The Forum for Integrative Medicine: Expanding the Clinical Toolbox for Patients with Complex, Chronic Illness

Details: Created: March 22, 2022; Last Updated: June 17, 2022

I had the opportunity to attend and moderate the 7th annual event from The Forum for Integrative Medicine "Expanding the Clinical Toolbox for Patients with Complex, Chronic Illness" held online on March 4-6, 2022. 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 from the conference and may not represent the exact statements of the speakers. Errors and/or omissions may be present.

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

Daniel Amen, MD spoke on "The End of Mental Illness" and shared:

Mental illness affects us all; personally or a loved one; no one escapes
Incidence is sky-rocketing with deaths from alcohol, drugs, and suicide the highest in recorded history
After the pandemic, everything doubled
Amen Clinics has over 200,000 brain scans from over 150 countries
Images have taught them that most psychiatric illnesses are not mental health issues at all; rather brain health issues that steal your mind
Arriving at the conclusion that the brain can have problems just like the heart can have problems is a powerful realization
In the future, there will be more focus on prevention of ending mental illness; know the risk factors and address them before trouble happens
Teenagers that sleep an hour less than peers have higher depression and suicide
Gut health issues are associated with anxiety, insomnia, and brain fog
Chronic infections like Lyme or COVID can cause people to be angry, depressed, or psychotic
Genes only load the gun; it's what happens to us that pulls the trigger
Need to put the body into a healing environment; including the ovaries to minimize mental illness in future offspring
Steps to End Mental Illness
- Step 1: Eliminate "mental illness" and call them brain health issues that steal the mind
  - The term "mental illness" stains everyone diagnosed; makes people less likely to see a psychiatrist
  - No one should be shamed for mental health disorders; they are not for cancer, diabetes, or heart disease
  - Before the pandemic, someone committed suicide every 14 minutes; has now doubled
  - Suicide is the 2nd leading cause of death in ages 10-34
  - Suicide has increased by 33% since 1999; cancer declined by 27%
  - "Mental Illness" has an emphasis on the psyche or the mind which are vague and hard to define
  - SPECT looks at blood flow and activity and how the brain works
  - SPECT tells good activity, too little, or too much
  - Cerebellum is most active part of the brain on SPECT
  - "Ring of fire" pattern is an overactive brain; 80% of the time in these cases, stimulants are like pouring gasoline on fire and will make thing worse
  - They work with nutrients, supplements, and diet to balance the brain
  - Ancient civilizations may have treated by drilling a hole in the skull to let out evil spirits; Hippocrates time may have changed the diet, added exercise, and bled the person; Middle ages may have used asylums and chained them; 18th/19th Century may have sterilized them; 20th Century might put them on a couch and blame the mother; 1950s may have used lobotomy; 1960s Electro-Convulsive Therapy; currently the focus is on 15 minute med-checks
  - Psychiatrists have been changed into prescribers; outcomes are no better than in the 1950s
  - Imaging changes the mental health discussion; everyone wants a better brain
  - What if mental health was really brain health? Medical, not moral.
  - A brain health focus increases forgiveness and compassion in families
- Step 2: Fall in love with your brain
  - Brain envy is very real; he wanted his mother's healthy brain; and eventually got his healthy brain
  - You are not stuck with the brain you have; you can make it better; he can prove it with SPECT
  - Seeing a scan is often the catalyst for no longer hurting your brain and falling in love with it
  - Biological data is required; you cannot treat based on symptoms alone
  - Learned about Brain SPECT imaging in 1991
  - SPECT + Psychiatry = Revolution
  - Smoking increases risk of strokes
  - Alzheimer's is universal hypoperfusion
  - Ideal to scan everyone at age 50; the brain is just as important as the colon
  - SPECT scans change 20 years before symptoms present
  - Single most important thing he has learned is that mild traumatic brain injuries ruin people's lives
  - Football players have thousands of sub-concussive blows
  - Drugs, including alcohol, and marijuana damage the brain
  - Psilocybin and ketamine are not in the top 15 interventions that he would explore for people; do the simple things first
  - OCD, autism have too much activity in the front part of the brain
  - Scans can see seizure activity; increased activity when someone is having a seizure; decreased activity in between seizure events
  - Conventional medicine will not accept imaging
  - A diagnosis of depression is like a diagnosis of chest pain; no cause, no path forward
  - Psychiatrists rarely look at the organ that they treat
  - Virtually all psychiatric medications have black box warnings
  - Imaging changes everything
  - Without a map, you are lost
  - Your brain's history is not it's destiny
- Step 3: Prevent or Treat 11 Major Risk Factors that Steal Your Mind
  - BRIGHT MINDS pneumonic
  - B = blood flow; low blood flow is number one brain imaging predictor of Alzheimer's and associated with depression, ADHD, and Schizophrenia
  - Brain cells don't age; blood vessels age
  - How to know blood flow is a problem: low perfusion on SPECT, caffeine, nicotine, high blood pressure, heart disease, not exercising, cerebral vascular issues, erectile dysfunction
  - Blood flow problems anywhere = blood flow problems everywhere
  - Keep blood flow healthy: exercise/weight lifting/coordination exercises like racquet sports, limit caffeine/nicotine, blood pressure healthy, protect your heart, gingko, peppers, beets, HBOT (huge fan)
  - Did a study that showed how HBOT improved blood flow to the brain
  - R = Retirement and Aging; doesn't have to lead to less blood flow in the brain
  - When you stop learning, your brain starts dying
  - Brain aging can be a factor if older than 50, no new learning, loneliness, high iron (ferritin should be below 150 or donating blood can be therapeutic), older telomeres
  - Keep from aging with: new learning, volunteering, social connections, meditation, coordination exercises, vitamins (B, C, D), donating blood if iron is high
  - Learning while exercising is particularly helpful for the hippocampus
  - I = Inflammation; chronic inflammation damages all organs and is associated with cancer, arthritis, autism, depression, dementia; COVID will be associated with all of these
  - Inflammation: high CRP, low omega 3 index, high uric acid, rosacea, pain, processed foods, gum disease, leaky gut or unhealthy microbiome
  - 3/4 of neurotransmitters come from the gut; gut is the second brain
  - Get the gut right and the brain will follow
  - Decrease inflammation: omega 3, probiotics, good nutrition, curcumin, floss
  - Higher omega 3 = healthier hippocampus
  - G = Genetic Risk; not a death sentence; but a wake-up call
  - Ignoring cognitive issues is not smart; if you knew a train was coming to hit you, wouldn't you at least try to get out of the way?
  - SPECT can tell years before symptoms if someone is likely to get dementia
  - You are not stuck with the brain you have; you can make it better
  - Genetic risks: family history, genetic testing
  - Decrease genetic risks: doing BRIGHT MINDS risk factors
  - If you have a genetic risk and address the risk factors, you don't have to develop the condition
  - Plaques thought to be a cause of Alzheimer's can be decreased with D, blueberries, sage, turmeric, green tea
  - We need to assess the brain just like we do for colon cancer or heart disease; brain is the most important organ you have
  - H = Head Trauma; brain is soft like soft butter; housed in a hard skull with sharp, bony ridges
  - Undiagnosed brain injuries are a major cause of homelessness, drug/alcohol abuse, depression, panic attacks, ADHD, and suicide
  - SPECT scan can start a domino of exponential personal growth; often do not admit what you cannot see
  - T = Toxins; substance abuse: alcohol, cocaine, marijuana; these do not make your brain healthy
  - American Cancer Society suggests any alcohol leads to increased risk of 7 types of cancer
  - Marijuana users have lowered blood flow to the brain and leads to abnormalities seen on SPECT scan
  - Mold exposure, carbon monoxide, pesticides, toxic chemicals, heavy metals, general anesthesia; virtually all firefighters have toxic-looking brains
  - General anesthesia damages the brain
  - Toxic risks: water damage, home or work exposure to mold, foreign travel, amalgams
  - Stop or avoid exposure; THINK DIRTY app
  - Avoid toxins: aluminum, parabens, BPA, phthalates, pesticides
  - Support 4 organs of detoxification: water for kidneys, fiber for gut, sweat/exercise, stop drinking, eat detox vegetables/brassicas
  - Inhaling organic solvents is the worst drug of abuse
  - How do you do marital therapy without looking in someone's brain? You might be missing the reason someone is "difficult"
  - M = Mind Storms; abnormal electrical activity in the brain; mood instability, irritability, temper, anxiety, memory/learning issues, headaches triggered from fluorescent lights
  - Treating mind storms: anti-seizure medications, ketogenic diet (can decrease seizures by 50% or more), neurofeedback, GABA
  - I = Immunity and Infections; Lyme, Toxoplasma
  - Schizophrenia map in the US overlaps with Lyme map; virtually identical
  - The idea that a psychiatrist can label Schizophrenia without looking at the brain is the height of arrogance and ignorance
  - COVID activates the limbic brain and causes inflammation in the brain; goes after the emotional structures of the brain and can lead to depression
  - Long COVID begins to show damage to the brain; low cerebellum and lower overall perfusion
  - Support immunity: boost immune system; D, probiotics, garlic, mushrooms, onions; best defense is the immune system
  - N = Neurohormone Deficiencies; testosterone in mood, motivation, sexuality, strength; thyroid in energy and mental clarity; DHEA in aging; estrogen and progesterone in blood flow
  - Test regularly, avoid disruptors such as sugar, pesticides, BPA, phthalates, parabens
  - D = Diabesity; wickedest of all; high blood sugar leads to atrophy in the brain
  - As weight goes up, size and function of the brain goes down in a linear pattern
  - Excessive fat leads to 7 of 11 risk factors: low blood flow, aging, inflammation, toxins, disrupts immunity and hormones, increases diabesity
  - America is 4% of world's population but 15% of COVID deaths
  - Diabesity strategy: calories do count, high quality protein/fat, colorful fruits and vegetables, spices (like a pharmacy) such as saffron
  - Saffron is equally effective to anti-depressants
  - S = Sleep Issues; 60 million Americans have sleep issues
  - Sleep apnea looks like early Alzheimer's in the brain
  - The brain cleans itself during sleep; need 7+ hours
  - Improve memory tomorrow by sleeping tonight
  - Hurts Sleep: caffeine (400 minute half life; stop after noon), warm room, light after dark, alcohol
  - Helps Sleep: dark room, no gadgets, music, hypnosis, low dose melatonin, journaling
  - His plan to end mental illness is to optimize brain function; create a revolution in brain health
- Step 4: First Do No Harm
  - Use least toxic, most effective treatments; medications are never the first thing
  - Don't start something like Xanax or Klonopin that are hard to stop
  - Think skills, not pills
  - Nutrient deficiencies: magnesium, choline, omega 3, C, D, E, potassium, and iron
  - Never give iron without prior testing
  - Nutraceuticals are a low cost option that should be considered
  - Magnesium, GABA, theanine can calm anxiety
  - Green tea, zinc, and rhodiola for focus
  - Saffron, SAMe, curcumin, omega 3 for depression
  - Ginkgo, phos-serine, huperzine A for memory
  - 6 anxiety strategies before meds: check low blood sugar, anemia, and high thyroid; meditation and hypnosis; slow deep breathing twice as long breathing out to trigger parasympathetics; calming exercise like Tai Chi; kill the automatic negative thoughts; supplement magnesium, GABA, theanine
  - Evil Ruler to Boost Mental Illness: diagnose based on symptoms with no biological data; ignore natural treatments and use medications as first line treatments; have insurance deny prevention
From Q&A discussion
- Does use scans to follow treatment but max is 4 per year due to radiation exposure; 2 scans to start (rest and concentration task); repeat the worst one
- Scans don't give you a diagnosis; give you the underlying biology of the person in front of you
- If you have a head trauma or Alzheimer's or stroke, scans can give you a diagnosis
- Loss, isolation, genetic vulnerability, head trauma, mold, COVID-19 can all cause depression but will not give you the same scan pattern
- Can tell that someone is depressed, but cannot tell the underlying biology without a scan
- If what a psychiatrist employs does not work, it often leads to shaming
- Contrast is not required for SPECT; not like a CT dye; level of radiation is about that of a head CT
- qEEG can be helpful for those that do not want SPECT
- AmenUniversity.com has a professional brain health course that teaches people how to read scans
- 160 places in the US and Canada that do brain SPECT; 10 centers around the country
- Write down 20 happiest moments of your life so that you can anchor to something when you are down
- Insurance does not want psychiatry to go in a medical direction; prefer symptoms with no biological data
- Head injury, dementia, seizures, strokes, resistant psychiatric disorders, cognitive impairment may be indications for SPECT
- Amen Clinics has software similar to NeuroQuant; NQ is MRI which looks at physical structure vs. SPECT which is function; SPECT is a leading indicator; MRI is a lagging indicator
- Looked at items that prematurely age the brain; marijuana aged the brain by 3 years; impact of CBD on the brain is unknown at this time
- Not a huge fan of statins because they often lead to depression and impact memory
- Cardiologist want to get cholesterol as low as possible; there is a cost to low cholesterol; if under 160, association observed with homicide, suicide, and depression; ensure total cholesterol is between 160-220; best cognitive function have total cholesterol around 225
- Social media impact on the brain has been devastating and likely cause for increase in suicide in teenage girls
- News is no longer balanced; they lead with things that scare you
- For vulnerable brains, EMF sensitivity is a real thing; percentage of sensitive people is unclear
- Uses Omega 3 Index by Bill Harris; regularly Omega 3s work well; 60/40 ratio EPA/DHA
- Likes OxyHealth HBOT for home and clinic use
- Vinpocetine can be helpful for increasing blood flow in the brain
- His supplement company is brainMD
- In terms of withdrawal from benzodiazepines, the approach is similar to head trauma; benzos cause a damage pattern in the brain; does not prescribe them; they negatively impact brain scans; withdrawal has to be done slowly while adding nutrients and good habits
- In PANDAS/PANS, sees basal ganglia are extraordinarily active and inflammation is found in the limbic structures of the brain; not unlike in COVID scans
- HBOT goes to 1.3 ATA at home; for head trauma 1.5; for Lyme up to 2.4 in clinic
- GABA can calm you down and make you sleepy; may be working in the gut through the vagal nerve; doses based on treatment response; 500-1000 twice a day
- In autism spectrum disorders, SPECT scans do change treatment; published on over 1000 patients; it is not one thing; ASD shows small cerebellar vermis, decreased activity in the cerebellum with hyper-frontality; anterior cingulate gyrus and lateral frontal lobes are hyperactive; cerebellum damage is very consistent in the classic pattern; not everyone is classic; can be toxic type, inflammatory type, traumatic type; if you don't look, how would you know?
- For treating the limbic system, they first look at SPECT; can be low or high in activity; when high, supplements and EMDR
- Naps can help in those that do not sleep normal schedules; in order to support brain cleaning
- Big fan of loving kindness meditation; simple to teach/do; 5-10 minutes a day
- Starts melatonin at .3 mg and rarely goes higher than 4-5 mg
- In long-haul COVID, autopsies have found clotting to be a huge problem in heart, liver, kidneys, and brain; omega 3 routinely is a good idea; treatment is to first look; supplements, HBOT, BRIGHT MINDS risk factors
- Study suggests 30 minutes of exercise with weights twice a week increased longevity; more did not matter
AmenClinics.com

Sarah B. Myhill, MBBS spoke on "The Diagnosis and Management of CFS and ME" and shared:

Worked for 40 years as an NHS general practitioner and more recently functional medicine; functional medicine asks the question "why"
CFS/ME/Fibromyalgia are not a diagnosis; they are clinical pictures; what is it?
CFS is a problem with energy delivery mechanisms
ME is different; it is CFS plus inflammation
Inflammation occurs with immune activation from chronic infections, allergy, and autoimmunity
Car analogy for poor energy delivery
- Fuel is the diet; without the right fuel, nothing else will fall into place
- Mitochondria are the engines; straight line between mitochondrial function and energy/fatigue
- Thyroid is the accelerator
- Adrenals are the gear box
CFS/ME and Fibromyalgia are among the most poorly treated conditions in Western medicine
When energy demand exceeds energy generated, symptoms emerge that stop us from spending energy
Sugars and carbs are addictive and in the long-term are massively damaging the biochemistry of the body
Symptoms are the sign-posts on our road to recovery
Poor energy delivery to the body leads to fatigue and poor stamina, post-exertional malaise, muscle pain, muscle power loss, blurred vision, and much more; pathologically fatigued will pay for any exertion over what they can do
Poor energy delivery to the brain leads to mental fatigue and what feels like dementia; light and noise intolerance; brain weighs 2% of the body but consumes 20% of total energy
Poor energy delivery to the heart leads to low blood pressure, POTS, "atypical" angina from lactic acid; low cardiac output is a "state of heart failure"
Poor energy delivery to the immune system leads to susceptibility to infection, unable to mount a fever; slow healing and repair
Lactic acid burn can be very persistent; need to improve energy delivery mechanisms
Mitochondria are essential for all organs to function; liver, kidneys, and others
To improve energy deliver mechanisms, must do all and in the right order
- Start with Paleo/Ketogenic diet, nutritional supplements, and good gut function to put fuel in the tank
- Support the mitochondrial engine and sleep
- Support the thyroid as the accelerator pedal
- Support the adrenals as the gear box
If you are eating carbs, you will have a fermenting guts and even supplements will then feed the fermenting gut
Then uses vitamin C at 5+ grams per day throughout the day to help kill gut fermenters, absorb minerals, protect form infection, support detox and antioxidant status
Then has foundational supplements and mitochondrial supplements
Balance the adrenals and thyroid; these kick the mitochondria into action; you need the mitochondria in a fit state to respond
Consider detoxification
Explore immunological and emotional holes in the energy bucket
Do not push to the point of post-exertional malaise
Paleo/Ketogenic diet fuels the body with ketones and removes gluten and dairy products
Gluten is only fit for animal feed; not for humans
Dairy products are meant for baby mammals and increase chances of cancer, heart disease, autoimmunity, osteoporosis, GI fermentation
Butter is the only safe dairy
Monitor ketones with a breath meter
Dairy is 10 parts calcium to 1 part magnesium; need to be 1:1; leads to magnesium deficiency
Dairy products are a risk factor for osteoporosis; they do not make it better
She created the PK Cookbook with many recopies that she uses with her patients
Basic supplements include: good multi, sunshine salt (minerals), D, methyl B12; then ascorbic acid at 5 grams in one liter of water and sipped throughout the day; the C helps to minimize upper gut fermentation which leads to supplements feeding microbes
Then can start working on mitochondria which may be going slow due to wrong fuel, deficient micronutrients, blocked by something (such as organophosphate pesticides), control mechanisms (thyroid/adrenals) are wrong, service and repair mechanisms are faulty (sleep, antioxidants)
Ketogenic is not high protein; it is a normal protein diet with high fat
Artificial sweeteners keep the psychological sweet tooth going
She has published papers on her approach that confirm that it works
ArminLabs now offers a mitochondrial function test
The correct fuel for the mitochondria are ketones
Heart and brain run 25% more efficiently on ketones
"Let fat be thy medicine and medicine be thy fat!"
You have to test to confirm that you are in ketosis
- Beta hydroxybutyric acid present in the blood; most accurate; expensive
- Acetoacetate in the urine; can have false negatives
- Acetone exhaled measured with breath testing; preferred method; can get false positives if you drink alcohol or have an upper-fermenting gut
Sugar is so toxic to the body that it will always burn sugar first to get it out of the way; any positive ketone reading will do
Make sure you are eating sufficient food; cutting down calories leads to fatigue due to restricting fuel in the tank
You do not lose weight by restricting calories; starvation mode leads to fatigue
Low protein diet leads to eating more and gaining weight; high protein diet leads to eating less and losing weight
Eating fiber is important for the mitochondria; ferments in the large bowel to creates SCFAs or ketone bodies
Number 2s should look like number 4s on the Bristol tool chart
Fats and oils are essential fuels; there is no such thing as a bad fat in nature; processing and heat damage them and make them dangerous
Saturated fats are perfect fuels and good for storage and cooking; unsaturated are essential for cell membranes and mitochondrial membranes; they fit our biochemistry perfectly
Only cook with saturated fats
Use cold pressed oils
Carbohydrates are essential; rate materials to make ATP, DNA, and RNA
10% have Gilbert's syndrome and are at greater risk of CFS as they are at risk of poisoning; cannot detoxify bilirubin; often do well with glutathione
Eat seasonally for variety; the more diverse the microbiome, the healthier we are
Every bacteria has a favorite food
Greater diversity of foods consumed leads to greater diversity of the microbiome
70% of calories commonly come from 4 foods
Bone broth can be helpful for supporting the connective tissue
Need to heal the gut to digest by chewing food properly
Chewing increases VEGF which improves leaky gut
All food should be eaten within a 10 hour period of time per day
Mitochondria raw materials: magnesium, CoQ10, niacinamide, Acetyl-L-Carnitine, B12, D-Ribose; order of importance
Vegetarians and vegans are almost always deficient in B12 and Acetyl-L-Carnitine
Magnesium is important for many enzyme functions
Absorption of magnesium is enhanced with Vitamin D
D-Ribose has to be considered as a carb as it is a sugar; should be a rescue only
Inhibitors of mitochondria: lactic acid, gut fermentation, diamino compounds (dyes from hair, foods, drugs), parabens, fire retardants, pesticides, nickel, mercury, toxic metals, malondialdehyde (poor antioxidants), mycotoxins, viruses, immunoglobulins
Thyroid and adrenals: allow closely matching energy delivery to energy demands
If you cannot gear up energy production, a predator becomes prey and then dies
If you waste energy, one may not survive the winter or a famine
Thyroid and adrenals are important for circadian rhythm
Need light during the day to stop melatonin; dark at night to trigger it
Melatonin stimulates TSH and thyroid gland production of T4 which is then converted to T3 and kicks the adrenals into life to produce cortisol and DHEA
Many with CFS go to bed late and wake up late; the cycle is not working properly
Underactive thyroid is not well treated; often under-treated
"A reliance on a TSH to diagnose hypothyroidism is the biggest single medical error of modern times."
Often is a secondary hypothyroid; not primary
Testing is done to rule out hyperthyroid and to consider potential thyroid glandular support
Average core temperature reflects thyroid function; fluctuations reflect adrenal function
Measure core temperature with far infrared device; if it fluctuates by 0.3 degrees C above or below the average, may need adrenal support such as pregnenolone
Average core temperature being consistently low is typical of underactive thyroid
Thyroid hormone is responsible for how fast mitochondria go and the number of mitochondria
Have to go gently with thyroid support as to not overshoot the sweet spot
Pulse rate is another useful test for thyroid; if resting pulse is below 70, particularly below low 60s, and you are not an athlete, thyroid may be too low
These foundational regimes are what she calls "Groundhog" regimes; they often lead to a lot of ground; they are outlined on her website at https://www.drmyhill.co.uk
Techniques are in her book "Ecological Medicine"
ME is CFS plus inflammation; after energy delivery mechanism optimization; need to look at inflammation
Inflammation occurs when the immune system is active/busy with infection, allergy, or autoimmunity
Avoid allergy with the PK diet
Avoid autoimmunity with avoidance of vaccines, high vitamin D
Avoid chronic infections with her Groundhog Acute regime
Infections come when least expected; stock up on Ascorbic acid, Lugol's iodine, salt pipe, sunshine salt, salt and dressings for skin breaches
She likes her patients to have a salt pipe and use it with Lugol's iodine and sniff from the salt pipe to provide support against infections
Vitamin C is the single most important "Groundhog Acute" weapon; she may use 10 grams of C per hour until bowel tolerance in acute scenarios
90% of infections come in through the gut
EBV is her most hated virus; causes many pathologies
Dr. Paul Marik has demonstrated the benefit of Vitamin C in those with blood poisoning; mortality went from 40% to less than 1%
Should check for G6PD before using IV C; does not appear to be an issue with oral vitamin C
Vitamin C attacks infections from inside out; iodine from outside in
Other weapons: herbs, spices, fungi (mushrooms), heat, light, rest; do not suppress symptoms
Sun bathing is very helpful for its antimicrobial properties
Improving energy delivery mechanisms warms up the body and all enzyme systems work better; microbes do not like heat
ME patients have chronic infections that are well-established
"Infection Game" book goes into more detail on how she approaches infections
Five common infections: EBV (Valcyclovir), Lyme (antibiotics), Mycoplasma (Doxycycline), fungal infections (Groundhog regimes/possible antifungals), long COVID (Ivermectin); likes ArminLabs for EBV, Lyme, and Mycoplasma; T-cell testing / ELISpot; urine mycotoxins for fungal infections
"Groundhog regimes" set you up with good health for life
From Q&A discussion
- Cell Danger Response occurs when too much energy has been spent and the mitochondria go into a protective, hibernation mode
- A high fat diet should not be a problem for those with apoE4; ketogenic diet should still be very desirable; you have to get your fuel from something
- Far infrared saunas can be helpful for supporting mitochondria, warming the body, helping detoxification; a favorite multitasking tool
- Any heating regime must be followed by a shower to wash toxins off the skin
- Phospholipids are a very useful treatment; oral PC can accomplish the same end goal, but takes longer
- Has not observed ascorbic acid causing kidney stones; helps to dissolve them
- In terms of liposomal C, evidence that it is more effective has not been compelling
- Some people find ascorbic acid too acidic; can be neutralized with magnesium carbonate; 2 parts AA and 1 part MC by weight is a neutral solution
- Iodine deficiency drives autoimmunity; not iodine excess; essential for the immune system, breast tissue, heart, brain
- In those that are severely iodine deficient, thyroid may go into overproduction temporarily when they start adding iodine; start with low doses and build up slowly; some may need 15-50mg daily; might use 3 drops in water at night of 15% Lugols; safe in Hashimoto's
- Long-term ketogenic diet will unmask borderline hypothyroid; keto diet does not lead to thyroid problems
- Primitive people would have been in ketosis most of the time except in the autumn; would then go back into ketosis when carb foods run out
- NAD levels come up well with niacinamide; keep things simple and inexpensive
- Vitamin C helps with excretion of heavy metals including iron; if having red meat, take C away from the meat; get the benefits of iron excretion without increased absorption of iron
- Ketone esters are expensive; doing the PK diet
- EMFs impact ion gradients across membranes; the negative possibilities are almost limitless
DrMyhill.co.uk

Samuel F. Yanuck, DC, FACFN, FIAMA spoke on "Immunological Drivers of MCAS and Brain Fog: What’s Under the Hood and What To Do About It" and shared:

Need to look for patterns in order to make progress in complex patients
If you think of symptoms as a laundry list, you will not win; need to think more in terms of a map; how are things related? What are the key points of intersection?
Chronic illness and body inflammation are co-activators of chronic illness
Body inflammation drives CNS and brain inflammation which leads to brain fog, fatigue, anxiety
Brain inflammation leads to NF-κB activation and diminishes serotonin and dopamine leading to depression
CRH turns on the stress chemistry system and production of cortisol; turns on NF-κB and macrophages in intestines in spleen and IL-6 in liver
Stress chemistry leads to apoptosis or cell death of Th1 cells and NK cells
Viral burdens are then allowed to expand such as EBV, CMV, HSV-1
When Th1 system is lost, viral burdens expand and are no longer in the background
They in part drive body inflammation
Loss of Th1 means that Th2 is no longer inhibited and Th2 is increased
Th2 leads to mast cell degranulation and IL4 turning on mast cell numbers and activity and additional histamine
Histamine drives neurogenic inflammation; creates a loop activation that pours out more histamine
Neurogenic inflammation makes GI inflammation worse
Histamine increases intestinal permeability
GI inflammation and intestinal permeability go hand in hand
Inflamed intestinal epithelium make many Th2 promoting cytokines and drive mast cell activity and degranulation
IgE cannot be used to check for mast cell overactivity; can have excess mast cell activity with normal IgE
Mast cell mitochondrial DNA lead to more mast cell degranulation; many loops involved in chronic illness; patterns become entrenched
Why doesn't the body just fix this? It gets stuck. Mechanisms are intended to work, but in some people, the response to a stressor fails to re-regulate.
Failure of re-regulation due to self-enforcing loops become important therapeutic targets.
Mitochondrial DNAs are highly inflammatory to the intestines; excessive mast cell degranulation leads to more degranulation and pouring out of mitochondrial DNA and GI inflammation which pushes all the gears
Same neurogenic inflammation that inflames the body inflames the brain
Histamine degrades integrity of the blood-brain barrier and leads to worsening CNS picture
Vagus nerve motor outflow integrity is diminished; outflow comes from brainstem
Vagus nerve dysfunction leads to more inflammation and impacts GI motility leading to SIBO
GI inflammation drives body inflammation which drives brain inflammation
Three parts: brain fog, histamine, T cell polarization
Part 1 - Brain Fog
- #1 functional medicine complaint
- Has implications beyond the brain; brain inflammation, neurodegeneration, and CNS autoimmunity
- Body inflammation drives brain inflammation which diminishes neuronal signaling
- Alteration of neuron-microglial signaling leads to loss of neurons and to brain immunity
- Impaired CNS circulation leads to low glucose, low oxygen, and low neuronal cellular nutrient status
- Microglia are the resident macrophages of the CNS and are sensitive to brain injury; they alter their morphology to a problematic behavior
- Body inflammation drives brain inflammation; brain inflammation drives body inflammation
- Lipopolysaccharides lead to a pouring out of pro-inflammatory cytokines from microglial cells in the brain
- Vagus nerve is involved in the communication with the macrophages
- Insulin and insulin resistance inhibit vagal motor outflow
- Loss of vagus nerve activity leads to body inflammation
- Neurons tell microglial cells whether or not a neuron is a dying neuron; microglial cells should then eat the neuron; every human loses brain cells everyday
- Dead cells in the brain lead to inflammation; it is normal to have phagocytosis of neurons by microglial cells; it has to be the dead ones
- Microglial cells are a form of macrophage that remove dead and dying neurons
- Phagocytosis of live neurons is a very bad thing; you want to remove only dead and dying neurons
- "Sculpture" is a good thing, but a shift in morphology of microglia in a brain with chronic inflammation leads to activated microglia phagocytosing stressed but viable neurons; this is not a good thing; more like an ice sculpture where the brain is melting away
- Neurons control the activity of the microglia
- Off signals from a neuron tells the microglia that things are good; on signals tell the microglia to remove the neuron
- On signals are inflammatory cytokines; inflammation tips the balance toward on signals which increases the error rate and more viable neurons are removed
- Brain inflammation is a much more important target than previously considered
- TGFb1 is an off signal that promotes tolerance; as are cytokines, neurotransmitters, BDNF, and other materials
- Diminishing viable neuronal loss is important
- T cells should not be in the brain; normally microglial cells will remove the T cells; if the microglial cells inappropriately respond to T cells and do not respond to them, this can lead to CNS autoimmunity
- Brain needs to not be inflamed; neurons need robust repair and neurotransmitter product and high enough electrical frequency; nutritional support and blood flow with glucose and oxygen are important for the health of the neurons to keep the microglial cells functioning in the health-promoting direction
- Brain inflammation leads to more on signals; low nerve growth factors leads to a "loss of off" signals as does low neurotransmitter levels
- Cerebral blood flow volume is diminished in POTS even when not standing; also diminished in CFS patients
- Need to have good support for cerebral blood flow volume
- Cognitive symptoms of CFS may be due to altered cerebral blood flow
- Think about the brain: blood flow, growth factors, neurotransmitter inhibition by inflammation and by histamine
- Traumatic brain injury can change cerebral blood flow; look for history of head injury
- Cerebral blood flow changes are seen in brain fog, chronic fatigue, POTS, and concussion
- Strategy: address body and brain inflammation, address vagus nerve, address microglial signaling (Lion's mane for nerve growth factor, Bacopa for neurotransmitter and increasing neuronal firing, and ensure TGFb1 levels are not too low with NAC)
- Many chronically ill patients have high TGFb1; use glutathione when elevated
- TGFb1 is made from nine cysteine residues; giving NAC can increase it; not ideal when already elevated; if you give glutathione, giving NAC is then ok; doing NAC alone may not be a good option
- Higher TGFb1 -> higher ROS; higher ROS -> higher TGFb1; glutathione can knock it down
- Support CNS circulation with ginkgo, butcher's broom, feverfew
Part 2 - Histamine
- Mast cells, neurogenic inflammation, pain
- Mast cell degranulation can directly induce microglial activation
- LPS can induce mast cell activation in the hypothalamus; can be blocked by Cromolyn; can stop the body inflammation from inducing MCAS in the brain
- Mast cells in the brain hang out waiting to release TNFa
- Evidence suggests that histamine in the brain matters a lot, and the job of the clinician is to lower histamine and reduce mast cell degranulation; have less
- Histamine opens the blood-brain barrier
- Mast cells increase epithelial permeability; leaky barriers; intestines, lungs; hollow spaces
- Mast cell releases histamine; the mast cell itself has histamine receptors which creates a loop
- Histamine stimulates the neuron as well; leads to release of CGRP, Substance P, and VIP from the neuron which then stimulates the mast cell; loop activation between mast cells and neurons
- CGRP drives migraines; Substance P drives pain; VIP is involved in many things; VIP drives Th2 dominance and more mast cell activation, histamine release, and chronic pain
- When neurons release Substance P, more histamine is released from adjacent mast cells; leads to a flare and spreading factor
- Interstitial cystitis and painful bladder syndromes follow the same mechanisms where histamine plays a role
- Some migraine medications are CGRP-inhibitors
- Th2 cells in the lamina propria of the gut lead to IL-5 and activation of eosinophils and IL-4 which leads to mast cells creating histamine which drives the enteric nervous system and resulting stimulation of the brain
- Pro-inflammatory cytokines also drive the brain to have a stress response which drives motor outflow of the stress response to drive M2 macrophages and Th2 cells; another loop
- Stress chemistry via noradrenaline drives M2 macrophages
- Th2 cell activation leads to mast cell degranulation which leads to increased histamine which leads to neurogenic inflammation (which also leads to more histamine) which leads to GI inflammation which leads to more Th2 entrenchment and the cycle becomes more entrenched
- IgE and mast cells are independent; can have MCAS without high IgE
- Inflamed intestinal epithelium leads to the production of IL-33 and TSLP which drive mast cell degranulation
- Mast cells release mitochondrial DNA; mtDNA can play a role in Ulcerative Colitis and Crohn's Disease
- Histamine receptors (H1-H4) exist throughout the body and can lead to many symptoms
- Some may need a low histamine diet
- Do not need a leaky intestine to have immune surveillance
- Dendritic cells can sample antigen in the intestine; present antigens to Th2 cells
- IL-25, IL-33, and TSLP stimulate innate lymphoid cells type 2 (ILC2) which stimulate Th2 cells
- Th2 cytokines such as IL-5 drive eosinophils, IL-4 and IL-9 drive mast cells, IL-4 and IL-13 drive M2 macrophages, IL-4 drives B cells to make IgE
- IL-9 is made by Th9 cells; TGFb1 and IL-4 together leads to Th9 cells which makes mast cell issues much worse
- Chronically ill patients have high TGFb1 levels and Th2 dominance which means IL-4 will be present and will be making Th9 cells
- If you provide curcumin, resveratrol, fish oil as step 1, you may promote more immune tolerance and more TReg cells; leads to more TGFb1 and could lead to more Th9 cells and more mast cell activity
- Instead, the first step should be to dampen Th2 to minimize driving mast cells; inhibit IL-4 and Th2 dominance first and then inhibit inflammation and promote production of TRegs
- Th1 inhibits Th2; Th2 inhibits Th1
- Histamine regulation: make less (inhibit mast cell degranulation with quercetin, luteolin, rutin to support normal mast cell function and bromelain to breakdown mtDNAs), clear faster (DAO, Aldehyde Dehydrogenase clears histamine; aldehydes from sugar, alcohol, perfumes, molds, building materials; B2, B3, iron, molybdenum), modulate Th2 excess
Part 3 - T-Cell Polarization
- NFkb of the inflammatory process and STAT3 of the autoimmune process co-activate
- Inflammation co-activates with stress chemistry and with dysbiosis
- Inflammation diminishes innate immune response / NK cell activity leading to more infection and more inflammation
- Inflammation diminishes Th1 responses; as will stress chemistry; leading to more infection and more dysbiosis
- NK cells and Th1 cells increase each other's activity; loss of one leads to loss of the other
- Loss of Th1 leads to dominance of Th2 which leads to asthma, allergy, sinusitis, respiratory infections and urinary tract infections; a dysfunction of hollow places
- Loss of Th1 and overproduction of Th2 leads to increase in Th17 which drives tissue destruction in the autoimmune process
- Brain inflammation drives body inflammation; body inflammation drives brain inflammation
- Many things make inflammation worse: dysglycemia, food, environment, detox issues, hormones, vascular or oxygen defects, and more
- If you start by trying to reduce inflammation in patients who have common T cell polarization imbalances, you can make them worse
- There are at least 7 T-cell polarization paths
- A naïve CD4 T cell is influenced by tissue cytokines to become a Th1, Th2, Th9, Th17, or Treg cells
- Autoimmunity is not driven by Th1 cells
- Th17 drives autoimmune tissue destruction
- Th17 is the key in autoimmunity; high neutrophil % in the 68-72+ range may be a clue for autoimmunity; not always high, but can be a strong indicator
- High hsCRP, think Th17; again not always
- Th1 cells kill bacteria and viruses; low in chronic infections and autoimmunity
- Total WBCs before 4 may be a clue for Th1 insufficiency; can be high if monocytes are above 12%
- Th2 cells kill parasites and expel pollen and other items from hollow spaces
- Eosinophils above 2% are a clue for Th2 dominance; so common
- TReg cells quiet all effective T cells and autoimmunity, but can be overactive in chronic infection
- High TGFb1 is a clue for excessive Treg activity driven by inflammation
- Th1 pathway antagonizes Th17; Th1 inhibits Th2 and Th17
- Th17 cells drive many autoimmune processes
- Th17 is promoted by Candida and Klebsiella and hollow space infection; need to address pathogens like dysbiosis, sinusitis, respiratory infections, urinary infections
- Regulatory T-cells quiet down all the others; Th1 blocks Th2 and Th17; Th2 blocks Th1
- Quieting autoimmunity could be with supporting Treg cells with curcumin and resveratrol; Th1 support blocks Treg
- Promoting regulatory T cells first squashes the Th1 response and leads to an increase in Th17
- Need to support Th1 first, quiet down Th2, then promote regulatory T-cells
- Many have too much Th2; very common in our modern world; so many are chronically inflamed, have stressful lives, environmental pollution with pesticides and plastics, head injury, brain inflammation, and hollow space inflammation
- Th2 dominance squashes Th1 and loses inhibition of Th17 and more autoimmunity
- If Treg cells are increased on top of that, the patient gets worse
- Naïve T-cells become Th2 cells under the influence of IL-4; Th2 cells then make IL-4 which repeats the cycle and further inhibits Th1
- Downregulate Th2 dominance with IL-4 inhibitors such as perilla, GATA3 inhibitors with Astragalus, downregulate histamine (quercetin, luteolin, rutin, NAC and bromelain to breakdown mtDNA)
- Native T-cells become Th17 under the influence of IL-21; turn on Th1 and get IFN-y which shuts down Th17
- Supporting Th1 response with support of IL-12 and IFNy such as berberine, baicalin, sulforaphane, and ginger
- Step 1 - balance T cell polarization by supporting Th1 response and inhibiting Th2 dominance
- Strong Th1 leads to better resolution of Lyme neuroborreliosis
- Better Th1 response leads to improvement in Rheumatoid Arthritis; Th17 cells were increased when there was not enough Th1 response
- Drivers of Th2 Polarization
  - Cortisol tanks Th1 response
  - Head injury -> high cortisol
  - Stress of final exams
  - Chronic rhinosinusitis
  - Intestine and lung barrier epithelial cell inflammation
  - Extracellular parasites
  - Plastics
  - Xenoestrogens
- When GI inflammation is present, it may make sense to empirically treat for parasites even without proof to downregulate Th2 response
- Many infections and irritations of the hollow spaces can lead to inflamed epithelium which leads to Th2 dominance, loss of Th1 status, and ultimately infection
- Step 2 - Once T-cell polarization is managed, you can then bring in anti-inflammatories via promotion of Tregs and inhibition of STAT3 with curcumin, resveratrol, black ginger, quercetin, sulforaphane, D, A
- Can then start a multi with a focus on autoimmunity
When TGFb1 is elevated, jumping into curcumin or inflammation-reducing tools can make things worse; Th17 dominance; can push more TGFb1 activation and increase of ROS
Pain itself can trigger stress chemistry
Steroids induce apoptosis if Th1 cells and NK cells leading to Borrelia and viral expansion; steroids intensify Th2 response
T-cells can oscillate between polarization types; want to keep them in the type desired
Golf courses are high in pesticides
Chronic viral activation often occurs when Th1 response is not adequate
Number of infections with loss of Th1 response and resulting inflammation is correlated to development and prognosis of coronary artery disease
IBD is a driver of Th2 dominance
Mold is a big promoter of Th2 dominance; Candida, Aspergillus, and others do this
Summary
- T-Cell Polarization
  - Modulate Th2 dominance: perilla, astragalus, NAC, quercetin
  - Pure Encapsulations Th2 Modulator
  - Support Th1 response: berberine, baicalin, sulforaphane, ginger, glutathione, and A
  - Pure Encapsulations Th1 Modulator
- Body and Brain Inflammation
  - Downregulate NFkb and STAT3: curcumin, resveratrol, quercetin, D; caloric restriction may promote NAD
  - Address vagus nerve with vagal devices, HRV, mindfulness
  - Need choline or PC for vagus nerve
- Break Neurogenic Inflammation Loop
  - Aldehyde dehydrogenase: B2, B3, iron, molybdenum; DAO, SAMe if needed
  - Stabilize mast cells: luteolin, quercetin, rutin, C
  - Break down mast cell mitochondrial DNA: bromelain
  - Pure Encapsulations Hist Rest
  - Breakdown mucous: NAC
  - Repair barriers: glutamine and glutathione
- Restore Balanced Neuron-Microglial Signaling
  - Nerve growth factors: Lion's mane
  - Neurotransmitter production and neuronal frequency of firing : bacopa
  - Be sure TGFb1 is not too low or too; care with NAC if high
  - CNS circulation: fatigue and POTS associated with diminished cerebrovascular flow volume: gingko, fever few, butcher's broom, vinpocetine
  - Pure Encapsulations Brain Reset
From Q&A discussion
- Immune system is not one thing that goes up and down; there is no such thing as supporting "the immune system" as it is not one thing
- When you upregulate Th1, you diminish chronic bacterial and viral burdens; reduces chronic background grind in inflammatory activations
- Supporting Th1 and downregulating Th2 dominance are both almost always suitable and often an essential starting point
- Pure Encapsulations Balanced Immune can be used next for NFkb and STAT3
- Pure Encapsulations Innate Immune Support supports the activity of NK cells
- A neuron is a current carrying wire; external EMF could diminish the efficiency of the signaling and could shift microglial cells to their health-negating morphology; those impacted may have less than robust neuronal firing; if the intrinsic field is more robust, extrinsic fields have less impact; reduce inflammation and reduce MCAS in the brain with Hist Reset and CNS circulatory activity with Brain Reset; trophic factors and neurotransmitters are an off signal; better circulation leads to adequate glucose to sustain frequency
- EDS is challenging; not missing basic things is what appears to work the best; basic labs looking for low ferritin and low glucose; explore basic biology
- When using exogenous glucocorticoids for adrenal support, long-term support of Th1 may be appropriate
- Some with insulin resistance have no constipation and no SIBO if they are robust; others have more fragile vagal tone and mild issues can matter a lot
- Measure TGFb1 level; if low, NAC is a building block for TGFb1; promote curcuminoids, D, fish oil to create tolerance to create more TGFb1; when high, liposomal glutathione can reduce
- Low glutathione is more commonly found at Quest vs. LabCorp; if LabCorp, want 240 or higher to be a robust level of glutathione which is needed for Th1 and barrier health
- Tough patients need to address environmental mold and dampen Th2 response directly
- When people get to a higher ground and are stable there for a couple of months, then he reduces supplements by 1/3 to 1/2 one at a time to identify what minimal support is needed to keep the patient improved
- LDN could be introduced after T-cell polarization focus
- Idea of transfer factors is common but not part of the modern immune conversation
- There are pathogens trying to kill you (not biofilm formers) and those that want to setup shop and co-exist in the body like EBV; they persist through time and do not kill the host; they spread better in a live host than a dead host
- Unclear whether or not there is a chronic form of COVID; further research is needed
CogenceImmunology.com, YanuckCenter.com

Ruth Kriz, MSN, APRN spoke on "Chronic UTIs and Interstitial Cystitis" and shared:

Quality of life of IC patients is lower than that of kidney dialysis patients
Often told it is in their heads or learn to live with it
More advanced testing sheds light on recurrent UTIs and IC
Cure is now possible in most of these patients
Health care focus is on acute illness or a diagnosis of a chronic condition with no focus on recovery or cure
Inappropriate treatment with antibiotics can lead to drug resistant infections
Both chronic UTIs and IC have pain, burning, urgency, and frequency of urination
UTIs respond to antibiotics; IC may or may not
UTIs are often positive on standard urine culture; IC generally negative
UTIs have no visible damage to bladder wall; IC does
Chronic UTIs and IC may be one process on a continuum
Current research hypotheses:
- Neurological - back injury, pain promotion, increased urinary nerve growth factor
- Allergic - higher histamine and mast cells
- Leaky bladder - damage to GAG layer
DMSO, Elmiron, pelvic floor therapy, Ditropan, Amitriptyline, IC diet have all been considered
Many tools can help reduce symptoms but do not address root causes
Low Th1 and presence of intracellular pathogens may play a role in IC
Assumptions practitioners make:
- Every acute UTI is a reinfection
- If standard culture is negative, there is no infection
- If the culture is contaminated, the specimen was not correctly collected
- A random urine is fine
- All colony counts reflect accurate bacteria load; bacteria are not always free-floating
- There is no need to treat a high bacterial load if no symptoms
- A short course of antibiotics is adequate
Infections can be found when urine is cultured in a soy broth culture medium
Mast cells can be in abundance in bladder tissue; Enterococcus has been observed under a microscope
IC is an infection
Many patients completely recover when the infections are treated
One study explored antibiotic therapies and found minimal benefits; was intended to show that it was not an infection
What if infections can hide in biofilms that cannot be cultured?
What if IC is an infection and the bladder wall will repair after treatment?
What if chronic infections need different treatment?
What if certain genetics are involved?
What if other triggers contribute and can also be treated?
At one time, ulcers were believed to be stress; not an infection
IC diet only helps to manage symptoms; huge overlap with the low histamine diet; can be helpful but does not fix an infection
Why can a standard urine culture be negative?
- Aren't any bacteria present
- Bacteria did not survive
- Human error / judgement / contamination
- Handling issues
- Collection issues (over-dilute urine)
- Bacteria is in a biofilm
- Cell wall deficient forms (don't grow on a culture plate)
Beta lactams can drive bacteria into a cell wall deficient form resistant to most antibiotics
These forms have been linked to chronic UTIs and to IC
Most still operate under the assumption that IC is not an infection based on negative urine cultures
CWD/L-forms/persister cells do not grow out on a culture plate; not responsive to antimicrobials
PCR is highly accurate, fast, sensitive, can detect L-forms; requires individual primer for each organism; some compounds like lidocaine will inactivate the primer; can only do 24 pathogens at a time
Microgen DX does PCR and Next Generation Sequencing; first report using PCR checks for 22 pathogens in 24-48 hours; additional testing with NGS takes non-human DNA and compares database of over 50,000 bacteria and fungi
Pathnostics does PCR testing for 48 pathogens
NGS is low cost and increased accuracy; expensive equipment; best to wait for the Level 2 report before determining a treatment path; does not do true sensitivity testing; more literature-based
More than two infections could suggest presence of a biofilm
Pathnostics only does PCR testing; 48 pathogens; does true sensitivity testing for pooled bacteria
Uses Microgen DX 90% of the time; Pathnostics can provide answers that Microgen DX does not
Microgen DX can do urine, vaginal/urine, semen/urine; Pathnostics does urine only
Almost 100% of men with issues are getting infection from the prostate; 10% have retrograde ejaculations
In men, need an antibiotic that has good prostate penetration
Biofilms can be produced by the bacteria; fails to consider that people can make biofilms in response to infection and inflammation
A biofilm in the bladder is a rigid structure; not a goo; fibrin gives it a rigid structure
Biofilms can be polysaccharide, protein/extracellular DNA, fibrin, or amyloid; most biofilms tend to be a mixture of types; fibrin biofilms have a polysaccharide dimension to them; some bacteria produce amyloid fibers or "hooks" that allow them to attach to a surface like the bladder wall.
Enterococcus, Klebsiella, E. Coli, Pseudomonas, and other bacteria in the urinary tract can create biofilms and amyloid hooks
Many diseases are considered biofilm diseases
Atherosclerosis, Alzheimer's, Lyme, and PANDAS may be biofilm diseases; possible or probable
Biofilms protect bacteria by limiting antibiotics getting in, transmit resistance genes, express efflux pumps, antibiotics inactivated by the pH inside the biofilm, persister cells are not responsive to antibiotics
What makes a chronic UTI and IC patient different? It's in the hypercoagulation and other genetics such as Vitamin D (100%), CBS (100% upregulated; leading to estrogen dominance and may play a role in endometriosis and PCOS), CYP450 1B1 (100%), and several other SNPs that lead to higher homocysteine
Found hypercoagulation genes in 70% of patients compared to 20% of the general population; PAI-1 4G deletion, Lp(a) and Leiden Factor V
Body responds with fibrin production in response to infection and inflammation
Biofilms make the immune system less able to address infection and antibiotics less able to access infections
Making fibrin? Prothrombin Fragments 1+2 (actively producing fibrin) and upregulated Thrombin/Anti-thrombin Complexes (good guys keeping things in check)
Fibrinogen Activity is old fibrin buildup; elevated Alpha-2 Antiplasmin prevents upregulation of T/AT Complex; elevated D-Dimer is a degradation product (how well the body is able to breakdown old fibrin)
Balance between coagulation and fibrinolysis/fibrin breakdown; clot vs. hemorrhage
Fibrin is broken down through T/AT complex and t-PA (clot buster used for heart attack/stroke)
Leiden Factor V screening test is Activated Protein C Resistance; cannot upregulate T/AT complexes, make more fibrin, unable to breakdown
PAI-1 binds to t-PA and prevents upregulation of T/AT complexes
Certain genetic presentations such as PAI-1 4G deletion may require biofilm busting support long-term
Lipoprotein(a) - generally thin, tall, narrow shoulders; lp(a) binds t-PA which inhibits fibrin breakdown
Lp(a) is a form of LDL cholesterol that will not be lowered by diet, exercise, or statin drugs; lowering total LDL does not reduce cardiac risk
Problems associated with Leiden Factor V and PAI-1 mutations: recurrent miscarriage, PCOS, endometriosis, Fibromyalgia, DVT/PE, sinusitis, prostatitis, ear infections, PANDAS?, Raynaud's?
Coagulation defects + pathogens result in fibrin generation resulting in biofilms resulting in chronic infections
Recurrent infection is more likely biofilm infection and not a re-infection
Up to 70% with biofilms have genetic mutations; when addressed makes disrupting biofilms more effective and possible to eliminate pathogens
Most biofilms are often less symptomatic than those that breakdown biofilms on an ongoing basis
VDR (Vitamin D Receptor) mutation: big deal, low vitamin D even at end of summer, needed for bladder to produce cathelicidin to prevent UTIs; cannot get well unless D is above 50; make D as well as others but always need to supplement; 100% of her patients
D is precursor or 17-OH-progesterone needed for cortisol and progesterone; leading to estrogen dominance
CBS upregulation leads to more ammonia; 100% of her patients; high ammonia damages GAG layer in the bladder which is the definition of an IC patient
Ornithine at bedtime can be helpful for ammonia and can help with sleep
Nrf2 support can help to produce more cysteine and less ammonia; Nrf2 decreases NFK-b which some mold toxins upregulate; those with mold toxins and those with damaged bladder wall may benefit from Nrf2 support; prevents E. coli from attaching to the bladder wall
Other contributors: mold toxins damage the kidneys and bladder; tick-borne infections can settle in the bladder wall; adrenal, thyroid, sex hormone production should be checked
Clearing mycotoxins allows the immune system to better respond to microbes impacting the bladder
Peeing at night may be related to low ADH from mold toxins
100% of her patients had CYP450 1B1; estrogen dominance
90% of her patients with elevated TSHs were iodine deficient; giving iodine led to avoidance of the need for thyroid medications
Diagnostics: D 25-OH, CD57 (consider mold or Lyme when below 100), Molecular Testing with MicroGenDx; Pathnostics may be indicated later
Sexual partners should be tested as symptoms often flare after sexual activity (immediate can be mechanics; 1-2 days later can be infection); use protection until sexual partner is clear
Hypercoagulation testing; LabCorp panel 504723; fibrin, T/AT, screen Leiden Factor V, and reflex to genetic testing
LP(a) should be below 10
Protein S is vitamin K dependent; K production comes from healthy gut flora; low Protein S may be a reflection of a need for gut recolonization with healthy bacteria
Testing for mold, Lyme, co-infections, thyroid, adrenals, hormones, etc. may be needed
Differences in treatment
- Treat based on molecular testing vs. standard cultures
- Chronic infection treatment vs. repeat, acute infection treatment
- Vitamin D between 50 and 100
- Reduce ammonia levels
- Address biofilms based on genetics
- Prevention protocols for those prone to chronic infections
Some may need to stay on Vitamin D and biofilm disruptors for life depending on their genetics
Helpful supplements: Vitamin D, ornithine, Nrf2 support; likes PatchMD glutathione, D, B vitamins
If D is not increasing with supplementation, check RBC magnesium
Brain fog improves with ornithine if the cause was high ammonia
Biofilm Disrupters
- Kirkman Biofilm Defense; can be helpful before first urine collection
- Biofilm Phase 2 Advanced; if Klebsiella or Pseudomonas found (they make their own biofilms; Bismuth can prevent biofilm formation)
- Boluoke; everyone with Leiden Factor V, PAI-1 4G deletion, or elevated Lp(a)
- Niacin; if elevated Lp(a)
Chip away at biofilms consistently without triggering major flares is best
Bladder instillations have been used to instill antibiotics locally; can also add biofilm disruptors
Takes about 4 months for the bladder wall to heal after the infections are gone
Check MicroGen urine for several months to make sure no pathogens are taking advantage of the bladder wall
Patient Guidelines
- Drink enough to urinate every 3 hours during the day
- Don't drink too much such that the antibiotics are over-diluted
- Stay on probiotics
- Retest 3-5 days after the last course of antibiotics
- No unprotected sex unless partner is not infected
Healing is not linear; it doesn't work that way
Address as many factors as possible
Repeat urine testing and repeated treatment as biofilms are broken down; make take 1-2 years
Take a longer view; is there less urinary frequency?, shorter duration of flares?, less severe flares?, small amounts of new foods now tolerated as bladder wall heals?
Having tools when needed for pain management can be very helpful
Loves herbals like Beyond Balance for Lyme and related infections
Uses antibiotics for the bladder infections
From Q&A discussion
- Has worked with a few urologists starting to work with MicroGen testing for prostate issues
- Important to consider which antibiotic has prostate penetration
- Bladder instillations are 10% or less; most can clear with oral antibiotics
- MicroGen is recently approved for New York residents
- Results with herbal protocols only have not been encouraging
- Looks at Vitamin D levels, hypercoagulation genetics and testing; not using any other genetic testing at present
- Ammonia is a moving target; blood and urine levels are not reliable; depends on protein intake, metabolism, and time since ingestion
- Urinary pH 6.4-6.7; certain pathogens flourish in specific pH; E. coli is at lower pH; Enterococcus is at higher pH and is the persister in 85% of cases; urinary pH is higher due to ammonia
- There are different types of biofilms; fibrinolytics will likely not impact biofilms where fibrin is not a significant component
- Not convinced that breaking down biofilms with these tools has negative impacts on beneficial biofilms
- Uses Boluoke for lumbrokinase; others may not be as good
- Uses Serrapeptase in children for biofilm support; Xylitol can be helpful in children
- Does not find Nattokinase is potent enough for her patient populations with genetic variations
- Prior to urine testing, stop all mucilaginous products a week prior, start biofilm disruptor 5-7 days in advance; often uses Kirkman Biofilm Defense for this purpose
- If urine culture is positive, need to continue to treat; organisms can be eradicated; correct biofilm disruptors are important to consider
- For iodine, tests with Doctor's Data; depending on result, determines the dosage and duration; can trigger hyperthyroid symptoms if done too aggressively
- If fibrinogen activity is high (old fibrin buildup), Lumbrokinase may still be used with anti-coagulants; it is a fibrinolytic; not an anti-coagulant; will not cause spontaneous bleeding but will prolong clotting time; if already anti-coagulated; two different mechanisms
- Patients have tried ozone bladder instillations; flared things; can check MicroGen to see which organisms may benefit from oxygen vs. be harmed by them; can be helpful in certain situations but in her patients, has not seen positive responses
RuthKriz.com

Paul S. Anderson, ND spoke on "Interrelationships Between the Endocrine System and Chronic Illness" and shared:

Discordance between training for acute care medicine and how treating the endocrine system in chronic care medicine works
Add interrelationships that are almost unique to the chronically ill patient; it makes even more layers of complexity and distance between what was learned in acute care model; much of it goes out the door in the chronic care model
Data pool is enormous to support the complexity of interrelationships between the endocrine system and chronic illness
Regardless of why there is a chronic illness (Lyme, mold, etc.)
- Underlying cytokine shift keeps going below the radar; leaves multiple imbalances
- Imbalances are responded to by the immune and endocrine system
- When the endocrine system attempts to rebalance, predictable endocrine shifts occur
- Shifts often do not return to normal; adds a chronic endocrinopathy to the chronic illness
The trigger doesn't matter; the same process ensues
The longer you have been ill and the more triggers you have, the more problems you have with the endocrine system and its response to itself
In acute cases, the endocrine system often returns to normal with no assistance
In chronic cases, there are multiple imbalances and impediments to cure that create an endocrine response that cannot return to normal without support
Toxicity, immune imbalance, genetics, cellular function, mitochondria, psychosocial, GI, infections; all pile on and no longer allow for auto-resolution
Acute is not equal to chronic
Many patients with chronic illness develop autoimmune conditions
Autoimmunity and the endocrine system interact
The hormonal system is impacted by inflammation
Conventional medicine often does not understand treating the endocrine system in complex, chronic illness; they generally don't believe it is necessary unless a more accepted autoimmune condition like Graves
Viruses impact primary and secondary immune functions
Post-COVID patients will be a new sector of the chronically-ill patient population
Specific endocrinopathies are seen in post-COVID
Can look and sometimes find easy problems with the thyroid; may respond to simple approaches like the introduction of thyroid medication; what is seen in the average chronically ill patient (sick longer than 2-3 and often 5-10 years)?
Thyroid balance is designed to respond to illness; can upregulate or downregulate; almost always returns to normal after acute illness; thyroid suppression is a tool to slow mitochondria and help the body operate at a new, slow normal in chronic illness
Chronic disease can cause thyroid suppression via direct T3 receptor ligand interference (toxins such as chemical/mold/metal and drugs can slow), increased rT3 (stress or inflammation), decreased T4 to T3 conversion (stress, inflammation, co-factors), and antibody increase or formation
Reverse T3 (rT3) is not a good predictor of anything in someone not chronically ill; a good predictor in chronically-ill patients
Auto-antibodies are seen in post-COVID
There is a need for peripheral receptor T3 and inside the cell T3
Labs: TSH, free T3, rT3, free T4, antibodies (TPO, anti thyroglobulin, TSI)
Looks at where in the range free T4 is compared to free T3 which may lead to insights around conversion problems
Thyroid resistance is different from thyroid conversion; resistance is reasonable T3 with high rT3
If T3 is lower in the normal range and rT3 higher, that represents a resistance pattern
Thyroid and adrenals balance (or imbalance) each other
Can be on a robust dose of thyroid and still have problems; adding more T4 is not always the solution
Looking at rT3 (huge trigger is the presence of too much T4) can often show that there may already be too much T4
Output of adrenal glands can impact thyroid function; most of acute medicine does not believe in adrenal problems except for Addison's, Cushing's, and a few other conditions
Thyroid problem may be low-hanging fruit and easy to find, but the problem may be related to stressed adrenals and not enough adrenal support; fixing the thyroid can crash the adrenals
It is hard for the body to heal without some thyroid support, but need to consider the ecosystem
As soon as you start putting in inputs, the system responds, and the entire case may change; can't rely on older labs to reflect the current picture
If the thyroid looks good but the patient is still not improved, it may be that the adrenals are crashing
Some patients need thyroid or T3 specifically, but it may be overstimulating to the system; a little bit can go too far
With thyroid, the adrenals may not be well-supported and wagging the dog (adrenal output) by the tail (thyroid); or they may not be supported in the rest of the body for their chronic illness and the body is turning down metabolism due to illness; adding thyroid without addressing the body can make people feel overstimulated
Rapidly dividing cells may start acting more normally; sub-threshold infections may be interacted with through the gut immune system or the bone marrow; can make a person feel worse when adding thyroid support
In acute illness, adrenals increase corticoid output to regulate the inflammatory portion of immune triggering; adrenals over-produce when we need it, but if the cytokines are never shutdown, there can be a crash leading to underproduction; not "pathologic" from a conventional medicine perspective, but is a "functional" issue
Corticoids may rise or fall in chronic illness
A stressful event and cytokines should double or triple cortisol output for the day; the longer that is done eventually leads to a low response or "flat line" response
Long-term adrenal "repair" cannot be persistent without treating the other affected processes
More impactful adrenal interactions include immune, thyroid, blood sugar control, and nutrients like C, B, minerals, D, etc.)
The need for things going away is a sign of healing; don't always know when that will be
Autoimmunity, chronic infections, and thyroid are key stressors of the adrenals; next would be blood sugar control and insulin
If hydrocortisone is a "1" strength, prednisone is a "4", and dexamethasone is a "30"
40mg of hydrocortisone is much lower than the same dose of prednisone
Hydrocortisone can impact aldosterone and mineral balance
Adrenal suppression is possible; can happen when the dose of the supplement exceeds normal adrenal output and for a reasonable period of time; suppressing the adrenals with steroids is hard to do unless using stronger steroids
AM cortisol, ASI, 24 hour cortisol, urine metabolites can be helpful labs; salivary testing has been around for a very long time; urine cortisol is reserved for ruling in/out Cushing's
With adrenal support, watch for sleep issues, water-weight gain, signs of thyroid adjustment needs, diet, lifestyle/stress; re-test a minimum of 60-90 days later
Pharmacists often think of prednisone in terms of dosing; hydrocortisone is different
Suppression, if it occurs, is not permanent and can be reversed
Testing will guide safety and efficacy
Estrogen and testosterone have a balance; testosterone tends to be more anti-inflammatory/pro-growth; estrogen tends to be inflammatory; don't want too much of either one; often, men and women both will become estrogen dominant as they adjust to a chronic illness
Chronically ill female patient population should be gauged against the free testosterone norm for females; which was not always available
BHRT can be a game-changer for the chronically ill community
Estrogen shifts during illness in males and females; aromatase activity dominates; can bind with androgen receptors, have direct inflammatory effect
Estrogen is in balance with progesterone/androgens
Aromatase occurs in men and women; lower in men; heavily influenced by inflammatory triggers; insulin resistance leads to higher aromatization; chronic illness triggers aromatase and leads to higher levels of estrogen
Androgen/estrogen balance impacts immune balance; in chronically ill patients, both the endocrine and immune system are often dysregulated; impacts Th1/Th2/Th17/Treg balance
Estrogens stimulate B cell autoimmunity and inhibit T cell autoimmunity
Pregnenolone and progesterone are the prime neurosteroids; DHEA is a collateral neurosteroid; think of high order steroids; estrogen is very clearly a neuroinflammatory hormone; estrogen competes out binding of progesterone and becomes directly inflammatory
Excess estrogen may lead to agitation, sleep issues, chronic pain
Need to explore balance of estrogen with testosterone, progesterone, and pregnenolone
Progesterone and pregnenolone are neuro-calming and anti-inflammatory; estrogen is neuro-inflammatory and neuro-excitatory
Nervous system changes with pain, sleep, and inflammation; estrogen can trigger seizures in some people; progesterone can stop seizures in some
Prime neurosteroids can be better than benzodiazepines and help with sleep and inflammation
Progesterone nasally bypasses first pass; as does progesterone in oil; troches, drops; dry progesterone does not work as well
Glutamate, zinc, glycine, and estrogen can be excitatory
Both male and females should monitor testosterone, estrogen, progesterone, and pregnenolone throughout their illness and recovery process
In males, if testosterone is low normal and estrogen is high, that is an inflammatory trigger with heightened aromatase; need to get inflammation down, look at diet
DHT has one additional hydrogen molecule as compared to testosterone; converted by 5-alpha reductase; NAD dependent; if DHEA leads to increase in DHEA and not T, may be an issue with NAD pathway being slow; chronically ill people often respond well to IV or oral NAD therapies
Testosterone has an inhibitory effect on adipose formation; estrogen excitatory effect
With testosterone, may need aromatase inhibitors and/or DIM
In chronically ill males, SHBG can rise due to inflammation; surrogate marker for inflammation
From Q&A discussion
- In chronically ill patients, may use separate T3 and T4 and adjust the doses separately; longer-term may compound T3/T4
- Fludrocortisone can be great early on while getting the terrain settled down; uses in sicker patients early on; may also be on a little hydrocortisone and adrenal supplements as well; not a great long-term treatment
- Should not take thyroid the morning of a blood draw for thyroid
- If TSH is low, you may do 48-72 hours with no thyroid; if still TSH suppression, may be on too much thyroid
- 80% with 24 hours suppression (low TSH) have a normal TSH at 48-72 hours; no persistent suppression
- Thyroid should be taken on an empty stomach
- Metal toxins will alter ligand binding outside or inside a cell; metal toxins block 5'deiodinase; solvents and organic toxins inhibit hormone ligand binding as they have an affinity for membranes; metals impact more factors
- Likes NR for NAD levels more than NMN; all NR is made from the same source; NMN appears to work as well as NR but has less data
- Glutamate receptors are stimulated by estrogens; can be hyper-sensitive for genetic reasons; glutamate can trigger mania; estrogen can as well
- Mechanisms of LDN are becoming better understood; he uses it more with non-autoimmune chronic illness
- In autoimmunity and cancer, LDN is an "important background player"; not always the homerun; keeps some receptors calm while working on other parts of the problem
- If a patient is likely to continue their cortisol support, they may continue when retesting to see that they are not overshooting; if looking for whether or not adrenals are improving, may continue natural support but stop hydrocortisone
- Acutely, putting patients on aromatase inhibitors like DIM may be a good idea; longer-term, they may not need it
ConsultDrA.com

Ann F. Corson, MD spoke on "Antimicrobial Treatment of Vector-Borne and Community-Acquired Infections" and shared:

Dr. Corson generously shared her slides here; much of the content available in the slides will not be repeated below
Has treated tick-borne diseases since 2003; mold since 2004; hypercoagulation since 2005
Geographical location impacts what products work best for a given population; different strains of microbes may be present
Patient Protocol Essentials: enzymes, anti-inflammatories, drainage and organ support, immunologic/nutritional/metabolic support, binders, antimicrobials
All essentials must be addressed either simultaneously or in a layered fashion
Enzymes are incredibly important; proteases and fibrinolytic enzymes
Anti-inflammatories are incredibly important; many herbs do multiple things in the body
Pathways must be open; cannot create garbage and not have the garbage chutes open
Binders provide help to remove the toxins out of people's bodies
Boluoke is the only lumbrokinase that has been clinically efficacious over the years; has been confirmed with cranial osteopaths in terms of what they feel in the body
Nattokinase is commonly Allergy Research Group; softgels need to dissolve further down in the gut
Most Nattokinase is soy-derived; very few react; US Enzymes has a product that is cleaned well and may be better tolerated by the small number that may not tolerate others
Marcozymes, Interfase, Interfase Plus, and Serrapeptase as proteases
Fibrenza from HCP Formulas is a good combination enzyme product
Seaxym from, US Enzymes may be helpful in those with sinus issues
Uses a lot of anti-inflammatories; acute inflammation after mold likes Flex Now Shea nut; for chronic inflammation, Nrf2 Activator, Curcumin Pure, CytoQuel; may use Ibuprofen
Drainage and organ support are very important; OGN-RESP may support restoration of the lungs; OGN-KB may help in those with chronic UTIs or IC; TOX-EASE GL may help with removal of toxins from the nervous system; TOX-EASE PST may help remove intracellular, deeper toxins in the body
For Raynaud's, Nestmann Aesculus may help to dilate the arteriols
Cholenest is a wonderful cholagogue to support the gallbladder
Solidago is a go to for kidney support; particularly with heavy metal detox when people have sore low back
Her patients use glutathione by the bucket load
BodyGuard may help against Babesia and also against EMFs
Glypho-X has been helpful in her patient population for glyphosate and other toxicants
Schisandra may protect the liver against mycotoxins and other stored toxins
sanPharma like for immune-modulating effects
Marco Pharma Somaplex line of trace minerals can be a nice way to introduce ionized trace minerals
Transfer factors can help to regulate immune confusion
Nature's Way "Alive" multivitamins are clean and inexpensive
Nature's Way Activated Charcoal is a cheap foundational binder
Bentonite can be helpful in sensitive patients
MicroChitosan appears to help binding of trichothecene mycotoxins
May have people on two different binders long-term; has not found concerns with binding essential nutrients
Beyond Balance BAB-3, BAR-2, BB-2 are her first go-to products in the line in her environment
Pau d' Arco ca be antiviral, anti-inflammatory, anti-Candida
IMN-V-III has been helpful for some resistant viruses; IMN-V-IV seems to go deeper and address some retroviruses
PARALLEVIARE is designed for parasite elimination; likes to use with RX anti-parasitics; helpful with Babesia as well
Cistus tincture appears to help with many different microbes, biofilms; helps in GI dysbiosis
Andrographis is a great antiviral and liver support (better than milk thistle)
Cryptolepis can disrupt the normal gut microbiome; likes Researched Nutritionals CryptoPlus; can be helpful for Bartonella and Babesia
NutraMedix Cumanda has been helpful with many tick-borne diseases; Enula helps with clearing cold/damp and can be helpful for Babesia; Houttuynia can be antihistamine, downregulate Th2, support for Bartonella; Mora for Babesia support; Samento as a potent antimicrobial for many different organisms and NK cell support and DNA repair; Stevia is antimicrobial; Takuna is antiviral; Teasel can be helpful for Borrelia
Researched Nutritionals Artemisinin Solo has been helpful for many microbes and for inflammation
Uses a tremendous amount of Dan Shen; helpful for hypercoagulation and Bartonella
Herbs wear many hats and do multiple things
Supreme Nutrition Morinda Supreme may help modulate the immune system; as does Astragalus
Scutellaria Supreme is a broad-spectrum antimicrobial; anti-inflammatory; mucosal membrane inflammation
Smilax Supreme binds endotoxins and helps with mycotoxins; helps spirochetal diseases
Uva Ursi Supreme may be helpful with GI dysbiosis; best used short-term in pulses
WOAD Supreme (Isatis) is antimicrobial, anti-inflammatory, and immune modulator via downregulation of Th2
Zane Hellas Oregano Oil is one of the best available
No longer uses IV antibiotics; herbal formulas are potent
Vast majority of her patients have MARCoNS
Treats with herbal medicines and uses allopathics at the end or in difficult cases such as Babesia duncani; often combines several tools for each microbial issue
Dan Shen has healing properties for the cardiovascular system; important in the pandemic era
May use pulsed Ceftin at the end of Borrelia treatment to see if there is any observed Herxheimer reaction
Many of the PEKANA drainage products are wonderful; has used since 2005; incredibly important for drainage and organ support; ITIRES for lymphatics; RENELIX for kidneys; DALEKTRO-N for trace mineral utilization; apo-INFEKT and MUCAN may support debris cleanup from microbes; apo-OEDEM and apo-PULM may be helpful in acute respiratory illness; learning to use these products has been one of the best things she has done
People with tattoos need to consider the impact of the heavy metals
Dan Shen can be initially provoking in some patients
PEKANA coro-CALM can help with palpitations as well as cardiac symptoms associated with anxiety; coro-CALM and PSY-stabil can be helpful in Bartonella and mold patients
NotaSAN can be a helpful anti-inflammatory and immune modulator that removes a lot of the background noise in the immune system and makes it more targeted/specific
Minerals taken in capsules may not be as well-tolerated as liquid minerals
Adding one drop of something can have an effect; low and slow
Herxing: reduce the dose of antimicrobials, increase enzymes, increase drainage, binders, pooping, water, Alka Seltzer Gold, Epsom Salt Baths
Faith and respect in the Divine is often a key to healing; there is always a spiritual aspect of healing
From Q&A discussion
- Long-haul COVID may consist of a hypercoagulable state and damage to the endothelial lining
- In sensitive patients, may start with Serrapeptase or Fibrenza that have a smaller amount of Nattokinase and slowly move up
- When starting fibrinolytic enzymes, toxins and other molecules can be released from the sludge; need to go slowly and increase over time
- Artemisinin has to be pulsed or it will stop working after about 3 weeks
- With Borrelia, may treat for 6 weeks and then take 3-6 weeks off as a pulsing strategy
- Duration of treatment depends on what she does and what the patient does; diet, mold avoidance, lifestyle recommendations, stress reduction; vast majority significantly better in 12-16 months; feeling better does not mean they are done; a couple of years is on the shorter side; longer are often compliance or repeated exposures to mold or tick bites; 2-4 years would be average
- For those that cannot get out of mold, getting better is difficult until out of mold; reduce inflammation with Flex Now, Nrf2 support, Curcumin Pure; can you stop your hand from burning if you don't take it out of the flame?
- There is always a way out and always something that can be done; getting locked in a situation and not seeing a way out is often part of the illness
- Therapeutic order is individualized for each patient: anti-inflammatories, enzymes, gentle binder, diet, environment, nutritional support, immune modulators; antimicrobials only after organ support, detox pathways open, inflammation down, enzymes supported, EFAs for membrane stability
- A single herb is often able to support multiple goals simultaneously
- For drainage in extremely sensitive patients, they are often sensitive due to mold; often need to support MCAS with Beyond Balance MAST-EASE or Flex Now; low dose enzyme like Serrapeptase; binder such as chlorella; ITIRES or Lymphonest for lymphatics; NutraMedix Parsley for kidneys
- Liver drainage may not help if they have significant GI dysbiosis; need to work on the gut
- Reducing inflammation and hypercoagulation with downregulation of the CNS inflammation (Scutellaria Supreme can be helpful for CNS inflammation) can be helpful in symptoms after COVID; Bartonella is often observed after COVID; pre-existing underlying infections may appear with COVID or with vaccination in some people
- For elevated TGFb1, avoidance of mold is the primary strategy; once out of mold, Flex Now and Nrf2 Activator can be helpful; may need to add CytoQuel or Curcumin Pure; brings down TGFb1, MMP9, C3a/C4a; combination of a comprehensive strategy
- For acute tick bites, if symptoms are present, treat aggressively; often with Ceftin and Doxycycline with Beyond Balance BB-2, Vital Guard, enzymes; Boiron LEDUM homeopathic 1M; may need to add BAR-2 or BAB-3 if concern of coinfections; if tick bite and asymptomatic and nothing at the bite site, LEDUM can be very important; Vital Guard and BB-2
AnnFCorsonMD.com

William A. Seeds, MD spoke on "The Cellular Signals That Influence Autoimmune Disease and How It Can Be Repaired" and shared:

Focus should be getting to root causes and fixing problems
Cell signaling and molecular pathways are the key to putting together an intricate array of how the cell functions in maintaining homeostasis as we age and through disease
Cell redox and cell efficiency are what health comes down to
Autoimmune processes like MS, RA, Lupus, anti-phospholipid syndrome, type 1 diabetes; all have commonalities
With a type 2 diabetes patient, there is an over-consumption of glucose; understanding this process provides a helpful framework
Post-prandial hyperglycemia plays a big role in propagating glucose issues; cell uses glucose, fatty acids, and proteins and uses these substrates to make NAD and ATP; while utilizing the least amount of oxygen and producing the least amount of ROS
Glucose leads to problem where we lose Krebs cycle efficiency and process that controls the flow of electrons and protons into the inner-membrane where ATP is made; the flow is critical to the homeostasis of the cell
When glucose goes wrong, there is more production of ROS and superoxides that take a toll; create more hydrogen peroxide, nitrogenous free radicals; start to over-consume the antioxidant system controlled by Nrf2 transcription that creates glutathione and other antioxidants
As we lose this flow, we start having problems with protein folding; oxidative stress leads to misfolding; normally should do the right thing for the cell but start doing the wrong thing; creates a phenotypical change in the cell; cell is no longer translating proteins according to its original genomic structure
Misfolding of proteins leads to lipid peroxidation and breakdown of the cell which leads to inflammatory environment
Redox gone wrong with increased ROS and protein folding can go a step folder and impact DNA repair mechanisms in the cell; nuclear and mitochondrial DNA; breakdown in DNA repair
Mitochondrial DNA is more susceptible to oxidative stress; inflammasomes create cytokines, chemokines, proteases; process pushes forward in a pro-inflammatory state
Fragments from the mitochondria activate immune responses, antibody responses to the fragments; ties into autoimmune diseases
Aspirin early on can act as an inhibitor of autoimmune disease via cGAS
Loss of metabolism of colonic cells is what leads to dysbiosis
Autoimmune disease is everything about gut dysbiosis and loss of self-tolerance
Dysbiosis is a reduction in microbial diversity and loss of beneficial microbes with increase in pathogenic bacteria and loss of self-tolerance
Colonocyte phenotype changes lead to dysbiosis; colonocytes maintain homeostasis and the microbiome
The job of the colonocyte is dominated by oxidative phosphorylation and fatty acid oxidation; requires high oxygen consumption; losing oxygen in the lumen kills critical anaerobes that control the immune system to keep us alive and well
Real estate is lost to the health-promoting microbes and towards the pathogenic microbes
Obligate anaerobes are lost; facultative anaerobes are gained; leads to nitrates that pathogens thrive on
Balancing the colonic microbiota is with prebiotics (GOS, FOS) and support for SCFAs such as butyrate that keeps colonocytes healthy; losing butyrate negatively impacts cell metabolism
Gut-Associated Lymphoid Tissue (GALT) is involved in recognizing pathogens, initiating innate immune responses, and presenting antigens to the adaptive immune system; crucial in immune tolerance
PPAR gamma influences autophagy; butyrate upregulates
Metabolites that are derived from the microbiota (postbiotics) are immune modulating; butyrate, propionate, acetate; important in controlling Treg cell expansion and differentiation
Kynurenine pathway, quinolinic, kynurenic, picolinic acid involved in regulating GI immunity
Indoles made from microbiota metabolism of tryptophan; postbiotics of the future
Tryptophan metabolites; tryptophan produces kynurenine which is involved in tuning of host immunity, tolerance, and metabolism; involved in regulation of IL-22 which is involved in epithelial barrier function; ensure that commensal bacteria outcompete pathogenic bacteria
Tryptophan is most important in supporting the gut; metabolites from the microbiome are indoles; augments health span across species and control bacterial fitness
Have to understand and relate to pathways to start fixing things
Breg cells are immunosuppressive cells that contribute to immunological tolerance; master regulatory cells; influence Treg cells and other B cells; inhibits pathogenic T cell production
SCFAs modulate Treg cells, control Th17 cells that are pro-inflammatory, and modulate macrophage differentiation
Butyrate increases tryptophan-metabolizing bacteria in the gut; metabolizes tryptophan into serotonin and 5-HIAA; 5-HIAA controls transcription to make more Breg cells that are a key to immune tolerance
Secondary bile acids are important in maintenance of the microbiome
Dysbiosis and loss of immune tolerance play a role in rheumatoid arthritis
The loss of self-tolerance is the beginning of autoimmunity
Rheumatoid arthritis benefits from a focus on impaired intestinal permeability; Zonulin-dependent increase if intestinal permeability results from microbial dysbiosis; cytokine inhibitors don't address the underlying problem
Butyrate is a zonulin antagonist; Larazotide is a peptide that reduces arthritic symptoms by 50% working on intestinal issues
Zonulin can lead to type 1 diabetes, MS, Lupus, RA, anti-phospholipid syndrome
Intestinal barrier function is a checkpoint between inflammation and autoimmunity
In type 2 diabetes, oxidative stress, NLRP3 activation of inflammasome; oxidative stress and cell signaling determines where we go with understanding these disease processes
The microbiota activates the inflammasomes which reinforces altered microbiota which reinforces altered inflammasome activation
In diabetes, Mitochondrial dysfunction is linked to inability to oxidize fats and a build-up of incomplete long-chain fatty acids
Glucose needs to be utilized in glycolysis and the citric acid cycle to make NAD/ATP utilizing least amount of oxygen and producing least amount of reactive oxygen species
Long-chain fatty acid backup increases Th17 cytokines and dysregulation of Th17/Treg
Latent autoimmune diabetes in adults often shares type 1 and type 2 diabetes features; risk for other autoantibody problems such as thyroid and brain
GLP1-RA peptide can support beta cell function
Ketones and ketone esters can be an energy source and a nutritional product that promotes neuronal cell survival, turns off inflammasome production, turns off NLRP3 sensors, is a histone deacetylase inhibitor, modulates gene expression, improves NAD and NADPH; NADPH is an influencer of glutathione and other antioxidants
MS is an immune-mediated disease of the CNS and myelin destruction ensues
Need to enhance remyelination and reduce inflammation
Thymosins are neuroprotective and neurorestorative; including remyelination and synaptogenesis
Thymosin alpha 1 establishes a regulatory environment; lower TA-1 seen in MS; can influence Breg cells
Thymosin beta 4 has been shown to increase proliferation of oligodendrocytes and support remyelination
Mitochondrial, Peroxisome and, Immune Modulation support: exercise, calorie restriction, trehalose, butyrate, Urolithin A, spermidine, ketone esters, GHRH/GHRP, GLP1 RA, MOTS-c, SS-31, carnitine, plasmalogens, phospholipids, TA1, TB4, Selank, Epitalon, Larazotide
Urolithin A is very important in immune modulation
Amazing work in Sarcoidosis with GHRH-R antagonists to modulate lung inflammation and fibrosis
From Q&A discussion
- Urolithin A and Spermidine are both tools he likes a lot; Spermidine important in autophagy; Urolithin A works like a spirulina; improves the microbiome; for anti-aging, rotate them; use care with lots of supplements; better to rotate them; don't want to create too much antioxidation; need redox
- Rotates supplements for 6 weeks to 3 months generally
- Butyrate is a postbiotic; initially need to supplement; uses BodyBio; likes using GOS and FOS prebiotics; takes 1-2 years to change dysbiosis; need to initiate a prebiotic process; need to give the bugs what they want
- Tributyrin molecule carries 3 butyrate molecules and gets to the colon; uses it in some cases
- Likes to slowly get to 6-8 grams of Butyrate
- Can do butyrate suppositories
- Used Bimuno, Nutraflora prebiotics; evolved to lactulose as a prebiotic in those with dysbiosis; uses in low doses; can use every 1-2 hours to help get peristalsis moving; makes microbiota resistant to antibiotics (keep the flora you want while taking antibiotics)
- We owe Patricia Kane a lot for her contribution to our understanding of phospholipids
- EMFs are an influencer that may make some more susceptible to glucose dysregulation; PEMF therapies can be helpful for many reasons
- Low-dose aspirin has a similar effect on the inflammasome as SPMs; have to use a lot of SPMs; downregulation of the inflammasome is largely via nutrition, exercise, butyrate, ketones, TA-1, TB-4
- Prebiotics and diet are the key; supplemental butyrate should not be the only focus
Seeds.md, SSRPInstitute.org

Greg Nigh, ND spoke on "Sulfate, Oxalates, and Biological Water: A Unifying Model of Health and Disease" and shared:

Bodies do not do anything by mistake
Cells don't act pathologically; they are doing something to establish homeostasis
Every cell is designed to fulfill a purpose
SIBO is often approached by finding a bacteria and getting rid of the bad guys while adding more good guys; that process doesn't work or only works short-term
People focus on SNPs such as CBS and think of these as a disease or condition
Many approach treatment via removal of uric acid, oxalates, and ammonia; seems sensible
There may be something else going on here
He is obsessed with water, water structure; fundamental to health and disease; when structuring of water breaks down, things go bad
Fundamental to the disease process is the loss of the structure of water and downstream consequences
Most water in the body is in a gel form; structured water
Structure is the interfacial water also called EZ or Exclusion Zone water
EZ water liberates hydrogens and traps deuterium
Solutes (ions, toxins, etc.) in the water prior to EZ formation get pushed out of the EZ (pure) water
Protons or hydrogen are liberated and accumulate just outside the EZ layer
The structured layer captures deuterium
Deuterium is the most important atom in biology; isotope of hydrogen; twice as heavy as hydrogen; abundant in the universe and in the body
Water is approximately 155 ppm deuterium
We constantly take in deuterium; it cannot be avoided
Cells have mechanisms to avoid using deuterium like hydrogen might be; cannot allow it to get into the mitochondria like hydrogen; deuterium causes significant problems for the pumps and shutdown the mitochondria
Deuterium is primarily stored in cells in the structured layer; deuterium binds to oxygen 5x stronger than hydrogen does
Hydrogen will be liberated much easier than deuterium; deuterium excess or trapping will exist in the structured layer; hydrogen/protons can then do their thing in the cell
Deuterium on the loose is an emergency/crisis for the cell
Deuterium can impact the mitochondrial pumps and lead to shutdown; mitochondria must have only protons/hydrogen
Mitochondria make deuterium-depleted water
If there is too much deuterium, the cell is thrown into division or malignancy
Numerous diseases are associated with mitochondrial dysfunction
Fundamentally, the deuterium problems must be fixed; part of that is fixing the mitochondria; but also how the cells manage deuterium
Sulfate is a key player in how cells get their water structured
Structuring of water is based on contact with electro-negative surfaces; maintained through sulfated molecules
Heparin sulfate is the main one; lines all cells and tissues supplying; creates EZ, traps deuterium
If the body loses access to sulfate, must find a plan B; generates hydrogen sulfide which creates symptoms but works; a problem when in excess; can be oxidized to sulfur dioxide and then to sulfite; then via SUOX enzyme to sulfate
Gout is an inflammatory process that allows for the oxidation of sulfur compounds
Heterozygous issues with SUOX often leads to sulfur problems
Plan B is to grow bugs in the bug that generate hydrogen sulfide from sulfur in the diet; the bugs are the workaround
Might there be a plan C? Oxalate is the backup quarterback to sulfate; oxalate and sulfate have the same charge; may be a substitute for sulfate; leads to symptoms but keeps the water structured
Water must be structured or it is game over
Oxalate may be an adaptation to loss of water structure; if sulfate can be addressed, oxalate may go away on its own
Glucose has a pathway that can lead to oxalate; excess glucose can lead to excess ATP production at a cellular level; too much ATP may be a provoker of malignancy
If you produce methylglyoxal, it can dampen the production of ATP; same pathway leads to structured water generation (deuterium-depleted water)
Cells desperately need deuterium-depleted water to get hydrogens; the key currency of the cell
Oxalate crystals may lead to many symptoms, but getting rid of oxalate may also have consequences if not coupled with addressing the reason oxalate is present, it is getting rid of the body's attempted fix
Too much deuterium due to loss of EZ water in and around the cells leads to a shutdown of the mitochondria; a protective response for the cell; the mitochondria cannot run if there is too much deuterium in its environment; oxidative stress goes up, oxalates go up, glutathione is depleted
Oxalate production is likely a compensation; accumulates in cells and deposited into matrix and tissue
Grounding is incredibly important in this context; allow us to establish more negative charge; leads to less dependency on oxalates
You fix the oxalate problem by fixing the sulfate problem
Common denominator is the loss of organization of structured/EZ water in the cell
As oxalates increase, water structure is restored; deuterium is sequestered and results in EZ
Oxalate is a better option than phosphate which has more serious consequences
Glyphosate impairs sulfate synthesis, promotes oxalate absorption via induced dysbiosis, and acts as a glycine analog which will increase endogenous oxalate production
High levels of glyphosate impact sulfate, water structure, oxalates
Cannot say enough bad things about glyphosate
Sulfate is the first choice for creating EZ water and keeping deuterium out of the mitochondria
When sulfate is not available, hydrogen sulfide is generated; when this fails, oxalate is an alternative
Therapeutic focus should be on restoring sulfate, not reducing oxalates as the priority
Sulfur dysregulation can lead to many presentations in many people
Sulfur is eaten and the body has to create sulfate; there can be too much coming in to process or the metabolites may not be leaving the body quickly enough for the incoming amount; overflows and leads to symptoms; have to stop inflow for a period of time and then support and reintroduce
If we do not fix the water structuring and focus on the mitochondria, the patient is not best served; it is forcing the mitochondria to make water that is not deuterium-depleted
People are often put on diets that focus on oxalates, but there may be a better way
Drinking DDW; diet should be high fat and low carb; fish oil, grass-fed animal oils; fats are low deuterium; starches and sugars are high deuterium
He drinks DDW to support his own health
DDW is direct relief for mitochondria
Lowest deuterium-depleted food is pork fat
Fixing the sulfur issue: low sulfur diet, molybdenum, HB12, butyrate, Epsom salt baths, glutathione
Low sulfur diet guide is available for purchase here
Prefers the Biotics Mo-Zyme Forte product for molybdenum; best clinical response; best to chew; some do well with 1 twice a day; others due 4 twice a day; the more it takes, the more of an issue there may be; could be that the SUOX enzyme needs major support or that Candida aldehydes are utilizing the molybdenum
Hydroxy-B12 can help to breakdown excess hydrogen sulfide in the blood via oxidation
Butyrate helps to lower GI inflammation
Epsom salt baths can be a game-changer; some have done nothing but Epsom salt baths and found their gut improves; sulfate is coming in; you no longer need the bugs in the gut if the problem is fixed
Glutathione can be a blessing and a curse; necessary with B12 to detoxify hydrogen sulfide in the blood; without it, RBCs may generate hydrogen sulfide
Garlic compounds enter the RBCs and lead to generation of hydrogen sulfide
Work on nervous system/ANS: Epson salt baths, tepid/cold showers, Safe and Sound, DNRS, breathwork, HeartMath, Alpha-Stim
You can do everything right, but if your vagal tone is dysfunctional, it will not work
Gut health should not be addressed with a killing strategy as the primary approach
Magnesium taurate can help to prevent formation of oxalates; high dose taurine, E, B6 can be helpful to mitigate the oxalates
Support reduction of deuterium (core problem), address sulfur->sulfate, address ANS/vagal tone, encourage oxalate to stop forming, work on the terrain (butyrate, Ion Biome)
There is no test for sulfur issues; the protocol is the test
The body can correct itself very quickly; therapeutic process does not always have to be lengthy; there are factors much more fundamental to the healing process than the "stuff" people are given or taking
From Q&A discussion
- Several DDW options: Extra Light Water HydroHealth, Preventa, Litewater
- Mountain Valley or Alive Water are not DDW but may be lower than tap water and have a positive effect over time
- Any liquids will increase the amount of deuterium introduced into the body
- Garlic has been most reactive; garlic, eggs, and kale are the top 3 and make up 80-90% of the short-term reactions people may have
- For two weeks, eliminate garlic, eggs, kales, onions, broccoli, cauliflower, cabbage, Brussels sprouts, asparagus, etc.; commonly people feel a little to dramatically better; then there is a reintroduction process starting with garlic; often symptoms return which provides clues
- For some, it is not a short-term reaction but a cumulative effect over time and have to limit how much they consume; some can eat any of the foods if the quantity is limited and/or they have adequate support with molybdenum, Epsom Salt Baths, etc.
- Benfotiamine has dramatically changed tolerance for garlic, alcohol in some
- There is an adaptive role for Candida; can help detoxify mercury and potentially supplying oxalates to a system with a severe sulfate problem; tumors produce oxalates
- Candida may be making oxalates in an attempt to contribute to a fix; address the need for the oxalates, and the Candida will be less difficult to address
- Oral sulfate can be valuable such as glucosamine sulfate; some patients benefit from high levels of MSM; taurine has a sulfate attached to it
- Best structuring of water happens in the body when it comes in contact with an electro-negative surface
- Water can be modified to be healthier; vortexed, magnetized, imprinted; structuring happens best in a healthy body, not outside the body
ImmersionHealthPDX.com

Magda Havas, PhD spoke on "The Medical Paradigm Change from Chemistry to Frequency" and shared:

Advances in science and medicine are often destabilizing revolutions
We do need chemistry to assess and treat illness
Moving away from chemistry and towards frequency to assess and treat the body
Certain uses of frequency are accepted by conventional medicine such as X-ray; mainstream medicine is not very accepting of frequency-based tools
An electric field is generated every time you put pressure on a bone
Cell death is the absence of an electrical potential across the cell membrane
Death is the absence of electromagnetic frequency; we are beings of light
3 Health Questions: essential nutrients? toxic substances? cells communicating?
Chemicals are not fast enough for cellular communication; cells whisper to each other electromagnetically; cells communication via biophotons
Essential frequencies: sunlight, Schumann resonance, PEMF, light therapy
Toxic frequencies: EMF, radio-frequency radiation, millimeter waves, ground current, dirty electricity
Cells communicating: EMFs and biophotons
Scars can interfere with cell-to-cell communication
Internal communication is primarily with frequency and vibration rather than chemical messengers
She shared this video that shows how water can extend the range of frequencies
Frequency therapy consists of PEMF, light, and sound therapy
Frequency therapy can help to overcome chronic illness that involves pain, inflammation, poor circulation, and more
PEMF devices are "electroceuticals"
PEMF therapy has also been used for depression and other mental/emotional presentations
She tested a PEMF mat device using live blood microscopy; showed normalization of rouleau formations of the red blood cells
PEMF is said to turn blood that is ketchup into blood that has the consistency of red wine
PEMF may improve circulation, improve oxygen transport, improve waste remove, and reduce risk of stroke or heart congestion
She visited BEMER in Europe and reviewed their research on blood circulation; WBCs behave differently after treatment; they move to the inside of the blood vessels
PEMF has been shown to be helpful in rheumatism and arthritis
Schumann resonance is the heartbeat of the earth and important to have exposure for health
PEMF is commonly used in horse racing to optimize their performance
Ondamed is another PEMF device from Germany; has a biofeedback component to adjust the frequencies
PEMF is being tested in Toronto for depression, anxiety, schizophrenia; results can last for up to 3 months
Seqex is a PEMF mat from Italy; has a lot of research that has been done on it; preset programs or a personalized prescription card
PEMF has been shown to assist healing of ulcerations of the feet
Many conditions have been supported with PEMF but only a small number of them have been studied such as arthritis, back pain, circulation, depression, pain, and wound healing
Environmental factors can interfere with internal communication and lead to illness; namely electrosmog
Can come through air, wires, or ground
Levels of electrosmog are increasing dramatically
Electrosmog and WiFi, smart meters, cell phones, cell towers have increased exponentially
It is a pollutant that cannot be seen, smelled, or tasted; and thus often ignored
Levels of radiation from smart meters can be off scale for many devices and often ping every minute
The vines around smart meters often die after a period of time from the radiation exposure
Poor power quality and microwave ranges are the two that are primary concern
There are good guidelines for ionizing radiation; nothing or poor guidelines for non-ionizing radiation; guidelines were not created with an understanding of the human body
EMFs lead to free radical damage and oxidative stress; 93 of 100 studies showed that oxidative stress is a factor; oxidative stress can contribute to cancer
Electrosmog is a trigger for cancer, reproductive problems; can lead to electrohypersensitivity (EHS)
Pain, fatigue, insomnia, memory, depression, anxiety, dizziness, nausea, and tinnitus are common symptoms observed with electrosmog
EMFs may contribute to Rapid Aging Syndrome; often attributed to aging; EMFs damage cells and lead to aging on the inside
0.65% can't work; 1.5% have severe EHS; 5% moderate; 30% mild; the remaining identify as asymptomatic, but are they? They may still be experiencing oxidative damage to their cells
1/3 of the population may have symptoms of electrosmog sensitivity or EHS
Electrosmog is a neurotoxin; non-ionizing radiation contributes to neurodegenerative disorders
One study looked at neurological deaths and cancer deaths in 20 countries in a twenty year period; cancer deaths have gone down; neurological deaths have more than doubled and up to 563% increases in females > 75 years old in the US; why are neurological deaths on the rise?
Common precursors for EHS: physical trauma to the nervous system such as whiplash or concussion, chemical exposures, electrical exposures such as a shock or lightning strike, biological trauma/infections, impaired immunity
Considering the reason for the sensitivity is important to determine the best path forward for treatment
A toolkit is needed for those harmed by electromagnetic frequencies; electromagnetic hygiene is extremely important
EMF Hygiene
- Measure exposures of dirty electricity and radio frequency radiation
- Distance is your friend
- Alter your behavior; WiFi and Bluetooth off; keep away from body; use speakerphone; connect to internet via a wired connection; limit screen time before bed; use wired keyboards and printers
- Don't buy wireless lightbulbs; they give off high RF emissions
- Smart appliances are harder to avoid
- Replace wireless devices with wired devices
- Filter dirty electricity
- Shield against RF radiation with films, fabrics, and paints
- Spend time in nature; nothing is more healing than being grounded
Toolkit
- Reduce exposure to external toxins; EMF, chemical, biological
- Reset the limbic system
- Support the immune system
- Detoxify; consider DNA analysis and don't forget dental contributors
She predicts that electrosmog is going to get a lot worse and that we will be using electrotherapy much more in the future than we are now; PEMF, light, and sound
WiFi in schools leads to anxiety-prone children that will have to take care of their neurologically-impaired children
Electrosensitive Society
They are working on questionnaires to assess for potential EHS
From Q&A discussion
- Any type of PEMF mat can have benefits; they are all very similar
- Light therapy is even more important than PEMF therapy; different frequencies of light can support the body and lead to stunning results
- Seqex has been very helpful for her personally; MAS is a less expensive mat that has a wide range of different frequency options
- Dr. Klinghardt has suggested that people with Lyme can become electro-sensitive; getting rid of Lyme may resolve the sensitivity; the bugs are putting toxins out into the body as a defense mechanism against the EMFs that adversely affect the microbes
- Reducing exposure is the priority; harmonization is an area that she has been testing; have been unable to find beneficial effects from their research or effects that are patient-specific
- Harmonizers might give you a false sense of security where the radiation may still be doing damage to your system
- Find a harmonizer with a money-back guarantee if exploring these
- LED lights on the ear is an approach that can be supportive of retraining the limbic system; can resolve a trauma in a matter of minutes without reliving a triggering trauma; Sheena Symington does a workshop for doctors on this approach
- Limbic system retraining can be very helpful for those with EHS; have been extremely effective
- Some TENS/microcurrent devices may be associated with Parkinson's in athletes
- Satellites don't emit a lot of radiation; quite weak and not as much of a concern as the towers near our homes, including 5G small cells; people with EHS do not appear to be reacting to satellites; StarLink may be different as it is closer to the earth, but not likely the most critical thing one may be reacting to
- Can put blockers/filters on the main electrical panel to block dirty electricity; some areas have a ground current problem that is very difficult to block and can contribute to cancer
- Blue-blocking glasses are really important; you can also dim the blue light in screens with software; glasses are better
- Cellphone cases do work to block radiation; not all cases are the same; if the case is shielding everything, the cell phone will not work which is not good; some cases depending on how the phone is held can increase exposure; best to test with a meter
- AntennaSearch.com and Verizon coverage map can be helpful to see what is in your area
- For dirty electricity mitigation, she has tested the Graham Stetzer filters and found them to be very effective; others may work similarly; may need to use several filters; the magnetic field increase near the filter but does not extend out very far; the field they generate around them is not of consequence; Microsurge meter is used to measure the dirty electricity
- Those with EHS can often not tolerate being in electric cars; they give off high fields where the batteries are; often in the backseat where an infant may sit; should have been shielded with Mu-metal, but not something that is done; many cars have become quite toxic
- Dirty electricity is an incoherent frequency; PEMF is a coherent frequency; one is noise, the other music
- Getting exposure to sunlight and nature is becoming more difficult in our modern world; the forest is an ideal place; exposure to UVB light at 211 nanometers can help with generation of vitamin D
MagdaHavas.com, TheRoseLab.com, GlobalEMF.net

Emily Givler, DSC spoke on "Microplastics, Macro Problems: The Intersection of Healthcare and Environmentalism" and shared:

Microplastics are < 5mm; nanoplastics < 0.001mm
Plastics are in our environment to an alarming degree; most come from the degradation of larger plastics
Plastics do not biodegrade the way other components do
Most microplastics end up in waterways
There is no going away; just smaller and smaller particulates
Synthetic fibers, paint dust, tire dust, fishing equipment, microbeads
Primary microplastics come from cosmetics, microfibers from clothing, textiles, fishing nets
Secondary microplastics are the breakdown of larger plastics such as water bottles by exposure to sun and waves
Synthetic fibers from clothing are the lion's share of microplastics; car times, city dust, road markings, marine coatings, personal care products, and plastic pellets contribute
Plastics degrade over hundreds to thousands of years and break into smaller pieces that end up in the body
50% of all virgin plastic on the planet has been created since 2005
As of 2020, over 1.6 billion surgical masks have ended up in oceans and roadways; 450 years to breakdown
Average human ingests 0.1-5 grams of microplastics per week; 5 grams is a full credit card size
Microplastics are found in drinking water and other beverages
Amount of plastic on the planet was expected to nearly double by 2050; 2040 since the pandemic
Food including fish, seafood, honey, table salt, drinking water, beer, wine, beverages, indoor air
Microplastics come from food packaging; disposing of the plastic which ends up in landfill or waterway and breaks down to secondary microplastics; heating foods leads to microplastic exposures
Infant feeding bottles have been found to release microplastics
Microplastics are found in salt on at least 5 continents; microplastics absorb contaminants and transfer them to the salt; comes from the plastics in the ocean
Salt is a daily source of exposure; other higher sources like mussels and oyster are not eaten daily
Looking for a plastic-free salt adds up over time
Salt producers are starting to incorporate filtration for microplastics into their manufacturing products
Celtic salt may be a good option
Vote with your wallet; many more organic and gluten-free products available now as compared to 10 years ago
Shellfish are of particular concern; clams, oysters, muscles
Some studies show water ingestion is the biggest source; others show inhalation via air is the biggest; be aware of both as they are big problems
Microplastics can be taken up from water and eventually into rain and snow
Dust in our homes have increasing concentrations of microplastics and are inhaled
Get the patient away from the poison
Minimize exposures to plastics
- Eliminate plastic foods and beverage containers
- Use plastic-free salt
- Filter your water
- Filter your air
- Dust regularly; have vents cleaned
- Stop wearing synthetic fibers
- Use a Guppy bag to filter microplastics in your washing machine
Reverse osmosis is the best method; carbon block filters such as TAPP 2 remove 100% of known microplastics (but not nanoplastics)
HEPA filtration for microplastics (but not nanoplastics); BlueAir down to 0.1 micrometers (still not fully addressing nanoplastics)
GUPPYFRIEND washing bag reduces microfibers entering rivers and oceans
Do laundry less often, wear natural fibers, wash full loads, avoid delicate settings, line-dry clothes, install a filter on washing machine or use a laundry bag or ball
Many ingested plastics expose us to persistent organic pollutants such as BPA, phthalates, flame retardants, PCBs, DDT
Microplastics have been found in stool samples and in human placenta and in the fetus; they are not confined to just the gut
BPA has been found in the liver and in fat tissue; not confined to GI or lungs
BPA is a primary toxin exposure when exposed to microplastics
BPA may play a role in behavior, cancer, infertility, diabetes, hypertension, PCOS, liver function, and heart disease
BPA toxicity leads to NOS uncoupling, peroxynitrite, DNA damage, mast cell dysfunction, NAD/NADPH steal, and cardiovascular disease; as well as increased blood pressure via NOS uncoupling
Phthalate toxicity may play a role in obesity, low testosterone, infertility, autism, mood disorders, allergies, asthma; more common in women due to personal care products
Increasing levels of plastics lead to increases in biofilms and changes in the microbial environment
The more plastic in our gut, the more changes in the microbiome are seen towards plastic-degrading microorganisms; the impact is not yet known
Biofilms in the surface on plastics may act as vectors for exposure to various pathogens
Plastics are primarily eliminated via glucuronidation; also focus on GI health to reduce beta-glucuronidase which impairs this pathway; reverses glucuronidation and increases recirculation of toxic compounds
Constipation increases the rate of retention
Microplastics increase viscosity in the intestines and suppress interaction of digestive enzymes with nutrients
Insoluble fiber can assist with micro and nanoplastic elimination
Glucuronidation is involved in 40-75% or more of xenobiotic elimination
Glucuronidation is the primary detox pathway for bilirubin, estrone, testosterone, progesterone, thyroxine, and histamine; also a heavy hitter for mycotoxins
Inhibitors of glutathione: high carb/low protein diet, elevated blood glucose/insulin, reduced caloric intake, depletion of hepatic glycogen stores, cannabis, plastics, genetic predispositions
Glucuronidation support: green tea, watercress, astaxanthin, dandelion, Calcium D-Glucarate, ellagic acid, rosmarinic acid, pterostilbene
UGT polymorphisms can impact glucuronidation; 19 human UGTs
Detoxification
- Insoluble fibers
- Resistant starches for microbiome support
- Herbs and nutrients: green tea, watercress, astaxanthin, dandelion, Calcium D Glucurate, ellagic acid, rosmarinic acid, pterostilbene
  - Astaxanthin can induce Nrf2
  - Dandelion is a favorite support; increases UGT enzymes, supports Nrf2, downregulates Keap1
  - Calcium D-Glucarate is almost always part of her protocols for glucuronidation support
  - Ellagic Acid increases UGT activity, modulates Nrf2; chestnuts are among the highest sources of this
  - Pterostilbene increases glucuronidation activity; more effective than resveratrol for Nrf2; pulsed 5 days on, 2 off
  - Rosmarinic Acid induces glucuronidation and Nrf2
- Professional Health Products has a Plastic Detox II product
Expanding the Clinical Toolbox
- Air and water filtration
- Organic/natural fibers for clothing and textiles
- Minimize plastic food packaging
- Address bowel motility; insoluble fibers and resistant starch
- Support glucuronidation with Calcium D-Glucarate, rosmarinic acid, dandelion
- Pulse Nrf2 support
From Q&A discussion
- Many of the microplastics look like fibers
- Microfiber cloths are a concern; but not more than any synthetic fiber; natural fiber cloths are a better option
- Fleece may be made from recycled-plastic bottles and can more readily breakdown
- HEPA filtration is the best but not adequate for nanoplastics
- Functional Genomic Nutrition Glucuronidation Assist was formulated to support glucuronidation and contains many of the ingredients discussed
- It is tough to eat our way out of these toxins; often need additional supplemental nutrients
- Microplastics are found in almost all salts; it is not the type but the brand that matters; mined salts are often lower than sea salts; look for a brand that is independently tested for microplastics; some Celtics are among the best she has seen
- Carbon filters have varying degrees of success for filtering micro and nanoplastics; best option for nanoplastics is reverse osmosis
- For evaluating glucuronidation, levels of beta-glucuronidase can be important; DUTCH hormone tests can show estrogen metabolism which can be an indicator; functional genomic testing can explore SNPs involved
- High levels of mycotoxin exposure with low levels in urine mycotoxin testing could be an indication of glucuronidation pathway impairment
- Has not seen research on sauna for microplastics; but beneficial overall for detoxification, if tolerated
- Change air filters more often than you think needed; clean ducting in HVAC
- All plastic water bottles contain microplastics
- As plastics are recycled, they become weaker and breakdown into micro and nanoplastics more readily; not ideal to wear things made from recycled plastic like fleece
TOLHealth.com, BeyondProtocols.org

James Greenblatt, MD spoke in "Finally Focused: A Functional Medicine Approach to ADHD" and shared:

Every 10-20 years, there is a different concept/view of ADHD
Was discussed in the 1600s in Germany
Very significant resurgence of psychiatric medications for ADHD
Wants to stop symptom-based madness of pharmacology as the only intervention and talk about an integrative, functional medicine approach
Feeling bored is a clue to look further
These are medical disorders
Untreated ADHD has significant implications for public health, self-esteem, and relationships
Divorces, self-esteem issues, academic achievement, sexual behavior, eating disorders, criminal activity, job performance; many outcomes of not treating ADHD
Young drivers with ADHD have 2-4 times as many motor vehicle crashes; risk of totaling a car exceeds that of a legally drunk adult
Prescriptions have gone up; a quick fix
Amphetamines do help 80-90% of kids but they are a band-aid and not addressing the underlying neurobiology
ADHD was most of what he saw as a child psychiatrist
Functional medicine includes biochemistry, lab testing, genetics, root causes; integrative medicine includes diet, lifestyle, environment, mindfulness, spirituality, and body-mind-spirit balance; need to understand both
Unique individual, unique biology, unique disease
Beta waves are used for attention, focus; alpha waves are relaxed/yoga; theta waves are unfocussed
ADHD is a neurobiologically-based disorder; increased theta to beta ratio in ADHD patients; increased theta/decreased beta
Joel Lubar, PhD was a founder of neurofeedback and developed a program to decrease theta and increase beta
Research supports neurofeedback as a treatment for ADHD; as effective as Ritalin
OPCs are a type of polyphenol in blueberries, grapes, green tea, and dark chocolate
Pycnogenol from pine bark is a concentrated source of OPC with reduction in hyperactivity, improved attention and concentration; decrease in anxiety
Combinations of OPCs tend to be better than single sources
Did experiments with OPCs looking at brainwaves; theta waves decreased and attention improved
When reading a book, theta should go down and beta should go up
Extracts of OPCs have been shown to improve attention; strengthens veins, improves circulation, reduces diabetic retinopathy, elastic skin, joint flexibility, reduce inflammation and histamine/allergy, slows cell mutagenesis, prevents ulcers
Elevated copper and low zinc is common in some children; OPCs bind copper
OPCs balance brain waves, normalize mineral balance, act as antihistamines, repair blood-brain barrier, act as antioxidants, stimulate BDNF
OPCs may be the only intervention in adults with ADHD
Magnesium is the most common nutritional deficiency with ADHD; 95% deficient; some may have genetic requirement for higher levels
Magnesium is part of the structure of ATP
Magnesium deficiency may lead to poor concentration, irritability, anxiety, mood lability, sleep dysfunction, depression/apathy
Medications, alcohol, caffeine, soft drinks, stress all deplete magnesium; soils are also depleted
Magnesium is depleted with rising cortisol levels
Stimulants for ADHD leach magnesium from the body; side effects of stimulant medications may be related to magnesium deficiency
Deficiency of magnesium can lead to irritability, agitation, anxiety, insomnia, facial tics, and nail biting
In the gut, magnesium and phosphorous complex and render each unavailable for absorption; impact of sodas is dramatic
Book - The Hidden Drug: Dietary Phosphate
Serum levels are not accurate; RBC is better but not always helpful; hair testing for Ca/Mg ratios helpful; looking at zinc/copper as well as lithium can be helpful
Forms of magnesium don't seem to be a big difference; glycinate is favorite; threonate better for some; oxide minimally absorbed
125-300mg magnesium glycinate before meals and bedtime; 200-300mg for sleep
ADHD kids have poor impulse control and are often sorry; not a discipline problem, not bad behavior
Nutritional lithium can be helpful for impulsive behaviors
Lithium in ground water in various geographic locations may impact the need for supplemental lithium; amounts vary around the globe
Most lithium comes from tap water
7-Up contained lithium; 7 is the rounded up number from 6.94; the atomic weight of lithium
Suicide rate is inversely associated with lithium levels
Higher lithium in water leads to lower depression and lower interpersonal violence
Low dose lithium orotate is 1-150mg; this is different than RX lithium carbonate; high dosages can be toxic
Lithium may be helpful in ADHD, DMDD, Conduct Disorder, Substance Use Disorder, Mood Disorders, Biopolar II, Autism, Alzheimer's with irritability; not for use in Bipolar I
The form of lithium does not matter; the dose matters
1mg lithium orotate is generally 1mg elemental lithium; 150mg lithium carbonate is 28mg elemental lithium
DMDD is Disruptive Mood Dysregulation Disorder; severe temper tantrums; persistent irritability; responds very well to integrative and functional medicine
20-30% with ADHD also have DMDD
Conventional treatment options for DMDD: Antidepressants, mood stabilizers, psychostimulants, antipsychotics, alpha-2 antagonists
DMDD is a lithium-deficiency disorder
Family history of addiction, aggression, suicide, bipolar; individuals typically response to nutritional lithium
Elevated copper is a common cause of ADHD; common in elementary school water fountains
Starts children on 1mg of lithium; higher doses can lead to side effects such as fatigue and sedation in some children; titrates to 2mg and then 5mg if needed; average in food and water is around 2mg
Mental health does not focus on prevention; should look at a model of prevention
Untreated irritability and aggression have serious later-life consequences
From Q&A discussion
- OPC mixtures include Pure Encapsulations CurcumaSorb Mind
- Some individuals have a higher need for lithium
- Nutritional deficiencies, stress, trauma may all contribute to elevated theta:beta ratios
- There is a long list of the effects of lithium including neuro-regenerative, neuro-proliferative, antioxidant, anti-inflammatory; increase in BDNF and decreased inflammation
- 240mg in children; adults 400-600mg magnesium glycinate; divided throughout the day
- A couple of people do better with magnesium threonate, but vast majority don't seem to do better than other forms
- Calcium:Magnesium ratio in hair mineral testing has been a helpful tool
- Skin picking or stimulant related activities are often helped by magnesium
- Lithium can be a preventer of Alzheimer's; some advocate everyone over a certain age should take it to prevent cognitive decline
- RX lithium can impair thyroid and kidney function
- Some of the genetics of ADHD are associated with dopamine; phenylalanine or tyrosine may be helpful; B12, magnesium, folate
- Calcium and magnesium in hair test should be in upper 50th percentile; magnesium is often low
- Lithium is commonly used once per day; morning or evening; some do sleep better; often in the evening; for irritability in kids, may dose twice per day
- Filtering our toxins with various filtration devices does filter out minerals including lithium
- Undetectable lithium has increased over the years; now 50-75% of kids; over-filtration may play a role
- Pure Encapsulations has a 1mg lithium that can be helpful for children
- Lithium was available in the 1940s in a salt-shaker; people started overdosing which led to deaths; lithium was then removed from 7-Up
JamesGreenblattMD.com, PsychiatryRedefined.org

Ashok Gupta, MA (Cantab), MSc spoke on "Neuroplasticity 'Brain Retraining' Approaches to Chronic Illness" and shared:

He had CFS/ME when in university; was a brick wall in front of him
Doctors had no cure and suggested it could go on for decades
Feels like your worst day of flu x 10; exhausted and drain from the slightest exertion
Found research from Professor Joseph LeDoux on the amygdala
Was able to get himself 100% better within a few months
Published his theory in Medical Hypotheses and setup a clinic to treat others
Refined the technique over time to identify what would work for most of the people most of the time
Humans have learned to adapt and survive in different environments; the number one priority of the body and brain is to ensure survival
Monitors the environment for chemical threats, biological threats, physical threats
Survival matters more than wellness
We live in a pro-inflammatory modern environment; immune system should turn on, examine threats, respond, and return to balance
An immune system that is continuously triggered is a less effective immune system
MEND
- M = Mind (stress)
- E = Exercise (more sedentary)
- N = Nighttime routine (pro-inflammatory bias)
- D = Diet (chemicals)
Ongoing immune triggering in the background creates an inflammatory bias
The immune system and nervous system become trained to over-react to stimuli
Companies train our brains to take action towards a conditioned stimulus (hunger = McDonalds; thirst = Coca Cola)
Mainstream medical system has become a sickness industry
70-80% of conditions in a doctor's office have no medium to long-term solutions
Small body of determined spirits are people that are fighting for more holistic care around the world
The map is not the territory; brains don't understand the environment around us 100%; it is an interpretation; processes 10-20% of surroundings, maps it to your past, and creates an interpretation of what you are seeing
Brain cares more about survival than about well-being, wellness, or health
The body is constantly priming the pump to keep us in a state of readiness
We live in a pro-inflammatory environment
The brain is constantly re-wiring itself and making new connection; our personality and physiological responses are re-wireable
Our genes are not our destiny; our upbringing is not our destiny
Chronic Illnesses: CFS/ME, Long-Haul COVID, Fibromyalgia, MCS, CIRS, MCAS, pain syndromes, anxiety/panic, adrenal fatigue, IBS, SIBO, burnout, Lyme, POTS; brain retraining may be helpful for these conditions
These are software conditions; conventional medicine is good at fixing hardware conditions
1:4 absences from work in the US are due to Long-Haul COVID
The nervous system runs through every part of our body and informs the body what to do
Brain stores conditioned responses to viruses and bacteria and informs the downstream immune system in terms of how to respond locally
Bio-electrical medicine is treating the electrical system of the body to shift downstream illnesses
Number 1 trigger is a physical trigger: virus, bacteria, mold, EMF; 2nd is chronic or acute stress; 3rd is a genetic factor such as poor detoxification, pro-inflammation, ACEs, birth experiences
ACEs and birth experiences can prime the limbic system; 3-4 times more likely to develop a chronic condition
Two amygdala site behind the eyes and are designed to protect us from danger; was associated with emotional responses; fight/flight responses; now, the amygdala is associated with pain syndromes and immune syndromes
Pre-disposing factors (genes, ACEs) prime the system for over-reaction; acute psychological stress; viral/bacterial/physical trigger
As the brain is fighting off COVID, physical symptoms are experienced as a result of the immune system response; create a vicious cycle
The brain may trigger the nervous system or immune system based on a conditioned response associated with the environment of the original stimulus
Physical symptoms are a conditioned response of the brain; can over-respond to neutral stimuli
Insula sits outside the limbic system; Gupta Program is retraining the limbic system, but also the insula which is responsible for detecting our state of being and create a response; an autonomic master
Amygdala protects from danger; insula creates sense of balance
Viscous cycle creates dysfunction in the hippocampus, chronic sympathetic arousal which uses up hormones and neurotransmitter; immune activation, HPA imbalance, oxidative stress; these lead to physical symptoms including fatigue, cognitive issues, sleep issues, post-exertional malaise, and more
Can have secondary illness cycles such as adrenal exhaustion, mitochondrial dysfunction, nitric oxide increases, latent viral reactivation, allergies/sensitivities
Cell Danger Response is a hyper-defensive response driven by the mitochondria; there is an ongoing communication where the brain is the upstream organ driving the CDR
The amygdala and insula become chronically sensitized to symptoms detected in the thalamus and cortex; "We are in danger"; trigger the fire service, the ambulance service
The brain and the body are playing a game of tennis, triggering each other, and keeping us in a state of hyper-arousal
The trigger can be external; not always within our own body
People may have exposure to mold or chemicals that was extreme and leads to over-stimulation
May have had 100 units of mold initially; once the limbic system and insula are trained to respond, 5% of the initial exposure may trigger 100% of the initial reaction
Patients suffering from mold illness are in a hyper-response and over-defensive response; many have been trained to improve their health even when living in the same home
Once the brain is trained for survival, it is difficult to tell the brain to stop reacting in an over-protective manner
The last Japanese soldier came off duty from World War II in 1975; for 30 years, he was trained to defend an island; did not believe the signals that said the war was over
If the amygdala is over-stimulated, it can no longer stop the signals coming into the brain
Took rats and gave sweet water combined with an immunosuppressant; later gave just the sweet water and had the conditioned immunosuppressant response; related to amygdala and insula
Teaching the brain to turn off learned, conditioned responses that are no longer relevant
The brain is inherently rewireable
Many practitioners use the Gupta Program alongside other treatments they may normally use
3Rs or Recovery
- Retraining the brain
- Relaxing the nervous system
- Re-engaging with joy
Like to use a gentle approach given the sensitivity of the nervous system in those they work with
Has published in 2002, 2010, 2012, and 2020; 2010 study showed 92% of participants improved and 67% achieved 80-100% full functioning; 2020 study showed 47% increase in perceived health, 37% reduction of Fibro scores, 46% reduction in pain catastrophizing, 45% reduction in anxiety, and 41% reduction in depression; in 8 weeks
Had a Long-COVID participant that was a marathon runner and was down for almost a year; in 8-9 weeks, was 60-70% recovered; within a few months, back to running marathons
From Q&A discussion
- Tools and techniques in the program are supportive of many conditions
- Some may be more prone to mold illness due to impairments in detoxification
- Living in a caravan in Arizona retrains the brain in the wrong direction
- Need to practically reduce the exposure and teach the brain not to hyper-react to an exposure
- The over-response may be what is creating the impairment in detoxification
- Sympathetic arousal impairs detoxification
- Some may need to take the program slower and explore it over a longer period of time
- Mindfulness is one component but is not the main feast of their program; now strong enough to retrain the original conditioned, survival networks
- Brain retraining is complementary to mindfulness
- EMDR retrains conditioned responses using a connection to an emotion or trauma and the incorporation of eye movements
- Parents have taken the program and taught it to their children
- Brain retraining program does not mean it is in the mind or the realm of psychology; it is working with the brain, not the mind
- Minimum of 30 minutes per day
- Program incorporates brain retraining, meditation, breathing, lifestyle support and techniques
- The brain is the master organ of downstream systems including the vagus nerve
- Training the brain allows for a natural stimulation of the vagus nerve
- There is no harm in doing the Gupta Program while doing other interventions
- Physical treatment is not required first before doing the program
- Has seen the program improve loss of smell and taste with Long-COVID; for some, it is the first thing to come back; for others, the last
- Once the system is in a relaxed state, the body can often tolerate higher levels of exposures without symptoms
GuptaProgram.com, TheMeaningOfLife.tv, TheCoronaVirusChallenge.com

Scott Antoine, DO spoke on "What You Must Know About PANS and PANDAS" and shared:

His daughter started to develop PANDAS/PANS at age 12
He and his physician wife felt that she was dealing with PANDAS; an infectious disease doctor suggested she did not have PANDAS
Another practitioner suggested psychiatric medications and psych care
Within 4 days of IVIG, her symptoms were virtually gone
The journey with their daughter led to that becoming the focus of their medical practice
The pain that you experience can become someone else's instruction manual
For many of these kids, this is an emergency situation
Toxicants are man-made chemicals; toxins are natural substances
These are not just autoimmune conditions
PANS/PANDAS are not rare; the concepts are not new; there is scientific evidence that infections and toxicants can cause neuropsychiatric symptoms; psychiatric medications are not the only way to treat; children are not destined to have ongoing flares
The immune system has Pathogen Associated Molecular Patterns (PAMPS) that trigger the immune system
Innate immunity is first and non-specifics; barriers, inflammatory cytokines, complement system, natural killer cells, and phagocytes
Adaptive/acquired immunity is very specific; T cells, B cells (antibodies; IgE, IgG, IgM, IgA); antibodies bind with antigens and release chemicals/messengers
Immune deficiency can result from a defect in any of these defenses
Autoimmunity occurs with immune reaction to self with tissue damage; genetic risk factors; intestinal and cutaneous microbiome contributes; infections stimulate activation of T cells; molecular mimicry
Some body tissues have a similar appearance to the immune system as various microbes
Microbial infection can alter antigen processing and promote cryptic self-recognition
PANDAS involves Group A beta-hemolytic Strep; pharyngitis, cellulitis, sepsis
Toxin-induced complications include Scarlet fever or a toxic shock syndrome
Glomerulonephritis and Rheumatic fever can be complications after Strep infections
Rheumatic fever occurs rarely today; 1-5 weeks after Strep infection; presents with carditis, polyarthritis, rash, subcutaneous nodules, chorea
Group A strep with genetic predispositions and molecular mimicry; acute Rheumatic fever treated with antibiotics
Sydenham's Chorea is a movement disorder linked to Rheumatic fever; molecular mimicry with Strep and neuronal structures in the basal ganglia; has been associated with OCD, ADHD, and executive functioning impairments
Antibiotics are typically given; can recur; some may benefit from steroids; IVIG "reboots" the immune system
Some of his patients have been diagnosed with ADHD, ODD, bipolar
In OCD, have seen low-grade inflammation, neural antibodies, innate and adaptive immune abnormalities
Dr. Susan Swedo at NIH published the connection between Sydenham's Chorea and OCD; anti-neuronal antibodies might results in behavioral disturbances
Next study focused on Strep and coined term PANDAS
Diagnostic criteria: OCD or tics, age 3 to puberty, episodic course, Group A Strep, neurological symptoms
Commonly found emotional lability, separation anxiety, nighttime fears or rituals, cognitive deficits, and oppositional behaviors
Symptoms do not go away on their own
In one study, IVIG led to significant improvement
Study looked at MRI with volumetrics and found caudate, putamen, and globus pallidus were significantly bigger than controls; same areas as Sydenham's Chorea
In mid-2000s, some did not have documented Strep
Studies were small
A new way to think about mental illness
Many still suggest that the condition does not exist
in 2012, PANS was discussed as a broader look at the potential factors involved
Mycoplasma has been shown to have similar presentation
Influenza has been linked to OCD since 1931; EBV and Borrelia have been linked to OCD and psychiatric conditions; Toxoplasma has been associated with OCD and anxiety; Bartonella and COVID have been implicated
PANS consists of PITANDS (infection-triggered) and non-infectious causes such as environmental factors, metabolic disorders, and stress
Environmental toxicants can impair or stimulate the immune system; glyphosate, heavy metals
Mycotoxins may be neurotoxic and linked to neuropsychiatric disorders; impair immune response leading to more bacterial and fungal infections
PANS Criteria
- Abrupt onset SEVERE OCD and/or restricted food intake
- Concurrent neuropsych symptoms; at least 2 of 7
  - Anxiety
  - Emotional lability or depression
  - Irritability, aggression, and/or severely oppositional behaviors
  - Behavioral/developmental regression
  - Deterioration in school performance
  - Sensory or motor abnormalities; tics
  - Somatic signs and symptoms
- Must also not be better explained by another disorder
Most children are extremely ill with extreme compulsions
OCD: fears of contamination, hand washing, fears of harming, checking, repeated words, arranging, religious/sexual thoughts, reasoning does not help; reassurance OCD
Often have thoughts of choking; textures can be an issue; feeding tube may be needed
Anxiety is often associated with OCD; mood can change suddenly; suicidal thoughts common; baby talk, selective mutism, new stuttering; deterioration in school performance; tics, clothing aversion, sleep disturbances, bed-wetting/urinary frequency
Think beyond PANS and refer out delirium, psychosis, encephalopathy, cognitive decline, persistent memory impairment, pervasive behavioral deterioration, seizures, movement abnormality not consistent with tics
Eye blinking/squinting/rolling, shoulder tics, neck movement
Need a good physical exam; vitals and hydration, signs of copper build-up seen in the eyes, petechiae or pharyngitis associated with acute Strep, heart murmurs, evidence of hand washing, Romberg exam (can see piano-like finger movements), normal or minimally depressed reflexes; writing/drawing/copying figures can be helpful
Worried, anxious, hyper-reactive, tearful, withdrawn, hopeless, "deer in the headlights"
Testing: clinical diagnosis; MRI, CBC, CMP, ESR and CRP (20% elevated), ASO, Anti-DNA-ase B, Rapid Strep or throat culture, peri-anal culture, serum copper, ceruloplasmin, iron, ferritin, thyroid panel, nutrient testing, ANA (positive in 40%), immunoglobulins including subclasses (48% have low levels), Celiac, lymphocyte subsets, vaccine responses (if no antibodies, can be specific antibody deficiency), urinalysis, infections (Mycoplasma, Lyme/co, influenza, EBV, HHV-6, Toxo, CMV, COVID), anti-neuronal antibodies
Elevated GAD-65 antibodies can be autoimmune encephalitis or possibly Type 1 diabetes
Cunningham Panel looks at several antibodies such as anti-tubulin, antilysoganglioside, anti-dopamine, and CaMKII
Heavy metal testing: blood is standard, urine and hair not accepted by mainstream; glyphosate
Mycotoxins: urine mycotoxins, C4a/TGFb1 trending, VCS impossible in kids and unreliable in adults, no utility for mold antibody testing
Mycotoxin illness may be present in 100% of his PANS patients
Food and environmental allergy testing, stool testing
Fully Functional Approach
- Identify infections, toxicants/toxins, immune dysregulation, neural loops/OCD; history, records, physical exam, labs, imaging
- Reduces these things; organic eating, less toxic cleaning products, mold remediation, glutathione and binders, heavy metal chelation
- Optimize detox
- Support body, immune system, social, psychological, family support
- Personalize the approach
Reduce inflammation: reduce refined sugar, eliminate IgE allergens, eliminate gluten and dairy for at least 30 days if possible, gluten sensitivity may play a part in undiagnosed neurological illness; Ibuprofen shortens flares from 12 weeks to 4 weeks; not useful as a prophylaxis
Antibiotics are commonly used; all trials have been positive, but varied
Tonsillectomy and adenoidectomy has not shown an effect on PANDAS
Cognitive Behavioral Therapy for OCD; really vital in their practice
Reducing stress, anxiety, and depression: SSRIs have mixed results
LDN for immune dysregulation; helps decrease autoimmunity
For stress, anxiety, depression, CBT, Family therapy, magnesium, Omega 3/SPMs, L-theanine, Inositol, GABA, self-soothing techniques such as tapping or visualization, NLP, homeopathy
Detoxification: adequate water intake, bowel movements, exercise; vegetable rich diet
Immunomodulation: steroid bursts can help to shorten flares but can worsen in those that are hyper-agitated; IVIG; IV Rituximab
Immunity: Vitamin D for immunoregulation and autoimmunity
Social and Family Support: traumatic event for the family; can be more impactful for families than having cancer; people scatter
Treatment must be personalized
Lyme disease is like a game of chess; you make a move and then see where you are at
Many things done in an ER when managing a code do not have double-blind placebo-controlled studies
From Q&A discussion
- Some cases of OCD, anxiety, depression as an adult may be from PANS being missed as a child
- Signs can be subtle leading to an eventual overflow; may not always have a defined sudden onset
- Has seen presentations like PANS in adults without previous signs
- IgM can persist or recur in patients with Lyme disease
- When IgGs are present to Mycoplasma, if a high titer, may consider herbals to support those potential issues; watch to see if it is going up or down
- Severe food restrictions are almost always Mycoplasma
- Infectolab looks at T-cells and can be helpful for tick-borne illnesses
- Has seen positive Infectolab tests, treated, and seen lower or negative subsequent test results
- When IgG titers for viruses are present, Infectolab can help to explore active vs. past infection
- PANDAS is not just strep either; there are often multiple contributors
- The allopathic community is starting to warm up to the idea of PANDAS, but the treatment options are generally limited to antibiotics, steroids, IVIG, tonsillectomy; maybe Rituximab and plasma exchange
- Biofilm disruptors can play a role in microbial management
- Has found peptides helpful in some children
- There is some overlap with the Neural Zoomer and Cunningham
- If Strep is present, antibiotics are the appropriate treatment to avoid progression to more complex illness
- Only about 10% of his patients need IVIG
FullyFunctional.com

Tania Tyles Dempsey, MD spoke on "MCAS, Endocrine Disruption, and The Epidemic of Metabolic Syndrome and Other Hormonal Disorders" and shared:

We are looking for ways to get patients better that have not found their way; need to have a large toolbox
MCAS is about dysfunctional mast cells; not a higher number of mast cells
Need to consider endocrine disorders from a mast cell perspective; not just a hormone perspective
Mast cells are produced in bone marrow; move through bloodstream and settle in tissues and organs and start to develop
No mast cell produces all 1,000+ mediators; differences in mast cells in various parts of the body in terms of the mediators that may be produced
Highest concentration in areas that are in closest contact with the environment; early pathogen and toxin recognition
Were most useful to help humans deal with parasites; not as useful today; function has evolved
Mast cells produce performed mediators (histamine, serotonin, etc.), cytokines, lipid mediators, chemokines, growth factors (including VEGF often looked at in Bartonella)
Positive function to mast cells; homeostasis, blood vessel repair, tissue damage
Normal, appropriately-reacting mast cells play a key biological role in the body
Mast cells are heterogeneous due to the environment around them; hormonal shifts impact mast cell development, pathogens
Mast cells have far-reaching effects
Mast cells impact organ systems and lead to inflammation resulting in various diseases
Strong association with interstitial cystitis, asthma, psoriasis, atopic dermatitis
Mast cells have potentially negative effects; have direct antimicrobial effects, but may be also cause abnormal tissue remodeling, cysts/tumors; double-edged
MCAS usually has an onset under age 20; though not recognized
Symptoms are inflammatory, wax/wane vs. chronic vs. episodic; different symptoms at different times of day; provoked with or without an identifiable trigger; usually progresses over time
Patients often know the month and day that their condition started; but that is often the straw that broke the camel's back in the presence of already primed mast cells
Three categories of MCAS: primary, secondary, idiopathic
Secondary is a trigger that leads to getting sick and then sicker; treating Lyme leads to improvement of MCAS; fairly rare; don't always completely recover from underlying MCAS; may have idiopathic MCAS
Primary is a clonal problem where one mutation leads to a clone of mast cells; fairly rare
Idiopathic has many mutations and can get worse with a trigger/triggers such as mold, Lyme; but stage was set previously
Must have symptoms consistent with chronic activation; abnormal at baseline and reactive to triggers
Must have signs and symptoms in at least two organ systems
Must not have another disease that better explains their symptoms
MCAS is not mastocytosis
MCAS may manifest with or without allergic symptoms
17% of the general population is though to have a mast cell disorder
Tryptase is a mediator produced by the mast cell, but other mediators such as heparin may be better to explore the potential of MCAS
Tryptase is observed in mastocytosis where there are more mast cells, but may not be in MCAS where there are not
Estrogen and progesterone both can activate mast cells; progesterone less so and may help to stabilize in some patients; impact of testosterone is unclear but may be anti-inflammatory
Estradiol induces ovarian mast cell degranulation; necessary, but abnormal response could lead to problems
Mast cells may be involved in symptom worsening perimenstrually and decreases during pregnancy
Hormone replacement may increase mast cell degranulation; may be more harmful than helpful for some patients
MCAS may play a role in endometriosis; some treat endometriosis with hormone suppression; may be helpful to explore the activation of the mast cells
Asthma and allergic disease are three times more common in women than men during reproductive years
Metabolic syndrome relates to the mast cells; type 2 diabetes, insulin resistance
Inflammation plays a role in the obesity epidemic; mast cells play a role; stabilizing mast cells has an effect on weight and insulin resistance
Mast cells express leptin and leptin receptors; suggesting a more involved endocrine/metabolic disorder
Bodies designed to withstand hours or days of not eating; pre-modern times, it was hard to gain weight; mast cells are constantly bombarded by our environment; body is always in fight or flight; excess calories, excess food; spirals; metabolic syndrome rising as toxins in our environment rise
PCOS involves inflammation; visceral adiposity in obese and non-obese correlating to insulin resistance; there are skinny and obese PCOS patients; all have insulin resistance as a root cause and low-grade inflammation; may be an autoimmune disorder; positive ANA and anti-TPO in one study; not proven, but not uncommon to see non-specific autoimmunity; mast cells are involved
PCOS: allergies, asthma, thyroid dysfunction/Hashimoto's, autoimmune disorder, increased sympathetic tone, sleep apnea, increase risk of venous thrombosis, IBS, gastroparesis
MCAS is very tightly linked to PCOS; may benefit from mast cell stabilization
Mice study with high fat diet used Cromolyn or Ketotifen showed reduction in body weight and glucose intolerance
Mast cell treatment has been helpful in chronic dyspareunia, vaginitis, and dysfunctional uterine bleeding; approached the gynecologic issue from a mast cell perspective
Metformin may be helpful in MCAS; can help with allergic disease and increase Treg cells
Our mast cells are environmental activists whether we like it or not
There are 1482 endocrine disrupting chemicals in the TEDX website
Mast cells react to endocrine disrupting chemicals (EDCs) as well as hormones; ubiquitous; breath, food, water, skin
Have developmental, reproductive, neurological, and immunological effects
Endocrine disruption can block action of hormones, alter chemical message sent by hormones, disrupt production, bind to carrier proteins, and epigenetically impact how the hormones act
Can have hormone mimics and hormone blockers
Environmental toxins interfere with the endocrine system
DES, DDT, PCBs, dioxin and others have led to health regulations
Low doses of EDCs can impact metabolic and gene expression
Greatest impact is at times of development, infancy, childhood, puberty, breastfeeding
Can impact menses, development/function of urogenital system, infertility, cancers
Sperm counts have dropped in last 50 years
Metabolism-disrupting chemicals are EDCs but impact energy homeostasis
Endocrine disruptors can be obesogenic; link between childhood obesity and EDCs
EDCs impact the function of human immune cells; far reaching effects on immune cells
BPA alters estrogen receptor expression in the heart; cardiac mast cells lead to perimyocarditis and fibrosis
Xenoestrogens impact mast cell degranulation; leading to asthma and allergic disease increase
EDCs in food impact the gut microbiota; microbiome plays a role in how EDCs are metabolized
The gut microbiome is the neglected endocrine organ; produces numerous chemicals of a hormonal nature
Environmental toxins impact our microbiome
Dysfunctional mast cells interact with the microbiota; microbiota interact with the mast cells; leads to gut issues commonly seen
Many of her patients have MCS or chemical intolerance (CI) or TILT
Mast cell activation may explain MCS
MCAS patients have high QEESI scores; high QEESI scores -> high likelihood of MCAS
QEESI (50 questions) and BREESI (screening)
Toxicant-Induced Loss of Tolerance (TILT) comes with a genetic susceptibility with an initial exposure event; loses tolerance over time and becomes "sensitive"; then low levels of exposure trigger ongoing symptoms
Often don't recognize underlying issues until "the straw that broke the camel's back"
Implants and pesticides have a high correlation with predicting chemical intolerance
RX treatments for MCAS: H1/H2 blockers, Leukotriene Inhibitors, LDN, Aspirin/NSAID/COX-2, corticosteroids, Amlexanox, Stabilizers (Cromolyn/Ketotifen), Benzodiazepines, Omalizumab, Imatinib, Hydroxyurea, Peptides
H2 blockers reduce stomach acid very little compared to PPIs; can be very effective
Likely a MCAS component to PANS
Non-RX: Low Histamine Diet, DAO, quercetin, luteolin, C, D, turmeric, NAC, ALA, methylation support, histamine decreasing probiotics; generally not enough on their own
Increasing prevalence of MCAS; not increasing recognition
More research needed
Need to understand impact of modern day living
Can the microbiome save us?
From Q&A discussion
- With resistant weight loss, consider MCAS, infections like Bartonella/Babesia which cause metabolic dysfunction; diet alone is not enough
- Amlexanox is a MCAS stabilizer peptide that also has research in weight loss
- For Heparin, want a range that starts at 0; looking at microscopic doses; different from someone that is taking heparin exogenously; has to be transported carefully and refrigerated centrifuge
- For peptides in the MCAS realm, BPC-157 has been a nice tool; fairly well tolerated by the majority of patients; may help with healing the gut which then improves MCAS; KPV has mast cell stabilizing properties; Thymosin Alpha 1 is not specific for MCAS, but in those with immune dysfunction as well, can be a role; Thymosin Beta 4 has not been tolerated by all of her patients
- When there is underlying mast cell dysfunction, some may respond negatively to vaccines such as HPV or COVID; there were themes of inflammation and dysfunction or allergic phenomenon that a vaccine may have highlighted; the vaccine was the straw that broke the camel's back
- Mast cells are designed evolutionarily to fight parasites; parasitic infection(s) including possibly Babesia could be perpetual mast cell triggers; if you could take away 100% of the infection, would the MCAS be 100% reversed? In a subset yes; in others no
- Rupatadine is another tool that may help some patients, but does not consistently stand out over other tools; may help with increased coagulation
- Rarely recommend bone marrow biopsy; could be indicated if tryptase is over 20 and need to rule out mastocytosis; do not need a bone marrow biopsy for MCAS
- Hereditary Alpha Tryptasemia may lead to elevated tryptase levels without mastocytosis or MCAS
- CD117 staining of a biopsy from endoscopy of colonoscopy can be suggestive of a mast cell condition or MCAS
- Want to get patients to living fullest lives; not just stable; ongoing medication may be needed in some patients
- MCAS symptoms may improve during pregnancy; less hormonal fluctuation; peri-menopause may be very difficult; menopause also has less hormonal fluctuation
- BHRT or birth control pills can be triggers for MCAS; have to do it carefully
- Majority of cycling female patients feel worse around their cycle; if there are things that they know trigger their mast cells, don't do it around the time of the cycle
- Natural history of MCAS is an escalation over time; first pregnancy, things may be quiet; after pregnancy, MCAS can occur; may escalate with subsequent pregnancies
- Complicated overlay with MCAS and autoimmunity; MCAS may be mimicking autoimmunity; ANAs may go up/down/disappear
DrTaniaDempsey.com, AIMCenterPM.com

Amy Derksen, ND spoke on "One In The Same: From PANS to COVID Long-Haulers to Chronic Lyme and Mold Illness" and shared:

Has worked in the chronic Lyme arena for over 15 years
Uses ART to identify patterns and blockages that labs may not identify; can help to validate ideas and elucidate therapeutic interventions
With Lyme, molds, PANS, there is generally an initial trigger such as Strep, mold, Lyme, Bartonella, Babesia, EBV, COVID, etc.
The immune system starts to be "on fire" and patients react to everything; the immune system reactivity becomes a major driver of the highly reactive, chronically inflamed state
Acute COVID support: Chinese Skullcap, LDM-100, Beyond Balance IMN-V and IMN-V-III, Flucommune, ViraCon; nasal sprays like ACS silver, Propolit, Enovid (nitric oxide nasal spray helpful for travel or potential exposures as a prevention); Briotech HOCL, zinc, high dose A, high dose D; glutathione and anti-inflammatories such as Boswellia Plus, curcumin, fish oil, IMN-CALM, CBD) and antioxidants (E, CoQ10, NAC, quercetin)
Nasal passages are the main route of transmission
In the acute stage, even sensitive patients seem to tolerate treatments they may normally react negatively to
Zinc needs are unreal; may correlate to COVID vulnerability; does not worry about copper balance with higher dose, short-term use
Researched Nutritionals CytoQuel has been a helpful tool for cytokines/inflammation
Body is begging for antioxidants to address the oxidative stress
For post-viral fatigue and lingering symptoms: other triggers may be activated such as EBV, CMV, Mycoplasma, Babesia, influenza; nasal sprays; Monolaurin/Lauricidin for EBV, CMV; LDI, Sterol 117, Humacel, Artemisia/Cryptolepis (Babesia), Transfer Factor PlasMyc, Mycommunity (low WBC), LDN
LDI: Influenza, Colds, Lyme, EBV, Mycoplasma mixes may be helpful tools
Briotech HOCL has been a good surface disinfectant that is tolerated well by sensitive patients; can be used for washing hands; facial spritz, eyes/nose/mouth; some have used nebulized
Transfer factors from Researched Nutritionals have been consistently helpful; PlasMyc, L-Plus, Multi-Immune; Th1/Th2 balance modulators; promotes immune tolerance, not immune ignorance
Chinese skullcap has been very helpful; good for nervous system, anxiety, sleep, neuroinflammation
Propolis has historically been helpful for herpes/HSV; antimicrobial, antioxidant, anti-inflammatory; H. Pylori; diffuser, nasal spray; good in mold patients; Propolit, Quantum Lysine Plus, BioPure
Lomatium/LDM-100 antiviral; can get a rash around day 7-9 and need to back off
Artemisia/Artemisinin for Babesia, COVID, anti-oxidant; needs to be pulsed or it will become ineffective
Andrographis provides more liver support than milk thistle; antiviral; anti-Strep; very bitter; short-term treatment
Zinc has been one of the more important nutrients, RBC zinc level; need more if KPU; long-term use may need copper; take with food to avoid nausea; some people may need life-long zinc support
Vitamin D; correlates to complications from COVID; can drive calcium levels up off too high; may consider high dose protocol for acute flare or acute illness
Long-term issues after COVID, Lyme, mold
- Mitochondrial depletion
- Methylation issues
- Glutathione depletion
- Ammonia build-up
- Digestive barrier compromise
- Adrenal/thyroid dysfunction
- Other pathogens triggered
- Disruption of bile flow
Helpful Labs
- Mitochondria: alanine/lysine over 2.5
- Methylation markers; normal homocysteine 6-8; high methylmalonic acid = low vitamin B12 in cells
- Thyroid/adrenal
- Histamine (not always elevated)
- Infections
- CBC
- Iron/TIBC/ferritin; ferritin can be falsely elevated in an inflamed state
- RBC zinc and magnesium
- Clotting tests
Nucleocapsid test for SARS-CoV-2 can be used for infection immunity; not immunity from vaccination
Great Plains Organic Acid Testing
- Glutathione indicators
- Serotonin/Dopamine
- Mitochondria
- Methylation/B vitamins
- GI dysbiosis
- Yeast/Candida/Mold
- Ammonia/urea cycle
- Arabinose on an OAT is elevated in 99% of her patients; does not use alone
- Clostridia drives quinolinic acid and dopamine; adults get mean; kids start biting
- HVA is a dopamine marker; can be a driver of fear and anxiety
- Oxalates can be elevated if there is a yeast issue
- High uracil is an indication of folate deficiency
- Orotic acid is a pretty stable urea cycle marker for ammonia
Uses GI MAP, but there are many good options; some do sensitivity testing
H. pylori tends to come and go; does not use triple antibiotics to treat; may use mastica; more opportunistic
Numerous elevations of opportunistic bacteria may be consistent with SIBO
High IgA represents an overactive, reactive immune system; need to calm things down
Mitochondrial Support
- CoQ10
- ALA
- Carnitine or Acetyl-L-Carnitine
- Exercise
- Folinic of 5-MTHF
- Creatine
- D-Ribose
- Glutathione
- E
- Researched Nutritionals ATP Fuel
- Integrative Therapeutics KPAX
- Need a loading dose to make clinical progress
Methylation Support
- High homocysteine: B6, B12, folinic, methylfolate
- Low homocysteine: SAMe
Supporting Glutathione and Liver Detox
- Viatrexx Liver
- Milk Thistle; #1 option for Herxing
- Castor oil packs
- NAC
- PC; Xymogen Phosphaline
- Glutathione
- Himalaya Liver Care
- Andrographis
- Taurine
- Pekana MUNDIPUR or apo-HEPAT
- Quicksilver QuickSilver Clear Way Cofactors
- Designs for Health Amino-D-tox
Addressing Ammonia
- Brain fog
- Breath stinks
- Reduce high ammonia foods, protein powders
- Yucca root
- Charcoal
- Slow methylation
- DIM Pro or DIM Detox
- Pteridin 4
Adrenal Support
- Glandulars
- Herbal adaptogens: Eleutherococcus, Ashwagandha (a favorite), Rhodiola
- Exercise
- Stress reduction
- Reduce sugar
- Support sleep
- Primary issue after COVID
Thyroid Support
- Levothyroxine or T3 or Armour
- Zinc
- Selenium
- Lithium orotate
- Iodine if not autoimmune
- Support adrenals
- LDA/LDI if autoimmune
Uses a lot of Ketotifen and LDN
Butyrate is well-tolerated and helpful for ammonia brain and supporting the microbiome
Binders: Charcoal, bentonite, butyrate, chlorella, Takesumi, TOX-EASE BIND, Cellcore, GI Detox, UltraBinder
Bile flow: ox bile, taurine, PC, digestive enzymes high in lipase, castor oil packs, HCL
Those with bile flow issues often do not tolerate fats in their diet well
Gut: butyrate, stool testing, Probiota HistaminX, MegaSporeBiotic, Culturelle, Bifidus; MegaMucosa for IgG/IgA support; antimicrobials such as andrographis or berberine
For parasites, PARALLEVIARE, PARA 1, PARA 2, Supreme Nutrition Mimosa, Botanifuge
For sleep, Cortisol Manager Allergen Free, lithium orotate, melatonin, hydroxyzine, Benadryl, Ketotifen, Phos Serine, Ashwaganda, adrenal glandulars
Glandulars are food for the adrenals; for some people can even be helpful to take at bedtime
Belief that you can get well: DNRS, Rapid Eye Therapy, Life coaching, MFY, tapping, meditation, positive affirmation
Acute flare support: D, A, tri-salts, baking soda, Alka Seltzer gold, binders, glutathione
From Q&A discussion
- LDN has been helpful for some with loss of smell and taste; need to focus on neuroinflammation
- Might pulse spore-based probiotics after 3-6 months; may not be needed on an ongoing basis
- Viruses may play a role in some cases of tinnitus; explore sinuses, lymphatic drainage
- Cholestyramine can be a helpful tool for high TGFb1, high MMP9, mold history, ongoing mycotoxins; often the one things that works well for mycotoxins for some of her patients; can mix with other fibers or chase with magnesium citrate
- For post-COVID hair loss, consider zinc, thyroid support (ideal TSH 1-2), adrenal glandular support
HolisticHealingArts.org

Alena Guggenheim, ND spoke on "Hypermobile Connective Tissue Disorders: A Primer for Integrative Providers" and shared:

Those with hypermobility syndromes may have more immune activation, neuro activation, susceptibility to infections and autoimmunity
Hard to find providers to help this population get diagnosed
Those with EDS are questioned, judged not to be ill but suffering from an imaginary illness, and given a psychiatric diagnosis; ignored, belittled, blamed for their condition
Part of the underlying physiology that leads to struggle in this population is the trauma experienced from engaging with the medical community; being gaslit about their own body; drives the fire that makes things worse
Integrative physicians are uniquely poised to help this population
Doctors are often taught that they need to stay in their lane
Patients are often labeled as psychosomatic
When to suspect hypermobile joint disorders
- Chronic joint instability
- Pain
- Fatigue
- Gut issues
- Postural symptoms; feel worse upright
- Allergy/atopy
- Autoimmunity
Common previous diagnosis: CFS, Fibromyalgia, chronic pain syndromes, IBS and functional dyspepsia; medically unexplained symptoms such as hypochondria, hysteria, conversion disorder, amplified pain syndrome, Bodily Distress Disorder, Munchausen's Syndrome
Hypermobility Spectrum Disorders (HSD) includes hypermobile EDS; deep end: EDS, Marfan, Loeys-Dietz, Sticklers, Charcot-Marie-Tooth; shallow end: joint laxity, benign hypermobility
14 subtypes of EDS
The label hEDS vs. HSD does not predict the symptom burden they carry
Chronic pain is found in up to 90% of patients with hEDS
HSD patients are more often younger and female
Prevalence of HSD has gone from 1/5000 in 2002 to 30.4/1000 (3.4% of population) in 2013; 2019 study estimated 0.2%; 1-4% of the population; not really a zebra diagnosis
EDS Myths
- There is no point in diagnosing; it does not change management
- You can't have it; only seen in children
- You can't have it; your Beighton score is too low
- You are too young
- You aren't wearing enough braces
- EDS is rare
- You can only have it if you have dislocations
- Requires a genetic test for diagnosis
- Causes broken bones
Musculoskeletal symptoms: hypermobility, subluxations, dislocations, recurrent sprains, muscle spasm, pes planus, arthralgia, myalgia, scoliosis, early osteoarthritis, labral tears, tendon/ligament tears; prolonged healing common
Skin symptoms: soft, stretchy, easy bruising, atrophic scarring, poor wound healing, telangiectasis, translucent skin
Cardiovascular symptoms: mitral valve prolapse, aortic root dilation, varicose veins, pelvic congestion syndrome, dysautonomia with tachycardia or hyper/hypotension
Pulmonary symptoms: spontaneous pneumothorax, reactive airway disease, dyspnea (air hunger)
Gastrointestinal symptoms: gastritis, IBS-D/C/M, rectal prolapse. GERD, esophageal spasms, low pressure dysphagia, dysmotility, SIBO, visceroptosis, hemorrhoids, vascular compression syndromes, hernias, diverticula, increased risk of IBD/celiac
Everything goes wrong when you scream sympathetic tone at the intestines all day
The biome is altered when motility is impacted
OB/GYN symptoms: vulvodynia, dyspareunia, pelvic prolapse; mixed data on endometriosis and infertility
Risk of miscarriage is mixed; premature labor increased; rupture of membranes, incompetent cervix, placenta previa; baby in odd position
Urinary symptoms: incontinence, enuresis, vesicoureteral reflux, renal cysts, bladder diverticula, interstitial cystitis, chronic UTIs, painful/overactive bladder; 40% reduced DAO activity resulting in less histamine breakdown; less of the protective glue that keep bacteria from burrowing into the bladder wall; culture down to 10,000cfus/ml; infection is found in the bladder and UA will be normal
ENT symptoms: swallowing issues, TMJ, apnea (90%), upper airway resistance disorder, dental crowding, resistance to local anesthetics
Practitioners may have bias based on a patient's body size
Ocular symptoms: blue sclera, retinal/vitreous detachments, myopia, globe rupture, glaucoma, accommodation defects, keratoconus
Neurological symptoms: dysautonomia, migraines/headaches, intracranial hypertension, spontaneous intracranial hypotension, CNS lesions, tethered chord, Chiari
Psychological symptoms: anxiety, OCD, PTSD, neurodiversity, ADHD, depression
Why are patients developing psychological symptoms? Often young women that look healthy; symptoms may be brushed under the rug
Need to ask if you were living a life with a body that felt different from your peers, anxiety/depression could be a sign of not being adapted to the condition that you have and could be expected; it may be the results of MCAS mediators
Can have a heavy psychological burden and not be psychiatric
Can start with a hypermobile phase, moving to a pain phase, then a pain+ phase, and then a stiffness phase
Suspects that people who experience trauma/ACEs may turn of the speed dial of the phases; the effect of trauma on the nervous system and immune system speeds up the process; a hypothesis at this time
Comorbidities: MCAS, autoimmunity, GI disorders, dysautonomia, neurological/spinal complications, vascular/nerve compression syndromes
Things to watch for: severe positional headaches and vision changes can be intracranial hyper/hypotension, Syrinx, and CSF leaks; CCI; Chiari; tethered cord
No two EDS patients will have the same symptom picture
Varying levels of pain, fatigue, dysautonomia, cardiovascular, gastrointestinal, psychological, urogenital, and neuromusculoskeletal symptoms
Pain can have many drivers: visceral/vagal, central sensitization/neuroplastic, proprioception, mechanical, dystonia, mast-cell mediated, inflammatory, mitochondrial, hypoperfusion, small fiber neuropathy, nerve compression
History has to start in childhood and work to present
Patients often normalize their experiences; have to ask the right questions to collect relevant history
Physical exam: Beighton score, goniometers (don't always work very well); connective tissue evaluation
Diagnostic Criteria: Since 2017, hEDS complex 3 part criteria; must meet all 3; generalized joint hypermobility; features of heritable connective tissue disorder; meet 2 or more of 3 categories (5 of 12 systemic manifestations; family history; 1 of 3 musculoskeletal complications); absence of exclusion criteria
Systemic manifestations: soft skin, skin hyperextensibility, unexplained striae/stretch marks, piezogenic papules of the heel, abdominal hernias not including hiatal, atrophic scarring at 2 sites, pelvic floor prolapses, dental crowding, bilateral arachnodactyly, arm span to height ratio > 1.05, mitral valve prolapse, aortic root dilation
Musculoskeletal complications are pain or instability
Some patients made need genetic testing: super stretchy skin, elephant knees, oranges or super atrophic scars, vascular or organ ruptures, kyphoscoliosis, spontaneous pneumothorax
From Q&A discussion
- Patients may either by hypermetabolizers of local anesthetics or the structure of their fascia leads to leaking away from the site of injection
- EDS Society has a list of providers; https://www.ehlers-danlos.com
- She has created a 14 hour training course for practitioners
- Marfan syndrome is significantly more rare compared to EDS
- Hard to know the contributor of infections or mold as testing for these is not easy; some test are not accessible to her in the university system
- Has not seen a confirmed case of Bartonella; mold is more complex; don't assume every patient has an infection or a mold exposure; explore history and timeline
- Some mediators of mast cells may lead to increased tissue laxity; collagen and elastin digesting enzymes
- Over-emphasis on the concept of "cure" can hurt patients and physicians
- People that are healthy are not better than those with a disability
- Sending people to a physical therapist that is not aware of hypermobility is more damaging than no physical therapy at all
- Patients may work with PTs, utilize braces, use silver ring splints or stabilizing vests; diagnosing POTS so that they can engage in exercise; exploring MCAS; looking for differential diagnosis
OHSU.edu

Amber Walker, PT, DPT, CFMP, CNPT spoke on "Unwrapping The Trifecta: Root Issues and Structural Influences" and shared:

Focuses on nervous system rebalancing; works with MCAS, dysautonomia, EDS, CIRS, hereditary angioedema
Was a patient herself living with these conditions
There is a connection between the trifecta of MCAS, POTS, and hEDS
hEDS involves hypermobility and systemic issues such as with skin tissue fragility, bruising, weakened vessels and organ walls
MCAS can be episodic; hypersensitive to environment; triggers inflammation; often to benign stimuli
POTS is a dysautonomia with an increase in heart rate with positional changes not typically accompanied by a drop in blood pressure
Structural issues with hEDS can lead to blood pooling and dysautonomia which can lead to mast cell mediator release; mast cell mediator release may alter connective tissues
Toxins impact all three conditions dramatically; influence mast cells, genetics, autonomic nervous system
POTS and MCAS are often resolved with removal of mycotoxins; hEDS often improves
Cervical spine and brainstem or laxity at C1/C2 can impact the autonomic nervous system
May be a pentad: MCAS, POTS, hEDS, GI issues such as SIBO, autoimmunity
Some add on craniocervical instability, tethered cord, and Chiari
There are many factors leading to the perfect storm: mold, Lyme, Chiari, CCI, ME/CFS, hEDS, SIBO, GI, dysautonomia, cervical spine alignments, MCS, metals, virus, trauma, autoimmune, hormones, MCAS; toxic burden influences all of these
Common root issues: internal health stressors, external health stressors, high toxic burden, nutritional deficits, ANS dysfunction, structural/musculoskeletal issues, lack of or improper movement, emotional trauma
Internal health stressors are infections, GI, hormones; external are toxicant exposures, mold, metals, EMFs
80-90% of her patients have a CIRS diagnosis and elevated mycotoxin levels; respond dramatically to treatment
With MCAS community, restricted diets can be a slippery slope; low-inflammation diet is often successful; low histamine diet can lead to increase in inflammation and reactivity over time
Working on internal and external stressors often allows for expansion of the diet
ANS dysregulation: breath, somatosensory exercises, grounding, Safe and Sound, auditory therapies, Tension and Trauma Releasing exercise, DNRS, Gupta, trauma work, Polyvagal theory; every patient with chronic illness should explore soothing strategies
Nervous system work can be triggering; need a good practitioner to guide
Glossopharyngeal nerve may be involved in swallowing issues; structural alignment influences cranial nerves and ANS regulation
Patients can have many structural and musculoskeletal issues; can have CCI, intracranial pressure, pelvic floor issues can result in incontinence; concussions, tethered cord; can have visual and vestibular abnormalities
CCI: underrecognized; delays in diagnosis; structural instability and craniocervical junction; fairly common in EDS community; most mobile portion of the cervical spine from C0 to C2
Dr. Jim Elliott looked at muscles impacted by whiplash and found fatty infiltrates in these muscles that stabilize the cervical spine; ligaments matter, but muscles do as well
Can be a chronic laxity without an accident or trauma
CCI can lead to stretching of the cranial nerves, pressure on brainstem, degeneration of levels below C2, ribs/spine/cranium can develop compensatory patterns
Dental specialist can be helpful in exploring cranial issues; TMJ, bite issues
Biotoxins can add stress to the visual system and lead to compensatory patterns in the neck and spine
Numerous CCI symptoms; common are clumsy, headaches worsened with cough or sneeze, choking on food, gasping for air, hoarseness, balance issues, vertigo, hearing changes, brain fog, difficulty with multi-tasking, feel like head is heavy, sleep apnea, ANS symptoms
CCI decision making: symptoms and history, questionnaires, PT physical exam, response to traction (controversial; can be dangerous in some cases), imaging, response to conservative management
Gentle physical exam can elucidate the impact of cervical spine issues
Most PTs are not experienced in working with hEDS or CCI; can make things worse
There are many overlaps with different conditions that impact the cervical spine and are not CCI; can have overlap as well
Upright MRI with flexion and extension is the preference
Chiari decompression surgery may not consider cervical spine; may fail if not considering CCI
CCI treatment: physical therapy, chiropractic (often avoids), chin tuck exercises (often avoids) bracing/cervical collars, cervical traction (often avoids), neck massage (often avoids), Botox/trigger point injections/dry needling, cervical epidurals/facet injections/nerve blocks, radio frequency ablation; steroids can be toxic to the cervical tissues
Adjustments might feel good initially but may need on an ongoing basis and contribute to more instability
Cervical collars can lead to weakness of the muscles over time
Recommends: training deep muscle stabilizers, isometric exercises, laser exercises, craniosacral, address nervous system, visual/proprioceptive and vestibular exercises; align and then stabilize
More invasive options: surgical fusion, Prolotherapy, Percutaneous Implantation of Craniocervical Ligaments
Chiari Malformation: can block CSF flow and lead to dysautonomic; 6 types; secondary mechanism due to CCI in some; "nature's airbag" phenomenon; may be an adaptation to CCI
Better success first looking at intracranial pressure and CSF leaks
Tethered Cord Syndrome is common with CCI and Chiari; pulling down of the spinal chord by a thickened filum terminale; low back pain, leg weakness, urinary symptoms
Tethered Cord release can help CCI and Chiari; CCI/Chiari surgeries can also impact Tethered Cord
Those with EDS are at higher risk for CSF leaks
Do not want to have CCI and Chiari surgery first if there is a CSF leak present
Referrals: PT, functional optometrist, biologic dentist, craniosacral, visceral manipulation, ANS specialists, lymph drainage, vestibular specialists
Movement is important to avoid deconditioning; can do too little or too much or incorrect movement
She healed from over a dozen different medical labels and conditions
She started surfing and her chemical sensitivities resolved virtually over night; had to do with the physical aspects of what she was doing on the surfboard
Exercise should be the right dose, spark joy, ground nervous system, and shift the focus external; in addition to stabilizing the cervical spine
With complex patients with high toxicant and inflammatory burden, will nervous system and structural work be tolerated? May need to lower inflammatory and toxic burden first. In others, structural work is needed before other work.
Functional root issues approach: medications, diet, compression socks/salt/hydration, structure alignment, internal and external stressors, nutrition, stress and lifestyle, social support, nervous system rebalancing, trauma, movement, detoxification
Many of these patients are empathic; may benefit from energy and boundary work
Every patient with these conditions should be screened for CCI, Chiari, Tethered Cord, CSF Leaks
Start with the gut, toxic burden, mold, and nervous system
From Q&A discussion
- hEDS is becoming more prevalent; also more on the radar
- Epigenetics plays a huge role in hEDS; people are born with a higher toxic burden which may make things seem more genetic in nature; there is hope
- Lyme and co-infections are very common in her patients; not as common as mold
- Many patients have Lyme and/or mold diagnosis
- Fluoroquinolones may be present in her patients history
- Supports conservative management for 95% of this population
- Surgical responses have been mixed; can dramatically improve quality of life; can worsen pain for some
- Reducing EMF exposure is a huge factor; impact of EMFs on mast cells can contribute and should be considered in a comprehensive plan
- Dysautonomia itself can be a spectrum
- Almost never sees these patients that do not have some mold and/or Lyme contributors
- Clean air, water, nutrition are all important topics; exposures through the skin matter
- Has had a number of patients that found FSM helpful
- Energetic techniques like CranioBiotic Technique can be helpful tools
- Supplemental collagen is not yet something she can clinically get behind; not a mainstay
- Opening detox pathways and supporting mitochondria are important
- For highly sensitive MCAS patients, consider energetic work, topical support, nervous system work
- Postural Restoration Institute may have PTs that can be helpful; no one group that works with these patients
- Low histamine diet may initially reduce the histamine in the bucket; it also can drain nutrients by cutting out most fruits and vegetables; may lead to more processed foods; may raise inflammation even more long-term
- Air hunger may be seen with vector-borne illnesses, but can also be related to structural issues
- Home traction units are intended to mimic a fusion and decrease compression; has seen good results in non-CCI patients but does not recommend for CCI
OriginWellnessColorado.com, MastCellsUnited.com

Christian Bogner, MD, FACOG, CFMNP spoke on "Autism: Pathophysiology and Tactics" and shared"

Got involved in autism 15 years ago; his 17 year old is impacted by autism
Moved from OB-GYN to integrative medicine about 6 years ago
Has worked with hundreds of families impacted by autism
Incidence is 1:44; 1:27 boys
Economic burden estimated to be $461 billion by 2025
50% of 25 year olds with autism never held a paying job
Autism is a self-sustaining system that feeds off itself
90% of patients have GI issues
Postulates that inflammation in the GI tract is caused by mold exposure
300+ toxins that mold species secrete
Many studies tie mycotoxins to many neurodegenerative diseases
GI system is impacted by mold; breaks the mucosal barrier causing disruption in gap junctions
Many toxins then leak into the portal system/into the blood; metals, food proteins, other toxins
Food proteins should never be absorbed into the blood; recognized as a foreign toxin
Everything then has to go through the liver; sponge for toxins
Filtration via the liver is complex; 70% of glutathione is produced in the liver to bind and neutralize toxins
A problem with production of glutathione impairs detoxification
Eggs, crucifers, garlic all contain cysteine which is an essential nutrient for production of garlic
Cysteine is stored in homocysteine as a reservoir; need specific enzymes to tap into this store
May have building blocks, but not be able to tap into it genetically
CBS gene liberates cysteine from homocysteine
P5P may help to stimulate CBS to liberate cysteine
Toxins coming into the liver deplete the glutathione reservoir
Oxidation is the next defense; body loses oxygen to "blow-up" toxins
Toxins are generally negatively charged; oxygen grabs the electrons
Most negatively charged molecules are stored in fat; difficult to excrete via the kidneys
Liver oxidation makes toxins water soluble so that they can be peed out; but comes at the cost of free radicals
Dr. Richard Frye has demonstrated oxidative stress in patients with autism
Liver is the only organ that consumes more oxygen than the brain
Food proteins, mycotoxins, other dietary toxins end up in the blood
When this occurs, the first cell to alert the immune system of the foreign particles is the mast cell
Mast cell is an immune cell that opens up to release its "flares"; 200 different chemicals including histamine, serotonin, and cytokines
Some cytokines lead to opening of the blood-brain barrier and lead to irritation of brain structures including the amygdala
Amygdala is a key area that is involved in autism; hyperstimulation driven by histamine
In neurotransmitter testing over 5 years with hundreds of kids, pattern of histamine stimulation of adrenaline; body starts to "itch" which leads to a threat response and adrenaline as an attempt to burn up histamine
Adrenaline is a trigger for activation of amygdala; chronic elevations have severe consequences
Chronic elevations of adrenaline lead to a rise of cortisol; the chronic stress response
Adrenaline is great for running from the bear, but not great for chronic stress
Cortisol levels are elevated in children with autism
When on steroids, more prone to yeast and mold
Giving steroids to premature babies leads to thrush; yeast overgrowth
Cortisol is a powerful suppressor of the immune system; CD4 and CD8 immune cells
Leads to more survival of mold in the body; creates a self-sustaining cycle
Genetic susceptibility in these individuals largely around genes responsible for metabolizing neurotransmitters
Higher levels of adrenaline are usually broken down by COMT; usually affected in those with autism; function is less functional; 70% less in homozygous patients
COMT gene should break down adrenaline into metanephrine
CALM powder with magnesium stimulates breakdown
Methylation in form of SAMe gets produced from methylated B9 and B12; problems with methylation in autism; not only MTHFR
Even if MTHFR and MTRR are working, still need MTR; impacted by aluminum, acetaldehyde, mercury, lead, nitrous oxide, hydrogen peroxide, high SAMEe
Aluminum content from numerous vaccines is not insignificant
Molds inhibit methylation
With high adrenaline and free radicals like superoxide and hydrogen peroxide, adrenaline is oxidized into adrenochrome
Adrenochrone is linked to Schizophrenia; at one time was the same diagnosis as autism
Children may be hallucinating; they cannot communicate so it is difficult to know
Adrenochrome is a big factor in autism; more in high-functioning autism
Sees problems in children with serotonin metabolism; mast cells secrete a lot of serotonin
Serotonin is broken down by MAO gene into 5-HIAA; MAO is X-linked; boys only have one copy; a variation means the gene is functional at only 30%
Precursor for serotonin is tryptamine; can almost guarantee both are high in autism
Ratio of autism in males:females is about 4:1
Tryptamine is broken down into bufotenin; a very psychoactive metabolite
Tryptamine is an ingredient in LSD, psylocibin, NMDA, mescaline, DMT
Bufotenin is 5-HO-DMT; causes children to lose touch with reality and a low functioning individual; literally "tripping"
Bufotenin leads to low functioning; adrenochrome leads to high functioning/high intelligence
Specific genes such as SUOX are involved in breakdown of sulphur, assembly of cysteine into glutathione
Sulphur breakdown via SUOX leads to beneficial hydrogen peroxide to keep yeast, mold, parasite controlled
HNMT is involved in breakdown of histamine; as is DAO
Can check the genes to see how best to help the patient with this viscous cycle
Dr. Russell Blaylock identified chronic microglial activation in autistic brains
Chemicals, air pollution, pesticides disturb prostaglandin E2 signaling and increase risk of autism
Environmental factors must be drivers for autism prevalence
Dr. William Shaw showed that Nystatin led to significant improvement in autistic children
Mycotoxins lead to the production of cytokines, trigger mast cells, deplete glutathione, activate microglia
Mycotoxins have vast impacts of every organ system; impact fertility
Ochratoxin A is involved in pathobiology of autism
Study showed that autism patients had higher levels of serum and urine mycotoxins
Ochratoxin injected into rats leads to microglial activation; involved in learning difficulties
Another study looked at behavior and pulmonary function; mold exposure led to higher abnormalities; those autistic children with evidence of mold have more severe presentations
Has checked hundreds of autistic children and not found one to have a negative mycotoxin test
Mycotoxins lead to a compromise of glutathione and oxidative stress/damage
Plasma glutathione and oxidized glutathione levels are different in autism
Low glutathione is found in very specific areas of the brain that impact autism and speech (Brodmann area 22)
Histamine is a trigger for the release of adrenaline
4 types of histamine receptors in CNS; all present in microglial cells in the brain; microglial cells shift into the reactive/inflammatory state
Risk of autism and asthma/eczema/allergy/food intolerances linked; all related to mast cells
Amygdala Hijack: explains autism; hyperstimulated by a perceived threat; can act too strongly; if threat leads to fear, anxiety, aggression and anger, amygdala overrides the frontal lobes; detects threats, decodes facial expressions, involved in social behavior; grows faster in those with autism
Spelling to communicate allows children to communicate
Some children cannot speak but they can type or write
Adrenaline can hyperactivate the amygdala; beta blockers can be very effective
Ammonia and propionic acid result in beta alanine similar to GABA; inhibitory neurotransmitter
GABA slows down amygdala; yeast resulting in this metabolite blocks effect of GABA
Oral GABA poorly crosses the blood-brain barrier
Higher cortisol is observed in autism
Autism genes of interest: MTHFR, MTRR, MTR, CBS, GSTP, GPX, SOD 1/2/3, HNMT, DAO, COT, DBH, MAO, MTHFS, PEMT, VDR, MAT1A; he likes MaxGen Labs
Two copies of genes
MTHFR affects 60% of population; 1 SNP is 30-40% reduction; 2 SNPs is 60-70% reduction
Problem with MAO gene (only from mom; boys have one); further inhibited by aluminum which leads to serotonin surges inhibiting COMT and more adrenaline
Mold starts the whole process in genetically susceptible children; results in immune suppression and yeast/mold overgrowth
Bufotenin is the most powerful hallucinogen known to man
Risperidone blocks 5HT2A Serotonin receptor which is good, but clinical response has not been positive
Bufotenin found to be elevated in autism and psychiatric disorders
Adrenochrome leads to: anxiety, bizarre ideations, paranoia, hallucinations (auditory, visual, taste, smell), visual spatial distortions, time space distortions, inappropriate laughter; more dark side, not happy campers; self-doubting stressful person
Adrenochrome keeps you looking healthy but comes with many consequences
80% of Schizophrenic patients smoke and yet have 40x reduced risk of cancer
General Approach
- MaxGen SNP testing; cover nutritional basics
- RealTime Labs for urine mycotoxin testing
- Step 1: Basic Supplements;
- Step 2: Mast Cell Stabilization; Mirica/PEA, Quercetin, Cromolyn
- Step 3: Liver Support; Calcium D Glucarate, NRF2 modulators (Resveratrol, Sulforaphane, Oxygen), Minerals (Molybdenum, Manganese, Zinc)
- Step 4: Binders; based on the mycotoxins found; charcoal is a safe choice and well-tolerated
- Step 5: Yeast/Mold; digestive enzymes (Interfase Plus, Candex; pulsing), Nystatin, Itraconazole, Ketoconazole, Amphotericin B; prefers Amphotericin B; no known liver toxicity with oral Ampho B
- Step 6: Yeast/Mold nasal; atomized Acetylcysteine with Ampho B; not always needed
- Ultimate goal is to get to the mold
- Killing mold releases more mycotoxins
- Cautious with probiotics as many produce histamine; does use Saccharomyces boulardii
- Binders are weak; if you use too many, you can make things worse; a little goes a long way
- Digestive enzymes can help to chew through biofilm and expose mold and yeast to antifungals
- Giving these alone can lead to worsening of behaviors as biofilms are broken down
- First 10 markers on OAT are yeast markers; often much higher after starting with Candex
- Itraconazole and Ketoconazole stab the mold and contents bleed out leading to die-off; Ampho B does not release the toxins; more choking the mold
From Q&A discussion
- Environmental mold exposure is not always wet drywall or a flooded basement; mold is everywhere, including in food; mold is not avoidable; the immune system is the problem that leads to the mold not being taken care of; need to have genetic susceptibility and a trigger to lead to high cortisol and immune suppression
- Generally does not provoke the urine mycotoxin testing; some may do a warm bath the night before the collection
- Collecting urine in a child is not difficult; can go in the bathtub with warm water and then be ready with the collection cup
- Neurofeedback can be a helpful tool for working with the limbic system; reminds the pathways of how to correctly fire
- Need to address hyperactivated amygdala via removal of the inflammatory trigger and then explore neurofeedback
- Genetic polymorphisms is both about removal of something that blocks the gene and addressing a deficiency that impacts the gene expressions
- Bufotenin is the result of a block in tryptamine metabolism; Riboflavin 5 Phosphate may help with stimulating MAO gene; mast cells release serotonin and cause imbalances
- It all comes back to the mold; mold is the trigger for all of it
- Has not seen "wow" responses without killing the mold; results are often obvious in first 4-8 weeks
- Bufotenin elevations may be seen in adults with chronic Lyme, mold issues, and many other conditions
- Adrenochrome leads to a hyper-alertness of the environment; see and feel energies; Schizophrenic patients avoid people to avoid these energies
- Methylation support when in an inflamed state can lead to more problems; produces more adrenaline, stimulates gene that breaks down adrenaline but other genes that lead to more adrenaline; niacin can act as a methyl acceptor and lead to lower adrenochrome; vitamin C, oxygen oxidizes; such as HBOT
DrBognerHealth.com

Neil Nathan, MD spoke on "Energetic Diagnosis: The Use of Intuition and Medical Devices to Improve Diagnosis and Treatment" and shared:

Book: Energetic Diagnosis
Wrote the book to create a dialog about intuition and its role in diagnosis and treatment; forms of perceiving energy to enhance diagnosis and treatment
Dia = across or through; gnosis = meaning to know or knowledge; cutting through information to get to knowledge
Diagnosis
- Begin with history and physical
- How much time?
- What should be the focus?
- How do you decide?
- Should the patient tell their story? Or focus?
Didn't ask about mold before 2005; or Lyme before he became aware; which questions to ask evolves over time
Patients can become obsessed about their story; leading to a "stuck place" in their healing
Certain words or descriptions can inform; body language, pausing, phrasing, emotional expression; what is not said? Could those items not discussed be insights to roadblocks to healing?
When a patient has numerous symptoms, complex history, many variables, numerous diagnosis, how do you identify the primary issue?
What could cause all or most of the symptoms?
There is a left-brained sorting of facts approach with facts and pattern recognition; there is an energetic aspect, a non-left-brained perspective; a feeling; can be more vague, but still presents value; at least as accurate as the pattern recognition
Intuition is something that virtually all physicians use, but don't talk about; how do you refine and improve it?
In his medical training, several doctors looked at the same ear; all had different diagnoses; practitioners even drew what they saw differently; they may have seen what they expected to see; may perceive what they saw through their intuition; not always based on a pristine, clear observation; chosen direction may be based on sense
Perceptual preferences: auditory, visual (linguistic or spatial), kinesthetic (do with the hands or body; feeling something)
More sophisticated perceptions: claircognizance (knowing), telepathy, precognition, clairsentience (empathy, feeling), auras, mental imaging (seeing another's thought), clairaudience, dowsing, energy medicine, energy cords
We are all wired to have these to a certain extent, but some of these gifts may be more innate to a given individual
Empaths can walk into a room feeling fine and pick up other people's feelings; the gift is the understanding of another person's experience; liability is reacting to other people's feelings
He has the gift of seeing the pictures from someone else's mind as they say things; at times the pictures don't align with the words
His primary gift is that of knowing; shared story of patient with ovarian cysts where he saw typed information across his visual field to ask about her rape; was ultimately a key part of her healing; was able to access accurate and helpful information
Whatever the source of the information, he found it invariably correct
At some point, the typed messages were no longer needed to "know" and they went away
May have insights and knowings that the person may be offended by being shared; have to be ready for it
People are often taught not to talk about these types of senses/gifts
Senses are often more accurate than conclusions of the left brain
Connection with the natural world is often the source of these energetic perceptions
Energy cords (book: Denise Linn's Energy Strands): parents, relatives, ancestors, teachers, friends, acquaintances, enemies, lovers, sexual partners, pets and inanimate objects such as artwork/journals/photographs, physicians/therapists
Cords to physicians and therapists are important; patients want something from practitioners and extend an energy cord; practitioner can accept/not accept
Some may be energy vampires or take energy from others; can't use someone else's energy to heal yourself; have to generate from your own life force
Seekers are not satisfied with superficial information; super eager to glean information from every source; learning is exciting
"May God surround me with seekers for the truth, and may God protect me from anyone who's found it" - Dr. Sidney Baker
Recognition is being in the presence of someone new and feeling like you have known them for your entire life
Know the difference between caring and compassion; caring implies reaching out with intent to be helpful; energetic extension of being/self; caring makes your energy field vulnerable to other influences; extending your energy field out; interferes with your own boundaries; can exhaust yourself by giving your energy away; compassion is an appreciation of the trials/suffering of another being without putting your energy out; caring is wonderful but want more compassion than caring
Energy cords or strands are not necessarily negative; some are nourishing; can also be toxic cords
There are toxic individuals in the world; have to discern who is safe for you or may mean you harm or take your energy
Aids for perception of energy: FSM, ART/muscle testing, dowsing, acupuncture, sound healing, magnets, crystals, dreams
Human touch is the most sensitive diagnostic tool in existence; osteopathy/biodynamic perceptions, Reiki, physical exam
Physical exams have become rare; opportunity to communicate through the hands
Connecting to the natural world is a profound source of healing ourselves and enhancing our perceptions
Intuition is a combination of acquiring patterns of recognition and using those gifts to enhance perceptions
Instinct is a more primitive and potentially more profound fountain of information which we are born with and need to nurture
Improving Intuition and Instinct
- Get back in touch with the natural world
- Take time to listen and be present
- Trust perceptions and honor them
Lie on the ground in nature and be present; soak up the experience
From Q&A discussion
- Lab tests may show infections, toxins, mitochondrial issues, methylation issues; what does the being in front of you need; left brain can lead to confusion; patient may not get better; may get worse; spinning our wheels
- Sit until it becomes clear where you need to start
- Toxins, infections, and stress are upstream; everything else is downstream
- Some patients may be stuck in the emotional or spiritual realm; most want to start in the physical realm
- Mold may trigger limbic/vagal dysregulation and MCAS; those then often need to be treated first
- Practitioner's ability to listen is key
- Empaths need to study their own energies, boundaries, connections; can be at risk of going down another person's rabbit hole
- Empaths should ask the question: "Who's feeling is this?"; understanding energy cords can be helpful; surrounding yourself with white/gold/purple light can be protective
- It is best to avoid energy vampires as much as possible; it will be depleting and the energy vampire will not benefit; may be your friends, family, relatives; avoid or protect
- The need for health-promoting frequencies may be a counter-balance to environmental frequencies such as EMFs/EMRs
- The impact of EMFs on the body is increasing and profound
- Our obsession for fast connections are leading to unreasonable exposure to EMFs on a regular basis
- Some of the most profound counter-balances to EMF exposure are in the natural world; transforms these energies as only nature can; earthing can reduce toxic energies and free radicals
- External energies/entities can interfere with the flow of energy in our bodies
NeilNathanMD.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.