How To Recover From Chronic Lyme And Tick Diseases with Dr. Todd LePine

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

The symptoms do not appear overnight. It's a slow process. So, you know, it's not like all of a sudden one day, you know.

You'Re gonna feel bad. Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman, and that's Pharmacy with an F, a place for conversations that matter. And if you or someone you know is suffering from a chronic infection with a tick-borne disease, such as Lyme disease, babesiosis, or lichia, bartonella, which is a big mouthful, otherwise known as chronic Lyme, then you should listen carefully to this conversation because it's one of the most important conversations that doesn't get had in traditional medicine. And I'm here with my colleague, friend, and partner at the Ultra Wellness Center, Dr. Todd LePine, a brilliant doctor, went to Dartmouth Medical School. He's board certified internal medicine. He's someone who's found functional medicine even before I did back in the early 90s. We go way back and worked together at Canyon Ranch. He teaches around the world is a leading thought leader in the field of functional medicine. And he's just an all-around great guy. And we are gonna talk about Lyme disease, which we both have had, by the way, and are both doing pretty good. So that's the punchline. There is a way out. It's not through the traditional doorway of six weeks or three weeks of antibiotics, and that's it. And otherwise, you're just a complainer and malingerer, right? Which is what our typical approach is. Lyme disease.

So welcome to the podcast.

Thanks Mark, thanks for having me. Okay, so we both live in tick country here. Yeah, absolutely. In fact, I had one crawling on me the other day. I was playing in my garden, I was like, working on my garden, like.

Got in the house, I'm like, sitting.

At my desk, I'm like, see one crawling, my gah, he didn't attach yet, but I was like, you dirty little. They're coming out. Yeah. So first let's just talk about the elephant in the room. Is there something called chronic Lyme disease? and why does traditional medicine not think there is and think everybody's just a whiner and complainer with psychological issues?

I think it's the concept of what is a disease really. You know, in Jeff Bland's book, the Disease Delusion, you know, is how we look at disease. And most doctors are trained to think that when you have an infection, you have a fever, you're sick, you've got to take an antibiotic. lower the fever, and then it's done. And chronic Lyme disease is a stealth infection, and you mentioned before, it's really not Lyme disease, it's tick-borne illness. And so you have to think not only could it possibly be Borrelia burgdorferi, but other species of bacteria that cause Lyme, and other co-infections, like you mentioned, Babesia, Bartonella, and the others. So you've got to really sort of think about what is it that may be driving these chronic type symptoms? And I have seen patients walk through my door with a 15-year history of quote-unquote fibromyalgia, which is not a diagnosis. It's like a chronic fatigue. Or chronic fatigue. It's a symptom, not a chronic fatigue. Exactly. Unexplained autoimmune issues, Parkinson's, Alzheimer's, multiple sclerosis. So just like syphilis, which is also a spirochetal illness, Lyme disease is the great mimicker. And, if you know the history of medicine way back when syphilis was very prevalent, it could mimic anything and everything. And, Lyme is the same thing. That's an incredible insight that people think.

You know, Lyme disease, you get the bullseye 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, 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, and 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 Lyme.

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

So, what is a typical approach in 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 in with Lyme disease. But they had acute Lyme, they had a fever, they had joint pain, they had a rash. You give them antibiotics, 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 it, it's not an issue. And I think 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 deficiency, 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? Oh 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 pre-disposed 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 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 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, it's, it's, 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 on- what does that mean, Todd? Yeah, that is, basically, Iatrogenica is the doctor does it. So a lot of times, it's caused by a doctor. Right, so a lot of times, Mark, you and I have seen it, 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. Absolutely. And it causes so much suffering. Needless suffering. So needless suffering, it's so underdiagnosed. It's not well appreciated by traditional medicine. No. 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 was he kind of mistake your, you know, everybody for somebody else you go know your wife is and you just have these weird.

He had like neuro Lyme.

Neuro Lyme, yeah. And about three other co-infections and we treated him with antibiotics and he got better. 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 a tick, one of those tick-borne infections. I gave her doxycycline for six weeks and I'm like, All our 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 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 to 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 not a 50-piece jigsaw puzzle, this is a thousand-piece jigsaw puzzle. Yeah, often, right? And you're not gonna, you're not gonna do a thousand piece jigsaw puzzle in five minutes. It takes a while.

My wife can do it in like half an hour.

Yeah, right. So you've gotta really listen well and then a lot of 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.

So 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 gonna develop polio 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 interferon 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 target 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 Dora. This is just more of like a.

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 it, HIV virus, cancer, et cetera. 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 system. 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 there 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 to a 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 the oral bowel, but SIBO is now rampant. And interestingly, 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 Bells Palsy is when your face gets paralyzed.

That's one of the symptoms of acute Lyme, 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 Bells Palsy that was caused from Lyme disease. And the term Bells 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, it's 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, my headaches, my achy, this and that. And you get this whole list of symptoms. 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 global. And exactly, and just like, you know, with the COVID virus, we see that the vector for the spread of the COVID virus is the airplane. It's not a mosquito, it's an airplane. All right, and how many of us travel and fly in planes? We go all over the place. There's also a theory, and I- that's.

Why it's good that the airlines have- yeah, exactly.

So also, there's a theory that Lyme may also be sexually transmitted. And I've had some privy to some people 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.

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. and he had a whole clustering of it. Then he said, well, why is this happening?

We just label it as juvenile rheumatoid arthritis.

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

And that- Most autoimmune diseases, I think, probably have some type of infectious origin. Because of microbes, for example, in your gut. So, leaky gut and all that. Hey, everyone, it's Dr. Hyman here. Now, I know we're all focused on being as healthy as possible during this unprecedented time, and that means drinking clean water, eating loads of anti-inflammatory foods, and it also means keeping our homes clean. Now, I've been doing my best to keep my family safe while indoors, and for me, this means using an air filter. Now, we know that toxic air particles can contribute to cardiovascular disease, lung disease, and even neurodegenerative diseases like Alzheimer's. These toxic particles come from cleaning products and stoves and pet dander and air fresheners and house paint and furniture and so much more. And that's why it's super important to filter our indoor air with the highest quality filter around. And a few years ago, I found Air Doctor, which is an air filter that's made by Ideal Living. And I loved it so much that I bought it and brought it into my home and my clinic. The Air Doctor is the first affordable air purifier that not only removes 100% of the particles, but also the vast majority of volatile organic compounds and gases. It features an ultra HEPA filter, which is 100 times more effective than ordinary HEPA filters. The Air Doctor is a 100% sealed system to ensure that all the air you breathe is pure and filtered. Now, I've teamed up with the makers of Air Doctor to give the Doctor's Pharmacy listeners the best deal yet on this amazing filtration system. Right now, if you go to drhyman.com/filter to access the Air Doctor filter for $329 and that's $300 off the normal price of this filter. And this is their biggest deal yet. You definitely want to take advantage. So head over to drhyman.com/filter to access the deal. Thanks for tuning in. Tell me about a patient or two you've had with Lyme disease and what you did to figure it out or chronic was chronic. And I, when people say chronic Lyme, I think that the term really refers.

To chronic Lyme and co-infections and co-infections. Yeah.

Chronic. Yeah. Chronic.

And often people have multiple ones.

I've had people have all four. Yeah.

Yeah.

It's, yeah.

It's, it's the, because the ticks can carry multiple bugs. Yes, exactly. Yeah. I think the, the ones that you probably see the most, or at least I, in my experience, I've seen the most, are Lyme with Bartonella and Babesia. 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. Like neurosyphilis. 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 figuring out the why. and why people are suffering. So, if someone comes in with MS, we're not thinking, oh, you have MS. We're thinking, you have inflamed nerves. Why are they inflamed? And then what are the causes? It could be heavy metals, it could be a nutritional deficiency, it could be gut issue, it could be tick infection, it could be multiple things.

So, I always say, if you just know the name of your disease, you don't really know what's wrong with you. You just know the diagnosis, but not the cause.

Exactly, Mark. You hit the nail on the head.

It's called label it, treat them and street them. that's really what happens.

Name it, blame it, tamen it game. That's Sidney Baker.

Exactly, yeah. Good old Sid. So that approach where somebody comes in and you've got five or 10 minutes and then you just want to treat the symptom, whether it's anxiety, constipation, here, take your MiraLAX, see you later, without thinking, well, what's causing it? And I think that I always go in to every patient with a Zen mind. I have no preconceived bias. I think we all have some type of cognitive bias because I've sort of seen that before, that kind of thing. It humbles me because every time I see patients, I'm always learning.

I'm always learning.

As much as I know, the more I know is the more that I know I don't know.

It's so true. I feel more and more ignorant the more I practice, more humble, and keep learning about things and learn from my patients because they're the biggest teachers.

And we call it practice. because you're practicing.

I mean, that's, that's so.

Tell us about some of these cases that you've had. Yeah, I had one case recently. It was a young girl in her late 20s and she came to see me and she had, she was very organized and she was also chronically ill. And I asked her, you know, when was the last time you felt well? And she goes, I can't remember. Wow. And she had a whole laundry list of symptoms. She had brain fog, she had fatigue, she had insomnia, she had sort of acne type symptoms. She had a lot of bloating. She was having joint pains. And she had seen multiple specialists. She saw even a few integrative specialists. And she was just at a standstill. Right. And she came in with a very organized thick binder. It must have been five inches thick.

Call that chart of Megaly.

Chart of Megaly. Exactly. Chart of Megaly. And big chart. And actually, because she was so organized, it really made my job easier. And I was able to take the time to speak to her and review all the records. And I saw that in her chart that she had a testing way back when for Lyme, but it was sort of like equivocal and it wasn't really addressed and treated properly. And I, you know, so I said, you know, I'm gonna put this on the back burner. Let's check your CD57 count. Let's see what it is. You know, so I did a standard approaches tour initially and empirically. And she also had limited resources in terms of spending money. But the one thing that flagged it was her CD57 count was low. And as I said, that's not a diagnostic of line, but it makes me suspicious the immune system is not functioning properly.

Yeah, I was like, oh, I'm gonna check it just to see. I was in sick country. I was a little tired and I thought I was working too hard. And it was like 30, which is normal, is like 120. And I was like, whoa. And then I was like, ah, Then I followed up with a tick test. I was like, I had positive and a PCR positive. I just sort of ignored it. I didn't even look at it for like six months or whatever. Oh, my test came back. I wonder what happened to that test. And I was like, oh shoot, I have Lyme disease. Yeah, exactly. Right. I did PCR tests, which we didn't.

Talk about, which is a test you.

Can do to actually look at the live. Yeah, polymerase chain reaction. And it's what they're using for COVID-19.

Which tells you that you have the virus. But if it's positive, you got it. Exactly. Yeah, exactly. It's pretty diagnostic. And so anyway, the testing that I ended up doing on her was the T-cell memory test, the Eli Spot test. And that came back positive dramatically. Like she had, there were a couple of the antigens and hers were beyond the measuring point. So she was having ongoing, Really greater than, you know, that- oh yeah, greater than. They couldn't measure it. And it was just a relief for her to realize that this is not in my head because she was starting to be treated like someone who had a malingering syndrome. I mean, she was struggling to get an answer for all of her myriad symptoms that doctors just could not put the pieces of the puzzle together.

Yeah, I always say, if you have a bunch of problems and symptoms and you go to the doctor and the doctor's like, well, your lab tests are fine, I can't find anything wrong. It means one of two things, either you're crazy or the doctor's missing something. And it's nine times out of 10, maybe 99 times out of 10, out of 100, the doctor's missing something. And it's because we're not trained how to think this way, like we do in functional medicine, which is what we do here at the UltraWellness Center in Lenox. And we're not trained how to navigate to the cause. So we just like, oh, you've got this diagnosis, we know what drug to give you. but we don't really know how to think differently about this disease from the root cause perspective and how to restore health. And that's what we do. And you sort of saw the clues. You saw the smoking gun, which is a CD57, you dug deeper, and then.

What did you do for her? Well, I actually put her on a course of doxycycline antibiotics, and I actually combined that with silver. And I don't know if you've used that, but if you actually, silver sort of turbocharges the effects of antibiotics. Some doctors actually give it intravenously, but I've had a fairly good success success orally. Yeah. Yeah. So I combined.

We called Argentin 23.

Oh, yeah. The silver salt. Not the colloidal silver, but the, the nanoparticle silver, like Argentin 23. Or I used silver silin in her particular case. I think they're, they're, they're pretty much identical. And she had a very good response with that. And then I also added in some artemisia, which they use for malaria. Yeah.

It's an herb.

An herb, exactly. It's an herb, exactly. And in fact, they actually won the Nobel Prize for that a couple of years ago. And that helps with the other forms, because the tricky thing about lime is that lime can take the regular bacterial spirochetal form, cell wall deficient form, and also the round body form, which is the more chronic.

Yeah.

And they're different forms, right? Exactly, yeah. and the organisms can go into the stealth mode where for a while they are sort of sitting in... They don't want to get caught. They don't want to get caught. Exactly.

By your immune system.

Exactly. And Lynn Margulis, who was the wife of Carl Sagan, wrote an excellent article about Lyme and round bodies. Yeah.

Really?

Yeah, you haven't read that?

No, she was incredible.

She discovered the whole mitochondrion connection. Endosymbiosis theory. Yeah. And she was a protist. She actually studied these very ancient bacteria and had a real good insight into these organisms. Because, you know, just like the COVID virus, the COVID virus does not kill people by itself.

No, it's the immune system's response to it.

Right, so it's how intelligent, if you will, our immune system's responses. and there's a lot of people who get bit by a tick and they're otherwise healthy, they're exercising and they, it doesn't bother them at all. Yeah.

You know, they're, they're, they're sort of, I think that's probably why I didn't feel so bad. Right. I think because I ate well, I exercise, tried to take care of myself and I was sort of in a, you know, an equilibrium. I didn't feel awesome, but I thought, oh, this is just, I'm working too hard, traveling too much, not sleeping great, like whatever. It just was, I sort of dismissed it. Right. but I was like, oh, wow. This is real. And a lot of our patients are struggling because they have other issues too.

Yeah. Well, and not only that, but the symptoms do not appear overnight. It's a slow process. So, it's not like all of a sudden one day, you're going to feel bad, especially you may get bitten, your immune system deals with it, and it's sort of sitting in stealth mode for years or months, and then all of a sudden, your immune system is compromised because you're not getting enough sleep, you're burning the candle at both ends, and then all of a sudden it can.

Come out, if you will, and reactivate.

So what happened or did you give her antibiotics, you gave her artemisinin, you gave her- and then I put her, I followed- yeah, my typical approach and actually there's a great paper, I don't know if you saw it, about the use of botanicals. So these are herbs which are oftentimes used to, just like antibiotics. Now, There are some doctors who will use antibiotics for months or even years. I've actually seen some of these patients and I think if you're really sick, perhaps giving intravenous antibiotics can be helpful to sort of cut down on the number of the organisms and to deal with it acutely. But at the same time, a lot of antibiotics affect the gut microbiome, they affect mitochondria, so it's a double-edged sword.

I mean, we used to work at a place called Canyon Ranch, which is a health resort. I call us resort doctors, the doctors of last resort. So we often see the patients who see everybody else, come here after they've done all these other things, including these two years of antibiotics, and are just a mess.

Exactly.

And we have to fix them.

Yeah, exactly. And so there was a paper that just recently came out looking at the use of botanicals in patients with Lyme disease, growing and then non-growing forms of Lyme disease, with the round body forms. And they found a variety of different herbs. The top ones were Japanese knotweed, which.

Actually has resveratrol in it, which turns out is a very high in resveratrol.

Yes, very high in resveratrol.

Healthy aging compound.

Yeah, and then the other top one was Cryptolepis, and then the other one was cat's claw. And these are actually found in various formulations out there. various treatments out there you might be aware of, there's the Cowden protocol, there's the Brunner protocol.

So just to back up a little bit, traditional medicine, three weeks antibiotics, you're done. Then there's the sort of group that uses like long-term two years of antibiotics, which is a little out of the box. And then there's the whole herbal protocols, which you're gonna get into now.

So what are the kinds of categories of herbal protocols? You mentioned Cowden, what other kinds of things? Yeah, there's a Cowden protocol, and then there's the Brunner protocol, which is he's an herbalist and he has his herbal tinctures. There's a Byron White protocols. And then there's a Dr. Zhang protocol. And what I would say is that.

I don't think-- He's a Chinese doctor.

Chinese doctor. Chinese herbs. Yeah, Chinese herbs. And with one of those-- A lot of garlic.

A lot of garlic. Exactly.

Garlic is phenomenal. Keep away vampires and lime. And biofilms. And biofilms. Garlic is very powerful on biofilms. And that's-- It's a great thing. I eat garlic almost every day. I really do.

Yeah, I do too. But this is like a whole next level. You're basically taking super concentrated garlic pills and if you live with someone or.

You have friends, you'll know it.

They're gonna complain. It's time for the moment I would say you could use perfume. Maybe that's it. I don't know.

Right, and I think the sparkies don't like it.

They don't like it either.

They crawl out of you.

What was that, that Zoolander movie where he had the new scented cologne, Garliq? That was kind of like what it is. Garliq. So what happened to this young lady?

So she is in the process of recovery. You know, she's not 100%, but she's dramatically feeling better. And there is some thought also that when people have chronic Lyme disease that you never 100% get rid of it. What you do is I think you get the levels of the Lyme in the body's down. And then you also improve the immune system, which is, you know, we always do a lot of immune support, things like medicinal mushrooms, which can have been shown to increase natural killer cell function, exposure to sauna, infrared light therapy has also been helpful just also getting out into the sunshine. Vitamin D, I oftentimes will check vitamin D in these patients and they're oftentimes low. and one of the things I tell my patients is that there is such a thing as healthy sunshine. And sunshine exposure does matter.

Put some light on your face and the rest of your body, you can be naked.

Exactly, yeah, and there's really very, very healthy benefits for immunomodulation with sunshine exposure, not just vitamin D, but sunshine exposure with ultraviolet radiation.

Absolutely. Light is powerful. So she got better?

She is, yeah, absolutely, is on her way to recovery. She's relatively recent. But she's one of many patients that I've seen. And in her case, hers was really interesting 'cause she had this whole combination of POTS, she had hypermobility, so she had this sort of Ehlers-Danlos type syndrome, which I said is oftentimes associated with people who tend to get chronic Lyme. She had bloating, which is a form of bacterial overgrowth. So she had a lot of these types of- She had to fix everything else.

So the thing is with Lyme, With these patients, we don't just treat the Lyme, we treat their whole system. So whatever else is going on, heavy metals, gut issues, nutritional deficiencies, hormonal problems, we'll sort those out and that'll help.

Them become more immunoresilient, which is the goal.

Yeah, resiliency, absolutely.

So Todd, do you think that it's possible to get rid of Lyme? I think if you get an acute infection and you catch it early enough, yes. Are we able to get rid of bacteria or virus? I call our bodies our chimeric organisms. We carry around billions of bacteria inside of us along with various viruses. So we're always exposed to these organisms. We're always exposed to these organisms.

So it's our immune system.

We're not sterile, you mean? We're not sterile. Exactly. We're not sterile.

We have the skin microbiome, we have the oral microbiome. We have more than that. We have all these other infections. We could have CM, cytomegalovirus and Epstein-Barr virus and we could have pneumocystis carinii, you know, bacteria. We can have all sorts of low grade TB and all these things that are hiding in us that are just kind of fine. They don't bother us. But then when our immune system gets nuked by, let's say, AIDS or by Lyme, which I think is the new AIDS, it actually creates this havoc where we can't cope with it anymore. And that's when things start to break down. Yeah, exactly.

Yeah, absolutely. I mean, we do live in a symbiosis. We have bacteria on our skin, we have in our mouth, we have it in our gut, and along with viruses, and when our immune system is immunotolerant, in other words, it tolerates these organisms and they're not in the wrong compartment, if you will. And that's actually one of the other things that Lyme does. Lyme goes into the interstitial department, into the connective tissues. And the immune system is not- It hides out there. It hides out, exactly. Hides out. That's there, yeah, exactly. And I think that's why the people who have hypermobility tend to have it more because for whatever reason, their connective tissues is not normal and perhaps the immune system can't get in there as well.

You know, I just sort of, this whole question of can you get rid of it is an open question and I kind of tend to agree with you. It's really about learning how to create immuno-resiliency and put it down. And often we'll see these Eli SPOT tests come back negative, like once they get treated. Absolutely. They're not really, the immune system isn't reacting to it anymore. Exactly. Or maybe it's gone. We don't really know 100%. but I just remember this patient I talked to this week who had Parkinson's disease, and he also had multiple tick infections and Lyme disease. And the neurologist was like, didn't pick it up, didn't notice it. And we've been treating him for years, and he was successfully treated for it, and I'll get into that in a minute. But his neurologist was like, I've never seen a patient with Parkinson's this long who's doing this great. You're not getting worse, you're stable, you're in rest in your symptoms, it's just incredible. And with him, he was tough. And you've got these patients with these tough diseases like dementia or MS, you kind of need a more aggressive approach. It's someone who has brain fog, a little achy, tired, insomnia as one patient. People with these more really serious conditions need more aggressive therapy. And I don't know if you've experienced it, but over the years, I've sort of really opened to what's happening in this space and trying to understand the kinds of therapies that actually are regenerative, that actually activate the body's capacity to activate its immune system and to heal, rather than trying to clobber it with a drug or even an herb. And the herbs can be great. I use herbs and I feel like they work for a lot of patients. But I feel like there's another class of therapies that's emerging that I think is where the money is for these chronic problems that are just resistant. Now, a lot of times with functional medicine, we'll get people better just using the basics, lifestyle, treat the basics. But there's a group that just doesn't get better. And this group, and people have been sick for decades or really struggling. And I've sort of explored a whole bunch of different things. And what I'm finding is there's a lot of therapies out there that are sort of off the grid. And the three that are the most, maybe four that are the most seeming prominent and potentially effective are stem cells and exosomes, which are sort of derivatives of stem cells that seem to help the body heal. I've had a bunch of patients who've gone and done that, not by my recommendation, but as a functional medicine doctor or any doctor, you should really listen to your patient. So when they come telling me this worked, that worked, I pay attention, especially when there's nothing else that's working. Like, what did you do? Tell me about it. Where'd you go? What do you see? Happen? Tell me about it.

It's like, I want to learn.

As opposed to to most docs, like, well, that can't be true.

I didn't learn about it in medical school.

It was spontaneous remission.

Right, oh, that, right, right, right.

I've heard that so many times. I actually gave a talk at Harvard once, and this guy who invited me was a friend, he was a doctor at Harvard, and I was talking about an autism case that completely reversed. And there was a pediatrician in the audience, and he's like, well, that could just be spontaneous remission. And then my friend got up and said, It may be, but it's weird that Dr. Hyman has had like five spontaneous remissions in his practice in the last month. That was very funny. So anyway, with these other treatments, stem cell exosomes one, I think hyperbaric oxygen is another, because stem cells help your body heal and repair itself. Hyperbaric oxygen just puts oxygen under pressure, hyperoxygenates you, which when oxygen is a therapeutic medicine that can help kill infections, basically, People say sunlight's the greatest disinfectant. Well, oxygen is one of the greatest disinfectants. Absolutely. And so hyperbaric oxygen, when you go in a tank and you sit there for two hours and you go to dive underwater, you know, atmospheric pressure. Then there's treatments that are being used in Europe and in Mexico, which are not available here.

And some of our colleagues like Jay.

Luber is using this for ALS. Yes, yeah. Thermal tunnel. Hyperthermia. Yes. which I personally experienced, because I was, I'm always trying stuff. And I went to San Antonio, Mexico. I did a podcast about this. I did hyperthermia, where they literally put me asleep and they heated me up to 107 degrees. So I was toasty. And Todd's like, his eyebrows are going up. Are you still alive? Yeah, I'm still alive.

I'm not a ghost.

And, and baked to a crispy crunch. I was like, yeah, it's all cooked. I'm good. I just did a little hot dog bun. I'm fine. and then they gave me antibiotics for Babesia, which I had and Lyme at the peak of the fever because it sort of flushes everything out. That's what fevers do. That's why I say, and so this hyperthermia treatment. And this patient of mine who had Parkinson's went and did that. He said it was a game changer. All of his Lyme symptoms went away, his joint pain, his fatigue, all these other issues. Parkinson's got better. So I think that can be a therapy, although it's very controversial. It's used a lot in Europe and Mexico. I've said patients who I have done everything I know how to do and they just won't get all the way better. And so they go there and they get better nine times out of ten. It's impressive.

So your two thoughts here, Mark, and not to interrupt you, but- Go ahead, guys. Because you're getting my brain going. And that's- I have one more last thing. One more last thing. And you're talking about hyperthermia. Well, guess how they used to treat syphilis. They actually used to inject malaria to patients to develop a high fever. Really, an old way of treating SIBO. See? Yeah, exactly. And then the other-- Everything goes around. The other clinical pearl, and I learned this from a rheumatologist who ended up becoming a Lyme specialist because of rheumatologists see a lot of rheumatologic conditions. Yeah, of course. She says, Ask your chronic Lyme patients, when was the last time you had a fever? Somehow or another, I think her theory was that the organism sort of hijacks.

The immune system such that your fever response doesn't-- that's so true. You know, I remember when I had chronic fatigue syndrome and I had Lyme, which I didn't know I had, I didn't know I had. It was years ago. I never got a fever. I never got sick. Exactly. Exactly. Like I just never got sick.

Exactly.

That kind of thing.

And that's a very important question that I ask my patients is when was the last time you had a fever? And it's like, well, years, years ago.

It's amazing. Yeah. And the last therapy, which is something we do here at the Ultra Wellness Center, which is very controversial, but is used a lot in Europe, and actually there are countries like Italy and Spain and China that are now using it for COVID-19 very successfully. intravenously is ozone therapy. And, it's been around for a long time. It's sort of not very well known in the United States. Medical ozone therapy, we think ozone is bad because it's the ozone layer and.

It'S a negative connotation.

It's bad for your lungs and it's terrible for your lungs and cause respiratory fibrosis and scarring and hardening of your lungs, it's not good. But, when you do it intravenously or rectally, it has a profound effect on one being germicidal, which kills the bugs because it's an oxidant, and two, it activates your own body's immune system to fight things and it activates your antioxidant systems. And when I was really sick, I did it and I found the most extraordinary results from it. And I've had multiple patients who've used it. And actually, I was hearing about this years ago from people and I kind of dismissed it. I did too. First time I heard it, like, oh, it's crazy. Right, I heard about this. Who's doing this? People were doing it. and even as a functional medicine doctor, I was like, oh, that's a little wacky. And yet these patients were saying to me, you know, Mark, the only time I really got better was when I did ozone. And I was like, maybe it was something else, I would sort of dismiss it. But then when I got sick, I figured it out. And I've been using with these patients and it's so remarkable. Now, I don't know if it actually is curative, but it definitely knocks it down and it activates your immune. So it changes the equilibrium. and then you don't feel sick. So, I think there's these other therapies, whether it's stem cells and exosomes, hyperbaric oxygen, hyperthermia, ozone therapy, that can help.

A lot of these really sick patients that are not getting better. What do you think? Mark and the other one to put in your black peptides. Peptides, absolutely. A good friend of mine, Dr. Ed Lee, who I call him the peptide guru, he's opened up my mind to peptides. And unfortunately, right now, and this is actually, I hope this goes out on the podcast, is that Right now, the FDA is trying to take away peptides as a therapy for integrative doctors, and they're going under the guise of the compounding regulations. These peptide therapies, which are basically around 40 amino acids in length, specifically for Lyme disease and for immune function, there's one particular peptide called thymosin alpha. which is amazing at immune modulation. So thymosin is like your thymus gland. And early on in our life, we have very large thymus glands. And interestingly, who are the people right now who don't die from the COVID infection? Children under the age of nine.

Because their immune system is so active.

Exactly. And it's sort of, it's intelligent and resilient is really what it is. Because we always think of like, I'm gonna make a stronger immune system. Well, that's sort of like autoimmunity, where your body overreacts. And I think that having a good response with your immune system, I call it an intelligent immune system response, is directly tied in with thymus function. And as we get older, our thymus gets less. And that's one of the theories is that the active healthy immune response in kids nine and under, they don't die of COVID It's the adults.

Now you're sort of causing immunoresilience or.

It'S sort of- Immunoresilience. Immuno rejuvenation. Exactly. It's waking up the immune system. And so peptide, I personally have not used that in Lyme disease, although not yet exactly. I will.

It's coming. I can hear it.

Exactly. Exactly.

Yeah.

And so that's another thing. And so there are other tools. And there is no one size fits all. I think ozone, hyperthermia, peptides, hyperbaric oxygen, all of these things have their place.

You just said a very important sentences. not everyone's the same. And I think this is my experience is that this is super customized based on the patient, personalized on, on what their illness and symptoms are, how they respond to different therapies. So we don't start off with the big guns. We start with simple things, which often will work for a lot of people. Yeah. But then we have a whole toolkit of things to work from.

Yeah.

That sometimes I'll just use herbs. Sometimes I will use antibiotics. Sometimes I don't. Sometimes I'll use Ozone therapy first. It just depends on what I'm seeing. I think it's really important for people to understand who suffer from these chronic problems that there is a solution, that there is a way to diagnose it, that there are a lot of novel treatments out there that are not being used by conventional medicine, and that people can get better from this. Right.

And the big thing is I look at these treatments, these alternative treatments, is really sort of the risk-benefit ratio. You know, what is the benefit and how much risk is it? yeah. And hyperbolic oxygen is really pretty safe. It's very safe. Exactly.

And ozone is very safe. Peptides are safe. Exactly. Hyperthermia.

Yeah.

You know, it's maybe a little more risky. Yeah. But it depends on the risk benefit. If you're super sick and you've tried, it's not as risky. Maybe taking antibiotics for two years. Exactly. And, you know, stem cells are pretty safe if they're on your own stem cells. Exosomes are safe. So there's a lot of these things that have a good benefit ratio. And I think, you know, it's really sort of an equation of Is there a scientific rationale for this? Is it, you know, has some evidence of clinical effectiveness? Is it safe? And what are the costs? Exactly, yeah. You know, and so we put that calculus together and we go, okay, well these are the kinds of things we can try.

Yeah, and you're like me, Mark, you always only, you know, what is the scientific evidence of this? Right? We always only, what's the mechanism? How does this work? Is we're intellectually curious and we've been trained in biochemistry. And I always tell my patients, if swinging a dead chicken over your head cures you, that's great because I don't know how it works, but if it works, there's no harm in it.

It's gonna swing the dead chicken. Exactly. I haven't used the chicken cure yet, but I'm gonna put it in my toolkit. Well, Todd, thank you so much for listening to this podcast, everybody, and thank you, Todd, for being on it. If you suffer from any of these problems, we at the Ultra Wellness Center here are very skilled and experienced in treating these complex chronic issues that nobody else can figure out. We now do all our consults virtually. We can see people in-house, but they don't need to come in. And we do lots of treatments with ozone or other therapies, IV nutrition, maybe new peptides, and so forth. And we really do help people navigate this landscape from a very, I think, balanced perspective. We're not extreme, we're very thoughtful, very methodical, and we look for the evidence where it's there, and we push the envelope where we can, where it's safe, and we see some really remarkable turnarounds for people who've been really sick for a decade sometimes. So, I'm just so happy that everybody's listening to this and that you're, if you know someone who has some kind of chronic mysterious illness or has diagnosed with chronic Lyme or other co-infections, you know, there is a way out. And sometimes it takes not the first person you see, not the 10th person you see, sometimes it's the 15th person. But I would not give up and I would not, you know, sign off on your life until you really dug all the pull out all the rocks and looked under them.

I'll leave also Mark with a ray of hope because a lot of people who are like this don't have a ray of hope. And I'll always tell my patients, a little bit of humor is always good to say, there's light at the end of the tunnel and it's not a train coming at you.

That's a good one. We'll leave you with that. There's light at the end of the tunnel and it's not a train. And there is hope. And I don't want people to give up hope because we really, we You know, one of the most frustrating things I hear in medicine is we don't want to give patients false hope. And I don't think that's a good statement because for the most part with functional medicine, there's always something to do. There's always a way to improve someone's health. You may not fix everything all the time, but you can definitely see dramatic improvements. And so I think this is really why we're here, why we're at the UlTrowaNO Center. It's why I do this podcast, to help people understand that there are different ways of thinking about health and disease and how to create a healthy humanity. So thank you all for listening. Thank you Todd for being on the podcast. If you love this podcast, please share with your friends and family on social media. If you want to come see us at the UltraWellness Center, go to ultrawellnesscenter.com and you can go to the Get Started page and teach all about what we do and how to get connected. and please share this with your friends and family. Leave a comment. We'd love to hear from you. Subscribe wherever you get your podcast, and we'll see you next time on the Doctor's Pharmacy. Hey, everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do, and introducing you to all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to DrHyman.com/picks to sign up. That's DrHyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer.

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