Chronic Lyme Disease: Symptoms You Shouldn't Ignore

Coming up on this episode of the Doctor's Pharmacy.

I first got lime, just regular garden variety lime. There was real discordance among the, you know, how they approached chronic illness and they didn't, no one seemed to know what was going on. I gradually got better and I had.

Many relapses and it wasn't a three course of doxycycline that got me better. Hey everyone, it's Dr. Mark here. Now I've recently found a new drink that fits into my Pegan diet and it's honestly something I always look forward to when I need a nourishing pick me up. It's Sun Goddess Matcha Green Tea from Peak. and it's the best tasting smoothest mixing matcha I've ever tried. I'm sure you heard me talk a lot about using food as medicine and matcha is a great example of this. It's full of polyphenols, which are especially helpful for our good gut bugs and also other antioxidants that it contains that support healthier aging, balanced blood sugar, improved digestion and a strong immune system. Matcha makes a great alternative to coffee because it provides sustained clean energy without the jitters. L-theanine is a powerful amino acid in matcha that helps you feel calm, focused and clear so you can get a boost without the crash. Peak Sun Goddess Matcha actually contains more theanine and chlorophyll because they shade their matcha plants 35% longer than any other brands. I really do feel awake, focused, and balanced after enjoying my matcha every morning. Right now, get up to 15% off on Peak Sun Goddess Matcha, plus a complimentary beaker and rechargeable frother. When you shop my link, peaklife.com/DrHymen, that's P-I-Q-E-L-I-F-E.com/DrHymen, and use the code Hymen. and now let's get back to this week's episode of the Doctor's Pharmacy. Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out Function Health for real-time lab insights. If you're in need of deepening your knowledge around your health journey, check out my membership community, Hymen Hive. And if you're looking for curated and trusted supplements and health products for your routine, visit my website, supplement store for a summary of my favorite and tested products. Hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine, a framework to help you understand the why or the root cause of your symptoms. Welcome to the doctor's pharmacy. Every week I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field. So let's just jump right in. if I could literally eliminate one condition from the planet Earth, it would be tick-borne illnesses. They are awful. I've had them. I've had Lyme disease. I've had Babesia. I've been sick from them.

I get it.

I promise you. And I've seen patient after patient who struggled not only for years, but often decades with chronic Lyme. And when I say chronic Lyme, I'm including every single tick-borne disease. Babesia, Ehrlichia, Babesiosis, Rocky Mountain Spotted Fever, all the tick-borne diseases. And there's even with Lyme disease. There's multiple strains of Lyme disease. And I spent a lot of my life studying it, both from a personal interest because I was really sick from it, and from trying to help my patients and figuring out what works and what doesn't work. And if you go online, if you listen to read books, you're gonna get a thousand different ideas. And I'm just gonna share with you what I've come to understand is probably the best approach, but just for the caveat that you're gonna hear a lot of other different opinions that it might be different from mine. I'm just gonna share with you what I found really works for me my patients and what I've been able to call from working with this disease for a long time, looking at the scientific literature, looking at actually often things that aren't in the scientific literature that people are using that can work. So what is Lyme disease? Lyme disease, and again, it's all the rubric of all these different conditions. They're all manifest a little bit differently, but essentially it's a illness that you get from a tick bite. And the ticks carry these little spirochetes, these little nasty things, almost kind of like syphilis. And, you know, syphilis used to be the great masquerader. We called them great masquerade because it would cause all these problems. And the same thing with chronic Lyme, autoimmune diseases, memory issues. I mean, Chris Christopherson had, quote, dementia, but it was Lyme disease. It can cause heart disease, arthritis, it can cause all sorts of gut issues, it can cause skin problems, it can cause cognitive issues. It's just a huge problem. And essentially, it can also manifest as chronic fatigue syndrome and people can't figure it out. Now, Let's just talk a little bit about, I'm gonna go kind of down the rabbit hole here, 'cause you asked and I'm gonna say it, 'cause I don't really get a chance to talk about this much, but I think it's an important thing to talk about. Diagnostics is challenging. You know, we have antibody tests. You've heard of coronavirus antibodies. They tell you if you have the infection. They don't necessarily tell you that you have the infection, they tell you that you've had the infection. And that's important to know for sure, but the question is, do you have an active infection? So a lot of our tests on antibody tests, you go to the regular doctor, they test you, they go, oh, you're fine, you don't have Lyme disease. they're really not that sensitive. Sensitive test means if you have it, it'll pick it up. In other words, if you have a bladder infection, you pee in a cup and you look under a microscope, it's like 100%, you're gonna find it, right? But this kind of test, you may not, and it's hidden because they hide, these little sneaky ticks hide inside your cells and they're hard to detect. There's another level of testing called PCR testing, which is often helpful to look at fragments of the DNA you know about, Coronavirus, PCR testing, same thing. And so we can detect these tick infections through PCR testing. Now, I had a positive PCR and I had, you know, I definitely had it. And when you have that, you have it for sure. It's active floating around your blood. But sometimes you don't have that. It's like looking for a needle in a haystack. And then you can look at your immune response to Lyme. And that's more what I look at because these are tests that were developed in Germany and Europe. We now have labs in the United States that do them. and essentially it looks at how do your white blood cells respond in real time to some tick that they give in the laboratory. And that is called the lymphocyte response assay, and that's very helpful. And we call it an LE spot test, and we use that a lot, and I find that really helpful to detect how your immune system's reacting. We look at your interferons, we look at all kinds of cytokines, you know about cytokines from the cytokine storm, we can tell like, for example, natural killer cells go down, CD57 is one of the immune cells goes down, so we have like ways of looking at this indirectly. Sometimes you can't really tell for sure, even with all these tests, so you have to kind of go on a clinical diagnosis. And Dr. Horowitz, Richard Horowitz is one of Lyme experts, written a lot of books on this, a friend of mine, and he's really quite brilliant about this. And he developed a Lyme questionnaire, which I encourage you to check it out. It's called MSIDS, M-S-I-D-S, and you can download it, it's free. And you can see, you know, if you score high on this, it's likely you might have Lyme. Now you might never know you got a tick bite. I don't remember ever getting a tick bite. I don't remember pulling a tick off me. I don't remember having a rash. I don't remember having anything, but I had full-blown Lyme disease. So, and it's like that for a lot of patients. They might not know. Now, if you live in the desert somewhere and, you know, Australia, probably you don't have Lyme disease, but, you know, pretty much everywhere in America, there's some degree of tick-borne illness. So then you got the diagnosis. Let's say we find you have it. but you know, most doctors just look for Lyme. They don't look for Babesia or Lichia or Bartonella or many of the other infectious agents that come with ticks or they don't look for different strains. So it's really important to do a cast a wide net when you suspect it. So let's say you have it, then what do you do? Well, traditionally you give three weeks of antibiotics and you're done. But that doesn't work unless you really have acute Lyme. If you have a acute Lyme for sure, you get a tick bite, you notice it, you have a rash, you go in the emergency room, you get doxycycline for three weeks, that usually knocks it out for most people. But when you have chronic Lyme, it doesn't. And I'm just going to take you through a number of different frameworks that people are using. One, which I'm going to sort of tell you what they are and then I'll tell you what I generally do, what I think is the most effective and the least harmful. One is long-term chronic antibiotics. Some people put them on, some doctors put people on antibiotics for three months, for three years. That's a problem. because those antibiotics are not benign. They cause gut issues and many other problems. You get a lot of secondary issues. They may control the symptoms somewhat, but they're not. No magic bullet. And it's. It's just a rough road. So I'm not a big fan of that. I'm okay sometimes with a short course, six weeks, hit them hard, you know, and hit the different forms, because there's a lot of different forms along. There's a cyst form, intracellular form. So you've got to hit all the forms of different drugs to get them to go away and different. different ticks need different drugs. So it's not like one size fits all. And sometimes you usually have not one infection, you might have two or three. Like I had Lyme and Babesia. Some people have Lyme and Bartonella. So you kind of have to go through all of the right treatments for each one. We use a lot of herbs. That's another category. There's a lot of people who use herbs, Dr. Jang herbs, Byron White herbs, there's the Cowden protocol. So there's a lot of protocols and herbal protocols that often can be very effective. I had a patient, for example, who had chronic Lyme and used the Jang herbs, which are from Dr. Jang, who's a Chinese physician, Chinese medicine physician. And one of the, one of the herbs there is garlic. Now, garlic, we know, is a very powerful antimicrobial. It works, but you smell pretty bad. You want to be friends while you're taking the drug? I'm taking the herb. So herbal protocols can be helpful. I use often as, as an adjunct. And then we go down a different rabbit hole. So there's a long-term antibiotics, there's short-term antibiotics. There's the herbs. and then there's all the stuff that I think actually works, which is way off the grid. Unfortunately, it's not easily found for most people. It's not accessible to a lot of people, and it can be expensive. But I think these are some of the most effective treatments. One is ozone therapy, and ozone therapy doesn't have to be that expensive. You can actually do rectal ozone. You can buy a machine for 800. You can do it at home. You can do it every day. And that's, that's kind of a very inexpensive way to get ozone on your own every day. And I, and for people have Lyme, I do recommend that, and help, but it takes a little longer than doing the IV version. And then there's intravenous ozone, we call it multi pass or 10 pass ozone. I think that is one of the most important foundations of tick-borne illness treatment and many other illnesses. The second thing I think that can be very helpful are peptides. And peptides are these small molecular weight proteins that are like little mini proteins and that your body uses to regulate all kinds of things, including your immune system. So thymus and alpha one, Lysine, beta-4 fragments and others can be really helpful. LL-37, I'm just kind of rattling them off. But there's a number of peptides out there that are antimicrobial peptides that are immune boosting peptides and that can be really helpful in helping people have their own immune system start to fight this. It's sort of like immunotherapy. Think about, you know, cancer immunotherapy where these treatments actually use your own immune system to kill the cancer. And then there's some things that have seemed maybe a little far out like hyperbaric oxygen therapy. That's essentially where you go in a, like a decompression chamber, which they use for scuba diving, and you go down under two atmospheres of pressure more under 100 oxygen. And guess what? Bugs don't like oxygen. Right. What did one of the famous Chief Justice in, in United States Supreme Court years ago said? The best disinfectant is sunlight. Right. So we, we need to, you know, oxygen is a great therapy. In fact, in, in there's, if you just go to PubMed, which is the National Library of Medicine research studies, just have an oxygen, intravenous oxygen, and you'll see it's actually been used in medical treatments for all kinds of things, including infections. So hyperbaric oxygen therapy can also be helpful. And that's an adjunct. I'll usually use herbs, I'll use antibiotics with that, and ozone. Sometimes combinations of these therapies help. And then there's kind of a last resort therapy, which we use in patients who just don't get better. And, and, and this has often been a miracle for people who've been sick for 20 years. It's called hyperthermia. and essentially what it is, is it gives you a fever. You, you, you under medical supervision with intravenous lines under anesthesia, they heat up your body to about 107 degrees. Now, that sounds crazy, and I've had it done twice, and I'm still alive. And I've sent my patients down to Mexico, to Europe to do this. And, and often it's one of those treatments that they go, my God, Dr. Hyman, this, this stopped it. This is the thing that worked after 20 years of struggling. I got a little better from this, this and this, but this is what knocked it out. So I think there's all kinds of therapies out there. And of course, you have to also fix your gut and get rid of heavy metals and deal with mold and balance your hormones and get your mitochondria working and get your nutritional levels right and optimize. So it's a comprehensive functional medicine approach that has to be used to treat chronic Lyme. But it is treatable and I'm a perfect example. If you're a long time listener, you might know that I've been drinking AG1 for a while now. I gave it a try one day and noticed right away how easy it is to drink and how much better it made me feel. Unlike a routine involving multiple pills and powders, which can be inconvenient and hard to maintain, AG1 makes it easy. 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I first got lime, just regular garden variety lime, like so many people do that live in Connecticut. And it was a moderate case. It wasn't dramatic. It didn't disable me. but I realized by going to many infectious disease doctors and ultimately ending up in the office of doctors like myself, Lyme doctors, that there's real discordance among the medical community and how they approach chronic illness and they didn't, no one seemed to know what was going on. I gradually got better and I had many relapses and it wasn't a three-course of doxycycline that got me better. And then I was really fine. I still had occasional relapses, but I was a healthy guy. I could run like five miles. play tennis all day and work six days a week, which I did for many, many years. Then in 2010, while I was sleeping, I got spider bites and I didn't think anything of it. And with those spider bites, a couple months later, my body exploded with arthritis all over, rapidly Progressive to literally every joint in my body, especially my spine. And I went to 25 doctors that couldn't help me. I went to other doctors like myself, who thought it was maybe prior Lyme. but I was the only one that's saying it wasn't. And none of the antibiotics that helped me previously helped me for this case. And I went to rheumatologists who diagnosed me with rheumatoid arthritis and spondylitis, which is arthritis in the spine. And it progressed very rapidly within six months. Despite treatment with different medications, including many antibiotics, I couldn't walk and ended up not walking for almost two years. I had to give up my practice for two and a half years. I was completely bed bound for about a year and a half. And I almost died on many occasions. I lost 50 pounds. I couldn't turn over in bed. I couldn't sit up on my own. I need 24-hour home care. I got severely anemic. And I have fevers 102 every night. It just. It was a dire situation. And I figured out in the last minute and put it all together, and I saved my own life. And I'm. It's not just, like, save my life. I'm back to a full life. and I, back in practice since 2013, you know, I lecture all over the place before COVID traveling around the world, and, you know, not limited in any way. And when I went back to my three top rheumatologists, when I recovered and I told them, you know, this is how I got better. Will it change how you practice? Like, no, I'm glad you got better, but we're not gonna. We're not gonna change.

Tell us more. What? What? what actually got you better, what you did to recover and what was the root of cause? Because functional medicine is really about looking at the root causes of disease and this is really what you're doing. You're looking at not just a label.

That people get like rheumatoid arthritis but what's underneath it and how do we fix it? I went to regular doctors and I went to functional medicine doctors as well. Like I said, I went to every specialist I can find and I did the elimination diets. I didn't find any heavy metals or anything like this. she wasn't able to help me to be perfectly honest. I took lots of antibiotics that flared me up but didn't get me better. And really it came down to that my infection was Bartonella, which is an antibiotic refractory infection, and it needed really just specific antibiotics. And that's what got me better. I took lots and lots of herbs that didn't help. And at first I wasn't a believer that herbals were helpful. And then I took my first herb to rock my world and it caused this huge Herxheimer and massive improvement. and that was liposomal Artemisinin. And I was like, oh, so that's how an herb's supposed to work. And, and then I ended up getting tremendous benefit from liposomal oil of oregano and my second herbal and then monolaurin. So there were a few supplements and herbals that were found really, really beneficial. But primarily for me, it was antibiotics. It was things like doxycycline and rifampin and Bactrim.

And, yeah. So those antibiotics, you know, are strong antibiotics. But, but Bartonella is really one of those tough infections. It's one of those tough infections that's often hard to find and hard to treat. And so, you know, people suffer for years from lead and things like this. And I've seen people literally for decades have problems and then you treat them and they get better. It's pretty miraculous.

No, I, I went back to a hematologist and they looked like I was a Martian. I mean, one was delighted that I got better. One treated me like it can't be like in disbelief. And I did a little dance in front of him to try and convince him. I mean, because he saw me not walking and I was like, look, I'm dancing. I'm not a good dancer, but, and then, One was just looking like I was a one-off, like I'm a one in a million case. And she's like, Look, one in a million things happen. I'm like, I'm not one in a million. I mean, I was, my mommy told me I'm special when I'm a kid, but I don't think I'm one in a million.

And I think there are other people that have very similar things. Yeah. Yeah, that's funny. I remember giving a talk at Harvard and I was presenting about a case of autism that had dramatically turned around. And one of the pediatricians there was like, well, you know, this might just be a case of spontaneous remission. and then one of the other doctors. Well, Dr. Hyman's had, like, five cases of spontaneous remission in his practice this year so far. Yeah. If you, if you understand what, what the roots are. And you also talk about in the book your dad, who had pretty bad heart failure and needed a heart transplant.

No, he did not have a heart transplant that they wanted.

He was going to, he was going to need one. Right.

Right.

So what, what? What was the sort of the discovery there? Tell us about your.

That's what galvanized my interest in doing what I do. It wasn't my own case. Like I said, my case of Lyme was pretty moderate and I wasn't planning on doing this as a career. And, but when I started learning about this, my heart, my father had had a case of what they thought was a viral meningitis in 1975. And then shortly after that became a non-specific heart palpitations and it got just worse and worse. Then he turned to atrial fibrillation, a specific type arrhythmia. and then he went into heart failure. And we took him to all the best doctors in New York City, at all the top teaching hospitals. And we don't skimp. We went to the best, and they all couldn't save him. And he got worse and worse. He had ejection fraction between 10 and 20. They said that his lifespan would be measured in months without a heart transplant. And I was just finishing up my residency at Yale. I was doing Lyme research. I'd already had some experience with Lyme personally, and I was looked it up and I was like, holy crap, Lyme can do this. So, I went to the cardiologist. I said, you know, Lyme can do this condition, dilated cardiomyopathy. Can we evaluate him? And, he rolled his eyes and discounted the whole thing. And, you know, they published a study in 2015 where they looked at people with his type of condition, his type of heart failure, went in and did heart muscle biopsies on all of them and found that 20% had Lyme DNA. He made a point in the study, to say that almost two-thirds of them had negative Lyme tests. So if you don't really have a big suspicion about what these infections can do, you're going to miss it. And I've treated about 50 cases.

See, what you just said was really important. I don't want to, I want to emphasize it. You say that, you know, 20 of the biopsies in the heart muscle were positive, but two-thirds of the people who had the positive test had a negative blood test. So in other words, you can get a blood test, it can look fine. Your doctor says your labs are fine, you don't have Lyme, but actually if you look deeper, you can actually find it because it may not always show up in the regular lab test. It's an important point.

Yeah, if you have to ask yourself who goes and gets a heart biopsy to diagnose Lyme, it's the silliest thing. The tests are antiquated, they're like 40 years old. I always say I won't get on a 40-year-old airplane. I'm not going to trust my health to outdated technology with blood testing. But long story short, he wouldn't evaluate them because my dad never had arthritis and didn't have a Bell's palsy. He said, you,'re a doctor, now do it. I was just a fresh out of school, basically. And, I basically treated him and his heart function completely normalized. He's 88 years old now. He never needed a heart transplant. He's not in heart failure at all.

And, that's the story. That's incredible. So, what you're saying is essentially you've cured an incurable condition according to traditional medicine. with treatment of his Lyme disease, which was causing his heart failure. And, I think this is important to underscore because so much of what we see in my world, in your world, people who are suffering from chronic illnesses who just don't get better bounce from doctor to doctor and are often misdiagnosed because doctors often don't have a framework for looking at root causes. And, you know, functional medicine is this framework for looking whether it's heavy metals, which I've had, or Lyme disease, which I've had, or Babesia, which I've had, or Mercury, which I've had, or mold, which I've had. You know, these are things which are typically ignored by traditional doctors. Even diet, for God's sake, which is more obvious, is often also ignored as the root cause of so many chronic illnesses. And I think what you're talking about is that there is hope for people who suffer and who struggled if they can figure out how to get to the right person, which is not always easy, but to even advocate for yourself and say, look, I've got this problem, but I'm not giving up and I'm going to go kind of dig until I find what's going on. And, yeah, it could be a number of different things from, from a perspective of causes that can cause the same syndrome. So you can have rheumatoid arthritis, but it could be heavy metals, it could be gluten, it could be lime, it could be Bartonella, it could be all kinds of things. But we, we basically just lump everybody into the same category. Oh, you've got rheumatoid arthritis, or you've got this or that disease. And we go, we know what to do. We give you the drug for that disease, but it doesn't really speak to the cause. and that's really what you guys have been talking about. It's so refreshing to hear you talking about that. So, Dana, I want to jump to you for a minute. You got sick and you also developed Lyme-induced heart failure and you're a pretty young woman. You started talking about how you got a tick bite and a rash and everything kind of went downhill from there and you went to doctor to doctor until you kind of found Dr. Phillips and got treated. So tell us about your story and how you ended up being treated by Dr. Phillips and what happened to you and how you got better. Sure.

So it was the summer of 2014. I was truly at the prime of my life. You know, I just signed a brand new deal with Sony and just wrote the songs for Celine and I was supposed to be traveling all over the place. And I was incredibly happy. So I say that because when doctors start saying like it's in your head or you're making it up or you want, you know, you just want attention, like those kinds of things are absolutely insane to me because so many people are like me where they get really derailed at the prime of their lives and nobody would make this stuff up. It's absolutely devastating. I got a tick bite. I saw the rash. I got it within five days. I caught it because I knew when I got back from New Jersey and got back to Manhattan where I lived and I saw it, I was lucky that I was in the minority that saw the bite and the rash on my shoulder. Most people never see it and many strains of Lyme do not produce a rash and many other tick-borne infections produce no rash. So that's an important thing for people to know. So I went right over to urgent care. I knew it was Lyme. They knew it was Lyme. They gave me three weeks of doxy cycling, an antibiotic, and said, you,'ll be fine. Go on with your life. They also told me not to Google Lyme and that I would get scared and that I don't want to be a crazy Lyme person. That was a clue that something really weird was going on. I had no idea that this very common, ubiquitous infectious disease that drives a pandemic of illness was a political hotbed. I had no clue. So I do take the doxy cycling. I try to move on with my life. And three months later, I wake up, all hell broke loose. The first symptom was that my breast was swollen overnight. I had all these fibrocystic changes and extreme pain. went to the internist. She sent me, she panicked. She sent me to an oncologist that day at Mount Sinai. He ruled out cancer. He agreed my breast was swollen and he agreed this was weird, didn't know why, just knew it wasn't cancer. Sent me on. I went to go on to have fibromyalgia, exercise-induced incredible weakness. There was a little gym in my building. I did my same lame workout that I do all the time. And just one day my arm stopped working in the midst of all this. Literally couldn't lift a fork, couldn't feed myself, couldn't walk. walk my 29 pound dog. And I went on to have incredible body pain, brain fog, visual disturbances, anxiety, depression, intrusive suicidal ideation where I literally couldn't stop thinking about jumping out my window, but I didn't want to, but I couldn't stop. It was something, it was like a monster took over my brain and my body. I went on to see three infectious disease doctors, tons of internal medicine and the oncologist and sports medicine, and nobody had any and what the, you know, I would ask them, especially the ID guys, you know, could this be related to the tick bite? No. Why not? Because you took the three weeks of doxy and it's cured 100% of the time in the test tube with doxy. Okay, that's actually totally not true. The other reason that one of them gave me, this is my favorite, you know, this well-known doctor at NYU said to me, because I went to medical school. So, I'm like, well, Ticks carry other infections too. Is there anything else? I was pushing them. At some point I said, Do you want to test me for inflammatory markers? Anything? He goes, oh, that's a pretty good idea. Okay, well this is my third visit with you. Are you kidding me? So I went on to have this horrible experience until December when I went into heart failure. And then everybody really got serious, really believed me. I mean, I do think some of them thought it was in my head because I had so many weird migrating symptoms that doctors are complete, when they don't understand something, they put you in the psychiatric bucket. You know, that's, that's a theme. I think, of course, you, you know that very well.

So.

And when you, when you have these things, you do feel crazy because nobody can give you any help. And also the fact that it's changing all the time and every day, it really feels crazy. So then in December, I went into heart failure. My ejection fraction was 40%. under 50 is considered heart failure for people who don't know. And yeah, yeah. And it was, I mean, I was so healthy before all of this. So then, thank God, I had a friend who knew about Dr. Phillips and seen him testify at some hearing and, like, knocked it out of the park and said, you know, you got to go see him. He's brilliant. And he's the only person I would see if I was in your position. So I went to him and he saved my life. Within two months of seeing him, my heart failure totally resolved. And he did talk to the Mount Sinai cardiologist who had been very concerned about it, did take my heart failure seriously, just didn't know the cause. And Steve really educated him about Lyme carditis. He didn't really even know very deeply about it. He was interested and he was educable. He was the only one, but he was. And I really appreciate that. But I was treated with a rotating course of antibiotics, antimicrobials, Chlorella, Chinese, I did a Chinese herbal protocol as well called the Zhang protocol. There are plenty of them of different Chinese medicines you can take. That was the choice I made because I lived in Manhattan and it was in the city and I could see them. And anyway, Dr. Phillips really came in and got me better. It was a miracle.

Yeah. Well, you know, I hear this story so much that people often suffer and they really struggle with trying to figure out how to get the right treatment. But, you know, I think what you're speaking to is, is they need to think deeply about rethinking medicine and rethinking how we approach disease based on root causes. One of the things I want to sort of jump into the both of you, and it's, and you talk a lot about these kinds of things in your book, chronic, which is great. It's called the hidden cause of autoimmune pandemic and how to get healthy again. And it's available now on Amazon everywhere. And people should get a copy. If you've been struggling, this is going to help you understand what's going on, maybe guide you to the right the right resources. What really is going on is that there's these chronic latent infections with clearly the tick infections, which is Lyme, Bartonella, Babesia, Ehrlichia, and there are lots of varieties of each one of these. So, they're often hard to detect. The testing is sort of a little bit outdated, as you mentioned, Stephen. And, I just wondered if you could speak a little bit about the testing.

So, the many infections do have an unfortunate commonality is that they're fastidious. it's a term that microbiologists use to describe infections that we can't isolate from animals and people that have the infection. So, Lyme is probably the best studied of all of them. If you inject Lyme bacteria into a dog and then let the dog get sick and then take the dog's blood sample a month later and you know the dog has Lyme, you can't find the actual bacteria in the blood. And, it's the same for all the animals studied and same for people. And, with the animal studies, they can cut them up and find that there's still Lyme bacteria alive after the same treatments that are supposed to cure it in humans. And in humans, they don't cut us up, thankfully. And, and that's the main difference in terms of the animal data and the human data. But they've isolated this bacteria, even though it's so hard to isolate, they've still isolated from about 75 patients, human patients, after up to two years of antibiotics. So it could be a really, really stubborn bacteria. But, believe it or not, it's easier to treat in my experience than some of the other infections, particularly Bartonella, Tularemia is really rough sometimes and so Coxiella Q fever is very, very difficult. And then, the parasitic infections that people never talk about because we're told to ignore them in med school. But, I do a broad range of a panel, a blood test panel for antibodies against nine different parasites.

People think, you know, Lyme disease, you get the bull's eye rash, maybe you get arthritis, Lyme arthritis or Lyme heart disease, you know, it's acute illness. You know, if you get neurologic Lyme, it's a thing, they diagnose it and they give people IV antibiotics. But, there's very little appreciation that if someone comes with Parkinson's disease or MS that you should be thinking about a tick infection. Exactly.

It's not even on the radar for most doctors. Exactly. But, in functional medicine, and we do think differently. Yeah, and if you actually go back into the history of understanding syphilis, there used to be primary syphilis, which is the acute infection, then you would have secondary and tertiary syphilis. It would appear years down the road as dementia and tabes dorsalis and problems with balance and all different kinds of things. So, you've got to have a broad understanding of how these things affect the body and then the immune system. So, maybe it's not chronic and acute.

Maybe it's primary and secondary lines.

Exactly, that's another way, right? It's how you want to word it, exactly.

So, what is a typical approach to thinking about Lyme disease and how did traditional doctors diagnose it and treat it and what is the general perspective?

The general perspective, and I think this is the CDC criteria, is basically you go to your doctor and you get a what's called a two-tiered testing. First is what's the ELISA screen test, and the ELISA is just a screening.

The antibody test.

It's the antibody test, enzyme-linked immunosorbent antibody. And if that's positive, then you then reflexively go to a Western blot test, which is supposed to be more sensitive and also it's more expensive. And this standard of how you diagnose Lyme disease is this two-tiered approach. And the unfortunate thing is if that's negative, which 50% of the time it is, you are going to be missing Lyme disease in a lot of your patients. So you might as well flip a coin. So I almost don't even do that. If it's positive and you have a clinical history, then it's helpful.

But 50 of the time, it's not going to be helpful. Most of the time, you know, acute disease. I mean, I remember working in the Nantucket ER and I remember seeing so many patients coming with Lyme disease. But they had acute Lyme, they had a fever, they had joint pain, they had a rash. You give them antibiotics in three weeks, they're fine. And the truth is a lot of people will get Lyme disease and get treated and they're fine or they get in, it's not an issue. And I think that that there's a subset of patients that are uniquely susceptible to the adverse consequences of these tick infections, whereas others are more resilient.

Do you find that, too? Absolutely. And you bring up a really good point. In fact, I just had a paper about people who have mannose-binding lectin deficiency.

Are you familiar with that, Mark?

That's a mouthful. Yeah, I heard about it.

Right.

So, I'm actually, it's relatively new to me. And, there's a condition, which is mannose-binding lectin efficiency, which you can draw on a routine lab test. And people who have this are more susceptible to developing infections like urinary tract infections and upper respiratory infections and lo and behold, chronic Lyme disease. So now I'm starting to actually check for this in my patients. Other patients that are finding it? Yeah, absolutely, yes, absolutely. The other thing that is also, I don't exactly sure the mechanism for it, but patients who have hypermobility, sort of a form of Ehlers-Danlos syndrome. And for whatever reason, those patients tend to have it a little bit more difficult to eradicate. And that may be related to the fact that Lyme is predisposed towards going towards connective tissue and they have a connective tissue disease or a mild form of it.

So what's the typical approach, traditional medicine, they just give them three weeks antibiotics and you're done?

Yeah, I mean the traditional approach approach is anywhere between one week to a month of antibiotics and then you're done and it's the end of discussion. I can't tell you the number of times that I've gone to.

And if you're still sick afterwards, the.

Doctor goes, well, it can't be Lyme. Exactly. Well, and then they call that post-Lyme syndrome. There's a whole diagnosis called post-Lyme syndrome where your testing may be negative, you still have symptoms despite the standard of care treatment and you fall into this nebulous category. Is it an ongoing immune reaction? is it the body's still trying to fight the infection and you're not seeing it on the lab testing, et cetera?

Yeah.

And so what is the approach to.

Post Lyme syndrome in traditional medicine? There is none. There is none.

There is none. It's there really is no treatment. I mean, that's sort of where, you know, if patients are fatigued, they may get provigil, if they're having problems sleeping, they're gonna throw ambien at them. If they're depressed, they'll get some prozac. Polypharmacy. Polypharmacy, and that's Iatrogenica Imperfecta, one of my favorite terms.

So most of the time when- what.

Does that mean, Todd? Yeah, that basically Iatrogenic is the doctor does it. So a lot of- Caused by a doctor. Right, so a lot of times, I mean, Mark, you and I have seen it with patients come into us and the problem is the doctors were treating them. So, number one thing is stay away from doctors.

Oh, yeah, it's true. Some of them. Yeah, for some of them, exactly. Yeah. So it's really, A very problematic issue. And I would say if there was one condition that I could erase from the planet, it would be tick-borne illness. It is one of the biggest scourges on humanity ever. And it causes so much suffering. So needless suffering. It's so underdiagnosed. It's not well appreciated by traditional medicine. And it's really real. And it does masquerade as all these other problems. So you mentioned a few of them. but it can cause all sorts of autoimmune diseases. It can cause all sorts of gut issues. It can cause all sorts of neurologic issues and mood issues. It can cause, like you said, neurodegenerative diseases. It can cause chronic fatigue syndrome, fibromyalgia, depression, dementia. I mean, I had a guy come in with Capgras syndrome, where he kind of mistake your, you know, everybody for somebody else you don't know your wife is and you just have these weird. He had like neurolyme. Neurolyme, yeah. And about three other co-infections and we treated him with antibiotics and he got better. Yeah. I had another patient who had all these MS symptoms. and she saw the best doctors at Cleveland Clinic and you know, you have MS and she ended up having Ehrlichia, which is one of those tick-borne infections. I gave her Doxycycline for six weeks and like all her symptoms went away. And I don't love antibiotics, but- Sometimes.

You have to use them.

Sometimes you have to use them. And I think having an open mind to who are those patients who are just not getting better, there's a whole subclass of them who really struggle with these chronic issues. that are undiagnosed, that nobody can figure out. And, you know, there's a lot of approaches to this. So we do different kinds of diagnostics here. And functional medicine has a very different approach. How would you sort of define the approach for functional medicine?

The approach for functional medicine is actually listen to the patient. I think the best thing you can do is take the time, and you can't do this in five or 10 minutes. As you well know, Mark, you have to really be astute. You have to listen really well. and you also have the clinical experience where you've seen a lot of patients and you can sort of put the pieces of the puzzle together because this is like, this is not a, you know, a 50 piece jigsaw puzzle. This is a thousand piece jigsaw puzzle.

Yeah.

Often.

Right.

And it, you know, you're not gonna, you're not gonna account do a thousand.

Piece jigsaw puzzle in five minutes.

Takes, takes a while. My wife can do it in, like, half an hour. Yeah. Right. So, so you've got to really listen well, and then a the confirmation of the Lyme is, in my opinion, done by advanced testing. Like the test that I really like and we use here is the ELISA spot testing, which basically is checking for the immune system's response to the bacterium.

How is that different than an antibody test, which is what traditional medicine uses?

Right, so exactly. So an antibody test is, say for example, you get a polio vaccination. You are going to develop polio antibodies. antibodies. Okay, if I test you right now for polio antibodies, you have polio antibodies. Does that mean that you have polio the disease? No. Okay. In chronic Lyme, some patients don't develop antibodies. So those antibodies will actually go away over time. So the antibody test is negative, especially in chronic Lyme. And if somebody has had the disease and the antibodies are positive, does that still mean that they still have the disease or is the disease gone away? So you're sort of up in the air, you're in this nebulous area. And that's why I think combining the clinical history with some of the more advanced testing, like the Eli spot test, where you actually take the person's blood, expose it to the antigens, the proteins that the tick has or the other co-infections that are there, and see the live cells immune response to it. So they, this is based upon memory T cells in the production of compounds like interfere on gamma.

Is your innate immune system. Your innate immune system, your primary. So, there's like two kinds of your immune system, right? There's one that's like the old ancient immune system. And, you're born with it. You're born with it. And that just like reacts to everything in a sort of like carpet bombing. And, that's why maybe the symptoms are so bad with this. And then there's the antibody, which is more like the smart missile or called adaptive immunity that actually targets specific bugs. So, it's a memory cell. So, like you get a memory cell.

To measles when you get the measles vaccine so you don't get measles. This is Dara. This is just more of like a wide widespread immune response and you can't.

Measure through typical tests. That's why this Eli spot is so.

Unusual and helps us determine what's going on. Exactly. And then one of the other tests, which I also use, and again, it's not really this test by itself is not diagnostic of Lyme, but the CD57, which is the natural killer cell. And we measure the overall level of the natural killer cells in patients. There are many conditions that can cause low natural killer cell function. So things like chronic Epstein-Barr virus may do HIV virus, cancer, etc. But Lyme is also one of those. So if a patient comes in with symptoms consistent with chronic Lyme and they have a low CD57 count, that ups the threshold for their probability of having chronic Lyme clinically. And then we also do the natural killer cell function test, which is not only the level of the natural killer cells, but are these cells actually able.

To do their thing?

Are they able to kill pathogens?

That'S really important. I think, you know, I have this Theory after seeing so many hundreds and hundreds of these patients is that the Lyme and these chronic tick infections are kind of like AIDS in a way. They suppress the immune system.

Absolutely.

And they're sort of, they sort of hijack it, and it makes your body unable to fight it. So what I've been finding, I don't know if you see this, Todd, but so many of these patients don't just have chronic Lyme, but they have a whole host of other things that destabilize your and it may be things that the body could handle when they're normally everything else is okay. There's heavy metals, there's gut issues, there may be mold issues, there may be nutritional factors. So there are all these things that are complex web of causative factors that don't get untangled with traditional medicine. And sometimes you need to treat all these things to get people back to normal.

Absolutely, yeah. And you bring up a really good thing so that patients who have chronic mold, so anybody who's out and if they have the diagnosis of mast cell activation syndrome, if they have the diagnosis of POTS, postural orthostatic tachycardia syndrome, where you, when you get up, your, your heart rate goes up high. If you have other symptoms like dysautonomia, which is part of POTS, if you have these types of things go along with someone who's got chronic lime, they sort of go together. The other one, which we see a lot of, is also a small intestinal bacterial overgrowth. I actually went a talk given by a gastroenterologist, and all of a sudden he was seeing all these patients with SIBO. Okay, when you and I went in our training, I never used to see SIBO. I mean, he has somebody with oral bowel, but SIBO is now rampant. Yeah, it's really true. Exactly, interestingly in patients who have chronic Lyme disease because Lyme bacteria is neurotrophic, in other words, it heads towards nervous tissue and affects nervous tissue, also connective tissue, that you get what is termed.

Bell's palsy of the gut, which is.

Bell's palsy is when your face gets paralyzed.

That's one of the symptoms of acute.

Lyme disease, is you'll get a paralysis of your face and your face will go limp. Exactly. In fact, one of my first cases of a severe case of Lyme disease when I had a private practice was a patient who I met to the hospital with acute Bell's palsy that was caused from Lyme disease. And the term Bell's palsy of the gut, so any patients who are out there, anybody who has refractory bad small intestinal bacterial overgrowth think of Lyme because this gastroenterologist, it got on his radar, so he started checking all of his patients for Lyme and lo and behold, they had it.

Yeah, I had a patient who had a little different syndrome, but she had severe constipation. She could only go with colonics and heavy duty medication and turned out she had Babesia, which is another tick infection and that is known to cause autonomic dysfunction of the gut, a paralysis of the gut essentially.

Yeah.

Which is what she was suffering from.

Wow.

Fascinating, right?

Yeah, it is. So, we see all these variable presentations and we do have a questionnaire we use called the MSIDS questionnaire, which is multiple immune, whatever deficiency, whatever questionnaire, symptom questionnaire. And it helps us to sort of make track of all these very weird symptoms that people have. I've got tingling, I get palpitations, I get headaches, I'm achy, this and that. And, you get with this whole list of symptoms and if people have a high score, it's likely that they have some issue. Now it may not be 100%, but your odds are higher and often people won't remember having a tick bite. They won't remember having a bullseye rash.

They won't remember an acute infection.

And you can live in Hawaii and have it. Yeah, it's everywhere. I live in Arizona. I can't get it.

Exactly.

Exactly.

It's everywhere. Just like, you know, with COVID And it's global. Exactly. And just like, you know, with the COVID virus, we see that the vector for the spread of the COVID virus the airplane. It's not a mosquito, it's an airplane. And how many of us travel and fly in planes? We go all over the place.

There's also a theory, and that's why.

It'S good that the airlines have check-ups. Yeah, exactly. So, also, there's a theory that Lyme may also be sexually transmitted. And, I've had some privy to some people who have done some small studies on checking for the DNA of Lyme in sperm, and it's been identified. so just like syphilis was actually sexually transmitted, I think there are in some cases Lyme may actually be sexually transmitted. So there can be transmission from the mother to the baby also. Yeah, maternal-fetal transmission. Maternal-fetal transmission. So you really have to think about it and just because somebody doesn't live in an area like the Northeast of America, you know, Lyme, Connecticut was where it all started. And the interesting thing about that is that it was an astute clinician who said all of a sudden, I've got all these kids with juvenile rheumatoid arthritis, which is a rare condition. You never see that. that. And he had a whole clustering of it. Then he said, well, why is this happening?

You know, we just label it as juvenile rheumatoid arthritis.

It's an autoimmune disease, but it's also infectious, right?

And that's- Most autoimmune diseases, I think.

Probably have some type of infectious origin. Because of microbes, for example, in your gut. Yeah. So, leaky gut and all that. Yeah. The ones that you probably see the most, or at least in my experience, I've seen the most, are Lyme with Bartonella and Babesia. Yeah. Those are probably the bigger co-infections. Bartonella as one is I think you probably have experienced this, that can cause neuropsychiatric illnesses. So we had a patient in the clinic. At the Ultra Wellness Center. At the Ultra Wellness Center, exactly, who was admitted to a psych hospital for psychosis and had Lyme and co-infections as a trigger for that. Just like, you know, it's like syphilis can cause madness, well Lyme can cause madness. Exactly, and it's not on the radar of neurologists, it's not on the radar of psychiatrists.

Everybody's in their silos, and that's what's so different about functional medicine is that we look at the whole picture. We look at, I joke that we're holistic doctors because we take care of people with a whole list of problems. And I think that that is what's unique about functional medicine and about the Ultra Wellness Center is that we don't just take things at face value. We dig deep into figure out the why. and why people are suffering. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at Dr. Mark Hyman. And we'll see you next time on the Doctor's Pharmacy. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more. And now you can have access to all of this information by signing up for my free Mark's Picks newsletter at drhyman.com/marks-picks I promise I'll only email you once a week on Fridays and I'll never share your email address or send you anything else besides my recommendations these are the things that have helped me on my health journey and I hope they'll help you too again that's drhyman.com/marks-picks thank you again and we'll see you next time on the doctor's Pharmacy this podcast is separate from my clinical practice at the Ultra Wellness Center and my work at Cleveland Clinic and function Health, where I'm the chief medical officer. This podcast represents my opinions and my guests opinions, and neither myself nor the podcast endorse the views or statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness Center in Lenox, Massachusetts. Just go to ultrawellnesscenter.com if you're looking for a functional medicine practitioner near you, you can visit ifm.org and search find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed Healthcare practitioner, and can help you make changes, especially when it comes to your health. Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. In keeping with that theme, I'd like to express gratitude to the sponsors that made today's podcast possible. Don't forget, there's a way to listen completely ad free. With Hyman Plus on Apple Podcasts, you can enjoy every episode without any breaks. Just open Apple Podcasts and tap Try Free to start your seven-day free trial.