Re-energize from Chronic Fatigue & Long Haulers, with Dr. Evan Hirsch

Everybody who has chronic fatigue and long haulers has 20 plus different causes. And then all of a sudden it's the straw that broke the camel's back.

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We have Evan Hirsch here today and he's wicked cool. I know, I love all of our guests, but he's also wicked cool and I'm convinced I know him in another life. Anyway, Evan Hirsch, MD is our guest today. He's world renowned fatigue and long haulers expert, which is apropos of what we're going to talk about today. And he's the founder and CEO of the International center for Fatigue. Through his best selling book, podcast and international online programs, he's helped thousands of people around the world resolve their ME cfs. Now I have to ask him what chronic fatigue, what's me?

Myalgic encephalitis. It's what the Brits and beyond call it.

Got it. So he's helped a lot of people heal their symptoms naturally and is on a mission to help 1 million more. He's been featured on television, podcasts, summits, and when he's not at the office, you can find him singing, musicals, dancing, and playing basketball with his family. Welcome, Evan.

Well, thanks for having me on. It's great meeting you guys.

Well, first, what's the definition of long haul? Let's talk about definition.

Yeah. So long haulers, the definition is basically a persistence of symptoms from getting the pandemic virus. And so those persistent symptoms, right now it's kind of the definition is up in the air, but it's like 12 weeks, so it's like three months. It keeps changing. It was 30 days initially, but basically three months after you get the C word and you still have persistent symptoms. That's considered long haulers. And you definitely need to address it because the sooner you address it, the faster you're going to get better. The reason why there are so many 200 plus different symptoms associated with COVID is because it lives in the bloodstream and consequently it can go anywhere in the body, and consequently it can cause inflammation in any part of the body. But the secret sauce really is treating a live active virus. So there was one study that was done that looked at people who were asymptomatic four months after they got Covid. And half of those people had positive live active virus on intestinal biopsy. So these are people who didn't have any more symptoms anymore. They still had live active virus. And so my supposition is that 100% of those people who actually still have symptoms have live active virus. And this is also what we see when you start to treat with antivirals. And everything that I do is natural because in the online health space I operate as a coach. And so we're using herbs and whatnot to go after these viruses, but that's kind of what we're seeing, is that you start to go after those and then the symptoms resolve. So that is the secret sauce is addressing the live active virus and then addressing all these other different components. Because why are we seeing younger people get it? Most of the people who are getting long haulers are active people, people less than the age of 50. And a lot of it happens because they either start being active too soon or they're training for marathons and stuff like that. And their adrenals and their mitochondria are already compromised, but it hasn't been an issue. But then all of a sudden you add in the virus and then they try to do stuff on top of it and they don't realize that they're actually sick or because it's so mild or whatever. And then that just causes additional stress on the human organ and then everything gets out of whack. But they also have these other pre existing conditions which aren't diabetes and high blood pressure and whatnot. They are heavy metals, chemicals, molds and other infections that are present. Everybody who has chronic fatigue and long haulers has 20 plus different causes. And then all of a sudden it's the straw that broke the camel's back.

Yeah, no, the thing that for me, Covid is so unique. Well, among a lot of other things. But Covid's one of the biggest unique things is people have this initial surge, they feel better and then whammo. And even if you don't go too long haul, at least for two, three weeks, people always have this like they feel better and then they, they get whacked. And I haven't seen that with any other disease maybe. I, I just literally have not seen that. So it's, you can see it post op.

Like I always say, I used to say when I did sur, you're going to feel really good and then you're going to do too much and Then the next day you're going to think a truck ran over you. And that's similar to what's happening when people recover from this, is they think they're better, they go back to normal, life is business as usual. And then it was way too much because of that underlying mitochondrial. I always say to people it's a mitochondrial issue. You have a mitochondrial problem and the virus is what triggered it. But really, this is a mitochondrial problem. It's affecting head to toe, your hair's falling out, your brain's not working, everything.

And it's this chronic stressor that you're just kind of on this tipping point. And then all of a sudden you're like, I'm gonna go for a run today because I feel great. And guess what? It puts you over the edge too much.

So you mentioned over 200 symptoms. So how would basically is it fair to say if after three months from getting sick you still feel unwell? You have long hauler.

Yeah, and I would even say after 30 days. I mean, because the thing is that is those. What ends up happening too is that the newer symptoms get worse and the older symptoms get better. So that's generally what people will report. Well, they'll say, hey, I started off with these. And people who have like five or more symptoms initially, even if they're really mild, they're more likely to get long haulers. But let's say that they have anosmia, so they have a hard time, they lost their sense of smell, and that maybe gets better at month one or maybe month two, too. But then all of a sudden they've got pain on the bottom of the feet that they never experienced before, which is awful. Right? But they didn't have it initially.

And that's not Lyme bartonella symptoms.

So that's actually a really great question because what we see is that Covid is acting in two different ways. So sometimes Covid is causing those symptoms, and sometimes Covid is a biofilm disruptor, or what I call the whack a mole effect, where it's causing. So you start hitting Covid and all of a sudden it causes some of these other infections to come out. And they're more opportunistic because Covid has hijacked the immune system off into left field. And then all of a sudden the other bugs become opportunistic because you need a somewhat intact immune system in order to keep all those bugs in check.

Is there any way to figure out before infection, Is there a genetic test? Is there some way to go okay, you're at risk and you're less at risk. Is there some way to suss that out because it feels so random?

Yeah, that is a really, really great question. And I don't know. I mean, it's all these causes that we see. So if you're going to check for all of those different causes before you go out and hang out with some of your friends and be like, oh, I've got mold, I've got adrenal gland dysfunction, I've got thyroid issues and all teetering on the edge. I really shouldn't get Covid. But who's going to do that? I mean, people do that when it comes to pregnancy. Right.

But I have to be honest with you, I was really nervous about COVID because I'm that you and I are like sole illness people. Except I never had the Lyme stuff here. I'm gonna knock on something. So anyway. Heavy metals, mycotoxins, chemicals. No glyphosate, celiac disease, adrenal fatigue. And so I was so terrified of COVID And my Covid was a little head, like, I was like, oh, I think I have a headache. And post nasal drip and fatigue. That was my Covid. Him, the strong, like, ox who nothing ever, I don't know, nothing ever seems to faze him. Got really sick. Like, really sick. And so that did not match my expectation for how things were going to go because I figured I would be the one down for the count and he would be like, Covid's not a big deal. And I'd be like, it really is. And it was totally opposite.

Well, this is, this is what's really interesting too, is that the, you know, when somebody comes into your office and they say, I never get sick, or they say I get sick all the time, they're both sick, right. And they both have issues. The person who never gets sick, their immune system usually isn't functioning well. Right. So I think that that's kind of part of it. And that's why a lot of these people who have more mild long haul or more mild Covid end up with long haulers, is because your immune system is not able to mount a strong enough response because it's dealing with all this other stuff. Not to say you're going to get long Covid. I mean, I certainly hope not. Knock on wood. But I'm just saying it's that maybe the immune system is distracted enough where it's not able to address it full on.

No. And I'll say, personally, I think I'm probably 94% better or something of that nature. But there's that little bit. We had Covid in August, so it's been, we're recording in January, so it's been a while. But there's this little piece that's not quite there.

Usually around household chores, seems to show up conveniently, like, sorry, I forgot to do that. I'm like, oh, convenient, that Covid brain. So convenient.

Well, at least she's understanding.

Or he'll like, you know, sometimes I'm like, oh, you're going through menopause. You can't think of your words sometimes. That's another way that I've seen it, right. I love to bust his chops because he's usually healthy and I'm like the hot mess.

So, baby, so you have a four step process, right?

I do.

All right. So what are the four steps?

Sounds so easy.

I know, right? So the first step is to assess all the causes. So of these 33 different causes, 75% can be. You can figure out based off your symptoms alone. And basically what I did and, you know, it'll make sense to you guys. When you're sitting down with somebody one on one, it's like, what are you? The first thing that you're doing, you're looking for diagnosis. Like, what do they have? What are all the causes that they have? Right? So 75% of these causes can be determined by symptoms alone.

Right.

What did we learn in medical school? I mean, this is like one of the things that holds true for medical school. 90% of a diagnosis is history and symptoms. Right. And then the 10% is labs and physical exam. Right. And the same goes here. So when people join our program, we've got this amazing workbook where they'll go through step one, usually in the first hour, and just based off their symptoms, they're going to know 75% of their causes. And then they can spend their money on the 25% where you really need it. So that's the first thing is assessing those causes. And what's also interesting is of those 20 plus causes that everybody has, the challenging thing is that everybody has a different 20 plus causes, right? So somebody might have 1, 3, 5, 7, 9, and somebody else might have 2, 4, 6, 8 and 10. Now the process is all about step four, which is removing the toxins. But we have to do step two and step three in order to be successful in step four. So step two is replacing the deficiencies. We start off with boosting the big three. So adrenals, mitochondria, and thyroid. So as you guys know, adrenals manage stress in the body, produce cortisol. It's our get up and go. And it got up and went in so many of these people. Pretty much everybody.

Most people, yes.

Yeah. And mitochondria produces 80 to 90% of our energy. It's in every cell except for red blood, cel and that combination. Then in turn, when you start to support the thyroid, if it's still needed, is really the biggest shift that I see. And I do it in that order. Adrenals, mitochondria, thyroid. Because thyroid will function better when you start taking stuff for adrenals. And then thyroid will get more into the cells when you start taking mitochondrial support. And so sometimes you don't even need additional thyroid after you do adrenals and mitochondria. But then if you do, we do this subjective ramp up, which everything works better. When thyroid works better. Right. And so step two is replacing the deficiencies. So these are deficiencies in hormones, in nutrients, so vitamin D, vitamin B12, minerals like iron, magnesium, and then neurotransmitter deficiencies. Sometimes I touch on it, sometimes I don't. It really depends on. That's one of those that is optional because you're going to get to those in step four as well. And a lot with. With step two stuff and then lifestyle habits. So we haven't even talked about lifestyle habits. And a lot of it is because the people who come to see me, they've already worked on their lifestyle habits. They've usually seen other functional medicine or natural medicine practitioners, which is great. And oftentimes they're also really tired. And so they can't make changes to their diet. They can't make changes necessarily to their sleep. They're just getting by. And so giving them a boost of giving them the step two products can really be helpful for improving their energy. Usually gives them an uptick of 2 points. So if they're like a 3 or 4 out of 10, with 10 as ideal energy, they'll end up being 4, 5, 6 out of 10 going into step 3 and step 4. And with lifestyle habits, obviously we're still replacing deficiency. So I would say deficiency in sleep. So not enough sleep. So they need to get more sleep, not enough good food. So that's a deficiency. Right. Not enough movement. Though a lot of people that we work with, if your energy is not like a 6 or 7 out of 10, you really shouldn't be moving that much. You know, like it's whatever you can do. Oftentimes I'll tell people, like, do five jumping jacks a day, you know, just kind of get your heart pumping, get it moving a little bit. Your lymph needs a little bit of that help. You know, you can do. You can go hot and cold in the shower, you know, like you were talking about. That can help too. And then, so step three is opening up the detoxification pathways. So this incorporates some of that. So it's. So it's. It's, you know, how do we get rid of crap out of the body? We poop it out, we pee it out, we sweat it out, we breathe it out. And so that's kind of what we're doing here, making sure that people are having bowel movements at least two a day, ideally, that we're opening up liver, kidney, lymph, neurolymph pathways in preparation for step four. Because generally, when you start to remove the toxins out of the body, it's going to be uncomfortable. They've formed this bond to you, right? I got my jersey coming out. They got to form this bond to you.

We're loyal to our toxins, right?

Exactly. They don't want to leave. And so it's uncomfortable for a variety of different reasons, but you get die off or you get a Herxheimer reaction where you feel worse. And so your success is really going to be based on how well you have done step three. So I think of this process as kind of like a funnel where as you're. You're dumping things into this funnel as you're starting to remove them, Step three determines how easily they are getting out of the body. So if the patency or the opening is very small, you're gonna overflow as you're dumping these toxins in. But if it's really open, you're gonna be able to get a lot of these toxins out in a more rapid fashion. And so then step four, we're talking about heavy metals, right? 100,000 pounds of mercury are dumped into our oceans every year.

Where's it coming from?

Coal plants. Even if we don't have that many in our country. I mean, we have had, but there's plenty of other countries that are still producing a lot of using a lot of coal plants.

So is this more about the fish that we're eating or actually being in the ocean? Because it's heavy, so it's not going to be aerosolized. What's the exposure mechanism then?

It's mainly fish. There is also obviously mercury amalgams. Those are Kind of the two biggest sources. But I do think that you're also going to get exposure. I mean. Yeah, it's a good question. You know, how does mercury do in water? And, you know, at what temperature is it going to become a vapor again? And are you going to get it through your skin swimming in the ocean or being near the ocean? Do people who live near the ocean, do they have more mercury toxicity? I don't know.

Well, it will wash up also. And it gets. If it's in one place, it'll get it everywhere else. All right, so we messed up this earth. We got it. So we got. We got mercury.

Lead. Don't forget lead.

Lead.

Plastics.

Yeah, plastics. 86,000 different chemicals we're exposed to on a regular basis. 500 different chemicals we're exposed to before we leave the house in the morning. Right. From everything that we're putting on our face and whatnot. It's worse for women than it is for men. I think it's 300 for men, 500 for women. And then we're looking at mold. And half of all the buildings in first world countries have water damage, and most of those have mold in them.

And let's pause for a second on that, Evan, because when you really drill into it, one thing that's particularly poignant that I find with my patients is dorm dormitories and schools and that, I mean, school teachers are just getting nailed with mold exposure. And kids who go to college, more often than not, those dorms are moldy and kids are getting exposed in their clients or if they're going to school in a place that's particular, like a Florida climate is much wetter. And so those buildings are all much more likely to have it. So the issue is these unconscious exposures. If you drive a car that had water damage, your car can have mold in it because it doesn't fully dry out.

Yeah. And that's a really good point. And people don't realize that it's a place that you lived in, had to have water damage, but it could have been when you were five years old and it's still in your body. And people are like, nah, I don't have any mold. I was like, okay, did you ever live in a place that had a. A flood in the basement? Did you ever. And people are like, oh, actually, every single winter it flooded. Did you ever live in a place that smelled musty? Did you ever live in a place that had cats that peed on the cardboard boxes when you were in medical school? That was part of My story, they peed on those boxes in the basement, grew mold and that was one of the ways that I was exposed. Did you ever live in a place that had a leaky roof that had to be repaired? Did you ever live in a place that ever. In the lifetime, I mean this is all in the lifetime of the home I live in a hundred year old home. How many busted water pipes have there been in this home? And so these are all things that are behind the walls. If you do see mold, it's very much the iceberg concept where it's like an eighth of what's actually really happening behind the walls. Right. So it's incredibly nebulous and it's a huge part of the work that we do, which is why we actually have a mold remediation specialist on staff who's done this several times to walk people through this process because it is such a big part of the work that we do. I mold plus some sort of infection.

Deadly.

Yeah, it's deadly. It's like the biggest reason why we see people with me, cfs, so heavy metals, chemicals, molds, and then infections. And these infections could be Lyme type infections where you've got borrelia, which you really can't have borrelia unless you've got symptoms that move around the body. Whether they're the joint pain, the muscle pain or the nerve pain. It's got to move around the body where this week or this day it's in this spot and then next week it's in a different spot and those symptoms have to come and go where some days are worse than others. If you don't have those symptoms, you really can't have borrelia. And the same goes for Bartonella where this is going to be pain on the bottom of the feet, muscle cramps usually in the calves at night, problems sleeping, hard time, falling asleep or staying asleep, mood issues, whether it's anxiety or depression, bartonella striae. So those scratch marks that people get, thyroid issues. I love telling the story about reversing people's thyroid issues and getting them off of thyroid medic. And one of the main ways of doing that is by treating Bartonella. And people don't have to have all these symptoms but having like three of them where like pain on the bottom of the feet, misdiagnosis, plantar fasciitis, maybe they've got fibromyalgia, maybe they've got muscle cramps, maybe they've got sleep issues. And that means they need to be treating some bartonella or maybe it's babesia, where they're sweating all the time or sweating spontaneously. Maybe it's every couple days or a couple weeks. They've got awful sleep, they've got anxiety to the point of panic attacks, depression to the point of suicidal thoughts and shortness of breath. And once again, you don't have to have all those, but a lot of those. Or maybe it's Epstein Barr virus, like having. I mean, they're pretty non specific, but it's the fatigue, the lethargy, sore throat, large lymph nodes, among other things. And then there's the parasites and the yeast and the other bacteria.

So I'm going to interrupt for a second. So here's. I'm with you 100% on what you're talking about. What I'm not, what I don't actually get is how do you do this in the group setting?

Because everybody. Wait, you do this in a group setting? I totally miss that.

Yeah, no, that he runs programs.

Well, I do one on ones and groups. So there is some depending on. Depending on which level they want to join, but there is just group components. And so fortunately, these symptoms that I was just mentioning, you can determine which one of these infections they have for the most part, for a lot of the infections, or at least the Lyme type infections based off of their symptoms. So in that first hour, they go through step one and they know which infections they have or a lot of them.

So you have a great questionnaire and you're like, if you scored 4 or 5 above on these number, then you've just. This is something you should check off as probably having. So you make them do the work. They're doing all their own work, except for the brain fog patients who are like, I don't know how to do this.

But in the group setting, are you getting actual testing, individualized testing?

Well, I have them get the 25% that everybody needs. So that's heavy metals, chemicals and molds and stool test. And then when we're in the group format, so then they're moving through and it tells them in step two. Okay, if you had this. Cause we basically have like a causes sheet where they have checked off and so they have this master sheet so they know what their 20 plus causes are. And then they know which supplements to take for each of those because they're basically layering on. Okay, now it's this. Cause now I take these supplements sort of thing. And then in the groups they get face to face time with me for five to 10 minutes. To answer what questions they have. If they're not sure what causes they have, they answer that. If we need to go over labs, we do that then. And then we also have an online community that's like a Facebook group, but it's not on Facebook. It's on mighty networks where they can ask questions as well. Because I think that the gold in a lot of this stuff is getting questions answered in an expeditious fashion so you can continue to move forward. Sometimes people don't know what the questions are so they just show up and they realize that they actually somebody else asks a question that they didn't even know that they had. And so that's kind of, that's how we do it. But we make sure we do our best. We're kind of like we're going to be hiring an accountability coach who's going to check in with people on a more regular basis. We do have one on ones with a health coach coach. We have one on ones with a nervous system retraining coach. We have one on ones with me. We've got groups with each one of those people as well as we've got community check in process. We've got meditations that happen every Saturday. So we're addressing it from mind, body, spirit, social, all those sorts of things in a group format.

That's great. That's really great. How can people reach you? How can people find you? And we'll put this all in the show notes, but how can they find you?

So I'm@fixyourfatigue.com f I x Y-O-U-R-F-A-T-I g u e.com I've got a free Facebook group where people can jump in there and there's lots of education. We've got quizzes on our site for Bartonella. If you have Bartonella, if you have Babesia, you want to actually the Babesia quiz isn't ready yet but we've got the Bartonella quiz so got a bunch of stuff on the website that hopefully can help people on their journey. And then we do offer free calls if people are interested in seeing whether or not we can help you or not. Jump on a free call and explore.

Is that how they get onto a group?

That's how they would get onto a group. Yep. And we're also working on creating like a standalone course where if people are self directed and they, they can't afford what we the investment for the larger group then they can go ahead and move through it at their own pace and that is something we're working on.

That sounds amazing.

That's awesome.

This is a huge contribution to the field. So. So, Al, thank you for doing the work. It's pretty impressive.

Thank you so much. Appreciate that.

So thanks for coming on. Our guest today is Evan Hirsch. And Evan, it's been awesome to have you here. Thank you.

Pleasure. Thank you.

Thanks so much for having me on, guys. Appreciate you.

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