The Hidden Cause of Your Chronic Illness (It's Not What You Think)

What makes the nervous system so sensitive? And once you understand that, you also know how to treat it. So when people have developed chemical sensitivity, they're often told, oh, you just have to learn to live with it. My message is, no, you don't. We can fix that. For people who have developed EMF sensitivity, we can fix that. We've been at this for 20-plus years. We have slowly filled up our toolbox in such a way that we really can help the majority of people who are All right, Neal, welcome back to the podcast.

So good to have you and see you again. We've known each other for decades and decades in dealing with complex patients who are struggling often to find a way out of a whole set of symptoms that nobody can help them with that are persistent and debilitating. And you really have mapped out an incredible framework for understanding complex chronic illness, whether it's mold, Lyme, chemical sensitivities, environmental illness, chronic fatigue, the whole spectrum of things that gets sort of dismissed by traditional medicine or it gets ignored or that doesn't have great tools for or any of the above. You really spent your life dedicated to trying to understand why these people don't get better and what the challenges are in treating them and how to actually think about resolving these issues. And you have been one of my mentors, one of my teachers. And I think I really appreciated your wisdom and insights and intelligence over the years. And It's all particularly important for me because I personally have had chronic fatigue syndrome. I personally have had Lyme disease and Babesia. I personally have had severe mold illness and almost died. I have really had these problems, heavy metal toxicity, mercury toxicity, and I've had to figure that out for myself. And now I feel healthy and good. I just went for a 15-mile bike ride this morning. I'm almost 67. I feel great. My time's about the same as it was, you 10, 15 years ago on a loop. So I think the reason I share the story is because I think there's hope out there and you provide a lot of hope. So, Neal, why don't we start out by you kind of framing the issue of like, why are so many people struggling with all these unexplained symptoms and why are they so sick without any kind of clear diagnosis? And often they're told their labs are normal, that this is just Psychological, and why is medicine sort of missing the boat on this?

The way conventional medicine works is based on a concept that is great for simple issues and absolutely doesn't work for chronic illness of almost any kind. It's based on the concept that, okay, I come into my doctor and I've got a sore throat. He does a strep culture, it's positive, he gives me penicillin and I get better.

Right.

Nice, simple. But chronic illness doesn't work that way. In the body, everything is connected to everything else. And conventional medicine is based on a one cause, one diagnosis, one treatment model that simply does not fit anymore. The world we live in is absolutely complicated. As I know you know, many of the people who come to see us have been gaslit by the medical community. They've been told it's in your head. There's no such thing as Lyme disease. There's no such thing as mold toxicity.

Yeah.

And we have helped thousands of people recover their health by knowing that there is another model, there is another way. But another part to your question is we live in an increasingly toxic world.

Yeah.

It is now known that there are 350,000 new chemicals in our environment in the last 70 years. The vast majority have never been studied in terms of whether they affect our health or not. And we add to that the increasing exposures to electromagnetic frequencies, EMFs. And so people are rolling out 10G now with no concept that We're being exposed to massive amounts of an energy that our bodies were never designed to deal with. So we have an increasing amount of toxicity. Our livers have to deal with things that 100 years ago no one had to deal with, and they're overworked.

Mm-hmm.

And so slowly the toxins continue to accumulate in our bodies. They trigger inflammatory reactions, which become chronic. And we are off to the races in the wrong direction. So I think that's what's happening and it's really tragic.

It is tragic. And I don't know if you ever experienced any of these problems yourself, Neil, but I suffered it from the inside out and I almost died from mold. My whole immune system collapsed. I got tremendous amounts of inflammation. I went in a terrible catabolic state. With Lyme disease, I had severe fatigue, brain fog, cognitive issues. And, you know, I developed those weird sensitivities to foods, weird sensitivities to chemicals. I would get rashes when I would eat certain things. Like, it was just really strange how my body completely broke down. And I think, you know, I felt so disabled by it and traditional medicine offered no solutions. And that's really how I got into functional medicine 30 years ago. And I think that a lot of people out there listening have these issues, whether it's, you know, chemical sensitivities or histamine responses we call MCAS now, is, you know, basically an advanced form of like histamine intolerance. We have all these weird autonomic symptoms, these long COVID issues. We have people getting so many tick-borne infections that aren't even diagnosed properly. And it's a lot of stuff that is all a big soup. And often, people have multiple things at the same time. Like, it's not just one thing. So, when you start to think about these patients and these people who are suffering, How do you start to approach them? How do you sort of help them understand what's happening and kind of guide them?

Well, the first thing I always look for is root cause. What is the primary thing that's making my patient sick? Unfortunately, there could be several root causes. In your case, and I remember talking to you when you were really ill with the mold toxicity.

Yeah. Thank you, by the way.

And you're welcome, by the way. The trick is to identify all of the root causes, Not just get focused on one, but also to try to prioritize which root cause needs to be treated in what order. And sometimes that varies from patient to patient. It's not as simple as it sounds. The biggest root causes that we see are mold toxicity, Lyme disease. We can talk about other environmental toxicities as well, and long-haul COVID.

Yeah.

Those 3 are the biggies of what we have to sift through. And a lot of physicians or patients get hung up on things that are downstream from that, the mast cell activation, limbic dysfunction, vagal dysfunction, methylation dysfunction, mitochondrial dysfunction, recurrent Epstein-Barr or other viruses. And they can get really caught up in that for years. thinking I'm treating a root cause, but it's really not the root cause. The root cause is something more profound that is weakening that immune system. And that's what we have to really get started on because otherwise we're just going to be not making any progress.

I agree. And I think, you know, I noticed this very early on when I was in practice that you have to focus on the upstream causes and you have to keep going up and up and up until you find out what the the higher-level order of things is rather than treating the symptoms. And, you're right, autonomic dysfunction, histamine intolerance, chemical sensitivities, these are the results, not the causes of something. And, just to clarify a little bit what you said about mold, about long COVID, and about environmental issues, and you said Lyme, but when you say Lyme, you mean the entire Lyme constellation of tick-borne illnesses because there's a million of them, Lyme, Babesia, Borrelia, Bartonella.

I mean Lyme and its coinfection buddies.

Yes. I knew you meant that. I just want to clarify.

Okay. There you go.

Because not everybody is kind of fluid with this as we are. But I think this is actually such an important point. And you highlight in your book, and you talk about this, the importance of doing things in the right order, that you can make someone sicker by doing the right thing in the wrong order. I wrote an article like probably 20 years ago called The Right Order of Things, which is exactly this. Start with the basics, and then you kind of layer in. If you start doing some things that might be helpful to someone later on, early on it could make them worse. So can you kind of explain that whole phenomena and why we have to sort of be sort of structured in how you approach these problems and not get people sicker?

By the time people reach me, many of them were like you at your worst, in which they're really exhausted, can't think straight, anxious, reacting to everything. And In that state, it's especially important to do things in the right order, because if you do it in the wrong order, they're going to get worse. And that order has to be figured out. For most people, starting with mold toxicity is the right order. For one major reason for it, and I'll give you several. One is mold toxicity looks like Lyme disease with its co-infections. Looks like long-haul COVID. And that's why teasing it out by symptoms is impossible. So if we know someone has mold toxicity, which has shown up very clearly on a urine mycotoxin test, the other are a little bit harder to diagnose by test. The easiest one to test for is mold. And if you have a mold positive test, that's a great place to start. We know it with certainty. A lot of the time, if we get rid of the mold, the people get either completely well, which means we don't have to go down the Lyme rabbit hole, or they get 70% better. And what's left symptomatically helps us hone in on what's the next layer that we have to be treating. So typically I will start with mold. But having said that, it is more complicated than that because For most of my patients, mold toxicity will trigger limbic, vagal, and mast cell dysfunction. And those all represent, from the body's perspective, safety or lack of safety. And we know that if a body doesn't feel safe, it can't heal. Not psychologically, physiologically.

You talk about the cell danger response. That's what you're talking about, right?

I am. That is correct. Often, in order to even get to treating the mold, many of our patients are so sensitive, they can't take the supplements they need, the binders that they need to take to even begin that treatment. So for them, we have to start with limbic and vagal rebooting, then add mast cells, which is present for most of them. Then we can get into the mold. Once we pull that layer off, then we can see whether or not there's a Lyme or long-haul COVID piece to it and get going on that. If we approach it that way, we will make progress. But I've had countless patients spend years working on Epstein-Barr or mitochondrial dysfunction, methylation dysfunction, and getting nowhere.

Yeah, because those are downstream.

Not only is it downstream, in a state of Cell danger response, which for your listening audience, cell danger response is a concept developed by Bob Naviaux. It's a brilliant way to understand the complexity biochemically of what's happening in almost every chronic condition. And on a simplistic level, on a cellular level, which extends to the whole organism, if someone is experiencing infection, toxins, or stress, or combinations of those, The cell shuts down in order to contain the infection, to deal with the stress, which extends to the whole body. And until that gets addressed, you're not going anywhere. And that is not psychological. You can't just decide, oh, I'm going to be better. You have to literally get the body better so it experiences that I am safer. The threat is either gone or almost gone. Now I can proceed to healing. So that helps us to understand again what to do in what order. Because you're in the first phase of cell danger response, the body will not respond to methylation or mitochondrial treatments. It won't respond to plasma exchange. It won't respond to peptides. It won't respond to much of that. It's basically going. Hey, I'm on survival mode. I, that's a lovely thing you're doing for me. I can't deal with it until I'm safer. So that's how I conceptualize the order in which we, we treat.

Have you ever climbed into bed exhausted, but your body just won't switch off? Your mind keeps racing, your muscles feel tight, and you can't fully relax. Well, a lot of times that can come down to one foundational nutrient, magnesium. It plays a critical role in sleep, recovery, stress regulation, and muscle function. Yet many people simply are not getting enough. And that's why I've recommended Magnesium Breakthrough from BiOptimizers for years. And now they've introduced Magnesium Breakthrough Advanced 10 with 10 bioavailable forms of magnesium and even more elemental magnesium to support sleep, muscle recovery, and metabolic health. It's become part of my evening routine, especially during periods of travel, training, and higher stress. Go to bioptimizers.com/Hyman and use the code HYMAN to save 15% off your order. If you're like me and tend to sleep hot, you know the summer months can make staying comfortable at night a lot harder. As a result, I found myself paying a lot more attention to the fabrics I use every day, especially the ones I'm sleeping in. Cozy Earth's bamboo sheet set has been a game changer for me. The fabric is soft and noticeably cooler, so I'm not waking up overheated in the middle of the night. I've also been reaching for their all-day tee a lot lately. It's soft, it's lightweight, and it still feels comfortable even on long hot days. Sometimes the small things in your life can have a bigger impact on how you feel than most people realize, especially when it comes to comfort and sleep quality. If you're looking to upgrade your daily essentials, head to cozyearth.com/Hyman and receive 20% off. Yeah, it's tough. I almost died from mold. I'm in this barn where you can see the background. It's an old 125-year-old barn. It was super moldy. I was coughing for a year. I was working really hard. I was doing Cleveland Clinic and I was just kind of ignoring my symptoms. I kind of knew something was up. The house kind of smelled a little moldy. I was like, oh, maybe something's going on. I checked it out and sure enough, it was full of mold. I moved out, but I ended up getting this cascade of things that happened where I had a root canal removed, I had antibiotic, gave me C. diff, and my whole system collapsed. And, I went into this massive inflammatory cell danger catastrophic catabolic state where I was in bed for 5 months and I lost 30 pounds and I couldn't eat and my whole colon and gut were all inflamed. And, And it was tough to get out of that. And I think, you know, for some people, you know, the question is, what are the right levers and where do you start? And for me, I was doing all the dietary stuff. I did all the supplements I think I could do. I thought I was doing all the right things, but it turned out I had to, and it sounds kind of like a crazy option for people, but I heard one of my patients, and I usually listen to my patients because they usually, they report what works out there in the wild. He said, I did ozone. I had really bad mold. poisoning and I did ozone and it helped me. I'm like, okay, well maybe I'll try that because I'm dying. I don't know what else to do. And I did it and it was like literally within 2 days it snapped me out of it. I don't know how it exactly worked, but then I sort of continued on to a mold detox. And I think the phospholipid exchange I find really helpful too, which is a whole different approach that was developed by Patricia Kane and others that uses high doses of phosphatidylcholine intravenously along with glutathione and methylating nutrients and other minerals to help mobilize the toxins. And I found that extremely helpful and I find it helpful for a lot of patients. So those, there's a lot of things that are in the toolkit for people, but you kind of, you know, I think what you're talking about, Neil, is that you really have to have the right map for people and really think properly about this. Maybe we can kind of back up a little bit and talk about this phenomenon of toxicity versus sensitivity. What's the difference? And how does, so how does this shift happen from like being tolerant of things to being intolerant? Like people get intolerant to food, to smells, to light, to sound, like react to everything. So how does this work?

Sensitivity refers to something neurological, like our senses, all of our senses, touch, smell, hearing, light, sound. So sensitivity refers to sensitivity to light, sound, touch, smell. Toxicity is, there's a toxin in our body which is inflaming our body on a systemic level. So it's helpful to separate that out. And we can do that just by are talking with our patients in history. One of the things I ask every patient is, have you developed any sensitivities? And we ask one specifically. If they have, they're already telling me that their limbic and vagal systems need help because the key to sensitivity is the limbic system. That's the part of the nervous system that specifically monitors our sensitivities and gets out of whack when it is inflamed by anything. Mold toxicity is the biggie. That's the one that we see the most. So by listening to the patient, if they're telling me that I can't think straight, I'm cognitively impaired, I'm fatigued, my joints and muscles hurt, that's generalized inflammation. You can call that the toxicity category. Sensitivity is those senses are on high alert and people become exquisitely sensitive to smell, for example, where they can smell mold, for example, and nobody else in the family can.

Yeah, like a mold dog. I have that. I can walk into a room and I'm like, oh, moldy.

Well, dogs have, we know, have a sense of smell a thousandfold greater than ours. But even humans can develop some of that when their limbic system gets fried enough. And, you know, I knew you when you had lost 35 pounds. And you do look much better now than you did back then. It's good to see.

It's amazing the body's recovery capacity. And for people listening, it feels hopeless. And I know people struggle with these conditions, never feel like they get the answers, but there is a framework for thinking about this. And your book is such an important contribution to the field. It's called Heal Your Body from Mold, Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness. And, you wrote it and then you redid it and updated it in the second edition, which includes EMF sensitivity, environmental toxins, COVID, long COVID. I think this is really important. And, I personally use the book because I think it's such a detailed resource for understanding these chronic illnesses and for giving hope to people who really struggle.

So, I would add to that. I wrote a book called The Sensitive Patient's Healing Guide, which focuses on the sensitivity component. And I have 20 experts who contributed to that book where we go over what makes the nervous system so sensitive. And once you understand that, you also know how to treat it. So when people have developed chemical sensitivity, they're often told, oh, you just have to learn to live with it. My message is, no, you don't. We can fix that. For people who have developed EMF sensitivity, we can fix that. So these are things that now that we understand how the body physiologically becomes more sensitive, we also have the capacity to fix it. So I want to really emphasize the hope that you're referring to, which is, you know, we've been at this for 20-plus years and we have slowly filled up our toolbox in such a way that we really can help the majority of people who are really sick.

So let's talk about how we diagnose these things and how we treat them and what works and what doesn't work. And I think it'd be helpful to kind of get your perspective because this cocktail of chronic kind of persistent illnesses, and I would say if I, as a doctor, if I could If I could do 2 things, it would be to get rid of mold and Lyme-related illness from the planet because they cause so much suffering. But we have to deal with it. And the question is, you know, traditional medicine doesn't really sort of acknowledge these conditions. The diagnostics are really not used. What are the diagnostics that you use to help figure this out? And then let's talk about after that some of the You know, the right ways of approaching this from a treatment perspective.

For mold toxicity, there are 4 labs that will help make the diagnosis. 3 of them measure mycotoxins in the urine, and 1 measures the, the, an immune response in the blood to it. Any of these tests, a positive result will really point us in the direction that you do have mold toxicity. Although people argue that you can get this from food ingestion, that's not been my experience. I can give you reasons why that—

So you think, yeah, because people dismiss it. They say, oh, this is just toxins from food. It's not really real when you—

It is not. Does it contribute a teeny bit to maybe having it in your urine? Yes, but not to an extent that we wouldn't pick it up on our testing. So urine mycotoxin to me is the standard. Anyone who presents with a complex illness should get a urine mycotoxin test. If you want me to talk about brands or which ones are better than others, I'm happy to do that, but I can otherwise leave it alone. Bottom line is you need a good test to measure.

So, you're saying urine, urine mycotoxins. And then, there's also a whole field of Richie Shoemaker, who's one of the pioneers in mold-related illness, has a phenomenon he talks about called CIRS where there's a lot of biomarkers that are used including MSH or C4a or TGF-beta-1. These are blood tests that you can get. Are they useful? Are they helpful? Do they not matter?

So number one, if you're interested, I've just finished a podcast with Richie in which we discussed the differences in our approach in about a 2.5-hour podcast that we did with Scott Forsgren and his Better Health Guy podcast. So if you want an excruciating discussion of the differences, that's going to be available. And I'm really happy that We've been able to do that. All those tests that you're measuring, they're blood tests, TGF-beta-1, C4a, MMP-9, VEGF. They're indirect measures of inflammation. They're helpful in telling us, yes, you're inflamed, but they will also be positive not just for mold, but they'll be positive in Lyme and co-infections, other infections, some viral infections. So if you want to document that someone is inflamed, they're helpful. Will they pinpoint mold? They won't. The urine mycotoxin test is absolutely specific for mold. And forgive me, it's not rocket science. If you're peeing out mycotoxins, they're coming from your body. You've gotten them into your system. So if we are, we can measure significant amounts of mycotoxins, mold toxins in your urine, You have it. There's no, forgive me, there's no really question about that. To me, that is the single most useful test to help put this away. It's very accurate and very useful. Then in the Lyme field, our testing has improved. We've gone from the fairly inaccurate serologies and Western blot to much more accurate immunoblots. That measure many more species of Lyme and Bartonella than we used to appreciate before. And there's some newer testing which I'm really fond of. Bob Mozayeni has a T-Labs test where you can send a specimen of your blood and you can look at it under the microscope with a special fluorescent stain that only stains that particular microbe. And it will tell you, is this in your body right now? And I find that, that a particularly useful test because our serology tests are testing immu— our, our immune system.

Like when you look for antibodies, it's not, it's not always helpful. So you're, what is, what is he measuring with this test?

It, it's helpful for the immunological tests are great for, for helping us to, to know you have it, or mostly that you've been exposed to it. But even when you're cured of it, your body's gonna still make those antibodies because of what we call immune memory. The same concept that we use to, for all of vaccinations is immune memory. So what I always wanna know is, okay, I've made the diagnosis, how am I coming with treatment? Have I gotten enough of the bugs out of the system so that this, we don't have to keep treating and I don't have to keep using antibiotics? And for me, the TLAB test is very helpful with that.

Yeah.

I'll give you one other test that I'm currently very fond of, which is Bruce Patterson's Radiance Lab does a test for 14 different cytokines. Cytokines are the result or what our immune system triggers in our body when we're fighting these threats of toxins and infection. And it turns out, especially from Dr. Patterson's research, that there's a different pattern of cytokines in Lyme. There's a different pattern of cytokines in long-haul COVID so that we can identify that much better. And we're— I'm doing research with him right now in which we're identifying a different pattern yet for mold toxicity. So with a single blood draw, what you can look at is what is this immune system fighting right now? What cytokines is it generating in a pattern that would immediately make me think, Oh, this is a long-haul COVID pattern. And it could be all of them together because we see that really quite commonly. So we are now evolving much better tests than we had 20 years ago to begin to hone in on which of these is the biggest issue here and what do I need to treat first.

I know, I know, another doctor talking about protein, but stay with me for a second because what matters isn't just how much protein you eat, it's actually whether your body can actually Use it. As we age, we naturally lose muscle and become less efficient in absorbing and utilizing protein. There's actually a term for this, anabolic resistance. And that's why I add Perfect Amino to my smoothie every morning. It gives you all 9 essential amino acids in a highly absorbable form that supports muscle protein synthesis and helps maintain muscle and bone health as you get older. And unlike many whey proteins that can spike insulin levels similar to sugar, Perfect Aminos Plus, it can help you hit your protein goals without adding a lot of unnecessary calories. So if you want to learn more, head to bodyhealth.com and use the code HYMAN20 for 20% off your first order. That's bodyhealth.com and use the code HYMAN20. I put a lot of consideration into what I eat. We have to eat real whole foods to stay healthy, and that is why I love my clean seafood box from Seatopia. It arrives blast frozen at my house. It's lab tested for microplastics and mercury, and it's packed with the variety of seafood that's full of bioavailable omega-3s. You get the best of seafood's nutritional properties without the cytotoxins sadly now often found in our oceans. My favorite is the Seatopia King Salmon, which is full of bioavailable EPA and DHA, and you get so much of it in a single meal that it actually beats what most people get in a week's worth of supplements. And honestly, it does taste so much better than a pill. Get your first box at seatopia.fish and use the code HYMAN for free shipping. So the tests, we can look at mold, urine toxins. We can look at different immune responses to tick infections. There's ways to look at heavy metals. There's ways to look at toxin load in the body. It all sort of gives you clues about what's happening. In the treatment of these patients, do you often start with like lifestyle, diet, and the gut? Or do you just kind of go right to the, what you see as the sort of the trigger, which would be like the mold or?

My bias is to start with the primary cause. I have had a lot of my colleagues Start with improving detoxification strategies, getting the diet built up. But the problem is the vast majority of patients who have mold toxicity have SIBO. They have intestinal dysbiosis. And you can't fix that until you get the mold and Candida out first. And one of the major tenets of functional medicine is fix the gut first, everything will follow. The exception to that is mold, which is if you have mold and Candida almost always comes with mold and you're not working on it, every strategy you use is likely to not work well. You can resp— our patients will respond to Rifaximin and then they'll get better for a couple of weeks and then they'll go right back to where they were. So my approach is to get going on the causation first. And honestly, once you get that out of the system, the body's innate healing powers will fix most of anything else later.

Yeah.

And if it doesn't, then we can use our normal tests and go, okay, you're deficient in zinc and selenium. I can give you these and those will be helpful to you. I can look at your fatty acid imbalances and we can balance that out, but you'll respond. infinitely better if you get rid of the primary driving root cause first.

So, let's talk about that. We talk about sort of diagnostics and it seems like mold and ticks definitely are things that I think about with every patient who's got anything that's chronic, even if it's autoimmune disease. I mean, it doesn't have to be chronic fatigue or histamine intolerance or any of these other things. It can be an actual disease that it underlies. For example, I had ulcerative colitis. That's what I got. But, that wasn't really the problem. The problem was the mold.

And, as soon as I got rid of the You may not know this, but me too. I also got ulcerative colitis from my mold.

Wow.

Okay. Brothers from another mother. What can I tell you?

Tell me about it. Oh my God, that was the worst. I was having 20 bloody bowel movements a day. I lost 30 pounds. I couldn't eat. My whole intestine was inflamed. And it wasn't until I really got the mold sorted that helped. But I'm curious, when you have someone with this complex illness, like somebody like me, Like, where do you, what do you do if you're not starting with the gut first? If you're sort of taking a little bit of a tack, you're going right to the root cause. What are the therapies? What are the modalities? What are the treatments that you find most effective in these complex chronic patients? And including mold, but also let me, I want to talk about the tick stuff a little bit.

Sure. First, I think this is central. We start with a good history. Again, when we were talking about why conventional medicine often doesn't get anywhere, it's You know, my, my histories are 2 hours long. So you really have to really listen to the patient. They will usually tell you what's going on if you just sit back and listen and don't interrupt their story, if you don't chime in or push it. But then once you hear their story, then you can really dig into some of the details. Asking them about, as in your case, do you have any mold exposure? Do you smell any mold? Do you have a barn or something nearby that might have moldy hay in it? Just saying. Water damage building, water. You start asking these questions. As I said, I ask every patient about their sensitivities. As soon as they start saying, yes, I'm sensitive to light and sound and smells and chemicals, I already know they've got a limbic issue and we're going to need to address that early on. If we don't, we're not going anywhere. I'll ask about mast cell activation early on. I'll ask them about, do you ever get a reaction to anything you eat or drink immediately? There are other manifestations of mast cell activation, but that's a tip-off. When someone says, I get immediate bloating and gas while I'm eating it, I don't even have to finish it. Great. I already know you have mast cell activation, that that's a piece of it. And then I look for the vagal piece as well. I'm looking for autonomic nervous system symptoms, palpitations, temperature dysfunctions. The vagus controls the gastrointestinal tract. So I'm looking for any GI symptom, probably has a vagal piece to it. POTS, low blood pressure are all things that will tip us off to there's a vagal piece to it. So I'm trying to, as I listen, put together in my mind what was the root cause, what has it triggered, what are the downstream pieces so I can then formulate my bigger picture. So yes, I always want to treat root cause, but for many of our patients, I can't treat root cause until I deal with the limbic vagal mast cell systems first.

And how do you deal with those things first?

Well, for all of those, Each of those has their own treatment. So for the limbic system, there's a number of very excellent programs out there that patients can do to do the reboot. There's Annie Hopper's Dynamic Neural Retraining Program. There's Ashok Gupta's Amygdala Retraining Program. Amygdala is another word for limbic. There's Kathleen King's Primal Trust. Those are 3 of my favorites, and there are some others. On the vagal side, there's a bunch of new devices on the market called vagal nerve stimulators. Gotta be careful with them. My sensitive patients can't take the most direct stimulation. There are devices like GammaCore, which go greatly over your neck. There are devices that attach to the earlobe, which is a branch of the vagus. Most of my patients need to use indirect stimulation, so I use Apollo Neuro a lot. To help reboot the vagus. I love osteopathic cranial work for the vagus. I love frequency-specific microcurrent. And then there's virtually anything that quiets the sympathetics, tai chi, yoga, meditation. They're all excellent. But it usually takes several vagal strategies coupled with limbic to move people off from the super sensitive bedridden into more functional and then able to do more. Then we get for mold into taking binders that are specific for what we see in their urine. So we know that whatever mycotoxins show up in your urine, we have a table in my book Toxic. There's a big table that shows what we know from the medical literature of which binders work specifically on which toxins. You can literally look at your report and figure out, okay, I'm going to need charcoal clay, chlorella, and Welcol or cholestyramine to get this out of me.

So there's specific binders for specific mold toxins is what you're saying?

Yes. We can make precision medicine out of this. And then for many of our patients, not only do they have mold toxin, They've colonized. The mold has actually colonized in their sinus, gut, or sometimes their lungs, and we are gonna need to use antifungals to get rid of those. So that's the mold treatment.

Those binders and antifungals, do you also add in things like ozone or phospholipid exchange or other therapies?

I know, I know the ozone worked for you. It doesn't work for most people. It's much more effective known for Lyme and co-infections than for mold. I love phosphatidylcholine. I think it's great. It's one of my favorites. I mean, I also use dozens and dozens of, I will call them naturopathic approaches to treating mold, other naturopathic binders, things to improve the gallbladder's ability to function better, the liver's ability to detox better, the kidney's ability to detox better, saunas to get toxins out of the skin better. So I've intentionally oversimplified it, but we have tons of tools at our availability to help people aided in their journey to pull these toxins out of their body.

And what about the tick stuff? Because the mold binders, antifungals, there's phospholipids, there's a lot of Great therapies. Tick infections seem harder and more treatment resistant.

They are harder and they're harder on the body because in my experience, most people won't get well with herbs alone. Most people, they're helpful and I use herbal approaches, but for most people, they'll need an antibiotic approach for a longer period of time than anybody wants in order to really get them free of that particular microbe. Unfortunately, the same antibiotics don't work the same for the different co-infections. So we'll use certain antibiotics for Lyme itself, others for Bartonella, others for Babesia, and then there's the lesser-known ones of Anaplasma and Ehrlichia, et cetera. But I mean, it's a whole field, as you well know. There's a whole group of physicians that are called LLMDs, which is Lyme literate MDs. In which we've all had to study this because it's, it's not as simple as that strep infection thing I talked about where you have a strep throat and you take an antibiotic for a week and you cure it. Doesn't work that way with these bugs. They're way more complicated. So the whole Lyme field, I think, is more complicated. But again, it takes a whole armamentarium of things that work on these particular critters to get them out of the body. They're what they're called stealth infections. They hide inside our cells. They're not just floating around in our bloodstream there. We have to literally pull them out of the cellular location and get at them, which is, forgive me, complicated.

One of the most powerful things you can do for your health is cook more of your meals at home. When you prepare your own food, you have control over the quality of ingredients, the oils you use, the amount of sugar and processed foods you're eating, even the materials you cook with. And that last part matters more than most people realize. A lot of cookware contains chemical coatings that can break down over time, especially with high heat cooking. And that's one reason I've been using Made In stainless clad cookware. It's completely free of coatings, built with high quality stainless steel, and designed for even heating and better heat control, whether you're sautéing veggies, cooking fish, or searing protein. Their cookware is used in over 4,000 top-rated restaurants, but it's also incredibly practical for everyday cooking at home. If you're looking to upgrade to clean cookware that will actually last, go to madenware.com and use the code HYMAN-HIVE for 10% off your first order. Most of us are walking around in a state of chronic stimulation. Your cortisol is elevated, your nervous system is stuck in go mode, And we wonder why we can't sleep or focus. Now, one thing I've been using that I genuinely look forward to at the end of the day is the infrared PEMF wrap from BoneCharge. PEMF, otherwise known as pulsed electromagnetic field therapy, delivers gentle electromagnetic frequencies into the body that mimic what you'd naturally absorb spending time on the earth. Combined with red and near-infrared light, it's one of the few recovery tools that works while you're absolutely doing nothing. I throw it on for 30 minutes while I'm reading or winding down, and I notice I sleep better, on the nights I use it. It's lightweight, it's low EMF, it's free shipping, HSA and FSA eligible. And honestly, one of the simplest things I've added to my evening routine. So head to boncharge.com/hyman and use the code HYMAN for 15% off. That's B-O-N-C-H-A-R-G-E.com/hyman and you'll get 15% off. Yeah, it is. It is. And I think, you know, I think, you know, we're talking about how we can get people better. And you dealing with the patients that are at the end of the road, and I have most of my career as well. My joke was I worked at a health resort and I'm a resort doctor, but the doctor of last resort. And I think you are too. Are there people with these complex chronic illnesses that you just haven't been able to help? Like, are there people who just are so stuck in their biology they can't kind of correct it? Because what happens I see in the biology is it's sort of stuck in this feed-forward cycle. And I was caught in that and I couldn't get out of it. It was like a, it was a loop. No matter what I did, I couldn't break it.

I do. I don't think there's a physician alive who can say they cure every person they ever see, and I'm certainly not one of them. I would say I've helped the vast majority of people I work with, but I certainly have folks that I haven't helped. And then I'll give you some reasons for that. In the mold field, the single number one reason that people aren't getting better is they haven't been able to get out of a moldy environment. They haven't been able to remediate their home properly, still in it. They financially can't afford to leave. And if you can't get out of the mold, you can't heal. So that's the biggie.

Yeah.

For other people, I think, that are really sick, there's often a spiritual, emotional, psychological, or energetic block. In which there's something else going on, preventing them from responding to the treatment we're giving them on a deeper level, and and that requires an even more in-depth work with the patient of figuring out with them. I'll usually say to them, you know, you're not responding to what I'm doing. Do you have any ideas about? where you, where your block is or where you're stuck. And most people have an idea. Most people will say, well, you know, I had all of this early childhood trauma and I never, I worked through some of it. I'm not sure I worked it out. And what I find is if we then do get into that, and that might take another year before they're even able to get back to treatment, then they can proceed. But we have to find the block. I call it the block where there's energetically, there's something blocking energy flow in the body. There are some energy healers sometimes who can do some great work in that regard, getting things. We just have to look deeper. Sometimes, and I don't love to talk about it, some people don't have the will to live. They get so sick and they just decide, I'm giving up. And that way of thinking prevents whatever they're doing from having any beneficial effect. So this, it becomes really complicated. And our goal as physicians or as would-be healers is to dig as deep as a patient will let us to find what they need from us to move them forward.

Yeah, I think that's really important, Neal. I mean, people get discouraged, disappointed, And frustrated and sometimes suicidal. And I definitely found myself there at different moments in different illnesses that I had. And I was like, I can't do this anymore. But I think hopefully people take away from this conversation that there is a way to think about this, that there is a roadmap, that there is an understanding of what's happening when people have these chronic complex illnesses, that if you're struggling, don't be hopeless. There is a way through it. I think I would encourage everybody to get your book.

Thank you.

And follow you on your social media, on Instagram, and your website, nealnathanmd.com. And the book is called Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Environmental Illness. It's out now. And, Neil, thank you for your dedication, your work, your teaching of me, your helping of me when I was sick. And I think you and I are both proof that there is a way out of this. We've both been really sick with this and probably motivated a lot of our work. And then there is a way to think through how to solve these chronic complex illnesses. So thank you so much for your career and work and dedication and all the things you put in your book.

Thanks. My take-home message is everything we talked about today is treatable. And so, yep, there's hope.

Absolutely. And I'm a living example. I've had all of it. I've had mold, I've had mercury, I had Lyme, Babesia, everything. You're right.

And still, and still here to laugh about it.

I'm still here. I'm feeling great, actually. Actually, I feel better than I felt ever.

That's, that's wonderful. Fabulous.

Yeah. All right, Neil, take care of yourself and we'll talk soon. If you loved that last video, you're gonna love the next one. Check it out here.