FREmedica

The Forum for Integrative Medicine: Navigating Recovery in Complex Chronic Illness

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I had the opportunity to attend and moderate the 6th annual event from The Forum for Integrative Medicine "Navigating Recovery in
Complex Chronic Illness" held online on March 5-7, 2021.  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.  

Ann Corson, MD presented on "Evaluation and Management of Complex Patients" and shared:

  • Approach to chronic patients to restore vitality
    • Reduce inflammation
    • Restore GI and respiratory mucosal integrity
    • Remove toxins
    • Address hypercoagulation
    • Address dominant pathogens
    • Support mitochondrial/detoxification function
    • Support genetic/epigenetic weaknesses
    • Support neuro-immune, neuro-endocrine, and neuro-hormone system functioning
  • Manage: toxins, infections, allergies, GI dysfunction, hypercoagulation, endocrine issues, methylation and liver issues, nutrition, structural, energetic, emotional, outside influences, spiritual practice 
  • Would not have the same success without cranial osteopaths supporting her patients
  • Mold grows at a greater rate in places with high EMR/EMF
  • Evaluates patients with history of risk factors for toxins and infections and complete medical history.  Travel history and community exposures.  Explores all of the places they have lived for mold exposure; lifetime mold exposure is key. 
  • Reviews physical and emotional trauma history, surgical history, dental history  
  • Considers social history including nutrition, smoking/alcohol/drugs, mold/EMF exposures, pets, family history and dynamics
  • Review of systems: fever, night sweats, flushes, colds hands/feet, cognitive function, headaches, balance, dysesthesias, sensory hypersensitivity, HEENT, shortness of breath, palpitations, abdomen, urinary, menses, genital, skin, joints, muscles. morning foot pain, morning stiffness, energy, sleep, psychiatric, neurological, exercise, detailed physical exam
  • Hypercoagulable people may have dysesthesias, restless legs, and burning in hands and feet
  • Bartonella can have burning in feet and lower legs that is worse at night
  • Children with issues with food textures are often Bartonella children
  • Exposure to trichothecenes can lead to significant hair loss
  • Joint cracking is a poor man's test for systemic inflammation; resolves with treatment
  • Racing palpitations when lying down at night is almost always biotoxin/mold related
  • Peeing multiple times a night is often related to mold exposure and mycotoxin burden
  • Treating hypercoagulation often leads to more regular menses without clots; clots are often related to hypercoagulation
  • Morning foot pain with the first few steps is often Bartonella
  • Morning stiffness can be inflammation and hypercoagulability
  • Looking at Chinese clock for times waking often correlates to stress in the associated organ system
  • Many psychiatric symptoms improve with treatment of infections and toxins
  • Many seizure-like and movement like disorders 
  • Every patient with POTS she has seen is a mold patient
  • When you remove stethoscope, a white ring is left; see how long it takes to refill; a red flare after refill may be a clue for MCAS
  • Subcutaneous nodules can be felt in people with Bartonella
  • A lot of acne can be related to Bartonella
  • Consider a 60X hand-held microscope to look at skin lesions for potential of Morgellons fibers
  • Look carefully at the cranial nerves as part of neurological exam
  • OCD behavior in children can be associated to Bartonella
  • Has seen autism spectrum disorder patients where Borrelia, Bartonella, and mold were playing a role and the ASD diagnosis was lost
  • Infection labs: IGeneX, Fry Labs, MDL, LabCorp, Galaxy
  • Medical workup may include: CBC, CMP, urinalysis, hypercoagulation, biotoxin illness panel, autoimmunity, hormonal, methylation genetics, urine and stool, urine mycotoxins, heavy metals (later in treatment), food allergy, nutrient testing, KPU, urinary amino acids, toxic, and essential elements
  • Often uses RealTime urine mycotoxin testing and EMMA environmental testing
  • With a leaky gut, people will become sensitive to the things they are eating most; need to address leaky gut before addressing food allergies
  • If you are looking at the river from the delta and looking upstream at the debris coming down and trying to clean it up at the delta, you need to get out of the river and go to the headwaters, clean the headwaters, and the river will clean itself; get to the root cause and let the body fix things itself
  • Secretory IgA is often high in those exposed to mold
  • Mycotoxins damage the gut all the way down
  • May see that there is Lactobacillus and even high levels, but they don't grow out in culture; may be impacted by manganese deficiency resulting from glyphosate exposure; may supplement with manganese when seeing no growth of Lactobacillus in culture
  • Autoimmune work up: anticardiolipin, antigliadin, thyroid auto-antibodies, antinuclear antibody, rheumatoid factor, cyclic citrullinated peptide, myelin basic protein auto-antibodies
  • Biotoxin illness work up: HLA, TGFb1, MMP-9, C3a, C4a, urinary mycotoxins, VEGF, ADH, VIP, MSH, Leptin
  • Those will susceptible HLA alleles may have more burden of toxins to remove from the body as part of treatment
  • Urine mycotoxin testing can show higher results as the body starts to mobilize and excrete toxins; the spike should go down over time
  • Trichothecenes can ease back up and not be related to ongoing exposure; more deeply rooted and harder to get out of the system
  • Beyond Balance TOX-EAST PST can be very helpful for deeper toxins
  • Mast cell activation: looks at physical exam, how people react to things, chemical sensitivity; most of the time, labs are not useful as the MCAS calms down as treating the underlying issues; was always treating this before it was called MCAS
  • People can have activation of the mast cells during Herxheimer reactions
  • Hormones: adrenal/thyroid function and sex hormones if indicated
  • Refers out for: mold inspection and remediation, cranial osteopathy, acupuncture, biological dentistry, ALF orthodontics, lymphatic drainage, neurological chiropractic, physical therapy, psychological counseling, or psychiatric treatment
  • Likes environmental sampling with EMMA and comparing to urine mycotoxins; both from RealTime
  • Treatment
    • Drainage and regulation to clean organs and the extracellular matrix
    • Enzymes of all kinds: fibrinolytic, proteolytic, biofilm busing agents
    • Allopathic antibiotics (less) and antiparasitics (more)
    • Herbal antimicrobials
    • Binders: doing patients a disservice if not using binders; uses combinations and rotations; charcoal, bentonite clay, chitosans, humic/fulvic acids, chlorella, CSM (rarely)
    • Nutraceuticals:  people often depleted in trace minerals and essential fats; phospholipids, mitochondrial support, multivitamins, and methylation support
    • Reduce systemic inflammation
    • Replete and optimize nutrition
    • Provoke toxic foci, remove, repair, revitalize 
    • Meridian and energy medicine: acupuncture, acupressure; some practitioners use electrodermal screening or biofeedback devices
    • Dietary: non-GMO, no glyphosate, paleo, allergen avoidance
    • Lifestyle: clean air and water, avoid disease vectors, avoid mold and toxic chemicals, avoid EMF, graded exercise
  • Gut Dysbiosis and Repair
    • Remove: GMO, glyphosate, additives, chemicals, plastics, mold toxins, metal toxins, provoking foods that upregulated the GALT, dysbiotic and invasive pathogens 
    • Repair: gut mucosal lining with butyrate, aloe, IonBiome, herbs, glutamine; treat hypercoagulability with fibrinolytics; downregulate GALT with immuno-metabolics, pre/probiotics; address invasive pathogens with antimicrobials (likes Supreme Nutrition Uva Ursi Supreme); digestive function with HCL, bile, and enzymes; elimination support for effective peristalsis 
    • Digestive enzymes have been damaged by glyphosate over the years; enzymes of pancreas have a lot of glycine and glyphosate may be substituted for glycine
    • Restore: normalize microbiome with pre/probiotics, fibers; restore redox potential with IonBiome; gastric acid production, pancreatic exocrine function to make enzymes; gallbladder function; peristalsis and elimination
    • Revitalize: GALT with immunomodulation, spagyric homeopathics; nutrient absorption; liver function including detoxification, methylation, metabolism, and hormone regulation
  • Herxheimer Reaction Support
    • Result from inflammatory cytokines, increased soluble fibrin, and toxin release
    • Buffer the "download" with: enzymes including fibrinolytic and proteolytic; drainage support for organs, lymphatics, and extracellular matrix; binders for bile acid chelation; nutraceuticals to optimize methylation, essential fats and phospholipids, trace minerals, and multivitamins; alkalization
    • Don't forget that if you have inflammation, you have increased soluble fibrin production
    • Enzymes, enzymes, enzymes
    • Herxheimers can result in skin rashes
    • Use care when treating Bartonella as Herxheimers can result in psychiatric issues such as cutting or suicide attempts
  •  Commonly Overlooked Issues
    • Biotoxin illness and mold exposure
    • Hypercoagulability: excess soluble fibrin; EMF creates hypercoagulation
    • Glyphosate poisoning and dietary compliance
    • Unrecognized infections such as Protomyxzoa and Funneliformis biofilms; dental infections including cavitations and root canals
    • Heavy metal toxicity / vaccine injury (common in children born after 1989 and in elderly with yearly flu shots)
    • Mast cell activation 
    • Structural issues
    • Genetic methylation faults
  • Biotoxin Illness Treatment
    • Remove from exposure; people will not get better if they are in mold
    • Reduce inflammatory cytokines
    • Remove toxins using binders and sweating
    • Nutritional support with glutathione and nutraceuticals
  • For reducing inflammatory cytokines and acute flare and some chronic, likes FlexNow shea nut product; also uses Researched Nutritionals CytoQuel and Curcurmin Pure and Xymogen Nrf2 Activator; in some cases, uses Nrf2 Boost when Nrf2 Activator is not available
  •  Remove the patient from ongoing mold exposure; not doing so doesn't work
  • Hypercoagulation Treatment
    • Fibrinolytic enzymes like Allergy Research Nattokinase softgels; Boluoke; other lumbrokinase products do not seem to work clinically
    • Proteolytic enzymes 
    • Other enzymes like Serrapeptase or Marcozymes
    • Heparin
    • Homeopathic immune modulators
    • Herbs like Dan Shen Supreme
    • Exposure to metals, mold, and environmental toxins can flare hypercoagulation; as can aggressive treatment that mobilizes these within the body
    • Herxheimer reactions from increased cytokines and soluble fibrin production almost always require an increase in enzymes
    • Dissolving fibrin can release toxins and infections and requires care; "anti-hypercoagulation hell"
  • Protection from Glyphosate
    • Eat 100% organic (found in smaller amounts in organic food)
    • Eat sauerkraut and apple cider vinegar; have bacteria Acetobacter that can metabolize glyphosate
    • Avoid supplements in gelatin capsules unless from grass-fed animals; collagen is often high in glyphosate; gummy vitamins
    • Avoid drugs derived from animal products; digestive enzymes can be an issue if derived from factory-farmed animals
    • Avoid vaccines that are high in glyphosate
    • Sunlight to make cholesterol sulfate
    • Eat high sulfur foods including crucifers, ginger, garlic, coriander, turmeric; MSM, Epsom salt baths
    • If sensitive to sulfur, fix the gut, then supplement
    • Trace minerals; use sea salt
    • Chelation with charcoal, humic/fulvic acids, herbs
    • HBOT (can help though she does not use)
    • Grounding to remove EMR
  • Heavy Metal Toxin Treatments
    • Remove and reduce exposure; amalgams, vaccines, diet
    • Chelation: traditional agents, nutritional support for metal detoxification, correct methylation, binders for elimination in stool; kidney and liver support such as Nestmann Solidago or glutathione; lymphatic drainage with Lymph Star Pro (particularly for aluminum)
    • Low back pain when moving metals is a clue for kidney stress
  • Mast Cell Activation Syndrome Treatment
    • H1 (Loratadine, Ketotifen) and H2 (Famotidine) blockers
    • Mast cell stabilizers (Cromolyn)
    • Leukotriene inhibitors (Montelukast)
    • Herbs: Beyond Balance MAST-EASE, Researched Nutritionals HistaQuel, NeuroProtek LP
    • Nutrients: DAO, bromelain, C
    • Low histamine diet; a last resort as strict diets can also be problematic and often need to fix the mold/underlying cause to resolve the MCAS 
  •  Patient Responsibilities
    • Have to get out of mold
    • Follow treatment protocols
    • Comply with dietary recommendations (paleo, non-GMO, no processed food, no high fructose corn syrup, limit to fresh fruit, avoid gluten and most grains, often need to avoid dairy)
    • Graded exercise when tolerated
    • Avoid blood-sucking insects
    • Avoid toxins in food, home, work, school, car; consider personal care and cleaning products
    • No smoking or drinking
    • See referral professionals: cranial osteopaths, therapists, biological dentists, acupuncturists
  • From Q&A discussion
    • If you walk into an acute mold exposure, FlexNow can immediately calm it and also help with long-term inflammation; helps to block initial rise from mold exposure
    • Nrf2 Activator is helpful for the second rise; CytoQuel also helpful for inflammatory cytokines; Curcumin Pure can be helpful for those that don't tolerate green tea in Nrf2 Activator; may use 2 or 3 of these
    • MAST-EASE or HistaQuel can be helpful as well for dealing with mast cells
    • Removing the patient from mold exposure and addressing mycotoxins will often reduce/resolve hypercoagulation
    • 1 in 4 are genetically prone to problems with mold; 1 in 5 are genetically prone to hypercoagulation
    • Some will need to be on a low level of enzymes for life; others will need enzymes with physical, toxic, or emotional stress
    • Hair loss in mold illness is the result of trichothecenes killing hair follicles
    • Has found C3a and C4a testing with LabCorp has been clinically helpful; has not used National Jewish
    • Aloe leaf extract is often used for GI support; not leaf/pulp; often mixes the aloe leaf extract 50/50 with warm water
    • In constipation, need to get the gut moving, make sure they are drinking enough water, need a good fiber such as organic acacia fiber, do stool test for pathogens, aloe can help constipation, avoid mold exposure, use binders that are less aggressive like chlorella after meals or a pinch of TOX-EASE BIND or GI Detox at night
    • Nepro-Rella from Marco Pharma is a good source of chlorella; generally tolerated by sensitive patients
    • Does not find the need to avoid digestive enzymes derived from Aspergillus in those with mold issues; they are isolated; check with company to see if they test for mycotoxins in the product
    • CranialAcademy.org is a resource for finding cranial osteopaths; look for those that do 100% osteopathic work and years of experience
    • For collagen, look for brands that use 100% grass-fed animals; some companies now test for glyphosate; get from areas of the world that are less contaminated with glyphosate
    • Want the body to make clean/fresh bile; bile salts are expensive to make; give the body the tools it needs to make bile such as cholagogue herbs, PS, taurine (or good protein in diet), trace minerals; increase turnover of old bile
    • Multiple binders can be taken together; uses chlorella at end of or after meals and other binders at night; often combines two different products at same time
    • Allergy Research Group MicroChitosan is one of the best tools for removing trichothecenes; has not found CSM to be helpful often since she started treating mold in 2004
    • For an acute tick bite, uses Beyond Balance BB-2, enzymes, Vital Guard Supreme, Doxycycline, or Cephalosporin; or combinations.  NutraMedix Cumanda can be helpful and may be used topically as well
    • Order of treatment is to prioritize getting out of mold; if you cannot get out of mold, you cannot control inflammation, MCAS, fix the gut, or get rid of infections; mold, mold, mold, mold, mold
    • If there is no option for a cleaner space, put on long-term anti-inflammatories, fibrinolytic enzymes, and a binder, support digestion with aloe/butyrate/IonBiome; you can make them feel better, but not help them; "a Band-aid on a huge gaping wound"
    • Likes the urinary mycotoxin testing from RealTime Labs; likes their EMMA test as well which correlates with the urine test; EMMA looks for both molds and mycotoxins; does not commonly do mold antibody testing unless mold is in the gut; mold in the body will be primarily in the sinuses; if someone has fungi growing in the gut, they will generally be very sick; looks at stool, urine, and sinuses
    • May need to use Lovenox in 1 out of 100 patients; not common
    • Fibrinolytic enzymes only degrade soluble fibrin; Nattokinase has mild activity against clotting factors; primarily degrades soluble fibrin; proteolytic enzymes degrade proteinaceous debris
    • Nattokinase primarily works intravascularly and is helpful for endothelial lining inflammation such as in Bartonella; Boluoke works intra and extravascularly; often helpful when people have congested extracellular matrix; stronger than Nattokinase; Boluoke is used for MI and stroke in Asia; early on with tissue congestion, might start with low dose Boluoke; when more inflamed without tissue swelling, may start with Natto; starting with low dose Natto in children and sensitive patients is often helpful; can be used together when people are especially inflamed from mold or heavy metals or patients that are more ill
    • Low pancreatic elastase could be related to glyphosate; pancreatic enzymes are impacted by glyphosate
    • Bruxism is often mold, parasites, or Bartonella
    • High rheumatoid factor is often mold, heavy metals, or infections like Lyme
    • Does not use a lot of imaging studies; in encephalopathy, VCS testing can be a helpful indicator
    • Depersonalization/derealization can be related to Bartonella and to mold
    • In those that cannot move, also consider air filtration, propolis diffusers, Thieves oil, cleaning well, ventilating well
    • Morning foot pain in the soles of the feet for the first few steps can be related to Bartonella; helpful tools include Beyond Balance BAR-2, Houttuynia (NutraMedix or Supreme Nutrition), Dan Shen Supreme, Bactrim, Doxycycline, macrolides; often needs the kitchen-sink.  Researched Nutritionals Crypto Plus, BioPure Cistus tincture, Smilax Supreme have been helpful
  • AmenClinics.com

Frank Shallenberger, MD spoke on "Ozone Therapy for Viral Infections" and shared:

  • Ozone is a super remarkable treatment as it applies to every single complex illness you ever deal with
  • No matter what your specialty is or approach to illness is, ozone added to what you do will lead to better results across the board
  • The impact of ozone as an oxidation therapy is universal for every problem we face
  • Antivirals are not an effective treatment for viral infections
  • Viruses are not alive and thus cannot be killed; they invade our cells and replicate using our RNA
  • Viruses have to use our cells to replicate and reproduce
  • Viruses can be destroyed on contact (dissolves the capsule), but approaches need to also address infected cells; which is the real problem
  • The only way to eradicate a virus is to get Th1/CD4/CD8 cells to kill cells that are infected in order to control the replication; if you cannot kill the cells, you cannot eradicate the virus
  • Interest should be in what kills the cells the produce the viruses; not killing the viruses
  • Antivirals and antibodies cannot kill the infected cells
  • Anything that upregulates Th1 is an effective antiviral therapy
  • Viral infections are easy to treat, but you cannot approach it that you are killing a virus; need to approach that you are killing the cells that make the virus
  • If the country next to you is launching missiles at you, you have anti-missile defenses to destroy each missile; this sounds good until you realize that you cannot keep up with the production of missiles; you have to go after the factories that are making the missiles; analogous to viruses
  • Adaptive shifting: body needs to maintain homeostasis; body has many systems to bring back to balance; these systems have backup systems
  • Three Layers of Immune System's Response to Antigen
    • Non-Specific Cellular Mediated Immunity (innate): NK Cells, cytotoxic cells, IFN-y, IL-2; many things interfere with this layer of defense such as stress, toxicity, poor sleep; Th1 system
    • Specific Cellular Mediated Immunity: body has seen the antigen before and has memory of it; Th1 system
    • Humoral System (Antibodies): if body has not seen it before; makes antibodies and immune complexes; holds things in check until the dominant Th1 system comes back online; Th2 system
    • What if the Th1 system never comes back online?  You are stuck with antibodies for a long time; many years or for life; antibodies can't fully deal with viruses
    • Anti-missile system is antibodies/Th2 system; addressing the missile factories is the Th1 system
    • When antibodies attach onto a virus, they secrete hydrogen peroxide and ozone to neutralize the virus; macrophages then destroy the virus
    • When the humoral system works, it creates symptoms; fever, myalgia, arthralgia, headaches, fatigue; not the virus that creates the symptoms, but the inflammatory cascade
    • If getting exposed to virus and Th1 is operating efficiently, there is no need to use the backup/antibody system and no symptoms will be expressed
  • Viral infections cannot be contained or controlled by killing virus; you must kill the factories that are making the virus
  • Antigen presenting cell presents to Th1/CD helper cell that produces IFN-y and IL-2; IFN-y activates NK cells and inhibits cancer cell replication; IL-2 activates CD8 cytotoxic cells that kill other cells; CD8 and NK have the ability to kill the cells that are making the virus/the factories; you cannot wipe out a viral infection without these
  • On the other side, Th2/CD4 cells secrete IL-4 and IL-10; IL-4 activates beta cells to create antibodies; secrete hydrogen peroxide/ozone to kill virus, but not the factories; you better have Th1 working or you will not get over the viral infection and be well; you will be sick for decades with flu-like symptoms constantly 
  • There is a negative feedback loop; when Th1 is operative, IFN-y and IL-2 are produced, but also are a negative feedback on the Th2 system; Th1 is the dominant system that will take care of everything including the factories and no antibodies are needed; antibodies make the patient feel sick; don't adapt to falling back on Th2
  • He used to check antibody levels on everyone in the 80s; used to think the viruses were the problem, but later realized the immune system was the problem
  • When you look for antibodies in sick people, you will find them all in sick patients
  • Not having antibodies doesn't mean you are not infected with viruses; we are all infected, but when you have a dominant Th1 system, you don't make antibodies; if dominant Th2 system, you make tons of antibodies
  • Antibodies are an indication of Th2 dominance which will not lead to resolution
  • Th2 dominance exert IL-4 and IL-10 which are a negative feedback for Th1; the antibodies make it harder to get back to Th1 dominance
  • Adaptive shift from healthy Th1 balance to unhealthy Th2 balance is what makes people sick
  • In 80s, he looked at men with AIDS to analyze Th1/Th2 and Th2 was dominant in 100% of AIDS patients; have antibodies to everything and are chronically sick; age-matched men without AIDS showed Th1/Th2 imbalance in 40%; 60% had a healthy Th1 balance; the 40% were at higher risk for the development of AIDS
  • 30-40% of the population has a dominant Th2 system and may never get over a virus; you cannot get over a virus with a Th2 system; you can survive it, but not kill the factories
  • Those with Th2 dominance are the chronically ill; Borrelia, mold, Candida, viruses, food allergies, and more; the ultimate, bottom line cause is the Th1->Th2 shift; can only live with but not control infection
  • Healthy balance is a dominant Th1/cellular immune system over Th2/humoral immunity; often feel like their problems started with a virus and that they are always sick
  • A large inoculum (dirty needs, transfusions with infections) can shift from Th1 to Th2; virulent virus, environmental antigens, and toxins like petrochemicals, pesticides, glyphosate, mercury, lead, arsenic; will all shift to Th2 dominance
  • Parasites create a shift towards Th2
  • Over-zealous hygiene, antibiotic overuse; cripple Th1
  • Vaccines by definition are substances that shift to Th2 balance; every good vaccine creates antibodies
  • Antibodies can kill free-floating viruses, but not the factories; if you can't kill the factories, you will never get over a viral infection
  • Antibodies produce ozone and hydrogen peroxide from singlet molecular oxygen and water
  • Ozone therapy upregulates cellular-mediated immunity by stimulating IFN-y and IL-2; ozone can shift back to Th1 from Th2
  • Ozone is gone in seconds when injected into the body; it forms peroxides instantaneously; peroxides mediate the effects of ozone
  • Peroxides are called ozonides; short-chained, mostly in cell membranes; can easily penetrate into cells and into mitochondria
  • Ozone disappears in seconds, but ozonides are stable and can last up to 1-2 weeks
  • When ozonides penetrate mononuclear blood cells, they stimulate the production of IFN-y and IL-2 to stimulate upregulation of Th1
  • Ozone is virtually a slam dunk for any viral condition you will encounter
  • Ozone potentiates all other therapies; herbs, acupuncture, etc.; keep doing what you are doing; add ozone and you have a more effective treatment
  • In 1994, Bocci exposed Peripheral Blood Mononuclear Cell to ozonides and then exposed to Th cells to measure expression of MX protein which is a marker for IFN-y; used MAH and found that MX protein expression went up 4-5 times and dramatically increased IFN-y production; twice a week is enough to keep IFN-y up all week
  • It is better to stimulate the body's production of cytokines with ozone than to deliver isolated cytokines
  • Ascorbic acid neutralizes ozone; should not use at the same time or before ozone as it will neutralize ozone; glutathione has a mild impact but does not neutralize and is considered OK 
  • Glutathione interrupts the production of TNF-a and reduces inflammation
  • Adding Vitamin C eliminates the IFN-y induction by ozone (not good); adding glutathione before ozone suppresses TNF-a but not IFN-y
  • Th cells can only produce cytokines to the extent they have calcium; adding calcium increases the cytokine production; he adds calcium to blood before ozone to maximize cytokine output
  • Heparin is better as an anti-coagulant than CPD which chelates calcium and decreases IFN-y production
  • Did mitogen studies on AIDS patients; tells if you are Th1 or Th2; confirmed AIDS patients were all Th2 dominant an had a very good response to ozone therapy; shifting back to desired Th1 response
  • Is more better?  Found that huge doses of ozone did not work any better than smaller doses; more is not better; cytokines have a "homing" effect; when the WBC are re-introduced after ozone, they often go to spleen, bone marrow, and lymph nodes
  • Ozone is less an antiviral treatment than it is an immune modulation treatment
  • Ozone works with anti-inflammatory therapies to reverse Th1 -> Th2 dominance and control viral infections
  • Steroids suppress the inflammatory cytokines that are produced by Th2; as much as steroids can be abused at high dose, healthy, normal, natural physiological dosages are powerful suppressors of Th2 activity and allowing Th1 to resume dominance; hydrocortisone, curcumin, boswellia, aspirin can help to shift back to Th1
  • Methods of administration of ozone for viruses: MAH, hyperbaric MAH, rectal insufflation, IV ozonated saline
  • Rectal insufflation can be a powerful tool; can move into lymphatics and into blood or through portal vein into liver; no IV access required; can be helpful for intestinal microbiome imbalance, fungal overgrowth, liver disorders, and systemic support
  • Ozonated saline traps ozone much like Co2 is trapped in a soda
  • Anything that stimulates NK cells, IFN-y, and IL-2 can shift from Th2 to Th1; anything that decreases antibodies (hydrocortisone) and IgE allergies (quercetin) can also shift back to Th1 by downregulating Th2
  • NK Stimulators (Th1 stimulators): D3, beta-glucan, selenium, C, astragalus (he takes daily), mushrooms, echinacea, melatonin (huge), angelica sinensis, HemoHIM, gallic acid, Skullcapflavone II, chlorogenic acid
  • Th2 Suppression (shifts back to Th1): quercetin, licorice, hydrocortisone
  • Antiviral Prevention
    • Avoid Th2 upregulators like environmental toxins, petrochemicals, parasites, overzealous hygiene, vaccines
    • Super Immune QuickStart, D3, K2, A, Melatonin
    • No toxic dose of melatonin has been discovered; no negative feedback inhibition; melatonin is huge at preventing viral infections 
  • Antiviral Treatment
    • Nebulized hydrogen peroxide
    • Zinc acetate lozenge; ionized zinc kills viruses on contact
    • Vitamin C
    • Rest/fluids
    • Hydrocortisone
  • From Q&A discussion
    • 10 pass may be better for acute situations; may need fewer passes in a single session with more chronic conditions
    • Ozone therapy can be used with blood thinning medications but may need to adjust the heparin
    • Ozone therapy is very good at breaking down biofilms that fungi can hide underneath; can be used in the sinuses, ozonated water, ozonated oil, ozone gas; many ways to introduce it into the gut and sinuses for fungal issues
    • Ozone therapy helps those with MCAS (which is a Th2 condition) by shifting back to Th1 dominance
    • While ozone is an oxidant, via hormesis it upregulates antioxidant defenses; an oxidant is the best antioxidant therapy
    • Ozone can improve mitochondrial function and ATP creation, but not as much as he had hoped on its own
    • How ozone is introduced into the body leads to different effects; all are really good and often best to be combined; blood is the most effective but other approaches are very helpful
    • Ozonated oils were invented by Nikola Tesla; can be very effective taken internally or applied topically; likely underutilized as it is so simple
  • AntiAgingMedicine.com

Dietrich Klinghardt, MD, PhD spoke on "Using Muscle-Tone Biofeedback to Better Understand Chronic Illness" and shared:

  • Did a PhD in mid-70s with a thesis on using methods of evaluating the autonomic nervous system and how it impacts the immune system
  • WBC have receptors that the ANS releases peptides to affect
  • Imaging techniques and lab tests have their limitations
  • What if the illness-causing infection is only in the brain and missed by available tests?
  • Many lab and imaging techniques demonstrate late illness
  • Underlying Factors in Chronic Illness
    • Infections
    • Toxins (glyphosate, aluminum, and others)
    • Overshooting immune reactions (MCAS, mold, autoimmunity)
    • Interference fields (dental, implants, scars); devitalized tooth causing pain in a shoulder; scar in pelvic flood that leads to migraine headaches
    • Psychological issues
    • Genetic predispositions
    • Metabolic and structural changes from the above
  • There are often 1-2 dominant issues that when addressed can collapse the illness
  • Looking in the blood, urine, saliva, or stool is not ideal; what if the infection or toxin or issue impacting the immune system is in the brain or CSF or bone or heart?; cannot test with other tools for interference fields or psychological issues
  • Many methods were developed that use physics to look into the body: HRV, EAV/EDS (Voll), AK (Goodheart), BDORT (Omura), VAS (Nogier), ART (Klinghardt); ART is a composite test that uses all of these systems
  • The majority of physicians in Europe use EAV/EDS devices; Simon Yu MD is an expert in the US
  • Applied Kinesiology has associated itself with real science; has deep origins into early cultures looking for clean food and water
  • Nogier's auricular system is the best tool for balancing the vagus nerve and parasympathetic nervous system
  • 2000 practitioners using ART throughout the world
  • ART can now be learned via online learning through the Klinghardt Institute 
  • ART can help to identify microbial or toxic stressors and where in the body these may be located
  • ART can be used to find if a particular herb, vitamin, or medication is getting to the body part where it is needed; drug uptake testing
  • Muscle tone is used to explore for stress or relaxation in response to a presumed stressor or balancer; muscle spindle records how long the muscle is
  • The sympathetic nervous system innervates human muscle spindles; the autonomic nervous system sets the thermostat; muscle spindles carry autonomic innervation
  • Depending on the stress exposed to, the muscle becomes longer or shorter
  • Applied Kinesiology has been scientifically validated; more research is needed
  • Practitioner should be in a specific mental state when testing including honesty, trust, assertive, precise, and have playful curiosity
  • Intermediary testing has been found to be more reliable than direct testing
  • Omura's Bi-Digital O-Ring Test (BDORT) has been patented as a reliable tool to assess the health of organs
  • Omura was the first in the US to warn of the dangers of EMF/EMR
  • ART uses a pol filter, signal enhancers, DVDs with frequencies, slides, mirrors, and other test materials
  • Using a mirror which reflects light to the body, if there is incoherent light, that will result in a stress response
  • The pol filter is used to test for coherent light emissions
  • 2017 paper with Klinghardt and Ruggiero; examined patients and found weak areas in the body using ART and then used ultrasound to confirm; then used ART to identify microbial stressors in various body compartments and used ultrasound to disturb their hiding places and later test with DNA Connexions urine test and was able to confirm the ART findings
  • Reviewed a publication on a person with OCD and anxiety where ART found stress related to wheat, barley, rye, lead, mercury, and Entamoeba; had remarkable improvement with treatment based on these findings
  • Reviewed a publication where addressing a scar resolved someone's chronic pain syndrome; scar treatment with neural therapy is often important in recovering healthy
  • Reviewed a publication where ultrasound was used in a child with autism; many have restrictions of the lymph drainage from the anterior neck; uses a cream that can reopen the drainage from the brain that can lead to dramatic improvement
  • ART is an extension of a physical exam
  • ART does not use any electricity in any of the instruments that are used
  • Tubulin in the nerves are a light-conductive structure; biophotons may transmit along nerve fibers; electric impulses along the nerves is true but at slow speed; inside the nerves, the light conductive system is at the speed of light
  • Body emits light from each cell and emits biophotons; the light is coherent in healthy cells or tissues
  • ART is used to identify where coherence has been lost, why it was lost, and how to restore it
  • From Q&A discussion
    • For EMF blocking in an apartment, metallic paints could be used inside the apartment along with shielding cloth on the windows; the most important time to shield is during sleep; sleep sanctuary/canopy creates a Faraday cage; is used over, down the sides, and under the bed; http://littletreegroup.com
    • To learn more about interference fields, read "Atlas of Neural Therapy" by Dosch
    • Can use ART to test for the amygdala and other components of the limbic system; focus is to remove toxins and infections in the area and using PK work to address the underlying issues
    • Diagnostic ultrasounds can also mobilize pathogens in the body
    • Autoimmunity is often triggered by unresolved trauma including inherited trauma
    • People with dysautonomia need to be 100% shielded from EMF exposure; can also be a dead tooth, childhood or intrauterine conflict
  • KlinghardtInstitute.com, SophiaHI.com

Neil Nathan, MD spoke on "Exploring the Cell Danger Response as a Model for Recovering from Chronic Inflammatory Illness" and shared:

  • Conventional medicine is stuck attempting to associate a single pathogen to a single illness; complexity is not part of the model; for most with chronic illness, things are much more complicated
  • Supplements and supportive therapies may help, but many are profoundly out of balance; putting the ship back on course will not suffice
  • Cell Danger Response Model comes from Dr. Robert Naviaux
  • Before a cell is broken or lysed, mitochondria sense a microbe or toxin; they decrease their oxygen consumption and make cell chemistry more oxidizing to shield the cell from injury
  • CDR is a coordinated response with 8 steps:
    1. Cellular metabolism shifts from making complex molecules, carbohydrates, fats, and proteins to sugars, fatty acids, and amino acids to prevents viruses and bacteria from using our cells
    2. Cell membrane stiffens to limit pathogens leaving the cell
    3. Antiviral and antimicrobial chemicals are released
    4. Autophagy and mitochondrial fission increases to remove intracellular pathogens
    5. DNA methylation and histones change to alter gene expression
    6. Endogenous retroviruses are mobilized
    7. Neighboring cells are warned of the danger
    8. Host cell behavior is altered to prevent spread of infection and sleep is altered to facilitate healing
  • Summer / Winter Metabolism
    • Biochemical design includes a built-in shift which is seasonal
    • mTOR is master fuel sensor in cells in the summer; facilitates protein synthesis and growth
    • AMPK is the master fuel sensor in winter; optimizes energy efficiency and recycling of cellular materials in autophagy
    • Cycle occurs to a lesser extent each night and during fasting
    • Pathways activated by AMPK support regeneration and are anti-inflammatory as they work to breakdown damaged proteins, lipids, glycans, RNA, and DNA
    • Various materials such as oxygen, ATP, cysteine, D, Folate, B12, heme, phospholipids, and many others have different effects based on the seasons
    • We no longer live with the seasons due to food being available year round; we are out of tune with the cycles
  •  CDR Specifics
    • Purinergic signaling nucleotides like ATP are released from cells under stress; the NLRP3 inflammasome is activated 
    • Sulfur metabolism shifts; glutathione is consumed in regulatory detox reactions and cysteine is diverted to hydrogen sulfide, taurine, and sulfate excretion; markedly interfering with methylation; the cell intentionally shuts down methylation to protect us from viral replication
    • Vitamin D in inactivated and decreased which leads to increased inflammation and autoantibodies
    • Activation of CDR stimulates histidine to yield histamine; critical for mast cell and eosinophil function
    • RBC and mitochondrial heme centers are released from damaged cells; feedback inhibitor of porphyrin synthesis; will often see a secondary porphyria and KPU
    • Tryptophan metabolism can go to either serotonin and melatonin or to kynurenic acid and quinolinic acid which induces IL-6; involved in anxiety and depression
    • Antiviral CDR is regulated by lysine; lysine opposes CDR
    • Low plasma levels of P5P increase the kynurenine/tryptophan ratio and sustain the CDR
    • Toxic heavy metals may accumulate and not be easily mobilized; CDR favors sequestration; heavy metal toxicity in most; protective mechanism; when threat is neutralized, heavy metal detoxification is automatic
    • When the host is sick, the biome is sick
  • CDR is initially adaptive but may become maladaptive once the environmental danger or threat is gone; body may not be able to right itself
  • ROS are the response to the disease, not the cause; need to target the creators of oxidative stress, not the oxidative stress itself; giving antioxidants is the old way of looking at things
  • Metabolomics is the ability to measure the unique chemical fingerprint from a single drop of blood; the end process metabolites
  • A sample of blood is like a sample of water from a river or ocean ecosystem
  • A single treatment of Suramin has been used to block the purinergic receptors; took autistic mice to almost normal
  • Looking at 612 metabolites, tested patients with CFS/ME; showed that this condition is not psychological at all
  • Identified abnormalities in 20 metabolic pathways; 80% were decreased
  • Abnormalities were in the following pathways: sphingolipid, phospholipid, purine, cholesterol, microbiome, riboflavin, P5C, BCAAs, and peroxisomal and mitochondrial metabolism
  • Diagnostic accuracy was 94% in males with 8 metabolites and 96% in females with 13 metabolites; this is a metabolic illness
  • Triggering events included biological (viral, bacterial, fungal/mold, parasitic), chemical exposures, physical, and psychological trauma; no single stressor was more prevalent
  • Sphingolipid imbalances were common to both males and females
  • Male and female chemistry is not the same
  • Low sphingolipid profile appears to be an adaptive response to opposed the spread of viral and intracellular bacterial infections; changes cell membrane chemistry
  • Membrane chemistry changes in response to danger
  • Sphingolipids are used by bacteria and viruses
  • Treatment 
    • CDR may be reversed by reversing all of the biochemical issues set off by its presence
    • 10 patients with autism; 5 received Suramin; 5 did not; the 5 that received it had immediate, profound changes in behavior; started talking and interacting after one treatment
    • Additional studies are underway
    • Purinergic signaling plays a role in sustaining the CDR; 19 purinergic receptors
    • In mouse model, a single injection of Suramin corrected 16 of 16 autism-like features
    • An American company is starting to manufacture Suramin
    • Suramin coupled with D, Lysine, methylation, P5P, heavy metal detox, and other toxicities and underlying infections and KPU are all part of the model, BUT you cannot start these until you neutralize the threat
    • You have to treat the toxin(s) and/or infection(s) first; the body has to feel safe; you cannot convince the body that it is safe if the threat is still present
    • Treatment necessitates rebooting of body systems
  • CDR is only the first part of a three step process that helps to understand and treat chronic illness
  • Acute illness is treating the injury; chronic illness treatment is unblocking the healing cycle
  • There are repeated cycles of incomplete healing
  • CDR1, CDR2, CDR3; if the body does not go through the complete healing response, the body is primed to be harmed by the next insult; we become more vulnerable over time; a viscous spiral
  • The original triggering event may no longer be present; there is a biological reaction to the injury
  • If healing is incomplete, more severe disease is produced; progressive dysfunction
  • Every chronic disease is a whole body disease
  • Cells that cannot communicate get stranded and are functionally lost to the tissue
  • Healing is blocked
  • Metabokines like ATP, SAMe, acetyl-CoA, and NAD+ modify DNA and histones and gene expression
  • Healing Cycle
    • Mitochondria are the orchestrators of safety; there are 3 different forms of mitochondria
      • M0 are uncommitted for growth and biomass replacement
      • M1 are pro-inflammatory for defense
      • M2 are anti-inflammatory for standard conditions
    • CDR coordinates mitochondrial function after injury
    • Healing cycle is a 3 step sequence for any kind of injury; beginning, middle, and end
    • Metabolism controls progression through the healing cycle using metabokines
    • Extracellular ATP is the most important metabokine at all stages of the healing cycle
    • ATP shifts from a source of energy to a danger signal molecule
    • Blocks in the healing cycle cause hundreds of chronic disorders
    • Antipurinergic drugs can restore normal signaling and healing when the threat has been neutralized
  • CDR1 is the "stuck place"; when toxins are removed and infections addressed, checkpoint 1 is where the body moves into CDR2
  • CDR1 is glycolysis and M1 mitochondria; danger is signaled; M2 mitochondria shift to M1 and initiate oxidative shielding response for damage control
  • A cell that adopts the CDR1 phenotype must disconnect communication with neighboring cells; a cellular autism; required to initiate healing but at a cost; creates a loss of function of organ systems
  • CDR1 ends with passage through checkpoint 1 which requires the creation of a less oxidizing and less inflammatory extracellular environment
  • CDR2 is aerobic glycolysis and M0 mitochondria and move into biomass replacement to replace cells lost in CD1 and restore organ function.  M0 mitochondrial release metabolic intermediates needed for polymer synthesis and cell growth; we back to a somewhat more normal metabolism
  • In CDR2, cells with too much damage move into senescence.  After cells stop growing, they begin to establish a symbiotic relationship with neighboring cells and move through checkpoint 2 and into CDR3
  • CDR3 is autonomous oxphos and M2 mitochondria 
  • CDR3 is cellular differentiation, tissue remodeling, adaptive immunity, detoxification, metabolic memory, sensory and pain modulation, and sleep architecture tuning; the body is moving into healing
  • Newly born cells must undergo cellular education that involves adjustments in gene expression, structure, and metabolism; healing is incomplete until cells receive their instructions and materials from older, neighboring cells that carry programming from before the activation of the CDR
  • Tissue detoxification restarts in CDR3 and continues through the health cycle; health cycle cannot be re-entered until extracellular ATP is decreased
  • Exercise is medicine and reminds the body how to heal
  • Sleep is medicine; slow wave sleep and increase in parasympathetic tone and is important for healing; disruptions are a risk factor for many illnesses
  • End organ resistance to hormone signaling is an intrinsic part of the CDR; patients with Lyme and mold have significant pituitary dysfunction; balancing hormones is hitting a moving target; re-establishment of hormone sensitivity begins in CDR3 and is required for healing
  • Patients do have adrenal, thyroid, and sex hormone dysfunction that do not always show up on tests the way conventional endocrinologists would expect
  • When CDR is activated, coordination between the two limbs of the vagus is disrupted; results in disinhibiting the sympathetic nervous system and HPA axis which dominate during illness; leads to a number of autonomic abnormalities including POTS, PANS, and PANDAS
  • Intrinsic to the CDR is interfering with the vagus nerve and mast cell activation; a very common and important player keeping patients sick
  • Virtually every chronically ill patient has mitochondria dysfunction to some extent; the question is when to provide mitochondrial supplements without making things worse
  • When patients are really ill, they may have a paradoxical response to mitochondrial support or not respond at all; have to move through CDR1 into CDR2 and CDR3 to get these to work; the cell is in survival mode and cannot benefit from these in CDR1; fix the threat or the mitochondria cannot heal
  • The same rationale is true for methylation support; these can backfire early in the CDR; CDR1 intentionally shuts down methylation to keep bacteria and virus from hijacking our own chemistry for their benefit 
  • In Dr. Nathan's early research, they did a study in CFS/ME patients using very low dose methylation support; ability to make glutathione and SAMe improved; large amounts are not needed and these only work when you take care of the toxin or infection first
  • Don't fix "lesions" or deficiencies as the patient may not be ready to receive it if they are still in CDR1; you have to know how stuck the patient is before you can move them forward
  • What looks like a biochemical deficiency may be a compensation; trying to fix a compensation may undermine the body's innate wisdom and make the patient worse
  • On a cellular level and the entire organ, healing may be resisted as it is perceived as a threat or change; may present as an exacerbation of their usual symptoms; patient feels like they need to stop all treatment until the symptoms resolve; if you stick with it, the body may recognize the benefit; everything we call a Herx may not be a Herx; you may need to stick with some treatments longer than you would like
  • Dr, Naviuax has looked at autism, PTSD, Gulf War Illness, Chronic Fatigue, depressive disorder and is now looking at Lyme disease with metabolomics; the profiles are not the same for all conditions and can distinguish the fingerprints of various conditions
  • Dr. Naviaux has expanded the healing cycle model to including aging; aging itself is a manifestation of the CDR; we can affect the aging process by improving the healing cycle
  • In his paper, he lists various disorders and categorizes them into CDR1 Disorders, CDR2 Disorders, and CDR3 Disorders; some cells can be in one stage while others can be in another
  • Mitochondria are in M1 stage in CDR1; M0 in CDR2; M2 in CDR3 and Health cycle
  • Many triggers can initiate the CDR: genetics, chemical pollution, flame retardants, metals, pesticides, infections, fever, MCAS, cytokines, microbiome
  • Used to think treating Bartonella with supplements and medications and a patient getting well was because of the treatment; now realizes maybe he was also treating other things that also responded to the same treatment; available testing is still not adequate to answer this question
  • When you treat mold toxicity, you are also treating total toxic load; mold toxin is easiest to measure and to treat, but improvement might be from the treatment also removing many other toxins from the body
  • When a patient responds to a change in diet or supplementation, there could be many reasons for the improvement other than the assumptions that might initially be believed
  • Mold and Lyme disease are two major triggers of the CDR; must identify the cause to treat the CDR
  • 92% of 112 ME/CFS patients had significant mycotoxins in their urine in Joe Brewer study
  • Brewer Approach is to analyze and remediate the environment or move, use urine mycotoxin testing and selective binders, and consider antifungals for the gut and sinuses
  • In some, environmental remediation and binders will resolve the condition; in Dr. Nathan's patients, this only works for 10%, and greater than 90% need antifungals for colonization to fully heal
  • If mold has been treated and the patient is still not well, Lyme and co-infections are next on his priority list; failure to address these infections will leave the patient in CDR1
  • Dr. Naviaux is now working with exposomics and looking for pesticides, flame retardants, phthalates, plasticizers, persistent organic pollutants, personal care products, and RX drugs; we will be able to explore the environmental toxicity component soon
  • From Q&A discussion
    • Phospholipids can help with cell membrane stiffening; works best for this as an IV; it is a blend of fatty acids, not just PC, that helps with the stiffening of the cell membranes; this will work when the membrane wants it to work; if the membrane is trying to hold in a pathogen, it may not be the right time for phospholipids
    • One of his favorite treatments for mold toxicity is IV phosphatidylcholine which can help to move mold toxins and can help move the body out of CDR1 as you are addressing the trigger for the CDR
    • In terms of herbs that might work like Suramin, there has been some research on Chinese Skullcap; while a great tool, it may not work or be tolerated until out of the cell danger response; he has not seen it reverse CDR1
    • The causes of the CDR are toxins, infections, and stress.  If stress is the primary trigger for the CDR, limbic system retraining (and vagal retraining) like DNRS is a wonderful tool.  If the larger trigger is a toxin or infection, it will help greatly as the majority of patients have limbic system dysfunction; but, if mold or Lyme are present, limbic system retraining will not be sufficient to cure the patient by itself 
    • Manifestations of limbic system dysfunction are extreme sensitivities to light, sound, touch, chemicals, food, EMF; emotional imbalance, mood swings, anxiety, depression, OCD
    • EMFs may be a trigger (or may add to) for the CDR; he saw this with the introduction of smart meters; EMF sensitivity is largely limbic, and limbic retraining can be very helpful
    • Regular interaction between the patient and practitioner is important to continue moving in the direction of healing
    • The vast majority of his patients improve, but it does take time and patience/persistence/dedication
    • If there is cellular resistance to healing with a particular intervention, it is often overcome in 10-14 days
    • Toxins need to be reduced and infections addressed to the point that the immune system can recover and regain containment
    • As people work through the symptoms of mold toxicity, they feel awful; later the limbic system and vagal nerve system gets involved to protect us; at a certain point, it goes from protective to becoming part of the problem; most will develop limbic system, vagal nerve, and MCAS over time; these have to be addressed first or they will not be able to tolerate treatment
    • In complex patients, the priority is almost always mold; when mold and Lyme are both present, mold is generally the priority and easier to treat; if you can remove the inflammatory mold layer, addressing the microbial issues is easier
    • No longer suggests glutathione as a provocation for urine mycotoxin testing for Great Plains, but does provoke for RealTime; stops binders for 3 days but does not stop antifungals
    • Has had patients that have used peptides, and they may help, but they won't get at the cause: microbes and toxins; may not respond as well to peptides if they are still in CDR1; better later in treatment
    • Patients may have to shift to a place of being ready for healing
  • NeilNathanMD.com

Neil Nathan, MD spoke on "Identifying the Patients You Can Help the Most" and shared:

  • It is best to do a new patient screening to ensure that the patient and doctor are a good match for each other
  • Patients may want something that you as a doctor are not able to give
  • Some patients jump around from one treatment to another and may not have the staying power to implement a treatment program that may be in their best interest
  • If a patient is too attached to their story, they may not be able to let go of it and move towards healing; they may be stuck in their story
  • Some patients may doctor-shop and move from doctor to doctor feeling that no one is able to help them; they may not stay with you long enough to make a difference
  • Some patients may find getting well to be scary and may sabotage their only healing process
  • There is no set timeline for healing; you may not be able to fix Bartonella in 3-4 months
  • If a practitioner cannot help a patient, neither the patient or the practitioner benefit; it is not enough to care; the practitioner may need to recognize there will be some patients that they cannot help
  • The patient needs to implement the things that practitioner suggests if they hope to improve 

Kristine Gedroic, MD spoke on "Lessons from The Pandemic: Managing COVID and COVID Long-Haulers" and shared:

  • COVID is a two-stage illness; there is an early viral phase and a later tremendous inflammatory state
  • Has worked with over 400 patients with COVID; only one required hospitalization who was on chemotherapy; moderate to severe symptoms were less than 2% of cases; more than 98% were relatively asymptomatic; no fatalities; no post-COVID syndrome
  • Their model is geared towards recovering innate immunity and resolving chronic inflammatory state and addressing toxins, fungus, parasites, embedded infections, and biofilms that lower innate immunity
  • Coronaviruses were discovered in 1960s; seven families
  • Beta coronaviruses: SARS, MERS, SARS-CoV2
  • Two staged illness; first stage depends in innate immunity
  • Strength of innate immune system is indirectly related to the amount of inflammation seen in later stages of the disease
  • Adaptive system is the newer defense system; 350 million years ago; more sophisticated; T/B cells
  • Second phase has significant morbidity and mortality 
  • COVID long-haulers appear to be a similar population to CFS/ME; the pandemic is drawing attention to this previously-discarded condition
  • The host microbiome is the root cause for the potential of the second phase of the illness
  • CoVs are enveloped, positive-strand RNA viruses with spikes on their surface; unusually large RNA genome; long been around in the fall and spring
  • Largest group of viruses in Nidovirales order; large replicase gene; can translate proteins by frameshifting RNA
  • 4 key proteins: Spike (attachment), Membrane (most abundant; defines shape), Envelope (smallest; viral assembly and budding), Nucleocapsid (binds RNA genome; viral assembly and budding)
  • Routes of infection: begins with attachment and entry; attachment to host cell is by interaction between S protein and ACE2 receptor; enters cytosol via cleavage of S protein by a protease enzyme which is then followed by fusion of the viral and cellular membranes; next step is translation of the replicase gene; the virus uses RNA as its DNA effectively; encapsulation occurs resulting in mature virus; virions are then transported to the cell surface in vesicles and released by exocytosis
  •  Two stages of illness
    • First phase begins like a common cold: shortness of breath, cough, diarrhea, fatigue, loss of smell, loss of taste, headache, fevers
    • Second phase is cytokine-related and begins around day 7; severe to life-threatening symptoms in respiratory, cardiac, and neurological systems; notable for hypercoagulation
    • Will not see a second phase if the virus is put out quickly in the first phase
    • Will see a highly inflammatory second phase in those with less efficient innate immune responses
    • Critical to shut the virus down early and not "wait and see"
  • Diabetes and obesity are two of the biggest risk factors
  • Patients that have diarrhea and severe GI upset early in the virus may be more at risk for progression to the second stage
  • The degree of adaptive response is proportional to the success of the innate immune system response
  • Substances to downregulated NF-Kb can be very helpful
  • The host needs to raise IFN early on to extinguish the virus
  • TNF and IL-6 are predictors of disease severity and fatality 
  • Possible Treatment Considerations in Phase 1: Zinc, Quercetin, C, D, Melatonin, Hydroxychloroquine, Ivermectin, herbs
  • Zinc inhibits activity of both Nidovirus polymerases; critical to get zinc into the cells early
  • Chloroquine is a zinc ionophore (transporter across cell membranes) that helps to increase intracellular zinc
  • Studies that left out zinc were dependent on the zinc levels and health of the host; zinc is highly deficient in many people and decline with age
  • Quercetin and Vitamin C act as an antiviral and immunomodulator
  • Quercetin is highly antiviral; present in many healthy foods; need to be farm to table; antioxidant, anti-inflammatory, antiviral, and immuno-protective; binds SAR-CoV protease and inhibits proteolytic activity; best to give with C since quercetin can become oxidized
  • The data on Ivermectin is overwhelming; was derived from a soil bacteria that acted as an anti-parasitic; "ver" in Ivermectin is for "vermifuge"
  • Ivermectin inhibits replication of many viruses, SARS-CoV-2 replication, is a potent anti-inflammatory, diminishes viral load, protects against organ damage, prevents transmission and development of COVID-19, hastens recovery, and avoids ICU admission and death
  • Ivermectin crosses from prophylaxis to early intervention to shutdown replication to later stage to reduce inflammation
  • There is a lot of research on the use of Ivermectin
  • Has not seen cases where Ivermectin was not helpful when acting early 
  • Cytokine storm occurs in second phase of illness; potentially fatal immune reaction; highly elevated levels of various cytokines
  • Th1 inflammatory mediators are pretty standard; COVID appears to be triggering a Th17/autoimmune reaction and much higher levels of inflammation
  • Recent article discusses the scientific evidence that COVID does trigger an autoimmune reaction
  • Anti-inflammation does not just happen; inflammation is the go mode; we need brakes to turn it off; may not have enough anti-inflammatory mediators
  • Cytokine storms have been associated with CMV, EBV, Group A Strep, influenza, variola, and SARS-CoV-1 and 2
  • People get infected and are asymptomatic when they might have an opportunity to shut things down
  • SAR-CoV-2 antibodies have reactions with 28 of 55 tissue antigens; cross-reactivity plays a role in multi-system disease and autoimmunity
  • We have to be mindful of an acceleration of autoimmune diseases
  • Possible Treatment Considerations in Phase 2: Ivermectin, PC, Butyrate, Glutathione, Support Detox Pathways, Biome Related Co-Infections
  • PC and Butyrate for this purpose were all done orally; makes a huge difference for some patients
  • PC is a TNF-a inhibitor; butyrate is a SCFA that can modulate inflammation; butyrate is a direct IL-6 inhibitor
  • COVID "Long-Haulers"
    • Symptoms continue after 21 days of diagnosis
    • CFS/ME, chronic Lyme patients very similar
    • Fatigue, brain fog, pain, breathlessness, dysrhythmias
    • There may be a relationship between COVID and Bartonella
    • There are hundreds of Bartonellas in the microbiome that can come out in the right circumstances
    • Also seeing activation of Mycoplasma
    • The mitochondria are the antiviral hub of our immunity
    • Glutathione can help to reduce serious manifestations of COVID-19
  • Herxheimer reactions are related to endotoxins and the products released by cell death
  • Herxing has become a phenomenon in the chronic illness space; now a "verb", but that is not a classic Herx reaction
  • Different Types of Herx Reactions
    • Biofilm Related - secondary infections that are not being managed properly or considered; started taking antibiotics and was in bed for days and days with whole-body pain; more of a toxic fungal reaction; have to bring in antifungals, scale back on antibiotic, round out the treatment
    • Toxicity Related - tremendous oxidative stress; foundational elements (mitochondria) are not stable; the immune system is an ATP-dependent process
    • Inflammation Related - similar to a state of host environment that needs to be repaired; cell membrane has not been supported; not getting enough fat; lost gallbladder and not absorbing fats; need fats and proteins to heal; nervous system needs fats
  • Number one friend of innate immune system is fever; breaks down VLCFAs; let the fevers ride; taking things to break the fever may prolong the illness
  • Seed and nut oils have antibacterial and antibiofilm properties
  • Best to treat for two weeks after acute illness and even longer for moderate illness
  • From Q&A discussion 
    • Hypercoagulation can play a role; FLCCC recommends aspirin; butyrate has anti-coagulation properties; natural enzymes can be helpful like Nattokinase
    • For Bartonella and Mycoplasma support, Bartonella herbs like those from Beyond Balance or Byron White; Zithromax could be helpful
    • Immunity is tied back to fungi in the gut; disorganization of the fungal mycobiome; also tied into trauma and stress; the mind-body connection is through the mycobiome; when we are calm and relaxed, it is more spore; when we are triggered, it is more hyphal and can trigger autoimmunity
    • At this point, it is difficult to know whether or not COVID-19 can reactivate after recovering from the initial illness; any virus has the potential to persist in the body
    • As a population, we need to get our health shored up; our immune system is always the best tool for safety and long-term health
    • Not seeing as much of an issue with MCAS which is generally parasitic in nature; the use of Ivermectin and quercetin may be minimizing MCAS in some with COVID
    • Patients with a lowered innate immune response, which can be evaluated with CD57, could be an risk factor for potentially more difficult courses with COVID
    • Mycoplasma testing has been through LabCorp or Quest; Bartonella has been IGeneX Bartonella Western Blot
    • With Mycoplasma IgG, a 4 fold titer elevation may warrant treatment even without a positive IgM; patients feel chest symptoms and asthma
    • For Bartonella, uses MC-BAR-1, MC-BAR-2 from Beyond Balance or A-BART, A-RMS/4B from Byron White  
  • GedroicMedical.com

David Musnick, MD spoke on "Sleep Dysfunction and Insomnia: An Integrative Approach" and shared:

  • Studying sleep dysfunction for more than 15 years
  • Critical for complex patients to get sleeping
  • Sleep goals: fall asleep in less than 20 minutes; decrease nighttime awakening and improve falling back to sleep; increase quantity and quality; improve feeling rested; decrease reliance on sleeping pills and caffeine 
  • 30% of American adults have some insomnia; 10-20% have chronic sleep problems; higher in patients with Lyme and mold
  • Women have more sleep dysfunction than men
  • Sleep history needs to be part of every patient intake
  • MCAS patients can have sleep problems as histamine disrupts sleep
  • Present with: low energy, can't get out of bed, keep waking up, want to get off sleeping pills, brain fog, inflammation
  • Sleep is restorative; important for growth hormone secretion
  • Glymphatics for brain detoxification most active during normal sleep
  • People with cognitive dysfunction have to get restorative sleep
  • Sleep is an interplay of multiple, complex signaling messages in multiple parts of the brain; regulated by biological clocks; circadian regulation originates in the hypothalamus
  • Brain inflammation can disturb sleep
  • GABA is a sleep-promoting neurotransmitter; melatonin, serotonin, glycine, and adenosine
  • PharmaGABA or regular GABA can be helpful
  • Adenosine builds up in the CNS throughout the day; turns down wake-promoting regions and augments sleep-promoting regions; as adenosine goes up, you have more pressure/desire to sleep; caffeine blocks the adenosine receptors
  • 1/2 life of caffeine is 5-7 hours or longer with some CYP genetics; stay as low in caffeine as possible
  • Some supplements have caffeine that may not be obvious; green tea extract should not be used past 4pm; chocolate has caffeine
  • Wakefulness promoters: Norepinephrine, Histamine, Glutamate (glutamine can turn into glutamate), Acetylcholine, Dopamine, CRF/Cortisol, Orexin
  • If histamine is too high, this can negatively impact sleep; stabilize the mast cells with a high quality luteolin
  • Sleep onset: hypothalamus sleep center inhibits arousal pathways (dopamine, norepi, histamine, serotonin) and leads to decline of sympathetic tone and decrease of circulating catecholamines; don't watch the news at night
  • Sleep is usually initiated like a switch; rapid onset of sleep and wakefulness; can be prolonged transition times with sleep dysfunction
  • Acute Sleep Loss: increase in norepi/epi, sympathetic tone; less than 6 hours increases neural inflammation and body inflammation for days; immune system is dysregulated by sleep loss; decreased Th1 and increased Th2 response including allergy and histamine responses
  • Consequences of inadequate sleep: feeling unrested/fatigued, increase all cause mortality, coronary artery ischemia, MI, and death; altered cortisol production; increased pain perception; aggravation of chronic pain; poor work performance; decreased short-term memory; impaired cognition; decreased balance and proprioception; dependence on caffeine; neuroinflammation; whole-body inflammation; slower tissue healing; tendonitis/overuse injuries related to defect of posture, muscle imbalance, or growth hormone deficiency; muscle soreness/tenderness; Fibromyalgia flares
  • Need 7-9 hours sleep; children 10-12; adolescents 9-10; adults over 65 have more disrupted sleep
  • Sleep Stages: 4 stages followed by REM make up a cycle; as stages change an deepen, brain EEG patterns change and slow; each cycle may be 90 minutes; normally 5 cycles; many patients do not get 5 cycles
  • Stage 1 and 2 are lighter; REM sleep is important
  • Some get enough quantity but not enough stage 3 and 4 sleep
  • Inadequate REM sleep can lead to emotional dysfunction, irritability, anxiety, cognitive dysfunction, tender points
  • Categories of Sleep Dysfunction
    • Onset insomnia is when falling to sleep takes greater than 20 minutes
    • Sleep maintenance dysfunction with insomnia after awakening
    • Sleep partner dysfunction (dog, cat, human)
    • Sleep movement disorders
    • Sleep stage disorders; inadequate stage 3 and 4 sleep
    • Sleep breathing disorders from sleep apnea
    • REM sleep disorders; nightmares
    • Inadequate quantity
    • Circadian dysfunction
  • Assessment: how rested in the morning, how many hours, how many days a week less than 8 hours, how many hours in bed, sleep efficiency should be at least 80% (hours asleep/hours in bed), snoring, stop breathing, sleepy during day
  • Reasons for sleep onset insomnia: stress, anxiety, blue light, exercise late in day, musculoskeletal pain, nasal congestion, excessive cortisol, sleep partner, neural inflammation
  • A lot of patients with Lyme and co-infections and mold have neural inflammation
  • Sleep onset insomnia: thyroid medications, beta blockers, NSAID, narcotics, alcohol, decongestants, diuretics, caffeine; avoid caffeine after 2pm
  • Light Factor: most bedrooms have too much light; can decrease melatonin secretion; blue light is beneficial in the day (attention, reaction, mood) but disruptive at night; can decrease melatonin, alter REM, cause delayed sleep onset; every cell phone and computer should have a blue light app; blue light at night impacts blood sugar regulation and circadian rhythm; use blue light blocking glasses after 8pm; use a dimmer switch in the bathroom to minimize light when getting ready for bed
  • Preparing for Sleep
    • Turn lights down 1/2 hour before bed
    • Minimize TV, cell, internet within 1 hour
    • Avoid blue light
  • Sleep Hygiene
    • Regular bedtime
    • In bed between 10-10:30pm
    • Avoid naps longer than 45 minutes
    • Do not lie in bed for more than 30 minutes; move to a low light room
    • Read a non-violent book under low light (no newspaper, websites, internet)
    • No TV or surfing the internet
  • Sleep Preparation
    • Set an alarm 30 minutes before sleep to start preparing
    • Reading a book on a device in airplane mode with blue light blocker with black background and white letters can help induce sleep
    • Reading if they wake up in the night
  • Noise Factor: air filter/continuous noise is OK; if noises impact sleep, soft ear plugs can help
  • Stress
    • Anything that causes stress increases catecholamines; stress management is essential for good sleep
    • Determine type of stress impacting sleep
    • Aerobic exercise for stress management
    • Tapping: Tapping Solution App; sleep tapping sequences
    • Ashwaganda and GABA/Theanine
    • Designs for Health Catecholacalm
  • Minimizing nighttime eating; avoid allergic foods; minimize nighttime chocolate
  • Cortisol
    • Show be lowest before bedtime
    • Hard to sleep when elevated; some have a reverse pattern
    • Order adrenal salivary index
    • Decrease cortisol at night
    • Ashwaganda can help taken 2 hours before bed
    • Tapping/meditation
    • If some can get to sleep by 10pm, they are not yet at the point their cortisol goes up and leads to being a night owl
    • Frequency Specific Microcurrent Calm Adrenals and Calm Sympathetics
  • Pain and Sleep Postures
    • Pain wakes people up
    • Shoulder, neck, hip, and low back 
    • Demonstrate sleep posture
    • Side sleeper pillow can make a neutral neck position
    • Body pillows or king-sized pillows to hug in front with pillow between knees
    • Various pillow positions can be very helpful to demonstrate best option
    • Have the patient bring their pillows or send picture of them lying in bed
  • Sleep Maintenance
    • Why are they waking up?  Pain?  Spasms?
    • For spasms, magnesium (not oxide) can be helpful
    • For excitotoxicity, magnesium threonate + another form
    • For night-time spasms, Hylands Leg Cramps formula
  • Majority of patients with Fibromyalgia get very little stage 3/4 sleep; tender points decrease with better sleep; consider FSM for Fibromyalgia and pain
  • Nasal obstruction: snoring, dry mouth, difficulty nose breathing, clear nasal discharge, nasal turbinate swelling/redness, decreased airflow or excessive noise in nasal opening with inhalation; common in mold patients and those with dust allergies; air filtration, vent cleanings, test for mold; Breath Right strips, nasal saline or spray, nasal cortisone or antihistamine, Nasalcrom, avoid nighttime snacks with milk or allergenic foods, neti pot rinses
  • Sleep apnea: more and more common even in normal weight; low stage 4 sleep; low oxygen saturation leads to waking; check and clean CPAP
  • Delayed Onset Sleep Phase Syndrome: greater than 6 months history of inability to fall asleep at socially acceptable hour; night hours; go to sleep when completely exhausted; dysfunctional sleep pattern; may have peak alertness after 10pm; use a sleep timer to go to bed and back up every few days; some do have genetic clock gene issues (avoid caffeine after 12-2pm, set alarm 30 minutes before bed to prepare, avoid news)
  • Melatonin: pineal gland; regulates sleep/wake cycles; decreases with age; take 90 minutes before bed; less excreted with ambient light; useful for jet lag, shift workers, patients over 65 or with head injury, circadian rhythm disorders; improves brain stem cell survival; 1.5mg and higher doses with medical supervision
  • Adolescents: 9 hours; often impacted by social activities/devices; often tired in AM and at school; caffeine; later bedtimes and sleep in times on weekends; can become a life-long pattern
  • Sleep Maintenance: inability to sleep 7.5-8 hours or fall back to sleep promptly after wakening; causes: BPH, hot flashes, pain, hypoglycemia, stress, anxiety
  • Early Awakening: depression, secondary to light or noise
  • Female Sleep: hot flashes from menopause need to be treated
  • Conventional Treatment: drugs with antihistamines, antidepressants, anti-anxiety drugs and sleep medications; patients may try alcohol, pain medications, herbs; drug treatments limit stage 3/4 sleep; Benadryl/Chlor-Trimeton may be used but disrupt sleep stages; antidepressants have side effects; Trazadone can be helpful; benzos limit stage 3/4 sleep and can be addictive; no Valium and Ativan; Ambien and Lunesta may be better options
  • Trazadone has fewer side effects and can help with Fibromyalgia; Ambien/Lunesta maintain normal sleep architecture; Ambien has numerous side effects; Sonata for late onset insomnia; Xyrem is a controlled-substance but induces sleep via GABA
  • Exercise: not after 5pm; interval training can be incredible but most patients cannot do it; walking; 30 minutes of aerobic exercise though not within 3 hours of bed
  • From Q&A discussion
    • Has not found problems with long-term use of melatonin; has had many patients on melatonin for long periods for brain support
    • Benzo drugs and antihistamines do not result in normal sleep; Ambien and Lunesta are closer to normal sleep architecture; tries to get his patients to sleep without medications; likes Lunesta better than Ambien
    • Some need a protein source before bedtime and avoiding sugars to stabilize blood sugar in support of sleep
    • Cortisol dysregulation is generally stress and anxiety related; avoid disturbing TV, movies, internet, email; staying up late often leads to cortisol elevation; may do salivary testing to show this to patients
    • Has not used mouth taping but uses other tools to improve nasal breathing; reducing swollen turbinates
    • Sleep hygiene includes EMF reduction; evaluating EMF in the sleep location can be important for some patients; no TV in bedroom, Wi-Fi off, consider Smart Meter, EMF-reflective beanie caps; some are more sensitive to EMFs than others and notice more from reduction strategies
    • Inclined bed therapy can be helpful; particularly in those with GERD; can develop low back pain of too elevated
    • If using sleep devices for tracking, be sure they are in airplane mode; most are not very good at measuring stage 3 and 4 sleep 
    • Uses FSM to calm adrenals, sympathetics, pain, neural inflammation in support of sleep

Suzanne Gazda, MD spoke on "Unraveling the Mysteries of Neurodegenerative Disease Through the Lens of Functional Neurology" and shared:

  • Neurologists are astute diagnosticians
  • There is rarely a clear-cut case; cases have become very complex
  • She entered integrative medicine a few years ago to find more tools to help her patients
  • Amazing brain; 85 billion neurons with trillions of connections and its own immune system
  • Brain may have evolved in part due to psilocybin and psychedelic experiences; Terence McKenna
  • Some have found that the human brain is shrinking and we may revert to Homo erectus 
  • In the alpha generation (2010 to present), study showed children that are in the digital world at age 2 lose the ability to see the big picture
  • Neurodegenerative diseases are incurable, debilitating, and common; from autism to Alzheimer's
  • Biggest risk factor for neurodegenerative disease is age
  • Dysregulation of the innate immune function contributes to these conditions
  • Examples: Alzheimer's, Parkinson's, Prion, MS, ALS, Autism, Motor Neuron Disease, Huntington's, Spinocerebellar ataxia, Spinal muscular atrophy 
  • Mechanisms: chronic neuroinflammation, mitochondrial dysfunction, loss of blood-brain barrier integrity, endotoxins, gut microbiome, age, environment, stress, trauma, vascular, genetics, EMF
  • With age, the innate immune system becomes less robust; in younger patients, microglia are activated but BDNF and NGF stimulate neuronal repair; in a dysregulated system, too many cytokines and chronic inflammatory cycle leading to neurodegeneration and cell death
  • The brain's immune system was discovered in 2015; the brain is not immune-privileged as previously thought; microglial cells are the innate immune cells; when activated, the cascade or avalanche of immune dysfunction begins
  • Chronic neuroinflammation leads to BBB loss of integrity
  • Chronic neuroinflammation is the downfall of the brain
  • Downstream effects result in mitochondrial injury and impact the CNS vasculature
  • Every protocol should start with a healthy diet and removal of inflammatory foods and healing the gut
  • The gut-brain connection is important; leaky gut means leaky BBB
  • High levels of endotoxins/LPS are likely in almost every case of NDG disease; directly and indirectly toxic to the microglia
  • Infections triggers are strong components of NDG disease
  • Examples: Mycoplasma, Chlamydia, Borrelia, Listeria, HSV-1, HSV-2, HHV-6, EBV, VZV, H Pylori, Porphyromonas, and others play a role in NDG disease
  • Lots of viruses associated with NDG disease
  • A 2018 study found gut microbes in the brain post mortem
  • Studies asked the question if Alzheimer's is contagious?  Neurosurgeons and caregivers had higher risks for getting the condition themselves; neurosurgeons die from the condition at 2.5 times higher rate
  • What's fermenting in our brain? HSV-1, HHV-6, HHV-7, Chlamydia, Candida, Porphyromonas, Mycoplasma, fungi
  • Infections have been associated with Parkinson's disease; connections to H1N1, influenza, Herpes, fungi, and microbiome
  • Patient survived COVID but developed NDG disease and was later diagnosed with a prion disease
  • SARS-CoV-2 antibodies react with 28 out of 55 human tissues in study with Vojdani and Kharrazian; worst were mitochondria, brain, gut membrane, BBB, thyroid, skin, connective tissue, heart, and lungs
  • COVID may lead to more autoimmune and more NDG disease
  • Social isolation as during the pandemic also plays a negative role in human health; impacts pre-frontal cortex, hippocampus, and amygdala
  • Almost all of her Bredesen patients have declined this year due to social isolation and life becoming routine
  • Her cases continue to become more complex than she has seen in 30 years
  • Multi-Hit and Hit and Run Hypothesis: one thing after another; lifestyle, diet, environmental toxins, viruses, mold, Lyme, etc.; massive NDG by the time that patients come to her; easier to see on NeuroQuant than standard MRI
  • With NDG disease, there is not one minute to lose; have to do everything right and can then stabilize the conditions when root causes have been addressed
  • Risk factors for NDG: microbiome, D deficiency, obesity, smoking, metals, air pollution, EMFs, vascular disease, stress, low IgG, brain injury, chemicals, electric shock, infections, BMAA
  • MS is linked to gut dysfunction
  • Butyrate supports the microglia and myelination
  • Parkinson's disease begins in the gut; gut creates alpha-synuclein which deposits as protein misfolding and Lewy bodies
  • The brain is very vulnerable to EMF; children are even more susceptible
  • Electrical workers have a higher risk of developing ALS
  • Military veterans have a 60% higher risk of ALS; 500,000 came back sicker than when they left; included weaponized Mycoplasma and mycotoxins
  • Air pollution is a risk factor for NDG disease
  • Alzheimer's disease has been shown to begin in some around age 20
  • Repetitive head trauma is a risk factor for NDG; professional athletes die from ALS at higher rates
  • Living around some rivers, lakes, and ocean can expose to neurotoxin BMAA; 25 times higher risk of ALS at Lake Mascoma in New Hampshire
  • Prisoners in Huntsville, TX had higher levels of ALS related to Mycoplasma; used in experiments; spread to guards and families in East Texas; area with higher NDG disease rates
  • Exposure to smoking, obesity, and low Vitamin D increase risk for MS in young people
  • We live in an aluminum world; a neurotoxin
  • Lake Shasta has 25,000 times the amount of aluminum considered safe
  • Working in fields with pesticides leads to higher risk for NDG disease
  • Stress is a driver of chronic neuroinflammation and activated microglia
  • Transgenerational emotional trauma plays a role; sees often in children with PANS/PANDAS; trauma travels
  • Dyslipidemia and vascular disease is a risk factor for Alzheimer's
  • Women with MS are at significantly higher risk for heart attack or stoke; study of 12K MS patients; when peripheral vessels are inflamed, the brain's vessels are inflamed; what is driving vascular disease?
  • 1 in 3 Americans are obese; 1 in 5 children
  • Blood-brain barrier regulates what goes in and what goes out
  • Magnesium, B1, B6, B12, glutamine important for brain health; reduce systemic inflammation, health the gut, reduce neuroinflammation
  • White matter degeneration is profound; appears years before seeing atrophy on MRI; can be a red flag that there is something that we need to be addressing
  • Addressing neglected white matter: heal the BBB, avoid brain injury, avoid hypoxia, sleep disorders, nocturnal hypoxia, check pulse pressure, reduce microglial activation
  • Might treat Alzheimer's in the future with MS drugs that rebalance the immune system
  • In 30 years in practice, has never seen anything so disturbing as PANS/PANDAS; acute onset OCD, depression, anxiety, loss of cognitive skills, tics, bed-wetting; 1 in 200 children; molecular mimicry, infectious triggers, and high neuronal antibodies
  • All disease begins in the gut and the nose; study found pockets of inflammatory T cells in the sinuses and surrounding tissues that can enter into the brain
  • Strep is a contributor, but there are multiple factors involved in PANDAS/PANS; pathogens and environmental factors
  • In adults with ADHD, found high levels of neuronal antibodies and strep; ADHD is an autoimmune encephalopathy 
  • CFS, OCD, mood disorders, Schizophrenia and Bipolar may all be immune-mediated; psychiatrists will need to understand this
  • NeuroQuant is not commonly known; MRI is the tip of the iceberg; NeuroQuant dives deep under the surface; MRI will find issues when it is too late
  • NeuroQuant reports she uses: Age Related Atrophy, Triage Brain Atrophy, LesionQuant, and General Morphology; 10 minutes, $275, no gadolinium; like looking in the looking glass; do not want to see red/atrophy or blue/neuroinflammation
  • Cunningham Panel is 5 neuronal antibodies; extraordinarily helpful in children with PANS/PANDAS (and in adults)
  • If the house is on fire from neuroinflammation that is allowed to burn, by tomorrow, the house will be ashes; we have to control the neuroinflammation
  • Have to look at environmental factors such as mold and air pollution; explore Cell Danger Response
  • Healing the brain: diet, healing the gut, sleep, exercise (raises BDNF), detox, control glucose/insulin, hormone balance, lower homocysteine, and reduce EMFs
  • Valter Longo Fasting Mimicking Diet; ketogenic diets; Prolon; studies in MS are impressive; data supports reduction of inflammation, immune reset; Ketogenic diets not good for ALS
  • Healing the vagus nerve is key to recovering health; the heart-brain connection is powerful; HeartMath is a great tool that is easier for people to implement
  • Meditation can improve gray matter, reduce stress, help brain function
  • Resisting anger rewires the brain to be calmer and more loving
  • Excited about energy medicine and quantum healing tools; Healy, Alpha-Stim, PEMF, acupuncture, human touch, music therapy, BioCharger, Focused Life Force Energy
  • Healing the brain: Omega-3, D-Ribose, CoQ10, D, PS/PC, magnesium threonate
  • Flavonoids can reduce inflammation: curcumin, ECGC, Luteolin, Quercetin, Scutellaria 
  • Loves Ashwaganda and Whole Fruit Coffee Extract (WFCE; boosts BDNF), Lions Mane (NGF)
  • Improve the immune terrain: LDN, IVIG, CBD, pro-resolving mediators, peptides
  • NAC and Quercetin can decrease TH17 and increase Th1
  • VIP, Synapsin, Cerebolysin can help with brain healing
  • Likes NanoVi to create healthy ROS; sends a signal for cellular repair
  • Photomodulation can assist in brain recovery and repair; mitochondrial function; may improve brain immune cell response
  • VieLight NeuroGamma has been excellent for cognitive issues
  • Low Laser Light Therapies may help promote neuroprotection
  • Nature in inexpensive and has healing power; we are the indoor generation which is terrible for health
  • Every program needs a protocol for neuroplasticity; BrainHQ and many other tools can be helpful; just like exercise; EndeavorRX is the first FDA approved brain game for ADHD
  • From Q&A discussion
    • Two biggest mimickers in MS are Lyme and mold; mold destroys the immune system and is the biggest bad-guy in the room
    • Valtrex was studied in Alzheimer's patients for viral contributors; need to help the immune system; antiviral support may be helpful in these protocols
    • CoreTechs Lab that does NeuroQuant has a COVID software that may be helpful in those with long-haul COVID
    • Methylene blue may hold promise for neuro-regeneration; being explored in the Bredesen realm
    • Treatment-resistant depression is common in MS patients; chronic neuro-inflammation causes demyelination and sparking the fire for neuropsychiatric symptoms
    • Hormone replacement therapy can be helpful unless there are risk factors; losing trophic factors after menopause are part of why women have more Alzheimer's
    • Autoimmune encephalopathy may present before NDG; Mayo AE Panel; Cunningham Panel; NeuralZoomer; NeuroQuant; we all have some blood-brain barrier impairments; IVIG can be a game changer
    • Ketamine can be healing for the brain; it is not just an experience; psychedelics may help those that have bee refractory to other treatments
    • Chronic use of Adderall may be toxic to the brain over time; treat ADHD as an immune-driven disease
    • Patients are in a Cell Danger Response; have to find the drivers and turn off the CDR
    • Checks for Strep antibodies (ASO/Anti-DNase) in adults with autoimmune encephalopathy; may be contributors to neuroinflammation
    • HBOT can be helpful in PANS/PANDAS and others with NDG disease
    • Mindfulness practices are hugely important in NDG disease; should be a part of most or all protocols
    • EWOT has been found helpful in Dr. Bredesen's work
  • SuzanneGazdaMD.com

Stephen Porges, PhD had a conversation with Neil Nathan, MD on "Redefining Integrative Medicine Through the Lens of the Polyvagal Theory" and shared:

  • Polyvagal theory is that our physiological state is an intervening variable; if our autonomic nervous system is calm, we react to the world in a different way than if our ANS is highly aroused/sympathetic; and in a different way when we are in a withdrawn/disassociated/shutting down state
  • The three states: calm, mobilized/fight/flight, dissociated/shutting down represent how the ANS evolved; we evolved with three different neural circuits; the newest is the calming system, ability to socialize to regulate our ANS is how mammals have thrived and survived; when ANS detects threat; we lose sociality and disrupt neural regulation of our homeostatic processes
  • If ANS is not calm/safe, you will have mental health and physical health disorders; end organs will be dysfunctional due to the improper regulation of the ANS
  • Dr. Nathan noted that the polyvagal system and limbic system are connected and are involved in the vast majority of patients that he sees
  • It is the body's surveillance and survival system; feelings of lack of security or trust, we autonomically react; the body is shifting state to deal with threat
  • All vertebrates react to treat; mammals have a safety system that will constrain or choreograph the rest of the body; we can use cues of safety to regulate our physiology
  • The patient's issues will always have a manifestation in the ANS; most of the issues are linked to the body detecting cues of threat and shifting state
  • Medical profession sees this as psychological, but it is actually neurological
  • Patients may have anxiety/OCD but also gastrointestinal problems; ANS is tuned to detect and react to threat which impacts regulation of visceral organs; it is one system
  • Dr. Nathan calls it "rebooting"; Dr. Porges calls it "different portals"; the information is moving in both directions and wants to honor the movement of the information
  • Vagus nerve is 80% sensory and 20% motor; it is taking in information and processing; it is our surveillance system of the visceral organs
  • In medical school, no time is given to the afferent limb of the vagus nerve; not even discussed
  • The organs are not separate from the nervous system; many are focused on the end organ and not the neural regulation
  • Dr. Nathan finds that many patients have seen many physicians first, and most have been told their condition is in their head; creating an iatrogenic PTSD process; the medical profession is not appreciating what is being done to patients
  • Do physicians understand feedback loops?  No, most understand levels, but not feedback loops where the brain is involved in the regulation of the organs.  Do they understand variability of the signals they are looking at?  No.  It is a simplistic view; if deficient, put something in which is presumed to work as well as endogenous production of the same molecules
  • Voice is often not given to the patient and is marginalization and trauma; the issue is not retribution; the issue is being heard and having presence; patients want someone to listen or be a witness
  • In the medical system, a diagnosis is given without treatment; medically-unexplained symptoms
  • Often, patients are transformed through the process of feeling safe and the practitioner becoming a co-regulator of the patient's ANS
  • The medical world has become a threat to the patients who are going to them for care
  • Dr. Nathan noted that one of the biggest challenges is that the profession likes one cause -> one diagnosis -> one treatment; illness is complicated and multi-factorial
  • Dr. Naviaux has discovered there are complicated biochemical interactions that are not linear; Dr. Nathan takes a complex methylation diagram and then balls it up to illustrate how it might really work and interact; the entire field of medicine is complexity
  • The autonomic nervous system has state changes just like water being a solid, liquid, or gas
  • If the body is in a safer state, it will be more efficient in how it metabolized what is given to it
  • When you give food to people that are frightened, it is not metabolized in the same way; the body requires feeling safe in order to have efficient digestion
  • We have become so disembodied that we lack the capacity to listen to our own bodies; practitioners listening empowers patients to become reembodied and has healing power
  • If a cell threatened, it is in survival mode and cannot respond to treatment that should work until fear is removed
  • Bacteria follow polyvagal theory; when things are good, they reproduce/socialize/interact/prosper; when things are bad, they go into defensive mode/hunker down; when things are life-threatening, they implode
  • The rules of polyvagal theory are the rules of living systems
  • The current model does not allow for the patient to be heard and to feel safe
  • Medicine is not a vending machine; many have gone into medicine to serve; many physician's that are retiring are frustrated and angry that their profession was taken from them
  • The pressure is there to do something different than what individuals need
  • The job of the clinician is to allow patients to become accessible; build mutual trust; physiological, the patient is shifting in front of your eyes
  • The upper-part of the face is where we get the connectedness that the nervous system requires
  • In some cases, telemedicine has the benefit of the patient being in the environment where they feel safe and less triggered
  • Dr. Nathan noted that the term PTSD was originally a reference to severe trauma in the armed forces; PTSD has evolved to understand that any interaction that produces trauma has residual and profound psychological effects; COVID is a global PTSD
  • PTSD and ACEs are externally focused; this dishonors the individual's responses; mild events can be re-tuners of our physiology and mental state that lead to changes that can last forever
  • Polyvagal helps to create a human narrative that emphasizes feelings and not events
  • What would the world be like if we have the notion of feeling embodied; institutions disembody us
  • What happens when people feel empowered to create and to solve complex problems?
  • Dr. Nathan shared that how we react to any event is a personal things in the context of each person's experience; an accumulation of negative events can set the thermostat of the nervous system
  • Uses a questionnaire to get insight into a person's autonomic state
  • The response to an event is related to the resilience of the ANS; retune the client to give back resilience; you do not need to talk about the insult, but rather work on improving resilience
  • ANS has shifted from safety and calmness to always reactive because the threat is always there or could be coming at any moment
  • Black Lives Matter is voice to express the fragility of challenge and threat that we need to be respectful; they need a voice; we need to listen
  • The presence of another safe mammal (dog, cat, human) allows us to feel safe, to sleep, to rest, to digest
  • How do we give cues of safety to the nervous system?  Intonation of vocalization becomes powerful; a melodic voice; a pet-directed voice; a mother/infant voice; certain frequencies in the acoustic realm the body cannot deny; the distilled essence of trust in specific modulations and vocalizations; based in the physics of our middle-ear structures; as mammals evolved from reptiles, mammals were able to hear vocalization that reptiles could not hear; frequency band of socialization
  • He created vocal music run through computer algorithms to increase the modulation of frequencies in the social communication range; Safe and Sound Protocol; frequency bands are compressed and become tighter; becomes more difficult to hear the words which is to feel loss of contact; when the voice comes back, you get a feeling of exuberation and engagement; in children with ASD or language delays, the effects have become profound
  • If middle-ear muscles are not working, we become attune to background sound and have hypersensitivity but are hyposensitive to human voice; lose the ability to extract voice
  • Safe and Sound Protocol can be helpful in those with trauma histories
  • Safe and Sound Protocol is an acoustic vagal nerve stimulator
  • The body has to welcome the information; some can feel de-stabilized initially
  • Dr. Nathan noted that if someone is exquisitely sound-sensitive, he might start with cranial-sacral work to quiet the system and later use the auditory approaches
  • Hearing sensitivity may be re-tuning of the apparatus to detect predator sounds; the body is doing a great job detecting predator, but there may not be a predator here; find the cues of safety to enable the body to calm down
  • Dr. Nathan noted that it is about safety, how we perceive safety; any medical provider needs to be aware that these issues are present in every person they interact with to some extent; taking the status of the vagus nerve into account as part of a treatment strategy is absolutely essential; have to honor each person's way of dealing with the universe
  • Intonation of voice is regulated by the vagus nerve as well; modulated voice reflects a calm and safe physiological state; voice is a projection of heart
  • Chinese word for listening is heart, ear, focus, and brain; it is the whole social engagement system when written with Chinese characters
  • Listening is not hearing; listening is affected by the autonomic nervous system
  • The area of the brainstem that is regulating the heart and the gut and pulling information into the brainstem also regulates the striated muscles in the face and head; therapists become more astute when looking at upper face and detecting intonation of voice
  • The stapedius muscle that regulates our ability to hear and listen is innervated by the 7th cranial nerve which connects into the brainstem at the nucleus ambiguus which is where the vagus nerve comes out; the trigeminal connects there as well; the sensory part is the major inputs into the nucleus ambiguus that regulates the new mammalian vagus; sensory part of the trigeminal nerve is below the forehead; rubbing the forehead or using devices in this realm also has an impact on the vagus nerve
  • Lessons learned from the pandemic: what is the most important things for our survival?  Interactions with others.  It is not personal wealth or accumulation of stuff that the body wants to be successful; we want relationships and to co-regulate with others
  • From Q&A discussion
    • How do you define compassion vs. empathy and not react to the cues of others while being supportive and understanding; requires a sense of responsibility of witnessing not fixing; do not disrespect the person's nervous system's ability to normalize by jumping into fixing; be a good witness
    • We want to be connected and experience connection; when we feel connected, we can solve virtually any problem; connection is a biological imperative for the survival of the species
    • In working with young children, predictability in the environment is seen as safety by the nervous system; a roller-coaster is like jumping out of a 10-story window but is in the confines of what is considered safe; as we become better listeners, we become more present with our children; listening vs. directing/fixing
    • We were gifted with the ventral vagal circuit that allows us to adaptively turn off defenses; mammals uniquely detect safety; we need to impose safety into our world; shift the nervous system from threat to safety
    • Mammals evolved with newer circuits; when we are under threat, we used the older circuits that are more self-oriented and defensive
    • His dream is that we shift medicine from evaluation to a shared journey about learning about our bodies; rather than diagnosis, we explore potential; we need to learn what the body is doing and why and deconstruct the responses; the body is doing exactly what it evolved to do; to keep us alive and protect us; at times, the body over-reacts with defensiveness; the root is keeping the body out of a state of threat; a "diagnosis" can be life limiting and the body reacts as though it has been threatened when it is often doing good things once understood
    • Certain cultures that are less social may on the surface appear to have less connection and thus more defense/threat, but it is important to explore the public vs. personal/private expressiveness
    • Dysautonomia is a nervous system that can no longer support growth and regulation; need to allow the autonomic nervous system to go back into homeostasis; many attributes of disease can self-heal 
  • StephenPorges.com

Ty Vincent, MD spoke on "Immune and Inflammatory Applications of Low Dose Immunotherapy" and shared:

  • Has done a number of LDI educational videos on his YouTube channel
  • Mixture lists are on his website
  • Any disease process that involves an immune or inflammatory reaction could be a good candidate for LDI
  • LDI may stop hypersensitivity reactions; may work for allergy, autoimmunity, inflammatory conditions
  • Must identify the correct antigen and dilution
  • Effective dose is given every 7 weeks with adjustments
  • Lyme disease LDI has been used for 7 years with good success; chronic infections are often an immunological process; may work better than antimicrobial approaches
  • Over time, the duration between each dose increases and in some, becomes unnecessary
  • A thorough interview and careful questioning helps to determine the best path forward
  • Prior successful interventions can often enlighten him to the LDI mixtures to consider
  • Many chronically ill patients have developed an "allergy" or hypersensitivity to Candida
  • Used to use antigens one by one, but over time has cast a broader net and used more antigens earlier on to decrease the time required to benefit from the treatment
  • Want to see an antigen dose that eliminates the symptoms 100% for at least 4 weeks or longer; and lengthen over time
  • Having a baby is an immunological shake-up and catalyst for the development of immune phenomenon
  • Skin conditions: symptoms are objective, most rooted in immune response process, sometimes the antigen is on the skin surface and other times it is internal; can reset the incorrect immune response without using tools that may be detrimental to the immune system
  • SF-B for bacterial issues; pustular lesions, boils, Hidradenitis suppurativa, Impetigo, stys, MRSA, otitis externa, some eczema
  • Impetigo can be related to Staph/Strep which everyone has; but not everyone gets Impetigo
  • SF-F for fungal issues; psoriasis, Athlete's foot, dandruff, tinea, jock itch, seborrheic dermatitis; scaly, flaky, itchy
  • Psoriasis will worsen with steroids after you stop; if a condition temporarily responds to steroids or worsens, it is usually a fungal antigen; the fungi will start to replicate; appears more commonly in areas with broken down skin
  • Autoimmune Skin Disorders
    • Vitiligo: H Pylori, Yersinia
    • Alopecia areata: H Pylori
    • Pyoderma Gangrenosum: Yeast
    • Pemphigus Vulgaris: SF-B
    • Psoriasis: SF-F
  • Sarcoidosis is related to Mycobacteria; always responds to the same mixture; if you don't change your showerhead every 6 months, you will inhale Mycobacteria
  • Herpetic conditions like HSV-1 and HSV-2 with cold sores, genital herpes, trigeminal neuralgia, nerve pain; Varicella can cause shingles, post-herpetic neuralgia, Ramsay-Hunt Syndrome
  • Inflammatory Arthritis
    • RA: Proteus (90%) or oral flora
    • Ankylosing Spondylitis: Klebsiella
    • Reiter's Syndrome: Chlamydia
    • Others: UTI mix, Lyme mix, Foods, Yeast, GI flora, Strep, autologous
  • Osteoarthritis
    • Not always wear and tear
    • Why don't all athletes get it?
    • Collagen LDI works well 
    • May be a true "autoimmune" condition not due to cross-reactivity with a microbe
  • Chemical/Metal/EMF Sensitivity
    • Chemical mix
    • Metal and EMF sensitivity respond to the chemical mix
    • Great majority of EMF sensitivity resolves with the LDI chemical mixture
    • Heavy metal toxicity is a separate issue from the immune process that may be helped with LDI
    • Latex, food colors, and MSG (though seems to be more of a biological issue than immune response) are isolated LDI mixes
  • Corn allergy is one of the worst allergies to have; can have airborne reactions; can have devastating symptoms when other food reactions are minor; getting corn reactions under control first often resolve other food allergies
  • IBD: tricky, complicated, multi-factorial; may have non-immune factors; 60-75% success
  • In some cases, the LDI dose units need to be increased in addition to adjusting the antigen and dilution
  • People often need more than one antigen mixture
  • Lyme disease is incorrectly seen as an infection; it is an immune response to the organism
  • People may feel better with antimicrobials but symptoms return when they are stopped; the organisms may be part of the biome and may not be possible to eradicate; aberrant immune-response is the issue
  • Interstitial Cystitis
    • Similar to Irritable Bowel Disease; this is Irritable Bladder Disease
    • Conventional medicine has no solutions
    • Responds well to LDI in majority of cases
    • Antigens: Yeast, UTI, Foods, Autologous
    • Endometriosis is a common co-condition
  • From Q&A discussion
    • In genetic EDS, there is an inability to properly make collagen; not immune-related and not likely to be fixed with LDI; could try the collagen LDI
    • In acquired EDS, finding the right antigen often leads to the condition self-correcting; it is related to inflammation
    • In those with vaccine-related issues, it has not been the vaccine antigens that were helpful in improving things; Borrelia or Candida or foods LDIs may be what helps those that developed issues after a vaccine
    • Narcolepsy is an autoimmune response often to influenza
    • SIBO is a secondary phenomenon in most people; when primary, antibiotics may work; vast majority have an immune tolerance issue to an organism in the normal ecosystem; Yeast LDI is the most common
    • Provocation Neutralization can also work for antigens; requires injections every couple of days; more involved and costly; LDI needed only every 7 weeks
    • LDI cannot give someone a new problem; you could give too strong of a dilution of an antigen they are reacting to and this could lead to a flare or increase in symptoms for a period of time
    • Negative effects of LDI is an indication that the right antigen is being used but at the wrong dilution
    • Post-COVID people may respond to a viral (URI) mixture that includes one strain of Coronavirus; some may have a response to Lyme or Yeast LDI
    • For kids on the autism spectrum, LDI has about a 40% response rate; some respond amazingly and become neuro-typical; some do not respond to any of the antigens; now combines a number of antigens that may impact neuroinflammation to evaluate quickly whether or not it will work for them; continuing to explore new options to support these kids
    • Immunological drugs or biologics can be used while using LDI
    • Has seen reversal of Osteoarthritis after LDI
    • LDI does not require the beta-glucuronidase enzyme that was used in EPD/LDA; effectiveness is the same
    • Some people with Vitiligo have regained pigmentation after using LDI  
    • Can LDI teach the immune system to let the bugs overgrow?  LDI only affects hypersensitivity or allergy part of the immune system; it has no negative impact on the immune defense; LDI is about tolerance
    • Has used Yeast LDI since 2009 and not seen any users developed yeast overgrowths
    • Borrelia is not a pathogen; Candida is
    • For Lyme patients, recommends LDI as a standalone and not treating with antimicrobials 
    • In mold illness, LDI can help with mold allergy but is not intended to be used or helpful for mold biotoxin illness
    • For MCAS, he created an LDI antigen for histamine where the immune system may be intolerant to histamine; in 20+ people, the histamine LDI did not work; has had success going back into their history to find reactions and then use LDI for earlier antigens; if you get the core upstream allergies under control, the rest of it often goes away
    • His personal mission is to find the antigen that can solve Type 1 Diabetes 
  • GlobalImmunotherapy.com 

Beth O'Hara, FN spoke on "Precision Mycotoxin Detoxification for Sensitive Patients and Those with Mast Cell Activation Syndrome" and shared:

  • Her family moved into an old farmhouse when she was 7; ongoing mold exposure, Lyme, Bartonella, Babesia
  • Scratched her skin until she bled from hives; head injury when she was 9; had a full medical school scholarship in neurology which she had to decline due to her own health; became a chronically ill patient instead
  • Did the whole traditional and holistic medicine circuit and tried therapy, homeopathy, Shamanism; a few things helped; most backfired; could not tolerate a sprinkle of quercetin or curcumin; severe insomnia; told she was crazy and it was all in her head; that she was attached to being sick
  • Eventually started piecing things together after 50 practitioners and the best functional medicine doctor in her area had no other ideas
  • She ultimately went from bedridden and using a cane at age 28 to being fully functional today and helping others regain their health
  • Super-sensitive people have trouble taking anything; feel like they are hanging off the edge of the cliff
  • Important to address mycotoxins first in recovery
  • Mast cells are interrelated to other cells of the immune system
  • Mast cells impact the nervous system; every nerve ending in the body has mast cells
  • Nervous system and mast cells are in constant communication
  • Working with sensitive patients with toxicity and mast cell activation needs to consider the nervous system
  • Mycotoxins impact the nervous system directly
  • You cannot separate the psychological, neurological, and endocrine when exploring the immune system
  • Cell danger response includes an increase of mast cell activity
  • People with sensitivities may react poorly to PC too early, methylation too early, P5P too early, low carb, metal detox before mold treatment, antimicrobials before mold is addressed, mitochondrial support too early; these work against the protective cell danger response
  • Mold is on the bottom of the pyramid, then Lyme, then nervous system dysregulation, MCAS, CDR, and many others that layer on top like SIBO, parasites, metals; have to address the foundation first
  • Addressing mold may help to resolve a number of other issues that don't then require specific treatment 
  • When mold is not addressed, it is hard to address the numerous other factors
  • Patients often want to jump to treating their specific issues like Lyme or SIBO when they need to address the foundation first
  • Precision Mycotoxin Detoxification
    • Urine mycotoxin testing has to be done slowly with glutathione challenge; don't push through feeling worse
    • Many with MCAS don't tolerate heat/sweating; sauna is not an ideal provocation for many; lymphatic drainage could be helpful; massage not ideal with hypermobility or EDS
    • Some sensitive patients will be unable to provoke the urine mycotoxin testing; results will be tip of the iceberg
    • With more sensitive patients, most detox protocols are too aggressive; constipation addressed first; personalized binders; do not push through Herxes; start with micro-dosing; address detox phases in the right order
  • Mold Detox Stages
    • Identify mycotoxins
    • Nervous system support
    • Low histamine/low lectin diet trial
    • Elimination; address constipation and water consumption
    • Support mast cells
    • Target binders
    • Support detox pathways
    • Antifungals
    • Biofilm busters
  • 95% of the people in her practice are dealing with mold illness
  • Trauma history matters in these patients; including intergenerational trauma
  • Many factors drive the CDR
  • Starts with most people with supporting the nervous system
  • Everyone is different in terms of what the focus of treatment may need to be
  • Sensitive patients rarely tolerate medications or supplements
  • Mast cells are found in the limbic system and at nerve endings; affect behavior in avoiding toxins, allergens, response to stress; involved in anxiety, depression, pain, migraines
  • Nervous system dysregulation may include: startling, weak/strong gag reflex, trouble sleeping, waking tired, wired and tired, wired after conversation, stressed with change, anxiety, depression, loss of intestinal motility (chronic constipation or diarrhea), high/low blood pressure, light/sound sensitivity, supplement reactions, history of Lyme, chemical sensitivities, food reactions, MCAS, EMF sensitivity, mold sensitivity, autoimmunity
  • Nervous system dysregulation is involved in POTS, autoimmunity, gut motility, neuropathy, tinnitus, Complex Regional Pain Syndrome, EDS, Fibromyalgia, CFS/ME, IBS
  • Rewiring Nervous System: work on limbic and vagal nerve together; Gupta or DNRS for limbic system; Safe and Sound, BrainTap, FSM, EFT, Qigong for vagus nerve; vagal structural issues may benefit from Rosenberg exercises, upper cervical chiropractic, craniosacral, osteopathic
  • Over 60% of her clients had early childhood trauma
  • Trauma work may be needed with somatic therapy, body work, Parts Work Therapy, EMDR, Acceptance and Commitment Therapy, medications, IV Ketamine
  • Frequently missed high histamine foods: aged beef, ground meats, thawed meat, leftovers, yogurt, fish, cinnamon, cloves, nutmeg
  • Mast Cell Supplements for Sensitive People: Perilla Seed, Quercetin, Neuroprotek LP, Baicalin, DAO, Vitamin A as Retinyl Acetate or Beta-Carotene, Baking Soda in water, D3/K2, Pro-Resolving Mediators, Adrenal Cortex; medications: Cromolyn, Ketotifen, H1/H2 blockers, Hydroxyzine
  • MCAS triggering additives: carrageenan, citric acid, sodium benzoate, potassium sorbate, guar gum, xanthan gum, citrus oils
  • Slow is Fast, but Fast is Slow in those with sensitivities  
  • Don't push through treatments; you can overdo and trigger a mast cell cascade that could take weeks or months to resolve; can go from a spark to a forest fire
  • Researched-Based Targeted Binders
    • Aflatoxins: Activated Charcoal, Bentonite Clay, Chlorella, Propolmannan, Zeolite
    • Chaetoglobosin: Activated Charcoal(?), Bentonite Clay(?), Chlorella(?), CSM(?), NAC(?), Sacc B(?) Propolmannan
    • Enniatin B: Activated Charcoal, Bentonite Clay, Chlorella, Propolmannan
    • Gliotoxin: Bentonite Clay, NAC, Propolmannan, Sacc B
    • Ochratoxin: Activated Charcoal, CSM, Glucomannan, Welchol (better tolerated than CSM in sensitive people), Zeolite
    • Strigmatocystin: Activated Charcoal, Bentonite Clay, Chlorella, Propolmannan, Zeolites
    • Trichothecenes: Activated Charcoal, Bentonite Clay, Chlorella, Propolmannan, L. rhamnosus, Propionibacterium freudenreichii ssp shermanii ss
    • Zearalenone: Bentonite Clay, Propolmannan, Sacc B, Zeolite, L. rhamnosus
  • Activated Charcoal and Bentonite are better tolerated; Sacc B, Propolmannan, Glucomannan are somewhat tolerated; Chlorella, Welchol, Zeolite are better later; CSM not often tolerated
  • Phase 2 Pathways and Mycotoxins Processed
    • Vast majority are detoxified by Glucuronidation
    • Glutathione does not have a major role in mycotoxin detoxification
    • Amino Acid Conjugation: Ochratoxin A
    • Sulfation: DEO, T2-Toxin
    • Glutathione Conjugation: Aflatoxin B-1, Ochratoxin A
    • Methylation Conjugation: Alternariol, Fusarium, Zearalenone
    • Acetylation: DEO, Nivalenol, Riordin E, Verrucarin A
    • Glucuronidation: Alternariol, Mycophenolic Acid, Diacetoxyscirpenol, Aftlatoxin B-2(?), Ochratoxin, DEO, Riordin E, T2-Toxin, Zearalenone, Sterigmatocystin, Verrucarin A
    • Salicylates are detoxified via Glucuronidation, Sulfation, and Glycine; if the Glucuronidation pathway is overwhelmed with mold toxins, salicylate detox may be impaired; 20-25% of her patients; if they can't tolerate salicylates, they can't do herbals or tolerate most of the natural MCAS treatments
  • Phase II Pathway Supports
    • Amino Acid Conjugation Support: protein, Betaine HCl, digestive enzymes
    • Sulfation Support: animal proteins, legumes, caffeine, ginger, magnesium sulfate, sulfur-containing vegetables, retinoic acid
    • Glutathione Conjugation Support: ALA, artichoke, cruciferous vegetables, curcuminoids, folate, magnesium, silymarin, selenium, B6
    • Methylation Support: betaine, folate, magnesium, methionine, SAMe, B6, B12, zinc 
    • Acetylation Support: calcium pyruvate, pantothenic acid, pantetheine, acetylated supplements (S-Acetyl Glutathione, NAC, N-Acetyl-Glucosamine); N-Acetyl-Glucosamine can also help to stabilize mast cells
    • Glucuronidation Support: astaxanthin, calcium d-glucarate, dandelion, ellagic acid, pterostilbene, rosemary; by far, the most important phase II detox pathway; hormone detoxification, fat soluble nutrients, CBD/THC, 70% of medications, majority of mycotoxins; ensure binders and drainage support is on board; calcium d-glucarate generally tolerated even with salicylate intolerance
  • Antifungal Options
    • Silver sprays
    • Sinus antifungals
    • L. sakei can help sinus microbiome after antifungals
    • For gut, silvers, Biocidin, RX antifungals
  • Beta-glucuronidase reverses glucuronidation 
  • Magnesium citrate is high histamine
  • Ascorbic acid is from corn fermentation; Metabolic Maintenance product is a good option or Camu Camu
  • Important to use mold-free coffee with coffee enemas
  • From Q&A discussion
    • Propolmannan is Xymogen OptiFiber or Colon Protect; may need to start low in those with SIBO
    • Generally avoids combination products to minimize variables in sensitive patients; also difficult to work with proprietary blends where the amount of each item is not known
    • With high beta-glucuronidase, includes calcium d-glucarate to support
    • Functional medicine often starts with the gut, but mold needs to be addressed first in mold patients; mycotoxins will dysregulate the gut and very little will help without addressing the foundation of mold/mycotoxins
    • Propolmannan is a more refined version of glucomannan; both from konjac root
    • Has Mast Cell Nervous System Reboot course to help determine potential tools to implement
    • Low sulfur diet leads to feeling better for 3-4 months and then can later backfire; some improved with molybdenum or IV nutrient balancing
    • Magnesium oxide, ParaSym Plus, and vagal work can be helpful for constipation; Metabolic Maintenance Low Acid Vitamin C powder is low histamine; often finds vagal nerve impingement
    • Testing for MCAS/histamine is challenging; generally goes by symptoms and case history
    • Had some where she suspected mycotoxins but urine testing was negative; found MyMycoLab mycotoxin antibody testing helpful in those cases
    • Not everyone is able to or in the place to heal
    • Mold free coffee: Purity is a good option and organic
    • Tinnitus is common in mycotoxin illness and salicylate intolerance; need vagal nerve work or treatment for atlas sublaxations
    • Food sensitivity testing may be done through Vibrant or Precision Diagnostics (formerly Dunwoody)
  • MastCell360.com

Brian Karr and Corey Levy CMI, CIE, WELL AP spoke on "Developing a Testing Plan to Identify Hidden Mold in Any Building" and shared:

  • 3 concepts of microbial growth: food source, temperature, water; cannot control the first two; you have to water the seed for it to grow
  • Assessments are driven around water; once there was a water source, mold does not pack its bags when the water source stops; it acts like a weed in the yard; the weed stays and has to be pulled
  • Mold becomes dormant with no active water source; the colony will roll in and out of active stages with air humidity; removing water without removing mold can make the problem worse; mold spores and fragments are particulate matter
  • If you have old water events that dried, the fragments are so small that they bypass our body's natural filters and can get into the lungs, blood, etc.
  • Water that happened anytime in the history of the building is important
  • Can be liquid water, temperature differentials that lead to high relative humidity, condensation; all can allow for a variety of mold and other organisms to grow
  • Mold: spores are for reproduction; mycotoxins are for defense; mVOCs are for digestion
  • Bacteria: Actinomycetes are gram-positive and produce biotoxins; Endotoxins are components of gram-negative bacteria that she upon death of a bacteria
  • Bacteria grows within 24 hours of a water condition; molds 24-48 hours  
  • Mycotoxins flow and lay on top of molds as a defense; protects their food source and from different inspects; spores are ejected and wrapped in mycotoxins and move throughout the home
  • mVOCs have a musty, mildewy, earthy smell
  • We need to look further than just mold and consider bacteria and bacterial endotoxins as contributors to CIRS; mold is not the only culprit
  • Level 1 is the heating and air conditioning systems circulating things around; Level 2 is the building's structural components; Level 3 is the dust that has settled on surfaces and gets pushed back into the air in our breathing zone
  • Fixing one wall where a problem is may not resolve the problem; the house is all connected; the air flow has moved out from the wall, pulled into your HVAC system, and settling on surfaces; need a holistic plan to clean the entire house
  • A mold colony is like a factory; smoke is coming out of the top; that is what impacts us; we can clean the air, but the real solution is to shutdown the factory and address the smoke that came out of the factory previously
  • Sources are in walls, ceilings, and cabinets, but they infiltrate the entire home
  • Reasons to sample: to confirm sources of contamination, to understand dispersion, to write the remediation strategy, to understand potential exposure
  • Important to understand the history of the home and to do thorough testing to understand how widespread the problem is
  • There is no perfect samples, but there are samples that can be misleading
  • Misleading Sample Types
    • Ambient air samples, petri dishes or plates, HERTSMI-2
    • Ambient air sampling: snapshot in time, detects only spores, no source determination, 70% false negatives
    • Petri dishes or plates: settlement only, detects only spores, does not detect spores that cannot grow, volume of growth is misleading; different types of agar that different molds benefit from; it may not be the right food for all molds and lead to false negatives
    • HERTSMI-2: only 5 molds, scoring system can be misleading, data based on CIRS patients; ERMIs with multiple molds at high levels may show a HERTSMI-2 of 8 that suggests it is healthy; that may not be the case; panel is too small to give a full picture of the health of the house; better to do an ERMI and calculate HERSTSMI-2 but not miss the fuller picture
  • Acceptable Sample Types
    • Source Area Samples: targeted air; surface swab, tape, bulk
    • Targeted Air Samples: in a wall cavity 
    • Dispersion Samples: ERMI, mVOC, Actinobacteria
    • Biotoxin Samples: mycotoxins, endotoxins
    • All via dust sample collection except mVOC which is done with air
  • Goal-Based Sampling for Hypersensitivity
    • Renter: wants to stay (source, dispersion, biotoxin optional), wants to leave (source, dispersion optional, biotoxin optional), litigation (source, dispersion, biotoxin)
    • Homeowner: wants to stay (source, dispersion, biotoxin), wants to leave (dispersion, biotoxin)
    • Buying/Renting: finding a healthy home; Phase 1 is visual inspection; may then see enough problems to walk away or there appears to be a smaller issue; Phase 2 is dispersion and biotoxin testing; if a problem is confirmed, source testing is Phase 3
    • Insurance or Litigation: building a plan to maximize coverage
      • Cause: prove source in home
      • Effect: source is cross-contaminating living areas exposing occupants
      • Effect: Exposure is impacting health
      • Insurance (cause/source; effect/exposure; optional effect/health impact)
      • Litigation (cause/source; effect/exposure; effect/health impact)
    • Better to have the data before contacting insurance company or most will be told it is not covered
  • 80-100% of homes have water-damage
  • If HVAC has issues, $20K+ to replace
  • ERMI
    • ERMI will be the best home screening test for hypersensitivity
    • Strength: PCR, historical perspective, ultra-fine particles
    • Weakness: does not identify source, flaw in scoring system; don't just look at the score
    • Reviewed two examples of ERMI to show why they are not always an accurate picture
    • Sample A: < 1.3; group 1: 14.22; group 2: 15:52; high group 2 makes the total look good; group 2 does not mean they are OK that they are present, but they are simply more common; high levels still matter
    • Sample B: 1.29; group 1: 10.88; group 2: 9.59; sample A looks better, but actually has higher numbers of both group 1 and group 2 molds
    • They do not look at the score as it can be misleading
    • They look for how many mold types are present out of the 36 total; how many of the molds have the ability to produce mycotoxins?  How does it relate to the issues that person may be dealing with?
  • From Q&A discussion
    • RealTime EMMA is a great test; pairs with ERMI as the mold species are not the same; do both if possible
    • EnviroBiomics for bacterial testing like Actinomycetes
    • No sample is perfect; have to explore the environment holistically; looking at mold and bacteria
    • Actinomycetes may lead to lower mold levels through competitive inhibition in some cases
    • Have to get rid of the source; there is no fancy machine that will fix all of your problems; get rid of the factories and then bring in filters
    • There is no "mold free"; when looking for a new environment, do basic visual and smell tests and then ERMI, dispersion sampling, and potentially sources if there appears to be an issue
    • Mycotoxins cannot be killed; they are not living; spraying or fogging is not a solution; you have to stop the water and remediate the mold with wire-brushing, HEPA vacuuming, or removal of the damaged materials
    • If you could kill everything, the dead "things" are still there; people may feel better for 2-3 months after fogging, but the source is still present and they create an issue with ultrafine particulates 
    • Musty smell is a sign for mold but is not required for mold to be present
    • For crawlspaces, a difficult issue; remove top layer of dirt, poor slab, and condition is a better option; proper dehumidification, exterior drainage, resolving temperature differentials; another option is an encapsulant system that offgasses to outside; really important to control moisture; remediation is needed before the appropriate waterproofing system is put in place; crawlspaces will eventually have water issues; putting insulation directly against the foundation wall can be a major problem as it hits the insulation and traps it leading to mold growth behind the insulation
    • Mold inspectors commonly often develop serious health problems as a result of their work
  • YesWeInspect.com, MoldFindersMethod.com

Eboni Cornish, MD spoke on "Morgellons Disease: Infections vs. Delusions" and shared:

  • If you treat Lyme, you have likely seen a Morgellons patient
  • Morgellons M&Ms
    • Multiple infections: bacteria, parasites, viral, yeast, others
    • Mold Illness
    • Mast Cell Activation Syndrome / Histamine Intolerance
    • Multiple initiators of the Cell Danger Response
  • Need an integrative management approach with Morgellons and most chronic illnesses; functional-medicine approach
  • Morgellons is a Lyme-associated illness with slow healing, ulcerative lesions
  • Publications show it is associated with Lyme and relapsing fevers
  • Stinging, crawling sensations, non-healing wounds, colored fibers coming out of the skin
  • First discussed in 1643 with Sir Thomas Browne
  • Delusion is mental illness; these are not self-inflicted or textiles
  • Evidence shows these are caused by infection; fibers are biofibers
  • Neuropsychiatric symptoms can occur but it is secondary to the infection
  • Check: adrenals, metabolic status, inflammatory markers, gut, diet
  • Many do well on Autoimmune Paleo diet
  • Toxins and cytokines can cross the blood-brain barrier; leaky gut = leaky brain
  • Tryptophan can lead to quinolinic acid and glutamate; excitatory response, anxiety
  • Infections and Toxins
    • Vector borne disease, viruses, fungi, parasites
    • Biotoxins, heavy metals, environmental
    • Immunoglobulins
    • MCAS
    • Detoxification imbalances: OAT, NutrEval, methylation
    • Imaging like SPECT scans
  • Fibers are made of collagen and keratin
  • A link has been made between Morgellons and Lyme disease
  • Treat the Lyme and co-infections, yeast, anti-helminthics, and biofilms
  • Similar condition in cattle called Bovine Digital Dermatitis
  • Morgellons is not a living organism of its own
  • Filaments are hair like and have keratin and collagen; come from keratinocytes and fibroblasts
  • Treatment is similar to treating Lyme
  • Tick-Borne Relapsing Fever (TBRF) Borrelias have been associated with Morgellons
  • Co-infections: Babesia, Bartonella, Ehrlichia, RMSF, Mycoplasma
  • Methylene blue and Clotrimazole has been a game-changing combination in her Morgellons patients; was published for stationary stage Bartonella; Clotrimazole has been helpful for biotoxin illness
  • Worsening of skin symptoms can be a Morgellons Herxheimer
  • Biofilms are a component; consider Nattokinase, Lumbrokinase, Serrapeptase, Stevia, Beyond Balance MC-BFM, Lactoferrin, Interfase Plus
  • Some parasitic involvement with protozoa, nematodes, flukes
  • Fibers are not living; have not seen living parasites coming out of the skin
  • For parasites, may use Methylene Blue, Researched Nutritionals Artemisinin SOD, Allergy Research Artemisinin, Coartem, Researched Nutritional CryptoPlus, BioPure Cryptolepis, Atovaquone/Zithromax
  • Anti-parasitics can be helpful with Morgellons: Tindamax, Flagyl, Alinia, Ivermectin, Albenza, Biltricide, Mebendazole
  • Toxoplasma is something she has anecdotally seen in her patients commonly in her Lyme and Morgellons patients; can be tick-borne; can present with neuropsych symptoms
  • Has not seen Disulfiram be helpful in her Morgellons patients
  • Works with a number of combination treatment options that have been helpful with her Morgellons patients
  • Most important part of Mast Cell Activation is identifying the activators or triggers; patients usually have many
  • Morgellons patients have itching, prickly, tingling, reactions to foods and chemicals, MCAS treatment can improve things notably and also improves sleep
  • Treatment for MCAS includes: histamine lowering probiotics, low histamine diet trial, herbs and prescriptions; support the nervous system; identify the cause; look for food allergies, infections, and environmental toxins; ascorbic acid, quercetin, B6/P5P, Omega 3, luteolin, NAC, Montelukast, Cromolyn, Ketotifen (very helpful and can help improve sleep)
  • Environmental toxins can play a role; biotoxins; balance treatment of infections and toxins; detoxification pathways have to be opened
  • Herxheimer responses in Morgellons patients can be debilitating
  • Urine mycotoxin testing can be very helpful; often sees Chaetoglobosin A which is associated with neurological function and skin lesions; some have seen lesions improve with treatment of Chaetoglobosin A
  • Biotoxin illness treatment: mold remediation, nasal antifungals, systemic antifungals, diet, supplements, binders, liver and gallbladder support
  • Morgellons patients will not improve without addressing mold if that is a part of their condition
  • Clinical Exam
    • Need 200X electronic microscope to examine patient for fibers
    • Comprehensive physical exam
    • Cardiovascular and Autonomic Dysfunction
    • Comprehensive ENT evaluation
    • Dental evaluation with biological dentist
  • Dental should be a cornerstone of the evaluation in Morgellons patients; looking for cavitations and parasites
  • Brain imaging could include structural (CT, MRI) or functional (fMRI, PET, SPECT)
  • Works with 33 psychiatrists around the world looking into root causes of neuropsychiatric conditions
  • SPECT looks at brain blood flow and activity; easy to understand; areas of brain that work well; don't work hard enough; work too hard
  • In Lyme on SPECT, see hypoperfusion (low blood flow), scalloping, toxic/unhealthy; also see a pattern that is not scalloped but have excessive limbic system activity/inflammation; limbic system may be on fire
  • There is not a "Lyme" pattern as other conditions can cause similar patterns; they can see the level of inflammation and monitor before and after treatment
  • SPECT underscores the need to reduce inflammation, understand potential toxic or infectious contributors, demonstrate the need for limbic system work
  • From Q&A discussion
    • Seeking Health Probiota HistaminX and Master Supplements TruBifido can help to lower histamine
    • A high number of her patients with Morgellons have Bartonella and respond well to Bartonella protocols
    • H. pylori has also been shown to be associated with Morgellons
    • Morgellons is where Lyme disease was 20 years ago
    • The majority of her patients with Morgellons also have exposure to a water-damaged building; at least 70% have biotoxin illness
    • Marianne Middleveen is accepting Morgellons samples for ongoing research
    • Amen Clinics has multiple functional medicine doctors on staff; it is critical to explore neuropsych conditions from a functional medicine perspective
    • Infections have been found in the skin lesions of patients with Morgellons; Bartonella, H. pylori, TBRF Borrelias
    • At present, there is no evidence to suggest that Morgellons is contagious; there have been some family members with the condition, but they are also in the same environment
    • Over time, has found food elimination diets more helpful than food allergy testing; KBMO FIT test has been helpful
    • The majority of her patients do improve with treatment
  • AmenClinics.com

Datis Kharrazian, PhD, DHSc, DC, MS, MMSc spoke on "The Role of Neuroinflammation in Chronic Disease" and shared:

  • Neuroinflammation or primed glial cells is a commonly overlooked issue; even in functional medicine communities
  • Primed glial cells are produced by something that causes significant inflammation in the brain, and the glial cells permanently change and become sensitive to inflammation for the rest of the person's life
  • Symptoms may include: episodes of not being able to think or focus, episodes of dizziness or vertigo, episodes where an entire side of the body becomes numb
  • Traumatic brain injury can be a trigger for glial cell priming
  • Glial cells become active when there is systemic inflammation
  • Some may trigger their brain shutting down by eating allergic foods; others may have cerebellum injury
  • The cells become primed and are often involved in the complex patient that has a disproportionate response to inflammation
  • Research on chronic traumatic encephalopathy shows that once you hit your head, there can be permanent changes to the glial cells in the brain; particularly if you lose consciousness; the person is susceptible to inflammation for the rest of their life
  • Patterns of priming may take 5-7 years after the injury; need to revisit the timeline for head injury; manifestations of a trauma may show up many years later
  • Glia means "glue"; were thought to "glue" cells together
  • In total volume, 2/3 of the bran are glial cells; 1/3 are neurons; glial cells are immune cells
  • Microglia are the concern with glial priming; normally scavenging and removing debris; body has to clear out protein aggregates like beta-amyloid, alpha-synuclein, and Lewy bodies
  • In a healthy brain, microglia keep the brain healthy; without debris removal, synapses cannot activate neurons which leads to brain atrophy
  • Astrocytes are another glial cell; involved in glutamate and GABA; maintains integrity of blood-brain barrier; many have leaky brain (as common as leaky gut); can make an impact on brain inflammation of the barrier is permeable
  • Brains are dynamic
  • Glial cells can be activated by systemic inflammation
  • Four pathways to activation
    • Blood-brain barrier permeability; pathogens, toxins can enter the brain; once breached, inflammatory cytokines can activate microglia
    • Vagal afferents can activate glial cells; inflammatory mediators in the liver or gut have been shown to activate the brain; inflammation in the gut can activate microglial cells; people with IBD often show more brain inflammation; direct connection between immune mediators in the gut to the brain and back
    • Some cytokines cross the BBB through passive diffusion and turn on glial cells; IL-1B can directly cross a normal barrier and activate the microglia
    • Pathways involved in blood vessels and astrocytes; heat-shock proteins, LPS, compounds that impact the vascular endothelia binding can directly impact astrocytes and turn on glial cells
  • Inflammation anywhere in the body has the potential to activate brain inflammation
  • When the brain is inflamed, nerve conduction speed goes down; inefficient brain function; "brain fog"; lack of neurological endurance due to decreased neuronal ATP production
  • When conduction speeds go down, this is a common cause of depression; most research moving to the cytokine model of depression over the neurotransmitter model; inflammation of the brain leads to depression
  • Microglial cells have a pro-inflammatory M1 type and anti-inflammatory M2 type
  • Microglial lose their legs and ability to scavenge when they become primed and they are stuck on one spot
  • In M1 state, pathogen elimination, tissue, damage, and neuroinflammation
  • In M2 state, growth factors are released, inflammation is resolved, homeostasis is restored
  • After a TBI, there are M1 and M2 states for the first 3-6 months to help with the healing of the injury; after 3-6 months, the primed cells stay in an M1, upregulated, active state and become sensitive to any inflammatory trigger
  • The location of the TBI impacts the area of primed glial cells; if systemic inflammation causes specific symptoms, this can also provide insight into where the primed glial cells may be located; the history often sheds light on the area of injury
  • Once the glial cells are primed, any secondary assault can increase the level of priming and lead to mental illness, psychosis, depression, anxiety
  • Chronic fatigue is a brain-based fatigue
  • Athletes need to ensure they avoid a second hit
  • The amount of brain inflammation and glial priming leads to dementia and other chronic conditions; move from primed to activated microglia and neurodegenerative diseases
  • Infections like Lyme or toxins can activate microglia
  • Is like a hard-boiled egg; you can't go back to the non-cooked state
  • After exposure to lipopolysaccharides from intestinal and blood-brain barrier permeability, there is LPS binding to TL4 receptors; turns on inflammation in the brain and body; microglia lose their legs and become less motile; remain in the M1 state; unproportional inflammatory response that can shutdown brain mitochondria and shutdown nerve conduction
  • Primed glial cells can happen from chemical insults; does not have to be a traumatic brain injury
  • With TBI, it does not always matter how hard they hit their head; what was the inflammatory level prior to the injury?
  • Those that smoke, are obese, eat poor diets, etc. may have more priming to smaller insults; the M2 activity prior to the insult matters
  • Subtle neuroinflammation: intermittent brain fog, variations in mental speed; moderate: depression from inflammation, need more sleep; severe: delirium, dementia, personality changes, tremors
  • Transient neuroinflammation is common and may happen infrequently; chronic neuroinflammation is more consistent; primed neuroglial cells may lead to not being able to think or concentrate after pollution or gluten exposure; neurological autoimmunity is where the neurons start to breakdown and lead to an immune response; seeing these as foreign and developing antibodies; start to see neuronal antibodies
  • Microglia do not return to homeostasis after injury but may become primed; unproportional response in the brain whenever these primed glial cells are activated
  • Stress can lead to an inflammatory response or neurogenic inflammation; can activate the primed glial cells
  • Ketones can have neuroprotective and anti-inflammatory effects; ketones can activate M2 pathways to shift to anti-inflammatory state; actual ketosis, not just exogenous ketones
  • Dietary interventions: increase essential fatty acids, lower fried foods, lower unhealthy oils, gluten/dairy/grain free, autoimmune paleo diet (particularly when neuronal autoimmunity is present), stabilize blood sugar, ketogenic diet, intermittent fasting (12-18 hours; at least 14 for significant benefit)
  • Getting rid of primed glial cells requires activation of autophagy; fasting is a powerful way to clear out primed glial cells
  • Intermittent fasting and fasting often easier once fat-adapted with ketogenic diet
  • Nutraceuticals have a smaller role to play in neuroinflammation
  • Need to explore: promote neuro-rehabilitation, explore blood-brain barrier, gut/brain response, treat gut, neurological autoimmunity
  • Curcumin, resveratrol, DHA, ALA, EGCG
  • Polyphenols: resveratrol, curcumin, quercetin, EGCG, flavonoids
  • Those that can cross the blood-brain barrier are the most effective for neuroinflammation
  • Some antibiotics can dampen microglial activation; improvement from antibiotics may not be the result of addressing an infection
  • Many natural flavonoids can shift from M1 to M2 state
  • Greatest evidence for curcumin, resveratrol; dosage is trial and error; notice less fogginess and more brain endurance
  • His personal rating for polyphenols for neuroinflammation
    • 5 stars: resveratrol, curcumin, apigenin, catechins (green tea)
    • 4 stars: luteolin, baicalein, rutin
    • 3 stars: naringenin, quercetin
    • 2 stars: hesperidin, fisetin, myricetin 
    • 1 star: chrysin, kaempferol
  • Flavonoids suppress the inflammatory mediators that turn on the microglial cells; support the reactive oxygen species and inflammatory pathways
  • Polyphenols do not have the same effect on everyone; depends on the microbiome integrity; different microbiomes have different responses to polyphenols; have to be converted to a metabolite that then crosses the blood-brain barrier
  • Example: pomegranate must be converted to urolithins by the gut microbiome or it cannot cross the BBB
  • If the polyphenols have no effect, it may be that the microbiome diversity is limited
  • Microbiome diversity is promoted by a diverse diet with numerous plant fibers; food restrictive diets may be working against this goal; as microbiome diversity declines, the conversion of polyphenols to metabolites declines; ability to convert hormones declines; lose immune function/tolerance
  • Polyphenols can increase microbiome diversity and lead to increased metabolites over time
  • Polyphenols may not cross an inflamed/permeable blood-brain barrier
  • Want to shift from M1 state to M2 state
  • Flavonoids can turn on autophagy
  • If you look to dampen brain inflammation, it is hard not to look to the flavonoids
  • Dampening brain inflammation with steroids is not a good option for chronic neuroinflammation
  • Cyrex has blood brain barrier permeability tests like S100B 
  • Essential fatty acids are important; DHA can dampen brain inflammation; if there are not enough essential fatty acids, healthy cell membranes break to provide DHA
  • Consider gallbladder/biliary stasis with fats: if bloating after meals, burping after fish oils, floating stools
  • Butyrate, propionate, and acetate can be taken supplementally; produced by fibers; SCFAs are one of the most overlooked compounds for brain inflammation; turn on TReg cells
  • Micronutrients will have less impact (in priority order): D, magnesium, A, E, B vitamins, zinc, calcium
  • Antioxidants: NAC or liposomal glutathione; glutathione dampens microglial inflammatory response
  • Consider: polyphenols, essential fatty acids, SCFAs, nutrients, antioxidants to manage neuroinflammation
  • From Q&A discussion
    • Kharrazian Institute has online programs on neuroinflammation to learn more
    • There is no lab test or imaging for the vagus nerve; motility studies of the gut can provide insight; look at the movement of the palate, gag reflex; lack of bowel sounds
    • Mast cells only play a role in neuroinflammation if the blood-brain barrier is permeable
    • Brain inflammation cannot easily be tracked; advanced imaging scans with iodine are ideal but not used in clinically settings; need to come back to the physical exam; different symptoms are associated with different areas of the brain
    • Works with Cyrex labs using ELISA testing (not micro-array testing) for autoimmunity which happens in end stages
    • Vegan diets can increase brain inflammation if the person is sensitive to lectins
    • Ketogenic diet may be a long-term tools for reducing brain inflammation; 2-3 day break per month; intermittent-fasting
    • Fiber is the best tool for increasing microbiome diversity; supplemental butyrate can be helpful
    • Has seen varied responses to peptide therapies; not a game-changer; need to dampen the inflammatory cascade with diet and fasting
    • Tremendous benefits with a ketogenic diet in those with apoE4
    • Hangovers are a type of neuroinflammation; alcohol binging can turn on glial cells (though not prime them) to an M1 state
    • Exercise and EWOT will turn on anti-inflammatory genes and support recovery of brain injury
    • High dose EFAs may be needed if significant brain inflammation is present
    • CBD is a powerful modulator of glial cells
    • Lack of sleep can activate the M1 inflammatory state of glial cells
    • Autonomic dysfunction may be associated with microglial inflammation; dysautonomia (can't digest, heart rate issues, pupil dilation) will be impacted by the area of the brain with injury
    • On a ketogenic diet, needs numerous vegetables or blended vegetable powders to get the fiber
    • Microglial cells go through autophagy; intermittent-fasting
    • With intermittent fasting, coffee or tea is allowed; MCT oil added may break the fast but not significantly
    • Best to use liposomal versions of curcumin and resveratrol; and possibly other flavonoids/polyphenols
  • DRKNews.com

Nasha Winters, ND spoke on "Metabolic Approach to Cancer: Practical Considerations and Application" and shared:

  • Practitioners at TFIM are already dealing with key issues at hand in those with a cancer diagnosis
  • Treatment should focus on the entire organism; not just the tumor or cancer cell
  • Very few have the education or motivation today on the lifestyle factors that are needed to stimulate the adaptive, cellular metabolic-flexible response needed to combat the daily assaults on our terrain and mitochondrial health
  • 1 in 8 women will have breast cancer; 50% of men 50-60 have microscopic prostate tumors; 100% of people over 70 have microscopic thyroid cancer; 1 in 2 men and 1 in 2.4 women will have cancer in their lifetime; 40% of all women 40-50 years old have microscopic breast tumors; 70% chance of recurrence after initial diagnosis
  • Fastest growing cancer is glioblastoma; lymphoma and leukemia growing in young people; fastest colorectal cancer in those under 35
  • When she started, the average age was 68; has now dropped to 45; seeing ovarian cancer in children under 10 years old
  • 12 EU nations have cancer as the number 1 cause or mortality; US is heading that direction
  • Can take 5-10 years for a cancer to become enough of an issue to be identified
  • 3 major factors over last 50 years: refined sugar, methods of farming, exposure to chemicals; irradiation, glyphosate; cancer is not simply bad luck
  • 95-97% are related to what we eat, think, and put on/in/around our bodies
  • 5 pounds of sugar per person consumed per year historically; now 175 pounds
  • The base of all chronic illness is our mighty mitochondria; depend on air, sun, water, soil, food to produce energy; originated from bacteria; passed down from mother; 10-20% of body weight is mitochondria; about 10 million billion; aging is a degeneration of the mitochondria; responsible for apoptosis/garbage dumping
  • Liver, brain, pancreas, heart need more mitochondria to function; rapid turnover cells have fewer mitochondria
  • Mitochondria are needed for the function of our DNA
  • Aging is the slow degeneration in our mitochondria; damage accumulates in our cells; leads to apoptosis; when you cannot apoptose, this becomes the root for cancer
  • Early warning signs of mitochondrial damage: night owl, caffeine as a crutch, loss of joy/stamina, subtle mood swings, mildly stressed, joint and muscle stiffness, fatigue, lethargy
  • Late signs: mental and physical fatigue, pain, slow recovery from exertion, foggy brain, dizzy spells, depression/anxiety, loss of libido, cold/heat intolerance, blurred vision, light/noise intolerance, shortness of breath, susceptibility to infection
  • Hallmarks of cancer: self-sufficiency and growth signals, insensitivity to growth inhibition signals, evasion of apoptosis, limitless replicative potential, angiogenesis, tissue invasion and metastases; mitochondria can no longer hold back the flood waters
  • Added 4 more: dysregulated metabolism, evasion of the immune system (co-infections and mold), unstable DNA, inflammation; these are terrain-centric and newer realizations in the cancer arena
  • Cancer cells appear to be invisible to the immune system
  • Somatic theory says it is an accumulation of mutations that leads to a tumor that needs to be removed; this is the medical mantra for some time
  • Metabolic theory are when early cancers come and go, established remain dormant, changing terrain may prevent progression or support regression, microenvironment manipulation can and will halt or slow growth and even reverse tumor
  • Cancer stem cells: normal cells become cancer cells due to mitochondrial toxins such as sugar, stress, mitochondrial poisons; cancer cells become normal cells by restoring mitochondrial function with intermittent fasting, CoQ10, HIIT exercise
  • Placing nuclei of a cancer cell into a healthy cell does not lead to cancer; but if you place the nuclei of a healthy cell into a cancer cell, you get cancer; it is a terrain issue; comes from the swimming pool that the nuclei are hanging out in 
  • You don't wake up with cancer; it happens over time
  • She has never had a patient believe they were sick at the time they got cancer
  • Standard of care cancer treatment will negatively impact the tumor, but also negatively impact the terrain increasing the likelihood of future problems
  • Consider source of water, connection to nature, sleep patterns
  • Pasteur promoted germ theory; Beauchamp promoted terrain theory; she approaches cancer as a terrain issue
  • Germ theory deemphasizes the immune system; terrain theory recognizes the power of harnessing the immune system
  • Germ theory emphasizes the killing of the germ; terrain theory de-emphasizes the germ
  • Essential determinants: fresh air, clean water/hydration, sleep, nutrition/digestion, rest/recreation, solar/lunar/lifecycles, environment/geography, exposure to nature, ecology/Gaian ecosystem
  • Common denominators: diet, take control of health, follow intuition, herbs/supplements, release suppressed emotions, increase positive emotions, embrace social support, deepening spiritual connection, reason/purpose for living
  • Longevity and blue zone regions come down to cultures have some history with fasting which supports autophagy
  • It's more about what you are not eating than what you are eating
  • Should have nothing but water for at least 13 hours per day
  • Terrain questions
    • Childhood trauma
    • NASAID/antacid use more than a couple times a year
    • History of metabolic syndrome, hypoglycemia, prediabetes, insulin resistance, PCOS, pancreatitis, pancreatic cancer, or Type I or Type II diabetes
    • Non-stick cookware, eating from plastic containers, drink unfiltered water
    • EBV, HPV, HSV, CMV, Lyme, shingles, infections, parasites
    • Overweight?  Drink more than 3 alcoholic drinks/week, less than 5 servings of vegetables per day
    • Streetlights or screen time after sunset
    • History of birth control pills, bioidentical or standard hormone replacement, steroids, fertility treatment, hormone blockade therapies
    • Hemochromatosis or elevated ferritin
    • Lack purpose
  • Illness is not related to the supplements we are not taking
  • What are the drops in the bucket that contribute to illness?  
  • Test, assess, address, don't guess labs: CBC, CMP, inflammation, GGT (glutathione, liver, toxicity), D3, thyroid, homocysteine (methylation, angiogenesis, B12), HbA1C (should be below 5), IGF-1, Ferritin, Fibrinogen; retests monthly until the terrain is stable
  • Tests are based on average population; we do not have a healthy population; you have to be an outlier
  • If T3 uptake is above 30, may have metabolic issues and androgen excess; below 30, looks at estrogen dominance
  • May look at Galectin-3 and incorporate modified citrus pectin
  • MMP can be elevated in cancer and lead to higher risk of fibrosis from radiation; MMP overlaps with mold which can also play a role in cancer
  • Magnolia Bark inhibits MMP
  • Propolis lowers TGFb1
  • Testing for toxicants, metals, GI, immune system, allergens, hormone metabolites, genetics, etc.
  • Runs a number of cancer markers
  • Does fresh tissue or blood biopsies to look at circulating DNA and mRNA
  • Looks at the biography of each patient that led to their biology: doshas, meridians, significant life events, ACEs
  • The biggest medicine happens in the relationship between the practitioner and patient and not with the tools that you provide them
  • Gene expression can be changed 
  • Need a diet that supports metabolic flexibility; a genetically-matched diet is ideal
  • Elevated insulin when you do radiation will make the radiation less effective and commonly lead to mutations down the road
  • She is the "Metabolic Flexibility Gal"
  • Carnivore, vegan, low-carb, fasting
  • Metformin, Berberine, and even some RX medications can be helpful
  • Need to consider toxic exposures; she looks by zip code; local Superfund cleanup sites?
  • A, D, zinc, B12, magnesium can often be deficient
  • The terrain is everything; the immune system is not working if the microbiome is off
  • She looks at neutrophil:lymphocyte ratio; related to all-cause mortality, COVID, cancer; cheapest blood test you can do to determine health and prognosis
  • She looks at the "Trifecta" of CRP, SED rate, LDH; serum calcium, homocysteine, elevated ferritin
  • Overall O2, pulse oximeter, fibrinogen, VEGF, copper/zinc; as platelets go up, cancer is cloaking itself; also go up in stress and viral conditions
  • Most are not deficient in hormones but have issues with hormone metabolites
  • Most Americans are outdoors less than 15 minutes a day; are you watching the sunrise and sunset?
  • Cortisol, insulin, and sex hormones; of one is off, the other two are likely off
  • Mental health can be associated with various genetic issues
  • What joy, gratitude, and purpose do you have?
  • Happy cells: nutrients, hold bread, veg out, circadian rhythm, exercise, fasting, mitigate blue light, cryotherapy (mitogenesis) and hyperthermia, mitochondrial toxins removed
  • Tylenol is a mitochondrial poison
  • Optimal terrain: healthy diet, veggies, mindfulness, nature, support network, clean air/water, avoid EMFs, garden, in bed by 10pm, check all cleaning and personal care products
  • Top vetted: proper diet/fasting, moderate exercise (HIIT, walking in nature), oxidative treatment, immune modulation, mental/stress, resolve nutrient deficiencies, detox, energy medicine
  • Low protein, high fat, nutrient dense diet often best
  • Healing foods: bone broth, greens, crucifers, ghee, coconut oil, sardines/anchovies, berries, hazelnuts/macadamia/pili nuts, fermented foods, olives
  • Ignore your health, and it will go away
  • From Q&A discussion
    • Protein is a cancer-promoter regardless of source; target: .8-1 gram/kg; leads to mTOR activation and says "grow"'; AMPK is cleanup and supported by fasting; if vegan/vegetarian, to get the needed protein, you have to take in more carbs; want low to moderate protein and carb
    • Nagalase become more confusing as it is not specific and sensitive enough; prefers her Trifecta
    • When you live the high fat lifestyle, you are naturally depleting deuterium; the water can be a helpful supplement to that to move faster
    • She eats propolis by the spoonful; 2-3 teaspoons per day; can help reduce TGFb1; through food and local source for best benefits and immune modulation
    • Mitochondrial dysfunction impacts sleep; the internal biological clock plays a role
    • High-dose melatonin can help to protect from radiation from CT scans; with high-dose vitamin C after; newer scans do not require gadolinium or exposure to radiation
    • 5 CT scans in your life is the same radiation exposure as Hiroshima or Nagasaki 
    • Uses Berkey water filters; Aquasauna and Pure Effect filters for under counter; do not take long showers or baths if the water is not filtered; consider whole house filtration
    • Ovarian cancer is driven by TGFb1; the treatment for ovarian cancer is surgery followed by chemo; those therapies drive up TGFb1; she gets a baseline and then checks to confirm the treatment did not make it worse
    • VEGF should be short-lived; if it remains elevated, this is a grow and metastasize signal
    • Broccoli sprouts, watercress, and homemade sauerkraut juice can help breakdown organophosphates and herbicides and is well-tolerated even in those with sulfur issues
    • In her experience, any form of hormone therapy has the potential to lead to cancer; even Ashwaganda can change hormone testing and metabolites
    • Supporting the adrenals and working with the terrain often resolves other hormonal dysregulation
    • Uses urine mycotoxin testing to explore for the potential of mold; cancer markers improve getting out of mold and increase when visiting environments with mold issues
    • Neutrophil:Lymphocyte ratio: if too many neutrophils and too few lymphocytes, all cause-mortality increases; sweet spot is 2:1; if 3:1, 4:1, you are in trouble; seeing with COVID, cardiovascular disease, cancer; if more lymphocytes than neutrophils, that could be overtreatment for cancer or myelodysplastic syndrome; chronically low WBC, elevated platelets could be chronic infections and toxicants; especially metals; more info in this talk
    • Mistletoe hits all of the 10 drops in the bucket; the most well-studied integrative cancer therapy in the world; immunomodulating, quality-of-life stimulating therapy
  • DrNasha.com

Russell Jaffe, MD, PhD, CCN spoke on "Nurturing Immune Tolerance and Resilience for Optimum Recovery and Survival" and shared:

  • Immune tolerance means that the stresses of daily living still leave you tolerant to the world you find
  • Most of us have lost tolerance and need to restore immune resilience
  • Chronic illness is often autoimmune and potentiated by toxic chemicals and minerals in an environment in which the immune system has lost tolerance
  • Inflammation is a repair deficit; toxin and immunotoxin load
  • Comprehensive detox and immune repair includes: eat/drink/think/do, personalized lifestyle repair, predictive biomarkers, proactive primary prevention in practice 
  • Autoimmunity impacts 23-50+ million Americans; 80% women; 100+ diseases; tolerance lost -> self attack -> tolerance restored
  • Innate immune system of skin, nose, mouth, lungs, and GI tract have many microbiomes; need to eliminate foreign invaders before they get in or with the innate immune system (often too impaired to talk about)
  • Adaptive immune system has natural immunity with passive (maternal) and active (infection); artificial immunity with passive (antibody transfer) and active (immunization) 
  • A healthy immune system has no allergies; tolerant; neutralize infections and allergens; repair and defend us from daily wear/tear
  • 50 billion dendritic WBCs recycle 50 pathogens per cell when energetic and healthy
  • Based on antioxidant ascorbate; maternal antioxidant to regenerate all others; and magnesium to buffer the acids of metabolism
  • First morning urine magnesium choline citrate is an important self-assessment and predictive biomarker
  • Too much defense work leads to a repair deficit; want balance; ability to defend and repair
  • Delayed hypersensitivities/allergies occur 3 hours to 3 weeks after exposure; symptoms often not specific; drain vitality and maintain state of "unwellness"
  • Hypersensitivity Types
    • Type 1: acute/RAST/IgE/Histaminic
    • Type 2: reactive antibody, B-cell
    • Type 3: Immune complex, vasculitis
    • Type 4: T-cell mediated
    • Delayed allergies are hard to find by history or serology
  • T-cells are critical in conditions like COVID
  • Lymphocyte Response Assay: 30cc blood sample can be used for > 500 cell cultures including foods, additives, preservatives, environmental chemicals, heavy metals, medications, mold, danders/hair/feathers, herbs
  • Substitute reactive items for 6+ months for strong items; 3+ for moderate; correct nutritional deficiencies, initiate detox, alkalinize
  • Outcome study in Fibromyalgia: 50% less pain, 70% less depression, 50% more energy, 30% less stiffness in 6 months and more over time
  • Diabetes study: in diabetic medicine, > 1% reduction in HbA1C in Type 1 and 2 and 18% reduction of insulin levels in Type 2 diabetes
  • Reactants in Type 1 and Type 2 diabetes: sweeteners, toxic minerals (more in type 1), environmental chemicals (more in type 1), food additives (more in type 1), cow dairy (more in type 2)
  • Adrenal Immune Connection: chronic stress lowers circulating cortisol, negatively impacts the immune system, increases inflammation
  • Eat foods and beverages to remain alkaline; not add acids
  • Inflammation = Repair Deficits; thyroid gland attacked -> increase in tissue permeability -> loss of thyroid function -> autoimmune thyroiditis
  • Inflammation is removing repair blocks; inflammation associated with Diabetes, autoimmune disease, arthritis, cardiovascular diseases, cancer, pulmonary disease, Alzheimer's, neurological diseases, prion diseases
  • 70% of the immune system is within the Peyer's patches of the gut; leaky gut leads to parasites, harmful bacteria, yeast, fungi, toxins, and undigested food moving into the body; address the causes
  • Microbiome essentials include: prebiotic fibers, probiotics bugs, and symbiotics (recycled glutamine with PAK)
  • Food becomes energy; eat what you can assimilate, utilize, and eliminate without immune burden
  • GI transit time is a predictive self-assessment; activated charcoal 2 capsules per 50 pounds; note the time and watch for black in the stool which is the transit time; 12-18 hours is ideal; usual is 72-144 hours; increases reabsorption of toxins
  • Heavy metals can lead to cellular damage, DNA changes, oxidative stress, and enzyme effects; aluminum, mercury, cadmium, arsenic, titanium dioxide 
  • 1 in 3 women; 1 in 2 men will develop cancer due to exposure to toxic chemicals
  • When he was young, they sprayed DDT and DDE to control mosquitos; they rode behind the spray truck
  • Industrial chemical exposure has increased 15 fold in the past 100 years
  • BioDetox Super Foods: garlic, ginger, onions, broccoli sprouts, eggs; rich in sulforaphane, IP6, minerals
  • All three phases are important: 1/metabolic, 2/conjugation, 3/lipotropic
  • Detox: want sulfur amino acids like cysteine/methionine, lipotropics/choline citrate/PC for bile, minerals/magnesium with choline citrate, good Omega 3 fats distilled under nitrogen, buffered ascorbates and antioxidants, pre/pro/symbiotics
  • Pro Repair/Pro Detox Nutrients: Personal C cleanse, Dark fruits/polyphenolics, B complex, BioDetox with whole greens, high sulfur, Omega 3 EPA/DHA
  • Liver and organ detox: micellized softgel with silymarin, carotenoids, tocopherols, tocotrienols, CoQ10, D3 for liver, spleen, and kidney support
  • Magnesium is an antioxidant that protects essential fats in transport
  • L-Ascorbate (reduced/buffered) repairs and renews and is universal maternal antioxidant; first 2000 mg per day is enough to manage daily infux of toxic minerals; C Cleanse is done weekly to overcome repair deficits and enhance detoxification; may range from 6 to 24 grams per hour
  • 80% of foods should be alkaline if unhealthy; 60% if healthy
  • Alkalinization: foods and water, Magnesium with choline citrate, abdominal breathing, green light and sunlight, eat in harmony with nature, locally grown organic, restorative sleep
  • Goal of urine pH after 6+ hours of rest is 6.5-7.5; can be too acid or too alkaline
  • Magnesium is enhanced with choline citrate to increase uptake; magnesium displaces toxic minerals and protects fats; choline supports acetylcholine and cholinergic bile; citrate energizes and alkalinizes; done based on the first morning pH; nature's stress buster; supports HPA axis; reduces inflammation; protects brain from depression
  • The immune system is the first line defense for viral infections; induce interferons and other cytokines; adaptive immune response is needed when the viral replication outpaces our innate defenses; want antibodies and lymphocytes (humoral and cell-mediated response), and distinguish what is foreign from self
  • Immune defense/repair/stay healthier: hydration, test urine pH, restorative sleep, digest/assimilate/eliminate without immune burden, air quality; buffered ascorbate, magnesium with choline citrate based, zinc, polyphenols (quercetin, OPCs), D3 (50-80, liver and detox support 
  • Restore immune tolerance: amplify response to invaders, understand inflammation to reduce toxic/immunotoxic load, hsLRA delayed allergy testing, detox/gut/immune repair, eat/drink/think/do 
  • From Q&A discussion
    • The C Cleanse helps to release toxic materials; looking for a release that is like an enema from within
    • A prion is a protein that has no genetic material of its own but hijacks our own cells to reproduce; can be detrimental or symbiotic; a prion that will kill you is one that is shaped to stack upon itself where it physically bursts/kills/damages; when you have an alkaline environment with antioxidants and a health milieu, this does not happen; have enough magnesium and ascorbate antioxidants
    • Can distill water and then add minerals back; do not drink distilled water without adding back Celtic sea salt; the more trace minerals the better; want a high mineral water source
    • Another option is water in glass; plastic adds chemicals that cause cancer; Pellegrino; Mountain Valley Spring water
    • Perque EPA/DHA Guard is the omega 3 product that he created
    • Choline citrate is a better option than choline bitartrate
    • Perque Liva Guard is the micellized silymarin product for detox organ support 
    • Could use beets to check transit time; but some then think it is blood in the stool
    • LRA from ELISA/ACT in the newer-generation; ALCAT is an older-generation of testing
    • Chicken eggs have been manipulated; goose, duck, quail eggs are not manipulated
    • GI motility can be improved with prebiotic fiber, probiotics, and symbiotics; more fermented foods
    • Sulfur sensitivity: restore antioxidant, polyphenolics, magnesium with choline citrate; MSM was developed as a cheap form of sulfur to fool mother nature; every time people try to fool mother nature, she says no; only 3% of MSM is biologically helpful; does not recommend using MSM
    • If there is an ionized calcium problem, PTH C peptide should be measured
    • After 1 gram of vitamin C, oxalate saturates in almost all people; ascorbate does not convert to oxalate
    • Interstitial cystitis is a repair deficit, autoimmune condition; their protocol worked well in 49 of 50 in a study of IC patients
    • A patient was told not to take vitamin C as it may lead to immune system upregulation; Dr. Jaffe disagrees with this caution; MS is a classic autoimmune condition
  • DrRussellJaffe.com

Deanna Minich, PhD spoke on "Modulating Detoxification with Food and Food Compounds" and shared:

  • Worked with Dr. Jeffrey Bland exploring metabolic detoxification
  • Blending scientific research with clinical experience
  • Phytonutrients are the underdogs of nutrition
  • Overall body burden is the accumulation of chemicals that overflows until we experience symptoms
  • Diets for detox are poorly defined: dry fasting, water fasting, juice fasting, allergen elimination, herbs/teas/supplements/laxatives/diuretics; more consumer-marketplace than practitioner arena
  • Cleansing is as old as humankind; always a need to push the inner-reset
  • How do you stimulate certain pathways and up/downregulate the various enzymes that might be involved?
  • "Detox" has a stigma as many of the tools have been less tested
  • 92% of naturopathic physicians use some type of detox in their work: cleansing foods, fruits/vegetables, supplements, organic foods, elimination diets, probiotics, fiber, cholagogue herbs, lymphogogue herbs, avoiding animal products, increased protein, fasting, laxative herbs
  • Some suggest "detox diets" can lead to imbalances
  • A comprehensive food-lifestyle approach: nutrition, dietary supplements, lifestyle factors
  • Her work is very evidence-based; she has participated in a number of scientific papers
  • "Color-density index" is related to the pigment density of certain foods as it relates to their nutrient functionality
  • Need to consider the potential for release of toxins from adipose tissue to be redistributed
  • Many toxins are lipophilic and are stored in fats; high fat diets may lead to bringing more toxins into the system
  • Eating high fat overall can stimulate the production of lipopolysaccharides (LPS); particularly when dysbiosis is present
  • Heavy metals were shown to be higher in those on a gluten-free diet; gluten free does not mean healthy; the quality of the food replacing the glutenous foods matters; often eating more rice which has higher arsenic levels; often get lower minerals; may be mineral-deficient with calcium, iron, magnesium, and zinc when using refined grains that are used in gluten-free products
  • Foods with rice are higher in arsenic, mercury, and lead; wheat higher in cadmium; gluten free have more arsenic and mercury
  • Need more nutrient-dense, gluten free foods
  • Reducing toxic load means avoiding toxins in foods: hormones, gluten, sugar, metals, plastics, microorganisms, antibiotics, aflatoxins, synthetic sweeteners, food allergens, AGEs, animal fat
  • Canned foods increases toxic burden; urinary BPA increase 2, 4, and 6 hours after by 152%, 206%, and 79% respectively
  • Ultra-processed foods have higher phthalates
  • Elimination diet: corn, soy, wheat/gluten, eggs, sugar, caffeine, alcohol, shellfish, peanuts; avoided for 10, 21, or 28 days to reduce "symptomatic noise"
  • Low pesticides on fruit and vegetables is protective for the risk of coronary heart disease
  • "Organic" does not mean "toxin free"
  • One study looked at meats and found that organically fed vs. conventionally fed animals did not change the carcinogen risk; the environment is becoming so toxic; toxins persist in the environment
  • Organically-grown is better and more sustainable but not toxin free
  • Some types of cooking can increase toxicity; longer cooking duration can increase risk of lung cancer; depends on duration and gene variants; need ventilation and not cooking on high heats with the wrong oils, consider cookware and potential toxins liberated into our food
  • Plasticizers migrate into food in the presence of heat; do not buy plastic containers of spices; roasted chickens with fat in plastic sitting under high-heat are a risk
  • Microplastics are consumed by humans and may be testable in the stool in the future; certain tea bags are made with microplastics
  • One of the best ways to detoxify is not to toxify
  • Reducing lipophilic toxins: reduce foods that contain pesticides (animal fat, meat, eggs, cheese, milk), buy organic/seasonal/local, soak food in mild solution of pure Castile soap and a scrub brush
  • First line of defense against toxins is nutrient status; healthy nutritional status can decrease body burden of environmental contaminants
  • Metabolic detox phases
    • First step: oxidation-reduction reactions; make fat-soluble toxins more water-soluble; cytochrome P450; induced by drugs, cigarette smoke, foods; needs B vitamins and iron; protein in every meal
    • Second step: protect the body from phase 1 compounds; C, E, carotenoids, flavonoids
    • Third step: conjugation; often called "phase 2"; amino acids or sulfur compounds like glutathione; protein
    • Fourth step: bile, urine, stool
    • Every meal should have protein and plants; detox mantra
  • Nutrition for phase 2: bolster inner-reserves of cell defense; antioxidant enzymes; Nrf2 inducers: fish oil, lycopene, curcumin, crucifers, garlic, catechins, resveratrol, ginger, purple sweet potato, isoflavones, coffee, rosemary, blueberry, pomegranate, naringenin, ellagic acid, astaxanthin, gamma-tocopherol; fermented foods may activate Nrf2
  • More microorganisms in whole food form can be helpful
  • Amino acids for phase 2 conjugation: arginine, glutamine, glycine, methionine, ornithine, taurine
  • Sulfation: garlic, broccoli, animal foods, lentils, peas, butter beans, barley, oatmeal, brazil nuts, almonds, peanut, mustard ginger; sulfur intolerance may be dysbiosis, pancreatic insufficiency, HCl insufficiency, or allergy; manganese can help
  • Broccoli cooked with powdered brown mustard seed can increase sulforaphane
  • Nutrition for methylation: green leafy vegetables, Mediterranean diet, B2/B6/B12/5MTHF, betaine; avoid smoking, excessive coffee, high alcohol
  • Heavy metals: top of the priority list; support for oxidative stress, essential minerals compete with metals, fiber; minerals are key as they drive co-factors
  • Nutrition for persistent organic pollutants (POPs): support oxidative stress, glutathione synthesis; vitamin C may help decrease POPs in one study; vitamin E and C can help reduce oxidative damage
  • Plants can help to prevent against numerous diseases; phytonutrients are key; need a variety
  • Polyphenols protect against plastics
  • Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application discusses the top plant foods for detox and their bioactives
  • Color is key to support detox
    • Challenge to eat 50 unique foods in 7 days
    • Detox program is color-coded with different focus on different days
    • For each color, she has lengthy lists of foods that fall into each category
    • Red is about inflammation and the immune system; ellagic acid (pomegranate) can help with metals and detoxification
    • Orange is about protective carotenoids; curcumin can help to remove heavy metals; need to ensure the source is clean of metals as well
    • Yellow is about digestion, fibers, catalytic activity; royal jelly is helpful for methylation; ginger can be helpful for toxicity; honey can be helpful for pesticides/glyphosate
    • Green is about green detoxifying foods, binders, chlorophyll, chelators, cilantro, matcha tea; chlorella 
    • Blue/purple are more rare; protective for the brain; anthocyanins; berries such as blueberries have numerous health benefits including increasing BDNF and reducing inflammation
  • Avoid toxins load: avoid toxins in foods, block absorption with fibers, optimize metabolic pathways with nutrients
  • Incorporate colorful foods to support oxidative stress and have a well-rounded lifestyle approach
  • Teas can be an excellent way to support metabolic detoxification pathways, soups, smoothies, soups, stews, juices; want quality protein/balanced fats/plants/herbs/spices
  • Emotions and stress are also toxins
  • From Q&A discussion
    • If you are living on planet earth, we need to be in touch with cleansing and detoxification; some may have more of a need than others or be more symptomatic than others, but pretty much everything can be related to toxicity; look through a lens of detoxification; everyone can be benefited by reducing toxic burden; toxin exposures even play a role in restless legs and sleep issues; reducing toxic load requires ongoing work
    • People often jump on the SNP bandwagon, the wildcard is epigenetics; we don't have a real-time way to look at function or enzymatic activity; there can be compensations or backup genes; there are too many extrapolations that are being made; it cannot be the be-all-end-all; look at functional biomarkers, intake forms, and assessments; SNPs are not it
    • Her detox programs have a foundation of food and lifestyle and often lead to significant improvement in symptoms; supplements may then be explored
    • Need to get the gut right to minimize LPS when dietary fats are incorporated; EFAs work better in the presence of a healthy gut milieu 
    • Protein: the dose makes the poison; moderate protein at every meal to stimulate enzymes for detoxification and conjugation co-factors; more is not necessarily better; the focus should be on plants with peppered proteins
    • Daily celery juice: the amount and continuity could have long-term effects; raw kale smoothies impacted thyroid health negatively; variety is ideal; nature works with diversity
    • Look into local sources of foods; local growers/farmers; local foods best serve your physiology
    • Rotate foods every 3 days; bring in one novel food a week; if you can't get fresh foods, consider a supplemental fiber; incorporate teas; some of the cultures that lived the longest often incorporated teas 
  • DeannaMinich.com

B. Robert Mozayeni, MD  spoke on "Bartonella: Pathology, Diagnosis, and Treatment Considerations" and shared:

  • Bartonella is an infection that can disturb any function in the body; can be anywhere in the body and disrupt that particular system; virtually any symptom is possible 
  • He started working with Bartonella in 2007
  • ILADS is working in a new data system to track outcomes
  • He got into Bartonella from cerebrovascular medicine
  • Neurological manifestations are common as the vascular system feeds the neurological system; nervous system is a set of sensors and trip wires
  • Bartonella is more than Cat Scratch disease
  • He was trained as a rheumatologist; most rheumatological conditions are the result of persistent infection
  • Can cause vascular inflammation
  • His experience is in autoimmunity, molecular immunology and biophysics, transplantation immunology and vasculopathy, neurovascular disease, and systemic small vessel disease, cognitive impairment
  • Uses transcranial doppler to explore the vascular system and blood flow; can provide insight to the type of cognitive impairment; patterns correlate
  • Bartonella overlaps with Lyme
  • With Lyme patients that do not get better, ask about history of fleas and cat scratches; more common than tick bites
  • Many types of testing for Bartonella; antibody response is a way to look at host response, not a way to diagnose infection; has been used historically as there was not a better way to test
  • Molecular sequencing testing can have erroneous results; want to be sure the lab does sequence confirmation
  • Galaxy recently moved to a digital PCR which is more sensitive; every sequence is confirmed by DNA sequence confirmation
  • Molecular testing is the key and the future for looking for microbes; antibodies are highly cross-reactive (especially IgM)
  • In a chronically ill patient, IgM doesn't mean much.  A positive IgM band on a Western blot does not mean it is a positive test for Borrelia
  • If a patient has a Borrelia Western blot that is more IgM positive than IgG positive, it may not be Borrelia; this has been seen in patients with Bartonella
  • In an acute scenario, positive IgM may be more accurate; in chronic Lyme, it may be more of an indication that the issue is something else
  • With available testing and use of different tools, it is now very hard to miss a case of Bartonella
  • In 2007, it was almost impossible to diagnose a case of Bartonella; have come a long way
  • Inflammatory diseases are more common in women
  • Exploring the possibility of skin biopsy testing being a better approach for testing of Bartonella
  • In one study, had one or more Bartonella PCR positive in 41% of patients; in the patients that were PCR positive, 33% reported a Lyme diagnosis, 50% with psychiatric disorder, and 85% with a neurological disorder
  • Multiple neuro-psychiatric manifestations of Bartonella; depends on where the vascular compromise is located
  • They had a case with a male that was psychotic for 18 months that improved with treatment for Bartonella
  • Bartonella striae have been discussed for some time; they are not typically stretch marks; deeper and more red/inflamed; biopsies to date have found Bartonella; ongoing research needed
  • Had a patient that was treated for several years and found the best options were Rifabutin, Minocycline (anti-inflammatory), and Clarithromycin
  • Bartonella and Borrelia have common insect vectors; becoming clear that ticks can transmit Bartonella, but sparse in the tick gut; many other insect vectors are greater risks for Bartonella
  • Is the disease the infection or host response?  It is both.  IFA results are an indication of the host response.
  • With more neurologic and neuropsych findings, consider Bartonella before Borrelia
  • Symptoms stem from endothelial inflammation and can damage collagen and create systemic inflammation
  • Bartonella are gram-negative proteobacteria with slow division time; can infect RBCs and other cells; need to treat long enough to treat slowly-dividing microbes; if you stop antibiotics and have a quick relapse, that could be Babesia but not likely to be Bartonella
  • Breast tissue cells cultured with Bartonella increase the expression of oncogenes
  • A strong Herxheimer response when starting Bartonella treatment may be related to Bartonella no longer being able to suppress the immune system
  • Bartonella can come from a tick or flea (has been found in 27% of one type of mosquito in Europe); any biting or stinging insect has the potential to transmit Bartonella; infects the skin and then blood vessel lining leading to flow disruptions and the formation of biofilms; a vascular biofilm is born that may be comprised of many organisms; can physically block the flow of blood
  • Sudden symptom development could be like a TIA where it may be related to blood flow impairment
  • Infected cells have been observed clustering or traveling together; becomes a blob that is difficult to move through the circulation
  • Has seen biofilms up to a centimeter long
  • Highest biofilm levels in younger patients with PANS/PANDAS
  • Does not start with biofilm busters like Nattokinase, Lumbrokinase, or Serrapeptase; may introduce later; within the biofilm, can have different stages of the lifecycle of an organism; antibiotics can take longer to penetrate a biofilm; you can cause a big Herx if you use antibiotics and biofilm busters too early
  • Glutathione can be helpful with breaking down biofilms
  • Has seen Bartonella in cases of PANS/PANDAS
  • Bartonella tracks are not just striae; the damage to the skin can be severe and may be associated with neuropsychiatric symptoms
  • Collagen can be disrupted in those dealing with Bartonella
  • Bartonella is closely associated with vessels and lymphatics; the brain has a lymphatic system as well called the glymphatics
  • Bartonella has been found in dust allergy extracts as it is found in dust mites; unlikely to cause illness, but could it lead to Bartonella antibodies in patients that had allergy treatment for dust?
  • White matter areas of the brain don't have collateral flow; in the gray matter, there is; parts of the brain don't work well together; do not have dementia, but have poor cognitive flexibility; more clock cycles needed to compute things
  • Often times, patients are unable to use the information the practitioner provides as they may not be able to cognitively process it due to their illness
  • Small vessel disease: mild cognitive impairment, executive dysfunction impaired, processing speed delays; not a dementia 
  • Can have migratory neuropathy, dysautonomia, POTS, fasciculations, tremors, muscle pain/twitching, headaches, fatigue (generally not severe; Babesia can exacerbate), decreased stamina
  • VEGF is not very reliable as an indicator of Bartonella; sees highly variable VEGF levels
  • Saw a patient with hypermobility, EDS, and MCAS; resolved with treatment for Bartonella
  • Often, at start of treatment, no antibodies will be detectable; but may be high after treatment has started for a period of time; majority have increasing antibody titers over time
  • A negative titer does not rule out; younger or not sick as long, more likely to be positive.  Even low titers are likely to be true positives; can confirm with molecular testing
  • Borrelia Western Blots that are IgM positive often normalize with treatment for Bartonella
  • Testing for Borrelia: do not use a negative test to rule it out
  • Molecular imaging is allowing for definition of the end point of treatment for Bartonella
  • What's missing: better molecular diagnostics, high resolution blood and tissue molecular imaging, novel antimicrobial strategies, vascular hemodynamic studies, glymphatic functional imaging, big data
  • Some of the toughest patients are the younger patients with PANS/PANDAS/neuropsych illness; would benefit from an in-patient treatment option
  • Standard view for Bartonella treatment is based on Bartonella being benign; then may only give Azithromycin for 2 weeks and may then use Doxy or Rifampin; Doxycycline is not an effective Bartonella treatment
  • Rifampin creates hormonal dysregulation which can make it difficult to use; need low dose hydrocortisone to improve treatment tolerance
  • Has found Clarithromycin and Rifampin/Rifabutin helpful
  • Newer explorations: Disulfiram (not very effective), Dapsone (some failures), Essential Oils, Methylene blue
  • In vitro findings don't necessarily mean they will work in a clinical setting but it is a starting point
  • A number of herbal options are available for Bartonella and biofilm treatment; many have been studied
  • Bartonella is present in all tissue including the eye; treatment can trigger uveitis with some RX medications
  • Can see liver enzyme elevations, increased need for adrenal support
  • Best to bring the infection down slowly; start low and build up slowly
  • Bartonella treatment is still new territory; has been fulfilling to see patient recoveries, but caution is advised
  • From Q&A discussion
    • Has had patients where they may have acquired their Bartonella from bed bugs; have not seen Lyme disease transmitted from bed bugs
    • IV glutathione may be breaking down bonds that leads to the dissolving of biofilms
    • In a few long-haulers with COVID, has also found relapses with Bartonella; Bartonella treatment then resolved the long-haul COVID; could long-haul COVID be happening more commonly in those with these persistent infections
    • If you see a number of IgM positivities, it may be worth exploring Bartonella as well
    • Galaxy Diagnostics can do Bartonella testing from skin biopsies 
    • Galaxy Diagnostics should soon be able to support patients in New York state
    • Has seen low WBCs in patients with Bartonella; low neutrophil counts are often seen at some point during treatment; in his experience has always recovered fully; may be a mistake to start Neupogen; they are making neutrophils, but the shape is changing and not getting counted; checks blood weekly; patients often most symptomatic when this is happening
    • Uses molecular imaging / blood smear to be negative twice in a row before stopping treatment; the blood can be cleared; we don't know if Bartonella can be cleared in every other tissue; has not seen relapses when using this approach except in one patient after COVID
    • May transition to natural antimicrobials such as allicin or liposomal oregano oil longer term to maintain health
    • Bartonella can cause depersonalization and derealization disorders
    • If Bartonella and Borrelia are both present, a focus on Bartonella treatment provides good Borrelia treatment, but Borrelia treatment is often not adequate for Bartonella
    • Bartonella is a contributor to hypercoagulation with higher levels of fibrinogen; often high normal; often slightly elevated D-Dimer
    • Clinically, sees patients having antibodies to both henselae and quintana; may not be valuable to speciate the IFA; treatment is not different; may be better to speciate on the molecular tools to differentiate between relapse vs. re-infection
    • Has not found a need for methylene blue or Clotrimazole to date given the effectiveness of his existing protocols; methylene blue is a great way to stain biofilms; may have future application
    • Rifabutin can cause uveitis in 15% of patients; this is from the antibiotic getting into the eye in those with Bartonella
    • Better testing is leading to better treatment pathways
    • Would like to find natural treatments that work well for his patients
    • Some of what we know about Borrelia in lab markers like C4a may actually be related to Bartonella as well; slightly elevated liver enzymes, slightly low neutrophils, fibrinogen (does not see elevated SED rate or hsCRP), low CD57 
    • Treatment duration varies tremendously; moving towards using the molecular testing to determine the end point; when you get to full planned treatment at full dose, often 6 months
    • Biofilms are a "place where many things can grow" including mycotoxin-producing molds; much of the mycotoxin burden may is likely from inside the body, not outside
  • TMGMD.com, GalaxyDX.com, TLabDX.com

Theo Theoharides, PhD, MD spoke on "From COVID-19 to Autism: The Role of Cytokine Storms in Chronic Inflammatory Conditions" and shared:

  • All inflammation is not the same; a defense mechanism of the body involving the immune response to real or perceived danger; can become destructive if not controlled
  • Localized interleukins and cytokines may lead to various chronic conditions
  • Look for pro and anti-inflammatory molecules; MMP-9 is pro-inflammatory; TGFb1 is ant-inflammatory but can be involved in fibrosis
  • The body does not have that many anti-inflammatory molecules
  • Cytokine storms are involved in severe COVID presentations; localized in the lungs; IL-1b, IL-6
  • Children don't seem to have severe illness but can develop Multisystem Inflammatory Syndrome after exposure to COVID; also seen in adults; many organs are infected and there is an inflammatory response
  • Over time with COVID, IL-6 becomes predominant
  • One study looked at marines with COVID infection; 1 in 10 did not make antibodies; 1 in 7 were re-infected
  • Micro-thrombi or emboli have been found in the lungs; mast cell activation was observed; luteolin may have beneficial actions
  • Long-haulers experience brain fog, confusion, difficulty multi-tasking, fatigue, irritability, inability to find the right word, memory loss, and many other symptoms
  • 35% did not return to normal after a few weeks; in another study, 53% developed post-COVID symptoms
  • SARS-CoV-2 can bind to glial cells in the brain; association to neurodegenerative disorders
  • Post-COVID syndrome has elements of Mast Cell Activation Syndrome
  • Danger signals cause brain inflammation: cachexins, EMFs, metals, herbicides, inflammatory cytokines, mitochondrial DNA, mycotoxins, neuroendocrine disruptors, neuropeptides, ROS, toxins, venoms, viruses, xenobiotics
  • Inflammatory triggers get into the brain in part due to mast cells increasing blood-brain barrier permeability
  • Inflammation of the amygdala may play a role in autism
  • Diseases involving mast cells: allergies, angioneurotic edema, asthma, atopic dermatitis (eczema), food intolerance, idiopathic urticaria, mastocytosis, mast cell mediator syndrome, MCS, non-IgE food allergy, rhinitis, urticaria pigmentosa
  • Mast cells secrete numerous mediators; primarily histamine and tryptase; only immune cell with pre-stored TNF; at the interfaces between us and the outside world
  • Heavy metals and herbicides (glyphosate and atrazine) trigger mast cell activation
  • Mast cells talk to macrophages and T-cells; they are not in isolation
  • Mast cells can respond to Borrelia and release only cytokines and no histamine or tryptase
  • Mast cells do not have to degranulate and release histamine or tryptase to be an issue
  • Mycotoxins can trigger mast cells; some may explore Caprylic Acid, Berberine, CSM, Glutathione, NAC, oregano oil, probiotics
  • Many with casein sensitivity do not tolerate Lactobacillus probiotics; prefers Bifidus which can degrade histamine
  • Every organ of the body can be affected by mast cell activation including the brain
  • Looking for tryptase release as an indicator for mast cell activation is not a reasonable approach
  • Allergic normally means high IgE
  • Dermatographia is a mast cell response to pressure (not allergy)
  • IgG1 is the good guy; IgG4 is the bad guy
  • If you eat something every day, you will have false positives with food testing; best to not consume suspected foods for 3 days prior to blood draw; chicken and rice often fairy inert
  • IgG4 levels commonly high in children with autism
  • 50% of chronic urticaria is autoimmune
  • Tryptase is elevated only in systemic mastocytosis
  • Looking for histamine in urine is difficult as the sample most be collected, stored, and shipped cold
  • Systemic mastocytosis is diagnosed by skin presentation and tryptase testing, bone marrow biopsy, 24 hour histamine
  • Measuring tryptase is not useful for Mast Cell Activation Syndrome
  • MCAS symptoms: brain fog, diarrhea, flushing, headaches, hives, hypotension, itching (urticaria), myalgias, palpitations, shortness of breath 
  • Cromolyn is not a mast cell stabilizer; works well in rats, but not in humans; quercetin is more effective
  • Antihistamines: Ketotifen, Rupatadine are among the better options
  • Benadryl contains dyes which many with MCAS respond to; need clear capsules and dye-free
  • Histamine is important for motivation; histamine is not all bad; too much of something is not necessarily the best
  • He has been studying mast cells for 40 years
  • Mast cells respond to hormones and neuropeptides; stress impacts mast cells
  • Mediators secreted without tryptase from various stimuli: CRH leads to VEGF; SCF leads to IL-6; IL-1 leads to IL-6; IL-33 leads to IL-31; IL-33+SP leads to VEGF and TNF; Borrelia leads to TNF; Sporothrix (mold) leads to IL-6 and TNF
  • Substance P and IL-33 lead to significant release of TNF and iL-1b from mast cells; mast cells can release tremendous amounts of pro-inflammatory molecules; creates a perpetual reaction
  • IL-6 is the major inflammatory molecule found in the blood and lungs of those with COVID
  • Stimulated mast cells release mitochondrial components that have inflammatory effects; the body perceives mitochondrial DNA as a pathogen; circulating mitochondrial DNA is an early indicator of severe illness and mortality with COVID
  • Inflammation impacts neuro-development and the potential for autism
  • Prenatal stress is a risk factor for the development of ADHD and autism
  • Fetal mast cells can be activated by maternal triggers such as IgE
  • Mast cells talk to microglia which defend the brain; tryptase and other mast cell mediators can activate microglia
  • The fear threshold from the amygdala is a key aspect of autism
  • Anti-mitochondrial antibodies have been observed to be high in children with autism
  • IL-38 which inhibits microglial inflammatory mediators and its receptors were decreased in the amygdala of children with autism
  • Drug Approaches: Cyproheptadine, Hydroxyzine, Rupatadine, Famotidine
  • Supplement Approaches: Algonot Brain Support, Caprylic Acid, DAO, Fibro Support, NeuroProtek, Luteolin, D3
  • Flavonoids can be potent anti-inflammatories, antioxidants, mast cell inhibitors, microglial activation inhibitors, neurotoxicity inhibitors, weak metal chelators, and memory support
  • 50% of children with autism improved with 3 months of use of Luteolin
  • Luteolin inhibits IL-6 and increases mental function; neuroprotective
  • Avoid: allergens, colorings, deodorants, perfumes, EMFs, flame retardants, heat, high histamine foods, plastics, preservative, stress
  • Luteolin inhibits entry of SARS-CoV-2 into cells; inhibits release of inflammatory cytokines
  • Not all luteolin supplements contain the same amount or same purity; very few contain indicated amounts
  • Tetramethoxyluteolin blocks mast cells and microglia; it is a skin cream called GentleDerm; no phenol intolerance issues; absorbed through the skin and temples
  • From Q&A discussion
    • Suppressing mast cells in those with parasites may not be a good approach as the mast cells are part of our defense against parasites; treatments are not, however, blocking mast cells fully
    • Certain major events like trauma may reset the mast cells and they then respond to everything
    • Tetramethoxyluteolin is not available as an oral product at present; exploring inhaled and nasal spray options for autism
    • Working on a water-soluble material as a future potential therapeutic tool; may be better than luteolin
    • Mast cell triggers may release certain mediators from the mast cells but not all
    • 50% of chronic eczema is autoimmune; Xolair could be useful
    • Luteolin is derived from peanut shells and fava beans which he tries to avoid; originally used chamomile; Algonot products are 98% pure; went to artichoke then chrysanthemum (some don't tolerate); now using orange and citrus peels; exploring other sources
    • Powdered luteolin is absorbed less than 10%; his is in olive oil to increase absorption 3-5 fold
    • If you give too many flavonoids, you can negatively impact the GI microbiome; best to limit to 1.5 grams per day of any flavonoid 
    • Pycnogenol has 15 phenolic groups; quercetin 5; luteolin has 4
    • Some may not tolerate more than 500mg / day of flavonoids 
    • Patients with MCAS may be more likely to develop post-COVID; research projects on this are underway
    • Treating MCAS is treating symptoms; treatment of many conditions is the treatment of symptoms; triggers need to be addressed when they can be identified, but the triggers may not always be known
    • There are some cases where the underlying problem is the mast cell
    • Mast cells release about 500 different molecules
  • MastCellMaster.com

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

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

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