Why Your Lab Tests Are Lying to You (Lyme, Mold, and Parasites) | Dr. Mark Su

A lot of people have no idea what's going on as it relates to Lyme. How do you even get chronic Lyme disease?

Lyme disease as a term is really loosely used. Anytime I'm talking to somebody, I don't care if it's a patient, but especially if it's a practitioner, I'm wondering how they're defining Lyme disease. Have you had known tick bites? A lot of people won't even know it because those ticks don't stay on forever. You know, I've both had patients saying, I thought it was a piece of dust, or I thought it was dirt. There is rationale, science, and basis to support the argument of in utero transmission. I hate to say I called veterinary offices, how come you guys are diagnosing parasites like on the spot looking at a poop right in front of you from the pet and the humans like we send to a lab and they, they can't diagnose it? You got something moving right in the sample, like what's going on there? I find that's the challenge with this topic is how do you prove it? You got to be able to have some explanation, rationale, and ideally some backup for the ration— your decision making.

So we've talked offline a bunch about Lyme, mold, parasitic infections. I know you have a lot of passion expertise in this, and my patients, um, with breast implants have a ton of problems with chronic inflammation. And I always explain breast implant illness the same way, so we're super clear. I just think it's a chronic inflammatory process. Of which a medical device, in this case a breast implant, plays a role. It's not the only thing that's contributing to chronic inflammation in our patients. And there's been, you know, studies published about bacterial contamination. There's been papers recently published about more of an organ rejection picture happening at the tissue level. But, but I wanted to like pick your brain about— and we can start with Lyme and kind of maybe for the audience, just explain Lyme on a basic level, and then maybe in your history-taking analysis workup, how do you feel about taking care of folks and helping them with Lyme? Because I find it to be a very complex problem.

So where do you want to start?

So if you get somebody historically, how do you determine you even just from history? Because a lot of people have no idea what's going on as it relates to Lyme? How do you even get chronic Lyme disease or Lyme disease?

Yeah. I mean, so the common story is, you know, the messaging that everybody hears about is it's quote unquote tick-borne, right? So it's these ticks are transmitters of bacteria, but it's more than bacteria. Alright. So I'll stop. I won't go further into that rabbit hole right now, but it's not just ticks also. Alright. So if we were to stop a second and just quickly say, hey, Lyme disease as a term is really loosely used, right? I mean, it depends. Anytime I'm talking to somebody, I don't care if it's a patient, but especially if it's a practitioner, I'm wondering how they're defining Lyme disease. Okay. Right. So are we talking about the specific Borrelia burgdorferi? Are we talking about the whole class of Borrelia? Are we talking about the other, what people call co-infections, the other bacteria, the parasite, cellular parasites, the viruses, et cetera. And if we expand it out to the whole spectrum of bugs, I'll call it like pathogens, right? The viruses, bacteria, parasites, whatever, then yeah, a lot of those aren't just carried by ticks. Right. And the other piece I'll just tack on that really quickly is there is rationale, science, and basis to support the argument of in utero transmission, hate to say. So it doesn't have to necessarily be like I was bit by a tick, or I was bit by many ticks, or I've never been bit by a tick. But, uh, if your mother in particular— I don't know about both, but let's say at least mother who carried you, uh, was seeded with Lyme disease, or broadly, it could have been even in utero.

Okay. Yeah, I haven't heard like a vertical transmission, you know, discussion about that before, so that's interesting. The, uh, The classification like that broadly makes it much different from— and that's why I asked you about this, you know, beforehand, because it is, it's a, it's a very, you know, vague, you know, description when you talk to the patients because, you know, you're trying to explain chronic inflammation and, um, you know, it ticks a lot of boxes. You know, there's just all sorts of problems that, you know, align with or have the same symptomology, basically.

Yeah, sure. Yeah.

So that ends up being a, that ends up being even more confusing for our patients.

So agreed. So, you know, it's interesting. I was going to flip it around and ask you what aspects for either the practitioners from your, you know, who you rub shoulders with or patients you know, when you say it's, it's confusing. Because when I think about, um, when I think about these— let's just stick with these 3 topics, right? Um, Lyme disease, mold-related illness, parasites. Um, they all are confusing in different ways. Uh, I personally, for whatever reason, I feel like the mold illness is more challenging. I don't— you know, could it be equally complicated? Maybe, maybe not. But I'm going to say I actually think of the Lyme disease issue as less complicated than the mold illness topic. But, um, but yeah, they all have challenges.

Oh, I, I do think of the other way. I feel like because of the lack of ability to actually benchmark test and define like who has Lyme very easily makes it harder. I mean, we do, uh, feel very comfortable with at least history of, of the patients if they can recount it. If they're good historians, they can say, oh yeah, I lived in a place that had Sure. Mold, or there was a flood, or there was a water leak, or what have you. And that's whether or not anybody listening understands how prevalent this is. It's extremely prevalent.

Yeah.

So historically, you can get that information, and then, you know, usually a provocative challenge with glutathione for a period of time, followed by a test to look for mycotoxins. Depending on which vendor you use, we, we tend to look more broadly because I have patients who have lots of problems with detox genetically. So we look at things more broadly. I'm not just looking at, you know, mycotoxin levels because that's just gonna be one piece of a very complex, uh, problem. And I haven't to date, unless you tell me differently, been convinced that there's a really clean simple way to help someone characterize from a practitioner's side Lyme.

Yeah.

So that, that becomes more— I, I guess I'll be, you know, very simple in that if we can test something, at least establish a, you know, we'll say in that Kodak moment of time, like, this is what it looks like right now. They have maybe this glyphosate level or this phthalate level or this, uh, DDTPH level or this mycotoxin level, you know, meaning ochratoxin, fumonisin, whatever, and/or, you know, your heavy metals. At least you get a picture. No, it's not perfect by any stretch. They may not be detoxing well or anything at that point, but if you told me there was a way to characterize Lyme that way, I'd be very excited.

Well, I mean, without going— we could go down the road of, uh, you know, me asking you, so what, what tests, um, you know, do you, your colleagues use? I could, I could easily talk about the, the tests that I use. We could talk about them categorically in methodology, you know, without getting real technical and details and all that kind of stuff. Um, but I mean, I think as a summary point, I would say, um, yeah, no, Lyme practitioners are using Lyme tests all the time, right? Right, all the time. And so in fact, though, as you, you and I both know, in this field of functional or less conventional/integrative medicine, labs are popping up recurrently year after year trying to improve on sensitivity, specificity, accuracy of their lab test for whatever they're testing for. So, I've seen that carousel over many years, 20-plus years, and people who've been around this longer than I have, more than 20-plus years with labs that say they've got something even better, better, better, and then Sometimes they stick around, sometimes they don't. But yeah, no, there's, there's definitely lab results, but I think the, the interpretation of the results in my mind, you're, you know, validating your point. It's, it's not necessarily the most straightforward. It doesn't— it's if you get technical, it's not necessarily the most straightforward interpretation, but I could apply that same argument to a lot of other topics as well.

So do you have something you prefer to look at initially for screening for them or just use your history to work? to help them?

Yeah, so, um, you know, let's, let's just quickly, for the sake of, um, being complete and for like being concrete, tangible for your, your, uh, audience, um, so back to your history question since you alluded to that right now, right? So yeah, people are always asking, okay, uh, have you had known tick bites? All right, but a lot of people won't even know it because those ticks don't stay on forever, right? So especially the baby, I mean, the countless numbers of times, you know, you and I both had patients saying I, I thought it was a piece of dust or I thought it was dirt or whatever. And then I go trying to flick it off and it, and it's moving, right? It's a, it's a baby tick, right?

A nymph tick.

Like you don't even know, like you think it's a pen mark or something. Right, right. And then you're like, it doesn't, it's moving and I can't get it off. Oh, it's attached to me, you know? So, and they usually, I think, you know, I usually tell patients, hey, they, they can de— self-detach, you know, 2, 3 days or possibly less. I don't know, but let's say 2 or 3 days, you know? So, people won't necessarily know they're a bit. That's what sucks, right? And then you got, you know, risk factors are, okay, well, the common things like how often are you in the woods, or do you live near woody, woodsy areas, you know, etc. People are always thinking about the deers because people, you know, the messaging is constantly about deers carrying the ticks and etc., etc. But even that's a little bit of a false herring, a red herring, right? Because it might be argued that statistically mice in our houses carrying the ticks are a much greater exposure than people being in the woods where the deer are.

Okay, so I was gonna say your pet.

Oh, absolutely. Yeah, that's where I was going next, right? So even if you're not in the woods or you don't live near woodsy areas, but your pets— I mean, this, this fall I've had two people tell me they— one guy literally told me he was picking 30-plus ticks off his dog each time they went out, right?

That would be the most common thing, I would think.

And then the domesticated animals come in the house and then there you have So yeah, and then those ticks are not staying on the dog, the pets either, right? So then they detach and then they're floating around the house, etc., etc. And so when we talk about, um, history, you know, okay, yeah, we could be real concrete about how often have you had tick bites, but also then what are your risk factors for having a tick bite, even if you don't know if you've had a tick bite. Uh, you're right, the in utero thing, the vertical transmission, we won't talk about that because that gets kind of hairy dicey, and that's like, how do you, you know, you can't backwards, uh, retro-diagnose it, etc. Right. Okay. So let's go to testing for a second if that's cool. I mean, so if we, if we talk about specific labs, right? And I'll just kind of go through a smattering of options, but not get real super technical. Look, IGENEX is the granddaddy, if you will, right? It's, it's kinda like the OG. I don't know any practitioner who doesn't trust IGENEX. All right. And we don't have to get real technical in detail and all that, but they have off, they have offer all kinds of different kind methodologies of tests and across the spectrum. You know, Borrelia, Bartonella, Babesia, Ehrlichia, Anaplasma, the whole kit and caboodle. You got other labs, right? No priority here, but you got— so Vibrant, you and I both use Vibrant quite often, you know, so I use them a lot. All right, different, a little different methodology. The reporting is a little different. You know, we won't get real technical now as to methodology, you know, differences and/or why they differ, etc., why we choose one or the other, etc. You know, some of that's pragmatic in terms of cost, insurances, and blah, blah, blah. Then you got, um, I think of a lab called MDL. Um, I'm suddenly blanking on the name of the— what it stands for right now. But that lab, um, I think of it as like a little in-between. They, they have reputable methodology, um, but yet they reportedly are decently insurance covered. Okay, but I, I'll admit, I don't, I don't know if I've, if I've used them— it's less than a handful of times over the many years. It just maybe habit or whatever, I don't know, you know. I'm just— I'll admit I just never got in the habit. But then, you kind of, in my mind, there's a whole smattering, but I think now it crosses over into different methodology.

Okay.

So, all those labs I just mentioned, they are all antibody-based, right? And, that gets into the nuances of the difficulty of interpretation. The question becomes like if you have a positive antibody, does that really mean it's there right now? As the kids say now, 6, 7, don't know, you're not really sure. Okay. You could make the argument, but I'll say if people have symptoms, and this is again, now we're factoring in, like you said, like the symptoms can really vary admittedly because Borrelia can cause certain symptoms. Bartonella are known to cause other symptoms. Babesia cause another one. So, when you say Lyme disease widely, yeah, you're covering a humongous gamut spectrum of symptoms. So, what do we really mean, right? And I think that's where a lot of this goes including specifically in breast implant patients is breast implant illness patients is how, how well can we correlate whatever symptoms people have to whatever finding we might come up with on whatever testing, right? And that's, that's a whole nother art, and that's a huge topic. But the bottom line is, um, the antibody testing, for the, for the most part, it is people who have symptoms, especially if they're more classic symptoms— and I can tell you what I think of as classic symptoms— I can bank my dollar on it. All right, now if we get into other methodology, which is where we start talking about ELISpot testing— IgeneX has some ELISpot testing. Um, there's a lab called, um, it just changed, crap, I'm blanking on it. Um, I apologize, I'm blanking on it. Um, that's terrible, I'm not going to remember off the top of my head because I'm under the gun here. But there's a couple, there's a, there's several labs that do, uh, they're testing directly for markers on T white blood cell, T lymphocyte white blood cells, right? So that's more of a direct test. And then the other type of direct tests are like PCR testing, which we all can remember from COVID years, right? So COVID is like PCR testing, is you're looking at gene sequences of the thing itself. Then the argument is, well, is it a live thing or is it a dead thing? Are we just seeing gene material but it's not actually there? You know, that's— there's arguments around all this stuff is what I'm getting at, but Again, that's where it's art of interpretation where, okay, the practitioner's gotta line up what the person's dealing with and the likelihood of correlation with finding. But look, IgeneX has got, they go across the board, antibody testing, the ELISpot testing, PCR testing. Vibrant's got antibody testing, they got PCR testing. I don't, unless I'm totally wrong, the ELISpot testing is not there. I don't recall that whatsoever. And then you got ELISpot-specific labs like the Armen Labs out of Europe, and then, um, that lab— I'm— shame on me, they've been renamed. It's called iLabs. i-Labs.

Oh, that didn't even pop up on my system. Damn.

Yeah, yeah. So, um, uh, they, they used to be called, um, they've renamed themselves. Uh, they previously like a European-specific, and then now they've created an office. Uh, they've— there's been a little bit of some business merging and this and that. So anyway, iLabs, um, I've known about them, I've used them, you know, here and there. So you have the ELISpot methodology and the PCR methodology. So it all varies as to which one practitioners use, but the antibodies are the tried and true. That's the one everyone's using, you know, for the most part. For the most part, antibodies.

Okay.

Yeah.

I mean, we've, we published a big paper on PCR analysis and I try to let people understand, like, okay, when we take scar tissue out of somebody that's internal around a device and the PCR shows these bacteria. Yeah, pretty hard to refute that because there is no reason for those to be there otherwise around a device.

Sure.

Um, what is interesting, uh, and this would be a good segue, is a group out of Denmark published a paper in the summer showing that implant placement and the subsequent scar tissue formation, if it becomes firmer which is what a lot of scar tissue does around implants, um, they feel it's an upregulated response like an organ rejection picture. So it's now a T-cell, B-cell, plasma cell response, and they measured it by looking at the transcriptome, so looking at RNA. And it is interesting because you and I both know, like, Obviously anything that looks at a PCR is just— you don't know if it's dead or alive, it's there because that's— you're looking at the DNA fragment. That's just fine. I, I find it fascinating that folks are now doing the RNA analysis of those microenvironments, and I, you know, hopefully it'll not be too long before something's commercially available that can, can be used. And I would love to be able to send that off and know, for instance, uh, yeah, there's 8 things there, only one of them is really the problem. It's the one that's really producing, uh, RNA. So I, I, you know, obviously we can, you know, kind of go on and on about this, but, you know, to date, like you said, those companies that use antibody, that makes sense. That means at least you've been exposed and you've got antibody to it, whether I presume they're IgG tests.

Yeah, there are IgG and there are IgM, right? And that's a, that's another level of complication, uh, you know, the more we talk about, the more I can, we could round up a bunch of complications, right? So there's, there's science behind why the IgM tests can be recurrently positive when in basic science IgM antibodies should only last maybe 6 weeks, you know, in the common like exposure to something new, right? Right. But it's, it's not, it's not 100% universally applicable to across the board. And there's science behind why these Borrelia in particular, those bacteria for Lyme disease, can generate IgM antibodies recurrently.

Okay.

Yeah.

So then it's not a fair— yeah, once again, coming into why it's so much more complicated than it sounds. Well, that being said, at least, I mean, you— and this is why I defer to folks who do this. All the time. And anytime I have somebody who's, you know, concerned about Lyme from a patient perspective, you know, I immediately say, hey, this is out of, you know, my scope. So I try to make sure I get them to folks like you that really understand it and can work with them to help me. This is— it's a very complicated thing.

Um, I'll back up though. Like, when you talk about screening, I think you might have used the word screening, you know, testing if you will, or sort of like first tier, first line, you know, just assessment beyond the history piece and just doing testing.

Yeah.

Yeah, I, I don't have any qualms myself on, you know, antibody testing. Again, that's what most everybody's used to and that's what most of the labs are based on. If someone's got, you know, sort of symptoms that don't add up, right? And there's not a conventional explanation for, they're not getting benefit or getting help, support from the conventional system, there's suspicion about Lyme disease, especially if the history like matches on any level, alright? And they have, uh, antibody positive tests like Yeah, I'll call a spade a spade. I'll make full— I'll have full confidence that on, on some level they're dealing with, you know, Lyme disease. And then it's just a matter of, you know, the bigger, the bigger challenge is more follow-up testing and how to interpret that compared to your initial baseline testing before treating. That's, that's kind of where more the trick comes into play.

Yeah, yeah, definitely is complicated. You know, moving to something like mold where Although I felt mold was more challenging initially a few years back, it's— one, I just accept the prevalence of it and try to listen and understand who's, you know, been exposed either by their work or home history, travel history. And then, you know, we do now a provocative challenge just with glutathione and then a vibrant total tox test because it reinforces one, you know, our suspicions. And then folks with a lot of problems with chronic mold exposure, with or without any of the other things going on, have a lot of I would say neural, you know, symptoms that we've seen either, you know, and not the— not even the classic ones. It's just a lot of processing issues and, and very hard, um, or can be very hard for, uh, our team to, to help take care of them because of those processing issues with information and planning. So we try to work extremely hard up front to identify. And, um, I have transitioned out of, uh, homeopathic solutions for that because of how difficult it is, um, seemingly treatment-wise. So we've traditionally used, you know, Cellcore, and then now I've gotten very, um, specific about medical therapies, uh, up front just to try to get them in a better position, um, pre-op if, if they're going to go, you know, through an operative treatment, just so that it becomes, um, I think, an easier path for them, you know.

Sure.

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Yeah, I mean, so the reason I say that, uh, the reason— yeah, the reason I say that is, um, on a paradigm level, on a high level, when it comes to Lyme disease, broadly speaking, with all the co-infections and stuff, right, the, the general idea is that those bugs have found a way of entry point into a person's body and then it's just, it's there. They're hard to get out, they're hard to get rid of, right? For various reasons we won't get into. They're just more stealth infections, if you will, like subclinical infections we call them. They, they cause symptoms, but they're not so easy to like test and, you know, in Western, in, in conventional medicine, like substantiate their presence and how much trouble they're actually causing. The problem that the greater complication for me with the mold illness topic is, it's like twofold. You could— a person can have, in the case of a Lyme disease problem, the source of that inflammation that's being generated recurrently is the bug inside. With the mold illness topic, it can be both. It can be fungus, you know, mold or yeast fungus in the body generating inflammation and mold toxins that generate their own inflammation inside the body, or it can be exposure to the mold outside the body, as you alluded to, in the environment.

Yeah, I see. Yeah.

So now you got two sources of where the problem could be coming from. All right. And then on top of that, when we start talking about the environment, as you know, you and I already know, like, that become— that can become like a meaningful, daunting perspective thought, uh, you know, for for an individual or the family, like, okay, what could be behind the walls and how scary could that be, you know? And then how much work and money is that going to take? And there's a good number of people who just— it's almost like, I don't know if I want to know, right? Because now I gotta— if I— if it's too big of a task and we can't— we don't feel we can do something about it, then what do you do?

Yeah, that's, that's a scary thing for sure. Yeah, that is, uh, I, I try to— I've gotten out of the habit of saying anything about anybody's home. What I do say is, I just, I want you to improve your air quality, and these are some steps you can take to improve your air quality. I certainly have been surprised by how many people come back and then say, oh, we found something in the master bedroom We found something in the master bathroom. We had a leak in the, you know, behind the refrigerator. Whatever the case may be, you know, they, they end up finding it. But I try to just stimulate them to think of air quality because that becomes, you know, paramount, like especially where they're sleeping, because those master bath problems seem to be the one of the bigger culprits.

Yeah, no, that's a great, um, yeah, that's an interesting sort of focal point. And, um, yeah, so, you know, I mean, this is where, you know, the mold illness community, practitioner community, there's, there's, there's, look, there's, there's all kinds of controversy or debates in the mold illness community, you know, on how we tackle things, you know, from a more aggressive approach to a gentler approach because there's a lot of gaslighting, right? Um, in this, at this current time, there's a lot of gaslighting in the mold illness community where patients are really up in arms and overreactive about, uh, about their, their environment, right? And so, um, yeah, we've— I find myself and people I rub shoulders with within our organization, ISEI, who you presented for us at the last virtual conference just November. Yeah, there's a good number of people who are spending more time trying to sort of walk people back away from the ledge, so to speak, who've been gaslit with stuff on social media or their friends or family or whatever the case may be to say, "Hey, look, it doesn't need to be that daunting. You don't have to catastrophize and think about all the worst things." And you definitely don't need to just say like, oh, you've got this mold toxin thing, you know, finding, like you said, on Total Tox from Vibrant or wherever other lab, you've got a finding, like you need to move. Like there are, there are practitioners out there saying that. All right. And that's just, you just went from 0 to 60, like yesterday. I mean, that, that's, that's kinda inappropriate. And so you're, you're actually, set saying that you take a almost complete opposite spectrum approach and saying, hey, look, you know, air quality, let's, let's focus on that piece first. And then you're finding some people are on their own digging further. And then finding sources. Whereas a lot of practitioners are more about like, okay, let's find that source or sources and deal with it. Where some people get daunted by looking for the sources because it could be a real, a real challenge, a real project.

Yeah. And there's no specific, and I'm not here to, you know, discuss like the efficacy of any of those tests for your home or anything. That's not the point. Yeah. I think, you know, If you ask me what the simplest route is for anybody to do a bit better, it's like control the quality of the fluid and the food. So if the food has got problems, as you know, with mycotoxin levels from grains or nuts or whatever, that's one step that everybody can take to adjust what's going in.

Yeah.

And then obviously air, you know, and there's a lot of systems, as you know, that are touted to do XYZ. Personally, we looked at these. I'm extremely sensitive to mold. I had a bad mold exposure several years ago that made me relatively ill for a period of time that we didn't understand, and it took quite a bit to understand it and then finally, you know, resolve it. So from an air filtration standpoint, you know, there's IQAir, there's Jasper. You have to get things that are rated to help take care of spores, basically. And, um, I'm— once again, I'm not there to, you know, belittle anybody's air filter. So like, just know that if you come on and talk to me about it, or you come in the office and talk to me about it, I'm going to be very specific about what I think so that you can, you know, improve that portion, right?

Yep.

If you're— if you're respiring spores all night long in your bedroom, what do you think is going to happen to you? You're not going to feel very good. So, all the, you know, and we don't have to go into all the problems with mitochondrial dysfunction and fatigue and brain fog and all the things that happen if you have a chronic problem like that. But, that's just a step you can take that doesn't involve tens of thousands of dollars of mitigation and all this thing. You know, all this stuff to your, to your home. That's very obviously disconcerting. Um, yeah, go ahead. I was gonna say, I just try to keep those things, make them actionable. Like, if you, if you talk to somebody, it's too overwhelming if you just say, oh my gosh, now you have to move. Like, yeah, that's not practical.

And where I've landed, um, for myself is it's— and this is the art right? It's how motivated or what's the, where, what's the patient, where are they coming from? Okay. Those who are really, really, really sick, they're more apt to have to dig into that level at some point. All right. People who aren't as sick, they can, a lot of people can get by even if they've got a mold source behind a wall. If they clean their air, but they don't ever deal with that source, it might be enough, right? They could— they feel better. Yeah. Could it completely resolve their issues? Probably not in principle, but they might be better enough that they can maintain that level just with that air filter for, you know, a meaningful length of time. And it's not a destiny that they're going to be worse and that that air filter is not— is insufficient. Okay. It's not a destiny. Just don't know. Right. So a lot of it for me is like, how sick is the patient? And then the second piece is, How, um, how motivated are they? Or similar to that is like, how much have they already read about stuff and what are their expectations, right? Person comes in and they're always like, I've listened to this podcast, I've listened to that podcast, I follow this person, that person, I've read this and that, my friends have fed me all this other stuff and like, I gotta get to the bottom of it. Okay. If I'm telling them to, you know, hey, just do a little bit of this or just clean your food or this and that, like, um, they might kind of feel like I'm not providing them the service or the knowledge base and expertise that they're looking for. But at the same time, if a person's not— if they're naive to all that, I don't need to sit there and gaslight them either. And like, if you don't find that thing, you're up a creek, right? I don't need to do that. So that's where it's a real art. It's a real art. But there's a lot of factors involved with the mold illness topic, is the bottom line. Oh yeah, we know this. All these topics are a complex— all these topics are complicated, but how we talk about them with patients doesn't have to be.

Well, that's, uh, I mean, that we're gonna segue to the one that I find is, or it has, has gotten me more motivated as of late, you know, by history taking. We're all taught in school that, you know, you have to start with the history and that will, you know, lead you basically to the answers. And, um, parasitic problems are, are probably really underappreciated. And certainly we didn't spend a ton of time in medical school learning about parasitic problems. But I, because of, you know, the, the, the patients I serve and our ability to travel, and we'll just say my location, right? I'm in Austin, Texas. It's very common for people to vacation in Mexico.

Sure.

And invariably I'll have patients show up with all sorts of, you know, symptomology consistent with a parasitic infection. And when you just ask them historically, I mean, I just go to like, okay, well, where do you vacation? And, you know, if they are in Mexico, I'm like, okay, did you eat off property ever? And basically, if the answer is yes, then I'm just like, well, okay, now you may not have this problem, but there's a really strong shot that you do have a parasitic problem. And most of them are like, oh yeah, I got sick.

Yeah.

And I'm like, well, didn't you do— what did you do for it? Oh, we just— yeah, we didn't do anything. Oh, okay. Um, And then you have groups of patients who may be from a, a nonprofit standpoint, do mission work around the world. Like, I have all sorts of people all the time who are coming in and, you know, they just have a parasitic problem, or, and they give you the history of traveler's diarrhea over and over again. And then for whatever reason, it's just not being appreciated, I guess, would be one way. Or I don't think you have to be a rocket scientist to figure it out. It's just ask a couple questions and then, you know, it'll all be laid out. And I've seen it play out in, you know, a number of scenarios. So, uh, like, by all means, give me your thoughts about, you know, the problem of parasitic infections.

Yeah, so, um, the, the short, the short version is, um, this was the topic that led me to the SOPO community, right? I mean, for those who don't know, the, the whole company was based on this topic effectively, all right? Uh, their, their flagship first product was regarding this topic, and I'd heard Todd Watts presented a, you know, a different conference years prior, you know, thought really well of him, and when this just was at the forefront of my thinking, I was like, I'm going to call up that company and see where they can point me for learning. Right. Fast forward. You know, I'm a kind of skeptic at heart, right? You got— I'm very inquisitive. I'm extremely curious and open-minded. But in the end, that's just like self-sabotage because I don't accept, you know, things on a whim at all. I have to go through a process of like proving it to myself or someone's got to prove it to me, etc., etc. So even after learning about this stuff, um, you know, I went on a journey, right? And I made all kinds of calls. I was— I was at one point— I mean, you know, fast forward— at one point I was— I called veterinarian— veterinary offices. How come you guys are diagnosing parasites like on the spot looking at a poop right in front of you from the pet, and the humans, like, we send to a lab and they, they can't diagnose it? And you got something moving right in the sample, like, what's going on there, right? And then who's the lab that you're working with? Do you ever send stuff to labs from the veterinarian clinics? Yeah, we do. Okay, who are they? I call them, then I call their upchain. I go upchain, upchain. At one point I'm talking to like the lab director of the second or first or second largest vet lab in the country, in the US, but their, you know, their upchain, uh, director of the lab is in Canada, right? And I— they were getting ready to transfer me to that director to have a chat, and all of a sudden they kind of like pick back up. The administrator picks back up and goes, so what is it again, blah, blah, blah, blah, that you're asking— wanting to talk about? And then I explained again. They're like, yeah, they're busy right now. And then I got blocked. I got, I got like ghosted, right? They wouldn't let me talk to that person. I called back some times and no one, they wouldn't call me back. And I'm like, what is going on here? Okay. So in the end, all that is to say, like I went through a real, I mean, I started doing the Quest and LabCorp, like IgG antibody tests to all these worm parasite labs that are there, but really aren't really helpful at all either. I, but I had to prove it to myself. All right. So I went through this whole thing for months. And in the end, you know, talk about, in this case, not so much complicated but frustrating, you know, talk about lab difficulties. Hey, at least we have labs for the Lyme testing and for the Lyme topic and the mold illness topic for the, for the worm parasites. Okay, being specific to worm parasites, not the malaria cellular parasites. Right, right, right. We basically don't have a tool there, right? So there's a couple labs, you know, you and I know there's a couple labs that are that aren't conventional. But I believe one of those labs, the guy who founded it, is a former CDC employee, like a lab, a lab director or lab manager. I don't know, but he was former CDC, is my understanding. So there's a couple labs that do this kind of work, but, um, you know, they're, they're sort of, they're off the mainstream grid, right? I mean, they're, they're not mainstream labs. They don't, right, insurance and blah blah. And in the end, a lot of the problem is that these worm parasites don't all— they're not constantly, or sometimes rarely, actually in the gut. So collecting poop isn't even really that accurate or sensitive because it's not going to be in the poop, right? So, and that's, that's basic science right there. That's not even alternative thinking.

We know that's why I tell everybody more, I'm just like, look, we'll look, but it's not going to tell us. If it's there, great. If it's not, it doesn't really mean anything.

Yeah, yeah. So it's, it's hard. I find it even— I find that's the challenge with this topic is How do you prove it, right? In this day and age where especially for the practitioners, we gotta defend what we're doing. Like, if there's an audit or a board or whatever else or God forbid lawsuit and all that kind, like, you gotta be able to have some explanation rationale and ideally some backup for the ration— your decision-making. So, that's the hard part. It's all upfront. It's all front-loaded in my opinion, right? Like, the diagnosis of it to substantiate the diagnosis is not easy. Now, you know, we could go down a rabbit hole technicalities of how we can indirectly suspect worm parasites through the eosinophil markers on the CBC, or, you know, people who have this sort of Th2 immune system reactivity, whether that means clinically or certain kinds of markers on blood testing, etc. But direct testing of the worm parasites is extremely challenging. And then how do you really identify when it's like you've treated enough? That's also really challenging. So I'm with you totally. This is a huge— hugely undervalued. And, you know, I could pull up slides easily on validation that it's a hugely undervalued topic from even the CDC's own website. Okay. World Health Organization. And across the board, we could, we could find all that.

Right.

But that doesn't change the fact that substantiating it for the individual patient in front of us on paper to say we can see it or we, we can see, you know, some meaningful signs substantiating this as a diagnosis and we're going to treat and then we're going to follow those markers, not just your symptoms. That's, that's the real challenge.

Yeah, I agree. I mean, Entamoeba histolytica is still the number one, you know, parasite around the world. I mean, that, that has been borne out time and time again, causes liver abscesses. I mean, you can look at the WHO data, doesn't matter. I mean, that's not changed. Um, that's why clean water is such a big deal around the world. I mean, people underestimate, you know, filtration of water Uh, it's a big problem. So, yeah, yeah, uh, I agree. Like, just like we've highlighted, you know, Lyme, parasite problems, very, you know, challenging. Uh, mold, still very challenging. I feel a little bit, uh, you know, better about that than, than others. Um, and then we haven't even gotten to all the fancy environmental toxins that people just show up with it have no explanation whatsoever. Those are fascinating. I mean, some of them are common. Like, you know, I'll have somebody who lived near a golf course for 30 years and has a bunch of atrazine, or I'll have somebody who grew up around ag and has a bunch of glyphosate. What are some others that are just common ones that pop up for you?

Now, I'll be honest with you, I don't really think about the specific other toxins like individually. I just think about them as a whole categorical group because in the end when I'm treating those things, I'm treating them as category anyway. Okay. So yeah, I mean, you know, you and I, when we're in conferences and we hear, you know, about atrazine or glyphosate, those are really common discussions. You know, microplastics is, you know, super on the radar these days as a hot topic, et cetera. But you know, I'll be honest with you, when I look at reports like the Total Tox like you talk about, and they've got all these chemical names, you know, 2,3-, you know, blah, blah, blah, dihydro, blah, blah, blah, blah. And I, I'm not really like memorizing or paying attention to the specifics because I'm not having, I'm not gonna treat that one thing in isolation. And the treatments I'm using are, you're just gonna round up like the whole category. So yeah, I mean, I think it's what I love about, you know, when you talk about like the, the Parkinson's connection as we know about from the mainstream media and such with, the golf courses and such. Um, uh, yeah, what I love about those news pieces is— and, and awareness is, is just that. It's the bringing to the— heightening the awareness to the general public about the effects of these toxins. You know, um, with all the news that still comes out, like, look, we're all inundated with so much information, right? With all that's out there, it's been— how many years has it been that we get news every year about lead and cadmium and arsenic or whatever in all kinds of foods. I mean, just across all kinds of foods. I mean, freaking almost all the rice cereals pulled off the market like 2 years ago for, for babies, right? Because of the arsenic. And yet now when people— when I, when I screen people at physicals for arsenic and we see them and they're like, where could that be coming from? Is it my water? Like, chances are not good. Like, it's, it's— chances are it's your food. Really? Which foods? I'm like, oh wow. Like You know, no judgment, no criticism. It's just that we, we don't— we're still not really aware, despite all the stuff going on in news, social media on top, we're still not really aware as a population how much we're exposed to all kinds of toxicities. And it's not to be daunting. Like, I've, you know, I've gotten to a place myself, like, it's not to be overwhelming and, uh, overfixated and, and daunted, uh, by the fact that we're surrounded by this stuff. It's to say It's just awareness to say, look, this is the world we live in. You're not— we can't, we can't live in a bubble. We can't run from it. We're not moving to Mars or whatever else. Okay. And if you live in the blue zones, okay, then you got some protection, but unless everyone's going to move to blue zones, which only lasts so long because then it's not going to be blue anymore. Okay. Like we're not escaping this. Right. So it's just, it's just, what are we going to do on an action step to mitigate and reduce these things? So same as what you said with the, uh, with the air filter, like, hey, you don't have to get overly whelmed with looking behind every single wall, whatever. Like, hey, if you clean your air and that, and that gets you far enough, fantastic, right? If you filter your, your water and you can see your results go down or you feel better, fantastic. Like, progress is still really meaningful. It doesn't have to be perfection, which is kind of like what I feel is this sort of unspoken vibe these days with all the stuff we get inundated with, you know, toxin this, toxin that, toxin that. I'm not minimizing any of that. It's all there, but it's easy to get overwhelmed with all the noise.

Yeah. I have that fundamental philosophy of like slow progress is better than no progress. So, there's— Yeah. There's just incremental change will actually, you know, help you more in the long run and fixating or over-fixating on certain aspects of it don't really serve you. So there's really no point in trying to do that. Yeah, the overwhelming amount of information, whether it's on whatever platform, it doesn't matter. It, it's pretty daunting to sift through. And I'm sure you, just like I, get asked every day over and over again about all of it. So I don't, you know, I, I just keep it very, you know, simple. Make the changes you can make and, and go from there and just keep baking, you know, if you can, incremental change, that's fine.

Having said that, you know, really briefly here, those, those 3 we talked about, right, with Lyme, mold illness, parasite, worm parasites, there's reasons those are— I, I, in my opinion right now, as it stands right now, there's reasons why those are sort of bigger players Right. Those toxins and stuff, I don't know that I, I don't know that I've seen data and I don't know that I've heard enough clinical observation stories that, you know, you treat those things, then people like feel better. Right. And so that for me, that's more of a long game. And whereas people who are symptomatic and sick, especially the really sick people, those first 3 topics, like they'll get bigger wins in how they feel. Addressing those as a front-loaded sequence priority than those other toxins for the most part. That's my observation. And I don't know that I've heard a lot to the contrary from colleagues.

No, I haven't. And we're in a very narrow group where we're looking at surgical patients. So, it's even a very small subset relatively speaking. Um, but certainly when you make, um, or help them improve on those, um, they do feel a lot better. There's a lot going on, you know, in our patient population, especially if they end up having surgery to add on to all those other, um, you know, issues. So it's a lot of work, it never stops. So, um, I think that's why we're thankful for people like you.

That's why I'm so much like, you know, appreciate because there's so few people like you who do specifically what you do. It's, you're, you're super, super, super narrow niche there, you know?

Yeah, I know. Some too. I, I hope to help as many people as possible.

For better or for worse.

That's right. It's, uh, it's definitely, yeah, it's a challenge. But, you know, we probably have upwards of 2.2 million breast implants placed annually worldwide. And depending on how someone, as we've discussed here, can manage their environment, you know, there's going to be a certain amount of chronic inflammatory response regardless to a device. And how that ultimately affects each individual is a combination of all the things we discussed and their ability to detoxify from all those things and stress and all the, you know, other inputs, if you will, from their, their lives. You're just— you're a collection of experiences and it's a lot to manage. It's not becoming, you know, easier. And, and certainly I've appreciated, like, your perspective on it because you do Approach it the right way. And the way I think about it is like you have to remain curious about things. If you're not, then that's— I mean, you're losing the art. Like, you have to be curious and ask questions. And that's how we've built our program, just like you've built your programs, just being curious about that specific problem and trying to learn as much as possible to help, if we can, as, as much as we can with each individual case, knowing they're all going to be a little bit different and and try to tailor it for them as best we can.

Yeah. And it's work. I mean, it is work because we have to keep learning. It's, it's, it's a lot easier to just keep doing what you know. So yeah, kudos. Like I said, kudos to you. I mean, for you to be like the front run— the frontier leader, if you will, like you're, you know, you, there's, you don't have a trend to follow, a sort of like a paved path to follow from a ton of other people who are plastic surgeons doing what you're doing. Like, it's really hard to be the, um, you know, the, the, the trends, the— to be against the grain, right? Uh, it doesn't— it doesn't even need to be trend setting or leaders. It's not like you're— a lot of people aren't intending to lead. It's just, um, so anyway, I mean, all that to say, it's just, yeah, thanks for— thanks for being who you are in the pres— in the, in the role and position that you fill in this community and, you know, in humanity at large to serve people's needs because, um Yeah, I don't know a single other person who does what you do myself.

Thank you. Well, there's— I think there's folks coming along. We'll try to expand our programs.

Yeah, I know you got some projects to do that, so that's awesome. That's awesome. Yeah, but you're still like, you know, yeah, being the first one to face the, uh, to face the, the firing squad, like, it's not easy. So anyway, thanks. Thank you.

Well, it's been a pleasure having you on today and let everybody know where to find you at Rootseek. So let's make sure everybody is aware of that.

Yeah, rootseekhealth.com is like our virtual practice. We have a few different entities, but rootseekhealth.com is our virtual practice. And then just Dr. Mark Su, drmarksu.com is kind of like the easiest central, central point.

Well, we'll put all this in the show notes too. I really appreciate having, uh, Dr. Siu on today. We've talked offline a bunch, and it's, it's been fun to have him on and pick his brain. He's super smart about all this, and I'm just constantly curious about all these things that certainly affect our patients. And, um, look forward to learning more.

So yeah, keep up your great work.

Thank you.