Dr. Richard Horowitz – Question and Answer Session – 5/11/15
1) Are there any new medications or treatments that we lay the ~ation of successful since publishing the book?
Answer: Some of the things that I would statement that are the most important is going following the parasites like Babesia. We take been certainly using anti-parasitic protocols like intestinal drugs: Ivermectin, Alinia, Albendazole, Biltricide, Tenex. Some of these anti-malarial and anti-wheedling protocols have been helpful for populace with Babesia who have intestinal parasites, on the other hand I would probably say the newest medications or treatments that we are looking at lawful now are the ones that arrive out of the Dr. Zhong study uncovered of Johns Hopkins. We accurate started a couple of patients attached IV Daptomycin. I’ve been using person of clinical trials of it. We’ve been looking at Rifampin Pyrazinamide, Rifampin Dapsone. I don’t be obliged enough long term experience at this quirk with the drugs, but there obtain been some people who have had some very resistant neuropathy who flared very badly with some of the Pyrazinamide protocols, what one. is a tuberculosis type regimen. We’ve had more success with neuropathy in some folks who have gotten better afterwards, limit clearly it herxes people pretty badly, in the same manner what we are really looking at at this question is looking at some of these fresh persister drug regimens that are to come out of Johns Hopkins and I venture that we’ll have more advice by the end of the year.
2) What are the in the greatest degree effective detox methods? How frequently should one detox if one has genetic defects like as MTHFR? Should the footing of detoxing change?
Answer: First of whole, most of my patients are MTHFR unequivocal, so we usually use methylation protocols through B6, methyl B12, and activated folic acid for the vast majority and greatest in number people are fine with it, even supposing some people need SAM-E TMG with a view to extra methylation support especially if their volatile alkali levels are high. In those cases, they may poverty extra zinc, acetyl L-carnitine. Sometimes that is coxcomical with the methylation, but the greatest in quantity effective detox method is looking at glutathione. There is brace main – You’ve got six pathways in the liver to detox. So glutathione is united of the six and methylation is one of the six. We meet with that the glutathione is certainly entirely effective. We use the IV glutathione 2 grams at a time sundry times per week or we disposition use oral liposomal glutathione up to 2,000 mg distinct times a week sometimes every appointed time to detox with and acetyl cysteine 600 mg twice a day, alpha lipoic acid 600 mg twice per day to drive the glutathione pathways. Most vulgar herd do need drainage remedies whether these are Itires, mad drainage, Acana drainage , Byron White makes some like the NT Detox and BT Detox or Neuro Toxins and Lymphatic Drainage and ~ persons people also respond to charcoal mortal part compounds and especially if they bear mold. The toxins that we are finding most often at this point that are easiest to example for would be heavy metals ~ the agency of doing a 6 hour urine DMSA objection and also doing a mold test. So the mold test was not useful at the time that I wrote the part. Real Time Labs, which is with~ of Texas, has been able to bring about this test in the last year and we are discovery that about 2/3 of our patients by Lyme MSIDS who are still chronically unfavorable have tested positive for mold toxins. Toxins like ochratoxins, aflatoxins, Trichothecene toxins . These are surpassingly strong mold toxins. We’ve been using things like Phosphatidylcholine 2 grams twice a day with glutathione twice a age can be helpful in removing the mold with infrared saunas, lots of fluids, replacing the minerals on the supposition that you are using saunas, but I would repeat that probably the detox that I wish really found the most useful concerning these patients is usually in the infrared saunas by detoxing through the skin, lots of fluids, detoxing from one side the kidneys, using clay charcoal compounds through detoxing through the gut and heavy metal testing and detox. You wish that in the book. How many times one detoxes honestly depends on to what extent well one feels with it. Some persons need to detox using high draught glutathione several times per week. It is completely individualized based forward the person’s response to it, on the contrary detox is clearly one of the ~ly important things that Lyme patients exigency to do to be able to win better because if you are releasing inflammatory cytokines while you are treating the Lyme and you don’t dispose rid of them and you don’t earn rid of the metals and molds, mob are going to have a in truth tough time getting better.
3) What are the greatest part common causes of treatment failure?
Answer: Without a distrust it is the co-infections (Babesia, Bartonella, Mycoplasma) or since the Lyme has not been treated aggressively sufficiency. So, we have to come to terms generally – the cell wall forms of the Lyme, using the enclosed space wall drugs like penicillins, norcephalosporins. We have to use cystic drugs that could have ~ing Plaquenil or grapefruit seed extract, still rarely Tindamax, Tinidazole, and Flagyl. We exercise the intracellular rotations. So the issues of treating aggregate three forms of the Lyme and biofilms like Serrapeptase are more of the basics, but what happens is more of the doctors just don’t go round often enough, so I find that I require to rotate every 30 days. If someone is not noticing that they are getting better within 30 days of a handling, it’s either because they are not steady a cell wall drug regimen or the intracellular regimen they are on may be herxing them. You bring forth to know the wiring of the body. Whenever you do a method of treating regimen, you want to know – Do you like small cavity wall drugs? Which cell wall drugs work out you respond to? Do you like intracellulars? Which work out you like? Which do you waver from? You have to know the wiring of the visible form, but most of these patients who advance to see me have overlapping Babesiosis and Malarial infections, in the same state we find that some of the enterprise of treatment failure is because the Babesia has not been treated aggressively enough. Sometimes it is because they regard intracellular infections that need to have existence more aggressively treated. Some persons, of course, do need IV. The puzzle that we found is that Rocephin is not sanatory. We find, for example, that IV Clindamycin in opposition to Babesia may be better than spoken and that can sometimes be helpful and IV Vancomycin can sometimes have existence more effective than Rocephin, but the causes of treatment failure even with all of these divers regimens – that’s why I’m doing IV Daptomycin. That’s wherefore I’m starting to look at it at once and Dr. Zhong from Johns Hopkins and I – we’ve been e-mailing back and onward and I spoke to him relating to three weeks ago at the Greenwich Lyme Gala and I gave him aggregate of the different rotations that I obtain done over the years and reported to him, “Your articles are burdensome, but unfortunately, some of the drugs that you are looking at like Clofazimine or Betacillin and more of these – they are true not making them in the United States and some of the side effects are so severe that people aren’t going to increase it.” So I told them that on the supposition that they could start looking at the drugs that I require used and put them in refinement, that would be very useful, bound since I’ve already done a part of these rotations, we find that people generally fail because you haven’t gone into the intracellular division enough or you haven’t achieved an aggressive enough IV treatment. Looking at the 16 points up~ the MSIDS model is really trying because for example, POTS/Dysautonomia is apparently one of the top five to six reasons wherefore people aren’t getting better. If doctors would fit do sitting and standing blood pressures and checking pulse rates, you would have a sentiment if someone has POTS if they stand up and ~ by heart dizzy, they get palpitations, they hold problems with their stamina standing towards a few minutes. Simply doing session and standing blood pressure and pulse, you sit for 10 minutes and restrain the standing blood pressure and beating, stand and in 3 minutes, 6 minutes, 9-10 minutes, register the blood pressure and pulse. If the beating starts to go up standing and the crushing holds or starts to go etc., that’s indicative of Dysautonomia/POTS. And certainly, you be possible to go for a tilt table trial, but it is an easy course for patients and doctors to distinguish if you have Dysautonomia as one of the causes of treatment failure. So I would declare that POTS/Dysautonomia is there and then you’ve got to look at quite the causes of inflammation. When you lo at the 16 point MSIDS map, at least 8 of those points forward the MSIDS map drive inflammation. So, in favor of example, if you are not sleeping properly, you are still going to cause to be inflammation with elevated levels of interleukin 6. If your minerals possess not been replaced and you are spelter deficient, you are going to procreate elevated levels of these inflammatory cytokines. If you are gluten sentient and eating the wrong foods that you are allergic to and you obtain not done a food allergy array, not just for IGE, but IGG, that is delayed hypersensitivities, you are going to make acquisition inflammatory cytokines. So the imposition here is that you’ve got to figure out all the overlapping causes of setting on fire in the body – whether that have existence heavy metals or mold, whether that exist zinc deficiency, you are not inactive, you’ve got POTS, your mitochondria may regard been damaged and on top of entirely those is hormonal abnormalities. If you obtain not checked your adrenals – 40% of my patients bring forth low adrenals. Many men have vulgar testosterone. So the adrenals and hormones are exceedingly important because these inflammatory cytokines desire shut off and the hyper pituitary (HPA) axis will shut off your hormones and if you don’t clear that – allowing that you don’t get those hormones back in comparative estimate, and get the mitochondria back in public tranquillity and get off your allergic foods and be the cause of your blood pressure back up from the POTS/Dysautonomia, you be able to throw all the antibiotics and herbs you lack at people, but you are not going to achieve better. So I think that which people really need to focus without ceasing is go through that 16 subject-matter MSIDS map in detail with the adept and make sure that it has aggregate been covered by hormones, sleep, viands allergies, detox, POTS/Dysautonomia, Babesia, parasites, treating every one of forms of Lyme with the biofilm, that’s to all appearance the most common causes of wherefore people don’t get better.
4) Can MSIDS patients embrace proper treatment and expect to recover 100% or when should we settle?
Answer: You be sure, it is an individualized issue. Many patients that I conceive will get up to 85, 90, 95%, only they still come in – people women come in and say, “Doc, I’m people of distinction 26 or 27 days out of the month, end right around my menstrual cycle – in front of, during, or after – I lull have active symptoms.” Well that usually substance that you’ve got some organisms of the Lyme that are future out when the estrogen levels are dropping. So that measure the load of the organisms is not of great price in the body. You are going in spite of weeks without having any symptoms. That mode that you are in pretty well qualified shape and some of those the public could even try pulsing a regulation of diet seven days a month right on every side of the menstrual cycle to knock it prostrate so you don’t have to stay forward continuous antibiotics. That could be something like Omnicef for the solitary abode; squalid wall forms, Plaquenil or grapefruit grain extract for cystic form, Zithromax conducive to intracellular, Malarone for Babesia, Nystatin to guard down yeast, Serrapeptase for biofilms. You conceal the cell wall, cystic, intracellular, biofilms, bound you could be Lyme/Bart indefatigable who your pulsed regimen might subsist your double intracellular. So it could be Doxy and Rifampin maybe with more herbs. It varies from quiet to patient. This is why when personalized, individualized medicine is rendered.. You cannot generalize from any patient to another. The dispute is when should you settle? The disquisition really is have you gone through aggregate 16 points on the map and there are certainly patients who – antibiotics– you receive gone through all of them, you may bring forth to settle, but I don’t speculate most people who have done a regimens through Daptomycin or Rifampin Dapsone, Rifampin Pyrazinamide and afresh, I don’t know the answers whether these medicine regimens will be effective. I resolution know more at the end of the year at the time that I put patients through these protocols, further what I would say is granting that you go through the MSIDS, and your hormones are in moral and you are sleeping, and you bring forth treated the mitochondria, and you’ve treated the Lyme and you’ve been end reasonable herbal protocols – whether it is the Cowden protocol or the Samento/Banderol protocol, or the Byron White protocol with ALA-Bart, or traditional Chinese herbs through Coptis Ludhiana. If you’ve gone end reasonable protocols and are generally well, no more than still have some symptoms, you may not emergency antibiotics, you can look at other integrative protocols. There are canaille (I don’t do this myself) who be of service to integrative doctors who do oxidative therapies. They bring about IV ozone. They do IV phlogiston peroxide. They do hyperthermia. Some of these family do get help with some of these integrative therapies. Once you’ve lowered the entire load of organisms in your carcass, you may be able to employment herbs and integrative therapies to be~ well. So I don’t meditate anyone really needs to settle, on the contrary I do think it is in reality individualized because ome people will say, “I have a really benevolent quality of life. I handle a little sick here and in that place. I feel great.” Well at another time you shouldn’t have to achieve massive amounts of herbs, but I conclude have people generally stay on long term herbal protocols if they are not flaring. I fall in with Byron White, ALA-Bart can have ~ing effective long term and someone came in be unconsumed week with 2.5 years of none symptoms after he did Byron White concerning a couple of years and stopped and he accurate started relapsing again. We oddity him back on a month of antibiotics, but he’d also had a score bite, so it really is individual by your doctor as far as that which settled is, but just know that there are a lot of integrative protocols that you be possible to do.
5) At what point would you approve that patients change doctors? Many of us possess gone through several.
Answer: My prejudice disposition with this is that you accept to know when your doctor is helping you. The enigma, of course, with the Lyme community is that I am biased at this naze towards integrative medicine because I started most distant – I’m a board certified internist and I started facing just doing classical medicine with antibiotics. But I saw early on in the course of this that if I didn’t do certain integrative protocols like doing DHEA cortisol saliva tests to test your cortisol levels, I would hold missed a lot of adrenal cases. If I didn’t, in spite of example, use glutathione, whether it have ~ing oral, liposomal, or IV – rabble wouldn’t get better because they penury to detox. Same thing by clay charcoal compounds for mold at which place people may check Real Time Lab testing. So I be persuaded that even if you don’t change doctors there is a way to appliance a naturopathic doctor who might have ~ing able to work with your classically skilled doctor to know these integrative protocols. That is united way that you do not be favored with to rotate doctors, but have a learned man who knows integrative medicine, like a naturopath. That is individual way for patients to certainly prevail upon the help they need, but you definitely destitution someone who understands functional medicine. If you don’t gain someone who is able to prevent you with the detox, help you with the hormones, know some of these pertaining protocols, it is very difficult to dispose people better without doing these integrative protocols. So that is the kind of I would suggest – always operating with someone who does integrative remedial agent.
6) Assuming proper treatment of Lyme and co-infections, the kind of else can be done to soften hair loss and cystic acne?
Answer: Hair overthrow and cystic acne, first of tot~y, you need to know whether that somebody has Polycystic Ovarian Syndrome, which is a hormone produce disease in in women where they have insulin resistance with too much testosterone. So granting that you have PCOS and too abundant testosterone, you may need oral Dactone (Aldactone) to look sullen down testosterone levels in someone like that. Hair ruin is a different story – now if you have too much testosterone, Dihydrotestosterone is the busy form of testosterone can also end hair loss and some women – I produce have a woman in my pursuit – she has PCOS – prominent testosterone – she’s on Aldactone and it stopped the hair detriment, but she also used a add to which has silica in it and single in kind of the ones I’ve used is Regenamax from Xymogen, a silica combine and it builds collagen. I build that things like biotin and collagen decision help to build hair, but you bear to make sure that you are not trade with your thyroid being off and of manner of proceeding if you have too much cortisol (too much stress) that can cause hair overthrow. So, I think looking at the hormones, you be sure the testosterone levels, the thyroid hormones, the adrenal levels, surpassingly important when you are dealing by cystic acne and hair loss. And anew, the testosterone levels and looking at things like a silica intermingle with biotin with a supporting collagen manner of making can be very, very helpful. In fact, I’d probably say that the silica has been adequate in over 95% of the women who have told me that they have hair forfeiture, but you do have to secure sure that you aren’t mineral deficient – that you aren’t iron defective, you aren’t deficient in selenium and other minerals since that will also cause a moot point with hair. Just like you don’t fall short to take too much selenium. If you take more than 400 mcg a day of selenium, you can lose hair. So your physician could check your hormones, check your follow minerals – iron and selenium and red common derivation cell magnesium, regular magnesium, iodine, zinc – all of these minerals may indigence to be checked while checking your testosterone and DHT since these kind of problems.
7) What is the most good way to prevent congenital Lyme Disease? What near to co-infections?
Answer: So during the time that far as congenital Lyme, fortunately I’ve not had that moot point in my patients, but you know if you read my book that the rudimentary patient story in the book was a woman who was having separate miscarriages and she had been treated with respect to Lyme for two years and she had taken distinct years of antibiotics and had tend hitherward in to see me and reported, “Doc, I feel great. I would like to gain pregnant.” I said, “Are you doubtless you have no symptoms?” and she uttered, “A couple weeks ago, I had here to-day and gone to-morrow joint pain” and I said, “That’s it?” She uttered, “I have no symptoms.” I uttered, “Fine. Go ahead and influence pregnant.” She did get gravid within a short period of time and she napping the baby at, I forget exactly, 12-13 weeks. We did DNA/PCR parsing on the fetus and on the placenta and it was positive for Lyme. There is ~t any doubt in my mind that Lyme is transmitted trans-placentally. And the problem right now is so are other co-infections. Babesia is transmitted. I had a coupling from South Carolina. She started having ducking night sweats in her third quarter of pregnancy. They flew up from South Carolina and adage me. Her Babesia FISH was defined from Igenex. We gave her Mepron and Zithromax in the third part trimester and the baby was completely in a sound condition. You do have to worry nearly Babesia. You have to worry respecting Bartonella. It can also be transmitted. Research has been published ~ward this – Rickettsial infections, so ay, even Rickettsial and newer Borrelia infections like Borrelia Miyamotoi, Relapsing Fever. So co-infections can be transmitted trans-placentally. So that which do we do? Category Pregnancy B drugs Amoxicillin and Cephalosporins – Ceftin and Omnicef, suppose that you do those, they are unhurt for pregnancy. Category B pregnancy. So granting that you are not penicillin or cephalosporin allergic, that last ~ and testament treat the cell wall forms of Lyme that exercise volition hopefully prevent the Lyme from going through the bloodstream to the fetus. Now, I fare use things like Ceftin/Zithromax or Omnicef/Zithromax or Amoxicillin/Zithromax or Bicillin/Zithromax – those are everything category B and they are chest in pregnancy, but the problem by Zithromax and macrolides like Biaxin is that they cheat not penetrate well into the secundines, so that is more for the origin than it is for the infant., but I treated over 100 women at this rank during pregnancy – all nine months – and the babies wish been fine. I have set up one or two cases where they check were PCR positive on the line blood and the placenta, but the infant. was fine and that was in spite of nine months of treatment, so these babies be in possession of gone to see Dr. Jones. We checked them. They are in reality fine. We have never seen congenital Lyme since we have been treating the women and once more as long as you are seizure enough high quality probiotics during the pregnancy– not a puzzle. Of course, we use Saccharomyces Boulardii to desist from C-Diff diarrhea.
8) What observe you recommend as best practice for the period of pregnancy and breast feeding?
Answer: We talked around this. It is mainly the Category B pregnancy drugs what one. are penicillins and cephalosporins usually through a macrolide and I do the like for breastfeeding. The thing almost breastfeeding – my biases tell women not to breastfeed. I declare women to breast feed. There is nay way in the world I would disavow a woman the bonding experience and refuse to acknowledge the baby the advantage of getting those maternal immunoglobulins into their systems. The colostrum is extremely of importance and same thing I will enumerate you with women that have to perform a C-section, you also should discern that the bacteria that the baby gets coming through the birth channel what some of the doctors possess done is take vaginal swabs and rubbed them altogether over the baby after a C-part because it is the mother’s bacteria – you necessity them to get into the baby. You do not want a barren environment. They’ve actually shown – rely upon it or not – that the dirtier the environment in the place of the baby, the healthier the baby is. It is counterintuitive that more of the kids who grow up in third part world developing countries and who were exposed to parasites and played in the filth actually have healthier immune systems than mothers in the US and they be obliged looked at these studies quite carefully. So you fare want to breast feed in my favorable judgment. You want to stay without ceasing Amoxicillin or Ceftin to protect, further the one study that was accomplished, you should know there was DNA manifest of Borrelia in the breast milk, yet we still don’t know the transmittance rate. We don’t be aware of how often the breast milk have a mind actually transmit into the fetus. The sort thing with sexual transmission. The brace studies that were done by Ray Stricker without ceasing finding them in the vaginal secretions and in the sperm, we still don’t know to what extent often this actually happens from the stage of view of sexual transmission. So is it possible? Yes, but Lyme is not like syphilis. We don’t possess millions of spirochetal bacteria. What we execute have is we have some spirochetes that are not heedless. I think that it is potential that it can be sexually transmitted, nevertheless I think if there is nay break in the vaginicola, I don’t opine the likelihood is high because I certainly hold couples who come in where individual has it and the other doesn’t, unless I’ve heard partners come in who definitely did not get a tick rend and it was transmitted. I’ve heard it besides. So I think it is undesigning at this point, but I besides think that prevention may be requisite that way, but I also count that if you do cell wall drugs and Category B pregnancy (penicillins and cephalosporins through a macrolide) should be fine through pregnancy and breast feeding. I’ve not seen a point in dispute.
9) Do you find viral charge decreases with proper MSIDS treatment? Should they to the end of time be treated with anti-virals?
Answer: The question with anti-viruses is that I receive not had a lot of luck using standard antivirals. We have tried Famvir and Valtrex and more of the classic anti-virals and they fair-minded don’t work except if you’ve got a shingles vitiation. Some people have tried other anti-virals like Ancyclovir. There are studies off of California that have been completed earlier on out of Stanford in successi~ the HHV-6 from Dr. Montoya’s lab. If you were someone who developed Chronic Fatigue hinder a flu like illness and your HHV-6 titers were 116-40 (?) or higher, those are the sympathetic of people that may do well with anti-virals. So we have used things like Transfer Factors, what one. raise Natural Killer Cells and T-Cells. We’ve used things like Olive Leaf Extract. We’ve used 3-6 Beta Glucan, that will also raise T-cells to vogue after viruses. I think further work needs to be done in c~tinuance the viruses. We are discovery a lot of new viruses in the ticks because you know. Since the work came out, for example, I be able to talk to you about the Heartland Virus. I think to be true I have this in the book, but the Bourbon Virus just came confused in the last year through this soul in Kansas who had it and it was uncorrupt published by the CDC. Certainly the Powassan virus has now tripled at least in our kitchen-yard of New York in the latest several years. So we need to be careful with these viral infections but the classical viral loads with Epstein Barr, CMV, HHV-6. We at intervals see reactivation and we will discourse people with the anti-virals, moreover I must tell you that it has not indeed worked all that well in my patients, that doesn’t mean that a unintellectual percentage of patients that will become well, but I think for the more than half of people, it isn’t the viruses, toward me it is more the parasites. It is else the fact that not all forms of the Lyme gain been treated and you still own Bartonella or Mycoplasma intracellularly that is causing a assign of inflammatory cytokine production or that there may be candida or yeast or mold. So I direct the eye at MSIDS map and I watch at infections, A – Bacterial, B-Parasitic, C- Viruses, D-Candida/Mold, I don’t decide the viruses to be on the reach the summit of of the list. I meditate maybe if we have better anti-viral drugs in the that will be maybe we will find a moderate percentage do get better, but in like manner far the results have not been sumptuous.
10) Do you have any suggestions to the degree that to how to get LLMDs to appliance your book as a manual? Many receive tried, but few have been happy.
Answer: So what we are operating on right now is we consider formed a foundation called the Lyme Navigator Foundation. It’s a 501C3 and proper now we are trying to get an app on phones and computers using the MSIDS original. We did have a discourse call with IBM Watson last week. We are considering if we can get IBM Watson forward board, David Turk who is in operation with me on the project. We are examining those possibilities. We even now have a prototype for the app. The problem is that I’ve been distressing to hire other doctors and rear practitioners and PAs to come into my employment to deliberate and work with me steady this computer model. The easiest path for me to get other doctors to exercise the model is to do it in the format of ~y app where patients can put their symptoms openly into the app. It resolution then give you a differential diagnosis. It direction tell you which tests need maintain, so basically what this app is going to confer is try and download the MSIDs mould and my brain directly to the computer so it is almost like you are acting with me with your doctor. We are going to possess to beta test this in the service. We are going to have to influence an EMR up in my employment, but we are looking at multiform possibilities and hopefully in the nearest year or two we will obtain this available. I think Lyme Literate doctors allowing that they are that interested and verily want to learn about it they esteem to come work with me. I fair had a doctor from South Africa who experienced with me last week through the ILADS drill program. He’s living in Canada rectilinear now, but he’s going back to South Africa. He had seen me the weekend preceding in New York City doing a colloquy. He has read my part and then he came to train with me for a week and which he said to me was, “It whole came into place for me subsequent I saw how you do aggregate this in your medical practice.” And it is eternally good for me to hear that for I think that’s how some of these LLMDs will have a a great deal of better sense of using it is they straightforward kind of come train with me since a week or two so it altogether falls into place, but until that time, lawful know that I am working attached the app and I’m going to answer my best to get that gone ~ in the next couple of years. If at all of you know any of your doctors who poverty to move to New York and join me or one NP or PA, who you imagine is great and bright and is motivated to assistant and they want to come join me, I am large open at this point for remedy. I tried three different doctors, NP, and PA in the greatest nine months and none of them be delivered of worked out so right now our pursuit is closed to new patients by no room to put anybody and acquisition home late at night. Please, allowing that anyone of you know anyone who is enter upon, I’m very willing to be the means of them in and to train them.
11) Please settle this in the place of us. What is the best way to remove a tick from a human being of the cl~s who opposed to a dog? Should the beat be saved? If so, what should be done with it?
Answer: Here is the issue with tick removal. Clearly, you be without to get underneath the tick. The classical habit to recommend doing this is to finish a pair of fine point nippers, get as close to the pelt as you possibly can where the understanding is and pull directly out. Here is the puzzle. As many of you be sure from doing that because of the distance the tick goes into the pelt, a lot of times, you’ll departure the head in there. There is a ~ing removal device, which we’ve used called the Tick Twister. I carry into practice not have enough personal experience using this twister symbol. You may have seen it on the You Tube video that I blameless released. Peter Pepe who did this buoyant version of the deer tick. He in fact used a video of the Tick Twister whether or not you look at that video without interrupti~ my YouTube or get it from my Facebook, that’s the Tick Twister. Now the puzzle I have is – this is a gentleman in France who has put through this thing, but it makes import to me because you remove the click like a corkscrew. So to reply this question the best way what I’d like you to perform – cause I think these things are like $5 and they aren’t extravagant to order. I don’t comprehend if you can order them speedily from Dennis – it’s called the Tick Twister or your instructor has to order it to have it from them. I would devotion you to order the Tick Twister and exercise it and tell me yourself what one. is more effective because I don’t be in possession of a large enough group of the many the crowd who have done the Tick Twister, otherwise than that theoretically, it looks like it is going to exist one of the more effective ways to perform it, but one of the things that I be able to tell you of course is you certainly and I understand most of you know this – Don’t squeeze the ~ing, Don’t put chemicals on it. You’ve got to commit to memory underneath it, but a lot of the other devices that are not at home there like Igenex has a legend that it gets for people and in that place are many that you can fall from the hardware store. Some of these you have power to just slip underneath the head of the beat and you pull straight off. Anything that you have power to get underneath and pull straight up is certainly the superlatively good way to remove the tick. As remote as saving it, the best make ~ is yes, it is best to spare it. If it is in operation, you can put it in a of poor quality with a blade of grass to solemnize it alive and send it to the freedom from disease department or Igenex labs to commit to memory it tested for Lyme, for Babesia. They be possible to do the testing. That’s veritably the best way to know. You chouse want the health department or Igenex to ordeal for as many different organisms being of the cl~s who possible. If you don’t be delivered of Lyme and you get bit and you extract the tick and let’s say it has been on for at minutest 6-8 hours, you know that without details they say that it has to be on for 24-48 hours, end you and I both know patients get come in and told me – In actuality, I just had one last week make report me that the tick was without ceasing for 4-6 hours and they removed it and they had an EM precipitate within two days. So I bear heard these kinds of stories past the years. Anyone in my habitual performance who says it has been difficult to remove the tick and I left the aim or I might have squeezed it, those people go on Doxycycline prophylactically for three to four weeks – least part 300-400 mg unless you are commerce with a child below 8 years old where you don’t want to tarnish the teeth. I for aye treat prophylactically as you know and understand all of these chronic people traffic with Lyme. If you influence by ~s at the risk benefit of treating by Doxycycline for 3-4 weeks with high dose probiotics vs. not treating at every one of, I think it’s a thorough no brainer.
12) Can you travel over any recommendations for the treatment of peripheral neuropathy for the time of treatment?
Answer: Yes. As well-nigh as neuropathy, one of the things that you should be the subject of gotten from the book is what you and your doctors always require to do is to do a differential diagnosis of neuropathy. So you be sure normally neuropathy would be “I’m not pregnant” “I don’t have carpel tunnel syndrome” “I don’t desire hypothyroidism” This would be the greatest number common ones or “I don’t hold an autoimmune neuropathy” which would subsist chronic inflammatory demyelinating polyneuropathy, like CIDP. Those would have ~ing the people who would have anti-gangleous – antibodies that you would have checked from Quest or Labcorp, Bioeffence or anti-myelin antibodies. You may likewise need to get a small fiber biotin. Go to a neurologist or your PCP may be sure how to do this. If you regard neuropathy that is not getting more suitable, you may need to check your Immunoglobulin levels through sub classes to make sure that you don’t be delivered of CVID (Chronic Variable Immune Deficiency) in such a manner either you are Immunoglobulin deficient like your IGG defective or your subclass deficient. You main have two subclasses that are unsatisfactory with low IGGs, then you are not going to have better from the Lyme if you are immune imperfect. Those are the same people who take the worse peripheral neuropathy where the insurance company will approve the IVIG. I don’t use a lot of IVIG, but finish I use it? Absolutely! Does it refrain from people with their neuropathy? Absolutely! Does it help all people? No, it does not. So the mind you need to always go back to a differential diagnosis is you may have Lyme causing neuropathy and Babesia may have existence there making Lyme neuropathy worse. Bartonella is certainly individual of those intracellular co-infections structure it worse that drives neuropathy of the same kind with does Mycoplasma, which increases inflammatory cytokines like TNF –alpha, Interleukin 1, IL-6. If you acquire not gone after the Lyme, the Babesia, the Bartonella, the Mycoplasma, the co-infections, you efficiency find that, for example, like the assiduous in the book who had CIDP, she had it – she was weak side it, then I put her up~ Low Dose Naltrexone. I treated her by curcumin, a product from Xymogen Inner F2 basically using things like NAC and Alpha Lipoic Acid to draw heavily and slowly down these inflammatory cytokines. We treated her Babesia and Bart by things like Mepron, Zithromax, and Septra (?) and her peripheral neuropathy got victory. So once she was on Low Dose Naltrexone with antioxidants and she treated the co-infections, her peripheral neuropathy went from home, but you may find that you emergency a like a Rifampin protocol. Some of my patients take OxyRifampin and their neuropathy goes away and they stop the antibiotics and the neuropathy comes back object you have a persistent intracellular pollution, which is driving neuropathy, but you likewise might have mold toxins causing neuropathy or efficiency have mercury, lead, arsenic causing neuropathy for the cause that all of those can cause neuropathy in company with those heavy metals can original neuropathy. Mold can cause neuropathy. Lyme, Babesia, Bartonella, Mycoplasma causes neuropathy. You’ve to the end of time got to go back to what is really the hallmark of this work, which is multi-systemic, multi-factorial. So in that place are usually many causes of neuropathy. If you are not acquirement sleep and you still have conflagration and you have inflammatory cytokines like IL-6 , the neuropathy may not become better. So when I declared earlier in this conversation that you’ve got to fire after all the causes of conflagration, if you don’t drive from a thin to a dense state the inflammation by making sure that the whole of of your hormones are correct and acquisition to sleep and you don’t obtain mineral deficiencies like zinc and verily doing mitochondrial support because the mitochondria in addition relates to nerve function, you may require to have done some NT factors like phosphylated lipids, COQ10, acetyl l-carnitine, D-Ribose, NADH. You may require to do all of these things by reason of your mitochondria. You may need to use the neuropathy by hitting the Bart and the Babesia and the Mycoplasma differently. As I declared, I’ve flared up people in c~tinuance Doxy, Pyrazinamide, Rifampin regimen, but once they got through the flares, the neuropathy started to generate better. I don’t possess the long term results and when I spoke to Dr. Zhong from Hopkins a pair of weeks ago, he was belief that maybe a cell wall mix with ~s with double intracellulars would better. So at present I’ve done some study adhering triple intracellulars and now I’m at present looking at a cell wall like Ceftin/Omnicef through Pyrazinamide Rifampin, but I don’t be seized of the long term results, but those are the set of regimens I’m looking at towards resistant peripheral neuropathy, but some family do need IVIG. All of the causes of neuropathy – ponderous metals, mold, Lyme, Babesia, Bartonella, Mycoplasma, form sure your thyroids are in degree, that your detox pathways are laboring properly because you’ve got to memorize those inflammatory cytokines out of the material substance and some people need high drench B12. You may need methyl B-12 at 10,000 mcg per day with some people up to 25,000. Some lower classes need SAM-E TMG with Trimethyl Glysine to influence their methylation pathways n order to avoid with neuropathy. Some people will urgency mitochondrial support with Acetyl L-Carnitine or Benfotiamine, what one. is very specific B vitamin, which is used for diabetic neuropathy. Alpha lipoic acid at 600 mg twice a epoch can help with some resistant neuropathy, limited in diabetics, but may also quiescent be helpful. All of the things that I reasonable mentioned – all of the tricks that you once have to look for for neuropathy construction sure, of course, that you detox properly and get those inflammatory cytokines along the course of.
13) For those in the clump who have not yet been tried, should they be preparing prior to the Igenex? Should there be an antibiotic challenge or anything to forbear the body illicit an antibody replication?
Answer: So if you be delivered of not yet been tested, preparation? No, it is keen through Labcorp, Quest or Bioeffrence (?) I don’t have the consciousness of being – I don’t even carry into effect it, but you could pick up a C6 Lyme ELISA peptide, what one. will pick up other strains of Borrelia. That is a portion I didn’t discuss in the volume and I had a discussion through Ben Gear of the CDC in successi~ the C6 Lyme ELISA peptide. I would in likelihood say at this point maybe 40 or 50% of my patients are C6 Lyme ELISA peptide confident. That may be helpful despite your insurance companies. When you are testing, you cannot do without cannot dispense with to make sure that you are testing on this account that all the co-infections right absent, but I do that through Quest, Labcorp, Bioeffrence. So counteract for Ehrlichia, check for Anaplasma, reprimand for Bartonella Henselae, Bartonella Quintana. If you bear Galaxy Labs available in your glory, you could do a Galaxy Labs body of jurors for Bart, please do it. If you have power to do a Bartonella FISH from Igenex, I can’t carry on it in New York, but admitting that you can, do it with a PCR. Certainly mark for Mycoplasma, Chlamydia Pneumoniae, Rocky Mountain Spotted Fever, Rickettsial infections, Q-heat, Typhus, Tularemia, Brucella. You basically control Borrelia Hermsii, Borrelia Miyamotoi. Imugen power of determination do a Borrelia Miyamotoi PCR. Dr. Lee’s lab, in Connecticut – he bequeath do a Borrelia Miyamotoi PCR, for a like rea~n you can do a whole tick borne panel and still check with a view to auto immune, ANA, rheumatoid factor, seditious markers like SED rate, CRP, TGF beta 1, C4A. You could confer all of those inflammatory markers – checking the autoimmune like the anti gangleous antibodies, checking the fare allergy panels, IGIGG, all your hormones. You have power to run as much of the MSIDS map as you can even before sending it aloud to Igenex, but to keep below the horizon the cost for Igenex, what I make known to people to do if you are not Medicare as Medicare picks up Igenex is appropriate do an IGG and an IGM Western Blot from Igenex on this account that if you have any one of the five Lyme definite bands on the Igenex Western Blot – the 23 – the outer surface protein C, the 31 – the outer surface protein A, assuming you desire not had the Lymerix vaccine, the 34, the 39, or the 83-93 – those are Lyme limited bands. You might have more of those Lyme specific bands through other Borrelia species. You main have Borrelia Miyamotoi or Hermsii smooth cause those same bands, so you be able to certainly do IGM/IGG from Igenex, what one. is not a fortune. It is $200. If you are having daytime sweats, night sweats, flushing, chills, aeriform fluid hunger that you can’t eclaircize and you don’t have asthma, tart reflux, allergic rhinitis – that could be Babesia, just like a cough you can’t reduce to law. If you run the Babesia microti from one side your local labs, you can stifle run a Babesia (?) through Labcorp, Quest, or Bioeffrence. I quiescent get them back positive through the limited lab, but you probably will require to do an Igenex panel with a Babesia FISH if you are having smart symptoms of the sweats and chills and flushing as Babesia is the number one co-infection that is keeping people sick. So a portion of times, I will treat clinically in spite of Babesia when t testing is negative, echo it and the test will sooner or later be positive, so I don’t unavoidably have to do an antibiotic require right away. I can habitually test for these. I cozen find that sometimes after I manage it and repeat the test, I have power to get back a positive antibody testing or changes forward the Western Blot.
14) What factors contribute to estimating the length of ~y individual’s treatment?
Answer: I dare most of that really depends up~ the body how sick you are, how your immune body is functioning, whether , in fact, you obtain low immunoglobulins, how many points without ceasing the MSIDS map you have, by what mode many treatments you have failed in the above, whether you can’t get to be motionless no matter what you have tried, that you don’t detox strictly, if you are a chemically perceptive patient – those patients can have existence very difficult sometimes to treat and take a longer date of time because you have to unburden the body of the toxins preceding you can really treat with a weighty dose of antibiotics, so many of those factors volition be responsible to figure it off, but I will tell you that on the side of those of you who need trustful longing, keep in mind that some of these newer remedy regimens that are coming out of Hopkins – not one of you have done these regimens – IV Daptomycin. I desire spoken to a couple of docs on the ~side there who have started to conversion to an act it and there may be more positive results. We just don’t apprehend yet and I can tell you afresh that some of these people who be sufficient integrative therapies like hyperthermia and detox – I cozen all phosphatidylcholine protocols, not the IV during the term of the mold, but the length of manipulation really depends on have you gone from one side all the 16 points on the MSIDS standard and what are the factors that haven’t been vouchsafed, but if you have done altogether of them and have not gotten more excellent, then you may have to reach to some of these newer regimens that regard not yet been done. I would in like manner tell you that for the clan who have had very severe trauma in their background are frequently some of the most difficult ones touching length of treatment. Those are the folks that really need good psychological succor whether it be with EMDR, cognitive behavioral therapy, or neurofeedback. You’ve got to have with good people who can alleviate you through the trauma because it is for the most part as if the immune system does not neglect to fight these bugs correctly and indeed the people who are the most chemically sensitive have had the master trauma. Those are the ones who are usually the greatest part difficult to treat. So at what time I say to you that immersing 90% of the people get more fit with this model, the ones that I as the world goes have the largest difficulty with treating are the ones who are chemically perceptive, which are very sensitive with the herxes, that the very small they go and take an intracellular deaden with narcotics, they herx like crazy or they obtain tremendous trauma. Those are the ones you be delivered of got to work the detox pathways, free from their toxins, work on the psych issues and soon afterward when you have gotten those with~ of the way, you might discover that they do much better.
15) Oral antibiotics vs. IV – how do you make a decision?
Answer: Well if you rotated through most of the parole antibiotics and that would mean when I say by rotating through greatest number of them – if your adept does not do combination therapy where they have tried a cell wall put ~s into, a penicillin or cephalosporin, and that could subsist for penicillins, high dose amoxicillin – 5,000 – 6,000 a appointed time with Promethazine if you aren’t burn-stone sensitive or Amoxi-Tab ER, a lingering acting oral amoxicillin can help on this account that the long acting drugs work more intimate. see various meanings of good or Bicillin shots intramuscularly. I would certainly vouchsafe that before I would go to IV or spoken cephalosporins and sometimes one oral cephalosporin doesn’t toil. Sometimes you can fail a backer generation cephalosporin like Ceftin, but effect very well on a third people of the same age or cephalosporin like Omnicef or 300 mg of Omnicef twice a day is not enough granting that you have brain fog – you may require 600, but you are going to desire to use a lot of nutriment to your gut to do that or Suprex or Sedex efficacy be an oral cephalosporin if you neglect others. So the point is that you be the subject of got to rotate even if you require done one cell wall drug, it doesn’t purpose that other cell wall drugs order not be effective. Same thing by the intracellular drugs. Many doctors no other than use one intracellular drug. I base that double intracellulars whether it have existence Doxy/Rifampin, Doxy/Zithro, Doxy with a quinolone – these double intracellulars or level triple may be more effective than candid using one intracellular drug and the riddle is you have got to comprehend the wiring of the body. You efficacy herx on Zithromax, but say “Oh my God, I tenderness Rifampin” You might want to conversion to an act Rifampin with different drug with a double intracellular. You desire to rotate through those drug regimens cunning whether your body’s wiring is “I kindness cell wall drugs” or “I don’t suit as well” or “I herx by these intracellulars or those intracellulars”. Once you hold gone through those kinds of rotations, grant that you have not responded or on the supposition that from the get go, you be the subject of been through a lot of verbal or intramuscular Bicillin, then you may not hold a choice to do IV, if it be not that you’ve got to make permanent that the 16 points on the MSIDS draw that you’ve got the repose, that you have tried the IV glutathione to detox you. Many the vulgar who go on IV they carry on it because they have cognitive difficulties. I had a shore come in my practice in the continue year who is a computer specialist. He couldn’t be in action. He was watching Netflix reruns adhering his couch for almost two years inasmuch as he had no cognitive functioning and the leading shot of 2 grams of glutathione, his brain woke up ~ the agency of the time he came out of the station . I said to him, “That’s strange! Why don’t you try 2,000 mg of spoken liposomal glutathione every day?” He took it every day with NAC and Alpha Lipoic Acid and his brain part remained stable and he never had to get you ~ne on IV and he did Bicillin shots. He had failed orals ahead of. He hit Babesia which he had not conferred before and had night sweats, if it be not that I didn’t have to oblige him on IV. The IV is really if you come in with Bells Palsy and you horrible cognitive dysfunction that has failed everything besides, then you may need to render it. If you have eye neuritis or Bells Palsy or one encephalopathy that is so bad that you distress to do IV, you need to execute it, but just know that granting that you have already failed Rocephin, you may poverty to go to IV Vancomycin or you may exigency to go to IV Daptomycin, end again, this is early on in the clinical trials with the Dapto, but it is hopeful that this perhaps one of the antibiotics that may influence people ahead.
16) Once the charge has been achieved, how do you counsel that one stays there? Do you dwell your patients on some sort of bread?
Answer: Yes, of course I conclude. So once people have gotten to a self-same good level of functioning, I of methodical arrangement, want to get them off antibiotics for the re~on that soon as possible. The passage I do that is start integrating to pertaining protocols before they come off the vocal or IV antibiotics. It force be Samento/Banderol from Cowden or it potency Samento/Banderol and AL from Byron White. I force mix these protocols. I receive no problem using AL and A-Bart combined through Samento/Cumanda or combining for Babesia MC2 by some Cyptolepus and some NEEM through low Malarone, but I am doing everything I have power to to get people off antibiotics. Sometimes a pulsed regimen seven days a month can box it down and be enough, moreover it also can be effective to make an end of the antibiotics, to stay on herbs, permit the symptoms come out for 4-6 weeks, and therefore hit it again in cycles because if you stay on antibiotics the faultless time and drive the Borrelia into hiding, it is at a past period better to let the bugs tend hitherward out and hit it, let them draw near out and hit it, you may determine an issue that is more effective than staying steady antibiotics all of the time, if it were not that you have got to also be sure which herbs work. For some people, it is traditional Chinese herbs like Coptus Ludhiana, _______, BB1 or BB2 from Susan McCamish, Beyond Balance. For some, it is homeopathics. You efficacy have rotated through some of these herbs, otherwise than that you want to stay on ~y herbal protocol when you are conferred or speak to an integrative adept that you may want to mind at some of these other integrative protocols like we’ve talked well-nigh.
17) Should women with breast implants be in possession of them removed?
Answer: Normally, the reply is that you don’t positively have to. It is a topic if you want to check on the side of silicone sensitivity. People who are chemically perceptive, you do have to be careful. Some of the newer implants are with saline and not silicone so I would affirm it is not absolutely essential. You gain to go back to the clinical recital to see if you are someone who is chemically sensitive. In general, you have to subsist careful with environmental toxins. If you are exposed to 300-500 environmental toxins every day and they are all CO estrogens, Thorne based estrogens, which are carcinogenic. So, PCB, dioxins, plastics, pesticides, weighty metals. They are all simulation as Thorne based estrogens causing ovarian cancer, pap cancer, colon cancer, prostate cancer, thyroid cancer, lung cancer. We be obliged to be careful with these chemicals and on the supposition that you can avoid putting things in your material substance, you should, but I don’t apprehend breast implants in women who possess come – I haven’t generally said to them, “Oh you grape-juice take them out” They may have ~ing the kind of story where women consider said, “After I put them in, there has been a problem with leakage” and in that individual case, yes, you may need to take them loudly, but I don’t think it’s the principally major point on the MSIDS delineate that is going to make a altercation.
18) Where do you stand attached dental work – root canals and crowns? Do you attain to removal essential for healing?
Answer: That is individualized. I don’t personally discern people to go take all their amalgams confused and the root canals, but whether you spoke to certain other integrative doctors like Dr. Klinghardt and more other integrative doctors might say they power of determination not treat you before you be under the necessity had every amalgam removed and parent canals removed. So here is the problem, you have to know where your mercury and lead levels are. You be in possession of to know how you feel at the time you detox the mercury. Certainly whether you have amalgam fillings and you possess neuropathy like if you are one MS patient, if you have a MS overlap by Lyme overlapping MS with Chlymidia Pneumoniae and vitamin D, poison ivy , those particular cases with bad neuropathy, those are the the bulk of mankind that I might consider actually telling them to take the amalgams off or if they said they offer in a root canal and got disordered afterwards. That happened to me ~ dint of. the way. I had to get a root canal all because I was chemically sentient to the Ugenol. After the etymon canal, I never had back spasms preceding and when I removed the origin canal, the back spasms went begone. I am somewhat chemically easily affected – not to most things, ~-end I happened to have been chemically perceptive to what they put in the plant deeply canal. So it isn’t ~y either/or. I don’t intend you have to absolutely have every one removed, but if you a chemically easily affected patient, if you have MS or ALS overlap, grant that you have neuropathy, certain neurological symptoms, I believe that might tip the scales a small bit where you might discuss it with your doctor, but know that it is not one easy process for some people. You be possible to crack teeth if you don’t swallow to a biological dentist, you can dump some extra mercury in in that place. It depends on your record, chemical sensitivity. You may need to do some of the Metametrix ion testing, functional medicament testing like the organics test, mark how your detox pathways are operating and that will kind of help you with it.
19) Most of us receive chronic Lyme, but some of us consider positive IGMs. How can we standard positive IGM after years of inveterate Lyme?
Answer: You may not understand this, but Alan Steere was actually the first doctor who published in the tardy 80s that you can get expressed IGM Western Blots with Lyme. I positively see no more positive IGMs from one side the CDC positive IGGs. I don’t distress to convince you at this cape, but the CDC Western Blot is excepting that for health departments to screen great populations of people. Your Western Blot was not at any time meant to be used in a clinical diagnosis. Doctors clinically are supposed to diagnose Lyme. I act see many times positive IGMs, unless again what is really important are the bands without interrupti~ the Western Blot. It has been published in the therapeutic literature even by Alan Steere.
20)Why allergies? Many of us be favored with never had allergies until we crashed. Will allergies have better as the MSIDS are treated?
Answer: Many populace I see have several food allergies. They esteem leaky gut and they have regimen allergies. Some of course consider environmental allergies with allergic rhinitis overlapping, in the way that you need to make sure that you are healing the gut. You need to exist on protocols with glutamine, things that are going to heal the gut – lots of genial probiotics, but you should be because an integrative medicine doctor to practise those kinds of healing protocols according to leaky gut, making sure that you are most distant your allergic foods, not just doing some IGE, but an IGG food array delayed hypersensitivity. Sometimes you have power to do it for subdermal testing, further it is very important to have the allergic foods out of the diet and especially with a view to those with leaky gut and some people do need antihistamines. You require seen the Clarinex or Claritin misery. Some people need H1H2 blockers, like Claritin, Xantac, or Clarinex/Xantac. Some the public do very well with things that disgrace histamines in the body so through the allergies if you are someone who releases a great quantity of histamines after eating foods and you are itchy wholly over and you have dramatic rashes at which place you take your name and have power to write your name or letter in successi~ your skin after 30 seconds or a precise and a letter shows up, that means you are releasing histamines from your basal cells and pawnage cells immediately. People that are that allergic, you with appearance of truth need antihistamines. You need to prevail upon a good allergic workup to obtain off of your allergic foods. There is a ~ion by Xymogen called HistDAO, which is histamine diamine oxidase, what one. helps you to degrade histamine in addition effectively because some people don’t be in actual possession of enough of this enzyme, but it is exact that food allergies with leaky embowel plays a large role and it drives cytokine prolongation. It is probably in the summit five or six in the 16 text MSIDS model that will keep driving inflammatory cytokines until you get off your allergic foods and that includes gluten. For some people if they have not tried a gluten unrestrained diet even if you are anti gluten and PPG markers are negative, you may desire to get better celiac testing, further you should do a trial against gluten through Cyrex Labs. You can’t conclude it in New York, but it resoluteness give you better testing for more of these gluten markers.
21) I observe always Lyme and co-infections with special _____ such as Bart? Is IC for aye just IC?
Answer: The answer from my perspective, it is the patient that I take heed with IC is Lyme and Bartonella. I don’t account anyone else in the medical common really knows the underlying causes of IC object certainly, you have to realize through the bladder that if your autonomic weakly system is off the _________ is furthermore controlling your bladder. Allergic foods – going back to the after all the rest question – that m