Episode #112: Morgellons with Dr. Eboni Cornish, MD

Welcome to Better Health Guy Blogcasts. Empowering your Better health and now here's Scott, your Better Health Guy. The content of this show is for informational purposes only and is not intended to diagnose, treat or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice or or his information to facilitate self treatment. As always, please discuss any potential health related decisions with your own personal medical authority.

Hello everyone and welcome to episode number 112 of the Better Health Guy Blogcast series. Today's guest is Dr. Ebony Cornish and the topic of the show is Morgellons. Dr. Ebony Cornish graduated from Brown University Undergraduate and Brown University Medical School. She completed her family Medicine residency at Georgetown University. During her training there, she volunteered her time by serving as a medical consultant on a D.C. human rights committee for individuals with disabilities. In 2003, as a Howard Hughes Medical Fellow, Dr. Cornish conducted translational research at the National Human Genome Research Institute of nih. She was an apprentice in the laboratory of Francis Collins, the current Director of NIH and the leader of the Human Genome Project. Under his leadership, she analyzed genetic associations of chronic illnesses. She is currently a member of the American College for the Advancement in Medicine, the Institute of functional medicine, and a 4M. She is on the Physician Advisory Board of the Charles E. Holman foundation for Morgellons Disease. She is a board member of the International Lyme and Associated Diseases Society Educational Foundation. One of her roles is the ILADS Physician Training Program which trains hundreds of doctors in the management of chronic tick borne illness. She is an expert in the treatment of Lyme disease, chronic fatigue, pandas, pans, biotoxin illness, fibromyalgia, among many other chronic conditions. In 2019, Dr. Cornish merged her private line practice with the National Amen Clinics. There she serves as a functional medicine provider and treats neuropsychiatric manifestations of disease from a holistic perspective. Dr. Cornish's approach to the treatment of chronic disease is to find the root cause of a person's health problems by performing a comprehensive evaluation of the body's various biological systems. She understands that all of these symptoms are interconnected and contribute to the emergence of disease as well as its resolution. Not only is she an amazing doctor, but she's also a mom of triplets. And now my interview with Dr. Ebony Cornish.

It is an honor for me today to have Dr. Ebony Cornish on the show. We have met several times in the past through I LADS and through the Forum for Integrative Medicine. Not only is she a bright doctor, but she truly and deeply cares about making a difference for her patients. I've been really looking forward to this conversation for some time now, and thank you so much for being here today.

Dr. Cornish, thank you for inviting me. I've been looking forward to this as well. Listen to your podcast the last two years and I learned a lot every time I listened to you and I've kind of been honored that you chose me to be on your show. So thank you.

Thank you so much. That means a lot. First, let's talk a little bit about how you were led to doing the work you're doing today. What made you choose these challenging, complex conditions that most of medicine doesn't even believe are real? Conditions such as chronic Lyme disease and Morgellons? Did you have some kind of personal health journey that played a role in doing what you do today?

That's an excellent question. One thing that happened to me early on when I first transitioned into functional medicine, I was kind of bored with family practice and my boyfriend at the time, who was now my husband, he said, I told him finally on my third date, my profession. And I was waiting for him to be impressed. Oh yeah, I'm dating a doctor. And he looked at me and he said, wow, you use quite a bit bit of pharmaceuticals, don't you? I don't think that should be the answer to your patients. There's more. And as we were early in our relationship, he gave me a lot of books on natural healing and just challenged me to think outside the box. And honestly, that was the title of my first job opportunity in functional medicine. And chronic Lyme was for doctors that think outside the box. So everything was kind of align there and with personal journeys. When I started doing functional medicine, it made me reflect on my own life because I had been diagnosed with what they call idiopathic conditions, meaning they didn't know why it was presenting. So when I was in training in med school at Brown, at about age 23, 24, I started to have seizures for the first time. I didn't have childhood epilepsy and they couldn't determine what the cause was. All my imaging was always normal. You know, EEGs were normal. And it made me realize that, okay, this is stress. And that was the conclusion by numerous neurologists. And my first seizure did take place as I was preparing for a board examination. And so I really kind of didn't think about it. But then over the years I've noticed that when I am stressed or when I don't take care of myself or when I eat poor, make poorer choices in food and lifestyle, it can trigger a seizure. And luckily when, you know, it's in control now. But when I have those onsets of downward spirals because we're all human and we have our moments where we might stay up to late and, you know, not get the rest we need, you know, I realized that I need to become more centered and focused. And then the second one was when we got pregnant with unexpected triplets. And that was a shocker. I mean, I cried when they told me. I just didn't believe it. And throughout the pregnancy, my family, especially my husband, I every day we were nervous. We're breathing, we're bringing in the world. Three humans. And I never forget my first doctor. He wasn't my OB gyn. He came in the room and he said to me, oh, only animals breed litters. You're going to have to reduce one of them. Right. That was my shock. And it's a colleague, I'm like, whoa. And the entire pregnancy, my husband and I, who had been practicing the vegetarian lifestyle, he's been vegetarian for years. We were strict about the diet. We were vegan, gluten free, fresh fruits and vegetables, green smoothies every morning all throughout my 32 and a half weeks of pregnancy. And I was told by doctors, oh, you can't do that, you must have this, you can't have such a restricted diet. Oh, what are you doing? You know, I was supposed to be on bed rest, I'm walking because I felt great, didn't have morning sickness. And then they just kept telling me, oh, you need to do more, you need to eat more, you need to eat differently. And surprisingly enough, I now have three three year old triplets who are completely healthy and are almost bilingual. They're learning Spanish now. So something worked. So that's kind of how I apply my lifestyle and my practice as one entity. And I learn a lot from myself and I'm able to use myself as an example for my patients.

Beautiful. So let's talk a little bit about Morgellons. How long has Morgellons been identified as a medical condition? And where did the name actually come from?

Okay, so in 1674 there was a person, Sir Thomas Brown, who actually visited a former French province called Logan Dog. And at that time he saw this outbreak of children who had horse hairs on their backs and he didn't know what to name it, so he called it Morgellons. And Morgellons itself is a derivative of the word nusculon, which means hooks or that are attached to small spindles. And then in 1682, Dr. Michael Irmolder, he drew these pictures of what he saw in children, which what he described as worm. Very similar to kind of this kind of collagenous fibers we see under microscopy today. Later on in 2002, the Morgellons research foundation started to open up to accept patients and stories of people who were suffering from symptoms consistent with the disease. And the first paper that I was exposed to was in 2006, when a colleague of mine, Virginia Sabley, she started to describe what it was she was seeing in her patient population. These non healing wounds, these fibers, and this Morgellon syndrome. But it's been around for years and it was described in, you know, 1674. People think it's something new, but it really isn't.

Yeah, Ginger Sabley, she's definitely one of my heroes in doing all of the work. And I know she's been a mentor and colleague of yours as well. What are the common symptoms that you see in your patients with Morgellons?

So typically I'll find patients who complain of kind of nebulous symptoms, crawling, itching, non healing wounds. Sometimes they'll get numbness and tingling at nighttime. The common presentation is always they see fibers that are being shed from their skin. But then you also have other systemic symptoms of fatigue and cognitive impairment that are also associated. But you definitely get a lot of the dermatologic manifestations. Joint muscle pain can also be associated with this illness. So it's pretty broad spectrum about the different etiologies.

Are there any common themes in terms.

Of patient stories, in terms of what might have led to the development of or presentation of the Morgellons itself?

That's an excellent question. A lot of times I might see some patterns. Typically I'll find patients have had exposures to some sort of infectious process. Okay. That's one of the big trends. I'll also find that patients who are exposed to very toxic environments, you know, report this condition. And a lot of patients, you know, believe it or not, just present with terrible lifestyle choices. You know, obesity, poor dieting, lack of sleep, all the things I mentioned earlier. So it's definitely consistent among the more jealous population of people who suffer from this chronic debilitating process to have those different causes. I see that constantly in my practice.

And do you? I've heard that in some cases people will have a history of some type of skin puncture or maybe they were gardeners or something. Soil based prior to the presentation of Morgellons Is that a common theme or not?

I have seen that in some cases. Not in all of them, actually. I was treating Morgellons when I was treating chronic Lyme before I knew what it was. And my first Morgellons patient actually had surgery and she saw the Morgellons fibers from her wound. She had been researched. She's the one who got me very involved in Morgellons, the Charles E. Holman foundation, and really educated me because I'd never heard of this condition. And after starting her care, I realized I was treating a lot of other more jealous patients and so were some of my associates. And I would think about this one story of a patient of mine who had terrible. Had sores all over her legs, arms. But she would get better as she went through her treatment for tick borne disease. And then when she had changes in her lifestyle or stress or other infections, they would, those sores would present again. And years later, when I started to study more about Morgellons, I told her, I said, let's look under the microscope. You have it. And she was like, oh, I'm so happy because I didn't want to tell you about these fibers. I thought you would think I was crazy. So, you know, that's kind of some of the stories that stick out to me.

One of the common questions when talking about Morgellons is, is it contagious? And so I'm curious, what are your thoughts on the possibility of it being contagious? We know in some cases, several people in the same household may present with Morgellons. When you're working in your medical practice, do you take any special precautions considering that possibility or do you feel like it's likely not containing.

So that's another great question. A lot of my patients, that's one of the first things they ask me right now. We don't have evidence, either published evidence or anecdotal, that I could be comfortable with saying that this is definitely a contagious illness. I think that just like with a lot of other chronic illnesses and infections, that families may have the same exposure, which could potentially lead to similar clinical presentations. Because we think at this time that Morgel and some of the etiologies could be infectious organisms. I don't actually think one infection is going to jump to another. However, those trends are, like I said earlier, usually due to those exposures. And when you take your precautions, I think you should take the same precautions you would take with all of your patients. Okay, good hygiene, cleaning. Those are Things we're all trained to do. But I don't necessarily think you need mask or, you know, anything that's even more severe. To take care of these cases, you should use the same sterility that you would use with anyone.

Are there any patterns that you observe either in laboratory testing? If we look at either immunological testing or inflammatory markers, toxicity markers, do you run any of the SIRS or chronic inflammatory response syndrome markers like C4A or TGF Beta 1 or MMP9? Do any of these seem to correlate to symptom presentation or severity in Morgellons?

So with my Morgellons patient population, and right now I would say it's over the number of 200. Through the last four or five years, I have seen typically high inflammatory markers. Some of the non specific inflammatory markers, C4A, ANA C reactive protein, TGF beta 1, which is also C4A and TGF beta seen quite often in patients who suffer from biotoxin illness. I also see that they also have those exposures to mold. When we do our due diligence, a lot of patients will also have igg subclasses, which this represents for your listeners, your immunoglobulins, your amount of immune cells into your body. They'll have deficiencies. And the one pattern I see most often is IgG2. Another colleague of ours, Kristin Gedrick, a few years ago at an ILS conference stated that that IgG2 deficiency is seen a lot of times in parasitic infections. So I definitely see that trend among patients and I'll see positivities for different chronic infections. Like I'll see chronic viral infections. A lot of patients have systemic candidiasis or yeast. Also I'll see in some cases positive tick borne disease or other chronic bacteria. But it definitely are. There definitely is some abnormalities that I see consistently among our patients.

What is the connection between Lyme disease and Morgellons? Is it your experience that patients with Morgellons also tend to have underlying underlying chronic Lyme disease?

That's an excellent question. We are just on the brink of discovery for understanding this connection. In about 2009, Ray Stricker and Gender Savely, they published a study on the newly emerging disease at that time which was called bovine dermatitis digitalis. And what they saw was that there were cattle who had decreased mix milk production, weight loss and they had these fibers that were coming from their hoof. And when they did staining, immunofluorescent staining and genotyping, they Found Borrelia. Well, taking it a step further, in 2013, Marianne Middleveen and other colleagues, they published a study where they looked at patients and the tissue samples and found that Borrelia burdorferi specifically was noted in pcr, which for your listeners is polymers chain reaction, the way you amplify DNA. They also saw Borrelia burdorferi in fish, which stands for fluorescent insight to hybridization. And under the microscope it was reproduced to show Borrelia burdorferi. So they published that and it was evidence that these wounds weren't self inflicted. And then take it a step further, in 2018 they published another study where they looked at about 30 patients who had Morgellon symptoms, actually had patients that were a part of that study, and they were found to have Borrelia burdorferi relapsing fever, Borrelia, which is another subspecies of this organism, as well as Bartonella, also using the same technical methodology that we used in our previous studies. So there's definitely been a published association between these underlying tick borne diseases and Morgellons. However, like I said, it's still early. I think that there are most likely just from anecdotal data, nothing published, but just my own experience yeast contributing to symptoms, biotoxin illness or mold toxicity contributing to these symptoms. And a lot of patients also have heavy metals. I also see a lot of my Morgello's patients who have the tick borne disease babesiosis, which is also a parasite. And I have quite well four patients who have the parasite Toxoplasma gondii. So there are quite a few different infections that have not only been studied or evidence based, but also I've seen in my practice. But we still have a lot more to do.

So if we look at the approximate 200 patients that you've worked with with Morgellons, about how many of those had some indication of chronic Lyme disease Out.

Of my patient population, when you see say indication, you look at it two ways, both clinically and from the testing. I would say about 70% of my patients have clinical symptoms that are consistent with vector board illness. And I would say from serology, there's about half the patients who are seropositive for vector borne illness, but some of them are positive for the clinical signs, symptoms and may not necessarily have positive testing. And as we know, that's one of the controversies with chronic vector borne disease is that the serology are sensitive. So I typically based it on the clinical presentation of our patients.

So if we look at a population of people with chronic Lyme disease that may also then present with Morgellons and those that may not have Morgellon symptoms. What do you think is the difference between those two populations? Is it a genetic link, is it a toxicity issue? Or are there some other factors that lead some in the chronic Lyme disease population to then present with Morgellons?

That's an excellent question and we don't quite have that answer yet. From personal experience, I have seen patients who have chronic Lyme disease have similar trends would be this is exacerbated from biotoxins or from lifestyle issues or from heavy metals and other environmental causes. But and I also see a lot of patients who do have what we call methylation imbalances, which are genetic problems that cause you to have problems, issues with detoxification. But I can't necessarily say at this point in time I can come up with a differential diagnosis of the causes of one presentation versus another. I think it's multifactorial, but we're going to find it one day.

What are the diagnostic criteria for Morgellons? And this came from a listener who had a question of could you have Morgellons without having filaments extra externally and skin lesions, but maybe have some internal presentation of Morgellons?

That's an excellent question. As we are going forward with trying to legitimize this disease, it's important that we kind of come up with this standard classification and qualifications for diagnosis. Personally and what I find among other doctors who do treat this condition, one of the requirements is that there are those microscopic filaments seen under microscopy. I actually use an electronic microscope in my office, which is 400x and I usually. I typically find fibers under the skin. There is question if someone has non healing wounds and fiber presentations, does that definitely mean Morgellons? The verdict is still out. But when I'm actually trying to justify that diagnosis and classify those patients, they have to have some of those symptoms. I reported earlier, the stinging, the crawling, the non healing wounds. Typically some patients may have exposure to chronic infections. And then the microscopic exam is very important. Now can I say 100% that everyone has those filaments that suffer from Morgellons. I can't. But as I said earlier, we're working hard to legitimize this disease to the general public and among our colleagues. So I do think it's important that we do utilize those skid exams and have some concrete data to present to others in our community.

Let's talk a little bit more about the fibers. Others refer to them as filaments. I think filaments is technically the more correct as I understand. What are they made of? Why is the body producing them? What do we think are maybe the underlying triggers for the production specifically of these fibers or filaments?

So the way I typically describe it, because these terms are used interchangeably, the filaments, as you alluded to, that is the most the more technical term. And the filaments are keratin and collagen as well in their composition, the filaments are what we see under electronic microscopy. The fibers are the way I look at it, what are what you see with the naked eye, what's shedding from the patient, what they typically report, because those filaments are typically not seen with the naked eye. That's why you utilize the electronic microscope for that. Clinically, I think that one of the reasons why patients may present with this condition, one of the associations can be the chronic vector borne untreated disease complex. Because we know that borrelia and its preference for collagen. Okay. I also think that there is a component of environmental illness that compounds this condition. So chronic infections as well as environmental exposures. And then as we earlier discussed, there definitely seems to be a subset of patients who have had surgery or scars of certain locations that tend to convert to this dermatological manifestation of disease.

Given that the fibers are made of, in part, collagen, we also know borrelia negatively impacts our collagen. But given that the fibers are made of collagen, does supplemental exogenous collagen in Morgellons patients make things better or worse?

That's an excellent question. And I have not found any direct correlation. I mean, it's inconsistencies with patients. I have a lot of patients who have no response to collagen. I have some patients who may have reported a response, but I think there are other potential causes for their symptoms. And it's not just that one thing. I haven't met a patient with Morgellons who simply use collagen as their only therapeutic intervention. So it's hard for me to have kind of a case and a control to that treatment option.

You talked a little bit earlier about some of the organisms that are associated with Morgellons in some of the research. Borrelia burgdorferi, relapsing fever. Borrelia, as you mentioned, bartonella. I've also heard H. Pylori in some cases. And so one of the things That I wondered relative to hormones, H. Pylori, it's so common in the general population. So if H. Pylori is seen in cases of Morgellons, is that more of a causal role or does it just happen to be present there because it's high in the general population Anyway, do we know if there was any testing done in control patients versus Morgellons patients?

That's a great question. And I think just like with the other infectious organisms we mentioned earlier, there are some that believe, and I do believe that H. Pylori could be a contributing factor to Morgellons presentation. It was that bacteria itself was actually cultured in some of the Morgellons fibers. So while it is just like tick borne disease is a very popular or kind of common presentation among the general population, I think that this infection does cause is the causative component of this disease. There has not been a study that I'm aware of and I learn something new every day, but not that I'm aware of. Currently that looks at case controls for Morgellons with H. Pylori.

Given that many people have Borrelia and Bartonella and H. Pylori but don't develop Morgellons, do we think Morgellons is caused by the bug or this community or mix of bugs or do we think it's the immune response or host response that really makes the disease? In other words, is it the immunological response that leads to Morgellons in some patients with Lyme disease?

Well as we know, tick borne diseases are able to evade the immune system. And Borrelia burdorferide specifically has the ability to do what we call molecular mimicry where it integrates its DNA in the host DNA and what that can lead to is a predisposition of autoimmunity. So in a lot of patients who suffer from vector board illnesses and other chronic bacteria tend to have an immunocompromised state already as one kind of predisposition, they're already immunocompromised. Then if you tackle on kind of the environmental toxins that they're exposed to and also some of the genetic mutations, inability to process histamine or glutathione, inability to process it, those are also confounding factors. So I tend to find that my Morgellons patients versus the patients with chronic tick borne disease that don't have Morgellons have a huge amount of other compounding variables and that contribute to their situation.

Let's talk a Little bit about some of the mental, emotional, psychiatric symptoms that often are present in Morgellons. Is your thought that those symptoms are of mental, emotional, psychiatric origin or are they the result of underlying infections?

That's an excellent question. And I get that all the time. It's the majority of my Port Jellens patients who present to my office, I'm never really their first doctor. Rare. It's rare. They tend to then to psychiatrists, dermatologists, other primary care doctors, and a lot of times they are misunderstood and even labeled delusional. There's a term delusions of parasitosis whereby patients are told that they have psychosis due to self inflicting wounds and textile fibers. So if you could imagine, if you've been on this journey whereby this disease complex, which in some cases, some patients can be mutilated, I've seen it look like leprosy in some cases when it affects the face of the extreme remedies. And they're giving these, they were getting provided these, you know, terms and diagnoses of exclusions and more importantly told that they do have psychiatric conditions because they have something that they can't quite explain that would affect the mood. I call it the life component. But then when we think about vector borne illness or the Lyme component, that organism, Borrelia burdorferi, shown to decrease the production of something called quinolytic acid, which helps your body produce serotonin. I work here at the Amen clinic, so I deal with a lot of patients who have neuropsychiatric manifestations of tick borne disease and their mood improves as you treat the underlying infectious process. So it is my thought that there are quite a few of my patients that not only have that Lyme perspective because they have a disease complex that people can't understand and they've been judged and, you know, dismissed. But also there is an actual scientific component leading to the decrease in the amount of that needed neurotransmitter, serotonin, that makes us happy. So I think it's multifactorial.

Yeah. And I think in Morgellons, unfortunately it's a condition where people are so commonly invalidated and told that it's all psychological. And so I think what I'm hearing you say, and my understanding as well, is there may be psychiatric symptoms in those with Morgellons, but that does not mean that it's a psychiatric illness or condition.

Correct? That's absolutely right. And it's important to differentiate the two. And that's why I go back to the need to have some set criteria for diagnosis.

Yeah, it's almost like Morgellons and pans or Pandas are both kind of at a similar place where there's still not a lot of acceptance. Acceptance kind of where we were with chronic Lyme disease 15 years ago. But hopefully from people doing the work like you're doing and really getting the message out there, hopefully people will start to understand that this is a very real condition. We all live in a very toxic soup in our environment. Something like we've never seen before. To what extent do we think Morgellons is an environmental illness? And when you're evaluating patients, what are the kind of key toxins that concern you in potentially being contributors to Morgellons?

I don't think that Morgellons is necessarily only an environmental issue. I do believe, however, that there are environmental triggers that contribute to this clinical presentation. Some of the most common things that I find, mercury and lead toxicity. A lot of my patients have dental amalgams that are rich in mercury or have had them removed not by a biological or holistic dentist, by a traditional dentist. And they tend to tell me, oh, yeah, I started to feel a lot worse after that. I have patients who are exposed to water damage, building and moldy environments, and also those who suffer from something we call Marcons, which is methicillin resistant form of Staph Aureus. So and I definitely, when I do some testing, one specific test is old testing, I'll find a lot of oxalates, pesticides, so other environmental components that are contributing to this presentation. But I definitely call it one of the M&Ms. I think about is Morgellons and mold. You know, there's a close, close connection. And if any providers listening are treating patients who have these chronic illnesses or infections, skin not quite healing and they don't quite understand it, look at their environment, you know, and that's what all that's even with any chronic illness.

What is the role of mold, exposure.

Of mycotoxins and the development of Morgellons? Is it that they may potentially be dysregulating the immune system? That kind of opens the door for Morgellons. And I'm curious, do you find a correlation between Morgellons and any specific molds or mycotoxins that are present in higher amounts in your Morgellons population?

That's excellent question. I definitely think when patients suffer from the chronic inflammatory response syndrome or sirs, that they have this chronic constant inflammatory process and the Way I view treating mold illness, it's a battle between the inflammation and your immune system. So typically, I'll have patients who have Morgellons who do have mold illness. And when I do some of the urine mold testing, one specifically Great Plains, they look for a mold, Chitobium globosum, that has been shown to be popular in or found in skin lesions. So I was like, oh, wow. And the more I tested patients, I found, like, I have about, you know, 50 to 60 patients who have that specific mold. But I also see quite a few patients who have Aspergillus. Okra toxin is very common among all of us, just from food. But I definitely see that toxin, that mold toxin in my patients. And surprisingly enough, Scott, I see quite a bit of systemic candidiasis. I've actually had some of my patients who I found who have Morgellons who have had very high Candida markers, you know, immune markers on blood tests, and I just couldn't get them to go down. We tried antifungals and the like, and when they cultured their homes with petri dishes, they found Candida in their homes or Candida on their pets. And it's like, wow, you know, maybe that could also be contributing to this presentation.

Yeah, that's very interesting. And I've seen that in some of the immunolytics testing, for example, with Candida showing up, and I've heard people suggest that that could be a source of re exposure. So that's interesting that you're exploring that possibility as well. You talk about the three MMs, mold morgellons and mast cells. What's the role of mast cell activation syndrome in the Morgellons population?

For those who are not aware of what the mast cell activation syndrome is, these mast cells are a normal. A part of a normal part of our immune system. So when they have some sort of activator, an allergen, a virus, a toxin, peptides, they start to do what's called degranulate, which is broken. I kind of look at it like popcorn popping. They're breaking down uncontrollably. And during that process, they're releasing numerous different mediators from those cells, and one of which that's seen the most often is histamine. Now, let's think about histamine. Just simply. Histamine is usually associated with allergies. Some people who have allergies, what do they present with? Skin rashes, itching. They can also have symptoms of insomnia. There's also a common association with this mast cell or histamine intolerance, with joint pain, muscle pain, cognitive impairment, malaise. So what I find is that some of my patients with Morgellons who have this numbness, tingling, itching, they tend to do well when I provide them compounded antihistamines like Ketopofen or even when I put them on histamine blockers, like combinations that block both receptors, H1 and H2, and then natural agents that lower histamine like quercetin and bromelain. Because I mean, it just makes sense, right? You have these patients with these skin symptoms, this itching, these rashes, these non healing wounds, and they also have these triggers. So when I started to find that it worked before I even knew about histamine intolerance, I'm like, wow, my Margellons patients feel better when I give them ketoxifen. Way to go. But then I'm like, oh yeah, now I understand my Morgellons. A lot of them are suffering from histamine intolerance and mast cell activation syndrome.

Some time ago, Dr. Omar Amin, who is a parasitologist, came to an interesting and for me unexpected conclusion around Morgellons. He called it neurocutaneous syndrome, suggesting that Morgellons is connected with dental material toxicity. I'm curious if you've observed any connections with your Morgellons patients and dental health, past dental work or specific dental materials that might have been previously placed in their mouth.

I am so happy that you asked that question because I would say a large percentage of my patients with Morgellons have dental complications. And I see what they report some of the biological dentists report as cavitations. We know that Borrelia can also make cavitations in the mouth. I see a lot of, you know, neurological, non specific gum pain. I've even seen patients who had fibers actually come out of their gums. So I, and I think a lot of patients of mine have the heavy metals, they have the old school mercury amalgams. So I do think there's something to be said about there being some sort of metal dental association with this illness, because it's definitely a very, very common pattern. In fact, all of most of my patients, I tell them to use good toothpaste that have binders like dental seat. And by research it's a great toothpaste that can some patients can alleviate those symptoms. I see a lot of yeast overgrowth or thrush in the mouths of my patients with very white tongues contributed to by Candida. So there's definitely an oral component to this illness.

Some have suggested that there's a correlation between Morgellons and genetically modified foods, Morgellons and chemtrails, Morgellons and microplastics in our environment. Do you feel that any of these play a role in Morgellons, in your opinion?

Well, that's a. The way I look at it, Scott, is this. As you alluded to earlier, we live in this toxic soup. But I also do my due diligence of trying as hard as I can with the limited evidence that we have available at finding something that is tangible, that is research. And who's to say that some of those other conditions cause this? Like you said earlier, Lyme 15 years ago was kind of an unknown illness. And I think Morgellons is where Lyme was 15 years ago. So you may interview me 15 years from now, and I will have more confidence in saying, yes, those are definitely contributing factors. But right now, what I can say confidently is that those are toxic that we're all exposed to that can compromise our health. But I don't have any, you know, kind of tangible, concrete answers that associated that they're associated with Morgellons at this time. But like I said, who knows, down.

The road, we'll come back and do this again in 15 years and see what happens.

I can't wait.

Let's move into treatment a little bit. So is the treatment, treatment of Morgellons any different from the treatment of chronic Lyme disease? Is it generally treated systemically as well as topically or locally where there's filaments or lesions present? And what are some of the tools that you found the most helpful from a treatment perspective in your Morgellons population?

And that's a great question, because I tend to look at all infections from functional medicine perspective, because a lot of patients, first thing they do, especially more jealous patients, they want me to eliminate the causative factor, get me the drug, get me better right away. But I call it kind of the preparatory phase, where we're stabilizing hormones, we're testing the gut, we're testing their toxic burden, and we're starting them on. Typically start people on agents that help bind, you know, like charcoal and clay, things like GI detox or Takasumi charcoal, and the list goes on. So I start them on that process because I understand that typically there is some sort of a toxic exposure in most cases. And I also focus on cleaning up lifestyle. It's one patient that I present on Recently, a patient is long standing of mine, she's now married, getting ready to have children. But when she presented, she had very, very terrible sores on her face. And she was very succumb to much scrutiny and was suicidal in a sense. And she wanted me to give her drugs day one. So I gave her some agents because there are things you can use over the counter like nizoral or antifungal shampoo or there are certain topical antibiotics that are helpful. But for her, I said, look, I'm not going to treat you quite yet. Because she was an uncontrolled diabetic. She had a terrible, terrible sleeping pattern. She just, you know, didn't. She was a mold inspector, home inspector. So she was exposed to mold day in and day out. And so I just made her initially some supportive methods for her sensations and I gave her a great nutritional plan, started her on a binder, other agents to help, you know, detox her, like nac, started her own probiotics. We did some work with her gut and got her hemoglobin A1C for diabetes and better control and changed her to a strict diabetic diet. She came to visit me. Six weeks without any antimicrobial treatment and 40% of her lesions had started to heal. And so that's what I tell patients because once they enter my doorstep, they're waiting for the answer. They want the treatment. You know, what they may have read on the Internet, what their friend might have, what they think should work, they want it right away. But I tell them Morgellons is multifactorial and there is a functional component. So just like when I used to treat chronic Lyme disease and I used to jump the first day at just giving antibiotics, you know, that was my initial treatment. I now treat my patients who suffer from chronic tick borne disease from a functional medicine perspective. So after we get some stability and I tell them you're committed to boot camp and you're committed to this process, then I transition to more of a treatment of the underlying disease process. So at that point, depending on what the cause is, we start either antibiotics. Some patients, we start anti malarials, some patients, we may start anti parasitics, but there's. And some patients may just use natural remedies as well, but there's no protocol for this. It's all individually tailored. So one Morgellons patient may have a completely different presentation than someone else by just tweeting certain antimicrobials. So I wish we had a textbook that worked for every patient. We do have some agents that have been shown to be successful among multiple cases. So a lot of the antibiotics we've seen, cipro, doxycycline, I'm starting to use, in my case, some disulfiram and some of the antiparasitics like ivermectin, albendazole, and even in some patients, antimalarials that treat the tick borne disease babesia. But it has to be individually tailored for that individual patient.

At your talk at ilads, you said that treatment must start with sleeping and pooping. And so I'm curious, how commonly are these issues in your patients? Why are they important? And what are some of the recommendations that you have for improving sleep and going with the flow?

So that's great. I always tell that's how I start every visit is with what I call neural endocrine support. Your brain and your hormone, your stress response, your mindfulness. Because we have to think about it. If we're not sleeping, our brains and our bodies aren't healing. When I find that I don't sleep, you know, as I said in the beginning, that's when I had seizures or other illnesses that plagued me. I'm like, wow, I didn't sleep well. It's that simple. You have to sleep and you have to get into a deep REM sleep in order for your immune cells to turn over, your gut cells to turn over to boost, to decrease inflammation and improve cognition. You're so surprised at how many patients I see who think they have all these debilitating illnesses. And I say, go get a sleep study because you snore. And they say, oh, wow, I'm much better, thank you. Didn't quite need your assistance. But that is the pillar to health. Quality sleep, mindfulness and relaxation. And poop. Now, poop is actually a Brown university medical school word and I use it constantly. Or it could maybe it's just a triplet mom word, I don't know because I see a lot of that regularly.

I bet you do.

But you know, even here, I got little. I get magic wands, my patients give me gifts. You know, they call me the poop queen because that's an area people are uncomfortable talking about. Bowel movement. But once again, we have to think about this very simply. Everything that we're exposed to and we eat, it goes through our digestive tract. And if it's not, that's the number one way we detox. So we talk a lot about detoxification strategies. Well, if a person is constipated, then that's going to impair their major detox pathway. You have to get it out. And I explain it to my patients that if I don't get, you have, I don't encourage you to successfully have one bowel movement a day. Then I've created a septic tank. And once people see that visual, even children, they're like, oh, I don't want to be a septic tank. Help me, please. And, you know, the gut is our second brain, Scott. And so a lot of, you know, you've had a lot of experts, experts here who speak on leaky gut and things like gut dysbiosis. But even if you take a step further, just look at tv, everything you watch, every other commercial is nausea, vomiting, diarrhea, irritable bowel, you know, people can't make it to bathrooms. And they're really pushing medication to help improve gut stability. Now, granted, I do that more from integrative and functional perspective, whereby I give them dietary changes, actually do a lot of stool testing to evaluate their gut microbiome and, you know, give them herbals as well, natural remedies. They feel better. You know, it's just very black and white medicine. If you don't sleep and you don't have bowel movements, nothing will work for you, pretty much, or it's going to take it. You know, you're going to have to work four times as hard at getting the right treatment protocol just because you missed the basics for sleep. I always encourage patients to make sure they're having a good sleep hygiene, that they are also not sleeping in front of the television, that they're decreasing their risk of exposure to electronic magnetic frequencies. So turn that phone to airplane mode, turn those devices to airplane mode. As a matter of fact, get them out the room. You're sleeping, you're supposed to be resting. I even have some of my patients participate in sleep courses that are online that get them in that regular pattern. I also encourage those who have severe insomnia to do more mindfulness activities throughout the day because sometimes we'll find that a patient has a lot of cortisol or stress hormone when I do testing while they're supposed to be resting. So that's leading to a non restorative sleep, even though they think, hey, I'm sleeping all night. But you're really not getting into that deep REM sleep. So good sleep hygiene, mindfulness, sometimes even taking baths, Epsom salt baths, which are great at detoxing right before bedtime and turning off those devices. Those are key as far as stabilizing your sleep pattern. That's imperative.

So let's broaden the poop discussion to a gastrointestinal health discussion. You talked a little bit about leaky gut. What are some of the tests that you like to perform to look at the health of the gut? Do you use the GI map? Do you have other tools that you like? And what are some of the top interventions that you often recommend to patients when you kind of implement your gut protocol, or what's called a 5R protocol?

So some of the tests that I use, a lot of times I'll use kbmo, which looks at food sensitivities, not necessarily allergies, but those foods that are causing your, what we call complement system to respond and to be inflamed, because that's a part of your gut health. What foods are we eating that are damaging you? That's kind of the removal phase. I also look at utilize tests like cdsa, test GI effects, as you alluded to, and GI mapp, because it's easy for us to say, hey, you know, your gut is impaired, but we have to understand the reason for that imbalance. A lot of times, we'll find the imbalance is with bad and good bacteria, an imbalance between the two, and we call that dysbiosis. We may also see that there's an imbalance because of too much yeast or other infectious organisms. We find that patients may not have the proper amount of enzymes needed to get the gut working or process their foods that they need to. They can also be deficient in things like butyrate, which feeds a small chain fatty acid that feeds good bacteria, or they could just have a lot of inflammation in the gut. So all of these tests screen for those different markers. And. And as you alluded to earlier, you have that functional medicine approach to the gut. The Rs, which I say remove, replace, rebalance, repair, reinoculate. So you want to kind of remove the junk, right? Remove the things that can potentially cause damage to your gut, like the stress, like the foods. I mean, a lot of patients, we talked a lot about treating with antimicrobials or antibiotics, but those also damage the gut. So I have to work three times as hard to help stabilize the gut in a patient that I'm using potentially toxic medications to treat Morgellons or any other debilitating chronic illness that requires that drug. And you also have to make sure you replace kind of that good cell layer. So I use things that are, you know, soothing to the gut, Things like glutamine that Helps stabilize that gut wall which becomes impaired with gut dysbiosis. I use a lot of immunoglobulin, things like mega mucosa, SBI protect. I used to use a lot of enterogram. And that gives you some of those immune cells, those immunoglobulins, and it works wonderfully at helping to heal the gut. And you also want to repair it. So replacing with the enzyme, repairing that gut lining and soothing it and reinoculate, that's when you start giving the good bacteria those good probiotics. Because if you try to give the probiotics too early in a patient's gut healing journey, they may have an adverse reaction to this because probiotics are still living organisms. So at times when you have that gut border impaired sometimes. And that causes that leaky gut. Well, sometimes things like good and bad bacteria leak out to the environment and also probiotics. And since a lot the majority of your immune cells are located in your gut, impaired gut or dysbiosis can cause your immune system to be compromised. So also the next are rebalance. You gotta relax because as I said, stress is a huge component of this leaky gut as well as gut dysbiosis. All right, so that's the approach I take. But it starts with the foods of the diet and removing the toxins.

You mentioned how important it is to address inflammation in the gut. We talked about mast cell activation earlier. Do you find that removing or reducing high histamine foods is an important part of getting the gut health back on track?

I definitely think it is. The histamine foods are some of our beloved foods, like avocado and spinach. But I typically have patients of whom I think are suffering from mast cell activation syndrome or histamine intolerance. And especially with my Morse patients, I have them do a two month challenge, lowering the histamine foods in their diet to assess if there is a clinical response. I definitely have patients and educate them about the importance of removing gluten because we know at our wheat, it's just not the wheat that our ancestors had and it's very toxic. And being cautious with the dairy as well and the sugars, but I definitely make those dietary restrictions and do elimination diets in all of my patients. But specifically with the Morgellons, the removal of the histamine rich foods, the sugar, the gluten and the dairy, and trying to focus on good grains, fruits and vegetables and lean meats, and that makes a huge difference.

And sometimes it's surprising the things that we used to think were healthy, like kombucha or bone broth, that now, in the realm of histamine and glutamate and some of these other things, we now kind of think they maybe not be so healthy for some people that are dealing with mast cell issues, for example.

And that's unfortunate because all of those things were recommendations. If you would interview me two years ago, I said, oh, that's across the board. But we know that fermented foods can possibly cause adverse reactions in patients who have mold illness and other things that you mentioned. It's just that, yes, they may have been healthy at one time, but just due to the environment we live in right now and this toxicity levels, the production is just not as clean as it once was. So with the bone and mineral, bone broth specifically, was a great recommendation that I would provide patients to heal the gut. And then I realized, oh, it may stimulate histamine release. So I've kind of withdrew that recommendation from my patients due to that. And the same thing with spinach. Spinach is great. You know, every patient eats spinach, but if you have histamine overload, it can be provoking. So, you know, and avocado. Who doesn't love avocado? It's the same thing. So one of my papers said, my patients told me, do you want me to eat rocks and paper? Dr. Cornish? Like, what are you telling me? And I said, no. There are numerous different cookbooks. You can look at institutions like, you know, the Institute to Functional Medicine. I just want to fix the gut. I just want to get you moving. And that same patient came back six weeks later and said, oh, thank you. I feel much better now. You really changed my life. But having that idea, and that's something that, you know, early on in my marriage, you know, committing to that whole foods lifestyle, having every meal with something that's a vegetable, eating green, maybe kale, and other cruciferous things. They help, and they help your immune system, and they help you fight off infections. So I tell patients, look, I can treat you. We can get better. But you have to meet me halfway, and you have to remove the junk. That's the first step. You got to move it.

Let's talk a little about pharmaceutical interventions versus natural interventions.

Do.

Do you find that Morgellons can be treated entirely naturally in some patients, or are the pharmaceutical interventions fairly commonly a necessity?

That's an excellent question. I have found that it's a combination of both. There are some patients who have come to my office who may have used Things they saw online like Silver and said that they were instantly, you know, treated, but then they kind of had relapses. So typically with Morgellon's cases, as I stated earlier, I work really hard at cleaning up the toxins and stabilizing our gut as we set that foundation. But I tend to utilize pharmaceutical interventions like antibiotics, anti parasitics, things that treat resistant forms of Borrelia, biofilm treating agents, and antihistamine and other supportive agents to help treat this underlying process because these patients are suffering and they're suffering from many nebulous symptoms and they need that support. However, I do simultaneously incorporate quite a few, both herbal and even in some cases homeopathic strategies to healing, because I don't think you can do one without the other for these patients. I have some of my pans or tick borne patients who may benefit more from an herbal approach as their primary approach. But I found in this population there has been for me a requirement of using both herbal and pharmaceutical.

Let's talk a little bit about disulfiram. You mentioned it earlier. I know that for Borrelia and Babesia there's a lot of excitement around disulfiram in the chronic Lyme population at this point there is some indication that it seems to be helpful for Bartonella, though maybe not as helpful as for Borrelia and Babesia. And so historically in the Morgellons realm, my understanding has been that the things that work the best are generally those things that address Bartonella. And so I'm curious, in your experience with Morgellons and Disulfiram, what are you seeing clinically so far?

So I recently introduced disulfiram in my practice after the ILADS conference meeting. The authors, Ken Ligner and we had training. So because I was one of those doctors who was quite frightened because I was reading a lot of the alarming side effects. So I had some colleagues who had been using it much earlier and having a lot of success with their patients who suffered from chronic tick borne disease, some of those resistant patients. And so since I've started to incorporate disulfiram in my practice, I have been very impressed. Now I've only seen, you know, a handful of patients thus far with positive reactions and follow up because I just started to incorporate it. But I will tell you, my one Morgellons patient of whom we had stabilized her gut, she had moved from her moldy environment. We made sure she didn't have yeast and she still had most of her wounds had resolved, but she still had Some that were on her scalp that for two years, that was the only one that remained. They started disulfiram and she was at a very, very low dose of 37.5. Twice a day of liposomal disulfiram and the lesion healed. So I definitely look forward to, to using this more aggressively with my patients. I just want to make sure that when I do incorporate it, that I've done my due diligence of evaluating the environment, the mold, the gut, the yeast, and that they're committed to that process because they're. And also the copper and the zinc, because sometimes you can have those adverse reactions if you just have a knee jerk response and you haven't taken the time to evaluate the patient's entire clinical picture. But I'm very impressed.

Beautiful.

That's really exciting. When you treat chronic Lyme CO infections, is there a particular order that you find works best in Morgellons? Is treating one particular CO infection what often leads to higher ground? What do you see around treating Lyme and CO infections for your Morgellons population?

So when I first started treating chronic tick borne disease about almost 10 years ago now, I was always taught treat Babesia first. If a person has Babesia, because that is the parasite, that's the organism that lives within the red blood cell, that's the one that doesn't really respond as well to antibiotics. So if you think a person has babesiosis, has those night sweats, those neuropsychiatric symptoms, that air hunger, any of those cognitive impairment, inappropriate changes in their blood pressure from lying to standing, that dysautonomia. So anything that presented in that Babesia realm or even positive serology, that that was the first thing to target. And you know, I still do that in my practice and I transition them to more of a Bartonella stage because that is very common. And it also is very debilitating due to the neurological manifestations of this organism. And it also lives what we call intrarythrocytic or lives within the red blood cell as well. So that to me is another dominant player. So I'm very aggressive with treatment of Bartonella as well. And then I'll transition more into the borrelia phase or you know, but I always make sure I'm having patients do yeast prevention methods. So we might be using things like nastatin or diflucan or other garlic, you know, monolaurin, things that help to decrease the yeast load. Because if they are on antibiotics, as I said, that does increase that risk. But yeah, but definitely always look at the Babesia as far as the co infections first and then the bartonella. But they sometimes look very similar.

We've talked a lot about the toxic soup, the importance of detoxification. What are some of your top detoxification tools? Do you like sauna therapy, for example? Do you like coffee enemas? Are there some really big detoxification support options that you find helpful?

So in my practice, I use quite a bit of Myers cocktail, which is a combination of different vitamins that helps with what we call phase two of the liver detoxification. So kind of clearing those toxins out the body. I use a lot of IV vitamin C, which is a great at immune boosting and also treatment of pain. Nac N acetyl cysteine, which is a precursor to glutathione. I use that pretty much regularly. I use a lot of clays and binders, things like chlorella, bentonite, clay, charcoal, zeolite, things that help bind and things that also can help chelate. I use agents like ADTA and dmsa, things that help to chelate and remove metals. So I have a broad arsenal. And I also think that things like low pressure hyperbarics, like very low pressure just at sea level, as well as infrared saunas are excellent forms of detox. But also remember, Scott, I told you already, the first phase of detox is the gut. So I make sure that gut health is that's imperative and regular bowel movements and sweating. Epsom salt baths, you know, those are all crucial and very important components of my clinical paradigm.

And I'm curious, in people with Morgellons, when they have skin lesions, do they tolerate Epsom salt baths pretty well or is it ever irritating?

I've seen both. I've seen it become extremely irritating in patients due to the open lesions. And I've seen patients who may prefer baking soda, but I've also seen it help. So I've seen a mix.

There are some that suggest that anti helminthics or anti parasitics can be helpful in Morgellons. You've mentioned them as well. If the filaments are not living, they're not parasites, which we know at this point that they aren't. Do we know why these medications are helpful in Morgellons? Are they possibly hitting Bartonella or some other organism that maybe is triggering that filament production?

And that's another. You always get great questions. So regarding the anti helmet and anti parasitics, I think that they are treating other parasitic infections like babesia like toxoplasma, like Blastocystis hominis, which I see quite often on CDSA results for patients with Morgellons syndrome. So some of the common ones I use Alenia, albendazole, Ivermectin and we think that they could also have some benefit for some of the other co infections as well. I definitely think there are more parasites that contribute to this disease complex than we that we know at this time because of the such a positive response, this positive response these patients have to the anti parasitic medications. I see that daily. You know, I have probably 80% of my patients on some, probably more on some sort of anti parasitic, whether they be herbal like parazoman or oregano oil or artemisinin to more of the prescription agents. So I think it's to be determined what all species contribute to this.

Let's talk a little about biofilms. You mentioned nac which can have some effect on biofilms. But what role do biofilms play in Morgellon's paper and how do you address them in a treatment protocol or do you even find that that's necessary?

I think that it's a requirement because the biofilm is so common in this patient population and you can treat the biofilm with systemic enzymes. I use a lot of things like lumbrokinase which breaks up fibrin, so it's a derivative of earthworm. So it's like a natural blood thinner. I use quite often serrapeptase and nanokinase, which are both enzymes that help break down proteins, which are important critical components of this biofilm niche that protects this infectious process. But also I use stevia. You know, there was work that was published by USHAPPI years ago, a couple years ago about the benefits of stevia on the biofilm as well as lactoferrin which binds ferritin and ferritin has also been shown to be a component of the biofilms as well. So I think it's critical that if you have a patient who you think has chronic resistant infections that you incorporate those biofilm strategies that I've discussed and there are others, but definitely an important component of my healthcare plan with patients.

Have you found in your patient population any relief in the realm of light frequency, sound, vibration? Is there a role for some of these physics based treatments solutions in Morgellons?

I think there is definitely a role in that, my treatment. I've had a patient of mine who uses PEMF for pain and sees benefit, which is pulse, electronic magnetic Frequencies. So it's a machine that kind of. You use different parts of your body to decrease pain. I've also had patients who've used rife machines to treat tick borne disease. Those aren't things that I use regularly, but I'm sure they are extremely helpful, not only in Morgellon's patients, but in all patients who suffer from chronic infections. I don't have a lot of experience personally with using those tools in my practice. However, I can't say that I have seen positive results in quite a few patients from that treatment.

I know in some skin conditions like psoriasis and eczema and vitiligo and things of that nature, some people will use ultraviolet light therapies. Does that help in any way with the skin presentations of Morgellons?

I have not and I actually had quite a few patients when I first started treating Morgellons who had. That was one of the initial, because you have to remember, Scott, they've tried numerous treatments out of desperation prior to seeing a physician who actually understands the disease process and can validate them. But they use the light therapy and didn't have benefit. So I don't have enough experience to say how helpful it is, but the limited amount of patients that I have used it, I haven't been impressed with the results.

Let's talk a little bit about treatment outcomes. Does the condition generally entirely resolve with treatment or does it need some longer term management or maintenance type therapies?

I have found that most patients can get to some sort of improvement with treatment. Now that might lead to scarring where the lesions were. Or there could also be some because this I think has a biofilm component. When their bodies are under stress, you might have severe relapses depending on what those stressors are. But the goal and the treatment of any chronic vector borne disease is to get a patient remission. And that means it's to the point where your immune system that was compromised is now able to coexist with that infectious organism to cause you to not be symptomatic. Right. So with Morgellons I think they do require my patients longer treatment intervals and a maintenance for them for their treatment. And they also have to really be strict with the dietary components. You know, I have patients who present in one visit, their lesions are completely healed and closed and just with scarring, the next visit, maybe after the holidays or after a lot of sugar or alcohol or just kind of what I say, falling off the wagon a bit, things flare up again. So I think that's the nature of chronic illness in general is you want to get these diseases in remission and boost immunity, and patients can get into remission and become stable. But it takes a lot of work.

What do you see on the horizon in terms of Morgellon's research? Better testing, better treatments? What are some of the things that are maybe around the corner that are exciting you that hopefully will improve the quality of life in those people dealing with Morgellons?

I think all of the above. You know, at the Charles E. Holman foundation, their website, you'll be able to find numerous different research articles. And as I alluded to in 2018, just a year ago, basically two years ago, now it's 2020, we had new research that confirmed that there were infectious organisms contributing to this illness. I hope to find more research on new organisms that are being studied. Definitely better testing. You know, I hope to find studies where we're culturing and looking under electron microscopies of these biofilm for other conditions. That's something I look forward to. And, and I think that it's all coming down the pipeline. We have some excellent researchers in this field that every day are beating the pavement because we want to find a cure for this, we want to find an end to this. And so one day we'll get there. But there are things coming down the pipeline every day, which is very exciting.

We've talked about the fact that Morgellon seems to be where chronic lyme disease was 15 years ago in terms of understanding, acceptance, even research. What do you think it'll take for Morgellons patients to gain more validation? To not be told by conventional medicine doctors that they have delusional parasitosis? What will it take to further legitimize this disease?

The first thing is that we have to make a concrete definition for criteria. All right, Diagnostic criteria. And that's what I alluded to earlier. And we have to train other physicians. I tell patient doctors, who are even chronic Lyme specialists in ilads, I say, you're probably treating Morgellons and you have no idea because the treatment is the same treatment you would possibly use to treat vector bore disease, because we know in some cases it is caused by it. So you're definitely treating, but it's just having more training. I love it. When I get referrals from other docs, I'm like, yes. You know, I do this Morgellon. So thank you. Having more things like this, educational sessions where we educate the general population, more research. Okay. And just kind of guiding the Patients to places where they can get proper and more evidence based solution and ideas because there's so much on the Internet and there's so much we just don't know. And just like with chronic Lyme disease, we did our due diligence of developing guidelines that were peer review and published. We had numerous physicians who published articles over the years to legitimize this disease. And we have an excellent training program where we train other doctors on how to treat it. And that's what it's going to take. It's going to take research, it's going to take classification of illness and it's just going to take awareness and training.

I loved in your talk on Morgellons at ilads, I think you asked how many doctors in the room treated chronic Lyme. Lots of hands went up. How many treated Morgellons? Lots of hands went down. And you said something to the effect of all of you that just put your hands down are treating it, you just don't know it.

Right? Exactly.

There is so much overlap.

It is so much overlap. And it was embarrassing. When I went back to my patient who I've been treating for three years and didn't know what Morgellons was prior to my other patient educating me on the topic. I'm like, oh, sorry, I never asked you about that. You were so ashamed to tell me that you had fibers. I just thought your wounds were improving because we were treating your Bartonella better. I didn't think of ever looking under the microscope. And it happens all the time. You get these patients and you must do a thorough skin examination for all patients with vector borne illness. That's mandatory and you'll be surprised at what you find. I don't think that every, let's clarify, not every tick borne disease patient has Morgellons or vice versa, but it's more common than you would think. And sometimes doctors are like, I don't want to deal with that, you know, but that's how doctors work with chronic Lyme disease 15 years ago and look where we are now. So. So I think awareness is happening. I'm so excited about it. I love it when my colleagues want to learn more and want to get trained on how to treat this. And you know, it's looked differently now it's becoming legitimized. I'm very excited about what's going to happen in the future.

For those people dealing with Morgellons, it can be a very difficult journey. Unfortunately, we know that suicide is not uncommon, so I'm Wondering what message of hope can you offer to those people that are currently dealing with Morgellons?

I would tell them you will get better. That's the one thing you have to always remember. You will get better. And I also would let you know you're not alone. There are other people who are dealing with this. They may be dealing with this in being silent about it, they may be dealing with this and getting help for it. But you aren't alone and people get better. And that's what's so, so reassuring and just makes me so excited about treating this condition. And keep faith. You know these diseases, not just Morgellons but chronic tick borne disease in general, can cause neuropsychiatric manifestations. It can be, you can have such, it can take such a toll on you because you may have people who don't believe you, family members who aren't supportive, doctors who aren't supportive. And you just don't have any place to turn. But you really do. You know, we have organizations out here to help people like you. So. But the first step is trying to consolidate all the other impairments in your life. So it really starts with you doing the hard work, changing your lifestyle, trying things differently, getting the rest you need and seeking help from professionals and from organizations who are familiar with this and don't take it personally, as we keep saying you're familiar with, your listeners are familiar with product Lyme and 15 years ago they weren't. This is no different. Just keep the faith and keep trying and you will get better.

Beautiful. Thank you. How do people find a doctor that knows how to treat Morgellons? How do they find resources that they can really explore to figure out their next step?

The best place is the Charles E. Holman foundation website. It has listed I'm a board physician or board member for that organization and it just has tons of research. You can also email the people at the foundation and they will link you up with others in your area that either can treat you or may have more information about local sources of treatment for you. We also have my mentor, we mentioned Ginger Sableye. She has an amazing book, legitimization of the disease Morgellons, which is amazing. It gives you a lot not only of the science, but from her experience of treating thousands of Morgellon patients over the years and getting them better, it gives you that treatment journey. And then we have documentaries soon to come out by Pie Ware on Morgellan Skin Deep, which will also give you an overview of physicians and patients experiences with this Disease complex. So there are definitely places to go. There are places not to go because sometimes it's overwhelming. But if you find those set resources to get you started on your journey, I think you'll be successful.

I will put the links to the Charles E. Holman foundation and also to the Skin Deep documentary in the show notes for people listening so that you have access to those. Tell us a little about your experience being involved in the documentary Skin Deep, the battle over Morgellons. How can people find it and watch that film?

Yeah, I mean, that film is groundbreaking. It reminds me of Under Our Skin when we film the film for Lyme disease that's available on Netflix. And it just gives you that overall holistic experience because you not only understand the physicians who are fighting to get the treatment for these patients, but you hear these stories of people who may be similar to you and you see them get better. So it's just a great movie. Pie Ware and his team did an amazing job of capturing this disease process and all the multifactorial issues that affect it and the social injustice behind it, the politics, the research, the clinical evidence, and specifically those patient stories which are so passionate. So you'll be able to soon find this on Netflix. It's great. I would recommend all of you look into it because it's so educational and it may change your perspective.

Yeah, and I have seen it and I do urge people to watch it. It will certainly open your mind and provide lots of new information and insights. The last question that I have is the same for every guest and that is, what are some of the key things that you do on a daily basis in support of your own health?

I was not looking forward to this question because all your interviewees, they leave all these elaborate and wonderful methods. You know, I go hike mountains and I all these wonderful exotic things they do. And then I thought about this. I said, he interviews me, he's going to ask me that. And the honest answer is I run after three year old triplets and I eat well and I try to get the rest I need, but it's a challenge. So I do apply those different things we talked about earlier to my own life. And I do try to find that work life balance. But I'm so happy in that peace with my family that it's reassuring to me. And even though if you can imagine life with toddlers is insane, it's a joy. So that's kind of what I do.

And I think you also are in your work life, living in your purpose and passion, which Also feeds us at a very deep level as well.

Right.

When you can help somebody, especially in this realm with a condition that so many others have invalidated them in having, I think that has to be highly rewarding for you as well.

It is. And it's just the fact that patients have hope. You know, I started, I did research for years, even in undergrad. So. And my mom even says as a young age, I always question why? Well, why, why? So I've always looked for answers and I've always tried to solve problems. And I've, you know, transitioned now to be a physician that treats complex illnesses that aren't well understood. But more importantly, I treat a patient population that is not well understood, that's dismissed quite often. And it is very rewarding when you can be a part of their healthcare journey and not only just listen to them, because I take a lot of time, at least an hour, an hour and a half on my initial visits listening to a patient, but come up with some solutions as a team and let someone know that you have their back. You know, we're going to get through this together. And the way I end most of my discharge handouts is I tell patients the best is yet to come. You can't give in to these diseases. You can't let them take over. You have to continue to have that fighting spirit, especially when you have a doctor or someone in your life who's fighting to make you better. You just have to commit, no matter how hard it is, and the best is yet to come.

Beautiful. That's such a great way to wrap things up. I have really enjoyed our conversation. You are a passionate practitioner. You are a hero in my mind and I'm sure in the minds of many, many others. And so I just appreciate all that you do to be there for a population of people that often find that there aren't a lot of practitioners and people to be there and be supportive. And so I think the work that you do is amazing. I'm looking forward to our follow up in 2035 when we do another interview and see what we've learned in the next 15 years. Just thank you so much for your time today. I appreciate it very, very much.

Oh, and thank you for always doing great interviews. You have some amazing guests and just being dedicated to our mission. I appreciate you. I appreciate the journey you've been through and how you've shared that with other patients. So I thank you as well. Scott, you're doing a great job. You're doing great job.

Thank you so much, Dr. Cornish. Thank you.

To learn more about today's guest, visit amen clinics@ AmenClinic.com that's amen a m e n clinic.com or visit the International Lyme and Associated Diseases Educational foundation iladef@iladef.org thanks for your interest in today's show. If you'd like to follow me on Facebook or Twitter, you can find me there as BetterHealthGuy. To support the show, please visit BetterHealthGuy.com donate if you'd like to be added to my newsletter, visit betterhealthguy.com newsletters and this and other shows can be found on YouTube, iTunes, Google Play, Stitcher, and Spotify.

Thanks for listening to this Better Health Guy blogcast with Scott, your Better Health Guy. To check out additional shows and learn more about Scott's personal journey to Better Health Health, please visit betterhealthguy.

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