Undiagnosed Infections Are Silently Causing Chronic Disease! Fix It With This

At this point, like you, I've seen over 13,000 chronically ill patients who've been to 30, 40 doctors. The most was 100, by the way, who ended up getting better. The key 6 root causes that I was finding is number 1, these infections, a bacterial infections like Lyme, but also one that a lot of people don't know about, which is Bartonella.

What you're saying here is that all of these have similar underlying causes, right? And that if you treat those underlying causes, the downstream effects tend to get better without treating them directly.

Correct. And that's the problem in medicine. The way we were taught is name the disease, throw the drug at it, but you didn't get to the root causes of why they were sick.

All right, Dr. Horowitz, Richard, so good to have you on the podcast. We were just chatting a little bit, and we've known each other for more than 2 decades, and we have shared so many patients together. And you and I are those kinds of doctors that people go to after they've seen everybody. Like, I used to work at Canyon Ranch, and my joke was it was a health resort and I was the doctor of last resort. I'm a resort doctor.

That's exactly what they would call me, is the doctor of last resort.

A resort doctor. Yeah. And so I think, I think, you know, we're going talk about this chronic disease epidemic. You recently wrote a book called Ending Chronic Illness, which is a really important book. We've come to all the same conclusion. Anybody who's really seriously looking at chronic disease, who's looking at root causes, who's trying to understand the body, who's seen 10,000+ patients knows that what we thought in medical school was not the right map for the body. And that so many of our chronic diseases have very similar underlying root causes and need a very different approach to address the dysfunction, dysfunctions we see in people. And so your book is really kind of a roadmap on how to do that, which is amazing because so many people are struggle and they suffer and they don't need to suffer. Maybe you can kind of take us back to how you're kind of a regular doc and you know, you got trained traditional medicine like I did. When did, when did you go, wait a minute, I think we're missing something here. What, what was that moment for you when you were like, wait, shit, this isn't the whole story?

For me, what was kind of interesting is it was almost a spiritual path because I did my medical training in Belgium and French for 7 years and I started studying with Tibetan Buddhist lamas in 1981.

Oh.

And when I was leaving, I dunno if you knew the story of—

I do. I do. I, yeah, I, you know, we talked about this. I actually majored in Buddhism in college. And Tibetan Buddhism was the same thing, so yeah.

So I'm leaving medical school and I go to my Tibetan teacher and I go to Lama Gyendun and I say, "Lama, what's the most important thing you want me to know as a doc?" And he said, "Richard, the most important thing is put yourself in people's shoes and do for them what you would want done for yourself." They call it exchanging yourself with others. Basic advice, love, wanting other people to be happy, compassion, wanting other people to be free from suffering. So here I moved to the Hudson Valley, New York after being at Mount Sinai, getting my internal medicine residency and board certified., and I move into the largest Lyme endemic area in the United States, which is where the monastery, Tibetan monastery was for me to continue practicing meditation. And here these Lyme patients are coming in. This is going back now to 1987.

Yeah.

Right. They're coming in, they're coming in with bullseye rashes. Nobody knows exactly what to do. I start a medical detective journey of like why these people are sick. 'Cause I sent them to neurologist and rheumatologist and infection. Nobody knew what to do, especially because the infectious disease doctors thought, you know, 30 days of antibiotics, that's it. Except they kept coming back sick. So I started on this journey and ultimately functional medicine came in because as I was discovering root causes of why they were sick, and I'll give you some examples. This woman in a wheelchair comes in, this is early on. She can't walk, she's in a wheelchair for 5 years and she's sweating bullets. She's got drenching night sweats. I just got back from a Lyme conference and learned about Babesia, this malaria-like parasite.

Yeah.

It's not supposed to be in the Hudson Valley. I test her for it and I test the ticks, it's positive. I give her Mephrone, Azithromax, which I published at the conference the year before. And lo and behold, she starts walking out of a wheelchair chair after 5 years, and she was on 5 years of antibiotics for chronic Lyme. It wasn't until the parasite got treated. Another patient then comes in shortly afterwards. She can't speak, she's got dysarthria, and I found out it was Bartonella. It was another bacteria. She went to a very famous Boston hospital, said it was a migraine. I treat the Bartonella, she talks for the first time.

Wow.

So one by one, what started happening is I started discovering these pieces to the puzzle, um, and mold toxicity started showing up shortly afterwards where these people were getting better from the protocols I've developed for Lyme, but Still, something was off, and I started discovering other viral infections. Long COVID patients were relapsing with Epstein-Barr and herpesvirus 6. They had Candida overgrowth in the gut. They were loaded with heavy metals on top of mold. The microbiome was off. They had leaky gut and intestinal hyperpermeability. So one by one, as these sick patients were coming in, I started discovering these pieces of the puzzle, and that's how the 16-point EBSIDS model came to be.

I don't know if you know this about me, but I was one of those patients. Like, really, I was 36. I, was really healthy the year before, riding my bike 100 miles a day for 3 days from Boston, New York on an, like an AIDS ride. And I could, you know, remember 30 patients at the end of the day with no problem. And I went from one day to the next, just like my whole system collapsed. And it was a very long period of recovery, but I ended up having heavy metal poisoning from mercury from living in China. My gut went crazy. I had leaky gut. I developed bacterial overgrowth. I had my belly was just bloated. Like I couldn't even eat anything. I had severe cognitive impairment. I couldn't sleep. My muscles were aching. My muscle enzymes were like 600. My autoimmune antibodies were high. My white count was low. I had all these like weird things going on. I ended up having Lyme disease, Babesia. I lived in an 1825 building and house. It was— there was the mold with the mold in the basement. I mean, I, it was like so moldy. And I had everything. I had heavy metals, I had mold, I had tick infections, I had gut issues, all of it. And my hormones started going wacky. My mitochondria went wacky and all the things that you describe in your book, I experienced as a patient. I only discovered all this because I was desperate to get better for myself. And I started treating me with my own, with what I learned from functional and systems medicine. And I started getting better and I started treating my patients. And they started getting better. And I was flabbergasted. Like, you did what and you got better? You just changed your diet and you did this or you did that and your migraines are gone or your arthritis is gone. Or I was sort of stunned as a traditionally trained doctor that these things were working.

No, and I had the same experience. I came on with allergies and asthma. My father was a surgeon. Every time I was sick, it was like, Harris, give him a shot. And nobody used probiotics right at that point. I had Candida overgrowth in my gut with leaky gut, with mast cell activation until I figured out I had to get off histamine foods. My asthma wouldn't go away. It was interesting. I went to Yeshe Donden, the Dalai Lama's personal physician at one point.

Oh my God.

Because of this connection, he takes my pulse and he goes, oh, trauma at 6 years old caused asthma. And I went, oh my God, my parents got divorced at 6.

Seriously.

So the type of experience you had, I also had leaky gut, intestinal hyperpermeability, metals. I chelated myself from metals for a year and a half. I think the doctors, by the way, like us who do this, who've had the personal experiences, they probably have more compassion for the patients. Oh, without a doubt. 'Cause they've been through this themselves.

Well, because, 'cause these are the patients that the joke in medical school was they have a supertentorial illness, which means it's all in their head.

Mm-hmm.

It's like a big fancy word for how doctors sort of basically are pretty, you know, derisive about patients and cynical. And they think that, oh, people are complaining of all these weird and vague things I didn't really learn about in medical school, so it's not really real, but it is. And people suffer tremendously. And that's what drives me so much in my work. And I know you too, you work tirelessly and I, patients. You've written all these books too. And your last book was Why Can't I Get Better? And How Can I Get Better? Which was great. So you, you've really been on this path a long time. And what I want to do is sort of get into the details of it because I think people listening really need to understand like what are the root causes? And then you came up with 6 things and they're very, it's a very similar thing we come up with in functional medicine. And what are the downstream effects? And at the end of the day, a lot of the suffering that we're seeing in chronic disease is inflammation. And there are many roads to get to inflammation, whether it's metals or mold or ticks or gut or food sensitivities or whatever the list is. But the end result is it has harmful effects across every system of the body. So let's talk about like, what are those 6 principal causes of inflammation that you described and how, how, how do you start thinking about digging around being a medical detective? Cuz that ultimately you'd be really good at finding these things.

Yes.

Which by the way, are things that traditional doctors never look for at this point.

Like you, I've seen over 13,000 chronically ill patients who've been to 30, 40 doctors. The most was 100, by the way, um, who ended up getting better. The key 6 root causes that I was finding is number 1, these infections, a bacterial infections like Lyme, but also one that a lot of people don't know about, which is Bartonella. Bartonella. Now there are 18 to 19 different subspecies of Bartonella. So if you try going to LabCorp Quest to get a Bartonella test, you're gonna miss it, right? And a lot of these long COVID patients who come in with VGF, with vascular endothelial growth factor, it's not from spike proteins that are actually inflaming the end, the endovascular air shoe. It's basically Bartonella. So, you know, we find Bartonella in a lot of these patients, which drives inflammation. Reactivated viruses, definitely Epstein-Barr herpes virus 6, especially in the long COVID population. Parasites like Babesia, very common at this point. And Candida. So it's, you know, it's basically bacteria, viruses, fungi, and parasites. But the second is the environmental toxins.

Well, before we jump to that, I wanna kind of dive in cuz a lot of people say, I went to the doctor, I got my test done. You implied that, you know, they miss it. How do you get people tested? What are the ways that, that people should think about finding out these things about themselves and these infections?

If I wanna check for Lyme and Bartonella, I'll go straight to an IgeneX immunoblot. Their IgM IgG immunoblot and Bartonella IgM IgG immunoblot. BartonellaFish, which checks for all these different species, or even T-Lab, very good BartonellaFish, BabesiaFish. They even do a good Lyme PCR. So I like these specialty labs. It's not that I can't use the local labs with an ELISA or a Western blot, but I find these specialty labs are really needed. And I play a game with people called Lyme bingo, which means that if you come in and you're tired and you're achy and you have brain fog and you can't fall asleep and you keep waking up and you're depressed and you're anxious and you have chest pain and shortness of breath, right? All the multisystemic symptoms of Lyme. Even if you go to a local lab and you get back one Borrelia-specific band on a Western blot, 23 outer surface protein C, 31 outer surface protein A, 34 outer surface protein B, 39, very specific, 8393. Now the 31 is a little nonspecific of the Abipsan-Barr autoimmune, but if you come in with a disease with good and bad days where the symptoms come and go with migratory pain, and here's the key, Lyme patients have migratory joint pain. Migratory muscle pain and migratory nerve pain, tingling, numbness, burning, stabbing vibration. The hallmark of Lyme is migratory pain.

Yeah.

So if you have migratory pain, it moves around, it moves around your body and you can't explain why.

Yeah.

Yeah.

And if you have that with even one of these bands that I mentioned on an immunoblot, which is recombinant DNA, you've been exposed to a Borrelia species.

So you're saying you need to go to a specialty lab like Hygenics that does testing differently than you'd get at a normal lab like Quest or LabCorp.

Correct. You can still get a Western blot and an ELISA that, but it might miss it. The C6 ELISA checks for 3 strains. Borrelia burgdorferi, Abzelangarinae from Europe, but, and even heart tick relapsing fever, Borrelia miyamotoi, which you have a Lyme-like illness, you go to the lab, oh, it's negative, but there's a relapsing fever Borrelia. It's like a cousin of Lyme disease.

Yeah.

It's also showing up in 25% of these patients.

Yeah.

So that's why you have to kind of understand we're in the middle of a tick-borne epidemic.

Yeah.

We're in the middle of an environmental toxin epidemic. I mean, these infections and toxins together, they're really pushing inflammation.

Don't forget mold. So we'll get to that. All right. So, so we kind of dive in in those things and then the toxins are the next big category, right? Tell us about the, the way in which those are prevalent and how they're—

I tested myself early on. A dentist friend of mine tested himself for heavy metals, was loaded. I tested myself loaded on mercury, arsenic, cadmium, aluminum myself. I chelated myself for a year and a half to pull 'em out with DMSA, with DMSA generally. And then afterwards we had mold in our house like most people do, right? Exposed. And I started looking for patients. So it's the same thing. I found it in myself, started looking for others. And I didn't realize at the time how important mold was. Mold is a mitochondrial poison.

Yeah.

And mold affects your immune system. So here's the problem. You get Lyme and Bartonella, which causes immune deficiency. You get, so it destroys your B cells from the bone marrow that make antibodies. 20% of my patients come in with chronic variable immune deficiency. Yeah. 85% subclass deficiency. You can't fight infections if you have immune deficiency.

It's interesting you say that cuz I, I, after seeing so many patients with tick infections, it was like, I was like, this is kind of like AIDS. It is. It just screws everything up.

Absolutely. People don't realize how badly this affects.

You don't die from it, but it screws everything up.

Then you get COVID with T-cell exhaustion on top of your B-cells, right? So now you can't, your natural killer cells are thrown off. You can't fight viruses and cancer the same way. And then you get mold toxins with gliotoxins on top of it, which are immunosuppressive. How can you expect people to get better when their immune system is so profoundly affected by this? So yes, the mold toxins and heavy metals on top of these other infections, they're really important to go after. And I found that the majority of the chronically ill patients patients where inflammation was driving their illness, it was absolutely the mold, the metals, and these infections at the top of the list of what I call the 6 rivers of inflammation, and which is in Ending Chronic Illness.

And, and your book Ending Chronic Illness, you, you do talk about how it's not just one thing.

Yeah.

Like it's, these things stack. It's like everybody has everything almost to some degree. It's all a whole system collapse and it's triggered by, and everybody's a little different. Sometimes there's more mold, some more ticks, some more metal, but it's usually a combination of, of the load of everything that just causes this system breakdown.

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Absolutely. And in fact, my wife, Lee, my beloved, had all 16 of these MSID factors that I'm describing. But as an example, We didn't know at the time she had leaky gut intestinal and she had mast cell activation. So she's thinking, oh, bone broth is good for me. And I had some chocolate the night before and a little bit of kimchi with some fermented vegetables. She wakes up the next morning vomiting on the floor with a migraine. And I said, what did you eat? And she told me and I went, oh my God, sweetheart, you have mast cell activation. We got her off the histamine foods. She has not had a migraine since. Now my Sicilian mother-in-law may have played some role in that. That's a separate issue with stress. But the point is, It was the histamine sensitivity.

Yeah.

Right. So each time I pulled a nail, I treated the Lyme, she got better. It's like peeling an onion in these people. Mm-hmm. Right. So yes, the leaky gut and the microbiome issues also, we now with the gut-brain axis, what we know about the microbiome in everything.

That's the other, that's the other main trigger you talk about.

Yeah. The microbiome.

So I mean the, the interesting part about every disease I looked at from ADD, ADHD to autism, to Alzheimer's, to allergies and asthma, to cancer, cardiovascular disease, chronic fatigue syndrome, fibromyalgia, digestive disorders, irritable bowel, inflammatory bowel, immune disorders, autoimmune disorders, rheumatoid arthritis, MS, um, mood disorders, depression, anxiety, OCD, psychosis, bipolar. All 16 MSIDS factors showed up in all these diseases. And my wife is one example.

Yeah.

I had to go after every one of these. And now she's in perfect— she's 8 years in remission since she did the Dapsone protocol for Lyme. It's a 9-week oral protocol and she's 8 years in remission without one symptom.

That's incredible.

But she's gotta be strict with her diet. Right? Staying off Candida, hypoglycemic diet. We both share similar, like, blood sugar swings if we're not careful with our diets.

I mean, it's, it's so true. It's like, you, you know, you have to go systematically through everything and it's not what we're trained to do. We're trained to the model that you talk about in your book, which is a single disease with a single label, with a single drug. And that's just not how the body works. We, no, it's just not.

No. And you know what's really sad for pe— the number of people, and I think you've seen this too, the number of people misdiagnosed that they would come in with MS. Right? Because they had demyelination and tingling numbness. They had optic neuritis. Their bladder wasn't working, except they were given the ABC drugs, Avonex, betaseron, Copaxone, Rebif, God forbid rituximab. Their B cells are gone. They weren't getting better. So it's not a question of do you have MS? It's a question of where's the demyelination coming from? Right? In these patients, we would find chlamydia pneumonia, Bartonella, Lyme, mold, heavy metals, mercury, lead, arsenic, microbiome. And when we treated these things, The demyelination got better. And that's why the drugs weren't working. And I found with a lot of these autoimmune illnesses, I, I had a patient recently with rheumatoid arthritis, true rheumatoid, CCP positive rheumatoid factor.

Yeah.

But he had migratory joint pain. So that's why the methotrexate wasn't working is we had to treat his Lyme and he had drenching night sweats and he was like 40. And I said, oh, you're in menopause. He, he didn't get the joke initially, but it's like, it was Babesia, of course. Yeah. Right. We treated it and now the autoimmune disease was much better.

Yeah.

So he had a true autoimmune illness. But then I have these other people, and you said it before, these autoimmune markers.

Yeah.

They're showing up. The Lyme is causing antidopaminergic antibodies, antithyroid antibodies, anticardiolipin antibodies, antimielin antibodies.

Yeah.

It's, it's causing this auto— so people come in with these autoimmune illnesses, but it's Lyme causing molecular mimicry. Your immune system is attacking the bug, right? The flagella, and it's causing these autoantibodies. It's not an autoimmune illness, it's the bacteria and the toxins that are combining to cause this type of inflammation. Yeah.

And just, just for people listening, when you say Lyme, you mean the whole spectrum of tick infections. Yes. As a whole, which is dozens.

Right. It is never Lyme disease anymore.

Right.

I, I called it the 3 Bs, Borrelia, Babesia, Bartonella. That's one of the chapters in the book. Yeah. Yeah. Because these 3 are showing up in the vast majority of people at this point. Sure.

Yeah. Yeah.

So, so the microbiome stuff is a big thing too. And leaky gut and food sensitivities.

What did you and I know about short-chain fatty acid bacteria years ago? Right. Driving inflammation. I mean, I take prebiotics, probiotics, and postbiotics every day because I found out that the microbiome is so important.

Yeah.

From everything from autism to Alzheimer's to auto, right? You can't get around it at this point.

Yeah.

Because of the gut-brain axis. So, you know, that's how I support my health. I, you know, do prebiotics and all of this every day.

Yeah.

You gotta feed your, you're not just eating for you, you're eating for your microbiome.

Yes.

Yes, of course. You know, you, you also said something in this long list of litany of diseases, which I think is worth doubling down on, which is all these conditions seem like separate diseases. They all have separate specialties. They all have separate experts that have to manage each one with all their separate cocktail of drugs. But what you're saying here, is that all of these have similar underlying causes. Right. And that if you treat those underlying causes, the downstream effects tend to get better without treating them directly.

Correct.

So that's a big aha for people.

And that's the problem in medicine. The way we were taught is name the disease, throw the drug at it, but you didn't get to the root causes of why they were sick.

Yeah.

You know, even in autism, I, I recently had a young patient, 12 years old, the mother had congenital Lyme and no one ever checked.

Yeah.

And the boy was living in a very mold toxic environment. So this kid at 12 years old, social problems connecting, right? We gave him Dapsone combination therapy for treating the Lyme, treating the Bartonella, pulled out the mold. Miracle. The kid's brain woke up. Now, the kid had been sick for 12 years and everyone had given up with him, you know, regarding that he had autism. There was nothing we could do. So, you know, we clearly need randomized multicentered trials and all of these things, right? There's no doubt. These are all, you know, anecdotal stories. But what the medicine says, what the science says, with over 2,000 references, by the way, you know, in Ending Chronic Illness, is there are 16 factors underlying all of these illnesses. So no matter what you're calling the illness, if you're tired, if you're achy, if you have pain, if you have brain fog, if you have mood disorders, you can't just take SSRIs and say, right? I mean, you know, Bobby Kennedy Jr.'s going after it right now with it to get people off of them. But if you have Lyme and Bartonella driving your illness with your mood disorder and mold, it's not gonna be enough. You've gotta get to these root causes and even trauma. I mean, I have to do vagal limbic retraining. I, you probably do this the same.

Yeah.

We find that probably at least a third of our population has such severe trauma that even if I address these other causes of inflammation, if I don't do limbic retraining with the Annie Hopper Dynamic Neural Retraining or Primal Trust or Gupta Amygdala Insula Retraining using the Apollo Neuro or the NeuroPod, getting their vagal system and everything in order, they will not get better, right? It's like—

It's resetting the neuro— autonomic nervous.

You've gotta reset the autonomic nervous system. It's— so that's why all of these 16 points are so important in these patients.

And all the things you're talking about, all these diseases, whether it's dementia or autism or depression or heart disease or cancer, or any of these chronic fatigue syndromes, all these things, they're all tied to inflammation. So autism is inflammation in the brain. Alzheimer's is inflammation in the brain. I wrote an article years ago basically about how, you know, autism and Alzheimer's are very similar. If you look at these patients, they have a very similar profile of genes. They have very similar biomarkers that are abnormal. They have like very different manifestations, but it's very, It's very interesting.

It's funny you say that cuz I just did a Medical Detective Substack on it.

Mm-hmm.

The mTOR pathway, right? We're using, uh, people using rapamycin and other things to get to it. It turns out that with autism and Alzheimer's, it's the same biochemical pathway. Yeah. Right. So they're, they're, they just don't have enough autophagy. They're, they're not getting rid of their damaged mitochondria. They've got an ongoing inflammatory response. And if you give sulforaphane glucosinolate, broccoli seed extract to the autistic population, mm-hmm. They did it at Johns Hopkins. Out of 30 of these kids, their brains work. Yeah. And the same thing with the Alzheimer's. So you're right, autism and Alzheimer's on a spectrum of brain, of neuroinflammation.

Yeah. It's all neuroinflammation.

And so instead of naming it, right, where is the inflammation coming from? And that's the whole point of End the Chronic Illness.

Yeah. I think that's what Sid Baker talks about, the naming and blaming game. We name the disease and then we blame the name for the problem. Oh, the reason you have joint pain is 'cause you have rheumatoid arthritis. No, that's just a name that we give to people who have that kind of joint pain. It doesn't mean anything about the cause. It could be mold, it could be metal, it could be Lyme, it could be a million things. The leaky gut. You also talk about one of the factors being vitamin and mineral or nutritional deficiencies. Can you talk about that? Because people think, sure, you know, we're, you know, we don't have malnutrition in this country and we're all eating plenty of food. And what's the big—

No, in the, in the top 6 root causes of inflammation, what I call the, you know, rivers of inflammation going into an ocean of inflammation, um, number 5 is vitamin mineral deficiencies. And what we're finding because of all the toxin loads is when you do not just serum minerals, and you know this well, I'll check magnesium, you need it for 300 detoxification enzymes, you need copper for superoxide dismutase, um, I need zinc for, you know, phase 1 liver functions and inflammation. When we look intracellularly at the red blood cell zinc, the red blood cell copper, the red blood cell magnesium, we're finding up to 20% of our patients are deficient, which means you cannot detoxify properly and deal with inflammation.

Yeah.

So, you know, somebody may have, for example, a normal or slightly low B12 level, but their methylmalonic acid level is high. So yeah, we're, we're finding a huge amount of vitamin mineral deficiencies. And a lot of this is because you're fighting these infections, you're dealing with all these toxins. You're depleting your system, including depleting glutathione. I don't know if you knew this, but I wrote the first article in the world literature in COVID-19 in April 2020 on glutathione and how it helps with COVID And what I didn't know at the time, not one of my patients died from COVID-19, not one, because I was blocking the first major inflammatory pathway I discuss in the book, NF-kappaB. We were giving all of our patients N-acetylcysteine, alpha-lipoic acid, glutathione. I didn't know at the time that the virus needs to lower glutathione to replicate.

Oh, amazing.

And I also didn't know that NAC was blocking von Willebrand factors so they weren't getting microclots and dying from it. So I was giving them the right treatment. I just didn't know why at the time. And then we were stimulating the Nrf2 pathway, opening up detox using curcumin, turmeric, broccoli seed extract, resveratrol, green tea. By simply doing these things with a little bit of vitamin D, you know, some extra zinc, I was giving them Immunotix 3,6-beta-glucan. By simply doing these things with a little bit of low-dose naltrexone, one of my favorites also for blocking the third pathway and LRP3 inflammasomes, not one patient died and only 2 were in the hospital. And I saw very few long COVID cases in my practice with it.

Yeah, it's true. I mean, it's, it's the nutritional deficiencies are quite significant. And, and I think, you know, with Function Health, the company I co-founded, we're doing, you know, now we've, I don't know, we've over half a million, half a million members. We've done over 100 million lab tests. 70% of people are deficient in one or more nutrient, not at the level you or I would think would be okay, but at the level the lab reference range thinks is okay. Like a vitamin D of 30 or a ferritin of 16 or homocysteine of like 14 or So like the numbers that are even greater than that, when you look at what the optimal ranges are, it's staggering. And vitamin D, you know, should be over 45. The 30 is their cutoff. So all the, all within their cutoffs on the lab, we're still seeing about 70% of the people deficient in one or more nutrients. So you're right. These nutrient deficiencies are so important and people don't understand that what they do is they basically keep the wheels of your biochemistry working. And if, if, if it's, if they're not adequate, then the system can't run and you You get, you know, kind of like, uh, kind of rusting. Things just kind of lock down. The last thing you kind of talk about in, in your 6 principles is sleep. But I'm, I'm wondering why you focus on sleep versus stress. 'Cause I think, I think of stress and sleeping under stress, right? But you, you focus just on sleep.

So it's interesting that I also found with sleep, same thing, the 16 same mSIDS factors are underlying sleep. But in my population of Lyme, these people don't fall asleep. Um, it takes hours to fall asleep. They keep waking up in the middle of the night. They sometimes have hypersomnolence. They're sleeping for 16 hours. They're not refreshed. I have patients who came in on Ambien, Lunesta, God knows what, they still could not sleep. So I mean, you know, when you, when you don't sleep, IL-6, interleukin-6 is high, it's driving inflammation. But ultimately we were even finding some of our thin young women had sleep apnea, like something I would never have expected to find. It wasn't just men with BPH, you know, that was causing it. It wasn't just menopause with low estrogen. We were finding multiple factors. And of course stress is one of them, of course. But the problem is we were finding these overlapping factors that until I treated the Lyme and the Bartonella the mold and healed the microbiome, right? And, and dealt with stress. And I have a whole section under L is for lifestyle and meditation. I mean, you and I both know we're living very stressful lifestyles for most people. The sleep, I found that when people couldn't sleep, whether I treated the infections, I detoxed the mold, if the sleep was still off, I was having a tough time getting these patients better. But they were all interrelated, right? Because the mold was causing problems with it. The Lyme and Bartonella was causing—

with the sleep.

Yeah. So it, it, it was all interrelated. It wasn't just, oh, I can't sleep at night. You know, why isn't my Ambien or Lunesta working at this point in time.

So you're able to get people who couldn't sleep back to sleeping?

Yes. Yeah. I mean, once the infections were treated, we detoxed the mold, the microbiome was treated, right? The mineral deficiencies. Once we started dealing with these first 6 rivers of inflammation, people were able to get to sleep a lot easier. Also, by the way, with the limbic vagal retraining.

Yeah.

Right. I mean, that, that was a key point in these people because when I, we're not, I don't wanna get too far into it.

Yeah. But I think, you know, I, I did Ibogaine. I've talked about it on the, on the show before. It's a, you know, it's an incredible plant medicine that has powerful effects on neuroinflammation and on mitochondria and epigenetics. And in one study, they looked at MS and they looked at the white matter lesions, which is inflammation in the brain before and after ibogaine and their symptom profile. And they were, there were only two cases in that report, but they both had like a 70% reduction in white matter lesions, which is unheard of. And they were able to get back to much more normal functioning. So I think, you know, There's a lot of really ways to sort of reset the system. It's, it's fascinating that, you know, you know, these, these plants and these other things like some of the supplements can have these effects.

Oh, absolutely. And, and in fact, you know, I recently published an article in the Journal of Alzheimer's Disease Reports. I'm, we can get to this just briefly about, yeah, I wanna get it. I reversed for the first time ever in the world, the most sensitive and specific biomarker for Alzheimer's, P-tau 217. Yeah. So again, we're dealing with neuroinflammation. But where did it come from? In my patient, it was coming from multiple MSID factors. It was Lyme. She had exposure to Babesia bartonella. She had heavy metals, she had metabolic syndrome, she had food allergies. We need to treat it all. But interestingly enough, we were finding that when we treated the Lyme disease with the 9 weeks of dapsone combination therapy, and she was sick for 15 years, by the way, with positive rheumatoid factors, with joint pain, some cognitive issues, which she didn't think were bad, completely reversed p-Tau 217. Now what's interesting is that that the Cochrane report, which came out about one week before my article got released, said, hey, we have no good things to treat Alzheimer's at this point. The article comes out one week later, and what I did is I proved the hypothesis, right? We're in the middle of an Alzheimer's epidemic where the NIH said that 42% of people over 55 years old are now going to become demented.

Frightening.

I mean, it is really frightening, especially when they say we don't have answers. So there was always— they looked at autopsy studies of Alzheimer's patients and they would find between biofilms, amyloid, and phosphorylated tau in the brains. So there was an association, but they couldn't say causation. This is the first time I proved causation by completely reversing this biomarker, P-tau 217, with this 9-week pro— and this woman was, by the way, was sick for 15 years.

And the symptoms got better.

Her symptoms, her joint pain got better. Rheumatoid factor reversed. 'Cause it wasn't rheumatoid arthritis. It was from the Lyme bacteria driving rheumatoid factors. We proved that.

What about her memory?

It also improved. She thought it was her meditation that was keeping her stable, and she noticed after she was done, it's like, oh my God, I'm so much clearer. I, by the way, I have a second patient. I just did the same. I haven't published it yet. We reversed his beta amyloid ratios with Dapsone. So here, so here we have an Alzheimer's epidemic where I found that all 16 MSIDS factors are associated with it. The Cochrane report is saying, hey, we don't have anything good out there to treat. And the drugs that are used for it, Lecanemab, Donanemab, they lowered phosphorylated tau by 23% in almost 7 years. I lowered it by 70%. By 63% in 9 weeks. Yeah. And that was because it was the infection driving the amyloid and the phosphorylated tau. And unfortunately, you go to a neurologist, they're not even gonna check you for Lyme disease or Bartonella or mold when you have Alzheimer's disease.

Right. And it's important to find out. I mean, people, people think, you know, Alzheimer's is one of those things there's nothing to do for it because of the bad drug, you know, debacle we have in terms of poor drugs and, and drugs that don't really work based on billions of dollars of research and hundreds and hundreds of studies. But, but what you're saying is using this approach, which is looking at root looking at treating the whole system, peeling all the layers of the onion, you can actually start to see changes in these people. And I've, I've seen the same thing in my practice. And Dale Bredesen, who's quoting a quote on your book, also has done this. And you know, for, for us out there doing it, we, we sound a little bit like quacks because, well, why we're reversing Alzheimer's? Well, it isn't really, Alzheimer's is just a, a symptom.

It's a neuroinflammation at this point.

And so if you can reduce the, the load on the brain, it, it can improve. Same thing with autism or ADD or depression. And, you know, and Chris Palmer's done this work at Harvard with schizophrenia, psychosis, bipolar disease. It's a trial program. Published, I think the other day on ketogenic diets was a randomized controlled trial for bipolar 1 and schizophrenia and psychosis showing reversal. So the data's really starting to emerge around this and, and ketogenic diets work by reducing brain inflammation. That's how they work. Your, your work is so important on the, on this. And I think that I, I wanna kind of double down on, on what you've been kind of alluding to, which is this DAPSON protocol. 'Cause it's, you, you mentioned a few times, you're like, what are you talking about? And what does it, what does this do? And how does it reverse Lyme? How does it reverse Alzheimer's? Like, Tell us about what it is, how you discovered, because you and I worked together with many patients and often I would say, hey, I got this complicated patient with these 3 ticks or this thing, what's the best drug protocol? And you'd kind of coach me through it. That's probably started out doing that 25 years ago with you. But this is kind of a newer iteration of your thinking on this. Because I think a lot of that, you're a part of the ILADS Society and—

I was one of the founding members of ILADS.

Founding members. And you and I both seen people who've just been on years of antibiotics, on IV antibiotics, on heavy doses. And often they don't really get that much better. I really worry about that approach.

Yeah.

So, no, I, and I do too, by the way. So, and that's why I never use long-term antibiotics anymore.

Yeah.

The real key point for me is about 10 years ago, Johns Hopkins researchers found out that Lyme was a specific type of a bacteria called a biofilm persistor bacteria, like tuberculosis and leprosy. We knew that Lyme persisted, at least those of us who've been treating it for a long time, cuz there's a lot of medical controversies, but it's definitely a persistent infection in many.

I mean, meaning the, the traditional medical establishment doesn't quite buy chronic Lyme disease.

Correct. They call it post-treatment Lyme disease syndrome. We don't know why people are sick. It's like you should read the 10 articles at this point. Well, 10 I published and 1 by Tufts where we've shown reversal of all of these symptoms using Dapsone combination therapy. So how did I come up with it? So when Hopkins discovered it was a biofilm persister drug, I remembered from Mount Sinai when I was, this is during the HIV epidemic, we would see these people come in with Mycobacterium avium intracellulare and TB. I was used to using INH, rifampin, pyrazinamide, and I said, you know, I wanted an excuse to use these TB-type drugs 'cause they were specific for biofilm persister bacteria. I looked at the qualities of dapsone.

So tuberculosis is one that's known in traditional medicine to be this, and that's why we use those drugs.

Absolutely.

Yeah.

So I looked at dapsone and it was, all right, it gets great penetration into the brain. Maybe I don't have to use IV drugs, which is true. I've never had to use IV drugs anymore since dapsone. It's amazing penetration in the brain. Um, number two, it blocks NLRP3 inflammasomes in the brain. So with Alzheimer's disease and autism and many of these, uh, different diseases, diseases, we know that there's an inflammatory pathway in the brain that gets switched on. Dapsone is an inflammasome inhibitor.

Yeah.

So in a study by Lee et al. with like 3,000 to 4,000 people over 16 years, he gave 'em 100 milligrams of dapsone. The rates of Alzheimer's were like this, and the people who didn't take dapsone was 6 times higher.

Oh.

So it's lowering inflammation in the brain, great penetration. It has antimalarial properties. It hits Babesia, not great, but about 25% of the cases. It's used for autoimmune diseases. We talked about all the autoimmune manifestations of Lyme, right?

And it's a biofilm persister.

Nature drug. So it checked all the boxes. So I started trying it and I published my first article, 2016, on 100 patients on low-dose Dapsone. Fatigue got better, joint pain got better, neuropathy got better, brain fog, headaches. It was the only thing statistically that didn't improve. But as I tweaked the protocol over the last 10 years, I got it down to 8 to 9 weeks at this point. And it doesn't matter whether you've been sick for 20, 30 years. If you have Lyme without active Babesia bartonella, without mold, this protocol will put about half of the people in remission. Inflammation from 9 weeks of antibiotics.

And it's not just dapsone, it's a cocktail.

It's a cocktail of drugs. So we found, and I did a study with Eva Schoppe from the University of New Haven in culture.

And by the way, this is a drug that was used for leprosy.

It is a leprosy drug, right? It's been around for 50, 60 years, right? They also use it, by the way, for Behcet's disease and a severe autoimmune illness. And so what I found is in culture, every time we added a drug, like when we added doxycycline to dapsone, It lowered the biofilm persisters. We added rifampin to doxy and dapsone. It lowered the biofilm persisters even more. We added Zithromax. So I came up with it because we found this 4-drug regimen sufficiently lowered these biofilm persisters. And if you pulse it, you cannot get rid of these persister bacteria by— with chronic antibiotics, it doesn't work. You've gotta pulse it. That's how you get rid of them. So we now do a 9-week protocol, which is not every day. Well, it's 9 weeks continuously, but they're on 4 probiotics with 500 billion of these different probiotics twice a day, right? With niacin, very low-carb diet. We don't see— I've had, by the way, seen a case of C. diff on this in years. No Candida as long as you're staying. And basically all the lab abnormalities of anemia and methemoglobin, they reverse within 6 to 8 weeks off the protocol. So right now I applied for an randomized NIH trial with a double-blind placebo multicenter trial. Unfortunately, it was turned down. Down. So I now have to reapply. I know Bobby Kennedy Jr. is big about Lyme. He wants to do something. But whoever the reviewers were— but I'm so confident. I submitted an R34 NIH grant because I know it's working at this point. But yes, it's a cocktail of drugs. But the beauty is all generic because I realize this is a worldwide epidemic where BMG Global Health said 1 out of 7 people in the world have now been exposed to Lyme, right? So we're dealing with a massive epidemic of Lyme. And by the way, same time, massive epidemic of Alzheimer's. And nobody has put These two together at this point.

And that's true. I mean, nobody's connecting the dots on that, but it's not that Alzheimer's is always this.

No, no, of course not.

And I think that's, you know, you kind of hinted in your book and I, in my first book I wrote, just because you know the name of the disease, it doesn't mean you know what's wrong with you, right? Alzheimer's is a syndrome. Of course. And it's got many causes and maybe a good cohort of those is ticks, but could be mold, it could be insulin resistance, it could be metals.

And look, even some of these drugs that are used out there, the anti-amyloid drugs, there may even be a place for them, but First, let's get rid of whatever the reversible causes of inflammation are. And that's not what the neurologists are doing, right? They're giving Aricept and Namenda and anti-amyloid drugs. We've got to get to the root causes of where the neuroinflammation is coming from. And that's what I'm highlighting in the chronic illness.

And you treat all— take patients with that same combination?

I do.

So it doesn't matter what the infection is.

Well, the beauty—

Because again, before it used to be this regimen for this one, this one for that one. Now you're saying everybody should get the same—

Well, so if it's Bartonella, Bartonella requires a minimum of 4 2-week pulses of Dapsone, but it's only 6 days of Dapsone. We found with Bartonella, Bartonella's actually much more difficult to treat than Lyme. If you don't have Bart, I can generally get you better much easier within this 9 weeks. But Bart requires about 2 to 3 months apart, just 2 weeks of antibiotics, short pulse, actually 13 days.

Separate.

Separately. If you have Babesia, mepronazithromax isn't working. The old drugs aren't working. So I have in my new book under the 3 Bs, tofeniquin. Tofeniquin is a newer drug for Babesia. We mix it with malerone and herbs like artemisinin, Chinese skullcap, Japanese knotwood, echornia. Uh, we find that when we mix these herbs with tofeniquin and malerone, we're getting much better results for Babesia. So you do have to treat some of these infections, you know, differently and separately. Um, but the beauty is, is we do have now some cutting-edge approaches that are getting much patient— many of the patients better.

And, and you also use, uh, In addition to the Dapsone, doxycycline, minocycline, Phampen, hydroxychloroquine, which is—

And the, the reason for Plaquenil, by the way, is it alkalizes the intracellular compartment. So these antibiotics are more effective, helps with the autoimmune manifestations. Yeah. Even hits the cystic forms of Lyme, another form of the bacteria that exists. So it took me a long time looking at the biochemistry of the bug and the science and the biology to figure this out. And, and 10 years later, you know, I've, I've published 10 studies, Tufts, by the way, published one that showed that this combination of rifampin-dapsone cures Lyme in the animal model. So now I have a culture study, we have animal studies, and I have 10 published studies with around 375 patients retrospectively, all statistically significant. Fatigue, brain fog, joint pain, muscle pain, nerve pain, day sweats, night sweats, neuropathy, it all gets better from the protocol.

And you also use methylene blue, which I find interesting. I do. So tell us about that, because I think people hear about it and people think, oh, they take these lozenges, their mouth gets blue.

Well, they're using it for Alzheimer's, right? I mean, they're using like low-dose methylene blue as a mitochondrial supplement for Alzheimer's. So one of the side effects of dapsone is elevated methemoglobin. It's where you don't carry oxygen well in the blood. So we started adding methylene blue because many of our patients, about 90%, have Bartonella. John Hopkins, again, they published that if you do for 6 days in culture rifampin, zithromax, and methylene blue, it kills Bart. So when I was designing the protocol, I realized I needed methylene blue to not only hit the Bartonella, but to lower the side effects of dapsone.

Interesting.

And it's got mitochondrial regeneration properties at the same time. At the same time. And we do a mitochondrial regeneration when we're done with the protocol anyway for all the free radical oxidative stress. So yeah, the methylene blue is an integral part of the protocol and we slowly go up to make sure people tolerate it.

It is also anti-infectious.

It is anti-infectious. And it's, they use it in the blood supply, by the way, to kill, I dunno if you knew this.

No.

In the blood plasma supply when they're treating for all the red blood cells are storing. Really? Methylene blue is what's used to kill all the infectious agents that's in our blood supply.

Oh, that's fascinating.

Yeah.

So it's anti-infectious. It protects against the side effects of the Dapsone, helps mitochondrial function, energy production.

And it's hitting Bartonella at the same, you know, when, again, when I designed it, I was looking at all of these factors at the same point. And, and again, I've been doing this for 42 years, right? With all these thousand, it took a while to figure this out.

Yeah.

You know, we're kind of there.

I know it's pretty, pretty crazy. I think it's, and you, you, you outline all these protocols in your book, right?

So what I do in Ending Chronic Illness, a lot of people, I, I did it like a cookbook in, in the chapter under the 3 Bs. I do this literally week by week. These are the medications, these are the lab tests you need to do. This is when you need an electrocardiogram to make sure your QT interval is good. It is written out literally like a cookbook that anyone can take Ending Chronic Illness to their doctor and they can just do it step by step so they know exactly the protocol. And I, I even put in here a low-dose Dapsone protocol for people that are sensitive, because many people get Herxheimer reactions where you're killing off the bacteria, the inflammatory response is huge. I, I told people how to do it much lower and slower, um, for those people who, um, and as an example, my wife, when we didn't know the dosage. We gave her Dapsone 50 milligrams for a year, repeated her test, PCR positive in the blood. I gave her 100 of Dapsone for 6 months, relapsed within a month or two. A patient came in, by the way, this is how I discovered the dose. A patient came in who was sick for 7 years, came in, he was his third month, fourth month on Dapsone. He comes in and says, doc, I'm feeling terrible. I said, oh, what, what are you taking? Well, I'm taking, you know, Doxy twice a day, rifampin twice a day, and Dapsone twice a day. I said, oh my God, you're taking too much. You're taking 100 twice a day. I said, stop it. Come back 'in a month.' He's been sick for 7 years. He comes back in a month and goes, 'Doc, I feel great. I have no symptoms.' I went, 'What?' I said, 'Stop. Don't take anything else. Just come back in 3 months.' Comes back in 3 months, no symptoms. Comes back in 6— so I said to my wife, 'Would you like to be a medical guinea pig? This guy took a double dose of Dapsone, 100 twice a day for 1 month, and he doesn't have symptoms.' And he felt sick because of the side effects of it. She— he was hurting badly when he did it.

Uh-huh.

My wife did it for 1 month. She's 8 years of remission. I had to figure out it's not long-term antibiotics. It would— it took me years to figure out the dose and how to combine the medications in a way that it was a very short-term effective protocol. And my wife was one of the first people actually who got better from it.

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Again, I've been following you for a long time and tracking all the different iterations of your thinking, and this is, this is definitely an evolution and it, it seems more elegant and, and it answers a lot of the questions that I have around these long-term antibiotic patients who just don't get better.

I, I do not do long. I don't believe long-term antibiotics should be given to anyone because you know the effect of the microbiome on the gut.

Yeah.

And it doesn't kill the Lyme.

Yeah.

It's suppressing the bacteria. Right. By the way, they've even shown in some of these you get more biofilm formation if, if you do this. So we need an entirely new approach, which is pulsing short-term while supporting the microbiome and then using these biofilm persister drugs like Dapsone. And, and I do believe, by the By the way, even in Alzheimer's, because dapsone inhibits this pathway in the brain, NLRP3 inflammasomes. I don't know why anyone has not taken dapsone like they did in the study from South Korea. 4,000 people, their Alzheimer's rates were like this. Huge low-dose dapsone.

And they used it for what there?

They were using for leprosy. But they found when they looked at the Alzheimer's cases, dapsone was stopping people from getting Alzheimer's disease. And it's 4,000 people over 15 years. That's incredible. That they looked at this.

That's incredible.

Wow. So let's kind of back up. We, we talked about all these 6 principal causes, the rivers of inflammation, ocean inflammation, right? The infections, the toxins, the microbiome, the leaky gut, food sensitivities, vitamin mineral deficiencies, and sleep. And then you talk about the 10 downstream secondary effects. And this is really when you have all these insults and you don't have enough of the right inputs, there's a cascading effect of dysfunction throughout the body that echoes. And it's all the systems of the body. It's basically a network and all the different ones are connected. Hormones, gut, immune, mitochondria, then detox. They're all, they're all kind of connected. And so this is how we think about things in functional medicine. But it's, you came to this through a different pathway and ended up in the same place. And I'd love you to sort of unpack the sort of the things that tend to go wrong because you can treat those directly, but if you don't treat the root causes, the six rivers, you, you, those things are, you might be able to move the needle a little bit, but they're gonna kind of not really get better.

Sure. I mean, and as an example, so one of the 10 downstream effects is mitochondrial dysfunction. If you have ongoing inflammation in your body, the mitochondria have nothing to protect them against all this free radical oxidative stress, right? It's not like the DNA that has histone surrounding it. So that's why we do a mitochondrial regeneration protocol after we do these treatments. But if you're somebody taking ATP 360 and CoQ10 and urolithin A and, you know, MitonR and the things I'm taking myself.

Yeah.

'Cause I'm doing my own biohacking, it's not gonna work. You may say, hey, I'm doing everything right. I'm exercising, I'm on a low-carb diet, I'm getting enough sleep, I'm doing mitochondrial.

Yeah.

Why isn't it working? Well, you didn't get to the first root causes of where the inflammation's coming from. Right. But also in this inflammation, it affects your hormones. Because the inflammation is affecting the hypothalamic pituitary axis. So men come in with low testosterone in their 20s with 100 to 200 testosterone, and they're getting beta HCG shots and they're getting, you know, testo— and it's like, hold on, it's the Lyme that's causing your low testosterone, right? And the adrenals are shot. Close to 100% of my patients have low adrenal function on a DHEA cortisol. And again, if you treat these 6 rivers of inflammation but you don't treat the adrenals, they're not gonna get better. I have a, I have a person, this guy was treating years ago. He was sick for about 8 years. We found Lyme, Babesia, Bartonella. We started looking for it and we found low adrenals. And before I even had a chance to treat the Lyme, and this was going through his hospital records, his cortisol were really low. And I said, all right, I'm gonna have to treat all this. But I said, let me give you some hydrocortisone for the, I mean, it was really low, literally Addisonian type low cortisol.

Wow.

He said, I don't wanna do it. They gave me prednisone in the hospital. I never wanna take steroids. I gave him an adrenal glandular. Now this guy had multiple MSID factors making him sick. Lyme, Babesia, Bartonella, the rest. Within a week of taking an adrenal glandular, he said, doc, I'm 80 to 90% better. So personalized precision medicine. Yeah. You know this the way I do. Even if you have 8 or 9 MSID factors on your list, it might be one factor that's keeping you ill. Yeah. And in a lot of the patients, it's adrenal. We do the mitochondrial, but you gotta definitely get the hormones. Balanced, but the other downstream effects is immune dysfunction. Many doctors don't check immunoglobulins subclasses. They don't check natural killer cells.

Yeah.

They don't do CD4, CD8. Well, if this is in an, you know, how do you check your immune system? Or they have autoimmune disease.

People don't really realize that you can actually test your immune system.

Right. So, and same thing, we check the autoimmune markers. One of the downstream effects. Yeah. Or you get neurological issues with brain fog and you're going from doctor to doctor and understanding why your memory's off. Right. And you've got amyloid and P-tau now maybe from other sources. Or psychological factors, trauma where you need the limbic retraining and then you're deconditioned. And a lot of people also, and you know this, have fatty liver. Yeah. One-third of the world's population has non-alcoholic steatohepatitis or fatty liver.

Now they call it metabolic disease.

Metabolic disease. Right. And they changed the name because they, and it, but just like PCOS is now PMOS, right? It's the same thing.

Reproductive.

Yeah. But it causes insulin spikes with metabolic syndrome.

Yeah.

And it's a silent factor for cirrhosis and for liver cancer.

Yeah.

And you could go to a doctor with normal lab tests, your liver functions are normal, but you're overweight. Overweight, the doctor doesn't check an ultrasound and there's the fatty liver.

Yeah.

We were finding it. So these 10 downstream effects is again, the liver, the immune system, autoimmune, mitochondrial, hormonal dysfunction, deconditioning, neurological issues, psychological issues, POTS dis— and POTS dysautonomia. People come in with long COVID to my practice, right? They're tired, they've tried everything. Nobody did sitting and standing blood pressure and pulse rates to find out if they had POTS dysautonomia.

Yeah.

Yeah. And so POTS dysautonomia is not treated with antibiotics, right? It's salt fluids, it's Midodrine, it's vagal retraining, it's limbic retraining. This too, because it causes fatigue, brain fog, anxiety, palpitations, right? POTS dysautonomia has a lot of the same symptoms as Lyme and Bartonella and mold. So that's why a differential diagnosis is so important in these patients. And dysautonomia shows up in 40 to 50% of our patients at this point.

I'm gonna push back a little on the differential diagnosis because that, in medical speak, that's what doctors do is they try to winnow down what your story is to one single diagnosis. But you're really talking talking about a true differential diagnosis, which is thinking through past the diagnosis. Okay, what is actually the root cause? What are the systems that out of balance? How do I treat all those, you know, 6 causes and 10 downstream factors? And, you know, you, you come upon the same framework that I have, which is that you have to deal with the root causes, but you have to also deal with the train wreck that happened as a result of those root causes, which is adrenal dysfunction or hormonal dysfunction or gut issues. You have to kind of clean up the mess. It's like, yeah, you have to put the train, if the train's off the tracks. You gotta fix the tracks, but then the train also went off the tracks and created damage everywhere. So you gotta clean that up. And, but if you, if you did the cleanup first and you don't deal with the root causes, people tend not to get better. That's the kind of trick people go, oh, and a lot of people out there are doing this. They're doing, they're giving hormones or they're giving, you know, gut stuff or they're giving different treatments, but they're not actually getting to the things that matter, like the mold, the tick.

I was surprised that when men come in in their 20s and 30s with low T and their testosterone is is off. For some reason, a lot of the doctors didn't know that Lyme and Bartonella, these things because of inflammation in the brain, cause low testosterone. And I will give them a little bit of Clomid, clomiphene, 25 milligrams, 2 or 3 times a week with Arimidex to stop aromatization. And I'll get their testosterone from 100 to 600 without beta-HCG, without shots, resetting the hypothalamic pituitary system, getting the hormones back in balance. So, you know, I have all of these tricks in the H is for Hormone chapter, you know, in Ending Chronic Illness. Because if you're a man and you want to have kids growing older, you can't be getting these shot, these testosterone Testosterone shots are shrinking your testicles by 15%. They're stopping your own hormone production. So yes, it's always about the root causes. But I find that, you know, even the functional medicine community, you see a complex patient that you're with them for hours. The beauty of the 16-point MSIDS model, it's a checklist, right? It's just make sure you've just gone through these things just to make sure you're not missing anything. And I find, you know, you can get caught up, you know, in these very complex patients where you might forget to check the mold or do the adrenals or because the patients are, you know, you're the first doctor really listening to them and taking the time to listen to them. You're right.

Checklist. And I do go through that mental checklist, you know, and I often have the echo of Sid Baker, who's my mentor, in my head. He says, have you done everything you can for this patient? Which means, what haven't I thought of? Like, what am I missing? Like, not what did I find, but actually what am I missing? And when you go hunting, you find stuff. And it may be the thing or may not be the thing, but you have to actually go hunting. And I think most doctors don't know how to hunt. They don't know how to hunt for the root cause. They don't know how to test for mold. They don't know how to test for metals. They don't know how to test for ticks. They don't know how to test for the gut microbiome. They don't know how to test for leaky gut, for food sensitivities. They don't know how to test for hormonal dysregulation. The whole gamut of things that you and I deal with every single day with our patients, and that gets these people who are literally incurable cured. It's not rocket science. It's, it, it's just good science.

But you know, you've gotta teach doc— I, I had a mentor just like you did with Sid Baker. My mentor was Dr. Rosenek. He was the most brilliant internist I ever met in medical school. He's the one who influenced influenced me like Sid Baker did for you.

Yeah.

And what he taught me is also to keep getting underneath to the root causes. But you know what, what I did in Ending Chronic Illness regarding that is I have, starting around page 30, if you have symptoms, like let's say you have neuropathy and you've been to all these doctors, you're on Lyrica and you're on gabapentin and you're on Elavil, you still have neuropathy. Maybe somebody's not checked you for Lyme and Bartonella and mold and heavy metal toxins that cause neuropathy. And what I find is I, and I did this in the book, I list the disease, right? The lab testing for it, right? And how you do the differential diagnosis so that people can actually work with their healthcare providers so they don't miss anything at this point. And, um, the Horowitz MCID questionnaire, which is on my website, cangetbetter.com, if you take this questionnaire, it will give you a probability of tick-borne, but also you bring it to your doctor. There's 38 items on there. You might forget to tell your doctor you have drenching night sweats intermittently, which was the Babesia, the parasite hiding in the background. So the beauty of the questionnaire questionnaire is we validated it in 1,600 people. It's an easy questionnaire to bring to your doctor so nothing is missed. Right. And so that's why—

Is that available in the book and online?

The questionnaire is in the book as well as these different— It's online also under cangetbetter.com. You can just download the questionnaire.

Cangetbetter.com.

Cangetbetter.com.

Yeah. And you've been referring to MSIS. What it stands for is Multiple Systemic Infectious Disease Syndrome. Just to ask, about that. What if it's not always infectious? Like what if, what if it's just mold or heavy metals? It may not be Lyme, right? How do, how does, how do you have the AI in there?

The way I'd now look at chronic illnesses after finding that these 16 factors are underlying literally autism, Alzheimer's, chronic fatigue, is it, you don't have to have Lyme making you ill. Absolutely not. But it could be, for example, chronic fatigue syndrome, ME/CFS, meaning you don't have Lyme that's causing it, but you may have Bartonella, you may have mold. I, I was surprised when I did the research on this book. Fibromyalgia. I didn't learn in medical school that mold toxins are showing up in 70 to 80% of fibromyalgia patients.

Yeah.

They're, they're getting drugs from their doctors for the pain and the, without understanding that the mold was driving the inflammation. I didn't know this, by the way, until I did my own research for the book. So these diseases for me are now kind of like Alzheimer's, MCID, chronic fatigue. Yeah. Meaning absolutely, you may not have Lyme, you may not have Bartonella, but you could have mold and heavy metals. You could have microbiome disruption, adrenal dis— the point Point being, you just go through the root causes and it's just a simple way of making sure that nothing is being missed. 'Cause both you and I have seen the miraculous results in getting people better with this. Yeah. 100%.

100%.

Yeah. With this type of protocol.

So we, we kind of dove into a little bit about the protocol for treating these infections, which is just for people listening, it's not what your traditional doctor will be doing or offering you, I promise. But it probably is what you should be doing. And, and the book, uh, Ending Chronic Illness is a great resource for that. Metals, we talked about chelation. That's a little more straightforward. Fixing the gut. I've done a lot of podcasts about that. That, that's, That's not that hard. I mean, it's, it's, it's, it's a, it's a process and it requires the 5R program we talked about in functional medicine, which is to rebuild your gut. The mold thing is a bit, a bit of a can of worms. So I want to kind of double-click on the mold thing because you, you keep mentioning it and it is a persistent thing. And then there's 50% of buildings are water damaged. In fact, I'm in my house now. Every year I have a guy come and inspect just because I got so sick from mold and almost died from it. And I paranoid about it. So every year I have it checked, anything wrong, I fix them. Most of us are walking around in a state of chronic stimulation.

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But I, you know, I, I, I don't know if you know this either, here, but about 10 years ago I had a series of things happen where I lived in an old barn in New England, not too far from where you have a place in Hudson Valley. It was an 1898 barn, so it was like 125 years old, you know? And there was mold in the basement and I thought, I didn't realize it. There was one of the windows that opened and leaked in. It kind of caught bad. I didn't really smell it, but I started having this cough. And I was running around writing books, giving talks, trying to change the world, the usual stuff. And I was coughing. I'm like, ah, it's going to go away. Ah, it's going to go away. And it didn't go away for a year. And then I was like, I think it's probably my house. So I had it checked, my house checked, and it was terrible. So I had moved out of my house, started renovating my house, and that was a whole project. And then I took an antibiotic for a dental, like a root canal that was infected. And I had the tooth pulled, but I took clindamycin and then I fell and broke my arm riding a horse in New Zealand. I was like, boom, boom, boom, boom. And I saw the lung doctor at Cleveland Clinic and I got prednisone for 10 days, which basically cured my cough, which was great. But then I just, my whole system collapsed and I got colitis. I got C. diff. I ended up just having this sort of cascading inflammatory problem and my whole gut was inflamed from basically basically my stomach all the way to my butt. And I developed ulcerative colitis. I was in bed. I lost 30 pounds. The mold was just devastating me.

Yeah.

And I, even though I kind of cleaned up the mold, I was, I was still, my system was in total breakdown and I thought I was gonna die. I literally thought I was gonna die. I couldn't work my months.

Moldiness is a lot more serious than people realize.

Yeah. It's so bad. Like, and it just, it, there was a cascading effect in my case. Right. But I want people to understand, This is a real thing.

And by the way, you can't just pick it up on doing a stachybotrys titer through, you know, Quest or LabCorp.

No, no.

So we mainly use real-time labs. Neil Nathan has been one of my mentors on this with Jill Krista.

Yeah.

And they're mentioned, by the way, in the book. But I use real-time labs from doing glutathione, getting people in saunas to mobilize the toxins and finding that up to 90% of my patients are showing up with aflatoxins, gliotoxins, trichothecenes. Yeah. I mean, they're showing up.

Mine were just so high. Yeah.

And the problem is, is that they're mitochondrial poisons and they, you know, they're affecting your immune system and they cause fatigue, brain fog, pain, neuropathy. They cause all the symptoms you see with Lyme disease, right? So I didn't initially, I was battling with Neil going, come on Neil, it's mostly tick-borne. And then I realized over time, no, no, it's a combination of fact. So, you know, so we did real-time labs and I found a protocol and I have it in there. I think it's under the L is for lifestyle chapter with an oral protocol. 'Cause I want people to be able to use things that are generic oral that anyone can get. So we're using oral, you know, phosphatidylcholine, phosphatidylcholine. I'm using one from Orthomolecular or Zymogen's Phospholine 4:1. We're using BioPC Pro. We're using a whole host and even GI detox from Biobotanical Research with bentonite clay and charcoal. And so I created a protocol and the protocol's written out also like a, a textbook, you know, a cookbook in the book where people understand exactly when you take these supplements with NAC, alpha lipoic acid, glutathione, phosphatidylcholine, when you take your GI detox, you know, how you do this, and we do get rid of the vast majority of these mold toxins doing oral protocols. Now, some people would do IV phosphatidylcholine, Patricia Kane protocols. My goal in doing this book was something that was accessible for the average person, just oral generic that anyone could do. And so that's why I wrote it out this way.

Yeah, I think, I think, I think the orals can work quite well. I found, you know, um, for myself, what rescued me was getting ozone therapy and hyperbaric oxygen together. Uh, it sounds like a crazy treatment, but I I was desperate and I did it and I was better within a couple of days starting to kind of recover. I also, I also did the intravenous phosphatidylcholine protocol, which I think is one of the most effective things that personally I've ever done to resuscitate my own mitochondria and get rid of toxins. And it gets rid of not just the mold, but it gets rid of a lot of cellular toxins and it reboots your cell membranes and your mitochondria. So this is a, you can do it orally. Sorry about People have a little trouble tolerating the high doses of phosphatidylcholine cuz it's like, it kind of makes you have to get diarrhea sometimes. Yeah. But it, but it's, it's actually, um, important to recognize that this is a real thing, that it has medical treatment even though your traditional doctors are not hearing about it or knowing about it. The, the testing, you know, I wanna kind of dive a little bit more on that. You talked about this Realtime Lab, which measures urine mycotoxins, and I've heard some controversy that that might actually pick up, you know, food mycotoxins that aren't actually—

it's, it's possible. There are food mycotoxins, about 25% are probably coming from foods also.

Yeah. So it may not just be what's in your system, but these are low molecular weight circulating mycotoxins or toxins that come from the mold that kept getting recirculated over and over. Even if you've removed yourself from the mold environment, they stay persistent in your system and you have to get rid of them. So that's kind of what the binders and other things you're talking about.

Exactly.

Yeah.

What about the other lab tests do you use for, for assessing this? Like the CIRS, the whole concept of chronic inflammatory response syndrome. It's almost like your, your kind of MCID syndrome, similar, but it's really specific on mold and there's specific lab tests. Do you find those helpful? Like the C4H, TGF-beta-1, MSH. MMP-9.

What I did, what I did, again, I have a specific chapter on inflammation and how to use these biomarkers. And it's, I did it as like a 3-level biomarker. Like the first level might be do a CRP, do a sed rate, do a C4A, look at VGF, vascular endothelial growth factor. So like there's a first set, I have 10 biomarkers I start with. The next level I do, for example, looking at functional medicine labs, like what's your free radical oxidative stress with lipid peroxides, 8-hydroxyguanine for DNA damage, protein carbonylation. Adrenals, T bars. And the third level, which I think people now need to get, is get your Alzheimer's biomarkers done. And these are, these are from Quest. Yeah. Like you can get a P-tau 181, P-tau 217, neurofilament light, and beta amyloid 42:40 ratio from Quest Laboratories. And it is completely covered.

Yeah, we do that. We do that with Function Health.

We now use, oh, you, yes. Yeah.

We have all the whole brain biomarkers on Function Health.

Okay.

And it's amazing. We're seeing people using them and then able to reverse.

I mean, I was shocked that 50% of my patients were showing up with these Alzheimer's biomarkers, right? And I just thought, oh, it's Lyme and Bartonella causing it. And then I, as I said earlier, it's like, hold, if you went to a neurologist with this, you're gonna be treated for Alzheimer's without finding out where the inflammation was coming from. So yeah, so I, I, I listed out these level biomarkers, which you've been doing actually for, of course, for years. You know, but the problem is they're not all specific in certain areas, right? I mean, VEGF we see with long COVID, but we see it with Bartonella. You'll see with cancer. You just have to know it. Not specific. Yeah, they're not specific. You have to know how to or pattern that they form. Correct.

And I think we're looking for patterns cuz any one biomarker is not gonna tell you the whole story, right?

Like somebody might have Lyme joint pain and their MMP-9 is high. The, the matrix metalloproteinase is high. It's like, okay, that confirms that the Lyme is affecting your joints, right? The MMP, you, you always have to clinically kind of put it together.

Yeah. When I, when I, when I first kind of got the aha about mold was probably close to 30 years ago. I had a patient and her daughter who came to see me and the, the mother had chronic fatigue and the daughter had juvenile rheumatoid arthritis. And they were sleeping in separate bedrooms. And I kind of, kind of took a history and I got that there was some mold issue and I started digging around. Turned out that I had their house checked and they had different molds in each of the rooms.

They were different.

And then I did the lab test, which is not available anymore. It was, it was Immunoscience, which is by Aristo Vaishdhani, who's—

I remember it. I remember it well.

And on that lab test, he, you could measure mycotoxin antibodies. So not just antibodies to the mold, which you could get, but also to the antibodies to the mycotoxins. And I, and I could see which molds they had in each, each the mother and the daughter, and they were different.

Mm-hmm.

And they matched the molds that were in their room.

Mm-hmm.

And the, because of this lab test and what we found with them, there was a lawsuit where they got to recover for, you know, to get their house redone from the insurance. Insurance companies did not like this. And the—

No, in general, the insurance companies do not like a lot of the things we do as functional medicine.

I mean, the insurance companies that paid for the house to be rebuilt. And so apparently, I don't know if it's true or not, I heard rumor that the lab was shut down by the sort of authorities in California because it was a California lab because of some of the pressure from the insurance companies.

Well, right now, I mean, there are labs like Vibrant Laboratories and Great Plains. I mean, there are other ones that now do, you know, some of these antibodies, but you're right, that was a very comprehensive protocol. Yeah.

I was like, wow, that, and now it's, you know, it's important to look because when you start looking, you'll find stuff. And I think that, you know, the sad thing is insurance often doesn't cover things for these patients. And it's, and sometimes the labs you're talking about are covered by traditional insurance, sometimes they're not. And I think, you know, people, it's unfortunate. We're, you know, I don't know if you're aware of this, but you might even wanna apply for this. But there's a grant that was established through the HHS Innovation Department at Medicare, Center for Medicare and Medicaid Innovation for $100 million to study functional in lifestyle medicine for chronic illness.

Oh, I didn't know about this.

Yeah. So there's a big pot of money. They're looking for centers to study. So if you're—

see, what I would like to do is take the 16-point MSIDS model and look at autism, ADHD, Alzheimer's disease, chronic fatigue syndrome, fibromyalgia, chronic Lyme disease, long COVID. Look at all of these diseases that are making people tired and achy with brain fog.

Yeah.

We already know they're associated, the 16 points, but how much is the causality, right? Yeah. So just like I now reversed the Alzheimer's biomarker for the first time, but we need a randomized multi- Center trial. I'd love to see that $100 million used.

Yeah.

That you take all of these major diseases affecting Americans where it'd be a great study. Yeah. I mean, look, 60% of Americans have one chronic illness. 25% have two or more. 86% of our healthcare costs and 70% is chronic disease. And our GDP is about to go to 20%.

And that's why Medicare is starting to go, wait a minute, we're, we're, we're, we're not getting this right.

No, we're, we're thinking about, it's got to be root, root cause medicine is the only way this is gonna be fixing what's going on right now. It's not what they're teaching in medical school of name the disease, throw the drugs at it. You've got to get to the underlying inflammatory factors.

It's true. My daughter just graduated medical school and she went into orthopedic surgery because of—

Oh, congratulations.

Because, you know, regular medicine's kind of screwed. This book should really be a textbook for doctors, honestly. I mean, it really should be. And I think, you know, for anybody who's struggling with chronic illness, who's hitting a dead end, who's gone to 30 doctors or 20 doctors or 5 doctors or 100 doctors, there, there are answers. And I think that's what drives you and I, I mean, we're probably what, you're in your 60s now?

I'm 70. I just turned 70.

Okay. Congratulations.

I'm, I'm catching up soon.

I'm sick.

67 this year. And you know, we're still going at it because we just see the desperation out there in people and we so, we so feel the suffering.

I mean, the most rewarding thing you could do, which I think you know at this point, is getting these chronically ill patients better that have been to so many doctors. It's like, what gives you greater joy?

Yeah.

Than getting these patients better who've been through, you know, the, the, the mill for years and years and years without answers. The, and I really learned this over time, the thing that gives me the greatest joy is It's always getting a chronically ill patient better. And, and that's why I wrote this book is I needed to get this information out for people so people would have it.

I'm working on a book now, which is, is similar. It's not, it's, it's not, it's not called Ending Chronic Illness, but it's, it's called like How to Live 100 Healthy Years essentially, which is a similar idea, but it's like, here's how the body actually works. What your, what your book really puts out there is this thesis that the map we had, that the constructs we developed in medical school to diagnose people according to specialties and diseases is outdated and that it's helpful to a point, but it doesn't really help you navigate this chronic landscape. I mean, this landscape of chronic disease, it doesn't help you navigate these patients who come in, who've struggled with vague symptoms that people often dismiss or the doctors dismiss or the relatives dismiss as, you know, they're just in all their head or this kind of way we kind of dismiss stuff that we don't understand. There is a map and I'm so grateful that you took the time. And this is a very long book.

I don't know.

It's 640 pages with over 2,000 scientific references.

But the references are not even in the book.

The references are, no, in fact, the references are on my website, cangetbetter.com. If you wanna see the references, go on cangetbetter.com and look on the bottom, you'll see the references.

I got the same problem. My book's like 800 pages and I'm like, and like I've got thousands of references and I have to put them on the website otherwise the book will be even 100 pages longer. I think you and I are part of a group, a larger group of physicians who recognize that the way we think about chronic disease is just flawed and that there is a, there's actually an emerging framework of systems thinking, of root cause thinking, of looking at personalized healthcare, personalized medicine. No two of you'll have the same disease. None of you'll have the same causes. No two of you'll have the same treatments. It's very personalized. And that requires, you know, a level of focus and understanding that, you know, most doctors just don't know how to do. And the framework you have is really, it's really powerful. And it's essentially what I do. I don't actually have the same labels, although a lot of this is overlapping almost entirely because it's just the body. But I think I have to wonder you know, in terms of where you're going next with all this in terms of the, the, the, the, the sort of Alzheimer's work, because that, that paper you published, and I wanna sort of dive into a little bit, you know, just to help people understand it. You know, you had a patient who had Alzheimer's who had elevated biomarkers of Alzheimer's and who also had tick infections, and then you treated the tick infections and their symptoms got better.

Alzheimer's biomarkers reversed.

Biomarkers got better.

And it's the first time in the world it's ever been done. I didn't realize that, by the way, when I published the paper, it's in the Journal of Alzheimer's Disease Reports, April 2026. So anyone can read it. But what, what astonished me astonished me is this P-tau 217, which most neurologists consider to be the most sensitive and specific biomarker for Alzheimer's. I reversed it completely to normal by 63% in 9 weeks with an oral antibiotic regimen. But here's the beauty is Dapsone combination therapy, the number one effect it always had was improving people's memory statistically in these 375 patients. But what I didn't have years ago, we couldn't get these Alzheimer's biomarkers, right? They didn't exist. Right. Now that I started testing people, it's like, oh my God, I possibly could reverse some of it. So that— this is kind of big news.

It's big news. It's almost like measuring a blood sugar for diabetes. You can see if it goes up, you can see if it goes down. It can be reversed, it can get worse depending on what you're doing.

And, and also that Alzheimer's is not just, you know, an end stage. There are 16 factors underlying it. And I prove the amyloid P-tau infection hypothesis that everyone's been talking for years. Like, chlamydia pneumonia can cause it, viruses can cause it, but none of the studies they have they done ever made a difference? That's what the Cochrane report was saying. So this is really the first study that gives people a glimmer of hope to say, if you were diagnosed with Alzheimer's, go through the model, right? Go through A is for, you know, ADHD, autism out. Go through the, the book, go through these 16 points and work with your doctor and then see if you do have any of these Lyme bands like we talked about for Lyme or even Bartonella, you need to be treating this because it may do it. Now again, we need a randomized multicenter controlled trial.

The case study.

We need, this is one case study. I, I have a second case study I recently did. Had it also. I, in fact, I kept him in my practice longer because he had it and he was getting divorced and I felt bad for him. He was a, you know, with me for like 30 years and I said, all right, I'll do my best. And lo and behold, the amyloid ratio, it reversed after he finished the Dapsone protocol. Again, it's two case studies at this point, but it means this is where the money needs to go right now. We should be putting our research monies into this.

Well, that's the thing, you know, when you think about it, like, you know, we spend billions of dollars on the wrong thing and even a few million in the right thing could make a massive difference. But the problem is, like you said, these drugs off-label. They're not, I mean, they're not, they're not necessarily making people money cuz they're all generic.

Well, that's why I'm giving them to people so that, you know, they are generic and people can afford them. Yeah.

But yes, but it's, it's the drug company aren't putting millions of dollars into these research studies cuz the government has to.

Right. But the top people in our government should really be looking at this cuz if almost 20% of our GDP is chronic disease healthcare costs, we're gonna break the bank in this country if we don't do something about it. Apart from all the suffering from people who have these chronic illnesses.

True. And I, I love that you, you came at this in a similar way that I did through the Buddhist lens of like understanding that, you know, being in service to people and helping relieve suffering and compassion is like a, it's a good way to live your life, you know?

You know, I, I like to think of myself as a good person, right? That I would have done this. But the truth is, is I really do think my Tibetan teachers had a huge influence on that. I wouldn't give up. Like I kept putting myself in people's shoes going, oh, you're not better. What else is it? What can I, like, I just would not give up.

Stubborn like me.

And 42 years later, it's like, all right, I've got these 13,000 people. We got better, right? We're explaining it. Yeah, so I think that motivation of loving kindness, compassion, and just not giving up, always trying to get people better, you have to have this as a physician. If you don't have this, you're just not going to go the full length.

And you also were sick yourself, so you understand it. That's the thing. Not that we wish all doctors get sick so they can be better doctors, but it does help.

And my wife, my beloved, had all 16 factors made her ill, and she's now 8 years without one symptom.

That's amazing. That's amazing.

Wow.

Well, thank you for writing this book. Thank you for the decades of persistent hard work, being a medical detective, figuring all the puzzles out of the body and helping people understand what they can do to actually get better from it.

Now this, you know, the beauty of this, this should give people hope that if you're someone suffering from chronic fatigue or aches and pains and neuropathy, brain fog, memory, concentration, mood disorders, there is hope for you. It's not like you just have to take drugs for the rest of your life or live with it. I basically broke down how you do the differential, how you look at the disease, right? What are the lab tests you need to do? What are the potential? And it's what I've done over 42 years to get people better. And every story, by the way, in Ending Chronic Illness are personal patients I have treated with autism, with Alzheimer's, whatever it was. These are personal patients I've treated myself.

That's true.

It's quite a career you've had. And people want to learn more, they can go to cangetbetter.com.

Cangetbetter.com and my Medical Detective Substacks that are free to sign up. Every week I do one. I did one today on heat stress and heat strokes because of the heat wave, the heat dome. People don't realize if you have cardiovascular risks and you're taking xylitol in your diet, which has now been linked, right, to strokes, right? And now you have heat stress that you are more at risk for certain strokes than you might have been from the past. So I actually did a Substack today on it just because of the what's going on now in our country with heat. But yeah, so the Medical Detective Substack, cangetbetter.com. I have a Facebook, Dr. Richard Horowitz. People can follow me.

And lots of books. Lots of books.

Lots of books.

Ending Chronic Illness is the new one. It's great. Everybody should get a copy. It's out now. And I'm— thank God I got my copy. I definitely have thought of you over the years as one of my mentors. And it's so great to have you on the podcast.

Mark, it's so great to see you again. It's been— it's been too long.

Yeah. If you love that last video, you're going to love the next one. Check it out here.