Get the Right Treatment for Complex Conditions, with Dr. Nafysa Parpia

We can have many different genes at play and different individuals which can produce the same diagnosis in different people. So no one gene is responsible for the same diagnoses.

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Hello and welcome Back to the Five Journeys podcast. I'm Dr. Wendy Trubo. This is Dr. Ed Levitan and our guest today is Nafisa Parpia. She is a board certified naturopathic doctor at Gordon Medical in San Rafael, California. And she spent over 10 years taking care of inspiring, empowering and really healing patients with complex chronic illnesses, which is essentially where infections and chronic illness and exposures and toxins meet up together. So welcome Nafisa. We're so excited to have this conversation with you today.

Thank you for having me here. I'm so excited to be here with the two of you. It's going to be a lot of fun.

Yeah, and we, we don't, we don't get to talk about like really complex people very often because as I send.

Them to Ed, I'm going to go see Ed.

That too. So I mean, when we talk about complex, let's define what that means first. What are we talking about? Who are the people that this refers to?

Okay, so I'm talking about the mysterious cases where there are many different causes contributing to their illness, many different causes contributing to inflammation in the body. So these are the diagnoses that just don't make sense to the medical establishment. Things like chronic fatigue syndrome, fibromyalgia, long haul Covid autoimmune conditions or chronic Lyme or tick borne diseases. Any post infectious illness. Actually, I'd say there are no true treatments typically given to these patients. There's great band aids, but no personalized medical investigation or treatment. The personalized pieces missing, I'd say.

So the people who are like, I went to 10 doctors and they finally just told me I had chronic fatigue syndrome, which is just to me a wastebasket diagnosis of I don't know what's wrong with you. So I'm going to label you as this.

Right, exactly that. Yeah. In fact, I'd say all of those, those illnesses I just listed would be waste acid diagnoses. We, we sort of, they get, they get that label hung on them. This is what you've got. And the patients might come to me and say, this is what I have.

Well, isn't it like irritable bowel syndrome? Ain't that a great one?

It is a great one. Right, well let's find out why and let's heal you from there. Yeah. So I tell my patients there are five issues that cause immune dysregulation which then contribute to inflammation in your system. Infections, toxins, diet and lifestyle, and structural integrity issues. When I talk about infections, I'm talking about acute and chronic. Could be maybe the herpes virus, the Epstein Barr virus, Cytomegalovirus, HSV6 or tick borne infections, for example, toxins, metals. I look at glyphosate, different solvents, pesticides. Now we have inflammatory chemicals, meaning the genes going epigenetic expression. We can have many different genes at play in different individuals which can produce the same diagnosis in different people. No one gene is responsible for the same diagnoses, different genes in different individuals which can produce the same diagnosis in different people. I just had had the blessing of meeting with Dr. Robert Navio, who is the scientist and researcher behind the cell danger response. And Eric, Dr. Gordon and I were just visiting with him. So I'm bringing some nuggets from him really around his research. And so no one gene is responsible for the same diagnoses in different people in almost all of these acquired complex chronic illnesses. So the exposures, glyphosate, metals, agent Orange, plastics for example, and then the infections, like I said, the herpes viruses, Epstein Barr for example, Lyme and co infections. So these are the myriads of causes that then cause what Dr. Navia was calling an ultimate cause of illness, which is the diagnosis that they all have in common, which is the hundreds of biochemical and genetic variables that act in a coordinated way. And it's individual for each patient. Then there's this impression, the medical establishment that these things are interdependent. But it's not true that, oh, you have Epstein Barr virus, oh, that's the only thing that's at play. Or you have mercury, that's the only thing. These patients, to summarize that these patients have many, many different causes and all those different causes are different for each patient. And then different patients will have different genes that express. And so there's hundreds of biochemical reactions going on through this and then somehow they then arrive at the same diagnosis. And so I asked them how do they arrive at the same diagnosis when the way to get there was so different. Right. And so he was saying that that is what is shared, and I like what is shared that gives them similar symptoms, though everything was different. Getting there. It's. It's the vulnerability of the end organ that the disease is named for.

Let's start untangling. So how does mold fit into the picture and mold toxins?

I guess so. When I'm thinking about mold, I tell my patients I'm. I'm looking for many different angles. I'm trying to understand, do you have an allergic response or a sensitivity response to the mold spores themselves? Do you have a high mycotoxin load? Those are the toxins that are created from the mold. Are you allergic to the mycotoxins themselves? And do you have an exposure? Where is that exposure? Is it in your home? Is it in your work? Is it in your car? Or is it in your body?

Or school? School. Don't forget school.

Dorms, dorms. Dorms are super, super wet.

Yeah. How many patients I've had company saying this was in my dorm. Right. Or. Or people who, who live in damp environments. Is it outside? But then also, could it be inside your body? Very, very well. So right in the gut, in the sinuses, on the skin. We know mold can, can be in those places.

And isn't it something like 50% of all buildings have had water damage at some point in time? And so it is basically the statistical. Never having been exposed in a building are almost zero. Because maybe it wasn't your house, but it was your friend's house or your school or your dorm or your college building or whatever. Like, the list is endless.

It is. But different people will have different sensitivities. So, for example, maybe Ed, you could be in mold in a moldy building and you'll be just fine. No problem. Whereas maybe I'm strong like bull.

Actually, I always talk about it's all relative. Well, relative to me, you're strong like bull. I'm strong like a mouse. Meaning you wa piece of paper at me and I'm like, what? Right.

So I could put you in a. In the same building, and you're not going to have a very good time at all. Probably suit to the genes or, and. Or other infections or structural integrity issues.

So, yeah. So, okay, so, so mold it. Does it seem like for you that mold is a inciting event for a lot of people?

I would say it is. I would say that a lot of people might have mold issues to begin with. They might have an allergy to mold or they might have an allergy to the toxins for mold or they might have a high load of the mycotoxins. A lot of the, a lot of people will have funguses in their sinuses while the mycotoxins and inflammation from that can cross the blood brain barrier and cause issues there with sleep, with hormonal disturbances. So it can be an exciting event for many things, perhaps for the hormonal system, hormonal imbalance even. But what I find is most of my patients who have tick borne disease, it's not just Lyme. Mold is almost always at play there. So often I'll see that they've been treated for a long time and Lyme has been chased for years, maybe with just an antibiotic or a few antibiotics over the years and, and mold was never paid attention to. And what I've also found is that if we treat mold first, people are more likely to have a better recovery with Lyme faster.

Where does heavy metals fall into this?

Heavy metals, I think they're very important to address. I look at their acute metal status before I look at their provoked status. I see a lot of high mercury. I'm looking at the NHANES data from the CDC to compare it to see if they're around 75th or 90th percentile when it comes to acute metal exposure. So mercury, lead, arsenic, cadmium, these are in the top 20 of the CDC status of what's considered high in the population. And so I want to understand if they've gotten acute exposure. Most of my patients eat a lot of fish. They've got high mercury. I'm seeing lead very high in my patients, my female patients who are starting, who are perimenopausal, who might, might have bone loss because the lead is as they're losing some bone, the lead that was stored in the bone, that's normal. Lead gets stored in the bones. I want our audience to know that it's then going to leach out into the rest of the system. So I'm finding these acute exposures, dealing with them first and then if it's appropriate, I'm going to provoke them to get an understanding of what the burden is in their cells. Because the metals bioaccumulate in the cells of the tissues like the cells of the thyroid or the kidneys a lot, the liver.

Let's talk about this, let's talk a little more about this. Because one thing you said that I want to call out. It's normal for lead to be stored in the bones, but it's not normal to have lead in your body. It's simply the body's protective response is to go, where can I put this thing? Okay, Bones, you're up. So, Bones, brain, fat, cells, organs. So it's just really important to remember that it's not normal to have lead. It's just your body's protective mechanism to make sure that you don't continue to have it in other places that could be worse, like your brain. But as you hit perimenopause and menopause and you recycle your bone and start to reform it, it gets released into your system. So. So. And that's when you're so vulnerable, because you already have the hormone ridiculousness going either too high, too low, or too irregular, which makes us nuts. Speaking for personal. Personal experience. And this is where you don't chime in just for the right.

No.

And then. And then you have this added layer of at your self exposing yourself to a talk. You're basically exposing yourself to a toxic right.

And I do tell my patients, just by virtue of being on the planet, you do have metals in your system. Unfortunately, it is the new normal. And it's not what I want, it's not what I wish, but it's a sad new normal. And what I need to do is look and see if you are above what's considered a normal or not. Of course I want it to be.

Zero in your life, Young Frankenstein, are you Abby Normal? Did you remember Young Brain, where you had to go look for the Abby Normal brain? So think about it. You came from people who came from people who had tremendous lead and mercury exposure as a way of life. Pipes were lead. There was lead in gasoline. There was lead and paint. There are leaded. There were leaded glass, you know, glass windows. There were just. The lead exposures were unending. And when you're pregnant or nursing, you're going to give 50% of that to your child. That's your legacy that you donate. So we wind up with a portion of what our ancestors had, right? Lots, lots of love. So. So it's part of. Part of it is that. But then you think about. Do you know of any studies going on about whether food in California from the wildfires have more mercury because the forests are sequestering the mercury, and when they burn, they release it. So is that winding up in our food chain, do you know?

I believe it is. I had a conversation with Dr. Lynn Patrick about that, and she was talking specifically about that. I can't remember if she cited some research on it, but I'm sure that she did. And I'll ask her for that research. Absolutely. What I am seeing in my patients who live here in California is way higher levels of mercury than ever before. So even, even people who are eating only salmon and they're saying, you know, I'm not eating tuna, I'm not eating swordfish, salmon that's supposed to be safe, wild salmon, shouldn't that be safe? I say, well, take a look at your metals. It should be, but. But it's not anymore. I tell them it's like birthday cake now.

I mean, the challenge is always, if you look deep enough, we shouldn't be breathing. So the question is, what's better, the omega 3s or the toxins? And how do you, how do you account for everything?

I know, I. I tell them to get omega 3s from algae now because it's going to be smaller than the fish. It's true. I don't want this to sound scary. Kind of is, but. But we have ways to deal with this, that's for sure. And yes, eat organic as much as we can and detox as much as we can. What does that mean? We have access to a sauna and there's so much we can do at home. Green products, green personal products, green cleaning products are really removing ourselves from the exposure as much as possible.

Yeah, totally. I mean, what I was saying the other day was we're essentially deluged. We're standing under a waterfall of toxins, exposure. So it's never a conversation like, oh, I'm going to be perfect. You're never going to be perfect. What we're trying to do is decrease that waterfall to a level where your body isn't frozen with exposure, where it can go, okay, I can deal with these specific smaller things. And to consistently work on moving your body, sleeping, exercising, doing these alternative extra things, IVs, saunas, hyperbaric oxygen tanks, all of which we have in our new wellness center, Nafisa. I'm so excited.

I can't wait to come visit your new.

I know you got to come to Boston in the springtime. And then I want to pile onto that because we have. We share a patient who. She's kind of like me in the sense that she has terrible detox genes. Terrible. And had a bunch of exposures for her. I don't have Lyme. It's like something I don't have. But she had Lyme and Babesia and Hashimoto's, which I also don't have. But she wound up in our practice with no Hair, head to toe. And I was joking with her, like stole her, I stole her. I know, I just, I loved her. I was like, you have to be my patient. So I stole her from Ed after he had dealt with the Lyme and the placebo BCA to a major extent and he had started working on the metals and the Hashimoto's. So I took her over and she was on this ramp up, her hair was growing back. So remember, head to toe, no hair. And I was like, there's always an upside. So she didn't have to pay for any waxing south of the border. Nothing she had to deal with. So that was an upside. However, she was like, I don't have any hair. So we started, her hair starts growing back and then she comes in like a year and a half ago and now it's falling out again. And I'm like, what's going on here? And what we got down to is that she had been eating more sushi high mercury tuna sushi specifically. And I was like, Kiki, you know you're not supposed to do that. Like once, once you have this issue, you're someone who's kind of primed to go back down that pump. So you can't. It's not just like you recover and go back to your old ways. You recover and then you build on the recovery and continue to detox and continue to be careful with yourself so that you don't wind up where you started because you'll backslide, right?

And so I tell my patients, so say you had a combination of mercury and a combination of Epstein Barr virus, those two things. It's usually more poor sleep, stress, all kinds of things. But say you had these two things that the doctor found and you could heal by, by, by fixing, by re. Recalibrating those things. But those two things together under many different biochemical pathways and genes expressing lit up a certain pathway of inflammation or immune dysregulation in your system. I tell them it's like putting Christmas lights along that pathway. Lights the way along that pathway. Now you can remove the trigger, but guess what? That pathway is now there. It's now lit up. So if you get another exposure, it's going to light up that same pathway, even though it could be a totally different exposure. Which is why these chronic illnesses start to mimic each other, because you've got your neuro immunopathways primed.

It's the yellow brick road. You're following the yellow brick road every time, right?

Each time. So they have to Be under immune modulation constantly and detox. I tell them detox is your best friend. Immune modulation is your best friend. Because now you've got this, you've got this tendency built in your body. And so in my experience, detox and immune modulation are the two things that are going to allow them to, to keep those pathways dim. Right. Because there's going to be another exposure, there's going to be more stress, there could be another tick bite. That's life. And so we have to know who we are, where we stand and how to protect ourselves.

And you have the keys to the kingdom on this one. Like this. Control is in your hands. It's not magical or mystical. Yeah.

I want to make sure what is your kind of your top three treatments?

Okay. So the first thing for me is I want to get the patient out of the exposure, whether it's an external exposure or whether it's internal exposure. Some doctors say I'm not going to treat your mold or mycotoxins until you're out of there. I don't take that stance. I want to actually start, begin treating even if they can't get out of there for a little while. Because at least I tell them I'm not going to get you better, that's for sure. But at least I have a hope, chasing after it a little bit. As you keep getting insulted by the exposures, I can keep pulling them away, but you're going to keep getting insulted more by those exposures. Maybe we can at least keep you somewhat stable. If I begin treatment, getting them out, then I want to. As with any complex chronic illness, I'm working on modulating their immune system first because I know that when I start to kill mold, just like when I start to kill any other infections, we're going to have a release of biotoxins, inflammatory cytokines for mold, it will be mycotoxins. And these people are already in a state of perpetual inflammation, inflammation that just didn't stop. It's inappropriate inflammation. So I want to modulate that inflammatory status first that they have. Then I will come in. I might start to bind the mycotoxins if those are high. But a lot of patients I find not a lot. I'm going to say 20% of my patients can't even handle binders yet. I need to understand what their methylation status is. I need to understand what their mineral, what their amino status is, because those are amino acid statuses, because those are co factors for their detoxification. Before I begin any detox, whether it's mycotoxins, toxins from mold or any toxins. I want to bolster them as appropriate. So I'm going to see if they can get out of their environment soon. I'm going to bolster their, their immune system or modulate their immune system, bolster their detox pathways as needed. I'm testing on the labs and then if they're ready, I'm starting to pull mycotoxins out and then I'm coming in with different treatments to kill funguses or mold that I've tested. The other thing is I might begin if they have an allergic response to mold or mycotoxins and they have mast cell activation syndrome, I might start treating mast cell activation syndrome first. So immune modulation, preparing them for detox, finally detox and then killing the infection and then I'm layering all of them. I also want you to know that this is how I approach most chronic infections with my patients, in that order. But typically I'm working on their mold before I'm working on tick borne disease. For example, if they have them both, which usually they do.

So what happens when you don't honor that order, Nafisa, because I know you're very committed to going in an orderly and systematic fashion. What happens when you're like, nah, I'll just do everything or I'm going to ignore it. What goes on?

Yeah, so a lot of times people come to me and they say, just, please, just kill the tick borne diseases first. And I say, okay, let's step back and look at what happens when we kill infections. When we kill infections, we get a release of biotoxins, inflammatory cytokines, there's byproducts of dying bugs, dying cells, and you're already in a state of perpetual inflammation. Inflammation is important in the healing response. That's stage one of the cell danger response, actually. So we should have inflammation as oxidative shielding, as protection when we encounter infections or toxins. That inflammation first step is important. But our patients have had so many insults to their system over time that now the inflammation that should have been transient has become perpetual. They're stuck in this cycle of inflammation. So now I tell them, okay, you're stuck in a cycle of inflammation. Do you agree? And they say, absolutely, I feel inflamed all the time. And I can say, look, here are your labs. It shows on your labs. You're also stuck in a, in a state of inflammation. So, so if I start to kill the infections and I'm increasing inflammation, I'm increasing Toxins, just like we talked about. That's going to make you feel worse. Okay, so then how about detox? I want to detox before I kill the infections. Because when I'm detoxing, first I am modulating the immune system. These patients already toxic from the biotoxins and from the inflammation. So I'm lowering their toxin load, getting immune regulation back into order as well. Then I want to start treating infections. Really, it's immune modulation, then detox, then killing the infections. But I don't want to forget balancing the rest of their systems as well. I've got to look at their genital urinary system, their GI system, their endocrine system, musculoskeletal system, because all of that comes into play as well. Typically, even before I begin detox, I'm balancing their hormones. Or if they're constipated, we're working on that. Or if they have diarrhea, we're working on that, working on the root causes of that to stabilize those systems before I detox. Because imagine someone's constipated, we have a rush of toxins coming through as we're flushing them out of their system. They're just going to recirculate. So there's so much that has to be taken care of and weaved very, very carefully for each patient. Now, this isn't the case for people who are not sick, Right? For people just coming in, they want some detox. They're not feeling well, they need some bouncing of hormones. It's a lot easier. So I just want our audience to, if they're feeling overwhelmed, to really know. This is for people who have complex chronic illness, the mysterious illnesses. You've been to 20 other doctors, or at least five. That's when we take a route like this.

What do you mean? When you talk about immune modulation, what are you referring to?

I'm referring to peptide therapies. Prior to the advent of peptides, I wanted to modulate their immune systems first. Boy, did I ever want to. But I found that if I tried to model their immune system and they still have the insults, it just didn't work, even though I wanted to. I would try things like maybe colostrum or quercetin, but these patients have raging infections. Didn't work so well. But what I found that with peptides, I can use things like BPC157 to bring inflammation down in the gut and in the rest of the body. TB4 frag to modulate the immune response. KPV to bring mast Cells back into order. Same with Amoxinox. Usually when I start with those peptides, not for everybody and everybody will have different dosages. But this is an example of how I can use peptides to modulate the immune system. It actually sticks in a way that I would say the other things that I wished had worked a few years ago before peptides came into my life so deeply, these work. I can then stabilize the immune system. I'm also using mast cell activation syndrome. I'm using medications before I use herbs because a lot of these highly sensitive patients can't even handle the herbs. They're going to reject those. So I might use keptotifen or cromolyn as well with the peptides or low dose naltrexone often all of those things. Then I can keep, those are good band aids for the immune system while I'm coming in and treating the causes. Then once I've treated the causes, those peptides, they actually help to retrain the immune system. They're not band aids anymore.

I will say that I am in some ways a very early adopter. I'm in functional medicine ahead of the majority. But in some ways I'm a very late adopter. And so I feel like I'm late to the game on peptides. I just got into it within the last six months and have found it to be game changing.

I have goosebumps right now as we're talking about the peptides. I have never met any other medicine, whether it's herbal or pharmaceutical or supplement nutraceutical. Nothing that can target the tissues like I want to and make things happen faster, make healing happen faster. For example, my patients, who could have been a patient for five years, maybe it takes two years now the ones who would have taken two years, it could take six months to a year.

Yeah. Instead of inching along. Right?

Yeah. It's amazing. Treatment needs to be well rounded. I think that's so important that people go chasing after Lyme or mold or just metals. I'm talking about for these patients with complex chronic illness.

Right.

So for a lot of people it could just be toxins. For my patients it's not, it's not just one metal, it's not just Lyme. So it needs to be well rounded. I need to really understand the whole picture. Every, every reason that I, that I can, with my clinical history and with the labs, putting those together to really get the full picture of the patient, understanding where they're inflamed in their system, working on the inflammation and working on just a well rounded treatment approach is a dance that's different with each patient. And people get better. They get better.

All right, Nafisa, here's the magic question where we're going to put this all in the show notes so you don't have to worry about spelling anything. But where can people find you? And do you have a gift for them? I heard a rumor you did.

Ah, okay. So they can find me. At Gordon Medical in the San Francisco Bay area, we do have patients come from all over the country. And a gift I have pre Talks book. There's also a Cell Danger Response ebook which will be coming out soon. So awesome.

So the first thing I want to say is thank you for being on this podcast. We love you personally, we love you professionally. We love working with you. So this has been great and a great opportunity to really dive in and untangle what's going on for people who are chronically ill. And then to the listeners, what I want to say is. Thanks for listening to another episode of the Five Journeys podcast. Our guest today is Dr. Nafisa Parpia. Nafisa, thank you being here and we will talk again soon. Don't go it alone.

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