Lyme Disease with with Dr. Darin Ingels: Rational Wellness Podcast 370

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Dr. Darin Ingels discusses Lyme Disease at the Functional Medicine Discussion Group meeting on June 27, 2024 with moderator Dr. Ben Weitz.  

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.] 

 

Podcast Highlights

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Dr. Darin Ingels is a Naturopathic Doctor with a license both in California and Connecticut, and his office is in Irvine, Califonia. His practice focuses on treating patients with Lyme disease,  Dr. Ingels has published three books, the most recent is The Lyme Solution: A 5-part Plan to Fight the Inflammatory Autoimmune Response and Beat Lyme Disease. His website is DarinIngelsND.com.  His office is in Laguna Hills and his phone is 949.551.8751.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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Podcast Transcript

Dr. Weitz:  Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me. And let’s jump into the podcast.

Hello, everybody. Thank you for joining our functional medicine discussion group meeting. I’m Dr. Ben Weitz. So we hope you’ll join some of our future meetings as well. We usually meet on the fourth Thursday of the month.

July 25th, Alan Barrier is going to speak about the hypothalamus pituitary adrenal axis.

August 22nd, it will be about Integrative Cardiology with Dr. Cynthia Fink. 

September 26th, Dr. Mark Pimentel will be talking about SIBO as the cause of IBS and all his exciting new research.

I encourage everybody to participate and ask questions. If you’re not aware, we have a closed Facebook page, the Functional Medicine Discussion Group of Santa Monica.  So please join that and we continue the discussion. We post a lot of articles and, uh, this is going to be recorded and included in my weekly Rational Wellness podcast. So please check that out. And if you enjoy listening to it, please give me a Ratings and Review on Apple Podcasts or Spotify.

So we’re so grateful that Dr. Darin Ingels has made the trek all the way from Irvine to speak to us about Lyme disease. Darin is one of the leading experts in the country on Lyme disease. He wrote a spectacular book called The Lyme Solution and his practice is focused on treating Lyme disease and I’ll let Darin introduce himself.

Dr. Ingels:  So, my own story, if you don’t know, is I was a Lyme patient. So nothing like getting an education on Lyme disease than getting the disease yourself.  I got bit by a tick in 2002, living about 30 minutes from Lyme, Connecticut.  I got bit two weeks before my own practice, so, uh, the timing of it couldn’t have been worse. And it really was the perfect storm. And I think, you know, as we kind of dig into Lyme, we’ll realize that it’s a common infection. I think there’s a lot of people that have that exposure, uh, but it is an opportunistic infection.  And it’s not just about killing the bug, it’s about all the other things we do to help heal the body, helping the terrain, the most inhospitable place for the organism. So, it took me about three years to go through my cascade of all the different Lyme treatments, and we’ll see this is a very common scenario with people dealing with Lyme disease, as often they cycle through treatment after treatment, often it’s targeted towards killing the organism, but we’ll see as we go through this that, there’s a lot more to it.

So, let’s dive in. So just a little background on Lyme disease, if you don’t know, it’s a bacterial infection primarily caused by the Borrelia species. Borrelia burgdorferi is the most common strain in North America. It’s transmitted primarily through the bite of a deer tick, the Ixodes tick in particular.  And this all started back in the late 1970s in Lyme, Connecticut. There was a group of children that started having this mysterious arthritic stuff. And juvenile rheumatoid arthritis is actually a very rare condition. But there were a lot of kids and there were a handful of adults that had all these arthritic things.  They didn’t really know what was going on. Nobody recalled getting, a rash or any kind of tick bite. And, uh, they started sending, uh, samples to a guy named Willie Bergdorfer. He was a researcher for the NIH. And his expertise actually is Rickettsial Illness, Rocky Mountain Spotted Fever. So they thought this was some weird Rickettsial Illness, and it took them several years, but they finally found this little critter under a microscope.  So the rule is, if you discover the bug, you get to name it after yourself. That’s why it’s Borrelia burgdorferi. It’s named after Dr. Willie Bergdorfer. And Dr. Bergdorfer just passed away not too long ago.

So there are at least five subspecies of Borrelia burgdorferi, over 100 strains in the U. S. and more than 300 strains worldwide.  This is important because when we talk about testing, testing looks at one strain. So often we’re missing the boat of all the potential Borrelia species that are out there that can cause infection, but there are a lot of them. We don’t even know how many strains are clinically relevant. Our best guess is it’s probably somewhere around 8, 8 to 10, uh, but nonetheless there are a lot out there.  Most of the cases in the United States come mostly from New England, the Central, Midwest. We’ll see in a little bit though that the East and West coasts of the United States are endemic for Lyme. And yes, even here in California, there is a ton of Lyme disease. The CDC says California is the fifth fastest growing state for Lyme disease.  I’ve had doctors in California tell patients there’s no Lyme disease. I had one doctor in San Diego tell my patient there’s no deer in California, I’m like, dude you need to get outside.  There’s deer everywhere. But deer, by the way, aren’t even the primary vector for carrying ticks. I mean, every furry little creature, mice, rats, squirrels, raccoons, all of them can carry these ticks.  So we get about 476,000 new cases of Lyme every year in the United States, more than 90,000 cases in Europe, and again, that’s new cases. We don’t really know how many new cases there are because of the reporting criteria.

Most people who have Lyme do not meet the CDC criteria for a positive Lyme test.  We’ll talk more about testing, but we’ll find that the testing was never designed to be diagnostic. The testing was designed as a surveillance tool for people who had known Lyme disease. So we know that whatever number’s out there, it’s probably much bigger than we think it is.  So, you can do the math, that’s almost half a million new cases a year.  We literally have millions and millions of people in North America living with Lyme disease. So, I mentioned transmissions primarily through the deer tick bite. There is very weak evidence that other biting insects might transmit Lyme. There’s a few small studies out of Europe with baby mosquitoes.  We actually have a colleague who is a medical doctor. His son is an entomologist in Florida. They actually were looking for Lyme in mosquitoes in Florida, and they found no evidence of Lyme in mosquitoes. So, I think that’s very low. However, other biting insects can transmit other diseases. They can transmit Bartonella and Babesia and Rickettsia.  We know Bartonella can be transmitted through fleas, it can be transmitted through lice. So, even though these biting insects may not carry Lyme per se, they can carry other tick borne illness and the symptoms look very, very similar.

We’ve now got ample evidence there is vertical transmission from mom to baby.  So if mom is pregnant, she can transmit it to her baby. And vertical transmission usually results in stillbirth, birth defects or these children start up with severe developmental delays. They miss all the early milestones and so forth. So, I’ve had parents come in where they got a nine year old child who’s having issues and mom found out she had Lyme.  She’s like, oh, I gave my baby Lyme. I’m like, well, if it started happening at seven years old, probably not. You know, if you live in the same area, child could have had their own ticks, but it’d be unlikely that was related to mom passing. With sexual transmission of the Lyme, we don’t really know, to be honest.  As far as I can tell, there’s only one study. Ray Stricker, who’s a researcher up in San Francisco, he did a study where he looked at the semen of men, looked at the vaginal secretions of women, he found it was like below 20 percent had evidence of Borrelia, but we don’t know if it actually gets transmitted.  Vaginal pH is very acidic, most organisms don’t thrive very well. So, Richard Horowitz, who’s really the Lyme guru of the country.  He’ll stand on stage and say his wife’s had Lyme forever, he’s like, we have unprotected sex, I’m not worried. So it’s possible, probably not probable, but we always err on the side of caution.  If one partner has Lyme, we do recommend barrier protection, just in case, because we don’t really know the truth. There’s other strains in the United States, Burrelia Burgdoferi, most of the East Coast, but we see it here on the West Coast. Borrelia miyamotoi has been an emerging strain that we see a lot more, about half the cases out in California are Borrelia miyamotoi.  There’s Borrelia mayonii, Borrelia lonestarii, Borrelia hermcii, which is causing what we call relapsing fever. In Europe, Borrelia afzalii and gorinii are the primary strains. So, it’s good to understand for a patient, where have they been in the world? Because, they may not have acquired Lyme here, they could have. We’ve been backpacking through Switzerland, and they got a bug while they were there, so it’s good to ask about foreign travel.  Uh, interestingly, Australia says there’s no Lyme in Australia, I guess ticks can’t swim that far. But, we’ve had a few Australian patients we’ve worked with that actually test CDC positive, so again, I don’t know what to tell you. I think they’re looking for the wrong thing, because they’re testing for Borrelia burgdorferi.

You’re looking for the North American strain in Australia, and you’re just, like, you’re probably looking for the wrong thing, would be my guess. This is just a map of how Lyme has changed over the years. Uh, the one on the left there is 2001, just kind of showing where we get, this is CDC positive Lyme. You can see, fast forward to 2022, that green is getting bigger and spreading.  Again, this is grossly unreported, but this is the CDC statistic and you can see that it’s getting worse. And again, if we start looking at where ticks and other infections are found, I’m sorry, no, this one’s on ticks. And you can see that the spread of ticks is starting to get worse and worse. They’re finding that the migration of birds has changed with climate change, and birds basically become the carrier of the tick hops on the birds.

Bird flies from Vermont to North Dakota, lands, and now there’s a new tick population in North Dakota. Uh, there’s been at least almost a 48 percent increase since 1996 of Lyme.  59 percent of U.S. counties have established populations, almost half of the country has established populations of these ticks.  And again, we’re seeing a merging of these regions where there used to be gaps, they’re now getting closer and closer together. So again, people who live in Texas and Colorado places, they say, well, there’s really not a lot of Lyme. Again, it’s been reported in all 50 states. In addition to that, we’re seeing all these other illnesses, Lyme disease, Rocky Mountain spotted fever, Anaplasmosis, Ehrlichiosis, Babesiosis Tularemia, Bartonella, again, all these are getting worse and worse.

Now this is just a map of Europe just to show again that they’re, pretty much almost all of Western Europe is endemic for Lyme disease, so, uh, they get it there too. If you’ve never seen a picture of a blacklegged tick, this is it. This is, there’s Ixodes scapularis, which is primarily on the east coast.  There’s Ixodes pacificus. I can’t tell the difference between the two, they look the same to me, but apparently there is a difference. These are the different species of the ticks, and these ticks are tiny. So a fully engorged tick is a large poppy seed. A non engorged tick is a very [00:12:00] small poppy seed.  So a lot of people, even if they had a tick on them, they would very easily think it was a fleck of dirt, uh, something else. And, uh, I can remember, after I had Lyme disease, I remember standing on my porch in Connecticut, and I saw a little fleck of dirt on my arm, and I went to flick it, and it started moving.  Dirt doesn’t move. Uh, and I realized, oh shoot, it’s another deer tick. I was already on treatment, so I’m kind of like, ha ha, screw you, you’re already dead. Uh, yeah, these things are very hard to find, and they like the warm, moist areas of your body. They like the back of your knees, armpit, behind your ears, hairline.  So again, a lot of people who get bit, even if they had a bullseye rash, they might not even see it. Because it does go to those areas we don’t usually check for. It is the number one spreading vector borne epidemic in the world. It can affect any organ, any tissue, and as a result of that, we see a very large variety of symptoms.

There’s over a hundred different symptoms of Lyme disease. Borrelia is also a true shape shifter. It has the ability to change its shape and it is one of the, as far as I know, I think it is the slowest replicating bacteria out there. So if you consider most bacteria in your body replicate every 10 to 20 minutes, Lyme replicates every 1 to 16 days.  And if you get tuberculosis, Mycobacterium tuberculosis, your doctor will put you on 3 hardcore antibiotics for 9 to 12 months. Why? TB is a very slow growing organism. It replicates every 15 to 20 hours. So why are we willing to give people hardcore antibiotics for a year for TB and we’re willing to give people two weeks of doxycycline for Lyme disease?  It makes zero biological sense. But this is, this is what they do. Uh, the nature that Borrelia can change its shape also makes it a true evader of the immune system. So the immune system’s effort to get rid of the bug, and I’ll show you a picture in a second how that looks, but this ability to get into different tissues, change its shape, it really is able to hide the immune system, which just makes it more difficult to kill.

So if you look at the picture here, you can see over there on the left, you know, that’s a spirochete. It’s a [00:14:00] sort of corkscrew shaped organism. Of course, this is a 2D image. We’re not appreciating it. It does look like a corkscrew. And that’s in its uncoiled, normal form. That’s the best time our immune system has to recognize it and kill it.

You can see in B there, some of them are starting to ball up. It goes in what they call a round body form or cyst form. That little gunky stuff around it is basically biofilm. It’s protecting the organism. And when it goes into that form, our immune system and most antibiotics will not kill it in that form.

Uh, they’ve done lots of studies on doxycycline, rifampin. They do not work when it goes into that round body form. Or what they call stationary bugs. And then you can see, uh, there’s like a couple of organisms, they’re all bound up in that biofilm together. Very hard to kill, and, uh, very hard for the immune system to recognize.

They’ve done studies with other organisms that when biofilm is present, you have to give 250 times the amount of antibiotic to kill the bug when biofilm is not present. So, part of our treatment we’ll talk about is breaking down the biofilm to expose the [00:15:00] organism to whatever treatment we’re instituting.

So I kind of break Lyme down into acute and chronic Lyme. In reality, it’s a gradation, it’s a continuation. But most people with acute Lyme disease are sick. They are acutely sick. I’ve treated over 8,000 Lyme patients at this point. Maybe I’ve treated 40 acute Lyme patients. You know, more often if people have these symptoms, they probably go to the ER, they go to their primary doctor.  I’m not either one of those, so more than likely they’re going somewhere else to get that initial help. But, headaches, stiff neck, high fever. When I had Lyme, I had 105 fever. It looks a lot like meningitis, and you can’t get any type of Lyme meningitis. Arthritis, swollen joints, back pain, spine pain, muscle aches.

That erythema migrans, that classic bullseye rash. I’ll show you a picture in a minute. That’s sort of the telltale path, mnemonic sign of Lyme disease. Uh, the CDC says 60-80% of people with Lyme get the erythema migrans rash. The research suggests it’s about 40%. Those of us in clinical practice will argue it’s less than probably 20%.  So if you’ve got the rash, you know, do not pass go. Do not collect $200. You know you have Lyme, but the absence of the rash doesn’t mean anything about whether you’ve been exposed to Lyme or not. Fatigue, Chills, Lymphadenopathy, Heart palpitations, there is a rare form of Lyme Carditis, which will cause an AV heart block.  You’ll see that on EKG. Shortness of Breath, Memory Loss, Brain Fog, and Bell’s Palsy, One Sided Facial Paralysis are all very common acute Lyme disease. This is kind of what the bullseye rash looks like, the target logo.  There are a lot of variations of this rash. I’ve seen patients that don’t have that necessarily, the red with the central clearing and then the red again.  When you see a flat, red, spreading rash, be suspicious. This gets confused with histamine reactions all the time from someone that got bit by a mosquito. Histamine reactions usually go away in 24 to 48 hours. These rashes will usually last days to weeks. Mine lasted almost eight weeks before it went away.  Mine started off about the size of, I’ll say, a baseball, and by the time it was done, it was almost 18 inches. It covered the entire back of my leg. And that’s very common for a Lyme rash. But it also doesn’t tend to itch. Most mosquito bites, horse flies, other bite instances, because of the histamine reaction, tend to get very itchy and raised.

This is flat and generally not itchy, at least not for several days, until after the bite. Acute symptoms can happen within 3 30 days following a tick bite. As I mentioned, CDC says a bunch of people get the rash, most people don’t. So again, the absence of the rash doesn’t really mean very much. And because Lyme causes so many different symptoms.

Misdiagnosis is really common. People go to their PCP, they go to the ER, they get all these standard tests. Frustratingly, most standard blood tests look normal in Lyme patients. You know, their white count is elevated, their CRP is normal, they’re not showing all the typical things of like autoimmune disease.

And so often though, they get all these blood tests, they might get a CT scan or an MRI, [00:18:00] everything looks normal. They get sent out the door with, you know, it takes Vibuprofen and good luck. But that’s a very, very common scenario. And chronic Lyme disease, we’ll see a lot of the same kind of symptoms, more debilitating fatigue, we might start getting abdominal change, bowel changes, more memory loss, cognitive impairment, more neuropathy, numbness, tingling, different kinds of sensory distortions, burning sensation in the skin, a type of neuropathy is very common with Lyme and Martinella.

A blundering joint pain, we call migratory joint pain, that’s another classic sign of Lyme. There’s a lot of things that cause joint pain, there are very few things that cause migratory joint pain. One day it’s my right shoulder, then it’s my left knee, then it’s my right ankle, then it’s my right wrist.

That is very classic for Lyme. You know, my big red flags, when you hear about arthritic symptoms and neurologic symptoms, think about Lyme, because again, there’s very few things that cause Lyme. Light and Sound Sensitivity, Dizziness, Vertigo, Sleep Disturbances, Rheumatism, I mentioned Heart Block, Coordination Problems, People all of a sudden will complain they’re clumsy, I’m dropping things, [00:19:00] I’m tripping, I call it Newly Acquired Dyslexia, it happened to me.  People start transposing letters and numbers, whether they’re writing it or typing it, I think it’s just part of the neurologic disruption that happens, and then you can start to see secondary endocrine disruption. Hypothyroidism following live is very common, but when we start having reproductive hormone issues, adrenal issues, all that could be affected after.

Lyme in children, uh, if you treat children in your practice, what’s a little bit different, again, these kids can be acutely sick. Uh, it looks sometimes like strep throat, a complaint of a sore throat, swelling glands, fever, uh, fatigue. You might see gait alterations. But mood changes, you know, it looks like PANS, Pediatric Acute Onset Neuropsychiatric Syndrome, where all of a sudden it’s anxiety, OCD, tics, Lyme is a major, major trigger for PANS.  We used to call it PANDAS because we said it was associated with strep. Strep can be a cause of it too, but in our practice, I would say Lyme is probably a bigger culprit than strep. So if you get these kids that all of a [00:20:00] sudden overnight turn into little demon seeds, I would be very suspicious of something like that.

The great imitator, the great imitator, Lyme looks like a lot of different things, any chronic neurologic illness can potentially be due to Lyme. You know, I think it’s kind of interesting, you know, you talk to a neurologist, talk to a rheumatologist, but any disease, MS, lupus, rheumatoid arthritis, they say, okay, well, here’s your label grade.  Why? I don’t know, you know, bad luck, bad genes. Well, is it possible that there’s an infectious cause that’s triggering this autoimmune inflammatory condition? And more often than not, they’ll say no, but when you go into the research, all you have to do if you’re really interested, go into PubMed, and type in any condition, and in capital letters and, this is what they call Boolean search, Molecular Mimicry.

Molecular Mimicry is the immune mechanism by which most organisms trigger this autoimmune response, and it’s amazing. Go type in Aromatoid Arthritis and Molecular Mimicry. Klebsiella, Proteus, all these different viruses have all been [00:21:00] associated as causes of rheumatoid arthritis. So, are we just going to give immune suppressive drugs, or are we just going to treat the underlying cause?

And you’ll be amazed at how much information is out there, on, you know, post infectious and post adventure. Uh, autoimmune issues. You know, for better or for worse, I think COVID kind of brought this to light. You know, all these people have long COVID, so you can get a virus and have all this sequelae afterwards, long after the viral infection is cleared.

Well, duh, I mean, you know, we’ve known this forever and ever. It’s just different organisms causing a different set of problems, but Lyme is a, I mean, we’ve been dealing with this for years with Lyme. There’s a lot of co infections. We know from the research, there’s Certainly the ticks up in New England, like 33 percent of the ticks that carry Lyme, also carry something else.

So if you suspect Lyme when we’re testing, we’re almost never testing just for Borrelia, we’re testing for other organisms that might have been transmitted during that tick bite. So Babesia, Bartonella, Hannaplasma, Ehrlichia, Mycoplasma. That’s why every time I go to another Lyme conference, we’ve learned there’s now 10 [00:22:00] other things that ticks carry that we need to test for.

But understand what’s in your area. I mean, here in California, I mean, we test for, I mean, it also depends on the symptoms too, but I routinely test for Lyme, Bartonella, Babesia, Mycoplasma, Anaplasma. Rickettsia, I hardly ever see, unless I have a patient that has symptoms that make me think Rickettsia. But the other ones, a lot of these viruses are pretty rare, uh, Powassan virus, I don’t know that we’ve even seen in California, Tularemia, Harlan virus, these kind of things are pretty unusual.

So, from my standpoint, there’s the first tier testing, and then as we get stuck, maybe the second tier would be some of these more obscure pathogens. So the diagnosis of Lyme disease, again, the CDC criteria was for surveillance purpose, it was never designed to be diagnostic, at the end of the day, Lyme is a clinical diagnosis, It’s based on your sign and symptoms.

This is even according to the CDC. Incredibly, infectious disease doctors don’t even follow the CDC guidelines. You know, if your test is negative by CDC, they say, well, you don’t have Lyme [00:23:00] disease, they will fight you tooth and nail on this. But that’s not even the CDC guidelines. Go figure. As again, I mentioned with all these different strains, we’re testing for one.

Maybe we’re just testing for the wrong stuff. So this is straight from the CDC’s website. Lyme is diagnosed based on signs and symptoms and a history of possible exposure to infected blacklegged tists. Laboratory tests are helpful if used correctly and performed with validated methods, blah, blah, blah.

But basically, it’s a clinical diagnosis. As I’ve mentioned, you know, this test was never designed to be diagnostic, it was designed to monitor people with no Lyme disease. So if you have somebody who has these symptoms and their tests come back negative, that doesn’t mean they don’t have Lyme. But, depending on what lab you use, and I’ll talk about that in a second, some labs do better testing than others, and, uh, again, I was a microbiologist before I was a doctor, I used to do Lyme testing for a living, so I know what I’m looking at.

If we even see Lyme specific antibodies, even though it doesn’t meet the CDC criteria, and you have clinical symptoms, just document that. It’s like, hey, we did this test, they’ve got Lyme specific [00:24:00] antibodies, their clinical symptoms fit Lyme, and, you know, they probably ruled out other things. So, at least it gives you justification of why you’re implementing some element of treatment.

So this is the CDC criteria. They do a Lyme screen. If that test comes back positive, it flexes over to what they call a Western blot. It’s a more specific antibody test for IgG and IgM antibodies against different parts of the Lyme organism. And so these, these antibodies are called BANs. They separate it out through electrophoresis, so they’re separating out the antibodies by weight.  And each weight antibody represents a different antigen on the Borrelia surface. Now again, we know some of these are specific. Some of them are not.  The CDC criteria says you have to have 2 out of 3 IgM or 5 out of 10 IgG to cause either one positive. Well, if you’ve got one Lyme specific IgM band, and you have clinical symptoms, why is it that relevant? I mean, it’s like being a little pregnant, right? I mean, you [00:25:00] are, you are. So if you’ve got Lyme specific antibodies, I think that’s relevant.

And for me, that’s important. In 40 years, this criteria has never changed. Uh, you know, we’ve learned about which antibodies are specific to Lyme, which ones are not. Why we’ve never even changed the criteria really just to focus on the Lyme specific antibodies, I don’t know. There’s a whole political thing behind this that I can’t even begin to speculate.

But, uh, nonetheless, this is where the criteria is and it hasn’t changed in 40 years. So yeah, just looking at these bands, so IgM, so 23, 39, these are Lyme specific antibodies. 41 is a very non specific antibody, it’s a flagellar protein. A lot of bacteria have the little tails, flagella, that’s how they swim through the body.

So flagellar protein antibodies by itself aren’t specific to Lyme. Uh, but yeah, 23, basically everything under 41 or less. 31 does cross react with Epstein Barr virus, so that’s a semi specific antibody, 23, 34, 39 and 93. All those antibodies [00:26:00] are very specific to Lyme. The other ones are not specific. So when something comes back to Western blot, it’s 45 and 58 and 66.

Without the Lyme specific antibodies, maybe it’s Lyme and maybe there’s something else going on, so we don’t have as much teeth behind our justification, but again, at the end of the day, we treat people, we don’t treat pieces of paper. This is the alternative criteria that was developed by ILADS. This is the International Lyme and Associated Disease Society, basically a group of doctors that kind of said, you know, the CDC is kind of off on this, and so again, if there’s even one positive band that’s Lyme specific, that’s relevant, and so again, it’s just a different interpretation of the same data.

So, really the pitfalls of testing is that a lot of people are seronegative, they don’t make antibodies. The further you get from year to year, the less likely you are to pick it up on a test. We know that immunity wanes with time, so, again, if you’re testing someone six months, six years, ten years, twenty years after their exposure, the likelihood of picking it up on an antibody test goes way [00:27:00] down.

Uh, again, because the, for a band to be considered positive, they are comparing you to a control, and you have to meet a certain percentage of the control. So they are measuring quantity of antibodies. So the CDC assumes if you have one, you have a very robust antibody response. There are a gazillion reasons people don’t have a robust antibody response.

And the lab that I use, they change it a little bit, but they used to give us a percentage. The cutoff was 60%. You had to be 60 percent of the control. Well, I get the test back, it was 59%. I’m like, that’s how much water you had to drink that day. That’s the difference between you do or don’t have Lyme? I mean, this is kind of the silliness of it.

So they only have one threshold where most tests kind of have a low, medium, high control. With this, it’s just a high control and that’s, so again, a lot of people unfortunately get missed even doing these kind of tests. Um, again, these labs aren’t testing for the breadth of antibodies, all the different strains of Borrelia, so it’s easy to miss.

And again, it can even take up to six weeks to make antibodies. So if you test someone right after their exposure, you might be too early in the window, or they haven’t made [00:28:00] antibodies yet. And you do the test and go, well, your test is negative. I’m like, well, you know, test them again in another three or four weeks and see if they’ve made antibodies then.

So I mentioned iLabs again, they came up with different criteria. At the end of the day, most iLabs doctors do the same thing I do. You know, they treat based on symptoms. And again, if there’s any evidence of Lyme specific antibodies, that’s relevant. Uh, again, it’s important to rule out other possibilities because Lyme does look like a lot of things.

So it’s good to run other tests, make sure they don’t have some other autoimmune disease or other explanation. And I also think sort of legally having that justification. You know, California, I’ll say, is a semi decent state. There are other states where they are very aggressive in going after practitioners for treating Lyme if the patient doesn’t meet the CDC criteria.

I’m sorry. So the labs that I use, uh, Igenex, they’re based out of Palo Alto, they do great testing. My only complaint about Igenex is that unless you have Medicare, they don’t take insurance and they’re expensive. So it’s not uncommon if you do a [00:29:00] full tick borne panel, 1, 500 to 3, 000 out of pocket. That’s a lot of money for people.

Uh, but their testing is great and reliable. Uh, we use a lab mostly called MDL, Medical Diagnostic Labs in New Jersey. They do very comprehensive testing. There are some tests that Igenex do, that MDL doesn’t do, but they build insurance. And for people who don’t have insurance, their cash pricing, if I run all the Lyme testing, Bartonella, Babesia, Mycoplasma, Anaplasma, their cash price is like 250 bucks, where Igenex is like 2, 500.

So, it’s a big savings, but again, they’ll bill those people’s insurance. So, they’re kind of our go to for testing, and they’re the only lab to actually send you a copy of the Western blot, the actuals, they take a, like a picture of the strip, so you can look at those percentages, you can see the different antibodies, and make a decision for yourself, you know, what you think Uh, Dr.

Richard Horowitz, he came up with this MS IDS questionnaire. He actually validated this research. It’s a free download. Uh, I recommend if [00:30:00] you’re treating Lyme, you know, have your patients fill this out periodically. It’s a good objective assessment on how they’re doing because it’s based purely on symptoms.

And there’s a score, and he actually did a study that found that if you score in the range that he says, there’s a high probability you have Lyme, even if your tests are negative. And the fact that he actually studied this is pretty cool. It’s a free download. Anybody can download it and fill it out for you.

Uh, I came up with my own little questionnaire. Dr. Hurwicz’s is a longer three page. This is my little one page cheat sheet. Same concept and uh, it’s in my book. Uh, I apologize. I had all these books sitting there. I was going to bring them and I completely forgot. So if anybody would like a copy of my book, uh, just grab me afterwards and I’m happy to send it to you.

So other labs to run. Again, it’s good to look at all the co infections. Look at endocrine function, thyroid, adrenal, run the CBC, iron panel, you know, sometimes you will see little changes metabolically after someone has Lyme. So just to be thorough, I like to look at immune markers, inflammatory markers, often [00:31:00] we’re looking at nutritional markers, and a lot of my patients have a lot of GI issues, so running a stool test in our practice is pretty common.

So conventional treatment, uh, if there is a known deer tick bite, this is the CDC recommendation. If it’s a known tick bite, they say give a single dose of 200mg of doxycycline for adults or children over 8. There’s actually zero recommendations if the child’s under 8, good luck. So uh, there’s no recommendations for other confections and this, the studies out there have never shown that this adequately treats Lyme disease.

What it does do is it suppresses the Lyme rash. And that sucks because that’s our marker that someone’s been exposed to Lyme. So not only does it not treat Lyme, now you potentially suppress the rash that would tell us you had Lyme, and it’s a completely worthless, ineffective approach. So for those who test positive for Lyme, it’s typically for adults, you know, doxycycline or [00:32:00] amoxicillin.

If people have neural Lyme, they’ll do IV rocephin, ceftrioxime. They’ve changed the guidelines recently. I think the latest recommendations from the IDSA, the Infectious Disease Society, I think they’ve shortened it from 21 to 14 days of treatment. They’re getting even shorter. For children, same thing, amoxicillin, doxy if they’re over eight, cefiroxime, and it’s just weight based dosing.

But again, it’s, you know, anywhere from 10 to 21 days, which we think is far inadequate. If the organism replicates every 16 days, And think about doxycycline. Doxycycline is not a bacteriostatic antibiotic. It’s not bactericidal. It actually doesn’t kill the bug. All it does is it stops the bug from replicating.

So you may have stopped the bug from replicating for one cycle. That’s it. Why would we expect this to be effective? You know, at least amoxicillin and bactericidal might actually kill the bug. So, a lot of the ILIS doctors who prefer the antibiotic approach, using two or three antibiotics in combination is kind of the norm now, [00:33:00] because you’re trying to stop it from replicating, you’re trying to break down the cell wall, and you’re often trying to get it from multiple approaches.

But, as you can imagine, the more antibiotics you add to the load, the greater the risk of side effects. So, the good news with antibiotics, I mean, some people do really well on it. They get better, and sometimes that’s the end of that. If you do get lucky enough to catch them early in their illness, there’s a good chance that, you know, you’ll treat them before they get into the chronic stage.

And, great. Uh, it can be really effective in the early stages of Lyme, and sometimes, you know, for people who have had exposure a while ago, some people do respond quite well to different antibiotic regimens. And of course there are some people where we’re not really sure and doing a therapeutic trial of antimicrobials I think is an accepted way and they do it in medicine all the time just to see if you get a clinical response.

If you improve on antibiotics, then there’s a good chance you’ve got this underlying infection and you’ll hear this in some of your patients where, you know, I was on antibiotics for sinus infection or had bronchitis and my joint pain [00:34:00] got better. You know, they weren’t even thinking about these other things in the background until they got treated for something completely unrelated.

Certainly the Lyme, but that’s kind of a clue that, oh, you got better on antibiotics, your other systemic symptoms got better. Maybe there is some other underlying infection that just never got addressed. The bad, of course, is that some people get really bad die off reaction. We call this a Gerrush Herxheimer reaction, a.

1. a. Herxheimer reaction, a. k. a. Herxing. And it’s really a combination of the organism, like, literally popping and releasing all the toxic material, plus it’s a combination of the immune system responding. And most people get these flu like symptoms. More tired, more foggy, more achy, just that general blah feeling.

A true die off only lasts for a handful of days, maybe up to 10 days tops. If it’s lasting longer than that, that’s not a die off. That’s them having a problem with whatever treatment they’re getting and they need to shift gears and do something different. Of course, the more combination of antimicrobials you use, nausea, loss of appetite, you know, disrupt the gut [00:35:00] microbiome.

So diarrhea, loose stool, abdominal pain, headaches, all that can happen. Of course. Some people were on antibiotics for weeks, months, even years, and, uh, I’ve seen people, I had one patient, uh, who was seen by a very well known Lyme doctor in the area where I was at the time. She had been hospitalized three times because of her antibiotics.

They made her so sick. And they kept giving her more toxic antibiotics, and I’m like, at what point do you draw a line in the sand and go, maybe this isn’t the right approach? But it is an approach. And of course, the ugly is, again, you can just completely wipe out your gut flora, C. diff infections, yeast infections, secondary infections.

Immune suppression, organ damage. All that can happen is for some people if they’re on antibiotics too. So, let’s dig into my world, natural treatments for Lyme. Um, I think starting with gut and diet is important. You know, the gut’s really the cornerstone of health, right? You know, 80 percent of your immune function stems from the gut.

So if your gut’s not functioning well, it’s very hard for your immune system to function well. And in terms of diet, you know, [00:36:00] there’s a lot of different diets that are promoted for various health reasons. I’ve always been an advocate, really, of an alkaline diet. I didn’t develop this. There’s books written about this going back to the 50s and 60s.

But the concept behind it makes a lot of sense. Now, if you look at cell physiology, your cells function best in an alkaline state. Your skin, your stomach, the bladder area, for women, the vaginal area, they’re very acidic to protect against outside invaders. The rest of your body is more or less alkaline.

Even your blood pH is slightly alkaline. And the argument I get all the time with, uh, alkaline diet is like, No, it doesn’t change blood pH. I’m like, I know it doesn’t change blood pH. That’s not what we’re trying to do. We’re trying to change cell pH. And it does do that. And you can actually check this very easily.

Have your patients just get some pH paper at the pharmacy. It’s very cheap. 30 to 60 minutes after eating, go pee on the strip. We want your urine pH between 7. 2 If you can get in that range, we know metabolically you’re kind of doing what your body wants to do, and we’re giving your cells the opportunity to function the way they should.

So all those enzymes work the way they should, [00:37:00] all the repair mechanisms work the way they should, and it seems pretty straightforward. So the way I’ve kind of divided it is in three categories. Category 1, these are foods you can eat as much as you want. Uh, and by the way, if you guys want these slides, just let me know and I’m happy to send them to you.

Um. So, most of these are vegetables, vegetables as a whole tend to be very alkaline forming, so it’s not about the pH of the food, it’s about how it breaks down the body, so like lemons and limes are very acidic, if I squeeze lemon juice on pH paper, it’s very acidic, when I drink lemon juice, as it breaks down the body, it makes me very alkaline.

So again, forget the pH of the food, it’s about what it does to you metabolically. So all the food, the foods you can eat a bunch of, you’ll see it’s a lot of vegetables, there’s a few fruits, a few nuts and seeds, grains and so forth. Category 2 are foods that are either kind of neutral when you break down, slightly acidic, maybe slightly alkaline.

So it’s not that you can’t have it, but you don’t want it to really be the bulk of your diet. I tell people to try to keep it about 25 percent of their dietary intake. The [00:38:00] best way to think about Category 2 is to take your plate, divide it in quarters. It shouldn’t take up more than a quarter of your plate.

So it’s all animal protein, eggs, fish, meat. It’s a lot of fruit. Again, it’s not that you can’t have it, it’s just not the bulk of your diet. So people are really eating a mostly plant based diet with some lean proteins, uh, eggs, and things of that nature. And then Category 3, these are foods that are just highly acid forming, that’s a lot of junk food, processed food, garbage food, which I’m sure your patients don’t eat anyway, uh, dairy products, coffee, they’re all very acid forming.

But again, people are like, well, I love my coffee, and I’m tired all the time, I need my coffee. I’m like, well, If you have one cup of coffee, and they do make low acid coffee, uh, check your pH. If you’re able to keep the rest of your diet very alkaline, that one cup of coffee may not make a difference, and you know, you’re okay.

So, you know, you can just check yourself and see how you’re doing. Uh, when we started getting into active treatment, I am a big proponent of herbs. Now, I’m an atropathic doctor by training. Herbs, you know, we spent years in [00:39:00] medical school learning about herbs, so, uh, you know, I’ve said I’ve treated over 8, 000 blind patients.

I have probably written 10 prescriptions for antibiotics. Herbs work really, really well. And I think the beauty of herbs, too, is that they are chemically complex. So when you look at the constituents, there are components that target Lyme and the co infection. There are components that are anti inflammatory.

There are components that help support the immune system. There are components that soothe the mucous membrane. So you can really mix and match herbs for your patient to really tailor to what their body needs to get them through their collection of symptoms. So often we’ll find there’s like a few core herbs that we’ll use because they work really well against Lyme and co infection.

Oh, but this is really great for joint pain. And this is really good for the reflux and the GI issues you’re having. So again, I like the ability of being able to have all these different possibilities. And then when I sit down with my patients, I’m like, we need a place to start, but we’ve got plan A, B, C, D, E, F, and G if we need it.

We just need to give whatever we start with an [00:40:00] opportunity to do what we want. So my, my rule for treatment is two months. Whatever you’re doing. Antibiotics, herbs, I don’t care. You get two months. If they’re not better in two months, you’re barking up the wrong tree, and you need to switch and do something different.

I have seen patients be on the same protocol for six months, a year, and they and the practitioner are waiting for the magic to happen. It hasn’t happened. Like if it hasn’t happened in two months, it’s not gonna happen. You need to switch gears and do something. So the beauty of plants is that Relative to antibiotics, I think they’re safer.

Side effects are really uncommon. If they do happen, they tend to be very mild, go away quickly. It’s a much more comprehensive approach because of the broad activity of the herbs. Definitely less negative impact because they’re plants. Plants tend to get absorbed in the first part of the small intestine.

Very little of it actually gets down to the large intestine where most of your bacteria live. So we don’t see the same die off like you do with antibiotics. A lot of these herbs cover Lyme and the common infections, so there is a lot of overlap. Uh, Dr. Lee Cowden, I think Dr. Cowden, [00:41:00] he’s a big name in the Lyme world.

Uh, we were at a lecture he gave a few years ago, and he kept talking about this herb. I go, well, this is, yeah, he’s from Texas. And he goes, this is the key herb. And I go, yeah, I’m hearing this herb, this is the key herb. I’m like, I don’t know what you’re talking about. He goes, well, it kills everything except people.

So, you know, a lot of these herbs, because they’re antibacterial, they’re antiviral, they’re antifungal, Again, if there is overgrowth of other microbes in the body without knowing what it is, there’s a good probability with plants you will cover that base. So I like that perspective. Again, it can be very much tailored to the individual needs, help and support the immune function.

There are very few herbs that truly have immune suppressive activity, uh, maybe more cost effective if people are paying for some of these antibiotics out of pocket, because insurance will put a cap on how much antibiotics somebody gets, um, and when it gets out of pocket, some of these are very expensive.

Herbs by and large tend to be pretty inexpensive. Clinically, they’re very effective. Again, I’ve had great success over the years using herbs, and you’ll have people come in who tried the antibiotic route, just didn’t work. You know, they’ve been on three, four, five, [00:42:00] six, eight, ten different antibiotic regimens, didn’t work, or they got worse, and they’re looking for the next option.

So, uh, there’s a Dr. Zhang out of Johns Hopkins, and he and our colleague, uh, Dr. Jacob Leonian and naturopathic doctors, they’ve been looking at different plant extracts on how they affect Lyme and Bartonella and Babesia, and so this is all published research out of Hopkins. And looking at different herbs that are effective against Borrelia, uh, crypto sangu, polygonum ano, that’s called Japanese knotweed jus nigra.

That’s black walnut Artesia annua, that’s sweet. Warm wood Osa is ka claw sti, and canes is sti and ensis is Chinese. And you’ll see as we look across, so this is for Borrelia, this is against Bartonella, we see a lot of the same players, and same thing with Dobesia, so when I talk about getting this overlap of how these herbs treat these other different infections, you know, we know that we can use these herbs and they’re going to cover a [00:43:00] broad base.

So just kind of going through some of the plants that I use, uh, Allicin, this is garlic, Allium Sativum, this is a very well known antimicrobial, uh, soldiers in Russia in World War I used to carry it on their pack, they called it Russian Penicillin, if they were out in the field and got wounded, they would rub the garlic in their wounds to prevent infection or they would eat it to keep their immune system healthy.

It contains a component called Allitrity, that characteristic odor of garlic is Allitrity getting converted to Allicin. Uh, again, very well established antimicrobial, but also helps improve blood flow, and it has mild anti inflammatory. Uh, it’s best as a time release capsule, so it releases that allicin over time.

Uh, people will definitely excrete this through their skin, so for one, drink it in garlic, two, be prepared that you’re gonna smell like a pizzeria. Uh, when I first had lime, uh, I was treated by a different Dr. Zhong in New York City, and he gave me a lot of his allicin, which is a great product. And I was still seeing patients.

Like, you know, people would walk in my room and they’re like, you know, like, what does that smell? So I had to [00:44:00] stop doing it because it was just becoming offensive to me and everyone around me. So, forewarned people, uh, it’s gonna get excreted through their breath and their skin. People can take chlorophyll to help offset some of the odor.

If they want to stay on garlic and they’re worried about the odor, chlorophyll will help bind up. Andrographis, Andrographis paniculata. This is a great herb. It has very broad antimicrobial activity, including parasites. This is also a very effective antiviral herb. Uh, Andrographis actually was approved in Thailand as a treatment for COVID 19.

Uh, it works great for a lot of different viral illnesses, but it’s also a hepatoprotective, an immune modulator, antidiarrheal, anti inflammatory, helps improve cardiac output. And, uh, they typically sell it as a standardized extract. Uh, the one we use has a 50 percent andrograph lye content. Uh, I, I like this plant a lot and, uh, we use that quite often.

Uh, Artemisia, Artemisia annua, there are different species of Artemisia. So, if you’re looking at using Artemisia, make sure you got the right one. There’s Artemisia annua, which is what we want to use. [00:45:00] There’s Artemisia vulgaris, there’s Artemisia absinthium. They have different purposes, they have different constituents.

So, The artemisinin we’re using contains a compound called artemisinin. There are some supplement companies that will sell pure artemisinin. Be careful with pure artemisinin. There’s at least 14 cases of it causing idiosyncratic liver toxicity. Uh, I believe these are people that already have, uh, underlying liver disease that made it worse.

But nonetheless, if you use pure artemisinin, you do need to test your patient’s liver enzymes periodically. probably every few months just to make sure it’s not causing a problem. I’ve never seen it with whole plant Artemisia, so that’s my preference is to use whole plant Artemisia. Uh, it’s got a sesquiterpene lactone with a peroxide bridge.

Basically think it’s the peroxide bridge that’s causing oxidative stress in the organism and that’s what’s killing it. Artemisia has been used forever as a treatment for malaria, so anything that treats malaria is probably going to treat Babesia, since they’re both blood parasites and kind of cousins of each other.

Um, it helps with autoimmune [00:46:00] reactions, has anti inflammatory effects. There are studies on artemisia for rheumatoid arthritis and other autoimmune diseases as an immune modulator. And, um, again, just make sure that, uh, artemisia, then, uh, check liver enzyme. But I would just recommend, there’s a lot of great companies that make whole plant artemisia.

Uh, Campciandra goes by the trade name of Bandarol. Uh, Nutramedic is the company that makes this particular one. This herb is somewhat unique to the Amazon jungle. It comes out of Peru. Nutramedics, uh, because they have a relationship with the Peruvian government, it’s one of the few companies that’s allowed to export it.

Uh, but it’s a very effective plant against Lyme and other co infections. They use it locally to treat malaria. Also, again, very potent anti inflammatory, treats arthritis. You can get some decent herds reactions with it, but it’s, it’s not too bad. Uh, Cemento, Cat’s Claw, Mouncaria Tomatosa, uh, has, uh, what they call alkaloids.

These are the active ingredients that help fight the infection. Also anti viral, it inhibits a lot of these pro inflammatory [00:47:00] cytokines, protects against oxidative stress, also useful treating co infections, and almost little to no side effects. There’s a woman out of the University of New Haven, Dr. Eva Shapi, SAPI, and she studied the combination of Cemento, Vanderol, and one I’ve talked about called Kumanda, and the combination of those three were more effective than doxycycline or rifampin in vitro, and it treated Lyme, whether it was replicating or not.

So there’s an argument that herbs actually may be more effective than antibiotics in some cases. These cases, uh, kafu is a nerve that’s used mostly in traditional Chinese medicine. Kafi, ensis. This is the root. It’s very rich in a compound called Burberry. You might know Burberry because it’s found in Golden Seal.

It’s found in Barberry, it’s found in, um, um, forgetting the third nerve. There’s, there’s three of ’em that are, are very rich in Burberry, but Copti is one of em. So, you know, burberine is a very well known antimicrobial, um, compound that again treats bacteria, viruses, fungi, parasites. Um. In vitro studies, [00:48:00] it’s found it’s as effective as a lot of antibiotics and ricketting for eradicating other infections, like staph infections and strep infections and so forth.

So I’ll use Coptis even for people who get bronchitis and sinus infections and things of that nature. Also very potent in anti inflammatory, and Coptis has this unusual effect that’s really effective at getting gallbladder sludge out. So if you’re someone who’s got gallbladder sludge and they don’t want to have their gallbladder taken out, it’s got like an 88 percent efficacy in getting gallbladder sludge out.

Go figure. Cordyceps is a medicinal mushroom that has been used in traditional Chinese medicine for 2, 000 years. Very potent immune booster, so a lot of these medicinal mushrooms, they don’t kill the organism, they just help support the immune system to fight the infection. They contain beta glucans. Beta glucans, you’ll find in a lot of supplements now, has an immune stimulating.

Particularly, they help increase T helper cells, activate NK cells, and macrophages. They also help improve circulation, and they’re great for fatigue and inflammation. They do have mild blood sugar lowering effects, so if you’re going to use Cordyceps, if you’ve got a diabetic, [00:49:00] particularly if they’re on insulin, just be careful.

Make sure they monitor their blood sugar a little bit more. Decimodium or Berber, this is a plant that also grows down in Peru in the Amazon jungle. This is really just to help support detox pathways. We can get a lot of people out of their HERX reaction if they start taking more Berber and then companies like Nutramix, they also make one that’s a combination of Berber and Pinela.

Uh, the two of those together work really well at just clearing out the toxins faster. So, we don’t want people to stop their treatment. If they start Hurtsing, sometimes they feel so bad, they just say, you know what, I, this treatment is making me feel worse, I’m going to stop. And then you never get past that point of feeling better.

So if we can get people through their treatment, get through those handful of days of Hurtsing, then usually when they come out the back end, they feel a lot better. And this is a plan you can use as a rescue medicine to get people through that time. So they can take this every 10, 15 minutes. 30 minutes until they feel like that hertz reaction goes away.

Uh, Hetunia, Hetunia cordata, uh, this is another plant that’s used a lot in Chinese medicine. It has a [00:50:00] historical use of treating it for leptospira. Leptospira like, uh, Lyme. Uh, syphilis is the other spirochete that we all know about. We don’t see a lot of leptospira here in the U. S., but it’s pretty common in China.

Uh, leptospira we see here mostly with dogs in the U. S. They can be a cause of meningitis for dogs. But nonetheless, anything that treats, uh, spirochete probably works for Lyme as well. And in vitro studies found it’s antibacterial, antifungal, enhances the immune system, gets rid of swelling and inflammation, and it’s also one of the plants that helps break down biofilms.

So again, if we’re trying to expose the organism, breaking down biofilms is a good thing. Uh, it does have a relatively short half life, so this is one you probably need to dose three times a day just to keep enough of the herb in your system. Japanese Knotweed, Polygonum Cuspidatum, again very broad spetum and microbial, and again we found in Dr.

Zhang’s research that this is one of the top herbs to deal with Lyme and a lot of the co infections. Lion’s Mane is another great medicinal mushroom, again it doesn’t kill [00:51:00] anything, but it helps stimulate oligodendrocytes, helps make myelin based protein. I think a lot of Lyme patients that are dealing with these cognitive issues, neuropathy issues, To a certain degree, there probably is some impairment of myelin function, and that’s why they have this.

So, anything you do to help repair a damaged neuron is a good thing. Otava, this is commando. This comes from a bark of a tree, again, that grows in South America. Probably one of the best broad spectrum, uh, herbs against Lyme and co infections. Also very potent anti inflammatory, and again, this is one of the three I mentioned with Dr.

Schappe. It was found to eliminate all the different forms of Lyme. Uh, Porreria, this is a nerve that gets used mostly in Chinese medicine, but treats high fever, muscle spasms, headaches. So, this is a good adjunct for your pad if people are having a lot of the acute symptoms of Lyme disease. Helps improve blood flow.

Uh, also anti inflammatory. It can cause blood pressure to drop a little bit, so if anyone has POTS, they’re already prone to low blood pressure, just be a little bit careful. [00:52:00] Wireweed, this is called Ceta Acuta, broad spectrum antimicrobial activity, reduces fever, protects the liver, immune modulator. I don’t use this one as much, uh, Stephen Buehner, who’s an herbalist, he wrote two books on, one on Lyme, one treating on co infection, he used a lot of Ceta Acuta, uh, I like to mention it, but, uh, I don’t use this one as much, uh, it blends well with my practice.

Uh, Yellow Dairu, Cryptolepis, I use a lot of this, Cryptolepis Sanguinale, I like to mention it. This is the one, again, that Dr. John also found with Japanese not wanting to be at the top of treating Lyme and all the co infections, and you’re probably getting the idea here that they’re anti microbial, anti inflammatory, and reduce fever.

They all have very similar mechanisms. So again, this gives us the ability to swap out. If you start someone on Cemento and Banderol, they don’t seem to be doing well with one. This is where I actually like using the individual herbs versus combinations, because if someone has a problem with one, very easy to switch out, where if you give them a combination, they have a problem.

I don’t know what herb is the culprit. And it’s hard to figure out. Uh, other herbs just to [00:53:00] mention, uh, there’s one called Oncaria Orynchophylla, which is a cushion of Cat’s Claw. Uh, Stephen Buehner really liked it for Neuroborreliosis. Chinese Skullcap, very well studied. Astragalus, Hawthornberry, Alcornia.

Uh, again, I don’t use these as much. I’ve been using more and more Chinese Skullcap since Dr. John published his research. Uh, and also very good anti inflammatory. I’m going to skip through some of this just because, you know. So, Dr. Cowden has a whole protocol where every month there’s a whole protocol that, you know, they change all the herbs.

The idea is to kind of never let the organism get used to what you’re doing. He used to be very involved. The company has recently revamped it. It’s a much simpler protocol now. I do what’s called a modified version of Cowden. And I really just narrow it down to like three or four herbs. I use the Cemento, I use the Vanderol, I use the Camonda, I use the Berber Pinella as a base.

And then I’ll add in these other herbs really just as adjunct therapies. Uh, so these [00:54:00] combinations again help target the microbes, support detox pathways, clear heavy metals. It’s a nine month protocol where every month it changes. Uh, I know Dr. Tran uses it a lot more than I do. Again, it still works for people, but the old version was just more, took more compliance, because every like two hours you had something to do.

The new version is much more simple for people. So again, I do a modified version of it, and here’s kind of the doses. Uh, for acute Lyme disease, it’s better to go in with higher doses. You know, at 15 to 30 drops twice a day, you put all the tinctures together in a little bit of water. So it’s nice for people who already take a lot of capsules.

These are liquids. They can just put it in water in one glass, pour it up and drink it, a dose in the morning, a dose in the evening, it’s pretty simple for people. And again, we can add in Berber, Penelope, if they’re getting heart sick, and they can all add in others really as supportive for whatever they’re experiencing.

For chronic, uh, I found if you try the same approach, a lot of people will get pretty significant hurt. So I like to start really with just one or two drops twice a [00:55:00] day, and then every two days titrate up slowly by one drop. So if they start with one drop twice a day, two days later they don’t feel any different, they go to two drops twice a day.

Two days later they don’t feel any different, they go to three drops. And what you’ll find is some people, even at very low doses, get clinical benefit. I have some people do one drop of Simvastatin and they start Hurksin. So I find a lot of people with Lyme tend to be very sensitive and a little goes a long way.

So don’t feel like you have to go in with high doses. Low doses often will really be clinically effective for people. And for children, again, we just drop the dose down based on body temperature. So the advantage is it’s pretty easy to administer their liquids. The herbs actually don’t taste bad at all.

Nothing’s uberly bitter and nasty tasting like some herbs are. Uh, clinically very effective, reasonably very cost effective. You know, if people are only using two or three drops twice a day, that tincture might last them six, eight weeks or longer. So it, it ends up being very cost effective. The disadvantage is, is that you can’t get irksing, but you can get that with any Lyme treatment.

I’d say all, most Lyme treatment does tend to be [00:56:00] long term. I tell my patients 6 18 months of treatment is normal. Because of the slow growing nature of Lyme, and the up and down cycles of it, that’s pretty normal. Sometimes people recover faster, sometimes it’s longer, but 6 18 months is very reasonable.

Dr. Zhang, different Dr. Zhang from the Dr. Zhang at Johns Hopkins. Uh, this Dr. Zhang is a Chinese medical doctor in New York City. He’s who I saw after I was on nine months of anaphylaxis getting worse, and he turned me around in a month. And so, he uses a series of verbs. He’s got an Artemisia, Hetunia, and he’s got a couple of combination products.

Again, I won’t go through all of them, but a lot of them I’ve already talked about. Uh, Again, I like his approach because I think it encompasses a very broad scope of what Lyme does to your body. So there’s herbs to target infection, herbs to reduce inflammation, herbs to support the immune system, herbs to break down little crystals and micro clots, and I think it’s very comprehensive.

And again, it turned me around in four weeks. So [00:57:00] some of the formulas, he’s got one called R 5081M, Uh, seven traditional Chinese herbs, including Smilax and Chinese Skullcap. Uh, these are effective in treating leptospira, trypanema. They also help remove detoxification, reduce inflammation. So I like this formula because part of it’s killing the bugs, and part of it’s helping support detox.

He’s got one called Circulation P. This is a combination of two traditional Chinese medicine formulas. There’s 10 herbs in it, and it’s really to help prevent platelet aggregation in the microplots. And you can tell Lyme patients, if you draw blood in your office, you can almost tell when you draw blood, instead of the blood coming out like water, it comes out like oil, you can see the viscosity even when you draw blood, and that’s just a sign of inflammation.

It’s very common with Lyme patients. AIM, this is a nerve called Sardentodoxae. Again, we don’t use this in Western medicine, this is a Chinese herb, uh, but it has, uh, pretty significant anti inflammatory and analgesic effects, so this is a great one in to help control pain in patients. inflammation. So [00:58:00] John’s Protocol, again, combinations of petunia, coptis, cordyceps.

You might add in the AIM if there’s a lot of inflammation or peraria if they have high fever and muscle aches. Artemisia is great for Babesia. Persistent Lyme Disease, same kind of herbs. The dosing actually doesn’t change as much between acute and chronic like it does with the liquids. But again, I just wanted to give you an idea of some other ways of using these herbs.

The advantages is clinically very beneficial. I’ve probably used his herbs more than anyone else’s over the years. Herbs reactions are not common actually. Very few side effects. I find they’re very well tolerated. The biggest downside is that his herbs are expensive and people usually spend 500 to 600 dollars a month on his formulas relative to others which are much less expensive.

Byron White is an herbalist. He’s got different combination formulas that he kind of puts together for individual infections. So there’s not really a protocol with his stuff, like AL [00:59:00] complex is for Lyme, ABAB is for Martinella, and so forth. So here you’re kind of picking the formula based on whatever the patient’s dealing with.

I’ve used them, he has one called A Myco for Mycoplasma, that I’ve used a lot, it works very well for Mycoplasma, and I’ve used ABAB and ABARD, and again, they work, it’s just again, they’re combination products, so if people have a problem with it, you just won’t know. What the problem is. People like these because again, it’s like one tincture or two tinctures.

It’s not multiple tinctures. They are really concentrated herbs. So the amount you use is usually anywhere from like two to six drops twice a day. It’s a lot less than even the other tinctures out there. So for people who don’t like to do a lot of stuff, this might be an option because it doesn’t require a lot of stuff.

Disadvantages, uh, it’s just that herxing is actually quite common because they are so concentrated. Each bottle is about a hundred bucks, so the bottle itself is expensive. Now again, they’re not using a lot of it, so often it still lasts a while, but [01:00:00] when you talk to people like, hey, I want you to buy this little tincture, it’s a hundred bucks.

Uh, I have some formulas I developed myself with allergy research. I have a product called PhytoTik Defense. So, I took a lot of the herbs that I had used when I was being treated by Dr. Chong. Uh, so it’s got Nezunia, Artemisia, Cat’s Claw, Coptis, Cordyceps, Lion’s Mane, and Beta Glucans. I wanted something to get the encompass line and all the other co infections.

I’ve got a product called Biofilm Neutralizer to break down biofilm. I’ve got a product called Herxipher Support to reduce inflammation and to get Herx reactions. And Mitochondrial cofactors to help support the mitochondria. So these four were designed to kind of work together. Uh, the nice thing for patients with this is that they’re pretty easy to take, pretty well tolerated, and all four of the formulas are about a hundred bucks a month.

So it’s fairly reasonable for people. Uh, so here’s just the dosing schedule on those. Uh, the advantages, uh, really is it’s clinically beneficial, easy to administer, it’s pretty inexpensive. I really haven’t come across any major disadvantages. [01:01:00] I mean, I don’t get complaints of people not tolerating it, upset stomach, bad diet offset.

So far, they’ve been out for about a year and a half, and, again, I really haven’t had any major complaints. Other botanical therapies, again, Stephen Buehner has two books if you’re interested. It talks about some of these other herbs. There’s also a company called Beyond Balance. Uh, they make a series of combination herbal formulas.

Susan McCamish founded the company. She’s an herbalist. They make some good products. They’re all in glycerin. So for people who don’t tolerate alcohol and so on liquids, this is a great option because they’re not alcohol based, they’re glycerin based. So it’s great for kids and I don’t see any people anymore, but people are using disulfiram as a treatment for Lyme for a while.

Which, you know, you get disulfiram, you can’t take alcohol. It’s a contraindication, so people can still use Beyond Balance while they’re on disulfiram, but I think disulfiram’s kind of fallen out of favor. I don’t see anybody really on it anymore. Managing HERX reactions. Anything that’s anti inflammatory is probably going to help.

You know, tons and tons of [01:02:00] research on curcumin and boswellia reduces all the pro inflammatory cytokines, help prove vascular endothelial function, reduces oxidative stress. Uh, so, my product has a combination of curcumin and boswellia together, and then if you alkalize the body, this is an old school environmental medicine trick that people are having die off reactions or having allergic reactions.

When you take an alkalizing agent, you start shifting your cell pH, a lot of these reactions get better. So the Herx reaction gets better. I’ve had people stop their asthma attack by taking Alka Seltzer Gold every hour. Uh, kind of the worst thing that happens if you get too much bicarbonate formula is it gives you a little bit of diarrhea.

Um, but often we’ll stop that. So sodium potassium bicarbonate, I think potassium bicarbonate is a more effective agent. So regular Alka Seltzer is sodium bicarbonate, and baking soda in your fridge is sodium bicarbonate. In a pinch people can use good old Arm Hammer baking soda, but it’s kind of gross and um, I don’t think it works nearly well as potassium bicarbonate.

[01:03:00] But the whole idea behind it is that bicarbonate is shifting your cell pH and we know that potassium bicarbonate locks increase your glutathione levels. Breaking down biofilm, this is the slime that surrounds the bug. Uh, there’s a lot of different ways to approach it, but again, that protective slime is, you know, keeping the immune system and the herbs or antibiotics from targeting the organism.

So anything we can do to break it down. Proteolytic enzymes like serrapeptase, like trypsin, natokinase, is very effective, alpha lipoic acid. So again, the product I developed, he biofilm neutralizer, it has all four of these in it, just as a way to break down biofilm. So it’s important with any kind of biofilm disruptor, you take it away from food.

If you take it with food, it’s going to digest your food, and it won’t do much to break down biofilm. Environmental lifestyle factors, of course, anything we can do to lower the body burden. I will argue that most of my chronic Lyme patients are toxic, for various reasons, and anything we can do to [01:04:00] improve their detox pathways, reduce their body burden.

Help. So, it’s just bringing awareness that, you know, get all the crap out of your house. The Windex, the 409, Uh, the Glade plug ins, all that stuff. I mean, my sister and I have this running thing now. She’s better about it. We go visit the Glade plug ins in the bathroom, and I unplug it, and she plugs it back in, I unplug it, she plugs it back in.

I think one time we took it in the trash.

Dr. Weitz: Anyway,

Dr. Ingels: yeah, so anything you do to people can reduce that stuff. So be aware of what you use around your home, what you use on your skin. Personal care products, makeup, shampoo, detergents, laundry stuff, all that roundup, all that adds to your body where it has to load, makes it harder to get well.

And this is stuff people have control of. They can control what they use in and around their body and around their home. Lifestyle maintenance, sleep is critically important. Most of my patients don’t sleep well for various reasons. Uh, this is just some of the things I use with my patients to help them get to sleep, stay asleep.

Uh, melatonin is great for some people, helping them fall asleep. GABA, PharmaGABA is better at staying asleep, getting deeper sleep. Magnesium, particularly Mag threonate has evidence that it penetrates the brain better than other Mag chelates. Get them into a deeper state of sleep. 5 HTP, 5 Hydroxytryptophan is a precursor to serotonin.  You could use straight L tryptophan as well. Um, 100 to 400 milligrams of bedtime. Uh, just be careful if someone’s already on an SSRI, you don’t want to get serotonin syndrome. And there’s a lot of herbs. I mean, Passionflower, we use a lot of. Ashwagandha, Valerian Root, Lemon Balm. I’m becoming a bigger fan of California Poppy.  California Poppy works really well. You just have to warn people, if they ever get drug tested, you know, we’ll test positive on a drug test. I had a patient in New York City that, uh, he didn’t have one. I can’t remember. He called me one day, and he was a big financier. And he was just pissed at me, yelling at me, he goes, I don’t know what you gave me, I flunked my drug test, da, da, da, da, da, it’s something in your supplements.

And he calls me back two days later, very apologetic, he goes, every morning I have a poppy bagel, poppy seed bagel. [01:06:00] The poppy seed bagel was causing a drug test to go positive, so anything that comes from the poppy plant will test positive for heroin on the drug test. So, you just have to warn people if they have a job where they get drug tested, but it doesn’t cause any of the effects that heroin does, it’s just a cross reaction.

But yeah, California poppy can be very effective too. Getting exercise, movement, you know, I think it’s good for obviously moving blood flow, moving lymph, especially the lymph. It’s good for enhancing mood. So trying to get some element of movement every day. And it’s hard. I mean, for when I had Lyme, I mean, it was all my strength just to sit in front of the television.

And so, you know, I would start stretching and then, you know, a couple of laps around the house. So gentle exercise usually works best. If someone does any kind of activity and it wipes them out for three days, it was too much. So they have to scale it back. So it started with, you know, yoga, walking, swimming, tai chi, qigong, you know, whatever they feel like they can do.

But a little bit of movement every day is Stress management, this is always the, I [01:07:00] think, the hardest thing for people. Having any chronic disease sucks. You know, you’re, you’re trying to figure out how to manage your stress. A lot of people we see, they’re, you know, financially in trouble because they’re ill.

Many of them aren’t working as much as they should, or they’re having trouble in the work they do. So there’s a lot of stress on how it affects them, how it affects their loved ones, their family, their kids. There’s a tremendous amount of guilt about having a chronic illness. For So helping people navigate that, whether it’s with a guidance, with a counselor, a therapist, a support group.  But try and help and encourage people to find ways to deal with stress because you’ll hear it from every Lyme patient. Every time they go through a stressful time, their symptoms get worse. Nothing else changes in their treatment, but it’s just the stress that’s kind of undermining everything else. So as much as we can help support them.

Other treatment approaches, I just want to mention, Low Dose Naltrexone. This is a medication that was designed to get people off drug and alcohol abuse. We know at low doses it has a very different effect. It binds to opioid [01:08:00] receptors in the brain for about 4 6 hours, and then it causes a natural release of your own opioids for about 20 hours.  So it can be great for pain modulation, it’s great for modulating the immune system. There’s actually quite a few studies on Low Dose Naltrexone. It’s very safe, it’s very inexpensive, and I find it’s kind of the 50 50. 50 percent of people feel like it helps, 50 percent of people feel like it did absolutely nothing, but to spend 45 bucks for three months to try it, you know, I think it’s pretty reasonable.  And there’s studies on it for cancer, fibromyalgia, multiple sclerosis, inflammatory bowel disease. There are no studies to date on Lyme disease, but most of us in the Lyme world try it anyway, and some people respond really well.  The dosing on it, you can start anywhere from like a quarter of a milligram to one milligram at bedtime. Uh, one of the side effects that some people do get is either disrupted sleep or they get really wild, flunky, vivid dreams. And if that happens, we just say take it during the day, don’t take it at bedtime.  Usually that’s okay. Once in a while I’ll feel like, you know, even during the day my [01:09:00] sleep’s goofed up. Okay, we try it and it’s fine. So, I think it’s worth, you can work up to, you know, three to four and a half milligrams. We go up by one milligram generally every two weeks, and so we get to a target dose.  It can take up to three months to get the full effect of it. So once you get to what you think is a target dose, wait three months before really saying yay or nay, it helped or didn’t help.

PEMF, Pulse Electromagnetic Frequency. The idea is that there’s these devices that create a signal that’s the same frequency as our own human cells.  And the Germans have done a ton of research on PEMF. There’s over 1,500 studies, and basically it helps improve circulation, help with tissue repair, and really offsets a lot of the negative effect of the bad frequency of like 5G and Wi Fi and cell phones and all that kind of stuff. So improved circulation, decreased pain, reduced inflammation, faster recovery after injury and surgery, healing skin wounds.

And Acceleration of Nerve Regeneration. And usually it just involves, you know, [01:10:00] laying on a mat or putting the device close to your body. It runs anywhere from 10 minutes to sometimes an hour. Uh, but it’s very safe and can be very effective. There’s a doctor named William Pollack, P A W L U K. He’s one of the top, like, researchers on PEMF.  And if you just go to drpollack. com, he’s got a ton of research on PMF. He’s got devices he sells. But he’s vetted a lot of these devices. And they range anywhere from A few hundred bucks to several thousands of dollars, but again, it’s something people can do at home, they can do for themselves, they can do every day, and again, can be very effective.

Other detox therapies, I’m a huge fan of sauna, people can tolerate it, it’s a great way to mobilize mycotoxins, heavy metals, other toxic stuff. Uh, some people are very heat tolerant, you gotta be careful with the heat tolerant people. Uh, constitutional hydrotherapy, this is alternating hot and cold packs on the chest.

This is a little naturopathic therapy just to help improve blood flow throughout the body. There’s different companies that make drainage remedies. [01:11:00] These are usually combination herbal products for homeopathics. So we use a lot of Picana in our office. Uh, gentle exercise, colon hydrotherapy. Again, there’s another great way to help promote detoxification, which is different than just doing a whole enema.

Uh, the alternating, you know, filling of the intestines, draining for the intestine. It’s really designed to stimulate the vagus nerve. That’s what helps induce that parasympathetic state. So it is a good way to clean out the colon, but that’s really not the intent behind doing colon hydrotherapy. It really is the upstream effect of what it does to the liver, the gallbladder, and you’ll see at the end of a colon hydrotherapy session, everything starts to turn green while that bile’s starting to work its way.

So I’ve had some people that, you know, they’ve tried all these other things, and sometimes we’ll do these other strategies, and they respond really well. I think supporting the mitochondria for a lot of our Lyme patients that are tired all the time, all these nutrients that support the mitochondria, don’t be shy about using higher doses, CoQ10, Acetyl L Carnitine, Propoic Acid, B6 Magnesium, NADH, all [01:12:00] these are in some way, shape, or form related to mitochondrial function.

And I’ve got the doses written down here. Neuropathy can also be a big problem for a lot of Lyme patients. So there’s a lot of nutrients they can do to help support the nerves. Phosphatidylcholine, either orally or IV, glutathione, B12. I like B12 shots. Uh, they work better than oral or sublingual B12. We talked about PEMF, hyperbaric oxygen.  It’s not easy or accessible for people, but if they do have access, again, it can be really helpful. Improving oxygenation, supporting the mitochondria, and stimulating nerve growth. And IVIG, it’s not at the top of my list, but if people are having more Guillain Barre kind of symptoms, if you can get insurance to cover it, it’s horribly expensive, it’s hard to get insurance to cover it, but we’ve had some patients that have done really well with IVIG.

And Low Dose Immunotherapy, this was developed by Dr. Ty Vincent. He’s a medical doctor in Hawaii. The idea behind LDI is that we’re basically trying to use dead organism that’s been diluted out really homeopathically [01:13:00] as a way to turn off this autoimmune mechanism to the butt. So if your immune system’s treating Lyme as an allergen and not a pathogen, it’s engaging a completely different part of your immune system.

So, it’s literally that. It’s been irradiated, it takes the Borrelia organism, it’s dead, it can’t reproduce, it can’t cause infection. We dilute it out hundreds, millions of times, and then we mix it with an enzyme called beta glucuronidase. And the beta glucuronidase seems to activate whatever you mix it with.  And in very specific dilutions, it just seems to turn off that autoimmune reaction. And we’ve had some amazing cases of people that, again, tried herbs, tried antibiotics, tried all these other things, nothing really helped. And then we do this, and It’s a game changer. The challenge of this therapy is you gotta find the right dose, you gotta find the right antigen.  And sometimes we get bamboozled and we think it’s one thing and it’s really something else.

Very quickly, I had a young kid come in who overnight had typical PANS, OCD, anxiety, and I did his blood test, his streptiters were through the roof. I’m like, okay, this makes sense, it’s a strep infection. I did the [01:14:00] LDI for strep, did absolutely nothing.  Okay, so four years ago he had Lyme disease, but he was treated, and as far as I know he’s fine. That night, I gave it to him in the morning, that night, she calls me in a panic, says that he’s got a monster headache, so we talked about doing some natural things to control it, and the next morning all his symptoms were 100 percent gone.

So it was actually, I think what happened was he had the strep infection, which was the catalyst for the Lyme that was in the background that really had probably never been treated. So, ultimately, our treatment goals here, treat the organism if it’s acute, uh, treat the other immune distractors, other allergies that distract from the immune system, detoxify the body, fix the hormones, get proper sleep, reduce inflammation, get the nutritional status up, help their mitochondria, get the circulation going, and modulate the immune system.  And this is the little book I wrote and that’s all of my information. Thank you very much.

 

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Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy. Listening to the Rational Wellness Podcast, I would appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review.  If you would like to work with me personally to help you improve your health, I do accept a limited number of new patients per month for a functional medicine consultation. Some of the areas I specialize in include helping patients with specific health issues, like gut problems, neurodegenerative conditions, autoimmune diseases, cardiometabolic conditions, or for an executive health screen and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way.  Please call my Santa Monica White Sports Chiropractic and Nutrition Office at 310 395 3111 [01:16:00] and we’ll set you up for a new consultation for functional medicine. And I look forward to speaking to everybody next week.