Episode #99: MCAS Revisited with Dr. Raj Patel, 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 as information to facilitate self treatment. As always, please discuss any potential health related decisions with your own personal medical authority.

Hello everybody and welcome to episode number 99 of the Better Health Guy Blogcast series. Today's guest is Dr. Raj Patel and the topic of the show is Mast.

Cell activation syndrome revisited.

Dr. Raj Patel received his Master's degree in Physiology from Rutgers University and his medical degree from Robert Wood Johnson Medical in New Jersey. He has trained to work with people of all ages with his education in family medicine and has extensive experience with various natural therapies including nutritional medicine, homeopathy, herbs and mind body medicine. Integrating these diverse therapies with allopathic or Western medicine has enabled Dr. Patel to offer a highly refined approach to health care that produces lasting results. Over the years, Dr. Patel has specialized in treating patients with autism spectrum disorders, Lyme and tick borne diseases, and mold illness or sick building syndrome from exposure.

To water damaged buildings.

While these conditions seem separate and unrelated, they share many common underlying characteristics and frequently coexist. Dr. Patel's interest in Lyme disease started in 2004 when he was diagnosed with it after having suffered from numerous seemingly unrelated symptoms for several years. Having successfully gone through his own journey with chronic Lyme disease utilizing a variety of treatment modalities, Dr. Patel has been able to refine his approach to treating chronic Lyme sufferers with incredible success. Dr. Patel is an active member of the International Lyme and Associated Diseases Society, or ILADS and and he's also completed advanced training in pediatric Lyme disease and is a frequent speaker at Lyme conferences. Dr. Patel deeply explores the impact of exposure to mold from water damaged buildings and finds this is key in recovering many of his patients dealing with chronic lyme disease. Today, Dr. Patel, as the founder of Medical Options for Wellness, sees primarily severe chronically ill patients who have not been able to recover in spite of working with numerous other doctors. And now my interview with Dr. Raj Patel.

This is my second podcast with Dr. Raj Patel and today the focus of our discussion is going to be on Mast Cell activation Syndrome or mcas. Over the past few years, exploring Mast cell activation has become a key part of Dr. Patel's practice and has notably improved his patient outcomes as well as his own health. Today we're going to dig into this important topic and learn how Dr. Patel approaches this in his practice, but also how it's impacted him personally and how he's used the same concepts to improve his own health. Thanks for being here today, Dr. Patel.

Thanks for having me.

Talk to us a little bit about.

What you hope people get out of our conversation today. What will listeners learn from this podcast?

Scott what I'd like to do is the reality with mast cell activation syndrome is that it's, it's a difficult condition to identify and address and treat completely. What I'm hoping to do is really provide very practical hands on tools and steps that both practitioners and individual patients suffering from mast cell can institute. We're not going to go a lot into the science. There's a ton of information about that online that you can access through various websites and blogs. My job today, what I'd like to accomplish is to really provide a step by step practical guide for you as a patient to get well.

Beautiful. There is so much information about mast cell activation available today and many different thoughts about it. What is mast cell activation syndrome in a nutshell?

So mast cell activation syndrome is really simply an exaggerated histamine response produced by immune cells called mast cells. And what happens is that when the immune system is damaged or imbalanced, you get an exaggerated release of these substances, not just histamines, but various other inflammatory compounds. And essentially what happens is that you have a tremendous amount of inflammation that results, which can then lead to a variety of symptoms. And that's part of what makes diagnosing mast cells so difficult is because the symptoms, depending on what parts of your body are being affected, can vary dramatically. And that can make the part about trying to identify and diagnose it very challenging.

So that's a good segue then. So how do you identify whether or not a patient is potentially dealing with mast cell activation? How prevalent is it in your patient population and what are some of the key symptoms that people might experience?

Let's see, how prevalent is it? What we're finding in our practice is that we deal primarily with patients with chronic Lyme disease, mold illness, various other chronic infections like viruses, parasites, EMF sensitivity. So it's a mixed population, but these are patients that have typically been ill for a number of years. Within that patient population, we're finding upwards of 70, 80% of them have some varying amounts of mast cell activation. And unless you've got a very high index of suspicion, it's very easy to miss milder cases and when those are missed and they're not properly identified, you can put a wrench in the treatment of some of these other conditions.

So how do you then identify whether a patient has mast cell activation syndrome?

So there's several things. As a patient yourself, what you can do is you can look for certain symptoms. Now, chances are these symptoms, a lot of them are non specific and they are found with Lyme disease and they're found with mold illness and a number of other conditions too. So what you really want to do is you want to look for are these symptoms either showing up or flaring up when they are triggered by certain foods. That's probably the single most reliable historical information that we look for. And those foods primarily are really fermented foods. If you eat, you know, yogurt or kombucha or soy sauce, you know, anything fermented, the symptoms can come on. Sometimes it can be very rapidly within minutes. More often it can take hours up to days to show up. The symptoms vary dramatically. As I mentioned earlier, they can include things like fatigue, skin itching, rashes, hives, flushing, swelling. You can also get abdominal symptoms with bloating, reflux, nausea, loose stools, cramps, discomfort, headaches are common. Anxiety is common. You can also get a lot of cognitive issues with focusing, concentration, short term memory, nasal sinus congestion, post nasal drip. Some people develop lung symptoms with wheezing and shortness of breath. You can get irregular heart rate, palpitations. So, you know, you can see that there's a huge variety of symptoms. And historically, if you're developing one or more of those symptoms, it's something that you really need to pay attention to. Now, in addition to history, we also look at lab markers. Now, if you do any amount of research, you're going to find that there's a whole host of lab markers that you can run. The reality is that most of the times it's very difficult to get an abnormal lab marker. So what you've got to realize is that a negative blood test doesn't rule out mast cell activation syndrome. The main ones that we tend to use as our first line of testing is histamine, a blood test for histamine and tryptase. Now we prefer to have the testing done either with provocation, where someone consumes something fermented, and then we do the blood test shortly afterwards, or when someone's feeling, you know, symptom, strongly symptomatic. These compounds have a very, very short half life in the blood. And that's why it's very hard to Catch them on a positive test. The one marker that we have used consistently is MMP9. And we're finding that that is probably the single most important lab marker that should be run Patients that suspect that they may have mast cell activation. And it's also very good marker to follow. As you institute the diet and as you institute some of the mast cell stabilizers, it should come down significantly.

What level of MMP9 might be a clue for you that someone's dealing with mast cell activation?

So if you look at the lab Test, we use LabCorp as our primary lab for running that test. And their normal is anything in the mid-900 range or lower. We find that this is an extremely broad range in healthy individuals. You'll typically find MMP9 is around in the mid 200 range or lower. So when. When we start seeing MMP9 levels around 300 or higher, we start worrying about mast cell activation.

What is then the first step that should be taken once mast cell activation is suspected or diagnosed?

So the single important first step is diet. Now, I can't tell you how many times we have patients, and this is very normal, natural human instinct. You know, you find you're suffering from these symptoms, you know, itching and hives and fatigue and brain fog, and you realize, okay, you've got a mast cell activation, you've got all these different supplements and medications that are available. You want to jump on it right away. What we find consistently is if the inflammation levels are really high, those medications and supplements may work for a day or a few days or a week, but inevitably, the effectiveness of these compounds drops dramatically. And then within weeks, the patient is back to where they were before with their symptoms. And these things don't work anymore. So we are very strict with our patients. We encourage them to institute a diet first. What that does is it reduces inflammation dramatically. A simple analogy that I use is if you're in the shower and you want to get dry and you want a towel, but you're not willing to come out of the shower, it's not going to work. So it's the same thing. If you're triggering this mast cell activation day in and day out, but you're not, and you're not willing to change your diet. The medications and supplements just are not going to work. So get the diet on board. It takes a good month, okay, three to four weeks for the level of inflammation and histamine and these inflammatory markers to come down enough that you start seeing significant, sizable symptomatic improvements, I'd say probably a good 70, 80% of our patients experience reasonably good improvement just with the diet alone. And then at that point, with what little inflammation that you might have left, then you want to come in with the mast cell stabilizers to get that down even further.

And my understanding is that your colleague, Dr. Talia Farshan recently did a video talking about more details of the diet specific specifically, and that that's available on your website as well, so people can refer to that for more detail.

Yeah, I mean, basically, in general, there are three groups of foods that you want to avoid. Fermented foods, high histamine foods, and leftovers. And there's a lot of variability on the different websites, so we do provide a fairly comprehensive list. There's also very good app, All I Can Eat that's free, that you can download for high histamine foods. But the bottom line is that when you see certain foods that vary from list to list, you're going to have to do your experiment and see whether that's a food that your body seems to be able to handle or not.

So early on, you implement the low histamine diet. You then explore the mast cell stabilizers and various antihistamines. Can you share a little bit about the more common interventions that you use with patients to help stabilize the mast cells, reduce the histamine from a supplement and medication perspective while you're simultaneously working on the triggers? That's going to be the focus of the rest of our discussion.

Yeah, so fortunately, we do have a nice wide array of both medications and supplements that will help in reducing or blending the histamine response. You know, in general, we tend to divide our patients into two groups that have mast cell those that have prominent GI symptoms versus those that don't. In individuals that have a lot of GI symptoms, you find Cromolyn sodium is a very useful medication. It's an old, old medication. It's a mast cell stabilizer, very safe with very, very few side effects. And the brand name is gastrochrome. And it's also available as a generic chromolyn sodium and it's typically taken about 10, 15 minutes prior to meals, about 100 milligrams, two to three times a day. Other things for GI dominant mast cell patients are DAO diamine oxidase. In individuals that have a enzyme deficiency to break down the histamine, DAO supplementation can be very helpful. Again, taken with meals. An herbal product, Holy Basil, can be also very helpful at helping to stabilize the histamine response. And then also certain strains of Probiotics. There's a couple of different brand names, Gut Pro and Probiotia Histaminex, that are fairly effective at supporting individuals. GI systems and mast cell activation. Now, in individuals that don't have a dominant GI component will typically go on to using antihistamines, ketotifen, quercetin and luteolin, which comes in a number of different compounds, and then pea.

So once the diet and supplementation then have been initiated, the person's starting to see improvements in their symptoms from the reduction in inflammation. How do you go about reversing mast cell activation? And is that even possible? Is the mast cell activation itself the core problem, or is that the result of these other triggers that we really need to focus on?

That's a very good question, Scott. The main message I want to get across to both patients and practitioners is, yes, you can get rid of mast cell activation. You don't need to live with it. It's just a matter of knowing how to go about it step by step. What we have found, and this list is evolving and growing, is that there are definitely certain, what we call either triggers or drivers of mast cell activation. When an individual's immune system has been damaged, you're going to get this mast cell response. We find that it's probably the most common in certain individuals. The risk factors that I would consider are, number one, how long have you been sick? The longer you've been sick, the more likely you've got mast cell activation. Number two, how many other conditions do you also have? Are you also suffering from other concurrent conditions like Lyme disease or, you know, mold illness or parasites and things like that? So that becomes another area of risk. We tend to kind of break down the drivers into kind of four levels and we address them in that order. So the first issues that you need to look at are electromagnetic fields and heavy metals. If you have a sensitivity to electromagnetic fields, that could very easily play a role in driving the mast cell number two, limbic system trauma. I think this is just something that you really can't avoid. If you've been ill for a while, anyone will have some degree of trauma over their illness. So that can result in unhealthy behavioral patterns, unhealthy patterns of thinking that can easily be reversed and that can help significantly in rewiring the limbic system and helping to overcome mast cell. And then the third piece is mold illness. And what I have to point out here is just a simple presence of mold. Water damage in your home, for example, is not the key. The key Is are you having an inflammatory response to the mold exposure? And if you are, then that could very well be a driver for mast cell activation. We tend to address, Scott, those three conditions. First and foremost, if the mast cell activation has not gone away, then we move on to the next level. The tier 2 would be identifying and eradicating the infections. CHR infections, parasites is probably, interestingly at the top of the list of what we find frequently can play a role in aggravating mast cell, but also chronic bacterial infections. Both Lyme, mycoplasma, Chlamydia can also play a role. The third tier becomes looking for a sensitivity to some of the healthy bacteria in the gut. LDA is low dose allergy. Desensitization was originally developed by Dr. Schrader. It's typically been used to reverse food intolerances. But we also have the ability to use a variation of that to desensitize an individual to some of the healthy bacteria in the gut. And the one that we seem to find consistently is Bacteroides. So if someone does have a sensitivity to Bacteroides, a series of a few shots done once every two months can help in reversing that. And if at that point it still hasn't gone away. We tend to look at vaccine issues. You know, if you've got, you know, someone that's had an obvious vaccine injury, as was the situation in my case, the. But also we can look at the vaccine issue as simply a layer of stress that the body was exposed to in the past. And this vaccine layer is typically buried down pretty deep because obviously the vaccine exposure was early on in childhood. So that layer may not emerge until some of these other issues have been addressed.

So let's take a look then at.

Each of these one by one and kind of dig a little deeper. So let's start then with EMFs, which you mentioned first. So, so what is EMF sensitivity, why do we develop it, and what are some of the key symptoms of EMF sensitivity?

So, you know, the whole issue of electromagnetic sensitivity is something that's been kind of growing and picking up steam. People are becoming more aware of it, people are trying to recognize it more. And fortunately, there's more and more science now starting to emerge proving that this may very well be a, not only a very real condition, but what I believe is that it's a hidden epidemic that's growing rapidly. I think some of the risk factors for an individual to develop this electromagnetic sensitivity, number one, obviously there's a genetic tendency that you may or may not have number two, exposure. Especially now with the advent of 5G, if you're being exposed to electromagnetic fields on a regular basis, with WI fi at home and also at work, you could potentially be at higher risk. And then the third component we also find is if you've got other health issues, if you're suffering from some of these chronic illnesses that we've mentioned, you're going to be at higher risk. And then lastly, heavy metal seems to play a very significant role. High levels of heavy metals, especially if they're stressing your system and your immune system, can play a role in increasing your likelihood of developing an EMF response.

And once someone has developed that response, what are the key symptoms that they present with?

So, again, much like mast cell, these symptoms are not specific for electromagnetic field sensitivity and overlap significantly with some of these other health conditions. They can include fatigue, feeling of headaches or a sense of pressure, fullness in the head, cognitive issues with focusing, concentration, sleep disturbances, numbness, tingling. Especially if you're holding a cell phone in your hand or you have a close contact with a device, you can feel that numbness and tingling in your arms. You can get joint pains, muscle aches, palpitations, lung symptoms with shortness of breath, ringing in the ears, sense of pressure, fullness behind the eyes, GI symptoms. I mean, there's really, it's a very broad range. Again, you know, what it comes down to is look at the link between exposure versus the development or aggravation of these symptoms. And if you have a high index of suspicion, most of the times, it's fairly easy to identify it.

I remember being at a conference several months ago with Dr. Theo Theohoridis, and one of the comments that he made was that mast cells are 10 times more active in the presence of a cell phone. And I thought that was really a compelling statement because we all walk around all day long with our cell phones. And so that connection seems to be getting more and more complex.

And I think one other thing that I want to really bring up is that, you know, we worry about these cell towers going up, you know, in our, maybe in our environment nearby. And yes, absolutely, that could potentially be a problem. But I think the bigger issue, what you got to realize, is that the intensity of these electromagnetic fields falls off rapidly with distance when you look at the formula. So things that are near you, your laptop, your cell phones, those are the things that are most likely going to affect you a lot more.

Oftentimes, it's hard to convince people that EMF exposure plays a role in their chronic illness. What references do you suggest or maybe give to your patients to get everybody in the family on board with working to reduce EMF exposure?

So I think, I think the important point to bring up here is having an open mind. You know, unfortunately, some people have already made up their mind that it's not an issue and it's hard to convince someone like that otherwise. But you know, if you're open minded, that there are some very good resources out there. There's a documentary out there called Generation Zapped. It was produced just recently, a few years ago, and it's a very nice summary looking at some of the science and case histories and what's going on. Another very good resource is bioinitiative.org they have a number of very good scientific articles which have been published. What these papers are showing is there's increase in free radical damage, oxidative stress, there's neurological symptoms, even the calcium channel blocker, sorry, calcium channels that maintain the electrostatic gradient across the cell membranes get disrupted and become leaky, which then interferes with cell membrane function, mitochondrial function and things like that. So, you know, those are the two issues. Another paper that I came across, it's a 2012 paper from the Journal of Environmental and Public Health and it's entitled Earthing Health Implications. And this is a review article. So it summarizes a number of papers that have been published prior to 2012 showing the benefits of connecting with natural electromagnetic field of the earth when you connect with it. Because most of us are either in houses or apartments or office, we wear shoes that are sold with rubber. So we don't have this natural connection that our parents and ancestors did. So by not being connected to this natural electromagnetic field of the earth, it's a lot easier to start developing, you know, various health issues and sensitivities to EMFs. And this paper, what it does is it summarizes and shows the various benefits from just even as little as half an hour or an hour of connecting with Earth.

So talk to us then about EMF mitigation or avoidance. What are some of the options that you recommend your patients implement to address or reduce their EMF exposure as one of the triggers for mast cell activation?

So I would encourage patients and individuals to try to go about this as scientifically as possible. You know, there are a number of, you know, shielding devices and all kinds of things out there. And, you know, if you can't measure it, you just don't know. You know, you can't go by feel. So I would recommend getting a tri Field meter. You can get one that's fairly inexpensive at a hardware store. And you can go around your house or your office and find hotspots. And if you are going to use some kind of a device, you know, that's either plugged in or, you know, or else you want to make sure that it's working and reducing some of these unhealthy EMFs. One of my favorites is using a silver lined cloth, a canopy. And you can use that, hang it from your ceiling, put it over your bed so that at least while you're sleeping at night, night, you're creating what we would call a Faraday cage. It's basically blocking all EMFs coming from outside and it gives your body a chance to heal at least for eight to nine hours while you're sleeping at night. Other options would be, as I mentioned earlier, connecting with the earth. Or you can get a grounding sheet that is connected with a rod into the ground. And so if you're doing a lot of work in front of a computer, for example, you can put that on the floor, put your bare feet on the grounded sheet, and that would then give you a significant amount of protection from any EMFs that you might be exposed to while you're at work on the computer.

So just to clarify there, you said a rod into the ground. So am I interpreting that you're not a fan of the grounding products that then actually plug into the outlet?

You know, it's kind of hit and miss. You've got to make sure that they're grounded appropriately. And you know, unfortunately we don't have a lot of, you know, different ways of, you know, being able to evaluate it. I mean, having tried both of them, my personal preference is if you can do it in the ground, that would be, be my first choice.

Yeah, I agree.

The other things that we also do is making sure that your methylation cycle is supported. That can help significantly in helping open up your detox pathways and help you handle the electromagnetic fields.

And you mentioned things like WI fi and, you know, even cordless phones, trying to reduce or eliminate some of these exposures. In our environment, where we are all day, lots of WI FI routers now have timers that you can set up so that when you're, you know, going to sleep or whatever, you can have them turned off. And so that's potentially something to explore as well. When EMFs are reduced and particularly, I know you've seen this with the canopies, but is this an easy process that you just put up the canopy you completely mitigate or reduce that exposure. Or is it possible that people can actually have a detox reaction if they do that too quickly? And if so, why do we have that kind of a reaction to the canopies?

One of the things that we know is that chronic exposure to electromagnetic fields is one of the major influences that will block or impair your detoxification pathways. When someone's pathways have been chronically blocked, our typical patient has not just one, but many reasons why their pathways can be blocked. Chronic infections can play a role. Heavy metals can play a role. EMFs can play a role. So what happens is that when someone is finally exposed for a period of time to an EMF free environment, as with the canopy, their body goes into a detox. And in some individuals it can be overwhelming. So we typically will tend to recommend for our patients to kind of ease into that very slowly, typically for about an hour or two initially, and then ramp it up to from night.

So let's talk for a second about heavy metals, which you tied into this EMF discussion. Oftentimes people find out they have a heavy metal burden and want to do really aggressive things. IV, DMPs, DMSA, EDTA, whatever. I mean, my understanding is that one of the things you've observed is that when you minimize the EMF exposure, that metal detoxification can happen with much gentler interventions. Can you talk about that a little bit?

Yeah. I mean, the reality is if you're living on this planet, you're going to have heavy metals, not just heavy metals, but a variety of other chemicals and, you know, pesticides, herbicides, I mean, you name it. So the body has a remarkable ability to store away many of these toxic compounds so that it doesn't affect your health. But it does, at some point reach a tipping point, especially in individuals that are more genetically predisposed. Their bodies can start getting stressed from the accumulation of these compounds. Now, chelators like EDTA, DMPs, I've used those in my practice in the past. I rarely use them anymore except on certain occasions. The reality is that they will only bind those heavy metals that are easily accessible. We know certain compounds like lead, for example, get locked away in the bones, or mercury is stored away in the fatty tissues. A lot of times those reserves are not accessible to chelating agents. But when you are able to open up the body's natural detox pathways, the body will naturally start to unload these things in an effort to get well and stronger. You know, I'll quickly share with you my own experience. You Know, I had a. I had a patient of mine I'd been treating for, you know, chronic fatigue and Lyme, and his system was so sensitive and fragile that we had to use extremely minute doses of antimicrobials. And even then he had a very hard time tolerating it. And it was a struggle for a good one to two years. When we finally uncovered the EMF piece and realized that he was having a huge issue, he went ahead and picked up a canopy and he used it. And he came in shortly afterwards, about two months afterwards. He only used it for one night. He told me that it took him about six to eight weeks to recover from it. And I was honestly, you know, shocked and surprised. I mean, I had heard about EMF sensitivity and blocking detox pathways, but I wasn't quite sure I know how, how significant of an issue this is for many of our patients. When I heard that story, it finally, the message came through loud and clear that, you know, that this patient had gone into a detox. You know, he was EMF free for a whole night, eight hours, for the first time in probably 10, 15, 20 years. And his body went into detox. And it was so overwhelming that it took him a good one to two months to recover. So, you know, it was at that. So that was a turning point for me in realizing that this is a far bigger issue than I had realized. And, you know, shortly afterwards, I actually invested in the canopy myself and, you know, I had a milder but similar response. You know, I remember my bowel movements were green for about two months, reflecting the unloading of the bile from the gallbladder and the toxins from the liver and gallbladder. And what was remarkable afterwards, besides feeling a sense of improvement, less reactivity to the mast cell, what was remarkable was my ability to tolerate caffeine. For those of my friends that know me well, I enjoy a good cup of coffee and, you know, for. Even though I had been able to handle caffeine in my younger days, I had found over the last 10, 15 years that my tolerance of caffeine had dramatically diminished where I would restrict myself only to decaf coffee. And I found that after this two month period, caffeine was hardly ever a problem anymore again. So that was kind of a nice little plus. But it also showed me how powerful the detoxification can be when you use the canopy.

It's almost like at a cellular level that when we're exposed to these EMFs, that our cells are in more of a fight or flight kind of mode. And once we take the EMFs away and at a cellular level, become more parasympathetic and can focus on cleaning, resting, digesting, detoxifying, similar to what we talk about, with sympathetic dominance and parasympathetic tone. Sounds like that's happening at a cellular level from the EMF exposure.

Yeah, absolutely, Scott. Because you know what? Your body is such an amazing organism that it will go into healing every chance that it gets. All we have to do is provide it with what it needs, a clean, healthy environment. And when you do that, things start shifting rapidly.

So let's talk then about the next trigger or driver that was the emotional trauma, the limbic system piece. So how often is there an emotional backdrop that contributes to health challenges in those with chronic illness? And what are some of the tools that you suggest in patients to explore and improve the emotional contributors to their health challenge?

So, you know, as I mentioned earlier, I think anyone that's been sick for any significant amount of time is going to have a certain amount of limbic system trauma. I think that's just reality. And there are a number of systems out there that are starting to create a very useful, effective, structured approach that we can use to help in reversing this limbic system trauma. Annie Hopper has developed the dynamic neural retraining system. This is something that I personally went through. Dr. Gupta has the amygdala retraining. Joe Dispenza also has a system. And basically what we're doing with these systems is we're bringing together quantum physics with the use of meditation and creative imagination to create a new reality. And, you know, we've known this. You know, there have been books, you know, Deepak Chopra, Napoleon Hill, you know, Think and Grow Rich. I mean, we've seen books and references to these principles in the past. But what we have now is a nicely structured approach that individuals can use. And we also now are starting to see the science in quantum physics that proves that this is very real.

So when we talk about limbic system retraining or rewiring, the trigger for that limbic system impairment could be an emotional trauma, but it could also be an infection or a toxin. It may not necessarily be that there was an emotional trigger for that limbic system impairment. And yet we can still benefit significantly from rebooting the limbic system or the alarm center in terms of how it is surveilling the environment around us. Is that a clear understanding?

Yeah, Scott, I think the reality is that it's probably a combination. For most individuals having toxic exposures from infections, mold exposure, emotional trauma tied in with it. And I think that individuals, I mean, I've seen remarkable, remarkable recoveries just from the limbic system work by itself. So it's hard to predict who's going to respond and who's not. I think the more trauma you've had to the limbic system, the more likely you can have a dramatic response. And I think it's something that's worthwhile exploring for most individuals that have been ill for a while. And if after doing it for three, four, five, six months, you've kind of seen a limited response, then great, use what you've learned and then move on to some of these other tools that we have available. And if you do respond completely, then that might be all that you have to do.

And it is interesting because the triggers or drivers for limbic system impairment overlap very significantly with those that trigger mast cell activation that we're talking about in this discussion. So tell us a little bit about how you use systems like DNRs or other limbic system rewiring tools in your practice. How often do you find it helpful for your patients? And have you personally used DNRs? You mentioned that you had, but tell us a little more about your personal experience with it.

Yeah, when I went through it, my. My primary symptom with mast cell was skin itching and mild flushing and hides occasionally. And it was around the same time that I started learning about the DNRs. So I went ahead and signed up for it, and I found it to be a very useful tool. And I've been involved in meditation and, you know, journaling and things like that, dream work for a number of years. And I had relied very heavily on those skills to help me cope with the stress of being ill through both lyme and mold illness and mast cell. But what I really appreciated about DNRs was the structured approach. And, you know, I found it helpful. I found that it took me to a higher level of functioning, both emotionally and physically. But it wasn't enough, in my case, to take away the mast cell issue completely. So I moved on and added other things that eventually helped.

And what kinds of clinical responses have you seen in your patient population with DNRs?

I've seen people with mold illness get completely well. I mean, I had one patient who, you know, single parent, couldn't move out of a water damaged, you know, home and ended up doing DNRs and basically, you know, recovered 90, 95% to the point where they were able to go back to school and, you know, Work and everything. So I've seen remarkable response, but it's not the norm consistently, you know, and I really feel that everyone is different. And I think that as individuals, you know, if you're sick, you got to try all of these things one by one. Eventually, by the time you get to the end, and you may not have to get to the end, something will, you'll find that is the primary driver for your mast cell. And when you address that, it'll go away.

So let's talk then about mold exposure, the next driver, another trigger for mast cell activation, also for limbic system impairment. How common is it that you see mold as a contributor to mast cell activation in your patients? How important is it to avoid mold in the environment in order to recover your health if you are genetically susceptible?

Yeah, you know, mold, emfs, mast cell are very closely intertwined and one will aggravate the other one. That's why we tend to address these things early on. If you have an inflammatory response to mold, it will definitely make your mast cell responses much more severe. So, you know, getting out of the moldy place, avoiding water damaged buildings, you know, when you're just going about stores and shopping and things like that is crucial. You know, there's a lot of information about mold illness. My previous podcast here with Scott about a year or two was on mold illness and there's a tremendous amount of very useful information on there. Also, if you go on our website, Medical options for wellness, there's a lot of information there. So I don't want to go into a lot of detail about mold illness, but suffice it to say that it is a very big issue. If you're having an inflammatory response, you're getting sick. When you go into a water damaged building, you've got to address that piece and have absolute avoidance as much as possible in order to give yourself a decent opportunity to be able to calm down the mast cell so that you can then go after the other issues.

And I will put links to all these things in the show notes. For Those interested in Dr. Patel's website, it's medicaloptionsforwellness.net and that'll be in the show notes as well.

So now we get to the item.

That everybody's really interested in and thinks should generally be the initial and primary focus of recovering from something such as Lyme disease. And yet in your approach, the microbial focus comes very late in the process. So why do you not start with the focus on killing the bug and is a focus on killing the bug Alone, one that results generally in higher ground for your patients.

Having gone through this, Scott, myself, you know, having been ill with Lyme disease for a Good, you know, 10, 11 years, and also mold illness, you know, and having seen my patients, you know, to me, you cannot have a narrow approach to just going after the bugs. You know, the typical patients that we see have not just Lyme disease, they may be called Lyme disease patients, but they typically suffer from multiple, multiple other health conditions. And you've got to cast a broad net and you've got to intelligently prioritize and figure out what is the primary stressor that the body needs for us to address first and then go in the right order. And when you do that, you'll find consistently the organisms associated with Lyme disease, as well as the Lyme bacteria, chronic intracellular infections, you know, they're gone within typically a year and a half, two years. You know, I hear stories of patients, you know, that have been in treatment for five, 10 years or longer. And usually in these individuals, we find consistently that there was one or more conditions that caused chronic inflammation that didn't get properly identified and addressed. So we find, take care of the source and cause of inflammation first, and that opens the window which allows eradication of these bugs very rapidly.

So let's talk then a little bit about the order in which you approach these microbial issues as part of your broader protocol. You start generally with fungus and sibo, then moving on to viruses, parasites, co infections, then borrelia, and then later mycoplasma and chlamydia. So talk to us a little bit about your rationale for this approach. Why is that order important, and why is Lyme not earlier in that process?

So what you got to realize is that Lyme is a chronic infection associated with immune compromise. When our immune systems are loaded down with multiple insults, multiple organisms, it is unable to mount an effective response against the Lyme bacteria. You can use antimicrobials, but antimicrobials only work well if you've got an immune system that's reasonably intact and working. Viruses. Are something that we all have in our system, in our body. You know, healthy individuals, all of us, you know, 99% of us have been exposed to Epstein Barr, for example, or the chickenpox virus, and our body will keep these viruses in check because your immune system is functioning. When the immune system gets bogged down by multiple insults, heavy metals, parasites, chronic infections, EMFs, mast cells, all these things we've been talking about, it's unable to Keep these infections under control so they start flaring up. And viruses are notorious for causing a tremendous amount of infection inflammation. So you know, going after the viral piece is critical early on. And when you have a lot of viral mediated inflammation, especially in the gut, you tend to get a lot of candida overgrowth and you get sibo and you get overgrowth of, you know, abnormal bacteria. Your microbiome gets affected, which then results in further immune compromise and dysregulation. So addressing the viruses, the fungal piece and the SIBO early on are crucial. After that, things can vary from patient to patient. If there are parasites, we'll tend to go after those first usually and then move on to the line co infections and then eventually the line. But you know, that sequence that you outlined, Scott, I would say is probably effective in a good 60 to 80% of our patients. But the other 20 to 40%, the sequence can vary. And one of the clues would be to really look at your symptoms very closely. You know, if your symptoms are very, very tied in to, let's say, Babesia, you're getting a lot of night sweats and you're getting a lot of air hunger and a lot of fatigue. You have maybe just a little bit of anxiety, but it's not a big issue. Well, go after the Babesia first and you'll notice that as the Babesia symptoms start to come down, the anxiety is going to start flaring. And as anxiety starts flaring up, that's telling you that the bartonella layer is now starting to emerge. So you'll find that your symptoms will vary and change and evolve as you go after the bugs one by one.

And Lyme co infections in your model comes before Borrelia or the main agent of Lyme disease is that because the CO infections generally produce more symptoms than Borrelia. What's the rationale for that?

Babesia is a malaria like parasite found inside of red blood cells. So we'll typically tend to address that very shortly after we address the other parasites, whether they're large parasites or smaller, you know, protozoans. If you've got a, if you've got a compromised immune system, I think it's easier to eradicate the Babesian Bartonella than it is aligned. Essentially, the mycoplasma and chlamydia are intracellular organisms. It's not unusual to have these organisms independent of the Lyme co infections. It's not unusual to have those pre existing. And because they're intracellular, cell wall deficient organisms are much harder to eradicate. And they tend to be a little deeper down in terms of the layering. So those typically tend to come at.

The end of the. And interestingly, one of the things that I had read and heard at a previous conference was the mycoplasma and chlamydia, and we're talking about chlamydia pneumoniae, are higher in prevalence in water damaged buildings as well. So it sounds like those are also things we environmentally get exposed to on a regular basis and then have to rely on the immune system in part to support us long term.

Exactly.

You generally dose microbial interventions very conservatively. So tell us a little bit about your microdosing strategy, terms of dealing with these overgrowths. What happens in the body when we use too much of a specific intervention and then that leads to inflammation?

I think I'd like to share that with my own experience, you know, early on, you know, back in around about 2004, 2005, when I first started identifying, you know, that I was suffering from Lyme and some of the co infections as a major cause of my fatigue that I'd been experiencing. Back then, we didn't have a lot of the wonderful master blends that we have, you know, at this point. So I tried some individual herbs and it was kind of hit and miss. And so I went on to antibiotics, and while they helped, there was massive hurt sink. And even after a year of a combination of IV and oral antibiotics, I found that my symptoms tended to start coming back. It was almost like they were putting a lid on it, but not really eradicating it. And I was being treated at that time with normal pharmacological doses of antibiotics. And while I would get massive hurting, sometimes the herxing would just stop and then we would have to change over to a different antibiotic and then the herxing would restart again. But I felt like I was treading ground and really not making a lot of long term progress. So after about a year, year and a half, we started exploring other options. What I learned from that experience, and then also having a similar experience when I started using herbal blends, when they started becoming available, was that herxing is a good thing, but when it's uncontrolled, it can lead to massive amounts of inflammation in the body. It makes patients feel horrible. And my personal take home was that you don't make a lot of progress. You know, I think in the Lyme community in the past, we've always felt that the more hurxing you could have, the better off you were, and the more effective the program was. What I'm finding now consistently is that we want to have hrcing, but we want to have it in a controlled fashion that is manageable, that allows the patient to continue functioning in their life so that the inflammation isn't out of control. And we find that when we do that, the antimicrobials that we're using, whether they're antibiotics or herbal blends, tend to continue working longer and that we don't have to keep shifting from one to the next to the next.

Another piece of that whole Herxheimer discussion, which we didn't really talk about much in this conversation, but I know you in your model use a lot of detoxification and drainage support and other things that also were 10, 15 years ago, probably not used as readily in this kind of realm. So that seems like the more detox and drainage support someone has on board, the less they also have these stronger reactions. Would you agree with that?

Yeah, I think a really simple way to visualize that is to realize that most of these organisms, especially the Lyme bacteria, is tucked away and hidden away in organs and tissues. When you introduce a antimicrobial, you're going to get a die off, obviously, and the breakdown products of the bacteria or whatever organism that you're targeting, those endotoxins end up in the bloodstream and those proteins will trigger an inflammatory response. Now, the faster that you can eliminate those toxins out of the body, the more shorter lived the inflammation the hurting is, and the faster you can then push the person's program and help them get well faster. So whatever you can do to enhance the exit pathways, you know, supporting the kidney, supporting the liver, use binders for the gi, encourage exercise, lymphatic massage or drainage. There's all kinds of things available these days. The more you open up the exit doors, the faster you can treat the patient and the faster they're going to get well.

So coming back to the drivers or triggers for mast cell activation, one of your recent explorations is the impact of the immune interplay with our normal GI flora. You specifically mentioned bacteroides earlier in the conversation. Tell us how you identified bacterioides as a contributor to mast cell activation. What percentage of your patients need to address this and how do you approach treating this issue with low dose allergen therapy?

One of the things that made me look into this area as I was going through my own journey with mast cell, trying to figure out, okay, what was driving my mast cell, because at that point, at the time that I developed my mast cell, the Lyme bacteria and co infections and parasites and viruses, they were all gone. So but what I realized is that the gut inflammation, while it had improved, was not totally normal. You know, when someone's GI tract is optimal, you can tell that by the quality of their bowel movements. You know, a healthy bowel movement is, you know, a, you know, one or two, you know, pieces that are well formed. They're encased in a very thin layer of, you know, mucus, and there's hardly any rectal soiling after a bowel move. If you have significant amount of rectal soiling, it's pretty much an indication that there is a significant amount of inflammation in mucus in the lining of the gut. So what I noticed for myself is that my gut wasn't as optimal as I would have expected it to be. After having gone through treating the Lyme, treating the mold illness, having completed the vip, each of those things helped, but there was still a component I felt in the gut that was missing. That's when I started exploring the LDA issue with Bacteroides. After just three or four of those injections, I found that the health of the colon, quality of the bowel movements dramatically improved. The mast cell calmed down a little bit. But again, it was not the magic piece in my situation.

So the last trigger or driver that we're going to talk about, you mentioned, another newer area that you've been exploring is the contribution of vaccine residues or imprints in terms of being a trigger for mast cell activation. How commonly do you think vaccines are a contributor to mast cell activation in your patients? Are there specific vaccinations you find more likely to be triggers for mast cell activation? And when you do find this is a potential issue, how do you explore treating it for a particular patient?

So we look primarily at the history. Okay, so does the individual have a history of any kind of vaccine related trauma, whether it was a severe febrile response, whether it was significant change in symptoms, whether. In my case, you know, when I was about three years old, I had a vaccine that apparently hit the nerve and resulted in a paralysis of my whole left side, you know, both the arm and the leg. And it took a number of years to recover from that. So sometimes it's really obvious, but I think in a lot of cases it's just a layer. I think that when you're introducing any kind of a bacterial antigen or any kind of an infectious antigen, you're gonna basically add a layer to the immune system. I don't want to say trauma, but Just maybe a layer or a residue that can affect immune functioning on a subtle level. So if there is a history, we'll explore that. But many times we'll go through this list that we've outlined, and if by the time LDA is completed, the person hasn't improved, we'll look at the vaccine layer. At that point, history may give us a clue which specific vaccine may be playing a role. Energetic testing can sometimes help. What seems to work is really creating what we call a homeopathic homochord. It's a blend of a variety of different homeopathic frequencies, and the body will tend to absorb or use the ones that it needs. And as the immune system gets rebalanced, we find that the mast cell piece really starts to regress in a dramatic fashion. It can take, depending on the severity of the imprint, anywhere from a few months up to six to nine months to be able to eradicate that layer. There's a tremendous amount of fatigue that can come in. I think in some situations, there may be some mitochondrial trauma. We're finding in our patients that mitochondrial dysfunction is really fairly common. But the key question becomes why? I think that the vaccine layer may be one of the many different influences that can affect mitochondrial function.

You have been a mentor of mine for several years now, and one of the things that I value and respect about you is your willingness to be open about your own personal health journey and how that journey has really impacted the work that you do with patients. So you've treated yourself for years as a result of Lyme and mold illness, and later you identify you were dealing with mast cell activation syndrome. Talk to us about your personal journey in recovering from mast cell activation. What were the steps you went through, and how did this lead you to higher ground today?

Oh, boy. How long do we have? You know, it's been an interesting journey, and I think in the end, I feel really fortunate and grateful. I mean, it was. It was difficult, at times, painful. I sympathize with my patients having gone through these illnesses. You know, it's hard. It's difficult. But I think that you come out of it a much stronger individual. For me, it was a transformation on a number of different levels, not just physically. And in the process, I had a chance to explore a lot of different tools. You know, everything from IV antibiotics, oral antibiotics, you know, different herbal blends, you know, rifing, ozone, and also, you know, for mast cell, you know, trying out all these different things and figuring out what plays a role and what does not. I mean, inevitably, I was always the worst patient, meaning that I had to go through every single step to finally find something that would work. But I feel fortunate in the sense that I was able to get an inside track in how to intelligently combine a variety of these different tools for each of these different conditions and how to address them in the right order. It's, you know, I tell my patients, you know, look at this. Look at this journey, you know, one step at a time. You know, it's overwhelming sometimes. And yes, there are some sacrifices that you end up making along the way, but I think in the end, you end up coming out a lot stronger as a human being, a lot more. Grateful for just the simple things that life, you know, offers us. And, you know, the bottom line is that there's really all these things can be treated, you know, and if you're not getting, well, if you're not responding, you know, step back, step back, and, you know, maybe come at it from a different perspective, a different viewpoint. You might get stretched in the process. You may have to, you know, entertain some types of therapeutic modalities that you may not have entertained in the past, and it might open up your world a little bit in the process, but, you know, having gone through it, you know, you just got to stick with it long enough, and you will get. It's just different for each individual.

And I know every piece of what we talked about today. The EMFs and the metals, the limbic system, the mold exposure, dealing with the microbial overgrowths, the bacterioides, the vaccine residues. I know all of those are things that you have personally explored in your own journey. And having known you for several years, I know you're doing quite well today. And so I think that's hopeful and inspiring for people to see that in the complexity of this all, or what seems very complex, that there are solutions and that people can get their lives back.

Absolutely.

So this has been a really powerful discussion. I think that understanding what mast cell activation is and that it's not itself the core problem, that we can look at these triggers or drivers to resolve mast cell activation entirely by addressing the underlying triggers, the underlying drivers, I think that's really empowering. How much has this approach changed your practice and your patient outcomes in the past few years? And what thoughts might you wish to share as we kind of wrap up our discussion?

You know, our approach is constantly evolving. It's constantly evolving, and a lot of it is just based on having gone through and learned things from what works and what is not working on ourselves. Looking at the research, sharing stories and insights with other health practitioners, going to different seminars. I mean, there is such a wealth of information that is rapidly coming on the scene. And as health practitioners, we're constantly finding new tools, new insights into these conditions. So it's a very exciting time.

The last question is the same that I ask every guest, and that is, what are some of the key things that you're doing on a daily basis in support of your own health?

I think the number one thing is take care of yourself. Give yourself in every moment what you need, not what you want. You might want that chocolate bar or something else, but you know, if you need more time, if you need rest, you know, whatever it is that you need, give yourself that. You know, part of this process is learning to love yourself, having a regular practice of connecting with your heart, center with the divine that's within you. Whether it's through, you know, some of the imaginative techniques, you know, with, you know, the limbic system work, or whether it's meditation, dream work, journaling, whatever makes you happy, you know, doing that on a regular basis can help you manage stress, help you gain insights in terms of what you might need as the next step in your healing journey. On a physical level, I think that canopy is an amazing tool. EMFs are not going to go away. So I think it's a good long term investment to help you stay healthy, you know, being careful with what you eat. You know, try to do organic as much as possible. You know, if you're healthy, 90% of the times, you can spread, splurge the other 10% of the time and just do what, you know, what you love in life. That's the bottom line.

Beautiful. This has been a really fantastic discussion. I thank you for being here. I honor you for your work, for everything that you do for your patients. I certainly have learned a tremendous amount from your work over the years and from knowing you and just want to thank you and honor you for, for being here today and for so openly sharing everything that you've learned from your personal journey with the community with the goal of really helping other people to improve their lives. So thank you so much, Dr. Patel.

Thank you, Scott. It's been an honor working with you all these years too.

To learn more about Today's guests, visit medicaloptionsforwellness.net that's medicaloptions4wellness.net medicaloptionsforwellness.net thanks for your.

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