The Forum for Integrative Medicine: Solutions For Complex Illness: Putting The Pieces Together

I had the opportunity to attend and moderate the 5th annual event from The Forum for Integrative Medicine "Solutions For Complex Illness: Putting The Pieces Together" held online on March 26-28, 2020.  This event has become such an amazing community of like-minded practitioners working hard to improve the lives of their 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 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.  

Joseph Burrascano, MD presented on "Tick-Borne Diseases – New Information for Clinicians" and shared:

• People may be seronegative because they have a Borrelia that is not Lyme Borrelia.
• Multiple Borrelia species infect patients.
• At least 8 types of Lyme Borrelia and 7 types of relapsing fever Borrelia may be relevant in the US.
• One study of 36 patients found Lyme Borrelia in only 1 patient but numerous non-Lyme Borrelias were identified.
• Another study looked at 29 patients and found that standard Western Blots would have found very few positives; though many were positive for other Borrelias.
• The message was that TBRF (Tick-Borne Relapsing Fever) Borrelia can cause illness and would be considered "seronegative Lyme".
• The strain used for lab testing (B31) was a lab strain and never collected from a real human patient.
• Many Lyme Borrelias and all relapsing fever Borrelias would be missed by a majority of available tests.
• A Lyme ImmunoBlot will not pick up relapsing fever; a TBRF ImmunoBlot will not pick up Lyme Borrelia.
• ImmunoBlot is much more precise than the Western Blot.
• Interpretation of a Western Blot in terms of bands is much more difficult and open to interpretation of the lab tech as compared to the ImmunoBlot.
• If you have a positive IgM for Borrelia on an ImmunoBlot, 99.3% chance it is Lyme; no longer need to do epitope testing for viral cross-reactivity.
• ImmunoBlot is highly sensitive even for early Lyme. Antibodies are developed early, but prior tests were not sensitive enough to pick them up.
• We now have a test for early Lyme.
• More Borrelia species are included in the ImmunoBlot than Western Blot.
• TBRF is often a period of about 3 days of fever and then periods of no fever for about 7 days. Each period of fever involves a "crisis" with fever up to 106.7F and then a "flush phase" with drenching sweats and decrease in body temperature.
• Of 543 patients diagnosed with Lyme, 29% were TBRF positive; 38% looking just at California residents.
• Soft ticks that can live for 10-20 years are a vector for TBRF; most attach for 5-30 minutes.
• One of the types of ticks are born infected and readily transmit disease.
• Some TBRF species can come from hard tick vectors as well.
• TBRF transmission during pregnancy is accepted.
• Transmission may occur rapidly; a mouse study showed infection within 15 seconds.
• TBRF testing has been difficult.
• Can see on a blood smear; which is different from Lyme Borrelia.
• Serologies commonly pick up only Borrelia hermsii.
• Some TBRFs have OspC and P41 (band 23 and 41) and may be incorrectly diagnosed as Lyme but actually be TBRF.
• Borrelia miyamotoi testing with an ELISA has low sensitivity.
• PCR testing for TBRF is only good in acute crisis in febrile stage.
• These still leave out many types of TBRFs.  If you can test for only hermsii and miyamotoi, you still miss a number of other species.
• TBRF ImmunoBlot is able to detect all clinically relevant species.
• Does not cross react with Lyme Borrelia.
• ImmunoBlot can be useful even in early disease.
• ImmunoBlot specificity is 97.6-98.6%. A positive ImmunoBlot is very specific and highly unlikely to be a false negative.
• Sensitivity is 66.7% in acute cases and 100% in late cases.
• New assays have changed the paradigm; many more Borrelia out there then previously thought; need to look broadly.
• TBRF mimics Lyme in terms of symptoms, but may have negative test result for Lyme Borrelia.
• Rapid transmission is accepted with TBRF; early testing can be useful. 
• Disulfiram has been shown to be active against Staph, Strep, Enterococcus, Bacillus, Listeria, Tularemia, and Mycobacteria.
• DSF is a potent efflux inhibitor which may synergize many other antimicrobials.
• DSF destroys Staph biofilms.
• DSF kills parasites such as Giardia and Entamoeba, some viruses, some fungi.
• DSF forms a disulfide; patients can begin to smell like garlic.
• Some bacteria have aldehyde dehydrogenase and also "get a hangover" with DSF.
• Some bacteria respond to the parent compound, but Borrelia likely responds to the metabolites which have a much longer half-life than the parent compound.
• Likely do not need frequent dosing with DSF.
• DSF in Lyme started from the work of Dr. Ken Liegner who had three treatment-resistant patients that were "cured" with several months of treatment.
• First patient was on triple antibiotics for 8 years and could not stop without relapse; took DSF for 4 months and now off all treatment for 3 years.
• Targets Babesia as well as Borrelia; minimal lasting effects with Bartonella; however, may open biofilms and make co-infections easier to treat with other interventions.
• Bartonella is a terrible biofilm former.
• It is best to do a yeast cleanout first before using DSF as yeasts ferment into alcohol and can then make one feel terrible on DSF.
• Anti-yeast and low carb diet before and during DSF treatment.
• Cannot take "azoles" while on DSF as it can lead to liver toxicity.
• No alcohol while on DSF including personal care products.
• DSF can create severe Herxheimer reactions; start very slowly.
• Often recommended to stop all other antibiotics before starting DSF.
• Need to test liver enzymes and CBC every 2 weeks initially.
• Vitamin C, nicotinamide, selenium, NAC can help Herxheimer reactions.
• Binders such as Beyond Balance TOX-EASE BIND and TOX-EASE II can be very helpful; anti-inflammatories; likes Researched Nutritionals CytoQuel, epsom salts, drainage remedies.
• During treatment, alpha lipoic (R form), curcumin, boswellia, D, fish oil, CBD.
• Zinc and vitamin C can reduce Antabuse-like reactions.
• Later, consider mitochondria, methylation, and lipid support.
• Toxicity is related to dose and duration; no reason to push hard.
• Liver issues can happen; monitor closely.
• Demyelination of the nerves can happen.
• Can lead to buildup of dopamine and deficiency of norepinephrine leading to mood effects such as agitation, mania, and depression.
• Green tea is contraindicated while on DSF as it can lead to liver toxicity.
• Neuropathy has been seen historically in alcohol and cocaine addicts in 1 out of 15,000; partially or entirely reverses after stopping the drug in that population.
• Inhibits testosterone and can reduce libido.
• Glutathione halves the effect of DSF; recommended to not use glutathione while using DSF.
• Clearance of benzodiazepines is reduced by 40-50%.
• No evidence of long-term problems other than neuropathy.
• Alpha-gal reported after bite from Lone Star tick (and possibly others).
• Tick bites another mammal then bites you and injects alpha-gal leading to sensitization.
• Cannot tolerate red meat from mammals; fish and poultry is ok.
• Our own gut flora makes alpha-gal; as does Borrelia burgdorferi.
• It may be that tolerance to alpha-gal already present is broken.
• Many food exposures and other allergies can appear after tick exposure.
• Getting the microbial burden under control with tools like DSF may allow the body to restore tolerance to alpha-gal.
• Remove infections and mold toxins, restore gut microbiome, support mitochondria, restore Th1/2/17/reg balance after microbial treatment started (transfer factors and anti-inflammatories), support thymus (growth hormone, DHEA, Metformin).
• Practitioners need to consider informed consent as many of these treatments are not considered mainstream.
• Lorraine Johnson from LymeDisease.org has been helpful in providing consent forms; they vary from state to state. Best to get an attorney to review consent forms.
• Anti-yeast protocol before DSF is ideal for days to weeks prior to starting DSF.
• DSF parent compound has a half-life of minutes, but the numerous metabolites all have different half lives and can be much longer. Different organisms respond to different metabolites. The long half-life explains why infrequent dosing can still be effective.
• With a week or so, people often have a Herx which then clears out and improvement is observed; duration of treatment after getting to target dose is commonly 6 weeks to 3 months.
• For thymus support, high protein at bedtime, arginine, heavy exercise can help with growth hormone.
• C6 peptide testing has not been very useful.
• IgXSpot is a T-cell test which is useful early on or in people with IgG deficiency or in late disease.
• Serologies are not very specific; PCR and ImmunoBlots are more specific and better to avoid potential cross reactivity impacting the test.
• Speciation is important with the ImmunoBlot; could lead to different treatment interventions over time. Will lead to better sorting out of optimal treatment options.
• For early disease, IgXSpot or ImmunoBlot. For disseminated disease and limited illness, serology may be adequate. For late stage disease, PCR.
• Bartonella Western Blot testing now available.
• Culture testing may be available soon.
• IGeneX has information about which Borrelia species are more common in various counties in the US.
• Lyme and TBRF ImmunoBlots are two different tests.
• For Bartonella, they become resistant to macrolides and fluoroquinolones over time. 30 or more types; can have more than one. Bartonella has thick biofilms. 2-3 drug regimen and considering biofilms may be important.

Neil Nathan, MD presented on "Update and Review of the Diagnosis and Treatment of Mold Toxicity" and shared:

• The science of diagnosing and treatment mold toxicity is still in its infancy.
• Persistent inflammation triggered by environmental toxins is linked to many common illness such as CFS/ME, Fibromyalgia, Lyme, mold toxicity, PANDAS/PANS, autism, and neurodegenerative disease; all have persistent, unrelenting inflammation.
• The underlying condition triggers MCAS, porphyria, methylation issues, reactivated virus/bacteria/parasitic infection, limbic system dysfunction, and vagal nerve dysfunction.
• Have to look for the root cause(s) of the conditions; downstream component focus will not succeed.
• Patients are very sick and have been made worse by being invalidated, dismissed, or doubted.
• Families are often not supportive given doctors have doubted their experience.
• New models include: Cell Danger Response, Horowitz MSIDS Map, Bredesen 36 Point ReCODE program, Shoemaker Biotoxin Pathway; all give us a logical approach.
• Patients are individuals and require a unique approach; an algorithm or protocol will not work.
• Mold is much more than mold; numerous components: fungi, Actinomycetes, Mycobacteria, VOCs, beta glucans, hemolysis, mannans, proteinases; an inflammatory soup.
• Actinomycetes may play a larger role than previously understood; research projects are underway to further explore.
• Measuring urinary mycotoxins is currently the easiest, most straightforward, and most accurate of all the measurement tools.
• Mold can be allergy, infection or colonization, or have toxin-induced effects. Several of these can occur simultaneously.
• If you are growing mold in the body that is producing mycotoxins, the ongoing trigger may be living inside the body.
• 25% of the population may be susceptible to mold toxins and have an inability to clear them from the system.
• Toxic molds include: Stachybotrys, Penicillium, Aspergillus, Chaetomium, Alternaria, Fusarium, and Wallemia. Not all molds are toxic.
• Molds in the outdoor environment do not really lead to illness. Molds create toxins to protect their ecological niche. Other than allergy, outdoor mold is not relevant.
• Innate immunity is the Biotoxin Pathway; acquired immunity is the allergy pathway.
• Mold can profoundly affect: Lyme, viruses, MCS, EMF sensitivity, food allergies, autoimmunity. Mold makes everything worse.
• Dr. Horowitz has communicated that 70% of stalled Lyme patients show evidence of mold toxicity.
• 10 million people in the United States may suffer with mold toxicity to some degree; it is not rare.
• Mold is the most common trigger for MCS.
• Mold is common in "electromagnetic dysthymia" or EMF sensitivity.
• There are many symptoms of mold toxicity, but some are big clues or more specific to mold.
• Sensitivity to everything possible occurs in mold illness.
• Dr. Bredesen has made mold toxicity one of the more important of the 36 points in his ReCODE program.
• Non-anatomic numbness or tingling can be seen with mold illness.
• Mold illness may look like Fibromyalgia, CFS, "atypical" MS/Rheumatoid Arthritis/Parkinson's/Alzheimer's, asthma, chronic sinusitis.
• Bartonella can also lead to numerous symptoms that may appear similar to mold illness.
• Mold illness may lead to diagnosis of anxiety, depression, depersonalization, cognitive impairment, mood swings, OCD.
• If it does not fit what is happening in the patient's life, think mold and think Lyme disease.
• Symptoms unique to mold illness: electrical shocks, ice pick pains, paresthesias (in areas such as nose, face, abdomen, back associated with ANS), internal vibrations or tremors (mold or Bartonella), increased sensitivity to everything.
• Mold illness is diagnosed with: Urine Mycotoxins (his favorite), VCS, biotoxin markers.
• Do more mycotoxin testing.
• Urine mycotoxins are far more specific and lead to a specific treatment protocol with enormous benefits.
• Markers like C4a and TGFb1 indicate inflammation but don't identify the cause (mold, Lyme, etc.).
• For urine mycotoxin testing, there are ELISA (RealTime and Vibrant Health) and LC/MS (Great Plains).
• He primarily uses RealTime and Great Plains.
• LC/MS is in theory more accurate and reproducible but measures metabolites; ELISA can measure toxins and metabolites.
• The tests do not measure the same thing; even when talking about the same named toxins.
• There is not a "better" test; both have value. He measures both when possible.
• Prefers challenge testing with glutathione for seven days (or until the patient feels worse if sooner) prior to the collection and/or sauna, bath, or hot tub.
• It is important to stop all binders 3 days before collection of the urine.
• Anything that can mobilize mold toxin can create an exacerbation of symptoms.
• Any positive test may be significant.
• Initial testing may not reflect load as they may have a compromised ability to detoxify; "tip of the iceberg".
• Subsequent testing may be much higher in 80% of patients; more accurate representation; they are now detoxing.
• Repeat testing with higher results may be: re-exposure, improved detox, excessive binding of toxins, excessive killing of mold leading to more release of toxin, or stimulating the mold to make more mycotoxins.
• Molds make toxins to protect themselves from a threat such as an antifungal medication.
• If the numbers are higher and detoxification is improving, the patient is getting better.
• Mold tests can be normal in a mold toxic patient if they are unable to mobilize and excrete the mold toxins.
• Some suggest urinary mycotoxins would be found in healthy people from food sources. A recent November study in Townsend letter with 82 controls and 103 mold patients showed 51% of controls do have ochratoxin. In healthy controls, the average was 1.6; in mold patients the average was over 18. Urinary mycotoxin tests are valid.
• A negative test may mean: not mold illness, inability to detox, patient has a different toxin than the test is measuring, or the test was not accurate.
• Testing is expensive, but optimization of treatment approach makes it worth the cost.
• VCS testing is not as specific as once thought: can be mold, Lyme, or mercury. Can pass the VCS and still have mold toxicity.
• If he has only one tool to use, it will be the urine mycotoxin testing.
• Urine mycotoxin testing can be an accurate tool for determining when treatment is complete.
• No longer believes that MARCoNS is a significant component of illness or treatment protocols. Common; even in healthy people. No longer tests or treats for it.
• In terms of genetics of mold toxicity, there has been no correlation between HLA-DR results and ability of a patient to get well. Some with no genetic predisposition, struggle to get well. HLA-DR is not helpful to measure; it has limited usefulness.
• Basics of treatment: evaluate and fix the environment, use binders, use antifungal therapy (and biofilm treatment) if colonized in the sinuses and GI tract.
• Dr. Shoemaker is deserving of much praise for the Biotoxin Pathway model and putting mold illness on the map.
• Testing the home: mold plates (Immunolytics), ERMI, IEP evaluation.
• 50% of what grows on mold plates are not toxic; need to have it evaluated.
• Remediation may be really expensive and may not always work.
• Evaluate home, work, and sometimes car.
• Air sample testing is the least accurate method.
• When in doubt, get an IEP to evaluate.
• HERTSMI-2 scoring system: over 15 too dangerous, under 11 probably safe, in between borderline.
• Ochratoxin is best bound by Cholestyramine, Welchol, and Activated Charcoal.
• Gliotoxin is best bound by Bentonate Clay, NAC, and Saccharomyces boulardii.
• Trichothecenes and Aflatoxins are best bound by Bentonite, Charcoal, and Chlorella.
• Zearalanone and Enniatin B are best bound by Bentonite and Saccharomyces boulardii.
• It is unknown what binds Chaetoglobosin at this time. Having treated many patients, a good selection of binders will address this.
• "Binder" does not mean tightly bound. "Adsorb" is a better term; like static cling.
• Generally starts with the binder that impacts the mycotoxin with the greatest levels.
• Sensitive patients will need to start with very small dosages; if some is good, more is not necessarily better. You can make a person worse with too much binder.
• Binders are best away from food and supplements/medications by 2 hours. Can be taken once daily; best at 3pm or evening.
• Saccharomyces can be taken with food.
• Uses compounded Cholesytramine; not standard RX with sugar or Splenda.
• Want glass-grown Chlorella to avoid contamination with arsenic and aluminum.
• Binders can and do mobilize toxins and can make the toxic patient worse.
• Constipation with binders is common and can be mitigated with magnesium and buffered vitamin C.
• Diet: high protein, low carb. Keto currently preferred.
• Eating yeast such as in cheese, vinegar, mushrooms does not seem to make a difference.
• There is some mold in dried fruits, aged cheese, mushrooms, coffee, beer, wine, processed meats, tomato products, and fermented food products. Most have not found this to be significant in terms of mold illness.
• Great Plains did a study of 8 patients that avoided all moldy foods, did urine mycotoxins, ate moldy foods for 10 days, and did another test.  7 of 8 had mycotoxin levels go down on the moldy food diet. Needs more research, but food is not the major source of toxicity; it is a water-damaged building.
• If patients improve with binders, they may not need antifungal therapy, but this is uncommon in his patient population.
• Often starts the antifungal treatment with Argentyn 23 nasal spray with a biofilm dissolving agent.
• Stronger patients may start with Amphotericin B nasal spray while more sensitive may need Nystatin. For intermediate patients, may use Itraconazole or Ketoconazole nasal spray. May used EDTA/xylitol spray for biofilms nasally.
• Later looks at the gut using oral Argentyn, possibly Nystatin if Candida is present, and Itraconazole. In some patients, may use a liquid Amphotericin B solution.
• Then incorporates biofilm therapies such as Beyond Balance BFM-1 or Interfase Plus.
• Mold allergy is very real, but is a different issue with different treatment approaches.
• If a patient can tolerate glutathione, it can be excellent for detox, but it can overtax sensitive patients.
• Some favorite products: Beyond Balance PRO-MYCO, MYCOREGEN, TOX-EASE BIND, Byron White A-FNG, Cellcore Biotoxin Binder, Biocidin Nasal Spray.
• Loves IV PC therapy and sinus insufflation of ozone.
• LDI and transfer factors can be very helpful tools.
• In sensitive or toxic patients, support the liver and GI detox, lymphatics, kidneys, skin, IV PC, and limbic system work with DNRS (his favorite).
• May need to do limbic retraining and polyvagal strategies first; and consider MCAS.
• Likes TOX-EASE GL, ITIRES, RENELIX for detoxification support.
• "The Toxin Solution" by Dr. Pizzorno supports general detox, GI detox, liver detox, and kidney detox. Has two week approaches outlined which have led to great benefit.
• Avoid toxins in food/water/environment, normalize bowels and avoid constipation, sweat; it is all about the toxic load!
• In order to detoxify, the gallbladder needs to work properly and bring the mold toxins into the small intestine so that it can bind properly with the binders that you give it.
• Numerous tools can help improving bile creation: Acetyl-L-Carnitine, Calcium pyruvate, Pantethine, PC, Ox Bile.
• Mobilzing the bile is improved with bitters, artichoke, milk thistle, and coffee enemas.
• Ozone insufflation can improve ability for the liver to detoxify.
• For GI detoxification, may need to provide probiotics, kill pathogens, eliminate allergens, add fibers, consider glutamine (can be converted to glutamate and not be well-tolerated; needs caution).
• In mold toxic patients, a focus on the gut won't work until the mold has been removed. If mold is a player, you have to deal with that first.
• For liver detox, TOX-EASE GL, milk thistle, alpha lipoic acid, NAC, artichoke, I3C, apo-HEPAT.
• Frequency Specific Microcurrent, lymphatic massage, oil pulling, and rectal ozone can be adjunct detoxification supports.
• New research with Dr. Nathan, Beth O'Hara, Emily Givler, Lari Young, and Deanna Minich focuses on improving the detoxification pathways associated with each mycotoxin. This work should speed healing for patients.
• A given mycotoxin can have several different detoxification pathways. For each mycotoxin and pathway, specific supplements and foods may optimize the detoxification pathway.
• This work is in progress and will be published this summer.
• Treatment results in significant clinical improvement for almost everyone.
• Improvement in those with Lyme disease using Disulfiram may also be associated in part to its impact on fungi; has not yet been studied. It may prove to be a helpful tool for mold illness in the future.
• The use of mitochondrial and methylation strategies may make the patient worse when they are under threat and in a cell danger response. One has to move from CDR1 to CDR2 or CDR3 for these tools to be helpful.
• Exploring genetic SNPs and treating them generally will not work when one is still in a cell danger response (CDR1) state.
• You don't want to make more ATP when the body is in a threat state as ATP is the "danger" signal. Timing is everything.
• Depersonalization can be from mold or Bartonella. To differentiate, may use a provocation approach using various Bartonella herbs to see if Bartonella is a potential issue for a given patient. Mold should be treated first even when Bartonella is present.
• Vast majority of over 300 patients doing DNRS have had great benefit. Has had over 80 patients using BrainTap with similar results; likely a different mechanism. DNRS more for the limbic system and BrainTap for vagal nerve and some limbic system support.
• Peptides may be a future therapy that could be helpful, but when still in a cell danger response threat state, they do not seem to be helpful.

Katie Dahlgren, ND spoke on "Obstacles to Cure – How to Identify and Treat Physical and Energetic Blocks to Promote Healing in the Chronically Ill Patient" and shared:

• What are the things that prevent patients from healing?
• Many patients have seen many gifted providers with limited progress; something is holding them back.
• Interference fields interfere with the body's attempt to regulate in a healthy direction. A non-healing body is not regulating.
• Scars are a common interference field. Scars can develop an interference that creates an ongoing pathology.
• Both having infected tonsils and having tonsils removed are significant. May need to treat the area of tonsil removal to remove an interference to healing. C-section scars can impact healing; particularly depending on the emotions in the field at the time.
• Head traumas are a big interference field. These are common. The head houses the brain as the master regulator; pituitary is very fragile and can be impacted by head injury leading to neuroendocrine dysregulation.
• Infections can impede healing. Can have superficial infections that never fully heal and may have organisms remaining in the tissue.
• Sports injuries should always be discussed; sports leads to potential for undiagnosed and untreated injuries. Cheerleaders, gymnasts, surfers commonly experience head injury.
• Treating interference fields can be done with injections, acupuncture, regular massage.
• Neural therapy is an injection technique for addressing interference fields; uses a weak, local anesthetic to temporarily shutdown cell to cell communication to reboot the area.
• The goal of neural therapy is to regulate the autonomic nervous system.
• Platelet Rich Plasma (PRP) can be helpful for both deeper and superficial injuries. Can help with dysregulation of collagen and damaged tissues. Isolates the repair molecules from the patient's own blood and reintroduces them to stimulate healing.
• Often does ozone prior to PRP to optimize outcomes.
• Ozone is a biological modulator that acts as a potent antimicrobial and optimizes oxygen utilization.
• Ozonides consume scar tissue, infections; support detoxification. Can be active for days to weeks after ozone treatment.
• Need to run G6PD testing to minimize negative outcomes.
• Microbes cause chronic inflammation and immune suppression.
• A reactivated virus can serve as an interference field.
• Basic labs: CBC with diff and platelets, CMP, G6PD, hsCRP, immunoglobulins, iron/ferritin, copper/zinc/mag, metals, D, thyroid, viral titers, Mycoplasma, Chlamydia, CD57, histamine, homocysteine, ASO/Anti-DNAse titers
• A healthy, resting system is 60% neutrophils and 30% lymphocytes; often see more lymphocytes than neutrophils in viruses; eosinophils can be allergies but can commonly be parasites.
• Mast Cell Activation Syndrome commonly related to parasites and other pathogens.
• Liver, kidney, alkalinity, electrolytes testing help to assess the overall system.
• hsCRP can help give some insights into the potential for infectious burden; body is working really hard to do something; need to identify the "something".
• Immunoglobulins - many have low IgG (congenital or acquired); IgA associated with gut immunity.
• Iron and ferritin - suddenly have high ferritin around the time of forest fires; exposure to smoke leading to inflammation and heavy metal exposure.
• Looks at serum and RBC copper, zinc, and magnesium; patients may think they are toxic but they are actually deficient.
• Heavy Metal Profile - in past couple of years, see elevated cadmium, lead, and mercury in blood when this was not the case historically.
• Vitamin D deficiency is observed in many patients.
• Thyroid is often a casualty and not the core problem; need to address and optimize.
• Viral titers looking for IgG more than 10 times the upper end of the reference range can suggest an active viral burden.
• Mycoplasma and Chlamydia antibodies; many have IgM positive infectious dragging down the immune system.
• CD57 NK cells help against Lyme and Mycoplasma; not super sensitive.
• Histamine is important to explore for potential of MCAS.
• Homocysteine related to methylation or inflammation.
• ASO and Anti-DNAse titers - psychiatric symptoms in adults can be similar to PANS/PANDAS in children. If no psychiatric history, there could be a pathogen involved in psychiatric symptoms.
• Great Plains Organic Acids helps to assess many different functional markers in the body; more insight into microbial and nutritional balance; elevations of yeast and fungal markers may indicate colonization, exposure, or both; bacterial markers may indicate dysbiosis in the gut.
• Best to treat microbial issues after detoxification and before focus on nutrient deficiencies or neurotransmitter imbalances.
• Likes to use urinary mycotoxins from RealTime Labs; finds it correlates well with pathology and symptomatology. Repeat testing can show increase due to improved detoxification; though could be a new exposure as well.
• GI MAP is her favorite stool test; weak in protozoa and parasites, but can show significant issues that need to be a focus of treatment. Finds Giardia commonly without patient knowledge of where it may have been acquired. Clostridia significant and not always easy to treat.
• Parasite treatment is a foundation to health recovery for many of her patients; difficult to test for.
• Likes DNA Connexions in part due to it being more cost-effective and looking for co-infections as well. Also uses IGeneX. Often need to pre-treat or provoke in order to maximize test results.
• Cunningham Panel is expensive but PANDAS/PANS is life-altering; life becomes a roller-coaster; one of the better ways to quantify the brain inflammation and the autoimmune component.
• Anti-Dopamine Receptor D1 can be associated with anxiety, aggression, mood swings, self-harm, eating disturbances. Anti-Dopamine Receptor D2 associated with a movement disorder. Anti-Lysoganglioside GM1 may be related to Lyme disease. Anti-Tubulin often elevated and associated with OCD. CaM Kinase II associated with active infections of viruses, Strep, or Lyme.
• Improving the environment is important to explore: reduce EMFs, look for mold. Likes to see Mycometrics ERMI for every patient. Rare that mold is in an obvious place.
• Testing for mold: ERMI, OAT, RealTime urinary mycotoxins, blood work for genetic susceptibility
• It is unlikely that patients will improve with any treatment without addressing environmental mold.
• HERTSMI-2 is clinically helpful; language is clear for patients to understand.
• EMFs lead to endocrine disruption, DNA damage, cancer, mitochondrial damage, accelerated aging.
• EMF symptoms: fatigue, heart arrhythmia, learning difficulty, anxiety, infertility, brain fog, neuropathy, headaches, memory problems, insomnia.
• Use blue light blocking glasses, EMF protective clothing, work with a building biologist, remove LED lights and replace with full spectrum, turn off WiFi, shield with paint or sleep sanctuaries.
• Various meters: https://www.lessemf.com/combi.html
• Dirty electricity from electrical wiring in the walls can negatively impact health.
• Earthing or grounding can be done in nature or using an earthing mat; our bodies miss connection to the earth.
• Emotional traumas such as divorce, death, abuse, neglect, illness, injury, or homelessness can play a role in illness.
• Family Constellation work can lead to healing in the entire family system.
• Interventions: Family Constellation, Applied PsychoNeurobiology (APN), Neurolinguistic programming (NLP), DNRS (amazing), and EFT.
• Immune modulation with LDN, fluconazole, Rifaximin, LDA/LDI (huge fan and some symptoms can resolve overnight).
• Peptides such as Thymosin Alpha 1 (restores immune function and decreases inflammation), Selank, Semax, Cerebrolysin, BPC-157, LL-37 are proving to be very helpful tools.
• Peptides are a true game-changer.
• Selank and Semax are nasal sprays; Selank helpful with anxiety/depression/memory/learning; Semax helpful with nerve regeneration/learning/attention/memory/ADD/ADHD.
• Thymosin Beta 4 can stimulate the immune system; can be more difficult to tolerate.
• Cerebrolysin is neuroprotective and may cross the blood-brain barrier; may help in Alzheimer's.
• LL-37 a favorite antimicrobial; also can be difficult to tolerate.
• BPC-157 isn't the place to start for most patients but can be very helpful at the right time. Can support wound healing, leaky gut.
• Finds mildly elevated liver enzymes commonly in cases with mold exposure.
• Likes ParaWellness for parasites and protozoa.
• International Peptide Society provides training to practitioners on how to use peptides.
• Parasites are a major factor for 90-95% of her patients; viruses 50-60%.
• Peptides, LDA/LDI, and injection techniques are some of her most helpful tools.
• In tinnitus, heavy metals and viral loads are prime suspects. Difficult to treat.
• Finds DNRS to be a helpful brain retraining program.

 Dietrich Klinghardt, MD spoke on "Corono 2020" and shared:

• Coronavirus hit the shores of the US in Kirkland, WA about 2 km away from his office.
• He has been using ART to determine remedies that may be most effective for his patients.
• Unique issue with Coronavirus is that nobody wants to treat it given how contagious it can be.
• 7 Coronaviruses are known to cause human pathology.
• First serious Coronavirus was SARS (death rate ~10%) around 2003 which he treated with herbs; next was MERS (death rate ~35%).
• More than 40 years after Lyme disease was discovered, there is no agreed upon lab test; nor is it acknowledged as an illness in many institutions.
• When COVID-19 occurred, Chinese had the genone and identified treatments within 4 weeks. This is unheard of unless someone knew what to look for.
• More than 3/4 with COVID-19 are male; starts with fever. When a dry hacking cough starts, things may get more serious.
• Transmission is through respiratory droplets; can survive on flat surface for 72 hours (unusual).
• 4-7 days incubation after exposure.
• Virus attaches to mucous membranes of eyes, nose, or mouth; still in those areas when symptoms begin before it becomes more disseminated.
• In the lingering phase, using propolis can be amazingly effective. Spraying the oral mucosa and throat with propolis is a simple tool. Uses HOCL in the nose and eyes.
• First documented outbreak in Kirlankd; 1 of 5 cities to first roll-out 5G. Measured EMFs in Evergreen Hospital; levels were higher than the instruments could measure; highest level he has ever seen. 6 of 10 patients died. It looks suspicious that 5G may be playing a role in the outbreak.
• Took longer to develop a test in the US than in China or Korea. Tests were PCR; unreliable and many false positives. First IgM/IgG test has emerged which will allow for us to determine who has already acquired immunity.
• The mortality rate is likely much lower as many never get tested that had the virus.
• Diagnosing: fever, dry cough; CBC low WBC (3000-3500) and low lymphocyte count (opposite of most viruses). Chest xray may show pulmonary infiltrates; may be hard to get an xray. CT scan is likely best avoided due to the amount of radiation exposure which may trigger further cytokine storms with COVID-19.
• No vaccine or specific antiviral treatment is available.
• Chinese study tested COVID-19 against numerous medications; biggest hits were chloroquine phosphate, Remdesivir (still in trials), and Nitazoxanide (Alinia).
• The French study showed Hydroxychloroquine and azythromycin resulted in 20 of 20 cured by day 5.
• Chloroquine phosphate is more effective than hydroxychloroquine.
• These medications became unavailable in the US overnight when this information came out. The treatment that works is not available to people.
• For every 10,000 people that are saved from death with COVID-19 with these medications, one may have damage resulting from the treatment.
• Herd immunity is either through vaccination or allowing people to acquire the illness with supportive treatment (thus far not available to most).
• Wash your hands; alcohol-based sanitizers are not a good option; consider HOCL.
• Don't touch eyes, nose, mouth with unwashed hands; avoid contact with sick people; sick people should self-isolate.
• Consider propolis tincture gargle/swish alternating with HOCL spray in the throat, eyes, and nose.
• The virus lingers early on within the mucous membranes and can be accessed with these tools.
• HOCL was studied with MERS and eliminated the virus; he sprays the face, hands, steering wheel, keys, door handles, etc.; uses stabilized HOCL from Briotech; others do not seem to work the same. 
• Promising treatment options: Vitamin C, Alinia, Hydroxychloroquine, Azythromycin, Artesunate, Propolis inhalation.
• ARDS results from NLRP3 infammasome which is inhibited by Vitamin C. Vitamin C prevents death. As much as 1 gram per hour while awake if sick; best to use a mix of liposomal and non-liposomal.
• Melatonin is another tool that can help with the inflammation that leads to ARDS.
• Report of someone dying from hydroxychloroquine was someone that took an aquarium-intended chlorine product; not hydroxychloroquine.
• Furins make the COVID-19 virus 1,000 time more transmissible than SARS; allows for viral entry into the cells. When it is inhaled, it is not highly active, but the furins activate the virus.
• Andrographis and Vitamin C have anti-furin properties.
• Silencing the inflammasome can also be effectively done with melatonin and Vitamin C.
• Can increase NO (nitric oxide) production in sinuses with humming; exhale and hum to increase NO production; 15-fold, powerful antiviral treatment. Hum throughout the day as a prevention; calms the inflammasome.
• Viroporins are created by the viruses to allow their "babies" to come out of the cell and infect other cells; release triggers NLRP-3 inflammasome and cytokine storm; calcium influx into the cell; shielding and Wi-Fi hygiene are critical in treating COVID-19.
• Melatonin inhibits NLRP3; used in Lyme, anti-aging, cancer, neurological illness.
• Why do pregnant mothers and infants not get severe illness? Pregnant mother has twice the melatonin; baby has over 10 times the melatonin circulating as adults.
• Melatonin decline with age correlates to increased targeting of older people with COVID-19.
• ACE2 receptor blockers: ACE inhbitors and angiotensin II receptor blockers are different blood pressure medication; receptors in the lung are the entry portal for COVID-19 virus; ACE inhibitors prohibit formation of angiotensin and the lungs express more receptors leading to the virus having more open doors; selenium is a natural ACE inhibitor and should be avoided; antiogtensin II receptor blockers (ARB) close the doors so that the virus cannot enter; Losartan is an example of an ARB that may be helpful.
• ACE inhibitor: lethal; ARB: life-giving.
• Uses very high dose melatonin; both at bedtime (ideally as suppository) and spread throughout the day. 
• Herbs that have stood out with SARS and now with COVID-19: calendula, licorice, Chinese skullcap, rosemary, andrographis, artemisia, dandelion.
• Use HOCL inhaler and fogger; propolis tincture/vaporizer, C, D.
• During infection, rest and drink purified water; do not force yourself to eat; not eating may facilitate healing.
• No NSAIDs; ibuprofen a disaster for this illness.
• Monitor and treat low potassium levels.
• His perspective is that the best solution is to let the infection happen and support the system with non-toxic biological measures in order to create true herd-immunity.
• There have been 40 mutations of the bug; once you have immunity, it will likely offer protection to these mutated variations.
• HOCL is not for oral use. When Briotech HOCL is nebulized, it is used undiluted.
• Colloidal silver has been ineffective in the Chinese study.
• Dandelion should be a combination of root and leaf (whole plant); weight towards the leaf; needs to be as bitter as possible.
• Disulfiram appears to be a useful tool for COVID-19.
• Andrographis is the king of the bitters; ideal before meals to turn on the digestive juices.
• Dr. Klinghardt skips dinner 3 times a week as a modified fast; skipping breakfast is a bad idea.
• Quercetin has been helpful with treating retroviruses, potent anti-inflammatory. Quercetin with African Frankincense and CBD/cannabis are the most potent anti-inflammatories.
• In Italy, every death in those with a Coronavirus-positive test is documented as a COVID death to get additional funding. Some regions are severely impacted.
• Lowest rates are in Russia.
• Most viruses do not want to kill us; they want to adapt with us and embed their genome into ours. If it is a natural virus, it will come and it will go. Even if it is not natural, it still has a higher consciousness; we will get through this.
• Once through COVID-19, Th2 immunity is primed to be on high alert.  If you have a good immune response, you will not get the same illness again (unless it mutates enough which could lead to a similar illness).  
• New RNA vaccines may ultimately prove helpful in providing immunity.
• Given how rapidly things are being learned, explore the latest from Dr. Klinghardt on the Klinghardt Institute YouTube channel.

Ann Corson MD spoke on "Hypercoagulability: What’s the Fuss about Fibrin?" and shared:

• Hypercoagulation is often overlooked even by the most experienced integrative practitioners.
• Hypercoagulation is present to some degree at one time or another in almost every chronically ill patient.
• Sensitive teeth should be a tip off to think about hypercoagulation.
• IDSA meeting in 2003 poster presentation reviewed 1,001 cases between 2001 and 2005; Lyme patients; 87% had low level activation of coagulation; 89.7% had one or more hereditary defects (4 times normal); 1.9% had normal results.
• Body maintains a balance of proteins that encourage or discourage blood clotting.
• A hypercoagulable state is when more molecules encourage clotting than those that encourage thinning.
• Chronically ill people are tilted towards being "sticky" all the time.
• Fibrin and thrombin link together to form a clot; in the majority of hypercoagulable patients, only soluble fibrin is produced.
• If the soluble fibrin outpaces the breakdown of fibrin, fibrin accumulates on the endothelial linings and creates a sludge-like layer which traps toxins and infections.
• Many Lyme-associated infections exist along the endothelial lining.
• Factors precipitating hypercoagulation: inflammation, aging, pregnancy, genetics (20-30%), infections, cancer, toxins, chemicals, mold, metals, allergens, physical trauma, vaccines, EMR/EMF, mycotoxins.
• If you are treating mold without treating hypercoagulation, you are not treating mold properly.
• When you start to move heavy metals, people can become horribly hypercoagulable.
• Hypercoagulation is worsened by any febrile illness, trauma, chronic inflammation (GI dysbiosis, dental cavitations, vasculitis, toxins), cytokine flares, detoxing too aggressively, glyphosate (via deficiency of heparan sulfate).
• Three different systems involved: platelet behavior, fibrin formation or thrombophilia (excess soluble fibrin deposits), fibrin degradation or fibrinolysis (genetic tendency creates weakness in breaking down fibrin).
• Platelet activation can be related to immune activation from toxins or infections including viral infections, junk food, platelets supply clotting factors to produce fibrin.
• Fibrin formation vs. degradation is a balance; pro-coagulant vs. anti-coagulant proteins and anti-fibrinolytic vs. fibrinolysis.
• Thrombin creates fibrin from fibrinogen; anti-thrombin, protein S, protein C, heparans, and GAGs are anti-coagulatnt proteins.
• PAI-1, Lipoprotein(a), and α₂-antiplasmin are proteins that stop us from breaking down fibrin.
• Plasmin is the "Roto-Rooter"; other items that breakdown fibrin include tPA, and kinases such as Streptokinase and exogenous kinases such as Lumbrokinase and Nattokinase.
• Fibrin creation is determined by thrombin level and rate of thrombin formation.
• Elevated fibrinogen (precursor to fibrin) is seen in inflammatory disorders, cancer, estrogen therapy, and during pregnancy.
• Clot formation: tissue factors make prothrombin go to thrombin; thrombin then makes fibrinogen go to fibrin.
• Production of fibrin is blocked by protein C and S as well as antithrombin with heparin.
• Plasminogen goes to plasmin via tPA (tissue Plasminogen Activator) to breakdown soluble fibrin; breakdown of soluble fibrin is measured by D-dimer.
• Inhibitors of fibrin degradation: LP(a), PAI-1 blocks tPA, α2-antiplasmin blocks plasmin.
• When fibrin degradation is inhibited, you build up a layer of sludge; need exogenous kinases to break down soluble fibrin and encourage production of plasmin from plasminogen.
• Very small amounts of soluble fibrin along the lining of the endotheial cell, it reduces oxygen diffusion by 500%; leading to tissue hypoxia.
• Excess soluble fibrin impacts delivery of nutrients, growth factors, hormones, minerals; impacts ability to remove wastes from tissues; overwhelms lymphatic system's ability to detoxify the body
• Can impact control of overall blood pressure; never met a patient with POTS that was not hypercoaguble and usually in mold.
• Can really help patients with a focus on hypercoagulation.
• Fibrin sludge traps toxins and pathogens; when you break it down with exogenous kinases, you uncover or release these into the system.
• Both the existence of these plaques and the release of materials within them can be problematic.
• Coagulation testing: pro-coagulant (Prothrombin 1+2, fibrinogen, Factor II activity, T/AT complexes, Activated protein C resistance, homocysteine, PT/PTT), anti-fibrinolytic (PAI-1, Lipoprotein(a), Alpha-2 antiplasmin), anti-coagulant (Antithrombin III, Protein S activity, Protein C activity), and Firbinolysis (D-dimer).
• Immune System Activation of Coagulation is explored with Fibrinogen Activity, Prothrombin Fragment 1+2 (increased thrombin formation), and T/ATs (or Thrombin/Antithrombin Complexes; increased thrombin breakdown).
• PT/PTT can indicate hypercoagulation; D-dimer elevation is associated with fibrin breakdown; SED rate being low (<5) can indicate hypercoagulation.
• Lipids are often elevated with inflammation; Antiphospholipid antibody testing can indicate autoimmunity and predisposition to hypercoagulation.
• If any of these are elevated, you are making too much fibrin: Prothrombin fragments 1+2, Thrombin/Antithrombin Complex, Fibrinogen activity.
• If T/ATs are elevated with Fragment 1+2, this is a normal response to break it down.
• When Fragment 1+2 is elevated and the T/ATs are low, this indicates fibrin deposition.
• Hereditary Thrombosis Risk Panel: Activated Protein C Resistance (often Factor V Leiden), Factor II Activity (Prothrombin; making too much thrombin leading to hypercoagulation), Lipoprotein(a) (inflammation or genetic weakness), α₂-antiplasmin (protects fibrin by blocking firbinolysis), Plasminogen Activator Inhibitor-1 (blocks fibrinolysis), Homocysteine (6-9 ideal; too high indicates toxicity; too low indicates hypercoagulation), Antithrombin, Protein C, Protein S (normally 1:1:1 balance; if more than 10-15 point deviation, imbalanced by stress, inflammation, trauma, genetics, or adaptation to hypercoagulation as an attempt to fix itself; low protein S can be an indicator of chronic hypercoagulation).
• 30% of the population has some genetic abnormality; hypercoagulators are more likely to develop chronic disease; as many as 95% of chronically ill patients are hypercoagulable.
• Symptoms: generalized pain, limbs fall asleep, achy or sharp stabbing shooting pains, neuralgic pain, brain fog, irritable, anxiety, insomnia, restless legs, stiff upon waking, nausea upon waking, poor morning appetite, painful teeth or loose sensation, no aerobic exercise tolerance.
• Signs: brain fogged, irritable, mottled skin, tear up several times during appointment, cold/clammy extremities though warm centrally, pale swollen tongue with scalloped edges, peri-umbilical tenderness, tissue congestion, feet can be deep purple, poor capillary refill.
• Treatment: reduce inflammation (omegas, detox, GI, drainage, infections, hydrate, clean diet, exercise, reduce stress), reduce insulin resistance (diet, exercise, minerals, herbs), decrease platelet activation (omegas, E, ginkgo, herbs like Dan Shen, anti-inflammatories, antioxidants, remove viral infections and toxins), dissolve excess fibrin (Heparin, Lovenox, fibinolytic and/or proteolytic enzymes starting low) use herbs/nutraceuticals/homeopathic immune modulators, eliminate infections and toxins such as mold/glyphosate/EMRs; address genetic weaknesses (may need enzymes during periods of physical or emotional stress for life).
• Fibrinolytics: Nattokinase (soybean fermented with Bacillus subtilis, resembles plasmin, can dissolve soluble fibrin, enhances production of plasmin, have never had a problem with Allergy Research Group Nattokinase softgels even in those with soy allergy, oral, acts 8-12 hours, lowers blood pressure). Lumbrokinase (Canada RNA Boluoke is the only one that works well, 6 proteolytic enzymes from earthworm, potent fibrin-dissolving, decrease fibrinogen, lower blood viscosity, reduce platelet aggregation, may be 30 times stronger than Nattokinase, important to take on empty stomach, active only in presence of fibrin, does not impact other blood proteins).
• Has treated hypercoagulation for 15 years and has not had a bleeding complication with Boluoke; has seen some nosebleeds but no serious complications. 
• In some cases, may treat during pregnancy which reduces many complications including eclampsia and miscarriage.
• Moving metals and mold toxins makes hypercoagulation significantly worse.
• Herxheimer reactions are increased cytokines and increased soluble fibrin production; can reduce Herx reactions with fibrinolytic enzymes.
• In some cases, fibrinolytic enzymes can lead to worsening and triggering of more fibrin production; related to thrombin release; need to focus on drainage and detox to minimize potential worsening.
• C4a elevation indicates mold, Lyme, or virus.
• Likes Canada RNA Boluoke for lumbrokinase; Allergy Research Group softgels (not capsules) for nattokinase.
• Have to think of hypercoagulation as a biofilm throughout the body; you can't wait to treat hypercoagulation as not addressing it delays the patients suffering; can start enzymes low and increase slowly.
• Heavy bleeding with clots during menstrual cycles can be a sign of hypercoagulation.
• May repeat hypercoagulation labs in 6-12 months.
• Rarely needs Heparin of Lovenox in her patients.
• Enzymes work better on an empty stomach; also away from binders.
• Fibrinolytics are Lumbrokinase and Nattokinase; proteolytics are proteases such as Serrapeptase. 

Jill Carnahan, MD spoke on "Understanding the Gut-Brain-Skin Axis" and shared:

• Has been working on her book with a co-author that is a rock climber; her first climb was a 3+ hour climb; she was terrified but was at the same time excited to become stronger and triumph over fear. Our current pandemic experience also puts us into a stress response; digging into the deepest parts of ourselves will serve as a springboard to move us forward.
• Metabolic endotoxemia is a big player impacting many patients; innate immune response becomes a persistent, low-grade inflammation due to endotoxins, primarily LPS.
• Endotoxins are higher up to five hours after a meal.
• Obesity is driven by endotoxemia.
• Common cytokines and interleukins that are seen in mold exposure.
• Involved in cardiovascular disease, diabetes, obesity, hypogonadism, autoimmunity, anxiety, and depression.
• Endotoxin is produced in the body and are inflammatory after crossing over the gut barrier and leading to an immune response; component of gram-negative bacteria; low levels in healthy people; level of toxicity depends on the type of dietary fat.
• Ketogenic diets high in saturated fats can drive endotoxemia; they may still be good for some patients, but not for others.
• Leaky gut causes: IBD, NSAIDs, SIBO, Celiac, protozoa, toxins, food allergies, alcoholism, diarrhea, strenuous exercise, increasing age, nutritional depletion.
• Gut lining is one cell layer thick.
• Toxic exposures like mold can lead to leaky gut; mold lowers MSH and is critical for integrity of tight junctions.
• Keystone strains like Akkermansia, Faecalibacterium prausnitzii, and Roseburia are good at creating a healthy mucosal barrier.
• Someone with significant intestinal permeability may have a higher cytokine burden and may not do as well with COVID-19.
• Type of fat in the diet is key; saturated fats (including coconut oil) make things worse; omega 3s better.
• Olive oil or fish oil lead to less endotoxin effects.
• Coconut oil increases, olive oil is neutral, cod, fish, vegetable decrease endotoxemia.
• Butter or lard suspected to be similar to coconut oil. Do more olive and fish than coconut oil.
• Circulating LPS activates the immune system and creates more inflammation via NFKb.
• Clinical manifestations of endotoxemia: metabolic syndrome, lipid problems, hypertension, type 2 diabetes, dementia, cancer, PCOS, non-alcoholic fatty liver disease, insomnia, mood disorders.
• Obese individuals have an escalated response to endotoxins.
• Type 2 diabetics have a more significant response to endotoxins.
• In order to have endotoxemia, you have to have leaky gut; start with the gut.
• In a mice experiment with injecting LPS, led to obesity and diabetes.
• Diabetics have a stronger response to endotoxins; endotoxins increase diabetes. Chicken or egg?
• Endotoxemia is ground zero for cardiovascular disease.
• Conditions linked: leptin resistance, chronic constipation (impacts nervous system), mood and appetite, depression, cognitive decline, memory loss (blood brain barrier inflammation), anorexia, anxiety, chronic pain, Parkinson's, hypogonadism, autoimmunity, psoriasis, Scleroderma, atopic dermatitis, acne, vitiligo, rosacea (can also be associated with SIBO).
• Liver gets the blunt of the LPS that enters the blood through the gut via leaky gut; overburdened liver often leads to issues in the skin.
• Skin bacteria are: Actinobacteria, Firmicutes, Bacteroides, and Proteobacteria; Actinobacteria are more abundant on the skin; where Firmicutes and Bacteroides are more abundant in the gut.
  Some skin issues are related to gram negative bacteria which produce LPS.
• Hand sanitizers may negatively impact our skin microbiome.
• Skin-Gut Axis is bi-directional; GI health is linked to skin balance; gut microbiome participates in inflammatory disorders; gut microbes facilitate anti-inflammatory response.
• Butyrate can help increase microbiome diversity.
• C-section babies have less diversity their entire life.
• Acne can be improved in many cases by starting with the gut.
• SCFAs are protective; can support with fibers like inulins, FOS, artichoke, chia, flax, fibrous foods.
• The data with probiotic spores is so good.
• Probiotics made her worse in her own healing journey; never led to improvement.
• Bacillus coagulans in a spore probiotic was a game changer for her own Crohn's.
• Spore-based probiotics reduced endotoxemia in a study she presented.
• Total Gut Restoration includes Recondition (spores), Reinforce (prebiotics), and Rebuild (bovine immunoglobulins).
• Finds spores to be helpful in Chrohn's, Ulcerative Colitis, and SIBO.
• Recondition: low microbibial diversity is best supported by increasing keystone strains. Many probiotics create a monoculture which is also not good. MegaSporeBiotic is her favorite.
• Bacillus spores can increase short-chain fatty acids by 40%.
• Bacillus spores shown to improve leaky gut by 60% in 30 days.
• Reinforce: proper fertilizer. Most prebiotics make SIBO worse; a precision prebiotic feeds strains selectively. Less likely to cause side effects. Still treats SIBO/SIFO prior to introduction. MegaPreBiotic.
• Rebuild: mucosal barrier support; bovine immunoglobulins. MegaMucosa.
• Bovine immunoglobulins passively bind pathogens and toxins.
• MegaMucosa contains polyphenols, mucin-building amino acids, and bovine immunoglobulins.
• Metabolic endotoxemia is the leading cause of mortality and morbidity worldwide.
• LPS is created by gram negative bacteria in the gut and on the skin.
• Can lead to many skin conditions such as acne, Scleroderma, psoriasis, atopic dermatitis, rosacea, and vitiligo.
• Gut biome governs skin biome.
• Butyrate can reduce inflammation in the gut and on the skin.
• Bacillus spores can increase butyrate production by 38%.
• Bacillus spores and precision prebiotics can increase the butyrate-producing bacteria in the gut.
• Saturated fats will carry more LPS; butter, lard, coconut oil more toxic. First choice is extra-virgin olive oil; avocado likely fine as well. Use less saturated fat in patients with endotoxemia.
• Cyrex has an antibody test for LPS, but no direct tests exist to test for serum endotoxins. Would also have to orchestrate testing according to meal time.
• BodyBio makes good butyrate products.
• Butyrate enemas can be helpful for those with Ulcerative colitis; through compounding pharmacies.
• MegaSporeBiotic is well-tolerated in SIBO/SIFO but best to titrate up slowly.
• Endotoxins dump into the liver; likely main cause of fatty liver disease.
• Standard probiotics may not be living by the time they get through our stomach, but still have some beneficial effects.
• In patients that do not tolerate MegaSporeBiotic, may need to start with smaller dose or smaller number of spores. Can create a Herxheimer. All of her patients have tolerated them when slowly introduced.
• With low IgG subclasses, look for tick-borne infections.
• Start with mold avoidance and mold toxin elimination then approach gut healing.
• With higher fat diets, may need more pancreatic enzymes to breakdown the fat.
• Butter, MCT, and coconut oil with meals will increae endotoxin levels postprandially.
• May have patients on MegaSporeBiotic and other probiotics if they are on antibiotics concurrently.
• Bovine immunoglobulins may bind to pathogens like H. Pylori and Clostridia.
• Clinical observation is that the bovine immunoglobulins may help with mycotoxin detoxification.
• Start with MegaSpore and MegaMucosa (or MegaIgG2000) and then later consider MegaPreBiotic.

Kent Holtorf, MD spoke on "The Use of Peptides and Stem Cells for Chronic, Multi-System, Complex Illness" and shared:

• Mentioned that Heparin and enzymes can be a game changer in his patients; things that weren't working then start working.
• He became severely ill in medical school which led to his passion for healing today.
• He ultimately had heart failure and found peptides were very helpful.
• Peptides have changed his life and his practice.
• His blood was so thick that it could not be drawn.
• He had Lyme, Bartonella, Babesia and was unable to get out of bed.
• Emotional stress is a huge problem in chronically ill patients; wipes out the immune system.
• Peptides have become a core of his practice.
• Immune dysfunction is at the core of so many conditions; fixing it gets patients better.
• In chronic illness such as Lyme, patients have become Th2 dominant with low Th1 function.
• Peptides are synergistic with most other therapies.
• Rarely uses antibiotics anymore in chronic Lyme patients.
• BPC-157 and TB4 Active Frag are two peptides that can be taken orally.
• Epitalon is the best anti-aging peptide; probably everyone should be on it.
• Peptides are naturally occurring short chains of amino acids; master regulators.
• 50 or more amino acids is a protein; less is a peptide.
• Peptides work at the cell surface as secondary messengers; very safe.
• Hormones work on receptors in the nucleus; more general; higher risk.
• Peptides regulate most processes in the system; a more precise bio-regulator.
• Peptides turn on numerous healing and anti-aging genes.
• Peptide Categories: Immune modulating (Thymosin Beta 4 increases Th1 and reduces Th2, BPC-157 reduces Th2, Thymosin Alpha 1 increases Th1, Thymulin), Sleep (Epitalon, DSIP/Delta sleep inducing peptide, CJC/Ipamorelin, AOD), Brain for memory/anxiety/depression/TBI (Semax, Selank, Cerebrolysin, Dihexa, Cortagen), Growth hormone (GHRP/GHRH, AOD), Antimicrobial (LL-37, TA1/TB4/TB4 Active Frag, BPC-157), Regjuvenation/Pain (BPC-157, TB4/TB4 Active Frag, Epitalon, DSIP, GHRH, GHRP), Mitochondria/Energy (MOTSc, BPC-157, TB4, TB4 Frag, 5-Amino-1MQ), Melanotropic (Melanotan, PT-141)
• Thymosin Beta 4 and BPC-157 can help minimize Herxheimer reactions.
• Standard growth hormone seems to work better than the growth hormone peptides.
• Side effects: some nausea, local reactions; very safe overall.
• Can help a large percentage of patients with numerous conditions with two key peptides: BPC-157 and TB4 Active Frag.
• Huge population of people have gut and systemic issues that can respond to these two peptide supplements when other therapies were unsuccessful.
• Very synergistic with other therapies.
• Can be expensive when on 4-5 peptides at a time and may cost over $600 a month.
• Many conditions associated with Th1/Th2 shift: Lyme and chronic bacterial/viral/fungal/parasitic infections, CFS/FM, autoimmunity, stress, toxic exposures, aging, dysbiosis/IBS/SIBO, cardiovascular disease, high cholesterol and triglycerides, insulin resistance/diabetes, obesity, depression/bipolar, dieting, anxiety, neurodegenerative disease, migraines, inflammation.
• Aging is correlated with lower Th1 and elevated Th2.
• Cytokine testing not clinically relevant; uses NK cell function for Th1 marker (number of less sensitive).
• A triggering event is under the backdrop of chronic Lyme or other infections.
• Biggest transmission for Lyme is in utero.
• Immune dysfunction set off with significant stress, other infections, illness, or accident.
• Measurable hypothalamic, pituitary, immune, GI, mitochondrial, detoxification, cognitive, sleep, hormone, peptide, and coagulation dysfunction.
• The largest gains are focusing on improving the immune system.
• A healthy immune system can manage many different infections that we may not ever fully eradicate.
• Most with chronic Lyme disease are asymptomatic for a period of time until a triggering event.
• Commercial labs are almost always officially negative; tests can be labeled inaccurate when positive in asymptomatic patients.
• After months or years, see a breakdown of Th1 and an overstimulation of Th2.
• Th1/Th2 balance correlated with progression of HIV to AIDS.
• Thymus declines around age 40-45 when many diseases of aging occur.
• Thymosin Beta 4 and TB4 Active Frag are thymosins secreted by thymus gland; immune modulation, tissue healing, antimicrobial.
• TB4 mechanisms: boost mitochondria, turn on healing genes, increase nitric oxide, serve as secondary messengers, turn on antioxidant production, and numerous other beneficial mechanisms.
• BPC-157 is 15 amino acids; in the GI tract; works systemically. Best treatment for leaky gut. Works well with TB4.
• Oral BPC-157 does appear to have systemic effects such as reduction of knee pain.
• BPC-157 supports heart, neuropathic pain, and protects against neuro and endotoxins; helps with autoimmune conditions such as RA, Lupus, MS, Crohn's, and Hashimoto's.
• BPC-157 can prevent MCAS; better than antihistamines.
• BPC-157 has broad-spectrum antimicrobial properties.
• BPC-157 shown to be helpful with traumatic brain injuries, MS, Alzheimer's, Parkinson's.
• TB4 has been shown to have antifungal effects against Aspergillus in mice.
• Water, caffeine, and alcohol are more toxic than peptides.
• TB4 cannot be taken orally; TB4 Active Frag is available orally.
• BPC-157 and TB4 Fragment can both be helpful for MCAS.
• BPC-157 helpful for numerous viruses.
• Low TB4 correlated with sepsis and mortality.
• BPC-157 has been used for IBD/IBS, leaky gut, ulcers, GERD, SIBO, food intolerance, MCAS, GI infections, binding mycotoxins and neurotoxins.
• Leaky gut equals leaky brain; gut inflammation equals brain inflammation.
• Giving peptides with a probiotic may improve the microbiome.
• BPC may help with spinal cord injury and nerve regeneration.
• TB4 can be helpful in PANS/PANDAS/autoimmunity; reduces TGFb1.
• BPC may be helpful with hypercoagulation.
• BPC has worked well for urinary incontinence.
• Thymic proteins support anti-aging and reduce rates of cancer.
• Mesenchymal stem cells are now being done earlier in the treatment; makes other treatments work better.
• Peptides boost effectiveness of stem cells.
• Stem cells are antimicrobial; may be combined with antibiotics.
• Stem cells may improve type 2 diabetes.
• LL-37 is an antimicrobial peptide and may be done slowly and later in treatment as it can lead to significant Herx reactions.
• Many think stem cells become a particular tissue; they don't; they deliver cytokines, peptides, and growth factors; the major effect is secretion of exosomes.
• Exosomes contain growth factors, cytokines, peptides, mRNA, mitochondrial RNA and DNA.
• Th1/Th2 dysfunction is a core component of the viscous cycle of multi-system disease. Addressing the immune dysfunction critical to break the cycle.
• Oral peptide therapy with BPC-157 and TB Active Frag may be helpful in modulating the immune system.
• LL-37 may not help until the immune dysregulation is addressed but can be very helpful later in treatment.
• Have had good results with peptides, stem cells, and exosomes in autism; TB4, BPC, Selank, Semax. Have seen significant improvement.
• Autism patients are very much like Lyme patients; often a maternal infection that sets off an increased Th2 response and immune dysregulation.
• Oral BPC has been well-tolerated; can increase Th1 and possibly lead to a Herx early on.
• Peptide training is available through International Peptide Society.
• His clinical experience is that the peptides have been as helpful as the research suggests; though nothing works for everyone.
• Peptides are another tool in the toolbox; though a big tool in their toolbox.
• Fixing leaky gut and the immune system improves the brain.
• Overwhelming majority of those with ALS have Lyme or relapsing fever; treating like Lyme may lead to higher ground.  

Kelly McCann, MD spoke on "Illness as Opportunity: Helping Our Chronically Ill Patients Transform" and shared:

• Talk therapy may not go deeply enough to shift a chronic illness.
• Anything that disturbs the peace can manifest in physical, emotional, or psychological issues.
• Healing is the application of loving to the places that hurt.
• When we are upset, our beliefs about how things should be have been violated and peace disturbed.
• Patients may have a victim mentality; this is an opportunity to look for clues to help patients; cannot shift and heal in victim mentality state.
• Realms of being: Physical, Mental (core beliefs; early conditioning), Emotional (feeling responses).
• The more we believe something, the more upset we will become when the belief is violated.
• Authentic self is a state of unconditional love, compassion, peace, and acceptance.
• All beings desire to grow, have lessons to learn, and have the skills and inner resources to learn.
• Effective listening is on 4 levels: content, tonality, person, and meaning.
• Provide a safe place for patients to share their feelings; acknowledge the courage involved in sharing.
• People want to be heard and understood.
• Listening to our own intuition is important; help patients tap into their intuition.
• Practitioners cannot help their patients unless they do their own inner work.
• Practitioners need to facilitate patients taking ownership and responsibility for their experience.
• How we are with our own state impacts our perception of reality.
• Louise Hay: our thoughts create our life experiences; thoughts have vibrations that attract diseases.
• In TCM, life energy or Qi flows through meridians; dysfunction leads to "dis-ease".
• Meridians can be associated with physical and emotional imbalances.
• Liver meridian is our life-planner and much more important than just the liver as an organ.
• Meridians activate on a schedule such as liver at 1-3am.
• Triple Heater is the only meridian that does not line-up with a physical organ.
• Chakras are another system; 7 main energy centers; can be open or closed; crown (7), third eye, throat, heart, solar plexus, sacral, and root (1).
• There is no intimacy without vulnerability.
• We have a body, but are not our body.
• We have emotions, but are not our emotions.
• We have a mind, but are not our mind.
• We have desires, but are not our desire.
• We are the center of pure self-consciousness and of will.
• Healing is the process of releasing judgments that separate our awareness of our own in loving and being.
• Those with chronic illness often have attachment to their issues including a victim mentality.
• Those with chronic illness often have more mental/emotional issues than healthy people.

Ben Lynch, ND presented on "Dirty Genes: Exploring Genetics vs. Epigenetics in Modern Health Conditions" and shared:

• COVID-19 is an indication that the entire globe has dirty genes; pharmaceutical applications to suppress symptoms only work so long.
• Integrative, naturopathic, and functional medicine need to be used in our daily lives.
• If you believe you are born to a genetic destiny, your potential to make changes is reduced.
• You can have perfect genes and still be very sick.
• Shared a cartoon: "Assuming present trends continue, the odds are quite good that we'll become the best-informed extinct species on the planet!"
• People can over-supplement and supplements can make us sick when incorrectly implemented.
• MTHFR is a genetic variant that has become the poster-child for all genetics; lots of publications; clinically-relevant when dirty; common.
• The way we help patients with genetics has been wrong; misinformation continues to circulate.
• The right way is the hard way.
• "Anytime you learn something new, forget everything you knew about it."
• Genetic reports often code things as yellow and red; he will no longer be doing that as they are not necessarily bad.
• Genetic reporting often makes people feel confused and leads to fear and a mental block.
• You cannot work with patients with just genetic information; or labs and history.
• You must understand the epigenetic controls of the genes; brings things to a new level.
• Activity of a gene is impacted by having enough substrate (raw materials) and cofactors (vitamins and minerals).
• If there is sufficient substrate and cofactors, there can still be blocks in the pathways that negatively impact patients.
• A dirty gene is a gene that is not functioning optimally.
• If on GAPS, Carnivore, or Paleo diet and have an underperforming MTR gene, this could lead to increase in homocysteine resulting from excess protein.
• A gene that was not born dirty can still become dirty; this is more common.
• Various types of "dirt" influence the function of a gene; as does a deficiency in co-factors.
• SNPs make it more significant that an environmental influence will slow down or speed up a gene.
• Dirty Gene Contributors: air pollution, poor sleep, mindset, medications, sugar/carbs, overeating, inflammation, WiFi, in utero exposures, tap water, breathing improperly, toxins, infections, mold, nutrient deficiencies, stress, processed foods, chemicals, variants; these lead to altered gene expression, symptoms, and development of disease.
• Breathing through the nose produces nitric oxide; mouth breathing does not.
• Need to focus on reducing EMFs and improving breathing.
• Don't focus on the negatives, but also look at the remaining capacity of a gene/enzyme; focus on what dirties the genes and work on improving those factors.
• Clean Gene Contributors: clean air, restful sleep, laughter, community, real foods, sauna, vacation, active lifestyle, breastfed, pure water, breathing properly, organic foods, meditation, targeted nutrients, hobbies, preconception care, non-GMO, variants; these lead to healthy gene expression, elimination of symptoms, and optimization of life.
• Not enough critical thinking taught in medicine.
• There are benefits to having impairments in MTHFR as well; involved in DNA repair. SNPs have good and potentially bad implications.
• If you are low folate, likely need more choline; if high in folate, likely less demand for choline.
• Folate comes leafy greens; though oxalates do as well.
• Folic acid slows natural killer cells.
• Folate receptor has a higher affinity for folic acid (not good) than MTHF; can then appear that you have high serum folates when you are deficient in the right folates in the right places; can have cerebral folate deficiency.
• We are making ourselves dumber by consuming folic acid.
• Cerebral folate deficiency can be mild to severe; many may have mild forms due to folic acid.
• Folic acid is the horse and buggy; we have much better folates now.
• Methionine is methylated homocysteine.
• 80% of methylation in the liver is consumed to create PC (cell membranes, bile flow, gallbladder) and creatine (neurological and muscle support and hydration).
• If you don't have enough vitamins on board, homocysteine goes up and the system starts breaking down.
• SAMe is used six times in the dopamine pathway; high homocysteine may lead to emotional disturbances.
• Some suggest you can't take certain nutrients with specific SNPs; it's not always that simple.
• On OAT, TCBA elevation will lead to 90% reduction of magnesium, 35% reduction of calcium, 56% reduction of zinc.
• Many people are riboflavin deficient; a co-factor for many genes.
• SAMe test: 250mg before bed; either become more calm and relaxed and fall asleep or get insomnia/irritable/alert.
• For those that feel worse, may show that their pathways are not open. Can counteract with 50-100mg niacin.
• Gut health is paramount and central to methylation; have to practice the fundamentals.
• Fundamentals are not sexy, but they work.
• You cannot say that high histamine means undermethylation.
• Key action points: Fundamentals, SNPs may increase or decrease disease susceptibility, "Got Dirty" genes more significant than "Born Dirty" genes, respect complexity and don't simplify, methylation, avoid chemicals, address infections, manage stress, explore co-factor deficiency, look at lab patterns; not always black and white.
• Often over-supplementing patients which creates more problems.
• People tell women to take folic acid to prevent birth defects but in fact are creating a problem with folic acid.
• 90% of pregnant women are choline deficient; the more choline deficient, the more folate they need.
• When you see low zinc or copper, the body may have them low for a purpose; you don't always jump to repleting without additional thought. Iron for example can be used to support microbes.
• MCV and MCH elevation indicates B12 or folate deficiency.
• Serum folates being high could be glutathione deficiency or MTR inefficiency.
• Optimal level for homocysteine is 6-8; lower than 5-6 may be protein malabsorption or low glutathione; higher than 8 may need B12, zinc, TMG, choline, methylfolate; if resistant, may be metals, acetylaldehyde, low glutathione, too much protein.
• Folinic acid is very underrated.
• If homocysteine levels are fine, folinic acid may be ideal; methyfolate is "rocket fuel".
• Likes to use folates in a lozenge for absorption; does not like standard tablets.
• When genetics are utilized properly, they are awesome. 
• 99% of the time, they are not used properly. 

Gerry Curatola, DDS spoke on "Understanding the Oral Microbiome, and its Essential Role in Nutrition, Inflammation, and Disease" and shared:

• Oral health is the 800 pound gorilla in the wellness room; often misunderstood.
• Oral microbiome is essential to systemic health; first line of defense.
• The oral microbiome is a magnificent, intelligent, semi-permeable membrane.
• The community of bacteria in the mouth can infiltrate the entire body via the digestive tract or the bloodstream.
• Number one bacteria in colorectal tumors is a commensal oral bacterial; others have been found in plaques and arteries around the heart.
• Weston A. Price was the father of the mouth-body connection; was ridiculed in 1917 for promoting the importance of the mouth in systemic health.
• "Drill 'em, fill 'em, and bill 'em" mentality in conventional dentistry.
• 80% of adult Americans have some stage of gum disease which makes them 2-10 times more likely to die from a heart attack and 3 times more likely to die from stroke.
• Diabetes and bleeding gums have a two-way relationship and increase risk of death by 400-700 percent.
• 90% of illness has an oral manifestation.
• Black hairy tongue can occur from rinsing with hydrogen peroxide.
• Chinese looked at the tongue as an indication of systemic health.
• The tooth/meridian/organ chart shows the associations between the teeth and associated meridians and organs in the body.
• Has observed connections between root canal teeth and tumors in associated areas with improvement upon removal of the root canal.
• Teeth are like circuit breakers; energetic shields around every organ system in the body.
• Upper molars correspond to breast cancers.
• The mouth is a gateway to disease in the body.
• 85% of adults over 35 have some form of gum disease.
• Antibiotics and antimicrobials have been found to be ineffective and harmful to the oral microbiome.
• "Scorched earth" approach of "kill, kill, kill" goes against the beneficial effect of the oral microbiome.
• Gum disease is the number one source of chronic, low-grade inflammation; a smoldering fire that ravages organ systems throughout the body.
• Biofilm around the teeth is called plaque and can have systemic consequences; can lead to heart disease, pregnancy complications, elevated inflammation, GI dysbiosis (oral bacteria do pass through the stomach).
• Naturopaths had it right all along.
• Oral microbiome is essential for life, for protection against environmental pathogens, for digestion, and for immune system regulation.
• 700 species in the oral microbiome and up to 6-10 billion organisms.
• We are married to our microbes; happy microbiome, happy body.
• Gum disease is a catalyst for cancer cell growth.
• Men with moderate to advanced gum disease had a 67% higher incidence of pancreatic cancer.
• The human body has 100 trillion life forms living in it; man is made of microbes; we are walking bacteria containers.
• The mitochondria of our cells evolved from bacteria.
• Balanced oral microbiome strengthens the immune system, aids digestion, produces vitamins, protects from pathogens, protects against gum disease, prevents cavities, helps avoid bad breath, minimizes staining.
• The oral ecosystem is an intelligent semi-permeable membrane.
• When balance is pro-inflammatory, spirochetes in biofilm are observed.
• On the opposite end, can have a desert with no biome; a hypotrophic biofilm.
• In a hypertrophic biofilm, tooth decay and gum disease may present; in hypotrophic, root/tooth sensitivity and ulcers/burning mouth.
• Oral care products with charcoal and clay are abrasive to teeth and strip the microbiome.
• Oil pulling is not magic; if you have a thick biofilm, it may be good short-term, but can lead to imbalance and a hypotrophic biofilm.
• Dental plaque is an unhealthy biofilm and results from many traditional oral care products that lead to loss of balance of the microbiome.
• Fluorine is a highly-reactive element in the periodic table; epidemic of dental decay 80 years after fluoridation; weakens teeth.
• Healthy oral microbiome is a thin, clear, odorless film.
• Demineralization of teeth occurs with an acidic diet.
• Diet is an essential component of promoting a balanced microbiome.
• We do not want toothpastes or mouthwashes that aim to kill everything.
• The oral microbiome is involved in nutrient collection, waste removal, and survival of the collective; a beautiful garden.
• An unbalanced microbiome converts from aerobes to anaerobes such as spirochetes and Fusobacterium.
• 80-85% have an imbalanced microbiome.
• The approach in dentistry for years was Roundup; the approach now is composting and organic gardening.
• Triclosan was the glyphosate of the dental world.
• The oral microbiome is like a coral reef protecting an island.
• Tricolsan is a toxin hidden in dental care products with a host of negative effects.
• Even after the FDA band triclosan in hand soaps, it was allowed to remain in toothpastes.
• Read the ingredient labels on conventional toothpastes; full of toxins; a "witches brew of garbage".
• Xylitol is an unnatural chemical and best avoided; comes from GMO corn cobs and then highly processed. Sugar alcohols disturb the oral and GI microbiome.
• Rebalance the oral microbiome by eliminating harmful products, alkaline/anti-inflammatory/antioxidant nutrition, stress management, and healthy exercise.
• He spent 20 years developing "Revitin" toothpaste which was created to feed the microbiome; reduced gingival inflammation by 26% in 7 days.
• In one study, Revitin showed 42% reduction in gingival inflammation, 46% reduction in plaque, and 72.5% reduction in bleeding after 14 days.
• If there would only be one vitamin, his choice would be Vitamin C.
• Oral cavity has an essential role in nitric oxide production.
• Nose breathing assists with nitric oxide generation; mouth breathing does not.
• Stress negatively impacts the oral microbiome; biome is supported by a parasympathetic state.
• Exercise alters the microbiome; increases fluid flows in the dental tubules.
• Microbiome Commandments: We are made of microbes; microbes run us; make peace with your microbes.
• Revitin has been used in dogs and cats; pet gum disease is more epidemic than human gum disease.
• Revitin is designed to be rubbed on the gums; even as a gum mask at bedtime; can be swallowed/eaten.
• Baking soda is abrasive to teeth enamel; though promotes an alkaline pH in the mouth.
• Hydrogen peroxide is oxidative and can lead to imbalance in the microbiome when used long-term.
• Using probiotics orally does not seem to have an effect; not as effective in the gut as once thought as well.
• If you can stick your finger on your teeth and scrape off a white film, that's a hypertrophic microbiome.
• Oil pulling should be done for two weeks max.
• Gum recession is best supported by a healthy microbiome; could be a bite issue stressing the bone. Pinhole technique can be used to raise healthy gums up on the teeth.
• Does not recommended commercial rinses; a teaspoon of Himalayan salt as a rinse can be helpful as it has trace minerals.
• Uses resopathy in his office for dental compatibility testing.
• 3D Cone Beam (CBCT) can be helpful looking for stealth infections; his office will read them.
• Cavitations affect the microbiome and become a nuclear reactor for superbugs.
• 86% of conventional wisdom tooth removals have cavitations in those sites.
• Ozone is not a solution for the defect of a cavitation; Lyme spirochetes, Candida, molds, metals.
• Cavitations become a suspicious root cause for those with autoimmune issues.
• Lichen planus is a microbiome imbalance; change products being used in the mouth.
• Sees connections between mold illness and dental disease; mold and cavitations, cavitations and mold.
• EBV impacts the sinuses and maxilla; mandible is mold and Lyme spirochetes.
• Improperly fitting dentures are a big problem.
• 100% of metal implants in a recent study released endotoxins; pro-inflammatory.
• Interdental plaque is like leaving the garbage out, it starting to smell, and the rats coming out. Floss, interdental stimulators, WaterPik can all be helpful.
• Uses ozone in dental procedures but there can be an overuse of ozone that negatively impacts the microbiome.
• Breastmilk (which he supports) and cow milk contain lactose which creates microbial imbalance. Breast-feeding on-demand creates a negative microbiome shift. Need to be on a schedule. Have a cloth or toothbrush and brush after breastfeeding.
• Zirconium implants have much better tolerance, do not produce endotoxins, do not interfere with the energetic meridians. Titanium implants are pro-inflammatory and act as an antennae for EMR.
• Root canals are the only procedure where something dead is left in the human body. It is impossible to sterilize a dead tooth. On 3D cone scans, can see infections that cannot be seen on xray. 

Simon Yu, MD spoke on "Parasites and Dental Problems: Missing Links When the Latest Medical Therapies Have Failed" and shared:

• Uses Acupuncture Meridian Assessment, a form of EAV, to identify hidden stressors.
• Parasites and dental infections are often the missing link for inflammation and immune dysregulation.
• Measures 40 main acupuncture points and looks at the patterns of imbalanced meridians.
• Has done EAV for 30 years.
• Multiple factors contribute to Lyme, Post-Lyme, Cancer: infections (parasites, fungi, bacteria, viruses), chemical carcinogens, heavy metals, nutritional imbalances, genetics, social, dental, EMF, emotions. These lead to metabolic dysfunction and mitochondrial damage and impact the extracellular matrix.
• 4.46 billion people in the world are infected by parasites.
• Parasites are the major trigger for silent inflammation.
• Antiparasitic and antifungal medications target cancer cells.
• Numerous articles written by Dr. Yu can be found at preventionandhealing.com
• The Th2 immune response is the first responder to helminths.
• RANTES which is a test used for dental cavitations may be due to dental parasites.
• Hidden dental infections and parasites often drive immune system imbalances.
• Extracted teeth can be tested with DNA testing to identify the often numerous infections associated with them.
• Hardest part of his job is to convince people to get their dental work done which may mean having teeth pulled.
• Reviewed several cases, some with significant kidney issues with possible need for transplant, that resolved with addressing dental and parasite issues.
• Discussed two Lyme patients, a husband and wife. Husband had a positive IGeneX test but was asymptomatic; wife had a negative test but was highly symptomatic. Her underlying issue was several root canals.
• In those with Lyme spirochetes, it is important to consider that there can be many dental spirochetes as well; dental issues may be the bigger underlying issue.
• Reviewed a case that had 10 years of IV antibiotics for Lyme. Identified dental cavitations; determines whether or not a cavitation needs a surgical intervention.
• Parasites can play a role in migraines.
• For epilepsy and seizures, look for dental problems and parasites.
• Was in the US Army for 25 years working in Oruro, Bolivia; in 2001, started using parasite medications based on EAV testing.
• Started with natural treatments which resolved GI issues, but adding RX options led to more significant systemic improvements.
• Parasite problems are overlooked in part due to unreliable stool tests, they are in the lung/liver/brain/pancreas, exposure from pets, advanced life force and difficult to eradicate.
• If you don't kill them, they may migrate to other places in the body.
• Parasites may be protozoa, helminths, roundworms, tapeworms, flukes.
• Can be co-infected with organisms insides parasites: viruses, nanobacteria, intracellular parasites, cell-wall deficient bacteria, Mycoplasma, spirochetes, prions, molds, yeast, Candida.
• Emotional parasitic relationships can be seen in some of the sickest people.
• Think parasites when numerous food allergies are present.
• Dental connections are observed in breast cancer.
• Beyond parasites and dental, he also looks for heavy metals, myctoxins, environmental toxins, food allergies, and does a tissue mineral analysis.
• When the latest medical therapies have failed, think dental.
• 9 out of 10 people don't come back to see him after he recommends pulling teeth.
• Underlying problems: nutrition, vaccinations, insecticides, preservatives, medications, chemicals, scars, parasites, dental problems, infections, toxins, psychological stress, heavy metals, acidosis, EMFs, allergies, miasms/DNA.
• Looking at homotoxicology, a root canal may years later lead to Lyme or cancer.
• He can see the effects of EMFs with the AMA system; looking at what meridians become stressed when in the presence of EMFs. A perfectly balanced meridian system can be notably dysregulated in the presence of a cell phone.
• Some people do not seem to be impacted by their cell phone when he tests them with AMA.
• He will generally detoxify, start drainage, parasites, improve nutrition and then do the dental work.
• Often sees parasites in the DNA testing associated with dental issues.
• Bruxism and tinnitus are often related to parasites.
• His work is often unlayering issues and is rarely done with one round of treatment.
• He never gives a single anti-parasitic remedy; uses a combination of several RX and natural options.
• Underdosing parasite medications is often less well-tolerated than higher dose. High doses kill parasites; lower dose may lead to parasites moving more deeply in the body.
• His experience has been that in those with Toxoplasmosis, there are often other parasites involved that need to be addressed first.
• Natural options alone are not strong enough to address parasites once there is systemic illness.
• Ensuring that liver, kidney, and lymphatics are open using drainage remedies is an important part of his treatment protocols.
• Gallbladder meridian is the most complex meridian that controls many different parts of the body.
• When treating parasites, there may be a release of heavy metals, mycotoxins, and other toxins.
• Has seen patients lose hair with parasite treatments and later identified there was a significant environmental toxic burden.
• Generally prefers not to put an implant in right away, but rather to do the extraction or procedure and then confirm with AMA testing that the original observed issue is resolved before putting in the implants; otherwise, the implant may need to come out later.
• Generally times parasite medications around the full moon, but some patients have found using the new moon cycle to be very helpful.

Eboni Cornish, MD introduced "Scenes from documentary film Skin Deep: The Battle Over Morgellons" and shared:

• Morgellons is a disease associated with filamentous fiber of unknown etiology.
• We are on the brink of discovery of understanding this complex and unique disorder.
• Publications show association with Morgellons and Borrelia, TBRF, Bartonella, H. Pylori, and other infections.
• If you are treating complex conditions, you are most likely treating patients with Morgellons.
• Morgellons is where Lyme disease was 12 years ago.
• Skin Deep is to the Morgellons conversation today what Under Our Skin was to the Lyme community 12 years ago.
• Crawling skin, numbness, tingling, neuropathies, chronic fatigue, cognitive impairment; overlap with other conditions.
• Do a skin exam. Don't ignore non-healing wounds or skin sensations or fibers.
• She had a Lyme patient with lesions that resolved with treatment but would relapse with exposure to mold or not following her diet.
• Was introduced to Morgellons by a patient, and there was no turning back.
• Morgellons is treated the same way that you treat other chronic conditions with an infectious component.
• M&Ms: Morgellons patients commonly have mold illness and MCAS.
• Morgellons patients are no different than other patients.
• To view the film, visit MorgellonsMovie.com

Bryan Rade, ND spoke on "Maximizing Mitochondria to Thoroughly Resolve Complex Chronic Illness" and shared:

• Comprehensive mitochondrial support has been a game-changer in his practice and made significant shifts in some of his difficult patients.
• Patients get better faster.
• Average person makes 24-60kg in ATP; half of our body weight.
• Mitochondrial dysfunction is a feature of virtually every disease.
• 90% of ATP is produced by the mitochondria.
• Mitochondrial dysfunction is induced by infections, molds, metals; mitochondrial disease is genetic, rare, and often more severe.
• Agents that directly inhibit mitochondria: mycotoxins, heavy metals, EMR, Borrelia and associated coinfections may impact mitochondria directly and via Cell Danger Response.
• Fatigue, brain fog, poor stamina, poor healing all associated with mitochondrial dysfunction.
• Mitochondrial suppression is a core feature of the Cell Danger Response.
• The underlying causes still need to be treated, but also support the mitochondria simultaneously.
• CDR increases autophagy and mitochondrial splitting to remove intracellular pathogens.
• Mitochondria shutdown oxygen consumption which leads to increases oxygen in the cytosol and leads to oxidation.
• With all the tools, plateaus are encountered; comprehensive mitochondrial support seems to break through in many cases.
• Mold illness is much more prevalent than he once thought.
• In his work with LDI, found that some patients have a hypersensitivity of allergy to their microbes.
• Reviewed a case where he had done numerous therapies such as chelation, LDA/LDI, SIBO treatment, microbial treatment, CBT, FCT, ART, and others but was still plateaued.  Incorporating mitochondrial support made a notable shift within a month.  Fatigue and brain fog notably improved.
• Symptoms of mitochondrial dysfunction: fatigue, impaired stamina, persistent hypertonicity (muscles like rocks; takes ATP for body to relax), low body temperature (mitochondria are workhorses of the thyroid), impaired wound healing, brain fog, memory impairment, heavy legs, pain on exertion
• Indirect symptoms: insomnia, xeroderma/xerophthalmia, osteoporosis, sarcopenia, air hunger, glutamine/butyrate don't heal leaky gut
• Partial mitochondrial support is only certain elements at low/medium/robust doses; comprehensive is supplementing all elements at robust doses
• Has observed that partial support has generally been a swing and a miss.
• Numerous partial support products are available but he has not observed clear benefits; often a drop in the bucket.
• Comprehensive Mitochondrial Support includes robust doses of these cofactors: benfotiamine, R5P, riboflavin, niacinamide, nicotinamide riboside, zinc, B5, methyl B12, methylfolate, manganese, acetyl-l-carnitine, R ALA, SAMe, magnesium; redox support: tocopherols, tocotrienols, calcium ascorbate, glutathione, A, taurine, proline, CoQ10, PQQ, melatonin; cell membrane: PC; ATP precursors: D-ribose; mito electrolyte support: D; biogenesis: quercetin, resveratrol, creatine.
• He uses a Mitochondrial Support Formula with a multi nutrient, ribose, and creatine.
• Loss of Nrf2 leads to decreased ATP levels and impaired respiration.
• Melatonin was developed in bacteria and has been unchanged; likely important and a perfect molecule.
• Photobiomodulation or IV laser therapy provides electrons directly to the body to support the mitochondria.
• Need oxygen from breathing, exercise, EWOT, HBOT, MAH for optimal mitochondrial function.
• Ozone therapy supports Nrf2 and mitochondrial function.
• He uses mitochondrial support earlier on now in his patients; gets patient results faster.
• A focus on adrenals and thyroid does not seem to help significantly; adaptogens need mitochondria to exert their positive effects; a major target of T3 is modulation of mitochondrial biogenesis and activity.
• Caloric restriction, ketogenic diet, HIIT, sleep are important for mitochondrial function.
• He has multiple phases of how the mitochondrial support is introduced with patients.
• Melatonin can pack a punch and lead to a Herx or die-off reaction.
• In the throws of a Cell Danger Response, mitochondrial support may be started very low or delayed to avoid flares.
• Labs: there is no perfect test to assess mitochondrial function.
• We need ATP to run everything; give what is needed to make ATP; remove stress, bugs, metals, EMFs, toxins, toxicants
• Healing is mediated by ATP.
• When supporting mitochondria, IV nutrient therapies seem to work better.
• Melatonin may be clearing out some of the damage in the mitochondria; allowing certain toxins to be released and leading to a Herx-like reaction.
• Uses Viatrexx drainage remedies to support patients with their protocols.
• IV laser can be helpful for microbial support; uses Weber medical laser.

Elisa Song, MD spoke on "What To Do When You Get Stuck – Understanding the Role of the Cell Danger Response in Pediatric Patients" and shared:

• Kids are sick and getting sicker.
• The new normal is that children are sick; 55% of kids have a chronic condition. By 2025, 8 in 10 kids will have a chronic condition.
• Need a root cause, integrative, functional medicine approach.
• Cell Danger Response plays a role in many conditions in children.
• There are 4 stages of health and healing: Health Cycle and Healing Cycle (3 stages of the CDR after a cellular injury; activated when cellular stress exceeds capacity of restorative sleep to repair damage and restore normal cell to cell communication).
• CDR is an adaptive, primitive response to chemical, physical, microbial, or psychological stress.
• Cells move through 3 CDR phases to re-enter the healthy cycle.
• Cells develop metabolic memory or "mitocellular hormesis" meaning cells learn how to be more resilient in the future.
• CDR1 is to extinguish the threat; injured cells disconnect from the rest of us as a protective response; mitochondria release ATP and extracellular ATP initiates the CDR. May see more mitochondrial dysfunction and MCAS.
• CDR2 is cleanup and repair; once the threat is neutralized, stem cells are recruited to proliferate and replace cells lost during CDR1; if the threat is not neutralized, the priority is survival; damaged areas or persistent infections are walled off with scar tissue by fibroblasts and myofibroblasts.
• CDR2 is where functional medicine shines.
• When CDR persists pathologically, chronic disease results.
• CDR3 is restore cell to cell communication and develop metabolic memory; cells that were autonomous in CDR1 and CDR2 must now re-establish cell to cell communication via the vagus nerve; decrease in extracellular ATP signalling that the cells are ready to re-enter the healthy cycle.
• Persistent CDR is what leads to persistent mitochondrial dysfunction, MCAS, and chronic disease.
• Specific conditions can get stuck in different phases of the CDR model.
• In CDR1, need to extinguish the threat, address biofilms, support mitochondria, reduce mast cell response.
• In CDR2, need to support mitochondria, reduce mast cell response, incorporate functional medicine, and address hypercoagulability.
• In CDR3, need to optimize cell communication including with the brain via the vagus nerve.
• In the Health Cycle, need to optimize restorative sleep and exercise.
• Biofilms can occur anywhere in the body; slime layer creating a functional community; microbes in biofilm are different than free-floating forms; goal of biofilm is the survival of the organisms and protection from immune response or antimicrobials; biofilms in tonsils can be a source of recurrent infection in PANDAS/PANS.
• Many different types of infections create biofilms; nearly all of them do.
• Relapses after stopping antimicrobials may be the result of biofilms.
• Biofilm approach: various enzymes or NAC on empty stomach, antimicrobials an hour later, binders an hour later; must reduce the free floating organisms first before attacking biofilms and releasing hidden organisms.
• Mitochondrial support is key to move through the healing cycle; there are different types of mitochondria at each phase of the CDR; can see hypotonia, regressions after illness/vaccines/anesthesia, low energy, poor endurance, clumsy, constipated, speech issues, worse in altitude (hypoxia).
• High alanine:lysine ratio can be a clue for mitochondrial dysfunction.
• Mitotoxins: many medications, nitrous oxide, vaccines, MSG, infections, metals, mold, pesticides, hypoxia, nutrition, psychological trauma, sleep deprivation, alcohol, cigarette smoke, dehydration, proprionic acid from Clostridia.
• Support mitochondria: CoQ10, L-carnitine, D-ribose, B vitamins, phospholipids; reduce mitochondrial stressors (excessive exercise, fasting/dehydration, extreme temperature, altitude, remove mitotoxins); strength training to build more mitochondria, antioxidants (eat rainbow, A, C, E, glutathione, ALA), sleep.
• Hand-writing decline is one of the more common symptoms in PANS/PANDAS.
• Mast cell activation and histamine: histamine receptors on every cell in the body; dermatographism, anxiety, worse on fermented foods, facial flushing, heat intolerance, tachydardia, eczema, hives, asthma, allergies, reflux, nausea, vomiting, diarrhea, abdominal pain, headaches, dizziness, fatigue, sleep disturbances, food reactions, sensitivity to NSAIDs.
• Has seen some high plasma histamine in MCAS; lab work not always helpful.
• MCAS treatment: reduce high histamine foods, increase foods in quercetin, normalize blood sugar.
• Zinc is a mast cell stabilizer.
• MCAS treatment: DAO, Cromolyn, luteolin, quercetin, PEA, Ketotifen, Chinese skullcap, C, zinc, LDN, CBD, homeopathic Apis or Histaminum, H1 and H2 blockers.
• Homeopathy is one of the safest form of medicines that can be used with evidence to back effectiveness.
• Study showed homeopathic histamine and apis resulted in significant inhibition of degranulation.
• In CDR2, functional medicine options shine; keep doing them. For hypercoagulation resulting from walled-off infections, may use enzymes such as Lumbrokinase, Nattokinase, and Serrapeptase; similar manner to biofilms with antimicrobials an hour later and binders an hour after antimicrobials.
• Hypercoagulation can keep the immune system stuck.
• Serum-derived bovine immunoglobulins can be a game changer in reducing LPS/endotoxemia.
• Psychological stress can trigger CDR as much as any physical stress.
• In CDR3, new cells need to be reconnected to the rest of the body via the vagus nerve; most practitioners are not paying enough attention to the vagus nerve.
• Healing is an active process; danger and threat are assumed by the brain. Healing requires optimal vagus nerve function.
• Health and healing require optimal cell to cell communication.
• Vagus nerve dysfunction symptoms associated with sympathetic overdrive; address "fight or flight" overdrive (PS, magnesium, epsom salts, theanine, meditation, diaphragmatic breathing, slow down); address adrenals (adaptogens, avoid Panax ginseng in kids due to testosterone elevation, sleep).
• To optimize HRV, cognitive behavioral therapy may be used; Dawn Huebner PhD self-help books for kids.
• Apps to help with mindfulness and meditation: Insight Timer, Stop Breathe Think Kids, Headspace, Calm, Oak, Inner Balance Heartmath HRV app.
• Gratitude is another tool for optimizing HRV.
• Loving kindness meditation: May you feel safe, may you feel happy, may you feel healthy, may you live with ease.
• Breathwork such as diaphragmatic breathing can lower cortisol, increase HRV, increase energy, decrease anxiety; belly breathing.
• Humming, singing, chanting, laughter yoga can optimize HRV.
• Acupuncture can optimize HRV; a device called Body Clock can be used to stimulate acupuncture points without needles; stimulating Shenmen and Point Zero on the ears; works similarly to vagus nerve stimulators; ear seeds are used in her practice.
• When you move back to the health cycle, it takes active effort to stay there.
• Kids may need 12 hours of sleep a night. For teenagers, 9.25 hours of sleep is ideal.
• Melatonin is neuroprotective; sleep key for clearing waste from the brain via the glymphatics.
• Sleep: turn off screens 1-2 hours before bedtime, blue light blockers, F.lux app for computer, Night Shift for iOs devices, PS, melatonin, inositol, homeopathics (coffea cruda for wired mind and body, ignatia for worries and grief).
• Fasting plasma amino acids for alanine and lysine.
• Homeopathic Gelsemium sempervirens may be helpful for anxiety that feels paralyzing; Argentum nitricum for anxiety when the brain is "going going" and you can't stop obsessing about things; Aconitum napellus for PTSD and surges of fear/panic attacks.
• PTSD is a sympathetic stuck state.
• Taiga is a pine needle extract from Australia that some of her PANS/PANDAS kids have done well with; azithromycin, Biocidin, Oil of Oregano, Monolaurin; tries to get PANS/PANDAS kids on immune modulators as soon as possible (SPM or pro-resolving mediators, LDN, CBD, chinese skullcap). It is not the microbe but the immune response that is the primary focus.
• Uses 30C for most homeopathics; works well and widely-available; particularly for emotional symptoms.  May use 9C for more physical symptoms.

David Musnick, MD spoke on "A Pathophysiology and Functional Medicine Approach to Assessing and Healing the Brain after Head Injury" and shared:

• Brain reserve is a level of structure and function below which symptoms of brain dysfunction can occur; the amount of reserve can vary depending on age, genetics, toxins, diet, education, infections, vaccines, head injuries, nutrient deficiencies, EMF exposure.
• A smaller secondary head injury can present with more of an effect than a more significant initial injury; cumulative effects.
• Concussion is a head injury from direct or indirect forces with or without losing consciousness that may lead to symptoms weeks or months after.
• Concussions may not lead to traumatic brain injury; TBI is a loss of function from injured brain regions.
• Overlap in pathophysiology between TBI and MCI.
• Symptoms of concussion: headache, brain fog, fatigue, dizziness, nausea, vomiting, seizures, depression, photophobioa, sound sensitivity, sleep issues, visual symptoms, hearing problems, anxiety, depression, irritability, PTSD.
• Each brain region has a different task; injury of that brain region has specific problems; most head injuries will impact more than one brain region.
• Head injuries are common in children, teens, athletes; can occur without hitting the head.
• Standard medical care after head injury does not improve brain reserve or function.
• Traditional methods are inadequate for concussion and TBI; must use a different approach addressing brain pathophysiology; improve brain reserve.
• No matter how far out from a brain injury, there is hope for improvement.
• Recovery takes time and investment.
• Pathophysiology: neural shearing, excitotoxicity, neuroinflammation, oxidative stress, oxygen deprivation, mitochondrial damage, blood-brain barrier permeability, brain autoimmunity, hormone dysfunction, microbiome and vagus dysfunction, protein transport abnormalities, neuron and synaptic structure decrease, neurotransmitter dysfunction, microglial priming, limbic system dysfunction
• Damage to the pituitary can lead to hormone dysfunction.
• Stages of head injury: acute (first 5 days; assess for brain bleed; rest, sleep, decrease brain congestion, increase mitochondrial function, limit excitotoxicity, improve oxygenation with HBOT), subacute (6 days - 2 months; decrease brain inflammation, oxidative stress, improve mitochondrial function, decrease EMF, support neurotransmitters and methylation, assess blood-brain barrier, assess pituitary and hormone impacts; HBOT, FSM, BDNF), and chronic (2 months or more; asses brain antibodies, hormones, cognitive status, improve brain structure and reserve, increase trophic factors, increase synaptic connections, and treat infections and toxins)
• Limit brain damage and increase brain reserves: limit neuroinflammation, excitotoxicity, free radicals, increase Nrf2, increase brain oxygenation, assess/repair blood-brain barrier, induce neural stem cells, stimulate synaptogenesis, protect the brain from further damage, incorporate brain injury diet, EMF measures, decrease brain neurotoxins, improve GI function, improve energy production, improve synaptic transmission
• Very important to avoid all activities that could lead to another head injury.
• Most TBI studies have been done in mice and rats and limited to 6 weeks after the injury.
• Excitotoxicity is the binding of the NMDA receptor and influx of calcium into a neuron or glial cell leading to cell death; triggered by neuroinflammation, LPS from bacteria, mitochondria, free calcium; worse when blood-brain barrier is permeable and worse with EMF exposure
• Stopping calcium supplements while treating a brain injury is important.
• Can block NMDA receptor with magnesium threonate and riboflavin.
• Microglia produce trophic factors; can migrate, move, and trim synaptic connections to improve function; can become "primed" by head injury and lose their processes; when active, can engulf dead cells, endotoxins, and bacteria; can increase neuroinflammation
• M1 vs. M2 microglia: M1 is inflammatory and is not protective; M2 is anti-inflammatory and produces trophic factors.
• Flavonoids can shift to M2; apigen (celery, parsley), luteolin (radicchio), anthocyanins (wild blueberries from Trader Joe's in a smoothie), CBD
• All patients make salads with radicchio, celery, parsley; with additional celery throughout the day.
• Lyme and co-infections: underlying causes need to be treated; issue if blood-brain barrier breach if infections impact the brain; infections can re-activate after a head injury; FSM can help with inflammation, infections, and mold toxins.
• Limit neuroinflammation and protect normal microglia and shift to M2 morphology.
• TBI leads to cell danger response and ongoing brain inflammation.
• Insomnia: less than 6 hours is associated with inflammation; need 8 or more hours; sleep may improve as neuroinflammation is treated; time-released melatonin can help sleep and neurogenesis taken 90 minutes before bed, not at bed.
• Neuroinflammation: work on intestinal permeability and microbiome, activate Nrf2, FSM decreases inflammatory cytokines
• Nrf2: mobilizes the brain's production of antioxidants and anti-inflammatories; aerobic exercise, DHA, organic green tea, curcumin
• Curcumin best studied for brain injury; increases Nrf2, decreases inflammation and reactive oxygen species. Longvida form is best for brain.
• Must address and heal GI and brain barrier; once blood-brain barrier is broken down, LPS, infections, toxins are allowed to enter the brain
• There are labs for blood-brain barrier antibodies; astrocytic protein S-100B and antibodies; uses Vibrant Labs Neural Zoomer and Cyrex Array 20; need to retest after 4 months from start of treatment to show healing has completed.
• Brain autoantibodies can be measured such as antibodies to dopamine receptors.
• To support blood-brain barrier permeability, R alpha lipoic, riboflavin, FSM, and EMF neuroprotection strategies.
• EMF may be even more damaging after head injury; limiting will help regain brain function; best to have an EMF technician measure the home. May advocate for a bed canopy in brain injury recovery.
• Oxidative damage: need diet high in polyphenols, C, E, alpha lipoic, elemental hydrogen (to quench peroxynitrite)
• Mitochondrial damage: leads to death of the cell and loss of neurons, damage to cells can release mitochondrial contents and increase free radicals and inflammation, brain fatigue and brain fog are the direct result of decreased mitochondrial function. Likes multiple, B vitamins, CoQ10, nicotinamide riboside, and FSM.
• Anyone attempting to improve mitochondria should be looking into FSM.
• Loss of neurons and synaptic density: need to induce neurogenesis and increase trophic factors.
• Repair: brain is neuroplastic, need to enhance trophic factors in late and chronic phases.
• Trophic factors and growth factors: BDNF is most well-known; exercise increases BDNF; need to improve mitochondria to get people ready for exercise; aerobic exercise 70-80% of max heart rate for 40 minutes.
• Resistance training is good for muscle but not for BDNF. HIIT is not as effective as heart zone training.
• Want to stimulate the migration and survival of nerve stem cells; taurine, lithium, melatonin, D, EGCG, DHA, and PC.
• Lithium has been shown to increase BDNF and NGF.
• Taurine can be in short supply in the brain, uses in all patients, neurotrophic effect, improves blood flow, activates neuronal stem cells, triggers new brain cells in the hippocampus; if you only use one supplement in those with head injury, taurine.
• Brain Region Localization Form from Kharrazian Institute can help identify impacted brain regions.
• Cognitive treatment: need multiple methods of active learning, animal matching game cards and SIMON game, Scrabble, crossword puzzles, BrainHQ.
• Vagus nerve dysfunction: can lead to GI and visceral problems, plays a role in SIBO and dysbiosis; FSM is one of the best ways to heal the vagus nerve and underlying head injury.
• Can treat with FSM in person and then support longer-term with home unit.
• FSM can support headaches, neck injuries, GI tract, vagus nerve; greatly improves outcomes in concussion and TBI; improves cell signaling, decreases inflammation, supports healing of blood-brain barrier, increases ATP.
• Cross-reactivity with brain: takes people off gluten, dairy; in some, spinach, corn, soy, and tomatoes.
• Brain injury diet: organic fruits and vegetables, gluten and dairy free, free range grass fed meat and poultry, pasture raised eggs; high in choline.
• Choline helps cell membrane repair: eggs, chicken, turkey, collard greens, Brussels sprouts, broccoli, Swiss chard, cauliflower, and asparagus are high in choline.
• Avoids browned proteins that lead to AGEs; use high flavonoid foods; ketogenic diet can be helpful in some cases.
• For brain oxygenation, HBOT can improve oxygenation and increase neurogenesis; Vinpocetine and Ginkgo can help with oxygenation.
• Uses audio visual entrainment using light and sound.
• Have hope; people do improve.
• Syapsin nasal spray seems to help with energy and brain fatigue/fog.
• Low dose naltrexone may decrease autoimmune responses.
• Has seen people with TBIs that were over 10 years old that responded to his approach.
• Peptides such as BPC-157 may be helpful in his brain injury patients.
• For NAD, Quicksilver NAD+ Gold, Alive By Nature sublingual NAD, topical NAD delivered through a patch.
• QEEG is a good functional test then followed by neurofeedback to improve hypo or hyper functioning areas.
• A vacation from treatments is a treatment; sometimes people need a break from treatment.
• The approach he outlined may be helpful in neurodegenerative conditions.
• Healing foods: radicchio, celery, parsley, pesto (broccoli sprouts, pine nuts, organic olive oil, cilantro, parsley, radicchio) 

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

• Works with Amen Clinics where they do lots of brain scans and work with patients with neuropsychiatric symptoms.
• Started looking for which brands of CBD to carry and found there were so many things that he needed to learn.
• Endocannabinoid system was discovered in the 1990s and modulates many systems.
• Marijuana is Cannabis Sativa; hemp is Cannabis Sativa; same plant.
• THC is the intoxicating component; CBD is non-intoxicating. It is not correct to say that CBD is not psychoactive as it can help with anxiety for example, and thus is psychoactive.
• There are many cannabinoids including CBC, CBG, CBN, and numerous terpenes that have different medical properties.
• CBD may have antipsychotic effects in schizophrenia; anxiolytic effects with social anxiety disorder through modification of cerebral blood flow; CBD may reduce withdrawal symptoms and cannabis/tobacco dependence.
• CBD may reduce anxiety via activity on the limbic brain.
• CBD has anxiolytic, antipsychotic, and neuroprotective properties. Has potential use in epilepsy, substance abuse, schizophrenia, social phobia, PTSD, depression, bipolar, sleep, and Parkinson's.
• Strong effects with anxiety are CBD-modulated.
• Endocannabinoid System (ECS) has CB1 and CB2 receptors; CB1: brain, lungs, vascular system, muscle, GI tract, reproductive organs, immune systems, liver, bone marrow, pancreas; CB2: spleen, bones, skin, immune system, liver, bone marrow, pancreas
• ECS modulates cognition, pain, mood, fertility, bone metabolism, immune function.
• We have cannabinoid receptors throughout the body.
• CB1 is highly expressed in the limbic system, basal ganglia, and cerebellum; affects "relax, eat, sleep, forget and protect"
• ECS is a vital component of the stress response.
• PPAR gamma activation degrades beta amyloid; CBD is a PPAR activator.
• CBD may be helpful in seizures.
• When a bottle of CBD says 1000mg, that's the entire bottle; not a serving size.
• There is THC-induced psychosis; THC-content has increased over the years; CBD reduces this effect; may be the result of mold.
• In some cases, may be smoking mycotoxins if the product is contaminated.
• CBD facilitates neurogenesis; protective against glutamate toxicity.
• CBD supports many different properties of neurodegenerative conditions; neuroinflammation protection.
• Studies have shown potential role for CBD in Alzheimer's.
• Autistic children have lower levels of endogenous cannabinoids.
• CBD compensates for low levels of neurotransmitters.
• Hemp is Cannabis Sativa with THC <= 0.3%; marijuana is Cannabis Sativa > 0.3% THC.
• Whole plant extract is somewhat misleading as the effective components are not really in the leaf or stem; it is all in the flower.
• With marijuana, Indica is more psychoactive. Sativa is more mind-dominant, anti-anxiety, anti-depressant, activating, increases alertness; Indica is more body-dominant, sedating, muscle relaxant, reduces nausea, and increases dopamine.
• Entourage Effect: the whole is greater than the sum of the parts.
• Full-spectrum products may work better than purified CBD products.
• Terpenes have therapeutic effects and are present in full-spectrum extracts.
• CBN may be most helpful for sleep.
• Leafly.com is a good resource to explain what different strains do.
• All good hemp companies should provide a COA (certificate of analysis) for every batch of product.
• CBD offers many additional benefits as compared to drugs which don't have additional benefits.
• Best to put liquid products under the tongue for 30 seconds or more to maximize absorption.
• CBD does not convert to THC.
• CBD easily passes the blood-brain barrier.
• May need to consider the impact of CBD on medications being taken.
• Better to take CBD with food (high fat, high calorie) to increase the amount that gets into the body.
• Types of products: CBD isolates (CBD only), broad-spectrum THC free (removes many cannabinoids), true full spectrum (everything in the plant; low levels of THC; full entourage effect); recommends true full spectrum.
• Critical to be organically grown; hemp is a bioaccumulator and was used to clean-up Chernobyl. Vast majority are not organic.
• Major brands often have labeling accuracy problems and do not deliver what they label; in one study, 31% were accurately labeled.
• A good product is tested for pesticides, solvents, metals, and molds.
• Hemp-oil scam on Amazon; products are often selling simple hemp oil that has no cannabinoids at all.
• 25-50mg CBD is a common dose.
• Want supercritical CO2 extraction; not solvents.
• THC is not good for the brain; highest CBD:THC ratio to achieve the effect is best.
• Adding organic lemon oil to a product may mask the "hempy" flavor or many products are available in gel caps.
• May need zero THC products in cases of military or people with security clearances or those that may be drug tested.
• Marijuana and THC may negatively affect the brain; CBD does not.
• CBD from hemp does not cause sedation and can be taken in the daytime.
• His product can be found at MDPure.net

Jill Crista, ND presented on "Breaking the Mold: Tools for Conquering Mold and Taking Back Your Health" and shared:

• Mold illness is more than spore illness; it includes mycotoxins, colonization, and other substances in water-damaged buildings such as VOCs, aldehydes, alcohols, MPA.
• Mycotoxins are made in a competitive environment. Where there is mold, there will be chemicals but not necessarily mycotoxins.
• In water-damaged buildings, mold is no longer in check; leads to biofilm (water-damage = microbial diversity + quorum behavior).
• Some fragments are very small; mycotoxins are 50 times smaller than the smallest spore.
• Can test for the following mycotoxins in urine: Aflatoxin, Chaetoglobosin, Citrinin, Enniatin B1, Gliotoxin, Ochratoxin A, Sterigmatocystin, Trichothecenes, Zearalenone; would like to see a Wallemia toxin become available.
• Mycotoxins are formed by fungal elements and fragments; stay ever suspended in the air; produced in competition like a "gas bomb"; lipophilic; can be absorbed through the skin; used in biowarfare
• Mycotoxins are immunotoxic, neurotoxic, dermatoxic, ailmentary toxic, nephrotoxic, hepatotoxic, hepatocarcinogenic, teratogenic, carcinogenic, genotoxic
• Mycotoxins inflame the sinuses and lungs.
• Mycotoxins lead to inflammation and irritation of the mucosal linings in the respiratory system, GI, and bladder
• Stachybotrys alters phospholipid synthesis related to surfactant (may make COVID worse); bile is a necessary component for lung protection via surfactant.
• Mycotoxins reduce nutrient absorption via damage to the lining of the gut.
• Mycotoxins are detoxed via CYP450, phase 2 via glutathione (all mycotoxins deplete glutathione), depletion of Nrf2 , inhibit protein synthesis, cause mitochondrial damage, cross blood-brain barrier, may cross placenta and are found in breast milk.
• Mycotoxins lead to low NK cell function, T/B cell deficiency, IgG subclass deficiency, low WBC, increase TGFb1 and impair Treg cells.
• Spore symptoms + mycotoxin symptoms = mold sickness
• If exposed to mycotoxins but not spores, may not have sinus or respiratory symptoms.
• New onset food allergies, cyclical vomiting, anxiousness, itching, chemical sensitivity (also with breast implants that can be moldy), ADH resistance, infertility in both genders, and many other symptoms may be present.
• Working through limbic system and cell danger response may be important tools after addressing the exposure.
• Crista Mold Questionnaire to assess for possibility of mold illness.
• Can be many other things to consider such as tick-borne disease, metals, MCAS, and many other differentials.
• Mold feels better with movement and better outside.
• Lyme has migratory symptoms; mold does not.
• Antibiotics are often made from molds as are statins; negative reactions may be a clue for mold.
• First tier testing: physical exam, urinary mycotoxins, stool test, sputum test, NeuroQuant (TBAR), VCS, CBC (low WBC, low T/B cell count), low NK function, low D, elevated liver enzymes/GGT, low IgG subclass 3, IgE (allergy to mold; not mycotoxins), elevated MMP9 (clue for MCAS), OAT (Great Plains markers 2, 4, 5, 6, 9).
• Urine Mycotoxin Testing: controversial; RealTime, Vibrant Wellness, Great Plains; levels correlated to symptoms; varying accuracy; unknown degree of contamination via ingestion; she has them limit moldy foods in diet prior; provokes with sauna evening before morning collection
• Peel the orange: Avoidance, Fundamentals, Protect, Repair, and Fight; Avoidance is the outer layer and must be done 100% of the time.
• Mold sick people are the most resistant to the fact the mold is a problem.
• Some people get out of the exposure and remain sick; normal people also have fungi in the sinuses; in some people, a cell danger response is triggered that says "we are not safe"; can get colonization over time.
• Want to reset the overall fungal burden; get the biome to behave as a harmonious community again.
• Avoid foods that are fungus, grow fungus, or have mycotoxin exposures.
• Kombucha generally makes mold patients sicker.
• Bitters are protective foods; support production of bile.
• Lots of bioflavonoids and good fats can be helpful.
• Mold fighting foods: garlic, onions, scallions, chives, leeks
• Mold fighting spices: clove, cumin, rosemary, sage, thyme, oregano, basil, bay leaf
• Protect and Repair: dilute toxins with clean, correct fats (PC, EFA, CoQ10), restore fat soluble nutrients, bioflavonoids and polyphenols, support detoxification of mycotoxins, restore mitochondria, rebuild immunity
• Binders: not enough alone; mycotoxins are the smoke; fungal overgrowth is the fire; put out the fire or you will always be dealing with the smoke; binders have a weak bond
• Bile is critical; acts as a detergent; involved in retina and vision changes; bile is 10 parts PC to 1 part cholesterol; glycine and taurine can be helpful
• Pre-Binders: stimulate production of bile with cholaretics and cholagogues; lipase may degrade mycotoxins
• Binders + laxative is not the right solution; bile is a laxative so best to start there
• Long-term use of binders such as CSM can lead to nutrient deficiencies.
• Botanical binders: food and fiber; kale, aloe, okra, flax, chia, rice bran, oat bran, psyllium, charcoal, bentonite, zeolite, GI Detox +, Takesumi Supreme
• Copious Clean Correct Fats: DHA, part of brain, neuroprotective, suppresses MMP9
• Quercetin as a bioflavonoid; anti-mycotoxin effects; used in animal feed to protect from mold; need a ton of bioflavonoids
• Milk thistle, artichoke, turmeric, dandelion support liver detoxification and supporting mycotoxin detoxification
• Mold inspectors should be taking quercetin, milk thistle, and DHA to protect themselves from exposure to mycotoxins; P100 does not block mycotoxins.
• Turmeric offers neuroprotection, antioxidant, and epigenetic support; increases availability of glutathione.
• Vitamin D: T-cell regulator, mycotoxins can block vitamin D receptors making people sensitive to the sun.
• Uses systemic and nasal antifungals; patients did not improve consistently until adding antifungals.
• Uses bontanical antifungals nasally and orally: garlic, thyme, pau d'arco.
• Nasal support until no evidence of ongoing mycotoxins; atomizer better than neti pots better than nasal sprays; 6 months minimum; many different options may be used including essential oils, colloidal silver; incorporate nasal biofilm breakers at various stages of treatment; propolis can be very helpful, but the source is important and often has mycotoxins; manuka honey in a neti pot can be helpful
• Many enzymes and supplements are activated by Aspergillus; may start with bromelain or papain initially; also to not overdo breaking down biofilms before patients are able to tolerate.
• Likes Gaia Swedish Bitters, Wise Woman Herbals Bitter Sweet Elixir, QuickSilver Bitters No 9 and Bitter X.
• Nothing replaces proper remediation; likes IntelliPure Air Filtration.
• Antifungal treatment may range from 6 months to indefinitely if exposures are not addressed.
• Can continue to see urinary mycotoxins even with no external source if colonization is creating a mycotoxin production factory inside the body.
• Likes Snow Lotus, Veriditas, Frontier Herbs, Aura Cacia, and Now have good essential oil products.
• Loves Biocidin LSF in a neti pot, atomizer, nasal spray or orally (except on PANS/PANDAS where it can be triggering)

Sonia Rapaport, MD spoke on "A Vigilant Fortress: Understanding and Treating the Overly Sensitive Patient" and shared:

• Vigilant: sympathetic excess, sensitive to sensory input
• Fortress: protected against attack; immune activation, hormonal response
• Consider the barrier between the inside and outside of the body; outside may include tick-borne disease, parasites, traumas/TBIs, mold, oral microbiome, Morgellons; inside may include obstacles to cure, CBD/cannabinoids, mitochondria, genetics/epigenetics, peptides/stem cells, hypercoagulability, transformation, cell danger response
• Barriers are gut, brain, skin, respiratory tract, genito-urinary tract, and psychospiritual barrier.
• Barriers are disrupted when things come into the body that the body perceives as being under siege; living organisms, toxins, trauma.
• Have to stabilize and repair the body, repair the barriers, and remove the external triggers for illness.
• Backstory: childhood, social systems, introvert/extrovert, ethnic background, education, diet, exposures, genetics, trauma, infections, medication history, patterns of response; affects present illness and defines shape of the response
• When were you last well?
• What exposures, traumas, illnesses have they had and how resilient have they been?
• Internal: hypermobility, dysautonomia, mitochondria, mast cell; external: infections, ACEs, TBIs, environmental exposures, toxicants
• Adverse Childhood Events (ACEs) are one of the best predictors for chronic illness, early mortality; traumas that occur in childhood that disrupt neuro-development; protection from ACEs are nurturing, employed, and educated parents, supportive family environment, social networks, basic needs met, adequate housing, and access to healthcare.
• Dysautonomia is when the ANS does not work well; important in determining how quickly one might recover or where to focus treatment.
• 75% of symptoms of mitochondrial dysfunction or a form of dysautonomia; toxins from mycotoxins, endotoxins, and toxins from organisms can lead to mitochondrial dysfunction.
• Symptoms of MCAS overlap with Lyme or mold. Impacts skin, GI tract, urinary tract (interstitial cystitis), respiratory tract, brain, histamine reactions; mast cells are found at our barriers.
• Hypermobility patients find that novocaine at the dentist may not last as long. Dental problems, nerve compression, dislocations, hyperextensible joints, scars, stretchy skin, scoliosis, hypotonia, Chiari malformation; associated with dysautonomia, POTS, MCAS.
• Beighton Score may be used to evaluate for hypermobility.
• Consider environmental exposures such as items on "The Red List" (https://living-future.org/declare/declare-about/red-list) and forever chemicals such as PFAS in drinking water.
• Extreme weather events: climate changes leading to precipitation and water-damaged buildings.
• Explore epigenetics and dirty genes.
• Toxicant-induced loss of tolerance means that a major exposure or series of smaller exposures turns off a person's tolerance for the substance; BREESI and QEESI questionnaires can be helpful.
• Traumatic brain injuries are important to understand in a patient's backstory; risk of post-concussion syndrome which can lead to numerous symptoms and impair the nervous system and immune system.
• Understanding the patient's personality can help identify what tools may best help in their recovery. Introverts tend to have more heightened nervous systems and more likely to have dysautonomia, mitochondrial dysfunction, and hypermobility.
• Explore the patient's spirit; calm fear. Emotions such as fear, anger, regret can impact healing.
• Important to find peace within ourselves; determination is important.
• The protective fortress is often very strong in patients.
• Treatment: ACEs, spirit, stabilize the milieu, repair boundaries, remove pathogens and triggers.
• Stabilizing the internal milieu includes a focus on immunity, nervous system, and endocrine system; improve detox pathways by supporting metabolism and drainage; optimize epigenetics.
• Repair boundaries: tight junction repair, awareness of psychospiritual.
• Remove pathogens and triggers: sweep out toxins, kill organisms and support detox, repair boundaries.
• Want to move forward from the backstory; cannot get well when stuck in their story.
• Laughter is a powerful tool.
• Joy is an inner feeling of ease; happiness originates more externally and is more situational; choose joy.
• Empaths are highly sensitive, spiritually open, attune to other's emotions, introverted; impacted by external triggers; can also be a super-power.
• The tighter the memory controls you, the worse your outcome will be; you cannot move forward to better health.
• The goal is to support patients in moving towards change and transformation.
• Fear is involved in the feeling of "safe" or "unsafe". Sympathetic nervous system is turned on when we feel unsafe.
• Accessing the Healing Power of the Vagus Nerve book talks about Polyvagal Theory and provides exercises that can be very helpful.
• "The Science of Well-Being" is a free course designed to increase happiness; https://www.coursera.org/learn/the-science-of-well-being
• Tapping can be helpful to calm fear responses.
• DNRS is a tool she loves; tremendously helpful for those that can do it. DNRS opens the door to do other things.
• If no gag reflex, will have people start with gargling to support vagus nerve.
• Craniocervical Instability (CCI) is a significant problem for some people; can correlate with EDS.
• Calming down a body that is in a super protective or highly vigilant mode is a key part of treatment.
• You cannot be grateful and hold on to resentment at the same time.

Dale Bredesen, MD spoke on "Reversal of Cognitive Decline in Alzheimer’s, Mild-Cognitive Impairment, and Subjective Cognitive Impairment" and shared:

• COVID is different than Alzheimer's; essentially a hundred years behind where viral understanding is; there is not a specific target in Alzheimer's like there is in COVID.
• Getting rid of amyloid does not resolve the disease.
• Neurodegeneration is the area of biggest biomedical therapeutic failure.
• Their focus is on understanding what these disease are; creating a model to explain the factors involved in the condition.
• Alzheimer's is on the rise.
• Conventional medicine suggests that nothing will prevent, reverse, or delay Alzheimer's.
• He was not trained in integrative and functional medicine; fits very well with an integrative medicine model and not at all well with the model he was taught in medical school.
• Many with Alzheimer's have a mycotoxin contribution; he has been shocked to see how many with cognitive decline have mycotoxins as a significant part of their condition.
• Alzheimer's is killing all of us; 15% will die from Alzheimer's; 2:1 women:men.
• Should be a rare disease if we can understand it well enough.
• People delay medical care given that there is very little that most believe can be done to improve the condition.
• Over 30 different genes impact Alzheimer's risk.
• Need to explore genetics, inflammation, homocysteine, insulin, hormones, toxicity, immune status, GI health, microbiome, blood-brain barrier, MRI volumetrics, and much more.
• Insulin resistance is a big risk factor for Alzheimer's; Type 2 diabetes makes one 2-5 times more likely to develop Alzheimer's.
• Conventional medicine uses mono-therapies without understanding the causes.
• 244 clinical trials for Alzheimer's in 1 decade; 243 failed and the 1 success (Namenda) has very minimal clinical impact.
• We need a paradigm shift.
• Current standard: 1 cause (unknown), 1 disease, 1 Rx monotherapy (ineffective)
• Research shows: 36 contributors, 6 subtypes, and many potential, personalized programs.
• Chronic illnesses are a signaling imbalance (osteoporosis: osteoblastic vs. osteoclastic; cancer: cytoblastic vs. cytoclastic; Alzheimer's: synaptoblastic vs. synaptoclastic)
• Master switch in Alzheimer's is APP; amyloid precursor protein; functions as a molecular switch; can be Anti-Alzheimer's under ideal conditions or Pro-Alzheimer's under less than ideal conditions.
• Amyloid is an anti-microbial barrier.
• They have looked at propolis as an anti-microbial peptide; good as a barrier. Amyloid is similar; a protective response to brain invasion by organisms or toxins; synaptoclastic.
• Want to determine why each person is on the wrong side of balance and work to enhance synaptoblastic and reduce synaptoclastic activity.
• Detoxifying too quickly can make patients worse.
• 95% of human Alzheimer's disease is not a simple genetic mutation; risk factors are not your future.
• With his protocol, cognition can improve; hippocampal volume increases have been observed.
• ApoE4 is most common risk factor (75 million Americans single copy, 7 million homozygous); ApoE carries around fats/lipids in the body; ApoE4 was earliest; later ApoE3 emerged.
• ApoE4 is pro-inflammatory but served early man well; is now a liability; ApoE2 showed up most recently.
• 99% of our genome is the same as a chimp.
• ApoE interacts with the nucleus of our cells and changes the programming of the cell. It is your butcher carrying around fats, and also your senator making the laws of the land.
• The perfect Alzheimer's drug would have to do dozens of things; an integrative medicine approach is needed to address the 36 holes in the roof.
• Subtypes: can have more than one; dozens of potential contributors; 10-25 different factors common.
• The goal is to get on prevention or early reversal as there is near uniform success.
• Subjective cognitive impairment is when you know something is wrong but the tests look fine.
• Mild cognitive impairment is when tests become abnormal; often a decade after SCI; 5-10% convert to Alzheimer's annually.
• Type 1 Inflammatory/Hot (increased hsCRP, look for causes of inflammation); Type 2 Atrophic/Cold (need hormonal, nutrient, and trophic factor support); Type 1.5 Glycotoxic/Sweet (combination of 1 and 2); Type 3 Toxic/Vile (a different problem, 15-20% but a contributor in over 50%, hidden epidemic, late 40s-mid 50s, often ApoE4 negative, toxins, CIRS, surgical implants, high C4a/TGFb1, urinary mycotoxins, MARCoNS, abnormal VCS); Type 4 Vascular/Pale; Type 5 Traumatic/Dazed.
• With Type 3 (most difficult to treat), identify toxins and pathogens, Ketoflex 12/3 diet, exercise, improve sleep, IV glutathione often helpful, treat MARCoNS, incorporate VIP, chlorella, remove exposures, sauna, coffee enemas, lemon water, lymph drainage massage, herbal teas, zeolite, whole coffee fruit extract for BDNF.
• Working with several doctors now doing a trial using personalized, precision medicine with 30 patients to be published in 2021.
• Nocturnal oxygen desaturation important.
• Continuous glucose monitoring has been helpful.
• Consider the role of oral pathogens and oral microbiome.
• Stimulation with light, magnetism, ultrasound appear helpful.
• Often chronic activation of the innate immune system and poor adaptive response; support balanced immune response.
• Alzheimer's should be a rare disease; currently 3rd leading cause of death in the US.
• The earlier treatment is initiated, the earlier it is to turn things around.
• Neurodegenerative diseases indicate a big requirement and limited support for a neural subsystem.
• MARCoNS may not be critical to address but may be a surrogate marker for biofilms.
• Amyloid binds metals and may be an anti-biofilm substance.
• Propolis is a cognition supporter and may lead to reduced rates of dementia.
• Children with autism are on the wrong side of the APP balance, have a bigger brain, more BDNF, less amyloid; opposite symptoms from ADHD; hypersensitive to stimuli; can be a response to various toxins.
• EMFs are currently difficult to test for the impact on the person in terms of contribution to Alzheimer's; very likely that long-term, high exposure will be a contributor.  Avoidance is wise.
• EWOT increases oxygenation; seems to be helpful with vascular disease, ocular disease, traumatic illness; poor oxygenation or rapid declines in glucose at night may be contributors to Alzheimer's.
• Alzheimer's in the neurosyphilis of the 21st century, but it is not one agent.

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.