Fighting Chronic Fatigue with Dr. Miles Nichols

Welcome to the Lyme Voice Network. We are chronic illness warriors, caretakers, and advocates who are overcoming illness in all of its many forms. We created this show to inspire, educate, and encourage you on your path to wellness. We're here to help you put the puzzle pieces of healing into place. Join us and our network of Lyme warriors as we discuss how fighting is a mindset, healing consists of choices, and living is the outcome.

Welcome to Lyme Voice Radio, where we talk about all things chronic illness. Lyme Voice is brought to you by Invita Medical. Over the last 20 years, Invita Medical Centers, located in Scottsdale, Arizona, has become a proud leader in precision precision-based chronic Lyme disease testing and treatment. From advanced CLIA-validated next-generation sequence testing for Lyme disease and co-infection identification to treatment of all primary and secondary co-infections using patient-targeted anti-infectious therapy, immunotherapy, and the elimination of infectious neurotoxins. Invita's highly trained medical team and facilities provide the latest in research-based precision for the treatment of chronic Lyme disease and tick-borne infections, helping to transform patient lives for the better. Call to speak to one of their patient care coordinators today to see if Invita is right for you. Welcome, welcome, welcome to another episode of Lyme Voice, and I am here with Miles Nichols. And my— Dr. Miles Nichols is a functional medicine doctor specializing in Lyme, mold illness, gut, thyroid, and autoimmunity. After Dr. Miles personally struggled with chronic fatigue in his early 20s, he dedicated himself to figure out the root causes. He suffered with and recovered from thyroid dysfunction, autoimmunity, a gut infection, Lyme, co-infections, and mold illness. Dr. Miles and his wife, Dr. Diane Mueller, co-authored How to Use Your Mind to Heal Your Mold and Lyme and Stress Resilience. They founded the Medicine with Heart functional medicine clinic in Colorado and also the Medicine with Heart Institute that trains other doctors in functional medicine. Dr. Miles has been a featured speaker at national conferences and professional associations. With a doctorate in Oriental medicine, he has extensive training and expertise around herbal remedies, herbal medicines, and has developed formulations used by functional medicine doctors across the country. Thanks so much for being here with us today, Dr. Miles.

You're welcome. Pleasure to be here. Looking forward to diving in on helping people understand a bit about what we do and how certain things can be helpful that maybe people haven't been exposed to before.

Yeah, you know, we did our pre-interview a couple of weeks ago and you mentioned several things that I've been implementing and also just thinking about since then. So I'm excited to bring your perspective to the mic.

Yeah, looking forward to it.

So give us a, an overview of your journey into the land of chronic illness that started for you in your early 20s and how that's shaped your practice.

Yeah, well, I still remember the day when I walked into Valerie's office. She was the president at the medical program I was in, and, and I was having a hard time getting to a morning class. They had a very strict attendance policy, and I She was saying, "Why is this a struggle for you? And it's risking you getting through school and following your dreams and aspirations." And I said, "I don't know. I have a hard time getting out of bed in the morning. And it doesn't matter if I got 8 hours of sleep, 9 hours of sleep, even 10 or 11 hours of sleep. Sometimes I feel more tired, not less tired." And she said, "There might be something medically going on." I said, "Yeah, I agree." Because even when I do wake up later in the day, I still don't feel great energy-wise. I feel okay, like I can get through, but then I go to sleep sometimes early and wake up late and still feel depleted all the time. And so that really inspired me because I was really feeling at that time like, am I, am I going to be able to follow my dreams? Am I going to be able to become a practitioner, to do the things that I want to do, to help people in the ways that I want to help people? And I felt that threatened And in that moment, I really became dedicated. I have to figure this out. And so that really inspired me. And I started going to a sleep specialist. That didn't help a lot. It helped a little. I got through school, but I struggled to get through school at that time. And I really started a journey. I started going to every person I could think of. I went to naturopaths. I went to acupuncturists, chiropractors, energy healers, functional doctors, integrative MDs. Name it. And a lot of things helped a little bit, but not a lot, until eventually I had to— I started studying functional medicine myself. I found a good mentor. I started testing for more things. That was when I was able to find that I did have a thyroid issue despite having been tested and told it was normal before by a conventional doctor. I figured out that optimal ranges are different, and my TSH had been in the 4 range, which is not good from a functional perspective, even though from a conventional perspective, it might not flag anything. So I finally figured out I had a thyroid issue, and then I started researching that there's a gut connection with thyroid. I found a gut infection, and then I found an autoimmune issue in the gut, and I discovered some treatments that really started to help, and really all on the natural side. I didn't really need any medications, herbs, nutrition, lifestyle, certain vitamins, certain nutraceuticals were able to help me. And then later, some peptide therapies, which I think we'll talk later about, were able to help me. It was a long road, and at one point I lived in a moldy home and I had to figure out getting out of that. And my wife, Dr. Diane Mueller, she also had her own chronic health struggles. So you're both dealing We were both in the thick of it dealing with our health struggles, and neither of us were served by the practitioners that we went to. So we felt like we had to figure it out on our own. And we were very fortunate to get some good mentors along the way, to learn some things from some other people, and then to figure out some things on our own through doing a lot of research, experimentation. And since then, after feeling much, much better after I've gotten my energy back. I feel much better. I feel like I have the energy to be passionate, to do the things that I want to do. Now, we've had lots and lots of people who have come into the clinic who were struggling in similar ways, had been to many, many other practitioners, not gotten results. And that, that's our, our typical patient at this point, struggling with either chronic fatigue or fibromyalgia or some other very significant quality of life issue where they feel like their brain isn't functioning or they're not able to be engaged in their life, or they can function but their quality of life is really poor, but no one's been able to figure it out or help them. And that's really the population that we've wound up specializing in, in working with. And that was really through our own discovery of recovery in ourselves that became confident in the ability to help people who hadn't had help in a lot of other places.

Yeah. Wow. And how long was that journey for you between that day you remember, "Why is it so hard to get out of bed?" and when you actually felt normal?

Well, it was a long time. It was about 10 years. But that, that was because—

Wow.

That was because I, well, maybe 7 or 8 years, but that was because I didn't have a good frame. It just took that long to try to find the right practitioners and try and find the right tests and to sort through all the different issues. Once I got the right diagnoses and started to sort through, it was really maybe 1 to 2 years after that that I was able to feel much, much better.

Awesome. I mean, it's amazing. It just kind of takes, You're going to doctors and they're testing your thyroid early on and they're saying, "Oh, you're fine," or, "You're within normal range." And then you go back, you find different practitioners who operate under different guidelines and different boxes and different understandings and different timelines, and they're like, "Oh, well, maybe you're within range, but here, let's listen to what you're actually saying and you're not functioning normally. So let's start there and figure out what's wrong there." Yeah, that can take years.

Yeah, it was quite a journey, and I think it is for a lot of other people. And hopefully my story can help people feel some hope that if you haven't found help so far, that there is some, some help out there. And just as a matter sometimes of going through a lot of different practitioners, a lot of different treatments, in order to find the thing or things that'll work together to help bring the body back into balance and fortunate to— although at my weakest point I was really questioning, am I going to be able to live my dreams? Now I really am living my dreams. I really am able to do the things that, that I love to do and have a functional medicine practice, and I'm able to train practitioners, I'm able to teach and travel and speak. It's really wonderful.

Yeah, that's awesome. So, okay, we're going to get into peptide therapy because we haven't addressed that much, but I think one of the things that intrigued me in our conver— in our prior conversations is that some of what you're doing, you're diving in and using your full resources from with a medical background to address stuff. But you're also coming at it from a simplistic standpoint of simply like one of your specialties is breathing.

Yeah.

And using breathwork to heal your body. So that's something anyone can do with or without a medical degree. It's not simply a practice, it's a practice that can be dove into. So let's start there because you have a couple of different certifications that I'd love to talk about.

Yeah, yeah, I'd love to. And breath is something that we all do. And I think a lot of people know that maybe there could be some work on their breathing, but I don't think a lot of people understand the power and potential of breath practices for how impactful they can be. And I think a lot of people get stuck on diet and supplementation and exercise as the main things that they're focused on doing. And there's so much possible from just a couple of additional practices, and breath is one of those things. Meditation is another of those things. Cold exposure is another of those things. And there's many, many deeply powerful. There's even research that really dives into how this stuff works, and there's a lot of misconceptions also about breathing. Some people think that what they need is to generally just be breathing deeper, but sometimes it's actually the opposite.

Yeah, and that's fascinating. You had said that air hunger is such a huge symptom in this Lyme community, and that was one of my very first symptoms for a long time, and I just thought I was out of shape. As an 18, 19-year-old, and I was like, "Oh, okay, I guess I'm out of shape. This is what adults feel like. They can't breathe if they don't exercise every day or something." But you had said that through breathing exercises, you can teach your body to tolerate more CO2.

Yeah, yeah. So one of the breath techniques that I really like is called Buteyko breathing. And So one of my certifications focused on Buteyko breathwork as the primary breathing intervention. And this is a breathwork that focuses on actually reducing the breathing volume, which means rather than— it's not that you're not breathing deeply, you can breathe deeply, but it's when people think take a deep breath, mostly they're thinking like that is fast and big., but the volume of air per minute, the amount that comes in, if you reduce it, you produce more CO2. Everyone talks about oxygen, want more oxygen, and that's important. Oxygen is very, very important. And CO2, carbon dioxide, is also incredibly important. CO2 is involved in the buffering system of regulating pH and the metabolism. It's involved in blood pressure regulation. It's involved in what I think is really important for the chronic Lyme population to understand, which is nervous system regulation. You can actually regulate the nervous system by increasing CO2 to go into the relaxed rest and digest parasympathetic nervous system state. And you can shift from sympathetic, which is that fight-flight state that's associated with anxiety, it's associated with Also a fast respiration rate. When people get into that sympathetic zone, the breathing becomes quicker. And even panic, panic and anxiety. So many of our patients who are struggling with chronic Lyme have anxiety and sometimes even panic attacks. And you can actually reverse a panic attack very quickly with good breathwork by reducing breathing, by increasing CO2 levels. And that Air hunger is a sign by the brain that it's not tolerating CO2 to the level that CO2 is present. And usually that's not because there's too much CO2. Often it's because the body has been trained over time to run on a lower CO2 level, and increasing that CO2 level takes a symptom of air hunger to start to— for the brain to start to be retrained. So that air hunger symptom often is a sign that we're dealing with a low CO2 tolerance, and through breath practice, we can increase that CO2 tolerance, which can then lead to the relaxed nervous system. And a relaxed nervous system and many other benefits— blood pressure benefits, as well as cardiovascular benefits, as well as circulatory benefits. We see a A lot of people who have cold hands, cold feet a lot of the time, especially in sympathetic dominance. And we can also get blood flowing to the extremities through increasing CO2 levels as well through breathwork. But it's not deep, fast breathing that does that. It's actually slowing or reducing the minute volume. It can still be deep into the belly, but it's very slow, and it's not trying to breathe deeply. It's really trying to breathe less total air and practicing that breathing less air, which will induce or worsen a symptom of air hunger temporarily. But by training the brain to be able to create a new baseline of tolerating more CO2, then that air hunger when you're not practicing will be less and won't be there as much. So you practice and train to increase the threshold, and then the symptom in day-to-day experience as you're breathing becomes less. An Ideally, the breathing slows in day-to-day breathing so that there's more parasympathetic nervous system activity, more circulation to the extremities, more blood pressure regulation, and many other impacts. Asthma and lung issues or shortness of breath or wheezing are also really strongly impacted by this kind of breathing in a positive direction.

It's funny, as you're talking, I'm like very conscious of how I'm breathing right now.

Yeah.

So before we had done the interview, I was familiar with like Wim Hof breathing practices and yoga and different aspects, but I was not familiar with the Buteyko.

Am I saying that right?

Buteyko. Yeah. Okay. And so I was looking it up on YouTube and practicing before we had our first call. And, and again, air hunger was a big thing for me for a long time, but so is the cold hands and extremities still something I still kind of deal with. And I just thought, like, it's one of those things. It's not hard to do it. It just takes— but you have to be intentional and practice it.

Yeah, it's not hard. And ideally, you do want to train your body to do it naturally throughout the day. And it's so— it's not even that you have to practice all the time, but the more you practice, the more your body is being trained to do that automatically. And And one other symptom that people have, a lot of people in Lyme and mold world have this chronic sinusitis and issues in their sinuses. And sometimes it's congestion, sometimes it's repeated sinus infections, sometimes it's difficulty nose breathing. And that then creates worse breathing patterns when you nose breathe. When you breathe through the mouth, that worsens, that increases the respiratory rate typically and causes a lot of problems. There's a lot of issues that come from breathing out of the mouth and not the nose. So the nose can actually unblock. A lot of people, if they notice they're a little stuffy or if one nostril isn't getting air in, which is really common, doing this practice of reduced breathing will often lead to finding that, oh wow, the nose is opening up and unblocking and there's air coming in through both nostrils. And then it feels like you're getting more air in easier because the nose is unblocked. And again, that reduced breathing can produce that. And that's a sign that you're increasing the CO2 tolerance if your nose unblocks and you start to get sinus drainage and clearing out. And so that's another thing as well for people to know that can be impacted by this kind of breathing.

Hmm. Well, and I know sometimes sinuses are some of the biggest issues Pain is a big one, but a lot of people deal with sinus stuff ongoingly.

Absolutely. And we in the clinic, we test for MARCONS, which is a multiple antibiotic resistant coagulative negative staph. A fancy way of saying it's a, it's a bacteria called staph that's resistant to multiple antibiotics that we commonly find in 95-ish of, of people struggling with mold and a lot who are struggling with Lyme. And so it's important to treat that too, but their breathing techniques can go a long way to helping. And often that treatment works a lot better when we combine it together with a breathing technique as well.

I think the thing that I've learned just about breathwork is just how powerful it is. It seems simple, but it's very powerful on a lot of different levels and what it does for you.

Yeah, and you mentioned Wim Hof breathing as well, which is something I've also deeply studied and also working to teach as well. And it's something that the breathing— and the Wim Hof breathing has research study that's fascinating. And it's in a little ways, it's opposite. It's not reduced breathing, it actually is big and faster breathing, but for a controlled period of time. You wouldn't want to breathe that way all day, every day. That's not the way to Just like you wouldn't want to lift weights all day, every day. You'd wear out your muscles, but a little bit of weightlifting is good to build that strength. Wim Hof is— think about it as almost the weightlifting of breathwork. It's this very intense and deep, sometimes spiritual type of a breathwork that you do, and it actually induces stress. They have a study where they saw that it brings adrenaline levels way up really quickly, and it brings cortisol levels way up really quickly, which you might think that's probably a problem, and it would be if you were doing that all day. But the model for a healthful adaptive stress response— if someone cuts you off, you want adrenaline, you want to slow down and react right away, you want to have that surge, but then you want it to dissipate really quickly afterwards. You don't want to hold on to that. You don't want it to become chronic. You want you to have this robust mounting of a stress response and then a quick release and relief. And that's what the Wim Hof breathing mimics. It's this deep, intense breathing that brings adrenaline and cortisol up, and then you breathe out and you hold a very long time, sometimes a minute and a half, 2 minutes, 2 and a half minutes, some people even 3 minutes. And that brings everything back down. And that's modeling a stress response that would be healthy. And They've done a study where they took endotoxin, which is something that a lot of— it's so interesting in the mold world. Everyone thinks mold and mold toxins, but there's some new evidence, some new research coming out showing that endotoxin may be as reacted to or more reacted to even than mold in people who think they have mold illness. Now, water-damaged buildings that have mold can also have bacteria that are releasing endotoxin. And so it's similar in the way that you get exposed to endotoxin, but you can also get exposed internally from infections. And they do a study where they inject dead E. coli into the bloodstream. And when they inject that E. coli, that's an endotoxin. People get sick and they feel miserable for about a day after that injection of endotoxin. What they did is they had Wim Hof do his breathing method and he mounted this really intense stress response and then relaxed and then mounted it and relaxed and mounted it and relaxed with his breathing technique. And he didn't have any of the symptoms. And he had all these anti-inflammatory markers go way up. Like he was really, his immune system was activating anti-inflammatory markers to get rid of the inflammation that was happening from the endotoxin that was injected into him. And certain pro-inflammatory markers went down. There was a lot of inflammation regulation and probably a quicker detoxification because he didn't have symptoms. They thought, "Well, maybe this is just him." I mean, he holds a bunch of world records. He's a pretty amazing guy in a lot of ways. Maybe it's his genetics, something like that, but he said, "No, let's train. I'm going to train 12 people and have them repeat this." He did. People, they repeated the study. They were injected with endotoxin, and they have over 1,000 people injected with endotoxin, and pretty much every single person has this reaction except these 12 people. And these 12 people also had no negative symptom. They had that mounting of high adrenaline and cortisol quickly, but then it came down. The people who didn't breathe, the controls, they mounted a stress response, their cortisol went up, but it stayed up a lot longer. It was more like a chronic stress response and symptomatic, whereas the breathing group did this really quick, robust adrenaline cortisol response, then back down, and all these anti-inflammatory things happening and clearing that toxin much quicker. So Wim Hof breathing is not a breathing that you'd want to do all day every day, but it's a breathing that you would do as a— just like a weightlifting where you might do it once a day or you might do it 3 times a week or something like that. You do it as a set practice and it develops that healthful stress response for being able to mount it and relax quickly. And that's There's so much HPA axis dysregulation. That's the hypothalamic-pituitary-adrenal axis, a fancy way of saying there's a lot of adrenal issues in— not from the adrenal glands themselves, but the brain doesn't communicate to the adrenal glands. There's a dysregulated communication in so many people who are struggling with Lyme. Yeah. And we need lots and lots of tools to be able to regulate that. Now, I will just mention to everyone a caution with relation to Wim Hof breathing, which is not for people with seizures, not for people who are pregnant, and it is for certain heart conditions. You want to check with your, your doctor before doing it because your heart rate will increase temporarily during— when the adrenaline goes, the heart rate increases, and then it goes, and then it decreases a lot, goes up and then it goes back down. And if you're very, very weak or struggling a lot, please seek a practitioner's support in guiding you through this kind of breathwork. But they did. The Wim Hof Foundation did a small trial, not a published study, but a small trial with people with Lyme specifically. Really? Yeah, they did. And you can find the video on YouTube, Wim Hof Lyme. You'll see it. And they got a group of— I don't remember how many people, but they got a group of people together. They did a training for them. And they had people feeling better in ways they hadn't from other treatments for a long time. So it's very, very helpful, but you want some good training and to use certain cautions with— just like with weightlifting, it's a little bit intense. With Wim Hof, it's a little bit intense. So use some caution, get good training with it, but it can be an immensely powerful and beneficial tool. And the research shows it. When you can clear endotoxin, when you can increase anti-inflammatory markers, when you can to re-regulate the stress response. That's powerful stuff.

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And that's why we called our first book Stress Resilience, because building the resiliency to handle stress. It becomes— in Lyme, in mold, in many chronic illnesses, the resilience goes way down. It's like the threshold for what you can tolerate becomes so narrow, and little things, you, you feel yourself reacting in ways that you wouldn't think of reacting if you were in your right mind. But it's almost like there's the short fuse that happens when the— sometimes the chronic infections can really inflame the nervous system. We also know that with certain chronic infections like Lyme, mold exposure, Bartonella, and a few others, that, that it can create this autoimmune neuropsychiatric syndrome where, where there's an autoimmune cross-reactivity where the immune system thinks that the Lyme bacteria or the mold toxin or the Bartonella bacteria that the immune system looks at the dopamine receptors in the brain and certain other receptor sites as very similar in their structure. And then there's a cross-reactivity where the immune system is thinking it's attacking the infection, but it's actually starting to attack receptors in the brain for neurotransmitters. And then we see neuropsychiatric symptom onset. So someone, they were never anxious in their life before, And then after a big mold exposure, a big chronic infection, or a chronic infection plus a big stress exposure, something, some perfect storm of things pushes them over the edge into a chronic stress response. Sometimes the immune system attacks receptor sites in the brain, and then we see that the personality almost transforms overnight in a way that, wow, I used to be able to tolerate a lot of stress, and now I can't tolerate hardly any, and I'm anxious a lot, and I I'm feeling like a lot of stuff starts to trigger me. And, and that's where some breathing techniques can help re-regulate. And then also some brain retraining can be really important and helpful as well in those situations. And, and of course, working on the infection, finding a practitioner to help work on the infection that created that cross-reactivity in the first place. Because if you, if you deal with the brain retraining but you don't deal with the infection, then you might perpetuate. It's a multifactorial piece of dealing with the infection, looking at regulating the immune and nervous system through things like breathwork is one really powerful tool, and then also some brain retraining can be a very, very powerful combination. It's a reason why we called our, our most recent book, How to Use Your Mind to Heal Your Mold and Lyme. We don't just use our mind, It's not just, just your mind, no. But the underappreciated area, I believe, is in the mind and the breathwork, and certain new therapies like peptide therapies, I think, are underappreciated as well. So use, of course, functional medicine, find a good practitioner, use herbs, use antimicrobials. Those are really important. And the people who I see get the best results are the ones who are also taking seriously and implementing breath practices, implementing brain retraining practices, implementing cold exposure, doing saunas, and this kind of creating a whole lifestyle out of it. Because we get people all the time, they say, hey, I've tried a million diets, I've tried antibiotics, I've tried a lot of different supplements, I've taken hundreds of them. They come to us, they say this, and And I say, well, we're going to need to keep working on the diet. We're going to need to keep taking supplements. Those aren't things we want to stop. But here are some missing things that haven't been done, or they've been done, but people practice for a little bit. They do some breathwork and then they get out of the habit for a little bit. They're doing some meditation and they get out of the habit. It's a lot of little things that add up. Yeah. And it's sort of like creating that, like you get into the groove, the rhythm of, oh, I'm getting my cold and I'm getting my breath and I'm getting my meditation and I'm getting the dietary stuff. I've dialed the supplements in. And then the magic happens and stuff starts to shift and transform. There's a great book called Tiny Habits and another one called Atomic Habits that really emphasizes the point that these little habits build and stack and become really significant over time. And I can't tell you how many times a patient comes in and says, oh, I've tried this, this, this, this, this. And I say, well, when? And they were all at different times. And so don't I encourage people, don't give up. If you think you've tried breathwork, don't give up that it wasn't helpful. It might need to be the right— it might either not be the right kind or the right way of practicing, or it might not have been in combination with the right amounts of other things.

That's so hard. I really enjoyed— we aired a few episodes back Dr. Mueller's summit recording that we had done, and her and I just talked about tiny habits. And, and I love the book Atomic Habits. And we talked about things that anyone can do, like making your bed at a certain point when you're healthy enough to walk around your bed, or these things that seem tiny, or breathwork, or being conscientious of alternative practices. And some people are like, they have worked so hard and have implemented so many things and have seen so many doctors that it's just exhausting. But one of the books I just read, they were just saying like chronic illness doesn't just get better. Yeah. And we all prove that and have walked it out. You know, you're still going and doing your due diligence in primarily Western medicine. That doesn't mean you're going to get better. Like it takes, it takes a lot. And one of the things I had, I have said to a lot of coaching clients is that I'm not saying it's mind over matter at all on any level. But what you put in your mind does matter because it sets the framework. And if you're telling yourself, oh, it doesn't matter, it doesn't matter, this is a waste of my time, this isn't going to work, and then you're trying to implement practices, well, that matters. For good or for bad, it matters.

Yeah, yeah, it does. And I think more awareness as well as research coming out that people are starting to understand how important the mind is. And I really do, though, I have a lot of compassion for and have experienced myself really struggling for a while on, I'm doing so much on my diet, I'm doing so much with exercise, I'm doing so much on supplementation, and, and why aren't I feeling better quicker? And I really do empathize with that too. And it's not, not a simple picture by any means, and it can take some time and some patience and I really feel honored to be in the position to be able to help guide people through a process. But I tell people it's often a year, 2-year process of even when we do find the right diagnoses and do have a good set of practices to get started on and a good targeted protocol to get started on, it still takes time. And you need to really stay, find your inner strength to stay motivated and sometimes really need to do a lot of things in tandem together that you've done in the past and you don't have a lot of faith in because you've done them in the past. But again, that right synergy, that right combination, that right bring the things together. I, I studied 4 or 5 breath systems before I found the Buteyko Method and the Wim Hof Method. I studied 4 or 5 other ones that didn't do all that much for me. It wasn't very helpful. It was kind of nice, but it wasn't very helpful. I, I took a lot of classes that we learned different breathworks, but it sometimes takes deepening and going deeper and investigating more to find what resonates for you, what works for you, and the right combination.

Finally, a proven and comprehensive Lyme protocol with no antibiotics, no potentially harmful therapies, and no outrageous prices or hidden ongoing costs. Lime Laser Center uses their unique technologically advanced laser system and their numerous other supportive technologies to help you gain control of your Lyme disease and overcome the often debilitating effects it has on your body and your life. With a completely free in-house consultation with a Lime Laser specialist, it's easy to learn more about the Lime Laser protocol and how it can help you overcome your Lyme time. Start healing your body naturally. You can hear all the past episodes of Lyme Voice at www.lymemevoice.com. You can also hear new episodes here on the WGLR radio every Tuesday at 11 AM Central Time. Lyme Voice is also available 24 hours a day and 7 days a week wherever you get your podcasts from. Give Lyme Laser a call today and and tell them Lyme Voice sent you. That's good advice. So before— I have two major things I want to talk to you about before we run out of time. One is cold exposure therapy, and then get into the peptide therapies. Yeah. And you had just talked about in our pre-interview, one of the things I deal with, and I know I'm dealing with some adrenal fatigue stuff going on, is my hands and feet getting really cold for no reason. And I know it's the loss of circulation or whatever that's happening, and it could be parasympathetic, but to me, that was something that I haven't dealt with since 2013. After I went through Invita Medical, that symptom went away for me. And I have a lot going on, so it's not super surprising. But one of the things you said to me, and I've been in a few situations where sometimes something is happening or I'm at an event or whatever, but sometimes I'm just simply going to bed and my hands are ice cold or my feet are ice cold and I'm like, I don't like this. So you had mentioned that you can kind of— we were talking about cold therapy because we had talked about Tony Robbins on his documentary has a plunge that he can go into and you can set it for whatever degrees you want. Yeah. And I don't have one of those currently, but you said two things. One is if you are having that response where your hands are becoming freezing cold and losing sensation, you can and doing all these other things as well, one of the things you can do is actually retrain your body to put them in cold water. So I've done the opposite. Sometimes I'm sitting in the living room and I like get a pot or a bucket and I'm like sitting there with hot, hot water to try to regulate things because I'm like, this doesn't feel good. And now I'm chilled. But I hadn't done the opposite of putting my hands in cold water to retrain my body. Yeah. And that's a really interesting concept.

Yeah, yeah, yeah. And so there is the one breathing thing that we talked about, and the nervous system regulation, the parasympathetic, can help, especially if a person— you know, sometimes you get a call and it's negative news and you get stressed, and sometimes within moments a person can feel their hands get cold. That's a stress response cold, and that's one where doing some reduced breathing, some breath holds on the exhale maybe, and then trying not to really deeply breathe, and then Exhale, breathe out, hold, and then hold as long as you can. Let that air hunger build, build, build, build, build. And then when you have to breathe in, don't take a huge breath in, just really small, tiny breath in, sips of air, and then back out until you feel regulated enough to hold again. And so that'll regulate the nervous system side, and you might feel a little bit. But then also on cold, you wouldn't want— so if your hands are cold and you go out full body into the cold, your hand stuff might get worse. So if someone does a full cold plunge, full body, and they already have cold hands, the cold hands, cold feet might get a little worse temporarily. But if you isolate, you keep the core temperature, the core blood is warm, and then you put your hands only in, or feet only, or hands and feet only in cold water. Could take just a little bowl of ice water and put them in that cold water. First, what's going to happen is the vessels are going to constrict and it's going to get colder. That's normal. And, but if you have enough warm core blood and you really work on— don't have a, you know, it's going to be a little stressful to put your hands in there, but if you really work on relaxing your body, relaxing your breathing while your hands are in there, then you can calm that stress response a little bit. Your body will release noradrenaline when you do. Put cold exposure, but you can relax yourself. And then after a couple minutes, those vessels can dilate. They can start to dilate, and you can start to feel your hand warming a little bit even while it's in the cold water because your body is starting to circulate there again. And it takes training, and in the beginning you might really go very slow, very small doses. You might do the hot water first so that your hands are prepped if it's too painful to go straight in the cold. You can do hot water first, but you want to end on cold because when you take it out of the cold, you want to train your body to re-start to circulate the blood there without help externally from the warmth. So it's okay to do warm first, but then second, or end on cold, and ending on cold trains the vessels. And you can alternate a little bit. Some people do hot, cold, hot, cold. If you alternate, that'll the vessels will open and close and open and close, and that's good. And then you want to end on cold. Try and really relax while you're in the cold. Try and really get that blood flowing nice and relaxed. And then little by little, if you do that a couple times, 2-3 times a day for a while, you train that blood flow to naturally be going to the hands.

That's awesome. Yeah, I really like that. And one of the things we had talked about is in Tony Robbins' documentary, he says that the reason he does a cold plunge every morning, and I know you have the same practice, is he does it because he never wants to do it.

Yeah. Yeah. I don't either.

Yeah.

And a little, a little battle with myself in the morning to get in there.

Right? It is. Well, and it's a big battle to do stuff you don't like that you don't want to do, but you know it's going to change the way your blood vessels are responding to all of life and set the stage for the rest of your day. And so in that sense, it's really neat. But I don't have a cold plunge currently. And you had suggested— I'm like, okay, what do you do if you don't have that? How do you start that practice? Just at the end of your shower, ending on a cold note. Yeah. And starting with maybe 15 seconds, but then maybe working your way up to several seconds. And the other thing you had said is like in your cold plunge, it circulates the water so that it's actually colder than if you're just sitting there and you create a little bubble of warmth within the cold. And so I've been doing this for a couple of weeks now, ending my showers on a cold note. There was a couple that I skipped because I was like, I don't want to do this. Yeah, I've been doing it and it's not pleasant and I don't want to do it each and every time. So, but I'm like, okay, for now until I have my own plunge at my house, like, this is what I can do. Yeah. So I was about a week into doing it And because it's a shower, at first I was just standing there, and then I started like trying to rotate within the shower, like 10 seconds in the front, 10 seconds in the back. Wasn't getting better, it just was like, oh, more, more yuck. But what I realized about a week into doing it was that I was sitting there like with my arms crossed, like crouched in the shower, you know, like hunched over, like trying to just tolerate the coldness, right? Yeah. And I was like, oh, I don't like this body posture. I don't like cringing and hunching over to tolerate what I'm putting myself through. And so I just— and I had told you this before I went on air— like, I just started going into it that sometimes I cross my arms because it is really cold, but I just stand there and make sure that my shoulders are square and my head is up. Like, this is something conscious that I'm doing, and I can deal with it even if it's only for 30 seconds. Like, I'm not going to be hunched over and crunched down. I'm just gonna stand there and deal with the cold.

Yeah, yeah, that awareness, that body awareness, and being able to learn to relax in the cold because it is a stress. But if you can relax in the face of stress, right, this is what we want metaphorically for life. Life brings you a stress that's challenging, that's difficult, that you don't want, but you can relax. You can have good posture. You can breathe slow and deep. You don't have to— because the first thing that happens when you go in the cold is it's, oh, it's this kind of reaction, and you tense up. And, and then you learn a little bit over time to— okay, I'm going in. This mental preparation. Okay, here's the cold, it's coming. Good posture, deep breathing, nice and relaxed. And then there's the cold, and that's what you want when a stress hits. In your life. Here's the stress. I'm relaxed and here's the stress. And that impulse, that instinct to tighten, to breathe quickly can almost training your body to, okay, when stress comes, like the stress hormones are coming, they will come when you get into the cold. It shows in research, it'll release noradrenaline in the system, norepinephrine in the system. It will. But so the stress is coming, but if you can face the stress, how do you relate to the stress, right? How do you relate to stress? How do you relate to stress hormones? If you can relate to them in a relaxed way, we know that noradrenaline then stimulates mitochondrial biogenesis in the fat tissue, and we see white fat becoming brown fat. And brown fat's associated with health outcomes, whereas white fat's associated with worse health. And brown fat produces more mitochondria that are the energy producers in the body. And we know aging has a lot to do with mitochondrial dysfunction.. And so a lot of people who are interested in, even who aren't ill, but especially people who are, mitochondria are very damaged in many cases. We do lab testing and we see many energy metabolism markers in the urine off for a lot of people with Lyme. But even people who have a good healthy function and they want to live longer, they want to optimize their function, really can do that by being able to tolerate this controlled dose, this short dose of stress hormone, actually stimulates the mitochondria to reproduce in the fat tissue because your body wants to produce the warmth to keep you warm. And mitochondria are the energy producers, and the warmth is a byproduct of their production of energy. And so if you can get warmth and energy at the same time, that's great. And the more you can get, the better you're going to be able to feel as you age. That's really a big part of aging. And so the cold exposure, from a lot of perspectives, just the mental perspective as a relationship to a metaphor for dealing with stress and staying relaxed, is already really, really valuable for people. And then being willing to go into a challenge, to face a challenge, makes— for me, it makes me more willing to take on other challenges in my life that I have as goals and dreams and aspirations, that they're not going to be easy, but I want to do what it takes to move in that direction. And if I know I'm going into the cold every day, then I feel that I can— well, I went into the cold already. I can do this other thing. I can work on this project that seems highly aspirational. I can bite this off and chunk it out and start to do it. And so I think people— there's a lot of mindset benefit, but there's also physiological stress hormone changes that produce mitochondria that help with longevity, that reduce inflammation. And so there's the practice that we talked about for just the hands or just the feet, but then there's the whole body cold like you did with the, the shower. And what's really interesting is if you do it for long enough, you'll get what sometimes is referred to as the wetsuit effect, where you'll be really relaxed with the cold on you and it'll— you'll feel like, like a warm wetsuit around your skin. It's really interesting. It takes a little while, so you know, give it some time. But that's when your mitochondria are starting to ramp up and your metabolism is starting to ramp up and you're starting to produce a lot of heat in response to the cold. And that's a, you know, you think evolutionarily, biologically, like we used to be exposed to a lot more cold and the body had a function to keep us warm. Animals are out there in what seems like very cold weather and a lot of them have coats and furs and things like that, but their function in the body of being able to regulate their temperature. And we see temperature dysregulation as a huge symptom with Lyme and especially Babesia. But with lots of, of patients who have Lyme are struggling with severe temperature dysregulation. And this can really build back the body's— train the body's ability to be able to get warm when it's cold out, to cool when it's warm out. That ability for the body to regulate temperature is really been lost largely in our very temperature-controlled existences these days, where it's easy to throw on the heat, it's easy to put a jacket on. But if you train, then you can stand out in the cold for a while and feel fine, and you can get in the cold. But it is really important also to do it carefully. Never force, never too long. Hypothermia is a real thing and can be very damaging. Frostbite's a real thing and can be very damaging. So it's a, it's a controlled training You want to know what you're doing. You want to have some— work it up gradually. But a cold shower is a great safe place to start without going to a workshop or anything like that. Cold shower, I feel comfortable as a general recommendation for a lot— for most people to trial that 30 seconds at the end or 15 seconds at the end, gradually maybe work up to about 2 minutes. And that's a great starting place. And then for those who are really serious about it, you can get that Plunge type of a thing that you can put either in your home or outside on your deck or porch, and then you can really get full body in the cold all the time.

Well, and I'll put a link to the video you talked about, the Lyme Wim Hof video on the show notes, and then also to the Plunge that you have sitting on your deck as a resource. You can check the show notes. But I just want to say, Like, I have loved everything you were saying for the last 5 minutes. I'm just like, oh my gosh, it's so powerful. It's so intriguing. It's so fascinating how something simple and it's somewhat paradoxical is controlling your breathing. And I love how you said like, this is what life is about. Like, we want to be able to handle stresses as they come and be okay within them. And then I had never heard, like, you can actually change one type of fat to another through cold therapy?

Is that what you said? The difference between brown fat and white fat is the mitochondrial density, like how many mitochondria are in there.

It's—

that's what makes fat brown. So as you stimulate the fat to start to produce more mitochondrial biogenesis or reproduction, then that white fat will slowly start to become a little more brown as it gets a higher mitochondrial concentration. And the more mitochondria that you have that are functioning well, the more you can produce energy, you can produce heat, you can— and mitochondrial diseases are widespread. Parkinson's has been discovered to be a mitochondrial disease. Many diseases— migraines often have a mitochondrial component. Many diseases, the list keeps growing on as we research more and more, we discover mitochondrial dysfunction is at the root of many different disease processes. So you can take things to help mitochondria. CoQ10, alpha-lipoic acid, and acetylcysteine and carnitine are all great things from a supplement-based perspective to help with mitochondrial function. But some of the best things are lifestyle things— exercise, cold exposure. These things really, really stimulate big mitochondrial benefits and biogenesis, which is what you really want to do for mitochondrial Okay, so let's get into peptide therapy because that leads—

what you're saying is part of regeneration. Yeah. And explain, give us an overview of peptide therapy. And then one of the questions I had for you as you get into it, can you do peptide therapy through telehealth? Like if someone wants to contact you, they can— you can send it out and do it online and do your consultations over state lines?

Yeah, yeah. So we, we do work across the US, and so we definitely can use peptides across the US. And the regulations are an ever-changing thing. So right now, yes, but we don't know— the, the regulations keep changing. And there are some that are in this gray zone where they're, they're kind of considered a little more on the supplement side, and some that are, that are definitely in the drug zone. And so for certain certain prescriptions we ask the people come once a year in person if it's getting into the drug zone, but some of them we can use. So it— and it's changing rapidly, so, so I don't know where it'll be once in the future here, but right now we are using for people all across the country. And in some cases, oh, we might need someone to come once a year, but in other cases we won't need that. So it just depends. There's several peptides that— first, what are peptides?

I think that's probably— yeah, so many of the clinics around this, around the country, are starting to use peptide therapy. I mean, some of them have for a while, but it's just becoming more common.

Yeah, yeah, yeah. So peptides are amino acid chains. Just like a protein is a bunch of amino acids, peptides are amino acid chains. So certain amino acids in a certain order on a chain is a peptide. The body produces these, so many of the peptides that we use are already being produced in the body, or they used to be, or they could be. For example, we use for Lyme disease often, although its availability has just declined, but alpha-thymosin-1 is a peptide that's produced by the thymus gland. The thymus gland produces a lot of the this in childhood, but the thymus gland mostly atrophies. Mostly it shrivels up. When they do autopsies, even on 35, 40-year-olds, often the thymus will be atrophied and shriveled up kind of like a raisin, like it's not really active much anymore. And but it's a big immune system regulator, and we know immune system is so important with chronic infections and with Lyme disease that, that alpha thymosin 1 has been researched with certain chronic infections that are pretty severe and serious, things like hepatitis C, which is a very severe viral infection. There's been research trials that have showed that alpha thymosin 1 helps significantly. And so it's— but the mechanism is by upregulating the part of the immune system that defends against infections. And so, and it doesn't bother autoimmunity. In fact, it helps. So there are two sides of the immune system. There's the side that that bolsters an anti-pathogenic effect, and then there's the side that can become overactive against cells in the body that can create autoimmune effect. And luckily we have some things that can regulate and increase the pathogen-fighting ability while also decreasing the attack against self. And that's really cool that we have things that can do that. And alpha thymosin-1 is one of those peptides that can do that, but unfortunately it's just started to become less available. One that is very available right now is called BPC-157. And I think maybe we need a better person naming these things because they're a little complicated, but BPC-157 is peptide that has been used. A lot of mice studies and rat studies look at using it for repairing gut lining for where people are struggling to get off of acid reflux medications and they have a lot of GERD, it can really help heal the stomach lining. And it has also been helpful post-surgery. They've done some studies with mice post-surgery where it stimulates tissue repair and it seems to cross the blood-brain barrier. So it's been used even in TBI and traumatic brain injuries, head injuries. And of course we know the neurologic impacts of Lyme and autoimmunity and things like that can start to add up and damage tissue. And, and even post-stroke recovery, post-heart attack tissue repair, BPC-157 is used. We use it a lot for leaky gut because we can take it orally. It's one— a lot of peptides you have to inject, but BPC-157 is one that we can take orally and have a good effect. And so So that makes it, one, easier to take. Two, it really is a strong impact on the gut. And we know with Lyme and mold and chronic infections of all kinds that— I mean, I can't tell you how many people we see who have a gut issue and they've had it treated 7, 8, 9 times and it still comes back because these other chronic infections have dysregulated the nervous system. And sometimes there's a sinus infection that drips back down into the gut. And then you get reinfected. And there's a lot of nuance there that we don't have time to go into, but BPC can be helpful with gut repair. It's not the only thing that we need to do for the gut, but it's a great peptide to help heal up leaky gut and can help some of the neurologic stuff, can help some tissue repair generally systemically in the body.

So how does peptides compare to like exosome therapy?

Exosomes a little more in the realm of stem cells, and stem cells are stimulating Stem cells are cells that can differentiate and become different kinds of cells, so they can— okay, they can sort of like morph. And so if you want to repair collagen in a joint, you could get a stem cell injection, or you could get an exosome injection, and that would stimulate a lot of— like, the cells could help to become collagen, repair that collagen, whereas a peptide would stimulate the body to start its own repair mechanisms and look at repairing its own tissue, but it wouldn't directly become that tissue. It wouldn't have its own little bit of a signaling. These are really signaling molecules that are signaling of different functions in the body. Another peptide that, that we really like, especially for people who do have some autoimmune expression, is KPV, or a lot of inflammation. And or fungal issues. And it's great with mold illness as well. And KPV is a peptide that can also be done orally, which is really nice, and it really can reduce inflammation in a big way. It can be applied topically to people with psoriasis. It can be used internally for calming inflammation and regulating the immune response, response, and That's a nice one. Then thymosin beta is also a nice one. That's one that also the injectable got taken off the market, but there is an oral version of thymosin beta. Thymosin beta-4 is one that also stimulates a lot of repair. Even though we're struggling to get thymosin alpha-1 right now with the regulations that are happening, thymosin beta orally we can get, and that stimulates a lot of repair. It's a little— it's somewhat helpful on the immune system, not exactly the same as thymosin alpha, but it's still— we find it to be helpful. And then LL-37 is one that is antimicrobial and helps with Lyme specifically. So there's a lot in the peptide world, but I don't want to overwhelm too much. But I think some good ones for people with Lyme to look into is BPC-157, especially for gut and tissue repair, one of the thymosins, thymosin alpha and/or beta, and then KPV, especially if an autoimmune issue, and LL-37 for the antimicrobial, antispirochete function.

Awesome. That's a great overview. One of the things that I've just knowing that a bunch of the clinics are now offering peptide therapies, and I, I've talked to enough people to know that it's a great tool for some people. And so I just get frequent messages and questions from people saying, hey, what do you think about peptide therapy? And the only thing that I've said thus far repeatedly is that it seems like to me— correct me if I'm wrong— it's an adjunct therapy like everything else. I mean, to me it's like nothing is going to be the silver bullet. So if you go into peptide therapy thinking one and done, like this is going to be the game changer, there's just not a lot of silver bullet within this, but the— if you understand that it's going to be one of many modalities that you end up using, then it can be— I think then it can open the door to a lot of healing.

Yeah, yeah, I agree. People always want the smoking gun, and even on the root cause front, a lot of people hang their hat on Lyme. They come into the clinic and we say, hey, yeah, there's Lyme, but there's also toxic burden and gut issues, mitochondrial dysfunction, and methylation issues. And if we just antimicrobials, you're not likely to get a ton better. And maybe, I'm open to the possibility, but people want that smoking gun. But it's generally multiple root causes and multiple treatments that are needed. And peptide would be one of, again, as we've emphasized here, one of many things together with herbs and supplementation, vitamins, minerals, and diet, and exercise, and cold exposure, and breathwork. Now we're talking, you know, meditation. Now we're talking brain retraining. Now we're getting— we're fitting the pieces of the puzzle together to get a plan that, that comes at things. Because generally chronic illness doesn't— a lot of times people can get exposed to Lyme and not have a problem, and it's a perfect storm. I mean, it's sometimes it's a genetic issue that makes them more susceptible, but often it's a perfect storm of a chronic infection and a toxic burden and a gut dysbiosis and some issue related to methylation and some genetic predisposition, and these are all working together. And it starts to feel convoluted and difficult to, to think about, but that's why we try and hold in the clinic that complication on the inside and then give a simple step-by-step plan on the outside for people while explaining that it is multivariable, multifactorial. And the other thing is, even as much experience as our clinic has, we don't expect to get it right on the first try. Like the treatment protocol, you know, I tell people it's going to take a year, 2 years, and we might not get it right on the first try, which is why we, we have the ability to contact between sessions so that we can tweak and hone and refine things for people. Otherwise we lose a lot of traction. And I think that's also a frustration point for a lot of people in their treatments, as they like they react to something or they're getting results and then they plateau. And then they, they have a hard time like making a change and knowing what change to make when that happens and getting in touch with a clinic in a timely fashion to get an adjustment to the protocol. And so, so we're often, we're tracking 2 or 3 or 4 different biomarkers that we're retesting and we're tweaking the protocol and we're seeing how those biomarkers change and the symptoms change. And then we're tweaking some more and then we're taking off a bunch of stuff stuff, and then we're putting in new stuff, and we're adding a peptide or two here and there. We're adding herbs here and there. We're increasing dose on certain things. We're decreasing. I mean, it's a very complicated process. And I think most people who have been in the Lyme world treating for a while know that it's not like you get your protocol, you do it for a year. I wish it were that easy. Peptides are, are a very helpful piece that can be added in at certain points in the treatment plan, and sometimes multiple peptides. They're very safe. The toxicity profiles are just really wonderful. We don't see a lot of adverse reactions. There's a— I mean, there are a couple. There's a peptide we use for sexual function, libido, that gives people some nausea as a side effect, but really minor side effects, um, all things considered, for how powerful these therapies can be. The sexual peptide is amazing. It's people who, you know, have erectile dysfunction or, or libido issues for women sometimes can experience an enormous benefit from a peptide that— little side effect of nausea for some people, but really amazing that men who, you know, even have struggled on some medications that maybe stop working a little bit, sometimes this really does amazing for them.

So peptides have so much power, so much potential, but they're not the silver bullet. Wow, interesting. Well, I just did an interview with Dr. Brad, who is the author of a book called Breaking the Chronic Nightmare of Lyme Disease, and he talks a lot about sexual dysfunction because— and intimacy issues because of how Lyme impacts your hormones, and Lyme impacts the way your glands function, and which is all hormone-related. So that's really interesting. Yeah. All right, Dr. Miles, how do people get a hold of you and where can they contact you for more information?

Yeah, so people who are looking to find out more about our clinic can go to medicinewithheart.com, and we have a great set of free tools like blogs that come out. You can go go pull open a blog about BPC-157 and read a bunch more about it than I was able to, to cover in this interview. So our blog's a great resource, medicinewithheart.com, and that's also where you can schedule a complimentary call with one of our staff to find out if the clinic would be a good fit for treatment as well, also at medicinewithheart.com. And then for practitioners practitioners who are looking to learn more about how to treat complex chronic illness, how to implement functional medicine into their practice, we have a training institute at mindbodyfunctionalmedicine.com. And that's where practitioners who are looking to learn functional medicine, learn to treat chronic issues like Lyme and mold, and want to implement functional medicine into their practice, even if they're brand new to functional medicine and Lyme and mold aren't where they want to go, they can, We have from the very beginning all the way to advanced chronic issue training in our institute at mindbodyfunctionalmedicine.com.

Awesome. Thanks so much for your time. Thank you for your expertise and sharing your own personal story.

You are so welcome, Sarah. Pleasure chatting with you and the audience, and I enjoy it.

Let's do it again sometime. Sounds good.

Great. Thank you.

Take good care. Bye. Hello friends, today's podcast is brought to you by these sponsors: Medical Bill Gurus. The experts at Medical Bill Gurus are dedicated to innovative solutions for any medical billing scenario, which we all have in this community. Oh my gosh. With empathy at the forefront of their daily mission, Medical Bill Gurus is dedicated to being in the trenches with patients and raise awareness for the daily challenges facing them. From medical billing errors to raising awareness for their diagnosis, Medical Bill Gurus takes pride in speaking with patients every day and helping them find guidance on how to navigate our broken healthcare system. Their patient advocates are available to help reduce medical bills and assist patients with navigating a dynamic health landscape. I also interviewed Daniel Lynch and founder of Medical Bill Gurus in episode 111. In addition to helping you get money back from your insurance company, if you need help deciphering what health insurance provider to choose, and I have done this several times a year for years now, or you are looking for a clinic that is covered by insurance, they are a great resource for all things related to medical bills, out which insurance provider you could or should have, they're an awesome resource. Again, I use them multiple times a year. Give them a call. All right, now on to the show. Disease is contrary to life. Therefore, wherever disease exists, life must also fight to exist.

Good job fighting, Lyme fighters. Keep it up. We'll see you next time. LymeVoice contains general information about medical conditions and treatments. The information is not advice and should not be treated as such. Okay, Lincoln? Okay. The medical information on LionVoice is provided as is without any representations, warranties, expressed or implied. Okay? Okay. LionVoice makes no representations or warranties in relation to the medical information on this podcast. You must not rely on the information on this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about your medical matter, you should consult your doctor or other professional healthcare provider. And for you, you consult your parents, okay? Okay. If you think you may be suffering from any medical condition, you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this podcast.

Got it, Lincoln?

Got it.