts badly to it; even the depleted patient. May help in those with tremors or parasethesias.
• Mineral supplementation is critical; you cannot get enough good minerals from your diet.
• Need the environment around us to be anti-inflammatory.
• Fungi create inflammatory reactions in the body.
• Fungi host Strep, Staph, and Mycoplasma within them. Fungi and Borrelia don't play well together.
• Yeast in spore state govern and prime the immune system and create immune balance; when antagonized, biofilms are produced.
• The focus has been on the "microbiome"; need to think about fungal communities and the "mycobiome".
• Antibiotic therapy may worsen the "mycobiome" and "microbiome".
• You cannot get rid of Lyme or Borrelia in a patient unless you get rid of mold illness.
• There is an adult PANS; it is just not recognized or labeled yet.
• Lyme makes the mold layer in the body more inflammatory.
• If there is no history of mold illness or Candida, the patient will generally do well treating Lyme. If there is a history, it is a much different issue and trickier to fix.
• Fungi and parasites are too big to blow up like bacteria and virus; it is more of a tolerance pattern that we need to develop.
• Excessive inflammation will kill the host; fungi and parasites help us with certain things.
• Candida takes EPA and forms a resolvin which is anti-inflammatory. It helps to govern our inflammatory response.
• Mycotoxin exposure must be removed; getting mold biofilm out and inflammation to stop.
• Common mycotoxins are found in all baby food.
• Cholesterol can drop 100 points in weeks with treatment of mold illness.
• Trauma is stored in the body; either had it or now have it from the illness itself; almost no escaping it. The brain is blocking the body's ability to heal due to trauma; have to deal with the trauma to heal.
• Don't forget the gallbladder; PRL Gallbladder ND and Swedish Bitters can be very helpful.
• Put minerals in a Power Shake; electrolytes when having muscle cramping.
• Avoid glyphosate; it is wrecking guts.
• The classic herx is mitigated by alkalinizing; Epsom salts can help.
• LDN can help high inflammation but not for a general Herx; does not work for all but magic for some.
• In their office, they don't see the classic Herx since they incorporate detoxification and drainage support into their protocols.
• IV PC helps with biofilms; oral PC (a complex of many phospholipids, not just PC) is more for supporting the internal cell membranes.
• PE (Phosphatidylethanolamine) which can be found in oral PC products may help anxiety; low PE is associated with anxiety.

Ann Corson, MD spoke on "Solutions for Mold, Glyphosate, Heavy Metals, and Other Environmental Toxins Making Us Sick" and shared:

• Mold creates systemic inflammation.
• There can be many different environmental toxins that create inflammation.
• Intermittent nosebleeds and hair loss can be associated with trichothecene mycotoxins.
• Don't go swimming in bioluminescent bays as these can be a source of biotoxins.
• Chronic infections such as Borrelia, Bartonella, and Babesia may have their own toxins.
• 25% of people have a genetically faulty hard drive and don't turn on an antibody response to toxins.
• These toxins can be absorbed through mucous membranes; a mask is not enough as they can come into the body through the skin and the eyes.
• Mold and mycotoxins lead to direct damage to the lining of the gut; they are like "sparks on a silk scarf".
• We can swallow, breath, or eat toxins.
• The blood-brain barrier can be damaged just like the gut barrier and lead to inflammation.
• Toxins are epigenetic modifiers that turn on inflammatory cytokines.
• Elevated cholesterol and LDL is a marker for chronic inflammation.
• Hypercoagulation, or thickened blood, plays a key role in chronic illness. This is often the result of microbes or toxins such as heavy metals.
• You never get rid of the infections until you remove the person from a toxic environment; must do both mold and infections. Assume mold, mold, mold!
• Can have profound fatigue, brain fog, and exercise intolerance.
• When a patient is encephalopathic, think mold or Babesia.
• Long-term mold patients cannot handle EMR/EMFs.
• Often have mast cell activation as well.
• She looks at urinary mycotoxins.
• Get the heck out; you will NEVER get better if still in mold.
• The whole planet is contaminated with glyphosate.
• Remove, remove, remove the toxins.
• Binding toxins is something that many practitioners do not do.
• Some of her patients have to change jobs, change schools.
• Reducing inflammatory cytokines may be done with FlexNow, Nrf2 Activator, Beyond Balance IMN-CALM, Ibuprofen, Curcumin Pure, CytoQuel and other tools.
• GI vitality must be restored after mold exposures; Zach Bush's RESTORE is a great tool.
• For binding, Researched Nutritionals MetalPul (also helpful for glyphosate), GI Detox, Microsilica, Beyond Balance TOX-EASE BIND.
• Excess fibrin is part of the inflammatory response.
• After an exposure, clean the body, change clothes, incorporate supplements.
• Used to think that chemtrails were only a California thing, but this is no longer the case and may be a source of exposure to heavy metals.
• Aluminum, mercury, lead, and cadmium are key metals to consider.
• Tattoos are horrible.
• We are exposed to toxins through vaccines, food, air, and water.
• Moving too many heavy metals too quickly can move them to the brain, kidneys, pancreas, and other organs. Detox of metals should be slow and low.
• Solidago is incredibly helpful for helping the kidneys to dump metals.
• Glyphosate is a modified glycine molecule.
• It is a desiccant for crops to dry them prior to harvest.
• Plants become deficient in vitamins.
• Glyphosate damages the gut and blood-brain barrier; unzips tight junctions.
• Glyphosate kills Lactobacillus and Bifidus - negatively impacting our microbiome.
• Autistic children often have Clostridia, Klebsiella, Salmonella, and other pathogens which may be the result of glyphosate impacting the microbiome.
• Glyphosate impacts liver function and bile flow.
• Serotonin is required for proper function of the bowel, not enough bile salts, can lead to constipation.
• It may not be Zika virus that leads to encephalitis but pesticides.
• Glyphosate was used to clean out pipes; as it is a chelator and can bind essential minerals.
• Glyphosate is an endocrine disruptor.
• Glyphosate-contaminated grain may explain the increase in gluten sensitivity.
• Glyphosate may result in autoimmune diseases via molecular mimicry.
• Manganese deficiency is huge; is needed for Lactobacilli to prevent overgrowth of pathogens; may need to replace in those with neuro-excitation.
• Eating aluminum doesn't have much of an impact but when bound with glyphosate, it more readily gets into the system.
• Glyphosate blocks the Shikimate pathway and the production of K2; contributes to the development of superbugs.
• Folic acid creates problems; does not solve them. Can lead to cerebral folate deficiency.
• Glyphosate leads to a deficiency of cholesterol sulfate, heparin sulfate, and chondroitin sulfate.
• Can glyphosate be put into proteins where glycine should be?
• Our collagen is full of glycine.
• Factory-farmed animals eating glyphosate and GMOs are full of it; from their body's come gelatin which are in various foods and supplements.
• Glyphosate contamination has been observed in vaccinations; MMR has more by an order of magnitude.
• Use care with animal products, digestive enzymes, glucosamine, and other.
• Getting sunlight on the skin helps us to get sulfate.
• Collagen from clean sources such as BulletProof can replete the body.
• We do not get enough trace minerals; BodyBio ELyte.
• Glypho-X from Supreme Nutrition or Researched Nutritionals MetalPul may help with glyphosate.

Christopher Shade, PhD spoke on "Beyond Detox: Integrating Autophagy into Detoxification Protocols for Clearing and Rebuilding Damaged Cells and Increasing Mitochondrial Density" and shared:

• A true "Herx" reaction is a die-off promoting a huge inflammatory response.
• Hepatocyte transporters can be blocked; another door opens that dumps the toxins back into the blood; can lead to skin issues, itching, rashes, brain fog.
• Bile flow, directionality, immune stabilization, and autophagy are all important aspects of excreting substances from the body.
• Resistance to toxicity is a moving target; when defenses are low, you are more susceptible and when high, you are more resistant.
• The microcosm is the cell; the macrocosm is the liver, gallbladder, GI, kidneys, skin, and lungs.
• The transport system uses ATP and magnesium as co-factors.
• Phase 1 is activation; substances are not reactive prior but are reactive after phase 1.
• Phase 2 is conjugation.
• Phase 3 is active transport; move it out.
• Metals do not need phase 1; the go into phase 2 and 3.
• Need proper coupling of phase 1 and phase 2 and then movement quickly into phase 3.
• LPS and endotoxins are toxins coming from the GI tract.
• The inflammatory reaction is a response to the perception of bacterial infection.
• When inflammation goes up, detoxification goes down.
• The biggest entrance of endotoxin is from leaky gut.
• We have an Antioxidant Detox Protein Repair Supersystem which is chemoprotective from damaging molecules; endotoxins or exogenous toxins.
• Glutathione and Vitamin C become oxidized.
• The master switch for upregulation of the chemoprotective system is Nrf2; activators are polyphenols, R-ALA, and sulphoraphane.
• Polyphenols, sulphoraphane, and ALA are mild toxins that turn up the chemoprotective system.
• Mercury and arsenic turn up the system also; but with side effects.
• Endotoxin inflames the liver and kidneys and leads to neuroinflammation (connected to GI dysfunction).
• Every hepatocyte is fed by blood and drained by bile.
• Two doors out: one feeds bile salts out and one feeds toxins out.
• The movement of bile is the movement of toxins.
• Cholestatis is toxostasis.
• Phos Choline is constantly donated into bile flow to keep the bile fluid and make liposomes of PC and bile salts to protect the membranes from the bile which is a detergent.
• When inflamed, we block transporters into bile and cannot get rid of bile and toxins. Turn up transporters in and down going out.
• Sympathetic dominance blocks the system. Fight or flight; energy is moved away from the luxury of detox.
• CBD balances glutamate/GABA and PNS/SNS (parasympathetic nervous system / sympathetic nervous system).
• Progesterone is excellent at moving the liver.
• Blocking endotoxin from moving out of the gut is a top action to support the transporters; RESTORE, charcoal, MegaMucosa.
• Liver Sauce and UltraBinder; dump the bile and pick up the junk. This is done in quick increments with the Liver Sauce and then the UltraBinder 30 minutes later for an hour total cycle.
• Liver Sauce is like "A1 for the liver" and contains bitters such as myrrh (primary Ayurvedic bitter for moving stagnant chi), quercetin, luteolin, DIM (for immune and Nrf2 support), and alpha lipoic acid as a driver.
• Quercetin is poorly absorbed but super when used in the right delivery system.
• We have bitter receptors throughout the body.
• Bitters No 9 worked well for men, but needed Bitter X for women.
• PC and bitters activate the transporters.
• Milk Thistle keeps the liver dumping toxins instead of throwing them back into the blood.
• The cell membranes make decisions about what genes are expressed inside the cells.
• With SIBO and SIFO, why is it there? Bile is like soap or detergent and is the washer and is antimicrobial. When working with SIBO, think about bile flow.
• Chronically toxic people have overactive immune systems, food intolerance, histamine issues, and MCAS. Stabilizing mast cells is key to moving toxins.
• DIM supports Nrf2, breakdown of solvents, is an immuno-tolerance promoter and upregulates TReg activity. It is an epigenetic modifier of Nrf2.
• Tumors grab and hold toxins and become sinks; not sure if it is the chicken or the egg.
• Mold exposures block the detoxification system and activate mast cells. DIM opens liver activity in mold patients, stimulates immuno-tolerance, and may reduce food sensitivities.
• Brain fog after eating is likely a permeability issue or MCAS. Quercetin and luteolin may be helpful; more effective than Cromolyn.
• Stabilizing the body's response to the movement of toxins allows for movement at a more rapid pace.
• Autophagy is cleaning out what is old and rebuilding new. If this is not working, there is layer after layer of dysfunction. Non-alcoholic fatty liver, obesity, cardiovascular disease.
• mTOR activation is laying down more. Insulin and BCAAs push mTOR. Too much protein prevents autophagy. If you can block mTOR, you can reverse fatty liver.
• Milk thistle blocks mTOR and clears fatty deposits to rebuild the liver.
• Quercetin stabilizes mast cells and blocks mTOR.
• Don't need B3, nicotinamide, NAD; both quercetin and milk thistle can help here.
• Alpha lipoic acid leads to moving things without having the system ready to take them out which can lead to symptoms, otherwise it can be wonderful.
• Everything then goes down the GI tract; cleaning up the mess with UltraBinder.
• 100 classes of toxins each; each binder is specific for different toxins; ideally use multiple.
• IMD, charcoal, clay, chitosan (Welchol mimic), and others can be helpful.
• Charcoal binds endotoxins. Clays and charcoals can be mold binders.
• Charcoal is a cytokine mop. Take charcoal when you have the flu.
• Chitosan is not allergenic.
• 82% of fatty liver cases in a study resolved with the QuickSilver Push/Catch system.
• CBD is a backdrop for all detoxification. If you don't have CBD in autism, it is hard to make headway due to neuroinflammation.
• CBD balances GABA/glutamate as well as PNS/SNS. Supports detoxification at a neurological level.
• Glutathione needs to be in the fridge. If not kept cold, it is no longer glutathione and becomes a toxic metabolite.

Anju Usman Singh, MD spoke on "PANS and PANDAS: An Integrative Approach To A Growing Problem" and shared:

• Children with autism used to get better with dietary changes 15-20 years ago.
• Patients may be doing really well and then are a mess.
• Some adult patients might have PANS; may be "autoimmune encephalitis".
• After four untreated strep infections, there may be a chronic autoimmune encephalitis, but not relapsing/remitting.
• PANS can be infectious or non-infectious.
• Mold, glyphosate, stress, trauma, allergens, and chemicals may be non-infectious triggers.
• Lyme, Mycoplasma, Bartonella, Babesia, herpetic viruses may be infectious triggers.
• Autoimmunity is not really an infectious disease but a dysregulated immune response.
• Protein in measles mimics myelin; the virus or vaccine may lead to autoimmunity.
• Strep antibodies cross-react with the basal ganglia; myosin in the heart with rheumatic fever.
• Sydenham Chorea is a movement disorder and is a little different than tics; IM penicillin monthly may be used.
• Autoimmune enchephalitis can be a progression to a chronic autoimmune condition.
• Autoantibodies cross the blood-brain barrier.
• Immune system and lymphatic channels are in the brain.
• Strep in the throat and gut are Group A. Upper-respiratory in sinus, gums, ears, tonsils, adenoids.
• Produce Th17 cells that then migrate in the body.
• Create a breakdown of blood-brain barrier and IgG stimulates microglial activation.
• Can be found in the anus; culture from above and below.
• Leaky gut and leaky brain; endotoxins from the gut can impact the body.
• The body can have an immune reaction to being around others that have triggers like Strep without actually having it; caregivers, family, schoolmates.
• May hide under biofilms and not be culturable.
• Rapid Strep test is available on Amazon.
• A trigger leads to autoimmunity to neuronal proteins, stimulates CAM Kinase II, leads to inflammation and activation of IDO and NMDA, leads to excitation.
• Quinolinic and kynurenic stimulate NMDA and more activation and excitation.
• Moleculara Cunningham Panel is best done when in an acute state or flare.
• CAM Kinase may come down but you may be left with neuroimmune inflammation.
• The traditional PANDAS world uses SSRIs.
• Tryptophan steal can be bypassed with 5-HTP.
• High kynurenic and quinolinic acid can impair the mitochondria.
• B3 can help stop excitation in the brain.
• Peak is 6.5 years old; more boys than girls (2:1 vs. 4:1 in autism). 1 in 250 children.
• 5-10% have observable behavioral issues related to Group A strep.
• Anorexia is big.
• Episodic, relapsing/remitting.
• OCD, tics, symmetry, body image distortion, even suicidal thoughts. Anxiety, depression, aggression, behavioral regression, school performance loss, sensory issues, tics, sleeping issues, frequent urination.
• On physical exam, may see red throat, strawberry tongue, peeling of fingers and toes, joint pain, swelling, skin findings.
• Criteria is not based on any labs.
• Often have a positive response to a 21-day course antibiotic trial; some respond to steroids.
• Bartonella, Lyme, and related infections may not be the trigger for the immune dysregulation but may become active as a result of it.
• Organic acid testing can show Candida, yeast, Clostridia, IDO upregulation for quinolinic/kynurenic, oxalates.
• Stool testing for dysbiosis and parasitology may be helpful.
• Amino acid testing. High dose NAC 900mg three times daily helped core issues in autism of speech, socialization, and behavior.
• Genetically, COMT and MAOA mutations are observed. COMT helps to detoxify dopamine and epinepherine, norepinepherine, and serotonin. MAOA is similar. SNPs may be expressed; infections may upregulate or downregulate the expression. These mutations are the harder patients with high dopamine symptoms: aggression, anxiety; don't do well with methyl donors as it makes more serotonin and dopamine.
• May not be overmethylated, but not using methyl groups and have an abundance of donors that inhibit the folate pathway; folate trap.
• Treat the infection with antibiotics, antivirals, or antifungals.
• Provide symptoms relief and immune system support.
• For immune system, may use IVIG at high doses which modulates the immune response; whereas lower doses may stimulate and make the autoimmune issue worse.
• Has not seen great results with plasmapheresis.
• Deal with the terrain and detox the matrix.
• Cleanup the environment, diet, and gut.
• Immune modulators may include zinc, D, A, C, LDN (modulates Th1/Th2) transfer factors, LDI (very helpful).
• Address dysautonomia (too much sympathetic, not enough parasympathetic)
• Address allergies and MCAS.
• Consider natural antiinflammatories.
• May also use homeopathics or essential oils.
• Her favorite supplement is diet.
• Biome depletion may be associated with numerous issues; can replenish with good parasites.
• Propranolol can help calm down an excitatory brain; downregulates sympathetic response.
• With salt cravings, work on adaptogens for the adrenals. Licorice upregulates cortisol; don't take at night.
• For MCAS, Cromolyn, H1 and H2 blockers, Singulair, Ibuprofen, Ketotifen.
• Natural options for MCAS include quercetin, luteolin, PEA (MCAS stabilizer), curcumin, EGCG, mangosteen, black cumin seed oil (a favorite).
• Biofilms are held together by calcium, iron, magnesium. Curcumin is a natural iron chelator and has a biofilm effect. Inhibits COMT and MAOA further.
• Cat's Claw is a natural calcium channel blocker.
• Kudzu may be helpful for collagen restoration.
• Essential oils can be helpful in those that will not take supplements.
• Lemongrass is the most potent antimicrobial. Thyme is the most potent antioxidant.
• Vitamin A may be used at 200,000 units daily for two days to support flares. It is used short-term as it can be toxic longer-term.

Amy Derksen, ND spoke on "Microbial Support Approaches for Complex, Chronic Infections" and shared:

• Lab Testing
  • Clostridia can lead to aggression.
  • Look at the gut and stool testing.
  • Quantitative immune response testing
  • Iron or ferritin (false high in inflammation)
  • Zinc and magnesium are crucial.
  • Alk Phos below 40 is either KPU or zinc deficiency.
  • Very low cholesterol may be that one is not digesting and has high fat in the stool.
• Lots of people say that coffee enemas are helpful.
• If eating nothing feels better, there are likely lots of gut reactions.
• If not moving the bowels, don't start killing.
• Antifungals sometimes help; may be sympathetic dominance.
• Salt cravings may be a clue for electrolytes.
• Magnesium citrate (CALM) helps to reduce oxalates.
• Dairy is a top trigger for constipation.
• Not sweating can be a clue for low electrolytes.
• IonCleanse: Not a lot of placebo effects with autism; language developments and other gains. It is not what comes out in the footbath, but better excretion for 48 hours after.
• Beyond Balance LYMPH-SPPT may be supportive in those with ear infections.
• Castor oil packs over the entire abdomen can support bile flow.
• Has not seen fungal issues with NAC as some have suggested.
• Consistently, colonics or coffee enemas are in the top three most helpful things for adults.
• Pectasol-C is becoming a favorite as it downregulates inflammation. Patients on antifungals that have red cheeks or ears with mild amounts of sugar; seems to downregulate immune reactions.
• May use 3-4 grams of Omega 3s in adults.
• Magnesium malate or glycinate for muscles, threonate for brain, citrate or oxide for constipation.
• Ketotifen (or Alaway eye drops in the nostrils 1 drop 2-3 times a day) can help some with food reactions.
• Quercetin before meals and at bedtime is a favorite for MCAS, allergies, and food or supplement reactions.
• Baking soda, Alka Seltzer Gold, Tri-Salts between meals have a calming effect and are alkalizing.
• LDI is a great tool to promote immune tolerance.
• PEA fatty acid for neuroinflammation. Luteolin as a MCAS stabilizer. Mirica combines the two; 1-4 three times daily.
• High histamine people can be sensitive to phenols.
• Beyond Balance IMN-CALM is very well tolerated; for calming down the overactive immune response.
• CBD should be a backdrop to most protocols especially in those with upregulated immune responses.
• High doses of CoQ10 up to 1200mg/day in adults or 400-800mg/day in children in crisis have been helpful for inflammation.
• Vitamin E at high dose once weekly can help calm the system and reducing inflammation..
• If zinc is not raising Alk Phos, consider B6 and Evening Primrose Oil.
• Melatonin in high doses can be protective for the brain; 30-60mg nightly in some patients. Oncotonin is a 10mg capsule.
• Estriol can be a great anti-inflammatory; studied for MS. Progesterone is very calming to the system.
• Mushrooms when WBC are 3.0 or lower can be great; great for EBV.
• Researched Nutritionals Transfer Factors can be great.
• When Lyme IgM positive but no IgG, may need antimicrobials.
• Gas and bloating may be bacteria or yeast; enzymes with evening meal is ideal.
• Probiotics such as MegaSporeBiotic to support gut immunity. Usually probiotics after killing phase and prebiotics later. Unless the probiotics are being used as a protection while doing antibiotics.
• ProBiota HistaminX has been helpful.
• Can take Saccharomyces boulardii and antibiotics at the same time. Do not take Saccharomyces and Diflucan at the same time. Rotate probiotics. Use care with Strep strains in those with PANDAS.
• Parasites are the number one thing to treat first.
• Some of the worst mold patients are her Arizona patients; has not seen a good ERMI yet.
• Aggravations 3 days before a full or new moon are a clue for parasites.
• High eosinophils or basophils may be parasites.
• GI MAP is her favorite stool test.
• Compounded Mebendazole often works well; it is not processed through the liver.
• Likes Botanifuge for parasites; 1-2 capsules three times daily for 3 months.
• Red ears, cheeks, hand-flapping, and tip toeing are clues for yeast.
• Biotin can be a great tool for breaking down yeast.
• Biocidin is a go to for microbial exposures; acute issues.
• Berberines are natural antifungals, antibacterials, blood sugar support, and do not impact good flora.
• LDI is amazing for yeast.
• Fluconazole is a Th1/Th2 modulator and very calming to the system. Can dose twice weekly.
• Strep testing must also swab the teeth; may consider Chlorhexidine mouth rinse or colloidal silver.
• Cat's Claw is resurging as a helpful tool in her practice.
• BioPure IDALIA for Lyme 3 nights a week is well-tolerated.
• Become familiar with ozone: mitochondrial support, antioxidant support, autoimmune support.
• BioPure Quintessence is well tolerated in terms of die-off due to the red root for drainage support.
• Lyme often flares in October, November, December.
• Beyond Balance MC-BAB-3 has been very helpful for strange autoimmune presentations.
• Viruses can play a role in tinnitus and hypersensitivity.
• Vitamin D up to 100,000 units daily for 3 days can really help address the flu.

Morley Robbins, MBA, CHC spoke on "Understanding the 3-Ring Circus of Iron Metabolism" and shared:

• We need more magnesium.
• We need more bio-available copper.
• We need less iron.
• Ceruloplasmin is the most important protein in the body.
• Every patient has a deficiency of bio-available copper.
• Iron is in the tissue, not in the blood.
• Doctors are trained to demonize copper and promote iron; this is all backwards.
• Iron is a waiter carrying oxygen. Iron and oxygen do not play well without enough bio-available copper.
• 46% of the copper in the body is in the bone marrow.
• Copper is the only element on planet Earth that activates oxygen.
• Blood tests to measure iron are not presenting the correct picture.
• Retinol loads copper into ceruloplasmin.
• Zinc triggers metallothionein which binds up copper.
• Zinc and iron are four-letter words.
• When vitamin A came out of the diet, A and hemoglobin in the blood dropped. We introduced iron which led to hemoglobin popping back up and then collapsing. We introduced retinol and hemoglobin increased. There is no correlation between hemoglobin and iron; there is with retinol and hemoglobin.
• Copper is not toxic, and iron is not deficient.
• A lack of bio-available copper causes iron accumulation in the liver; we have iron-toxic livers.
• The ideal ferritin level is 0.
• High Fructose Corn Syrup shuts down copper absorption in the human body.
• You cannot measure ferritin in a copper-deficient organism.

Michael McEvoy spoke on "Joint Hypermobility: The ECM & Complex Illness: Problems and Solutions" and shared:

• Cusack Forum for Ehlers-Danlos Syndrome is a helpful resource.
• EDS is a dramatically under-diagnosed condition in the population.
• Hypermobility component is overlooked; breakdown of connective tissue and extracellular matrix (ECM).
• Modulation of the ECM can help with patient symptoms.
• Many stealth infections including Lyme coinfections can lead to hypermobility.
• Do not prescribe flouroquinolones in hypermobile patients; they damage mitochondrial DNA.
• Borrelia and Bartonella live in connective tissue and hide from the immune system.
• Mold and CIRS lead to higher MMP-9 levels which degrade connective tissue.
• Worst "floxers" are those with hypermobility or EDS.
• Trivalent metals bind to negatively charged sulfates in the connective tissues.
• Most common symptoms: pain, circulatory problems, inability to utilize growth factors, neurological complaints, bowel disorders, structural abnormalities such as craniocervical instability, spinal leaks.
• There is an enormous link to autoimmune conditions in the hypermobile population.
• Pisinger book "The Extracellular Matrix and Ground Regulation: Basis for a Holistic Biological Medicine" on regulation.
• ECM regulates growth factors and cytokines including TGFb1.
• Modulating the ECM may include use of polysaccharides which comprise the ECM such as aloe vera, cordyceps, maitake, and others.
• All fluid in the body is charged with electrolytes, ions, and proteins. Gerald Pollack's 4th Phase of Water discusses how water hydrates tissues and maintains a charge. Hyaluronic acid draws water into tissues.
• Fibroblasts are like a spider that spins the web of connective tissue; in communication with macrophages and mast cells.
• Naviaux's new cell biology with Cell-Danger Response (CDR) discusses how ATP is released and becomes the danger signal and metabolic processes in the cell shutdown at the expense of removing the threat or danger.
• MCAS is common in EDS; not just histamine intolerance.
• Mast cells are integral in tissue remodeling; is it part of a healing process the body is going through that is needed to heal?
• TGFb1 is a CIRS cytokine, but it is a ubiquitous cytokine and is immunosuppressant. We need TGFb1 to activate TRegs.
• Total C4 levels are associated with autoimmunity; measure it.
• Discussed a case of healing a wound with Aquamin red algae polysaccharide and other interventions.
• Elevation in TGFb1 can be due to a defect in the tissue.
• Have to have balanced mTOR; those with low muscle tone may have an mTOR deficiency.
• High TGFb1 in the blood could be a tissue level problem.
• Some possible tools include magnesium, aloe, CBD, hydration and electrolytes, C, mushrooms (maitake, lion's mane), probiotics, D, turmeric, physical therapy and others.
• If hypermobility was the result of a chronic illness, find and fix the trigger and that could resolve the ECM issue.
• One case of hypermobility he worked with was caused by Bartonella and resolved with Bartonella treatment.
• Pathogens live in the connective tissue.
• Amino acid intake is important to rebuilt tissue.
• Sodium ascrorbate has been very helpful.
• Aloe vera, marine algae, lion's mane, maitake, and trace minerals.
• Low RBC manganese could be a Lyme indicator.
• If working with MCAS patients, antihistamines are anticholinergic which may lead to an increase in POTS symptoms.
• Work on connective tissue, clear the microbes, use hydration and polysaccharides, and amino acids.
• BPC-157 is being explored. MegaComplex-GF from chicken embryos.
• ParaSym Plus is an acetylcholine promoter which is helpful for the vagus nerve, POTS, and gastroparesis.
• RCCX is the most significant gene influencer of the immune system, connective tissue, and stress response; cortisol and aldosterone. It is a copy number variation which is rare. Huntington's associated.
• Low C4 = lower TGFb1 and lower TReg.
• Endogenous retroviruses are central to our body, but their RNA shows up in autism, cancer, and autoimmunity.
• HERV-K in C4 gene has an impact in schizophrenia.
• Mold can be an epigenetic trigger of RCCX.
• If C4 is low, you need to look at how to turn on TRegs; Bacillus subtilis, bovine immunoglobulins modulate TRegs.
• Urinary aldosterone will be low in suspected RCCX.
• Aldosterone modulates immunity and clotting (not just sodium).

Dietrich Klinghardt, MD spoke on "Anti-Retroviral Approaches in Chronic Illness" and shared:

• 90% of his prior failed patients were high in retroviral activity.
• Dr. Klinghardt is the last standing naturopath.
• Treats Lyme entirely with herbs; has given up on antibiotics.
• Everything else is secondary to Wi-Fi.
• Alzheimer's disease is delayed onset autism, aluminum.
• Environmental mold is important.
• Lyme treatment is 1000 times easier to address with dealing with the retroviruses.
• Detoxifying glyphosate is huge; always comes with 60 other chemicals.
• Autism and aluminum go together.
• We are all mutants that live in a Wi-Fi environment.
• Found 8 of 10 with autism had Lyme.
• We are all born with retroviruses.
• 2% of our DNA is used for transcription of proteins; the rest was believed to be junk. 8% of that is retroviral material.
• Methylation is the principle mechanism to silence retroviral DNA; without methylation, we develop "AIDS minor".
• Retroviruses are in vaccinations.
• We can acquire external retroviruses.
• Vaccines are grown on aborted embryos. Getting vaccinated is not for vegans or vegetarians.
• Vaccines are a great idea, but not executed well.
• Every biting insect has retroviruses.
• All neurological diseases are linked to insect bites.
• No lab currently is able to test for these.
• Retroviruses are in cat fleas and feces of cat fleas survive for weeks.
• The link between MS and retroviruses gets stronger everyday.
• There is a link between breast cancer and retroviruses.
• EBV is the iceberg; retroviruses are underneath.
• EBV presents due to retroviral immune suppression.
• Treating EBV never works; treat the retrovirus, and the EBV goes away.
• High retroviral burdens are associated with autoimmunity.
• RA, Lupus, Scleroderma, CFS, non-Hodgkin's lymphoma, cancers, autism are all linked to retroviruses.
• Not all retroviruses in our DNA are bad; they downregulate immune response during pregnancy to create fetal tolerance.
• Pregnancy is a localized autoimmune disease.
• Retroviruses can induce genetic mutations. He has seen children with autism that had a gene mutation that neither of the parents had. Retroviruses can cause spontaneous mutations of genes.
• Retroviruses are activated by Wi-Fi and disabling of the methylation and acetylation processes in the body.
• Shutting off Wi-Fi will be the biggest thing you can ever do for yourself.
• When you minimize Wi-Fi exposure, you can start detoxing and feel miserable for six weeks as a result.
• Glyphosate carries aluminum to the pineal, thyroid, and brain.
• ATP is the signal for the cell-danger response (CDR); exposure to EMFs lead to cells feeling threatened.
• CD39 and CD73 are CDR markers. Turning off Wi-Fi normalizes.
• Suramin was licensed in 1912 and is a fantastic tool to mitigate the CDR. The WHO says it is a top 10 crucial medication but it was taken off the market.
• Cannabis has retroviral activity.
• Higher CD26 observed with lower retroviral activity.
• Nagalase is the only easy to get marker for retroviral activity.  0.65 or below indicates not actively infected; the higher, the more retroviral activity.
• RANTES is another tests for measuring retroviral activity but is not available in the US.
• Retroviral infections live longer with glutathione. Injectable glutathione cannot be packed with nitrogen so the glutathione is oxiized and thus does not work. Liposomal glutathione works, but not significantly.
• Melatonin is an absolute miracle drug. Transdermal melatonin at bedtime is the most neurologically healing agent for the brain that he has ever encountered.
• Glutathione is overrated; melatonin is underrated.
• DHEA with melatonin can be helpful for immune regulation.
• Melatonin can be fantastic for Lyme as an antibacterial agent
• Melatonin is fantastic for anti-aging; better than growth hormone.
• Fantastic for fertility if both the male and female are doing; safe during pregnancy.
• Melatonin is a fantastic antifungal.
• Broccoli sprouts and cistus tea can be helpful for retroviruses.
• Cistus worked in every case of failed HIV treatment. Start with the tea and then use the medical drugs.
• Ki Science Retro-V powder or BioPure EN-V for retroviral silencing.
• Pantethine, luteolin, selenium, Ecklonia cava can be helpful.

Allison Siebecker, ND spoke on "SIBO – Small Intestinal Bacterial Overgrowth" and shared:

• 2/3 of SIBO cases are chronic.
• Main cause of IBS; 60% of IBS is caused by SIBO
• 45 million people in the US have SIBO.
• Food poisoning, stomach flu, and travel's diarrhea can be common triggers.
• It is not bad bacteria; that may have been an initial trigger, but SIBO is normal commensal flora that is overgrown and is more of a location issue. It is not an infection but behaves like one.
• SIBO impacts a billion people worldwide; the majority with IBS will have SIBO.
• Practitioners treating Lyme, mold illness, EDS, and POTS will see SIBO all the time in their patients.
• Symptoms are created from eating.
• LPS endotoxins inhibit phase 2 and 3 detoxification.
• Bacterial overgrowth will lead to excess LPS.
• SIBO treatment may be a pre-req for detoxifying effectively.
• SIBO treatment is needed before one will tolerate sulfur.
• SIBO is a common secondary consequence of underlying illness.
• The small intestine is its own distinct organ.
• Bloating the food reactions to carbs are hallmark symptoms; as well as burping, farting.
• Anxiety is very common in SIBO; negative futuring.
• Hydrogen sulfide symptoms are not that common; may lead to activation of endogenous viruses.
• There can be a physiologic underlying cause; small list; structural and functional causes.
• Protections include HCl and bile.
• Anatomy can trap bacteria where the ileocecal valve (ICV) is not working properly. It should prevent back-flow into the small intestine.
• Migrating motor complex impacts motility which is important for moving bacteria out of the small intestine. Occurs when fasting.
• What has gone wrong to allow accumulation of bacteria in the small intestine? It is a matter of terrain.
• MMC occurs between meals and overnight; eating turns it off. Occurs only in the small intestine, primarily in the top 2/3 of the small intestine and is known as the "housekeeper wave".
• A lack of a functional MMC creates a stagnant river.
• Deficient MMC is seen in Scleroderma, diabetes, EDS, hypothyroidism, Parkinson's, Lyme and co-infections, and other conditions.
• Adhesions can obstruct the small intestine.
• Immunodeficiency plays a role; the rate of SIBO in HIV is 88%.
• Taking acid blockers and PPIs can increase SIBO.
• Dr. Pimentel talks about food poisoning; CDT toxin looks like vinculin and impacts the ICC cells that generate the MMC.
• Molecular mimicry may occur where the immune system damages the ICC nerve cells and decreases MMC waves.
• Post-infectious IBS is SIBO.
• IBS Blood test is a test for CDT and anti-vinculin antibodies.
• Bacteria eat carbs.
• Gas in SIBO can swell up the abdomen and lead to really bad pain; the muscles contract against the gas and lead to pain equal to kidney stones.
• Hydrogen-dominant SIBO tends to be more diarrhea; methane more constipation.
• Methane leads to reverse motility.
• There is a massive differential diagnosis list.
• Symptoms can overlap many conditions; cannot diagnose based on symptoms alone.
• There is a SIBO breath test for hydrogen and methane. Hydrogen sulfide test coming soon.
• Breath testing is very reliable.
• A sugar solution is given, breath is collected; one day prep diet.
• Lactulose is used; 3 hour breath collection, tests both hydrogen and methane and is the best test.
• Hydrogen sulfide testing looks for a pattern on the 3 hour test; no hydrogen in the third hour and generally no methane.
• In treating, first line is diet and lifestyle.
• Then, probiotics, prebiotics, HCl, and enzymes may be explored.
• There are three main antimicrobial treatment options: RX antibiotics, herbal antibiotics, and the elemental diet.
• Treatment incorporates diet.
• 70-91% success rate in treatment.
• Prokinetics amplify and coordinate motility; stomach and small intestine.
• If improved with treatment, prevention is diet and prokinetics.
• If they relapse, investigate more underling causes for chronicity and treat again.
• Don't assume all symptoms are SIBO; figure out what it is.
• Natural treatment is a longer course.
• The Elemental Diet can result in 70% decrease in gas.
• Hydrogen and primarily diarrhea may be treated with Rifaximin.
• If methane gas or both hydrogen and methane with constipation, may use Rifaximin with Neomycin or Flagyl.
• Methanogens require different treatment.
• Rifaximin alone is not successful enough.
• Rifaximin is an antibiotic with ubiotic properties; is not systemically absorbed and works in small intestine, prevents antibiotic resistance, anti-inflammatory for NFkb, does not lead to yeast, increases beneficial flora in large intestine. Low side effects.
• No antibiotic resistance to Rifaximin yet, but she sees clinical signs of resistance.
• Berberine, neem, oregano for hydrogen.
• AlliMed or Atrantil for methane.
• Combines two herbs together; more than two don't seem to work. Likes single herbs as many are sensitive patients that don't tolerate combination products well.
• She wants to reserve some herbs for future treatment options.
• Elemental Diet is 2-3 weeks to starve the bacteria, but feed the patient. Water fasting may be used.
• Prevention: visceral manipulation helps with MMC and structural issues, prokinetics such as Iberogast, Ginger, and other supplements to support MMC at night before bed while fasting.
• Natural prokinetcs and LDN are not enough for everyone; may need RX options.
• More information at siboinfo.com.

Theo Theoharides, PhD, MD spoke on "I Am Hypersensitive to Everything – Now What?" and shared:

• Many conditions mimic mast cell disorders.
• Scratching the skin with a fingernail and getting a welt or dermatographia; mast cells responding to pressure; that is not allergy or at least not only an allergy.
• Total IgE might be allergy or parasites or other causes.
• IgG4 is more and more associated with food allergy.
• He likes IgG1 and IgG4.
• Things you repeatedly eat will turn out to be positive.
• Eat chicken and rice for a few days and then take the allergy test or you will show allergy to the things you eat a lot.
• If antihistamines don't help, IL-31 may be a player.
• Autoimmune uticaria might be a response against the IgE receptor.
• 100 different substances are released from mast cells.
• Mast cells are involved in many conditions such as Lyme, interstitial cystitis, CFS, FMS.
• Paul Ehrlich initially thought that granules were nourishing and fed other cells.
• Mast cells are in tissues; IgE is in blood.
• Mast cells release every known cytokine.
• Mast cells respond to Borrelia.
• Fungi put out mycotoxins which trigger mast cells.
• 80% of symptoms may disappear when leaving a moldy house.
• Metals, herbicides like atrazine and glyphosate may trigger mast cells.
• Glyphosate binds to aluminum.
• Eliminate the triggers and block the mast cells.
• Can affect every organ of the body at the same time.
• First things to measure is tryptase; 15 or over is high.
• Can have MCAS without elevated tryptase.
• Can give DAO as a supplement.
• Still don't know why some mast cells release their contents and others do not.
• Heparin is in mast cells.
• Mast cells fire 10 times more in the field of a cell phone.
• Mast cells release substances similar to Substance P.
• VEGF increases and leads to leaky vessels.
• Gestational environment reaches the fetus.
• Mast cells play a role in autism.
• Mast cells open the blood-brain barrier. 
• Many have chronic sinusitis; gets into the brain.
• The only drug is Gastrocrom which is a "miserable" option.
• 3,000 flavanoids in nature.
• Luteolin is his favorite and supports mast cell and microglial activation.
• Luteolin blocks Substance P and IL-33 which increase IL-1 (anti-inflammatory) 1,000 times. Mast cells make cytokines.
• mTOR activation is stopped with luteolin.
• Cyproheptadine is one of his favorites.
• Caprylic acid is very useful in those with fungal triggers.
• D3 has anti-allergic properties; check 1,25 which is the active form.
• Sigulair or Xolair for significant illness.

Kiran Krishnan, CSO spoke on "Chronic Illness Solutions Addressing Common Dysfunctions in the Standard American Gut" and shared:

• Has been deconstructing microbiome research.
• The idea of feeding the microbiome is complicated.
• Many different conditions have a GI component; Hashimoto's vs. diabetes.
• GERD and cancer can have the same origin and sequence of events.
• We all have a different microbiome. At best, 50% similar; significant differences.
• Since all are different, how do you know the ideal for a given person?
• Some may have high Klebsiella, and that may be normal for them.
• Keystone strains, of which there are a dozen or so, hold up the rest of the microbiome in large part and protect the host from severe dysfunction.
• If you expose a microbiome sample to Cipro and Augmentin, 99.9% died, but bounced back in 12 hours. However, they returned in different proportions. Each species individually were resistant to the same antibiotic. Community structure is important. When a keystone strain is impacted, the community dies.
• Biofilms are a communication medium; one or two strains in the community produce the biofilm. If those fall apart, the community falls apart.
• Lower keystone strains lead to falling apart of the mechanisms that keep other pathogens from emerging.
• Normal commensal organisms then begin to overgrow when the orchestrators are lost; leads to low diversity.
• Diversity is both uniformity and richness. Can have lots of bacteria but predominated by a few and still a lack of diversity. Need both richness and uniformity.
• Low keystone strains and low diversity = dysbiosis.
• Increase the keystone strains and you increase diversity in most chronic illnesses.
• Low levels of important post-biotics are relevant as they control the immune system, hormone production, and other key functions. Butyrate is an example.
• Enterocytes feed on SCFAs.
• Starts with dysbiosis such as with Clindamycin that can cause problems for up to 2 years; lose keystone strains and lose the control mechanisms and diversity. It is not an absence but a loss of function due to lack of uniformity.
• BDNF, GABA, hormones, and more all become compromised.
• Physical structures such as the mucosa become dismantled. The inner part is communication but should not be populated by commensals. The structure is maintained by SCFAs and leads to translocation of commensals, foods, and toxins in the inner layers. Disrupted mucoscal structures and disrupted immune response; master controller of immune response in the body.
• Recruits huge numbers of immune cells which leads to mucosal inflammation; should be about tolerance and understanding.
• Obesity, IBS, diabetes, colon cancer can be helped with intelligent management of the microbiome.
• Crohn's and colitis are conditions of low diversity.
• Akkermansia is one of the keystone strains; can even reverse the process of diabetes. Protects from 62 chronic illnesses. Want 5% but most have undetectable levels.
• Faecalibacterium prausnitzii may be important in Crohns, colitis, IBD, and neurological disorders; another keystone strain.
• Depression and GERD can be related to mucosal dysfunction and translocation of bacteria.
• Mucosal dysfunction is involved in the progression from HIV to AIDS; extent of leaky gut was a predictor of mortality.
• Aging is controlled by diversity in the microbiome.
• Leaky gut opens the flood gates for things to pass into basolateral circulation.
• LPS shedding increases during the process of digestion; leads to more inflammation and metabolic endotoxemia.
• From the gut to the blood; eating becomes the most toxic thing you can do when there are mucosal integrity issues.
• This is increased by high fat meals; LPS is a lipid; gets carried in with lipid carriers which are produced by the body in response to high fat meals.
• Reduce eating fat until you fix the gut.
• High calorie meals stress the microbiome.
• Coconut oil is the MOST toxigenic fat; worse than vegetable oils. Olive oil preventative.
• Fish oil is really good; gram negative bacteria make a less toxigenic version.
• Omega 6 oils can be good or bad depending on the population converting Omega 6 to Omega 3.
• Inflammatory cascade with LPS binding to CD14 receptor; studied in sepsis. LPS entering circulation is a mini-sepsis every time you eat food. Can lead to a sepsis like condition in your joints, brain, or hypothalamus.
• All preventable and reversible.
• LPS endotoxemia is involved in heart disease, lipid problems, hypertension, diabetes, dementia, cancer, PCOS, non-alcoholic fatty liver.
• More LPS translocation creates more tight junction dysfunction; worsens over time.
• Can induce autoimmunity in animals with an injection of LPS endotoxins.
• LPS endotoxemia is the biggest driver of mucosal integrity issues.
• The primary insult in diabetes is from LPS endotoxemia. LPS plasma levels are a predictor of type II diabetes. Can start central insulin resistance in the brain irrespective of body mass.
• Chronic constipation and stasis are associated with LPS migration impacting the neurological system and MMC which leads to chronic SIBO.
• Alzheimer's is driven by LPS endotoxemia.
• Men with low testosterone should focus first on stopping endotoxemia in the gut.
• Fix the dysbiosis and increase keystone strains and diversity which results in post-biotics and healthy mucosal immune response. Can treat virtually all patients with respect to the gut in the same way; they all have the same dysfunction.
• First fix the gut by increasing keystone strains and diversity; no traditional probiotics. Feed those you already have in your gut and that will manage the diversity issue.
• Spore bacteria can do this. Reinforce the changes with the right prebiotics to feed the bacteria.
• Glyphosate exposed to the microbiome for 3 weeks was "scary".
• Precision prebiotics can help support the keystone strains.
• Then provide the tools that are needed to fix the mucosa; you cannot fix the lining of the gut without the microbes as they do the job.
• Glutamine is a tool that the healthy microbiome should use, but you have to fix the microbiome first.
• Recondition, Reinforce, Rebuild.
• Bovine IgG binds and neutralizes toxins including mold toxins; could be important in SIBO.
• Polyphenols are food for the microbiome.

Ty Vincent, MD spoke on "Chronic Illness Solutions Addressing Common Dysfunctions in the Standard American Gut" and shared:

• If there are healthy people with a germ without symptoms, it may not be an "infection".
• Some can have absence of the microbe but still have the symptoms.
• Infection means the microbe is present and causes disease in the majority of people. If you give an antimicrobial, patients should get better and stay better.
• SIBO is not an infectious disease; most are having an immune response to Candida at a low level but resulting in dysbiosis. Restore the immune tolerance for Candida, and SIBO resolves.
• The immune response may play a key role. Most true infections are infections you carry normally that end up in the wrong place.
• If we look for strep DNA in "snot", we would all have it; antibiotics are not the right solution. E. coli is fine in the gut but bad in the bladder.
• A true bladder infection you can treat in 3-5 days. Interstitial cystitis may need to be treated with antimicrobials forever if that is the strategy used.
• EBV is like looking for a man with ears; stop testing EBV titers as they don't mean anything.
• CMV can be a pathogen that can cause harm; EBV maybe not - may be more immune-mediated.
• Sarcoid is an immune response to Mycobacteria.
• Borrelia and Bartonella are not "infections". Borrelia is not an inherent pathogen. Everyone has been exposed to Mycoplasma and maybe Borrelia.
• People on immune suppressing drugs don't get overwhelming Borrelia and Bartonella infections.
• Acne is an autoimmune disease with a loss of tolerance for Propionibacterium; normal skin bacteria. LDI has an "SBF" blend.
• Psoriasis is an immune response to fungi.
• Herpes Simple 1 and 2 might be an infection initially; reactivations that are focal are immune intolerance conditions; LDI can stop it.
• Gluten can cause symptoms of MS, but you don't have a gluten infection.
• PANDAS - the first "A" is autoimmune.
• He doesn't use the term "post Lyme" but more that people "react" to Borrelia.
• All Herx reactions are immune-mediated. Treating real infections doesn't lead to a Herx. Die-off response is an antigen-based response.
• All of the flora that make up you are part of "self" and can trigger autoimmunity. If a self-protein for LDI doesn't work, you have to find the bug that triggered the problem.
• There are many ways to reprogram immune responses: LDA/LDI, EPD, NAET, SLIT, provocation/neutralization, homeopathy, vibrational machines.
• Some patients with horrible immune response problems eliminate all of them with DNRS.
• Crohn's may respond to Saccharomyces cerevisiae and parasites.
• Hashimoto's may respond to H. Pylori and many other LDI mixes.
• It is not possible to "de-Candida-fy" a human being.
• Overall uses the yeast LDI the most; can be impacting Lyme patients as well.
• Lyme patients respond more like immune response conditions and not like an infection.
• There are 74 species of Borrelia and other co-infections in his Lyme mix.
• The challenge is finding the right dose (dilution) for each patient.
• Lyme testing is 100% useless.
• One of his favorite antigen mixtures is collagen and immune reactions to target proteins.
• If you have an immune response to yeast, your body kills it, and it is not always present when testing. It is not an overgrowth or infection, but rather an allergy. The thing that is not there is what the issue is when you do stool testing.
• LDI cannot lead to a Lyme infection; the antigens are dead.
• Viruses are probably the only thing that go through the filters with autologous LDI.
• If someone had Mono, it may be more likely to have a chronic immune response to EBV.
• There is a list of all of the antigens and typical dose ranges available.
• Some parasites are chronic immune responses and not true "infections" but can lead to systemic inflammatory symptoms.
• With bizarre psych problems, think parasites and hope that they are still harboring the bugs.
• 6C is a common starting dose for most antigens.
• Hidradenitis suppurativa which is a condition that impacts the underarms and can require surgery may be an immune reaction to Diphtheroids.

Mary Ackerley, MD spoke on "Environmentally Acquired Neuroinflammation" and shared:

• She categorizes patients in different levels. Level 1 is often self-treating. Level 2 is mold, Lyme, mild TBIs and tolerates treatment. Level 3 is autonomic dysfunction, neurological, psychiatric, cognitive symptoms; patients with really inflamed brains.
• Many CIRS symptoms are psych symptoms; anxiety and insomnia are the most common symptoms that she sees.
• Mold makes everything worse; any test will be worse with mold.
• Memory, focus, brain fog, irritability, extreme reactivity, complex treatment, impulsivity.
• Often initially anxiety and insomnia are early signs.
• OCD, visual hallucinations (organic, not schizophrenic), suicidal ideation (10-15%), memory lapse, word finding, asking same question.
• 50% of her patients have joint hypermobility.
• There is a genetic component to true psych conditions.
• Neuroinflammation is microglial activation and may be associated with infections, toxins, traumatic brain injury, and mast cell activation.
• TBIs are pretty common and contribute to the symptom picture.
• Cytokines are a cause; but not only cause of neuroinflammation.
• TGFb1 is the most commonly elevated in CFS and also in mold and Lyme; this says a lot about the causes of CFS.
• Inflammation is a root cause of psychiatric illness.
• If you hear psychiatric, think inflammation.
• Uses the NeuroQuant Triage Brain Report; items in red represent atrophy.
• Inhalational toxicity is linked to neurological diseases including Alzheimer's.
• NeuroQuant can also be used for TBIs (traumatic brain injury)
• The amygdala is often much higher (larger) in activation in her patients than in healthy controls.
• Most mold patients also fit CFS/ME, FMS, or post-Lyme diagnosis.
• Once the amygdala is triggered, there is limbic system activation which amplifies anger, fear, stress, and hypothalamic activation.
• The limbic system and mast cells are clearly interlinked.
• Mast cells are triggered by things you are breathing and can set off the HPA axis resulting in more MCAS.
• TBIs increase sensitivity to mold and other contaminants and increase the leakiness of the blood-brain barrier.
• CIRS, PANS, KPU, autism, and MCAS often show basal ganglia atrophy. Histamine plays a big role in PANS.
• NeuroQuant - metals, iron, and lead may go to areas of atrophy.
• A lot of information is in the limbic system; treat MCAS and retrain the brain.
• If using NeuroQuant to diagnose mold of Lyme, there is no patient that has just one thing or another.
• apoE4 contributes to hypermobility and cerebrovascular inflammation.
• NeuroQuant shows the brain is on fire and not a psychiatric condition.
• When the amgydala is in the 99th percentile, the patient needs brain retraining; she insists they do it.
• LDN may be helpful for brain inflammation and microglial activation.
• PEA may help with pain; had one with 9-10 neuro pain go down to 3-4.
• NeuroProtek works better than VIP in a lot of patients.
• HBOT has been helpful.
• Anything you do for Nrf2 will help a depressed patient: resveratrol, curcumin; likes Researched Nutritionals CytoQuel.
• Body work is great for patients; cranial and lymphatic work to drain the brain.
• DNRS and functional optometry can be helpful.

Annie Hopper spoke on "The Brain, Chronic Illness, and Limbic System Rehabilitation" and shared:

• She lived in a condo where she could not be around any EMFs.
• Walking by laundry exhaust led to convulsions.
• EMF led to burning sensations and convulsions.
• She was one of the patients that were not getting better with anything she tried.
• Became homeless as she could not find an environment she could survive in.
• The limbic system is the feeling and reacting brain.
• It evaluates safety and is the protective analytical gate to analyze incoming stimuli and assign a threat level.
• Amygdala, hypothalamus, cingulate cortex, and hippocampus comprise the limbic system.
• The amygdala is the fear center.
• Hippocampus is for remembering; including remembering traumas for future protection; storing information.
• Cortisol can cause a decrease in the size of the hippocampus; can regenerate.
• The hypothalamus is the body's internal chemist.
• Mold, EMF, any physical trauma, bacteria, viruses, chemicals, emotional trauma, and others can create the perfect storm of stressors.
• Hers was smoke, mold, and chemicals.
• This is not a psychiatric illness but a trauma to the brain.
• Fibromyalgia, Lyme, MCS, CFS/ME commonly have limbic system involvement.
• Fight or flight or freeze such as in POTS.
• Limbic system is a trauma feedback loop. Trauma leads to inflammation and a distorted reaction.
• Over time, you need less and less of a stimuli to generate a reaction.
• The brain gets stuck in a chronic stress response.
• Until the body gets the message that you are safe, the vagus nerve cannot function appropriately.
• This affects the body on a cellular level and leads to a cell danger response.
• When the body is sending an unsafe message, the cells will respond appropriately. A number of symptoms go away when you move out of the fight or flight stage. Changing the cell danger response allows the body to start functioning normally.
• Limbic system impairment can lead to sensitivity to touch, smell, sound, and light; they trigger the stress response. If you normalize the impairment, you can stop the sensory perception from becoming a trigger.
• Humans have a negativity bias which becomes exaggerated. With limbic system impairment, that bias is magnified. Intruding negative thoughts, focus on survival, preoccupation with real and perceived threats. Inability to access positive emotions; a state of feeling that happy is not important; the brain forgets how to be happy. Can train the brain how to get into an elevated emotional state.
• Brain is stuck in trauma; revisiting a traumatic event is often counterproductive. Going back a trauma when stuck in a trauma loop strengthens the trauma. She avoids traditional talk therapy.
• There are 5 Pillars of Recovery and the DNRS system is experiential.
  • 1) Recognize limbic system impairment and maladapted stress response.
  • 2) Identify and interrupt all pathways of the past.
  • 3) Complete full rounds for one hour daily to regulate the stress response.
  • 4) Implement incremental training.
  • 5) Elevate your emotional state.
• You can shutoff the maladapted stress response.
• Symptoms can ebb and flow with a goal of complete resolution of symptoms.
• Truth 1: environmental factors are involved.
• Truth 2: focus on rewiring the brain.
• They offer a 5 day boot-camp or 14 hour DVD series including a streaming option.
• Their DNRS coaches have recovered from their own limbic system impairment with DNRS.
• Extreme stress, mental illness, schizophrenia, personality disorder, and lack of motivation are contraindications for DNRS.

Neil Nathan, MD spoke on "Practical Applications of Polyvagal Theory for Healing" and shared:

• Note: My notes from Dr. Nathan are a little more abbreviated than some of the other presenters as I was preparing for the Q&A to follow his talk.  Dr. Nathan has been one of my heroes in this realm, and I highly recommend his book "Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness".  
• Polyvagal Theory - dorsal and ventral branches of vagus nerve.
• Generally think of sympathetic vs. parasympathetic. For most patients, sympathetic dominates.
• Dorsal branch of the vagus nerve is older; unmyelinated; requires massive shutdown of the autonomic nervous system.  Second vagal pathway (or ventral) is myelinated.
• Ventral branch is primary above diaphragm; dorsal below.
• Patients are scared, the world is not safe, become hypervigilant to everything.
• No one with cell danger response methylates well; it is an intentional and intelligent part of the response.
• To give nutrients you may to more robust patients, you often find that many cannot tolerate.
• Patients are metabolically habituated to the state they are in and the body works to remain there.
• As patients get better, there can be a withdrawal from the prior metabolic state; it may present as what we think of as a Herx.
• There is a Listening Project Protocol that has been used to treat children on the autism spectrum; https://integratedlistening.com
• Many patients have an immobile palate; the uvula does not move or moves from side to side.
• If you put a finger down the throat and keep it there and there is no gag reflect, cannot elicit, there is a vagal nerve component.
• People need to feel safe.
• "Accessing the Healing Power of the Vagus Nerve: Self-Help Exercises for Anxiety, Depression, Trauma, and Autism" book by Stanely Rosenberg has exercises for quieting down the vagus nerve.
• Frequency-specific microcurrent (FSM) has frequencies for the vagus nerve and rebooting other areas of the brain.
• BrainTap uses different frequencies of light and sound to reboot parts of the brain. He had 9 stuck patients that all moved forward with this technology; 20 minutes three times a week.
• Datis Kharrazian talks about the gut brain axis and the benefits of gargling, singing.
• As a practitioner, cues of safety start with you, your room, color, approach and manner, facial expressions, comfort level, reception area. Patients need to feel safe in their work with you.

Below is a video that Wally Taylor, MD put together on his thoughts about the event: 

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.