Exclusive Dr. Hyman+ Ask Mark Anything: Rosacea, Tick Borne Illness, And More

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Hi everyone, welcome to another episode of Ask Mark Anything. My name is Hershel Peretz and I'm the Dr. Hyman Plus Community Manager. I'm joined by Darcy Gross.

Hi, Darcy. Hi.

And she's one of the producers of the Longevity Roadmap docuseries. And we're here, of course, with our expert, Dr. Mark Hyman.

Hi, Dr. Hyman.

Hi, guys. Thanks for joining us today, everyone. So let's go ahead and get started and ask Mark anything. So we'll start with our first question. So, Dr. Hyman, our first question is, what is Lyme disease and how do you treat it?

Well, that reminds me of a quote from Mark Twain who said, if you want me to speak for a day, give me an hour's notice. If you want me to speak for an hour, give me a week's notice. If you want me to speak for 10 minutes, give me a year's notice. So I literally could speak about this for an entire day. So I'm going to try to instill it into 10 minutes, but this is one of the most horrible conditions known to humankind. If I could, as a doctor, wave my wand and create a magic trick and eliminate one condition from humanity, it would be chronic Lyme disease. And what I mean by that is all tick-borne illnesses, Babesia, Ehrlichia, Bartonella, Lyme, all the strains of Lyme, Rocky Mountain spotted fever, all the strains of, of Babesia. I mean, there's just so many of these tick-borne illnesses that are causing so many people to suffer. and they're hard to treat, they're hard to diagnose. And I personally am an expert in it, unfortunately, because I've had Babesia and I've had Lyme and I've been very sick from them and I've had to figure it out for myself. So I'm going to share with you one, how do we know you have it? How do we diagnose it? What are the treatment options? What have I found works best and help you sort of create a roadmap for thinking about how to navigate this? The first is how do you diagnose it? Not everybody gets a rash. Not everybody gets a bullseye rash, which is classic for Lyme. Most people don't know they're bit most people have no symptoms initially. They just feel chronically ill. And they can cause all sorts of different symptoms from chronic fatigue syndrome to cognitive dysfunction to Alzheimer's, which is often misdiagnosed Lyme. And it can cause Parkinson's, can cause depression, autoimmune disease, arthritis, heart failure. I mean, the list goes on and on. Gut issues. It's the great masquerader. We used to call syphilis the great masquerader. Well, tick-borne illnesses are today's great masquerader. And how do you diagnose it? Well, the first thing I would do is take a free test. It's called the MSIDS questionnaire, M-S-I-D-S. And it's developed by Richard Horowitz. It's a quiz essentially to look at your symptoms, to score them, to look at your exposures and your risks, and you get a score. And it doesn't definitively tell you, but it says, gee, you know, if I have a high score, the likelihood that something's going on is high, and it gives you different ranges of scores. And so that's the first place I would start. You can Google it online, you can link to it in the show notes, and it's free. The second is how do you diagnose Lyme? How do doctors diagnose Lyme? So the average doctor will do an antibody test like coronavirus, right? Coronavirus, you get an antibody test, same thing. It's a record of whether your body's been exposed to the infection, but not whether it's active or still going on. So for example, if you've got coronavirus or COVID-19, you will have positive antibodies even after you're better and the virus is out of your system because it's your body's memory of the infection. It doesn't tell you whether you have it or not. Now, some of the tests do help like IgM levels and so forth, but they're really not very sensitive. So you can miss a lot of people with these infections. And by the way, most doctors will just check for Lyme. They won't check all of the strains of Lyme, they won't check all of the other co-infections. So you really have to cast a wide net because these are showing up with all sorts of different symptoms and they're often missed. The second kind of test is called a PCR test. We're familiar with that with COVID because in COVID, we use PCR testing to check for COVID-19. And so people are familiar with that test and it looks for the DNA or the RNA of the material and actually can tell you that there's some particles of this bug floating around in your system. Now, most of the time it's negative because these hide, they hide in your cells, they hide in your organs and tissues and they don't come out. So they're hard to detect. But if you have a PCR positive, which I did, it means you have this problem. Next thing you can do is how does your immune system respond to this? So there's a test called CD57. It's one of the natural killer cells and it's very suppressed with Lyme. Now I think Lyme and when I say Lyme, I'm referring to all of these tick infections. Okay? I think this chronic Lyme is like a it's like eight in a way. It suppresses your immune system. It makes you sick in general. And it's this chronic thing that just is hard to get rid of. So you often have to look at the immune cells. And so I often will do something called an Elispot test, which looks at your lymphocyte, your white blood cell responses, not through antibodies, but through your innate immune system and other ways that actually shows that you have an active infection. and I find these most helpful. The first test was developed in Germany called Harman Labs, the one in the United States is called Infecto Labs, and we use those in my clinical practice to help determine whether or not someone's exposed. That's still not perfect, okay? Still not perfect, but it's a big advance. And then you have to go on your clinical picture, your history, symptoms, and so forth. So that's sort of the diagnosis. In terms of the treatment, I would sort of break it up into four buckets. The first bucket is conventional medicine. It says three weeks antibiotics, by you're done. If you're not better, it's not Lyme. So that's just nonsense. If you have an acute infection and you take doxycycline for three weeks, yes, most of the time it will clear it. But again, most people don't know they've had tick bite that they're infected and they're kind of just hit by this later on because they have chronic fatigue or they have autoimmune disease or they have something else going on. So I'm not a big fan of that unless you have an acute infection. and then often you might have co-infections for which doxycycline doesn't really work, so you might need to take other drugs. The next group is we call the ILABs community, and they've done a lot of great work to advance our understanding of Lyme and Lyme-related conditions. And they often use heavy doses of long-term antibiotics and multiple antibiotics. They might treat you for a year or two years or three years, and often people will improve, but it doesn't really fix the problem. because most of these drugs are not what we call microbiocidal or germicidal, meaning, it means to kill. Suicide, homicide means to kill. They might be suppressing it and you'll feel a little better, but it won't cure it. So, I'm not a huge fan of these long-term antibiotic regimens, especially now that we have other treatments. The third category is a whole group of herbal cocktails that can be very effective for people. and there's one group of cocktails called the Zhang cocktail, Z-H-A-N-G from Dr. Zhang, who's a Chinese traditional herbalist and includes garlic and other kinds of compounds. And those actually have been very effective for my patients on a selective basis. And you might need to take them for three to six to 12 months. There's also the cowden protocol. There's also the Byron White protocols. And I'll use these in combination with other therapies very often. Those can be effective, but again, not always going to cure the problem. And then there's a fourth category, which unfortunately today is not accessible to most people, is not widely available, is definitely not covered by insurance, and it often can be very expensive. But it's the stuff that really works. First, I would say, and often can be done inexpensively at home, is ozone therapy. Now, I cured myself of many conditions through using ozone therapy. I've talked about in the podcast. If you look at the FDA website, It says it will kill you. Don't use it. It's dangerous. But guess what? So is water. If you inhale water, it will kill you. It's called drowning. If you inhale ozone, it's damaging your lungs. It's very dangerous, but don't inhale it. It should be used in other ways. You can drink water and you can drink ozone water and you can put ozone in your veins and you can put it up your butt and that's all safe. But certainly don't drink it. I mean, don't put it in your lungs. And ozone therapy has been around for a long time. I've written a lot about it. We can connect to different articles and so forth in the show notes. What I would say is I would research someone in your area who does ozone therapy if you can. There are great training programs around the country. It's available around the country in most cities now. The cheap version is rectal ozone. You can go online. I don't have any affiliation with these companies. There's many different companies that make this longevity ink. There's simply O3. You can literally buy a home ozone generator for less than $1,000. and you can do rectal ozone, which sounds gross, but actually it works. And you have to do it every day, and you can do up to a liter of ozone rectally every day, and over time it will really, really help. Ideally, you can do what we call a multi-pass or 10-pass ozone therapy. I do that in my clinic, in my office. I found it extremely helpful, and it can really help because ozone is the most powerful germicidal compound on the planet. If you have an ozone generator and you're sticking in room full of infection overnight, all the bugs will be killed overnight. and they use it in hospitals, they use it in various places where they want to sanitize environments. It's actually a known thing. And so that's really good and there's many roots, but for sure, rectal ozone, intravenous ozone, intramuscular ozone can also be used. And then there's another kind of group of therapies including hyperbaric oxygen therapy. Now, there was a famous Supreme Court justice, I forget his name, I don't remember. He said the best disinfecting is sunlight. In fact, ozone, I mean, oxygen is incredibly damaging to most bacteria. Most bacteria like to live in dark, cold, I mean, dark, warm, low oxygen places, and particularly these tick infections. So oxygen can be a really powerful tool. And using hyperbaric oxygen, which is under pressure and decompression chamber, we usually use 2.4 atmospheres, 90 minutes, usually 30 to 40 sessions. Usually they cost between 200 to $400 depending on what city you live in. It's not cheap, but it can be very effective and help bring back cognitive function, energy. And I personally used it and found it to be a great benefit. There are even home chambers you can buy for, I think, maybe $10,000. They can use that at home. This is another home treatment. The next is a group of treatments that are also a little more expensive and challenging to get, including peptides, which are little proteins that your body makes to help regulate your immune system and every other function in your body. Bimistinol, Alpha-1, L-37, PD-4 fragments. I'm just listing them off. But these molecules you can take by subcutaneous injection and they can be really effective in helping to regulate your immune system and keep these infections under control. Lastly, there's something called exosomes, which is a very basic stem cell-like treatment where they take the active components of stem cells and they give those intravenously. Those can be very effective and it can be a great part of therapy, but they're expensive. Lastly, this is the last resort I use, but it's like the Hail Mary for patients who just don't get better. It's called hyperthermia. They use it in Europe, they use it in Mexico. And essentially is where you heat your body up. And basically what your body does to kill infections is create a fever. Well, you're creating an artificial fever. You heat the body up under anesthesia. And then when your body's super heated up, all the bugs get scared and like leave the cells and are floating around and you wham it with antibiotics. And I've had this done a number of times to myself to help cure myself. I've recommended to many patients and it's been a remarkable therapy. It has to be done by skilled doctors in a medical setting under anesthesia. and there are some risks to it, but it is generally pretty safe. So that's in a nutshell, in 10 minutes or less, my approach to tigecycline injections.

And Darcy, over to you for the next question.

All right. So hi, good morning, Dr. Hyman. Happy to start us off with the next question, which is all about, I know we've talked a lot about skin conditions, but the community wants to know a little bit about rosacea. So if you could speak to exactly what is rosacea, if there's a cause, I mean, of course there's a cause, and of of course, the functional medicine approach to treating rosacea.

Sure, sure, sure. I love this question. I see this commonly in my practice. The medical term for it is acne rosacea. It's not exactly acne, but essentially we see it a lot in alcoholics. WC Fields was the classic famous person where he had a big round bulbous nose called rhinophyma. He was an alcoholic and that's a big cause of It's often blotchy acne on the cheeks and face, often a lot of fine blood vessels you see in the face. You'll see these people sort of red, ruddy looking, little blood vessel lines. We call them spider veins. That's a really common condition. Now, what causes it is the issue. Now, as most skin conditions, it's not caused from the outside in, it's caused from the inside out. and from a functional medicine perspective, we have to treat the inside out to get the skin healthy. You can saunter all kinds of creams, lotions, potions and gels on the face, but ultimately, if you don't deal with what's going on inside, it's sort of like mopping the floor while the sink's overflowing. It might help a little, but you got to stop the sink from overflowing by turning off the faucet. So what is or what are the causes of acne rosacea? In my experience as a functional medicine doctor, it's coming from the gut. and it's usually fungal overgrowth. It can be H. Pylori, which is a bacteria in the stomach that causes ulcers that can also cause rosacea. And again, this is not, you know, wacky stuff. You can Google it on Natural Library Medicine, PubMed. And most doctors don't do this. They just give them antibiotics. They just, you know, give them topical stuff, and it's just, it's, it's not enough. So I basically put people on elimination diet. I give them usually an I'll test their stool. I'll test food allergies. I'll look at gluten, Dairy, I'll check leaky gut, and I'll usually put them under fungal and also I'll give them by antifungal, I'll treat that, and then I'll do a gut reboot and repair program and that includes prebiotics, probiotics, polyphenols and a whole gut reset program, sometimes digestive enzymes. And we've created with our team, you guys involved, we created something called Gut Food as a result of my own recent autoimmune disease with colitis, as a result of a bad infection that I got from taking antibiotic. for a bad tooth. And it's just been so helpful. These are five highly researched ingredients that are designed to help reboot the gut and be taken long term as a multivitamin for the gut. So I help people go through this process of getting rid of the bad stuff, whether it's foods and bones, and then rebuilding the gut and helping heal it. So that usually takes care of it for most people and it's not that hard to treat, believe it or not.

Well, I hope you enjoyed that teaser of exclusive content that you get every single month with Dr. Hyman Plus. if you want to listen to the full episode and get access to ad-free podcast episodes, plus Ask Mark Anything episodes, plus monthly functional deep dive episodes, I guess that's why we call it Dr. Hyman Plus, then head on over to the Doctor's Pharmacy on Apple Podcast and sign up for your seven day free trial.

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